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STATEMENT OF JAMES
R. FISCHL, DIRECTOR VETERANS AFFAIRS AND REHABILITATION COMMISSION THE
AMERICAN LEGION BEFORE
THE COMMITTEE ON
VETERANS’ AFFAIRS
UNITED
STATES HOUSE OF REPRESENTATIVES ON THE PRESIDENT’S BUDGET REQUEST FOR FISCAL
YEAR (FY) 2003 FOR
THE DEPARTMENT OF VETERANS AFFAIRS (VA) FEBRUARY 13, 2002
Thank
you for the opportunity to appear before you today to express the
views of The American Legion concerning the President’s budget
request for FY 2003 for VA. On September 11,
2001, The American Legion National Commander, Richard J. Santos, was
preparing to present testimony before a joint session of the
Veterans’ Affairs Committees, when America was attacked by
terrorists. Although the
National Commander did not testify, he submitted his written testimony
to both Committees. In
that testimony, The American Legion outlined its FY 2003 budget
recommendations for VA. Copies
of this congressional testimony were shared with the Administration. The American
Legion continues to believe that the primary mission of the Veterans
Health Administration is to meet the health care needs of America's
veterans. The American
Legion greatly appreciates the actions of all Members of Congress
regarding the $1.3 billion increase in VA medical care funding for FY
2002. Congress, like The
American Legion, quickly recognized that the President’s budget
request for FY 2002 was totally inadequate.
Immediately after the President signed the FY 2002 budget,
Secretary Principi was prepared to end the enrollment of additional
Priority Group 7 veterans. Many
of these veterans would have included recently separated service
personnel from the Persian Gulf War, Kosovo and even Afghanistan.
Fortunately, President Bush intervened and agreed to seek supplemental
appropriations to allow VHA to continue its enrollment of additional
Priority Group 7 veterans. Recently,
VA briefed The American Legion that the Administration will seek a
$142 million supplement to the FY 2002 appropriations.
The American Legion still believes this additional request will
not cover the anticipated shortfall. The
American Legion recommends increasing the proposed supplemental to
$300 million reflecting The American Legion’s original FY 2002
funding level for VA medical care. VETERANS
HEALTH ADMINISTRATION (VHA) The American
Legion finds it hard to contemplate the President’s FY 2003 budget
request without a clear vision of FY 2002 funding.
Focusing ahead, The American Legion is very concerned with
VA’s approach to the veterans’ medical care budget in FY 2003. The
major reason for Secretary Principi’s inadequate FY 2002 estimates
was the dramatic increase of new patients choosing to enroll in VA.
Many factors are driving more veterans to use VHA as their
primary health care provider: ·
Many Medicare+Choice health maintenance organizations (HMOs)
withdrew from the program; ·
Many HMOs have collapsed; ·
VHA has opened community based outpatient clinics; ·
Double-digit increase in health care premiums; ·
The dramatic fluctuations in the national economy make VHA a
more cost-effective option for veterans; and ·
VHA’s reputation for quality of care and patient safety is
attracting new patients. Where
comparable data exists, VHA continues to outperform the private sector
in all indicators in health promotion and disease prevention.
The American Legion adamantly believes VHA is the best health
care investment of tax dollars. The
average cost per patient treated within VHA is unmatched by any other
major health care delivery system, especially with comparable quality
of care. The
reason VHA medical care continues to increase annually is not due to
uncontrollable cost increases or poor cost estimates, but rather
because thousands of veterans are voting with their feet.
