[Senate Hearing 114-212]
[From the U.S. Government Publishing Office]
S. Hrg. 114-212
HEARING ON PENDING HEALTH AND BENEFITS LEGISLATION
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HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED FOURTEENTH CONGRESS
FIRST SESSION
__________
SEPTEMBER 16, 2015
__________
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COMMITTEE ON VETERANS' AFFAIRS
Johnny Isakson, Georgia, Chairman
Jerry Moran, Kansas Richard Blumenthal, Connecticut,
John Boozman, Arkansas Ranking Member
Dean Heller, Nevada Patty Murray, Washington
Bill Cassidy, Louisiana Bernard Sanders, (I) Vermont
Mike Rounds, South Dakota Sherrod Brown, Ohio
Thom Tillis, North Carolina Jon Tester, Montana
Dan Sullivan, Alaska Mazie K. Hirono, Hawaii
Joe Manchin III, West Virginia
Tom Bowman, Staff Director
John Kruse, Democratic Staff Director
(II)
C O N T E N T S
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September 16, 2015
SENATORS
Page
Isakson, Hon. Johnny, Chairman, U.S. Senator from Georgia........ 1
Blumenthal, Hon. Richard, Ranking Member, U.S. Senator from
Connecticut.................................................... 1
Sullivan, Hon. Dan, U.S. Senator from Alaska..................... 3
Brown, Hon. Sherrod, U.S. Senator from Ohio...................... 26
Boozman, Hon. John, U.S. Senator from Arkansas................... 27
Manchin, Hon. Joe, III, U.S. Senator from West Virginia.......... 30
Rounds, Hon. Mike, U.S. Senator from South Dakota................ 35
Hirono, Hon. Mazie K., U.S. Senator from Hawaii.................. 38
Letters for the record
Tillis, Hon. Thom, U.S. Senator from North Carolina.............. 42
WITNESSES
Lynch, M.D., Thomas, Assistant Deputy Under Secretary for Health
Clinical Operations, Veterans Health Administration, U.S.
Department of Veterans Affairs; accompanied by Robert Worley,
Director of Education Service, Veterans Benefits
Administration; Cathy Mitrano, Deputy Assistant Secretary for
Office of Resource Management, Office of Human Resources and
Administration; Susan Blauert, Deputy Assistant General
Counsel, Office of General Counsel............................. 4
Prepared statement........................................... 5
Response to request arising during the hearing by:...........
Hon. John Boozman.......................................... 28
Hon. Joe Manchin III
Hon. Mike Rounds........................................... 37
Response to posthearing questions submitted by:
Hon. Johnny Isakson........................................ 45
Hon. Dean Heller........................................... 46
Wescott, Joseph W., II, Legislative Director, National
Association of State Approving Agencies........................ 47
Prepared statement........................................... 49
Butler, Roscoe G., Deputy Director for Health Care, The American
Legion......................................................... 52
Prepared statement........................................... 53
Morosky, Aleks, Deputy Director, National Legislative Service,
Veterans of Foreign Wars....................................... 60
Prepared statement........................................... 61
Kettl, Donald F., Professor, School of Public Policy, University
of Maryland.................................................... 66
Prepared statement........................................... 68
APPENDIX
Moran, Hon. Jerry, U.S. Senator from Kansas; prepared statement.. 83
American Federation of Government Employees (AFGE), AFL-CIO;
prepared statement............................................. 83
Moten, Beth, Legislative and Political Director, American
Federation of Government Employees (AFGE), AFL-CIO; prepared
statement...................................................... 86
Aircraft Owners and Pilots Association, General Aviation
Manufacturers Association, Helicopter Association
International, National Association of State Aviation
Officials, National Business Aviation Association; joint
prepared statement............................................. 87
Zumatto, Diane M., National Legislative Director, AMVETS;
prepared statement............................................. 90
American Speech-Language-Hearing Association (ASHA), Academy of
Doctors of Audiology (ADA), and American Academy of Audiology
(AAA); prepared statement...................................... 92
Children of Vietnam Veterans Health Alliance; prepared statement. 96
Concerned Veterans for America; prepared statement............... 96
Atizado, Adrian M., Deputy National Legislative Director,
Disabled American Veterans (DAV); prepared statement........... 98
Stonecipher, John L., President and CEO, Guidance Aviation;
prepared statement............................................. 104
Elizabeth Welke, J.D., Legislative Associate, Iraq and
Afghanistan Veterans of America (IAVA); prepared statement..... 106
International Hearing Society; prepared statement................ 107
Warthen, Travis, Vice President, Leading Edge Aviation, Inc.;
prepared statement............................................. 110
Military Officers Association of America (MOAA); prepared
statement...................................................... 112
U.S. Office of Personnel Management (OPM); prepared statement.... 115
Stier, Max, President and CEO, Partnership for Public Service;
prepared statement............................................. 122
Paralyzed Veterans of America; prepared statement................ 125
Bonosaro, Carol A., President, Senior Executives Association;
letter......................................................... 128
Wyatt, Dr. Scott, President, Southern Utah University; prepared
statement...................................................... 130
Hubbard, William, Vice President of Government Affairs, Student
Veterans of America (SVA); prepared statement.................. 133
Saunders, Michael, National Deputy Legislative Director, The
Retired Enlisted Association; prepared statement............... 138
Grundmann, Susan Tsui, Chairman, U.S. Merit Systems Protection
Board; prepared statement...................................... 139
Mower, Michael, Chief Operating Officer, Upper Limit Aviation;
prepared statement............................................. 148
Reid, Lois, Chief Executive Officer, Upper Limit Aviation; letter 150
Veterans Education Success (VES); prepared statement............. 154
HEARING ON PENDING HEALTH AND BENEFITS LEGISLATION
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WEDNESDAY, SEPTEMBER 16, 2015
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 2:32 p.m., in
room 418, Russell Senate Office Building, Hon. Johnny Isakson,
Chairman of the Committee, presiding.
Present: Senators Isakson, Boozman, Heller, Cassidy,
Rounds, Tillis, Sullivan, Blumenthal, Brown, Tester, Hirono,
and Manchin.
OPENING STATEMENT OF HON. JOHNNY ISAKSON,
CHAIRMAN, U.S. SENATOR FROM GEORGIA
Chairman Isakson. This hearing of the Senate Veterans'
Affairs Committee will come to order. I want to thank the
Members for being here and Ranking Member Blumenthal for his
attendance and all of you in the audience for your attendance.
We have a jam-packed agenda where we are going to discuss
legislation that is being proposed by Members of the Committee
and other Members of the Congress, and we have two panels. The
first panel will be members of the Veterans Administration
testifying on the agenda. We will do Q&A after that period, and
then we will have panel two, where we have The American Legion,
Veterans of Foreign Wars, a public policy person from the
University of Maryland, and the National Association of State
Approving Agencies will be testifying, as well. So, we are
going to have a busy, busy day.
Now, I would like to introduce Ranking Member Blumenthal
for any opening statement he might want to make.
STATEMENT OF HON. RICHARD BLUMENTHAL,
RANKING MEMBER, U.S. SENATOR FROM CONNECTICUT
Senator Blumenthal. Thank you. Thanks very much, Mr.
Chairman. Thanks to everyone who is participating and attending
this hearing and to my colleagues.
We do have a packed agenda, a lot of bills reflecting the
many needs that our veterans have, and most of them are
bipartisan bills, again, reflecting the work of this Committee,
its practice of leaving party differences at the door and
working together to meet the needs of our veterans. It is one
of the great things about this Committee, and I want to thank
the Chairman for continuing that tradition and giving me and
others the opportunity to introduce bills that are important to
our veterans.
First, the Career Ready Student Veterans Act, which I have
introduced proudly with Senator Tillis and many other Senate
colleagues, would make sure that our GI benefits are
appropriate, applicable, and honestly administered. Too many of
our veterans are misled into squandering those GI Bill benefits
as a result of the pitches and the ads that they see,
squandering them on worthless degrees, in fact, sometimes no
degrees at all, and that hurts not only them, but also us as
taxpayers, and this bill moves the GI Bill benefits system
toward a more effective and efficient method.
The Fry Scholarship Enhancement Act, which has been
introduced by Senator Brown and Senator Tillis, I thank both of
them and I am proud to be a cosponsor. Currently, Fry
Scholarship beneficiaries are barred from receiving
supplemental funding from the Yellow Ribbon Program, which is
used in cases where tuition fees at private schools exceed the
amounts provided by the Post-9/11 GI Bill. This measure will
help to remedy that gap and it will help people across the
country, including one of my constituents, Sarah Green, a
surviving spouse. She has two children who are using the Fry
Scholarship to attend college, and she was disappointed to
learn that her children, who lost their father while servicing
our country after 9/11, are not eligible for this program.
I want to thank Senator Hirono for the Veterans' Survivors
Claims Processing Automation Act, which will enable more
survivors to process their claims through the currently all-
too-lengthy, time consuming process for VA survivor benefits.
We cannot forget the families of the fallen, and I thank
Senator Hirono for her leadership on this issue.
Thank you to Senator Hirono, as well, for the Department of
Veterans Affairs Emergency Medical Staffing Recruitment and
Retention Act. Getting good people and making the system more
flexible for them to care for our veterans is critical.
Let me just close on this note, accountability. A lot of
the focus and work in this Committee has been on accountability
on the part of the VA. There is no question, in the wake of the
debacle that we saw in Phoenix and elsewhere--with inordinate
delays, cooked books, faulty recordkeeping, and worse--that
there is a need for accountability so as to enhance and sustain
the credibility of this great organization and the many, many,
many hard working, honest, incredibly dedicated people who work
there. We should be thanking them; many of them are veterans,
as well.
The bill that I have introduced, S. 1856, is a common sense
accountability measure that is tough and constitutional. Tough
and constitutional is what we need in an accountability
measure. We are going to hear from Don Kettl, our expert
witness on issues of public sector management, as to why this
bill provides, to quote him, ``a strong and sensible strategy
for solving many of the VA's most important problems.''
There is a lot of important work to do on this agenda. This
hearing is a sound and solid beginning. I thank my colleagues
for their dedication to this cause.
Thanks, Mr. Chairman.
Chairman Isakson. Thank you, Mr. Ranking Member.
Your comments cause me to say something for the public and
the press that is here and anyone else, the Members of the
Committee. You know, 3 months ago, we faced a major crisis when
Richard and I both got a press release where the VA said it was
going to be shutting down hospitals because they were running
out of funding and, in a way, indirectly sort of blamed us for
that. So, we had a ``come to vision'' meeting at the VA--the
four corners, the Chairman and Ranking Member of the House of
Representatives Committee and Richard and I. We met for, what
was it, I guess about 3 hours that morning, really talking
about how to solve problems rather than cause problems. We
ended up saving the Veterans Choice Program, not closing any
facility whatsoever, and having a far more accountable system
in terms of veterans' benefits for health care. I want to thank
Richard for his cooperation in getting us from point A to point
B in doing that, as well as the Chairman and Ranking Member of
the House.
I think in the weeks ahead, we are going to find a similar
resolution for the Denver situation. I am very hopeful that it
is going to happen. We are very close to that actually
happening, which will be two of the major problems that we
faced when we came in as the new Ranking Member and new
Chairman of this Committee, both of which are being resolved in
the interest of our veterans and in the best interest of the
country.
Hopefully, this hearing today on bills before us will be a
continuation of that type of a commitment, and I thank Richard
for his cooperation and work on that.
Senator Blumenthal. Thank you.
Chairman Isakson. What we are going to do, we are not going
to do opening statements by any other Members. You are welcome
to submit statements, or you can wait until the very end and
talk all you want, but----
[Laughter.]
Chairman Isakson [continuing]. We are going to hear from
the people who have given us their valuable time, who have come
here. Then, we are going to go by the ``early bird'' rule when
we go to questions and answers.
Our first panel is Thomas Lynch, M.D., Assistant Deputy
Under Secretary for Health Clinical Operations, Veterans Health
Administration, U.S. Department of Veterans Affairs, and that
is a mouthful. He will be accompanied by Robert Worley,
Director of Education Service, Cathy Mitrano, Deputy Assistant
Secretary for the Office of Resource Management, and Susan
Blauert, who is Deputy Assistant General Counsel, Office of
General Counsel at the Department of Veterans Affairs.
So, we will turn to you, Dr. Lynch. Make it as brief as you
can, but do not leave anything out. If you go over the 5-minute
timer and it blinks a little bit, just keep on talking until
you have gotten your point across.
STATEMENT OF THOMAS LYNCH, M.D., ASSISTANT DEPUTY UNDER
SECRETARY FOR HEALTH CLINICAL OPERATIONS, VETERANS HEALTH
ADMINISTRATION, U.S. DEPARTMENT OF VETERANS AFFAIRS;
ACCOMPANIED BY ROBERT WORLEY, DIRECTOR OF EDUCATIONAL SERVICE,
VETERANS BENEFITS ADMINISTRATION; CATHY MITRANO, DEPUTY
ASSISTANT SECRETARY FOR OFFICE OF RESOURCE MANAGEMENT, OFFICE
OF HUMAN RESOURCES AND ADMINISTRATION; AND SUSAN BLAUERT,
DEPUTY ASSISTANT GENERAL COUNSEL, OFFICE OF GENERAL COUNSEL
Dr. Lynch. Thank you, sir. Good afternoon, Mr. Chairman,
Ranking Member, and Members of the Committee. Thank you for
inviting us here today to present our views on several bills
that would affect VA benefits, programs, and services. As you
indicated, joining me today is Cathy Mitrano, Robert Worley,
and Susan Blauert.
Mr. Chairman, we appreciate the Committee's attention to
the many subjects important to the veterans we care for and we
support many of the bills you are considering today.
VA fully supports S. 1450, which would allow for increased
flexibility with physicians' schedules. This bill not only
helps with ensuring the continuity of hospital and emergency
care operations, but also with enhancing our recruitment and
retention of these vital medical professionals by accommodating
their variable work schedules.
VA sincerely appreciates Senator Hirono for sponsoring
S. 1451, as this is one of VA's legislative proposals last
year. VA recognizes the grief that a family has after the death
of a loved one, and any efforts that VA can take to improve the
notification process for a claim will ease anxiety in this time
of stress.
VA also supports S. 1460, which would authorize recipients
of the Marine Gunnery Sergeant John David Fry Scholarship to be
eligible for the Yellow Ribbon Program under the Post-9/11 GI
Bill. There are costs associated with this bill, as VA would
need to refine existing technology to calculate eligibility and
award payments.
VA supports the general intent of S. 1693, which would
expand emergency treatment for certain veterans who were unable
to access the VA health care system within the prior 24 months
due to prolonged waiting periods. However, we request that no
further action be taken on this bill until VA has completed its
comprehensive review of the Department's Care in the Community
Report, as required by Public Law 114-41, which includes
evaluation of programs relating to emergency care.
VA supports the intent behind S. 1938, to improve
accreditation requirements for programs for veterans and their
beneficiaries, but we have some recommendations to improve the
final language of that bill.
The draft legislation to improve educational assistance
would make a number of changes that would affect the education
benefits provided to veterans. VA is supportive of many of
these sections and recommends some technical edits with others.
VA does not support S. 563, the Physician Ambassadors
Helping Veterans legislation, as we already have authority to
appoint physicians on a ``without compensation'' basis, which
is currently being used routinely. In fact, VA is in the
process of establishing such a pilot program in at least two
locations. We would like to evaluate the results from that
pilot in order to better inform the Committee whether any
legislative actions are necessary.
In addition, VA does not support S. 564, the Veterans
Hearing Aid Access and Assistance Act, because it is
unnecessary and will unduly restrict the authority of the
Secretary, which he already has to appoint health care
practitioners under hybrid Title 38. Through this authority, VA
is able to: (1) determine those occupations that possess the
medical expertise needed for delivering high-quality health
care; and (2) hire and retain highly-trained professional staff
with credentials consistent with the qualification standards
established for those occupations. Further, VA has concerns
with the inconsistent licensure requirements for hearing aid
specialists, which will fragment hearing health care services
and limit the delivery of comprehensive hearing health care.
VA is also very concerned with the accountability bills on
the agenda. Although S. 1856 is less onerous of the two bills,
VA still has a number of legal and policy concerns with both
bills, as described in more detail in our written testimony.
Mr. Chairman, I thank you for the opportunity to testify
today. My colleagues and I would be pleased to respond to any
questions that you or the other Members of the Committee may
have.
[The prepared statement of Dr. Lynch follows:]
Prepared Statement of Thomas Lynch, M.D., Assistant Deputy Under
Secretary for Health Clinical Operations, Veterans Health
Administration (VHA)
Good afternoon Chairman Isakson, Ranking Member Blumenthal, and
Members of the Committee. Thank you for inviting us here today to
present our views on several bills that would affect VA benefits
programs and services. Joining me today are Robert Worley, Director of
the Education Service in the Veterans Benefits Administration,
Catherine Mitrano, Deputy Assistant Secretary for Resolution
Management, and Susan Blauert and Kim McLeod, who are both Deputy
Assistant Counsels in VA's Office of General Counsel
s. 290, increasing the department of veterans affairs accountability to
veterans act of 2015
S. 290 the ``Increasing the Department of Veterans Affairs
Accountability to Veterans Act of 2015,'' would amend chapter 7 of
title 38 by adding new sections 715, 717, and 719. These sections would
affect Senior Executives, defined as career Senior Executive Service
(SES) or Title 38 SES-equivalent employees, who work at VA.
VA has policy concerns about the implementation of sections 715,
717, and 719, as added by S. 290. VA is concerned that the provisions
in this bill would impede VA's ability to recruit, retain, reward, and
manage world-class talent to lead and sustain a transformed VA.
VA has made it clear that it intends to transform VA into an
organization that focuses on Veterans. This transformation depends on
expert career Senior Executives who are trained and motivated to lead
the VA workforce in better, more effective ways. VA Senior Executives
include highly-qualified individuals with private-sector business
backgrounds, medical doctors and public health care professionals with
specialty care and research backgrounds, Veterans, and dedicated
employees who have worked their way up through the Civil Service to the
senior-most career leadership positions in VA.
VA already is challenged to recruit and retain highly-qualified
Senior Executives, in that many Senior Executives take a pay cut to
join or stay at VA. For instance, the salary and benefits offered to
most VA medical center directors are lower than the compensation
package offered for a comparable position in the private sector. This
bill, as currently drafted, would compound the challenges facing VA by
arbitrarily capping VA Senior Executives' performance ratings,
requiring VA to deliver those ratings to Congress while other agencies'
executive ratings remain confidential, and requiring VA Senior
Executives to change locations and programs every 5 years. Even the
bill's reduction of retirement benefits for VA Senior Executives
convicted of certain crimes singles out VA Senior Executives for
treatment unparalleled in other agencies. Highly-qualified
professionals are less likely to join or stay with VA as Senior
Executives when they could serve elsewhere with higher pay and less
punitive treatment.
In general, section 715 would reduce the annuity paid to VA Senior
Executives who are removed from their senior executive position under
38 U.S.C. 713, or who leave VA while removal proceedings under section
713 are pending, if they have been convicted of a felony that
influenced their performance while employed as a VA Senior Executive.
There are practical concerns regarding implementation of section
715 that we believe would prove impractical for VA and the Government.
First, section 715 does not specify whether it would apply to felony
convictions in Federal or State court. Assuming section 715 will only
to apply to convictions in Federal court, the section does not specify
the roles and responsibilities of the various Government components
that investigate (e.g., VA's Office of Inspector General, Federal
Bureau of Investigation) and prosecute (e.g., DOJ) Federal criminal
matters. The section also does not address the roles and
responsibilities of OPM, the agency that administers Federal retirement
systems.
In order for section 715 to work properly, VA would have to be
notified that an individual who was removed from VA under section 713
was convicted of a felony. VA would then have to determine that the
former employee's conviction influenced his or her performance while
employed at VA and also determine the ``covered period'' applicable
under section 715. Next, VA would need to notify OPM, which would have
to exclude the ``covered period'' from the individual's annuity, and
recalculate the annuity. Assuming that the individual retired a number
of years ago, OPM may also need to collect annuity payments that have
already been made to the individual. Further complicating this matter,
an annuity may need to be recalculated by OPM if an individual's
conviction is overturned on appeal.
Section 715 also raises a number of legal issues, including
concerns arising under the Due Process, Takings, and Ex Post Facto
Clauses of the U.S. Constitution. Several of VA's concerns are shared
by the U.S. Department of Justice (DOJ) and the U.S. Office of
Personnel Management (OPM). . The bill raises substantive due process
concerns if interpreted to have a retroactive effect. Additionally, OPM
might need to collect annuity payments that have already been paid to a
retired senior executive. Such collections would implicate the Fifth
Amendment's Takings Clause. Finally, the legislation may raise concerns
under the Ex Post Facto Clause, which are raised when a law would make
punishable acts taken that were not punishable at the time they were
committed.
VA is unable to determine the costs for section 715, based on some
of the implementation concerns expressed above. Significantly, whatever
costs would be incurred by VA in making a determination under this
section would also result in costs to DOJ, which would have to defend
the Government in litigation before the courts, and OPM, which would
have to adjust the pension of a VA Senior Executive, and defend its
adjustment, if appealed by the employee, before the U.S. Merit Systems
Protection Board.
Section 717 would essentially require a forced distribution by
limiting the number of individuals who can receive the top two rating
levels (``outstanding'' and ``exceeds fully successful''). Section 717
would require VA to consider complaints and reports (including pending
reports) from various Government agencies when determining the rating
of a VA Senior Executive. Section 717 would also require the Secretary
to reassign VA Senior Executives once every 5 years to a position at a
different location that does not include the supervision of the same
personnel or programs. Under the proposed bill, VA would also be
required to contract with a nongovernmental entity to prepare a report
on management training for VA Senior Executives. The bill would mandate
that VA prepare a plan for implementing the findings in the
nongovernmental entity's report.
VA Senior Executive performance ratings must be based on an
individual's performance in order to maintain VA's OPM performance
management certification. Limiting outstanding performance ratings to
only 10 percent of VA Senior Executives, as proposed in the bill, would
draw an arbitrary line for Senior Executive performance that is not
based on individual performance. It would require the Department to
rank executives against each other, rather than individual and
organizational standards that are clearly established at the beginning
of a performance period. VA's concerns are shared by OPM, which
accredits SES performance management systems for the Government. OPM's
current regulations prohibit assigning candidates to categories based
on percentages.
By capping the number of individuals who can receive outstanding
performance ratings, the bill would also prevent the Secretary from
making meaningful distinctions in performance and from appropriately
assessing and rewarding individual executives' innovations and
leadership achievements. Considering complaints and pending reports
when reviewing Senior Executive performance also raises concerns about
the ability of the employee to respond to management's review of his or
her performance, since these complaints or pending reports may not be
available to the employee. Moreover, complaints may later be
unsubstantiated, and pending reports may be changed before they become
final.
Requiring all Senior Executives to rotate to different positions
every 5 years would broaden the experience base of our executives.
However, legislating this particular approach may prevent key Senior
Executives identified by the Secretary from fully mastering strategic
positions, and may hinder the recruitment and retention of highly
qualified SES and title 38 SES-equivalent employees. In requiring
periodic rotation, the bill constrains the Secretary's ability to
determine which executives to reassign based on VA's needs. The
legislation could further hinder the Secretary's efforts to create
continuity and stability within VA's operations.
Under section 3(b) of the bill, VA must prepare and report to
Congress a plan to implement the recommendations of a report issued by
a nongovernment contractor on management training for VA Senior
Executives. If the expectation is that VA subsequently will implement
this plan, section 3(b) might raise non-delegation doctrine concerns,
because it would give a nongovernmental contractor authority to
implement changes in Government policy and decide which policies should
be changed. To avoid these concerns, we would construe section 3(b) as
not necessarily requiring VA to implement the plan.
There may also be little value for VA to enter into a contract with
a nongovernmental entity to review and report on VA's management
training programs. VA already has a robust portfolio of learning and
development offerings available to its executives, including executive
coaching, onboarding and orientation programs, and just-in-time
workshops, which develop the critical skills required to address VA's
current challenges. In addition, VA works with OPM, which offers cost-
free guidance to Federal agencies on management training.
The costs associated with this section are as follows:
Initial year/first year costs:
Performance Appraisal System:
- SES Automated System: $18,000
- GS Automated System: $3,000,000
- Nongovernment Independent Training (one time cost):
$1,250,000
Five Year Costs:
Performance Appraisal System:
- SES Automated System: $90,000
- GS Automated System: $5,000,000
SES Relocation:
- Relocation Costs (negotiable per contract) $21,000,000
- Relocation Costs (required by regulation) $90,000,000
Ten Year Costs:
Performance Appraisal System:
- SES Automated System: $180,000
- GS Automated System: $7,500,000
SES Relocation:
- Relocation Costs (negotiable per contract): $42,000,000
- Relocation Costs (required by regulation): $180,000,000
Section 719 would limit the Secretary's authority to place VA
Senior Executives on administrative leave or in any other type of paid
non-duty status for more than 14 days during a 365-day period.
While VA does not object to the purpose of section 719, it does
have significant concerns about the section, as currently drafted. VA
recommends removing ``any other type of paid non-duty status'' from
section 719(a), as this could be construed to mean that sick leave,
earned annual leave, and excused absences for other purposes (such as
weather-related closures), which are types of paid non-duty status,
would also be subject to the limitations in this section. VA also
recommends that the limitation of 14 days be increased to 60 days, as
most administrative investigations that form the basis for disciplinary
action take at least 30 days to complete.
VA is unable to determine the costs for this section.
For the reasons stated above, VA has major legal and policy
concerns with S. 290.
s. 563, physician ambassadors helping veterans act
S. 563 would create a new section 7405A in title 38 establishing
the Physician Ambassadors Helping Veterans Program. The bill would
require VA to use its authority under 38 U.S.C. 7405 to seek to employ
physicians on a without-compensation basis in any practice area where
the average wait time for veterans seeking care exceeds VA's wait time
goals or in any medical facility with demonstrated staffing shortages.
The bill would also require the appointment of a volunteer coordinator,
who would seek to establish relationships with local medical
associations, recruit physicians for employment under this Program, and
serve as the initial point of contact for physicians seeking employment
on a without-compensation (WOC) basis in the facility. The bill would
require that physicians appointed on a WOC basis agree to commit to
serving a minimum of 40 hours in a year in the facility where they have
been appointed. VA would be required to provide a credential or
privilege, or decide within 60 days that such credentials or privileges
will not be granted, for physicians who seek non-compensation
employment under this Program. VA would be required to submit an annual
report to Congress on physicians employed under this Program; the
report would be required to include the number of physicians employed
on a WOC basis in each Veterans Integrated Service Network (VISN) and
information about staffing levels and appointment waiting times for
facilities in each VISN.
VA greatly values the services of WOC physicians, and will continue
to leverage existing authorities to encourage WOC physicians to provide
additional clinical capacity and expertise, but VA does not support
S. 563 because VA already has authority to appoint WOC physicians under
38 U.S.C. 7405. Under current practice, the facility Chief of Staff,
Physician Recruiter, or another member of the Human Resources Office
coordinates WOC physician recruitment efforts, while the legislation
would require a new position, the Volunteer Coordinator, to handle
these responsibilities. Additionally, the legislation directs the
Medical Facility Director to grant credentials or privileges to
practice medicine within 60 days, but there may be circumstances in
which a determination could not be made within that time period. For
example, if there was a pending investigation underway, a history of
patient complaints, or a refusal or inability to comply with VA
standards or protocols, it could be difficult to make a determination
in the allotted time. Similarly, it may be particularly difficult to
make these determinations for international medical graduates.
Furthermore, the bill's reporting requirements would be resource
intensive because VA does not currently have an automated system to
track or monitor appointees in WOC status.
VA estimates the costs of this bill would be negligible and would
only be required for administration of the bill's requirements.
s. 564, veterans hearing aid access and assistance act
S. 564 would amend VA's appointment authority to include licensed
hearing aid specialists and would require an annual report on the
provision of hearing aid services to Veterans. Section 2(a) of S. 564
would amend 38 U.S.C. 7401(3) to include ``licensed hearing aid
specialists,'' and would include ``licensed hearing aid specialists''
among those whose qualifications can be prescribed by the Secretary.
VA does not support section 2(a) of S. 564 because we do not
believe it is necessary. VA already has authority under 38 U.S.C.
7401(3) to appoint health care occupations it considers ``necessary for
the recruitment and retention needs of the Department.'' Additionally,
VA has authority under 38 U.S.C. 7402(b)(14) to establish qualification
standards for health care occupations. Further, VA has concerns about
the lack of standardized educational or professional health licensure
requirements for hearing aid or instrument specialists. If this
employee category is added to title 38, it could fragment hearing
health care services and limit the delivery of comprehensive hearing
health care.
VA provides comprehensive hearing health care services and employs
both audiologists and audiology health care technicians who, in
collaboration, deliver high quality and efficient care. VA audiologists
are doctoral-level professionals trained to diagnose and treat hearing
loss, acoustic trauma and ear injuries, tinnitus, auditory processing
disorders, and patients with vestibular complaints. VA currently
employs 320 audiology health technicians (commonly known as audiology
assistants) who function under the supervision of audiologists. Some of
these audiology health technicians are licensed as hearing aid
specialists, although they are hired as health technicians whether or
not they are licensed as hearing aid specialists. VA can appoint
hearing aid specialists as audiology health technicians under title 5.
Audiology health technicians have a broader scope of practice than the
typical hearing aid specialist. VA developed this position associated
core competencies for health technicians to provide efficient support
services and assist audiologists in providing comprehensive hearing
care. VA audiology health technicians have duties and responsibilities
beyond that allowed by State law for hearing aid specialists. The
majority of states (33) only require a high school education, while
nine states have no educational requirement and eight states require an
associate degree. Hearing instrument specialists are licensed to sell
hearing aids and are regulated primarily for their hearing aid sales
roles. The license does not require professional education, clinical
training, or experiential health care apprenticeships. Using
occupations with limited or inconsistent educational and licensing
requirements would fragment VA's current high quality health care
delivery system.
Section 2(b) of S. 564 would require VA, not later than 1 year
after the date of the enactment of this Act and not less frequently
than once every year thereafter, to report to Congress on several
matters. First, VA would be required to report on timely access to
Veterans to hearing health services furnished directly by VA, and VA's
contracting policies for providing health care services to Veterans at
non-VA facilities. VA would be required to report on staffing levels of
audiologists, hearing aid specialists, and health technicians in
audiology; a description of performance metrics with respect to
appointments and care; the average wait times for appointments for
disability rating evaluations, hearing aid evaluations, dispensing of
hearing aids, and any follow-up hearing health appointments; and the
percentage of Veterans whose waits times fell within certain defined
time periods. Each report would also be required to include the number
of Veterans who received care in the community for hearing health care
appointments, the number of Veterans referred for certain identified
services, and the policies of the Veterans Health Administration
regarding the referral of Veterans to care in the community, and a
description of how such policies will be applied under the Patient-
Centered Community Care (PC3) program.
VA does not support section 2(b) of S. 564 because it is
unnecessary. The requested data and information are already compiled as
part of an ongoing and automated process. VA would be happy to brief
the Committee on the various types of information currently compiled
and disseminated on staffing levels and access to care.
Furthermore, VA recommends against requiring in statute reporting
standards specific to the PC3 program. Under the VA Budget and Choice
Improvement Act, Public Law 114-41, VA is required to review the full
range of its current Care in the Community program, including PC3, and
submit a report to Congress with recommendations for how to consolidate
these authorities and programs into a single program to be known as the
``Veterans Choice Program.'' Until such a review and plan is complete,
we believe it would be inappropriate to institute a reporting
requirement that may have little purpose or value in the future if the
PC3 program is modified.
VA cannot estimate the cost of this provision at this time because
we cannot know at what grade these positions would be classified, so we
cannot determine the average salary or benefits for these positions.
s. 1450, department of veterans affairs emergency medical staffing
recruitment and retention act
S. 1450 would allow VA to arrange flexible physician and physician
assistant work schedules to allow for the hiring and full
implementation of a hospitalist physician system and to accommodate the
unusual work schedule requirements for Emergency Medicine (EM)
Physicians.
VA supports increased flexibility for critical medical personnel.
Hospitalist physicians and EM physicians specialize in the care of
patients in the hospital, often working irregular work schedules to
accommodate the need for continuity of efficient hospital care. VA
believes that increased scheduling flexibility would align VA practice
with the private sector, facilitating the recruitment, retention of
emergency physicians and the recruitment, retention and operation of a
hospitalist physician system at VA medical centers (VAMC). We note
concerns that the Office of Personnel Management will provide in its
statement for the record with respect to certain of the bill's
provisions. The Administration looks forward to working with the
Congress and our agency partners to finalize language on these
provisions.
VA believes S. 1450 would be cost neutral in terms of impact on
salaries as it merely authorizes flexibility in physician and physician
assistant work schedules to allow for the hiring and full
implementation of a hospitalist physician system and improvements in EM
physician coverage and enhanced ability to recruit EM trained and
experienced physicians.
s. 1451, veterans' survivors claims processing automation act of 2015
S. 1451, the ``Veterans' Survivors Claims Processing Automation Act
of 2015,'' would authorize VA to pay benefits to a survivor of a
Veteran who has not filed a formal claim if the record contains
sufficient evidence to establish the survivor's entitlement to such
benefits. The bill would specify that the date on which a survivor
notifies VA of the Veteran's death would be treated as the date of
receipt of the survivor's application for benefits. S. 1451 would be
applicable to claims based on a death occurring on or after the date of
enactment of this legislation.
VA supports S. 1451. The Department submitted a similar legislative
proposal for the Fiscal Year (FY) 2016 Budget. Under 38 U.S.C. 5101(a),
a claimant must file a formal claim as a condition of receiving
benefits. However, when a survivor of a Veteran files a claim for VA
benefits based upon the Veteran's death, the information and evidence
necessary to decide the claim is often contained in the Veteran's
claims file. As a result, it is not necessary from a practical
standpoint for a claimant to file a formal claim in such circumstances.
Elimination of the formal-claim requirement would automate the delivery
of uninterrupted benefits to qualifying survivors.
VA has one technical comment. VA would prefer to change the
language from ``the date on which a survivor of a Veteran notifies the
Secretary of the death of the Veteran,'' to ``the date on which the
Secretary is notified of the Veteran's death.'' The modified language
would allow VA to be more liberal when providing benefits in instances
where the survivor is not the individual notifying VA of the Veteran's
death.
VA estimates that there would be no benefit or general operating
expenses (GOE) associated with S. 1451.
s. 1460, fry scholarship enhancement act of 2015
S. 1460 would allow recipients of the Marine Gunnery Sergeant John
David Fry Scholarship to be eligible for the Yellow Ribbon program
under the Post-9/11 GI Bill. The Yellow Ribbon program is currently
available to Veterans and most transfer-of-entitlement recipients
receiving Post-9/11 GI Bill benefits at the 100% benefit level
attending institutions of higher learning. The program provides payment
for up to half of the tuition-and-fee-charges that are not covered by
the Post-9/11 GI Bill, such as charges that exceed an academic year cap
or out-of-state charges, if the institution enters into an agreement
with VA to pay or waive an equal amount of the charges that exceed
Post-9/11 GI Bill coverage. This bill would take effect for the
academic year (August 1) beginning after the date of enactment.
VA does not object to S. 1460, subject to Congress identifying
acceptable offsets for the additional benefit costs. VA would need to
make modifications to its existing information technology (IT) systems
to implement this legislation. Specifically, VA would need to modify
the Benefits Delivery Network (BDN), the VA-Online Certification of
Enrollment (VA-ONCE), and the Post-9/11 GI Bill Long-Term Solution
(LTS), to calculate eligibility and award Yellow Ribbon program
payments for Fry Scholarship beneficiaries. VA estimates that it would
require 1 year from the date of enactment to make the IT system changes
necessary to implement the proposed legislation.
