[Senate Hearing 111-658]
[From the U.S. Government Publishing Office]
S. Hrg. 111-658
SERVICES FOR VETERANS IN ALASKA: FIELD HEARINGS IN ANCHORAGE AND
FAIRBANKS
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HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED ELEVENTH CONGRESS
SECOND SESSION
__________
FEBRUARY 16 AND 17, 2010
__________
Printed for the use of the Committee on Veterans' Affairs
Available via the World Wide Web: http://www.access.gpo.gov/congress/
senate
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COMMITTEE ON VETERANS' AFFAIRS
Daniel K. Akaka, Hawaii, Chairman
John D. Rockefeller IV, West Richard Burr, North Carolina,
Virginia Ranking Member
Patty Murray, Washington Lindsey O. Graham, South Carolina
Bernard Sanders, (I) Vermont Johnny Isakson, Georgia
Sherrod Brown, Ohio Roger F. Wicker, Mississippi
Jim Webb, Virginia Mike Johanns, Nebraska
Jon Tester, Montana Scott P. Brown, Massachusetts\1\
Mark Begich, Alaska
Roland W. Burris, Illinois
Arlen Specter, Pennsylvania
William E. Brew, Staff Director
Lupe Wissel, Republican Staff Director
----------
\1\ Hon. Scott P. Brown was recognized as a minority Member on March
24, 2010.
C O N T E N T S
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February 16, 2010--Anchorage
SENATORS
Page
Begich, Hon. Mark, U.S. Senator from Alaska...................... 1
WITNESSES
Carroll, Timothy Patrick, CMSgt, USAF (Ret)...................... 3
Prepared statement........................................... 4
Davidge, Ric, MPA, Alaska State Council President, Vietnam
Veterans of America; Board Member, Alaska Disabled Veterans
Business Alliance.............................................. 7
Prepared statement........................................... 8
Fierros, Gabriel, OIF Veteran.................................... 9
Owens, Rich, Alaska State Chairman, National Committee for
Employer Support of the Guard and Reserve...................... 10
Jefferson, Hon. Raymond M., Assistant Secretary of Veterans'
Employment and Training Service, U.S. Department of Labor...... 18
Prepared statement........................................... 19
Finn, Belinda J., Assistant Inspector General for Audits and
Evaluations, Office of Inspector General, U.S. Department of
Veterans Affairs; accompanied by Brent Arronte, Director,
Benefits Inspections Division, Office of Audits and
Evaluations, Office of Inspector General....................... 23
Prepared statement........................................... 24
Bilosz, Mark M., Director, Anchorage Regional Office, Veterans
Benefits Administration, U.S. Department of Veterans Affairs;
accompanied by Willie C. Clark. Sr., Western Area Director; and
Patrick Kelley, Veterans Service Center Manager, Anchorage
Regional Office................................................ 26
Prepared statement........................................... 28
Katkus, Brig. Gen. Tom, Adjutant General, Alaska National Guard.. 30
Prepared statement........................................... 32
Myers, Jan, Director, Family Programs, Alaska Department of
Military & Veterans Affairs.................................... 33
Prepared statement........................................... 34
Addendum..................................................... 36
APPENDIX
Clapp, Steven, AFGE National Representative; comments filed at
hearing........................................................ 53
Simmons, Zulene, Chugiak, Alaska; comments filed at hearing...... 54
Kell, Russell N., Vietnam Veterans of America; letter............ 58
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February 17, 2010--Fairbanks
SENATORS
Page
Begich, Hon. Mark, U.S. Senator from Alaska...................... 61
WITNESSES
Boisseau, Linda, Department Service Officer, Disabled American
Veterans....................................................... 63
Prepared statement........................................... 65
Attachment............................................... 68
Roof, SPC Robert L., USA (Ret.), OIF Veteran..................... 69
Prepared statement........................................... 71
Sheehan, Joe, LTC, USA (Ret), Chairman, Northern Alaska Military
Retiree Council................................................ 76
Prepared statement........................................... 78
Woolf, Ron, Unit Representative, Employer Support, Guard and
Reserve........................................................ 79
Prepared statement........................................... 82
Jefferson, Hon. Raymond M., Assistant Secretary of Labor for
Veterans' Employment and Training, U.S. Department of Labor.... 91
Prepared statement........................................... 93
Finn, Belinda J., Assistant Inspector General for Audits and
Evaluations, Office of Inspector General, U.S. Department of
Veterans Affairs; accompanied by Brent Arronte, Director,
Benefits Inspections Division, Office of Audits and
Evaluations, Office of Inspector General....................... 96
Prepared statement........................................... 98
Response to request arising during the hearing by Hon. Mark
Begich..................................................... 120
Bilosz, Mark M., Director, Anchorage Regional Office, Veterans
Benefits Administration, U.S. Department of Veterans Affairs;
accompanied by Willie C. Clark. Sr., Western Area Director; and
Patrick Kelley, Veterans Service Center Manager, Anchorage
Regional Office................................................ 100
Prepared statement........................................... 102
Response to request arising during the hearing by Hon. Mark
Begich...................................................122, 131
Pendergrass, Susan, DrPH, Network Director, VISN 20, Veterans
Health Administration, U.S. Department of Veterans Affairs;
accompanied by Alex Spector, Director, Alaska VA Health Care
System......................................................... 104
Prepared statement........................................... 106
Addendum..................................................... 112
Response to request arising during the hearing by Hon. Mark
Begich...................................................125, 129
Bowen, Verdie, Administrator, Office of Veterans Affairs,
Department of Military and Veterans Affairs for the State of
Alaska......................................................... 114
APPENDIX
McBride, Ladd, Veteran, USA (Ret.), and a geriatric nurse
practitioner; comments filed at hearing........................ 135
Davis, Charlotte M., Vietnam Veteran; comments filed at hearing.. 137
McDonald, Col. William, USAF (Ret.); comments filed at hearing... 139
Tordoff, Hugh Twig; questions/comments filed at hearing.......... 141
SERVICES FOR VETERANS IN ALASKA
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TUESDAY, FEBRUARY 16, 2010
U.S. Senate,
Committee on Veterans' Affairs,
Anchorage, AK.
The Committee met, pursuant to notice, at 10:30 a.m.,
Anchorage Assembly Chambers, Hon. Mark Begich, Member of the
Committee, presiding.
Present: Senator Mark Begich.
OPENING STATEMENT OF HON. MARK BEGICH,
U.S. SENATOR FROM ALASKA
Senator Begich. This hearing, the Field Hearing on Services
for Veterans' Affairs in Alaska is called to order. I first
want to thank all the people that are here. I appreciate the
opportunity to have this field hearing. We are having multiple
opportunities for veterans. One will be this field hearing
which is a chance for us to talk with different presenters
about some of their issues and concerns. We also have folks
from the VA to address some of these concerns. Along with that,
we will be in Wasilla this afternoon for a roundtable, which is
more of a kind of free discussion with folks. Then we will be
in Fairbanks, as well as in Kotzebue.
So, those that are wondering how these work: field hearings
designed like this are an opportunity for a Congressional
record to be created based on information that will be
presented by, for example, our first panel and our second
panel. It is not a process that you're normally used to. There
is no testifying and so forth; there are panels in the field
hearings. The roundtables that we have are more of an open
discussion. Again, those are in Wasilla, Kotzebue, and
Fairbanks. But, again, we appreciate all the folks that are
here. This is an opportunity for us to hear and to ask some
questions.
Along with that, for folks that are in the audience, this
is an opportunity, again, for questions and comments, during
the meeting, after the meeting or even before. If you have some
issues that you want to make sure are raised, please put those
down on this form and staff will be in the back to collect
them.
I have a statement that I'll read into the record here, and
then we'll open with our first panel of individuals. Again,
thank you all for being here. For the folks from Washington,
DC, I thank you for arriving to a warmer climate and less snow
than you left. We can also show you how to move snow. It's a
skill here.
This hearing will focus on the state of services for
veterans in Alaska, support for returning veterans, job
opportunities for veterans, benefits for veterans, and a
December audit by the VA office of the Inspector General on the
VA Regional Office in Anchorage. The Committee has held
multiple hearings on VA benefits, health care, and services.
However, this is the first time we are specifically focusing on
the unique challenges confronting returning Alaska veterans of
Operations Iraqi and Enduring Freedom.
I'm pleased that the Committee is joined today by Assistant
Secretary of Labor, Ray Jefferson, who will speak to some of
the services that the Department of Labor offers to veterans,
in particular, those transitioning from military to civilian
life. In addition, I hope to hear more about some of the
Department of Labor's core functions: conducting employment and
training programs; enforcing relevant Federal laws and
regulations; and providing transition services.
Alaska is one of the few States with a growing veteran
population--70,000 within our State. Alaska has the highest per
capita veteran population in the Nation. The Anchorage RO has
the highest proportion of compensation claims in the total
workload of any regional office. Compensation workload grew by
82 percent in the last 5 years. According to a 2009 VA State
Summary Report of Alaska, in 2008 nearly 1,500 veterans from
the conflicts in Iraq and Afghanistan sought treatment in our
VA facilities.
I applaud the efforts of VA employees in Alaska. These men
and women work hard to help veterans who seek their assistance.
There are many things the VA does well in Alaska. However,
there is always room for improvement, as evidenced by the
recent VA IG report dated December 7, 2009, that showed that
the Anchorage VA Regional Office failed to meet requirements in
13 of 14 areas covered during the inspection. This concerns me
deeply because providing accurate, timely, and comprehensive
services to our veterans is one of my top priorities in the
U.S. Senate.
More work needs to be done. I hope that both of our panels
will shed some light on the issues such as: why we continue to
hear veterans are not aware of their eligibility for VA
benefits and services; why some veterans are not receiving
appropriate VA services; and why veterans struggle finding
employment. I hope to discuss these and other important issues
with our panels today.
Indeed, our unique geography, diversity, and way of life
require that the VA develop a unique strategy to care for our
veterans, especially those who reside in rural areas. Back in
Washington, we have worked hard to ensure that VA has the
resources to provide the best care possible. Congress has
provided record-breaking funding increases for the VA. Last
year I supported the Veteran Health Care Budget Reform and
Transparency Act to secure funding for veterans' health care 1
year in advance of the regular appropriations process. This
bill was signed into law in October, 2009. We have followed up
that success with passage in the Senate of a Caregivers' Bill,
which will help wounded warriors and the families who care for
them. This bill also improves care for women veterans who
reside in rural areas and those who are homeless. It has been
sent to the House of Representatives. We expect to finalize
this bill in the coming months.
Finally, I note that there are many veterans here today who
would like to testify. While we cannot accommodate everyone's
request to speak, we do want to hear your views. The Committee
is accepting, as I said, written testimony or other documents
you may want to present for the record.
In addition, Committee staff is joined by VA staff who can
respond to the questions, concerns and comments that you raise.
Once again, thank you all for being here. What I would like to
do is introduce the first panel of four individuals. First,
I'll just read their names in Alaskan. I'll call on each one
separately to give their testimony. We'd like to keep the
testimony close to 5 minutes, though unlike the Assembly, we
have no clock that ticks away. I will tell you when you're
close. Please bear with me.
Tim Carroll, is a retired U.S. Air Force Commander
Sergeant. Ric Davidge, MPA, is the Alaska State Council
President, of the Vietnam Veterans of America, and Board member
of the Alaska Disabled Veterans Business Alliance. Gabriel
Fierros, is an OIF veteran. Rich Owens, is the Alaska State
Chairman, and National Committee for Employer Support of the
Guard and Reserve.
Thank you all for being here. What I would like to do is
have you testify in the order that I read your names. If I can
have retired Commander Chief Tim Carroll first. Thank you very
much for being here. There's a button, just push it down, which
should activate the mic. As long as you've got a green light,
you're good.
STATEMENT OF CHIEF MASTER SERGEANT TIMOTHY PATRICK CARROLL,
USAF (RETIRED)
Chief Carroll. First off, Senator Begich, thank you for
taking the time to come out to----
Senator Begich. You have to move that mic a little closer.
Chief Carroll. Can you hear now? Better?
Senator Begich. Move that mic a little, pretend you're like
Mick Jagger.
Chief Carroll. Put it all the way in my throat here.
Senator Begich. We'll ask the technician, Mike, to adjust
the mic.
Chief Carroll. Senator Begich, I want to thank you for
taking the time to listen to our veterans and for committing
yourself to helping those who dedicated their service to this
country.
A Speaker. We still can't hear you.
Chief Carroll. You, too, are servants of this great Nation
and I for one----
Senator Begich. I apologize. I don't know if we can adjust
that volume a little bit more. I'm looking for the tech person.
You have to hug it like this [indicating].
Chief Carroll. How is that?
A Speaker. Still can't hear back here.
Senator Begich. We have to go with what we have while the
tech guy works on the volume. Go ahead.
Chief Carroll. I won't do the can-you-hear-me-now thing.
I'll try to speak up a little bit.
First off, Senator Begich and members of the traveling team
with you, thank you for taking the time to listen to our
veterans and for committing yourself to helping us who
dedicated our lives to service to this country. You too are
servants of this great Nation and I for one thank you for your
tireless efforts on our behalf. I am retired Chief Master
Sergeant Tim Carroll, a 28-year veteran of the U.S. Air Force;
the son of an Air Force veteran; and now the father of an
active-duty Air Force airman. I am honored to be given this
opportunity to provide testimony on my experiences with the
transition from active duty to veterans status of the U.S. Air
Force. I retired from active duty in October 2008. While on
active duty, I was the command chief master sergeant for the
third wing at Elmendorf Air Force Base. In this role I had lots
of opportunity to hear and to experience those who were
transitioning out of the Air Force, but had little opportunity
to hear of their transition once they hit the VA system.
On a scale of 1 to 10, with 10 being perfectly satisfied,
my personal transition would rate at a 9.0. This is due in
large part to the professionals at the Elmendorf Air Force
Base, third mission support squadron, the third medical group,
and the staff of the Anchorage Veterans Administration, who
were attentive to my needs and very much helped me and my
family as we managed our expectations for retirement.
I believe those who transitioned alongside me found the
same experience. I do know that there are a large number of
veterans that had different experiences, and I was able to help
some of those people with what we could on the active-duty
side. Again, I did not see them once folks went into the
Veterans Administration; therefore, when I made the transition
myself, it was a first-time experience that I relied on a lot
of people to help with. The staff at the Anchorage Veterans
Administration helped in every way that they could, but we did
deal, of course, with the Salt Lake City Regional Office on
issues that were related to the medical transition. My number 1
issue as I retired was finding adequate employment, and as you
very well know, the timing when transitioning between careers
whether military or otherwise, is very crucial to maintaining a
quality-of-life and a standard of living for our families. With
two teenage daughters under my roof, retirement is a relative
term and it was absolutely essential that I secured employment.
The timing that it took to get the DD-214 to marry up to the
compensation disability rating did cause a gap in my ability to
seek a government job. I find myself now in the private sector
and it's working very well.
Again, I would rank my personal experience a 9 on a scale
of 1 to 10.
I look for your questions, Senator Begich. And in closing,
again, I want to thank you for the efforts you are putting
forth to take care of our veterans.
[The prepared statement of Chief Carroll follows:]
Prepared Statement of CMSgt Timothy Patrick Carroll, USAF (Ret.)
Honorable Senators and Distinguished Members of the U.S. Senate
Committee on Veterans' Affairs, Thank you for taking the time to listen
to our Veterans and for committing yourself to helping those who
dedicated their service to this country. You too are servants of this
great Nation; I for one thank you for your tireless efforts on our
behalf.
I am retired Chief Master Sergeant Timothy Patrick Carroll, a 28-
year veteran of the United States Air Force, the son of an Air Force
veteran, and now the father of an Air Force Airman. I am honored to be
given this opportunity to provide testimony on my experience with the
transition from active duty to veteran status of the United States
Armed Forces.
I retired from active duty in October 2008. On a scale of 1-10 with
10 being perfectly satisfied, I would rate my transition experience at
9.0. The professionals of Elmendorf Air Force Base's 3rd Mission
Support Squadron, the 3rd Medical Group, and the staff of the Anchorage
Veterans' Administration were attentive to my needs and very much
helped my family and me manage our expectations for retirement. I
believe those who were transitioning at the same time as me found the
same experiences. Of course, with two teenage daughters still under my
roof, retirement is a relative term.
Overall, I am pleased and satisfied with the outreach and support I
have received from the Veterans Administration. I address specific
programs and my experiences below.
job search
One of the greatest challenges I believe military members have in
entering the civilian workforce is effectively communicating their
skills to prospective employers. The Transition Assistance Program was
very helpful in opening my mind to the realities of retirement and did
equip me with many tools necessary to prepare for the transition; but
the reality of communicating my skills was a greater challenge than I
ever anticipated. Fortunately for me, it worked out well, as I am now
the CEO of a small business in Anchorage.
education
I was one of the fortunate young Airmen who had a supervisor that
cared enough to threaten me with bodily harm if I failed to open a
Veterans' Education Assistance Program (VEAP) account before the
program ended. I complied and deposited the minimum required twenty-
five dollars to open the account. Many of my colleagues were not so
fortunate and failed to open the account. We were repeatedly told what
a bad deal the VEAP was, thus it is not surprising to me that so many
did not buy into the program. Many years later, when Congress opened
the window for those of us with a VEAP account to join the Montgomery
GI Bill program, I made the required payments and converted. Over the
course of my career, I took advantage of the USAF Tuition Assistance
program and obtained my Bachelor's Degree here at the University of
Alaska Anchorage. Today, with the aid of the Post-9/11 GI Bill, I am
pursuing my Masters Degree with Wayland University in Anchorage. I have
heard many complaints about the backlog in processing Post-9/11 GI Bill
claims and at this point am pleased with the response I have received
from the Veteran's Administration in producing my eligibility
certificate. I begin classes this month and anticipate filing for
benefits payment in the coming weeks. I did receive an unsolicited
phone call from a Veterans Administration official inquiring if I knew
of the education benefit, and how to proceed with the program. I found
this call very informative and helpful, and again appreciate both the
Congress and the Veteran's Administration for enabling me to pursue
higher education.
medical care
I am currently enrolled in the TRICARE Prime program and receive
care at the Elmendorf Air Force Base hospital. I found the transition
from Active Duty to Retiree was seamless in the quality and
accessibility of care for my family and me. I am also enrolled in the
TRICARE Retiree Dental Program and am satisfied that the benefits we
receive are sufficient to care for my needs. When I first joined the
Air Force in 1980, my recruiter told me that my medical care would be
free for life. This was not a major point in my decision to serve or
continue serving, and the premiums I pay today are acceptable. After
having three children in orthodontics braces, I do wish the coverage
for orthodontics provided a higher expense coverage rate.
I have not yet sought medical care from the Veteran's
Administration and can therefore not comment on that quality. I do know
that the VA has again extended a helping hand to make sure I am aware
of the process to access care in the VA facility.
service connected disability compensation
When the time came to retire, I received assistance from the
American Legion in submitting my claim for service-connected disability
compensation. I submitted my claim under the Benefit Due at Discharge
program (also known as Fast Track) on June 28, 2008, in advance of my
October 1, 2008 retirement. The medical staff at the Anchorage VA
medical Center evaluated my claim items in August 2008. I received my
rating decision from the VA Regional Office in Salt Lake City on Jan
26, 2009. I am currently appealing the rating decision I received based
on inconsistencies in the report I received along with the rating
decision, and my experiences in the exam room in Anchorage. All in all,
I am satisfied with the timing and attention I received from the VA
throughout this claim process.
housing
During the course of my active duty career, I moved too frequently
to enjoy the benefits of home ownership. During the last half of my
career, I was in key and essential designated positions, which required
me to live in government provided housing on-base. When I retired, I
was faced with the task of finding a home that maintained my family's
standard of living without having any equity in a home to cash in for
down payment. I used the VA Home Loan Guarantee program to purchase my
home in Eagle River without a down payment.
Throughout my transition period, no one told me that if I had been
assigned a compensable disability rating, the VA funding fee would be
waived on my mortgage application. Rather, I stumbled on this benefit
while comparing on-line mortgage rates using a lender's on-line
calculating tool. When I inquired of other retiring members if they
knew or had been told of this benefit, no one had.
Timing was not in my favor in that upon my retirement, I had to
vacate government housing, yet my disability rating had not been
determined and thus the funding fee was in place. Thankfully, I
encountered a seller and real estate agent who were very patient and we
deferred closing the loan for as long as we could. Ultimately, we
closed on the house and rolled the $12,000 funding fee into our
mortgage. Upon receipt of my compensable disability rating, I applied
to the VA for a refund of the funding fee, which was approved and
applied to the principle of my loan in a timely manner.
survivor benefit plan
Being an enlisted member, I found myself living paycheck to
paycheck for the bulk of my career. This made investment options very
difficult. The Air Force Casualty Affairs representative at Elmendorf
AFB was very helpful and informative in assisting my wife and I in the
decision to enroll into the Survivor Benefit Plan. This decision had to
be made at the most stressful and uncertain time we had ever
encountered in our lives as we truly did not know where we would be
living, what my employment would be or what our financial situation
would look like. Having an open window at the two-year point to opt out
of the plan made making this decision less risky. Ultimately, we
decided to enroll and I am presently paying a monthly premium into the
Survivor Benefit Plan. Knowing that my wife will receive some
continuing benefit should I precede her in death brings great peace of
mind to me.
death benefits
The VA provided end of life care for my father through a terminal
illness and into death. I saw first hand the care and comfort the VA
provided to my mother during this difficult time and I rest well
knowing that should my wife need the same help, the VA will be there.
life insurance
I converted my Active Duty Serviceman's Group Life Insurance to the
Veterans Group Life Insurance program. I am not a fan of term life
insurance, however, the premiums are affordable and the term will allow
me to be sufficiently covered while my children are still under our
care. I would have preferred to make a similar contribution to a whole
life policy during the course of my career, which I did with a private
carrier.
joint federal travel regulation
In my situation, my family chose to remain in Alaska for a number
of reasons, mostly to allow my high school daughters to complete their
schooling in the same high school where they started. My children
endured frequent moves throughout their school experience and we chose
to offer them some measure of stability at the end. Unfortunately,
children school is not a qualifying reason to extend household goods
shipment authority beyond one year after effective retirement date. I
would like to see this changed in the JFTR.
In closing, I again thank you for your efforts to take care of our
Veterans and their families. I urge you to continue to support these
programs that bring comfort and peace of mind to the small segment of
our population that donned a uniform in selfless and untiring service
to our great Nation.
Thank You!
Senator Begich. Thank you very much. Let me move down the
panel. I'll have questions for each one of you afterwards.
STATEMENT OF RIC DAVIDGE, MPA, ALASKA STATE COUNCIL PRESIDENT,
VIETNAM VETERANS OF AMERICA; BOARD MEMBER, ALASKA DISABLED
VETERANS BUSINESS ALLIANCE
Mr. Davidge. Senator, first thing I'd like to point out,
the Alaskan Congressional Delegation, including former Senator
Ted Stevens, is the only State congressional delegation that
unanimously supported advanced funding. Thank you. Most
Alaskans don't know that. We are the only State delegation that
unanimously supported advanced funding. The highest legislative
priority funding for all nine national weapons service
organizations over 5 years and we finally got it passed.
One of the things that surprises me, and I shouldn't be
surprised at my age, but having worked for Senator Stevens,
having worked for President Reagan, having worked in
Washington, DC, off and on for many, many years and now as an
advocate for veterans in the State of Alaska, I'm constantly
amazed at how Federal agencies disregard acts of Congress.
As you know from my written testimony, I gave you some
evidence of that, particularly with respect to service-disabled
veteran-owned businesses and veteran-owned businesses. A law
was passed in 1999, executive orders have been signed,
directives have been issued, strategic plans are in place. It
is not discretionary under existing strategic plans, executive
orders, and hopefully the change in law that's being put
forward by the House Veterans' Affairs Committee and we look
forward to the Senate doing the same thing. It will no longer
be discretionary to provide a 3 percent set-aside for service-
disabled veterans all for business and all Federal services. As
you know we have a resolution in the State Legislature of
Alaska calling for congressional oversight hearings in Alaska
dealing with the refusal or inability of Federal agencies to
meet that 3 percent set-aside goal. It's currently in House
Rules. It should be on the House floor this week for passage,
and we don't expect any negative votes. The bottom line is,
Senator, the law is the law is the law is the law. And why
Federal agencies seem to feel, quote, ``you know I just don't
have time for this; it's just too much work; you know what I'd
have to do to find service-disabled veterans who own businesses
and qualify them to get them a procurement opportunity. I just
don't have the time.'' Or ``I've been directed not to comply.''
The only Federal agency in Alaska in our opinion--which I'm
speaking on behalf of the Veterans Business Alliance and I have
testimony from the president that I've provided to you,
Senator--is the Corps of Engineers. The Corps of Engineers does
a lot of work in Alaska; thank God for their efforts. The Air
Force, no. The Army, no. The VA is making an effort nationally.
They've met their requirement, not in this State. The Forest
Service, the National Parks Service, all other Federal agencies
in Alaska that were involved actively in doing things and
spending money up here and issuing contracts, except for the
Corps of Engineers, have effectively said that it's just not
something that's important to them.
Again, Congress passed a law; the President of the United
States signed an executive order; there are strategic plans in
place at every Federal agency. The only way, Senator, that you
could ensure as a former Federal manager that these people will
do what they're supposed to do under law is to put it in their
evaluation criteria. If you have a senior Federal official that
has procurement under their responsibility, and they are
specifically evaluated based on their compliance on the 3
percent set-aside, guess what, it will get done. Thank you.
[The prepared statement of Mr. Davidge follows:]
Prepared Statement of Ric Davidge, Chairman, National Committee on
Economic Opportunities, Vietnam Veterans of America; Alaska State
Council President, VVA; and Member, Board of Directors, Alaska Veterans
Business Alliance
Mr. Chairman:
``It's just too much work.''
``First I have to find those guys, then I have to qualify them, and
then I have to notify them of these opportunities.'' ``I just don't
have the time.''
Or how about: ``We've been directed not to follow Public Law 109-
461.''
That is the attitude in almost every Federal agency approached by
the Alaska Veterans Business Alliance over the past two plus years,
even with Congressional staff in attendance. There are exceptions, and
let me make those clear to you: The Army Corps of Engineers has made
the effort and has met with success. Hoorah!
The US Forest Service? NO
How about the National Park Service? NO
The Veterans Administration? NO
The US Air Force? NO
The US Army? NO
And so it goes.
Representatives of the Alaska Veterans Business Alliance
accompanied by a staff member of our Congressman, in a meeting with the
Alaska Contracting office of Veterans Affairs, then located in
Anchorage, were told that they were directed not to follow Public Law
109-461 which contracts out of the VA set-aside for SDVOB. Now the
Veterans Affairs Contracting Office has moved out of Anchorage and all
contracting is done in Seattle. Not easy for Alaskan SDVOB to meet
with.
We even have a state legislative joint resolution (HJR16) that
passed the House without objection and is now under consideration in
the Senate calling for Congress to hold joint committee oversight
hearings in Alaska to ask the heads of each of these Federal agencies
why? Why do Federal agencies in Alaska refuse to comply with the law,
with the Executive Order, or even with their own regulations and agency
specific strategic plans requiring conformance?
The original law Public Law 106-50 passed in August 1999 allowed an
easier opportunity for a Service-Disabled Veteran-Owned Company to go
into business for themselves by bidding on Federal Contracts. Three
percent (3%) of all federally Budgeted dollars are to be set-aside for
SDVOB's. In October 2004 President Bush signed an Executive Order
(E.O.) 13360 mandating that Federal Contracting Officers achieve the 3%
``goal.'' To date this ``goal'' is no where near being met as the law
intended for it to be--certainly not in Alaska.
According to the Small Business Administration, of the 2008 goals
and achievements out of a total of 24 Federal Agencies only 4 agencies
were meeting or exceeding their ``goals.'' Meeting their goals were DOL
at 4.34% for a SDVOB, VA had their goal up to 11.76% for a SDVOB, EPA
had their goal up to 3.66% for a SDVOB, and GSA had their goal up to
3.93% for a SDVOB.
The embarrassment and slap in the face to all Veterans comes from
their own of DOD. DOD had their goal at 1.00% which as adjusted and was
1.04% for a SDVOB. These numbers reflect nation wide numbers--certainly
not our Alaskan experience.
Out of these 24 Federal Agencies there were a total of 92 Funding
Departments that achieved a 1.4862% with a total of $6,450,206,999.20.
These numbers are prime contracts, again according to the Small
Business Administration's 2008 goals and achievements report.
When it came to subcontracting opportunities for the SDVOBs, based
on the SBA 2008 report, forty-four (44) reporting agencies (or funding
departments) achieved only 0.9% of the 3% goal with a total of
$2,250,720,437.00.
It is time for both the House and Senate Small Business Committees
to introduce legislation that:
(1) Changes the language from ``may'' to ``shall'' in Public Law
106-50
(2) Provides enforcement to ensure that the 3% ``goal'' is being
achieved by all Federal Agencies
(3) And not just on a ``nationwide'' basis as the Contracting
Officers are always saying, but specifically in Alaska.
(4) If the agency can't meet their 3% goal then they should lose
something--can we suggest putting achieving these goals in the
standards for performance for all contract officers and other
decisionmakers?
The Senate Veterans' Affairs Committee also needs to introduce
companion legislation that the House Veterans' Affairs Committee
introduced last December to fix the Veterans Affairs Acquisition
process and changes the wording from ``may'' to ``shall.'' H.R. 3719,
H.R. 4220, and H.R. 4221.
Veterans of Modern Warfare (VMWUSA) along with the Vietnam Veterans
of America (VVA) are two Veteran Service Organizations Nationally
standing together to make sure the laws for SDVOB work as they were
intended by Congress back in 1999.
If the Members of Congress want to get serious and get this done,
they have to make compliance a part of the performance evaluation of
every procurement officer and other key decisionmaker in the Federal
Government. We also recommend it be part of the performance evaluation
of every senior Federal administrator in every Federal agency
responsible for procurement.
It is an honor.
Senator Begich. Thank you very much, Mr. Davidge.
Gabriel Fierros, thank you for your service, too. I
appreciate you being here today.
STATEMENT OF GABRIEL FIERROS, OIF VETERAN
Mr. Fierros. Thank you very much for inviting me to speak
today. I'm just going to get right down to it. I joined the
Army right after high school. I served 10 years and 9 months.
During that time, I had four deployments. My first deployment
was 6 months to Kosovo in March 2001; my second deployment was
in support of OIF for 12 months starting in February 2003. I
was injured for approximately 6 weeks due to a grenade blast,
but remained in-country. My third deployment was in support of
OIF for 4 months starting December 2004. My last deployment was
also in support of OIF and was planned for 12 months starting
October 2006.
I was injured in April 2007, in a helicopter crash outside
of Baghdad. Eventually I was transferred to Walter Reed for
approximately 6 months for injuries to my left eye and
treatment for a TBI. Then I was transferred to the Warrior
Transition Brigade until my temporary medical retirement in May
2009. Since the accident in April 2007, some of the continuous
medical treatments I have received both at Walter Reed and Fort
Richardson are speech therapy, occupational therapy, mental
health, neurology, physical therapy, and ophthalmology. I
started my medical proceedings in December 2008. If I had a
choice, I probably would have stayed in for a full 20 years.
But I was told by medical personnel that they would be
initiating my med board because my medical condition was not
improving.
I received my disability rating from the Army of 70
percent, and was unsure whether or not I wanted to get out. So,
I applied for continuation on active duty. The application was
lengthy, and it was taking way too long for the process, so in
the long run I withdrew my application, decided to accept my
medical board findings and retired temporarily. I filed for my
VA compensation claim in May 2009 for 13 different service-
connected health problems. As of today I've been notified twice
that my claim has been delayed for vague reasons. I have been
told because I am under the old system, my claim will take
longer to process. There are way too many delays and just as I
think I've fulfilled my obligation, I am told that I have one
more appointment, one more appointment, and one more
appointment.
In fact, soldiers that have retired after me on the new
pilot program have already received both their VA and their
Army claims at the same time. It's also very difficult to
obtain accurate information about the VA claim process. When I
started, I was not told of the long delays and tedious process.
I feel that the best source of information regarding my claim
process was older veterans. I found many veterans were very
eager to give advice, recall their experiences, and recommend
people that could help out. That's the end of my testimony.
Senator Begich. Thank you very much, Mr. Fierros.
Mr. Fierros. You're welcome.
Senator Begich. Rich Owens.
STATEMENT OF RICH OWENS, ALASKA STATE CHAIRMAN, NATIONAL
COMMITTEE FOR EMPLOYER SUPPORT OF THE GUARD AND RESERVE
Mr. Owens. Thank you, Senator Begich, for this opportunity
to address the Field Committee Hearing. As a State chairman,
I'm very proud to represent the 40-plus volunteers spread
across Alaska which compose the Alaska State ESGR Committee.
Since ESGR interfaces with and has responsibility for both
military air members as well as employers, I'd like to address
three points today. First, the length and frequency of
deployments have caused more stress by employers especially the
small business owners which are the bulk of the employers of
our soldiers. Many of these business owners who hired our
reserve members are few and far between. Times have changed and
the frequency and length of deployments may start to have a
negative effect on hirability of reserve component members. The
unstable job market is in difficult economic times and does not
really have an answer. If the business goes under or is forced
to downsize in order to survive, they legitimately may not have
the ability to put reserve members returning from deployments
back to work. This is not a reflection on the quality of our
soldiers, but rather the grim reality that no one can say when
we'll have enough growth in our economy to get all of our
reserves back to work. The funding issues for our Alaska ESGR
committee are not unique. I'm sure that other States are
feeling the pinch as well. Where we are unique, however, is our
geographic separation. Each of our four ESGR regional
committees cover areas larger than most States. Only the
Anchorage region can travel to most of its service area by
road. The southwest region must travel by plane, boat, or snow
machine; the southeast region by boat or plane; and the
northern region by plane or car. It is difficult to train five
major job positions within each committee when we only have
funding to bring one or occasionally two volunteers to our
steering committee meetings or State meetings.
Not only does this make it difficult for them to perform
their duties, but it also creates additional turnover when they
get frustrated. What we do as volunteers is not hard once you
have the training. Volunteers need to be confident in their
position whether they're working with soldiers or employers.
This confidence comes with training. The national ESGR office
has been helpful in trying to accommodate our special needs.
But with the tight budget we are now operating under, doing
more with less will be the order of the day. Thank you.
Senator Begich. Thank you very much, Mr. Owens. Thanks to
all the panel for the diverse views on some of the work of the
VA. I'm going to ask a few questions. First, Gabriel, if I can
ask you a couple of questions. Your thoughts were very
interesting to me regarding the time it took you to kind of go
through the process and try to get back into the military, but
that did not work out well because of the timeline. Can you
describe that a little bit more to me? What happened at that--
--
Mr. Fierros. At the initial time of my application for the
coed, I had filled out the application, sent it in through my
pueblo--it got down there pretty quick--but just seemed to
stall once it got to the coed side of the Army. And it stalled
and stalled while it was getting closer to my retirement date.
So, I kind of panicked and withdrew my application. So, it was
just a tedious process, so much waiting and waiting, and there
wasn't really any answers as to why it was taking so long
either. So----
Senator Begich. Did you have communication with them--I
mean, would you be calling them? Or how did you----
Mr. Fierros. All my information came from the pueblo there
on Fort Richardson; and he did a fine job of getting the
information for me, though it seemed like he just wasn't
getting the information either.
Senator Begich. He wasn't going to?
Mr. Fierros. Yeah. Something was going on there, but I'm
not sure what.
Senator Begich. In that process, is there a time table of
response that they have to have it by, or do they have to
respond to you by so many days?
Mr. Fierros. I'm not too sure about that. I couldn't tell
you.
Senator Begich. Tell me, if you can, just on the claim
process--I note that you had several related disabilities when
you were going through the process. When they took action, were
there some of those disabilities that they clearly had no
question of and some they did or how did that work?
Mr. Fierros. All of them shouldn't really be questioned.
They're all documented through the military. They're in my
medical records so I didn't see the reason why--sleep studies
that I had already done before, you know, or neurology
appointments that I go to every 3 months anyway, so--and
there's a lot of repeats and a lot of stuff that--you know, I
just recently got out, so I don't understand why there was such
a need to send me back through all that. I understand they need
their own information, but there is just--it's tedious on my
part. I'm trying to--you know, support my family and I have to
take off work to go, you know, to appointments all day long. I
spend pretty much the 3 days that I have off--because I work a
four/ten shift--going to appointments for the VA, for the Army.
It's hard on family life.
Senator Begich. When you said there are repetitives, some
of the work that was already done already was happening or you
already had certain tests, you already had certain medical
documentation within your file; but you were applying for
disability. There were requirements of additional visits, which
were basically duplicates?
Mr. Fierros. Yes.
Senator Begich. Is that what you tought--they were
duplicates?