More and more veterans are choosing to use their earned benefit
– access to VHA. However,
enrollment in VHA is clearly limited by existing discretionary
appropriations. The
American Legion urges Congress to evaluate several options that would
assure every veteran that wants to enroll in VHA can enjoy that earned
benefit. The key factor driving the increases in medical care
funding requirements is the unexpected and dramatic increase in demand
for care from VHA. The American
Legion does not oppose veterans paying for the treatment of nonservice-connected
medical conditions. In
fact, The American Legion’s GI Bill of Health (a blueprint for VA
health care for the 21st Century) advocates collecting from
veterans and all third-party insurers, including Federal health
insurers. This plan also
recommends VA provide health care benefits packages on a premium basis
for those veterans with no health care coverage. To cover the cost
of the dramatic increase in the enrolled Priority Group 7 veterans
population, VA proposes a $1500 deductible for the Priority Group 7
veterans. The American
Legion questions the President’s logic behind this new initiative to
collect $363 million. The
VA shows an “accounting adjustment” of $892 million, (cost of the
Civil Service Retirement System and Federal Employees Health Benefit
Program accrual for employees) as an increase in the medical care
funding. Add to that the
first-party and third-party collections from the Medical Care
Collection Fund (MCCF), which VA estimates will reach nearly $1.5
billion. This budget
picture presented to veterans is seriously skewed.
After stripping away all of these “increases” the actual
request for increase in medical care funding is $1.4 billion, barely
covering the cost of inflation. In
essence, veterans will be paying the cost of the “increase” out of
their pocket. Under the
President’s plan, VA would charge Priority Group 7 veterans 45
percent of reasonable charges until the deductible amount of $1500 is
reached. After the
deductible is met, the inpatient and outpatient co-payments will
resume. According to VA,
approximately 25 percent of Priority Group 7 veterans report having
billable insurance. According
to VA, 55-60 percent of Priority Group 7 veterans are over the age of
65, and thus Medicare-eligible. , VA is prohibited from billing the
Centers for Medicare and Medicaid Services (CMS), but can bill the
Medicare supplemental insurers. Only the remaining 15-20 percent of Priority Group 7 will be
expected to generate over $500 million in medical care costs. In FY 2002, VHA
estimates first-party collections will reach $228 million.
VHA estimates that in FY 2003 it will collect $192 million in
first-party collections. In
FY 2002, VHA estimates third-party collections will reach $577
million. VHA predicts FY
2003 will generate $529 million in third-party reimbursements.
VHA expects to collect $363 million in deductibles in FY 2003.
This new proposal calls for fewer first-party reimbursements,
fewer third-party reimbursements, but more in deductibles. The American
Legion believes these are optimistic estimates, at best.
VHA’s past MCCF performance in meeting collection
expectations is a major concern to The American Legion. VHA’s
billing and collection reputation is rather embarrassing. The American Legion believes in order for billing and collections to improve VA must be provided with the resources to obtain the necessary technology and to properly train MCCF personnel or consider contracting out the entire process. Unlike
in the private sector, Medicare-eligible veterans cannot use their
Medicare benefits in a VHA facility.
When Medicare-eligible veterans receive health care treatment
for any medical condition in the private sector, the federal
government reimburses the health care provider for a portion of that
service. When
Medicare-eligible veterans receive health care treatment for the same
medical conditions within VHA, the federal government will not
reimburse VHA for any portion of that service.
This equates to a restriction on veterans' right to access
health care of their choice and using their Medicare insurance
coverage. The
American Legion believes that Medicare subvention will result in more
accessible, quality health care for all Medicare-eligible veterans.
Furthermore, Medicare subvention should greatly reduce
incidents of fraud, waste and abuse in billing because it will occur
between two Federal agencies with congressional oversight.
Today's fiscal realities requires VHA to seek other revenue
streams to supplement the growing demand for service and not simply
rely on saving more dollars to serve more veterans.
The American Legion strongly recommends allowing Medicare
subvention for Medicare-eligible veterans enrolled in VHA. While
there is much dialogue concerning the tremendous patient population
growth, very little has been mentioned about the addition of health
care professionals to meet the growing demand for health care.
The American Legion understands that there are currently many
veterans waiting to enroll in VHA.