VA estimates the benefit costs associated with enactment of the
bill to be $492,000 in FY 2016, $2.7 million over 5 years, and $6.2
million over 10 years. Although VBA administrative costs are estimated
to be insignificant, IT costs are estimated to be $5 million. This IT
estimate consists of the design, development, testing, and deployment
of the new functionality that would be needed to meet the requirements
of this legislation.
s. 1693, expanding emergency treatment for certain veterans
Today, only Veterans who are ``active Department health-care
participants'' (as defined by 38 U.S.C. Sec. 1725(b)) and who meet all
of the other administrative and clinical eligibility criteria of
section 1725 are eligible to receive reimbursement under this section
for the reasonable value of (unauthorized) non-VA emergency treatment
of non-service-connected disabilities furnished them by non-VA
emergency providers. To be such a participant, a Veteran, in addition
to being enrolled in VA's health care system, must, pursuant to section
1725(b)(2)(B), have received care under 38 U.S.C. chapter 17, within
the 24-month period preceding the furnishing of the non-VA emergency
treatment. S. 1693 would amend section 1725(b)(2)(B) to include
Veterans who have been unable to receive care under chapter 17 within
the mandated 24-month period because of a waiting period imposed by the
Department with respect to a new patient examination of such Veterans.
VA supports S. 1693 but, as discussed below, requests that no
further action be taken at this time. We recognize that some Veterans
have been enrolled in VA's health care system but unable to become
actual users of the system because they have not been able to receive
their ``new patient examination'' due to waiting periods (in
appointment scheduling) for care in VA. As a result, although enrolled,
they fail to meet the full statutory definition of an ``active
Department health-care participant'' for purposes of being able to
receive reimbursement under section 1725. The bill would provide a fair
remedy for those whose section 1725 claims are denied solely because VA
scheduling procedures and wait times prevented them from receiving VA
care within the 24-month period preceding their receipt of non-VA
emergency treatment.
While the goal of this bill is well-intentioned, we believe it
premature for Congress to take any action on this measure until VA has
completed its comprehensive review of the Department's Care in the
Community programs, which includes a review of the monetary benefits
available under section 1725. For that reason, we respectfully request
that the Committee forbear consideration of S. 1693 (and any similar
measure) until VA has an opportunity to complete its review and share
the results, including recommendations, with the Committee.
VA estimates that the cost associated with enactment of S. 1693
would be $2.86 million in FY 2017, $3.0 million in FY 2018, $15.8
million over 5 years, and $35.8 million over 10 years.
s. 1856, va equitable employee accountability act of 2015
S. 1856, the ``Department of Veterans Affairs Equitable Employee
Accountability Act of 2015,'' would amend chapter 7 of title 38 of the
United States Code by adding new sections 715, 709A, 717, and 719. It
would also amend chapter 73 of Title 38 by adding a new section 7324A.
These sections would affect all VA employees occupying a position under
a permanent or indefinite appointment who are not on a probationary or
trial period.
S. 1856 is a more measured alternative to a series of recent
legislative proposals targeting VA employees by providing extraordinary
authority to sanction them, not available in other Federal agencies.
However, VA has legal and policy concerns with S. 1856.
Section 2(a) of S. 1856 would amend chapter 7 of Title 38 by adding
in a new section 715, which would give the Secretary authority to
suspend a VA employee without pay if the Secretary determines the
performance or misconduct of the employee is a clear and direct threat
to public health or safety. The Secretary would be authorized to remove
an employee so suspended after providing a written statement of
charges, allowing the employee not less than 7 business days to respond
to the charges, and, at the request of the employee, providing a formal
review of the proposed removal action within 15 business days of the
employee's request. A decision to remove an employee under section 715
could be appealed to the Merit Systems Protection Board (MSPB) under
section 7701 of Title 5, and employees may seek judicial review of an
MSPB decision under section 7703 of Title 5. If the Secretary
determines a suspension or removal under this provision is unwarranted,
illegal, violates a collective bargaining agreement, or is a prohibited
personnel action, the employee is entitled to back pay for the time the
employee was suspended or removed. At this time the Department does not
have costs associated with this section.
Section 715 raises a number of policy concerns. Under section 715,
an employee would be able to have his or her proposed removal reviewed
by a ``Department authority duly constituted for purposes of this
section,'' before the Secretary can make a determination on the
removal. An employee would also be entitled to appeal a removal
decision to the MSPB and subsequently to the U.S. Court of Appeals for
the Federal Circuit. Typically, an employee who is removed from the
government receives notice of a proposed removal, an opportunity to
respond, and a decision on the proposed removal. If entitled, the
employee may appeal the removal action to the MSPB, or the employee may
file a discrimination or whistleblower retaliation complaint. If the
employee appeals to the MSPB, the employee may seek judicial review of
the MSPB decision before the U.S. Court of Appeals for the Federal
Circuit. By adding in a new departmental review, section 715 would add
in an unnecessary new process, because a removal proposed under this
section is already subject to review by the Secretary, and
subsequently, if the action is taken, by the MSPB and the U.S. Court of
Appeals for the Federal Circuit. Section 715 would also add to the cost
of the agency to litigate and adjudicate the personnel action, as the
section requires a new ``Department authority duly constituted for
purposes of this section.'' To remedy this policy problem, VA
recommends eliminating the departmental review in section 715(b)(3).
VA also recommends that section 715 apply in cases where the
Secretary determines the performance or misconduct of an employee
``significantly or adversely impacts Veteran health care or benefits.''
This standard, in lieu of the proposed ``clear and direct threat to
public health or safety'' standard is more particularly suited to the
mission of VA and will provide the Secretary better flexibility in
addressing its unique mission needs. In addition, it will avoid the
application of case law decided in other contexts that have previously
interpreted ``clear and direct threat to public safety'' in a manner
that could restrict the Secretary's ability to invoke section 715.
Similarly, VA recommends the proposed standard for removal in section
715(a)(2) be changed from ``is necessary in the interests of public
health or safety,'' to `` is necessary in the interests of providing
quality veteran health care and benefits.''
The back pay provision in section 715(e) provides a modicum of
protection for employees who ultimately have their suspensions or
removals under this section reversed. However, VA recommends clarifying
that the determination that triggers back pay can be made by the
Department, the Secretary, or by the courts on appeal. As currently
drafted, the back pay provision is limited to determinations made only
by the Secretary. Finally, to clarify the Secretary's authority when
section 715 is invoked, VA recommends adding the clause,
``Notwithstanding any other provisions of law,'' to subsections 715(a),
(b), and (c).
Section (2)(c) of S. 1856 would require the Inspector General to
submit, no later than one year after S. 1856 is enacted, a report to
Congress on the number of suspensions or removals taken pursuant to
section 715. The Inspector General's report must include, among other
things, the number of ``suspensions or removals that the Inspector
General considers to be retaliation for whistleblowing.'' VA recommends
removing section 2(c)(2)(E), as the Inspector General is not involved
in taking disciplinary actions under section 715 and, moreover, may not
be able to make a finding of whistleblower retaliation.
Section 3 of S. 1856 would amend chapter 7 of Title 38 by adding in
a new section 709A, which would require the Secretary to annually
assess the performance of political appointees in a manner similar to
the assessment of career Senior Executive Service employees.
Section 4 requires managers to determine, not later than 30 days
before the end of the probationary period, whether the employee has
demonstrated successful performance. Probationary employees can be
terminated for performance or conduct deficiencies and as such, it is
recommended that the language be amended to require managers to also
determine if the employee's conduct warrants continued employment past
the probationary period. It should be noted that some probationary
employees may meet the definition of ``employee'' as outlined in 5
U.S.C. 7511, and if a probationer meets the definition of ``employee,''
management can no longer terminate during the probationary period with
limited due process and appeal rights. Therefore, in some cases, even
if a manager were to determine that a probationary employee was not
suitable for continued employment, an employee who is serving a
probationary period but has completed more than 1 year of current
continuous service would be entitled to due process, including, if
applicable, a performance improvement plan or application of
progressive discipline, 30-days advanced notice, a right to review
evidence, application of mitigating and aggravating factors, etc.,
prior to separation.
Section 5 of S. 1856 requires that VA evaluate managers, as part of
their annual performance plans, on actions that they have taken to
address poor performance and misconduct among subordinate employees and
steps that that the manager has taken to improve or sustain high-levels
of employee engagement. VA is already committed to the principles of
section 5 of S. 1856 and supports this section.
Section 6 of S. 1856 would require VA to provide all managers with
periodic training on whistleblower rights and managing and motivating
employees. VA already offers managers the training discussed in section
6. Moreover, some training, such as whistleblower rights and
protections, is already required for all managers. Nevertheless, VA is
committed to the principles of section 6 of S. 1856 and supports this
section.
Section 7 of S. 1856 would require VA to develop a promotional
track, which does not involve a transition to a management position,
for employees who are considered technical experts. VA is committed to
ensuring that its employees are allowed to advance in their careers,
regardless of whether the employee wants to be a manager. Consequently,
VA supports this section.
Section 8 of S. 1856 would amend Title 5 to expand the definition
of ``personnel action'' under 5 U.S.C. 2302, which addresses prohibited
personnel practices, to include performance evaluations under Title 38.
VA is committed to ensuring that all performance evaluations are based
on merit. Consequently, we do not have any legal or policy concerns
with section 8.
Section 9 of S. 1856 would require that any VA employee who
participated personally and substantially in a VA acquisition over
$1,000,000 or held a key position relating to acquisition obtain a
written opinion from an ethics counselor regarding restrictions on
activities that the official may undertake on behalf of a VA contractor
or subcontractor within a 2 year period beginning on the date that the
employee terminates his or her employment with VA.
VA has some legal and policy concerns about section 9. The
$1,000,000 threshold under section 9 would seemingly encompass a large
number of VA's acquisitions. Moreover, this threshold falls below the
$10,000,000 threshold set under the Procurement Integrity Act. To that
extent, VA recommends that the acquisition threshold for section 9 be
set at $10,000,000. Section 9, as currently drafted, would also
encompass all acquisitions that an employee worked on during their
career at VA. Because this number can be significant, VA recommends
that language be inserted to section 9 that triggers the requirement
under that section to acquisitions in which the employee participated
during his or her last year of employment with VA. Limiting section 9
to the employee's last year of employment with VA also mirrors the
criminal conflict of interest statute, 18 U.S.C. 207, which prohibits
employees from representing any non-Federal parties in connection with
any specific party matters that were under their official
responsibility during the last year of employment. Assuming that VA's
recommended changes to section 9 are incorporated, similar changes
should also be made to section 10 of S. 1856.
Section 11 of S. 1856 stipulates that the Secretary may not place
any covered individual on administrative leave for more than a total of
14 business days during any 365 day period without notification to the
Committees on Veterans' Affairs of the Senate and the House of
Representatives. A covered employee is one who is subject to
investigation or for whom any disciplinary action is proposed or
initiated. An investigation conducted by local VA employees typically
takes a minimum of 60 calendar days to complete and 45 calendar days
for Department employees from outside the local facility. Therefore, VA
suggests that this language be modified to allow the Secretary to
approve 30 business days of administrative leave under the
circumstances described in this section.
In section 719(c)(1) and (2), administrative leave includes ``leave
to which an employee of the Department is otherwise entitled, or credit
for time or service'' and ``includes any type of paid non-duty
status.'' Based on this language, the Secretary would be required to
report to Congress any annual leave, sick leave, leave without pay,
credit hours, compensatory hours, or excused absence for weather
related events, for example, taken by an employee in excess of 7
business days. Therefore, VA suggests modifying the in section
719(c)(1) to language used by OPM, which is ``an administratively
authorized absence from duty without loss of pay or charge to leave for
which the employee is placed due to an investigation or for whom any
disciplinary action is proposed or initiated.'' It is also suggested
that section 719(c)(2) be modified to include the clause ``without a
charge to leave'' to clarify the definition of administrative leave..
Section 12 of S. 1856 would amend chapter 73 of Title 38 by adding
in a new section 7324A to Title 38, which would require, within 60 days
of the date of enactment of S. 1856 and periodically thereafter, VA's
Office of Medical Inspector (OMI) to submit ``a report on any problems
or deficiencies encountered by the Department in carrying out the
programs and operations of the Veterans Health Administration,
including any recommendations for corrective action.'' Under section
7324A, OMI's report must be submitted to the Secretary, the Under
Secretary for Health, and Congress.
VA does not support section 7324A(a), as OMI's work would be
duplicative of reports produced by VA's Office of Inspector General's
(OIG), Office of Healthcare Inspection. OIG's Office of Healthcare
Inspection routinely prepares reports on deficiencies within the
Veterans Health Administration, and these reports include
recommendations for corrective actions. OIG submits these reports to
the Secretary and the Under Secretary for Health, in addition to both
the House and Senate Committees on Veterans' Affairs.
However, VA supports section 7234A(b), which would require OMI to
provide their reports to Congressional oversight committees, as this
would promote transparency, ensuring that Members of Congress are
apprised of the issues encountered in the conduct of OMI's
investigations. It will also help to restore trust in OMI and in VHA's
broader quality assurance mission.
However, only a small percentage of OMI's work in recent years
consists of internal reviews requested by the Secretary or Under
Secretary for Health, or so-called ``blue cover'' reports requested by
Members of Congress. Approximately 95 percent of OMI's current work
involves investigating whistleblower allegations that are referred to
the Secretary by the U.S. Office of Special Counsel (OSC) for review.
The Office of the Secretary releases VA's report of investigation to
OSC, which then provides un-redacted copies (along with its
determination whether each report meets statutory requirements) to the
House and Senate oversight committees when OSC eventually closes the
case.
VA also supports section 7234A(c), which requires protecting any
medical or other personally identifiable information contained in its
reports. Currently, VA redacts such information from reports before
they are shared with the public.
If enacted, VA anticipates the cost for implementing section 7324A
would be approximately $150,000 during the first year, $750,000 for the
first 5 years, and $1,500,000 for 10 years.
Section 13 of the bill would require a report from the Comptroller
General on the implementation of these provisions and as assessment of
the effects of these provisions. We defer to the U.S. Government
Accountability Office on this provision.
VA is unable to determine costs for the remainder of the
legislation. However, there could be significant costs to VA to defend
the Government in litigation over the legislation in courts.
VA also has policy concerns about the implementation of section
S. 1856; however, these concerns are more limited than our concerns
with other pending legislation. VA is concerned that the provisions in
this bill would impede VA's ability to recruit, retain, reward, and
manage world-class talent to lead and sustain a transformed VA.
The Secretary has made it clear that he intends to transform VA
into an organization that focuses on Veterans. This transformation
depends on a world-class workforce who are trained and motivated to
contribute their talents to the VA and our Veterans in better, more
effective ways. VA fully supports the concept that employees whose
performance and conduct does not meet the standards our Veterans
deserve must be held accountable. However, by singling out VA
employees, many of whom are Veterans themselves, with legislation that
provides them fewer protections and subjects them to greater scrutiny,
a clear message is sent that VA employees are in a different, inferior
class within the Federal workforce--a class that needs very close
oversight with rapid and severe penalties for misdeeds or poor
performance. This will hinder the Secretary's efforts to make the ``VA
class'' of employees the very finest employees to serve our Veterans
and ensure that they timely receive the benefits and care to which they
are entitled.
s. 1938, career ready student veterans act of 2015
S. 1938, the ``Career-Ready Student Veterans Act of 2015,'' would
amend title 38, United States Code, to improve the approval of certain
VA programs of education for purposes of educational assistance.
This bill would amend 38 U.S.C. 3676(c), pertaining to the approval
of non-accredited courses, by adding new requirements to the criteria
that must be met for State approving agencies to approve institutions'
written applications for approval of non-accredited courses. First, in
the case of a program designed to prepare an individual for licensure
or certification in a State, the program would need to meet any
instructional curriculum licensure or certification requirements of
that State. Second, in the case of a program designed to prepare an
individual for employment pursuant to standards developed by a board or
agency of a State in an occupation that would require approval or
licensure, the program would need to be approved or licensed by such
board or agency of the State.
The bill also would add subsection (f) to section 3676 to permit VA
to waive the aforementioned requirements in the case of a program of
education offered by an educational institution if VA determined:
The educational institution was accredited by an agency or
association recognized by the Department of Education;
The program did not meet the requirements at any time
during the two-year period preceding the date of the waiver;
The waiver furthers the purposes of the educational
assistance programs administered by VA or would further the education
interests of individuals eligible for assistance under such programs;
The educational institution does not provide any
commission, bonus, or other incentive payment based directly or
indirectly on success in securing enrollments or financial aid to any
persons or entities engaged in any student recruiting or admission
activities or in making decisions regarding the award of student
financial assistance, except for the recruitment of foreign students
residing in foreign countries who are not eligible to receive Federal
student assistance.
Subsection (d) of the proposed legislation would add a new
subsection to section 3679 of title 38 to require VA to disapprove a
non-accredited course of education designed to prepare an individual
for licensure or certification in a State or for employment pursuant to
standards developed by a board or agency of a State in an occupation
that requires approval or licensure, if the educational institution
providing the course of education does not publicly disclose any
conditions or additional requirements, including training, experience,
or exams, required to obtain the license, certification, or approval
for which the course of education is designed to provide preparation.
Subsection (e) of this bill would amend section 3672(b)(2)(A)(i) to
include the new approval requirements for non-accredited courses in the
approval requirements for ``deemed approved'' accredited programs.
The bill would also amend 38 U.S.C. 3675, to apply the new
requirements in section 3676(c), to the approval conditions for
accredited courses offered by private for-profit institutions.
VA supports the intent behind this bill. However, we do not support
the bill as currently drafted for a number of reasons.
If enacted, the bill would ensure that non-accredited courses
pursued by GI Bill beneficiaries meet all of the State requirements for
licensure or certification in a given occupation or career field and
would be approved by the State board or agency that developed the
standards. VA does not oppose the concept of additional criteria for
the approval of non-accredited courses. However, we note that, as
written, the bill would not allow the Secretary to waive the
requirement for non-accredited courses, as the institution must be
accredited in order to meet the criteria for a waiver. VA is unclear as
to the reason why an accreditation requirement would be inserted in the
approval criteria for non-accredited programs. In general, an
institution's accreditation applies to all of the courses offered by
the institution, and accredited courses have different approval
requirements.
Additionally, the bill would ensure that accredited courses at
private, for-profit institutions meet all State requirements for
certification and licensure. VA supports efforts to ensure that
Veterans and other GI Bill beneficiaries are well-trained and
adequately equipped to obtain employment and achieve economic success.
However, we note that the proposed licensure and certification
requirements would not be applied to similar programs at public and
private, not-for-profit institutions. Consequently, the bill does not
ensure that all Veterans and beneficiaries would receive all of the
training required for licensure or certification in their chosen
occupational fields.
VA also has concerns about the language in the new section 3679(d),
which would require the disapproval of waived programs if the
educational institution does not publicly disclose the additional
conditions or requirements needed in order to meet licensing or
certification requirements. VA believes ``the Secretary or the
appropriate State approving agency'' should be substituted for ``the
Secretary,'' as the State approving agencies are responsible for the
approval of non-accredited courses. As State employees, they have
subject matter expertise with regard to the specific State requirements
for licensure or certification and, consequently, are better-positioned
to determine the gaps in training or conditions that must be
publicized. In addition, to be consistent with approval authorities in
other sections of chapter 36, VA believes that both the Secretary and
the SAA should have this authority.
VA is unclear as to the intent underlying the proposed amendment to
3672(b)(2)(A)(i). As written, it could be interpreted to include non-
accredited programs in a ``deemed approved'' category. However, if the
intent is to make the proposed paragraphs (14) and (15) of section
3676(c) apply to accredited programs at public and proprietary not-for-
profit institutions of higher learning as well, then it should be
reworded to read, ``Subject to paragraphs (14) and (15) of section
3676(c) of this title, an accredited.'' In addition, we note that, as
currently drafted, the licensure and certification requirements could
not be waived for these programs. VA believes that the waiver authority
should apply to accredited programs at public and proprietary not-for-
profit institutions of higher learning as well as to accredited courses
at private, for-profit institutions and non-accredited programs.
VA estimates that there would be no additional mandatory or
discretionary cost requirements associated with the enactment of this
bill.
draft bill regarding improvements in educational assistance
Section 1 of the proposed legislation would add a new section
(3326) under subchapter III of chapter 33, title 38 U.S.C.
Specifically, this section proposes to recodify the provisions of
Public Law (Pub. L.) 110-252, section 5003(c), to bring those
requirements into title 38, and it proposes a few amendments to those
requirements.
The Post-9/11 GI Bill (or chapter 33) requires individuals to
relinquish eligibility to some other VA education benefit, as
applicable, in order to receive the chapter 33 benefits.
Subsection (a) of the proposed 38 U.S.C. 3326 would define the
eligibility requirements for individuals to elect chapter 33
educational benefits. Individuals would be able to elect to receive
chapter 33 benefits if, as of August 1, 2009, they were entitled to the
MGIB-AD, MGIB--Selected Reserve (SR), or the Reserve Educational
Assistance Program, and had some or all of their entitlement remaining
under those programs. Individuals would be able also to elect chapter
33 if they are making contributions to receive MGIB-AD, or previously
declined participation in the MGIB-AD program.
Subsection (b) of the proposed 38 U.S.C. 3326 would call for the
cessation of contributions toward MGIB-AD if an individual elects to
receive chapter 33 while still making contributions to MGIB-AD. The
obligation to make contributions would cease the first month after the
individual elects chapter 33 benefits.
Subsection (c) of the proposed 38 U.S.C. 3326 would address the
revocation of remaining entitlement transferred to a dependent under
MGIB-AD, if the individual who transferred the benefit elects to
receive chapter 33 benefits instead. The proposed legislation would
allow the transferor to revoke any unused benefits that have been
transferred to a dependent. If the transferor revoked the transferred
benefits from his or her dependent, then the remaining entitlement
would be available for the transferor to use under chapter 33. If the
transferor did not elect to revoke the transferred MGIB-AD benefits,
then those benefits would remain available to the dependent under MGIB-
AD.
Subsection (d) of the proposed 38 U.S.C. 3326 would state that
individuals who make an election would be eligible for benefits under
chapter 33, rather than under the relinquished benefit. It also would
state that if individuals elected to receive chapter 33 in lieu of
MGIB-AD, and had previously used entitlement under MGIB-AD, they would
have eligibility under chapter 33 for the number of months of
entitlement that were remaining under MGIB-AD, plus any entitlement
that was revoked from a dependent in accordance subsection (c).
Subsection (e) of the proposed 38 U.S.C. 3326 would allow
individuals who elect to receive educational assistance under chapter
33 to receive payments at the rate available under the relinquished
benefit if their educational pursuit is authorized under the
relinquished benefit, but not under chapter 33. Any entitlement used
would be charged against chapter 33 in the same manner as it would be
charged against the relinquished benefit.
Subsection (f) of the proposed 38 U.S.C. 3326 would outline
additional chapter 33 assistance for members who made contributions
toward the MGIB-AD program. A refund of MGIB-AD contributions would be
issued to a qualifying Veteran as an increase to the last monthly
housing stipend when benefit entitlement is exhausted. The amount of
the refund would be calculated by taking the remaining months of
entitlement under MGIB-AD, at the time of the chapter 33 election, plus
the number of months, if any, of entitlement under chapter 30 that were
revoked by the individual and dividing that number by 36. The result
would be multiplied by the dollar amount that the Veteran contributed
toward the MGIB-AD, and the resulting amount would be issued in
conjunction with the final monthly housing stipend. This proposed
legislation would also change the corresponding language currently
contained in section 5003(c) of Pub. L. 110-252 by also authorizing
refunds to individuals pursuing programs at non-degree granting
institutions.
Subsection (g) of the proposed 38 U.S.C. 3326 would provide for
continued entitlement to additional assistance for critical skills,
specialty, and/or service (i.e., a college fund or kicker) to which an
individual was entitled under MGIB-AD or MGIB-SR prior to relinquishing
one of those benefits and establishing eligibility under chapter 33.
The additional assistance would be paid in conjunction with the
individual's monthly housing stipend.
Subsection (h) of the proposed 38 U.S.C. 3326 would provide VA with
the authority to make an alternative election for an individual if the
election submitted by the applicant is not in his or her best interest.
If an individual elected to receive a benefit that would be clearly not
in his or her best interest on or after January 1, 2016, VA would be
able to change the election and would be required to notify the
individual of the change within 7 days. The individual would be allowed
30 days from the date he or she received the VA notification to modify
or revoke the election made by VA. In addition, VA would notify the
individual of the change of election by electronic means whenever
possible. These provisions are not included in section 5003(c) of Pub.
L. 110-252; therefore, they would constitute a new authority.
Subsection (i) of the proposed 38 U.S.C. 3326 would provide that
any election made under section 3326 would be irrevocable.
Finally, this section would repeal subsection (c) of section 5003
of the Post-9/11 Veterans Educational Assistance Act of 2008 (Pub. L.
110-252; 38 U.S.C. 3301 note).
VA does not object to (a) through (g) of the proposed 38 U.S.C.
3326 because these provisions are, generally, identical to those that
were enacted in section 5003(c) of Pub. L. 110-252, with the exception
of one minor change in the proposed section 3326(f), which would also
authorize refunds of MGIB-AD contributions to individuals receiving
monthly stipend payments for pursuit of non-degree programs under 38
U.S.C. 3313(g).
However, VA has concerns with subsection (h) of the proposed 38
U.S.C. 3326, which would allow VA to make an alternative election on
behalf of the Veteran that VA determines is in his or her best
interests. As individuals' situations are different, elections made in
the best interest of a Veteran would be highly subjective. While one
claims examiner might view an election option as being the best,
another might disagree. Therefore, VA recommends specific criteria for
an election be added to the legislation that would eliminate
subjectivity. For example, in some instances, a Veteran elects to
relinquish MGIB-AD to receive chapter 33 benefits when he or she has
only a few months of MGIB-AD entitlement remaining. If the individual
has more than one qualifying period of service, it may be in that
individual's best interest to finish 36 months of entitlement under
MGIB-AD before beginning to receive chapter 33 benefits--the individual
could then receive up to 12 months of entitlement under chapter 33. If
this situation met the criteria in the legislation as enacted, the
Veteran's claim would be processed under the chapter 30 program until
his or her entitlement under that program ends.
VA also recommends that the proposed legislation include language
to allow VA to make an election in cases where a Veteran or
Servicemember applies for chapter 33 benefits and does not elect to
relinquish any benefit. This would allow VA to maximize automation,
improve processing times, and obviate the need to contact the Veteran
for an election.
Further, VA has concerns with the impact this subsection would have
on the automation of original claims using LTS. If VA has to make an
alternative election under chapter 33 when a Veteran is eligible for
more than one benefit, claims' examiners would have to review the
majority of chapter 33 original claims. The need for this review would
limit the number of original claims that could be automated through LTS
without human intervention, increasing the length of time that Veterans
would be waiting to receive their benefits.
VA estimates the cost of this section would be insignificant
because subsections (a) through (g) of the proposed 38 U.S.C. 3326 are
provisions that are already in place under section 5003(c) of Pub. L.
110-252 and, therefore, would result in no additional cost. In some
cases, subsection (h) may result in a Veteran receiving a better
benefit that would increase costs to VA. However, due to VA's current
outreach efforts, such as the GI Bill Comparison Tool, and the amount
of information available to assist Veterans in making informed
decisions on education benefits, VA does not anticipate making a
significant number of alternative elections. Therefore, anticipated
costs to the readjustment benefits account are insignificant.
Section 2 would amend 38 U.S.C. 3684(a) to define the term
``educational institution'' to include a group, district, or consortium
of separately accredited educational institutions located in the same
State, and which are organized in a manner that facilitates the
centralized reporting of their enrollments. This legislation would also
amend section 3684(a) to include individuals enrolled under chapters 32
and 33.
The proposed legislation would apply to any reports of enrollment
submitted on or after the date of enactment.
VA supports section 2. This legislation would allow each
institution in a district/consortium to certify a student's enrollment
regardless of where the student is matriculated. Furthermore, since
school certifying officials at ``District'' institutions have access to
student records and all courses have universal numbering, VA compliance
visits could be done at any institution and records would be available
for students who attend any of the institutions included in the group,
district, or consortium.
There would be no additional cost for implementing this provision
because the reporting fees would be paid to the school that is
certifying the enrollment, regardless of the location of the
institution.
Section 3 would amend subsection 38 U.S.C. 3313(c)(1)(A) to limit
the benefits paid for pursuit of certain degree programs at a public
institution of higher learning (IHL). It would limit the amount of
tuition and fees payable for certain programs at IHLs, specifically
those that involve a contract or agreement with an entity (other than
another public IHL) to provide a program of education or a portion of a
program of education, to the same amount per academic year that applies
to programs at private or foreign IHLs. This section would be effective
the first day of a quarter, semester, or term (whatever is applicable)
after the legislation's enactment.
VA supports legislation that would limit the amount of tuition and
fee payments at public IHLs that involve contracted training. VA is
concerned about high tuition and fee payments for enrollment in degree
programs involving flight training at public IHLs. Education benefit
payments for these types of programs have increased tremendously with
the implementation of Public Law 111-377, and in some cases, public
institutions seem to be targeting Veterans for their flight-related
training programs.
There has been a significant increase in flight training centers,
specifically those that offer helicopter training, that have contracted
with public IHLs to offer flight-related degrees. Sometimes these
programs charge higher prices than those that would be charged if the
student had chosen to attend the vocational flight school for the same
training.
Additionally, VA has also noticed a growing number of VA
beneficiaries are taking flight courses as electives. VA allows for
``rounding out,'' whereby non-required courses may be taken to bring a
student's course load up to full-time status in the student's last
term. Based on anecdotal evidence, some schools are enrolling students
in these very expensive flight courses when ``rounding out'' is
applicable. In most cases, these courses are not specifically required
for the Veteran's degree.
VA is still determining the costs associated with this provision.
Section 4 would add a new section 3699 to title 38, U.S.C.,
requiring VA to make available to educational institutions information
about the amount of educational assistance to which a Veteran or other
individual is entitled under chapter 30, 32, 33, or 35. This
information would be provided to the educational institution through a
secure information technology system accessible by the educational
institution and updated regularly to reflect any amounts used by the
Veteran or other individual.
VA supports the intent behind providing educational institutions
with the number of months of educational assistance to which a Veteran
is entitled. Currently, VA provides the amount of a Veteran's
entitlement (original and remaining) and other information (i.e., the
delimiting date) to the educational institution through the VA Online
Certification of Enrollment (VA-ONCE) system. The educational
institution in which the student is enrolled can view this information
for individuals training under chapters 30, 1606, and 1607 after VA
processes an award for education benefits. This functionality is not
currently available for Veterans or other individuals training under
chapters 32, 33, or 35; therefore, VA would need to make programming
changes to VA-ONCE in order to make this information available as well.
VA recommends removing the requirement to provide information for
individuals training under chapter 32 from the proposed legislation.
Chapter 32 usage has decreased from 560 beneficiaries in FY 2008 to 2
beneficiaries for fiscal year 2015 through June 30, 2015. Because
eligibility for chapter 32 ends 10 years after an individual's release
from active duty, the majority of those with remaining entitlement are
likely also eligible for benefits under chapter 33.
VA estimates the administrative costs for developing the functional
requirements of this section to be $500,000, and the information
technology (IT) costs associated with this section to be $5 million to
make enhancements to VA-ONCE to provide newly required information to
educational institutions.
Section 5 would amend 38 U.S.C. 3672(b)(2)(A) to authorize State
Approving Agencies (SAA) to determine if a program of education is
deemed to be approved for purposes of this chapter if the program is
one of the following:
An accredited standard college degree program offered at a
public or not-for-profit proprietary educational institution that is
accredited by an agency or association recognized for that purpose by
the Secretary of Education.
A flight training course approved by the Federal Aviation
Administration (FAA) that is offered by a certified pilot school that
possesses a valid FAA pilot school certificate.
An apprenticeship program registered with the Office of
Apprenticeship, Employment Training Administration, Department of
Labor; or a State apprenticeship agency recognized by the Office of
Apprenticeship pursuant to the Act of August 16, 1937 (popularly known
as the ``National Apprenticeship Act;'' 29 U.S.C. 50, et seq.).
A program leading to a secondary school diploma offered by
a secondary school approved in the state in which it is operating.
A licensure test offered by a Federal, state, or local
government
This legislation also would amend 38 U.S.C. 3675(a)(1) to
substitute ``A State approving agency, or the Secretary when acting in
the role of a State approving agency'' for ``the Secretary or a State
approving agency.'' Further, this legislation proposes to amend section
3675 to expand the approval of other courses by authorizing an SAA, or
the Secretary when acting in the role of a SAA, to approve accredited
programs (including non-degree accredited programs) not covered by
section 3672 of title 38.
VA supports the clarification of the approval requirements codified
in 38 U.S.C. 3672(b)(2)(A), as detailed in section 2(a) of the proposed
legislation. To be ``deemed approved,'' accredited programs must meet
the requirements of a number of provisions in chapter 36 of title 38.
Consequently, compliance with those provisions must be verified, which
the proposed change will make more explicit. However, to be consistent
with approval authorities in other sections of chapter 36, VA believes
that both the Secretary and the SAA should have approval authority.
VA also supports the proposed change to 38 U.S.C. 3675 in section
5(b) of the bill, to make those approval provisions apply to accredited
non-degree programs at public and private non-profit IHLs that are not
covered by section 3672 or by any of the approval requirements
currently contained in chapter 36 of title 38. However, VA does not
support modifying the current language that grants approval authority
to both the Secretary and the SAA. The Secretary was granted authority
under Public Law 111-377 to approve those programs, if necessary. While
VA has no plans to take over approvals of all educational programs, it
does appreciate this flexibility of authority.
VA estimates there are no costs associated with this section.
Section 6 would amend 38 U.S.C. 3676(c)(14) as it pertains to the
criteria used to approve non-accredited courses. Under the proposed
legislation, VA, in consultation with the SAA and pursuant to
regulations, would determine if additional criteria may be deemed
necessary for the SAA to approve an institution's written application
for a course of education. VA and the SAA must treat public, private,
and private for-profit educational institutions equitably.
The legislation would also amend 38 U.S.C. 3675(b)(3) to include
this requirement as part of the approval conditions for accredited
courses offered by private for-profit institutions.
This change would apply with respect to criteria developed pursuant
to 38 U.S.C. 3676(c)(14) on or after January 1, 2013, and an
investigation conducted under 38 U.S.C. 3676(c) that is covered by a
reimbursement of expense paid by VA to a state, pursuant to 38 U.S.C.
3674, on or after October 1, 2015.
While VA agrees with the intent underlining section 6, that the
approval requirements for non-accredited courses should be applied
equitably regardless of the type of institution providing the training,
VA does not believe that it should be interjected into the SAA approval
requirements applicable to educational institutions located in the
state over which the SAA has jurisdiction. VA is not aware of any
widespread concerns regarding unfair practices or unequal treatment
with respect to additional SAA approval requirements. VA is concerned
about the amount of resources that could potentially be involved in
regulating the process, reviewing the SAA requirements, and making
determinations regarding necessity and equity. In this instance, VA
would have to coordinate with all 50 States, territories, and
institutions of higher learning regarding policy and procedure changes.
At this time, VA cannot quantify the level of effort required for
coordination of this scope. Consequently, VA recommends adding the
requirement that any additional criteria treat public, private, and
proprietary for-profit educational institutions equitably, without
requiring a formal process and a VA decision on each additional
requirement. This would ensure the consistent application of additional
SAA approval requirements, allow states to promulgate additional
requirements for educational institutions located within their borders,
and avoid the potentially burdensome administrative process proposed in
this section.
At this time, VA cannot quantify the costs and level of effort
required for coordination of this scope.
