U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON : 

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

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

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

43–999 2009

INDEPENDENT LIVING PROGRAM 

HEARING 

BEFORE THE

SUBCOMMITTEE ON ECONOMIC OPPORTUNITY 

OF THE

COMMITTEE ON VETERANS’ AFFAIRS 

U.S. HOUSE OF REPRESENTATIVES 

ONE HUNDRED TENTH CONGRESS 

SECOND SESSION 

JULY 10, 2008 

Serial No. 110–97 

Printed for the use of the Committee on Veterans’ Affairs 

( 


wwoods2 on PRODPC68 with HEARING
ii 

COMMITTEE ON VETERANS’ AFFAIRS 

BOB FILNER, California, Chairman 

CORRINE BROWN, Florida 

VIC SNYDER, Arkansas 

MICHAEL H. MICHAUD, Maine 

STEPHANIE HERSETH SANDLIN, South 

Dakota 

HARRY E. MITCHELL, Arizona 

JOHN J. HALL, New York 

PHIL HARE, Illinois 

SHELLEY BERKLEY, Nevada 

JOHN T. SALAZAR, Colorado 

CIRO D. RODRIGUEZ, Texas 

JOE DONNELLY, Indiana 

JERRY MCNERNEY, CALIFORNIA

ZACHARY T. SPACE, Ohio 

TIMOTHY J. WALZ, Minnesota 

DONALD J. CAZAYOUX, JR., Louisiana 

STEVE BUYER, Indiana, Ranking 

CLIFF STEARNS, Florida 

JERRY MORAN, Kansas 

HENRY E. BROWN, JR., SOUTH CAROLINA

JEFF MILLER, Florida 

JOHN BOOZMAN, Arkansas 

GINNY BROWN-WAITE, Florida 

MICHAEL R. TURNER, Ohio 

BRIAN P. BILBRAY, California 

DOUG LAMBORN, Colorado 

GUS M. BILIRAKIS, Florida 

VERN BUCHANAN, Florida 

STEVE SCALISE, Louisiana 

MALCOM A. SHORTER, Staff Director 

SUBCOMMITTEE ON ECONOMIC OPPORTUNITY 

STEPHANIE HERSETH SANDLIN, South Dakota, Chairwoman 

JOE DONNELLY, Indiana 

JERRY MCNERNEY, California 

JOHN J. HALL, New York 

JOHN BOOZMAN, Arkansas, Ranking 

JERRY MORAN, Kansas 

STEVE SCALISE, Louisiana 

Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records 

of the Committee on Veterans’ Affairs are also published in electronic form. The printed 

hearing record remains the official version. Because electronic submissions are used to 

prepare both printed and electronic versions of the hearing record, the process of converting 

between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process 

is further refined. 


wwoods2 on PRODPC68 with HEARING
iii 

C O N T E N T S 

July 10, 2008 

Page 

Independent Living Program .................................................................................. 1 

OPENING STATEMENTS 

Hon. John J. Hall ..................................................................................................... 1 

Chairwoman Herseth Sandlin, prepared statement of .................................. 33 

Hon. John Boozman, Ranking Republican Member ............................................. 2 

Prepared statement of Congressman Boozman ............................................. 34 

WITNESSES 

U.S. Department of Veterans Affairs, Ruth Fanning, Director, Vocational 

Rehabilitation and Employment Service, Veterans Benefits Administration . 22 

Prepared statement of Ms. Fanning ............................................................... 48 

American Legion, Mark Walker, Assistant Director, National Economic Commission .................................................................................................................. 15 

Prepared statement of Mr. Walker ................................................................. 44 

McCartney, Bruce, Midway, GA ............................................................................. 4 

Prepared statement of Mr. McCartney ........................................................... 34 

National Council on Independent Living, John A. Lancaster, Executive Director .......................................................................................................................... 5

Prepared statement of Mr. Lancaster ............................................................. 40 

Paralyzed Veterans of America, Richard Daley, Associate Legislation Director 14 

Prepared statement of Mr. Daley .................................................................... 42 

SUBMISSIONS FOR THE RECORD 

Disabled American Veterans, Kerry Baker, Associate National Legislative 

Director, statement .............................................................................................. 52 

Maui County Veterans Council, Wailuku, Maui, HI, Rogelio G. Evangelista, 

President, letter .................................................................................................... 54 

National Rehabilitation and Rediscovery Foundation, Inc., Marianne Talbot, 

Ph.D., President, statement ................................................................................ 55 

MATERIAL SUBMITTED FOR THE RECORD 

Hon. Stephanie Herseth Sandlin, Chairwoman, Subcommittee on Economic Opportunity, Committee on Veterans’ Affairs, to Ms. Ruth Fanning, Director, Vocational Rehabilitation and Employment Service, U.S. 

Department of Veterans Affairs, letter dated July 11, 2008, and VA 

responses ....................................................................................................... 57 


wwoods2 on PRODPC68 with HEARING

wwoods2 on PRODPC68 with HEARING
(1) 

INDEPENDENT LIVING PROGRAM 

THURSDAY, JULY 10, 2008 

U.S. HOUSE OF REPRESENTATIVES, 

COMMITTEE ON VETERANS’ AFFAIRS, 

SUBCOMMITTEE ON ECONOMIC OPPORTUNITY, 

Washington, DC. 

The Subcommittee met, pursuant to notice, at 1:17 p.m., in Room 

334, Cannon House Office Building, Hon. Stephanie Herseth 

Sandlin [Chairwoman of the Subcommittee] presiding. 

Present: Representatives Herseth Sandlin, Hall, Boozman, and 

Scalise. 

OPENING STATEMENT OF CHAIRWOMAN STEPHANIE 

HERSETH SANDLIN, AS PRESENTED BY HON. JOHN J. HALL 

Mr. HALL [presiding]. Good afternoon, ladies and gentlemen. The 

Committee on Veterans’ Affairs Subcommittee on Economic Opportunity hearing on the Independent Living Program (ILP) will come 

to order. First, I will ask you to join me in standing and saying the 

pledge. The flag is at both ends of the room. 

[Pledge of Allegiance] 

Mr. HALL. Thank you, and thank you for joining us. Thank you 

for your patience while we were voting. Today’s hearing will give 

the Subcommittee the opportunity to learn more about the U.S. Department of Veterans Affairs (VA) Vocational Rehabilitation and 

Employment (VR&E) Independent Living Program and how it is 

assisting our veterans in a seamless rehabilitation into family and 

community life. As many of you know, the goal of the Independent 

Living Program is to ensure that eligible disabled veterans are able 

to maintain maximum independence in their daily living by developing learned skills that may benefit them for future employment. 

Some of our panelists might recall this Subcommittee held its 

first hearing back in March of last year that gave our new Members the opportunity to learn about the programs under our jurisdiction. One such program that was considered was the Vocational 

Rehabilitation and Employment. But today, we are here to specifically review the Independent Living Program. 

As we will hear from our panelists, many of our most severely 

disabled veterans’ lives have been profoundly changed for the positive as a direct result of these independent living (IL) services. Unfortunately, Members of this Subcommittee have also heard from 

veterans that have raised concerns that the VA staff is poorly 

trained to properly refer veterans to available resources, mismanagement of claims by VA personnel that cause a delay in servVerDate Nov 24 2008 04:45 Feb 14, 2009 Jkt 043999 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 E:\HR\OC\43999.XXX 43999

wwoods2 on PRODPC68 with HEARING
2 

ice, and the need to increase the current statutory limit of 2,500 

slots annually. 

Earlier this year, we received a letter from a veteran who urged 

the full Committee Chairman to consider reviewing independent 

living services for veterans with chronic and severe post traumatic 

stress disorder (PTSD). Specifically, this veteran would like to see 

an expansion of the independent living services to provide Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) 

veterans with opportunities for employment services that can also 

benefit older veterans who have service connected psychiatric disabilities. 

I am interested in hearing from our panelists about this and 

other suggestions to determine how we can best serve all our veterans, especially in light of the Department of Veterans Affairs Office of Inspector General’s report dated December 17, 2007. A few 

of the issues of concern raised in this report include VR&E rehabilitation rate calculations and information on total program participation and outcomes were not fully disclosed in the VA Performance and Accountability Report; the 2,500 statutory cap was underutilized in fiscal year 2006 and services to our veterans were delayed; and the VA should effectively monitor the number of new 

independent living participants and detailed information should be 

provided to Congress for review. It is very important that we examine these concerns, especially at a time when the VA Secretary recognizes an increased need for independent living services over the 

next 10 years. 

Today’s servicemembers are returning with PTSD, traumatic 

brain injury, amputations, and severe burns that would have been 

fatal in previous conflicts. Congress must continue to reexamine 

the development and results of this program to provide the best 

services in a timely manner. The men and women who serve our 

Nation honorably deserve, and should receive, the best our country 

can offer. I look forward to working with Chairwoman Herseth 

Sandlin, Ranking Member Boozman, and other Members of this 

Subcommittee to explore how we can improve the VA’s Independent Living Program for our servicemembers and veterans. 

I now recognize Mr. Boozman for his opening remarks. 

[The prepared statement of Chairwoman Herseth Sandlin appears on p. 33.] 

OPENING STATEMENT HON. JOHN BOOZMAN 

Mr. BOOZMAN. Thank you very much, Chairman Hall. I think the 

first order of the day is to thank both members of our first panel 

for their service to their country. I believe both Mr. Lancaster and 

Mr. McCartney are service-disabled veterans of the Vietnam War 

and they honor us with their presence here today. So, we really do 

appreciate you very, very much. 

Chairman Hall, I believe you and I would agree that the VA’s 

Vocational Rehabilitation Employment Program should be the 

crown jewel of programs for disabled veterans. The program is generous in its benefits and the law provides VR&E staff with wide 

latitude in determining who qualifies for the program. It is important to note that employment is the goal of the VR&E Program and 


wwoods2 on PRODPC68 with HEARING
3 

for the vast majority of those who participate in the Program a job 

is reasonable and achievable. 

Unfortunately for our most severely injured, employment is 

sometimes not an option so the VR&E Program includes independent living services for those who cannot work because of their 

service connected disability. Such a program is designed to enable 

such veterans to achieve maximum independence in daily living 

and VA may contract for these services with qualified providers. 

Title 38 defines independence and daily living as ‘‘the ability of a 

veteran, without the services of others,’’ or ‘‘with the reduced level 

of the services of others, to live and function within such veteran’s 

family and community.’’ That is a fairly broad definition. And I 

would hope that Ms. Fanning would describe how her staff determines what fits within the definition. 

I want to make a point about one way we judge the Program’s 

performance. As an example of the difficulty we face in using VA 

data to determine the Program’s performance, I would call your attention to the latest Veterans Benefits Administration (VBA) Annual Benefits Report. On pages 77 to 84, the report shows 884 veterans receiving independent living services, and on page 86, the 

data shows 949 participants and 2,957 veterans rehabilitated. 

Clearly the inconsistency between the number of participants and 

the number of those rehabilitated, as well as the two different 

amounts of participants, does not give us a clear understanding of 

how the Program is doing. So I hope that we can work together so 

that we can make the data a little bit more understandable for us. 

Finally, I am glad to have Mr. Lancaster, Executive Director of 

the National Counsel on Independent Living with us today. I understand that the National Council on Independent Living (NCIL) 

is not represented on the Secretary’s Advisory Council on Rehab. 

It seems to me that the NCIL should be a member of the Committee because of their broad experience in independent living. And 

I urge Secretary Peake to consider, in fact I urge him to invite, 

NCIL to become an active member in his Advisory Committee. 

Thank you, Mr. Chairman, and I yield back. 

[The prepared statement of Congressman Boozman appears on 

p. 34.] 

Mr. HALL. Thank you, Mr. Boozman. Before I proceed, regarding 

consistency, I just want to mention that, the first time I mentioned 

the 2,500 statutory cap, I mistakenly misspoke and said dollars as 

opposed to people. I intended to say 2,500 individuals. 

I would like to welcome our panels testifying before our Subcommittee today. I remind all of our panelists that your complete 

written statements have been made part of the hearing record. 

Please limit your remarks so that we may have sufficient time to 

provide followup with questions once everyone has had the opportunity to provide their testimony. 

Joining us in our first panel is Mr. Bruce McCartney, an Army 

veteran from Midway, Georgia; and Mr. John A. Lancaster, Executive Director of the National Council on independent living. Mr. 

McCartney, thank you for your service. Thank you for traveling 

from Georgia to be here with us today. You are now recognized for 

5 minutes. 


wwoods2 on PRODPC68 with HEARING
4 

STATEMENTS OF BRUCE MCCARTNEY, MIDWAY, GA; AND JOHN 

A. LANCASTER, EXECUTIVE DIRECTOR, NATIONAL COUNCIL 

ON INDEPENDENT LIVING 

STATEMENT OF BRUCE MCCARTNEY 

Mr. MCCARTNEY. Chairman Hall and Members, on behalf of the 

hundred or so disabled vets who know I am here, and the couple 

hundred thousand who do not, I welcome this invite. My name is 

Bruce McCartney. In 1986, I was medically retired from the United 

States Army under Chapter 61 after 171⁄2 years of active-duty service. 

I served four combat tours in Vietnam as a DUSTOFF and 

ground pounding combat medic. One-thousand four-hundred seven 

boots on the ground days. It was my job to go to the wounded soldier who walked into a booby trap or was laced across the gut with 

an AK–47, try to keep him alive until we could get him to the hospital. I was not always successful. But more often than not, death 

was cheated of another victim. 

When I came home from Vietnam, there was little help available 

to transition the disabled veteran. One day you are in the War, the 

next day you are back in the world trying to regain some semblance of normalcy. If perchance you met or heard about a veteran 

who had acquired a particular VA service or program, then you applied. Other than that, there was not much assistance offered by 

many. I am one of the fortunate, or so I thought. Had I known 

when I applied for the Independent Living Program in November 

of 2003 that it was leading me into a 4-year nightmare that would 

affect me both mentally and physically, I would not be testifying 

before this Subcommittee today. 

In 1990, I was advised by the Savannah Vets Center to apply for 

Voc Rehab Services. I met with a case manager, was aptitude tested, and advised I should seek a vocation as a registered nurse or 

a teacher. With my experience in combat medics, the nursing 

course made sense. Unfortunately, school exacerbated by PTSD and 

my education was sporadic at best and disruptions were the norm. 

After many counseling sessions with him, his final statement to me 

was, ‘‘If you ever get straightened out, come back and see me.’’ 

I languished for years, much like untold numbers of disabled veterans even as we speak. In October of 2000, fate knocked on my 

door. It was during the filming of the documentary, ‘‘In the Shadow 

of the Blade,’’ that I was reunited with my friend and fellow 

DUSTOFF medic from Vietnam, Jake Bailado. He told me of a 

cousin who was also a disabled Vietnam veteran who had applied 

for ILP. They assisted him in obtaining a small tractor to help him 

work his farm. After several years of PTSD therapy outside the VA 

system, in November of 2003 I met with Voc Rehab counselor Tina 

Hutchison in Savannah to apply for ILP. My goal was to try to obtain an interest-free loan to replace my antiquated tractor so I 

could cultivate my nine-acre property. Ms. Hutchison advised that 

my goal was out of the question because it was considered a vehicle. But ILP would in fact assist me with acquiring a greenhouse. 

That is where the nightmare began. To call it a run around is 

to put it mildly. Delaying tactics became the norm. Phone calls 

were not returned. Application processes were delayed. Emails 


wwoods2 on PRODPC68 with HEARING
5 

went unanswered. And years passed. It was almost as if the people 

who were being paid to help were just hoping I would just die or 

go away. During my ordeal, I talked with several other disabled 

veterans who also needed and were qualified for ILP. I urged them 

to apply, but seeing the difficulty I was having and how it was affecting me both physically and mentally, they decided it was not 

worth their well being to go through with what I was going 

through. I began to wonder if this was the whole point. After all, 

when word gets around how difficult the process is, fewer veterans 

will pursue it. 

Sharing with them a letter I received with Atlanta Region Director L. R. Burkes in 2007 apologizing for his subordinates’ failures 

and promising needed improvements, these veterans did indeed 

apply for ILP. They then began the experience the status quo. 

Complete an application, it gets lost. Complete another, it goes into 

a black hole some call the process. Emails and phone calls again 

are not answered. Sometimes when they are, the veteran is treated 

with disrespect and scorn as if he or she is asking for a handout 

instead of a benefit which they earned with their broken bodies. 

Now as I network with even more disabled veterans, it appears 

that ILP is a benefit that is being held close to the vest, not to be 

disseminated. Is this because of the 2,500 cap, which equates to 

less than 1 percent of the eligible 100 percent disabled veterans 

population? I cannot answer that. I do know that malfeasance is 

being overlooked while the consequences of ineptitude are being 

suffered by the very deserving people the VA exists to serve, America’s disabled vets. 

The American people, through their Congress, have made it clear 

that they want to support the troops and they want to support veterans. This body passes legislation for such programs, but when 

bureaucratic land mines prevent us from actually assessing the 

programs afforded the opportunity to make a difference for veterans is missed. 

Many years ago in the rice paddies of Vietnam, I aided the 

wounded. Now these many years later, I have vowed to advocate 

for my wounded brothers, yet again. It has become a formidable 

task that needs your involvement. I am asking you to take this battle to task. As American veterans both young and old have fought 

for you, we need you to fight for us now. One thousand four hundred and seven days fighting the enemy in Vietnam. One thousand 

four hundred and sixty three days fighting the VA for an ILP. 

Thank you. 

[The prepared statement of Mr. McCartney appears on p. 40.] 

Mr. HALL. Thank you, Mr. McCartney. Mr. Lancaster, you are 

now recognized. 

STATEMENT OF JOHN A. LANCASTER 

Mr. LANCASTER. Thank you, Chairman Hall and Ranking Member Boozman. Thanks for this opportunity to testify before you on 

behalf of the National Council on Independent Living. Mr. 

Boozman, if we did get an official request to serve on the VA’s 

Independent Living Program Committee we would gladly and honorably accept that role and do what we could. 


wwoods2 on PRODPC68 with HEARING
6 

I am a disabled vet as well, only I guess I am far more fortunate 

than Bruce next to me in that years ago, I did get relatively what 

I consider decent service from the VA system. It sent me back to 

my alma mater where I was able to get a law degree. It did great 

physical rehabilitation for me. It even then, before there was an 

Independent Living Program per se, gave me a few independent 

living services. They gave me driving lessons with hand controls on 

the car, which is a major part of independent living, being able to 

get around. 

Fortunately, I have had a successful life and a successful career 

and have not had to rely on such services. And my career over the 

years has brought me to my current position as Executive Director 

of the National Council on Independent Living. We are an association representing all the Centers for Independent Living and State 

Independent Living Councils around the country. This Independent 

Living Program is, as you know, funded through Title 7 of the Rehabilitation Act and administered by the Rehabilitation Services 

Administration of U.S. Department of Education. Three hundred 

and thirty six centers receive direct Federal funding through Title 

7 of the Rehab Act. Another maybe 70 to 80 centers receive indirect 

funding through their State governments and through indirect Federal funding, making a little over 400 centers in this country providing independent living services to people with very severe disabilities in every Congressional district in the country, except five. 

And we will get those other five sooner or later. 

Services they provide are peer counseling. People with severe disabilities working with, mentoring, showing through steps other 

people with severe disabilities how to manage their lives, how to 

be fully included in the community, and how to be productive citizens. They provide information and referral. They do independent 

living skills training on everything from managing one’s life in 

their own home to balancing checkbooks, to navigating housing authority processes, to navigating employment service processes. And 

then fourth, all of these centers are providing advocacy on some 

level or another. Individual advocacy on behalf of the individual 

who might need that advocacy, and systems advocacy, working 

with the community to make sure that the community is more accessible to and inclusive of people with disabilities. 

And I have included in my written testimony the value of our 

program. The number of people that have been able to get out of 

institutions; the number of people that they have prevented from 

going into institutions; the employment services that they have delivered; personal care attendant services; transportation services; 

assistive technology. 

We welcome the opportunity, and indeed some of our centers are 

starting to working closely with the VA on a number of independent living initiatives. And I indeed, personally, have met with 

Ruth Fanning and we have had a successful, I hope, beginning in 

terms of continuing a dialog. 

There are some differences in the way the VA approaches independent living to what we do. At the core of our belief in our system is consumer control. That you take the individual and you put 

them in control of their own services and their own lives, and you 

support them and teach them, and mentor them in getting to that 


wwoods2 on PRODPC68 with HEARING
7 

point. So that the veteran, in this case, the disabled veteran, would 

become the hub and the controller, if you will, of the things that 

that individuals needs to participate fully in the community and 

ideally to have a job. If that means personal care attendant, personal care attendant. If that means access to affordable, accessible, 

inclusive housing, then that gets provided or at least you work with 

a veteran to make sure that they get their Section 8 voucher if that 

is what they need, or whatever other support. If it is home modifications, home modifications. Those sorts of advice and suggestions. So we have a much, I think, more expansive, broader view. 

We feel that independent living does not stop with the ability to 

operate in your home. That it really ends when the person has 

achieved full inclusion in their community and has achieved economic self-sufficiency. Often, that means a job. 

We have three recommendations in this area, which our network 

certainly has a major responsibility for, at least in two of them. 

Number one, there needs to be much great sharing of information 

between the Veterans Administration and the Independent Living 

Program, and State veterans organizations and the Independent 

Living Program. And when I say the national VA, the Department 

of Veterans Affairs, we are talking more here about regional and 

local offices than a dialog that might go on between, say, Ruth and 

I here in Washington. It has got to live down in the communities 

across the country. So, there are training programs we could be 

doing. There is some, you know, encouragement from ideally up 

here in Congress to get parties talking together down at the local 

level. But there needs to be a better understanding between the 

two systems. And certainly we take responsibility for that. And 

there are some things, good things going in that regard in States 

like Alaska, Minnesota, Michigan, in particular, Florida. So we do 

have some things going there. 

Second—— 

Mr. HALL. Mr. Lancaster, in the interest of time, please summarize. 

Mr. LANCASTER. Yeah, two final recommendations. Second, the 

need for CILs to better understand, Centers for Independent Living, in our network, the whole veterans world and for lack of a better word the veteran culture and to establish relationship with veterans service organizations (VSOs) as well as State and Federal VA 

things. 

Third, and I think this would go a long way, is in that system 

of 336 direct federally funded centers out there around the country, 

if the money could be provided, and I figured it would be in the 

neighborhood of $25 million, frankly, to place one veteran, ideally 

a disabled veteran, as an employee in every single one of those centers with the primary responsibility of reaching to the veteran community and to disabled veterans in their community that need 

Independent Living Programs so that we do not have the type of 

misunderstanding and miscommunication that was so eloquently 

explained by Mr. Bruce McCartney here next to me. So I think that 

would be a real solid recommendation that would go a long way to 

promoting the independent living of disabled veterans in this country. Thank you. 