Additional health care professionals will also help reduce the
long waiting periods for appointments, especially for specialized
care. In the private
health care industry, there is great concern over the growing nursing
shortage, yet this budget fails to address any recruitment or
retention proposal, much less, funding. The American Legion recommends VHA
medical care receive $23.1 billion in FY 2003 and that all third-party
reimbursement, to include Medicare, be considered as a supplement
rather than an offset. MEDICAL AND
PROSTHETIC RESEARCH
The
contributions of VA medical research include many landmark advances,
such as the successful treatment of tuberculosis, the first successful
liver and kidney transplants, the concept that led to the development
of the CT scan, drugs for treatment of mental illness, and development
of the cardiac pacemaker. The
VA biomedical researchers of today continue this tradition of
accomplishment. Among the
latest notable advances are identification of genes linked to
Alzheimer’s disease and schizophrenia, new treatment targets and
strategies for substance abuse and chronic pain, and potential genetic
therapy for heart disease. Many
more important potentially groundbreaking research initiatives are
underway in spinal cord injury, aging, brain tumor treatment, diabetes
and insulin research, and heart disease.
The American Legion views these research advances as so
significant that it has devoted a column in its magazine to VA
Research and Development. Dollar
for dollar, others recognize VA as conducting an extraordinarily
productive research program. Currently the VA devotes 75 percent of its research funding
to direct clinical investigations and 25 percent to bioscience.
The
Quality Enhancement Research Initiative (QUERI) is the highest
priority within the VA’s Research and Development program.
The Institute of Medicine has recognized this program as the
best of its kind. QUERI
is a multidisciplinary, data-driven national quality improvement
program designed to promote the systematic translation of evidence
into practice. In other
words, “putting research results to work.” Currently, QUERI
focuses on 10 priority conditions.
These conditions include congestive heart failure, heart
disease, mental health, substance abuse, HIV/AIDS, diabetes, stroke,
spinal cord injury, dementia/Alzheimer’s and prostate cancer.
Without sufficient funding, VA will not be able to continue all
of the QUERI initiatives that involve new technology and the cutting
edge of scientific advances. This
will have a direct impact on the rapidly aging veteran population.
VA’s
overall research program requires a significant increase in funding
above current levels in each of the next several years to perform
important research and evaluation studies. The President’s budget request of $409 million is
inadequate and should be increased, especially with the growing
threats of nuclear, biological and chemical terrorism. The American Legion recommends $420 million for the research budget in FY 2003. MEDICAL CONSTRUCTION
AND INFRASTRUCTURE SUPPORT
MAJOR CONSTRUCTION
The
VA major construction program continues to be under funded.
The major construction appropriation over the past few years
has allowed for only one or two projects per year.
For FY 2001, 16 major ambulatory care or seismic correction
projects were submitted to OMB. Of
this number, only one major VHA project was recommended.
For FY 2002, 28 major projects have been submitted for funding.
Over
the past several years, The American Legion has testified that VA’s
major and minor construction appropriation must include all
infrastructure priorities. Unfortunately,
over the past several years, VA has not received appropriate funding Private
consultants have been warning for years that dozens of VA patient
buildings were at the highest level of risk for earthquake damage or
collapse. Currently, the
VHA has identified 890 buildings in its inventory as being at risk.
Of those 890, 560 are identified as essential – defined as bed, clinic,
psychiatric, research, boiler plant, etc.
Additionally, VHA has identified 67 patient care and other
related use buildings as Extremely High Risk – danger of collapse or
heavy damage. Along with
the necessary ambulatory care and patient safety projects, it will
require well over $250 million to address VHA’s current major
construction requirements. The
Capital Asset Realignment for Enhanced Services (CARES) program has
impeded construction projects throughout VHA.
Many much needed construction projects that would maintain and
update VHA’s infrastructure are being put on the back burner while
CARES awaits full implementation.
The American Legion fears that the CARES process does not allow
for the local VA managers to implement the facility improvement
projects that they know are necessary to maintain a functional service
delivery system. The
President’s budget request for only $194 million severely inhibits
VHA’s ability to properly care for America’s veterans. The American Legion recommends $310 million
for major construction in FY 2003. MINOR
CONSTRUCTION The
American Legion believes that Congress must be consistent from year to
year in the amount invested in VHA’s infrastructure.
Annually, VHA must meet the infrastructure requirements of a
system with approximately 5,000 buildings that support 600,000
admissions and over 35 million outpatient visits.
