THE FISCAL YEAR 2013 BUDGET FOR 

VETERANS’ PROGRAMS 

HEARING 

BEFORE THE

COMMITTEE ON VETERANS’ AFFAIRS 

UNITED STATES SENATE 

ONE HUNDRED TWELFTH CONGRESS 

SECOND SESSION 

( 

FEBRUARY 29, 2012 

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THE FISCAL YEAR 2013 BUDGET FOR 

VETERANS’ PROGRAMS 

HEARING 

BEFORE THE

COMMITTEE ON VETERANS’ AFFAIRS 

UNITED STATES SENATE 

ONE HUNDRED TWELFTH CONGRESS 

SECOND SESSION 

FEBRUARY 29, 2012 

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 

PATTY MURRAY, Washington, Chairman 

JOHN D. ROCKEFELLER IV, West Virginia 

DANIEL K. AKAKA, Hawaii 

BERNARD SANDERS, (I) Vermont 

SHERROD BROWN, Ohio 

JIM WEBB, Virginia 

JON TESTER, Montana 

MARK BEGICH, Alaska 

RICHARD BURR, North Carolina, Ranking 

Member 

JOHNNY ISAKSON, Georgia 

ROGER F. WICKER, Mississippi 

MIKE JOHANNS, Nebraska 

SCOTT P. BROWN, Massachusetts 

JERRY MORAN, Kansas 

JOHN BOOZMAN, Arkansas 

KIM LIPSKY, Staff Director 

LUPE WISSEL, Republican Staff Director 

(III) 

C O N T E N T S 

FEBRUARY 29, 2012 

SENATORS 

Page 

Murray, Hon. Patty, Chairman, U.S. Senator from Washington ........................ 1 

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

Akaka, Hon. Daniel K., U.S. Senator from Hawaii .............................................. 6 

Johanns, Hon. Mike, U.S. Senator from Nebraska ............................................... 7 

Brown, Hon. Sherrod, U.S. Senator from Ohio ..................................................... 8 

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

Brown, Hon. Scott P., U.S. Senator from Massachusetts ..................................... 10 

Boozman, Hon. John, U.S. Senator from Arkansas .............................................. 11 

Tester, Hon. Jon, U.S. Senator from Montana ...................................................... 115 

Moran, Hon. Jerry., U.S. Senator from Kansas .................................................... 118 

Begich, Hon. Mark, U.S. Senator from Alaska ..................................................... 121 

WITNESSES 

Shinseki, Hon. Eric K., Secretary 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; Hon. Roger W. Baker, Assistant Secretary for Information and Technology; and W. Todd Grams, Executive in Charge for the 

Office of Management and Chief Financial Officer ........................................... 12 

Prepared statement .......................................................................................... 14 

Response to prehearing questions submitted by: 

Hon. Patty Murray ........................................................................................ 25 

Hon. Richard Burr ........................................................................................ 41 

Response to posthearing questions submitted by: 

Hon. Patty Murray ........................................................................................ 126 

Hon. Richard Burr ........................................................................................ 155 

Hon. Mark Begich ......................................................................................... 310 

Hon. Johnny Isakson .................................................................................... 312 

Hon. Roger F. Wicker ................................................................................... 316 

Hon. Scott P. Brown ..................................................................................... 320 

INDEPENDENT BUDGET REPRESENTATIVES

Schrier, William, Western Region National Vice Commander, The American 

Legion; accompanied by Tim Tetz, Director, National Legislative Commission ........................................................................................................................ 326 

Prepared statement .......................................................................................... 328 

Blake, Carl, National Legislative Director, Paralyzed Veterans of America ...... 336 

Prepared statement .......................................................................................... 337 

Hall, Jeffrey, Assistant National Legislative Director, Disabled American Veterans ...................................................................................................................... 341

Prepared statement .......................................................................................... 342 

Zumatto, Diane, National Legislative Director, AMVETS ................................... 349 

Prepared statement .......................................................................................... 350 

Kelley, Raymond, National Legislative Director, Veterans of Foreign Wars ..... 354 

Prepared statement .......................................................................................... 355 

Page

IV 

OTHER WITNESSES

Tarantino, Tom, Deputy Policy Director, Iraq and Afghanistan Veterans of 

America ................................................................................................................. 359 

Prepared statement .......................................................................................... 360 

(1) 

THE FISCAL YEAR 2013 BUDGET FOR 

VETERANS’ PROGRAMS 

WEDNESDAY, FEBRUARY 29, 2012 

U.S. SENATE, 

COMMITTEE ON VETERANS’ AFFAIRS, 

Washington, DC. 

The Committee met, pursuant to notice, at 10 a.m., in room 418, 

Russell Senate Office Building, Hon. Patty Murray, Chairman of 

the Committee, presiding. 

Present: Senators Murray, Akaka, Brown of Ohio, Tester, Begich, 

Burr, Isakson, Johanns, Brown of Massachusetts, Moran, and 

Boozman. 

STATEMENT OF HON. PATTY MURRAY, CHAIRMAN, 

U.S. SENATOR FROM WASHINGTON 

Chairman MURRAY. Good morning and welcome to this morning’s 

hearing on the Fiscal Year 2013 Budgets and the Fiscal Year 2014 

Advanced Appropriations Request for the Department of Veterans 

Affairs. 

I want to welcome all of our panelists today. I really appreciate 

you coming and helping us work our way through these critical 

issues for our veterans. 

You know, as I do most weeks when I am home, last week I convened a roundtable discussion with veterans from across my homestate of Washington. I heard from the very men and women whose 

lives this budget is actually going to touch. 

While some of the veterans, as always, praised the care and access they were receiving from the VA, many of them did lay out 

concerns that must be addressed in this budget and in future 

budgets. 

I heard from veterans who still face unacceptably long wait times 

for mental health care, are still not getting the type of mental 

health care that they need in their own community. I heard from 

women veterans who are struggling to receive specialized care, and 

I heard from veterans who are just really fed up with the dysfunction of the claims system. 

I also heard from veterans who still find themselves confronted 

by obstacles to employment and who told me they are even afraid 

to write the word ‘‘veteran’’ on their job application because of the 

stigma that they believe employers today attached to that. 

Last year’s passage of the VOW Hire Heroes Act was a great 

first step in tackling these problems and the high rate of veteran 

unemployment, but there is a lot of work left to be done. 

2 

As I am sure Secretary Shinseki will talk about, now is the time 

to take advantage of the public-private partnerships and the sea of 

goodwill that exists in corporate America toward our veterans 

today, but doing so will also require beating back misinformation 

about the invisible wounds of war. 

I am pleased that the Administration has shown real leadership 

in engaging private partners in this area, and I will continue to 

highlight the tremendous skills, leadership ability, and discipline 

that our veterans bring to the table. 

I also look forward to learning more today about VA’s involvement with the President’s proposed Veterans’ Job Corps. Any way 

that we can get our veterans both employed and more involved in 

bettering our communities is a program worthy of investment. 

As everyone on this Committee knows: with the end of the war 

in Iraq and the coming withdrawal of troops from Afghanistan, the 

budget challenges will only continue for the VA. 

Last year this Committee held a hearing to explore the long-term 

costs of war, and what is 100 percent clear is that we have an obligation that will continue long after the fighting is over. 

As we review this budget, fulfilling our Nation’s obligation to our 

veterans not only today but throughout the course of their lives 

must be our most pressing consideration. 

Now, let me tell you that as a longtime Member of the Senate 

Budget Committee and as someone who has seen just how difficult 

this year’s budget is for many other agencies, when this budget arrived on my desk I was very encouraged. 

Given the current fiscal environment, the VA has done a good job 

putting together a budget that reflects a very real commitment to 

provide veterans with the care and benefits they have earned. So, 

thank you, Secretary Shinseki, for your efforts in doing that. 

I also want to applaud VA’s ongoing commitment to end homelessness. This is an area where you are making real strides, and 

I am encouraged to see that the Administration has again requested an increase in funding for homeless programs. 

I am hopeful we will continue to see a significant effort to reduce 

the number of homeless veterans and prevent those who are at risk 

from becoming homeless, but I also believe the VA has some real 

work to do in the area of serving female homeless veterans. 

While VA has done a good job putting together a budget that 

works to tackle the challenges that our veterans face, there is also 

clearly room for improvement. 

For the third year in a row, VA has proposed cuts in spending 

for major construction and nonrecurring maintenance. These continued cuts are deeply troubling given last year was the first time 

VA’s budget even outlined the Department’s vision for a 10-year 

construction plan with a price tag that approached $65 billion. 

Yet despite that plan, for the past 2 years VA has requested only 

a fraction of the amount that it needs. I am disappointed at the 

size of the gap between the funding needed to bring facilities up 

to date and the funding requested from the Congress. 

In addition, this budget request proposes a series of initiatives 

intended to save money including better controls on contract health 

care, better strategies for contracting, and cutting administrative 

overhead. 

3 

I am pleased to see the VA recognizes the importance of efficiency, but I have some concerns with those proposals. A GAO report released on Monday showed many of these initiatives from last 

year’s budget did not, in fact, generate the savings that the VA 

predicted. 

I will review each of the initiatives in this budget with an open 

mind, but I want to be clear: our first priority—our obligation— 

must be to ensure that we are fulfilling and honoring our commitment to our veterans. 

If the VA fails to meet the proposed cost-saving estimates, it will 

have to find a way to make up the difference so veterans do not 

end up paying the price. 

Medical care collections is another area where VA has to do a 

better job of both predicting targets and collecting funds. It is impossible to build the budget on funding that is not collected. 

Another area of concern to me is mental health care. At a hearing last year, the VA witnesses acknowledged they may, in fact, 

need more resources to meet the high demand for mental health 

care. I want a straightforward answer from the VA about their actual needs and whether the Department’s proposed a 5-percent increase is enough. 

Last year I asked the VA to conduct a survey of mental health 

providers that revealed significant shortcomings. VA proposed a 

plan to fix the problems, and they must complete those steps as 

scheduled. But the VA cannot stop with what was outlined in that 

initial plan. It must continue to work to find ways to make real 

and substantial improvements. 

This year we will continue to be aggressive in our oversight of 

VA mental health care. Not every veteran will be affected by invisible wounds; but when a veteran has the courage to stand up and 

ask for help, the VA must be there every single time. The VA must 

be there with not only timely access to care but also the right type 

of care. 

Challenges like PTSD or depression are natural responses to 

some of the most stressful experiences a person can have, and we 

will do everything possible to ensure that those affected by these 

illnesses can get the help, can get better, and get back to their 

lives. 

Finally, like Chairman Miller and Senator Tester and others, I 

remain very concerned about the questions surrounding the effects 

of sequestration on veterans’ health care. Throughout the Budget 

Control Act process that established sequestration, I made it very 

clear that including VA among those agencies that would receive 

automatic cuts is unacceptable and repeatedly made clear that this 

should not be the case. 

And although I am confident that all veterans programs including health care will be protected in the event of sequestration, I 

want to make sure you know that I will not accept anything else. 

I believe our veterans deserve clarity on this issue; and if it cannot 

be provided today, I am going to continue to work to get it. 

In fact, I have already asked the Government Accountability Office to issue a formal legal opinion to provide some resolution on 

this issue. 

4 

Secretary Shinseki, as you well know, budgets are a reflection of 

our values; and thanks to your work, this budget request demonstrates a strong commitment to our veterans. While we are in a 

position to make sure the VA has the increased funding it needs, 

we should also be mindful that the demand for services is going to 

continue to increase no matter the number of troops deployed. 

I look forward to working with my colleagues on this Committee 

and on the Budget and Appropriations Committees on which I also 

sit and, of course, with Secretary Shinseki and his entire team and 

the leaders from the veterans’ community to make sure that we 

keep this long-term commitment. 

So, I thank all of you for being here today and my Committee 

members, and with that I will turn to our Ranking Member, Senator Burr, for his opening statement. 

STATEMENT OF HON. RICHARD BURR, RANKING MEMBER, 

U.S. SENATOR FROM NORTH CAROLINA 

Senator BURR. Thank you, Madam Chairman. 

Mr. Secretary, welcome. Welcome to your leadership team and 

welcome to the veterans’ service organizations who are here this 

morning. 

We are here today to review the President’s budget request for 

the Department of Veterans Affairs for fiscal year 2013, which includes a 41⁄2 percent increase in discretionary spending. 

I continue to believe that it is important that we provide adequate funding so that veterans of all generations will be able to receive the benefits and services they have earned and deserved 

without hassles or delays, but we also need to analyze the budget 

request to ensure that we spend the taxpayers money wisely and 

more importantly that the funding will actually lead to better outcomes for veterans, their families, and their survivors. As we will 

discuss today, I have questions about whether that is the case for 

several areas of today’s budget. 

To start with, the budget for mental health care includes an advanced appropriations request for fiscal year 2014 of $6.4 billion. 

If adopted, it will represent a 4 percent increase over fiscal year 

2013 and a 66 percent increase over the fiscal year 2008 level. 

But at hearings last year, the Committee heard about the devastating struggles some veterans face when trying to get mental 

health treatment they need from the VA. 

In fact, VA’s survey of its mental health providers last year was 

pretty clear on the problem. Seventy percent survey respondents 

indicated they did not have enough mental health staff to meet the 

current demand for care. Forty-five percent indicated that lack of 

off-hours appointments is a barrier to care, and 51 percent said it 

took 30 days or more for a veteran to be seen for a specialty appointment such as Post Traumatic Stress Disorder. 

Clearly, this is an instance where increased funding has not 

translated to better services for veterans. Today I hope we will get 

a better understanding of how VA plans to address these issues, 

how the requested funding would be used, and whether it may be 

time for VA to start looking outside the box to find solutions to the 

barriers veterans face in assessing this needed care. 

5 

Another area of concern is the backlog of disability claims, a 

pretty common discussion we have in this Committee. This budget 

requests a 41-percent increase in staff since 2008, but let us look 

at what has happened during that time. 

The number of claims pending at the end of the year has more 

than doubled. The average number of days to complete a claim has 

increased by 26 percent. The quality of decisions has trended down 

and is now below 84 percent. According to one performance measure, there has been a 16-percent decline in the number of claims 

completed annually by employees. 

Productivity. The appeals resolution time has increased from 645 

days to 747 days, and VA decided hundreds of thousands less 

claims than it received. 

With statistics like these, it must be a priority to ensure the initiatives the VA is pursuing to get the situation under control will 

actually be effective so that veterans, their families, and their survivors receive timely, quality decisions when they seek benefits 

from the VA. 

Another area of the budget I would like to briefly mentioned is 

the legislative proposal to spend $1 billion over 5 years on the Veterans’ Jobs Corps programs. While I believe it is important that we 

help our veterans find meaningful work, I am interested to learn 

how VA would suggest paying for this program and about how it 

would be structured. So, I hope that VA will be able to provide us 

with more details about the proposed program today. 

Madam Chairman, the final item I want to highlight before I 

turn it back to you is the continued increase in staff at the VA Central Office and quite honestly at the VISN level. For example, since 

fiscal year 2008 the staff of the VA Central Office has grown by 

close to 40 percent and the Office of Human Resources and Administration has seen an 80-percent increase over the same period. 

Also the staff at the VISN headquarters has increased by 52 percent between 2008 and 2011. 

I think we need to ask serious questions about whether this increase in staffing directly benefit our Nation’s veterans, whether 

these employees are essential to delivering services to the veterans 

who use the VA system, and whether any of the funds could be put 

to better use. 

The bottom line is that particularly in this time of record deficits, 

we need to ensure that when we spend the limited money as we 

have we do it wisely and that we make certain that the veterans 

are the ones that receive the benefits and services that have been 

earned and deserved. 

The trend lines are troubling to me. They should be troubling to 

this Committee and they should be troubling, quite frankly, to the 

VA. I will focus much of my attention on those today in questions 

to the Secretary and to his leadership team. 

I thank the Chair. 

Chairman MURRAY. Thank you, Senator Burr. 

We will now turn to our Senators for opening remarks in order 

of appearance. Senator Akaka, we will start with you. 

6 

STATEMENT OF HON. DANIEL K. AKAKA, 

U.S. SENATOR FROM HAWAII 

Senator AKAKA. Thank you very much, Madam Chairman, and I 

want to say Aloha to Secretary Shinseki and his leadership staff 

at the VA. I want to thank all of you for your service to veterans 

and, of course, to our country. 

I do not need to tell you what you have been hearing that Secretary Shinseki and the leadership staff has been improving the 

services because claims have dropped and that is an indication of 

the care and treatment which is our duty to provide to veterans 

that is something that we must continually strive to improve, and 

you have been doing that. 

I am encouraged to see that the total budget request for VA was 

$13 billion above last year. I know we have budgetary constraints, 

but we owe it to our veterans who have sacrificed for our country, 

and you have planned and are moving along and have been progressing about meeting those needs. 

I am glad to see increases in budget requests for mental health, 

suicide prevention, and Iraq and Afghanistan veterans’ programs. 

I am also encouraged by major increases in funding for homeless 

vets and women’s vets programs. 

While budget increases provide opportunities, we all know that 

these resources must be utilized with thought and efficiency in 

order to best serve our veterans and their families. 

As the Defense Department continues to reduce its participation 

in overseas contingency operations and more veterans come home 

to their families, VA’s capacity to treat veterans is sure to be tested 

even more. 

Mr. Secretary, we have talked about this, and I know that you 

are doing all you can to prepare for the anticipated growth in the 

number of veterans seeking VA services. 

Secretary Shinseki, I am also very pleased to see that an important project for Hawaii’s veterans which I have championed for 

years is in the budget: a much needed care facility in West Kahului 

that would alleviate some of the overcrowding at Spark Matsunaga 

Medical Center at Tripler Hospital. This proposed lease will certainly help to meet the needs of our veterans in Hawaii. 

Mr. Secretary, I have been impressed with all that you and your 

team have been able to accomplish in the past 3 years. You have 

made tremendous strides to improve mental health care, suicide 

prevention, homelessness, and help veterans find jobs among other 

accomplishments. 

However, we know that there are areas where we can improve 

the care and services provided to our veterans that they earned 

and the most certainly deserve. 

So, I look forward to hearing your testimony today, Mr. Secretary, and continuing to work with my colleagues and VA to help 

provide the best care we can to our veterans and their families. 

Thank you very much, Madam Chairman. 

Chairman MURRAY. Thank you very much. 

Senator Johanns. 

7 

STATEMENT OF HON. MIKE JOHANNS, 

U.S. SENATOR FROM NEVADA 

Senator JOHANNS. Madam Chair, Ranking Member Burr, thanks 

for holding the very, very important hearing. 

Let me just start out and offer an observation, Mr. Secretary. 

First of all, I want to say thank you for stopping by my office a 

week or 10 days ago. As you know, over the past few years while 

I have been here and you have been in your position, we have had 

an opportunity to meet on a number of occasions, and I have always appreciated that. 

I come away from those meetings absolutely convinced that you 

and your team have the best interests of vets in your heart and you 

are trying to do everything you can to deal with all of the problems 

that we are going to mention today. 

But one of the things that we have found in working with vets 

in my Senate office, and it is the reality of the Veterans Administration, is every veteran has an individual problem that is not easily solved with one sweeping policy approach or whatever. 

We have found that we really have to sit down with each vet and 

talk to them and help them work through that problem. Even in 

my Senate office, we have found that we have to staffup to do that. 

I have more people in my Senate offices working on the veterans’ 

caseload than any other caseload that we work on. So, it is just 

part of what we have to do. 

I think we have a great perspective on what the veterans need, 

and you are always willing to bring that to the fore. I have been 

in your position before and the complexities of what you are doing 

are the norm. 

So, I want to start out on a positive note and just tell you I think 

your heart is in the right direction, but I do think as we look at 

the metrics and the progress we are making, it is important to see 

what is working and what is not working and just simply acknowledge that and try to figure out, is there something we are missing 

here? 

I also wanted to just mention briefly, and I will not dwell on this 

long but it is worth a mention to me. As you know, like other areas 

in the country we are struggling with a VA hospital that was built 

decades ago. Notwithstanding the kind of heroic efforts of the staff 

there and the doctors and the nurses and the administrative personnel, it is just a very, very difficult situation. 

We are very pleased that we are on the priority list, and we are 

making our way to a point at which where we hope we can solve 

that problem and replace the facility. I think today we are like 18, 

if I am not mistaken. So, I am aware of the fact that it just does 

take a while. 

We are hoping to work with you and your staff. Maybe there are 

some things we can do. There is a serious parking problem. It is 

right in the middle of Omaha, and so, maybe there are some things 

we can do to move the project forward. 

I will wrap up with one last thought. We are seeing some areas 

of improvement that I wanted to mention, again hoping to keep 

this on a note of, look, you are doing some things that I think are 

making a difference. 

8 

The first is in the processing of Post-9/11 GI Bill benefits. In 

2011 we at least, I do not know about other Senate offices, we at 

least received no complaints about delays or problems with education benefits. I do not know what we are doing with education 

benefits but at least from our experience something is working. 

Whatever model, if I could somehow be transferred to the disability claims, and I appreciate they are much more complicated, 

but that seems to be working. You have had to ramp that up pretty 

significantly. 

So, I am hoping I can hear some thoughts and maybe there are 

some ideas that would work in other areas of the VA system. 

We are also hearing veterans express to us that the expanded access to information via that eBenefits system is something that 

they appreciate, they feel good about. I think all of us have been 

optimistic and hopeful, maybe that is a better way of putting it, 

hopeful that that eBenefits system would pay benefits. We think it 

is. 

We think as veterans are getting more used to that it is paying 

some dividends and hopefully saving some staff time because people can get information or whatever they are needing there. 

I will just wrap up, and again thank you, Madam Chair, I do appreciate the opportunity to be here. 

Thank you, you and your whole team for the work that they are 

doing. My hope is that we can advance the cause because there is 

so much more to be done. Thank you. 

Chairman MURRAY. Thank you, Senator Johanns. 

Senator Brown of Ohio. 

STATEMENT OF HON. SHERROD BROWN, 

U.S. SENATOR FROM OHIO 

Senator BROWN OF OHIO. Thank you, Chairman Murray. I appreciate your leadership on veterans’ issues. 

Thank you, Secretary Shinseki, and all of you who dedicate a big 

part of your lives. It is nice to see you again. Thank you for coming 

to Ohio, those of you that have, and the service that you provide 

for veterans in my State and for all of us. 

It is a good budget. It shows a strong commitment to veterans. 

I think when you look at what the advanced appropriations mark 

is, a $40 billion, the request with the advanced appropriations with 

the $13 billion increase it is saying the right thing for people who 

clearly have earned it. It reflects the understanding that we all 

have about service to country. 

I applaud the VA for its investments in eliminating the disability 

claims backlog. We are all, of course, still very concerned about 

that as Senator Johanns said. 

We still hear horror stories of 12-, 18-, and 24-month delays. We 

should, of course, never tolerate them, and I know your views 

about that, Secretary Shinseki. I know that we need to continue to 

push and with better trained staff and improvements in electronic 

and other processing efficiencies. 

Also, on a similar note, the disability rating system clearly needs 

substantial improvement. A bum knee in Charlotte should be treated the same as a bum knee in Cincinnati. The backlog in disability 

ratings is in many ways related: fixing both at the same time 

9 

makes sense, and I know your commitment to wanting to do that, 

and we expect to see results as we move forward. 

I am aware, too, of the funds in this budget to train outreach coordinators and operate targeted clinics and provide other services 

specific to particularly rural veterans but everywhere who simply 

do not know enough about veterans services. 

People from the VA, officials from the VA joined me in a field 

hearing in Appalachia, two areas of Ohio, Appalachia Ohio, one in 

2007 and one in 2010. We talked about everything from applying 

for benefits, and veterans benefits to the earned-income tax credit. 

So many low-income veterans do not know enough about any of 

those services. 

The fact that today I believe there are 30 community-based outpatient clinics, CBOCs, in Ohio speak to your commitment to going 

everywhere to reach veterans not just in the VA centers in Cincinnati and Chillicothe and Cleveland but well beyond that. I am 

very appreciative of that, but the outreach efforts obviously need 

to be stepped up, targeted at not just the demographic of rural Appalachia, but certainly other places too. 

My last point. Our main concern about the Department’s outsourcing of more and more work. The quality of outsourced work 

is often subpar. This whole political view that outsourcing, you 

know, whether it is selling turnpikes or selling prisons or outsourcing part of the military, the work often is subpar. 

The cost savings are usually illusory and often the costs are significantly greater we learn from outsourcing. I mean, the contractors give political campaign contributions. I am not saying you are 

any part of that to be sure, but that happens too often. 

We go places with outsourcing that does not lead to good government. We also—I think many contractors lack the dedicated service 

mentality, if you will, of career civil servants. It is always popular 

to beat up Federal employees and State employees and all of that. 

We have gone through that politically in State, after State, after 

State in this country and in the Federal Government. 

I like the idea. I think an individual’s motivation to serve our 

veterans as a career leads to better serve contrasts sometimes to 

services provided by companies that are motivated by profits, and 

some of the most dedicated people that I have ever met provide 

service to veterans and have made that their career. They could 

make more money somewhere else but they want to serve. 

And this whole idea that outsourcing saves money, enhances 

quality is pretty ill founded. The VA and our veterans cannot simply be viewed as just another client. We see this at the very basic 

level of services in places like Dayton, and I appreciate very much 

the Secretary’s focus on fixing other problems in Dayton. 

But where laundry was outsourced, workers tell me that sometimes it does not come back clean, and what is the point of outsourcing if that happens? 

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

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

health insurance provider rather than a health care provider, and 

we never should get close to that line. 

On a lighter note, thank you for earlier this week—I guess today 

is Wednesday, on Monday was the first day, and I was lucky 

10 

enough to be there at the Parma Community-Based Outpatient 

Clinic when the VA, for reasons that I disagreed but probably 

needed to shutdown the VA hospital in Brecksville. Part of the deal 

was that they would put this community-based outpatient clinic, 

this CBOC, in Parma. It is terrific. It was crowded the first day. 

People will use it. It serves an important population, and I thank 

you for that. 

Chairman MURRAY. Thank you very much. 

Senator Brown of Massachusetts. 

STATEMENT OF HON. SCOTT P. BROWN, 

U.S. SENATOR FROM MASSACHUSETTS 

Senator BROWN OF MASSACHUSETTS. Thank you, Madam Chair. 

I want to hear the testimony of the folks. I will be very brief. I 

agree with Senator Burr on the job issues and the fact that we are 

going to be spending a lot of money, happy to do it. I want to see 

how it is going to be paid for, but also importantly see if there is 

any duplication overlap. There seems to be a lot of things happening in that field. 

When we have these types of issues, we usually throw everything 

against the wall and see what sticks. I want to make sure that we 

do it efficiently. We do not just keep throwing money out there but 

actually that we have programs. If they are working, that is improving; if they are not, let us get rid of them. 

I am concerned still about obviously the long timeframe in filing 

claims. I will say I am very pleased with what is happening in 

Massachusetts with the new blood out there and new people helping and really seem energized. It helps that we are in the same 

building and we have had some great success and I have made that 

public in our veterans’ hearing that we had on this very issue, and 

I know the big elephant in the room is the one million returning 

veterans and the obligations we have to keep them and get them 

whole, and I am thankful. 

I know you have already met with Secretary Panetta to discuss 

that VA/DOD mission to make sure that we do not just have a million new veterans coming. 

If they are going to be released, they need to be released in a 

thoughtful, methodical manner so you are not overwhelmed and 

really just in so deep you cannot get out. 

So, I will just stop with that. I look forward to hearing the testimony. I am going to be going to the floor, Madam Chair. I have 

to speak, but then I will be back. Thank you. 

Chairman MURRAY. Senator Isakson. 

STATEMENT OF HON. JOHNNY ISAKSON, 

U.S. SENATOR FROM GEORGIA 

Senator ISAKSON. I, too, will be very brief because I am anxious 

to hear from each of you. But first of all, Secretary, thank you for 

taking the time to come to my office 2 weeks ago. 

Second, I have two pieces of good news. One is on the jobs front, 

and you probably have heard about this; but if you have not, I 

wanted to make you aware. 

Lewis Jordan, who was the founder of ValuJet and AirTran, 

which is now Southwest, has created a foundation called Gratitude 

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America, which is a web-based platform to match job needs with 

veterans; and it has the component that links them with training 

for the jobs. 

So, it makes the full circle where, if a veteran is looking for a 

job, he can search it on the Internet. If he finds a job he likes but 

he is not qualified, it matches him with the closest training facility 

where he can get the training. 

I think it is a great idea, and it is something that is very important. I appreciate Lewis doing that and I thought you would want 

to know. 

The second is I want to compliment Director Goldman at the 

Dublin VA. I have spent a day in Dublin, GA, last week. He serves 

a third of the State—51 counties—and he is trying to partner with 

the General, the Commander of Robins Air Force Base to merge 

the VA clinics in Perry and Macon, GA, with the base DOD health 

care on the base to utilize the facilities, advantage of having all the 

imaging equipment and everything already on the active-duty base 

and not have to have redundant cost in staffing to other clinics, 

which I think is a great idea to make better health care available 

but also at a lower cost to the Veterans Administration and the 

taxpayers. 

I wanted to bring those two pieces of good news to your attention. Thank you for what you do, and thank you for being here. 

Chairman MURRAY. Thank you. 

Senator Boozman. 

STATEMENT OF HON. JOHN BOOZMAN, 

U.S. SENATOR FROM ARKANSAS 

Senator BOOZMAN. Thank you, Madam Chair, and again very 

quickly I just want to thank the Secretary for being here and the 

team that he assembled, for your hard work. 

Senator Brown mentioned that, you know, that there are a lot of 

individuals in the VA that are there because they want to be and 

could have other opportunities, and certainly you are in that category. You have led soldiers and now you are serving veterans and 

so we really do appreciate that very, very much. 

The other thing I would say is, as Senator Isakson mentioned, 

I do appreciate the fact that you are very willing to work with Congress and very approachable, you and your staff; and so that is 

something that is appreciated. 

So, we appreciate all that you guys have done in your past and 

are looking forward to it your doing a bunch in the future. 

I yield back, Madam Chair. 

Chairman MURRAY. Thank you very much. 

With that I want to again welcome Secretary Shinseki. Thank 

you for coming here today to give your perspective on the Department’s fiscal year 2013 budget and the fiscal year 2014 advanced 

appropriation request. 

Secretary Shinseki is accompanied today by Steve Muro, Under 

Secretary for Memorial Affairs; Allison Hickey, Under Secretary for 

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

also have Todd Grams, Executive in Charge of the Office of Management and Chief Financial Officer; and Roger Baker, Assistant 

Secretary for Information and Technology. 

12 

Thank you all for joining us today. 

Secretary Shinseki, your remarks will, of course, appear in the 

record, but we welcome your opening statement. 

STATEMENT OF HON. ERIC K. SHINSEKI, SECRETARY OF VETERANS AFFAIRS; ACCOMPANIED BY HON. ROBERT A. PETZEL, MD, UNDER SECRETARY FOR HEALTH; HON. ALLISON A. 

HICKEY, UNDER SECRETARY FOR BENEFITS; HON. STEVE L. 

MURO, UNDER SECRETARY FOR MEMORIAL AFFAIRS; HON. 

ROGER W. BAKER, ASSISTANT SECRETARY FOR INFORMATION AND TECHNOLOGY; AND W. TODD GRAMS, EXECUTIVE 

IN CHARGE FOR THE OFFICE OF MANAGEMENT AND CHIEF 

FINANCIAL OFFICER 

Secretary SHINSEKI. Thank you, Madam Chairman, Ranking 

Member Burr, distinguished Members of the Senate Committee on 

Veterans’ Affairs, thank you again. I look forward to these. This is 

an opportunity to extend the dialog we have in other fora, but 

thanks for this opportunity to present, as the Chairman said, the 

President’s 2013 Budget and 2014 Advance Appropriations Requests for VA. 

This Committee has a long history of strong support for our Nation’s veterans, and I can speak to that first hand having worked 

personally the past three budgets with you. 

The President has demonstrated his own respect and sense of obligation for our 22 million veterans by sending the Congress once 

again another strong budget request for VA, and I thank the members for your unwavering commitment, and I am here to answer 

your questions but also seek your support on this budget request. 

I would also like to acknowledge the representatives from our 

veterans service organizations who are here today. I would tell you 

as we develop our budgets, their insights, their experience is helpful as we put together our arguments for resources and as we 

strive to continuously improve our programs. 

Madam Chairman, thanks for introducing the members of the 

panel. I have a written statement which I ask to be submitted for 

the record. 

Chairman MURRAY. Without objection. 

Secretary SHINSEKI. This hearing occurs at an important moment 

in our Nation’s history, not the only one. There have been others 

that I could refer to. I am old enough to have experienced our return from Vietnam and to have witnessed personally the end of the 

cold war. 

We are again in another period of transition, an important one. 

Our troops have returned home from Iraq and their numbers in Afghanistan are likely to decline over time; and history suggests, as 

the Chair indicated, VA’s requirements from these two operational 

missions will continue to grow for sometime long after the last combatant leaves Afghanistan, maybe as much as a decade, maybe 

even more. 

We must provide access to quality care, timely benefits and services and job opportunities for every generation of veterans; and the 

generation at hand is the one that comes home today from Iraq and 

Afghanistan. 

13 

In the next 5 years, more than a million veterans are expected 

to leave military service. This generation relies on VA at unprecedented levels. Through September 2011, of approximately 1.4 million veterans who deployed and returned from operations Enduring 

Freedom and Iraqi Freedom, 67 percent have used some VA benefit 

or service in some way, a far higher percentage than those from 

previous wars. 

The 2013 budget request would allow us to fulfill the requirements of our mission. Health *Care for 8.8 million enrolled veterans, compensation and pension benefits for nearly 4.2 million veterans, life insurance covering 7.1 million active duty servicemembers and enrolled veterans at a 95-percent customer satisfaction 

rating, educational assistance for over a million veterans and family members on over 6,500 campuses, home mortgages and veteran 

loans with the Nation’s lowest foreclosure rates, and burial honors 

for nearly 120,000 heroes and eligible family members in our 131 

National Cemeteries, befitting their service to our Nation. 

This 2013 budget request continues the momentum in our three 

priorities that you have heard me speak about over the past 3 

years. Increasing access to care, benefits and services; eliminating 

the claims backlog; and ending veterans’ homelessness through effective, efficient, accountable use of the resources you provide. 

Access encompasses VA’s facilities, programs, and technology. It 

is a broad term but there is a lot it encompasses. This 2013 budget 

request allows VA to continue improving access by opening new or 

improved facilities closer to where veterans live and providing telehealth and telemedicine linkages, with connectivity where it is 

needed, in veterans homes. 

Also VA is fundamentally transforming veterans access to benefits through a new electronic tool called the Veterans Relationship 

Management System. This is an effort to improve our telephone 

service. 

By collaborating with DOD to turn the current Assistance Program that we both share into an outcomes-based training and education program that fully prepares departing servicemembers for 

the next phase of their lives; and by establishing a National Cemetery presence in eight rural areas and better serving rural and 

women veterans. I am happy to provide details later. 

We expect that more than 1 million veterans will leave the military over the next 5 years, potentially all will enroll in VA. Over 

600,000 of them, based on our historical trend, will likely seek care, 

benefits, and services from VA in the out years. 

Regarding the backlog, from what we know now, fiscal year 2013 

will be the first year in a long time in which our claims production 

going out the door will exceed the number of incoming claims; and 

the paperless initiative we have been building for the past 2 years, 

an automation tool, becomes critical to reversing backlog growth 

and increasing quality. We must not hesitate. Stability in IT funding is critical to our success. 

Homelessness. From January 2010 to January 2011 alone, the 

estimated number of homeless veterans declined by 12 percent. We 

have created momentum in the homeless program. Much remains 

to be done to end veterans homelessness by 2015 and the 2013 

budget is a presentation of how we continue to do that. 

14 

We are now developing a dynamic homeless veterans registry. I 

think you appreciate that much of what we understand about 

homelessness is an estimate of real numbers. We are not able to 

count everyone out there but it is a statistically valid process. 

In the meantime, over the past 3 years, we have been building 

a registry of former and current veterans by name so we know who 

they are, what their issues are, where they reside, and whether 

they are migratory and move from one VA footprint to the next. 

So, as we think about adjusting the footprint based on what we 

see day-to-day, we want to be careful that we are not doing something that ignores maybe an issue that is going to require help. 

So, building a veterans registry today with over 400,000 names 

of current and formerly homeless veterans allowa us to better see, 

track and understand the real causes of veterans homelessness. In 

the years ahead, we think this information will not only help us 

more effectively prevent it—that is where we are headed—not just 

for veterans, but perhaps for other communities as well where we 

have partnered in taking on the homeless issue. 

We look to develop more visibility of the at-risk veteran population in order to prevent veterans from falling into homelessness, 

and this budget supports that plan. 

So, Madam Chairman and Members of the Committee, we are 

committed to the responsible use of the resources you provide and 

the resources we seek in the 2013 budget. I know that has been 

a question some of you have posed; but for both the 2013 budget 

and 2014 advance appropriations requests, we are committed to the 

responsible use. 

Again thank you for this opportunity to appear before this 

Committee. 

[The prepared statement of Secretary Shinseki follows:] 

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

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

Committee on Veterans’ Affairs: Thank you for the opportunity to present the President’s 2013 Budget and 2014 advance appropriations requests for the Department 

of Veterans Affairs (VA). For the past three budget requests, the Congress has supported the very high priority that the President has placed on funding for programs 

that provide care and benefits for our Nation’s 22 million Veterans and their families. This submission seeks your support of the President’s continued high priority 

support for Veterans who have earned this Nation’s respect and the benefits and 

services we provide. 

We meet at an historic moment for our Nation’s Armed Forces, as they turn the 

page on a decade of war. Recently, the President outlined a major shift in the Nation’s strategic military objectives—with a goal of a more agile, more versatile, more 

responsive military focused on the future. The President also outlined another important objective—keeping faith with those who serve as they depart the military 

and return to civilian life. As these newest Veterans return home, we must anticipate their transitions by readying the care, the benefits, and the job opportunities 

they have earned and they will need to smoothly and successfully make this 

transition. 

The President’s 2013 Budget for VA requests $140.3 billion—comprised of $64 billion in discretionary funds, including medical care collections, and $76.3 billion in 

mandatory funds. The discretionary budget request represents an increase of $2.7 

billion, or 4.5 percent, over the 2012 enacted level. Our 2013 budget will allow the 

Department to operate the largest integrated healthcare system in the country, with 

more than 8.8 million Veterans enrolled to receive healthcare; the eighth largest life 

insurance provider covering both active duty members as well as enrolled Veterans; 

a sizable education assistance program serving over 1 million participants; a home 

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

15 

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

continues to lead the country as a high-performing organization—for the fourth time 

in a 10-year period besting the Nation’s top corporations and other Federal agencies 

in an independent survey of customer satisfaction. In 2013, VA national cemeteries 

will inter about 120,000 Veterans or their family members. 

The Department of Veterans Affairs fulfills its obligation to Veterans, their families, and survivors of the fallen by living a set of core values that define who we 

are as an organization: ‘‘I CARE’’—Integrity, Commitment, Advocacy, Respect, and 

Excellence—cannot be converted into dollars in a budget. But Veterans trust that 

we will live these values, every day, in our medical facilities, our benefits offices, 

and our national cemeteries. And where we find evidence of a lack of commitment 

to our values, we will aggressively correct them by re-training employees or, where 

required, removal. We provide the very best in high quality and safe care and compassionate services, delivered by more than 316,000 employees, who are supported 

by the generosity of 140,000 volunteers. 

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 at VA. Effective stewardship requires an unflagging commitment to apply 

budgetary resources efficiently, using clear accounting rules and procedures, to safeguard, train, motivate, and hold our workforce accountable; and to assure the proper 

use of time in serving Veterans on behalf of the American people. 

During the audit of the Department’s fiscal year 2010 financial statement, VA’s 

independent auditor certified that we had remediated 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. We have also dramatically reduced the number of significant financial 

deficiencies since 2008, from sixteen to two. 

Another example of VA’s effective stewardship of resources is the Project Management Accountability System (PMAS) developed by our Office of Information Technology. PMAS requires Information Technology (IT) projects to establish milestones 

to deliver new functionality to its customers every six months. Now entering its 

third year, PMAS continues to instill accountability and discipline in our IT organization. In 2011, PMAS achieved successful delivery of 89 percent of all IT project 

milestones. VA managed 101 IT projects during the year, establishing a total of 237 

milestones and successfully executing 212 of them. Of the 25 IT projects that missed 

their delivery milestone date, more than half delivered within the next 14 days. Ensuring IT projects meet established milestones means that savings and delivery of 

solutions are achieved throughout development, and that Veterans reap improvements sooner. By implementing PMAS, we have achieved at least $200 million in 

cost avoidance by stopping or improving the management of 45 projects. 

VA’s stewardship of resources continues with the expansion of our ASPIRE dashboard to the Veterans Benefits Administration (VBA). Originally established in 2010 

for the Veterans Health Administration (VHA), ASPIRE publicly provides quality 

goals and performance measures of VA healthcare. The success of this approach was 

reflected in its contribution to VHA’s receipt of the Annual Leadership Award from 

the American College of Medical Quality. On June 30, 2011, VBA established an ASPIRE Web site at http://www.vba.va.gov/reports/aspiremap.asp for aspirational goals 

and monthly progress for 46 performance metrics across six business lines. This new 

effort expands the Department’s commitment to unprecedented public transparency 

by sharing performance and productivity data in the delivery of Veterans’ benefits, 

including compensation, pension, vocational rehabilitation and employment, education, home loans, and insurance. 

Through the effective management of our acquisition resources, VA achieves positive results for Veteran-owned small businesses. VA leads the Federal Government 

in contracting with Service-Disabled, Veteran-Owned Small Businesses (SDVOSB). 

In 2011, more than 18 percent of all VA procurements were awarded to SDVOSBs, 

exceeding our internal goal of 10 percent and far exceeding the governmentwide 

goal of three percent. 

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. This allows the timely notification to next-of-kin of potential survivor benefits. Since that time NCA has avoided possible collection action by discontinuing $100.3 million in benefit payments. In addition, we implemented the use 

of Medicare pricing methodologies at VHA to pay for certain outpatient services in 

16 

2011, resulting in savings of over $160 million without negatively impacting Veteran care and with improved consistency in billing and payment. 

VETERANS JOB CORPS

In his State of the Union address, President Obama called for a new Veterans Job 

Corps initiative to help our returning Veterans find pathways to civilian employment. The budget includes $1 billion 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. Veterans will restore our great outdoors by providing visitor programs, restoring habitat, protecting cultural resources, eradicating 

invasive species, and operating facilities. 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. 

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. This 

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

This approach ensures that VA requirements are reviewed and updated based on 

the most recent data available and actual program experience. 

The 2013 budget request for VA medical care appropriations is $52.7 billion, an 

increase of 4.1 percent over the 2012 enacted appropriation of $50.6 billion. This request is an increase of $165 million above the 2013 advance appropriations enacted 

by Congress in 2011. Based on updated 2013 estimates largely derived from the Enrollee Health Care Projection Model, the requested amount would also allow VA to 

increase funding in programs to eliminate Veteran homelessness, fully fund the implementation of the Caregivers and Veterans Omnibus Health Services Act, support 

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 continues to assume $500 million in unobligated 

balances from 2012 that will carryover and remain available for obligation in 2013— 

consistent with the 2012 budget submitted to Congress. 

The 2014 request for medical care advance appropriations is $54.5 billion, an increase of $1.8 billion, or 3.3 percent, over the 2013 budget request. 

PRIORITY GOALS

Our Nation is in a period of transition. As the tide of war recedes, we have the 

opportunity, and the responsibility, to anticipate the needs of returning Veterans. 

History shows that the costs of war will continue to grow in VA for a decade or more 

after the operational missions in Iraq and Afghanistan have ended. In the next 5 

years, another one million Veterans are expected to leave military service. Our data 

shows that the newest of our country’s Veterans are relying on VA at unprecedented 

levels. Through September 30, 2011, of the approximately 1.4 million living Veterans who were deployed overseas to support Operation Enduring Freedom and Operation Iraqi Freedom, at least 67 percent have used some VA benefit or service. 

VA’s three priorities—to expand access to benefits and services, eliminate the 

claims backlog, and end Veteran homelessness—anticipate these changes and identify the performance levels required to meet emerging needs. The 2013 Budget 

builds upon our multi-year effort to achieve VA’s priority goals through effective, efficient, and accountable program implementation. 

EXPANDING ACCESS TO BENEFITS AND SERVICES

Expanding access for Veterans is much more than boosting the number of Veterans walking in the front door of a VA facility. Access is a three-pronged effort that 

encompasses VA’s facilities, programs, and technology. Today, 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 sparse, or by using social 

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

and facilities. Expanding access also means finding new ways to break down artificial barriers so that Veterans are aware of and can gain access to VA services and 

benefits. Technology is the great enabler of all VA efforts. IT is not a siloed segment 

of the budget, providing just computers and monitors, but rather the vehicle by 

17 

which VA is able to extend the reach of its healthcare to rural America, process benefits more quickly, and provide enhanced service to Veterans and their families. The 2013 budget request includes $119.4 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. VRM established a 

single queue for VBA’s National Call Centers ensuring calls are routed to the next 

available agent, regardless of geography. Call-recording functionality was implemented that allows agents to review calls for technical accuracy and client contact 

behaviors. VA recently deployed ‘‘Virtual Hold ASAP call-back’’ technology. During 

periods of high call volumes, callers can leave their name and phone number instead 

of waiting on hold for the next available operator, and the system automatically 

calls them back in turn. The Virtual Hold system has made nearly 600,000 return 

calls since November 2011. The acceptance rate for callers is 46 percent, exceeding 

the industry standard of 30 percent, and our successful re-connect rate is 92 percent. Since launching Virtual Hold, the National Call Centers have seen a 15 percent reduction in the dropped-call rate. In December 2011, VA deployed ‘‘Virtual 

Hold Scheduled call-back’’ technology, which allows callers to make an appointment 

with us to call them at a specific time. Since deployment, over 185,000 scheduled 

call-backs have already been processed. 

In December, VA deployed a pilot of its new ‘‘Unified Desktop’’ technology. This 

initiative will provide National Call Center agents with a single, unified view of VA 

clients’ military, demographic, and contact information and their benefits eligibility 

and claims status through one integrated application, versus the current process 

that requires VA agents to access up to 13 different applications. This will help ensure our Veterans receive comprehensive and accurate responses. 

Key to expansion of access is the eBenefits portal—one of our critical VRM initiatives. eBenefits is a VA/DOD initiative that consolidates information regarding benefits and services and includes a suite of on-line self-service capabilities for enrollment/application and utilization of benefits and services. eBenefits enrollment now 

exceeds 1.2 million users, and VA expects enrollment to exceed 2.5 million by the 

end of 2013. VA continues to expand the capabilities available through the eBenefits 

portal. Users can check the status of a claim or appeal, review the history of VA 

payments, request and download military personnel records, generate letters to 

verify their eligibility for Veterans’ hiring preferences, secure a certificate of eligibility for a VA home loan, and numerous other benefit actions. In 2012, Servicemembers will complete their Servicemembers’ Group Life Insurance applications 

and transactions through eBenefits. Also, 2012 enhancements will allow Veterans 

to view their scheduled VA medical appointments, file benefits claims online in a 

‘‘Turbo Claim’’ like approach, and upload supporting claims information that feeds 

our paperless claims process. In 2013, funding supports enhanced self-service tools 

for the Civilian Health and Medical Program of the Department of Veterans Affairs 

(CHAMPVA) and VetSuccess programs, as well as the Veterans Online Application 

for enrolling in VA healthcare. 

VA and the Department of Defense (DOD) have broken new ground in the development and implementation of the Integrated Disability Evaluation System (IDES). 

This system supporting the transition of wounded, ill, and injured Servicemembers 

is fully operational and available to Servicemembers as of October 1, 2011. Because 

of the complexity of these cases, the Veterans Benefits Administration devotes four 

times the level of staffing resources to processing IDES cases than claims from other 

Veterans. VA has reduced its claims processing time in IDES from 186 days in February 2011 to 104 days in December 2011. The 2013 budget requests an additional 

$13.2 million and 90 FTE to support IDES enhancements. 

The DOD/VA team is further developing programs to enhance the transition of all 

Servicemembers to Veteran status. Together we are transforming the current Transition Assistance Program (TAP) from a series of discrete efforts to one that uses 

an outcome-based approach. This approach will be more integrated and, once complete will be mapped to the life cycle of every Servicemember, from recruitment 

through separation or retirement. In July 2011, VBA launched on-line TAP courseware, which provides the capability for Servicemembers to complete the course without attending the classroom session. VA and DOD also are collaborating on a policy 

for implementing mandatory TAP participation. 

VA will improve access to VA services by opening new or improved facilities closer 

to where Veterans live. The 2013 medical care budget request includes $792 million 

to open new and renovated healthcare facilities, including resources to support the 

activation of four new hospitals in Orlando, Florida; Las Vegas, Nevada; New Orleans, Louisiana; and Denver, Colorado. These new VA medical centers are projected 

to serve 1.2 million enrolled Veterans when they are operational. This budget also 

18 

includes an initiative to establish a national cemetery presence in eight rural areas 

where the Veteran population is less than 25,000 within a 75-mile service area. In 

addition to expanding access at fixed locations, VA is deploying an additional 20 Mobile Vet Centers in 2012 to increase access to readjustment counseling services for 

Veterans and their families in rural and underserved communities across the country. These new specialty vehicles will expand the existing fleet of 50 Mobile Vet 

Centers already in service by 40 percent. In 2011, Mobile Vet Centers participated 

in more than 3,600 Federal, state, and locally sponsored Veteran-related events. 

More than 190,000 Veterans and family members made over 1.3 million visits to VA 

Vet Centers in 2011. 

The Board of Veterans Appeals (BVA) leverages video conference technology to increase the capability of, and access to, video hearings to provide Veterans with more 

options for a hearing regarding their appeal. The VA is currently upgrading this 

video conference technology both at BVA and at VBA regional offices. In 2011, the 

number of video hearings increased from 3,979 to 4,355 or 9.4 percent. The Board 

is also working with VBA and VHA to allow video hearings to be held from more 

locations in the field, which will be more convenient for Veterans. Initially, the expanded video capability will be used to reduce the backlog of hearings and the time 

Veterans have to wait for them. 

We are working harder than ever to reach out to women Veterans. Women represent about eight percent of the total Veteran population. In recent years, the number of women Veterans seeking healthcare has grown rapidly and it will continue 

to grow as more women enter military service. Women comprise nearly 15 percent 

of today’s active duty military forces and 18 percent of National Guard and Reserves. For the estimated 337,000 women Veterans currently using the VA 

healthcare system, VA is improving their access to services and treatment facilities. 

The 2013 budget includes $403 million for the gender-specific healthcare needs of 

women Veterans, an increase of 17.5 percent over the 2012 level. 

VHA regularly updates its standards for improving and measuring Veterans’ access to medical care programs. In 2010, VHA implemented new wait time measures 

that assess performance meeting the new standard of providing medical appointments within 14 days of the desired date, replacing the previous 30-day desired-date 

standard. In 2011, 89 percent of medical care appointments for new patients occurred within 14 days of the desired date, an increase of 5 percentage points over 

the 2010 level of 84 percent. The President’s request for 2013 ensures we are able 

to continue to improve our performance in providing this service. 

Access improvements are central to VHAs new Patient-Aligned Care Teams 

(PACT) model. VA views appointments as a partnership. We are implementing a national initiative to reduce costly no-show appointments. Also, Veterans can manage 

appointments by visiting MyHealtheVet Web site, where they can view all of their 

pending appointments. In another effort to help Veterans make and keep appointments, VA is implementing a pilot program that offers child care to eligible Veterans seeking medical appointments at three VA medical centers in 2012 and 2013. 

The first of these facilities, the Buffalo VAMC, began providing services in October 2011. Each pilot site will be operated onsite by licensed childcare providers. 

Drop-in services will be offered free of charge to Veterans who are eligible for VA 

care and who are visiting a medical facility for an appointment. 

VA is taking full advantage of technology to expand access to its medical centers. 

In 2008, VA established a presence on Facebook with a single Veterans Health Administration (VHA) page. In 2009, VA established the Post-9/11 GI Bill Facebook 

page to raise awareness about the implementation of this new benefit program. 

With over 39,000 subscribers (‘‘or fans’’), this page serves as our primary ‘‘real-time’’ 

tool to communicate GI Bill news and directly interact with our clients. VA also 

launched a general VBA benefits page, which describes all of our services. VBA 

posts to its followers seven days a week and is followed in 18 different countries 

and 15 different languages. In June 2011, VA outlined a Department-wide social 

media policy that provides guidelines for communicating with VA online. By November 2011, VA had established Facebook pages for all 152 of its medical centers. This 

event marks an important milestone in our effort to transform how the Department 

communicates with Veterans and provides them access to healthcare and benefits. 

By leveraging Facebook, VA continues to embrace transparency and engage Veterans in a two-way conversation. VA currently has over 345,000 combined Facebook 

‘‘fans.’’ As of January 2012, the Department’s main Facebook page has over 154,000 

fans and its medical centers have a combined following of over 69,000. 

19 

ELIMINATING THE CLAIMS BACKLOG

To transform VA for the benefit of Veterans, we must streamline the claims processing system and eliminate the claims backlog. We are vigorously pursuing a 

claims transformation plan that will adopt near-term innovations and break down 

stubborn obstacles to providing Veterans the benefits they have earned. 

As we pursue a multi-focused approach to eliminate the claims backlog, workload 

in our disability compensation and pension programs continues to rise. VA has experienced a 48 percent increase in claims receipts since 2008, and we expect that the 

incoming claims volume will continue to increase by 4.2 percent in 2013, to 

1,250,000 claims from 1,200,000 in 2012. At the same time, Veterans are claiming 

many more disabilities, with Iraq and Afghanistan Veterans claiming an average of 

8.5 disabilities per claim—more than double the number of disabilities claimed by 

Veterans of earlier eras. As more than one million troops leave service over the next 

5 years, we expect our claims workload to continue to rise for the foreseeable future. 

In 2013, our goal is to ensure that no more than 40 percent of the compensation 

and pension claims in the pending inventory are more than 125 days old. While too 

many Veterans will still be waiting too long for the benefits they have earned, it 

does represent a significant improvement in performance over the 2012 estimate of 

60 percent of claims more than 125 days old, demonstrating that we are on the right 

path. 

VA is attacking the claims backlog through an aggressive transformation plan 

that includes initiatives focused on the people, processes, and technology that will 

eliminate the backlog. We are implementing a new standardized operating model in 

all our regional offices beginning this year that incorporates a case-management approach to claims processing. It establishes distinct processing lanes based on the 

complexity and priority of the claims and assigns employees to the lanes based on 

their experience and skill levels. Integrated, cross-functional teams work claims 

from start to finish, facilitating the quick flow of completed claims and allowing for 

informal clarification of claims processing issues to minimize rework and reduce 

processing time. More easily rated claims move quickly through the system, and the 

quality of our decisions improves by assigning our more experienced and skilled employees to the more complex claims. The new operating model also establishes an 

Intake Processing Center at every regional office, adding a formalized process for 

triaging mail and enabling more timely and accurate distribution of claims to the 

production staff in their appropriate lanes. 

VA is increasing the expertise of our workforce and the quality of our decisions 

through national training standards that prepare claims processors to work faster 

and at a higher quality level. Our training and technology skills programs will continue to deliver the knowledge and expertise our employees need to succeed in a 

21st Century workplace. We are establishing dedicated teams of quality review specialists at each regional office. These teams will evaluate decision accuracy at both 

the regional office and individual employee levels, and perform in-process reviews 

to eliminate errors at the earliest possible stage in the claims process. Personnel 

trained by our national quality assurance staff comprise the quality review teams 

to assure local reviews are consistently conducted according to national standards. 

Using ‘‘Design Teams,’’ VBA is conducting rapid development and testing of process changes, automated processing tools, and innovative workplace incentive programs. The first Design Team developed a method to simplify rating decisions and 

decision notification letters that was implemented nationwide in December 2011. 

This new decision notification process streamlines and standardizes the development and communication of claims decisions. This initiative also includes a new employee job-aid that uses rules-based programming to assist decisionmakers in assigning an accurate service-connected evaluation. VBA’s Implementation Center, established at VBA headquarters as a program management office, streamlines the 

process of innovation to ensure that new ideas are approved through a governance 

process. This allows us to focus on initiatives that will achieve the greatest gains. 

VA continues to promote the Fully Developed Claims (FDC) Program. We believe 

utilization of the FDC Program will significantly increase as a result of the public 

release last month of 68 more Disability Benefits Questionnaires (DBQs), bringing 

the total number of DBQs publically available to 71. DBQs are templates that solicit 

the medical information necessary to evaluate the level of disability for a particular 

medical condition. Currently used by Veterans Health Administration examiners, 

the release of these DBQs to the public will allow Veterans to take them to their 

private physicians, facilitating submission of a complete claims package for expedited processing. VA plans an aggressive communications strategy surrounding the 

release of these DBQs that will promote the FDC program. We also continue to 

20 

work with the VSO community to identify ways to boost FDC program participation 

and better inform and serve Veterans and their advocates. 

This year VA is also beginning national implementation of our new paperless 

processing system, the Veterans Benefits Management System (VBMS). We are implementing VBMS using a phased approach that will have all regional offices on the 

new system by the end of 2013. We will continue to add and expand VBMS 

functionality throughout this process. Establishment of a digital, near-paperless environment will allow for greater exchange of information and increased transparency to Veterans, our workforce, and stakeholders. Increased use of state-of-theart technology plays a major role in enabling VA to eliminate the claims backlog 

and redirect capacity to better serve Veterans and their families. Our strategy includes active stakeholder participation (Veterans Service Officers, State Departments of Veterans Affairs, County Veterans Service Officers, and Department of Defense) to provide digitally ready electronic files and claims pre-scanned through online claims submission using the eBenefits web portal. VBA has aggressively promoted the value of eBenefits and the ease of enrolling into the system. The 2013 

budget invests $128 million in VBMS. 

ENDING VETERAN HOMELESSNESS

The Administration is committed to ending homelessness among Veterans by 

2015. Between January 2010 and January 2011 homelessness declined by 12 percent, keeping VA on track to meet the goal of ending Veteran homelessness in 2015. 

The VA’s Homeless Veteran Registry is populated with over 400,000 names of current and formerly homeless Veterans who have utilized VA’s Homeless Programs— 

allowing us to better see the scope of the issues so we can more effectively address 

them. 

In the 2013 Budget, VA is requesting $1.352 billion for programs that will prevent 

and treat Veteran homelessness. This represents an increase of $333 million, or 33 

percent over the 2012 level. This budget will support our long-range plan to eliminate Veteran homelessness by reducing the number of homeless Veterans to 35,000 

in 2013 by emphasizing rescue and prevention. 

To get Veterans off the streets and into stable environments, VA’s Grant and Per 

Diem Program awards grants to community-based organizations that provide transitional housing and support services. VA’s goal is to serve 32,000 homeless Veterans 

in this program in 2013. Transitional housing is also provided through the 

Healthcare for Homeless Veterans program. Permanent housing is achieved with 

Housing Choice Vouchers in the Department of Housing and Urban Development 

(HUD)-VA Supportive Housing (HUD-VASH) Program, and by 2013 VA plans to 

provide case management support for the nearly 58,000 HUD Housing Choice 

vouchers available to assist our most needy homeless Veterans. 

Culminating two years of work to end homelessness among Veterans, the Building 

Utilization Review and Repurposing (BURR) initiative helped identify unused and 

underused buildings and land at existing VA property with the potential for 

repurposing to Veteran housing. The BURR initiative supports VA’s goal of ending 

Veteran homelessness by identifying excess VA property that can be repurposed to 

provide safe and affordable housing for Veterans and their families. As a result of 

BURR, VA began developing housing opportunities at 34 nationwide locations for 

homeless or at-risk Veterans and their families using its Enhanced Use Lease 

(EUL) authority (now expired). The housing opportunities developed through BURR 

will add approximately 4,100 units of affordable and supportive housing to the 

projects already in operation or under construction, for an estimated total of 5,400 

units. 

Although the Department’s Enhanced Use Lease authority has expired, the Administration will work with Congress to develop future legislative authorities to enable the Department to further repurpose the properties identified by the BURR 

process. Beyond reducing homelessness among our Veterans, additional opportunities identified through BURR may include housing for Veterans returning from Iraq 

and Afghanistan, assisted living for elderly Veterans, and other possible uses that 

will enhance benefits and services to Veterans and their families. 

Of all claimants served by the Veterans Benefits Administration (VBA), homeless 

Veterans represent our most vulnerable population and require specialized care and 

services. The 2013 budget requests $21 million for the Homeless Veterans Outreach 

Coordinator (HVOC) initiative, which would provide an additional 200 coordinators 

nationwide to expedite disability claims; acquire housing and prevent Veterans from 

losing their homes; expedite access to vocational training and job opportunities; and 

resolve legal issues at regional justice courts. These new case managers would significantly improve outcomes on behalf of the Nation’s homeless Veterans. For examVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00026 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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ple, the initiative would improve the timeliness of disability claims decisions for 

homeless and at-risk Veterans by reducing the claims processing times by nearly 

40 percent between 2011 and 2015. 

In 2011, VHA hired 366 (or 90 percent of 407 total positions) homeless or formerly 

homeless Veterans as Vocational Rehabilitation Specialists to provide individualized 

supported employment services to unemployed homeless Veterans through the 

Homeless Veterans Supported Employment Program. Recent initiatives to increase 

employment of Veterans in Federal and other public-sector jobs will help to reduce 

homelessness and also ensure their families are supported. On January 18, 2012, 

VA hosted a career fair for Veterans in Washington, DC. Over 4,000 Veterans attended this event to explore and apply for thousands of public and private sector 

job opportunities. 

The VA also helps Veterans obtain employment with education and training assistance. The National Cemetery Administration (NCA) is helping to provide employment opportunities for homeless Veterans through a new, paid Apprenticeship 

Training Program serving Veterans who are homeless or at risk of homelessness. 

The program will be based on current NCA training requirements for positions such 

as Cemetery Caretakers and Cemetery Representatives. Veterans who successfully 

complete the program at national cemeteries will be guaranteed full-time permanent 

employment at a national cemetery or may choose to pursue employment in the private sector. The Veterans Retraining Assistance Program is a joint effort with VA 

and the Department of Labor to provide 12 months of retraining assistance. The 

program is limited to 54,000 participants from October 1, 2012, through March 31, 

2014. Education and training assistance are preventive programs. 

Other preventive services programs include the Supportive Services for Veteran 

Families, which provides rapid case management and financial assistance, coordinated with community and mainstream resources, to promote housing stability. In 

time, VA will transition its homeless efforts primarily to prevention. Through coordinated partnerships with other Federal and local partners and providers, VA will assist at risk Veterans in maintaining housing, accessing supportive services that promote housing stability, and identifying the resources to rapidly re-house Veterans 

and their dependents if they should fall into homelessness. This shift to increased 

preventive efforts will require us to be much more knowledgeable about the causes 

of Veterans’ homelessness, about the details of our current homeless and at-risk 

Veteran populations, and about creating action plans that serve Veterans at the individual level. 

MEDICAL CARE PROGRAM

The 2013 budget requests $52.7 billion for healthcare services to treat over 6.33 

million unique patients, an increase of 1.1 percent over the 2012 estimate. Of those 

unique patients, 4.4 million Veterans are in Priority Groups 1–6, an increase of 

more than 64,000 or 1.5 percent. Additionally, VA anticipates treating over 610,000 

Veterans from the conflicts in Iraq and Afghanistan, an increase of over 53,000 patients, or 9.6 percent, over the 2012 level. 

Medical Care in Rural Areas 

The delivery of healthcare in rural areas faces major challenges, including a 

shortage of healthcare resources and specialty providers. In 2011, we obligated $18.8 

billion to provide healthcare to Veterans who live in rural areas. Some 3.6 million 

Veterans enrolled in the VA healthcare system live in rural or highly rural areas 

of the country; this represents about 42 percent of all enrolled Veterans. For that 

reason, VA will continue to emphasize rural health in our budget planning, including addressing the needs of Native American Veterans. The 2013 budget continues 

to invest in special programs designed to improve access and the quality of care for 

Veterans residing in rural areas. For example, in the remote, sparsely populated 

areas of Montana, Utah, Wyoming and Colorado, VA has supported the development 

and expansion of a network-wide operational telehealth infrastructure that supports 

a virtual intensive care unit, tele-mental health services, and primary care and specialty care to 67 fixed and mobile sites. Again, IT investment is the foundation of 

our work in all of these areas. 

In rural areas with larger populations, funding supports the opening of new rural 

clinics, such as the one located in Newport, Oregon, which serves over 1,200 Veterans. This clinic is a unique partnership between VA and the local Lincoln County 

government. The county government provides clinical space, equipment and supplies, while VA funds the salaries for the primary care and mental health providers. 

22 

Mental Healthcare 

The budget requests $6.2 billion for mental health programs, for an increase of $312 million over the 2012 level of $5.9 billion. VA is increasing outreach opportunities to connect with and treat Veterans and their families in new, innovative ways. 

In April 2011, VA launched the first in a series of mobile smartphone applications, 

the PTSD Coach. It provides information about PTSD, self-assessment and symptom 

management tools, and information on how to get help. VA developed this technology in collaboration with DOD and with input from Veterans, who let the development team know what they did and did not want in the application (app). As of 

the end of 2011, the app had just over 41,000 downloads in 57 countries. In addition, VA is developing PTSD Family Coach that will complement the Coaching into 

Care national call center, which provides support to family members of Veterans. 

In 2011, VA also launched Make the Connection, a national public awareness campaign for Veterans and their family members to connect with other Veterans to 

share common experiences, and ultimately to connect them with information and resources to help with the challenges that can occur when transitioning from military 

service to civilian society. This is an important effort in breaking down the stigma 

associated with mental health issues and treatment. The campaign’s central focus 

is a Web site, www.MakeTheConnection.net, featuring numerous Veterans who have 

shared their experiences, challenges, and triumphs. It offers a place where Veterans 

and their families can view the candid, personal testimonials of other Veterans who 

have dealt with and are working through a variety of common life experiences, dayto-day symptoms, and mental health conditions. The Web site also connects Veterans and their family members with services and resources they may need. 

Long-term Medical Care 

As the Veteran population ages, VA will expand its provision of both institutional 

and non-institutional Long-Term Care services. These services are designed not just 

for the elderly, but for Veterans of all ages who have a serious chronic disease or 

disability requiring ongoing care and support, including those returning from Iraq 

and Afghanistan suffering from traumatic injuries. Veterans can receive long-term 

care services at home, at VA medical centers, or in the community. In 2013, the 

Long-Term Care budget request is $7.2 billion. VA will continue to provide longterm care in the least restrictive and most clinically appropriate settings by providing more non-institutional care closer to where Veterans live. This budget supports an increase of 6 percent in the average daily census in non-institutional longterm care programs in 2013, resulting in a total average daily census of approximately 120,100. 

MEDICAL RESEARCH

Medical Research is being supported with $583 million in direct appropriations in 

2013, an increase of nearly $2 million above the 2012 level. In addition, approximately $1.3 billion in funding support for medical research will be received from 

VA’s medical care program and through Federal and non-Federal grants. Projects 

funded in 2013 will support fundamentally new directions for VA research. Specifically, research efforts will be focused on supporting development of New Models of 

Care, 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 2013 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. The pilot phase of MVP was 

launched in 2011. Surveys were sent to 17,483 Veterans and approximately 20 percent of those then completed a study visit and provided a small blood sample. By 

the end of 2013, the goal is to enroll at least 150,000 participants in the program. 

Like with so much of VA research, the impact will be felt not just through improved 

care for Veterans but for all Americans, as well. 

VETERANS BENEFITS ADMINISTRATION

The 2013 budget request for the general operating expenses of the Veterans Benefits Administration (VBA) is $2.2 billion, an increase of $145 million, or 7.2 percent, 

over the 2012 enacted level. With the support of Congress, we have made great 

strides in implementing our comprehensive plan to transform the disability claims 

process. This budget sustains our investments in people, processes, and technology 

23 

in order to eliminate the claims backlog by 2015. In addition, this budget request 

includes funding to support the administration of other VBA business lines. 

Post-9/11 and other Education Programs 

The Post-9/11 GI Bill program provides every returning servicemember with the 

opportunity to obtain a college education. As expected, the Post-9/11 GI Bill program 

has become the most used education benefit that VA offers. Just as with the original 

GI Bill, today’s program provides Veterans with tools that will help them contribute 

to an economically vibrant and strong America. In 2013, VA estimates that 606,300 

individuals will participate in this benefit program. The timeliness and accuracy of 

processing Post-9/11 GI Bill claims continues to improve. From 2010 to 2011, VA 

processing times for original and supplemental claims improved by 15 days (from 

39 to 24 days) and 4 days (from 16 to 12 days), respectively. Over the last two years, 

VA has successfully deployed a new IT system to support processing of Post-9/11 

GI Bill education claims. With improved automation tools in place, VA will be able 

to begin reducing education benefit processing staff in 2013. 

Vocational Rehabilitation and Employment (VR&E) 

The VR&E program is designed to assist disabled Servicemembers in their transi- tion to civilian life and obtaining employment. The budget request for 2013 is $233.4 

million or a 14.2 percent increase from 2012. The number of participants in the program increased to 107,925 in 2011 and is expected to grow to over 130,000 by 2013. 

VA is also expanding VR&E counseling services available at IDES sites to assist 

Servicemembers with disabilities in jumpstarting their transition to civilian employment. In 2012, VA will assign 110 additional counselors to the largest IDES sites, 

serving an additional 12,000 wounded, ill, and injured Servicemembers. Funds requested in 2013 will support further expansion, adding 90 more counselors to the 

program. 

In 2009, VA established a pilot program called VetSuccess on Campus to provide 

outreach and supportive services to Veterans during their transition from the military to college, ensuring that their health, education and benefit needs are met. By 

the end of 2012, the program will be operational on 28 campuses. The 2013 budget 

includes $8.8 million to expand the program to a total of 80 campuses serving approximately 80,000 Veterans. 

NATIONAL CEMETERY ADMINISTRATION

VA honors our fallen soldiers with final resting places that serve as lasting tributes to commemorate their service and sacrifice to our Nation. The 2013 budget includes $258 million in operations and maintenance funding for the National Cemetery Administration (NCA). In 2013, NCA estimates that interments will increase 

by 1,500 (1.3 percent) over 2012. Cemetery maintenance workload will also continue 

to increase in 2013 over the 2012 levels: the number of gravesites maintained will 

increase by 82,000 (2.5 percent) and the number of developed acres maintained will 

increase by 138 (1.6 percent). 

The 2013 Budget will allow VA to provide more than 89.6 percent of the Veteran 

population, or 19.1 million Veterans, a burial option within 75 miles of their residence by keeping existing national cemeteries open, establishing new State Veterans 

cemeteries, as well as increasing access points in both urban and rural areas. VA’s 

first grant to establish a Veterans cemetery on Tribal trust land, as authorized in 

Public Law 109–461, was approved on August 15, 2011. This cemetery will provide 

a burial option to approximately 4,036 unserved Rosebud Sioux Tribe Veterans and 

their families residing on the Rosebud Indian Reservation near Mission, South 

Dakota. 

NCA provides an unprecedented level of customer service, which has been 

achieved by always striving for new ways to meet the burial needs of Veterans. In 

2011, NCA initiated an independent study of emerging burial practices including 

‘‘green’’ burial techniques that may be appropriate and feasible for planning purposes. The study will also include a survey of Veterans to ascertain their preferences 

and expectations for new burial options. The completed study will provide comprehensive information and analysis for leadership consideration of new burial 

options. 

CAPITAL INFRASTRUCTURE

A total of $1.14 billion is requested in 2013 for VA’s major and minor construction 

programs, an increase of 6.3 percent over the 2012 enacted level. VA is also proposing legislation in 2013 that would enhance the ability of the Department to collaborate with other Federal Departments and Agencies, including the Department 

of Defense (DOD) on joint capital projects. This legislative proposal would allow apVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00029 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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propriated funds to be transferred among Federal agencies to effectively plan and 

design joint projects when determined to be cost-effective and improve service delivery to Veterans and Servicemembers. 

Major Construction 

The major construction request in 2013 is $532 million in new budget authority. 

The major construction request includes funding for the next phase of construction 

for four medical facility projects in Seattle, WA; Dallas, TX; Palo Alto, CA; and St. 

Louis (Jefferson Barracks), MO. Additionally, funds are provided to remove asbestos 

from Department-owned buildings, improve facility security, remediate hazardous 

waste, fund land acquisitions for national cemeteries, and support other construction related activities. 

Minor Construction 

In 2013, the minor construction request is $608 million. It would provide for constructing, altering, extending and improving VA facilities, including planning, assessment of needs, architectural and engineering services, and site acquisition and 

disposition. It also includes $58 million to NCA for land acquisition, gravesite expansions, and columbaria projects. NCA projects include irrigation and drainage improvements, renovation and repair of buildings, and roadway repairs. 

INFORMATION TECHNOLOGY

The 2013 budget requests $3.327 billion for Information Technology (IT), an in- crease of $216 million over the 2012 enacted level of $3.111 billion. Veterans and 

their families are highly dependent upon the effective and efficient use of IT to deliver benefits and services. In this day and age, every doctor, nurse, dentist, claims 

processor, cemetery interment scheduler, and administrative employee in the VA 

cannot do his or her jobs without adequate IT support. Approximately 80 percent 

of the IT budget supports the direct delivery of healthcare and benefits to Veterans 

and their families. 

We have made dramatic changes in the way IT projects are planned and managed 

at the VA. As described earlier in this testimony, the Project Management Accountability System (PMAS) has reduced risks by instituting effective monitoring and 

oversight capabilities and by establishing clear lines of accountability. Additionally, 

we have strengthened security standards in software development and established 

an Identity Access Management program that allows VA to increase on-line services 

for Veterans. 

The IT infrastructure supports over 300,000 employees and about 10 million Veterans and family members who use VA programs, making it one of the largest consolidated IT organizations in the world. This budget request includes nearly $1.8 billion for the operation and maintenance of the IT infrastructure, the backbone of VA. 

A sound and reliable infrastructure is critical to support the VA workforce and all 

of our facilities nationwide in the effective and efficient delivery of healthcare and 

benefits to Veterans. It is also critical that we support new facility activations, our 

major transformational initiatives, and the increased usage of VA services while 

maintaining a secure IT environment to protect Veteran sensitive information. 

Improving services for Veterans and their beneficiaries requires using advanced 

technologies. For example, VA will continue to utilize MyHealtheVet to improve 

access to information on appointments, lab tests and results, and reduce adverse reactions to medications. The 2013 budget continues an investment strategy of funding the development of new technologies that will have the greatest benefit for 

Veterans. 

The delivery of high-quality medical care to an increasing number of Veterans is 

highly dependent upon adequate IT funding. VA’s health IT investments have, and 

will continue, to greatly improve the delivery of medical care with regards to quality, patient safety and cost effectiveness. This includes transformation of mental 

health service delivery through IT enabled self-help, providing data and IT analytical tools for VA’s research community, and creating an open exchange for collaboration and innovation in the development of clinical software solutions. Additionally, 

initiatives focused on ‘‘Care at a Distance’’ are heavily reliant on technology and require a robust IT infrastructure. 

The 2013 budget request for integrated Electronic Health Record (iEHR) is $169 

million. The iEHR is a joint initiative with DOD to modernize and integrate electronic health records for all Veterans to a single common platform. We must take 

full advantage of this historic opportunity to deliver maximum value through joint 

investments in health IT. When DOD and VA healthcare providers begin accessing 

a common set of health records, iEHR will enhance quality, safety, and accessibility 

of healthcare—setting the stage for more efficient, cost-effective healthcare systems. 

25 

In 2013, we plan to leverage open source development to foster innovation and 

speed delivery for a pharmacy and immunization solution. 

An integral part of iEHR is the Virtual Lifetime Electronic Record (VLER), which 

is enabling VA transformation. VLER creates information interoperability between 

DOD, VA, and the private sector to promote better, faster and safer healthcare and 

benefits delivery for Veterans. The 2013 budget will ensure continued delivery of enhanced clinical and benefits information connections and build increased capability 

to support women’s healthcare. Additionally, we will develop a modern memorial affairs system for the dynamic mapping of gravesite locations. The 2013 budget request for VLER is $52.9 million. In addition, the 2013 budget requests $92 million in the IT appropriation for 

VBMS. As noted earlier, the VBMS initiative is the cornerstone of VA’s claims 

transformation strategy. It is a comprehensive solution that integrates a business 

transformation strategy to address people and processes with a paperless claims 

processing system. Achieving paperless claims processing will result in higher quality, greater consistency and faster claims decisions. Nationwide deployment of 

VBMS is on target to begin in 2012 with completion in 2013. 

This budget also includes funding to transform the delivery of Veterans’ benefits. The 2013 IT budget requests $111 million for the Veterans Relationship Management (VRM) initiative. We will use this funding to improve communications between 

Veterans and VA that occur through multiple channels—phone, web, mail, social 

media, and mobile apps. It will also provide new tools and processes that increase 

the speed, accuracy and efficiency of information exchange, including the development of self-service technology-enabled interactions to provide access to information 

and the ability to execute transactions at the place and time convenient to the Veteran. In 2013, Veterans will see enhanced self-service tools for the Civilian Health 

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

VetSuccess programs, as well as the Veterans Online Application for enrolling in VA 

healthcare. 

LEGISLATIVE PROGRAM

VA has outlined in this budget a strong legislative program that will advance our 

mission to end Veteran homelessness and help Wounded Warriors by improving our 

system of grants for home alterations so Veterans can better manage disabilities 

and live independently. Our legislative proposals would also make numerous other 

common-sense changes that improve our programs, including provisions that will reduce payment complexities for both our student Veterans and the schools using the 

Post-9/11 GI Bill. 

SUMMARY

VA is the second largest Federal department with over 316,000 employees. Our 

workforce includes physicians, nurses, counselors, claims processors, cemetery 

groundskeepers, statisticians, engineers, IT specialists, police, and educators. They 

serve Veterans at our hospitals, community-based outpatient clinics, Vet Centers, 

mobile Vet Centers, claims processing centers, and cemeteries. Through the resources provided in the President’s 2013 Budget, VA is enabled to continue improving the quality of life for our Nation’s Veterans and their families and to completing 

the transformation of the department that we began in 2009. Thanks to the President’s leadership and the solid support of all Members of the Congress, we have 

made huge strides in our journey to provide all generations of Veterans the best 

possible care and benefits that they earned through selfless service to the Nation. 

We are committed to continue that journey, even as the numbers of Veterans will 

increase significantly in the coming years, through the responsible use of the resources provided in the 2013 budget and 2014 advance appropriations requests. 

RESPONSE TO PREHEARING QUESTIONS SUBMITTED BY HON. PATTY MURRAY TO

U.S. DEPARTMENT OF VETERANS AFFAIRS

HEALTH CARE

Question 1. As OEF/OIF/OND veterans age over the next 60 years, what levels 

of funding will be needed to maintain current health care service levels? 

a. What portion of this is expected to be the result of increased demand among 

veterans versus veterans’ becoming more sick and having more complex needs? 

Response. The 2011 VA Enrollee Health Care Projection Model (base year FY 

2010), which supports the VA 2013 budget and 2014 advance appropriations request 

for medical care, estimates that the total number of military Servicemembers deVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00031 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
26 

ployed in support of OEF/OIF/OND will reach 2.4 million in FY 2015, with the last 

separation from active duty occurring in FY 2042. As of 2010, there were 708,000 

OEF/OIF/OND enrollees. Enrollment is expected to increase 62 percent by 2014, 

double to 1.46 million by 2020, and increase to 1.7 million by 2031. In 2013, VA 

has budgeted nearly $3.3 billion for this group of Veterans. 

The Model reflects the unique utilization patterns of OEF/OIF/OND enrollees. For 

example, OEF/OIF/OND Veterans have an increased need for hearing and speech 

exams, dental services, physical medicine, prosthetics, outpatient psychiatric and 

substance abuse treatment, and residential rehabilitation. In addition, as this population ages over the Model’s 20-year horizon, the projections will reflect the higher 

utilization of health care services associated with older populations. For example, 

the 2011 Model is projecting an increase of over 200 percent in outpatient mental 

health visits for this population by FY 2020. 

Question 2. What impact will the end of the war in Iraq, the drawdown of troops 

in Afghanistan, and the reduction of forces across the military have on VA? What 

does the FY 2013 budget do to prepare VA for these impacts, and how is the Department working collaboratively with DOD to prepare for these changes? 

Response. The Department of Veterans Affairs (VA) works closely with the Department of Defense (DOD) at the local and Departmental levels to meet the needs 

of redeploying and transitioning Servicemembers and Veterans. DOD is still developing operational plans and details for how they intend to reduce forces over the 

next five years. VA is aware of the potential impact the force reduction may have 

on VA providing benefits and services, especially at the points of transition from active duty to Veteran status. VA has been actively collaborating with DOD on this 

issue from the Secretarial level on down, in order to identify any new requirements 

from a resource or program perspective. 

In addition to this collaboration with DOD, VA has and will continuously evaluate 

overall mission requirements through efforts such as: periodic refresh of the VA 

Strategic Plan; execution of planning, programming, budgeting, and evaluation 

(PPBE) processes through the VA Office of Corporate Analysis and Evaluation to 

support strategic decisionmaking and align resources to achieve VA priorities for 

Veterans; and leveraging robust data analysis and predictive modeling capabilities 

through the VA Office of Data Governance and Analysis to support strategic and 

programmatic planning, as well as policy development. 

The VA budget supports the requirements and needs for the Department in fiscal 

2013 and the advanced appropriation request for health care in fiscal 2014. The FY 

2013 budget includes the impact of the end of the war in Iraq, and the drawdown 

of troops in Afghanistan, but it does not include the impact of the reduction in the 

size of DOD troop strength because that specific data is not yet available. Based 

upon VA’s current analysis, the Iraq and Afghanistan drawdown and the DOD force 

reductions will have a negligible impact on the FY 2013 budget. 

Question 3. Enrollment and utilization projections. 

a. Considering what VA has learned from the addition of a reliance metric last 

year to the Enrollee Health Care Projection Model, and considering CBO’s projection 

that unemployment will be 8.2 percent at the end of 2012, what does the Department project will be the change in reliance for FY 2013 and beyond? 

Response. Demand for VA health care increased during the economic downturn, 

primarily reflected by a small increase in Veteran enrollment, a small increase in 

current enrollees moving into Priority 5 or Priority 7, and a significant increase in 

enrollee reliance on VA health care. An estimated $1.5 billion is now embedded in 

the base year FY 2010 expenditures as a result of the economic downturn from FY 

2008 through FY 2010. 

The 2011 VA Enrollee Health Care Projection Model’s starting point (FY 2010) reflects the high point of the economic downturn. Because demand for VA health care 

is correlated with changes in economic conditions, the increase in demand associated 

with the economic downturn through 2010 is expected to decline as unemployment 

rates return to normal levels. 

The 2011 Model uses the Office of Management and Budget’s (OMB) November 2011, economic assumptions (unemployment rate forecast) for FY 2011 through 

FY 2021. OMB forecasts that the rate will come down from the FY 2010 high of 

9.7 percent to 8.7 percent in FY 2013. 

Background: The economic downturn mostly impacted Veterans in Priorities 5 

and 7 under age 65. From 2008 through 2010 (the base year in the 2011 Model): 

• An estimated 50,000 more Veterans enrolled than anticipated in a stable economic environment. Enrollment in Priority 5 increased by an estimated 30,000 due 

to changes in enrollee transition between priorities. 

27 

• Responses to the VHA Enrollee Surveys indicate that outpatient reliance increased from 47 percent to 51 percent from 2007 to 2009 for enrollees under age 

65. 

b. Please discuss how the concerns raised by GAO in their report GAO–11–205, 

Veterans’ Health Care: VA Uses a Projection Model to Develop Most of Its Health 

Care Budget Estimate to Inform the President’s Budget Request, were addressed in 

the development of the FY 2013 budget and the FY 2014 advance appropriation request. 

Response. In the subject GAO report (GAO–11–205, January 2011), the GAO described how the VA develops the budget estimates for its health care program. The 

GAO report did not contain any recommendations and did not raise any concerns. 

The process described in the subject report was essentially the same process that 

was used to develop the FY 2013 budget and the FY 2014 advance appropriation 

request 

Question 4. How much money has been obligated thus far for the caregivers program (Title I—Caregiver Support, of Public Law 111–163)? Please provide a breakdown of that funding. 

a. How many veterans are currently enrolled in the program 

Response. As of February 14, 2012, 3,113 approved primary Family Caregivers 

were enrolled in VA’s Program of Comprehensive Assistance for Family Caregivers. 

In order to implement Title I of Public Law 111–163, VA has obligated the amounts 

on the chart below. 

FY 2011 1st Qtr FY 2012 

Instruction and Training ................................................................................................. $3,933,563 $81,422 

Travel, lodging, and per diem expensed to attend training .......................................... $141,832 $24,122 

Lodging and subsistence for VA appointments ............................................................. $60,784 $56,284 

Respite care .................................................................................................................... $1,308,503 $249,734 

Ongoing technical support ............................................................................................. $10,687,172 $3,146,041 

Mental Health ................................................................................................................. $6,600 $9,108 

Monthly stipend .............................................................................................................. $11,002,530 $16,568,583 

CHAMPVA ......................................................................................................................... $0 $201,783 

Total ....................................................................................................................... $27,140,984 $20,337,077 

The total cost of Sections 101–104 in 2011 was $30.8 million. This includes additional requirements such as the Caregiver Web site, and the implementation of 

other evidence based practices and staffing. 

Question 5. What steps have been taken by VA to increase collections for the 

MCCF over the past year, including any efforts to improve identification of billable 

services? Does the FY 2013 budget request continue to support efforts to increase 

collections and improve identification of billable services, and if so how? 

Response. VA has taken multiple steps to increase collections for the Medical Care 

Collections Fund (MCCF) focused on identifying more billable opportunities including: 

• Deployment of Consolidated Patient Account Centers (CPACs): VA is transitioning billing and collection activities from individual medical centers to seven (7) regionally aligned centers of excellence in an effort to capture more billable opportunities. This business model demonstrates efficiency through standardized business 

processes, performance accountability, and stringent internal controls to ensure consistency. Four (4) CPACs are fully operational—Mid Atlantic (Asheville, NC), Mid 

South (Smyrna, TN), North Central (Madison, WI) and Florida (Orlando, FL). Three 

(3) CPACs are being deployed in Fiscal Year 2012—West (Las Vegas, NV), Central 

Plains (Leavenworth, KS) and North East (Lebanon, PA). CPACs are being deployed 

one year earlier than mandated by Public Law 110–387. 

• Recoveries from Fee Care: VA can bill third party payers for Veterans receiving 

non-service-connected Fee care with insurance. In an effort to enhance charge capture for these services, VHA has deployed reengineered business processes, provided 

staff training and developed a process to improve performance in key areas. 

• Revenue Cycle Enhancement Teams (RCET): RCET visits identify opportunities 

to improve billable opportunities at lower performing facilities by developing action 

plans and tracking follow up until completion. Over the past year, more than 30 visits have been completed across the organization by cross functional teams of experts. 

28 

• Enhancing Electronic Business Capacity: VA continues to enhance electronic 

business transaction capabilities that result in faster payments. Specifically, VA increased the number of pharmacy claims transmitted electronically by 43% over the 

last year and the amount of revenue collected through electronic funds transfer by 

nearly 30%. 

With regard to FY 2013, VA believes the budget estimate of $2.966 billion for collections, which represents a $199M increase, or 7.2% compared to FY 2012, supports 

efforts to increase collections and improve identification of billable services. This increase includes $125 million in collections contingent on new authorities found in 

VA’s submitted legislative proposals that we hope Congress will enact. 

Question 6. There have been system-wide shortcomings in human resources functions including a slow hiring process, downgrading of VA employees, and others. 

a. What steps has the Department taken to identify problems in: 

i. local human resources operations; and 

ii. the ability of regional or national-level human resources to create and enforce policy and conduct oversight? 

b. Please also provide the results of any reviews or evaluations of these offices 

or functions. 

c. Please detail progress on any efforts to correct deficiencies that have been identified, including accomplishments to-date and offices or personnel responsible. 

Response. The VA human resources structure includes centralized human resources functions of strategic planning, policy development, and oversight and compliance as well as decentralized human resources operational functions. Operational 

functional authorities that have been decentralized include appointing authority, authority to process and authenticate notifications of personnel actions, and authority 

to effect management-approved employment actions on behalf of officials, employees, 

and facilities for which service is provided. With decentralized operational functions, 

each Administration Head (i.e., the Under Secretary for Benefits, Under Secretary 

for Memorial Affairs, and Under Secretary for Health) is delegated the authority to 

perform H.R. operations for all employees within their respective organizations. The 

Veterans Health Administration (VHA) also provides operational support for the Office of Information and Technology. H.R. operations for all other staff offices are performed in VA Central Office. VA’s decentralized operating authority allows for local 

decisions that are consistent with statutory and regulatory requirements but affords 

flexibility. 

Although H.R. operations are largely decentralized, controls are in place to ensure 

oversight and accountability. VA’s Accountability System, our official framework for 

conducting H.R. reviews, is designed to promote continuous improvement, including 

corrective action to address weaknesses/deficiencies and merit system violations. All 

accountability activities are reviewed by the Office of Human Resources Management (OHRM) and appropriate management entities to determine and implement 

needed changes to VA’s human capital goals and objectives, H.R. programs and 

processes, and the accountability system itself. Case violations involving potential 

prohibited personnel practices are referred to appropriate oversight agents—Office 

of Inspector General, Office of Special Counsel, Office of Personnel Management 

(OPM), etc. Systemic concerns are referred to the Assistant Secretary for Human 

Resources and Administration for consideration for Department-wide action. 

a. What steps has the Department taken to identify problems in: i. local human 

resources operations; and ii. the ability of regional or national-level human resources to create and enforce policy and conduct oversight? 

Response. VA’s Directive 5024, Human Capital Management Accountability Systems establishes VA policies for human capital management (HCM) accountability 

systems, and outlines responsibilities for the conduct and review of Human Resources Management (HRM) program assessments. The VA HRM accountability program is the responsibility of top VA management, line managers, and human resources officials working together to ensure Federal and VA’s HRM programs, policies and delegated H.R. authorities are carried out and are in accord with merit systems principles, Title 5 and Title 38 provisions, or other applicable laws, rules and 

regulations related to human resources management. This is accomplished through 

OHRM’s guided accountability onsite reviews in a sampling of H.R. offices and the 

use of an Annual H.R. Self-Evaluation Instrument for all H.R. offices. The H.R. Self 

Evaluation of human capital helps measure VA’s performance against the human 

capital accountability and assessment framework, which has been developed by 

OPM. The H.R. Self-evaluation instrument exists to assist field facility Directors in 

conducting yearly, systematic, and internal facility H.R. self reviews. As part of the 

accountability program, each field station conducts an annual HRM self-evaluation 

29 

as an integral part of local management’s systematic internal review system, to include the separate Delegated Examining Unit (DEU) assessment at facilities where 

such units exist. Documentation used to prepare the self-evaluation is maintained 

for review during on-site visits. In addition to reviews by OHRM, the policy offices 

within OHRM monitor policy implementation. Also, through the Human Resources 

Academy, competency assessments, career mapping, and both strategic and technical human resources courses are leveraged to support human resources professionals. 

b. Provide the results of any reviews or evaluations of these offices or functions. 

Response. During 22 onsite assessments in fiscal year 2011, staff identified both 

required and recommended actions to enhance program effectiveness. In general, 

human resources professionals need to gain additional competencies to effectively 

partner and consult with management in accomplishing their organization’s mission. Overall, assessed facilities were generally cited for administrative and processrelated problems. Compliance errors are mainly the result of poor procedural or administrative processes and/or inattention to detail. 

c. Detail progress on any efforts to correct deficiencies that have been identified, 

including accomplishments to-date and offices or personnel responsible. 

Response. Facilities report to OHRM on required actions 20 days after receiving 

the report and every 60 days thereafter. In addition, H.R. offices are required to outline actions proposed and taken to close each required and recommended action and 

provide evidence of how they are closing each action. OHRM continues to formally 

verify closure of the required actions and recommendations stemming from its onsite assessment visits. Key findings of site visit assessments, including systemic 

compliance issues, are reported to local management and VA leadership, in order 

to assess and promote continuous improvement in the overall HC program. 

Under the VHA H.R. Delivery Model, which was approved July 14, 2010, Veterans 

Integrated Service Network (VISN) Human Resources Officers assess gaps in 

human resources processes and implement initiatives to reduce gaps identified. 

Also, VHA established Consolidated Classification Units (CCU) in 2010; these CCUs 

are providing oversight and ensuring consistency on all classification actions at VHA 

medical facilities. To date, 14 CCUs are in place with the remaining 7 CCUs to be 

established in the near future. A National Classification Strategy is underway and 

work is ongoing to establish a National VHA Classification Office. In addition, 

Workforce Management and Consulting (WMC) has initiated national classification 

conference calls that include all VISN classification specialists. This forum addresses all national and regional classification issues and will ensure consistency and reduced variation across VHA. In January 2011, WMC formed a team of H.R. professionals that are collaborating and coordinating with each VISN H.R. Officer to visit 

VHA Medical Centers to review each H.R. program and to provide hands-on consultation and operational guidance. To ensure compliance with Merit System Principles, WMC conducted onsite reviews at all VISN 17 facilities and reviewed classification actions performed by the CCU and found that current actions are in compliance with OPM classification standards. 

Question 7. Please discuss the level of funding requested in the FY 2013 budget 

to continue implementation of the Amputee System of Care. Also, please discuss the 

progress the Department has made in implementing the Amputee System of Care 

to date including: 

a. Number and type of personnel, as well as existing vacancies. 

b. Operational status of each site or team, and expected date of full operational 

capability for those sites or teams that have not yet achieved that status. 

c. Discussion of benefits to care or operational efficiencies expected as a result of 

providing more prosthetic care by the Department. 

Response. Establishment of the Amputation System of Care (ASoC) began in 2009 

and all sites of care are fully operational, although the system of care continues to 

evolve and mature. The vision of the ASoC is to be a world leader in providing lifelong amputation care. 

There is a total of 58 FTE dedicated to the Amputation System of Care; currently, 

there are 11 staff vacancies. The number of Amputation Clinic teams has grown by 

over 10 percent since the initial rollout in 2009, and amputation rehabilitation care 

is now available at 111 sites throughout VHA. All sites are fully operational to provide services appropriate to meeting the requirements of their designated level of 

care. Recruitment efforts are ongoing to fill remaining vacancies by the end of FY 

2012. 

The ASoC is comprised of four distinct components of care similar to the hub-andspoke model utilized by VA Polytrauma System of Care, and includes: 

30 

• Component 1: 7 Regional Amputation Centers (RAC) provide comprehensive rehabilitation care through an interdisciplinary team and serve as a resource across 

the VA system through tele-rehabilitation. They provide the highest level of specialized expertise in clinical care and technology and provide rehabilitation and consultation to the most complicated patients. These facilities include: Bronx, Denver, 

Minneapolis, Palo Alto, Richmond, Seattle and Tampa VA medical centers (VAMC). 

The staffing supported through ASoC funding at these locations includes: 

– 7 Physician Medical Directors (2 vacancies, currently) 

– 7 Amputation Rehabilitation Coordinators 

– 7 RAC Prosthetists (6 vacancies, currently) 

– 7 Program Support Assistants (1 vacancy, currently) 

• Component 2: 15 Polytrauma Amputation Network Sites provide full range of 

clinical and ancillary services to Veterans closer to their home. The staffing supported through ASoC funding at these sites includes: 

– 15 Amputation Rehabilitation Coordinators 

– 15 Program Support Assistants (2 vacancies, currently) 

• Component 3: 111 Amputation Clinic Teams provide specialized outpatient amputation care, and staffing for these teams is supported by the VAMCs where they 

are located. 

• Component 4: 22 Amputation Points of Contact facilitate referrals and access 

to services. These VA facilities ensure at least one person is identified to act as the 

point of contact for consultation and assessment, and to refer the patient to a facility capable of providing the level of services required. 

The ASoC has committed an additional 13 FTEE to support the Servicemember 

Transitional Amputation Rehabilitation (STAR) Program at the Hunter Holmes 

McGuire Polytrauma Rehabilitation Center at the Richmond VAMC. This residential rehabilitation program was developed and initiated for Servicemembers and 

Veterans recovering from amputations, and who are not yet ready to live independently. This program has 10 designated residential beds providing post-acute rehabilitation services, and focuses on community re-integration and vocational rehabilitation. 

The ASoC also utilizes Orthotics and Prosthetic (O&P) Services as part of the integrated system of VA physicians, therapists, and prosthetists working together to 

provide the best devices and state-of-the art care. The VA O&P Service has over 300 

individuals ranging from fitters to certified orthotists and prosthetists, operating in 

78 facilities across the country. Sixty five of these facilities have national accreditation by the American Board for Certification in Orthotics, Prosthetics and Pedorthics, or the Board of Certification/Accreditation International. 

One of the benefits of including O&P Service as part of the ASoC team is that 

it offers complete care to the Veteran by incorporating biological factors, socioeconomic factors, social/contextual factors and psychological factors into unified care. 

Conversely, the fragmentation of care and lack of insurance coverage in the private 

sector has made it difficult for civilian patients to receive similar orthotic and prosthetic services. 

The VA O&P Service offers Veteran-centered care, whether provision of that care 

comes from the VA O&P staff, or through one of more than 600 contracts nationally 

with accredited local orthotists and prosthetists. The VA pays the full cost of the 

prescribed limb as well as repairs. 

The benefits of VA providing O&P Service further extends to the public sector by 

advancing development of new technologies, and education and training of professionals in the field. VA fosters and initiates interactions with manufacturers to gain 

access to new prosthetic and orthotic technology. Often this technology is first released commercially to the VA, thereby benefiting Veterans with the newest and 

most advanced systems. VA O&P clinicians provide feedback to the manufacturers 

for modification and enhancements to the technologies that advance even newer 

technologies. Further, the Department in partnership with orthotic and prosthetic 

academic programs at US universities and colleges has established 17 residency positions programs at 10 VA locations for academic year 2013, with three more sites 

planned for 2014. This collaboration with the prosthetic educational system, which 

includes a contractual training program, will further strengthen clinical care by providing training courses for VA’s orthotic fitters and serving as a feeder program for 

newly trained clinicians. 

BENEFITS

Question 8. VBA’s Claims Transformation Plan focuses on people, processes, and 

technology. What are the projected gains in production, timeliness and quality anVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00036 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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ticipated by the various components of the Claims Transformation Plan? Please provide the data source, summary of the data, and analysis for projected gains in production, timeliness and quality. 

Response. VBA’s Transformation Plan is a people-centric, results-driven, forwardlooking integration of solutions that will ensure total lifelong engagement with Veterans, Servicemembers, their families and survivors. Consisting of more than 40 

People, Process and Technology initiatives that are in various stages of implementation the goals of the Plan are to: 

• improve claims production 45 to 60 percent, reducing the claims completion period to within 125 days in 2015 • enhance quality and accuracy by 14 percent to achieve a claims quality of 98 

percent in 2015 

Performance Gains by Initiative Category (Projected for FY 2012—FY 2015) 

People: changing how we’re organized and trained to do the work 

• Productivity Gain: 15–20 percent • Quality Gain: +4 percent • Gains by People Program: 

– Intake Processing Centers (IPC): for quick, accurate triage; Combined with 

cross functional teams, potential to save 39 days 

– Segmented Lanes: cross-trained raters co-located to increase knowledge 

transfer, speed, and accuracy; Combined with IPC, potential to save 39 days) 

– Challenge Training: Trainees process 1.3 disability claims per day at 98% accuracy 

Processes: making improvements that result in quality and timeliness gains 

• Productivity Gain: 15–20 percent • Quality Gain: +4 percent • Gains by Process Program: 

– Simplified Notification Letter (SNL): potential 20% national gain in productivity could equal 250 thousand more rating cases per year 

– Electronic Disability Benefits Questionnaires (DBQ): increases capability to 

submit Fully Developed Claims (FDC) and reduce average days to complete 

Technology: acquiring and refining systems that enable us to do our jobs better 

• Productivity Gain: 15–20 percent • Quality Gain: +6 percent • Gains by Technology Program: 

– Veterans Benefits Management System: Improves productivity by 15–20 percent; increases quality by 6 percent 

– Veterans Relationship Management: Reduces Veterans’ calls by 25 percent 

and increases client satisfaction by utilizing the Internet for status inquiries 

and expanding availability of self-service functions. 

The predicted gains in productivity and quality are estimates based on existing 

information and projections developed by field experts. The Plan is built on a datadriven approach focusing on performance management and the use of key metrics 

to enable business decisions that improve claims processing quality and timeliness 

and assure Transformation performance. 

VBA’s Transformation Plan is executed by the Implementation Center in VA Central Office—a program management office with dedicated resources to oversee the 

implementation of the Transformation Plan using a governance process to achieve 

standardization and sustainability. The Implementation Center has developed performance measures that will track the impact of the Plan’s more than 40 initiatives. 

We have already begun the rollout of transformation initiatives. In February 2012, we began the deployment of the Simplified Notification Letter (SNL) initiative, a new claims processing initiative that will significantly increase decision 

output (150,000 to 200,000 more decisions per year). The new decision notification 

process will also streamline and standardize the communication of claims decisions. 

Veterans will receive one simplified notification letter in which the substance of the 

decision, including a summary of the evidence considered and the reason for the decision, are all rendered in a single document. Testing of this initiative at the St. 

Paul Regional Office resulted in productivity increases of 31 percent, while sustaining a 90-percent accuracy rate, and reductions of 14 days in average processing 

time. 

We are also transforming our local quality assurance process, establishing dedicated teams of quality review specialists at each regional office. These teams will 

evaluate decision accuracy at both the regional office and individual employee levels, 

and perform in-process reviews to identify and eliminate errors at the earliest posVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00037 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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sible stage in the claims process. The quality review teams are comprised of personnel trained by our national quality assurance (Statistical Technical Accuracy Review or ‘‘STAR’’) staff to assure local reviews are consistently conducted according 

to national standards. An initial focus of these teams is to reduce medical examination errors, which currently represent 36 percent of our benefit entitlement quality 

errors. In addition to quality improvements, the need for reexaminations will be 

minimized, thereby reducing claims processing time in 39-day increments for every 

reexamination avoided. 

Question 9. VBA is relying heavily on IT and specifically the Veterans Benefits 

Management System (VBMS) in order to transform the claims processing system. 

VA’s FY 2013 Budget Submission notes that VA will begin a nationwide deployment 

strategy for the Veterans Benefits Management System in 2012. Please provide: 

a. The deployment strategy, plan and timeline; 

Response. VBMS national deployment begins in selected regional offices in 

July 2012 and will follow a prescribed schedule which will be integrated with VBA’s 

Transformation Plan. By the end of fiscal year 2012, 16 regional offices will be using 

VBMS. National deployment is scheduled to be completed by the end of calendar 

year 2013. 

b. The number and type of claims processed to date using VBMS; 

Response. The first two phases of VBMS have been deployed to the Providence 

Regional Office and the Salt Lake City Regional Office. Phase 1 was the initial 

VBMS prototype. Phase 2 added functionality and scale, both of which will continue 

to increase throughout FY 2012. As of February 16, 2012, VBMS processed to completion 443 of 908 disability compensation claims (49 percent). VBMS is being used 

to process most original disability compensation claims in Providence and Salt Lake. 

Any supplemental claims received on cases previously processed in VBMS will also 

be processed in VBMS. 

c. The average time to complete, accuracy rate and number of appeals filed for 

claims processed using VBMS. 

Response. As of February 16, 2012, the average time to complete a claim in VBMS 

was 131 days. Claims processed using VBMS are being reviewed for accuracy by 

VBA’s national quality review staff, Systematic Technical Accuracy Review (STAR), 

in the same manner as all other claims. VBA recently instituted a special STAR review of claims processed in VBMS to confirm the validity of the calculator 

functionality in VBMS. VBA will be conducting training for the review, and the accuracy rate specific to VBMS claims will be available upon completion of training. 

Ten claims processed in VBMS are under appeal. 

Question 10. Employee training has to be one of the major components of improving the timeliness and accuracy of claims decisions. Please provide a detailed breakdown of the type of training being provided to Compensation Service and Pension 

and Fiduciary Service employees. What is provided in the FY 2013 budget for training Compensation Service and Pension and Fiduciary Service employees? 

Response. Compensation Service has developed a comprehensive national training 

program for claims processors consisting of standardized training modules for all 

phases of claims processing and levels of experience. The 2012 National Training 

Plan for claims processors at the intermediate and journeyman experience levels 

was released in November 2011. 

The Compensation Service requires that each claims processor participate in a 

minimum of 80 hours of training. For intermediate and journeyman level employees, 

40 of these hours cover mandatory topics that provide new guidance to the field and 

address national quality issues. The remaining 40 hours consist of 20 hours of technical-training electives that address local quality issues and 20 hours of station-determined topics that include courses required of all VA employees. All training must 

use nationally approved lesson materials developed by the Compensation and Pension Service and must be documented in VA’s Talent Management System (TMS). 

Entry-level claims processors undergo a robust training program consisting of 

three to four weeks of training on basic claims-processing skills at the employees’ 

home stations, followed by four to eight weeks of centralized training with a concentration on practical knowledge application. Veterans Service Representatives 

(VSRs) participate in a four-week centralized training program to learn to develop 

or promulgate claims, and Rating VSRs (RVSRs) participate in an eight-week centralized training program to learn to make decisions on claims, including how to 

weigh evidence. All students, regardless of the curriculum, process actual cases 

under the guidance of experienced instructors and mentors during this centralized 

training. Cases are reviewed by several subject matter experts to ensure the cases 

are processed correctly and the students are provided with any necessary follow-up 

training and feedback. Our redesigned and expanded 8-week centralized Challenge 

33 

Training Program for new claims processors has achieved dramatic results. On completion of the training, employees work significantly faster and at a higher quality 

level. Trainees from the most recent class averaged 1.33 cases per day with 98 percent accuracy, compared to the legacy Challenge curriculum, following which trainees averaged one-half case per day and 60 percent accuracy. Compensation Service 

also provides training to claims processors of all levels through ‘‘Live Meetings’’ on 

emerging topics and initiatives and web-based training. The Compensation Service 

also deploys Training Assistance Teams to field offices to provide on-site training 

specifically geared toward improving decision accuracy at that office. 

Pension employees are required to complete 85 hours of training annually through 

the National Training Curriculum, which includes: 40 hours of mandatory technical 

training; 20 hours of specific technical training identified through local quality reviews; 20 hours of developmental training; and five hours of VA mandated training 

(e.g., Privacy Awareness, Ethics). 

New fiduciary employees are provided initial training that consists of two weeks 

of instructor-led training and followed by on-the-job training with an experienced 

field examiner. New field examiners must complete computer-based training 

through the Training and Performance Support System (TPSS). Additionally, Pension and Fiduciary Service has developed a three-week centralized training for all 

fiduciary personnel. This training is supplemented by VA-mandated training. 

We anticipate that this improved training, consistency of delivery, and progression 

of employees to journey status will increase accuracy and productivity beginning in 

FY 2013. 

The FY 2013 budget request supports centralized training for over 1,000 Compensation, Pension, and Fiduciary employees. 

Question 11. How many FTE were supported by FY 2011 and FY 2012 funding 

for the compensation and pension quality assurance program? How many FTE will 

be supported in the FY 2013 budget request for the compensation and pension quality assurance program? How many compensation and pension decisions were reviewed during each of the past two fiscal years? 

Response. In FY 2011, 61 FTE supported Compensation and Pension (C&P) Service until the Pension and Fiduciary (P&F) Service was established in April 2011. At 

that point, 54 FTE remained on the Compensation Service’s Quality Assurance 

Staff, while seven FTE were transferred to P&F Service’s Quality, Training, and 

Site Visit Staff to conduct quality reviews. Currently, 59 FTE support Compensation 

Service’s Quality Assurance Program, and we expect no changes in this staffing for 

FY 2013. Seven FTE currently support P&F Service’s quality reviews, and this staff 

will increase to eight FTE in FY 2013. 

In FY 2010 and FY 2011, respectively, 32,311 and 38,001 compensation claims 

were reviewed. In FY 2010, 1,529 pension claims and 4,424 fiduciary claims were 

reviewed, while in FY 2011, 1,510 pension claims and 4,047 fiduciary claims were 

reviewed. As oversight of fiduciary activities is consolidated from 56 regional offices 

to six hub sites this year, P&F Service will review staffing requirements and sample 

sizes for quality reviews. 

Question 12. Does the FY 2013 budget request for Vocational Rehabilitation and 

Education take into account any of the proposed effects that the ongoing business 

process re-engineering will have on staff time or the efficiency of operations? 

Response. Vocational Rehabilitation and Employment (VR&E) Service anticipates 

a need for additional field staff, which is reflected in the fiscal year 2013 budget 

request. VR&E Service expects continued workload increases of ten percent or higher due to the growth in disability compensation and pension claims, including claims 

for the additional Agent Orange presumptive conditions. This increase in workload 

is also due to the increased outreach that will be conducted by the requested 110 

staff who will be housed at the Integrated Disability Evaluation System sites, and 

to the expanded entitlement for certain Veterans under the recently enacted VOW 

to Hire Heroes Act. 

JOINT VA/DOD PROGRAMS

Question 13. Please provide the cost—for both the current and next fiscal year— 

of disability examination contracts to support the Integrated Disability Evaluation 

System. Provide the costs to VBA and VHA separately. 

Response. The Veterans Health Administration Disability Examination Management Contract (DEM) contract is a national Indefinite Delivery/Indefinite Quantity 

(ID/IQ) contract that has a minimum obligation of $100,000 per each of the five 

awarded vendors over the life of the contract. The base year began in FY 2011 and 

extends into four option years. The contract is centrally managed by the Office of 

Disability and Medical Assessment (DMA) with contracting officers assigned from 

34 

the Denver Acquisition and Logistics Center. The contract is executed and funded 

through VAMCs’ medical service budget. The contract allows them to request disability exam services in support of their disability exam programs, as needed; to include the Integrated Disability Evaluation System (IDES). The contract resources 

can be used by VAMCs to support backlogs or surges in demand for disability examination requests. For FY 2011, a total of $500,000 was obligated and in FY 2012, 

$800,000 has been obligated. No funds will be obligated from FY 2013 and beyond. 

All funds will have to come from the local VAMC’s budget if it elects to use the contract. As of January 2012, no contract exams have been completed in support of 

IDES. 

VBA’s Quality, Timeliness, and Customer (QTC) Medical Services, Inc., contract 

has generated 4,649 compensation and pension exams for the IDES program 

through the first quarter of FY 2012 at a cost of $5.5 million. VBA estimates that 

the total cost of IDES exams completed by QTC in FY 2012 will be approximately 

$22.3 million. The estimated cost for all IDES exams to be completed in FY 2013 

is $23 million. 

Question 14. Please describe the systems in place to monitor the quality of VHA 

and contract exams and rating decisions conducted as part of the Integrated Disability Evaluation System. 

Response. IDES ratings, both preliminary and final ratings, are subject to the 

same quality assurance process as all ratings prepared by VBA. This process, called 

Systematic Technical Accuracy Review (STAR), utilizes a random sample of claims 

to assess claims processing accuracy. Claim reviews conducted at VA regional offices 

that serve as IDES Rating Activity Sites (D-RAS) include a sample of IDES ratings. 

STAR reviews ten cases monthly from each of three IDES sites (Providence, Seattle, 

and Baltimore) and is required to complete the reviews within five days of receipt. 

IDES decision documents are held to the same standard as any other rating and 

reviewed using the same criteria. 

The VBA medical examination contract specifies that there will be a quarterly 

quality review. This quality review determines whether the contractor has met the 

standard or acceptable level of performance (ALP) required by VBA. The contract 

requires that the completed examination reports meet VA’s Compensation Service 

worksheet requirements so that Rating Veterans Service Representatives may use 

these reports to complete rating decisions. An ALP of no less than 92% quality must 

be met. The VBA Medical Director for Contract Exams and Compensation Service’s 

rating experts perform these quarterly quality reviews. 

Every quarter, 148 examinations are randomly selected from completed examinations. The compensation worksheets are used to evaluate all exam reports. Since 

each contractor-completed report is considered a ‘‘product’’ that is paid for by the 

government, it must be measured against the requirements of the specific worksheet 

that was requested by the VA regional office. 

As noted above, VHA has not contracted out any IDES exams. However, if VHA 

facilities were to contract out IDES examinations, each local individual health care 

facility that uses contracted resources is responsible for 100% review of those examinations that have been performed by contracted examiners. Moreover, disability examination requests and associated completed examinations managed by the VAMCs 

are randomly sampled and reviewed against seven specific examination request indicators and nine examination criteria by DMA Quality Assurance staff. VHA does 

not monitor the quality of any VBA contract exams including IDES. 

Question 15. What are the resource demands that are envisioned as a result of 

the mandatory participation of servicemembers in the Transition Assistance Program? 

Response. The VOW to Hire Heroes Act of 2011 requires VA to provide the TAP 

briefings to all separating Servicemembers. VBA currently has 258 FTE providing 

transition assistance briefings. VA is working with the Department of Defense 

(DOD) to determine the number of installations, number of separating Servicemembers, and methodology for service delivery. 

Question 16. The FY 2013 budget request identified that VA facilities have over 

$9 billion in facility condition assessment-documented deficiencies. Over the last 

three years, VA’s budget requests for non-recurring maintenance have continued to 

decrease while the operating costs per square foot have continued to rise. Given the 

realities of aging infrastructure, tight budgets, and projected utilization increases, 

what has VA done to mitigate the risks of not making solid investments in addressing basic facility maintenance issues? 

Response. VA ensures infrastructure needs are being addressed with the safety 

and security of our Veterans and employees as our guiding principle, resulting in 

obligations of $2.15B in FY 2010 and $1.98B in FY 11. 

35 

The non-recurring maintenance (NRM) discussion is important to be viewed within the Department’s overall efforts to plan for infrastructure needs. Developed first 

in the FY 2012 budget process, the Strategic Capital Investment Planning (SCIP) 

process is a VA-wide planning tool VA uses to evaluate and prioritize its capital infrastructure needs for the current Budget cycle and for future years. SCIP quantifies the infrastructure gaps that must be addressed for VA to meet its long-term 

strategic capital targets, including providing access to Veterans, ensuring the safety 

and security of Veterans and our employees, and leveraging current physical resources to benefit Veterans. 

VA infrastructure funding requirements will continue to be balanced against other 

Department and National priorities. SCIP continues to be a critical and viable datadriven process that identifies all current and future gaps in safety, security, access, 

utilization and other related areas that most affect the delivery of benefits and services to Veterans. SCIP then evaluates the means, including specific projects (major, 

minor, non-recurring maintenance, leasing, or non-capital) to efficiently mitigate 

these gaps. SCIP continues to be a realistic blueprint in that it details a comprehensive methodology to mitigate all currently-identified capital needs. In a tight fiscal 

climate, this blueprint is an essential tool both this year and into the future, as 

SCIP projects are prioritized each year to ensure that only the highest priority 

projects are included in VA’s annual budget request. 

VA will continue to update this plan in order to capture changes in the environment, including evolving Veteran demographics, newly-emerging medical technology, advances in modern health care delivery and construction technology, and 

increased use of non-capital means (when appropriate) in a continuous effort to better serve Veterans, their families, and their survivors. 

VA is also looking at alternative strategies to traditional capital approaches to 

meet our overall needs including the use of: 

• Tele-medicine • Extended hours for the provision of services on site • Mobile clinics • Care from private sources through contracts or on a fee-basis • Continuous demographic data validation • Non-construction/capital alternatives 

Question 17. In the FY 2012 budget request, VA identified $18.5 million in savings through the Real Property Cost Savings and Innovation Plan via repurposing 

assets, demolition and mothballing, green improvements, increasing telework, and 

renegotiating GSA Leases. How much has been saved so far, per category? Is VA 

on track to achieve the anticipated level of savings in each category? 

Response. The $18.5 million in savings, identified in the FY 2012 budget, was a 

portion of the overall Real Property Cost Savings and Innovation Plan that totaled 

$66 million in VHA savings. The lower $18.5 million was intended to be the Medical 

Facilities portion of the overall savings; however, VA has since updated this cost 

savings plan to better account for the savings related to VHA. 

In the recently released FY 2013 budget the updated initiatives that are part of 

the Real Property Cost Savings and Innovation Plan have been described, including 

repurposing assets, demolitions and mothballing, energy and sustainability, improved non-recurring maintenance contracting, and reduction in leasing. The total 

savings for VHA remain at $66 million; however, it is all classified as Medical Facilities savings now. 

The below table provides a status of the savings achieved through Q1 FY 2012 

for each of the initiatives that make up the $66 million VHA savings target. VA has 

saved approximately $48 million of the total $66 million projected VHA savings 

through Q1 FY 2012. We are on target to meet the full VHA savings target by end 

of FY 2012. 

Cost Savings Initiative 

Total Estimated 

VHA Savings 

(by end of 

FY 2012) 

Savings 

Achieved 

(through Q1 

FY 2012) 

1. Energy Savings and Sustainability ......................................................................................... $43 M $36 M 

2. Repurpose Underutilized Assets .............................................................................................. $6 M $3 M 

3. Demolition or Mothballing ....................................................................................................... $3 M $1 M 

4. Improved Non-Recurring Maintenance Contracting ................................................................ $8 M $2 M 

5. Reduction in Leasing .............................................................................................................. $6 M $6 M 

Total .................................................................................................................................... $66 M $48 M 

36 

WOMEN VETERANS

Question 18. A 2010 GAO report identified a number of improvements that should 

be made to enhance VA services to women veterans. Included among these recommendations were facility improvements. Last year, VA provided a list of improvements that they intended to make over the course of ten years. Please provide an 

update on how much was spent, to date, in FY 2012 on these projects. Please also 

provide a list of remaining projects, their costs, and amount requested in the FY 

2013 budget to address these projects. 

Response. New space and renovations for privacy and women’s health are critical 

elements in the prioritization process for our construction programs, with privacy 

ranking in the top criteria under safety and women’s health ranking in the second 

highest criteria under Secretarial priorities. As can be seen in the attached spreadsheet, a significant amount of funding has been and continues to be targeted toward 

privacy and women’s health projects. In fact, for VHA’s FY 2011 construction programs, privacy and women’s health supported over 1/3 of the available NRM and 

Minor funding ($884 million out of a total of $2.5 billion); and privacy and women’s 

health represents almost 60% of the planned projects with the appropriated and requested FY 2012 and FY 2013 budgets ($1.5 billion out of $2.51 billion). (see attached spreadsheet) 

INFORMATION TECHNOLOGY

Virtual Lifetime Electronic Record (VLER) 

Question 19. Tables 10 and 20 of the Virtual Lifetime Electronic Record Capability 

Area 1, Concept of Operations v. 2.0 (CONOPS), dated April 8, 2011, and signed by 

the VA Deputy Secretary in August 2011, detail the Go/No Go Criteria and Threshold Measures for nationwide rollout of VLER. 

a. Is the JEC still scheduled to make a Go/No Go decision in July 2012? 

Response. Yes. 

b. Based upon the criteria set forth in tables 10 and 20, is VLER on track for 

a Go recommendation by the Department? 

Response. We are working toward a ‘‘go’’ recommendation. Though some criteria 

are already met, data is still being collected for other criteria in anticipation of making the decision. 

c. If VLER is on track for a Go recommendation, please detail the Department’s 

analysis in support of this determination, and if VLER is not on track for a Go recommendation, please detail the criteria currently not satisfied and any corrective action(s) necessary to achieve readiness for a July 2012 Go recommendation by the Department. 

Response. Data will be collected through at least March 31, 2012. VLER Health 

information exchanges have been successfully deployed at 12 pilot sites nationwide 

and are in production use. As of Feb 14, 2012, 41,006 Veterans have provided authorization to participate in health data record exchange through the Nationwide 

Health Information Network (NwHIN). A total of 494 electronic health summaries 

have been retrieved by an NwHIN private partner from VA supporting the ‘‘treatment’’ purpose of use and 982 electronic health summaries have been retrieved by 

VA from an NwHIN private partner supporting the ‘‘treatment’’ purpose of use. System performance is being monitored. Surveys of Veterans and clinical users about 

their perception of VLER Health are pending. Scalability issues that may impact 

the timeline and VLER Health geographic deployment such NwHIN system capacity, automated interoperability testing for new private sector health information exchange partners, the availability of successful identity matching traits, and automated Veteran authorization processes are still being addressed by VA, the NwHIN 

Exchange and the HHS Office of the National Coordinator for Health IT (ONC). The 

deployment of an ‘‘NwHIN Direct’’ project (secure one-way email) is being removed 

as Go/No Go criterion for VLER Health as the decision should only address the 

NwHIN Exchange bi-directional exchange capabilities. Final Go/No Go criteria reports will not be available until the conclusion of the Performance and Measurement 

and Analysis period, June 11, 2012. 

Question 20. Please describe the organizational structure, and governance and 

programmatic hierarchies, for the development, implementation, and rollout of the 

VLER functional capabilities other than health, e.g., personnel and military history 

and benefits; and delineate the area(s) of responsibility for which VA, DOD and the 

VA/DOD Interagency Program Office (IPO) is each responsible. 

Response. The VA/DOD Joint Executive Council (JEC), Benefits Executive Council 

(BEC), and Benefits Information Sharing/Information Technology Working Group 

(BEC IS/IT) provide the structure and governance for decisionmaking and 

37 

prioritization of non-health (benefit) functional capabilities (e.g., Disability Claims 

Adjudication). The BEC IS/IT is responsible to jointly develop use cases and benefit 

requirements. It recommends priorities, objectives and metrics to the BEC, who forwards to the JEC for approval. Once approved, and documented in the VA/DOD 

Joint Strategic Plan, the Departments proceed to execute and implement material 

and non-material solutions. 

The BEC IS/IT meets frequently to review and monitor progress to ensure delivery of capabilities as jointly planned. Issues are escalated to the BEC when required. Generally, the IPO only participates in benefits related capability discussions when health data is required to adjudicate a claim. 

Integrated Electronic Health Record (iEHR) 

Question 21. VLER CONOPS, dated April 8, 2011, identifies as a risk and issue: 

Synchronization: iEHR, VLER, and other interagency data exchange efforts are 

not synchronized. DOD and VA senior leadership must establish appropriate authoritative governance and programmatic infrastructure. 

According to the meeting minutes from the SECDEF/SECVA meeting held on 

June 23, 2011: ‘‘[t]o ensure the synchronization of iEHR and VLER initiatives, both 

efforts will be managed by the iEHR Program Executive.’’ 

a. Please define synchronization as used in CONOPS and the SECDEF/SECVA 

meeting minutes, and as applied to the iEHR and VLER initiatives. 

Response. Per the Interagency Program Office (IPO) Charter, ‘‘synchronization’’ 

can be defined per the following: 

‘‘* * * Derived Authorities from the Departments. To ensure the IPO fulfills its purpose and mission, the Secretary of Defense and the Secretary of 

Veterans Affairs, respectively, delegate to the Director of the IPO, their authorities to: 

i. Acquire, develop, and implement-to include financial management, and 

information technology (IT) systems acquisition and development-all common DOD/VA EHR and VLER Health systems, capabilities, and initiatives, 

as defined by the iEHR and VLER enterprise architectures. 

ii. In collaboration with the HEC and BEC, collect and integrate the Departments’ EHR and VLER Health functional requirements into program 

roadmap(s)/integrated master schedule. 

iii. Develop and propose the interagency budget and acquisition strategies 

to meet integrated interagency requirements. 

iv. Direct the Departments’ personnel resources supporting related interagency initiatives.’’ 

b. Has such synchronization between the initiatives been achieved? If not, detail 

the steps taken, to date, to achieve synchronization. 


229q1M20.eps
38 

Response. ‘‘Synchronization,’’ per the charter above, is still being implemented at 

the IPO. IPO Advisory Board, Leadership, Program Management and project 

progress meetings are attended by VLER Health and iEHR Program Managers and 

the IPO Technology Director. All have offices at the IPO and have begun coordination on all levels of program implementation to ensure progress and coordination 

on strategies, planning, and program management activities. At least one IPO technical office, Standards and Interoperability, is already equally supporting iEHR and 

VLER Health with the same leadership staff and using the same methodologies. 

c. What remaining challenges must be overcome before full synchronization is 

achieved? 

Response. Full synchronization can be achieved when both the Departments and 

the IPO move forward with a comprehensive implementation scope for both iEHR 

and VLER Health. iEHR planning documents described in response to question 24 

in this document are not completed and the decision to implement VLER health nationally has not yet been made. The Departments have made significant progress 

in overcoming previous challenges by enhancing IPO’s staffing levels and signing a 

new IPO charter. 

d. Has synchronization been impacted by the delay in hiring a permanent Program Executive? If so, detail the steps taken to mitigate this impact. 

Response. No. VA executive sponsors for the iEHR, VLER and the IPO and highly 

engaged IPO interim leadership appointed experienced senior program staff in 2011 

to begin work toward synchronizing this work in the IPO. 

Question 22. Please describe how investments made in VLER will be leveraged 

during development and implementation of the iEHR. For example, detail how investments in VLER data-sharing capabilities of foundational health care data and 

architecture can and will be incorporated into the iEHR. 

Response. The Virtual Lifetime Electronic Record (VLER) enables the sharing of 

comprehensive health, benefits, and administrative data between the Departments 

of Defense (DOD) and Veterans Affairs (VA) from the time an individual enters the 

service until the final benefit is administered. In addition, VLER supports sharing 

of health data with private healthcare providers through the Nationwide Health Information Network (NwHIN). This comprehensive health data will be foundational 

to the integrated Electronic Health Record (iEHR) effort which seeks to develop and 

implement shared electronic record (EHR) capabilities in the Departments. The 

combination of the comprehensive patient health data from VA, DOD and private 

healthcare partners through VLER and the state-of-the-art EHR tools through iEHR 

will enable providers at both Departments to deliver the highest quality of 

healthcare to Servicemembers and Veterans. 

Question 23. Please report on the status of the ‘‘budget quality’’ implementation 

plan and the iEHR Independent Cost Estimate. For each document: 

a. Has the document gone through concurrence and received all necessary approvals? 

b. If available, please provide a copy of the document. 

c. If the document has not yet received final approval, please provide an expected 

approval date. 

Response: Effective October 27, 2011, based on the re-chartering of the IPO, DOD 

and VA initiated activity to establish a joint program baseline for the iEHR. As a 

result, the iEHR program is developing documentation that will contain sufficient 

program and technical information for independent cost activity to be completed. 

This documentation will be available by the end of the fourth quarter FY 2012. 

Question 24. Provide a copy of the iEHR Project Plans and any related documents 

(artifacts) including but not limited to: the iEHR Strategic Plan, Concept of Operations, Program Management Plan, Joint Master Test Plan, Joint Integrated Master 

Schedule, Joint Evaluation Plan for Success, Joint Business and Technical Requirements, Risk & Issues Management Plan, Communications Plan, Change Management Plan, and Quality Management Plan. 

Response. The iEHR program is in the Planning State. As part of its focused effort to establish Program Management discipline and standards, the content of the 

Program Plans and related documents (artifacts) noted in this Question For the 

Record (QFR) will be contained in program documentation currently in development. 

As program documentation becomes available, we commit to sharing final versions 

with the Committee. The iEHR FY 2012 Execution Plan and Program Management 

Plan are in development. These documents will serve as a basis for the iEHR organizational Concept of Operations. 

39 

ACQUISITION & CONTRACTING

Question 25. The President’s FY 2012 Budget Submission for VHA, at page 1A– 4, estimated $355 million in operational improvements and savings from ‘‘acquisition improvements.’’ 

a. Please identify, by business line, whether such operational improvements and 

savings are on track to be realized during FY12. Response. In its FY 2012 budget submission, VA identified $1.2 billion in oper- ational improvements, of which $355 million was identified as savings resulting 

from acquisition improvements. Individual VISN targets were set as a percentage 

of FY 2008 spend. Initial FY 2012 roll-out included initiatives carried over from the 

OMB-mandated FY10–11 Acquisition Savings program (OMB Memorandum M–09– 

25, Improving Government Acquisition, July 29, 2009). VHA is currently collecting 

savings data under these initiatives as appropriate. 

Concurrently, VHA convened an interdisciplinary Tiger Team in late Q1 of FY 

2012 to review and revise the VHA-specific acquisition savings initiatives based, in 

part, on input received from the Government Accountability Office (GAO) and the 

Office of Inspector General (OIG). That group was chartered with providing recommendations to improve the program. Specifically, the group has been charged with 

proactively addressing anticipated issues from reviews; providing more rigorous definitions, methodology, documentation, review/internal auditing for the program; identifying new initiatives; identifying other savings/avoidance areas not previously captured; removing any carry-over initiatives that risk double counting with other operational improvement initiatives; and consolidating initiatives as necessary to ensure 

more rigorous methodology. The team recommendations are anticipated for delivery 

on or about March 1. 

Savings by Service Line 

In preliminary analysis, VA has identified initial FY 2012 savings goals for initiatives as identified in the FY 2010–2011 OMB program. 

OMB Initiative 

Grouping VA Initiative Number and Title Expected 2012 Savings (Goal) 

Percentage 

of Goal 

26—Reduce VHA Contracts ............................................................... $10,000,000 2 .82% 

14—Increase Competition VHA .......................................................... 5,000,000 1 .41 

15—Bring Back Contracts—COE ...................................................... 10,000,000 2 .82 

13—Consolidated Contracting ........................................................... 192,000,000 54 .08 

24—Reverse Auctions Utilities .......................................................... 40,000,000 11 .27 

25—Med/PDB ..................................................................................... 2,000,000 0 .56 

27—Property Reutilization ................................................................. 20,000,000 5 .63 

28—Prime Vendor .............................................................................. 1,000,000 0 .28 

50—Increase Negotiation ................................................................... 75,000,000 21 .13 

Total VA Acquisition Savings ..................................................... $355,000,000 100 .00% 

These savings percentages are considered estimates and will be revised as necessary. This initiative list does not include any new initiatives or reporting entities 

that have been identified as part of the Tiger Team’s review. It is important to note 

that to ensure that VISNs have maximum flexibility to achieve goals, yearly savings 

goals will be Network-based as opposed to initiative-based. Networks will be permitted to identify the savings mechanisms/initiatives that best suit their needs. 

b. If VHA will not fully achieve such improvements and savings during FY 2012, 

please explain why. 

Response. At this time, VHA anticipates meeting the $355 million FY 2012 goal. 

As of the January report, VHA stood at 7.2% of annual goal. Upon the adoption of 

the Tiger Team recommendations, VHA will revise its monthly reports to include 

previously unreported initiatives and reporting offices. Additionally, some reporting 

mechanisms for current initiatives provide quarterly reports on or after the 15th of 

the month following the end of the Quarter. VHA anticipates that these unreported 

initiatives and offices as well as increased reports from existing initiatives will provide an increased accounting of YTD savings achieved. 

DISCHARGE CHARACTERIZATIONS AND VA BENEFITS AND OTHER POLICIES

Question 26. According to recent reports, certain Veterans discharged for homosexual conduct pre-Don’t Ask Don’t Tell (DADT) or under DADT continue to be adversely impacted by their discharge characterization. In some instances, LGBT vetVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00045 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
40 

erans have been denied access to VA benefits because of their discharge characterization. 

With the repeal of DADT, and the adoption of a new regulatory framework allowing open service, veterans discharged under DADT and pre-DADT for homosexual 

conduct may now be eligible for discharge upgrades and restoration of VA benefits. 

Please describe: 

a. The steps taken by VA to evaluate the number of veterans who were and continue to be denied VA benefits because of an adverse discharge characterization 

under DADT or based upon the pre-DADT regulatory scheme. 

b. The steps taken or that will be taken by the Department to ensure full restoration of VA benefits to those veterans who would otherwise be eligible but for their 

adverse discharge characterization under DADT or based upon the pre-DADT regulatory scheme. 

Response. When an individual files a claim for benefits, the Veterans Benefits Administration (VBA) is responsible for reviewing the character of discharge (COD) 

provided by the military services. An ‘‘Honorable’’ discharge is binding on the Department of Veterans Affairs (VA). Under 38 U.S.C. 5303, a discharge under certain 

specified conditions bars eligibility for VA benefits, regardless of the COD, unless 

it is determined that the individual was insane when committing the acts that resulted in the discharge (see 38 CFR 3.354(b)). 

In other cases, if the COD is an undesirable discharge, an other than honorable 

discharge, or a bad conduct discharge, VBA makes a determination whether the discharge was under dishonorable conditions for the purpose of determining benefit eligibility. When making that determination, VA is bound by the criteria stated in 38 

CFR 3.12(d). Those criteria do not indicate, nor have they in the past, that VA may 

find a Veteran ineligible for benefits based on violation of the Don’t Ask Don’t Tell 

(DADT) policy. Because it is not VA policy to terminate or deny benefits based on 

violation of DADT, there would be no need to review cases for these actions. 

As stated in 38 CFR 3.12(d)(5), a discharge may be considered to have been issued 

under dishonorable conditions if the reason for discharge was based on: ‘‘Homosexual acts involving aggravating circumstances or other factors affecting the performance of duty. Examples of homosexual acts involving aggravating circumstances 

or other factors affecting the performance of duty include child molestation, homosexual prostitution, homosexual acts or conduct accompanied by assault or coercion, 

and homosexual acts or conduct taking place between servicemembers of disparate 

rank, grade, or status when a servicemember has taken advantage of his or her superior rank, grade, or status.’’ This criterion does not apply to or address DADT. 

If a Veteran received a ‘‘Dishonorable’’ discharge from his or her branch of service 

based on DADT, the individual would need to apply to that service department requesting an upgraded discharge. 

When VA notifies a claimant of an unfavorable COD determination, the notification letter includes instructions on how to apply to the Service Department Discharge Review Board to change the character of a discharge and how to apply for 

a correction of military records through the Service Department Board for Correction of Military Records. Enclosed with the letter is a copy of the DD Form 293, 

Application for the Review of Discharge or Dismissal from the Armed Forces of the 

United States, and a copy of the DD Form 149, Application for Correction of Military Records. The addresses for the Service Departments are listed on the back of 

each form. 

Question 27. The Department has taken preliminary steps to ensure that VA is 

a welcoming place for LGBT veterans and their families. Please describe in detail 

the steps taken, and that will be taken, by the Department to ensure that VA is 

a welcoming place for LGBT veterans and their families. 

Response. VA is taking steps to ensure that its health care system is more inclusive through the creation of an Office of Health Equity, visitation policies, and new 

training programs. The Department’s recently established Office of Health Equity 

(OHE) brings focus on its efforts to provide a more equitable health care system and 

improve overall quality of care through health equity. Among many other projects, 

OHE will work to eliminate health treatment disparities among LGBT, women, and 

minority Veterans. Over the next year, OHE will implement an integrative action 

plan to achieve health equity for all Veterans receiving VA health care services, including LGBT Veterans. VA’s visitation policies are supportive of the rights of Veterans’ same-sex partners, and the right of Veterans to name same-sex partners as 

their surrogate decisionmakers. To reinforce the Department’s focus and commitment to equitable visitation rights and the appropriate implementation of this policy, the Veterans Health Administration’s (VHA) Deputy Under Secretary for Health 

Operations and Management required all of VA’s network directors and chief medical officers to ensure all facilities have a written policy in place and that these poliVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00046 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
41 

cies are consistent with the new Joint Commission definition of ‘‘family.’’ The Joint 

Commission defines ‘‘family’’ as a person or persons who play a significant role in 

an individual’s life. VA is also developing training programs targeted to mental 

health and women’s health providers on services for transgender Veterans. The 

goals of these programs are to increase awareness of the psychological and emotional needs of transgender Veterans and address the needs of different groups of 

clinical providers. 

In terms of benefits, VA awards benefits to all eligible Veterans and does not discriminate on the basis of sexual orientation. 

VA has also created a more inclusive workplace for its LGBT employees through 

enhanced policy initiatives, training programs, and outreach and awareness activities. 

• The Department added gender identity and parental status to the list of protected bases in the Secretary’s Policy Statement. The Department also implemented 

an internal complaint process to provide formal redress for complaints based on sexual orientation. Most recently, VA’s Diversity Council launched a LGBT work group 

to address emerging LGBT issues in the Department’s workforce and service delivery. In addition, VA is adding a survey item in its Voice of VA Survey to assess 

perceptions of fairness and treatment of LGBT employees. • In terms of training, the Department has conducted training workshops to educate its leadership and workforce on issues of cultural competency for the LGBT 

community. VA has also implemented Mandatory EEO, Diversity, and Conflict Management Training for Managers and Supervisors covering LGBT diversity. In fiscal 

year 2011, over 27,000 executives, managers, and supervisors were trained. • Finally in terms of outreach, the Department conducted outreach and awareness activities focused on LGBT issues. Within the past year, VA held its third annual LGBT Program to increase awareness of LGBT issues in the workplace and 

in our service population. Additionally, the Department also convened its third 

LGBT Observance Program that focused specifically on the needs of LGBT Veterans. 

Moreover, VA has engaged the National Coalition of LGBT Health, which represents 

over 70 LGBT organizations, in a dialog about emerging LGBT issues and their impact on VA health care and benefits services. 

RESPONSE TO PREHEARING QUESTIONS SUBMITTED BY HON. RICHARD BURR TO

U.S. DEPARTMENT OF VETERANS AFFAIRS

GENERAL

Question 1. In connection with the Department of Veterans Affairs (VA) fiscal 

year 2011 budget request, VA indicated in response to questions about the method 

of travel used by employees of the Office of the Secretary that ‘‘travel regulations 

address the allowable modes of travel for reimbursement purposes, but the predominant method of travel has and will continue to be commercial airlines’’ [emphasis 

added]. 

a. For fiscal years 2009, 2010, and 2011, please identify the number of trips taken 

each year by senior VA personnel (Presidential Appointee with Senate Confirmation 

(PAS), career or non-career General Schedule (GS) employees, career or non-career 

Senior Executive Service (SES) or SES Equivalent, consultant, contractor, etc.) 

using a military or other government-provided aircraft. 

Response. Total number of trips taken each fiscal year using military or other 

government-provided aircraft are as follow: 

Fiscal Year 2009—total of 3 trips 

Fiscal Year 2010—total of 12 trips 

Fiscal Year 2011—total of 4 trips 

b. For each trip during those years where a military or other government-provided 

aircraft was utilized for travel, please identify: (1) the purpose of the trip, (2) the 

destination of the trip, (3) the duration of the trip, (4) the number and title of any 

VA employees (PAS, career or non-career GS employee; career or non-career SES 

or SES Equivalent, consultant, contractor, etc.) who were passengers on the aircraft, 

(5) the total cost to the Federal Government to operate the aircraft used for the trip, 

(6) the amount of any reimbursement VA provided to the Department of Defense, 

a military service, or another government entity in connection with the trip, (7) the 

justification for using military or other government-provided aircraft rather than a 

commercial airline, and (8) all supporting documentation, the agenda, and the 

itinerary related to the trip, as well as copies of any memoranda, reviews, comments 

and/or opinions rendered by VA’s Office of General Counsel regarding the trip. 

Response. [Extensive supporting documentation is held in Committee files.] 

42 

For fiscal years 2012 and 2013, please identify the number of trips that have been 

taken or are expected to be taken by senior VA personnel (PAS, career or non-career 

GS, career or non-career SES or SES Equivalent, consultant, contractor, etc.) using 

a military or other government-provided aircraft. 

Response. As of March 29, 2012, in fiscal year 2012 VA did not usemilitary or 

other government-provided aircraft for any trips. In fiscal year 2013, VA may use 

military or other government-provided aircraft but no estimates are currently available. Cost figures can only be provided once travel is complete. For every official 

trip conducted by the Secretary, a cost analysis is made to determine efficiencies 

that may warrant a request for military air. If military air is requested, the provisions of 41 CFR 101–37 are met using the appropriate decision process outlined in 

OMB Circular A–126 and each request is submitted to the Agency General Counsel 

for review and approval. 

c. In total, for fiscal year 2012, how much (if any) is expected to be spent by VA 

in order to pay for transportation by military or other government-provided aircraft? 

Response. As of March 29, 2012, in fiscal year 2012 VA did not use military or 

other government-provided aircraft for any trips. No estimates are currently available and cost figures can only be provided once travel is complete. For every official 

trip conducted by the Secretary, a cost analysis is made to determine efficiencies 

that may warrant a request for military air. If military air is requested, the provisions of 41 CFR 101–37 are met using the appropriate decision process outlined in 

OMB Circular A–126 and each request is submitted to the Agency General Counsel 

for review and approval. 

d. In total, for fiscal year 2013, how much (if any) is requested in order to pay 

for transportation by military or other government-provided aircraft? 

Response. In fiscal year 2013, VA may use military or other government-provided 

aircraft but no estimates are currently available. Cost figures can only be provided 

once travel is complete. 

Question 2. In October 2011, the House of Representatives passed H.R. 2302, 

which included a provision that would require VA to submit to Congress quarterly 

reports outlining the cost for conferences or meetings sponsored by VA that have 

at least 50 attendees or cost $20,000 or more. 

a. During fiscal year 2011, how many conferences or meetings did VA sponsor 

that met those criteria and what was the total cost of those conferences and meetings? 

b. During fiscal year 2012, how many conferences or meetings does VA expect to 

sponsor that meet those criteria and how much in total is expected to be expended 

on those conferences or meetings? 

c. For fiscal year 2012, please identify the 25 most expensive conferences or meetings already sponsored or expected to be sponsored by VA, the locations of those 

conferences or meetings, and the purposes of those conferences or meetings. 

d. For fiscal year 2013, what is the total amount requested for purposes of holding 

conferences or meetings that meet those criteria and how many conferences or meetings would that funding level support? 

Response. [These questions are repeated and answered in posthearing questions, 

section GENERAL, Question 3, a–f.] 