Section 7 would amend 38 U.S.C. 3693 by inserting a new subsection
(a) that would require VA to conduct an annual compliance survey of
educational institutions and training establishments offering one or
more courses approved for enrollment of eligible Veterans or
individuals, if at least 20 such Veterans or individuals are enrolled.
VA would be responsible for:
Designing the compliance surveys to ensure that such
institutions or establishments, as the case may be, and approved
courses are in compliance with all applicable provisions of chapters 30
through 36 of title 38;
Surveying each of these educational institutions and
training establishments not less than once during every two-year
period; and
Assigning not fewer than one education compliance
specialist to work on compliance surveys in any year for each 40
compliance surveys required to be made under this section for such
year.
Additionally, VA, in consultation with the SAAs, would annually
determine the parameters of the surveys, and not later than September 1
of each year, make available to the SAAs a list of the educational and
training establishments that would be surveyed during the fiscal year
following the date of making such list available.
VA supports this section as it would improve the compliance survey
process. VA recognizes the importance of compliance work in ensuring
timely and accurate payments to Veterans and their families. As such,
VA and the National Association of State Approving Agencies formed a
joint committee, the Compliance Survey Redesign Working Group, to
streamline and enhance the compliance survey process.
Currently, there are approximately 16,000 approved domestic and
international IHLs and non-college degree institutions. Of the 16,000
institutions, there were 11,260 active institutions in calendar year
2013. During FY 2013 and FY 2014, VA and SAAs completed well over
10,000 surveys, with just over 5,000 surveys completed in FY 2014. VA
anticipates completing a similar number of reviews in 2015. This work
will be split roughly in half between VA and SAAs, as it has been for
the last few years.
The statute requires VA to conduct annual surveys at 100 percent of
schools with greater than 300 beneficiaries and non-college degree
programs. Schools with high numbers of beneficiaries are more likely to
have one or more full-time school certifying officials and may not need
a visit annually. Institutions with a smaller number of beneficiaries
are more likely to have school certifying officials who have other
duties, and these institutions may not be as well-versed in school
certifying official requirements, especially as they relate to the
Post-9/11 GI Bill program.
This section would also create a new provision that would require
the Secretary to consult with SAAs when determining the parameters of
which institutions would receive a compliance survey each year. VA
believes this provision is unnecessary as VA already consults with SAAs
when determining where surveys will be conducted. With the
implementation of section 203 of Public Law 111-377 (Post-9/11 Veterans
Educational Assistance Improvements Act of 2010), VA was granted the
authority to utilize SAAs to assist VA in conducting compliance surveys
at GI Bill-approved institutions. Although VA can use the services of
SAAs, VA continues to be ultimately responsible for conducting
compliance surveys.
There are no mandatory costs associated with section 7, and there
would be only minimal administrative costs associated with this
provision.
Mr. Chairman, thank you for the opportunity to present our views on
the legislation today and we will be glad to answer any questions you
or other Members of the Committee may have.
Chairman Isakson. Thank you very much, Dr. Lynch.
Let me start out by asking you this question. You referred
to the two accountability bills. You mentioned specifically the
Blumenthal bill was, in your words, ``less onerous,'' but you
did not address S. 290 one way or another. I assume that is the
other bill you are talking about.
Dr. Lynch. Yes, sir.
Chairman Isakson. And what is your position on S. 290, the
Moran bill?
Dr. Lynch. Our position on S. 290 is that we do not support
it.
Chairman Isakson. OK. Are you submitting for the record, or
will you submit after this hearing your reasoning behind that?
Dr. Lynch. The reasoning is included in our written
testimony, Mr. Chairman.
Chairman Isakson. In your written testimony? Good.
My second question, you said you supported the intent of
S. 1938, but you had some recommendations. Are those
recommendations in the written testimony, as well?
Dr. Lynch. Yes, sir.
Chairman Isakson. OK. Then let me ask the $64,000 question.
You very casually referred to the discussion draft language
with regard to educational assistance. I think you used one
sentence. This is the flight issue, flight schools, helicopter
training, pilot training. All that is swirling around in the
Capitol the last couple of weeks. I have had a number of visits
in my office, and I understand you all have had a number of
visits, and there are a lot of opinions back and forth in terms
of what Congress should or should not do.
The reason I put that subject on the agenda as a discussion
draft is to start getting the information on the table. Would
you care to elaborate on that issue?
Dr. Lynch. We discussed that extensively in the written
testimony. Mr. Worley would be happy to address the matter
further.
Chairman Isakson. Mr. Worley.
Mr. Worley. Thank you, Mr. Chairman. We have been concerned
for, really, the last 2 years that the significant rise in
payouts specifically related to contracted flight programs,
where they contract with a public institution of higher
learning. Under the Post-9/11 GI Bill, that means that there is
no statutory limit on the amount of money that could be paid to
an individual in a program at an IHL that contracts with a
flight program, or any other contracted program, for that
matter.
We have seen the costs go up. For example, in fiscal year
2013, the number of beneficiaries in flight programs was about
1,700 and we paid out $42 million. In 1 year, the payout number
went up to $80 million for about 1,900 beneficiaries, so an
increase of 200 in the number of students and a nearly doubling
of the costs.
As we look at these payouts in fiscal year 2013 and 2014,
there were about 279 individuals who were individually paid
$100,000 or over for their programs. It was our concern that
that probably was not the intent of the Post-9/11 GI Bill, to
pay out that kind of money, in some cases individuals receiving
hundreds of thousands of dollars.
Chairman Isakson. Excuse me. Let me interrupt you.
Mr. Worley. Yes, sir.
Chairman Isakson. I want to make sure I understand what you
are saying. You are saying individuals. Do you mean individuals
who were veterans who were claiming the benefit got paid, or do
you mean people training under the benefit got paid?
Mr. Worley. I am talking about the beneficiaries. The
veterans who earned the benefit and were using the benefits in
some cases have been paid $500,000, $600,000, $700,000 for
pursuing flight programs that are associated with public IHLs.
Chairman Isakson. I want you to tell me how that works. I
am going to take the Chairman's prerogative here and get a
couple things on the record, if everybody does not mind, if
that is OK with you.
When you tell me an individual got $100,000, you are
talking about a veteran who was eligible for the program got
$100,000 personally?
Mr. Worley. Yes, sir. Well--no----
Chairman Isakson. Whether or not they were trained?
Mr. Worley. No. They received the benefits. In the Post-9/
11 GI Bill, as you know, Mr. Chairman, the tuition and fees
gets paid to the school and the housing, books, and supplies
get paid directly to the veteran. I am talking about the sum
total of the benefits either paid on behalf of the veteran or
paid to the veteran is $100,000 or more, depending on the
situation. Because they are in a flight program in these cases,
that is a contracted program with a public IHL. There is no
cap. We pay the in-resident rate at a public IHL. There is no
limit on that.
Chairman Isakson. IHL, for your information, is institution
of higher learning; correct?
Mr. Worley. Yes, sir.
Chairman Isakson. And that is a public school, right?
Mr. Worley. Yes, sir. Well----
Chairman Isakson. I apologize----
Mr. Worley [continuing]. There are private IHLs, but we are
talking about public IHLs.
Chairman Isakson. And you have an 85/15 rule, is that
correct?
Mr. Worley. Yes, sir.
Chairman Isakson. And that rule is designed to see to it
that no more than 85 percent of the students in flight training
are beneficiaries of the VA GI Bill and at least 15 percent
have to be private pay?
Mr. Worley. Essentially, that is----
Chairman Isakson. Is that what the 85/15 rule means?
Mr. Worley. That is the 85/15 rule which is in statute.
Yes, sir.
Chairman Isakson. That sounds like a pretty easy rule to
enforce, but I read some of the articles in the Los Angeles
Times and some other commentaries where it seemed like the
enforcement of that rule varied from school to school.
Mr. Worley. I would say that it is a somewhat complicated
rule and there have been times in the past where a more lenient
application of the rule has happened. We have tightened that up
through a significant focus on proper application of the 85/15
rule and enforcement. We reviewed all public schools that
contract with flight programs to look at that, and some have
been suspended as a result of violations of the 85/15 rule.
As you know, Mr. Chairman, the 85/15 rule is really
designed to prevent institutions from targeting veterans purely
for their benefits. So, a program should be attractive by at
least 15 percent to other individuals, non-veterans.
Chairman Isakson. And in all cases of people who are paid
benefits under that program, the VA ensures the 85/15 rule
applies?
Mr. Worley. Uh----
Chairman Isakson. Let me restate, to make sure I am clear
on the question. In all those cases where veterans have
qualified for GI benefits for helicopter or fixed-wing
training, in all those cases at public institutions, the 85/15
rule applied?
Mr. Worley. The 85/15 rule applies to----
Chairman Isakson. VA made certain at least 15 percent of
the students were private pay, non-GI beneficiaries?
Mr. Worley. It is the responsibility of the school to
ensure that the 85/15 rule is not broken, and the VA, through
compliance survey work in partnership with the State-approving
agencies, enforce that and review it.
Chairman Isakson. OK. For the membership, you are going to
hear more about this issue later on. I wanted to get some
things on the table. One of our members, Senator Moran, wanted
to introduce a statement for the record, which I think the
staff has, is that correct?
Mr. Shearman. It is on its way.
Chairman Isakson. I would like to ask unanimous consent
that the statement that is on its way from Senator Moran be
entered into the record.
[The prepared statement of Senator Moran can be found in
the Appendix.]
Chairman Isakson. I have gone through your testimony. I
would like a precise VA evaluation of your position on this
issue within a reasonable period of time. I do not know when it
may come before us or whether it is going to come before us at
all, but it has gotten enough publicity and there is enough
angst in Congress on both sides of the issue where I want to
make sure we do what is right as a Committee, which is why I
took a little extra time, and I apologize to the Members for
having done so.
With that said, I will recognize Ranking Member Blumenthal.
Senator Blumenthal. Thanks, Mr. Chairman.
I noticed that a number of your comments on S. 290--or, I
am sorry, the bill that I have introduced requiring
accountability, seem to focus on the difference between the way
the VA does accountability and other agencies, as would be
implemented under this bill. Is it not important to increase
accountability in the VA so that maybe it provides a model for
other agencies? And does this bill not strike you as better
than some of the alternative measures that have been proposed?
Dr. Lynch. I think, Senator, we acknowledge that the bill
is perhaps less onerous than others, but I think we still have
technical concerns regarding the bill, which Ms. Mitrano would
be happy to address. I think from a clinical standpoint, my
concerns would be that these bills may impair our ability to
attract, recruit, and retain the best employees because of the
more rigid accountability to which VA is held.
Senator Blumenthal. Are you saying that the best and the
brightest would be deterred by the provisions of S. 1856
because it is rigid and inflexible? Is that the point?
Dr. Lynch. I think my concern is more toward S. 290. I
think that concerns regarding the S. 1856 bill would be more on
a technical basis, and I might turn to Ms. Mitrano to discuss
that a little bit further.
Senator Blumenthal. Well, the technical stuff, we can deal
with off the record. We do not need to spend that time at this
hearing. But, I would like your endorsement and support for the
goals and basic concepts that are embodied in S. 1856. As I
understand you, there may be some technical issues, but,
basically, you feel it is a good idea.
Dr. Lynch. My position is that I am concerned about some of
the accountability that is imposed and the way it is imposed. I
feel that it may, in fact, deter some individuals, good
individuals who might want to come to work for the VA because
of the requirements of the bill.
Senator Blumenthal. Is there any empirical evidence to
support that?
Dr. Lynch. There is no empirical evidence. It is based on--
--
Senator Blumenthal. Is there any evidence?
Dr. Lynch [continuing]. Experience working in health care
systems.
Senator Blumenthal. I know for a long time, and I have seen
it in other contexts, the fear has been raised that
transparency and accountability in our health care system will
somehow deter good doctors from coming forward, but I think
that the evidence is, in fact, to the contrary, that in
Connecticut and elsewhere, in fact, doctors welcome
accountability--the good ones--because they are far from
fearful that they will be held accountable, and I would think
that management and managers are the same. They do not come to
a place wondering what will happen to them if they do a bad
job. The best people come to a potential opportunity hoping
that there will be the flexibility so they can do a good job.
Dr. Lynch. I do not argue that people come to a job with
optimism. I think what has been seen in the VA over the past
year and one-half, there have been a number of good people who
have been grouped in with those who may not have performed
satisfactorily. So, there has been a blanket judgment on VA
employees and VA physicians. I think this leads people to be
reticent to look at the VA as an opportunity because of what
they have seen.
Senator Blumenthal. My time has just about expired, but I
agree with you completely in your assessment of what has
happened to some degree over the past year, which, in my view,
is the strongest indictment of the present system and the
strongest evidence as to a need for reform and for flexibility
for good judgments about people and holding accountable the
ones who should be rather than, as you said, grouping them
together and perhaps drawing too broad a brush. So, I really
welcome your comments. I hope that we share the same goals and
that we can work through the technical difficulties.
Thanks, Mr. Chairman.
Chairman Isakson. Thank you.
According to the early bird rule, the next four to question
will be Senator Sullivan, Senator Brown, Senator Boozman, and
Senator Manchin. Senator Sullivan, you are first.
HON. DAN SULLIVAN,
U.S. SENATOR FROM ALASKA
Senator Sullivan. Thank you, Mr. Chairman, and I want to
thank you and Ranking Member Blumenthal for the authority to
enable me to hold a field hearing and listening sessions with
the Veterans' Affairs Committee in Alaska over the recess and
to allow the staffers of this Committee to come to Alaska to
see what some of the challenges-- significant challenges--are,
with regard to the implementation of the Choice Act in Alaska.
I also want to thank Dr. Lynch, Dr. Shulkin, and others of
your team who spent almost a week in Alaska. I know we got a
lot out of that trip. I appreciate you taking the time to come
up, tour the facilities, go to the listening sessions, and hold
the hearing that we actually had in my State.
I did want to mention Secretary McDonald was in Alaska
before I was there, about a week before. I was actually in the
great State of North Carolina doing Marine Corps training at
Camp Lejeune while the Secretary was there.
I will say that one of the themes of his visit, a little
bit was still this theme of ``the problems in the VA are kind
of caused by the Congress.'' I do not think that is helpful,
and I think we need to just get rid of that whole line of--it
is almost whining, right. We need to focus on addressing these
challenges. There is a lot of blame to go around. But to have
the Secretary come up to Alaska and kind of insinuate that it
is really Congress's fault, it is not helpful and it is
actually inaccurate. So, I will pass that message on to him,
but I wanted to make sure that you all heard about that.
Dr. Lynch, I am sure that you would agree that we had a
good result out there. In particular, I wanted to talk about
from Dr. Shulkin's testimony, the six points that he made
during the hearing we had in Alaska and to fix the huge problem
in my State about the implementation of the Choice Act. I am
sure that you saw it is quite a big problem.
I know that one of the things that you have been talking
about is starting to implement a way to correct those problems
based on his six priorities by November. I am actually not
pleased with that date of November, so I would like to work
with you, Dr. Shulkin, and other senior officials at the VA to
move that up. You saw that it is an urgent need to address some
of these problems.
What I want to do just briefly was talk about those six
points and see from your perspective if those were required--if
we needed additional legislation or through regulations we are
able to address some of these. I do not know if you have those
in front of you, but he talked, point one, about honoring the
VA's agreements to ensure continuity of care for veterans
seeking care with partners in the DOD, Indian Health Services,
and tribal organizations. Do you have that authority, or do we
need to do something legislatively?
Dr. Lynch. We have that authority, Senator. Further, there
is no question that we will continue to honor those agreements
and look for ways that we can perhaps incorporate those into
future Choice legislation. But there is no question----
Senator Sullivan. You have that authority now.
Dr. Lynch [continuing]. That we have the authority to work
with DOD and the tribal nations to provide health care.
Senator Sullivan. Because, again, what I want to do is work
with you, work with Dr. Shulkin, to do what we all thought was
very important when we were out in Alaska, is to fix this
problem, and his six points were very helpful in that regard.
Dr. Lynch. Absolutely. I do----
Senator Sullivan. Do you have those six points in front of
you?
Dr. Lynch. I do not have them in front of me,
unfortunately.
Senator Sullivan. OK, because we can--I am going to run out
of time here, but----
Dr. Lynch. I will be happy to talk with you after the
hearing----
Senator Sullivan. Yes, because what we want to know--if we
want to be able to work with the Committee and with the VA to
make sure that any authorities that are needed with regard to
those six points that he laid out in Alaska, I want to make
sure we have the ability, hopefully to get through the
Committee, to give you that legislative authority to fix those
problems.
Dr. Lynch. I can tell you that within about half a week of
getting back, Dr. Tuchschmidt and I did meet with the network
director, as well as the TriWest chairman, and we are moving
ahead with the plan to integrate what had been a very
successful care management system on the part of the Alaska
Health Care System----
Senator Sullivan. Right.
Dr. Lynch [continuing]. With individuals from TriWest.
Senator Sullivan. Let me ask you, on that November 2015
date that you or somebody had mentioned, I would like to
accelerate that. We have real problems in my State. A lot of
veterans are suffering. Can you commit to me to move that date
up by several months or by a few months, at least, like this
month? [Laughter.]
Dr. Lynch. Well, we have already met with TriWest and the
network and we are moving ahead with the process of integrating
service to the veterans between TriWest and the VISN 19. I can
commit to that, yes.
Senator Sullivan. OK.
Dr. Lynch. The rest, I would like to speak to you a little
bit to make sure we are on the same page.
Senator Sullivan. OK. Thank you. And thank you, Mr.
Chairman, again, for the opportunity to hold that hearing up in
Alaska. It was very important.
Chairman Isakson. Thank you for your leadership in doing
so.
Senator Brown.
HON. SHERROD BROWN, U.S. SENATOR FROM OHIO
Senator Brown. Thank you, Mr. Chairman, and thank you for
holding this really important hearing on a number of things
this Committee should do.
I want to thank Ranking Member Blumenthal for his words in
support of the Fry Scholarship Enhancement Act. I want to thank
Senator Tillis for his work on it. It has been endorsed by a
number of groups. I would just like to mention, a number of
witnesses on the second panel, the VFW, the National
Association of State Approving Agencies have supported it, the
Military Officers Association of America, the IAVA have
submitted testimony for the record supporting the bill. It has
the support of Gold Star Wives, the National Military Family
Association, the Tragedy Assistance Program for Survivors, the
Student Vets of America, and the Paralyzed Vets of America. So,
I thank all them.
I would like to ask Mr. Worley a series of pretty simple
questions just to hear in your words an explanation of the
importance, sort of the hole we face to fill. I think that from
the discussions you have had with my staff, I think there is
nobody better to explain it than you.
Please explain the Fry Act's significance and its targeted
beneficiaries, if you would.
Mr. Worley. Thank you, Senator. The Fry Scholarship is a
very important benefit. It came into effect around the same
time as the Post-9/11 GI Bill. What it provides for is for
children of military members who are killed in the line of duty
and are on active duty at the time the full Post-9/11 GI Bill
benefit. That is, again, at the 100 percent benefit level. The
Choice Act recently passed last year, Section 701 of that Act,
as you well know, includes spouses into the Fry Scholarship
benefit opportunity. So, it is a very important benefit for
those family members that we are proud to administer and
implement.
Senator Brown. So, what is the glitch that necessitates
this legislation, the Enhancement Act?
Mr. Worley. It is really, in my view, sir, an oversight in
the last. The provisions for the Post-9/11 GI Bill provides for
the opportunity to use Yellow Ribbon if a school offers that.
The way the provision for the Fry Scholarship is put into the
law, it just does not include the Yellow Ribbon opportunity.
So, we welcome this correction, if you will, so that Fry
Scholarship beneficiaries can use the Yellow Ribbon program.
Senator Brown. So, let me repeat and make sure I get it.
You are telling me that spouses and children of veterans who
have died in combat since the September 11 attacks are treated
less favorably under the law and this would correct it, or
treated less favorably when it comes to educational benefits
than are the spouses and children of veterans who did not die
in combat.
Mr. Worley. That is correct, sir, according to the law.
Senator Brown. Thank you. This gets to the core of why this
Committee should move on the Brown-Tillis bill. I hope the
Chairman will join the Ranking Member in supporting it. I look
forward to working with Members of both parties on this.
Thank you, Mr. Chairman.
Chairman Isakson. In response to the statement, the
Chairman has taken a position never to cosponsor legislation
before the Committee. Therefore, there is no prejudice. But the
Chairman always votes for the most intelligent proposal coming
forward. [Laughter.]
Knowing the Senator from Ohio as I do--Tillis and Brown is
a dynamic combo, I can tell you that.
Senator Boozman.
HON. JOHN BOOZMAN, U.S. SENATOR FROM ARKANSAS
Senator Boozman. Thank you, Mr. Chairman.
Dr. Lynch, the first thing I would like to ask you, and you
might not have the answer to this--it is really important to
the people of Arkansas--the Central Arkansas Veterans Health
Care System has been without a director for a year now. Dr.
Margie Scott has been Interim Director, but she was recently
reassigned to be VISN 16 Chief Medical Officer. The Veterans
Hospital in Fayetteville has been without a director since
March 2015. What is the status of filling those slots?
We have really been blessed in Arkansas in having two
excellent facilities. The reason for that is that we have had
excellent leadership, and it really is important that we get
those filled.
Dr. Lynch. Senator, I do not have the specifics. I know we
have been working very hard to begin recruiting and filling
those positions. I can get that information for you in terms of
where we are in that process.
Senator Boozman. Good. That would be very helpful, if we
could get that done----
Dr. Lynch. Absolutely.
Senator Boozman [continuing]. As far as some information
fairly shortly.
Dr. Lynch. Absolutely.
[The information requested during the hearing follows:]
Response to Request Arising During the Hearing by Hon. John Boozman to
Thomas Lynch, Assistant Deputy Under Secretary for Health Clinical
Operations, Veterans Health Administration, U.S. Department of Veterans
Affairs
Response. VA's selection of Senior Executive Service (SES) leaders
is a thorough and rigorous process. VHA conducts a comprehensive
background check, which includes the verification of the nominee's
credentials and references check. The nomination package is then
submitted to VA's Corporate Senior Executive Management Office (CSEMO)
for concurrence and to the VA Chief of Staff (COS) for final approval,
on behalf of the Secretary of VA.
A nominee for the CAVHS Director position was identified, the
clearances and reference checks are complete, and the nominee is
currently going through the approval process.
Senator Boozman. Like I say, we are blessed. We have got
two excellent facilities that worked really hard to take care
of veterans. But, again, that comes through leadership, and I
think we have seen that all over the system.
In regard to Senator Moran and Senator Tester's
legislation, the Physician Ambassadors Helping Veterans Act, in
your testimony, I believe you said, basically, it was not
needed because there was already a statute in place----
Dr. Lynch. Yes, sir.
Senator Boozman [continuing]. That would do the same thing.
Do you feel like with the existing authority that you have now,
is it used? Is it used appropriately?
Dr. Lynch. We have about 4,000 physicians now who are
performing services without compensation. They are
predominately from our academic affiliates. We are initiating
pilots at at least two sites, and probably more, to begin to
look at expanding this to community physicians who may be
willing to help the VA.
I think there are some things that we have to learn, moving
forward. I think that we are understanding the credentialing
and privileging process. I do not think that is an obstacle. I
think we do need to learn a little bit about how we are going
to train the community physicians in an efficient fashion to
work in VA. I think we also have to learn how we are going to
use the new processes of focused and ongoing professional
reviews that are required by the Joint Commission and how we
are going to apply those to volunteer physicians and how much
work that is going to take. I think we are going to have to
learn what is the best way to go out and recruit those
physicians. Is it to work with a volunteer recruiter, or is it
to actually look for a senior physician in the community who
might be interested in working with the VA in the recruitment
of those physicians.
I have actually been working on the pilot program. I have
had interest from actually more than two sites. I will be
meeting with them later this week. But those are the questions
that really, I think, need to be asked before we move forward
with a large-scale program.
Senator Boozman. Sure. Is liability a problem?
Dr. Lynch. Liability is not a problem.
Senator Boozman. OK.
Dr. Lynch. Those physicians would be covered for what they
do while they are working for the VA.
Senator Boozman. Mr. Worley, you mentioned--again, I was
listening to the testimony about the flying situation. It is
interesting. I had a couple of Air Force Colonels in earlier
today and they were talking about the fact that the airlines
were so aggressively hiring right now, and with fighter pilots
being in a situation where they were not flying as much as they
have sometimes in the past, that we are losing a lot of fighter
pilots because the industry is snagging them up. So, it is good
to provide that service. I mean, these are kind of jobs that we
are looking for, good high-paying jobs for our veterans to
acquire.
You mentioned that some were charging $500,000, $600,000,
$700,000 for flight training. Does the veteran participating in
the training have knowledge of that, of those fees, and should
the State Approving Agency be authorizing payments of this
magnitude? Does the VA have the authority to stop these bad
actors?
Again, I am--do not misunderstand. I am totally against
that, and I am sure that we have similar situations not only in
flight training, but just in education in general. But, I
guess, what I am saying is my concern is that in order to
rectify and throw out a few bad apples, that we do not hurt
people that are legitimately trying to pursue an excellent
career.
Mr. Worley. Thank you, Senator. I would respond to that by
saying that we, first of all, we certainly are not interested
in the VA in restricting the benefits----
Senator Boozman. I understand. Yes. I understand.
Mr. Worley. We are very supportive of the breadth of
opportunities that the Post-9/11 GI Bill provides for veteran
servicemembers and their families.
This is specifically a situation that I do not think was
anticipated when the Post-9/11 GI Bill was passed, that a
public institution of higher learning that does not have a cap
on its in-resident rate would contract with another approved
entity--these are GI Bill approved non-IHL institutions like
flight schools--and end up paying those kinds of payouts. There
really is not a comparable other contracted situation that we
know of today. It is flight schools that are the primary
concern.
With respect to that, we felt like it was necessary to
support this legislation in recognition of our concern on the
high amount of money that is going out, notwithstanding the
great job market that is out there. But, if the cap that is
proposed in the legislation--again, we support that cap as a
way of just putting some limits on what is going on today. The
85/15 rule by itself is right now our only tool, but it is not
sufficient to fix this problem.
Senator Boozman. OK. My time is up. Thank you, Mr.
Chairman.
Chairman Isakson. Thank you, Senator Boozman.
Senator Manchin, Senator Rounds, Senator Hirono, and
Senator Tillis.
Senator Manchin.
HON. JOE MANCHIN, U.S. SENATOR FROM WEST VIRGINIA
Senator Manchin. Thank you, Mr. Chairman, and thank you all
for being here today.
Dr. Lynch, there are many reports that the VA is not
holding people accountable for their actions, and that is in
all agencies, I know. We get that from GAO and IG all the time.
But in West Virginia, at the Beckley VA in West Virginia--I
think I brought to your attention some time ago, it has been
over 6 months now--there were allegations, which were
substantiated by Special Counsel, that they were switching
antipsychotic drugs based solely on cost, not on performance
and not on results, solely on cost. They have been doing that
for years. One of the recommendations by the investigator was
to take appropriate actions against the leadership in that VA
center and others, as warranted, in proving actions were not
inconsistent with VHA policy.
I have asked for an update, I think for the last 6 months.
I have not gotten anything yet. I do not know if you know about
this, or----
Dr. Lynch. Senator, I know that it is being looked at very
carefully. I am reluctant to speak in public----
Senator Manchin. OK.
Dr. Lynch [continuing]. About what I know.
Senator Manchin. OK.
Dr. Lynch. But, I think I can assure you that the
accusations are being looked at and are being assessed by VA--
--
Senator Manchin. Well, I think they have been verified--
Special Counsel has verified they were accurate.
Dr. Lynch. And they are now being looked at by our Office
of Accountability review at this point----
Senator Manchin. To take action on the employees----
Dr. Lynch [continuing]. To make decisions regarding the
necessity for action, sir, yes.
Senator Manchin. Can we meet with you later on this, or
maybe in private, so you can bring me up to speed? To be honest
with you, the veterans themselves are concerned because they
are not getting the right prescriptions that help them, and
they found out about the switching, so now they have been
substantiated saying that we were not getting the best medicine
because they are making cost decisions, not based on
performance or outcome. So, if you could help me with that, it
would be greatly appreciated.
Dr. Lynch. Yes, sir.
Senator Manchin. Let me tell you the other one I have a
problem with, and the drug problem in my State and all over
this country is just horrendous. It is the number 1 killer,
prescription drugs. Now I see where the FDA has approved for
children as young as eleven years old to be prescribed
oxycontin. You all have been able to take care of dependent
children. Are you all prescribing that? Will you be doing that
or practicing that?
Dr. Lynch. We do not treat dependent children in VA.
Senator Manchin. You do not?
Dr. Lynch. We do not. So, that is not a VA issue.
Senator Manchin. I thought that there was a limited number
of dependent children that were treated, but you are saying
there are no dependent children?
Dr. Lynch. Not that I know of, Senator.
Senator Manchin. I will check that out, then. OK. At least
you do not have to answer that one, but----
Dr. Lynch. I have been in the VA system for 30 years as a
provider and I have yet to see a child.
[The information requested during the hearing follows:]
Response to Request Arising During the Hearing by Hon. Joe Manchin to
Thomas Lynch, Assistant Deputy Under Secretary for Health Clinical
Operations, Veterans Health Administration, U.S. Department of Veterans
Affairs
Question. Does VA treat dependent children? CHAMPVA?
Response. The statute governing the Civilian Health and Medical
Program of the Department of Veterans Affairs (CHAMPVA), Title 38
United States Code 1781, provides for health coverage to the dependents
of a Veteran who has been rated permanently and totally disabled due to
a service-connected disability. A child of a qualifying Veteran can be
covered under CHAMPVA until the age of 18. Eligibility can be extended
to the age of 23 if the child is a full-time student at an accredited
school.
The Patient Protection and Affordable Care Act, Public Law 111-148,
was signed into law on March 23, 2010. Included in the Public Law was
Section 2714, Extension of Dependent Coverage, which extends health
care coverage to dependent children up to age 26 through a parent's
group or individual health insurance. CHAMPVA is not considered a group
or individual health insurance, but a Federal Benefit Plan; therefore,
Congressional legislation is required for CHAMPVA to extend eligibility
for dependent children up to age 26.
As for treating dependent children in a VA health care facility,
there is no statutory or regulatory restriction that precludes VA
facilities from providing treatment to eligible CHAMPVA beneficiaries
in VA facilities. Currently, both eligible children and adults access
medical care in VA facilities through the CHAMPVA In-House Treatment
Initiative also known as CITI. VA facilities are not required to
participate in CITI. Participation is based on the facility determining
that an excess capacity to provide medical care and services exist
within the facility and have the resources to provide the needed care.
However, VA facilities primarily provide treatment to adults and would
have limitations on resources needed to provide pediatric and
adolescent care to beneficiaries under CHAMPVA.
Senator Manchin. Well, let me follow up on this, then----
Dr. Lynch. OK.
Senator Manchin [continuing]. Because of the addictive
opiates that are on the market today, and there are many more
coming out to consumers and you are using them.
Could you all--and I think you all would be the ones that
would kind of change the culture of America if our veterans,
VA, Medicare, Medicaid, things that we have oversight on, would
not be prescribing opiates for pain relief. There are other
ways to cure pain or, basically, to handle pain. Have you all
considered--I know you have tried probably more alternatives
than anybody else. How is that working?
Dr. Lynch. Senator, the VA has what we call a three-step
plan. The first step of treatment is by the primary care
provider. If the primary care provider reaches a point where he
or she no longer feels competent to work with this patient,
that patient can be referred to a facility committee, which
generally consists of an interdisciplinary group of specialists
that might include pharmacists, physical therapists,
psychologists, a number of individuals to meet with and work
with the patient to develop a plan to help control that
individual's pain. The third step is that each of the networks
is putting in place a specialty inpatient program to begin
helping those patients who are most difficult to treat in terms
of their pain and their use of opioid narcotics.
Response to Request Arising During the Hearing by Hon. Joe Manchin to
Thomas Lynch, Assistant Deputy Under Secretary for Health Clinical
Operations, Veterans Health Administration, U.S. Department of Veterans
Affairs
Issue. Senator Manchin also requested a listing of the alternative
therapies that were available at the VISNs in his state of West
Virginia.
Response:
visn 4--clarksburg vamc
The VAMC provides the following: Pain Clinic, Physical
Therapy, and a multidisciplinary pain management educational group on-
site.
The VAMC refers Veterans offsite for Chiropractic Care,
Aqua Therapy, and Acupuncture as needed.
visn 5--martinsburg vamc
Yoga--Clinical Video Telehealth with Community Based
Outpatient Clinics
Yoga is provided as a part of the DRS Chronic Pain clinic continuum
of services. For those Veterans who reside within the catchment areas
of our CBOCs, we are working on providing ``tele-yoga,'' which occurs
at the same time of the face-to-face sessions. We are currently
awaiting approval for ``ports'' so that services will be simultaneous
with those happening in the Heroes Health & Wellness Center. Tele-Yoga
will be made available at Cumberland and Harrisonburg CBOCs, and then
expanded to other CBOCs as appropriate.
Mindfulness--Clinical Video Telehealth with Community
Based Outpatient Clinics
Mindfulness Meditation is offered as a part of the holistic
continuum of care within our Chronic Pain clinic. In hundreds of
studies, researchers have examined meditation's effects, such as
attention regulation, awareness of the body, depression, Post Traumatic
Stress Disorder, addiction and pain. In these studies, meditation has
been shown to help pain, sometimes significantly, though not cure it.
Guided Imagery--Martinsburg VA Medical Center
Guided Imagery is another meditation technique. Chronic Pain
affects every aspect of living. Guided imagery is an easy relaxation
technique that can help manage stress and reduce. This modality relies
on the concept that your body and mind are strongly connected.
Meditation sends a quiet message to the muscles and mind to relax,
draining the tension out of the body leading to a reduction in pain.
Biofeedback--Martinsburg VA Medical Center
Provided in a one-on-one forum through our Behavioral Psychologist
as part of an integrated model of care.
Acupuncture--Offered in the community under fee-based
Due to vacated position, currently provided through Choice.
Recruiting for vacant position of physiatrist with medical acupuncture
certification.
visn 6--beckley vamc
Veterans are provided the following via fee basis referrals to the
community:
Epidural injections
Vertebral facet therapy
Hydrotherapy
Chiropractic
Acupuncture
Veterans/residents of the CLC are offered additional options:
Art Therapy (weekly or bi-weekly)
Music Therapy (weekly)
Creative Arts Therapy (weekly)
Pet Therapy (weekly)
Aromatherapy (2-3 times a week)
BioFeedback (Snoezelen Therapy) (2-3 times a week)
visn 9--huntington vamc
Complementary/ Alternative therapies offered at the VAMC
Huntington, WV:
Acupuncture
Chiropractic therapy (through community referral)
Art therapy
Animal-assisted therapy
VA Medical Center Huntington has two Community Based Outpatient
Clinics in Charleston, WV and Prestonsburg, WV. It also has two small
Outreach Clinics in Lenore, WV and Gallipolis, OH.
Senator Manchin. Well, you know we have a tremendous
addiction problem, right----
Dr. Lynch. Yes.
Senator Manchin [continuing]. And a lot of our veterans,
because of the service they have given to our country, have
been over-prescribed, if you will, and I get that complaint
continuously from returning servicemembers in West Virginia.
They can get any concoction of pills they want from VA.
Dr. Lynch. I will also let you know, because I looked it up
before I came down here this morning, how the West Virginia
facilities are doing with respect to the Opioid Safety
Initiative, which is VA's plan to help begin to control the use
of narcotic opioid prescriptions. Statistically, all of the
facilities are doing very well and some of them are actually
performing better than the national average.
Senator Manchin. Mm-hmm.
Dr. Lynch. So, I do not think that solves the problem, but
I think it does give us a way forward and it tells us that your
facilities in West Virginia are performing and taking this
seriously.
Senator Manchin. Well, my time has run out. I would like to
get with you personally on this and delve into it a little bit
deeper, if you will.