[The prepared statement of Mr. Lancaster appears on p. 40.] 


wwoods2 on PRODPC68 with HEARING
8 

Mr. HALL. Thank you, Mr. Lancaster. Let me recognize myself 

for a few questions. First Mr. McCartney, thank you for your service and for your moving testimony. In your opinion, what would be 

the major change that the VA needs to make regarding the Independent Living Program? If you could wave a magic wand and 

have one thing change, what would that be? 

Mr. MCCARTNEY. Directives need to come out that the Independent Living Program is something to be exploited by each case 

manager to every veteran that comes into the door, that it is explained to them. All these 272,000 100-percent disabled veterans 

and the hundreds of thousands of others with 60 and 70 percent 

disabled, who are qualified for the Program. And then they need 

to action these in a fast track. It should not take a year, it should 

not take 2 years, 3 years, 4 years, for one person to get a Program. 

Mr. HALL. Thank you. In trying to get assistance from the Independent Living Program, do you think that the VA personnel understood the Program and how it should help veterans? 

Mr. MCCARTNEY. I think there is a break down from the lowest 

echelon to the highest echelon. I have been in contact with each 

chain of command. And at each level of command, from the Director’s Office down to the local case manager, is repeatedly delay, no 

answer. Personally, I felt like I had the plague or they just wanted 

me to go away. 

Mr. HALL. And sir, what is the status of your application today? 

Mr. MCCARTNEY. It was completed in 2007, in December of 2007. 

And there was supposed to be a 1-year followup between myself 

and my case manager. I do not know who my case manager is. 

Every month I fill out my report and I have it for them whenever 

they are ready for it. 

Mr. HALL. What was the problem, or what was more the problem, your counselor or the program itself? 

Mr. MCCARTNEY. The personnel running the program. Like I say, 

I think it is a close held program. And the ILP is put at the bottom 

list of everything. I have communications from the case manager 

that said, after 2 years in the process, in November of 2005, they 

say, ‘‘Well, I had a really extremely heavy caseload and I can finally get around to your case now.’’ 

Mr. HALL. Thank you. What do you think, Mr. McCartney, is the 

greatest benefit of the ILP? Let us know when you—— 

Mr. MCCARTNEY. Right now it is hard for me to see any benefits 

of it. 

Mr. HALL. I understand, sir. 

Mr. MCCARTNEY. Because I am advocating for eight veterans 

right now who are going through the same exact thing that I am. 

Some of them it has been 15 months since they submitted their application. 

Mr. HALL. Mm-hmm. 

Mr. MCCARTNEY. And they were resubmitted. So are there any 

real benefits? Negligible. 

Mr. HALL. When you find some, you will come back and tell us? 

Mr. MCCARTNEY. I definitely will. 

Mr. HALL. Thank you. Mr. Lancaster, how many referrals does 

NCIL get from the VA per month? 


wwoods2 on PRODPC68 with HEARING
9 

Mr. LANCASTER. I do not have that information. And I would suspect that with the exception of two or three States that the answer 

would be zero. In Michigan I know there is, there is a direct linkage and a memorandum of understanding in place between the 

State of Michigan which includes the Independent Living Program. 

And I do not know the number of referrals that that amounts to. 

But we can find that information out. But I know in a lot of States 

what we have learned from a survey that we did to ourselves that 

the number of veterans they are seeing is increasing dramatically. 

Interestingly enough they are seeing a large number of Vietnam 

veterans and a smaller number of Iraqi/Afghani veterans, although 

it is our suspicion that in the future we will start seeing more of 

those as well. But they are coming in off the street. They are not 

coming in as referrals. Or off the street may be the wrong word, 

but they are coming by a word of mouth referral or some other referral than through the VA. 

Mr. HALL. Thank you, sir. Now I will recognize Ranking Member 

Boozman and also acknowledge the presence of our Chair, Chairwoman Herseth Sandlin, and turn the Chair back over to her at 

the same time. Mr. Boozman? 

Mr. BOOZMAN. Thank you, Mr. Hall. I was reading, and you mentioned in your testimony, your caseworker saying something to the 

effect that if you ever get straightened out come back and see me. 

So we are glad that you have gotten straightened out and that you 

are here seeing us. At first you wanted a tractor, and then, you 

were persuaded, or pushed into the greenhouse. Has that been 

helpful? I know you have gone through this tremendous ordeal. But 

is that something that, you know, if we could forget about that, is 

that entity being helpful to you in what you are trying to get done? 

Mr. MCCARTNEY. Initially, I wanted an interest free loan, or assistance getting an interest free loan, so I could buy my own tractor. 

Mr. BOOZMAN. Right. 

Mr. MCCARTNEY. And then pay it back. After 4 years, 4 years 

and a couple of days, my greenhouse was completed. Unfortunately, 

the contractors were not paid as they should have been and they 

kept showing up at my door. And I took out a line of credit and 

paid them off. And when they got paid then they reimbursed me. 

I felt morally that I had to do that because I had a good relationship with all three contractors that worked on this project. Since 

the project has been completed I have had—— 

Mr. BOOZMAN. That is my next question. Have they subsequently 

reimbursed you? Is that—— 

Mr. MCCARTNEY. The contractors. 

Mr. BOOZMAN. Have you gotten paid for—— 

Mr. MCCARTNEY. Yes, sir, I have. The day after they got the 

check they came to my door and said, ‘‘We appreciate you putting 

this money up front for us.’’ You know, 75, 80 days is too long to 

pay a contractor. 

Mr. BOOZMAN. But since that time the VA has reimbursed you? 

Mr. MCCARTNEY. Yes, sir. The VA? 

Mr. BOOZMAN. You got your—— 

Mr. MCCARTNEY. No, the contractors. The contractors reimbursed 

me, yes, sir. 


wwoods2 on PRODPC68 with HEARING
10 

Mr. BOOZMAN. Okay, very good. 

Mr. MCCARTNEY. Since we have been completed, I have had 

three 4–H clubs come to the greenhouse. I am doing all hydroponics. That is unheard of in southeast Georgia. I have had a couple master gardeners come and emulate my hydroponics system. 

We have had two high school horticulture classes come. And it is 

an educational process for them in that I make them determine the 

volume of a four by eight pool, and how much chemicals or nutrients to add to this. So it is a good learning process for them. It is 

really been good for me that I am in my comfort zone and I can 

do what I like to do in my comfort zone. 

Mr. BOOZMAN. Very good. Mr. Lancaster, Mr. McCartney has 

very well, in detail, been able to deduce his experience through the 

years. In your experience with dealing with other veterans, have 

they had the same problems? Or is it a regional phenomenon? 

Or—— 

Mr. LANCASTER. No, I would say that there are a number of veterans who experienced significant disabilities, often one similar to 

Mr. McCartney, like PTSD, who have had similar experiences over 

the years. There has been some fairly good efforts through the Vets 

Centers to deal with some of the counseling issues. But in terms 

of getting some of the hard support issues toward independent living and productivity like Mr. McCartney is talking about, I think 

there are some real issues going on. 

Mr. BOOZMAN. You deal with these things. We can see how long 

this takes. What would be a reasonable time factor to get a greenhouse? To accomplish that task that he was trying to get done? 

Mr. LANCASTER. I would say from application point to when he 

is up and running, not knowing a lot about Mr. McCartney’s business I have to, you know, confess there. So I do not know what the 

start up time. But I would think in terms of application to approval, you know, a reasonable time might be in the area of a, you 

know, maybe a month. And then immediately start getting that, 

you know, assistance going. 

Mr. BOOZMAN. Right. 

Mr. LANCASTER. I mean, I cannot see why it should take all that 

long. 

Mr. BOOZMAN. Do you agree, he mentioned, one of the things 

that Mr. McCartney mentioned was the fact that lots of veterans 

do not know about the program. That we need a better education 

program to, so that veterans in this situation will be aware. Is that 

a fair statement? 

Mr. LANCASTER. I would say that is a very fair statement. I 

would also say, as I said in my testimony, our system, the Independent Living Program, needs to know more about the VA’s Independent Living Program so that we can better serve veterans. And 

that is a shortcoming on our part. Our centers are stretched pretty 

thin. So it would be really good to have some sort of training program that we could implement, or the VA could implement, or 

somebody could implement, to be systematically training Centers 

for independent living on what is available through the VA. So that 

when a veteran comes in we can appropriately refer if the referral 

has them coming from us. And then also people need to look at 

what our system, which has been around since 1978, can do for vetVerDate Nov 24 2008 04:45 Feb 14, 2009 Jkt 043999 PO 00000 Frm 00014 Fmt 6633 Sfmt 6633 E:\HR\OC\43999.XXX 43999

wwoods2 on PRODPC68 with HEARING
11 

erans. It is already an established system funded in part by the 

Federal Government through the Rehabilitation Services Administration. And, you know, it is a, it is a really good system that empowers people into taking responsibility for their own lives and getting involved in the community and achieving economic self-sufficiency. 

So let us not reinvent the wheel, here. Let us create the linkages 

and the support systems to make what is out there work. 

Mr. BOOZMAN. Right. Again, I thank both of you for your service 

to your country. Your testimony today was very helpful. Thank 

you, Madam Chair. 

Ms. HERSETH SANDLIN [presiding]. Thank you, Mr. Boozman. I 

just have one quick followup before turning over to Mr. Scalise for 

his questions. Mr. Lancaster, then, I know that the Centers for 

Independent Living conducted a survey on some of what you were 

just discussing in terms of this need for a more formal connection—— 

Mr. LANCASTER. Mm-hmm. 

Ms. HERSETH SANDLIN [continuing]. And relationship, and the 

ideas of systematic training, and understanding among the Centers 

are stretched thin. What has been the attempt in the past to improve the relationship between the Centers and the VA? Is this primarily a budgetary matter? Or are there some bureaucratic issues 

as it relates to identifiable individuals within the VA that are here 

to help establish a more formal connection? You had mentioned in 

your response to Mr. Boozman that maybe there is some responsibility on the part of the Centers. I mean, what has been done in 

the past? 

Mr. LANCASTER. Well frankly, to be real honest, not a lot has 

been done. There has been a big, how shall I say it, lack of understanding between what our system has to offer and our lack of understanding and knowledge of the VA system. Traditionally and in 

past years veterans tended to turn to veterans service organizations for most of their needs and service and advocacy, or directly 

to the VA. Recently we have been seeing a major shift in that. That 

is why we did this survey. That is why we are starting to really 

look at these issues where we are starting to see significant numbers of veterans coming for the first time, Vietnam era ones are the 

largest number, but now more and more of the Iraqi/Afghani veterans coming to us for assistance in accessing housing, for peer 

support and mentoring, for employment-related services, for personal care attendant services. And also for other services, like access to assistive technology and good advice in that regard. So 

there is a variety of different things that these veterans are starting to come to. 

Now we feel they are coming to the right place. Then again, we 

also know that some veterans are not looking at us as a support 

system and a place where they can get services that will empower 

them and help them access what they need because we are not veterans. I am, personally, and some are, but for the most part it is 

not like a VSO. And that is where our system needs to reach out 

and better understand, for lack of a better word, kind of the veteran community culture, and the brother- and sisterhood, if you 

will, that exists among veterans. 


wwoods2 on PRODPC68 with HEARING
12 

And why the recommendation that I made I think would be so 

valuable. If there could be resources made available for every single one of those 336 directly federally funded centers to have the 

funds to hire a veteran, preferably a disabled veteran, to work in 

their centers, to do outreach to veterans service organizations, to 

the State Veterans Affairs Agencies, and the VA, to broker and 

work with and help put together the services, I think it could go 

a long toward developing a, kind of a more seamless system, if you 

will, that would be far more responsive. And that could cover the 

myriad of opportunities that are available between the VA, State 

veterans organizations, and State veterans benefits, and what veterans service organizations have to provide. 

Ms. HERSETH SANDLIN. Thank you very much. Mr. Scalise, you 

are recognized. 

Mr. SCALISE. Thank you, Madam Chair. Sergeant McCartney, 

your testimony had mentioned VA has some contract counselors. 

What is your experience been with them compared to the regular 

staff? 

Mr. MCCARTNEY. The consultants. 

Mr. SCALISE. Yeah. 

Mr. MCCARTNEY. Superb. My consultant was a veteran. That 

made it easier. He, he could empathize with what I had been 

through and what I was going through. And he was a shoulder that 

I often went to when I was having problems with the Regional Office or the Director’s Office, or even my local case manager. 

Mr. SCALISE. Still followed the same procedures? I guess what I 

would be curious to find out is what was he doing differently than 

the other staff? Or what were they not doing within the guidelines 

that they are all supposed to follow why would you maybe get one 

experience—— 

Mr. MCCARTNEY. He did not come on board until after Congressman Barrow endorsed a letter to Congressman Filner about getting 

this project started. It was way overdue. Only then was he contacted by the Director, who said, ‘‘Let us get on this one and let 

us get it done soon.’’ So that is when he came aboard. I have only 

been in contact with him for a matter of months. And everything 

was professional and aboveboard. And when I called him or 

emailed him with a question or a concern, I got immediate replies. 

So—— 

Mr. SCALISE. And why do you not think you got that same kind 

of response from some of the staff that you dealt with in the past? 

Mr. MCCARTNEY. Malfeasance. Ineptitude. Caseload. Lack of caring for disabled veteran needs. 

Mr. SCALISE. So you could sense not only procedurally maybe 

they approached things differently, but just from maybe a sense of 

urgency to want to help? You did not find that from some of that 

staff that you did find with the contract person? 

Mr. MCCARTNEY. Not only could I sense it. I felt it. I lived it. 

Mr. SCALISE. Now, you said you are also helping some other veterans. Eight other, I think you said, at the current, at present 

time. 

Mr. MCCARTNEY. Yes, sir. 

Mr. SCALISE. Now, are you going through the consultant with 

them? Or is this going through a different channel? 


wwoods2 on PRODPC68 with HEARING
13 

Mr. MCCARTNEY. Everything starts at the local case manager 

level. From there they get their application from the case manager. 

The case manager sends it to the Regional Office. The Regional Office sits on it for a period of time. Then it goes back to the case 

manager and says, ‘‘Okay, well we are going to approve this. You 

know, we have found that this veteran would be qualified.’’ Now 

that is a change in the system from when I first applied. The case 

manager went into the computer, looked at my records and says, 

‘‘Yes, you are qualified for independent living.’’ That is when the 

process started then. Now we have a delay, that the case manager 

has to send to Regional, Regional might take a month or two or 

three or six or seven, as is the case with a couple of the veterans 

that I am working with now, before they send anything back down. 

Mr. SCALISE. Is that a policy change? 

Mr. MCCARTNEY. I cannot answer that. I would presume it would 

be. Because like I say, when I applied, when I applied with the 

case manager in November of 2003 she said, ‘‘Well, you are qualified.’’ Now the veterans are applying with the case manager, they 

do a small interview, a bio, and it, they might get called back in 

a month or two. 

Mr. SCALISE. So they are not able to get that immediate response? 

Mr. MCCARTNEY. Pardon me. 

Mr. SCALISE. They are not able to get that immediate response—— 

Mr. MCCARTNEY. No. 

Mr. SCALISE. All right. That is all I have for now. Thank you. 

And thank you both for your service. 

Ms. HERSETH SANDLIN. Thank you. I do not have any further 

questions. I do want to thank you, Mr. McCartney, for being here 

and sharing your experience. I can certainly appreciate the level of 

frustration with the lack of responsiveness, which oftentimes can 

be a lot more frustrating than not getting the desired outcome such 

as having some sort of forward progress and resolution to the needs 

under the ILP program. We appreciate the insights you have been 

able to offer today. Mr. Lancaster, we appreciate your testimony as 

well, your service to the country, and for being here today and for 

offering your testimony. Thank you very much. 

Mr. LANCASTER. Madam Chairwoman and Ranking Member, 

thank you for this Subcommittee bringing attention to this matter 

and holding this hearing. Thank you very much. 

Ms. HERSETH SANDLIN. Thank you. 

Mr. BOOZMAN. Absolutely. 

Ms. HERSETH SANDLIN. I would now like to invite our second 

panel to the witness table. Joining us is Mr. Richard Daley, Associate Legislation Director of the Paralyzed Veterans of America; 

who is accompanied by Ms. Theresa Barnes Boyd, Vocational Rehabilitation Consultant of the Paralyzed Veterans of America; and 

Mr. Mark Walker, Assistant Director of the Economic Commission 

for the American Legion. We thank you all for joining us today. Mr. 

Daley, I think we will go ahead and begin with your testimony. 

You are recognized for 5 minutes. 


wwoods2 on PRODPC68 with HEARING
14 

STATEMENTS RICHARD DALEY, ASSOCIATE LEGISLATION DIRECTOR, PARALYZED VETERANS OF AMERICA, ACCOMPANIED BY THERESA BARNES BOYD, VOCATIONAL REHABILITATION CONSULTANT, PARALYZED VETERANS OF 

AMERICA; AND MARK WALKER, ASSISTANT DIRECTOR, NATIONAL ECONOMIC COMMISSION, AMERICAN LEGION 

STATEMENT OF RICHARD DALEY 

Mr. DALEY. Chairwoman Herseth Sandlin, Ranking Member 

Boozman, and Members of the Subcommittee, I would like to thank 

you for this opportunity for Paralyzed Veterans of America to discuss the Department of Veterans Affairs Independent Living Program which is administered by VA’s Vocational Rehabilitation and 

Employment (VR&E) Program. PVA believes that the VR&E Program is one of the most critical programs that the VA administers 

in assisting veterans with disabilities to successfully transition to 

civilian life. 

The primary mission of the VR&E Program is to provide veterans with service connected disabilities all the necessary services 

and assistance to achieve maximum independence in daily living to 

the maximum extent feasible, to become employable, and obtain 

and maintain suitable employment. In 1980, when the Independent 

Living Program was first developed, it was a pilot program. It had 

a 500 cap maximum to the program. The program was successful 

and the 500 cap seemed to be forgotten. And they went, actually 

went beyond the 500. Years after dealing with the 500 case cap, 

the VA met with Congressional staff members to request the case 

cap be removed. Congress at that time would not remove the cap 

because they wanted the VA to implement stronger guidelines for 

the program. However, Congress did accede to increase the case 

cap from 500 to 2,500 in 2001. 

Even though the new case cap was increased, the VA continued 

to bump up against the case cap for many years. This caused a 

slow down in delivery of services. They had to request counselors 

when they got close to the cap to send their applications into the 

national office for review, and the review took some time. And so 

they never quite finished all the applications for that year and they 

ran over into the next fiscal year, then they could approach the 

cases and open them up again. The cause in the delay also placed 

a burden on the VR&E staff because they had to take the time to 

review the applications and they had to also monitor the number 

of people that were actually applying so they did not reach the 

2,500 or exceed it. 

PVA strongly opposes any unnecessary delay in services, especially services to severely disabled veterans. PVA is extremely disappointed that VR&E staff is still forced to abide by the arbitrary 

2,500 new case cap. At this time when the continuation of our military efforts in Operation Iraqi Freedom and Operation Enduring 

Freedom are unfortunately resulting in ever increasing numbers of 

veterans who sustain serious injuries, any limit imposed on the delivery of services to the severely disabled veterans is at best contrary to the intent of Congress and the American people. 

To achieve the successful outcome with the approximately 95,000 

veterans each year, VR&E has made progress through continual 


wwoods2 on PRODPC68 with HEARING
15 

improvement of its programs. In 2004, VR&E hired an Independent 

Living Coordinator to manage the Program. In 2005, the Independent Living Standards of Practice were issued for the VR&E 

field staff and provided guidance for them. And over the last 3 to 

4 years VR&E has not met their limit in that gap, but that is probably because of the slow down in procedures that you heard about 

earlier. 

The removal of the IL cap, the greater attention directed to serving veterans with severe disabilities, PVA recommends that VR&E 

be given additional, professional, full-time employee positions for 

the Independent Living Specialist counselors. These experienced 

counselors should be fully devoted to delivering the service to those 

veterans determined to have serious employment handicaps and 

partnering with other programs in the community to bring to the 

veteran the full range of independent living services available. 

Madam Chairwoman, that concludes my testimony. I would be 

happy to answer any questions you may have. 

[The prepared statement of Mr. Daley appears on p. 42.] 

Ms. HERSETH SANDLIN. Thank you, Mr. Daley. Mr. Walker, you 

are now recognized for 5 minutes. 

STATEMENT OF MARK WALKER 

Mr. WALKER. Madam Chairwoman, Ranking Member Boozman, 

and distinguished Members of the Subcommittee, thank you for the 

opportunity to present the views of the American Legion regarding 

the Independent Living Program. The Independent Living Program 

serves severely disabled veterans who VA determined at that time 

were unable to pursue an employment goal. The Independent Living Program provides the veteran with an evaluation and counseling, prosthetic appliances, adaptive automobile equipment, 

wheelchair training, and other services necessary to enable a severely disabled veteran to achieve maximum independence in daily 

living. Veterans may remain in an Independent Living Program for 

a maximum of 30 months. 

Chapter 31 of Title 38, United States Code, limits the number of 

veterans who can be placed in Independent Living Program to 

2,500 annually. The American Legion supports the removal of this 

cap. VA should effectively manage and monitor the number of new 

Independent Living Program participants and provide detailed information to Congress on delays in veterans services until a decision has been made to remove the annual statutory cap. 

Severely disabled veterans state that the independent living 

services assisted them in adjusting to home life and participating 

with family and community at a higher level. The Program has 

provided severely disabled veterans much needed assistance and 

possible hope for future employment. In February 2007, the VA 

Secretary stated that the Vocational Rehabilitation and Employment Program anticipates a steady increase in the demand for 

independent living services over the next 10 years. At this time in 

the Nation’s history, it is paramount that we ensure the VA is capable of enabling veterans with disabilities to have a seamless 

transition from military service to successful rehabilitation and on 

to suitable employment after military service. 


wwoods2 on PRODPC68 with HEARING
16 

For severely disabled veterans this success will be measured by 

their ability to live independently, achieve the highest quality of 

life possible, and realize the hope for employment given advances 

in medical science and technology. To meet America’s obligation to 

these specific veterans and other eligible vocational rehabilitation 

employment veterans, VA leadership must continue to focus on 

marked improvements in case management, vocational counseling, 

and most importantly job placement. 

The American Legion strongly supports the Independent Living 

Program and is committed to working with VA and other Federal 

agencies to ensure that America’s severely disabled veterans are 

provided with the highest level of service and employment assistance. 

Again, thank you for the opportunity to present the opinion of 

the American Legion on this issue. 

[The prepared statement of Mr. Walker appears on p. 44.] 