Question 3. During fiscal year 2010, VA created the National Outreach Office in 

the Office of Public and Intergovernmental Affairs with the stated goal to ‘‘standardize how outreach is being conducted throughout VA.’’ In follow-up questions to 

the hearing on the fiscal year 2012 budget, VA was asked to provide the total 

amount VA, as an enterprise, spent on outreach during fiscal year 2010. VA responded by stating, ‘‘[w]hile we are not currently able to extract the total spending 

for outreach across the department for [fiscal year] 2010 and [fiscal year] 2011, we 

are working diligently toward that goal for [fiscal year] 2012.’’ 

a. Please provide the total amount VA spent on outreach during fiscal year 2010 

and fiscal year 2011 and estimates for how much will be spent during fiscal years 

2012 and 2013. The data should include a breakdown of money spent by VA Central 

Office, Veterans Integrated Service Networks (VISNs), Regional Offices, and VA 

medical centers. 

Response. VA created the National Veterans Outreach Office (NVO) within the 

Office of Public and Intergovernmental Affairs (OPIA) in FY 2010 to coordinate outreach throughout VA, and to standardize outreach-related activities. The NVO has 

made considerable progress in researching and analyzing VA’s outreach programs 

and activities in 2011, and has already developed a framework to track outreach efforts that are part of VA’s major initiatives. The final frameworkincludes building 

a process for VA’s administrations (Veterans Health Administration, Veterans Benefits Administration and National Cemetery Administration) and staff offices to: 

43 

• provide Veterans with high-quality products and information on activities that 

are consistent; • provide trained outreach coordinators to assist Veterans; • evaluate and develop metrics to measure the effectiveness of outreach programs; and • track costs associated with outreach programs. 

The embedded table, previously provided to the Committee in March 2012, gives 

expenditure data on advertising outreach, a component of VA’s outreach efforts. 

Outreach through advertising is targeted to helping VA reach Veterans who may 

be contemplating suicide; struggling with homelessness, unemployment, or mental 

illness; for those Veterans who live in rural areas; to make Veterans aware of available benefits and services; and VA hiring and recruitment. Table 1 details VA advertising activities and obligations for the period 2009–2012 and planned for 2013. 

The mechanisms for advertising outreach activities have included Public Service 

Announcements, multi-media projects, Internet promotion, transportation and billboard advertisements. Outreach activities and events for Homeless Veterans Outreach, Health Benefits Awareness, Mental Health Awareness, Women Veterans 

Outreach and Suicide Prevention Outreach will continue in 2013 using earned 

media, including news releases, social media, fact sheets, printed materials, etc. FY 

2013 funding to supplement these activities with paid advertising will be determined as part of the operational planning process. 

b. Does standardizing the outreach efforts of VA include coordinating projects and 

initiatives at all levels of the organization? If so, please detail how the National 

Outreach Office has met these goals and please describe what new initiatives the 

office is undertaking to that end. 

Response. Yes, but it is important to note that OPIA only has supervisory authority over those personnel who are assigned or detailed to the National Veterans Outreach Office. In addition, hundreds of other VA employees enterprise-wide assigned 

to VBA, VHA and NCA are typically involved in outreach activities on any given 

day; those employees work for and respond to their respective chain of command. 

In an effort to better coordinate the outreach efforts of all VA employees, VA established a workgroup made up of representatives from VHA, VBA and NCA and VA 

staff offices, including: Centers for Women and Minority Veterans, Small and Disadvantaged Business Utilization, Homeless Veterans Initiatives Office, Center for 

Faith Based and Neighborhood Partnerships, and others. In 2011, the NVO held 


229q1VAb1.eps
44 

workgroup meetings to solicit input and ideas from headquarters and field facilities; 

and built buy-in for development and implementation of the plan to coordinate outreach activities and initiatives. OPIA held a national training conference in which 

‘‘Outreach Day’’ was a major activity to orient VA’s professionals to the outreach 

plan and obtain their final comments on developing a series of products and resources to improve outreach coordination, collaboration and uniformity across VA. 

Recognizing the need for centralized outreach management, NVO has developed the 

first capability to provide critical and consistent information to VA’s Outreach community: 

• An intranet site that houses important information to enhance how VA Outreach coordinators execute outreach including policies and procedures, the National 

Veterans Outreach Guide, links to the Congressionally mandated 2010 Biennial Report to Congress on the VA’s outreach activities, and other links. 

• An online National Veterans Outreach Guide that provides best business practices, expert recommendations, proven examples of successful VA outreach activities 

in serving Veterans, and lessons learned. This guide outlines processes for how to 

conduct outreach events, track expenditures, measure the success of activities and 

tap into key VA resources and contacts, plus so much more. 

• Next steps include finalizing a proposal for a robust National Veterans Outreach System (NVOS) which will allow VA Outreach leaders to populate a series of 

fields with information about planned outreach activities. The NVOS will be an 

interactive tool that allows users to systematically and uniformly enter, store, organize, view, retrieve and report outreach-related data easily. The goal of the database 

is to provide a more advanced, easy-to-use tool that may either be used in concert 

with existing data collection methods or replace less efficient and effective approaches. It will also provide the data necessary to extract any number of data pulls 

including the costs associated with outreach in a fiscal year and the number of 

events executed. 

Question 4. During this year’s State of the Union, the President proposed the Veterans Job Corps. The 2013 VA Budget Fast Facts describes the program as follows: 

‘‘A Presidential initiative of $1 billion over the next five years to establish a conservation program impacting up to 20,000 veterans to protect and rebuild America’s 

land and resources.’’ 

a. Describe in detail how the initiative would be administered. Please include information on which other agencies would participate, what the responsibilities 

would be of the non-VA agencies, what types of jobs are envisioned through the initiative, and what criteria would be used to select participating veterans. 

Response. The Veterans Job Corps proposal, which requires legislative authorization and funding from Congress, will focus on employment for all Veterans, but will 

focus on Post-9/11 Veterans. The initiative will put returning Veterans back to work 

on projects building on their military experiences and skills—from serving on conservation projects to restore and protect public lands and resources to serving our 

communities as law enforcement officials and firefighters. 

The Department of Veterans Affairs (VA) will coordinate a Federal Steering Committee that will evaluate competing proposals from implementing Federal agencies, 

and would be authorized to transfer funding to those agencies for approved projects. 

VA will serve as the lead for the Federal Steering Committee, which will be composed of policy officials representing implementing Federal agencies. The United 

States Department of Agriculture (USDA), the Department of Interior (DOI), National Oceanic and Atmospheric Administration (NOAA) at Department of Commerce, and the Department of Defense (DOD) Army Corps of Engineers (ACOE) are 

envisioned as the implementing agencies that will execute a range of conservation 

and infrastructure projects in our local, state, and national parks, forests, marine 

sanctuaries, and other public lands. The Department of Justice and the Department 

of Homeland Security are envisioned as the implementing agencies that will issue 

grants to local entities to hire Veterans as law enforcement officials and firefighters. 

As proposed, project proposals would be submitted by the USDA, DOI, NOAA, and 

ACOE in conjunction with state and local agencies and other stakeholders. Grants 

for law enforcement officers and firefighter will be evaluated using existing program 

criteria, in addition to the number of Veterans that can be hired. Federal land management agency projects would be evaluated using basic threshold requirements, 

such as whether the project provides conservation or recreation benefits on public 

lands and waters and if the project is ready to be implemented. Other likely project 

selection criteria will include the number of Veterans that can be hired and other 

benefits to Veterans, such as long-term career development and educational opportunities. We expect that many Veterans would be hired by DOI and USDA to address outstanding maintenance issues in national parks, refuges, forests, and other 

45 

Federal public lands, as well as by state resource management agencies where Veterans can do similar work on state and local lands. 

The projects would be implemented through contracts to businesses, cooperative 

agreements and grants to non-Federal entities, and direct hiring of a small number 

of Veterans for temporary positions. VA will leverage existing on-line resources to 

coordinate efforts among stakeholders and match Veterans with employment opportunities. VA would also develop a framework for monitoring and evaluating progress 

to ensure proper oversight and accountability. 

b. Please describe the program in detail, including the amount of payments, subsidies, and benefits veterans would receive through this program; how much it 

would cost per participant; what opportunities veterans would have to continue 

working for the Federal agency after completing the program; and how much of the 

overall programmatic cost would go toward administration. 

Response. Details of the Program will be finalized as part of the ongoing discussion between the Administration and Congress on this proposal. The amount of payments and subsidies, the number of Veterans served, and the future employment 

opportunities will depend on the submissions of projects to the VA-led Steering 

Committee, that will disburse funds for the proposals which will provide the greatest benefits to our Nation’s Veterans. 

c. If the initiative would require $1 billion in mandatory funding over the next 

five years, what VA program changes would VA propose to offset this funding increase? 

Response. All of these proposals are included in the President’s FY 2013 Budget. 

In September the Administration put forward the American Jobs Act together 

with a plan for deficit reduction that had a net savings of $4 trillion. The Administration is willing to work with Congress to draw on that list to find mutually acceptable pay for options. 

Question 5. In 2010, VA began operating the Fast Track Claims Processing System to process claims for three conditions presumed to be related to Agent Orange 

exposure. The fiscal year 2013 budget request reflects that ‘‘analysis and planning 

regarding system retirement will be conducted in [fiscal year] 2012.’’ 

a. To date, how much in total has been spent (from any account) on developing, 

enhancing, and operating the Fast Track Claims Processing System, including funds 

for contractor support? 

Response. To date, $11.3 million has been spent on Fast Track development, enhancement, and operations. 

b. Is any funding (from any account) requested in the fiscal year 2013 budget in 

order to operate, expand, or retire the Fast Track Claims Processing System? 

Response. The budget request for Fast Track is $1.8 million annually for operations and maintenance. 

c. Since its inception, how many claims have been filed by claimants on-line using 

this system? 

Response. As of February 24, 2012, 4,288 claims have been filed by claimants 

using the on-line system. 

d. How many claims have been processed through the Fast Track system and how 

long on average did it take to complete those claims? 

Response. As of February 24, 2012, 14,933 claims have been processed through 

Fast Track. Of these, over 10,000 were incorporated into Fast Track by Veteran 

Service Representatives on behalf of the claimants. The average time to complete 

Fast Track claims is 135 days. 

e. How many Fast Track claims are currently pending and how long on average 

have they been pending? 

Response. As of February 24, 2012, 26,848 claims were pending for approximately 

125 days on average. 

f. What, if any, changes have been made in the manner, means, or method of implementing the Fast Track Claims Processing System, either in the field or within 

the headquarters of the Veterans Benefits Administration, since it began in 2010? 

Response. VA has made the following changes to Fast Track since 2010: 

• Developed and deployed an easy to use interface for the input of Disability Benefits Questionnaires (DBQs) for both the public and VA users; 

• Developed and deployed a ‘‘Short Form’’ to allow VA users to quickly input essential data into Fast Track since Fast Track is a stand-alone system which cannot 

pull data from VA’s Corporate database; and 

• Added the ability to generate or suppress letters to Veterans and physicians to 

allow VA users more flexibility in corresponding with Veterans and their physicians. 

46 

Question 6. In the budget request, VA requested an additional $165 million to the 

enacted fiscal year 2013 appropriations for medical care. In briefing slides provided 

to the Committee staff, VA indicates this increase in funding request is due to 

‘‘[a]nnual update of actuarial model and long-term care estimates’’ and ‘‘[e]nhanced 

funding provided to meet facility activations, implementation of the Caregivers Act, 

and other strategic initiatives such as ending Veteran homelessness.’’ 

a. Please provide the Committee with a more detailed justification for the additional funding request, broken down by program and initiative. 

Response. For FY 2013 there were changes in the adjusted actuarial estimates for 

health care, the estimates for long-term care, the estimates for other health programs (i.e., CHAMPVA), and obligations as shown below ($ in millions): 

Adjusted actuarial estimates .............................................................. $(1,715 ) 

Long-term care .................................................................................... (271 ) 

Other health programs ........................................................................ (119 ) 

Total reductions ......................................................................... (2,105 ) 

Less reduction in obligations ............................................................. 110 (detail composition below) 

Total net reduction in estimates ............................................... (1,995 ) (detail below) 

Composition of reduction in obligations: 

Appropriation request increase ...................................................... 165 

Reimbursement increase ................................................................ 50 

Collection decrease ......................................................................... (325 ) 

Net reduction in obligations .................................................. (110 ) 

Details of investment of $1,995: 

Zero homelessness ......................................................................... 892 

Activations ...................................................................................... 448 

New Models of Care ....................................................................... 433 

Expand Health Care Access ........................................................... 120 

Caregivers ....................................................................................... 30 

Improve Mental Health ................................................................... 20 

Other ............................................................................................... 52 

Total ....................................................................................... $1,995 

b. Please identify which facility (new VA hospital, Community Based Outpatient 

Clinic (CBOC), Outreach Clinic, etc.) activations would be supported with this increase in funding. 

VHA Response: The activation funding requested in the FY 2013 Advance Appropriation (FY 2012 President’s Budget) was $344 million plus the activation increase 

requested in the FY 2013 President’s Budget (see response to question 6a above), 

which was $448 million. This equals a total of $792M for FY 2013 activations. The 

specific projects making up the $792M are listed in the table below. 

47 

Question 7. Under the Veterans Health Care Budget Reform and Transparency 

Act of 2009, VA is able to update the current fiscal year budget estimate for medical 

care, as well as provide a request for the following fiscal year advance appropriations for medical care. In the President’s budget request, VA indicates that ‘‘VA was 

able to re-invest over $2 billion in both 2012 and 2013 in high priority medical programs.’’ Please provide a detailed breakdown of what programs this funding was 

‘‘re-invested’’ in and please detail how this increase in funding would be utilized for 

each program. 


229q1VAb6b.eps
48 

Response. The data for FY 2013 is provided in response to question 6a above. For 

FY 2012 there were changes in the adjusted actuarial estimates for health care, the 

estimates for long-term care, the estimates for other health programs (i.e., 

CHAMPVA), and obligations as shown below ($ in millions): 

Adjusted actuarial estimates ........................................................... $(2,559 ) 

Long-term care ................................................................................. (210 ) 

Other health programs ..................................................................... (115 ) 

Total reductions ....................................................................... (2,884 ) 

Less reduction in obligations ........................................................... 698 (detailed composition below) 

Total net reduction in estimates ............................................. (2,186 ) (detail below) 

Composition of reduction in obligations:.

Appropriation change ................................................................... 000 

Transfer to Joint DOD-VA DemoFund ........................................... (234 ) (North Chicago) 

Transfer to DOD-VA Fund ............................................................. (15 ) (Health Sharing Incentive) 

Contingency not appropriated ...................................................... (240 ) 

Reimbursement increase .............................................................. 57 

Unobligated balance increase ...................................................... 63 

Collection decrease ...................................................................... (329 ) 

Net reduction in obligations ............................................... (698 ) 

Details of investment of $2,186:.

Zero homelessness ....................................................................... 559 

Activations .................................................................................... 831 

New Models of Care ..................................................................... 610 

Expand Health Care Access ......................................................... 113 

Caregivers ..................................................................................... 43 

Improve Mental Health ................................................................. 31 

Other ............................................................................................. (1 ) 

Total ..................................................................................... $2,186 

Question 8. The fiscal year 2013 budget request includes $1.352 billion for programs related to prevention and reduction of homeless veterans. 

a. Do the fiscal year 2013 request and fiscal year 2014 advance funding request 

require legislative authority to release funding for these programs? 

Response. VA is taking decisive action toward its goal of ending homelessness 

among our Nation’s Veterans. To achieve this goal, VA has developed a plan to end 

homelessness that will assist every eligible homeless Veteran and Veteran at-risk 

for homelessness. VA will assist Veterans to acquire safe housing; needed treatment 

and support services; homeless prevention services; opportunities to return to employment; and benefits assistance. Specific programs which provide these services 

include the VA Grant Per Diem Program (GPD), Health Care for Homeless Veterans 

Program (HCHV), and the Supportive Services for Veteran Families Program 

(SSVF). 

VA’s FY 2013 budget submission includes requests for authorization legislation on 

a number of fronts to reflect this priority, and it is critical to secure timely enactment to further VA’s efforts of ending homelessness among our Nation’s Veterans. 

In order to achieve its goal, VA needs the extension beyond 2012 of the HCHV program (38 U.S.C. 2031) as well as the authorities granted by 38 U.S.C. 2102A, 2033, 

and 2041. In addition, VA is asking that Congress increase the amounts authorized 

to be appropriated for the GPD Program (38 U.S.C. 2013, 2061) and the SSVF program (38 U.S.C. 2044). These requests for legislative authority are included in VA’s 

FY 2013 Budget Submission, Summary Volume (Volume 1 of 4) at pages 3A-5–3A-6. 

b. What metrics were used to determine how much funding is needed for each program? Please provide any metric templates currently developed. 

Response. VHA Homeless Programs developed a budget request based on historical allocations, expansion of existing programs using established priorities, and new 

initiatives based upon actuarial modeling of projected workload. Increased funding 

for homeless programs is needed to continue existing services, expand existing programs, and establish new initiatives in order to meet VA’s goal of ending homelessness among Veterans. In determining costs for each of the services included in the 

49 

Ending Veteran Homelessness Initiative, estimates were based on (1) the number 

of Veterans estimated to need services, (2) costs of other needed services, e.g., services designed to prevent homelessness, and (3) costs of case management services 

associated with permanent affordable housing programs. 

Question 9. In fiscal year 2011, Congress appropriated $799 million for homeless 

veterans programs. 

Please provide a detailed breakdown of how this money was utilized within these 

various programs, the number of veterans who accessed these programs, how each 

program was effective in reducing the number of homeless veterans, and what 

metrics are used to determine the effectiveness of these programs. 

Response. In the fiscal year (FY) 2011 President’s Submission, VA requested $799 

million for homeless Veterans’ program initiatives, along with sustainment funding 

in the areas of HCHV and Domiciliary Care for Homeless Veterans (DCHV). 

Sustainment funding is provided to VA’s medical centers through the Veterans’ Equitable Resource Allocation (VERA) and is handled locally, not by VHA Homeless 

Programs. As a result of expanded access and outreach efforts, HCHV sustainment 

and DCHV sustainment costs were higher than anticipated in FY 2011, resulting 

in a total of $933 million, rather than $799 million, in funding. With this funding, 

VA was able to deliver services to approximately 160,000 Veterans. The table below, 

drawn from Volume 2—Medical Programs, page 1L–14 of the FY 2013 Budget Submission provides more detail). 

* $ in Thousands (Chart extracted from Volume 2—Medical Programs, page 1I–14) 

Number of Veterans Accessing Each Program 

In FY 2011, VA provided services (both health care and benefits) to almost 

188,000 Veterans who are homeless at risk for homelessness. A majority of these 

Veterans (over 160,000) were served by one or more of VA’s specialized homeless 

programs including: 


229q1VAb9a.eps
50 

• The HCHV program conducted aggressive outreach and provided outpatient 

services to more than 95,000 Veterans and offered more than 8,100 episodes of contract community-based residential treatment. • The DCHV program provided intensive residential rehabilitation and treatment 

to over 8,000 Veterans. • The Compensated Work Therapy/ Transitional Residences (CWT/TR) program 

provided structured transitional housing to approximately 1,400 Veterans. • The GPD program provided community-based transitional housing to over 

30,000 Veterans. • VA continues to collaborate with the Department of Housing and Urban Development (HUD) to implement approximately 30,000 supportive housing units aligned 

with VA case management and supportive services through the HUD-VA Supported 

Housing (HUD-VASH) Program. • In FY 2011, 44 Health Care for Reentry Veterans (HCRV) Specialists saw over 

11,000 Veterans in 1,008 of 1,295 (78%) total state and Federal prisons; Veterans 

Justice Outreach (VJO) Specialists saw more than 15,000 Veterans at earlier stages 

of justice involvement, for a combined total of over 27,000 justice-involved Veterans. 

In addition to these direct service programs for homeless Veterans, VA launched 

two homeless prevention initiatives—SSVF and the HUD-VA Homeless Prevention 

Demonstration (VHPD) programs; initiated the Homeless Veteran Supported Employment Program (HVSEP) and supported the National Call Center for Homeless 

Veterans. 

Program Effectiveness 

The 2011 Point-in-Time Estimates of Homelessness: Supplement to the Annual 

Homeless Assessment Report published in December 2011, estimates that on any 

given night in 2011 there were approximately 67,495 homeless Veterans and that 

homelessness among Veterans has declined by nearly 12 percent since January 2010. VA has taken decisive actions toward its goal of ending homelessness 

among the Nation’s Veterans, and has developed a continuum of care designed to 

assist every eligible homeless Veteran as well as Veterans at risk for homelessness. 

With the exceptions of very new programs such as VJO and SSVF, studies of the 

effectiveness of VA specialized homeless services have been conducted. Generally, 

these studies have been conducted early in the implementation of the initiatives and 

have been both observational and experimental in design. For example, the effectiveness of the HUD-VASH program was documented in a randomized control trial 

that compared HUD-VASH to intensive case management without HUD rental assistance and to usual VA services. 

Such studies are extremely expensive to conduct and generally are limited to a 

representative sample of Veterans and the prescribed timeframe. However, the implementation of all specialized VA homeless programs is monitored on a continual 

basis. To further develop monitoring capacity, VA continues to develop its new National Homeless Registry. The Homeless Registry will be a real-time data resource 

for service providers, VA policymakers, administrators, and researchers. In addition 

to data collected with the VA specialized homeless programs, the Homeless Registry 

will incorporate VA inpatient and outpatient data as well as data collected through 

HUD’s national Homeless Management Information System (HMIS) database. The 

Homeless Registry is the ‘‘next generation’’ monitoring tool and will provide important documentation of progress toward VA’s Plan to End Homelessness among 

Veterans. 

Metrics 

Ongoing monitoring of VA specialized homeless services includes measures of program structure (e.g., staffing, staffing vacancies, program costs); program processes 

(e.g., demographic and clinical characteristics of program participants, duration of 

participation in the different programs); and program outcomes (e.g., housing status, 

employment status, provisions for aftercare). Feedback to program sites in the field 

is delivered through a series of measures based on relative performance. 

Explicit studies of program effectiveness also include measures of program structure, process and outcomes. Data collection in those studies is generally more intensive than during ongoing monitoring and tends to be longitudinal in nature. For example, the previously mentioned effectiveness study of HUD-VASH collected a wide 

array of measures on each study participant quarterly for a minimum of three years 

following program entry. 

Specific metrics in place to determine the effectiveness of these programs: 

• Number of Homeless Veterans (on any given night), reported in the Supplemental Chapter on Homeless Veterans in the Annual Homeless Assessment Report 

(AHAR). 

51 

• Percent of vouchers issued to the medical center/facility that result in a homeless Veteran achieving resident status in Public Housing Authority. 

• Percent of Veterans discharged from GPD or DCHV programs who discharge to 

an independent housing arrangement. 

• Percent of Veterans admitted to the HUD-VASH program who were chronically 

homeless at the time of admission. 

Question 10. The fiscal year 2013 budget request includes $21 million for 200 additional full-time equivalents (FTE) to be Homeless Veterans Outreach Coordinators 

(HVOC) in the Veterans Benefits Administration. The purported purpose of the new 

HVOCs is to support VA’s goal of ending veterans’ homelessness. According to the 

fiscal year 2013 budget request, the additional resources in 2013 are intended to 

‘‘accelerate services for an additional 43,000 Veterans and their families by decreasing the frequency and duration of their episodes of homelessness’’ and ‘‘[t]he resources will also assist veterans and their family members maintain safe and permanent housing, get connected to employment opportunities, and improve the overall health care status.’’ 

a. Please explain how the manner, means, and methods of utilizing these HVOCs 

do not duplicate, compete with, and overlay already existing veteran homelessness 

outreach programs, initiatives, FTE, and other resources that are on-going in the 

Veterans Health Administration (VHA) VISNs and VA medical centers. 

Response. VBA’s HVOCs are targeted outreach positions dedicated to assisting 

homeless Veterans and Veterans at-risk of homelessness and their families with 

their VA benefits, including compensation, pension, education, vocational rehabilitation, insurance, and housing. One of their most important functions is to ensure 

homeless Veterans’ claims are appropriately expedited within the claims processing 

system. VBA’s goal is to process homeless claims in 75 days. VBA needs these additional FTE to reach our goal and provide timely benefits to these Veterans and their 

families. Although both VBA and VHA conduct outreach and provide referrals, 

HVOC duties are specialized and do not duplicate already existing homeless outreach programs within VHA. 

VHA’s homeless outreach efforts are directed at health care delivery and VBA’s 

outreach efforts are focused on benefit delivery. Both functions are necessary to 

meet the complex psychosocial, mental health and health care needs of homeless 

and at-risk Veterans. VHA and VBA homeless Veteran outreach staffs work closely 

to optimize services to homeless Veterans at VA settings and in the community. 

Specifically, VHA’s homeless outreach staff is comprised of social workers, other licensed professionals, paraprofessionals and/or peer specialists. All have duties specified in either a professional functional statement or position description. Some of the 

staff perform outreach duties on a full-time basis others less than full-time. VHA’s 

outreach efforts focus on the identification and assessment of homeless and at-risk 

Veterans, engagement in VA’s health care programs, and referral and linkages to 

VA and community benefits. VHA homeless outreach efforts are accomplished 

through community partnerships and coordination with VBA’s HVOC’s. 

b. Please identify where it is anticipated these 200 HVOCs will be located (i.e., 

existing Veterans Benefits Administration Regional Offices, leased space in the community, VA medical centers, CBOCs, etc.). 

Response. HVOCs will have a presence at existing regional offices and in locations 

that have high homeless Veteran populations. They will also spend time at VA medical centers (VAMC), Community-Based Outpatient Clinics (CBOC), prisons/jails, 

and Veterans treatment courts. 

Full time equivalent (FTE) allocations at regional offices will be based on several 

factors. Our 20 current HVOCs are overworked. Each of our regional offices that 

currently has an HVOC will receive a second HVOC to assist with workload and 

help sustain our efforts to date. The remaining 180 FTE will be placed in areas that 

have the highest concentration of at-risk and homeless Veterans throughout the 

country. VBA will also consider other factors such as Veteran population, population 

density, and workload. 

c. Please provide the Committee with copies of any veteran homelessness needs 

assessment demonstrating the need for these specific outreach coordinators and that 

current VA resources in place are not adequate to address the needs. 

Response. VBA is targeting our efforts to reach areas that have a higher concentration of homeless women, have higher foreclosure rates, and are rural. 

Question 11. In 2009, 2010, and 2011, VA’s Board of Veterans’ Appeals published 

a Veterans Law Review. 

a. During fiscal year 2011, how much was spent on the operation and publication 

of the Veterans Law Review? 

52 

Response. In fiscal year 2011, the total expenditure to publishthe Veterans Law Review was $23,127.60, spent almost entirely on printing costs. 

b. During fiscal year 2012, how much is now expected to be spent on operation 

and publication of the Veterans Law Review? 

Response. In fiscal year 2012, the estimated expenditures to publish the Veterans Law Review (again almost entirely for printing costs) are approximately $24,500. 

c. During fiscal year 2013, how much is requested for purposes of operating and 

publishing the Veterans Law Review? 

Response. In fiscal year 2013, the requested expenditures for publication of the 

Veterans Law Review (again almost entirely for printing costs) are approximately 

$26,000. 

Question 12. The December 2010 report from the National Commission on Fiscal 

Responsibility and Reform included a recommendation to reduce Federal spending 

on travel, printing, and vehicles. 

a. During fiscal year 2012, how much in total is projected to be expended by VA 

on travel costs; how much in total is projected to be expended on printing costs; and 

how much in total is projected to be expended to purchase, lease, operate, or maintain vehicles? 

b. For fiscal year 2013, how much in total is requested for travel costs; how much 

in total is requested for printing costs; and how much in total is requested to purchase, lease, operate, or maintain vehicles? 

Response. [These questions are repeated in and answered posthearing questions, 

section GENERAL, Question 5.] 

Question 13. According to VA’s Fiscal Year 2011 Performance and Accountability 

Report, VA has ordered 25 electric vehicles in order to conduct a ‘‘pilot study.’’ 

a. What make and model of electric vehicles were ordered, what was the total cost 

to VA to purchase or lease these vehicles, and what was the total cost to the Federal 

Government (if different)? 

Response. VA is currently scheduled to receive 26 electric vehicles (EVs) through 

the General Services Administration’s (GSA) EV pilot program: 

• 5 Think City vehicles 

• 1 Nissan Leaf 

• 20 Chevrolet Volts 

VA is paying the same lease cost for these EVs as for a standard vehicle of a similar class. GSA’s pilot program funding covers the incremental costs of the electric 

vehicles and the acquisition cost of charging stations for the participating agencies. 

Agencies only pay for the costs associated with installing the charging station at the 

EV site. 

GSA would have information on the cost to purchase or lease these vehicles both 

for VA and Federal-wide. 

b. For fiscal year 2013, how much in total is requested for purposes of this initiative? 

Response. No funding is requested 

c. How and where will these vehicles be used? 

Response. Most of the vehicles are assigned to VHA facilities in the San Francisco, San Diego, Los Angeles, Detroit and Washington/Baltimore metropolitan 

areas. One additional vehicle is assigned to VBA in Detroit. VA is deploying each 

vehicle to the most appropriate use at the selected locations. For example, how the 

vehicle is used depends on the distance that needs to be traveled, the number of 

people that must be accommodated, whether or not equipment and/or other supplies 

are being moved and other related factors. 

d. What are the specific objectives of the pilot study and what benchmarks will 

be used to determine whether it is successful? 

Response. The pilot study is a GSA initiative. GSA’s stated objectives are to determine if EVs are a cost effective option for Federal fleets, and where and for what 

kinds of uses. GSA is collecting data electronically from the charging stations and 

from the agencies leasing the vehicles. 

e. Please provide copies of the Executive Decision Memorandum (or comparable 

document) approving the pilot study and supporting documents of justification and 

implementation. 

Response. The pilot study is a GSA program in which VA, along with other Federal departments and agencies, is a participant. VA does not have access to GSA 

internal support and approval documentation. 

f. What cost comparisons were performed to assess the differential between the 

costs of operating an electric vehicle fleet versus other types of vehicle fleets (gasoVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00058 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
53 

line, natural gas, or hybrid)? Please provide any documentation comparing the costs 

of electric vehicles with other types of vehicles (gasoline, natural gas, or hybrids). 

Response. Under this pilot, GSA pays all operating expenses for leased vehicles 

in their fleet regardless of fuel type. 

Question 14. According to VA’s Fiscal Year 2011 Performance and Accountability 

Report, VA is ‘‘noncompliant with the Debt Collection Improvement Act of 1996’’ because VA does not charge interest or administrative costs on delinquent debts owed 

to VA. VA has previously explained to the Committee that, ‘‘in 1992, the Deputy 

Secretary of Veterans Affairs made a decision not to implement the statutory interest and administrative charges on Compensation and Pension debts.’’ VA has also 

indicated that ‘‘[t]he majority of debts created for compensation are due to beneficiary death, incarceration and fugitive felons.’’ 

a. What is the legal authority relied upon by VA to forego collecting interest and 

administrative costs with respect to delinquent debts? 

Response. Please see the decision paper below, which was signed by then Deputy 

Secretary Principi in 1992. 

54 


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inat.l.tuted prooedure. to comply with th~a. raquireaant •• 

Recommsndation; 

Ravlse an~ implement procadurea to ebarqa intareat at the 

prescribed rat. on compans.tion, panaion, and othar banetit d.btg. 

VilA Position! 

Tha Vateran. Sanetit. Admini.tration i. oppo •• 4 to ch.r~in~ 

intere.t 01'1 compana.tion and pan5ion-relatlld debts tor tha 

follow1n9 reaaona: 

Moat C&P debtor. live at or near the poverty l.vel and ere alderly with no r.aource. to pay the dabts aueh 1.ss 

intereat oharqm •. 

Inter.at ~harqaa Would 1.ad not t~ a reduotion in the 

pension d.bt 10a4 but to en increa.e .. intereat eharqae and acbnini.trativa coata are acSdael to the amount. already unpayahl.. 'l'ha and ra.ul.t would. ba not only an inor .... ci 

debt total but al.o !nerealod •• ntal aa4 tinlneial 

burden. tor eld~ly, 4i.ahlad, and d<1tuta vatarans. 

Th. Dapartment i. .lr.ady abla to recoUp a hlqh paraent.q. ot oa.p.na.t.l.on and pan.1on d.bta by withholdlnq ovarpayment. trom on-qo1nq paymMnt •. 

Charging int~ •• t on C&. da»t. wou14 dateat tha p~po •• to~ wbioh th. ben.tit ie beinq paid. In pan.1on c •••• , the vetaran ne.ca ~e pen.lon to oat the b.-1c 

n.oeaaitie. ot 11f.. In oOllpan •• Uon 0 •••• , 1:11e disabled 

v.taran lIIOly not be ahl •. to maka a liv1ri'l without th. 

eompen •• tion payment. 
55 


229q1VAb14a2.eps

VA Ilf<BT .GIIT CIR ~004 

Int~ract charqinq is intended to COQrc~ debtor. to 

liquidata d.Qts on a t1~ely ba.is or auffar a monatary panalty. aacaUlle lIIost CSP debtors would be W\able to pay d.bta, tha "i:hraat" or cnarqinq intar •• t: would •• rve no 

practical purpo.a. 

Intar.st charging i. inconaiatent 1n ralation to .imilar 

b.netit proqram. ,.uch ao social s.curity. 

Implementation ot intQrQat charqinq would co.t: the 

Oepart:mant approximately 5835,000 over a 23-month period. Ba.ad on current: and proj.cted level. or collect10na and 

tha inor.acad debt load cau.ad by the addition ot interest cnerqalS, implomantation or the proqt;'4l!I vo~lc1 not 

ba coat-affective tor the Oapartment. 

VBA hac d.volop.d, and the Departmant haa aUbmitt.d, laqi.lat1v. proposals to axa=pt VA from tha requirement in .uec ••• ive 

Conqr.ellea. Implalllentation ot the law hac bean aVoidad on tn .. grounda that panding leqialation would remove the requirement. 

OIG potition: 

We disaqrea with oontinuing ~o prcpoa. laqialation ~o exempt c.p d.bt. t~oa intarest charqe. tor the tollowinq raaaonsl 

Reci~ient. ot compe~.at1on er pans10n ovarpaymanta havQ ua. ot thesCi fW\4e w:l.th • coat to tha Government (imputed inter.at) IUlUl the tun411 are repaid. 'rbi. practica, in 

etteot, provide. an intar.at free loan that i. not 

.quitably av.ilLble to other •• 

The "threat" of charqing interest - to coerc. dabtor. to 

liquidate dabte on a timely bads - ceull! indue. an illerealle at cash collection. above the current 11 pereant 

rat.. In al!dition. by net eharqin9 intu •• t. tn. 

D.partm.nt loae. the ability to ancourage quick r.paY1lent •• 

tnterlat charg-inq WOUld not IUltairly burden vatarana 

lUIule to p.y CiP debt.. EXi.tinq waiver and cQJ:Ipromi.a procedure. provide for nonpayment ot dabta vh.n it ia .~ainst aquity an4 g'004 Qcnsoionoe. 

WA'. 083S,OOO implamantation coat OVal;". tvo-year pa.riod. i •• one-tilla co.t. VISA'I Novlllber l.!I91 co.t bl"etie 

analy.i. projeots 1nter •• t accruala of n.arly $5 million 

annually in ,ucceedinq year •• 

More importantly, the lanquaq. of the law 18 claar in tho 

requ1r8lllellt that tha.e charge. be lavi.d. The initi.l lag'ialetiva requirulII1t waa •• tabl1ahed in 1980. Tha W\aueee •• tul attupta to 

obe.1ft leqi.lativa r.li.f in auoea.aiv. Conqr..... .hould be 

accepted and the requirement. implement.d. Thera l1ae alao be.n 
56 


229q1VAb14a3.eps 229q1VAb14a4.eps

.14;Zt t'J\..A. 1:114:74::11731 VA DEBT IIGIIT ern 141005 

il1c:rec:uuQ oPb<0Il1e1on. to IIA'a legislative 1nit1ativ .. withill the 

Adminilltration, makinq lIIgi.lativa relief lese likely to occur. ThQ Oepartment ot ~Qucation for~.lly cppoee4 the VA proposal on ~he 

grounds that 1t could e.tebl1.h.e precedent tbat could adversely affect Govarfllllent~wida COllection proviaiona. 

The Chief Financial Of ticer' a poaition (copy attached) ia a ooncurrence with our poaition and alDO inclUde. the .tat~ane that 

VA should begin to aues. interest· and "dminitSntiy. cotta on de11nqyene C&P debta as requirea by law. The cro po.ieion paper also indicates that the Departmental decition ehould taxe into 

conaidaration the fact that the legislative propoaal. to dats have noe been approved. We 11ql"e8 tbat alSministrativ. coate .hould elso 

be alleaaa.d·. 

Another factor to conlid&r 18 that the GAO hae 1sIIued tive reports &inCCl 1986 r.colDlll8l1d!n\J that the VA implament proc.dure, to charge in~ere.t and administrative costl on C" debtl. The late.t r.port {July 19911 did not includ. a recommendation to the Sacretary but 

rathor to the OKS, r'aool1\llland1n\J that OMS cUrect VA to assaas int.rest and administrative oosta on CiP debts. 

The decision optiona outlined below alao addr •• s intar.at charqinq on loan quaranty debts. VBA h",s ained. to reviae the currant 

interest rate on loan quaranty dabta to the qovlrnmant-~id. rate ac raoommanc1 .. ci by th\;o audit r.port.. Hov.vU, no aotion ha. be.n tuen 

aincI the report wae issued in 1987. VBA'a plan i. to dave lop two 

projeot. aimultanooualy to charqe intareQt on both CaP and loan 

'fUaranty dabt. it requirecl to do 10. xt the final d.oiaion 10 that 

the. D.partment will not Charql intara.t on C'P debt., • timetabla 

tor implamentinq loan iUaranty interelt oharqinq ahould ba 

rOq\liracl. 

peputy sQcret,ry's Deciaion; 

QRtion 1. 

Imp18l11ent the recommendation to revia. and implement 

proceduraa to oharqa intaraat at tha prescri~a~ rata on campana at ion and panlion (CiP) 4abts. Administrative 

coata should alao b •••••••• 4. 

P~ovid. a time·phaee4 tmplamantation plan to the OIG tor 

charqinq inter.at and admini.trative coata on both c&P 

an4 loan ;uar.ney debta. Int"aat enarqinq .hould baqin ftO later than ootober 1, 11194 un1e.. auttioient 

justification can be provid.cl ~or a later date. 

U .. lFUV:U J.t:Z3 l""ll. 61Z72517Jl V A DEBT IIGIIT eTR 

Do not implement intor.at·charginq on CiP debt •. 

Provide a tima·phaead implamentation plan to the OIG tor 

charq1nq int~reat and adminiatrative co.ta on lo~n 

quaranty debts. Intoreat oharqinq anould baqin no latar 

than Ootober 1, 199.4 unla •• aufticiant :luatitieation can 

,be provided tor a later dete. : ~~ 

7/fIyJ DATE ~ () JOPifCIPI 

~008 
57 

b. What is the total amount of debt to VA created in fiscal year 2011 as a result 

of VA beneficiaries being incarcerated or having fugitive felon status? 

Response. VA tracks fugitive felon and incarcerated beneficiary cases by year of 

referral to the field for processing rather than by year of debt establishment. Although we are not able to provide the specific debt amounts created by year, we estimate (based on case tracking and sampling) the average annual amount of debt 

created for the years 2003 through 2010 to be $32,121,505. 

c. What is the total amount of debt to VA expected to be created in fiscal year 

2012 and in fiscal year 2013 as a result of incarceration of beneficiaries or beneficiaries deemed to be fugitive felons? 

Response. We do not project any significant change. The numbers of cases referred 

in recent years have remained constant or declined. 

d. If VA assessed interest and administrative costs, in accordance with the Debt 

Collection Improvement Act of 1996, on any of those debts that are or are projected 

to be delinquent, what would be the total amount of those assessed charges in fiscal 

year 2012 and fiscal year 2013? 

Response. VA systems are not programmed to handle the charging of interest and 

administrative fees. VA is therefore not currently able to estimate the amount of 

interest or administrative charges on current or projected delinquent debt with any 

degree of accuracy. 

Question 15. With respect to VA’s fiscal year 2012 budget request, VA was asked 

whether the budget request included ‘‘funding for benefits that are projected to be 

overpaid and not recouped.’’ In response, VA indicated in part that, ‘‘[a]lthough 

there is no specific line item for overpayments in the budget request for the Compensation and Pension account, these payments are accounted for in the baseline 

budget estimates and are not identified as funds that VA does not expect to recoup.’’ 

VA also indicated that for fiscal year 2012 the Readjustment Benefits account included ‘‘a net increase of $7.2 million in obligations associated with overpayments.’’ 

a. For fiscal year 2012, what is the total amount of benefits now projected to be 

overpaid? 

Response. For Compensation/Pension benefits, we provide the following projections, which detail the FY beginning balance, establishments, collection/offsets, 

write-offs and the ending balance. 

(Dollars in millions) 

Beginning Balance ................................... $1,138.7 

Establishments ......................................... $870.0 

Collections/Offsets .................................... $649.1 

Write-Offs .................................................. $233.0 

Ending Balance ........................................ $1,126.6 

Collections/offsets are reflected as a total applied to the entire portfolio rather 

than just against new establishments. 

Readjustment projections are as follows: 

(Dollars in millions) 

Beginning Balance ................................... $334.6 

Establishments ......................................... $594.0 

Collections/Offsets .................................... $557.5 

Write-Offs .................................................. $12.3 

Ending Balance ............................... $358.8 

Collections/offsets are reflected as a total applied to the entire portfolio rather 

than just against new establishments. 

b. For fiscal year 2013, what amount is included in the Readjustment Benefits account for overpayments of benefits? 

Response. Please see the response to 15c. 

c. For fiscal year 2013, what amount is included in the Compensation and Pension 

account (including any amounts in the budget baseline) for overpayments? 

Response. In the recalculation for the FY 2013 President’s Budget request, the Readjustment Benefits account is projecting a net increase of $24.2 million in obligations associated with overpayments in FY 2012 and $15.2 million in FY 2013. These 

58 

projections are based on historical trends and updated each budget cycle. While obligations for the net increase are incorporated into the budget, these amounts may 

be collected in the future and are not identified as funds that VA does not expect 

to recoup. Although there is no specific line item for overpayments in the budget 

request for the Compensation and Pension account, these payments are accounted 

for in the baseline budget estimate and are not identified as funds that VA does 

not expect to recoup. 

Question 16. VA’s Fiscal Year 2011 Performance and Accountability Report contains the following information: 

One cause of overpayments in both the Compensation and Pension programs has been the implementation of the Fugitive Felon program. This 

program*** prohibits Veterans or their dependents who are fugitive felons from receiving specified Veterans’ benefits. The law requires VA to 

retroactively terminate awards to Veterans and other beneficiaries from the 

date the beneficiary became a ‘‘fugitive felon.’’ As of January 2011, nearly 

23,000 fugitive felon cases have been referred to field stations resulting in 

a total of nearly $165 million accumulated overpayments which cover multiple warrant years. VA’s Committees on Waivers and Compromises had 

waived nearly $22 million in overpayments. 

a. To date, how many current or former fugitive felons have had their overpayments to VA waived? 

Response. VA has waived 751 overpayments from 2003 through the end of 2010. 

b. To date, what is the total dollar amount of overpayments to fugitive felons that 

have been waived? 

Response. The annual average amount of debt waived for the years 2003 through 

2010 is estimated to be $2,222,314. Although VBA’s current systems do not allow 

tracking of waivers at the level of detail to report actual amounts waived, VA is 

working to enhance its corporate systems to support processing and collection of additional financial and debt data. These system enhancements are projected for completion within the next 2 years. 

c. For fiscal year 2013, what amount is included in the budget request in order 

to waive recoupment of overpayments to fugitive felons? 

Response. There is not a specific line item for overpayments in the budget request 

for the Compensation and Pension account. The Compensation and Pension budget 

model projects caseload, obligations, and outlays over ten years. Compensation payments are based on combined degree of disability, and Veterans often receive compensation for multiple injuries or diseases. Budget forecasts are based on combined 

degrees of disability. 

Question 17. Under current law, VA is required to reduce, but not terminate, the 

compensation payments to certain beneficiaries who have been incarcerated for 

more than 60 days. 

a. What was the total amount of VA benefits paid to incarcerated beneficiaries 

during fiscal year 2011? 

Response. Incarcerated Veterans are entitled to a portion of their benefit payments. Although VA is not able to calculate the actual amount of benefits paid to 

incarcerated beneficiaries in FY 2011, we estimate that $2.6 million was paid based 

on data from September 30, 2011. At that time, 2,013 incarcerated Veterans were 

in receipt of compensation payments. This includes 1,452 Veterans service-connected 

in excess of 10 percent as well as 561 Veterans service-connected at 10 percent (or 

zero percent service-connected and entitled to compensation under 38 CFR 3.317). 

Veterans service-connected in excess of 10 percent received compensation at the 10 

percent rate ($123 monthly), and Veterans service-connected at 10 percent received 

half of their compensation at the 10 percent rate ($61.50 monthly). If the number 

of incarcerated beneficiaries did not change through FY 2011, VA would have paid 

approximately $2.6 million to these Veterans. 

b. What is the total amount of VA benefits expected to be paid to incarcerated 

beneficiaries during fiscal year 2012? 

Response. Please see the response to 17c. 

c. What is the total amount included in the fiscal year 2013 budget for VA benefits expected to be paid to incarcerated beneficiaries? 

Response. The Compensation and Pension budget model projects caseload, obligations and outlays over ten years. Budget forecasts are based on combined degrees 

of disability. Although payments to incarcerated beneficiaries are accounted for in 

the baseline budget estimate, specific benefit payments to incarcerated Veterans are 

not uniquely identified and forecasted. 

59 

Question 18. According to VA’s Fiscal Year 2011 Performance and Accountability Report, VA paid $45 in interest penalties per million dollars disbursed during 2011. 

a. In total, how much did VA pay in interest penalties during fiscal year 2011? 

Response. In total, VA paid $684,778.78 in interest penalties during fiscal year 2011 while disbursing over $15.1 billion in payments. 

b. In total, how much does VA expect to pay in interest penalties during fiscal 

year 2012? 

Response. Based on actual interest paid through February 2012, VA expects to pay $732,584 in interest penalties during fiscal year 2012 while disbursing an estimated $15.9 billion in payments. 

c. In total, how much is included in the fiscal year 2013 budget request in order 

to pay for interest penalties? 

Response. In accordance with the Prompt Payment Act regulations at 5 CFR 

1315.10(b)(5), VA did not include interest penalties in the fiscal year 2013 budget 

request. Interest penalties are paid from funds for the program for which the penalty is incurred. 

Question 19. VA’s Central Office houses a number of different entities, including 

the Office of the Secretary, the Office of Congressional and Legislative Affairs, the 

Office of Public and Intergovernmental Affairs, and other support offices. 

a. How many employees currently are assigned or detailed to each of these respective entities within VA’s Central Office? Please identify the status of those employees as permanent or detailed; career or non-career; and GS, SES or SES Equivalent, 

or other pay scale. Please identify the locations (VISNs, VA medical centers, Veterans Benefits Administration Regional Offices, etc.) from where these employees 

are being detailed. 

b. If VA’s fiscal year 2013 budget request is adopted, how many full-time equivalents would VA expect to be assigned or detailed from outside VA’s Central Office 

to VA’s Central Office during fiscal year 2013? 

Response. [These questions are repeated in and answered posthearing questions, 

section GENERAL, Question 7.] 

Question 20. For the period October 1, 2010, thru December 31, 2011, please provide a listing (without names or other personal identifiers) of those VA employees 

who have been approved to receive, or have received, Recruitment, Relocation and/ 

or Retention Incentives. It is requested that the listing include the employee’s grade 

(SES, SES Equivalent, title 38, GS, etc.); duty station (VA Central Office, VA Field 

location—VISN, VA medical center, Veterans Benefits Administration Regional Office, etc.). Please list the amount approved for each Incentive category. 

a. For those receiving Relocation Incentives, please list the losing and receiving 

duty station/location. 

Response. The embedded spreadsheet, below, is a listing of individual Recruitment, Relocation and Retention Incentives paid from October 1, 2010 through December 31, 2011, by grade. Losing and receiving duty stations/locations cannot be 

reported due to system limitations. Incentives payments have been attributed to the 

Administration or Staff Office where the individual was employed on the date the 

information was extracted from the Personnel Accounting Integrated Database 

(PAID) system. In the case of internal VA employee transfers, the incentive may actually have been paid by a different Administration or Staff Office prior to the 

transfer. 

[This extensive information was received and is being held in Committee files.] 

b. For those receiving Retention Incentives, please identify the level of approving 

official (i.e., Secretary, Deputy Secretary, Chief of Staff, Under Secretary, Assistant 

Secretary, VISN/VA medical center/Regional Office Director, etc.). 

Response. VA does not maintain a central electronic file that identifies the approving official for each employee’s retention incentives. This information is in locally maintained paper files and would require several months to compile. 

VA Handbook 5007, Pay Administration, Part VI, Recruitment and Retention Incentives, documents VA’s policy as follows: 

‘‘a. Retention allowances must be approved by an official at a higher level 

than the one recommending the payment. The authorizing official’s signature 

signifies concurrence with the determination that an allowance is needed to retain a critical VA employee and authorization of the allowance percentage. 

‘‘b. The Secretary, or designee, is the approving official for retention allowances for employees occupying positions centralized to that office. 

‘‘c. Administration Heads, Assistant Secretaries, Other Key Officials, and 

Deputy Assistant Secretaries, or their designees, recommend retention allowances for employees occupying positions in their organization which are centralVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00065 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
60 

ized to the Secretary. They, or their designees, approve retention allowances for 

employees occupying Central Office (VACO) positions in their organizations, 

which are not centralized to the Secretary; and employees occupying field positions centralized to their offices. 

‘‘d. Facility directors may approve retention allowances for title 38 and title 

5 employees in non-centralized positions under their jurisdiction provided that 

the amount of the allowance, when combined with all other VA payments, does 

not cause an employee’s total pay to exceed the aggregate limit on pay.’’ 

The Department is currently updating the incentives policy to reflect higher levels 

of approval. 

c. For those receiving Retention Incentives within the VA Central Office, please 

further identify the specific office (i.e., Office of Public and Intergovernmental Affairs, VHA Deputy Undersecretary for Health for Operations and Management 

(DUSHOM), Veterans Benefits Administration Compensation and Pension Service, 

Office of the Secretary, etc.). 

Response. The table below is a summary of Central Office Retention Incentives 

paid from October 1, 2010 through December 31, 2011, by Staff Office and Administration. 

d. For those receiving Retention Incentives, please identify, where applicable, 

whether the Incentive was being offered because (1) the employee was likely to 

leave because of retirement; (2) the employee indicated an intent to leave for a different Federal position; or (3) of another authorized reason. 

Response. VA does not maintain a central electronic file documenting the approved reasons for each employee’s retention incentives. This information is in locally maintained paper files and would require several months to compile. 

The Code of Federal Regulations at 5 CFR 575.307 requires VA to establish the 

required documentation for determining that an employee would be likely to leave 

the Federal service in the absence of a retention incentive. VA Handbook 5007, Pay 

Administration, Part VI, Recruitment and Retention Incentives, documents VA’s 

policy as follows: 

‘‘Evidence that the Employee is Likely to Leave Federal Employment. 

Each supervisor shall make a separate certification that an employee, or for 


229q1VAb20c.eps
61 

group authorizations, a significant number of employees in the group, is 

likely to leave Federal. This certification will only be made when the supervisor is reasonably convinced that the employee is likely to leave Federal 

service. Such a certification may be based on: 

‘‘(1) Receipt by an employee, or for group authorizations, a significant 

number of employees, of one or more bona fide offers of employment, as evidenced by a formal written job offer or affidavit signed by the employee or 

employees providing the position and salary being offered, the name and location of the organization, and the prospective date of employment; or 

‘‘(2) Evidence of high demand in the private sector for the knowledge and 

skills possessed by the employee or group of employees and significant pay 

disparities between Federal and non-Federal salaries; or 

‘‘(3) A discussion with the employee of the employee’s career plans.’’ 

A supervisor’s certification documenting the reason for determining the likelihood 

of an employee leaving Federal employment should be included in each retention incentive case file. However, VA’s OIG November 14, 2011, audit of retention incentives for VHA and VA Central Office cited case files that lacked documentation to 

support VA retention incentive decisions, including supervisors’ certifications that 

the employees were likely to leave Federal service in the absence of monetary incentives were missing from some files. VA senior officials concurred with OIG report 

recommendations and provided acceptable corrective action plans which are currently being implemented. 

Employees who intend to leave VA for another Federal position may be granted 

a retention incentive only if VA has provided a general or specific written notice 

that the employee’s position may or would be affected by the closure or relocation 

of the employee’s office, facility, activity, or organization, per 5 CFR 575.315(b)(3). 

Question 21. Last year, VA was unable to provide the Committee with information 

concerning the percentage and number of contracts awarded by VA’s Central Office 

to service-disabled veteran owned small businesses (SDVOSBs) and veteran owned 

small businesses (VOSBs). VA indicated that a data analysis of VA’s service contracts was underway, preventing a complete response. 

a. Based on that data analysis, please provide the Committee with the percentage 

and number of contracts awarded by VA’s Central Office to SDVOSBs and VOSBs. 

Response. The information follows: 

b. Please provide the Committee with details (type, amount, and purpose) of the 

current contracts awarded to SDVOSB/VOSBs by VA’s Central Office. Also, please 

itemize this data by individual offices within VA’s Central Office. 

Response. The spreadsheet for questions a and b follows: 


229q1VAb21a.eps
62 


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75 

Question 22. In the last year, the VA Center for Veterans’ Enterprise (CVE) has 

been working on eliminating the backlog of SDVOSBs and VOSBs awaiting certification of their statuses in order to begin bidding on VA set-aside contracts. 

a. How does CVE measure the effectiveness of its communications with SDVOSBs 

and VOSBs during the verification process? 

Response. Although this is not currently being measured, VA believes that this 

will be useful going forward. The CVE Strategic Communication Plan, which is 

being developed, will use a number of tools to measure the effectiveness of its communications with SDVOSBs and VOSBs. These tools include, but are not limited to, 

call center volume, Congressional correspondence volume, telephone and e-mail surveys, the percentage of initial applications that are denied, the percentage of initial 

denials that are overturned, and direct feedback from Veterans during focus groups 

and presentations at conferences, workshops, and other venues attended by CVE 

leadership. 

b. Please provide the Committee with the current number of companies awaiting 

verification and the current average time companies have been awaiting verification 

once all documents have been submitted and verified by CVE. 

Response. As of April 11, 2012, there are 1,143 companies with complete applications awaiting verification. The average processing time for these applications is 61 

days. 

Question 23. Last year, the Committee learned that VISN 20 contracted with a 

company called Values Coach, Inc., for $394,000. In a response to an inquiry from 

the Committee, VA indicated that VISN 20 hired Values Coach to design a program 

‘‘to enhance performance in the area of customer satisfaction.’’ 

a. For fiscal year 2012, how much was spent across all VISNs on customer services contracts to enhance customer satisfaction? 

b. For fiscal year 2013, how much will be spent across all VISNs on customer 

services contracts to enhance customer satisfaction? 

c. For the VISN 20 Values Coach contract, please describe the metrics used to determine whether customer satisfaction changed as a result of this contract. 

d. Please provide a detailed description of the process required to secure contracts 

for customer service training to enhance customer satisfaction. 

e. Does the Federal Government (VA, Office of Personnel Management, etc.) provide coaching services which would train Federal employees to improve their customer service skills? If so, please describe the program(s) in detail. 

Response. [These questions are repeated in and answered posthearing questions, 

section GENERAL, Question 9.] 

Question 24. The VA Office of Human Resources and Administration produced the 

‘‘VA Organizational Briefing Book, June 2010.’’ Within the handbook there is a chart 

reflecting the ‘‘Organization of the Department of Veterans Affairs.’’ The handbook 

then discusses the mission, scope, and functions of each subordinate office within 

VA that is reflected on the chart. Associated with each subordinate office is a chart 

reflecting the respective organizational make-up. Since June 2010, there have been 

a number of office reorganizations. 

a. Please provide an up-to-date chart for each office that has undergone any reorganization since the publication of the 2010 handbook. Please note the effective date 

of the reorganization on the chart, as well as the total full-time equivalents (SES/ 

SES Equivalent, GS, career or non-career) assigned to the office as of February 13, 

2012. 

Response. In November 2011, the Department began an extensive process to review, revise and update information related to organizational structures, mission, 

functions and tasks. Updated documents will be posted on the VA’s Web site when 

this process is complete. 

b. Please identify any offices currently undergoing reorganization and the anticipated completion date for the reorganization. 

Response. In November 2011, the Department began an extensive process to review, revise and update information related to organizational structures, mission, 

functions and tasks. Updated documents will be posted on the VA’s Web site when 

this process is complete. 

Question 25. VA has a number of tools available to assist veterans from losing 

homes guaranteed through the VA home loan program. In the unfortunate instances 

these programs do not work and a veteran goes into foreclosure or default, VA is 

required to reimburse the holder of the mortgage for up to 25% of the purchase 

price. In order to avoid incurring large costs to the Loan Guaranty Service and taxpayers, VA has the authority to purchase the properties from the banks and later 

sell the properties instead of paying the guaranty. 

76 

VA Clarification: The formula prescribed in 38 U.S.C. § 3732 for determining how 

much VA reimburses the holder of the mortgage are more complex than the process 

stated in the question. Prior to a foreclosure on property securing a GI Loan, a VA 

fee panel appraiser determines the property’s fair market value. This appraisal is 

reviewed either by the servicer’s certified appraisal reviewer or by VA appraisal 

staff. To determine the net value of the property, VA reduces the property’s fair 

market value by the established cost factor that reflects VA’s estimated loss on 

property resale and VA’s estimated costs for acquisition, management and disposition of the property. 

A holder of a defaulted GI Loan may elect to convey the property to VA if the 

net value is greater than the difference between (a) the total indebtedness represented by the defaulted GI Loan and (b) VA’s maximum guaranty obligation for 

the GI Loan. Conversely, if the net value of the property is less than that difference, 

the holder generally will have no such option to convey the property to VA, and VA 

will pay the guaranty amount to the holder, who will retain title to the property. 

The conveyance of the property does not substitute for the guaranty liability. The 

amount of guaranty payment is based on variables such as net value, total indebtedness, and the foreclosure sale amount. 

a. Please provide the number of homes the VA Loan Guaranty Service has taken 

possession of during the last five years. 

Response. Between October 1, 2006, and September 30, 2011, VA’s Loan Guaranty 

Service acquired 61,024 properties. 

b. How much has VA spent to acquire properties in the last five years, and how 

much has VA recouped in sales of those attained property assets? 

Response. VA paid $6.3 billion to acquire 61,024 properties. VA has recouped $5.3 

billion in sales of 59,109 acquired properties during the same time period. 

c. Of the properties that VA has acquired over the last five years, please detail 

the number of those properties VA still holds. 

Response. As of September 30, 2011, VA had an inventory of 7,038 properties acquired within the last five years. 

d. Please detail the plan to dispose of the remaining properties held by VA. 

Response. VA has a management and marketing contract with a property management service provider, currently Bank of America, to accept new property assignments and to manage, market, and dispose of the existing inventory. This has resulted in a decline in the overall inventory of properties from 10,521 on January 1, 

2011, to 7,123 on September 30, 2011; 7,038 of the total inventory on September 30, 

2011 were boarded between October 1, 2006 and September 30, 2011. VA will continue through its management and oversight of this contract to reduce this 

inventory. 

Question 26. In the fiscal year 2013 budget request, the National Cemetery Administration (NCA) proposed a new initiative to expand burial access to rural communities. The proposal is ‘‘to establish a national cemetery presence*** where 

the Veteran population is less than 25,000 within a 75-mile [radius].’’ 

a. What are NCA’s estimates for usage and burial? 

Response. Interment projections in the below table are based on an analysis of 

a sample of cemeteries in similar rural locations. More precise estimates will be determined based on actual usage. 

b. The fiscal year 2012 appropriation language requires NCA to develop cost estimations for five rural cemeteries. Of the eight states included on the initial list for 


229q1VAb26a.eps
77 

the new rural initiative, how many areas within each state meet all the current requirements as proposed by the rural initiative (population, distance, and lack of current burial options)? 

Response. The table below lists county/city pairs in each of the eight states. Each 

city represents a potential focal point for establishing a National Veterans Burial 

Ground and meets the criteria for the Rural Veterans Burial Policy, i.e., there is 

no open national cemetery serving Veterans in the state and no more than 25,000 

Veterans, who do not have reasonable access to a burial option in a national or state 

Veterans cemetery, reside within 75 miles of the focal point. The area selected within each state for a National Veterans Burial Ground contains the largest number 

of Veterans up to the 25,000 threshold. 

State County City 

Idaho Twin Falls Twin Falls 

Idaho Lemhi Salmon 

Idaho Teton Idaho Falls 

Maine Penobscot Millinocket 

Maine Washington St. Stephen 

Montana Flathead Kalispell 

Montana Blaine Lewistown 

Montana Valley Glasgow 

Montana Beaverhead Dillon 

Montana Yellowstone Laurel 

Nevada Humboldt Winnemucca 

Nevada White Pine Ely 

Nevada Esmerelda Tonopah 

Nevada Elko Elko 

North Dakota Ramsey Devils Lake 

North Dakota Mountrail Stanley 

North Dakota Bowman Bowman 

North Dakota Cass Fargo 

Utah Sevier Richfield 

Utah San Juan Blanding 

Utah Uintah Vernal 

Utah Iron Cedar City 

Wisconsin Marinette Marinette 

Wisconsin Oneida Rhinelander 

Wyoming Sweetwater Rock Springs 

Wyoming Park Cody 

Wyoming Sheridan Sheridan 

Wyoming Laramie Cheyenne 

c. Of the eight states that meet the initial criteria for the new rural initiative, 

have any filed paperwork or are awaiting approval for a state cemetery grant? 

Response. Idaho has received and accepted an opportunity offer for an expansion 

grant at Idaho State Veterans Cemetery in Boise. The State is currently working 

on requirements for funding in 2012. 

Montana has received and accepted an opportunity offer for an expansion and improvement grant for Western Montana Veterans Cemetery in Missoula and is currently working on requirements for funding in 2012. Another improvement grant for 

Montana State Veterans Cemetery in Helena is in the project inventory. 

Nevada received an expansion and improvement grant in 2011 for Southern Nevada Veterans Cemetery in Boulder City. Construction is in progress. The State has 

78 

received and accepted an opportunity offer for an expansion grant for the same cemetery and is currently working on requirements for funding in 2012. An additional 

operations and maintenance grant for the cemetery is in the project inventory. One 

grant pre-application for establishment of a cemetery in Fallon has been submitted 

but requires matching funds before being considered. 

North Dakota was awarded an operations and maintenance grant in 2011 for 

North Dakota Veterans Cemetery in Mandan. 

Maine was awarded two grants in 2011. One was an expansion Grant for Southern Maine Veterans Cemetery in Springvale. Construction is in progress. The other 

was an operations and maintenance grant for Maine Veterans’ Memorial Cemetery 

Civic Center Drive in Augusta. An improvement grant for Maine Veterans’ Memorial Cemetery Mt. Vernon Road in Augusta, ME, is in the project inventory. Another 

improvement grant pre-application for Northern Maine Veterans’ Cemetery in Caribou needs matching funds before being considered for funding. 

Utah had two grants funded in 2011 for Utah State Veterans Cemetery in 

Bluffdale. One was an operations and maintenance grant. The other was an expansion and improvement grant. 

Wisconsin has one operations and maintenance grant for Southern Wisconsin Veterans Memorial Cemetery in Union Grove, WI, that is in the project inventory. 

Wyoming has received and accepted an opportunity offer for an operations and 

maintenance grant for Oregon Trail Veterans Cemetery in Evansville and is currently working on requirements for funding in 2012. Another improvement grant for 

the same cemetery is in the project inventory. 

Please note that the service area for each proposed National Veterans Burial 

Ground does not overlap with a planned or existing State or Tribal cemetery. 

d. According to the fiscal year 2013 budget request, 89% of veterans were served 

by a burial option within 75 miles of their residence in 2011. Of the remaining veterans not served by a burial option within 75 miles, how many live in the eight 

states meeting the initial criteria for the rural initiative? Please detail the information by state. 

Response. Note: These numbers include Veterans expected to be served by the 

eight new National Veterans Burial Grounds since they are not included in the 89% 

of Veterans currently served. 

State Unserved 

Veterans 

Idaho .................................. 54,092 

Maine .................................. 7,806 

Montana ............................. 34,594 

Nevada ............................... 13,690 

North Dakota ...................... 42,962 

Utah .................................... 35,687 

Wisconsin ........................... 42,654 

Wyoming ............................. 46,607 

Total* ............................. 278,092 1 .30% 

* As of 9/30/11 

Question 27. During the first session of the 112th Congress, the Senate Committee on Veterans’ Affairs held two hearings on issues within VA’s mental health 

program. The hearings highlighted the problems veterans face in accessing needed 

on-going treatment in mental health clinics. These hearings also probed the results 

of a VA survey of Veterans Health Administration mental health providers who revealed the problem with veterans accessing care. How does the fiscal year 2013 

budget address the issues relating to wait times for appointments, a lack of availability of follow-up appointments, staffing shortages, and lack of space in the mental 

health clinics which were raised in the Committee hearings? 

Response. VA’s 2013 budget provides $6.2 billion for mental health care, an increase of $450 million, or 12 percent, over the FY 2011 enacted level. Over the fouryear period from 2009 through 2012, VA will have spent $21.0 billion on mental 

health care. VA is expanding mental health programs and is integrating mental 

health services with primary and specialty care thus providing better coordinated 

care for our Veteran patients. 

On April 19, 2012, VA announced the department would add approximately 1,600 

mental health clinicians—to include nurses, psychiatrists, psychologists, and social 

workers as well as nearly 300 support staff to its existing workforce of 20,590 menVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00084 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
79 

tal health staff as part of an ongoing review of mental health operations. VA’s ongoing comprehensive review of mental health operations has indicated that some VA 

facilities require more mental health staff to serve the growing needs of Veterans. 

VA is moving quickly to address this top priority. Based on this model for team delivery of outpatient mental health services, plus growth needs for the Veterans Crisis Line and anticipated increase in Compensation and Pension (C&P)/Integrated 

Disability Evaluation System (IDES) exams, VA projected the additional need for 

1,900 clinical and clerical mental health staff at this time. As these increases are 

implemented, VA will continue to assess staffing levels. 

On April 24, 2012, VA announced that it has expanded its mental health services 

to include professionals from two additional health care fields: marriage and family 

therapists (MFT) and licensed professional mental health counselors (LPMHC). 

The two fields will be included in the hiring of an additional 1,900 mental health 

staff nationwide mentioned above. Recruitment and hiring will be done at the local 

level. The new professionals will provide mental health diagnostic and psychosocial 

treatment services for Veterans and their families in coordination with existing 

mental health professionals at VA’s medical centers, community-based outpatient 

clinics, and Vet Centers. 

VA has developed qualification standards for employment as LPMHCs and MFTs 

and has announced the appointments of mental health and health science professionals to serve on professional standards boards. The boards will review applicants 

for LPMHC and MFT positions in the Veterans Health Administration (VHA) to determine eligibility for employment and the government grade level appropriate for 

the individual in the selected position. The boards will also review promotions in 

these positions. 

In FY 2012, VA is following up on the issues raised by the query of mental health 

professionals with the Mental Health Action Plan, which focuses on actions in four 

areas. 

• To address scheduling issues, VHA conducted an internal review of the mental 

health scheduling process and is also providing continuing support for the OIG review of the mental health scheduling process. VHA has added new performance 

measures in FY 2012 to allow VISN/VACO leadership to identify and improve processes that impact timeliness for facilities that are not currently providing timely follow up for Veterans discharged from inpatient mental health care; timely provision 

of enhanced care for Veterans identified at risk for suicide; timely access to PTSD 

services; and timely access to eight sessions of psychotherapy for OEF/OIF/OND 

Veterans with PTSD . During FY 2012, VHA is developing additional measures to 

monitor access for other types of mental health services for deployment in FY 2013. 

Additional efforts are also aimed at improving the scheduling system overall. The 

goal of the National Medical Scheduling initiative is to replace VHA’s existing 

scheduling system with one that allows VHA to provide more Veteran-centric scheduling, to make the process easier and more efficient for schedulers, and to more effectively manage resources. VHA is currently reviewing responses to the Request for 

Information (RFI) which was issued to assess the current market for scheduling replacement options. Next steps may include use of a contest to identify best practices 

and ultimately issuance of a Request for Proposal (RFP). • To address staffing issues, VHA has developed and is implementing a national 

mental health staffing model starting in FY 2012. Full implementation of the model 

will provide VISN/VHA leadership with a national standard for staffing mental 

health services. In conjunction with the utilization projection models used by VHA 

in developing the budget requests, expected increases in demand for mental health 

services are built into the budget request. Targeted increases in staffing will be deployed in FY 2012 and FY 2013 as appropriate based on the mental health staffing 

model. Additionally, targeted increases will be provided to address staffing requirements for the expected increase in C&P /IDES exams. • To address space shortages, VHA has requested that facilities evaluate both 

short-term and long-term strategies. Because of the length of time required to fully 

develop capital improvement plans, facilities have identified short-term actions to 

improve utilization of existing space such as use of off-hours scheduling, use of telemental health, sharing of offices for administrative staff, reallocation of space from 

programs that have decreased demand to programs that are increasing in demand 

as well as planned capital improvements or minor renovation projects that will open 

in FY 2012/2013. Long-term plans include prioritization of capital improvement 

plans for mental health space needs and/or leasing space in the FY 2014 SCIP planning cycle. New space and renovations for mental health is a critical element in the 

prioritization process for the SCIP process, with projects supporting mental health 

needs ranking in the second highest criteria—Secretarial priorities; safety is the 

first criteria. This has been the mental health ranking for the past two SCIP 

80 

prioritization cycles, and it is anticipated to remain as such in the FY 2014 process 

as well. With this designation in the priority ranking, a large amount of funding 

has been and continues to be targeted toward mental health projects or projects that 

potentially include mental health facets. In fact, for VHA’s FY 2012 and FY 2013 

budgets, mental health specific projects represent over 13 percent and mental health 

plus potential mental health projects represent over 25 percent of the planned funding with the appropriated and requested budgets ($321 million and $623 million, respectively, out of $2.51 billion.) 

• To ensure continued identification and improvement to address barriers to access for mental health care, VHA has initiated additional quality improvement processes, including the use of site visits to all VHA health care systems in FY 2012, 

to collaborate with facilities/VISNs in identifying opportunities for improvement in 

care and best practices for dissemination throughout VA in the provision of care. 

The site visits to review mental health programs at all VHA health care systems 

are currently in process and are scheduled to be completed by September 30, 2012. 

Selected follow-up visits will be schedule for FY 2013. In FY 2012, VHA is also developing a staff survey and a Veteran survey for use by facilities in obtaining routine feedback about perceived barriers to care from front-line mental health staff 

and Veterans using mental health services. Also in FY 2012, VHA leadership has 

chartered a workgroup to review the mental health program overall, identify gaps 

in care, and develop a plan to address within FY 2012 and FY 2013. 

Question 28. Within the President’s fiscal year 2013 Budget Submission, VA listed 

a ‘‘VA Real Property Cost Savings and Innovation Plan,’’ reflecting savings of $66 

million in fiscal year 2013 and $66 million in fiscal year 2014. VHA’s portion purportedly includes a number of initiatives to repurpose vacant and underutilized assets. VA indicated it has ‘‘identified 166 vacant or underutilized buildings to repurpose for homeless housing and other initiatives.’’ 

a. Please describe in detail the ‘‘other initiatives’’ being considered by VA and the 

current status and manner of planning (contract, internal VA, etc.) for each initiative. 

Response. All buildings identified in this section of the VA Real Property Cost 

Savings and Innovation Plan have been successfully out-leased to 3rd parties, having been repurposed using VA’s recently-expired (December 31, 2011) Enhanced-Use 

Lease (EUL) Authority. While VA does have other authorities and internal options 

for repurposing assets, this section of the cost savings plan focuses on EULs specifically, because they transfer operational costs to such 3rd parties for an extended 

period of time, allowing operational cost savings to occur while providing value to 

the VA, Veterans, and local communities. 

VA remains committed to the objective of the EUL program to effectively leverage 

and manage its inventory of underutilized properties through projects beneficial to 

Veterans, VA, Federal and state governments, local communities, and American taxpayers. The Administration will work with the Congress to develop future legislative 

authorities to enable this Department to further repurpose its underutilized properties. 

The $66 million in savings is specific to VHA, but is not all related to the 

repurposing of vacant or underutilized assets. VA included other initiatives in the 

savings plan, such as savings from green management actions and reductions in 

leasing, that contribute to the overall $66 million savings for VHA. These savings 

will be realized by the end of 2012 as required by the Presidential Memorandum 

of June 2010 for disposing of unneeded Federal real estate. Savings in 2013 and 

2014 would be recurring savings from the actions taken by the end of 2012; no additional actions are included in the plan beyond 2012 in accordance with the Presidential Memorandum. 

b. Please provide a list of the locations of these 166 underutilized assets; the proposed or planned purpose for each asset; and the fiscal year in which the asset is 

expected to be repurposed to achieve the purported savings. 

Response. The requested information is included in the spreadsheet below. This 

information includes permanent housing, transitional housing, assisted living facilities, and nursing/long-term care facilities. 

81 


229q1VAb281.eps

RepurposedBulldmgs 

Department of Veterans Affa"rs 4912 

Location 

Augusta, Uptown 

Augusta, Uptown 

Augusta, Uptown 

Bath 

Bath 

Bath 

Bedford 

BHS,8rockton 

Canandaigua 

Chillicothe 

Chillicothe 

Chillicothe 

Danville 

Dayton 

Fort Harnson 

Fort Harrison 

Fort Harrison 

Fort Harrison 

Fort Harnson 

Fort Harnson 

Fort Harnson 

Fort Harnson 

Fort Harrison 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Fort Howard CBOC 

Square 

Buildin Footage Pro osed Pur ose 

7 13,288 Permanent Veteran Housmg 

76 56,712 Permanent Veteran Housing 

18 28,530 Permanent Veteran Housmg 

Pcem"e,t "d T""ti",1 

52 3,458 Veteran Housmg 

39 960 Permanent Veteran Housmg 

60 17,185 Permanent Veteran Housmg 

Pcem""t "d T,,,,,,,,,I 16,000 Veteran Housm 

Permanent and Transtlonal 

16,000 V",," Ho,"iop 

Pcem",ot "d ",,,ti,,,1 

35 79,932 Veteran Housmg 

31 

227 

2 

14 

35 

41 

42 

10 

11 

12 

14 

15 

16 

37 

43 

44 

59 

61 

63 

64 

9,140 Permanent Veteran Housm 

Permanent and Transtlonal 

460 Veteran Housmg 

19,700 Permanent Veteran Housing 

10,644 Permanent Veteran Housmg 

10,646 Permanent Veteran Housmg 

10,641 Permanent Veteran Housmg 

3,417 Permanent Veteran Housmg 

3,417 Permanent Veteran Housm 

3,417 Permanent Veteran Housmg 

2,453 Permanent Veteran Housmg 

9,092 Permanent Veteran Housing 

2,453 Permanent Veteran Housmg 

2,186 Permanent Veteran Housmg 

P"m""'"d""it1Oool 

13,250 Veteran Housin 

Target Population 

Non-senior disabled and at-nskVeterans 

Non-senior disabled and at-nskVeterans 

Non-senior disabled and at-fisk Veterans 

HomelessVeteram and their families 

HomelessVeterans and their families 

Homeless Veterans andtheirfamiiles 

Homeless senior and low-income senIOr 

Veterans and their families 

Homeless Veterans 

Homeless and at-risk Veterans and their 

Homeless and at-risk Veterans and their 

families 

Homeless and at-risk Veterans and their 

families 

Homeless and at"nsk Veterans and their 

families 

Status 

012012 Executed EUL 

012012 ExecutedEUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

Q12012 Executed EUL 

012012 Executed EUL 

Homeless,dlsabled,and senior Veterans and Deferred due to expiration 

their families of EULAuthorlty 

Homeless and at-nsk Veterans and their 

families 

Homeless Veterans and their families 

Homeless Veterans and their families 

Homeless Veterans and their families 

Homeless Veterans and their families 

Homeless Veterans and their families 

Homeless Veterans and their families 

Homeless Veterans and their families 

Homeless Veterans and their families 

Homeless Veterans and their families 

Homeless Veterans and their families 

Homeless Veterans and their families 

Homeless and at"rlSk Veterans and their 

Homeless and at-fISk Veterans and their 

families 

Homeless and at-risk Veterans and their 

families 

Homeless and at-nskVeterans and their 

families 

Homeless and at-risk Veterans and their 

families 

Homeless and at-fISk Veterans and their 

families 

Homeless and at-risk Veterans and their 

families 

Homeless and at-nsk Veterans and their 

families 

Homeless and at-risk Veterans and their 

families 

Homeless and at-fisk Veterans and their 

families 

Homeless and at-risk Veterans and their 

families 

Homeless and at-nsk Veterans and their 

families 

Homeless and at-risk Veterans and their 

families 

Homeless and at-fISk Veterans and their 

families 

Homeless and at-risk Veterans and their 

families 

Homeless and at-nsk Veterans and their 

families 

Homeless and at-risk Veterans and their 

Homeless and at-nsk Veterans and their 

families 

Homeless and at-rISk Veterans and their 

families 

Homeless and at-risk Veterans and their 

families 

Homeless and at-risk Veterans and their 

famdles 

Pagelof6 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 ExecutedEUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 ExecutedEUL 

Q12012 Executed EUL 

012012 ExecutedEUL 

012012 Executed EUL 

012012 Executed EUL 

Q12012 ExecutedEUL 

Q12012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

Q12012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 ExecutedEUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

012012 Executed EUL 

Included in Originali 

166 List ! 

No 

No 

No 

No 
82 


229q1VAb282.eps

RepurposedBulldmgs 

Square Induded in Original! 

Location Building Footage Proposed Purpose Target Population Status 166li5t 

Permanent and Transitional Homeless and at-nsk Veterans and their 

Fort Howard CBOC 68 1,740 V",,", H""08 families 012012 Executed EUL Y" 

~:;~,:~g~::~::''';;t'OC"' Homeless and at-risk Veterans and their 

Fort Howard CBOC 70 1,620 families 012012 Executed EUL Y" 

~:;~,:;g~::~:g"";It'OC"' Homeless and at-risk Veterans and their 

Fort Howard CBOC 156 1,800 families 012012 Executed EUL No 

~:;~,:;g~::~::,,,;,,,OC"' Homeless and at-risk Veterans and their 

Fort Howard CBOC 5,210 families 012012 Executed EUL 

~:;~,:;g~::~:g'"c;'t'OC"' Homeless and at-nsk Veterans and their 

Fort Howard CBOC 225 119,118 families 012012 Executed EUL N, 

~:;~,:;g~::~::''';It'OC"' Homelessandat-nskVeteransandthelr 

Fort Howard CBOC 226 8,360 families 012012 Executed EUL Y" 

~:;~,:;g~::~::,,,;,,,,,", Homeless and at-risk Veterans and their 

Fort Howard CBOC 228 610 families 012012 Executed EUL Y" 

~:;~,:;g~::~:g"""t"'" Homeless and at-nsk Veterans and their 

Fort Howard CBOC 230 1,590 families 012012 Executed EUL 

~:;~,:;g~::~::''';It'OCo' Homeless and at-nsk Veterans and their 

Fort Howard CBOC 1240 2,234 families 012012 Executed EUL N, 

~:;;,:;g~::~:g"";ltoce' Homeless ~nd ~t-rlsk Veter~n' ~nd their 

Fort Howard CBOC 1244 1,310 families 012012 Executed EUL N, 

~:;~,:;g~::~::,,,;,,,,,o' Homeless and at-risk Veterans and their 

Fort Howard CBOC T245 2,731 families 012012 Executed EUL N, Pgem""t"d""'t,,,,' Homeless and at-risk Veterans and their 

FortHow~rd CBOC 1246 2,332 Veter~n HOUSIn families 012012 Executed EUL 

Permanent and Transitional Homeless and at-nskVeterans and their 

Fort Howard CBOC 1247 1,160 V",,", H'''IOg families 012012 Executed EUL Y" 

~:;~,::g~::~:g"";It"'" Homeless ~nd ~t-nskVeterans and their 

Fort Howard CBOC 1248 300 families 012012 Executed EUL N, 

~:;~,:;g~::~::""",oco' Homeless and at-risk Veterans and their 

Fort Howard CBOC 225A 12,368 families 012012 Executed EUL Pgem""t"d""'t,,,,' Homeless and at-nsk Veterans and their 

FortHow~rd CBOC 1239 2,175 Veteran HOUSing families 012012 Executed EUL 

Homelessandat-nskVeteransandtheir 

Knoxville 63,832 Permanent Veteran Housing families 012012 Executed EUL Y" 

Homeless ~nd ~t-nskVeterans and their 

Knoxville 8,775 Permanent Veteran Housing families 012012 Executed EUL Y" 

Homeless and at-risk Veterans and their 

Knoxville 17,278 Permanent Veteran Housing families 012012 Executed EUL 

Homeless and at-risk Veterans and their 

Knoxville 42,706 Permanent Veteran Housing families 012012 Executed EUL 

Homelessandat-nskVeteransandtheir 

Knoxville 27,442 Permanent Veteran Housing families 012012 Executed EUL Y" 

Homeless ~nd ~t-nskVeterans and their 

Knoxville 4,981 Permanent Veteran Housing families 012012 ExecutedEUL Y" 

Homeless and at-risk Veterans and their 

Knoxville 10,446 Permanent Veteran Housing families 012012 Executed EUL 

Homeless and at-risk Veterans and their 

Knoxville 9,567 Permanent Veteran HOUSIn families 012012 Executed EUL 

Homeless and at-rISk Veterans and their 

Knoxville 26,895 Permanent Veteran Housing families 012012 ExecutedEUL y" 

Homeless and ~t-rlSkVeteransandthelr 

Knoxville 10 3,352 Permanent Veteran Housing families 012012 Executed EUL y" 

Homeless and at-nsk Veterans and their 

Knoxville 11 6,001 Permanent Veteran Housing families 012012 Executed EUL 

Homeless and at-risk Veterans and their 

Knoxville 4,659 Permanent Veteran Housing families 012012 Executed EUL 

Homeless and at-nskVeterans and their 

Knoxville 13 4,645 Permanent Veteran Housing families 012012 Executed EUL yg; 

Homeless and ~t-nskVeteransandthelr 

Knoxville 14 26,000 Permanent Veteran Housing families 012012 Executed EUL yg; 

Homeless and at-risk Veterans and their 

Knoxville 27 28,894 Permanent Veteran Housing families 012012 Executed EUL 

Homeless and at-fisk Veterans and their 

Knoxville 11,119 Permanent Veteran Housing families 012012 Executed EUL 

Homeless and at-rISk Veterans and their 

KnOXVille 62 720 Permanent Veteran Housing families 012012 Executed EUL yg; 

Homeless~nd at-nskVeteran,andthelr 

Knoxville 65 4,652 Permanent Veteran Housing families 012012 Executed EUL yg; 

Homeless and at-risk Veterans and their 

Knoxville 66 26,061 Permanent Veteran Housing families 012012 Executed EUL 

Homeless and at-fisk Veterans and their 

Knoxville 42,313 Permanent Veteran Housing families 012012 Executed EUL Yg; 

Homeless and at-rISk Veterans and their 

Knoxville 68 43,107 Permanent Veteran Housing families 012012 Executed EUL yg; 

Homeless and at-risk Veterans and their 

Knoxville 74 43,849 Permanent Veteran Housing families 012012 Executed EUL yg; 

Homeless and at"rlsk Veterans and their 

Knoxville 75 4,476 Permanent Veteran Housing families 012012 Executed EUL 

Homeless and at-fisk Veterans and their 

Knoxville 7,076 Permanent Veteran Housing families Q12012 Executed EUL Yg; 

Page2of6 
83 


229q1VAb283.eps

RepurposedBulldmgs 

Square Inc1udedin Originali 

Location Building Footage Proposed Purpose Target Population Status 166 list 

Homeless and at-nsk Veterans and their 

Knoxville 81 43,835 Permanent Veteran Housing families 012012 Executed EUL y" Homeless and at-risk Veterans and their 

Knoxville 82 43,836 Permanent Veteran Housing families 012012 Executed EUL y" Homeless and at-risk Veterans and their 

Knoxville 85 43,836 Permanent Veteran Housing families 012012 Executed EUL y" Homeless and at-risk Veterans and their 

Knoxville 99 2,850 Permanent Veteran Housing families 012012 Executed EUL 

Homeless and at-nsk Veterans and their 

Knoxville 101 55,311 Permanent Veteran Housing families 012012 Executed EUL y" Homeless and at-risk Veterans and their 

Knoxville 102 55,817 Permanent Veteran Housing families 012012 Executed EUL y" Homeless and at-risk Veterans and their 

Knoxville 122 1,294 Permanent Veteran Housing families 012012 Executed EUL y" Homeless and at-risk Veterans and their 

Knoxville 135 1,462 Permanent Veteran Housing families 012012 Executed EUL 

Homeless and at-risk Veterans and their 

Knoxville 136 5,849 Permanent Veteran Housing families 012012 Executed EUL y" Homeless ~nd ~t-rl"kVeteran" and their 

Knoxville 161 5,119 Permanent Veteran Housing families 012012 Executed EUL y" Homeless and at-risk Veterans and their 

Knoxville 163 26,121 Permanent Veteran Housing families 012012 Executed EUL y" Homeless and at-risk Veterans and their 

Knoxville 167 4,000 Permanent Veteran Housing families 012012 Executed EUL 

Homeless and at-risk Veterans and their 

Knoxville 171 800 Permanent Veteran HOUSing families 012012 Executed EUL y" Homeless and at-risk Veterans and their 

Knoxville 173 5,504 Permanent Veteran Housing families 012012 Executed EUL y" Removed,bulldlngln use by 

Leavenworth 42 12,232 TBD TBD I'oo,'f""'ty 

Leavenworth 5,495 TBD 1',mo."d,b",ld",m",by local facIlity Yes 

Mixed-Use Development At-risk Veterans and their families, 

Lincoln 70,781 including housing Community 012012 Executed EUl No Mixed-Use Development At-risk Veterans and thelf families, 

Lincoln 15,394 o<lod,,, h""" Community 012012 Executed EUL No 

~~::,~':;o~:::opm'"t At-risk Veterans and their families, 

Lincoln 28,236 Community 012012 Executed EUL 

Mixed-Use Development At-nsk Veterans al1d their families, 

Lincoln 7,541 Includln housln Community 012012 ExecutedEUL 

Mixed-Use Development At-risk Veterans al1d their families, 

Lincoln 18,161 including housing Community 012012 Executed EUL No Mixed-Use Development At-riskVeteransandthelffamllles, 

Lincoln 2,955 includln~houslng Community 012012 Executed EUL No 

~~::,~':;o~:::opm'"t At-nsk Veterans alld their families, 

Lincoln 3,315 Community 012012 Executed EUL 

Mixed-Use Development At-nsk Veterans al1d their families, 

Lincoln 3,480 Indudin hOUSing Community 012012 Executed EUL 

Mixed-Use Development At-risk Veterans al1d their families, 

Lincoln 797Iccicd",ho",m, Community 012012 Executed EUL No 

~;;::,~::;ce,:::opm,ct At-risk Veterans and their families, 

Lincoln 12 11,607 Community 012012 Executed EUL No 

~;;::,~':;o~:::opm,ct At-risk Veterans alld their families, 

Lincoln 13 1,245 Community 012012 Executed EUL 

Mixed-Use Development At-nsk Veterans al1d their families, 

Lincoln 660lnciudin housil1g Community 012012 Executed EUL 

Mixed-Use Development At-risk Veterans al1d their families, 

Lincoln 17 SOD Iccicdm,hp",m, Community 012012 Executed EUl No 

~;;::;~::;c,,:::ppm'"t At-risk Veterans and their families, 

Lincoln 18 1,900 Community 012012 Executed EUL No 

~~~~:,-~s~~u:~~~opment At-risk Veterans alld their families, 

Lincoln 19 1,000 Community 012012 Executed EUL 

Mixed-Use Development At-nsk Veterans and their families, 

Lincoln 8,595 Indudin housil1g Communltv 012012 Executed EUL 

Mixed-Use Development At-risk Veterans al1d their families, 

Lincoln 34 1,900 Iccicdm,ho",,,, Community 012012 ExecutedEUL No 

~~~~:,-~gS~~u:~~~opment At-risk Veterans and their families, 

Lincoln 4D 3,431 Community 012012 Executed EUL No Mixed-Use Development At-risk Veterans alld their families, 

Lincoln 42 2,904 Includln hOUSing Community 012012 Executed EUL 

Mixed-Use Development At-nsk Veterans and their families, 

Lincoln 23,525 Indudin housiDK. Community 012012 ExecutedEUL 

RenovationofcommefCIal 

bUilding and Increased parking VeteranS and PubliC 

Memphis 5,716 cap~clty 012012 ExecutedEUL No 

Deferred due to expiration 

Milwaukee 12 7,316 TBD TBD of EULAuthofity 

Page30f6 
84 


229q1VAb284.eps

RepurposedBulldmgs 

Square Inc1udedin Originali 

Location Building Footage Proposed Purpose Target Population Status 166 list 

Deferred due to expiration 

Milwaukee 16 3,494 TBD TBD y" Minneapolis 222 61,969 Permanent Veteran Housing HomelessVeteram and their families I "mo.Y'd, bwld",lo '" by local facility Yes 

Minneapolis 210 4,733 Permanent Veteran Housing Homeless Veterans and their families 012012 Executed EUL y" Minneapolis 2ll 19,160 Permanent Veteran Housing Homeless Veterans and their families 012012 Executed EUL 

Minneapolis 18,778 Permanent Veteran Housing Homeless Veterans and their families 012012 Executed EUL 

Mlnne~p~115 3,893 Permanent Veteran Housln Homeless Veterans and their families 012012 Executed EUL 

Minneapolis 229 14,020 Permanent Veteran Housing Homeless Veterans and their families 012012 Executed EUL y" Homeless and at"rlsk Veterans and their Deferred due to expiration 

Northampton 20 20,784 Pecm",,'V,"'"o H""o, famllu:,s ofEULAuthonty y" ::;;c:;'~::~:g'c",,,,oooi Homeless and/or at-nskVeterans and their 

Northport 23 6,932 families 012012 Executed EUL 

::;::;,~::~::,""""oooi Homeless and/or at-risk Veterans and their 

Northport 6,932 families 012012 Executed EUL 

::;~,::g~::~:g,"O,it'OOol HomeleS5 and/or at-risk Veterans and their 

Northport 6,932 families 012012 Executed EUL 

::;;c:;g~::~::,"O;it"O" Homeless and/or at"flsk Veterans and their 

Northport Z7 5,12D families 012012 Executed EUL No ::;;c:;'~::~:g',"o;",oool Homeless and/or at-fisk Veterans and their 

Northport 28 2D8 families 012012 Executed EUL Pecm",'" "d T,"",'''oool Homeless and/or at-risk Veterans and their 

Northport 240 Veteran Housln families 012012 Executed EUL No Deferred due to expiration 

Orlando 519-522 25,771 TBD TBD 10fEULA"h,,"y Ye> 

Perry Point 1080 2,984 Permanent and TranSitional VetNOO Ho",,,, Homeless Veterans andthelrfamliles I :,~;~:;:,':,~~;:: :: ;it, Pecm"",,,d,",,,"'oool HomelessVeterans andthelrfamliles PerryPomt 1105 2,984 Veteran Housm I :~~:;:,':;~;:: :~c "" Permanent and Transitional Homeless Veterans and their families IBwidlo"W,ppgdf" PerryPomt 1172 2,746 Vetec" H,,,,,, different bUlldmg on site y" Perry Point 1062 2,726 ::;~c::g~::~:g',"O,it,OO" Homeless Veterans and their famiiles 012012 Executed EUL Ye> 

Perry Point 1063 2,984 ::;;c:;,~::~::,"o;",oooi Homeles5Veterans andthelrfamliles 012012 Executed EUL 

PerryPomt 2,984 ::;~c:;'~::~::,"O,,',OO,' Homeless Veterans and their families 012012 Executed EUL 

Perry POint 1066 3,078 ::;~c:;g~::~:g,"",,,,oool Homeless Veterans and their families 012012 Executed EUL y" Perry Point 1067 2,984 ::;~c::g~::~::,"O,it,OO" Homeless Veterans and their families 012012 Executed EUL Ye> 

Perry Point 1068 2,984 ::;;c:;e~::~:g'"o;",cooi HomelessVeterans andthelrfamliles 012012 Executed EUL 

PerryPomt 2,984 ::;~c:;e~::~::"o""oooi HomelessVeterans and their families 012012 Executed EUL 

Perry POint 1070 2.984 ::;~c::g~::~:,·"O,it'OOol Homeless Veterans and their families 012012 Executed EUL y" Perry Point 1071 2,811 ::;~c:;g~::~::"O;it,OO" Homeless Veterans and their families 012012 ExecutedEUL Ye> 

Perry Point 1073 2,726 ::;;c:;e~::~::"o,,,,cooi Homeless Veterans ~ndtheirfamilies 012012 Executed EUL y" PerryPomt 2,726 ::;~c:;e~::~:g'''O''''OOol Homeless Veterans and their families 012012 Executed EUL 

Perry POint 1075 2,726 ::;~c:;g~::~:;"o,it'OOol Homeless Veterans and their families 012012 Executed EUL y" Perry Point 1077 2,811 ::;~c::g~::~:g'''O;it'OOol Homeless Veterans and their famiiles 012012 Executed EUL Ye> 

Perry Point 1078 2,984 ::;;c:;e~::~::"o,,,,oooi Homeless Veterans and their families 012012 Executed EUL Pcern",,,,,,d,,,,,'''o,,"1 Homeless Veterans andthelrfamliles PerryPomt 2,984 Veteran Housln 012012 Executed EUL 

Permanent and Transitional Homeless Veterans and their families Perry POint 1080 2,984 VetNOo H,,,,,, 012012 Executed EUL No Perry Point 1082 2,811 ::;~c::g~::~:g'''O;it,OO'' Homeless Veterans andtheirfamiiles Q12012 Executed EUL y" Perry Point 1083 3,574 ::;;c:;e~::~::"o;",oooi Homeles5Veterans andthelrfamliles 012012 Executed EUL 

PerryPomt 2,984 ::;::;e~::~::"o""oo,' Homeless Veterans and their families 012012 Executed EUL 

Perry POint 1085 3,641 ::;~c:;g~::~:,'''O,it'OOol Homeless Veterans and their families 012012 Executed EUL Ye> 

Perry Point 1086 3,574 ::;~c::g~::~:;"O;it,OO" Homeless Veterans andtheirfamiiles 012012 Executed EUL y" Perry Point 1087 2,642 ::;;c:;e~::~:g'"o,,,,oooi Homeless Veterans andthelrfamliles 012012 Executed EUL 

1088 

Pcern",'" "d T"",'''o,,"1 Homeless Veterans andthelrfamliles PerryPomt 012012 Executed EUL y" 2,642 Veteran HOUSing 

Page4of6 
85 


229q1VAb285.eps

RepurposedBuddmgs 

Square Induded in Original! 

Location Building Footage Proposed Purpose Target Population Status 166li5t 

Permanent and Transitional Homeless Veterans and their families PerryPomt 1089 3,574 V",,"c Hoc,", 012012 Executed EUL y" 

Perry Point 1093 3,641 ::;~,::g~::~::"c,;t"c,' Homeless Veterans and their families 012012 Executed EUL y" 

Perry Point 1095 3,574 ::;~,::g~::~:g·"C'It"C" Homeless Veterans and their families 012012 Executed EUL y" 

Perry Point 1103 2,811 ::;~,::g~::~::"c,,,,,c,' Homeless Veterans and their families 012012 Executed EUL 

PerryPomt 1104 2,811 ::;~,::g~::~:g'"c"t"c,' Homeless Veterans and their families 012012 ExecutedEUL y" 

Perry Point 1106 2,984 ::;~,::g~::~::"C'It"C" Homeless Veterans and their famiiles 012012 Executed EUL y" 

Perry Point 1107 2,984 ::;~,::g~::~::"c,,,,cc,' Homeless Veterans and their families 012012 Executed EUL y" 

PerryPomt 1108 2,984 ::;~,::g~::~:g'"c"t"c,' Homeless Veterans andthelrfamliles 012012 Executed EUL 

PerryPomt 1110 2,726 ::;~,::g~::~::"c"t"c,' Homeless Veterans and their families 012012 Executed EUL y" 

PerryPomt 1111 2,726 ::;~,:;g~::~:g'''C'ItOC'' Homeless Veterans and their famiiles 012012 Executed EUL y" 

Perry Point 1112 2,726 ::;~,:;g~::~::"c,,,,cc,' Homeless Veterans andthelrfamliles 012012 ExecutedEUL 

PerryPomt 1113 2,811 ::;~,:;g~::~:g'"c"t'oc,' HomelessVeterans and their families 012012 Executed EUL 

PerryPomt 1117 2,811 ::;~,::g~::~::"C;It"C" Homeless Veterans and their families 012012 Executed EUL y" 

Perry Point 1121 2,811 ::;~,::g~::~:,'''C'It''C'' Homeless Veterans and their families 012012 Executed EUL y" 

Perry Point 1125 3,078 ::;~,::g~::~::"c,,,,cc,' HomelessVeterans and their families 012012 ExecutedEUL y" 

PerryPomt 2,961 ::;~,:;g~::~:g'''c;",oc,' Homeless Veterans andthelrfamliles 012012 Executed EUL 

Perry POint 1131 3,641 ::;~,:;g~::~::"c;""c,' Homeless Veterans and their families 012012 Executed EUL y" 

Perry Point 1132 3,641 ::;~,::g~::~:g'''C'It''C'' Homeless Veterans and their famiiles 012012 Executed EUL y" 

Perry Point 1138 3,078 ::;~,:;g~::~::"c;",cc,' HomelessVeterans and their families 012012 Executed EUL y" Pgem,,,ct ,cd T"c"t'oc,' Homeless Veterans andthelrfamliles PerryPomt 1139 2,984 Veteran Housin 012012 Executed EUL 

Permanent and Transitional Homeless Veterans and their families Perry POint 1141 2,726 V",,"c Hoc,", 012012 Executed EUL y" 

Perry Point 1143 3,078 ::;~,::g~::~::"C'It"C" Homeless Veterans and their famiiles 012012 Executed EUL y" 

Perry Point 1146 3,078 ::;~,:;g~::~:g'''c;",cc,' Homeless Veterans and their families 012012 Executed EUL 

PerryPomt 2,984 ::;~,:;,~::~::"c"t'oc,' HomelessVeterans and their families 012012 ExecutedEUL 

PerryPomt 1152 3,641 ::;~,::g~::~:g'''C'It''C'' Homeless Veterans and their families 012012 Executed EUL y" 

Perry Point 1154 3,574 ::;~,::g~::~::"C;It"C" Homeless Veterans and their famiiles 012012 ExecutedEUL y" 

Perry Point 1155 3,641 ::;~,:;,~::~::"c;",cc,' HomelessVeterans and their families 012012 Executed EUL 

PerryPomt 3,641 ::;~,:;'~::~:g'"c"t"c,' HomelessVeterans and their families 012012 ExecutedEUL Nc Perry POint 1163 2,746 ::;~,::g~::~::"C'It"C" Homeless Veterans and their families 012012 Executed EUL y" 

Perry Point 1164 2,642 ::;~,::g~::~:,'''C;It''C'' Homeless Veterans and their families 012012 Executed EUL y" 

Perry Point 1165 2,642 ::;~,:;'~::~::"c''''cc'' Homeless Veterans and their families 012012 Executed EUL Pgem,,,ct,cd,,c,,"cc,' HomelessVeterans and their families PerryPomt 2,746 Veteran Housln 012012 Executed EUL 

Permanent and Transitional Homeless Veterans and their families Perry POint 1167 2,984 V",,"c Hoc"cg 012012 Executed EUL No Perry Point 1168 2,984 ::;~,::g~::~:g'''C;It''C'' Homeless Veterans and their families 012012 Executed EUL y" 

Perry Point 1169 2,746 ::;~,:;'~::~::"c'''''c'' Homeless Veterans and their families 012012 Executed EUL 

PerryPomt 2,642 ::;::;,~::~::"c"t"c,' Homeless Veterans and their families 012012 Executed EUL Pecm,cgct,cd"c,lt"c,' Homeless Veterans and their families Perry POint 1173 2,746 Veteran Housing Q12012 Executed EUL y" 

Homeless, at-risk and senior Veterans and Buildmg swapped for 

Topeka 269 2,157 Permanent Veteran Housmg their families 1"ff",;tb"""c8 cc ,lt, y" 

Homeless, at-nsk and senior Veterans and IBOIldm8;w,pp,dfc, Topeka 60 6,362 Permanent Veteran Housmg their families different bUilding on site 

Homeless, at-risk and senior Veterans and 

Topeka 1,639 Permanent Veteran Housing their families 012012 Executed EUL 

Page50f6 
86 

Question 29. Following the fiscal year 2012 budget hearing, the Committee asked 

a question relating to VA research into the ‘‘health conditions and risk factors that 

relate to homelessness and on the effectiveness of VA homeless services.’’ In VA’s 

response, VA provided the Committee with information about current studies underway and stated that ‘‘[w]e anticipate preliminary data on most of them to be available by the end of [f]iscal [y]ear 2011, and final reports by the end of [f]iscal [y]ear 

2012.’’ 

a. Please share any preliminary data VA may have from these studies. 

Response. VA recognizes the importance of studying and understanding the homeless and at-risk of homelessness Veteran population. To this end, VA is conducting 

several ongoing studies in order to better understand the risk factors related to 

homelessness and the effectiveness of VA homeless services. These studies have informed and will continue to inform VA’s strategy to end Veteran homelessness. 

VA has already published some of the research findings from studies that were 

ongoing during the FY 2012 budget hearings. For example, with regard to research 

on homeless risk factors, VA and HUD collaborated on the Veteran Homelessness: 

A Supplemental Report to the 2010 Annual Homeless Assessment Report to Congress 

(Vet AHAR). The Vet AHAR describes the extent and nature of homelessness among 

Veterans. The Vet AHAR analyzes the demographic characteristics of homeless Veterans, including race, ethnicity, gender, age, and disability status. These characteristics are compared to those of other populations including the non-Veteran homeless population, the total Veteran population, and the population of Veterans living 

in poverty. These comparisons highlight the higher risks of homelessness faced by 

Veterans, particularly poor Veterans. 

The Vet AHAR found that female Veterans are at especially high risk of homelessness, and the risk increases considerably if the female Veteran is impoverished. 

Female Veterans are more than twice as likely to be homeless as female non-Veterans, and female Veterans in poverty are more than three times as likely to be 

homeless as female non-Veterans in poverty. Additionally, male Veterans are at a 

lower risk of homelessness when compared to their non-Veteran counterparts; however, male Veterans living in poverty are at greater risk of homelessness. Furthermore, the prevalence of sheltered homelessness among minority groups in poverty 

is very high. More than 18 percent of poor Hispanic/Latino Veterans, 26 percent of 

poor African American Veterans, and 26 percent of poor American Indian and Alaska Native Veterans were homeless at some point during 2010. Young Veterans (between the ages of 18 and 30) are also at high risk of using the shelter system, especially young Veterans in poverty. Young Veterans are more than twice as likely to 


229q1VAb286.eps
87 

be homeless as their non-Veteran counterparts, and young Veterans in poverty are 

almost four times as likely to be homeless than their non-Veteran counterparts in 

poverty. Last, homeless Veterans are largely white men with a disability and between the ages of 31 and 61. For more information, please find the Vet AHAR at 

the following link. 

http://www.va.gov/HOMELESS/docs/2010_AHAR_Veterans_FINAL_10242011.pdf 

Additionally, in August 2011, the VA National Center on Homelessness among 

Veterans published a study entitled Prevalence and Risk of Homelessness among 

U.S. Veterans: A Multisite Investigation. The principal findings of this study indicate 

that Veteran status is associated with a higher risk of homelessness and that a 

greater proportion of Veterans were in the homeless population than in either the 

general population or the population living in poverty. More specifically, in terms 

of age, across the general homeless population (Veterans and non-Veterans), males 

had the highest risk for homelessness in the 45–54 year age group. For females, risk 

for homelessness was highest among the 18–29 year age group and risk declined 

as age increased. For more information, please find study at the following link. 

http://www.va.gov/HOMELESS/docs/Center/Prevalence_Final.pdf 

VA continues to study the effectiveness of VA homeless services. For example, the 

VA’s National Center on Homelessness among Veterans is completing a study on 

Veterans exiting the HUD-VA Supportive Housing (HUD-VASH) Program and completing a study examining the effectiveness of a pilot program implementing the 

Housing First Model at selected HUD-VASH sites. Preliminary findings from the 

HUD-VASH Exit Study reveal that male Veterans with substance use disorders are 

disproportionally represented in the negative exits. Additionally, chronically homeless Veterans admitted to HUD-VASH are able to maintain housing at similar rates 

to the non chronic homeless population. Finally, the most prevalent factor in a negative discharge was failure to comply with the Landlord/Tenant lease agreements. 

b. How has the preliminary data been used to ensure VA is providing the needed 

services to reduce the number of homeless veterans? 

Response. Throughout the course of these research studies, VA has used the preliminary and now final data from Prevalence and Risk of Homelessness among U.S. 

Veterans: A Multisite Investigation and the preliminary and now final data from the 

Vet AHAR to inform VA’s strategic plan for the Ending Veteran Homelessness Initiative. VA continues to carefully review all major research publications in the field 

of homelessness as well as preliminary and finalized VA homeless research data to 

ensure VA is effectively preventing and ending Veteran homelessness. 

c. Are the final reports still expected to be available at the end of fiscal year 2012? 

Response. VA is in the process of finalizing several studies and reports on VA 

homeless programs and services. For example, VA is finalizing a report examining 

the characteristics and trends of Veterans exiting the HUD-VASH Program. VA is 

also examining the effectiveness of the Housing First Model in the HUD-VASH Program by examining trends, lease up rates, treatment engagement, and the impact 

of housing on Emergency Room and acute hospitalization rates. 

Question 30. The Secretary of Veterans Affairs recently announced that the number of homeless veterans dropped by 12 percent from 2010 to 2011, bringing the approximate number of homeless veterans in 2011 to 67,495. Both the President and 

the Secretary attribute the improvement to over a billion dollars invested in homeless initiatives by the Federal Government. The fiscal year 2013 budget request indicates the goal of reducing the number of homeless veterans to 35,000 in 2013. 

a. Please describe what manner, means, and methods, if any, are currently in 

place, or will be in place, to specifically identify the homeless veterans who have 

been removed from the homeless count in 2011. 

Response. The Secretary of VA and the Secretary of HUD announced that the annual HUD Point in Time (PIT) count decreased by 12 percent from 2010 to 2011, 

bringing the number of homeless Veterans on any given night in 2011 to approximately 67,495. The decrease in the number of Veterans identified through the PIT 

count is a positive indicator that modest but significant gains have been made in 

reducing Veteran homelessness. However, it is important to clarify that PIT data 

is self reported de-identified data. VA cannot identify Veterans from the PIT count 

who have exited homelessness. 

b. If there are no tracking methods in place and coordinated and utilized across 

VHA and the Veterans Benefits Administration, are there any plans to develop such 

a tracking capability? 

Response. Through its comprehensive Homeless Registry,VA can identify homeless Veterans that have exited homelessness. The VA Homeless Registry is a database and reporting system that provides longitudinal Veteran-specific, identified information related to homelessness and at risk for homelessness. The Homeless RegVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00093 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
88 

istry provides reports that detail the number of homeless Veterans entering and 

exiting VA services including permanent housing. It can also provide data regarding 

the Veteran’s current engagement with VA treatment and benefit services that are 

critical to helping Veterans obtain and maintain permanent housing. Currently, the 

VA Homeless Registry is in field testing, with intent to be fully deployed in fiscal 

year 2012. 

Additionally, future plans for the comprehensive VA Homeless Registry include 

data matching and integration with HUD’s Homeless Management Information System (HMIS). HMIS is a software application used by HUD-funded Homeless Continuums of Care (CoC) providers to record and store client-level information on the 

characteristics and service needs of homeless individuals and families. Once VA obtains the appropriate data sharing agreements with the local CoCs, VA will have 

an internal and external data system that can monitor prevalence rates and program effectiveness for our Veterans. Although this full integration is dependent on 

communities’ willingness to share their Veteran identified HMIS data with VA, 

HUD and VA are working closely with local CoCs to make full data integration a 

reality. 

Question 31. In fiscal year 2011, VA allocated $17 million for non-recurring maintenance for correcting patient privacy deficiencies. In the questions for the record 

following the fiscal year 2012 budget hearing, VA provided a list of women’s projects 

from the fiscal year 2012 Strategic Capital Investment Planning process. 

a. Please provide an updated list of construction projects relating to correcting patient privacy deficiencies. 

Response. The information is in the spreadsheet that follows: 


229q1VAb311.eps

U.S. Department of Veterans Affairs 

FY2011, FY2012 and Beyond Women/Privacy-Type Construction Projects 

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VISN Facility Project Category Project Number Project Year Project Title Cost ($) Obligations ($) Obligation ($) 

FY2011 Actual Obligations 

Togus NRM Projects 402-10-513 Grandfathered Construct Private Bathrooms and Showers for $4,426,249 $352,449 S4,073,800 

Ward 4S of B200 

Togus NRM Projects 402-11-019S Grandfathered Women's Privacy Bathroom Remodels $59,829 $59,829 $0 

Togus NRM PrOjects 402-12-545 Grandfathered Women's Clinic RenovatIOn $1,468,759 S118,759 S1,350,000 Togus Clinical Specific Initiatives 402-CSI-312 Grandfathered Mental Health Domiciliary / Lodger BUilding $4,503,334 $396,696 $4,106,638 

White River NRM Projects 405-10-104 Grandfathered Renovate for a Women's Comprehensive Care $852,402 S852,402 $0 

Junction CliniC 

White River Minor Construction Project 405-305 Grandfathered Psych & Polytrauma Rural Residential Care $7,869,000 $6,550,000 $0 

Junction Center 

Bedford NRM Projects 518-10-110 Grandfathered Correct MH Deficiencies Inpatient 6B ward $3,137,505 S237,505 $2,900,000 

Boston NRM PrOjects 523-11-007 Grandfathered Renovate Oncology Bathroom $106,700 $106,700 $0 Brockton NRM Projects 523A5-08-140 Grandfathered Mental Health Safety Improvements $2,760,000 $2,760,000 $0 Brockton NRM Projects 523A5-11-007 Grandfathered Renovate Bathrooms Mental Health $119,700 5119,700 $0 Brockton NRM Projects 523A5-12-102 Grandfathered MH08 Mental Health Safety Improvements Ph 4 $2,700,000 S103,162 $0 Brockton NRM Projects 523A5-12-145 Grandfathered Patient Privacy Improvements $1,800,000 $47,082 $0 Brockton Clinical Specific Initiatives 523A5-CSI-301 Grandfathered Mental Health Addition $4,397,700 $4.397,700 $0 Brockton Clinical Specific In illatives 523A5-CSI-303 Grandfathered CLC Patient Privacy & Safety Improvements, Bldg $3,300,000 $247,067 $3,052,933 

4 

Boston Clinical Specific Initiatives 523-CSI-101 Grandfathered Women's Imaging Site Prep $1,970,700 $1,970,700 $0 Manchester NRM PrOjects 608-10-302 Grandfathered Privacy Upgrades $259,965 S259,965 $0 Manchester NRM Projects 608-11-202 Grandfathered Women's Veteran Health Initiative $164,670 S164,670 $0 

Northampton Minor Construction Project 631-333 Grandfathered Renovate NHCU, Building 1 $6,041,000 $4,905,042 $0 Providence NRM Projects 650-11-101 Grandfathered Renovate Mental Health Outpatient Clinic Wing $3,929,386 S269,386 $3,660,000 

36 

Providence NRM Projects 650-11-113 Grandfathered Provide Exam Room Curtains for Patient Dignity & $60,081 $60,081 $0 

Privacy 

Providence NRM Projects 650-11-114 Grandfathered Replace Locks on Patient Room Doors for $28,950 $28,950 $0 

Female Patient Security 

Providence Minor Construction Project 650-334 Grandfathered New Bedford Community Based Outpatient Clinic $3,842,000 $200,000 $0 

Expansion 

Providence Clinical Specific Initiatives 650-CSI-328 Grandfathered Building 35 ExpanSion For Mental Health $3,618,000 $259,064 $3,358,936 

WestHaven NRM Projects 689-09-104 Grandfathered Mental Health Security Corrections $8,518,000 $8,518,000 $0 WestHaven NRM Projects 689-09-204 Grandfathered Women's Health Clinic RenovatIOn $832,154 $76,154 $756,000 WestHaven NRM PrOjects 689-10-215 Grandfathered Unisex Privacy Bathrooms $625,559 S173,559 $452,000 West Haven NRM Projects 689-11-110 Grandfathered Women Veterans Privacy Improvements $949,034 $99,034 $850,000 West Haven Minor Construction Project 689-390 Grandfathered Mental Health Access Expansion $9,890,000 $774,557 $0 

Buffalo NRM project 528-10-110 Grandfathered EnVironmental Improvements $979,000 $979,000 $0 

Buffalo NRM project 528-11-103 Grandfathered Renovate 5B CliniCS $525,093 $50,093 $475,000 BataVia Minor Construction PrOject 528-353 Grandfathered Ward C Privacy RenovatIOns $8,270,000 $897,266 $0 

Albany Minor Construction PrOject 528-805 Grandfalhered Correct Physical Medicine and Rehabilitation $4,688,390 $2,515,590 $0 

Service Deficiencies 

Canandaigua NRM project 528A5-11- Grandfalhered Renovate Bathroom, 6-1 - 4TH FL & ROPC $32,497 $32,497 $0 

505SL 

Canandaigua NRM project 528A5-11- Grandfathered Women's Health Privacy & Security Upgrades $47,000 S47,000 $0 

516SL 

Bath NRM project 528A6-11-629 Grandfathered Renovate Bathrooms to Add Showers $380,870 $38,087 $0 

OCAMS-2/2

229q1VAb312.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VISN Facility Project Category Project Number Project Year Project Title Cost{$) Obligations ($) Obligation ($) 

Syracuse NRM projecl 528A7-11-701 Grandfathered Renovate 7 West for Patient Ward-Design $2,689,510 $314,510 $2,375,000 Syracuse NRM project 528A7-11-703 Grandfathered Expand clinical space & reception on 2 East and 2 $1,156,900 $1,156,900 $0 

West 

Albany NRM projee! 528A8-11-820 Grandfathered Basemenl C-wlng Women's Bathroom $198,192 $198,192 $0 

E. Orange NRM projee! 561-11-101 Grandfathered Upgrade for Patlenl Centered Care, Phase 1 $490,000 $490,000 $0 

East Orange Mmor Construction Project 561-340 Grandfathered Construe! New Emergency Department $9,769,100 $449,852 $0 

Castle Point Minor Construction Project 620-332 Grandfathered Expand and Renovation Urgent Care Area $9,257,500 $954,347 $0 

New York NRM project 630-08-103 Grandfathered ER/Admitting Area Modernization $5,842,000 $5,842,000 $0 New York NRM project 630-10-105 Grandfathered Admitting Areal ER Expansion Phase 2 $3,380,000 $338,000 $3,042,000 New York NRM project 630-10-124 Grandfathered Women Health Clinic Renovation $375,000 $375,000 $0 New York NRM project 630-11-104 Grandfathered Improve Privacy at Harlem Women's Clinic $190,666 $190,666 $0 New York NRM project 630-11-108 Grandfathered Renovate Patient Wards: 4S Medical/Surgical $6,480,900 $669,157 $0 

Ward 

Brooklyn NRM project 630A4-11-417 Grandfathered Women's CliniC Renovation $265,051 $265,051 $0 

Brooklyn NRM project 630A4-11-426 Grandfathered Renovate Patient Wards $6,419,710 $641,971 $5,777,739 Northport NRM project 632-10-142 Grandfathered Renovate Valley Stream Outpatient Clinic $185,788 $185,788 $0 

Wilmington NRM project 460-10-104 Grandfathered Renovate 5 East Clinic Areas $3,894,000 $3,894,000 $0 Wilmington NRM project 460-11-130 Grandfathered Renovate 5 Ward West $6,429,301 $445,051 $5,984,250 Wilmington NRM project 460-11-131 Grandfathered Renovate 8 Ward West $5,744,362 $244,362 $5,500,000 Wllmmgton NRM project 460-12-202 Grandfathered Expand & Update Chemo $150,494 $30,494 $120,000 

Butler Minor Construction Project 529-311 Grandfathered Replace DomicIliary Extended Stay Unit $4,061,538 $3,174,454 $0 

Clarksburg NRM prajee! 540-11-101 Grandfathered Renovate and Increase Mental Health Area 4A $6,447,295 $447,295 $6,000,000 Clarksburg NRM project 540-11-106 Grandfathered Enhance and Expand Acute Inpatient Mental $4,959,566 $459,566 $4,500,000 

Health 

Coatesville NRM project 542-10-114 Grandfathered Improve Patient Safety & Security B-59 $2,479,000 $0 

Coatesville NRM project 542-11-123 Grandfathered Re-Key Medical Center $348,868 $0 Coatesvlle Clinical SpeCifiC Initiatives 542-CSI-201 Grandfathered Construct Hospice Addition Bldg. 138 $4,800,000 $0 

Erie NRM project 562-10-113 Grandfathered Renovate 7th FloorWest $1,187,925 $0 

Lebanon NRM project 595-10-105 Grandfathered Renovate to Expand Inpatient Unit B1-2 $6,288,730 $5,659,857 Lebanon NRM project 595-10-148 Grandfathered Renovate Primary Care/Speclalty Clinic Building $1,750,000 $242,997 $1,507,003 

17 

Lebanon Minor Construction Project 595-109 Grandfathered BehaVioral Health Treatment Complex $7,766,440 $0 

Lebanon Minor Construclion Project 595-901 Grandfathered Expand BehaVior Health CliniC Services $7,400,000 $0 

Philadelphia NRM projee! 642-10-117 Grandfathered Install key card access $563,050 $0 

Philadelphia NRM projee! 642-11-108 Grandfathered Upgrade Women's Clinic $1,083,758 S900,000 

Philadelphia NRM project 642-12-110 Grandfathered Rekey Medical Center $2,056,305 $2,000,000 Philadelphia Clinical SpeCific Initiatives 642-CSI-103 Grandfathered Expand NHCU $1,715,000 $0 Philadelphia Clinical SpeCific Initlat[ves 642-CSI-104 Grandfathered CLC Upgrades 4 Unit C ph 1 $4,400,000 $0 Philadelphia Clinical SpeCific Initiatives 642-CSI-105 Grandfathered UPgrade CLC Unit C ph 2 $4,400,000 $0 

Drive) NRM project 646-10-108 Grandfathered UD, Site Prep for ICU $2,292,000 $2,292,000 $0 

Wilkes-Barre NRM projee! 693-07-125 Grandfathered Sleep Lab Renovallons $5,397,630 $539,763 $4,857,867 Wilkes-Barre NRM project 693-11-121 Grandfathered ER Expansion $4,553,619 $553,619 $4,000,000 Wilkes-Barre NRM project 693-11-122 Grandfathered Expand EXisting Oncology $4,511,018 $511,018 $4,000,000 

Baltimore NRM project 512-11-139 Grandfathered Installation of a Card Key Access/Physical $1,330,470 $1,330,470 $0 

Security Improvement 

Baltimore NRM project 512-11-156 Grandfathered Upgrade EXisting Pallent Rooms on 3rd and 5th $608,000 $608,000 $0 

floors to Planetree 

R;'IliimnrA Mlnnr PrOj!'lct S17-S11 Gr;'lnrif8thArAri Managed Care/Emergency Department $!='l,S7?,nnn $R:l::l,R?7 $0 

Improvements & Enrollment Center 

OCAMS - 21

229q1VAb313.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VtSN Facility Project Category Project Number Project Year Project Title Cost{$) Obligations ($) Obligation ($) 

Perry POint Minor Construction Project 512-519 Grandfathered Expand OEF/OIF and Renovate Building 80 for $8,000,000 $700,000 $0 

Outpatient Mental Health 

Perry Point NRM project 512A5-11-314 Grandfalhered Emergency Mental Helath Patient Safety $1,585,850 $1,585,850 $0 

Improvements 

Perry Point NRM project 512A5-11-322 Grandfathered Mental Health Security Hardware $99,898 $99,898 $0 

Martinsburg NRM project 613-09-201 Grandfathered CLC Cultural Tranformation to Renovate 5B (Ph $65,416 $65,416 $0 

1) 

Martinsburg NRM project 613-11-114 Grandfathered Add Private Patient Bedroom Baths to 4A and $341,437 $341,437 $0 

CAT-5 Program 

Martinsburg NRM project 613-11-117 Grandfathered Bldg 213 HOPE MH Outpatient Clinic Security $246,434 $246,434 $0 

Enhancments 

Beckley Minor Construction Project 517-316 Grandfathered Specialty/Ancillary Care Construction $2,248,189 $200,000 $0 

Durham NRM project 558-10-119 Grandfathered Renovate Emergency Department $2,440,000 $2,440,000 $0 

Durham NRM project 558-11-115 Grandfathered Women's Health Clinic Reconfiguration $219,964 $219,964 $0 

Fayetteville NRM project 565-09-101 Grandfathered Renovate Lab for Patient Privacy $628,543 $628,543 $0 Fayetteville NRM project 565-11-301 Grandfathered Lactation Room $110,962 $110,962 $0 Fayetteville NRM project 565-11-302 Grandfathered Renovation of Private rooms on 2C for women's $835,901 $835,901 $0 

health 

Fayetteville, NC Clinical Specific Initiatives 565-CSI-111 Grandfathered Expand Clinical Area $0 

Hampton NRM project 590-11-113 Grandfathered Renovate and Install Mammography Equipment $0 Hampton Clinical Specific Initiatives 590-CSI-902 Grandfathered Expand Women's Mental Health Services and $3,740,000 $3,381,361 $0 

Primary Care Clinic 

Asheville NRM project 637-10-111 Grandfathered Renovate Ward 1 West $2,860,000 $355,000 

Asheville NRM project 637-10-112 Grandfathered Renovate for Women's Health $267,000 $0 Asheville NRM project 637-11-103 Grandfathered Renovate Emergency Dept. Phase 2 $497,269 $0 

Asheville NRM project 637-11-119 Grandfathered Renovate Ward 5 East $883,298 $540,000 

Richmond Minor Construclion Project 652-310 Grandfathered Mental Health Recovel)! Center Enhancement $9,537,940 $0 Richmond Minor Construction Project 652-311 Grandfathered Dialysis ExpanSion $9,660,188 $0 

Salem NRM project 658-11-103 Grandfathered Remodel Women's Health Clinic $205,000 $0 Salisbury NRM project 659-11-272 Grandfathered Womens Health $84,023 $0 Salisbury Minor Construction Project 659-333 Grandfathered Long Term Care Renovation, Bldg 42, Phase II $9,510,000 $0 

Salisbury Minor Construction Project 659-334 Grandfathered Mental Health Renovation, Phase 3 $6,020,000 $0 Salisbury Minor Construction Project 659-335 Grandfathered Long Term Care Renovation, Phase 3 $9,080,000 $0 

Atlanta Minor Construction Project 508-336 Grandfathered Primary/Urgent Care Improvements $9,817,823 $0 

Atlanta Clinical Specific Initiatives 508-CSI-101 Grandfathered Mental Health CliniC Addition $4,702,064 $0 

Augusta NRM project 509-11-105 Grandfathered Inpatient Women's Bathrooms (T-21) $392,683 $0 

Charleston NRM project 534-11-930 Grandfathered Renovate Bathrooms $421,113 $0 Charleston Minor Construclion Project 534-320 Grandfathered New Post Traumatic Stress Disorder/Mental $9,267,553 $8,492,713 $0 

Health Research Addition 

Columbia, SC Clinical Specific Initiatives 544-CSI-401 Grandfathered Community LIving Center Phase 3 $0 

Dublin NRM project 557-10-102 Grandfathered Renovate DomlClllal)! BUilding 1 DB $0 Dublin NRM project 557-11-101 Grandfathered Female DomiCiliary Bathroom $0 Montgomery NRM project 619-10-107 Grandfathered Renovate NurSing Home Phase 2 $2,515,738 $2,515,738 $0 Montgomery Minor Construction Project 619-107 Grandfathered Relocate Acute Mental Health Beds to Building $8,982,624 $748,667 $0 

120 

Tuscaloosa NRM project 679-10-112 Grandfathered Primary Care CliniC Upgrades, Bldg. 38 $0 Tuscaloosa Minor Construction Project 679-311 Grandfathered Construct The Cottages, Phase II $0 

Bay Pines NRM project 516-11-133 Grandfathered Privacy and EOC for Women Veterans $0 

Bay Pines NRM project 516-11-134 Grandfathered Renovate Patient Wards Bl00, 3C & 4A $6,891,008 

I-'lnes NKM project 516-11-3U2 Grandtathered Kenovate Public I::lathrooms 1::l-1UU (f-CA=LJ) $U 

OCAMS - 21

229q1VAb314.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VISN Facility Project Category Project Number Project Year Project Title Cost{$) Obligations ($) Obligation ($) 

8 W. Palm Beach NRM project 548-10-104 Grandfathered Public Restroom Renovation $842,126 $842,126 $0 

W. Palm Beach NRM project 548-10-105 Grandfathered Congregate Bath Renovation in Community LIving $156,582 $156,582 $0 

Center 

West Palm Beach Minor Construction Project 548-125 Grandfathered Mental Health Domiciliary $9,903,242 $503,549 $0 

West Palm Beach Clinical Specific Initiatives 548-CSI-111 Grandfathered Hospice and Palliative Care Wing $4,740,804 $4,288,026 $0 

Gainesville NRM project 573-11-120 Grandfathered Construct PsychiatriC Ward at 50 (SCIP 2012) $4,944,588 $444,588 $4,500,000 Gainesville NRM project 573-11-30, Grandfathered Remodel Rooms - Women's Privacy and Dignity $107,352 $107,352 $0 Gainesville NRM project 573-11-801 Grandfathered Renovate Medlcaullntensive Care Unit(MICU) $425,030 $0 Gainesville NRM project 573-11-806 Grandfathered Renovate GYN Clinic $52,508 $0 Gainesville Minor Construction Project 573-325 Grandfathered Expand Intensive Care Unit $477,398 $0 

Lake City NRM project 573A4-11-301 Grandfathered Renovate Women's Restrooms $78,880 $0 

Tampa NRM project 673-10-862 Grandfathered Showers BUilding 30 D Floor $61,217 $0 Tampa NRM project 673-11-101 Grandfathered MRI Women's Imaging $94,115 $847,035 Tampa NRM project 673-11-813 Grandfathered Restroom Renovations $0 

Huntington NRM project 581-11-102 Grandfathered Construct Dialysis CliniC Building 1W $1,704,000 Huntington NRM project 581-11-103 Grandfathered Renovate First Floor BUilding 1W for Ambulatory $2,989,660 $298,966 $2,690,694 

Care 

Huntington Clinical SpeCifiC Initiatives 581-CSI-102 Grandfathered Renovate Bldg 7 for Women's Health $2,916,259 $0 

LouIsville Clinical SpeCifiC Initiatives 603-CSI-401 Grandfathered Substance Abuse Relocaton & Expansion $552,284 $0 

Memphis NRM project 614-10-102 Grandfathered Expand Emergency Department $396,588 $3,890,000 

MemphiS NRM project 614-10-104 Grandfathered Renovate for Women's Comprehensive $3,903,879 $3,903,879 $0 

Healthcare 

Mountain Home NRM project 621-11-128 Grandfathered Renovate Space for Primary Care Medical Home $1,350,000 $1,350,000 $0 

Model, Bldg 160 

Mountain Home NRM project 621-11-140 Grandfathered Renovate CLC Cultural changes Phase II $299,785 $299,785 $0 Mountain Home NRM project 621-11-143 Grandfathered Renovate Space for Women's Privacy, B-160 $69,860 $69,860 $0 Mountain Home Minor Construction Project 621-320 Grandfathered Expand Emergency Room, Building 204 $3,274,000 $276,729 $0 

Mountain Home Minor ConstruCllOn PrOject 621-321 Grandfathered Community Living Center, Building 162, Add $1,462,000 $160,327 $0 

Second Floor 

Murfreesboro NRM project 626A4-10-101 Grandfathered Ambulatory Surgery Ph 3 $1,730,188 $0 

Murfreesboro NRM project 626A4-11-504 Grandfathered Expand 7A Female Beds $107,957 $0 

10 Chillicothe NRM project 538-10-110 Grandfathered Renovate for Women's Clinic $731,910 $0 

10 Chillicothe Minor Construction Project 538-107 Grandfathered Renovate Community living Center B-211 West $9,801,030 $0 

10 Chillicothe Minor Construction Project 538-108 Grandfathered Clinical Addition to Building 31 $9,822,465 $0 10 Cleveland NRM project 541-06-1018 Grandfathered Renovate SICU $1,824,600 $0 

10 Cleveland NRM project 541-13-101 Grandfathered Renovate Mental Health Clinic (North) $1,887,522 $1,737,585 

10 Cleveland Minor Construction Project 541-370 Grandfathered Emergency Department (ED) and Specialty Care $9,163,000 $810,504 $0 

Clinic Addition 

10 Cleveland Clinical SpeCific Initiatives 541-CSI-101 Grandfathered Renovate/Expand Palliative Care Ward $2,290,200 $1,645,000 $0 

10 Dayton NRM project 552-10-249 Grandfathered Renovate Units A & E, B-320 $3,470,000 $3,470,000 $0 

10 Dayton NRM project 552-10-269 Grandfathered FCA-Renovate Domlcilary, Building 410 $9,225,000 $9,225,000 $0 

10 Columbus NRM project 757-11-110 Grandfathered Expand Clinic Area, 2nd Floor $474,850 $474,850 $0 

10 Columbus NRM project 757-11-111 Grandfathered Expand Clinics, 3rd Floor $498,450 $498,450 $0 

11 Ann Arbor NRM project 506-11-105 Grandfathered Construct Cllmcs in Prior InfUSion Area $347,270 $66,016 $281,254 

11 Ann Arbor NRM project 506-11-136 Grandfathered Renovate CLC Ward $430,383 $51,879 S378,504 11 Battle Creek NRM project 515-11-104 Grandfathered Renovate Building 8 For Mental Health $588,100 $58,810 $0 

11 Creek prOject 515-11-1U9 Grandtathered Vanous Locations $747,84U $74,784 ::;673,146 

OCAMS - 21

229q1VAb315.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VISN Facility Project Category Project Number Project Year Project Title Cost{$) Obligations ($) Obligation ($) 

11 Battle Creek Minor Construction Project 515-310 Grandfathered Renovate NHCU For Patient Privacy $6,269,000 $5,632,076 $0 11 Battle Creek Minor Construction Project 515-312 Grandfathered Inpatient Mental Health Expansion B39 $9,273,318 $8,357,099 $0 11 Battle Creek Minor Construction Project 515-313 Grandfathered Renovate Mental Health Clinic, Building 7 $8,999,000 $787,136 $0 11 Danville NRM project 550-10-101 Grandfathered Renovate Clinic Space Building 98, Phase II $4.449,000 $4.449,000 $0 11 Danville NRM project 550-11-108 Grandfathered Renovate Patient Shower and Toilet Spaces $486,760 $48,676 $438,084 

BUilding 101 

11 Danville NRM project 550-11-114 Grandfathered Female Veterans Privacy Improvements $113,753 $48,753 $65,000 11 Danville Minor Construction Project 550-314 Grandfathered Construct Small House Model Homes (2) $4,018,000 $4,018,000 $0 11 Indianapolis NRM project 583-10-170 Grandfathered Construct Womens Imaging SUite $317,138 $317,138 $0 11 Indianapolis NRM project 583-11-103 Grandfathered Renovate Intensive Care Unit for Privacy $289,238 $289,238 $0 11 Indianapolis NRM project 583-11-108 Grandfathered Construct Womens Health Center $127,951 $127,951 $0 

11 Saginaw NRM project 655-11-102 Grandfathered Renovate Toilet Rooms Building 1,2,3,4 $2,540,144 $224,639 $2,315,505 12 Jesse Brown NRM project 537-07-135 Grandtathered Relocate and Expand Outpatient DialysIs $1,056,027 $1,056,027 $0 

12 Jesse Brown NRM project 537-10-955 Grandtathered Convert Eye CliniC SUite 5324 to Exam Rooms $68,863 $68,863 $0 12 Jesse Brown NRM project 537-11-137 Grandfathered Remodel TOilet on 10 th Floor $24,820 $24,820 $0 

12 Chicago - Jesse Minor Construction Project 537-318 Grandfathered Expand Outpatient Speciality CliniCS $5,380,000 $1,224,739 $0 

Brown 

12 Chicago - Jesse Minor Construction Project 537-320 Grandfathered Expand Outpatient CliniCS, Bldg,30-2nd Floor $9,894,000 $801,049 $0 

Brown Addition 

12 North Chicago NRM project 556-11-112 Grandfathered Building 133EF Mental Health Area Safety $26,124 $26,124 $0 

Concerns 

12 North Chicago NRM project 556-11-125 Grandfathered Women's Restroom Renovations, Bldgs 7,11 & $159,277 $159,277 $0 

66 

12 Hines NRM project 578-10-080 Grandfathered Renovate for Hospice, Bldg. 217 $474,838 $474,838 $0 12 Hines NRM project 578-11-056 Grandfathered Upgrade Patient Rooms, Bldg 200, 15th Floor $83,278 $83,278 $0 12 Hines NRM project 578-11-062 Grandfathered Correcting Women Veteran Infrastructure $80,891 $80,891 $0 

Deficiencies, B217 

12 Hines NRM project 578-11-099 Grandfathered Additional Work for Women's Health Center $176,477 $176,477 $0 

12 Hines NRM project 578-11-148 Grandfathered Renovate Congregate Bath In Hospice Wing $500,000 $30,800 $469,200 12 Iron Mountain NRM project 585-10-105 Grandfathered Renovate Outpatient CliniC $1,326,577 $0 12 Iron Mountain NRM project 585-11-101 Grandfathered Relocate Emergency Department $1,473,627 $0 12 Madison NRM project 607-09-122 Grandfathered Renovate Clinical Space $2,930,000 $0 

12 Madison NRM project 607-11-140 Grandfathered Women's Health Improvements $136,977 $0 

12 Madison Minor Construction Project 607-394 Grandfathered Consolidate Intensive Care Units $888,711 $0 12 Tomah NRM project 676-10-132 Grandfathered Rebuild Greenhouse $347,000 $0 12 Tomah NRM project 676-10-140 Grandfathered Renovate 2nd & 3rd Floors Building 401 $8,666,000 $0 12 Tomah NRM project 676-11-033 Grandtathered Modifications to BUilding 400 1st Floor $89,600 $0 

12 Tomah NRM project 676-11-063 Grandfathered Construct Women's Health SUite $27,500 $0 

12 Milwaukee NRM project 695-10-191 Grandfathered Building 109 - Women's Health $693,125 $0 12 Milwaukee NRM project 695-11-101 Grandfathered Rekey MH, Phase 1 $17,958 $0 12 Milwaukee NRM project 695-11-102 Grandfathered Rekey MH, Phase 2 $32,596 $0 12 Milwaukee NRM project 695-11-140 Grandfathered Upgrade Public Restrooms $470,437 $0 12 Milwaukee Minor Construction Project 695-223 Grandfathered Modernize Acute Care Ward 6C-5CN $6,572,284 $0 12 Milwaukee Minor Construction Project 695-315 Grandfathered Expand Primary Care/Specialty Clinic Consolidate $9,987,500 $8,717,000 $0 

Kitchen 

12 Milwaukee Clinical Specific In illatives 695-CSI-314 Grandfathered Construct Community living Center (2) $4,930,000 $0 15 Kansas City NRM project 589-11-1796 Grandfathered T-21 Improve Womens Health Restrooms $187,942 $0 15 Columbia, MO Minor Construction Project 589-330 Grandfathered Relocate Intensive Care Unit $945,407 $0 15 Wichita Minor Construction Project 589-339 Grandfathered Expand Primary Care $759,482 $0 15 Kansas City Minor Construction Project 589-369 Grandfathered Emergency Room Expansion $5,659,146 $0 

OCAMS - 21

229q1VAb316.eps

VISN Facility 

15 Kansas City 15 Leavenworth 15 Topeka 15 Columbia 15 Topeka 15 Leavenworth 15 Leavenworth 

15 S1. Louis 

15 St. LouIs 15 S1. LouIs 

15 Manon 

15 Marion 15 Marion 16 Alexandria 16 Alexandria 16 Alexandria 16 Alexandria 16 BiloXI 16 BiloXI 16 Fayetteville 16 Fayetteville 16 Houston 16 Houston 16 Houston 

16 Houston 16 Houston 

16 Houston 

16 Houston 16 Jackson 

16 Jackson 

16 Jackson 16 Little Rock 

16 lillie Rock 16 Little Rock 16 Muskogee 

16 New Orleans 16 New Orleans 

Project Category 

Minor Construction Project Minor Construction Project Minor Construction Project 

NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project 

Minor Construction Project 

NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project NRM project 

Minor Construction Project 

NRM project NRM project NRM project 

Project Number Project Year 

589-375 Grandfathered 589-380 Grandfathered 589-381 Grandfathered 589A4-11-117 Grandfathered 589A5-11-118 589A6-11-115 589A6-11-116 

657-10-135JB 657-11-151JB 657-11-200JC 657 A5-11-060 657A5-11-106 657A5-11-114 

502-10-114 502-11-124 502-11-302 502-304 520-09-131 520-09-132 564-10-102 564-10-106 580-10-112 580-11-116 

580-11-403 

580-11-404 

580-11-410 

580-11-520 580-11-560 586-09-112 586-09-113 586-11-201 598-10-302 598-11-221 598-382 

623-10-020 629-10-120 629-10-121 

Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered Grandfathered 

Project Title 

Transitional Nursing Home Care Unit (TNHCU) 

Nursing Home Care Unit Relocation 

Community living Center 

Remodel Community Living Center Bathrooms-3 

East 

T21 Renovate Clinic Check Ins I Restrooms T21 Expand Examination Rooms On Ward A5 T21 Renovate Bathrooms 

MH - Renovate Wards 51 N2 & 51W BUilding 51 

for SUicide Prevention 

FCA Renovate Ward 5281, BUilding 52 

T21 - Address Women's Health/Pnvacy Issues 

Modify Community Based Outpallent Clinics for 

Women's Privacy 

FCA - Renovate Isolation Room 

T21 - Primary Care Expansion for Womens 

Health CliniC 

Primary Care for Mental Health, B-9 Refurbish Ward 45A B Wing Refurbish Ward 45A, A- and C-Wings Expand Building 7 For Primary, Specialty, Mental Health and Emergency Department Upgrade Public Restrooms, 1st floor, Bldg 3 

Upgrade Public Restrooms, Upper floors, Bldg 1 

Construct Connection from Clinical Addition to 

Patient DIning B-2 

Renovate Specialty CliniC for Palliative Care 

Radiation Therapy 

Door Alarms on Mental Patient Rooms 

Add 3 Beds in GI Recovery NU 5H 

Add 2 Beds In MICU 3rd Floor 

Renovate Outpatient Clinics 8-100 Renovate PC cliniC space In 8-100 

Renovate 2000 SF In Beaumont CBOC 

Renovate 1st Floor, C-Sectlon for NewWomen's 

Clinic 

Renovate 2C for Outpatient Specialty ClinicsPhase 1 Renovate for Patient Aligned Care Team 

Improvements 

Provide Primary Care Expansion Into 38 

Modifications to Primary Care Clinic for PACT 

Program 

Construct New Substance Abuse Building 

TOPC Patient Aligned Care Team 

Renovate Baton Rouge Essen Clinic to all Primary 

Care Expansion 

Renovate Hammond CBOC for Pnmary Care Expansion 

Total Project 

Cost{$) 

$9,073,869 $9,962,000 $9,526,158 

$397,601 

$882,062 

$67,823 

$711,300 $143,627 

$89,787 $62,723 

$170,689 

$8,522,698 

$41,120 

$127,000 

$253,765 

$1,470,000 

$428,250 $155,000 

$38,264 

$119,799 $171,984 

$298,390 $186,746 

$1,616,679 $4,020,848 

$536,883 

$4,300,000 

$131,704 

$1,252,900 

$591,683 

FY2011 

Obligations ($) 

$534,114 

$810,971 

$1,001,158 

$397,601 

$882,062 

$67,823 $71,130 

$143,627 

$89,787 $62,723 

$170,689 

$6,479,000 

$41,120 

$127,000 

$28,765 

$1,470,000 

$428,250 $155,000 

$38,264 

$119,799 

$171,984 $298,390 $186,746 

$116,679 

$4,020,848 

$536,883 

$4,300,000 

$131,704 $697,913 $792,153 

$1,252,900 

$591,683 

FY2012 Planned 

Design or 

Construction 

Obligation ($) 

$0 

$9,151,029 

$8,525,000 

$0 $0 $0 

$0 

$0 

$1,600,000 

$0 $0 $0 $0 $0 $0 $0 

$0 

$0 $0 

$225,000 

$0 $0 

$0 

$0 

$0 

$0 $0 $0 

$1,500,000 

$0 $0 $0 $0 

$0 

$0 $0 $0 

229q1VAb317.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VISN Facility Project Category Project Number Project Year Project Title Cost ($) Obligations ($) Obligation ($) 

16 Oklahoma City Minor Construction Project 635-407 Grandfathered Mental Health ExpanSion $8,701,000 $770,000 $7,931,000 16 Oklahoma City Minor Construction Project 635-408 Grandfathered 1st and 2nd Floor CliniC ExpanSion $8,218,000 $633,495 $0 17 Dallas NRM project 549-07-103ES Grandfathered Polytrauma Renovations $2,207,500 $2,207,500 $0 17 Dallas NRM project 549-09-904 Grandfathered Building 2 Ward Renovation for Patient Privacy $1,331,041 $1,331,041 $0 17 Dallas NRM project 549-11-906 Grandfathered Renovate 7B Patient Privacy $2,130,958 $130,958 $2,000,000 