This accomplishment requires a substantial inventory
investment. The FY 2001
appropriation of $166 million for minor construction was not nearly
enough to meet future physical improvement needs.
With the added cost of the CARES program recommendations and
the nearly $42 million request for minor upgrades in the research
facilities, it is essential that funding be increased considerably
from that of past fiscal years. It
would be foolish to reduce this investment.
The President’s budget request for $211 million falls short
of VHA’s minor construction needs. The American Legion recommends $219 million for minor construction in FY 2003. GRANTS
FOR THE CONSTRUCTION OF STATE EXTENDED CARE FACILITIES The
State Extended Care Facilities Grant Program continues to be a
cost-effective provider of quality care services to the nations’
veterans who require domiciliary, nursing home, and hospital care.
The State Veterans Home
Program must continue, and even expand its role as an integral vital
asset to VA. State homes
are in a unique position to help meet the long-term care requirements
of the Veterans’ Millennium Health Care and Benefits Act (Public Law
106-117). By 2010, 42 percent of the entire veteran population, an
estimated 8.5 million veterans, will be 65 or older, with half of that
number over 5 years of age. By
2030, most Vietnam Era veterans will be 80 years of age or older. As many VA facilities reduce long-term care beds and VA has no plans to construct new nursing homes, state veterans’ homes are relied upon to absorb a greater share of the needs of an aging population. If VA intends to provide care and treatment to greater numbers of aging veterans, it is essential to develop a proactive and aggressive long-term care plan. The
Veterans Millennium Health Care and Benefits Act requires VA to
provide long-term nursing care to veterans rated 70 percent disabled
or greater. The new law
also requires VA to provide long-term nursing care to all other
veterans for service-connected disabilities and to those willing to
make a co-payment to offset the cost of care.
Further, it requires VHA to provide veterans greater access to
alternative community-based long-term care programs.
These long-term care provisions have placed greater demand on
VHA and on the State Extended Care Facilities Grant Program.
This legislation has been on the books for almost 2 years and
it is time for full implementation. The
American Legion believes it makes economic sense for VA to look to
State governments to help fully implement the provisions of PL
106-117. VA spends on
average $225 per day to care for each of their nursing care patients
and pays private-sector contract facilities an average per diem of
$149 per contract veteran. The
national average daily cost of care for a State Veterans Home nursing
care resident is about $140. VA
reimburses State Veterans Homes a per diem of $40 per nursing care
resident. Over the long
term, VA saves millions of dollars through the State Extended Care
Facilities Grant Program. The
American Legion supports the State Extended Care Facilities Grant
Program and believes the federal government must provide sufficient
construction funding to allow for the expected increase in long-term
care veteran patients. The
President’s budget request for $100 million should be increased to
help meet the growing demand for care by veterans of the “Greatest
Generation.” The
American Legion recommends $110 million for the Grants for the State
Extended Care Facilities for FY 2003. NATIONAL
CEMETERY ADMINISTRATION (NCA) The
National Cemetery Administration (NCA) is making great strides in
meeting the interment needs of the nation’s veterans and their
dependents. As of October 31, 2001, NCA maintains more than 2.4 million
gravesites at 120 national cemeteries in 39 states (and Puerto Rico).
Currently, 75 percent of all veterans live within 75 miles of
open national or state veterans’ cemeteries.
The ultimate goal is to have 90 percent of all veterans living
within 75 miles of open national or state veterans’ cemeteries.
NCA’s
workload is increasing by nearly five percent per year, with
cremations accounting for the majority of new interments.
The peak years for the interment of World War II veterans is
expected to be 2006 to 2010. Over
the next decade, new national cemeteries are planned for Atlanta, GA;
Miami, Fl; Pittsburgh, PA; Detroit, MI; and Sacramento, CA. P.L.
106-117 requires NCA to contract a study to determine where additional
national and state veterans’ cemeteries will be required through
2020.