[The information requested during the hearing follows:]
Response to Request Arising During the Hearing by Hon. Joe Manchin to
Thomas Lynch, Assistant Deputy Under Secretary for Health Clinical
Operations, Veterans Health Administration, U.S. Department of Veterans
Affairs
Issue. Senator Manchin requested a review of how VA handles Opioid
safety issues and how officials are dealing with the issue found that
of a facility switched antipsychotic medications because of cost
reasons.
Response:
pain management with opioids
After many years of promoting the aggressive treatment of
pain with powerful opioid analgesics, the United States is in the midst
of an epidemic of misuse and abuse of opioid analgesics. Misuse and
abuse of opioids can result in overdose, dependency and other negative
consequences.
The safe and appropriate use of opioids is an especially
important issue for VA due to the number of Veterans who have
battlefield injuries and other conditions associated with chronic pain.
Changing VA's patterns of opioid prescribing and consumption requires a
significant cultural shift on the part of providers and Veterans alike
and also requires that VA make other pain treatments available as it
relies less on opioids. This cultural shift must be done in a careful
and measured fashion to avoid the unintended consequence of Veterans
receiving inadequate pain care.
va opioid safety initiative
To address opioid use in Veterans, after conducting a
pilot in several VISNs, in August 2013 VA implemented a system-wide
Opioid Safety Initiative (OSI). The OSI is intended to augment VA's
national pain management strategies, which among other things include,
stepped care, complementary/integrative medicine and focuses of 4 key
metrics:
- The percent pharmacy users receiving an opioid analgesic
- The percent of pharmacy users receiving an opioid who are
also receiving a benzodiazepine (combined use increases risk of
an adverse event)
- The percent of pharmacy users receiving opioids for longer
than 90 days who are also receiving a urine drug screen to
monitor treatment
- The percent of pharmacy users who are receiving aggregate
doses of opioids greater than or equal to a 100 morphine
equivalent daily dose (MEDD)
To monitor the impact of the OSI, quarterly OSI trending
data is disseminated to VAMC and VISN OSI points of contact and to VHA
senior clinical managers. Data outlier facilities are required to
submit action plans to VA Central Office and continued follow-up is
conducted until they are no longer outliers.
clarksburg vamc
The Clarksburg VA has made significant progress in the use of
opioids, but like the VA system as a whole and in the United States in
general, there will always be more work to do. From the fiscal quarter
beginning in July 2012 to the fiscal quarter ending in June 2015:
The percent of pharmacy users receiving an opioid
decreased 22% (3,125 to 2,438 Veterans), while the national percentage
decreased 17% (679,376 to 563,801 Veterans).
The percent of pharmacy users receiving an opioid or
tramadol who are also receiving a benzodiazepine decreased 30% (311 to
217 Veterans), while the national percentage decreased 31% (122,633 to
84,470 Veterans).
- The percent change for this metric must be considered
within the context that Clarksburg has a significantly lower
percentage of Veterans receiving an opioid or tramadol who are
also receiving a benzodiazepine compared to the rest of VA.
The percent of pharmacy users receiving opioids for longer
than 90 days who also received a urine drug screen to monitor treatment
increased 27% (1,259 to 1,722 Veterans), while the national percentage
increased 35% (160,601 to 247,533 Veterans).
- The percent change for this metric must be considered
within the context that Clarksburg has a significantly higher
percentage of Veterans receiving opioids for longer than 90
days who also received a urine drug screen to monitor treatment
compared to the rest of VA.
The percent of pharmacy users who are receiving doses of
opioids greater than or equal to 100 MEDD decreased 19% (132 to 107
Veterans), while the national percentage decreased 23% (59,499 to
45,768 Veterans).
martinsburg vamc
The Martinsburg VA has made significant progress in the use of
opioids. From the fiscal quarter beginning in July 2012 to the fiscal
quarter ending in June 2015:
The percent of pharmacy users receiving an opioid
decreased 8% (1,294 to 1,190 Veterans), while the national percentage
decreased 17% (679,376 to 563,801 Veterans).
- The percent change for this metric must be considered
within the context that Martinsburg has a significantly lower
percentage of Veterans receiving an opioid compared to the rest
of the VA.
The percent of pharmacy users receiving an opioid or
tramadol who are also receiving a benzodiazepine decreased 28% (376 to
272 Veterans), while the national percentage decreased 31% (122,633 to
84,470 Veterans).
The percent of pharmacy users receiving opioids for longer
than 90 days who also received a urine drug screen to monitor treatment
decreased 13% (445 to 388 Veterans), while the national percentage
increased 35% (160,601 to 247,533 Veterans).
- The percent change for this metric must be considered
within the context that Martinsburg has a significantly higher
percentage of Veterans receiving an opioid for longer than 90
days who also received a urine drug screen to monitor treatment
compared to the rest of the VA and the number of patients on
opioids for longer than 90 days has significantly decreased
over time.
The percent of pharmacy users who are receiving doses of
opioids greater than or equal to 100 MEDD decreased 48% (145 to 75
Veterans), while the national percentage decreased 23% (59,499 to
45,768 Veterans).
beckley vamc
The Beckley VA has made significant progress in the use of opioids.
From the fiscal quarter beginning in July 2012 to the fiscal quarter
ending in June 2015:
The percent of pharmacy users in Beckley receiving an
opioid decreased 18% (2,632 to 2,171 Veterans), while the national
percentage decreased 17% (679,376 to 563,801 Veterans).
The percent of pharmacy users receiving an opioid or
tramadol who are also receiving a benzodiazepine decreased 31% (1,054
to 729 Veterans), while the national percentage decreased 31% (122,633
to 84,470 Veterans).
The percent of pharmacy users receiving opioids for longer
than 90 days who also received a urine drug screen to monitor treatment
increased 30% (612 to 869 Veterans), while the national percentage
increased 35% (160,601 to 247,533 Veterans).
The percent of pharmacy users who are receiving doses of
opioids greater than or equal to 100 MEDD decreased 34% (91 to 60
Veterans), while the national percentage decreased 23% (59,499 to
45,768 Veterans).
huntington vamc
The Huntington VA has made significant progress in the use of
opioids. From the fiscal quarter beginning in July 2012 to the fiscal
quarter ending in June 2015:
The percent of pharmacy users receiving an opioid
decreased 20% (4,513 to 3,589 Veterans), while the national percentage
decreased 17% (679,376 to 563,801 Veterans).
The percent of pharmacy users receiving an opioid or
tramadol who are also receiving a benzodiazepine decreased 34% (895 to
595 Veterans), while the national percentage decreased 31% (122,633 to
84,470 Veterans).
The percent of pharmacy users receiving opioids for longer
than 90 days who also received a urine drug screen to monitor treatment
increased 60% (741 to 1,864 Veterans), while the national percentage
increased 35% (160,601 to 247,533 Veterans).
The percent of pharmacy users who are receiving doses of
opioids greater than or equal to 100 MEDD decreased 31% (270 to 186
Veterans), while the national percentage decreased 23% (59,499 to
45,768 Veterans).
Senator Manchin. OK. Thank you, sir.
Chairman Isakson. On that point, I want to acknowledge the
VA's action at Tomah, WI, and what you have done to deal with
what was a very tragic situation, and thank Senator Manchin,
Senator Baldwin, and Senator Johnson, who have all three been
outstanding spokesmen on this opioid issue. I also appreciate
Senator Manchin's leadership on the Committee to continue to
bring it up, because we do need to bring it under control and
make sure when meds are prescribed, they are only necessary and
we are not acting like a candy store. So, I appreciate Senator
Manchin raising that issue continually in all the hearings.
Senator Rounds.
HON. MIKE ROUNDS, U.S. SENATOR FROM SOUTH DAKOTA
Senator Rounds. Thank you, Mr. Chairman.
Dr. Lynch, with regards to the S. 564, the Veterans Hearing
Aid Access and Assistance Act, the VA does not support the bill
because there is a lack of standardized education or
professional licensure requirements of hearing aid or
instrument specialists, as I understand it. What type of
certification would you like to see for these and other
specialists before you could support this type of legislation?
Dr. Lynch. First of all, I think VA does not feel it is
required. We already are able to hire audiology technicians
that work with our audiologists to provide care. They provide a
broad range of services with respect to hearing aid
evaluations, assessing patients post-implantation or post-
obtaining a hearing aid, and also dealing with hearing aid
adjustments and problems.
So, VA thinks that we already have a model that we can use.
Hearing aid specialists can be recruited into those positions,
and actually, our audiology technicians, if they undergo
certification by the Council on Accreditation in Occupational
Hearing Conservation, can perform hearing tests within the VA.
Right now, community providers and the hearing aid
specialists cannot perform the level of hearing tests that we
require for C&P examinations and for our audiology
examinations.
Senator Rounds. How far should a veteran have to travel?
What is an appropriate maximum distance that a veteran should
have to travel in order to get glasses or hearing aids?
Dr. Lynch. I think the Choice legislation has said about 40
miles, sir.
Senator Rounds. Right now, I have got veterans in the
Pierre-Fort Pierre area in South Dakota. They have to travel
halfway across the State just to get a pair of glasses. I am
interested in being able to provide some sort of certification
that if we can provide for hearing aids, and--look, these
folks, if they were not veterans, would be able to get adequate
hearing aids locally. But if they want to access or assess VA
services or at least get payments for hearing aids and glasses
right now, they have to travel, literally, travel across the
State to get eyeglasses.
I met one guy who is 83 years old. You do not want him
driving halfway across the State without glasses to get
glasses.
Dr. Lynch. No, sir.
Senator Rounds. So, what I am suggesting is that there may
be some middle ground here for some of those areas,
particularly in the rural parts of the country, where veterans
should have access to these services, and I am not so sure that
they would agree with your assessment that it has to be
according to a set of standards. A lot of other people get
hearing aids and they do not have to wait and find someone with
those specific great standards that the VA is expecting. I sure
would at least like your consideration of some sort of minimum
standards for those areas that may not be within your service
area.
Dr. Lynch. I am sure we would be happy to work with your
office to look at that further and to see if we could identify
whether or not there is a middle ground. I will let you know,
interestingly, it may not solve all the problems, but VA is
also beginning to use telehealth not only to do hearing
testing, but also to fit hearing aids so that, particularly in
the rural States like North and South Dakota--I am from
Nebraska--before I left Nebraska, we were actually having our
audiologist in Omaha work with patients in Central Nebraska to
provide hearing aid placement, and it was actually very
popular.
Senator Rounds. My point is, look, there has got to be a
way to take care of these folks that are in these rural areas,
and it is a fairly large part of the country that I think
qualifies where we do not have those available right now, and I
would just like to see it fixed. So, I will just take it that
you will work with us and we will try to find a way around----
Dr. Lynch. I will commit that we will be happy to sit down
and work with you and see if we can come to a resolution.
Senator Rounds. Fair enough. I have one more question, and
this will be for Mr. Worley. With regard to the flight
training, I am just curious, you indicated that the IHLs were
contracting with approved flight schools and that that may have
been part of the problem that you had not anticipated. But, I
know prior to 9/11, approved flight schools were still
authorized and folks were getting GI benefits and basically
picking up licensure, back in the 1970s, anyway. I am just
curious, what happened and why is it that an IHL coordinating
with an approved flight school is adding to the cost?
Mr. Worley. The difference in the example you use is, and
this is true today, a vocational flight school--if I just go
directly to a flight school, there is a cap built in that
today, this year, is $12,000 a year. So, we cannot pay more
than $12,000 for someone going to a vocational flight school to
get a commercial license or whatever.
Senator Rounds. One more question, sir, if I could. I am
out of time, but do you allow--will you allow for a commercial
rating, a commercial and an instrument rating, or do you go all
the way to an ATP under the flight school guidelines?
Dr. Lynch. I would have to----
Senator Rounds. Do you know?
Dr. Lynch. I would have to take that for the record, sir. I
think any--if it is associated with a degree program at a
public IHL, which is the scenario we are talking about here, it
would be--if it is approved by the State Approving Agency or
the VA, in that scenario, then it would probably cover any of
those. But I would like to take that for the record to get a
specific answer to you for all the ratings.
Senator Rounds. I would like that. Thank you.
Thank you, Mr. Chairman.
[The information requested during the hearing follows:]
Response to Request Arising During the Hearing by Hon. Mike Rounds to
Thomas Lynch, Assistant Deputy Under Secretary for Health Clinical
Operations, Veterans Health Administration, U.S. Department of Veterans
Affairs
Response. GI Bill benefits can be paid for FAA-approved vocational
flight training programs offered by flight schools with a pilot school
certificate issued under part 141 of the Federal Aviation Regulations,
in addition to flight training required as part of a standard college
degree program. Such programs include Commercial Pilot (fixed-wing,
rotor-wing, etc.), Instrument, Multi-Engine, Flight Engineer, Airline
Transport Pilot, Commercial Flight Instructor (fixed-wing, rotor-wing,
ground, instrument, multi-engine, etc.), as well as type ratings for
numerous commercial aircraft. Benefit payments are limited to the
actual net cost of tuition and fees, up to a maximum of $12,048.50 for
the current academic year, under the Post-9/11 GI Bill. Montgomery GI
Bill beneficiaries receive reimbursement for 60% of the approved
charges, subject to the availability of remaining benefit entitlement.
Chairman Isakson. Thank you, Senator Rounds.
On the question about eyeglasses and hearing aids, is it
not true in some of the VISNs, they have contracted with
Walmart to be the provider of optometry services?
Dr. Lynch. I cannot confirm that. We may be talking about
it, but I do not think we have come to an agreement, if it has
been under discussion, not that I----
Chairman Isakson. In answer to Senator Rounds' question,
where you have a reputable provider of that type of service
that serves rural America, that would provide much easier
access. I am not advocating for Walmart by any stretch of the
imagination, but I believe in VISN 7 that has been approved in
certain areas to be the provider of access, and you might check
that out. That might help Senator Rounds out, as well.
Dr. Lynch. Absolutely.
Chairman Isakson. Not for hearing aids, but for eyeglasses.
Senator Rounds. Mr. Chairman, in this particular case, we
have got plenty of optometrists in the Pierre-Fort Pierre area
that are clearly qualified, and yet they are not allowed to
provide the glasses for our VA constituents. In order to get
the glasses, you have got to go out to Sturgis to pick up the
glasses, which is 170 miles away.
Dr. Lynch. And just to be clear, that is an issue we are
aware of and is being worked on. We would be happy to work with
you.
Senator Rounds. Thank you.
Dr. Lynch. I think it does not make sense and we need to
figure out a better way to do it, and there have been
conversations with respect to optometrists and how best for the
veteran to obtain the glasses once they have had the
examination.
Senator Rounds. Thank you. Thank you, Mr. Chairman.
Chairman Isakson. You ought to be able to figure out a way
to make that work.
Senator Rounds. Yes, sir.
Chairman Isakson. Senator Hirono.
HON. MAZIE K. HIRONO, U.S. SENATOR FROM HAWAII
Senator Hirono. Thank you, Mr. Chairman, for holding
today's hearing and for following through on the commitment
that you made during the Committee markup that we had in July
that you would hear some of your members' bills, including my
own.
I would like to say a few words regarding the three bills
on the agenda that I introduced, and I would like to thank Dr.
Lynch for acknowledging a couple of the bills that I had
introduced, basically in support.
S. 1450, the Department of Veterans Affairs Emergency
Medical Staffing, Recruitment, and Retention Act, S. 1451, the
Veterans' Survivors Claims Processing Automation Act, and
S. 1693, a bill to provide VA emergency care reimbursement for
new VA enrollees.
S. 1450 relates to the restrictive requirements on minimum
hours for full-time physicians and physician assistants. This
bill is based on VA's proposal contained in its budget request
for fiscal year 2016. As you testified, current statutory
limitations make it difficult for VA medical centers to recruit
and retain providers from the private sector, and, really,
recruitment and retention is a huge challenge for VA, I know
very well, speaking to the VA people in the State of Hawaii.
I also would like to acknowledge your willingness to work
on the accessibility of issues for veterans who live far from
providers, such as Senator Rounds' situation and also in
Hawaii, where we have islands and it is really hard for our
veterans to drive from one island to another. In fact, you
cannot. So, I acknowledge the willingness to really pay
attention to the specific needs of our veterans.
So, getting back to S. 1450, this bill would make it easier
for VA medical centers to recruit providers by giving the
Secretary the flexibility to modify minimum hour requirements
for full-time physicians and physician assistants and making it
easier for VA to accommodate the irregular work schedules of
emergency care physicians and hospitals, in particular. With
this flexibility, VA could better accommodate the needs of
these providers and better meet the needs of our veterans,
ensuring that they have the care they need when they need it
the most.
S. 1450 is supported by the American College of Emergency
Physicians and the Veterans of Foreign Wars. Mr. Chairman, I
would like to request that the letters of support from these
two organizations be included in the record.
Chairman Isakson. Without objection.
[The letters of support from Senator Hirono follow:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Senator Hirono. I do understand that the Office of
Personnel Management has some questions regarding S. 1450 and I
look forward to working with them and with you and with the
Chair to enable this Committee to move S. 1450 along.
Regarding S. 1451, the Veterans' Survivors Claims
Processing Automation Act, this bill would make it easier for
survivors of veterans to access benefits. Current statutory
limitations require survivors to file formal claims regardless
of whether VA or the Federal agencies already have the
information it needs to make determinations about benefits. It
makes so much sense that where the VA already has this
information, to make claimants go through the process of
collecting information that you already have and then
requiring, I assume, the VA to then review this information
really does not make any sense. So, I am glad that we are on
the same page regarding this kind of flexibility, not to
mention that we want to get the benefits to the people as soon
as possible.
So, again, the VA has already requested this kind of
authority and flexibility. Veterans groups, including The
American Legion, Disabled American Veterans, Veterans of
Foreign Wars, and Paralyzed Veterans of America have already
supported this measure.
Turning to S. 1493, a bill that I introduced from last
Congress to provide an emergency safety net to around 144,000
veterans waiting for VA care, I appreciate the continuing
support of the VFW and the Iraq and Afghanistan Veterans of
America, their support of this bill. This bill really addresses
a catch-22 situation in current law that puts veterans who are
new enrollees in the VA system at financial risk if they
experience a medical emergency and they have not met the
current law's requirement that they should have visited a VA
facility within the past 24 months. The intent of this
requirement is to encourage veterans to seek preventative care,
which decreases the need for the more expensive emergency care.
I know you understand this particular catch-22 and it
really flows from the inability of the veterans to get the kind
of--the appointments that they needed, which I realize the VA
is addressing very effectively in most places, including
Hawaii, I would think, now. I know that you have some concerns
about this particular bill as you are undergoing a review as to
what would be involved in meeting the provisions of this bill.
So, the one question I would have is how long is your
review process going to take?
Dr. Lynch. I think we have a Congressional mandate to have
a report back to Congress by November 1, which will deal with
how we are going to integrate a number of non-VA care services
into a unified package, and that is part of that discussion.
So, I would suspect we should have some information back around
November 1.
Senator Hirono. Before the end of this year. I would
appreciate that.
Mr. Chairman, I am rapidly--in fact, I seem to have gone
over my time, but just very briefly, we are at the point of
about 2 weeks away before a number of VA authorized measures,
with regard particularly to the homeless veterans, will expire,
and I know that you are well aware, as are a number of us, that
we need to make sure that these programs continue beyond this
fiscal year.
Thank you very much, Mr. Chairman.
Chairman Isakson. Thank you, Senator Hirono.
Senator Tillis.
HON. THOM TILLIS, U.S. SENATOR FROM NORTH CAROLINA
Senator Tillis. Thank you, Mr. Chairman.
First, Mr. Chair, an update. Senator Tester and I met again
with Secretary McDonald and many of his senior staff this week.
We had a very productive discussion. I look forward to giving
you an update on that and, hopefully, we can have a committee
hearing focused on some of the good things that I think the VA
is doing in short order.
I want to go back. Senator Brown mentioned one of the two
bills that I wanted to talk about. Going back to the Fry
Scholarship Enhancement Act, I actually think it may be better
termed the Fry Scholarship Correction Act, because I do not
believe that any reasonable person thinks that we intended not
to have somebody who was killed in the line of duty, to have
their families or their dependents be entitled to this. So, I
will not get into the specifics of that because I think that is
one of these policies where we should have uniform support, and
I would expect it.
I did want to get to some of the mechanics, though. I think
that the 10-year cost of the benefit is estimated to be about
$6.2 million. The cost to implement the underlying IT system is
estimated to be $5 million, almost the equivalent of the 10-
year cost of the benefit. So, this may be less of a question
and more of a statement.
I think it may speak to some of the things that we need to
fix at the IT level, when a program that is fundamentally
bringing in a new class of recipients, and it only relates to
the circumstances that led them there, would cost $5 million in
a year before we could get it online. Please, if you would like
to comment on that or comment on the merits of the bill, I
would welcome anyone to speak.
Mr. Worley. Senator, I would just comment that in order to
take care of this new aspect of the benefit, at least three of
the IT systems that we use would be impacted: the one that the
school certifying officials use to input the information; the
what we call Benefits Delivery Network, BDN, which is a legacy
system that actually is on the other end paying the benefits;
and our long-term solution, which is essentially the Post-9/11
GI Bill automation.
We do not like it any more than you do, but it does take
time to--and we--right now, the whole system is basically in
sustainment, so we have to get a development contractor and go
through that process. So, that is why it takes that amount of
time and that amount of money.
Senator Tillis. Yes. I just think it is a good example of
how we have to become more agile so that when we fix what was
obviously an oversight or an unintended consequence of the Fry
Scholarship Program, that we get to a point where we allow
other people who should have been entitled from the beginning
to come on board, that the cost to do that almost equals the
cost of the benefit we want to give them and delays the process
of having the systems and process infrastructure in place by a
year. So, I want to help remove those barriers, particularly if
some of those barriers really relate to either statutory or
other requirements that you must get through in order to do
your job. I sincerely believe you all know we want to do this
as quickly as possible for the families of fallen soldiers.
The other one I want to speak about is S. 1938, which I am
a cosponsor on with Senator Blumenthal. I appreciate his work
on this. It has to do with the Career-Ready Student Veterans
Act. Again, when we have men and women in uniform coming back,
they want to get skills that make them career ready. We want to
make absolutely certain that they are putting their time and
their energy into education that is going to get them the kinds
of certifications they need in the States where they intend to
get work.
I was not able to be here during the opening comments. I do
not know if you had any comments on this bill, whether or not
you support it, but I would be interested in your feedback now.
Mr. Worley. Senator, we do support the intent of the bill.
We agree with you 100 percent that a course of instruction
should result in the credential that it is supposed to provide
the opportunity for the veteran to take. We do have some
questions and concerns about some of the language in the bill,
specifically with respect to the waiver, applicability of the
requirements to all types of schools, and applicability of the
waiver requirements to all types of schools, and we would like
to work with the Committee to help with that if----
Senator Tillis. Well, I would like to do that, because I
think it is critically important. I have personal experience
where I helped a veteran who worked on my staff down in the
legislature to make sure that he was investing his time, while
he is working a full-time job, trying to get the skills that he
needs to move into another position, to make sure that he is
spending that money wisely and not finding out he worked really
hard, worked nights, raised a family, and still got a--he
thought he got something, but he really did not get something
that would help him get the job he wanted. So, I look forward
to working with the Ranking Member and with the Members of the
Committee to move forward.
The last thing, it has nothing to do with the subject
matter, but I do want to just mention, Mr. Chair, that the
meeting with the VA, the Secretary and everybody, went well,
but there is one thing that still nags at me that is not done,
and that is getting a permanent replacement for the Inspector
General. I think we are working on 20 months now. If you take a
look at some of these programs that we want to do to really
make you all more agile, make you more able to do the great
things you want to do, we need somebody there who is looking at
some of the systemic problems and issues that only an IG who is
in the permanent position can do. So, I, for one, want to
remind everybody that we need to get to that. Hopefully, the
administration will agree and come forward with a nominee.
Thank you, Mr. Chair.
Chairman Isakson. Well, since you raised the question, 2
weeks ago, I talked to the Chief of Staff of the administration
and made a recommendation on an applicant that they ought to
interview, and in that conversation, I encouraged them,
whomever they hire, they needed to get about doing it. It has
gone far too long without having a designated IG.
Second, for the Veterans Administration itself, too many
people in high positions of responsibility are titled
``acting'' and not permanently hired. I think that sends a bad
signal all the way. We have got too many acting directors of
VISNs, too many acting directors of departments. So, I am
hoping that both the administration, as far as the IG is
concerned, will make their appointment, but that the VA also
will designate those people that are permanent as permanent and
no longer as acting so we can move forward with the business of
the VA.
I want to thank our panelists for their attendance, and if
they will excuse themselves to the back, we will bring forward
the second panel. [Pause.]
Response to Posthearing Questions Submitted by Hon. Johnny Isakson to
Mr. Robert Worley, Director of Education Service, Veterans Benefits
Administration, U.S. Department of Veterans Affairs
Question 1. During the discussion on capping Post-9/11 GI Bill
benefits for certain education programs, it was mentioned that very
large dollar amounts had been paid out in benefits for students in
flight degree programs.
a. i. What is the largest amount of cumulative Post-9/11 GI Bill
benefits paid out to or on behalf of one individual for flight degree
training since August 1, 2009?
Response. Since inception through July 31, 2015, the highest amount
paid for a student in a flight degree program was $916,708.44.
ii. Was this an outlier or were other individuals paid
similar amounts?
Response. Yes, VA paid similar amounts for students attending
public institutions of higher learning (IHLs) with contracted
flight programs. VA identified 29 students that were paid over
$500,000 since the inception of the Post-9/11 GI Bill.
iii. Was this individual in an associate's or bachelor's
degree program?
Response. The student was enrolled in an Associate of
Science, Professional Pilot degree program at Mid-South
Community College; however, the program was withdrawn in 2013.
The student transferred to Southern Utah University to pursue a
Bachelor of Science, General Studies with a concentration in
flight studies.
iv. How many academic years did this enrollment span?
Response. The student attended 4 academic years. The first
recorded academic term started on January 23, 2012. The last
date of attendance was recorded on August 3, 2015. This student
has 5 months and 28 days of entitlement remaining.
v. Did the student complete their degree?
Response. No, the student's education file does not show a
data entry of graduating from any degree or certificate
program.
vi. Is their last flight degree institution currently in
compliance with the 85-15 rule? Were the amounts adjusted for
this individual following a compliance survey, and if so, what
were the changes?
Response. The flight program at Southern Utah University is
currently suspended due to violation of the 85-15 Rule.
Students who were enrolled at the time of the suspension can
continue to complete their program. VA is still reviewing
students' records to determine if adjustments need to be made.
b. Please provide the number of Post-9/11 beneficiaries in flight
degree programs for whom benefits were paid out in the following dollar
ranges for FY 2014:
i. $500,000 or more
ii. $300,000 to $499,999
iii. $100,000 to $299,999
iv. $50,000 to $99,999
v. $49,999 or less
Please include for each dollar range the number of students based
on the initial reporting by IHLs as well as the corrected number of
students after completion of the compliance surveys in 2015, if
available.
Response. VA has not made corrections for excessive hours certified
at this time. School catalogs are still under review to determine the
total amount to be repaid.
------------------------------------------------------------------------
Number of Total Expenditure
Range of Expenditures Paid for FY 2014 Trainees Paid
------------------------------------------------------------------------
$500,000 or more........................ 1 $534,881
$300,000 to $499,999.................... 40 $14,522,676.28
$100,000 to $299,999.................... 167 $27,773,854.13
$50,000 to $99,000...................... 208 $14,460,999.39
$49,000 or less......................... 1495 $22,524,789.79
------------------------------------------------------------------------
Please note: This is the number and amount paid out and any adjustments
are not reflected.
Question 2. VA reported that 10 flight degree programs were
suspended from enrolling new students using VA benefits due to non-
compliance with the 85-15 rule.
a. How many VA students were enrolled in these 10 flight degree
programs for FY 2014?
Response. In FY 2014, there were 456 students enrolled at the 10
public IHLs with contracted flight programs.
b. What is the total amount of Post-9/11 GI Bill benefits paid out
for the students in these 10 suspended flight degree programs for FY
2014? What is the corrected amount of benefits for these students
following the compliance surveys in 2015?
Response. No compliance survey adjustments were made. When a school
is suspended for the 85-15 Rule, current students are not impacted;
however, no new enrollments are allowed.
In FY 2014, the total amount paid under Post-9/11 GI Bill benefits
to students at the 10 suspended public IHLs with contracted flight
programs was $41,016,171.21. Below is a table showing this information.
----------------------------------------------------------------------------------------------------------------
Location of Number of
Name of institution institution trainees Total cost
----------------------------------------------------------------------------------------------------------------
Big Bend Community College...................................... Washington 30 $670,841.61
Chandler-Gilbert Community College.............................. Arizona 1 $37,584.50
Delaware State University....................................... Delaware 10 $124,643.30
Dodge City Community College.................................... Kansas 12 $1,043,725.85
Dodge City Community College.................................... Arizona 87 $11,207,646.61
Dodge City Community College--Provo............................. Utah 17 $1,559,787.88
Palm Beach State College-Central Campus Lake Worth.............. Florida 109 $2,968,309.95
Palm Beach State College-South Campus Boca Raton................ Florida 0 $0.00
Palo Alto College............................................... Texas 0 $0.00
Pulaski Technical College-N Little Rock......................... Arkansas 51 $1,023,719.25
Southern Utah University........................................ Utah 68 $15,702,297.46
Tarrant County College.......................................... Texas 2 $41,485.00
Yavapai College................................................. Arizona 69 $6,636,129.80
-----------------------------
Total....................................................... 456 $41,016,171.21
----------------------------------------------------------------------------------------------------------------
______
Response to Posthearing Questions Submitted by Hon. Dean Heller to Mr.
Robert Worley, Director of Education Service, Veterans Benefits
Administration, U.S. Department of Veterans Affairs
I have a few questions about a provision in the draft discussion
related to flight training schools.
This draft will cap tuition rates at public institutions under the
GI Bill--effectively keeping veterans from using their benefits for
flight training school.
I think we know where some of the veterans groups, the VA, and the
flight schools are at on this, but I'd like to share a letter from two
of my constituents who wrote me on this issue.
Question 1. The first, from a grandmother whose grandson is in
flight school:
``The problem is that my grandson, as many other veterans,
researched this through the VA. Why would he chose a school
whose program would not meet the VA standards? The fact that
the Congress would take away any benefits because the law was
not `clearly' written is inexcusable.''
Response. Use of a cap is not in our view ``taking away'' any
education benefits. The cap's purpose is not aimed at limiting
Veterans' educational opportunities, but to improve the integrity of
the education benefits program by limiting profits that VA believes are
so excessive that they constitute abuse of the program. Veterans are
still able to pursue a flight degree and use education benefits should
they choose to do so.
Question 2. The second letter, from a 6-year Army veteran who
recently separated after two deployments to Afghanistan:
``The purpose of my message is to express my strong
disagreement with the proposed changes to the G.I Bill * * *.
This unrealistic cap practically crushes the dream of flight
training for all veterans * * *.Instead of having the innocent
pay for the guilty, your Committee should address the source of
the abuse * * *.''
``Personally, I have always dreamed of pursuing a career in
aviation. The G.I bill represented an opportunity to achieve
that dream, it is truly a shame to have this taken away because
of the greed of a few individuals.''
So, before taking a drastic action to cutoff access to this
program, I'd like to know what VA has done to weed out bad actors.
Question 3. Has VA conducted an audit of flight training schools?
Response. Yes, VA conducted compliance surveys of all (110) IHLs
with contracted flight programs in April and May 2015. VA also
conducted compliance surveys at all vocational flight schools in
July 2015.
Question 4. What percentage of those schools were either
overcharging or violating VA rules?
Response. Of the 110 IHLS surveyed in April and May 2015:
9% of the schools surveyed were in violation of the 85-15
Rule requirements;
2% of the schools were conducting training with flight
schools that were not approved; and
36% of the schools were certifying hours in excess of
those listed in the catalog.
Please note that some of the schools overlapped in the categories
mentioned above.
For the vocational flights schools reviewed in July 2015, VA found
no violation of its rules or overcharged amounts.
Question 5. What solutions, besides imposing a cap, would help weed
out bad actors?
Response. VA has concluded that legislation which would set a
reasonable cap for costs of contracted flight programs is the only
effective means of curtailing the specific problem of excessive charges
by flight schools.
Chairman Isakson. Let me welcome our second panel and thank
you for your patience during the first one.
Our second panel includes Joseph W. Wescott II, Legislative
Director of the National Association of State Approving
Agencies; Roscoe G. Butler, the Deputy Director for Health Care
of The American Legion; Aleks Morosky, Deputy Director of the
National Legislative Service, Veterans of Foreign Wars; and
Donald F. Kettl, Professor of the School of Public Policy,
University of Maryland.
Welcome to all of you. We will begin with Dr. Wescott. I
made you a doctor. You are a doctor? Well, that is good. I got
it right.
STATEMENT OF JOSEPH W. WESCOTT II, LEGISLATIVE DIRECTOR,
NATIONAL ASSOCIATION OF STATE APPROVING AGENCIES
Mr. Wescott. Chairman Isakson, Ranking Member Blumenthal,
and Members of the Committee on Veterans' Affairs, I am pleased
to appear before you today on behalf of the National
Association of State Approving Agencies and appreciate the
opportunity to provide comments on certain bills pending before
this Committee. I am accompanied today by our Legislative
Committee Vice Chair, Retired Sergeant Major Robert Haley.
The S. 1460 Fry Scholarship Enhancement Act, NASAA feels
strongly that it is very much in keeping with the spirit and
purpose of this important program to extend the Yellow Ribbon
GI Bill Education Enhancement Program to cover the worthy
recipients of the John David Fry Scholarship. As such, we
strongly support this bill.
The S. 1938 Career-Ready Student Veterans Act, the primary
responsibility of State Approving Agencies is to approve
quality educational programming in which a qualified veteran or
dependent can enroll while using the GI Bill, which will
prepare them for employment in a satisfying career. Already,
many SAAs require that certain degree programs be accredited by
the programmatic accrediting agency. So, although this problem
is seemingly not widespread, one disappointed veteran is too
many. NASAA supports this bill.
The discussion draft, a bill to make improvement in the
laws administered by the Secretary of Veterans Affairs relating
to educational assistance, we support the provisions of Section
1 of the discussion draft relating to the recodification and
improvement of the election process for post-9/11
beneficiaries. We do not oppose Section 2, relating to
centralized reporting of veteran enrollment, as long as
individual campuses continue to maintain a contact person so as
to provide support to the veteran population.
NASAA supports Section 3 of this bill, as it provides for
clarification of assistance provided for certain programs of
education, particularly contracted programs offered in
conjunction with institutions of higher learning. It is
important that we provide measures to improve cost control for
specialized degree programs, such as aviation degrees offered
by colleges and universities, which involve a contracted
program which may or may not be approved by a State Approving
Agency.
NASAA strongly supports, as well, the provisions of Section
4, which will provide updated information on the amount of
educational assistance to which veterans or other individuals
are entitled. This allows school officials to be in a better
position to assist veterans in planning for and being
successful in their educational programs.
NASAA strongly supports Section 5, relating to the role of
State Approving Agencies, and sees these provisions as critical
to the protection of our veterans and the fair and equitable
administration of GI Bill educational benefits. This section
seeks to clarify and codify State approval authority and
oversight over all non-Federal facilities. In addition, since
the passage of Public Law 111-377, there has been no statutory
authority for the approval of accredited NCD programs at public
or private not-for-profit institutions, a situation that
Section 6 corrects.
NASAA does not oppose the section of the bill relating to
additional reasonable criteria in that it requires that when
the Secretary determines the review of that criteria is
necessary, the Secretary must do so in consultation with the
State Approving Agency, and the criteria must be necessary and
treat all sectors of education within the State equitably.