18 Albuquerque NRM project 501-11-109 Grandfathered Enhance Inpatient Environments, BUilding 41 $590,698 $0 18 Albuquerque Minor Construction Project 501-318 Grandfathered Acute Geriatric Psychiatry Unit $5,648,859 $0 18 Albuquerque Minor Construction Project 501-324 Grandfathered Medical and Surgical Intensive Care Unit $9,054,000 $710,234 $0 

Consolidation 

18 Albuquerque Clinical Specific Initiatives 501-CSI-102 Grandfathered New Mental Health Space $1,740,000 $989,499 $0 

18 Big Spring NRM project 519-11-201 Grandfathered Renovate Restrooms- Phase I $543,850 $54,385 $0 

18 Prescott NRM project 649-12-103 Grandfathered Cultural Transformation of Community Living $446,478 $41,478 S405,OOO 

Center (Flnlshes/Slgnage) 

18 Prescott Minor Construction Project 649-407 Grandfathered Renovate/Expand Emergency Department $4,377,745 $3,718,400 $0 18 Tucson Minor Construction Project 678-319 Grandfathered Mental Health ExpanSion $7,465,000 $5,075,000 $0 18 Tucson Clinical Specific Initiatives 678-CSI-105 Grandfathered Clinical Support Building $510,000 $495,698 $0 

19 Denver NRM project 554-11-103 Grandfathered Renovate Inpatient Mental Health $589,550 $589,550 $0 

19 Denver NRM project 554-11-807 Grandfathered CLC Restroom Remodel $22,542 $22,542 $0 

19 Grand Junction NRM project 575-10-110 Grandfathered Renovate OPA for PCMH Program $785,563 $0 

20 BOise NRM project 531-11-115 Grandfathered Womens Health CliniC $77,418 $0 

20 BOise Mmor Construction Project 531-320 Grandfathered Intensive Care Unit 3rd Floor BUlldlrg 67 $860,173 $0 20 BOise Clinical Specific Initiatives 531-CSI-102 Grandfathered ReSidential Mental Health Facility $390,755 $3,683,405 20 Portland NRM project 648-11-146 Grandfathered Create Womens Clinic Phase 2 $132,451 $0 20 Portland NRM project 648-11-147 Grandfathered Renovate 8C Waiting Area $149,486 $0 

20 Roseburg NRM project 653-10-529 Grandfathered Patient Centered Care Renovations $314,182 $0 

20 Roseburg Minor Construction Project 653-325 Grandfathered New Mental Health Substance Abuse ReSidential $9,991,098 $971,526 $0 

Rehabilitation Treatment Program Building 

20 Seattle NRM project 663-09-121 Grandfathered Remodel Outpatient Pharmacy for Pallenl Privacy $276,000 $276,000 $0 

and Security 

20 Seattle NRM prOject 663-11-009 Grandfathered Relocate Primary Care Providers to B1 4th Floor $27,862 $27,862 $0 20 Seattle NRM project 663-11-015 Grandfathered ENT Clinic Remodel $43,972 $43,972 $0 20 Seattle Minor Construction Project 663-376 Grandfathered Expand Specialty Clinics at Seattle $9,343,656 $876,704 $0 20 American Lake NRM project 663A4-11-012 Grandfathered Building 7 and Building 2 Domiciliary $59,513 $59,513 $0 

20 American Lake NRM project 663A4-11-017 Grandfathered Women's CliniC Soiled Utility Rooms $27,461 $27,461 $0 

20 Spokane NRM project 668-08-110 Grandfathered Renovate Third Floor North $1,195,829 $1,195,829 $0 

20 Spokane NRM project 668-11-113 Grandfathered Correct Adult Psych Unit DefiCiencies $358,418 $358,418 $0 20 Spokane NRM project 668-11-118 Grandfathered Primary Care Exam Room Reconfiguratlon $96,695 $96,695 $0 20 Walla Walla NRM project 687-11-001 Grandfathered Yakima CBOC Renovation $116,659 $116,659 $0 20 Walla Walla NRM project 687-11-002 Grandfathered Renovate Richland CBOC $129,834 $129,834 $0 20 Walla Walla Minor Construction Project 687-301 Grandfathered Construct Specialty Clinic Care Facility $8,378,063 $7,009,194 $0 

20 White City Minor Construction Project 692-337 Grandfathered Replace Dom Bed B205 $9,960,000 $7,757,713 $0 

21 Fresno NRM project 570-11-109 Grandfathered Remodel Temporary Emergency Department for $120,490 $120,490 $0 

Hemotology-Oncology 

21 Fresno NRM project 570-11-126 Grandfathered Renovate Women Veteran Waiting Areas at $372,098 $372,098 $0 

CBOC's 

21 Fresno NRM project 570-11-127 Grandfathered Additional Women's Health Exam Rooms for $229,290 $229,290 $0 

Primary Care 

OCAMS - 21

229q1VAb318.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VISN Facility Project Category Project Number Project Year Project Title Cost ($) Obligations ($) Obligation ($) 

21 Fresno Minor Construction Project 570-217 Grandfathered Mental Health Psychosocial Rehab Recovery and $9,601,511 $952,228 $0 

Health Care for Homeless Veterans Center 

21 Sacramento Minor Construction Project 612-003 Grandfathered Consolidated Outpatient Surgical Specialty $0 21 Martinez NRM project 612-11-142 Grandfathered Women's Health Privacy and Security $0 21 Martinez NRM project 612-11-162 Grandfathered Construct Bathrooms, Mare Island $0 21 Sacramento Clinical Specific Initiatives 612A4-CSI-103 Grandfathered Women's Health Relocation for OEF/OIF $2,665,373 $1,489,531 $1,175,842 

Veterans 

21 Palo Alto NRM project 640-11-148P Grandfathered Renovate for Extended Care, Building 100 $1,143,213 $1,143,213 $0 21 Palo Alto Minor Construction PrOject 640-378 Grandfathered Building 2 Seismic Correction - Outpatient Mental $9,487,918 $8,260,336 $0 

Health Center 

21 Reno NRM project 654-11-210 Grandfathered Relocate PATPU $519,691 $519,691 $0 21 Reno NRM project 654-11-219 Grandfathered Hardware 5c Upgrade $63,451 $63,451 $0 21 San FrancIsco NRM project 662-11-005 Grandfathered Intensive Care Unit (ICU) Corrections $479,300 $479,300 $0 21 San FrancIsco NRM project 662-11-006 Grandfathered Interventlonal GI SUite Renovation $328,487 $328,487 $0 21 San FrancIsco NRM project 662-11-007 Grandfathered Correct PICU Aesthetic Deficiencies $289,049 $289,049 $0 21 San FrancIsco NRM project 662-11-104 Grandfathered Women's Clinic Renovations $299,159 $299,159 $0 21 San FrancIsco NRM project 662-11-105 Grandfathered Bldg 203, 1A Ward Elder Care Renovations $582,974 $582,974 $0 21 San FrancIsco NRM project 662-11-177 Grandfathered Oncology Renovation $443,902 $443,902 $0 21 San FrancIsco NRM project 662-11-203 Grandfathered Correct Women Shower Privacy Issues at the $80,061 $80,061 $0 

PICU 

21 San FrancIsco NRM project 662-11-207 Grandfathered Renovate for Patient Care $198,933 $198,933 $0 

22 Long Beach NRM project 600-11-160 Grandfathered Renovate Personal Care Area $400,000 $400,000 $0 22 Loma Linda NRM project 605-11-781 Grandfathered In Inpatient Wards $2,942,630 $294,263 $0 22 San Diego NRM project 664-09-105 Grandfathered Dental to Ambulatory Care & Police $3,090,150 $3,090,150 $0 22 West Los Angeles NRM project 691-09-110WL Grandfathered Correct BUilding 500 Restroom Deficiencies I $489,000 $489,000 $0 

Root Cause Analysis Falls 

22 West Los Angeles NRM project 691-11-129WL Grandfathered Renovate Building 500 Sub-Specialty Clinics $4,410,540 $441,054 $0 22 West Los Angeles NRM project 691-11-130WL Grandfathered Renovate Building 304 Second Floor $3,751,060 $375,106 $0 22 West Los Angeles NRM project 691-11-140WL Grandfathered Renovate Bathrooms for Women's CliniC In B500 $137,742 $137,742 $0 

22 West Los Angeles NRM project 691-11-90'WL Grandfathered Renovate Patient Centered Care Areas, Phase 1 $393,804 $393,804 $0 22 West Los Angeles NRM prOject 691-11-903WL Grandfathered Renovate Patient Centered Care Areas, Phase 2 $98,291 $98,291 $0 23 Fargo NRM project 437-11-101 Grandfathered Remodel ICU and DialysIs $0 

23 Fargo NRM project 437-11-120 Grandfathered Remodel PT/OT & ProsthetiCS $0 23 Fargo NRM project 437-11-130 Grandfathered Environmental Enhancments for Female Veterans $247,127 $247,127 $0 23 SIOUX Falls NRM project 438-11-107 Grandfathered Modify Aberdeen CBOC $34,748 $34,748 $0 23 SIOUX Falls NRM project 438-11-117 Grandfathered Women's Health Initiative Primary Care $177,000 $177,000 $0 23 Fort Meade NRM project 568-11-114 Grandfathered Upgrade Bldg. 113 Public Restrooms $76,740 $76,740 $0 23 Fort Meade NRM project 568-11-12; Grandfathered Quarters 144 Women Veterans Hoptel $346,133 $346,133 $0 

ConverSion 

23 Hot Springs NRM project 568A4-11-209 Grandfathered Female Veterans Quarters Improvements $105,332 $105,332 $0 23 Minneapolis NRM project 618-11-100 Grandfathered Expand and Renovate Gastrointestinal Procedure $2,383,209 $2,383,209 $0 

Unit 

23 Minneapolis NRM project 618-11-102 Grandfathered Women's Clinic Improvement for Rochester $19,199 $19,199 $0 

CBOC 

OCAMS - 21

229q1VAb319.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VISN Facility Project Category Project Number Project Year Project Title Cost{$) Obligations ($) Obligation{$) 

23 Minneapolis NRM project 618-11-117 Grandfathered Renovate Dental CliniC $433,000 $433,000 $0 23 Minneapolis NRM project 618-11-124 Grandfathered Expand Blood Draw Room $289,612 $289,612 $0 23 Minneapolis NRM project 618-11-160 Grandfathered Women's Clinic Improvements $43,408 $43,408 $0 

23 Omaha NRM project 636-11-107 Grandfathered Psychiatric Ward Enhancement OM $499,257 $499,257 $0 

23 Omaha NRM project 636-11-109 Grandfathered Improve Environment for Female Veterans $387,537 $387,537 $0 

23 Des Moines Minor Construction Project 636-345 Grandfathered Ward 3B Expansion & Renovation $5,295,500 $862,266 $0 23 Des MOines NRM project 636A6-10-711 Grandfathered Wander Garden Construction $245,039 $245,039 $0 

23 Iowa City NRM project 636A8-11-001 Grandfathered Renovation of 5E and 4E $4,249,950 $424,995 $0 

23 Iowa City NRM project 636A8-11-005 Grandfathered Renovate 8 East for Endoscopy & Cardiology $2,684,420 $268,442 $0 23 Iowa City NRM project 636A8-11-012 Grandfathered 6 West Women's Health CliniC $131,390 $131,390 $0 

23 Iowa City NRM project 636A8-11-013 Grandfathered Renovate Restrooms for ADA & Female Privacy $483,423 $483,423 $0 23 SI. Cloud NRM project 656-11-201 Grandfathered Upgrade Women's Clinic, Bldg 29 $143,369 $143,369 $0 

23 SI. Cloud Minor Construction Project 656-317 Grandfathered Expand & Renovate Wards Building 49, 1 st and $9,478,780 $8,303,980 $0 

2nd Floors 

Privacy (excluding Specific Women's Projects) Sub-totals $850,336,055 $353,126,340 $137,787,437 

Specific Women's Projects Sub-totals $33,748,301 $22,849,668 $7,443,877 

FY2012 and FY2013/Beyond Planned Obligations 

1 Bedford NRM Project 518-12-108 Grandfathered Renovate CLC Building 62 $4,800,000 $0 $4,800,000 

1 Manchester Minor Construction 608-313 FY2012 Constructior Mental Health Addition & Improvements $5,713,000 $0 $5,225,000 1 Manchester NRM Project VHA1-608-2013- FY2013 Design Women's Clinic Upgrades $1,900,000 $0 $0 

1 Newington Minor Construction VHA1-689A4-201 FY2013 Design Expand Primary Care Clinic $9,850,000 $0 $0 

1 Northampton Minor Construclion 631-110 FY2012 Design Northampton Permanent Support Housing $6,300,000 $0 $6,300,000 

Northampton NRM Project Grandfathered Renovate Cherry Street PRRTP $450,000 $0 S450,000 Providence NRM Project 650-10-118 Grandfathered Renovate Wing 3A for Clinical Space $3,632,000 $0 $3,632,000 Providence NRM Project 650-11-106 Grandfathered Relocate Respiratory Service to 4B & Convert $500,000 $0 S500,OOO 

Space 

Providence NRM PrOject VHA 1-650-2013- FY2013 Design Renovate Mental Health Outpatient Services $4,300,000 $0 $0 

Wlng3B 

Providence NRM Project VHA1-650-2013- FY2013 Design Renovate Wing 5A for Improved Clinic Space $4,448,000 $0 $0 

Togus NRM Project 402-13-552 Grandfathered Relocate Mental Health B206 $200,000 $0 S200,000 

West Haven NRM Project 689-11-506 Grandfathered Primary Care Realignment-Building 2 North $850,000 $0 $850,000 West Haven Minor Construction 689-375 GF Constructs ICU Step Down Expansion $6,689,000 $0 $6,018,000 West Haven Minor Construction 689-376 GF Constructs Surgical Specialty Clinics Renovation $6,285,000 $0 $5,798,000 West Haven Minor Construction 689-387 GF Constructs Surgical Specialty Clinic Addition $8,020,000 $0 $7,008,000 West Roxbury NRM Project 523A4-08-101 Grandfathered OEFIOIF Ambulatory Care Upgrades $468,000 $0 S468,000 West Roxbury NRM Project 523A4-12-201 FY2012 Design Ward Renovation Patient Privacy $4,400,000 $0 S440,000 

Albany Minor Construction 528-809 GF Constructs New Emergency Department $7,785,000 $0 $7,130,000 

Batavia Minor Construclion 528-352 FY2012 Constructior Ward B Privacy Renovations $4,054,000 $0 $3,638,000 Batavia NRM Project VHA2-528A4-201 FY2013 Design Renovate C ward $5,500,000 $0 $0 

Bath NRM Project 528A6-11-612 Grandfathered Upgrade Toilet Rooms, Budding 92 $40,000 $0 $40,000 

Buffalo NRM Project 528-11-101 Grandfathered Renovate PhYSical Therapy $2,100,000 $0 $2,100,000 Buffalo NRM Project 528-12-100 FY2012 Design Renovate Ward 9C $450,000 $0 $45,000 

Buffalo NRM Project VHA2-528-2013- FY2013 Design Renovate 9th floor patient Ward 2 $4,838,850 $0 $0 

Canandaigua NRM Project 528A5-12-504 Grandfathered Renovate B1 Specialty Clinics 3rd Floor $812,700 $0 S812,700 

Syracuse NRM Project 528A7-12-702 Grandfathered ICU 6 East Renovation $310,000 $0 S310,000 Syracuse NRM Project 528A7-12-703 Grandfathered Renovate for Comp & Pen f Women's Clinic $230,000 $0 S230,000 Syracuse NRM Project 528A7-12-718 Grandfathered CLC Patient Bathroom Modifications $65,000 $0 $65,000 

Bronx NRM Project 526-11-103 Grandfathered Renovate Women's Health & Admin Med $1,042,500 $0 $1,042,500 Brooklyn NRM Project 630A4-1 0-40 1 Grandfathered 12WI15W Ward Renovation $3,200,000 $0 $3,200,000 

OCAMS - 21

229q1VAb3110.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VISN Facility Project Category Project Number Project Year Project Title Cost{$) Obligations ($) Obligation ($) 

3 Brooklyn NRM Project VHA3-630A4-201 FY2013 Design Renovate Womens Health Clinic $2,700,000 $0 $0 3 Brooklyn NRM Project VHA3-630A4-201 FY2013 Design Improve Radiology Pallent Privacy $2,100,000 $0 $0 3 Lyons Minor Construction 561-235 GF Constructs Renovation Community LIving Center $6,831,000 $0 $6,256,000 3 Lyons NRM Project 561A4-08-119 Grandfathered Correct Psych Unit Deficiencies - Nurses Call $300,000 $0 $300,000 3 Montrose NRM Project 620-09-202 Grandfathered Renovation to Community LIving Centers $4,950,000 $0 $4,950,000 3 Montrose Minor Construction VHA3-620-2013- FY2013 Design Expand Outpatient Services bUilding 3 $7,000,000 $0 $0 3 New York City NRM Project 630-09-113 Grandfathered Cllnlcallmprovements/4W Step Down Unit $2,500,000 $0 $2,500,000 

New York City NRM Project VHA3-630-2013- FY2013 Design Renovate 4 North ward/ Ambulatory Surgery $5,500,000 $0 $0 

Northport NRM Project VHA3-632-2013- FY2013 Design Renovate Post Traumatic Stress Disorder $7,403,000 $0 $0 

Residence 

Northport Minor Construction VHA3-632-2013- FY2013 Design Renovate Emergency Room $9,900,000 $0 $0 

St.Albans NRM Project 630A4-10-402 Grandfathered Renovate Rehab Medicine $2,200,000 $0 $2,200,000 St.Albans NRM Project VHA3-630A5-201 FY2013 Design Renovate Ward C1 $2,100,000 $0 $0 

4 Altoona, PA Minor Construction 503-307 FY2012 Design Expand & Improve Behavioral Health Clinic $9,794,285 $0 $820,000 

Butler Minor Construction 529-312 FY2012 Constructlor Dementia Long Term Care Unit Replacement $7,000,000 $0 $6,420,000 

Clarksburg Minor Construclion VHA4-540-2013- FY2013 DeSign Improve Ambulatory Care Support & Physical $9,150,000 $0 10 

Security 

Clarksburg Minor Construction VHA4-540-2013- FY2013 DeSign Construct Behavioral Health Villas $5,000,000 $0 $0 

Coatesville NRM Project 542-09-120 FY2012 Design BUilding 3, Phase II, Construct Imaging SUite & $7,500,000 $0 $750,000 

Outpatient Services 

Erie NRM Project 562-08-110 Grandfathered Renovate Behavioral Health $500,000 $0 $500,000 

Erie Minor Construction 562-313 FY2012 Constructior Expand Behavioral Health $6,000,000 $0 $5,625,000 Erie, PA Minor Construction 562-314 FY2012 DeSign Replace Community Living Center $9,556,837 $0 $956,000 

Lebanon NRM Project 595-10-107 Grandfathered Renovate to Expand Oncology/DialysIs $1,750,000 $0 $1,750,000 

Lebanon Minor Construction VHA4-595-2013-' FY2013 Design Construct Intensive CareUnlUMedicallSurgical $9,900,000 $0 $0 

Unit 

Philadelphia Minor Construction VHA4-642-2013- FY2013 DeSign Upgrade Community Living Center - Addition for $7,785,000 $0 $0 

New Recreation Center 

Philadelphia NRM Project VHA4-642-2013- FY2013 Design Renovate Primary Care Clinic - Patient Aligned $1,947,000 $0 $0 

Care Team (PACT) 

Philadelphia NRM Project 642-11-131 Grandfathered Upgrade Pallent Areas Unit C $3,100,000 $0 $3,100,000 

Philadelphia NRM Project 642-11-151 Grandfathered Upgrade Toilets 1st Floor $200,000 $0 $200,000 

Wilkes-Barre NRM Project 693-09-129 Grandfathered Renovate Wound Care Clinic $4,300,000 $0 $4,300,000 Wilkes-Barre, PA Minor Construction 693-1102 FY2012 DeSign Build Community Living Center, Phase 1 $9,722,000 $0 $972,000 

Baltimore NRM Project VHA5-512-2013- FY2013 DeSign Convert Semi Private Beds to Private 3A $3,000,000 $0 $0 

Martinsburg NRM Project 613-12-101 FY2012 Design Renovate Mental Health Domiciliary Bldg 502, E $3,685,000 $0 $368,500 

Pod, Phase 1 

Martinsburg NRM Project 613-12-201 FY2012 DeSign CLC Cultural Tranformation to Renovate 5A (Ph $4,307,000 $0 $430,700 

2) 

Martinsburg NRM Project 613-12-203 FY2012 Design Renovate 200 Row for Mental Health Domicliliary, $4,607,000 $0 $460,700 

Phase 2 

Martinsburg, WV Minor Construction 613-115 FY2012 DeSign Build Women's Well ness Center $7,497,550 $0 $799,000 Perry Point Minor Construction 512-531 GF Designs 36-Bed Psychiatric Residential Rehabilitation $7,777,000 $0 $661,000 

Treatment Program Replacement, Phase 2 

VAMHCS Minor Construction 512-523 FY2012 Constructior Construct New Substance Abuse Residential Rehab Treatment Program Beds $8,562,000 $0 $7,892,000 

Washington Minor Construction 688-327 GF Constructs Mental Health Domiciliary $6,500,000 $0 $5,463,000 Washington Minor Construction 688-333 GF Constructs Comprehensive Nursing Rehabilitation Center 3rd $9,839,000 $0 $9,039,000 

Floor Expansion 

Washington Minor Construclion 688-336 FY2012 Constructlor 4E Patient Ward Renovation/Expansion $7,253,000 $0 $6,622,000 

OCAMS - 21

229q1VAb3111.eps

FV2012 Planned 

Design or 

Total Project FV2011 Construction 

VISN Facility Project Category Project Number ProjectVear Project Title Cost ($) Obligations ($) Obligation ($) 

ComprehenSive Nursing Rehabilitation Center 

Washington Minor Construction 688-342 GF Designs Addition for Blind Rehab & OEFJOIF Transitional $7,050,000 $0 $750,000 

Rehab 

Washington NRM Project 688-11-007 FY2012 Design Renovate Restrooms Phase I $2,770,000 $0 S277,OOO 

6 Asheville NRM Project 637-10-114 Grandfathered Renovate 5 South for Mental Health $450,000 $0 S450,000 6 Asheville NRM Project VHA6-637-2013- FY2013 Design Renovate Ward 5-East $4,142,000 $0 $0 

Beckley Minor Construction 517-314 FY2012 Constructior Patient Care Expansion $4,750,000 $0 $4,228,000 

Durham Minor Construction VHA6-558-2013- FY2013 Design Construct New Outpatient Care Building #17 $9,700,000 $0 $0 

Durham Minor Construction VHA6-558-2013- FY2013 Design Renovate and Expand Community LIving Center $9,900,000 $0 $0 

and Hospice Bldg #23 

Fayetteville NRM Project 565-11-113 FY2012 Design Renovate Bathrooms Phase I $1,650,000 $0 S165,000 

Fayetteville, NC Minor Construction VHA6-565-2013- FY2013 Design Construct Stand alone Community LIving Center $9,800,000 $0 $0 

Fayetteville, NC NRM PrOject VHA6-565-2013- FY2013 Design Renovate 2nd Floor for a 25 Bed Medical/Surgical $8,588,000 $0 $0 

nursing Unit 

Hampton NRM PrOject 590-11-401 Grandfathered Renovate ED Bldg 11 OB $225,000 $0 S225,000 

Hampton Minor Construction VHA6-590-2013- FY2013 Design Construct 2nd Floor Addition on BUilding 110B for $9,974,000 $0 $0 

Specialty and Primary Care 

Hampton NRM Project VHA6-590-2013- FY2013 Design Renovate and Expand Emergency Department $3,538,000 $0 $0 Hampton NRM Project VHA6-590-2013- FY2013 Design Renovate 1 East In Building 110 to Convert into $2,750,000 $0 $0 

Clinical Space 

Hampton Minor ConstrucllOn VHA6-590-2013- FY2013 Design Construct New Mental Health Building $9,718,500 $0 $0 

Richmond NRM Project 652-11-109 Grandfathered Renovation of Multiple Inpatient Areas $1,330,200 $0 $1,330,200 

Richmond NRM Project 652-12-106 Grandfathered Renovate Public Restrooms / Phase II $990,000 $0 S990,OOO Richmond NRM Project VHA6-652-2013- FY2013 Design Emergency Room Improvements $2,400,000 $0 $0 

Richmond NRM Project VHA6-652-2013- FY2013 Design Improve Patient Privacy 4C/4B $2,420,000 $0 $0 

Salem Minor Construction VHA6-658-2013-' FY2013 Design Expand/Renovate Emergency Department $6,600,000 $0 $0 Salisbury Minor Construction 659-332 GF Constructs Mental Health Care Renovallon, BUilding 4, $9,460,000 $0 $8,640,000 

Phase2 

Salisbury Minor Construction 659-337 FY2012 Design Renovate Intensive Care Unit $9,126,000 $0 $770,000 

Salisbury Minor Construction 659-341 FY2012 Design Renovate Building 11 for Residential Care $8,226,000 $0 $625,000 Salisbury NRM Project VHA6-659-2013- FY2013 Design Renovate Medical/Surgical Nursing Units on $4,000,000 $0 $0 

floors 2-3 for Patient Privacy Bldg 2 

Atlanta Minor Construction VHA7-508-2013- FY2013 Design Construct Primary/Urgent Care Addition $9,999,000 $0 $0 

7 Augusta NRM Project 509-12-104 FY2012 Design Renovate Mental Health Units, B110 $600,000 $0 $60,000 

Birmingham NRM Project 521-12-101 FY2012 Design Renovate Emergency Room Urgent Care Facility $112,500 $0 $11,250 

Charleston NRM Project VHA7-534-2013- FY2013 Design Expand and Renovate Emergency Department $3,025,000 $0 $0 

Charleston Minor Construction VHA7-534-2013- FY2013 Design Relocation of EXisting Community Based $5,062,000 $0 $0 

Outpatient Clinic-Beaufort SC 

Charleston NRM Project VHA7-534-2013- FY2013 Design Expand Gastrointestinal $2,750,000 $0 $0 

Charleston NRM Project VHA7-534-2013- FY2013 Design Convert 3BS to Clinical Space $3,960,000 $0 $0 Columbia, SC NRM Project VHA7-544-2013- FY2013 Design Renovate 3W for Medical Surgical Unit $2,500,000 $0 $0 Columbia, SC NRM Project VHA7-544-2013- FY2013 Design Renovate Inpatient Psychiatry and Substance $3,200,000 $0 $0 

Abuse to Implement B1 06 

Dublin NRM Project 557-10-108 Grandfathered Renovate 13A for EndoscopIc SUite $2,430,000 $0 $2,430,000 

Dublin NRM Project 557-12-102 FY2012 Design Renovate B34 To Outpatient MH $724,000 $0 $72,400 

Montgomery NRM PrOject 619-12-102 FY2012 Design Renovate Building 3A, 4th Floor to Clinical Space $272,732 $0 $27,273 

OCAMS - 21

229q1VAb3112.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VISN Facility Project Category Project Number Project Year Project Title Cost ($) Obligations ($) Obligation ($) 

Montgomery NRM Project 619-12-105 FY2012 Design Renovate Urgent Care, Radiology/Nuclear $272,800 $0 $27,280 

Medlne, Prosthetics 

Tuscaloosa Minor Construction VIIA7-679-2013- rY2013 Design Construct Community Living Center Cottages $9,993,000 $0 $0 

Phase III 

Bay Pines Minor Construction 516-327 GF Constructs Expand/Renovate B-1 01 Community Living $6,925,000 $0 $5,939,000 

Center 

Bay Pines NRM Project 516-11-135 Grandfalhered Sebring CBOC buildout $360,000 $0 $360,000 

Bay Pines NRM Project 516-12-101 Grandfalhered Renovate B-22 2nd Floor for Clinics, Phase I $979,950 $0 $979,950 Bay Pines NRM Project 516-12-123 FY2012 Design Renovate Community liVing Center Phase II $494,959 $0 $49,496 

(Eden Concept) 

Orlando NRM Project 675-12-804 Grandfathered Renovate Primary Care Lake Baldwin $504,000 $0 $504,000 

San Juan NRM PrOject 672-12-101 FY2012 Design Expand Emergency Department & Observation $700,000 $0 $70,000 

Unit 

San Juan NRM Project 672-12-120 Grandfathered Renovation of Bathrooms and Main COrridors at $977,958 $0 $977,958 

Outpatient Addition Building 

San Juan NRM PrOject 672-12-128 Grandfathered Renovate Community liVing Center $558,071 $0 $558,071 

Restrooms/Showers 

Tampa NRM Project 673-10-859 Grandfalhered Improve Community liVing Center Family Area B $500,000 $0 $500,000 

&C 

Tampa NRM Project 673-12-103 Grandfathered Spinal Cord InjUry B Renovation $833,377 $0 $833,377 Tampa Minor Construction VHA8-673-2013- FY2013 Design Construct New Mental Health Clinic, 80 Bed $9,125,000 $0 $0 

Domiciliary, and Primary Care CliniC 

West Palm Beach NRM Project 548-12-101 Grandfathered Replace/Rekey Master Key System $291,482 $0 $291,482 

West Palm Beach NRM PrOject VHA8-548-2013- FY2013 DeSign Renovate 5B for Private Rooms $4,000,000 $0 $0 

Leestown NRM Project 596-12-103 Grandfathered Renovate Prosthetics In Building 1 $45,000 $0 $45,000 

Louisville Minor Construction VHA9-603-2013- FY2013 Design Construct Community Outpatient Clinic at Fort $6,530,000 $0 $0 

Knox 

Memphis NRM Project VHA9-614-2013- FY2013 DeSign Expand Emergency Department $0 $0 

10 Chillicothe Minor Construction 538-105 GF Constructs Renovate NurSing Home Care Unit B211-AB $0 $8,172,000 10 Chillicothe NRM Project 538-13-101 Grandfathered Renovate OccupallOnal Therapy Building 3 $0 $119,900 10 Chillicothe NRM Project 538-13-105 Grandfathered Correct Safety Issues for Acute Mental Health $95,000 $0 $95,000 

Ward, B35CD 

10 Clnclnnali Minor Construclion 539-323 GF Constructs Relocate NurSing Home Care Unit, Phase 2 $9,605,000 $0 $8,621,000 10 Cincinnati Minor Construction VHA10-539-2013 FY2013 Design Construct Inpatient Bed Tower Addition to Correct $9,900,000 $0 $0 

Patient Privacy, Floors 4 & 5 

10 Cincinnati NRM Project VHA 10-539-2013 FY2013 DeSign Renovate Pulmonary/Sleep Lab $1,500,000 $0 $0 10 Cincinnatl,OH Minor Construction 539-326 FY2012 DeSign Relocate Community LIVing Center, Phase 4 $8,534,012 $0 $853,000 10 Columbus ACC NRM Project 757-12-201 FY2012 Design Expand Clinical Space, 4th Floor $1,450,000 $0 $145,000 10 Columbus, OH Minor Construction 757-200 FY2012 Design BUild SpeCially Care Addition $9,000,000 $0 $900,000 10 Dayton NRM Project 552-11-109 Grandfathered Renovate B-330 1st Floor, Oncology/OEF/OIF $2,860,000 $0 10 Dayton NRM Project 552-13-101 Grandfathered Renovate Rehabilitation Dept B-330 $990,000 $0 10 Dayton NRM Project 552-13-202 Grandfalhered Renovate Patient Wards for Privacy, 3rd and 4th $735,000 $0 $735,000 

Floor B-330 

10 Dayton NRM Project 552-13-203 Grandfalhered Renovate Facility Restrooms-FCA $262,500 $0 S262,500 

11 Ann Arbor NRM Project 506-12-107 Grandfalhered Convert Prior ER to Clinics $250,000 $0 $250,000 11 Ann Arbor Minor Construction VHA1'-506-20'3 FY2013 Design BUild Out CliniCS In Prior Emergency Room I $9,540,000 $0 $0 

Urgent Care 

11 Ann Arbor NRM Project VHA11-506-2013 FY2013 Design Construct Clinics In 2West and 3West, Health $5,000,000 $0 $0 

Services Research & Development 

11 Ann Arbor Minor Construction VHA11-506-2013 FY2013 DeSign Expand Ambulatory Care Clinical Exam Rooms $8,480,000 $0 $0 

OCAMS - 21

229q1VAb3113.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VISN Facility Project Category Project Number Project Year Project Title Cost{$) Obligations ($) Obligation ($) 

11 Battle Creek NRM Projecl 515-10-114 Grandfathered Install Cenlralized Waiting Room Building 2 $225,000 $0 S225,000 11 Battle Creek NRM Project 515-12-108 Grandfathered Build Out Muskegon CBOC $491,754 $0 S491 ,754 

11 Battle Creek Minor Construction 515-304 FY2012 Constructior Ambulatory Care Expansion B2 $8,724,000 $0 $7,837,000 

11 Danvllle,IL NRM PrOject 550-12-101 Grandfathered Renovate Community living Center Building 101 $456,000 $0 S456,000 

for Privacy 

11 Danville,IL NRM Project VHA11-550-2013 FY2013 Design Renovate Community living Center Building 101 $5,016,000 $0 $0 

for Pallent Pnvacy 

11 Detroit NRM Project 553-12-103 Grandfathered PACT Renovations $75,000 $0 $75,000 11 Indianapolis NRM Project 583-12-102 Grandfathered Renovate Intensive Care for Privacy $300,000 $0 $300,000 11 Indianapolis NRM Project 583-12-103 Grandfathered Renovate Ambulatory Care $300,000 $0 $300,000 11 Indianapolis NRM Project 583-12-106 Grandfathered Renovate ProsthetiCS $100,000 $0 $100,000 11 Indianapolis NRM Project 583-12-146 Grandfathered Renovate Exam Rooms for Privacy $150,000 $0 $150,000 

11 Marion Minor Construction 610-302 GF Constructs Clinical Services Expansion, BUilding 138-4 $6,402,000 $0 $5,900,000 

11 Saginaw NRM Project 655-12-107 Grandfathered Building 22 Bathroom renovation $62,000 $0 $62,000 

12 Hines NRM Project 578-11-071 Grandfathered Renovate 15th Floor for PM&R, bldg 200 $500,000 $0 S500,OOO 12 Madison NRM Project VHA12-607-2013 FY2013 DeSign Expand ED/AdmiSSions $3,866,000 $0 $0 12 Milwaukee Minor Construction 695-314 FY2012 Constructior Construct NHCU Homes (4) $6,960,000 $0 $6,320,000 12 North Chicago Minor Construction 556-304 FY2012 Constructior Construct Four Unit Community Living Centers $6,936,000 $0 $6,322,000 12 North Chicago NRM Project VHA12-556-2013 FY2013 DeSign Renovate Specialty Clinics/Operating Rooms $9,950,000 $0 $0 

12 Tomah Minor Construclion 676-320 FY2012 Constructlor Construct Community Living Center $4,747,000 $0 $4,269,000 

12 Tomah Minor Construclion 676-321 FY2012 Constructlor Construct Clinical Addition B-400 $4,739,000 $0 $4,334,000 

12 Tomah Minor Construclion 676-322 GF Constructs Renovate Building 2 for TranSitional ReSidency $9,667,000 $0 $6,135,000 

Program 

15 Columbia, MO NRM Project 589A4-11-108 Grandfathered Renovate Intensive Care Unit $450,000 $0 $450,000 15 Columbia, MO NRM Project 589A4-12-102 FY2012 Design Relocate Cardiology $327,800 $0 $32,780 15 Columbia, MO Minor Construction VHA15-589A4-2C FY2013 DeSign Expand Ambulatory Care Addition, Phase 1 $9,979,000 $0 $0 15 Kansas City Minor Construction VHA15-589-2013 FY2013 Design Construct Inpatient Mental Health BUilding for $9,950,000 $0 $0 

RightSIZing 

15 Marion Minor Construction 657-343 FY2012 Constructior MICU, Day Surgery, Surg & Med Spec $9,957,000 $0 $9,132,000 

15 Marion,IL NRM Project 657 A5-1 0-1 08 Grandfathered Remodel Emergency Department $2,100,000 $0 $2,100,000 15 Marion,IL Minor Construction VHA 15-657A5-2C FY2013 DeSign Contruct Mental Health ReSidential Rehabilitation $2,000,000 $0 $0 

Treatment Program Addition 

15 Poplar Bluff NRM Project 657 A4-1 0-01 03 Grandfathered Expand/Modify Emergency Room $690,000 $0 S690,000 15 Poplar Bluff Minor Construction VHA 15-657A4-2C FY2013 DeSign Construct Clinical and Urgent Care Addition $9,985,000 $0 $0 15 SI. LOUIS NRM Project 657-11-106JC Grandfathered Expand Triage (Pallent Aligned Care Team) Area $220,000 $0 $220,000 15 SI. LOUIS NRM Project 657-11-151JB Grandfathered FCA Renovate Ward 52S1, BUilding 52 $1,600,000 $0 $1,600,000 15 SI. Louis NRM Project VHA15-657-2013 FY2013 Design Renovate Operating Rooms, Emergency $8,376,000 $0 $0 

Department, and Triage 

15 Topeka Minor Construction 589-379 FY2012 Constructior Specialty Care Addition $4,500,000 $0 $4,050,000 15 Topeka NRM PrOject 589A5-10-132 Grandfathered MH-Renovate Building 2 Wards 2-3B and 2-3C, $6,000,000 $0 $6,000,000 

Phase I 

15 Wichita NRM Project 589A 7 -CSI-338 Grandfathered MH - Construct Behavioral Health Building $4,000,000 $0 $4,000,000 

Renovate portions of B-7 4th floor for 

16 Alexandria NRM Project 502-11-122 Grandfathered Oncology/Chemotherapy, Out Patient Palliative $618,000 $0 $618,000 

Care, and Ambulatory Surgery Pre-Op Clinic 

16 Alexandria NRM Project 502-12-203 Grandfathered Renovate for Sleep Lab Space $25,000 $0 $25,000 16 Alexandria NRM Project 502-12-204 Grandfathered Renovate for new Emergency Department and $1,750,000 $0 $1,750,000 

Urgent Care Clinic 

OCAMS - 21

229q1VAb3114.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VISN Facility Project Category Project Number Project Year Project Title Cost{$) Obligations ($) Obligation ($) 

16 Alexandria NRM Project 502-12-205 Grandfathered Renovate for Residential Rehabilitation Treatment $50,000 $0 $50,000 

Program (RRTP) 

16 Biloxi NRM Project 520-11-120 Grandfathered Upgrade Restrooms, Bldg 5 $80,000 $0 $80,000 16 Fayetteville Minor Construction 564-341 FY2012 Constructlor Renovate Former Army Reserve Center $6,651,000 $0 $6,651,000 16 Fayetteville, AR NRM Project 564-12-106 Grandfathered Renovate Patient Bathrooms, Bldg 1 $210,000 $0 $210,000 16 Fayetteville, AR NRM Project 564-12-108 Grandfathered Renovate Physical Therapy for IT, Bldg 1 $50,000 $0 $50,000 16 Houston NRM Project 580-11-104 Grandfathered Renovate Public Bathrooms $235,000 $0 S235,000 16 Houston Minor Construction 580-317 FY2012 Constructlor Floor in Bldg 100 for Specialty $9,889,000 $0 $9,049,000 

16 Houston Minor Construction 580-319 FY2012 Constructlor Renovate Bldg 108 for Mental Health $9,815,000 $0 $8,980,000 

16 Jackson NRM Project 586-08-110 Grandfathered Renovate SICU $1,500,000 $0 $1,500,000 16 Jackson NRM Project 586-09-111 Grandfathered Renovate Basement D-Sectlon for Oncology $1,850,000 $0 $1,850,000 

Expansion 

16 Jackson NRM Project 586-09-114 Grandfathered Renovate 3K for MH OIP Clinics $2,280,000 $0 $2,280,000 16 Jackson NRM Project 586-10-107 Grandfathered Renovate 4C for Improved Patient Environment $6,500,000 $0 $6,500,000 16 Jackson NRM Project 586-12-101 Grandfathered Renovate 4L for MICU/CCU and Step Down Unit $350,000 $0 $350,000 16 Jackson NRM Project 586-12-103 Grandfathered Renovate 4A for Expanded Inpatient Ward $315,000 $0 $315,000 16 Jackson Minor Construction 586-393 GF Designs Provide 3rd Floor for Community liVing Center $9,666,000 $0 S834,000 

ExpanSion, Phase 1 

16 Jackson Minor Construction VHA 16-586-2013 FY2013 DeSign Construct New Outpatient Services Center $9,900,000 $0 $0 16 Jackson NRM PrOject VHAI6-586-2013 FY2013 Design Renovate Ward 4C- North & South for Patient $5,500,000 $0 $0 

Privacy 

16 Little Rock NRM Project 598-12-119 Grandfathered 5E/4D Step-Down & Telemetry $1,000,000 $0 $1,000,000 16 Little Rock NRM Project 598-12-12- Grandfathered Renovate 6B DialysIs $250,000 $0 $250,000 16 Little Rock NRM Project 598-12-123 Grandfathered Convert to Single Bed Patient Rooms $500,000 $0 S500,000 16 New Orleans NRM Project 629-12-101 Grandfathered Renovate Urgent Care Center $720,000 $0 S720,000 16 New Orleans NRM Project 629-12-106 Grandfathered Correct Patient Privacy Issues at Clinics $85,000 $0 $85,000 16 North Little Rock NRM Project VHAI6-598AO-2C FY2013 Design Expand Outpatient & Consolidate Administrative & $7,902,000 $0 $0 

Support Spaces 

16 Oklahoma City Minor Construction 635-406 GF Constructs Surgical IntenSive Care Unit Expansion $9,700,000 $0 $8,000,000 16 Oklahoma City NRM Project VHA 16-635-2013 FY2013 DeSign Renovate 6 East for Patient Privacy $2,650,000 $0 $0 16 Oklahoma City NRM Project 635-12-303 Grandfathered Relocate and Expand DialysIs $100,000 $0 S100,000 16 Oklahoma City NRM Project 635-12-305 Grandfathered Renovate 6 East Patient Unit $265,000 $0 $265,000 16 Oklahoma City NRM Project 635-12-309 Grandfathered Remodel Public Restrooms for ADA $70,000 $0 $70,000 16 Oklahoma City, Of< Minor Construction 635-410 FY2012 DeSign Expand Lawton Outpatient Clinic $2,676,750 $0 $268,000 16 Shreveport NRM Project 667-CSI-101 Grandfathered Mental Health ExpanSion, Bldg #1-2S $4,561,188 $0 $4,561,188 17 Bonham Minor Construction VHA17-549A4-2C FY2013 Design Renovate and Expand Ambulatory Care & and $9,800,000 $0 $0 

Lab 

17 Corpus Christi Minor Construction VHA17-671-2013 FY2013 DeSign Renovate and Expand Corpus Clinic $10,000,000 $0 $0 17 Dallas NRM Project 549-11-906 FY2012 DeSign Renovate 7B Patient Privacy $2,000,000 $0 $200,000 

17 Dallas NRM Project VHA 17-549-2013 FY2013 Design Renovate Medical Inpatient Nursing Unit for $2,893,000 $0 $0 

Privacy6B 

17 Dallas NRM Project VHA17-549-2013 FY2013 DeSign Establish Acute Coronary Syndrome/Observation $3,820,000 $0 $0 

Unit (ACS/OBS) 

17 Waco NRM Project 674A4-CSI-S16 Grandfathered LTC Green HouseB11 $3,120,000 $0 $3,120,000 18 Albuquerque NRM Project 501-11-107 Grandfathered Primary Care Areas, Building 41, Phase $2,000,000 $0 $2,000,000 18 Albuquerque NRM Project 501-12-119 Grandfathered Remodel Renal Dialysis $150,000 $0 S150,000 18 Albuquerque Minor Construction 501-320 FY2012 Constructior Ambulatory Surgery $9,000,000 $0 $8,140,000 18 Albuquerque Minor Construction 501-321 GF Constructs Outpatient Mental Health ExpanSion $9,150,000 $0 $8,350,000 

OCAMS - 21

229q1VAb3115.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VtSN Facility Project Category Project Number Project Year Project Title Cost ($) Obligations ($) Obligation ($) 

18 Albuquerque NRM Project 501-CSI-104 Grandfathered Expand for Women's Clinic and OEF/OIF Space $350,000 $0 S350,000 10 Albuquerque Minor Construction VilA 18-501-2013 rY2013 Design Renovate 8ulldlng 41, 4A Quadrant, 20 8ed Ward $9,760,000 $0 $0 18 Albuquerque, NM Minor Construction 501-325 FY2012 Design Build Acute Psychiatric Unit $9,714,000 $0 S827,000 18 Albuquerque, NM Minor Construction 501-326 FY2012 Design Build New Community Living Center, Phase 1 $9,597,200 $0 $850,000 18 Amarillo NRM Project 504-10-704 Grandfathered Renovate North In-Patient Ward $3,960,000 $0 $3,960,000 18 Amarillo Minor Construction 504-220 FY2012 Constructior Emergency Room $5,033,000 $0 $4,621,000 18 Amarillo Minor Construction VHA18-504-2013 FY2013 Design Construct Community LIving Center $9,900,000 $0 $0 18 Amarillo Minor Construction VHA18-504-2013 FY2013 Design Construct Primary Care Clinic $9,988,000 $0 $0 18 Big Spring, TX Minor Construction 519-368 FY2012 Design BUild Community LIving Center $8,253,405 $0 S734,000 

18 EI Paso Minor Construction 756-302 FY2012 Constructlor Dental & Clinical Expansion $0 $9,104,000 

18 Phoenix NRM Project 644-13-006 Grandfathered Renovate E113 Spinal Cord Injury Clinic $0 $75,000 18 Phoenix Minor Construction VHA18-644-2013 FY2013 Design BUild New Outpatient Behavioral Health BUldllng $9,714,000 $0 $0 18 Phoenix AZ Minor Construction 644-230 FY2012 Design Expand BUilding 1 for Clinical Services $9,944,960 $0 S864,000 18 Phoenix, A2 Minor Construction 644-232 FY2012 Design Renovate Community LIving Center, Phase 2 $9,896,250 $0 S859,000 18 Prescott NRM Project 649-12-118 Grandfathered Renovate Endoscopy, BUilding 107, Floor 5 $1,260,000 $0 $1,260,000 18 Tucson NRM Project 678-CSI-103 Grandfathered Expand for Polytrauma Rehabilitation $1,726,000 $0 $1,726,000 18 Tucson NRM Project 678-CSI-104 Grandfathered Expand for Women's Health and OEF/OIF $410,000 $0 S410,000 18 Tucson Minor Construction VHA18-678-2013 FY2013 Design Expand Clinics for Patient Aligned Care Teams $9,762,000 $0 $0 

(Phase 1) 

18 Tucson, AZ Minor Construction 678-324 FY2012 Design Build Mental Health Beds $9,846,380 $0 S848,000 19 Cheyenne Minor Construction 442-101 GF Designs BehaVioral Health Unit $7,638,000 $0 S667,000 19 Cheyenne, WY Minor Construction 442-215 FY2012 Design Replace 20 Community liVing Center Beds $0 $777,000 19 Grand Junction NRM Project VHA19-575-2013 FY2013 DeSign Elimination of Substandard Beds on 3rd Floor $0 $0 

19 Grand Junction, C( Minor Construction 575-205 FY2012 DeSign Build OTI PT/ ProsthetiCS Building $0 S909,000 

19 Montana HCS Minor Construction 436-110 GF Constructs Correct Pallent Privacy $0 $8,985,000 19 Salt Lake City, UT Minor Construction 660-330 FY2012 DeSign Build Specialty CliniCS Building (B.51) $0 $990,000 19 Salt Lake City, UT Minor Construction 660-302 FY2012 Design Build Rehab/Prosthetics & OrthofNeurofHolistic $9,964,000 $0 $996,000 

MediCine Addition (B 01) 

19 Sheridan Minor Construction 666-308 GF Constructs Mental Health Residenllal Rehab $9,886,000 $0 $8,987,000 

19 Sheridan, WY Minor Construction 666-309 FY2012 DeSign Expand Domiciliary $9,105,000 $0 S910,000 

20 Alaska NRM Project 463-12-113 Grandfathered DomiCiliary Upgrades $116,000 $0 S116,000 20 BOise NRM Project 531-12-102 Grandfathered Remodel BUilding 27 for Oncology $455,000 $0 5455,000 20 BOise Mmor ConstruCllOn 531-317 GF Constructs Replace & Modernize Surgeryllntensive Care Unit $9,985,000 $0 $9,046,000 

20 BOise Minor Construction 531-319 FY2012 Constructlor Construct New Extended Care Unit $9,983,000 $0 $9,177,000 20 Portland Minor Construction 648-340 FY2012 Constructlor New Emergency Dept Bldg, Phase 1 $9,825,000 $0 $9,025,000 

20 Portland Minor Construction VHA20-648-2013 FY2013 DeSign Expand Emergency Department, Phase 2 $9,408,000 $0 $0 20 Portland NRM Project 648-12-106 Grandfathered Safety DefiCiencies, FY12, Auto door sensors $250,000 $0 S250,000 20 Portland NRM Project 648-12-120 FY2012 DeSign Bldg. 100 Ward 90 Remodel $2,475,000 $0 $247,500 

20 Roseburg Minor Construction 653-321 FY2012 Constructior Protective Care Unit (PCU) Relocation $9,990,000 $0 $9,120,000 20 Roseburg Minor Construction 653-322 FY2012 Constructior Bldg 2 Acute Psych Ward Replacement SeismiC $9,775,000 $0 $8,925,000 

20 Seattle NRM Project 663-11-111 Grandfathered Renovate Unit 6 East for Cancer Care $2,000,000 $0 $2,000,000 20 Seattle NRM Project 663-12-106 Grandfathered Renovate 5 East for new Endoscopy Suite $445,500 $0 $445,500 20 Seattle Minor Construction 663-376 GF Designs Expand Specialty Clinics $9,344,000 $0 S939,000 20 Seattle NRM Project VHA20-663-2013 FY2013 DeSign Renovate 5 East for new Endoscopy Suite $4,455,000 $0 $0 

OCAMS - 21

229q1VAb3116.eps

FY2012 Planned 

Design or 

Total Project FY2011 Construction 

VISN Facility Project Category Project Number Project Year Project Title Cost ($) Obligations ($) Obligation ($) 

20 Seattle NRM Project VHA20-663-2013 FY2013 Design Renovate 6 West for new 25-bed Acute MediCine $5,000,000 $0 $0 

Ward 

20 Spokane NRM Project VHA20-668-2013 FY2013 Design Renovate Basement Mental Health Buildirg $1,650,000 $0 $0 20 Spokane Minor Construction VHA20-668-2013 FY2013 Design Construct Intensive Outpatient Mental $9,870,000 $0 $0 

Health/Education BUilding 

20 Vancouver Minor Construction 648-342 FY2012 Design Build Primary Care Clinic $9,300,000 $0 $930,000 

20 White City Minor Construction 692-331 GF Constructs Expand Ambulatory Care Clinic $9,966,000 $0 $9,240,000 

20 White City NRM Project VHA20-692-2013 FY2013 DeSign Renovate Building 201 for Primary Care $3,900,000 $0 $0 

20 White City Minor ConstrucllOn VHA20-692-2013 FY2013 Design Replace Seismically Deficient Domiciliary Bldg $9,600,000 $0 $0 

203 

21 Fresno NRM Project 570-10-106 Grandfathered Expand Community Living Center Medical Gas $150,000 $0 $150,000 

System 

21 Fresno, CA Minor Construction 570-218 FY2012 DeSign Expand Community liVing Center $9,735,400 $0 5974,000 21 Livermore NRM Project 640A4-12-120L Grandfathered Renovate CLC, BUilding 90 $95,099 $0 $95,099 21 Martinez NRM Project 612-12-213 Grandfathered Construct CNS/CLC Vestibule, MTZ $800,000 $0 S800,000 21 Menlo Park Minor Construction VHA21-640AO-2C FY2013 Design BUilding 334 National Center for Post Traumatic $9,950,000 $0 $0 

Stress Disorder Expansion and Renovation 

21 Menlo Park, CA Minor Construction 640-382 FY2012 Design Expand Homeless Domiciliary Outpatient and $9,800,000 $0 $980,000 

Therapy Programs 

21 PaioAlto NRM Project 640-12-114P Grandfathered Renovate Dialysis SUite, Building 100 $1,800,198 $0 $1,800,198 21 Palo Alto MlnorConstrucllOn VHA21-640-2013 FY2013 DeSign Expand Emergency Department Facilities $9,975,000 $0 $0 21 Reno NRM Project 654-12-705 Grandfathered Renovate Dental $165,000 $0 $165,000 21 Reno NRM Project 654-12-707 Grandfathered Upgrade CLC Palliative Care Room - Phase 2 $50,000 $0 $50,000 

21 Reno Minor Construction 654-317 FY2012 ConstructiorTCU Culture and Patient Safety Improvements $9,800,000 $0 $8,569,000 21 Reno Minor Construction 654-339 FY2012 Constructior Specialty Clinic Bldg $9,970,000 $0 $9,005,000 

21 Reno NRM Project VHA21-654-2013 FY2013 Design Renovate Inpatient rooms on 3C and 4C for $1,250,000 $0 $0 

private rooms 

21 Reno, NV Minor Construction 654-412 FY2012 DeSign Relocate, Upgrade & Expand ICU $9,500,000 $0 5950,000 21 Sacramento Minor Construction 612-111 GF Designs Consolidate/Expand Medical Procedures $9,960,000 $0 5833,000 21 San FranCISco NRM Project 662-12-202 Grandfathered Dental Service Renovation $1,500,000 $0 $1,500,000 

21 San FranCISCo Minor Construction 662-611 FY2012 Constructior Emergency Prep/Response $9,935,000 $0 $8,929,000 

22 Loma Linda NRM Project 605-09-166 Grandfathered Consolidate ICUs $8,000,000 $0 $8,000,000 

22 Loma Linda Minor Construction 605-325 FY2012 Constructlor NHCU Cultural Transformation $8,894,000 $0 $8,118,000 

22 Loma Linda, CA Minor Construction 605-329 FY2012 DeSign Expand Community LIVing Center $9,993,600 $0 S999,000 22 Loma Linda, CA Minor Construction 605-330 FY2012 DeSign Expand Emergency Department $9,592,683 $0 $959,000 22 Loma linda, CA Minor Construction 605-331 FY2012 DeSign Consolidate IntenSive Care Unit $9,482,496 $0 $948,000 22 Long Beach NRM Project VHA22-600-2013 FY2013 DeSign B150 SCI T-1 Conversion to Long Term Care $8,512,000 $0 $0 

Beds 

22 Los Angeles OPC NRM Project 691 GE-12-1 05LJI Grandfathered Renovate Mental health Ambulatory Care Clinic - $2,011,000 $0 $2,011,000 

Downtown 

22 Sepulveda NRM Project 691A4-12-104Srv FY2012 DeSign Renovate Ambulatory Care Mental Health CliniCS $1,963,000 $0 $196,300 22 West Los Angeles NRM Project 691-12-103WL Grandfathered Renovate Inpatient Mental Health $7,211,100 $0 22 West Los Angeles NRM Project 691-12-106WL FY2012 DeSign Renovate BUilding 500 Bathrooms $995,000 $0 22 West Los Angeles NRM Project 691-12-108WL FY2012 Design Renovate Ambulatory Care Mental Health Clinics $8,454,600 $0 5845.460 

23 Des MOines Minor Construction 636-343 GF Constructs Emergency Department Expand/Renovate $4,633,000 $0 $4,177,000 

23 Des MOines NRM Project 636A6-11-308 Grandfathered Women's Clinic within Existing Hospital $400,000 $0 $400,000 23 Des MOines NRM Project 636A6-11-930 Grandfathered Upgrade Primary Care Check In $100,000 $0 5100,000 23 Des MOines NRM Project 636A6-12-201 Grandfathered Wander Garden Phase II $50,000 $0 $50,000 

OCAMS - 21
105 

b. In fiscal year 2013, how much is requested to correct patient privacy deficiencies? Also, please provide a list of facilities that will receive funding in fiscal 

year 2013. 

Response. New space and renovations for privacy and women’s health are critical 

elements in the prioritization process for our construction programs, with privacy 

ranking in the top criteria under safety and women’s health ranking in the second 

highest criteria under Secretarial priorities. As can be seen in the attached spreadsheet, a significant amount of funding has been and continues to be targeted toward 

privacy and women’s health projects. In fact, for VHA’s FY 2011 construction programs, privacy and women’s health supported over 1/3 of the available NRM and 

Minor funding ($884 million out of a total of $2.5 billion); and privacy and women’s 


229q1VAb3117.eps
106 

health represents almost 60 percent of the planned projects with the appropriated 

and requested FY 2012 and FY 2013 budgets ($1.5 billion out of $2.51 billion). 

[Refer to spreadsheet for question 31a.] 

Question 32. In fiscal year 2012, VA requested $3.04 million to continue a ‘‘Health 

and Wellness Initiative’’ started in fiscal year 2011. In response to a question for 

the record asking how effective this program has been in promoting healthier employees, VA responded that ‘‘[p]rogram effectiveness measures will be reviewed at 

six months and at the end of the fiscal year.’’ 

a. Please describe the specific objectives of this program and what benchmarks 

will be used to measure success. Please provide the Committee with documents assessing the effectiveness of the program. 

Response. The objective of this program is to support the transformation of the 

VA into a model employer by providing a program which supports a healthier workforce. This initiative supports VA Strategic Goal #4, 4.1 which focuses on improving 

internal customer satisfaction with management systems and support services including operations and business process of Human Resources. Healthier employees 

will be better able to provide high-quality service to Veterans and their families. 

Data obtained in FY 2011, which is identified as the baseline year, will continuously be measured against data obtained in subsequent years. Data from annual 

completion of the health risk assessments will be used to identify programs and 

measure program effectiveness through employee self identification of: 

a. Absenteeism rates—Days taken off work for non-work related medical, personal 

or other reasons. (self reported via the health risk assessment) 

b. Presenteeism rates—Lack of desire to perform assigned duties. Merely showing 

up for work (self reported via the health risk assessment) 

c. Improved management of chronic medical conditions (self reported via the 

health risk assessment). 

d. Increased job satisfaction (determined by satisfaction survey results). (FY 2012 

is the baseline year for this survey.) 

Thus far participation has increased 6% in FY 2012 to an overall participation 

rate of 16%. The following table presents the baseline for absenteeism for FY11: 

HPLI Absenteeism Report 

April 17, 2012 

Condition Avg Days N= Age %Pop Per Person Aggregate 

Allergies ................................................................ .1731 9516 45 .0 33 % $432 .15 $4,112,386.45 

Anxiety .................................................................. .5369 2453 44 .0 8 % $1,339 .98 $3,286,977.30 

Arthritis ................................................................. .2755 4275 51 .0 15 % $687 .61 $2,939,535.14 

Asthma ................................................................. .2124 2491 46 .0 8 % $530 .16 $1,320,629.52 

Autoimmune .......................................................... .4867 712 48 .0 2 % $1,214 .87 $864,987.86 

Back Pain ............................................................. .5074 3948 47 .0 13 % $1,266 .42 $4,999,808.35 

Cancer .................................................................. .5 790 53 .0 2 % $1,248 .00 $985,920.00 

Depression ............................................................ .5384 3331 46 .0 11 % $1,343 .83 $4,476,294.16 

Diabetes ................................................................ .1861 2137 52 .0 7 % $464 .43 $992,483.11 

Diabetes Type 1 .................................................... .3426 135 45 .0 % $855 .11 $115,439.80 

Digestive ............................................................... .3147 2361 45 .0 8 % $785 .39 $1,854,303.11 

Heart Disease ....................................................... .4571 933 53 .0 3 % $1,140 .99 $1,064,542.73 

Hypertension ......................................................... .1443 7122 49 .0 25 % $360 .26 $2,565,737.31 

Mental ................................................................... 1 .3971 402 43 .0 1 % $3,487 .26 $1,401,878.10 

Metabolic .............................................................. .1325 2002 47 .0 7 % $330 .74 $662,136.42 

Migraines or headaches ....................................... .5454 3811 44 .0 13 % $1,361 .34 $5,188,079.54 

Neck Pain ............................................................. .3202 3004 47 .0 10 % $799 .34 $2,401,221.88 

Periph Vascular Disease ...................................... .3252 143 53 .0 % $811 .63 $116,063.71 

Pulmonary ............................................................. .5289 95 52 .0 % $1,320 .25 $125,423.91 

Respiratory ............................................................ .415 1438 49 .0 5 % $1,035 .81 $1,489,487.67 

Seizures ................................................................ .1879 141 46 .0 % $469 .11 $66,143.91 

Stroke .................................................................... .1979 96 52 .0 % $494 .00 $47,423.84 

HPLI absenteeism results for participants meeting these criteria: Starting: 10/1/2010, Ending: 9/30/2011 

Total participants completing an HRA: 28402 

LEGEND: 

Avg Days = Number of days the average person with this condition misses per 30 days due to the condition—generally a partial day such 

as 0.5 (e.g. 1/2 a day). 

N = Count of participants with the condition shown. 

Age = average age of the stated percent of individuals who responded to the question. 

% Pop = Percentage of the total HRA population with the condition. ‘‘Per person’’ and ‘‘Aggregate’’ figures are annual costs and assume 

a labor cost per hour of $39.00 

Total absenteeism loss is estimated at: $41,076,903.81 

107 

Chairman MURRAY. Thank you very much, Mr. Secretary. Let me 

begin the questions by getting this one off the table. It is on the 

issue of sequestration and cuts to spending. Like I said in my opening remarks, I believe that all VA programs, including medical 

care, are exempt from cuts; but there is some ambiguity between 

the Budget Act and the existing law. 

When I asked the Acting OMB Director to address this issue during a Budget Committee hearing 2 weeks ago, he said OMB has 

yet to make a final determination. 

So, I am concerned that by not settling this issue now we are 

really failing to provide our veterans with the clarity that they 

really deserve to have. 

So, while you are here I wanted to ask you: do you believe that 

all VA programs, including medical care, are exempt from any future cuts? 

Secretary SHINSEKI. I think, Madam Chairman, the answer that 

the OMB Director provided you is the same one that I understand. 

They are still addressing the issue. 

For my purposes, I would tell you I am not planning on sequestration. I am addressing my requirements and presenting my budget as you would expect me to do. 

I think sequestration, in part or in whole, is not necessarily good 

policy, and I think the President would argue that the best approach here is a balanced deficit reduction, and he believes that the 

budget he has presented does that and asks that the Congress look 

at that budget and favorably consider it. 

Chairman MURRAY. I think we all hope that that is the outcome, 

but we want to provide clarity to our veterans. They are very concerned about this issue. 

Mr. Secretary, last year we talked a lot about mental health 

care, and I think we together uncovered a lot of serious issues best 

summed up by a veteran that I heard from recently who uses Ann 

Arbor Medical Center and had to wait months and months to get 

into counseling, but then he had glowing things to say about his 

mental health providers once he got in. 

So, in order to address those types of issues, the VA has to be 

certain it has enough resources to not only keep up with the increasing number of veterans who are seeking mental health care, 

but also to bring down that unacceptably long wait time. 

Over the course of the last fiscal year, the number of Iraq and 

Afghanistan veterans who are looking for mental health care went 

up by about 5 percent. That is about 18,000 veterans every quarter. 

So, I wanted to ask you this morning if you believe the increase 

in mental health funding in the budget request is sufficient to accomplish the goals and keep up with this increasing demand. 

Secretary SHINSEKI. I believe that the budget, if you look at the 

2013 budget request, I think is adequate for us to meet what we 

understand our requirements are in 2013. Are there issues out 

there that we will discover between now and the execution of the 

budget, I would say if we do, Madam Chairman, I would be the 

first to tell you. 

Now, you asked us to do a survey and we did. It was very hastily 

done. Senator Burr referred to some of the output, the conclusions 

108 

out of that survey. Out of 20,000 of our mental health providers, 

319 were surveyed and the results were as described. 

My question of the Veterans Health Administration (VHA) was 

did you go to the places that we thought there would be problems 

and the answer was yes because we were asked to go figure this 

out. 

So, I would say we got a pretty pure response. What I think we 

need to do is to make sure we are going to take another broader 

look here and make sure we understand across the larger population what our issues are and where there are opportunities for 

reallocation or, as it becomes clear, to hire more people. 

I would offer to the Chair, I took a look at what we have done 

in mental health over the last four budgets. If we look at 2012 to 

2013, it is rather unimpressive. I mean, it is 5 percent and it 

matches the increase in the medical budget. 

But between 2009 and 2013, our increase is 39 percent in mental 

health; and if you include the 2014 advance appropriation, it will 

go up 45 percent. 

Chairman MURRAY. And that is the result of the number of soldiers who are coming home with the invisible wounds of war which 

is dramatically increasing, correct? 

Secretary SHINSEKI. True, but we are trying to anticipate that 

there is going to be a larger requirement here in the out-years even 

if we do not have clarity. We are trying to prepare for that. We 

want to do a larger survey here as I indicated and then see what 

the outcomes are. 

But let me turn to Dr. Petzel for any details here. 

Dr. PETZEL. Thank you, Mr. Secretary. 

Madam Chairman, as a result of the hearing that we had earlier 

in the year, we have now done two things that are, I think, important and on point with regard to your question. 

One is that we have developed a staffing model. It is the only 

staffing model that I know that is available about mental health. 

It is in the beginning stages, but it is giving us some information 

about what the need might be. 

But I think more importantly we are sightvisiting all 152 of our 

medical centers to look at the access to mental health services, 

both the initial appointment and subsequent appointments for 

PTSD in-patient program, group or individual psychotherapy. 

And what we are finding is that we do meet the criteria for the 

first appointment in most every instance. We are having some difficulty in some parts of the country making the next appointment 

in a timely fashion, getting them, as you mentioned earlier, into 

the specialty services. This could be the result of three things. 

One is: do we have enough staff out there? Have we given 

enough positions and enough resources? Two is: are those positions 

filled? Are they filling those positions in a timely fashion? And the 

third is: are we getting the appropriate level of productivity out of 

each one of those people? 

If we do discover, as the Secretary just mentioned, that we do 

have additional needs that are unmet, I can guarantee you we will 

be in communication with the Committee about those needs and for 

that discussion. 

109 

Chairman MURRAY. OK. I appreciate that. This is a top priority 

for us this year. 

Secretary SHINSEKI. I would just share that in fiscal year 2011 

we hired about 897 additional mental health professionals bringing 

us up to about 20,500 mental health professionals. 

So, the interest is there in trying to determine what the requirement is, and we are not hesitant about increasing those numbers. 

Chairman MURRAY. Thank you very much. 

Senator Burr. 

Senator BURR. I thank the Chairman. Since the Chair just asked 

about mental health, let me just ask if my information is correct. 

In December, the VA polled their facilities and they found there 

were 1,500 open mental health positions. Is that accurate, Dr. 

Petzel? 

Secretary SHINSEKI. Let me turn to Dr. Petzel. 

Dr. PETZEL. Could you repeat that number, Senator Burr? 

Senator BURR. That December 2011, the VA polled their facilities 

and found that there were 1,500 mental health slots that were unfilled meaning—— 

Dr. PETZEL. Out of 20,500 that is true, yes. 

Senator BURR. OK. I just wanted to make sure the information 

I had was correct. 

Mr. Secretary, I wanted to thank you for something unrelated to 

this budget hearing. March 31 in North Carolina we will have the 

first in the country Welcome Home Vietnam Vets Day, an all-day 

event and I want to thank you for the VA’s cooperation in making 

sure that the VA presences there to make sure that we are able 

to catch those who have fallen through the cracks, work with those 

who have problems and will have a VA mobile presence there as 

we will from DOD and a lot of private-sector entities that are working on employment, placement. 

I think this is a very, very special event that is long overdue and 

hopefully it will be the first of a total of 50 that are held around 

this country; and I thank you for the VA’s participation. 

I am going to ask for chart number 1 to go up. Earlier I mentioned a number of performance matrices that seem to be heading 

in the wrong direction when it comes to claims processing; but I 

want to start by talking about the quality of VA’s decisions on disability claims. 

Your goal is to have 98-percent accuracy, but for the past 3 years 

accuracy nationwide has been about 84 percent; and as of December 2011, the accuracy rate at regional offices around the country 

varies from 94 to 61. 

Mr. Secretary, in total how much is VA requesting for 2013 budget to carry out all of those quality initiatives including the quality 

review teams at each of the regional offices? 

Secretary SHINSEKI. Thank you, Senator. Let me turn to Secretary Hickey to answer that. 

Ms. HICKEY. Thank you, Senator Burr, for your question. I am 

glad that you are asking about quality because we are very focused 

on both production and quality. It is not a trade for one or the 

other. 

I cannot give you the very specifics on each one of those costs, 

but I can tell you we expect the impact to be significant in our abilVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00115 Fmt 6633 Sfmt 6601 H:\112TH HEARINGS\73401.TXT PAULIN
110 

ity to produce a more accurate and more consistent response across 

the board. 

Our quality review teams are a critical part of this. For those of 

you who may not be aware of what those are, we have taken our 

Systematic Technical Advisory Review (STAR) teams, nationally 

recognized even by I think by Members of your Committee staff, 

based out of Nashville, TN. 

We have replicated their skill level, their training, and what they 

do every single day now inside every single regional office across 

the Nation. 

Their responsibility will be not just to check quality at the end 

of the process, but to also work closely with our employees in a 

training environment to check different parts in our process where 

we make most errors and to correct those issues early. 

Senator BURR. At what point on a calendar would you make a 

determination as to whether those quality initiatives are going to 

work and what indicators would you look at to make that decision? 

Ms. HICKEY. Thank you, Senator, for your follow-up question. I 

will tell you we have already done that. No initiative that we have 

in our transformation plan of the 40 plus initiatives in the people 

category: how we are organized and trained to do our work; in the 

process environment: how we have adjusted some of our business 

processes; or in our technology solutions have not been tried, tested, and measured for impact before we are implementing them. 

So, in fact, on the quality of review teams—— 

Senator BURR. But at some point you have got to say we are 

going to look at it and see if this is working. 

Ms. HICKEY. We did, sir, absolutely. We did in local pilots and 

we just announced this week, in fact—— 

Senator BURR. So, a year from now when we get together for the 

2014 budget, if the quality has not improved or the timeliness 

down, it will have failed? 

Ms. HICKEY. No, sir, I do not expect the quality not to have improved. We have some very significant decisions and initiatives. 

Senator BURR. My point is what if it does not. 

Ms. HICKEY. Sir, then we will adjust as necessary to find the reasons why. We will tackle that hard, but I do not expect that to be 

the answer. I expect us to see improvement in both quality and 

production. 

Senator BURR. Thank you. 

Secretary SHINSEKI. Senator, if I might, quality is a function of 

trained people with the right tools, and we are working on both 

items right now. 

Senator BURR. My question was simple, Mr. Secretary. At what 

point will we determine whether what we have implemented is 

working? 

Secretary SHINSEKI. Fair. We will be happy to provide that. We 

set a target of ending this issue with backlog in 2015. We begin 

fielding the automation tool we have been building for 2 years in 

4th quarter of this fiscal year. We expect that the tool will be rolled 

out nationally through 2013, in this budget; and as we do that, we 

expect both speed and quality to go up. 

Senator BURR. If I could ask the Chair for just one additional 

question on this round, and I would call up the second slide. VA 

111 

made this projection last year at the budget hearing. ‘‘Productivity 

due to the impact of the overall transformation plan which will rise 

from 89 annual claims per direct labor in 2012 to 129 in 2015.’’ 

As you can see from the chart, we talked about productivity per 

FTE best year at 79.5 percent. This year we are looking at 73.5 

percent. What percentage increase in individual productivity do you 

expect from the Veterans Benefit Management System and what 

percent do you expect from other initiatives that are underway at? 

Secretary SHINSEKI. I will turn to Secretary Hickey for the details. I would say what these charts do not reflect, Senator, is that 

in the last 3 years we have taken on some other projects that are 

unaccounted for here. 

The GI Bill requirement to get that program up and running, 

and today we have over 600,000 youngsters in college under an 

automated system that did not exist in 2009, and I think we all recall that first semester we had to do everything manually, and it 

was not the prettiest process. 

But we did that manually, got 173,000 youngsters in a school 

and on their path to the future. At the same time, we began building this automation tool for the GI Bill. By April we had the first 

part of that tool out and fielded and we have added four or five 

more versions to make it more productive. 

We will get better over time. It is hard for me to give you a day 

and a month when this quality factor will meet any of our expectations but we set on 2015 as the date on which we would have the 

backlog solved and the quality at 98 percent. That is what we are 

focused on. 

I will give you the best way points that we can figure out but 

that will be a product of what we are doing to train our work force 

and what we are doing to give them the right tools. We are talking 

about the right tools now. 

But in this same time you are questioning about the growth in 

our human resource investments for the Department, we’ve focused 

on training for our 300,000 employees, many of them who have 

never been trained on their job, so they can produce what we expect and that they can leverage these tools. 

Ms. HICKEY. Thank you, Senator Burr. I would like to first start 

by saying thank you to you, Chairman Murray and the Members 

of this Committee for unprecedented budget increases that VBA 

has enjoyed in the last 3 years. 

I think we need to put that in a little context. That 36 percent 

was used to tackle a 48 percent increase in claims over the same 

period of time, and that was to support nearly 12 million servicemembers, veterans, their families, and survivors; and that is including a net increase in the last year of half a million new veterans to our rolls using our benefits and services. 

For the second year in a row, we also completed more than a million claims using those resources. That is 16 percent more claims 

per year than we have done in 2008, before that chart started 

doing some of those things. 

I will tell you and put frankly on the table that we have paid 

more than $3.3 billion to Vietnam veterans based on new Agent 

Orange presumptive conditions. I thank you for celebrating our 

112 

Vietnam Veterans, we put more than $3.3 billion into the hands of 

117,000 of those Vietnam Veterans out there in the last year. 

That had an impact on that line. That impact was that there 

were 260,000 other claims in backlog we did not get to. That also 

had an impact on FTE because we put two times the FTE associated with each one of those claims on those very difficult, complex 

and old claims. 

In addition, we stood up in the same period of time and put four 

times the level of FTE to our most wounded, ill, and injured in our 

integrated disability evaluation system to get those folks taken 

care of right and well the first time. So, that also had an impact 

on the line that you laid out in front of us. 

The positive news about all of that is we are nearly done. We are 

down to the double digit levels of the Agent Orange Nehmer cases, 

99.9 percent done through those 250,000 cases. 

We are now capable of shifting all of those 13 resource centers 

we had across the Nation that were hunkered down doing those 

Nehmer Agent Orange claims. Tomorrow we are shifting that all 

back into normal backlog caseload. It will be focused on our benefits for discharged veterans. It will be focused on our Quick Start 

veterans, and it will be focused frankly on our oldest cases we have 

on the books during the month of March. 

Chairman MURRAY. Thank you, Senator Burr. 

Senator Akaka. 

Senator AKAKA. Thank you, Madam Chairman. 

General Shinseki, as you know, we often face challenges in treating our veterans who live in many rural and remote areas. This is 

especially true in places like Alaska and Hawaii where you just 

cannot get some places by jumping in a car and driving there. 

I know that you are working on an MOU with the Indian Health 

Service to find solutions to help provide services to our Native 

American veterans, and I commend you and all of your involvement in these efforts. 

Mr. Secretary, can I get your commitment to look into possible 

ways of working with the Native Hawaiian Health Care Systems 

and the Native American Veteran Systems to provide services for, 

in this case, Native Hawaiian Veterans who live in many of the 

rural parts of the State of Hawaii? 

Secretary SHINSEKI. Senator, you have my assurance that we will 

do our utmost to provide for any of our veterans wherever they 

live, including the most rural and remote areas, the same access 

and quality to health care and services as we provide to someone 

living in a more urban area. 

There is a challenge with that but we are not insensitive to that 

challenge, and we are working hard to provide VA-provided services and, where we cannot, to make arrangements, if quality services exist in those areas, make arrangements for veterans to be 

able to participate in those local opportunities. 

We are, I think you know, working and have been now for some 

time, on signing an MOU with the Indian Health Service so that 

wherever they have facilities and we have a vested interest, a veteran, an eligible veteran going to an Indian Health Service facility 

will be covered by VA’s payments. We are in stages of trying to 

bring that MOU to conclusion. 

113 

We intend to do that. Where tribes approach us prior to the signing of that MOU to establish from a tribal Nation a direct relationship with VA because they have a medical facility and would like 

us to provide the same coverage, we are willing to do that but that 

will be on a case-by-case basis. 

Senator AKAKA. Thank you. 

Secretary Shinseki, staffing shortages continue to be a problem 

although there has been progress. Some clinics are seeing staffing 

levels below 50 percent causing excessive waiting times for veterans that need care. I understand this is an issue you have been 

working on. As you know, the number of veterans needing services 

is growing yearly, and it shows that you have been making 

progress. 

Can you provide an update to the department’s progress to address staffing levels? 

Dr. PETZEL. Mr. Secretary, thank you. 

Senator Akaka, thank you for the question. We have talked 

about mental health earlier and the efforts that we are making to 

try to assess whether there is adequate staffing there. 

I think you are probably talking about primary care which is our 

largest outpatient clinic operation. We treat 4.2 million veterans in 

our primary care system and that accounts for the lion’s share of 

our budget expenditures. 

We assessed staffing 3 years ago when we began to implement 

what we call the Patient Aligned Care Team or PACT program and 

have done it again recently, and we are finding that we are now 

able to bring up the support staffing and the physician staffing to 

reasonable levels associated with the standards around the 

country. 

I would like to take off-line any information you have about specific places where there is a 50-percent vacancy rate. I am not 

aware of the fact that we have this around the country so I would 

be delighted to meet and talk with your staff and find out where 

these areas might be so that we can address them specifically. 

Senator AKAKA. My time has expired but, Secretary Shinseki, as 

we face budget constraints, we must all work to improve our efficiencies and redouble efforts to look for ways to get the most for 

our budgeted resources. 

My question to you is: Can you talk about any steps you are taking to improve the acquisition process at VA and any efficiencies 

that you have been able to realize in this area? 

Secretary SHINSEKI. Senator, I would tell you that we have been 

working for several years now on restructuring our acquisition 

business practices. Three years ago acquisition was spread 

throughout the organization. 

Now it is consolidated in two centers. One comes directly under 

Dr. Petzel and that is for all medical acquisition, gloves, masks, 

aprons. We ought to be able to leverage that into a bulk purchase 

and get a good price on those kinds of things. 

For everything else we have an Office of Acquisition Logistics 

and Construction. We have a director who heads that office, and 

everything else governing acquisition is consolidated under his 

review. 

114 

Both offices work acquisitions and the work of both offices then 

comes up to my level, to the Deputy Secretary, as part of our 

monthly oversight review process. 

Chairman MURRAY. Thank you. Thank you very much. 

Senator Johanns. 

Senator JOHANNS. Thank you. 

Mr. Secretary, let me, if I might, visit with you about the National Call Center. This is something that I think we had high 

hopes for. You might have had high hopes for, but I have to tell 

you it is not working well. Here is what we are running into. 

The complaints kind of fall into two separate categories. The first 

category would be people that call the call center and no one answers. I mean, it just rings and rings and rings, and there is no 

one there. 

I will tell you in my own Senate office my staff has run into this 

problem where we just cannot get a live person on the other end 

of the line. 

The second area is you finally get somebody, a live person to answer the phone, and you get connected with them and they do not 

have information. You know, the veteran is or we are calling in or 

somebody is calling in, what is going on with my claim or whatever 

it is, and you are just not getting a responsive human being on the 

other end of the line. 

I am guessing what it is is they just do not have access to the 

information that we are seeking, and so it seems to me that we are 

creating an expectation of service when really there is not much 

service there. 

I would like to hear your thoughts or whoever’s thoughts on your 

team about the call center, what are the prospects for that, are you 

hearing these problems; and if we are still committed to the call 

center, what is in place or what will be in place to try to solve the 

issues that I have raised. 

Secretary SHINSEKI. Thank you, Senator. I have tested the call 

system myself, and sometimes have been pleasantly surprised, 

other times disappointed, but that has been something I have done 

for 3 years now; and then demanded that we go out and fix it. 

So, we are in the process of putting a fix in place called the Veterans Relationship Management System. If the concerns you are 

expressing are anything where the experience occurred 6 months 

ago and longer, I would offer that we have put this tool in place 

and changes are occurring weekly, and I will ask Secretary Hickey 

to provide some detail. 

But I, like you, think when a veteran picks up a phone and calls 

VA, there ought to be someone there that answers. Or, if he or she 

chooses to come in online, that it ought to have information that 

is useful to them that is easily discovered so they do not have to 

run through a series of traps to find what they are looking for. 

We owe them, and that is the first step in any service organization and that is our intent here. So, let me call on Secretary 

Hickey. 

Ms. HICKEY. Senator Johanns, thank you very much for your 

question, and I appreciate your comment earlier about eBenefits. 

That is actually part and parcel of our multi-prong approach in our 

Veteran Relationship Management (VRM) capability about being 

115 

able to converse with that veteran in the time and the method that 

they choose. We have surveyed our veterans, and 73 percent of 

them want to meet us online. So, eBenefits is part of that solution. 

But let me address specifically your questions, first about no live 

person. Let me tell you about the two new pieces of functionality 

that we have measured outcomes on from our J.D. Powers’ Voice 

of the Veteran (VOV) Pilot Survey, the first of which is virtual 

hold. 

It means if a veteran calls us and there is a long waiting time, 

they can elect this hold option, hang up the phone, continue feeding 

the baby, getting ready for work, doing whatever it is they need to 

do, and we will call them back on cue. Ninety-two percent of our 

veterans have elected that option, and we have connected with 

them. 

The second one is our scheduled callback, meaning I cannot wait 

on the line with you now but can schedule a time that I can talk 

to you, and you will guarantee to call me back. We have just implemented that one in December. 

Between those two, one million veterans have elected those options. As a result, we have seen clear, demonstrated, measurable 

performance. We have a 15-percent improvement in overall satisfaction on the ability of our veterans to get through, and we have 

seen a dropped call rate reduction of 30 percent. 

Those are both part and parcel of the new technology and the 

new ways we using our Veteran Relationship Management (VRM) 

system’s capabilities. 

In another VRM initiative, previously our call agents would have 

had to cycle through 13 different databases to get that veteran or 

family member, or survivor the information they needed. 

Today, as we deploy this, and it is critical for our IT budget, unified desktop puts all 13 databases worth of that critical information 

you want to know on one screen, making our call agent much more 

effective in delivering a good outcome. 

Also built into this is world-class call recording, call tracking, 

and data analytics that we are literally using every single day to 

improve our service in that environment. 

Senator JOHANNS. I am out of time but if I could just ask as 

these things are being implemented, as we are going down the road 

here if periodically you could give us on the Committee an update 

as to the progress you are seeing because I do think there is real 

hope with the call center. 

You know, the veteran, at least, can get somebody who can answer their question, et cetera. So, I would just like to stay abreast 

of how they are doing so I do not lose track of it. 

Ms. HICKEY. I would be very happy to do that, Senator. 

Chairman MURRAY. Thank you very much. 

Senator Tester. 

STATEMENT OF HON. JON TESTER, 

U.S. SENATOR FROM MONTANA 

Senator TESTER. Thank you, Madam Chairman. 

I appreciate seeing Secretary Shinseki and all of the folks on the 

panel today. 

116 

A special thank you to you, General, for coming to Montana last 

summer. The veterans are very appreciative of that as was I. And 

you, too, Bob; thank you very, very much for being there and listening and hearing. So thank you very, very much. 

I want to talk a little bit about what Senator Akaka talked about 

very, very quickly, and that is the kind of strategies that the VA 

is using to recruit folks. 

This is not in the GP area. This is an area that is much more 

difficult in my opinion, and GP is not easy, but that is the need 

for mental health professionals. 

As you know, Dr. Petzel—I think you were there when we 

opened the facility in Helena—it is a great facility. We still do not 

have staffing at this point in time as far as psychiatrists. 

Do you have the adequate amount of flexibility to be able to go 

out and recruit—and it can go to the Secretary or to Dr. Petzel— 

to be able to go out and recruit and really get folks in because I 

am not sure we are there yet? 

Dr. PETZEL. Thank you, Mr. Secretary, and thank you, Senator 

Tester. I am aware of the issues at Fort Harrison. We have four 

psychiatrist vacancies. In general, we can recruit around the country very successfully for psychiatric social workers, for psychiatric 

nurse clinicians, and for clinical psychologists. 

The most difficult recruitment for us is the M.D. position of psychiatrists. 

Senator TESTER. Yes. 

Dr. PETZEL. We are not unique. This is an issue that all health 

systems around the country face. We are very competitive, however, in terms of wages, in terms of working conditions and the 

other kinds of things that are appropriate, and are needed for 

recruitment. 

So, I think we are in a position to do the best job we can of recruiting. I do not know what we could add right now to the basket, 

if you will, of things that we have to offer. It is a matter of identifying the people that want to come to places like Helena, which is 

beautiful, by the way. 

Senator TESTER. Thank you. 

Dr. PETZEL. In an environment where there just are that many 

of them. 

Senator TESTER. OK. Well, I just think that it has been an ongoing problem particularly in rural and frontier areas like Montana, 

and it is not a problem that I think bodes well for the veteran who 

has issues that revolve around mental health because we all know 

if we have professional help, quality-of-life advances and the costs 

go down. 

So, I want to talk about health IT for a second. We can all agree 

that advanced appropriations have allowed the VA, I think, to be 

more efficient, more effective to deliver quality health care for our 

veterans. 

However, it is my understanding that the exclusion of health 

care-related IT funds and advanced appropriations have put us in 

somewhat of a bind. It is hard to deliver quality care when you 

cannot make corresponding investments in things like phone systems that connect to veterans’ electronic health records, allow the 

VA better to coordinate it. 

117 

Can you speak, just speak about this issue and how the inclusion 

of health care-related IT funds and advanced appropriations could 

improve the quality of health for our veterans? 

Secretary SHINSEKI. Thank you, Senator. I would just begin by 

saying Congress provided us a very unique mechanism called the 

advance appropriation, and it is a gift to VA because it really gives 

us opportunity for continuous budgeting every year by submitting 

two budgets. It gives us two looks at our budget. 

So, we submit what we understand our best estimate is as an advance appropriation and then we come back a year later and we 

submit the actual budget and we can make adjustments. 

The advance appropriation applies primarily and solely to health 

care and so Dr. Petzel has his continuous budget. Everyone else is 

on annual budgeting. 

Under advance appropriations, we have the budget for medical 

services, medical compliance and reporting, and medical facilities. 

What happens is when we have a delay, a C.R., it affects the rest 

of the budget where IT resides. Dr. Petzel has his authorization to 

start building facilities and standing them up but then we have to 

wait, as sometimes happens, on a delay until the IT budget gets 

released so that now it can catch up to him. 

In a case last year, I think the budget CR lasted until April so 

it is a pretty significant period. 

We are a bit off stride here and I am trying to figure out how 

we can get this together and link up the authorities you provide 

along with the budget to do his business and get him the tools that 

allow him to see patients. There is no separation between medical 

IT and medicine today—that is all one treatment discussion. 

Senator TESTER. Well, let us know how we can help you be more 

effective in the IT area and I think Chairman Murray and Ranking 

Member Burr will help on this, too. I just think that it is really 

important in this day and age and—— 

Secretary SHINSEKI. Can I just follow very quickly, Madam 

Chair, or just add here. 

Senator TESTER. Go ahead. 

Secretary SHINSEKI. What sometimes happened, as happened last 

year, the IT budget is now released in April, and it is a big number 

because it is all IT. Well, really in it you have the paperless system 

that goes with Secretary Hickey’s operation and you have medical 

IT that goes with Dr. Petzel’s operation. 

I am just trying to be clear here. The piece that I am concerned 

about is the medical IT. So, we link decision to do things for veterans in the medical sense along with the tools to be able to do 

that. 

What happened last year, as sometimes happens, this large IT 

budget gets identified in April and we can now go forward, and an 

assessment is made by Congress. Well, it cannot possibly spend 

their budget before the end of the year so we lose $300 million in 

the Congressional budget process at a time when we really need 

that funding to marry these two things up. Secretary Baker can 

now not deliver what we have already approved a year before and 

we are delaying that. 

So, I think—— 

Senator TESTER. A timing issue. 

118 

Secretary SHINSEKI. Yes. I think there is a mechanism here of 

getting stride on both ideas, and we would be happy to work with 

you on it. 

Senator TESTER. Thank you. I want to thank everybody for being 

here today. I will get into the rural cemetery thing with Mr. Muro, 

but we will propose those questions in writing. Thank you all very, 

very much. 

Chairman MURRAY. Thank you very much. 

Senator Moran. 

STATEMENT OF HON. JERRY MORAN, 

U.S. SENATOR FROM KANSAS 

Senator MORAN. Madam Chairman, thank you very much. 

Mr. Secretary, in 2008 Congress passed the Rural Veterans Access to Care Act. This was a piece of legislation I was involved with 

in my days in the House. It was signed into law. The program is 

now referred to as Project ARCH, Access Received Closer to Home; 

and that legislation set certain criteria that if a veteran lived a certain number of miles from an outpatient clinic or from a VA hospital, the VA would provide those services locally using a local physician, a local hospital. 

My legislation was broad in its initial form. It was narrowed by 

Congress to create pilot programs, and the VISN that Kansas is in 

was included as one of those pilots. 

I have expressed my complaint to the VA before because when 

the VA then implemented its pilot program, it did not choose a 

VISN as a pilot project. It chose a community. 

In my view, we have taken legislation that created a pilot program and created a pilot program within a pilot program, and we 

now have a project ongoing in Pratt, Kansas to demonstrate whether or not this idea works. 

I would love to hear the report of progress being made but also 

used this moment as an opportunity to again encourage the Department to expand this pilot so that you can take more than one 

community. 

What happens in Pratt, Kansas, which is less than an hour from 

Wichita, is significantly different than what happens in Atwood, 

Kansas, which is 5 hours from Wichita; and the access to providers 

is totally different between those kind of communities. 

So, while I am certainly pleased a pilot program is ongoing, I am 

not certain, in fact, I am completely uncertain, let me say that differently. I am completely certain the VA has not chosen wisely as 

it has narrowed the project to a very small scope to determine how 

it works. 

In that regard, along the same topic of that CBOCs, we have an 

ongoing problem similar to what has been expressed in regard to 

mental health by Senator Tester, and I understand the doctor’s testimony about the inability to attract and retain professionals; but 

it is sure becoming clear to me that we have that same problem 

outside of mental health. 

Our ability to retain physicians in CBOCs across the rural Kansas, and I assume across the country, is a huge problem. And more 

and more we have nurse practitioners, physician assistants, that 

119 

the availability of a physician has become very limited, and we 

have many CBOCs now where no physician is generally present. 

And I understand the Secretary’s testimony about IT as a potential solution. We certainly have offered to our VISN to make certain that we do everything as a Member of the Senate now to provide VA with the resources to provide the necessary personnel. 

My assumption is my answer will be very similar to what you 

told Senator Tester, and it is the same one that I hear from VISN 

folks in Kansas is it is not really a resource issue. We can pay sufficient amounts of money to attract medical professionals, but we 

are struggling like everyone else to attract those professionals. 

I have heard that answer for a long time. You said it again 

today, Dr. Petzel. In some fashion that cannot be the final answer. 

Just because everybody else is struggling to attract professionals to 

take care of patients, we can not afford to allow the VA to have 

the same—I understand the problem. I do not mean to be critical 

in that sense but there has to be something more than, well, everybody is experiencing this problem. There has to be a path to a 

solution. 

Secretary SHINSEKI. I am going to ask Dr. Petzel to address your 

question. I would say, Senator, the rural areas are particularly 

challenging because of the lack of availability. I think, and Dr. 

Petzel said that our tools are really on reaching out. We want highly qualified, and we want talent. Our tools are what we are able 

to compensate and what we are able to award to recognize performance of good people doing outstanding work and retaining them 

through bonuses for the high-quality ones. 

Our tools are limited, but we owe you the best efforts we can to 

go after that talent. The biggest challenges are in the rural communities, and we have to circle our wagons here. 

Senator MORAN. Mr. Secretary, I appreciate your sentence that 

you owe us that. We understand we owe our veterans that but I 

would also tell you that Congress, I owe you every tool possible to 

help you meet that criteria; and the complaint or concern I have 

is that I am not being asked to do something to solve the problem. 

So, what I am asking for is tell us what we can do to provide 

the assistance so that when we have a hearing 6 months from now, 

or we are back here next year talking about the budget the answer 

to whether or not there is a doctor at CBOC is not that or that we 

are meeting the mental health needs of veterans particularly in 

rural areas is not every health care provider, every community, 

every rural State is having the same struggle we are. Help us help 

you solve this problem. 

Secretary SHINSEKI. OK. Fair enough. 

Senator MORAN. Thank you. Dr. Petzel. 

Chairman MURRAY. Dr. Petzel, do you want to very quickly respond? 

Dr. PETZEL. I will try to be very quick. 

Thank you, Senator Moran. The M.D. issue first. You are absolutely right that we all have this difficulty in certain rural parts 

of the country. 

I would say that if you look at our MD situation across the whole 

system, we do not have a recruitment problem. It is very important 

that we focus on the fact that this is rural America. 

120 

Two things that we would like to do. One is that we need to expand our tuition reimbursement program to be able to provide an 

incentive for people to go to rural areas by reimbursing them for 

their tuition from medical school. 

The second one was an idea that the Secretary had. I do not 

want to get into the details of it but to do something like the military does with their Uniform Services Medical School and that is 

recruit people, pay for their medical education with an obligation 

to follow on and work with us in particular parts of the country. 

Those are two areas that we are trying to explore. 

Secretary SHINSEKI. Thank you, Senator. I will just put a little 

finer point on what Dr. Petzel said. I thought that if we went into 

areas, rural areas and found a highly talented youngster, with 

great potential and targeted that individual and got them through 

college and the medical school process, that they would be going 

home, and so, in the long run we would not be facing the retention 

bonuses and those kinds of things. You would have provided someone for the long-term as a solution to that requirement, in that 

community. That is part of the discussion here. 

Senator MORAN. I appreciate your thoughts and please consider 

me an ally. We can follow up with the ARCH question at a later 

time. Thank you. 

Chairman MURRAY. Thank you. 

Senator Begich. 

STATEMENT OF HON. MARK BEGICH, 

U.S. SENATOR FROM ALASKA 

Senator BEGICH. Thank you very much. I also want to ask along 

these same comments that Senator Moran—and I like some of 

these ideas that you have just mentioned—so I would be anxious 

to participate. 

I know in one of our hospitals in Alaska they actually give a bonus to employees—a pretty significant bonus, up to $10,000—to 

recruit and retain nurses because of the high capacity and the 

need. So, thank you for offering those ideas. 

Let me also say thank you, Mr. Secretary, for the two staff that 

you sent up to Alaska. I think it was last week or the week before, 

and Chairwoman Murray for sending Committee staff also. 

It is important, as you know, to come up to Alaska to understand 

what rural is all about. I know you have been there. Thank you 

for your visit and your team’s visit. It makes a difference to the 

people there but also I think opens the eyes to a lot of folks how 

we have to deliver health care in the most remote rural areas of 

this country. So, thank you for that commitment. 

Let me, if I can, and I know we have had some conversations, 

Mr. Secretary, in regards to the idea of the Alaska Arrows card and 

the idea of trying to weave through this access issue in parts of the 

country that have limited access to veterans’ care. 

In Alaska specifically, as you know, we talk about the roadless 

areas, those areas of 80 percent of the communities of Alaska that 

do not have access by road. So, when we read, and I noted your 

testimony about Internet connect and get the mobile van out there, 

there is no mobile van possible. The mobile van is in the air, and 

that is the only way to get it. 

121 

So, I know we have talked in a very positive vein about how to 

create this access, and I just wanted to check in with you on a kind 

of update on that. I know we have kind of talked about the quality 

of care through our Indian Health Services which is superior to so 

much care that has been given today across the country and it is 

high quality care. 

Tell me kind of where you think we are at at this point. I know 

you have been very responsive. I know we have been badgering you 

and your team on a pretty regular basis because, as you have seen, 

the veterans all they want to do is go across the street to Indian 

Health Service clinic to get the regular checkups as a choice, not 

as a requirement. 

If they choose to go to a VA hospital clinic, so be it. But if it is 

across the street, let us make that happen because the quality of 

care is equal or in some cases we would argue better in certain specialties of the VA. 

So, what is your latest on that? 

Secretary SHINSEKI. I think that, as you and I have discussed, 

I think you will recall that we have put in a policy that would 

allow veterans from Alaska to go locally and reduce the amount of 

veterans having to travel to the lower 48. There is a rather robust 

program underway there. 

As I described, we are working with the Indian Health Service 

to establish this MOU which would open a lot of processes especially for Alaskan native veterans. 

In the meantime, based on my visit to Alaska, and with the Alaska Native Tribal Health Consortium, we have established discussions with them in trying to ensure that however the IHS MOU 

progresses that we are ready to provide health to veterans who are 

being seen now in the consortium. 

Senator BEGICH. Do you feel that is going in the right direction 

with the tribal consortium? 

Secretary SHINSEKI. Let me turn to Dr. Petzel since his people 

are in negotiations and discussions. 

Senator BEGICH. OK. 

Dr. PETZEL. Thank you, Mr. Secretary, and Senator Begich, I 

really do sympathize with what you talk about in terms of the 

ruralness of Alaska as well as other parts of the country. 

While we are waiting for the MOU to be finished, Alaska is one 

of two places where we are proceeding with tribal interactions, and 

I hesitate to use the word ‘‘pilot,’’ to get specific agreements within 

a tribal unit in Alaska. 

I believe it is the Southeast Alaskan Tribal Association, we are 

progressing in getting some arrangements made. It would be wonderful from my perspective if a veteran could make a choice and 

access tribal clinics. If, indeed, that was more convenient and the 

care was successful, and that we could work out the reimbursement 

arrangement. 

I think that is what we are trying to do in Alaska. We have another effort going on in South Dakota to do that. 

Senator BEGICH. And you feel, I guess the ultimate question, you 

feel it is moving in the right direction. 

Dr. PETZEL. Absolutely. 

122 

Senator BEGICH. Excellent. The last, I have two quick ones. One 

is Senate Bill 914 authorizes a waiver that I have introduced on 

the collection of co-payments for telehealth, telemedicine. 

I guess the general comment is I know we have about 200 veterans or so. I think about 100 or so are already in the program in 

Alaska. I know others across the country. The idea is, especially 

with mental health services, telehealth is a huge winner in a lot 

of ways. It actually works very successfully. We have asked that to 

be waived through this legislation, the co-pay, so it increases the 

capacity of telehealth. 

Can either one of you give me a thought, Mr. Secretary, of supportive, I know any time you take dollars away but my view is telehealth is just a money saver. And especially with the shortage of 

mental health services, this is a potential way to meld the two 

problems and create a solution. 

Secretary SHINSEKI. Senator, neither Dr. Petzel nor I are familiar with this legislation. So, if I may, I will provide that for the 

record. 

Senator BEGICH. Absolutely. That is on Senate Bill 914. We will 

get you some information on that. 

The last comment, if I can, Madam Chair, if I can just add to 

my concern, Under Secretary Hickey, actually our last call was Friday from someone who could not get through on the 800 number. 

So, it is not old; it is new. 

And I know when I was Chair of the Student Loan Corporation, 

one of the things we did on that, because we had a call center. As 

you can imagine, a lot of people upset when their loan rates 

changed or they did not get their payment in or whatever it might 

be. 

So, we had to go through a whole revamping of the system; but 

the metrics we measured by were on a regular basis reported so 

we could see where the possibilities are. 

You had mentioned that you are going to have or you have a system that you can see the metrics of success, wait time, call time, 

hold time, response, all of those. 

I want to echo what my colleague on the other side said that I 

would really anxiously want to see that because this is our number 

1 caseload work is around the VA issues. 

Second to that within the VA is the 800 number, lack of response 

or inadequate response I should say. And that is current, not 6 

months ago or a year ago. This is very current and customer service is the name of the game, how to make sure these veterans have 

the services they need. 

Is that something you can provide sooner than later so I can get 

a better understanding? 

Secretary SHINSEKI. I am going to dive into those numbers today 

based on the testimony. 

Senator BEGICH. Very good. Thank you, and I think the only solution to your issue on the IT is your whole Department should be 

a 2-year budget process instead of 1-year and 2-year. That is my 

personal opinion. That would solve a lot of problems. 

Chairman MURRAY. Thank you very much. 

Senator Boozman. 

123 

Senator BOOZMAN. Thank you, Madam Chair. I just have a couple of concerns. The budget request includes operational efficiencies 

that are estimated could save $1.2 billion. That has been done in 

the past by, you know, various administrations. Last year’s budget 

request also included operational efficiencies of just over $1 billion. 

In the past, GAO has really questioned, you know, whether or 

not those savings have come about. I guess if they do not come 

about, how are you planning for the risk? What is your contingency 

plan if you do not see a billion dollars in savings? 

Secretary SHINSEKI. I am going to call on Dr. Petzel to respond 

since they looked at his budget for the savings, anticipated savings, 

but I can tell you that right off the top, $362 million was saved because of our conversion to dialysis services using a Medicare standard pay rate instead of paying the rates we were being charged 

previously. $200 million was in improper payments savings, because we reduced those. Through the program management accountability system program office in IT, about $200 million was in savings because we terminated projects that were not going to deliver; and 

then about another $100 million was from the first notice of death 

office in which we stopped payment on veterans’ accounts after 

they passed away. In the past, this has been an issue with as much 

as $100 million in overpayments. And for the future, we agreed to provide as a minimum $173 million in savings, by reducing waste in 2012 and 2013. That is part 

of our effort to get at the savings and efficiencies. 

Let me just ask Dr. Petzel to provide more detail. 

Dr. PETZEL. Thank you, Mr. Secretary, Senator Boozman. 

The savings let us just go through a little bit of what went on 

in 2011. We saved a large amount of money. The GAO reviewed 

that and we are still actually negotiating with them about what 

they actually found. 

The essence is going to be that we, indeed, can validate the savings that we claimed from the various operational efficiencies. They 

do have a legitimate criticism about the way we measured things 

and the granularity of the measurement which we are going to be 

improving. 

For 2013, as the Secretary mentioned, we are going to save a 

large amount of money on payments for dialysis. We have contracts 

or blanket purchase agreements with virtually every dialysis center 

that we use that is going to save us hundreds of millions of dollars 

over what we would have expended had we not been able to do 

that. 

The Medicare rate payment change that occurred with the regulations allowing us to charge Medicare rates for both the professional fee and the facility fee is going to save us about $300 million. That is absolutely money that we know we would have spent 

otherwise had we not been able to do that. 

In the efficiencies with fee care, again something we can measure 

easily, it is going to be over $200 million. Acquisition fees have 

about $355 million in savings. 

There is a long list, and I am not going to take the time to go 

through that, but I am absolutely confident that we will be able to 

save this money in VHA. 

124 

Secretary SHINSEKI. Madam Chair, if I may add just one last 

comment here. We are going to look at all of this and work it hard. 

I have cautioned that in the end we have to focus on what makes 

sense for veterans, and I will use dialysis as an example. We are 

after the best prices we can get; and if you just look at that, you 

may be encouraged to outsource all of it. 

I have argued that dialysis is something we have to retain a handle on. We should do a certain amount, a certain portion of it inhouse. Why do I say that? I am just concerned that if we provide 

funds and let somebody else take care of dialysis, we ignore what 

a medical profession is supposed to do, and that is, as long as we 

are doing dialysis, we will have to ask ourselves what causes it, 

why do we have to do this, what are the things on the front end 

that allow us to deal with preventing diabetes so that dialysis does 

not become a fact that we have to live with. I think the medical 

profession is the best at asking those questions and that is why I 

think within VA we need to retain a piece of that operation. 

Senator BOOZMAN. Very quickly, the President has proposed a 

billion dollars in funding for the Veterans Conservation Corps. He 

anticipates that that will create 20,000 jobs for veterans. 

We all agree that there is a lot of backlog in the work that needs 

to be done in the parks and the infrastructure and those kind of 

things. 

I had the opportunity to be the Chairman and then the Ranking 

Member on the Economic Opportunity on the House side and really 

worked very closely pertaining to the TAP program and busy with 

lots of veterans about their dreams and aspirations. 

I have a lot of concern about spending a billion dollars in that 

direction. That is not, you know, kind of the direction that we were 

going in the Committee I do not believe. And, like I said, I visited 

with lots of veterans and I really do not know. A billion dollars is 

a lot of money. 

I think that could be, you know, put to good use but for myself 

I really do not believe that that is the direction that we need. I 

have never heard a veteran express to me that that is the route 

that they would like to go. 

So, again, I just want to express some real concern in that 

regard. 

Chairman MURRAY. Thank you very much, Mr. Secretary. Obviously we have had a lot of participation by Members at this time. 

We have another panel that needs to present today. We want to 

give them sufficient time and I have been called the to the Capitol 

so I am going to submit the rest of my questions for the record. 

And, Senator Burr, do you have any more comments before the 

Secretary leaves? 

Senator BURR. Madam Chairman, I am going to submit a lengthy 

set of questions. I would ask the Secretary and his leadership team 

for a quick response to them lieu of asking a second round of questions and would make four points to you. 

These are disturbing trends that I see from the information as 

we analyze the prior year. VA took in 430,000 more claims than 

were decided. 

Two, appeals that resulted in a decision took 1123 days to come 

to fruition. That is disturbing. The VA central office staffing inVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00130 Fmt 6633 Sfmt 6601 H:\112TH HEARINGS\73401.TXT PAULIN
125 

crease to 40 percent 2008. In that same timeframe human resource 

administration increased 80 percent. 

For VISNs created in 1995, we envisioned 22 VISNs, a total of 

154 to 220 employees and an annual budget of $27 million. Today, 

we have 21 VISNs, roughly 1340 staff and a $165 million annual 

cost. 

Many of my questions will be reference to these four areas and 

I look forward, Dr. Petzel, with you and others to discuss some of 

the trends that I see that should raise and do raise flags for me 

and hopefully would raise flags for both of you. 

Again I thank you. 

Secretary SHINSEKI. May I respond, Madam Chairman? 

Chairman MURRAY. Yes. 

Secretary SHINSEKI. I will be happy to provide the details, and 

I, like you, am concerned and watched the growth. There has been 

growth of the veteran population. In the last 2 years, we have 

added 800,000 veterans to our enrollment. The VA headquarters is 

1 percent of our budget today as it was in 2008, and it is a reflection of accommodating that growth, and I will be happy to provide 

the details. 

Chairman MURRAY. Mr. Secretary, thank you very much to you 

and your team for accommodating our Committee today. We appreciate that and ask that you answer the questions that will be submitted to you by myself and the Members of the Committee in a 

timely fashion. 

126 

RESPONSE TO POSTHEARING QUESTIONS SUBMITTED BY HON. PATTY MURRAY, 

CHAIRMAN, TO U.S. DEPARTMENT OF VETERANS AFFAIRS


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229q3VA2m2.eps

BENEFITS 

Question 3: How many VR&E participants does VA anticipate enrolling in FY13 through its 

Coming Home to Work Program? 

Response: The term "Coming Home to Work" is used to describe the Vocational 

Rehabilitation and Employment (VR&E) program that provides early intervention and outreach 

services to Veterans and Servicemembers as they transition out of the military. For fiscal year 

(FY) 2013, the VR&E program is expecting 130,588 participants, a 10% increase over FY 

2012. 

Question 4: The VA Innovation Initiative includes three VR&E projects related to 

entrepreneurship and self-employment. To date, how many veterans have completed each 

program? 

Response: The three VR&E Innovation Initiatives include Veteran Entrepreneurial Transfer 

(VETransfer), Veteran Self-Employment Accelerator (VetSEA), and EAdvantage. 

VETransfer is a business incubator which provides new businesses with office space and 

shared facilities, such as telecommunication systems and internet connections, in a 

dedicated building. This program is designed to support the successful development of 

entrepreneurial companies through an array of business support resources and services, 

and through its network of contacts. VETransfer has been in contact with 214 Veterans and 

is actively working with seven Veterans who are receiving VR&E self-employment benefits. 

VR&E has also referred seven additional Veterans who are in the process of being 

engaged with VETransfer. No Veterans have yet completed the program, as the training 

and follow-up generally take two or more years. 

VetSEA is a virtual business accelerator, an on-line interactive tool to guide Veterans in 

planning, launching, and sustaining self-employment ventures. VetSEA is currently 

working with 16 Veterans who are receiving VR&E self-employment benefits. No Veterans 

have completed the program, as the training and follow-up generally take two or more 

years. 

• EAdvantage provides business training and mentoring, however has not yet started 

working directly with Veterans. The kickoff for this contract was held on September 12, 

2011, and the curriculum catalog and website are currently being finalized. The website is 

scheduled to be operational for Veterans beginning in May 2012, and at that time, Veterans 

can begin enrolling in services. 

Question 5: Please describe all existing claims processing pilots and initiatives including the 

specifics of each pilot in terms of location, size, purpose, time frame for completion, and 

measures for success. What criteria are used to detenmine which regional office hosts a pilot 

and how are successful pilots integrated into the larger Claims Transformation Plan? 

Response: VBA is pursuing a major organizational transformation grounded in VA's Agency 

Priority Goals (APGs), specifically: 

• Eliminate Veterans disability claims backlog (no claim pending more than 125 days and 

98 percent accuracy in 2015) 

• Improve Veterans' access to benefits and services 

• End Veteran homelessness by 2015 

VBA's Transformation Plan is based on more than 40 initiatives in the areas of People, 

Processes and Technology, selected from ideas submitted from employees and stakeholders. 

Transformation is not a "once and done," flip-of-the-switch proposition - it is a dynamic 

process of intaking, researching, testing and launching new ideas and initiatives. Under the 

Transformation Governance Process, VBA initiatives progress through a series of decisions as 

they mature from proposals to pilots to nationally deployed initiatives. 

Initiatives are being implemented through a deliberate process and rolled out to regional 

offices (ROs) in a multi-year, phased approach that will ensure success and minimize risk. Key 

initiatives that are currently in pilot or implementation phases are described in this document. 

VBA's Implementation Center is a program management office (PMO) with dedicated 

resources using a governance process to achieve standardization and sustainability. Its 

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229q3VA2m3.eps

primary mission is to synchronize and oversee implementation of the Transformation Plan. 

Additionally, the Implementation Center will develop performance measures that will track the 

impact of the Transformation Plan. 

The successful execution of the plan is expected to result in a 45 to 60-percent increase in 

productivity and a 14-point increase in quality in 2015 from an FY 2011 baseline. 

People Initiatives (How VBA is changing workforce organization and training) 

Intake Processing Center (IPC) enables quick, accurate claims triage (getting the right 

claim in the right lane the first time). This initiative was rolled out to the Wichita, Ft. 

Harrison, and Milwaukee ROs on March 26, 2012. National deployment is expected by 

the end of fiscal year 2013. The IPC has the potential to save 40 days combined with 

Segmented Lanes and Cross-functional Teams, discussed below. 

Segmented Lanes will improve the speed, accuracy and consistency of claims decisions 

by organizing claims processing work into distinct categories, or lanes (Express, Core, 

and Special Operations), based on the amount of time required to process the claim. 

This initiative was rolled out to the Wichita, Ft. Harrison, and Milwaukee ROs on March 

26,2012. National deployment is expected by the end of fiscal year 2013. Segmented 

Lanes have the potential to save 40 days combined with IPC and Cross-functional 

Teams 

Cross-functional Teams initiative consists of teams of cross-trained raters co-located to 

reduce rework time, increase staffing flexibility, and better balance workload by 

facilitating a case-management approach to completing claims. This initiative was 

rolled out to the Wichita, Ft. Harrison, and Milwaukee ROs on March 26, 2012. National 

deployment is expected by the end of fiscal year 2013. Cross-functional Teams have 

the potential to save 40 days combined with IPC and Segmented Lanes 

• National Level Challenge Training provides training to employees on claims processing 

through a standardized curriculum. The 8-week program enables new raters to process 

1.3 disability claims per day at 98-percent accuracy (actual) - up from an average of 0.5 

cases per day and 60-percent accuracy. 

• Skills Certification improves performance and accelerates productivity of claims 

processors. 

Process Initiatives (How VBA is making improvements that result in quality and timeliness 

gains) 

Simplified Notification Letter (SNL) standardize and streamline the Veteran's decision 

notification. SNL reduce complexity and time by 10-20 percent in testing. This initiative 

was fully implemented nationally on March 12,2012. Overall productiVITY is a key metric 

used in determining this initiative's effectiveness. 

Quality Review Teams (QRT) will improve claims quality through assessments 

throughout the process. It has the potential to improve quality 4 points; improve quality 

insight from four-month lag to one week. QRT was fully implemented nationwide on 

March 5, 2012. 

Disability Benefits Questionnaires (DBQs) change the way medical evidence is 

collected, giving Veterans the option of having their private physicians complete a form 

that provides the medical information necessary to process their claims. This initiative 

was nationally implemented on March 19,2012. DBQs have the potential to reduce 

exam processing times and improve quality. 

Rater Decision Support Tools establish consistent rater performance, and include three 

rules-based calculators (Special Monthly Compensation, hearing loss, and joints). The 

rules-based calculators have the potential to improve quality by six percentage points 

from 2011 to 2015. 

• Paperless Compensation and Pension Records Interchange (CAPRI) was nationally 

implemented in November 2011. This initiative eliminates the requirement to print and 

file CAPRI records at substantial cost and time savings. Paperless CAPRI has saved 

printing of 13 million pages of medical records and 220,000 hours of printing and filing 

time since implementation. 

• Acceptable Clinical Evidence (ACE) allows VHA medical personnel to use existing 

medical evidence and complete a DBQ in lieu of an in-person exam. This reduces the 

burden on the Veteran and caregiver to travel to VA Medical Centers to complete 

exams and reduces the time waiting for evidence in claims cycle. In the ACE pilot 

conducted by St. Paul Regional Office and Minneapolis VA Medical Center, 39 percent 

of exam requests were completed using ACE, with average processing time of six days. 

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The current national average exam processing time is 27 days. National 

implementation is being planned for every regional office with a VA medical center 

located in the same metropolitan area. National tracking metrics are currently being 

developed jointly between VBA and VHA. 

Technology Initiatives (building systems that transition VBA to a paperless, automated, rulesbased, multichannel access environment) 

Veterans Benefits Management System (VBMS) standardizes disability compensation 

claims processing through Web-based paperless system. As of March 16, VBMS has 

completed over half (56 percent or 563) of its 1,000 established claims. The average 

days to complete a claim in VBMS is 135 days. National rollout is expected to begin in 

July 2012. 

Veterans Relationship Management (VRM) initiative improves telephone service and 

online Web access, including electronic claims submission as it goes online in summer 

2012. Total contacts (including phone, email, and online eBenefits sessions) have 

increased 5.4 million (59 percent), from 9.1 million to 14.5 million from FY 2009 to FY 

2011. The VRM initiative includes: 

o Virtual Hold - ASAP system automatically calls the Veteran back versus making 

them hold. We have achieved 92-percent reconnect success rate and caller 

satisfaction was up 15 percent. Virtual Hold was implemented on September 26, 

2011. 

o Scheduled Call Back allows the Veteran to pick a date and time for VA to call 

them back. There is a 77 -percent reconnect success rate and 18-percent 

acceptance rate. Scheduled Call Back was fully implemented on December 6, 

2011. 

o Customer Relationship Management/Unified Desktop (CRMIUo) combines 13 

systems into one database. CRM/UD improves call center representatives' 

ability to efficiently find accurate information for the Veteran. CRM/UD is 

scheduled to be implemented by the end of fiscal year 2012. 

o Veteran Online Application Direct Connect (VOC) provides standardized e-forms 

to facilitate electronic interviews. VDC reduces control time from 11 to 0 days. 

The standardized e-forms have the potential to save 32 cents to 37 cents per 

page. 

• eBenefits is VA and DOD's online self-service portal that enables Veterans and 

Service members access to benefits and services. User enrollment has increased from 

250,000 in March 2011, to over 1.4 million as of the end of March 2012 

Stakeholder Enterprise Portal (SEP) for VSOs and Physicians facilitates stakeholder 

roles in the claims process in a secure environment with identity access tools. SEP has 

the potential to reduce control time from 11 days to 0 days. 

• Long-Term Solution (L TS) is a fully automated education claims processing system. VA 

has issued five major releases of the L TS. We have seen a 51-percent improvement 

in original claims (56 to 29 days) and a 44-percent improvement in new enrollments (29 

to 13 days). 

VBA uses a number of criteria to select regional offices as pilot sites. These include proven 

station leadership and performance; adaptability to change; strong workforce partnerships; 

size of the regional office in regards to the capacity of the Veterans Benefits Management 

System; experience with one or more initiatives of the overall model to reduce risk; limited or 

no other national projects (such as Agent Orange/Nehmer processing) to reduce variables; 

size and location of station to test difference in organizational structure, workflow, and network 

support structure; and the impact to national production during the transition. 

Question 6: A significant portion of VA's claims transformation efforts focus on the paperless 

benefits delivery system. However, there are millions of beneficiaries whose claims exist in a 

paper based environment. As the Department transitions to the paperless benefits delivery 

system, what is the plan to address existing paper based claims? 

Response: VBA's Transformation Plan includes an strategy for conversion to a paperless 

system that provides a combination of scanning and electronic or web-based submission of 

documents. The transition to a paperless system may take an extended period of time as we 

continue to encourage Veterans, Servicemembers, their families, and their representatives to 

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take advantage of our web-based and electronic systems. As VBA pursues these advances 

and expands the ingest strategy, we will continue to process paper claims. 

Question 7: Please provide the current performance standards for employees involved with 

the processing of claims. 

Response: Please see attachments A, B, and C for current performance standards for 

Veterans Service Representatives (VSRs), Rating Veterans Service Representatives (RVSRs), 

and Decision Review Officers (DROs). 
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ATTACHMENT A: 

NATIONAL PERFORMANCE PLAN 

VETERANS SERVICE REPRESENTATIVE (VSR) 

ELEMENT 1 - QUALITY (Critical) 

The VSR must consistently and conscientiously exercise sound, equitable judgment in applying stated 

laws, regulations, policies and procedures to ensure accurate information is disseminated to veterans 

and accurate decisions are provided on all benefit claims administered by the Department of Veterans 

Affairs. 

Standard 

Quality of Work 

Successful Level 

GS-7: 

GS-9: 

The accuracy rate during the evaluation period equals or 

exceeds 80% (cumulative) 

The accuracy rate during the evaluation period equals or 

exceeds 85% (cumulative) 

GS-10:The accuracy rate during the evaluation period equals or 

exceeds 90% (cumulative) 

GS-11: 

Indicator 

The accuracy rate for work produced during the evaluation period equals or exceeds 

91% (cumulative) 

A random selection will be made of an average of 5 actions per month to include outputs, personal 

interviews, IRIS and congressional responses. Outputs selected will be reviewed prior to concurrence 

by a second signature to determine the accuracy of the originator.' The selection of actions, while 

random, must reflect an appropriate mix of work performed by the employee throughout the month (i.e. 

not from a single day or single week). 

Only one error is counted per action reviewed (others may be tracked to assist with employee 

development). A checklist (Attachment A) to be used will mirror the STAR worksheet and will include a 

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

If a routine review of a VSR's work demonstrates the need for quality improvement (i.e. significant 

percentage of cases sent to the Rating Board are not ready to rate), an expanded sample of an 

average of 10 cases per month will be reviewed for quality purposes . 

• Outputs reviewed for the GS-11 VSR should include claims authorized. 

ELEMENT 2 - TIMELINESS (Critical) 

Timely processing of veterans claims is of paramount importance, as it is highly correlated with 

customer satisfaction. The VSR will operate in an efficient manner to accurately finalize claims using 

all appropriate workload management tools and processes. 

VSRs are responsible for the cycles/type of work respective to their assigned duties. If multiple 

timeliness sub-elements apply to a VSR (e.g. average days awaiting award, non-rating, and corrective 

actions) they must meet the fully successful level for all applicable sub-elements to be successful for 

the element. 

Standard 

Timeliness of Rating End Products (including EP 930 series) 

Fully successful: All grade levels must meet locally established timeliness requirements, which are to 

be derived from end of year station targets. 

The percentage of claims in each cycle pending over the locally established cycle goal must align with 

station goals for percentage of claims greater than 125 days. Goals are set by management for each 

station. 

Cycle Times 

a. Average Days Awaiting Development 

b. Average Days Awaiting Evidence 
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c. Average Days Awaiting Award 

d. Average Days Awaiting Authorization 

Timeliness of Non-Rating & Control End Products (Le. EPs 600, writeouts, 800 series) 

Fully successful: All grade levels must meet locally established timeliness requirements, which should 

be derived from station targets. 

Timeliness of Workload Management (includes rating and non-rating end products and 

VACOLS diaries) 

Fully successful: All grade levels must manage their workload, including suspense dates, in 

accordance with locally established workload management plans. There will be no more than two 

instances where the VSR fails to show compliance with established workload management procedures. 

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

Fully successful: All grade levels must meet locally established timeliness requirements, which should 

be derived from station targets. There will be no more than 5 instances where the VSR fails to meet 

established timeliness, or failure of employee to notify their supervisor when cases cannot be worked 

within established time frames and reasons thereof. Extenuating circumstances and notification to the 

employee's supervisor will be considered. An incident will not be called until after the first notification 

of non-compliance of the above standard. 

Timeliness of Special Projects & Duties (Le. Women Veterans Coordinators, AEW Project, etc.) 

Fully successful: There will be no more than 3 instances of tasks not being worked within established 

time frames, or failure of employee to notify their supervisor when cases cannot be worked within 

established time frames and reasons thereof. Extenuating circumstances and notification to the 

employee's supervisor will be considered. An incident will not be called until after the first notification 

of non-compliance of the above standard. 

Timeliness of Corrective Actions 

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

action, or failure of employee to notify their supervisor when cases cannot be worked, within three days 

of the case being returned to them for correction. Extenuating circumstances and notification to the 

employee's supervisor will be considered. An incident will not be called until after the first notification 

of non-compliance of the above standard. 

Indicators 

VETSNET Operations Reports 

Local Tracking Reports 

Supervisory Observation 

ELEMENT 3 - OUTPUT (Critical) 

Processes a minimum cumulative average number of outputs per day. Outputs are defined as actions 

that move a veteran's claim forward to the next step in the claims process. Outputs will be counted as 

follows: 

Initial development (rating EPs to include EP 930s and appeals) - 1 

Initial development (non-rating EPs to include EP 600s) -.7 

Ready for decision - 1 

Process award/decision (generate award, clear end product) - .7 

Authorize award - .33 

Successful Level 

GS-7: 4.5 

GS-9: 5 

GS-10: 5.5 

GS-11: 6 

Indicators 

VOR 

ASPEN 

• Duplicate credit will not be allowed for self-correction of a VSR's error . 

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

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

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

2 
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ELEMENT 4 - TRAINING (Critical) 

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

computer applications in order to provide optimum service to our veteran population. 

Employees are encouraged to actively participate in self-developmental activities. 

Performance for this standard will be mitigated when the VSR's supervisor has not allotted sufficient 

time for VSR to complete training requirements or if the VSR is not provided a schedule of available 

training and the deadline they are to complete. 

It is the responsibility of supervisors to provide VSRs with a training schedule in advance so they can 

complete their training requirements. 

Successful Level 

GS-7/9/10/11: Timely completion of 80 hours of training during evaluation period. Completes 

mandatory training within assigned deadlines with no more than one violation during evaluation period. 

Indicators 

LMS 

Supervisory Observation 

ELEMENT 5 - Organizational Support (Non-critical) 

Functions as a team member to enhance resolution of claims and customer service contacts by work 

actions. Maintains professional, positive, and helpful relationships with customers by exercising tact, 

diplomacy, and cooperation. 

Performance demonstrates the ability to adjust to change or work pressures, to handle differences of 

opinion in a businesslike fashion, and to follow instructions conscientiously. As a team member, 

contributes to the group effort by supporting fellow teammates with technical expertise and open 

communications and by identifying problems and offering solutions. Performance also demonstrates 

the ability to effectively communicate in a courteous manner with customers during the personal or 

telephone interview process. 

Successful Level 

GS-7/9/10/11 : 

Indicator 

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

Verbal and/or written feedback from internal and/or external customers. Observations by a 

supervisor with the complaint documented. 

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

the issue, reveals that the complaint/incident should have been handled more prudently and was not 

unduly aggravated by the complainant. Disagreeing, per se, does not constitute "discourtesy". Valid 

complaints or incidents will be determined by the supervisor and discussed with the employee. 

ELEMENT 6 - COMMUNICATION TO CLAIMANTS (non-critical) 

VSR provides information to veterans and claimants that is accurate, concise, and complete. This 

information may be in the form of notification letters, written correspondence to claimants (to include 

IRIS and congressional responses), Report of Contacts (VAF 21-0820), and other verbal 

communication with claimants such as personal interviews. 

Successful Level 

GS-7: 

GS-9: 

GS-10: 

GS-11: 

Indicator 

The accuracy rate during the evaluation period equals or 

exceeds 80% (cumulative) 

The accuracy rate during the evaluation period equals or 

exceeds 85% (cumulative) 

The accuracy rate during the evaluation period equals or 

exceeds 90% (cumulative) 

The accuracy rate for work produced during the evaluation period 

equals or exceeds 91% (cumulative) 

Cases selected for review for Element 1 - Quality will also be reviewed for this element. 

3 
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ATTACHMENT B 


229q7B.eps

NATIONAL PERFORMANCE PLAN 

JOURNEY-LEVEL RVSR 

ELEMENT 1 - QUALITY OF WORK 

The RVSR must consistently and conscientiously exercise sound, equitable judgment in 

applying stated policies to ensure accurate and timely decisions on compensation and pension 

benefit claims administered by the Department of Veterans Affairs. 

SUCCESSFUL LEVEL: The rating decision accuracy rate during the evaluation period 

equals or exceeds 85%. 

INDICATORS: A random selection will be made of an average of five cases per month 

per employee. The cases selected will be reviewed prior to concurrence by a second 

signature to determine the accuracy of the originator of the decision. Only one error is 

counted per case reviewed. The errors will be called using the applicable categories 

identified on the STAR Checklist for Rating. 

ELEMENT 2 - PRODUCTIVITY 

Processes a minimum cumulative average number of weighted cases per day. Cases will be 

counted for production purposes as follows: 

Y, case = all formal ratings not listed below regardless of the number of issues rated 

1 case = 110, 020, 165, SOC, SSOC with less than 8 issues rated 

2 cases = 010, 020,165, SOC, SSOC with 8-15 issues rated 

3 cases -16-23 issues rated; 4 cases = 24-31 issues rated, etc. 

SUCCESSFUL LEVEL: 3.5 weighted cases per eight-hour day (cumulative), effective 

February 18, 2007 

INDICATORS: Production reports 

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

supervisor, and 2nd signature review (of trainees only) are considered deductible time. 

Note: On a monthly basis, local management will validate a sample of completed cases 

recorded by individual RVSR to ensure accurate reporting. 

ELEMENT 3 - CUSTOMER SERVICE 

Functions as a team member to enhance resolution of claims and customer service contacts 

by work actions. Maintains professional, positive, and helpful relationships with 

internal/external customers by exercising tact, diplomacy, and cooperation. 

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

differences of opinion in a businesslike fashion, and to follow instructions conscientiously. As a 

team member, contributes to the group effort by supporting fellow teammates with technical 

expertise and open communications and by identifying problems and offering solutions. 

Successful achievement in this element reflects support of all scorecard goals. 

SUCCESSFUL LEVEL: No more than 3 instances of valid complaints or incidents. * 

INDICATOR: Verbal and/or written feedback from internal and/or external customers. 

Observations by a manager with a complaint documented. 

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

sides of the issue, reveals that the complainUincident should have been handled more 

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

constitute "discourtesy". Valid complaints or incidents will be determined by the supervisor and 

discussed with the employee. 
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ATTACHMENT C 


229q7C1.eps

PERFORMANCE PLAN DRO 

ELEMENT I - OUALITY OF WORK 

The DRO must consistently and conscientiously exercise sound, equitable judgment in applying stated policies to 

ensure accurate and timely decisions on compensation and pension benefit claims administered by the 

Department of Veterans Affairs. 

SUCCESSFUL LEVEL: Accuracy rate during the evaluation period equals or exceeds 90%. 

INDICA TORS: An unbiased selection will be made of an average of five cases per month per employee. The 

cases selected will be reviewed [prior to concurrence by a second signature, if applicable] to determine the 

accuracy of the originator of the decision. Only one error is counted per case reviewed. The errors will be called 

using the categories identified on Attachment 1. 

ELEMENT 2 - PRODUCTIVITY 

Processes a minimum cumulative average number of 3 weighted cases per day. Cases will be counted for 

production purposes as follows: 

Note: 

y, case ~ deferred/supplemental development actions when no other action listed below is possible. This 

exeludes sending/preparing a DRO election letter. This credit is not limited to formal appeal cases and 

can inelude any case for which substantive review and deferred/development by a DRO is appropriate. 

y, case ~ Informal conference held; case certified to BV A; preparation time for a hearing; formal hearing 

held (the 112 case for preparing for a hearing should be reported separately from the 1/2 case awarded for 

holding a fonnal hearing). 

I case ~ SOC, SSOC or DRO decision (includes EPs 172/174/070) with less than 8 issues decided. 

2 cases ~ SOC, SSOC or DRO Decision with 8·15 issues decided. 

3 cases ~ 16-23 issues rated; 4 cases ~ 24-31 issues decided, etc. 

I. Only one type of case credit can be taken at a time. For example, if a DRO does a separate SOC and a rating, 

only one credit would be taken. The credit with the greater weight should always be used. If separate decisions 

combine to eight or more issues, this can be combined and 2 case credits taken. 

2. The Y, case development credit may apply to cases where an NOD has not been filed. To be applicable, the 

cases must have already had a decision made on them, and brought to the DRO's attention because of some 

conflict with the facts or law as applied in the case. This would also apply to any cases assigned to the DRO by 

VSC management based on the complexity/sensitivity of the case. This credit does not apply to routine rating 

development cases and, again, can only be claimed exclusive of any other weighted action listed above. 

3. The case credit review for an SOC [EP 172 or 174] should be taken per the parameters in M21A Appendix C. 

Concerning fonnal hearings (EP 174), a full case credit is only available if the formal hearing is actually held; 

otherwise, the only credit available is the 112 case for preparation time, if applicable. 

4. The term "DRO decision" is defined as any rating related to an appeal where the DRO has made a favorable 

decision requiring some type of award action. Separate DRO decision and rating decision documents for the 

same issue are not required. 

5. Weighted case credit for non-appeal cases is the same as the RVSR weights. 

SUCCESSFUL LEVEL: 3 weighted cases per day (cumulative) 

INDICATORS: Production reports 

* Leave, union time, special projects or assignments pre-approved at the discretion of the supervisor, and 2nd 

signature reviews (oftrainecs only) arc considered deductible time. 
136 

(Resuming with Question 8 next) 


229q7C2.eps
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229q3VA2m6.eps

Question 8: In March 2011, VA indicated that the Loan Guaranty Service was working with the 

Office of Tribal Government Relations to draft a new Native American Direct Loan program 

policy rnanual. Please provide a copy of the new manual. 

Response: The Native American Direct Loan (NADL) manual is not yet complete. It is 

pending the development of coordinated outreach protoool between two programs within VA. 

A critical piece of the NADL program is outreach. The VA Home Loan program is working to 

coordinate outreach strategies with the new Office of Tribal Government Relations (OTGR), 

leveraging common materials, networks, and activities wherever possible. Recently, the Home 

Loan program senior managers participated in the Department's first-ever Tribal consultation 

on matters of concern to Tribal nations with regard to their Veteran members. This was the 

first of a series of four meetings, and the agendas were published in the Federal Register on 

March 19,2012. In this Register notice, VA specifically indicated that tribal input is sought on 

recommendations for increasing awareness and utilization of the NADL program. VA's Home 

Loan program will continue participation in the remaining sessions. The feedback and results 

from these sessions will provide OTGR and the Home Loan program the necessary tools to 

craft effective outreach protocols. Once outreach is integrated with OTGR, the Home Loan 

program will craft metrics to gauge its outreach performance and include those metrics in the 

final draft of the new NADL manual. 

JOINT VA/DOD PROGRAMS 

Question 9: Section 1631 of the Wounded Warrior Act (title XVI of Public Law 110-181), 

provides VA with the authority to provide rehabilitation and vocational benefits to members of 

the Armed Forces with severe injuries or illnesses. In order to make more effective use of this 

authority in FY13, how does VR&E plan to improve its relationship with DOD to encourage the 

referral of eligible servicemembers? 

Response: VA is collaborating with the Department of Defense (DOD) to effectively 

implement Section 1631 of the Wounded Warrior Act. A national memorandum of 

understanding was signed on February 3,2012, by VA's Under Secretary for Benefits and 

DOD's Under Secretary of Defense, which directs local military installation commanders to 

mandate an appointment with a Vocational Rehabilitation Counselor (VRC) for every 

Servicemember referred to the Physical Evaluation Board. VA will add 110 VRCs at military 

installations with the Integrated Disability Evaluation System in FY 2012, and funds to support 

an additional 90 VRCs have been requested in the FY 2013 budget. VA anticipates that these 

additional resources will help eligible Active Duty Servicemembers make informed choices 

about how to best utilize VR&E or Post-9/11 GI Bill benefits as Veterans, resulting in increased 

career employment outcomes. The presence of these counselors at military installations will eassist DOD in referring eligible Servicemembers to the program. 

Question 10: Given DOD's requirement to utilize the VA Schedule for Rating Disabilities in 

making a determination of disability in the Integrated Disability Evaluation System, what 

actions has VA taken to improve DOD's understanding and application of VA's rating 

schedule? 

Response: VBA's subject matter experts have provided training on the VA Schedule for 

Rating Disabilities (VASRD) to DOD staff several times per year since 2009. This training 

consists of a five-consecutive-day course on the application of the VASRD. The attendees are 

members of the DOD and the Coast Guard's Physical Evaluation Board (PEB) who provide a 

rating for Servicemembers. Members of the Board for Correction of Military Records, the 

Board for Correction of Naval Records, and the Physical Disability Board of Review (appeals 

boards) also attend this training. DOD is responsible for requesting the training, soliciting 

attendees, providing continuing education credits to the attendees, and securing the trainhg 

location. The DOD staff primarily consists of active duty physicians and a few line officers who 

assign evaluation percentages for disabilities at the service PEBs and appeals boards. VBA 

provides DOD participants with a copy of the VASRD training manual and a student training 

guide that is modified to cover only topics relevant to the PEB process. VBA conducted fiveday courses during the following months: 

• October 2011 

• January 2011 

• August 2010 Page 6 of 40 
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229q3VA2m7.eps

July 2010 

January 2010 

August 2009 

The next VASRD training session is scheduled for the week of June 11,2012. Additionally, 

DOD staff members contact VBA's policy and training staff by email and phone on a regular 

basis for guidance in evaluating specific cases and clarification of general VASRD issues. 

CONSTRUCTION 

Question 11: Please provide a list of priority weights for the major criteria and subcriteria used 

to inform the FY2013 Strategic Capital Investment Plan decision plan. 

Response: 

FY 2013 Decision Criteria and Priority Weights 

Priority Priority 

Major Criteria Weight Sub-Criteria Weight 

Improve Safety and Security .324 

Seismic .437 

Safety and Compliance (excludes Seismic) .345 

Security and Emergency Preparedness .218 

Departmental Initiatives .216 

Major Initiatives .543 

Supporting Initiatives .289 

DOD Collaboration .094 

Energy Standards .074 

Fixing What We Have .200 

Reduce Facility Condition Assessment 

Deficiencies .775 

Other Gaps (includes parking, functional and 

self-defined gaps) .225 

Increasing Access .155 

Utilization .377 

Client Veteran Access to Services .296 

Customer (Internal) Access to Services .152 

Wait Times .108 

Support Structures .067 

Right Sizing Inventory .057 

Space - New 

Construction/Renovation/Lease .560 

Space - Collocation .229 

Space - Disposal/Reuse .118 

Space - T elework .093 

Ensure Value of Investment .048 

Best Value Solution .657 

Maximize Efficiencies .343 

Question 12: The Committee has heard from facilities expressing a need for minor 

construction or non-recurring maintenance funding to modify clinic layouts, in order to fully 

implement the Patient Aligned Care Team (PACT) model. Please provide a list of projects, 

including costs, for any construction related to the implementation of the PACT model 

nationwide. 

Response: The table below includes the list of projects, including costs, planned for FY 2012 

and FY 2013 for construction and non-recurring maintenance related to the Implementation of 

the PACT model. 

VISN I Location 

I Project Title/Brief Description 

I Estimated 

Budget Cost Type 

FY12 Planned 

20 I Vancouver I WA I Build Primary Care Clinic I $9,300 Minor 

23 I Sioux Falls I SO I Build Primary Care Addition I $3.149 Minor 

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FY13 Planned 

1 Newington CT Expand Primary Care Clinic $9,850 Minor 

4 Philadelphia PA Renovate Primary Care Clinic - Patient Aligned Care $1,947 NRM 

Team (PACT) 

6 Hampton VA Construct 2nd Floor Addition on Building 11 DB for $9,974 Minor 

Specialty and Primary Care 

7 Atlanta GA Construct Primary/Urgent Care Addition $9,999 Minor 

8 Tampa FL Construct New Mental Health Clinic, 80 Bed $9,125 Minor 

Domiciliary, and Primary Care Clinic 

18 Amarillo TX Construct Primary Care Clinic $9,988 Minor 

18 Tucson AZ Expand Clinics for Patient Aligned Care Teams $9,762 Minor 

(Phase 1) 

20 White City OR Renovate Building 201 for Primary Care $3,900 NRM 

Question 13: Please explain the $32 million decrease in requested funding for asbestos 

abatement. 

Response: Funding from the Asbestos and Other Airborne Contaminates line item is used 

when asbestos health hazards have been identified and evaluated in association with a 

construction project. Disturbance of asbestos during construction will require costly 

precautions to avoid hazards. Asbestos will be abated in the most cost-effective manner. In FY 

2012, asbestos funding was requested to primarily support two projects - San Juan, Seismic 

Corrections Building 1 and Bay Pines, Outpatient Improvement project. These projects require 

approximately $60M for asbestos abatement. The FY 2012 request along with balances 

remaining in the line item will support the requirement. The FY 2013 request for asbestos 

abatement funds was based on requirements for on-going projects and maintaining an 

adequate balance for any unforeseen requirements. 

Question 14: The FY13 budget requests $2 million to contract for the services of a claims 

analyst. Please provide the rationale for this decision, including any cost-benefit analysis that 

may have been done in order to evaluate whether to keep this function in-house or to contract 

for it. Please also share how many contractor claims were made on VA construction projects 

between FY09 and FY11. 

Response: The claims analysis line item is used when construction contractors submit claims 

against VA because they believe that VA owes them more than what was settled when a 

change was made to the original contract. VA has experienced a steady increase in the size 

and scope of its major construction program and has several high value, high visibility projects 

underway. The magnitude and complexity of these projects increase the possibility of claims 

and the need to adjudicate them. The funds in the Claims Analysis line item are used to 

contract for independent analysis of VA's potential liability on claims, assistance with 

documentation to aid VA's legal counsel in developing its case, and expert witness services in 

defense of VA. VA does not have the expertise in house to defend claims given the relatively 

small number over the last several years. VA last requested funding for Claims Analysis in FY 

2009. VA requested additional funding in the FY 2013 budget to ensure expedient 

adjudication of potential claims. VA had 5 contractor claims on projects between 2009 and 

2011. 

Question 15: Please explain the decision-making criteria that VA uses to decide whether to 

implement energy/green management investments, including any return on investment criteria 

that may be used. 

Response: The Energy Independence and Security Act (EISA) of 2007 increased the 

requirements on Federal agencies as initially mandated in the Energy Policy Act of 2005. 

Specifically, EISA, mandated environmental and fleet management improvements, and 

imposed significant new requirements in the areas of energy efficiency and sustainable 

buildings. 

In order to meet new and existing requirements and provide more efficient, healthier and 

environmentally friendly environments for Veterans and their families, VA has been investing in 

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energy and water system improvements, renewable energy system installations, and is 

implementing and practicing sustainable building principles. We constantly strive to find new 

ways to manage energy costs. 

VA considers the following factors in its energy/green management investment decisions: 

a. Supporting the VA mission: The average age for VA facilities is more than 50 years old. As 

a consequence, the energy and water infrastructure in many facilities needs to be upgraded 

and modemized to be fully functional and best support VA's mission. Energy and water 

efficiency projects contribute directly to improved functionality and operational efficiency of 

building subsystems. 

b. Cost efficiency: Energy and water infrastructure improvements and renewable energy 

investments create future utility cost savings that VA can redirect to caring for Veterans. In 

addition, these investments improve the reliability and functionality of VA's infrastructure to 

ensure water, electricity, steam and hot water are available to VA facilities. VA conducts 

detailed feasibility studies and uses these studies as a basis for evaluating and selecting 

investments. VA uses technical feasibility and economic analyses to inform energy/green 

management investment decisions. 

c. Meeting statutory requirements: VA selects sites and projects that can provide necessary 

levels of improvement in the performance metrics related to the Energy Policy Act of 2005 

and EISA requirements. Key performance metrics include energy and water intensity, use 

of renewably generated electricity, installation of building-level metering systems, and 

incorporation of sustainable design principles. 

d. Improving VA sustainability: VA strives to improve the condition of facilities in which 

Veterans visit and stay. Facility condition includes indoor air quality, thermal comfort, 

infection control, health, safety, and many other conditions impacting Veterans. VA takes 

into consideration the extent to which proposed energy/green management projects 

improve sustainability. VA uses sustainable building survey instruments to understand 

which investments (as well as low- and no-cost measures) will lead to improved facility 

conditions. 

e. Enhancing energy security: VA also considers enhanced energy security in its decision 

making. By reducing energy consumption and generating energy from renewable sources, 

VA facilities reduce their dependence on imported energy sources. Installing energy 

systems that run on renewable fuels adds a level of energy security because dependence 

on traditional fuels and traditional fuel supply sources is reduced. This helps facilities 

ensure fuel supply as well as manage energy costs. 