Ms. HERSETH SANDLIN. Thank you, Mr. Walker. Let me start 

with a question to both of you, just to clarify. Is your organization’s 

position that the statutory cap should be removed entirely or increased? If the organization’s position is that it should be increased 

rather than removed, do you have a number? A projected number 

that you would suggest? 

Mr. DALEY. PVA believes at this time it should be removed. 

There is a bill in the Senate to actually remove it. And we probably 

do not know what will happen. We do not know about the caseload 

that we will get from the current conflict. There are probably 

many, many people out there that could qualify for the program if 

it is removed. 

Ms. HERSETH SANDLIN. Mr. Walker. 

Mr. WALKER. The American Legion also desires for the cap to be 

removed. 

Ms. HERSETH SANDLIN. Have your organizations both held this 

position for many years? Or was this a modification of the position 

in light of the increased numbers of severely disabled veterans we 

are seeing returning home from OIF and OEF, as well as some of 

the more severely disabled veterans from past conflicts, particularly those Vietnam veterans who may be suffering from PTSD and 

have a high degree of service-connected disability? 

Mr. DALEY. I was not as familiar with the legislative goals of 

PVA in, say, 2000, 2001. I was working with the organization in 

another capacity. But why should we have a cap on any program 

that is for the severely service-disabled veteran? And say, ‘‘Well, 

sorry, thanks for serving your country. Come back in October 1st, 

our new fiscal year, so we can deliver benefits to you.’’ No, I do not 

think that we should ever have a cap and we have probably felt 

that way all along. 

Ms. HERSETH SANDLIN. I appreciate that and I am asking a question that goes back. I am asking the question because prior to this 

hearing, this particular program has not gotten the attention we 

think it warrants. A number of other veterans service organizations 

felt that they were not in a position to provide testimony as they 

do in other hearings because this program is one that VSOs are not 

as familiar with. This occurrence sort of goes to the issue of Mr. 

Lancaster’s testimony, and perhaps both of you could comment on 


wwoods2 on PRODPC68 with HEARING
17 

it. As he recognized the issue, he said, ‘‘Look, well there is just sort 

of a general lack of understanding of everybody’s systems, whether 

it is the VA’s system program, whether it is the systems with the 

Centers of Independent Living, or whether it is the VSOs, and how 

to make those referrals smooth and what everyone can provide.’’ I 

mean, would either of you like to comment on Mr. Lancaster’s 

statements? 

Mr. DALEY. To address what you are referring to, Chairwoman, 

about if people do not know about, I called several service officers 

that are out in the field for PVA and asked them about the program. And of course our service officers, they deal with paraplegics 

and quadriplegics, so of course they qualify for Independent Living 

Programs. And they knew nothing about it. They said, ‘‘I know of 

it, and it exists somewhere within the VA. But I cannot tell you 

much about it.’’ One service officer with more than 20 years experience, he said, ‘‘Well, let us look it up in the VA publication and see 

what it says.’’ This is the publication of all the Federal benefits. 

And you go to the index, independent living is not in there. So how 

would a veteran know about it? How would the parent or the 

spouse that is taking care of the severely disabled veteran even 

say, ‘‘Well, there is a program here where you may be able to receive help.’’ It is a secret. 

And too, since I did not know much about the program, I asked 

my colleague Theresa Boyd to accompany me because she has been 

very instrumental in putting together several vocational employment programs for PVA, the one that you have heard about in 

Richmond, Virginia. And we have two more on the drawing board 

now and she is responsible for that. But she is familiar with the 

Independent Living Program also. She has had many years with 

the VA. So I wish you could get a little knowledge from her. 

Ms. HERSETH SANDLIN. Well, I will seek some insight from her 

afterward. Maybe Mr. Walker wants to comment, and then I am 

going to turn it over to my colleagues. But it is good to know of 

Ms. Boyd’s experience with the VA as well and perhaps particularly with this program? With the Independent Living Program? 

Okay. Mr. Walker. 

Mr. WALKER. Well, the American Legion has found the same 

things. There is not a lot of outreach with this program. And there 

are just a lot of severely disabled veterans that do not know it even 

exists. So I think there needs to be some outreach, obviously, and 

ILP must engage other community based services as well. But we 

found the same thing to be true. That the word is not out about 

the program that can assist severely disabled veterans. It is not 

known as it should be. This is why we want the removal of the cap 

as well. 

Ms. HERSETH SANDLIN. If my colleagues would indulge me for a 

moment, I would like to ask Ms. Boyd then. Based on your experience, both with the VA and with PVA, what accounts for this lack 

of outreach? Do you have any recommendations on how we go 

about coordinating the sharing and facilitating of exchanging information more effectively to target and reach severely disabled veterans? 

Ms. BOYD. I think one of the issues that makes it a little confusing is that you cannot apply directly for a program of indeVerDate Nov 24 2008 04:45 Feb 14, 2009 Jkt 043999 PO 00000 Frm 00021 Fmt 6633 Sfmt 6633 E:\HR\OC\43999.XXX 43999

wwoods2 on PRODPC68 with HEARING
18 

pendent living. You have to first go in to the Vocational Rehabilitation Program and apply for services, and then a counselor, a VA 

counselor, has to make the determination that you are not currently reasonably feasible to achieve a vocational goal. So you have 

to go through that process first. And that may be, while everybody 

is familiar with the regular Voc Rehab Program, they are not that 

familiar with independent living because you do not apply directly 

for independent living. 

As far as outreach activities, I think it is difficult when you have 

this cap for 2,500 to go and say, ‘‘We want you to increase your outreach activities but only do it to 2,500 veterans.’’ It is very difficult. 

In previous years when I worked for VA we did bump up against 

the cap. And that was very hard to manage. And nobody was very 

happy with VA when they went over the cap. So we were constantly trying to do these measures, estimate each month as we got 

near the end of the fiscal year and got nearer to that cap, and tried 

to slow the process down which was very frustrating for both counselors and, of course, veterans. So I think that may explain some 

of the lack of outreach. 

As far as recommendations I think there is plenty that could 

help improve the program. I believe that specialty counselors are 

called for, which could improve those linkages with community 

based programs. It is very hard, if you are a full service counsel 

in the VR&E program, to try to devote the time necessary for these 

cases with severe disabilities, and to go out and develop community 

resources to work with. There is just not a lot of time. It is the 

caseload issue. So I would, and I think PVA strongly recommends, 

specialty IL counselors. 

I also think that more staff perhaps at the Central Office to manage the program would help. If you really want to increase the program increase the outreach activities, remove the cap, then you can 

expect that there will be more veterans needing to be served. And 

with that, I think, has to come appropriate resources. 

Ms. HERSETH SANDLIN. Thank you very much. Mr. Boozman. 

Mr. BOOZMAN. Thank you, Madam Chair. Ms. Boyd, we really 

have two things going on in the sense that you mentioned the reasons and I think that makes sense. If you have a capped program 

where you are bumping up against the cap then it does not make 

a lot of sense to go out and, right or wrong, to advertise the program. On the other hand, if you have a capped program and you 

know that you are going to be servicing so many individuals, you 

know, or about that number, unlike a lot of the other things that 

deal with it, it seems like it would be easier to plan your resources. 

Does that make sense? If you know that you are, you are going to 

be handling about 2,500 cases or whatever? 

Ms. BOYD. I do not think it makes sense to the individual counselor out there. It can make sense from a national headquarters 

when you are trying to manage it. But I think it is difficult when 

you are managing individual caseloads and your counselors are out 

doing outreach. I think that is hard to manage. 

I will give you an example of how hard that cap was to manage, 

and this was several years ago when I worked at VA and we had 

to monitor that cap, as I said, very closely. And we were kind of 

estimating how much it was increasing each month. And 1 month 


wwoods2 on PRODPC68 with HEARING
19 

it took us by complete surprise and I think it might have been the 

month of July. And it jumped up like 300 cases in 1 month. And 

it had not done that before. It put us over the cap. And then we 

were all in trouble for that. Was that due to just an increase in outreach activities? Who knows? But that was very hard to manage 

and predict. And so while you say it should be easier to manage, 

you would think so. But I think once you get down to the service 

delivery level, it is not. It is very difficult to manage that. 

Mr. BOOZMAN. I guess what I am saying is you kind of know how 

many folks are going to be in the program. The testimony that we 

heard where the gentleman had so much trouble with the delivery. 

Where is the bottleneck in the system? Now are we playing some 

games where caseworkers actually, because of the cap, is there a 

way to manipulate that without giving services, that they push 

them over into the next year? Because we are bumping up? I mean, 

does that kind of stuff go on? 

Ms. BOYD. I think you will find that there is not a VA counselor 

that does not want to serve a veteran. And so to answer that question VA did everything in its power not to delay services. And so, 

if that meant trying to provide some services under a different status, for example extended evaluation, VA counselors did everything 

to try not to delay services. 

Mr. BOOZMAN. But in this case that we heard, I mean that is inexcusable. 

Ms. BOYD. Yes. 

Mr. BOOZMAN. There is no, I mean, it is inexcusable. And probably we have other cases like that, you know? So I guess I am asking, where is the problem in that? You have kind of a finite number of people that you are going to deal with. Now you might, you 

have the problem of not bumping over the cap. That is what I was 

saying earlier. It is not like we get you in a situation where, not 

now because you are not with the VA, but we get the VA in a situation where they do not really know what kind of funds they are 

going to have until late in the system and all that. But in this particular situation, you know that you are going to have this group 

of people to service through the system. Your only problem is trying to keep that down. Why cannot we service that many people? 

Where is the bottleneck in the system? And in this case, it is inexcusable. I mean, there is no way to, so where is the bottleneck in 

the system? And do, in your experience, do we play games? Because of the cap, do we push people, do we, does it lay on the desk 

sometimes for months because somehow that pushes people into 

the cap system? Does that make sense? As far as providing assistance? 

Ms. BOYD. I understand what you are saying. And to answer that 

part of your question I go back to what I said earlier. I think, my 

guess would be that happens rarely. More likely what counselors 

are doing are figuring out another way to serve them without having them counted as a new case, a new IL case, until the start of 

the next fiscal year. I think they try very hard not to delay services 

intentionally. So they might, I do not know if I would call it playing 

games, but they might try to maneuver a different strategy to offer 

services without having to declare them a new IL case, would be 

my guess and my experience in working in VA. 


wwoods2 on PRODPC68 with HEARING
20 

Mr. BOOZMAN. But the bottleneck, like you say, the person on the 

civilian side says, ‘‘You need to get this rolling within a month.’’ 

That is normal for, you know, the civilian side. What drug this 

thing on for years? 

Ms. BOYD. I do not know. And it is inexcusable, as you said. I 

think some of the issues might be whatever was going on in that 

office, if there was counselor turnover. VA does have a pretty labor 

intensive, up front eligibility and entitlement processing that takes 

some time. And as I said, in the case of an IL program you cannot 

apply directly for that. The counselor first has to gather information and make the determination that you cannot achieve, or are 

not currently reasonably feasible to achieve a vocational goal. So it 

may be a combination of all those things. Counselor turnover, processing a heavy caseload, but in the end as you said, it is still inexcusable. And nobody would feel good about a case like that. 

Mr. BOOZMAN. Yeah. 

Ms. BOYD. The veteran was not well served. 

Mr. BOOZMAN. Right. Thank you very much. And I appreciate 

your testimony. I feel kind of bad, asking you questions in the 

sense of your VA experience. It is good to have you where you are. 

I think that you are valuable in the sense, you know, now that you 

can see both sides. And again, thank all of you for being here. Your 

testimony is very helpful. 

Ms. HERSETH SANDLIN. Thank you, Mr. Boozman. I would just 

like to comment, too. I think based on what Mr. McCartney had 

stated in response to the question, ‘‘Was it the counselor or the program,’’his response was, ‘‘It was the personnel who were in charge 

of this program.’’ So I think the other recommendation you had 

made was the issue of staff at the Central Office to manage these 

programs. While Mr. Boozman said we do not expect you to defend 

the VA; yet from your experience in being able to intuit what might 

have happened in this situation, I think there are clearly a number 

of factors. Also in this instance, there was an issue of accountability with the local caseworker, and the staff needed to manage 

the program effectively. 

We have a vote that has been called, but I think we have time 

for Mr. Scalise’s round of questions for this panel of witnesses. 

Then we will return after a brief recess for our final panel. 

Mr. SCALISE. Thank you, Madam Chair. And I will cut it short 

so we can get out in time for the vote. But how long, has the cap 

been in place since the program started? 

Ms. BOYD. Originally the program was started as a pilot program 

in I believe 1980. And at that time a cap of 500 was placed on the 

program because it was a pilot program. Then what happened is 

people kind of forgot about the cap, and VA went over the cap. And 

I believe it was in about 2,000 or something Congress called VA up 

and they had a discussion about the cap. And at that time VA 

asked for the cap to be removed. Congress wanted stronger guidelines on the program. And they did agree to increase it to 2,500. 

Mr. SCALISE. So was the cap put in place purely for financial reasons? Or was it because it was a pilot and they wanted to see how 

it worked before they made it more open ended? 

Ms. BOYD. I believe it was because it was a pilot program. 


wwoods2 on PRODPC68 with HEARING
21 

Mr. SCALISE. So now the, I mean this is going back to 1980 so 

I think we are beyond the pilot stages, but the cap, as you said, 

is not 2,500 and we are, at what point in the fiscal year, I guess 

they start at zero on October 1st and then when they hit 2,500 they 

have to stop. When do they hit 2,500 now, typically, like in the last 

few years since that number has been in place? 

Ms. BOYD. I do not know if they have reached the cap in the last 

couple of years. When I worked at VA, we did bump up against it 

and exceed it. And it was typically about this time of year, in the 

fourth quarter of the fiscal year. Around July and August, it got 

pretty dicey. We were getting pretty close and I talked about the 

time where it jumped up in 1 month. And it was very hard to manage. You are trying to manage, you are trying to estimate, you 

know, the next month. You know, do we have to cut it off today 

or can we let it go a while longer? And so it was about this time 

of year that it got very difficult to manage. 

Mr. SCALISE. When they are getting close and they know they 

still have a few months left where there might be light at the end 

of the tunnel but there are still services that are being requested, 

do they try to prioritize within that while they are—— 

Ms. BOYD. Exactly. And that is what Mr. Daley was talking 

about in his testimony. It was burdensome, I think, on both the VA 

staff and the veterans who had to wait for that. Because one thing 

VA did was try to make a determination at that time as to who 

was most in need of services. In other words, who could wait until 

the start of the new fiscal year and who needed the services right 

away? 

Mr. SCALISE. How closely do your organizations work with them 

in making those kind of determinations? 

Ms. BOYD. PVA working with VA to make those. 

Mr. SCALISE. Yeah. 

Ms. BOYD. I think that that is a VA determination solely. 

Mr. SCALISE. Okay. And then we are this, for this fiscal year we 

are at the cap? Close to the cap? Where—— 

Ms. BOYD. I do not have that information. 

Mr. SCALISE. Okay. I appreciate it and that is all I have for now, 

thank you. Madam Chair. 

Ms. HERSETH SANDLIN. Thank you. Well, we thank you for your 

testimony and the insights you have offered today and we will look 

forward to following up with you on some of the suggestions that 

you have offered to the Subcommittee. Thank you very much. 

We will now take a brief recess and return. Let me see how 

many votes; we have four votes. So it may take us a little bit of 

time to get back here. We will look forward to hearing from our 

third and final panel for the day when we return. So we are in recess for the time being. 

[Recess] 

Ms. HERSETH SANDLIN. Well, thank you for indulging this delay 

in the time. It is always hard to predict how long debate and motions to recommit will take and in this case we may have gotten 

back and gotten some of your testimony in during the break, but 

that is always very hard to predict. Also, the Ranking Member had 

a flight to catch as well as some family circumstances that came 

up at the last minute. So we will go ahead and take your testiVerDate Nov 24 2008 04:45 Feb 14, 2009 Jkt 043999 PO 00000 Frm 00025 Fmt 6633 Sfmt 6633 E:\HR\OC\43999.XXX 43999

wwoods2 on PRODPC68 with HEARING
22 

mony. I will have some questions for you. Then since there are no 

other Members here to object, I am going to recognize counsel for 

the Minority if there are any questions that he would like to ask 

for the record that the Ranking Member may have been prepared 

to ask before he had to leave. 

Joining us on our third panel is Ms. Ruth Fanning, Director of 

Vocational Rehabilitation Employment Service for the Veterans 

Benefits Administration for the U.S. Department of Veterans Affairs; who is accompanied by Dr. Lucille Beck, Consultant for Rehabilitation Services, National Director for Audiology and Speech Pathology of the Veterans Health Administration; and Dr. James F. 

Burris, Chief Consultant Geriatrics and Extended Care for the Veterans Health Administration. 

Ms. Fanning, I am going to recognize you first for 5 minutes. I 

know we received your testimony just late last night, but it would 

help a lot if we can get it sooner just for future reference. It helps 

counsel and staff prepare. It helps Members prepare, and have a 

better chance to read it than the day of the hearing. We would appreciate if in the future you can get it to us a little bit sooner than 

this time. We appreciate you being here today, and look forward to 

your testimony. You are recognized for 5 minutes. 

STATEMENTS OF RUTH FANNING, DIRECTOR, VOCATIONAL 

REHABILITATION AND EMPLOYMENT SERVICE, VETERANS 

BENEFITS ADMINISTRATION, U.S. DEPARTMENT OF VETERANS AFFAIRS; ACCOMPANIED BY LUCILLE B. BECK, PH.D., 

CONSULTANT FOR REHABILITATION SERVICES, NATIONAL 

DIRECTOR, AUDIOLOGY AND SPEECH PATHOLOGY, VETERANS HEALTH ADMINISTRATION; AND JAMES F. BURRIS, 

M.D., CHIEF CONSULTANT, GERIATRICS AND EXTENDED 

CARE, VETERANS HEALTH ADMINISTRATION, U.S. DEPARTMENT OF VETERANS AFFAIRS 

STATEMENT OF RUTH FANNING 

Ms. FANNING. Madam Chairwoman and Members of the Committee, thank you for inviting me to appear before you today to discuss independent living services provided by VA’s Vocational Rehabilitation and Employment Program. My testimony will provide an 

overview, address the cap of 2,500 new independent living cases 

per fiscal year, and describe VR&E’s efforts to improve and facilitate the delivery of these essential services. I am pleased today to 

be accompanied by Dr. Lucille Beck, Chief Consultant for Rehabilitation Services, and Dr. James Burris, Chief Consultant for Geriatrics and Extended Care. I would also like to voice my appreciation for the opportunity to learn from the testimony of all the prior 

panelists, particularly Mr. McCartney. 

Independent living services may be provided to VR&E applicants 

when it is determined during the initial evaluation that they cannot, due to the severity of their disabilities, currently pursue a vocational goal. After this determination, each veteran participates in 

a thorough assessment of his or her potential IL needs. The evaluation begins with a preliminary assessment that is usually performed at the veterans’ home. And during this assessment the 

counselor obtains information about a variety of issues. Those inVerDate Nov 24 2008 04:45 Feb 14, 2009 Jkt 043999 PO 00000 Frm 00026 Fmt 6633 Sfmt 6633 E:\HR\OC\43999.XXX 43999

wwoods2 on PRODPC68 with HEARING
23 

clude housing, personal and emotional needs, leisure and vocational activities, and the ability of the veteran to perform activities 

of daily living. If potential IL needs are identified, a comprehensive 

assessment of IL needs is conducted. If the IL needs are found and 

it is determined that the achievement of goals is possible, the counselor works with the veteran to develop an independent living plan 

that outlines the goals, services, and assistance to be provided, and 

benchmarks that are used to determine progress in achieving 

greater independence in daily living. 

Independence in daily living translates to the veteran’s ability to 

live and function within his family and community either without 

the services of others or with a reduced level of those services. 

Total programs of IL services are usually no longer than 24 months 

but can be extended for an additional 6 months. Some IL services 

that VA provides include training in activities of daily living, attendant care during the period of transition, transportation when 

special arrangements are needed, peer counseling, training to improve awareness of rights and needs, assistance in identifying and 

maintaining volunteer or supported employment, services to decrease social isolation, and adaptive equipment that increases functional independence. 

With the passage of Public Law 108–103, the Veterans Education 

and Benefits Expansion Act of 2001, the limit on the number of 

new IL cases per year was increased from 500 to 2,500. VR&E 

Service monitors newly developed IL plans monthly to track the 

total IL cases in comparison to this legislative cap. Tracking over 

the past 2 years demonstrates the ability of VR&E counselors to 

provide needed services within the current 2,500 statutory cap; on 

average over the past 3 years 2,300 new cases of IL services in 

each year. 

Veterans with severe disabilities who participate in programs of 

independent living have achieved results that include increased 

independence, decreased isolation, decreased dependence on outside 

supports, enhanced family relationships, improved medication and 

therapeutic intervention compliance, greater community involvement, pursuit of full or part-time volunteer employment, and importantly progression from Independent Living Programs to other 

VR&E employment programs. 

As a result of increased outreach we anticipate more veterans 

will participate in programs of independent living services. Also the 

medical stabilization of returning OEF/OIF veterans with catastrophic injuries will necessitate their participation in vocational 

rehabilitation programs. The aging Vietnam era veteran population 

and the increasing number of veterans receiving compensation due 

to presumptive diseases will also likely increase the utilization of 

independent living services. 

I would just like to highlight that we have provided the field in 

2005 with guidelines for the administration of the Independent Living Program. We have provided extensive training to the field in 

implementing those guidelines. We are currently conducting a 

study to obtain a more comprehensive understanding of the veterans who participate in IL Programs and this study is expected 

to be completed by the end of this fiscal year. 


wwoods2 on PRODPC68 with HEARING
24 

I would like to conclude, since I am running out of time, with 

just an illustration of a veteran who we have assisted in Vocational 

Rehabilitation in the Independent Living Program. A veteran with 

an 80 percent VA disability rating applied for Chapter 31 benefits. 

He had also had a multitude of non-service connected disabilities 

and used a wheelchair due to the difficulties he had with ambulation as a result of his disabilities and injuries. His IL goals included increasing his ability to access his home independently, increasing his ability to socialize, and enhancing activities of daily 

living by providing adaptive computer equipment and teaching him 

how to use that equipment. 

Our VR&E counselor worked with a rehabilitation engineer to 

determine how best to increase the accessibility of the veteran’s 

home. Based on the engineer’s assessment and recommendation, 

VR&E provided the installation of solar-powered remote-controlled 

gates, on the veteran’s property. Prior to installing the gates the 

veteran would have had to manually open and close those gates 

and this was difficult for him due to his disabilities. Now the veteran uses the gates daily and is able to come and go on his property without difficulty or pain. 

