Veterans Affairs: Opportunities Exist to Improve Potential Recipients' Awareness of the Temporary Residence Adaptation Grant
Published: 2010-07-15T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: Adaptive housing assistance grants help eligible service members or veterans adapt or modify a residence to accommodate disabilities sustained through military service. The Veterans' Housing Opportunity and Benefits Improvement Act of 2006 authorized the Department of Veterans Affairs (VA) to expand its existing adaptive housing assistance grants to include eligible individuals temporarily living in a home owned by a family member, known as Temporary Residence Adaptation (TRA) grants. The act also mandated GAO to issue interim and final reports on VA's implementation of TRA. This final report examines (1) the characteristics of TRA grants and grantees and (2) what accounts for low utilization of the program and how to ensure that the program serves its intended recipients. To address these objectives, GAO analyzed VA data and documents and interviewed service members and veterans who both had and had not used the TRA grant.
section_title: What GAO Found
paragraphs: Use of the TRA grant program has been low--from the program's inception on June 15, 2006, through April 4, 2010, VA processed only 18 TRA grants. Therefore, only a very small proportion of the thousands of individuals potentially eligible for adaptive housing assistance have used TRA. Half of these grantees were under the age of 40 and half were over the age of 40. The average age of those under 40 was 26 years. Among those over 40, seven were over the age of 60. Of the 11 TRA grantees we interviewed, all had lost the use of both legs, and most also had other disabilities, such as brain trauma. Three of the grantees we interviewed were injured abroad while serving in Operation Iraqi Freedom, four grantees were injured domestically in a vehicle or sporting accident, and four grantees suffered an illness, such as multiple sclerosis. Of the 18 TRA grants that had been awarded, 11 were for the maximum allowable amount of $14,000, and 3 others were near that maximum. In some cases, the cost of adaptations exceeded the amount of the TRA grant and was supplemented by donations, other grants, or the grantee's own funds. Interviews we conducted with 50 service members and veterans eligible for adaptive housing benefits suggest that awareness of TRA may be low and that the program may not be reaching all of the individuals who could benefit from it. While most of the 50 interviewees were familiar with adaptive housing benefits in general, 38 were not familiar with the TRA program in particular and did not know that adaptive housing grants can be used to modify a home owned by a family member. In addition, while TRA was not applicable for the personal circumstances of many of the interviewees, in seven cases individuals described personal circumstances well suited for use of TRA and said they likely would have used the TRA program had they previously been aware of it. An additional seven said they would have at least considered using the program had they been aware of it. The extent to which TRA is addressed in VA's information sources about adaptive housing benefits is limited--for example, VA does not have a separate fact sheet for TRA, and it is unclear how consistently VA representatives publicize the opportunity to use TRA when conducting outreach to and interviews with service members and veterans. One of the stated core values of the VA office that administers TRA is to communicate to veterans in a timely, thorough, and accurate manner. A better understanding is needed of potential information gaps that may be occurring when severely disabled service members transition to civilian life and when veterans are informed about adaptive housing benefits. Additional efforts to make eligible individuals better aware of the TRA grant program could help ensure that the program more fully serves its intended beneficiaries.
section_title: What GAO Recommends
paragraphs: GAO recommends that VA evaluate current methods of communicating information about TRA grants to eligible individuals and take appropriate measures to improve awareness of the program among such individuals. VA agreed with GAO's recommendations and described actions to address them.

section_title: Letter
paragraphs: As of June 2010, more than 38,000 service members had been wounded in  action as part of Operation Enduring Freedom or Operation Iraqi  Freedom. Congress has enacted several laws to help service members  adjust to their injuries and successfully transition to civilian life after  serving in the military. Among the benefits available to service members  and veterans are adaptive housing grants, which help eligible individuals  adapt or modify a residence to accommodate disabilities sustained during  military service.
The Veterans’ Housing Opportunity and Benefits Improvement Act of 2006  authorized the Department of Veterans Affairs (VA) to expand its existing  adaptive housing assistance grants to include eligible individuals  temporarily living in a home owned by a family member, known as  Temporary Residence Adaptation (TRA) grants. Section 101 of the act  mandated us to submit an interim report by June 15, 2009, and a final  report by June 15, 2011, on VA’s implementation of TRA. In June 2009, we  issued our interim report, which provided information on TRA grants,  grant recipients, and VA’s policies and processes for administering TRA.  This final report examines (1) the characteristics of TRA grants and  grantees and how TRA grants have been used and (2) what accounts for  service members’ and veterans’ low utilization of the TRA grant program  and what, if anything, could be done to ensure that the program serves its  intended recipients.