NCA
is preparing “fast track” construction projects to open new
national cemeteries. This
allows burials to occur in each section of a new cemetery as it is
being constructed. Instead
of taking the conventional approach to new cemetery construction,
“fast track” authority would permit the planned new national
cemeteries to open in less than half the normal time, which is seven
years. The most recent cemetery to open under the “fast track”
authority is the Fort Sill, Oklahoma National Cemetery.
Burials began on November 5, 2001.
The
National Shrine Initiative continues to be one of the highest
priorities of the NCA. This
is an ongoing commitment and scheduling continues to fulfill the
pledge of aesthetically improving the national cemeteries.
Major improvements and renovations have started at several
cemeteries with wonderful results. However, there is much that remains
to be done. A tremendous amount of time and money is needed to continue
this commitment. The American Legion recommends $140
million for NCA in FY 2003. STATE
CEMETERY GRANTS PROGRAM The
State Cemetery Grants Program, which provides 100 percent federal
funding for new state veterans’ cemeteries, has received a
significant increase in the number of state cemetery applications.
Within the next several years, NCA is hopeful that up to 30 new
state veterans’ cemeteries will be opened. The workload and
budgetary requirements of NCA will continue to grow over the next
15-20 years. The American
Legion continues to fully support the further development of the State
Cemetery Grants Program. The American Legion recommends $30
million for the State Cemetery Grants Program in FY 2003. VETERANS’
EMPLOYMENT AND TRAINING PROGRAMS (VETS) The
American Legion adamantly opposes the President’s new initiative to
transfer VETS from the Department of Labor (DoL) to VA. In the
President’s budget request for FY 2003, he proposes to add $197
million to VA budget for a new competitive grant program that replaces
programs currently administered by DoL. The American Legion expressed opposition to a similar
recommendation proposed by the Congressional Commission on
Servicemembers and Veterans Transition Assistance back in 1999.
The American Legion strongly suggests this Committee consider
oversight hearings before such an initiative is allowed to prevail.
DoL has all of the expertise and resources for effective job
placement and training. The
National Veterans Training Institute (NVTI) provides standardized
training for all veterans’ employment advocates in an array of
employment and training functions. Some
suggest that moving VETS to VA would improve the overall performance
of VA’s Vocational Rehabilitation Program (Voc Rehab).
Others would argue that moving Voc Rehab to VETS in DoL would
be a much better approach. Nearly
all VETS employees attend NVTI and receive continuing training, few
(if any) Voc Rehab employees have attended NVTI training.
The American Legion perceives the relationship between VETS and
DoL much more germane than VETS and VA. The
American Legion welcomes the opportunity to work with the Assistant
Secretary for Veterans’ Employment and Training (ASVET) and his
staff to improve and enhance the overall performance of VETS.
However, The American Legion believes reinventing the wheel
within VA would be counterproductive and ineffective.
The American Legion believes that many of VETS problems stem
from persistent inadequate Federal funding, failure to be staffed at
Federally mandated levels, and inconsistent national leadership.
The
mission of VETS is to promote the economic security of America’s
veterans. This stated mission is executed by assisting veterans in
finding meaningful employment. Annually,
DoD discharges approximately 250,000 service members. These recently separated service personnel are actively
seeking immediate employment or preparing to continue their formal or
vocational education. The veterans’ advocates in VETS program play a
significant role in helping the recently separated service personnel
(veterans) reach their employment goals. 1)
VETS continues to improve by expanding its outreach efforts
with creative initiatives designed to improve employment and training
services for veterans. 2)
VETS provides employers with a labor pool of quality applicants
with marketable and transferable job skills.
3)
VETS took the initiative in identifying military occupations
that require licenses, certificates or other credentials at the local,
state, or national levels. 4)
VETS helps to eliminate barriers to recently separated service
personnel and assist in the transition from military service to the
civilian labor market. VETS
started an information technology project with the Computing
Technologies Industry Association, to recruit veterans recently
separated from the military; assess their interest and skill level for
a career in information technology; provide occupational skills
training and certification; and place these veterans into information
technology jobs. VETS
continues to expand its PROVET (Providing Re-employment Opportunities
for Veterans) program. PROVET
is an employer-focused job development and placement program that
focuses on screening, matching and placing job ready transitioning
service members into career-building jobs.