Finally, Section 7 mandates appropriate changes to 38
U.S. 3693 compliance surveys, which would allow for flexibility
to adjust resources to specific high-risk educational
institutions as needs arise and allow SAAs to provide needed
technical assistance and training visits to schools, as well.
NASAA supports this section.
Mr. Chairman, today, 56 State Approving Agencies composed
of approximately 175 professional and support personnel are
supervising over 12,000 approved facilities with 100,000
programs. Last year, SAAs conducted more than 50 percent of all
the compliance surveys accomplished. But even more
impressively, we increased the number of education and training
programs we approve by over 75 percent. This is just further
evidence that we remain strongly committed to working closely
with our VA partners, our VSO stakeholders, and educational
institutions to ensure that veterans have access to quality
educational programs.
Mr. Chairman, I pledge to you and this Committee that we
will not fail in our critical mission and in our commitment to
safeguard the public trust, to protect the GI Bill, and to
defend the future of those who have so nobly defended us. I
thank you again for this opportunity and I look forward to
answering any questions that you or committee members may have.
[The prepared statement of Mr. Wescott follows:]
Prepared Statement of Dr. Joseph W. Wescott II, Legislative Director,
National Association of State Approving Agencies
introduction
Chairman Isakson, Ranking Member Blumenthal and Members of the
Committee on Veterans Affairs, I am pleased to appear before you today
on behalf of the 56 member state agencies of the National Association
of State Approving Agencies (NASAA) and appreciate the opportunity to
provide comments on bills pending before this Committee, particularly
S. 1460, S. 1938, and the draft bill pertaining to improvements in the
laws administered by the Secretary of Veterans Affairs relating to
educational assistance and for other purposes. As a part of our review
of these bills, we will also provide some additional comments that
address the role of state approving agencies in approving and providing
oversight of educational programs that provide for a secure future for
our Nation's heroes and their families.
role of the state approving agencies: past and present
State Approving Agencies were established shortly after passage of
the Veteran' Readjustment Act of 1944, or the GI Bill of Rights.
Congress, recognizing that it was the responsibility of the states
within our Federal system of government to oversee the education of its
citizens, required that each state establish a ``State Approving
Agency'' and the Governor of each state designated a state bureau or
department as the SAA. The SAA was to be supported by reimbursement of
its expenses by the US Department of Veterans Affairs (VA). Thus
evolved a truly cooperative Federal-state effort that maintains the
rights of the states while monitoring and protecting a federally-
sponsored program administered under the terms and conditions of
Federal law.
From a role of simply advising VA as to which educational and
training programs were state-approved, State Approving Agencies have
evolved to become the primary source of assuring institutional
accountability. With specialized authorization under the Code of
Federal Regulations and state statues, they exercise the state's
authority to approve, disapprove and monitor education and training
programs. SAAs also assist the states and VA with exposing fraudulent
and criminal activity involving the payment of veteran's benefits.
In 1948, SAA representatives met to form a professional
organization to promote high professional standards, create a forum for
the exchange best practices, and to promote uniformity of purpose and
practice. For almost seventy years now, NASAA has worked with our VA
partners, the VSOs, and all agencies to ensure that the greatest
numbers of quality programs are available to those eligible for
education and training programs. We do this through our primary mission
of program approval and our related efforts; compliance, training,
liaison and outreach. Indeed, with the exception of Federal facilities,
the State Approving Agencies are responsible for the approval of all
programs of education and training within the Nation.
s. 1460, fry scholarship enhancement act of 2015
There are no more worthy recipients than those who receive the
Marine Gunnery Sergeant John David Fry Scholarship. The scholarship is
available to surviving children and surviving spouses of active duty
members of the Armed Forces who died in the line of duty on or after
September 11, 2001. Full tuition and fees are paid directly to the
school for all public school in-state students capped at the statutory
maximum amount per academic year equal to the post-9/11 G.I. Bill.
However, unlike dependents of living veterans who are eligible for
Transfer of Entitlement under the Post-9/11 GI Bill and who can
participate in the Yellow Ribbon program, recipients of the Fry
Scholarship cannot. NASAA feels strongly that it is very much in
keeping with the spirit and purpose of this important program to extend
the Post-9/11 G.I. Bill Yellow Ribbon Education Enhancement program to
cover the recipients of this scholarship. As such, we support this
bill.
s. 1938, career ready student veterans act
The primary responsibility of state approving agencies is to
approve quality educational programming in which a qualified veteran or
dependent can enroll while using the GI Bill, which will prepare them
for gainful employment and a satisfying career. While it is true that
all persons that attend career schools, such as law or nursing, do not
always seek or find satisfying employment in that particular career
field, it is certainly not an unfair expectation for a veteran who
graduates from such programs to be qualified to sit for the license or
certification exam. Already, many SAA's require that certain degree
programs be accredited by the programmatic accrediting agency, so
although this problem is seemingly not widespread, one disappointed
veteran is too many. NASAA does however believe strongly that this
requirement should apply equally to public and not-for-profit
institutions as well as proprietary for profit institutions and non-
accredited schools. Of course, that requires that we be aware of the
deemed approved programs, which we will address later in this
statement. Given our role to safeguard the future of veterans and their
families and to protect the integrity of the GI Bill educational
program, NASAA supports this bill.
discussion draft, a bill to make improvements in the laws administered
by the secretary of veteran affairs relating to educational assistance,
and for other purposes.
Though our primary role is to approve quality education programs
and provide oversight of those programs at educational and training
institutions, we understand well the importance of timely payment of
benefits to veterans and the importance of veteran enrollment in the
correct chapters of entitlement available to them. We often work with
the VA Education Liaison Representatives in our states to help resolve
difficult cases involving veteran payment issues and entitlement. As
such we support the provisions of this bill in Section 1 relating to
the recodification and improvement of the election process for Post-911
beneficiaries. NASAA does not oppose Section 2, relating to centralized
reporting of veteran enrollment but would desire that even though
reporting is centralized, that individual campuses must continue to
maintain a contact person so as to provide support to their veteran
population and local accountability to state approving agencies and VA
personnel. NASAA supports Section 3 of this bill as it provides for
clarification of assistance provided for certain programs of education,
particularly contracted programs offered in conjunction with
institutions of higher learning (IHLs). It is important that we provide
measures to improve cost control for specialized degrees offered by
colleges and universities, which involve a contracted program which may
or may not be approved by a state approving agency. For example, some
public higher education institutions have instituted extreme costs for
aviation program fees as there are presently no caps in place for
public IHLs. In some cases, benefits have been paid for aviation degree
programs at public IHLs provided by a third-party flight contractor
with no approval issued by the governing SAA. This was exacerbated by
the implementation of 3672. And some students were taking flight
classes as electives with no cost cap for flight fees. In those cases,
students could foreseeably take flight classes as an ``undeclared''
student for up to two years. This section would limit Chapter 33
payments for aviation programs and similar contracted training at
public institutions to the prevailing cap, presently $21,084.89. There
would be no impact on the institutions' ability to access Yellow Ribbon
funds. We feel strongly that veterans should continue to have access to
quality contracted programs overseen by state approving agencies, but a
reasonable cap is necessary to protect both our veterans and the
integrity of the GI Bill.
NASAA supports as well the provisions of Section 4 which will
provide through a secure information technology system to educational
institutions offering SAA approved programs updated information on the
amount of educational assistance to which veterans or other individuals
are entitled. This allows school officials to be in a better position
to assist veterans in planning for and being successful in their
educational programs. We might add that we would also like to see
changes and improvements made to VA information technology systems such
that all original and supplemental chapter 33 claims, to the maximum
extent possible, are adjudicated electronically, to include on-the-job
training and apprenticeship programs, which are all still processed
manually. Indeed, for the last two years, we have worked side by side
with our VA partners to redesign the compliance survey process so that
corrections to claims generated during those visits would be handled
utilizing the VA Once automation system and not paper referrals. We
continue to work with the VA to further refine the handling of these
claim adjustments so that veterans may receive monies owed them as
expeditiously as possible.
NASAA strongly supports Section 5 relating to the role of state
approving agencies and sees these provisions as critical to the
protection of our veterans and the fair and equitable administration of
GI Bill educational benefits. This section seeks to clarify and codify
State approval authority and oversight over all non-Federal facilities.
It would accomplish this by identifying SAAs as the primary entity
responsible for approval, suspension, and withdrawal. These proposed
changes would ensure that an actual process for approval, suspension,
and withdrawal will be adhered to (as opposed to our current scenario
under the present often misunderstood ``deemed approved'' concept). The
law does not do away with the concept that accredited degree programs
at public and not for profit private institutions of higher education
(IHLs) may be ``deemed approved,'' rather, it would maintain the intent
of the statute by adhering to an expeditious list of approval criteria
for those programs that have been reviewed and/or endorsed by another
appropriate entity. Furthermore, these changes would lessen the
opportunity for third-party contracted training programs to be ``deemed
approved'' with no review, in that SAAs would clearly possess the
authority to review contracted training programs as a part of their
annual evaluation of programs and policies.
In addition, since the passage of the Post-9/11 Veterans
Educational Assistance Improvements Act of 2010 (111-377) in
January 2011, there has been no statutory authority for the approval of
accredited NCD programs at public or private not-for-profit
institutions. We estimate over 10,000 such programs are in existence
today over which neither us nor the VA have existing statutory
authority to maintain their approval. These programs include teacher
certification programs, accounting certificates, dental assisting as
well as graduate certificates not a part of a degree program. Section 6
expands 3675 to cover all accredited programs not already covered under
3672, while maintaining all previous approval criteria for private-for-
profit institutions. We are concerned with the recent proliferation of
transition and training programs at accredited institutions of higher
learning, particularly community colleges, as well as certifications
that may or not meet industry standards or have real earning power.
As the oversight of education within their borders remains both a
key role and responsibility of the states, NASAA strongly supports
``additional reasonable criteria'' which are used to approve non-
accredited courses. Examples of such criteria that states mandate
within their borders include a requirement for licensing to operate an
educational institution or requirements for health and safety
regulations. Likewise, some states require additional attendance
requirements or a careful monitoring of standards of progress. Such
additional criteria are for the protection of the states and their
residents and/or citizens. NASAA does not oppose the section of the
bill relating to additional reasonable criteria in that it requires
that, when the Secretary determines that if review of the state
criteria is necessary, the Secretary must do so in consultation with
the State approving agency and the criteria must be necessary and treat
all sectors of education within the state equitably. Equitable
application of statute is a shared value of our member agencies.
Finally, Section 7 mandates appropriate changes to 38 US 3693 (
Compliance Surveys) to maximize the opportunity to protect the GI Bill
while changing the manner in which we perform these surveys to reflect
the changes that have occurred in higher education and training in the
past three decades. The current statutory requirements for VA to
conduct Compliance Surveys represent an almost impossible mission,
given present resources. The statute requires an annual survey be
conducted at each and every facility that offers anything other than a
standard college degree as well as each and every institution enrolling
at least 300 GI Bill recipients. This section makes changes in the law
to allow for a manageable mission in which VA, with the assistance of
SAA partners, can conduct compliance surveys on a regular scheduled
basis at the majority of approved institutions, while allowing for
continued waiver of those institutions with a demonstrated record of
compliance. At the same time, NASAA feels strongly that no school
should go without a visit of some kind for longer than three years.
Such compliance surveys should be designed to ensure that the
institution and its approved courses are in compliance with all
applicable provisions of chapters 30 through 36 of this title, but
should also allow for limited program review, interviews with veteran
students and training for school officials. Plus, the changes should
allow for flexibility to adjust resources toward specific high-risk
educational institutions as specific needs arise, allowing both VA and
SAAs to be nimble and proactive in response to risks identified through
the new complaint system and will allow SAAs to provide needed
technical assistance and training visits to schools. By amending the
law to provide that ``the Secretary will conduct a compliance survey at
least once every two years at each institution or facility offering one
or more courses approved for the enrollment of eligible veterans or
persons if at least 20 veterans or persons are enrolled in such course
or courses,'' we will make sure that schools that need a visit will
receive one and will allow enough flexibility for SAAs to focus more on
their primary roles of approval, training and technical assistance. We
believe in the wisdom of preventing problems through carefully
approving programs that provide jobs to veterans, not by creating debts
or allowing veterans to go months without proper payment when such
could and should be avoided.
conclusion
Mr. Chairman, today, fifty-six (some states have two) and the
territory of Puerto Rico, composed of approximately 175 professional
and support personnel, are supervising over 12,000 approved facilities
with 100,000 programs. Last year, we increased the number of compliance
visits we conducted to 2,672 visits, an increase of 17% over the
previous year and more than fifty (50) percent of the visits
accomplished by state approving agencies and the VA. But even more
impressive, we increased the number of education and training programs
we approved by over 75% while expanding our outreach efforts to new
institutions and veterans by 26%. I am also pleased to report that
State Approving Agencies, through NASAA, have taken a leading role in
assisting their individual states in becoming compliant with Section
702 of the Choice Act and because of that initiative 47 states are
compliant with section 702 requirements and the others are working
diligently to become so before years end. This is just further evidence
that we remain strongly committed to working closely with our VA
partners, VSO stakeholders and educational institutions to ensure that
veterans have access to quality educational programs delivered in an
appropriate manner by reputable providers. For we all share one
purpose, a better future for our veterans and their dependents.
Mr. Chairman, I pledge to you that we will not fail in our critical
mission and in our commitment to safeguard the public trust, to protect
the GI Bill and to defend the future of those who have so nobly
defended us. I thank you again for this opportunity and I look forward
to answering any questions that you or committee members may have.
Chairman Isakson. Thank you, Mr. Wescott.
Mr. Butler.
STATEMENT OF ROSCOE G. BUTLER, DEPUTY DIRECTOR FOR HEALTH CARE,
THE AMERICAN LEGION
Mr. Butler. Chairman Isakson, Ranking Member Blumenthal,
and distinguished Members of the Committee, on behalf of our
newly elected National Commander Dale Barnett and over two
million members of The American Legion, we thank you for the
opportunity to testify regarding pending legislation.
There are several bills on the agenda for today and you
have our full written remarks on the record. Therefore, I will
focus on a couple of key concerns and then answer any questions
you may have.
Accountability within VA is a concern to all veterans.
Although we have seen VA move to react to last year's scandals,
we know that veterans in the community are still frustrated
about a perceived lack of consequences for those responsible
for the failures. Last year's Veterans Access to Care and
Accountability Act provided VA with some easier measures for
firing executives within VA. Contrary to fears of draconian
purges and a new spoils system, this authority has been
scarcely used. Veterans need to see there are consequences for
those who manipulate the system to their benefits and to the
determent of the veterans they serve. The system should be
simple and transparent, open for all to see.
We should not need new laws to terminate VA employees if
they are committing crimes. VA should already have that
authority. If a VA employee commits a crime, they should be
prosecuted by special prosecutors, if necessary. We should not
need to micromanage how VA handles their managers with quota
rationing. Working toward arbitrary quotas and numbers is
perhaps what led to VA's problems in the first place.
VA can restore accountability by becoming directly
accountable to the veterans in the community and engaging with
them, showing them step by step the measures they are taking to
right the mistakes when a medical system fails our veterans.
While The American Legion applauds the aims of S. 290 and
S. 1856, we do think there is more work to be done to make sure
we are not just adding more layers to a bureaucracy when layers
need to be stripped away to enable more direct accountability.
S. 1450, the Veterans Affairs Emergency Medical Staffing
Recruitment and Retention Act, will provide much needed
flexibility for staffing so VA facilities can implement
staffing models more in keeping with current medical practices.
This is especially necessary in terms of staffing emergency
rooms. Doctors and nurses do not keep to the same schedules to
a nine-to-five office workers, and, therefore, the government
regulations about hourly staffing can make VA shift planning
far more difficult than comparable civilian medical centers.
This is a common sense fix that will help with staffing,
particularly as emergency rooms have had to close because of
staffing scheduling issues. It makes sense to staff VA
facilities as you would other medical facilities.
Finally, S. 564, the Veterans Hearing Aid Access and
Accountability Act, is a simple measure that could provide some
help to VA in terms of relieving staffing burdens. According to
VA's own figures, veterans attended over 903,000 appointments
for audiology services in fiscal year 2014. This area of
treatment is growing, and hearing loss and tinnitus are the two
most prevalent service-connected disabilities, and yet not all
required services need a full-time audiologist. In April of
this year at an IOM presentation, it was estimated nearly half
of patients awaiting care in VA were for audiology services.
Furthermore, treatment often requires multiple visits. Not
all of these visits require an audiologist. This legislation
would enable the hiring of hearing aid specialists who could
take some of the workload off the audiologists and still
deliver the needed care to veterans. This is a small fix, but
could potentially have a big impact on this large and growing
segment of the veteran population.
Thank you again, Mr. Chairman, Ranking Member Blumenthal,
for turning the Committee's attention to getting this right. I
appreciate the opportunity to present The American Legion's
views and look forward to answering any questions you may have.
[The prepared statement of Mr. Butler follows:]
Prepared Statement of Roscoe G. Butler, Deputy Director of Health Care,
National Veterans Affairs and Rehabilitation Division, The American
Legion
Chairman Isakson, Ranking Member Blumenthal, and distinguished
Members of the Committee, On behalf of our National Commander, Dale
Barnett, and the over 2 million members of The American Legion, we
thank you for this opportunity to testify regarding The American
Legion's positions on pending legislation before this Committee. We
appreciate the Committee focusing on these critical issues that will
affect veterans and their families.
s. 290: increasing the department of veterans affairs accountability to
veterans act of 2015
To amend title 38, United States Code, to improve the
accountability of employees of the Department of Veterans Affairs, and
for other purposes.
Reacting to the firing of Phoenix VA Healthcare System Director in
November of last year, then National Commander of The American Legion
Mike Helm noted:
``This is one long-overdue step in a journey that is far from
over. Unfortunately, as we all soon discovered after the story
broke last April, this problem was not isolated to Phoenix. It
was widespread, and we expect to see additional consequences,
even criminal charges if they are warranted, for anyone who
knowingly misled veterans and denied them access to medical
services.''\1\
---------------------------------------------------------------------------
\1\ ``Legion: VA director's overdue firing applauded''--Nov. 24,
2014
The American Legion believes it is important to ensure there is
accountability at all levels within VA and that the process is
completely transparent. Where VA employees are found to have engaged in
wrongdoing, The American Legion supports the appointment of a special
prosecutor to be assigned to investigate and vigorously prosecute any
VA employees engaged in fraudulent practices designed to improperly
award bonuses or other financial or meritorious awards to the
perpetrator.\2\ While those in the Senior Executive Service (SES) can
and should receive performance bonuses when their performance is
exemplary, The American Legion believes any bonuses need to be tied
clearly to quantitative and qualitative measures.\3\ There must be an
open process for determining these awards that all stakeholders can
examine to determine the propriety of the awarded bonuses.
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\2\ Resolution No. 107--Aug. 2014
\3\ Resolution No. 128--Aug. 2014
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This legislation addresses some of the concerns of The American
Legion. Our organization supports increased accountability, and those
employees found guilty of having committed crimes at the expense of the
veterans entrusted to their care should never profit from those crimes.
To receive bonuses based on manipulation and lies undercuts any trust
with the veterans' community. Requiring additional transparency about
SES performance outcomes is also laudable and supported by The American
Legion.
While The American Legion understands the intent of over hauling
the VA's performance appraisal system, The American Legion has concerns
with the proposed changes. We believe there must be a system that is
clear, transparent and tied to observable quantitative and qualitative
goals. However, the level of specificity and the quota rationing may be
too constrictive to VA's ability to manage. This should be worked out
in collaboration between Congress and VA to ensure the system remains
an effective management tool.
The American Legion recognizes the importance of reforming the
bonus system and indeed the management culture within VA, and applauds
the initial efforts by VA Secretary Robert ``Bob'' McDonald to begin
that process, as well as the diligence of this Committee to direct
oversight efforts toward that task. This legislation has great
intentions, and the portions related to adding transparency to the
system and preventing employees from profiting at the cost of veterans
is important. With further work, perhaps more of the legislation could
be supported, and The American Legion looks forward to working with
this Committee to ensure impactful legislation is passed toward this
end.
The American Legion generally supports this legislation, but
believes additional work as noted above may be necessary to support the
entire legislation.
s. 563: physician ambassadors helping veterans act
To amend title 38, United States Code, to establish the Physician
Ambassadors Helping Veterans program to seek to employ physicians at
the Department of Veterans Affairs on a without compensation basis in
practice areas and specialties with staffing shortages and long
appointment waiting times
S. 563 would increase the timeliness and quality of care for
veterans enrolled in the VA healthcare system. The Physicians
Ambassadors Helping Veterans Act would direct the VA to use its
existing authority to promptly offer privileges to physicians who
volunteer to serve at least 40 hours per year at VA medical centers.
This bill would eliminate the barriers for licensed physicians who are
not employed by the Department of Veterans Affairs to volunteer their
time and expertise for the purpose of getting veterans the medical care
they need in a timely and efficient manner.
The American Legion supports this legislation.
s. 564: veterans hearing aid access and assistance act
To amend title 38, United States Code, to include licensed hearing
aid specialists as eligible for appointment in the Veterans Health
Administration of the Department of Veterans Affairs, and for other
purposes
Many veterans throughout the country are experiencing long wait
times and having to travel long distances for audiology appointments.
The increased use of hearing aid specialists used by VA would lead to
decreased wait times, provide more convenient care, and increase
follow-up audiology services for several thousand enrolled veterans.
Recently, The American Legion reached out to the VA regarding wait
times for audiology appointments. According to VA figures, as of
July 2015, there were 12,910 new enrolled patients and 4,351established
patients who were waiting longer than 30 days for an audiology
appointment. Currently, under the Veterans Choice Program any veteran
waiting over 30 days is given the option to seek care in the private
sector. Nevertheless, the Denver Acquisition and Logistics Center
(DALC) reported that there were no backlogs in processing hearing aids
for veterans. The American Legion believes VA already has the authority
to address this problem through the outsourcing of care, however
outsourcing care ultimately distances VA from its mission of caring for
the veteran. Ultimately, VA's own resources should be built up to
address these problems in-house.
The American Legion supports the hiring and utilization of hearing
aid specialists to perform hearing aid testing, fitting, and dispensing
services.\4\ Such additions would augment VA's capacity in-house
without necessity for creating an overabundance of full audiologists.
VA would be able to better manage their workload and maximize their
ability to deal with the easier problems, freeing up audiologists to
deal with more serious medical issues.
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\4\ Resolution No. 64--Sept. 2015
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The American Legion supports S. 564.
s. 1450: veterans affairs emergency medical staffing recruitment and
retention act
To amend title 38, United States Code, to allow the Secretary of
Veterans Affairs to modify the hours of employment of physicians and
physician assistants employed on a full-time basis by the Department of
Veterans Affairs
The Veterans Affairs Medical Staffing Recruitment and Retention Act
would give the Veterans Health Administration (VHA) the ability to
address the unbalanced work schedules that are often associated with
providing emergency room health care. Since 2003, The American Legion
through the ``System Worth Saving Program'' has been actively tracking
staffing shortages at VA medical centers across the country. The
American Legion's 2014 System Worth Saving report entitled `` Past,
Present, and Future of VA Health Care'' found that several VA medical
centers continue to struggle to fill critical positions across many
disciplines within the healthcare system.
The American Legion believes the Veterans Health Administration
must continue to develop and implement staffing models for critically
needed occupations.\5\
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\5\ Resolution No. 101--Sept. 2015
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The American Legion supports S. 1450.
s. 1451: veterans' survivors claims processing automation act of 2015
To amend title 38, United States Code, to authorize the Secretary
of Veterans Affairs to adjudicate and pay survivor's benefits without
requiring the filing of a formal claim, and for other purposes.
Eligibility for survivors' benefits can often be easily obtained
either by evidence held by VA or through items such as a death
certificate. For example, if a veteran received 100 percent service
connection for 10 years prior to their death, the surviving spouse is
entitled to Dependency and Indemnity Compensation (DIC). DIC benefits
could also be awarded based upon a service-connected condition either
causing or contributing to the veteran's death. This information could
easily be extracted from a death certificate.
S. 1451 strives to reduce the burden for many grief-stricken
surviving spouses. If evidence obtained by VA clearly indicates the
veteran's death was caused or contributed to by military service or a
previously service-connected condition, then the award should be
granted. The American Legion supports VA discovering more effective and
efficient methods to administer its disability benefits, provided those
methods do not strip away due process from veterans.\6\ The American
Legion strongly believes S. 1451 would assist in reducing the burden on
surviving spouses and allow VA to adjudicate claims in a more efficient
manner.
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\6\ Resolution 28--May 2015
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The American Legion supports S. 1451.
s. 1460: fry scholarship enhancement act of 2015
To amend title 38, United States Code, to extend the Yellow Ribbon
G.I. Education Enhancement Program to cover recipients of the Marine
Gunnery Sergeant John David Fry scholarship, and for other purposes.
S. 1460 would expand the Yellow Ribbon G.I. Education Enhancement
Program (public-private contributions for educational assistance in
addition to post-9/11 educational assistance) to the child of an
individual who, on, or after September 11, 2001, dies in the line of
duty while serving on active duty.
The American Legion currently has no position on S. 1460.
s. 1693: veterans emergency health safety net expansion act of 2015
A bill to expand eligibility for reimbursement for emergency
medical treatment to certain veterans that were unable to receive care
from the Department of Veterans Affairs in the 24-month period
preceding the furnishing of such emergency treatment, and for other
purposes.
Under current law, Title 38, United States Code (U.S.C.) 1725 and
1728 VA is permitted to make payment and reimbursement to a claimant
for emergency treatment provided to service- connected and nonservice-
connected veterans with a timely filing limit for unauthorized
inpatient or outpatient care claims (two years from the date of care
for service-connected veterans and 90 days for nonservice-connected
veterans). Several veterans have reported to The American Legion that
delayed payments for emergency care treatments by the VA to non-VA
providers have resulted in numerous credit issues for those veterans
who received emergency care treatments.
Veterans who have not been seen at the VA medical center in 24
months have to pay out of pocket if they receive emergency medical
treatment outside the VA healthcare system, and will not be reimbursed
by the VA. Under this bill the burden of that cost would shift from the
veteran to the VA. This legislation includes a provision that would
prevent insurance companies from denying and/or limiting reimbursements
to the VA for medical care rendered to veterans who have insurance on
the basis that VA is not an in-network provider. According to VA, this
provision is estimated to enable the VA to have the ability to collect
an estimated $98 million in 2015, or $1.1 billion over 10 years, from
insurers who would no longer be able to list VA hospitals as out-of-
network.\7\
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\7\ KSNT.com--June 12, 2014
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The American Legion believes VA should promptly pay non-VA
providers for emergency care furnished; furthermore, VA should conduct
outreach to veterans regarding the effect of delayed payments of claims
for emergency medical care furnished by non-VA medical providers.\8\
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\8\ Resolution No. 100--Sept. 2015
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The American Legion supports S. 1693.
s. 1856: department of veterans affairs equitable employee
accountability act of 2015
A bill to provide for suspension and removal of employees of the
Department of Veterans Affairs for performance or misconduct that is a
threat to public health or safety and to improve accountability of
employees of the Department, and for other purposes.
This legislation attempts to address the issues of accountability
within the Department of Veterans Affairs. The lack of accountability
has been a consistent problem dating back long before the health care
access crisis came to the forefront in Phoenix last year. Even so, when
manipulation of the scheduling system was brought to light, and it was
apparent that the secret wait lists were in use in at least 70 percent
of VA facilities examined, only one employee connected to the scandal
has been fired, and for offenses unrelated to the wait time scandal.\9\
\10\
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\9\ Washington Times--June 9, 2014
\10\ Arizona Central--December 23, 2014
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Secretary Bob McDonald has publically commented on the Byzantine
and arduous process, noting on 60 Minutes last year that ``[I] can't
punish or fire a thousand people right now, [I'm] discovering how
different the Capitol is from capitalism. To fire a government manager
he has to put together a case and prove it to an administrative judge *
* * . So we propose the action, the judge rules and the individual has
a time to appeal. That's why we have a lot of people on administrative
leave.'' \11\
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\11\ 60 Minutes--November 9, 2014
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This legislation proposes to make it easier to remove VA employees
in certain circumstances, however in doing so may actually create more
bureaucracy, rather than less needed to efficiently clean up the VA.
It's staggering to think that VA currently does not have the authority
to rapidly remove employees if:
Their supervisor has reasonable cause to believe the
employee committed a crime that could lead to imprisonment
The employee is believed to be a threat to themselves or
others
The employee is engaging in behavior that may result in
loss or damage of government property
Yet these are the provisions the legislation puts forward as
criteria for expedited firing. These are provisions that should already
be baseline, yet there are other actions outside immediate threat to
physical health or crimes that should still lead to dismissal. Shunting
a veteran to a secret wait list may not directly lead to physical harm,
a lawyer for the employee certainly can tie up a firing with that
argument, but that kind of culture that puts gaming the system above
the veterans' best interests is exactly what all of the stakeholders
are trying to fix.
The American Legion does not support this legislation at this time,
although we recognize the intent to attempt to improve accountability.
The American Legion believes we will get more accountability with a
more streamlined system to remove bad actors from the system, not by
adding more layers of bureaucracy and conditions.
The American Legion does not support this legislation.
s. 1938: career ready student veterans act
To amend title 38, United States Code, to improve the approval of
certain programs of education for purposes of educational assistance
provided by the Department of Veterans Affairs, and for other purposes.
It is important to keep in mind that there are different types of
accreditation, including institutional accreditation and program
accreditation. Institutional accreditation is typically done by
regional and national accreditation bodies. Programmatic accreditation
is for specific programs offered within an educational institution.
Programs are typically accredited by specialty organizations. An
example would be the American Psychological Association (APA) and the
American Bar Association (ABA) which are programmatic accreditation
bodies, respectively.
It is common for licensing and certification agencies to require
institutional accreditation and/or program accreditation. In Virginia,
for example, to be licensed as a clinical psychologist:
The applicant shall hold a doctorate from a professional
psychology program in a regionally accredited university, which
was accredited by the APA within four years after the applicant
graduated from the program, or shall meet the requirements of
subsection B of this section.\12\
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\12\ LIS Virginia Law
This does not make effective use of GI Bill benefits if an
individual uses the benefit to prepare for a licensed or certification
occupation, but the program does not meet licensure requirements. This
would include the requirement that a program be accredited by a
programmatic accrediting agency.
The American Legion urges the requirement apply equally to
institutions of higher education, as well as non-accredited schools.
This always means the Congress should not exclude deemed approved
degree programs, and ensure that State Approving Agencies (SAAs) can
have adequate oversight of all institutions of higher learning.
The American Legion also believes if this task should fall as a
responsibility of the SAA, the proposed legislation should incorporate
how the Department of Defense (DOD) determines program approval for
usage of Tuition Assistance (TA). Questions remain as to if the
legislation would only cover meeting the licensure or certification
standards in the respective state where the institution is located. If
that is the case, it is troubling for those veterans who do not plan to
practice in the state where the school is located or individuals taking
distance learning courses. The legislation should make clearer who will
determine the requirements for these programs in all states.
If the intent of the Congress is to add to the existing workload of
the SAAs, which are already spread thin, then Congress should give
great consideration and revaluation of the existing budget of the SAAs,
to include increasing such budgets to ensure the SAA's are able to take
on their current workload, as well as the possibility of this new add-
on. The American Legion believes there is validity in the underlying
reason for the proposed legislation and supports S. 1938. However, we
also believe there are a few items that need to be fleshed out.\13\
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\13\ Resolution No. 312--Aug. 2014
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The American Legion supports this legislation, with some revisions,
and we look forward working with the Committee.
discussion draft: a bill to make improvements in the laws administered
by the secretary of veterans affairs relating to educational
assistance, and for other purposes
Section by section analysis:
Sec 1. Recodification and improvement of election process for Post-9/11
Educational Assistance Program
Section 1 represents another administrative improvement to the
processing of the Post-9/11 GI Bill. The American Legion is pleased to
participate in and recognize ongoing efforts like this to improve the
Department of Veterans Affairs' products, services and processes. The
American Legion supports the Senate's efforts to streamline how VA
approves initial claims for Post-9/11 GI Bill beneficiaries. Currently,
claims processors must go through a time-intensive back-and-forth with
potential student-veterans who accidentally revoke the wrong GI Bill
benefit before they can properly enroll them in Chapter 33. This bill
would allow VA to make a reasonable effort to contact the veteran to
enroll them in the best education benefit that suits their needs. This
section goes further in also adjusting how VA reimburses veterans
eligible for the Montgomery GI Bill (Chapter 30) and who have paid into
the benefit, but elect to use Chapter 33 instead. Currently, Chapter
30-eligible veterans who elect to use Chapter 33 must wait until they
have finished using their benefits before the VA can repay them for
their Chapter 30 contribution. Under this law, the Chapter 30
contribution would be prorated and added into living stipend payments
while the veteran is enrolled in Chapter 33. The American Legion
supports this section of the discussion draft proposed legislation
Sec 2. Centralized reporting of veteran enrollment by certain groups,
districts, and consortiums of educational institutions
This section amends veterans' educational assistance program
reporting requirements under which enrolled veterans (or eligible
persons) and educational institutions must report enrollment
information to the Secretary of Veterans Affairs (VA). It requires
individuals and educational institutions participating in the post-
Vietnam era and post-9/11 veterans' educational assistance programs to
report to the Secretary such enrollment and any updates on interruption
or termination of the education (thereby making the enrollment
reporting requirements for the post-Vietnam and post-9/11 programs
consistent with other veterans' educational programs).
Finally, it defines ``educational institution'' to permit the
inclusion of groups, districts, or consortiums of separately accredited
educational institutions located in the same state that are organized
in a manner facilitating the centralized reporting of enrollments.
Increasing program consistency and streamlining reporting requirements
are often desirable administrative improvements. In this case, for
example, community college districts in a state that have multiple
schools would be allowed to centralize their veterans' educational
assistance program reporting information and submit only one report for
the district as a whole rather than having to submit multiple reports
for each school. The American Legion is pleased to participate in and
recognize ongoing efforts like this to improve the Department of
Veterans Affairs' products, services and processes. The American Legion
supports this section of the discussion draft proposed legislation
Sec 3. Clarification of Assistance provided for certain programs of
education
The American Legion supports measures to improve cost control in
the case of a program of education at any institution of higher
education (IHL) that enters into a contract or agreement with an entity
to provide such a program of education to servicemember or veteran
students using GI Bill. Some institutions of higher learning (IHL) have
instituted extreme costs for certain programs as there are presently no
caps in place for certain contracts between IHL's and third party
providers. The American Legion agrees with the senate discussion draft
legislation that cost control is needed and strongly supports this
section of the discussion draft proposed legislation.
Sec 4. Provision of information regarding veteran entitlement to
educational assistance
Allowing higher education institutions to access their respective
student-veteran body education benefits in real time will allow for
school certifying officials and institution to better provide academic
and financial advising to those beneficiaries about other financial aid
opportunities and programs available to them prior to the semester
beginning. This section also falls in line with President Obama's 2012
Executive Order, Establishing Principles of Excellence for Education
Institutions Serving Servicemembers, Veterans, Spouses, and Other
Family members, section 2(g), which states:
``Provide educational plans for all individuals using Federal
military and veterans educational benefits that detail how they
will fulfill all the requirements necessary to graduate and the
expected timeline of completion.''
However, without this provision of the draft legislation, it is too
difficult for higher education institutions and their staff to properly
advise their respective GI Bill beneficiaries in this way, as well as
ensure their success in higher education.
Sec 5. Role of State Approving Agencies
While The American Legion applauds the expansion of the GI Bill
applicability, we find it problematic that State Approving Agencies
(SAAs) have been removed from a large portion of the approval process.