Question 16: Please explain the decrease in the amount offunding requested for facility 

activations in FY13. 

Response: The activation requirements are phased prior to the completion of the specific 

projects. The difference in the amounts for FY 2012 and FY 2013 is a function of the variation 

in this phasing. 

Question 17: Please provide an update on the amounts of bid savings achieved for each 

major medical facility construction project and how VA plans to obligate them. 

Response: Currently, VA has bid savings in the amount of $4.029 million on one project - the 

Phase 4 Gravesite Expansion at Indiantown Gap, PA. Additional bid savings are expected on 

the Cemetery Expansion at Tahoma, WA, pending the outcome of a bid protest. Previous bid 

savings on other projects have been transferred to support the FY 2012 Program Level funding 

for Major Construction projects, as reflected in the FY 2013 Budget Volume 4 appendices, 

pages 58-63 and 102-105. 

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Question 18: In response, to a pre-hearing question on the Real Property Cost Savings 

and Innovation Plan, VA identified $48 million in savings that has already been achieved 

through the first quarter of FY12. Please provide further detail on each project that has 

contributed to these savings, including: 

a. the initial cost to undertake the project 

Response: Initial costs would be considered start up costs, specific to these initiatives, 

to allow for the savings to be realized. Initial costs to undertake the Real Property Cost 

Savings and Innovation plan initiatives are estimated as follows: 

• Repurpose Underutilized Assets: None. Staff overhead is general program costs, 

not specific to this initiative, and is already in place. 

• Demolition or Mothballing: Demolition costs to execute these actions are included 

within the Medical Facilities budget. No additional resources were necessary. 

• Energy Savings and Sustainability: None. Staff overhead is general program costs, 

not specific to this initiative, and is already in place. 

Improved Non-Recurring Maintenance: Cost of increasing VA contracting staff 

estimated at $2 million per year. This cost is netted out in the calculation of cost 

savings from improved contracting for non-recurring maintenance. 

• Reduction in Leasing: None. These are basic contract actions completed with 

normal staff overhead that was already in place. 

b. the amount, to date, that has been saved in FY12; and 

c. any estimated savings for the remainder of FY12 (if applicable). 

Response: For parts band c of the question, please find further detail on estimated 

savings from each initiative below as of June 2012: 

VA C t S · I 't' I' Tolal Savings !-,P:=:r,::;oj",e=.:ct:.::e.::.d---,-::-:--:-:-:c:-_-r::-:-:-:-:-:-_-ITolal Savings os avmgs", la Ives A-h' db I .. I' Q22012 Q32012 Q42012 (VHA Onl ) ~ leve y mila Ive Projecled by y (Ihrough 012012) Jan 12;~ar 31. Apr ~;;~n 30. JUI12'0~;P 30. Inilialive 

Repurpose Underutilized Assets 

Demolition or tvklthbaliing 

Energy Savings and 

Sustainability 

Improved Non-Recurring 

Maintenance Contracting 

Reduction in Leasing 

Subtotal (Savings by 

Quarter) 

$ 3,007,681 

$ 910,730 

$ 40,346,992 

$ 2,377,250 

$ 6,101,000 

$ 52,743,653 

$ 1,007,681 $ 1,007,681 $ 1,007,681 $ 6,030,722 

$ 366,667 $ 366,667 $ 366,667 $ 2,010,730 

9,090,013 $10,097,100 $10,188,360 $ 69,722,465 

$ 1,843,250 $ 1,843,250 1,843,250 $ 7,907,000 

$ 964,611 $ 1,019,833 $ 1,019,833 $ 9,105,276 

$13,272,221 $14,334,529 $14,425,790 $ 94,776,193 
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Question 19: VA's Enhanced-Use Lease authority expired on December 31,2011. Please 

describe how the Department will improve oversight and management of EULs, and address 

the concerns of the Office of Inspector General in Audit of the Enhanced-Use Lease Program, 

11-00002-74, February 29,2012. 

Response: The Departrnent concurs with the Office of Inspector General (OIG) finding that 

the Enhanced-Use Lease (EUL) program could benefit from additional process, monitoring, 

and reporting enhancernents. Moreover, we concur with the OIG's recornrnendations on 

improving the EUL process and procedures. We have already undertaken many efforts to 

irnprove prograrn operations prior to and during the tirne of the audit. The table below outlines 

some of VA's efforts to address the six specific OIG recommendations and general program 

oversight. These efforts and our cornmitrnent to continual irnprovement are ongoing. 

OIG Recommendation Key Actions 

1) Establish standards to ensure · Create EUL Project Scorecards with performance 

complete lease agreements are metrics based on VA's strategic goals to ensure 

negotiated in line with the Portfolio Managers (PMs), throughout the EUL 

Department's strategic goals. process, negotiate EUL projects in line with the VA's 

strategic goals 

· Create a Checklist of Key EUL Project Documents 

that will be required to be maintained by PMs 

throughout EUL formulation and execution phase 

2) Institute adequate policies and · Issue guidance for the oversight and monitoring of the 

procedures to govern activities such EUL portfolio during the post-transaction stage of the 

as monitoring EUL projects and EU lease, including defining roles and responsibilities 

calculating, classifying, and of EUL stakeholders (new handbook/directive is 

reporting on EUL benefits and awaiting final signature) 

expenses · Develop a new and improved set of tools to assist in 

the on-going oversight of EULs, including improved 

collaboration with on-site resources, model based 

payment and program benefits/outcomes, and 

recurring compliance tracking 

3) Recalculate and update EUL · Review and improve EUL calculations used to report 

expenses and benefits previously expenses and benefits 

reported in the Annual · Create a comprehensive methodology for reporting 

Consideration Report. program outcomes 

· Create individual Program Outcomes Tracking Sheet 

for each EUL to calculate program outcomes to 

ensure consistency across projects. 

· Work with subject matter experts in program areas to 

ensure data collected and rates utilized in these 

calculations are being used correctly 

4) Establish oversight mechanisms · Finalize OAEM Records Management System and 

to ensure major EUL project ensure major EUL project decisions are documented 

decisions are documented and and maintained 

maintained in accordance with · OAEM Records Management System will include 

policy. guidance for the EUL portfolio and outline how OAEM 

and the PMs will organize and store EUL documents 

5) Establish criteria to measure · Issue a policy statement on the method for tracking 

timeliness and performance in EUL projects on the EUL project list 

project development and execution · Develop a Timeline Matrix tool to systematically track 

EUL project progression and the length of time an 

EUL project takes to complete specific phases 

· Establish criteria for when EUL stakeholders must 

reevaluate project viability 

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6) Establish criteria and guidelines 

for assessing projects to determine 

whether they remain viable 

candidates for the EUL program 

Draft Procedures for Reviewing and Checking Validity 

of Continuing with a Project and for reassessing 

projects on the EUL project list 

Develop criteria and guidance for removing projects 

from the EUL project list based on the timeliness and 

performance of the project during the formulation and 

execution phases 

VA also notes the achievements and benefits the EUL program has delivered to Veterans and 

their families or the Department over the past 20 years. The EUL program has been 

instrumental in delivering services to Veterans through its unique, non-conventional authority 

to enter into long-term public/private partnerships consistent with VA's mission. As part of the 

EUL program, VA launched the Building Utilization Review and Repurposing (BURR) initiative 

in 2009 to help end Veteran homelessness by reusing VA land and buildings. An estimated 

total of 5,400 units of affordable and supportive housing are under development as a result of 

the BURR initiative and VA's EUL program. Through December 2011, EUL projects have 

benefitted VA through the repurposing or disposal of approximately 6 million gross square feet 

and 1,000 acres of land at VA sites across the country. 

WOMEN VETERANS 

Question 20: VA's FY13 budget submission states that VA is developing an automated sexual 

assault reporting process under a fast track process. Please describe the automated process, 

and provide information on how and when it will be piloted. 

Response: Significant actions have been taken across VHA to improve the reporting and 

prevention of sexual assaults. All Veterans Integrated Service Networks (VISN) have action 

plans in place to improve physical security requirements. Networks are submitting regular 

progress reports on implementation of those plans. In addition, comprehensive staff education 

has occurred on how to report and prevent sexual assaults. Preliminary data from the first two 

quarters of FY 2012 indicates a trending downward between the first and second quarters in 

FY 2012 in the total number of events occurring in VHA facilities. This is despite 

improvements in reporting, and data validation against information contained within the Office 

of Security and Law Enforcement's databases. 

VA has developed an issue brief tracking system which tracks reports of sexual assaults 

submitted from all facilities within the system. This issue brief tracking system was piloted 

between July and September, 2011, and was deployed nationwide on October 1, 2011. It 

allows VA to track sexual assault reports by VISN and to address these incidents with 

leadership. As part of the pilot, quarterly reports of these assaults are being created and 

supplied to VHA leadership. VHA is also correlating these reports with information from the 

Office of Security and Law Enforcement to ensure the accuracy of data entered by field 

personnel, and appropriate reporting to VA police. 

Question 21: VA's FY13 budget submission includes a $60 million increase in funding to 

provide health care to women veterans. Please describe how VA plans to utilize this funding, 

including how much will be spent to expand access to gender specific health care services and 

staff trainings to be more inclusive to women veterans. 

Response: The number of women Veterans seeking healthcare has grown rapidly and it will 

continue to grow as more women enter military service. Women comprise nearly 15 percent of 

today's active duty military forces and 18 percent of National Guard and Reserves. In the 

Budget process, VA identifies health care costs that are specific to women, including screening 

(i.e. breast and cervical), cancer treatment (i.e. breast, cervical and other gynecologic), and 

other reproductive health care, including general and specialty gynecological care, infertility 

treatment, maternity care and newborn services. The estimates for each type of care include 

personnel costs associated with the care, which account for approximately 47 percent or $188 

Million of the $403 Million FY 2013 total gender-specific cost estimate. This is an increase of 

$60 Million over the FY 2012 level of $343 Million. 

VA projects an increasing number of women Veterans using VA health care. As VA is 

enhancing comprehensive primary care delivery to women Veterans, it is expected that 

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providers will identify, treat and refer more often for gender-specific conditions. In addition, VA 

continues to work on construction and space modification initiatives to ensure Women 

Veterans' privacy concerns are being met. Since FY 2010, VA has trained over 1,200 

providers in women's health, and now has designated women's health providers at every 

medical center and at 60 percent of community based outpatient clinics (CBOCs). In addition, 

VA has staffed 144 full-time Women Veterans Program Managers (WVPMs) at VA facilities 

nationwide. VHA plans to continue to deploy and enhance training to support the goal of 

ensuring every site of care has a minimum of one trained Women's Health Provider. Going 

forward, VHA will continue to assess the demand for gender specific health care services in 

order to make any necessary adjustments within the delivery system. 

OPERATIONAL EFFICIENCIES 

Question 22: GAO recently released findings that raise serious questions about savings VA is 

counting on from operational improvements. This is not the first time the Department has been 

criticized for its budgeting with respect to operational improvements. In this year's budget, VA 

is counting on nearly $1.29 billion in savings from similar operational improvements for FY13 

and $1.33 billion for the next fiscal year. 

a. What is the Department's contingency plan if these savings are not realized? 

Response: We are confident that the savings will be realized. Based on current fund 

allocations of the available appropriations there is no indication of a need for a contingency 

plan. 

b. How will the Department ensure that medical centers and other VA operations have 

enough funding throughout the year? 

Response: The Department will ensure that medical centers and other VA operations have 

sufficient funding throughout the year by closely monitoring the monthly budget execution of 

appropriation allocations. Current information and projections indicate that sufficient funding is 

available. 

Question 23: Despite not achieving Medical Care Collections Fund (MCCF) estimated targets 

since FY09, the Department's FY13 budget continues to estimate growh in the MCCF even 

when the current year's estimate will fall below the amount of collections recovered in FY09. 

Understanding that the MCCF provides the Department additional resources outside of the 

three distinct medical accounts, please clarify how the Department makes resource 

adjustments when MCCF revenues fall short of target collection amount. 

Response: When revenue estimates fall short as in FY 2013 ($3.291 billion in the FY 2012 

President's Submission versus $2.966 billion in the FY 2013 President's Submission, a 

difference of $325 million), VA considers multiple options for making resource adjustments, 

such as re-evaluating program requirements and the use of unobligated balances. 

Question 24: The Fee Care Savings initiative proposed under Operational Improvements is 

projected to generate $400 million in savings over the next two years through several 

component initiatives. Please provide the level of funding dedicated to electronic 

improvements identified in the Fee Care Savings initiative, to include a timeline for full 

implementation of the component initiatives. 

Response: The Fee Care Savings initiatives included two areas where automation changes 

were introduced including re-pricing transactions and improved reports for revenue generation. 

Both were considered part of our overall product licensing and did not incur additional 

technology costs. The re-pricing initiative was completed and deployed in FY 2011. The 

improved reports for revenue generation are currently in process with expected delivery in Q1 

FY 2013. 

Question 25: In addition to the operational improvement initiatives, what other steps is VA 

taking to identify facilities that spend significantly more than the average on staffing and 

operational costs? What is the Department doing to reduce these costs when appropriate? 

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Please provide more details regarding this analysis, including the amount of cost savings the 

Department is anticipating. 

Response: VHA is monitoring the monthly execution of the 21 networks. Each network is 

responsible for monitoring and overseeing the budget execution of its medical facilities and the 

relative amounts spent on staffing and operational costs. The Department is committed to 

achieving the savings identified in the President's Budget ($1.237 billion in FY2012, $1.284 

billion in FY 2013, and $1.328 billion in FY 2014). 

Question 26: What steps has VA taken to implement Executive Order 13589 in order to 

reduce wasteful spending? 

Response: VA developed reduction targets totaling $173.4 million which were submitted to the 

Office of Management and Budget (OMB) in December 2011, and subsequently approved. 

Administrations and staff offices provided plans showing how they will achieve their targets 

across the seven categories and where their redirected money will be spent. 

a. How much has the Department saved so far? 

Response: In VA's quarter 1 report to OMB on March 1,2012, VA reported actual spending 

of $256.3 million less than the target spend for that quarter. VA monitors actual spend 

monthly. 

b. What effects, if any, on delivery of health care and other services have resulted from 

reductions in employee travel? 

Response: Travel can be and is an important part of the delivery, execution, or training for the 

provision of care and services that VA provides Veterans. That said, to date, VA is not aware 

of any negative effects related to the care and services that VA provides based on reductions 

in employee travel as required by Executive Order 13589. 

c. Explain the rationale for allowing advisory committees to hold meetings at expensive hotels 

while VA or other government facilities are close at hand? 

Response: Advisory committees are governed by Public Law 92-462, the Federal Advisory 

Committee Act (FACA) 5 U.S.C. App. The regulations (41 C.F.R. § 102-3.95(a)) implementing 

the FACA explain principles that apply to the management of advisory committees to "provide 

adequate support." Agencies should identify requirements and assure that adequate 

resources are available to support anticipated activities. Considerations related to support 

include office space, necessary supplies and equipment, Federal staff support, and access to 

key decision makers. 

The regulation explains what policies apply to advisory committee meetings. The agency head 

is required to ensure that "each advisory committee meeting is held at a reasonable time and 

in a manner or place that is reasonably accessible to the public." 41 C.F.R. § 102-3.140(a). 

Also, the agency head must ensure that the meeting room or other forum selected is sufficient 

to accommodate advisory committee members, advisory committee or agency staff, and a 

reasonable number of interested members of the public." 41 C.F.R. § 102-3.140(b). 

VA does not hold meetings at hotels while VA or government facilities are close at hand. Our 

policy is to hold advisory committee meetings at VA or other government facilities wherever 

feasible. We apply judgment in deciding venues based on accommodating public access, size 

of anticipated meetings, need for breakout rooms, and access to transportation to a 

government facility. 

As of May 2012, in fiscal year 2012, over haW the meetings were held in VA or other 

government facilities, and a quarter were not held in VA facilities due to the need for breakout 

rooms. The remaining meetings were done offsite because of distance to a VA facility or to 

accommodate expected public attendance at first meeting. In the cases where a VA facility 

was not used, discounts or waivers were provided by the hotel or facility for meeting space, 

audio visual equipment, and phone lineslWiFi internet. Additionally, room rates were below 

the General Services Administration per diem rate. 

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Question 27: What, if any, capability does the Department have to evaluate the efficiency of 

business processes in offices or medical centers? If such capability exists, what actions have 

been taken over the course of the last year? 

Response: The VHA's Chief Business Office (CBO) and Consolidated Patient Account 

Centers (CPAC) have several mechanisms in place to evaluate the efficiency of business 

processes. CPAC utilizes workflow and business intelligence collection, analysis and reporting 

tools to evaluate performance metrics on a routine basis. When routine analysis reveals 

performance issues, relevant business processes are evaluated and adjusted/redesigned as 

appropriate. Over the last year, CPAC's use of these tools to analyze and modify business 

processes has resulted in significant improvement in industry standard performance measures 

such as Days-to-Bill and accounts receivable over 90 days. CPAC also maintains a 

comprehensive Quality Assurance program to ensure minimal variation between business 

process inputs and outputs. As part of the program, high priority business processes are 

reviewed on a regular basis and modified as necessary when unacceptable variance is 

detected. 

CBO has also implemented a robust performance monitoring framework to evaluate the 

effectiveness of Non VA Care (Fee) billing procedures. For this effort, analysts regularly 

monitor dashboards and performance metrics to determine whether current procedures are 

producing desired results. When performance issues are detected, Fee billing procedures are 

thoroughly analyzed and adjusted as necessary. As of March 2012, performance analysis 

indicates that Fee business processes are operating efficiently. 

The CBO's Purchased Care Program, the entity managing VA's health care payer services, 

also has multiple efforts both in place or planned to assure efficient business processes are in 

place to positively impact programmatic area. For example, the Civilian Health and Medical 

Program of the Department of Veterans Affairs (CHAMPVA) Program has developed a robust 

set of industry standard performance indicators, providing leadership a view into current 

performance as well as future outcomes. These indicators, analyzed and reviewed on a 

monthly basis, document positive programmatic outcomes. The program recently received a 

three year URAC (formerly called the Utilization Review Accreditation Commission) 

accreditation, evidence of effective business practices. 

In other payer programs such as the Non-VA Care Program, the CBO has a relationship w~h 

VHA's Veterans Engineering Resource Centers (VERC) which provide unique system redesign 

focus to our business practices. These joint efforts have resulted in development of 

streamlined and standardized business practices for the initial decision points, monitoring and 

management of Non-VA Care. These standardized business practices are currently being 

deployed across all VA health care facilities. 

Question 28: Please detail the mechanisms in place for oversight of awarding SES 

performance bonuses. How confident is the Department in the integrity and efficacy of this 

process? 

Response: VA needs the best and brightest leaders to continue to serve our Nation's 

Veterans. To attract and retain the best leaders, VA uses all the tools available including 

performance awards to recognize our highest performers. 

VA's executive performance management program is sound. In the fiscal years (FY) 2009 and 

2010, the Department made significant program management improvements to ensure the 

program is credible, transparent, and consistent with law and regulation. VA implemented 

additional changes in fiscal year (FY) 2011 and is leveraging the Office of Personnel 

Management's (OPM) new government-wide system to achieve further improvements in FY 

2012. 

In the past, VA's Performance Review Board (PRB) process, through which executive 

performance results are assessed, was decentralized. We now have one centralized VA PRB 

that serves the entire Department to recommend performance ratings and awards for the 

Secretary's consideration. VA will continue to use this rigorous PRB process in the future. 

Per established procedures, each year, before executive performance award 

recommendations are forwarded for the Secretary's decision, a final check is done with VA's 

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Office of Inspector General and Office of General Counsel to determine if there are any 

ongoing investigations or audits that may reflect unfavorably on the executives. Throughout 

the Department, we have communicated the requirement to make meaningful distinctions in 

performance, as required for certification of our Senior Executive Service (SES) appraisal 

system, and have been successful in achieving greater distinctions. In 2010, VA provided 

comprehensive performance management training for executives across the Department to 

ensure all understood the program and had an opportunity to express their concerns. Senbr 

leadership is fully engaged in this program. 

SES performance awards are the culmination of VA's rigorous performance appraisal process. 

OPM, with concurrence from the Office of Management and Budget (OM B), has certified, 

under provisions of 5 U.S.C. 5307(d)(2), that VA has a performance appraisal system that, as 

designed and applied, makes meaningful distinctions in performance. In a joint memorandum 

dated June 10, 2011, OPM and OMB provided guidance regarding budgetary limitations on 

awards, including SES performance awards, for Fiscal Years 2011 and 2012. Before the 

budgetary restrictions were imposed, 5 U.S.C. Section 5384 already limited expenditures for 

Career SES awards. The aggregate amount of performance awards paid could not exceed 10 

percent of the aggregate amount of basic pay paid to Career executives in VA during the 

preceding FY or 20 percent of the average of the annual rates of basic pay paid to career 

appointees in such agency during the preceding fiscal year. Over three previous years, VA 

allocated less than the 10 percent of aggregate pay: for FY 2008 performance, 9 percent; FY 

2009,8 percent; and FY 2010,7 percent, and the same percentages for SES-equivalent title 

38 awards. The 5 percent limit on awards expenditures, which VA applied to FY 2011 awards, 

acknowledged the need for restrained spending but also permitted us to recognize our very 

highest performers. 

Although 5 U.S.C. Section 5384 allows agencies to grant individual Career SES performance 

awards that are no lower than 5 percent and no higher than 20 percent of an executive's 

salary, for FY 2010 performance, the highest award VA granted was 15.5 percent. Unlike the 

practice in some government agencies, a VA executive who receives a Presidential Rank 

Award does not also receive an additional performance award for that year. 

VA is confident in the integrity and efficacy of this process. 

INFORMATION TECHNOLOGY 

Virtual Lifetime Electronic Record (VLER) 

Question 29: The Virtual Lifetime Electronic Record Capability Area 1 (VCA-1), Concept of 

Operations v 2.0 (CONOPS), dated April 8, 2011, and signed by the Deputy Secretary in 

August of 2011, identifies high-likelihood / high-impact VLER risks and issues. Specifically, 

tables 11 and 12 of CONOPS detail selected risks and issues rated "high" on the risk exposure 

index or "Level 5" (catastrophic) using the Cost and Schedule Consequence Impact Rating. 

a. Please detail the current status of each risk and issue identified in Tables 11 and 12, and 

describe any steps taken pursuant to the applicable mitigation or remediation plan. 

b. Please also identify, and provide the same detail for, any additional risk or issue currently 

rated "high" on the risk exposure index, or "Level 5" using the impact rating and not listed in 

Table110r12. 

Response to a and b: 

Risks: 

Risk 1: Projects (e.g., VistAWeb, VistA Imaging, Radiology, and Veterans Relationship 

Management) that VCA 11 is dependent upon must be adequately funded and delivered on 

time in order to prevent a change in the scope of VCA 1 that could impact funding and/or 

delivery schedule. 

Update: These projects were not a part of VCA 1 capability and should not have been 

listed as a risk. Does not apply. 

Risk 2: If iEHR, VLER, and other interagency data exchange efforts are not synchronized (e.g., 

CIIF, data standards, service framework, and specifications), the Departments will incur cost 

overruns, duplications, and lack of standardization and interoperability. 

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Update: Data exchange efforts have been synchronized betv.een VLER Health and the 

Common Information Interoperability Framework (CIIF) through co-location at the IPO 

so this is no longer a risk. 

Issues: 

Issue 1: The current NwHIN identity management specification lacks maturity and scalability, 

resulting in inability to discover and subsequent exchange of health data. 

Update: National rollout will still be able to proceed. Timelines for deployment to new 

sites will account for the continued maturing of identity specifications. 

Issue 2: The current immature standards and spedfications impact the ability of the 

Departments to further develop a robust health data exchange capability. 

Update: National rollout will still be able to proceed. Timelines for deployment to new 

sites will account for the continued maturing of standards and specifications. 

Issue 3: DOD and VA do not have adequate government full time staff to perform inherently 

governmental duties. 

Update: Staffing is adequate. This is no longer an issue. 

Issue 4: DMDC's funding in support of VLER does not exist for any future development. 

Update: Funding is available for FY12 and has been requested for FY13. 

Issue 5: VLER requires multiple Departments to work together to achieve success. Potential 

competing priorities for any of the federal partners impacts the overall program success. 

Update: Competing priorities have been mitigated through organizational solution. 

Integrated Electronic Health Record (iEHR) 

Question 30: Please describe how iEHR governance has been connected to VLER oversight 

and implementation. 

Response: The Interagency Program Office (IPO) Charter was signed on October 27, 2011. 

It states that the IPO: 

"a. Serves as the single point of accountability for the Departments in the development and 

implementation of the integrated electronic health record (EHR) and Virtual Lifetime Electronic 

Record (VLER) Health systems, capabilities, and initiatives with th e goal of full interoperability 

between the DOD and VA. 

b. Is authorized by the Departments to lead, oversee, and manage all interagency planning, 

programming and budgeting, contracting, architecture, capability acquisition and development, 

data strategy and management, testing and evaluation planning, infrastructure requirements 

and funding, common services, implementation, and sustainment related to and including the 

integrated EHR (iEHR) and VLER Health." 

Both iEHR and VLER Health are under the IPO governance structure. There is not separate 

iEHR governance. 

Question 31: Please report the status of iEHR requirements, including, but not limited to, 

decision(s) on design methodologies, application priorities, implementation schedule, and 

deployment sequence. For each iEHR requirement identified in your response, describe the 

scope and status of the requirement in detail. 

Response: VA and DOD have agreed to create a single common, joint electronic health 

record. The iEHR platform will be an open architecture, non-proprietary design. We are now 

in the process of identifying the specific requirements for the development of the iEHR. As 

soon as the requirements are finalized, the Departments will furnish the Committee with the 

requested documentation. Based on leadership defined priorities, a preliminary iEHR Initial 

Operational Capability (IOC) definition was agreed to at the Interagency Program Office (IPO) 

Advisory Board meeting held on March 13, 2012. The IOC targets delivery of iEHR baseline 

capability to two sites (consisting of multiple VA and DOD facilities) no later than 2014, with 

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primary effort on providing a Service Oriented Architecture-based supporting irtrastructure. 

Clinical capability for Lab and Immunization has been identified as the priorities. In addition, 

Pharmacy Orders Fulfillment and Inventory Management will be addressed at North Chicago. 

The two sites for 10C under consideration are Hampton Roads and San Antonio. 

Ongoing risk reduction efforts in the areas of Identity Management, Access Control, and Single 

Sign-on/Context Management, Enterprise Service Bus, Presentation Layer, Development Test 

Center/Environment and Health Data Dictionary mapping \Mil continue in support of framing 

the iEHR enduring capability. 

IT Hardware & Infrastructure 

Question 32: In his June 29, 2011, letter to the Committee outlining the Department's IT 

reprogramming baseline plan, the Secretary wrote in relevant part: 

The reduction of VA's IT budget in FY 2011 requires a rebalancing of 

investments between development programs designed to transform VA 

and infrastructure programs to sustain reliable systems and quality 

service. In FY 2011, VA will defer the replacement of essential IT 

equipment that is well beyond its useful life. This will increase the 

potential for a hospital or benefits office outage, which would have a 

substantial impact on quality of care and timely delivery of benefits for 

Veterans. For example, 26 percent of IT servers are beyond their 5-year 

useful life (3,866 of 14,615 servers). Similarly, 25 percent of the 860 

telephone switch (PBX) systems for which VA facilities rely upon to 

communicate with Veterans and their families, are beyond their expected 

10-year lifespan (214 of 860), and 30 of those PBX systems are beyond 

15 years of age and at a high risk for failure. 

These challenges are manageable this year, but set the conditions for a 

more serious dilemma in maintaining investment balance should such 

reductions occur in FY 2012. 

In light of the reduction to VA's IT budget in FY11 and current FY12 spending levels: 

a. What is the Department's strategy for maintaining a viable investment balance between 

development programs and infrastructure programs over the next five fiscal years? 

Response: IT is fundamental to the VA's ability to serve our Veterans. VA cannot operate its 

hospitals, benefits offices, or even its cemeteries without information technology. More than 

80% of VA's IT staff work at the hospitals and benefits offices providing direct support to those 

who serve Veterans. 

The Department's budget request for FY 2013 provides for the proper operation and 

maintenance of an infrastructure designed to meet the day-to-day operational needs of VA. 

The sustainment of activities, replacement of equipment that reaches the end of its useful life, 

and major infrastructure upgrades needed to maintain currency with the rapidly changing 

technological environment are all part of that regime. The budget provides for ensuring 

continued operations in the event of outages, ensuring OIT meets expected service levels. 

The budget request will provide for an infrastructure that is capable of detecting and correcting 

anomalous situations without human intervention, as well as capable of accepting and 

operating the new products and systems being developed by the Department's agile 

development process. 

Nevertheless, VA must address several trends outlined in the budget request that serve to 

escalate the costs of operating IT in the Department remains. These drivers - outlined in 

detail in the Department's FY 2013 budget request - include: new employees; new facility 

activations; new systems and platforms that come online; an increase in the use of mobile 

computing; and increased reliance upon WAN/LAN and other telecommunication. Additionally, 

there is the challenge of addressing deferred equipment replacement. The relationship 

between equipment that has aged beyond its useful lifespan and reports of incidents and 

outages is a direct correlation. The scale of what may be referred to as the IT Debt (which is 

the sum of replacement costs for all hardware commodities that have aged beyond useful 

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lifespan) can be tracked and correlates with the approximately 36% increase in incidents over 

the years 2009-2011. 

In response, VA is investigating changes in the infrastructure paradigm as ways to improve its 

cost effectiveness. Strategies such as using outside entities for telephone and printing 

services, and changes in how VA approaches life-cycle management of hardware (such as 

leasing versus buying where appropriate, leveraging economies of scale on commodity 

contracts), are being reviewed as mechanisms to reduce the cost of VA's IT infrastructure; 

every dollar that is not expended servicing the infrastructure is another dollar that can be used 

to develop innovative solutions serving our Veterans. 

The FY 2013 budget request prevents equipment replacement deferrals from interfering with 

required service levels and provides the basis for a strong, scalable, effective infrastructure 

now and into FY 2014 and beyond. 

b. If additional budget rescissions or reductions occur, what is the Department's plan to 

mitigate impact on IT equipment that has exceeded its useful life? Is deferred replacement 

of aging equipment a viable long term strategy? 

Response: Deferred replacement of aged equipment is no longer a suitable option, and was 

never positioned as a long-term strategy. The deferral was a time-limited, risk management 

strategy to deal with an increase in development of new IT capabilities/systems. If it is 

maintained as a long term strategy, then current service levels will further deteriorate. 

In some cases - a paradigm shift may obviate the need for a life-cycle management (LCM) 

strategy of costs for certain infrastructure items (such as the Voice-as-a-Service [VaaSj pilot 

that may prove that VaaS strategy is superior to a PBX replacement strategy based on LCM). 

But in other cases, a change in how the Department approaches LCM funding would likely be 

required to make the paradigm shift (such as increased funding for a server/storage 

virtualization program as part of a coordinated Lifecycle replacement of aged server 

hardware). 

In the end, however, if the Department's IT budget request were not granted in full, VA would 

look to prioritize its investments within the appropriated funding to minimize the impact on 

service delivery to our Veteran community. 

Project Management Accountability System (PMAS) 

Question 33: In his January 26, 2012, briefing to the Senate and House Committees on 

Veterans' Affairs, Assistant Secretary Roger Baker identified as an ongoing challenge the 

alignment of all processes for a 3500 person development organization to fully support PMAS. 

a. To date, what steps has the Department taken to achieve such alignment? 

Response: In his January 26, 2012 briefing to the Senate and House Committees on Veterans 

Affairs, Assistant Secretary Baker indicated that, at a high level, the processes necessary to 

fully support PMAS in a 3,500 person development organization existed at the highest levels, 

but needed to be improved at the project and program levels. VA's IT development 

organization has taken significant steps to ensure that the processes are fully aligned. VA's 

success in delivering projects on time and within scope in FY 2011 is evidence of improved 

process alignment. Through the implementation of improved processes in the development 

organization, VA has identified a cost avoidance of nearly $200 million by eliminating poorly 

performing projects and restructuring others. In FY 2011, VA managed 101 IT projects and 

successfully delivered 89 percent of all project milestones. 

For example, VA mandates the use of Pro Path for the management of all IT projects. Pro Path 

is an innovative, front-end tool that was established to enhance and encourage standard, 

repeatable processes that can be utilized easily across the organization. Pro Path serves as 

the first step in a long-term investment toward improving our development processes. 

Moreover, VA is working to instill processes that support PMAS by requiring every project 

manager to ensure proper planning is completed before a project can begin. This pre-planning 

phase, which is referred to as "Milestone Zero," ensures that a project meets the PMAS 

requirements to enter the "Planning" state to graduate to "Milestone 1." This stage requires the 

involvement of the OIT Deputy Assistant Secretary or Deputy CIO for the office responsible for 

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the project. This stage also requires the involvement of the Departmental customer for whom 

the project will be completed, as well as an Integrated Project Team (lPT). The IPT consists of 

all stakeholders necessary to ensure the proper execution of the project, and is also 

responsible for ensuring the project and increment requirements are in place, and also serves 

as the governing and management mechanism for the project. By instituting processes at the 

Milestone Zero stage and establishing standard processes for involvement by all stakeholders 

in the earliest stages of project planning, VA is making significant progress aligning 

development processes to PMAS. 

b. If full alignment has not yet been achieved, please detail the remaining challenges 

preventing such alignment. What steps will the Department take to overcome these 

remaining challenges? 

Response: VA continues to refine the Milestone Zero process, including the development of 

templates to be used for projects to instill consistency in the development process. We also 

continue to incorporate lessons learned into the PMAS Guide. The most recent version of the 

PMAS Guide, version 3.0, was released in September, 2011. 

ACQUISITION & CONTRACTING 

Question 34: One area where greater oversight and accountability is needed is in contracting. 

In VISN 20 the network director has spent more than half a million dollars to hire a motivational 

speaker, and purchase thousands of his books, including a copy of one of his books for every 

employee in the network, in addition to large purchases of his other books. Every contract 

needs to add value, address a necessary problem, not be duplicative, and not be something 

VA should perform itself. What oversight is in place to ensure that, before VA enters into a 

contract, it is appropriate and necessary? 

Response: The response to this question will be provided in a future batch of questions. 

Question 35: In its July 2011 briefing to the Committee, the Department identified benefits it 

expects to realize through its Transformation Twenty-One Total Technology (T4) acquisition 

strategy, including: 

Savings for the Government: reduced cycle time, fewer source selections, 

increased savings associated with contract administration, overhead, 

program management, and competition in a post award environment. 

a. How does the Department evaluate and measure the accrual of such savings? 

Response: Savings are measured in time and dollars: 

Procurement Administrative Lead Time (PAL T) is defined the hne from receipt of a complete 

requirements package to the time of contract award. Comparison is made to the prior year 

and trends will be analyzed to determine where further process improvements can be made. 

Dollar savings are measured based on: 

a) The comparison between the Government's cost estimate and/or prior historical pricing, 

and task order award prices 

b) Avoidance of preparation of unnecessary documents 

c) Conversion from assisted to direct acquisition 

d) Avoidance of costs associated with formal source selection 

b. To date, please detail any savings realized through T4. Is T4 meeting the Department's 

expectations for savings and efficiencies? If not, why? 

Response: Twelve competitive awards have been made under T4 thus far. The following 

savings have been realized based on these twelve awards: 

a. Standard PALT time for service contract/task order awards is 150 days. Average PALT 

for service contract/task order awards at the Technology Acquisition Center (TAC) for 

2011 was 67 days. Average PALT time for the first 12 competitive T4 awards was 50 

days. 

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b. Summary of dollar savings: 

Total independent Government cost estimate (IGCE) for the 12 awards was 

$1,198,576,452.74 as compared to the total award values of $854,749,325.66. 

The most notable example was the estimate for one order was $855,000,000 

based on recent and reliable historical data; the award amount was 

715,355,639.01, nearly a 20% savings. Note also the IGCE for the basic T4 

awards was based on General Services Administration (GSA) Schedule 70 rates. 

The T4 awarded labor rates averaged a savings against the GSA rates of 13.54% 

for Government site rates and 23.43% for Contractor site rates. 

II. Elimination of preparation of acquisition plans based on an average of 40 hours 

preparation and review time for a total of 12 awards is estimated to be a total of 

$47,909 (40 hours per document multiplied by average rate of $99.81 multiplied by 

12 awarded task orders) 

III. Use of direct acquisition versus Federal Supply Schedule or Government-Wide 

Acquisition Contracts for 11 of the orders is estimated to be .75% Industrial 

Funding Fee (IFF) x $139,393,686.65 or $1,045,452.64. Actual savings realized 

on the obligated value of $28,415,408.50 is $213,115.56. 

IV. One task order out of the 12 awarded would have been a candidate for a full 

formal source selection estimated to have cost about $300,000 - $400,000 and 

taken six months on average. Using the streamlined processes under T4, 

estimated dollar savings based on the four month reduction in time is $266,000 

($400,000/6 months multiplied by 4 months) 

Question 36: In his February 1, 2012, testimony before the House Committee on Veterans' 

Affairs, Deputy Secretary Gould described the Department's acquisition transformation 

initiative, stating in part: 

VA has established the Senior Procurement Council and implemented 

metrics to measure critical contracting requirements, implemented an 

enterprise spend analysis process, established a risk management office 

to oversee the A-123 process, established a Supplier Relationship 

Management initiative to work with our suppliers to improve our 

contracting processes, provided training to ensure a professional 

acquisition workforce, and developed information technology (IT) systems 

to simplify and standardize how we implement contracting throughout the 

Department. 

For each measure identified above: 

a. Has the measure been fully implemented? If not, what is the status of implementation? 

Response: The VA monitors eleven (11) core procurement metrics, and numerous supporting 

measures. The eleven core procurement metrics are reviewed on a monthly basis by VA's 

Senior Procurement Council (SPC). All of these metrics are fully implemented at the 

enterprise Chief Acquisition Officer (CAO) and Head of Contracting Activity (HCA) levels. 

b. How does the measure enable VA to better manage its contracting and acquisition 

processes, and how does VA track and evaluate such improvements? 

Response: Collectively, these measures provide insight into key aspects of operational 

contracting performance: customer satisfaction, compliance with laws & regulations, 

achievement of federallDepartment goals and mandates, and attainment of improvement 

objectives. Continuous monitoring supports identification of performance risks, provides timely 

identification of deviations from plan, and focuses top management attention on issues 

requiring corrective action. Most performance targets are reviewed monthly when system 

generated data is available. Some performance targets are reviewed quarterly, such as 

performance data derived from periodic stakeholder surveys. Performance trends are also 

maintained and reviewed to support analysis within the context of historical norms andlor 

operational anomalies. 

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Question 37: In his February 1,2012, testimony before the House Committee on Veterans' 

Affairs, Deputy Secretary Gould reported: 

Within VHA, procurement staffs were reorganized under a new 

management line that provides management and oversight dedicated to 

improving procurement operations. VHA completed its reorganization at 

the end of fiscal year (FY) 2011. 

a. Please describe this reorganization and new management line. 

b. How does this new line improve procurement operations and enhance oversight? 

c. How does the Department measure and evaluate such improvements? 

Response: VHA continues to transform and improve its acquisition operations. The 

completion of the reorganization in FY 2011 implemented a new acquisition business model 

that promotes centralized decision making and decentralized execution, based on the 

recommendations of a formal study completed at VA's request. VHA has realigned its 

acquisition staff under a centralized structure with three regional offices. These regional 

offices will concentrate on running an acquisition organization with a deliberate approach to 

training and oversight. The four major focus areas are: 

1) Customer and stakeholder satisfaction; 

2) Operational regional service area offices; 

3) Performance monitors; and 

4) Seamless transition. 

VHA's primary goal in reorganizing its acquisition operations is to transform into a customerfocused organization through the effective and innovative use of acquisition policies, 

procedures and processes to provide the best possible care to our Veterans and improve 

patient safety. Veterans Integrated Service Network (VISN) Directors and the Network 

Contract Managers will collaboratively prepare Customer Service Agreements. The 

agreements will focus on establishing customer service measures that meet the intent and 

regulations established in the Federal Acquisition Regulation (FAR) and Veterans Affairs 

Acquisition Regulation (VAAR) while still providing excellent customer service and patient care. 

VHA leadership has communicated clear expectations to its staff officers regarding each 

acquisition organization role and provided appropriate training to staff to ensure they are 

competent and effective leaders within the organization. 

All acquisition workforces previously reporting to the VISN Medical Center Directors have now 

been realigned under the VHA Procurement and Logistics Office (PL&O). This Office has 

created three Service Area Offices (SAOs) based on geographic location: East, Central and 

West. VHA has created several goals for these SAOs: 

• Achieve cost savings as identified in the Office of Management and Budget's (OMB) 

Improving Government Acquisition Initiative; 

Enforce standardization of contract requirements; and 

Establish staff as business conSUltants and value-added team members for VHA. 

VHA's reorganization also included developing quality assurance and compliance programs to 

promote standardization and greater compliance with Federal regulations and policies. The 

quality program is designed to plan, implement, monitor, identify and correct processes; it 

establishes checks and balances as required by the VA Office of Acquisition and Logistics 

Instruction Letter IL 001AL-09-02; and allows VA to identify best practices that can be used to 

promote standardization and efficiency. The VHA Operations Quality Office provides direct 

oversight to VHA acquisition activities. 

The Quality Office provides the Chief Procurement Office a comprehensive assessment of the 

entire acquisition program, not just individual procurement actions. The compliance program's 

key elements include: (1) organizational management; (2) human capital; (3) acquisition 

planning and information management; and (4) contracting. The goals of the quality program 

are to ensure compliance with VA poliCies, procedures and regulations; determine if the 

processes are helping us achieve our stated objectives; validate our processes and discover 

"best practices" to improve our business model; and establish an IS09001 :2008 Quality 

Management Standards organization. The Quality program will provide the oversight 

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necessary for VHA to become a world-class professional acquisition organization. In sum, this 

reorganization improves oversight, performance, and customer service, and ensures VA 

policies and procedures are followed. All of this contributes directly to achieving the 

Department's mission and improving patient care. 

SMALL BUSINESS VERIFICATION 

Question 38: The Department's Center for Veterans Enterprise (CVE) began verification of 

service-disabled veteran-owned and veteran-owned small businesses in May 2008. Since that 

time, CVE has modified its verification program. 

a. What metrics does CVE currently utilize to evaluate the operational efficiency and 

effectiveness of its verification processes and procedures? 

Response: CVE requires that 95% of all verification decisions are accurate and completed 

within its established timelines: 90 days for initial applications and 60 days for requests for 

reconsideration (R4R). 

b. Based upon these metrics, please describe the top five operational or organizational issues 

affecting the verification program. 

Response: The top five operational or organizational issues affecting the verification program 

are: Technology, Training, Process Management Oversight, Communications, and Oversight. 

c. Please detail any steps taken or that will be taken by CVE to resolve each such issue 

identified. 

Response: 

Technology 

Requirements for the newest version of the Vendor Information Pages (VIP?) are in 

development and being gathered throughout the business improvement process. 

During the interim, CVE has performed two contract modifications to streamline 

processes and improve overall functionality of the system. 

Training 

CVE is implementing a training program and has hired a training manager to facilitate 

the continual training on our systems, processes, and customer service. 

Process Management Oversight 

A change control board will oversee all process system changes and make sure that all 

changes are within regulatory guidance and become policy. CVE is continually revising 

its Standard Operating Procedures to ensure clarity, standardization and consistent 

implementation of all processes. 

Communications 

CVE's goal is to communicate to the Veteran community every 30 days to keep them 

aware of their application status. CVE has also established a customer service team to 

handle all Veteran and Congressional inquiries. 

Oversight 

CVE has hired a new Director & Deputy Director. There are also three new team leads 

that oversee initial application processing, requests for reconsideration and quality 

assurance. CVE continues to fill additional positions and have recently hired in the 

training, records management and technology areas. 

EXTENSION OF CERTAIN BENEFITS 

Question 39: Following the repeal of Don't Ask Don't Tell (DADT), a number of issues have 

arisen affecting VA and gay and lesbian veterans. For example, a federal lawsuit was recently 

filed against VA because the Department refused to extend benefits to the same-sex spouse of 

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RESPONSE TO POSTHEARING QUESTIONS SUBMITTED BY HON. RICHARD BURR TO

U.S. DEPARTMENT OF VETERANS AFFAIRS

GENERAL

Question 1. In connection with the Department of Veterans Affairs (VA) fiscal 

year 2011 budget request, VA indicated in response to questions about the method 

of travel used by employees of the Office of the Secretary that ‘‘travel regulations 

address the allowable modes of travel for reimbursement purposes, but the predominant method of travel has and will continue to be commercial airlines’’ [emphasis 

added]. 

a. For fiscal years 2009, 2010, and 2011, please identify the number of trips taken 

each year by senior VA personnel (Presidential Appointee with Senate Confirmation 

(PAS), career or non-career General Schedule (GS) employees, career or non-career 

Senior Executive Service (SES) or SES Equivalent, consultant, contractor, etc.) 

using a military or other government-provided aircraft. 

Response. Total number of trips taken each fiscal year using military or other 

government-provided aircraft are as follow: 

Fiscal Year 2009—total of 3 trips 

Fiscal Year 2010—total of 12 trips 

Fiscal Year 2011—total of 4 trips 

b. For each trip during those years where a military or other government-provided 

aircraft was utilized for travel, please identify: (1) the purpose of the trip, (2) the 

destination of the trip, (3) the duration of the trip, (4) the number and title of any 

VA employees (PAS, career or non-career GS employee; career or non-career SES 

or SES Equivalent, consultant, contractor, etc.) who were passengers on the aircraft, 

(5) the total cost to the Federal Government to operate the aircraft used for the trip, 

(6) the amount of any reimbursement VA provided to the Department of Defense, 

a military service, or another government entity in connection with the trip, (7) the 

justification for using military or other government-provided aircraft rather than a 

commercial airline, and (8) all supporting documentation, the agenda, and the 

itinerary related to the trip, as well as copies of any memoranda, reviews, comments 

and/or opinions rendered by VA’s Office of General Counsel regarding the trip. 

Response. [Extensive supporting documentation is held in Committee files.] 


229q3VA2m24.eps
156 

c. For fiscal years 2012 and 2013, please identify the number of trips that have 

been taken or are expected to be taken by senior VA personnel (PAS, career or noncareer GS, career or non-career SES or SES Equivalent, consultant, contractor, etc.) 

using a military or other government-provided aircraft. 

Response. As of March 29, 2012, in fiscal year 2012 VA did not usemilitary or 

other government-provided aircraft for any trips. In fiscal year 2013, VA may use 

military or other government-provided aircraft but no estimates are currently available. Cost figures can only be provided once travel is complete. For every official 

trip conducted by the Secretary, a cost analysis is made to determine efficiencies 

that may warrant a request for military air. If military air is requested, the provisions of 41 CFR 101–37 are met using the appropriate decision process outlined in 

OMB Circular A–126 and each request is submitted to the Agency General Counsel 

for review and approval. 

d. In total, for fiscal year 2012, how much (if any) is expected to be spent by VA 

in order to pay for transportation by military or other government-provided aircraft? 

Response. As of March 29, 2012, in fiscal year 2012 VA did not use military or 

other government-provided aircraft for any trips. No estimates are currently available and cost figures can only be provided once travel is complete. For every official 

trip conducted by the Secretary, a cost analysis is made to determine efficiencies 

that may warrant a request for military air. If military air is requested, the provisions of 41 CFR 101–37 are met using the appropriate decision process outlined in 

OMB Circular A–126 and each request is submitted to the Agency General Counsel 

for review and approval. 

e. In total, for fiscal year 2013, how much (if any) is requested in order to pay 

for transportation by military or other government-provided aircraft? 

Response. In fiscal year 2013, VA may use military or other government-provided 

aircraft but no estimates are currently available. Cost figures can only be provided 

once travel is complete. 

Question 2. The fiscal year 2013 budget request includes (1) funding for 3,380 fulltime equivalents (FTE) under General Administration for VA’s Office of the Secretary, Office of Human Resources and Administration, Office of Policy and Planning, Office of Operations, Security and Preparedness, Office of Public and Intergovernmental Affairs, Office of Management, Office of Congressional and Legislative 

Affairs, Office of General Counsel, and Board of Veterans’ Appeals (Board); (2) funding for 20,757 FTE under General Operating Expenses (GOE) for the Veterans Benefits Administration (VBA); and (3) funding for 262,912 FTE under the Veterans 

Health Administration (VHA) Medical Services, Medical Support and Compliance, 

and Medical Facilities accounts. 

a. For all three of the above FTE account groupings, please identify how many 

of the stated number of FTE are ‘‘virtual’’ FTE whose positions are funded by and 

whose responsibilities support offices at the VA Central Office level, but the employees are physically located outside of VA Central Office and in the field. Please display this information regarding virtual employees by responsible office field location 

(i.e., Veterans Integrated Service Network (VISN), VA medical center (VAMC), VBA 

regional office, or other office). 

b. How much is allocated for these employees’ salaries and benefits? 

c. If ‘‘virtual’’ FTE located in the field are not included within the above figures, 

please explain why they are not so reflected and under which organizational levels 

the FTE are reflected. 

Response to 2a-c: VA notes that various FTE listed in the embedded spreadsheets 

provide support to Veterans or activities in the field although they report through 

a VA Central Office organizational structure. 

For the Veterans Health Administration (VHA), several examples include: 

• Employees that work in VHA’s Consolidated Patient Account Centers provide 

medical center billing functions in regional locations to enhance efficiencies and consistent practices; 

• Readjustment Counseling staff provide Vet Center counseling and support in 

Vet Centers across the country. They are aligned through Central Office rather than 

each medical center, to maximize efficiencies and ensure consistent training and 

practices. 

• The Office of Workforce Management and Consulting provides human resource 

consultation and operational guidance to the broad VHA community to ensure an 

engaged and high-performing workforce to care for Veterans and their families; 

• The Employee Education System supports dynamic learning that contributes to 

a high-performance VHA workforce serving Veterans; 

• The National Center for Organization Development offers organizational assessment and consultation services to VA organizations nationwide; 

157 

• The Office of Academic Affiliations conducts an education and training program 

for health profession students and residents to enhance the quality of care provided 

to Veteran patients within the VHA healthcare system; and 

• Many of the ‘‘virtual’’ Patient Care Services staff are part-time clinicians that 

provide health care to our Veterans at one of VA’s more than 1,400 sites of care. 

Beyond VHA, a sample of examples where the work of these employees supports 

a combination of field and VA Central Office functions are provided below: 

• In the Office of General Counsel (OGC), the ‘‘virtual’’ FTE all perform work that 

supports both VA Central Office and the field. For example, OGC’s ‘‘virtual’’ Reports 

Analysis Planning & Statistics Division and ‘‘virtual’’ OGC budget staff provide support for OGC’s 22 field-based Regional Counsel offices as well as for OGC’s VACObased Staff Groups. Similarly, OGC’s ‘‘virtual’’ Knowledge Management and Professional Development Division staff provides support for all OGC training and knowledge-management activities, both in VACO and in the field. In addition, OGC’s 

Eatontown, NJ-based attorneys at the Technology Acquisition Center support IT acquisition activities for the benefit of VA facilities in the field as well as in VACO; 

• In the case of the Veterans Benefits Administration, all of the virtual employees 

listed work for VBA Central Office. These employees provide guidance, training, and 

oversight to the field. Outbased locations allow flexibility in recruiting, and program 

offices benefit from assigning staff at or near an existing regional office. Most of 

these positions do not involve routine travel to Washington, DC or co-location with 

Central Office. 

The requested information in 2a and 2b is provided in three attached documents 

as described below. All offices responding to this request for data indicated that the 

data provided does represent ‘‘virtual’’ FTE located in the field as requested under 

2c. No ‘‘virtual’’ employees were reported for the Office of the Secretary, Office of 

Policy and Planning, and the Office of Congressional and Legislative Affairs. 

As the question here relates to the ‘‘virtual’’ employees for FY 2013, the attached 

data is a projected estimate for FY 2013 based on data as of June 2012. 

The first spreadsheet (A) labeled ‘‘NonVHA-Report’’ contains responses for all organizations requested by the question, where applicable, except VHA. Information 

for VHA is provided in the .pdf file labeled ‘‘VHAReport’’ with an accompanying Station Table key excel sheet (B) labeled ‘‘Station Table.’’ VHA information is organized 

by the VHA Central Office Program Office to which the virtual employees are assigned. Due to technical limitations of the Personnel Accounting Integrated Database (PAID) system, VHA is unable to provide local duty station information in conjunction with the virtual employee’s VHACO Program Office assignment. 

The spreadsheet (C) labeled ‘‘VHAReport’’ includes the VHA ‘‘station code’’ that 

a program office is assigned to and therefore may not represent the city/state for 

every employee in that office (e.g., some may work from home or in other cities) and 

may not reflect where the employees actually sit (e.g., VHACO employees assigned 

to station 635 Oklahoma City VAMC actually have an office in downtown Oklahoma 

City, not at the medical center). 

As noted earlier, many of the VHA Central Office employees who are not in station 101 (VA Central Office) are employees in centralized functions that are part 

of Central Office but operate in the field. This includes VHA’s Chief Business Office, 

with over 5,000 employees, and VHA’s procurement and logistics with over 2,000 

employees. 

158 

NONVHA-REPORT


GQ2b1.eps

Dept. of Veterans Affairs Projected and Planned FY 2013 Virtual Central Office FTE 

(As of June 2012) 

: . ,- -, - " - -, 

I FY13 Virtual CO FTE I FY13 Virtual FTE Field Location 

VBA Section 

VBA 1 ALAC, Austin, TX 

VBA 1 Army IMCOM, Ft Sam Houston, TX 

VBA 1 Army IMCOM, Ft Sam Houston, TX 

VBA 8 Austin lTC, TX 

VBA 1 Frederick Acquisition Office, MD 

VBA 1 Ft Knox, KY 

VBA 1 Hines lTC, IL 

VBA 1 Jacksonville NAS, FL 

VBA 1 JB Lewis-McChord, WA 

VBA 1 JB McGuire-Dix, NJ 

VBA 1 Military installation TBD Asia 

VBA 1 Military installation TBD Europe 

VBA 1 Nellis AFB, NV 

VBA 2 Other, Andrews AFB, MD 

VBA 1 Other, Atlanta, GA 

VBA 1 Other, Bayonne, NJ 

VBA 6 Other, Bethesda, MD 

VBA 1 Other, Broken Arrow, OK 

VBA 1 Other, Cambridge, MA 

VBA 1 Other, Fort Belvoir, VA 

VBA 7 Other, Ft. Belvoir, MD 

VBA 8 Other, Hines, IL 

VBA 1 Other, Huntington, WV 

VBA 9 Other, Indianapolis, IN 

VBA 1 Other, Lake City, FL 

VBA 1 Other, Manchester, NH 

VBA 1 Other, Minneapolis, MN 

VBA 125 Other, Nashville, TN 

VBA 1 Other, Newark, NJ 

VBA 1 Other, Orem, UT 

VBA 9 Other, Orlando, FL 

VBA 1 Other, Palm Harbor, FL 

VBA 1 Other, Portland 

VBA 1 Other, Quantico, VA 

VBA 2 Other, Salt Lake City, UT 

VBA 1 Other, Seattle, WA 

VBA 1 Other, Sherveport, LA 

VBA 10 Other, 51. Petersburg, FL 

VBA 1 Other, Waco, TX 

VBA 1 Other, Winston-Salem, NC 

I 
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GQ2b2.eps

VBA 1 Randolph AFB, TX 

VBA 1 RO, Albuquerque, NM 

VBA 1 RO, Denver, CO 

VBA 1 RO, Honolulu, HI 

VBA 2 RO, Lincoln, NE 

VBA 1 RO, Manchester, NH 

VBA 1 RO, Muskogee, OK 

VBA 1 RO, Nashville, TN 

VBA 1 RO, New York, NY 

VBA 2 RO, Philadelphia, PA 

VBA 1 RO, Providence, RI 

VBA 1 RO, Salt Lake City, UT 

VBA 1 RO, st. Louis, MO 

VBA 8 RO, st. Petersburg, FL 

VBA 1 RO, Togus, ME 

VBA 1 RO, Waco, TX 

VBA 2 RO, Winston-Salem, NC 

VBA 9 VBA Academy, Baltimore, MD 

FY 13 Estimated Total Projected 

252 Salary and Benefits 29,120,299 

BVASection.r-____________ -, __________________________ ,-______________________ ~ 

BVA 7 Wilkes Barre, PA 

FY 13 Estimated Total Projected 

7 Salary and Benefits 343,946.20 

OHRA Section 

OHRA 0.5 Asheville, NC 

OHRA 1 Austin, TX 

OHRA 1 Chicago,IL 

OHRA 1 Cincinnati,OH 

OHRA 1 Cleveland, OH 

OHRA 1 Cleveland, OH 

OHRA 1 Cleveland, OH 

OHRA 1 Cleveland, OH 

OHRA 1 Cleveland, OH 

OHRA 1 Cleveland, OH 

OHRA 1 Cleveland, OH 

OHRA 3 Cleveland, OH 

OHRA 2 Colorado Springs, CO 

OHRA 1 Dallas, TX 

OHRA 1 Dallas, TX 

OHRA 1 Denver, CO 

OHRA 1 Fayetteville, NC 

OHRA 1 Florida 

OHRA 1 Hawaii 
160 


GQ2b3.eps

OHRA 1 Hines, IL 

OHRA 1 Hines, IL 

OHRA 1 Hines, IL 

OHRA 4 Houston, TX 

OHRA 1 Indianapolis, IN 

OHRA 1 Iowa City, IA 

OHRA 1 Levenworth, KS 

OHRA 3 Little Rock, AR 

OHRA 1 Livermore, CA 

OHRA 1 Minneapolis, MN 

OHRA 1 Murfreesboro, TN 

OHRA 2 Phoenix, AZ 

OHRA 1 On a, WV 

OHRA 0.5 Phoenix, AZ 

OHRA 1 Pittsburgh, PA 

OHRA 2 Pittsburgh, PA 

OHRA 1 Saginaw, MI 

OHRA 1 Slidell, LA 

OHRA 1 Tucson, AZ 

OHRA 1 AITC Austin, TX 

OHRA 2 Atlanta, GA 

OHRA 1 Biloxi, MS 

OHRA 1 Denver, Colorado 

OHRA 1 Denver, Colorado 

OHRA 1 Detriot, M I 

OHRA 1 Hampton, VA 

OHRA 1 Long Beach, California 

OHRA 1 Orlando VAMC 

OHRA 1 Orlando, Florida 

OHRA 1 Tampa, Florida 

OHRA 1 VAMC Altoona, PA 

OHRA 1 VAMC Augusta 

OHRA 1 VAMC- Augusta, GA 

OHRA 1 VAMC Dallas, TX 

OHRA 1 VAMC Dayton, OH 

OHRA 1 VAMC Long Beach, CA 

OHRA 1 VAMC Los Angeles, CA 

OHRA 1 VAMC Memphis 

OHRA 1 VAMC Milwaukee, WI 

OHRA 1 VAMC Northampton, MA 

OHRA 1 VAMC Northport 

OHRA 1 VAMC Phoenix, AZ 

OHRA 1 VAMC- San Diego, CA 

OHRA 1 VAMC Tampa, FL 

OHRA 1 VAMC Tuscaloosa, AL 

OHRA 1 VAMC Wilkes Barre, PA 

OHRA 1 VBA Regional Office New Orleans, LA 
161 


GQ2b4.eps

OHRA 1 VBA Seattle Washington 

OHRA 1 VHA Louisville, KY 

OHRA 1 VHA Louisville, KY 

OHRA 1 VHA New Orleans, LA 

OHRA 1 VHA New Orleans, LA 

OHRA 1 VHA NYC - Manhattan Campus 

OHRA 1 VHA, Danville, IL 

OHRA 1 VHA, Orlando, FL 

OHRA 1 VHA, Philadelphia, PA 

OHRA 1 VHA, San Antonio, TX 

OHRA 2 VISN 15 NBO Leavenworth, KS 

OHRA 1 VISN 19 Salt Lake City, UT 

OHRA 1 West Palm Beach, Florida 

OHRA 1 Wilkes-Barre, PA VAMC 

OHRA 1 Lexington, KY 

OHRA 1 Jackson, MS 

OHRA 1 Sacramento, CA 

OHRA 1 Longview, TX 

OHRA 1 San Francisco, CA 

OHRA 1 Lafayette, LA 

OHRA 1 Sepulveda, CA 

OHRA 1 Washington, DC 

OHRA 1 Washington, DC 

OHRA 1 Washington, DC 

OHRA 1 Melbourne, FL 

OHRA 1 San Antonio, TX 

OHRA 1 Nashville, TN 

OHRA 1 VAMC Syracuse, NY 

FY 13 Estimated Total Projected 

105 Salary and Benefits 11,721,495 

OPIA Section 

OPIA 1 Roseburg, OR VAMC 

OPIA 1 Minneapolis VAMC-MINUTE 

OPIA 1 Albuquerque, NM VAMC 

OPIA 1 Puget Sound, Seattle 

OPIA 1 Ann Arbor Healthcare System 

OPIA 3 Washington, DC Regional Office 

OPIA 3 New York Regional Office 

OPIA 3 Los Angeles Regional Office 

OPIA 3 Dallas Regional Office 

OPIA 4 Atlanta Regional Office 

OPIA 3 Chicago Regional Office 

OPIA 3 Denver Regional Office 

FY 13 Estimated Total Projected 

27 Salary and Benefits 2,616,912 
162 


GQ2b5.eps

OGe Section 

OGC 1 Atlanta, GA 

OGC 1 Boston, MA 

OGC 1 Buffalo, NY 

OGC 1 Indianapolis, IN 

OGC 1 Los Angeles, CA 

OGC 1 Philadelphia, PA 

OGC 1 Altoona, PA 

OGC 1 Sarasota, FL 

OGC 1 St. Louis, MO 

OGC 1 St Petersburg, FL 

OGC 1 Sterling, KY 

OGC 1 Roanoke, VA 

OGC 1 Overland Park, KS 

OGC 1 Leavenworth, KS 

OGC 1 Fetus, MO 

OGC 2 Nashville, TN 

OGC 5 Austin, TX 

OGC 6 Chicago, IL 

OGC 16 Eatontown, NJ 

OGC 1 Portland, OR 

OGC 1 Lakewood, CO 

OGC 1 Godfrey, IL 

OGC 1 Kansas City, MO 

OGC 1 Brooklyn, NY 

FY 13 Estimated Total Projected 

49 Salary and Benefits 6,946,575.64 

OM Section 

OM 1 Street, MD 

OM 1 Sahuarita, AZ 

OM 1 Minocqua, WI 

OM 1 Pensacola, FL 

OM 1 San Diego, CA 

OM 1 Mountain Home, ID 

OM 2 Austin, TX 

FY 13 Estimated Total Projected 

8 Salary and Benefits 903,662 

OSP Section 

losp I 1 Haverhill, MA I 

10Sp I 1 Martinsburg, WV VAMC I FY 13 Estimated Total Projected 

2 Salary and Benefits 260,000 
163 

STATION TABLE


GQ2a1.eps

Department of Veterans Affairs, Veterans Health 

Administration June 2012 - Station Table 

Station Number Station Name 

101 (VHACO) (101) CO WASHINGTON DC 

102 

103 

104 

116 

118 

200 

211 

212 

284 

301 

304 

306 

307 

308 

310 

311 

313 

314 

315 

316 

317 

318 

319 

320 

321 

322 

323 

325 

326 

327 

328 

329 

330 

331 

333 

334 

335 

339 

340 

341 

343 

344 

345 

346 

348 

349 

350 

351 

354 

355 

362 

372 

373 

376 

377 

389 

392 

393 

394 

395 

397 

402 

405 

436 

(VHACO) (102) sse TOPEKA KS 

(VHACO) (103) OIT WASHINGTON DC 

(VHACO) (104) FSC AUSTIN TX 

(VHACO) (116) OED BRECKSVILLE OH 

(VHACO) (118) TAC EATONTOWN NJ 

(VHACO) (200) AITe AUSTIN TX 

(VHACO) (211) SIC NO LITTLE ROCKAR 

(VHACO) (212) LETC NO LITTLE ROCKAR 

(VHACO) (284) BOC PHILADELPHIA PA 

(VHACO) (301) RO BOSTON MA 

(VHACO) (304) RO PROVIDENCE RI 

(VHACO) (306) RO NEW YORK NY 

(VHACO) (307) RO BUFFALO NY 

(VHACO) (308) RO HARTFORD CT 

(VHACO) (310) ROIC PHILADELPHIA PA 

(VHACO) (311) RO PITTSBURGH PA 

(VHACO) (313) RO BALTIMORE MD 

(VHACO) (314) RO ROANOKE VA 

(VHACO) (315) RO HUNTINGTON WV 

(VHACO) (316) RO ATLANTA GA 

(VHACO) (317) RO ST PETERSBURG FL 

(VHACO) (318) RO WINSTON-SALEM NC 

(VHACO) (319) RO COLUMBIA SC 

(VHACO) (320) RO NASHVILLE TN 

(VHACO) (321) RO NEW ORLEANS LA 

(VHACO) (322) RO MONTGOMERY AL 

(VHACO) (323) RO JACKSON MS 

(VHACO) (325) RO CLEVELAND OH 

(VHACO) (326) RO INDIANAPOLIS IN 

(VHACO) (327) RO LOUISVILLE KY 

(VHACO) (328) RO CHICAGO IL 

(VHACO) (329) RO DETROIT MI 

(VHACO) (330) RO MILWAUKEE WI 

(VHACO) (331) RO ST LOUIS MO 

(VHACO) (333) RO DES MOINES IA 

(VHACO) (334) RO LINCOLN NE 

(VHACO) (335) ROIC ST PAUL MN 

(VHACO) (339) RO DENVER CO 

(VHACO) (340) RO ALBUQUERQUE NM 

(VHACO) (341) RO SALT LAKE CY UT 

(VHACO) (343) RO OAKLAND CA 

(VHACO) (344) RO LOS ANGELES CA 

(VHACO) (345) RO PHOENIX AZ 

(VHACO) (346) RO SEATTLE WA 

(VHACO) (348) RO PORTLAND OR 

(VHACO) (349) RO WACO TX 

(VHACO) (350) RO LITTLE ROCK AR 

(VHACO) (351) RO MUSKOGEE OK 

(VHACO) (354) RO RENO NV 

(VHACO) (355) RO SAN JUAN PR 

(VHACO) (362) RO HOUSTON TX 

(VHACO) (372) RO WASHINGTON DC 

(VHACO) (373) RO MANCHESTER NH 

(VHACO) (376) RMC ST LOUIS MO 

(VHACO) (377) RO SAN DIEGO CA 

(VHACO) (389) DMC ST PAUL MN 

(VHACO) (392) EAO BALTIMORE MD 

(VHACO) (393) SAO JACKSON MS 

(VHACO) (394) CAO DETROIT MI 

(VHACO) (395) WAO DENVER CO 

(VHACO) (397) AMC WASHINGTON DC 

(VHACO) (402) HCS TOGUS ME 

(VHACO) (405) MROC WHT RIVER JCT VT 

(VHACO) (436) HCS FT HARRISON MT 

Station Number Station Name 

437 (VHACO) (437) HCS FARGO ND 

438 

442 

452 

459 

460 

463 

478 

481 

483 

484 

485 

486 

492 

493 

494 

495 

496 

498 

499 

500 

501 

502 

503 

504 

505 

506 

508 

509 

512 

513 

515 

516 

517 

518 

519 

520 

521 

523 

525 

526 

527 

528 

529 

531 

532 

533 

534 

535 

537 

538 

539 

540 

541 

542 

544 

546 

548 

549 

550 

552 

553 

554 

555 

556 

557 

558 

(VHACO) (438) HCS SIOUX FALLS SO 

(VHACO) (442) MROC CHEYENNE WY 

(VHACO) (452) RO WICHITA KS 

(VHACO) (459) HCS HONOLULU HI 

(VHACO) (460) MROC WilMINGTON DE 

(VHACO) (463) HCSROANCHORAGE AK 

(VHACO) (478) V1HCSBEDFORD MA 

(VHACO) (481) V4HCSPITTSBURGH PA 

(VHACO) (483) V6HCNDURHAM NC 

(VHACO) (484) V7SENOULUTH GA 

(VHACO) (485) V8HCSBAY PINES FL 

(VHACO) (486) V9HCNNASHVILlE TN 

(VHACO) (492) V16HNJACKSON MS 

(VHACO) (493) V17HNARLINGTON TX 

(VHACO) (494) V18HNMESA AZ 

(VHACO) (495) V19HNGLENOAlE CO 

(VHACO) (496) V20HNVANCOUVER WA 

(VHACO) (498) V22HNLONG BEACH CA 

(VHACO) (499) V23HNMINNEAPOLIS MN 

(VHACO) (500) MC ALBANY NY 

(VHACO) (501) HCS ALBUQUERQUE NM 

(VHACO) (502) MC ALEXANDRIA lA 

(VHACO) (503) MC ALTOONA PA 

(VHACO) (504) HCS AMARillO TX 

(VHACO) (505) MC AM lAKE/TACOMAWA 

(VHACO) (506) HCS ANN ARBOR MI 

(VHACO) (508) MC ATLANTA GA 

(VHACO) (509) MC AUGUSTA GA 

(VHACO) (512) HCS BALTIMORE MD 

(VHACO) (513) MC BATAVIA NY 

(VHACO) (515) MC BATTLE CREEK MI 

(VHACO) (516) MC BAY PINES Fl 

(VHACO) (517) MC BECKLEY WV 

(VHACO) (518) MC BEDFORD MA 

(VHACO) (519) HCS BIG SPRING TX 

(VHACO) (520) HCS BILOXI MS 

(VHACO) (521) MC BIRMINGHAM AL 

(VHACO) (523) HCS BOSTON MA 

(VHACO) (525) MC BROCKTON MA 

(VHACO) (526) MC BRONX NY 

(VHACO) (527) MC BROOKLYN NY 

(VHACO) (528) HCS BUFFALO NY 

(VHACO) (529) MC BUTLER PA 

(VHACO) (531) MC BOISE 10 

(VHACO) (532) MC CANANDAIGUA NY 

(VHACO) (533) MC CASTLE POINT NY 

(VHACO) (534) MC CHARLESTON SC 

(VHACO) (535) MC CHICAGO IL 

(VHACO) (537) HCS CHICAGO IL 

(VHACO) (538) MC CHILLICOTHE OH 

(VHACO) (539) MC CINCINNATI OH 

(VHACO) (540) MC CLARKSBURG WV 

(VHACO) (541) MC CLEVELAND OH 

(VHACO) (542) MC COATESVILLE PA 

(VHACO) (544) MC COLUMBIA SC 

(VHACO) (546) MC MIAMI FL 

(VHACO) (548) MC W PALM BEACH FL 

(VHACO) (549) HCS DALLAS TX 

(VHACO) (550) HCS DANVILLE IL 

(VHACO) (552) MC DAYTON OH 

(VHACO) (553) MC DETROIT MI 

(VHACO) (554) HCS DENVER CO 

(VHACO) (555) HCS DES MOINES IA 

(VHACO) (556) FHCC NORTH CHICAGO IL 

(VHACO) (557) MC DUBLIN GA 

(VHACO) (558) MC DURHAM NC 

561 (VHACO) (561) HCS EAST ORANGE NJ 

562 (VHACO) (562) MC ERIE PA 

564 (VHACO) (564) MC FAYETTEVILLE AR 
164 


GQ2a2.eps

Station Number Station Name 

565 (VHACO) (565) MC FAYETTEVILLE NC 

566 

567 

568 

569 

570 

573 

574 

575 

578 

580 

581 

583 

584 

585 

586 

589 

590 

593 

594 

595 

596 

597 

598 

600 

603 

604 

605 

607 

608 

609 

610 

612 

613 

614 

617 

618 

619 

620 

621 

622 

623 

626 

627 

629 

630 

631 

632 

635 

636 

637 

640 

641 

642 

644 

645 

646 

648 

649 

650 

652 

653 

654 

655 

656 

657 

(VHACO) (566) MC FORT HOWARD MD 

(VHACO) (567) HCS FORT LYON CO 

(VHACO) (568) HCS FORT MEADE SO 

(VHACO) (569) MC FORT WAYNE IN 

(VHACO) (570) HCS FRESNO CA 

(VHACO) (573) HCS GAINESVILLE FL 

(VHACO) (574) MC GRAND ISLAND NE 

(VHACO) (575) MC GR JUNCTION CO 

(VHACO) (578) MC HINES IL 

(VHACO) (580) MC HOUSTON TX 

(VHACO) (581) MC HUNTINGTON WV 

(VHACO) (583) MC INDIANAPOLIS IN 

(VHACO) (584) HCS IOWA CITY IA 

(VHACO) (585) MC IRON MOUNTAIN MI 

(VHACO) (586) MC JACKSON MS 

(VHACO) (589) HCS KANSAS CITY MO 

(VHACO) (590) MC HAMPTON VA 

(VHACO) (593) HCS LAS VEGAS NV 

(VHACO) (594) MC LAKE CITY FL 

(VHACO) (595) MC LEBANON PA 

(VHACO) (596) MC LEXINGTON KY 

(VHACO) (597) HCS LINCOLN NE 

(VHACO) (598) HCS LITTLE ROCK AR 

(VHACO) (600) HCS LONG BEACH CA 

(VHACO) (603) MC LOUISVILLE KY 

(VHACO) (604) MC LYONS NJ 

(VHACO) (605) MC LOMA LINDA CA 

(VHACO) (607) MC MADISON WI 

(VHACO) (608) MC MANCHESTER NH 

(VHACO) (609) MC MARION IL 

(VHACO) (610) HCS MARION IN 

(VHACO) (612) HCS MARTINEZ CA 

(VHACO) (613) MC MARTINSBURG WV 

(VHACO) (614) MC MEMPHIS TN 

(VHACO) (617) HCS MILES CITY MT 

(VHACO) (618) HCS MINNEAPOLIS MN 

(VHACO) (619) HCS MONTGOMERY AL 

(VHACO) (620) HCS MONTROSE NY 

(VHACO) (621) MC MOUNTAIN HOME TN 

(VHACO) (622) MC MURFREESBORO TN 

(VHACO) (623) MC MUSKOGEE OK 

(VHACO) (626) HCS NASHVILLE TN 

(VHACO) (627) MC NEWINGTON CT 

(VHACO) (629) HCS NEW ORLEANS LA 

(VHACO) (630) HCS NEW YORK NY 

(VHACO) (631) MC NORTHAMPTON MA 

(VHACO) (632) MC NORTHPORT L I NY 

(VHACO) (635) MC OKLAHOMA CITY OK 

(VHACO) (636) HCS OMAHA NE 

(VHACO) (637) MC ASHEVILLE NC 

(VHACO) (640) HCS PALO ALTO CA 

(VHACO) (641) MC PERRY POINT MD 

(VHACO) (642) MC PHILADELPHIA PA 

(VHACO) (644) MC PHOENIX AZ 

(VHACO) (645) MC PITTSBURGH PA 

(VHACO) (646) HCS PITTSBURGH PA 

(VHACO) (648) Me PORTLAND OR 

(VHACO) (649) HCS PRESCOTT AZ 

(VHACO) (650) MC PROVIDENCE RI 

(VHACO) (652) MC RICHMOND VA 

(VHACO) (653) HCS ROSEBURG OR 

(VHACO) (654) HCS RENO NV 

(VHACO) (655) MC SAGINAW MI 

(VHACO) (656) HCS ST CLOUD MN 

(VHACO) (657) HCS ST LOUIS MO 

658 (VHACO) (658) MC SALEM VA 

659 (VHACO) (659) MC SALISBURY NC 

660 (VHACO) (660) HCS SALT LAKE CITYUT 

662 (VHACO) (662) MC SAN FRANCISCO CA 

Station Number Station Name 

663 (VHACO) (663) HCS SEATTLE WA 

664 

665 

666 

667 

668 

670 

671 

672 

673 

674 

675 

676 

677 

678 

679 

680 

686 

687 

688 

689 

691 

692 

693 

695 

700 

701 

702 

705 

730 

731 

732 

733 

734 

735 

736 

740 

741 

742 

752 

756 

757 

758 

760 

761 

762 

763 

764 

765 

766 

78 

769 

770 

776 

777 

785 

788 

791 

792 

793 

794 

795 

796 

797 

798 

799 

(VHACO) (664) HCS SAN DIEGO CA 

(VHACO) (665) SCSC SEPULVEDA CA 

(VHACO) (666) MC SHERIDAN WY 

(VHACO) (667) MC SHREVEPORT LA 

(VHACO) (668) MC SPOKANE WA 

(VHACO) (670) MC SYRACUSE NY 

(VHACO) (671) HCS SAN ANTONIO TX 

(VHACO) (672) MC SAN JUAN PR 

(VHACO) (673) MC TAMPA FL 

(VHACO) (674) HCS TEMPLE TX 

(VHACO) (675) MC ORLANDO FL 

(VHACO) (676) MC TOMAH WI 

(VHACO) (677) HCS TOPEKA KS 

(VHACO) (678) HCS TUCSON AZ 

(VHACO) (679) MC TUSCALOOSA AL 

(VHACO) (680) MC TUSKEGEE AL 

(VHACO) (686) MC LEAVENWORTH KS 

(VHACO) (687) MC WALLA WALLA WA 

(VHACO) (688) MC WASHINGTON DC 

(VHACO) (689) HCS WEST HAVEN CT 

(VHACO) (691) HCS W/LOS ANGELES CA 

(VHACO) (692) SORCCWHITE CITY OR 

(VHACO) (693) MC WILKES BARRE PA 

(VHACO) (695) MC MILWAUKEE WI 

(VHACO) (700) MBM DUBLIN GA 

(VHACO) (701) VHASCSEVEN HILLS OH 

(VHACO) (702) HRC TOPEKA KS 

(VHACO) (705) ORM WASHINGTON DC 

(VHACO) (730) CPAC ASHEVILLE NC 

(VHACO) (731) CPAC MURFREESBORO TN 

(VHACO) (732) CPAC MADISON WI 

(VHACO) (733) CPAC ORLANDO FL 

(VHACO) (734) CPAC LEBANON PA 

(VHACO) (735) CPAC LEAVENWORTH KS 

(VHACO) (736) CPAC LAS VEGAS NV 

(VHACO) (740) HCS HARLINGEN TX 

(VHACO) (741) HAC DENVER CO 

(VHACO) (742) HEC ATLANTA GA 

(VHACO) (752) OC LOS ANGELES CA 

(VHACO) (756) HCS EL PASO TX 

(VHACO) (757) ACC COLUMBUS OH 

(VHACO) (758) OC LAS VEGAS NV 

(VHACO) (760) CMOP LEAVENWORTH KS 

(VHACO) (761) CMOP CHELMSFORD MA 

(VHACO) (762) CMOP TUCSON AZ 

(VHACO) (763) CMOP DALLAS TX 

(VHACO) (764) CMOP MURFREESBORO TN 

(VHACO) (765) CMOP HINES IL 

(VHACO) (766) CMOP NTH CHARLESTONSC 

(VHACO) (768) HRC INDIANAPOLIS IN 

(VHACO) (769) NSO ST LOUIS MO 

(VHACO) (770) CMOP LEAVENWORTH KS 

(VHACO) (776) OISC BRECKSVILLE OH 

(VHACO) (777) EES WASHINGTON DC 

(VHACO) (785) VCSCOST LOUIS MO 

(VHACO) (788) MSN ATLANTA GA 

(VHACO) (791) DOC DENVER CO 

(VHACO) (792) PAIC BALTIMORE MD 

(VHACO) (793) UNKNOWN 

(VHACO) (794) AMS SOMERVILLE NJ 

(VHACO) (795) SO BELL CA 

(VHACO) (796) SV&DCHINES IL 

(VHACO) (797) NAC HINES IL 

(VHACO) (798) CAl FT DETRICK MD 

(VHACO) (799) NCPS ANN ARBOR MI 
165 

VHA REPORT

Veterans Health Administration, Department of Veterans Affairs 

June 2012 

Routing 

Symbol Organization Name 

Number 

of 

Virtual 

FTEE Station Code(s) 

Projected and 

Estimated FY13 

Total Salary & 

Benefits 

10A2A Workforce Management and 

Consulting (10A2A) 

197 629, 635, 654 $20,862,819 .08 

10A2B Employee Education System 

(10A2B) 

376 777 $38,066,180 .17 

10A2C National Center for Organizational Development 

(10A2C) 

45 539 $5,253,318 .45 

10A2D Academic Affiliations (10A2D) 18 662, 657, 652 $2,811,923 .42 

10A3 Office of Finance (10A3) 85 741 $11,936,781 .20 

10A4B Quality and Safety (10A4B) 58 799, 405, 528, $7,910,115 .71 

10NA1 Emergency Management 

(10NA1) 

94 613, 640, $11,524,772 .13 

10NA2 Procurement & Logistics 

(10NA2) 

2183 308, 358, 459, 460, 481, 483, 493, 501, 502, 

503, 504, 506, 508, 509, 512, 515, 516, 

517, 519, 520, 521, 526, 528, 529, 534, 

538, 539, 540, 541, 542, 544, 546, 548, 

550, 552, 553, 554, 557, 558, 562, 564, 

565, 570, 573, 580, 583, 586, 589, 590, 

595, 598, 600, 610, 612, 613, 619, 623, 

626, 629, 635, 637, 640, 642, 644, 646, 

648, 649, 652, 654, 655, 659, 662, 667, 

672, 673, 675, 678, 679, 688, 693, 695, 

701, 730, 741, 756, 757, 777 

$192,808,935 .46 

10NA8 Occupational Safety & Health 

Management (10NA8) 

31 657 $3,493,787 .15 

10NB1 CBO Member Services 1075 702, 742 $69,625,011 .35 

10NB2 CBO Purchased Care 909 741 $67,534,071 .82 

10NB3 CBO Revenue Operations 3378 730, 731, 732, 733, 734, 735, 736 $202,937,428 .71 

10NC1 Homelessness (10NC1) 44 518, 541, 561, 640, 642, 673, 691 $5,383,871 .19 

10NC2 Surgical Services (10NC2) 27 648, 554 $2,852,562 .44 

10NC5 Mental Health Operations 

(10NC5) 

281 506, 518, 520, 523, 549, 640, 689, 528A5 $25,429,255 .24 

10NC6 Supply Processing & Distribution (SPD) (10NC6) 1 539 $131,019 .89 

10NC7 Dental (10NC7) 1 688 $259,381 .75 

10NC9 Rural Health Operations 

(10NC9) 

1 402 $74,910 .26 

10P DUSH for Policy and Services 

(10P) 

1 506 $68,654 .69 

166 

Veterans Health Administration, Department of Veterans Affairs—Continued 

June 2012 

Routing 

Symbol Organization Name 

Number 

of 

Virtual 

FTEE Station Code(s) 

Projected and 

Estimated FY13 

Total Salary & 

Benefits 

10P1 ADUSH Policy & Planning 

(10P1) 

23 573, 695, 741 $2,472,482 .37 

10P2 ADUSH for Informatics and 

Analytics (10P2) 

385 776 $52,233,196 .30 

10P3 Public Health (10P3) 35 640, 648, 688, 689 $5,628,044 .62 

10P4 Patient Care Services (10P4) 1266 405, 459, 506, 512, 523, 528, 531, 539, 541, 

549, 552, 554, 558, 573, 578, 580, 581, 

583, 586, 590, 595, 598, 603, 608, 612, 

630, 631, 636, 637, 640, 642, 648, 652, 

656, 660, 662, 663, 678, 688, 689, 691, 

695, 700, 760, 761, 762, 763, 764, 765, 

766, 770 

$148,395,138 .66 

10P6 National Center for Ethics 

(10P6) 

11 663, 630 $1,774,598 .68 

10P7 Health Information (10P7) 199 776 $27,949,107 .19 

10P8 Readjustment Counseling 

(10P8) 

1790 402, 405, 436, 437, 438, 442, 459, 460, 463, 

501, 502, 503, 504, 506, 508, 509, 512, 

515, 516, 517, 518, 519, 520, 521, 523, 

526, 528, 534, 534, 537, 539, 540, 541, 

544, 546, 548, 549, 550, 552, 553, 554, 

557, 558, 561, 562, 564, 565, 658, 570, 

573, 575, 578, 580, 581, 583, 585, 586, 

589, 590, 593, 595, 598, 600, 603, 605, 

607, 608, 610, 612, 613, 614, 618, 619, 

620, 621, 623, 626, 629, 630, 631, 632, 

635, 636, 640, 642, 644, 646, 648, 649, 

650, 652, 653, 654, 655, 657, 658, 659, 

660, 662, 663, 664, 667, 668, 671, 672, 

673, 674, 675, 676, 678, 687, 688, 689, 

691, 693, 695, 740, 756, 757 

$149,285,418 .34 

10P9 Research & Development 

(10P9) 

85 508, 558, 618, 644, 688, 792 $10,546,783 .98 

10R Research Oversight (10R) 25 508, 518, 578, 605 $3,704,951 .16 

Total 12624 $1,070,954,521 .42 

Question 3. In October 2011, the House of Representatives passed H.R. 2302, 

which included a provision that would require VA to submit to Congress quarterly 

reports outlining the cost for conferences or meetings sponsored by VA that have 

at least 50 attendees or cost $20,000 or more. 

a. During fiscal year 2011, how many conferences or meetings did VA sponsor 

that met those criteria and what was the total cost of those conferences and meetings? 

Response. On August 24, 2012, VA provided the Committee with consolidated 

training conference data from January 1, 2005 through July 1, 2012. 

b. For fiscal year 2011, please identify the 25 most expensive conferences or meetings sponsored by VA, the locations of those conferences or meetings, and the purposes of those conferences or meetings. 

Response. On August 24, 2012, VA provided the Committee with consolidated 

training conference data from January 1, 2005 through July 1, 2012. 

167 

c. During fiscal year 2012, how many conferences or meetings does VA expect to 

sponsor that meet those criteria and how much in total is expected to be expended 

on those conferences or meetings? 

Response. On August 24, 2012, VA provided the Committee with consolidated 

training conference data from January 1, 2005 through July 1, 2012. 

d. For fiscal year 2012, please identify the 25 most expensive conferences or meetings already sponsored or expected to be sponsored by VA, the locations of those 

conferences or meetings, and the purposes of those conferences or meetings. 

Response. Please see the answer to 3c. 

e. For fiscal year 2013, what is the total amount requested for purposes of holding 

conferences or meetings that meet those criteria and how many conferences or meetings would that funding level support? 

Response. FY 2013 first quarter executed training conferences and estimated second quarter data are expected to be provided in VA’s report to Congress as required 

by Public Law 112–154. 

f. For conferences or meeting events that cross fiscal years and are multisessioned (i.e., VA Senior Executive Strategic Leadership Course), please note the 

fact that they are sub-parts of a larger conference or meeting. 

Response. On August 24, 2012, VA provided the Committee with consolidated 

training conference data from January 1, 2005 through July 1, 2012. That data provided start and end dates, the training conference title, location, number of participants, total obligations, and a web URL where available. 

Question 4. During fiscal year 2010, VA created the National Outreach Office in 

the Office of Public and Intergovernmental Affairs with the stated goal to ‘‘standardize how outreach is being conducted throughout VA.’’ In follow-up questions to 

the hearing on the fiscal year 2012 budget, VA was asked to provide the total 

amount VA, as an enterprise, spent on outreach during fiscal year 2010. VA responded by stating, ‘‘[w]hile we are not currently able to extract the total spending 

for outreach across the department for [fiscal year] 2010 and [fiscal year] 2011, we 

are working diligently toward that goal for [fiscal year] 2012.’’ 

a. Please provide the total amount VA spent on outreach during fiscal year 2010 

and fiscal year 2011 and estimates for how much will be spent during fiscal years 

2012 and 2013. The data should include a breakdown of money spent by VA Central 

Office, Veterans Integrated Service Networks (VISNs), Regional Offices, and VA 

medical centers. 

Response. VA created the National Veterans Outreach Office (NVO) within the 

Office of Public and Intergovernmental Affairs (OPIA) in FY 2010 to coordinate outreach throughout VA, and to standardize outreach-related activities. The NVO has 

made considerable progress in researching and analyzing VA’s outreach programs 

and activities in 2011, and has already developed a framework to track outreach efforts that are part of VA’s major initiatives. The final frameworkincludes building 

a process for VA’s administrations (Veterans Health Administration, Veterans Benefits Administration and National Cemetery Administration) and staff offices to: 

• provide Veterans with high-quality products and information on activities that 

are consistent; 

• provide trained outreach coordinators to assist Veterans; 

• evaluate and develop metrics to measure the effectiveness of outreach programs; and 

• track costs associated with outreach programs. 

The embedded table, previously provided to the Committee in March 2012, gives 

expenditure data on advertising outreach, a component of VA’s outreach efforts. 

Outreach through advertising is targeted to helping VA reach Veterans who may 

be contemplating suicide; struggling with homelessness, unemployment, or mental 

illness; for those Veterans who live in rural areas; to make Veterans aware of available benefits and services; and VA hiring and recruitment. Table 1 details VA advertising activities and obligations for the period 2009–2012 and planned for 2013. 

The mechanisms for advertising outreach activities have included Public Service 

Announcements, multi-media projects, Internet promotion, transportation and billboard advertisements. Outreach activities and events for Homeless Veterans Outreach, Health Benefits Awareness, Mental Health Awareness, Women Veterans 

Outreach and Suicide Prevention Outreach will continue in 2013 using earned 

media, including news releases, social media, fact sheets, printed materials, etc. FY 

2013 funding to supplement these activities with paid advertising will be determined as part of the operational planning process. 

168 

b. Does standardizing the outreach efforts of VA include coordinating projects and 

initiatives at all levels of the organization? If so, please detail how the National 

Outreach Office has met these goals and please describe what new initiatives the 

office is undertaking to that end. 

Response. Yes, but it is important to note that OPIA only has supervisory authority over those personnel who are assigned or detailed to the National Veterans Outreach Office. In addition, hundreds of other VA employees enterprise-wide assigned 

to VBA, VHA and NCA are typically involved in outreach activities on any given 

day; those employees work for and respond to their respective chain of command. 

In an effort to better coordinate the outreach efforts of all VA employees, VA established a workgroup made up of representatives from VHA, VBA and NCA and VA 

staff offices, including: Centers for Women and Minority Veterans, Small and Disadvantaged Business Utilization, Homeless Veterans Initiatives Office, Center for 

Faith Based and Neighborhood Partnerships, and others. In 2011, the NVO held 

workgroup meetings to solicit input and ideas from headquarters and field facilities; 

and built buy-in for development and implementation of the plan to coordinate outreach activities and initiatives. OPIA held a national training conference in which 

‘‘Outreach Day’’ was a major activity to orient VA’s professionals to the outreach 

plan and obtain their final comments on developing a series of products and resources to improve outreach coordination, collaboration and uniformity across VA. 

Recognizing the need for centralized outreach management, NVO has developed the 

first capability to provide critical and consistent information to VA’s Outreach community: 

• An intranet site that houses important information to enhance how VA Outreach coordinators execute outreach including policies and procedures, the National 

Veterans Outreach Guide, links to the Congressionally mandated 2010 Biennial Report to Congress on the VA’s outreach activities, and other links. 

• An online National Veterans Outreach Guide that provides best business practices, expert recommendations, proven examples of successful VA outreach activities 

in serving Veterans, and lessons learned. This guide outlines processes for how to 

conduct outreach events, track expenditures, measure the success of activities and 

tap into key VA resources and contacts, plus so much more. 

• Next steps include finalizing a proposal for a robust National Veterans Outreach System (NVOS) which will allow VA Outreach leaders to populate a series of 

fields with information about planned outreach activities. The NVOS will be an 


229q1VAb1.eps
169 

interactive tool that allows users to systematically and uniformly enter, store, organize, view, retrieve and report outreach-related data easily. The goal of the database 

is to provide a more advanced, easy-to-use tool that may either be used in concert 

with existing data collection methods or replace less efficient and effective approaches. It will also provide the data necessary to extract any number of data pulls 

including the costs associated with outreach in a fiscal year and the number of 

events executed. 

Question 5. The December 2010 report from the National Commission on Fiscal 

Responsibility and Reform included a recommendation to reduce Federal spending 

on travel, printing, and vehicles. 

a. During fiscal year 2012, how much in total is projected to be expended by VA 

on travel costs; how much in total is projected to be expended on printing costs; and 

how much in total is projected to be expended to purchase, lease, operate, or maintain vehicles? 

Response. 

FY Administration Total Employee Travel Costs 

($ millions) 

Total Printing Costs 

($ millions) 

Total Fleet 

Costs 

($ millions) 

Grand Total Costs 

($ millions) 

2012 Total VA (Appropriated) .......................... $282 $56 $82 $420 

2013 Total VA (Appropriated) .......................... $282 $56 $88 $426 

To implement Executive Order 13589, ‘‘Delivering an Efficient, Effective and Ac- countable Government,’’ OMB agreed on a VA cost savings goal of $173 million annually for all spending categories for fiscal years 2012 and 2013. The FY 2013 employee travel target spend and reductions included below are those amounts identified by VA and approved by OMB for compliance with Executive Order 13589; additionally, these amounts have been adjusted to meet requirements related to OMB 

Memorandum M–12–12, ‘‘Promoting Efficient Spending to Support Agency Operations,’’ and have been approved by OMB. With OMB approval, no target has been 

set for executive fleet because the number of vehicles in VA’s fleet is minimal. 

FY Agency 

Total 

Travel 

Reduction 

Total Printing 

Reduction 

Total Supplies 

Reduction 

Total IT 

Devices 

Reduction 

Mgt Support 

Contracts 

Reduction 

Grand Total 

Target 

Reductions 

($ millions) 

2012 VA ............. $56.2 $11.5 $24.8 $11.3 $69.6 $173.4 

2013 VA ............. $58.4 $9.7 $72.1 $15.9 $17.4 $173.5 

b. For fiscal year 2013, how much in total is requested for travel costs; how much 

in total is requested for printing costs; and how much in total is requested to purchase, lease, operate, or maintain vehicles? 

Response. See above table in 5a. 

Question 6. According to VA’s Fiscal Year 2011 Performance and Accountability 

Report, VA has ordered 25 electric vehicles in order to conduct a ‘‘pilot study.’’ 

a. What make and model of electric vehicles were ordered, what was the total cost 

to VA to purchase or lease these vehicles, and what was the total cost to the Federal 

Government (if different)? 

Response. VA is currently scheduled to receive 26 electric vehicles (EVs) through 

the General Services Administration’s (GSA) EV pilot program: 

• 5 Think City vehicles • 1 Nissan Leaf • 20 Chevrolet Volts 

VA is paying the same lease cost for these EVs as for a standard vehicle of a similar class. GSA’s pilot program funding covers the incremental costs of the electric 

vehicles and the acquisition cost of charging stations for the participating agencies. 

Agencies only pay for the costs associated with installing the charging station at the 

EV site. 

GSA would have information on the cost to purchase or lease these vehicles both 

for VA and Federal-wide. 

b. For fiscal year 2013, how much in total is requested for purposes of this initiative? 

Response. No funding is requested. 

c. How and where will these vehicles be used? 

170 

Response. Most of the vehicles are assigned to VHA facilities in the San Francisco, San Diego, Los Angeles, Detroit and Washington/Baltimore metropolitan 

areas. One additional vehicle is assigned to VBA in Detroit. VA is deploying each 

vehicle to the most appropriate use at the selected locations. For example, how the 

vehicle is used depends on the distance that needs to be traveled, the number of 

people that must be accommodated, whether or not equipment and/or other supplies 

are being moved and other related factors. 

d. What are the specific objectives of the pilot study and what benchmarks will 

be used to determine whether it is successful? 

Response. The pilot study is a GSA initiative. GSA’s stated objectives are to determine if EVs are a cost effective option for Federal fleets, and where and for what 

kinds of uses. GSA is collecting data electronically from the charging stations and 

from the agencies leasing the vehicles. 

e. Please provide copies of the Executive Decision Memorandum (or comparable 

document) approving the pilot study and supporting documents of justification and 

implementation. 

Response. The pilot study is a GSA program in which VA, along with other Federal departments and agencies, is a participant. VA does not have access to GSA 

internal support and approval documentation. 

f. What cost comparisons were performed to assess the differential between the 

costs of operating an electric vehicle fleet versus other types of vehicle fleets (gasoline, natural gas, or hybrid)? Please provide any documentation comparing the costs 

of electric vehicles with other types of vehicles (gasoline, natural gas, or hybrids). 

Response. Under this pilot, GSA pays all operating expenses for leased vehicles 

in their fleet regardless of fuel type. 

Question 7. VA’s Central Office houses a number of different entities, including 

the Office of the Secretary, the Office of Congressional and Legislative Affairs, the 

Office of Public and Intergovernmental Affairs, and other support offices. 

a. How many employees currently are assigned or detailed to each of these respective entities within VA’s Central Office? Please identify the status of those employees as permanent or detailed; career or non-career; and GS, SES or SES Equivalent, 

or other pay scale. Please identify the locations (VISNs, VA medical centers, Veterans Benefits Administration Regional Offices, etc.) from where these employees 

are being detailed. 

Response. As of June 2012, 5 employees were detailed to one of the seven Staff 

Offices of VA Central Office or the Office of the Secretary (OSVA). Please see the 

below table. 

Staff Office/Office 

of the Secretary 

the Employee has 

been detailed to 

Field Office, Administration, or Facility Employee is Detailed From 

Employee’s 

Career 

Status 

Employee’s 

Pay Plan 

HRA VHA Employee Education System, VHA ..................................................... Career GS 

OSVA Office of Information & Technology/Product Development, OIT ............... Career GS * 

OSVA VHA, Executive Correspondence ................................................................ Career GS * 

OSVA VBA, Deputy Under Secretary for Benefits ................................................ Career GS * 

OSVA Office of Management, Office of the Assistant Secretary ....................... Career GS 

* Note: Two of the OSVA details ended in July 2012 and one ended in August 2012. 

b. If VA’s fiscal year 2013 budget request is adopted, how many full-time equivalents would VA expect to be assigned or detailed from outside VA’s Central Office 

to VA’s Central Office during fiscal year 2013? 

Response. The use of details to one of the seven Staff Offices of VA Central Office 

or OSVA in FY 2013 cannot be accurately forecasted. Detailee requirements are 

driven by temporary and short-term emergent workload needs that are not part of 

the normal budget planning process. 

Question 8. For the period October 1, 2010, through December 31, 2011, please 

provide a listing (without names or other personal identifiers) of those VA employees who have been approved to receive, or have received, Recruitment, Relocation 

and/or Retention Incentives. It is requested that the listing include the employee’s 

grade (SES, SES Equivalent, title 38, GS, etc.); duty station (VA Central Office, VA 

171 

Field location—VISN, VAMC, VBA regional office, etc.). Please list the amount approved for each Incentive category. 

a. For those receiving Relocation Incentives, please list the losing and receiving 

duty station/location. 

Response. The embedded spreadsheet, below, is a listing of individual Recruitment, Relocation and Retention Incentives paid from October 1, 2010 through December 31, 2011, by grade. Losing and receiving duty stations/locations cannot be 

reported due to system limitations. Incentives payments have been attributed to the 

Administration or Staff Office where the individual was employed on the date the 

information was extracted from the Personnel Accounting Integrated Database 

(PAID) system. In the case of internal VA employee transfers, the incentive may actually have been paid by a different Administration or Staff Office prior to the 

transfer. 

[This extensive information was received and is being held in Committee files.] 

b. For those receiving Retention Incentives, please identify the level of approving 

official (i.e., Secretary, Deputy Secretary, Chief of Staff, Under Secretary, Assistant 

Secretary, VISN/VA medical center/Regional Office Director, etc.). 

Response. VA does not maintain a central electronic file that identifies the approving official for each employee’s retention incentives. This information is in locally maintained paper files and would require several months to compile. 

VA Handbook 5007, Pay Administration, Part VI, Recruitment and Retention Incentives, documents VA’s policy as follows: 

‘‘a. Retention allowances must be approved by an official at a higher level 

than the one recommending the payment. The authorizing official’s signature 

signifies concurrence with the determination that an allowance is needed to retain a critical VA employee and authorization of the allowance percentage. 

‘‘b. The Secretary, or designee, is the approving official for retention allowances for employees occupying positions centralized to that office. 

‘‘c. Administration Heads, Assistant Secretaries, Other Key Officials, and 

Deputy Assistant Secretaries, or their designees, recommend retention allowances for employees occupying positions in their organization which are centralized to the Secretary. They, or their designees, approve retention allowances for 

employees occupying Central Office (VACO) positions in their organizations, 

which are not centralized to the Secretary; and employees occupying field positions centralized to their offices. 

‘‘d. Facility directors may approve retention allowances for title 38 and title 

5 employees in non-centralized positions under their jurisdiction provided that 

the amount of the allowance, when combined with all other VA payments, does 

not cause an employee’s total pay to exceed the aggregate limit on pay.’’ 

The Department is currently updating the incentives policy to reflect higher levels 

of approval. 

c. For those receiving Retention Incentives within the VA Central Office, please 

further identify the specific office (i.e., Office of Public and Intergovernmental Affairs, VHA Deputy Undersecretary for Health for Operations and Management 

(DUSHOM), Veterans Benefits Administration Compensation and Pension Service, 

Office of the Secretary, etc.). 

Response. The table below is a summary of Central Office Retention Incentives 

paid from October 1, 2010 through December 31, 2011, by Staff Office and Administration. 

172 

d. For those receiving Retention Incentives, please identify, where applicable, 

whether the Incentive was being offered because (1) the employee was likely to 

leave because of retirement; (2) the employee indicated an intent to leave for a different Federal position; or (3) of another authorized reason. 

Response. VA does not maintain a central electronic file documenting the approved reasons for each employee’s retention incentives. This information is in locally maintained paper files and would require several months to compile. 

The Code of Federal Regulations at 5 CFR 575.307 requires VA to establish the 

required documentation for determining that an employee would be likely to leave 

the Federal service in the absence of a retention incentive. VA Handbook 5007, Pay 

Administration, Part VI, Recruitment and Retention Incentives, documents VA’s 

policy as follows: 

‘‘Evidence that the Employee is Likely to Leave Federal Employment. 

Each supervisor shall make a separate certification that an employee, or for 

group authorizations, a significant number of employees in the group, is 

likely to leave Federal. This certification will only be made when the supervisor is reasonably convinced that the employee is likely to leave Federal 

service. Such a certification may be based on: 

‘‘(1) Receipt by an employee, or for group authorizations, a significant 

number of employees, of one or more bona fide offers of employment, as evidenced by a formal written job offer or affidavit signed by the employee or 

employees providing the position and salary being offered, the name and location of the organization, and the prospective date of employment; or 

‘‘(2) Evidence of high demand in the private sector for the knowledge and 

skills possessed by the employee or group of employees and significant pay 

disparities between Federal and non-Federal salaries; or 

‘‘(3) A discussion with the employee of the employee’s career plans.’’ 

A supervisor’s certification documenting the reason for determining the likelihood 

of an employee leaving Federal employment should be included in each retention incentive case file. However, VA’s OIG November 14, 2011, audit of retention incentives for VHA and VA Central Office cited case files that lacked documentation to 

support VA retention incentive decisions, including supervisors’ certifications that 


229q1VAb20c.eps
173 

the employees were likely to leave Federal service in the absence of monetary incentives were missing from some files. VA senior officials concurred with OIG report 

recommendations and provided acceptable corrective action plans which are currently being implemented. 

Employees who intend to leave VA for another Federal position may be granted 

a retention incentive only if VA has provided a general or specific written notice 

that the employee’s position may or would be affected by the closure or relocation 

of the employee’s office, facility, activity, or organization, per 5 CFR 575.315(b)(3). 

Question 9. Last year, the Committee learned that VISN 20 contracted with a 

company called Values Coach, Inc., for $394,000. In a response to an inquiry from 

the Committee, VA indicated that VISN 20 hired Values Coach to design a program 

‘‘to enhance performance in the area of customer satisfaction.’’ 

a. For fiscal year 2012, how much was spent across all VISNs on customer services contracts to enhance customer satisfaction? 

Response. See embedded attachment. Please note the expenditures reflected for 

the VISNs in the spreadsheet cover a wide range of expenditures that fall under 

the general category of customer satisfaction efforts including implementation of a 

system in VISN 6, for example, that enables the tracking of customer satisfaction 

at the clinic level. 

Amount Spent on Customer Services Contracts to Enhance Customer Satisfaction 

Department of Veterans Affairs—April 2012 

VISN/NCO Number 

(a) Amount Spent 

on Customer Services Contracts for 

Fiscal Year 2012 

to April 2012 

(b) Amount Projected to Spend on 

Customer Services 

Contracts for 

Fiscal Year 2013 

VISN 1 ......................................................................................................................... 0 Unknown 

VISN 2 ......................................................................................................................... 0 Unknown 

VISN 3 ......................................................................................................................... 0 Unknown 

VISN 4 ......................................................................................................................... 0 Unknown 

VISN 5 ......................................................................................................................... 0 Unknown 

VISN 6 ......................................................................................................................... est. 644,630 Unknown 

VISN 7 ......................................................................................................................... 0 Unknown 

VISN 8 ......................................................................................................................... 0 Unknown 

VISN 9 ......................................................................................................................... 0 0 

VISN 10 ....................................................................................................................... 377250 170000 

VISN 11 ....................................................................................................................... 0 0 

VISN 12 ....................................................................................................................... 278950 46100 

VISN 15 ....................................................................................................................... 0 0 

VISN 16 ....................................................................................................................... 0 0 

VISN 17 ....................................................................................................................... 0 0 

VISN 18 ....................................................................................................................... 0 0 

VISN 19 ....................................................................................................................... 0 0 

VISN 20 ....................................................................................................................... 192100 10000 

VISN 21 ....................................................................................................................... 0 0 

VISN 22 ....................................................................................................................... 0 0 

VISN 23 ....................................................................................................................... 58305 53805 

Totals ........................................................................................................ $1,551,235 $279,905 

b. For fiscal year 2013, how much will be spent across all VISNs on customer 

services contracts to enhance customer satisfaction? 

Response. Please see embedded attachment for question 23a. 

c. For the VISN 20 Values Coach contract, please describe the metrics used to determine whether customer satisfaction changed as a result of this contract. 

Response. Since October 2010, the VISN 20 ‘‘Culture of Change’’ Steering Committee has overseen initiatives, including the Values Coach contract, to assist with 

transitioning the organization to a more Patient-Centered Culture. The Committee 

analyzes employee survey scores, facilitates educational opportunities for employees, 

and seeks improvement in Labor-Management relationships. The Values Coach contract enabled VISN 20 facilities’ staff to improve their adoption of a patient-centered 

culture. This was assessed through meetings, town halls and other venues. The 

services offered help teach patient-centered values, Plain Tree and other concepts. 

d. Please provide a detailed description of the process required to secure contracts 

for customer service training to enhance customer satisfaction. 

174 

Response. The process for securing a contract begins with a clear requirement, 

typically established by a program manager. Establishing the requirement and determining that a contract is required to meet it, may involve several levels of review 

and discussion. In VISN 20, the network leadership adopted an initiative that had 

shown success in one of its Medical Centers and extended it throughout the VISN. 

In this instance, the requirement identified is the need to enhance client focus of 

staff throughout a medical center—this is a cultural change and requires the support of professionals who have been able to deliver comparable changes at multiple 

layers of a hospital organization. In these instances, it may be suitable for a contractor’s services to be retained by the government. As stated earlier, since October 2010, the VISN 20 ‘‘Culture of Change’’ Steering Committee has overseen initiatives, including the Values Coach contract, to assist with transitioning the organization to a more Patient-Centered Culture. The Committee analyzes employee survey 

scores, facilitates educational opportunities for employees and seeks improvement in 

Labor-Management relationships. 

As it relates to the process to secure contracts, the requesting office defines their 

requirement and provides the contracting officer with procurement and funding documentation. Based on the information provided and market research results, contracting decides the acquisition strategy. A solicitation is then created and released 

to potential offerors. Upon receipt of the offer, a technical evaluation panel evaluates the offers based on the evaluation factors in the solicitation. Following evaluation of the final offerors, contracting selects the offerors whose proposal is most advantageous and provides the best overall value to the Government, consistent with 

the evaluation factors established in the solicitation. Best value awards are made 

against Federal Supply schedules. Contract requirements are reviewed by warranted Contracting Officers. If required, a legal review may be performed by OGC. 

Once the requirement is established, VHA’s contract oversight process will be applied to securing a contract to meet the requirement. VHA contracting oversight 

process focuses on ensuring that all contracting regulations have been followed. The 

Integrated Oversight IL, IL001AL–09–02, guides the contract review process for all 

of VA [see attached]. The process for contract review is dependent upon the contract 

value. Typically, the higher the dollar value, the more levels of review, including 

a review by legal. Contracting oversight ensures that all requirements of law, executive orders, regulations, and all other applicable procedures, including clearances 

and approvals, have been met (see references FAR 1.602–1 Authority, paragraphs 

(a) and (b) provided below). 

The contracting office determines if a requestor’s requirement is appropriate and 

necessary based on the supporting documentation provided. A contracting officer’s 

role is to be a business advisor in relation to the procurement strategy and to ensure the proper contracting regulations are followed. If the requestor requests a particular brand name, or vendor (sole source) for example, the requestor is responsible 

for providing supporting justification/documentation to the contracting office, and 

the contracting office is responsible for approving or rejecting the request based on 

the supporting justification/documentation provided. For example, if a doctor requires a particular piece of equipment to perform a surgery or an engineer has particular design requirements, contracting will review supporting documentation provided by the requestor and determine if the requirements are appropriate and necessary. 

Reference: 

FAR 1.602–1 Authority, paragraphs (a) and (b), state, contracting officers have 

authority to enter into, administer, or terminate contracts and make related determinations and findings. Contracting officers may bind the Government only to the 

extent of the authority delegated to them. Contracting officers shall receive from the 

appointing authority (see 1.603–1) clear instructions in writing regarding the limits 

of their authority. Information on the limits of the contracting officers’ authority 

shall be readily available to the public and agency personnel. No contract shall be 

entered into unless the contracting officer ensures that all requirements of law, executive orders, regulations, and all other applicable procedures, including clearances 

and approvals, have been met. 

175 

ATTACHMENTS FOR QUESTION 9D FOLLOW: 


229q23r1.eps

IL 001AL-09-02 

June 19, 2009 

DEPARTMENT OF VETERANS AFFAIRS 

Deputy Assistant Secretary for Acquisition and Logistics 

Washington, DC 20420 

OFFICE OF ACQUISITION AND LOGISTICS INFORMATION LETTER 

TO: Under Secretaries for Health, Benefits, and Memorial Affairs; Assistant 

Secretary for Management; Director, Office of Construction and Facilities 

Management; Veterans Integrated Service Network Directors; Directors, VA 

Medical Center Activities, Outpatient Clinics, Medical and Regional Office 

Centers, and Regional Offices; Directors, Denver Acquisition and Logistics 

Center, VA Austin Information Technology Center, Records Management 

Center, VBA Benefits Delivery Centers, VA Health Administration Center; 

Executive Director and Chief Operating Officer, VA National Acquisition 

Center; VA Health Revenue Center; VA Health Eligibility Center and Chief 

Information Officer 

ATTN: Heads of the Contracting Activities (HCAs) and Department of Veterans 

Affairs (VA) Contracting Officers (COs) 

SUBJ: Integrated Oversight Process (lOP) 

I. Background 

A. Over the past several months, VA has worked to establish a more fluid, 

less labor intensive oversight process that replaces the traditional 

technical reviews with peer reviews, Contract Review Teams (CRTs), and 

Contract Review Boards (CRBs). The overall goal is to implement an 

oversight process that is efficient in how time and resources are allocated 

and effective by holding COs responsible for building quality during the 

process, rather than after the fact. 

B. By distributing responsibility for reviews, VA will model the best practices 

being used at other federal agencies. This new oversight system 

promotes quality throughout the acquisition cycle and an infrastructure 

that is sustainable over the long-term. It is understood that moving to a 

distributed oversight process represents a significant change to the culture 

within VA. Over the next several months, the Office of Acquisition, 

Logistics, and Construction (OALC) will continue to provide training and 

guidance for COs and Legal Counsel to reinforce and refine this process, 

as necessary. 
176 


229q23r2.eps

2. 

IL 001AL-09-02 

June 19, 2009 

C. Note that legal reviews are part of the oversight process. See 

Attachment 1 for the applicable thresholds. While feedback from Legal 

Counsel is advisory in nature, the CO is urged to adhere to any legal 

advice to prevent unknown violations of law and/or regulation and to 

minimize litigation risks associated with protests and contract claims. If 

the CO decides not to adhere to the Legal Counsel's advice, a justification 

must be provided in the file. Ultimately, the CO is responsible and 

accountable for the quality and accuracy of all contracting packages. 

II. Policy 

A. Effective immediately, reviews for all acquisitions will be conducted within 

each Administration and Veterans Integrated Service Network (VISN) 

operating unit. The role of the Office of Acquisition and Logistics (OAL) 

will be to strategically monitor this process and provide guidance and 

feedback to each buying unit as a means to continuously improve the 

process. In accordance with the IL, each acquisition organization will be 

responsible for conducting reviews. The OAL Risk Management Team 

will mentor, as needed, before packages are sent to the Office of General 

Counsel (OGC), Professional Staff Group (PSG) V or Regional Counsel 

Office. This process will continue until the end of the fiscal year, at which 

time the organizations will work directly with OGC, with no OAL Risk 

Management Team involvement. 

B. The processes described in this Information Letter (IL) and thresholds 

defined in Attachment 1 supersede any policy that currently exists in the 

Veterans Affairs Acquisition Regulation (VAAR) or preceding ILs. 

C. It is the responsibility of each HCA to ensure that the appropriate 

structures and processes are in place to conduct these reviews. See 

section III of this Information Letter for guidance on the composition of 

CRTs and CRBs. 

D. Note that some form of independent review must be done for all 

acquisition actions above the Simplified Acquisition Threshold (SAT). For 

actions above the SAT, but below the CRT thresholds (see Attachment 1), 

peer or second-level reviews will suffice. Under no circumstances shall a 

CO release a solicitation or sign a contract/modification at any value 

unless a peer or second-level review is conducted. Any review comments 

must be documented in the file. 

E. Each HCA, or their designees, will meet monthly with the responsible 

OGC, i.e. PSG V or Regional Counsel to analyze specific review 

comments to identify any systemic issues associated with adherence to 
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3. 

IL 001AL-09-02 

June 19,2009 

policies and procedures. This analysis will be shared with COs to help 

improve performance and to target any remedial training needs. 

III. Major Tenets of the lOP 

A. CRTs - For actions whose life cycle costs fall within the thresholds 

established in Attachment 1, CRTs must be assembled. The CRT will be 

composed of acquisition and legal professionals assigned by the HCA or 

designee and OGC Legal Counsel. The primary purpose of the CRT is to 

ensure that contract files are appropriately documented and the 

acquisition complies with this IL, the Federal Acquisition Regulation, the 

Veterans Affairs Acquisition Regulation (subject to paragraph 2 of section 

II above), and any other VA acquisition policy. To ensure the CRT adds 

maximum value and integrity to the process, it should be composed, to the 

maximum extent possible, of acquisition professionals who are not directly 

involved with the specific acquisition. At least one member of the CRT 

should have a Federal Acquisition Certificate in Contracting at a level 

equal to or greater than the value of the specific procurement. 

CRT Findings 

1. A series of comprehensive guides and checklists have been developed 

to serve as guidance for reviewers to follow. They can be found at the 

Acquisition Resource Center which is contained within the Electronic 

Contract Management System, or eCMS. 

(Please see the following website: 

http://arc.aac.va.gov/Acquisition/Pages/ARCHome.aspx) 

2. The forms in Attachment 3 shall be completed and signed by the CO 

and submitted with the file to the CRT. Review comments from the 

CRT will be given to the CO and inserted into the contract file. The CO 

has the discretion to follow the advice of the CRT and is ultimately 

responsible and accountable for the quality and accuracy of all 

contracting packages. 

B. CRBs - The CRB is responsible for reviewing all acquisitions at the 

solicitation and pre-award phases whose total value is estimated to 

exceed $5 million. The key phases are prior to release of solicitation; 

before commencement of negotiations and prior to award. The CRB 

should be composed of seasoned professionals. 
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4. 

IL 00IAL-09-02 

June 19, 2009 

1. Role of CRB: 

a. Serve as the principals responsible for review of acquisitions above 

$5 million; 

b. Minimize vulnerabilities leading to potential protests, disputes, 

claims, and litigation against VA; 

c. Ensure compliance with established federal and VA acquisition 

policies and procedures; 

d. Provide senior level advice on contracting actions and support to 

the CO; 

e. Provide consistency across VA; and, 

f. Improve the knowledge of VA acquisition personnel as they 

embrace and implement good business practices. 

2. CRB Membership 

Membership should include: 

a. A Chairperson who should be the HCA or senior level designee; 

b. An assigned representative from OGC's PSG V or Regional 

Counsel who are non-voting members; 

c. Technical advisors who may be appointed by the CRB chair to 

inform on technical matters, as they are non-voting members. 

3. Exceptions to CRB 

Pre-award CRB reviews are not required for proposed Federal Supply 

Schedule (FSS) awards at the National Acquisition Center. The 

standard pre-award review process for proposed FSS awards will 

apply. 

4. Waivers for CRB 

The HCA may: 

a. waive any CRB requirement included herein; or, 
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5. 

IL 00IAL-09-02 

June 19,2009 

b. require a CRB for any contract action not identified in this policy. 

(Note: For any waiver granted under clause "a" above, the HCA must 

document the file detailing each rationale for the waiver.) 

5. CRB Process 

a. The CO will prepare a pre-solicitation or pre-award package and 

submit it to the designated Chairperson. This package should 

include all pertinent documents, including, but not limited to, the 

solicitation or proposed contract, acquisition plan, and price 

negotiation memorandum. 

b. The Chairperson of each CRB will conduct a "Go/No Go" review to 

determine if the package contains all the required documents. If 

the submission does not pass this initial review, the Chairperson 

will notify the submitting CO of the specific deficiencies before 

scheduling a full CRB review. 

c. After accepting the documentation, the Chairperson will schedule a 

meeting of the CRB at the earliest opportunity. 

d. In the event that the CRB identifies the need for mandatory 

corrective action, the Chairperson will advise the CO not to proceed 

until the corrective action is taken. 

e. The cognizant CO will annotate the file to explain the disposition 

of both mandatory and advisory CRB finding. Written responses 

to the CRB are required for mandatory findings only. The CO 

may be required to resubmit all or part of the package as directed 

by the CRB. Awards may not be made until mandatory findings 

are implemented. 

6. CRB Findings (See Attachment 2) 

a. CRB findings are categorized as mandatory or advisory. The CO 

must address mandatory findings. The CO must advise the CRB in 

writing, within three business days (or such longer period granted 

by the Chairperson in writing) after receipt of CRB mandatory 

findings, of the corrective action taken for each finding. 

b. Each CRB may provide advisory findings. The CO must annotate 

the file as to the disposition of advisory findings. 
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6. 

IL 001AL-09-02 

June 19, 2009 

c. Submitted documentation must include all previous CRB comments 

including the corrective action the CO took to address all findings. 

d. Awards may not be made until the CO addresses all pre-award 

findings. 

IV. Legal Reviews 

For acquisition actions whose total value (including options) falls within the 

dollar ranges established in Attachment 1, a legal review is required. The 

primary purpose of this review is to ensure that the action fully complies with 

applicable laws and regulations. While feedback from Legal Counsel is 

advisory in nature, the CO is urged to adhere to any legal advice to prevent 

unknown violations of law and/or regulation and to minimize litigation risks 

associated with protests and contract claims. 

If the CO decides not to adhere to the Legal Counsel's advice, a justification 

must be documented in the file. Ultimately, the CO is responsible and 

accountable for the quality and accuracy of all contracting packages. 

V. Pont of Contact 

Please direct questions regarding the new oversight process to Division of 

Risk Management and Compliance (001AL-P3) at (414) 902-5405. 

Maurice C. Stewart 

Associate Deputy Assistant Secretary for 

Acquisition & Logistics Programs and Policy 

Attachments (3) 
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7. 

IL 00IAL-09-02 

June 19, 2009 

Attachment 1-

Intearated Oversiaht Process 

Action Contract Review 

Teams (CRTs) 

(a) Supply or service solicitations or request for $1 millionquotations (except as listed below or provided $5 million 

in VAAR 801.602-72 through VAAR 801.602-

75) (includes indefinite delivery, option year, 

and multi-year solicitations or RFOs 

(b) If Supply or service procured is a $500,000-

consolidated acquisition activity performing $5 million 

acquisitions for three or more physically 

separated VA medical centers (excluding 

outpatient clinics) 

(c) Fixed price, sealed bid construction $2 millionsolicitations, construction solicitations other $5 million 

than 8(a) construction solicitations 

(d) 8(a) construction solicitations and task $2 millionorders $5 million 

(e) Request for Proposal (negotiated) $1.5 millionconstruction solicitations and task orders $5 million 

(f) Solicitations or RFOs for proposed (f)(1) 

task/delivery orders against basic contracts, CRT is 

GWACs or blanket purchase agreements not required 

(includes orders under Federal Supply 

Schedule contracts*) (f)(2) 

$1 million-

(1 ) Where price is the only factor $5 million 

(2) Which include non-price evaluation factors 

(3) Which include services (f)(3) 

$1 million-

* Exceptions include High Tech Medical $5 million 

Equipment 

(g) Solicitations for cost-reimbursement, $100,000 -

incentive, time-and-materials, and labor-hour $5 million 

contracts (see VAAR 816.102(b)) 

(h) Utility service agreements $100,000 -

$5 million 

(i) Solicitations for advisory and assistance $100,000 -

services (see VAAR 837.2) $5 million 

U) Proposed letter contracts and ensuing $100,000 -

formal Contracts $5 million 

Legal Review CRB 

Thresholds 

$500,000- > $5 million 

$5 million 

$500,000- > $5 million 

$5 million 

$2 million- > $5 million 

$5 million 

$2 million- > $5 million 

$5 million 

$1.5 million- > $5 million 

$5 million 

(f)(1) > $5 million 

Legal Review 

not required 

(f)(2) > $5 million 

$1 million-

$5 million 

(f)(3) > $5 million 

$1 million-

$5 million 

$100,000 - > $5 million 

$5 million 

$100,000 - > $5 million 

$5 million 

$100,000 - > $5 million 

$5 million 

$100,000 - > $5 million 

$5 million 
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8. 

IL 00IAL-09-02 

June 19,2009 

Action 

(k) Any Proposed agreement that is unique, novel 

or unusual 

(I) Documents relating to Bonds FAR 28.102-1 

FAR 28.203 

(m) Solicitations or proposed contracts containing 

an economic price adjustment clause (other than 

a pre-approved V A clause) based on a cost index 

of material or labor or where one of the economic 

price adjustment clauses specified in FAR 

16.203-4 is used 

(n) Proposed multi-year contracts where the 

cancellation ceiling exceeds 20% of the contract 

amount, regardless of the dollar value of the 

proposed contract (VAAR 817.105-1(b)) 

(0) Proposed solicitations where the contract 

term total of the basic and option periods may 

exceed 5 years, regardless of the dollar value of 

the proposed acquisition (VAAR 817.204). 

(p) Membership agreements in a group 

purchasing organization 

(q) Request a legal review if a proposed 

termination settlement or determination of 

amounts due the contractor under a terminated 

contract involves the expenditure of $100,000 or 

more 

(r) Consignment agreements with an anticipated 

expenditure of $250,000 or more per year 

(except under an FSS contract) 

(s) Proposed contract with hotels or similar 

facilities for conferences or similar functions 

where VA's commitment, expenditure and liability 

(combined) exceed $25,000 

(t) Requirements for scarce medical specialist 

contracts and contracts for health-care resources 

under 38 U.S.C. 7409 or 38 U.S.C. 8153: 

Competitive solicitation, quotation, proposed 

contract or agreement with an anticipated 

value of >$1.5M including options. 

Each non-competitive solicitation, quotation, 

proposed contract, or agreement with an 

anticipated value of or > $500,000. 

Contract Legal Review CRB 

Review Teams Thresholds 

(CRTs) 

All All > $5 million 

All All 

All All > $5 million 

All All > $5 million 

All All > $5 million 

$25,000 $25,000 

-- $100,000 

$250,000 $250,000 > $5 million 

$25,000 $25,000 > $5 million 

$1,500,000 $1,500,000 > $5 million 

$500,000 $500,000 > $5 million 
183 


229q23r9.eps

(u) 

(v) 

9. 

IL 00IAL-09-02 

June 19, 2009 

Action 

Mistakes in Bids 

Modifications (except for priced options) 

1) When modification is $100,000 or more 

(i) Construction 

(ii) Supplies andlor Services 

2) When the modification is for a time 

extension of 60 days or more. 

3) When the contractor takes exception to 

VA's accord and satisfaction language. 

4) Novation 

5) Change-of·name agreement 

(w) Assignment of Claims 

(x) Interagency Acquisitions (lAs) 

1) Each proposed V A Central Office IA 

with another Federal agency to be 

awarded under authority of the 

Economy Act, regardless of dollar 

value. 

2) Each proposed VA field facility IA with 

another Federal agency awarded 

under authority of the Economy Act 

involving an anticipated expenditure of 

VA funds of $250,000 or more. 

Contract Review Legal Review CRB , Teams (CRTs) Thresholds 

All All 

All All > $5 million 

$100,000 $100,000 

All All 

All All 

All All 

All All 

All All 

All All > $5 million 

$250,000 $250,000 >$5 million 
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PAGE 1 OF2 ATTACHMENT 2 

CONTRACT REVIEW BOARD (CRB) SUMMARY SHEET- ACTIONS ABOVE $5 MILLION 

DESCRIPTION 

Of SUPPLY 

ORSERVICE 

CUSTOMER 

OTHER 

COMPETITION 

{FAR P.rt 6) 

CONTRACT 

TYPE 

{FAR P.rt 16j 

SPECIAL PROVISIONS 

SOLICITATlON 

PRE·NEGOTIATIONS 

PRE·AWARD 

APPROVE 

SIGNATURESIOATES 

SOLICITATION PRE-NEGOTIATIONS PRE-AWARD 

Administration: 

[ IVHA: VtSN __ _ MC __ _ 

VBA VACO NCA 

[I Supply 

[I Service* 

( IA&A 

[ I Full &Open 

App. FAR Part: 

Fixed·Price: 

( I Firm Fixed-Price 

[ I FP/EPA [I FPI 

FPILOE 

Office: Program Manager: 

SoHcitationNo: 

Estimated Amount: 

tssuanceDate: 

Closing Date: 

Contracting Officer: 

'If Service. is this a Performance-Based Acquisition (PBA)? [I Yes [1 No If no, 

why not? 