During the veteran’s IL Program, he began to interact with his 

community at a greater rate. He began to attend community events 

and he joined a couple of different social clubs. Using a computer 

was also very important to this veteran and he had difficulty using 

a computer because his injuries placed limitations on the use of his 

hands. The veteran’s IL plan included an adaptive computer, 

speaking software, and private instruction to teach him how to use 

the equipment and voice activation software. Today the veteran is 

able to use the computer to take care of his finances, communicate 

with his family and friends, shop, and conduct research. 

VR&E foresees an increased need for independent living services. 

We continue to assess our progress and develop methodologies and 

strategies to improve the delivery of benefits to these deserving 

veterans. Last year over 2,700 independent living participants were 

rehabilitated, demonstrating they had achieved the goals of their 

program or made substantial gains in independence as a result of 

VR&E services. 

Madam Chairwoman, this concludes my statement. I would be 

pleased to answer any questions from you or any other Members 

of the Committee. 

[The prepared statement of Mr. Fanning appears on p. 44.] 

Ms. HERSETH SANDLIN. Well, thank you, Ms. Fanning. And I 

know at the beginning of your testimony you recognized Mr. 

McCartney so let me start there. Do you know when was the last 

time the office that Mr. McCartney dealt with was visited for quality assurance? 

Ms. FANNING. I do not have that date with me but I can take 

that for the record and followup with you. 

[The following was subsequently received from the VA:] 

The last Vocational Rehabilitation and Employment (VR&E) quality assurance oversight survey of the Atlanta Regional Office was in June 2007. A 

rating is not provided as a part of the site visit protocol. Instead, offices are 

provided specific feedback regarding management and operational issues 

geared toward improving the service. The Atlanta quality oversight survey 

included three commendable findings and five action items. 


wwoods2 on PRODPC68 with HEARING
25 

Commendable findings included: (1) effective operational management and 

fiscal oversight, (2) effective working partnerships with the employment 

community leading to increased job opportunities for veterans, and (3) effective working relationships with the military leading to strong outreach with 

resulting early intervention services for servicemembers exiting the military 

due to service connected disabilities. 

Action items included: (1) suggested information technology enhancements 

to improve out-based counselors’ access to computer systems, (2) consistency 

of data entry, (3) consistently informing veterans in writing regarding entitlement determinations, (4) consistency in using required worksheets for 

documenting evaluation and planning actions, and (5) increased frequency 

of case management meetings. 

Ms. HERSETH SANDLIN. If you could take it for the record, and 

then if you could tell us how the office was rated when that quality 

assurance visit was conducted, we would appreciate it. 

What measures are generally taken as it relates to the folks at 

a more local level in administering and implementing this program 

to assure accountability, responsiveness, and quality assurance? 

Ms. FANNING. Well, as I noted in my testimony, we did prepare 

standard operating procedures (SOPs) for the field in 2005. And 

since that time we have provided extensive training to the field in 

implementing those policies. In addition to that, and to supplement 

our current quality assurance program in which we regularly monitor casework and provide field offices with feedback, we have implemented a special review of independent living cases. I believe 

that these are some of the most important services that we provide 

and we want to ensure that the field is providing the services consistently and in accordance with the guidelines that we have given 

them. 

Ms. HERSETH SANDLIN. What about Mr. Lancaster’s testimony 

when he stated that he felt that there should be a more formal connection, a better understanding, between the Centers for Independent Living, the national centers, and the VA’s programs? Do 

you have any thoughts on the survey that they conducted? Any 

ideas for more kinds of systematic training so that there is a better 

familiarity between the two entities? Also, certainly as the VA 

does, will you continue working with the VSOs to make sure that 

there is constant communication and some outreach activities that 

occur? 

Ms. FANNING. I agree with Mr. Lancaster. It is vital to our providing excellent services to veterans that we coordinate and collaborate with all community resources that are attempting to provide excellent services themselves. I first met Mr. Lancaster back 

in February and subsequent to that, we have met together just to 

start forming a relationship. We had our leadership conference for 

all of our VR&E managers in St. Petersburg a couple weeks ago 

and I had invited Mr. Lancaster to come and speak with all of our 

staff. Unfortunately, he was not able to join us but he helped us 

arrange for one of the Independent Living Center managers from 

Michigan to come to our conference. And she co-presented with the 

VR&E manager from Michigan. There is an excellent collaboration 

in place in Michigan. And we wanted to let the VR&E officers know 

about that collaboration. We provided them with all of the Center 

for Independent Living points of contact and locations throughout 

the country. And we provided them with training tools that they 

could take back to educate their staff about the services provided 


wwoods2 on PRODPC68 with HEARING
26 

by the Centers for Independent Living. We also have followup 

meetings planned with Mr. Lancaster’s staff later next month. 

Ms. HERSETH SANDLIN. Now let us go to some of the testimony 

of the second panel with regard to the statutory cap on those participating. As you know, the number of ILPs in any fiscal year at 

2,500. Has this limitation caused problems in placing veterans into 

the program? 

Ms. FANNING. I took a look at that very closely upon my arrival 

in my new position and in preparation for this hearing. In the last, 

as I said, the last 3 years the average number of veterans entering 

new plans of independent living has been 2,300. So at the current 

time we are not reaching the goal. No cases are being held and no 

veterans have been prevented from entering into programs of independent living. 

Ms. HERSETH SANDLIN. At least those who have applied, or those 

who have become aware of the program through that contact with 

a VR&E counselor who would then be working with that counselor 

have applied for the program. Can you assure the Subcommittee of 

that universe of veterans that no one has been denied participation? 

Ms. FANNING. Yes. And as was mentioned earlier, veterans apply 

for Vocational Rehabilitation Services not particularly for independent living. As a part of our process in screening veterans and 

determining entitlement, we look at whether a veteran is able to 

obtain and sustain gainful employment. If that is not feasible for 

a veteran then independent living services are explored as an option. In addition, though, I want to point out that independent living services are also incorporated into employment programs. And 

I think that, you know, one of the reasons that the cap is not presenting an issue for us at this time is that as a part of the training 

we have done over the past 2 years, we have educated the field 

staff about the need to look at independent living needs at every 

point in the process. So even for a veteran who comes in that has 

significant disabilities who can enter into a program leading toward employment, we look at the independent living needs we can 

provide concurrently. 

Ms. HERSETH SANDLIN. Okay. Has that number gone up? You 

said 2,300 over the last 3 years. Did that number go up from the 

prior 3 years or 5 years? I mean, I would anticipate that in light 

of the serious injuries sustained by many in OIF and OEF the 

number would have gone up, just as we saw an increased utilization of the VA following those operations. 

Ms. FANNING. At this point it has not gone up. It is actually 

lower than it was last year at this point in the year. Currently we 

have had 1,277 new IL plans written this year. And again, I think 

that the reason for that is that counselors are more informed as a 

result of training. And independent living services are being provided concurrently with job ready services. And I think that is really best for veterans. We do not want to operate in a stovepipe manner. We want to provide comprehensive services that will shorten 

the time of the rehabilitation program and move veterans to their 

goals. 

Ms. HERSETH SANDLIN. Does the U.S. Department of Defense 

(DoD) offer you the names and contact information of any serviceVerDate Nov 24 2008 04:45 Feb 14, 2009 Jkt 043999 PO 00000 Frm 00030 Fmt 6633 Sfmt 6602 E:\HR\OC\43999.XXX 43999

wwoods2 on PRODPC68 with HEARING
27 

members who have been medically retired or medically discharged 

on a timely basis? 

Ms. FANNING. We currently have full time Voc Rehab counselors 

at 12 military treatment facilities (MTFs). We have 13 counselors 

at 12 MTFs. We are in very close contact with DoD, reaching out 

to the warrior transition units. DoD is reaching out to us as well 

to make sure that as veterans are coming home, and particularly 

veterans with disabilities, that we are there providing early intervention. Our goal is to reach veterans while they are still servicemembers, while they are anticipating discharge and going through 

the medical rehabilitation phase, and help them get into the Voc 

Rehab program. So that even while they are still active duty they 

can start pursuing the training or whatever services they will need 

to reach their goals. 

Ms. HERSETH SANDLIN. Okay. Well then given how you have 

somewhat explained where we have been in not even reaching the 

cap, what kind of the comprehensive approach to delivering the 

services, would you be opposed to? Would the VA be opposed to increasing or removing that cap altogether, since it does not seem to 

really be coming into play one way or another from your testimony 

on delivering services to veterans? 

Ms. FANNING. At this point what I can say is that the cap is not 

presenting any kind of barrier to us. So I could not, you know, comment as to whether it would be appropriate to remove the cap or 

not. I can say that as the Director of the program, it is my job to 

ensure veterans are getting those services and that we are not 

holding anyone back. And no one is being held back. We are able 

to operate within the current cap. 

Ms. HERSETH SANDLIN. Do you know if there have been any instances, say in the last 10 years, from documentation that you have 

where you could provide when the requests for independent living 

services exceeded the cap number? The requests. Not the applications that were approved, but the number of requests? 

Ms. FANNING. Well, as I mentioned earlier, veterans do not apply 

for independent living services when they come to Voc Rehab. 

Ms. HERSETH SANDLIN. Not directly. So it has to be something 

that the counselor recommends? Or makes the veteran aware of? 

Ms. FANNING. The counselor is required to evaluate the need for 

independent living services, particularly when a veteran is found to 

be infeasible to pursue a vocational goal. That is a requirement. 

And if a veteran is found to be infeasible, unable to achieve an employment goal, and independent living services are not recommended, that decision by the counselor requires concurrence 

from their manager. So we have extra accountability in place to ensure that we evaluate that thoroughly and provide the services to 

veterans who need them. 

Ms. HERSETH SANDLIN. Are the counselors themselves aware at 

any point in time in the fiscal year what the total number is and 

if anyone is bumping up, if the program is bumping up against the 

cap? Or is that something that is known only by those in managerial positions? 

Ms. FANNING. We make the field aware on a monthly basis exactly where we are in relation to the cap. 

Ms. HERSETH SANDLIN. Overall. 


wwoods2 on PRODPC68 with HEARING
28 

Ms. FANNING. And we do that for two reasons. One, because we 

want to keep independent living, the need to develop independent 

living services and plans in everyone’s mind. We talk about it on 

every single hotline call. We also as a part of that let them know 

how many plans we have had thus far in the fiscal year. On the 

hotline managers are invited, and in my experience in most offices 

or at least many offices, their staff are in the room as well during 

call. The call is intended to provide them with a lot of communication and information about their ability to work within the program. 

Ms. HERSETH SANDLIN. Do you have information that you could 

share with the Subcommittee that documents the number of instances in which a counselor recommends participation in ILP for 

the veteran but then that decision is overridden by a manager? Not 

specific cases, but overall, do you track that type of information? 

Ms. FANNING. I do not, we do not track when the decision is overridden, no. 

Ms. HERSETH SANDLIN. Let me just ask couple of questions here 

more generally to VR&E. The 2004 VR&E Task Force stated, 

‘‘VR&E’s best efforts regarding employment of veterans resulted in 

only 10 percent of those participating in the program obtaining employment.’’ The Report also states that VR&E averaged only about 

10,000 a year for several years. Do you agree with the Report? 

What has been VR&E’s average on getting people employed? 

Ms. FANNING. Our rehabilitation rate currently is 74.6 percent. 

And the way the rehabilitation rate is calculated is based on those 

veterans who have received planned services that will lead toward 

rehabilitation. So of those veterans who are provided a plan of 

services, whether it is independent living or employment, who exit 

the program during a given year, 74.6 percent currently are exiting 

as rehabilitation. The 10 percent number based on overall participants includes, our current overall participants, which is over 

94,000. Our applicants this year were around 60,000. So you can 

see that there is a lot of cross over from prior years. So to just look 

at the number of overall participants, that moves from year to year 

because services can extend. For example, independent living services can be for up to 30 months. It does not provide a good estimate 

of the success. What we look at are those veterans who actually get 

to the point of a plan being developed and enter into a plan, and 

then exit from the plan during a given year. And that is a success 

rate that measures, actually, those individuals who provided concrete services to assist them, either to maximize their independence, or to become employed, or both. 

Ms. HERSETH SANDLIN. Well, I appreciate that explanation of the 

calculation and I certainly understand the importance of having 

identifiable measurements. Just a couple more questions before I 

turn it over to counsel to see if there are any further questions that 

are specific, again, to ILP. In fiscal year 2007, the VA Secretary 

stated that VR&E anticipates a steady increase in the demand for 

ILP services over the next 10 years. My questions are, can you tell 

the Subcommittee today how the VA proposes to meet that increase 

over the next 10 years? Are you going to need more funding and 

personnel? Are there any internet technology issues or concerns we 


wwoods2 on PRODPC68 with HEARING
29 

should be made aware of that would facilitate the delivery of the 

services your program provides? 

Ms. FANNING. Well, we have been very fortunate to have the support of Congress in providing resources to us. Currently our caseload has decreased to the point of what we consider, what has been 

considered the ideal level, that being—— 

Ms. HERSETH SANDLIN. What is that? 

Ms. FANNING. One-to-125 ratio. And currently we are about 1-to121 ratio. We are actively doing outreach. If we get more veterans 

enrolled into our program, I think that is a very good thing. I think 

it is a very robust and excellent program that provides good services. And I trust that if we need more resources and our caseload 

starts to grow that that will be taken care of and we can let, I can 

let my leadership know and communicate with Congress. You 

know, at this time I think we are equipped to provide services and 

we are equipped to bring more veterans onto our rolls. 

Ms. HERSETH SANDLIN. Well I would like to say I would like to 

hope that you could count on that support. I do think, however, 

that we are going to have to dig a little deeper and get some additional information from you. Some of the questions that we will 

give you following the meeting for the record, you may have readily 

available or they may just give you some ideas on what could be 

tracked to kind of help us understand a little bit better how this 

program is working and being administered. The final two questions, and this is sort of along that line. I know we talked, again, 

the cap and where you have been, about 2,300. How many veterans, in fiscal year 2007 were recommended for ILP? I know you 

said they do not apply, but this is what I really want to get at because I think Mr. Boozman had some of the same questions about 

the influence of the cap. This number has a potential influence for 

making decisions about the cap. Do you track or can you provide 

the total number of veterans who in fiscal year 2007 were recommended for ILP? And then the breakdown of those that were 

recommended? How many applications were approved and how 

many were not? 

Ms. FANNING. I do not have the data with me. But I, what I can 

break down is how many veterans were found infeasible and of 

those which veterans were provided independent living services. 

Ms. HERSETH SANDLIN. Okay. Let us start with that. Okay. One 

last question, according to the audit, a Vocational Rehabilitation 

and Employment Operations Report, in fiscal year 2006 the cap 

was underutilized, which I think you have also documented for the 

past 3 years. We have been at 2,300 so we have 200 cases there 

that could be added. But that audit also indicated that it found 

that services to the veterans were delayed. Clearly we heard Mr. 

McCartney’s experience in terms of the delay and lack of responsiveness. Do you have any idea of the timeliness of any responses 

whether before you came on board or whether your predecessors 

addressed it? Or how you may have addressed that report, that 

might have been specific causes of such a result? You do not need 

to address the underutilization. I think you have done that already. 

But what about any delays in those services for the VR&E operation in general? 


wwoods2 on PRODPC68 with HEARING
30 

Ms. FANNING. Well, first I would like to say that the delays that 

Mr. McCartney experienced are unacceptable. And my hope is that 

we dig in, and we are doing, as I said, special independent living 

reviews as a part of our quality review process, and that his situation is not typical of what we will find. And the reason we are 

doing the reviews, however, is to look for situations just as he described so that we can take corrective action if it does occur. I am 

sorry, repeat your question? 

Ms. HERSETH SANDLIN. Well I think submitting any information 

about delays, since we do not know if there was a quality assurance visit down to that particular office. I understand from your 

testimony that you are stating that Mr. McCartney’s experience is 

not the typical one. But when you do see delays in service, have 

you been able to identify any specific causes for that? Has it been 

in the past that Congress was able to allocate additional resources 

when the caseload was too high? Is there a lack of sufficient staff 

in the Central Office overseeing and monitoring the Program? A 

lack of the linkages with the community organizations that can 

help address that specific veterans’ employment and independent 

living needs? Have you been able to identify any specific causes for 

delays? 

Ms. FANNING. Well, certainly I think providing the standard operating procedures, providing guidance from the Central Office 

level, was done in recognition of the field being primarily focused 

on providing employment services, and the rate of independent living being so much less that obviously the counselors would have 

less expertise in the independent living area. So we have tried to 

mitigate that and correct that by providing the SOP and extensive 

training. We have added an Independent Living Coordinator in 

Central Office after the task force recommendations were released. 

And since I have arrived, we have added a second person. Because 

we found that that expertise has been very valuable to the field. 

They need someone who they can come in to for expert advice. And 

also, we need folks we can send out on quality site visits to really 

take a look at independent living services in various field offices as 

we go out to do those reviews. 

In terms of any delays, I think as one of the previous panelists 

had mentioned, caseloads or staffing shortages could certainly play 

a role in an office if that is present, if they have shortages. Over 

the last few years, the caseload size gotten more into the appropriate realm in terms of what was considered ideal as a result of 

being able to enhance staffing. The Independent Living Program, 

getting a plan started itself, does take a little bit longer because 

during the entitlement process when the counselor completes the 

entitlement and determines that the veteran is not feasible to pursue employment, then a second tier of evaluation occurs. We do a 

comprehensive independent living needs assessment. As I mentioned earlier, that is done in the veteran’s home. It can involve expert advice from rehab engineers or other folks with expertise, depending on what the veteran’s needs are. Unfortunately, even 

though that is very needed in order to identify appropriately what 

the needs are and the services, that does add additional time. 

Ms. HERSETH SANDLIN. Mr. Brinck, did you have any questions? 


wwoods2 on PRODPC68 with HEARING
31 

Mr. BRINCK. Thank you, Ms. Chairwoman. Ms. Fanning, Sergeant First Class McCartney mentioned several names of friends of 

his who were disabled veterans seeking ILP services. Would you 

get those names from him? Mr. Boozman has asked that you get 

those names and provide us with the status of each of those cases, 

if you would, please. 

[The following was subsequently received from the VA:] 

The information requested is of a sensitive nature and is being provided 

under separate cover to the Chairwoman and Mr. Boozman. 

So as a follow on to the Chairwoman’s last question, what is the 

average time it takes to complete the evaluation and independent 

living plan? 

Ms. FANNING. Currently the average time for evaluation and 

planning is 105 days. 

Mr. BRINCK. Nationally. 

Ms. FANNING. Nationally. And that is in in line with the target 

for the field, which is also at 105 days. 

Mr. BRINCK. And the Savannah satellite office, do you have data 

on them? 

Ms. FANNING. I do not. 

Mr. BRINCK. Can you provide that for us in terms of caseload and 

average time to complete the plans? 

Ms. FANNING. I can provide information about the Atlanta Regional Office, which covers all of Georgia. I do not know if I can 

provide specifically information about Savannah. But I will take 

that for the record. 

[The following information from VA was subsequently received:] 

VR&E Service conducted a site visit in June 2007 at the Atlanta Regional 

Office (RO). The Savannah outbased office was not visited, but the site visit 

report indicated the Atlanta RO was performing well overall. At that time 

Savannah had three case managers and an average caseload of 142 each. 

Savannah currently has four case managers with an average caseload of 

110 each. 

In FY08, the average number of days a case was in evaluation and planning status for the Atlanta office was 93. The FY08 target was 105 days. 

Mr. BRINCK. All right. Thank you. One final question, do you 

have an estimate, in your testimony you of course stated that you 

had not bumped up against the cap for the last couple years. But 

a little later on you mentioned that there were possible influences 

that may increase the requests for IL services. Do you know, do 

you have an idea of what the cost would be to remove the cap? Or 

to put it another way, what is the cost for, an average cost per IL 

Program participant? 

Ms. FANNING. Currently the average cost of an IL program is approximately $11,000. I do not have costing on removing the cap. 

That is something I would be happy to take for the record. 

[The following information from VA was subsequently received:] 

Because we are not currently exceeding the cap, no cost would be associated 

with removal of the cap. If workload increases in the IL program, historical 

costing data would be utilized to calculate the increased cost to fund the 

IL program: 

• FY2006—$10,500 average cost per IL case 

• FY2007—$11,545 average cost per IL case 

• FY2008—$12,640 average cost per IL case 


wwoods2 on PRODPC68 with HEARING
32 

Mr. BRINCK. Thank you. Thank you, Madam Chairwoman. 

Ms. HERSETH SANDLIN. Thank you. Well, thank you for your testimony and for your responsiveness to our questions today. We will 

look forward to working with you to get some of the additional information we have requested for the record. We thank both Dr. 

Beck and Dr. Burris for joining you as well and the Committee 

staff and counsel, as well as the Members of the Subcommittee. We 

look forward to working with all of you, as well as those that testified previously. Thank you for your patience and for taking the 

time. I know votes have a tendency to slow us up in the afternoon 

hearings that we have. We really do value your expertise, your insights, and your service to our Nation’s veterans and the work that 

you are doing. Again, thank you, the hearing stands adjourned. 

[Whereupon, at 4:27 p.m., the Subcommittee was adjourned.] 


wwoods2 on PRODPC68 with HEARING
(33) 

A P P E N D I X 

Prepared Statement of Hon. Stephanie Herseth Sandlin, Chairwoman, 

Subcommittee on Economic Opportunity 

Today’s hearing will give the Subcommittee the opportunity to learn more about 

the Department of Veterans Affairs Vocational Rehabilitation and Employment’s 

Independent Living Program and how it is assisting our veterans in a seamless rehabilitation into family and community life. 

As many of you know, the goal of the Independent Living Program is to ensure 

that eligible disabled veterans are able to maintain maximum independence in their 

daily living by developing learned skills that may benefit them for future employment. Some of our panelists might recall that this Subcommittee held its first hearing back in March of last year that gave our new members the opportunity to learn 

about the programs under our jurisdiction. One such program that was considered 

was the Vocational Rehabilitation and Employment, but today we are here to specifically review the Independent Living Program. 

As we will hear from our panelists, many of our most severely disabled veterans’ 

lives have been profoundly changed for the positive as a direct result of these independent living services. Unfortunately, members of this Subcommittee have also 

heard from veterans that have raised concerns that VA staff is poorly trained to 

properly refer veterans to available resources, mismanagement of claims by VA personnel that causes a delay in service, and need to increase the current statutory 

limit of 2,500 annually. 

Earlier this year, we have received a letter from a veteran who urged the full 

Committee Chairman to consider reviewing independent living services for veterans 

with chronic and severe post traumatic stress disorder. Specifically, this veteran 

would like to see an expansion of independent living services to provide Operation 

Iraqi Freedom and Operation Enduring Freedom veterans with opportunities for 

employment services that can also benefit older veterans who have service-connected psychiatric disabilities. I am interested in hearing from our panelists about 

this and other suggestions to determine how we can best serve all our veterans, especially in light of the Department of Veterans Affairs Office of Inspector General’s 

report dated December 17, 2007. 