SAAs focus explicitly on the GI Bill and serve to protect it, and, by
extension, the veterans using it. They ensure that programs meet
certain eligibility criteria, in order to see that the funds are not
wasted, but are put to the best use possible. Their unique focus on how
GI Bill funds are spent makes their mission distinct from all other
oversight and approving bodies. Furthermore, as federally authorized
arms of their respective state governments, SAAs are in a unique
position to evaluate programs that are offered in their state, given
their proximity. This arrangement also maintains the federalism
required by the Constitution.
Therefore, The American Legion supports the SAAs, and believes that
they should have a role in reviewing, evaluating, and approving all
educational and training programs for GI Bill use. While some may argue
that the work that the SAAs do is redundant to the work of accrediting
bodies, The American Legion believes that SAAs approval is, in fact,
unique. This is because the charge of the SAAs is to specifically focus
on protecting GI Bill funds. While traditional accreditation provided
by Department of Education-recognized accrediting bodies does a
significant portion of work toward ensuring quality programs, SAA
approval should work in tandem with that accreditation, rather than the
stark division that is represented in the current statute.
However, under Pub. L. 111-377, SAAs lack the statutory authority
to inspect many questionable programs that have sprung up since the
passage of the Post-9/11 GI Bill at not-for-profit institutions. Given
that the original mandate of the SAAs was to protect GI Bill funds from
being squandered in unscrupulous programs, it seems reasonable that
SAAs should be allowed to inspect all suspicious programs, even if they
are housed in not-for-profit institutions. As such, The American Legion
supports the portion of the legislative proposal submitted by NASAA
that would statutorily make SAAs the primary approving body for all
programs approved for GI Bill use. Programs may still be deemed
approved, but at the discretion of the SAAs, not the VA secretary.
As the author of the original G.I. Bill and one of the biggest
driving forces behind the creation and implementation of the Post-9/11
G.I. Bill, The American Legion has long been at the forefront of
supporting and developing legislation that improves higher education
benefits for servicemembers.\14\ This legislation helps to address some
of the legitimate concerns about how some aspects of higher education
funding for veterans are administered, and will improve the higher
education process for all veterans.
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\14\ Resolution No. 312: Ensuring the Quality of Servicemember and
Veteran Students' Education at Institutions of Higher Learning--Aug.
2014
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The American Legion supports this draft legislation.
conclusion
As always, The American Legion thanks this Committee for the
opportunity to explain the position of the over 2 million veteran
members of this organization. For additional information regarding this
testimony, please contact Mr. Warren J. Goldstein at The American
Legion's Legislative Division at (202) 861-2700 or
[email protected].
Chairman Isakson. Thank you very much, and please pass on
our regards to the new Commander and thank him for his service.
Mr. Morosky.
STATEMENT OF ALEKS MOROSKY, DEPUTY DIRECTOR, NATIONAL
LEGISLATIVE SERVICE, VETERANS OF FOREIGN WARS
Mr. Morosky. Chairman Isakson, Ranking Member Blumenthal,
and Members of the Committee, on behalf of the Veterans of
Foreign Wars of the United States, I would like to thank you
for the opportunity to testify on today's pending legislation.
In the interest of time, I will comment briefly on each of
the bills on the agenda. For VFW's complete testimony, I refer
you to our written statement.
The VFW strongly supports the Increasing the Department of
Veterans Affairs Accountability to Veterans Act. We believe
this bill will prevent Senior Executive Service (SES) employees
who are under investigation for serious crimes from being able
to retire with full benefits if they are subsequently found
guilty. Veterans cannot understand why, and they should not
have to accept that a VA executive can commit a crime and opt
to retire without any consequence. We also support other
sections of this bill which would reform the SES performance
appraisal system and limit the amount of time SES employees may
be placed on administrative leave.
The VFW supports the Physician Ambassadors Helping Veterans
Act, which seeks to streamline the VA credentialing process for
volunteer physicians. We believe that the current VA policies
that require volunteer doctors to go through a similar process
as permanent employees is overly cumbersome and inhibits
volunteerism. That said, we believe that placing a 60-day
deadline on the VA to credential volunteer doctors is overly
prescriptive. As such, we encourage the Committee to amend this
bill to require VA to develop a more streamlined credentialing
process for volunteer doctors.
The VA does not support the Veterans Hearing Aid Access and
Assistance Act, which would authorize VA to hire hearing aid
specialists as full-time employees at Department facilities to
provide hearing health services alongside audiologists and
hearing health technicians. Although we appreciate the bill's
intent to increase hearing aid health access, the VFW believes
that VA has the ability to address that issue under its current
hiring authority.
The VFW supports the VA Emergency Medical Staffing
Recruitment and Retention Act, which would grant VA medical
staff the ability to have flexible working hours that best suit
the demand for health care by the veterans they serve. We
believe this bill will put VA on par with the rest of the
health care industry.
The VFW supports the Veterans' Survivors Processing Claims
Automation Act, which would allow VA to pay benefits to
veterans' survivors who have not filed formal claims, so long
as there is sufficient evidence in the veteran's record to
establish eligibility. We also believe, however, that the
survivor should have the opportunity when providing
notification of the veteran's death to submit necessary
documents that may be contained in the record, such as the
death certificate, also without the need to file a formal
claim.
The Fry Scholarship Enhancement Act of 2015 extends the
Post-9/11 GI Bill Yellow Ribbon Program to cover recipients of
the Fry Scholarship. The VFW strongly supports the bill,
believing that in no instance should dependents of
servicemembers who paid the ultimate sacrifice receive less
than any other beneficiary.
The VFW supports S. 1693, which would authorize VA to
reimburse veterans for emergent care who were unable to receive
care within a 24-month period. The current policy is
particularly problematic for newly enrolled veterans, many of
whom have not been afforded the opportunity to receive a single
VA appointment due to appointment wait times. The VFW strongly
believes that this should never prevent veterans from seeking
emergent, possibly life-saving care that they may need.
The Department of Veterans Affairs Equitable Employee
Accountability Act provides many provisions aimed at improving
accountability at VA. The VFW supports the vast majority of
those provisions, but has concerns with its proposed employee
suspension and removal process. The bill outlines a process for
the suspension and removal of employees for performance or
misconduct that is a threat to public health or safety. The VFW
suggests that the reasons for removal be broadened to include
gross mismanagement, gross waste of funds, and abuse of
authority, in addition to clear and direct threat to public
health and safety that are already covered by the bill. This
would allow the Secretary to quickly remove an employee based
not only on the harm they bring veterans, but also on the harm
that they bring to other employees and to VA.
While the VFW supports the provision for immediate removal
of employees without pay, the remaining procedures for removal
and the appeals process have considerable differences with H.R.
1994, which the VFW already supports. Our membership insists
that a prompt removal process be developed to give the
Secretary broader authority to remove bad employees. The VFW
looks forward to working with the Committee and finding common
ground to remove bad actors from VA's workforce.
Finally, the VFW supports a discussion draft which offers a
variety of enhancements to the way the GI Bill benefits are
processed. This bill strengthens the authority of State
Approving Agencies, improves the information available to
student veterans about their benefits, and makes a favorable
adjustment in the way that veterans are reimbursed for Chapter
30 contributions, among many other improvements. The VFW was
one of the main proponents of the Post-9/11 GI Bill and we
thank the Committee for its dedication in continuing to improve
this critically important benefit.
Mr. Chairman, this concludes my testimony. I would be happy
to answer any questions you or other Members of the Committee
may have.
[The prepared statement of Mr. Morosky follows:]
Prepared Statement of Aleks Morosky, Deputy Director, National
Legislative Service, Veterans of Foreign Wars of the United States
Chairman Isakson, Ranking Member Blumenthal and Members of the
Committee, on behalf of the men and women of the Veterans of Foreign
Wars of the United States (VFW) and our Auxiliaries, I would like to
thank you for the opportunity to testify on today's pending
legislation.
s. 290, the ``increasing the department of veterans affairs
accountability to veterans act of 2015''
One of the greatest needs within the Department of Veterans Affairs
(VA) is culture change. Like most places, VA employees work in an
environment that rewarded specific outcomes based on specific
performance standards. Unfortunately, over time, these outcomes became
unattainable. But instead of evaluating why standards could no longer
be met, VA leadership put pressure on employees to achieve the
unattainable. This left employees with two options--be a poor performer
or find a way to do the impossible. All too often, the doing the
impossible was the wrong thing to do.
Now VA is left with an employee-base that has been trained to
believe that doing the wrong thing is right. To change this paradigm,
VA needs the authority to take quick and decisive actions against those
senior managers who perpetuate doing wrong and ensure they have proper
training so they will be the leaders VA needs them to be. S. 290, takes
steps to do both.
Section 2 will allow the Secretary to reduce a Senior Executive
Service (SES) retiree's annuity payment when the SES employee is found
guilty of a felony, for the period of time the felony occurred. Simply
put, if an SES employee is under investigation for that crime, and they
choose to retire, VA will be able to reduce that employee's retirement
annuity by the number of months or years that employee committed the
crime.
Veterans cannot understand and they should not have to accept that
a VA executive can commit a crime and opt to retire without any
consequence. The VFW supports Section 2.
Section 3 redefines the SES performance appraisal system and
ensures SES employees have quality training. Accountability goes much
further than firing employees. Quality training and job performance
evaluations provide employees with a clear understanding of their job
expectations and how to best execute their duties, as well an annual
opportunity to honestly review that performance. Section 3 limits the
number of SES employees who can receive ``outstanding'' level to 10
percent of employees and allows 20 percent to receive ``exceeds fully
successful'' level evaluation. This will prevent the practice of making
every employee outstanding; leaving the employee to believe there is no
room for improvement. The second part of this section establishes a
review of the current SES training program, ending with a report on any
areas that need to be improved. The VFW supports Section 3.
Section 4 limits the period of time VA can place an SES employee on
administrative leave, but provides VA the ability to extend that period
of time if they report to Congress why that employee's administrative
leave lasts longer than 14 days. The VFW sees this provision as more of
a congressional oversight role than a disciplinary tactic. Congress
should know why executives are on extended administrative leave and
what VA is doing to either bring that employee back to work or removed
from service. The VFW supports Section 4 of this legislation.
s. 563, the ``physician ambassadors helping veterans act''
This legislation would streamline the process health care providers
undergo when applying to volunteer at VA medical facilities. The VFW
supports this legislation and would like to offer suggestions to
strengthen it.
VFW members and their families embrace the spirt of volunteerism.
Every year, more than 10,000 VFW and Auxiliary members volunteer their
time at VA facilities throughout the country. With their assistance and
the support of more than 66,000 additional volunteers, VA is able to
maintain vital programs that help veterans reintegrate back into
civilian life, provide much needed aide and services to homeless
veterans, organize recreational activities that improve patients'
quality of life, and expand access to care for veterans. Unfortunately,
the process volunteers are required to undergo is often cumbersome,
especially for physicians who wish to volunteer their time at VA
medical facilities. Such physicians must go through processes that were
designed for health care providers being hired by VA medical
facilities, to include the credentialing process.
This legislation seeks to streamline that process by establishing
at 60-day deadline for VA to complete the credentialing process for
volunteer physicians. While the VFW supports expediting the approval
process for volunteer physicians, we do not support establishing an
arbitrary deadline for the VA credentialing process. While it may be
grueling at times, the credentialing process serves to ensure the
safety of those under VA's care and should not be unduly rushed. We
also fear such a mandate would result in VA medical facilities
prioritizing volunteer physicians over new hires in an effort to meet
statutory requirements, further delaying VA's lengthy employment
process. That is why we urge the Committee to amend this legislation
and require VA to develop a new hiring process specifically tailored
toward volunteer physicians. The new process must not impede a medical
facility's ability to process applications for new hires. It should,
however, reduce or eliminate requirements that may not be necessary for
volunteer physicians, such as requiring a minimum of three references
from previous employers.
As the demand on the VA health care system continues to grow,
opportunities for new volunteers will also grow. However, not all VA
medical centers have staff dedicated to recruiting volunteers,
developing volunteer assignments, and maintaining a program that
formally recognizes volunteers for their contributions. That is why the
VFW supports requiring each VA medical center to have at least one
volunteer coordinator to establish a relationship with local
organizations, recruit new volunteers, and serve as the initial point
of contact for persons seeking to volunteer at VA medical facilities.
However, volunteers must not be considered a solution to VA's staffing
shortages. The VFW continues to believe that the only way VA can
provide veterans the timely access to the care they have earned and
deserve is by ensuring VA has the resources and tools necessary to
maintain appropriate staffing levels at each VA medical facility.
Volunteers are a vital force multiplier, but VA cannot rely on
volunteers to meet the health care needs of our Nation's veterans.
s. 564, the ``veterans hearing aid access and assistance act''
This legislation would authorize VA to hire hearing aid specialists
as full time employees at department facilities to provide hearing
health services alongside audiologists and hearing health technicians.
Hearing aid specialists would assume many responsibilities currently
performed by technicians and audiologists. Although we appreciate this
bill's intent to increase hearing health access and reduce wait times
for hearing aids and repairs, the VFW believes that VA has the ability
to address these issues under its current hiring authority.
The VFW strongly believes that VA must improve timeliness in
issuing and repairing hearing aids. A February 20, 2014, VA Office of
Inspector General (VAOIG) report revealed that 30 percent of veterans
were waiting longer than 30 days to receive new hearing aids, and
repairs took an average of 17 to 24 days to complete, far exceeding
VA's timeliness goal for those services. According to the report, the
long wait times were attributed to a steadily increasing work load,
which will likely continue to increase as the veteran population grows
older. This problem is compounded by the fact that many audiology
clinics are not fully staffed. Additionally, VAOIG found that the
Denver Acquisition and Logistics Center, which performs major hearing
aid repairs for VA medical centers nationwide, lacked an adequate
tracking system for the devices it receives.
However, adding a new class of provider whose scope of practice
overlaps that of existing employees does not get to the root of the
problem. To fully address these issues, VA must develop and
periodically evaluate the staffing levels and scope of practice for
audiologists, hearing health technicians and other health care
professionals to ensure VA audiology clinics have the staff necessary
to meet timeliness standards.
s. 1450, the ``department of veterans affairs emergency medical
staffing recruitment and retention act''
The VFW supports this legislation, which would grant VA medical
facility staff the ability to have flexible working hours that best
suit the demand for health care by the veterans they serve. In response
to last year's access crisis, VA has made a full fledged effort to
increase access for veterans who rely on the VA health care system for
their health care needs. In the past year, VA has completed more than
2.7 million additional appointments at VA medical facilities than
previous years by expanding clinic hours, adopting best practices from
the private sector, and increasing the number of health care employees
by more than 12,000. Yet, VA continues to face numerous challenges in
meeting the growing demand on its health care system.
One of those challenges is the statutory 40-hour work week
limitation for title 38 employees. While most health care providers
work a traditional 40-hour work week, hospitalist and emergency room
physicians often work irregular schedules to accommodate the need for
continuity of efficient hospital care. The VFW supports efforts to
eliminate this access barrier and improve VA's ability to recruit and
retain high-quality hospitalist and emergency room physicians.
s. 1451, the ``veterans' survivors claims processing automation act''
The VFW supports the intent of this legislation, which would allow
VA to pay benefits to veterans' survivors who have not filed formal
claims, so long as there is sufficient evidence in the veteran's record
to establish eligibility. Covered benefits would include Dependency and
Indemnity Compensation (DIC), Death Pension, funeral expenses, and
accrued benefits. This would allow expedited access to benefits for
survivors, while also giving VA an additional tool to reduce the claims
backlog by issuing decisions more quickly. Often, veterans' records
already include the documents necessary to grant benefits to his or her
survivors. Such documents may include DD Form 214, service-connected
disability ratings, medical records, and household income information.
The VFW believes that survivors should not be made to fill out
unnecessary paperwork or resubmit evidence when adequate documentation
is already on file. We do believe, however, that the survivor should
also have the opportunity when providing notification of the veteran's
death to submit necessary documents that may not be contained in the
record, such as the death certificate, without the need to file a
formal claim. Additionally, we believe that this legislation should
require VA to issue a report on how many survivors are granted benefits
under this authority, in order to ensure that it is properly utilized
at all VA Regional Offices and Pension Management Centers.
s. 1460, the ``fry scholarship enhancement act of 2015''
The VFW supports this legislation, which extends the Post-9/11 GI
Bill Yellow Ribbon Program to cover recipients of Marine Gunnery
Sergeant John David Fry Scholarship.
The Fry Scholarship is available to surviving children and
surviving spouses of active duty members of the Armed Forces who died
in the line of duty on or after September 11, 2001. The scholarship
provides full tuition and fees paid directly to the school for all
public school in-state students capped at a statutory maximum amount
per academic year equal to the post-9/11 G.I. bill.
Currently, dependents of living veterans who are eligible for
Transfer of Entitlement under the Post-9/11 GI Bill may participate in
the Yellow Ribbon Program, which covers additional costs for out-of-
state tuition or private colleges and universities. Recipients of the
Fry Scholarship, however, are not eligible for the Yellow Ribbon
Program. The VFW believes this must be corrected. In no instance should
the dependents of those who made the ultimate sacrifice receive a
lesser benefit than others.
s. 1693, to expand eligibility for reimbursement for emergency medical
treatment to certain veterans that were unable to receive care from the
department of veterans affairs in the 24-month period preceding the
furnishing of such emergency treatment.
The VFW supports this legislation which would authorize VA to
reimburse veterans who were unable to receive VA care within a 24-month
period for emergent non-VA care. The strict 24-month requirement is
problematic for newly enrolled veterans, many of whom have not been
afforded the opportunity to receive a VA appointment due to appointment
wait times, despite their timely, good faith efforts to make
appointments following their separation from military service.
Currently, VA does not have the authority to reimburse veterans if
they experience medical emergencies during such a waiting period. This
barrier to access has caused undue hardship on veterans who are
undergoing the difficult transition from military service back to
civilian life and has resulted in veterans receiving unnecessarily
large medical bills through no fault of their own. VA is aware of this
problem and has requested the authority to make an exemption to the 24-
month requirement for veterans who find themselves in this situation.
The VFW strongly supports this legislation and believes that long
appointment wait times should never prevent veterans from seeking the
emergent, possible life-saving, care they need.
s. 1856, the ``department of veterans affairs equitable employee
accountability act of 2015''
This bill provides a long list of provisions aimed at improving
accountability within VA. The VFW supports the vast majority of these
provisions, but has concerns with its proposed employee suspension and
removal process.
Section 2 of the bill would amend Chapter 7 of title 38 by
including a new paragraph that outlines the suspension and removal of
employees for performance or misconduct that is a threat to public
health or safety. While it is critically important to ensure the safety
and health of veterans, the narrow definition of performance or
misconduct this provision provides would be limited to health care
providers and only in cases when negligent care is involved. This
leaves out a vast majority of employees and situations when removal
should take place.
The VFW suggests that reasons for removal be broadened to include
gross mismanagement, gross waste of funds, abuse of authority, as well
as the clear and direct threat to public health and safety that are
current in the legislation. This will allow the Secretary to quickly
remove an employee based not only on the harm they bring to veterans
but also the harm they bring to other employees and VA.
While the VFW supports your proposal for immediate removal of
employees without pay, the remaining procedures for removal and appeal
process have considerable differences with H.R. 1994, which the VFW
supports. Our membership insists that a prompt removal process be
developed to give the Secretary broader authority to remove bad
employees. The VFW looks forward to working with both parties to find
common ground and a final solution to removing bad actors from VA's
workforce.
The VFW supports the remaining sections of this bill, as they
provide clearer guidelines on evaluating job performance and personnel
actions, improve management training, provide promotion opportunities
for technical careers and improve medical oversight, among other
provisions. Each of these will improve overall accountability and
sustainability of a quality workforce.
s. 1938, the ``career-ready student veterans act''
The VFW supports this legislation to ensure that education programs
in fields that require licenses and credentials offer the proper
programmatic accreditation necessary for employment in each state as a
condition of GI Bill approval.
Some schools offer degrees that do not provide graduates the needed
credentials to qualify for certain professions. Worse yet, many of
these schools offer prospective students unclear information about
programmatic accreditation and the requirements for professional
certification. Some schools use terms like ``fully accredited,'' which
in theory may be true for the institution, but in reality do not offer
the programmatic accreditation needed to secure employment.
Unfortunately, student-veterans often fall prey to misleading
recruiting sales tactics. We believe that student veterans need to be
given the resources to be informed shoppers when deciding how best to
use their education benefits.
discussion draft
The VFW supports this draft bill, which offers a variety of
enhancements to the way GI Bill benefits are processed.
Section 1 would streamline how VA approves initial claims for Post-
9/11 GI Bill (Chapter 33) beneficiaries. Although improvements have
been made in recent years, we remain concerned that it still takes too
long to approve initial claims, due to outdated business practices.
Currently, claims processors must go through a time intensive back and
forth with potential student-veterans who accidentally revoke the wrong
GI Bill benefit before they can properly enroll them in Chapter 33.
This bill would allow VA to make a reasonable effort to contact the
veteran to enroll them in the most advantageous benefit.
The section also adjusts how VA reimburses veterans eligible for
the Montgomery GI Bill (Chapter 30) and who have paid into the benefit,
but elect to use Chapter 33 instead. Currently, Chapter 30-eligible
veterans who elect to use Chapter 33 must wait until they have finished
using their benefits before VA can repay them for their Chapter 30
contribution. Under this legislation, the Chapter 30 contribution would
be prorated and added into living stipend payments while veterans are
enrolled in Chapter 33, granting them a faster system of reimbursement
while they are still in school and need it most. The VFW fully supports
this section.
Section 2 would allow educational institutions to report
enrollments to VA as groups, districts or consortiums. The VFW supports
this, believing it will bring consistency across the different chapters
of GI Bill benefits, making it easier for VA to determine beneficiary
status and track student-veterans as they seek to accomplish their
academic goals.
Section 3 places a cap on the amount of tuition and fees that may
be paid under the Post-9/11 GI Bill for programs of education in which
a public institution of higher learning enters into an agreement with
another entity to provide such education. The cap would be set at the
same amount allowable for private and foreign institutions of higher
learning.
Currently, third party training programs that contract with public
schools are able to charge unlimited fees since public schools have no
set dollar amount cap. The law states only that the Post-9/11 GI Bill
covers the actual cost of in-state tuition and fees. Last year, it came
to light that some contracted flight training programs were charging
exorbitant fees, which far exceeded the cost of an average in-state
education. The VFW believes this is a loophole that must be closed by
placing reasonable caps on these sorts of training programs.
Still, we believe that veterans should have a path to receive the
training necessary to enter highly technical, high demand fields like
aviation, which offer good paying jobs to those who are qualified. We
also recognize that it may not be realistic for certain flight schools
to provide that training within a $21,235.02 cap per academic year. For
this reason, we encourage the Committee to further examine this issue
in order to determine what reasonable caps might be for flight training
and similarly contracted training in other high demand fields, so that
veterans can continue to have access to these kinds of programs, but
that such programs offer transparency in their fee schedules and cannot
simply charge the government an arbitrary rate. This is why the VFW
also continues to support strict enforcement of standing VA policies,
like the 85/15 rule, which ensures that third party contractors and
their partner schools are charging appropriate fees, while continuing
to offer high quality training to veterans.
The VFW supports section 4, which would require VA to make
available to institutions of higher learning, by secure internet Web
site, information on the amount of education benefits each student-
veteran has remaining. This will allow schools to provide better
counseling to veterans on how best to maximize their remaining benefits
to achieve their academic goals.
Section 5 would codify the authority of State Approving Agencies
(SAAs) to inspect and approve non-college degree (NCD) programs at not-
for-profit institutions of higher learning to validate their quality.
This is an authority previously held by SAAs, but rescinded by the
Post-9/11 Veterans Educational Assistance Improvements Act of 2010. As
a result, some not-for-profit schools developed NCD programs of
questionable value. Although the VA Office of Economic Opportunity
issued guidance allowing the SAAs to inspect NCD programs in subsequent
years, the VFW still believes that this policy should be strengthened
by statute.
Section 6 would require VA to apply the same reasonable criteria
standard when approving education programs across all types of
institutions of higher learning: public, private, and proprietary for-
profit. The VFW believes this is equitable and supports this section.
Section 7 makes changes to the way VA and the SAAs must conduct
compliance surveys every year. Under current law, VA must conduct
compliance surveys annually on all facilities reporting at least 300
enrolled GI Bill recipients. The VFW believes that this is an
impossible mission, which will cause some smaller schools to go years
without a compliance survey, as VA and the SAAs struggle to satisfy the
requirement to survey schools with large veteran populations. Such a
requirement can hinder both VA's and the SAAs' response to at-risk
programs that may enroll far fewer veterans, while wasting significant
time and resources inspecting perennial top performers who happen to
have large student veteran populations. This section would correct that
problem by requiring that compliance surveys be conducted once every
two years at each educational institution or training establishment
that enrolls at least 20 GI Bill recipients.
Mr. Chairman, this concludes my testimony and I will be happy to
answer any questions you or the Committee members may have.
Chairman Isakson. Thank you very much.
Professor Kettl.
STATEMENT OF DONALD F. KETTL, PROFESSOR, SCHOOL OF PUBLIC
POLICY, UNIVERSITY OF MARYLAND
Prof. Kettl. Mr. Chair and Ranking Member Blumenthal and
Members of the Committee, I want to thank you very much not
only for the opportunity to testify here today, but more
importantly, for your sustained and careful attention to the
need to try to provide for our veterans the care and benefits
they have so richly deserve and for which they have worked and
sacrificed so much.
I want to speak in particular in favor of S. 1856, but
before doing that, I want to talk about the broad problems of
performance that the VA must--absolutely has to try to find
ways of resolving, trying to find ways, in particular, of
improving the accountability and performance of the Department
of Veterans Affairs. We have talked a lot already today and
have talked more broadly about the issue of trying to improve
accountability and performance by making it easier to fire
employees and to increase accountability; we surely want to be
able to remove people who have performed poorly.
But, the question is, how much of the problem would we
solve if, in fact, we did that? My own guess is that would be
somewhere in the neighborhood of 5 percent, perhaps, of the
VA's problems. But suppose even that it was as high as 50
percent, ten times higher than what my best guess would be.
What are we going to do to solve the other 50 percent of the
performance and accountability problems that the VA faces?
The lesson from the best managed private companies is that
you cannot fire your way to success and that success and
performance really must build on other strategies that try to
build the people power inside organizations to deliver results,
and I want to look at five things in particular that are
important about that.
The first is the question of inadequate resources. It is
clear from testimony that we have heard already that the VA in
too many places is simply short-staffed. There are 41,500 staff
vacancies as of June of this year, including 5,000 physicians
and 12,000 nurses. In some cases, vacancy rates are as high as
20 percent. It it clear that the VA is not going to be able to
perform better unless it has the staff in place to be able to
do so.
And that gets into the second topic, which the Chair,
Senator Isakson, mentioned just a little while ago, the
importance of vacancies in key areas. Twenty-five percent of
the medical director positions in VA facilities are vacant.
Among the vacancy rate leaders are the Department's Veterans
Integrated Service Networks, which are responsible for
coordinating care; the vacancy rate is 43 percent. Those simply
are much too high, so we have to fill those positions if we
expect to be able to solve the problems.
The third point is that it is very clear that these
vacancies hurt the Department's performance. It is not
surprising that I have data in my testimony that show across
the board for those units of the VA that are operating under an
acting or vacant manager, that the level of performance by
employees and the level of employee morale is substantially
lower than it is when there is a manager--not surprising,
because, in fact, the VA's own surveys demonstrate that.
On top of that, it is also clear that the more morale in
the VA suffers, the more the staff members within the VA feel
under attack, the higher the level of vacancies are likely to
be. The Partnership for the Public Services Best Places to Work
in the Federal Government has surveyed Federal agencies and
according to the survey, it turns out that both the lowest
level of employee satisfaction and the biggest drop in
satisfaction in 2014 were: the lowest was the Department of
Homeland Security; next after that is the Department of
Veterans Affairs. So, it is unlikely we are ever going to be
able to solve the problem of performance unless we can find a
way to try to improve employee morale.
I come now to the fifth point that I want to talk about,
which is the rate at which the VA actually fires employees. If
you look carefully at data for the Office of Personnel
Management, which I included in my testimony, it turns out that
layoffs and discharges in the private sector amount on an
annual basis to about 1.1 percent of the workforce. In the
Federal Government overall, it is about 0.4 percent. That is
substantially lower. But in the VA, it is more than 1.5 times
higher than it is in the rest of the Federal Government,
approaching the levels of what it is in the private sector.
So, it is not clear not only that increasing the rate of
firing would solve the problems of performance in VA, because
there are many other problems that we have to solve, but more
fundamentally, it is not clear that the rates of firing in the
VA are substantially out of line with what is the case in the
private sector, according to the Federal Government's own
statistics.
So, what we need to do is to focus much more on solving the
real underlying problems, and that is why I am here today in
support of S. 1856. It would hold the Department's top managers
more accountable. It develops stronger performance rubrics and
measures to try to ensure that managers are held accountable.
It would require managers to make an affirmative decision at
the end of the probationary period of employees to retain them.
But, most importantly, it would also create a strong employee
development system within the Department to try to ensure that
the best managers which we need for the future are managers
that we cultivate now.
There are important human capital strategies that the VA
needs to focus on much more carefully. In particular, since the
VA has now been placed on the High-Risk List of the Federal
programs most prone to waste, fraud, abuse, and mismanagement
by the GAO, it is an opportunity for this Committee, in
particular, to conduct intensive oversight to ask the top VA
officials about what the VA plans to do to remove itself from
that list.
Our Nation's veterans have given so much to this country
and the country has made promises to them. It is a sacred
obligation to make good on those promises and it is going to
require improved management, especially better management of
the people within the VA, to make good on the promises that our
Nation has made.
Thanks very much to the Members of the Committee and I look
forward to answering any questions that you might have.
[The prepared statement of Prof. Kettl follows:]
Prepared Statement of Donald F. Kettl, Professor, School of Public
Policy, University of Maryland
Let me thank the Committee for the opportunity to testify today on
the important issues facing our Nation's veterans and the care they're
earned from the Department of Veterans Affairs. It is always a great
privilege to speak before a congressional committee. It is an even
greater privilege to speak about such an important issue.
I am Donald F. Kettl, a professor at the University of Maryland
School of Public Policy. I have devoted my professional career over the
last 40 years to exploring how best we can ensure that government
serves our people. I have written and researched extensively on issues
of public management. I have consulted broadly for government agencies
in the United States and abroad, and I have chaired two blue-ribbon
commissions in Wisconsin. I want to draw on that experience today to
explore how we can best serve the Nation's veterans.
In my testimony before you today, I want to speak in support of S,
1856, ``The Department of Veterans Affairs Equitable Employee
Accountability Act.'' It provides a strong and sensible strategy for
solving many of the VA's most important problems. Before speaking
directly to the act's provisions, however, let me first talk about the
broad problems of performance that the VA faces.
There is one thing on which we can all agree: The Department of
Veterans Affairs is not now performing at the level that we--the Nation
and its veterans--expect. As the Government Accountability Office has
repeatedly documented, the VA's health care system is struggling to
deliver timely, high-quality, cost-effective health care. Those
problems, in fact, have put the VA's health care system on the GAO's
list of 32 high-risk programs especially prone to fraud, waste, abuse,
and mismanagement.\1\ The problems are large. They must be solved.
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\1\ U.S. Government Accountability Office, High-Risk Series: An
Update, GAO 15-290 (February 2015), at https://docs.google.com/
viewer?url=http%3A%2F%2Fwww.gao.gov%2Fassets% 2F670%2F668415.pdf
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Some reform proposals have focused squarely on the VA's managers,
both at the highest levels and at the department's middle levels. These
proposals have begun with a singular diagnosis of the problem--that the
VA is troubled by the poor performance of these managers--and a
singular solution to the problem--that Congress must make it easier for
the department to fire poor-performing managers and that Congress
should then pressure the Department to ensure that this happens. The
department has certainly been troubled by serious management problems,
and poor performing managers certainly should be fired. More broadly,
the Nation's human capital system, for both political appointees and
civil service, has fallen out of sync with the challenges it faces, and
the system needs fundamental reform.
Before examining the legislation pending before this Committee, we
need to step back and ask three questions. First, how many of the VA's
problems would be solved by making it easier to fire poor-performing
managers? Second, would proposals focusing solely on making it easier
to fire these managers actually help? Third, what other steps can we
take to improve care for veterans.
understanding the va's problems
No one knows for sure just how many of the department's problems
flow from the difficulty in firing poorly performing managers. My best
guess is that it is probably about 5 percent. But suppose it's far, far
higher--higher, in fact than I believe anyone realistically supposes.
Let's assume that the problem of firing poor performers is as high as
50 percent of the problem.
Can we fire our way to success in solving any of the VA's issues?
And, even if we could, what should we do to solve the other 50 percent
of the problem? The answer to this question requires working through a
series of puzzles.
1. Inadequate resources. In part, the VA's problems flow in part
from not enough resources, in both money and people. A July 23, 2015
report in USAToday, based on a Freedom of Information Act request,
showed that the VA had 41,500 staff vacancies in June of this year,
including 5,000 physicians, almost 12,000 nurses, and more than 1,200
psychologists. In some locations, one of five positions was vacant.\2\
The VA can't provide the care that veterans deserve if it doesn't have
the resources to do so. Part of the answer requires providing the VA
with more money, but many Members of Congress are understandably
reluctant to do so without assurance that the money will be spent well.
---------------------------------------------------------------------------
\2\ Meghan Hoyer and Gregg Zoroya, ``VA has 41,500 unfilled medical
jobs, forcing vets into costly private care,'' USAToday (July 23,
2015), at http://www.usatoday.com/story/news/nation/2015/07/23/va-has-
41500-unfilled-medical-jobs-forcing-vets-into-costly-private-care/
30504525/
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2. Critical management vacancies. In addition to problems in
providing sufficient staffing for front-line care, the VA has been
struggling to recruit managers. As Chairman Johnny Isakson pointed out
in a July 23, 2015 letter to VA Secretary Robert McDonald, the
department has a vacancy rate of 25 percent among its medical
directors. Among the leaders of the department's Veterans Integrated
Service Networks, which are responsible for coordinating the care for
veterans, the vacancy rate is 43 percent.\3\
---------------------------------------------------------------------------
\3\ Sen. Johnny Isakson to Secretary Robert McDonald (July 23,
2015), at http://www.veterans.senate.gov/newsroom/majority-news/
isakson-to-va-secretary-fill-vacant-va-leadership-positions-now
---------------------------------------------------------------------------
3. Vacancies hurt the department's performance. These vacancies
have created severe problems for managing the turnaround that the VA
needs. As the department's Undersecretary for Health, David Shulkin,
has pointed out, ``How can you possibly make the changes that we are
doing unless you have the right leadership in place?'' \4\ Moreover,
vacancies badly hurt employee performance and morale. In the VA's All
Employee Survey, facilities with a vacancy in the director position in
FY 2015 had lower scores across all survey questions.
---------------------------------------------------------------------------
\4\ Scott Maucione, ``VA's top health official's five ways to
transform access to health care,'' FederalNewsRadio.com (September 4,
2015).
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
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Source: Department of Veterans Affairs, 2014 All Employee Survey (AES).
This evidence makes clear that vacancies in key VA senior
management positions hurt the department's performance.
4. A focus on increasing the firing of senior managers increases
the number of vacancies. Firm survey evidence is hard to come by, but
the accumulated analysis of reporters for the media and anecdotal
evidence from the field makes one thing clear: VA employees feel under
assault, and that is vastly complicating the challenge of filling
critical vacancies throughout the department. The Partnership for
Public Service's ``best places to work in the Federal Government''
shows that the VA is second-lowest in employee satisfaction and had the
second biggest drop in satisfaction in 2104, in both cases after the
Department of Homeland Security.\5\ It's one of the most troubled
departments in the Federal Government, and continued attacks on the
department aren't making it any better.