Mr. Fierros. Yeah, they were duplicating. Actually, more
recently they signed me up for another sleep study and I told
them, no, because I just actually had a checkup at the sleep
study clinic--same thing they wanted but for some reason they
were saying that it wouldn't work in the VA system.
Senator Begich. Same study you already did?
Mr. Fierros. Yeah, which it was done, you know, for the
Army, not for the VA. I thought they were about sharing
information, but I guess not.
Senator Begich. I have a feeling the next panel will
hopefully have a question or two from what you've just laid out
to see how that works. Thank you, Gabriel, that was very good.
Mr. Fierros. OK.
Senator Begich. Ric, your testimony has all around good
detail in some of the issues around the 3 percent set-aside. I
mean, you're right about the Corps. I've seen some of their
documentation. They do a pretty good job. We've talked multiple
times on it. But what I'm reading in your testimony and hearing
in your verbal testimony is that many of the departments are
not fulfilling the 3 percent set-aside for disabled veterans in
any form. They're just kind of putting the paper out there. So,
how do you--I guess I'm asking you: How do you see it from your
perspective? Are they trying to process--nothing really comes
back, because of the way the process is set up, or they're not
even trying that?
Mr. Davidge. Let's take for example, the statement: How do
I find these guys? Well, there's a list that's available on the
Internet of over 300 service-disabled veteran-owned businesses
in Alaska. But the procurement officer was unaware of that. We
have legislation in Juneau now that deals with veterans
preferences for veteran-owned businesses in Alaska--a 7 percent
preference on State procurements. Our effort there is also to
get a State registry, so that any State veteran-owned business
that would want to apply for State procurement, which would
include other additional points for Purple Heart disability, et
cetera, et cetera, would be available on the Internet. The day-
to-day life of a procurement officer is an interesting
experience. The bottom line is, in my opinion, and I think this
is a shared opinion of the board of directors of the Veterans
Business Alliance in Alaska, is that they have a relationship
with certain contractors. They like that relationship. It's an
easy relationship, and for them to find new contractors or
subcontractors or partners, et cetera, is just a lot of work.
The bottom line is they're not held to any accountability for
not just effort, but for success. Now, we have a number of
service-disabled veteran-owned businesses who have begun to
have success, but it's in response to being rather nasty and
getting in the face of certain managers to say, ``You just let
out this contract; you let it out for the same guy. This is not
a service-disabled veteran. They won't even sub with me. This
is exactly what I do. I've been doing it for 5 years
successfully up here. Why can't I get consideration?''
My point is: If you don't put it in the performance
evaluation, you have no hammer. Again, the House Veterans'
Affairs Committee has two bills that will now, in the VA--
hopefully, another bill is being put together--do it
nationally. The set-aside is not discretionary, it is
mandatory. And even in those bills at your meetings with the
Committee staff, they're looking at specific language requiring
performance requirements for supervisors and procurement
officers.
Senator Begich. Should it--if I can add a comment--should
it be not only the supervisor, but the division or the
department as a unit?
Mr. Davidge. Yes, any supervisor, any individual all the
way up to a director of an agency that has procurement
requirements under them should have this evaluation in their
performance evaluation criteria. It should be written into
their personnel contract.
Senator Begich. Does the Association feel that it's readily
available for you--I know the Corps did a pretty good job with
the presentation to me on what they've done. I've not
necessarily seen that from our agencies. This may be a pretty
leading question: Is there a need for uniformity in how they
report this? Doesn't seem like I see it, maybe you see it.
Maybe I'm missing that.
Mr. Davidge. Well, yes and no. When you look at
procurements they're all different----
Senator Begich. Sure.
Mr. Davidge [continuing]. In many ways, particularly in
Alaska.
Senator Begich. I guess their percentage-- in other words,
if they're actually reaching their target.
Mr. Davidge. Some of them are exceeding their targets; the
Corps of Engineers is a great example.
Senator Begich. Yes, a great example.
Mr. Davidge. As we like to say in management, certain
organizations take on the corporate culture, unless that
culture is shifted. People are beginning to see how difficult
that is. One of the problems we faced when I worked for the
Reagan Administration is taking management directives from
members of the Cabinet down to the ground and actually getting
those guys on the ground to actually do something. The only way
to do that is to put it in their performance evaluation.
Let me offer a comment with respect to our new veteran
here. Let me say the VA clinic here is one of the best in the
country. One of the problems we've seen is--which you have
testimony from our nationally-accredited VSO--the VA, both in
benefits and services is not in the habit of notifying the
veteran's service officer who has filed a claim for that
veteran. I have a son who is here in the audience today, 4
years in Iraq, IEDs, et cetera, et cetera, et cetera, has brain
problems. Getting him to make an appointment is a difficult
problem. Not notifying the VSO when the VSO specifically
requested to be notified so they can ensure that this veteran
comes and attends those meetings would be a very good thing to
do. There is no reason, given the agreement between the veteran
and VSO with the power of attorney, that the VA cannot notify
that VSO to help this veteran get to a meeting. It is not just
veterans with mental problems or brain damage problems, it's
veterans that are going through the transition of being a
warrior to being a civilian.
Senator Begich. Is there--if I can just stay on this with
you, Ric. Is there one single thing to help fix this, that you
believe could fix that problem, make that connection?
Mr. Davidge. I think there is a very solid, easy way to get
the VSO to help the new veteran get to their appointments, get
their claims processed, et cetera. If you've got a veteran who
has Traumatic Brain Injury who is not making a mental health
appointment, there may be a reason other than the simple fact
that they're not remembering it, but that should go for all
veterans. When the veteran is notified of the appointment, the
VSO should be notified of it. And if my VSO doesn't take care
of that veteran, he's not going to be my VSO very long.
Senator Begich. OK. Very good. Tim, I want to ask you,
because you rated your experience pretty high in your
relationship with at least transitioning. That's why we wanted
this panel, so we could get a sense, a diverse viewpoint. Tell
me now that you've gone through it, what made it easier for
you? You rated it pretty high. You almost had a 10. It's pretty
good. So, I'm trying to take from your perspective and
Gabriel's over here, what did it, do for you to move through
that system in an easier or faster fashion?
Chief Carroll. It's hard to put a finger on exactly what
would have made a difference. I was pretty aggressive in trying
to understand the system myself.
Senator Begich. Can I interrupt? When you say
``aggressive,'' tell me what you mean by that. I know when I'm
aggressive what it means, but everyone has a different
perspective, please.
Chief Carroll. I stayed on the phone; I stayed on the
Internet; I was asking the questions of: What do I need to do
to meet the timing? What are the things that I need to provide?
What can I do? Be it printed, be it online, be it via the
phone, I was a squeaky wheel trying to make sure that I was
armed with the right information for what my responsibilities
were. Even still, the reason it's not a 10 is that there are a
couple of things that I didn't know. I'll tell you, the VA, the
Transitional Assistance Program, the TAP, that's run through
the military family readiness centers, is absolutely essential,
I believe, to transiting or transitioning veterans. The VA
representative who presented that briefing did a fantastic job
of running down the litany of benefits of making sure that we
were armed with what it was that we had available. Even still,
there were things that I didn't get from there, and things
that--I'll point to one specifically. The VA funding fee on
home loans----
Senator Begich. VA funding fees on home loans?
Chief Carroll. On a home loan, correct, using the VA
mortgage guaranty program. With a compensable disability, the
VA funding fee, the upfront cash fee is waived. I think you
know each time you use a VA loan the percentage goes up, up,
up. With a compensable disability, that fee is waived. Nobody
told me that. The only way I found it was I was doing some on-
line search for home loans and USAA, a great organization out
there, takes good care of us, they have an on-line calculator.
And one of the questions on their on-line calculator was
compensable disability and I clicked ``no'' because I didn't
know yet, and it showed the bottom line of what the mortgage
was going to be. Just for the grins of it, I went back up and
clicked ``yes'' to see what that would do, and it made a
$12,000 difference in my mortgage. What is that all about? Then
I went asking questions. No one told me that. I couldn't find
that information anywhere, and I was looking pretty hard for
things. I know someone will tell me, Tim, it was printed right
there on the top line and you missed it. But, I'm telling you,
I didn't know. I circled back to a lot of folks that were
retiring at the same time and nobody knew that. I couldn't find
anyone who knew that. Now, OK. That's one little thing, but
that's an instant cash, instant effect. My mortgage, because we
closed it, was $12,000 higher than it needed to be.
Now to the VA's defense, once the disability rating was
determined, I made application to the VA, and very timely, it
was not slow-rolled by any stretch of any imagination, they
refunded the funding fee and it went against my mortgage. So,
instantly, we got some equity on our loan. So, the VA responded
well to that piece once I made that application. However, I
would not have even known it on the front end if not by
accident.
Senator Begich. Very good.
Chief Carroll. I asked the questions of veteran services
organizations who were very helpful. I used the American
Legion, all of the service organizations were more than
accommodating for outreach to try to help us. The VA was very
good about making sure we knew what resources were available to
us to help do it. I guess I'll throw it in here now. The
downside, the unintended consequence, is when the VA is telling
us to go to the service organizations to file our claim, when
the VA tells us in virtually every written document that I've
gotten that you can get a legal representative to represent
you, it automatically creates an air of adversarial
relationship. And, you know, hearing ``you can bring a gun to
the fight if you want,'' tells me, well, what kind of fight is
it that I need to bring a gun? What kind of fight is it that I
need to have the service organization representing me? What
kind of fight is it that I need to have a lawyer represent me?
If the system is so cumbersome--which it is--that I need to
have that kind of help, then there's something wrong with the
system.
Gabriel is a perfect example: the repeated proof and the
repeated evidence that he has to provide over and over and over
again for something that's painfully obvious, come on. Can't we
skinny that down just a bit and make it not so burdensome that
we have to have legal representation to get the rights and the
benefits that we deserve?
Senator Begich. Thank you very much. Before we bring on the
next panel, I want to ask Ric: Is there something that we can
do through our jobs efforts to make a difference in regards to
making sure that those employers who are really pulling the
weight here, making sure they rehire when soldiers come back?
Is there something we can do within our jobs agenda that can
help? It's a pretty broad question, but is there something that
you sense would make a difference? One target?
Mr. Owens. I think that, you know, the way they started to
schedule the deployments, so you know further out, that
definitely helps the employers to plan or to know in advance
when their employees will be gone. But I think that for the
small employer, by the time someone goes out for their second
or third deployment, if you've only got three plumbers in your
company and you pull one of them out, then by the third time
you pull that one person out, it became, you know--they do it.
I think the fact that within Alaska, if you look at the cases
that we have and the situations that come up, 95 percent of the
questions that we get are resolved with phone calls. They very
seldom actually have to go to the Department of Labor or
beyond. So the level of support is still there, but what I fear
is that as business stretches out longer and longer--
subconsciously some of these employers, all things being
equal--when someone comes in looking for work, they don't have
to tell the business that they're in the Guard or Reserve in
advance. But I think it's a small town and you know when
someone is in the Guard or Reserve. Subconsciously they may
have a bias against the soldiers, and it's not very apparent
right now, but, I mean every now and then--more often now than
when I started with ESGR, I hear a comment out there that's--
the predictability of deployments, you know, when it's going to
happen, how long it's going to be. I don't want that to enter
into, you know, the employability of the soldiers.
Senator Begich. Right.
Mr. Owens. And I think that, we realize that our budget for
ESGR has been has been trimmed down considerably from when I
started as well. So on one hand we've got a smaller budget, on
the other hand the demand for ESGR services is tenfold.
Senator Begich. Probably one of the peak times now?
Mr. Owens. That's one of the things we're struggling with.
When we pulled all of the soldiers out of western Alaska, we
deployed a crew out there. He's got an Army out in western
Alaska that he couldn't fly to, or float to, or snow machine
to, but we can only bring one person in to train them for
either ombudsman services or employer outreach, military
outreach.
Senator Begich. Very good. Thank you, Rich.
Mr. Davidge. Senator, I have one quick thing I'd like to
add.
Senator Begich. Very quick.
Mr. Davidge. I think it's time to look at how we use our
National Guard and Reserves. We work with Guard and Reserve
people that are coming back. This is not what they signed up
for. That does not mean they shouldn't serve. I'm simply
saying, when you sign up to be in the National Guard, you want
to serve in your State or at least in your region, and the
whole motivation of joining the Guard and being involved in
that kind of thing is different than joining the active
service. Our reliance on the Guard and Service Reserve, in my
personal opinion and as a contact medic in Vietnam, is beyond
the concept of how it was originally set up. Nationally we need
to look at expanding active duty as opposed to relying on Guard
and Reserve because we're destroying families; we're destroying
economies, we're destroying businesses as an unintentional
consequence to the way in which we're deploying those men and
women.
Senator Begich. Thank you very much, Ric. Thank you all
very much for your testimony. Again, for the audience, if
you're not familiar with field hearings, all of this enters
into the Congressional Record. It helps us determine what
efforts we should make for the veterans when we go back to
Washington. So, again, to all four of you, thank you very much
for your testimony and your participation today.
Let's bring the next panel up. The next panel as they get
up here, we're reminding folks that if you have additional
questions or comments please utilize the document that we have
available in the back at the table. Please feel free to fill
out the comments. Again, we will have a roundtable in Wasilla.
We will have a roundtable meeting in Fairbanks, and then we're
going out to Kotzebue to hear from rural Alaskans about the
delivery of jobs and health care. Please have a seat. I'm just
biding time, that's what I'm doing as you get situated.
Thank you very much. We're going to do a quick test on the
mics. Let's try your table over here. Just talk into the mic to
see how we're doing.
[Pausing.]
We have five panelists in this next panel. What we'll try
to do--to the people in the audience, as you hear the testimony
from this next panel you may have questions, individual
comments, or information that you want to offer them. What
we'll try to do is allow a little flexibility as we finish this
hearing. There will be a couple of us that have to attend to
other issues, but we ask that if you have questions on the way
out of here these people can have conversations, but very
limited because today is a field hearing. But, again, there is
opportunity.
Let me introduce the five panelists then we'll go right
through the list. As I read these, it's not necessarily the
order you'll be called. I just want to forewarn you.
The Honorable Ray Jefferson, Assistant Secretary of Labor
for Veterans' Employment and Training. Brigadier General Tom
Katkus, Adjutant General, Alaska National Guard. Mark Bilosz,
director, Anchorage Regional Office, Veterans Benefits
Administration, Department of Veterans Affairs. You have a
couple of folks accompanying you. Belinda Finn, Assistant
Inspector General for Audits and Evaluations, Office of
Inspector General, Department of Veterans Affairs. Jan Myers,
Director, Family Programs, Alaska Department of Military and
Veterans Affairs.
The order will be, just so people will know and prepare
mentally, the Honorable Ray Jefferson, then it will be Belinda
Finn, Mark Bilosz, Brigadier General Katkus, and then Jan
Myers.
Let's start with Ray Jefferson. Again, thank you very much
for attending and taking up my offer so fast. It was only a
month and one-half ago when I ended by asking you to come to
Alaska. I'm not sure what you expected. I think you picked the
right week to be here.
STATEMENT OF HON. RAYMOND M. JEFFERSON, ASSISTANT SECRETARY OF
VETERANS' EMPLOYMENT AND TRAINING SERVICE, U.S. DEPARTMENT OF
LABOR
Secretary Jefferson. Aloha, Senator. Senator Begich,
veterans, citizens of Alaska, members of the Anchorage
community, I'm thrilled and honored to be here today. I call
Hawaii home. This is my first time in Alaska. I'm really
excited for being here this week and learning as much as I can.
Let me talk about three things: Who we are, what we do, and how
we're serving the veteran community in Alaska. Who we are?
Myself a veteran served with the rangers and special forces,
lost my hand to a grenade in the line of duty, went through the
VA program and now I have the privilege of serving as your
Assistant Secretary for Veterans and Employment.
As an agency we have 240 people around America. Our mission
essentially is that we proudly serve these men and women behind
me today, these veterans and transitioning services members in
America. We prepare them in their quest for meaningful careers,
maximize their employment opportunities, and we protect their
employment rights. We have five primary aspirations.
The first is serving as a national focal point for
veterans' employment. That involves ensuring we serve all
communities with unique needs. Homeless veterans, women
veterans, veterans in rural areas, veterans who have been
wounded, ill, or injured, and veterans who are members of the
National Guard and Reserve. We also want to increase awareness
of access to and participation in our programs and to do what
we're doing today, which is convening, collaborating, and
communicating with all of our stakeholders. We work in
partnership with Congress, sir, as you know, and also the
Department of Defense, Veterans Affairs, private sector,
nonprofits, the VSOs, ESGR, who is here today, as well, and
other government agencies. So, what are some of the things that
we're doing?
In addition to serving as a national focal point, we also
want to increase our second aspiration: Engagement with
employers, particularly the private sector. We want to provide
meaningful employment with particular emphasis on green jobs
and find seamless transition for our transition services
members.
A fourth major aspiration is boosting the impact of USERRA,
by increasing awareness of it and commitment to it.
And the fifth is providing excellent service to our
veterans and transitioning servicemembers. So, how will these
five aspirations translate to what's happening on the ground
here in Alaska? Let me start with one of our programs--jobs for
veterans State grants. We have 2000 employment representatives
around America; 13 of those are here in Alaska. Eight are
accessible through the Anchorage and Fairbanks communities.
Some of these employment representatives we call local veteran
employment representatives and they connect veterans with
employment opportunities. We also have disabled veteran
outreach program specialists who provide intensive services to
disabled veterans. With our homeless veteran integration
program we have one standdown that we handle every year in
Anchorage. We also want to do a much better job of serving our
Native American veterans. Thus far we've met and convened a
gathering of tribal leaders. We're launching and completing a
study to identify best practices to serve Native American
veterans and we're also going to major convening events of
Native American tribal leaders and tribal veterans this year.
What we want to learn from the Native American veterans is what
they need and how we can do a better job serving them.
USERRA, employment rights. Alaska has five to six
complaints a year. There's tremendous support for the veteran
community here. We want to make sure the process of submitting
these complaints is more efficient and more effective; we're
moving to an electronic case management system and we're
implementing quality and process control measures there.
Finally, the Transitional Assistance Program. In Alaska, we
have about 60 employment workshops a year, and we have roughly
1500 servicemembers who transition out of the military in
Alaska each year as well. We have a two-and-a-half-day
employment workshop and for the first time in 17 years we're
going through a complete transformation. We want to make it
more economically relevant, immediately useful, and engaging
for participants. We're going to shift it from the current 268
slide show PowerPoint presentation to something which is much
more dynamic and high energy with higher quality facilitation;
prepared templates so veterans don't need to restart their
cover letter and resume every time they prepare one; life and
career planning; resiliency training; stress reduction
techniques; and also new best practice assessments. So let me
conclude, sir----
Senator Begich. You're sending that to Congress?
Secretary Jefferson. Maybe we can do a demonstration
project. [Laughter.]
In conclusion, sir, I'd like to say this: We met last time
on November 18. You invited me out to Alaska and I called your
office the very next day. I don't want to assume that we're
doing the right things in Washington. We're grateful and
honored to be here with you this week to learn from you, to
learn from the men and women seated behind me and also on this
panel to make sure that we're asking the right questions, we're
developing the best programs, and what we're doing is valuable
and will provide veterans and transitioning servicemembers with
the excellent service that they've earned and deserve. Thank
you, sir.
[The prepared statement of Secretary Jefferson follows:]
Prepared Statement of Raymond M. Jefferson, Assistant Secretary for
Veterans' Employment and Training, U.S. Department of Labor
Senator Begich and Distinguished Members, thank you for inviting me
to appear before you today to discuss the employment assistance and
outreach services provided to the Veterans in Alaska.
The mission of the Veterans' Employment and Training Service (VETS)
is to provide Veterans and transitioning Servicemembers with the
resources and services to succeed in the workforce by maximizing their
employment opportunities, protecting their employment rights, and
meeting labor market demands with qualified Veterans.
We accomplish our mission through three distinct functions: 1)
conducting employment and training programs; 2) enforcing relevant
Federal laws and regulations; and 3) providing transition assistance
services.
vets' programs
VETS administers a formula grant program to States that directly
meets the goals of its mission. The Jobs for Veterans State Grants
(JVSG) program funds two occupations, the Disabled Veterans Outreach
Program specialist (DVOP) and the Local Veterans Employment
Representatives (LVER). DVOP specialists provide outreach services, and
intensive employment assistance to meet the employment needs of
eligible Veterans. LVER staff conducts outreach to employers and
engages in advocacy efforts with hiring executives to increase
employment opportunities for Veterans, encourages the hiring of
disabled Veterans, and generally assists Veterans to gain and retain
employment. In Alaska, VETS funds six LVERs and seven DVOPs. Of these
13 individuals, eight are accessible in Anchorage and Fairbanks.
To meet the needs of homeless Veterans and help reintegrate them
into the workforce, VETS administers the Homeless Veterans'
Reintegration Program (HVRP). In Alaska, VETS sponsors one stand-down
each year in Anchorage for homeless Veterans. The stand-down provides
basic services, medical care, food and clothing for Alaska's homeless
population. Veterans with significant barriers to employment or
service-connected disabilities are also served through the Veterans'
Workforce Investment Program (VWIP)--a focused and innovative training
program that coordinates services available through other VETS
administered programs.
Both the homeless and workforce investment Veterans programs are
funded through a competitive grant process. This year, for the first
time ever, VETS will issue a Solicitation for Grant Applications (SGA)
for homeless women Veterans. We also will soon issue an SGA to
reinstitute the Incarcerated Veterans Transition Program (IVTP) to
assist Veterans who will be transitioning back to society from
incarceration. Additionally, we are in the process of developing an SGA
for both HVRP and VWIP. Service providers for these deserving
populations in Alaska are encouraged to apply for these competitive
grants.
native american veterans
To meet the needs of Native American Veterans, especially those on
tribal lands, Secretary Solis hosted--and VETS participated in--a
Summit of Tribal Leaders at the Department of Labor late last year. We
discussed the challenges facing Native American Veterans and potential
solutions. This event began the process of better serving this
community. VETS will also participate in a number of major Native
American outreach events in 2010. Furthermore, we are conducting a
study on the employment needs of Native American Veterans living on
tribal lands to identify best practices for serving this population.
userra
Our compliance programs investigate an average of five or six
complaints per year filed by Veterans and other protected individuals
in Alaska under the Uniformed Services Employment and Reemployment
Rights Act (USERRA). We also assess complaints alleging violations of
statutes requiring Veterans' Preference in Federal hiring, and
implement and collect information regarding Veteran employment by
Federal contractors.
One of our commitments to Veterans is to increase awareness of
USERRA, thereby increasing our ability to protect vulnerable
populations. To improve USERRA's impact, VETS recently completed a
Lean-Six-Sigma quality enhancement and process efficiency assessment of
USERRA, with a view toward streamlining, improving quality, and
increasing responsiveness to our Veteran clients. The goals of the
assessment were to: 1) identify ways of ensuring a consistent, high
standard of investigations; and 2) determine other steps to improve the
program and its outcomes. We have begun work on identifying an
electronic case management system to eliminate the paper-centric aspect
of investigations and improve efficiency. Access to this system will be
shared with our Federal enforcement partners. We are also working
closely with the Office of Personnel Management (OPM) to ensure that
the Federal Government serves as a role model for honoring USERRA.
transition assistance program
VETS' transition assistance services are offered through the
Transition Assistance Program (TAP), which provides employment
workshops and direct services for separating military members,
including those who are seriously wounded and injured.
TAP is a Department of Defense (DOD) program that partners with the
Department of Labor (DOL), the Department of Veterans Affairs (VA), and
the Department of Homeland Security (DHS). TAP has four components:
1. Pre-separation counseling--this is mandatory for all
transitioning Servicemembers and is provided by the military services;
2. TAP employment workshops--these are voluntary on the part of the
transitioning Servicemember and are administered through DOL and its
state partners;
3. VA benefits briefing--these briefings are also voluntary and
administered by the VA; and
4. Disabled Transition Assistance Program--also voluntary and
administered by the VA.
tap employment workshops
Since 1991, when DOL began providing employment workshops pursuant
to section 502 of the National Defense Authorization Act for Fiscal
Year 1991 (P.L. 101-510), we have provided employment and job training
assistance and other transitional services to more than one million
separating and retiring military members and their spouses. DOL was
further directed to provide these services at overseas locations by
section 309 of the Veterans Benefits Act of 2003 (P.L. 108-183).
VETS began facilitating TAP workshops at overseas military
installations where, by previous interagency agreement, the DOD had
provided TAP workshops since the program's inception. We are currently
conducting TAP employment workshops at 55 sites overseas, including
Germany, Japan, Italy, Korea, Guam and the United Kingdom. Our mission
is to provide TAP at every location requested by the Armed Services or
National Guard and Reserve Components.
VETS provides employment search workshops based on projections made
by each of the Armed Services and DHS, for the U.S. Coast Guard. DVOPs
and LVERs are the primary source for TAP Employment Workshop
facilitation stateside. However, because of the distance between many
state employment offices and the military installations, as well as the
rapid increase in Workshop participants, contract facilitators were
added in early FY 1992 and supplemented by Federal staff in FY 1996.
Alaska currently does not use contract facilitators.
DOD recently set a goal for TAP Employment Workshop participation
of 85 percent of separating servicemembers. Eighty-one percent of
active-duty transitioning Servicemembers currently attend the DOL TAP
employment workshops, a 30 percent increase in participation since
2001. TAP employment workshop participation is expected to increase
over the next year, and we plan to target workshop delivery to spouses
and family members of separating Servicemembers, including those with
limited English proficiency.
VETS is committed to ensuring a consistently high level of
instruction, service and quality for all Servicemembers and spouses
attending TAP Employment Workshops. Therefore, VETS requires that all
TAP facilitators receive training conducted by the National Veterans
Training Institute (NVTI) at the University of Colorado in Denver. NVTI
provides competency-based training to further develop and enhance the
professional skills of Veterans' employment and training service
providers throughout the United States.
An Alaska DVOP or LVER representative attends each TAP workshop
session here to discuss their respective roles and responsibilities in
providing job search assistance. Since most transitioning
Servicemembers return to some other state, this information is provided
to help the Servicemember contact the DVOP and LVER representative in
their respective states to assist them directly with their re-
integration into the local job market in their areas.
Alaska averages more than 60 TAP employment workshops annually with
approximately 1,500 transitioning Servicemembers in attendance. This
includes about one work shop per quarter with the Coast Guard. There
are four major TAP sites, encompassing all military service branches
plus the U.S. Coast Guard with an additional four sites that vary in
size and frequency according to need.
National Guard and Reserve personnel in Alaska are informed that
they can attend TAP for up to 180 days after they complete their active
duty commitment. An individual DVOP or LVER can facilitate a TAP
employment workshop, or they may do so as a unit.
The Alaska DVET (Director of Veterans' Employment and Training)
meets annually with the DVOPs and LVERs who facilitate the TAP
employment workshops to discuss transitioning Servicemember's feedback
and curriculum updates based on the input provided by these TAP
recipients.
In addition to presently reviewing TAP's performance and impact, we
are also working to modernize the workshop, increase its effectiveness
and improve participants' employment outcomes. Specifically, we want
the content to be more economically relevant, immediately applicable,
and engaging for participants. Thus far, we've solicited input from
external content experts and service providers to help us determine
what should be included in a best-practice employment transition
program. We are working in close cooperation with our partners at DOD,
the Department of Veterans Affairs (VA) and the Department of Homeland
Security (DHS) in this endeavor.
Late last year, our three agencies engaged in a weeklong working
group to develop a joint, multi-year, strategic plan for TAP. We're all
committed to ensuring the plan is action-oriented and will have a
direct, positive impact on our transitioning Servicemembers. The plan
will involve an increased emphasis on the employment needs of the
Reserve components and Servicemembers who have been wounded or injured,
or who are ill.
reserve component and national guard employment workshop
Global military commitments have necessitated a mobilization of
Guard and Reserve members that is unprecedented in modern times. The
longer mobilization periods result in these Servicemembers now being
eligible for Veterans' benefits, including TAP. The employment workshop
is available for Guard or Reserve Members, along with all other
Servicemembers, at one of the 215 transition offices located on
military installations in the United States as well as overseas
locations.
However, Reserve and National Guard members usually transition at
fewer locations, referred to as demobilization sites. Typically the
demobilization process is rapid, taking a matter of days once the
Servicemembers arrive back in the United States from overseas. During
demobilization, Servicemembers may be expected to participate in many
separate briefings and activities. This leaves little or no time for a
full two and one-half day employment workshop. Nevertheless, we have
found that many National Guard and Reserve Servicemembers would benefit
from such transition assistance. Our State Directors have coordinated
with each State Adjutant General, and they work directly with the
individual Reserve and National Guard commanders to make special
arrangements following demobilization in order to present a modified
TAP employment workshop to Guard and Reserve Servicemembers. Based on
requests from Reserve Component Commanders or Adjutant Generals and
through coordination with our VETS' state directors and local VA staff,
VETS has offered to tailor the workshops to the identified needs of the
transitioning Reserve and National Guard members.
In fact, since 2001 VETS has provided transition services to over
146,000 National Guard and Reservists. These transition services range
in size and content from mobilization and demobilization briefings to
the full-scale TAP employment workshops. They are provided in 43 states
and the District of Columbia. In some states, National Guard and
Reserve members have been allowed to attend the regular TAP for Active
Component Servicemembers. The services provided to the National Guard
and Reserve are tailored to the needs and requests made by DOD.
To meet the transition needs of the National Guard and Reserves, in
FY 2007, DOL directed the NVTI to develop a modular version of the TAP
employment workshop. The traditional TAP employment workshop was turned
into a 15-module menu from which Reserve and National Guard commanders
may select relevant services for their unit members. This modular TAP
menu includes a mandatory module that covers local labor market
information, USERRA, the One-Stop Career Center system, small business
opportunities, and the risks of homelessness. The other 14 modules
consist of the current TAP employment workshop curriculum broken down
into logical and connected blocks of instruction. This is not a new or
separate curriculum for the Reserves and National Guard; rather it has
been packaged to better serve this community.
USERRA briefings are conducted upon request and through outreach by
VETS' staff. This year, VETS already has provided TAP briefings and
USERRA outreach to the State of Alaska Army and Air National Guard
units, as well as Marine Corps Reserve.
In closing, I again thank you for allowing me to address you today
on this very important issue. I would be pleased to respond to any
questions you may have.
Senator Begich. Thank you very much. Again, we'll do the
same routine. I'll ask each person who testified and then I'll
come back with a list of questions. The next person on the
panel is Belinda Finn. Let's move that mic. Thank you very
much.
Ms. Finn. Thank you. Can you hear me?
Senator Begich. Yes.
STATEMENT OF BELINDA J. FINN, ASSISTANT INSPECTOR GENERAL FOR
AUDITS AND EVALUATIONS, OFFICE OF INSPECTOR GENERAL, U.S.
DEPARTMENT OF VETERANS AFFAIRS; ACCOMPANIED BY BRENT ARRONTE,
DIRECTOR, BENEFITS INSPECTIONS DIVISION, OFFICE OF AUDITS AND
EVALUATIONS
Ms. Finn. OK. Senator Begich, thank you for the opportunity
to be here today to testify about our inspection of the VA
Regional Office in Anchorage, AK. With me today is Mr. Brent
Arronte, who is the Director of our Benefits Inspection
Division. The Benefits Inspection Program is an initiative to
ensure our Nation's veterans receive timely and accurate
benefits and services. The OIG was scheduled to review all 57
Regional Offices on a 5-year cycle. But we've recently began a
hiring initiative that will allow us to review all of the
offices in 3 years. During our inspections, we've reviewed
functional areas and operational activities using five
protocols that cover: claims processing; data integrity;
management control; information security; and public contact.
We report on our results as a snapshot in time for each era.
In the summer of 2009 we conducted an inspection of the
Anchorage office focusing on 14 operational activities and
found that the office had issues in meeting standards for 13 of
those areas. We concluded that the management team has
challenges in the oversight of operational activities,
improving insufficient network capacity to support business
processes, providing training to staff, and managing an
internal claims brokering process. We believe that two issues
contributed to the challenges in management oversight at the
office. First, the VARO did not have a veterans service center
manager for approximately 8 months during fiscal year 2009,
that position had been filled shortly before our visit.
Additionally, the director of the office is actually located in
Salt Lake City and manages from afar. Both of these positions
are key in managing effective operations in the office.
Also, as you report, as a result of the capacity issues,
the employees had difficulty consistently accessing the
computer applications they needed to perform their jobs. The
employees told us this problem had been occurring for over a
year. We also noted that the director was moving claims from
Anchorage to offices in Fort Harrison, MT, and Salt Lake City,
UT. This movement of claims made it difficult for the staff to
manage the workload and associate mail with the corresponding
claim folder. Because of this movement of work, we compared the
staffing levels in Anchorage to the Boise VARO, and we found
that the Boise office had 22 additional full-time employees for
a comparable inventory of rating and nonrating claims. We
recommended that the director improve oversight of the quality
assurance process, develop a mail routing guide to ensure
proper mail processing, research the causes and solutions to
improve network capacity issues, and provide additional
training to staff. The director concurred with all of our
recommendations, and provided responsive comments and action
plans.
Thank you, again, Senator, for the opportunity to be here
today. Mr. Arronte and I would be pleased to answer any
questions.
[The prepared statement of Ms. Finn follows:]
Prepared Statement of Belinda J. Finn, Assistant Inspector General for
Audits and Evaluations, Office of Inspector General, U.S. Department of
Veterans Affairs
Senator Begich, thank you for the opportunity to testify today on
the Office of Inspector General (OIG) report, Inspection of the VA
Regional Office, Anchorage, Alaska. I am accompanied by Mr. Brent
Arronte, Director, Benefits Inspection Division, Office of Inspector
General, Department of Veterans Affairs.
background
The Benefits Inspection Program is a new OIG initiative to ensure
our Nation's veterans receive timely and accurate benefits and
services. The Benefits Inspection Division contributes to the
improvement and management of benefits processing activities and
veteran services by conducting onsite inspections at VA Regional
Offices (VAROs).
Under the current organizational structure, the Benefits Inspection
Division, consisting of two teams, will complete a review of all 57
VAROs during a 5-year cycle, performing 12 inspections annually. The
OIG recently implemented a new hiring initiative to create a second
Benefits Inspection Division. Tentatively, this new division will be
operational by the end FY 2010. This initiative would allow the OIG to
complete a review of all VAROs within a 3-year period.
For each inspection, we issue a report describing VARO performance
as measured against current VBA and VA policy. The scope of our
inspections allows for a narrow review of work performed at each office
and our reports represent a ``snapshot'' in time. Currently, we perform
our reviews using five protocols focused on distinct functional areas
and specific operational activities within the VARO. The protocols are
claims processing, data integrity, management controls, information
security, and public contact. We designed these protocols based on a
risk analysis of previous OIG national audits and Combined Assessment
Reviews, VBA's Compensation and Pension Site Visit reports, Government
Accountability Office (GAO) reports, and information provided by the
Senate and House Veterans' Affairs Committees. Our plan is to review
the protocol areas annually to identify new high-risk areas and adjust
as necessary.
anchorage varo results
In late July and early August 2009, we conducted onsite work at the
Anchorage VARO. Our inspection focused on the following 14 operational
activities within the 5 protocol areas:
Processing of disability claims for specific service-
related conditions--Post Traumatic Stress Disorder, Traumatic Brain
Injury, diabetes and disabilities related to herbicide exposure, and
Haas claims. A Haas claim is a claim affected by a U.S. Court of
Appeals for Veterans Claims decision that involves veterans who served
in waters off Vietnam but did not set foot in Vietnam and whether those
veterans are entitled to the presumption of service connection to
herbicide agents.
Integrity of VBA's Claims Management Data--Establishing
correct dates of claim and properly tracking veteran's claims folder
using VBA's Control of Veterans Records (COVERS) database.
Management Controls over Claims Processing--Systematic
analysis of operations (SAO), a management driven analysis of key
business activities designed to identify existing or potential
problems; systematic technical accuracy review (STAR), an integral part
of VBA's quality assurance program designed to measure VARO performance
in processing claims; and accountability for VARO date stamps and usage
of the claims process improvement business model. This business model
requires employees to rotate between the different teams within the
VARO to maintain skills required to process claims.
Security of Veterans' Information--Mail handling
procedures and controls for the safeguarding of veterans documents to
prevent unauthorized destruction
VARO Public Contact Functions--Inquiry Routing and
Information System (IRIS), VA's internet based public message system
that allows beneficiaries a means to communicate with VA
electronically.
During our visit, we interviewed the VARO Director, Veterans
Service Center Manager (VSCM), supervisors, and employees responsible
for processing claims and providing benefit services to veterans and
their dependents. We reported the Anchorage VARO management team faces
challenges in providing benefits and services to veterans. These
challenges include addressing oversight of operational activities,
improving insufficient network capacity to support business processes,
providing training to staff, and managing an internal claims brokering
process. The VARO did not meet VBA's standards for 13 of the 14
operational areas inspected.