To address these objectives, we collected and analyzed VA data on TRA  grants and grantees, reviewed VA’s individual case files on these grantees,  and conducted individual interviews with the majority of TRA grantees to  learn about their use of the grants. We also conducted telephone  interviews with 50 service members and veterans under the age of 35 who  had qualified for adaptive housing benefits but had not applied for TRA.  These 50 interviewees consisted of two nonprobability samples, one of 25  individuals who had applied for adaptive housing and one of 25 individuals  who were eligible for adaptive housing but had not applied. We also  spoke with VA staff, a veterans service organization, and officials from the joint VA-Department of Defense (DOD) Federal Recovery Coordina tion  Program. For a detailed description of our scope and methodology, see  appendix I.
We conducted our work between August 2009 and July 2010 in accordance  with generally accepted government auditing standards. Those standards  require that we plan and perform the audit to obtain sufficient, appropriate  evidence to provide a reasonable basis for our findings and conclusions  based on our audit objectives. We believe that the evidence obtained  provides a reasonable basis for our findings and conclusions based on our  audit objectives.
subsections: section_title: Background
paragraphs: Since 1948 VA has provided adaptive housing assistance grants to eligible  individuals who have certain service-connected disabilities to construct an  adapted home or modify an existing home to accommodate their  disabilities. Today, VA provides adaptive housing assistance primarily  through two programs—Specially Adapted Housing (SAH) and Special  Housing Adaptation (SHA).
The SAH grant program provides financial assistance to service members  and veterans who are entitled to compensation for permanent and total  service-connected disability due to the loss or loss of use of multiple  limbs, blindness and limb loss, or a severe burn injury. In general, eligible  individuals may receive up to three SAH grants totaling no more than 50  percent of the cost of constructing or acquiring a specially adapted house  or remodeling an existing house with adaptations. As shown in table 1, the  maximum aggregate grant amount was $63,780 for fiscal year 2010 and is  adjusted annually based on a cost-of-construction index. Grants may be  used to construct a house or remodel an existing house, or they may be  applied against the unpaid principal mortgage balance of a specially  adapted house. The SHA grant program is similar to SAH but is for  individuals with slightly less severe disabilities and may be used for  slightly different purposes; for fiscal year 2010, the maximum amount was  $12,756, which also is adjusted annually based on a cost-of-construction  index. SAH and SHA are administered by VA’s Veterans Benefits  Administration.
In 2006 Congress created the TRA benefit, which allows veterans to apply  for a grant to adapt a home owned by a family member with whom they  are temporarily residing. The benefit was further extended to active-duty  service members with the passage of the Housing and Economic Recovery  Act of 2008. The TRA grant program enables service members and  veterans eligible under the SAH and SHA programs to use up to $14,000  and $2,000, respectively, to modify a family member’s home. As shown in  table 1, a TRA grant can only be used once and counts as one of the three  grants allowed under either SAH or SHA. TRA grants also count toward  the maximum allowable amount, $63,780 under SAH and $12,756 under  SHA. The TRA grant program will expire on December 31, 2011, unless  Congress extends it before then.
section_title: Use of TRA Has Been Low and TRA Grantees Include Both Younger and Older Veterans
paragraphs: Only 18 TRA grants have been used since the inception of the program.  The age of these grantees and the cause of their disabilities varied, and the  majority of the grantees have used the maximum allowable TRA grant  amount of $14,000, although some adaptations have cost more than this  amount.
subsections: section_title: The TRA Grant Program Has Not Been Widely Used
paragraphs: Use of the TRA grant program has been low—since the TRA program’s  creation on June 15, 2006, through April 4, 2010, VA has processed a total  of 18 TRA grants. Of these, four grants were processed in 2007, five grants  in 2008, eight grants in 2009, and one grant in 2010, as of April 4. While  comprehensive data are not available on the total number of service  members and veterans who have a disability rating qualifying them for  adaptive housing assistance, our analysis of VA data indicates that this  number is well in excess of 10,000. As a result, only a very small  proportion of those potentially eligible for adaptive housing assistance  have used TRA. Because VA does not track the specific living  arrangements of individuals eligible for adaptive housing benefits, it is not  known how many of these individuals would have also met the criteria  that would be required specifically to receive a TRA grant.
section_title: TRA Grantees Include Both Younger and Older Veterans and the Causes of Their Disabilities Vary
paragraphs: As shown in table 2, the age of the 18 TRA grant recipients when they were  approved for a grant ranged from 23 to 92. Half of these grantees were  under the age of 40 and half were over the age of 40. The average age of  those under 40 was 26 years. Among those over 40, seven were over the  age of 60. In addition, of the 16 grantees for whom a discharge date was  available, 7 had been discharged prior to 1974.