[ I Set-Aside: 

Type: 

App. FAR Part: 

Cost Reimbursement: 

[ICPIF [ICPAF 

[ICPFF [ICost 

Sharing 

[ ] Other than F&O 

Type: 

App. FAR Part: 

Incentive: 

[ICost [I Delivery 

[ I Price (Award Fee) 

Performance 

[ I GSAFSS: 

Schedule: 

App. FAR Part: 

Indefinite Delivery: 

[ IIDIIQ 

[ I Requirements 

Min Qty: 

~~~~~; Number of Firms Solicited Date Published in Date of Pre·proposal Cont. Dale Due Diligence Held 

(if other than F&O): Fed8izOpps: (if applicable): (if applicable): 

Number of Offers 

Received: 

Date Negotiations 

Completed: 

SOLICITATION 

PRE-AWARD 

Date Tech Eval Received: Number in Competitive 

Range 

(if applicable): 

Final Proposal Revisions Proposed Awardee or 

Received: Awardees: 

CRB CHAIR SUPERVISORY 

CONTRACT SPECIALIST 

Proposed Award 

Amounl(s): 

GENERAL COUNSEL 

Award Date: 

Contract Specialist: 

POP: 

[ I Commercial Item 

App. FAR Part: 

Other: 

(IT&M [I LH 

[I Letter []BOA 

Ceiling: 

Date Offers Received: 

Proposed Award Date: 

PROCUREMENT 

ANALYST 

CONTRACT REVIEW BOARD (CRB) SUMMARY 

SHEET, PAGE 2 OF 2 

MANDATORY FINDINGS ADVISORY FINDINGS 
185 

e. Does the Federal Government (VA, Office of Personnel Management, etc.) provide coaching services which would train Federal employees to improve their customer service skills? If so, please describe the program(s) in detail. 

Response. At VA, Veterans are our customers. Across our organization we are focused on improving the customer service we provide to Veterans, their families and 

their survivors. At the Department level, VA provides coaching services for the development and enhancement of executive leadership skills. This coaching heightens 

the awareness and emotional intelligence of leaders, which in turn yields better outcomes for customers, employees, and the organization at-large. VA Executive coaching is available to newly appointed Senior Executive Service (SES) members and existing SES who have taken on a new responsibility level. Coaches are affiliated with 

the Center for Creative Leadership, and have many years of experience working 

with executives and leaders from a variety of organizations (public and private). Additionally, there are several opportunities for coaching embedded in VA Learning 

University sponsored training. 

More broadly, in 2011 the Department announced VA Core Values and Characteristics that apply universally across all of VA. The Core Values are the basic elements of how we go about our work—they define ‘‘who we are’’—and form the unVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00191 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN

229q23r12.eps 229q23r13.eps
186 

derlying principles we use every day in our service to Veterans. The Core Characteristics define ‘‘what we stand for’’ and what we strive to be as an organization. The 

Values are Integrity, Commitment, Advocacy, Respect and Excellence (‘‘I CARE’’). 

The Core Characteristics help guide how we will perform our core mission; they 

shape our strategy, and will influence resource allocation and other important decisions made within VA. The Characteristics are Trustworthy, Accessible, Quality, 

Agile, Innovative, and Integrated. 

A few examples of the many ways VA focuses on customer service are included 

below. 

In VBA, all call center agents are required to complete a telephone techniques 

training program. This program focuses on effective customer service and active listening skills, acknowledgement of customers’ feelings, and effective call management techniques. Call center agents also complete call simulations training, which 

allows the agents to apply their skills via role playing scenarios. As part of VBA’s 

standard quality review process, all call center agents receive a monthly coaching 

session where they are provided feedback on their technical proficiency and how 

they can continue to strengthen client contact behaviors. 

In the National Cemetery Administration (NCA), the National Training Center 

trains leaders and technical experts in operational standards and measures to ensure our Nation’s veterans and their families are honored with dignity and respect 

and a final resting place and lasting memorial. Customer service is also an integral 

part of NCA training programs. NCA incorporates customer service modules into the 

design for every mission-critical occupation, such as the NCA Caretaker Training, 

the Foreman Training and the Cemetery Representative Training Programs. These 

programs focus on assessing employee proficiency in customer service basics, convey 

the importance of exceeding expectations, and offer practical applications illustrating the role of the NCA employees in providing Veterans and their families with 

the highest level of customer service. 

In VHA, the employee-customer (patient) relationship is at the heart of the Patient Aligned Care Team (PACT) transformational initiative. Four regional PACT 

teams, comprised of patient-centered care consultants, will facilitate the culture 

change for patient-centered care at all VA facilities across the country, within their 

designated region. These teams will not only serve as consultants, but will also conduct training with local staff on the implementation of patient-centered principles. 

Finally, the VHA ‘‘Treating Veterans with I.C.A.R.E.’’ program is designed to enhance the ability of staff to communicate effectively and compassionately with Veterans in health care settings. Emphasis is placed on how to connect with the Veteran, appreciate their position as a customer, respond appropriately with care and 

empathy, and empower the patient. This training has standardized materials including facilitator guides and is designed to be delivered at VA facilities. 

VA defers to OPM and other Federal Departments to discuss details of executive 

branch-wide coaching and customer service training. 

Question 10. In response to questions about VA’s fiscal year 2012 budget request, 

VA indicated that, ‘‘[a]t the end of FY 2010, VA’s total outstanding delinquent debt 

was $1.3 billion’’ and that, of that amount, ‘‘$784 million was attributable to delinquent benefit debts.’’ 

a. What was the total amount of outstanding delinquent debt at the end of fiscal 

year 2011? 

Response. Based on the Treasury Report on Receivables (TROR) the total outstanding delinquent debt for FY 2011 was $1.2 billion. 

b. What portion of that amount was debt created in connection with VA benefit 

payments? 

Response. Based on the TROR benefit debt at the end of FY 2011 was $732 million. 

c. What is the total value of debts for which VA waived recoupment during fiscal 

year 2011? 

Response. In FY 2011 VA wrote off or waived a total of $247 million. 

d. What is the total value of debts deemed uncollectible during fiscal year 2011? 

Response. The total of all uncollectible debts is $1,198,614,941.11. 

e. What is the total amount of delinquent debt projected to be outstanding at the 

end of fiscal year 2012? 

Response. We do not have a way to provide an estimate of the future predicted 

debt level for delinquent debt. However, we can provide an estimate for new debt 

established. For FY 2012, we expect to establish $1.46 billion in new debt. 

f. What is the total amount of delinquent debt projected to be outstanding at the 

end of fiscal year 2013? 

187 

Response. We do not have a way to provide an estimate of the future predicted 

debt level for delinquent debt. However, we can provide an estimate for new debt 

established. In FY 2013 we expect to create $1.48 billion in new debt. 

Question 11. For fiscal year 2013, VA projects to spend $76.4 billion in mandatory 

funding. According to VA’s budget request, that funding will, in part, be used to pay 

for items such as medical examinations, state approving agencies, awards under the 

Equal Access to Justice Act (EAJA), and reimbursements to the General Operating 

Expenses account for certain costs of administering VA benefit programs. 

a. In total, how much of that mandatory funding will be spent other than in the 

form of direct benefits paid or provided to veterans, their families, or their survivors? 

Response. For FY 2013, approximately $273.1 million, or 0.42 percent, of the 

$61.7 billion for the compensation and pension mandatory account is for non-direct 

benefits paid for Veterans and survivors. Over 99 percent of total obligations in compensation and pension mandatory funding is attributed to direct benefit payments. 

For FY 2013, $32.3 million, or 0.26 percent, of the $12.6 billion dollar appropriation requested for the readjustment benefits account is expected to be spent on nondirect benefits provided to Veterans, their families, or their survivors. Over 99 percent of readjustment benefits mandatory funding is for direct benefits paid or provided to Veterans and their families, survivors, and institutes of higher learning. 

b. Of that total, please identify how much would be spent for each category of nonbenefit payments, such as the amounts that would be spent on information technology, on contractor services, or on personnel expenses. 

Response. For the compensation and pension account, the $273.1 million in nondirect benefit payments is outlined below. 

• $250.6 million for Medical Exam Pilot Program: Public Law (P.L.) 104–275 authorizes VA to carry out a pilot program over 10 regional offices for examinations 

with respect to medical disability of applicants performed by persons other than 

VA employees. 

• $13.3 million for Equal Access to Justice Act payments: Public Law 99–80 authorizes the award of attorney fees and other expenses to eligible individuals and 

small entities that prevail against the government in civil actions for judicial review of agency action. 

• $9.2 million for OBRA: The OBRA Act of 1990, Pub. L. 101–508 authorizes VA 

to perform data matches with the Internal Revenue Service and Social Security 

Administration to ensure proper payments are made to eligible beneficiaries. 

For the readjustment benefits account, the $32.3 million in non-direct benefit payments is outlined below. 

• $19.0 million for State Approving Agencies: Pub. L. 110–252 increased the maximum funding level for State Approving Agencies to $19.0 million. State Approving Agencies assess whether schools and training programs are of appropriate 

quality for Veterans to receive VA education benefits while attending them. 

• $12.8 million for Reporting Fees: Reporting fees are paid by VA to educational institutions for each person enrolled who is participating in a VA education program. Pub. L. 111–377 increased the reporting fee rates from $7 to $12 per enrolled veteran or $11 to $15 per enrolled veteran if educational assistance checks 

are in temporary custody of an institution. 

• $0.5 million for Reimbursement to General Operating Expenses (GOE): Pub. L. 

101–237 and Pub. L. 105–368 authorized reimbursement for GOE expenses related to outreach and distribution of information to Veterans regarding education 

benefits. 

OFFICE OF INFORMATION AND TECHNOLOGY

Question 1. The Office of Information and Technology (OIT) has outlined 16 major 

transformational initiatives developed to support the Secretary’s goal ‘‘to transform 

the Department of Veterans Affairs*** into a high performing 21st century organization.’’ 

a. What is the total amount VA expects to spend on developing these 16 major 

transformational initiatives? Please breakout the funding by initiative. 

Response. The Office of Information and Technology (OIT) provides support to 

each of the Secretary’s 16 Major Initiatives. For FY 2013, VA has requested 

$376,810,000 for development. The breakdown of the development budget by Major 

Initiative is reflected in the table below. 

188 

FY 2013 Budget Submission 

(in thousands of dollars) 

Major Initiative Development Marginal 

Sustainment 

Major 

Initiative 

Total 

MI 01—Eliminate Veteran Homelessness .................................................................... 3,075 879 3,954 

MI 02—Veterans Benefits Management System (VBMS) ............................................ 38,525 53,728 92,253 

MI 03—Automate GI Bill Benefits ...............................................................................

MI 04—Virtual Lifetime Electronic Record (VLER) ...................................................... 49,939 3,000 52,939 

MI 05—Improve Veterans Mental Health .................................................................... 8,818 310 9,128 

MI 06—Veterans Relationship Management (VRM) .................................................... 99,439 11,486 110,925 

MI 07—New Models of Health Care (NMHC) ............................................................... 35,724 1,101 36,825 

MI 08—Enhance the Veteran Experience and Access to Health care (EVEAH) .......... 67,816 3,934 71,750 

MI 09—Ensure preparedness to meet emergent national needs ............................... 3,025 11,490 14,515 

MI 10—Enabling Systems to Drive Performance and Outcomes (STDP) .................... 4,062 100 4,162 

MI 11—Integrated Operating Model (IOM) .................................................................. 20,065 13,625 33,690 

MI 12—a Human Capital Investment Plan (HCIP) ..................................................... 14,640 1,000 15,640 

MI 13—Research & Development (R&D) ..................................................................... 18,521 3,665 22,186 

MI 14—Strategic Capital Investment Planning (SCIP) ............................................... 1,000 3,162 4,162 

MI 15—Health care Efficiency ..................................................................................... 4,659 2,000 6,659 

MI 16—Health Informatics .......................................................................................... 7,500 1,656 9,156 

Total ..................................................................................................................... 376,808 111,136 487,944 

b. When does VA expect to see these projects moved from the development stage 

to activation? 

Response. Each Major Initiative contains a unique set of projects that provide the 

functionality envisioned by the initiative. Five of the Major Initiatives are scheduled 

to accomplish their transformational goals in FY 2012 (GI Bill/IVMH/STDP/R&D/ 

SCIP). 

For each project supporting an initiative, and based on PMAS principles, customer 

facing functionality is delivered to the customer in increments on a 6-month or less 

basis. Complete project transition from a development state is uniquely determined 

by each project’s defined scope of requirements. 

c. Once these projects become activated, what will be the costs associated with operating and maintaining these projects? 

Response. For FY 2013, Product Development, under the Major initiative con- struct, has budgeted $111 million for the incremental transition of projects to activation. The marginal sustainment by Major Initiative is reflected in the chart above. 

d. For each of the 16 major transformational initiatives, please provide the Committee with a detailed description of each of the information technology (IT) products, software, or other items that would be the end result of each initiative. 

Response. The following list of projects and deliverables is not an exclusive list. 

These are some of the key IT projects managed under the initiatives, although some 

projects may not be listed. This list of deliverables does not include non-IT projects 

and deliverables for the initiatives. 

1. Eliminate Veteran Homelessness (EVH) 

• Handheld device pilot for use by Homeless Program case and outreach workers. 

– This will provide users the ability to track Veterans receiving assistance. 

Deliverables will include the capability of accessing other VA applications to 

scheduling, clinical ancillary programs and mental health via the use of the 

handheld device. • The Web-management Toolkit for the Department of Housing and Urban Development—VA Supported Housing (HUD-VASH)—completed in FY 2012. 

– Provides case managers and Veterans access to on-line resources that will 

help attain and maintain permanent Veteran housing, general information, 

best practices and program specific data to providers and will be expanded 

to cover other Homeless Programs. 

• Homeless Operations and Management Evaluation System (HOMES)— 

– Completed in FY 2012. Performs case management and tracking functions for 

the Homeless Program 

• In FY 2013, the Homeless Repository will also expand its two-way interface to 

more entities and provide those entities with up-to-date Veteran information. The 

information shared by VA then will be used by those entities to address homeless 

Veteran benefit gaps. 

189 

• Veteran Re-Entry Matching Service project—collecting and processing information 

about incarcerated Veterans designed to address community reentry needs of incarcerated Veterans by preventing homelessness. 

– Reduces the impact of medical, psychiatric and substance abuse problems 

upon community readjustment to decrease the likelihood of re-incarceration. 

2. Veterans Benefits Management System (VBMS) 

VBMS deployment is occurring in phases. 

• Phase 1 was deployed in November 2010 and completed in May 2011. 

– Phase 1 utilized a new electronic claims repository and scanning solution, as 

well as new claims processing software integrating with elements of the current legacy platform. 

• Phase 2 was deployed in May 2011 and completed in November 2011. 

– Phase 2 validated and refined the VBMS technology solution, as well as provided additional business requirements for future technology releases. 

– In addition, Phase 2 increased system capacity by adding more users, stations, claims, and claim types. 

• In August 2011, VBA began implementing transformation initiatives to drive consistency, standardization, and improvement in delivery of benefits. 

– VBMS is one of the technology solution components enabling all claims to be 

completed within 125 days at 98 percent accuracy by 2015. 

• VBMS Major Release 2 was deployed in November 2011. 

– Major Release 2 enhanced user interface, claims’ establishment, and rating 

capability. 

• VBMS Major Release 3 is scheduled to deploy in July 2012 in support of national 

deployment. 

• Subsequent major and minor software releases are scheduled through FY 2014. 

3. Automate GI Bill Benefits 

Since March 2010, Long Term Solution (LTS) has been incrementally developed 

to provide Post-9/11 GI Bill benefits in a timely and effective manner. 

• Release 1.0 of the LTS, deployed on March 31, 2010, provided calculations for 

chapter 33 eligibility, entitlement, and delimiting date as well as calculations for 

chapter 33 awards (with no amendments) including calculation of tuition and fees, 

Yellow Ribbon, housing, books and supply, chapter 30 kicker, chapter 1606 kicker, 

and calculations for intervals between terms. Interface with VADIR system (VA’s 

internal database of military data) included. 

• Release 2.0, deployed June 30, 2010, added capability to process amended awards 

to comply with existing requirements in title 38, chapter 36. Interface with 

WEAMS (system that records school approval data) included. 

• Release 2.1, deployed August 23, 2010, provided for a data conversion from the 

FET (Front-End Tool) system, initially used to calculate chapter 33 benefits. All 

chapter 33 claims processed in LTS effective R2.1. 

• Release 3.0, deployed October 30, 2010, added interface with VAONCE (the system schools use to report enrollment and changes of enrollment). 

• Release 4.0, deployed December 20, 2010, provided interface with the chapter 33 

BDN system (the payment system for chapter 33). Included initial claimant selfservice (via eBenefits). 

• Release 4.2, deployed on March 5, 2011, provided functionality to implement 60- 

day requirement deadlines contained within Pub. L. 111–377. 

• Release 5.0, deployed June 4, 2011, implemented numerous additional provisions 

of Pub. L. 111–377 and also provided a scheduling feature for housing payments. 

• Release 5.1, deployed October 17, 2011, completed the functionality required to 

address Pub. L. 111–377 including calculation of benefits for training at non-degree schools, correspondence schools, flight schools, and for apprenticeship and onthe-job training. 

• Release 5.11, deployed on December 19, 2011, enhanced the processing of student 

debt management issues caused by the implementation of the tuition and fee payment cap required by Pub. L. 111–377. 

• Release 5.2, deployed on February 21, 2012, was a technical release to prepare for 

automation in Release 6 and to address system and security requirements that 

were previously deferred. 

• Release 6.0, scheduled for July 30, 2012, will provide end-to-end automation of selected supplemental claims without human intervention. • FY 2013 activities will include knowledge transfer and continuation of activities 

for full sustainment, as well as, subject to additional funding, development of user 

functionality for continued enhancements to the LTS system. 

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4. Virtual Lifetime Electronic Record (VLER) 

Deliverables for VLER are explained in the context of the following four focus 

areas: 

• Nationwide Health Information Network (NwHIN) 

a. The key to sharing critical health information is pushing for interoperability 

and utilizing the NwHIN standards, allowing agencies like VA and DOD to partner 

with private sector health care providers to promote better, faster and safer care 

for Veterans. 

• Warrior Support 

b. The VLER Warrior Support Projects ensure that information is available to end 

users in a timely fashion to support Integrated Care for Servicemembers and Veterans of Operation Enduring Freedom, Operation Iraqi Freed and Operation New 

Dawn and severely ill and injured Servicemembers and Veterans 

• Memorial Affairs Modernization 

c. Designed in the 1990s, modernizing and redesigning the Memorial Affairs Burial Operations Support System (BOSS) will allow VA the flexibility to adapt to current needs and improve overall stability of the platform and consistency of services 

it provides to Veterans and their families at over 180 locations including 131 VA 

National Cemeteries. 

• Health Information Technology Sharing 

d. In 2011, the Bidirectional Health Exchange (BHIE) interface implemented an 

application that enables VA providers to select for viewing DOD neuropsychological 

assessments and imagery from the DOD Healthcare Artifact Information Management System. BHIE also implemented updates to an existing application to enable 

VA clinicians to view DOD inpatient notes. BHIE currently is supporting approximately 450,000 monthly health information exchange queries from VA to DOD, at 

a rate of over five million per year. 

5. Improve Veterans Mental Health 

In FY 2012, deliverables include: 

• Deployment of software to track patients at high risk of suicide; 

• Software to identify a patient’s principal mental health provider to all medical 

staff treating the Veteran; 

• Deployment of a number of mental health assessment tools to ensure sufficient 

information is collected during patient assessments to make good clinical decisions; and 

• Deployment of goal setting module in My HealtheVet. 

In FY 2013, deliverables include: 

• Provide a tool for clinicians to assign and distribute assessment instruments for 

evaluating the mental health condition of a Veteran based upon that Veteran’s 

unique treatment and service needs; 

• Adopt a tool to conduct structured assessments that is used to manage and evaluate mental health care within primary care settings; and 

• Implement a tool to allow the identification of at-risk Veterans so that proper care 

may be given at VA health care facilities. 

6. Veterans Relationship Management (VRM) 

In FY 2012, the VRM initiative made a number of important achievements that 

will be leveraged into the next fiscal year. 

• VONAPP Direct Connect (VDC) 1.0 provides Veterans the ability to apply for VBA 

benefits by answering guided interview questions through the security of the 

eBenefits portal. Introduced in VDC release 1.0 were guided interviews for the 

Declaration of Status of Dependents and Request for Approval of School Attendance. 

• Virtual Hold and Scheduled Call Back technology was successfully deployed for 

all VBA National, Pension, and Education call centers. Virtual Hold allows callers 

to hang up rather than wait on hold and be automatically called back without losing their position on the call queue. Scheduled Call Back enables callers to schedule a returned call up to 7 days in advance. 

• The VRM Customer Relationship Management/Unified Desktop (CRM/UD) was 

deployed at the VBA National Call Center (NCC) in St. Louis. CRM/UD improves 

the VBA NCC business processes by capturing caller history, which facilitates 

first contact resolution, and aids in personalizing service to Veterans. CRM/UD 

streamlines data access by providing a single, unified view of VA clients through 

one integrated application versus the current process that requires Public Contact 

Agents to access up to 13 applications. 

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• Interactive Voice Response (IVR) enhancements were introduced allowing VBA to 

re-record IVR information as needed, eliminating the need to place change orders 

with the vendor. Recent changes to the recordings provided a simplified IVR for 

callers seeking agent assistance and enhanced the self-service function to include 

providing payment information for Education Chapter 33 participants. • Multiple releases expanded the existing self-service features available via the 

eBenefits portal. New functionality includes the ability to login with a DS Logon 

using a smart phone, status of an appeal at the Board of Veterans’ Appeals 

(BVA); access to Post-9/11 GI Bill enrollment status and enhanced claims status 

features, and VA payment history. • The framework for the Stakeholder Enterprise Portal (SEP) was delivered and 

will provide a secure, consistent, and seamless entry point to VA web-based systems and self-service functions for VA’s stakeholders and business partners providing services on behalf of Veterans. • In addition, VRM has implemented the ability to assign a VA identifier to active 

duty military personnel at VA facilities. This minimizes inaccuracies in identifying a Veteran and decreases the number of duplicate records. • Critical components of VRM are directed at improving telephone services through 

integration of new telephony technologies. 

7. New Models of Health Care (NMHC) 

• This portfolio of multi-year programs is designed to transform the delivery of 

healthcare within VA and to position VA as a leader in the healthcare industry 

through innovations for both Veterans and providers. 

• To help facilitate the redesign of primary care, the Primary Care Management 

Module will be reengineered to create a national database identifying all members 

of the PACT and tracking of all patient care providers, both VA and non-VA. 

• Specialty Care has completed a Multiple Sclerosis Home Automated Telemanagement (MS Hat) pilot project providing MS patients a way of monitoring their rehabilitation, providing patients with tele-rehabilitation, and tracking patient 

progress in real time. 

• VA is developing software to track and report abnormal test results and is also 

developing a Breast Cancer Clinical Case Registry to provide immediate access to 

breast cancer screening results. 

• To alert providers of pregnancy and lactation status when prescribing potentially 

unsafe medication drugs, VA is developing a notification tool of teratogenic medications within the Computerized Patient Record System (CPRS). 

• My HealtheVet (MHV) is a forward-facing web portal that helps replace a visitbased, hospital-centric model with a Veteran-centric health care model. Capabilities enhancements have been developed to support web-based tools to help Veterans, their families, and care providers increase their knowledge of health conditions, better manage their personal health records, and communicate with health 

care providers in a secure online environment. 

• The MHV Secure Messaging project improves the clinician-patient relationship by 

providing patients and clinicians with the ability to send non-urgent, secure messages without using email and risking the exposing confidential information. 

• The MHV Online Viewing Personal Health Record (PHR) project will allow Veterans to view and manipulate portions of their PHRs downloaded from VistA or 

self-entered. As a result, Veterans’ ability to manage their care will be improved 

and their PHRs will contain information from a broader range of VA services delivered. Providers are more likely to engage and adopt tools containing comprehensive health information which can be integrated into CPRS. 

• The MHV and eBenefits Portal Integration (MHVEB) project will provide VA a 

Single Sign-On (SSO) capability for MHV. The SSO functionality will allow users 

to sign on to the MHV portal from another eAuthentication-enabled portal, as well 

as to sign on to another eAuthentication-enabled portal from the MHV portal. 

• The MHVEB project will leverage DOD DS Logon Level 2 credentials to provide 

an SSO capability from eBenefits. Users can map their eBenefits account to their 

VA Patient MHV account to seamlessly navigate to and from their MHV account 

• The VistA Imaging Enhancements project is part of the VA System of Records for 

maintaining electronic medical images and scanned documents. Work includes 

providing functionality for capturing, storing, and retrieving images for clinical 

use; and promoting VistA interoperability with commercial medical devices and 

the delivery of all patient images to clinicians in any facility. 

• Various mobile applications are in development, including the pilot testing for the 

Clinic-in-Hand project which allows VA the ability to exchange health-related 

data with Veterans and their family caregivers using mobile healthcare applications designed to provide support and improve Veteran health though intervenVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00197 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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tions targeted at disease management and prevention. Other mobile applications 

in development include Mobile Blue Button, Provider Mobile Apps, hi2 Patient 

Medication Reconciliation, and a VA Information Application. 

• The Enterprise Mobile Applications project will develop a distributed mobile applications development and production environment to reduce development time, 

improve code quality, reduce risk to source systems, reduce application cost, and 

provide objective metrics. 

• The Clinical Video Teleconferencing (CVT) project will develop a national CVT 

scheduling system to ensure resources at both ends of a telehealth visit for Veterans and healthcare providers are coordinated with patients across different 

VistA scheduling systems and to provide for workload capture. 

• The Home Telehealth Capability Enhancements project will use home telehealth 

technologies to support Veterans in non-institutional care settings, thereby reducing hospital admissions, clinic visits, and emergency room attendances, and improving the quality of care and standard of living for Veterans. 

• The Document and Ancillary Imaging application involves imaging functionality 

for document imaging, management, and integration to the medical record, in 

order to allow clinicians to view high-quality images and documents. 

• The Health Risk Assessment project will deliver the Veteran a systematic approach to collecting information that identifies risk factors, provides individualized feedback and links the Veteran with at least one intervention to promote 

health, sustain function, and prevent disease. 

• The National Teleradiology Program (NTP) Enterprise Infrastructure Engineering 

project will add fault tolerance to existing network infrastructure to improve network uptime and minimize interruption of service in the operation of NTP’s mission to provide convenient and cost-effective radiologic image interpretation service for VA facilities. 

• The Patient Advocacy Database will help patient advocates by feeding information 

into their tracking database from the VA Inquiry Routing and Information System. 

• The Resident Assessment Instrument/Minimum Data Set is used to assess residents of long-term care facilities, guide the development of individualized care 

plans, evaluate the quality of care provided, and determine workload and Veterans Equitable Resource Allocation reimbursements. This project will develop 

software to improve clinical relevance of assessment items, and improve reporting 

and quality measures. 

• The VA/DOD Image and Scanned Document Sharing Phase 1 project will provide 

the capability to scan, store, and display DOD records that are not electronic so 

they can be viewed by VA practitioners in CPRS and will enhance VistA Imaging 

to allow viewing of DOD radiology images and scanned document files. 

8. Access to Healthcare 

Deliverables will focus on the following areas of Healthcare Access: 

• In FY 2011, Rural Health created an automated eligibility determination for program-eligible Veterans within the Electronic Medical Record via a clinical reminder, which notifies staff when an eligible Veteran presents for VA services. 

– In FY 2012, Rural Health staff will be provided the ability to manually establish eligibility within the Electronic Health Record and the ability to generate 

reports from the electronic health record for internal and mandated Congressional reports. 

• During FY 2011, Veteran Point of Service Kiosks were activated at four pilot 

sites. Since pilot site activation, kiosks have successfully checked-in over 90,000 

patients. 

– During FY 2012, kiosk devices will be deployed to remaining VISN medical 

centers and designated Community Based Outpatient Clinics. 

– During FY 2013, enhanced interfaces with authoritative information systems 

will be released to improve read/write data capabilities and streamline facility staff management of kiosk processes and Veteran responses submitted 

through the kiosks. 

• In FY 2011, the Emergency Department Integration System (EDIS) v1 and Bed 

Management Solution (BMS), Class III, were deployed VA-wide. In FY 2012 and 

FY 2013, both EDIS v2 and BMS v1 will provide enhanced system capabilities reducing bed wait times, increasing patient information available to the health care 

providers, and integrating a full inpatient flow system. 

– In FY 2012, initial deployment of an enhanced and fully integrated Surgical 

Quality Workflow Management system will begin, continuing through FY 

2014. 

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9. Preparedness 

• In accordance with Office of Management and Budget (OMB) Memorandum 11– 

11, VA will continue to implement Homeland Security Presidential Directive 12 

(HSPD–12) during FY 2012 and FY 2013. VA will complete nearly 100% Personal 

Identity Verification (PIV) credential issuance in FY 2012 and begin requiring the 

use of the PIV credentials for Logical Access Control System (LACS) interface in 

FY 2012. The HSPD–12 compliance program will have two primary efforts that 

will continue development into FY 2013. 

– VA will complete improvements to the Personal Identity Verification (PIV) 

card management system in FY 2012 with two interfaces to automate Employee Sponsorship and the Background Investigation portion of the PIV registration process. Completion of the full development and implementation of 

both of those interfaces will run into FY 2013. 

– Additionally, in FY 2012, VA will initiate design of the Physical Access Control Systems (PACS) HSPD–12 Compliant Enterprise Wide Architecture. The 

enterprise PACS Architecture full development and implementation will continue into FY 2013. 

• The Integrated Operations Center (IOC) and corresponding continuity of operations (COOP) sites will achieve initial operations capability at two sites (Sites 

A and C) during FY 2012 with full operational capability not realized until FY 

2013. 

10. Systems to Drive Performance and Outcomes (STDP) 

• In FY 2012, the STDP initiative will continue to provide VA leadership with effective and flexible tools to review, analyze, and project, on an ongoing basis, cost 

and performance trends that impact/reflect changes in the budgetary environment, program efficiency and management priorities. These tools will be expanded 

in FY 2012 to address emerging VA Dashboard requirements and increase utilization of available tools. 

11. Integrated Operating Model (IOM) 

• IOM supports the VA Facilities Management Transformation Initiative, which 

will result in increased enterprise performance through the acquisition, development, and fielding of an enterprise construction project management system. 

When completed, the new web-based software will be capable of document control; 

collaboration between designers, managers, construction contractors, developers, 

owners, and program officials; and include the ability to run reports at the project 

and program level as well as link submittals to possible future actions such as 

RFP’s and contract modifications. 

• IOM supports the effort to implement a new VA Time and Attendance System 

(VATAS), which will improve efficiencies in workforce management workflows and 

personal productivity, and enhance transparency in the collection, delivery and 

use of VA workforce information. When completed, VATAS will make timekeeping 

more efficient and will eliminate the over 170 disparate VistA time and attendance systems currently used in the field. The new system will be centrally managed and hosted, and will also support cost accounting needs to better access and 

track labor costs related to VA employees. 

• IOM supports VA’s effort to migrate VA to a new Human Resource Information 

System (HRIS) Shared Service Center (SSC) in accordance with federally mandated Human Resource Line of Business Initiative to reduce stove pipe H.R. IT 

systems. When completed, the migration will streamline core H.R. requirements 

for personnel actions processing, employee benefits administration, and compensation management in the form of an interface with DFAS for payroll processing 

support. This system will replace VA’s legacy HR/Payroll (PAID) system and will 

improve the management of human capital throughout VA. 

• IOM supports VA’s effort to develop and implement the IT Project Management 

Accountability System (PMAS) Dashboard in order to support VA’s goal of 

proactively managing VA’s IT projects and ensuring that the OIT program and 

project managers have access to the resources and tools they need. When completed, this dashboard tool will support VA’s PMAS which is a metric-based, 

standardized system to effectively manage VA’s IT systems and increase accountability across the enterprise in order to effectively deliver functionality to meet 

IT business needs. PMAS provides near-term visibility into troubled programs, 

better insight into scarce resources, and frequent deliveries to customers ensuring 

that project functionality is on track while increasing the probability of successful 

programs. 

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12. Human Capital Investment Plan (HCIP) 

• In FY 2012, the Performance and Talent Management System (PTMS) will automate a paper based process and enable a modernized SES performance and talent 

management system that will be integrated with the VA’s Talent Management 

System (TMS). • VA will continue to develop the Equal Employment Opportunity/Alternative Dispute Resolution Electronic (EEO/ADR) Dashboard, which leverages technology 

and pulls information from various data systems to display a variety of indicators 

that provide valuable, real-time information for managers and possibly trigger 

management to determine if there are opportunities for intervention. • Child Care Records Management System (CCRMS) application (initial release in 

FY 2012), is a custom online system/application which encompasses an intranet 

web site for dynamically displaying information about VA facilities and key staff 

nationwide, along with administrative application for maintaining the data via 

internet. • The Central Office Human Resource Services (COHRS) Workload Tracking system 

(initial release in FY 2012), will be used to map, assess and improve the current 

business processes for attracting, recruiting, and hiring VA H.R. staff; assessing 

competency levels of H.R. staff and assisting in developing individual development 

plans; and designing and developing a software application capable of capturing 

the division’s workload as well as performance metrics (such as time-to-fill or classify a position). • The ‘‘VA for Vets’’ hiring initiative support system went live in FY 2012 and provides an integrated tool suite with a military-civilian skills assessment translator, 

a robust case management tool for deployed employees, a seamless Federal employment application process with integration to USAJobs 2.0 and 3.0 and a virtual collaboration center to allow deployed Veterans access to co-workers and 

home office information while activated on military duty. • In FY 2013, HCIP will develop new interfaces and begin the integration to VA 

Enterprise Architecture to eliminate duplication, incompatibility and redundancy. 

13. Research and Development (R&D) 

• GenISIS provides the required environment for launching VA as a world leader 

in personalized medicine that improves Veterans’ healthcare and potentially 

opens the door to ground breaking research. GenISIS also establishes a secure 

computing environment for large-scale computation necessary for genomic studies 

and a trackable, centralized recruitment tool to manage enrollment of as many 

as one million Veterans in the Million Veteran Program (MVP). 

– In FY 2013, the GenISIS Computing Infrastructure Module will be completed 

and GenISIS will continue to develop the ability to enroll Veterans through 

multiple mechanisms (including web, phone, and kiosks). • For Point of Care Research (POC-R), Veterans are enrolled in comparative research projects at the time they are receiving usual clinical care. They are randomized at a decision point in clinical care where two or more alternative treatments or strategies are considered equivalent. Data are analyzed to determine 

which treatment is more effective. VHA can then use the results from POC-R to 

determine best practices for Veterans’ health conditions. 

– In FY 2013, validation of the electronic clinical trial systems that are extracting data for POC-R pilot studies will be validated. 

• VA Informatics and Computing Infrastructure (VINCI) and Consortium for 

Healthcare Informatics Research (CHIR) improves the quality of care and treatment for Veterans by allowing VA researchers the ability to accelerate findings 

and identify emerging trends. This is made possible by advanced data mining in 

a high performance, secure, and virtualized computing environment that provides 

large-scale analysis of data from many sources without the threat of compromising Veterans’ personal or sensitive data and subjecting VA to high risk of data 

loss. VINCI currently supports more than 100 users. 

– In FY 2013, VINCI will upgrade to a 10 gigabytes-per-second interconnecting 

network speed on servers at Austin Information Technology Center. Additionally, VINCI will deploy grid architecture with support for file systems that 

lend themselves to processing terabytes of data. 

• Research Administrative Management System (RAMS) will improve Veteran 

healthcare by enabling VHA to recruit and retain world-class physician researchers and administrators. This will be accomplished by implementing an enterprisewide system accessible by active field research offices and Office of Research and 

Development (ORD) Central Office that will reduce regulatory and administrative 

burdens. These burdens were identified in a recent Office of Policy and Planning 

review as the single largest impediment to the conduct of research for Veterans. 

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The implemented tool will support the major business functions of the local research office; management of the Research and Development Committee, its subcommittees, and local research offices reporting to ORD; and provide a common 

database for tracking and reporting of administrative research program data. 

Without RAMS, VA cannot comply with the Presidential directive mandating regulatory simplification. 

– In FY 2013, RAMS framework will be implemented, including framework test 

plan and results report, schema, data model, data dictionary, and entity relationship diagram. Additionally, the RAMS Research Project Management 

module will be deployed to end users in a pre-production environment. 

14. Strategic Capital Investment Plan (SCIP) 

• VA will implement a SCIP Automation tool which will assist in the collection of 

the various capital investment planning needs for major construction, minor construction, non-recurring maintenance and leasing. 

– Two phases of the tool will be designed for delivery, the Short Term Solution 

(STS) and the Long Term Solution (LTS). The STS was released in February 2011. The LTS involved the acquisition of a solution which is scheduled 

to be fully implemented in FY 2012. In FY 2013 VA will be completing enhancements to the SCIP Automation tool. 

15. Health Care Efficiency (HCE) 

• In FY 2011 and FY 2012, HCE enhanced the existing Fee Basis Claims System 

and program integrity tools. HCE enhanced the existing VistA software for Beneficiary Travel; and for Facilities automation, HCE developed requirements and acquisition documents for an Application Package to integrate multiple Real Time 

Location System (RTLS) applications and for a repository to pull and analyze 

data. 

• FY 2013 deliverables include: 

– A National Data Repository for RTLS that will aggregate data from multiple 

VistA databases and provide tracking and reporting capabilities up to the national level. This data repository will enable the VA to achieve significant enhancements in asset tracking efficiency, as well as achieve significant 

workflow process enhancements and efficiencies through real time and near 

real time tracking of assets and processes. 

– Additional enhancements to the Fee Basis Claims System will take place to 

include bi-directional interfaces with VistA software. 

– Award of a contract to develop a Vet Traveler solution to further automate 

processing of BT claims 

16. Health Informatics (hi2) 

• FY 2011 deliverables: 

– Developed two Team-facing Health Management Platform (HMP) software 

modules; 

– Selected and launched the first HMP Pilot Site (San Diego); 

– Completed an Initiative level Governance Plan; 

– Created a national Informatics and Analytics Training Plan; 

– Developed online graduate-level Informatics lectures and coursework; and 

– Delivered two Nursing Informatics workshops 

• FY 2012 deliverables: 

– Develop the third and fourth Team-facing HMP software modules; 

– Create the HMP Collaboration Development Environment (CDE) for use with 

other development efforts, including research and local development; 

– Develop the first Patient-facing and System-facing HMP software modules; 

– Launch the first VA 10 x 10 Health Informatics Course (American Medical 

Informatics Association (AMIA) endorsed)Deliver two Nursing Informatics 

workshops; 

– Deliver standardized position descriptions for Health Informatics job series; 

and 

– Distribute and configure HMP servers in the Region 1 Data Processing Centers (Denver and Sacramento) to support HMP software testing by HMP pilot 

sites: San Diego, Loma Linda, Portland and Indianapolis. 

• FY 2013 deliverables: 

– Develop the fifth and sixth Team-facing HMP software modules; 

– Develop the 2nd and 3rd Patient-facing and System-facing HMP software 

modules; 

196 

– Deploy HMP software modules to VA medical centers to assist with health 

care delivery for Veterans; 

– Share VA Health Informatics educational content with Federal partners; and 

– Conduct a follow-up Health Informatics Workforce Survey to evaluate workforce development efforts launched in FY 2010, 2011, and 2012. 

Question 2. In January 2012, OIT released a Request for Information for a new 

patient scheduling system which VA will rely on private industry to develop for VA. 

In a recent briefing with Committee staff outlining the plan, it was indicated that 

an off-the-shelf program could meet 80 percent of VA’s requirements. Yet, VA believes it needs something ‘‘more robust’’ than an off-the-shelf program. 

a. Please describe, in detail, the business case analysis for moving forward with 

a custom built software system versus enhancing an off-the-shelf program to meet 

VA’s needs. 

Response. VA has completed review of the request for information (RFI) packages. 

There were 35 submissions with varying technical solutions. VA is entering into an 

assessment and review of current VA scheduling processes to determine whether 

these technical solutions will be of value. VA is also formally developing the VA 

scheduling process and the Statement of Work for a scheduling system. VA has yet 

to decide on what type of technical solution will be applied. 

b. How much does VA expect to spend in total on the new patient scheduling software system? 

Response. VA has not started a Life Cycle Cost Estimate, but plans to complete 

this analysis by January 2013. 

c. How much does VA expect to spend in fiscal year 2013 on a new patient software system? 

Response. VA will only be able to determine this figure after the completion of 

our Concept Exploration and our Life Cycle Cost Estimate, which are planned for 

January 2013. 

d. Please provide the Committee with a timeline of deliverables for this project. 

Response. VA will only be able to determine a timeline of deliverables for this 

project after the completion of our Concept Exploration and our Life Cycle Cost Estimate, which are planned for January 2013. 

Question 3. Because of a history of poor performing IT development projects, VA 

initiated the Program Management Accountability System (PMAS) to provide better 

oversight of development projects within OIT. PMAS is a performance-based measurement discipline that is designed to reduce risk by instituting management, controlling, and reporting mechanisms. According to the budget justification, using 

‘‘PMAS, VA has identified a cost avoidance of nearly $200 million by eliminating 

poorly performing projects.’’ 

a. How much funding was spent on these projects prior to OIT eliminating the 

projects? Please display the information by amount and project. 

Response. In 2009, as a result of significant difficulties in delivering IT development, the Department reviewed all 280 ongoing IT development projects. The review 

resulted in the cancellation of some projects, leading to a cost avoidance of nearly 

$200 million. The canceled projects and associated cost savings are listed below. Due 

to historical record keeping techniques, most of the dollar amounts are estimates 

rather than actual accountings. 

Project Description Estimated Cost 

Avoidance Prior Spend on Project 

1. Scheduling 

Replacement 

To create an Enterprise-level outpatient scheduling 

application that supports re-engineered appointment processes and patient-centric view of appointments regardless of location of care. 

$37 million $127.0 million 

2. Pharmacy ReEngineering Pre 1.0 Replaces existing national and local drug files and 

serves as the basis for the Pharmacy Reengineering; will help control inventory nationwide. 

$7 million $8.5 million 

3. Enrollment System 

Redesign (ESR) v4 

Rehosting of the Income Verification Matching application from a .Net standalone database to the 

ESR application. 

$6.3 million $1.5 million 

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Project Description Estimated Cost 

Avoidance Prior Spend on Project 

4. CHDR—Chemistry & 

Hematology: ADC 

Automation 

Supports interoperability between Veteran Affairs 

and the Department of Defense for ordering 

drugs and drug allergy. 

$0 $1.1 million 

5. Barcode Expansion Extends use of Bar Code technology via wireless 

handheld devices to positively identify patients 

during lab specimen collection, blood administration, medication administration, vitals sign collection, and to provide for wireless read only access to the patient’s chart. 

$0 $1.2 million 

6. Delivery Service Delivery Service enables the loosely-coupled applications/services in the HealtheVet service oriented architecture (SOA) to function properly.Delivery Service provides the mechanism for 

allowing one application/service to communicate 

with another. 

$1.4 million $0 

7. Organization Service Organization Service is a foundational component of 

the HealtheVet service oriented architecture and 

establishes a centralized and standardized set of 

business logic for the management of organizations, locations, and medical devices. 

$1.4 million $0 

8. ASISTS Modification— 

Case Management 

Request to modify the Automated Safety Incident 

Surveillance and Tracking System (ASISTS) to include a Workers’ Compensation case management module that will allow Workers Compensation Specialist to manage the employee case 

after the Department of Labor has approved their 

request for compensation claim. 

$0 $1.8 million 

9. National Teleradiology Program— 

Radiology 

Provides workflow / messaging enhancements for 

tele-radiology in support of pilot project. Enables 

tele-radiology system to pull reports from prior 

comparison studies and send them to tele-radiologist. 

$0 $0.88 million 

10. RMS—Rights 

Management Server 

Provides security for e-mail messages and attachments by controlling what recipients can do with 

messages. 

$0.1 million $0 

11. Radiology 

Standardization 

Create and deploy standard Radiology terminology 

files. 

$1 million $2.7 million 

12. Lab Data Sharing 

and Interoperability 

(LDSI) Terminology 

Support 

Provide Systematized Nomenclature of Medicine— 

Clinical Terms mappings and maintenance to 

LDSI files 

$0 $0.45 million 

13. Financial and 

Logistics Integrated 

Technology 

Enterprise 

(Integrated Financial 

Accounting System) 

Provide standardized business processes in a COTSbased FSIO-compliant integrated financial management system with accurate and auditable financial data $85 million $117.7 million, 

Total for FLITE 

14. Financial and 

Logistics Integrated 

Technology 

Enterprise (Strategic 

Asset Management) 

Provide consolidation and integration of critical 

asset management systems into an enterprisewide, standardized centralized COTS solutions 

$13 million See 13 above 

198 

Project Description Estimated Cost 

Avoidance Prior Spend on Project 

15. Financial and 

Logistics Integrated 

Technology 

Enterprise (Corporate 

Data warehouse) 

Provide integrated data repository to facilitate query 

and reporting of data from multiple interfacing 

financial and logistical systems 

$48 million See 13 above 

b. Are the projects within the 16 major transformational initiatives subject to review under PMAS? If so, how have they performed? 

Response. The Major Initiatives comprise projects that are both IT- and non-IT 

in nature. Projects within the 16 major transformational initiatives that have IT 

portions are subject to review under PMAS. In FY 2011, Major Initiative IT projects 

met nearly 90 percent of their deliverables—far above the industry standard of 

around 35 percent. VA continues to deliver in FY 2012 at the same level of execution. 

c. Once a project is ‘‘paused’’ under PMAS, what metrics does VA use to determine 

if a project will be re-planned and restarted or closed? 

Response. Projects are paused if directed by the Assistant Secretary for Information and Technology or his designee; if the project is unfunded but has a business 

need, or if the project is issued three consecutive failures (‘‘3 strikes’’) to meet a 

product delivery within the established schedule. ‘‘Paused’’ projects under PMAS are 

required to have a review by IT senior leadership every 60 calendar days. When a 

project is Paused, no further development activity will occur until it is reviewed by 

senior IT leadership and a course of action is approved. Once IT leadership determines a course of action for a Paused project, the project can be re-planned, re-started or closed. The decision on whether to continue with a project is based on whether 

the project has an approved Business Requirements Document (BRD), an Integrated 

Project Team (IPT) Charter, and a Project Charter approved and signed in accordance with ProPath. A Paused project will be closed if the project objectives have 

been met, business priorities have changed, or the project has suffered poor performance. Project performance is measured in the PMAS dashboard, which tracks each 

project increment for schedule adherence, cost adherence, scope drift, spend plan 

execution, product quality, and number of red flags. 

Question 4. In June 2011, VA created a Reduction Task Force tasked with identifying efficiencies across OIT and repurposing available funding into other projects. 

The focus of the task force is to identify and eliminate duplication, find hardware 

efficiencies and savings through the use of cloud computing, and identify savings 

through policy and architecture changes. 

a. What efficiencies has the Task Force identified and how much savings has been 

identified? 

Response. As of May 1, 2012 the Ruthless Reduction Task Force (RRTF) has identified 50 efficiencies, including the following proposed policy or process changes: 

• One CPU Device Per End User Policy; 

• Eliminate Desktop Printers; 

• Mobile Device Management Policy; 

• Renegotiate Enterprise License Agreements (Microsoft); 

• Move all Multi-Function devices to business lines/Managed Print Services; 

• Server Virtualization to reduce total number of physical servers; 

• Beneficiary Identification and Records Locator Subsystem (BIRLS) and Veterans Assistance Discharge System (VADS) review; 

• VISN Data Warehouse Elimination; 

• Corporate Data Warehouse Health Data Repository (CDW HDR); consolidation 

with the National Data Warehouse Service; and 

• Eliminate Dedicated Fax Lines. 

Each of these initiatives is being analyzed to determine if it is appropriate for implementation, at what scale and timeline, and potential cost avoidance. 

b. What projects benefited with funding increases as a result of the task force? 

For each project, please identify the amount of funding increases received. 

Response. VA is now collecting data and information to quantify cost efficiencies 

in the VA IT program that have been realized as a result of the RRTF initiatives. 

Upon realization of savings through RRTF, these funds will be redirected to other 

critical prioritized unfunded IT requirements. 

199 

Question 5. Over the last several years, VA and DOD have been working toward 

creating an integrated electronic health record (iEHR). Both the Secretaries of VA 

and DOD have agreed to initial next steps and to establish an Open Source Custodial Agent. 

a. How much will VA spend in total for the development portion of iEHR? 

Response. A program-level cost estimate is in development. The program level requirements document, acquisition strategy, and systems engineering plan, all in development, will provide the basis for the cost estimate. 

b. Please provide the Committee with a detailed description of the deliverables for 

fiscal year 2013. 

Response. The FY 2013 Execution Plan is in development. It will address ongoing 

risk reduction efforts as well as enduring iEHR infrastructure and prioritized clinical capability. 

c. Please provide the Committee with a detailed description of the anticipated 

deliverables for fiscal year 2014. 

Response. Planning for FY 2014 will be part of the overall program planning, 

which is still in development, as noted in part a. 

Question 6. On February 28, 2012, VA notified Congress that the contract associated with the Enterprise Service Bus procurement for iEHR was terminated. The 

Enterprise Service Bus would create the central hub and would allow private sector 

products to be incorporated into the system. 

a. How much funding has been obligated, to date, on this contract? 

Response. This information cannot be released due to potential legal issues related to the termination of the contract. 

b. Please describe the metrics behind the decision to terminate this contract. 

Response. After the award was made, a VA contracting officer discovered indications of impropriety. Subsequently, VA moved quickly to terminate the contract. 

This is being investigated so the details cannot be discussed publicly at this time. 

To date, VA’s review has found no wrongdoing by government employees. 

c. How will this cancellation affect the overall mission to create an integrated electronic health record? 

Response. The DOD/VA IPO has assessed the impact of the contract stop on the 

development of iEHR Enterprise Service Bus and determined that impact will be 

minimal. With that said, the contract has now been re-awarded. 

d. Please provide a timeline of deliverables for this project. 

Response. The work on iEHR continues and the timeline to complete program 

deliverables remains on schedule. VA and DOD have agreed to create a single common, joint electronic health record. The iEHR platform will be an open architecture, 

non-proprietary design. VA and DOD are targeting delivery of iEHR baseline capability to two sites (consisting of multiple VA and DOD facilities) no later than 2014, 

with primary effort on providing a Service Oriented Architecture-based supporting 

infrastructure. Full rollout of the iEHR is expected in 4–6 years. 

The IT budget request for FY 2013 remains critical to working on this initiative. 

This project enables medical providers at the first fully integrated VA and DOD 

North Chicago medical facility to have a more efficient way to examine and review 

health records from both DOD and VA systems and provide better care to Veterans 

and Servicemembers. 

VETERANS HEALTH ADMINISTRATION

Question 1. According to a survey VA conducted in December 2011, VA had 1,500 

open positions for mental health providers. In fiscal year 2011, VA mental health 

providers saw 1.4 million unique patients. As more veterans return home from war, 

VA may see an increase of patients coming to VA to seek treatment for mental 

health conditions. 

a. What steps has VA taken to fill the 1,500 open positions in mental health? How 

many are still open today? When will any remaining positions be filled? Please display the 1,500 open positions by VISN and clinical type (i.e., MD, Nurse, Social 

worker, etc.). 

Response. VA’s 2013 budget provides $6.2B for mental health care, an increase 

of $665 million, or 12 percent, over the FY 2011 actual. VA is expanding mental 

health programs and is integrating mental health services with primary and specialty care thus providing better coordinated care for our Veteran patients. With a 

workforce of over 20,000 mental health professionals, and an estimated average vacancy rate of seven to eight percent due to normal staff turnovers, the Veterans 

Health Administration (VHA) is likely to have 1,400–1,600 vacancies in mental 

health at any point in time. VHA has begun monitoring vacancies to identify variation in the rates across sites and disciplines. The purpose of monitoring is to enVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00205 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
200 

sure that active recruitment efforts are in place and that vacancies are filled in a 

timely fashion. 

VHA established the National Recruitment Program (NRP) in December 2010 

that provides the agency with an in-house team of professional recruiters that utilize best practice, private sector recruitment methods to target historically hard-tofill Title 38 and Hybrid 38 vacancies, particularly Physicians. The Office of Workforce Management & Consulting assigned a professional recruiter to each Veteran 

Integrated Service Network (except VISN 12) to aggressively source and identify 

candidates to fill mission-critical healthcare needs. In FY 2011, the National Recruitment Program directly supported 369 requisitions, referred over 1,800 candidates to clinical hiring managers, and secured 159 selections. Of the referred candidates, 91.8 percent were health care professionals, 73.5 percent were physicians. 

Finally, 16 percent of FY 2011 selections were for rural/highly-rural vacancies. 

Fully staffed in December 2011, agency-wide implementation of the NRP is complete. VISNs have a dedicated National Healthcare Recruitment Consultant actively 

and successfully impacting mission critical shortages, utilizing private sector recruitment practices. As of March 8, 2012, the team is actively recruiting 584 requisitions, has referred 1,521 candidates, and secured 202 selections. Of the selections, 97.2 percent are health care professionals, 67.3 percent physicians, 22.11 percent are Veterans, and approximately 13 percent are to fill rural/highly-rural 

vacancies. 

As of January 2012, the methodology for collecting data on the mental health vacancy rate was changed to reflect all vacancies associated with mental health 

whether or not the positions were listed on a formal mental health organization 

chart. Vacancies were self-reported by the facilities. To make data comparable 

across sites, facilities were given explicit instructions in how to identify a ‘‘mental 

health’’ vacancy as the formal organization of mental health is different across facilities. Because of this, the data is not directly comparable to the December 2011 data. 

The data from May 2012 is attached below. 

201 

VHA facilities use a variety of strategies to recruit mental health providers 

including: 

• Open continuous posting; • Use of recruitment/retention incentives; • Use of dedicated recruiters who attend community job fairs, and colleges; • Use of recruitment incentives, such as the Student Loan Repayment Program 

(SLRP) and the Education Debt Reduction Program (EDRP); • Recruitment advertising in specialty journals or newspapers; • National VHA recruitment advertising; • Coordination of recruiting efforts with affiliated schools of medicine; • Academic affiliation with schools of psychology, nursing, and social work; • Internship and practicum programs; • Review and analysis of local labor market salary data to determine if salaries 

are competitive; and • Use of new hiring authority to hire Licensed Professional Counselors and Licensed Marriage and Family Therapists. 

b. While VA is filling those positions, what steps has VA taken to ensure that veterans receive the course of treatment prescribed to them, either through fee-basis, 

telemental health, or other options available to VA? 

Response. In addressing vacancies, sites may use existing staff, contract staff, 

locum tenens and consultant psychiatrists or psychologists to provide needed mental 

health services. Increasingly, telemental health services may be provided from sites 

that have extra capacity to cover sites with limited capacity. For example, in FY 

2012 VHA sent approximately $12 million to the Veterans Integrated Service Networks (VISNs) to place specialized staff at carefully selected sites to deliver CogVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00207 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN

B3bpg2.eps
202 

nitive Processing Therapy (CPT) and Prolonged Exposure (PE) therapy through clinical video teleconferencing to Veterans located at remote Community-Based Outpatient Clinics (CBOC) and at non-VA community sites, as well as to establish regional pilot Evidence Based Psychotherapy (EBP) for PTSD telemental health clinics 

at three selected sites (Charleston, SC; San Diego, CA; and San Antonio, TX). The 

regional clinics are intended to enhance on-site services for the treatment of Post 

Traumatic Stress Disorder (PTSD) with access to telemental health services. Fee 

basis care is also used if the facility is unable to provide timely mental health services and appropriate timely care is available in the community. 

c. In fiscal year 2013 and fiscal year 2014, how much does VA expect to spend 

on fee-basis care for mental health patients? 

Response. VA expects to spend $7.4 million in 2013 and $7.7 million in 2014 on 

fee-basis care for mental health patients. 

Question 2. During the first session of the 112th Congress, the Senate Committee 

on Veterans’ Affairs held two hearings on issues within VA’s mental health program. The hearings highlighted the problems veterans face in accessing needed ongoing treatment in mental health clinics. These hearings also probed the results of 

a VA survey of VHA mental health providers who revealed the problem with veterans accessing care. 

a. How does the fiscal year 2013 budget address the issues relating to wait times 

for appointments, a lack of availability of follow-up appointments, staffing shortages, and lack of space in the mental health clinics which were raised in the Committee hearings? 

Response. [This question appears as #27 and was answered in the prehearing VA 

responses.] 

b. When will veterans begin to see improvements in their access to mental health 

care? 

Response. VA is continually expanding mental health programs and is integrating 

mental health services with primary and specialty care thus providing better coordinated care for our Veteran patients. Thus, Veterans should be seeing continuous improvements in access. VISNs/facilities have been tasked with reviewing data on access; when problems are identified, they have been required to develop and implement correction actions to comply with VA policy. For example, some sites have implemented special access clinics so that any Veteran who walks in the door, either 

from the community or from another medical provider in the hospital, can be seen 

for a full mental health assessment same-day. Other sites are increasing the use 

of Telemental health clinics to improve access to CBOCs and between VA medical 

centers (e.g., general mental health, substance use disorders, residential rehabilitation treatment programs (RRTP) admission screenings, PTSD groups, and C&P 

exams). Another example is a site augmenting access to specialty psychiatric services by participation in the National Telemental Health Center Bipolar Disorder 

consultation pilot, whereby Veterans are provided additional care by bipolar disorder experts at the Boston VAMC. One VISN has contracted with State Community Mental Health Clinics to serve as distal points of telemental health care (provided by VAMC mental health providers) in strategically-located remote rural 

counties. 

Through the site visit process and review of data from its Mental Health Action 

Plan, VHA continues to identify systemic opportunities to improve access to specific 

types of care. For example, access to evidence-based psychotherapies has been problematic at some sites. To address this, VHA sent approximately $12 million to the 

VISNs in FY 2012 to hire specialized staff at carefully selected sites to deliver CPT 

and PE through clinical video teleconferencing to Veterans located at remote CBOCs 

and at non-VA community sites, as well as to establish regional pilot EBP for PTSD 

telemental health clinics at three selected sites (Charleston, SC; San Diego, CA; and 

San Antonio, TX). The regional clinics are intended to enhance on site services for 

the treatment of PTSD with access to telemental health services. Variation in staffing has also been identified as an issue. The implementation of the staffing model, 

anticipated to be implemented by the end of FY 2012, will help ensure that staffing 

is consistent across VHA. 

Question 3. In the fiscal year 2013 budget request, VA reported that an update 

to the actuarial model found that, because of significantly lower estimates, less 

funding was needed for health care services, long-term care, and other health care 

programs than what Congress appropriated for fiscal year 2012 and fiscal year 

2013. The VA budget justification books indicate that the extra funding will be reinvested in homeless veterans programs, the Caregivers and Veterans Omnibus 

Health Services Act, activation of medical facilities, and other programs. 

203 

a. If VA’s actuarial model indicated there was $2 billion in extra funding for fiscal year 2013, why is VA requesting an additional $165 million for medical care? Response. VA does not agree with the characterization of $2 billion in ‘‘extra funding’’ for fiscal year 2013. Those funds are needed to provide essential medical care 

services to our Nation’s Veterans. The request for $165 million in FY 2013 above 

the enacted appropriation for FY 2013 is based on the updated actuarial estimates 

for the demand for health care services by enrolled Veterans in FY 2013 less the 

carryover funds from FY 2012 and the updated estimates for collections, and reimbursements in FY 2013. 

b. What assumptions in the actuarial model caused a downward revision of $3 billion in fiscal year 2012 and $2 billion in fiscal year 2013? 

Response. After adjusting for the civilian pay freeze in 2012 and several services 

that were not modeled in the actuarial model used as the basis for the FY 2012 

Budget, the updated model projections were $556 million (or 1.1 percent) lower than 

the 2010 Model for 2013. The $556 million reduction was largely due to more current data on utilization patterns of enrollees and revised estimates of the impact 

of the recession on Veteran’s use of VA health care. 

c. For each of the programs whose funding would increase as a result of this reinvestment, how much would it increase? Please detail how this increase in funding 

would be utilized for each program. 

Response. For FY 2012 there were changes in the adjusted actuarial estimates for 

health care, the estimates for long-term care, the estimates for other health programs (i.e., CHAMPVA), and obligations as shown below ($ in millions): 

Adjusted actuarial estimates ....................................................................................... ($2,559 ) 

Long-term care ............................................................................................................. ($210 ) 

Other health programs ................................................................................................. ($115 ) 

Total reductions ................................................................................................... ($2,884 ) 

Less reduction in obligations .................................................................................. $698 (detail composition below) 

Total net reduction in estimates ......................................................................... ($2,186 ) (detail below) 

Composition of reduction in obligations: 

Appropriation change ............................................................................................... $000 

Transfer to Joint DOD/VA Fund ................................................................................ ($234 ) (North Chicago) 

Transfer to DOD/VA Fund ......................................................................................... ($15 ) (Health Sharing Incentive) 

Contingency not appropriated .................................................................................. ($240 ) 

Reimbursement increase .......................................................................................... $57 

Unobligated balance increase ................................................................................. $63 

Collection decrease .................................................................................................. ($329 ) 

Net reduction in obligations ................................................................................ ($698 ) 

Details of investment of $2,186.

Zero homelessness ................................................................................................... $559 

Activations ................................................................................................................ $831 

New Models of Care ................................................................................................. $610 

Expand Health Care Access ..................................................................................... $113 

Caregivers ................................................................................................................ $43 

Improve Mental Health ............................................................................................. $31 

Other ......................................................................................................................... ($1 ) 

Total ..................................................................................................................... $2,186 

d. Please provide the Committee with a more detailed justification for the additional request of $165 million, broken down by program and initiative. 

Response. [Although the questions differ slightly from prehearing question 6a&b, 

these responses to 3d&e are copied from that list.] 

For FY 2013 there were changes in the adjusted actuarial estimates for health 

care, the estimates for long-term care, the estimates for other health programs (i.e., 

CHAMPVA), and obligations as shown below ($ in millions): 

Adjusted actuarial estimates .............................................................. $(1,715 ) 

Long-term care .................................................................................... (271 ) 

Other health programs ........................................................................ (119 ) 

Total reductions ......................................................................... (2,105 ) 

204 

Less reduction in obligations ............................................................. 110 (detail composition below) 

Total net reduction in estimates ............................................... (1,995 ) (detail below) 

Composition of reduction in obligations: 

Appropriation request increase ...................................................... 165 

Reimbursement increase ................................................................ 50 

Collection decrease ......................................................................... (325 ) 

Net reduction in obligations .................................................. (110 ) 

Details of investment of $1,995: 

Zero homelessness ......................................................................... 892 

Activations ...................................................................................... 448 

New Models of Care ....................................................................... 433 

Expand Health Care Access ........................................................... 120 

Caregivers ....................................................................................... 30 

Improve Mental Health ................................................................... 20 

Other ............................................................................................... 52 

Total ....................................................................................... $1,995 

e. Please identify which facility (new VA hospital, Community Based Outpatient 

Clinic (CBOC), Outreach Clinic, etc.) activations would be supported with this increase in funding. 

VHA Response. The activation funding requested in the FY 2013 Advance Appropriation (FY 2012 President’s Budget) was $344 million plus the activation increase 

requested in the FY 2013 President’s Budget (see response to question 6a above), 

which was $448 million. This equals a total of $792M for FY 2013 activations. The 

specific projects making up the $792M are listed in the table below. 

205 

Question 4. The fiscal year 2013 budget request includes operational improvements that VA estimates could save $1.2 billion. The fiscal year 2012 budget request 

also included operational efficiencies of just over $1 billion. 

a. For fiscal year 2012, how much has been saved, to date, by the operational improvements identified in the fiscal year 2012 budget request? Please provide the 

amount saved by each category listed in the fiscal year 2012 budget request. 

Response. Please see chart below. 


229q1VAb6b.eps
206 

b. Please describe in detail the operational improvements included in the fiscal 

year 2013 budget request. 

Response. VHA operational improvements included in the fiscal year 2013 budget 

request: 

• Fee Care Payments Consistent with Medicare: Dialysis Regulation Savings and 

other care services are the estimated cost savings from purchasing dialysis treatments and other care from civilian providers at the Centers for Medicare and 

Medicaid rates instead of current community rates. 

• Fee Care Savings: Fee care savings will be generated through the application of 

the following initiatives: use of electronic re-pricing tools, use of contract and 

blanket ordering agreements, decrease contract hospital average daily census, decrease payments to insurers, decrease interest penalty payments to contract hospitals and insurers, and increase revenue generation through the use of automated tools. 

• Clinical Staff and Resource Realignment: Cost savings will be achieved through 

the conversion of selected physicians to non-physician providers; conversion of selected registered nurses to licensed practical nurses; and to more appropriately 

align the required clinical skills with patient care needs. The methodology for reporting savings associated with this initiative is currently under revision in response to recommendations from the Government Accountability Office (GAO). 

• Medical & Administrative Support Savings: The indirect cost savings will be produced by more efficiently employing the resources in various medical care, administrative, and support activities at each medical center and in VISN and central 

office operations. 

• Acquisition Improvements: Acquisition improvements cost savings will be achieved 

through eight ongoing initiatives: Consolidated contracting; Increasing competition; Bring Back Contracting in House; Reverse Auction Utilities, MED PDB/EZ 

Save, Reducing contracts, property re-utilization, and using prime vendors to 

achieve additional price concessions. The methodology for reporting savings associated with this initiative is currently under revision in response to recommendations from the GAO. 

• VA Real Property Cost Savings & Innovation Plan: This is part of VA’s Real Property Cost Savings and Innovation Plan following the Presidential Memo on Real 

Property (June 2010). VHA’s portion includes the following initiatives: 

– Repurpose Vacant and Underutilized Assets—VA has identified 166 vacant or 

underutilized buildings to repurpose for homeless housing and other initiatives. 

– Demolition and Mothballing—VA has identified 199 vacant or underutilized 

buildings to demolish or mothball which will reduce operating costs after the 

cost of demolition. 

– Energy and Sustainability—VA will achieve these savings by regionally pooling energy commodity purchasing contracts, aggressively pursuing energy 

and water conservation, and investing in the co-generation of electric and 

thermal energy on-site. 


B31pg29.eps
207 

– Improved Non-Recurring Maintenance (NRM) Contracting Processes—By improving how it plans and executes NRM projects, VA is reducing its reliance 

on external sources of support for the contracting process, saving fees. 

– Reduction in Leasing—By consolidating operations previously located on 

leased properties into owned spaces, VA is reducing its underutilized space. 

c. For the category ‘‘Acquisition Improvements,’’ please provide the business case 

for the eight on-going initiatives. 

Response. The business case for Acquisition Improvements are pending completion of the methodology revision in response to recommendations from the GAO. 

Question 5. The fiscal year 2013 budget request includes a proposal to shift $320 

million in funding and 1,080 FTE for VA’s Biomedical Engineering Services from 

Medical Facilities to the Medical Services account. 

a. How much was appropriated for fiscal years 2010, 2011, and 2012? 

Response. Dollars are not appropriated specifically for the Biomedical Engineering 

Services. The costs of the Biomedical Engineering Services are currently covered 

under the Medical Facilities appropriation and under the proposed move would 

switch to the Medical Services appropriation. The actuals and estimates of funds required for Biomedical Engineering Services are shown in the table below. 

2010 Actual 2011 Actual 2012 Estimate 

Dollars in Millions ....................................................................................... $263 $274 $288 

b. Please describe in detail the purpose of this office and the reasoning for shifting 

these funds to the Medical Services account. 

Response. Biomedical Engineering Services are responsible for the overall management of medical technology in VHA, including requirements analysis, installation and deployment, and on-going sustainment. Biomedical Engineering Services 

includes personal services and other costs associated with maintenance and repair 

of all medical equipment used in the treatment, monitoring, diagnosis, or therapy 

of patients. In order to properly align the appropriation requests with the nature 

of the services provided, funds are moved from the Medical Facilities appropriation 

to the Medical Services appropriation. 

c. Please provide an updated organizational chart reflecting at least three supervisory line levels above where the Biomedical Engineering Services are located within the VHA Central Office structure. 

Response. Biomedical Engineering falls under Healthcare Technology Management, which would report to ADUSH for Administrative Operations to the DUSH 

for Operations and Management. A VHA organizational chart is attached below. 


Batch3VHA5.eps

Chief of Staff 

Under Secretary for 

Health 

Veterans Health Adm

March 2011 

Date 
209 

Question 6. The fiscal year 2013 budget request proposes spending $601 million 

in fiscal year 2013 and $99 million in fiscal year 2014 for facility activations. 

a. For fiscal year 2013 and fiscal year 2014, please provide the Committee with 

a list of the facilities and amounts assigned to each activation and please identify 

the facility by type (VAMC, CBOC, Vet Center, etc.). 

Response. The $601 million in FY 2013 and $99 million in FY 2014 represent only 

the Medical Services portion of the total activation obligations for those respective 

years. The total activations for all three medical appropriations is $792 million and 

$135 million for FY 2013 and FY 2014, respectively (see page 1A–5 of vol. 2 of 4 

of the FY 2013 Budget submissions). Projects included in the FY 2013 activations 

amount are listed in the following chart. As is our standard practice under advance 

appropriations, we will revisit the FY 2014 request for activations during the FY 

2014 budget process, and a final list of FY 2014 projects will be included in the FY 

2014 President’s Budget request. 

210 


B3bpg6.eps

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6 Win,ton·SiI m N:: Win,ton·Salem . ~Ith Care QntEl'Lease $12 

6 Wilmington N:: Wilmington. OJtp.ti.nt dini<Lease ~lf 

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20 Salem CR Salem· O>mmunit)'Based OJtp.tient dini<Le.", $3 

20 Eugene CR Eugene· Ci:>mrrunity·Ba,ed CVpatient dini<Lea,. $12 

21 P.lo ~to 0>. Palo ~to· Qnters for Krbulatoryo... .nd PoI)'1rauma Rehabilitation (00 $10 

21 Fl-bnterev 0>. r'bntEl'ey' ~.hh Care Centellease $10 

21 San Fr an<isc~ 0>. San Fr.ncisco • Rese<r<h LeaseLea,e $2 

22 Loma linda 0>. Lom.Lind.· ~alih 0... Qntelleas. $32 

22 San Ciego 0>. San Ci.go . OJtpatient dinicLease $13 

Total $792 
211 

b. Please describe in detail how the activation funds will be spent. 

Response. The activation funds in the table include both recurring and non-recurring activation costs. Recurring costs are based on the ongoing costs incurred from 

the expanded services resulting from the project. Examples of recurring activations 

costs include the startup costs for clinicians for new clinics or clinics expanding; 

startup costs for housekeeping staff to help maintain the larger footprint of Community Living Centers; etc. These recurring activations costs must be separately budgeted for until the Enrollee Health Care Projection Model picks up these costs for 

the new/expanded facility in a future budget year. 

Non-recurring costs support both existing space as well as new space; renovated 

space assumes a reuse factor to balance new furniture and equipment with replacement expectations. Examples of non-recurring activations include replacing existing 

furniture for newly converted Community Living Centers; one-time costs for new 

medical equipment to fully operationalize new Spinal Cord Injury Centers; and onetime costs for new furniture to outfit new Domiciliaries. Activations funding also 

provides the upfront funding to help move existing equipment; train employees on 

the new systems; and hire activation managers for larger outpatient clinics and new 

and replacement medical centers. 

Question 7. The fiscal year 2013 budget request includes proposed funding of $102 

million in 2013 to expand health care access for veterans. According to the budget 

justification, this initiative aims to provide the ‘‘clinically appropriate quality care’’ 

to veterans in the right place and the right time. This would also include the use 

of technology where appropriate. 

a. How much is projected to be spent in fiscal year 2013 on this initiative? 

Response. VA anticipates obligating $120 million on this initiative in FY 2013, of 

which $102 million is for Medical Services, as proposed in the FY 2013 Budget. 

b. How much is projected to be spent in fiscal year 2014 on this initiative? 

Response. VA is currently requesting no advance appropriation funding for this 

initiative in 2014. Requirements for this initiative will be re-assessed during the FY 

2014 budget process. 

c. For the following sub-initiatives, systems redesign, transportation, and hospital 

quality and transparency, please provide a detailed analysis of how these initiatives 

will increase access to care for veterans. 

Response. 

Systems Redesign: Systems Redesign is engaged in many activities aimed at 

improving outpatient and inpatient access. The following is an overview of these 

activities. 

Outpatient: VHA schedules over 85 million appointments per year. Ensuring timely access to face-to-face and non-face-to-face venues of care requires clinic managers 

to understand and implement systems engineering operational strategies in day-today clinic management that will ensure the volume of patient requests for appointments are able to be met with adequate numbers of appointment slots. Systems Redesign oversees this at a national level, and teaches and leads initiatives to improve 

access and provide consultative assistance to local facilities. Systems Redesign also 

manages the scheduling policy, scheduler education, measurement strategy and 

analysis, and educational efforts including the VHA’s Access Academy, Patient 

Aligned Care Teams (PACT) collaboratives, Virtual Specialty collaboratives, the National Initiative to Reduce Missed Opportunities (no-shows), etc. Finally, this group 

is managing VHA’s efforts to establish business needs for new scheduling software 

which will lead to eventual acquisition and implementation of this badly needed 

functionality. 

Inpatient: Inpatient access and flow. Knowledge and tools to ensure timely inpatient care have exploded in the last 10 years. In order to ensure VHA managers 

have the best operational management tools available, Systems Redesign leads a 

large menu of activities. These include one of the most used VHA web pages containing improvement projects and efforts, a menu of educational events including 

virtual collaboratives to improve patient handoffs and transitions, and management 

of hospital flow. Systems Redesign also hosts a National Flow Academy to help local 

managers learn queuing theory and improvement strategies. In the recent past, 

these efforts included Cancer Care Collaborative Improvement Efforts and the Bedside Care Collaborative. Engineering colleagues have helped to create over 12 toolkits to share knowledge system-wide. 

In addition, Systems Redesign has lead efforts to improve informatics tools designed to support, manage, and improve inpatient access, transparency, and visibility. As a result of these efforts, VHA will soon have the ability to see all inpatient 

bed access data nationally. These information systems are described in the following 

paragraphs: 

212 

The Bed Management Solution (BMS) provides VHA facility leaders and front 

line staff with key resource allocation and bed availability information to ensure 

Veterans receive the most appropriate level of care and services in a timely 

manner for optimal patient care. All facilities have installed BMS. BMS reports 

are now available and increasingly being used to manage inpatient flow within 

and between facilities—including patient bed availability and patient bed requests. Systems Redesign has sponsored numerous BMS workshops, flow improvement collaboratives, and provide ongoing technical support to assist facilities in improving their ability to manage inpatient flow. In addition, Systems 

Redesign began the process of a detailed assessment of 35 VA to gather information needed to establish future VHA policy governing inpatient flow. 

The Emergency Department Integration Software (EDIS) provides critical 

Emergency Department (ED) flow information and will ultimately link with 

BMS through the Comprehensive Flow Manager (CFM) to more efficiently 

transfer patients from the ED to the inpatient setting, avoiding lack of inpatient 

access, costly and clinically concerning delays and patients waiting unnecessarily in the ED. EDIS has been installed in every VA facility where it is appropriate. Sites are on schedule to complete training in the use of EDIS. In addition, EDIS application data elements are being incorporated into national databases. In 2011, planning began for the incorporation of stroke protocols in EDIS. 

The Surgical Quality and Workflow Manager (SQWM) will provide critical 

pieces of information relative to surgical flow to ensure patient access to needed 

surgical services and efficient and quality-focused patient hand-off to and from 

the surgical setting. A Commercial Off-The-Shelf (COTS) product for SQWM 

was selected ahead of schedule, and an aggressive implementation timeline, to 

include training and implementation workshops, has been developed. 

Finally, future development of CFM, currently in the conceptual stages, will provide a system linking BMS, EDIS, and SQWM together to allow for effective resource allocation which will ultimately enhance patient access to inpatient services 

across the board. 

Health Care Quality and Transparency: The focus of the Health Care Quality and 

Transparency initiative has been to enhance the internet presence to display quality 

and safety information using a single web portal that is useful and understandable 

for our stakeholders Veterans, their families and the general public. By providing 

our stakeholders with more useful information about care they can receive at VA 

facilities, they can make more informed decisions about their own health care. Also, 

by increasing our internet presence to provide quality of care information, VHA is 

increasing access to, and awareness of information about VA health care, not only 

for the general public, but for transitioning Veterans and Servicemembers who may 

not be aware of VA health benefits. As a result of providing more useful and understandable quality and safety information, the initiative will also create an increase 

in health literacy, attract a new generation of enrollees, and generate shared public 

interest and transparency in VA care and services across multiple agencies. 

Major milestones of the initiative began in 2010 when VA began posting core 

quality measures on the Web site www.hospitalcompare.hhs.gov, which is sponsored 

by the Centers for Medicare and Medicaid Services (CMS). VA’s partnership with 

CMS provides the Veteran with the ability to compare up to 3 VA and non-VA hospitals based on proximity to the Veteran’s zip code. In the summer of 2011, VA expanded our reporting through CMS to include outcome measures, including risk-adjusted hospital mortality and readmission rates for three common conditions, Chronic Heart Failure (CHF), Acute Myocardial Infarction (AMI), and Community-Acquired Pneumonia (CAP). 

In addition, VA also began April 2010 to provide the most up-to-date information 

by initiating a separate reporting site, VA Hospital Compare (www.hospital 

compare.va.gov) which provides quality and outcome information that reflects care 

provided in the previous quarter. In FY 2011, this site began to include patient satisfaction (HCAHPS) measures through the ASPIRE dashboard. 

Other accomplishments include researching and understanding the needs of Veterans for quality and safety information in efforts to provide more useful information via the internet. As a result of our efforts, version 1.0 of the redesigned Quality 

of Care Web site was released in March 2011. Additional usability studies were completed on the VA’s ASPIRE Web site. VA’s ASPIRE Web site provides a much broader dashboard of quality and safety based measures, not on a comparison with average performance, but with goals that we believed represented the highest possible 

level of performance—our system’s aspirations. Originally intended to be an internal 

reporting system, ASPIRE was released to the general public in FY 2011 in order 

to demonstrate VA’s commitment to those goals. Since then, we have enlisted Veterans and others to provide input into the design of the site in order to make it 

213 

more useful and easier to navigate. Some changes have already been made based 

on that input, and we are working with web developers to produce a completely revised, Veteran-centric format. We expect those revisions to be released to the public 

on a new Quality of Care Web site on or before September 30, 2012. 

Question 8. In an August 2009 report, the Office of Inspector General (OIG) estimated that $1.5 billion in improper payments could be avoided with more effective 

policies and procedures in fee care collections. In August 2010, the VA Inspector 

General reported that VHA improperly paid 28 percent of inpatient fee claims, resulting in net overpayments of $120 million in fiscal year 2009 and an estimated 

$600 million in improper payments over a 5-year period. Between these two audits 

of inpatient and outpatient medical care, OIG estimated potential improper payments of $1.5 billion through fiscal year 2015 could be avoided by more effective 

policies and procedures to oversee and manage fee care services. In response to the 

Inspector General’s audit recommendations, VHA contracted with the National 

Academy of Public Administration (NAPA) to conduct an independent review of the 

fee care program. In its report, NAPA indicated that VHA could learn a tremendous 

amount by looking at how TRICARE or Medicare contracts out inpatient and outpatient claims. Has VA acted on the recommendation from the NAPA study and 

looked at how TRICARE and Medicare collect on their inpatient and outpatient 

claims? If not, does VA intend to do so? If a cost-benefit analysis has been conducted, please provide a copy of the report. 

Response. In response to the NAPA study, VHA established a National Fee Program Organizational Assessment Analysis and Planning Workgroup to analyze options for the most effective model to support back office functions of claims processing. The workgroup conducted a detailed analysis utilizing NAPA’s recommendations and assessed how other entities such as TRICARE and Medicare process 

claims via contract. From this effort, the group intends to provide the Under Secretary for Health with recommendations to assure the most effective and efficient 

operational model to support the Non-VA Care Program. The preliminary findings 

and recommendations from the workgroup are under review. 

Question 9. VHA has approximately 153 hospitals, 833 CBOCs, and 300 Vet Centers, which require upkeep through the non-recurring maintenance (NRM) and repair subaccount of the Medical Facilities account. Maintenance and repair may be 

key elements to sustaining the buildings VA already owns and utilizes on a daily 

basis. The fiscal year 2014 advanced appropriation request proposes to cut NRM in 

half as compared to the fiscal year 2013 level. Please describe the metrics involved 

in estimating how much funding is needed in this account. 

Response. The funding amount included for the FY 2014 advance appropriation 

request in the 2013 President’s Budget for NRM is an estimate, based on the need 

to balance priorities across all programs. The request will be reviewed during the 

formulation of the 2014 President’s Budget in the context of the FY 2014 Strategic 

Capital Investment Planning (SCIP) process results. The metrics used to inform the 

SCIP process criteria include ensuring safety and security, fixing facility deficiencies, supporting Departmental initiatives, increasing access, right-sizing inventory, and ensuring value of investment. 

Question 10. In April 2011, the VA Office of Inspector General released an ‘‘Audit 

of VHA’s Office of Rural Health.’’ In the findings, the Inspector General found the 

Office of Rural Health (ORH) had several program weaknesses including: ‘‘inadequate assessment and mitigation of financial risk; lack of policies and procedures 

to ensure staff followed management directives; * * * ineffective project monitoring 

system; lack of procedures to monitor performance measures; and inadequate assessment of rural healthcare needs.’’ 

a. The Inspector General made six recommendations to the Under Secretary for 

Health; please provide the Committee with the status of the open recommendations. 

Response. The Office of Rural Health (ORH) received notification on March 12, 

2012 that the Inspector General’s audit of the VHA’s Office of Rural Health is now 

closed based on the status report compiled by ORH and submitted to the OIG on 

September 27, 2011. Attached below is a summary of the status of the recommendations as of March 2012. 

214 

Office of Rural Health (ORH) 

Update on the Status of VA’s Response to OIG Recommendations 

March 2012 

Recommendation 1: We recommended that the Under Secretary for Health implement financial controls, such as 

providing written guidance to program sponsors and implementing a mechanism to monitor 

the use of rural health funds. 

VHA Status 3/2012: 

Fiscal Year (FY) 12 update—The Office of Rural Health (ORH) has instituted policies and procedures that ensure sound financial stewardship of its funds. The obligation rates by the 

Veterans Integrated Service Networks (VISNs) of rural health funds are closely monitored by 

the ORH budget analyst. If the obligation rates are deemed to be inadequate given the 

point in time during the fiscal year, ORH program analysts contact the responsible VISN 

Rural Consultant (VRC) to investigate the matter. In addition, any project/program budget 

changes requested by the field must submitted by the responsible VRC and undergo a formal review process by the ORH program analysts and the ORH Director and Deputy Director. 

The VRCs must document why the change is requested and how the funds will be redirected. This includes providing information on how the change will impact rural Veterans, 

as well as updating project milestones, performance measures and quality measures. All 

changes are recorded in the project electronic record in the ORH Management and Analysis 

Tool. 

Recommendation 2: We recommended that the Under Secretary for Health establish management policies and procedures to ensure VHA’s proposal selection process is followed. 

VHA Status 3/2012: 

For the FY 2013 rural health project review process, a concept paper submission system was 

established to reduce the number of full proposal submissions, a clear set of guidelines for 

approval and disapproval of concept papers for reviewers was created and implemented, 

and a workshop was held for the VRCs by ORH staff to help further develop and refine 5 

page project proposals to be considered for funding in FY 2013. Proposals will be reviewed 

by the Selection Review Committee (SRC) in the summer of FY 2012 and will consist of 

members as described above. The tasks and responsibilities of the SRC will remain as described above and well as those in established ORH policies and procedures for the proposal selection process. 

Recommendation 3: We recommended that the Under Secretary for Health implement an effective communication 

plan to effectively coordinate and collaborate with key rural health care stakeholders in the 

use of rural health care funds. 

VHA Status 3/2012: 

• ORH has recently developed collaboration with the American Legion to disseminate electronically to their 2.1 million members, the ORH newsletter, fact sheets, Rural Health Resource 

Center study findings, ORH activities and other information of interest or relevance to rural 

and other Veterans. 

• Additionally, there are now well over 3000 email addresses in the ORH contacts database 

that receive regular updates to ORH activities and study findings. 

• The ORH Web site has received over 20,000 hits in one year. 

• ORH intends to increase dissemination of important rural Veteran health issues and study 

findings through a partnership with the National Rural Health Association which has a 

membership of over 20,000 rural health providers, professionals, advocates and educators. 

• ORH’s latest newsletter can be found at http://www.ruralhealth.va.gov/news/index.asp 

• There are now 15 monthly ORH fact sheets available for download from the ORH Web site 

• There are now 10 ORH issue briefs available for download from the ORH Web site 

• There are now 15 peer reviewed articles authored by ORH or other VA staff on rural Veteran 

Health issues available for download on the ORH Web site 

• Video production as described above did not take place due to loss of key personnel, however, the ORH communications team is making plans for a new series of videos focused on 

rural Veteran health issues 

• There will be four ORH speakers at the National Rural Health Association annual meeting 

presenting on topics such as improving rural Veteran access to health care; implementing a 

teleretinal screening program for rural Veterans, and establishing a telemental health network for Native Veterans. 

• The Director of ORH presented to the National Rural Health Association Public Policy Institute on ORH’s programs and activities in Washington DC, in January 2012. 

• ORH participated in National Rural Health Day by giving a National webinar on rural Veteran health issues sponsored by the National Organization of State Offices of Rural Health 

in November 2011. 

215 

Office of Rural Health (ORH)—Continued 

Update on the Status of VA’s Response to OIG Recommendations 

March 2012 

Recommendation 4: We recommended the Under Secretary for Health establish a project monitoring system, such 

as an Access database on a portal and implement monitoring procedures that would provide relevant, reliable, and timely project management information. 

VHA Status 3/2012: 

ORH has moved its database to the portal provided by the VHA support service center (VSSC). 

The new database is called the ORH management and analysis tool (OMAT). All of FY 2012 

funded project information has been entered into this electronic database. 

Recommendation 5: We recommended that the Under Secretary for Health establish procedures to monitor performance measures to determine the impact of rural health care funding on improving access 

and quality of care for rural veterans. 

VHA Status 3/2012: 

VA Response. Core performance measures along with project/program specific measures have been developed and included with each project record in the OMAT database. VRCs will begin entering 

their project milestones and measures into the database Spring 2012. 

Recommendation 6: We recommended that the Under Secretary for Health reassess the rural health initiatives approved for funding by Office of Rural Health in their FY 2012 budget to align planned use 

of resources to their greatest rural health needs. 

VHA Status 3/2012: 

VA Response. ORH staff continues to conduct focus groups to better understand rural Veteran health care 

needs. In addition, ORH continues to fund rural Veteran outreach activities to help rural 

Veterans understand their benefits, to help them enroll in the VA health care system and to 

educate Veterans on how to better manage their chronic health conditions. The ORH strategic plan refresh has been implemented and each action item associated with goals and 

objectives is updated and monitored quarterly. 

In FY 2011, no ORH funds were used to fund fee care. In addition in 2012, no ORH funds for 

fee care were included in the ORH Spend Plan. However, ORH has allocated $30 million to 

the pilot project ‘‘Access Received Closer to Home’’ (Project ARCH) that is a non-VA Contract Care Pilot Program. 

b. In fiscal year 2011, the Office of Rural Health was appropriated approximately 

$268 million; please provide the Committee with a detailed analysis of how this 

funding was utilized. 

Response. VA appreciates Congress’ continued support of rural health-focused resources. ORH outlines the following in regards to their FY 2011 rural health spending plan of $273.9 million. 

VA is committed to improving access and quality of health care services to rural 

and highly rural Veterans. This funding improved access and the quality of care for 

rural and highly rural Veterans by developing evidence-based policies and innovative practices to support the unique needs of the Veterans residing in geographically 

remote areas. It allowed VA to meet the goals of the ORH program and improved 

the quality of care and services to our Veterans. There were two major components 

that comprised the $273.9 million VA provided to rural health in FY 2011. VA allocated $23.9 million on centrally managed programs of the Office of Rural Health 

and $250 million on projects and initiatives. The rural health spending plan focused 

on major initiatives and programs described below. 

• ORH Centrally Managed Programs—$23.9 million. These funds were used primarily for the following initiatives: 

– Telehealth ($7 million). VA obligated $7 million to support rural health Telehealth projects. The Telehealth projects used information and telecommunications technologies to deliver care remotely. It enabled care to be provided 

near or in the rural Veteran’s community or home at the time when care was 

necessary. It reduced the need for travel by patients and providers and increased access to care for rural Veterans in over 36 specialty areas. It improved access and provided high quality service for rural Veterans. 

– Veterans Rural Health Resource Centers (VRHRC) ($6.5 million). VA used 

$6.5 million to support the VRHRCs. There are three VRHRCs: White River 

Junction, VT; Iowa City, IA; and Salt Lake City, UT. They function as fieldbased clinical laboratories and serve as rural health experts for all VISNs. 

They act as educational and clinical repositories and provide programmatic 

support to ORH and a resource for all Veteran Rural Consultants (VRC). 

216 

They make recommendations based on evidence-based studies and analyses 

that impact the care to rural Veterans. – Teleradiology Services Sustainment ($717,437). VA provided $717,437 for 

teleradiology services for rural Veterans in all 21 VISNs. These were outreach services that enhanced the access to and quality of radiology services 

for Veterans living in rural and highly rural areas and improved the quality 

of services while providing services closer to their homes. – Other Administrative Funds ($9.7 million). With the remainder of the administrative funds, VA supported the following: 

o ORH Salaries and Supplies ($1.6 million) 

o VISN Rural Consultants ($1.1 million) 

o Veteran’s Rural Health Advisory Committee ($60,000) 

o Office of Academic Affiliation Rural Residency Program ($276,300) 

o ORH Policy and Planning Group Contract ($777,950) 

o Additional support for Projects and Initiatives ($5.9 million) 

• Project and Initiative Funds—$250 million. These funds were used primarily for 

the following initiatives: 

– Project Access Received Closer to Home (ARCH) ($3.1 million). VA utilized $3.1 million to support implementation of Public Law 110–387, the ‘‘Veterans’ 

Mental Health and Other Care Improvements Act of 2008,’’ Section 403. This 

required VA to conduct a pilot program to provide non-VA care for Veterans 

meeting the statute’s eligibility criteria in five Veterans Integrated Service 

Networks (VISNs). The VISNs that conducted the pilot program were: 1, 6, 

15, 18 and 19. This pilot program improved access for eligible Veterans by 

connecting them to health care services closer to their homes through contractual arrangements with non-VA providers. This program is underway. – Sustainment Funding ($246.9 million) for over 300 projects and programs including the priority programs listed below: 

o CBOC rural areas ($70.5 million). VA continues to improve access to care 

for Veterans in geographically remote areas through the expansion of 

CBOCs throughout the country. Fifty-two CBOCs were supported by ORH 

funding in FY 2011. Funding the rural and highly rural CBOCs at $70.5 

million improved access and services for the rural and highly rural Veterans in 12 of our 21 VISNs. In previous reports to Congress, VA estimated 

$87.8 million for 51 CBOCs. This estimate was revised to $70.5 million; the 

difference funded Public Law 110–387, section 403, requirements. One additional CBOC, Albany CBOC, was added to the list for funding in FY 

2011. 

o Women Veterans Health ($603,978). VA continues to work in rural and 

highly rural regions to identify gender-based gaps and disparities related 

to women’s care. Other ongoing projects included, educating providers on 

gender-specific issues, enhancing primary care for women Veterans in rural 

areas; and ordering, providing, tracking and timely follow-up of mammogram and pap-smear results in rural areas. VA also provided bio-feedback 

therapy to women Veterans in rural/highly rural areas to regulate pain and 

anxiety. 

o Telehealth ($30.5 million). VA continued to support and expand telehealth 

into rural and highly rural areas. Services included tele-renal, tele-psych, 

tele-dermatology, tele-mental health, tele-amputee clinic, tele-rehab, telepharmacy, tele-polytrauma, tele-radiology and others. 

o Home-Based Primary Care (HBPC) ($25.9 million). Twenty-one HBPC sites 

in twelve VISNs were funded in FY 2011. They provided cost-effective primary care services for Veterans in rural and highly rural areas. 

o Outreach Clinics ($5 million). These clinics provided primary care services, 

case management, and mental health services. Each rural outreach clinic 

is part of a VA network, maintaining VA’s quality standards and access to 

VA facilities for specialized needs. 

o Behavioral Health ($1.5 million). Substance abuse and treatment, including 

alcohol and other substances, were addressed in mental health and other 

specialty treatment programs like tobacco cessation were supported 

through ORH funding in FY 2011. 

o Homeless ($4.9 million). To support the Secretary’s goal of ending Veteran 

homelessness, the rural health program supported projects that provided 

outreach and identified and prevented homelessness by providing prevention services. In addition, other services were provided to help Veterans 

learn about benefits and services for which they and their families qualified. 

217 

o Transportation ($3.2 million). To support access to care from and to rural 

and highly rural areas, including remote-island locations, funds were provided to purchase vans, supplement travel fares, hire drivers, support shuttle buses, and identify transport models for improved rural access. 

o Mental Health ($856,807). Mental Health is high priority for VA. Several 

projects were funded to address and treat mental health disorders including 

depression, Post Traumatic Stress Disorder (PTSD), suicide prevention, 

substance abuse and other problems experienced by Veterans living in 

rural and highly rural areas. 

o Sustainment of 76 additional rural health projects ($103.9 million). Other 

types of projects to improve access and quality of care included rural mobile 

health clinics that extended access to primary care, case management and 

mental health services in rural areas where it was not feasible to establish 

a fixed point of access. ORH initiated geriatric health care programs to provide more opportunities for Veterans to stay close to home. VA has Medical 

Foster Homes, which provide non-institutional long-term care for Veterans 

who are unable to live independently and prefer a family setting. Other efforts included projects focused on speech, language, physical therapy, occupational therapy and rehabilitation that were provided for Veterans in 

rural and highly rural settings. 

The funds for rural health improved access and high-quality services for the rural 

and highly rural Veterans by providing high-quality care in the homes and in the 

communities of the rural Veterans across the country. VA provided a wide range 

of services and benefits through this rural health funding in response to the unique 

needs of rural and highly rural Veterans. The rural health program supported VA’s 

transformation to an integrated delivery system that emphasized a full continuum 

of care in a patient-centered environment, by providing care that specifically addressed the needs of rural and highly rural Veterans. 

c. Please provide the Committee with a detailed analysis of how the fiscal years 

2012 and 2013 funding will be utilized to ensure that taxpayer dollars will be used 

in an effective and efficient manner. 

Response. In FY 2012, ORH was appropriated $23.89 million for ORH Centrally 

Managed Programs and $250 million to support rural health projects and initiatives. It is anticipated that approximately the same amount of funds will be provided to ORH for FY 2013. The spend plan for FY 2012 is delineated below. 

PART A—ORH Centrally Managed Programs 

Project Title Description of line item FY12 Funding 

ORH Salary, Supplies, and Other Funds support annual salaries, travel, training, and supplies for 

the Office of Rural Health 

1,786,615 

Veterans Rural Health Advisory 

Committee (VRHAC) 

Veterans Rural Health Advisory Committee—12 person Federal 

Advisory Committee that provides advice and counsel to the 

SecVA on issues affecting rural Veterans. 

70,000 

Veterans Rural Health Resource 

Centers (VRHRC) Funding 

Annual budget for 3 Veteran Rural Health Resource Centers 6,753,543 

VISN Rural Consultants (VRCs) VRC salary and travel costs 1,174,254 

Quality Management 1,200,000 

Transportation Partnership 2,000,000 

HRSA Partnership 65,227 

ORH Projects Additional support for projects approved for FY12 7,928,842 

Office of Telehealth Services 2,911,519 

TOTAL PART A .......................................................................................................... $23,890,000 

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PART B—Projects and Initiative Funds 

Project Title Description of line item FY12 Funding 

Project ARCH—Public Law 110- 

387, Section 403 

Section 403 of the law requires VA to conduct a pilot program 

that would provide non-VA care for highly rural enrolled Veterans in five VISNs. (VISNs 1,6,15, 18 & 19) meeting the 

statute’s eligibility criteria 

35,000,000 

FY 12 new projects, sustainment of 

existing projects, and expansion 

of existing projects 

From over 460 projects that were submitted and reviewed, 285 

projects were approved, addressing many VHA and ORH priorities such as Telehealth, Women veterans, Mental Health, 

Homelessness, and Access & Quality 

215,000,000 

TOTAL PART B .......................................................................................................... $250,000,000 

Category Number of 

Projects FY 2012 Funding 

Access & Quality .................................................................................................................. 45 27,712,926 

CBOC .................................................................................................................................... 54 72,901,561 

Collaboration & Outreach .................................................................................................... 15 12,718,980 

Geriatrics .............................................................................................................................. 51 43,036,639 

Homelessness ....................................................................................................................... 2 961,699 

Mental Health ...................................................................................................................... 34 13,341,135 

Specialty Care ...................................................................................................................... 35 6,490,781 

Tele & Models of Care ......................................................................................................... 57 31,710,485 

Training & Education ........................................................................................................... 15 3,475,481 

Women Veterans .................................................................................................................. 12 2,597,589 

Project ARCH ........................................................................................................................ 1 35,000,000 

Office of Telehealth Services ............................................................................................... 1 52,724 

TOTAL ALL CATEGORIES .............................................................................................. 322 $250,000,000 

VISN Number of 

Projects FY 2012 Funding 

VISN 1 .................................................................................................................................. 3 724,000 

VISN 2 .................................................................................................................................. 9 4,765,047 

VISN 3 .................................................................................................................................. 7 3,944,318 

VISN 4 .................................................................................................................................. 6 4,134,720 

VISN 5 .................................................................................................................................. 7 3,500,926 

VISN 6 .................................................................................................................................. 21 26,520,035 

VISN 7 .................................................................................................................................. 20 16,220,765 

VISN 8 .................................................................................................................................. 12 12,243,996 

VISN 9 .................................................................................................................................. 10 3,177,664 

VISN 10 ................................................................................................................................ 10 9,979,330 

VISN 11 ................................................................................................................................ 11 8,853,299 

VISN 12 ................................................................................................................................ 18 4,935,385 

VISN 15 ................................................................................................................................ 17 12,623,524 

VISN 16 ................................................................................................................................ 19 24,921,392 

VISN 17 ................................................................................................................................ 15 3,982,493 

VISN 18 ................................................................................................................................ 20 7,000,420 

VISN 19 ................................................................................................................................ 36 13,979,919 

VISN 20 ................................................................................................................................ 25 22,719,231 

VISN 21 ................................................................................................................................ 37 24,189,954 

VISN 22 ................................................................................................................................ 6 3,016,515 

VISN 23 ................................................................................................................................ 10 2,914,343 

Program Offices ................................................................................................................... 1 600,000 

Project ARCH ........................................................................................................................ 1 35,000,000 

Office of Telehealth Services ............................................................................................... 1 52,724 

TOTAL ALL VISNs ......................................................................................................... 322 $250,000,000 

Question 11. The Office of Rural Health oversees Project ARCH (Access Received 

Closer to Home), a pilot program which provides veterans in rural communities acVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00224 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
219 

cess to healthcare services within their local communities. The pilot program is established at five sites and began delivering services on August 29, 2011. 

a. Please provide the Committee with how much funding has been allocated to 

support this pilot program in fiscal year 2012 and fiscal year 2013. 

Response. In FY 2012, the ORH has allocated $35 million toward Project ARCH. 

In FY 2013, ORH will allocate $35 million toward Project ARCH. 

b. What steps has VA taken to ensure lessons learned from Project HERO 

(Healthcare Effectiveness through Resources Optimization) have been taken into account to ensure Project ARCH will be utilized fully at the five sites? Please provide 

the Committee with how many veterans will be eligible for Project ARCH at each 

location and how many veterans have accessed services through this pilot program. 

Response. ORH oversees Project ARCH (Access Received Closer to Home), a pilot 

program which provides Veterans in rural communities access to health care services within their local communities. The pilot program, as directed by law, is established at five sites and began delivering services on August 29, 2011. Monthly calls 

are conducted between the Program Manager for Project HERO and the Program 

Manager for Project ARCH to ensure any lessons learned can be passed along to 

either program. The Project Manager for Project ARCH is also the liaison from ORH 

to Project HERO. 

Eligibility for the Project ARCH is by statute and as such can fluctuate broadly 

between VISNs and type of care Veterans require. Because of this, estimations are 

by Veteran encounters not by number of unique Veterans. Estimations for the number of Veterans encounters were based on the type of service being requested and 

the site of care. Noted below are the total number of estimated encounters expected 

by VISN. 

VISN 1 VISN 6 VISN 15 VISN 18 VISN 19 

2,799 3,340 6,286 3,466 4,666 

The source of the projected numbers are annual estimates based on the original 

contract for fiscal years 2012, 2013, and 2014 as this is a three year pilot. 

Actual Numbers of the encounters submitted by VHA to Humana Veterans and 

Cary Medical Center, the two contractors, are below: 

The two primary care sites (Farmville (VISN 6) and Pratt (VISN 15) each had 

less encounters 114 and 30 respectively, while the three pilot sites offering specialty 

services (Northern Maine (VISN 1), Flagstaff (VISN 18), and Billings (VISN 19) had 

well over 300 encounters each with VISN 1 at 447, VISN 18 at 341 and VISN 19 

at 514 for a grand total of 1,446 encounters. However, the pattern of increase in 

number of encounters by month since Project ARCH began enrolling patients differs 

somewhat across pilot sites. The number of encounters in Northern Maine gradually 

increased over time and dropped off in February, the number of encounters in 

Farmville, Flagstaff, and Billings also increased over time but with less regularity 

and the number of encounters in Pratt has remained fairly consistent with less than 

10 per month at this primary care site. 


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VA has contracted for an independent evaluation of the Project ARCH program, 

including its development, implementation, and performance. 

Question 12. The fiscal year 2013 budget request includes approximately $990 

million for VA’s acquired immune deficiency syndrome (AIDS) program. According 

to the budget justification, ‘‘[t]his program ensures that Veterans with Human Immunodeficiency Virus (HIV) infection receive the highest quality, comprehensive 

clinical care, including diagnosis of their infection, timely linkage to care, and reduction in HIV-related disparities.’’ 

a. Please provide the Committee with a detailed analysis of how this funding will 

be utilized in the treatment and prevention of HIV/AIDS. 

Response. Please refer to the table below for a detail of the $990 million in estimated obligations for HIV/AIDS care at VA health care facilities. 

Components of the HIV Care 

Estimated for FY 2013 

Diagnostic Condition/Service Obligations 

Prescription Drugs** ............................................................. $464,010,000 

Diagnostic Services** ........................................................... $53,323,000 

Treatment for: 

Mental Health .................................................................... $105,778,000 

Human Immunodeficiency ................................................. $70,420,000 

Disease of Genitourinary System ...................................... $37,766,000 

Circulatory System Disease .............................................. $34,491,000 

Neoplasms ......................................................................... $26,896,000 

Musculoskeletal and Connective Tissue ........................... $21,421,000 

Other Conditions ............................................................... $19,163,000 

Disease of Digestive System ............................................ $17,322,000 

Other Factors Affecting Health Status ............................. $16,667,000 

Infectious and Parasitic Disease ...................................... $16,287,000 

Respiratory System ........................................................... $15,139,000 

Other Signs and Symptoms .............................................. $15,091,000 

Injuries and Poisonings .................................................... $12,872,000 

HIV Counseling .................................................................. $9,317,000 

Ischemic Heart Disease .................................................... $9,165,000 

Drug Monitoring ................................................................ $7,775,000 

Oral Disease ...................................................................... $7,744,000 

Skin and Subcutaneous Tissue ........................................ $7,553,000 

Eye Disorders .................................................................... $7,343,000 

Pneumonia ......................................................................... $5,785,000 

Chest Pain ......................................................................... $4,367,000 

Diabetes mellitus .............................................................. $4,305,000 

$990,000,000 

** Designates a Service 

Conditions based on Primary Diagnosis 

b. Please provide how much VA expects to spend in fiscal year 2013 on the national overhead for the VHA National HIV Program Office, including the staff titles, 

salary costs, and benefits. 

Response. The table below provides the estimated obligations for salaries for the 

four HIV/AIDS positions in the Office of Public Health. 

HIV, HCV and Public Health Pathogens Program 

(VHA Office of Public Health, Clinical Public Health) 

Salary + 

Benefits 

Director, HIV Hepatitis, and Public Health Pathogen Program ................................................................................... $273,936 

Deputy Director, HIV Hepatitis, and Public Health Pathogen Program ....................................................................... $205,888 

Senior Program Manager, HIV Hepatitis, and Public Health Pathogen Program ........................................................ $130,546 

Program Coordinator, HIV Hepatitis, and Public Health Pathogen Program .............................................................. $88,788 

Total ..................................................................................................................................................................... $699,158 

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Question 13. Within the fiscal year 2013 budget request, VA listed a ‘‘VA Real Property Cost Savings and Innovation Plan,’’ reflecting savings of $66 million in fiscal year 2013 and $66 million in fiscal year 2014. The fiscal year 2013 budget request indicates VA has identified 494 vacant or underutilized buildings in VA’s inventory for potential reuse or repurposing. 

a. Besides those buildings that VA already identified to support veteran homelessness at last year’s hearing and in this year’s budget request, what other initiatives 

is VA considering for vacant and underutilized assets? 

Response. VA has an aggressive disposal and reuse program that has resulted in 

reusing or disposing of more than 787 building assets since 2003, accounting for approximately 8.5 million square feet of space. A significant portion of this success was 

the result of assets repurposed, via VA’s Enhanced-Use Lease (EUL) authority, 

which expired in December 2011 and was recently modified and enacted in Public 

Law 112–154. VA continues to constantly review its portfolio of vacant or underutilized assets for potential reuse opportunities and/or plans for disposing of the asset. 

With VA’s modified EUL authority, VA may execute a process similar to the original 

Building Utilization Review and Repurposing (BURR) initiative that identified the 

initial set of properties for reuse. The initial BURR process was very successful, contributing more than 2 million square feet and approximately 208 buildings to the 

disposal and reuse numbers above. 

The SCIP process supports reduction in vacant and underutilized assets. As part 

of SCIP, an annual space assessment is conducted. This analysis reviews what space 

each VAMC currently has in its inventory, plus whatever space would be added via 

projects that are currently funded and/or in-process, and comparing that to the projected space needs for the next 10-years. The result of this analysis is the amount 

of square footage that needs to be added to meet demand or the amount to be disposed or reused to right-size the facility. Using the results of this assessment, the 

SCIP process requires that all excess space have a planned disposal or reuse action 

to ensure facilities would be right-sized for the 10-year planning horizon. These two 

requirements (i.e., the space analysis and the planned disposal requirement), along 

with on-going monitoring of its capital portfolio, allows VA to proactively and consistently manage its portfolio of vacant or underutilized assets. 

In addition, VA has annual disposal calls, where each building is reviewed to determine if it is vacant or underutilized. Every asset that is classified as vacant or 

underutilized is required to create a disposal or reuse plan for that asset, unless 

justification can be made as to why it should not be disposed of (i.e. strong historic 

significance, plans for renovation and future use). 

Even with a strong disposal and reuse program, the VA is still faced with a number of challenges when dealing with its vacant and underutilized property. First, 

many of the current buildings that are no longer needed are historic or are in an 

unusable condition. Second, some vacant or underutilized buildings may have reuse 

potential, but due to the location of the asset on the medical center campus, it has 

limited value for other government agencies or third party groups. 

Third, with the modified EUL authority, VA’s options for eliminating vacant and 

underutilized assets have been limited to repurposing for supportive housing. 

b. In 2008, the Government Accountability Office (GAO) issued a report entitled 

‘‘Progress made in Reducing Un-needed property, but VA Needs better Information 

to Make Further Reductions (GAO–08–939).’’ GAO estimated that VA spent $175 

million in fiscal year 2007 operating underutilized and vacant building space at its 

medical facilities, where 98% of such space exists. GAO developed the estimate because VA did not track such costs. GAO recommended, and VA agreed, that VA 

should develop an annual cost estimate of spending on underutilized and vacant 

property. Please describe what tracking mechanism VA has developed and implemented to track these properties and monitor the annual costs to maintain them. 

Response. Based on the Government Accountability Office (GAO) recommendation, VA reviewed the most appropriate way to track cost associated with vacant 

and underutilized assets. The resulting methodology provides valid cost estimates 

for both vacant and underutilized assets. 

One important distinction between a vacant building and one that is underutilized 

is that the underutilized building is still in use and supporting VA’s mission. The 

underutilized designation implies that the given space is not being used as efficiently as it should, but nevertheless, is still being used to support the Department’s 

mission. For this reason, costs to maintain a vacant building are significantly different than maintaining an operational, but underutilized building. 

For vacant buildings, VA uses a $2/square foot metric as cost to maintain the 

building. This was derived in two ways. First, DOD provides a ‘‘sustainment’’ cost, 

per square foot, for maintaining various types of space. Included in that list is maintaining vacant space, with was estimated between $1–2/square foot. Second, VA reVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00227 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
222 

viewed actual costs incurred in support of a set of vacant buildings in its portfolio 

in various geographic locations. The result was between $1.50 and $2.50 per square 

foot of maintenance. Using these two factors, VA decided to use $2/square foot as 

the standard support cost for vacant buildings in its inventory. Based on 2011 numbers, VA estimated it spent approximately $9.5 M maintaining vacant buildings. 

For underutilized buildings, the costs are driven by definitions provided by the 

Federal Real Property Council (FRPC) and OMB, for standard operational costs for 

a building. These costs include such things as normal recurring maintenance, 

grounds upkeep, janitorial services, and utilities in accordance with FRPC guidance. 

Each underutilized building is assigned an operational cost based on actual expenses at the local facility; therefore the estimate includes local cost considerations 

as well as including actual costs incurred. Based on 2011 numbers, VA estimated 

it spent approximately $24.7 million maintaining underutilized buildings. This is 

not surprising, as again these buildings are still in operation providing Veteran 

services. 

In summary, VA estimates it spent $34.2 million in 2011 for maintaining vacant 

or underutilized buildings, a significant difference from the initial GAO provided estimate of $175 million. In addition, truly vacant buildings only account for $9.5 million in cost, the remaining is support for underutilized buildings that are still in 

operation supporting VA’s mission. 

Homeless Veterans 

Question 1. The fiscal year 2013 budget request asks for an additional $43 million 

for Department of Housing and Urban Development-VA Supportive Housing (HUDVASH) case management. A letter sent to the Committee on February 1, 2012, provided VA’s homeless plan, which included an additional 400 case managers to support the HUD-VASH program for fiscal year 2013. Currently, VA funding supports 

1,543 case manager positions for the HUD-VASH program. 

a. What measures did VA use to determine the appropriate case management 

staffing needed for this program? 

Response. In FY 2008 and FY 2009, facilities were funded for staffing at a ratio 

of 1 case manager per every 35 Veterans. In subsequent years, the funding formula 

was altered to provide staffing at a ratio of 1 case manager per 25 Veterans as additional emphasis was put on targeting the most chronically homeless Veterans who 

were in need of more intensive case management services and the adoption of Housing First principles. This determination was based on the best evidence-based practices being utilized by successful programs in the community. 

b. What is VA’s plan to transition HUD-VASH case managers into different roles 

once VA has reached the planned program expansion of 60,000 HUD-VASH 

vouchers? 

Response. With the focus on admitting the most at-risk, chronically homeless Veterans into the HUD-VASH program, many of the Veterans housed through the program will continue to need intensive case management in order to stabilize and 

maintain their housing. It is also expected that there will be a turnover of 10–15 

percent of vouchers each year, which means 6,000–7,500 new Veterans will be admitted, and in need of support to find housing and become more integrated into the 

community. VA does not yet have adequate long term experience with this program 

to know exactly how many case managers will be needed to support Veterans in 

HUD-VASH over time. However, if the need for supportive services does diminish 

drastically, some staff resources will be diverted to outreach to identify new Veterans who may be at risk for homelessness, and to focus additional efforts into 

prevention. 

c. In addition, this plan includes benchmarks for reducing homelessness each 

year. One of the benchmarks for VA is to reduce the number of homeless veterans 

on any given night to 59,000 by June 2012. Is VA on target to meet this goal and 

how does VA plan to measure the success in meeting this goal? 

Response. According to The 2011 Point-in-Time Estimates of Homelessness: Supplement to the Annual Homeless Assessment Report, 67,495 Veterans were homeless 

in the United States on a single night in January 2011. Homelessness among Veterans has declined by nearly 12 percent since the January 2010 Point-in-Time (PIT) 

count, which identified 76,329 homeless Veterans. VA is on track to reach the goal 

of reducing homelessness to 59,000 on any given night by the end of FY 2012. VA 

plans to use the 2012 Point-in-Time Estimates of Homelessness: Supplement to the 

Annual Homeless Assessment Report (referenced 2012 report has not been published) 

as its measure of success in meeting this goal. 

Question 2. The fiscal year 2013 budget request includes $1.352 billion for programs related to prevention and reduction of homeless veterans. 

223 

a. Does the fiscal year 2013 request and fiscal year 2014 advance funding request 

require legislative authority to release funding for these programs? 

b. What metrics were used to determine how much funding is needed for each program? Please provide any metric templates currently developed. 

Response. [These questions appear and were answered in the prehearing responses as Question 8.] 

Question 3. In fiscal year 2011, Congress appropriated [$934 million] for homeless 

veterans programs. 

Please provide a detailed breakdown of how this funding was utilized within these 

various programs, the number of veterans who accessed these programs, how each 

program was effective in reducing the number of homeless veterans, and what 

metrics are used to determine the effectiveness of these programs. 

Response. [This question appears and was answered in the prehearing responses 

as Question 9.] 

Question 4. The fiscal year 2013 budget request includes $21 million for 200 additional FTE to be Homeless Veterans Outreach Coordinators (HVOC) in the Veterans 

Benefits Administration. The purpose of the new HVOCs is to support VA’s goal of 

ending veterans’ homelessness. According to the fiscal year 2013 budget request, the 

additional resources in 2013 are intended to ‘‘accelerate services for an additional 

43,000 Veterans and their families by decreasing the frequency and duration of 

their episodes of homelessness’’ and ‘‘[t]he resources will also assist veterans and 

their family members maintain safe and permanent housing, get connected to employment opportunities, and improve the overall healthcare status.’’ 

a. Please explain how the manner, means, and methods of utilizing these HVOCs 

would not duplicate, compete with, and overlay already existing veteran homelessness outreach programs, initiatives, FTE, and other resources that are on-going in 

the VHA, VISNs, and VAMCs. 

b. Please identify where it is anticipated these 200 HVOCs will be located (i.e., 

existing VBA regional offices, leased space in the community, VAMCs, CBOCs, etc.). 

Are there additional costs to be incurred to find them offices from which to operate? 

If so, please explain and provide the amount needed. 

c. Please provide the Committee with copies of any veteran homelessness needs 

assessment demonstrating the need for these specific outreach coordinators and that 

current VA resources in place are not adequate to address the needs. 

Response. [Questions 4a–c were answered in the prehearing responses as Question 10.] 

d. Please provide the Committee with VBA’s hiring strategy to ensure the additional staff are hired in a timely manner to have the greatest impact on homeless 

veterans. Does VBA plan to hire new staff, shift current staff into these positions, 

or contract for these services? 

Response. The 200 additional HVOCs will be incorporated into VBA’s 2013 Resource Allocation Model (RAM) and allocated as unique FTE. 

FTE allocations at regional offices will be based on several factors. Our 20 current 

HVOCs are overworked. Each of our regional offices that currently has an HVOC 

will receive a second HVOC to assist with workload and help sustain our efforts to 

date. The remaining 180 FTE will be placed in areas that have the highest concentration of at-risk and homeless Veterans throughout the country. VBA will also 

consider other factors such as Veteran population, population density, and workload. 

Once the fiscal year 2013 RAM is finalized, VBA field offices will hire these additional FTE as HVOCs. VBA plans to either hire new employees for these positions 

or fill these positions internally, rather than contracting these positions. 

Question 5. Following the fiscal year 2012 budget hearing, the Committee asked 

a question relating to VA research into the ‘‘health conditions and risk factors that 

relate to homelessness and on the effectiveness of VA homeless services.’’ In VA’s 

response, VA provided the Committee with information about current studies underway and stated that ‘‘[w]e anticipate preliminary data on most of them to be available by the end of [f]iscal [y]ear 2011, and final reports by the end of [f]iscal [y]ear 

2012.’’ 

a. Please share any preliminary data VA may have from these studies. 

b. How has the preliminary data been used to ensure VA is providing the needed 

services to reduce the number of homeless veterans? 

c. Are the final reports still expected to be available at the end of fiscal year 2012? 

Response. [These questions appear and were answered in the prehearing responses as Question 8.] 

Question 6. The Secretary of Veterans Affairs recently announced that the number 

of homeless veterans dropped by 12 percent from 2010 to 2011, bringing the approximate number of homeless veterans in 2011 to 67,495. Both the President and the 

224 

Secretary attribute the improvement to over a billion dollars invested in homeless 

initiatives by the Federal Government. The fiscal year 2013 budget request indicates the goal of reducing the number of homeless veterans to 35,000 in 2013. 

a. Please describe what manner, means, and methods, if any, are currently in 

place, or will be in place, to specifically identify the homeless veterans who have 

been removed from the homeless count in 2011. 

b. If there are no tracking methods in place, coordinated and utilized across VHA 

and the VBA, are there any plans to develop such a tracking capability? Please describe what is being developed and the anticipated implementation timeline. 

Response. [These questions appear and were answered in the prehearing responses as Question 30.] 

Question 7. In fiscal year 2011, VA was appropriated almost $934 million for the 

program specific homeless programs. 

a. At the end of fiscal year 2011, did VA utilize all funding appropriated for program specific homeless programs? If not, please provide the Committee with information regarding which programs had remaining money available at the end of fiscal year 2011. 

Response. Yes, VA utilized all appropriated funding. The FY 2011 actual was 

$934 million, an investment of $135 million over the FY 2011 budget request ($799 

million) in VA’s high priority homeless Veterans programs. 

b. How much funding was directed toward national overhead for the VHA Homeless Veteran Program Office, the Homeless Veteran Initiative Office, and the National Center on Homelessness Among Veterans? Please provide the Committee 

with how much each office spent on salary costs and benefits. 

Response. VA’s financial systems are not capable of generating a report of national overhead data (for example, indirect costs such as square footage). However, 

VHA’s Homeless Program Office is able to provide the following information regarding salary and lease costs. 

VHA’s Homeless Programs manages two types of funding, President’s Budget Specific Purpose (PB SP) and Specific Purpose (SP). The FY 2011 actual spending of 

$934 million for ‘‘program specific homeless programs’’ refers to the PB SP funding. 

VHA’s Homeless Programs staff includes the National Center on Homelessness 

Among Veterans. Salaries for VHA Homeless Programs’ full-time equivalent (FTE) 

positions are funded through a combination of PB SP and SP funding. 

In FY 2011, VHA’s Homeless Programs incurred $6 million in salary and benefits 

costs and $353 thousand in lease costs. 

The Homeless Veteran Initiative Office (HVIO), managed at the Department level, 

received an FY 2011 budget of $2.7 million from VHA’s Homeless Programs’ PB SP 

funding. HVIO paid its operational costs, including salary and lease costs, from this 

funding. 

Question 8. The fiscal year 2013 budget request includes approximately $3.5 million for the Getting to Zero initiative, which ‘‘provides funding for additional administrative support for [the] H[omeless] V[eteran] P[rogram] O[ffice].’’ Please provide 

additional information on how these funds will be utilized and the direct impact expected on reducing homelessness among veterans. 

Response. Previously known as the Homeless Veteran Program Office, the Homeless Veteran Initiative Office (HVIO) is the Department’s office that leads VA’s initiative to Eliminate Veterans Homelessness. HVIO is responsible for policy development, reporting Agency Priority Goal performance, inter and intra-agency coordination, developing and maintaining strategic external partnerships and socializing 

VA’s plan to end Veterans homelessness. HVIO serves as the Department’s coordinating office with the US Interagency Council on Homelessness (USICH). A member 

of the office is the Designated Federal Official for the VA’s Congressionally mandated Advisory Committee on Homeless Veterans. HVIO also coordinates plans and 

assists with execution of the Advisory meetings and reports. HVIO coordinates VA 

involvement in the planning and development in joint conferences and national initiatives with Federal departments that assist homeless Veterans including Labor, 

HUD, Department of Health and Human Services and the Department of Justice. 

HVIO has responsibility for executing the national homeless outreach efforts 

contract. 

Approximately $2 million of the funding in the FY 2013 budget will be used for 

staff salaries and benefits; $400,000 leased space, supplies, copy machine lease, 

travel, training, equipment, Advisory Committee meetings and parcel post service 

for outreach materials; and approximately $900,000 will be used for ongoing outreach and communication support with external partners, stakeholders and Veterans to educate and inform them on specialized homeless programs. 

225 

Question 9. The fiscal year 2013 budget request includes approximately $196 million for Health Care for Homeless Veterans (HCHV). This money is allocated to two 

HCHV budget lines, one for Sustainment and another for Initiatives. 

a. Please provide the Committee with a detailed analysis of how this funding will 

be utilized for HCHV Initiatives. 

Response. The budget line item titled ‘‘Health Care for Homeless Veterans— 

Sustainment’’ is allocated to the ongoing support of pre-existing HCHV case management and outreach staffing. This pertains to positions previously developed 

through establishment of HCHV programs prior to the introduction of the Ending 

Veteran Homelessness initiative. The line item titled ‘‘Health Care for Homeless 

Veterans—Initiative’’ refers to program development, expansion, and staffing costs 

tied directly to this initiative. 

For FY 2013, ‘‘Sustainment’’ is projected to require approximately $58.5 million 

in allocation. VHA projects the ongoing support of the ‘‘Initiative’’-related costs at 

approximately $93.7 million. These funds will be expended to support: 

• Expanded HCHV emergency, transitional housing, and low/demand/safe haven 

housing programs along with assigned case management staff; 

• Community Resource and Referral Centers (CRRCs); 

• Approximately 120 staff positions (rural outreach workers, psychiatrists, nurses, 

addictions therapists, peer support personnel, program support assistants, etc.) tied 

to prevention and outreach efforts developed through the Eliminate Veteran Homelessness initiative; 

• Homeless Patient Aligned Care Team (HPACT) program sites and selected referral program projects; 

• Medical facilities support for homeless program site renovations for fire and 

safety code requirements and expanded leased space to accommodate staffing additions generated through this initiative. 

The remaining $43.3 million will be used to fund new prevention and employment 

initiatives in HCHV in FY 2013. 

b. Please provide the Committee with the locations of the Community Resource 

and Referral Centers; a breakdown of how the Centers are staffed; and what services are available at each location. 

Response. Community Resource and Referral Centers (CRRCs) are being developed under the Model Development core of the National Center on Homelessness 

Among Veterans. As such, these programs are being developed and evaluated as 

practice-informed models for possible wider dissemination. Sites are in various 

stages of development and most are not yet providing services, although several locations are offering CRRC-type linkage and referral assistance for Veterans while 

facilities are being prepared. VA is implementing CRRCs at the following locations: 

VISN 3—New York Harbor HCS 

VISN 4—Philadelphia VAMC 

VISN 5—Washington DC VAMC 

VISN 7—Atlanta VAMC 

VISN 10—Louis Stokes Cleveland VAMC and Akron CBOC 

VISN 11—John D. Dingell VAMC Detroit 

VISN 12—Jesse Brown Chicago VAMC 

VISN 16—Southeastern Louisiana VA HCS 

VISN 18—Phoenix VA HCS 

VISN 19—Eastern Colorado HCS 

VISN 20—Portland VAMC 

VISN 21—San Francisco VAMC 

VISN 22—Southern Nevada HCS 

VISN 23—Central Iowa HCS and Nebraska/Western Iowa HCS 

CRRC models were funded with the following basic staffing: Social Workers, Peer 

Supports, Vocational Rehabilitation Specialist, Addiction Counselors, Registered 

Nurse, Physicians, and Administrative Assistant. 

The following basic services are provided at all CRRCs: Intake, Case Management 

Services, Housing services, Vocational Employment services, Educational services, 

Primary Health services, Mental Health services, Substance Abuse Services, Economic Benefit services, and Communication services such as internet and mail. 

Legal services are provided in conjunction with community partners. 

Some CRRCs also have HPACT Teams that provide primary care services. Those 

include: 

VISN 4—Philadelphia VAMC 

VISN 5—Washington DC VAMC 

VISN 11—John Dingell Detroit VAMC 

226 

VISN 12—Jesse Brown Chicago VAMC 

VISN 16—New Orleans South Louisiana HCS 

VISN 18—Phoenix VA HCS 

VISN 19—Denver Eastern Colorado HCS 

VISN 20—Portland VAMC 

VISN 21—San Francisco VAMC 

VISN 22—Las Vegas Southern Nevada HCS 

Women Veterans 

Question 1. In fiscal year 2011, VA allocated $17 million for non-recurring maintenance for correcting patient privacy deficiencies. In the questions for the record following the fiscal year 2012 budget hearing, VA provided a list of women’s projects 

from the fiscal year 2012 Strategic Capital Investment Planning process. 

a. Please provide an updated list of construction projects relating to correcting patient privacy deficiencies. 

b. For fiscal year 2013, how much is requested to correct patient privacy deficiencies? Also, please provide a list of facilities that will receive funding in fiscal 

year 2013. 

Response. [These questions appear and were answered in the prehearing responses as Question 31.] 

Question 2. In the last 10 years, the number of women veterans enrolling for VA 

services has nearly doubled. This trend is expected to continue in the coming years. 

The fiscal year 2013 budget request includes $403 million for gender specific health 

care. As noted in the Independent Budget, VA’s own statistics show that ‘‘51 percent 

of women veterans who use the VA system divide their care by using both VA and 

non-VA providers.’’ 

a. For fiscal year 2013, how much funding does VA expect to spend on fee-basis 

care for women veterans? What performance measures does VA have in place to ensure women veterans are receiving quality care? 

Response. Based upon FY 2008-FY 2011 Fee Basis expenditure disbursements for 

health care for women, expenditures have increased by an average of 20.8 percent 

since FY 2007. It is estimated that VHA will spend $302 million in FY 2013 on Fee 

Basis care for women. Currently there are existing performance measures ensuring 

quality care for all Veterans, including access to care and timeliness of care. In addition, the Non-VA Care Coordination (NVCC) program has a patient satisfaction 

query component in which Fee Basis utilization review nurses collect patient information about the patient’s satisfaction in reference to a non-VA care experience. The 

information collected from this component promotes a key measure in ensuring 

quality care directly from the Veteran. The NVCC program implementation will improve upon the quality care experience as it also contains specifications in the selection of providers promoting verification that they are appropriately certified. 

b. In fiscal year 2011, VA’s actual budget for gender specific health care was 

$287.5 million; please provide the Committee with a detailed breakdown of how this 

money was utilized. 

Response. See itemized list below. 

FY 2011 Women’s Gender Specific Health Care 

[dollars in thousands] 

Diagnosis Category Obligations 

Benign Neoplams ............................................................... $5,867 

Breast/Skin Neoplasm ........................................................ 16,960 

Complications of Pregnancy ............................................... 32,724 

Genitourinary Neoplasm ..................................................... 6,278 

Osteopathies ....................................................................... 2,380 

Breast Disorders ................................................................. 11,474 

Other Disease of Genitourinary .......................................... 39,611 

Other Factors Affecting Health Status ............................... 20,295 

Other ................................................................................... 7,095 

Pregnancy and Delivery ...................................................... 6,395 

Diagnosis Category Subtotal ..................................... $149,079 

227 

Program Description Obligations 

Women’s Clinic ................................................................... $88,034 

Gynecology .......................................................................... 32,149 

Women’s Surgery ................................................................ 408 

Women’s Stress Disorder Treatment Teams ...................... 2,274 

Mammogram ....................................................................... 10,142 

Female Gender Specific Cancer Screening ........................ 5,389 

Program Subtotal ............................................................... 138,396 

Total Gender Specific Care ....................................... $287,475 

Vet Centers 

Question 1. In the fiscal year 2013 budget request, VA proposes spending $222 

million for readjustment counseling services at Vet Centers. Some Vet Centers offer 

evening and weekend hours; however, this might not be widely known by veterans. 

a. How many Vet Centers offer evening and weekend hours and how much of the 

funding will be utilized to provide evening and weekend hours to veterans? 

Response. Vet Center policy states that upon request from Veterans, Vet Centers 

will maintain non-traditional appointment schedules, after normal business hours 

during the week and on weekends, to accommodate working Veterans and family 

members. Currently, over 280 of the 300 Vet Centers have established non-traditional hours each week to provide both individual and group counseling services. 

The remaining locations offer non-traditional hours as needed. Most of these locations are new and are still establishing a client base. 

There is no specific funding for providing evening and weekend hours to Veterans 

and their families. Vet Center staff adjust their tours of duty as needed to take into 

account for providing services during non-traditional hours. 

b. What mechanisms and outreach efforts are in place to ensure veterans know 

that local Vet Centers provide evening and weekend hours? 

Response. Vet Center non-traditional hours are regularly highlighted during Vet 

Center outreach presentations at the various Federal, State, and locally organized 

events in which the Vet Center staff participate. It is also discussed as a part of 

scheduling for Veterans who seek services at a Vet Center. Vet Center media (Web 

site, print media, press releases) is continuously monitored for opportunities to further communicate this benefit. 

COMPENSATION AND PENSIONS

Question 1. In 2010, VA began operating the Fast Track Claims Processing System to process claims for three conditions presumed to be related to Agent Orange 

exposure. The fiscal year 2013 budget request reflects that ‘‘analysis and planning 

regarding system retirement will be conducted in [fiscal year] 2012.’’ 

a. To date, how much in total has been spent (from any account) on developing, 

enhancing, and operating the Fast Track Claims Processing System, including funds 

for contractor support? 

b. Is any funding (from any account) requested in the fiscal year 2013 budget in 

order to operate, expand, or retire the Fast Track Claims Processing System? 

c. Since its inception, how many claims have been filed by claimants on-line using 

this system? 

d. How many claims have been processed through the Fast Track system and how 

long on average did it take to complete those claims? 

e. How many Fast Track claims are currently pending and how long on average 

have they been pending? 

f. What, if any, changes have been made in the manner, means, or method of implementing the Fast Track Claims Processing System, either in the field or within 

the headquarters of the VBA, since it began in 2010? 

Response. [These questions appear and were answered in the prehearing responses as Question 5.] 

Question 2. According to VA’s Fiscal Year 2011 Performance and Accountability 

Report, VA is ‘‘noncompliant with the Debt Collection Improvement Act of 1996’’ because VA does not charge interest or administrative costs on delinquent debts owed 

to VA. VA has previously explained to the Committee that, ‘‘in 1992, the Deputy 

Secretary of Veterans Affairs made a decision not to implement the statutory interest and administrative charges on Compensation and Pension debts.’’ VA has also 

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indicated that ‘‘[t]he majority of debts created for compensation are due to beneficiary death, incarceration and fugitive felons.’’ 

a. What is the legal authority relied upon by VA to forego collecting interest and 

administrative costs with respect to delinquent debts? 

b. What is the total amount of debt to VA created in fiscal year 2011 as a result 

of VA beneficiaries being incarcerated or having fugitive felon status? 

c. What is the total amount of debt to VA expected to be created in fiscal year 

2012 and in fiscal year 2013 as a result of incarceration of beneficiaries or beneficiaries deemed to be fugitive felons? 

d. If VA assessed interest and administrative costs, in accordance with the Debt 

Collection Improvement Act of 1996, on any of those debts that are or are projected 

to be delinquent, what would be the total amount of those assessed charges in fiscal 

year 2012 and fiscal year 2013? 

Response. [These questions appear and were answered in the prehearing responses as Question 14.] 

Question 3. With respect to VA’s fiscal year 2012 budget request, VA was asked 

whether the budget request included ‘‘funding for benefits that are projected to be 

overpaid and not recouped.’’ In response, VA indicated in part that, ‘‘[a]lthough 

there is no specific line item for overpayments in the budget request for the Compensation and Pension account, these payments are accounted for in the baseline 

budget estimates and are not identified as funds that VA does not expect to recoup.’’ 

VA also indicated that for fiscal year 2012 the Readjustment Benefits account included ‘‘a net increase of $7.2 million in obligations associated with overpayments.’’ 

a. For fiscal year 2012, what is the total amount of benefits now projected to be 

overpaid? 

b. For fiscal year 2013, what amount is included in the Readjustment Benefits account for overpayments of benefits? 

c. For fiscal year 2013, what amount is included in the Compensation and Pension 

account (including any amounts in the budget baseline) for overpayments? 

Response. [These questions appear and were answered in the prehearing responses as Question 15.] 

Question 4. VA’s Fiscal Year 2011 Performance and Accountability Report contains the following information: 

One cause of overpayments in both the Compensation and Pension programs has 

been the implementation of the Fugitive Felon program. This program * * * prohibits Veterans or their dependents who are fugitive felons from receiving specified 

Veterans’ benefits. The law requires VA to retroactively terminate awards to Veterans and other beneficiaries from the date the beneficiary became a ‘‘fugitive felon.’’ 

As of January 2011, nearly 23,000 fugitive felon cases have been referred to field 

stations resulting in a total of nearly $165 million accumulated overpayments which 

cover multiple warrant years. The Committees on Waivers and Compromises had 

waived nearly $22 million in overpayments. 

a. To date, how many current or former fugitive felons have had their overpayments to VA waived? 

b. To date, what is the total dollar amount of overpayments to fugitive felons that 

have been waived? 

c. For fiscal year 2013, what amount is included in the budget request in order 

to waive recoupment of overpayments to fugitive felons? 

Response. [These questions appear and were answered in the prehearing responses as Question 16.] 

Question 5. Under current law, VA is required to reduce, but not terminate, the 

compensation payments to certain beneficiaries who have been incarcerated for 

more than 60 days. 

a. What was the total amount of VA benefits paid to incarcerated beneficiaries 

during fiscal year 2011? 

b. What is the total amount of VA benefits expected to be paid to incarcerated 

beneficiaries during fiscal year 2012? 

c. What is the total amount included in the fiscal year 2013 budget for VA benefits expected to be paid to incarcerated beneficiaries? 

Response. [These questions appear and were answered in the prehearing responses as Question 17.] 

Question 6. According to VA’s Fiscal Year 2011 Performance and Accountability 

Report, VA paid $45 in interest penalties per million dollars disbursed during 2011. 

a. In total, how much did VA pay in interest penalties during fiscal year 2011? 

b. In total, how much does VA expect to pay in interest penalties during fiscal 

year 2012? 

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c. In total, how much is included in the fiscal year 2013 budget request in order 

to pay for interest penalties? 

Response. [These questions appear and were answered in the prehearing responses as Question 18.] 

Question 7. The summary of compensation and pensions appropriations in the fiscal year 2013 budget request reflects that several Omnibus Budget Reconciliation 

Act (OBRA) payments are expected to be made to VBA, VHA, and OIT during fiscal 

year 2012. According to the budget request, ‘‘[a]fter 2012, VHA will no longer be reimbursed by the Compensation and Pension account for the administrative costs associated with income verification matching.’’ 

a. Please provide a breakdown of how those OBRA payments are expected to be 

spent during fiscal year 2012. 

Response. The total current estimate for FY 2012 for OBRA obligations are $26.3 

million from the Compensation and Pension mandatory budget. Of this total, an estimated $8.1 million is VBA obligations for OBRA, $11.3 million is for VHA OBRA 

and $6.9 million is OBRA obligations for IT. VBA OBRA obligations consist of approximately $7.6 million in payroll to support 90 FTE and approximately $0.5 million in non-pay obligations such as rent, printing, and supplies. 

b. Please provide a breakdown of how OBRA payments for VBA and OIT are expected to be spent during fiscal year 2013. 

Response. The total estimated obligations for FY 2013 for OBRA are $9.2 million 

from the Compensation and Pension mandatory budget. Of this total, an estimated 

$9.1 million is VBA obligations for OBRA and remaining $145 thousand is obligations associated with IT OBRA. VBA OBRA and IT OBRA reimbursements are used 

to pay administrative costs and IT-related costs associated with income verification 

data matches. VBA OBRA obligations consist of approximately $8.4 million in payroll to support 101 FTE and approximately $0.7 million in non-pay obligations such 

as rent, printing, and supplies. 

VETERANS BENEFITS ADMINISTRATION

Disability Compensation, Pensions, and Burial 

Question 1. VA has a number of initiatives underway to reach its goal of a 98% 

accuracy rate. 

a. For each of these initiatives, please describe the impact it is expected to have 

on the accuracy rate. 

Response. VBA is pursuing a major organizational transformation grounded in 

VA’s Agency Priority Goals (APGs), specifically: 

• Eliminate Veterans disability claims backlog (no claim pending more than 125 

days and 98 percent quality by the end of 2015) 

• Increase access to services and benefits 

• End Veteran homelessness by 2015 

VBA’s Transformation Plan is based on more than 40 initiatives in the areas of 

People, Processes and Technology, selected from ideas submitted from employees 

and stakeholders. Transformation is not a ‘‘once and done,’’ flip-of-the-switch proposition—it is a dynamic process of intaking, researching, testing and launching new 

ideas and initiatives. Under the Transformation Governance Process, VBA initiatives progress through a series of decisions as they mature from proposals to pilots 

to nationally deployed initiatives. 

Initiatives are being implemented through a deliberate process and rolled out to 

regional offices (ROs) in a multi-year, phased approach that will ensure success and 

minimize risk. Key initiatives that are currently in pilot or implementation phases 

are described below, many of which impact both productivity and accuracy. 

VBA’s Transformation Plan will be coordinated through the Implementation Center—a program management office (PMO) with dedicated resources to oversee the 

implementation of the Transformation Plan using a governance process to achieve 

standardization and sustainability. Additionally, the Implementation Center will develop performance measures that will track the impact of the Transformation Plan. 

The successful execution of the plan is expected to result in a 45 to 60-percent 

increase in productivity and a 14-point increase in quality in 2015 from FY 2011. 

People Initiatives (How VBA is changing workforce organization and training) 

• Intake Processing Center (IPC) enables quick, accurate claims triage (getting the 

right claim in the right lane the first time). This initiative was rolled out to the 

Wichita, Ft. Harrison, and Milwaukee ROs on March 26, 2012. National deployment 

is expected by the end of fiscal year 2013. The IPC has the potential to save 40 days 

combined with Segmented Lanes and Cross-functional Teams, discussed below. 

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• Segmented Lanes will improve the speed, accuracy and consistency of claims decisions by organizing claims processing work into distinct categories, or lanes (Express, Core, and Special Operations), based on the amount of time required to process the claim. This initiative was rolled out to the Wichita, Ft. Harrison, and Milwaukee ROs on March 26, 2012. National deployment is expected by the end of fiscal year 2013. Segmented Lanes have the potential to save 40 days combined with 

IPC and Cross-functional Teams 

• Cross-functional Teams initiative consists of teams of cross-trained raters co-located to reduce rework time, increase staffing flexibility, and better balance workload by facilitating a case-management approach to completing claims. This initiative was rolled out to the Wichita, Ft. Harrison, and Milwaukee ROs on March 26, 

2012. National deployment is expected by the end of fiscal year 2013. Cross-functional Teams have the potential to save 40 days combined with IPC and Segmented 

Lanes 

• National Level Challenge Training provides training to employees on claims 

processing through a standardized curriculum. The 8-week program enables new 

raters to process 1.3 disability claims per day at 98-percent accuracy (actual)—up 

from an average of 0.5 cases per day and 60-percent accuracy. 

• Skills Certification improves performance and accelerates productivity of claims 

processors. 

Process Initiatives (How VBA is making improvements that result in quality 

and timeliness gains) 

• Simplified Notification Letters (SNL) standardize and streamline the Veteran’s 

decision notification. SNL reduce complexity and time by 10–20 percent in testing. 

This initiative was fully implemented nationally on March 12, 2012. Overall productivity is a key metric used in determining this initiative’s effectiveness. 

• Quality Review Teams (QRT) will improve claims quality through assessments 

throughout claims processing. It has the potential to improve quality 4 points; improve quality insight from four-month lag to one week. QRT was fully implemented 

nationwide on March 5, 2012. 

• Disability Benefits Questionnaires (DBQs) change the way medical evidence is 

collected, giving Veterans the option of having their private physicians complete a 

form that provides the medical information necessary to process their claims. This 

initiative was nationally implemented on March 19, 2012. DBQs have the potential 

to reduce exam processing times and improve quality. 

• Rater Decision Support Tools establish consistent rater performance, and include three rules-based calculators (Special Monthly Compensation, hearing loss, 

and joints). The rules-based calculators have the potential to improve quality by six 

percentage points from 2011 to 2015. 

• Paperless Compensation and Pension Records Interchange (CAPRI) was nationally implemented in November 2011. This initiative eliminates the requirement to 

print and file CAPRI records at substantial cost and time savings. Paperless CAPRI 

has saved printing of 13 million pages of medical records and 220,000 hours of 

printing and filing time since implementation. 

• Acceptable Clinical Evidence (ACE) allows VHA medical personnel to use existing medical evidence and complete a DBQ in lieu of an in-person exam. This reduces 

the burden on the Veteran and caregiver to travel to VA medical centers to complete 

exams and reduces the time waiting for evidence in claims cycle. In the ACE pilot 

conducted by St. Paul Regional Office and Minneapolis VA Medical Center, 39 percent of exam requests were completed using ACE, with average processing time of 

six days. The current national average exam processing time is 27 days. National 

implementation is being planned for every regional office with a VA medical center 

located in the same metropolitan area. National tracking metrics are currently being 

developed jointly between VBA and VHA. 

Technology Initiatives (building systems that transition VBA to a paperless, 

automated, rules-based, multichannel access environment) 

• Veterans Benefits Management System (VBMS) standardizes disability compensation claims processing through Web-based paperless system. As of March 16, 

VBMS has completed over half (56 percent or 563) of its 1,000 established claims. 

The average days to complete a claim in VBMS is 135 days. National rollout is expected to begin in July 2012. 

• Veterans Relationship Management (VRM) initiative improves telephone service 

and online Web access, including electronic claims submission as it goes online in 

summer 2012. Total contacts (including phone, email, and online eBenefits sessions) 

have increased 5.4 million (59 percent), from 9.1 million to 14.5 million from FY 

2009 to FY 2011. The VRM initiative includes: 

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– Virtual Hold-ASAP system automatically calls the Veteran back versus making them hold. We have achieved 92-percent reconnect success rate and caller 

satisfaction was up 15 percent. Virtual Hold was implemented on September 26, 

2011. 

– Scheduled Call Back allows the Veteran to pick a date and time for VA to 

call them back. There is a 77-percent reconnect success rate and 18-percent acceptance rate. Scheduled Call Back was fully implemented on December 6, 

2011. 

– Customer Relationship Management/Unified Desktop (CRM/UD) combines 

13 systems into one database. CRM/UD improves call center representatives’ 

ability to efficiently find accurate information for the Veteran. CRM/UD is 

scheduled to be implemented by the end of fiscal year 2012. 

– Veteran Online Application Direct Connect (VDC) provides standardized eforms to facilitate electronic interviews. VDC reduces control time from 11 to 

0 days. The standardized e-forms have the potential to save 32 cents to 37 cents 

per page. 

• eBenefits is VA and DOD’s online self-service portal that enables Veterans and 

Servicemembers access to benefits and services. User enrollment has increased 75 

percent. • Stakeholder Enterprise Portal (SEP) for VSOs and Physicians facilitates stakeholder roles in the claims process in a secure environment with identity access tools. 

SEP has the potential to reduce control time from 11 days to 0 days. 

Question 2. Over the past three years, VA took in over 430 thousand more claims 

than were decided, the inventory of pending claims rose to over 810,000 by the end 

of fiscal year 2011, and 60% of those claims are considered by VA to be backlogged. 

a. In total, how many claims will VA need to decide each year to reach the goal 

of eliminating the backlog by 2015? 

Response. In order for VBA to eliminate the disability claims backlog in 2015, 

VBA estimates that we need to complete 1 million claims in FY 2012 and 1.4 million 

claims in FY 2013. We are currently working on projections for FY 2014. 

b. What precautions will VA take to make sure there is a focus on training and 

improving quality, while VA tries to reach that level of productivity? 

Response. VBA’s Transformation Plan will improve and standardize processes to 

eliminate the claims backlog, achieve efficiencies, improve quality, and reallocate capacity. We will relentlessly streamline our processes and eliminate repetition and 

rework, while keeping our focus on delivering optimal client service. Through these 

improved processes, VBA will achieve productivity gains of 15 to 20 percent and 

quality enhancements of four percent. VBA’s Transformation initiatives such as 

Quality Review Teams (QRTs), Simplified Notification Letter (SNL), and Challenge 

training, are currently underway and will help VA achieve accurate benefits and 

service delivery and our goal of 98-percent quality. VBA has established QRTs at 

each regional office to bridge the gap between local and national quality metrics and 

foster consistency. The SNL standardizes and streamlines the decision-notification 

process and helps integrate essential information into one simplified notification, 

while reducing complexity and time. The national-level Challenge training provides 

a standardized curriculum to new claims processors to help ensure high quality and 

productivity. 

c. Does the fiscal year 2013 budget request include any funding for more nearterm measures that could help veterans, family members, and survivors whose 

claims are already pending? 

Response. VBA’s FY 2013 budget request includes FTE projections of 14,520 for direct claims processing and support for 1.4 million claims, and $72.1 million dedicated to transformation initiatives. Initiatives are being implemented through a deliberate process and rolled out to regional offices in a multi-year, phased approach 

that will ensure success and minimize risk. Throughout FY 2013, VBA will continue 

to roll out the Veterans Benefits Management System, cross-functional teams, specialized lanes, and integrated processing centers. 

Question 3. VA’s ‘‘appeals resolution time’’ has increased by over 100 days since 

2008 and, for those appeals that result in a decision by the Board, it took on average 

1,123 days to go through the appeal process in 2011. 

a. Please explain the root cause for delays at each step of the appeals process, 

what actions VA is taking to reduce delays at each step of the appeals process, and 

when we can expect to see improvements as a result of those actions. 

Response. The appeals resolution time (ART) is a joint measure between the Veterans Benefits Administration (VBA) and the Board of Veterans’ Appeals (BVA). It 

represents the average length of time it takes the Department to process an appeal, 

from the date a claimant files a notice of disagreement (NOD) until the case is fiVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00237 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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nally resolved, whether the appeal is resolved at the VBA regional office (RO) or 

at BVA. Note that ART measures the time to a final resolution, such as an allowance, a denial, or a withdrawal of an appeal. This measure does not include remands, since a remanded appeal is not yet resolved. Remand time is included in 

the ART once the matter on remand reaches final resolution. The average ART includes many appeals that resolve at the RO level and never come to BVA for 

decision. 

A contributing factor to VBA delays in the appeals process in recent years is due 

in large part to the readjudication of previously denied claims for the new Agent 