Our analysis of disability claims processing revealed a 29 percent
error rate at the Anchorage VARO. The error rate represents our
analysis of 78 disability claims and not the entire caseload of the
VARO. Of the 78 claims reviewed, processing errors occurred in 23
claims, of which only three errors directly affected veterans'
benefits. The VARO underpaid two veterans, one for $288 and one for
$4,758. The other error did not involve monetary benefits. The majority
of processing errors involved claims for PTSD and Haas claims. These
errors occurred because of a lack of training for Rating Veterans
Service Representatives (RVSR) responsible for making disability
determinations.
Of those 13 operational areas that did not meet VBA standards, 9
occurred because of a lack of management oversight. These areas were:
tracking veterans claims folders, establishing the correct dates of
claim, correcting errors identified by VBA's STAR quality assurance
program, completing SAOs, safeguarding VARO date stamps, safeguarding
veteran's personally identifiable information (PII), properly handling
claims related mail, responding to electronic inquiries submitted by
veterans, and, responding to congressional inquiries.
For approximately 8-months during FY 2009, the VARO had no manager
for its Veterans' Service Center, a key management position affecting
many operational areas in the Anchorage VARO. Further, the VARO
Director geographically residing in Salt Lake City may have also
attributed to diminished oversight. For example, the Director could not
observe the effectiveness of SAO recommendations designed to improve
station performance and delays in implementing several SAOs occurred
while waiting for the Director in Salt Lake City to approve the plan.
In addition to the 14 operational areas inspected, we identified
serious concerns regarding network capacity to support current business
processes. Employees reported difficulty maintaining consistent access
to certain VBA applications required to perform their jobs. These
difficulties included applications being unresponsive and the need for
employees to restart their computers several times a day. The employees
informed us this problem had already existed for over one year. We
estimated the Anchorage VARO might lose 7.5 productive hours per rating
specialist a month due to network capacity problems.
The VARO Director implemented an internal brokering plan that moves
rating-related claims between Anchorage, AK, Ft. Harrison, MT, and Salt
Lake City, UT. VBA normally brokers work between VAROs because of
insufficient resources to process certain types of work. The Anchorage
VSCM informed us it is difficult to create a workload management plan
and to control the workload of pending claims brokered to other VAROs.
A supervisor from the Anchorage VARO indicated brokering impacts mail
handling procedures and it is difficult to associate claims related
mail with claims folder located at other VAROs. Currently, the OIG is
performing a national audit to determine the effectiveness of claims
brokering across all VBA regional offices.
Because the Anchorage VARO was moving so much work to other VARO's,
we compared staffing levels between the Anchorage VARO and the Boise
VARO to determine if the staffing level was commensurate with similar
VARO's. Our analysis revealed the Boise VARO has 22 additional full-
time employees while maintaining a comparable inventory of rating and
non-rating claims. We based this comparison on the total number of
actual claims pending in each office. We believe this provides the best
comparison of actual workload, rather than the number of veterans who
reside in each state or those veterans who might file claims.
The Benefits Inspection Division completed 6 VARO inspections
during FY 2009. A comparison of the percentage of claims processing
errors revealed the highest error rate occurred at the San Juan, PR
VARO, (41 percent), followed by Anchorage, AK (29 percent), Roanoke, VA
(25 percent) Baltimore, MD (20 percent), Nashville, TN (19 percent) and
Wilmington, DE (11 percent). These error rates represent our analysis
of a sample of disability claims and not the entire caseload at each
VARO. None of the VAROs inspected complied with 100 percent of the
operational areas we reviewed. The Baltimore office had the highest
rate of non-compliance with VBA standards followed by Anchorage, San
Juan, Nashville, Wilmington, and Roanoke.
We recommended the Director improve oversight of the quality
assurance process for several of the operational areas that did not
meet standards, develop a mail routing guide to ensure proper
processing of mail, research the cause and solutions to improve network
capacity issues, and train staff to maintain required skills. The VARO
Director concurred with all of the OIG's recommendations in the
inspection report.
summary
Although our inspection found the Anchorage VARO management team
faces many challenges in providing benefits and services to veterans,
we believe the Director's comments to our recommendations are
responsive. The Benefits Inspection Division has not performed any
follow-up regarding the implementation of these recommendations at this
time.
Senator Begich, thank you for the opportunity to testify here
today. Mr. Arronte and I would be pleased to answer any questions that
you may have.
Senator Begich. Thank you very much. Let me ask Mark
Bilosz, Anchorage Regional Office, VA Benefits Administration,
Department of Veterans Affairs to testify next.
STATEMENT OF MARK M. BILOSZ, DIRECTOR, ANCHORAGE REGIONAL
OFFICE, VETERANS BENEFITS ADMINISTRATION, U.S. DEPARTMENT OF
VETERANS AFFAIRS; ACCOMPANIED BY WILLIE C. CLARK. SR., WESTERN
AREA DIRECTOR; AND PATRICK KELLEY, VETERANS SERVICE CENTER
MANAGER, ANCHORAGE REGIONAL OFFICE
Mr. Bilosz. Thank you, Senator. Senator Begich, it is my
pleasure to be here today to discuss our efforts in meeting the
needs of veterans residing in Alaska. I will discuss important
benefits and services provided to veterans living in Alaska as
well as discuss concerns about the Anchorage Regional Office,
addressed in the recent VA Office of Inspector General report.
The Anchorage Regional Office administers the following
benefits and services: disability compensation; pension
benefits; vocational rehabilitation and employment assistance;
and outreach for all veterans and survivor benefits. Our goal
is to deliver these benefits and services in a timely,
accurate, and compassionate manner. This is accomplished
through the administration of a comprehensive and diverse
benefits program.
Currently a total of 34 employees work in the Veterans
Services Center and seven employees work in the vocational
rehabilitation and employment division within the Regional
Office. Employees at the Anchorage Regional Office are very
motivated and provide excellent service to Alaska veterans.
Performance indicators revealed that the Anchorage Regional
Office is performing much better than it has in the past,
completing a greater number of claims each month while
improving its accuracy. As the out-based director of the
Anchorage Regional Office, I visit the Anchorage office at
least quarterly and often more than that. I have also daily
discussions with division management to maintain an open line
of communication and provide direction and oversight. A new VHA
clinic is scheduled to open in May 2010 and VBA has secured
space at the new site. Anchorage Regional Office is looking
forward to moving into this new space as it will provide us
with improved working space. In June 2009 a new Veterans
Service Center Manager reported to duty at Anchorage. The
Veterans Service Center Manager position was vacant for
approximately 8 months. This position was vacant due to the
difficult task of recruiting an experienced individual to the
Anchorage area.
Additionally, the Anchorage Regional Office has recruited
and hired two new supervisors. The appointment of the new
supervisors has had a positive impact on the overall management
and performance of the office this fiscal year.
For example, rating inventory has trended in a positive
direction every month this year. Compared to December of last
year, the Anchorage RO completed 226 more claims this year,
showing an increase of about 16 percent. In addition, rating
and authorization quality have both shown improvement.
In fact, due to the focus on internal training within our
office, rating quality at the Anchorage RO exceeds the national
average. The Anchorage vocational rehabilitation and employment
division is one of the top performing divisions in the Nation.
It was identified as a top performer in fiscal year 2009 with a
VA Level II Performance Award.
In addition to providing improvements in quality, the
management team has successfully implemented several policies
pertaining to the workload that I would like to highlight: a
policy for the timely corrective action of errors identified by
the VBA; and a national quality review program was implemented.
A policy outlining control and tracking of claims folder was
implemented. This policy provides for better control of the
location of the claims folders. The management team implemented
a consistent local quality review process to complete timely
quality assurance reviews that ensure veterans' service
representatives are establishing direct data claims. A most
recent review completed in January showed only a 1 percent
error rate. As VBA has an ethical and legal responsibility to
maintain adequate controls over all date stamps throughout our
facilities, two new electronic date stamps with locking devices
are now in place and both stamps remain in secure locations.
The Veterans Service Center also has taken action to more
efficiently safeguard veterans' personal identifiable
information. All employees will receive training on the proper
safeguard and destruction of materials, desk inspections of
work stations and common areas are performed regularly.
In September 2009 a new work flow plan was implemented to
ensure Veterans Service Center staff would properly control and
process all mail. To ensure Congressional inquiries are
processed in a timely and accurate manner, a new policy for
handling Congressional correspondence was implemented in
November 2009. Our goal is to complete Congressional inquiries
within 5 days. So far this fiscal year we're under that goal at
4.3 days.
The VA Office of Inspector General conducted an inspection
of the Anchorage Regional Office during the summer of 2009. The
OIG report recommended 12 areas of improvement. Action has been
taken to correct the deficiencies as identified by the OIG.
Those items have been addressed in my oral and written
testimony that you've received today. With the help of OIG
report findings, specific shortfalls of the Anchorage Regional
Office have been identified and action plans are in place.
The VA senior leadership is committed to providing the
necessary resources, funding and employees and facilities to
the Anchorage Regional Office which were the best possible
services provided to the Alaskan veterans and their families.
I'm fully committed to continue to improve claims processing in
Alaska, Mr. Chairman.
This concludes my testimony. I greatly appreciate being
here today and I look forward to answering any of your
questions.
[The prepared statement of Mr. Bilosz follows:]
Prepared Statement of Mark M. Bilosz, Director, Anchorage VA Regional
Office, Veterans Benefits Administration, U.S. Department of Veterans
Affairs
Senator Begich and Members of the Committee, it is my pleasure to
be here today to discuss our efforts in meeting the needs of Veterans
residing in Alaska.
The Anchorage Regional Office (RO) serves Veterans throughout the
state. We also provide outreach services to Veterans in Fairbanks, Fort
Wainwright, Fort Richardson, Elmendorf Air Force Base, and Eielson Air
Force Base.
The Anchorage RO administers the following benefits and services:
Disability compensation and pension for Veterans and
dependents;
Vocational rehabilitation and employment (VR&E)
assistance; and,
Outreach for all Veteran and survivor benefits.
Our goal is to deliver these comprehensive and diverse benefits and
services in a timely, accurate, and compassionate manner.
The Anchorage RO is responsible for delivering non-medical VA
benefits and services to over 76,400 Veterans and their families in
Alaska. Approximately 14,000 of these Veterans receive disability
compensation. In fiscal year 2009, the Anchorage RO completed more than
2,100 decisions on Veterans' disability claims.
The Denver Regional Loan Center (RLC) administers VA home loan
services to Alaska Veterans. Alaska Veterans are served by a full time
RLC employee who is stationed at the Anchorage RO. Most Native lands
are leasehold estates, which qualify for VA's guaranteed loan program.
VA has guaranteed 65,575 home loans in Alaska with a cumulative loan
amount of over $9 billion.
staffing
The Anchorage RO hired five employees as a result of the American
Recovery and Reinvestment Act. The employees are making direct
contributions to improving claims processing by assisting with
development of claims and mail processing. Currently, 34 employees work
in the Veterans Service Center (VSC) and 7 employees work in VR&E.
Employees at the Anchorage RO are very motivated and provide
excellent service to Alaska Veterans. Performance measures indicate
that the Anchorage RO is performing well, completing a greater number
of claims each month while improving accuracy.
management team
As the out-based Director of the Anchorage RO, I visit Anchorage at
least quarterly and hold weekly videoconference calls with division
management to maintain open lines of communication. In addition, I hold
a weekly conference call with the Veterans Service Center Manager
(VSCM) to provide direction and oversight. I also communicate regularly
with the Anchorage VA Medical Center Director, as the Anchorage RO is
currently co-located with the Medical Center.
A new VA clinic is scheduled to open in May 2010, and the Veterans
Benefits Administration has secured space at the new site. The
Anchorage RO is looking forward to moving into this new space as it
will allow VSOs and all claims files to be located in the RO. The new
facility will also include a large training room.
In June 2009, a new VSCM reported for duty in Anchorage. The VSCM
position was vacant for approximately eight months due to the
sometimes-difficult task of finding an individual with the right
leadership and managerial skills to fit the position. Many times
relocating an employee and his/her family to Alaska is difficult.
Additionally, the Anchorage RO recruited and hired two new
supervisors. The appointment of the new supervisors has had a positive
impact on the overall management and performance of the office this
fiscal year.
For example, rating inventory has trended in a positive direction
every month this year. Compared to December of last year, the Anchorage
RO completed 226 more claims this year, an increase of 16 percent. In
addition, rating and authorization quality have both improved. Rating
quality at the Anchorage RO exceeds the national average.
A new training plan was developed and implemented in September
2009. Rating Veteran Service Representatives (RVSRs) receive weekly
training from the Decision Review Officer. Training topics are aimed at
eliminating the errors found during various reviews. All RVSRs attend
the monthly Systematic Technical Accuracy Review calls to discuss
commonly found errors and to prevent future errors.
The Anchorage RO's VR&E division is one of the top performing
divisions in the Nation. Identified as a top performer in fiscal year
2009, the VR&E division was awarded Level II performance award.
outreach efforts
Our employees conduct an average of 580 personal interviews per
month, and last year conducted 47 Transitional Assistance Program (TAP)
briefings for 1,078 servicemembers. VR&E personnel provide monthly DTAP
briefings at Elmendorf Air Force Base and Fort Wainwright.
The Anchorage RO conducted two significant rural outreach
initiatives in 2009. In February and March, the RO participated jointly
with the Alaska VA Health Care System to offer Alaska VA Education
Forums. Teams traveled to Kotzebue, Fairbanks, Nome, Dillingham,
Ketchikan, Juneau, and Sitka to provide benefits information and
counseling to Veterans and medical providers.
We also participated in two Homeless Standdowns at Fort Richardson
and in Fairbanks in August 2009. An RO representative provided
information and VA benefits counseling at these events. Earlier this
month, a Standdown was held to introduce Veterans to the VA Domiciliary
facility in Anchorage.
In October 2009, the Anchorage RO teamed with the Medical Center to
staff an information booth for 500 Veterans and family members via the
Alaska Federation of Natives (AFN). AFN is the largest statewide Native
organization in Alaska. Its membership includes 178 villages (both
federally-recognized tribes and village corporations), 13 regional
Native corporations and 12 regional nonprofit and tribal consortiums
that contract and run Federal and state programs.
As of December 31, 2009, 134 servicemembers were participating in
the DOD/VA Disability Evaluation System Pilot at Ft. Wainwright, Ft.
Richardson, and Elmendorf AFB. This pilot is instrumental in
streamlining disability processing for separating servicemembers.
improvements in service delivery
The new management team successfully implemented several new
workload management and quality assurance policies and procedures.
A policy for the timely corrective action of errors identified by
VBA's Systematic Technical Accuracy Review Staff was implemented in
November 2009. The VSCM tracks all errors and corrective actions. A
review process was established to ensure Veterans Service
Representatives (VSRs) correctly enter claims data into our processing
systems. Refresher training was provided to all claims assistants and
VSRs. Weekly training is held on scheduled topics and errors identified
in quality reviews.
A policy outlining the use of COVERS, VBA's system to control and
track claims folders, was also implemented in November. This policy
requires claims folders to be ``COVERed'' every Monday and also
requires supervisors to perform weekly spot checks.
Systematic Analyses of Operations (SAOs) are now completed
accurately and timely. A tracking mechanism is in place to monitor the
status of required SAOs and training on SAO writing techniques was
provided.
The VSC has also taken action to more efficiently safeguard
Veterans personally identifiable information. All employees received
training from the Records Management Officer in August 2009 on the
proper safeguard and destruction of materials. Inspections of
workstations and common areas are performed regularly. Two new
electronic date stamps, with locking devices, are now in secure
locations.
In September 2009, the Triage Workflow Plan was implemented to
include a mail routing guide to ensure VSC staff properly control and
process the mail. The Triage Coach provides the VSCM with a monthly
summary of all mail actions as well as any required follow-up actions.
Triage training is conducted every Thursday to ensure the workflow plan
is being properly implemented.
An Inquiry Routing and Information System (IRIS) Quality Review
Policy was implemented in November 2009 to improve quality assurance
reviews. The IRIS system is the electronic method Veterans use to
communicate with VA. The Public Contact supervisor reviews a minimum of
five IRIS responses per employee every month. The supervisor also
discusses errors during weekly training sessions with individual
employees to ensure the highest level of quality and accuracy is
maintained.
To ensure Congressional inquiries are processed in a timely and
accurate manner, a new policy for handling Congressional correspondence
was implemented in November 2009. The Public Contact Team maintains a
log of all Congressional correspondence where inquiries are annotated
within one day and assigned to an employee to review and complete. The
individual receiving the assignment has two working days to present a
response for approval by the VSCM. Our goal is to complete
Congressional inquiries within five days.
The Anchorage RO reports the results of internal brokering to VBA
leadership monthly. The Western Area Office is informed monthly of any
transfers of work. Brokering claims, or sending claims to another RO,
is done to provide better service to our Veterans. Brokering is a
short-term strategy to assist ROs with workflow challenges.
va office of inspector general report
The VA Office of Inspector General (OIG) conducted a review of the
Anchorage RO from July 28, 2009 to August 6, 2009. The five areas
examined were disability claims processing, data integrity, management
controls, information security, and public contact. The OIG report
recommended 12 areas of improvement. Action has been taken to correct
the deficiencies identified by the OIG.
The Western Area Director and staff conducted an on-site review of
the Anchorage RO from January 6, 2010 to January 7, 2010. A major part
of this visit was to evaluate compliance with the OIG's
recommendations. All action plans implemented in response to the OIG's
recommendations were reviewed for compliance and effectiveness. The
Western Area Director found the Anchorage RO had implemented the
required actions to be fully compliant with all 12 of the OIG
recommendations.
conclusion
VA leadership and the employees of the Anchorage RO are committed
to ensuring the best possible service is provided to Alaska Veterans
and their families. Mr. Chairman, this concludes my testimony. I
greatly appreciate being here today and look forward to answering your
questions.
Senator Begich. Thank you very much. I know you have two
individuals with you also. We'd like to introduce them. Willie
Clark, who is the Western Area Director, and Patrick Kelley,
Veterans Service Manager for the Anchorage Regional Office.
Thank you for being here. I will have some questions, though
now I'd like to now introduce, Brigadier General Tom Katkus.
General Katkus. Good morning, Senator.
Senator Begich. If I can make one comment to all Alaskans.
You should be very proud of the Brigadier General. He was there
in Washington, DC, last week with the snow as deep as can be,
but he kept his appointments with his team. I thank you for
that.
STATEMENT OF BRIGADIER GENERAL TOM KATKUS,
ADJUTANT GENERAL, ALASKA NATIONAL GUARD
General Katkus. Senator, I have more snow in my front yard
at home.
Senator, I'm a member of an organization, a very proud
privileged position that takes a holistic view of its
membership. We have programs in place to mentor and develop
young children and young adults into the military. We take care
of our military members through paid compensation training, and
then we take care of those veterans who leave the organization
through retirements, national cemeteries, et cetera. What I'd
like to report on is one particular portion that was very small
but has been a very intricate part of Alaska, and that's the
Alaska Territorial Guard. They didn't fit too many molds out
there and through a great deal of effort I'd like to report a
very positive development. As of February 1 the Federal
Government reinstated all of the ATG members' retirement
benefits. There was a lot of bureaucratic process to get this
accomplished. There's been a great deal of confusion about how
the ATG veterans were credited with this act of service that
they performed between 1942 and 1947. Each member that received
his discharge was credited with 5 years again of active Federal
service. And these 5 years have a monetary impact on veterans
only if they served in the National Guard or active duty for 15
or more years and this 5 years of Alaska Territorial Guard time
made them eligible for a Federal retirement.
The State of Alaska does not consider the 5 years of active
Federal service toward the Alaska National Guard State Annuity
unless this provides the veteran enough credit for the National
Guard retirement. Of roughly 6,500 members of Alaska
Territorial Guard between 1942 and 1947, we have received 1,592
discharge applications from veterans or family members. Of that
number, 1,057 ATG discharges have been received from the U.S.
Army. We have over 72 charges that are pending certification by
the Army Personnel Center. We had 149 discharges of the 163
living Alaska Territorial members that we've identified. Of
those, six applications are pending certification in St. Louis
and eight have not applied as of this time. Our plan is to
continue presenting these discharges at ceremonies in each
member's community. In 2009, we had posted over 20 such
ceremonies in villages throughout Alaska. There are currently
22 ATG members eligible for military retirement. They each
spent 20-plus years of active military service with additional
ATG time that we've managed to credit. That now is calculated
into their retirement check and adjusted accordingly by the
defense accounting system. We're continuing our research to
find other members who now qualify for retirement as a result
of this act of Federal service. We have found four new ATG
members eligible. Three will be receiving or have received
their check on 1 February and the fourth will be receiving his
check March 1. Another benefit of this investigation into the
ATG: along with retirements from service, survivors' benefits
are awarded to widows of those members.
We've worked hard to dig through the military personnel
records and found that there were ATG members that had 15 years
of National Guard service. As a result of this search, we've
identified 32 spouses that might receive survivor benefit
payments now. As of 27 January, all 32 packages have been sent
to the auditors at St. Louis. They'll go through to make sure
that all time is calculated properly, and those spouses who are
eligible will start receiving the monthly survivor benefits.
That's approximately 55 percent of the base pay of their
spouse. This also includes health care. With those numbers from
the ATG service, the list goes on. We found that six members of
the ATG who were eligible for the National Guard are now
eligible for State retirement with the National Guard. So these
retirement documents were sent to the Division of Retirement
for the State, they'll review them and now that they are
officially retired from the National Guard, they are eligible
for the State annuity. So it's not 5 years of active Federal
service, but rather 15 years of State annuity as they were
members and in employment of the State after 1969.
The VA offers a grave marker free of charge for each
veteran. We initially had problems last summer when the VA
would not send markers to the Post Office boxes. After
discussing this issue with the director of mortuary services,
this was corrected and our ATG veterans now receive this
honorable benefit.
I would be remiss if I did not mention the Alaska National
Guard military funeral honorary team, which is supported by
National Guard Bureau. The team has a motto of honoring those
who serve, which is reflected by their willingness to serve any
place any time. Last year the funeral honors team provided 158
services to servicemembers throughout Alaska.
Additionally, as it applies to ATG veterans, if they did
not receive an honor ceremony in the past, the team will go out
and have the service and present the flag to the family.
Senator, thank you for your time today, and thank you,
personally for the efforts that have been made by the
Congressional delegation over the past years to make sure that
this very small, but very important piece of Alaska's history
and our veterans was reflected positively and service to them
could be completed.
[The prepared statement of General Katkus follows:]
Prepared Statement of Brig. Gen. Thomas Katkus, Adjutant General,
Alaska National Guard; and Commissioner, Alaska Department of Military
and Veteran Affairs
Good Morning, I'm Brigadier General Thomas Katkus, the Adjutant
General for the Alaska National Guard and Commissioner for the Alaska
Department of Military and Veteran Affairs.
This morning I would like to provide a status update on the Alaska
Territorial Guard. Effective February 1, the Federal Government
reinstated ATG member's retirement benefits.
There has been a great deal of confusion among the ATG veterans due
to a poor understanding on how time is credited for their active
Federal service between 1942 and 1947. Each member upon receipt of
their discharge is credited five years of active Federal service. These
five years have a monetary impact on the veteran only if they served in
the National Guard or active duty military, for 15+ years and the five
years of ATG time made them eligible for Federal retirement. The state
of Alaska does not consider the five years of active Federal service
toward the Alaskan National Guard state annuity unless this provides
the veteran enough credit for a National Guard retirement.
Of the roughly 6,500 original ATG members, 1,592 ATG discharge
applications have been received by DMVA from veterans and family
members.
1,057 ATG discharges have been received from the U. S. Army. Over
72 discharges are pending certification by the Army Personnel Center.
149 discharges have been issued to the 163 living ATG members that
we have identified. Six applications are pending certification in Saint
Louis and eight have not applied.
We plan is to continue presenting these discharges at ceremonies in
each member's community. In 2009, we hosted 20 of these ceremonies in
villages throughout Alaska.
There are 22 ATG members eligible for Federal military retirement.
They each spent 20+ years in active military service and with the
addition of the ATG time now receive a combined retirement check from
the Defense Accounting System.
We are continuing the research to find other members who now
qualify for retirement. To date we have found four new ATG retirement
eligible veterans. The first three started receiving their new check on
the first of February. The last member will be receiving his check by
the first of March.
Along with retirements come survivor's benefits for widows. We have
worked hard to dig through our military personnel records to find all
the ATG members who served 15+ years in the National Guard. As a result
of this search, we've identified 32 spouses that might receive
survivor's benefits payments. As of 27 January have all 32 packages are
on the desks of the auditors in St. Louis. Once they go through the
verification process, those spouses who are eligible will start
receiving the monthly survivor's benefits. This includes pay and
healthcare.
We also found six members of the ATG who were eligible for National
Guard state retirements. These retirement documents were sent to the
Division of Retirements. There are no surviving members or spouses
found and the benefit will be paid to the next of kin.
The VA offers a grave maker free of charge for each veteran. We had
a problem last summer when the VA would not send the markers to Post
Office boxes. After discussing this issue with the Director of Mortuary
Services this was corrected and our ATG veterans now receive this
honorable benefit.
I would be remiss in not mentioning our Alaska National Guard
Military Funeral Honors Team along with the VA grave markers. This team
has a motto of ``Honoring Those Who Serve'' and this is reflected by
their willingness to serve any place any time. They performed over 158
services in 2009 alone and are projecting even more services this year.
Additionally, if an ATG veteran did not receive an Honor Ceremony in
the past, the team will go out now and do the service and present the
flag to the family.
Thank you for your time today to bring you up to date on this very
important Alaskan issue.
Senator Begich. Thank you very much, General. Let me ask
the last presenter, Jan Myers, Director of Family Programs,
Alaska Department of Military Veterans Affairs. We want to see
how that mic works. We may do a little swap. We'll see how that
works.
STATEMENT OF JAN MYERS, DIRECTOR, FAMILY PROGRAMS, ALASKA
DEPARTMENT OF MILITARY VETERANS AFFAIRS
Ms. Myers. Good morning, sir. My name is Jan Myers, and I
would like to thank you for the opportunity to speak to you
today. I serve as the Alaska National Guard State family
program director and as such have oversight of programs
designed to assist and care for our military veterans and their
families. We are available 24 hours, 7 days a week and 365 days
a year with high quality troop and family support to meet the
needs of our servicemembers, veterans, and their families. I
will briefly describe some of those programs pertinent to
today's discussion.
The Alaska National Guard family assistance centers offer
information and referral services to troops and families from
all military branches, whether active, guard, reserve, retired,
or not. Professional consideration and confidentiality are
fundamental elements found at each family assistance center.
With topics running the gamut from personnel issues requiring
advice to difficult challenges resulting in referrals to
outside researches. We have nine family assistance centers
throughout Alaska that are ready to serve military members,
veterans, and their families in building strong resilient
communities. Our sexual assault prevention and response
program's mission is to end sexual violence and ensure high-
quality comprehensive and preventative measures, encouraging
competent servicemembers and families. We also promote change
that fosters a military environment that is responsive to
victims and survivors of sexual assault. The suicide prevention
program recognizes the seriousness of suicidal behaviors and
potential within the military. The mission is to implement
appropriate control measures that address and minimize the risk
factors of suicide while strengthening the factors that
mitigate those risks.
We aid and equip commanders and leaders with skills and
resources necessary to combat suicide by providing quality
interactive training on prevention, intervention, and
postvention. We work to ensure early identification and
treatment of emerging deployment-related health concerns for
our troops and veterans. Through our military life consultants,
we provide short-term nonmedical solution-focused counseling
services to individuals, couples, and families. We advocate
psychological fitness for our members and their families
through the office of our psychological health director. We
also provide training on topics related to military life and
everyday issues. The child and youth program helps our youth
understand why family members serve in the military and
introduce coping skills to deal with the stresses of
deployment.
Employer support of Guard and Reserve seeks to promote a
culture by which all American employers support and value the
military service of their employees. The Alaska committee
conducts employer and military outreach and an ombudsman
program to recognize outstanding support, increase awareness of
the law, and resolve conflicts through mediation. We are
evolving now to assist troops with finding jobs. The transition
assistant adviser is the Statewide point of contact to assist
members in assessing veterans' affairs, benefits, and health
care services. They provide assistance in obtaining
entitlements through the TRICARE military health system and
access to community resources whether our troops are going from
civilian life to active duty or retiring. We are there to help
them through the process.
We also provide assistance with education benefits to
ensure all members have an opportunity to attain their
educational goals. Our Honor Guard, as the General mentioned,
performs funeral honors in accordance with service tradition to
all eligible veterans when requested by an authorized family
member. Our Yellow Ribbon Program provides information and
referral for servicemembers, families and employers throughout
the deployment cycle. The Yellow Ribbon Reconnecting Veterans
Outreach Program is a partnership constituted between Alaska
National Guard, Alaska Veterans Affairs, and Veterans Service
Officers from the State and was funded through a Federal
appropriation. This program has been operating since January
2009 and the goal is to visit every village in our great State
while assessing our veterans' needs. To date nearly 125
villages have been connected and 1,021 veterans or family
members have been personally briefed, questions answered, and a
survey filled out. We also provide VA applications for our
veterans. The outreach team has found older veterans, including
the Alaska Territorial Guard or their family members to be our
biggest audience. They appreciate our effort and applaud the
follow-up.
All 42 of our folks are available to travel where the need
is and we service all branches no matter what status. I
appreciate, again, your time for me to be here.
[The prepared statement of Ms. Myers follows:]
Prepared Statement of Jan Myers, Director, Family Programs, Alaska
Department of Military Veterans Affairs
Good Morning. I am Jan Myers and I would like to thank you for the
opportunity to speak to you today.
I serve as the AKNG State Family Program Director and as such have
oversight of programs designed to assist and care for our Military,
Veterans and their Families. We are available 24 hours, 7 days a week,
365 days a year, with high quality Troop & Family Support to meet the
needs of our Servicemembers, Veterans and their Families. I will
briefly describe some of those programs pertinent to today's
discussion.
The Alaska NG Family Assistance Centers (FACs) offer information
and referral services to Troops & Families from all military branches,
whether active, Guard/Reserve, retired or not. Professional
consideration and confidentiality are fundamental elements found at
each FAC, with topics running the gamut from personal issues requiring
advice to difficult challenges resulting in referrals to outside
resources. We have 9 FACs throughout Alaska that are ready to serve,
assisting military members, veterans and their Families in building
strong resilient communities.
Our Sexual Assault Prevention and Response Program's mission is to
end sexual violence and ensure high quality, comprehensive, and
preventative measures, encouraging competent Servicemembers and
Families. We also promote change that fosters a military environment
that is responsive to victims and survivors of sexual assault.
The Suicide Prevention Program recognizes the seriousness of
suicidal behaviors and potential within the Military. The mission is to
implement appropriate control measures that address and minimize the
risk factors of suicide while strengthening the factors that mitigate
those risks. We aid and equip commanders and leaders with the skills
and resources necessary to combat suicide by providing quality
interactive training on prevention, intervention, and postvention. We
work to ensure early identification and treatment of emerging
deployment-related health concerns for our troops and veterans.
Through our Military Life Consultants, we provide short term, non-
medical; solution focused counseling services to individuals, couples,
and Families. We advocate psychological fitness for our members and
their Families through the office of our Psychological Health Director.
We also provide training on topics related to military life and
everyday issues.
The Child and Youth Program helps our youth understand why Family
members serve in the military and introduce coping skills to deal with
the stresses of deployment.
Employer Support of the Guard and Reserve seeks to promote a
culture in which all American employers support and value the military
service of their employees. The Alaska Committee conducts employer and
military outreach, and an ombudsman program to recognize outstanding
support, increase awareness of the law, and resolve conflicts through
mediation. We are evolving now to assist troops with finding jobs.
The Transition Assistance Advisor is the statewide point of contact
to assist members in accessing Veterans Affairs benefits and healthcare
services. They provide assistance in obtaining entitlements through the
TRICARE Military Health System and access to community resources.
Whether our troops are going from civilian life to active duty or
retiring, we are there to help them through the process.
We also provide assistance with education benefits to ensure all
members have an opportunity to attain their educational goals.
Our Honor Guard renders professional military funeral honors, in
accordance with service tradition, to all eligible veterans when
requested by an authorized Family member.
Our Yellow Ribbon Program provides information and referral for
servicemembers, Families and employers throughout the deployment cycle.
The Yellow Ribbon, ``Reconnecting Veterans Program'' is a partnership
constituted between Alaska National Guard, Alaska Veterans Affairs, and
the Veteran Service Officers from the state and was funded through a
Federal Appropriation. This program has been operating since January
2009 and the goal is to visit every village in our great state while
assessing our veteran's needs. To date, nearly 125 villages have been
connected and 1021 Veterans or Family members have been personally
briefed, questions answered, and a survey filled out. We also provide
VA applications for our veterans. The outreach team has found older
veterans, including the Alaska Territorial Guard or their Family
members, to be our biggest audience. They appreciate our effort and
applaud the follow-up.
All 42 of our folks are available to travel where the need is and
we service all branches, no matter their status.
I appreciate your time and I am available for any questions.
______
Addendum
Senator Begich. Thank you very much. We're going to be
tight on time. I'm going to walk through a few things here. I
don't want to go too far past noon. I know the Anchorage
assembly and the mayor would not want me to sit in the seat too
long. They have so much business to take care of tonight. I'll
leave it at that. [Laughter.]
First, thank you, Ray, for coming this long distance and
being part of Alaska. One thing you mentioned which I wanted to
follow up on--it wasn't here that you talked about, it was
outside the building while we were talking about the tour of
the VA building. You talked about new job opportunities in
regard to technology and the Internet. Can you put on the
record what you envision there?
Secretary Jefferson. Yes.
Senator Begich. I thought that was interesting, especially
for us here in Alaska--a new avenue.
Secretary Jefferson. Sir, one of the things I've been
looking at is: How do we provide value and help veterans in
rural America? Communities where you don't have Fortune 1000
companies, have smaller enterprises, and where people are
geographically dispersed. It's hard to move around. We're going
to be in Kotzebue on Wednesday and Thursday. What could be an
innovative solution? One of the things that I want to explore
is the value of e-commerce: Internet-based home businesses,
where an individual using the Internet can create a whole
business around us. There's actually an interesting book out
which has been a New York Times best seller maybe a year now
called The 4-Hour Workweek that lays out the whole model. I
think you'd want to spend more than 4 hours a week on it.
Senator Begich. We're looking for that job.
Secretary Jefferson. This individual has done quite well
for himself, for no other reason than for the book. On a
serious note what we want to look at if this is a model that
can be used for veterans in rural America. One of the things I
mentioned as I'm working out in Washington, DC, is to bring all
the government agencies that touch most of the business
development together so we can work as a synergistic team. The
Department of Commerce, Small Business Administration, the
Minority Business and Development Agency, et cetera, for all of
us to come together and ask: How can we better serve veterans
in America? What do we currently have? Let's make sure that all
veterans are aware of everything that's out there. What are
some of the new opportunities such as this e-based commerce in
a home-based business?
Senator Begich. All of those agencies have aspects that
they're working with in some form or another.
Secretary Jefferson. Yes, though we are not communicating
with one another. We need to break that stovepipe down and I'm
working on that now.
Senator Begich. Are you going to try to be the lead
convenor of that----
Secretary Jefferson. Yes.
Senator Begich. I know about local bureaucracy; Federal is
even a much different ball game when defining who takes the
lead and puts effort into it. Is that what you're thinking you
should be able to do? Or are you looking for a partner to do
that?
Secretary Jefferson. In the short time I've served in this
position, we do like to be action oriented. My understanding is
that all heads are stepping up to bring the meeting together.
We're working to make it happen, before the holidays, though
it's a little challenging with people's travel schedules. We're
working right now. My goal is to get the agency heads together,
get commitment at the senior level, and cascade that down to
all the States.
Senator Begich. You will start with the convening of that?
Secretary Jefferson. Yes.
Senator Begich. Can you keep us informed, at least myself
and the Committee?
Secretary Jefferson. Yes, sir.
Senator Begich. The other comment is that I appreciate your
review of your 268-page PowerPoint.
Secretary Jefferson. Page by page.
Senator Begich. I don't know if I've ever seen or done a
268-page PowerPoint. I can only imagine the effectiveness of
that. I say that because it sounds like you understand that
just doesn't work.
Secretary Jefferson. It doesn't work, sir. And this was a
well-intentioned program. One of the things that we talk about
as an agency is, one, transformation; and two, incorporating
best practices. So, what are the adult learning principles? We
know it's having people do things. We want to have them doing
and practicing their skills during employment workshops and
then bringing in the best practices which I previously
mentioned so there's new content. They enjoy it; they can use
it immediately, and it has long-lasting benefits to the
servicemember.