PROVET programs are currently operating in several states.
In addition to employment services, VETS also supports the
Transition Assistance Program (TAP), the Disabled Transition
Assistance Program (DTAP), Veterans Preference in the Federal
workplace, and the Uniformed Services Employment and Re-employment
Rights Act (USERRA). The
American Legion strongly recommends restoring funding for the ASVET
within DoL’s FY 2003 budget at a funding level of $300 million.
Staffing levels for Disabled Veterans Employment Program
Specialists and Local Veterans Employment Representatives should match
the Federal mandates or those statutes should be rewritten. The
American Legion recommends an increase in the NVTI budget to $3
million annually. The
American Legion further recommends that VA send Voc Rehab employees to
NVTI training. VETERANS
BENEFITS ADMINISTRATION
Under
the proposed budget for FY 2003, mandatory spending for compensation,
pension, education, burial, and other benefit programs is expected to
be $31.5 billion. This is
an increase of $ 3.4 billion over the level approved for FY 2002.
It represents the funding requirements for ongoing statutory
benefit payments to some 3.25 million veterans, dependents, and
survivors, as well as the impact of recent, expanded statutory and
regulatory entitlements, higher average benefit payments, and certain
new legislative proposals. It
also includes an estimated 1.8 percent cost-of-living adjustment.
Under
General Operating Expenses (GOE), the budget request for FY 2003
includes a total of $1.2 billion for discretionary spending to cover
staffing and other costs associated with the administration of the
various benefits and service programs within the Veterans Benefits
Administration (VBA). This
represents a net increase of $94 million over the amount approved for
FY 2002. It
includes an additional 125 FTE to support current efforts to bring the
case backlog under control and support a new case development program
at the Board of Veterans Appeals. The budget request also includes
funding for a number of information technology initiatives that will
provide much needed direct and indirect support toward improving the
claims process. In
addition to this modest staffing increase, the FY 2003 budget request
for VBA describes a number of steps that, over time, are expected to
steadily reduce the backlog of pending cases to about 250,000 and the
claims processing time to 100 days by the end of FY 2003.
As part of the strategy to reach these rather ambitious goals,
VBA has implemented a broad spectrum of regulatory, programmatic, and
administrative changes, in addition to its long-term strategic plan
initiatives, that are intended to improve the regional offices’
operational efficiency and decision-making. Also, recommendations of
the Secretary’s Claims Processing Task Force have been accepted and
are in the process of being implemented over the next year. VA expects
these changes to produce both near-term and long-term improvements in
the quality and timeliness of the decision-making process. The data upon
which VBA’s budget request is predicated shows a continued overall
increase, rather than a decrease, in the volume of incoming claims.
With more complex claims per case and the level of available
adjudication expertise, it is doubtful that regional offices will be
able to achieve the dramatic increases in production and improvements
in quality that will be necessary to reach the claims processing goal
of 100 days with a backlog of 250,000 cases.
In an effort to achieve such ambitious production goals, The
American Legion is concerned that regional offices will emphasize
expediency rather than ensuring full compliance with the due process
and assistance requirements of the Veterans Claims Assistance Act and
other provisions of the law. Even
with the implementation of the many changes and efficiencies
described, claims development and adjudication will continue to be a
very labor intensive and time-consuming process. The
American Legion believes that the requested staffing increase is
insufficient to meet the expected workload demand in FY 2003. BENEFIT PROGRAMS
The
American Legion is pleased to see some special attention being given
to expediting the 81,000 oldest claims by the nation’s oldest
veterans. No veteran or
survivor should have to wait a year or longer for a decision on their
claim, least of all elderly claimants.
Tragically, many die before receiving a decision and the
long-awaited benefits to which they were entitled. The Tiger Team
initiative at the Cleveland VA Regional Office and the nine Service
Delivery Network (SDN) Resource Centers will go a long way toward
alleviating much of the hardship and frustration that thousands of
veterans experience while waiting for their claim to be decided. The
FY 2003 budget proposal outlines the various internal changes VBA is
making and intends to make in order to improve the level and quality
of the service it provides veterans.