All 18 TRA grantees qualified under the SAH (rather than SHA) grant  program, which, as noted earlier, is for individuals with more severe  service-connected disabilities. According to the 11 grant recipients or their  caregivers with whom we spoke, all of the grantees had lost the use of  both legs and required the use of a wheelchair or walker. Some of these  grantees suffered from a spinal cord injury, and one was paralyzed from  the neck down. In addition, three grantees suffered from brain trauma and  one from a hearing impairment. The cause of the disabilities varied among  the 11 grantees. Three of the grantees were injured abroad while serving in  Operation Iraqi Freedom, four grantees were injured domestically in a  vehicle or sporting accident, and four grantees suffered an illness, such as  multiple sclerosis.
Five of the 11 TRA grantees we spoke with used the grant to adapt the  home of a parent, 2 to adapt the home of a son or daughter, and 4 to adapt  the home of another relative, such as an uncle or sibling. Nine of the 11  grantees still lived in their relative’s adapted home at the time we  contacted them, and in some cases, the grantee or caregiver indicated the  grantee would likely continue to live there for an extended period of time.  Five caregivers told us the grantee was unable to care for himself or  herself and would likely require long-term live-in assistance. Four other  grantees told us that they lived independently or planned to do so in the  future. For example, one grantee lived with his parents for about 2 months  while he recovered from injuries and subsequently purchased his own  home. Another grantee continued to live in the home owned by her  brother but was able to live independently.
section_title: The Majority of the TRA Grantees Used the Full Grant Amount
paragraphs: As shown in table 3, the dollar amount of the 18 TRA grants that had been  processed as of April 4, 2010, ranged from $3,575 to $14,000. Eleven of  these grants were for the maximum allowable amount of $14,000, and  three others were near that maximum. Our review of VA’s case files found  that in 8 of 18 cases, the cost to adapt the relative’s home, as recorded in  the file, exceeded $14,000. For example, in one case, the cost to adapt a  bedroom and bathroom was $62,115. According to the file, the TRA grant  was supplemented by a grant of $23,865 from a nonprofit organization, and  the grantee paid the remaining uncovered cost of $24,250. In another case,  the cost of adapting a bathroom, replacing a sliding door, building a  platform in the sun porch, and adding a ramp to the exterior door was  $24,500. According to the file of this grantee, $10,500 not covered by TRA  was funded by the grantee’s uncle and by donations from contractors.
Some TRA grantees made adaptations to a home prior to using the TRA  grant. The cost of those adaptations would not necessarily be included in  VA’s case file and thus would not be reflected in table 3. For example, a  caregiver of a grantee told us that prior to using the TRA grant, the family  spent more than $50,000 installing hardwood flooring throughout the  house to make it wheelchair accessible.
We were not able to identify comprehensive and up-to-date data on the  typical costs for adapting a home to accommodate severe disabilities like  those experienced by individuals eligible for adaptive housing grants.  However, VA’s 2004 Report to Congress: Assessment of the Adequacy of  VA Authorities to Provide Specially Adaptive Housing provided some  information on typical costs for making certain home adaptations. The  report cited the typical cost for adapting a bathroom to make it  handicapped accessible as $22,000, which included installing a bidet that  washes and dries, a toilet or urinal with an automatic flush sensor, and a  shower or bathtub with automatic soap and shampoo dispensers. The  typical cost to adapt a kitchen was cited as $8,000, which included  installing an automatic shut-off stove, raising a dishwasher, lowering  countertops, and installing a side-by-side refrigerator. The report also  noted that the cost of widening four doorways, which a typical home  might require, was $2,400. The VA report did not address the TRA program  in particular, but it did note that the SHA grant amount of $12,000 would  typically not cover the full cost of adaptations needed to accommodate a  grantee’s disabilities.