Senator Begich. Very good. Thank you. Belinda, first, I
appreciate the report that was done. I think, you know, for
your capacity, to do reviews not every 5 years but now every 3
years is probably a huge benefit for the Regional Offices,
because I think there's always room for improvement no matter
what you're doing. Your office went through a lot of issues,
and I want to follow up to make sure I understood what you
said, and that is regarding the areas of concern. The Regional
Office has accepted those as areas of concern and are taking
action to do something. Is that--did I hear you say that right?
That there was no disagreement, necessarily, but they
recognized them. They acknowledged them. Am I saying that
correctly?
Ms. Finn. Yes, sir, they accepted all of the
recommendations. While the team was on staff, there was
discussion back and forth on the various issues that we found.
But the office did concur with all of our recommendations and
proposed appropriate actions.
Senator Begich. And what will be the follow-up from your
agency and your staff? How are you making sure that what they
have committed to is fulfilled and there's actually results? In
other words, the plan may be a good paper plan, but what
happens to make sure that you can come back and say this is
exactly what we hoped for and what's your mechanism to do that?
Ms. Finn. In this case, our mechanism generally will be our
second visit to each Regional Office that hopefully will take
place somewhere between 3 and 5 years, depending on how soon we
hire everybody and how the schedule works out.
Senator Begich. Is there anything we can do? Especially
when I was mayor we did audits all the time; we always had a
team that would follow up on a regular basis. If you wait too
long, the systems don't get corrected as quickly as you like.
They may get corrected, but they're not really producing
results. Is there a mechanism to speed that up at all, or is it
just really a staffing issue that you have to make sure that
you have a lion's staff to follow up?
Ms. Finn. The Senate and the House Veterans' Affairs
Committee have been very supportive of our inspection program
and provided more resources so that we could increase our
cycle. I think the other action is to continue to keep the
focus on our findings through hearings such as this.
Senator Begich. Excellent. Do you think the types of
recommendations that you've made are--assuming from your
perspective--reasonable; do you think it's what is going on in
the Anchorage region? How do we compare, I guess, to other
regions that you're reviewing? I'm not sure what the right
phrase is. Are we in the middle, in the bottom, on the top? How
do we rank in the bigger picture of Regional Offices when it
comes to the VA and its administration?
Ms. Finn. We did cover that in our written testimony that
will be part of the record, and Anchorage is somewhere in the
middle. I will say that our inspection--our protocols and our
team, they are pretty tough, because all of our inspectors are
folks who used to work at VBA and so they know the process.
Senator Begich. They know it all.
Ms. Finn. They know where the errors occur. Brent, our
director here spent 8 years with VBA before coming to the IG.
So, none of the offices that we have inspected so far have
gotten a clean bill of health. Everybody--every office has had
some type of issue.
As far as the percentage of errors, Anchorage is in the
middle. Baltimore was the highest office with issues, and
Anchorage followed them. However, I will say that when we
looked at particular claim folders and looked at the errors on
those, we had only--of the errors we found, a number of those
are procedural, and Anchorage had three errors that actually
affected veterans' benefits. I think, Brent will correct me if
I'm wrong, that in several other offices that rate has been
much higher with where the errors affected benefits a lot more.
Senator Begich. So, a lot of what was occurring here was
process and as you shook it down, all the way down to the
levels of the benefits they received there was minimal or there
was still benefit impact, but not like some others.
Mr. Arronte. Yes, normally, that's correct. There was a
higher rate of procedural problems, like Belinda said. There
were three disability claims that actually affected the
veteran's monthly benefit. And I believe that's probably one of
the lowest rates of the seven or eight offices that we had
visited.
Senator Begich. I want to thank you. I'm going to zip over,
take a few minutes and go until about ten after. Mark, if I can
ask you a few questions. Thank you for the tour of the office
today. I do have to say the office is small and cramped and I
know you're looking forward to better space to actually be able
to better process the claims; and it's in a better environment.
I can tell you I can only imagine what that's like when the
load gets heavy. I want to ask verbally for the record: What
efforts are you making with regard to the training? I thought
you pointed out in the report that training was one of the
issues for employees. What are you doing to train your
employees to be better qualified or better prepared to handle
these?
Mr. Bilosz. We're making an investment. We are taking the
time to have weekly training sessions with our employees. We're
reviewing the errors that are being found on national quality
reviews and also the errors that are being found on our local
quality reviews and incorporating those as part of our training
program. This has helped us to really improve our training. We,
again, appreciated the Office of Inspector General's report
where we took all of the areas that they found which we needed
to improve on and incorporated that as part of our review
period. We've used that.
Senator Begich. As you've reviewed, I know they're in your
testimony. Are those the measurements that your employees know
that you're measuring to? These are some of the measurement
metrics you're going to use in the long term, or is it more of
a management knowledge? Do the employees understand how they're
being measured?
Mr. Bilosz. Yeah. We share that. That's part of their
training--to understand what we're doing, how what we do
affects our services to veterans. You may not have noticed as
you zipped into the office, but there was a big white board
where we walked in and it had a lot of the data on it. The
employees see it when they come in. They know how what they do
affects the claims process and how what they do affects the
quality of the claims process, too.
Senator Begich. During the tour, I forget which one
mentioned to us, but the staffing levels that you now have, how
many of those folks are new to the process in the last year?
Some discussions occurred, I don't remember----
Mr. Bilosz. We have six rating specialists that actually do
the rating decisions for veterans; and three of those have less
than 6 months of experience. We feel that six is adequate to
get the job done, but they have to be fully trained, so we are
ramping up the training with those folks so that they're able
to process claims as quickly as they can.
Senator Begich. Do you have a high turnover rate that is
caused by some factor that's explainable? I went through one
office of the VA. What is it like there?
Mr. Bilosz. It hasn't been a high turnover rate. I think
that we've had a few people leave over the past year which
we've replaced, obviously. We've also increased our staffing
level from about 28 or 29 to 34, so we've had new people come
on board. We've also promoted some folks. As I said we have two
new supervisors that came up through the ranks and, again,
that's left a little bit of a void there in the short term.
Senator Begich. Do you have a question, comment, Patrick?
Mr. Kelley. I do not feel--we do not have a high turnover
rate, but we have people that will transfer down to the Lower
48 and get out of the VA down there which is generally when
their spouse transfers through the military or circumstances
such as that. But we haven't had anyone just quit with the
exception of one employee.
Senator Begich. Very good. One of the comments was the
review from Salt Lake City and kind of how that connection is.
Comment on that?
Mr. Bilosz. Pat is the Veterans Service Center Manager.
He's responsible for the day-to-day operations of the office.
Me being the director there, I have oversight over Pat to
ensure that he and the service center are performing the way
they should be, making sure that when we have a process in
place that it's being accomplished. So, again, Pat and I talk
daily. We have more formal meetings a couple times a week. So,
we're all on the same page as to what is occurring in the
office.
Senator Begich. Is it possible--I'm going to move to two
last questions for a couple of folks remaining here--but I want
to first thank you folks for testifying for the record. Mark,
you had some interesting statistics that you had mentioned this
year already. Can you, by June, prepare a data point report
that you could present at least to me and the Committee to give
us an understanding of kind of where you're at compared to a
year ago? And how that also addresses some of the concerns that
the IG has brought up. Is that something you can do?
Mr. Bilosz. Absolutely.
Senator Begich. I'd be very interested in that. The metrics
you used to measure were impressive the last 9 weeks of this
year. I want to compare a longer period of time and compare a
flow. And if you wouldn't mind presenting it, that would be
fantastic.
Mr. Bilosz. Absolutely.
[The additional information requested during the hearing
follows:]
Senator Begich. Two quick things, then we're going to
close. First, General Katkus, I want to thank you all for the
effort with the ATG. I'm impressed that you are finding more
folks who are eligible for benefits, so I want to thank you for
that.
Is there anything more we can do in the system from the
Federal end to help with regards to this, or what we've done in
the change of law to kind to give you the tools you need?
General Katkus. Sir, there was one last area of concern.
That was the Federal association to use National Guard
resources to help on this. Your letter to General Carpenter
resulted in my being notified on the way over here that he has
funded a Federal position to assist on that. I think that was
the last hurdle we had.
Senator Begich. Did he know you were coming to this
hearing?
General Katkus. I think it was just timing, sir.
Senator Begich. The position will be funded by them?
General Katkus. Yes, sir.
Senator Begich. Excellent. That will assist you in your
efforts. Fantastic. That's great news. Thank you and your team
and all the folks.
The other thing I wanted to ask is what Rich Owens brought
up, and that is maybe a dual question to you and Jan. You heard
the concern that the well times, the deployment times are
having more of an effect especially on the small businesses,
not necessarily the large businesses, but the smaller
operations. They're starting to see the impact. Are you
preparing or are you looking at that issue in a--kind of a
vetted measure, rather than waiting for it to grow into a
bigger problem? Is that something that is a concern to you? I
heard from Rich. It makes me nervous, a little bit, to be
frank.
General Katkus. I'll start off before Jan. I'm sure she's
got some answers on that, also. As commander of the National
Guard, we're going to affect soldiers and airmen in their
career paths, because they're going to be away from the job.
Those businesses have to be engaged. We have to engage them in
a positive way. We try to do that in recognition programs. We
try to keep them informed. We try to keep them involved and
stress the importance of each drill. I think that the Nation as
a whole, all is in concert that we are at war and they're
making sacrifices. But those small businesses continue to make
sacrifice after sacrifice. Now after 8 years, it is a concern,
and we'll do our level best to continue to engage them. But if
anyone has ideas on how to better compensate the businesses or
make up for that loss of an employee, we'd certainly be open to
support that and try to engage on those areas.
Senator Begich. Jan, do you have anything to add to that?
Ms. Myers. Just that they are moving toward finding jobs
and different jobs that possibly they can do with the rotation
that we have coming up. More to come.
Senator Begich. Ray, you gave some good commentary on kind
of bridging this larger group of agencies and maybe part of
that could be--I'm assuming you're thinking this. If not, I
don't want to assume the obvious--the Guard and how they
participate in that small business community, maybe there's an
opportunity to figure out the work you're doing and getting
this connection together. It does make me nervous. My wife runs
four small businesses. I was a small businessperson for many,
many years. The plumber example you gave, I actually had that
situation with my plumber. He has three employees, and one has
gone away off and on. When that happens the workload shifts,
and you end up at the bottom of the list, literally.
Secretary Jefferson. We actually met with the national
director of ESGR right before the storm a week and a half ago,
and we're going to talk about looking at some things, because
it's a challenge. Use Hawaii as an example, because Hawaii and
Alaska have a lot of similarities: 90 percent of the companies
are small businesses; 90 percent of those have less than 10
employees. What do you do when one or two of those are
deployed? I think what General Katkus was talking about is
exactly the way to look at this: Are there some ways we can
provide a temporary fill or a temporary solution? So we want to
talk to ESGR about that and see what options we can come up
with.
Senator Begich. Could you keep us informed on that?
Secretary Jefferson. Yes, sir.
Senator Begich. Very good.
Jan, I'd be very interested in the information on the work
you're doing with regard to suicide prevention. It's a growing
concern from my other role as a member of the Armed Services
Committee. We have had this on our agenda a couple of times,
and it's a growing concern of how we handle it, especially
since the numbers have not decreased; they're increasing. What
do we do regarding preventative work? I know from the
Department of Defense they're having mental health workers now
in the field, which is a huge plus. They have a lot to hire.
They're going to the field rather than waiting for the back
end. I'd be very interested, if you wouldn't mind, to maybe
share with our staff at some point some of the ideas that
you're working on, some of the work you're doing specifically,
and things that you think we could be doing in this area to
have a positive effect, not only for veterans, but, obviously,
our active military. What we can do more as preventative work?
If you're willing to do that--I was very intrigued by some of
your conversation on that.
Ms. Myers. Sure. Love to, sir.
Senator Begich. Thank you very much.
Let me end there. Thank you. We've run over a little bit.
Secretary Jefferson. Sir, if I could make one comment. We
have our State director for veterans employment and training
here, if I can just briefly introduce him. For any veterans who
are unemployed or who know someone who is unemployed, or just
seeking a job change, this is our State director for veterans
employment and training. Please contact him. He will get you
access to the employment representatives for Alaska. This is a
portal, and we are ready and eager to help those veterans in
Alaska find meaningful employment in their careers.
Senator Begich. Thank you very much. Thank you to all those
that traveled a great distance to be here. Thank you for being
at the hearing today. I appreciate all the commentary. Again,
all your statements, written and verbal, will be in the record
to be shared with the Committee. Thank you very much.
At this time the meeting is adjourned.
[Field hearing adjourned at 12:15 p.m.]
A P P E N D I X
----------
Statement Submitted at Hearing by Steven Clapp, AFGE National
Representative, Anchorage, Alaska
Statement Submitted at Hearing by Zulene Simmons of Chugiak, Alaska
Prepared Statement of Russell N. Kell, Vietnam Veterans of America
SERVICES FOR VETERANS IN ALASKA
----------
WEDNESDAY, FEBRUARY 17, 2010
U.S. Senate,
Committee on Veterans' Affairs,
Fairbanks, AK.
The Committee met, pursuant to notice, at 1 p.m., Fairbanks
North Star Borough Administrative Center, Hon. Mark Begich,
Member of the Committee, presiding.
Present: Senator Mark Begich.
OPENING STATEMENT OF HON. MARK BEGICH,
U.S. SENATOR FROM ALASKA
Senator Begich. We'll call this meeting to order. This is a
Field Hearing on Services for Veterans in Alaska for the
Veterans' Affairs Committee of the U.S. Senate.
First, I know that we have two mayors here. Mayor Hopkins,
thank you very much for being here. Mayor Isaacson from North
Pole, there you are. Thank you both for being here today and
for your interest in veterans' issues, and thank you for the
great weather. I have come from the deep cold of Washington,
DC, where there is fifty-plus inches and 25 to 30 degree
weather. It's amazing to come to Alaska and be in warmer
weather with less snow, I have to tell you.
I also have some folks here I'll introduce in a second from
Washington, DC, and I did tell them that they will be able to
come to the tropics if they can come with me to Alaska in
February. So, they are here. We want to give them special
recognition for, one, traveling to Alaska, but, two, for
traveling in February. We give them extra credit points, just
so you know that. When they come in the summer, they don't get
any extra points for that.
Let me make a few comments and then I'll describe what
today is going to be about and how it will work. This hearing
will focus on the State's services for veterans in Alaska,
including support of returning veterans, job opportunities for
veterans, benefits for veterans, and the December audit by the
VA Office of Inspector General of the VA Regional Office in
Anchorage.
The Committee has had multiple hearings on VA benefits,
health care, and services; however, this is the first time we
are specifically focusing on the unique challenges confronting
returning Alaskan veterans of Operations Iraqi and Enduring
Freedom.
I'm pleased that the Committee is joined today by Assistant
Secretary of Labor Ray Jefferson. Ray, just raise your hand. I
know you'll be on our second panel. He was with me in Anchorage
for a field hearing. We've been to Wasilla, today we're in
Fairbanks, and then we're off to Kotzebue tomorrow. So, we're
giving him a full, rounded Alaskanized approach to getting
people familiar with what's going on here in Alaska. In
addition, you'll hear when he testifies a little bit about the
Department of Labor and some of the efforts and work they're
doing.
We are also joined by Dr. Susan Pendergrass, the Director
of Veterans' Integration Service Network, or VISN 20. Dr.
Pendergrass is responsible for the VA Northwest Health Network.
Thank you again. She'll be on the second panel.
I want to give you a little bit of statistics though most
of you know this already: Alaska has over 70,000 veterans;
about 11 percent of our population. We are the highest per
capita in the Nation. The Alaska population is very diverse,
but also spread not only in the urban areas, but into the rural
areas. So we have very unique situations that face our veterans
in the challenges that they face, not only in employment, but
other services that they need. Along with that, each year about
1,500 individuals from the military, especially from our recent
conflicts, move out of active service and into veteran
capacity.
I want to applaud the VA employees in Alaska for the work
they do--and the VA does a lot of very significant work in
making a difference for Alaskan veterans; however, there is
always room for improvement, as evidenced by the recent VA IG
report dated December 7, 2009, that showed the Anchorage VA
Regional Office failed to meet requirements in 13 of the 14
areas covered during the inspection. This concerns me deeply
because providing accurate, timely, and comprehensive services
to our veterans is one of my top priorities as a Member of the
Veterans' Affairs Committee. More work needs to be done.
I hope that both of our panels will shed some light on the
issues, such as why we continue to hear from some veterans that
are not aware of their eligibility for VA benefits and
services; why some veterans are not receiving appropriate VA
services; and why veterans have such a tough time finding
employment. I hope to discuss these and other important issues
with our panels today.
Indeed, our unique geography, diversity, and way of life
require the VA develop a unique strategy to care for our
veterans, especially those who reside in rural areas. Back in
Washington, we have worked hard to ensure that the VA has the
resources to provide the best care possible. Congress has
provided record-breaking funding increases to the VA. Last
year, I supported the VA's Veterans Health Care Budget Reform
and Transparency Act to ensure funding for veterans' health
care 1 year in advance of the regular appropriation process.
This bill was signed into law in October 2009.
We have followed up on that success with passage of the
Caregiver's Bill, which would help wounded warriors and their
families who care for them. This bill, which also improves care
for women veterans, those who reside in rural areas, and those
who are homeless, has been sent to the House of Representatives
for their action and we expect action later this year.
Finally, I know there are veterans here in the audience. As
you know, back some time ago I came up and had a veterans'
roundtable at one of the facilities here. Today is a little
different. Today is a congressional hearing that I'm chairing
here on behalf of the Senate Veterans' Affairs Committee. The
process, just so everyone is aware, is we will have two panels
that will present testimony? You will see diverse thoughts and
views on the services of the VA. This hearing will help us
create a congressional record to understand specifically
Alaskan issues that we can then bring back to Washington, DC.
I know there are individuals who would like to testify.
This congressional hearing does not allow for individual
testimony; but saying that, we have created a document to allow
anyone to submit testimony. Anything presented today will be
part of our congressional record, shared with the rest of the
Committee, as well as with my office. There is a form we put
out front that you can fill out and put down additional
comments, concerns, or questions that you're not getting
answered by the Veterans Administration. Let us know that. The
staff will collect those or you can put them on the table.
Would every staff member raise your hand. These are the folks
that you want to hand that term to, please give it to them so
we can make sure we keep a record of it.
Again, it's not the normal process that a lot of people are
familiar with when they walk into an assembly chamber like this
where people line up for 3 minutes to give testimony. This
hearing is for the Committee to learn what we can do to improve
veteran services.
So, that's the process here. Several of us in between our
next appointment, leaving from here to our next one, will have
available time for people to come up to our special guests to
give them additional information.
I will now introduce panel 1.
Linda, I practiced your name; I think I got it right.
Boisseau. Is that----
Ms. Boisseau. Boisseau, yes, sir.
Senator Begich. Very good. Today we have Linda Boisseau,
Department Service Officer, Disabled American Veterans. We also
have Robert Roof, an OIF veteran; Joe Sheehan, a Lieutenant
Colonel, U.S. Army Retired, and Chairman of the Northern Alaska
Military Retiree Council; and Ron Woolf, Unit Representative,
Employer Support of the Guard and Reserve. We're going to have
a ceremony afterwards with some other folks that are anxious to
sign up, we're very excited about that.
The order will be just that, and we'll start with Linda,
who will give her presentation. As I said to the people who are
testifying, just imagine we're in your living room, all of us.
Keep it casual. That's what we try to do here: to give you the
flexibility to express your views on things that we can do to
improve service. Linda.
Ms. Boisseau. I would like to have a Miller Lite, sir.
Senator Begich. A Miller Lite for Linda.
[General laughter.]
STATEMENT OF LINDA BOISSEAU, DEPARTMENT SERVICE OFFICER,
DISABLED AMERICAN VETERANS
Ms. Boisseau. Mr. Chairman and Members of the Committee,
I'm glad to be here on the behalf of the Disabled American
Veterans. I know that the VA has problems and there's no need
in continually ragging on it and saying, OK, you failed 13 out
of 14 things. So, if possible, I would like to just bring up a
few instant issues that we're having problems with.
First of all, sir, we're having to broker out our claims. A
lot of them go to Salt Lake City. They also go to Seattle, WA,
and they also go to San Diego, CA. I cannot overemphasize how
horrible San Diego, CA, is on their claims. I wish the OIG
would go in there and pull a lot of the claims that are being,
you know, done down there to come back to Alaska. They result 9
times out of 10 is a Notice of Disagreement or appeals. It's
like they give vets zero percent or they deny them. There's no
in-between. It's really very, very poor.
That's been one of--we have problems with Salt Lake City
and Seattle, but not half as much as we do with San Diego, CA,
rating our claims.
Another issue that I have is mail continues to be
misplaced. Instructions to VA by the veterans are overlooked
and communication is non-existent. We've had a rash of people
supposedly not showing up for their C&P exams. I don't know if
it's a miscommunication from the people that are supposed to be
sending out the notices to people who have C&P exams, but
there's been no mail forthcoming to--these people have missed
appointments and are being denied their claims through the VA
because of this supposed mailed-out notice of C&P exam missed.
That's been another big issue that we're having. Some of these
are pretty serious with Post Traumatic Stress Disorder that
they have had since 2000. Now they're doing a review and
threatening to take them down from 100 percent to 50 percent,
assuming that their GAF has changed--their GAF score. Which is
not 52, it's 42, according to the records, but it was quoted as
52. It's just a--it's very irritating and when people have Post
Traumatic Stress Disorder, they haven't worked since 1989, they
even have trouble coming to some of the groups, and don't even
speak but have to sit in the corner. Yet they still need the
camaraderie because they can't continue staying in the dark,
shall we say, all the time. I find that so offensive, and they
need to fix that supposed C&P notification. I don't believe
it's happening, honestly, for the majority of them.
The phone centers cannot provide the information to
veterans other than what is input into the system, and that is
the problem. When we call 1-800-827-1000, we usually get
Phoenix, AZ, out of Alaska. We have a problem with Phoenix in
the fact that here in Alaska if you get 50 percent or higher
rating, you receive up to $170,000 property tax exemption.
When my veterans asked for the property tax exemption
paperwork and the civil service preference letter, Phoenix
seems to have a terribly difficult problem understanding what
in thunder the property tax exemption letter is that has to be
presented to the borough no later than the 31st of March. So,
that is a delay for my veterans receiving those benefits. I
would like to have that fixed. Somebody needs to educate those
people that we live in Alaska and maybe some of--as you noted
before, sir, when you came in--our circumstances are quite
different from the Lower 48.
Notes are not updated on a regular basis. We have a veteran
that was awarded disability pension in August 2009. The veteran
has a VA medical appointment scheduled back in November 2009
and again in February at the Fairbanks medical clinic. All
right. He lives in Northway, which is 258 miles from the
medical clinic here in town. The winter bus schedule out of
Northway is such that the veteran has to stay in Fairbanks for
at least four nights. He has to arrive on Wednesday and depart
on Sunday, through no fault of his own; there's no other
transportation for this gentleman. The veteran has to have paid
this out of his pocket, $776.10 out of his pocket, because his
file did not reflect--it was not put into the computer that he
was awarded disability pension. His annual income other than
the pension that he receives is from social security, which is
only $3,072, sir. He's in poverty through no fault of his own.
He hasn't got the money to pay for something that should be
taken care of by the Veterans Administration.
There are some claims that haven't had a progress note or
action for approximately 6 months and the claims are still
active. That's another huge problem. An example: a Notice of
Disagreement received and dated, stamped by the Anchorage VA,
July 30, 2008. On December 10, 2008, the spouse received a
letter from the VA indicating that the Notice of Disagreement
procedure would be sent. On November 13, 2009, after a service
officer inquiry as to the status of the claim, the VA indicated
that the file had been closed and shipped to St. Louis, MO,
prior to the date originally received and the date stamped. No
communication on this death benefit for the spouse has been
received as of this date.
Thank you for your time, sir.
[The prepared statement of Ms. Boisseau follows:]
Prepared Statement of Linda Boisseau, Department Service Officer,
Department of Alaska, Disabled American Veterans
Mr. Chairman and Members of the Committee: Thank you for the
opportunity to present testimony on the current state of veterans
services available to Alaska's 76,000 veterans. Before I begin my
formal statement, I would like to thank Senators Begich and Murkowski
and Representative Don Young for their support of funding reform and
Senator Murkowski for her special interest and support of women
veterans.
In Alaska and across the country, the Department of Veterans
Affairs (VA) offers a comprehensive array of benefits and services to
military veterans and their survivors, including health care,
vocational rehabilitation, readjustment counseling, disability
compensation and pensions, educational assistance, home loans, life
insurance, and burial services.
Disabled American Veterans (DAV) Department Service Officers assist
our National Service Officers (NSOs) in representing veterans and their
families with claims for benefits from government agencies, including
VA, and the Department of Defense. Veterans need not be DAV members to
take advantage of this assistance, which is provided free of charge.
NSOs function as attorneys-in-fact, assisting veterans and their
families in filing claims for VA disability compensation and pension;
vocational rehabilitation and employment; education; home loan
guaranty; life insurance; death benefits; health care and much more.
One of the biggest problems facing Alaska's veterans today is their
inability to get correct or timely decisions on claims for disability
compensation. As you are aware, VA's Office of Inspector General (VA
OIG) recently completed an inspection of the disability compensation
claims processing and Veterans Service Center (VSC) operations at the
VA Regional Office in Anchorage. During this review, the OIG found that
the Anchorage RO did not meet the requirements for 13 of 14 operational
areas reviewed. While this may come as a surprise to some, it is
consistent with what is been happening at VA Regional Offices across
the United States.
During recent inspections of other Regional Offices, as well as in
reviews of Veterans Benefits Administration (VBA) operations in
general, the VA Inspector General found the same problems as those
identified in Alaska: inaccurate decisions, too much workload, not
enough trained staff, inadequate oversight and quality control, and
insufficient IT capability to handle the mountain of paper claims.
In March 2009, VA OIG reported on the overall system and found that
almost a quarter (22%) of all veterans' claims for disability
compensation were decided incorrectly in the 12-month period reviewed.
During that period, over 200,000 veterans received inaccurate decisions
on disability compensation. Here in Alaska, the OIG found that 29% of
the cases reviewed had errors resulting in veterans being denied
compensation due to them. Equally troubling, of the cases which the
Regional Office itself found, 42% of those errors were not corrected.
The chart attached at the end of my testimony depicts the result of the
last six VA OIG visits.
And while errors go uncorrected, the volume of claims is rising
faster than VA's ability to address this growing workload. As of
January 11, 2010, there were 466,985 claims for disability compensation
and pensions awaiting rating decisions; 162,352 (37.3%) of the claims
have exceeded VBA's 125-day strategic goal. In fact, the average time
to approve a rating has exceeded 180 days for more than a decade. And
to complicate the problem even further, claims folders for almost
300,000 veterans were misplaced and claims for 141,000 veterans are
lost.
VA today continues to rely on a cumbersome paper-based system to
review and evaluate claims for disability compensation and pension.
Beginning with the application for benefits, which is now a 23-page
document, the system has become increasingly complicated. Moreover, in
the past several years, there has been about a 50% increase in the most
complex disability compensation applications, those in which a veteran
cites eight or more disabilities, requiring even greater time and
expertise to correctly reach a correct, equitable decision.
Unfortunately, the VBA has yet to develop a modern information
technology (IT) system to begin to move from such a paper-centric
system to a contemporary electronic system. Regional Offices are being
overwhelmed with massive amounts of paper, from the applications
themselves to piles of medical evidence supporting those claims.
In fact, after a recent inspection at the Roanoke, Virginia VA
Regional Office, the VA OIG found nearly 11,000 folders sitting on top
of file cabinets already filled to capacity with the paper claims and
supporting evidence of tens of thousands of veterans. After calling in
the building engineer to look at the situation, they determined that
the load on floors 10, 11 and 12 of the 14-story building was double
what is considered safe and heavy enough to cause the entire building
to collapse.
Mr. Chairman, too many disabled veterans and their survivors must
wait too long for disability compensation and pension rating decisions
that are too often wrong or inaccurate. If we do not address these
problems and reform the claims processing system here in Alaska and
across the United States, the entire system is in danger of collapsing
on itself just from the sheer weight of the workload.
Congress must reform the claims processing system so that disabled
veterans and their survivors are able to apply for benefits through a
simple, uniform and modern IT-based process that enables VA to make
accurate decisions within acceptable timeframes. Active duty
servicemembers should be able to apply for benefits before discharge
and receive accurate decisions by the time of their discharge.
To accomplish these goals, VBA must develop a work culture that
emphasizes quality at all steps of the process. It must begin with the
development of a management culture that measures and rewards the
quality of results, not just the quantity, and that provides sufficient
training of both VA's management and workforce in order to arrive at
correct decisions.
VBA must modernize its IT infrastructure and optimize its business
processes. The current paper-centric system must be replaced with a
secure and accessible paperless system that rapidly moves and organizes
information necessary to help rating specialists reach correct
decisions. The new system must optimize both the workflow and the
business processes.
VBA must also implement a simpler and more transparent benefits
application and approval process. There should be a universal and
simple application procedure that provides veterans with regular
updates on the progress of their claims and allows them to access their
records and pending claims securely from any location.
In the short term, there are several reforms that VBA could begin
to immediately implement either on its own, or consonant with
Congressional action. For example, VBA wastes significant time by
ordering a VA medical examination for virtually every claim for
compensation, even when sufficient medical evidence from the veterans'
private physician already exists. VBA should create standardized
templates for private physicians so that private medical evidence can
be developed and delivered in a standardized manner that meets VBA
requirements and allows VBA rating specialists to use that private
medical evidence to make determinations without the need for redundant
VA examinations.
VBA should also take advantage of their existing authority to
provide deferred rating decisions quickly to veterans when there is
sufficient evidence to establish a compensable service-connected
condition. This would allow VBA to quickly adjudicate those issues
where the service connection matters and levels of disability are clear
cut, assign an interim rating so that the veterans could begin to
receive financial support and access VA health care services. Then, at
a later date VA can schedule any necessary exams and develop the
evidence necessary to determine the final rating for other more
complicated disabilities.
VBA must also take steps to establish comprehensive and uniform
systems to train and provide continuing education to its workforce,
including more substantial on-the-job-training. They must develop and
implement a new quality control regime that places emphasis on the
quality of decisions made, rather than only on the quantity of work
completed and reward employees accordingly. A renewed commitment to and
investment in training and quality control will help to ensure that
benefits decisions are done right the first time, which will save time
over the long run. For a more detailed explanation of these
recommendations and their origins, please refer to the Independent
Budget for fiscal year 2011, in which DAV is a major participant and
partner along with AMVETS, Veterans of Foreign Wars of the United
States and Paralyzed Veterans of America.
Although DAV NSOs and Department Service Officers do not heavily
focus on the VA health care system, I would like to make a few comments
on the state of medical care available to Alaska's veterans. Today, VA
operates a medical center in Anchorage, and Community-Based Outpatient
Clinics (CBOCs) in Fairbanks, Kenai and Matanuska-Susitna Valley, in
total providing more than 130,000 outpatient visits a year. We
recognize the unique challenges our veterans face in Alaska and I am
pleased DAV Resolution 247, adopted by the delegates to DAV's last
National Convention, assembled in Denver, Colorado, August 22-25, 2009,
fully supports the right of rural veterans to be served by VA. Our
resolution further notes that funding for additional rural care options
and outreach be sustained and not be the cause of reductions in highly
specialized VA medical programs.
Public Law 109-461 authorized VA to establish the Veterans Health
Administration Office of Rural Health to promulgate policies, best
practices and innovations to improve services to veterans who reside in
rural areas. We strongly urge this Office to coordinate with VA medical
care facilities and veterans service organizations in Alaska to ensure
alternative and creative programs and services are developed to meet
the unique needs of sick and disabled veterans residing in this area.
Mr. Chairman, this completes my written testimony.
Attachment
Senator Begich. Thank you very much. You did very well.
What I'll do is take the testimony from all four and then I'll
come back with questions.
Ms. Boisseau. Thank you for your time on this, sir, very
much.
Senator Begich. Very good. Thank you very much. Robert.
Robert and I had a great conversation just before we started,
and I told him, don't worry, just say what's on your mind.
STATEMENT OF SPC ROBERT L. ROOF, USA (RET.)
Mr. Roof. I'll do the best I can, sir. I do want to say
before I go on with my tirade, pointing fingers and attempting
to describe the flaws in the system, I'd like to mention that I
do so humbly. For despite the errors of a few and the system as
a whole, there have been many more instances of good
individuals, many who are sitting in this room today, that I
have come across that have done their best to aid in my path of
recovery and transition.
I would also like to acknowledge the idea that my
generation of veterans has the greatest understanding and
support than any generation of the past. It is with the utmost
respect to the warriors that have come before me, those
individuals who have tirelessly helped me to navigate my
recovery and to you, Senator, that I dare to voice my
complaints. Sadly, there are still issues that must be
addressed, particularly health care issues.
I've found that there lacks available counseling. In order
to get in and see anybody or to be prioritized, you must
basically be a harm to yourself or someone else. There's just a
lack of people available. And when I was seen in counseling, it
was once a month at best. A few times I had appointments
canceled without being notified until I was walking through the
door, yet I continually got reminded that, you know, if I'm
going to miss an appointment that I need to notify them so that
someone else can have my time slot, or if I fail to go to a
certain number of appointments, then, you know, I'm at risk of
losing my counseling, which I've never heard of happening, but
the threat is always there.
Numerous times because of the lack of VA facilities here in
Fairbanks, I've had to fly to Anchorage, missing--you know,
taking time off of work and losing days' worth of wages and/or
missing out on school. To get down there and find my meds that
I was supposed to be receiving not be there and then be told by
the nursing staff that I need to do my best to, next time I
have an appointment, to call and let them know, to remind them
to order my medication, when I thought that's what my patient
record was for. As someone suffering from the disabilities I
have, I have trouble remembering if I locked my door when I
leave the house each day, let alone trying to worry about if me
flying to Anchorage and losing out on my day, if, you know, I'm
going to get the care that I went down there for.
Since my transition out of the military--I was a gunshot
wound victim and receiving OT and was meeting with surgeons
before I left Fort Campbell, but after receiving my orders to
get out on a medical board there has been no follow-up care on
my injury, which at this point I'm sure there's not much that
could be done. But it was a simple fact that I fell through the
cracks, basically. There was no further attention paid to my
gunshot injury. The only issue that has somewhat been addressed
is the PTSD.
I mentioned the lack of VA facilities here in Fairbanks.
You know, you have to go all the way out on post and--which is
a hassle in itself at times just trying to go through the gate.
I've been trying to go back to school since I returned to
Alaska and I enlisted the help of the voc rehab program as
opposed to the GI Bill because as a disabled veteran, I thought
it was the goal of the voc rehab program to provide the
additional support needed for disabled veterans such as myself,
and that has not been the case. When I first went to set up my
voc rehab, I was told by the counselor that I needed to go out
and gather up all this information. As I mentioned, as a person
with my disabilities, I'm not the most sociable. And, as a
student, I mean it's--the school system is hard enough to
navigate on my own, but then with the additional problems that
I have, basically, I was on this wild goose chase. I brought
back this information, which I thought he had asked for
numerous times, and he failed to communicate exactly what he
was looking for or what I thought he was looking for didn't
work, and after the third time I was finally able to give him
what he needed.
And, let's see, I apologize----
Senator Begich. No, you're doing fine.
Mr. Roof. At one point, I enrolled in a class that was
for--it was a humanities degree requirement for my program. I
received a phone call from the voc rehab counselor stating that
this class wasn't listed on my degree requirements and that
therefore the VA was going to fail--was not going to pay for it
and that I cannot be out there freelancing my education.
Honestly, I really don't care for school. I love to learn, but
school is just really not for me, and I really don't want to
spend any more time with it than I have to. I'd much rather
just get on with life and get my degree. So, you know, I felt
insulted that this accusation was made. The fact is, he just
didn't have a full understanding, apparently, of how the school
system works and what was really being asked of me to fulfill
these degree requirements. How can he sit there and make these
accusations that I'm out there freelancing my education when he
doesn't even know what's going on? So, I think part of that is
lack of understanding, too, on the veterans coordinator up at
the university who I've tried to speak with on multiple
occasions and who was always unavailable.
And the aid needed to navigate the school system. Like I
said, apparently there's the Office of Student Services for
Disabilities though I just recently found out that they could
have been doing a lot more to help me get through my classes by
tailoring my classes more to my needs. This is all new
information. Here, I've been faking my way through my education
now for 2 years just trying to get by and scrape by and get
whatever little I can out of it. And here, you know, like I
said, all this stress and all this trouble and failing classes
could have hopefully been avoided if I would have, you know,
had the additional aid and support that I felt I needed.
Speaking of voc rehab and what's disheartening about it is
that under this new GI Bill--not to sound like a money-grubber,
but part of the reason why I chose the voc rehab is, like I
said, is for the additional support I thought I would receive
as a disabled veteran. And now, I mean, I might as well just
have done the GI Bill and gotten the additional money so that I
wouldn't have to try to work and go to school and put this all
together when, you know, if I'm not getting the help, then I
might as well just switch over the programs.