Orange presumptive conditions (Parkinson’s disease, ischemic heart disease, and bcell leukemias) required under U.S. Court of Appeals, Ninth Circuit decision, 

Nehmer v. the Department of Veterans Affairs (VA). VBA claims inventory increased 

more than the appeals inventory for the period. In the beginning of FY 2010, VBA’s 

thirteen resource centers began preparing to review and readjudicate nearly 100,000 

claims resulting from the Nehmer litigation. Over the course of FY 2011 and FY 

2012, VBA has adjudicated nearly 248,000 Agent Orange claims for the new presumptive conditions and provided over $3.3 billion in retroactive benefits to over 

121,000 Vietnam Veterans and their survivors. The reallocation of resources necessitated by this dramatic workload increase resulted in a significant loss in claims 

processing capacity and left fewer resources to process the regular rating workload, 

including appeals. This included 1,100 Veterans Service Representatives (VSRs) and 

almost 1,200 Rating VSRs (RVSRs) working Agent Orange claims in FY 2011. Because of this, the current VBA appeals workload is not a true indication of either 

past or future workload performance. 

To improve efficiencies, VBA has created an Appeals Design Team tasked with 

developing, testing, and evaluating improvements in the appeals process. The Design Team’s recommendations are aimed at improving timeliness in each segment 

of the appeals process and making it more Veteran-centric, trust-earning, and consistent. Several of these recommendations were implemented as part of a pilot at 

the Houston RO on March 1, 2012. The recommendations are designed to reduce the 

appeals processing time at the RO level. It is anticipated that the remainder of FY 

2012 and most of FY 2013 will be dedicated to the testing and national rollout of 

these recommendations before the overall impact can be seen on processing 

timeliness. 

One common root cause for an initial delay in the appeals process is identifying 

a legitimate and intended NOD. As such, the Design Team created a standardized 

NOD form to assist in identification and control of the appeal, and encourage the 

Veteran to specify the claimed condition and evaluation being sought, allowing VBA 

to narrow the scope of the appeal review. The new form also prompts early Decision 

Review Officer (DRO) involvement in the appeal. DROs are contacting the appealing 

party early in the appeals process to clarify any questions or outstanding issues associated with the appeal. Historically, if the claimant does not specify the condition 

and evaluation sought, an appeal is continued as to all issues. 

A waiver of RO jurisdiction form was created that would address the longest area 

of delay at the RO level, which is attributed to the continual submission of new evidence and VBA’s duty to address and decide on each new submission. This waiver 

grants VBA the ability to certify the appeal to BVA along with any new evidence, 

once all development at the RO level is complete. On May 19, 2011, VA transmitted 

the ‘‘Veterans Benefit Programs Improvement Act of 2011’’ to Congress. Section 204 

of this bill would automatically waive the right to initial consideration of certain evidence by the agency of original jurisdiction. The House has passed a similar provision as part of H.R. 1484, and the Senate Veterans’ Affairs Committee has reported 

out S. 914, section 404 of which also has this language. The potential benefits that 

would result from enactment of the proposal include expedited adjudication of 

claims on appeal and a reduction in the time spent processing appeals, both at the 

agency of original jurisdiction and BVA, allowing more time for deciding new claims. 

VA is hopeful the Committees will be successful in advancing this provision to enactment by the close of the 112th Congress. 

VBA is piloting the elimination of the traditional election process and doing de 

novo reviews on all appeals. Elimination of the election process allows VBA to save 

a minimum of 60 days due to the fact that VBA would no longer send the election 

letter (which allows 60 days for a response from the claimant). 

Once VBA has certified the appeal and transferred the file to BVA, the average 

length of time from the date that BVA received an appeal to the issuance of a Board 

decision during FY 2011 was 240 days. This 240-day time period includes the time 

that the file was with a Veterans Service Organization representative with offices 

co-located at BVA, for preparation of written argument. In FY 2011, BVA’s average 

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cycle time (i.e., the time from when an appeal is physically received at BVA until 

a decision is reached, excluding the VSO time referenced above) was 119 days. 

BVA is responsible for conducting hearings and issuing detailed appellate decisions concerning complex legal matters. In FY 2011, BVA issued approximately 90 

decisions per FTE, which includes Veterans Law Judges (VLJ), attorneys, and administrative support staff, for a total of 48,588 decisions. In FY 2012, BVA projects 

issuing 47,600 decisions based on the current level of FTE supported. To meet the 

challenge of the growing appeals backlog with the resources available to it, BVA has 

implemented efficiencies in two key areas, i.e., hearings and remands. VA has also 

submitted several legislative proposals to improve the appeals process. 

Approximately 25% of appellants before BVA request a hearing before a VLJ. Current statutory authority gives appellants the right to an in-person hearing before 

a Board VLJ, or they may waive that right and elect a hearing by Video teleconferencing (VTC) technology. In FY 2011, 66% of appellants who requested an optional 

Board hearing requested an in-person hearing at their local RO, as opposed to a 

VTC hearing. An average of 75 percent of scheduled in-person hearings in FY 2011 

took place, meaning that 25 percent of those Veterans scheduled for hearings did 

not appear for the hearing. Moreover, data confirms that over the past five years, 

the national average show rate for field hearings is 73 percent. This leaves the VLJ 

who traveled to the field station with substantial blocks of time without scheduled 

activity, and thus, a loss of productive time to decide appeals. 

For FY 2012, BVA decreased the number of available field hearings by 25% in 

favor of increasing VTC hearings, which take place between the VLJ in Washington, 

DC and the Veteran at his or her local RO. The results, both in monetary and time 

savings for VA, are already being realized. VLJs are gaining time in the office, with 

an anticipated increase in decisional output (ranging from 2% to 5%) over the next 

few years. Additionally, VA will save an estimated $307,400 in travel funds in FY 

2012, ultimately reaching a savings of $864,354 through 2015. 

Regarding remands, in FY 2011, BVA remanded 44% of appeals before BVA 

(21,464) to the AOJ, generally VBA. Approximately 75% of all remands return to 

BVA, creating a significant amount of delay for the Veteran and rework for VA. 

VLJs determined that 40% of FY 2011’s remands (8,585) were avoidable, i.e., a remand could have been avoided if the RO properly processed and reviewed the case 

in accordance with existing laws and regulations. 

To reduce these avoidable remands, BVA has analyzed the data from its Remand 

Reasons Database (collecting reasons for remands since 2004) and determined that 

the top reason for remand is inadequate medical examinations and opinions. BVA 

has partnered with the Veterans Health Administration (VHA) to develop training 

tools and provide direct training to VA clinicians to improve VA compensation and 

pension examinations. Additionally, BVA and VBA have agreed to a mandatory joint 

training program to aid in standardizing adjudication across the system, driven by 

the most common reasons for remand. BVA has established an interactive training 

relationship with VBA’s key organizations involved in the appellate process, i.e., the 

Systemic Technical Accuracy Review (STAR) staff, DROs, and the Appeals Management Center staff. The combination of these efforts should reduce the number of 

avoidable remands in the system. 

VA has submitted legislative proposals to Congress that would streamline the appellate process. Specifically, VA has proposed a provision that would allow BVA to 

determine the most expeditious type of hearing for those appellants who request a 

hearing before a VLJ. The proposal includes a ‘‘good cause’’ exception for those appellants who do not desire a video conference hearing. VA has also proposed an 

automatic waiver provision, establishing a presumption that an appellant, or his or 

her representative, has waived RO consideration of any evidence he or she files after 

filing the Substantive Appeal to the Board. This would eliminate readjudication of 

the appeal by the RO in some cases, in favor of the Board directly addressing the 

evidence. Additionally, VA has proposed reducing the time period to file a Notice 

of Disagreement (NOD) from 365 days to 180 days, to ensure timely processing of 

appeals and less rework due to stale evidence. 

b. Please identify what level of funding is requested in total for fiscal year 2013 

for purposes of processing appeals, including steps that occur at VBA. 

Response. For FY 2013, VBA requested approximately $21 million for the Appeals 

Management Center to support 249 FTE. VBA requested approximately $93 million 

for the 951 claims processors, supervisors, and support staff dedicated to processing 

appeals at VBA field offices. 

The President’s total budget request for BVA for FY 2013 is $78 million, expressly 

for the purpose of issuing timely and quality decisions in appeals. 

234 

Question 4. In the fiscal year 2013 budget proposal, the request for disability compensation, pensions, and burial includes $416 million for Other Services, which is 

$71.7 million higher than the amount expected to be spent on Other Services during 

fiscal year 2012. Please provide a detailed itemized list of how the $416 million 

would be utilized during fiscal year 2013. To the extent any of the funds will be 

spent on contracts, please explain the nature of the contract and the expected 

outcomes. 

Response. Funding of $416 million is requested for Compensation, Pensions, and 

Burial other services in FY 2013. These funds allow for an increased amount of contract medical examinations (some of which are reimbursed from the Compensation 

and Pensions benefits account, authorized by Public Law 104–275) and the continuation and implementation of VBA’s transformation, to include support for the Veterans Benefits Management System, the Veterans Relationship Management initiative, and VA Innovation Initiatives. 

See the table that follows: 

Compensation & Pensions (C&P) Service 

2013 President’s Budget 

Other Services Funding Request 

Medical Examinations ...................................................................................................................... $269.5M 

Veterans Benefits Management System .......................................................................................... 31.9M 

Transformation Plan ......................................................................................................................... 15.7M 

VA Innovation Initiative .................................................................................................................... 15.0M 

Educational development, training, and testing ............................................................................. 13.2M 

Implementation Center ..................................................................................................................... 4.2M 

Work Earnings Loss Study ................................................................................................................ 2.6M 

C&P Operations ................................................................................................................................ 1.1M 

Fiduciary Asset Verification Contract ............................................................................................... 1.0M 

Advisory Committees ........................................................................................................................ 0.6M 

Management Support* ..................................................................................................................... 61.2M 

Total Other Services Funding Request .................................................................................... $416.0M

* Half of this amount is C&P Service’s portion of must-fund contracts to internal and external customers, e.g., the Department of Homeland Security, the Department of the Treasury, the National Archives and Records Administration, and several VA customers (Debt Management Center, Financial Services Center, etc.). The remaining funds consist of C&P Service’s portion of the Veterans Relationship Management initiative; VBA infrastructure investments, such as the co-location or relocation of facilities and associated equipment contract costs; 

and equipment operating, maintenance, and repair services contracts. 

Question 5. According to the fiscal year 2013 budget request, VA has ‘‘established 

dedicated teams of quality review specialists at each regional office.’’ 

a. Nation-wide, how many FTEs are currently assigned to these quality review 

teams? 

Response. 600 FTE are assigned. 

b. If the fiscal year 2013 budget request is adopted, how many individuals Nationwide would be assigned to these teams? 

Response. VA’s budget requests no change to the current number of quality review specialists. 

Question 6. On page 4B–10 of volume 3 of the fiscal year 2013 budget request, 

a chart indicates that VA received 854,000 claims in fiscal year 2008 and 872,000 

claims in fiscal year 2009. A similar chart in the fiscal year 2012 budget request 

indicates that VA received 888,000 claims in fiscal year 2008 and over 1 million 

claims in fiscal year 2009. Please reconcile those figures. 

Response. There was an error in the chart on page 4B–10 of volume 3 of the 2013 

budget. Disability rating claims receipts for 2008 through 2011 were as follows: 

FY Claims Received 

2008 .............................................. 888,112 

2009 .............................................. 1,013,712 

2010 .............................................. 1,192,346 

2011 .............................................. 1,311,091 

Question 7. In response to questions about VA’s fiscal year 2012 budget request, 

VA provided this prediction: ‘‘Investments in information technology will begin to 

235 

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.’’ 

a. Please quantify the increased productivity and reduced costs expected during 

2012, in terms such as individual productivity of claims processing staff, cost per 

case, or overall operating costs. 

Response. VBMS initially rolled out to Providence in November 2010, Salt Lake 

City in May 2011, and Wichita and Fort Harrison in March 2012. 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. 

b. Please quantify any increased productivity and reduced costs expected during 

2013, in terms such as individual productivity of claims processing staff, cost per 

case, or overall operating costs. 

Response. VBMS initially rolled out to Providence in November 2010, Salt Lake 

City in May 2011, and Wichita and Fort Harrison in March 2012. 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. 

Question 8. According to the fiscal year 2013 budget request, VA will begin to expand VMBS to more sites during fiscal year 2012 and expects it to be fully rolled 

out to all sites by the end of 2013. 

a. When VA begins rolling out VBMS to new sites, is it expected that those sites 

will experience short-term declines in productivity as employees are trained on the 

new technology? If so, please quantify the expected decline and how long it is expected to last at each site. 

Response. Yes, it is expected sites will experience short-term declines in productivity as employees are trained on VBMS. VBMS is being deployed as part of a complete people, process, and technology transformation at two regional offices in 

March 2012. VA will be able to obtain data on the short-term declines in productivity and the expected duration after the two regional offices complete their transformation. 

b. Once VBMS is in place at a regional office, how will the office be expected to 

deal with paper-based claims that are already pending at that office? 

Response. VBMS is taking a ‘‘point forward approach’’ to transitioning offices to 

fully functional paperless centers. All paper claims currently pending will continue 

to be processed in paper. Once VBMS is launched at an office, all new claims received will be processed in VBMS as paperless claims. However, end users will use 

VBMS to make decisions on both paper and paperless claims. 

c. During fiscal year 2012, what percentage of claims does VA expect to be handled using VBMS? 

Response. By the end of FY 2012, VBMS could potentially handle 15% of new incoming, rating-based claims. 

d. During fiscal year 2013, what percentage of claims does VA expect to be handled using VBMS? 

Response. Once additional functionality is added in November 2012, VA will be 

better positioned to determine potential capacity for FY 2013. 

Question 9. 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, ‘‘[i]n late 2012, VA estimates production will begin to 

outpace receipts’’ and that ‘‘productivity*** will rise from 89 annual claims per 

[compensation and pension] direct labor FTE in 2012 to 129 in 2015.’’ 

a. Please quantify how that increase would be achieved, including what percent 

increase in individual productivity VA expects from VBMS and from other initiatives that are underway. 

Response. VBA’s Transformation Plan cuts across three major areas (People, Process, and Technology) to drive consistency, standardization, and improvement in delivery of benefits to Veterans, Servicemembers, their families, and survivors. VBA 

expects a 15-to-20 percent increase in production from technology initiatives to include the Veterans Benefits Management System (VBMS), and Veterans Relationship Management (VRM). We expect a 15-to-20 percent increase in production from 

people initiatives such as, cross-functional teams, intake processing center, segmented lanes, and challenge training. Finally, we expect productivity to increase by 

15 to 20 percent for process initiatives, which include Simplified Notification Letter 

(SNL), Quality Review Teams (QRTs), and Disability Evaluation Questionnaires 

(DBQs). 

b. Currently, how many claims are projected to be completed during fiscal year 

2012 per compensation and pension direct labor FTE (including in that FTE total 

236 

any contractors who perform claims processing functions, such as gathering evidence, or are supplementing the work of direct labor FTE)? 

Response. In FY 2012, VBA expects to complete 1,175,000 disability compensation 

and pension claims. Measured against the total 14,320 direct labor FTE in the 2012 

budget for all work activities related to the compensation and pension programs, the 

projected output equates to 82 disability claims per FTE. However, it is important 

to recognize that these FTE are devoted to many claims and work activities in addition to processing rating-related disability compensation claims. Although disability 

claims (both original claims and claims for increase) are the primary subset of 

claims by which we measure production and output, there are other major work efforts that are critical to the overall delivery of compensation and pension benefits, 

including appeals, survivors’ benefits, pension income adjustments and matching 

programs, dependency and other account maintenance activities for beneficiaries already receiving benefits, burial benefits, outreach, IDES support, transition assistance programs, National Call Centers, personal interviews with Veterans and other 

beneficiaries, and fiduciary and guardianship activities. 

c. How many claims are projected to be completed during fiscal year 2013 per 

compensation and pension direct labor FTE (including in that FTE total any contractors who perform claims processing functions, such as gathering evidence, or are 

supplementing the work of direct labor FTE)? 

Response. In FY 2013, VBA expects to complete 1,400,000 disability compensation 

and pension claims using 14,520 FTE, or 96 disability claims per FTE. Please also 

see additional explanation above. 

Question 10. According to information provided in connection with the fiscal year 2012 budget request, VBA expended $32 million in fiscal year 2010 to pay for claims 

processing staff to work overtime and VBA’s budgets for fiscal years 2011 and 2012 

also included $32 million to pay for claims processing staff to work overtime. VA 

also indicated that ‘‘[r]egional offices are allotted overtime funds based on local 

workload and support of national programs.’’ 

a. What metrics are used to gauge whether overtime work by claims processing 

staff is effective? 

Response. All claims worked during overtime hours are included in VBA’s overall 

workload metrics, and therefore this completed work is held to the same standard 

as VBA’s traditional production and timeliness standards (average days pending, average days to complete, number of completed claims, etc.). One gross measure of the 

effectiveness of overtime worked can be seen in VBA’s national production. In FY 

2012, VBA saw a 22-percent production increase during the first month in which 

mandatory overtime was implemented, as compared to the average monthly production to date in FY 2012. However, it is important to note that not all of the work 

accomplished on overtime directly translates into completed cases. Additional actions completed on overtime, such as supplemental development for evidence, are required steps in the claims process, but do not allow for immediate completion of the 

claim. Separating these actions from those that directly result in completed claims 

is difficult, as the impact of this work in terms of a completed claim is not seen 

until a later date. 

b. During fiscal year 2011, 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. During FY 2011, $48.1 million was expended for overtime work for 

compensation and pension claims processing. In FY 2011, VBA implemented 20 

hours of mandatory overtime per month for Rating Veterans Service Representatives. Overtime was a key factor in VBA’s 24-percent surge in output during May 

through September FY 2011, as compared to the average monthly production prior 

to implementing mandatory overtime in FY 2011, and exceeding its FY 2011 production target by five percent. Prior to implementing mandatory overtime, VBA averaged production of 78,000 claims per month. During the months of mandatory overtime, VBA averaged 96,500 claims per month. There are other factors that contributed to the productivity increase, including increases in employee experience and 

proficiency, fewer Nehmer claims to be worked, and the normal end-of-year production surge; however, the implementation of mandatory overtime was undoubtedly a 

major contributing factor to this production increase. 

c. During fiscal year 2012, 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. In FY 2012, VBA plans to expend an estimated $35.3 million in overtime for compensation and pension claims processing. VBA implemented mandatory 

overtime on February 15, 2012, to focus on the oldest claims in the inventory. OverVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00242 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
237 

time usage will include initial development and promulgation of claims. VBA will 

closely monitor the impact of transformation and fluctuations in workload in order 

to focus overtime efforts where they are most needed. In the first month of mandatory overtime, VBA completed 95,700 claims, a 22-percent increase in production 

compared to the average of the previous months this fiscal year. Similarly, VBA 

completed just under 97,000 claims per month during the mandatory overtime period in FY 2011. With the continuation of overtime in FY 2012, we expect to see 

at least a similar level of production. We will also begin to see increased production 

as we roll out transformation initiatives. 

d. For fiscal year 2013, 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. The FY 2013 budget request includes $46.9 million for overtime in the 

compensation and pension programs. Overtime will continue to be a key factor in 

meeting the annual production goal of 1.4 million claims in FY 2013. VBA expects 

greater efficiencies as we fully implement VBA’s transformation plan, and consequently a greater impact seen by the overtime worked. 

e. For fiscal years 2011 and 2012, please identify the 10 regional offices that were 

or will be allocated the most funding for overtime hours. 

Response. Resource allocations are primarily based on each station’s workload and 

special mission requirements, which consequently influence the staffing and funding 

levels authorized, including overtime funding. The FY 2011 allocations were heavily 

directed toward Nehmer processing and the regional offices with Day One Brokering 

Centers assigned to work Nehmer cases. FY 2011: Philadelphia, Seattle, 

St. Petersburg, Waco, St. Paul, Winston Salem, Houston, San Diego, Columbia, and 

Milwaukee expended the greatest amount of overtime funds. FY 2012 through 

March 24, 2012: Muskogee, St. Louis, Philadelphia, Seattle, St. Petersburg, Waco, 

Atlanta, St. Paul, Winston Salem, and Houston have been allocated the most overtime funding. 

f. For fiscal year 2013, please identify the 10 regional offices expected to receive 

the largest allocations of funding to pay for overtime hours. 

Response. Several factors will continue to dictate the allocation of overtime funding in FY 2013. Offices responsible for special missions (e.g., Benefits Delivery at 

Discharge, Quick Start, Pension Management Centers, Resource Centers, Fiduciary 

Hubs, etc.) generally have a larger workforce and greater need for overtime funding. 

While VBA does not foresee major changes in the methodology for overtime distribution in FY 2013, it is anticipated that overtime funds will be used to help offset any 

production impact as transformation initiatives are deployed and regional offices receive training and adapt to the new technologies and process changes. 

Question 11. According to VA’s Fiscal Year 2011 Performance and Accountability 

Report, one of VA’s goals for 2012 is to ‘‘introduce new benefit application forms for 

the [fully-developed claims] program * * * to streamline the process and improve 

timeliness of processing claims in the program.’’ Also, 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] 

program.’’ 

a. How many fully-developed claims have been filed each year since the fully-developed claims program was initiated? 

Response. 

Fiscal Year (FY) FY2010 Program Start 

(June 15, 2010) 

FY2011 FY2012 

(projected) 

FY2013 

(projected) 

FDC Receipts .................................................................. 2,883 19,241 29,412* 48,529** 

* This projection is based on Fully Developed Claims (FDC) receipts fiscal year to date 2012 (2,451 FDC average receipts per month multiplied by twelve). Data is as of end of month February 2012. 

** This projection is based on the annual rate of increase (65%) in FDC receipts from Fiscal Year 2011 (19,241) to the projected Fiscal 

Year 2012 receipts. 

b. How many fully-developed claims are expected to be filed during fiscal year 

2012 and during fiscal year 2013? 

Response. See Table One above. 

c. On average, how many days did it take to complete fully-developed claims during fiscal year 2011? 

Response. 

238 

Fiscal Year (FY) FY2010 FY2011 FY to Date 

2012* 

Program Start 

(June 15, 2010) 

to Date 

Number of Fully Developed Claims (FDCs) Completed ............. 723 13,950 8,564 23,237 

Average Days to Complete ......................................................... 34.2 84.7 104.2 90.3 

* Data as of end of month February 2012. 

Please note that an FDC receipt does not always equal an FDC complete. Claims are removed from the FDC program for various reasons after they are initially flagged as FDCs. Examples of FDC program removal reasons include receipt of evidence from the claimant that requires further development on the claim, claimant failure to report for a VA examination, etc. VA is working to better inform claimants on 

these issues. 

d. To date in fiscal year 2012, how many days on average is it taking to complete 

fully-developed claims? 

Response. See Table Two above. The increase in ADC since 2010 is primarily due 

to program expansion. Our goal is to process FDCs in 90 days. To combat the growing ADC for FDCs, VA will issue new FDC guidance and benefit application forms 

that will streamline the FDC process. VA will also release VONAPP Direct 2.0 that 

will electronically accept FDCs. These enhancements will assist VA in achieving its 

goal of processing FDCs within 90 days. 

e. Please quantify what impact it is expected to have on the average number of 

days it takes to complete fully-developed claims once the new forms are rolled out. 

Response. In FY 2012, VA will introduce new FDC program guidance and benefit 

application forms that will together clarify and streamline FDC processing. These 

enhancements will support VA in achieving its goal of processing FDCs within 90 

days. 

f. For fiscal year 2013, how long is it projected to take to complete fully-developed 

claims? 

Response. For fiscal year 2013, it is projected that fully-developed claims will take 

an average of 90 days to complete. 

g. For fiscal year 2013, what level of funding is requested for purposes of promoting the fully-developed claims program? 

Response. As FDC is a transformation initiative, funding for it is included in VBA’s overall transformation budget of $18 million. VBA is considering promoting 

the program by implementing an FDC training course for Veterans Service Officers 

(VSOs); and disseminating FDC program information, benefit applications, and marketing materials, such as an FDC program trifold brochure, to VSOs, Veterans, and 

other potential claimants. 

Question 12. According to VA’s Fiscal Year 2011 Performance and Accountability 

Report, VA’s failure to meet national accuracy rate goals for compensation entitlement claims is in part due to ‘‘attrition of experienced personnel, especially in positions where extensive training is required.’’ 

a. Please identify the claims processing positions with the highest attrition rates 

during fiscal year 2011 and the overall level of attrition for claims processing staff 

during fiscal year 2011. 

Response. Please see table below. 

0996 Series Occupations 

Average Onboard 

Employee 

FY 2011 

Total Losses 

FY 2011 

Total Loss Rate FY 2011 

02 Decision Review Officer .................................................................... 307 .8 18 6% 

05 Veterans Service Representative ...................................................... 6718 .1 446 7% 

04 Veterans Service Representative (Rating) ....................................... 3116 .6 176 6% 

Total ........................................................................................ 10142 .5 640 6% 

b. For fiscal year 2011, please identify the specific regional offices with highest 

attrition rates for claims processing personnel. 

Response. Please see table below. 

Station Onboard 

Employee Avg Total Losses Total Loss Rate 

(373) RO Manchester, NH ......................................................................... 25 .5 5 20% 

(438) HCS Sioux Falls, SD ........................................................................ 36 .8 5 14% 

(459) HCS Honolulu, HI ............................................................................ 46 .7 6 13% 

(339) RO Denver, CO ................................................................................ 159 .8 20 13% 

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Station Onboard 

Employee Avg Total Losses Total Loss Rate 

(354) RO Reno, NV ................................................................................... 58 .9 7 12% 

(351) RO Muskogee, OK ............................................................................ 244 .3 28 11% 

(313) RO Baltimore, MD ........................................................................... 114 .3 13 11% 

(405) MROC Wht River Jct, VT ................................................................. 17 .8 2 11% 

(397) AMC Washington, DC ...................................................................... 123 .9 13 10% 

(402) HCS Togus, ME ............................................................................... 134 .8 14 10% 

(329) RO Detroit, MI ................................................................................. 125 .5 13 10% 

(333) RO Des Moines, IA .......................................................................... 77 .8 8 10% 

c. What are the expected attrition rates for claims processing positions during fiscal year 2012 and fiscal year 2013? 

Response. Please see table below. 

Service FY 2012 FY 2013 

0996 Positions in Compensation & Pension Services ............................................................ 6% 6% 

These rates are based on the actual attrition trends for FY 2009–FY 2011. 

Question 13. According to the fiscal year 2013 budget request, additional discretionary funding for the compensation, pension, and burials programs is requested 

for fiscal year 2013 ‘‘to support increased contract medical examinations.’’ Also, according to the summary of compensation and pension mandatory funding, VA expects to spend $236 million on contract medical examinations in fiscal year 2012 

and $248 million on contract medical examinations in fiscal year 2013. 

a. In total, how many compensation and pension examinations are expected to be 

provided during fiscal years 2012 and 2013 and how much in total is expected to 

be spent (from any account) on those examinations? 

Response. VBA expects to provide approximately 260,000 contract examinations 

during fiscal year 2012, and approximately 265,000 during fiscal year 2013. 

The projected cost of the exams for fiscal year 2012 is approximately $271 million 

and approximately $288 million for fiscal year 2013. The total projected cost is $559 

million. 

b. Please identify all funding sources used to provide compensation and pension 

examinations and provide a breakdown of how many examinations will be provided 

using each funding source. 

Response. The funding used to complete these examinations is provided in accordance with Public Law 104–275. 

Mandatory Funding 

FY Projected # of 

Exams Total 

FY 2012 208,000 $216,800,000 

FY 2013 212,000 $230,400,000 

Public Law 108–183 provides VBA the authority to use discretionary funding to 

obtain contract medical disability examinations. The chart below provides the projected number of examinations completed using this funding source. 

Discretionary Funding 

FY Projected # 

of Exams Total 

FY 2012 52,000 $54,200,000 

FY 2013 53,000 $57,600,000 

Question 14. According to VA’s Fiscal Year 2011 Performance and Accountability 

Report, VA has ‘‘awarded five Disability Examination Management Contracts’’ in 

order to provide disability examinations in the United States, Asia, Europe, and 

Latin America. 

a. How much does VA expect to spend on these contracts during fiscal year 2012 

and how much is VA requesting to spend on these contracts in fiscal year 2013? 

240 

Response. The Disability Examination Management (DEM) Contract is an Indefinite Delivery/Indefinite Quantity (IDIQ) contract managed by the Office of Disability and Medical Assessment (DMA). It includes five vendors who provide disability examination services within the United States and two vendors who provide 

disability examination services overseas. Within the U.S., for VA medical centers 

(VAMC) using the DEM contract, all resourcing is through their current budgets 

and on an as needed basis. Currently, several VAMCs are using the contract and 

others are prepared to use it when contingencies and surges in demand dictate the 

need. The Foreign Medical program has budgeted $4.1 million in FY 2012 and $4.3 

million in FY 2013 in support of increased claims and need for overseas examinations. 

b. How many examinations per year are expected to be provided through these 

contracts and what is the average expected cost per examination? 

Response. The average cost of examinations varies across vendors and/or regions 

but ranges from a low of $175 to a high of $595. Each of the five vendors has a 

guarantee of a minimum of $100,000 for the life of the contract, including the 4 option years. The rates overseas are based on U.S. pricing. For FY 2012, $4.1 million 

has been budgeted to pay for disability examinations for 2,900 claims for 1,350 Veterans residing overseas. 

c. Please identify the locations within Asia, Europe, and Latin America where 

these examinations are expected to be provided. 

Response. Examination locations overseas include: Naha, Okinawa (Japan); 

Tokyo, Japan; Frankfurt, Germany; San Jose, Costa Rica; and Mexico City, Mexico. 

Additionally, a modification to expand examination services in Korea has been sent 

to the Contracting Officer and Vendors for approval. 

d. Please explain any performance standards that will be required for the examination providers, such as timeliness of examinations, quality of examination reports, or driving-distance for Veterans. 

Response. Under the contract performance standards, each contractor shall schedule examinations as close to the Veteran’s or Servicemember’s home of record as feasible but generally no further than 50 miles for non-specialist examinations and 100 

miles for specialist examinations. The timeliness standard for examinations in country are 26 days for general compensation and pension disability examination requests, 35 days for Department of Defense examinations, and 45 days for overseas 

(the time is measured from the receipt of the examination request). The quality of 

all overseas examination reports are reviewed by VHA clinical staff on receipt from 

the contractors for sufficiency, then forwarded to VBA for adjudication action. To 

date, VBA has not returned any contract examinations back to DMA as insufficient. 

Question 15. For beneficiaries living abroad, VA has contracted with local medical 

providers to conduct compensation and pension examinations through the Foreign 

Medical Program. In 2011, VA announced that it had started a new program (the 

overseas disability examination program) to have VA personnel travel abroad to provide disability examinations to claimants who are living outside of the United 

States. In part, VA noted that, in June 2011, VA staff had traveled to Japan for 

three weeks in order to provide examinations for 39 veterans. 

a. During fiscal year 2011, how much in total was expended with respect to the 

overseas disability examination program, how many trips did that funding support, 

how many VA personnel traveled for that purpose, how many veterans were served, 

how many examinations were provided, and what was the average quality of the 

examinations? 

Response. In June 2011 and September 2011, a total of five VHA compensation 

and pension staff conducted 513 compensation and pension disability examinations 

on 85 Veterans residing in Naha, Okinawa (Japan), during two separate visits. The 

cost to the government for the five VHA personnel was $27,517, including travel and 

lodging. The duration of the two visits was 2–3 weeks for each visit. Navy personnel 

housed VHA staff at the government rate at Camp Lester, allowing for a further 

savings to the Government. Further, having experienced VHA compensation and 

pension clinicians perform examinations as opposed to local national contract examiners allowed VA to see a substantial savings since costs for exams overseas range 

from $2,000-$5,000 per exam. All examination findings were reviewed by Office of 

Disability and Medical Assessment (DMA) staff for quality and VBA staff for sufficiency for rating purposes and none were returned as inadequate or insufficient. 

b. For fiscal year 2011, how much in total was expended to provide disability examinations through the Foreign Medical Program (FMP), how many examinations 

were provided, how long on average did it take to complete examinations through 

this program, and what was the average quality of the examinations provided? 

241 

Response. In FY 2011, $3.4 million was paid on 2,700 claims for 1,344 Veterans. 

The quality of the examinations varies by geographic regions and the timeliness 

ranges from 3 months to 12 months based on the location of the examinations conducted. 

c. During fiscal years 2012 and 2013, how much in total is expected to be expended with respect to the overseas disability examination program, how many trips 

would that funding support, how many VA personnel would travel for that purpose, 

how many veterans would be served, how many examinations would be provided, 

and what is the expected average quality of the examinations? 

Response. The initial overseas trips to Naha, Okinawa (Japan) proved successful 

and cost effective in providing disability examinations to Veterans residing overseas. 

However, DMA began piloting a new overseas program in February 2012 that provides contracted disability examinations to Veterans residing overseas in contractually specified areas identified with the highest concentrations of Veterans. These 

examinations are scheduled with, and performed by, trained contracted disability 

examiners. Upon successful evaluation of performance in Japan, the next contracted 

examinations will be scheduled in Germany. The vendors supplying services overseas are the same ones providing these examinations within the United States; 

thus, they meet all VA training requirements. DMA expects their examination quality to meet VA standards set forth in the contract. However, as an added measure, 

all overseas contracted VHA examinations are reviewed by VA trained disability examiners and only released to the requesting Regional Office after full review. These 

examinations are also part of the overall quality audit performed by VHA. VHA and 

VBA are working to develop fiscal year 2013 budgets based on the ability to provide 

overseas contracted examinations through the established rates of the contract. 

d. For fiscal years 2012 and 2013, how much in total is expected to be expended 

to provide disability examinations through the Foreign Medical Program, how many 

examinations are expected to be provided, how long is it expected to take on average 

to complete examinations through this program, and what is the expected average 

quality of the examinations provided? Response. For FY 2012, $4.1 million has been budgeted for exams in support of 2,900 claims and 1,350 unique Veterans. In FY 2013, $4.3 million has been budgeted for exams to support 3,000 claims for 1,350 Veterans. Although, VBA has not 

conducted specific quality reviews of foreign cases, the Pittsburgh Regional Office, 

which has responsibility for processing overseas claims, reports that the quality varies by geographic region and the timeliness ranges from 3 months to 12 months 

based on the location of the examination conducted. 

e. On average, how many claims are filed each year by beneficiaries living in foreign countries? 

Response. Foreign claims are processed at three regional offices. White River 

Junction processes claims for Veterans residing in Canada. The Houston Regional 

Office processes claims for Veterans residing in South America, Central America, 

Mexico, and the Caribbean. Pittsburgh processes claims for Veterans residing in foreign countries other than the ones previously listed. During FY 2011, a total of 

2,192 foreign claims were filed, and as of March 31, 2012, a total of 918 foreign 

claims were filed for FY 2012. Since FY 2011, data indicates that on average 153 

foreign claims are filed per month. 

f. For Veterans living in the United States, how long on average does it take to 

receive a VA-provided compensation and pension examination? 

Response. As of April 2012, the average time to receive a completed VA compensation and pension examination provided by VHA was 25.8 days for a Veteran residing in the United States. The average time to receive a completed compensation and 

pension examination provided by a VBA contractor was 29.7 days for a Veteran residing in the United States. 

Question 16. In response to questions about the fiscal year 2012 budget request, VA indicated that it was requesting $16.4 million in order to contract with private 

entities to retrieve medical records from private medical providers. VA also indicated that, ‘‘[i]n order to gauge the effectiveness of the current contract, VA is evaluating the timeliness of the seven regional offices using the contractor’s services as 

compared to the timeliness of regional offices requesting medical records directly 

from private physicians.’’ 

a. In total, how much has been or will be spent on that initiative during fiscal 

year 2012? 

Response. The program is currently operating under a contract awarded with FY 

2011 funds. The total value of this contract is $2,272,033 and runs until September 2012. FY 2012 monies will be used to award an option period to the contract 

valued at $593,436. 

242 

b. To date, what is the average time it takes to obtain private medical records 

at the regional offices using the contractors and what is the average time it takes 

to obtain private medical records at other regional offices? 

Response. Since September 2011, the average time it takes the contractor to obtain medical records or receive a response necessary to close out the claims development action (i.e., no records exists or records destroyed) is 13.25 days. 

It takes other VA regional offices 40+ days to receive private medical records. 

c. How many claimants’ medical records have been obtained or are expected to 

be obtained by the contractors during fiscal year 2012? 

Response. Between September 2011 and March 2012, we have received 11,440 private medical records and were able to close out an additional 4,025 requests with 

responses from the physician, which include but are not limited to reasons such as, 

‘‘the records were destroyed.’’ Based on forecasted claims submissions against our 

current success rate, we anticipate receiving 19,515 private medical records and 

closing out an additional 7,110 requests during FY 2012. 

d. How much (if any) is requested with respect to this initiative for fiscal year 

2013 and how many contractors would that level of funding support? 

Response. The FY 2013 budget request is based on initiating national deployment 

of the program. The cost estimate for year one during ramp up is $10 million. The 

budget is based on a price-per-record retrieval estimate and not on a contract full 

time employee (FTE) resource number. 

Question 17. In response to questions about VA’s fiscal year 2012 budget request, 

VA indicated that ‘‘VBA’s 2012 General Operating Expense budget request 

includes*** $72.7 million and 66 FTE for program management and oversight 

of transformation initiatives.’’ 

a. Please provide an itemized list of how those funds have been or will be expended during fiscal year 2012. 

Response. Please see the chart below. 

VBA Initiative FTE FY 2012 Budget 

Request (m) 

Transformation Plan Initiatives ............................................................................................... 10 $29 .9 

Veterans Relationship Management (VRM) ............................................................................. 16 $7 .7 

Veterans Benefits Management System (VBMS) ..................................................................... 40 $35 .1 

Total ....................................................................................................................... 66 $72 .7 

b. How much is requested for these purposes for fiscal year 2013? 

Response. VBA’s 2013 General Operating Expense budget request includes $62.5 

million and 79 FTE for coordination and tracking of transformation initiatives, to 

include the Veterans Benefits Management System and Veterans Relationship Management. 

Question 18. In response to questions about VA’s fiscal year 2012 budget request, 

VA indicated that, for purposes of revising VA’s disability rating schedule, VA 

‘‘plans to spend $750,000 for a work earnings loss study, $387,000 for a medical consultation contract, and payroll resources of approximately $1.1 million’’ during fiscal 

year 2011, and the fiscal year 2012 budget included ‘‘$1 million for a work earnings 

loss study, $391 thousand for a medical consultation contract, and payroll resources 

of approximately $1.1 million.’’ 

a. How much in total was actually expended during fiscal year 2011 to update 

the disability rating schedule? Please provide an itemized list of how that funding 

was expended. 

Response. Please see the chart below. 

Purpose 

FY 2011 

Expenditures 

Scottsdale forum costs ..................................... $197,136 

Work earnings loss study ................................. 524,806 

Medical consultation contract .......................... 205,311 

Payroll resources ............................................... 1,086,401 

Travel ................................................................ 35,312 

Total ......................................................... $2,048,966 

243 

b. During fiscal year 2012, 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. 

Response. Please see the chart below. 

Purpose 

Projected 

FY 2012 

Expenditures 

Oct. 2011 NYC forum costs .............................. $108,310 

Jan. 2012 NYC forum costs .............................. 82,242 

Work earnings loss study ................................. 1,201,793 

Medical consultation contract .......................... 201,358 

Payroll resources ............................................... 1,663,219 

Travel ................................................................ 120,000 

Total ......................................................... $3,376,922 

c. What level of funding is requested for fiscal year 2013 for purposes of updating 

the rating schedule and how are those funds expected to be spent? 

Response. Please see the chart below. 

Purpose 

Projected 

FY 2013 

Expenditures 

Forum costs ...................................................... N/A 

Work earnings loss study ................................. $2,445,000 

Medical consultation contract .......................... N/A 

Payroll resources ............................................... 2,094,845 

Travel ................................................................ 90,000 

Total ......................................................... $4,629,845 

Question 19. In response to questions about VA’s fiscal year 2012 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 continues to be 15 full-time employees dedicated to processing 

Camp Lejeune-related claims. 

b. If the fiscal year 2013 budget request is approved, how many employees would 

be dedicated to handling these claims at the Louisville regional office? 

Response. VBA’s FY 2013 budget does not include any additional full-time employees exclusively dedicated to processing Camp Lejeune-related claims at the Louisville Regional Office. However, in order to continue meeting timeliness expectations, the regional office Director will continue to monitor this unique workload and 

reassign claims processors as needed. 

Question 20. 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 2012 budget request, VA indicated that there was a ‘‘sharp decline in 

brokering’’ because VA was using its resource centers to handle certain claims based 

on Agent Orange exposure. VA also provided this information: ‘‘Measurements do 

not currently exist to determine the cost effectiveness of workload brokering. VBA 

is currently engaged in refining existing data systems and workload tracking mechanisms to allow appropriate data collection to support cost-effectiveness analyses.’’ 

a. In total, during fiscal year 2011, how many claims were brokered by VA? 

Response. In total VA brokered 40,747 claims. This was a decrease from 105,337 

in fiscal year 2010. 

b. During fiscal year 2012, how many claims does VA expect to broker? 

Response. Through the end of March 2012, VBA has brokered 19,348 claims. Beginning March 1, 2012, VBA began utilizing its 13 resource centers for specialized 

brokering missions. These resource centers had worked exclusively Nehmer workload in FY 2011. Resource centers will be focused on Benefits Delivery at Discharge, 

Quick Start, appeals, and the oldest workload from designated stations. This increase in brokering is expected to be around 65,000 claims for the second half of 

2012, or about 85,000 claims total for the year. 

244 

c. What is the status of efforts to determine the cost-effectiveness of brokering? 

Response. VBA has not completed an analysis on the cost-effectiveness of brokered work due to the limited and unique nature of Nehmer brokering that occurred 

in FY 2011 and first part of FY 2012, and other shifts in the brokering strategy. 

The level of complexity associated with the work being brokered is a significant shift 

from the previous brokering strategy and therefore would significantly complicate 

any cost-benefit analysis. As VBA moves toward a paperless claims process through 

VBMS, the overall volume and costs associated with brokering will continue to decrease. While brokering claims and associated claims files in paper form will remain 

prominent during FY 2012 and 2013, we anticipate the ability to accomplish more 

paperless brokering going forward. As our brokering and business process model 

changes, we will closely monitor and analyze data and costs to assess the effectiveness of our process and technology improvements. 

Question 21. VA and 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 2011, how much in total did VA expend with respect to IDES 

(including both mandatory and discretionary funds) and how many VA employees 

were dedicated to the IDES process? Response. During fiscal year 2011, VA spent approximately $21.7 million for salaries and general operating expenses for 239 VBA FTE dedicated to disability claims 

processing in the IDES process. Veterans filing claims through the IDES sites are 

captured in the nationwide Veteran caseload count and total compensation benefit 

obligations. The total mandatory dollars expended as a result of the IDES process 

is not uniquely identified or forecasted. 

b. During fiscal year 2012, how much in total does VA expect to expend with respect to IDES (including both mandatory and discretionary funds) and how many 

VA employees will be dedicated to the IDES process? 

Response. During fiscal year 2012, VA estimates it will spend approximately $38.6 

million for salaries and general operating expenses to support 380 VBA FTE dedicated to disability claims processing in the IDES process. Increased staffing in 2012 

includes senior-level claims processing and supervisory personnel, which increases 

payroll costs. Veterans filing claims through the IDES sites are captured in the nationwide Veteran caseload count and total compensation benefit obligations. The 

total mandatory dollars expended as a result of the IDES process is not uniquely 

identified or forecasted. 

c. For fiscal year 2013, how much in total is VA requesting with respect to IDES 

(including both mandatory and discretionary funds) and how many VA employees 

would that level of funding support? 

Response. During fiscal year 2013, VA estimates it will spend approximately $39.1 

million for salaries and general operating expenses to support 380 VBA FTE dedicated to disability claims processing in the IDES process. Veterans filing claims 

through the IDES sites are captured in the nationwide Veteran caseload count and 

total compensation benefit obligations. The total mandatory dollars expended as a 

result of the IDES process is not uniquely identified or forecasted. 

d. Please identify any IDES sites that currently do not have sufficient VA personnel to meet all relevant staffing goals. 

Response. As of May 1, 2012, there are not any IDES sites that have insufficient 

VA personnel to meet all relevant staffing goals. When VA and DOD agreed to expand IDES worldwide, VA planned for and staffed each site at its full operational 

capability at the stand-up of each IDES expansion location. With troop withdrawal 

from Afghanistan anticipated to produce an increase in the IDES population, currently VA, upon notification, is able to send out ‘‘surge teams’’ to handle those areas 

that are identified for an increase in returning Servicemembers. 

Question 22. According to VA’s Fiscal Year 2011 Performance and Accountability 

Report, VA planned to ‘‘implement the Remodeled Integrated Disability Evaluation 

System program at three military treatment facilities’’ during the first quarter of 

2012. 

a. What is the current status of that initiative? 

Response. The Remodeled IDES (rIDES) initiative was put on hold to reassess the 

process and apply lessons learned for future improvement of IDES. 

b. If this initiative has been canceled or postponed, please explain what factors 

led to that decision. 

Response. The following factors led to the rIDES project being deferred: 

• rIDES was recommended to be reassessed and lessons learned applied to IDES. 

245 

• The rIDES timeline would decrease the overall IDES timeliness goal from 295 

days to 180 days. 

• The Department of Defense (DOD) was anticipating a large troop withdrawal 

from Afghanistan and therefore IDES numbers were expected to increase. 

• Days to complete the DOD Physical Evaluation Board (PEB) phase of the current IDES process was increasing due to a mandate requiring Servicemembers to 

discuss their case with an advisor. 

c. Please describe any on-going efforts to improve the timeliness of the IDES 

process. 

Response. In order to improve the timeliness of the IDES process, VA plans to 

increase resources for the IDES preliminary disability ratings process, identify best 

practices to implement system-wide, and continue electronic data sharing between 

the Disability Rating Activity Sites and the Military Physical Evaluation Board. 

Pension and Fiduciary Service 

Question 1. According to VA’s fiscal year 2013 budget request, VA’s fiduciary program is supervising over 122,000 incompetent beneficiaries. 

a. For fiscal year 2013, what level of funding is requested to support the fiduciary 

program and what total level of staffing would that funding support? Please provide 

a list of the positions that would be filled with that funding. 

Response. Funding for the fiduciary program is included in the compensation and 

pension programs. In 2013, approximately $76 million will support 693 fiduciary 

program FTE. Fiduciary employees at VA Central Office and the fiduciary hubs include the following positions: Assistant Director, Chiefs, Program Analysts, Fiduciary Hub Managers, Assistant Fiduciary Hub Managers, Supervisory positions/ 

Coaches, Management Analysts, Training Managers, Field Examiners, Legal Instrument Examiners, and Clerical positions. 

b. What were the key performance outcomes for the fiduciary program during fiscal year 2011 and what are the expected performance outcomes for fiscal years 2012 

and 2013? 

Response. Key performance indicators and outcomes for FY 2011 for the fiduciary 

program are listed in the following table along with targets for FY 2012 and FY 

2013. 

Measure 

FY 2011 

FY 2012 

Target 

FY 2013 

Target Actual Target 

Accuracy ......................................................................................................... 90% 88% 92% 94% 

Follow-up appointments pending <= 120 days ........................................... 90% 62% 90% 90% 

Follow-up appointments processed <= 120 days ........................................ 92% 83% 92% 92% 

Initial appointments pending <= 45 days ................................................... 90% 64% 90% 90% 

Initial appointments processed <= 45 days ................................................ 92% 78% 92% 92% 

% accountings reviewed within 14 days ...................................................... 94% 93% 94% 94% 

% accountings not seriously delinquent ....................................................... 95% 96% 95% 95% 

c. What portion of those incompetent beneficiaries also have a representative 

payee assigned for purposes of Social Security benefits? 

Response. Although Pension and Fiduciary Service works closely with the Social 

Security Administration’s (SSA) representative payee program, VA does not have 

data concerning the number of VA beneficiaries who are unable to manage their financial affairs and also have a representative payee for SSA benefit purposes. 

Question 2. According to VA’s Fiscal Year 2011 Performance and Accountability 

Report, VA plans to accomplish the following during 2012: Increase staffing for the 

Pension and Fiduciary Service, complete revisions to the fiduciary manual, deploy 

a new Fiduciary Program System, and finish consolidating fiduciary functions into 

six hubs. 

a. Please provide an updated timeline for when these actions are expected to be 

completed. 

Response. 

Increased Staffing 

VA established the Pension and Fiduciary (P&F) Service in April 2011, and it was 

fully staffed with 42 full-time employees as of January 2012. 

Revisions to the Fiduciary Manual 

We are currently drafting a notice of proposed rulemaking that would revise VA’s 

fiduciary regulations in 38 C.F.R. part 13. VA expects to publish the proposed rule 

246 

for notice and comment as early as August or September of this year. In the interim, P&F Service will implement program improvements that do not require rulemaking using VBA’s ‘‘fast letter’’ process, under which the agency provides mandatory policy guidance to its field personnel. Revision of the fiduciary portion of the 

Adjudication Procedures Manual will begin as soon as the proposed rule is published 

for notice and comment. 

New Fiduciary Program System 

P&F Service is working with VA’s Office of Enterprise Development (OED) to replace the current electronic workload management system, Fiduciary-Beneficiary 

System (FBS). The new system will include rules-based functionality, communicate 

with other VA systems, and facilitate the processing of accountings and field examination reports. OED has outlined the following three phases for creating the new 

system: 

1. Clean-up the data contained in FBS so that it is compatible with VBA’s corporate database, which contains all beneficiary records. 

2. Migrate FBS data to the corporate database and modify FBS to allow users to 

view information in the corporate database. 

3. Build a new user-friendly, rules-based, front-end system, which will provide all 

of the functionality required to properly administer the fiduciary program. 

Completion of the first phase is expected in the Fall of 2012. At that time, we 

will be able to provide a better estimate for complete replacement of FBS. 

Fiduciary Hubs 

On March 26, 2012, consolidation of VA’s fiduciary work and staffing into six hubs 

was completed. 

b. What level of funding will be available for each of these initiatives during fiscal 

year 2012 and what level of funding, if any, is requested for each initiative for fiscal 

year 2013? 

Response. P&F Service will not require additional funding for the proposed rulemaking effort currently underway. 

Development of FBS will begin in FY 2012 with an initial investment of $950,000. 

Funding for the remainder of the project will be determined in 2013 along with 

other priorities. 

The level of fiduciary funding requested for FY 2013 will include elements unique 

to hub consolidation activities. $375,000 has been allocated for travel associated 

with consolidation, including two weeks of new Field Examiner training hosted by 

each of the hubs (for 55 new Field Examiners), pre-consolidation site visits to each 

of the consolidating stations, and help teams to prepare the transfer of work from 

consolidating stations to the hubs. Travel funding requested for fiscal year 2013 will 

mainly be limited to mandatory Field Examiner travel. VBA expects to spend 

approximately $300,000 per year on mandatory field examination travel in fiscal 

years 2012 and 2013 (this expense is not a result of or unique to the consolidation 

initiative). 

Due to a preexisting need and the addition of 55 new out-based Field Examiners 

in fiscal year 2012, 88 new GSA-leased vehicles are being procured. VBA estimates 

an annual cost of $542,784 for these vehicles. While approximately half of this annual cost will be incurred in fiscal year 2012, the full annualized amount is requested for fiscal year 2013. 

In standing up the hubs, each of the host regional offices will require additional 

space, supplies, and utilities. During fiscal year 2012, $611,605 in general operating 

expense funds have been allocated for these expenses. 

c. Please outline the outcomes that are expected to be achieved as a result of these 

initiatives. 

Response. P&F Service is fully staffed and provides policy and procedural guidance, quality assurance, and training to support approximately 300 field examiners, 

200 legal instruments examiners, and 50 fiduciary managers nationwide. 

P&F Service will revise all existing program guidance, starting with 38 CFR part 

13. The purpose of this project is to ensure program administration consistent with 

current law and VA policy, and to provide clear and concise guidance for field personnel. The anticipated outcomes of the improved guidance are increased quality 

and improved timeliness. 

The new version of FBS is being designed to significantly enhance workload management and provide an historical record of fiduciary performance. We anticipate 

greater efficiencies related to fewer miles traveled per field examination and the 

ability to leverage resources based on improved workload management. This system 

will allow for a more timely selection process based on better data. 

247 

The Hub concept gains efficiencies in resource allocation, timeliness, quality and 

consistency through centralized management and assignment of work without regard to state borders or regional office jurisdiction. 

Question 3. 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.’’ 

a. Please provide an update on the status of this initiative. 

Response. In FY 2011, VA launched a Web site for fiduciaries, which provides information regarding their duties and responsibilities, references, forms, and frequently asked questions. The online training program for fiduciaries is still in the 

initial stages of development. 

b. Does the fiscal year 2013 budget request include any funding to advance this 

initiative? 

Response. Given the need to fund the development of a new information technology system for the fiduciary program and the development of standardized training for fiduciary personnel, there is no specific funding request for this initiative in 

the 2013 budget. However, P&F Service has adequate resources to continue working 

with VBA’s Office of Employee Development and Training to plan the initiative and 

develop training content. 

Question 4. According to the fiscal year 2013 budget request, VA is requesting an 

increase in funding for Other Services in order to provide ‘‘oversight services to ensure responsible management of fiduciary assets.’’ 

a. What level of funding is requested for this purpose? 

Response. VA requested $1.42 million for this purpose. 

b. Please provide additional detail as to what ‘‘oversight services’’ would be provided with this funding. 

Response. In reference to certification of a person for payment of benefits of a beneficiary, 38 U.S.C. § 5507(b) states in part ‘‘the Secretary shall request information 

concerning whether that person has been convicted of any offense under Federal or 

State law which resulted in imprisonment for more than one year.’’ In accordance 

with this law, P&F Service entered into a contract with Accurint, which is a service 

of LexisNexis Risk Solutions, to provide instant criminal background checks on prospective fiduciaries. The use of this service will help VA disqualify individuals who 

do not meet the basic requirements for service as a fiduciary. The 2012 budget request only accounted for the use of Accurint background checks for six months. The 

amount requested for 2013 increased to fund the use of this program for a full year. 

Oversight services funding will also support training and conferences for employee 

development and support FBS replacement. Centralized training, along with position-specific conferences will provide all field examiners and legal instruments examiners with the knowledge and skills to better select and conduct oversight of fiduciaries. Additionally, this standardized training will provide fiduciary personnel 

with the tools necessary to identify and address any performance issues with fiduciaries earlier in the process. The combination of new systems and training will 

allow fiduciary program employees to be more efficient and effective in protecting 

VA’s most vulnerable beneficiaries and their dependents. 

c. What metrics would be used to determine whether the oversight services are 

effective? 

Response. P&F Service has added additional metrics to a new tool used by fiduciary personnel to prepare field examination reports. This will allow us to better 

measure the performance of fiduciaries. 

Effectiveness of training will be evident in standard metrics for the program, to 

include: 

• Quality—The expected performance outcome for FY 2013 is 90.0%. At the end 

of FY 2011, quality was 88.1%. 

• Timeliness of account audits—The expected performance outcome for FY 2013 

is 94%. Timeliness in FY 2011 was 86%. 

• Timeliness of follow-up and initial field examinations—The expected performance outcome for FY 2013 is 92%. In FY 2011, 82.5% of follow-up and approximately 

78% of initial filed examinations were performed timely. 

• Receipt of accountings—The expected performance outcome is to obtain 95% of 

all accountings due before they mature to a seriously delinquent status, or 120 days 

past due. As of April 2012, 92.3% of all accountings were received before the 120- 

day threshold. 

248 

Appeals Management Center 

Question 1. Since 2003, certain cases remanded by the Board have been handled 

at a centralized entity called the Appeals Management Center. In response to questions about the fiscal year 2012 budget request, VA indicated that $16.3 million was 

spent on the Appeals Management Center during fiscal year 2010, that VA expected 

to spend $18 million on the Appeals Management Center during fiscal year 2011, 

and that VA was requesting $18.3 million to spend on the Appeals Management 

Center during fiscal year 2012. 

a. During fiscal year 2011, how much was actually spent on the Appeals Management Center and what level of staffing did that funding support? 

Response. The Appeals Management Center (AMC) obligated $18.5 million in FY 

2011 which supported 190 FTE. 

b. During fiscal year 2012, how much is now expected to be spent on the Appeals 

Management Center and what level of staffing will that level of funding support? 

Response. The AMC is authorized to increase its staffing level to 249 FTE in FY 

2012. It is projected that the AMC will achieve a cumulative FTE average of 243 

for the year, with total funding needs projected to be $20.5 million. 

c. In total, how much funding is requested for fiscal year 2013 for the Appeals 

Management Center and what level of staffing would that funding support? 

Response. In the FY 2013 request, VA estimated $21.5 million for the AMC to 

support 249 FTE. 

d. For fiscal year 2011, what were the key performance outcomes for the Appeals 

Management Center (in terms of timeliness, quality, input versus output, pending 

inventory)? 

Response. In FY 2011, the AMC exceeded several key performance indicators, including production and processing timeliness. 

• Timeliness: At the end of FY 2011, the AMC’s average processing timeliness 

was 367.6 days, vs. a target of 380 days. This was a significant improvement over 

FY 2010 processing time of 428.2 days. 

• Inventory/Output: In FY 2011, the AMC completed 18,212 claims, which was 

an 11-percent increase over FY 2010. Production was only slightly below receipts 

of 18,844. Pending inventory at the end of FY 2011 was 20,281 vs. a beginning of 

year inventory of 19,649. The target inventory at the end of FY 2011 was 18,500. 

• Quality: The AMC ended FY 2011 with 74.5 percent quality vs. a target of 90.0 

percent. 

To improve efficiencies, VBA has created an Appeals Design Team tasked with 

developing, testing, and evaluating improvements in the appeals process. The Design Team’s recommendations are aimed at improving timeliness in each segment 

of the appeals process and making it more Veteran-centric, trust-earning, and consistent. Several of these recommendations were implemented as part of a pilot at 

the Houston RO on March 1, 2012. The recommendations are designed to reduce the 

appeals processing time at the RO level. It is anticipated that the remainder of FY 

2012 and most of FY 2013 will be dedicated to the testing and national rollout of 

these recommendations before the overall impact can be seen on processing 

timeliness 

The Appeals Design Team has instituted in-process reviews and also revised a 

Quality Review Certification Worksheet designed to address the prior year’s top 10 

avoidable remand reasons. The Design Team will also hold breakout sessions at the 

Veterans Service Center Managers’ and Directors’ Conferences to get input and 

feedback from VBA managers and leadership. These measures will help to improve 

the overall quality of appeals processing and reduce avoidable remands. 

e. For fiscal years 2012 and 2013, what are the key performance targets for the 

Appeals Management Center? 

Response. For FY 2012, the AMC production target is 30,000 claims, almost double the FY 2011 target. The increased target reflects the addition of RVSRs, as well 

as current employees becoming more proficient in their positions through experience. The continued focus on internal training programs and the addition of resources are expected to increase both output and quality. The overall average days 

pending target was decreased to 180 days, and average processing days target was 

decreased to 270 days. Achieving these targets would represent significant performance improvement over FY 2011. The accuracy target remains at 90 percent, and 

is one of the key focuses of the AMC during FY 2012. 

FY 2013 targets will be formulated based on FY 2012 achievements, input from 

the AMC Director, and the Office of Field Operations. 

249 

Education 

Question 1. According to the fiscal year 2013 budget request, the discretionary request for Education programs includes $14.6 million for Other Services. Please provide a detailed itemized list of how the $14.6 million would be utilized during fiscal 

year 2013. 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 table below itemizes the $14.6 million for Other Services (contracts) in Education’s discretionary request. 

Education Service 2013 President’s Budget 

Other Services Funding Request 

Post-9/11 GI Bill Support ............................................................................................................................................. $6.6M 

Instructional Systems Development & Training ........................................................................................................... 0.6M 

Execution of Public Laws 101–237 & 105–368: Outreach pamphlets and letters .................................................... 0.2M 

Customer Satisfaction Surveys ..................................................................................................................................... 0.1M 

State approving agency contract review ...................................................................................................................... 0.1M 

Management support .................................................................................................................................................... 7.0M 

Total Other Services Funding Request ................................................................................................................ $14.6M 

The $14.6 million budget request contains funding of $7.6 million for the following 

contracts: 

• Strategic management and oversight services and continued systems engineering support contract for the Post-9/11 GI Bill 

• Customer satisfaction surveys to measure claimants’ satisfaction with the delivery of education benefits 

• Contract for the development of computer-based and instructor-led training materials for new employee training and refresher training 

• Execution of Public Laws 101–237 and 105–368 that includes outreach pamphlets and letters. 

The remaining $7 million is management support costs. Management support 

costs for all VBA programs are prorated across business lines based on direct program FTE. Over half of $7 million is Education Service’s portion of essential contracts to internal and external customers for services such as security, mail, and 

background investigations. This includes the Department of Homeland Security, the 

Department of the Treasury, the National Archives and Records Administration, 

and several VA customers (Debt Management Center, Financial Services Center, 

etc.). The remaining funds are Education Service’s portion of the Veterans Relationship Management initiative; VBA infrastructure investments, such as the collocation 

or relocation of facilities and associated equipment contract costs; and equipment 

operating, maintenance, and repair services contracts. 

Question 2. According to the fiscal year 2013 budget request, ‘‘[o]bligations for 

2012 increase over the original budget estimate by $28.2 million to retain temporary 

GI Bill claims processors and to hire additional temporary claims processors, resulting in an increase of 435 FTE.’’ 

a. How was that $28.2 million originally expected to be spent? 

Response. Public Law (P.L.) 111–377, the Post-9/11 Veterans Educational Assistance Improvements Act of 2010, expanded the scope of educational benefits for Veterans thereby resulting in additional claims processing workload. $28.2 million was 

initially targeted for maintaining temporary FTE to address the workload increase 

from Public Law 111–377. These legislative changes prompted additional development modifications to automated processing in the Long-Term Solution (LTS) claims 

processing system. Additionally, the Veterans Retraining Assistance Program authorized by Title II of Public Law 112–56, the VOW to Hire Heroes Act of 2011, 

is expected to provide educational benefits to an additional 99,000 unique Veterans 

through March 31, 2014. Although additional funding was provided for Public Law 

112–56, through the judicious management of hiring and attrition and redirecting 

management support FTE from the C&P program, VA was able to realign the resources necessary to retain the temporary GI Bill claims processors and add 110 additional term employees to address the workload increases. 

b. For how long will these temporary employees be retained by the Education 

Service? 

Response. VA estimates the temporary employees will be retained until early 

2013. 

250 

c. Once their terms are complete, does VA plan to transition some or all of these 

temporary employees into positions with other VA business lines? 

Response. VA anticipates that these temporary employees will only be retained 

until early 2013. 

Question 3. According to VA’s Web site, individuals with questions about education benefits may call 1–888–GIBILL–1 but they should ‘‘[b]e advised this line 

only accepts calls from 7:00 AM–7:00 PM central time Monday–Friday and you may 

experience long hold times.’’ In addition, the fiscal year 2013 budget request reflects 

that, in fiscal year 2011, the abandoned call rate for the Education Call Center was 

20%. 

a. Currently, how many employees work at the Education Call Center, what is 

the average hold time, and what is the abandoned call rate? 

Response. There are currently 302 employees at the Education Call Center (ECC). 

Performance is improving in FY 2012. For example, the average hold time for the 

month of April 2012 was 4:41 minutes. By contrast, the average time for FY 2012 

through April is 10:51 minutes. The abandoned call rate for month of April 2012 is 

11.7%, compared with 25% for the fiscal year to date through April 2012. 

Callers may experience a wait time during peak volumes so VA implemented the 

Virtual Hold technology where the caller can leave their name and phone number 

and VA will return their call. 

b. If the fiscal year 2013 budget request is adopted, how many individuals would 

work at the Education Call Center during fiscal year 2013? 

Response. We do not expect to change the 302 FTE at the ECC in FY 2013. 

Since the ECC is co-located with the Muskogee, Oklahoma, Regional Processing 

Office (RPO), resources are shifted from the RPO to meet increased demands at the 

ECC when needed. 

GENERAL ADMINISTRATION

Office of the Secretary 

Question 1. Last year, VA was unable to provide the Committee with information 

concerning the percentage and number of contracts awarded by VA’s Central Office 

to service-disabled veteran owned small businesses (SDVOSBs) and veteran owned 

small businesses (VOSBs). VA indicated that a data analysis of VA’s service contracts was underway, preventing a complete response. 

a. Based on that data analysis, please provide the Committee with the percentage 

and number of contracts awarded by VA’s Central Office to SDVOSBs and VOSBs. 

b. Please provide the Committee with details (type, amount, and purpose) of the 

current contracts awarded to SDVOSB/VOSBs by VA’s Central Office. Also, please 

itemize this data by individual offices within VA’s Central Office. 

Response. [These questions appear and were answered in the prehearing responses.] 

Question 2. In the last year, the VA Center for Veterans’ Enterprise (CVE) has 

been working on eliminating the backlog of SDVOSBs and VOSBs awaiting certification of their statuses in order to begin bidding on VA set-aside contracts. 

a. How does CVE measure the effectiveness of its communications with SDVOSBs 

and VOSBs during the verification process? 

b. Please provide the Committee with the current number of companies awaiting 

verification and the current average time companies have been awaiting verification 

once all documents have been submitted and verified by CVE. 

Response. [These questions appear and were answered in the prehearing responses.] 

Question 3. CVE is part of VA’s Office of Small and Disadvantaged Business Utilization (OSDBU), which is under the Office of the Secretary. Although OSDBU reports to the Secretary, funding for OSDBU and CVE is provided by VA’s Supply 

Fund. Please provide the Committee with detailed itemized budgets for fiscal years 

2010 through 2013. Please include individual budget lines, FTE (permanent and 

contract), and applicable justifications. 

VA Response. For the years FY 2010 and FY 2011, budget information for the two 

centers within OSDBU, the Center for Veterans Enterprise (CVE) and the Center 

for Small Business Utilization (CSBU), was consolidated. Therefore a separate budget for CVE alone is not available. The budget for the two centers was broken out 

in FY 2012 under the new Executive Director. In lieu of the budget for FY 2010 

and FY 2011, we are providing expenditures for CVE. Please see the attached 

imbedded spreadsheet. 

The increase in the CVE budget between FY 2011 and FY 2012 was due to a 

number of factors including: 

251 

• Anticipated replacement of the current management information system (MIS); 

• Additional contracting staffing to accommodate the manual bypass procedures 

necessary until the replacement of the MIS; and 

• Additional capabilities for customer service, help desk and the Verification Assistance Program. 

Although the budget for FY 2012 is significantly higher, actual spending was far 

less than what was budgeted due to the fact that the replacement MIS will come 

in FY 2013. 

CVE has seen improvements in many of its operations including: 

• Average processing time on initial applications decreasing from over 100 days 

to 85 days as of June 2012 data; 

• Average processing time on requests for reconsideration decreasing from over 

200 days to 73 days as of August 2012 data; and 

• Approval rate for initial applications and reverifications with a full document 

examination increasing from 31 percent at the end of FY 2011 to 59 percent as of 

September 2012 data. 

In June 2012, the Secretary directed that a Senior Executive Task Force be stood 

up to examine the Verification Program and make recommendations on various 

issues to include staffing and infrastructure. The FY 2013 budget is not finalized, 

pending the outcome of the Task Force recommendations. 

FY 2010 Thru FY 2012—Center for Veterans Enterprise 

Prepared by: OSDBU 

FY 2010 

Expenditure 

Report 

FY 2011 

Expenditure 

Report 

FY 2012 

CVE Budget 

Regular Pay .................................................................................... $1,026,989 .53 $2,253,196 .71 $2,485,129 

Night differential ............................................................................ $0 .00 $11 .97 $0 

Holiday pay ..................................................................................... $366 .56 $1,301 .13 $0 

Overtime ......................................................................................... $49,761 .02 $113,883 .64 $272,833 

Employee special pay ..................................................................... $0 .00 $0 .00 $0 

Terminal leave ................................................................................ $0 .00 $6,336 .00 $15,000 

Incentive awrds cash/noncash ....................................................... $25,064 .00 $49,876 .00 $0 

Locality pay .................................................................................... $239,948 .19 $514,033 .31 $0 

Advanced fed employ health FEHB ................................................ $0 .00 $86 .39 $0 

Recoup advanced FEHB from carriers ........................................... ....................... ($86 .39) $0 

Regular benefits—BOC 12xx ......................................................... $352,680 .18 $735,609 .98 $663,230 

Total regular pay and benefits ............................................. $1,694,809 .48 $3,674,248 .74 $3,436,192 

Travel—BOC 21xx .......................................................................... $43,827 .61 $0 .00 $94,500 

Real property rental—GSA—BOC 23xx ......................................... $151,323 .65 $0 .00 $0 

Other printing & reproduction—BOC 24xx .................................... $1,555 .84 $0 .00 $0 

Service agreements—BOC 25xx .................................................... ....................... ......................... $20,691,150 

Contractor support ......................................................................... $7,164,912 .89 $7,320,308 .53 $20,591,150 

$100,000 

Supplies—BOC 26xx ...................................................................... $14,944 .72 $0 .00 $40,000 

Equipment—BOC 31xx ................................................................... $171,193 .42 $0 .00 $40,000 

Grand total ..................................................................................... $9,242,567 .61 $10,994,557 .27 $24,301,842 

Total Federal Government on board ...................................... 20 .1 22 .0 19 

Total contractors on board .................................................... 20 .0 78 .0 160 

*Due to past OSDBU leadership decisions, FY 2010 and FY 2011 OSDBU budgets were not broken out by center. 

**No final FY 2013 budget as explained in response. 

Question 4. According to the fiscal year 2013 budget proposal, 89 FTE are requested for the Office of the Secretary. 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 2013 budget is approved. 

Response. 

1. Secretary of Veterans Affairs (PAS) 

2. Executive Assistant (GS–15) 

3. Staff Assistant (GS–13) 

4. Staff Assistant/Scheduler (GS–14) 

5. Deputy Secretary of Veterans Affairs (PAS) 

252 

6. Special Assistant (Career GS–13) 

7. Staff Assistant (GS–11) 

8. Chief of Staff (Non-Career SES) 

9. Deputy Chief of Staff, Administration (Career SES) 

10. Executive Assistant (GS–15) 

11. Staff Assistant (GS–13) 

12. Senior Advisor, Strategy (Non-Career SES) 

13. Staff Assistant (GS–13) 

14. Senior Advisor (Career term SES) 

15. Senior Advisor/CTO (Non-Career SES) 

16. Senior Advisor, Budget (Non-Career SES) 

17. Senior Advisor Strategic Communications (Non-Career SES) 

18. Special Assistant, (Non-Career GS–13) 

19. White House Liaison (Non-Career GS–12) 

20. Special Assistant (GS–15) 

21. Staff Assistant/VSO Liaison (GS–13) 

22. Staff Assistant (GS–13) 

23. Ombudsman/NGO (GS–15) 

24. Special Assistant (GS–15) 

25. Special Assistant/Staff Coordinator (GS–9/11) 

26. Staff Coordinator (GS–14) 

27. Staff Coordinator (GS–14) 

28. Staff Coordinator, (GS–14) 

29. Program Management Officer (GS–15) 

30. Staff Assistant (GS–13) 

31. Special Assistant/Staff Coordinator (GS–9) 

32. H.R. Liaison/Staff Assistant (GS–14) 

33. Management Analyst (GS–13) 

34. Executive Secretariat (Career SES) 

35. Deputy Executive Secretariat (GS–15) 

36. Staff Assistant (GS–13) 

37. Executive Writer/Correspondence Analyst (GS–13) 

38. Executive Correspondence Analyst (GS–14) 

39. Executive Correspondence Analyst (GS–13) 

40. Executive Writer (GS–14) 

41. Executive Writer (GS–13) 

42. Correspondence Analyst (GS–13) 

43. Correspondence Analyst (GS–11) 

44. Program Specialist (GS–11) 

45. Program Support Assistant (GS–7) 

46. Program Support Assistant (GS–7) 

Subsidiary 

Center for Minority Veterans (7) 

47. Senior Program Analyst (GS–14) 

48. Program Analyst (GS–13) 

49. Program Support Assistant (GS–9) 

50. Director (Non-Career SES) 

51. Program Analyst (GS–13) 

52. Deputy Director, (GS–15) 

53. Program Analyst (GS–13) 

Center for Women Veterans (5) 

54. Senior Program Analyst (GS–14) 

55. Program Analyst (GS–13) 

56. Deputy Director (GS–15) 

57. Program Support Assistant (GS–9) 

58. Director (Non -Career SES) 

Office of Survivors Assistance (3) 

59. Director (GS–15) 

60. Program Analyst (GS–13) 

61. Staff Assistant (GS–9/11) 

Center for Faith Based & Neighborhood Partnerships (4) 

62. Program Specialist (GS–13) 

63. Deputy Director (GS–14) 

64. Director (Non-Career GS–15) 

253 

65. Program Specialist (GS–9) 

Office of Employee Discrimination Complaint Adjudication (24) 

66. Secretary (GS–6) 

67. Associate Director (GS–15) 

68. Paralegal (GS–11) 

69. Attorney (GS–14) 

70. Intern, (GS–5) 

71. Attorney (GS–14) 

72. Attorney (GS–14) 

73. Attorney (GS–14) 

74. Attorney (GS–14) 

75. Administrative Officer (GS–12) 

76. Secretary (GS–6) 

77. Attorney (GS–13) 

78. Attorney (GS–14) 

79. Attorney (GS–14) 

80. Paralegal (GS–11) 

81. Intern, (GS–4) 

82. Attorney (GS–14) 

83. Secretary (GS–6) 

84. Attorney (GS–13) 

85. Attorney (GS–14) 

86. Attorney (GS–14) 

87. Attorney (GS–13) 

88. Attorney (GS–14) 

89. Director (Career SES) 

Question 5. The fiscal year 2013 budget proposal reflects that the Office of the Secretary now expects to expend $228,000 on Other Services during fiscal year 

2012, which is 87% higher than the amount requested ($122,000). The Office of the 

Secretary requests $125,000 for Other Services for fiscal year 2013. 

a. Please identify any amounts included or excluded from those Other Services 

amounts that are attributable to reimbursements from other VA offices. 

Response. $37,000 (included) is attributable to reimbursements from other VA offices. 

b. Please provide an itemized list of how those funds are expected to be expended 

during fiscal year 2012. 

Response. 

($ in thousands) 

Reimbursement ................................................................................ $37 

Reception fund ................................................................................. 15 

Contracts (training, advisory committee stipends, outreach 

booth rentals) ............................................................................... 102 

Copier (CMV/CWV) ......................................................................... 20 

OSVA Contracts (training, copiers, etc.) ....................................... 53 

Total .......................................................................................... $227 

NOTE: Additional funds carried over from FY 2011 were used to address needed ‘‘Other 

Services’’ beyond the budget amount. 

c. Please provide an itemized list of how those funds are expected to be expended 

during fiscal year 2013. 

Response. 

($ in thousands) 

Reimbursement ................................................................................ $37 

Reception fund ................................................................................. 15 

Contracts (training, advisory committee stipends, outreach 

booth rentals) ............................................................................... 33 

Copier (CMV/CWV) ......................................................................... 20 

OSVA Contracts (training, copiers, etc.) ....................................... 20 

Total .......................................................................................... $125 

Note: Additional funds carried over from FY 2012 will be used to address additional 

needed ‘‘Other Services’’ beyond the budget amount. 

Question 6. According to the fiscal year 2013 budget proposal, the Office of the 

Secretary now expects to expend $488,000 on travel during fiscal year 2012, which 

254 

is 29% higher than the amount requested ($379,000). For fiscal year 2013, $279,000 

is requested for travel for this office. 

a. Please identify the reasons for the increase in travel spending during fiscal year 

2012. 

Response. The original request of $379,000 was based on the expected budget authority for FY 2012. This original amount was found insufficient to meet the full 

range of critical travel requirements to support necessary site visits, meetings, 

training and other responsibilities throughout the fiscal year. 

b. Please explain what circumstances are expected in 2013 that will allow for lesser expenditures on travel. 

Response. The original request of $279,000 was based on the expected budget authority for FY 2013. VA will continue to seek opportunities to reduce travel and better leverage video-teleconferences and other methods to reduce overall travel costs 

and requirements. Additional FY 2013 travel requirements may be met with reallocated General Administration funding. 

Question 7. According to the fiscal year 2013 budget proposal, the Office of the 

Secretary now expects to spend $217,000 on supplies and materials, which is 25% 

higher than the amount requested ($174,000). For fiscal year 2013, that office requests $100,000 for supplies and materials. 

a. Please provide an explanation of how these funds are expected to be expended 

during fiscal years 2012 and 2013. 

Response. 

($ in thousands) 

Fiscal Year 12 

Reimbursement ............................................................................ $43 

Copier/Equipment ........................................................................ 20 

Supplies ........................................................................................ 129 

Publications .................................................................................. 15 

Total .......................................................................................... $217 

Fiscal Year 13 

Reimbursement ............................................................................ $43 

Copier/Equipment ........................................................................ 10 

Supplies ........................................................................................ 36 

Subscriptions ................................................................................ 11 

Total .......................................................................................... $100 

b. Please explain what circumstances are expected in 2013 that will allow for lesser expenditures on supplies and materials. 

Response. OSVA continues to carefully evaluate all purchases and spending related to supplies and materials to both minimize requirements and maximize savings. Reductions in supplies and subscriptions are planned. FY 2012 carryover funds 

may be available to address additional needed ‘‘supplies and materials’’ beyond the 

FY 2013 budget amount. 

Question 8. The Office of Survivors Assistance is one special office under the Office of the Secretary. For fiscal year 2013, VA requests $552,000 for that office to 

support three employees. 

a. During fiscal year 2012, how much in total is currently expected to be expended 

with respect to the Office of Survivors Assistance? 

Response. The Office of Survivors Assistance expended $327,537for Fiscal 2012. 

OSA hired its Staff Assistant during the last month of the 3rd Quarter (June 2012) 

and OSA did not attend all training/events planned due to cancellations by hosting 

agencies. 

b. For fiscal year 2013, please identify the pay-grades of the employees who are 

expected to work for the Office of Survivors Assistance. 

Response. For Fiscal Year 2013, the Office of Survivors Assistance will have the 

following pay grades of employees: 

GS—15 Director 

GS—13 Program Analyst 

GS 9/11—Staff Assistant 

Question 9. According to the budget request, the functions performed by the Office 

of Survivors Assistance include ‘‘[a]dvocating for the needs of survivors in the policy 

and programmatic decisions of VA’’ and ‘‘[t]racking and recommending survivor legislative issues.’’ 

255 

a. Please explain whether the Office of Survivors Assistance is currently performing these functions and, if so, how. 

Response. The Office of Survivor Assistance (OSA) advocates for the needs of survivors in the policy and programmatic decisions of VA by participating in all levels 

of senior leadership meetings such as the Executive Leadership Board meetings 

with the Secretary and Chief of Staff; Senior Management Council; Strategic Review 

Group; Special Programs Meetings; and Strategic Planning Efforts. OSA works very 

closely and collaboratively with other organizations regarding survivor issues and 

also participates in organizational meetings to provide information needed to make 

informed decisions by respective organizations. 

b. Please explain whether any changes will be made to the scope of activities carried out by the Office of Survivors Assistance during fiscal year 2013 and, if so, 

whether the budget request supports any such changes. 

Response. At the present time, there are no additional changes that will be made 

to the scope of activities carried out by the Office of Survivors Assistance during 

fiscal year 2013. 

c. Please explain what outcomes or performance metrics are used to gauge the effectiveness of the Office of Survivors Assistance. 

Response. OSA currently gauges its effectiveness by internal and external collaborative outreach efforts with survivor groups, the Department of Defense, Federal, 

State and local agencies as well as Veterans Service Organizations, faith-based and 

community organizations, hospice and palliative care industries along with the funeral industry, and other stakeholder groups to promote the awareness of benefits 

and services that Survivors may be eligible to receive. Outreach efforts include conducting presentations, serving as panel members, facilitating and coordinating 

events; conducting conference calls and hosting exhibit booths. OSA also measures 

effectiveness by the number of persons accessing its Web site and electronic 

mailbox. 

Board of Veterans’ Appeals 

Question 1. Last year, VA was unable to provide the Committee with information 

concerning the percentage and number of contracts awarded by VA’s Central Office 

to service-disabled veteran owned small businesses (SDVOSBs) and veteran owned 

small businesses (VOSBs). VA indicated that a data analysis of VA’s service contracts was underway, preventing a complete response. 

a. Based on that data analysis, please provide the Committee with the percentage 

and number of contracts awarded by VA’s Central Office to SDVOSBs and VOSBs. 

b. Please provide the Committee with details (type, amount, and purpose) of the 

current contracts awarded to SDVOSB/VOSBs by VA’s Central Office. Also, please 

itemize this data by individual offices within VA’s Central Office. 

Response. [These questions appear and were answered in the prehearing responses.] 

Question 2. The fiscal year 2013 budget request includes $74 million to support 

527 employees for the Board. 

a. Please provide a breakdown of the positions that would be filled in fiscal year 

2013 and the number of staff for each type of position. 

Response. The breakdown of the Board’s 527 FTE is as follows: 4 executives; 64 

Board members; 329 attorneys; and 130 administrative staff. 

b. Please identify how many members of the Board (or veterans’ law judges) currently are employed at the Board? 

Response. There are 58 members of the Board currently employed at the Board, 

with 5 pending nominations awaiting Presidential approval and one vacancy. 

c. Please provide a breakdown of the number of Board members who were existing 

Board employees when selected to become a Board member, the percentage who 

were selected from other VA offices, and the percentage who were selected from outside of VA. 

Response. Currently, 56 Board members were existing Board employees when selected to become a Board member (97 percent). Two Board members were selected 

from another VA office (3 percent). 

Question 3. According to the fiscal year 2013 budget proposal, the average appeals 

resolution time in fiscal year 2010 was 656 days. According to the fiscal year 2010 

annual report provided by the Chairman of the Board, ‘‘[t]he average length of time 

between filing the appeal and the Board’s disposition was 886 days’’ in fiscal year 

2010. Also, the report from the Chairman reflects that it took on average 243 days 

between filing of a Notice of Disagreement to issuing a Statement of the Case, 42 

days from the issuance of the Statement of the Case to VA’s receipt of a Substantive 

Appeal, 609 days from receipt of the Substantive Appeal to certification of the apVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00261 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
256 

peal to the Board, and 212 days from the Board’s receipt of a certified appeal to 

the Board’s issuance of a decision, which would total to 1,106 days. 

a. Please reconcile these statistics for fiscal year 2010, including what specific 

time periods are included in or excluded from each total. 

Response. The appeals process at VA is bifurcated, with most steps for processing 

an appeal occurring at the Veterans Benefits Administration (VBA) regional office 

level. If the matter is not resolved to the Veteran’s satisfaction, the appeal may be 

transferred to the Board of Veterans’ Appeals (BVA or Board) for a final agency decision. The Appeals Resolution Time (ART) is a joint measure (i.e. VBA/BVA) that 

represents the average length of time it takes the Department to process an appeal 

from the date a claimant files a Notice of Disagreement (NOD) until a case is finally 

resolved, whether the appeal is resolved at the regional office level or at the Board. 

Thus, the ART includes many appeals that are resolved and never come to the 

Board for decision. In FY 2010, the average ART for resolution of appeals at any 

and all different levels of the appeals process, including appeals that resolve at the 

earliest level after the NOD, was 656 days. 

The BVA Report of the Chairman is similar to the ART in some aspects, but quite 

different in other aspects. Like the ART, the Report of the Chairman measures the 

average time intervals for particular portions of the appeals process, but unlike the 

ART, the BVA Report of the Chairman does not measure how many appeals were 

resolved at each stage of the appeals process. Rather, the BVA Report of the Chairman considers all Board dispositions, to include remands, and focuses on discrete 

time intervals during the process. Additionally, the categories of time intervals 

measured by the BVA Report of the Chairman are slightly different than those intervals measured by the ART. 

The BVA Report of the Chairman sets forth five separate time intervals in the 

appeals process, and reports the average elapsed processing time for each interval. 

This is calculated by starting with a particular action during the fiscal year, looking 

backwards to the preceding action, and averaging the number of days for processing. 

For example, for Statements of the Case (SOC) issued in FY 2010, it took an average of 243 days from the receipt of the NOD for VA to issue an SOC. Likewise, for 

all Substantive Appeals received by the Department in FY 2010, the data shows 

that the Substantive Appeals were received in an average of 42 days from the date 

that the SOC was issued. Similarly, for all appeals certified to the Board in FY 

2010, the data shows that appeals were certified in an average of 609 days from 

the date that the Substantive Appeal was received by the Department. As these reported times are average times for specific parts of the appeals process, they should 

not be added to determine the average total time to resolve an appeal. Each time 

interval may contain a different universe of appeals (as some appeals are resolved 

at each stage and drop out). 

The 886 number referenced in the question (and appearing at the top of page 19 

in the BVA Report of the Chairman for 2010) shows the average length of time between filing the appeal (the Substantive Appeal, or VA Form 9) and the Board disposition. The Board is required by statute to report this time period. Note that this 

figure is not the same as the ART, as it does not include the time from the filing 

of a Notice of Disagreement, which is a significant period of time preceding the VA 

Form 9, and which is reflected in the calculation for the ART. Also note that the 

BVA Report of the Chairman reports time to all Board dispositions (allowances, denials, remands, dismissals), whereas the ART measures time to a final resolution 

(allowance, denial, dismissal). In other words, the overall time listed in the BVA Report of the Chairman, FY 2010 (886 days) is quite different from the ART (656 days) 

since it measures time to a Board disposition (including remands), whereas the ART 

measures time periods to any final resolution of appeals within the Department as 

a whole, at any point following the NOD. 

b. For fiscal years 2011, 2012, and 2013, what time periods are included in or excluded from the appeals resolution times reflected in the fiscal year 2013 budget 

request? 

Response. As explained in Question 3a, the ART is a joint measure between VBA 

and BVA that represents the average length of time it takes the Department to 

process an appeal from the date a claimant files an NOD until a case is finally resolved, whether the appeal is resolved at the regional office level or at the Board. 

If the Board remands a case, the clock continues to tick in the ART for that appeal, 

as it has not yet been finally resolved. The method for calculating the ART has not 

changed over the subject years. 

Question 4. According to the fiscal year 2013 budget proposal, the average appeals 

resolution time increased from 645 days in 2008 to 747 days in fiscal year 2011, 

257 

but is expected to decrease to 675 days in fiscal year 2012 and 650 days in fiscal 

year 2013. 

a. What factors accounted for the 102 day decline in timeliness between 2008 and 

2011? 

Response. As explained above, the ART is a joint measure between VBA and BVA 

that represents the average length of time it takes the Department to process an 

appeal from the date a claimant files an NOD until a case is finally resolved, whether the appeal is resolved at the regional office level or at the Board. 

A contributing factor to VBA delays in the appeals process in recent years is due 

in large part to the readjudication of previously denied claims for the new Agent 

Orange presumptive conditions (Parkinson’s disease, ischemic heart disease, and bcell leukemias) required under U.S. Court of Appeals, Ninth Circuit decision, 

Nehmer v. the Department of Veterans Affairs (VA). VBA claims inventory increased 

more than the appeals inventory for the period. In the beginning of FY 2010, VBA’s 

thirteen resource centers began preparing to review and readjudicate nearly 100,000 

claims resulting from the Nehmer litigation. Over the course of FY 2011 and FY 

2012, VBA has adjudicated nearly 248,000 Agent Orange claims for the new presumptive conditions and provided over $3.7 billion in retroactive benefits to over 

132,000 Vietnam Veterans and their survivors. The reallocation of resources necessitated by this dramatic workload increase resulted in a significant loss in claims 

processing capacity and left fewer resources to process the regular rating workload, 

including appeals. This included 1,100 Veterans Service Representatives (VSRs) and 

almost 1,200 Rating VSRs (RVSRs) working Agent Orange claims in FY 2011. Because of this, the current VBA appeals workload is not a true indication of either 

past or future workload performance. 

With respect to the Board’s timeliness, an appropriate measure to examine is the 

time interval from the receipt of the certified appeal at the Board to the issuance 

of the BVA decision (regardless of the disposition—allowances, denials, remands, 

dismissals). This measurement, which is reported in the Board’s annual Report of 

the Chairman, represents the total time that the Board was in physical possession 

of the appeal and able to work on it (as opposed to the time periods prior to certification and receipt, at which point the appeal is under the control of VBA). 

The main factor that contributed to delays at the Board is the direct correlation 

between the number of full time equivalents (FTE) BVA has on board and the number of decisions it is able to issue. BVA is a lean organization with a singular mission—to decide appeals on behalf of the Secretary. By statute, and with few exceptions, the Board decides appeals in docket order. Thus, when there are fewer FTE, 

the Board is able to produce fewer decisions, which in turn causes delay for newer 

appeals, thereby increasing the average time it takes for the disposition of all appeals. BVA constantly looks for business process re-engineering as a way to increase 

the number of decisions that can be made. In addition, VA has proposed a number 

of legislative proposals to the Congress which would also assist BVA in carrying out 

its mission. 

b. What factors will allow a reduction in timeliness during fiscal years 2012 and 

2013? 

Response. Factors that will impact timeliness in appeals both at VBA and the 

Board include the Department of Defense’s planned draw down of Servicemembers 

and the VOW to Hire Heroes Act of 2011, which mandates participation in the 

Transition Assistance Program upon separation from service. This very beneficial 

program will likely result in an increase in compensation claims receipts at VBA. 

As BVA historically gets approximately 5 percent of all VBA receipts, an increase 

in workload at VBA necessarily translates into an increased workload at BVA. 

Question 5. According to the fiscal year 2013 budget request, it appears that the 

Board expects its backlog of appeals to grow from approximately 20,000 appeals in 

fiscal year 2011 to over 65,600 appeals in fiscal year 2013. 

a. How many appeals does the Board expect to receive in fiscal years 2012 and 

2013? 

Response. BVA expects to receive 66,600 appeals in FY 2012, and 73,924 appeals 

in FY 2013. Historical trends consistently show that BVA receives an average of 5 

percent of all VBA claims receipts. The Board projected these receipts accordingly. 

b. How many decisions does the Board expect to issue during fiscal year 2012? 

Response. Based on the number of FTE currently sustainable on the FY 2012 

budget, BVA expects to issue 47,600 decisions. 

c. With the requested level of funding, how many decisions does the Board expect 

to issue during fiscal year 2013? 

Response. As the level of funding for FY 2013 has remained the same as that for 

FY 2012, BVA expects to issue 47,600 decisions. 

258 

Question 6. In response to questions about the fiscal year 2012 budget request, VA indicated that the Board expected to spend $1 million on travel in fiscal year 

2011 and $1.1 million on travel in fiscal year 2012 in order to conduct in-person 

hearings at field offices. 

a. During fiscal year 2011, how many in-person hearings were conducted at field 

offices and how much did the Board spend on travel for those hearings? 

Response. In FY 2011, the Board conducted 9,747 hearings in the field (or ‘‘Travel Board hearings,’’ expending $746,753 (which includes the cost of travel, lodging, and 

per diem). 

b. During fiscal year 2012, how many travel hearings does the Board expect to 

conduct and how much in total does the Board now expect to spend on those travel 

hearings? 

Response. Pursuant to 38 U.S.C. § 7107, appellants have a right to ask for a hearing before the Board to be held at the Board’s principal location in Washington, DC, 

or at a regional office of the Department. While BVA affords the appellant an opportunity to participate in a hearing through electronic means, the appellant can decline such a hearing, while maintaining his or her right to an in-person hearing. 

Therefore, BVA Judges must by law travel to the field in cases in which the appellant has requested an in-person hearing. VA has proposed legislation to allow BVA 

wider use of video conferencing capabilities in conducting hearings. The potential 

benefits include serving more Veterans, reducing the waiting time for a hearing on 

appeal, and increased productivity by the Board in issuing final decisions on appeal. 

Additionally, fewer funds would be required for travel. 

In FY 2012, the Board expects to conduct 7,150 hearings in the field, expending 

$836,526. Notably, at the time of the planning of the FY 2012 budget, BVA expected 

to conduct 9,000 field hearings, with the planned expense of $1,054,000, as it intended to maintain the level of Travel Board hearings conducted in FY 2011. However, since that time, BVA has altered its planning in order to gain efficiencies for 

Veterans Law Judges and realize cost avoidance in travel dollars. Specifically, for 

FY 2012, BVA decreased the number of field hearings by 25 percent, to be made 

up by an increase in video teleconference hearings. 

c. During fiscal year 2013, how many travel hearings does the Board plan to conduct and what level of funding is requested for that purpose? 

Response. In FY 2013, the Board expects to conduct 5,070 hearings in the field, 

with funding requested for $900,000. This represents an additional 25 percent decrease in field hearings, in favor of an increase in video teleconference hearings. 

Question 7. According to the fiscal year 2013 budget request, VA now expects to 

spend $2.6 million on Other Services during fiscal year 2012, which is 29% higher 

than the amount requested for fiscal year 2012, and the Board is requesting $2 million for Other Services for fiscal year 2013. 

a. Please explain what led to the expected increase in Other Services during fiscal 

year 2012. 

Response. In FY 2011, BVA set aside $588,000, in order to fund a customer satisfaction survey contract in conjunction with VBA. That contract was delayed in FY 

2011, and ultimately was not let during the fiscal year. VA’s appropriations language allowed BVA to carry over $500,000 to fund such a contract in FY 2012. 

Therefore, the current FY 2012 plan for Other Services is higher than initially indicated, by $500,000. 

b. Please provide an itemized list of how these funds are expected to be spent during fiscal year 2012. 

Response. The itemized list is as follows: 

Customer Service Survey: $500,000 

Franchise Fund (Interagency agreements): $268,755 

Dept of the Army—$3,792 

OGC (Cyberfeds, & Hein Online)—$3,930 

Office & Resolution Management—$53,000 

Human Resources & Admin (HR&A, HCIP)—$131,000 

Records Center and Vault—$168 

Security & Investment Center—$1,000 

Defense Finance & Accounting—$47,285 

Financial Service Center—$28,580 

Contracts: $1,746,245 

Transcription Services—$952,869 

West Legal Database—$391,564 

Shredding Services—$23,725 

Promisel & Korn Data System—$378,087 

259 

c. Please provide an itemized list of how these funds would be spent during fiscal 

year 2013. 

Response. The itemized list is as follows: 

Franchise Fund (Interagency agreements): $272,250 

Dept of the Army—$4,000 

OGC (Cyberfeds, & Hein Online)—$4,500 

Office & Resolution Management—$54,000 

Human Resources & Admin (HR&A, HCIP)—$131,000 

Records Center and Vault—$170.00 

Security & Investment Center—$1,000 

Defense Finance & Accounting—$49,000 

Financial Service Center—$28,580 

Contracts: $1,776,000 

Transcription Services—$960,000 

West Legal Database—$392,000 

Shredding Services—$24,000 

Promisel & Korn Data System—$400,000 

Office of General Counsel 

Question 1. According to the fiscal years 2013 budget request, VA is seeking total 

resources of $103.9 million for the Office of General Counsel and 729 FTE. 

a. Please provide a list of the positions that would be filled in fiscal year 2013 

with that level of funding and the number of staff for each position. 

Response. OGC’s request will sustain current (FY 2012) staffing levels of approximately 480 attorneys, 90 paralegals, and 155 support staff (including legal assistants, data specialists, clerical staff, and budget and H.R. support). These personnel 

are distributed across OGC’s 22 Regional Counsel Offices in the field and eight subject-matter-specific staff groups in VA Headquarters. OGC does not anticipate creating any new positions in FY 2013, but may fill behind existing employees who retire or resign. 

OGC’s current staffing, which is expected to continue without significant modification into FY 2013, is as follows (Note: Information current as of April 4, 2012. Includes FTE on board and vacancies approved to fill. Fractions indicate part-time 

personnel. The VACO Staff Groups and OGC Front Office are treated as a single 

unit for budget allocation purposes): 

Headquarters Attorneys Paralegals Support Total FTE 

FY 2012 

Budget 

($ thousands) 

Front Office: GC, Deputy GC, and support ................................. 3 0 2 5 

Staff Group 1: Torts, Loan Guaranty, ......................................... 17 0 3 20 

Staff Group 2: Compensation & Pension Benefits, Insurance, 

Regulatory Law, Cemetery Law .............................................. 15 1 5 21 

Staff Group 3: HR/Labor Relations Law, Ethics, Health Care 

Law ......................................................................................... 24 3 1 28 

Staff Group 4: EEO, Information Release and Security, 

Appropriations ......................................................................... 20 0 3 23 

Staff Group 5: Procurement Law ................................................ 51 0 5 56 

Staff Group 6: Management & Operations ................................. 5 2 33 40 

Staff Group 7: Veterans Claims Litigation ................................. 73 5 33 111 

02REG: Regulations .................................................................... 2 0 8 10 

Total ........................................................................................ 210 11 93 314 $48,369 

Region 1: CT, MA, ME, NH, RI .................................................... 15 1 5 21 $2,618 

Region 2: NYC, part of NJ .......................................................... 15 1 4 20 2,884 

Region 3: MD, DC, part of WV .................................................... 9 3 2 14 2,078 

Region 4: PA, DE, part of NJ ...................................................... 12 5 1 18 2,395 

Region 5: GA, SC ........................................................................ 13 0 4 17 2,207 

Region 6: FL, PR ......................................................................... 18 9 3 30 3,474 

Region 7: OH, part of WV ........................................................... 13 4 4 21 2,623 

Region 8: TN, AR ......................................................................... 11 5 1 17 2,209 

Region 9: MS, AL ........................................................................ 10 2 3 15 1,838 

Region 10: IL, IA ......................................................................... 14 2 4 20 2,699 

Region 11: MI, WI ....................................................................... 13 3 0 16 2,108 

Region 12: MO, KS, NE ............................................................... 14 5 4 23 2,713 

Region 13: TX (Western, Northern, Central), OK ........................ 13 5 6 24 2,860 

260 

Headquarters Attorneys Paralegals Support Total FTE 

FY 2012 

Budget 

($ thousands) 

Region 14: TX (Southern), LA ..................................................... 15 4 4 23 2,972 

Region 15: MN, ND, SD ............................................................... 7 1 2 10 1,417 

Region 16: CO, MT, UT, WY ........................................................ 10 2 0 12 1,788 

Regions 17/18: CA, HI, Pacific Islands, part of NV ................... 24 8 4 36 5,325 

Region 19: AZ, part of NV .......................................................... 12 3 2 17 2,159 

Region 20: OR, WA, ID, AK ......................................................... 12 4 2 18 2,253 

Region 21: upstate NY, VT ......................................................... 10 4 1 15 1,792 

Region 22: IN, KY ........................................................................ 8 2 1 11 1,319 

Region 23: NC, VA ...................................................................... 11 3 3 17 2,094 

Region Total ............................................................................ 279 76 60 415 

OGC-WIDE TOTALS .............................................................. 489 87 150 729 $102,194 

b. For each regional counsel office, please identify the number and type of staff 

that would be located at the office during fiscal year 2013 and a description of the 

functions performed by that office. 

Response. As noted above, OGC’s FY 2013 funding request will sustain FY 2012 

staffing levels and mix at each Region. 

With respect to the functions performed by each office, OGC’s 22 Regional Counsel 

offices provide legal service and support to VA field facilities (Medical Centers, Regional Benefits Offices, National Cemeteries, and the like) within their geographic 

areas of jurisdiction. The various Regional Counsel offices vary in terms of staff size, 

number of clients served, and size of their geographic territory, but all Regional 

Counsel offices provide the same core menu of legal services to the VA facilities 

within their respective geographic areas, e.g., employment law advice and representation, administrative tort claim adjudication, information law counseling, review of 

contracts and other business law services. 

c. If the fiscal year 2013 budget request is adopted, what would be the expected 

total budget for each regional counsel office? 

Response. For FY 2013, as in years past, OGC will allocate resources, including 

personnel, to each Regional Counsel office based on the specific case load that Region is expected to bear. Over 94 percent of OGC’s budget—including the budgets 

allocated to each Regional Counsel office—is devoted to payroll. For that reason, the 

Regions’ individual budgets fluctuate as payroll rises (e.g. as vacancies are filled or 

employees are promoted), and falls (e.g. as employees retire or resign). Some Regions also require more travel funding than others to facilitate attorney travel to 

remote clients (such as Region 18’s client facilities in the Philippines and Guam) or 

supervisor travel to remote subordinates (such as Region 6’s out-stationed staff in 

Puerto Rico). 

OGC estimates that the Regions’ FY 2013 budgets will be approximately equivalent to the amounts allocated to each Region in FY 2012. (See response to question 

1.a. above.) 

Question 2. According to the fiscal year 2013 budget request, VA Office of General 

Counsel now expects to spend $1.7 million on equipment during fiscal year 2012, 

which is 38% higher that requested for fiscal year 2012 ($1.2 million), and that office requests $525,000 for equipment in fiscal year 2013. 

a. Please explain what led to the expected increase in equipment expenditures 

during fiscal year 2012 and how that funding ($465,000) was originally expected to 

be spent. 

Response. The Office of General Counsel was going to lease equipment over a 5 

year period beginning in fiscal year 2012 but decided to purchase the equipment in 

fiscal year 2012. The funds were transferred from our Travel and Rents, Communications and Utility accounts to cover the additional expense. 

b. Please provide an explanation of how these funds are expected to be expended 

during fiscal year 2013. 

Response. The Office of General Counsel will replace all outdated equipment—Fax 

machines, date stamp machines, dictation equipment that has exceeded its life expectancy. We will also begin replacing outdated furniture (i.e. more than 10 years 

old). 

Question 3. According to the fiscal year 2013 budget request, VA Office of General 

Counsel now expects to spend $1.3 million on Other Services during fiscal year 

2012, which is 57% higher than the amount requested for fiscal year 2012 

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($838,000), and that office is requesting $1.1million for Other services in fiscal year 

2013. 

a. Please explain what led to the expected increase in Other Services during fiscal 

year 2012. 

Response. Our Other Services account increased by $476,000 since our Congressional submission for the following reasons: 

Account Amount of 

increase Reason for Increase 

Repair of furniture and equipment .................... $15,000 To extend the useful life of furniture and postpone the need 

to purchase new items 

Training ............................................................... $234,000 To maintain skills and ensure familiarity with new developments 

Relocation Services ............................................. $150,000 To pay relocation expenses regarding the replacement of two 

Regional Counsels positions vacated by retirements 

Contracts ............................................................ $77,000 Short-term personnel support pending recruitment of permanent replacements 

Total ........................................................... $476,000 

b. Please provide an itemized list of how these funds are expected to be spent during fiscal year 2012 

Response. The Office of General Counsel plans to spend its Other Services funding 

in FY 2012 as follows: 

Account Amount Purpose 

Repair of furniture and equipment .................. $52,000 To extend the useful life of furniture and postpone the need 

to purchase new items 

Security ............................................................. $10,000 Cost for security at leased space 

Human Capital Investment Plan (HCIP) .......... $178,000 Pro-rata charge for VA’s online training system 

Security & Investigation ................................... $15,000 Cost for background investigation and new ID badges 

Office of Resolution Management .................... $38,000 Cost for internal mediation 

Financial Service Center ................................... $35,000 Cost to process payments 

Record Center & Vault ..................................... $2,000 Storage of files 

Office move ....................................................... $20,000 Relocation of the Roanoke area office 

Furniture moving .............................................. $10,000 Reconfiguring cubicles and offices 

Notaries ............................................................. $2,500 Notary renewals 

Tort training video ............................................ $14,000 Tort training video 

Award event expenses ...................................... $10,000 Award event expenses 

Shredding contracts ......................................... $8,000 To ensure the proper destruction of retired paper records 

Meeting room rentals ....................................... $32,500 For approved training events 

Case related expenses ...................................... $20,000 Transcribers, filing fees, mediators 

Contract labor ................................................... $77,000 Short-term personnel support pending recruitment of permanent replacements 

Defense Finance & Accounting Service (DFAS) $92,000 Payroll processing expense 

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Account Amount Purpose 

DA (Army) Financial Disclosure ........................ $10,000 Cost to process financial disclosure statements 

Training1 ........................................................... $524,000 To maintain skills and ensure familiarity with new developments 

Relocation Expenses ......................................... $150,000 Relocating 2 Regional Counsels—Region 15 & 20 

Total ......................................................... $1,300,000 

1 As OGC’s staffing remains flat while workload continues to grow, it becomes critical that all OGC employees are fully trained to carry out 

their assigned duties as efficiently and effectively as possible. 

c. Please prove an itemized list of how these funds would be spent during fiscal 

year 2013. 

Response. The Office of General Counsel plans to spend their Other Services funding in FY 2013 as follows: 

Account Amount of 

increase Purpose 

Repair of furniture and equipment .................. $57,000 To extend the useful life of furniture and postpone the need 

to purchase new items 

Security ............................................................. $26,000 Cost for security at leased space 

Human Capital Investment Plan (HCIP) .......... $178,000 Pro-rata charge for VA’s online training system 

Security & Investigation ................................... $15,000 Cost for background investigation and new ID badges 

Office of Resolution Management .................... $121,000 Pro-rata charge to fund this VA office 

Financial Service Center ................................... $35,000 Cost to process payments 

Record Center & Vault ..................................... $2,000 Storage of files 

Furniture moving .............................................. $10,000 Reconfiguring cubicles and offices 

Notaries ............................................................. $2,500 Notary renewals 

Award event expenses ...................................... $10,000 Award event expenses 

Shredding contracts ......................................... $8,000 To ensure the proper destruction of retired paper records 

Case related expenses ...................................... $20,000 Transcribers, filing fees, mediators 

Meeting room rentals ....................................... $39,500 For approved training events 

Cleaning service ............................................... $9,000 Region 3 

Defense Finance & Accounting Service (DFAS) $94,000 Payroll processing expense 

DA (Army) Financial Disclosure ........................ $10,000 Cost to process financial disclosure statements 

Training ............................................................. $313,000 To maintain skills and ensure familiarity with new developments 

Relocation Expenses ......................................... $150,000 To pay relocation costs to replace up to two retiring Regional 

Counsel/Assistant General Counsel 

Total ......................................................... $1,100,000 

Question 4. Within the Office of General Counsel, Professional Staff Group VII 

represents VA before the U.S. Court of Appeals for Veterans Claims (Veterans 

Court). 

a. Currently, how many employees are assigned to Professional Staff Group VII 

and what is the average number of active cases per attorney? 

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Response. As of April 30, 2012, there were 108 FTE assigned to Professional Staff 

Group VII (PSG VII). That total included two attorneys who are indefinitely recalled 

to active duty with the Navy and Air Force, meaning that the positions are carried 

on PSG VII’s books, but the employees are working elsewhere. In addition, a third 

PSG VII attorney is detailed for twelve months to an Ethics Pilot Project elsewhere 

in the Office of the General Counsel. 

As of April 30, 2012, PSG VII had 23 vacancies, comprised of 14 support staff and 

9 attorney positions. At that time, the average caseload was approximately 42 active 

cases per attorney. The term ‘‘active case’’ signifies a case in which the Secretary 

has yet to file his brief or an equivalent dispositive pleading. 

b. For fiscal year 2013, what level of funding is requested to support Professional 

Staff Group VII and how many employees would that level of funding support? 

Response. In FY 2013 budget requests an FTE level of 111.25 and a funding level of $13,777,534 for PSG VII. 

c. Please provide a list of the positions that would be filled with that level of funding. 

Response. 

Position Title Number 

Supervisory Program Specialist ................ 1 

Attorney ..................................................... 73 .25 

Paralegal Specialist .................................. 5 

Legal Assistants ....................................... 16 

Program Service Specialist ....................... 1 

Program Support Assistants ..................... 13 

Program Analyst ....................................... 2 

Total ................................................. 111 .25 

d. With the requested funding level, what would be the expected average number 

of active cases per attorney during fiscal year 2013? 

Response. In fiscal year 2013 we anticipate 40 cases per attorney. 

e. How many motions for extension of time did Professional Staff Group VII file 

during fiscal year 2011? 

Response. In FY 2011, PSG VII filed 1,786 extension motions, an average of 149 

extension motions per month. PSG VII met approximately 92 percent of its deadlines without seeking an extension (or further extension). By comparison, in FY 

2011 appellants and their representatives met 90 percent of their deadlines without 

an extension. 

f. How many motions for extension of time has Professional Staff Group VII filed 

to date during fiscal year 2012? 

Response. As of March 31, 2012, PSG VII had filed a total of 11,127 pleadings 

during FY 2012, of which 1,143 represented extension motions. Thus, at this point 

in the Fiscal Year, PSG VII is averaging 1,855 pleadings per month, and 191 extension motions per month. 

Question 5. According to VA’s Fiscal Year 2011 Performance and Accountability 

Report, VA ‘‘is making substantial progress in completing a monumental, multi-year 

project to completely reorganize and rewrite all of VA’s compensation and pension 

regulations’’ and expects the final regulations ‘‘to be completed and published in 

2012.’’ 

a. Is this project still expected to be completed during 2012? 

Response. The fundamental work to reorganize and rewrite VA’s compensation 

and pension regulations will be completed in 2012. A final internal coordination review must still be accomplished, after which VA will then finalize its plan to secure 

comments through a public review and comment phase. As a result, the regulations 

will not be completed and published in 2012. 

b. Is this project still expected to be completed during 2012? 

Response. The Department has frequently reviewed the various options for deploying the product of this major reorganization and rewriting initiative. We have 

determined that a more deliberate review of most, or all, of the rewrite project package, vice multiple partial reviews of package components, is likely to produce the 

most effective understanding and acceptance of this work. While this adds time to 

the implementation of the new regulations, it also provides a more comprehensive 

and structured review opportunity to stakeholders. 

c. Please provide an estimate of the resources needed to complete this project. 

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Response. The regulation rewrite portion is not expected to require additional resources, but the implementation of these rules will require more resources over 

time. Areas of cost include training program revisions, manuals and forms updating, 

skills certification materials, and IT projects to modify our claims processing systems. Costs have not been finalized and will be reflected in future budgets as necessary. 

d. Does the Fiscal Year 2013 budget request include any funding necessary to 

complete this project? 

Response. No specific funding was requested in FY 2013. Implementation budget 

planning will occur in 2013. 

Question 6. Under current law, if an individual is a prevailing party at the Veterans Court, that individual may be eligible to receive an award of attorney fees 

under EAJA. 

a. What is the total amount VA expended during fiscal year 2011 for EAJA 

awards by the Veterans Court, how much is expected to be spent during fiscal year 

2012 on those EAJA awards, and how much is requested in the fiscal year 2013 

budget to pay for those EAJA awards? Response. Total EAJA obligations in FY 2011 were approximately $12.6 million. A total of $13.0 million is estimated for FY 2012, and a total of $13.3 million is estimated for FY 2013. 

b. For fiscal year 2011, how many individuals received awards of EAJA fees from 

the Veterans Court, what was the average award amount per individual, and in how 

many of those cases did VA not contest the EAJA award? 

Response. According to data published in its annual report, the Veterans Court 

granted 2,627 EAJA applications in FY 2011. The annual report can be found at: 

http://www.uscourts.cavc.gov/documents/FY_2011_Annual_Report_FINAL_Feb_29_ 2012_1PM_.pdf. VA’s data indicate that the average EAJA award was approximately $5,298 per 

case. Although precise numbers are not available, it is accurate to say that VA did 

not contest the vast majority of the EAJA applications filed in FY 2011. In many 

of those cases, VA negotiated a reduced award with the appellant’s counsel, such 

that a fee contest and thus, further litigation, was not necessary. 

c. In fiscal year 2011, what percentage of appeals to the Veterans Court resulted 

in an award of EAJA fees? 

Response. According to data published in its annual report, the Veterans Court 

disposed of 4,620 appeals in FY 2011. It awarded EAJA fees in 2,627 appeals. The 

annual report can be found at: http://www.uscourts.cavc.gov/documents/FY_2011_ Annual_Report_FINAL_Feb_29_2012_1PM_.pdf. 

d. In the cases for which EAJA fees were awarded, what percentage were attributable to cases in which the Veterans Court remanded the case to VA and what percentage were attributable to cases in which the Veterans Court reversed VA’s decision in whole or in part? 

Response. Although VA cannot provide the precise number of cases in which the 

Veterans Court awarded EAJA based upon a reversal vice a remand, it is accurate 

to say that only a small fraction of EAJA awards were made in appeals involving 

a reversal. This is because, generally speaking, the Veterans Court disposes of many 

more cases by remand than by reversal. For example, the Veterans Court’s FY 2011 

annual report reflects that a total of 1,298 appeals were remanded, whereas only 

706 appeals were reversed or vacated and remanded in whole or in part. The FY 

2011 annual report also reflects 837 appeals that were affirmed or dismissed in 

part, reversed/vacated and remanded, in part. We do not believe that this figure, 

which mixes affirmances with other dispositions, changes the overall dynamic that 

the Veterans Court tends to issue many more remands than reversals. The annual 

report can be found at: http://www.uscourts.cavc.gov/documents/FY_2011_Annual_ 

Report_FINAL_Feb_29_2012_1PM_.pdf. 

e. If available, please provide any statistics regarding the number of cases that 

are remanded by the Veterans Court that ultimately result in an award of benefits 

by VA and the percent of appeals that are remanded by the Veterans Court more 

than once. 

Response. VA does not systematically maintain such statistics. It is worth noting, 

however, that the law affords a claimant the opportunity on remand to submit additional evidence and present additional arguments to VA. In other words, the record 

is not closed. Moreover, new statutes, regulations, or binding interpretations of law 

may take effect while a case is under further development on remand. Therefore, 

when VA ultimately readjudicates a claim on remand, the legal and factual landscape might be dramatically different than when the claim was initially considered 

and remanded by the Veterans Court. 

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f. Please provide any available information or statistics regarding the number of 

cases in which the attorney who represented the prevailing party before the Veterans Court continues to represent that party before the Board on remand. 

Response. VA’s best estimate is that the attorney before the Veterans Court (or, 

at least, the same law firm) will stick with the case on remand to VA in approximately 50 percent of the cases. 

g. If there is an award of EAJA fees by the Veterans Court, does VA track which 

Board member issued the decision that led to that award of EAJA fees? If so, what 

is done with that information? 

Response. VA does not systematically maintain such statistics. 

Office of Management 

Question 1. According to the fiscal year 2013 budget request, the Office of Management plans to spend $36.5 million on Other Services during fiscal year 2013. 

Please provide an itemized list of how those funds would be expended. 

Response. Of the $36.5 million in ‘Other Services,’ the majority of these costs 

($26.7 million) are for payments to the Defense Finance and Accounting Service 

(DFAS) for VA’s payroll processing. The specific breakdown is as follows: 

Of the $36.5 million in Other Services: 

A. $30.5 million is from reimbursable authority for the following: 

– $26.7 million for payroll processing with the Defense Finance and Accounting 

Service (DFAS) 

– $3.8 million for contracts primarily related to the assessment and remediation of internal controls over financial reporting, as well as for maintenance 

and repair of equipment. 

B. $6 million is requested in budget authority for the following: 

– $4.8 million for financial management initiatives, including the Integrated 

Operating Model (IOM) and Audit Readiness contracts 

– $943,000 for recurring annual expenses and Service-Level Agreements 

(SLAs), including equipment repair and maintenance and payments for services 

provided by the Franchise Revolving Fund 

– $220,000 for training/tuition. 

Question 2. According to the fiscal year 2013 budget request, the Office of Management now expects to spend $561,000 on equipment during fiscal year 2012, 

which is 979% higher than the amount requested for fiscal year 2012 ($52,000), and 

that office requests $101,000 for equipment for fiscal year 2013. The budget request 

includes this explanation: ‘‘Equipment decreased because onetime expenses in 2012 

for office equipment and furniture for new and expanded office space.’’ 

a. Please explain what specifically has been or will be purchased during fiscal 

year 2012 with these funds, the reasons for those purchases, and how that increased 

funding ($509,000) was originally expected to be spent. 

Response. The increased obligations in 2012 are primarily the result of a move 

of existing staff to a different location and to accommodate staffing increases. The 

new and reconfigured space required the purchase of additional office equipment, 

and furniture and fixtures. 

A total of $460,000 is for office furniture/fixtures and equipment for the new and 

expanded office space to accommodate additional hires and space requirements. 

Unobligated balances are being used to fund this one-time requirement that originated from the move and expansion of the work force. 

b. Please explain when the decision was made to purchase new office equipment 

and furniture for this office and provide any supporting documentation. 

Response. The decision was made in 2011 within the planning and budgetary 

process. 

c. Please provide an explanation of how these funds ($101,000) are expected to be 

expended during fiscal year 2013. 

Response. These funds are budgeted for normal office furniture/fixtures and equipment replacement. 

Question 3. The Office of Finance within the Office of Management oversees the 

financial operations at VA’s Debt Management Center. 

a. During fiscal year 2012, how much in total is expected to be expended to operate the Debt Management Center and what level of staffing would that funding 

support? 

Response. The 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 appropriated funding. Projected reveVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00271 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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nues in FY 2012 will support $13.6 million in expenditures and a staffing level of 

142. 

b. For fiscal year 2013, what level of funding is requested to operate the Debt 

Management Center and what level of staffing would that funding support? 

Response. The 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 appropriated funding. Projected revenues in FY 2013 will support $16.6 million in expenditures and a staffing level of 

155. 

c. How many telephone lines does the Debt Management Center currently operate 

and how many would be operated with the requested level of funding for fiscal year 

2013? 

Response. We currently have 48 telephone lines (toll free). By FY 2013 we plan 

to have 72 telephone lines. 

d. During fiscal year 2011, 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 2011, 643,505 debts valued at $1.6 billion were referred to the DMC. During the fiscal year, we had collections of $1.3 billion. 

e. How many debts are expected to be referred to the Debt Management Center 

during fiscal year 2012 and 2013? Response. For FY 2012, we expect $1.45 billion in new debt to be referred to the DMC and $1.48 billion of new debt to be referred to the DMC in FY 2013. 

f. Please explain the performance outcomes for the Debt Management Center during fiscal year 2011 and the expected performance outcomes during fiscal year 2012 

and 2013. 

Response. The DMC has many different measures used to measure performance 

outcomes. They are dropped-call rate, dollars collected per dollars spent on operations, timeliness of clearing unidentified payments in suspense, timeliness of check 

processing, timeliness of responses to Congressional inquiries and other correspondence. For FY 2011, DMC met or exceeded all performance standards. We believe we 

will continue this trend in FY 2012 and 2013. 

Office of Human Resources and Administration 

Question 1. The VA Office of Human Resources and Administration produced the 

‘‘VA Organizational Briefing Book, June 2010.’’ Within the handbook there is a chart 

reflecting the ‘‘Organization of the Department of Veterans Affairs.’’ The handbook 

then discusses the mission, scope, and functions of each subordinate office within 

VA that is reflected on the chart. Associated with each subordinate office is a chart 

reflecting the respective organizational make-up. Since this handbook was published 

in June 2010, there have been a number of office reorganizations. 

a. Please provide an up-to-date chart for each office that has undergone any reorganization since the publication of the 2010 handbook. Please note the effective date 

of the reorganization on the chart, as well as the total FTE (SES/SES Equivalent, 

GS, career or non-career) assigned to the office as of March 5, 2012. 

b. Please identify any offices currently undergoing reorganization and the anticipated completion date for the reorganization. 

Response. [These questions appear and were answered in the prehearing responses as Question 24.] 

Question 2. In fiscal year 2012, VA requested $3.04 million to continue a ‘‘Health 

and Wellness Initiative’’ started in fiscal year 2011. In response to questions about 

VA’s fiscal year 2012 budget request asking how effective this program has been in 

promoting healthier employees, VA responded that ’’[p]rogram effectiveness measures will be reviewed at six months and at the end of the fiscal year.’’ 

Please describe the specific objectives of this program and what benchmarks will 

be used to measure success. Please provide the Committee with documents assessing the effectiveness of the program. 

Response. [These questions appear and were answered in the prehearing responses as Question 32.] 

Question 3. Staffing in the Office of Human Resources and Administration increased 80% since 2008. In fact, the fiscal year 2012 budget request includes funding for an additional 204 employees and the fiscal year 2013 budget request would 

add 40 employees to the Office of Human Resources and Administration. 

a. What measures does VA use to determine if additional staff is needed in the 

Central Office? 

Response. Nearly all of the additional staff hired since 2008 was hired beginning 

in Fiscal Year 2010 to provide support for the Human Capital Investment Plan 

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(HCIP). These are reimbursable FTE funded by the VA program offices who are receiving the benefits of corporate-wide training and human resources initiatives. 

HCIP is integral to the VA-wide transformation effort and is designed to support 

the Secretary of Veterans Affairs’ top three priorities: expanding access to benefits 

and services, eliminating the disability claims backlog and ending Veteran homelessness. The program seeks to ensure that VA employees are appropriately prepared to provide effective services to Veterans by applying new approaches to recruitment, hiring, retention, training and development. 

Since FY 2010, staffing levels for the VA’s HCIP program were predicated upon 

workforce planning estimates for each initiative as they were rolled out. Independent government cost estimates are developed for each initiative that include the 

number of FTE needed to properly award and monitor contracts, test and deliver 

programs and products, and to evaluate how the HCIP initiatives achieve their intended purpose. Workforce estimates are compared to historical FTE usage as well 

as reviewed by an independent verification and validation contractor to ensure that 

the FTE allocation supports the completion of the initiative within time and budget 

constraints. It should be noted that a percentage of the staffing needs have been 

met by obtaining temporary contractor support and taking advantage of the Office 

of Personnel Management’s capacity to provide affordable training through its established programs, thereby maintaining FTE levels below what would otherwise 

have been required for a program of this scope. 

The additional resources and FTEs supporting HCIP have been dedicated to 

human capital management programs that include: 

• Creation of a new Veterans Employment Services Office (VESO) and the VA for 

Vets program dedicated to increasing the number of Veterans in the VA workforce. 

VESO has created a robust military skills translator for the VA’s online Career Center. This translator has been so effective that it is now being deployed across multiple Federal agencies. In FY 2012, VESO also hosted a series of job fairs during 

which 8,000 Veterans were interviewed and approximately 2,000 received job offers. • New hiring reform process to improve the efficiency of efforts to bring new employees to the VA. VA decreased the average time to hire new employees from more 

than 120 days in 2009 to about 70 days today • Increased Learning Opportunities through VA’s Learning University (VALU), 

providing career, technical and other training using a corporate approach and a new 

centralized Training Management System. Providing Training to approximately 

140,000 VA professionals each year. • Creating mission-ready leadership under the auspices of VALU and VA’s new 

Corporate Senior Executive Management Office (CSEMO). VA entirely revamped 

the SES management system into an effective tool for developing strategic leaders 

to provide the best possible care and service to Veterans. • Improving the capacity for handling conflict management within the Department via an expanded Workplace Alternative Dispute Resolution (ADR) program. 

This resulted in an increase in ADR participation from 45 percent in 2008 to 56 percent today for the purpose of addressing discrimination complaints and grievances. 

The estimated cost avoidance for this program is $90 million a year. 

Beginning in FY 2011, a prioritization process was put in place to identify the 

best use of HCIP funds. Evaluation criteria were developed and each factor was 

clearly defined to ensure consistent application across projects. 

As in previous years since the inception of HCIP, criteria for measuring outcomes 

will be applied to the FY 2013 initiatives. In 2013, special focus will be placed on: 

• completing projects begun in FY 2011 and FY 2012; 

• revising and establishing projects that have immediate, tangible and measurable impact on the services provided to Veterans; 

• addressing needs associated with mandates, statutes, directive, findings or 

other documented deficiencies; and 

• establishing projects that closely align with overall VA/HRA transformation priorities. 

b. How will these additional staff in the Office of Human Resources and Administration directly benefit veterans? 

Response. As stated in question 3a, one of the most heavily weighted criteria for 

approving an initiative is its ability to have immediate, tangible and measurable impact on the services provided to Veterans. Programs that increase staff productivity 

allow VA to more quickly address the needs of Veterans. Training that improves 

competencies in the areas of human resources, financial management, project management, acquisition and information technology (IT) certification allows VA to provide an improved level of service to Veterans. Programs developed and administered 

by the Veterans Employment Services Office, which includes the VA for VETS proVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00273 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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gram (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. Alternative dispute resolution programs have a substantive return on investment, allowing government funds to be directed to Veterans programs 

instead of adjudicating employee grievances. 

Question 4. According to the Congressional Research Service, in 2009 VA made 

payments totaling nearly $180 million to the Department of Labor (DOL) to cover 

benefits paid to employees receiving workers’ compensation under the Federal Employees’ Compensation Act (FECA). 

a. How many current VA employees are on workers’ compensation? Please detail 

this information by the three major administrations (National Cemetery Administration (NCA), VHA, and VBA). 

Response. Under FECA, the Department of Labor’s Office of Workers’ Compensation Programs (DOL OWCP) identifies costs in Chargeback Years (CBY) (July 1 to 

June 30). The period covered by the Chargeback Year is different from that covered 

by the fiscal year. The DOL Chargeback Year quarters are broken out as follows: 

Q–1 = July–September 

Q–2 = October–December 

Q–3 = January–March 

Q–4 = April–June 

CBY 2011 (7/1/2010—6/30/3011), the most recent complete year of data, provides 

a representative picture of all cases actively receiving compensation or medical benefits through DOL OWCP. The number of VA cases was as follows: 

NCA: 87 cases receiving compensation; 253 cases receiving medical benefits 

VHA: 5,604 cases receiving compensation; 15,269 cases receiving medical benefits 

VBA: 59 cases receiving compensation; 205 cases receiving medical benefits. 

b. What is the average amount of time employees on workers’ compensation receive payments prior to returning to work? 

Response. These data are not centrally tracked. Time spent on workers’ compensation depends on the type/degree of injury, and is the exclusive responsibility of DOL 

OWCP. 

Question 5. The DOL Office of Workers’ Compensation Programs (OWCP) provides 

all Federal agencies a quarterly estimate of the cost of workers compensation benefits. OWCP also sends each agency a yearly statement of FECA costs for the previous fiscal year. 

a. What was the total amount of FECA costs for fiscal years 2010 and 2011 as 

provided by OWCP, and what was the estimate for costs in the first quarter of fiscal 

year 2012? 

Response. CBY 2010, the cost was $182,212,380; for CBY 2011, the cost was 

$186,254,136. For CBY 2012, the cost was $200,569,180. CBY 2012 figures include 

an additional 28 day compensation payment (14 for the year, rather than the normal 13), as happens approximately every 22 years due to distributing a fixed payment cycle over an odd number of days in a year (a ‘‘leap payment,’’ if you will). 

Without this payment, VA costs would have been approximately 10 percent lower 

than the figure shown, or a slight decrease from the 2011 CBY total. 

b. For each administration, please provide the amounts VA is requesting for 

FECA payments in fiscal year 2013. 

Response. DOL administers payment of expenses and provides VA a bill following 

the close of the CBY on June 30 of each year. The amount requested in the FY 2013 

VA budget is $186,241,385 as depicted by the table below: 

CBY 2013 

Veterans Health Administration (VHA): 

Medical Care (Program) ....................................................................................................................................... $170,784,655 

Medical Services .......................................................................................................................................... 124,488,213 

Medical Facilities ........................................................................................................................................ 16,075,676 

Medical Support and Compliance ............................................................................................................... 30,220,766 

Medical and Prosthetic Research ............................................................................................................... 2,359,307 

Total—VHA ......................................................................................................................................... 173,143,962 

Veterans Canteen Service .................................................................................................................................... 1,679,124 

Veterans Benefits Administration ........................................................................................................................ 5,249,866 

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CBY 2013 

National Cemetery Administration ....................................................................................................................... 2,642,975 

Board of Veterans’ Appeals ................................................................................................................................. 52,788 

Information Technology ........................................................................................................................................ 1,970,303 

Administration: 

General Operating Expenses (Staff Offices) ............................................................................................... 747,277 

Inspector General (IG) ................................................................................................................................. 195,308 

Facilities (Construction) .............................................................................................................................. 623 

Supply Fund ................................................................................................................................................. 252,934 

Franchise Fund ............................................................................................................................................ 306,225 

Total—Administration ........................................................................................................................ 1,502,367 

FY Total VA Chargeback ..................................................................................................................... $186,241,385 

Question 6. VA’s oversight of FECA claims is provided by staff at individual facilities. Specifically, these offices are charged with implementing the VA workers’ compensation strategic plan with the goal of returning employees to work. 

a. Does VA currently perform audits of individual workers’ compensation cases to 

evaluate their accuracy and management? 

Response. VA performs such audits periodically. In FY 2012, VA’s Office of Inspector General (OIG) concluded an audit of VHA’s workers’ compensation case management, available at http://www.va.gov/oig/pubs/VAOIG–10–03850–298.pdf. See the 

answer to 6b for an update on the actions VA has taken in response to this report. 

b. What oversight apparatus is in place to monitor workers’ compensation management at local facilities? 

Response. HRA has conducted follow-up reviews and training in response to the 

OIG’s findings. 

Before the OIG’s report was issued on September 30, 2011, on August 18, 2011, 

the Assistant Secretary for Human Resources and Administration (A/S HRA) issued 

a memo requiring a complete review of all Return to Work (RTW) cases where the 

employee had been identified as having work capacity but had not RTW. A complete 

review was conducted and completed in April 2012. The response to this memo led 

to a reduction of 11 percent in such cases and greater emphasis in this area of program management. The memo raised facility leadership awareness to this specific 

element of workers’ compensation (WC) case management. Directors were required 

to obtain responses/information on specific WC cases that had not benefited from 

proper case management techniques. The memo led to the review and identification 

of poor case management confirming recent OIG findings of VHA program management. As noted, while the OIG report focused on VHA, the lessons learned were applied across the Department more broadly. A/S HRA’s memo resulted in near term 

improved attention to specific cases. To further increase awareness, WC data is included in the Monthly Performance Report and reviewed by senior leadership. VA’s 

Office of Occupational Safety and Health has provided and is planning face-to-face 

training in WC case management—a complex field requiring significant technical 

competence. 

c. Please detail by administration what programs or initiatives are in place to 

limit workplace incidents that lead to workers’ compensation claims. 

Response. Under the Department’s safety policy (Directive 7700) and strategic 

plan each Administration has developed safety programs and guidebooks to address 

their individual needs. This material is posted at www.va.gov/vasafety. VA’s Safety 

Steering Committee (SSC) is another facet of the VA Safety and Health program, 

designed to reduce and correct potential hazards before they occur. The SSC membership consists of representatives of all three Administrations, key offices and five 

labor unions within the VA. 

NCA: NCA Directive 7700 (dated January 24, 2011), Occupational Safety and 

Health, defines policies and responsibilities of NCA’s comprehensive occupational 

safety and health program. NCA’s approach is characterized by four basic elements: 

Management Leadership/Employee Involvement; Worksite Analysis; Hazard Prevention/Control; and Safety/Health training. Annual workplace evaluations are conducted by VHA; findings and deficiencies are identified; and abatement actions are 

tracked through completion. 

VHA: VHA Directive 7701 (dated August 9, 2012), Occupational Safety and 

Health, defines policies and responsibilities of VHA’s comprehensive occupational 

safety and health program. VHA’s Occupational Safety and Health training program 

emphasizes employee skill and understanding in hazard recognition, standard proceVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00275 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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dures, best practices and emerging issues. Medical center employees receive initial 

and annual OSHA compliance training based on job classification and supervisor assignments. Annual workplace evaluations are conducted at all VHA facilities, deficiencies are identified and the safety and health compliance programs evaluated. All 

findings and deficiencies are tracked through abatement. 

VBA: VBA Directive 7700, (dated March, 2010) Occupational Safety and Health, 

defines policies and responsibilities of VBA’s comprehensive occupational safety and 

health program. VBA’s approach to maintaining a safe and healthful work environment for employees is to minimize safety and health hazards through the development of safe work practices and employee training. Annual workplace evaluations 

are conducted and deficiencies are identified for correction. 

Question 7. For fiscal year 2013, the Office of Human Resources and Administration is requesting $303 million for Other Services. Please provide a detailed itemized 

list of how those funds are expected to be spent. 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 fiscal year 2013, it is expected that costs for contracts associated 

with HCIP will be on par with the amount projected to be spent in FY 2012, which 

is approximately $ 242 million. As previously mentioned, HCIP is part of the 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. 

HCIP training realized a significant return on investment for FY 2010 and FY 

2011. For example, HCIP training contributed to a $3.6 million cost avoidance associated with a reduction in Informal EEO Complaints. 

A breakdown of our current estimated FY 2013 contract costs of $253.4 million 

is included below. The decrease in contract costs from the FY 2013 budget amount 

of $303 million is associated with the Human Resources Information System (HRIS). 

HRIS was originally included in a reimbursable program in the FY 2013 President’s 

budget, however legal reviews delayed award of the HRIS development contract 

such that HRIS deployment is not expected to be completed in time to begin collecting reimbursements for operations in FY 2013. Instead, HRIS reimbursements 

will be collected in FY 2014. 

Current Estimated FY 2013 Contract Costs 

Office Contract Description Cost (in Millions) 

Human Capital Investment Program Training and Transformation Initiatives $242 .3 

Office of Resolution Management 

(EEO complaint Processing) 

Contracts for Investigation of EEO complaints, 

Court Transcription Services 

$3 .7 

Administration Contracts with Other Government Agencies for Mailroom Operations, Employee Health Unit and Employee Fitness Center $3 

Office of Human Resources and 

Administration 

Child Care Subsidies $4 

Miscellaneous Individual training, copier and equipment maintenance and 

other contracts 

$0 .4 

Total $253 .4 

The miscellaneous contract costs comprise routine equipment and system maintenance costs, internal reimbursements for IT costs, financial transaction processing, 

and individual training requests. 

Question 8. According to the fiscal year 2013 budget request, the Office of Human 

Resources and Administration plans to spend $21,955,000 on travel during fiscal 

year 2012 and requests $22,231,000 for travel during fiscal year 2013. 

a. To date, how many employees have traveled during fiscal year 2012 and what 

was the average cost per trip? 

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b. In total, how many employees are now expected to travel during fiscal year 

2012 and what is the average cost per expected trip? 

Response to a and b: The travel budget identified in the HRA chapter in the budget is primarily for travel provided for Human Capital Improvement Plan (HCIP) 

programs. 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) 

Actual* Estimate 

(Sept) FY 2012 FY 2013 

VALU sponsored travel .......................................................................... $7.7 $1.9 $9.8 $16.1 

All other HRA travel not included in VALU totals ................................ $2.6 $0.2 $2.8 $3.6 

Total ............................................................................................. $10.3 $2.1 $12.6 $19.7 

*As of August 21, 2012 

OHRA Travel unique number of trips 

Actual* Estimate 

(Sept) FY 2012 FY 2013 

VALU sponsored travel .......................................................................... 5,803 1,300 7,100 11,473 

All other HRA travel not included in VALU totals ................................ 1,783 125 1,908 2,600 

Total ............................................................................................. 7,586 1,425 9,008 14,073 

*As of August 21, 2012 

Average Cost 

(whole $) 

FY 2012 FY 2013 

VALU sponsored travel .......................................................................................................................... $1,403 $1,403 

All other HRA travel not included in VALU totals ................................................................................ $1,356 $1,385 

Total ............................................................................................................................................. $1,393 $1,400 

c. For fiscal year 2013, how many trips is the $22.2 million expected to support? 

Response. As a result of VA’s overall efforts to find efficiencies and reduce travel 

and in compliance with the President’s Campaign to Cut Waste, HRA’s current FY 

2013 travel estimate is now $19.7 million. This will support an estimated 14,073 

unique travel trips at an average cost of $1,400 per trip. This estimate is subject 

to revision as new Departmental guidance regarding training conferences is released. 

Question 9. According to the fiscal year 2013 budget request, the Office of Human 

Resources and Administration plans to spend $2.1 million on supplies and materials 

during fiscal year 2012, which is 29% higher than requested for fiscal year 2012 

($1.6 million), and that office requests $2.1 million for fiscal year 2013 for supplies 

and materials. 

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a. Please explain what led to the expected increase in supplies and materials dur- ing fiscal year 2012 and how that funding ($475,000) was originally expected to be 

spent. 

Response. In FY 2012, the newly created Veterans Employment Services Office is 

reaching out to Veterans through the VA for VETS program (http://vaforvets.va.gov/ 

Pages/default.aspx), and conducting Veteran hiring events across the country. These 

events are heavily attended by Veterans eager to learn more about job opportunities 

for Veterans at VA. The size and scope of these events necessitates a significant increase in the dollars spent on supplies and materials. Educational and informational 

materials are made available to all Veterans who attend the hiring events. HRA 

strives to fulfill its fiduciary responsibilities by limiting expenditures on supplies 

and materials to those items essential to meeting the goals and objectives of HCIP. 

In keeping with the President’s Executive Order 13589, Promoting Efficient Spending, the Office is currently investigating ways to effectively deliver its programs 

while reducing the amount spent on supplies and materials. 

b. Please provide an explanation of how these funds are expected to be expended 

during fiscal year 2012 and fiscal year 2013. 

Response. Most of the supply and material funds will be used in conjunction with 

conducting training courses, and for educational and informational brochures for 

Veterans programs. 

Question 10. In connection with VA’s fiscal year 2012 budget request, the Office of Human Resources and Administration indicated that it expected to spend $9.5 

million during fiscal year 2012 on a ‘‘Corporate Senior Executive Management 

Office.’’ 

a. Currently, how many VA employees or contractors perform work for this office? 

Response. As of May 22, 2012, there are 27 Federal employees currently in the 

Corporate Senior Executive Management Office (CSEMO). 

As part of the VA’s Human Capital Investment Plan, CSEMO initiated projects 

that are part of an enterprise-wide transformational initiative designed to develop 

the VA’s human capital into a proactive, forward looking, and professional workforce 

that will provide improved service to Veterans in the 21st century. Some of these 

projects are supported via contracts. None of the contracts is tied to specific numbers of individuals. 

b. What performance metrics are used to gauge whether this office is effective? 

Response. Secretary Shinseki centralized the lifecycle management of VA’s executive cadre and established CSEMO in October 2009. CSEMO began operations in 

2010. Since the stand up of CSEMO VA has greatly improved the fairness and credibility of our processes and policies for hiring, developing and compensating executives. Responsibilities include administering VA’s Senior Executive recruitment 

process, minimizing the time positions remain vacant, onboarding new executives, 

administering programs for performance management, incentives, talent management, and taking appropriate action to reduce turnover. These responsibilities drive 

CSEMO’s performance metrics: time it takes to fill positions, percent of positions 

filled, hiring sources (internal, external), number of applicants, and performance 

rating distributions. 

c. In terms of those performance metrics, what outcomes has this office achieved 

to date and what outcomes is it expected to achieve by the end of fiscal year 2012? 

Response. 

Recruitment process. VA continues to streamline the entire SES recruitment process all to improve our service to Veterans. VA’s process is automated, efficient, and 

collaborative, and is considered a model for other department and agencies to emulate. VA is proactive in recruiting senior executives to fill anticipated vacancies, ultimately reducing the amount of time the positions are vacant. In support of the 

President’s Hiring Reform Initiative, VA was one of the first Departments to aggressively implement the ‘‘resume only’’ recruitment process that eliminates the requirement for applicants to submit lengthy narratives for employment consideration. This 

process makes it easier for those outside government to apply for executive positions 

and encourages a more diverse applicant pool; the process and tools VA developed 

in this regard have been shared with other agencies as a best practice. In July 2010, 

VA centralized the Executive Resources Board (ERB) process for conducting the 

merit staffing process for initial career appointment to the SES, eliminating multiple Boards that functioned independently. With this staffing process, the ERBs 

meet virtually, each member working independently online. This process too is being 

reviewed by other agencies for adoption. VA takes advantage of the opportunity to 

hire from other agencies current executives with proven records of success. VA has 

sharpened its qualifications requirements to ensure we are not emphasizing agencyrelated experience to the detriment of well qualified candidates from outside VA. VA 

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is committed to diversity in the broadest sense by attracting executive talent with 

strong executive qualifications including minorities, women, individuals with disabilities, from within VA, outside VA, and outside the government. CSEMO is further improving its internal system through the development of a database to improve tracking recruitment processes and to more efficiently produce related reports 

and metrics. 

Fill rate. CSEMO actively works to fill VA’s SES positions, to include proactively 

recruiting for projected vacancies. The goal is to have a fill rate of 95 percent. As 

of May 22, 2012, VA is at 92 percent. The improved recruitment process has streamlined hiring and enabled CSEMO to move closer to its goal and ensure VA hires 

the right person for the right job at the right time—all so that we can continue to 

fulfill the Department’s mission to care for our Nation’s Veterans, their families and 

survivors. 

Onboarding. Executive onboarding is the process of integrating and accelerating 

the contribution of new leaders into VA. Research shows that the absence of a systematic onboarding process can derail the new hire experience for the vast majority 

of executives. VA was 1 of 7 agencies to pilot OPM’s Executive Onboarding Framework that was recommended to the President’s Management Council (PMC) for 

governmentwide implementation. In alignment with the PMC’s Career Development 

Initiative and in support of VA’s strategic mission and the Secretary’s Transformation Initiatives, in January 2011, CSEMO launched an 18-month Executive 

Onboarding Program, in which each senior executive participates in a range of transition activities which include training and developmental programs. This structured onboarding program helps senior executives build leadership capabilities, establish networks and relationships, gain knowledge and insight of the organizational structure and achieve executive success. The goals of onboarding are to welcome new executives and minimize the time required for executives to become productive in their agency, organization and new position and to prepare them to be 

successful senior executives. VA provides a robust orientation for new executives to 

foster an understanding of VA and its governance process, and to communicate the 

strategic vision and direction of the agency. CSEMO will soon automate portions of 

the onboarding process to streamline the program. As part of the overall onboarding 

program, CSEMO launched its one-on-one executive coaching program to help improve new executives’ organizational performance, job satisfaction, retention, and resolve disputes between employees. In March 2011, VA launched its Senior Executive 

Strategic Leadership Course. It is specifically designed to use executive education 

as a driving force to lead change for VA. This is a 5‡-day course through which executives learn key content and insight, participate in simulations and group activities, and work on designated VA challenges for potential implementation. The 

course addresses strategic leadership and working across functional and organizational lines to improve service delivery to Veterans. 

Performance Management. Performance management is a continuous process of 

identifying, measuring, and developing the performance of organization members 

and aligning performance with the strategic goals of the organization. Components 

of an effective executive-level performance management system include goal setting, 

performance feedback, and training designed to maximize employee, leader, and organizational performance. Since 2010, CSEMO has driven a re-engineering effort to 

improve executive performance management and to hold executives accountable for 

organizational performance through monthly reviews, quarterly initiative assessments, and on-going training opportunities. In the last two years, the Department 

has made significant improvements to ensure the program is credible, transparent, 

and consistent with law and regulation. VA implemented fiscal year (FY) 2011 

changes and is implementing new Government-wide improvements in FY 2012. 

Incentives. VA is improving its incentives program (recruitment, relocation, retention), including strengthening its control mechanisms and program oversight, and 

ensuring that each justification fully supports the incentive. CSEMO has oversight 

of VA’s incentive program for Senior Executives. VA has been engaged in a thorough 

review of its incentive program which has resulted in greatly strengthened processes, control mechanisms, and program oversight. 

Talent Management. VA is developing an executive talent management system 

through which the Department will assess its current executives against VA’s highest missions and priorities. The Department is committed to attracting highlyskilled executives, developing and retaining them given the dynamic ‘‘war for talent’’ 

environment. CSEMO’s Senior Executive Talent Management program is a deliberate process through which VA will build the capacity to achieve mission and organizational goals with the right talent, in the right place, at the right time, and close 

talent gaps through a systematic process that integrates each element of the career 

lifecycle. Successful talent and succession management are critical to VA’s ability 

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to transform into a 21st Century organization focused on our Nation’s Veterans as 

its clients. 

Senior Executive Collaborative Web site. VA launched an executive collaborative 

Web site in 2011 to enhance communication among VA’s executives. This tool helps 

break down silos and stovepipes in VA in order to improve service delivery to Veterans, and promotes idea sharing/problem solving among our executives. In addition 

to delivering timely, valuable information, it enhances networking, knowledge sharing and collaboration. The Web site provides senior executives an opportunity to 

share with their peers ideas, knowledge, and best practices. 

Turnover and Retention. Great emphasis is placed on hiring and retaining the 

best executives for VA’s critical positions. In some cases these executives came from 

managing large organizations or programs successfully in the private sector. Those 

same skills and experiences are needed to manage our large organizations, medical 

centers, or resource intensive programs such as the Post-9/11 GI Bill. In 2011, 

CSEMO implemented several programs that are expected to reduce SES turnover 

and enhance retention by improving candidate job fit, orientation and on-boarding 

processes, timeliness and quality of performance feedback, and training and development. Continued improvement of recruitment, onboarding, training, and development activities will lead to reduced SES voluntary resignations, particularly among 

SES staff new to VA (i.e., low tenure), as well as shifts in SES retention associated 

with changes in Federal administrations. Continued improvement of SES performance management systems and training will also improve the ability to track retention rates by performance. 

d. For fiscal year 2013, how much is requested for this office and what outcomes 

are expected to be achieved with that level of funding? 

Response. CSEMO’s requested budget for FY 2013 is $10.4 million. This funding 

will enable CSEMO to maintain and improve the systems and processes in place, 

including strong program management and oversight, and to implement new initiatives as needed. Among those are: improvements to VA’s Executive Onboarding Program to ensure success for all senior executives and to better enable them to think 

and act strategically, continued development of automated talent management system for talent and succession management, continuing leader development, enhancements to the Senior Executive Collaborative Web site to provide even better 

communication efforts among VA’s executives, and development of an integrated automation system to tie CSEMO’s different programs together. The funding requested 

in the FY 2013 budget will continue to enable and enhance CSEMO’s mission to 

provide oversight of VA’s senior executive management program and to develop 

strong executive life cycle management all to improve the programs and benefits 

provided to our Veterans. 

Question 11. In connection with VA’s fiscal year 2012 budget request, the Office 

of Human Resources and Administration indicated that it expected to spend $4.3 

million during fiscal year 2012 on a ‘‘leadership infusion’’ initiative, which was described as ‘‘procur[ing] seats in pre-designed and custom leadership and management training programs.’’ 

a. During fiscal year 2012, how many individuals have received or are expected 

to receive training through this initiative and what is the expected cost per training 

activity? 

Response. The Leadership Infusion Program is a partnership with the Office of 

Personnel Management (OPM) which provides seats in its open-enrollment leadership programs, as well as custom programs for VA offices. For more than 45 years, 