The median number of days from the submission of a grant application to  VA’s approval of the 12 grants approved after June 15, 2006, was 299, with  a range from 34 to 641 days. After a veteran or service member submits  an application for adaptive housing assistance and decides to take  advantage of the benefit, he or she must make a number of decisions  related to the project—including arranging for mortgage and construction  financing, hiring architects, working with VA to review and approve  adaptation plans, and soliciting bids from and selecting contractors— before VA approves the grant. VA staff told us that the length of time from  application to approval is often driven by the amount of time needed by  the recipient for project design.
After VA approves a veteran’s or service member’s grant, construction  begins on the project. Among the 16 TRA grants for which construction  was completed as of April 4, 2010, the construction phase of the grant  process—that is, the period between the grant approval date and VA’s final  payment for services—ranged from 20 days to 233 days, with a median of  45 days. Most of the TRA grantees or their caregivers with whom we spoke  generally said that once the grant was approved, they did not experience  any problems in the construction phase of the grant process.
section_title: Most Individuals We Spoke with Were Unaware of TRA, and Some Could Have Benefited from the Program
paragraphs: To explore the underlying reasons for low use of TRA, we interviewed 50  service members and veterans under the age of 35 who were eligible for  adaptive housing but had not used TRA. Half these individuals had applied  for some form of adaptive housing assistance and half had not.
subsections: section_title: Awareness of TRA May Be Low
paragraphs: Our interviews suggest that awareness of the TRA grant program may be  low among service members and veterans eligible for adaptive housing  benefits. Of the 50 service members and veterans we spoke with, most  were familiar with adaptive housing benefits in general, but 38 of the 50  were not familiar with the TRA program in particular, and they did not  know that adaptive housing grants can be used to modify a home owned  by a family member. Ten individuals—nine of whom had applied for  adaptive housing—were familiar with TRA, and two said they were unsure  as to the extent to which they were familiar with the program.
There are a variety of mechanisms through which individuals can learn  about adaptive housing benefits. VA benefits counselors, SAH agents, and  military services coordinators—who work directly with offices on military  installations that provide education, medical, family and personal  counseling—may speak individually with injured service members and  provide information on adaptive housing. VA military services  coordinators also typically assist in conducting Transition Assistance  Program and Disabled Transition Assistance Program briefings, which  may cover housing benefits, among other things, to service members in the  process of being discharged. Participation by service members in these  briefings is voluntary and consists of 3-day seminars conducted by VA,  DOD and the Department of Labor at military installations for personnel  within 1 year of separation from the military or 2 years of retirement.  Additionally, DOD Recovery Care Coordinators and Federal Recovery  Care Coordinators, both of whom oversee recovery plans for injured  service members, also provide information about relevant benefits, which  could include adaptive housing. Further, DOD’s Wounded Warrior  programs offer recovering service members and their family assistance  with medical and nonmedical support, the latter of which can include  information about adaptive housing benefits. In addition to these federal  agencies, veterans service organizations—such as Paralyzed Veterans of  America and Disabled American Veterans—offer a wide range of  assistance to veterans and their dependents, which can include informing  veterans about benefits available to them and assisting with the  application process.
The Veterans Benefits Administration’s mission is to provide benefits to  veterans and their families in a timely and responsive fashion and one of  the agency’s stated core values is to communicate to veterans in a timely,  thorough, and accurate manner. With regard to adaptive housing, VA sends  annual letters to eligible individuals reminding them of the availability of  adaptive housing benefits and offering the opportunity to speak with a VA  representative. When an eligible individual applies for adaptive housing  benefits, a VA representative typically visits that individual to conduct an  interview and provide additional information. In addition, VA’s Web site  includes fact sheets on the SAH and SHA programs that provide  information on topics such as eligibility requirements, use of the grants,  and how to apply for the benefits.
However, while eligible service members and veterans have various means  through which they can learn about adaptive housing in general, the extent  to which they are informed about TRA in particular is unclear. Of the 50  individuals we spoke with who were eligible for adaptive housing but had  not used TRA, 43 said they could not recall ever receiving information  about the program from VA or other sources. Even among those who had  applied for adaptive housing—and thus presumably had been briefed on  the options available—the majority were not familiar with TRA. As noted  earlier, we also spoke with 11 service members and veterans who had  used TRA grants. In those interviews, we found that 8 of the 11 grantees  learned about the TRA grant through VA—for example, through a case  manager or representative providing documentation describing the  grant—and the other 3 grantees learned about the program while  conducting their own research on adaptive housing assistance.