I mean, I can't really touch base on employment. I've found
a job; I work part-time. Like I said, I've been going to school
just simply because I got the job with the same company my
mother works for and they've been more than gracious to give me
time off for, you know, appointments and to go to class, or if
I have PTSD flare-ups, as I have had recently. I've taken a
leave of absence from work now for 2 weeks. So, once I lose
this job or move on in the world, you know, that's something
I'll have to face, but as of right now I can't really touch
base on employment opportunities.
That's about it. All I can really say, too, is recently I
was just contacted as part of that PTSD lawsuit saying that I
was shorted on my medical board ratings. I've only been given
30 percent for PTSD when the standard was supposedly 50
percent. And so this makes me, what, you know, out of 4,300,
not a large number. But I just don't understand why--you know,
who's accountable for this, the fact that there's supposed to
be a set standard and--to my understanding, we were all
shorted. So, it doesn't really pertain to these issues, but,
basically, you know, I've been getting the short end of the
stick now for a little while and that's just one more way. So
thank you for your time.
[The prepared statement of Mr. Roof follows:]
Prepared Statement of SPC Robert L. Roof, USA (Ret.)
To members of the Senate Committee of Veteran's Affairs, I would
like to first take this opportunity to say thank you for your time, and
the request to present whatever testimony I may concerning the issues
that are facing today's recently discharged veterans. I appeal to you
not only as disabled combat veteran myself, but also as a patriotic
citizen who truly and rightfully believes in these United States.
Before I go on my tirade pointing fingers and attempting to
discriminate every hole in the system I would like to mention that I do
so humbly. For despite the errors of a few and the system as a whole,
there have many more instances of good individuals that I have come
across that have done their best to aid me in my path of recovery and
transition. I would also like to acknowledge the idea that my
generation of veterans has had the greatest understanding and support
then any generation past. It is with the utmost respect to the warriors
that have come before me, those individuals who have tirelessly helped
me to navigate my recovery, and to you Senators that I dare begin to
voice my ``complaints.''
You've asked to me to share my story of transition, particular
since leaving active duty, but for the combat wounded veteran our story
begins the day we are injured. To my understanding some the issues that
I had to face have been addressed since they occurred but I would like
to mention them because it will help for a clearer understanding of the
larger issue and help shine light on why I am so qualified to share my
concerns.
Briefly, I was born and raised in the communities of Fairbanks and
North Pole, Alaska. I graduated from North Pole High School in 2003 and
enlisted in the US ARMY Delayed Entry Program in March 2004 and shipped
to Infantry School at Ft. Benning in July 2004. Upon graduation from
OSUT I was stationed at Ft. Campbell, KY, with the newly stood up 4th
BCT which would then be flagged the 506th RCT. In November 2005 I
deployed with B Co, 1/506th In, 101st ABN DIV (AASSLT) to Ar Ramadi,
Iraq in support of Operation Iraqi Freedom IV.
I loved the Army, I loved the Infantry. In the short year I was at
Ft. Campbell prior to deployment I successfully earned my Air Assault
Badge, my Expert Infantryman Badge, amongst other certificates and most
importantly the respect of my peers and leaders. My Army career was off
to an amazing start, I had yet to fail a task that the Army had given
me and I took pride in playing even the smallest role in the backbone
of the Army and these United States. I loved being a ``Grunt.''
But as a Infantryman you also know that you are expendable. That is
what keeps our military as strong as it needs to be, maintaining the
fighting force is a first and foremost responsibility, something I
fully understood . . . the mission must always go on. Yet I had this
perceived conception that if you fell in battle and were able to
survive then our government would be there to help stand you back up.
When America needed its sons and daughters to answer the call there I
was willing waiting for my orders.
It is through this detail of my love and success that I hope to
convey that I poured myself into performing the best I possibly could
and put my trust in our military and government. But it is because of
this that made it so difficult to accept the circumstances that I had
to deal with due to my war injuries and the erosion of my belief in the
way our military treats it own. The military is tough business to run
but I feel that there is a certain code that should be used to conduct
it if America is going to live up to the promise it has made to its
warriors.
On 20 May 2006 while manning the .50 Caliber machine gun mounted to
the turret of a Humvee I took a single enemy sniper round to my left
chest/axilla. From there I was ground medevaced to my Battalion Aid
Station where medics attended to me until I was airlifted to Al
Taqqadium Air Base. From there I moved on to Balad, then was airlifted
to Landstuhl where I spent my 21st Birthday, and then flown to Walter
Reed. This is where my difficulties would begin.
While at Landstuhl I was able to make contact with my mother, who
was instructed at that time by a member of my nursing staff that she
should try to meet me at Walter Reed because that was my final
destination based on all information available at the time. My mother
attempted to make contact with the Army to see about getting a flight
to meet me at Walter Reed she was then informed it would take nearly 10
days to process. This is something that any parent or loved one simply
can't accept, so instead she was able to purchase her own tickets and
bring herself and her husband to Walter Reed where they wheeled their
luggage around the hospital waiting for me until they were finally able
to find assistance and get lodging. To this day my mother was never
able to get reimbursed and eventually gave up trying. In the scheme of
things it isn't that big a deal but a matter of principle that my loved
ones were told that it would be over a week before the military could
help her come to my side.
My first difficulty at Walter Reed was in regards to my immediate
care by my team of doctors. The resulting surgeries from my injury had
left a fairly large hole in my chest/arm and when trying to discuss a
treatment plan with my doctors, there was a lack of. At first it was
presented to us that I would have this large whole in chest/arm for the
rest of my being and that was just no getting any answers out of my
doctors. Again, I know the Army has its way of doing things and that at
the time I was lowly PFC, who am I to ask questions? But I did not nor
do not believe that is the most beneficial approach if we are truly
concerned with the mental and physical wellbeing of our injured troops.
I can honestly say that it wasn't beneficial to lie in that hospital in
that beginning week not knowing what was to become of me. It took my
mother contacting Senator Ted Stevens office for my doctors to finally
come in and answer the questions we had, which weren't many, but the
simple reassurance and insight of the doctors made it a little easier
to start to accept what had happened to me.
After my impatient stay I was downgraded to outpatient status and
attached to the Medical Hold Company where I made it very clear that I
was only ``attached'' and not ``assigned'' as I was eager to return to
Ft. Campbell. I had heard the horror stories of fellow soldiers who had
been at Walter Reed for years waiting to see what the Army had in store
for them, and I wished not to become part of that trap. Because my
mother was still at Walter Reed I was able to just stay with her at the
Mologne House Hotel on the compound and therefore I didn't have to
suffer the poor living conditions that others had to deal with, but I
do remember listening to some of the other soldiers discuss how
terrible their quarters were. My barracks at Ft. Campbell had black
mold that seemed to get ignored by our chain of command, but then again
none us had open wounds we had to care for either. I was asked by a
leader in my Med Hold Company if I could reschedule an appointment so
that I could stand in formation for a Change of Command ceremony,
something I refused to do.
After my last outpatient appointment I was reassigned to my unit
back at Ft. Campbell where I served on Rear Detachment with many of the
other wounded soldiers from my company. It is at this time that I began
my symptoms and was diagnosed with PTSD.
It was here me and my fellow wounded E-4 and below types was asked
to trim hedges and run lawnmowers by able-bodied, newly transferred, E-
5 types. But let me mention that my skin graft to my chest/arm hadn't
healed sufficiently enough to provide me with the strength to properly
and safely maneuver a push lawnmower. Nor do I think it was the job of
my friend was ankle was held together by bands and had a flat land
walking profile to try and drag his bad leg over the uneven ground we
were asked to cut. Prior to our injuries we would have willingly
performed these duties, but not like this, not as we were still doing
our best to heal ourselves.
We were moved 3 separate times because there were no barracks for
us as our company barracks were being ``reset'' for the return of our
company that was still in Iraq. It is also here that we ``discouraged''
from attending our appointments because there was painting to be done,
it is here that we were punished for not showing up to formation or
flag raising duties, because whatever medication many of us were on
interrupted or lengthened our sleeping schedules.
Whatever lack of understanding on the part of the Rear D leadership
there was, it didn't get much better when my company returned from
Iraq. Since my departure from Iraq there had been changes in leadership
on the company and platoon level. So now my new leaders who knew
nothing of me and prior performance and I were faced with challenge of
what to do with me until the Army and my injuries dictated what was
next for me. As it would come to be I would eventually start my Med
Board due to the permanent damage to my chest/arm and the PTSD both
which interfered with my responsibilities as an infantryman.
Looking back I do want to say that I no negative feelings on the
actions of the leadership and the things were we asked to do on Rear
Detachment. It was simply the result of untrained leaders who hadn't
been properly trained in how to deal with those of us who had these
injuries. I understood it then and I understand it now. Before I was
discharged, Ft. Campbell was very close to setting up its Warrior
Transition Unit, and from what I have heard it addresses many of the
challenges that I and others had to face post-injury with our regular
line companies. I just feel it is important for me to voice how much I
agree with the establishment of the WTUs and that I hope that they are
making a difference in the recovery and even possibly saving the
careers of injured soldiers. The worst thing that can be done is
forcing someone to soldier when they haven't fully healed.
In June 2007 I was placed on the TDRL with a combined disability
rating of 60%.
The process of leaving Ft. Campbell was interesting to say the
least. Once I had received my Med Board findings and received my
retirement orders then it was all out rush to try and check all the
boxes that I had to check before I could leave, yet my doctor was a
little unpleasant with the idea that I was leaving the area while my
arm/chest injuries were stilling being treated. Since my last
appointment with him at Ft. Campbell I have not had any further
treatment or attention paid to my chest/arm, with the exception of
brief physicals for VA C&P exams and Army Med Boards. At this point I
don't believe that much there is anything that could be done besides
continuing my prescription for pain medication that I have to take to
help numb the daily pain. But the fact that I was doing OT at Ft.
Campbell, and my doctor was concerned with me not finishing whatever he
may have had in mind simply makes me wonder.
Upon leaving Ft. Campbell I returned to Alaska where I enrolled in
school at the University of Alaska-Fairbanks hoping to keep myself busy
and to try and move on with my life. I was able to find employment at a
local liquor store with the help of my mother, as it is the same
company she works for. I simply took because it was offered to me and I
had made it very clear that school was my priority and that I may have
occasional VA appointments to attend.
(Also upon my return to Alaska I would receive a VA pre-
stabilization rating of 100%, which would eventually be downgraded to a
stabilization rating of 80% due to the improvement of my hearing. I can
also say that my PTSD is anything but stabilized and has gotten worse.)
My PTSD really began to give me even more trouble as I was away
from my fellow wounded friends and had little support here with the
exception of a few family members and friends who understood nothing of
my situation, but I was able to scrape by through the use medication,
some counseling, and trying to force my way through school, and I
believe at one point I was making some progress.
In December 2008 I had my Army PEB re-evaluation where I was
permanently retired at a stabilized 60% combined rating. But in light
of recent events I have now learned that I was one of the 4,300
veterans who were shorted on my PTSD rating. Apparently a 50%
disability rating is the standard when rating for PTSD, yet I among all
these others were given less, myself 30%. (So I don't know what this
will mean for my final rating if it will be increased or not. But why
were we shorted?)
You have asked me to describe some of the difficulties I have had
in the transition from active duty to being veteran and a civilian . .
.
For starters the first difficulty is simply accepting the lowered
social status that being a veteran is. When you wear the uniform, you
are easily identifiable. It's all there . . . name, rank, awards,
combat patches. As veteran you lose that, my physical scars are hidden
by my clothing; my mental scars are buried even deeper and everything I
worked so hard for in the Army had been taken away from me and doesn't
mean anything in the civilian sector. If only it was so easy to walk
around with a t-shirt that says ``I have PTSD, please don't bother
me.'' Even if it was, how can I ask society to understand something
that I don't even understand?
The foremost difficulty is trying to find a place to fit in and
people to relate to. I've been trying to go to school for a profession
that probably isn't suited for me, yet I have been faking my way
through my courses because I can't actually concentrate to learn and
retain anything. When I am in class, young 19 and 20 year kids stare at
me because I remain at my seat during group activities and projects. At
work, I am berated on a daily basis by alcoholics and other members of
societies' cesspool. I frequently am told that I need to ``be more
sociable and friendly.'' I have to listen to people get upset because I
don't ask them how their day is going, but instead try focus on
counting money correctly and trying check ID birth and expiration
dates. At home I find myself sifting through my book, music, and movie
collections trying to find something to block out the demons, but
usually find myself staring off into space. The few intimate
relationships I have been able to maintain are usually hindered by my
bouts of depression and anxiety. My personal interactions last until
the Valium wears off. It is hard to accept being a disabled veteran
since the age 22 and never knowing what tomorrow is going to bring.
I have tried to use some of the resources available to me when they
are available. As I have mentioned I have been trying to go to school
to make something of myself but it has not been an easy process. I
choose to go the route of VA Voc Rehab when deciding to use my
education benefits hoping that it would be tailored to the more
specific needs of disabled veterans such as myself. Yet this hasn't
been case. When I first went to set up my education plan I was told to
go out and find all sorts of information that was required to put
together my future education goals. Naturally I wasn't really sure
where to start and was further disheartened when my Voc Rehab counselor
not only couldn't guide me but I felt sent me on a wild goose chase.
Again I would like to remind you that I thought that by going the Voc
Rehab route as opposed to the G.I. Bill route I would have access to
additional resources and aid in the whole planning of my Vocational
Rehabilitation. I went out and found what I thought was being asked of
me and returned it to the counselor only to be told it was sufficient
enough. It was only on the 3rd time that I have apparently gathered the
necessary information to set up my education plan. I truly felt and
still feel that there was a complete lack of communication on the
counselor's part in making it clear what he needed from me. It is
because of this that I spent time, fuel, and energy searching for
something that should have been easier to obtain had I been given
proper guidance.
I enrolled in a course one semester and again lacking information
and not knowing how the course withdraw process worked I ended up
failing a course I could not complete due to a flair up of my PTSD
symptoms. But instead of getting sympathy, and an air of understanding,
instead I got the lecture that if I fail another course then we may
have re-analyze the VA's commitment in my future educational goals.
Understandable, we can't have the VA dumping tax-payer dollars down the
drain while I sit around trying to battle my way through my new
disability. Sadly I had the misconception that I would get a little
more support being a disabled veteran using the Voc Rehab program.
As per my degree requirements I have to take humanities elective.
When I enrolled in this course I then received emails and phone calls
from the counselor informing me that the UAF Veterans Coordinator had
informed them that this course wasn't part of my degree and the comment
was made that I can't just be out there ``free lancing my education.''
Let me make it very clear that I hate school. I love learning new
things, but if I had it my way, I'd be done with school already and on
with life. When I tried to explain things I became extremely frustrated
that such an accusation was made toward me especially considering that
I was going off of the same piece of information that it had been such
a pain to get a hold of in the first place. It reached the point where
I decided that I wasn't going to put up with it anymore and I decided
that I would pay for the course out of my own pocket because I wasn't
going to deal with any more of the counselor's lack of competence in
this matter.
When I contacted a supervisor about some of these issues I was
basically told that it wasn't the Voc Rehab counselors' job to ``hold
my hand.'' Fair enough, but then why I am using the CH. 31 Voc Rehab
benefits which provides no additional support when I might as well use
CH. 33 G.I. Bill benefits where I stand to at least gain additional
monetary benefits. But that's not what I am after; I just want to get
healthy enough to function. As it may not be the job of Voc Rehab
resources to ``hold my hand.'' At the same time I don't believe it's my
job to hold theirs. How can accusations of how I am handling my
schooling be made when these individuals no nothing more of how the
university works then I do?
(But I do ask the question: Will we ever see a day when Voc Rehab
compensation will match G.I. Bill compensation?)
The VA isn't the only one to blame when in regards to some of these
issues though, the university has their weight to bear as well. I have
yet to officially meet with an academic advisor to plan my course of
action. The Veterans' Coordinator is never allowed to be seen the two
times I have requested, and it is only in this past semester that I
have learned the Student Services for Disabilities could have been
helping me to possibly tailor my courses to fit my needs a little
better. I just wish there were someone that could say, ``We understand
you have problems, but we are going to work the best we can to help you
be successful in school, here is what is available to help you.''
All of these resources, whether they be for school or for
healthcare are difficult obtain at times. The first battle is even
learning they exist, and then trying to access them is a whole
different battle altogether. It seems like whenever I go anywhere to
ask for help, there is always someone else I have to talk to first.
Then when I go to speak to that person, I have first have to talk to
another additional individual.
As we all know access to healthcare is probably the largest issue
concerning veterans. When I have actually been able to get an
appointment I haven't had too many issues, but have had issues none the
less.
Mental health counseling appointments are non-existent. When I was
receiving counseling it was once month until my counselor left for a
new job and has yet to be replaced. Unless you are at the very moment
they ask you, an immediate danger to yourself or others there are no
time slots available. Instead I have maintained myself with a steady
stream of Valium until I eventually slide just far enough down the
spiral that I can honestly say I may injury myself or others.
I have taken time off work on multiple occasions to go to
appointments to have them be canceled by the doctor without informing
me before I walk though the door, or to sit and wait for hours to get
in for a 10 minute visit. These are appointments requested by the
doctor mind you. Or better yet I had to take time off of work, skip
class, fly to Anchorage at 6AM for a 1015 appointment, only to be taken
into the examination room at 1130 and be told that my medication wasn't
ordered and I would have to come back the following month. So not only
had I lost a half day's wage, class room time, but the icing on the
cake was when the nurse also informed me that I should be sure to call
next time before I fly down to make sure that VA employees had ordered
my medication. Mind you I spend half my day trying to remember if I
locked the house before I left it.
As far as my employment goes, as I mentioned I was fortunate to
find a job that has been willing to be more then gracious in letting me
take time off for school and my injury related issues. But it has come
at the cost of sanity and overall wellbeing, as of writing this
testimony I have in fact taken an indefinite leave of absence from my
work to try to recover from a recent mental breakdown. I am doing my
best to just manage my simple daily affairs and hope that one day soon
I might be able to return to work providing I can get my PTSD back
under control. But these are going to be real concerns if I lose this
job because I can't work, or what am I going to do in the future when I
can't find an employer who is willing to give me the time off I need to
battle my demons and spend my time waiting for canceled appointments.
I feel terrible, for it seems that all I have provided is a laundry
list of complaints, and don't feel I have addressed what was asked of
me. I wish I could provide solutions instead of excerpts of whining.
Unfortunately, there are no easy answers and filling holes I feel is a
mighty task and I applaud the efforts given whatever they may be. As
with much in life there must be some level of attrition when addressing
who should receive and how much in benefits should be given out. It is
sad that there are individuals out there that have found a way to take
advantage of the system, while those of us who fully deserve it are
forced to fight tooth and nail for what we have earned.
For me the two biggest problems facing a young, transitional,
disabled combat veteran such as myself . . . is the understanding of my
injuries, particularly the PTSD and the availability and utilization of
resources.
I don't understand myself, society doesn't understand me, and the
resources are lacking right now to help bring me back as a
participating member of society through counseling and education. What
resources are available, nobody either knows about them themselves or
they choose to not inform me about them.
Thank you for your time.
Senator Begich. Thank you, Robert, very good. I appreciate
your testimony.
Lieutenant Colonel Sheehan, why don't you go next. I
appreciate you being here and good to see you again.
STATEMENT OF LTC JOE SHEEHAN, USA (RET.), CHAIRMAN, NORTHERN
ALASKA MILITARY RETIREE COUNCIL
LTC. Sheehan. Good afternoon, Senator, and ladies and
gentlemen. I'm Joe Sheehan, a retired Army officer, a life-long
Alaskan, and a former inspector general for the Army here in
Alaska.
First, sir, I want to thank you all for coming here to
listen as well as for allowing me the opportunity to contribute
here today. And, Senator, I'd like to also personally recognize
you and thank you for your focus on veterans' and retirees'
issues since you've been in office.
In the interest of time, I'll let my written submission
speak for itself. It lays out the same broad issues that are
unfortunately just as valid today as they were 3 years ago.
And, frankly, that's truly the problem. I could tell you the
horror stories of veterans with lost records, delays, and
denied benefits, et cetera, but I don't want to focus on the
symptoms of problems in VA. You'll hear that from others, and
the VA IG report is damning enough.
Instead, I want to constructively focus instead on laying
out a vision for the way ahead on systemic issues, for where to
go from here. How can VA better meet its mission obligations to
veterans? How can that effort also make a critical difference
in this fragile but interdependent fabric of health care that
we have here in Alaska with limited capabilities? And how can
we leverage VA and interagency capabilities to pioneer a model
for the rest of the system that might benefit everybody?
I have five key points I want to take away here. The first,
Senator, is that I appreciate your determined efforts since we
talked in November, toward establishing the Alaska Health Care
Task Force. That is a critical effort. I can't tell you how
important that is to prioritize and help develop a strategic
vision up here for improving efficiencies and useful support.
That can't be done from Washington, DC, in a cookie-cutter
fashion; it has to be done from the ground level. It will
significantly improve access to health care for the rest of
Alaskans in addition to us Federal beneficiaries, of which we
comprise 43 percent of all Alaskans. And there are many
examples where veterans, retirees, and our active-duty family
members in Alaska are unfairly denied both access and delivery
of health care on a level equitable to other States, and that's
a proven fact.
The second critical need, meanwhile, is to take care of the
low-hanging fruit, such as a few unique and simple frustrations
that we have that we can't surmount because Congress must allow
them an actual legislation and word of law. Some of these
include things like: the inability of TRICARE managers here in
Alaska to designate patients to civilian PCMs, just as most
other States do; the lack of reimbursable travel provision and
TRICARE for life, where people have to travel around from our
remote regions and have nothing when they get there, and have
to take their families along with them; proposed distance and
drive-time limits on TRICARE Prime here in Alaska, which are
currently on waiver of being threatened again.
The third issue I want to discuss is that I don't want to
see all of the dedicated members of VA tarred. Many wonderful
people, like Linda B. over there, work daily and work very hard
and there isn't a veteran in this town that doesn't know her.
However, I do want to say that we do need to change the culture
of VA as an agency and especially in regard to both its level
of commitment and its focus of investment here in Alaska.
I'd love to get specific and I can later if you'd like, but
the key concerns are in the areas of attitude, capacity,
access, and outreach. VA has an unhealthy Anchorage-centric
mentality in a State one-fifth the size of the United States.
Rural vets do not have acceptable, let alone equitable, access
to health care. Fairbanks should be a more viable VA hub for
Northern Alaska and the watershed that it serves.
VA education programs should be the catalyst for spreading
a homegrown health care capacity across this State and the
synergy of these and other task force-style ideas would save VA
a lot of money while delivering far better access to veterans,
but would also grow sustainable health care services for all of
our rural veterans and serve as a foundation for the prosperity
of this State. We cannot fail to do that. This would be a win/
win for everybody.
The fourth point is the importance to note that VA, as you
well know and I know you know this, is not the only subset of
Veterans' Affairs. Too often, however, hundreds of veterans'
bills, quote/unquote, focus upon VA, but most of the Members of
Congress don't seem to understand that these bills usually do
not include or even help retirees and the families of our
active-duty military. These active-duty military are on the
same TRICARE and are not part of the VA system. A young
specialist or young airman has to go out there and find access
in the community here in Alaska while they have two kids, and
they have trouble finding that, and especially doing it
affordably and a lot of times things are deferred as a result
of that.
However, while they're entirely separate systems, there is
much to be improved by way of mutual support and shared
efficiencies, and we aren't mining those now, but these must be
allowed in legislation and by policy.
This brings me to my fifth and final point. With respect,
sir, Congress has been part of the problem instead of being
part of the solution, and that's why I appreciate your direct
efforts here today and your focus on these issues. Too much of
the system is based upon stovepipe parochialism and entangling
regulations which restrict each agency's ability to effectively
offer a best practices approach to delivering services and
health care, let alone optimize efficiencies between agencies.
Then there is the annual fight to sustain things like the
funding of inadequate band-aid patches for things like 21
percent Medicare that we spend all that energy on every year.
And why? Often the best answer is not more money, but to truly
fix the programs or policies at hand. We need to change the
paradigm at both VA and in Congress, otherwise, if we do what
we always did, we'll get what we always got.
The bottom line, sir, is we can do better, we should do
better, we must do better.
Senator, and ladies and gentlemen, I could cover more, but
my 5 minutes are up. So, subject to your questions, this
concludes my initial statement. Thank you.
[The prepared statement of LTC. Sheehan follows:]
Prepared Statement of Joe Sheehan, Northern Alaska
Military Retiree Council
VA/AFAP 2010 ISSUE SHEET
FWA 2010
Two related issues submitted by the Northern Alaska Military
Retiree Council:
1. ISSUE TITLE/SUBJECT: TRICARE authorization to designate patients
to a civilian PCM.
SCOPE: Bottom line: Alaska TRICARE managers need authorization,
like other states already have, to designate to civilian PCMs (primary
care managers) for care unavailable locally or too distant for the
members who are in TRICARE Prime. This greatly affects both our active
duty military families and retirees in Alaska, as well as having a
direct impact upon the ability of local military medical capacity to
optimally manage patient requirements and demand using best practices.
In addition to providing many efficiencies for the TRICARE system as
well as the promised and equitable level of service/care for retirees
and active duty family members, this would benefit the entire fragile
interrelated fabric of health care in Alaska by supporting a more
robust medical capacity in these under-served areas. TRICARE managers
in other states can and do establish civilian PCMs, but Alaska has no
such authority within the TMA or contract at this time, even though we
are arguably in the greatest need due to remote and far flung health
care facilities with very limited capabilities that are not now
sufficient or mutually supportive. This is yet another example of where
Alaska has been excluded, by policy, from levels of care standards
equitable to that provided to the rest of the US.
RECOMMENDATION: Approve authorization for Alaska TRICARE managers
to designate patients to a civilian PCM and best manage their available
resources.
2. ISSUE TITLE/SUBJECT: Modify the TMA proposed rule change
language which allows exclusion of Alaska's TRICARE Prime enrollees who
are not within drive time waiver areas.
SCOPE: The TRICARE Management Activity (TMA) has proposed a rule
change (below) which rightly codifies the current reimbursement rate
demonstration project as permanent. That highly successful demo project
has been sustaining our critical local rates and access to care since
we asked for that as an interim band-aid solution to the access
concerns of our active duty military families and military retirees who
all rely upon TRICARE access. However, our concern with this current
proposal is the wording at the end which would allow TRICARE to
specifically exclude Alaska's Prime enrollees who are not enrolled to a
military treatment facility and thus can be subject to losing
eligibility for Prime based upon an arbitrary drive time (distance)
concept which is inappropriate for Alaska. This problem is especially
critical to both our active duty family members and retirees who are
just outside this limited drive time area, which has recently been
waived for now. This issue is directly related to our other submitted
issue (see issue # 1, above) regarding the need to allow TRICARE
managers to designate to a civilian primary care manager (PCM). The
availability of care in Alaska's remote areas does not fit a cookie
cutter approach appropriate for more densely populated regions of our
Nation and this part of the TMA rule would be highly detrimental to
Prime enrollees who truly have no other valid option for promised and
equitable levels of care. They should not be forced to reduce their
policy to TRICARE Standard due to location. A fair and more effective
alternative solution is proven by the example of other states who can
establish civilian PCMs, but Alaska has no such authority within the
TMA or contract at this time. In addition to hurting our active duty
family members and retirees who reside outside these drive time limits,
approval of this proposed rule will result in the certain failure by
TMA to allow TRICARE managers the flexibility to manage for best
practices in the best interests of its patient population which must
rely upon TRICARE PRIME, since there is no other equitable level of
promised health care available.
TMA's Proposed Rule:
``TRICARE Management Activity published a proposed rule in
the Federal Register on Nov. 27, 2009, to incorporate current practices
from an ongoing demonstration project as permanent changes to
the administration of the TRICARE program in Alaska.''
``TRICARE has recognized the unique circumstances existing in
Alaska, which make the provision of medical care to TRICARE
beneficiaries through the TRICARE program operated in the other
49 states unrealistic. Recognizing these unique conditions and
circumstances, the Department of Defense has conducted a
demonstration project in the State of Alaska since
implementation of the TRICARE program under which certain
exceptions have been made for administration of the program in
Alaska.''
``This rule proposes no change to the TRICARE benefit or to
those who are eligible for it. However, the rule does eliminate
the financial underwriting of health care costs in the State of
Alaska by a TRICARE contractor. In addition, TRICARE Prime may
be limited to those eligible beneficiaries enrolled to a
military treatment facility and those eligible for TRICARE
Prime Remote.''
RECOMMENDATION: Modify the TMA rule proposal to specifically
eliminate any potential to restrict Alaska's TRICARE Prime enrollment
or coverage using a drive time limitation. Instead, specifically allow
Alaska's TRICARE managers to more flexibly resolve the problem by
designating these enrollees to a civilian PCM (see issue #1).
CONTACT INFO: Joe Sheehan, [email protected].
Senator Begich. I want to thank you, Joe, for your
testimony. And just to remind folks, as you do testify and you
have that written statement, that is also part of the record.
Again, thank you for visiting Washington, DC, that one time. It
gave me a great idea and I appreciate you sharing that number 1
choice because we moved it forward. I thank you for that.
LTC. Sheehan. Thank you for your efforts, sir.
Senator Begich. Absolutely. I'll have some questions I know
on that. Ron Woolf, thank you for being here with the ESGR and
a great group of supporting our employers supporting the Guard.
Oh, you know what we need to do, we need to slide that
microphone over. I apologize. One, we want to make sure the
people can hear you, but also that it's on the record. There we
go. So, please.
STATEMENT OF RON WOOLF, CONTROLLER AT GOLDEN VALLEY ELECTRIC
ASSOCIATION; AND UNIT REPRESENTATIVE, EMPLOYER SUPPORT, GUARD
AND RESERVE
Mr. Woolf. I'd like to thank you for the opportunity to
testify here today. In my real job, I'm the controller at
Golden Valley Electric Association and I volunteer to support
men and women serving our Nation's National Guard and Reserve.
I think I'll just read my testimony.
Senator Begich. Sure, please.
Mr. Woolf. Thank you. Members of our local Employer
Supported Guard and Reserve met to discuss my testimony and the
message we'd like to share. ESGR is a Department of Defense
organization that seeks to promote a culture in which all
American employers support and value the military service of
their employees.
The Nation's reserve components, referring to the total of
all National Guard members and reserve forces from all branches
of the military, comprise approximately 48 percent of total
available military manpower. The current national defense
strategy considers the National Guard and Reserve as full
partners in the fully integrated total force. ESGR's mission
focuses on building relationships between guard members and
reservists and their employers. We strive to educate employers
about the Uniform Services' Employment and Reemployment Rights
Act, USERRA, while promoting the benefits of hiring military
personnel.
USERRA is a Federal law intended to ensure that persons who
serve or have served in the Armed Forces, reserves, National
Guard, or other uniform services are not disadvantaged in their
civilian careers because of their service, are promptly
reemployed in their civilian jobs upon their return from duty,
and are not discriminated against in employment based on past,
present, or future military service. The Federal Government is
to be a model employer, as it says in the act.
Our experience with Fairbanks employers is excellent. As
you've mentioned, we have a lot of veterans and a lot of
military in Alaska. The Federal and State upper management are
very well versed on USERRA, but mid- and low-level managers do
not receive training on the Act's requirements. This is an
opportunity where the Veterans' Affairs Committee can help our
returning soldiers.
When I first started with ESGR, our mission was to educate
employers about their traditional National Guard and Reserve
employees who are gone for short periods of time. We've
informed employers about the importance of those missions. The
extended deployments now being experienced by our soldiers has
created new challenges for our men and women returning to the
workplace. I'd like to share the following experiences with
you.
Deploying or returning servicemembers are often put in
situations that make the transition difficult due to their
immediate supervisors' lack of knowledge. They are not provided
authorized benefits, they're excluded from consideration for
promotion, and forced to provide written documentation to
justify the rights they are granted under the law.
Servicemembers have had to educate their immediate
supervisors on their rights. The Federal Government is to be a
model employer under USERRA and yet large entities like Federal
and State agencies often have the largest number of inquiries
or requests for assistance after deployment due to lack of
knowledge of mid- and low-level managers. Co-worker
relationships are challenging for many National Guard and
Reserve servicemembers. Deployed servicemembers return to a
work environment that sometimes is hostile due to lack of
knowledge on the part of the co-workers, co-workers who have
had to pick up additional workloads or wonder why the deployed
employee received a benefit or seniority when they are not at
work. Co-workers hired while a servicemember is deployed often
have the hardest time understanding the situation because they
did not see the support the deployed worker received prior to
deploying, all the effort made by the deploying servicemember
to help the employer prior to their departure.
When servicemembers return to this type of workplace
negativity, it is hard to readjust to their jobs and their
deployment can be seen as a cause of strife in the workplace.
When one local soldier returned to work with an employee that
was temporarily promoted to backfill his position during his
deployment, that employee enlisted the support of several other
personnel in the office in an attempt to keep himself at the
higher grade. This led to a very negative work environment
until several months later when the temporary replacement was
moved to another position in the department.
Businesses and organizations have a difficult time
temporarily replacing National Guard and Reserve members who
are educated and trained for their jobs that need to be filled
by other employees. Some businesses and organizations are
unable to find temporary employees and will fill from within or
for a current employee the opportunity to work temporarily in
another position at a higher level, which still leaves the
employer short of personnel.
The Veterans' Affairs Committee can help National Guard and
Reserve members by rallying the support of mid- and low-level
managers for our soldiers. While this is an overall task to
educate all employers, you do have influence over our Federal
managers and front line employees. Education will be the key to
understanding perhaps federally mandating supervisor training
that includes USERRA. It would benefit the employer, employee,
and the co-workers.
We at ESGR have posters that identify basic USERRA rules
directed primarily to the employer. We could use the same
medium directed toward co-workers to provide an understanding
and to obtain their support rather than a disdain for our
soldiers and airmen. Thank you.
[The prepared statement of Mr. Woolf follows:]
Senator Begich. Thank you very much. That was very good,
Ron. Thank you for your testimony. Thank you, all four of you,
for your testimony and presenting it. I have some questions.
I'll randomly go through them and then as I finish this, we'll
have a second panel with some questions you have generated for
me to ask them, which is good. That's part of the process here,
and so you have given me some good thoughts.
Linda, you had mentioned several areas that claims are sent
out or brokered to, but the one that really stuck out for you
was San Diego.
Ms. Boisseau. Oh, the claims are horrible, sir.
Senator Begich. And is it that once they receive them, it's
the process they take? Or is it a combination of things, how
long it takes them to do it, or lack of communication? What are
the----
Ms. Boisseau. It's a little bit of both.
Senator Begich. OK.
Ms. Boisseau. First of all, it's not necessarily the length
of time. It's the caliber of the rating decision that they
render.
Senator Begich. Because you said there's a high rate of
appeals off of those.
Ms. Boisseau. Absolutely, because of--they have not looked
at the evidence that was presented in the medical records. It's
like they didn't even open the darn thing.
Senator Begich. Is there something you have at your
disposal and if not I'll be asking some other folks on the next
panel, but these claims get brokered out to, you said, Salt
Lake, Seattle, and San Diego as examples. Do you have in your
capacity to report, well, San Diego, 70 percent go to appeal?
Or Seattle, 20. Do you have any of that hard data? If you
don't, that's OK, I'll ask the next panel to----
Ms. Boisseau. No, not at this time, but the thing of it is
we have to broker those claims out because we do not have the
people trained in Anchorage----
Senator Begich. Right.
Ms. Boisseau [continuing]. To handle obviously the rating
systems. I'm not being disrespectful and I do understand that.
I'm not dinging the VA here for that, you know, because to
become a rater, it's a very long process if you're worth your
salt; and it's really an intense system, you know. But for some
reason they have a lot----
Senator Begich. They always have a high appeal rate.
Ms. Boisseau. A very high appeal rate as compared to the
other sources, yes, sir.
Senator Begich. That's a good point. I mean part of what
the process of this hearing is, is to not only look at some of
the VA services, the employment services, those issues, how we
can look to improve them, but this is good information. I'll--
--
Ms. Boisseau. It's like having to do the claim all over
again because you're trying to start from square one because
then you've got the official Notice of Disagreement. They have
to go through the process, and we win anywhere from 63 to 82
percent of those claims on appeal or Notice of Disagreement. I
mean, like from February of last year to this year, we have
done over $8 million in claims just for the disabled veterans
in the State of Alaska.
I mean, we're out there humping and trying really hard----
Senator Begich. Right.
Ms. Boisseau [continuing]. I mean I'm just at a frustration
level, which I know also for Anchorage because they don't have
control over those raters from those other places.
Senator Begich. Other places.