A few of the issues of concern raised in this report include: 

• VR&E rehabilitation rate calculations and information on total program participations and outcomes were not fully disclosed in the VA Performance and Accountability Report; 

• the 2,500 statutory cap was underutilized in fiscal year 2006 and services to our 

veterans were delayed; and 

• the VA should effectively monitor the number of new Independent Living participants and detailed information should be provided to Congress for review. 

It is very important that we examine these concerns, especially at a time when 

the VA Secretary recognizes an increased need for independent living services over 

the next 10 years. Today’s servicemembers are returning with Post Traumatic 

Stress Disorder, Traumatic Brain Injury, amputations and severe burns that would 

have been fatal in previous conflicts. 

Congress must continue to reexamine the development and results of this program to provide the best services in a timely manner. The men and women who 

serve our Nation honorably deserve and should receive the best our country can 

offer. 

I look forward to working with Ranking Member Boozman and Members of this 

Subcommittee to explore how we can improve the VA’s Independent Living Program 

for our servicemembers and veterans. 

f 


wwoods2 on PRODPC68 with HEARING
34 

Prepared Statement of Hon. John Boozman, Ranking Republican Member, 

Subcommittee on Economic Opportunity 

Good afternoon. Madam Chairwoman, I think the first order of the day is to thank 

both members of our first panel for their service. I believe both Mr. Lancaster and 

Mr. McCartney are service-disabled veterans of the Vietnam War and they honor 

us with their presence here today. 

Madame Chair, I believe you and I would agree that VA’s Vocational Rehabilitation and Employment program should be the crown jewel of programs for disabled 

veterans. The program is generous in its benefits and the law provides the VR&E 

staff with wide latitude in determining who qualifies for the program. It is important to note that employment is the goal of the VR&E program and for the vast 

majority of those who participate in the program, a job is reasonable and achievable. 

Unfortunately, for our most severely injured, employment is sometimes not an option so the VR&E program includes independent living services for those who cannot work because of their service-connected disability. Such a program is ‘‘designed 

to enable such veteran to achieve maximum independence in daily living’’ and VA 

may contract for these services with qualified providers. 

Title 38 defines ‘‘independence in daily living’’ as, ‘‘the ability of a veteran, without 

the services of others or with a reduced level of the services of others, to live and function within such veteran’s family and community.’’ That is a fairly broad definition 

and I would hope that Ms. Fanning would describe how her staff determines what 

fits within that definition. 

I want to make a point about one way we judge the program’s performance. As 

an example of the difficulty we face in using VA data to determine the program’s 

performance, I would call your attention to the latest VBA Annual Benefits Report. 

On pages 77 and 84, the report shows 884 veterans receiving independent living 

services and on page 86 the data shows 949 participants and 2,957 veterans rehabilitated. Clearly, the inconsistency between the number of participants and the 

number of those rehabilitated as well as the two different amounts of participants 

does not give us a clear understanding of how the program is doing. 

Finally, I am glad to have Mr. Lancaster, Executive Director of the National 

Council on Independent Living with us today. I understand that the National Council on Independent Living is not represented on the Secretary’s Advisory Council on 

Rehabilitation. It seems to me that NCIL should be a member of the Committee because of their broad experience in independent living and I urge Secretary Peake 

to invite NCIL to become an active member in his advisory Committee. 

I yield back. 

f 

Prepared Statement of Bruce McCartney, 

Midway, GA (Veteran) 

Executive Summary 

I enrolled in the VA Independent Living Program (ILP) in November 2003. Four 

plus years later, after constant emails, phone calls and inquiries, the process was 

completed. 

Many other disabled veterans (Vietnam and OIF) are having similar issues as the 

ones I faced trying to get assistance with the ILP. The issues appear to be lack of 

understanding of the program by local case managers, lack of transparency (where 

is the paperwork in the process), lack of assistance (took months to get a reply), lack 

of oversight and auditing (took over 4 years to complete this application and that 

does not include a proper post-project dialog) and pass the buck syndrome (inquiries 

to higher command are met with auto reply emails/letters that led to no solutions). 

The issues with ILP appear systemic as the Director’s office, The Inspector General’s Office, Regional Headquarters, and local case managers either can not provide 

adequate answers to the veterans they are assisting or do not respond to inquires 

for assistance. 

The ILP is a great concept, but is poorly advertised and has weak follow through; 

much like a train that has to be pushed by its passengers. 

My name is Bruce McCartney. In 1986 I was medically retired from the United 

States Army under Chapter 61 after 171⁄2 years of active duty service. I served four 

tours in Vietnam as a DUSTOFF and combat medic. It was my job to go to the 

wounded soldier who’d walked into a mine or was laced across the gut with an AK– 


wwoods2 on PRODPC68 with HEARING
35 

47 and try to keep them alive until we could get them to the hospital. I wasn’t always successful, but more often than not death was cheated of another victim. 

There seemed to be little trained and experienced assistance available to transition the disabled combat veteran from military service to civilian life, although 

today that appears to be vastly improved. On the 15th of January you’re a HERO, 

on the 16th of January you’re a ZERO unaware of the myriad of programs available 

from the VA to assist your broken body and soul. To try and regain some semblance 

of normalcy to a life that was disrupted by the bane to mankind we know as war 

was relegated to fate. If, per chance, you met or heard about a veteran who had 

acquired a particular VA service or program then you applied. Other than that, 

there was not much assistance offered by many of the VA counselors or employees. 

I am one of the fortunate. Or so I thought. Had I known when I applied for the 

Independent Living Program (ILP) in November 2003 that it was leading me headon into a 4 year nightmare that would affect me both mentally and physically, I 

would not be testifying before this Committee. 

In 1990, I was advised by the Savannah Vet Center to apply for Voc Rehab services. I met with a case manager, was aptitude tested and advised to seek a vocation 

as a teacher or registered nurse. With my experience in combat medics he recommended the nursing course. Unfortunately, due to my disabilities, my education 

was sporadic at best and disruptions were the norm. After many counseling sessions 

with him his final statement (in 1995) to me was, ‘‘if you ever get straightened out, 

come back and see me.’’ I languished for years outside the VA system, much like 

untold numbers of disabled veterans even as we speak. 

October 2000, fate knocked on my door. It was during the filming of the documentary ‘‘In The Shadow Of The Blade’’ that I was reunited with my friend and fellow DUSTOFF medic from Vietnam, Jake Bailado. He told me about a cousin who 

was also a disabled Vietnam veteran who applied for ILP. They assisted him in obtaining a small tractor to help him work his farm. 

After several years of continuous treatment with a civilian therapist, I met with 

Voc Rehab counselor Tina Hutchison in Savannah to apply for ILP. My goal was 

to see if VA could assist me in obtaining an interest free loan to replace my antiquated tractor so I could cultivate my 9 acre property. Ms. Hutchison advised me 

that my goal was out of the question, but ILP would in fact assist me with acquiring 

a greenhouse. 

The following is a 4 year recap of my ILP gone awry: 

Nov 03—Met with VR&E counselor (Tina Hutchison) in Savannah, GA. Applied 

for Independent Living Program (ILP). 

1/26/04—Got email reply saying ‘wheels in motion.’ 

3/2/04—Requested situation report (SITREP). 

5/5/04—Received reply to the above request (almost 2 months to the day) ‘I have 

contacted an ILP contractor to come to this area and do an ILP assessment for 

3 vets, including you. . . .’ 

6/23/04—Interviewed with Jennifer Johnson, ILP contractor from Atlanta. 

6/24/04—Provided email response to Johnson’s request for more info. 

7/27/04—Received email request for a SITREP from Johnson. 

7/27/04—Replied to above from Johnson. ‘I sent my report to Tina Hutchison 

several weeks ago. Now it’s in the hands of Tina. . . .’ 

12/20/04—Received phone call from Hunter Ramseur (another VA consultant 

from Atlanta who figured he’d get some interviews done while in Hilton Head 

Island, SC). He came to the house for interview. Hunter requested some documents with a promise to return them upon his arrival to Atlanta. Have yet to 

receive them. 

3/4/05—Telephonically requested SITREP from Hutchison. Her reply—‘just got 

new guidelines, will know something very soon’. Also advised her about documents given to Ramseur not returned. Hutchison promised to get in touch with 

him and have them returned. 

5/16/05—Emailed Hutchison a request for SITREP. Also advised her still nothing back from Ramseur. 

9/22/05—No contact from anyone (VA or consultant) for more than 6 mos now 

since telephonic conversation 3/04/05. Emailed Hutchison a request for SITREP. 


wwoods2 on PRODPC68 with HEARING
36 

12/5/05—Still no contact from anyone. Emailed Hutchison. 2nd anniversary has 

now come and gone. Is there really an IL program? Is Hutchison still working 

in Savannah? Hello. Is anyone out there? 

12/6/05—Emailed complaint to Inquiry Routing & Information System (IRIS). 

12/6/05—Received email from Hutchison. ‘sorry . . . have scheduled appointment 

for 15 Dec.’ 

12/7/05—Receive response from IRIS above. ‘‘after discussing your case with Ms. 

Hutchison, she reports that due to her current caseload it has been difficult to 

complete a specific proposal for your ILP and meet other demands on her time. 

She now has the information from the 2 contractors. . . .’’ 

12/7/05—Replied to Ms. Hutchison email ‘0900 will be fine.’ 

12/15/05—Arrived in Savannah VA office at 0850 for appt. Checked in with 

front desk. At 0930 Ms. Hutchison asked if I have an appt. Felt like another 

bs meeting. Was given another orientation sheet (NOTE: orientation sheet is 

given to all first time VA applicants). Told me Hunter had recommended concrete floor greenhouse with elec/water/etc. Now she had all the recommendations she would forward to whomever to get final approval. 

2/2/06—Emailed MS. Hutchison asking for SITREP. 

2/7/06—Sent another inquiry to IRIS again—no reply. 

2/21/06—Sent another inquiry to IRIS about 2/7/06 inquiry. 

2/22/06—Received reply from IRIS. ‘‘. . . request has been sent to Mr. Ramseur 

to provide information . . . I encourage you to keep in contact with Hutchison. 

. . .’’ 

2/23/06—Responded to IRIS’s response. ‘‘. . . after I met with Hutchison 15 dec 

she told me she had ALL the paperwork she needed . . . and I have sent 

Hutchison 10 emails with only 2 replies and 3 phone messages—0 returned. 

. . . 

2/24/06—Emailed Hutchison with the information outlined in IRIS response of 

2/23/06. 

2/24/06—Received email from Hutchison stating she had contacted Ramseur 

(AGAIN?) for the info from him. 

2/27/06—Received followup from IRIS. ‘‘she is communicating with you directly 

. . . please continue to work with her to complete a plan of service.’’ 

3/27/06—Emailed Hutchison requesting SITREP—‘‘we are going on just about 

21⁄2 years since this process was started and I think that’s a little excessive.’’ 

3/31/06—Received email from Hutchison. ‘‘Proposal has been sent to Atlanta for 

review/approval . . . am looking primarily at the 8′ × 10′ size range. . . .’’ 

4/1/06—Replied to Ms. Hutchinson email acknowledge receipt of her email of 

3/31/06. Requested copies of Johnson/Ramseur reports. 1st request for Johnson/Ramseur reports. 

5/11/06—Emailed Hutchison for SITREP and 2nd request for Johnson/ 

Ramseur reports. 

5/19/06—Received email from Hutchison ‘‘final approvals have been received. I 

am looking for providers and contractors. . . . Request for information from your 

file have to go through the freedom of information office in Atlanta and must 

be in writing. If you need I can get you an address.’’ 

5/19/06—Emailed Hutchison for address. 3rd request for Johnson/Ramseur reports. 

6/6/06—Since received no reply with address, sent written request for information from my file to Ms. Hutchison office via certified mail. 4th request for 

Johnson/Ramseur reports. 

6/7/06—Ms. Hutchinson’s office received certified mail on 1:55 pm, June 07, 

2006 per USPS. 

7/28/06—No reply in over 60 days. Emailed Hutchison again for information/address. 5th request for Johnson/Ramseur reports. 


wwoods2 on PRODPC68 with HEARING
37 

7/28/06—Received email from Hutchison ‘‘I’m off on Monday so I will call you 

on Tuesday.’’ 

7/31/06—Stayed in-house all day to receive call. Call never came. 

8/1/06—While at a doctor’s appt, Ms. Hutchison calls and leaves msg, ‘‘I’m returning your call.’’ 

8/2/06—Emailed Ms. Hutchison again ask for SITREP and status of requests for 

Johnson/Ramseur reports. 6th request for Johnson/Ramseur reports. 

8/7/06—Emailed Hutchison ‘‘did you forward the request for consultant reports 

I sent you—7th request for Johnson/Ramseur reports. 

10/30/06—Met with Congressman Barrow’s Legislative Assistant in Savannah 

regarding lack of response with VA ILP. 

10/30/06—Upon return from Congressman Barrow’s LA called VR&E Regional 

office in Atlanta. After short recap of situation, was advised to FAX a request 

for another voc rehab counselor if I was unhappy with Ms. Hutchison. With that 

answer it appeared to me the problem was not only with Hutchison but in fact 

was systemic (approx 3 years of issues with no real answers from VA counselor, 

IRIS, and ATL regional office). 

10/30/06—Mailed request IAW FOIA to VR&E Regional office, Atlanta, GA. 

This is the same request asked of Hutchison on 7 previous occasions (via cert 

mail). 

11/6/06—Mailed entire 40+ page packet of entire experience with ILP to VA Inspector General (IG). 

11/9/06—Certified mail delivered Decatur VR&E office 7:47am, 11 NOV 06. 

12/12/06—Received phone call from Congressman Barrow’s LA. Says he was advised that since some of my disability is for PTSD, VA will not release any information from my files to me, but will release them to my therapist. 

12/12/06—Advise Karla Hillen (therapist of 7 years) of situation. She requested 

I sign release of records form. Went to her office and sign forms. 

12/13/06—Therapist requested release of info from Hutchison/regional office. 

1/26/07—Received call from Ms. Hutchison. Says got final approval (AGAIN???) 

and is going to turn entire packet over to Hunter Ramseur when he comes to 

Savannah next Tuesday. He will again come out to house for prelim survey, negotiation and coordination for project completion. Additionally she states she 

will mail me documents for signature/return. . . . 

1/29/07—Received packet from VA IG. ‘‘Unfortunately, we are unable to take action on your correspondence as it is unclear exactly what you are alleging and 

why you are requesting OIG involvement. We ask that you summarize the 48 

pages. . . .’’ 

2/5/07—Received call from therapist. They’ve received Johnson/Ramseur reports. Received 11 pages via fax. Both reports recommendation similar. Still no 

word from Ramseur. Included is application approval from Grant Swanson 

VR&E Regional Office. DATED 4/3/06. NOW ALMOST 1 YEAR SINCE APPLICATION WAS APPROVED WITH STILL NO ACTION BEING TAKEN; 

3 YEARS PLUS SINCE INITIAL APPLICATION WAS SUBMITTED. 

2/15/07—Haven’t heard a word from Hutchison or Ramseur. Received nothing 

in mail from Hutchison. Will fax summary back to IG office today. 

2/15/07—Faxed summary back to IG office. 

2/19/07—Johnson/McCartney/Singleton (another veteran having problems with 

ILP) met with Congressman John Barrow in his Savannah office. This and 

other veteran issues are discussed. Congressman agreed to provide letter of endorsement on package to be sent to veteran affairs committee members. 

3/1/07—Received email from Ms. Hutchison asking if I received paperwork she 

allegedly mailed for signature/return. 

3/1/07—Replied to Ms. Hutchison’s email ‘‘on 1/26/07 you stated Ramseur would 

be picking up packet and would be in contact with me. Also that you would mail 

documents for signature. I have not heard from Ramseur or received anything 

from you.’’ 


wwoods2 on PRODPC68 with HEARING
38 

3/2/07—Ms. Hutchison read above email (according to Read receipt on email). 

3/18/07—Received letter from IG. ‘We have opened a case. . . . 

4/3/07—NOW ONE YEAR ANNIVERSARY OF APPLICATION APPROVAL 

FROM ATLANTA (4/3/06) AND STILL NOTHING. 

4/12/07—Received call from Ramseur stating he was just given case file and 

would like to come down to meet getting the project underway. I asked him why 

it took him so long to get in touch he wasn’t sure to what I was referring. Then 

I advised him that on 26 Jan 07 Hutchison called me and advised he would pick 

up my packet from her in be in touch shortly. He assured me he had no such 

knowledge thereof and in fact had just been contacted by the Director to take 

over this project and get completed ASAP. 

4/16/07—Receive letter from L.R. Burks dtd 4/10/07 apologizing for the delay 

and provided excuses for what had (actually had not) transpired. Stated that 

procedures were put into place to prevent future occurrences. 

4/18/07—Replied to Burks letter. 

4/24/07—Received reply from Burks ‘‘. . . respond more rapidly more effectively 

to your needs as well as other veterans. . . .’’ 

SEE ALL EMAILS FOR UPDATE. 

12/3/07—1405 hrs, Received message on answering machine from Amy Thompson, assistant VR&E director in Atlanta. 

12/3/07—1520 hrs, Returned call and left msg on voice mail. 

12/4/07—0810 hrs, Returned call and left msg. 

12/4/07—1030 hrs, Returned call and talked to Amy. She stated she would like 

to help me address some of the concerns I addressed to Director Fanning. Gave 

a recap and sent her copy of my recap. She will read and call back. 

12/4/07—1710 hrs, Amy calls and again apologize for shoddy treatment. States 

one thing for certain ‘‘authorization for payment for electrician was completed 

today and he should receive payment in 7–10 days.’’ I find this incredulous because I have email from Hunter Ramseur 11/16/07 stating the same thing. APPARENTLY SOMEONE IS NOT DOING THEIR JOB AND TELLING FALSEHOODS TO COVER IT UP . . . AGAIN . . . Sent copy of Hunter’s email to her. 

She explained that apparently someone doesn’t understand the payment process 

is a 2 step process—Step 1 Approve at Regional Office. Step 2 Forward to Austin for payment. SEEMS TO ME IN ALL ACTUALITY IT’S A 3 STEP PROCESS. Step 1 Approve at Local Office. Step 2 Approve at Regional Office. Step 

3 Forward to Austin for payment. Not withstanding. Why does it take 50+ days 

to process an invoice for payment? 

And another question. First email from Hunter is 10/26 stating invoice for 

Robinette is at the Regional Office for processing. . . . 

Author’s note: It appears Director Fanning has requested an in-house investigation to address the problems I outlined to her. I really believe it’s going to take 

an upper echelon visit to look into not only what I addressed, but really come 

down and open this Pandora’s box. Who knows how many veterans are affected 

by this malfeasance. The Regional Director L.R. Burks told me in his last letter 

that all problems had been addressed and corrective actions taken to preclude 

further occurrences. Apparently that is not true. 

Amy Thompson called veteran Singleton 12/3/07 and states she couldn’t find his 

records but would call him back. 12/7/07 Vy, clerk in VR&E office, called him 

back and stated Amy was out of office. Also stated she couldn’t find his records 

but would call him back Monday 12/10/07 to talk again. 

12/27/07—Sent Thompson an email inquiring as to whereabouts of $$$$$ 7–10 

days from Dec 4th makes Dec 18th. Is someone lying again? 

1/25/08—Received call from Grant Swanson . . . tries to justify (we process thousands of pieces of paper yearly and occasionally one falls thru the crack . . . 

this ENTIRE case has fallen thru the crack repeatedly. 

Asks to get copy of Robinette invoice (invoice for the electrician). I faxed to him. 

Grant stated that I am trying to be a surrogate in-between Robinette and the 

VA . . . Amy, deputy director VR&E, stated that I or Robinette should contact 

Finance directly and thus, made me a surrogate in her last email. . . . I never 


wwoods2 on PRODPC68 with HEARING
39 

talked to finance, but sent a followup letter to Ruth Fanning and Congressman 

Filner. Isn’t this VR&E’s job to ensure that the contractors get paid? Says 

doesn’t know if there’s anything that can be done but will try . . . my thoughts 

. . . SOMETHING WILL BE DONE . . . it was still in excess of 30 days when 

I PAID him. 

* All emails and correspondence available upon request. Approximately 80 

pages. 

Nearing project completion, another roadblock to completing my ILP project develops at VA Regional Office. Contractors who complete work are not being paid according to their purchase order contracts. 30 days then 60 days pass and still no 

payment for services rendered. Having worked with these contractors, been the recipient of their services, and having developed a relationship with them, morally I 

just could not sit idly by. I took out a line of credit loan and pay them, which they 

returned when they were finally paid by VA. Three contractors, one ILP project, all 

not paid as contracted. Then, instead of correcting the situation, I am chastised by 

the Regional office and Director Fanning’s office for ‘interfering’. I can sleep at night 

though. However now there are three contractors who will never work for VA again. 

During my ordeal I met several disabled veterans who also needed and were 

qualified for the ILP. I urged them to apply, but seeing the difficulty I was having 

and how it was affecting me physically and mentally they opted to wait see if in 

fact there was an ILP. It just wasn’t worth their well-being to go through what I 

was going through. I had to agree with them. 

Once work was finally begun in April 07 and I shared with them the correspondence from the Atlanta Region Director, L.R. Burks, highlighting the changes that 

were made to prevent future occurrences, did they apply for ILP. Unfortunately, it 

appears Director Burks was only paying lip-service to quiet this vet, for the same 

problems I encountered are still being encountered by disabled veterans as we 

speak. 

Disabled 101st Airborne trooper Donald S. went to the Savannah Outpatient Clinic (OPC) in mid April 07 to obtain an application for ILP services. He was given 

VA Form 28–1900, completed and mailed it to VA regional office as instructed. In 

August, after no contact, he called the VA regional office in Atlanta and subsequently received a letter from that office stating they had received his application. 

Shockingly they also stated he would have to complete VA Form 28–1900 before any 

action could be taken. I’m curious how many VA Form 28–1900’s have to be completed before action is initiated? In November he called again to determine status. 

He was advised that a query was sent to St. Petersburg for his records. The response to his question asking whether or not they would follow up was answered 

with ‘‘we’ll just wait for them to respond, but you can contact them if you wish; 

here’s the phone number.’’ He did their work by calling and was told that office had 

received nothing from Atlanta. 

Also, 100 percent-disabled 1st Cav, Silver Star (2 awards) recipient James Johnson obtained, completed, and submitted VA Form 28–1900 in April 07. In January 

08, after no response, he again went to Savannah OPC for another form. He was 

advised by a case manager it was best to complete the application via the Internet. 