OPM has trained Federal managers, executives, and employees to be effective Government leaders. VA seeks to provide training for its more than 70,000 managers 

and supervisors, as well as to aspiring leaders at all levels to ensure leadership ability is assessed, trained and evaluated throughout an employees’ life cycle within VA. 

The training addresses contemporary leadership challenges through a perspective of 

public service and Constitutional values. 

The Leadership Infusion Program is designed to augment the curriculum of existing VA leadership development programs and to provide developmental opportunities for those VA employees with robust Individual Development Plans. OPM programs are designed for employees at the GS 9 level and above, is competency driven, and linked to VA’s new leadership competency model. 

b. Who is responsible for determining what training courses an individual should 

attend? 

Response. An individual’s supervisor is responsible for identifying the training 

program in accordance with an approved Individual Development Plan. Additionally, some of the programs are being offered as part of the curriculum in VA’s leadership development programs, where employees were competitively selected to take 

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part in the program. These courses include Leadership VA, Leadership in a Democratic Society offered by Federal Executive Institute, the Aspiring Leader Program, 

and others. 

c. What metrics are used to determine whether these training activities are effective? 

Response. A comprehensive training evaluation is completed by each employee following each session that provides a detailed report measuring the following: satisfaction, learning effectiveness, job impact, business results, and return-on-investment. This evaluation model, also known as the ‘‘Kirkpatrick’’ model, is recognized 

in the training industry as the accepted best practice for program evaluation. 

d. How do these training activities differ from training offered through other VA 

training initiatives? 

Response. These programs are generally 3–5 days in length and most are offered 

as an interagency training, where employees from a number of Federal agencies are 

taking the programs at one of OPM’s Management Development Centers. Additionally, these programs are also associated with a governmentwide leadership certification process. The other initiatives are delivering training to VA employees only, 

and are not currently linked to certification. 

e. For fiscal year 2013, how much in total is requested for purposes of this initiative, how many individuals are expected to attend training through this initiative, 

what is the expected average cost per training activity, and what outcomes are expected to be achieved through these training activities? 

Response. The request for FY 2013 is $2.04 million. VA Learning University 

(VALU) anticipates delivering the open-enrollment programs through OPM’s Management Development Centers, as well as custom offerings for various VA departments. The funding will allow VA to train approximately 600 employees at a cost 

of $3,500 per one week program. Please see the responses to Questions 12, a–c, for 

the anticipated outcomes. 

Question 12. In connection with VA’s fiscal year 2012 budget request, the Office 

of Human Resources and Administration indicated that it expected to spend $30.5 

million during fiscal year 2012 on a ‘‘Basic/Advanced Supervisory Management 

Training’’ initiative. 

a. During fiscal year 2012, how many individuals are expected to receive training 

through this initiative and what is the expected cost per training activity? 

Response. A high-performance workforce ensures a fiscally responsible organization dedicated to serving Veterans and their families. It is vitally important to establish and maintain programs to educate supervisors on a range of common managerial issues, including developing and discussing goals with employees, mentoring 

programs, communicating about progress and conducting performance appraisals. 

There are a number of tasks associated with this initiative, to include the development of online training for new supervisors, and a leadership portal that will serve 

as a collaborative space for supervisors, managers and aspiring leaders, as well as 

a repository of resources, in addition to development and implementation of VALU’s 

leadership development programs. The supervisory training task is designed to support approximately 70,000 VA supervisors and managers. The instructor-led training is intended to deliver 2,000 training instances per month, while the leadership 

portal allows for a total of 70,000 licenses to be utilized to meet the demand. The 

candidacy-based leadership development programs are of varying sizes, from 50–80 

per cohort, and include an online component for hundreds more. The cost for the 

task linked specifically to enterprise-wide, face-to-face and Webinar training delivery is approximately $10 million dollars for training of approximately 23,000 VA 

employees at an average cost of $800 per employee for face-to-face training, and 

$115 per student for webinars. Additionally, the funding in this initiative covers 

evaluation across all of VALU’s training initiatives. 

b. What metrics are used to determine whether these training activities are effective? 

Response. A comprehensive training evaluation was designed to measure effectiveness and is used consistently across all VA’s training initiatives. The evaluation 

measures: 

• Training Effectiveness. 

• Learner Reaction: Percentage of learners who respond favorably to the following 

aspects of training: 

– Content relevancy; 

– Instructor effectiveness; 

– Performance improvement; 

– Overall satisfaction; and 

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– Recommendation likelihood. 

• Learning Gain: Average knowledge gain among the learner population. • Behavior Change Among Learners: 

– Percentage of supervisor who assessed behavior change among the learner 

population; and 

– Percentage of learners who self-assessed behavior change. 

• Organizational Impact: The change in organizational performance as a result of 

training. • Return on Investment: The monetary return or gain for initial training investments. • Quality Control and Training Program Management. • Training Course Comprehensiveness. • Percentage of VA occupations covered by training. • Evaluation Data Collection Rates for Training Owners and • Quality: VA Learning University’s quality standards guide and approach. 

c. How do these training activities differ from training offered through other VA 

training initiatives? 

Response. These training activities are designed specifically for VA supervisors, 

managers and aspiring leaders, where curricula have been linked to VA’s leadership 

competency model. The other initiatives are linked to other technical and/or core 

competencies, and designed for varying target populations. 

d. For fiscal year 2013, how much in total is requested for purposes of this initiative, how many individuals are expected to attend training through this initiative, 

what is the expected average cost per training activity, and what outcomes are expected to be achieved through these training activities? Response. For FY 2013 $32 million is requested, to include ongoing development 

of the online supervisory training tool, online leadership development portal, 

VALU’s leadership development programs, in addition to the instructor-led training 

via classroom and Webinar. These tools offer the potential to reach 70,000 employees via the leadership portal and supervisory training, and approximately 2,000 employees per month in the classroom and Webinar training, at an average cost per 

course of $800 per employee for face-to-face training, and $115 per student for 

webinars. Please see the responses to Questions 12, a–c, for the anticipated outcomes. 

Question 13. In connection with VA’s fiscal year 2012 budget request, the Office of Human Resources and Administration indicated that it expected to spend $10 

million during fiscal year 2012 on a ‘‘Transformational Leadership’’ initiative. 

a. During fiscal year 2012, how many individuals are expected to receive training 

through this initiative and what is the expected cost per training activity? 

Response. VALU’s Transformational Leadership Curriculum and its components 

are focused on change management, change leadership and executive development. 

All courses offered provide practical skills in leading change and creating a culture 

that embraces and appropriately manages change and the change initiatives established for an organization. In addition to traditional classroom or on-line coursework 

on change management, this program also allows an organization to target the leadership team, or the organization as a whole, for joint training and teambuilding to 

focus on its change initiatives and develop a program for executive, leadership, and 

staff to assist in implementing change on initiatives identified by that organization. 

These joint trainings, called Change Academies, drive change in local organizationspecific areas in support of the major initiatives identified in VA’s Strategic Plan. 

There are several different offerings through the VA Transformational Leadership 

Curriculum. These have been broken down by type of offering and the anticipated 

number of participants through September 30, 2012. 

1. Video series—4 videos—complements the management book ‘‘Switch: How to 

Change Things When Change is Hard’’ by providing another mode of learning as VA 

institutes a common language with which to understand change and change management; costs go down with each completion 

a. approximately 30,000 completions 

b. estimated $4.00 per completion 

2. E-learning courses—three courses in Veterans Advocacy curriculum were completed in July 2012. VA owns the courses, relevant for a long period of time, cost 

reduced with each completion—no costs for these courses in future years. 

a. approximately 20,000 completions 

b. estimated $20.00 per completion 

3. Webinars—currently 8 webinars in our catalog—costs include facilitator and 

producer plus web connection fees 

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a. approximately 852 completions 

b. estimated $117 per completion 

4. Instructor-led training (24 courses in the catalog)—costs include venue, 

facilitator, materials and facilitator travel 

a. approximately 4650 completions 

b. estimated $165 per completion 

5. Instructor-led training (Change Academy)—VA customized events, costs include 

program administration, design, venue, facilitators, materials and facilitator travel 

(costs include 5 day executive level design and implementation) 

a. approximately 3000 completions 

b. estimated $2000 per completion 

6. Executive level training (externally provided)—University of North Carolina 

(UNC) Kenan-Flagler School—costs include program costs for UNC only 

a. approximately 388 completions 

b. estimated $6200 per completion 

b. What metrics are used to determine whether these training activities are effective? 

Response. The Transformational Leadership Curriculum conducts level 1 and 

level 2 Kirkpatrick evaluations of all training. In addition, we participate in level 

3 and level 4 Kirkpatrick evaluations conducted by an independent contractor 

through VALU. All materials are evaluated periodically to ensure continued instructional soundness and currency of the materials. All training has been mapped to 

VA’s competencies. Results of all evaluations are reported weekly and a semi-annual 

report is prepared for specific aspects of the program. 

c. How do these training activities differ from training offered through other VA 

training initiatives? 

Response. As stated earlier, VALU’s Transformational Leadership Curriculum and 

its components are focused on change management, change leadership and executive 

development. All courses offered provide practical skills in leading change and creating a culture that embraces and appropriately manages change and the change 

initiatives established for an organization. This program is unique in that it also 

provides a customization option through the Change Academies that allow a specific 

organization to focus on their change initiatives and develop a program for executives, leadership and staff that will assist in the implementation of change based 

on local initiatives that support the major VA initiatives identified in VA’s Strategic 

Plan. 

d. For fiscal year 2013, how much in total is requested for purposes of this initiative, how many individuals are expected to attend training through this initiative, 

what is the expected average cost per training activity, and what outcomes are expected to be achieved through these training activities? 

Response. 

FY 13 Training Activity 

Estimated 

Number of 

Participants 

Estimated 

Avg. Cost 

Per Activity 

Estimated FY 

13 Total Cost 

Per Activity 

Expected Outcomes 

Video Series 30,000 $2 $60,000 This video series is customized to VA and will result 

in an increased understanding of VA best practices in change management in support of the 

transformational initiatives that serve our Veterans. Video series is used in conjunction with 

Change Academies and other Transformational 

Leadership training. 

E-Learning 20,000 $15 $300,000 e-learning courses are custom designed to meet the 

needs of VA and cover topics such as Veterans 

Advocacy, the history of Veterans Benefits, etc. 

The outcomes will increase awareness of Veterans issues and the culture of serving Veterans. 

As the number of participants grows, the cost 

per activity decreases. 

278 

FY 13 Training Activity 

Estimated 

Number of 

Participants 

Estimated 

Avg. Cost 

Per Activity 

Estimated FY 

13 Total Cost 

Per Activity 

Expected Outcomes 

Webinars 900 $120 $108,000 Webinars span a series of 8 topics that are delivered using technology. Topics are all in support 

of theory and best practices around Change 

Management and transforming an organization. 

The outcomes will be increased ability to appropriately lead and manage VA’s change initiatives. 

Instructor-Led Training 4,880 $165 $805,200 The ILT courses provide practical skills and application in change management. The projected outcomes from these courses are increased ability 

of VA leadership to lead change efforts, create a 

culture that embraces change, and better management of VA’s change initiatives. 

Change Academy 3,250 $1850 $6,012,500 Change Academies are customized to the change 

efforts for a particular group or facility. These 

hands-on sessions provide the group the opportunity to focus on their change initiatives and 

develop plans and programs for executives, leadership and staff that will assist in the implementation of change. The outcomes vary depending on the need, but generally include fully developed change management strategies, communication, and implementation plans. Includes Executive Level design and implementation. 

UNC Kenan Flagler 

School 

100 $6200 $620,000 The UNC Kenan Flagler business school offers a 

leadership immersion course for senior leaders. 

The outcomes from this course include development of critical leadership skills including selfawareness, conflict management, power and influence, motivation, delegation, empowerment, 

and team leadership. All VA SES’s training completed by end of FY 2012. On-going training established for newly assigned SES employees. 

Total Estimated Cost $7,905,700 

Office of Policy and Planning 

Question 1. The fiscal year 2013 budget request includes $8.4 million to be spent 

on Other Services by the Office of Policy and Planning. Please provide a specific 

itemized list of how these funds would be spent. To the extent any of these funds 

will be spent on contracts, please explain the nature of the contract and the expected outcomes. Response. Of the $8.4 million, $8.2 million will be used for the contracts listed below and the remaining $200,000 will be used to fund training and VA franchise 

fund activities. 

• The Office of Corporate Analysis and Evaluation will contract for assistance 

with its analytical work in support of VA’s integrated strategy of creating a Department-wide, multiyear programming capability to make data-driven decisions about 

resource allocation. This includes an interagency agreement with Department of 

Labor to establish and maintain a programming database. ($2.5 million) • The Office of Policy will contract for support in developing, analyzing, and reviewing policy issues affecting Veterans, as well as support in developing the strategic plan to implement VA’s goals and objectives in accordance with Government 

Performance and Results Modernization Act of 2010. ($900,000) • The Office of Data Governance and Analysis will contract for assistance with 

data analysis and governance to assist programs, operations, and procedures, as 

well as inform VA-wide decisionmaking. ($1.4 million) 

• The enterprise Program Management Office will contract for support in executing the Department’s major transformational initiatives while developing Department-wide program management standards and doctrine. ($3.2 million) 

279 

• Contract support will also be used for emergent studies for policy and strategy; 

enabling VA senior leaders to make well informed resource allocation and policy decisions based on verifiable data, sound analysis, and validated strategic projections. 

($200,000) 

Question 2. For fiscal year 2013, the budget request includes over $26 million for 

the Office of Policy and Planning and would support 117 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 2012 

and fiscal year 2013 and the number of contractors that are expected to be assigned 

to each such office. 

Response. The list below of offices, and positions and pay-grades assigned to that 

office, covers both fiscal 2012 and fiscal 2013. OPP’s contracts are firm fixed price 

and dictate outcomes, not the number of employees assigned to the project. 

HEADQUARTERS/OPERATIONS

Assistant Secretary 

Program support ......................................................................... GS-11 

Principal Deputy Assistant Secretary ...................................... SES 

Program support ......................................................................... GS-11 

Executive Assistant .................................................................... GS-15 

Communication analyst ............................................................. GS-9 

Senior policy advisor .................................................................. GS-15 

Director ....................................................................................... GS-15 

Human capital manager ............................................................ GS-14 

Budget analyst ............................................................................ GS-9 

Administrative officer ................................................................ GS-12 

OFFICE OF VA/DOD COLLABORATION

Executive director ....................................................................... SES 

Program support ......................................................................... GS-11 

VA/DOD Integrated Disability Evaluation Service 

Deputy Director ...................................................................... GS-15 

Management analyst .............................................................. GS-14 

Management analyst .............................................................. GS-13 

Joint Executive Council/Senior Oversight Committee Service 

Deputy Director ...................................................................... GS-15 

Special assistant ..................................................................... GS-15 

Management analyst .............................................................. GS-14 (X 5) 

Junior management analyst .................................................. GS-7 

Student career intern ............................................................. GS-7 

CORPORATE ANALYSIS AND EVALUATION

Executive Director ...................................................................... SES 

Analysis and Evaluation Service 

Director .................................................................................... GS-15 

Operation researchers ............................................................ GS-14 (X 6) 

Programming Service 

Director .................................................................................... GS-15 

Budget analyst ........................................................................ GS-14 (X 2) 

Management analyst .............................................................. GS-14 

Operation researcher .............................................................. GS-14 

Student career intern ............................................................. GS-11 

OFFICE OF POLICY

Deputy Assistant Secretary ....................................................... SES 

Program support ......................................................................... GS-7 

Policy Analysis Service 

Director .................................................................................... GS-15 

Management analyst .............................................................. GS-14 (X 2) 

Management analyst .............................................................. GS-11 

Management analyst .............................................................. GS-11/12/13 

Student career intern ............................................................. GS-9 

Student career intern ............................................................. GS-7 

Strategic Studies Group 

Director .................................................................................... GS-15 

Management analyst .............................................................. GS-14 (X 2) 

Management analyst .............................................................. GS-9 

Student career intern ............................................................. GS-9 

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Strategic Planning Service 

Director .................................................................................... GS-15 

Management analyst .............................................................. GS-14 (X 2) 

Management analyst .............................................................. GS-13 (X 2) 

Management Analyst ............................................................. GS-11/12/13 (X 2) 

OFFICE OF DATA GOVERNANCE AND ANALYSIS

Deputy Assistant Secretary ....................................................... SES 

Program support ......................................................................... GS-9 

NATIONAL CENTER FOR VETERANS STATISTICS AND ANALYSIS

Executive Director ...................................................................... SES 

Program support ......................................................................... GS-11 

Analysis and Statistics Service 

Director .................................................................................... GS-15 

Statisticians ............................................................................ GS-14 (X 4) 

Management analyst .............................................................. GS-14 (X 2) 

Management analyst .............................................................. GS-13 

Management analyst .............................................................. GS-12 

Student career intern ............................................................. GS-9 

Reports and Information Service 

Director .................................................................................... GS-15 

Management analyst .............................................................. GS-14 (X 3) 

Management analyst .............................................................. GS-13 (X 2) 

Management analyst .............................................................. GS-12 

Student Career intern ............................................................ GS-7 

Office of the Actuary 

Chief Actuary .......................................................................... SL 

Deputy Chief Actuary ............................................................. GS-15 

Economist ................................................................................ GS-14 

Actuaries ................................................................................. GS-14 (X 4) 

ENTERPRISE PROGRAM MANAGEMENT OFFICE

Executive Director ...................................................................... SES 

Deputy Director .......................................................................... GS-15 

Program support ......................................................................... GS-11 

Deployed senior program manager ........................................... SES 

Program Management Policy Service 

Director .................................................................................... GS-15 

Management analyst .............................................................. GS-14 (X 3) 

Management analyst .............................................................. GS-13 (X 4) 

Operational Management Review Service 

Director .................................................................................... GS-15 

Management analyst .............................................................. GS-14 (X 5) 

Management analyst .............................................................. GS-13 

Management analyst .............................................................. GS-11 

Resource Management Service 

Director .................................................................................... GS-15 

Management analyst .............................................................. GS-14 (X 4) 

Management analyst .............................................................. GS-13 (X 2) 

Management analyst .............................................................. GS-11 

Question 3. In connection with VA’s fiscal year 2012 budget request, the Office 

of Policy and Planning indicated that the Enterprise Program Management Office 

was incorporated into the Office of Policy and Planning in 2010 and that operating 

expenses for that office would be paid for through reimbursements from other VA 

offices. 

a. What performance measures are used to gauge whether this office is effective? 

Response. In 2011, the OPP revamped its performance measures to create metrics 

that are relevant and measurable. These updated metrics were introduced in the fiscal year (FY) 2013 budget request. One of these measures specifically applies to the 

enterprise Program Management Office’s (ePMO) mission of developing Departmentwide program management standards and doctrine. The measure calculates the percent of Departmental Major Initiatives adhering to the program/project management 

standards identified. 

b. In terms of those metrics, how did the office perform during fiscal year 2011 

and how is it projected to perform during fiscal years 2012 and 2013? 

Response. As the above performance measures were just introduced in the fiscal 

2013 budget, we do not have data for fiscal 2011; however, in fiscal 2011 the ePMO 

281 

set the conditions for and implemented a program management framework to begin 

transforming Department-wide business processes and foster accountability 

throughout the Department. Significant accomplishments in FY 2011 include: 

• As the designated auditor for Department-level transformational programs with an estimated value of $2.6 billion, ePMO conducted detailed execution reviews and 

‘‘lockdowns’’ from February through early June to verify contract baselines and build 

procurement packages for the major initiative (MI) information technology (IT) 

projects. These efforts resulted in 387 procurement packages being awarded or made 

actionable, for a total value of $785 million. This amount accounts for 100 percent 

of the MI IT funded procurements for FY 2011. • Created requirements and implemented required core program management 

(PM) supporting documents, including work breakdown structures, integrated master schedules, and risk registers. The establishment of these PM artifacts has resulted in the implementation of a disciplined program management framework 

within the Department. • Established a contract change control process to ensure any adjustments are 

well coordinated across the Department, including the MIs, the Office of Information 

and Technology (OIT), and the Office of Acquisition Logistics and Construction 

(OALC). • Completed an extensive prioritization effort for the FY 2012 MI IT budget by 

gathering required data on 120 IT projects and guiding the designated voting panel 

through several rounds of discussion and voting. The process was so successful it 

has been adopted by the OIT; and is being applied to all internal prioritization 

needs. • Created a strategic acquisition framework to guide key phases/decisions for VA 

programs. 

In addition to the performance metric described above, FY 2012 objectives for the 

ePMO include: 

• Establishment and implementation of a comprehensive program assessment tool 

to gauge program maturity. • Creation of a well-defined process to establish programs with well-articulated 

and validated requirements, supported by holistic, transparent, well-understood, 

and consistently applied program/project management practices. • Development of comprehensive certification and/or credential requirements for 

program managers. • Development and implementation of acquisition program lifecycle doctrine 

across VA. • Establishment of requirements development and management doctrine within 

VA that aligns the VA strategic plan, planning, programming, budgeting, and evaluation process, and enterprise-wide solutions. • Creation of a comprehensive program management lessons learned and best 

practices repository. 

• Creation of mechanisms to communicate proposed business process improvements to process owners and VA leaders. 

• Creation of mechanisms to monitor process and/or business owner implementation of appropriate process improvements. 

Question 4. According to VA’s Fiscal Year 2011 Performance and Accountability 

Report, the Office of Policy and Planning ‘‘[c]reated a planning, programming, budgeting, and evaluation (PPBE) process, which established a 2012 program baseline; 

delivered a prototype programming database to demonstrate programming concepts 

and capabilities; issued integrated programming/budgeting guidance for the 2013– 

2017 resource cycle; and established a PPBE integration team to ensure synchronization, coordination, and synergy of VA’s PPBE efforts.’’ 

a. How much was spent for this office to develop a ‘‘planning, programming, budgeting, and evaluation*** process?’’ 

Response. The Office of Corporate Analysis and Evaluation (CAE) is responsible 

for leading the development of a corporate planning, programming, budgeting, and 

evaluation (PPBE) process and a multi-year programming capability within VA. In 

FY 2011, total obligations for CAE were $4.122 million, which included both government FTE and contract support. 

b. How many individuals perform work for the ‘‘PPBE integration team?’’ 

Response. In FY 2012, within OPP, 14 individuals in CAE work for the PPBE integration team. The same number is expected for FY 2013. 

c. What measurable outcomes are attributable to these efforts? 

Response. In 2011, the OPP revamped its performance measures to create metrics 

that are relevant and measurable. These updated metrics were introduced in the FY 

2013 budget request. One of these measures specifically applies to CAE’s mission 

282 

to create a PPBE process. The measure calculates the percentage of VA resource 

requirements that are aligned to the 5-year program, with clear end-state and 

outcomes. 

d. How much is requested for these purposes for fiscal year 2013? 

Response. The FY 2013 request for CAE is $4.575 million, which includes both 

government FTE and contract support. 

Office of Operations, Security, and Preparedness 

Question 1. For fiscal year 2013, the Office of Operations, Security, and Preparedness requests $18.5 million and 102 employees. Please provide a list of the positions 

that would be filled with that funding and the pay-grades for those positions. 

Response. The OSP request of $18.5 million is the total budget request for the 

Office. The personnel services portion of that request is $12.9 million to support 102 

FTE. 

Series Grade Title Position/Office 

SES ES Director, Personnel Security and Identity Management Personnel Security & Identity Management 

GS-0080 11 Security Specialist Personnel Security & Identity Management 

GS-0080 12 Security Specialist Personnel Security & Identity Management 

GS-0080 12 Security Specialist Personnel Security & Identity Management 

GS-0080 12/13 Special Security Representative National Security 

GS-0080 12/13 Special Security Representative (ROS) Contingency Operations 

GS-0080 13 Physical Security Specialist Homeland Security Presidential Directive12 

GS-0080 14 Acting Director/Deputy Director, PSS Personnel Security & Suitability Service 

GS-0080 14 Special Security Officer National Security 

GS-0301 12/13 Emergency Management Spec (Training) Planning 

GS-1811 12/13 Criminal Investigator (Watch officer) Criminal Investigator 

GS-1811 13 Criminal Investigator Criminal Investigator 

GS-1811 13 Criminal Investigator Criminal Investigator 

GS-1811 13 Criminal Investigator Criminal Investigator 

GS-1811 13 Criminal Investigator Criminal Investigator 

GS-1811 13 Criminal Investigator (Watch officer) Criminal Investigator 

GS-1811 13 Criminal Investigator (Watch officer) Criminal Investigator 

GS-1811 14 Chief Criminal Investigator 

GS-1811 15 Director, Police Service Police Lead 

GS-301 11/12/13 Staff Assistant Special Assistant to the A/S 

GS-301 14 Senior Staff Assistant to DAS—Office of Emergency Management (OEM) Staff Assistant 

GS-301 11 Staff Assistant Operations 

GS-301 11 Readiness Operation Spec Contingency Operations 

GS-301 11 Staff Assistant Support 

GS-301 11/12/13 Emergency Management Spec (DHS LNO) Planning 

GS-301 11/12/13 Emergency Management Spec (Exercise) Planning 

GS-301 11/12/13 Emergency Management Spec (Planner/LNO) Planning 

283 

Series Grade Title Position/Office 

GS-301 12 Readiness Operation Spec. (Supv; Director Site C) Contingency Operations 

GS-301 12/13 Emergency Management Spec (Continuity) Planning 

GS-301 12/13 Emergency Management Spec (Evaluator) Planning 

GS-301 12/13 Program Analyst 

GS-301 12/13 Readiness Operations Specialist (NOC Liaison) Integrated Operations Center 

GS-301 13 Readiness Operation Spec (Supv; Deputy Director 

for Site B) 

Contingency Operations 

GS-301 13 Readiness Operation Spec (Team Lead) IOC 

GS-301 14 Emergency Management Spec National Security 

GS-301 14 Lead Emergency Mgt. Spec Planning 

GS-301 14 Readiness Operation Spec (Supv) Integrated Operations Center 

GS-301 14 Readiness Operation Spec (Supv; Site B Director) Contingency Operations 

GS-301 14 Team Lead/Exercises Planning 

GS-301 15 Director, HSPD-12 Program Management Office Homeland Security Presidential Directive12 

GS-301 15 Dir—Emergency Management Spec Director, EM 

GS-301 15 Director, Resource Management Director, ORM 

GS-301 15 Director/(Supv.) VA IOC (FY 12) Integrated Operations Center 

GS-301 7 Program Specialist Personnel Identification Verification Office 

GS-301 7 Program Specialist Personnel Identification Verification Office 

GS-301 7 Program Specialist Personnel Identification Verification Office 

GS-301 7 Program Specialist Personnel Identification Verification Office 

GS-301 7 Program Specialist Personnel Identification Verification Office 

GS-301 7 Program Specialist Personnel Identification Verification Office 

GS-301 9/11/12 Readiness Operation Spec Integrated Operations Center 

GS-301 9/11/12 Readiness Operation Spec Integrated Operations Center 

GS-301 9/11/12 Readiness Operation Spec Integrated Operations Center 

GS-301 9/11/12 Readiness Operation Spec Integrated Operations Center 

GS-301 9/11/12 Readiness Operation Spec Integrated Operations Center 

GS-301 9/11/12 Readiness Operation Spec Integrated Operations Center 

GS-301 9/11/12 Readiness Operation Spec Integrated Operations Center 

GS-301 9/11/12 Readiness Operations Specialist Contingency Operations 

GS-301 9/11/12 Readiness Operation Spec Integrated Operations Center 

GS-303 7 Program Support Assistant Operations 

GS-341 13 Administrative Officer Operations 

GS-343 14 Management Analyst Budget Analyst 

GS-343 14 Management Analyst Administrative Officer 

GS-343 14 Management Analyst Resource Manager 

284 

Series Grade Title Position/Office 

GS-343 11 Director, PIV Office Homeland Security Presidential Directive 

GS-343 11 Program Analyst Homeland Security Presidential Directive 

GS-343 11/12/13 Management Analyst (Planner/LNO) Planning 

GS-343 13 Program Analyst Homeland Security Presidential Directive12 

GS-343 13 Program Analyst Operations 

GS-343 13 Program Analyst—GIS Planning 

GS-343 14 Deputy Director, HSPD-12 Homeland Security Presidential Directive12 

GS-343 14 Senior Policy Analyst Support 

GS-343 9/11/12 Program Analyst—Geographic Information System Planning 

SES SES DAS OEM DAS OEM 

SES SES Director, Security & Law Enforcement OSLE Lead 

GS-301 12 Program Analyst Program Analyst 

GS-301 13 Staff Assistant to Director ORM Staff Assistant 

Assistant Secretary Assistant Secretary 

Question 2. For fiscal year 2013, the Office of Operations, Security, and Preparedness requests $4 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 (DHS/FPS) Contract Guards for the GSA 

leased spaces in the Capital Region ($2.7 million); Contract support from FEMA for 

the Continuity of Government spaces ($200,000); and Program support for the 

HSPD–12 program management office ($1 million). We also pay for support for our 

Continuity of Operations sites and Continuity of Government sites which are located 

outside of the National Capital Region ($200,000). Additionally, we have some maintenance contracts for equipment. 

Question 3. According to the fiscal year 2013 budget request, the Office of Operations, Security, and Preparedness now expects to spend $1.1 million on equipment 

during fiscal year 2012, which is 86% higher than the amount requested for fiscal 

year 2012 ($611,000), and that office requests $436,000 for equipment for fiscal year 

2013. 

a. Please explain what led to the expected increase in equipment expenditures 

during fiscal year 2012 and how that funding ($525,000) was originally expected to 

be spent. 

Response. The increase was due to delays in construction of the new VA Integrated Operations Center (IOC) which caused delays in procurement of the initial 

outfitting and furnishing of those spaces. The original amount of funding was the 

initial estimate to complete initial outfitting and furnishing of the new Reconstitution site at Site C. Contract awards for all initial outfitting for both sites will occur 

in the 4th quarter of FY 2012. Initial outfitting includes desks/workstations, chairs 

and miscellaneous office needs initially identified during the planning phase of the 

projects. Final outfitting would be for items identified after the new spaces have 

been in use for a period of time. 

b. Please provide an explanation of how these funds are expected to be expended 

during fiscal year 2012 and fiscal year 2013. 

Response. The $1.1 million consists of $700K carried over from FY 2011 for furniture and initial outfitting of the new VAIOC. Construction delays caused a change 

in the procurement timeline. The other $400K is for furniture and initial outfitting 

of the new Site C facility being constructed in FY 2012. 

The funds identified for use in FY 2013 are for final outfitting for both sites as 

needed, and for possible reconfiguration and re-outfitting of the spaces currently 

being used as the VA IOC. 

285 

Office of Public and Intergovernmental Affairs 

Question 1. For fiscal year 2013, the Office of Public and Intergovernmental Affairs requests a total of $26.5 million and 94 employees. Please provide a list of the 

positions that would be filled with that funding and the pay-grades for those positions. 

Office of Public and Intergovernmental Affairs (OPIA) 

Employees Position Report 

Position Title Grade FTE 

Office of the Assistant Secretary 

1 Assistant Secretary .................................................................................................. SES 1 

2 Staff Assistant ........................................................................................................ 12 1 

3 Executive Director .................................................................................................... SES 1 

4 Program Analyst ...................................................................................................... 12 1 

5 Program Support Asst (OA) ..................................................................................... 11 1 

6 Staff Assistant ........................................................................................................ 14 1 

7 Chief of Staff .......................................................................................................... 15 1 

Office of National Veterans Sports Programs and Special Events 

1 Public Affairs Specialist .......................................................................................... 14 1 

2 Staff Assistant ........................................................................................................ 9 1 

3 Public Affairs Specialist .......................................................................................... 14 1 

4 Program Manager .................................................................................................... 13 1 

5 Program Specialist .................................................................................................. 9 1 

6 Program Management Officer ................................................................................. 15 1 

7 Consultant ............................................................................................................... N/A 1 

8 Program Specialist .................................................................................................. 13 1 

9 Program Specialist .................................................................................................. 11 1 

10 Vacant Deputy Director ........................................................................................................ 15 1 

Office of National Tribal Governmental Relations 

1 Program Specialist .................................................................................................. 14 1 

2 Director .................................................................................................................... SES 1 

3 Program Specialist .................................................................................................. 13 1 

4 Program Specialist .................................................................................................. 12 1 

5 Program Specialist .................................................................................................. 13 1 

Office of Intergovernmental Affairs 

1 Deputy Assistant Secretary ..................................................................................... SES 1 

2 Clerk ........................................................................................................................ 4 1 

3 Program Analyst ...................................................................................................... 14 1 

4 Program Support Assistant ..................................................................................... 10 1 

5 Program Support Asst (OA) ..................................................................................... 9 1 

6 Program Analyst ...................................................................................................... 14 1 

7 Program Analyst ...................................................................................................... 14 1 

Office of Homeless Veterans Initiatives 

1 Director .................................................................................................................... SES 1 

2 Program Specialist .................................................................................................. 15 1 

3 Program Specialist .................................................................................................. 12 1 

4 Program Support Asst (Typ) .................................................................................... 7 1 

5 Staff Assistant ........................................................................................................ 14 1 

6 Program Specialist .................................................................................................. 9 1 

7 Administrative Officer ............................................................................................. 12 1 

8 Management Analyst ............................................................................................... 14 1 

9 Program Specialist .................................................................................................. 14 1 

10 Program Analyst ...................................................................................................... 14 1 

11 Program Analyst ...................................................................................................... 14 1 

12 Management Analyst ............................................................................................... 12 1 

13 Deputy Director ........................................................................................................ 15 1 

14 Program Analyst ...................................................................................................... 14 1 

15 Program Specialist .................................................................................................. 14 1 

Office of Online Communications 

1 Public Affairs Specialist .......................................................................................... 14 1 

2 Public Affairs Specialist .......................................................................................... 11 1 

3 Public Affairs Specialist .......................................................................................... 12 1 

4 Public Affairs Specialist .......................................................................................... 11 1 

5 Program Specialist .................................................................................................. 13 1 

286 

Office of Public and Intergovernmental Affairs (OPIA)—Continued 

Employees Position Report 

Position Title Grade FTE 

Office of Public Affairs 

1 Program Support Assistant ..................................................................................... 10 1 

2 Public Affairs Specialist .......................................................................................... 15 1 

3 Public Affairs Specialist .......................................................................................... 15 1 

4 Public Affairs Specialist .......................................................................................... 15 1 

5 Dep Assistant Secretary .......................................................................................... SES 1 

6 Public Affairs Specialist .......................................................................................... 15 1 

7 Public Affairs Specialist .......................................................................................... 15 1 

8 Special Assistant ..................................................................................................... 14 1 

Office of Media Relations 

1 Public Affairs Specialist .......................................................................................... 15 1 

2 Program Support Asst (OA) ..................................................................................... 7 1 

3 Public Affairs Specialist .......................................................................................... 13 1 

4 Student Trne ............................................................................................................ 5 1 

5 Public Affairs Specialist .......................................................................................... 14 1 

6 Public Affairs Specialist .......................................................................................... 14 1 

7 Public Affairs Specialist .......................................................................................... 14 1 

8 Public Affairs Specialist .......................................................................................... 14 1 

Office of Public Relations Regional Offices 

1 Public Affairs Specialist .......................................................................................... 11 1 

2 Public Affairs Specialist .......................................................................................... 14 1 

3 Public Affairs Specialist .......................................................................................... 14 1 

4 Public Affairs Specialist .......................................................................................... 13 1 

5 Public Affairs Specialist .......................................................................................... 13 1 

6 Public Affairs Specialist .......................................................................................... 14 1 

7 Public Affairs Specialist .......................................................................................... 13 1 

8 Public Affairs Specialist .......................................................................................... 13 1 

9 Public Affairs Specialist .......................................................................................... 13 1 

10 Public Affairs Specialist .......................................................................................... 14 1 

11 Public Affairs Specialist .......................................................................................... 14 1 

12 Public Affairs Specialist .......................................................................................... 11 1 

13 Public Affairs Specialist .......................................................................................... 13 1 

14 Public Affairs Specialist .......................................................................................... 14 1 

15 Public Affairs Specialist .......................................................................................... 13 1 

16 Public Affairs Specialist .......................................................................................... 11 1 

17 Public Affairs Specialist .......................................................................................... 14 1 

18 Public Affairs Specialist .......................................................................................... 11 1 

19 Program Support Asst (OA) ..................................................................................... 7 1 

20 Public Affairs Specialist .......................................................................................... 14 1 

21 Public Affairs Specialist .......................................................................................... 11 1 

22 Public Affairs Specialist .......................................................................................... 11 1 

Office of Media Products 

1 Public Affairs Specialist .......................................................................................... 15 1 

2 Public Affairs Specialist .......................................................................................... 14 1 

3 Public Affairs Specialist .......................................................................................... 13 1 

4 Public Affairs Specialist .......................................................................................... 14 1 

5 Public Affairs Specialist .......................................................................................... 11 1 

6 Public Affairs Specialist .......................................................................................... 13 1 

7 Student Trainee ....................................................................................................... 7 1 

8 Public Affairs Specialist .......................................................................................... 11 1 

Total FTE .................................................................................................................. 94 

Question 2. For fiscal year 2013, the Office of Public and Intergovernmental Affairs requests $8.5 million for purposes of the Paralympics program. 

a. During fiscal year 2012, 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. In FY 2012, $7.5 million will be dispersed through the grant program. 

Currently, 13.33 percent is projected to be used to pay the salary costs for employees 

287 

of the U.S. Olympic Committee/U.S. Paralympics. The U.S. Olympic Committee/U.S. 

Paralympics is projecting to use other sources to fund administrative costs for the 

U.S. Paralympics Integrated Adaptive Sport Program, and use the grant received 

from VA for designated programs. 

b. 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. In FY 2013, the expected amount to be dispersed through the grant 

program is the same as the FY 2012 amount, as is the disbursement plan. 

Question 3. According to the fiscal year 2013 budget request, the Office of Public and Intergovernmental Affairs now expects to spend $4 million on Other Services 

during fiscal year 2012, which is 152% higher than the amount requested for fiscal 

year 2012 ($1.6 million), and that office requests $1.5 million for Other Services for 

fiscal year 2013. 

a. Please explain what led to the expected increase in Other Services during fiscal year 2012 and how that funding ($2.4 million) was originally expected to be spent. 

Response. The Other Services funding level changes are a result of carryover funding. Estimates at the time of budget submission were that a carryover of $2.4 

million would be needed, based on office requirements. After further review, FY 

2011 funding of $2.3 million was carried over to FY 2012. 

b. Please provide an itemized list of how these funds are expected to be expended 

during fiscal year 2012 and fiscal year 2013. To the extent any of these funds will 

be spent on contracts, please explain the nature of the contract and the expected 

outcomes. 

Response. The OPIA carried over $2.3 million from FY 2011 to FY 2012. In the 

President’s 2013 budget, these resources were planned to be expended in 2012 for 

the following purposes: 

1. For grant allowance subsidy for payout in Sept/Oct timeframe by the National 

Sports Programs and Special Events. Estimated expenditure: $300,000. 

2. For contract services to update the Web site and establish a social media section on the Web page for Veterans who are training to use Facebook and blogs to 

track their way to Gold in the London 2012 Games. Also to produce videos for disabled Veterans who are training. Estimated expenditure: $600,000. 

3. For contract services to do an in-depth cost benefit analysis of the VA National 

Veterans Sports Programs & Special Events Office grants and the cost to the VA 

to provide the six national events. The goal is to capture VA’s cost estimate of Return on Investment for both programs, and to assist in providing recommendations 

for program office enhancements. Estimated expenditure: $350,000. 

4. To help support the Warrior Games in 2012. VA awarded a grant to the United 

States Olympic Committee to support the Warrior Games. Last year more than 30 

percent of the athletes were Veterans. Estimated expenditure: $250,000. 

5. Provide two adaptive sport-specific camps for elite athlete Veterans and members of the Armed Forces. Estimated expenditure: $150,000. 

6. For programs to provide expertise in the national, regional, and communitybased Paralympic and adaptive sport programs, including integration of diverse Veteran Service Organization, Paralympic Sport Club, and state and local government 

entities. Estimated expenditure: $150,000. 

7. OPIA estimates that $500,000 will be required to stand up and implement the 

National Veterans Outreach (NVO) office. VA created the NVO office within OPIA 

in FY 2010 to coordinate outreach throughout VA, and to standardize outreach-related activities. Estimated expenditure: $500,000. 

Question 4. According to the fiscal year 2013 budget request, the Office of Public 

and Intergovernmental Affairs now expects to spend $1.1 million on travel during 

fiscal year 2012, which is 70% higher than the amount requested for fiscal year 

2012 ($660,000), and that office requests $1.1 million for travel for fiscal year 2013. 

a. Please explain what led to the expected increase in travel during fiscal year 

2012 and how that funding ($465,000) was originally expected to be spent. 

Response. Previously known as the Homeless Veteran Program Office, the Homeless Veteran Initiative Office (HVIO) expected an FY 2012 travel increase of 

$465,000, at the time of the FY 2013 Budget release. That figure has since been 

decreased by $285,000. The original FY 2012 travel increase of $465,000 was to support OPIA’s Homeless HVIO travel connected to VA’s efforts to end Veterans’ homelessness, which is one of the Department’s top priorities. 

b. How many trips is that level of funding expected to support each year and what 

is the average expected cost per trip? 

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Response. Although HVIO FY 2012 original travel increase was $465,000, that figure has since been decreased by $285,000. HVIO FY 2012 current estimate travel 

budget is $165,000, with an estimate of 122 trips, at an average cost of $1,352.00 

to include VA staff and members of VA’s Advisory Committee for Homeless 

Veterans. 

Office of Congressional and Legislative Affairs 

Question 1. For fiscal year 2013, the Office of Congressional and Legislative Affairs requests $6.3 million and 48 employees. Please provide a list of the positions 

that would be filled with that funding and the pay-grades for those positions. 

Response. In FY 2013, the Office of Congressional and Legislative Affairs (OCLA) 

is requesting a total budget of $6.3 million that will fund an average of 48 FTE. 

The specific positions that would be supplemented by this funding, and their associated pay-grades are outlined below: 

1) Assistant Secretary for Congressional and Legislative Affairs (PAS) 

2) Deputy Assistant Secretary for Congressional and Legislative Affairs (Political 

Appointment—SES) 

3) Associate Deputy Assistant Secretary for Congressional and Legislative Affairs 

(Career SES) 

4) Special Assistant to the Assistant Secretary (Schedule C GS–15) 

5) Special Assistant to the Assistant Secretary (Schedule C GS–14) 

6) Director of Operations (GS–15) 

7) Director, Legislative Affairs Service (GS–15) 

8) Director, Congressional Liaison Service (GS–15) 

9) Director, Benefits Legislative Affairs Service (GS–15) 

10) Director, Health Legislative Affairs Service (GS–15) 

11) Director, Corporate Enterprise Legislative Affairs Service (GS–15) 

12) Assistant Director, Congressional Liaison Service (GS–14) 

13) Advisory Committee Management Officer (GS–14) 

14) Administrative Officer (GS–14) 

15) Administrative Officer (GS–14) 

16) Executive Correspondence Analyst (GS–14) 

17) GAO Liaison Team Leader (GS–14) 

18) Congressional Relations Officer—Legislative (GS 12/13/14) 

19) Congressional Relations Officer—Benefits (GS–12/13/14) 

20) Congressional Relations Officer—Benefits (GS–12/13/14) 

21) Congressional Relations Officer—Health (GS–12/13/14) 

22) Congressional Relations Officer—Health (GS–12/13/14) 

23) Congressional Relations Officer—Health (GS–12/13/14) 

24) Congressional Relations Officer—Health (GS–12/13/14) 

25) Congressional Relations Officer—Corporate Enterprise (GS–12/13/14) 

26) Congressional Relations Officer—Corporate Enterprise (GS–12/13/14) 

27) Congressional Relations Officer—Corporate Enterprise (GS–12/13/14) 

28) Congressional Relations Officer—Corporate Enterprise (GS–12/13/14) 

29) Senior Congressional Liaison Representative (GS–13) 

30) Congressional Liaison Officer (GS–13) 

31) GAO Liaison (GS–13) 

32) Congressional Liaison Representative (GS–12) 

33) Congressional Liaison Representative (GS–12) 

34) Congressional Liaison Representative (GS–12) 

35) Program Analyst—Health (GS–12) 

36) Correspondence Analyst (GS–11) 

37) Program Analyst—Congressional Liaison Service (GS 9/11) 

38) Program Analyst—Congressional Liaison Service (GS–11) 

39) Program Analyst—Benefits (GS–11) 

40) Program Analyst—Legislative Affairs Service (GS–11) 

41) Program Analyst—Corporate Enterprise (GS–11) 

42) Staff Assistant (GS–11) 

43) Program Analyst (GS–9/11) 

44) Staff Assistant (GS–9/11) 

45) Senior Congressional Liaison Assistant (GS–9) 

46) Staff Assistant (GS–8) 

47) Congressional Liaison Assistant (GS–8) 

48) Congressional Liaison Assistant (GS–7) 

Question 2. According to the fiscal year 2013 budget request, the Office of Congressional and Legislative Affairs now expects to spend $180,000 on Other Services 

(Contracts, Agreements, etc) during fiscal year 2013, which is 65% higher than the 

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amount requested for fiscal year 2012 ($109,000), and that office requests $180,000 

for Other Services for fiscal year 2013. 

Response. OCLA’s FY 2012 budget operating plan was revised following receipt 

of the year’s final budget. The revised plan for FY 2012 is outlined below (funding 

figures in thousands): 

FY 2012 

Average employment ..................... 48 

Personnel Services ......................... $5,761 

Travel ............................................. $164 

Printing and reproduction ............. $13 

Other services ................................ $368 

Supplies and materials ................. $130 

Total authority ............................... $6,436 

OCLA’s projected FY 2013 updated budget operating plan is listed below: 

FY 2013 

Average employment ..................... 48 

Personnel Services ......................... $5,761 

Travel ............................................. $166 

Printing and reproduction ............. $13 

Other services ................................ $287 

Supplies and materials ................. $75 

Total authority ............................... $6,302 

a. Please explain what led to the expected increase in Other Services during fiscal 

year 2012 and how that funding ($71,000) was originally expected to be spent. 

Response. OCLA implemented a congressional knowledge management system 

during FY 2011. This system is used to track congressional inquiries and other related congressional requests to centralize information and monitor status. OCLA estimated the annual lease fees for the system to be approximately $82,000.00. This 

resulted in the increase in other services, as FY 2013 would be the first full year 

of the lease. However, additional savings are anticipated to be identified through the 

review of existing contracts. 

OCLA expects a net reduction in the Other Services category of $81,000.00; the 

FY 2013 request is $287,000.00. 

b. Please provide an itemized list of how these funds are expected to be expended 

during fiscal year 2012 and fiscal year 2013. To the extent any of these funds will 

be spent on contracts, please explain the nature of the contract and the expected 

outcomes. 

Response. Below is an itemized list of how these funds are expected to be expended during FY 2012 and FY 2013. Contracts are listed below with explanations 

and desired outcomes. 

(1) Congressional Quarterly Web site 

a. FY 2012: $89,931.00 Est. Cost FY 2013: $95,000 (based on last year’s estimate of a $4,200 increase) 

b. Subscription service for access to Congressional Quarterly Web site. 

(2) Service Level Agreement (SLA) (Financial Service Center) 

a. FY 2012—$3,133.02 Est. Cost FY 2013: $3,133.02 

b. SLA is with the Austin Finance Center for the administration of pay and 

travel. 

(3) Defense Finance and Accounting Services (DFAS) 

a. FY 2012: $3896.15 Est. Cost FY 2013: $3896.15 

b. DFAS accounting database. 

(4) Franchise Fund Payment (FDM) 

a. FY 2011: $316.00 (not billed until end of FY) FY 2012: anticipate similar 

charge for FY 2012 and FY 2013 

(5) Congressional Knowledge Management System (CKMS) 

a. FY 2012: $22,000.00 Est. Cost FY 2013: $82,000.00 

b. CKMS was implemented in FY 2011. Payment of the partial lease is due 

in FY 2012. The full lease costs will be incurred in FY 2013. 

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Question 3. According to the fiscal year 2013 budget request, the Office of Congressional and Legislative Affairs now expects to spend $198,000 on supplies and 

materials during fiscal year 2012, which is 57% higher than the amount requested 

for fiscal year 2012 ($126,000), and that office requests $198,000 for supplies and 

materials for fiscal year 2013. 

Response. OCLA’s FY 2012 budget operating plan was revised following receipt 

of the year’s final budget. The revised plan for FY 2012 is outlined below (funding 

figures in thousands): 

FY 2012 

Average employment ..................... 48 

Personnel Services ......................... $5,761 

Travel ............................................. $164 

Printing and reproduction ............. $13 

Other services ................................ $368 

Supplies and materials ................. $130 

Total authority ........................... $6,436 

OCLA’s projected FY 2013 updated budget operating plan is listed below: 

FY 2013 

Average employment ..................... 48 

Personnel Services ......................... $5,761 

Travel ............................................. $166 

Printing and reproduction ............. $13 

Other services ................................ $287 

Supplies and materials ................. $75 

Total authority ........................... $6,302 

a. Please explain what led to the expected increase in supplies and materials during fiscal year 2012 and how that funding ($72,000) was originally expected to be 

spent. 

Response. The FY 2013 budget request was amended and the amount requested 

for OCLA ‘‘Supplies and Materials’’ has been adjusted to $75,000.00. This amount 

is actually $51,000.00 less than current year spending. 

The reduction in ‘‘Supplies and Materials’’ is a result of continuing stewardship 

and renewed focus on efficient use of resources. 

b. Please provide an itemized list of how these funds are expected to be expended 

during fiscal year 2012 and fiscal year 2013. 

Response. Major Expenditures during FY 2012 and projected in FY 2013 are: 

Copier Lease (Xerox) .................................................................. FY 2012: $3,000 .12 

FY 2013: $3,000 .12 

Copier Lease (Xerox) .................................................................. FY 2012: $3,744 .44 

FY 2013: $3,744 .44 

Copier Yearly (Ricoh) Maintenance Agreement ....................... FY 2012: $3,661 .44 

FY 2013: $3,661 .44 

Copier Yearly (Ricoh) Maintenance Agreement ....................... FY 2012: $5,326 .80 

FY 2013: $5,326 .80 

Periodicals, Newspapers, Congressional Directories, Other 

Congressional subscription services, etc. .............................. FY 2012: $27,759 .35 

FY 2013: $20,000 .00 

Office Supplies, Toner, Projector Screens, Replacement TVs, 

etc. ............................................................................................ FY 2012: $39,593 .37 

FY 2013: $39,000 .00 

The request of $75,000.00 for ‘‘Supplies and Materials’’ represents, as a percentage of the total office budgetary request, approximately 1.2% of the $6.3 million requested for annual operations. OCLA consistently tries to reduce costs associated 

with supplies and materials. 

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Question 4. In connection with VA’s fiscal year 2012 budget request, the Office 

of Congressional and Legislative Affairs indicated that, in 2010, it had ‘‘defined performance measures and metrics for the office.’’ 

a. In terms of those measures and metrics, please assess the performance of the 

Office of Congressional and Legislative Affairs during fiscal year 2011. 

Response. Below please find a summary of OCLA’s workload and relevant performance metrics: 

FY 2011 Total 

Hearings ........................................ 46 

Briefings ........................................ 454 

Responsiveness: 

• Percentage of responses to pre and post-hearing questions for the record that 

are submitted to Congress within the required timeframe: 90% 

• Percentage of testimony submitted to Congress within the required timeframe:

98% 

• Percentage of Title 38 reports that are submitted to Congress within the required timeframe: 33% 

Government Accountability Office (GAO) Activities: 168 

(activities include entrance conferences, exit conferences, draft reports, final reports) 

OCLA Liaison Service: 

Inquires: 19,642 (includes letters, e-mails, phone calls, walk-ins) 

Closed letters: 4,368 

Advisory Committee Meetings: 44 

b. In terms of those measures and metrics, what performance outcomes are expected during fiscal year 2012? 

Response. OCLA expects to sustain its FY 2011 performance outcomes. Specific 

target goals are: 

• Percentage of responses to pre- and post-hearing questions for the record that 

are submitted to Congress within the required timeframe: 85% 

• Percentage of testimony submitted to Congress within the required timeframe:

90% 

• Percentage of Title 38 reports that are submitted to Congress within the required timeframe: 85% 

OCLA will continue to focus on process improvements and performance, especially 

in the area of congressionally mandated reports. 

c. In terms of those measures and metrics, what performance outcomes are expected during fiscal year 2013 if the requested level of funding is provided? 

Response. OCLA expects to achieve the following performance outcomes in FY 

2013: 

• Percentage of responses to pre- and post-hearing questions for the record that 

are submitted to Congress within the required timeframe: 90% 

• Percentage of testimony submitted to Congress within the required timeframe:

90% 

• Percentage of Title 38 reports that are submitted to Congress within the required timeframe: 85% 

Office of Acquisition, Logistics, and Construction 

Question 1. For fiscal year 2013, the Office of Acquisitions, Logistics, and Construction requests $13.9 million for Other Services. Please provide an itemized list 

of how these funds will be spent. To the extent any of these funds will be spent 

on contracts, please explain the nature of the contract and the expected outcomes. 

Response. The $13.9 million requested by the Office of Acquisitions, Logistics, and 

Construction (OALC) for Other Services in FY 2013 will be spent as shown in the 

table below. 

Administrative Overhead, non-contract 

Training ........................................................................... $295,000 

Permanent Change of Station moves ............................ $893,000 

Repair of Furniture & equipment ................................... $49,000 

Maintenance & repair services ...................................... $43,000 

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Total ........................................................................... $1,280,000 

Support Agreements with Other Federal Agencies 

Financial Service Center (FSC) SLA ............................... $360,000 VA centralized Finance Center 

Security Investigations (SLA) .......................................... $28,000 Employee security investigations 

Financial Disclosure SLA ................................................ $11,000 Financial disclosure & ethics 

Defense Finance & Accounting Service (DFAS) .............. $32,000 Payroll processing 

VA Central Office Human Resources Service (CORHS) .. $300,000 Support aggressive hiring schedule 

Total ........................................................................... $731,000 

Essential Contract Support with Outside Agencies 

Federal Facilities Council (FFC) ..................................... $30,000 Support new technologies for design/construction 

HCIP Reimbursement ...................................................... $125,000 Workforce development 

Advisory Council Historic Preservation Liaison .............. $182,000 National Historic Preservation Act 

National Institute of Building Sciences (NIBS) .............. $50,000 Building design support 

Seismic Instrumentation ................................................. $58,000 Seismic instrument maintenance 

Western Regional Office Build Out ................................ $1,210,000 Western regional office expansion 

Eastern Regional Office Build Out ................................. $902,000 Eastern regional office expansion 

Western Regional Office Hoteling ................................... $1,200,000 Temporary space—Western regional office 

Total ........................................................................... $3,757,000 

VAFM Transformation Initiative Contracts 

VAFM Transformation Initiative ...................................... $1,434,000 Implementation of Enterprise Facilities Management 

system 

SharePoint Contract ........................................................ $1,200,000 Convert government off the shelf (GOTS) IT to existing platform 

Process Documentation .................................................. $246,000 Publish OALC/CFM procedures 

Total ........................................................................... $2,880,000 

Acquisition Improvement Initiative Contracts 

Acquisition Improvement Initiative ................................. $5,000,000 Develop acquisition workforce 

Total ........................................................................... $5,000,000 

OALC Transformation Contracts 

OALC Transformation Contracts ..................................... $246,000 Transform OALC lines of business 

Total ........................................................................... $246,000 

Grand Total ............................................................ $13,894,000 

.

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OFFICE OF INSPECTOR GENERAL

HOUSING

Question 1. VA has a number of tools available to assist veterans from losing 

homes guaranteed through the VA home loan program. In the unfortunate instances 

these programs do not work and a veteran goes into foreclosure or default, VA is 

required to reimburse the holder of the mortgage for up to 25% of the purchase 

price. In order to avoid incurring large costs to the Loan Guaranty Service and taxpayers, VA has the authority to purchase the properties from the banks and later 

sell the properties instead of paying the guaranty. 

a. Please provide the number of homes the VA Loan Guaranty Service has taken 

possession of during the last five years. 

b. How much has VA spent to acquire properties in the last five years, and how 

much has VA recouped in sales of those attained property assets? 

c. Of the properties that VA has acquired over the last five years, please detail 

the number of those properties VA still holds. 

d. Please detail the plan to dispose of the remaining properties held by VA. 

Response. [Question 1, a–d were answered in the prehearing responses.] 

e. What is the cost of upkeep for homes VA has taken possession of following a 

default or foreclosure of a VA-backed loan? 

Response. The average cost for upkeep of the 16,388 properties sold in FY 2011 

was $4,533 per property, which includes taxes, maintenance costs, and capital improvements. 

f. What is the process for acquiring properties in both the Acquired and Vendee 

accounts? 

Response. VBA assumes that this question pertains to the process by which VA 

acquires refunded and vendee loans in its portfolio. VA occasionally acquires (purVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00299 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN

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chases from the lender) VA-guaranteed loans when the Veteran borrower can resume regular monthly payments, but where the loan holder is unwilling or unable 

to modify the loan to cure the delinquency and make future payments affordable. 

These acquired (refunded) loans are then serviced by VA’s contract portfolio 

servicer. While 67 percent of acquired (refunded) loans are performing, some delinquent loans are eventually foreclosed, with VA acquiring the properties. This is 

similar to the manner in which VA acquires VA-guaranteed loan foreclosures. 

Properties that VA acquires after guaranteed loans are foreclosed are offered for 

sale with VA seller (vendee) financing. Vendee loans are serviced by VA’s contract 

portfolio servicer until the loans are paid off or sold. If a Vendee Loan goes delinquent while VA owns it, and it is eventually terminated, then at the foreclosure 

sale, VA typically acquires the property that secured the loan and adds it to its inventory of properties available for sale. 

Question 2. The fiscal year 2012 VA budget request housing workload section for 

2012 stated: ‘‘The number of refinance loans will decrease as interest rates rise from 

the lower levels of 2011.’’ The fiscal year 2013 housing 2012 workload section states: 

‘‘In 2012, an increasing interest rate environment will reduce the number of Veteran 

borrowers able to lower the interest rates on their mortgages.’’ According to Freddie 

Mac, since February 10, 2011, the U.S. 30-Year fixed rate mortgage rate has fallen 

from 5.05% to 3.87% on February 9, 2012. 

a. In light of U.S. 30-Year fixed rate mortgage rates continuing to stay near 

record lows, how will the projected number of borrowers able to refinance during 

2012 be affected? 

Response. If mortgage rates continue to stay low during 2012, then borrowers who 

have not recently refinanced may have the ability and desire to exercise this option. 

However, if mortgage rates do not fall or stabilize, the vast majority of borrowers 

who wanted to refinance will have already done so, and VA’s refinance volume 

growth will likely slow. 

b. How does this continued favorable interest rate environment for borrowers affect VA’s workload and resource needs? 

Response. There are minimal effects on VA’s workload and resource needs as a 

result of the current favorable interest rate environment for borrowers. Low or declining interest rates typically cause an increase in the number of Interest Rate Reduction Refinancing Loans (IRRRLs). No appraisal or credit underwriting package 

is required by VA on IRRRLs, and increased IRRRL activity does not necessitate 

an increase in resources. 

c. Please explain how VA projects changes in interest rates in order to develop 

workload statements for the annual budget submission. 

Response. VA uses economic assumptions from the Office of Management and 

Budget to determine estimates for interest rate changes, and subsequently workload 

projections and assumptions for the annual budget submission. 

Question 3. Veterans attempting to utilize their VA home loan entitlement have 

raised concerns to the Committee regarding the competitiveness of VA-backed loans 

as opposed to Federal Housing Administration (FHA) or other traditional mortgage 

products. There are limitations on the types of fees and other settlements cost veterans are allowed to pay, but there are no similar restrictions for veterans or nonveterans who use FHA or traditional mortgages. Veterans must be protected to ensure they are purchasing quality homes and are not taken advantage of at closing; 

however, veterans using VA home loans should not be adversely affected by overly 

stringent VA rules. 

a. What steps does VA take to ensure that veterans utilizing VA-backed loans are 

competitive in the housing market? 

Response. VA’s Loan Guaranty program is competitive in the marketplace, and 

in order to maintain the program’s viability, VA continually strives to improve efficiency of operations and to effectively communicate with industry stakeholders who 

are critical to the delivery of loan guaranty benefits. VA balances stakeholder and 

Veteran needs with necessary safeguards and protections. Additionally, VA’s Minimum Property Requirements ensure that Veterans purchase homes that are in 

safe, sound, and sanitary condition. Efforts to ensure that the program is competitive in the housing market are outlined below. 

Prior to October 1992, VA established the interest rate to be charged on VA-guaranteed loans. As a result of legislation in 1992, interest rates on VA-guaranteed 

loans were determined by the private market, bringing VA’s program in line with 

other loan products in the industry. 

VA credit guidelines afford lenders the opportunity to make sound and prudent 

underwriting decisions based on the ability of a Veteran to afford a loan. VA underwriting guidelines allow Veterans to be afforded every possible opportunity to purVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00300 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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chase a home. As an example, VA does not require a minimum FICO score, as 

would a conventional lender. Instead, VA instructs lenders to look at a Veteran’s 

entire situation and use indicators such as residual income and debt ratios and to 

be flexible in evaluating a Veteran’s income and employment situations. 

VA continues to enhance our competitiveness in the mortgage market through efforts and initiatives targeted at increasing efficiency and timeliness for loan underwriting and closing. VA has made it possible for lenders to utilize automatic lending 

authority to originate, process, underwrite, and close loans with minimal VA involvement. VA information technology innovations have enabled lenders to request 

a case number and appraisal assignment online and enabled lenders and Veterans 

to obtain a Certificate of Eligibility online. Additionally, an appraiser’s report can 

be uploaded online where a lender representative can review and issue a Notice of 

Value (NOV). Once the loan is closed, lenders can request evidence of the guaranty 

online. VA is also currently enhancing the capability of our systems to allow any 

lender to submit requested loan files electronically rather than by mail. This will 

greatly speed lenders’ ability to comply with VA’s oversight process and procedures. 

With delegation of authorities and automation of the program, VA has established 

and maintains a robust oversight program, which ensures lenders and other stakeholders comply with VA-specific laws, regulations, policies, and procedures. 

b. In situations where a mortgage originator or seller is unwilling to make up the 

monetary amount that is remaining at closing, what tools are available to veterans 

to make up for a shortfall? 

Response. VA is aware that some lenders provide the Veteran-borrower the opportunity to offset some of those costs by using a ‘‘premium pricing’’ option. This option 

allows the Veteran-borrower to pay an increased interest rate in return for providing a closing cost credit to cover the shortfall, as long as VA’s regulations do not 

prohibit the specific costs that are being credited. 

With regard to specific closing costs, VA maintains a list of allowable and unallowable fees and charges. This list is currently under revision to ensure that VA’s 

guaranteed loan program remains competitive in the marketplace. Revision of the 

fees and charges will require changes to VA regulations. 

c. Please detail the termite and pest inspections required by VA. How do they differ from those required by FHA? 

Response. Conditions which impair the safety, sanitation, or structural soundness 

of the dwelling will cause the property to be unacceptable, per VA’s Minimum Property Requirements, until such time as the defects or conditions have been remedied 

and the probability of further damage eliminated. Such conditions include but are 

not limited to decay, and termites. 

VA requires the NOV be conditioned for Wood Destroying Insect Information (i.e., 

a termite inspection) if the property is located in an area where there exists a probability of termite infestation. Specifically, VA requires the NOV be conditioned in 

areas deemed ‘‘very heavy’’ or ‘‘moderate to heavy’’ according to the Termite Infestation Probability Map published in The Council of American Building Officials 

(CABO) One and Two Family Dwelling Code. (Please note that CABO has been superseded by the International Code Council Residential Code, which retained the 

CABO map.) If there is a question about the location of an infestation probability 

boundary line in relation to the subject property, VA’s Regional Loan Center of jurisdiction is contacted to determine if this requirement is applicable. 

In addition, VA fee appraisers must look for and report evidence of wood-destroying insect infestation, fungus growth, and dry rot in addition to any VA requirement 

for an inspection of the property by a wood-destroying insect inspector. In the event 

the appraiser reports evidence of termites, the NOV is to be conditioned for wooddestroying insect information, irrespective of location. 

It is VA’s understanding that FHA no longer mandates automatic termite inspections; instead, FHA now determines whether or not a termite inspection is required 

based on the information provided in the appraisal report. Per FHA Mortgagee Letter 2005–48, FHA Repair and Inspection Requirements for Existing Properties and 

Revisions to FHA Appraisal Protocol: 

‘‘Lenders must review the appraisal to determine whether the appraiser 

has reported any property conditions that will affect the health and safety 

of the occupants or the security and the soundness of the property and 

must require immediate repair where the property condition poses a threat 

to these criteria. 

FHA no longer mandates automatic inspections for the following items 

and/or conditions in existing properties: Wood Destroying Insects/Organisms: inspection required only if evidence of active infestation, mandated 

296 

by the state or local jurisdiction, if customary to area, or at lender’s discretion’’ 

Question 4. On April 19, 2011, the Federal Reserve issued a rule defining ‘‘Qualified Mortgages.’’ The rule was in response to changes in the Dodd/Frank Wall Street 

Reform and Consumer Protection Act (Public Law 111–203). VA will be forced to 

abide by the Federal Reserve rule unless and until they develop their own rule defining what constitutes loans as ‘‘Qualified Mortgages.’’ The last update the Committee received from VA stated that the proposed rule was in VA’s concurrence 

process. 

a. Please provide the Committee a detailed update on the status of VA’s proposed 

rule. 

Response. VA’s Loan Guaranty Service drafted VA’s regulation on Qualified Mortgages (QM), pursuant to the requirements of section 1412 of the Dodd-Frank Wall 

Street Reform and Consumer Protection Act. Section 1412 of the Act also directs VA 

to consult with the Consumer Finance Protection Bureau (CFPB). Loan Guaranty 

Service amended the draft rule to incorporate minor clarifying changes requested 

by the CFPB. The regulation package is currently in the review process within VA. 

b. When will the Federal Reserve rule take effect, and will VA’s rule be in place 

prior to this date? 

Response. The proposed rule on Qualified Residential Mortgages (QRM Rule) was 

published in the Federal Register on April 29, 2011 (76 FR 24090). VA is not aware 

of when the QRM Rule will take effect and does not know if VA’s rule will be in 

place prior to the effective date of the QRM Rule. However, section 941 of the DoddFrank Act exempts VA-guaranteed loans from the risk-retention provisions of this 

law: 

(B) OTHER FEDERAL PROGRAMS.—This section shall not apply to any residential, multifamily, or health care facility mortgage loan asset, or 

securitization based directly or indirectly on such an asset, which is insured 

or guaranteed by the United States or an agency of the United States. For 

purposes of this subsection, the Federal National Mortgage Association, the 

Federal Home Loan Mortgage Corporation, and the Federal home loan 

banks shall not be considered an agency of the United States. 

In its preamble, the proposed QRM rule explains that it exempts securitizations 

that are collateralized solely by loan assets insured or guaranteed by the United 

States. VA’s loans are expressly mentioned in this section. 

Question 5. According to the fiscal year 2013 budget request, fiscal year ‘‘2012 obligations for Specially Adapted Housing grants decreased by $20 million.’’ The request for fiscal year 2013 calls for an increase in obligations of nearly $5 million. 

a. Please describe what changes in assumptions or obligations led to the $20 million decrease between the fiscal year 2012 budget estimate and the current estimate. 

Response. FY 2012 budget request was formulated based on actual historic data 

through FY 2010. At the time this budget was developed, the number of Specially 

Adapted Housing (SAH) grant payments had increased from 1,236 in FY 2008, to 

1,562 in FY 2009, and 1,811 in FY 2010. As this rapid growth was not predicted 

to continue in the long-term, Loan Guaranty Service assumed a more modest longterm growth rate of five percent for SAH grant approvals, which when applied to 

SAH grant payments, resulted in a projected 1,948 SAH grant payments in FY 

2012. 

The current estimate for the FY 2013 budget request factors in FY 2011 actual 

grant payment data, which indicated that the number of SAH grant payments 

dropped to 1,354 in FY 2011. Since this payment activity was also reflected in SAH 

grant approval activity for the current estimate, Loan Guaranty Service projected 

SAH grant approvals to remain constant in FY 2012. The decrease from 1,948 to 

1,354 projected payments from the original budget estimate to the current estimate 

decreased SAH grant payment obligations by $24 million. This decrease was partially offset by an increase in the average grant amount, also based on actual FY 

2011 data, which increased SAH grant payment estimates by $4 million. 

b. Given the $20 million downward estimation for fiscal year 2012, please detail 

the assumptions underlying an increase between fiscal year 2012 and 2013. 

Response. Despite the large single-year decrease in SAH beneficiaries from FY 

2010 to FY 2011, the three-year historical average is a 6.2 percent annual increase 

in beneficiary payments. As explained above, beginning in FY 2013, Loan Guaranty 

Service utilizes a long-term assumption of a five percent annual increase in SAH 

grant approvals. This assumption was combined with a 3.1 percent cost-of-construcVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00302 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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tion index assumption for FY 2013. This results in a projected $5 million increase 

in SAH grant payments for FY 2013. 

Question 6. The Specially Adapted Housing Assistive Technology Grant Program 

will be fully implemented during fiscal year 2012. Under current law, the program 

is able to provide grants of up to $200,000 to individuals or entities for the development of assistive technology. The total amount of grants cannot exceed $1 million 

in a fiscal year. 

a. What is the process for an interested individual or entity to apply for the 

grants, and how does VA evaluate a grant application? 

Response. VA is currently promulgating regulations to implement the program. 

When the final regulations governing the grant program are published, interested 

individuals and entities will be able to apply for the grants via grants.gov. Criteria 

for evaluating applications are under review, but will likely include considerations 

such as: 

• The overall innovative qualities of the proposed assistive technology; • Demonstration of need among severely disabled Veterans for the proposed technology; • The extent to which the proposed assistive technology project is specifically designed to promote the ability of severely disabled Veterans to live more independently; • The extent to which the proposed development concept, size, scope and approach are feasible; and • Inclusion of a meaningful and achievable implementation plan with major milestones within a specific timeframe. 

In addition, qualifying applicants must submit a complete package of required 

standard forms, such as the Application for Federal Assistance (SF–424) and Assurances for Non-Construction Programs (SF–424B). 

b. Has VA issued any Specially Adapted Housing assistive technology grants to 

date? 

Response. No, VA cannot issue any grants under this new program until final regulations are published. 

c. What is VA’s evaluation process for technologies developed through the 

program? 

Response. As the SAH Assistive Technology Grant program is a new initiative, 

VA is in the process of developing many program processes and procedures that will 

ensure grantees are using Government funds appropriately and for the purpose of 

developing truly innovative assistive technologies. The post-award evaluation process will contain controls to ensure these goals are achieved. Award payments will 

be staggered so that meaningful progress can be evidenced to VA prior to subsequent installments. 

Grantees will be required to provide VA with regular updates on the progress of 

their projects so that VA can evaluate grantees’ progress. 

d. How will the grants distributed through this program benefit veterans utilizing 

Specially Adapted Housing or Special Housing Adaptation programs in the long 

term? 

Response. The long-term goal is that the grants distributed through this program 

will aid in the development of new assistive technologies for severely disabled Veterans, and particularly those that qualify for Specially Adapted Housing assistance. 

In turn, these Veterans will have a wider range of innovative products and features 

from which to choose when applying their own grant funds to the adaptation of their 

homes. Ultimately, these new technologies should further facilitate the ability of severely disabled Veterans to live more independently in their homes. 

e. Do veterans or service-disabled veterans receive preference when VA evaluates 

grant applications? 

VBA Response. When evaluating grant applications for its various programs, VA 

does not give preference to any particular group and bases award solely on the stated evaluation criteria. 

NATIONAL CEMETERY ADMINISTRATION

Question 1. In the fiscal year 2013 budget request, NCA proposed a new initiative 

to expand burial access to rural communities. The proposal is ‘‘to establish a national cemetery presence*** where the Veteran population is less than 25,000 

within a 75-mile [radius].’’ 

a. What are NCA’s estimates for usage and burial? 

b. The fiscal year 2012 appropriation language requires NCA to develop cost estimations for five rural cemeteries. Of the eight states included on the initial list for 

the new rural initiative, how many areas within each state meet all the current reVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00303 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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quirements as proposed by the rural initiative (population, distance, and lack of current burial options)? 

c. Of the eight states that meet the initial criteria for the new rural initiative, 

have any filed paperwork or are awaiting approval for a state cemetery grant? 

d. According to the fiscal year 2013 budget request, 89% of veterans were served 

by a burial option within 75 miles of their residence in 2011. Of the remaining veterans not served by a burial option within 75 miles, how many live in the eight 

states meeting the initial criteria for the rural initiative? Please detail the information by state. 

Response. [These questions appear and were answered in the prehearing responses as Question 26.] 

Question 2. On October 1, 2011, VA increased the plot-interment allowance for eli- gible veterans not buried in a national cemetery from $300 to $700. 

a. Please provide the Committee with the number and total amount of plot-interment allowance payments made to eligible veterans since the beginning of fiscal 

year 2012. 

Response. Through January 2012, plot allowances were paid on behalf of over 6,400 beneficiaries, and obligations were nearly $2 million. 

b. For fiscal year 2013, how many plot-interment allowances does VA expect to 

disburse? Please breakdown this information by both the number and total amount. 

Response. VA estimates that in FY 2013, over 34,200 plot allowances will be paid, and obligations will be $24.4 million. 

Question 3. The current strategic target for the percent of the veteran population 

served by a national, state, or tribal government veterans’ cemetery within 75 miles 

of their homes is 94%. Are tribal veterans’ cemeteries counted as a burial option 

in order to calculate the distance from a veteran cemetery for non-Native American 

veterans? 

Response. Tribal Veterans’ cemeteries are not counted as a burial option in order 

to calculate the distance from a Veteran cemetery, because burial in a tribal cemetery is restricted to those Veterans who are recognized by the tribal organization 

no matter where they reside in relation to these cemeteries. 

Question 4. In September 2011, while performing accuracy verifications of gravesite maps at Fort Sam Houston National Cemetery, cemetery personnel discovered 

errors associated with a ‘‘raise and realign’’ project completed in 2004. Because of 

these errors, NCA initiated a system-wide audit of all 3.1 million gravesites at VA’s 

131 national cemeteries and 33 soldiers’ lots. Phase I of the audit, which included 

85 cemeteries where ‘‘raise and realign’’ work had been performed since 2001, has 

been completed. As of February 24, 2012, 1.5 million gravesites have been audited 

and 115 errors have been identified. 

a. When will the full audit of all 3.1 million gravesites be completed? 

Response. All NCA employees are the custodians of a sacred trust and strive to 

be the model of excellence in the delivery of burial benefits. We have created a culture of accountability in which errors are addressed immediately and openly. NCA 

regrets the grief and emotional hardship our errors cause and seeks to correct errors 

in consultation with family members. Where an error occurred, NCA corrected the 

error and contacted the affected families, wherever possible, to extend our sincerest 

apologies. NCA also ensured VA’s congressional committees and the local congressional offices were notified of the issues. In April 2012, NCA initiated the second 

phase of its comprehensive system-wide review to verify that the remaining 1.6 million gravesites at VA’s 131 national cemeteries and 33 soldiers’ lots are accurately 

marked. By the end of calendar year 2012, NCA will have audited all 3.1 million 

gravesites within the VA cemetery system. Our findings will be reported to Congress. 

b. As part of NCA’s National Shrine Commitment many national cemeteries will 

continue ‘‘raise and realign’’ and other beautification projects. What safeguards have 

been implemented to avoid similar errors that have been identified through the system-wide audit? 

Response. Future renovation contracts to raise and realign headstones and markers will require contractors to keep headstones or markers at the gravesite. This 

control measure will reduce the likelihood of inaccurate replacement upon project 

completion. NCA will also hire certified contracting officer representatives at each 

of its Memorial Service Network offices to oversee future gravesite renovation 

projects. Additionally, for any headstone which employees or contractors need to 

move for any reason, NCA will adopt a new process to track temporary movement 

or replacement of the headstone or marker within the national cemetery. 

Question 5. In 2010, NCA added a headstone medallion to the available memorial 

benefits. A headstone medallion is available to be affixed to an existing privately 

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purchased headstone or marker placed in a private cemetery to signify the 

deceased’s status as a Veteran. In 2011, over 7,000 medallions were provided by 

NCA. What type of outreach activities have been or will be undertaken to inform 

veterans’ families, funeral homes, or private cemeteries of the availability of headstone medallions? 

Response. NCA has used a multi-tiered approach to outreach and inform the public of the Medallion benefit: 

• Updated the NCA Web site (Web 1.0); • Updating the Federal Benefits for Veterans, Dependents and Survivors (VA 

Pamphlet 80–11–01); • Updating the NCA Information Sheet–1 (IS–1); • Publication of new brochures, fact sheets; and • Creation of informational videos. 

We conduct outreach at dozens of annual conferences and conventions at the national level, including American Legion, VFW, DAV, AARP, and the National Funeral Directors Association. Combined with our outreach efforts at the local level, 

in FY 2011 NCA staff participated in 3,268 outreach events (90 national and 3,178 

local) reaching an estimated 450,236 people. Current benefit information is provided 

with displays of the new Medallion benefit. 

Question 6. According to the fiscal year 2013 budget request, in 2008, 56.8 percent 

of all interments in national cemeteries were full casket burials. In 2012, that proportion is expected to fall to 51.6 percent and continue to decrease to 48.9 percent 

in 2017. Of the remaining 51.1 percent of interments in 2017, it is projected that 

22.5 percent will be in-ground cremains and 28.5 percent will be columbaria niche. 

a. How will the change in veteran burial preference effect future NCA acreage and 

construction needs? 

Response. The number of National Cemeteries offering a columbaria option increased from 9 in 1996 to 39 in 2011 to accommodate the trend in burial option preference to a higher percentage of cremation interments. This trend will extend the 

developed acreage at these cemeteries to accommodate a greater number of interments and increase the need for columbarium construction. 

NCA continues to add columbarium at open national cemeteries as needed according to projected Veteran population, death rates and columbarium usage. 

Cremation interments result in greater burial density per acre than either preplaced crypt or traditional casketed burial options. A columbarium interment option 

provides twice as many interment sites as preplaced crypts and almost four times 

the number of sites as traditional caskets per acre. An in-ground cremain option 

provides 1.5 times the number per acre of interment sites as preplaced crypts and 

2.8 times the number of sites as traditional caskets. Furthermore, cremation burial 

options may allow a cemetery to use land not suitable for casketed burials due to 

slope or water table levels. 

NCA also plans to meet Veterans’ future burial needs and expectations through 

new policies targeted to those who reside in densely populated urban areas and 

sparsely populated rural communities. In response to challenges of travel time and 

distance to national cemeteries in five of our largest markets, NCA’s Urban Initiative will create columbaria-only facilities in the urban core of these cities. The 

Urban Initiative will improve access to these cemeteries by placing a burial option 

closer to where the Veteran population lives in Los Angeles, the San Francisco/Oakland Bay Area, Chicago, New York City and Indianapolis. NCA will implement its 

Rural Veterans Initiative by establishing and operating small National Veterans 

Burial Grounds within existing public or private cemeteries where no more than 

25,000 Veterans who have no national or state Veterans cemetery option within 75 

miles of their residence reside. A location for a National Veterans Burial Ground 

has been identified in Maine, Wisconsin, North Dakota, Montana, Wyoming, Nevada, Idaho, and Utah. In addition, NCA has undertaken an Emerging Burial Practices Study. This independent assessment of burial and memorial practices not currently offered in our national cemeteries will include a national survey and focus 

groups of Veterans and their families to ascertain whether options such as 

mausoleums and ‘‘green’’ burial practices are of interest to Veterans and are considered acceptable in a national shrine. NCA anticipates that the findings of this study 

will provide important information and perspectives that will drive our strategic 

planning for decades to come. 

b. Please detail the assumptions that led to these projections. 

Response. NCA uses Veteran population and Veteran death data from the VA Office of the Actuary through the VETPOP 2007 model. NCA uses state and county 

data from this model as well as trends in burial choice by type and by cemetery 

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teries is developed by independently developing a projection for each cemetery and 

summing them to derive the national projection. For each cemetery, first and second 

interments by type of interment—full-casket, in-ground cremain, and niche—are 

independently developed. From these projections, total full-casket, total in-ground 

cremain, total niche, total firsts, etc. can be derived. 

To project the interments and gravesites, NCA uses a ratio correlation method. 

Our model: 1) calculates historical usage ratios; 2) projects the usage ratios; and 3) 

derives projected interments and gravesites by applying the projected usage ratios 

to the projected Veteran deaths. 

To estimate depletion dates, NCA uses a perpetual inventory method. The model 

iteratively subtracts projected first interments from the sum of 1) available sites in 

developed acres and 2) an estimate of potential sites in undeveloped acres. 

Question 7. The fiscal year 2013 budget request for NCA operations and management includes a request for an additional $260,000 resulting in an additional four 

FTE to meet the demands of increased interments, as well an additional $1,200,000 

to fund contract maintenance personnel. 

a. How does NCA measure the efficacy of contracting for maintenance work performed at national cemeteries versus hiring additional NCA staff to perform the 

same duties? 

Response. The primary mission of a National Cemetery is the interment of Veterans and their eligible dependents. The secondary mission is the perpetual care of 

these national shrines. NCA has over 3.1 million gravesites in its 131 national 

cemeteries and 33 soldiers lots and monument sites. Under certain circumstances 

it is more efficient to contract work associated with the daily care of the grounds, 

i.e. mowing, trimming around headstones and markers, raise/realign/clean 

headstones and markers, fertilization, tree maintenance, sunken graves maintenance, etc. Unlike the interment of Veterans, NCA does not consider these activities 

to be inherently governmental. 

Before any work activity is contracted, the cemetery must consider the nature of 

the work and compare the cost to hire and train employees, purchase and maintain 

equipment, and procure supplies against the cost to hire a contractor who has the 

equipment and human capital to start providing services right away. Much of the 

maintenance required in a national cemetery is seasonal or intermittent and often 

can be effectively addressed by contracting it out. Contracts are normally setup for 

one year with optional years included. The Scope of Work for maintenance contracts 

is carefully written to follow the NCA Operational Standards and Measures for cemetery maintenance. Financial deductions could be levied against the contractor as 

well as termination of the contract should the work performance fail to meet the 

Standards and Measures. 

b. Of the current awarded maintenance contracts utilized by NCA, how many 

have been awarded to SDVOSBs or VOSBs? 

Response. NCA uses VOSB contractors for all maintenance contracts. NCA awarded 115 maintenance contracts in 2011. Of these, 106 were awarded to SDVOSB and 

9 to VOSB contractors. 

c. Given the high unemployment rate of veterans, what steps has NCA taken to 

hire unemployed veterans? 

Response. At present, approximately 74 percent of NCA’s workforce is Veterans. 

Building on this record, NCA partners with VA’s Veterans Employment Service Office (VESO) to streamline the application and employment process for Veterans and 

has made several direct hires of Veterans as a result. NCA regularly conducts outreach to Veterans at large and small venues across the country, including the VAsponsored Veterans Employment Expo in Washington, DC in January 2012 and the 

June 2012 National Veteran Small Business Conference and VA for Vets Veterans 

Hiring Fair in Detroit. 

In 2012, NCA will develop and implement an employment/training program in 

support of the Secretary’s Major Initiative, Eliminate Veteran Homelessness. 

Through this program NCA will partner with VA’s Homeless Veterans Initiative Office, VA for Vets, and VA Learning University to identify and recruit Veterans who 

are homeless or at risk for becoming homeless for participation as apprentices in 

a year-long paid employment and training program at national cemeteries across 

the country. Apprentices who successfully complete the program will normally be afforded the opportunity to transition to full time employment at a National Cemetery 

or will be able to use training certification to pursue employment in the private 

sector. 

Question 8. For fiscal year 2013, NCA requested $46,000,000 for state and tribal 

veteran cemeteries grants. According to NCA, 29 new state and tribal facilities will 

be opened between 2013 and 2018. 

301 

a. Please provide the number of states or tribal organizations that applied for 

NCA grants in 2011, and what is the projected number for 2012. 

Response. The State Veterans Cemetery Grants Program (SVGP) received 14 preapplications from 11 states/territories; we project possibly 10 pre-applications in FY 

2012. 

b. Of those states and tribal organizations that submitted an initial application, 

please provide the number that received notifications that they meet the initial requirements for grants in fiscal year 2011. 

Response. Of the 14 pre-applications submitted by 11 states and tribal organizations in fiscal year 2011, all of them met the initial requirements for grants. Each 

of the 11 submitting states and tribal organizations was notified. 

c. Please provide the number and locations of state or tribal grant proposals that 

have been fully approved and are waiting for VA to obligate grant money. 

Response. VA has offered grant opportunities for 22 projects to be awarded this 

fiscal year pending all requirements are met. None of the 2012 state or tribal grant 

proposals have met all grant requirements for full approval yet. These requirements 

include completion and submission of design/bid documents, final vendor bid tabulations, final application forms, a Memorandum of Agreement, and approved final construction documents. 

INSURANCE

Question 1. During 2011, the Servicemembers’ Group Life Insurance Traumatic 

Injury Protection Program (TSGLI) published a rule in the Federal Register adding 

certain genitourinary (GU) system losses to the TSGLI schedule of losses. This additional coverage applied to all qualifying injuries since October 7, 2001. 

a. Since the inception of the new rule, how many qualifying loss payments have 

been made under TSGLI? 

Response. As of April 30, 2012, twelve TSGLI claims have been paid for genitourinary (GU) losses since December 2, 2011, the effective date of the new GU losses 

rule. On February 22, 2012, Insurance Service completed an outreach mailing to individuals who have been identified by the Department of Defense Joint Theater 

Trauma Registry (JTTR) as having suffered a GU injury and who did not receive 

the maximum TSGLI benefit. 

b. What has been the total amount paid through TSGLI for GU system losses? 

Response. The total dollar amount of TSGLI benefits paid for GU system losses 

is $450,000 as of April 30, 2012. 

c. For fiscal year 2013, how many additional payments does VA expect will be 

made for retroactive awards? 

Response. In FY 2013, VA estimates that 25 retroactive GU claims will be paid, 

for an estimated cost of $1 million. This represents one-fourth of our total estimate 

of 100 retroactive GU claims at a cost of $4 million. Our estimates are based on 

assumed response and approval rates applied to the outreach mailing to approximately 240 Veterans identified by JTTR. Although some lag in response to the mailing is expected, we would anticipate that most of the claims will be received and 

paid in the second half of FY 2012. 

Question 2. Total insurance collections for fiscal year 2012 are currently estimated 

to be $1.6 billion, a $231 million increase over the original fiscal year 2012 budget 

estimate. The estimate for fiscal year 2013 is $1.3 billion, a decrease of $291 million 

from the current fiscal year 2012 estimate. 

a. Given the increase in collections between the original and current fiscal year 

2012 estimates, what assumptions went into determining the amount of offsetting 

collections VA estimates will be collected during fiscal year 2013? 

Response. The decrease in collections from 2012 to 2013 is mainly attributed to 

a decrease in SGLI extra hazard and TSGLI payments collected from DOD. SGLI 

extra hazard payments are payments that fund the difference between SGLI claims 

incurred during hostile military action and what would be expected under peacetime 

experience. TSGLI payments are extra hazard payments that fund the excess of 

TSGLI claims paid over TSGLI premiums received. The TSGLI premium is $1 per 

month and is intended to cover the civilian incidence of traumatic injuries. Since 

SGLI extra hazard and TSGLI payments depend completely upon hostile military 

action, Insurance Service only projects for these types of payments early in the year 

of execution. 

Please note that extra hazard payments and TSGLI payments are collected from 

DOD and then transferred to Prudential. Therefore these payments are both an obligation and a collection and as a result do not impact net outlays. 

302 

b. The fiscal year 2013 budget request includes an estimate that VA insurance 

will collect $188 million in ‘‘other collections’’ during fiscal year 2013. Please detail 

what other collections are included in this line item. 

Response. The majority of ‘‘other collections’’ includes $90.3 million of repayments 

of policyholder’s loans and liens, $8.8 million of interest earned on loans, and $87.8 

million of income offsets and adjustments in the U. S. Government Life Insurance 

(USGLI) and National Service Life Insurance (NSLI) programs. The majority of the 

income offsets and adjustments is attributed to NSLI premiums received from noncash sources such as deductions from dividends for paid-up additional insurance 

premiums. 

READJUSTMENT BENEFITS

Vocational Rehabilitation and Employment 

Question 1. According to the fiscal year 2013 budget request, the Vocational Rehabilitation and Employment (VR&E) program and the VA Loan Guaranty Service 

have established a task force to improve coordination of the delivery of Specially 

Adapted Housing to veterans. 

a. Please describe what agreements or other protocols the two services have developed as a result of the task force. 

Response. VR&E and Loan Guaranty Services are in the process of developing a 

directive that outlines their continued commitment to provide and coordinate home 

modifications for Veterans with severe disabilities. 

b. How will VA measure the effectiveness of the task force and the coordination 

between agencies? 

Response. Effectiveness will be measured by the number of referrals and requests 

for services from Loan Guaranty, the number of coordinated cases, time required to 

provide services, and the satisfaction level of Veterans served. 

Question 2. VR&E’s VetSuccess.gov Web site currently partners with DOD and 

DOL on veterans’ employment issues. Additionally, VetSuccess.gov contains a link 

to the National Resource Directory with the goal of assisting veterans to find jobs. 

a. Aside from the links and partnerships described above, has VR&E explored any 

private sector solutions or web based capabilities that assist veterans with finding 

employment? 

Response. VR&E works with the Direct Employers Association and the National 

Association of State Workforce Agencies to provide Veterans access to the Job Central database with over eight million job openings listed in Fortune 500 companies 

and state workforce organizations. VR&E is also working with VA’s Veteran Employment Service to integrate VetSuccess.gov with VAforVets. This integration will 

allow VetSuccess.gov to leverage the existing VAforVets’ career planning and management tools for Veterans. Using funds requested in the FY 2013 Budget, these 

tools will be further enhanced and expanded on VetSuccess.gov to fit private industry employment needs. VR&E also provides direct links on VetSuccess.gov to a number of other private sector job boards to assist Veterans with finding employment. 

These include: Jobs For Vets, VetJobs, Monster.com, Simply Hired, Indeed, and 

JobAlot. 

b. Are employers looking to hire veterans able to post job listings to the National 

Resource Directory or VetSuccess.gov? 

Response. Employers can directly post job listings on VetSuccess.gov and search 

for Veterans’ resumes that are a match for their staffing needs. While the Veterans 

Job Bank (hosted on the National Resource Directory) does not allow employers to 

directly post jobs, the site does identify jobs labeled as ‘‘Veteran Committed’’ by employers, and makes these job postings accessible for Veterans using the Veterans 

Job Bank. 

Question 3. The fiscal year 2013 budget request for VR&E requests an additional 

145 direct FTE. 

a. Please describe how VR&E determined the necessity of the additional FTE. 

Response. The additional FTE was determined to be essential in increasing 

VR&E’s focus on accessible counseling, outreach, and transition services to Veterans 

and Servicemembers. FTE will be devoted to the VetSuccess on Campus (VSOC) and 

Integrated Disability Evaluation System (IDES) initiatives. In FY 2013, 90 FTE will 

support the IDES initiative at 27 IDES sites, while 52 FTE will be utilized to expand VSOC to 23 additional sites, and 3 FTE will be utilized for management support, training, and oversight of these two programs. 

b. What is the current rehabilitation counselor to trainee ratio for VR&E? 

Response. As of February 2012, the ratio is 1:140. 

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c. What are VR&E projections of the rehabilitation counselor to trainee ratio for 

the next three years? 

Response. For the next three years, VR&E is projecting a counselor to Veteran 

ratio of approximately 1:125. 

Question 4. In 2011, there were 83,332 participants in the VR&E program. That 

number is expected to increase to 91,874 by 2013. What are the long-term projections for participation and average degree of disability for future VR&E participants? 

Response. VR&E is currently projecting a 10 percent increase after 2013 for trainees participating in the VR&E program through the completion of DOD’s drawdown. 

VR&E serves Veterans with various physical and psychiatric disabilities ranging 

from 10% to 100%. The severity and degree of disabilities that Veterans acquire cannot be accurately projected; however, the bulk of Veterans served by VR&E, have 

disabilities ratings between 30%–60%. This is not anticipated to change. 

Question 5. For fiscal year 2013, VA requests an additional $5.9 million and 52 

FTE for the expansion of VetSuccess on Campus. The expansion will add VetSuccess 

at 52 additional campuses serving an estimated 80,000 servicemembers, veterans, 

and family members. 

a. Of the 28 campuses where VetSuccess is currently located, what percentage of 

eligible students take advantage of the program? 

Response. In fiscal year 2011, VetSuccess on Campus was located at eight sites, 

and counselors served 5,897 Veterans. This represents 77% of the 7,662 eligible students at the eight sites. In fiscal year 2012, VetSuccess is being expanded to an additional 24 sites, bringing the total number of sites to 32. As of May, 2012, 

VetSuccess on Campus is located at 14 sites although six of those sites have been 

operational for up to two months. Thus far this fiscal year, 2,981 eligible students 

have taken advantage of the VetSuccess on Campus program. When factoring in return visits, VetSuccess on Campus Counselors provided services to 5,362 eligible 

students in fiscal year 2012 through the end of May. The number of eligible students served this fiscal year represents 55% of the 9,731 eligible students. 

b. Please describe the process of selecting and opening a new VetSuccess on Campus site. 

Response. The selection process focuses primarily on colleges with student Veteran enrollment greater than 800, but the process remains flexible with consideration of other factors. Collaboration with VHA’s Vet program is also a factor in determining expansion locations. Additional criteria that are used to select perspective 

schools include: 

• Willingness and ability to accommodate a full-time Vocational Rehabilitation 

Counselor and a full or part-time VHA employee (Vet Center or VITAL); and 

• Location within 25 miles of a VA regional office, VR&E outbased office, Vet 

Center, VA Medical Center, or Community Based Outpatient Clinic. 

Once schools are identified, memorandums of understanding are drafted and 

signed by school officials and regional office directors. The locally designated VA regional office coordinates office set-up, information technology, and other support at 

the campus. 

Question 6. Rehabilitation services provided to veterans in VR&E include five separate tracks: reemployment with previous employer, rapid access to employment, 

self-employment, employment through long-term services, and independent living 

services. 

a. Please provide the number of VR&E participants in each rehabilitation track. 

Response. Please see the chart below for the number of participants by track as 

of February 29, 2012. This number is dynamic and changes daily. Track selection 

became a mandatory data entry field in VR&E’s case management system on July 1, 

2012, and as such, this chart does not represent the total participants in the VR&E 

program. 

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Re-Employment with Previous Employer Rapid Access to Employ- ment Self-Employment Employment Through Long- Term Services Independent Living Serv- ices No Track Identified Total 

428 2,260 231 58,774 2,731 5,346 69,770 

0.6% 3.2% 0.3% 84.2% 3.9% 7.7% 100% 

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b. What type of rehabilitation training and resources do trainees participating in 

the self-employment track receive while in VR&E? 

Response. VA may furnish services and assistance to Veterans with an approved 

self-employment rehabilitation goal based on assignment to one of two categories: 

Category 1: 

• Comprehensive training, incidental services such as business license fees • Minimum stocks of materials, such as inventory of salable merchandise or 

goods, expendable items required for daily operations, and items which are consumed on the premises • Essential equipment, including machinery, occupational fixtures, accessories, 

and appliances 

Category 2: 

• Incidental training in the management of a small business 

• License or other fees required for employment and self-employment 

• Personal tools and supplies, which the Veteran would ordinarily require to 

begin employment 

c. How does VR&E measure rehabilitation for those participating in the self-employment track? 

Response. Veterans are declared rehabilitated when they have successfully completed the self-employment program and the business has been operating and generating viable income for at least 12 months. 

Question 7. The VA budget for fiscal year 2013 requests $23.9 million and a total 

of 200 FTE to support the expansion of IDES to include VR&E services. 

a. Please describe in detail how the expansion will be administered. Please include information on which IDES sites will have VR&E counselors, at what point 

during the IDES process the mandatory counseling services will occur, whether 

counseling will commence prior to the issuance of a disability rating, and whether 

servicemembers will receive counseling prior to receiving a determination of an employment handicap. 

Response. VBA is expanding IDES to 110 sites in FY 2012, and 90 sites in FY 

2013. Installations have not yet been identified for the expansion in FY 2013, but 

will meet the following criteria: 

• Have a population of exiting Servicemembers who are referred to the Physical 

Evaluation Board (PEB) that is greater than 100 per year; and 

• Have the ability to accommodate one or more full-time vocational rehabilitation 

counselors (VRCs) onsite. 

Servicemembers referred to the IDES sites will be referred to the VRCs for a 

mandatory counseling appointment when notified they are being referred to the 

PEB. Counseling will occur prior to determination of an employment handicap or 

disability rating. 

The FY 2012 budget supports 110 FTE for the implementation of VR&E into the 

IDES process. This initiative will require the recruitment and hiring of 89 and the 

reassignment of 21 Vocational Rehabilitation Counselors by VA, and the allocation 

of office space at IDES installations by the Department of Defense. 

This FTE will allow VR&E to serve approximately 12,000 (25%) of the anticipated 

48,000 IDES participants in FY 2012. The base year of this initiative will provide 

data that will inform decisions related to future resource allocation. The chart below 

depicts the initial allocation of counselors at 48 IDES installations in FY 2012. 

Military Installation Medical Board 

Projection 

VRCs 

Needed 

Nellis AFB ...................................... 140 1 

Ft. Campbell .................................. 751 3 

San Diego NMC .............................. 1105 6 

Bethesda NNMC ............................. 256 2 

Ft. Meade ....................................... 245 2 

Walter Reed NMMC ........................ 245 2 

Patuxent River NMC ....................... 192 1 

Andrews AFB .................................. 132 1 

Ft. Drum ......................................... 635 3 

Ft. Gordon ...................................... 1258 7 

Ft. Stewart ..................................... 666 3 

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Military Installation Medical Board 

Projection 

VRCs 

Needed 

Ft. Benning .................................... 421 2 

Robins AFB .................................... 133 1 

Beaufort NH ................................... 152 1 

Ft. Jackson ..................................... 128 1 

Portsmouth NMC ............................ 682 3 

Ft. Eustis ....................................... 450 2 

Quantico NHC ................................ 180 1 

Ft. Lee ............................................ 152 1 

Langley JB ...................................... 167 1 

Ft. Belvoir ...................................... 134 1 

Jacksonville NH .............................. 259 2 

Pensacola NH ................................. 104 1 

Camp Lejeune ................................ 1135 6 

Ft. Bragg ........................................ 884 4 

Seymore-Johnson AFB .................... 115 1 

Cherry Point NH ............................. 181 1 

Great Lakes FHCC .......................... 172 1 

Minot AFB ...................................... 100 1 

Ft. Sam Houston ............................ 575 3 

Ft. Sill ............................................ 408 2 

Sheppard AFB ................................ 108 1 

Ft. Polk ........................................... 646 3 

Ft. Leonard Wood ........................... 520 2 

Ft. Bliss ......................................... 820 3 

Ft. Hood ......................................... 1957 9 

Ft. Riley .......................................... 936 4 

Richardson JB ................................ 188 1 

Ft. Wainwright ............................... 150 1 

Ft. Carson ...................................... 909 4 

Hawaii NHC .................................... 253 2 

Tripler AMC .................................... 497 2 

Camp Pendleton ............................ 390 2 

29 Palms NH ................................. 101 1 

Travis AFB ...................................... 145 1 

Ft. Huachuca ................................. 120 1 

Ft. Lewis ........................................ 1060 5 

Bremerton NH ................................ 115 1 

b. Of the requested $23.9 million in fiscal year 2013, $5.7 million is listed as nonpay. What expenses or services are covered by this line item? 

Response. The $5.7 million in non-pay consists of administrative expenses to support the implementation of the additional 90 IDES counselors requested for FY 

2013. These administrative expenses cover items such as employee travel, training, 

office equipment, and supplies. 

Veterans Retraining Assistance Program 

Question 1. The Veterans Retraining Assistance Program (VRAP) was established 

by section 211 of the VOW to Hire Heroes Act (Public Law 112–56). Participating 

veterans will receive the Montgomery GI Bill-Active Duty full-time benefit rate for 

up to 12 months. Up to 45,000 veterans, ages 35 to 60, may participate in the program during fiscal year 2012 and an additional 54,000 veterans are eligible between 

October 1, 2012, and March 31, 2014. 

a. What are the expected FTE requirements for processing of VRAP claims for fiscal years 2012 through 2014? Please detail that information by fiscal year and type 

of FTE. 

Response. The temporary staffing increase for claims examiners for the processing 

of VRAP claims equates to 85 FTE in 2012 and 90 FTE in 2013. Expected FTE for 

FY 2014 are not yet finalized. 

307 

b. Given the number of expected FTE in fiscal year 2012 (2,030) and the number 

of FTE requested for fiscal year 2013 (1,849), what assumptions were relied on to 

determine that implementation of VRAP will not require VA to hire or retain more 

temporary or full-time staff during fiscal years 2012 through 2013 beyond the levels 

identified in the budget request? 

VBA Response. To estimate the FTE levels required to implement VRAP, VA assumed that claims for eligibility would exceed those that are actually paid under 

VRAP. We estimated that 65 percent of all claims would be received in the first 90 

days of the program. The expected FTE levels were based on current claims processing timeliness, the necessary FTE to support claims processing, and the anticipated initial surge of VRAP claims. 

Question 2. The Post-9/11 Veterans Educational Assistance Improvements Act 

(Public Law 111–377) eliminated interval pay for VA education programs, including 

the Post-9/11 GI Bill and Montgomery GI Bill. 

a. Will veterans participating in VRAP be subject to similar interval pay restrictions? 

VBA Response. Veterans participating in VRAP will be subject to the same interval pay restrictions as individuals training under other VA education programs, 

such as the Montgomery GI Bill and the Post-9/11 GI Bill. 

b. For veterans enrolled in an eligible institution, under VRAP, how will customary breaks (holiday or end of term) affect monthly payments? 

VBA Response. Similar to the other VA education programs, Veterans training 

under VRAP will receive payment for customary breaks or holidays of less than 

seven days within a term. Payments will terminate at the end of each term. 

Veterans Job Corps 

Question 1. President Obama proposed the Veterans Job Corps during the State 

of the Union. The White House Press Office stated that the program would put 

20,000 veterans back to work with jobs at national parks and through other related 

Federal conservation projects. A request of $1 billion for the new program was made 

part of the fiscal year 2013 VA budget request. 

a. Describe in detail how the initiative would be administered. Please include information on which other agencies would participate, what the responsibilities 

would be of the non-VA agencies, what types of jobs are envisioned through the initiative, and what criteria would be used to select participating veterans. 

b. Please describe the program in detail, including the amount of payments, subsidies, and benefits veterans would receive through this program; how much it 

would cost per participant; what opportunities veterans would have to continue 

working for the Federal agency after completing the program; and how much of the 

overall programmatic cost would go toward administration. 

c. How did VA develop the estimate of $1 billion for the Veterans Job Corps? 

What offsets within VA programs does VA propose to fund this new program? If VA 

funding is not going to be proposed by the Administration, what other offsets does 

VA propose to pay for the new program? 

Response. [Items a–c appeared and were answered in the prehearing responses.] 

d. What are the expected staffing requirements to administer this program? 

Response. Details of the Program will be finalized as part of the ongoing discussion between the Administration and Congress; however, the Veterans Job Corps 

initiative would likely require minimal VA staff resources. 

e. How will veterans who are interested in participating be selected? How long 

would it take for the program to be operational and when would the first veterans 

begin to work under this program? 

Response. Operational details regarding the Veterans Job Corps initiative will be 

finalized as part of the ongoing discussion between the Administration and Congress. Initial plans call for VA to leverage existing online resources to coordinate 

and synchronize efforts across stakeholders and to match veterans with opportunities. 

Question 2. The Veterans Job Corps, although not detailed in the fiscal year 2013 

VA budget request, was included as a line item in the request under the Veterans 

Employment and Infrastructure Enhancement Transfer Fund. I understand that VA 

will transfer money, from this line item, to other departments and agencies that 

participate in the program. How would VA distribute funds out of the Veterans Employment and Infrastructure Enhancement Transfer Fund? Would VA make direct 

transfers to other government agencies or would VA process individual applications 

independently? 

Response. Operational details regarding the Veterans Job Corps initiative will be 

finalized as part of the ongoing discussion between the Administration and ConVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00313 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
308 

gress. Initial plans call for project proposals to be submitted by the Department of 

Agriculture, the Department of Interior, the National Oceanic and Atmospheric Administration (NOAA) at Commerce, the Army Corps of Engineers, and the National 

Cemetery Administration at VA, in conjunction with state and local agencies and 

with the public and other stakeholders. VA, in consultation with a Federal Steering 

Committee composed of policy officials representing implementing Federal agencies, 

will select projects for funding based on selected criteria. The projects will be implemented through contracts to businesses, cooperative agreements and grants to nonFederal entities, and by directly hiring a small number of Veterans for positions. 

Question 3. The mission of the Department of Labor Veterans’ Employment and 

Training Service is to provide ‘‘resources and expertise to assist and prepare [veterans] to obtain meaningful careers * * *.’’ Why has VA been tasked with overseeing the Veterans Job Corps and not the Veterans’ Employment and Training 

Service? 

Response. VA and the Department of Labor share a strong interest in working 

together to assist Veterans secure employment and work collaboratively on a number of initiatives in this area. 

Education 

Question 1. According to the fiscal year 2013 budget request, VA now expects to spend $12.2 million on reporting fees during fiscal year 2012, which is 96% higher 

than the amount VA originally expected to spend ($6.2 million). The budget request 

indicates that there is ‘‘a $6 million increase in reporting fees due to legislative 

changes under [Public Law] 111–377, which increased the reporting fee multipliers 

from $7 to $12 and $11 to $15.’’ 

a. Please explain the assumptions or calculations that led to the expectation that 

the increases in reporting fees would nearly double the amount being spent during 

fiscal year 2012. Response. There were two factors that, when combined, explain the $6 million increase in FY 2012 reporting fees from the FY 2012 budget request to the current 

estimate. First, based on FY 2011 actual data, the total trainees for whom reporting 

fees would be paid increased from 816,628 to 979,084. The programs which saw the 

largest projected increase based on FY 2011 data were chapter 33 (81,738) and 

chapter 30 (28,325). Additionally, the Veterans Retraining Assistance Program, established by section 211 of the VOW to Hire Heroes Act (Title II of Public Law 112– 

56), added 45,000 trainees for FY 2012. In total, the increase in estimated trainees 

resulted in an increase in obligations of over $1.2 million in reporting fees. Additionally, Pub. L. 111–377 increased the reporting fee multipliers from $7 to $12 and $11 to $15. Under the old multipliers, the average fee was historically 

around $7.60. The same distribution of fees translates to a $12.45 average under 

the new multipliers, a 64% increase. When applied to the increased number of trainees for the current estimate, a 64% increase in reporting fees results in an additional $4.8 million in obligations. 

b. For fiscal year 2011, how many institutions received reporting fees from VA? 

Response. The reporting fee information for calendar year 2011 is not currently 

available. 

c. Please identify the 10 largest payments made to an institution and the 10 

smallest payments made to an institution. 

Response. The reporting fee information for calendar year 2011 is not currently 

available. 

d. For fiscal year 2013, how many institutions are expected to receive reporting 

fees from VA? 

Response. Reporting fees are projected based on the number of trainees receiving 

education benefits in a given year. VA does not project the number of institutions 

expected to receive reporting fees in future years. 

Question 2. In the fiscal year 2013 budget request, VA proposed legislation ‘‘to increase funding available to provide contract vocational and educational counseling’’ 

to certain veterans or members of the Armed Forces. 

a. In fiscal year 2011, 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. VR&E provides educational and vocational counseling services under 

Chapter 36 to eligible Servicemembers and Veterans. This counseling is provided by 

VR&E counselors nationwide and through contracts VA has awarded to provide 

counseling services under both Chapter 31 and Chapter 36. VR&E obligated $3.5 

million for contracted services under Chapter 36 in FY 2011 and $3.6 million in FY 

2010. This number was uncharacteristically low due to the fact that VR&E was 

309 

transitioning to new contracts which were awarded late in the fiscal year. By comparison, $5.4 million was obligated in FY 2009 for contracted services under Chapter 36. VR&E is unable to obtain data regarding the total number of individuals 

who sought and received counseling under Chapter 36 in FY 2011 due to a problem 

with the corporate database. The issue with the database has been identified, and 

VR&E is working on correcting the problem to ensure that this important data is 

available in the future. 

b. In fiscal year 2012, 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. The current cap on Chapter 36 contracted services is $6 million for FY 

2012, which will enable VR&E to fund contracted counseling for approximately 

12,000 Servicemembers or Veterans. Due to the drawdown and the current job market, there may be a bigger demand for Chapter 36 counseling. If the budget allocation for contracted services exceeds this demand, the gap would be filled by VR&E 

counselors providing these services directly. In FY 2010, 6,501 Veterans completed 

Chapter 36 counseling. 

c. In FY 2013, how many individuals are expected to seek this type of counseling? 

Response. VR&E anticipates the need for additional funding in FY 2013; however, 

the current legislative limit for FY 2013 is $6 million Please note that VA has submitted a legislative proposal as part of the FY 2013 budget that would increase 

funding available to provide contract vocational and educational counseling to not 

more than $7 million in any fiscal year. The increase from FY 2012 is based on providing an additional 2,000 or more vocational assessments to exiting Servicemembers at IDES sites and/or referred by DOD as seriously disabled. Increased 

funding for this type of counseling will enable Servicemembers to engage in vocational rehabilitation services, including entering training and education programs, 

as soon as practical. 

Question 3. According to the summary of readjustment benefits in the fiscal year 

2013 budget request, a reimbursement of $530,000 to General Operating Expenses 

and Information Technology was originally expected during fiscal year 2012 and 

now a $4.9 million reimbursement is expected. Please describe how those funds are 

expected to be used during fiscal year 2012. 

Response. There are three contributing factors to the increase of reimbursements 

to General Operating Expenses and Information Technology for FY 2012. 

• An increase of $2.0 million associated with the Veterans Retraining Assistance 

Program, as established by section 211 of the VOW to Hire Heroes Act of 2011 (Title 

II of Public Law 112–56), for information technology costs associated with the administration of this program. 

• An increase of $2.1 million authorized under Public Law 108–454 for the transfer of funds to reimburse for costs associated with implementing on-the-job training 

provisions to the Information Technology appropriation. 

• An increase of $0.2 million authorized under Public Law 106–419 for the transfer of funds to reimburse for costs associated with system changes to implement new 

provisions related to licensing and certification to the Information Technology appropriation. 

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VA hosts and participates in hiring fairs for Veterans to find both private and public sector jobs. 

On January 18, VA held a career fair in Washington, D.C. Over 4,100 Veterans attended; 

2,600 Veterans participated in interviews with public and private employers, and more than 

500 Veterans received tentative job offers. VA is hosting a multi-state hiring fair in Detroit, 

Michigan which starts on June 26,2012. It will be held in conjunction with VA's National 

Veterans Small Business Conference which focuses on helping Veteran-owned businesses 

maximize opportunities in the federal marketplace. VA continues to partner with private sector 

companies and is participating in the U.S. Chamber of Commerce's "Hiring Our Heroes" job 

fairs. 

VA has reached out to the leadership of the Employer Partnership of the Armed Forces to 

learn more about their program. As appropriate, VA will continue to reach out to other federal 

agencies that have programs aimed at improving Veterans' employment to determine if there 

are any lessons learned that can be shared. 

Question 3: Secretary Hickey, Alaskan veterans are required to use the toll free number (1-

800-827-1000) for VA benefits. They are never able to speak to a person on the other end of 

this line. Some report being able to schedule an appointment through the phone system, 

however some report being called back 4 hours earlier than scheduled (due to 4 hour time 

difference between east coast and Alaska) while others are never called back at all. Other 

veterans are not able to set up an appointment and instead have to leave their information on 

an answering machine. They are informed that they will get a call back within 5-7 days. Most 

report never getting a call back. The Veterans Services Organizations are swamped with 

veterans who could otherwise take care of their own needs if their phone calls were returned. 

Can we please look into a more effective way for Alaska Veteran's to request their benefits? 

Response: As part of VA's quality control process, the Virtual Hold system is consistently 

monitored, and all caller feedback is carefully reviewed. The "Virtual Hold" telephone 

appointment system allows callers to schedule a return call during non-business hours and 

peak call times. This provides a choice to the caller. In order to receive a return call, callers are 

asked to provide their name and telephone number. Currently, the system does not aliON 

callers to leave messages. All return calls are scheduled using Eastern Time. Callers in the 

Alaska Time Zone may schedule calls with the National Call Centers from 4 am to 5 pm local 

time. 

Our current monitoring reflects that the system is functioning correctly at this time. Based on 

previous feedback, several enhancements were recently made to the system to provide better 

service to Veterans. The messages played to callers were modified and enhanced to notify 

callers that appointments are scheduled using Eastern Time. Additionally, the system was 

modified so that all calls are returned within an average of 48 hours, versus the initial sevenday appointment window. The system currently achieves a successful re-connect rate of 77 

percent and makes three attempts for the return call. 

To better notify Veterans and beneficiaries of the telephone appointment system, VBA is 

providing information through our call agents and social media sites. Inquiries can also be 

submitted through secure e-mail. Additionally, answers to frequently asked general and claimspecific questions can be found on the eBenefits self-service portal. (www.ebenefits.va.gov/). 

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measurement tools exist to accurately determine caseloads. This is a labor intensive task that 

requires tool development and testing, along with validity and reliability assessments. 

Since the issuance of the GAO report, FRCP developed and instituted the use of a workload 

intenSity tool. This tool is currently used to assess all new referrals to the program. The tool is 

based on the professional judgment of experienced FRCs, review and evaluation of similar 

management tools, and detailed work activity and client logs maintained by FRCs in the past. 

The results yielded from the intensity tool, currently used in enrollment decisions, will be 

analyzed and used to further refine the tool so that it may be used to balance and measure 

client workload (Phase 2). 

Recommendation 3: clearly define and document the FRCP's decision-making process for 

determining when and how many FRCs VA should hire to ensure that subsequent FRCP 

leadership can understand the methods currently used to make hiring decisions. 

VA concurred with GAO recommendation. FRCP has documented the current process used 

for staffing decisions. The current process considers the anticipated referrals, enrollment 

projections, expected attrition, and target caseload in determining the need for additional 

FRCs. The current process will be revised when Phase 2 of the intensity measurement tool is 

in place. Staffing processes and plans are reviewed annually and updated as needed. 

Recommendation 4: develop and document a clear rationale for the placement of FRCs, 

which should include a systematic analysis of data, such as referral locations, to ensure that 

future FRC placement decisions are strategic in providing maximum benefit for the program's 

population. 

VA concurred with the GAO recommendation. FRCP will develop a FRC placement strategy 

based upon a systematic analysis of data as well as discussions with DOD and SOC 

stakeholders. The established process IMII be documented and updated annually in the FRCP 

business operation planning document. 

Question 1a: How much of the proposed VA budget will be dedicated to this program? Are 

there any plans to expand or cut back this program? 

Response: FRCP is funded through the Veterans Health Administration and is not a separate 

line item. In FY 2012, FRCP is funded at $6.2 million. There are no plans at this time to 

expand or cut back this program. Any changes to program scope or function would be 

considered in the context of other benefits and services provided to wounded, ill, and injured 

Service members and Veterans. 

Question 2: There were some issues surrounding the perception that wounded service 

members seen by an FRC would be automatically switched to veteran status because the FRC 

is a VA employee. As I expressed to Sec. Shinseki, I think the FRC is a good program that 

has potential to address the care of service members and veterans. What has been done 

within this program to address this stigma, so that an FRC is seen as an effective coordinator 

of care and not as someone that could end a military career? 

Response: FRCP has continued its outreach and education to dispel the perception that the 

assignment of an FRC is synonymous with the end of a military career. FRCP has partnered 

with the Services and wounded warrior programs to get the message out. Additionally, 

working with VA and DOD case managers and care coordinators to reinforce the FRC role has 

assisted in getting the message out to the target audience. At every opportunity, FRCP 

leadership and FRCs attend conferences, trainings, and briefings to increase program 

awareness and understanding. 

Question 3: I am informed that you recently determined that VA coverage of an FDA approved 

prostate cancer treatment, Provenge, will only be allowed on a non-formulary basis. Access to 

a prescription drug that is non-formulary requires veterans to go outside of the VA, a process 

which takes at least 6 months to navigate. Do you believe that such a wait and bureaucratic 

obstacles to treatment for a veteran with metastatic prostate cancer is acceptable? 

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Response: Sipuleucel-T (Provenge) is an autologous immune therapy that is manufactured by 

collecting immune cells from the blood of a patient, mixing those removed immune cells with a 

complex mixture at the manufacturer's laboratory, and administering the final product to the 

patient intravenously. When first approved by the FDA there was restricted access to this 

process because of the complexity and limited abilities of the manufacturing process. 

Manufacturing abilities were expanded in May 2011. VA has been meeting with the 

manufacturer to determine the best way to make this process available to Veterans since it 

requires training at each medical site, coordination of blood cell collections outside of VA, and 

shipping and receiving issues of the final product. There are concerns in the medical 

community about the design of a part of the pivotal trial that found a 4.1 month survival 

advantage over placebo. VA has proposed making this available through Coverage with 

Evidence Development (CEO), using a VA clinical trial similar to other CEO efforts by CMS. 

Currently, VA has Criteria for Use for Sipuleucel-T which were finalized in April 2012. 

A drug that is non-formulary does not require Veterans to go outside of VA. It is important to 

note that VA's "non-formulary with Criteria for Use" status is nearly identical to "formulary with 

prior authorization" status widely used in other health plans. As shown in the table below, 

other major health plans vary in coverage of Sipuleucel-T with all having this drug in either 

"non-formulary", "not covered", or "non-preferred" status, with or without prior authorization. 

Formulary Positions for Sipuleucel-T 

DOD Kaiser 

Dept. Of Uniform Permanente - United BC/BS 

Drug Name Veterans Affairs Formulary DOD Basic Core California Humana* Healthcare* Illinois" 

Sipuleucel Non-

(Provenge®) Non-formulary formulary Non-formulary Non-formulary NC/PA,QL Tier 3 Tier 3 

*Tler ClasSifications 

Tier 2 - This drug is available at a mid-level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs 

Tier 3 - This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs 

NC - Not Covered- Drugs that are not covered by the plan 

PA - Prior Authorization required 

QL - Quantity Limit- The quantity covered is restricted 

Question 4: Veterans as a group are one of the highest at-risk groups for developing prostate 

cancer, especially those exposed to Agent Orange. Access to appropriate and sound cancer 

treatment needs to be ensured. I'm concerned that budget limitations may be impacting the 

care that Veterans are receiving. Are budget restrictions impacting access to quality cancer 

treatment? 

Response: VA is committed to ensuring that Veterans in need are provided high quality 

cancer care. A recent study of VA's cancer program found that the quality of cancer care in 

VA is "generally similar to or better than care for fee-for-service Medicare beneficiaries" 

(Keating NL et al. Ann Intern Med. 2011; 154:727-736). The analysis further found that the 

"survival rate for older men with cancer in the VHA was better than or equivalent to the survival 

rate for similar FFS-Medicare beneficiaries" (Landrum MB et al. J Clin Oncol 2012; doi: 

10.1200/JCO.2011.39.5525). Thus, there is an objective basis on which to state that the 

quality of cancer care in VA during the study period is at least as good as Medicare. 

In the past three years, FDA approval of new anti-cancer treatments has quickened. Most of 

these newly approved anti-cancer treatments have resulted in significant increases in the cost 

of cancer care, with attendant increased scrutiny and review of the use of expensive anticancer drugs in general. As new treatments continue to be approved at an increasing rate, 

there may be increased financial pressures on VA. 

Question 5: Follow up: I've heard multiple examples of new therapies for prostate cancer not 

being added to the national formulary and instead being set up as non-formulary, which seems 

to be done with the intent to restrict access. If budget restrictions are not impacting access, 

why wouldn't new FDA-approved drugs to treat cancer be available to all the veterans in the 

VA system who qualify under the labeled indication? 

Response: The other new drugs for metastatic prostate cancer are cabazitaxel (Jevtana) and 

abiraterone (Zytiga). Both were approved for use following the failure of multiple other 

therapies. For example, most Veterans with prostate cancer will first receive surgery or 

radiation therapy. When the disease progresses, they will be started on hormone therapy. If 

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the disease progresses again, they will receive a standard chemotherapy drug. If the disease 

continues to progress, then either cabazitaxel or abiraterone are appropriate. There are 

adverse reactions to each of these therapies that require careful monitoring and may be 

complicated by other diseases commonly seen in Veterans. VA is currently developing Criteria 

for Use of both of these agents to help identify patients most likely to benefit from therapy and 

to assist in monitoring for toxicities. The cost of these therapies is approximately $3,800 to 

$5,900 per month. 

It is important to note that VA's "non-formulary with Criteria for Use" status is nearly identical to 

"formulary with prior authorization" status widely used in other health plans. As shown in the 

table below, other major health plans vary in coverage with all having these drugs in either 

"non-formulary", "not covered", or "non-preferred" status, with or without prior authorization. 

Formulary Positions for Selected Oncology Drugs 

Dept. Of Kaiser 

Veterans DOD Uniform DOD Basic Permanente - United BetBS 

Drug Name Affairs Formulary Core California Humana* Healthcare* lIIinois* 

Abiraterone Non- Non- Tier 3 

(Zytiga®) formulary Formulary formularv Formulary IPA.OL Tier 3 Tier 2/QL 

Cabazitaxel Non- Non- Non-

(Jevtana®) formulary formulary formulary Formulary Unknown Unknown Unknown 

Tier ClasSifications 

Tier 2 - This drug is available at a mid-level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs 

Tier 3 - This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs 

NC - Not Covered- Drugs that are not covered by the plan 

PA - Prior Authorization required 

QL - Quantity Limit- The quantity covered is restricted 

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Response: Extended wait times are not acceptable customer service, and VA monitors and 

tracks average wait times daily for every call center. When wait times exceed three minutes, 

VA offers callers the capability to hold their place in line and receive a call back, rather than 

holding on the phone. This service enhancement has increased customer satisfaction. 

"Promptness in speaking to an agent" improved 4 percent on our customer satisfaction survey 

with a 10 point scale, from a score of 5.4 in November to 5.6 in February. Additionally, the 

Overall Satisfaction Index score increased 20 points, or 3 percent, from 720 in November to 

740 in February. The Overall Satisfaction Index is scored on a scale up to 1000 points. 

Tax Increase for Veterans: 

Question 3: On a month to month basis, veterans are seeing an increase in their TRICARE 

medical premiums. Concurrently, they have seen their Federal Withholding increase on their 

monthly benefits. These changes occurred due to the expiration of a veterans' tax credit that 

expired at the end of 201 O. Veterans did not receive an explanation for these changes on their 

benefit statements. You have received nearly 100 letters and phone calls from constituents on 

this issue. 

• Mr. Secretary, beginning this past January, I have received numerous letters and phone 

calls from veterans in Mississippi seeking an explanation for increased TRICARE medical 

premiums as well as an increase in their Federal tax with holdings on their monthly 

statements. 

The VA did not provide an adequate explanation for these changes on the monthly 

customer statements. I understand these increases were due to the expiration of a 

veterans' tax credit last year. What initiatives wi II the VA undertake in the future to ensure 

our veterans are informed in a timely manner about changes in their statements in plain 

English? 

Response: VA benefits are tax-exempt, so those levels have not changed. When VA benefit 

levels are altered, VA makes every effort to notify veterans via direct mail, internet outreach, 

etc. For example, in December 2011, Veterans received a cost-of-living adjustment for the first 

time in two years. VA posted this information on its Internet web pages and through the joint 

VA/DOD eBenefits portal. In addition, VA uses its Internet and social media sites to inform and 

educate Veterans and their families on changes to benefit levels. VA defers to the Department 

of Defense on what effect, if any, tax adjustments have on the TRICARE program and what 

are the different forms of outreach to beneficiaries. 

VA Claims Backlog: 

Question 4 In the January 30 Washington Post stated that "the number of pending claims 

before the VA stood at 853,831 on Friday, an increase of nearly 100,000 from last year and 

nearly 500,000 from three years ago." The previous goal of the VA has been to end the 

backlog by 2015. While this backlog has grown, the budget for the Veterans Benefits 

Administration reached $2 billion in 2012, a 20 percent increase over the previous year, which 

the VA says will accelerate services for veterans. 

• Are veteran's receiving timely and appropriate care following submission of their claims? 

Response: VA is committed to making dramatic improvements in the processing of Veterans' 

disability claims, and we continue our aggressive efforts to expedite the delivery of benefits. 

Our transformation initiatives are focused on ensuring Veterans receive the information and 

assistance needed to help them throughout the claims process and that they are provided with 

timely and accurate decisions. There is still much work to be done to ensure that all Veterans 

receive the level of timely and quality service they have earned and deserve. VA's 

transformation plan integrates people, process, and technology initiatives in an aggressive 

strategy to meet our 2015 goal of processing all disability claims in less than 125 days with 98 

percent accuracy. VBMS' funding request is $128 million for FY 2013. This funding is critical to 

our transformation strategy. However, the magnitude and complexity of the changes needed 

are not easily accomplished and will take until 2015 to fully achieve. 

VBA completed an unprecedented number of disability claims (over 1 million claims) in each of 

the last 2 years with the additional employees, advanced technologies, and training supported 

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by the budgetary increases we received. However, the volume of incoming claims has grown 

at an even faster pace. VBA's annual incoming claims volume over the last ten years has 

nearly doubled. This growth is driven by a number of factors, including our extensive outreach 

efforts; improved access to benefits through the joint VA and Department of Defense PreDischarge programs; Agent Orange presumptive disabilities for Veterans who served in the 

Republic of Vietnam; increased demand as a result of ten years at war; the aging of our 

Veteran population; new regulations for processing certain claims related to Gulf War service, 

traumatic brain injuries, and post traumatic stress disorder; and the impact of a difficult 

economy. VA's 2012 budget provides essential resources to support our integrated approach 

to transformation that will bring the fundamental and dramatic improvements in claims 

processing so urgently needed. VBA expects quality and production levels to continue to 

increase each year through 2015 and beyond as a result of the transformational process 

changes and technological advances. Our FY 2013 budget request is critical to reaching our 

goal of eliminating the backlog and achieving 98 percent accuracy in 2015. 

Question 4b: Noting this shortfall, do you think the VA can clear the backlog of claims by 2015 

as claimed? 

Response: We are confident we are on the right path and making the investments necessary 

to transform VA to meet the needs of our Veterans and their families. Our goal is to complete 

all claims in less than 125 days with 98 percent accuracy. Based on current projections, VBA 

is on track to reach our goals. However, as our environment over the next few years changes, 

we may face new challenges that could impact our ability to reach our goal. Events such as 

the addition of new presumptive conditions, court decisions, and legislative requirements could 

potentially create workload surges that are not currently factored into our projections. We will 

continue to monitor these potential challenges. 

Infectious Diseases: 

Question 5: Mr. Secretary, I understand you have received several inquiries regarding the 

need to allow individual VAMCs to procure technologies that will help them reduce the 

incidence of hospital acquired infections (HAl). which are costing lives (270 per day) and costs 

to hospitals ($28-40 billion annually). As you know, the primary means to prevent HAls is 

optimal hand washing. Hand hygiene reminder systems have proven effective in reducing 

HAls by as much as 89%, and in reducing the costs associated with HAls by as much as 67%. 

How is the VA working to ensure that individual VAMCs can procure such technologies? 

Response: National Contracting and the Real Time Location System (RTLS) Program are 

currently evaluating bids for RTLS technology in VHA. The solicitation for bids contained 

criteria for an optional module incorporating hand hygiene. 

Question 5b: Is the Real Time Location System part of the VA's infection control strategy to 

improve hand hygiene compliance and reduce HAls? 

Response: RTLS technology is one approach being considered to monitor compliance to the 

hand hygiene process among health care providers, but at this time, these systems are in their 

infancy for this application. The National Infectious Diseases Service is providing subject 

matter expertise to the RTLS Program for input regarding application of RTLS technology for 

the hand hygiene process. 

Veterans Schooling-For-Profit Schools: 

Question 6: Sen. Tom Carper, D-Del., a Navy veteran and chief Senate sponsor the Military 

and Veterans' Education Protection Act, seeks to improve the quality of education at for-profit 

schools by preventing any institution from surviving solely on federal aid. It would do this by 

preventing schools from receiving more than 90 percent of tuition from federal education 

programs, including all money from Education Department grants, GI Bill and survivors' 

education programs from the Veterans Affairs Department, and tuition assistance from the 

military services. 

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• Why are the for profit schools let on a base when veterans service organizations who would 

be able to counsel veterans and help them in the transition from military life to civilian life 

are not allow the same courtesy. 

Response: VA defers to DOD regarding school representatives and Veterans service 

organizations access to military installations. 

Home Care-Home Dialysis: 

Question 7: According to estimates provided by the VA for FY2011, over 27,000 veterans 

have End Stage Renal Disease and approximately 16,500 of those veterans receive dialysis 

from the VA either on contract with a provider or on an outpatient basis from a VA facility. 

Many studies demonstrate that home-based dialysis therapies, incliding peritoneal dialysis 

and home hemodialysis, are less costly than in center hemodialysis, while providing equal, if 

not better, patient outcomes. 

• What programs or efforts does the VA employ to better educate patients and professionals 

in the VA system about the benefits and savings associated with home-based dialysis 

therapies?" 

Response: Education of patients with chronic kidney disease (CKD) in relation to home 

dialysis has been associated with an increased proportion of CKD patients selecting home 

dialysis as their preferred dialysis modality. With this in mind, VA's clinical practice guideline on 

the management of patients with CKD in primary care recommends early patient education 

concerning renal replacement therapy options including home dialysis modalities when there is 

clear evidence of progression of CKD. In addition, early referral to a nephrologist is 

recommended to supplement this education, to ensure the patient has a complete 

understanding about end stage kidney disease (ESKD) and the treatment, and to assist in 

patient management. 

In 2011, home dialysis professional guidance was issued to the VA nephrology field detailing 

VA's home dialysis benefits as well as the operational requirements of and the Joint 

Commission standards for VA home dialysis programs. 

Home Dialysis utilization reviews were conducted with VA nephrology physicians at the 2011 

annual VA nephrology meeting. A home dialysis subcommittee that was formed was tasked 

with identifying ways to increase the availability of home therapies for Veterans and to facilitate 

the process of initiating home hemodialysis and peritoneal dialysis programs within VA. 

One of two developing initiatives which will promote home dialysis includes a 2011 VA 

Innovation Initiative (funded patient education tool) entitled "MyHealtheKidneys." In 

collaboration with VA, the Medical Education Institute is designing a Veteran-centric virtual 

patient navigator which will usher patients into a virtual kidney clinic and empower them 

through education to optimize their kidney health care choices. MyHealtheKidneys has 

been enriched with information about the benefits of home dialysis modalities. The 

expectation is the tool will be easily accessible to Veterans and professionals nationally via the 

web and the Veterans Health Library, and standardize the content of the educational material 

that veterans receive regarding dialysis choices. The expected availability of the tool is 2013. 

A second developing education initiative, targeting professional education, is the VA Specialty 

Care Access Networks-Extension for Community Healthcare Outcomes (SCAN-ECHO) 

program. SCAN-ECHO is a regularly recurring specialist-to-primary care clinician teleconsultation and education program. Renal SCAN-ECHO programs are being initiated in 

several regions across the country and home dialysis is expected to be an essential 

component of the planned curriculum. 

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RESPONSE TO POSTHEARING QUESTIONS SUBMITTED BY HON. SCOTT P. BROWN TO

U.S. DEPARTMENT OF VETERANS AFFAIRS


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Veterans Affairs (VA). The program, the first of its kind in the federal governrnent, offers 

career-search tools for Veterans seeking employment at VA, career-development services for 

Veterans currently employed at VA, and coaching and reintegration support for military 

Servicemembers. A combination of online resources and one-on-one support. VA for Vets is a 

gateway for Veterans to find a rewarding career serving our nation's Veterans. 

VA for Vets is focused on increasing the number of Veterans employed by the VA. In July 

2012. VA for Vets will expand to Feds for Vets, allowing all Veterans and transitioning 

Servicemembers to use the online tools and in-person resources available to support 

employment preparation and job search across the entire federal government. This includes 

military-skills translation, resume building, assessments, job searches, training, and one-onone coaching with professionally certified career coaches. 

The military-skills translator included on the VA for Vets website allows Veterans to enter their 

military occupation code as well as rank (which accounts for years of experience); secondary, 

tertiary, and collateral duties; and training and certifications. All of these qualifications are 

factored into the civilian jobs identified, making this the most comprehensive skills translator 

available to Veterans. The DOD-VA Veterans Employment Initiative Task Force evaluated all 

military skills translators and job boards on the market and identified the VA for Vets tools as 

the best of the market for Veterans seeking civilian employment. 

In addition, DOL, VA, DOD and the Veterans Job Bank (hosted on the National Resource 

Directory) each have online resources that allow Veterans to enter military occupation codes 

and identify possible civilian job opportunities. These resources provide similar information to 

meet Veterans' needs, regardless of what website they choose to utilize. Through the DODVA Veterans Employment Initiative Task Force, these resources will be integrated to simplify 

how Veterans access these resources and ensure there is a one-stop portal for accessing key 

employment resources. 

Question 4: Are there opportunities to better streamline the jobs/employment effort under one 

"unity of command," so to speak, or do you think this is working as it is? How often does each 

separate executive agency coordinate to reduce redundancies and achieve common goals in 

furtherance of improving employment among veterans? 

Response: There are opportunities to streamline the jobs/employment efforts. Through the 

DOD-VA Veterans Employment Initiative Task Force, VA, DOD, and DOL are meeting weekly 

to analyze federal government Veterans employment programs to identify redundancies and 

programs that may not be achieving their intended outcomes. We are striving to make the 

connections between Veterans and employers as simple and seamless as possible. 

In addition, VA has a long-standing relationship with DOL, resulting in increased efficiencies in 

providing employment services to Veterans. VA works with each agency at the national and 

local level to advance, improve, and expand employment opportunities for Veterans. 

VA meets with DOD and DOL on a consistent basis to coordinate efforts. 

Question 5: Does VA have a plan to measure the success of its jobs programs? 

Response: VBA's Vocational Rehabilitation and Employment (VR&E) program for servicedisabled Veterans measures program success by the number of Veterans who successfully 

complete a plan of services and obtain suitable employment. In FY 2011, over 7,000 Veterans 

successfully completed a vocational rehabilitation plan. VBA participates in many job fairs 

nationwide including the Chamber of Commerce's "Hiring Our Heroes" Job Fairs. At this time 

we are tracking participation and outcomes when available. 

VA and DOL are working collaboratively to implement the Veterans Retraining Assistance 

Program (VRAP), which was established under Public Law 112-56. However, VA defers to 

DOL for the measurement of employment outcomes of VRAP. VA will routinely provide DOL 

all necessary information pertaining to the status of each Veteran's participation in education 

and training programs, allowing DOL to follow-up with each participant for the purpose of 

providing employment assistance and tracking employment data. VA expects this information 

to be used in the joint VA-DOL collaborative report due to Congress by July 1,2014. 

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Question 6: Will we know by this time next year how many veterans aged 18-24 used this 

online resource and were hired as a result? 

Response: With detailed coordination with the VA field offices and headquarters staff, VA can 

extract data to report the number of Veterans hired in the 18-24 age range. This data call 

would take a significant amount of time to perform. Offices would have to report the names to 

the headquarters program office to crosswalk the data with online VA for Vets resources. 

VetSuccess.gov, the website for VA's program focused on helping Veterans who have serviceconnected disabilities become suitably employed, maintain employment, or achieve 

independence in daily living, does not currently have the capability to report demographic 

information, and this will not exist by this time next year. However, VR&E Service is expanding 

its reporting capability and planning integration with eBenefits to capture demographic 

information on Veterans using VetSuccess.gov. VR&E Service will also be able to report the 

number of Veterans who were hired by private industry employers as a result of using 

VetSuccess.gov. The proposed enhancements are scheduled to be complete by June 2013. 

Question 7: How many disability claims are currently pending in the queue and how many 

claims do you expect will be pending this same time next year? 

Response: As of March 31,2012, there were 861,755 disability claims pending. VBA 

estimates that there will be 685,455 disability claims pending at the end of FY 2013. 

Question 8: Your goal is to process every disability compensation claim within 125 days and 

with 98 percent accuracy by 2015. You've also said that the only way to achieve this goal is to 

shift to an electronic paperless claims system-sort of like a TurboTax program for veterans 

claims that would take, say, 30-45 minutes to complete. Is it still your position that a paperless 

system is the only way to get there? 

Response: Electronic paperless processing is a critical element in our ability to reach our 

transformation goals. VBA's Transformation Plan incorporates people, process, and 

technology initiatives. In order to fully gain the benefits of this transformation, we must operate 

in a paperless environment. The Veterans Benefits Management System will dramatically 

reduce the amount of paper in the current disability claims process, and employ rules-based 

claims development and decision recommendations where possible. VBMS' funding request is 

$128 million for FY 2013. This funding is critical to our transformation strategy. Additionally, by 

using a services-oriented architecture and commercial off-the-shelf products, VBA will be 

positioned to take advantage of future advances in technology developed in the marketplace to 

respond to the changing needs of Veterans over time. 

a. Is VA still on track to meet this goal in 2015? 

Response: Based on current projections, VBA is currently on track to reach this goal. 

However, as our environment over the next few years changes, we may have new challenges 

that impact our ability to reach our goal. Historically, unexpected events create a surge in VBA 

workload. New presumptive conditions, court decisions, and legislative requirements add 

unexpected volume. We will continue to monitor these challenges. 

b. Is the transition to a paperless system complete, and when can we expect to see a 

reduction in the backlog ... when will it begin to actually come down? 

Response: VBA's Transformation Plan includes a strategy for conversion to a paperless 

system that provides a combination of scanning and electronic or web-based submission of 

documents. The transition to a paperless system may take an extended period of time as we 

continue to encourage Veterans, Servicemembers, their families, and their representatives to 

take advantage of our web-based and electronic systems. As VBA pursues these advances 

and expands the ingest strategy, we will continue to process paper claims. 

Question 9: How long does an average veteran wait for his or her claim to be processed? 

Response: As of March 31,2012, the national average number of days to complete a claim in 

FY 2012 is 241 days. 

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Question 10: I'm interested in learning more about the use of advanced wound therapies by 

the VA for diabetic foot ulcers and venous leg ulcers. I understand 20 percent of veterans 

suffer from diabetes, compared to 7 percent of the total population, and that 13 percent of 

these veterans will develop foot ulcers that require amputation. If wouldn't mind, would you 

please get back to me on whether the VA Prosthetics Budget provides access to these types 

of therapies for our veterans? I think we have a real opportunity to provide an FDA-approved 

preventive therapy that can achieve wound closure and, by the way, pays for itself with an 

associated reduction in the number of amputations necessitated by complications arising from 

leg ulcers. 

Response: Prosthetic and Sensory Aids Service (PSAS) is fully funded to continue provision 

of advanced wound care therapies and related technologies. VA increased spending for 

advanced wound care (e.g., therapies, equipment, products) by 66 percent in FY11 ($76M) 

over the amount spent for this in FY10 ($4S.6M). PSAS is adequately funded in FY12, and 

expects to continue to be adequately funded in FY13 to provide the full spectrum of 

technologies and devices that Veterans need related to this care and services. 

Question 11: Proper ID verification for the purpose of VA benefits not only combats fraud, 

mistaken identities, and overpayment, but it also improves the efficiency of ID management 

systems. DOD uses a smart card with biometrics for its beneficiaries to address this 

challenge. While the VA subscribes to the use of a smart ID card for its employees and 

contractors, complying with a federal mandate, I understand the VA has no plans for issuing 

smart ID cards to its beneficiaries. If this is true, how does the VA and the DOD plan to 

succeed in their joint Virtual Lifetime Electronic Record initiative if they don't have a common 

ID management system? 

Response: For many years, VA has viewed identity management as a key tenet to improving 

the Department's security posture and achieving efficiencies in the management of digital 

identities. The Virtual Lifetime Electronic Record (VLER) will leverage current VA and DOD 

identity management solutions by using existing federated credentials. VA and DOD maintain 

the following family of products that support individual identification to systems and services in 

physical and virtual world. 

DOD Electronic Data Interchange Person Identifier (EDI PI)-virtual credential: is provided 

to all person records that exist within DOD's person data repository (i.e., Defense 

Enrollment Eligibility Reporting System (DEERS)). This includes DOD civilian, military, 

retiree, contract support, family members, DOD beneficiaries, and VA beneficiaries. DOD 

EDI PI is a unique number used across DOD as an identifier for DOD systems to manage 

accounts/records and communicate between systems about individuals without using the 

social security number (SSN). VA has agreed to adopt the DOD EDI PI allowing 

information systems in both departments to access beneficiary record. This is an essential 

ingredient that helps VLER to combine data from unconnected systems. 

• VA provides their employees and selected contract support personnel a Homeland Security 

Presidential Directive (HSPD) 12 VA Personal Identity Verification Card (PIV) credential. 

Both the DOD PIV (CAC) and VA PIV are held to the same standards for background 

investigations, identity proofing, enrollment, and credentialing. 

DOD Common Access Card (CAC)-physical identification and virtual credential: is 

provided to DOD civilians, DOD Military, and selected contract support personnel. The 

DOD CAC is the Department's Homeland Security Presidential Directive (HSPD-12) 

Personal Identity Verification (PIV) credential. A non-CAC DOD identification card, 

providing physical identification, is provided to DOD farnily members, DOD retirees and 

DOD beneficiaries to support benefits and entitlernents. 

Database Specification (DS) Logon credential-virtual credential: is offered to all VA 

beneficiaries, active/reserve military, military retirees, and DOD family members. It is a 

simple credential (i.e., username/password) that is intended to be used by individuals to 

view and act on their own information. It is linked to an individual's affiliation with DODIVA, 

supported by federal identity proofing processes, and will help authenticate beneficiaries to 

DOD, VA and joint DODIVA systems. DOD intends to provide DS Logon credentials to all 

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military personnel while they are affiliated with DOD so that the credential can transition 

with them to the VA. To date, there have been over 1 million DS Logon credentials 

distributed and they are used by VA and DOD self-service applications and portals (e.g., 

eBenefits, TRICARE Online, and miIConnect). 

VA envisions many VA and most joint DODN A systems using the above virtual credentials as 

means to authenticate beneficiaries to services (to include, but not limited to Virtual L~etime 

Electronic Record (VLER) and patient portals under integrated Electronic Health Record 

(iEHR)) or to exchange information amongst systems. The process to enable systems is 

ongoing and is expected to take place over several years. 

Question 12: What is the Department of Veteran Affairs' official position on the Caring for 

Camp Lejeune Veterans Act of 2011 (S. 277)? 

Response: On June 8, 2011, VA provided testimony before the Senate Committee on 

Veterans' Affairs regarding various pieces of pending legislation before the Committee. S.277 

was one of the pieces of legislation VA provided views on. The below text is excerpted from 

VA's written testimony and covers the written views VA provided on S.277. 

"S. 277 Caring for Camp Lejeune Veterans Act of 2011 

S. 277 would amend title 38 to extend special eligibility for hospital care, medical services and 

nursing home care for certain Veterans stationed at Camp Lejeune during a period in which 

well water was contaminated notwithstanding that there is insufficient scientific evidence to 

conclude that a particular illness is attributable to such contamination. It would also make 

family members of those Veterans who resided at Camp Lejeune eligible for the same 

services, but only for those conditions or disabilities 

associated with exposure to the contaminants in the water at Camp Lejeune, as determined 

by the Secretary. 

VA takes the Camp Lejeune matter very seriously but has a variety of significant concerns with 

this bill. For example, although we believe that the intent of S. 277 is to provide these Veterans 

with the same enrollment and treatment authority as for Persian Gulf and post-Persian Gulf 