Ms. Boisseau. I don't know that it's being brokered out
until I receive the final determination on that claim. So, it's
nothing like, hey, wait a minute. Should I put a note on this:
Do not broker out. I can't do that. I can't do that. That would
be ludicrous.
Senator Begich. Right. But you don't get noticed on when
they----
Ms. Boisseau. I get no notice until the claim comes back.
Senator Begich. Until completion.
Ms. Boisseau. Absolutely. Yes, sir.
Senator Begich. So you don't know where it's actually being
dealt with at that point?
Ms. Boisseau. Correct.
Senator Begich. Let me ask you one other question and that
is--I thought it was interesting--the Call Center. I don't want
to put words in your mouth, but what I heard was your concern
that the Call Center, when there are questions they may not be
aware of some of Alaska's, kind of unique situations----
Ms. Boisseau. Absolutely.
Senator Begich [continuing]. Like the property tax
exemption is a great one.
Ms. Boisseau. Absolutely.
Senator Begich. And you're right, it's 170,000.
Ms. Boisseau. Uh-huh.
Senator Begich. And, you know, how does that work?
Ms. Boisseau. Hunting, fishing license, all the other stuff
that goes with it.
Senator Begich. Right. The hunting license, the fishing
license.
Ms. Boisseau. But they can't get any of that without that
letter stating, you know, that----
Senator Begich. Right.
Ms. Boisseau. You know. And they have to be handled in a
timely manner, by the 31st of March. And if it's not, then----
Senator Begich. Yeah, you lose the year.
Ms. Boisseau. Absolutely.
Senator Begich. There's no two ways about it.
Ms. Boisseau. They do not acknowledge the property tax
like, let's say that somebody filed in January of this year. It
was granted, you know, all the way. But I mean retroactively
they still have to pay those taxes. So I mean----
Senator Begich. That's right, yeah.
Ms. Boisseau [continuing]. For that delay, it's a big loss
of revenue for the veteran's family.
Senator Begich. And is it your sense, and I'll ask this as
we get to the next panel, but is it your sense that maybe some
additional training for those call centers----
Ms. Boisseau. Perhaps on Alaska's unique situation. I
don't----
Senator Begich. Right, for those that handle Alaska calls.
Ms. Boisseau. It should not be that difficult. But who is
to say? The VA may take it any time and say, OK, we're not
going into Phoenix anymore on the 1-800 number; maybe we're
going to go to blah, blah, blah. So it's an easy fix, but it's
frustrating because the veterans are not getting that paperwork
in a timely manner.
It's a simple, easy fix if the training includes, ``Alaska
is unique with the property tax exemption ladder.'' It
shouldn't take a rocket scientist to figure that out--to make
sure that if it says Alaska, let's just say, OK; Alaska, the
benefits associated with 50 percent or higher. That's an easy
fix for a telephone person.
Senator Begich. Yeah. And the good thing about Alaska is we
just have one area code, so it's not complicated to figure----
Ms. Boisseau. No, it's not.
Senator Begich. I'm learning that in DC, you can be calling
just a few miles and have a whole different area code.
Ms. Boisseau. I'm not trying to be mean about it, but it
does----
Senator Begich. No, no, that's good information.
Ms. Boisseau. It does need to be fixed. I mean, these
little things add up to frustration levels at----
Senator Begich. Yeah.
Ms. Boisseau. But, I mean, $170,000. I would be chewing
somebody's foot off. OK?
Senator Begich. Yeah. No, I hear you. Thank you, Linda.
That was very good. That helps me with some additional work.
But let me ask Robert.
You did a great job. You had good testimony. You clearly
are anxious to be productive, have a job, work, get educated,
do all the things that you want to do to be successful in life.
I noted you found additional services through student
services within the university that you were unaware of, but
not until later down the road, where you had a veterans'
coordinator maybe not as aware of some of those services. Is
that a fair statement or am I----
Mr. Roof. Well, she works in financial aid. It's just one
of those things that you----
Senator Begich. Two different----
Mr. Roof. You tag ``veterans'' onto something and so
automatically I say, oh, that's for me. You know, like that's
who I think I should be talking to----
Senator Begich. Gotcha.
Mr. Roof [continuing]. Naturally. Because like I said,
navigating this whole system, that's all I spend my time doing,
you know, trying to find some guidance. So I've tried talking
to them, you know, as far as asking is this the correct
paperwork I'm filling out; is this what I need to be doing?
Senator Begich. Right.
Mr. Roof. Is there anything else I need to know as a
student, as a disabled veteran going to UAF, is there anything
else I need to know that can help me be successful? Like that's
all I'm trying to do, is get on with my life and move past, you
know, these things that have happened to me. I don't regret any
of this, but I'm trying to now make a new path in life and any
help I can have doing that--and, like I said, in dealing with
all these things--I'd be more than grateful.
And not knowing about them until after all this time--you
know, I've probably taken years off my life just stressing out
about this stuff; and it's unfortunate to me, I feel, that I've
had this much trouble in trying to--like I said, I'm not
looking for handouts, I'm not looking for people to sit there
and do my homework for me.
Senator Begich. Right.
Mr. Roof. But just tailoring these classes--I mean, I don't
know how to learn some of the ways some of these other students
do. I mean, everybody has different learning styles, but
coupled with the PTSD and my own learning style, it's very
frustrating. Like I sit in class, yet I can't concentrate and
just----
Senator Begich. Well, let me ask this, Robert. Was the
assumption that when you saw the veterans' coordinator, you had
a broader sense of what they were offering, but learned it was
really about financial aid.
Mr. Roof. Correct.
Senator Begich. And when you went to student services, it
was much broader and suddenly you saw some opportunity there.
Mr. Roof. Well, all that I really got out of student
services--my VA counselor at the time had told me that, you
know, the university has something, but basically all that was,
was I went in and they asked, oh, what is it that you feel? And
I said, well, I have terrible anxiety. You know, there's times
where I may just need to get up and walk out of class because
I'm having whatever issues. And so, it's basically a letter
that's written up and you get two choices. It says this student
might choose to leave class for a few minutes to, you know,
bring himself back together and then return; or this student
likes to work in smaller groups because he can't deal with
large groups at this time. And that was all it was. There was
no additional explanation that I have these difficulties
concentrating and, you know, whatever. I wasn't informed that
there could be more that was done.
Senator Begich. Sure.
Mr. Roof. Say I was, you know, an autistic student or, you
know----
Senator Begich. Well, let me ask you this, Robert, if I
could. Would it have made a difference if when you walked in to
the university for the first time and you wanted to be a
student, that there was a person that said they work with
veterans and they worked on everything: financial aid,
services, stuff that students need. They said I'm going to be
your partner while you figure out what you want to do and help
you through this early stage of getting started. Would that
have made a difference to you?
Mr. Roof. Sir, what's the voc rehab program for? That's my
question. That's what I thought I would be getting from them.
That's why I elected to use the voc rehab program. And I may be
wrong. I----
Senator Begich. Well, we're going to ask some folks next
up, so----
Mr. Roof. Apparently, I was wrong because when I--I failed
to mention before, but when I made a call to the supervisor
explaining that I was basically told that they--the voc rehab
program--weren't there to hold my hand. So, therefore, I feel
that it's not my job to hold voc rehab's hand.
Like why am I going out and being sent to find all this
information and all these inner workings of the school system
when--and constantly, you know, being forced to prove that I'm
doing the right thing, like I don't have enough problems going
on. I don't need to be harassed by people that are supposed to
be helping me.
Senator Begich. Right, right.
Mr. Roof. So yes, basically, it would be nice if there was
someone there at the university or in-house at the VA that
says, OK, this is your goal, this is what we want to do, this--
you know, make you a productive member of society again. And,
say these are the necessary steps that you'll be taking.
Senator Begich. Right. Kind of guide you.
Mr. Roof. Right.
Senator Begich. To give you the freedom to figure it out,
but also be there to kind of say, well, here's the 20 services
that are available for you. Kind of help you select, but yet at
the end of the day you're ultimately responsible for it, though
helping guide you through that.
Mr. Roof. Right. Well, just being aware of the information.
Like I said, I just now found out about the whole disability
thing----
Senator Begich. Sure.
Mr. Roof [continuing]. And the tailoring of this. To say
these are certain things someone that better understands.
That's just it; I think part of the problem with voc rehab is
he doesn't fully understand the whole----
Senator Begich. The whole picture.
Mr. Roof. The whole picture of my disabilities and the
school system. Like I said, when you put those two things
together there's a reason why I failed my class. It's not
because I didn't show up or I didn't want to be there or I
didn't do the work. It's because I had other issues going on. I
have symptoms, flare-ups, or whatever, and things happen. It's
not me wanting to go burn, you know, taxpayer dollars and
freelancing my education, as they put it. I'm just trying to
get on with life.
Senator Begich. Yeah. That's very good, Robert. Thank you
very much for some of that information.
Let me go to Joe. When you were in my office, you were
like, bam, bam, bam, and once again you are consistent with
that, which clearly shows your military background; that is,
about mission, accomplishment, and goals.
So, I want to pick one of them out and comment on one. I
agree with you on the efforts of--on the issue of the Congress
and how they can really mess things up because there are
multiple jurisdictions; they try to, you know, package a little
bit here, package a little bit here--stovepiping.
So, in your situation of your description, the culture
change which is probably the most difficult to do in any
organization--military/non-military, government/non-
government--what would be the one thing that you could say
here's that would make a difference to really help change the
culture of the VA to understand what we need to be doing? This
may be a bigger question than you can answer in a very simple
way, but could you try to do that? Give me a thought there.
LTC. Sheehan. Yes, sir. I honestly don't know if I'm in a
good position to judge that. I can give you a spectator's
viewpoint----
Senator Begich. Sure.
LTC. Sheehan [continuing]. And I think that would give a
fair assessment. I would say, you know, it's a large and
ponderous bureaucracy that's tied down by politics and cultural
inertia, if you will, which is not anybody's fault in
particular. You've got some wonderful people leading it:
General Shinseki and General Peake before him at the very top.
In the trenches every day, like I said, there are wonderful
people like Linda B., who, you know, are caring and dedicated,
are making it happen, and they know where the rubber meets the
road, what they need on the ground.
Unfortunately, what you have in between there, and I don't
want to tar everybody, is a lot of people who are invested in
the status quo and there's rice bowls to protect and there's
budgets that come down from Congress, and it's the typical
thing in any typical bureaucracy.
Senator Begich. Organization, yeah.
LTC. Sheehan. And I don't mean that as a pejorative. I mean
it as a----
Senator Begich. No, no, no, that's good.
LTC. Sheehan [continuing]. As a definition of a
bureaucracy. And so the question is, are you listening? Do you
have a cycle and a process for self-improvement? And even if
you do, are you able to fit that into the paradigms that are
given to you by Congress and the mandates for roles and
missions and say this is what you must do and you can't cross
money over to other agencies and everything like this.
So it's real easy to tar people with saying they're not
doing whatever, and I think in many ways people have their arms
tied behind their backs yet there are some people who outright
need to be fired. I'll just give you that perspective. On the
other hand, you know, 99 percent of them out there are working
hard and they have effective leadership. They just need to have
the sort of task force effort we've been discussing----
Senator Begich. Right.
LTC. Sheehan [continuing]. To be able to say----
Senator Begich. To kind of shake it up a little bit.
LTC. Sheehan [continuing]. How can we make this work on the
ground? What kind of culture do you have? And going back to,
you mentioned my military background, so this is my
perspective. How can you win the battle if you know that you're
losing it and you aren't listening to your commanders out there
on the ground who are decisively engaged every day? That's what
they've got to do. We don't do that well, I'll tell you, which
is a charitable way of saying it.
Senator Begich. Thank you very much. Ron, I just wanted to
comment and then you can comment if you want to. I was very
intrigued by your comments about the Federal Government and
that we could be doing more with our mid-level management
regarding education on the importance of the program. It seems
like what I was hearing is there's just an information gap. Is
that----
Mr. Woolf. Exactly. I think the training needs to go down
to the managers that are on the front lines that deal directly
with our deployed soldiers. Get some education for them plus
something that would give the rest of the employees
understanding of what's going on and the rights that their
fellow employees who choose to be in the guard and reserve----
Senator Begich. I want to ask at a later time, maybe not
during the hearing here, but for my staff to follow up on a
question. And that is, I know when I was mayor of Anchorage,
every Monday we had new employee orientation. You know, we'd
have a high turnover rate in one department, low in others, but
generally you have new people always coming in. And because of
the conflicts we're engaged in, how engaged everyone is, I'd be
very curious as we talk to the Federal workforce what kind of
orientation do they offer at that first point of entry for a
new employee, for example. Because there are all ranges,
everything from the entry-level staff to management and
everything in between.
So you've given me some real good food for thought here. I
greatly appreciate that.
Mr. Woolf. Thank you.
Senator Begich. Let me end this panel. Again, thank you all
very much. You did a great job in helping shed some light on
the positives and the negatives and where we can make some
improvements. So thank you very much.
We're going to switch out panels. Again, thank you all for
being here, absolutely.
[Pause.]
Senator Begich. If the next panel can line up, that'd be
great. As the next panel is coming up, I want to say we're
going to run a little bit behind, so I want to keep things
rolling along here. We have five presenters, some with
additional staff. Go ahead and take your seats, those that are
participating in the next panel.
This next panel will be five individuals: the Assistant
Secretary of Labor, Ray Jefferson, Secretary of Labor for
Veterans' Employment and Training; Mark Bilosz, Director,
Anchorage Regional Office, Veterans Benefits Administration,
U.S. Department of Veterans Affairs; Verdie Bowen, Sr.,
Administrator, Office of Veterans Affairs, Department of
Military and Veterans Affairs, State of Alaska; Belinda Finn,
Assistant Inspector General for Audits and Evaluations, Office
of Inspector General, U.S. Department of Veterans Affairs; and
Dr. Susan Pendergrass, Director of the VISN 20, Veterans Health
Administration, Department of Veterans Affairs.
We have other folks who will be joining them for the
question portion if there are questions that they need to
answer.
What I'd like to do at this time, if Borough Assembly
Member Hank Bartos is still here. He was here earlier. We want
to thank him for joining us in this presentation and meeting
today.
We will lead off with Assistant Secretary Ray Jefferson.
Ray, you have been around a little bit in the last couple days
and I really appreciate you coming here to Alaska. For those
that are unaware of what enthusiasm is, you are about to feel
it and see it. I'm always nervous now going to meetings with
Ray because I always thought I was impromptu with ideas and
getting things done. He, by far, exceeds me by light years.
So, Ray, you're on.
Mr. Jefferson. All right.
Senator Begich. Thank you very much for coming here, Mr.
Secretary.
STATEMENT OF HON. RAYMOND JEFFERSON, ASSISTANT SECRETARY OF
VETERANS' EMPLOYMENT AND TRAINING SERVICE, U.S. DEPARTMENT OF
LABOR
Mr. Jefferson. Thank you, sir, it's my pleasure. So,
Senator Begich, thank you very much for the invitation. And to
those behind me, veterans and citizens of Alaska and the
Fairbanks community, I'm thrilled to be with you here today.
Let me tell you a little bit about who we are and what we
do and how we can be helpful. Myself, a veteran, served with
one of the ranger battalions, through the ranger bat, and also
1st Special Forces Group. I lost my hand in the line of duty
trying to protect some colleagues from a hand grenade, went
down through the voc rehab program through the Department of
Veterans Affairs, and right now I have the privilege of serving
with this great agency.
What we do is we proudly serve veterans and transitioning
servicemembers. We prepare and guide them in their quest for
meaningful employment; we protect their employment rights; we
maximize their employment opportunities. How do we do that? We
have 240 people around America, so we do it in partnership with
Congress, sir, with the Department of Defense, Department of
Veterans Affairs, ESGR and State workforce agencies, the
veterans service organizations, the private sector, and
nonprofits and other government agencies around America.
So, what are some of the programs that we have that are
relevant here and can help veterans in Alaska? First let's
start with a program that we call Jobs for Veterans State
Grants. In simple terms, we have 2,000 employment
representatives around America; 13 of them are in Alaska and 8
of those 13 can be accessed through Anchorage or through
Fairbanks. So if you're a veteran who is seeking employment or
who wants to make a change, contact one of our 13 employment
representatives. Tom Hall, I'm going to quickly ask if you
could just stand up. This is my State director. This is the go-
to person in Alaska for employment opportunities.
Number 2, homeless veterans. We do one stand-down a year.
It is in Anchorage, but we can connect you with opportunities
if you are a homeless veteran. Three, Rob Roof, I hope you're
still here.
Audience Member. He stepped out.
Mr. Jefferson. All right. I would like to connect him with
a program we have called America's Heroes at Work. If you know
a veteran who has PTS or PTSD or TBI, we have a program that
can help them find meaningful employment. It gets rave reviews
from the servicemembers who are in it and also from the
employers. I also want to connect Rob and any other veteran
taking advantage of the new GI Bill in Alaska with Student
Veterans of America. Sir, this is a new veterans service
organization. Their whole job is to make sure that when
veterans like Rob hit campus that they can assimilate easily to
the culture, the programs, the resources there. That's what
it's set up for and it's a great dynamic new, young veterans
service organization.
Let's shift to Native American veterans. I, myself, am part
Penobscot. My great-grandfather was 100 percent Native
American. This is an issue that's near and dear to my heart.
We've recently invited a core group of tribal leaders to the
U.S. Department of Labor. The Secretary and all the agency
heads were there to begin learning how we can better serve
tribal leaders throughout America. But that's what's happening
in Washington.
Right here in Alaska this morning we met with a variety of
Native Americans and Native American veteran business leaders,
and we are doing an assessment right now to determine the best
ways to serve Native American veterans in America. And, as of
today, I am instructing that team to make contact with the
tribal council leaders in Alaska to make sure that the issues,
recommendations, and suggestions of tribal council leaders here
are heard. Sir, I want to thank you for bringing me to that
meeting this morning.
We are also going to be out more on the tribal lands and to
the major convening events and conferences of Native Americans
and Native American veterans this year, 2010.
Next, rural outreach. You know, it's great if you have a
lot of fancy companies in your city, but suppose you're in
Kotzebue where we're going tomorrow, or in the villages? So we
want to be exploring the power of e-commerce and Internet-based
home businesses to provide employment opportunities for
veterans in rural America, and, sir, as you've educated me,
highly rural Alaska.
Two more quick things--USERRA, protecting employment
rights. You know, I was very glad to know that the employer
community in Alaska is very supportive of the guard and
reserve. In this entire State with this tremendous number of
veterans, there's only five to six complaints a year. That's
incredible. But we also know that there's tremendous stress
being placed, so we want to look at how we can work to help
employers that have very small numbers of employees where some
of those are guard and reserve that are going for extended
deployment. We are meeting with the head of ESGR in DC to begin
a dialog to try to get to some action items and see if there
are some things we can do even as a demonstration project.
Finally, we have 165,000 servicemembers who leave the
military every year. They go to a 3-day transition assistance
program. I'm really changing this to a transition acceleration
program. The bottom line is this program hasn't been modernized
in 17 years. Right now it's a 240 slide Power Point show over 3
days. You can imagine how exciting that is. We're going to go
ahead and transform the entire thing, bring in best practices,
improve the facilitation. We want to make it economically
relevant, immediately useful, more engaging, and even fun--let
me bring that word in--for participants.
So this is my first trip to Alaska. I'm a kama'aina of
Hawaii. Hawaii is home. I look forward to this being the
beginning of a relationship, this being the beginning of a
journey; and also the opportunity to learn from all of you here
in this room regarding decisions of Alaska and how we can do a
better job.
Thank you, sir.
[The prepared statement of Mr. Jefferson follows:]
Prepared Statement of Raymond M. Jefferson, Assistant Secretary for
Veterans' Employment and Training, U.S. Department of Labor
Senator Begich and Distinguished Members, thank you for inviting me
to appear before you today to discuss the employment assistance and
outreach services provided to the Veterans in Alaska.
The mission of the Veterans' Employment and Training Service (VETS)
is to provide Veterans and transitioning Servicemembers with the
resources and services to succeed in the workforce by maximizing their
employment opportunities, protecting their employment rights, and
meeting labor market demands with qualified Veterans.
We accomplish our mission through three distinct functions: 1)
conducting employment and training programs; 2) enforcing relevant
Federal laws and regulations; and 3) providing transition assistance
services.
vets' programs
VETS administers a formula grant program to States that directly
meets the goals of its mission. The Jobs for Veterans State Grants
(JVSG) program funds two occupations, the Disabled Veterans Outreach
Program specialist (DVOP) and the Local Veterans Employment
Representatives (LVER). DVOP specialists provide outreach services, and
intensive employment assistance to meet the employment needs of
eligible Veterans. LVER staff conducts outreach to employers and
engages in advocacy efforts with hiring executives to increase
employment opportunities for Veterans, encourages the hiring of
disabled Veterans, and generally assists Veterans to gain and retain
employment. In Alaska, VETS funds six LVERs and seven DVOPs. Of these
13 individuals, eight are accessible in Anchorage and Fairbanks.
To meet the needs of homeless Veterans and help reintegrate them
into the workforce, VETS administers the Homeless Veterans'
Reintegration Program (HVRP). In Alaska, VETS sponsors one stand-down
each year in Anchorage for homeless Veterans. The stand-down provides
basic services, medical care, food and clothing for Alaska's homeless
population. Veterans with significant barriers to employment or
service-connected disabilities are also served through the Veterans'
Workforce Investment Program (VWIP)--a focused and innovative training
program that coordinates services available through other VETS
administered programs.
Both the homeless and workforce investment Veterans programs are
funded through a competitive grant process. This year, for the first
time ever, VETS will issue a Solicitation for Grant Applications (SGA)
for homeless women Veterans. We also will soon issue an SGA to
reinstitute the Incarcerated Veterans Transition Program (IVTP) to
assist Veterans who will be transitioning back to society from
incarceration. Additionally, we are in the process of developing an SGA
for both HVRP and VWIP. Service providers for these deserving
populations in Alaska are encouraged to apply for these competitive
grants.
native american veterans
To meet the needs of Native American Veterans, especially those on
tribal lands, Secretary Solis hosted--and VETS participated in--a
Summit of Tribal Leaders at the Department of Labor late last year. We
discussed the challenges facing Native American Veterans and potential
solutions. This event began the process of better serving this
community. VETS will also participate in a number of major Native
American outreach events in 2010. Furthermore, we are conducting a
study on the employment needs of Native American Veterans living on
tribal lands to identify best practices for serving this population.
userra
Our compliance programs investigate an average of five or six
complaints per year filed by Veterans and other protected individuals
in Alaska under the Uniformed Services Employment and Reemployment
Rights Act (USERRA). We also assess complaints alleging violations of
statutes requiring Veterans' Preference in Federal hiring, and
implement and collect information regarding Veteran employment by
Federal contractors.
One of our commitments to Veterans is to increase awareness of
USERRA, thereby increasing our ability to protect vulnerable
populations. To improve USERRA's impact, VETS recently completed a
Lean-Six-Sigma quality enhancement and process efficiency assessment of
USERRA, with a view toward streamlining, improving quality, and
increasing responsiveness to our Veteran clients. The goals of the
assessment were to: 1) identify ways of ensuring a consistent, high
standard of investigations; and 2) determine other steps to improve the
program and its outcomes. We have begun work on identifying an
electronic case management system to eliminate the paper-centric aspect
of investigations and improve efficiency. Access to this system will be
shared with our Federal enforcement partners. We are also working
closely with the Office of Personnel Management (OPM) to ensure that
the Federal Government serves as a role model for honoring USERRA.
transition assistance program
VETS' transition assistance services are offered through the
Transition Assistance Program (TAP), which provides employment
workshops and direct services for separating military members,
including those who are seriously wounded and injured.
TAP is a Department of Defense (DOD) program that partners with the
Department of Labor (DOL), the Department of Veterans Affairs (VA), and
the Department of Homeland Security (DHS). TAP has four components:
1. Pre-separation counseling--this is mandatory for all
transitioning Servicemembers and is provided by the military services;
2. TAP employment workshops--these are voluntary on the part of the
transitioning Servicemember and are administered through DOL and its
state partners;
3. VA benefits briefing--these briefings are also voluntary and
administered by the VA; and
4. Disabled Transition Assistance Program--also voluntary and
administered by the VA.
tap employment workshops
Since 1991, when DOL began providing employment workshops pursuant
to section 502 of the National Defense Authorization Act for Fiscal
Year 1991 (P.L. 101-510), we have provided employment and job training
assistance and other transitional services to more than one million
separating and retiring military members and their spouses. DOL was
further directed to provide these services at overseas locations by
section 309 of the Veterans Benefits Act of 2003 (P.L. 108-183).
VETS began facilitating TAP workshops at overseas military
installations where, by previous interagency agreement, the DOD had
provided TAP workshops since the program's inception. We are currently
conducting TAP employment workshops at 55 sites overseas, including
Germany, Japan, Italy, Korea, Guam and the United Kingdom. Our mission
is to provide TAP at every location requested by the Armed Services or
National Guard and Reserve Components.
VETS provides employment search workshops based on projections made
by each of the Armed Services and DHS, for the U.S. Coast Guard. DVOPs
and LVERs are the primary source for TAP Employment Workshop
facilitation stateside. However, because of the distance between many
state employment offices and the military installations, as well as the
rapid increase in Workshop participants, contract facilitators were
added in early FY 1992 and supplemented by Federal staff in FY 1996.
Alaska currently does not use contract facilitators.
DOD recently set a goal for TAP Employment Workshop participation
of 85 percent of separating servicemembers. Eighty-one percent of
active-duty transitioning Servicemembers currently attend the DOL TAP
employment workshops, a 30 percent increase in participation since
2001. TAP employment workshop participation is expected to increase
over the next year, and we plan to target workshop delivery to spouses
and family members of separating Servicemembers, including those with
limited English proficiency.
VETS is committed to ensuring a consistently high level of
instruction, service and quality for all Servicemembers and spouses
attending TAP Employment Workshops. Therefore, VETS requires that all
TAP facilitators receive training conducted by the National Veterans
Training Institute (NVTI) at the University of Colorado in Denver. NVTI
provides competency-based training to further develop and enhance the
professional skills of Veterans' employment and training service
providers throughout the United States.
An Alaska DVOP or LVER representative attends each TAP workshop
session here to discuss their respective roles and responsibilities in
providing job search assistance. Since most transitioning
Servicemembers return to some other state, this information is provided
to help the Servicemember contact the DVOP and LVER representative in
their respective states to assist them directly with their re-
integration into the local job market in their areas.
Alaska averages more than 60 TAP employment workshops annually with
approximately 1,500 transitioning Servicemembers in attendance. This
includes about one work shop per quarter with the Coast Guard. There
are four major TAP sites, encompassing all military service branches
plus the U.S. Coast Guard with an additional four sites that vary in
size and frequency according to need.
National Guard and Reserve personnel in Alaska are informed that
they can attend TAP for up to 180 days after they complete their active
duty commitment. An individual DVOP or LVER can facilitate a TAP
employment workshop, or they may do so as a unit.
The Alaska DVET (Director of Veterans' Employment and Training)
meets annually with the DVOPs and LVERs who facilitate the TAP
employment workshops to discuss transitioning Servicemember's feedback
and curriculum updates based on the input provided by these TAP
recipients.
In addition to presently reviewing TAP's performance and impact, we
are also working to modernize the workshop, increase its effectiveness
and improve participants' employment outcomes. Specifically, we want
the content to be more economically relevant, immediately applicable,
and engaging for participants. Thus far, we've solicited input from
external content experts and service providers to help us determine
what should be included in a best-practice employment transition
program. We are working in close cooperation with our partners at DOD,
the Department of Veterans Affairs (VA) and the Department of Homeland
Security (DHS) in this endeavor.
Late last year, our three agencies engaged in a weeklong working
group to develop a joint, multi-year, strategic plan for TAP. We're all
committed to ensuring the plan is action-oriented and will have a
direct, positive impact on our transitioning Servicemembers. The plan
will involve an increased emphasis on the employment needs of the
Reserve components and Servicemembers who have been wounded or injured,
or who are ill.
reserve component and national guard employment workshop
Global military commitments have necessitated a mobilization of
Guard and Reserve members that is unprecedented in modern times. The
longer mobilization periods result in these Servicemembers now being
eligible for Veterans' benefits, including TAP. The employment workshop
is available for Guard or Reserve Members, along with all other
Servicemembers, at one of the 215 transition offices located on
military installations in the United States as well as overseas
locations.
However, Reserve and National Guard members usually transition at
fewer locations, referred to as demobilization sites. Typically the
demobilization process is rapid, taking a matter of days once the
Servicemembers arrive back in the United States from overseas. During
demobilization, Servicemembers may be expected to participate in many
separate briefings and activities. This leaves little or no time for a
full two and one-half day employment workshop. Nevertheless, we have
found that many National Guard and Reserve Servicemembers would benefit
from such transition assistance. Our State Directors have coordinated
with each State Adjutant General, and they work directly with the
individual Reserve and National Guard commanders to make special
arrangements following demobilization in order to present a modified
TAP employment workshop to Guard and Reserve Servicemembers. Based on
requests from Reserve Component Commanders or Adjutant Generals and
through coordination with our VETS' state directors and local VA staff,
VETS has offered to tailor the workshops to the identified needs of the
transitioning Reserve and National Guard members.
In fact, since 2001 VETS has provided transition services to over
146,000 National Guard and Reservists. These transition services range
in size and content from mobilization and demobilization briefings to
the full-scale TAP employment workshops. They are provided in 43 states
and the District of Columbia. In some states, National Guard and
Reserve members have been allowed to attend the regular TAP for Active
Component Servicemembers. The services provided to the National Guard
and Reserve are tailored to the needs and requests made by DOD.
To meet the transition needs of the National Guard and Reserves, in
FY 2007, DOL directed the NVTI to develop a modular version of the TAP
employment workshop. The traditional TAP employment workshop was turned
into a 15-module menu from which Reserve and National Guard commanders
may select relevant services for their unit members. This modular TAP
menu includes a mandatory module that covers local labor market
information, USERRA, the One-Stop Career Center system, small business
opportunities, and the risks of homelessness. The other 14 modules
consist of the current TAP employment workshop curriculum broken down
into logical and connected blocks of instruction. This is not a new or
separate curriculum for the Reserves and National Guard; rather it has
been packaged to better serve this community.
USERRA briefings are conducted upon request and through outreach by
VETS' staff. This year, VETS already has provided TAP briefings and
USERRA outreach to the State of Alaska Army and Air National Guard
units, as well as Marine Corps Reserve.
In closing, I again thank you for allowing me to address you today
on this very important issue.
Senator Begich. Thank you very much. I have to tell you,
when you mentioned that Power Point yesterday, I could not
imagine sitting in a training program, seeing 240 Power Point
slides and thinking that's going to get me excited. So I thank
you for that. Ray also learned today that when he asked the
question how many people have been to Hawaii, I whispered in
his ear, that's our second home. So many Alaskans visit Hawaii.
So thank you again for being here.
The next person I'd like to hear from is Belinda Finn,
Assistant Inspector General for Audits and Evaluations, Office
of Inspector General, who did the report in regards to the VA
Anchorage Regional Office. She'll give a summary of that.
STATEMENT OF BELINDA J. FINN, ASSISTANT INSPECTOR GENERAL FOR
AUDITS AND EVALUATIONS, OFFICE OF INSPECTOR GENERAL, U.S.
DEPARTMENT OF VETERANS AFFAIRS; ACCOMPANIED BY BRENT ARRONTE,
DIRECTOR, BENEFITS INSPECTIONS DIVISION, OFFICE OF AUDITS AND
EVALUATIONS
Ms. Finn. OK. Can everybody hear me? OK.
Senator Begich. Very good. This is much better than the
Anchorage assembly room, I want you to know.
Ms. Finn. Yes, it is.
Senator Begich. You hear that, Fairbanks, what I said?
Ms. Finn. Senator Begich, thank you again for the
opportunity to be here today and testify about our inspection
of the VA Regional Office in Anchorage. With me today is Mr.
Brent Arronte, who is the director of our Benefits Inspection
Division.
The Benefit Inspection Program is a recent initiative to
ensure that our Nation's veterans receive timely and accurate
benefits and services. The OIG had been scheduled to review all
57 regional offices during the 5-year cycle, but we recently
began a hiring initiative that will allow us to review the
offices in 3 years.
During our inspections, we review functional and
operational activities in each VARO using five protocols that
cover claims processing, data integrity, management controls,
information security, and public contact. We report on our
results of each inspection as a snapshot in time.
In the summer of 2009, we conducted an inspection of the
Anchorage VARO focusing on the 14 operational activities and
found that the office had problems meeting standards in 13 of
those areas. We concluded that the management team has
challenges in the oversight of the operational activities;
improving insufficient network capacity to support the business
processes; providing training to staff; and managing an
internal claims brokering process. We felt that two issues
specifically contributed to the challenges in management
oversight at the office.
First, the office did not have a Veterans Service Center
manager for approximately 8 months in fiscal year 2009 and the
manager had just recently come to the office when we did our
inspection. Additionally, the VARO director manages the office
from afar; he is currently located in Salt Lake City. Both of
these positions are key to managing the effective operations of
any regional office.
As a result of the network capacity issues, the regional
office employees had difficulty consistently accessing the
computer applications required to perform their jobs and
employees told us this problem had been occurring for over a
year.
During our review, we noted that the director had moved
many claims from the Anchorage office to offices in Fort
Harrison, MT, and Salt Lake City, UT. This movement of claims
made it difficult for the staff to manage workload and
associate mail with the corresponding claim folder. Because of
this, we compared the staffing levels between Anchorage and the
Boise VA Regional Office. Our analysis showed that Boise had
about 22 more full-time employees for a comparable inventory of
rating and non-rating claims.
I'd also like to add that my office is currently working on
a national review of VBA's claims brokering process and we hope
to report out later this year on results from the national
program.
In conclusion, we recommended that the VARO director
improve oversight of the quality assurance process, develop a
mail routing guide to ensure proper mail processing, research
the cause and solutions to improve network capacity, and
provide additional training. The director concurred with all of
our recommendations and provided responsive comments and action
plans to our recommendations.
Senator, that concludes my oral testimony today. Thank you
again for the opportunity to be here. Mr. Arronte and I would
be pleased to answer any of your questions.
[The prepared statement of Ms. Finn follows:]
Prepared Statement of Belinda J. Finn, Assistant Inspector General for
Audits and Evaluations, Office of Inspector General, U.S. Department of
Veterans Affairs
Senator Begich, thank you for the opportunity to testify today on
the Office of Inspector General (OIG) report, Inspection of the VA
Regional Office, Anchorage, Alaska. I am accompanied by Mr. Brent
Arronte, Director, Benefits Inspection Division, Office of Inspector
General, Department of Veterans Affairs.
background
The Benefits Inspection Program is a new OIG initiative to ensure
our Nation's veterans receive timely and accurate benefits and
services. The Benefits Inspection Division contributes to the
improvement and management of benefits processing activities and
veteran services by conducting onsite inspections at VA Regional
Offices (VAROs).
Under the current organizational structure, the Benefits Inspection
Division, consisting of two teams, will complete a review of all 57
VAROs during a 5-year cycle, performing 12 inspections annually. The
OIG recently implemented a new hiring initiative to create a second
Benefits Inspection Division. Tentatively, this new division will be
operational by the end FY 2010. This initiative would allow the OIG to
complete a review of all VAROs within a 3-year period.
For each inspection, we issue a report describing VARO performance
as measured against current VBA and VA policy. The scope of our
inspections allows for a narrow review of work performed at each office
and our reports represent a ``snapshot'' in time. Currently, we perform
our reviews using five protocols focused on distinct functional areas
and specific operational activities within the VARO. The protocols are
claims processing, data integrity, management controls, information
security, and public contact. We designed these protocols based on a
risk analysis of previous OIG national audits and Combined Assessment
Reviews, VBA's Compensation and Pension Site Visit reports, Government
Accountability Office (GAO) reports, and information provided by the
Senate and House Veterans' Affairs Committees. Our plan is to review
the protocol areas annually to identify new high-risk areas and adjust
as necessary.
anchorage varo results
In late July and early August 2009, we conducted onsite work at the
Anchorage VARO. Our inspection focused on the following 14 operational
activities within the 5 protocol areas:
Processing of disability claims for specific service-
related conditions--Post Traumatic Stress Disorder, Traumatic Brain
Injury, diabetes and disabilities related to herbicide exposure, and
Haas claims. A Haas claim is a claim affected by a U.S. Court of
Appeals for Veterans Claims decision that involves veterans who served
in waters off Vietnam but did not set foot in Vietnam and whether those
veterans are entitled to the presumption of service connection to
herbicide agents.
Integrity of VBA's Claims Management Data--Establishing
correct dates of claim and properly tracking veteran's claims folder
using VBA's Control of Veterans Records (COVERS) database.