He stated he would rather have a paper copy to take home for completion and submission. He was then asked ‘‘what, are you computer illiterate?’’ Becoming extremely frustrated and agitated, Mr Johnson informed the case manager that he 

was partially blind from 14 glaucoma operations and wanted a paper copy. Only 

then was he provided same. 

Just recently, February 08, disabled vet Larry Bacon applied for ILP due to his 

disabilities. Just several weeks ago he had an appointment with his case manager, 

Steve Goist. This case manager advised this disabled vet that according to his 

records Mr Bacon was unable to be gainfully employed. Since Voc Rehab was designed to get vets back to work there was nothing he could do for him. Mr Bacon 

told this case manager he was aware of his inability for conventional gainful employment and had applied for ILP. Mr Goist stated he ‘‘would see what I can do 

and let you know.’’ Of course, this is yet another disabled veteran who is expecting 

to never hear from VA again. 

Iraq veteran Santiago, a double amputee, was out briefed by a VA counselor on 

Fort Stewart. He was told to apply for Voc Rehab. As a result of his disabilities Voc 

Rehab was not a viable option. I met him recently and thought he was a good candidate for ILP. He had absolutely no knowledge of ILP and told me of his out-processing experience by VA. When I called and inquired about ILP with the VA representative on Fort Stewart who was responsible for providing guidance to medically 

discharged combat veterans, I was told ILP was ‘‘some sort of medical thing and 


wwoods2 on PRODPC68 with HEARING
40 

I should call the Charleston Medical Center for information.’’ She did provide me 

with their phone number though. 

Fortunately when a staffer from Director Fanning’s office was informed of the 

first two cases I described in January 08 a phone call was placed and immediate 

attention was provided for these two disabled vets. Should disabled veterans like 

Bacon, Santiago, Potane, Baker, Frank, Foster, and others have to make that same 

call to receive the benefits they paid for with their blood? Many of these vets and 

others have opted to just give up. THE SYSTEM IS BROKE. Director L.R. Burk, 

your promises of change weren’t worth the paper they were written on. 

These are just a couple of disabled veterans I happened to come in contact with. 

The repeated experiences mirror each other. How many other untold numbers of 

disabled vets need advocates, to get the VA to do their job? 

As I network with other disabled veterans and encourage them to apply for their 

ILP, a benefit which they earned with their broken body and sometime spirit, I realize that not one iota has changed. Delays, failure to respond to emails, conveniently 

‘‘lost’’ paperwork, and unreturned phone messages are the rule rather than the exception. THE PROBLEM IS SYSTEMIC, from the Director’s office, the Inspector 

General’s Office, to Regional Headquarters, down to local case managers. 

After meeting several disabled veterans from South Carolina, I soon realized the 

problem is worse there. After contacting the Regional offices in Charleston and Columbia I’m told by both that ‘‘most disabled vets aren’t qualified for ILP’’ and ‘‘we 

process very few ILP’s.’’ This makes me believe the South Carolina ILP program is 

worse than what is being experienced in Southeast Georgia. A repeated inquiry to 

Director Fanning’s office to determine the number of ILP’s in Georgia and South 

Carolina is ignored. 

Perhaps this Subcommittee can obtain information Region by Region to determine 

where the most severe problems exist. And believe me there are problems. Malfeasance is being overlooked daily while consequences of ineptitude are being suffered 

by many disabled veterans. 

Many years ago, in the rice paddies of Vietnam, I aided the wounded. Now these 

many years later I have vowed to advocate for these my wounded brothers yet 

again. However, it has become a formidable task that needs Congressional involvement. As American veterans both young and old have fought for you, we need you 

to fight for us. 

Thank You. 

f 

Prepared Statement of John A. Lancaster, 

Executive Director, National Council on Independent Living 

Executive Summary 

The National Council on Independent Living (NCIL) will provide testimony regarding Independent Living and the current services within the Veterans’ Administration Vocational Rehabilitation and Education’s Independent Living Program 

(ILP). 

The National Council on Independent Living is the oldest national cross-disability, 

grassroots organization run by and for people with disabilities. 

Centers for Independent Living across the country are assisting veterans in navigating the VA system, obtaining housing, and personal assistance services, and are 

providing information and referral. 

Centers for Independent Living want to collaborate actively with the VA. Centers 

have asked for more funding to be allocated to help assist the VA in providing essential and timely services to veterans and their families. 

Centers in Alaska, Minnesota and Michigan are working with their communities 

to make sure our veterans are receiving the proper supports to reintegrate into their 

communities. 

Centers for Independent Living have been focusing on one-on-one support to assist 

people with disabilities in outlining their future goals, learning that there is a way 

to have a high quality of life with a disability, and creating a support network within the community to ensure continued independence. 

Centers for Independent Living and NCIL are on record requesting additional 

funding to be allocated to help assist the VA in providing essential and timely services to veterans and their families. 

NCIL and our Veterans Taskforce welcome the opportunity to discuss how Centers for Independent Living can help the Department of Veterans Affairs and the 


wwoods2 on PRODPC68 with HEARING
41 

1 Rehabilitation Services Administration response to NCIL Freedom of Information Act request 08–00115–F. November 19, 2007 

Vocational Rehabilitation Employment program enhance services for our Nation’s 

returning and aging veterans. 

Chairman Filner, Ranking Member Buyer, and distinguished colleagues of the 

Committee on Veterans’ Affairs, thank you for this opportunity to comment on VA’s 

Independent Living program. My name is John Lancaster and I am the Executive 

Director of the National Council on Independent Living. 

The National Council on Independent Living is the oldest national cross-disability, 

grassroots organization run by and for people with disabilities. Founded in 1982, 

NCIL is the association representing Centers for Independent Living (CILs) and 

statewide Independent Living Councils (SILCs), which provide independent living 

services and advocate civil rights of people with disabilities throughout the United 

States. 

A majority of our Centers for Independent Living and statewide Independent Living Councils receive federal funding under Title VII of the Rehabilitation Act, administered by the Rehabilitation Services Administration of the Department of Education. 

Centers for Independent Living serve our Nation in all but five Congressional Districts. These Centers are non-residential, cross-disability advocacy organizations. 

CILs serve people with disabilities of all ages and income; including people with 

physical, cognitive and sensory disabilities, as well as the growing population of people with mental illnesses and PTSD. All Centers for Independent Living offer four 

core services of independent living skills training, peer support, individual and systems advocacy, and information and referral. Many Centers offer additional services 

such as support groups, community advocacy projects, home modification programs, 

assistive technology loan banks, attendant care services, deaf interpreters services, 

Braille services, recreation, and other community collaboration efforts. 

According to data collected by the Rehabilitation Services Administration, during 

Fiscal Years 2004–2006, Centers for Independent Living: 

Attracted over $520 million through private, state, local, and other sources annually; 

Moved 8,381 people out of nursing homes and institutions, saving states and the 

Federal government well over $160 million, not to mention improving people’s quality of life, and; 

Provided the core services of advocacy, information and referral, peer support, and 

independent living skills training to over 3 million individuals with disabilities.1

In that same period, Centers provided other services to over 659,000 individuals 

with disabilities in their respective communities that included: 

Services to over 56,000 youth with disabilities; 

Assistance to over 169,000 people in securing accessible, affordable, and integrated housing; 

Transportation services to over 106,000 people with disabilities; 

Personal assistance services to over 163,000 people with disabilities; 

Vocational and employment services to 105,000 people with disabilities, and; 

Assistance with Assistive Technology for 114,000 people with disabilities. 

NCIL and all Centers for Independent Living believe in the principle of consumercontrol and that community-based services are an essential element of integration, 

which will ensure the full participation of people with disabilities in all aspects of 

society. NCIL has long worked to garner the support and services that people with 

disabilities need to achieve community integration and economic self-sufficiency. We 

believe people with the most significant disabilities can be contributing members of 

society given the proper supports. Our philosophy demands all individuals be given 

every opportunity to succeed when other agencies are content with labeling them 

unemployable. 

NCIL recently developed a Veteran’s taskforce, which conducted a survey of our 

Centers for Independent Living. Results showed Centers for Independent Living are 

indeed working with veterans to obtain housing, assist them in navigating the VA 

system, acquiring personal attendant care, and providing information and referral. 

One common theme that came out of the survey loud and clear is that there must 


wwoods2 on PRODPC68 with HEARING
42 

to be a formal connection between Centers for Independent Living and the VA. 

When Centers for Independent Living get a referral from the VA it is usually at 

a time of crisis. We would welcome a formal relationship with the VA and Veteran’s 

Service Organizations to better assist veterans with disabilities and their families. 

The core belief of Independent Living, which NCIL and all Centers for Independent Living subscribe to, is that all people have the right to decide how to live, 

work, and participate in their communities, and that consumer-directed and community-based services are the most effective and cost efficient method for the full integration of the wounded warriors back to civilian life. 

The reports of the President’s Commission on Care for America’s Returning 

Wounded Warriors, as well as the VA’s Vocational Rehabilitation and Employment 

Taskforce, support these fundamental Independent Living core beliefs and agree on 

the need to create more IL programs, which increase access to community-based 

services. 

While the VA’s long history of assistance to returning warriors has focused primarily on clinical treatment and compensation, Centers for Independent living have 

been focusing on one-on-one support to assist people with disabilities in outlining 

their future goals, learning that there is a way to have a high quality of life with 

a disability, and creating a support network within the community to enhance the 

lives of all. 

Fortunately, Centers for Independent Living want to collaborate actively with the 

VA. Centers for Independent Living and NCIL is on record requesting additional 

funding to be allocated to help assist the VA in providing essential and timely services to veterans and their families. Many Centers for Independent Living employ 

veterans and have reached out to include veterans with disabilities on their staff 

and boards of directors so that they may use their real life experience to improving 

VA programs in their local community, and use existing programs to help expand 

capacity to serve newly injured and aging veterans who proudly served our country 

to live independently within their own local communities. 

Centers in Alaska, Minnesota and Michigan are working with their communities 

to make sure our veterans are receiving the proper supports to reintegrate into their 

communities. In Alaska, the CIL works with the VA, offering veterans access to 

their mobility loan closet or their TBI support groups. In Minnesota CILs are important and valuable community resources for the VA providing peer-to-peer supports 

and accessing community supports at a faster pace. Our independent living specialists in Michigan are now doing some work with the VA, including Pre-IL assessments, comprehensive assessments, case management and other IL supports as 

needed. 

NCIL encourages all Veteran Affairs programs to connect with local Center for 

Independent Living through out the country. NCIL and our Veterans’ Task would 

welcome the opportunity to discuss how Centers for Independent Living can help 

the VA enhance services for our Nation’s returning veterans. To this end, NCIL 

looks forward to working with you and your staff to address these policy issues. 

Thank you for your time and attention to this critical issue. 

f 

Prepared Statement of Richard Daley, 

Associate Legislation Director, Paralyzed Veterans of America 

Chairwoman Herseth Sandlin, Ranking Member Boozman, and members of the 

Subcommittee, on behalf of Paralyzed Veterans of America (PVA) I would like to 

thank you for the opportunity to testify today on the Department of Veterans Affairs 

(VA) Independent Living Program which is administered by VA’s Vocational Rehabilitation and Employment (VR&E) Program. 

PVA believes that the VR&E Program is one of the most critical programs VA administers in assisting veterans with disabilities to successfully transition to civilian 

life. The primary mission of the VR&E program is to provide veterans with serviceconnected disabilities all the necessary services and assistance to achieve maximum 

independence in daily living and to the maximum extent feasible, to become employable and to obtain and maintain suitable employment. In VR&E’s mission statement, independent living services is mentioned first, emphasizing the importance of 

the independent living program and the Congressional intent for the VR&E program 

to focus on providing services to veterans with severe disabilities. 

In 1980, when the Independent Living (IL) program was first developed, it was 

implemented as a pilot program and imposed a 500 new case cap to the new program. In the succeeding years, the program grew and proved successful in helping 

veterans with severe disabilities to gain greater independence in their daily living 


wwoods2 on PRODPC68 with HEARING
43 

activities. The 500 new case cap seemed to be forgotten and the caseload for independent living continued to grow well beyond 500 new cases a year. Following years 

of dealing with the 500 case cap, VA met with Congressional staff members to request that the cap be removed. Congress at that time was not willing to remove the 

cap as they wanted VA to implement stronger guidelines for the program. Congress 

did, however, increase the cap from 500 to 2,500 new cases in 2001. 

Even though the new case cap was increased, VA continued to bump up against 

the cap for many years. This meant that starting in the fourth quarter of each fiscal 

year VR&E had to constantly monitor the number of new IL cases opened around 

the country. As VR&E approached the cap limit, they had to slow down or delay 

delivery of independent living services for new cases until the start of the next fiscal 

year. When the VA approached the cap limit, VR&E tried to ensure that veterans 

most in need would be served without delay. VR&E did this by requesting that 

counselors submit their new IL cases to Central Office for review. VR&E staff at 

Central Office then tried to make the determination as to who needed services immediately and who could wait. Unfortunately, this procedure is quite disruptive and 

can endanger the success of the rehabilitation process. Imagine engaging in outreach activities, developing new cases, and then having to explain to veterans with 

the most severe disabilities that they must wait to receive any services. 

In addition to the delay in services, the cap has placed an unnecessary burden 

on VR&E staff. Time devoted by VR&E counselors in the field preparing requests 

to serve new IL cases and time spent by Central Office staff reviewing such requests 

as well as the constant monitoring of the new IL case count can certainly be used 

in more productive ways to provide services to veterans. While VR&E may not have 

reached the cap in the last year or two, the cap still presents an unnecessary burden 

and seems to be in direct conflict with providing the necessary services to veterans 

with severe disabilities. 

PVA strongly opposes any unnecessary delay in services for veterans, especially 

services to severely disabled veterans. PVA is extremely disappointed that VR&E 

staff is still forced to abide by the arbitrary 2,500 new case cap. At this point in 

time when the continuation of our military efforts associated with Operation Iraqi 

Freedom and Operation Enduring Freedom (OIF/OEF) are unfortunately resulting 

in ever increasing numbers of veterans who sustain serious injuries, any limit 

placed upon the delivery of services to severely disabled veterans is at best contrary 

to the intent of Congress and the American public. 

The VR&E program provides services to approximately 95,000 veterans each year. 

In FY 2007, VA reported that the VR&E program rehabilitated 11,008 veterans 

with service-connected disabilities. Of the total number of veterans rehabilitated, 

8,252 veterans were determined rehabilitated through obtaining employment and 

2,756 veterans were determined rehabilitated through achieving their independent 

living goals. 

To achieve these outcome results, VR&E has made progress through continual improvement in its programs. In 2004, VR&E hired an IL Coordinator to manage the 

program. In 2005, IL Standards of Practice were issued to VR&E field staff providing detailed guidance. Over the last 3 to 4 years, VR&E Central Office staff have 

provided numerous training sessions on the delivery of IL services. 

Yet there is still much more that can be done to ensure that veterans with severe 

disabilities are well served in the areas of independent living and vocational rehabilitation. Outreach activities targeting severely disabled veterans can be enhanced. 

Stronger linkages with other advocacy and community-based programs can be established. Finally and perhaps most importantly, VR&E needs to direct more time and 

attention to assisting those veterans who after achieving their independent living 

goals are ready to move toward developing vocational goals that may include volunteer work, part-time employment, and even full-time employment. 

With the removal of the IL cap and greater attention directed at serving veterans 

with severe disabilities, PVA recommends that VR&E be given additional professional full time employee positions for IL specialist counselors. These experienced 

counselors should be fully devoted to delivering services to those veterans determined to have serious employment handicaps and to partnering with other programs in the community to bring to veterans the full range of IL services available. 

These specialty counselors will be able to target their efforts on enhancing both the 

accessibility and quality of independent living services available to veterans with severe disabilities. 

PVA’s recommendation for IL specialist counselor is based upon our own experience. PVA has developed and implemented a new Vocational Rehabilitation Services 

program to ensure that all veterans with spinal cord injury or disease have equitable employment opportunities and that the estimated 85 percent unemployment 

rate among PVA members becomes a grim statistic of the past. In partnership with 


wwoods2 on PRODPC68 with HEARING
44 

VA and cooperate sponsors (Health Net Federal Services and Tri West Healthcare 

Alliance), PVA has been able to open two vocational rehabilitation services offices: 

one at the VA SCI Center in Richmond, Virginia and more recently at the VA SCI 

Center in St. Paul, Minnesota. We also anticipate opening a third office in San Antonio, Texas this fall. PVA’s vocational services at these two offices are delivered by 

Mr. Rick Schiessler and Ms. Diane Acord. Both rehabilitation counselors have many 

years of experience and proper credentials to specialize in providing services to individuals with SCI disabilities. Our new program appears to be very promising and 

in less than a year’s time, we are serving well over 100 veterans and have assisted 

20 veterans with severe disabilities obtain employment. The average starting salary 

of our employed veterans is $39,400. We believe a large part of our success so early 

in the development stage of the program is due to our specialty counselors who are 

able to devote all of their attention to providing services to veterans with SCI disability. 

In addition to specialty IL counselors in the field, PVA also recommends that staff 

at Central Office responsible for managing the IL program be increased. As stated 

earlier, VR&E has an IL Coordinator who manages the program. However, having 

only one individual trying to manage an entire national program appears unrealistic, especially if the IL cap is removed and VR&E places more emphasis on serving 

veterans with severe disabilities. PVA recommends that if Congress wishes VR&E 

to improve the IL program, then management of the program should be properly 

resourced. 

Chairwoman Herseth Sandlin, Ranking Member Boozman, and members of the 

Subcommittee, Paralyzed Veterans of America supports your efforts to review and 

improve the existing vocational rehabilitation programs of the Department of Veterans Affairs, especially those programs designed to serve veterans with the most 

severe disabilities. We look forward to working with you to ensure that the best 

services are available particularly for veterans with severe disabilities. This concludes my testimony. I would be happy to answer any questions you may have. 

f 

Prepared Statement of Mark Walker, 

Assistant Director, National Economic Commission, American Legion 

EXECUTIVE SUMMARY 

The mission of the Veterans Rehabilitation and Education (VR&E) program is to 

help qualified, service-disabled veterans achieve independence in daily living and, 

to the maximum extent feasible, obtain and maintain suitable employment. The 

American Legion fully supports these goals. The Independent Living Program (ILP) 

was established in 1980 by P.L. 96–466, the Veterans Rehabilitation and Education 

Amendments. The program serves severely disabled veterans whom the Department 

of Veterans Affairs (VA) determined were unable to obtain and maintain suitable 

employment when achievement of a vocational goal is not feasible. ILP services and 

assistance provided to veterans include evaluation and counseling; prosthetic appliances; eyeglasses; communication devices; adaptive automobile equipment; wheelchair training; and other services necessary to enable a severely disabled veteran 

to achieve maximum independence in daily living. Veterans may remain in the ILP 

for a maximum of 30 months. Chapter 31 of Title 38, U.S. Code limits the number 

of veterans who can be placed in the ILP to 2,500 annually. The American Legion 

supports the removal of the cap. Additionally, the VA should effectively manage and 

monitor the number of new ILP participants and provide detail information to Congress on delays in veterans’ services until a decision has been made to remove the 

annual statutory cap. 

The total number of veterans who were rehabilitated through the Independent 

Living Program in FY 2006 and FY 2007 were 2,162 and 2,756 respectively. In February 2007, the VA Secretary stated that VR&E anticipates a steady increase in the 

demand for ILP services over the next 10 years. Severely disabled veterans stated 

that the Independent Living Services assisted them in adjusting to home life and 

participating with family and community life at a higher level. For example, a veteran from Georgia described that once he was accepted into the ILP, he was supplied with special walking shoes, an exercise machine, and a computer. The Independent Living services allowed him to better operate and feel more productive at 

home. The program has provided severely disabled veterans much needed assistance 

and possible hope for future employment. 

During this time of war we all have an important mission in enabling our injured 

soldiers, sailors, and airmen and other veterans with disabilities to have a seamless 


wwoods2 on PRODPC68 with HEARING
45 

transition from military service to a successful rehabilitation and on to suitable employment after service to our Nation. 

The American Legion strongly supports the ILP and is committed to working with 

the VA and other Federal agencies to ensure that America’s severely disabled veterans are provided with the highest level of service and employment assistance. 

Again, thank you for the opportunity to submit the opinion of The American Legion 

on this issue. 

Madam Chairwoman and distinguished members of the Subcommittee, thank you 

for the opportunity to present the views of The American Legion regarding the Independent Living Program (ILP), which falls under the Department of Veterans Affairs (VA) Vocational Rehabilitation and Education (VR&E) program. 

VOCATIONAL REHABILITATION AND EMPLOYMENT SERVICE 

Since the forties, VA has provided vocational rehabilitation assistance to veterans 

with disabilities incurred during military service. The Veterans Rehabilitation and 

Education Amendments of 1980, Public Law (P.L.) 96–466, changed the emphasis 

of services from training, aimed at improving the employability of disabled veterans, 

to helping veterans obtain and maintain suitable employment and achieve maximum independence in daily living. Vocational Rehabilitation and Employment 

(VR&E) program employment goals are accomplished through training and rehabilitation programs authorized under Chapter 31 of Title 38, U.S. Code. Title 38 provides a 12-year period of eligibility after the veteran is discharged or first notified 

of a service-connected disability rating. To be entitled to VR&E services, veterans 

must have at least a 20 percent service-connected disability rating and an employment handicap or less than a 20 percent disability and a serious employment handicap. 

The mission of the VR&E program is to provide comprehensive services and assistance necessary to enable veterans with service-connected disabilities and employment handicaps to become employable, then obtain and maintain stable and 

suitable employment. The American Legion fully supports these goals. The Independent Living Program (ILP) was established in 1980 by P.L. 96–466, the Veterans 

Rehabilitation and Education Amendments. The program serves severely disabled 

veterans, who VA determined were unable to obtain and maintain suitable employment, when achievement of a vocational goal is not feasible. ILP services and assistance provided to veterans include evaluation and counseling; prosthetic appliances; 

eyeglasses; communication devices; adaptive automobile equipment; wheelchair 

training; and other services necessary to enable a severely disabled veteran to 

achieve maximum independence in daily living. Veterans may remain in the ILP for 

a maximum of 30 months. Chapter 31 of Title 38, U.S. Code limits the number of 

veterans who can be placed in the ILP to 2,500 annually. 

Administration of VR&E and its programs is a responsibility of the Veterans Benefits Administration (VBA). Historically, VBA has placed emphasis on the processing of veterans’ claims and the reduction of the claims backlog, which is extremely important. However, providing effective employment programs through 

VR&E must be a priority as well. 