---------------------------------------------------------------------------
\5\ Partnership for Public Service, ``Best Places to Work Agency
Rankings'' (2015), at http://bestplacestowork.org/BPTW/rankings/
overall/large
---------------------------------------------------------------------------
In fact, the Office of Personnel Management's 2014 Federal Employee
Values Survey shows that the VA is among the Federal Government's most
troubled departments. Its employee engagement score is low. The fact
that it has so many employees only multiplies the problem.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Source: Department of Veterans Affairs, based on 2013 Office of
Personnel Management Federal Employees Viewpoint Survey.
Secretary McDonald has pointed out that the attacks on the
department are making it harder to hire. He has said, ``We can't hire
the people [we need] when Members of Congress are going to somehow
differentiate the VA versus other departments in government. That
doesn't cause people in government to want to work for the VA.'' \6\
---------------------------------------------------------------------------
\6\ Quil Lawrence, ``Some Veterans Affairs Reforms Undermine
Medical Recruitment Efforts,'' NPR.com (August 31, 2015), at http://
www.npr.org/2015/08/31/436377436/some-veterans-affairs-reforms-
undermine-medical-recruitment-efforts
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5. The rate at which the VA fires employees for cause is already
above the Federal average. The underlying assumption of many debates
about the VA is that poor performers are allowed to continue in their
positions. There is a question about whether we ought to adjust the
balance of employee rights and managerial flexibility. But a careful
look at the rate at which the VA terminates employees for disciplinary
or performance reasons shows that it terminates employees at a rate
more than one and a half times the Federal Government's average.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Source: Office of Personnel Management, FedScope.
The question is often raised--rightly--about whether government
jobs in general enjoy more employment security than in the private
sector. In July 2015, for example, the Bureau of Labor Statistics found
that layoffs and discharges in the public sector occurred at a rate of
0.4 percent of the workforce, compared with 1.1 percent of the
workforce in the private sector. However, the public and private
comparisons include both termination for cause and layoffs for
strategic and economics reasons; the BLS data do not separate them. The
private sector has a higher rate of layoffs because the nature of its
functions and business models are more variable.
It seems very likely, therefore, that public employees are
terminated for cause at a lower rate than in the private sector, but
the gap is smaller than is often believed. Moreover, since termination
for disciplinary or performance reasons is higher in the VA than
throughout the rest of government--0.75 percent of VA employees in
2014--it is likely that the gap between termination for cause in the VA
compared with the private sector is not as large as usually assumed.
What does this mean? The VA is in trouble, but a singular focus on
firing bad performers:
Won't help the department hire the managers it needs.
Will further damage the department's performance.
Won't deal with most of the department's biggest problems,
which lie beyond the performance of some poor department managers.
steps to real reform
The firing process unquestionably needs to be improved. There's no
place in the Federal Government for bad managers and bad management.
But:
We need to find the right balance between firing poor
performers, and other disciplinary actions, on the one hand, and
providing the protections that employees need to prevent political
interference in their work, on the other. The Nation's civil service
original civil service act was the product of a partnership between a
Democratic Senator, George Pendleton (Ohio), and a Republican
President, Chester Arthur (New York). It's evolved since through
bipartisan support of both parties.
We need to find the right balance between these
disciplinary actions and the fundamental talent management requirements
of the Nation's veterans care system.
We need to find the right balance between these talent
management needs and the mission of serving the Nation's veterans.
We can't expect to solve any of these problems by dealing
with the VA in isolation, especially in changing the balance on any of
these issues.
legislative recommendations for improving veterans care
Let me explore the two principal pieces of legislation now before
the Committee.
S. 290. The ``Increasing the Department of Veterans Affairs
Accountability to Veterans Act of 2015,'' S. 290, would take steps to
impose greater penalties on poor-performing employees, toughen the
standards for employee performance ratings, mandate the reassignment of
Senior Executive Service employees every five years, and restrict the
Secretary's ability to place employees on administrative leave.
On a broad level, placing restrictions on employee benefits for
those convicted of a felony makes sense. We need improvements in the
employee rating system, although mandated distribution of ratings
rarely works well. The SES originally anticipated that the Federal
Government would create a corps of senior executives who would move
among Federal managerial assignments. However, mandating reassignment
within the VA without fixing the SES's broader issues would surely not
prove effective. Finally, no one wants employees to be placed on
administrative leave any longer than necessary, but due-process
standards need to dictate the length of an administrative leave, not an
arbitrary period.
More fundamentally, S. 290 does not deal with the fundamental
issues facing the VA, and it would not get at the core problems that
must be solved if we are to serve our veterans well.
S. 1856. The ``Department of Veterans Affairs Equitable Employee
Accountability Act,'' S. 1856, would significantly advance the Nation's
efforts to strengthen health care for its veterans. In particular:
It provides the Secretary with greater power to suspend
without pay and remove an employee found to behave in ways that do not
serve the needs of veterans. More managerial flexibility is clearly a
good step.
It establishes reasonable procedures to ensure that
employees suspected of posing such a threat are provided with due
process, in the best bipartisan traditions of the Nation's civil
service policies.
It clearly holds the department's top officials
accountable for the department's management. In particular, it focuses
on the importance of recruiting employees, motivating them, training
them for their roles, and holding them accountable. The VA is a people-
based business. Better people policies are essential to better
performance. Key managers need to be subject to an annual performance
plan that provides a game plan for effective management.
It focuses the performance plan for managers squarely on
the department's human capital needs. It cannot fulfill its mission
without planning for the people it needs, recruiting them, training
them, retaining them, and developing them for future leadership
advances. Every great private company follows these steps. The nation
owes its veterans nothing less.
It requires managers to make an affirmative decision to
keep employees at the end of the probationary period. Too often, it's
been easy for low-performing employees to slip through to permanent
status. A government position ought to be earned through demonstrated
successful performance. It is the responsibility of the manager to
review each employee during the probationary period to ensure that the
employee's work rises to that level--and to conduct regular reviews and
to provide career help afterwards to ensure that the employee's
contributions continue to advance.
It puts training at the center of the VA's career
development work. The most essential component is helping employees
learn how best to motivate, manage, and lead. We are now not only
trying to solve the serious problems that plague the department today.
We are also building the foundation on which its future service to
veterans depends. The only effective way to avoid future crises is to
build--now--for the capacity the department will need tomorrow.
It provides a separate promotional track for technical
experts outside of the management track. As the Nation's largest health
care system, the VA will need.
It engages the department directly with the GAO. That is a
valuable step in improving the department's performance.
oversight recommendations for improving veterans care
In addition, the Committee could significantly improve its
oversight of the department's care for veterans through its oversight
functions. A regular, sustained strategy for reviewing the following
issues would prove especially effective, through the Committee's
hearings and through the staff's field investigations:
Removal and due process. Reviewing the balance between
efforts to identify, suspend, and remove employees who have shown
themselves unworthy of the public trust, on the one hand; and the due-
process protections afforded them under the law and Constitution, on
the other. In the United States, there's always been a balance between
sanctions and due process. The VA is at the frontier of an important
effort to re-set this balance. That is an important effort, and the
Committee could support that effort through its oversight.
Accountability. Solving the department's problems will
require developing a performance plan for the department and ensuring
that its managers understand their own contributions to the
department's performance. The Committee could advance this effort
through regular oversight of the department's overall performance plan,
as well as its efforts to bring managers' work into alignment with this
plan.
Human capital. The VA's success will ultimately depend on
planning for the employees it needs, recruiting them, hiring them,
training them, retaining them, and developing them. The Committee could
advance this effort through oversight of the department's strategic
human capital management.
High-risk progress. In 2015, GAO placed the VA's health
care programs on its high-risk list of programs most prone to fraud,
waste, abuse, and mismanagement. GAO has identified core problems in
the department's management; improving care for veterans will require
solving these problems. The Committee could advance the department's
performance through regular oversight of the department's plan for
getting off the high-risk list and of the progress in can demonstrate
in doing so. In particular, it would be useful to ask the department's
senior managers to testify, on a regular basis, about the steps they
are taking to develop a plan for improving the department's performance
and how they will close the gap with the best-performing departments
and agencies in the Federal Government.
Our Nation's veterans have given so much to the country. The
country has made promises to them, and it is a sacred obligation to
make good on those promises. Nothing could be a more fundamental
measure of the greatness of our Nation. The VA's problems now are
significant, but they are eminently solvable. Through its work, this
Committee has the potential to help the department make the big steps
that are needed.
Chairman Isakson. Professor, you are a gem. [Laughter.]
I hope everybody, particularly the VA folks that are here
today, paid close attention to your testimony, particularly the
references to the temporary nature of so many appointees in
responsibility, acting appointees, vacancies that are there,
and the fact that the VA has really suffered from a cultural
depravity, if you will, within its own organization of a bad
attitude that has kind of perpetuated itself.
I say that to say this. I personally think Secretary
McDonald is making a Herculean effort to change that culture. A
lot of the things that we see that are negative about the VA
today are historical references to something that happened two,
three, four, five, six, seven, eight, 10 years ago. I know that
the Secretary is trying to motivate upper management and
leadership and to enter into training to try to really change
the whole paradigm at the VA. I think he is moving in the right
direction, but I am going to make sure he reads your testimony
because I have never heard it said better.
Prof. Kettl. Well, thank you, Senator. I appreciate that. I
think there is an incredibly unusual opportunity here with the
strong support of this Committee, with the commitment of the
Secretary, and with the opportunity that is presented by having
the VA being placed on the High-Risk List from GAO, which means
there are specific items for action that GAO has identified and
analytical horsepower that comes from the GAO to be able to do
that, which creates, in that conversation, opportunities to lay
out a strategic plan for the Nation's future, for the VA's
future, to be able to solve these problems. There is tremendous
opportunity here in the way that all these forces are coming
together.
Chairman Isakson. Well, your testimony added a lot to this
meeting and I am going to make sure the Secretary and Deputy
Secretary Gibson get it. I appreciate very much your insight.
You are right on target.
Mr. Wescott, the members of your organization, are those
people like SACS, Southern Association of Colleges and Schools;
or what is your membership made up of?
Mr. Wescott. Our membership is made up, Mr. Chairman, of
the State Approving Agencies. There is a State Approving Agency
generally set up by a Governor in each State and we are
responsible for approving programs so that a veteran can enroll
in that program and use his GI Bill benefits, so----
Chairman Isakson. This is just for veterans programs?
Mr. Wescott. That is correct, sir.
Chairman Isakson. OK. You knew Pete Wheeler, I guess, from
Georgia.
Mr. Wescott. I know of him, sir, yes.
Chairman Isakson. Unfortunately, he just passed away a
couple of months ago, but served 63 years as Veterans
Commissioner in Georgia and did an outstanding job.
Mr. Wescott. Indeed.
Chairman Isakson. A great guy.
Mr. Wescott. Yes. Yes. I did meet him.
Chairman Isakson. On your testimony on Section 3--and this
is not a trick question by any stretch of the imagination, but
you were supportive of Section 3 in this discussion draft the
way it is written?
Mr. Wescott. Yes, indeed, sir, we are.
Chairman Isakson. And prior to 9/11/2001, flight training
schools available for GI benefits were capped at $21,085
maximum benefit per year, is that correct?
Mr. Wescott. Prior to----
Chairman Isakson. Somebody is shaking their head back there
behind you, but----
Mr. Wescott. Prior to 9/11, the cap for the private flight
training was $10,000, so----
Chairman Isakson. OK.
Mr. Wescott. And I think that cap has been adjusted for
inflation today until it is somewhere a little over $12,000.
And that is for private stand-alone flight schools.
Chairman Isakson. Did a private school have to affiliate
with an institution of higher learning that was public?
Mr. Wescott. No, sir, they did not.
Chairman Isakson. That was a new add-on with the new GI
Bill, is that right?
Mr. Wescott. Yes. What happened with the new GI Bill, and
then also Public Law 111-377, was that IHL programs, degree
programs within those institutions, were declared to be deemed
approved. So, there was not as close oversight by the SAAs over
those deemed approved degree programs. Then, some flight
institutions and IHLs came together to provide that training
because, as opposed to the individual private stand-alone
flight schools, there was no cap in place on the fees and
tuition that could be charged.
Chairman Isakson. There is a lady behind you who has either
got a bad headache or she is wagging her head to the side that
you are not telling me the truth, or what you said was not
right. So, if you will give me a statement as to what you are--
amplification might be, I would appreciate it.
Audience Member. Do you want me to give you a written
statement?
Chairman Isakson. I do.
Audience Member. OK.
Chairman Isakson. A written statement because you are not
on the official panel, but I acknowledge anybody who has a
comment, and I could tell you had one, so----
[Laughter.]
Audience Member. I do. They are not talking about
Chapter 30.
Chairman Isakson. OK. Thank you.
[Written statement from Ms. Lois Reid, Chief Executive
Officer, Upper Limit Aviation, is in the Appendix.]
Chairman Isakson. Mr. Butler, thank you for your service
and what you do. Do you have any comment on the flight question
that has been raised or was referred to in Section 3?
Mr. Butler. Other than we support that particular
provision, as well. We support any educational program that
would benefit our veterans, so we are in support of that
provision.
Chairman Isakson. Mr. Morosky, did you have a--I think in
your comments, you were supportive, as well, is that correct?
Mr. Morosky. Mr. Chairman, we support a cap. The only
caveat that we had in our testimony was we are not sure what
that cap should be and whether it should be different than the
current private school, international school cap. The way the
code is set up, it covers public schools, it covers private
international schools, it covers vocational programs. There is
nothing in Chapter 33 that talks about a private entity that
contracts with a public school, so maybe there should be and
maybe the cap should be different. It is something that we
should take a look at. What we do not want to do is set a cap
that shuts all veterans out of flight training and, therefore,
the opportunity to pursue this, but at the same time, not allow
the loophole to continue where schools can charge exorbitant
fees.
Chairman Isakson. My time is up.
Senator Blumenthal.
Senator Blumenthal. Thank you. I want to join the Chairman
in thanking you, Professor Kettl, and all the witnesses who are
here today, but I particularly appreciate Professor Kettl
accepting our invitation to be here today. I can tell you the
Chairman, in my experience, has never before called any witness
a gem. [Laughter.]
Chairman Isakson. First time for everything.
Senator Blumenthal. And he does not use four-letter words,
I can tell you, at least in my presence.
I do want to follow up on a couple of your comments which I
thought were tremendously insightful and important. I just met
with the CEO of a major American corporation about an issue
completely unrelated to this hearing, yet, I thought to myself
as you were testifying, if I said to that CEO, our solution for
improving the performance and personnel in your company is to
figure out a better way of firing people, he would look at me
as though I were crazy.
Now, the difference in the public sector is that the
measurements for good performance often seem indistinct or
indecipherable or difficult to discern, because unlike his
company, the end of quarter revenue, profit, performance, and
so forth are not measured the same way. So, one of the
questions I would welcome your thinking about is not only--and,
by the way, I really welcome and thank you for your support for
the bill S. 1856--but also how the VA can attract the doctors
and nurses and others to fill those 41,000 positions, because a
lot of them are health care positions and a lot of those skills
are in short supply. As you know, there is a shortage of
primary care doctors in the country, generally, and that is
reflected in some of those vacancies.
So, I would like very much not only to submit your
testimony to Secretary McDonald, but perhaps ask you to
undertake an assignment for us. I figure that I am more in the
category of student than professor. Very rarely does a student
give a professor an assignment. But, if you could be involved,
and maybe we can involve you in heading a team to consider this
issue, because I said at the beginning of this hearing, and I
believe it is true, that there are so many, many, many hard
working, proficient professionals who come to work every day.
They work long hours. They do not punch clocks. They are there
for patients or veterans who need their help. They really care.
And there has been this broad brush that has tarred them.
How do we keep them? How do we reward them? How do we
attract them? That is kind of a long-winded way of asking a
question, but if you have thought any more about this issue, I
would welcome your comments.
Prof. Kettl. Senator, this is something that really is
going to require a lot more work, because it is a very complex
and, unfortunately, a very deep-rooted problem. And let me say
that not only would I certainly welcome the chance to be able
to continue working with the Committee on this issue and with
the Department, as well, but my students would appreciate the
irony of being handed a homework assignment myself.
Two points, if I might. The first is that if you step back
and ask about the opportunity to be able to recruit people for
a mission of this sort, what area of medicine could possibly be
more valuable and something that would be easier to motivate
people for than trying to take care of the veterans who have
given so much to this country. If you cannot motivate people
and recruit people on that basis, I do not know what would be
the possible basis for recruitment. There is nothing that is
more central to the public interest, it seems to me, than that,
and it needs to begin with a central statement reinforcing the
Department's mission.
But then the second piece is that it is very clear, and
unfortunately, if you look across the board, and I have some of
the data in my testimony about the Federal Employee Value
Survey results, unit by unit by unit within the VA, and the one
lesson, unfortunately, that comes through very clearly is that
the VA sits almost at the bottom in every single one of its
units. But, on the other hand, you look at NASA and NASA sits
at the very top. What is it that NASA is doing that the VA is
not? What is it that is possible to discover that what NASA is
doing could be transferred to the VA?
That is something that we can identify, learn from. There
is data that the Office of Personnel Management has where
people have done in-depth research, including the Partnership
for Public Service. There are leaders and managers at NASA who
would be available to tell us what it is that they do to
motivate people. And there are people inside the VA who are
receptive to this message.
If I could just add one other piece to this. NASA is doing
an incredible job, as one example on this, but NASA is also at
a point where their mission is under fundamental assault,
perhaps, or at least fundamental reexamination, and they are
under tremendous pressure from private sector competition at
the same time. But despite that, they have employees who are as
motivated as any within the Federal Government.
On the other hand, you would think that within the VA you
would have one of the easiest jobs of motivating employees,
given the nature of the mission, yet we are falling short. That
tells us that we have the opportunity to be able to solve this
problem, but it requires strong and effective leadership from
the top and the ability to be able to learn from what others
are doing, from what the Partnership for Public Service is
doing, from what the Government Accountability Office is
discovering, from what we can discover from the data that the
Office of Personnel Management has.
The information is there and that would provide a game plan
for figuring out what to do, and this Committee has an
opportunity by then engaging in an ongoing dialog with the top
leadership of the Department by saying, you are now on the GAO
High-Risk List. What is your plan for getting off?
Senator Blumenthal. Thank you very, very much.
Chairman Isakson. Senator Boozman, followed by Senator
Tillis.
Senator Boozman. Thank you, Mr. Chairman.
Mr. Wescott, in regard to the really high charges that are
being charged by some of the schools so inappropriately, so you
all do not have any inability to approve or disapprove or----
Mr. Wescott. Let me----
Senator Boozman [continuing]. When something stands out so
much, right----
Mr. Wescott. Thank you so much for that question, Senator.
What happened was back in 2011, 111-377 was passed by the
Congress and it changed some of the roles between the State
Approving Agencies and the VA, and degree programs became
deemed approved at the public and not-for-profit privates. So,
at that point, the oversight, especially given the
interpretation of some of the leadership of the VA at that
time, of those degree programs was removed from the State
Approving Agencies. One of the things we seek in this law is to
return some of that oversight and correct that condition.
I can say that due to the new leadership that came in with
the VA, Education Service Director Rob Worley and Deputy Under
Secretary Coy, we have been able to, starting in fiscal year
2015, to begin to look some at those programs. But, again,
during the time when these large amounts of tuition and fees
began to be assessed against veterans, we were not in an actual
oversight position over the schools.
Senator Boozman. Is a one-size-fits-all--I guess I think
Mr. Morosky summed it up well. You know, we want to make it
such that certainly nobody is cheating the system at all. On
the other hand, we do not want to make it such that an
individual is not allowed to pursue a profession that we would
aspire our veterans to be in, if that is what they would like
to be in.
But, I guess fixed-wing versus helicopters, fuel costs make
a huge difference in flight training and things generally. Are
you comfortable with just saying, it is this dollar figure?
Mr. Wescott. I am certainly amenable to looking at the
dollar figure that is chosen. But I certainly feel like we need
to find some dollar figure that will take care of this issue.
It is my understanding that the highest payout for a single
veteran in a flight program is somewhere in the neighborhood of
$913,000. Somewhere between $20,000 and $900,000, we need to
find a cap to----
Senator Boozman. No, and I agree. I guess our concern is,
you know, why that did not immediately set off red flags, that
we are all very, very concerned about it----
Mr. Wescott. Right.
Senator Boozman [continuing]. And fix that problem.
Prof. Kettl, you talked a lot about accountability, which
is so important. There are various ways of doing that. I was
struck in your written testimony, you talked about oversight
recommendations for improving the situation, which, again,
directly relates to us. So, could you go through some of those
and kind of point out to us how you think we could do a better
job of providing oversight to hold people accountable.
Prof. Kettl. Senator, I think, first of all, it is
important to recognize that you have identified one of the most
important issues here, which is that this Committee has an
important role on an ongoing basis to, on the one hand, keep
the VA's feet to the fire, but on the other hand, provide
positive incentives for leadership in the right directions on
this. I do not for a second want to defend the right of people
who have performed badly to continue to hold their jobs. We
need to root them out. But, what do we do with the rest of the
problem, and the rest of the problem is most of the problem,
and most of the problem has to be done through the people
process.
So, I think it requires, in part, an effort and a strategy
to ask the VA directly, what is your plan for solving this
problem? What is your strategic human workforce plan to try to
identify what kind of people you need and how you are going to
get them, how you are going to motivate them? How are you going
to hold them accountable? How are you going to try to develop a
performance plan that links the Department's strategic goals to
its objectives? How are you going to ensure that you can fill
the vacancies in these strategically important areas that are
in greater need with the greater levels of vacancy in some
places around the country than others? Do you need greater
flexibility in some cases, or is it a matter of recruiting? How
are you going to lead people to try to deal with the underlying
problems of motivation that exist there?
In particular, how are you going to work with the Committee
and with the GAO to develop an action plan for the future, over
the long haul, that will stretch across administrations to
ensure that you get off the High-Risk List? No agency wants to
be on it. There now are 32 different programs that are on the
High-Risk List. Over the course of time, 24 programs have
gotten off of it. There is no reason why the VA cannot be one
of them, and this Committee can play an important role in
helping the VA develop such a plan and hold them accountable
for enforcing it.
Senator Boozman. Very good. Thank you, Mr. Chairman.
Chairman Isakson. Senator Tillis.
Senator Tillis. Thank you, Mr. Chair.
Dr. Wescott, it is good to see you.
Mr. Wescott. Good to see you, sir.
Senator Tillis. Thank you for your service to the State and
in your national legislative role. Thank you for your service
as a combat officer in the Army.
Mr. Wescott. Thank you, sir.
Senator Tillis. I want to congratulate you. After working
really hard at Wake Forest, you finally were able to get
admitted to N.C. State for an advanced degree. [Laughter.]
I want to go back to the two bills that I am working with
Ranking Member Blumenthal and Senator Brown on. We will go with
maybe the Fry Scholarship Enhancement Act. I am not going to
restate what I said earlier except that it really does look
like we are making a correction to what was clearly an
oversight. So, I understand, I think, for most of the
panelists, you support it. Professor Kettl, I do not know that
you would have a position on that, but it seems like the other
members of the panel support, as did the prior panel, and that
we can move forward with that, hopefully, in an expeditious
manner.
Then I can move to the Career-Ready Student Veterans Act.
Dr. Wescott, tell me some areas about that that you had either
some questions or concerns with respect to the discussion
draft.
Mr. Wescott. Well, certainly, one of the areas is--the
primary concern that I had and our association had would be
that it would be applied to all sectors of education, not just
unaccredited, but accredited institutions, as well. When we
issue an approval for even an accredited institution, we run
into cases where a program will not yet be accredited
programmatically, so what I will do on in that case is I will
exclude that program.
In fact, someone called me the other day and suggested that
one of our nursing degree programs at one of our for-profit
institutions was not approved by the Nursing Board. I can tell
you that within an hour, I had accreditation documentation from
the institution, because if in North Carolina I had a degree
program like that on the books, we would have suspended that
program immediately.
So, we are very supportive of this. We understand that
there may be other States where this is an issue and we
certainly would like to see this legislation passed.
Senator Tillis. Well, thank you for that. Mr. Butler or Mr.
Morosky, did you have any comment on that?
Mr. Morosky. Senator, we would be more than happy to look
at any tweaks that Mr. Wescott may have. We support the intent
of the bill entirely. You know, all too often, the issue of
credentialing and veterans not being able to translate their
military skills comes to bear. That is bad enough. It is even
worse when they get civilian training and then they are still
not able to get the credentialing after all that. So, we
certainly support everything that this bill is trying to do.
Mr. Butler. The Legion, likewise. The only concern or
comment we had, that if we are going to add additional workload
or responsibility to SSA, then there should be corresponding
budgetary consideration as to that additional increase in
workload.
Senator Tillis. I think that is a good point. When you
consider the unemployment rate among veterans, and some of that
has to link back to just having the right deployable skills,
and when they go to school, making sure that they can go out
and get the jobs that they were studying for. I look forward to
working with you all and I appreciate the Ranking Member's
leadership in moving this forward. I look forward to working
with you all.
The last topic, actually, is that I want to associate with
the comments of the Chair and the Ranking Member with respect
to Professor Kettl's comments. I have spent a lot of time down
in the VA facilities in North Carolina. The vast majority of
the people in those facilities are good people. Half of them
are veterans. The other half, many of them left good paying
jobs or deferred good paying jobs in the private sector because
they may not have served in the military, but they want to
serve those veterans out of respect for them.
I am reminded sometimes with the commentary that we hear of
a ``Dilbert'' cartoon from years ago that says, ``The floggings
will continue until morale improves.''
We have got to make sure that we get to the underlying
cause that is precipitating the morale problems and other
things for good hard working people and still hold those who
are accountable, or those who are responsible for unacceptable
behavior accountable and terminate them. And I think the
Department has terminated some 1,400 people since Secretary
McDonald has come in; probably appropriately so.
But, we do have to focus on the underlying challenges that
we have there that do not make this the best place in the
Federal Government to work. As I told Secretary McDonald the
other day, I not only want them to rank highest among Federal
Government agencies, I want them to beat many of the Fortune 50
companies as the best places to work. They have got a great
product. They are providing great services for men and women
that deserve it.
So, we should not lose sight of the fact that the vast
majority of them are good people. We are here to help them.
Thank you, Mr. Chair.
Chairman Isakson. Thank you, Senator Tillis.
Ranking Member Blumenthal, do you have any other comment?
Senator Blumenthal. I do not. Thank you, Mr. Chairman.
Chairman Isakson. I would like to thank all of our
witnesses for their testimony today.
We will leave the record open for 7 days for any
information that is to be submitted to the Committee.
The Senate Veterans' Affairs Committee stands adjourned.
[Whereupon, at 4:25 p.m., the Committee was adjourned.]
A P P E N D I X
----------
Prepared Statement of Hon. Jerry Moran, U.S. Senator from Kansas
As a Member of the Senate Veterans Affairs Committee, I appreciate
the opportunity to collect views from key stakeholders regarding
numerous pieces of important legislation. However, some entities with
varying views do not always have the opportunity to voice their
opinion, specifically as it relates to a perspective that I share
regarding draft legislation that would place caps on professional
aviation training. This is a circumstance where close examination is
necessary to make certain that subjective caps do not create
unnecessary burdens and consequences on the institutions and veterans
seeking this specialized training.
I understand there are extreme examples of abuse and cost overruns
occurring in some professional aviation training programs for veterans.
I agree that controlling cost and eliminating waste and abuse of
veterans' educational benefits is critical as stewards of taxpayer
dollars and for the sustainment of the GI benefit program.
The overwhelming majority of student-veterans who enter these
programs and the institutions that provide aviation training are honest
actors who play by the rules. The examples of waste and abuse are
deplorable but they do not represent all flight training programs and I
fear that those who conduct honorable and superior programs are
unnecessarily caught in the fray.
Should this bill be further considered, I will offer amendments to
remove the offending provisions and should that effort fail I will
vigorously oppose this legislation.
Before we negatively impact institutions with professional aviation
programs that are properly serving veterans utilizing GI education
benefits, the VA should take a closer look at enforcing and upholding
its own policies. Part of the issue is mismanagement and poor decisions
made from within the VA system.
I would urge my colleagues, the VA, and other interested parties to
address the core problems in the way this program is managed and
administered instead of addressing the symptoms. I look forward to
discussing ways in which we can improve oversight on the implementation
of GI educational benefits and avoid a circumstance that would diminish
or eliminate professional aviation training programs across the
country.
______
Prepared Statement of American Federation of Government Employees, AFL-
CIO
Chairman Isakson, Ranking Member Blumenthal, Members of the
Committee, thank you for the opportunity to present the views of the
American Federation of Government Employees, AFL-CIO and its National
Veterans Affairs Council (AFGE) regarding pending legislation. AFGE
represents over 670,000 Federal employees, including more than 220,000
employees of the Department of Veterans Affairs. AFGE's representation
of non-management, front line employees working in virtually every non-
management position in the Veterans Health Administration (VHA),
Veterans Benefits Administration (VBA), and National Cemetery
Administration (NCA) allows us to share a unique perspective with the
Committee. AFGE also greatly appreciates the efforts by Members of this
Committee to solicit the views of our AFGE local officials and the
employees they represent in settings where they feel free to share
their concerns and recommendations without reprisal.
s. 1856
AFGE strongly supports S. 1856 and applauds Ranking Member
Blumenthal for his leadership in introducing meaningful and
comprehensive accountability legislation. S. 1856 would provide highly
effective tools for increasing VA accountability while preserving
essential protections against retaliation and prohibited personnel
practices. Accountability will only be achieved when managers utilize
the tools provided to them to properly manage their workforces. S. 1856
enhances VA management training and evaluation to ensure that managers
make full use of the accountability tools available to them through
current law and this important legislation.
S. 1856 will achieve the accountability improvements that S. 1082
can only promise. In fact, whereas S. 1856 increases protections for
whistleblowers and other vocal employees, and takes a multi-prong
approach to reducing mismanagement, S. 1082 decreases protections for
these employees and does not create any new tools for addressing
mismanagement.
Section 2: Current law requires managers to provide the following
due process protections before a termination or other adverse action
becomes final:
30 days advance written notice;
7 days to respond and present evidence;
Right to secure representation;
Right to examples of performance problems; and
Written decision with specific reasons.
Current law provides for an exception to the 30 day notice
provision when the supervisor has reasonable cause to believe that an
employee committed a crime which could lead to imprisonment (5 U.S.C.
7513). Supervisors may also suspend an employee without pay if the
agency considers it necessary in the interest of national security (5
U.S.C. 7532). In addition, supervisors may also reassign the employee
or place the employee on paid, nonduty status if his or her continued
presence in the workplace during the notice period ``may pose a threat
to the employee or others, result in loss of or damage to Government
property, or otherwise jeopardize legitimate Government interests'' (5
CFR 752.404).
Section 2 of S. 1856 provides supervisors with an additional
flexibility: the immediate suspension without pay of an employee who
presents a clear and direct threat to public health or safety rights.
Notice and other due process rights apply after suspension and before
removal. The employee also retains full MSPB appeal rights. The
employee is entitled to back pay for the post-suspension period if the
Secretary determines that the termination is not justified.
Section 3: As noted earlier, accountability can only be achieved if
managers use the tools they are given in current law and new
legislation to properly manage the workforce. The requirement in
Section 3 of the bill for annual performance plans for VA political
appointees addresses this problem through the following critical
performance measures:
Hiring, selection and retaining well-qualified employees;
Engaging and motivating employees;
Training and developing employees for leadership roles;
Holding every manager accountable for employee performance
problems.
Section 4: This section also ensures that managers will fulfill
their workforce-related responsibilities by requiring that each manager
provide feedback to probationary employees and assess whether the
employee is suitable for permanent status, especially in light of
findings in the August 2015 MSPB report, Adverse Actions: The Rules and
The Reality, that supervisors are reluctant to terminate poor
performers in both management and non-management positions during
probationary periods.
Section 5: Similar to the evaluation requirements for political
appointees in Section 3, this section increases accountability by
requiring that all managers be evaluated for addressing poor
performance and misconduct, and their abilities to improve employee
engagement.
Section 6: This section addresses growing evidence that VA managers
have not been receiving sufficient training on workforce management. It
enhances accountability by mandating manager training in key workforce
management areas: whistleblower rights, employee motivation and
managing poorly performing employees.
Section 7: This section provides the VA with a valuable new
workforce retention tool: the ability to promote high achieving
employees to technical expert positions when that is more suitable or
desirable than a management track position.
Section 8: AFGE has seen a number of whistleblowers, especially
those in licensed medical and behavioral health professions suffer
great harm to their careers as a result of retaliatory negative
performance evaluations. Current law does not provide clear Office of
Special Counsel jurisdiction over Title 38 employees filing such
complaints. Section 8 of the bill closes this major gap in the law.
Sections 9 and 10: These comprehensive ``revolving door''
provisions that safeguard against conflicts of interests between
acquisition personnel and other personnel involved in sourcing
decisions, and contractors doing business with the VA. Contracts based
on self-interest rather than need or merit have been a longstanding
problem in VHA, VBA and NCA, at both the local and national level.
Section 11: This section halts the abuses of extended paid
administrative leave that have wasted taxpayer dollars and prevented VA
employees from being put back to work to serve veterans. This section
also mandates the collection of data on the use of administrative leave
that is sorely needed to separate rhetoric from actual practice.
Excessive use of administrative leave has been another symptom of VA
management's reluctance and inability to use current law and policy to
manage the workforce properly.
Sections 12 and 13: AFGE also supports new reporting requirements
for the Office of the Medical Inspector and an assessment of the impact
of new SES personnel rules, in light of reports of high vacancy rights.
s. 1451
As the exclusive representative of VA employees processing survivor
benefits, AFGE supports S. 1451. AFGE greatly appreciates Senator
Hirono's efforts to bring additional attention to survivor benefits and
the Senator's efforts to streamline this process.
Based on feedback from our membership, AFGE shares the concerns
addressed in S. 1451 with the current backlog for processing survivor
benefits. AFGE believes that ``non-rating'' claims are not provided
with adequate attention from the Veterans Benefits Administration
(VBA). As of August 2015, the non-rating total workload was just shy of
415,000 claims with over 265,000 claims pending for 125 days. AFGE
members are proud of their success with VBA in reducing the disability
claims backlog, now below 100,000. However, AFGE believes VBA has not
adequately prioritized the non-rating claims, worsening the backlog.
AFGE believes the inadequate attention on non-rating claims also
created problems elsewhere, such as the current backlog of dependency
claims. Unfortunately, VBA has once again turned to the quick fix of
contracting out even though contractor work on the dependency claims
has wasted taxpayer dollars that would be better spent hiring
additional claims processors. Contracting out also increases
inaccuracies that increase the workload for VBA employees. Therefore,
AFGE urges Congress and VBA to place additional attention on the non-
rating backlog, including survivor benefits, by increasing in-house
capacity as opposed to relying on contractors.
Thank you for the opportunity to testify on these important
legislative issues.
______
Prepared Statement of Beth Moten, Legislative and Political Director,
American Federation of Government Employees, AFL-CIO
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
______
Prepared Joint Statement of Aircraft Owners and Pilots Association,
General Aviation Manufacturers Association, Helicopter Association
International, National Association of State Aviation Officials,
National Business Aviation Association
Collectively, our five aviation associations represent hundreds of
thousands of individuals and companies from all segments of the general
aviation community, including flight schools, pilots, aircraft owners,
operators, businesses that utilize aircraft, mechanics, and
manufacturers. We welcome and thank the Committee for this opportunity
to offer a written statement for the record.
The industry is extremely concerned about language in Section 3 of
the discussion draft of the bill to amend 38 U.S.C. 3313. We believe
that language will create for many veterans a Hobson's choice requiring
them either to select a program that will severely limit the
availability of funds that they were told they were entitled to when
they elected to serve their nation or severely restrict the number of
fully funded programs available to them.