The extent to which TRA is addressed in VA’s information sources about  adaptive housing benefits is limited. VA’s Web site includes fact sheets for  SAH and SHA, but there is no separate fact sheet for TRA. Fact sheets for  those two programs do list TRA as an option for how the grants can be  used, but the specific information provided is not comprehensive. For  example, the fact sheets include the maximum TRA grant amount  available but do not mention that the grant may only be used once.  Additionally, the grant is referred to as a “temporary grant,” but the fact  sheets never provide the formal name of the benefit, Temporary Residence  Adaptation, which could limit potential applicants’ ability to find the  program using an electronic word search. As noted earlier, VA sends  annual outreach letters to individuals eligible for adaptive housing  assistance reminding them of the availability of their benefits, but a recent  sample outreach letter we reviewed did not contain information on TRA.  VA officials told us that when TRA was created in 2006, a one-time letter  was sent out to individuals eligible for adaptive housing notifying them of  the availability of the benefit.
VA officials told us that when VA representatives conduct an interview  with an individual who has applied for adaptive housing assistance, they  typically provide information about the TRA option. However, the extent  to which this information is consistently or comprehensively provided is  unclear. For example, until recently VA did not include TRA in the  checklist of items that representatives were to cover when conducting the  interview.
Additionally, VA conducts comprehensive annual surveys of SAH grantees  to measure their satisfaction with various areas of the program. VA also  conducts annual surveys of individuals who are eligible for an SAH grant  but have not applied, focusing on the reasons these individuals have not  applied for a grant and the barriers they may face in learning about the  program. In 2009 survey results provided to us by VA, 88 percent of  respondents said they had been aware of SAH prior to receiving the  survey. To date, these surveys have not specifically included questions  about TRA because, according to VA officials, the agency must obtain  approval from the U. S. Office of Management and Budget prior to  changing its survey tool. VA officials told us that they anticipate including  questions about TRA in the 2010 surveys.
section_title: Our Interviews Found Veterans Who Could Have Benefited from TRA
paragraphs: In our 50 interviews with service members and veterans who had not used  TRA, 7 individuals or their caregivers described personal circumstances  well suited for use of TRA. In five of the seven cases, the individuals were  not aware of TRA until we described the benefit to them. In the other two  cases, the individual or caregiver became familiar with TRA only after  adaptations to a relative’s home had already been made. In all seven cases,  including the following examples, the individual or caregiver told us that  they think they would have used the TRA program had they previously  been aware of it.
A veteran of Operation Iraqi Freedom who was injured in an ambush  attack said that he lived in a home owned by his mother and father from  November 2006 through March 2009. He said that his parents paid to adapt  part of the bathroom and add a ramp to the home, and that had he known  about TRA he would have used it to help pay for the adaptations.
A service member lived with his mother for a little over a year after  sustaining injuries in a motor vehicle accident and becoming paralyzed in  July 2008. He told us that his mother made $15,000 in adaptations to her  home and that, had he been aware of TRA, he could have used the grant to  help pay for the adaptations.
The mother of a veteran who was also injured in a motor vehicle accident  told us that her son lived with her for about 6 months and that she paid  approximately $2,000 to $3,000 to add a ramp and widen doorways in the  mobile home she owned. She said that she would have had her son apply  for TRA to pay for the adaptations.
A veteran of Operations Iraqi Freedom and Enduring Freedom who was  paralyzed in a training exercise said that he lived with his parents for  about a year while recovering from his injuries, and that his parents spent  between $40,000 and $50,000 to widen doorways and add a ramp, chair-lift,  and roll-in shower. The veteran said that had he known about it, the TRA  grant probably would have been useful to offset the cost of the  adaptations.
In addition to those cases, another seven individuals, including the  following examples, told us that had they been aware of TRA, they would  have at least considered using the grant.
A quadriplegic veteran we spoke with was in the process of jointly  purchasing a house with his parents so he could use an SAH grant, which  requires the veteran to be at least partial owner of the home. However, he  said that had he been aware of TRA, he would have considered using it to  make adaptations to his parents’ current home, where he presently  resides.
Another quadriplegic veteran said that had he been aware of TRA, he  would have considered using it to modify his father’s home, which wasn’t  wheelchair accessible, instead of living with his grandmother for 8  months.