Management Controls over Claims Processing--Systematic
analysis of operations (SAO), a management driven analysis of key
business activities designed to identify existing or potential
problems; systematic technical accuracy review (STAR), an integral part
of VBA's quality assurance program designed to measure VARO performance
in processing claims; and accountability for VARO date stamps and usage
of the claims process improvement business model. This business model
requires employees to rotate between the different teams within the
VARO to maintain skills required to process claims.
Security of Veterans' Information--Mail handling
procedures and controls for the safeguarding of veterans documents to
prevent unauthorized destruction
VARO Public Contact Functions--Inquiry Routing and
Information System (IRIS), VA's internet based public message system
that allows beneficiaries a means to communicate with VA
electronically.
During our visit, we interviewed the VARO Director, Veterans
Service Center Manager (VSCM), supervisors, and employees responsible
for processing claims and providing benefit services to veterans and
their dependents. We reported the Anchorage VARO management team faces
challenges in providing benefits and services to veterans. These
challenges include addressing oversight of operational activities,
improving insufficient network capacity to support business processes,
providing training to staff, and managing an internal claims brokering
process. The VARO did not meet VBA's standards for 13 of the 14
operational areas inspected.
Our analysis of disability claims processing revealed a 29 percent
error rate at the Anchorage VARO. The error rate represents our
analysis of 78 disability claims and not the entire caseload of the
VARO. Of the 78 claims reviewed, processing errors occurred in 23
claims, of which only three errors directly affected veterans'
benefits. The VARO underpaid two veterans, one for $288 and one for
$4,758. The other error did not involve monetary benefits. The majority
of processing errors involved claims for PTSD and Haas claims. These
errors occurred because of a lack of training for Rating Veterans
Service Representatives (RVSR) responsible for making disability
determinations.
Of those 13 operational areas that did not meet VBA standards, 9
occurred because of a lack of management oversight. These areas were:
tracking veterans claims folders, establishing the correct dates of
claim, correcting errors identified by VBA's STAR quality assurance
program, completing SAOs, safeguarding VARO date stamps, safeguarding
veteran's personally identifiable information (PII), properly handling
claims related mail, responding to electronic inquiries submitted by
veterans, and, responding to congressional inquiries.
For approximately 8-months during FY 2009, the VARO had no manager
for its Veterans' Service Center, a key management position affecting
many operational areas in the Anchorage VARO. Further, the VARO
Director geographically residing in Salt Lake City may have also
attributed to diminished oversight. For example, the Director could not
observe the effectiveness of SAO recommendations designed to improve
station performance and delays in implementing several SAOs occurred
while waiting for the Director in Salt Lake City to approve the plan.
In addition to the 14 operational areas inspected, we identified
serious concerns regarding network capacity to support current business
processes. Employees reported difficulty maintaining consistent access
to certain VBA applications required to perform their jobs. These
difficulties included applications being unresponsive and the need for
employees to restart their computers several times a day. The employees
informed us this problem had already existed for over one year. We
estimated the Anchorage VARO might lose 7.5 productive hours per rating
specialist a month due to network capacity problems.
The VARO Director implemented an internal brokering plan that moves
rating-related claims between Anchorage, AK, Ft. Harrison, MT, and Salt
Lake City, UT. VBA normally brokers work between VAROs because of
insufficient resources to process certain types of work. The Anchorage
VSCM informed us it is difficult to create a workload management plan
and to control the workload of pending claims brokered to other VAROs.
A supervisor from the Anchorage VARO indicated brokering impacts mail
handling procedures and it is difficult to associate claims related
mail with claims folder located at other VAROs. Currently, the OIG is
performing a national audit to determine the effectiveness of claims
brokering across all VBA regional offices.
Because the Anchorage VARO was moving so much work to other VARO's,
we compared staffing levels between the Anchorage VARO and the Boise
VARO to determine if the staffing level was commensurate with similar
VARO's. Our analysis revealed the Boise VARO has 22 additional full-
time employees while maintaining a comparable inventory of rating and
non-rating claims. We based this comparison on the total number of
actual claims pending in each office. We believe this provides the best
comparison of actual workload, rather than the number of veterans who
reside in each state or those veterans who might file claims.
The Benefits Inspection Division completed 6 VARO inspections
during FY 2009. A comparison of the percentage of claims processing
errors revealed the highest error rate occurred at the San Juan, PR
VARO, (41 percent), followed by Anchorage, AK (29 percent), Roanoke, VA
(25 percent) Baltimore, MD (20 percent), Nashville, TN (19 percent) and
Wilmington, DE (11 percent). These error rates represent our analysis
of a sample of disability claims and not the entire caseload at each
VARO. None of the VAROs inspected complied with 100 percent of the
operational areas we reviewed. The Baltimore office had the highest
rate of non-compliance with VBA standards followed by Anchorage, San
Juan, Nashville, Wilmington, and Roanoke.
We recommended the Director improve oversight of the quality
assurance process for several of the operational areas that did not
meet standards, develop a mail routing guide to ensure proper
processing of mail, research the cause and solutions to improve network
capacity issues, and train staff to maintain required skills. The VARO
Director concurred with all of the OIG's recommendations in the
inspection report.
summary
Although our inspection found the Anchorage VARO management team
faces many challenges in providing benefits and services to veterans,
we believe the Director's comments to our recommendations are
responsive. The Benefits Inspection Division has not performed any
follow-up regarding the implementation of these recommendations at this
time.
Senator Begich, thank you for the opportunity to testify here
today.
Senator Begich. Thank you both very much for being here and
I will have some questions. I won't make it Groundhog Day where
it's the same questions as yesterday.
Ms. Finn. That's good. Thank you.
Senator Begich. You betcha. So the next person to present
is Mark Bilosz, who is the director of the Anchorage Regional
Office, Veterans Benefits Administration, Department of
Veterans Administration.
STATEMENT OF MARK M. BILOSZ, DIRECTOR, ANCHORAGE REGIONAL
OFFICE, VETERANS BENEFITS ADMINISTRATION, U.S. DEPARTMENT OF
VETERANS AFFAIRS; ACCOMPANIED BY WILLIE C. CLARK. SR., WESTERN
AREA DIRECTOR; AND PATRICK KELLEY, VETERANS SERVICE CENTER
MANAGER, ANCHORAGE REGIONAL OFFICE
Mr. Bilosz. Thank you. Senator Begich, it's my pleasure to
be here today to discuss our efforts in meeting the needs of
veterans residing in the State of Alaska. Accompanying me here
today is the Western Area VBA director, Mr. Willie Clark, and
the Veterans Service Center manager in Anchorage, Patrick
Kelley.
I will discuss important benefits and services provided to
veterans living in Alaska, as well as discuss concerns about
the Anchorage Regional Office addressed in a recent VA Office
of Inspector General report. The Anchorage Regional Office
administers the following benefits and services: disability
compensation and pension for veterans; vocational
rehabilitation and employment assistance; and outreach for all
veterans and survivor benefits. Our goal is to deliver these
benefits and services in a timely, accurate, and compassionate
manner. This is accomplished through the administration of
comprehensive and diverse benefits programs.
Currently, a total of 34 employees work in the Veterans
Service Center and 7 employees in the vocational rehabilitation
and employment division within the regional office. Employees
at the Anchorage regional office are very motivated and are
providing excellent service to Alaska veterans. Performance
indicators reveal the Anchorage Regional Office is performing
much better than in the past, completing a greater number of
claims each month, while improving accuracy.
As the outbased director of the Anchorage Regional Office,
I visit Anchorage at least once quarterly and have daily
discussions with division management to maintain an open line
of communication and provide direction and oversight. A new VHA
clinic is scheduled to open in May 2010 and VBA has secured
space at the new site. The Anchorage Regional Office is looking
forward to moving into this new space, as it will provide us
with improved working space.
In June, a new Veterans Service Center manager reported for
duty in Anchorage. The Veterans Service Center manager position
was previously vacant for approximately 8 months. This position
was vacant due to the difficult task of recruiting an
experienced person to the Anchorage area.
Additionally, the Anchorage Regional Office recruited and
hired two new supervisors. The appointment of the new
supervisors has had a positive impact on the overall management
and performance of the office this fiscal year, as the station
is making strides toward improvement in many performance
measures. For example, rating inventory has trended in a
positive direction every month this year. Compared to December
of last year, Anchorage completed 226 more claims this year--an
increase of about 156 percent. In addition, rating and
authorization quality have both showed improvements. In fact,
due to the focus on internal training, rating quality in
Anchorage exceeds the national average.
The Anchorage Regional Office vocational rehabilitation
division is one of the top performing divisions in the Nation
and it was identified and awarded a Tier II level award last
year. In addition to the improvements in quality, the
management team has successfully implemented several policies
pertaining to the workflow that I'd like to highlight here
today.
A policy for timely corrective actions of errors identified
by the Veterans Benefits Administration's National Quality
Review Program was implemented. A policy outlining control and
tracking of claims folders was implemented. This policy
provides for better control of the location of claims folders.
The management team has implemented a consistent local quality
review process to complete timely quality assurance reviews
that ensure veterans service representatives establish the
correct date of claim. The most recent review in January showed
only a 1 percent error rate. As VBA has an ethical and legal
responsibility to maintain adequate controls over all date
stamps throughout our facilities, two new electronic date
stamps with locking devices are now in place and kept in secure
locations.
The Veterans Service Center has also taken action to more
efficiently safeguard veterans' personal identifiable
information. All employees receive training on the proper
safeguard and destruction of materials, desk inspections of
work stations and common areas are performed regularly. In
September a new workflow plan was implemented to ensure
Veterans Service Center staff properly control and process all
mail.
To ensure congressional inquiries are processed in a timely
and accurate manner a new policy for handling congressional
inquiries was implemented. Our goal is to complete inquiries
within 5 days and so far this fiscal year we're completing them
within 4.3 days.
The Office of Inspector General conducted an investigation
during the summer of 2009. The Office of Inspector General
report recommended 12 areas of improvement. Action has been
taken to correct the deficiencies identified by the Office of
Inspector General and those items have been addressed in my
oral testimony and my written testimony that you also have
today.
With the help of the OIG report findings, specific
shortfalls at the Anchorage Regional Office have been
identified and action plans are in place. VA senior leadership
is committed to providing the necessary resources, funding,
employees, and facilities to the Anchorage Regional Office to
ensure the best possible service is provided to Alaska veterans
and their families. I also am fully committed to continuing to
improve the claims processing in Alaska.
Mr. Chairman, this concludes my testimony and I greatly
appreciate being here today and look forward to answering any
of your questions.
[The prepared statement of Mr. Bilosz follows:]
Prepared Statement of Mark M. Bilosz, Director, Anchorage VA Regional
Office, Veterans Benefits Administration, U.S. Department of Veterans
Affairs
Senator Begich and Members of the Committee, it is my pleasure to
be here today to discuss our efforts in meeting the needs of Veterans
residing in Alaska.
The Anchorage Regional Office (RO) serves Veterans throughout the
state. We also provide outreach services to Veterans in Fairbanks, Fort
Wainwright, Fort Richardson, Elmendorf Air Force Base, and Eielson Air
Force Base.
The Anchorage RO administers the following benefits and services:
Disability compensation and pension for Veterans and
dependents;
Vocational rehabilitation and employment (VR&E)
assistance; and,
Outreach for all Veteran and survivor benefits.
Our goal is to deliver these comprehensive and diverse benefits and
services in a timely, accurate, and compassionate manner.
The Anchorage RO is responsible for delivering non-medical VA
benefits and services to over 76,400 Veterans and their families in
Alaska. Approximately 14,000 of these Veterans receive disability
compensation. In fiscal year 2009, the Anchorage RO completed more than
2,100 decisions on Veterans' disability claims.
The Denver Regional Loan Center (RLC) administers VA home loan
services to Alaska Veterans. Alaska Veterans are served by a full time
RLC employee who is stationed at the Anchorage RO. Most Native lands
are leasehold estates, which qualify for VA's guaranteed loan program.
VA has guaranteed 65,575 home loans in Alaska with a cumulative loan
amount of over $9 billion.
staffing
The Anchorage RO hired five employees as a result of the American
Recovery and Reinvestment Act. The employees are making direct
contributions to improving claims processing by assisting with
development of claims and mail processing. Currently, 34 employees work
in the Veterans Service Center (VSC) and 7 employees work in VR&E.
Employees at the Anchorage RO are very motivated and provide
excellent service to Alaska Veterans. Performance measures indicate
that the Anchorage RO is performing well, completing a greater number
of claims each month while improving accuracy.
management team
As the out-based Director of the Anchorage RO, I visit Anchorage at
least quarterly and hold weekly videoconference calls with division
management to maintain open lines of communication. In addition, I hold
a weekly conference call with the Veterans Service Center Manager
(VSCM) to provide direction and oversight. I also communicate regularly
with the Anchorage VA Medical Center Director, as the Anchorage RO is
currently co-located with the Medical Center.
A new VA clinic is scheduled to open in May 2010, and the Veterans
Benefits Administration has secured space at the new site. The
Anchorage RO is looking forward to moving into this new space as it
will allow VSOs and all claims files to be located in the RO. The new
facility will also include a large training room.
In June 2009, a new VSCM reported for duty in Anchorage. The VSCM
position was vacant for approximately eight months due to the
sometimes-difficult task of finding an individual with the right
leadership and managerial skills to fit the position. Many times
relocating an employee and his/her family to Alaska is difficult.
Additionally, the Anchorage RO recruited and hired two new
supervisors. The appointment of the new supervisors has had a positive
impact on the overall management and performance of the office this
fiscal year.
For example, rating inventory has trended in a positive direction
every month this year. Compared to December of last year, the Anchorage
RO completed 226 more claims this year, an increase of 16 percent. In
addition, rating and authorization quality have both improved. Rating
quality at the Anchorage RO exceeds the national average.
A new training plan was developed and implemented in September
2009. Rating Veteran Service Representatives (RVSRs) receive weekly
training from the Decision Review Officer. Training topics are aimed at
eliminating the errors found during various reviews. All RVSRs attend
the monthly Systematic Technical Accuracy Review calls to discuss
commonly found errors and to prevent future errors.
The Anchorage RO's VR&E division is one of the top performing
divisions in the Nation. Identified as a top performer in fiscal year
2009, the VR&E division was awarded Level II performance award.
outreach efforts
Our employees conduct an average of 580 personal interviews per
month, and last year conducted 47 Transitional Assistance Program (TAP)
briefings for 1,078 servicemembers. VR&E personnel provide monthly DTAP
briefings at Elmendorf Air Force Base and Fort Wainwright.
The Anchorage RO conducted two significant rural outreach
initiatives in 2009. In February and March, the RO participated jointly
with the Alaska VA Health Care System to offer Alaska VA Education
Forums. Teams traveled to Kotzebue, Fairbanks, Nome, Dillingham,
Ketchikan, Juneau, and Sitka to provide benefits information and
counseling to Veterans and medical providers.
We also participated in two Homeless Standdowns at Fort Richardson
and in Fairbanks in August 2009. An RO representative provided
information and VA benefits counseling at these events. Earlier this
month, a Standdown was held to introduce Veterans to the VA Domiciliary
facility in Anchorage.
In October 2009, the Anchorage RO teamed with the Medical Center to
staff an information booth for 500 Veterans and family members via the
Alaska Federation of Natives (AFN). AFN is the largest statewide Native
organization in Alaska. Its membership includes 178 villages (both
federally-recognized tribes and village corporations), 13 regional
Native corporations and 12 regional nonprofit and tribal consortiums
that contract and run Federal and state programs.
As of December 31, 2009, 134 servicemembers were participating in
the DOD/VA Disability Evaluation System Pilot at Ft. Wainwright, Ft.
Richardson, and Elmendorf AFB. This pilot is instrumental in
streamlining disability processing for separating servicemembers.
improvements in service delivery
The new management team successfully implemented several new
workload management and quality assurance policies and procedures.
A policy for the timely corrective action of errors identified by
VBA's Systematic Technical Accuracy Review Staff was implemented in
November 2009. The VSCM tracks all errors and corrective actions. A
review process was established to ensure Veterans Service
Representatives (VSRs) correctly enter claims data into our processing
systems. Refresher training was provided to all claims assistants and
VSRs. Weekly training is held on scheduled topics and errors identified
in quality reviews.
A policy outlining the use of COVERS, VBA's system to control and
track claims folders, was also implemented in November. This policy
requires claims folders to be ``COVERed'' every Monday and also
requires supervisors to perform weekly spot checks.
Systematic Analyses of Operations (SAOs) are now completed
accurately and timely. A tracking mechanism is in place to monitor the
status of required SAOs and training on SAO writing techniques was
provided.
The VSC has also taken action to more efficiently safeguard
Veterans personally identifiable information. All employees received
training from the Records Management Officer in August 2009 on the
proper safeguard and destruction of materials. Inspections of
workstations and common areas are performed regularly. Two new
electronic date stamps, with locking devices, are now in secure
locations.
In September 2009, the Triage Workflow Plan was implemented to
include a mail routing guide to ensure VSC staff properly control and
process the mail. The Triage Coach provides the VSCM with a monthly
summary of all mail actions as well as any required follow-up actions.
Triage training is conducted every Thursday to ensure the workflow plan
is being properly implemented.
An Inquiry Routing and Information System (IRIS) Quality Review
Policy was implemented in November 2009 to improve quality assurance
reviews. The IRIS system is the electronic method Veterans use to
communicate with VA. The Public Contact supervisor reviews a minimum of
five IRIS responses per employee every month. The supervisor also
discusses errors during weekly training sessions with individual
employees to ensure the highest level of quality and accuracy is
maintained.
To ensure Congressional inquiries are processed in a timely and
accurate manner, a new policy for handling Congressional correspondence
was implemented in November 2009. The Public Contact Team maintains a
log of all Congressional correspondence where inquiries are annotated
within one day and assigned to an employee to review and complete. The
individual receiving the assignment has two working days to present a
response for approval by the VSCM. Our goal is to complete
Congressional inquiries within five days.
The Anchorage RO reports the results of internal brokering to VBA
leadership monthly. The Western Area Office is informed monthly of any
transfers of work. Brokering claims, or sending claims to another RO,
is done to provide better service to our Veterans. Brokering is a
short-term strategy to assist ROs with workflow challenges.
va office of inspector general report
The VA Office of Inspector General (OIG) conducted a review of the
Anchorage RO from July 28, 2009 to August 6, 2009. The five areas
examined were disability claims processing, data integrity, management
controls, information security, and public contact. The OIG report
recommended 12 areas of improvement. Action has been taken to correct
the deficiencies identified by the OIG.
The Western Area Director and staff conducted an on-site review of
the Anchorage RO from January 6, 2010 to January 7, 2010. A major part
of this visit was to evaluate compliance with the OIG's
recommendations. All action plans implemented in response to the OIG's
recommendations were reviewed for compliance and effectiveness. The
Western Area Director found the Anchorage RO had implemented the
required actions to be fully compliant with all 12 of the OIG
recommendations.
conclusion
VA leadership and the employees of the Anchorage RO are committed
to ensuring the best possible service is provided to Alaska Veterans
and their families. Mr. Chairman, this concludes my testimony. I
greatly appreciate being here today and look forward to answering your
questions.
Senator Begich. Thank you very much. Thank you for your
testimony. The next person to present is Dr. Susan Pendergrass,
who is the director of the VISN 20, Veterans Health
Administration, Department of Veterans Affairs. Dr.
Pendergrass.
STATEMENT OF SUSAN PENDERGRASS, DrPH, NETWORK DIRECTOR, VISN
20, VETERANS HEALTH ADMINISTRATION, U.S. DEPARTMENT OF VETERANS
AFFAIRS; ACCOMPANIED BY ALEX SPECTOR, DIRECTOR, ALASKA VA
HEALTH CARE SYSTEM
Dr. Pendergrass. Thank you very much, Senator Begich. Thank
you for the opportunity to appear before you and discuss VA
health care of Alaskan Northwest Network. I'm accompanied today
by Mr. Alex Spector, who is the director of the Alaska Health
Care System. I would like to thank you for your leadership and
the advocacy on behalf of veterans and Alaskan veterans. You
have continued to show that commitment and we are very
appreciative of all of the assistance that you have given us.
My written testimony has been submitted and I will focus my
remarks on several issues that are important to the Alaskan
veterans including TeleHelp, rural help outreach, and the
Veterans Beneficiary Travel Program.
We provide access to health care to eligible Alaskan
veterans through an integrated delivery system which consists
of clinical care sites, joint ventures of DOD facilities, and
contract care. We have continued to see an increase in the
number of veterans using VA health care. It has grown by close
to 14 percent since 2005.
We have clinics and Vet Centers in Anchorage, Fairbanks,
Kenai, and Wasilla, and we are providing primary care including
preventative services, health care screenings, and mental
health services at all of those sites. Our inpatient care is
provided through the DOD Joint Venture Hospital on Elmendorf
Base, contracts with Providence Alaska Medical Center in
Anchorage, and we purchase care from community hospitals
throughout the State.
In addition, we have two outreach clinics. Outreach clinics
are not clinics that are open 5 days a week, but several times
during the week, and those are in Homer and Juneau, AK. We are
expanding the Juneau outreach clinic, which is currently under
construction and will be completed by mid summer, and the hours
of that clinic will then expand. We have a new construction
replacement of our main clinic in Anchorage and that will
provide expanded capacity to serve the veterans.
By the end of 2010, we will have a VA clinic presence that
will serve more than 88 percent of enrolled veterans, who will
have the care in the borough with which they reside. So 88
percent of those veterans will have access to care in their
boroughs.
We have specialty services and have continued to improve
our care with homeless veterans. We have inpatient mental
health services that are provided by contract care and we also
have specialty VA programs. We use the Lower 48 State veterans
service capability. We have active programs here and long-term
care in both for institutional and non-institutional services.
What we are doing also is to have an active coordinated
home care TeleHelp program, where 31 percent of the TeleHelp
users live in highly rural areas, 16 percent live in rural
areas, and 53 percent in the urban areas. This enables us to
place an assistant device in the home that the individual can
utilize to monitor help information, provide that information
to the VA so they do not have to come in for a visit. We have
been using that primarily to monitor chronic diseases, but we
are now expanding to help monitor some conditions such as PTSD,
substance abuse, and some psychiatric disorders.
The Alaskan VA health care system has recently also
expanded TeleHelp in several specialty areas. We have
implemented a Teleretinal Diabetic Screening program. This
enables an individual with diabetes to get an eye exam, it's
read, and the monitoring of any effects of eye disease as a
result of their diabetes. We also have instituted
teledermatology so that a picture can be taken of a lesion and
read by a dermatologist remotely and provide for treatment and
consultation so that the individual does not have to travel for
that specialty service.
We have just recruited a psychiatric nurse practitioner for
a telemedicine mental health provider. We have just connected
this month that provider with Anchorage and the Fairbanks
clinic and through TeleHelp we will allow a VA
neuropsychologist to screen veterans for TBI. Again, its very
difficult to provide these specialists within some of the rural
and remote areas. So using tele-mental health and telemedicine
is one of our primary options.
We are also exploring options to partner with other groups
such as the American Native Health Consortium, the Bristol Bay
Area Health Consortium, and the Maniilaq Health Corporation.
We've hung great promise in increasing the use and availability
of mental health care resources to the Alaskan veteran system
and the veterans in Alaska.
We have also established several rural health pilots that
are reaching out into the Yukon-Kuskokwim area and it is a
pilot in which we are able to try to enhance primary care to
rural veterans and be able to contract that service through the
Tribal Health Consortium. We've also placed tribal veteran
representatives to assist in outreach to the Alaskan Native
veterans and in training other VA health care providers of VA
benefits.
We have a special outreach to the Alaska Native Tribal
Health Consortium organizations and a major deployment with--
and also we have the deployment of the Alaskan National Guard
in our OEF/OIF outreach. We have a Memo of Understanding with
the State of Alaska Department of Military and Veterans Affairs
to meet the needs of the returning servicemembers.
Our final benefit I would like to address is the VA
Beneficiary Travel Program. In 2009, we spent over $4 million
to transport Alaskan veterans by ambulance, car, van and air
travel, as well as mileage reimbursement. Approximately 50
percent of travel expenses were airline tickets for travel; 77
percent of that was within Alaska and the remaining were to VA
facilities in the Lower 48.
In summary, we continue to increase access to meet the
needs of the Alaskans residing in--the veterans residing in
Alaska. We have included not only clinical services, but
additional sites of care to try to improve that access, and we
have maintained a high performance rating and quality of care,
access standards, patient satisfaction, and employee
satisfaction.
I thank you again for the opportunity to testify at this
hearing.
[The prepared statement of Dr. Pendergrass follows:]
Prepared Statement of Dr. Susan Pendergrass, Director, VA Northwest
Network (VISN 20), Veterans Health Administration, U.S. Department of
Veterans Affairs
Good Morning Senator Begich and Members of the Committee. Thank you
for the opportunity to appear before you today to discuss VA health
care in the Northwest Network (Veterans Integrated Service Network
(VISN) 20) and Alaska. I am accompanied today by Mr. Alex Spector,
Director of the Alaska VA Healthcare System (AVAHS).
First, Senator Begich, I would like to thank you for your
leadership and advocacy on behalf of Alaska's Veterans. During your
tenure on the U.S. Senate Committee on Veterans' Affairs, you have
consistently demonstrated your commitment to Veterans and to improving
the care and benefits they receive.
Today, I will briefly review the VA Northwest Network and the
Alaska VA Healthcare System. I will also discuss several issues
important to Alaskan Veterans, including telehealth, rural health
outreach, and VA's beneficiary travel program.
va northwest network (visn 20)
The VA Northwest Network (VISN 20) includes the states of Alaska,
Washington, Oregon, most of Idaho, and one county each in Montana and
California. Our 135 counties cover approximately 23 percent of the
United States land mass. Eighty-six (86) percent of our total counties
are classified as medically underserved areas or containing medically
underserved populations.
Our network of health care facilities is composed of 6 medical
centers (including 2 complex care hospitals), 1 independent outpatient
clinic (Anchorage), 1 rehabilitation center, 33 operational community-
based outpatient clinics (CBOCs) or part-time outreach clinics and 2
mobile clinics. Other services include 5 nursing home care units, 2
homeless domiciliaries and 16 readjustment counseling centers (Vet
Centers), as well as 4 mobile Vet Centers operating in Washington,
Idaho and Oregon.
Approximately 1,180,000 Veterans live in the Pacific Northwest and
Alaska, 29 percent of whom received health care services from VA in
fiscal year (FY) 2009. Our medical centers currently operate
approximately 1,655 inpatient beds, including acute medical/surgical,
domiciliary, mental health, nursing home and rehabilitative care, and
VISN 20 facilities recorded approximately 33,000 hospital admissions
and 2.7 million outpatient visits in FY 2009. VISN 20's patient
population has an average age of 60.8 years, and 46.6 percent of our
patients are service-connected Veterans. Approximately 9.5 percent of
our patients are women.
The VA Northwest Health Network continuously strives to improve
access, quality, patient satisfaction and wellness to better serve the
Veterans of the Pacific Northwest. Two of our health care systems have
major academic affiliations and our Network hosts a significant number
of Centers of Excellence, while also supporting a large and broad
research portfolio that was funded in excess of $33 million last year.
We also have expansive and collaborative relationships with the
Department of Defense (DOD), including two highly successful
partnerships in Alaska.
The VA Northwest Network has not only exceeded inpatient and
outpatient satisfaction goals, but its employee satisfaction scores are
also strong. For each of the past several survey cycles, VISN 20 has
received some of the highest scores in the country. We recognize that
employees who feel challenged and valued are more productive and
healthier, and we continually strive to make VISN 20 an employer of
choice. For the second year in a row, VISN 20 ranked highest among
networks for Diversity Acceptance. Other top satisfiers included: Type
of Work, Coworkers, Senior Management, Work Conditions, Customer
Satisfaction and Praise.
Given VISN 20's large and diverse geographic nature (including
rural or frontier lands and remote islands), access to care is a
priority. In FY 2010, the Network will activate five new sites of care
in three states (California, Oregon and Montana). In FY 2009, we also
hired two new full-time employees to support Tele-Health and Rural
Health efforts across the Network.
alaska va healthcare system
The Alaska VA Healthcare System (AVAHS) provides access to health
care to eligible Alaskan Veterans through an integrated delivery system
consisting of clinical care sites, joint venture DOD facilities and
contract care. By FY 2009 estimate, there were over 76,400 Veterans
living in Alaska; 26,708 are enrolled in VA. AVAHS has continued to
increase the number of Veterans seeking health care, growing by 13.6
percent since FY 2005. In FY 2009, AVAHS provided services to more than
15,000 Veterans; this consisted of 142,246 outpatient visits and more
than 60,000 visits to private sector providers. This latter effort
amounted to approximately 38 percent of the FY 2009 budget for VISN 20.
AVAHS was home to 488 full-time employees in FY 2009 and received a
five percent increase in its operating budget for a total of $118.1
million, with a 5.44 percent increase for FY 2010.
The AVAHS provides medical care to Alaska Veterans through VA
clinics in Anchorage, Fairbanks, Kenai and Wasilla. These cities are
also home to VA Readjustment Counseling Centers, or Vet Centers, which
provide counseling, psychosocial support and outreach to Veterans and
their families. AVAHS provides or contracts for a comprehensive array
of health care services. AVAHS directly provides primary care,
including preventive services and health screenings, and mental health
services at all locations. AVAHS inpatient care is provided through the
VA/DOD Joint Venture Hospital located on Elmendorf Air Force Base, as
well as through a contract with Providence Alaska Medical Center in
Anchorage. Inpatient care in outlying communities is provided through
purchased care from local hospitals. AVAHS has hired specialists in
general surgery, podiatry, orthopedics, urology, cardiology,
ophthalmology, and inpatient medicine. Specialists in dermatology and
neurology travel from the Lower 48 and hold clinics at the Anchorage VA
facility. The Anchorage facility also has a small dental clinic and an
audiology clinic. Audiologists travel to VA CBOCs and Coast Guard
clinics in Southeast Alaska to provide better and more convenient care
to Veterans.
In addition, we provide care through two VA outreach clinics in
Homer and Juneau, Alaska. The Homer outreach clinic is an extension of
the Kenai CBOC and serves Veterans once a week at the South Peninsula
Hospital under a contract agreement for space and ancillary services.
The second VA outreach clinic provides care once a month under a
sharing agreement with the Coast Guard in the Juneau Federal Building.
Currently, Anchorage-based primary care providers travel to Juneau to
staff this clinic. Additional space for the Juneau VA outreach clinic
is currently under construction, and VA expects this will be completed
by mid-summer. The expanded space will allow for a full-time primary
care and mental health staff and be operational on a daily basis. AVAHS
also is constructing a new replacement clinic in Anchorage that will
offer expanded capacity. It will be located just outside the Muldoon
Gate entrance to Elmendorf Air Force Base, and it will be connected to
the Third Medical Group Hospital by a secure, enclosed access point.
Access to the VA clinic will be outside the Air Force Security
checkpoint, and the clinic is scheduled currently to open in May 2010.
VA has located its sites of care in areas of the state with the largest
concentration of Veterans. By the end of FY 2010, more than 88 percent
of enrolled Alaskan Veterans will reside in a borough with a VA
clinical presence.
------------------------------------------------------------------------
FY 2009
Area Vet. FY 2009 % Veterans
Pop. Enrollees Enrolled
------------------------------------------------------------------------
Anchorage............................. 31,301 12,426 39.7%
Fairbanks............................. 13,182 4,200 31.9%
Mat-Su................................ 10,157 3,414 33.6%
Southeast............................. 7,798 1,827 23.4%
Kenai................................. 5,951 3,414 57.4%
West/SW Alaska........................ 4,308 804 18.7%
Northern Alaska....................... 1,144 112 9.8%
Kodiak................................ 1,343 320 23.8%
Valdez/Cordova........................ 1,259 337 26.8%
------------------------------------------------------------------------
AVAHS also participates in one of nine nationally recognized VA/DOD
joint ventures at the 3rd Medical Group (MDG), Elmendorf Air Force
Base, and an Inter-Service Sharing Agreement with Bassett Army
Community Hospital at Fort Wainwright. If a Veteran requires care that
is unavailable at an AVAHS clinic or a VA/DOD facility, VA refers the
patient to the nearest VA facility, the VA Puget Sound Health Care
System (VAPSHCS) in Seattle, WA, or contracts for care with a local
provider. VA is required by law to ensure such fee-for-service care is
consistent with the care provided in the contiguous United States.
AVAHS offers a comprehensive continuum of care for homeless
Veterans. VA provides outreach and a 50 bed Domiciliary for Homeless
Veterans, along with programs in Compensated Work Therapy and Veterans
Industries, Compensated Work Therapy Transitional Residence, and the
Department of Housing and Urban Development-VA Supportive Housing (HUD/
VASH) program in Anchorage. This program expanded to Fairbanks in
December 2009. AVAHS also provides oversight for two grant and per diem
programs awarded to the Salvation Army Adult Rehabilitation Program in
Anchorage and the Rescue Mission located in Fairbanks.
Inpatient mental health services are provided through contract care
in local community psychiatric facilities and hospitals, as well as
specialized programs at VA facilities in the Lower 48. There is an
active contract nursing home program and other non-institutional care
programs, including adult day care, respite, homemaker/home health
aide, and skilled nursing. AVAHS started a Home-Based Primary Care
program in July 2009 that serves more than 60 Veterans within a 20 mile
radius of the Anchorage VA Clinic.
access
AVAHS exceeded VA's national performance goals for primary care
access in FY 2009. Nationally, VA requires that 99 percent of Veterans
will be scheduled within 30 days of the desired date for an
appointment. AVAHS has continually exceeded this measure, as less than
0.12 percent of Veterans waited more than 30 days in FY 2009. In FY
2010, AVAHS has continued to exceed these standards.
For most of FY 2009, AVAHS was not meeting the national performance
measure for mental health access. VA's national standards require
prompt evaluation of new patients (those who have not been seen in a
mental health clinic in the last 24 months) with mental health
concerns. New patients are contacted, within 24 hours of the referral
being made, by a clinician competent to evaluate the urgency of the
Veteran's mental health needs. If it is determined that the Veteran has
an urgent care need, appropriate arrangements, e.g., an immediate
admission, are to be made. If the need is not urgent, the patient must
be seen for a full mental health diagnostic evaluation and development
and initiation of an appropriate treatment plan within 14 days. Across
the system, VA is meeting this standard 95 percent of the time.
However, AVAHS was not meeting this performance measure for most of
FY 2009. In response, AVAHS performed an analysis to identify barriers
and conducted a systems redesign to remove obstacles and provide timely
care for these patients. After implementing these corrective action
plans, AVAHS met or exceeded the measure for the last few months of FY
2009, and through January in FY 2010, 100 percent of new mental health
patients are seen within 14 days of their initial evaluation and 97
percent of established mental health patients are seen within 14 days.
telehealth
Coordinated Care Home Telehealth--AVAHS has an active Coordinated
Care Home Telehealth (CCHT) program with 223 enrolled Veterans
throughout the state. Thirty-one (31) percent of telehealth users live
in highly rural areas, 16 percent live in rural areas and 53 percent
live in urban areas. Veterans enrolled in the CCHT program receive a
device that uses a standard phone connection to send information from
their home to CCHT staff in Anchorage. Types of information sent by
patients include blood pressure, pulse, weight, blood sugar, and oxygen
measurements. Patients also answer health-related questions. The CCHT
registered nurse staff reviews the information on a daily basis and can
identify early warning signs or ``out of bounds'' measurements before
the patient even begins to be symptomatic. Initially, CCHT was focused
on working with Veterans with chronic diseases such as diabetes,
hypertension, congestive heart failure, chronic obstructive pulmonary
disease or depression. In recent months, however, AVAHS has explored
uses of home telehealth to monitor other conditions such as Post
Traumatic Stress Disorder (PTSD), substance abuse and bipolar disorder.
Additionally, Veterans who are at risk of losing their independence are
receiving special attention from CCHT care coordinators.
Through the daily use of the home telehealth technology, Veterans
are improving their ability to live in their own home safely,
healthfully, and for a longer period of time. CCHT results have been
impressive. Ninety-five (95) percent of CCHT users with diabetes have
improved their blood sugar control and 93 percent with high blood
pressure have improved blood pressure control.
Tele-Retinal Imaging--AVAHS implemented a tele-retinal diabetic
screening program in FY 2009. This program allows Veterans with
diabetes to be screened for diabetic eye disease. Images are captured
at the Anchorage, Fairbanks or Kenai clinics and forwarded to analysts
at the VA Puget Sound Health Care System for interpretation. These
analysts later forward a consultative report with recommendations back
to the patient's primary care provider for implementation. During FY
2009, 280 patients received these services, and through January FY
2010, 108 patients have been cared for through this technology.
Tele-Dermatology--AVAHS started a tele-dermatology program in
November 2009. This program employs technology to facilitate timely
dermatology care to Veterans in Alaska. Images of skin lesions are
captured while the patient is in clinic. Those images, along with a
request for consultation, are forwarded to the VA Puget Sound Health
Care System for interpretation. There, a dermatologist writes a
consultative report with recommendations and forwards this information
to the primary care provider. Interpretations and recommendations are
received within 24 to 48 hours. Thus far, 37 consults have been
completed this fiscal year.