Historically, VA has been lacking in its efforts to find employment for disabled 

veterans. The Vocational Rehabilitation program has historically been marketed to 

veterans as an education program and not an employment program. A majority of 

veterans attended universities and colleges with few enrolled in training programs, 

such as apprenticeships and on-the-job training that can lead to direct job placement. 

Until recently, VR&E’s primary focus has been providing veterans with skills 

training, rather than obtaining meaningful employment. Clearly, any employability 

plan that doesn’t achieve the ultimate objective, a job, is an injustice to those veterans seeking assistance in transitioning into the civilian workforce. 

MANAGEMENT AND PERFORMANCE STANDARDS 

In 2003, the Secretary of Veterans Affairs established a task force to examine the 

entire VR&E Program. The resulting 2004 VR&E Task Force Report contained 110 

recommendations to redesign the program to become ‘‘a proactive, employment-driven, 21st Century program that can effectively serve veterans with disabilities.’’ The 

task force reported areas of concern in VR&E’s provision of employment services to 

veterans, workload management, fiscal accountability, performance measurement, 

and information technology (IT) management including a concern that VR&E’s IT 

systems did not produce the information and analyses needed to manage program 


wwoods2 on PRODPC68 with HEARING
46 

activities. As of April 2007, VR&E reports that 89 of 110 recommendations have 

been fully implemented and 13 are planned for implementation. As of July 2008, 

VR&E reports that out of the 13 remaining recommendations for implementation, 

4 of those will be implemented within 12 months and 8 will be implemented beyond 

12 months. 

The Government Accountability Office (GAO) issued a report in June 2004 that 

concluded that VA has not been effective in meeting its mandate to find jobs for 

disabled veterans. The report agreed with the 2004 VR&E Task Force Report finding that VA had not prioritized returning veterans with service-connected disabilities to the workforce and that the VR&E Program has emphasized education over 

employment. The 2004 VR&E Task Force Report stated, ‘‘VR&E’s best efforts regarding employment of veterans have resulted in only 10 percent of those participating in the VR&E program obtaining employment,’’ and stated, ‘‘Despite the tens 

of thousands of VR&E program participants in a given year, the number of veterans 

rehabilitated by obtaining a job or achieving ILP goals has averaged only about 

10,000 a year for several years.’’ 

Another problem hindering the effectiveness of the VR&E program as previously 

cited in reports by the Government Accountability Office (GAO) is exceptionally high 

workloads for the limited number of staff. This hinders the staff’s ability to effectively assist individual veterans with identifying employment opportunities. 

As mentioned above, Chapter 31 of Title 38, U.S. Code limits the number of veterans who can be placed in the ILP to 2,500 annually. Due to the statutory annual 

cap on the number of ILP participants, VR&E Service instructed VA Regional Offices (VAROs) to discontinue placing veterans into ILP status as they approached 

the cap unless approved by VA Central Office (VACO). From FY 2002 through FY 

2006, VR&E issued interim procedures that prohibited VR&E staff from approving 

new veterans into the ILP unless VACO program officials authorized the placements. The interim procedures further directed that if authorization were denied, 

the veteran should be considered a priority for initiation in the new FY and held 

in the Evaluation and Planning phase until that date. 

As a result, the cap was underutilized in FY 2006 and services to entitled veterans were delayed. An average of 225 veterans per month entered the ILP nationwide from October 2005 through June 2006. However, during the months of July 

2006 through September 2006, subsequent to issuance of the interim procedures, an 

average of 45 veterans per month entered into the ILP. Ultimately, a total of 2,162 

veterans entered the ILP in FY 2006. Even though the number of new veterans that 

entered the program did not exceed the annual cap, VR&E service anticipated exceeding it, which delayed veterans from entering the ILP when they were eligible. 

This cap delays benefits to severely disabled veterans who are entitled to participate 

in the ILP. VA has made efforts since 2001 to remove the cap; however, the cap 

remains in effect. 

The American Legion supports the removal of the cap. VA should effectively manage and monitor the number of new ILP participants and provide detailed information to Congress on delays in veterans’ services until a decision has been made to 

remove the annual statutory cap, especially during a period of armed conflict. 

VA reports that VR&E rehabilitation rates as a measure of Chapter 31 program 

performance in the annual VA Performance and Accountability Report (PAR). The 

PAR should include data on total program participants, including those who discontinued program participation, those who obtained and maintained suitable employment, and those who achieved ILP goals. Currently, the PAR does not accomplish 

that. The PAR should provide accurate and complete information for budgetary and 

resource decisions. 

Unfortunately, most veterans discontinued participation in the Chapter 31 program and were not rehabilitated. Data in Benefits Delivery Network (BDN), the 

major computer system used by VBA to process veterans’ claims, does not provide 

VR&E management with sufficient information to analyze the reasons for the high 

rate of program discontinuation. Once the reasons are identified, the information 

could be used to design interventions to reduce the probability of veterans dropping 

out of the program. 

VBA currently has a study, Veterans Employability Research Survey, which is 

scheduled for completion in September 2008. Study results will be used to establish 

nationwide procedures to help reduce the number of veterans who discontinue the 

VR&E program. 

It seems that the VR&E program has remained in a perpetual state of transition 

for the past 25 years, according to countless GAO and VA reports. The 2004 Task 

Force Report stated that the VR&E system must be redesigned for the 21st Century 

employment environment. The American Legion continues to support strong leadership and continued verification of the recommendations made in the 2004 Task 


wwoods2 on PRODPC68 with HEARING
47 

Force Report. In fiscal year (FY) 2006, VR&E funding was $702 million, and the program served about 90,000 veterans. Adequate funding is needed to assist the management staff of VR&E to continue its implementation of the recommendations. 

REHABILITATION AND EMPLOYMENT OUTCOMES 

Numbers of Rehabilitated/Employed Veterans 

Year Veterans successfully 

rehabilitated 

Veterans successfully employed 

with suitable jobs 

FY 03 9,549 7,525 

FY 04 11,129 18,392 

FY 05 12,013 19,279 

FY 06 Not available Not available 

FY 07 11,008 18,252 

The above demonstrates the improved outcomes for the VR&E program. 

Although there are improvements needed in the VR&E program, veterans who 

have gone through the program stated that the counseling, training, education, and 

skills that they acquired led to gainful employment both within the public and private sectors. A veteran from Massachusetts went into the VR&E and received an 

associate degree. Currently, he operates his own small business, while completing 

his bachelor’s degree. Severely disabled veterans stated that the Independent Living 

Services assisted them in adjusting to home life and participating with family and 

community life at a higher level. 

For example, a veteran from Georgia described that once he was accepted into the 

ILP, he was supplied with special walking shoes, an exercise machine, and a computer. The Independent Living services allowed him to better operate and feel more 

productive at home. The program has provided severely disabled veterans much 

needed assistance and possible hope for future employment. 

2008 VR&E AND INDEPENDENT LIVING PROGRAM PARTICIPANTS 

Locations VR&E Program Participants 

Veterans Placed in the 

ILP 

Indiana 1,880 163 

Arkansas 1,382 24 

South Dakota 781 43 

North Dakota 569 29 

District of Columbia 2,318 11 

New York City 1,700 219 

The total number of veterans who were rehabilitated through the Independent 

Living Program in FY 2006 and FY 2007 were 2,162 and 2,756 respectively. In February 2007, the VA Secretary stated that VR&E anticipates a steady increase in the 

demand for ILP services over the next 10 years. 

At this time in the nation’s history, it is paramount that we ensure VA is capable 

of enabling injured veterans with disabilities to have a seamless transition from 

military service to a successful rehabilitation and on to suitable employment after 

military service. For severely disabled veterans, this success will be measured by 

their ability to live independently, achieve the highest quality of life possible, and 

realize the hope for employment given advances in medical science and technology. 

To meet America’s obligation to these specific veterans and other eligible VR&E veterans, VA leadership must continue to focus on marked improvements in case management, vocational counseling, and most importantly job placement. 

The American Legion strongly supports the ILP and is committed to working with 

VA and other Federal agencies to ensure that America’s severely disabled veterans 

are provided with the highest level of service and employment assistance. Again, 


wwoods2 on PRODPC68 with HEARING
48 

thank you for the opportunity to present the opinion of The American Legion on this 

issue. 

f 

Prepared Statement of Ruth Fanning, 

Director, Vocational Rehabilitation and Employment Service, 

Veterans Benefits Administration, U.S. Department of Veterans Affairs 

Madam Chairwoman and members of the Subcommittee, thank you for inviting 

me to appear before you today to discuss the independent living services provided 

by VA’s Vocational Rehabilitation and Employment (VR&E) program. My testimony 

will provide an overview, address the cap of 2,500 new independent living cases per 

fiscal year, and describe VR&E efforts to improve and facilitate the delivery of these 

essential services. 

Overview of Independent Living 

Independent living (IL) services may be provided to VR&E applicants when it is 

determined during the initial evaluation that they cannot, due to the severity of 

their disability(ies), currently pursue a vocational goal. After this determination, 

each veteran participates in a thorough assessment of his or her potential IL needs. 

The evaluation begins with a preliminary assessment. During this assessment, the 

counselor obtains information about a variety of issues, including housing, personal 

and emotional needs; leisure and avocational activities; and the ability of the veteran to perform activities of daily living. If potential IL needs are identified, the 

VR&E counselor or another provider with specialized experience and/or training 

completes a comprehensive assessment of IL needs. This assessment is usually performed at the veteran’s home. If IL needs are found and it is determined that 

achievement of appropriate goals is possible, the counselor works with the veteran 

to develop an Independent Living Plan. This plan outlines the goals, services, and 

assistance to be provided and benchmarks to be used to determine progress in 

achieving greater independence in daily living. 

Independence in daily living translates to the ability of a veteran to live and function within family and community, either without the services of others or with a 

reduced level of those services. Services are tailored to each veteran’s needs and 

may include a discrete service or a comprehensive program of services necessary to 

achieve maximum independence in daily living. 

Total programs of IL services are usually no longer than 24 months duration. In 

exceptional circumstances, the counselor may request a 6-month extension. 

Some of the IL services VA provides include training in activities of daily living, 

training in skills needed to improve an individual’s ability to live more independently, attendant care during a period of transition, transportation when special arrangements are required, peer counseling, housing integral to participation in a program of special rehabilitation services through an approved independent living center or program, training to improve awareness of rights and needs, assistance in 

identifying and maintaining volunteer or supported employment, services to decrease social isolation, and adaptive equipment that increases functional independence. 

IL services may also help a veteran become able to participate in an extended 

evaluation. The purpose of an extended evaluation is to assess the ability of the veteran to achieve a vocational goal. Discrete IL services may also be provided as components of other rehabilitation plans. The IL services included in these plans must 

be directly related to the achievement of the plan goal, whether that goal is vocational training, a more extensive assessment of vocational feasibility, or employment. 

The VR&E Officer must approve IL program costs exceeding the counselor approval limit of $25,000 per calendar year. Program costs exceeding $75,000 per calendar year can be approved by the Director of the VA Regional Office. Program 

costs in excess of $100,000 per calendar year and IL-related construction costs exceeding $25,000 must be approved by the Director of VR&E Service. 

VR&E performs quality assurance reviews of IL casework. Cases are reviewed 

during oversight visits at regional offices, and the results are used to develop training or provide additional guidance when appropriate. 

Independent Living Cap 

With the passage of P.L. 107–103, the Veterans Education and Benefits Expansion Act of 2001, the limit on the number of new IL cases per year increased from 

500 to 2,500. VR&E Service monitors newly developed IL cases monthly to track 

total IL cases in comparison to the legislative cap. Tracking over the past 2 years 


wwoods2 on PRODPC68 with HEARING
49 

demonstrates the ability of VR&E counselors to provide needed services within the 

current 2,500 statutory cap. On average, 2,300 new cases have entered IL services 

each of the past 3 years. 

Independent Living Services and Results 

Veterans with severe disabilities who participate in programs of independent living have achieved results that include increased independence, decreased isolation, 

decreased dependence on outside supports, enhanced family relationships, improved 

medication and therapeutic intervention compliance, and greater community involvement. Other positive outcomes include veterans being able to leave long-term 

institutional care to live in the community with reduced reliance on other federally 

funded service providers, pursuit of full or part-time volunteer employment, and 

progression from IL programs to other VR&E employment programs. 

As a result of increased outreach, we anticipate more veterans will participate in 

programs of IL services. Also, the medical stabilization of returning OEF/OIF veterans with catastrophic injuries will necessitate their participation in vocational rehabilitation programs. The aging Vietnam Era population and the increasing number of veterans receiving compensation due to presumptive diseases will also likely 

increase the utilization of IL services. 

VR&E Service closely monitors the number of entering cases to ensure priority 

services are provided to veterans with the most serious disabilities. We also provide 

training and guidance to field staff to incorporate IL services into Individualized 

Written Rehabilitation Plans and Individualized Extended Evaluation Plans when 

appropriate. 

Training 

In early 2005, Guidelines for the Administration of the Independent Living Program were published and implemented. These guidelines include standards of practice and mandatory job aids for counselors. Use of these tools improved the quality 

and consistency of independent living assessments, plan development, service delivery, and case closures. 

To reinforce the understanding and use of these tools and practices, VR&E Service provides targeted and extensive training about IL services for counselors and 

managers, including training workshops for vocational rehabilitation counselors directly responsible for developing IL plans and providing IL services. 

As a part of ongoing IL training, VR&E Officers and Assistant VR&E Officers also 

receive information about community partnerships facilitating IL planning and service delivery. Building on collaboration with the Executive Director for Centers for 

Independent Living, a panel presentation at the recent VR&E Leadership Conference focused on information about Centers for Independent Living and current 

initiatives at these Centers to work with veterans with severe disabilities. 

Another panel at the VR&E Leadership Conference addressed methods and services to facilitate the employment of individuals with severe disabilities, such as 

traumatic brain injury, post traumatic stress disorder, spinal cord injury, severe 

mental illness, and polytrauma. Panelists included representatives from Easter 

Seals, the Vocational Rehabilitation Services Program sponsored by Paralyzed Veterans of America, and the Compensated Work Therapy program within the Veterans 

Health Administration (VHA). 

Current and Future Studies 

To obtain a more comprehensive understanding of the veterans who participate 

in IL programs, VR&E Service funded an Independent Living Participant Study. 

This contracted study will provide the first comprehensive analysis of the veterans, 

services, and outcomes achieved by veterans participating in total programs of IL 

services. This study will expand our knowledge about the disabilities and disability 

ramifications of IL program participants; the use of technology and adaptive equipment to minimize or ameliorate disability ramifications in daily life; and utilization 

of other VA benefits and benefits available through private providers or other state 

or federal sources. Recommendations to improve the administration of IL services 

under the VR&E program will be provided. The study is expected to be completed 

by September 30, 2008. 

Next year, VR&E plans to fund a study to examine factors influencing the employment of individuals with severe injuries. Many of these individuals will initially 

utilize IL services, either in total programs of independent living or through IL services included in other rehabilitation plans. The objective of this project is to collect 

data and perform a comprehensive analysis of factors influencing the successful employment of veterans of the military with severe injuries. The population studied 

will include individuals with disabilities such as traumatic brain injury, spinal cord 

injury, blindness, amputation, severe mental illness, burns, and polytrauma. RecVerDate Nov 24 2008 04:45 Feb 14, 2009 Jkt 043999 PO 00000 Frm 00053 Fmt 6604 Sfmt 6621 E:\HR\OC\43999.XXX 43999

wwoods2 on PRODPC68 with HEARING
50 

ommendations will be provided on methods to improve employment outcomes and 

train counselors in working with and planning rehabilitation programs for servicemember and veterans with severe injuries. 

Cooperative Relationships 

In cooperation with the Specially Adapted Housing Grant program administered 

by VA’s Loan Guaranty Service, VR&E independent living services help meet the 

needs of veterans with severe disabilities and mobility impairments. In 2005, VR&E 

Service and Loan Guaranty Service established formal procedures to facilitate cooperative relationships while maintaining the integrity of each program. When working with veterans who have home-modification needs, VR&E counselors investigate 

eligibility for the Specially Adapted Housing grant, and may assist the veteran in 

the application and coordination process. 

Specially Adapted Housing Agents, as part of their initial interview protocol, discuss potential eligibility for IL services. Specially Adapted Housing Program Managers regularly attend VR&E management conferences to provide information on 

the Specially Adapted Housing Program. 

This cooperation has resulted in the delivery of life-changing services to veterans. 

In one instance, a veteran with quadriplegia received home modifications and a generator from the Specially Adapted Housing Program. IL services included adaptive 

equipment and assistive devices such as a voice activated computer and a flashing 

telephone and doorbell. Another veteran, blinded in Vietnam, needed a bedroom and 

bath constructed on the first floor of his home. VR&E and the Specially Adapted 

Housing Program were able to jointly complete these modifications, ensuring the 

veteran’s safety in his home and increased independence. 

VR&E also works with programs administered by VHA, including the Home Improvements and Structural Alterations (HISA) program, the Automobile Adaptive 

Equipment program, and the Visually Impaired Services Team (VIST) program. The 

VHA provides HISA grants up to $1,200 for nonservice-connected veterans or up to 

$4,100 for service-connected veterans who need modifications to their homes to facilitate entry and provide access within the home. 

VA’s Automobile Adaptive Equipment program helps veterans or servicemember 

who are service-connected for the loss or loss of use of one or both feet or hands, 

or who have service-connected abnormal adhesion of the bones of a joint of one or 

both knees or one or both hips. Veterans with severe burns resulting in a rating 

of loss of use of their extremities also qualify. The program can provide, among 

other things, power steering, brakes, windows, doors, mirrors, seats, automatic 

transmission, van lifts, wheelchair and scooter lifts, shipping costs, and other special 

equipment necessary to the individual. 

VHA’s Compensated Work Therapy (CWT) programs provide supported employment opportunities for veterans with severe mental illness and other catastrophic 

disabilities, including traumatic brain injury and spinal cord injury. CWT programs 

are offered at over 162 locations across the country. The staff of these programs provide a range of vocational rehabilitation services to veterans who express an interest 

in employment. Any veteran may participate who has a severe mental illness or 

other severe disability and receives a referral from a VA Medical Center clinician 

or physician. For veterans with severe disabilities, CWT services can be an essential 

bridge from unemployment to employment. 

VHA’s Visual Impairment Service Team (VIST) offers a wide variety of services, 

including visual exams, devices to assist with daily living, and adapted computers 

and training to veterans with visual impairments. VHA also offers an array of prosthetic devices and services for patients based upon such factors as enrollment, medical evaluations, and prescriptions. 

VR&E participates in work groups and Committees that discuss and recommend 

policies to serve veterans likely to participate in IL services. These committees include the Committee on Care of Veterans with Severe Mental Illness (SMI) and the 

Traumatic Brain Injury Caregivers Panel. The SMI Committee is a VHA Committee 

created to discuss, develop, and review VA treatment protocols, funding, and initiatives for veterans with mental illness. Members include VHA clinicians as well as 

members of service organizations and organizations dedicated to mental health 

issues in the private sector. Section 744 of the, P.L. 110–181, signed by the President on January 28, 2008, mandated the creation of the Traumatic Brain Injury 

Caregivers Panel. The purpose of the 15 member panel is ‘‘to develop coordinated, 

uniform, and consistent training curricula to be used in training family members 

in the provision of care and assistance to members and former members of the 

Armed Forces with traumatic brain injuries.’’ Panel members were appointed after 

receiving Department of Defense and White House approval. 


wwoods2 on PRODPC68 with HEARING
51 

Services to Seriously Wounded 

VR&E is an integral part of a seriously injured servicemember’s or veteran’s adjustment and reintegration into their community. Working together with military 

treatment facilities, the Department of Labor, VHA, as well as VHA’s Care Coordinators, and VBA personnel, VR&E provides an optimal program of vocational rehabilitation and employment services to assist with seamless transition from military 

to civilian life. 

Early intervention services for a seriously wounded OIF/OEF servicemember or 

veteran begins with a VR&E Vocational Rehabilitation Counselor directly contacting 

the individual to inform him or her about available benefits. This initial contact may 

occur while the servicemember is receiving treatment at a medical treatment facility, a VA Medical Center, or the individual’s home. VR&E staff is equipped to go 

anywhere necessary to deliver the initial orientation and provide assistance to the 

wounded warrior and his or her family. 

This initial contact allows for the vocational rehabilitation process to begin earlier 

during medical rehabilitation and enables the veteran to make the transition quickly to work or to a program of employment services after he or she is discharged and 

ready to pursue vocational goals. This early intervention also gives hope to veterans 

as they readjust to their disabilities and plan for their future. 

Once the eligible servicemember or veteran completes the initial orientation and 

the vocational assessment, a plan of service is developed to assist in meeting the 

individual’s vocational goals. In developing the rehabilitation plan, VR&E staff work 

closely with MTF and VHA personnel, communicating with medical teams to obtain 

current information about the veteran’s physical capacities and projected recovery 

timelines. VR&E is also collaborating with the new Federal Recovery Coordinators 

to ensure seamless and timely delivery of services. 

For servicemembers and veterans who are physically recovering from catastrophic 

injuries and need independent living services in addition to planning for their vocational goals, an extended evaluation period may be needed. Individuals who are so 

severely disabled that a decision cannot be made about whether an employment goal 

is currently feasible may be provided an extended evaluation of more than the basic 

12 months. VR&E Service has authorized field managers to approve extended evaluations for OIF/OEF servicemembers and veterans up to a total of 18 months. 

Another tool to assist the injured servicemember or veteran is the ‘‘Coming Home 

to Work’’ (CHTW) initiative. The CHTW initiative began in September 2004 as a 

pilot at Walter Reed Army Medical Center. In November 2005, responsibility for 

CHTW was transferred to VR&E Service and became an integral part of VR&E’s 

early intervention and outreach efforts to OEF/OIF servicemembers. CHTW is established at all MTFs, with current staffing provided to 13 Regional Offices serving 

major MTFs to support this initiative. CHTW provides opportunities for eligible 

servicemembers to fast track into VR&E services, obtain work experience, develop 

skills needed to make the transition to civilian employment, determine the suitability of potential careers, and make the transition into competitive employment 

positions. 

The need for early VR&E outreach through CHTW has grown and is no longer 

contained only within the major Military Treatment Facilities. The Department of 

Defense has begun assigning injured servicemembers pending medical separation to 

healthcare facilities across the country. In order to meet the increased need for early 

VR&E outreach, CHTW has been expanded to all VR&E field offices to focus on the 

development of solid working relationships with the military chain of command, government agencies, and the VA local service delivery team. This close coordination 

and collaboration is vital to the success of VR&E early outreach efforts for wounded 

servicemember and veterans. 