A service member who was injured in Operation Iraqi Freedom and is in  the process of retiring from the military stated that he would have  considered using a TRA grant to live with his mother for a period of time.
An additional three veterans or their caregivers, including the following  examples, told us they could envision using TRA at some point in the  future, and two of these three had not been previously aware of TRA until  we described the program to them.
The mother and caregiver for a veteran who was paralyzed in a car  accident told us that her son needs constant care and will continue to live  with her for an extended period of time. She said she could envision using  the TRA benefit now that she was familiar with it.
The grandmother and caregiver for a veteran who suffers from an immune  system disorder told us that her grandson’s condition will likely worsen.  She said he will continue to need to live with relatives and might use TRA  at some future time.
Of the 50 individuals we interviewed, many told us that TRA was not  applicable to their personal circumstances. For instance, a little less than  half of the interviewees said they did not use TRA—or would not have  used it had they been aware of it—because they owned their own home,  did not live or want to live with family, or did not need or want to make  adaptations to a family member’s home. Additionally, three veterans we  spoke with said that they did not use TRA in part because it would have  counted against the overall maximum amount allowable to them for  adaptive housing. They said they would rather use their adaptive housing  benefits on a home they owned than on a temporary residence. Finally,  one veteran and one caregiver each said they had not applied for adaptive  housing benefits in general because they believed VA’s process could be  difficult or very time-consuming.
section_title: Conclusions
paragraphs: Use of the Temporary Residence Adaptation grant program among  individuals eligible for adaptive housing remains low. Our interviews with  50 individuals who had not used TRA, while not statistically generalizable,  suggest that many eligible individuals may not be familiar with the  program. The Veterans Benefits Administration’s mission is to provide  benefits to veterans and their families in a timely and responsive fashion  and one of the agency’s stated core values is to communicate to veterans  in a timely, thorough, and accurate manner. While VA has a variety of  mechanisms to provide service members and veterans with information  about adaptive housing benefits in general, it is unclear to what extent the  agency provides information specifically on TRA. As a result, the program  may not be reaching all of the individuals who could benefit from it.  Moreover, several of the individuals we interviewed appeared to be in a  position to use and benefit from the program. More information is needed  on why eligible service members and veterans may not be familiar with the  TRA program. Specifically, a better understanding is needed of potential  information gaps that may be occurring when severely disabled service  members transition to civilian life and when veterans are informed about  adaptive housing benefits. Additional efforts to make eligible individuals  better aware of the TRA grant program could help ensure that the program  more fully serves its intended beneficiaries.
section_title: Recommendations
paragraphs: To help ensure that the TRA program serves its intended beneficiaries to  the greatest extent possible, we recommend that the Secretary of Veterans  Affairs direct the Under Secretary for Benefits to    evaluate the current methods of communicating information about the  TRA grant to eligible individuals, and take appropriate measures to improve awareness of the program among  such individuals.
section_title: Agency Comments
paragraphs: We provided a draft of this report to VA and DOD for their review and  comment. In its comment letter, which is reprinted in appendix II, VA said  that it concurred with our conclusions and recommendations. The agency  stated that in the fourth quarter of fiscal year 2010, it will conduct an  evaluation of its internal and external communications with service  members and veterans about the TRA grant, as well as the media and  technology used to communicate with potential grant recipients. VA also  said that beginning in the first quarter of fiscal year 2011, it will identify  ways to improve service members’ and veterans’ awareness of TRA grants,  which will include an investigation of the applicability of marketing and  communication tools employed by other agencies and companies to  disseminate information. VA also provided technical comments that we  incorporated as appropriate. DOD had no comments on the draft report.
We are sending copies of this report to the Secretaries of Veterans Affairs  and Defense and interested congressional committees. In addition, the  report will be available at no charge on GAO’s Web site at  http://www.gao.gov.
If you or your staffs have any questions about this report, please contact  me at (202) 512-8678 or sciremj@gao.gov. Contact points for our Offices of  Congressional Relations and Public Affairs may be found on the last page  of this report. GAO staff who made major contributions to this report are  listed in appendix III.
section_title: Appendix I: Scope and Methodology
paragraphs: To describe the characteristics of Temporary Residence Adaptation (TRA)  grants and grantees and how the grants have been used, we analyzed  Department of Veterans Affairs (VA) data on selected characteristics of  TRA grants and grantees for the period between June 15, 2006 (the date  TRA was created) and April 4, 2010. In responding to our data request, VA  headquarters staff gathered information on approved TRA grants from the  VA Regional Loan Centers and compared it to the information in its  SAHSHA system to ensure the grants were in fact approved and  processed.