However, there are a number of external factors that have an
ongoing impact on VBA’s ability to drastically improve regional
office performance and production.
In FY 2003, while there will be a slight decrease in the number
of pension claims, this will be more than offset by the substantial
increase in the overall number of compensation claims.
Most of this increase is expected to come from the continued
influx of new and reopened claims.
The number of Agent Orange-related diabetes claims is expected
to be up substantially over FY 2002.
VBA must also rework thousands of cases as a result of Nehmer
v. United States Veterans’ Administration. Congress
has recently expanded entitlement to service connection for
radiation-related diseases as well as disabilities affecting veterans
who served in the Persian Gulf War.
The requirements of the Veterans Claims Assistance Act of 2000
have greatly increased the regional office’s workload and processing
time. The United States
Court of Appeals for Veterans Claims and the United States Court of
Appeals for the Federal Circuit have continued to issue precedent
decisions requiring frequent and often far-reaching changes in
adjudication procedures and the reworking of thousands of previously
decided and pending cases. The
American Legion tentatively supports VBA’s proposed initiatives for
FY 2003. We hope these
will enable substantial progress to be made toward the overall goal of
providing veterans proper and timely decisions on their benefit
claims. The
American Legion is deeply concerned that the 125 additional staff for
VBA in FY 2003 may not be adequate, if VBA is to be even partially
successful in meeting its stated claims processing goal of 100 days.
BOARD
OF VETERANS APPEALS
Veterans
or other claimants must have the right to appeal any decision by the
regional office to the Board of Veterans Appeals (BVA or the Board).
BVA staffing for FY 2002 is 464 FTE.
In FY 2003, however, it is projected to further decline to 451
FTE. The American Legion
is again concerned by this reduction.
Given the current number of initial appeals and remands pending
in the regional offices coupled with the fact that the Board will soon
begin a major new initiative to do the development work that the
regional offices would have normally done pursuant to a BVA remand,
manpower shortages may adversely impact on the timeliness of
decisions. In
FY 2001 and for the first quarter of FY 2002, the number of new
appeals filed in the regional offices has continued to rise.
This reflects a high level of dissatisfaction with regional
office actions. However,
over the same period of time, the number of cases transferred to the
Board has steadily declined, due to the overall slow down in claims
processing. In
particular, regional office compliance with the requirements of the
Veterans Claims Assistance Act has prolonged the development of
appeals and their eventual transfer to the Board.
The
American Legion’s longstanding concern with the appeals process is
with those factors that contribute to an annual influx of 60,000 to
70,000 new appeals. Veterans
and other claimants feel they are not treated fairly or properly by a
system that is very complex, highly bureaucratic, and legalistic.
They feel very strongly that the process is basically
adversarial and not “user friendly.” This perception is reinforced by the fact that, in FY
2001, the BVA allowed the claimant’s appeal in 22.3 percent of the
cases and remanded 48.8 percent of the appeals for further required
action. The Board only
affirmed regional office decisions 27 percent of the time.
Of
the approximately 60,000 appeals decided in FY 2000 and 2001, the
Board remanded about 32,000 cases for additional development and
readjudication. Unfortunately,
most of the appellants in these cases are still waiting on action by
the regional offices. Some
of these appeals date from 1997 and 1998, and as noted previously, the
issue on appeal in these cases is much older still. Remands
involve substantial additional work for the regional offices.
To try and reduce this portion of their workload as well as
provide more timely decisions on all appeals, VA regulations will go
into effect later this month authorizing the BVA to fully develop
appeals without the necessity of remanding them back to the regional
office of such action. This
will involve reorganization of the BVA staff and the reassignment of a
limited number of FTE from the Compensation and Pension Service to
assist in the additional development work. Under
this new program, it’s expected that the Board will be able to
provide more expeditious and complete development of appeals.