Tele-Mental Health--During FY 2009, AVAHS successfully recruited a
psychiatric nurse practitioner for a new position as a tele-mental
health provider. Currently, a Tele-Mental Health Clinic is held with
the Kenai CBOC by videoconference 3 to 5 days per month. Approximately
60 unique patients are being seen through this clinic, and four to six
additional Veterans are being seen each month.
VA will open a new Tele-Mental Health this month to connect
Anchorage and the Fairbanks CBOC to allow a VA neuropsychologist to
screen Veterans for Traumatic Brain Injury (TBI). A PTSD Tele-Mental
Health Group Clinic was initiated on January 7, 2010, by a VA
psychologist/PTSD specialist for Veterans in the Anchorage DeBarr
Clinic and the VA Domiciliary in mid-town (Anchorage). As a result of
the successful deployment within the city, AVAHS plans to expand this
service to its CBOCs in the near future. In addition, AVAHS has
assembled a working group to explore the best method for expanding
group counseling opportunities to its CBOCs.
AVAHS tele-mental health services have been offered to the Yukon-
Kuskokwim Health Corporation (YKHC) in Bethel, AK. A video-conference
for staff consultation between Anchorage and Bethel has been held with
educational and screening instruments shared. YKHC has requested peer-
to-peer consultation with VA professional staff as needed. VA has
visited both YKHC and Maniilaq Health Corporation in Kotzebue to
educate local health care providers about AVAHS' tele-mental health
resources.
A recent VA presentation to the Alaska Federal Healthcare
Partnership Telehealth and Technology committee resulted in positive
contacts with staff from the Alaska Native Tribal Health Consortium,
Bristol Bay Area Health Corporation, and Maniilaq Health Care
Corporation. This venue holds promise for spreading the message about
tele-mental health resources at AVAHS.
rural veterans
AVAHS has initiated several programs to meet the needs of Veterans
living in rural Alaska, including:
Rural Veteran Liaison--This is a 3-year pilot program to hire a
full-time VA employee to be a local community-based contact for VA
questions on health care and benefits. In June 2009, VA hired a Bethel-
based liaison to perform outreach to the Yukon-Kuskokwim area. AVAHS
has continued to recruit for a Kotzebue-based position since December
2008 and recently added Nome to the recruitment announcement. So far,
there have been no qualified applicants for the position to cover the
northern area of the state, but VA continues to advertise and respond
to inquiries.
Rural Health Care Pilot Project--This project is a 1-year pilot
program that began in August 2009. The goal of the pilot is to enhance
primary care for rural Veterans through contract care. The pilot areas
are the Bethel census area, Bristol Bay Borough, Dillingham Census
Area, Nome Census Area, Northwest Arctic Borough, Wade Hampton Census
Area, and the city of Cordova. Under the pilot, Veterans may be
authorized three primary care visits and two mental health visits
within a 6 month period. If the Veteran requires additional visits, the
Veteran or health care provider may contact VA to request additional
care as needed. VA sent letters to 548 enrolled Veterans in the pilot
areas inviting them to participate, and through January 2010,
approximately 20 percent have enrolled and 10 have requested
appointments (eight for primary care and 2 for mental health care).
Tribal Veteran Representative (TVR) Program--The TVR program uses
local community volunteers to assist VA in reaching out to Alaska
Native Veterans. A TVR is an Alaska Native Veteran or recognized
individual appointed by an Alaska Native health organization, tribal
government, tribal council, or other tribal entity to act as a liaison
with local VA staff. The representative is a volunteer unless paid by
the Alaska Native entity who selects the individual to represent them.
Collaborative training is provided by VA health care and benefits
staff. VA has completed two annual trainings, one in Anchorage and the
other in Southeast Alaska, and as of January 25, 2010, 12 people have
completed the TVR training.
Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF)
Outreach--AVAHS made special efforts to reach out to Alaska Native
Tribal Health Consortium organizations upon the first major deployment
of the Alaska National Guard in OEF/OIF. A multi-disciplinary group of
VA staff traveled to rural areas to provide education on PTSD, TBI, and
Suicide Awareness and Prevention. Audiences included providers, nurses,
mental health staff, community health aides, behavioral health
specialists, and village-based counselors. In addition to the
educational aspect of these sessions, VA staff and Alaska Native Tribal
health staff focused on providing a pathway of care for each system to
work together to ensure returning servicemembers and other Veterans
living in rural areas could seamlessly access their Alaska Native
health benefits as well as access their benefits through the VA health
care system. The presentations on the pathway of care focused on the VA
enrollment, eligibility, and fee authorization process to assist
Veterans in accessing VA health care and how to bill for reimbursement
from VA should their health corporation seek authorization to provide
services to Veterans. Packets of information with contact names and
phone numbers were given to each participant, and information tables
were staffed in community settings such as post offices, grocery
stores, and community gatherings to raise awareness within the general
community.
AVAHS has a signed a memorandum of understanding with the State of
Alaska Department of Military and Veterans Affairs that outlines a
partnership to work together to meet the needs of returning soldiers.
OEF/OIF staff members regularly attend Post Deployment Health Re-
Assessment (PDHRA) events and Yellow Ribbon Reintegration Program
events to deliver information about VA benefits to servicemembers and
their families. AVAHS actively participates in pre- and post-deployment
events for active duty servicemembers. VA also participates in outreach
with the National Guard's ``Reconnection Veterans'' program, which has
a goal of sending its liaisons to all 237 villages in Alaska within a
single year. The Rural Veteran Liaison and OEF/OIF staff members have
accompanied these liaisons on a number of trips to rural Alaska to
provide information about various VA programs and benefits.
beneficiary travel
Beneficiary travel benefits are a limited benefit for Veterans who
meet specific eligibility criteria outlined in Federal statute. In FY
2009, AVAHS spent $4 million for travel for Alaskan Veterans. Types of
travel include ambulances, cabs, wheelchair vans, mileage
reimbursement, and air travel. Approximately 50 percent of travel
expenses were for airline tickets for travel within (77 percent) Alaska
and to VA facilities in the Lower 48 (23 percent). VA purchased almost
3,900 tickets at an average cost of $552 per ticket.
Veterans are eligible for beneficiary travel benefit if they:
Are rated 30 percent or more service-connected;
Are rated less than 30 percent service-connected, but only
for travel in connection with treatment or care of their service-
connected condition;
Are receiving VA pension;
Have an annual income below the maximum applicable annual
rate of pension ($11,830 for a single Veteran); or
Are traveling for a scheduled compensation and pension
examination.
conclusion
In summary, AVAHS has continued to increase access to meet the
needs of Veterans residing in Alaska. These have included not only
clinical services but additional sites of care. AVHAS has maintained a
high performance rating in quality of care, access standards, patient
satisfaction, and employee satisfaction. Senator Begich, thank you
again for the opportunity to testify at this hearing.
Addendum
Senator Begich. Thank you very much. Our last person on
this panel is Verdie Bowen who is the administrator, Office of
Veterans Affairs, Department of Military and Veterans Affairs
for the State of Alaska. Good to see you again, Verdie.
STATEMENT OF VERDIE BOWEN, ADMINISTRATOR, OFFICE OF VETERANS
AFFAIRS, DEPARTMENT OF MILITARY AND VETERANS AFFAIRS FOR THE
STATE OF ALASKA
Mr. Bowen. Thank you, Senator, for inviting me here. I have
a couple of things that I'd like to address today and the first
one is the prescription drug coverage that we have at the
Pioneer Homes; and the next area I'd like to highlight is the
GI Bill and some of the issues that we have experienced in the
State.
First of all, I want to really let you know that your
staff, especially C.W. Floyd, have been a world of help on most
of the stuff that we have done. He's sitting back there
smiling, but it's actually the truth. When I----
Senator Begich. Don't get his head to grow too large.
Mr. Bowen. No, I won't. When I was appointed to this
position in May of last year, I think I was in the office about
20 hours before my first phone call came in about the denial of
prescription drugs--VA prescription drugs--to members within
our VA home. And it specifically dealt with veterans, which at
that time we had 14 veterans in the homes that the Pioneer Home
had refused to administer the medications that came to them
free. They wanted veterans to purchase the medications through
the pharmacy. It took probably about 3 weeks to determine that
the reason they had stepped back in time was because someone
had unearthed a policy that was covered with dust in the corner
which said that they could not administer medications to those
people that are unable to administer medications themselves
from pharmacies outside of the Pioneer Home. I thought that
this would be an easy fix, that we should be able to just sit
down and open up the bottles and hand the pills out. But,
apparently, you know, it shows you how inept I am at
administering medications, especially in this case.
We sat down and had a roundtable before the end of that
month and I thought we had a work-around where we were bringing
in a part-time physician assistant to help with these issues,
and that lasted about 2 weeks. Then I went back through the
process and I--at that time, the unique experience that I had
was that I discovered that we had 60 representatives in the
State of Alaska. At that time, I didn't know, but before that
time they had always spoken to me.
I had also spoken to probably 20 retired State
representatives. The last person that called me was Mayor
George Wuerch to let me know that his neighbor was involved
with this process as well. But the unique thing about this was
it fell under the Department of Social Services. Next, I spoke
to the commissioner of social services, then we had a complete
roundtable. Bill Hogan, who was outstanding, stepped in and put
in a large fix. He wrote an Administrative Order to fix the law
so that they could receive their medications.
Currently, as I speak today, I am glad to announce that the
State House has taken ownership of this and it's passed into
State law so that this will never happen again. And what is
going to occur for our veterans in the home is that if this
ever does come into effect, then the State itself will take on
the cost of the medications, not the patient. But in this
process, we also uncovered the fact that our patients that were
in the homes that fell under Indian Health Care Services that
were receiving medications would also be denied theirs as well
if they were incapacitated. So this law will also fix that.
Currently, like I said, it is through both committees in
the House and Senate and it's now in the Finance Committee to
get its final review. To me it took too long, really. It gives
you a point to understand that when you have State and Federal
agencies involved, there's a lot of bureaucratic nightmares
that you have to follow through to try to fix. A problem so
simple as that should have taken just a few hours; instead, it
took probably about 7 months. So it gives you an idea that some
of the problems that we're facing within the VA system itself
are virtually that same kind of nightmare and ownership as you
trace each one of the problems back to the end of their
programs.
The next thing I'd like to talk about is the new GI Bill in
its current status. I'm a firm believer that if you're in
Muskogee, OK, today and you're unemployed it's because you
choose to be. General Shinseki has done such a wonderful job of
fixing some of the issues that we have with the Post-9/11 GI
Bill. The first thing I really want to point out about the
Post-9/11 GI Bill, which is probably the greatest thing that
has occurred for veterans since the GI Bill that was introduced
after World War II, are the values that the veteran receives,
especially here in the State of Alaska--and I'll give you some
examples.
Here in Alaska, a veteran will receive up to $159 per
credit hour, which means if they go to UAA, it's free. They
receive $13,429 in fees that are covered. That allows them to
go to the aeronautical school at UAA and it covers all of their
fees. They get $1,000 each year for their books, for their fees
for their books. And this is something that's unique that a lot
of people won't point out, but in rural Alaska where you have
less than six people per square mile, this program will give
you $500 to fly into the schools. Also in the State of Alaska,
we're blessed to have 16 of our universities that are located
here to be part of the Yellow Ribbon Program, and what that
means is that if their tuition is higher than the $159, then
they will utilize the Yellow Ribbon Program to cover that
extended cost. Who is covered under this cost is any person
that has accomplished 36 months past 9/11.
This here, like I said, is an outstanding program. But, you
know, there are some issues that we have that need to be
addressed. Robert brought these up and this is something that
you won't find in my memos, but he did bring up something about
voc rehab. Voc rehab is probably half of----
[Microphone feedback]
Senator Begich. There we go.
Mr. Bowen. Maybe that's not a good sign. Voc rehab
virtually is about half of the payment to the veteran. When
you're dealing with your monthly stipend, if I had my book--I
bet you Miss B has her book that will tell you that voc rehab
is probably around six to eight hundred dollars a month stipend
that they receive, versus the amount that they receive through
the Post-9/11 GI Bill. You see, under the Post-9/11 GI Bill,
they receive $1,836 for their monthly living stipend. Under the
voc rehab program, I, too, was under the impression that voc
rehab would provide them the services that they need--the
extended services that they need--to help them get through the
programs if they have special needs.
I spoke to the guidance counselor at UAA, Mr. Floyd,
several months back and we discussed some of the needs and
resources available for disabled veterans. He was under the
same understanding--that the voc rehab program could provide
these guys special assistance. We have disabled veterans
currently enrolled under the Post-9/11 program that need
special counseling, that need special tutoring and things like
that, which are not provided under the new Post-9/11 GI Bill.
So, this is probably something that we need to look into,
bringing the benefit levels under the voc rehab program up to
the level that Post-9/11 is currently.
This concludes my testimony and I want to thank you for
having me speak before you.
Senator Begich. Thank you very much. Our time is running
short, but I want to walk through a couple things. I'll just
start first with Ray. We've had lots of opportunities already,
so I'll just ask you a couple of quick things if I could.
Mr. Jefferson. Yes, sir.
Senator Begich. I thought this was interesting on the young
student vets. Can you expand on what that is within the
university, not only for me to understand, but also Robert is
still here and others to kind of hear--explain that to us a
little bit more.
Mr. Jefferson. Sure. So, as you know, sir, there's a
variety of veterans service organizations. Some of them have,
you know, a long history: American Legion, Vietnam Veterans, et
cetera.
Senator Begich. Sure.
Mr. Jefferson. One of the newer ones is Student Veterans of
America and I would encourage people to go to the Web site. It
is an organization created by and created for this youngest
generation of veterans from OEF/OIF. What they really focus on
is helping this young generation of veterans take full
advantage of the new GI Bill, but also I would say to deal with
all of the potential challenges of going----
Senator Begich. Like a mentor to----
Mr. Jefferson. Well, sir, a few things. You can find a
mentor, you can--they will help you--they are on many campuses.
So, for example, the way it works is if Robert--if there's a
Student Veterans of America coordinator of the University of
Alaska campus, you contact this person. And it was exactly what
he said. You know, I want to call someone and say, hey, I'm
here; I came from OEF/OIF, you know, how do I transition here?
How do I get help with the courses? How do I just navigate this
huge campus system. And, by the way, when I lost my fingers to
a grenade, I went through the same process at the University of
Hawaii, and it takes a while to adjust to being in a room with
folks who maybe are a few years younger than you who have come
straight from high school, you know, and you've been doing all
these other things in the military.
So Student Veterans of America help with that transition,
that translation, to make sure that whatever needs you have are
addressed and they serve as a bridge between the new GI Bill
and the veteran and the resources and programs of that
university. So, I would highly encourage folks to take
advantage of it to connect. I don't know for a fact that
they're in Alaska. I believe they're in all 50 States. I would
say they're very dynamic, they're growing, and they're very
action-oriented.
Senator Begich. Very good. Now, that's something that we
can obviously, from our office, too, follow up to see if Alaska
has----
Mr. Jefferson. Yes, sir.
Senator Begich [continuing]. Someone at our university.
Mr. Jefferson. And we can connect. We have a great
relationship with the president, sir, so we can make that
connection this week.
Senator Begich. Fantastic. That'd be great. The second
thing real quick, if I can, you mentioned the American Vets at
Work.
Mr. Jefferson. Yes, sir. American Heroes at Work.
Senator Begich. American Heroes at Work. Can you, for the
audience that's here and because I didn't ask you this
yesterday, just describe a little bit about how that works.
Mr. Jefferson. Absolutely. We had a chance, sir, to dialog
on that yesterday.
Senator Begich. Right.
Mr. Jefferson. One of the programs that we have is designed
to help veterans with PTS and/or TBI and/or PTSD find
meaningful employment. What we found is the accommodations that
these veterans want and need tend to be very normal, easy
accommodations, but the employers themselves just need to be
educated. So this program connects a veteran with an employer
and educates the employer on the accommodations.
And here is what's so interesting about the accommodations.
Many of them are things such as: I want to be able to get up
and walk around for, you know, 10, 15 minutes a few times a
day; please don't walk up behind a veteran, you know, and grab
him or her from behind or on his shoulders; please don't place
them in areas where there's lots of loud, unexpected noises or
very bright lights. When employers hear what the accommodations
are, it's the same thing anyone would want a great percentage
of the time.
The other thing I'd say is we brought the employers and the
veterans together and they rave about this program. It's called
America's Heroes at Work. I will connect with your office, sir,
so you will have access to that. Robert, if you're still here,
I'd love to connect you with our director for this program and
also anyone else here in the building.
And, again, our access point directly is Tom Hall. Tom,
would you stand one more time, please. You're getting some good
exercise with me. It's a great program, sir. We just need to
raise awareness of it. I want to do a lot more with it.
Senator Begich. That's great. I mean, you told me about it
a little bit and that's why I wanted you to kind of expand a
little bit here. But, again, thank you for that. That's a great
access point and I know people will take advantage of it.
Robert is here and he's patiently watching and listening. So
thank you.
Mr. Jefferson. All right.
Senator Begich. Thank you, Ron. Now Belinda, I promised you
I wouldn't have the same questions as yesterday. One thing that
intrigued me was an item I think you added today and that's of
a national brokering process review you're doing. You've done a
pretty significant review on the Anchorage Regional Office in a
variety of areas, but on a national level you're taking a look
at brokering as a whole.
I know Linda B. brought up a lot of issues about brokering.
Is that what you're looking at, the whole system and trying to
figure out what's good, what's bad? Is that--it will go on
automatically [referring to the microphone]. Yeah.
Ms. Finn. Yes. We're looking at brokering from a number of
aspects. One of them is to try to determine how much the
brokering process improves the timeliness of claims processing.
We would also--I'm not sure whether we've been planning to look
at error rates or appeal rates, so I've been making notes on
that to possibly add.
Senator Begich. Yeah. Why I wanted to ask this question is
because what I hear from a lot of folks, at least so far in
this process we've been going through in the last few days, is
timeliness is not as significant coming from the broker, and
it's less timely if they get it and then there's an error on
it, which is like they're repeating the workload.
To me, the great measurement will be--I'll use the example
I was given that San Diego sends ratings back and yet of those
53 to 60 percent, I forget the exact number, are being turned
right over into being approved, yet 9 out of 10 are being
appealed. And then you compare that to Salt Lake and Seattle
where that's not occurring. Why is that?
You know, that's an interesting question. Is that
worthwhile to look--I mean I'm not into the appeal process, I
don't understand all the details, but it sure seems on the
surface that would be worth looking at.
Ms. Finn. I would agree, it does sound like it's
worthwhile. I will mention, about a year ago we looked at the
National Quality Assurance Program in VBA and one of the things
we noted was that brokered claims were not included in the
quality reviews and not included in the national quality rates.
Senator Begich. Really?
Ms. Finn. Yes. And so we recommended that VBA establish a
process to review those brokered claims for accuracy and
include that in the rate. They agreed with that recommendation,
but I don't know right this second what action they have taken
to make that happen.
Senator Begich. Could you--and maybe someone else might
have a comment on that--but could you at least at a minimum, if
we don't hear the answer to that when I move through the panel
here, get us an answer? See what has happened from that
recommendation from a year ago.
Ms. Finn. Yes, sir. I will do that.
[The information requested during the hearing follows:]
Senator Begich. I think that would be very interesting. The
second question is in regards to, you said, the challenges in
the network. Is that the communication network? I'm trying to
think of how you described that, and I'm now reverting back to
the Anchorage regional office. You talked about the challenges
in the network. Can you----
Ms. Finn. Yes, sir. It's the challenges in the network
access to--I'm not sure whether it's over the Internet or just
the VA network.
Senator Begich. OK.
Ms. Finn. But the VBA applications that are needed to
process claims, many of these are run obviously not out of
Anchorage, but in other locations. And if the folks working in
Anchorage couldn't access the applications, it's very hard to
do the job.
Senator Begich. So it may not be as computerized, in
essence, is what you're saying?
Ms. Finn. I believe it was problems with the network
bandwidth in Anchorage.
Senator Begich. Right. And, C.W., he's kind of like Radar
O'Riley on M.A.S.H. C.W. hands me the word ``bandwidth.''
Ms. Finn. Yes.
Senator Begich. So I have a feeling that may be the issue.
Is that part of it?
Mr. Arronte. Yes, that--when we were on site, correct, it's
bandwidth.
Senator Begich. OK.
Mr. Arronte. It was a T1 line and I think the director had
indicated that there were going to be three or four additional
T1 lines brought in. It should help that connectivity problem.
Senator Begich. Has that occurred, Mark?
Mr. Bilosz. Yes, I think there were three T1 lines that
were added and it has improved things dramatically. And we're
also expecting when we move into the new building in May it
will even be better. So it has improved.
Senator Begich. Great. I know in the simple world I live
in, my mother-in-law just went from dial-up, if you can believe
this, to cable and you can only imagine what that's like. You
know, she can actually get a photo in seconds rather than
hours. That's interesting.
That's what I was trying to understand. I wasn't real clear
on that, but now it makes a lot of sense.
And the last question is you mentioned accessing computer
issues. Is that the same thing? You had mentioned accessing
computer issues. Is that similar to----
Ms. Finn. Yes, accessing the applications.
Senator Begich. It's all the same.
Ms. Finn. It requires bandwidth.
Senator Begich. OK. Same thing. The bandwidth isn't strong
enough, so therefore the applications weren't as robust as they
could have been. Is that a fair----
Ms. Finn. Yes, they couldn't access them.
Senator Begich. Very good. Well, again, on the national
brokering, it is exciting that you're doing that and I think
this hearing, hopefully, brought some ideas to the table that
we can incorporate. And please let us know, is that
progressive? It sounds like, you know, several months from now
you might be down the path on it, but let us know how that
progresses. I think the Committee would be very interested. As
you know, appeals have been an issue that percolates at the
Committee level on a regular basis.
Ms. Finn. Yes, sir. We will. As a matter of fact, I'm just
going to take a second to say----
Senator Begich. Sure.
Ms. Finn [continuing]. I really appreciate the opportunity
to be here and out in the field and here with the issues from
veterans. We work real hard to make sure that when we look at
an issue, we answer the questions that are important, you know,
and the issues that need to be fixed. So this has been a great
opportunity for me and I've been taking a lot of notes.
Senator Begich. Great. Thank you very much. Thanks to you
and your team. Mark, again, thank you and your team that's here
with you. I want to ask you, and I know I asked you this in
Anchorage, but I want to make sure the Fairbanks folks also
hear this. And that is, the issues that were brought up in the
report and the items of concern, there is no disagreement to
fix those problems; you agreed with the recommendations. Is
that a fair statement?
Mr. Bilosz. Yes.
Senator Begich. And that you're taking active steps to move
forward to--as you identified in your written testimony in more
detail than your verbal, but you basically are taking steps to
get this process cleaned up and moving in the right direction.
Is that a----
Mr. Bilosz. Yes, we----
Senator Begich. I don't want to put words in your mouth. I
just want to make sure the Fairbanks folks hear exactly what we
talked about in Anchorage also.
Mr. Bilosz. Yes. We implemented action items to address all
of the issues and we're monitoring those, and they are having a
positive impact on our performance.
Senator Begich. We agreed yesterday when I asked Belinda
the question on, you know, when their next site review might
be, she had indicated that since they have more resources, they
can go from 5-year review cycles down to 3 years, which is
great. And what I have asked is that you report back to me and
the Committee by June the progress that you have had in all
these metrics of measurement. That is still a commitment that
you're comfortable with making?
Mr. Bilosz. Yes, sir, I had a note.
[The information requested during the hearing follows:]
Senator Begich. OK. Good. Again, that was for the Fairbanks
audience to know that, you know, sometimes we have these great
reports and they're not--you know, in a lot of ways they're
criticisms, but they're also about how to improve the system
because no matter what we do in life, there's always room for
improvement. And what happens sometimes is those reports kind
of move on and then people will do their own work, and the next
thing you know the report isn't reviewed by the public and they
then call us and say, well, what happened? And then we say,
good question, and then we call and they say, well, geez,
there's--of those 13 items, seven of them got implemented, we
don't know why the other six didn't.
So this process of bringing it back in June will allow us a
chance to publicly say here's a success or here are areas that
just aren't working out as well as we thought. Is that fair?
Mr. Bilosz. Fair--very much so, yeah.
Senator Begich. Very good. Again, I want to thank you for
the willingness to kind of step up to it. Rating qualities is,
I think, the phrase you used. How do you measure rating quality
or rating qualities? I may not have written that down exactly
the way you said it, but I remember that phrase.
Mr. Bilosz. Yeah. We have a National Quality Review program
that's located in Nashville and every month a series of rating
decisions gets sent to that facility.
Senator Begich. Is it a random selection of those?
Mr. Bilosz. It's a random selection. Every regional office
in the country sends files there.
Senator Begich. So they send them off to this location?
Mr. Bilosz. Yes, and they have a group of folks there with
experience review the files and determine if there are errors
or if there aren't errors. Some errors, just as the IG found in
their inspection, some errors affect payment, others are just
administrative type of errors. But they report that back on a
monthly basis to the regional office and in my office, for
example, we use that data to train people to make sure that
those mistakes aren't repeated.
Senator Begich. I know you and I talked about this
yesterday. In your office, and I didn't see it, but you pointed
it out to me, and that is you keep a wall chart basically to
make sure people understand what the measurements are that
we're measuring for success.
Mr. Bilosz. Yes. You know, it's vital that we are providing
quality service to veterans, timely service to veterans, and if
our employees don't know what that is, then they can't perform
to the level that they need to. So we update that daily with
our performance measures and it allows our employees to know
how what they do day in and day out affects the veterans in the
State of Alaska.
Senator Begich. Very good. Dr. Pendergrass, I'm going to
move to you, if I can. I appreciate the shopping list of items
you're working on, and it is impressive. One thing I'd love to
get if I could--again this is very parochial, obviously, it's
Alaska and I'm more interested in Alaska issues and what's good
for Alaska veterans--but I think this would be also important
for many of my colleagues on the Committee who are from rural
States.
I'd be curious if you could give us, not right now, but
later, more of a written report on the several demonstration
projects we have with you, especially with the Tribal Health
Consortium, with Maniilaq and other organizations we're doing
work with. Because one of the things that I am hopeful for is
that we will be able to prove that a veteran in a small village
can go to an Indian Health Services facility, get the services
they need rather than having to fly or be transported all the
way across to maybe Fairbanks or to Anchorage or to Seattle or
wherever else they might have to be sent. There might be a
facility right next door to their home that is run by Indian
Health Services, paid by the same taxpayers as the VA, and
available.
A good example of that is in Nome. The Indian Health
Service will be building $170 million health care facility,
brand new, starting this spring. It will be a state-of-the-art
Indian Health Service provider. It would be a shame to have a
veteran who lives literally right there to be forced to go to
another place because we don't have arrangements with IHS. And
I know you are using Alaska as kind of a pilot. As Ray and I
talked today, if you can do it in Alaska, you can do it
anywhere. That's our attitude here.
So I'd be curious, if you'd give a report to the Committee
on how these demonstration projects are working and how they've
been implemented. Because one of the complaints I've heard is
it's taking a while to get through the bureaucracy which I know
is because of the stovepiping that goes on, and we want to make
sure these move forward if they are successful. Do you have any
quick comment?
Dr. Pendergrass. Well, in my--I have a briefing document
from last week that we didn't present, but----
Senator Begich. Because of a little snow----
Dr. Pendergrass [continuing]. I do have it. I do have an
expanded version----
Senator Begich. Excellent.
Dr. Pendergrass [continuing]. Of what the rural initiatives
are. The challenge for us is both access and efficiency of the
VA system and balancing that with VA's--it's similar to an HMO
in that we have very specific internal services and
capabilities that we need to use first. And sometimes that
requires--and sometimes we are prohibited from providing
services outside of our system.
[The information requested during the hearing follows:]
Senator Begich. That's only a function of the laws that
people like myself can pass.
Dr. Pendergrass. Yes, that's right.
Senator Begich. And so, I guess, here's why. I think you
will find in Alaska, those who are familiar with our Indian
Health Services here, it is a robust and very successful
program. It's run by Tribal Consortium.
Dr. Pendergrass. Right.
Senator Begich. It is very unique in its delivery system.
There's a program in our facility in Anchorage called Nuk which
is a holistic medicine program. It has reduced emergency care
injury by 68 percent, a great statistical data. And because it
provides such good quality service, they get incredible reviews
across the country. So, it just seems that there's an
opportunity here.
So, I would say to you don't limit what the potential is if
there's a law that says you can't cross the line because the
real end product here is about service to the veteran.
Dr. Pendergrass. Right. And I think the task force group
will be able to----
Senator Begich. Help us.
Dr. Pendergrass [continuing]. Sort that out because the
pilot is a pilot, and it would require some legislative
changes.
[Update to the requested information, dated June 2010,
follows:]
Senator Begich. Exactly. Well, I'll look forward to that.
One last thing, just a quick question on mental health service
professionals. What are you finding in recruitment in a sense
of trying to get folks to be in that service? Because what I
hear, it's a problem.
Dr. Pendergrass. It's----
Senator Begich. In all areas, not just----
Dr. Pendergrass. It is a major problem. We have not been
able to entice the professionals up here full-time. We're using
opportunities for traveling up for short periods of time. We
did that to do some of the mental health C&P exams.
Senator Begich. Is it----
Dr. Pendergrass. We're using locums.
Senator Begich. Is it--and, you know, you can be very frank
here. Is it because they have to go to Alaska or is it because
of the cost, or that the income is not as great as they could
get doing it elsewhere, or it's a family--what's the draw here?
What's the----
Dr. Pendergrass. Well, it's a number of factors. First of
all, the supply of professionals----
Senator Begich. Is already small?
Dr. Pendergrass [continuing]. Is small. The compensation
that working for a private or even a State facility--state
salary is different than private sector, and so the salary is
an issue.
Senator Begich. Not competitive.
Dr. Pendergrass. It's not competitive. And then you're in a
very rural, highly rural, medically underserved area which is a
problem----
Senator Begich. It's tough.
Dr. Pendergrass [continuing]. Across a number of States,
but Alaska especially.
Senator Begich. Brian Rogers just walked in. He's our
chancellor for the university here. Where did he go? Oh, there
you are, over there. I point that out only because I think what
we have to figure out is what we can do in the education arena
to try to entice people, one, to enter the field at the front
end because if we can create the supply then at least some who
still don't want to, you have a larger supply to work from.
This is something that I know I'll see the Board of Regents
tonight at a reception and maybe it's an idea which we can have
more discussion.
Dr. Pendergrass. The VA has an ability to help offset some
of the student loans as part of the employment. It may be
additional incentive to that, working in a rural area.
Senator Begich. Very good. That's a good point. I again
apologize because of the timing. We're real close, but Willie,
did you have some additional comments? [Gesturing to the
microphone.] That's about as far as it will go; so you just
speak and you'll be OK.
Mr. Clark. OK. All right. Good. Thank you, sir, for
allowing me the opportunity to speak.
Senator Begich. Sure.
Mr. Clark. I am Willie Clark. I'm in charge of VA Benefits
Operations for the Western U.S., which includes Mr. Bilosz'
office and now Mr. Kelley's office here in Anchorage.
Three things quickly I'd like to bring up. You talked about
the--or asked a question about brokering quality.
Senator Begich. Yes.
Mr. Clark. We started that last year. So as a result of the
IG report, we are measuring quality on our brokered cases.
Senator Begich. Excellent. Good.
Mr. Clark. The second thing is the San Diego office that
Linda brought up----
Senator Begich. Yes.
Mr. Clark. The San Diego office, believe it or not, is one
of our best performing stations in VBA. This is the first that
I have heard of that. I asked Mr. Bilosz and Mr. Kelley.
Senator Begich. Well----
Mr. Clark. They had not heard anything from Linda. So what
we're going to do----
Senator Begich. You have today.
Mr. Clark. Well, we're certainly going to talk to her about
that and we will address any concerns that she has.
Senator Begich. Will you share that with the Committee?
Mr. Clark. Yes, sir. We'll certainly do that. Last, we
talked about the call center in Phoenix.
Senator Begich. Yes.
Mr. Clark. At all of our call centers we have State
benefits books that speaks to tax exemption letters, a license,
and the full gambit for each State. So I--that's another one
that surprises me. I will certainly get with the Phoenix
office, that's under my responsibility as well, and make sure
that they are trained and providing those letters.
Senator Begich. Let me ask you quickly, on the books that
you provide to those trainers, are those--before the trainers
utilize them for those States like in Alaska, are people like
Linda at that level reviewing them to give you--to make sure--
because they--you know, sometimes what we do is--and I had this
actually with the VA recently in a Committee hearing. They were
saying, well, we notify veterans, we put the legal notice in
the paper and so forth. And I said, well----
Mr. Clark. Yes, sir.
Senator Begich [continuing]. You know, no one pays
attention----
Mr. Clark. Yes, sir.
Senator Begich. No offense. I mean, my father-in-law is a
retired colonel.
Mr. Clark. I understand, I understand.
Senator Begich. You know, he's not looking in the want ads
for classifieds by the VA, he's looking, you know, elsewhere.
So do you kind of reverse it back and say, you know what,
here's the book, let's go back to the people on the front line
in Alaska. Have them look at this; how would you use it? Is
there something missing here? Or even how it's laid out to make
sure it's readily usable. Do you do that?
Mr. Clark. Well, we have certain people that we do it with.
I don't know at Linda's level what happens.
Senator Begich. OK.
Mr. Clark. But, certainly, in this case because, again, all
States are different.
Senator Begich. Absolutely, oh, yeah.
Mr. Clark. These call centers, they're set up to get a call
from any State, so they must know. And all they do is open the
book to that particular index that speaks to that State----
Senator Begich. Right.
Mr. Clark [continuing]. And then they are to give out those
letters. But I will check that to be sure that in all cases,
but specifically Alaska, that we have the correct information.
[The information requested during the hearing follows:]
Senator Begich. Very good. And I'm just a big fan of
encouraging because we have--it's no criticism to the VA; it's
a criticism to kind of our bureaucracy of how we do business.
Sometimes we get closed in and we forget that the person on the
line may get that exact same index and say, you know what, you
know, they're never going to find it the way you have it listed
here. Because they see it from a different perspective of the
caller who is going to make that call.
So I would just encourage, as I do with all agencies, you
know, I do it through the Commerce and others that this is a
technique I used when I was mayor and it made a big difference
in usability of the documentation.
Mr. Clark. OK, sir.
Senator Begich. Just a little thought there.
Mr. Clark. Yes, sir. We'll do that.
Senator Begich. The only thing I'll say and end here,
which, Verdie, I have two parts. One is to say thank you for
the work I know you did along with C.W. on the ATG, making sure
those individuals received the benefit that they justly deserve
that was taken away for a short period of time.
And I want to thank you for the hard work you did to kind
of plow through it, find these folks, find the recipients, find
their dependents. I know between you and the work you did out
of your office, through our office wit C.W. and some others
that were really helpful there. I just want to say thank you
for doing that.
Mr. Bowen. Thank you, sir.
Senator Begich. And you laid out some good thoughts here.
So I'm going to not burn up time here, but I do want to have
some follow-up on the voc rehab which we'll do through our
office and your office.
Mr. Bowen. Yes. As a matter of fact, sir, I wrote myself a
note here that my voc rehab person will send a memo over to
C.W. and compare the two programs.
Senator Begich. That would be great, so we can kind of see
what we need to do to improve on it.
Mr. Bowen. Yes.
Senator Begich. Let me end there. Again, to the panel,
thank you all very much. As we try to--as I attempted to do in
the last 2 days in these hearings is to bring out ideas and
not--you know, we can spend a lot of time pounding on each
other, which is not hard to do in the world we live in it seems
today; but it's better to find those ideas, see where we can
improve, recognize criticism is not a negative, but it's a
positive to improve a system that's delivering service to
thousands, and in this case millions, around the country.
And so I thank you all for your public service. Thank you
for your willingness to step up and say here's what we can do
to make it better.
Also I think an example that, Belinda, you laid out which I
really appreciate that you like these field hearings because it
gives you a little food for thought and that's why I like them:
to get out and hear what people have to say. So thank you all
for being here.
Thank you to the audience that is here. We are going to go
next door? Right through that door. We're going to do a press
event in regards to the folks that are signing on to support
our Guard and their employment. It's just another opportunity
to highlight the great work that our business community is
doing.
So, again, thank you all very much. This meeting is
adjourned.
A P P E N D I X
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Statement Submitted at Hearing by William ``Ladd'' McBride,
Senior Chief Petty Officer, USNR (Ret.)
Statement Submitted at Hearing by Charlotte M. Davis,
Vietnam-era Veteran
Statement Submitted at Hearing by William McDonald, Colonel, USAF
(Ret.)
Statement Submitted at Hearing by Hugh Twig Tordoff