Veterans, the bill does not do so because it fails to amend section 1710(e)(2) to address the 

new special eligibility provision. As the legislation is written, VA would be required to provide 

treatment for any condition that cannot be specifically eliminated as related to the 

contaminated water at Camp Lejeune. This bill would not make the special eligibility of these 

Veterans subject to the limitation that care may not be provided "with respect to a disability that 

is found, in accordance with guidelines issued by the Under Secretary for Health, to have 

resulted from a cause other than the service or testing described in such subparagraph." As a 

result, this bill grants these Veterans a broader special eligibility than that conferred on Persian 

Gulf and post-Persian Gulf Veterans. 

The Agency for Toxic Substances and Disease Registry (ATSDR) is conducting ongoing 

research related to the potential exposures at Camp Lejeune. Current ATSDR research is 

concentrating on refining hydrological modeling to determine the extent of benzene 

contamination. This information will then be used along with results from ongoing population 

studies to determine if the potentially exposed population at Camp Lejeune has experienced 

an increase in adverse health effects such as birth defects, cancers, and mortality. VA will 

closely monitor this research and will quickly consider the findings and take appropriate action. 

In addition, VA will support these studies by acting on ATSDR requests to confirm specific 

Veteran's health issues. VA has a close working relationship with ATSDR which allows the 

Department to stay informed about current research. 

We are also greatly concerned that the Department of Defense (DOD), and consequently VA. 

is unable to accurately identify those that may have visited for short periods of time at Camp 

Lejeune and surrounding areas during the period of potential exposure. While the legislation 

provides that the Secretary in conjunction with ATSDR shall determine the applicable period, 

discussion usually centers on the period of 1957-1987. DOD records have proven 

problematic in identifying all potential beneficiaries, especially since the legislation does not 

provide for any limitations as to how long an individual had to be on base at Camp Lejeune. It 

is possible through the Defense Manpower Data Center to identify Veterans assigned to Camp 

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Chairman MURRAY. With that, I would like to invite our second 

panel to join us today. As I said, I have been called to the Capitol 

so I will introduce the panel. I will let our first speaker go and I 

will be turning the gavel over in a very bipartisan way to my colleague Senator Burr, not to give you practice, only to let you do it 

today. [Laughter.] 

I appreciate your accommodating me with this. 

INTRODUCING THE INDEPENDENT BUDGET 

REPRESENTATIVES 

Chairman MURRAY. If we could keep the room quiet as everybody 

changes chairs here I would really appreciate it because I would 

like to introduce the panel as they are coming out. 

We are going to be moving now to our second panel. Could we 

please have it quiet in the room as they come up and join us and 

are seated in the appropriate places. 

I want to extend a very, very warm welcome to a friend of mine 

from Washington, Bill Schrier. Mr. Schrier is the American Legion’s Western Region National Vice Commander. 


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326 

Bill, thank you so much for being here today and for coming all 

the way across the country, for the tremendous work you do, and 

for your participation on this panel today to bring a local perspective that I think is important for all of us to hear. So, I appreciate 

that. 

Mr. Schrier is accompanied today by Tim Tetz, who is the Director for the National Legislative Commission for the American Legion. 

We also have the witnesses here who are here on behalf today 

of the Independent Budget. Carl Blake, the National Legislative Director of the Paralyzed Veterans of America. Jeffrey Hall, the Assistant National Legislative Director for the Disabled American 

Veterans. 

Diane Zumatto, National Legislative Director of AMVETS. Raymond Kelley, National Legislative Director for the Veterans of Foreign Wars. And finally, I want to welcome to the panel Tom 

Tarantino, Deputy Policy Director for Iraq and Afghanistan Veterans of America. 

We are going to begin with Mr. Schrier and then move down the 

table in order. The Independent Budget witnesses will have 15 minutes total and The American Legion and Iraq and Afghanistan Veterans of America will be given 5 minutes each. 

I again apologize to all of you. Obviously we have had tremendous participation, and the Committee hearing has gone longer. I 

know that I and my staff and all the Members of the Committee 

will be looking at your testimony. It is extremely important to us, 

and we will be submitting to you questions as well even though we 

do not have a lot of Members present. 

And I especially want to thank Senator Burr for his accommodating my schedule as well. 

So, with that, Mr. Schrier, thank you again, and we will begin 

with you. 

STATEMENT OF WILLIAM SCHRIER, WESTERN REGION NATIONAL VICE COMMANDER, THE AMERICAN LEGION; ACCOMPANIED BY TIM TETZ, DIRECTOR, NATIONAL LEGISLATIVE COMMISSION, THE AMERICAN LEGION 

Mr. SCHRIER. Thank you, Madam Chair. 

Chairman Murray, Ranking Member Burr, and Members of the 

Committee, I would like to take this opportunity to thank you for 

the invitation to be here before you today and testify on behalf of 

The American Legion, the Nation’s largest patriotic wartime veterans service organization and about the President’s proposed 

budget for the Department of Veterans Affairs. 

The American Legion is grateful for the increase in the budget 

to deal with the needs of our Nation’s veterans. For those who have 

borne the way of war for this Nation, we must always remember 

that a promise made is a promise that must be kept. We find likeminded allies who recognize the importance and even duty to ensure that we are keeping the promise to America’s veterans. 

Chairman Murray, you know the importance of holding government to the promise made to our veterans. The American Legion 

in Washington State knows how tirelessly you fought for the veterans at the Madigan Army Hospital Center to ensure that their 

327 

wounds of war were not being given the short end of the stick in 

the interest of financial savings. 

The American Legion also knows how hard it is for this Committee to have fought the VA to ensure hard work on passing the 

Caregiver’s Act and not lost the narrow implementation. 

We stood with you in those fights. We are here today because you 

have shown the willingness to listen to the needs of America’s 

veterans in the fight to make sure that we keep this end of the 

promise. 

The Department of Veterans Affairs is dedicated to providing 

earned benefits to those who have served. The President’s budget 

is ambitious and certainly an increase of size especially at a time 

when government must be seeking ways of saving money. It is a 

positive step forward for our veterans. 

The American Legion remains concerned, however, that there are 

areas where a lack of foresight or faulty planning may lead the VA 

to default on the promise to our veterans. We cannot allow this to 

happen. 

One of the greatest shortfalls is the proposed budget for major 

and minor construction. While we are pleased to see the needed 

projects such as mental health services building in Seattle moving 

forward, when viewed as a whole, the construction budget fails to 

meet the needs of even VA’s own internal strategic building plan. 

The Strategic Capital Investment Plan or SCIP provides the VA 

with a 10-year plan to address the most critical infrastructure 

needs. The American Legion was concerned that under the current 

budget figures it would take close to 40 years for the needs of the 

10-year plan to be met. 

We all heard recently on the importance of investment in infrastructure. These are the kinds of bills that you pay for now, or you 

pay for later. When infrastructure is given the short end up front, 

it becomes more expensive at the back. 

Yes, these are serious needs, and yes, it will require billions of 

dollars in funding and these billions of dollars are those that we 

cannot afford not to spend. We cannot condone veterans be placed 

in aging facilities that cannot meet even their most basic of needs. 

If we fail to fund construction now, we will break the promise once 

again to our veterans. 

Failures to reach necessary funding levels are not only concerns 

but must contend with this budget. We must also look closely to 

the VA. It intends to spend their money and where they spend 

their money and make sure that it is not based on smoke and mirrors but on real money that will be there when veterans need it 

most. 

Ambitious prospects in the budget for Medical Care Collections 

Fund, MCCF, are unfortunately based on premises. The American 

Legion fears that this will not bear fruit in the real world of 2013. 

Setting aside even concerns that the OIG found in the ineffective 

process while cost cutting for the VA over $110 million annually in 

revenue were unable to be collected. That is a great concern with 

the proposed increases in the billing amounts. 

The VA’s new budget proposes to bill private insurance at the 

preferred provider rate rather than the current Medicare rate. This 

328 

changed billing reflects 90 percent of the proposed increase in this 

area of the budget. 

Frankly, this has never been authorized before; and even if authorized, the VA will be hard pressed to meet these overly optimistic budget targets. When this fails to generate the necessary 

revenue, the VA will be forced to find savings elsewhere in the 

budget and, of course, that means more broken promises to our 

veterans. 

Finally, we are concerned about him the overall budget prospect 

as a whole in these turbulent times of fiscal strife in the government. Surely, this Committee is aware of the pessimism of the 

American people regarding the ability of Congress to come to terms 

and to pass a complete budget. 

While we acknowledge that many worked tirelessly to break 

these budget deadlocks and surely share the frustration of the people when we cannot reach these decisions. Continuing resolutions 

and half measures make for uncertain planning. 

While advance appropriations offers relief, there are still projects 

that languish waiting for start dates, contracts that linger waiting 

for approval of an operating budget that the government moves 

from month to month. 

Questions remain about the VA’s protection of sequestration and 

whether this, too, will suffer an across-the-board cut of 2 percent 

despite the seeming protection from previous interpretation of 

budget controls. 

VA planners need a stable environment to ensure seamless benefits for the veterans they serve. More importantly, American veterans need to see this for themselves. 

Chairman Murray, that concludes my report, and I sense we will 

not be taking questions right now. Again thank you and you, Senator Burr, for allowing me to be here. 

[The prepared statement of Mr. Schrier follows:] 

PREPARED STATEMENT OF WILLIAM F. SCHRIER, WESTERN REGION NATIONAL VICE

COMMANDER, DEPARTMENT OF WASHINGTON, THE AMERICAN LEGION

Chairman Murray and Members of the Committee: On behalf of the 2.4 million 

members of The American Legion and our National Commander, Fang A. Wong, I 

appreciate this opportunity to comment on the President’s budget request. 

As thousands of troops return from deployments to Iraq and elsewhere in a shifting of our national security focus, it’s encouraging to see that President Obama’s 

FY 2013 budget for the Department of Veteran Affairs (VA) pivots to meet the need 

caused by this prioritization. On the surface, a double-digit increase in an operational budget would be the envy of any agency during these dire fiscal times. Yet, 

the fact that 72 percent of this increase is benefits to disabled, poor and student 

veterans causes the veteran advocate reason to pause. Will the resources remaining 

be capable to meet the needs of these returning veterans and those from previous 

war eras? 

While grateful for this increase, The American Legion remains concerned this increase is not only short of the ultimate need, but also a byproduct of budget and 

funding gimmickry that will ultimately only endanger veteran care if unsuccessful. 

Moreover, we remain concerned that these increases are directed not toward the 

veteran and his/her care, but rather the bureaucratic structure unable to meet 

present needs of the veteran. 

ADVANCED APPROPRIATIONS FOR FY 2014

Due to the successful passage of the Veterans Health Care Budget Reform and 

Transparency Act of 2009 (P.L. 111–81) three of the four accounts that make up the 

Veterans Health Administration (VHA) are funded in advance of the traditional 

budget cycle. Those three accounts—medical services, medical support and compliVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00334 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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ance, and medical facilities—are funded one year in advance and supplemented as 

necessary during the following year. 

While The American Legion joined in supporting the advance appropriation 

model, we remain concerned accurate projections on population and utilization and 

other challenges still remain. 

One such challenge came to our attention this year regarding the procurement of 

medical equipment and Information Technology (IT) purchases. When IT within the 

VA was combined together across the entire agency in 2006, it was implemented to 

improve efficiency, contracting, management and other challenges inherent with 

three disjointed IT management teams. This has proved somewhat successful. 

However, we are hearing that procurement of medical equipment and IT is hampered at medical facilities due to budget implementation failures through continuing 

resolutions. While a VA medical center director might have his/her operational funding beginning October 1 because of advance appropriations, much needed IT or medical equipment might be delayed due to a continuing resolution impasse in Congress. This has a detrimental impact on the veteran and his/her care. 

MEDICAL SERVICES

Over the past two decades, VA has dramatically transformed its medical care delivery system. Through The American Legion visits to a variety of medical facilities 

throughout the Nation during our System Worth Saving Task Force, we see firsthand this transformation and its impact on veterans in every corner of the Nation. 

While the quality of care remains exemplary, veteran health care will be inadequate if access is hampered. Today there are over 22 million veterans in the United 

States. While 8.3 million of these veterans are enrolled in the VA health care system, a population that has been relatively steady in the past decade, the costs associated with caring for these veterans has escalated dramatically. 

For example between FY 2007 and 2009, VA enrollees increased from 7.8 million 

to 8.1 million. During the same period, inpatient admissions increased from 589 

thousand to 662 thousand. Outpatient visits also increased from 62 million to 73 

million. Correspondingly, cost to care for these veterans increased from $29 billion 

to $39.4 billion. This 36 percent increase during those two years is a trend that dramatically impacts the ability to care for these veterans. 

While FY 2010 numbers seemingly leveled off—to only 3 percent annual growth— 

will adequate funding exist to meet veteran care needs? If adequate funding to meet 

these needs isn’t appropriated, VA will be forced to either not meet patient needs 

or shift money from other accounts to meet the need. 

Even with the opportunity for veterans from OIF/OEF to have up to 5 years of 

care following their active duty period, we have not seen a dramatic change in overall enrollee population. Yet The American Legion remains concerned that the population estimates are dated and not reflective of the costs. If current economic woes 

and high unemployment rates for veterans remain, VA medical care will remain increasing enticing for a veteran population that might not have utilized those services in different times. 

Finally, ongoing implementation of programs such as the Pub. L. 111–163 ‘‘Caregiver Act’’ will continue to increase demands on the VA health care system and, 

therefore, result in an increased need for a budget that can adequately deal with 

the challenges. 

The final FY 2013 advanced appropriations for Medical Services was $41.3 billion. 

In order to meet the increased levels of demand, even assuming that not all eligible 

veterans will elect to enroll for coverage, and keep pace with the cost trend identified above, there must be an increase to account for both the influx of new patients 

and increased costs of care. 

The American Legion recommends increasing the FY 2014 budget for VA Medical 

Services to $44 billion. 

MEDICAL SUPPORT AND COMPLIANCE

The Medical Support and Compliance account consists of expenses associated with 

administration, oversight, and support for the operation of hospitals, clinics, nursing 

homes, and domiciliaries. Although few of these activities are directly related to the 

personal care of veterans, they are essential for quality, budget management, and 

safety. Without adequate funding in these accounts, facilities will be unable to meet 

collection goals, patient safety, and quality of care guidelines. 

The American Legion has been critical of programs funded by this account. We 

remain concerned patient safety is addressed at every level. We are skeptical if patient billing is performed efficiently and accurately. Moreover, we are concerned that 

specialty advisors/counselors to implement OIF/OEF outreach, ‘‘Caregiver Act’’ imVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00335 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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plementation, and other programs are properly allocated. If no need for such individuals exists, should the position be placed within a facility? Simply throwing more 

money at this account, increasing staff and systems won’t resolve all these 

problems. During the previous budget, this account grew by nearly 8 percent to $5.31 billion. 

The American Legion questions the necessity for that rate to continue at this time. 

The American Legion recommends increasing the FY 2014 budget for VA Medical Support and Compliance to $5.52 billion. 

MEDICAL FACILITIES

During the FY 2012 budget cycle, VA unveiled the Strategic Capital Investment 

Planning (SCIP) program. This ten-year capital construction plan was designed to 

address VA’s most critical infrastructure needs within the VA. Through the plan, 

VA estimated the ten-year costs for major and minor construction projects and nonrecurring maintenance would total between $53 billion and $65 billion over ten 

years. Yet during the FY 2012 budget, these accounts were underfunded by more 

than $4 billion. 

The American Legion is supportive of the SCIP program which empowers facility 

managers and users to evaluate needs based on patient safety, utilization, and other 

factors. While it places the onus on these individuals to justify the need, these needs 

are more reflective of the actuality as observed by our members and during our 

visits. Yet, VA has taken this process and effectively neutered it through budget 

limitations, thereby underfunding the accounts and delaying delivery of critical 

infrastructure. 

So while failing to meet these needs, facility managers will be forced to make do 

with existing aging facilities. While seemingly saving money in construction costs, 

the VA will be expending money maintaining deteriorating facilities, paying increased utility and operational costs, and performing piecemeal renovation of properties to remain below the threshold of major or minor projects. 

This is inefficient byproduct of budgeting priorities. Yet, as will be noted later, 

the reality remains that the SCIP program is unlikely to be funded at complete levels necessary to deliver on the ten year plan. Therefore, this account must be increased to meet the short term needs within the existing facilities. 

With a final FY 2013 Advance Appropriations budget of $5.74 billion, The American Legion recommends an FY 2014 budget increase to $6 billion to ensure facilities are maintained to proper levels, particularly in an austerity period where much 

needed improvements by construction are being neglected and facilities are expected 

to extend their normal operating life. 

The American Legion recommends increasing the FY 2014 Medical Facilities 

budget to $6 billion. 

MEDICAL AND PROSTHETIC RESEARCH

The American Legion has maintained a position that VA research must focus on 

improving treatment for medical conditions unique to veterans. Because of the 

unique structure of VA’s electronic medical records (VISTA), VA research has access 

to a great amount of longitudinal data incomparable to research outside the VA system. Because of the ongoing wars of the past decade, several areas have emerged 

as ‘‘signature wounds’’ of the Global War on Terror, specifically Traumatic Brain Injury (TBI), Posttraumatic Stress Disorder (PTSD), and dealing with the aftereffects 

of amputated limbs. 

Much media attention has focused on TBI from blast injuries common to Improvised Explosive Devices (IEDs) and PTSD. As a result, VA has devoted extensive 

research efforts to improving the understanding and treatment of these disorders. 

Amputee medicine has received less scrutiny, but is no less a critical area of concern. Because of improvements in body armor and battlefield medicine, catastrophic 

injuries that in previous wars would have resulted in loss of life have led to substantial increases in the numbers of veterans who are coping with loss of limbs. 

As far back as 2004, statistics were emerging which indicated amputation rates 

for US troops were as much as twice that from previous wars. By January 2007, 

news reports circulated noting the 500th amputee of the Iraq War. The Department 

of Defense response involved the creation of Traumatic Extremity Injury and Amputation Centers of Excellence, and sites such as Walter Reed have made landmark 

strides in providing the most cutting edge treatment and technology to help injured 

servicemembers deal with these catastrophic injuries. 

However, The American Legion remains concerned that once these veterans transition away from active duty status to become veteran members of the communities, 

there is a drop off in the level of access to these cutting edge advancements. OngoVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00336 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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ing care for the balance of their lives is delivered through the VA Health Care system, and not through these concentrated active duty centers. 

Many reports indicate the state-of-the-art technology available at DOD sites is not 

available from the average VA Medical Center. With so much focus on ‘‘seamless 

transition’’ from active duty to civilian life for veterans, this is one critical area 

where VA cannot afford to lag beyond the advancements reaching servicemembers 

at DOD sites. If a veteran can receive a state-of-the-art artificial limb at the new 

Walter Reed National Military Medical Center (WRNMMC) they should be able to 

receive the exact same treatment when they return home to the VA Medical Center 

in their home community, be it in Gainesville, Battle Creek, or Fort Harrison. 

American Legion contact with senior VA health care officials has concluded that 

while DOD concentrates their treatment in a small number of facilities, the VA is 

tasked with providing care at 152 major medical centers and over 1,700 total facilities throughout the 50 states as well as in Puerto Rico, Guam, American Samoa and 

the Philippines. Yet, VA officials are adamant their budget figures are sufficient to 

ensure a veteran can and will receive the most cutting edge care wherever they 

choose to seek treatment in the system. 

The American Legion remains concerned about the ability to deliver this cutting 

edge care to our amputee veterans, as well as the ability of VA to fund and drive 

top research in areas of medicine related to veteran-centric disorders. There is no 

reason VA should not be seen at the world’s leading source for medical research into 

veteran injuries such as amputee medicine, PTSD and TBI. 

In FY 2011 VA received a budget of $590 million for medical and prosthetics research. Only because of the efforts of the House and Senate, was this budget kept 

at that level during the FY 2012 budget due to significant pressure from The American Legion. Even at this level, The American Legion contends this budget must be 

increased, and closely monitored to ensure the money is reaching the veteran at the 

local level. 

The American Legion recommends FY 2013 budget for Medical and Prosthetics 

Research be increased to $600 million. 

MEDICAL CARE COLLECTIONS FUND (MCCF)

In addition to the aforementioned accounts which are directly appropriated, medical care cost recovery collections are included when formulating the funding for 

VHA. Over the years, this funding has been contentious because they often included 

proposals for enrollment fees, increased prescription rates, and other costs billed directly to veterans. The American Legion has always ardently fought against these 

fees and unsubstantiated increases. 

Beyond these first party fees, VHA is authorized to bill health care insurers for 

nonservice-connected care provided to veterans within the system. Other income collected into this account includes parking fees and enhanced use lease revenue. The 

American Legion remains concerned that the expiration of authority to continue enhanced use leases will greatly impact not only potential revenue, but also delivery 

of care in these unique circumstances. We urge Congress to reauthorize the enhanced use lease authority with the greatest amount of flexibility allowable. 

However, the collection of fees and insurance payments comprises nearly 98 percent of the revenue gathered within this account. In the previous budget cycle, this 

account was budgeted to decrease to $2.77 billion. The American Legion remained 

skeptical that the VA was meeting these deadlines even at a reduced level. We were 

well aware that failure to meet these budgeted amounts equated to a reduction in 

appropriations and therefore a reduction in services at some level. 

In the first quarter of FY 2011, VHA reported a 12.3 percent decrease below the 

budgeted collections—an amount totaling nearly $100 million. They remained below 

projections for the second quarter of FY 2011 when the Senate Veterans’ Affairs 

Committee shared our concern in a letter requesting detailed plans on how VA was 

going to improve on MCCF collections. To date, our fears have not been assuaged 

that VA can actually deliver on projected savings, even when reduced during the 

previous budget cycle. 

In May 2011, the VA Office of Inspector General (OIG) issued a report auditing 

the collections of third party insurance collections within MCCF. Their audit found 

that ‘‘VHA missed opportunities to increase MCCF by * * * 46 percent.’’ Because 

of ineffective processes used to identify billable fee claims and systematic controls, 

it was estimated VHA lost over $110 million annually. In response to this audit, 

VHA assured they’d have processes in place to turn around this trend. 

According to the VA, approximately 90 percent of the proposed increase in the 

MCCF account for FY 2013 will be based on the ability for VA to bill private insurance companies a ‘‘preferred provider’’ rate rather than the Medicare rate. When 

332 

this proposal was included in previous submissions, it never was authorized. Clearly, the VA will be hard pressed to meet the collection levels optimistically budgeted 

for 2013. Without those collections, savings must be garnered elsewhere to meet 

these shortfalls, thereby causing facility administrators and VISN directors to make 

difficult choices that ultimately negatively impact veterans through a lack of hiring, 

delay of purchasing, or other savings methods. 

It would be unconscionable to increase this account beyond the previous levels 

that were not met. To do so without increasing co-payments or collection methods 

would be counterproductive and mere budget gimmickry. While we recognize the 

need to include this in the budget, The American Legion cannot support a budget 

that penalizes the veteran for administrative failures. The American Legion recommends budgeting $2.95 billion for Medical Care Cost 

Collections. 

APPROPRIATIONS FOR FY 2013

The remaining accounts within VA are being allocated funding for FY 2013. These 

include funding for general operation of VA Central Office (VACO), the National 

Cemetery Administration (NCA) and Veterans Benefits Administration. 

VETERAN BENEFITS ADMINISTRATION (VBA)

Any discussion of the VBA must include discussion of the ongoing backlog of veterans’ benefits claims. Despite improvements to the claims processing system enabling VBA to process claims more rapidly, the backlog has continued to grow as the 

influx of claims each year continues to exceed a million claims a year over the past 

three years. Additional claims resulting from additions to presumptive conditions 

associated with the aftereffects of the chemical herbicide Agent Orange have contributed to this backlog. The American Legion can further foresee significant increases to claims as more servicemembers return from wars in Afghanistan and Iraq 

and are assimilated into the civilian veteran population. Further cuts to military 

manpower will drive more veterans into the civilian populace and as servicemembers transition from active duty to the civilian world, more claims will continue 

to pour in. 

Despite improvements to claims processing by the beginnings of implementation 

of the Veterans Benefits Management System (VBMS), the VBA’s fully electronic 

claims processing system, overall VBA will be strained beyond their already struggling capacity without proper funding to adequately address the backlog. While 

there have been significant improvements in funding to VBA over the past six years, 

this trend must continue if there is any hope to stave off disaster. The system is 

already strained to its limits and is struggling to even ‘‘tread water.’’ Further improvements in this area must be made so that veterans can finally receive prompt 

and accurate service addressing their needs for injuries and conditions sustained 

during their active duty service, as well as the residual aftereffects of that selfless 

service. 

VBA is also deeply involved in a massive overhaul of the ratings schedule for payment of disability for every major body system. Potential changes to ratings for 

mental health disorders and major musculoskeletal groups will be rolled out over 

the coming years, and implementation of these changes will require extensive training of VBA personnel to ensure they are properly administering the benefits system. 

The American Legion has long been critical of training within VBA, and lack of 

proper training contributes to high error rates which further tie up the claims systems with lengthy appeals that would be unnecessary if the claims had been decided 

properly, by properly trained personnel, on the first go-around. 

In other areas of compensation, pension and fiduciary programs administered 

within VBA have been ongoing consolidation. Whether or not these consolidations 

contribute to savings and more efficient operation is a matter of open debate. The 

American Legion contends consolidation has often created more problems than it 

has solved, and often necessitated additional personnel at the local level to fix problems created by removing staff to remote areas out of direct contact with the veterans they purport to serve. 

Furthermore, by VBA’s own admission, consolidation of fiduciary programs has resulted in pulling personnel away from claims processing to be moved to the new fiduciary hubs, thereby creating a vacuum in claims processing, an area already 

tasked to the limit. Given the lengthy training period necessary to bring new claims 

processing hires up to speed and effectiveness this only portends more problems in 

the already troubled claims processing arena. 

Increased funding in this area is necessary to provide for new employees to handle the massive caseload, more extensive and better organized training targeted to 

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address key areas of deficiency in claims processors, and to ensure personnel adequate for full use of the VBMS system. Furthermore, as the proliferation of pilot 

programs to solve the challenges of the claims systems continues to evolve, more 

funding will be needed to ensure that the more advanced and effective business 

models can be replicated and implemented on a national level so there is consistency 

in every Regional Office. 

VBA’s final FY 2012 appropriation for budget was $2 billion, a reduction from the 

FY 2011 levels. Given the dire need of enhancements in this area, The American 

Legion is recommending a 10 percent increase in this budget for FY 2013 to account 

for the many areas of need, including increased staffing and training. As with all 

areas of VA budgeting, The American Legion is concerned that any increases in 

funding actually reach down to the regional level, rather than be swallowed up by 

an endlessly expanding VACO bureaucracy. Congress has shown good faith recognizing the dire need for funding to ensure veterans receive timely access to benefits, 

but oversight must be exercised to ensure this money actually reaches the veteran 

on the street, where it is most deserved. 

The American Legion recommends budgeting $2.2 billion for the Veterans Benefits Administration (VBA). 

INFORMATION TECHNOLOGY

Like the VBA budget, the Information Technology (IT) budget was slightly pared 

back in FY 2012. The American Legion was unable to gauge the progress gained 

on the 76 IT projects proposed during that budget cycle. In addition to the implementation and launch of the VBMS system, the greatest long-awaited project is the 

launch of the joint VA and Department of Defense (DOD) lifetime record—Virtual 

Lifetime Electronic Record (VLER). 

The American Legion remains a strong advocate for the implementation of such 

recordkeeping, yet we are pessimistic the VA and DOD are making sufficient 

progress toward that end. 

During the previous budgeting, VA was unable to provide information on the overall cost of creating such a system, but assured veteran advocates there was enough 

flexibility to address any costs associated with the project. In the meantime, several 

releases and announcements have been issued by VA toward the continued evolution of this project, but there is little to demonstrate we’re any closer to producing 

a ready model. The American Legion calls upon Congress to continue to pressure 

VA and DOD to move toward this system as expeditiously as possible. With the development and launch of VBMS nearly complete, the entire IT focus should center 

on VLER. 

In order to provide the necessary resources for the nationwide rollout of VBMS 

and still maintain efforts toward development of VLER, The American Legion believes a small increase is justified within IT. 

The American Legion recommends budgeting $3.3 billion for Information Technology. 

MAJOR AND MINOR CONSTRUCTION

After two years of study the Department of Veterans Affairs (VA) developed the 

Strategic Capital Investment Planning (SCIP) program. It is a ten-year capital construction plan designed to address VA’s most critical infrastructure needs within the 

Veterans Health Administration, Veterans Benefits Administration, and National 

Cemetery Administration. 

The SCIP planning process develops data for VA’s annual budget requests 

through analysis of VA facilities nationwide. These infrastructure budget requests 

are divided into several VA accounts: Major Construction, Minor Construction, NonRecurring Maintenance (NRM), Enhanced-Use Leasing, Sharing, and Other Investments and Disposal. In the 2013 budget submission, VA estimated implementation 

of SCIP would require between $51 billion and $62 billion. Activation of these facilities would require approximately $10 billion to $12 billion more. 

The American Legion is very concerned about the lack of funding in the Major 

and Minor Construction accounts. In FY 2012 The American Legion recommended 

to Congress that the Major Construction account be funded at $1.2 billion and the 

Minor Construction account be funded at $800 million. However, Congress only appropriated $589 million and $482 million respectively to those accounts. Based on 

VA’s SCIP plan, Congress underfunded these accounts by approximately $4 billion 

in FY 2012. Clearly, if this underfunding continues VA will never fix its identified 

deficiencies within its ten-year plan. 

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Investment Type 

Estimated Cost of SCIP 

Implementation FY 2013 Budget Proposal 

Completion at present 

funding level 

Major Construction ................................ $20.1–$24.6 billion $532 million 38–45 years 

Minor Construction ................................ $8.6–10.5 billion $608 million 14–18 years 

The American Legion also understands there is a discussion to refer to SCIP in 

the future as a ‘‘planning document’’ rather than an actual capital investment plan. 

Under this proposal, VA will still address the deficiencies identified by the SCIP 

process for future funding requests but rather than having an annual appropriation, 

SCIP will be extended to a five year appropriation, similar to the appropriation 

process used by the Department of Defense as its construction model. Such a plan 

will have huge implications on VA’s ability to prioritize or make changes as to design or project specifications of its construction projects. The American Legion is 

against this five year appropriation model and recommends Congress continue funding VA’s construction needs on an annual appropriations basis. 

The American Legion recommends Congress adopt the 10-year action plan created 

by the SCIP process. Congress must appropriate sufficient funds to pay for needed 

VA construction projects and stop underfunding these accounts. In FY 2013 Congress must provide increased funding to those accounts to ensure the VA-identified 

construction deficiencies are properly funded and these needed projects can be completed in a timely fashion. 

The American Legion recommends budgeting $5.3 billion for Major Construction 

and $1.2 billion for Minor Construction projects within VA. 

STATE VETERANS HOMES CONSTRUCTION GRANTS

Perhaps no program facilitated by the VA has been as impacted by the decrease 

in government spending than the State Veterans Homes Construction Grant program. For the past two fiscal years, Congress has appropriated $85 million toward 

the construction, upgrade, and expansion of long term care facilities operated by the 

states. 

This program is essential in providing services to a significant number of veterans 

throughout the country at a fraction of the daily costs of similar care in private or 

VA facilities. Yet, in order to qualify for the Federal grant, states must put forward 

a percentage of the overall planning and construction costs. With a downturn in the 

economy, a majority of the states have been unable to leverage state funding for 

these projects. That coupled with a significant increase in 2009 helped eliminate the 

backlog that had been building. 

As the economy rebounds and states are pivoting toward resuming essential services, taking advantage of depressed construction costs, and meeting the needs of an 

aging veteran population, greater use of this grant program will continue. The 

American Legion encourages Congress to maintain the funding level of this 

program. 

The American Legion recommends budgeting $85 million for State Veterans 

Homes Construction Grant program. 

NATIONAL CEMETERY ADMINISTRATION (NCA)

No aspect of the VA is as critically acclaimed as the National Cemetery Administration (NCA). In the 2010 American Customer Satisfaction Index, the NCA 

achieved the highest ranking of any public or private organization. This wasn’t a 

one-time occurrence; it has been replicated numerous times in the past decade. In 

addition to meeting this customer service level, the NCA remains the highest employer of veterans within the Federal Government and remains the model for contracting with veteran-owned businesses. 

The NCA is comprised of 131 national cemeteries. NCA was established by Congress and approved by President Abraham Lincoln in 1862 to provide for the proper 

burial and registration of graves of Civil War dead. Since 1973, annual interments 

in NCA have increased from 36,400 to over 117,426 in 2011. 

While NCA met their goal of having 90 percent of veterans served within 75 miles 

of their home, their aggressive strategy to improve upon this in the coming five 

years will necessitate funding increases for new construction. Congress must provide 

sufficient major construction appropriations to permit NCA to accomplish this goal 

and open five new cemeteries in the coming five years. Moreover, funding must remain to continue to expand existing cemetery facilities as the need arises. 

335 

The average time to complete construction of a national cemetery is 7 years. The 

report of a study conducted pursuant to the Millennium Bill concluded that an additional 31 national cemeteries would be required to meet the burial option demand 

through 2020. In order to adequately fund these five new cemeteries, Congress must 

be prepared to appropriate the resources now. 

In addition, within the SCIP plan, the NCA identified a need of $563 million in 

major construction projects, $517 million in minor construction projects, and $231 

million in activation. While not as overwhelming as the need within other agencies 

of the VA, these are considerable. 

The American Legion recommends budgeting $100 million for each of the major 

and minor construction categories within NCA. 

While the costs of fuel, water, and contracts have risen, the NCA operations budget has remained nearly flat for the past two budgets. Some of these expenses have 

been a result of efficiency transformations within the cemetery. Others have been 

due to the thriftiness of cemetery superintendents. 

Unfortunately recent audits have shown cracks beginning to appear because of 

these savings. Due predominantly to poor contract oversight, several cemeteries inadvertently misidentified burial locations. Although only one or two were willful violations of NCA protocols, the findings demonstrate a system about ready to burst. 

To meet the increased costs of fuel, equipment, and other resources as well as 

ever-increasing contract costs, The American Legion believes a small increase is necessary. In addition, we urge Congress to adequately fund the construction program 

to meet the burial needs of our Nation’s veterans. 

The American Legion recommends budgeting $260 million for National Cemetery 

Administration’s Operating Budget. 

STATE VETERANS’ CEMETERIES GRANT PROGRAM

The NCA administers a program of grants to states to assist them in establishing 

or improving state-operated veterans’ cemeteries through VA’s State Cemeteries 

Grants Program (SCGP). Established in 1978, this program funds nearly 100 percent of the costs to establish a new cemetery, or expand existing facilities. For the 

past two budgets this program has been budgeted $46 million to accomplish this 

mission. 

In 2007, the Dr. James Allen Veteran Vision Equity Act of 2007 (Public Law 110– 

157) authorized VA under the SCGP to provide additional Federal assistance to 

states for the operation and maintenance of state veterans cemeteries. Prior to passage of this law, VA could only provide Federal funds for the establishment, expansion, and improvement of state veterans’ cemeteries. VA could not fund the operation or maintenance of state veterans’ cemeteries. 

The new authority granted by the Act authorizes VA to fund Operation and Maintenance Projects at state veterans’ cemeteries to assist states in achieving the national shrine standards VA achieves within national cemeteries. Specifically, the 

new operation and maintenance grants have been targeted to help states meet VA’s 

national shrine standards with respect to cleanliness, height and alignment of 

headstones and markers, leveling of gravesites, and turf conditions. The Act authorizes VA to award up to a total of $5 million for such purposes each fiscal year to 

ensure state veterans’ cemeteries meet the highest standards of appearance and 

serve as national shrines to honor the Nation’s military servicemembers with a final 

resting place. 

In addition, this law allowed for VA to provide funding for the delivery of grants 

to tribal governments for Native American veterans. Yet after the passage of this 

act, we have not seen the allocation of funding increased to not only meet the existing needs under the construction and expansion level, but also the needs from operation and maintenance and tribal nation grants. Moreover, as these cemeteries age, 

the $5 million limitation must be revoked to allow for better management of resources within the projects. 

State cemetery grants are managed through an intricate list of priority groups, 

assigning rank and priority to projects based on burial need, matching funds from 

the state or tribal government, and other factors. The 2012 priority list has over 100 

applications for grants valued at over $250 million. Sixty applications, totaling over 

$150 million, already have matching funds necessary to leverage the grant money 

from NCA. In order to meet this growing need, the grant funding must be increased. 

The American Legion recommends budgeting $60 million for State Veterans’ 

Cemeteries Grant Program. 

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CONCLUSION

In conclusion, The American Legion is optimistic the President has proposed a 

budget adequate to meet the needs of the more than 1 million servicemembers who 

are returning after deployments in support of the Global War on Terror. We’re hopeful savings generated through downsizing of the military are leveraged against the 

need of thousands of servicemembers who will be discharged to create the savings. 

Yet, we’re more than pessimistic these will be accomplished without budget gimmickry such as carryover funds, lofty collection goals, and other schemes. 

As we’ve seen in previous years, when these slights of hand are used, it almost 

always negatively impacts the care and benefits afforded to our Nation’s veterans. 

Too often while veteran advocates celebrate dramatically increased budgets, the veteran patient, claimant, or widow is left wondering where the money went. We must 

not do so again. 

Our Nation’s veterans deserve adequate and responsible funding to the fullest 

level possible. After over a decade of service, our newest era of veterans will join 

the ranks of generations of their brothers and sisters who are owed a great debt. 

Our debt is one paid for by the sweat in the ungodly heat of Iraq. Our liability 

was earned by the young Marine trudging up and down the rugged mountains of 

Afghanistan. This obligation was earned in the darkened cockpit of a medical evacuation flight jetting over the Atlantic. It is a debt of tears, blood and sacrifice and 

deserves to be repaid in honest true money. 

Chairman MURRAY. Mr. Blake. 

STATEMENT OF CARL BLAKE, THE NATIONAL LEGISLATIVE 

DIRECTOR, PARALYZED VETERANS OF AMERICA 

Mr. BLAKE. Madam Chairman, Senator Burr, on behalf of the coauthors of the Independent Budget, the Paralyzed Veterans of 

America is pleased to be here today to offer our views on the Administration’s budget request for fiscal year 2013 and the Advance 

Appropriation for Fiscal Year 2014. 

In the interest of time, I will limit my comments to just a couple 

of concerns with particular issues that are in the budget request. 

First, let me say up front we certainly appreciate the increase 

that the Administration has provided for in its budget request. 

That being said, we have real concerns as addressed also by the 

Committee Members here about the impact that sequestration may 

have. 

Simply put, we find it absurd that more than 6 months after the 

Budget Control Act was passed, there is still no definitive position 

on whether or not VA programs, and in particular health care programs, are protected from sequestration. I think the Committee 

and all the Members of Congress have made it clear, and I think 

it is time for a final decision to be made. 

With regards to some specific issues in the budget request, we 

echo the concerns that were raised here by Members of the Committee with regards to medical care collections and the roller coaster ride that has existed in recent years in determining the estimates for that. 

We also agree with the concerns that were raised about perceived 

management and the program improvements and efficiencies, 

whether those savings were actually realized and the impact of not 

realizing those savings may have on the delivery of health care. 

Probably, the largest or the single biggest concern that we have, 

however, is with a particular disclosure in the President’s budget 

that outlines what they have said is approximately a $3 billion excess in resources that were provided for fiscal year 2012 and about 

$2 billion in excess resources for fiscal year 2013. 

337 

This fact sort of begs the question. How can the Administration clearly say that they have $3 billion in excess resources for this fiscal year with fully 7 months of the fiscal year left to go? 

You know, we all hear the stories about shortages in staffing and 

those questions were raised earlier and all these different things. 

It just sort of boggles the mind that we suddenly have this excess 

resources, and we are not talking about a small pot of money either. We are talking about 5 percent of the VA budget. 

It is particularly troubling in light of the fact that the VA could 

potentially face a cut of 2 percent under sequestration. So, we 

would certainly encourage the Committee and all the Members of 

Congress to really investigate this and get to the bottom of this. 

This single fact could pose a bigger problem for the VA in its delivery of care than any other issue that the VA is facing, we believe, in the coming years, this year and in the coming years. 

With regards to fiscal year 2014 advance appropriation, I would 

just highlight a couple of concerns that we have. 

First, with regards to the increase in medical support and compliance, I would point to the fact that it is a some pretty substantial increase projected for 2014. This is not unlike some of the comments you made, Senator Burr, about the growth in administrative 

function within the VHA. 

At the same time, the advance appropriation provides for a very 

substantial decrease in medical facilities. While I understand that 

some of that is based on the assumption that they will transfer a 

certain amount of money and some FTE from the medical facilities 

into medical services, it also is contingent on a cut in nonrecurring 

maintenance of almost halving that account. 

I think given a lot of discussion in recent years about the impact 

of funding on nonrecurring maintenance and what effect it is having on VA facilities, the Committee should certainly be interested 

in looking into that further, and I know my colleague from the 

VFW as he addresses construction will probably touch on this as 

well. 

And so with that, I will conclude my statement and will be happy 

to take any questions you may have. 

[The prepared statement of Mr. Blake follows:] 

PREPARED STATEMENT OF CARL BLAKE, NATIONAL LEGISLATIVE DIRECTOR, 

PARALYZED VETERANS OF AMERICA

Chairman Murray, 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) health care 

system for FY 2013. 

As the country faces a difficult and uncertain fiscal future, the Department of Veterans Affairs likewise faces significant challenges ahead. Following months of rancorous debate about the national debt and Federal deficit during the summer of 

2011, Congress agreed upon a deficit reduction measure, Public Law 112–25, that 

could lead to cuts in discretionary and mandatory spending for VA. The coauthors 

of The Independent Budget—AMVETS, Disabled American Veterans, Paralyzed Veterans of America, and the Veterans of Foreign Wars—have serious concerns about 

the potential reductions in VA spending. While changes to benefits programs and 

cuts to discretionary programs have unique differences, the impact of these possibilities will be equally devastating for veterans and their families. 

Discretionary spending in VA accounts for approximately $62 billion. Of that 

amount, nearly 90 percent of that funding is directed toward VA medical care programs. The VA is the best health-care provider for veterans. Providing primary care 

338 

and specialized health services is an integral component of VA’s core mission and 

responsibility to veterans. Across the Nation, VA is a model health-care provider 

that has led the way in various areas of medical research, specialized services, and 

health-care technology. The VA’s unique system of care is one of the Nation’s only 

health-care systems that provides developed expertise in a broad continuum of care. 

Currently, the Veterans Health Administration serves more than 8 million veterans 

and provides specialized health-care services that include program specific centers 

for care in the areas of spinal cord injury/disease, blind rehabilitation, Traumatic 

Brain Injury, prosthetic services, mental health, and war-related polytraumatic injuries. Such quality and expertise on veterans’ health care cannot be adequately duplicated in the private sector. Any reduction in spending on VA health-care programs 

would only serve to degrade these critical services. 

The Independent Budget veterans service organizations (IBVSOs) are especially 

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, the FY 2012 

and FY 2013 advance appropriation budget proposal released by the Administration 

last year included ‘‘management improvements,’’ a popular gimmick used by previous Administrations to generate savings and offset the growing costs to deliver 

care. Additionally, the FY 2013 Budget Request and FY 2014 advance appropriation 

recommendation includes many of the same ‘‘management and program improvements.’’ Unfortunately, these savings are often never realized leaving VA short of 

necessary funding to address ever-growing demand on the health-care system. In 

fact, the Government Accountability Office (GAO) outlined its concerns with this 

budget accounting technique in a report released to the House and Senate Committees on Veterans’ Affairs in June 2011. In its report, the GAO states: 

If the estimated savings for fiscal years 2012 and 2013 do not materialize 

and VA receives appropriations in the amount requested by the President, 

VA may have to make difficult tradeoffs to manage within the resources 

provided. 

This observation reflects the real possibility that exists should VA health care, as 

well as other programs funded through the discretionary process, be subject to 

spending reductions. 

Moreover, we believe that continued pressure to reduce Federal spending will only 

lead to greater reliance on gimmicks and false assumptions to generate apparent 

but illusory funding. This is particularly true given the VA’s claim in the FY 2013 

Budget Request that it was provided nearly $3.0 billion in excess resources in FY 

2012 and more than $2.0 billion in excess resources in FY 2013. We question how 

the VA can make such a claim, particularly about FY 2012, when there remains 

fully seven months in this current fiscal year (FY 2012). This information deserves 

the highest level of scrutiny and oversight that this Committee can provide. While 

the VA claims that changes in its assumptions included in its actuarial model have 

led to this determination, the IB would argue that wide-ranging and sweeping 

changes in its assumptions would be necessary to lead to an approximately five percent change in funding needs. Additionally, the claim of excess resources does not 

seem to match the all-too-common reports that we receive of understaffed facilities 

and unavailability of services. 

In light of the Administration’s continued inability to determine its position with 

regards to sequestration, we have serious concerns about the fact that the VA 

claims to have nearly five percent in excess resources when it faces the prospect of 

up to a two percent reduction in funding under the rules of sequestration. We cannot emphasize enough the need for VA to state unequivocally that its programs will 

not be cut through sequestration. 

Meanwhile, Congress once again failed to fulfill its obligations to complete work 

on appropriations bills funding all Federal departments and agencies, including VA, 

by the start of the new fiscal year on October 1, 2011. Fortunately, as has become 

the new normal, last year the enactment of advance appropriations shielded the VA 

health-care system from the political wrangling and legislative deadlock. 

Finally, the IBVSO’s remain concerned about the continued downward revision of 

estimates in Medical Care Collections. In fact, in its original advance appropriation 

estimate for FY 2012, the VA projected collections of approximately $3.7 billion. 

Last year, the Administration revised that estimate to approximately $3.1 billion. 

This year, the Administration once again revised the collections estimate for FY 

2012 down to approximately $2.7 billion. At the same time, the collections estimate 

for FY 2013 was revised down from an estimate of $3.3 billion last year to a current 

estimate of approximately $3.0 billion. Given these revisions, we believed then, and 

continue to believe now, that the VA budget request and ultimately the funding proVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00344 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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vided through the appropriations process, was insufficient for VA to meet the demand on the health-care system, and may be insufficient going forward. 

FUNDING FOR FY 2013

For FY 2013, The Independent Budget recommends approximately $57.2 billion for 

total medical care, an increase of $3.3 billion over the FY 2012 operating budget 

level provided as an advance appropriation by Public Law 112–10, the ‘‘the Department of Defense and Full-Year Continuing Appropriations Act for FY 2011.’’ Meanwhile, the Administration recommended an advance appropriation for FY 2013 of 

approximately $52.5 billion in discretionary funding for VA medical care as a part 

of its FY 2012 Budget Request. When combined with the $3.3 billion Administration 

projection for medical care collections, the total available operating budget recommended for FY 2013 is approximately $55.8 billion. 

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 2013, The Independent Budget recommends approximately $46.0 billion for Medical Services. Our Medical Services 

recommendation includes the following recommendations: 

Current Services Estimate ......................................................... $43,855,969,000 

Increase in Patient Workload .................................................... $1,510,394,000 

Additional Medical Care Program Costs ................................... $675,000,000 

Total FY 2013 Medical Services ......................................... $46,041,363,000 

Our growth in patient workload is based on a projected increase of approximately 

110,000 new unique patients—priority groups 1–8 veterans and covered nonveterans. We estimate the cost of these new unique patients to be approximately 

$1 billion. 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 $349 

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. 

Finally, our increase in workload includes the projected enrollment of new priority 

group 8 veterans who will use the VA health-care system as a result of the Administration’s continued efforts to incrementally increase the enrollment of priority group 

8 veterans by 500,000 enrollments by FY 2013. We estimate that as a result of this 

policy decision, the number of new priority group 8 veterans who will enroll in VA 

should increase by 125,000 between FY 2010 and FY 2013. Based on the priority 

group 8 empirical utilization rate of 25 percent, we estimate that approximately 

31,250 of these new enrollees will become users of the system. This translates to 

a cost of approximately $134 million. When compared to the projections that the Administration had previously made for increased utilization for this Priority Group, 

we believe that our recommendations are on target for those projections. 

The Independent Budget also believes that there are additional projected funding 

needs for VA. Specifically, we believe there is real funding needed to restore the 

VA’s long-term-care capacity (for which a reasonable cost estimate can be determined based on the actual capacity shortfall of VA) and to provide additional centralized prosthetics funding (based on actual expenditures and projections from the 

VA’s prosthetics service). In order to restore the VA’s long-term care average daily 

census (ADC) to the level mandated by Public Law 106–117, the ‘‘Veterans Millennium Health Care and Benefits Act,’’ we recommend $375 million. In order to meet 

the increase in demand for prosthetics, the IB recommends an additional $300 million. This increase in prosthetics funding reflects a significant increase in expenditures from FY 2011 to FY 2012 (explained in the section on Centralized Prosthetics 

Funding) and the expected continued growth in expenditures for FY 2013. Additionally, it is worth noting that the VA has actively implemented the new caregiver program mandated by Public Law 111–163, the ‘‘Caregivers and Veterans Omnibus 

Health Services Act.’’ However, we believe that still greater funding should be appropriated, above what the VA has currently allocated for this program, in order to 

more effectively and efficiently operate the program. 

340 

For Medical Support and Compliance, The Independent Budget recommends approximately $5.6 billion. Finally, for Medical Facilities, The Independent Budget recommends approximately $5.6 billion. While our recommendation does not include an 

additional increase for nonrecurring maintenance (NRM), it does reflect a FY 2013 

baseline of approximately $900 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 $2.1 billion annually for NRM (Refer 

to Construction section article ‘‘Increase Spending on Nonrecurring Maintenance). 

For Medical and Prosthetic Research, The Independent Budget recommends $611 

million. This represents a $30 million increase over the FY 2012 appropriated level. 

We are particularly pleased that Congress has recognized the critical need for funding in the Medical and Prosthetic Research account in the last couple of years. Research is a vital part of veterans’ health care, and an essential mission for our national health care system. 

Last, Mr. Chairman, I would like to note one late change to our IB budget recommendations for State Home Construction Grants which arose after we went to press. 

Late last week VA finally released the FY 2012 grant priority list for State Home 

repair, renovation and new construction projects and there was a significant increase in State matching funds certified as available. After reviewing the newly released Priority List for FY 2012, there is now $321 million worth of Priority 1 State 

Home projects for which the States have certified matching funds available. As a 

result, the Federal funding required for Priority 1 projects will be at least $204 million in FY 2013, and that number is likely to rise even higher as States approve 

additional matching funding this year for a backlog of projects currently estimated 

at $400 million. While this recommendation is not reflected specifically in The Independent Budget, this change reflects what we believe our recommendation should 

now be. 

ADVANCE APPROPRIATIONS FOR FY 2014

As we have noted in the past, Public Law 111–81 requires 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 2013) and provide detailed estimates of the funds necessary for the medical care 

accounts for FY 2014. Moreover, the law also requires a thorough analysis and public report of the Administration’s advance appropriations projections by the Government Accountability Office (GAO) to determine if that information is sound and accurately reflects expected demand and costs. 

The 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. 

As for the specific recommendations for advance appropriations for FY 2014 offered by the Administration, considering our concerns about the funding levels provided for FY 2012 and FY 2013, we believe that those estimates may be insufficient 

to meet the continuing increase in demand for health care services. We are also 

skeptical of the substantial increase in funding that the Administration calls for in 

the Medical Support and Compliance account for FY 2014. Given the scrutiny on 

funding for administrative functions within the VA health care system, we are not 

certain that this projected increase truly reflects a wise investment in resources. 

Last, we have serious concerns about the significant reduction in funding projected for Medical Facilities in FY 2014. While we understand that the Administration intends to transfer approximately $320 million in resources and 1,080 FTE 

from Medical Facilities to Medical Services in FY 2014, this does not fully account 

for the reduction in funding. The Administration’s proposal also reflects a plan to 

reduce funding for Non-Recurring Maintenance by nearly $300 million as well. This 

substantial decrease in NRM funding certainly cannot be justified given the massive 

backlog of maintenance and construction projects that currently exists. This fact is 

even more troubling given the GAO’s findings in its report on advance appropriations last year that identified deficiencies in NRM funding. We encourage the Committee to conduct aggressive oversight to ensure that the Administration is not cutting funding in these critical areas simply as a way to drive down its spending 

projections. 

341 

In the end, it is easy to forget, that the people who are ultimately affected by 

wrangling over the budget are the men and women who have served and sacrificed 

so much for this Nation. We hope that you will consider these men and women 

when you develop your budget views and estimates, and we ask that you join us 

in adopting the recommendations of The Independent Budget. 

This concludes my testimony. I will be happy to answer any questions you may 

have. 

Senator BURR [presiding]. Thank you. 

Mr. Hall. 

STATEMENT OF JEFFREY HALL, ASSISTANT NATIONAL 

LEGISLATIVE DIRECTOR, DISABLED AMERICAN VETERANS 

Mr. HALL. Ranking Member Burr, thank you. 

On behalf of the Disabled American Veterans and as a co-author 

of the Independent Budget, I am pleased to be here today on behalf 

of our 1.4 million members to offer our views and recommendations 

regarding the independent budget for fiscal year 2013 as it relates 

to veterans benefits programs, judicial review, and the Veterans 

Benefits Administration. 

As you know, we are now on our third year of VBA’s latest effort 

to transform its outdated, inefficient claims processing system into 

a modern rules-based digital system. 

Over the next year, we will begin to see whether those strategies 

to transform the people, processes, and technologies will finally result in a cultural shift away from speed and production into a business culture of quality and accuracy which to us is truly the only 

way to get the backlog of claims under control. 

Although we have been very pleased with VBA’s increasing partnership and collaboration with VSO stakeholders, we urge this 

Committee to provide constant and aggressive oversight of the 

many transformation activities taking place throughout this year. 

Perhaps the most important initiative, as you know, is the Veteran’s Benefits Management System or VBMS, which is scheduled 

to begin its roll out nationally in June of this year with final completion of the roll out in late 2013. 

So, as VBA works to complete, perfect, and the deploy this vital 

new IT system, it is absolutely crucial that sufficient resources are 

provided. 

We do note, Ranking Member Burr, that the budget for VBMS drops down from $148 million in fiscal year 2012 to $128 million 

in fiscal year 2013. While we do not know the reason for the decrease in budget, we cannot emphasize enough the vital importance 

of the VBMS and the need for sufficient funding in order to complete the development and implementation. We hope this Committee will thoroughly examine whether that level of funding is 

sufficient also. 

In order to sustain VBA’s transformation efforts, the IB for fiscal 

year 2013 recommends maintaining current staffing levels in most 

business lines. Given the large increases in claims processors over 

the past few years, we believe VBA should be focusing its efforts 

on properly training new and existing employees with an emphasis 

on quality and accuracy to ensure that claims are done right the 

first time. 

We note that the vocational rehabilitation and employment service budget proposal for fiscal year 2013 does request funding for apVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00347 Fmt 6633 Sfmt 6601 H:\112TH HEARINGS\73401.TXT PAULIN
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proximately 150 new counselors designated for the expansion into 

the integrated disability evaluation system and the VetSuccess on 

Campus Program. 

We fully support both of these increases and these programs. 

However, in order to reach voc rehabs target of having one counselor for every 125 veterans served, they will need approximately 

195 additional counselors in fiscal year 2013 to accomplish this. 

Additionally, the Independent Budget is also recommending a 

staffing increase at the Board of Veterans Appeals. Although the 

board is currently authorized to have 544 full-time employees, its 

adopted budget for fiscal year 2012 only supports 532; and for fiscal 

year 2013, the budget request further would reduce that number 

to 527. 

Looking at the historical appeals rates and the rising number of 

original compensation claims, the IBVSOs recommend that the 

VBA be provided sufficient funding for an authorized workforce of, 

in fiscal year 2013, of at least 585 full-time employee equivalents. 

Finally, the IBVSOs once again call on Congress to enact legislation to finally end the inequitable prohibition on concurrent receipt 

for all disabled veterans and eliminate the unfair offset between 

the survivors benefit plan and the dependents’ indemnity compensation for veterans widows and their dependents. 

Ranking Member Burr, this concludes my statement. I will be 

happy to answer any questions. 

[The prepared statement of Mr. Hall follows:] 

PREPARED STATEMENT OF JEFFREY C. HALL, ASSISTANT NATIONAL LEGISLATIVE

DIRECTOR, DISABLED AMERICAN VETERANS

Chairman Murray, Ranking Member Burr and Members of the Committee: On behalf of the Disabled American Veterans (DAV) 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) 2013 budget 

related to veterans benefits, judicial review and the Veterans Benefits Administration (VBA). The Independent Budget is jointly produced each year by DAV, 

AMVETS, Paralyzed Veterans of America and Veterans of Foreign Wars. While 

there are dozens of recommendations in this year’s Independent Budget related to 

VBA’s benefit programs and claims processing reform, I will only highlight some of 

the most critical ones in my testimony, and commend the full text of the IB that 

is now available online. 

Madam Chairman, we are now in the third year of VBA’s latest effort to transform its outdated, inefficient, and inadequate claims-processing system into a modern, automated, rules-based, and paperless system. VBA has struggled for decades 

to provide timely and accurate decisions on claims for veterans’ benefits, especially 

veterans’ disability compensation, and there have been numerous prior reform attempts that began with great promise, only to fall far short of success. Over the next 

year, we will begin to see whether their strategies to transform the people, processes 

and technologies will finally result in a cultural shift away from focusing on speed 

and production to a business culture of quality and accuracy, which is the only way 

to truly get the backlog under control. 

RESOURCE RECOMMENDATIONS

Adequate Staffing for the Veterans Benefits Administration 

In order to sustain the transformation efforts underway at VBA, The Independent 

Budget for FY 2013 generally recommends maintaining current staffing levels in the 

VBA, with only modest increases for the Vocational Rehabilitation and Employment 

Service and the Board of Veterans’ Appeals. Due to substantial support from Congress, VBA’s Compensation Service experienced significant staffing increases between fiscal years 2008 and 2010, which supported an increase in the number of 

claims processed each of those years. Unfortunately, however, an even larger increase in new and reopened claims volume contributed to a rising backlog. HistoriVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00348 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
343 

cally, it takes approximately two years for a new Veterans Service Representative 

(VSR) to acquire sufficient knowledge and experience to be able to work independently with both speed and accuracy. It takes an additional period of at least two 

years of training to become a Rating Veterans Service Representative (RVSR) with 

the skills to accurately complete most rating claims. As such, the full productive capacity of the employees hired in recent years is only now becoming evident. 

This year VBA will roll out a new operating model for processing claims for disability compensation, which will change the roles and functions of thousands of 

VSRs and RVSRs at Regional Offices across the country. VBA is also planning to 

launch new IT systems, including the Veterans Benefits Management System 

(VBMS) and expand the functionality of their eBenefits system. Together these 

transformations are expected to have a significant effect on the productive capability 

of VBA’s workforce. While these changes are being fully implemented, and the effect 

on workforce requirements analyzed, the Independent Budget veterans service organizations (IBVSOs) do not recommend an increase in staffing for VBA’s Compensation Service for FY 2013. However, we do recommend that VBA initiate a scientific 

study to determine the workforce necessary to effectively manage its rising workload 

in a manner that produces timely and accurate rating decisions. 

Moving forward, should there be a decline in personnel dedicated to producing 

rating decisions, an increase in claims or the backlog, or should any of the longawaited VBA information technology initiatives fail to produce the projected reductions in processing times for claims, Congress must be prepared to act swiftly to intervene with the additional staffing resources. 

Staffing Increase for Vocational Rehabilitation and Employment Service 

In 2009, the Government Accountability Office (GAO) conducted a study to assess 

the Vocational Rehabilitation and Employment Services’ (VR&E’s) ability to meet its 

core mission functions. GAO found that 54 percent of VBA’s 57 regional offices reported they had fewer counselors than needed and 90 percent reported that their 

caseloads have become more complex since veterans began returning from Afghanistan and Iraq. 

VBA’s current caseload target is one counselor for every 125 veterans served; however, feedback received by the IBVSOs from counselors in the field suggested an actual workload as high as one to 145. Based on comparisons with state vocational 

rehabilitation programs and discussions with VR&E personnel, even the 1:125 ratio 

may be too high to effectively manage VR&E’s workload, particularly in providing 

service to seriously disabled veterans. 

Madam Chairman, we are pleased to note the VR&E budget proposal for FY 2013 

does request funding for approximately 150 new counselors; however, these individuals are designated for expansion of the Integrated Disability Evaluation System 

and the VetSuccess on Campus program. While the IBVSOs fully support both of 

these increases and programs, we cannot be certain what impact, if any, these additional out-based counselors will have on the VR&E’s current caseload ratio of approximately 1:145. 

However, based upon the feedback from the field and VBA’s projections of future 

workload, in order for VR&E to meet their caseload target of one counselor for every 

125 veterans served the IBVSOs are recommending an increase in funding for 

VR&E to accommodate approximately 195 additional full-time employees for FY 

2013. 

Staffing Increase for the Board of Veterans’ Appeals 

The Independent Budget also recommends a funding increase at the Board of Veterans’ Appeals (Board) sufficient to support an authorized workforce of at least 585 

full-time employee equivalents (FTEE) for FY 2013. Based on historical trends, the 

number of new appeals to the Board averages approximately five percent of all 

claims received, so as the number of claims processed by VBA is expected to rise 

significantly, so too will the Board’s workload rise commensurately. Considering the 

number of claims processed at VBA having grown to over one million, and projected 

to rise even higher, it is virtually certain that the Board’s workload will begin to 

escalate even faster. 

The Board is currently authorized to have 544 FTEEs; however, its budget in FY 

2011 could only support 532 FTEEs. The FY 2013 the budget proposal calls for a 

further reduction down to 527 FTEE; however, expected workload projections by the 

Board indicate that the authorized level for FY 2013 should be closer to 585 FTEEs. 

The IBVSOs are concerned that unless additional resources are provided to the 

Board, its ability to produce timely and accurate decisions will be constrained by 

an inadequate budget, and either the backlog will rise or accuracy will fall. Neither 

344 

of these outcomes is acceptable. At a minimum, Congress should increase funding 

to the Board in order to sustain 585 FTEE in FY 2013. 

Dedicated Courthouse for the Court of Appeals for Veterans Claims 

Madam Chairman, I would also like to highlight a recommendation in this year’s 

Independent Budget concerning the United States Court of Appeals for Veterans 

Claims. Since the Court’s inception in 1988, it has been housed in commercial office 

buildings, making it the only Article I court that does not have its own courthouse. 

The IBVSOs believe that the Court should be accorded at least the same degree of 

respect enjoyed by other appellate courts of the United States. Congress previously 

acted on this in fiscal year 2008 by allocating $7 million for preliminary work on 

site acquisition, site evaluation, preplanning for construction, architectural work, 

and associated studies and evaluations for the construction of the courthouse. It is 

time for Congress to provide the funding necessary to construct a permanent courthouse in a location of honor and dignity befitting the Court and the veterans it 

serves. 

VETERANS BENEFITS RECOMMENDATIONS

The Veterans Benefits Administration provides an array of benefits to our Nation’s veterans, including disability compensation, dependency and indemnity compensation, pensions, vocational rehabilitation, education benefits, home loans, and 

life insurance. Unfortunately, the failure to regularly adjust benefit rates or to tie 

them to realistic annual cost-of-living adjustments (COLAs), can threaten the effectiveness of these other benefits. For example, the annual COLAs do not take into 

account the rising cost of some basic necessities, such as food and energy. In addition to prudent increases in a number of specific benefits programs to meet today’s 

rising costs of living, The Independent Budget includes a number of recommendations designed to make several existing benefits more equitable for all veterans, particularly disabled veterans. 

Eliminate Remaining Concurrent Receipt Penalties 

Today, 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 can 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. Many nondisabled 

military retirees pursue additional careers after serving in order to supplement 

their income, thereby justly enjoying a full reward for completion of a military career with the added benefit of full income from civilian employment. In contrast, 

military retirees with service-connected disabilities do not enjoy the same full earning potential. 

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. Congress previously removed this offset for veterans with service-connected disabilities rated 50 percent or greater. The IBVSOs 

believe Congress should enact legislation to repeal the inequitable requirement that 

veterans’ military longevity retired pay be offset by an amount equal to their disability compensation if rated less than 50 percent. 

Repeal 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 dependency 

and indemnity compensation (DIC) for survivors of disabled veterans is inequitable 

and should be repealed. 

A veteran disabled in military service is compensated for the effects of serviceconnected 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 Department of Veterans Affairs. 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. 

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, however they may participate in the SBP, which is a survivor’s annuity purchased through deductions from their spouse’s military retirement pay. Upon 

345 

the military retiree’s death, the annuity is paid monthly to eligible beneficiaries 

under the plan. If the veteran died of 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 all entitlement to the SBP annuity. 

This offset is inequitable because there is no duplication of benefits since payments under the SBP and DIC programs are made for different purposes. Under the 

SBP, coverage is purchased by a veteran and paid to his or her surviving beneficiary 

at the time of the veteran’s death. 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 fully repeal the offset between 

dependency and indemnity compensation and the Survivor Benefit Plan. 

Adaptive Housing and Automobile Grants 

Service-connected disabled veterans who have impairments or loss of use of at 

least one of their hands, feet or eyes may be eligible for several grants to adapt their 

housing or automobiles, including the Specially Adapted Housing Grant and the 

Automobile and Special Adaptive Equipment Grants. However when veterans who 

have already received these grants are forced to move to a new home, or stay temporarily in someone else’s home, or need to replace an outdated automobile, they are 

restricted in accessing the full benefits of this program. To remedy this, Congress 

should establish a supplementary housing grant that covers the cost of new home 

adaptations for eligible veterans who have used their initial, once in-a-lifetime grant 

on specially adapted homes they no longer own and occupy. A separate grant should 

be provided for special adaptations to homes owned by family members in which 

veterans temporarily reside. VA should also be authorized to provide a supplementary auto grant to eligible veterans in an amount equaling the difference between their previously used one-time entitlement and the increased amount of the 

grant. 

Compensation for Quality of Life and Noneconomic Loss: 

Madam Chairman, our Nation’s 3.2 million service-disabled veterans rely greatly 

on VA’s disability compensation program as an essential source of financial support 

for themselves and their families. However, a number of recent studies and commissions have all agreed that VA’s disability compensation program does not do enough 

and should be revised to compensate for the loss of quality of life and other noneconomic losses that result from permanent disabilities suffered while serving in the 

Armed Forces. 

In 2007, the Institute of Medicine (IOM) published a report entitled, ‘‘A 21st Century System for Evaluating Veterans for Disability Benefits,’’ recommending that 

the current VA disability compensation system be expanded to include compensation 

for noneconomic loss and loss of quality of life. The IOM report stated that, 

‘‘* * * Congress and VA have implicitly recognized consequences in addition to 

work disability of impairments suffered by veterans in the Rating Schedule and 

other ways. Modern concepts of disability include work disability, nonwork disability, and quality of life (QOL) * * *.’’ 

The congressionally-mandated Veterans Disability Benefits Commission (VDBC), 

established by the National Defense Authorization Act of 2004 (Public Law 108– 

136), in 2007 also recommended that the ‘‘* * * veterans disability compensation 

program should compensate for three consequences of service-connected injuries and 

diseases: work disability, loss of ability to engage in usual life activities other than 

work, and loss of quality of life.’’ That same year, the President’s Commission on 

Care for America’s Returning Wounded Warriors, chaired by former Senator Bob 

Dole and former Health and Human Services Secretary Donna Shalala, also agreed 

that the current benefits system should be reformed to include noneconomic loss and 

quality of life as a factor in compensation. 

The Independent Budget concurs with all of these recommendations and calls on 

Congress to finally address this deficiency by amending title 38, United States Code, 

to clarify that disability compensation, in addition to providing compensation to 

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service-connected disabled veterans for their average loss of earnings capacity, must 

also include compensation for their noneconomic loss and for loss of their quality 

of life. The Canadian Veterans’ Affairs disability compensation program and the 

Australian Department of Veterans’ Affairs disability compensation program already 

do just that. It is now time for our Congress and VA to determine the most practical 

and equitable manner in which to provide compensation for noneconomic loss and 

loss of quality of life and then move expeditiously to implement this updated disability compensation program. 

CLAIMS PROCESSING REFORM RECOMMENDATIONS

Over the past decade, the number of veterans filing claims for disability compensation has more than doubled, rising from nearly 600,000 in 2000 to over 1.4 

million in 2011. This workload increase is the result of a number of factors over the 

past decade, including the wars in Iraq and Afghanistan, an increase in the complexity of claims and a downturn in the economy causing more veterans to seek VA 

assistance. Furthermore, new presumptive conditions related to Agent Orange exposure (ischemic heart disease, B-cell leukemia and Parkinson’s disease) and previously denied claims, resulting from the Nehmer decision added almost 200,000 

new claims this year; leading to a workload surge that will level off in 2012. During 

this same decade, VBA’s workforce grew by about 80%, rising from 13,500 FTEE 

in 2007 to over 20,000 today, with the vast majority of that increase occurring during the past four years. 

Yet despite the hiring of thousands of new employees, the number of pending 

claims for benefits, often referred to as the backlog, continues to grow. As of February 4, 2012, there were 891,402 pending claims for disability compensation and 

pensions awaiting rating decisions by the VBA, an increase of more than 114,000 

from one year ago, and almost double the 487,501 that were pending two years 

prior. The number of claims pending over 125 days, VBA’s official target for completing claims, reached 591,243, which is a 66 percent increase in one year and 

more than double the 185,040 from two years ago. 

More important than the number of claims processed is the number of claims 

processed correctly. The VBA quality assurance program is known as the Systematic 

Technical Accuracy Review (STAR) and is now available publicly on VA’s ASPIRE 

Dashboard. The most recent STAR measure for rating claims accuracy for the oneyear period ending September 2011 is 84 percent, about the same level as one year 

prior, and slightly lower than several years earlier. However, the VA Office of Inspector General (VAOIG) reported in May 2011 that based on inspections of 45,000 

claims at 16 of the VA’s 57 regional offices (VAROs), claims for disability compensation were correctly processed only 77 percent of the time. This error rate would 

equate to almost 250,000 incorrect claims decisions in just the past year. 

Cultural Change Needed to Fix Claims-Processing System: 

Under the weight of an outdated information technology system, increasing workload and growing backlog, the VBA faces a daunting challenge of comprehensively 

transforming the way it processes claims for benefits in the future, while simultaneously reducing the backlog of claims pending within its existing infrastructure. 

There have been many positive and hopeful signs that the VBA is on the right path; 

however, the critical choices made by VBA over the next year will determine whether this effort will ultimately succeed. It is essential that Congress provide careful 

and continuing oversight of this transformation to help ensure that the VBA 

achieves true reform and not just arithmetic milestones, such as lowered backlogs 

or decreased cycle times. 

One of the more positive signs has been the open and candid attitude of VBA 

leadership over the past several years, particularly progress toward developing a 

new partnership between VBA and veterans service organizations (VSOs) who assist 

veterans in filing claims. The IBVSOs have been increasingly consulted on a number of the new initiatives underway at VBA, including disability benefit questionnaires (DBQs), Veterans Benefit Management System (VBMS), and many, but not 

all business process pilots, including the I-LAB at the Indianapolis Regional Office. 

Building upon these efforts, VBA must continue to the reach out to its VSO partners, not just at central office, but also at each of the 57 regional offices. 

In order to drive and sustain its transformation strategies throughout such a massive organization, VBA must change how it measures and rewards performance in 

a manner designed to achieve the goal of getting claims decided right the first time. 

Unfortunately, most of the measures that VBA employs today are based primarily 

on production goals, rather than quality. This bias for speed over accuracy has long 

been VBA’s cultural norm, and it is not surprising that management and employees 

347 

today still feel a tremendous pressure to meet production goals first and foremost. 

While accuracy has been and remains one of the performance standards that must 

be met by all employees, new performance standards adopted over the past two 

years appear to have done little to create sufficient incentives to elevate quality 

above production. 

Over the next couple of crucial years, it will be particularly important for VBA 

and Congress to remain focused on the principal goal of enhancing quality and accuracy, rather than focusing on reducing the backlog. VBA should change the way it 

measures and reports progress so that there are more and better indicators of quality and accuracy, at least equal in weight to measures of speed and production. In 

addition, VBA should develop a systematic way to measure average work output for 

each category of its employees in order to establish more accurate performance 

standards, which will also allow the VBA to better project future workforce requirements. 

Implementing a New Operating Model for Processing Claims: 

As the Veterans Benefits Administration begins to implement a new operating 

model for processing claims for disability compensation, it must give priority to best 

practices that have been validated to increase quality and accuracy, not just speed 

and production. VBA has conducted more than 40 different pilot programs and initiatives looking at new ways of establishing, developing, rating, and awarding 

claims for benefits. Dozens of other ideas flowed from individual employees and regional offices, leadership retreats, and an internal innovation competition, leading 

to new initiatives such as quick pay, walk-in claims, and rules-based calculators. 

In order to test how best to integrate these and other pilots and initiatives conducted over the past two years, VA established the I-LAB at the Indianapolis Regional Office to develop a new end-to-end operating model for claims processing. The 

I-LAB settled on the segmentation of claims as the cornerstone principle for designing the new operating model. The traditional triage function was replaced at the ILAB with an Intake Processing Center, staffed with an experienced claims processor, whose responsibility was to divide claims along three separate tracks; Express, Core, and Special Ops. The Express lane is for simpler claims, such as fully 

developed claims, claims with one or two contentions, or other simple claims. The 

Special Ops lane is for more difficult claims, such as those with eight or more contentions, longstanding pending claims, complex conditions, such as Traumatic Brain 

Injury and special monthly compensation, and other claims requiring extensive time 

and expertise. The Core lane is for the balance of claims with between three and 

seven contentions, claims for individual unemployability (IU), original mental health 

conditions, and others. 

VBA has seen some early indications that productivity could increase through the 

use of the new segmentation strategy at the I-LAB; however, it may still be too soon 

to judge whether such results would be reproduced if applied nationally. While the 

VBA certainly needs to reform its claims-processing system, it must first ensure 

that proper metrics are in place in order to make sound decisions about the elements of its new operating model. 

By the end of 2011, the VBA stood up an Implementation Team to develop a strategy and plan for implementing the new operating model for processing claims. With 

the Secretary’s ambitious goal of processing all claims in less than 125 days with 

an accuracy rate of 98 percent by 2015, VBA’s strategy calls for 2012 to be a year 

of transition; full implementation of the new operating model is planned for 2013; 

in 2014, the VBA anticipates stabilization and assessment of the new system; and 

2015 is planned as the year of ‘‘centers of excellence,’’ an apparent reference to a 

future state that will centralize some VBA activities or functions. 

Critical to the success of this implementation strategy will be the choices made 

by VBA this year. It will also be absolutely essential for Congress to provide strong 

oversight to ensure that the enormous pressures on VBA to show progress toward 

eliminating or reducing the claims backlog does not result in short term gains at 

the expense of long-term reform. 

Stronger Training, Testing and Quality Control 

Madam Chairman, training, testing, and quality control must be given the highest 

priority within the Veterans Benefits Administration if the current claims processing reform efforts are to be successful. Training is essential to the professional 

development of individuals and tied directly to the quality of work they produce, as 

well as the quantity they can accurately produce. However, the IBVSOs remain concerned that under the rising pressure of increasing workload and backlogs, VBA 

managers and employees often choose to cut corners on training in order to focus 

on production at all costs. It is imperative that efforts to increase productivity not 

348 

interfere with required training of employees, particularly new employees who are 

still learning their job. 

Furthermore, after employees have been trained it is important that they are regularly tested to ensure that they have the knowledge and competencies to perform 

their jobs. A GAO report published in September 2011 found that there did not exist 

a nationwide training curriculum for VBA’s Decision Review Officers (DROs), despite the fact that 93 percent of regional managers interviewed supported such a 

national training program, as did virtually every DRO interviewed. We would note 

that following a recent DRO examination in which a high percentage failed to 

achieve acceptable results, the VBA required all DROs to undergo a one-week training program to enhance their knowledge and job skills. This is exactly the type of 

action that should regularly occur within an integrated training, testing, and quality 

control program. 

In 2008, Congress enacted Public Law 110–389, the Veterans’ Benefits Improvement Act of 2008, which required VBA to develop and implement a certification examination for all claims processors and managers. While tests have been developed 

and conducted for VSRs, RVSRs, and DROs, the tests for supervisory personnel and 

coaches have yet to be completed. VBA cannot accurately assess its training or 

measure an individual’s knowledge, understanding, or retention of the training material without regular testing. The IBVSOs believe it is essential that all VBA employees, coaches, and managers undergo regular testing to measure job skills and 

knowledge, as well as the effectiveness of the training. At the same time, VBA must 

ensure that certification tests are developed that accurately measure the skills and 

knowledge needed to perform the work of VSRs, RVSRs, DROs, coaches, and other 

managers. 

One of the most promising developments over the past year is VBA’s new initiative to stand up Quality Review Teams (QRTs) in every regional office. Developed 

from a review of the best practices used at certain high-performing regional offices, 

the QRT program will assign full-time, dedicated employees whose sole function is 

to seek out and correct errors in claims processing. QRTs will also work to develop 

in-process quality control measures to prevent errors before decisions are made. The 

IBVSOs strongly support this program and recommend that VBA make service in 

a QRT unit a career path requirement for those seeking to rise to senior positions 

in Regional Offices or at VBA’s headquarters in Washington, D.C. 

Madam Chairman, the IBVSOs believe the only way for VBA to make and sustain 

long-term reductions in the backlog is by producing better quality decisions in the 

first instance. The only way to institutionalize such a cultural shift within the VBA 

is by developing and giving priority to training, testing and quality control 

programs. 

New Information Technology Systems 

After two years of development, VBA’s Veterans Benefits Management System 

(VBMS) is planned to be rolled out nationally beginning in June of this year. The 

VBMS is designed to provide a comprehensive, paperless, and rules-based method 

of processing and awarding claims for VA benefits, particularly disability compensation and pension. The IBVSOs have been especially pleased with VBA efforts to incorporate the experience and perspective of our organizations throughout the VBMS 

development process. Understanding the important role that VSO service officers 

play in the claims process, VBA proactively sought frequent and substantive consultation with VSOs, both at the national VBMS office and at the pilot locations. 

The IBVSOs are confident that this promising partnership will strengthen VBMS 

for VBA, VSOs, and most importantly, veterans seeking VA benefits. 

As VBA turns the corner on VBMS development leading to deployment, it is imperative that Congress provide full funding to complete this essential IT initiative. 

In today’s difficult fiscal environment, there are concerns that efforts to balance the 

Federal budget and reduce the national debt could result in reductions to VA programs, including IT programs. Over the next year, Congress must ensure that the 

funding required and designated for the VBMS is protected from cuts or reprogramming, and spent as Congress intended. 

Another key IT component is eBenefits, VA’s online portal that allows veterans 

to apply for, monitor, and manage their benefits over the Internet. With more than 

2 million users registered, eBenefits provides a web-based method for veterans to 

file claims for disability and other benefits that will ultimately integrate that information directly into the VBMS to adjudicate those claims. As with VBMS, it is crucial that Congress and the VBA provide eBenefits full funding in order to support 

the ongoing transformation of the claims processing system. 

In closing Madam Chairman, the IBVSOs remain concerned about VBA’s plans 

for transitioning legacy paper claims into the new VBMS work environment. While 

349 

VBA is committed to moving forward with a paperless system for new claims, it has 

not yet determined how to handle reopened paper claims; specifically whether, when 

or how they would be converted to digital files. Because a majority of claims processed each year are for reopened or appealed claims and because files can remain 

active for decades, until all legacy claims are converted to digital data files, VBA 

could be forced to continue paper processing for decades. Requiring VBA employees 

to learn and master two different claims processing systems—one that is paperbased and the other digital—would add unnecessary complexity and could negatively affect quality, accuracy, and consistency. 

While there are very difficult technical questions to be answered about the most 

efficient manner of transitioning to all-digital processing, particular involving legacy 

paper files, the IBVSOs believe the VBA should do all it can to shorten the length 

of time this transition takes to complete, and should provide a clear roadmap for 

eliminating legacy paper files, one that includes clear timelines and resource requirements. While this transition may require significant upfront investment, it will 

pay dividends for the VBA and veterans in the future. 

Madam Chairman, this concludes my statement and I would be happy to answer 

any questions from you or other Members of the Committee. 

Senator BURR. Thank you, Mr. Hall. 

Ms. Zumatto. 

STATEMENT OF DIANE ZUMATTO, NATIONAL LEGISLATIVE 

DIRECTOR, AMVETS 

Ms. ZUMATTO. Yes. Good afternoon, Senator Burr. 

On behalf of AMVETS and the co-authors of the IB, I thank you 

for this opportunity to share our recommendations with you today. 

My main focus will be the NCA or the National Cemetery Administration. 

The single most important obligation of the NCA is to honor the 

memory, achievements, and sacrifices of our veterans who so nobly 

served in this Nation’s Armed Forces. These acts of self sacrifice by 

our veterans obligate America to not only preserve but to rehabilitate and expand our national cemetery system as necessary to meet 

the needs of American veterans. 

These venerable and commemorative spaces are part of America’s historic material culture. They are museums of art and American history. They are fields of honor and hallowed grounds, and 

they deserve and require our most respectful stewardship. 

The sacred tradition of our national cemeteries began in 1862 

when the earliest military graveyards were situated at battle sites, 

at field or general hospitals, and at former prisoner of war sites; 

and since that time, more than three million burials have taken 

place within the NCA system. 

The NCA currently maintains stewardship of 131 of our Nation’s 

147 national cemeteries as well as 33 Soldiers Lots, which are currently located in 39 States and Puerto Rico. 

As of late 2010, there were more than 20,021 acres of historic 

landscape, funerary monuments and other architectural features 

included within established NCA sites. 

VA estimates that of the roughly 22.4 million veterans alive 

today that approximately 14.4 percent of them will choose a National or State veterans cemetery as their final resting place. With 

the transition of an additional one million servicemembers and the 

veteran status over the next 12 months, this number is expected 

to continue rising until approximately 2017. 

In fiscal year 2011, the NCA, which is the Nation’s largest cemetery system, invested an estimated $31.49 million into the National 

350 

Shrine Initiative in its efforts to improve the appearance of our national cemeteries. 

In order to adequately meet the demands for interment, gravesite maintenance, and related essential elements of cemetery operations, the IBVSOs recommend $280 million for the NCA’s operations and maintenance budget in fiscal year 2013 with an annual 

increase of $20 million until the national shrine commitment operational standards and measures goals regarding height and alignment of headstones and markers as well as the appearance of 

gravesites are reached. 

Finally, the IBVSOs call on the Administration and Congress to 

provide the resources needed to meet the sensitive and critical nature of the NCA’s mission and to fulfill the Nation’s commitment 

to all veterans who have served their country honorably and faithfully. 

That concludes my statement and I will be happy to take any 

questions. 

[The prepared statement of Ms. Zumatto follows:] 

PREPARED STATEMENT OF DIANE M. ZUMATTO, NATIONAL LEGISLATIVE DIRECTOR, AMVETS 

Chairman Murray, Ranking Member Burr, and Members of the Committee, As a 

co-author of The Independent Budget (IB), AMVETS is grateful for this opportunity 

to present the views of The 1B regarding the funding requirements for the Department of Veterans Affairs’ (VA) National Cemetery Administration (NCA) for Fiscal 

Year 2013. 

The venerable and honorable history of our national cemeteries spans roughly 150 

years when the earliest military graveyards were, not surprisingly, situated at battle sites, near field or general hospitals and at former prisoner-of-war sites. With 

the passage of the National Cemeteries Act of 1973 (P.L. 93–43), the Department 

of Veterans’ Affairs (VA) became responsible for the majority of our national cemeteries. The single most important obligation of the National Cemetery Administration (NCA) is to honor the memory of America’s brave men and women who have 

selflessly served in this Nation’s Armed Forces. Many of the individual cemeteries, 

monuments, grave stones, grounds and related memorial tributes within the NCA 

system are richly steeped in history and represent the very foundation of these 

United States. 

With the signing of the Veterans Programs Enhancement Act of 1998 (P.L. 105– 

368) which officially re-designated the National Cemetery System (NCS) to the now 

familiar National Cemetery Administration (NCA). The NCA currently maintains 

stewardship of 131 of the Nation’s 147 national cemeteries, as well as 33 soldiers’ 

lots. Since 1862 when President Abraham Lincoln signed the first legislation establishing the national cemetery concept, more than 3 million burials have taken place 

in national cemeteries currently located in 39 states and Puerto Rico. As of late 

2010, there were more than 20,021 acres of landscape, funerary monuments, grave 

markers and other architectural features, much of it historically significant, included within established installations in the NCA. 

VA estimates that approximately 22.4 million veterans are alive today and with 

the transition of an additional 1 million servicemembers into veteran status over the 

next 12 months, this number is expected to continue to rise until approximately 

2017. On average, 14.4 percent of veterans choose a national or state veterans’ cemetery as their final resting place. As new national and state cemeteries continue to 

open and as our aging veterans’ population continues to grow, we continue to be a 

nation at war on multiple fronts. The demand for burial at a veterans’ cemetery will 

continue to increase. 

The Independent Budget veterans service organizations (IBVSOs) would like to acknowledge the dedication and commitment demonstrated by the NCA leadership 

and staff in their continued dedication to providing the highest quality of service 

to veterans and their families. It is in the opinion of the IBVSOs that the NCA continues to meet its goals and the goals set forth by others because of its true dedication and care for honoring the memories of the men and women who have so selflessly served our Nation. We applaud the NCA for recognizing that it must continue 

to be responsive to the preferences and expectations of the veterans’ community by 

351 

adapting or adopting new interment options and ensuring access to burial options 

in the national, state and tribal government-operated cemeteries. We also believe 

it is important to recognize the NCA’s efforts in employing both disabled and homeless veterans. 

NCA ACCOUNTS

In Fiscal Year 2011, the National Cemetery Administration operated on an esti- mated budget of $298.3 million associated with the operations and maintenance of 

its grounds. The NCA had no carryover for Fiscal Year 2011. The NCA was also 

able to award 44 of its 48 minor construction projects and had four unobligated 

projects that will be moved to Fiscal Year 2012. Unfortunately, due to continuing 

resolutions and the current budget situation, the NCA was not able to award the 

remaining four projects. 

The IBVSOs support the operational standards and measures outlined in the National Shrine Commitment (P.L. 106–117, Sec. 613) which was enacted in 1999 to 

ensure that our national cemeteries are the finest in the world. While the NCA has 

worked diligently improving the appearance of our national cemeteries, they are still 

a long way from where they should be. 

The NCA has worked tirelessly to improve the appearance of our national ceme- teries, investing an estimated $39 million into the National Shrine Initiative in Fiscal Year 2011. According to NCA surveys, as of October 2011 the NCA has continued to make progress in reaching its performance measures. Since 2006, the NCA 

has improved headstone and marker height and alignment in national cemeteries 

from 67 percent to 70 percent and has improved cleanliness of tombstones, markers 

and niches from 77 percent to 91 percent. Although the NCA is nearing its strategic 

goal of 90 percent and 95 percent, respectively, for height and alignment and cleanliness, more funding is needed to continue this delicate and labor-intensive work. 

Therefore, the IBVSOs recommend the NCA’s Operations and Maintenance budget 

to be increased by $20 million per year until the operational standards and measures goals are reached. 

The IBVSOs recommend an Operational and Maintenance budget of $280 million 

for the National Cemetery Administration for Fiscal Year 2013 so it can meet the 

demands for interment, gravesite maintenance and related essential elements of 

cemetery operations. This request includes $20 million for the National Shrine Initiative. 

The IBVSOs call on the Administration and Congress to provide the resources 

needed to meet the critical nature of the NCA’s mission and to fulfill the Nation’s 

commitment to all veterans who have served their country so honorably and faithfully. 

STATE CEMETERY GRANT PROGRAMS

The State Cemetery Grants Program (SCGP) complements the National Cemetery 

Administration’s mission to establish gravesites for veterans in areas where it cannot fully respond to the burial needs of veterans. Several incentives are in place to 

assist states in this effort. For example, the NCA can provide up to 100 percent of 

the development cost for an approved cemetery project, including establishing a new 

cemetery and expanding or improving an established state or tribal organization 

veterans’ cemetery. New equipment, such as mowers and backhoes, can be provided 

for new cemeteries. In addition, the Department of Veterans’ Affairs may also provide operating grants to help cemeteries achieve national shrine standards. 

In Fiscal Year 2011, the SCGP operated on an estimated budget of $46 million, 

funding 16 state cemeteries. These 16 state cemeteries included the establishment 

or ground breaking of five new state cemeteries, three of which are located on tribal 

lands, expansions and improvements at seven state cemeteries, and four projects 

aimed at assisting state cemeteries to meet the NCA national shrine standards. 

Since 1978, the Department of Veterans’ Affairs has more than doubled the available acreage and accommodated more than a 100 percent increase in burials 

through this program. 

With the enactment of the ‘‘Veterans Benefits Improvement Act of 1998,’’ the NCA 

has been able to strengthen its partnership with states and increase burial services 

to veterans, especially those living in less densely populated areas without access 

to a nearby national cemetery. Through Fiscal Year 2010, the state grant program 

has established 75 state veteran’s cemeteries in 40 states and U.S. territories. Furthermore, in Fiscal Year 2011 VA awarded its first state cemetery grant to a tribal 

organization. 

The Independent Budget veteran’s service organizations recommend that Congress 

fund the State Cemetery Grants Program at $51 million for Fiscal Year 2013. The 

352 

IBVSOs believe that this small increase in funding will help the National Cemetery 

Administration meet the needs of the State Cemetery Grant Program, as its expected demand will continue to rise through 2017. Furthermore, this funding level 

will allow the NCA to continue to expand in an effort of reaching its goal of serving 

94 percent of the Nation’s veteran population by 2015. 

VETERAN’S BURIAL BENEFITS

Since the original parcel of land was set aside for the sacred committal of Civil 

War Veterans by President Abraham Lincoln in 1862, more than 3 million burials 

have occurred in national cemeteries under the National Cemetery Administration. 

In 1973, the Department of Veterans’ Affairs established a burial allowance that 

provided partial reimbursement for eligible funeral and burial costs. The current 

payment is $2,000 for burial expenses for service-connected deaths, $300 for nonservice-connected deaths and a $700 plot allowance. At its inception, the payout covered 72 percent of the funeral costs for a service-connected death, 22 percent for a 

non-service-connected death and 54 percent of the cost of a burial plot. 

Burial allowance was first introduced in 1917 to prevent veterans from being buried in potter’s fields. In 1923 the allowance was modified. The benefit was determined by a means test until it was removed in 1936. In its early history the burial 

allowance was paid to all veterans, regardless of their service connectivity of death. 

In 1973, the allowance was modified to reflect the status of service connection. 

The plot allowance was introduced in 1973 as an attempt to provide a plot benefit 

for veterans who did not have reasonable access to a national cemetery. Although 

neither the plot allowance nor the burial allowance was intended to cover the full 

cost of a civilian burial in a private cemetery, the recent increase in the benefit’s 

value indicates the intent to provide a meaningful benefit. The Independent Budget 

veterans’ service organizations are pleased that the 111th Congress acted quickly 

and passed an increase in the plot allowance for certain veterans from $300 to $700 

effective October 1, 2011. However, we believe that there is still a serious deficit between the original value of the benefit and its current value. 

In order to bring the benefit back up to its original intended value, the payment 

for service-connected burial allowance should be increased to $6,160, the non-service-connected burial allowance should be increased to $1,918 and the plot allowance 

should be increased to $1,150. The IBVSOs believe Congress should divide the burial benefits into two categories: veterans within the accessibility model and veterans 

outside the accessibility model. 

Congress should increase the plot allowance from $700 to $1,150 for all eligible 

veterans and expand the eligibility for the plot allowance for all veterans who would 

be eligible for burial in a national cemetery, not just those who served during wartime. Congress should also increase the service-connected burial benefits from 

$2,000 to $6,160 for veterans outside the radius threshold and to $2,793 for veterans 

inside the radius threshold. 

Congress should increase the non-service-connected burial benefits from $300 to 

$1,918 for all veterans outside the radius threshold and to $854 for all veterans inside the radius threshold. The Administration and Congress should provide the resources required to meet the critical nature of the National Cemetery Administration’s mission and to fulfill the Nation’s commitment to all veterans who have 

served their country so honorably and faithfully. 

EDUCATION, EMPLOYMENT AND TRAINING

During this time of persistent unemployment in our country, the veterans’ community as a whole has been hit disproportionately hard, but for Iraq and Afghanistan veterans and Reserve Component members, the job prospects are particularly 

bleak. Estimates as recent as October 2011 suggest that the unemployment rate 

among veterans returning from Iraq and Afghanistan are at least 3 percent greater 

than the national average. In consideration of the tremendous sacrifices our veterans have made for this Nation, Congress and the Administration must make a 

concerted effort to guarantee that all veterans have access to education, employment 

and training opportunities to ensure success in an unfavorable civilian job market. 

Assisting those who have honorably served to secure the proper skills, certifications and degrees so that they can achieve personal success is and should always 

be central to our support of veterans. In addition, disabled veterans often encounter 

barriers to entry or reentry into the workforce. The lack of appropriate accommodations on the job can make obtaining quality training, education and job skills especially problematic. These difficulties, in turn, contribute to low labor force participation rates and leave many disadvantaged veterans with little choice but to rely on 

government assistance programs. At present funding levels, entitlement and benefit 

353 

programs cannot keep pace with the current and future demand for such benefits. 

The vast majority of working-age veterans want to be productive in the workplace, 

and we must provide greater opportunities to help them achieve their career goals. 

Thankfully, this Congress passed the VOW to Hire Heroes Act in recognition of 

these veterans’ employment challenges, an important step in improving veterans’ job 

prospects. 

EDUCATION

In 2008, Congress enacted the Post-9/11 GI 13111 and ensured that today’s veterans have greater opportunities for success after their years of voluntary service 

to our Nation. The Independent Budget veterans’ service organizations (IBVSOs) 

were pleased with the quick passage of this landmark benefit and worked with Congress to quickly correct unforeseen inequities via the ‘‘Post-9/11 Veterans Education 

Assistance Improvement Act of 2010.’’ When it was signed into law, leaders in Congress and in the veterans’ advocacy community touted the prospect that the Post9/11 GI Bill could create a new ‘‘Greatest Generation,’’ offering critical job skills and 

training to a new generation of leaders. 

The IBVSOs are concerned that the Post-9/11 GI Bill may be vulnerable to budgetary attacks as the conflicts in Iraq and Afghanistan draw to a close. The benefits 

of the Post-9/11 GI Bill must continue to remain available to honor the sacrifice of 

our Nation’s veterans. To support this request, the Department of Veterans Affairs 

must develop the metrics to accurately measure the short- and long-term impacts 

of these educational benefits. The IBVSOs believe that the Post-9/11 GI Bill is an 

investment not only in the future of our veterans but also our Nation. 

TRAINING AND REHABILITATION SERVICES: VOCATIONAL REHABILITATION AND

EMPLOYMENT

Vocational rehabilitation for disabled veterans has been part of this Nation’s commitment to veterans since Congress first established a system of veterans’ benefits 

upon entry of the United States into World War I in 1917. Today the Vocational 

Rehabilitation and Employment (VR&E) Service, through its VetSuccess Program, 

is charged with preparing service-disabled veterans for suitable employment or providing independent living services to those veterans with disabilities severe enough 

to render them unemployable. Approximately 48,000 active duty, Guard and Reserve personnel are discharged annually, with more than 25,000 of those on active 

duty found ‘‘not fit for duty’’ as a result of medical conditions that may qualify for 

VA disability ratings. With a disability rating the veteran would potentially be eligible for Vocational Rehabilitation and Employment services. According to the most 

recent report from the Government Accountability Office (GAO) on VR&E services, 

the ability of veterans to access VR&E services has remained problematic. 

The task before Vocational Rehabilitation and Employment’s (VR&E) VetSuccess 

program is critical, and the need becomes clearer in the face of the statistics from 

the current conflicts. Since September 11, 2001, there have been more than 2.2 million servicemembers deployed. Of that group, more than 941,000 have been deployed 

two or more times. As a result, many of these servicemembers are eligible for disability benefits and VR&E services if they are found to have an employment handicap. Specifically, 43 percent may actually file claims for disability. Due to the increasing number of servicemembers returning from Iraq and Afghanistan with serious disabilities, VR&E must be provided the resources to further strengthen its program. There is no VA mission more important than that of enabling injured military 

personnel to lead productive lives after serving their country. In the face of these 

facts, of concern to The Independent Budget veterans service organizations (IBVSOs) 

are the current constraints placed on VR&E as a result of an average client to counselor ratio of 145:1 compared to the VA standard of 125:1. VR&E, working through 

outside contractors, continues to refine and refocus this important program so it can 

maximize its ability to deliver services within certain budgetary constraints. Given 

the anticipated caseload that future downsizing of the military will produce, a more 

concise way to determine staffing requirements and a more rigorous manpower formula must be developed. 

With this in mind, the IBVSOs recommend that VA needs to strengthen its Vocational Rehabilitation and Employment (VR&E) program to meet the demands of disabled veterans, particularly those returning from the conflicts in Afghanistan and 

Iraq. It must provide a more timely and effective transition into the workforce and 

provide placement follow-up with employers for a minimum of six months. Congress 

must provide the resources for VR&E to establish a maximum client to counselor 

standard of 125:1 and a new ratio of 100:1 to be the standard. VR&E must place 

a higher emphasis on academic training, employment services and independent livVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00359 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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ing to achieve the goal of rehabilitation of severely disabled veterans. Congress 

should provide the resources to support the expansion of VR&E’s quality assurance 

staff to increase the frequency of site visits. Congress and the Administration must 

ensure that VR&E is provided the necessary resources to upgrade its legacy Corporate WINRS and the new VetSuccess information technology platform as part of 

the Veterans Benefits Administration’s upgrade of its larger IT systems. 

Congress must also conduct oversight to ensure that Vocational Rehabilitation 

and Employment (VR&E) program services are being delivered efficiently and effectively. VR&E must develop and implement metrics that can identify problems and 

lead to solutions that effectively remove barriers to veteran completion of VR&E 

programs. 

TRANSITION ASSISTANCE PROGRAMS

The Transition Assistance Program (TAP) was developed to assist military families leaving active service. The Department of Labor (DOL) began providing TAP 

employment workshops in 1991, pursuant to section 502 of the ‘‘National Defense 

Authorization Act for Fiscal Year 1991’’ (P.L. 101–510). It is an interagency program 

delivered in partnership by DOL and the Departments of Veterans Affairs, Defense 

(DOD) and Homeland Security (DHS). Returning to civilian life is a complex and 

exciting time for servicemembers. TAP and the Disabled Transition Program 

(DTAP) will, generally, now be mandatory thanks to the ‘‘VOW to Hire Heroes Act’’ 

(P.L. 112–56) and will result in the program becoming an even greater benefit in 

meeting the needs of separating servicemembers as they transition into civilian life. 

As part of the new TAP, eligible members will be allowed to participate in an apprenticeship or pre-apprenticeship program that provides them with education, 

training and services necessary to transition to meaningful employment. These new 

TAP classes will also upgrade career counseling options and re ́sume ́ writing skills, 

as well as ensuring the program is tailored for the 21st century job market. TAP 

is also available for eligible demobilizing servicemembers in the National Guard and 

reserves. The news is that efforts to improve both TAP and DTAP are under way. 

The IBVSOs recommend that all Transition Assistance Program (TAP) classes 

should include in-depth VA benefits and health-care education sessions and time for 

question and answer sessions. The Departments of Veterans Affairs, Defense, Labor 

and Homeland Security should design and implement a stronger Disabled Transition Assistance Program (DTAP) for wounded servicemembers who have received serious injuries, and for their families. Chartered veterans service organizations 

should be directly involved in TAP and DTAP or, at minimum, serve as an outside 

resource to TAP and DTAP. The DOD, VA, DOL, and DHS must do a better job 

educating the families of servicemembers on the availability of TAP classes, along 

with other VA and DOL programs regarding employment, financial stability and 

health-care resources. Congress and the Administration must provide adequate 

funding to support TAP and DTAP to ensure that active duty, as well as National 

Guard and reserve servicemembers, receive proper services during their transition 

periods. 

Senator BURR. Thank you, Ms. Zumatto. 

Ray, how are you? 

STATEMENT OF RAYMOND KELLEY, NATIONAL LEGISLATIVE 

DIRECTOR, VETERANS OF FOREIGN WARS 

Mr. KELLEY. Good. Ranking Member Burr, on behalf of the more 

than two million members of the Veterans of Foreign Wars and our 

until auxiliaries, thank you for the opportunity to testify today. 

In partnership with the IB, it is VFW’s responsibility to take 

care of construction accounts so I will limit my remarks to that. 

Every effort must be made to ensure that facilities are safe and 

sufficient environments to deliver care. 

Since 2004, utilization in VA has grown from 80 percent to 121 

percent and facility conditions have dropped from 81 percent to 71 

percent. This is having an impact upon the delivery of health care. 

To determine and monitor the condition of facilities, VA conducted a Facility Condition Assessments or an FCA. These assessVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00360 Fmt 6633 Sfmt 6601 H:\112TH HEARINGS\73401.TXT PAULIN
355 

ments include inspections of building systems such as electrical, 

mechanical, structural and architectural safety. 

The FCA review team can grant a rating of an ‘‘A’’ to an ‘‘F’’. An 

‘‘A’’ through ‘‘C’’ is either a new condition, a new facility or an average condition of a facility. An ‘‘F’’ means the condition of the facility requires immediate attention. 

To correct the efficiencies of the ‘‘D’s and ‘‘F’s, VA will need to 

invest nearly $10 billion. VA is requesting $400 million for four of 

the 21 partially funded VHA major construction projects in fiscal 

year 2013, leaving well over $5 billion remaining in partially funded projects dating back to fiscal year 2007. 

These projects include improving seismic deficiencies, improving 

spinal cord injury centers, completing a polytrauma blind rehab 

and research facility as well as expanding mental health facilities. 

This request is too low to support the ever-growing need of veterans. Therefore, the IB partners request that Congress provide 

funding of $2.8 billion to cover all major construction accounts. 

This will allow VA to complete all current partially funded major 

constructions seismic corrections, and mental health centers, and 

the fund before VA-identified projects for fiscal year 2013. 

Although VA’s funding request for minor construction account is 

lower than the IB’s request, this level of funding will allow VA to 

fund more than 120 projects. 

Even though non-recurring maintenance or NRM is funded 

through VA’s medical facilities account and not through the construction account, it is critical to VA’s capital infrastructure. 

VA is requesting $774 million in NRM for fiscal year 2013; but 

to keep pace with need and to reduce the backlog of NRM, $2.1 billion is needed. The IB is not requesting this amount of funding for 

NRM, only pointing out that the actual need to reach, that is the 

amount needed to reached the VA’s strategic goals. 

Enhanced use lease gives VA the authority to lease land and 

buildings as long as the lease is consistent with VA’s mission. Although an enhanced used lease can be used for a wide range of activities, the majority of these leases result in housing for homeless 

veterans and assisted living facilities. 

In fiscal year 2013, VA has 19 buildings or parcels of land that 

are planned for enhanced used lease. However, this authority has 

expired and we encourage Congress to reauthorized enhanced use 

lease so VA can continue to put empty and underutilized space to 

work for veterans. 

Ranking Member, this concludes my testimony, and I look forward to any questions you or the Committee has. 

[The prepared statement of Mr. Kelley follows:] 

PREPARED STATEMENT OF RAYMOND KELLEY, DIRECTOR, NATIONAL LEGISLATIVE

SERVICE, VETERANS OF FOREIGN WARS OF THE UNITED STATES

Madam Chairman and Members of the Committee: On behalf of the more than 

2 million men and women of the Veterans of Foreign Wars of the U.S. (VFW) and 

our Auxiliaries, I would like to thank you for the opportunity to testify today. The 

VFW works alongside the other members of The Independent Budget (IB)— 

AMVETS, Disabled American Veterans and Paralyzed Veterans of America—to 

produce a set of policy and budget recommendations that reflect what we believe 

would meet the needs of America’s veterans. The VFW is responsible for the construction portion of the IB, so I will limit my remarks to that portion of the budget. 

356 

1FY 2012 Budget Submission, Construction and 10-Year Capital Plan, February 2011, Vol. 4 

of 4, p. 9.3–11, 12 2 Ibid, p. 9.3–13, 14 

3 Ibid, p. 8.2–4. 

4 Ibid, p. 81–1. 

5 Ibid, p. 9.3–14 15. 

6FY 2012 Budget Submission, Construction and 10-Year Capital Plan, February 2011, Vol. 4 

of 4, p. 2–85. 7FY 2012 Budget Submission, Construction and 10-Year Capital Plan, February 2011, Vol. 4 

of 4, p. 1–4. 

With an infrastructure that is more than 60 years old, the Department of Veterans Affairs (VA) has a monumental task of maintaining and improving its vast 

network of facilities to ensure the Veterans Health Administration (VHA) can provide accessible, high-quality health care to our Nation’s veterans. Currently, VA 

owns 5,300 buildings and manages more than 800 leases. In 2005, VA began using 

the Federal Real Property Council (FRPC) Tier 1 performance measures to assess 

its capital portfolio goals.1 The two measures that directly affect patient services are 

utilization and condition. In 2004, VA’s utilization was at 80 percent, well below capacity. That utilization grew to 121 percent in 2010, and is projected to grow even 

more in the coming years. During the same time period, the condition of VA’s infrastructure decreased from 81 percent to 71 percent.2 These trends show that funding 

for the next few years will be critical for VA to fulfill its mission. 

VA has developed the Strategic Capital Investment Plan (SCIP) to address the 

critical deficiencies in its infrastructure. SCIP uses six criteria to assess deficiencies, 

or gaps, in its ability to deliver efficient, high- quality, accessible services and care 

for veterans. The six gap criteria are access, utilization, space, condition, energy, 

and other (which includes safety, security, privacy, and seismic corrections).3 It was 

also determined that to close all these gaps it would cost between $53 billion and 

$65 billion.4

To determine and monitor the condition of its facilities, VA conducted a Facility 

Condition Assessment (FCA). These assessments include inspections of building systems, such as electrical, mechanical, plumbing, elevators, and structural and architectural safety; and site conditions consisting of roads, parking, sidewalks, water 

mains, water protection. The FCA review team can grant ratings of A, B, C, D, and 

F. Assessment ratings A through C conclude the assessed is in new to average condition. D ratings mean the condition is below average and F means the condition 

is critical and requires immediate attention. To correct these deficiencies, VA will 

need to invest nearly $10 billion.5 To close the gaps in access, VA will need to invest between $30 billion and $35 billion dollars in major and minor construction and 

leasing. The remaining $20 billion is needed to close the remaining nonrecurring 

maintenance deficiencies. 

MAJOR CONSTRUCTION ACCOUNTS: 

By estimation of the Department of Veterans Affairs, the cost to implement all 

currently identified gaps in major construction, Congress will have to authorize and 

appropriate between $20 billion and $24.5 billion over the next 10 years. Currently, 

there are 35 major construction projects that are authorized, dating back as far as 

2004. Only three of these projects are funded through completion. The total unobligated amount for all currently congressionally budgeted major construction projects 

is $2.8 billion.6 Yet the total funding requested for FY 2012 major construction ac- counts was only $725 million. 

At this level of funding, it will take VA more than 25 years to complete its current 

10-year capital investment plan. The Independent Budget veterans service organizations (IBVSOs) understand that fiscally difficult times call for spending restraints, 

but without quality, accessible medical centers, VA will not be able to deliver quality, accessible care. The IBVSOs recommend $2.8 billion to complete all partially 

funded and future major construction needs to close all identified gaps by 2021. 

MINOR CONSTRUCTION ACCOUNTS: 

To close the minor construction gaps within its 10-year timeline, VA will need to 

invest nearly $8 billion in Veterans Health Administration minor construction 

alone.7 Minor construction projects allow VA to address issues of functional space 

within existing buildings and improve facility conditions at a cost of less than $10 

million. In past years VA and Congress requested and appropriated nearly 10 percent of the total need to close the minor construction gaps. However, the Administration and Congress decreased funding for minor construction by about $250 million over the past two years. If this rate of investment is continued, it will take 

357 

8FY 2012 Budget Submission, Construction and 10-Year Capital Plan, February 2011, Vol. 4 

of 4, p. 8.2–88. 9Title 38, U.S.C., paragraph 8162, as amended through Public Law 112–7, enacted March 31, 

2011, printed May 2, 2011. 10FY 2012 Budget Submission, Construction and 10-Year Capital Plan, February 2011, Appendix 10-Year Capital Plan, p. 10-46–49. 

more than 16 years to complete all current minor construction gaps. Congress and 

VA must put minor construction back on track by investing 10 percent of the total 

cost to complete the 10-year minor construction plan. With this in mind, the 

IBVSOs recommend $969 million in FY 2013 to achieve this goal. 

NONRECURRING MAINTENANCE ACCOUNT: 

Even though nonrecurring maintenance (NRM) is funded through VA’s Medical 

Facilities account and not through the construction account, it is critical to VA’s capital infrastructure. NRM embodies the many small projects that together provide for 

the long-term sustainability and usability of VA facilities. NRM projects are onetime repairs, such as modernizing mechanical or electrical systems, replacing windows and equipment, and preserving roofs and floors, among other routine maintenance needs. Nonrecurring maintenance is a necessary component of the care and 

stewardship of a facility. When managed responsibly, these relatively small, periodic 

investments ensure that the more substantial investments of major and minor construction provide real value to taxpayers and to veterans as well. Accordingly, to 

fully maintain its facilities, VA needs an NRM annual budget of at least $2.1 billion. 

Given the low level of funding NRM accounts have historically received, the 

IBVSOs are not surprised that basic facility maintenance remains a challenge for 

VA. In addition, the IBVSOs have long-standing concerns about how this funding 

is apportioned once received by VA. Because NRM accounts are organized under the 

Medical Facilities appropriation, it has traditionally been apportioned using the Veterans Equitable Resource Allocation (VERA) formula. This formula was intended to 

allocate health- care dollars to those areas with the greatest demand for health care, 

and is not an ideal method to allocate NRM funds. When dealing with maintenance 

needs, this formula may prove counterproductive by moving funds away from older 

medical centers and reallocating the funds to newer facilities where patient demand 

is greater, even if the maintenance needs are not as intense. The IBVSOs are encouraged by actions the House and Senate Veterans’ Affairs Committees have taken 

in recent years requiring NRM funding to be allocated outside the VERA formula, 

and we hope this practice will continue. 

CAPITAL LEASING: 

The Department of Veterans Affairs enters into two types of leases. First, VA 

leases properties to use for each agency within VA, ranging from community-based 

outpatient clinics (CBOC) and medical centers, to research and warehouse space. 

These leases do not fall under the larger construction accounts, but under each administration’s and staff office operating accounts.8

The second type of lease, called enhanced-use lease (EUL), allows VA to lease 

property they own to an outside-VA entity. These leases allow VA to lease properties 

that are unutilized or underutilized for projects such as veterans’ homelessness and 

long-term care. Proper use of leases provides VA with flexibility in providing care 

as veterans’ needs and demographics changes. 

VA has moved to leasing many of its CBOCs and specialty clinics to increase access of primary and specialty care in local communities as well as a way to be more 

modular as veterans’ demographics change. The IBVSOs see the value in providing 

quick, accessible health care, but caution a leasing concept that will rely on contracting inpatient care. Not having accessible inpatient care can and has left VA 

looking for ways to treat veterans in their greatest time of need. As Strategic Capital Investment Planning continues to move forward and more leases are entered 

into, some of which may have inpatient alternatives, the IBVSOs will be continue 

to be vigilant to ensure that VA has viable contingency plans for inpatient care. 

EUL gives VA the authority to lease land or buildings to public, nonprofit, or private organizations or companies as long as the lease is consistent with VA’s mission 

and that the lease ‘‘provides appropriate space for an activity contributing to the 

mission of the Department.’’ 9 Although EUL can be used for a wide range of activities, the majority of the leases result in housing for homeless veterans and assisted 

living facilities. In 2013, VA has 19 buildings or parcels of land that are planned 

for EUL.10 The IBVSOs encourage VA to continue to improve their transparency of 

358 

potential EUL properties. Improving dialog with veterans in the communities will 

reduce the backlash that often occurs when VA property is being repurposed. 

EMPTY OR UNDERUTILIZED SPACE AT MEDICAL CENTERS: 

The Department of Veterans Affairs maintains approximately 1,100 buildings that 

are either vacant or underutilized. An underutilized building is defined as one 

where less than 25 percent of space is used. It costs VA from $1 to $3 per square 

foot per year to maintain a vacant building. 

Public Law 108–422 incentivized VA’s efforts to properly dispose of excess space 

by allowing VA to retain the proceeds from the sale, transfer, or exchange of certain 

properties in a Capital Asset Fund. Further, that law required VA to develop short 

and long term plans for the disposal of these facilities in an annual report to Congress. With this in mind, VA has begun a review of buildings and properties for 

finding possible reuse or repurpose opportunities. Building Utilization Review and 

Repurposing or BURR will focus on identifying sites in three major categories: housing for veterans who are homeless or at risk for being homeless; senior veterans capable of independent living; and veterans who require assisted- living and supportive services. The three phases planned include identifying campuses with buildings and land that are either vacant or underutilized; site visits to match the supply 

of building and land with the demand for services and availability of financing; and 

last, identifying campuses using VA’s enhanced- use leasing authority. Under the 

BURR initiative, if no repurposing is identified, VA will begin to assess its vacant 

capital inventory by demolishing or disposing of buildings that are unsuitable for 

reuse or beyond their usefulness. The IBVSOs have stated that VA must continue 

to develop these plans, working in concert with architectural master plans, community stakeholders and clearly identifying the long-range vision for all such sites. 

PROGRAM FOR ARCHITECTURAL MASTER PLANS: 

A facility master plan is a comprehensive tool to examine and project potential 

new patient care programs and how they might affect the existing health-care facility design. It also provides insight with respect to growth needs, current space deficiencies, and other facility needs for existing programs and how they might be accommodated in the future with redesign, expansion, or contraction. 

In many past cases VA has planned construction in a reactive manner. Projects 

are first funded and then placed in the facility in the most expedient manner, often 

not considering other future projects and facility needs. This often results in shortsighted construction that restricts rather than expands options for the future. 

The IBVSOs believe that each VA medical center should develop a comprehensive 

facility master plan to serve as a blueprint for development, construction, and future 

growth of the facility; $15 million should be budgeted for this purpose. We believe 

that each VA medical center should develop a comprehensive facility master plan 

to serve as a blueprint for development, construction, and future growth of the 

facility. 

VA has undertaken master planning for several VA facilities, and we applaud this 

effort. But VA must ensure that all VA facilities develop master plan strategies to 

validate strategic planning decisions, prepare accurate budgets, and implement efficient construction that minimizes wasted expenses and disruption to patient care. 

PRESERVATION OF VA’S HISTORIC STRUCTURES: 

The Department of Veterans Affairs has an extensive inventory of historic structures that highlight America’s long tradition of providing care to veterans. These 

buildings and facilities enhance our understanding of the lives of those who have 

worn the uniform, of those who cared for their wounds, and of those who helped 

to build this great Nation. Of the approximately 2,000 historic structures in the VA 

historic building inventory, many are neglected and deteriorate year after year because of a lack of any funding for their upkeep. These structures should be stabilized, protected, and preserved because they are an integral part our Nation’s history. 

The cost for saving some of these buildings is not very high considering that they 

represent a part of American history. Once gone, they cannot be recaptured. For example, the Greek Revival Mansion at the VA Medical Center in Perry Point, Maryland, built in the 1750s can be restored and used as a facility or network training 

space for about $1.2 million. The Milwaukee Ward Memorial Theater, built in 1881, 

could be restored as a multipurpose facility at a cost of $6 million. These expenditures would be much less than the cost of new facilities and would preserve history 

simultaneously. 

359 

The IBVSOs encourage VA to use the tenants of Public Law 108–422, the ‘‘Veterans Health Programs Improvement Act,’’ in improving the plight of VA’s historic 

properties. This act authorizes historic preservation as one of the uses of the proceeds of the capital assets fund resulting from the sale or leases of other unneeded 

VA properties. 

Madam Chairman, this concludes my testimony and I look forward to any questions you and the Committee may have. 

Senator BURR. Thank you, Mr. Kelley. 

Mr. Tarantino, is that correct? 

OTHER WITNESS 

STATEMENT OF TOM TARANTINO, DEPUTY POLICY DIRECTOR, 

IRAQ AND AFGHANISTAN VETERANS OF AMERICA 

Mr. TARANTINO. Yes, Senator, it is. 

Senator Burr and Members of the Committee, thank you for allowing me to testify and represent IAVA’s 200,000 members and 

supporters on the President’s fiscal year 2013 budget request. 

My name is Tom Tarantino, and I am the Deputy Policy Director 

for IAVA. I proudly served 10 years in the Army being my career 

as an enlisted reservist and ending service as active-duty Calvary 

officer. Although my uniform is now a suit and tie, I am proud to 

work with this Congress to have the backs of America’s servicemembers and veterans. 

While IAVA is pleased with the Administration’s recognition that 

the VA needs increased resources to adequately care for veterans 

of Iraq and Afghanistan, we believe that VA health care must be 

fully funded to the level recommended in the 2013 Independent 

Budget. Even though the proposed VA budget does show a 4.5 percent in- crease over 2012, it is still more than $4 billion less than what the 

Independent Budget recommends. 

I am also deeply concerned that Congress has not passed a regular budget in what actually is years. Fortunately, Congress has 

maintained VA funding both current and in advanced in the various continuing resolutions and ad hoc appropriations bills. However, we are concerned that if this irregular budgeting process continues and the security that advance funding is meant to provide 

to VA health care may erode. When political concerns and dangers 

brinksmanship threaten VA, it is the veterans and servicemembers 

who can least afford to bear the burden that get the impact. 

We are at a critical juncture for both servicemembers and veterans. As the Department of Defense budget shrinks, it threatens 

the earned benefits like retirement and TRICARE. As the active 

duty and reserve component is planning to shed over 90,000 activeduty servicemembers over the next few years, the workload on the 

VA system is only going to increase. So, failing to fully funded the 

VA or appropriate the budget in advanced will inflict pain and 

hardship on thousands of veterans. 

Among the most useful programs administered by the VA are its 

educational programs. More than 700,000 veterans and their family members have used the Post-9/11 GI Bill to further their education, increase their job skills and secure employability. 

One of the single greatest threats to the success of the future of 

GI Bill is the lack of useful metrics and subsequent inability of the 

360 

VA and State approving agencies to prevent fraud, particularly in 

the realm of for-profit schools. 

IAVA recognizes that the majority of for-profit schools are honest 

actors and that they provide an invaluable resource for many military members and veterans who do not need or wish to pursue a 

traditional education. 

However, as pointed out in the Independent Budget, many forprofit schools are simply just not holding up their end. For example, for-profit schools receive more than a third of GI Bill funds 

while accounting for less than a third of GI Bill graduates. It does 

not appear that we are giving veterans the tools that they need to 

make sound educational choices. 

IAVA recommends a three-prong approach that is necessary to 

solve this problem. First, we must collect useful data on both student and institutional success. Without mandatory, uniform data 

collection across-the-board, private, public, profit, not-for-profit, we 

will never be able give students the tools to make the educational 

choices that meet their needs. 

We also need a clear, comprehensible, and easily accessible consumer education for veterans. Having data on schools is useless unless we can present it to students in a manner they can digest. 

This should include both online methods of comparing schools as 

well as a commitment to increase educational counseling for 

veterans. 

And finally, we have to ensure that the free and open market can 

weed out poorly performing schools by changing the 90/10 role to 

include and classify DOD and VA benefits as government funds because they are. 

All of this must be executed with one goal in mind and that is 

to preserve the GI Bill. Preserving the integrity of the GI Bill 

should be a top priority for every lawmaker on Capitol Hill. 

The benefit not only provides upward economic mobility for individuals who participate but it benefits your entire community as a 

Nation and the Nation as a whole in the long run. 

The original World War II GI Bill returned $7 in taxes and economic output for every dollar that was spent on the program. Like 

then, the Post-9/11 GI Bill is currently threatened by schools that 

their whole existence is separating veterans from their hard earned 

benefits. 

America’s newest veterans also face a tough economy and serious 

employment challenges. In 2011, the average unemployment rate 

for Iraq and Afghanistan veterans was 12.1 percent. 

Congress took bold action last year in passing the VOW to Hire 

Heroes Act and we thank this body for their work. This year IAVA 

stands ready to help implement this law so that veterans can get 

back to work but we also hope that Congress will continue to focus 

on the veterans who do not choose to go in the workforce but 

choose to go directly to school so that they can get the job training 

that they need. 

I thank you for your time and attention. 

[The prepared statement of Mr. Tarantino follows:] 

361 

PREPARED STATEMENT OF TOM TARANTINO, DEPUTY POLICY DIRECTOR, IRAQ AND AFGHANISTAN VETERANS OF AMERICA

Chairwoman Murray, Ranking Member Burr and Members of the Committee, On 

behalf of Iraq and Afghanistan Veterans of America’s 200,000 member veterans and 

supporters, thank you for inviting me to testify on the President’s FY 2013 budget 

request for the Department of Veterans Affairs. 

My name is Tom Tarantino and I am the Deputy Policy Director for IAVA. I 

proudly served 10 years in the Army, beginning my career as an enlisted Reservist, 

and leaving service as an Active Duty Cavalry Officer. Throughout these 10 years, 

my single most important duty was to take care of other soldiers. In the military, 

they teach us to have each other’s backs, both on and off the field of battle. And 

although my uniform is now a suit and tie, I am proud to work with this Congress 

to continue to have the backs of America’s servicemembers and veterans. 

IAVA is the largest veterans group dedicated to speaking for the nearly 2.4 million veterans of Operation Enduring Freedom, Operation Iraqi Freedom and Operation New Dawn. At IAVA, we tell veterans ‘‘We’ve got your back,’’ a military saying 

meaning: ‘‘We’ll support you no matter what.’’ We hope that Congress shares this 

sentiment and passes a VA budget that will not only tell but also show veterans 

that ‘‘Congress has your back.’’ 

While IAVA is pleased with the administration’s recognition that the VA needs 

increased resources to adequately care for veterans of Iraq and Afghanistan, we believe that VA health care must be fully funded to the level recommended in the 

2013 Independent Budget (IB)—$57.2 billion Even though the proposed VA budget shows a 4.5% increase over 2012($52.7 billion), that is still more than $4 billion less 

than what the Independent Budget recommends. 

IAVA is also deeply concerned that Congress has not passed a regular budget on 

time in years. Fortunately, Congress has maintained VA funding (both current and 

advance) in various continuing resolutions (CR) and ad-hoc appropriations bills. 

However, WE ARE concerned that if the CR process continues, then the security 

that advance funding is meant to provide for VA health care may erode. Advance 

funding was intended to provide security for the VA health care system when Congress was late passing a budget. That security is increasingly irrelevant if years 

pass without a budget at all. The budget crisis during the summer of 2011 highlighted the need to ensure that the VA is funded in advance and that the process 

is immune to political infighting. I was encouraged that last year both the House 

and Senate came up with solid VA appropriations bills when other bills never made 

it off the drawing board. Nonetheless, it proved disappointing that despite the bipartisan cooperation demonstrated to put those bills together, they never made it to 

the President’s desk for signature. Our nation has made a covenant with its servicemembers and veterans, many of who have sacrificed pieces of themselves in service 

to our country. When political concerns and dangerous brinkmanship threaten the 

VA, the impact falls on those servicemembers and veterans who can least afford to 

bear the burden. IAVA stands with the VSO community in urging Congress and the 

Administration, in the strongest possible terms, to ensure that the VA continues to 

be fully funded and funded in advance. 

We are at a critical juncture for both servicemembers and veterans. As the Department of Defense budget shrinks, threatening earned benefits like retirement 

and TRICARE, and the active duty and reserve components plan to shed over 

90,000 servicemembers, the burden on the VA system will only increase. Failing to 

fully fund the VA or appropriate the budget in advance will inflict pain and hardship on thousands of veterans. 

EDUCATION

Among the most useful programs administered by the VA are its educational programs. More than 700,000 veterans and their family members have used the Post9/11 GI Bill to further their education, increase job skills, and secure their employability. But one of the single greatest threats to the success and future of the GI 

Bill is the lack of useful metrics and the subsequent inability of the VA and State 

Approving Agencies (SAA) to prevent fraud, particularly in the realm of for-profit 

schools. IAVA recognizes that the majority of for-profit schools are honest actors and 

that they provide an invaluable resource for many military members and veterans 

who do not wish pursue a traditional education. However, as pointed out in the IB, 

for-profits received more than a third of GI Bill funds while accounting for less than 

a third of GI Bill graduates in 2009. Additionally, GI Bill users are pursuing education at for-profits in large numbers. Out of the top ten institutions receiving GI 

Bill money, eight are for-profits. By and large, IAVA believes this industry is not 

producing a return proportional to the benefits being spent. 

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IAVA believes that a three-pronged approach to the problem is necessary to solve 

this problem: 

1. We must collect useful data on both student and institutional success. Without 

mandatory, uniform data collection across the board, we will never be able to give 

student veterans the tools to make educational choices that meet their needs. 

2. We need clear, comprehensible, and easily accessible consumer education. Having data on schools is useless unless we can present it to students in a manner that 

they can digest. This should include both online methods of comparing schools as 

well as a commitment to increase educational counseling for veterans. 

3. We must ensure that the marketplace can weed out poorly performing schools 

by changing the 90–10 rule to include and classify DOD and VA benefits as government funds. 

One of the biggest obstacles to veterans and servicemembers educating themselves and making informed decisions about the use of their benefits is the lack of 

meaningful and consistent data presented in an easily accessible and digestible format. The first step toward addressing this problem is to collect meaningful and consistent data that can be used to compare program outcomes across a variety of education, trade and credentialing programs. Metrics should be similar to those collected by the Department of Education (DOE) for institutions that receive Title IV 

funding. 

Expanding the VetSuccess program, re-engineering the Transition Assistance Program (TAP), and expanding VA educational counseling services are quick but substantial ways to improve consumer education. IAVA commends the VA for expanding the VetSuccess program from 8 to 80 campuses and recommends an even more 

aggressive expansion. The VA has shown that VetSuccess is working and our conversations with students and university administrators have borne out the VA’s assessment. The program is currently funded for $18 million. IAVA recommends dramatically increasing this figure. Even at $50 million we are spending less than 

0.007% out of the $7.2 billion we spend annually on the GI Bill to ensure that these 

benefits are used wisely. This sum will ultimately be far less than the potential billions in taxpayer dollars wasted on educational programs that do not provide the 

services that they advertise. Along with the improvements made to TAP as part of 

the VOW to Hire Heroes Act, we must also create a track for veterans who are 

choosing to go to school rather than directly in to the workforce. These veterans 

should be able to take advantage of VA vocational counseling/education that is currently available to all veterans using VA education benefits. Right now, a veteran 

can choose to opt-in to VA educational counseling. Very few actually do. IAVA believes that this should be offered to all veterans, allowing them to opt out if they 

choose to. 

IAVA is also concerned with how the government supports the State Approving 

Agencies (SAA). We must reform and clarify the responsibilities of the SAAs, in 

order to ensure that their efforts are targeted and effective. We rely on the SAAs 

to help ensure quality and compliance in all states and territories; yet, we give them 

only $19 million per year to do this. This small amount spent to ensure that public 

funds are well used is penny wise and pound-foolish. At the current level of funding, 

each state receives an average of $380,000 to perform an extremely broad range of 

work-intensive tasks across hundreds of campuses statewide. As with the 

VetSuccess program, spending a fraction of a percent to make sure that billions are 

well spent is pound-wise. 

All of this must be executed with one goal in mind: preserve the GI Bill. Preserving the integrity of the GI Bill should be a top priority for every lawmaker on 

Capitol Hill. The benefit not only provides upward economic mobility for the individuals who participate, but it benefits their entire communities and the Nation as a 

whole in the long run. The original Post-World War II GI Bill, the Servicemen’s Readjustment Act of 1944, returned $7 dollars in taxes and economic output for every 

$1 that was spent on the program. Like the Post-9/11 GI Bill, the program was 

threatened early on by unscrupulous actors and predators whose sole reason for existence was to separate veterans from the benefit they had (literally) fought so hard 

to receive. Today, nearly a third of all those who are eligible to use the Post-9/11 

GI Bill have used it, and many have passed on the benefit to their children or 

spouses. Further education, combined with the discipline, technical skills, maturity, 

and knowledge that America’s fighting men and women have developed through 

their service, will deliver greater return for our country. The Post-9/11 GI Bill has 

the potential to be the engine of future economic growth, or at least one of the key 

components for securing our economic future. 

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SUICIDE AND MENTAL HEALTH

Sadly, suicide has become a major issue for servicemembers and veterans. Army 

suicide rates continue to trend upward; DOD-wide data is not consistent or regularly reported and therefore harder to track. Meanwhile, the VA estimated that in 

2009 18 veterans took their own lives each day. The VA also does not consistently 

share its data on veteran suicide. In addition, it does not generally account for the 

almost half (about 1.1 million) of Iraq and Afghanistan veterans who have never set 

foot in a VA hospital. We will never be able to get a handle on this epidemic until 

we can, at the very least, determine its scope. To do so, IAVA recommends expanding the Center for Disease Control and Prevention’s Violent Death Reporting System 

to all 50 states. Once we can accurately collect data on veteran suicide, we can more 

efficiently target resources and develop programs to combat the problem. Like the 

GI Bill, we can make reasonable investments upfront to ensure that the resources 

we expend later on are more effective, efficient, and saves lives. 

A critical step to understanding how we can stop veteran and servicemembers suicides is to understand that suicide itself is not the whole issue. Suicide is the tragic 

conclusion of the failure to address the spectrum of challenges returning veterans 

face. These challenges are not just mental health injuries; they include challenges 

of finding employment, reintegrating to family and community life, dealing with 

health care and benefits bureaucracy, and many other issues. Fighting suicide is not 

just about preventing the act of suicide. It’s about providing a ‘‘soft and productive 

landing’’ for our veterans when they return home. 

A 2011 RAND survey of veterans in New York State revealed that many veterans 

face difficulty navigating the complex systems of benefits and services available to 

them. While this survey was specific to New York veterans, the results are indicative of veterans’ experiences nationwide. Veterans reported that they do not know 

how to find the services they need or apply for the benefits they have earned. Even 

when they are able to find services appropriate for their needs, many veterans report frustration in accessing these services. Some veterans report long waiting periods to get an appointment at the VA, while others report having to repeat their stories and experiences to a number of different providers. These delays and lack of 

continuity do not help veterans already suffering from mental health issues. Additionally, the RAND survey revealed that the difficulty in accessing services is not 

limited to the VA. Most respondents could not identify a state agency or non-profit 

that provided direct mental health services. 

To complicate the bureaucracy, we also know that many veterans are not seeking 

care because of the stigma attached to mental health injuries. Multiple studies confirm that veterans are concerned about how seeking care could impact their careers, 

both in and out of the military. These concerns include the effect on their ability 

to get security clearances and how co-workers and supervisors would perceive them. 

It is critical that we continue to work to reduce this stigma. 

To combat this, IAVA recommends that the VA and DOD partner with experts 

in the private and nonprofit sector to develop a robust and aggressive outreach campaign to veterans. This campaign should focus on directing veterans to services such 

as Vet Centers, as well as state and local community-based services. The broader 

campaign should be integrated into local initiatives like San Francisco’s 311 Veterans portal. Most importantly, the campaign should be well funded and reflect the 

best practices and expertise of experts in both the mental health and advertising 

fields. For our part, IAVA has partnered with the Ad Council to launch a public 

service awareness campaign that is focused on the mental health and invisible injuries confronting veterans of Iraq and Afghanistan. A key component of the campaign 

has focused on reducing the stigma of seeking mental health care. We are happy 

to share our best practices from this campaign to aid in a national effort. 

EMPLOYMENT

America’s newest veterans also face a tough economy and serious employment 

challenges. In 2011, the average unemployment rate for Iraq and Afghanistan veterans was a staggering 12.1 percent, leaving an average of 234,000 combat veterans 

struggling to find gainful employment after their service in the most severe economic situation in decades. 

Finding a job as a returning veteran is hard, but finding quality employment is 

even harder. Today, Iraq and Afghanistan veterans leaving the active duty military 

are faced with civilian employers who do not understand the value of their skills 

and military experience. According to a 2010 survey, 60 percent of employers do not 

believe they have ‘‘a complete understanding of the qualifications ex-servicemembers 

offer.’’ National Guardsmen and Reservists who leave behind their civilian lives to 

serve alongside active duty troops are also inadequately protected against job disVerDate Nov 24 2008 17:34 Jan 25, 2013 Jkt 000000 PO 00000 Frm 00369 Fmt 6633 Sfmt 6621 H:\112TH HEARINGS\73401.TXT PAULIN
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crimination. Additionally, separated servicemembers with college degrees earn on 

average almost $10,000 less per year than their non-veteran counterparts. Historical 

trends show this wage gap could continue for decades; Vietnam veterans earned significantly less than their civilian peers until they reached their fifties. 

In 2011, Congress took bold action to stem the tide of rising veteran unemployment. By passing the VOW to Hire Heroes Act, you will ensure that veterans military skills will be translated into their equivalent civilian skills, veterans will have 

the resources to retrain themselves in to new markets, and that employers will hire 

more veterans. This bill is a huge step forward and we thank you for spearheading 

it. IAVA stands ready to assist Congress to effectively and efficiently implement this 

new law in 2012. 

But many of the provisions of the VOW to Hire Heroes Act will rely heavily on 

the ability of the Department of Labor (DOL) Veterans Employment and Training 

(VETS) program to transform outdated and inefficient services. I am concerned that 

the proposed budget for DOL VETS seems to be reduced by $5 million in FY 2013. 

This is, frankly, unacceptable. What is even more unacceptable is that while the 

programs that we are updating come out of this Committee’s scope and jurisdiction, 

the funding and accountability for these programs is nowhere near the reach of either veterans affairs or veterans appropriations subcommittees. This is not a recipe 

for success. Perhaps it is time that we reevaluate where the VETS program should 

live. IAVA believes that the VA is a more suitable agency for the VETS program, 

if for no other reason then that is where veteran will go if they need veterans’ services. It is time that we match services with the expectations of their customers. 

CONCLUSION

Caring for the men and women who defend freedom is a solemn responsibility 

that belongs to lawmakers, business leaders, and everyday citizens alike. In the past 

several years we have seen a turning point in the way we care and provide for our 

Nation’s warriors. Despite critical successes, however, veterans’ education, mental 

health, employment, and advance healthcare funding are not up to standard. We 

must remain ever vigilant and continue to show the men and women who volunteer 

to serve their country that we have their backs. Thank you for your time and 

attention. 

Senator BURR. Mr. Tarantino, thank you and on behalf of all the 

Members of the Committee, I would like to thank the entire panel 

for your willingness to be here. 

Let me make every assurance to you, all of your testimonies are 

in their hands. I would also ask you to make yourself available to 

all Members and the Committee for questions that will follow up 

this. 

I would like to make a couple of comments and then ask one 

question at the end. 

Mr. Tarantino, I agree with what you just said. The data is absolutely essential to our ability to evaluate what we are doing but 

more importantly the effectiveness of what we are doing. 

I might throw a cautionary note out. Not all individuals who 

leave active duty are after a degree but most are after a career; 

and when you start looking at placement, you may find out that 

the assessment that we make about one institution versus another 

institution is actually reversed and that those that maybe do not 

do a good job of providing a degree do a great job of providing the 

tools for a career; and I think that is where we have to stay 

focused. 

Many of you heard me with our colleagues at the VA as I have 

questioned the need for our focused stay on delivering a product to 

a veteran, and I will work with the Secretary and his leadership 

team, if they need plus ups in central office or if they need plus 

ups in public relations or wherever it is; but the only way that I 

will sit still is if I know that the core mission of the VA which is 

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to deliver that benefit to individual servicemembers is being 

fulfilled. 

So, Ms. Zumatto, you talked about the national cemeteries. Secretary Muro was the here. You noticed he did not get any questions. I will speculate. It is because he is doing a damn good job. 

It is because he understands what the mission is, and we have got 

work to do. I think he would be the first to admit it, but he is not 

losing focus of exactly what that threshold of accountability is 

going to be for him, and I appreciate you pointing that out. 

I think all of you have questions on sequestration. I have them. 

One, I do not think this should have ever been something we entered into. I think that Congress is here to do our job. It is not to 

leave it up to a super committee or group of individuals that then 

decide that we would rather punt the ball than throw it. 

I think that it is time for us to do our job. It starts with doing 

a budget. We are required by law to do one annually. Without a 

budget, it is hard to do appropriations bills. It is a very simple 

process. 

Carl, you pointed out dollars that have been designated as not needed, $3 billion and $2 billion respectively. I have the same concern in advance, so far in advance we can identify that; and I think 

if you go back all of you to when we started working on advanced 

appropriations, this is one of the concerns that skeptics had that 

you have a plus up only to find out it was not needed so it could 

be shifted somewhere else or to grow something. 

So, I think the Chairman is committed, as am I, to get to the bottom, work with the VA and try to understand how this happened 

and quite possibly talk about different ways to reprogram money. 

I know from the standpoint of the Intelligence Committee when 

an agency that is under our jurisdiction wants to reprogram 

money, they have got to get approval from us to reprogram that 

money. I think that is probably a wise thing and we will look at 

any potential changes that need to be made. 

Some of you mentioned, and I am sure all of you are concerned 

about the construction and maintenance. I will just make a personal observation. Facilities are crucial to the access and the quality of care that our veterans received in the future. We are in the 

21st century and medicine has changed. 

I will not comment on other States but in North Carolina, and 

Dr. Petzel knows this, I have got two facilities that were opened 

in the 1950s. They are not constructed in a way to put an MRI machine much less some of the new technologies that is going in. Even 

to run a computer that is networked means drilling through walls 

that were never intended to have holes much like the Capitol of the 

United States where we have to make the drill bits to actually drill 

through those. 

But more importantly, they are not conducive to outpatient care. 

You have to navigate the health care facility to find the room that 

they happen to be doing endoscopies in that day; and by every 

standard in health care today, we exposed somebody to an institution that has a much higher likelihood of providing a means of 

infection. 

I think it is important, and the VA is headed on a new course 

of creating that super outpatient facility that can handle the 95 

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percent of the veterans needs. It will take us a while to do it but 

we will never get there if we do not build that into our long-term 

and short-term maintenance requests, construction requests. 

I think that I could question whether the total that is in the 

budget this year even comes close to handling just the maintenance 

needs that we have in existing facilities and I think, Ray, you probably agree with me on that. 

Those are just some of my thoughts, having heard your testimony and then trying to put it in perspective with what we heard 

from the VA and what the Administration’s budget proposal is. 

I would just pose one more question to each of you. If you want 

to respond you can. What trends do you see that you have not highlighted in your testimony that you think should be alarming to our 

Nation’s veterans and to policymakers in Washington? 

And I will just start down here and go down the line. 

Mr. SCHRIER. Ranking Member Burr, the signature wounds in 

Vietnam were about PTSD and Agent Orange. The signature 

wounds in our wars today are about PTSD and TBI. The stigma 

has never been taken off PTSD. 

A young warrior still in uniform is frightened to step forward 

when he is suffering or she is suffering symptoms. We need to remove that. 

And TBI, a good analogy, former players from the NFL are currently suing the NFL because they are suffering from concussions 

that goes back 30 and 40 years and these symptoms are now manifesting themselves. 

What will our warriors suffering from TBI today be facing in 20, 

30, 40 years, and what are we going to do about it today to ensure 

there is something there tomorrow to take care of them? 

Thank you. 

Senator BURR. A fascinating thing in high school football today, 

many schools around the country are getting a baseline that they 

can establish for players so that, as you have individuals who have 

concussions, you can compare after to the baseline to figure out 

whether there was a brain change. 

Novel approach but we are beginning to recognize the importance 

of that. Maybe we will from the standpoint of our military personnel as well. 

Carl. 

Mr. BLAKE. I will frame my answer sort of as a broad-based idea 

about demand for health care services. While the VA sort of shows 

its trends in its budget every year, it seems like when they returned the next year the demand trends spiked higher than what 

they had originally projected which sort of points to my concerns 

about how you end up with excess resources when you have a demand curve that is much steeper. 

As far as something to think about in the near short-term, longterm with regards to demand, we have to keep in mind we are basically drawing down in Iraq now and at some point in the near 

future we are probably going to draw down in Afghanistan. 

While there is the commonly held belief that at some point demand will reach a plateau and maybe tail off because of the aging 

population of veterans, we do not believe we have gotten to that 

point yet and we believe that you can see an even higher spike in 

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demand for services as you have these individuals who are now out 

of Iraq and who may be leaving the service and who will eventually 

be returning from Afghanistan and presumably leaving the service 

as well. 

So, we have to make sure that we are in a situation where we 

are able to meet their unique health care commands while continuing to meet the demand of the population of veterans that the 

VA serves today. 

Senator BURR. When I made the comment earlier to the Secretary which will be in the form of a question that the VA took in 

430,000 more claims than were decided, it is not to give the VA a 

black eye. It is to say let us make sure that our expectations on 

what we can accomplish are rational. 

It is hard for me to believe that you can have 430,000 more 

claims this year and within a 3-year period we can illuminate the 

backlog. Under my calculation, you are going to have to process 

150,000 more claims than you take in every year to eliminate the 

backlog. If you just look at what is in front of us in additional 

claims to come in, I am not sure you could make a rational statement like that. 

So, I hope through our dialog we are able to get not just on the 

disability side but throughout the VA a rational discussion about 

what expectations should be because I think we have got to have 

a yardstick. There has got to be a matrix and there has got to be 

accountability. 

Mr. Hall. 

Mr. HALL. I would just like to follow up with that exact point regarding the disability claims process. As you are well aware, VA 

has a lot of parts in motion and with a complete transformation 

process that we are looking at over the course of a year, I would 

like to commend VA on one aspect and that is it is very, very difficult and challenging to not only transform an antiquated system 

into a modern paperless system, at the same time reducing the 

backlog. 

And so, while they are working toward reducing the backlog, that 

is why we want to ensure that the focus remains on quality and 

accuracy. As far as a specific trend, veterans, as you know, communicate electronically. The VA is trying to get there with their IT 

system and as my comments had mentioned earlier about the 

VBMS system, we hope it gets there as well but we just do not 

know what the outcome is going to be. 

We know that there are positive results coming out of it from 

test stations and we will have to wait and see what happens when 

it goes out nationally. But I guess the best would be that we are 

cautiously optimistic about that but veterans demand that modernized system. The VA is trying to get there and hopefully we can 

all help them get there together. 

Senator BURR. Great. I agree with you. The VA deserves credit 

for trying something different. None of us know whether it will 

work. I would only say this that in the time that we have designed 

this and begun to implement it the trend that you cannot ignore 

is that in 2008 our productivity per FTE in the claims process was 

87 claims per year. Today 2011 73.5 claims per year. 

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It is alarming to me. I am hopeful that the IT thing will be the 

solution. But we have taken our eye off of what we are producing 

out of the current work force and roughly getting 14 less claims per 

employee that processes claims; and when you look at that trend, 

that is very troubling from a standpoint of if this does not work, 

we start at a new lower baseline of productivity and it means that 

the ability to do away with the backlog is that much longer. 

Ms. Zumatto. 

Ms. ZUMATTO. Thank you, Senator Burr. I just want to say that 

I appreciate your comments and that I agree with all of the additional comments made by my IB partners. As far as NCA having 

any alarming issues, I do not think I have the expertise right now 

to speak to that but I will be meeting with the folks at the NCA 

and if I come up with something I will let you know. 

Senator BURR. Share it with us. Right. 

Ms. ZUMATTO. Thank you. 

Senator BURR. Mr. Kelley. 

Mr. KELLEY. I think my testimony pointed out my concerns with 

construction, but I want to touch on another issue that we have ignored in the past that has led to lack of research in other areas. 

I will use Agent Orange as an example. It took us 40 years to 

finally get to the point where we are really taking care of the folks 

that were affected by Agent Orange. We cannot let that happen to 

folks who have been exposed to burn pits. We lack the science to 

identify it, to diagnose it, and to treat it. We need research dollars 

and we need research dollars specifically for burn pit exposure. 

Senator BURR. I hear you loud and clear; and as a guy that is 

trying to get the same thing done for Camp Lejeune Marines for 

three decades, I hear your warning and the frustration. 

Tom. 

Mr. TARANTINO. Senator, we are alarmed about the lack of clarity with the high suicide rate among veterans. We do a pretty good 

job of tracking the active duty but we really do not have any clear 

idea of the suicide epidemic in the veterans’ population. 

The VA does a good job or a decent job of tracking veterans within their system; but in terms of OIF OEF vets, that is just over half 

in which means around half of Iraq and Afghanistan veterans 

never set foot in a VA hospital; and we have no idea what is happening out in that population. 

So, when we are looking at the budget and increases to mental 

health and sort of this shotgun approach to suicide prevention and 

mental health where we are trying to develop programs with 

awareness but we are not doing it in a targeted fashion, it is one 

thing to increase awareness about stigma and having a suicide-prevention campaigns; but if you do not know where are the problem 

areas, what are the methodologies, and, you know, what type of 

issues are those servicemembers facing, then you are basically 

crawling around in the dark. 

And so, we are proposing that we need to have a national effort 

to track veterans suicide in all 50 States. There are a couple of 

ways to do it. I am happy to talk about it with you off-line. But 

until we do that, we are never going to get our hand around this 

issue, and we are never going to solve this problem. 

369 

Senator BURR. I think I can speak for the Chairman in saying 

that the Committee is committed to do a much better job at understanding the problem and, more importantly, the trend. We find it 

alarming. 

And to speak for VA, I think they take this very seriously. In our 

last hearing relative to progress we were making, one individual— 

and I put this caveat in, their responsibility was the hot line—said, 

well, the progress is evident by the fact that we are getting more 

calls to the hotline. 

Now, when you look at things from an overall architecture, you 

get more calls to the hotline you have got a much greater problem 

out there than what you might have thought. 

So, I think we have got to connect these things within the Administration to understand how to interpret something like an increase in calls, but I think we are all committed not just in the veterans population but in the active-duty force to make sure that 

wherever these pressure points are that we find a way to relieve 

them long before we reach a suicidal end. 

Let me note that we did have great participation from Members 

today. I want to thank you on behalf of the Chairman and myself 

for your willingness to be here, for the insight that you give us, and 

for the time that you put into not only your testimony but your proposals. 

This hearing is adjourned. 

[Whereupon, at 12:32 p.m., the Committee was adjourned.] 

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