In FY 2001, with a staff of 454 FTE, the BVA issued
approximately 31,000 decisions. Of
these decisions, approximately 8,500 or 48.8 percent were remands.
Now, the Board itself will undertake this development in the
majority of those cases, which would have otherwise been remanded.
The American Legion believes that more, rather than fewer staff
at the Board will be needed in FY 2003 to handle this additional
workload. By
substantially reducing the number of remands, the regional offices
should be able to concentrate on completing more pending benefit
claims and completing the outstanding remands.
While The American Legion believes this new procedure will
ultimately benefit veterans and provide more timely service, we are
concerned that, in the interest of expediency, the regional offices
may try and use this program as a way around full compliance with
their responsibilities under the Veterans Claims Assistance Act.
In our view, the high remand rate of the past several years is
a direct reflection of poor decision-making and the lack of an
effective quality assurance program.
Since the BVA will be assuming the responsibility for
correcting errors and mistakes by the regional offices, there will be
an incentive for the regional offices to try and shift as much of the
appellate workload onto the Board as possible.
VBA must ensure this does not happen.
More stringent quality assurance standards and performance
measures must be promptly implemented.
To make this program a success there must also be a closer
working relationship and improved communication between VBA and the
Board at all levels.
The
American Legion recommends a total of $1.3 billion in VBA-GOE. HOMELAND
SECURITY The
important role of VA in Homeland Security is not highlighted in the
President’s budget request. The
American Legion saw the critical actions of VA in response to the
September 11, 2001 disasters. VA
employees sprang into action to assist response personnel, victims,
and surviving family members. Yet,
VA was not actually a part of any emergency response plans immediately
implemented, but rather acted unilaterally.
VA employees provided medical care, counseling, and claims
processing. VA was prepared to do even more if called into action. The
Director of Homeland Security, Tom Ridge, will need the cooperation of
an array of Federal agencies. Since
VA medical facilities are geographically diverse, VHA is a logical
partner for the pre-positioning of inoculations and medical supplies
needed to address acts of terrorist or natural disasters.
Currently, every VA campus is scheduled to undergo an
evaluation under CARES. Homeland
Security requirements must be included in the criteria used to
determine possible utilization of physical plants that may currently
be considered underutilized. In the
event of a nuclear, chemical, or biological terrorist attack, each VA
campus may become a key element in the care and treatment of mass
causalities. As national
emergency plans are reviewed at every level of government – local,
state, and national – VA must be seen as valuable resource.
Whether housing response workers, military forces, or law
enforcement personnel; providing quality medical care; or serving as a
command, control and communications center, VA must have the resources
to meet the assigned mission as back up to DoD and the National
Disaster Medical System. SUMMARY
Mr. Chairman and
Members of this Committee, The American Legion applauds the leadership
of President Bush and his Administration, especially under the current
wartime conditions. As an organization of wartime veterans, we continue to stand
shoulder-to-shoulder with the President, Congress, and our
comrades-in-arms – past, present, and future. The
American Legion knows that the President’s budget request is focused
on winning the war on terrorism.
Therefore, adequate defense spending is extremely critical and
The American Legion fully supports the direction the President has
chosen. However, the cost
of waging war continues long after the dead are buried, the guns are
silenced, and the treaties are signed.
The war continues to rage in the hearts and minds of its
veterans. No combat
veteran completely walks away from any war untouched, physically or
mentally. The
cost of freedom rests in this nation’s ability to recruit and retain
young men and women willing to pay the ultimate sacrifice in the name
of liberty. This nation
has been blessed since its inception with similar citizen-soldiers,
sailors, airmen, and Marines that have set a standard of excellence
for others to follow. Recently,
a new generation of Purple Heart recipients demonstrated on the field
of battle the courage, determination, and loyalty exhibited by -- the
Minutemen, the Roughriders, the doughboys, the GIs – that preceded
them in protecting and defending America against all enemies, foreign
or domestic. Mr.
Chairman and Members of this Committee, The American Legion doesn’t
ask for much, just another installment in the ongoing cost of freedom. Back to Witness List |