The Impact of Independent Living Services 

This example highlights the impact that IL services have on our veterans. A veteran with an 80 percent VA disability rating applied for Chapter 31 benefits. He 

also had a multitude of non-service connected disabilities and used a wheelchair due 

to the difficulties he had with ambulation due to his disabilities and injuries. His 

IL goals included increasing his ability to access his home independently, increasing 

his ability to socialize, and enhancing activities of daily living by providing adaptive 

computer equipment and teaching him how to use the equipment. 

Our VR&E counselor worked with a Rehabilitation Engineer to determine how 

best to increase the accessibility of the veteran’s home. Based on the engineer’s assessment and recommendation, VR&E provided for the installation of solar-powered 

remote-controlled gates on the veteran’s property. Prior to installing the gates, the 

veteran would have to manually open and close the gates. This was difficult for him 


wwoods2 on PRODPC68 with HEARING
52 

due to his disabilities. Now, the veteran uses the gates daily and is able to come 

and go on his property without difficulty or pain. 

During the veteran’s IL program, he began to interact with his community at a 

greater rate. He began to attend community events and joined a social club. Using 

a computer was very important to this veteran and he had difficulty using a computer, as his injuries placed limitations on the use of his hands. The veteran’s IL 

plan included an adaptive computer, speaking software, and private instruction to 

teach him to use the equipment and voice activation software. Today, the veteran 

is able to use the computer to take care of his finances, communicate with family 

and friends, shop, and conduct research. 

Concluding Remarks 

VR&E anticipates an increased need for independent living services. We continue 

to assess our progress and develop methodologies and strategies to improve the delivery of benefits to these deserving veterans. Last year, over 2,700 independent living participants were rehabilitated—demonstrating they had achieved the goals of 

their programs or made substantial gains in independence as a result of VR&E services. 

Madam Chairwoman, this concludes my statement. I would be pleased to answer 

questions from you or any of the other members of the Subcommittee. 

f 

Statement of Kerry Baker, 

Associate National Legislative Director, Disabled American Veterans 

Madam Chair and Members of the Subcommittee: 

On behalf of the 1.3 million members of the Disabled American Veterans (DAV), 

I am honored to present this testimony to address the Department of Veterans Affairs’ Independent Living Program (ILP). 

The purpose of the Vocational Rehabilitation and Employment (VR&E) program 

is to provide all services and assistance necessary to enable veterans with serviceconnected disabilities to become employable and obtain and maintain suitable employment, and to the maximum extent feasible, achieve independence in daily living. 

However, in any case wherein the VA has determined that the achievement of a vocational goal by a veteran currently is not reasonably feasible, such veteran shall 

be entitled, in accordance with the provisions of 38 U.S.C.A. 3120, to an ILP designed to enable such veteran to achieve maximum independence in daily living. See 

38 U.S.C.A. § 3109 (West 2002). 

In accordance with 38 U.S.C.A. § 3120, a program of independent living services 

and assistance may be made available under this section only to a veteran who has 

a serious employment handicap resulting in substantial part from a service-connected disability. Eligibility for acceptance into the ILP is hinged on a determination 

that achievement of a vocational goal currently is not reasonably feasible. See 38 

U.S.C.A. § 3106(d) and (e). 

An ILP for services and assistance to a veteran shall consist of such services as 

the Secretary determines necessary to enable such veteran to achieve maximum 

independence in daily living. The scope of services and assistance provided is governed by 38 U.S.C.A. § 3104, and include the following: 

1. Evaluation, including periodic reevaluations as appropriate with respect to a 

veteran participating in a rehabilitation program, of the potential for rehabilitation of a veteran, including diagnostic and related services (A) to determine 

whether the veteran has an employment handicap or a serious employment 

handicap and whether a vocational goal is reasonably feasible for such veteran, and (B) to provide a basis for planning a suitable vocational rehabilitation program or a program of services and assistance to improve the vocational rehabilitation potential or independent living status of such veteran, as 

appropriate; 

2. Educational, vocational, psychological, employment, and personal adjustment 

counseling; 

3. An allowance and other appropriate assistance, as authorized by section 3108 

of title 38; 

4. A work-study allowance as authorized by section 3485 of title 38; 

5. Placement services to effect suitable placement in employment, and postplacement services to attempt to insure satisfactory adjustment in employment; 

6. Personal adjustment and work adjustment training; 


wwoods2 on PRODPC68 with HEARING
53 

7. (A) Vocational and other training services and assistance, including individualized tutorial assistance, tuition, fees, books, supplies, handling charges, licensing fees, and equipment and other training materials determined by the 

Secretary to be necessary to accomplish the purposes of the rehabilitation program in the individual case, 

(B) Payment for the services and assistance provided under subparagraph (A) 

shall be made from funds available for the payment of readjustment benefits; 

8. Loans as authorized by section 3112 of title 38; 

9. Treatment, care, and services described in chapter 17 of title 38; 

10. Prosthetic appliances, eyeglasses, and other corrective and assistive devices; 

11. Services to a veteran’s family as necessary for the effective rehabilitation of 

such veteran; 

12. For veterans with the most severe service-connected disabilities who require 

homebound training or self-employment, or both homebound training and selfemployment, such license fees and essential equipment, supplies, and minimum stocks of materials as the Secretary determines to be necessary for such 

a veteran to begin employment and are within the criteria and cost limitations that the Secretary shall prescribe in regulations for the furnishing of 

such fees, equipment, supplies, and stocks; 

13. Travel and incidental expenses under the terms and conditions set forth in 

section 111 of title 38, plus, in the case of a veteran who because of such veteran’s disability has transportation expenses in addition to those incurred by 

persons not so disabled, a special transportation allowance to defray such additional expenses during rehabilitation, job seeking, and the initial employment stage; 

14. Special services (including services related to blindness and deafness) including— 

(A) language training, speech and voice correction, training in ambulation, 

and one-hand typewriting, 

(B) orientation, adjustment, mobility, reader, interpreter, and related services, 

and 

(C) telecommunications, sensory, and other technical aids and devices; 

15. (15) Services necessary to enable a veteran to achieve maximum independence 

in daily living; 

16. Other incidental goods and services determined by the Secretary to be necessary to accomplish the purposes of a rehabilitation program in an individual 

case. 

A rehabilitation program (including individual courses) to be pursued by a veteran 

shall be subject to the approval of the Secretary. 

Unfortunately, Congress has limited programs of independent living services and 

assistance to no more than 2,500 veterans in each fiscal year. The first priority is 

afforded to veterans for whom the reasonable feasibility of achieving a vocational 

goal is precluded solely as a result of a service-connected disability. See 38 U.S.C.A. 

§ 3120(e). However, among those veterans who are provided a program of independent living services and assistance, the VA is required by 38 U.S.C.A. § 3120(c) 

to include, to the maximum extent feasible, a substantial number of veterans who 

are receiving long-term care in VA hospitals and nursing homes, to include contract 

nursing homes. 

The DAV’s experience has been that this program provides an invaluable benefit 

to the most seriously disabled veterans. We have not experienced many problems 

with its implementation or the types of services it provides. However, the 2,500 statutory limit on enrollees is incredibly low considering that the program must provide 

services to brand new seriously disabled veterans, those in nursing homes and hospitals, and those in between. 

Including the reasons above, the statutory limit is exceptionally low considering 

that we are at war, which renders this program more of a necessity than ever. 

Therefore, the DAV’s primary suggestion is that the statutory limit should be removed entirely. 

Madam Chair, this concludes my testimony on behalf of DAV. We hope you will 

consider our recommendations. 

f 


wwoods2 on PRODPC68 with HEARING
54 

Statement of Rogelio G. Evangelista, 

President, Maui County Veterans Council, Wailuku, Maui, HI 

Maui County Veterans Council 

Wailuku, Maui, HI 

July 10, 2008 

House Committee on Veterans Affairs 

Attn: Ms. Orfa Torres 

Dear Committee members: 

On March 31, 2008 the Maui County Veterans Council presented Dr. Richard 

MacDonald, Voc Rehab Counselor, with the ‘‘President’s Award’’ for having significantly improved the quality of lives of more than 250 of our most severely psychiatrically and physically disabled Vietnam, Korean and World War II veterans. Dr. 

MacDonald attributes these remarkable results to the close collaboration he has 

with our Maui CBOC treatment professionals and the unique and profound effectiveness of the Independent Living Program (ILP). In fact, the entire Maui CBOC 

healthcare staff, VA and veteran communities on Maui, Molokai and Lanai fully endorse and utilize the IL services provided by Dr. MacDonald. This is because, in addition to Clinic provided therapy and medications, these IL, services have been so 

effectively providing veterans the means they needed to better utilize their time, 

skills and interests to help and share with other people. In this way, the IL Program 

transforms these hard-to-reach veteran’s lives, formerly characterized by profound 

depression, isolation, and lack of purpose, into active, meaningful and socially connected lives. These amazing results benefit the veterans, their families, communities, and the VA in terms of reduced treatment costs over time. 

Given this use of the Independent Living Program (ILP) services to these special 

needs veterans has been utilized far more extensively in Maui County than elsewhere, they have undergone several Site Surveys by VACO Vocational Rehabilitation and Employment (VR&E) staff, including the last one 2 months ago. Dr. MacDonald states that these surveys have resulted in better assurance that IL services 

are provided here within the scope, guidelines and intent of the Chapter 31 Program. However, these actions have also resulted in larger numbers of veterans 

awaiting these services. Nevertheless, Dr. MacDonald is doing the best he can to 

expedite these services. 

As noted, the Maui County Veterans Council is promoting this unique utilization 

of IL services for these special needs veterans because they have proven to be so 

critically effective and sustaining to them. However, given IL, services are needbased, there should be no cap on the number of veterans who receive them in a 

year. We also wish to note that Dr. MacDonald, as the sole provider of Chapter 31 

services here, provides our veterans with VR&E employment services as well as IL 

services. Nonetheless, the demand for IL services here remains extraordinarily high 

because we have such a high percentage of older vets living here still suffering from 

PTSD who are applying and benefiting from these services. 

Lastly, even though we acknowledge our Nation’s highest priority is to serve OIF/ 

OEF veterans, we cannot ascribe a lesser priority to serving our older veterans especially knowing how essential these ILP services are in concert with VHA assistance 

to unlocking the potential of these special needs veterans to live out the remainder 

of their lives with a restored sense of purpose, family, social and community connection. 

Thank you all for what you do for Veterans. God Bless the United States of America and its Veterans. 

Respectfully submitted, 

Rogelio G. Evangelista 

f 

President 


wwoods2 on PRODPC68 with HEARING
55 

Statement of Marianne Talbot, Ph.D., 

President, National Rehabilitation and Rediscovery Foundation, Inc. 

The Hope Project: An Independent Living Program for 

Disabled Veterans with TBI 

The Need 

Medical and neurosurgical techniques have improved since the seventies, resulting in a dramatic increase in the survival of persons diagnosed with traumatic brain 

injuries (TBI). It is estimated that 5.3 million Americans currently live with longterm or permanent disabilities resulting from TBI (CDC, 1999; Thurman et al., 

1999). The numbers have been increasing with the return of wounded soldiers from 

the conflicts in Iraq and Afghanistan. As of 2007, approximately 22 percent of the 

more than 30,000 wounded soldiers from Iraq and Afghanistan have sustained a 

TBI (Stanford Medicine, 2007). The numbers continue to rise. The recently released 

RAND Corporation (2008) report on the Invisible Wounds of War: Summary and 

Recommendations for Addressing Psychological and Cognitive Injuries provides some 

sobering estimates on the number of deployed servicemembers who have sustained 

a TBI and are suffering from psychological issues such as post traumatic stress disorder (PTSD). Based on surveys, the total number could reach as many as 320,000 

(Tanielian, et. al, 2008). TBI may co-occur with PTSD and/or traumatic amputation. 

The cognitive, physical, and psychosocial changes that occur in an individual post 

injury are profound, with lifelong and life altering disabling conditions (NIH, 1999). 

The current standard of care following TBI has been first emergency medical care 

and stabilization followed by acute and post-acute rehabilitation with the ultimate 

goal of independent living. Although the optimal objective of rehabilitation is successful independent living through community re-integration, programs and services 

that support this transition are not part of the conventional standard of treatment. 

A significant gap exists with programs focusing on the transition from post-acute 

rehabilitation to independent community living. 

Community re-integration programs (CR) or independent living programs (IL) are 

crucial to the quality of life for disabled veterans and their families. These programs 

provide a vital role within the rehabilitation process. By promoting the transfer of 

skills learned during acute and post-acute rehabilitation, individuals learn how to 

apply and generalize those skills within the community through CR/IL programs. 

Successful CR/IL includes the following constructs to be present in one’s life: independent living aspects (self care, daily routine, compensatory strategies); productivity/occupation (meaningful and productive focus); socialization and social supports 

(supportive network, leisure activities); and general integration factors (housing, 

community involvement and satisfaction with quality of life) (Karlovits & McColl, 

1999). 

The next step is to develop a CR/IL prototype that will become part of the standard of care for disabled veterans to promote independence and self-sufficiency, thus 

successful community re-entry. 

The Hope Project Overview 

The Hope Project, developed by the National Rehabilitation & Rediscovery Foundation (NRRF) in 2006, is a transitional community reintegration/independent living 

program designed to provide disabled veterans and their families with a comprehensive, community-integrated program to increase independence and self-sufficiency 

within a learning environment. This unique program focuses on the transition from 

post-acute rehabilitation to long-term community living and incorporates the constructs that constitute successful independence and re-entry into the community. 

Improving the success of CR/IL for disabled veterans is essential to allow them to 

be productive members of their families, communities, and society. 

Through a series of six courses, taught over a 9 month period at Virginia Tech, 

Northern Virginia Center, individuals partake in classes to learn about lifespan 

issues related to the long-term needs post TBI, PTSD, and traumatic amputation. 

Family education and involvement is highly encouraged during this process. Two 

courses are offered each semester. The program includes the following curriculum: 

Fall Semester 

Module I—self care, self reliance, and compensatory strategy development 

Module II—daily routine development 

Spring Semester 

Module III—health, leisure education, and socialization 

Module IV—productive focus 


wwoods2 on PRODPC68 with HEARING
56 

Summer Semester 

Module V—support team development (family involvement/participation) 

Module VI—practicum and mentoring opportunity 

Program Impact 

• The Hope Project has been documenting the vital importance of this prototype 

as part of the standard of care within TBI rehabilitation 

• The Hope Project is advancing the high quality of treatment for disabled veterans with TBI and is documenting the program’s efficacy 

• The Hope Project will give rise to the development of a model CR/IL program 

that can be replicated within communities where disabled veterans reside augmenting and complementing the exceptional services that currently exist within 

the Department of Defense and the Department of Veterans Affairs 

Partnerships and Adjunct Services 

Partnerships and adjunct services include Virginia Tech, Northern Virginia Center, Department of Marriage and Family Therapy to provide individual, couples, and 

family therapy services as well as a family support group and graduate level interns. Virginia Tech Department of Adult Learning is collaborating with NRRF to 

collect data regarding the efficacy of the program and to conduct the program evaluation. Virginia Tech is also providing classroom space as an in-kind contribution 

to ensure program success. 

NRRF collaborates and coordinates with multiple disciplines including academia, 

industry, military services, and the U.S. Department of Veterans Affairs. Partnerships with local industry are on-going for practicum and employment opportunities 

for participants at the completion of the program. 

Program Director 

Marianne Talbot, Ph.D., is the Program Director and President of NRRF. Dr. Talbot earned her Ph.D. in Human Development from the Virginia Tech. She has a 

Master of Arts in Education and Human Development from the George Washington 

University in Washington, D.C., and a Bachelor of Arts from Eckerd College in St. 

Petersburg, Florida. She has national certifications as a Rehabilitation Counselor 

(CRC), Case Manager (CCM), Rehabilitation Provider (CRP), and Movement Analyst 

(CMA). During her master’s level internship, Dr. Talbot worked at the National Institutes of Health (NIH) in the clinical neuropsychology section administering psychometric tests and collaborating with the neurosurgery section on research protocols. Dr. Talbot has 22 years of experience working in neuro-rehabilitation. Additionally, she serves on several boards and Committees and is President of the 

Northern Virginia Brain Injury Association. 

References 

Centers for Disease Control and Prevention (CDC). (1999). Traumatic brain injury 

in the United States: A report to Congress. 

Karlovits, T. & McColl, M. (1999). Coming with community reintegration after severe brain injury: A description of stresses and coping strategies. Brain Injury, 13, 

845–861. 

National Institutes of Health (NIH). (1999). Rehabilitation of persons with traumatic brain injury. Journal of American Medical Association, 282, 974–983. 

Final Report on the President’s Commission on the Care for America’s Wounded 

Warriors (July, 2007). 

Richter, R. (Summer, 2007). Fog of war: One soldier’s struggle with Iraq’s trademark injury. Stanford Medicine, 20–24. 

Tanielian, T, Jaycox, L.H., Schell, T.L., Marshall, G.N., Burnam, M.A., Eibner, C., 

Karney, B.R., Meredith, L.S., Ringel, J.S., & Vaina, M.E. (2008). Invisible wounds 

of war: Summary and recommendations for addressing psychological and cognitive 

injuries. RAND Corporation. 

Thurman, D., Alverson, C., Dunn, K., Guerrero, J., & Sniezek, J. (1999). Traumatic brain injury in the United States: A public health perspective. Journal of 

Head Trauma Rehabilitation, 14, 602–615

f 

. 


wwoods2 on PRODPC68 with HEARING
57 

Committee on Veterans’ Affairs 

Subcommittee on Economic Opportunity 

Washington, DC 

July 11, 2008 

Ms. Ruth Fanning 

Director 

Vocational Rehabilitation and Employment Service 

U.S. Department of Veterans Affairs 

810 Vermont Avenue, N.W. 

Washington, D.C. 20420 

Dear Ms. Fanning: 

In reference to our House Committee on Veterans’ Affairs Subcommittee on Economic Opportunity hearing on ‘‘Independent Living Program’’ on July 10, 2008, I 

would appreciate it if you could answer the enclosed hearing questions by no later 

then August 11, 2008. 

In an effort to reduce printing costs, the Committee on Veterans’ Affairs, in cooperation with the Joint Committee on Printing, is implementing some formatting 

changes for material for all Full Committee and Subcommittee hearings. Therefore, 

it would be appreciated if you could provide your answers consecutively on letter 

size paper, single-spaced. In addition, please restate the question in its entirety before the answer. 

Due to the delay in receiving mail, please provide your response to Ms. Orfa 

Torres by fax at (202) 225–2034. If you have any questions, please call (202) 225– 

3608. 

Sincerely, 

Stephanie Herseth Sandlin 

Chairwoman 

Questions for the Record 

The Honorable Stephanie Herseth Sandlin 

Chairwoman 

Subcommittee on Economic Opportunity 

House Committee on Veterans’ Affairs 

July 10, 2008 

Independent Living Program 

Question 1: How many veterans were recommended by counselors for the Independent Living Program in fiscal year 2004, 2005, and 2006? 

Response: Data on the number of veterans with independent living (IL) plans are 

available from fiscal year (FY) 2005 forward. Tracking procedures were implemented at that time to track new plans against the 2,500 cap. Total IL plans per 

year include cases that have been re-evaluated for changes in plan or have been 

transitioned from an employment plan to a program of independent living services. 

Data for both new plans and total plans by year is as follows: 

Fiscal Year New IL Plans Total IL Plans 

2004 Data not available 3,545 

2005 2,588 3,667 

2006 2,213 3,129 

Question 2: How often does the VA exceed the 24-month time in providing services to veterans? 

Response: From FY 2004 through FY 2006, 13 percent of independent living 

plans exceeded the 24-month timeframe. IL plans may be extended for an additional 


wwoods2 on PRODPC68 with HEARING
58 

6 months if circumstances require an extension. Such extensions require a second 

level managerial review and approval. 

Question 3: What is the average time for a response when a veteran calls the 

VA to check on the status of an application? 

Response: Vocational Rehabilitation and Employment (VR&E) does not track response time of routine inquires concerning status of claims. All Veterans Benefits 

Administration’s (VBA) regional offices have toll free lines staffed with trained customer service personnel versed in all VBA benefits information. Phone counselors 

are trained to provide immediate feedback regarding the status of pending claims. 

If claims have not yet been logged into the regional office’s computer information 

system, customer service operators are able to transfer calls to the appropriate 

VR&E office for status information. Regional office VR&E operations are staffed 

with personnel equipped to immediately research and provide status information. 

Question 4: When was the last time that the office Mr. McCartney dealt with 

was visited for quality assurance and how did the office rate? 

Response: The last VR&E quality assurance oversight survey of the Atlanta Regional Office was in June 2007. A rating is not provided as a part of the site visit 

protocol. Instead, offices are provided specific feedback regarding management and 

operational issues geared toward the improving the service provided. The Atlanta 

Regional Office quality oversight survey included three commendable findings and 

five action items. Overall, the survey identified no significant findings except the 

need for increased frequency of case management meetings. 

Results of the survey included commendations for: 

• effective operational management, 

• effective fiscal oversight, 

• effective working partnerships with the employment community leading to increased job opportunities for veterans, and 

• effective working relationships with the military leading to strong outreach with 

resulting early intervention for service connected disabled servicemembers 

exiting the military. 

Action items included: 

• information technology (IT) enhancements to improve out-based counselors’ access to computer systems, 

• consistency of data entry, 

• consistently informing veterans in writing regarding entitlement determinations, 

• consistency in using required worksheets for documenting evaluation and planning actions, and 

• increased frequency of case management meetings. 

Question 5: What happens after the veteran is not part of the Independent Living Program and becomes unemployed once again and needs assistance? Can the 

veteran see a counselor or will the veteran need to reapply for the program once 

again? 

Response: Veterans who participate in total programs of independent living services include individuals who are so severely disabled that they could not feasibly be 

employed will not have been determined infeasible for employment due to the severity of disability conditions. However, as a part of an independent living program, 

veterans may obtain volunteer employment or part-time employment that is within 

their ability to perform. The optimal goal of the independent living program is to 

assist each veteran in overcoming his or her disabilities to the extent that they become feasible and can pursue services that result in gainful employment. 

A veteran who has been determined to be infeasible may reenter vocational rehabilitation services within 1 year without reapplying for services. Past the 1 year 

point, a veteran may also file an informal claim via telephone or letter. A VR&E 

counselor will contact him or her to discuss further assistance needed. Any time a 

veteran becomes unemployed after VR&E makes a rehabilitation determination or 

if the veteran discontinues participation in the VR&E program, he or she may reapply and a VR&E counselor will work with him or her to determine further rehabilitation needs leading to reemployment. Even if the veteran’s delimiting date has 

passed, VR&E may provide employment services; if the veteran has a serious employment handicap, the delimiting period may be waived and the veteran may be 

provided whatever services are determined necessary to successful rehabilitation. 

Æ 


wwoods2 on PRODPC68 with HEARING