To estimate the number of service members and veterans who may be  eligible for adaptive housing assistance, we analyzed data from VA’s  SAHSHA system on the number and selected characteristics of individuals  who applied for such assistance between October 1, 2000, and October 31,  2009. We also analyzed data from VA’s Veterans Service Network on the  number and selected characteristics of service members and veterans who  had not used the benefit but who received a rating that qualified them for  adaptive housing assistance between October 1, 2003, and October 31,  2009. VA could not provide the number of individuals who received a  rating that made them eligible for adaptive housing assistance from fiscal  years 2001 through 2003 because VA did not consistently track such  information until fiscal year 2004. In addition, because VA does not track  the living arrangements of individuals eligible for adaptive housing  benefits, we could not estimate the number of individuals who may have  met the criteria specifically required to receive a TRA grant—that is,  individuals who lived or planned to live with a relative who owns a home.  We assessed the reliability of the data we received from VA by reviewing  relevant documentation, interviewing knowledgeable officials, and  performing electronic testing of the data. We determined that the data  were reliable for the purposes of this report.
We also reviewed VA’s case file, which included construction contracts  and invoices describing work performed, for each of the 18 individuals  who had received a TRA grant as of April 4, 2010. In addition, we  interviewed 11 of the 18 TRA grantees, or their caregivers, to obtain  information on their use of the grant, the nature of their disabilities, their  living circumstances, and any barriers they may have faced in using the  grant. Five of the interviews were with the grantee and six were with the  grantee’s caregiver. In addition to the grantees we interviewed, three  grantees were deceased and four others declined to speak with us. We  obtained information on those seven grantees, as available, from their VA  case files and VA data.
To determine what accounts for service members’ and veterans’ low  utilization of the TRA grant program and what, if anything, could be done  to ensure that the program serves its intended recipients, we conducted  telephone interviews with 50 service members and veterans who had  qualified for adaptive housing benefits but had not applied for TRA. These  interviews were comprised of (1) a nonprobability sample of 25  individuals who had applied for adaptive housing between July 1, 2006  (after the creation of TRA) and October 31, 2009, and (2) a nonprobability  sample of 25 individuals who became eligible for adaptive housing  between July 1, 2006, and October 31, 2009, but had not applied for the  benefit. We limited our selection to individuals who were under the age of  35 because we believed that younger veterans would be more likely to  potentially live temporarily with a family member, as required to receive a  TRA grant.
Applying these criteria resulted in 516 individuals who had applied for  adaptive housing benefits and 97 who had not. From each of these two  categories, we randomly selected 50 individuals and began contacting  these individuals (up to 3 attempts per individual to reach them and  conduct an interview) until we completed our target of 25 interviews from  each list, resulting in a total of 50 interviews. Forty-three of our  interviewees were veterans, 5 were service members, and 2 were service  members on the Temporary Disability Retired List.
In addition to our interviews, we reviewed documentation from VA,  including the agency’s policies and procedures on use of adaptive housing  benefits, examples of outreach and informational documents, and its  annual surveys of the Specially Adapted Housing Grant Program. In  addition, we reviewed documentation on the Department of Defense’s  Recovery Care Coordinator and Wounded Warrior programs, as well as the  Federal Recovery Coordination Program. Finally, we conducted interviews  with staff from VA, a veterans service organization, and the Federal  Recovery Coordination Program.
We conducted this performance audit between August 2009 and July 2010  in accordance with generally accepted government auditing standards.  Those standards require that we plan and perform the audit to obtain  sufficient, appropriate evidence to provide a reasonable basis for our  findings and conclusions based on our audit objectives. We believe that  the evidence obtained provides a reasonable basis for our findings and  conclusions based on our audit objectives.
section_title: Appendix II: Comments from the Department of Veterans Affairs
section_title: Appendix III: GAO Contact and Staff Acknowledgments
subsections: section_title: GAO Contact
section_title: Staff Acknowledgments
paragraphs: In addition to the contact named above, Jason Bromberg (Assistant  Director), Rudy Chatlos, Tarek Mahmassani, Cory Marzullo, John McGrail,  Josephine Perez, and Jennifer Schwartz made key contributions to this  report.