The need for this provision is, as yet, unknown. The Department of
Veterans Affairs (VA) has in place rules and regulations intended to
ensure that market forces hold the cost of flight training in check.
Specifically, the rule known as the 85/15 rule, requiring that no more
than 85 percent of students enrolled in a flight training degree
program can have their education paid for with VA funds, is designed to
hold prices in check under the theory that the price sensitivity of the
remaining 15 percent who are using private or alternate sources of
funding would hold flight training costs down.
Unfortunately, the enforcement of this rule across VA regions can
be most charitably described as uneven. According to one flight school
operator whose operations fall under the jurisdiction of two VA
regional offices, the school routinely gets differing interpretations
from each office. In one instance, a single VA official changed the
interpretation of the 85/15 rule four times in one conversation.
The original legislation introduced in the House of Representatives
(H.R. 475, the GI Bill Processing Improvement and Quality Enhancement
Act of 2015) was based upon a request from the Department of Veterans
Affairs and state authorizing agencies, and was intended to protect the
U.S. taxpayer from a relatively small number of instances of flight
schools and public institutes of higher learning charging significantly
higher fees than normal to achieve the FAA certificates necessary to
work in the aviation industry.
The aviation industry had raised concerns with members of the House
of Representatives that the proposed solution in their legislation--
capping funds available to veterans enrolled in flight training degree
programs at public colleges and universities--would leave veterans with
far too little money to achieve their educational goals and is
discriminatory because only flight training degree programs would be
subject to the cap. In attempting to address the discriminatory nature
of the House proposal, the Senate has instead created a provision that
is destined to harm even more of the very people the Post-9/11 GI Bill
was intended to help--veterans of the United States' Armed Forces--and
yet will fail to address the discriminatory nature of the provision. To
the best of industry's knowledge, flight training is the only degree
program for which colleges and universities normally contract such
programs of education.
According to the Congressional Budget Office cost estimate for H.R.
475, an estimated 600 veterans would be denied full access to the
benefits promised them by the American people. The report further
states that the first year the cap is in place, each affected veteran
will lose approximately $30,000 in payments. The amount lost is
expected to grow in each subsequent year.\1\
---------------------------------------------------------------------------
\1\ Congressional Budget Office, H.R. 475 GI Bill Processing
Improvement and Quality Enhancement Act of 2015, cost estimate report
as ordered by the House Committee on Veterans' Affairs, August 26,
2015, 6, https://www.cbo.gov/sites/default/files/114th-congress-2015-
2016/costestimate/hr475.pdf.
---------------------------------------------------------------------------
The aviation industry's concern about H.R. 475 and the Senate's
discussion draft relates to veterans' ability to earn a college degree
in aviation that includes, as part of the course of study, flight
training that leads to the Federal Aviation Administration (FAA)
certificates considered necessary to be employable as a commercial
pilot.
While fair treatment of veterans must, of course, be the first
priority of this Committee, it is worth noting that legislation that
would severely restrict flight training benefits for veterans would
have enormous detrimental impact on the aviation industry--and
especially the helicopter sector. The helicopter industry is in the
midst of a worsening pilot shortage. Veterans separating from the
military are seen as highly valued employees and a vital potential pool
of new pilots. Further, reducing the pool of new pilots ultimately
hurts the veterans because fewer pilots will cause the industry to
contract, leaving fewer openings for those veterans seeking other
careers in the helicopter industry such as maintenance technicians,
dispatchers, or business managers.
Under the current language of the Post-9/11 GI Bill (Public Law
110-252), public colleges and universities are allowed to partner with
flight schools to offer aviation degree programs that lead to FAA pilot
certifications and careers in the aviation industry. The law allows
flight training expenses, which include hourly aircraft rental fees and
the instructor's hourly rate, to be treated as course fees.
The Senate's discussion draft affects the entire flight training
industry. However, due to significantly higher fixed operating costs
(primarily maintenance-related) for helicopters, it has a
disproportionate effect on helicopter flight training. In addition, the
Department of Veterans Affairs initially raised its concerns with
regard to fees charged at certain helicopter flight schools. Therefore
much of the industry research has focused on helicopter flight
training.
HAI worked closely with the staff of the House Veterans' Affairs
subcommittee on economic opportunities to provide an understanding of
the costs associated with flight training. Since one of the goals of
the Post-9/11 GI Bill is to provide veterans with the education and
training necessary to enter their chosen career field, employability
within the aviation industry was defined and used as a benchmark for
entry-level pilot jobs. As the predominant entry-level position in the
industry is as a helicopter flight instructor, we defined
``employable'' as a commercially rated pilot holding certificated
flight instructor (CFI) and certificated flight instructor-instrument
(CFII) certificates from the FAA.
FAA regulations require a pilot to hold, at a minimum, a commercial
pilot certificate in order to conduct revenue flights such as an
instructional flight. A pilot must also receive additional training and
be certificated as a flight instructor in order to give instruction.
And in today's flight instruction industry, flight instructors are
expected to be able to teach pilots how to fly in poor visibility
weather, known as instrument conditions. In order to give that
instruction, flight instructors require additional training and
certification. Therefore a commercial pilot certificate with CFI and
CFII is considered the minimum credentials required to be employable.
HAI polled flight schools providing helicopter flight training
through public colleges and universities to determine an historical
average cost to achieve employability under the following assumptions:
the minimum number of hours required by the FAA to achieve each level
of certification; the least expensive helicopter available to rent at
the flight school appropriate to the type of training and environmental
conditions.
HAI surveyed 15 flight schools affiliated with public colleges and
universities. Thirteen responded. The results indicate that flight
training alone (not counting academic tuition, books, or other fees)
costs $112,500 (\5%) in a four-year college aviation degree program,
and $107,500 (\5%) in a two-year college aviation degree program.
Based on HAI's survey results, the total cost for tuition and
flight training at a four-year college aviation degree program is
approximately $212,500, while the total cost for a two-year program is
approximately $122,500.
Both the Senate's discussion draft and the flight training
amendment to H.R. 475 seek to impose the same caps on flight training
degree programs at public institutes of higher learning as are
currently in place for all degree programs at private colleges and
universities--currently $20,240 per year, or slightly less than $81,000
for a four-year college career. That clearly falls far below the cost
of the required flight training, let alone flight training plus
tuition, books, and other related expenses.
Proponents supporting an amendment to cap flight training benefits
have argued that there would remain additional funds available through
the Department of Veterans Affairs' Yellow Ribbon program. According to
the Department's own information,
[t]his program allows institutions of higher learning (degree
granting institutions) in the United States to voluntarily
enter into an agreement with VA to fund tuition expenses that
exceed either the annual maximum cap for private institutions
or the resident tuition and fees for a public institution. The
institution can contribute up to 50% of those expenses and VA
will match the same amount as the institution.\2\
\2\ U.S. Department of Veterans Affairs. ``Education and Training:
Yellow Ribbon Program.'' Created Nov. 21, 2013. Last Reviewed July 9,
2015. http://www.benefits.va.gov/gibill/yellow_ribbon/
yellow_ribbon_info_schools.asp
---------------------------------------------------------------------------
However this ignores the economic reality that the amount forgiven
for a veteran student can be amortized across scores or even hundreds
of students in a lecture class setting; it is impossible to amortize
the cost of flight training with one student and one instructor in a
two-seat training aircraft. Based on HAI's survey, the average combined
cost to rent a helicopter with instructor is $349 per flight hour. That
cost is driven primarily by the cost of required maintenance and does
not change. The assumption in the HAI survey was that it will require
210 flight hours for a pilot to achieve all the certificates necessary
to be employable.
Margins at flight schools are very thin. Therefore, for a flight
school to bill only half the price of an instructional flight is to
guarantee a loss on every flight. It is unreasonable to expect any
college or university to discount the cost of fuel and equipment by as
much as 50 percent in order to continue to operate a flight training
degree program under VA's Yellow Ribbon program.
The aviation industry strongly believes that Congress should direct
the Department to adopt uniform enforcement of market force regulations
and allow those market forces to exert their influence before adopting
a legislative solution.
As associations representing the broad spectrum of the general
aviation industry, we urge the Committee to remove section 3 from the
discussion draft document and continue to fulfill the promises made to
America's veterans in the Post-9/11 GI Bill.
Further, we request that the Department of Veterans Affairs be
directed to enforce its own regulations uniformly--specifically the 85/
15 rule--allowing market forces to regulate flight training prices, as
the rule is intended to do, and to convene a working group of flight
training industry leaders and associations to examine the costs
necessary to train veterans to meet both FAA requirements and
employability standards for professional careers in the aviation
industry.
Finally, we request the Committee direct the Government
Accountability Office (GAO) to conduct a study of the flight training
industry and the associated costs for a commercial rotorcraft
certificate with IFR, CFI and CFII ratings. The study should examine
course completion rates, the need for additional safety-related
training, the needs of potential employers, and the private student
loan market, and should include a cost/benefit analysis of training in
piston aircraft vs. turbine aircraft, and its effect on employability.
It should examine the value of creating benchmarks and their potential
beneficial effect on reducing excessive expenditures on courses that
are being frequently retaken by veterans. Because stand-alone flight
school programs are less costly than combined academic/flight school
programs, the study should examine the benefits of creating an
accreditation program that would grant accredited flight schools parity
with flight training programs associated with academic institutions. As
a subset of the study, the GAO should examine the costs borne by the
United States Department of Defense in training military pilots to the
same level of proficiency as veterans that receive commercial flight
training.
We do not dispute that there were some instances of the VA being
charged far more than is necessary for some veterans' flight training.
We agree that, while within the law, such charges exceed the intent of
the Post-9/11 GI Bill and should be addressed. But we firmly believe
the best way to keep flight training fees in line with the costs to
train veterans to employable status as a pilot is for the aviation
industry, the Department of Veterans Affairs, and state authorizing
agencies to work together. We look forward to working with the
Committee to find the solution that best serves the needs of both the
veteran and the taxpayer.
Veterans have given the nation their very best. They deserve the
very best from the nation in return.
Submitted very respectfully,
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mark R. Baker,
President and CEO,
Aircraft Owners and Pilots Association.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Peter J. Bunce,
President and CEO,
General Aviation Manufacturers Association.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Matthew S. Zuccaro,
President and CEO,
Helicopter Association International.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Greg Principato,
President and CEO,
Natl. Association of State Aviation Officials.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Ed Bolen,
President and CEO,
National Business Aviation Association.
______
Prepared Statement of Diane M. Zumatto, National Legislative Director,
AMVETS
Distinguished members of the Senate Veterans' Affairs Committee, on
behalf of the 23 million American Veterans in this country, AMVETS, a
leader since 1944 in preserving the freedoms secured by America's Armed
Forces and providing support for Veterans, Active Duty military, the
National Guard/Reserves, their families and survivors, it is my
pleasure, to offer this `Statement for the Record' concerning the
following pending legislation:
s. 290, increasing the department of veterans affairs accountability
act of 2015
Even though AMVETS made a conscious decision to elevate the issue
of VA accountability to the very top of our list of legislative
priorities, we do not believe that this bill is goes far enough to the
do the necessary job.
While there are a couple of provisions which we approve of in this
bill, we cannot endorse limiting the number of annual ``Outstanding''
or ``Exceeds-Fully-Successful'' performance ratings, as this seems
counter-productive. The last thing VA should do is ``punish'' their
best employees through the application of this provision; instead
AMVETS would recommend focusing more on the ill-performing employees.
As far as the provision for reassigning SES employees ``at least
once every five years * * * to a position at a different location that
does not include the supervision of the same personnel or programs'',
AMVETS sees both positive and negative outcomes.
On the positive side: this would ensure that SES employees
have a broad range of both personnel and programmatic experiences which
could conceivably be beneficial.
On the negative side: this would seriously curtail any
form of institutional memory and the development of any real expertize
in any specific area.
AMVETS believes that if, or until, each and every VA employee, not
just SES personnel as stipulated in S. 290, can be held accountable for
their actions or lack thereof, the VA system will remain broken,
unsatisfactory and unsafe. AMVETS believes that H.R. 1994, while
perhaps not perfect, is currently the best option available to address
the VA accountability problem.
s. 563, the physician ambassadors helping veterans act
While AMVETS doesn't doubt the good intentions of this legislation,
we do not believe that it will have a substantive effect on VA patient
wait times or quality of care.
s. 564, the veterans hearing aid access & assistance act
We heartily offer our support for this legislation which would
allow licensed hearing aid specialists to provide hearing aid services
to veterans as VA providers.
Many of the wounded veterans who have returned from the conflicts
in Iraq and Afghanistan sustained sensory injuries, including hearing
loss and tinnitus, the treatment of which may require the use of
hearing aids or other prosthetic items to help those injured rebuild
their lives and gain independence.
This much needed legislation would improve hearing healthcare
access, service and outcomes for veterans, as well as:
reduce treatment and follow up costs;
improve quality of life;
shorten appointment wait times;
strengthen the VAs hearing healthcare team; and
shorten veteran travel time by providing access in rural
and urban settings.
As a hearing impaired veteran myself, both AMVETS and I would like
to take this opportunity to thank Senator Moran and Senator Tester for
introducing this important piece of legislation and for all you do in
support of American Veterans
s. 1450, the department of veterans affairs emergency medical staffing
recruitment & retention act
AMVETS supports this legislation, but believes this is might be
more appropriately a policy, rather than a legislative issue.
s. 1451, the veterans' survivors claims processing automation act of
2015
AMVETS supports this legislation which would take the burden of
filing a claim for benefits from the surviving spouse of a recently
deceased veteran and, if there is sufficient evidence in the record to
warrant such payment, would automatically pay those benefits.
s. 1460, the fry scholarship enhancement act of 2015
AMVETS supports this legislation which seeks to extend the Yellow
Ribbon G.I. Education Enhancement Program to cover recipients of the
Marine Gunnery John David Fry Scholarship.
s. 1693, a bill to expand eligibility for reimbursement for emergency
medical treatment to certain veterans that were unable to receive care
from the va in the 24-month period preceding the furnishing of such
emergency treatment
AMVETS thinks this bill is too limiting and that during a medical
emergency, a veteran should be able to seek care at the nearest
facility regardless of whether it is a VA facility or not and if that
facility is a non-VA hospital, the veteran should be reimbursed for
their expenses without the 24-month caveat.
s. 1856, the department of veterans affairs equitable employee
accountability act of 2015
AMVETS cannot fully support this bill because it only calls for the
suspension or removal of VA employees if their performance or
misconduct is a threat to public health or safety. What about instances
of unethical, fraudulent, improper or poor performance which isn't a
threat to public health or safety? AMVETS also believes that all
employees should be held accountable for their behavior and actions, or
lack thereof, not just managers.
AMVETS does, however like the provision that would require an
annual performance plan for political appointees and, though as already
stated, we think all employees need to be held accountable, we are glad
to see some added accountability for hiring well-qualified people and
improved training for managers.
s. 1938, the career-ready student veteran act of 2015
AMVETS support this legislation.
draft legislation, to make improvements in the laws administered by the
secretary of veterans affairs relating to educational assistance
AMVETS is completely and utterly opposed to this draft legislation
which claims it would make improvements in the laws administered by the
Secretary of Veteran Affairs relating to educational assistance.
AMVETS strongly believes that since veterans ``earn'' their G.I.
Bill benefits, no one, neither Congress, nor the VA should be able to
control, how those benefits are utilized. Unfortunately, this appears
to be nothing more than an ill-conceived, unjust and prejudicial
attempt to reduce our veterans' earned benefits and curtail their
freedom to pursue aviation training.
Additionally, if this bill gets signed into law, it will be the
start of a very ``slippery slope''. Down the road I can see the law
being expanded to add further limits on how educational benefits may be
utilized. Maybe the next cap will apply to medical school and the next
might be for law school, etc.
The only purpose I can attribute the drafting of this legislation
to, is cost savings for the VA. This situation highlights, what to
AMVETS is one of the biggest problems with the VA--and that is that
there seems to be more focus on VA employees and what's good for them,
than on the needs of veterans. If cost-savings truly is the impetus
behind this bill, I can suggest a number of other options which would
bring about the same end result.
Before we start legislating what veterans can and cannot study with
their G.I. Bill benefits, let's review and eliminate all
inconsistencies, inefficiencies and duplications in VA's educational
policies and procedures. Additionally, we must require continuity
throughout the VA so that policy is appropriately and equitably applied
and enforced throughout the country. We also should look for
consistency in all the schools, to ensure that we're comparing apples-
to-apples.
Some additional cost saving suggestions, include:
require some form of pre-enrollment qualification and
testing to ensure student success. Think of how this is done in the
military, many apply and would love to get into military flight
schools, but very few are accepted and even fewer successfully complete
their programs;
limit the number of times a class can be repeated;
require successful, on-going progress throughout the
program; and
allow schools to issue short-term ``incomplete'' grades to
students who are within a number of flight hours
Perhaps the most important point I'd like to make, is that there
are three individual components involved in this situation:
the VA;
the School; and
the veteran
Let's make sure we deal with the first two, before we take anything
away from our veterans.
This completes my statement at this time and I thank you again for
the opportunity to offer our comments on pending legislation. I will be
happy to answer any questions the Committee may have.
______
Prepared Joint Statement of The American Speech-Language-Hearing
Association (ASHA), the Academy of Doctors of Audiology (ADA), and the
American Academy of Audiology (AAA)
The American Speech-Language-Hearing Association (ASHA), the
Academy of Doctors of Audiology (ADA), and the American Academy of
Audiology (AAA) respectfully submit this joint statement for the record
in opposition to S. 564, the Veterans' Access to Hearing Health Act of
2015. The bill would authorize the Secretary of the Department of
Veterans Affairs (VA) to appoint hearing aid specialists under Title 38
of the United States Code as professionals eligible to provide
healthcare to veterans in the Veterans Health Administration. While we
appreciate and support the intent of the bill sponsors to ensure
appropriate access to hearing health services by our Nation's veterans,
we strongly believe that S. 564 would not in any way advance this
effort.
Hearing loss is one of the top service related disabilities for
veterans and requires complex and comprehensive treatment. While noise-
induced hearing loss is common, veterans frequently present with
complex audiology and vestibular pathologies that may be exacerbated by
tinnitus, Traumatic Brain Injury, or Post Traumatic Stress Disorder.
This complexity is further intensified by the increased number of
veterans with combat-related hearing loss.
The provision of hearing aids is neither simple nor straight
forward--especially when addressing the complex needs of veterans. As
with all technologies, the technology of hearing aids is becoming
increasingly more complex and the options beyond hearing aids, such as
streaming capabilities, direct audio input, or Bluetooth coupling, are
becoming more numerous. Coupled with advances in understating complex
ear brain interactions, the provision of hearing aids requires advanced
education and training to effectively service our veterans.
Audiologists are doctoral-level professionals who undergo a
rigorous four year post-graduate program that includes academic
education, clinical training, and a required national exam. They are
qualified to evaluate the effects of acoustic trauma and ear injuries
on hearing; to detect underlying medical conditions; and to diagnose
and treat tinnitus, hyperacusis, vestibular issues, auditory processing
disorders, and hearing loss. Audiologists provide a complete diagnostic
evaluation to veterans in need of hearing healthcare services. As you
know, veterans frequently present with complex auditory and vestibular
pathologies that may be exacerbated by tinnitus, Traumatic Brain
Injury, or Post Traumatic Stress Disorder. They require and deserve the
highest standard of care.
Hearing aid specialists are trained in the fitting of hearing aids.
While some states require a college-level associates degree as a
minimum educational requirement to become a hearing aid specialist,
many states still require only a high school diploma. Further, there
are no national standards or dedicated curricula that outline the core
competencies of a hearing aid specialist. In testimony before the U.S.
Congress, the VA has expressed concern that the lack of standardized
education for hearing aid specialists could lead to fragmented hearing
healthcare services and limit delivery of comprehensive care.
Timely access to care in the VA should not come at the expense of
diminished access to high quality services provided by the most highly
trained individuals. Given the minimal training required to become a
hearing aid specialist in comparison to the extensive education and
training of an audiologist, hearing aid specialists are ill-equipped to
provide the quality hearing health services that our Nation's veterans
require and deserve.
va hiring authority
Another career classification for hearing aid specialists as
proposed by S. 564 is unnecessary and administratively burdensome. The
VA does not need additional legislative authority to hire hearing aid
specialists. Both Title 5 of the U.S. Code and Pub. L. 113-146, the
Veterans Access, Choice and Accountability Act (Choice Act), provide
the VA the necessary authority to hire hearing aid specialists within
the VA and to contract out to these individuals, as appropriate, in the
fee-for-service market. The VA has established policies for hearing
healthcare services that are intended to ensure best practices and to
provide the highest level of care for veterans by emphasizing the need
for a care team lead by an audiologist. We believe that the current VA
model is appropriate to address the complex hearing healthcare needs of
veterans.
Further, S. 564 would add hearing aid specialists to the list of
professionals eligible to provide healthcare services to veterans under
Title 38 of the U.S. Code. Hybrid Title 38 is not the appropriate
statutory authority under which to define the scope of practice for
hearing aid specialists. The VA's hiring authority for these
individuals should remain under Title 5. With the exception of
positions created specifically for the VA, all other professionals
listed under Hybrid Title 38 have higher education requirements (at
least two years of college) and national standards for certification,
and/or requirements to pass a national exam in order to establish
standardized core competencies. While hearing aid specialists are
licensed in each state to fit and dispense hearing aids, there is no
uniformity among states in their standards. (See www.asha.org/
uploadedFiles/State-Licensure-Trends-Hearing-Aid-Dispensing.pdf)
Hearing aid specialists are currently hired under the Health Aid
and Technicians Series 0640 of Title 5. The level of education and
training for hearing aid specialists is consistent with the knowledge,
skills, and abilities of health technicians who work in the VA
audiology clinics under the supervision of an audiologist. Many VA
audiology health technicians are hearing aid specialists. VHA Handbook
1170.02. Section 1170.02 defines the role of the audiology health
technician in part, to increase productivity by reducing wait times, to
enhance patient satisfaction, to reduce costs by enabling health
technicians to perform tasks that do not require the professional
skills of a licensed audiologist. The job of these technicians
includes, for example, checks of hearing aids and other amplification
devices, trouble shooting and minor repairs to hearing aids, ear molds
and other amplification devices, and electroacoustic analysis of
hearing aids. No modification of existing law is needed for the VA to
hire or contract with the hearing aid specialist consistent with their
scope of practice.
The VA also has the capability to contract services for hearing aid
specialists through its fee-for-service program ``where timely referral
to private audiologists or other VHA facilities is not feasible or when
the medical status of the veteran prevents travel to a VHA facility or
a private audiologist.'' VHA Handbook 1170.02, Appendix A.
department of labor (cos)
We believe that the VA is appropriately using hearing aid
specialists in their role as technicians. This classification is
supported by the Department of Labor Standard Occupational
Classification (COS), which defines hearing aid specialists under
``Broad Occupation: 29-2090 Miscellaneous Health Technologists and
Technicians.'' This falls under a broader category of ``Health
Technologists and Technicians'' (29-2000), and the major heading is
``Healthcare Practitioners and Technical Occupations'' (29-0000). (See
www.bls.gov/soc/2010/soc292092.htm) Occupation Code 29-2092 provides
that a hearing aid specialist may:
``Select and fit hearing aids for customers. Administer and
interpret tests of hearing. Assess hearing instrument efficacy.
Take ear impressions and prepare, design, and modify ear molds.
Excludes ``Audiologists'' 29-1181).''
Currently, hearing aid specialists can be hired by the VA as health
technicians and work appropriately under the supervision of
audiologists. According to the VA Handbook, technicians perform tasks
that do not require the professional skills of a licensed audiologist.
This is an appropriate model of care given the complex needs of
veterans and the required level of care.
s. 564 will lead to fragmented care
We remain deeply concerned that the legislation could lead to
fragmented care due to the lack of uniformity in education and training
required for the licensing of hearing aid specialists. Additionally,
individuals seeking a dispensing license are not required to be
trained, educated, or credentialed as health care professionals unless
they choose to pursue an Applied Science Degree in Hearing Instrument
Science. According to the International Hearing Society (IHS) Web site,
there are currently seven programs offering an associate's degree in
Hearing Instrument Sciences. A quick review of these programs shows no
uniformity in program requirements. (See www.ihsinfo.org/IhsV2/
education/collegeprograms.cfm)
Most states require hearing aid specialists to sit for an exam
prior to getting their license; however, there is no uniformity among
exams. Some require both practical and written exams, while some are
written or practical only. Some require the IHS exam, while others
devise their own. In order to sit for the exam, the individual must
meet requirements that vary from state-to-state.
In most states, hearing aid specialists are only required to have a
high school diploma or general education diploma (GED) and training.
Eleven states require hearing aid specialists to complete two years of
college or post-secondary education in any field of study prior to
applying for a license. Some states also require the completion of a
distance learning program prior to taking the exam. A list of
requirements by state can be found on ASHA's Web site at www.asha.org/
uploadedFiles/State-Licensure-Trends-Hearing-Aid-Dispensing.pdf.
Those interested in obtaining a hearing aid dispensing license can
obtain experience either by attaining an associate's degree in Hearing
Instrument Science or gaining experience through an apprenticeship
program. Many of these apprenticeship programs are run by hearing aid
manufacturers who have a vested interest in selling their product. In
most instances, hearing aid specialists acquire their training through
apprenticeships and mentoring from other licensed hearing aid
specialists. There is no uniformity in the continuity of practice and
no real basis in science.
We would like to bring to your attention an article that was
published in the December 2013 edition of ``The Hearing Professional,''
which provides information on the two paths toward hearing dispensing
licensure. This illustrates the fragmented and disparate nature of
hearing aid specialist training. (See https://ihsinfo.org/IhsV2/
hearing_professional/2013/oct-dec/THP%20Q4%202013%20R2%20Low-
Res%20Web.pdf)
We encourage you to review the desirable skills of an apprentice,
which can be found on page 23. These skills do not reference education
and training in healthcare, but rather emphasize characteristics, such
as being good at your job, being driven, and being a salesman who stays
on top of technology. Our veterans deserve healthcare practitioners
dedicated to staying on top of science, research, and best practices,
not the latest features of a hearing aid. In comparison, audiologists
are doctoral-level professionals with education in the health sciences
as well as extensive externship requirements.
The VA is required to develop uniform standards and qualifications
for professions identified in Hybrid Title 38. Given the disparity in
licensure and education requirements that range from an associate's
degree to a two year apprenticeship with a GED, it would be difficult
for the VA to develop uniform standards and qualifications that are not
based on the lowest level of education and training. This could result
in the decrease in access to the highest quality of care.
intent of the legislation
S. 564 would permit the VA to hire hearing aid specialists to
independently deliver hearing healthcare services that currently can be
provided only by licensed audiologists. While the stated intent of the
legislation is to ensure that veterans have access to quality care, the
reality is that the hearing aid specialists, represented by the IHS,
are pursuing an expanded scope of practice through the VA system. Their
primary goal is to achieve parity with audiologists both at the Federal
and state levels. (See The Hearing Professional, Volume 62, No.
4 October--November--December 2013, page 34). To this end, the hearing
aid specialists are also advancing apprenticeship standards through the
Department of Labor that go well beyond their scope of practice as
defined in state licensing laws.
S. 564 would permit hearing aid specialists to work independent of
audiologists in the VA. While hearing aid specialists play an important
role in the VA in support of audiologists, their training and education
does not prepare them to work independently with veterans who
frequently present with complex medical needs. The education and
training of hearing aid specialists are not parallel to that of an
audiologist, and Federal legislation should not be used to bolster the
status of a profession.
In sum, S. 564 has the potential to inappropriately elevate hearing
aid specialists to a higher level of professional recognition, beyond
their current education levels and Department of Labor classification
as health technicians. Their training and education do not merit
parity, through recognition under Hybrid Title 38, with audiologists or
other health care professionals who have college and doctoral level
degrees.
s. 564 and perceived wait times
S. 564 is not a simple fix to alleviate wait times for the VA
audiology services. The VA has specific requirements related to the
delivery of hearing aids and related services. Prescriptions for
hearing aids are based on a complete (not basic) diagnostic audiology
evaluation, which is not within the scope of practice of hearing aid
specialists, as well as a hearing aid evaluation, which is within the
scope of a hearing aid specialist. Not all veterans are eligible for
hearing aids. In addition, eligibility must be determined by an
audiologist before the veteran schedules an audiologic evaluation.
The argument that the hearing aid specialists can remove the burden
of dispensing hearing aids from the VA audiologists' workload runs
contrary to current policies of the VA, which require the best practice
of both a compete audiologic evaluation and a hearing aid evaluation
prior to the dispensing hearing aids. (See VHA Handbook 1170.07
Appendix A www.va.gov/vhapublications?ViewPublication.asp? pub_ID=2397)
implementation of choice act and oig recommendations
ADA, AAA, and ASHA are aware that the VA Office of Inspector
General (OIG) report dated February 20, 2014, found that the VA was not
timely in issuing new hearing aids to veterans or in meeting timely
goals to complete hearing aid repair services. We understand that the
VA is currently working to implement the recommendations of this
report.
Additionally, our members are reporting that--since the
implementation of the Choice Act--the VA is now contracting with more
audiologists. It is our understanding that wait times that may have
been in existence when the Act was first introduced three years ago
have been reduced. We also strongly encourage the Committee to contact
the VA to discuss the VA's plans for staffing and what the VA is
currently doing to ensure timely access to hearing health services. We
remain committed to working with the Committee to ensure quality,
appropriate, and timely hearing healthcare services in the VA. As
outlined above, S. 564 does not advance this effort. It simply furthers
the interests of the hearing aid specialists in their attempt to
practice audiology without the proper education, training, clinical
experience, verification of knowledge, or license to practice. We urge
you to table further discussion of S. 564 until the VA has had the
ability to fully implement the Choice Act and recommendations made by
the OIG, which we believe are the most appropriate means to improve
access to hearing health services.
The American Speech-Language-Hearing Association is the national
professional, scientific, and credentialing association for 182,000
members and affiliates who are audiologists; speech-language
pathologists; speech, language, and hearing scientists; audiology and
speech-language pathology support personnel; and students. ASHA
supports its members through professional development, research,
advocacy and public awareness of communication, hearing and balance
disorders.
The Academy of Doctors of Audiology is dedicated to the advancement
of practitioner excellence, high ethical standards, professional
autonomy and sound business practices in the provision of quality
audiologic care.
The American Academy of Audiology is the world's largest
professional organization of, by, and for audiologists. The active
membership of more than 12,000 is dedicated to providing quality
hearing care services through professional development, education,
research, and increased public awareness of hearing and balance
disorders.
______
Prepared Statement of the Children of Vietnam Veterans Health Alliance
Thank you for holding a hearing on S. 564, the Veterans' Hearing
Aid Access and Assistance Act. Children of Vietnam Veterans Health
Alliance (COVVHA) stands in strong support of this badly needed
legislation, which would increase veterans' access to hearing
healthcare services by enhancing the Department of Veterans Affairs'
(VA) ability to utilize hearing aid specialists.
COVVHA is committed to serving as a voice for the children of
Vietnam veterans, including second and third generation victims of
Agent Orange and Dioxin Exposures worldwide. We believe in empowering
each other to hold the companies and governments responsible for
causing so much devastation and suffering to our generations.
In April, the VA, in a statement to the Institute of Medicine,
highlighted that nearly half the Veterans waiting for appointments at
that time were waiting for audiological appointments.
It is particularly troubling that the VA has not created an
appropriate staffing model to meet the ever growing need for hearing
services amongst veterans. With hearing loss and tinnitus continuing to
be the most prevalent service-connected disabilities affecting veterans
who receive disability compensation, failure to adjust staffing is
unacceptable.
S. 564 would allow the VA to hire hearing aid specialists--an
ability the VA currently does not have the authority to do--and ask
that the VA report back to Congress on an annual basis regarding wait
times and the number of audiologists, hearing aid specialists, and
hearing technicians hired by the VA. It truly is a common sense piece
of legislation that would help deal with the current backlog faced by
many of our Nation's veterans.
As you may be aware, COVVHA expressed our support for S. 564 in a
letter addressed to Senators Moran and Tester following the bill's
introduction in the 114th Congress and we continue to strongly support
the bill. We believe that passage of this bill will help those Veterans
in need of hearing aids, who are unable to access them due to physical
limitations, long distances to VA facilities, and long wait times for
appointments.
We encourage the Committee to continue to advance this bill, and
Members of the Committee to support S. 564.
______
Prepared Statement of Concerned Veterans for America
s. 290 (moran), the increasing the department of veterans affairs
accountability to veterans act of 2015
To amend title 38, United States Code, to improve the
accountability of employees of the Department of Veterans Affairs, and
for other purposes.
In the wake of last year's VA scandals, Congress approved a measure
allowing for VA Senior Executive Service (SES) officials to be more
easily removed from VA employment. However, more accountability is
needed. This bill would make strides toward increasing accountability
for SES officials by requiring that a removed employee's covered
service not be considered for the calculation of the annual annuity for
the individual, and by allowing the Secretary to order that the covered
service of an employee who retires prior to a final determination not
be considered for the annuity. Additionally, it further clarifies the
criteria for yearly performance appraisals for SES employees, as well
as restricts the amount of administrative leave--or any other paid non-
duty status--on which a given employee may be placed to 14 days in any
365-day period.
CVA SUPPORTS this legislation.
s. 563 (moran/tester), the physician ambassadors helping veterans act
To amend title 38, United States Code, to establish the Physician
Ambassadors Helping Veterans program to seek to employ physicians at
the Department of Veterans Affairs on a without compensation basis in
practice areas and specialties with staffing shortages and long
appointment waiting times.
This legislation would establish a volunteer program that would
allow qualified physicians to provide assistance on a no-compensation
basis at VA medical centers that are experiencing staffing shortages,
or in practice areas or specialties that exceed wait time goals
established by the Department of Veterans Affairs. While this is no
substitute for more comprehensive reform that addresses the issues
faced by VA in a more systemic way, CVA believes that marshalling the
resources of the community to serve veterans in need is an important
short-term step toward addressing the issues of an understaffed VA,
which often results in extended wait times for veterans in need of
care.
CVA SUPPORTS this legislation.
s. 564 (moran/tester), the veterans hearing aid access and assistance
act
To amend title 38, United States Code, to include licensed hearing
aid specialists as eligible for appointment in the Veterans Health
Administration of the Department of Veterans Affairs, and for other
purposes.
CVA has NO POSITION on this legislation.
s. 1450 (hirono), the department of veterans affairs emergency medical
staffing recruitment and retention act
To amend title 38, United States Code, to allow the Secretary of
Veterans Affairs to modify the hours of employment of physicians and
physician assistants employed on a full-time basis by the Department of
Veterans Affairs.
Current VA practices regarding schedule management for medical
professionals are misaligned with best practices that are being
utilized in the private sector. This legislation would provide
statutory authorization to allow flexibility in scheduling that mirrors
private sector practices, which will assist in recruiting and retention
of medical professionals. CVA stands by its call for comprehensive VA
reform, but we regard movement toward alignment with industry best
practices as progress.
CVA SUPPORTS this legislation.
s. 1451 (hirono), the veterans' survivors claims processing
automation act of 2015
To amend title 38, United States Code, to authorize the Secretary
of Veterans Affairs to adjudicate and pay survivor's benefits without
requiring the filing of a formal claim, and for other purposes.
CVA has NO POSITION this legislation.
s. 1460 (brown/tillis), the fry scholarship enhancement act of 2015
To amend title 38, United States Code, to extend the Yellow Ribbon
G.I. Education Enhancement Program to cover recipients of the Marine
Gunnery Sergeant John David Fry scholarship, and for other purposes.
CVA has NO POSITION on this legislation.
s. 1693 (hirono)
To expand eligibility for reimbursement for emergency medical
treatment to certain veterans that were unable to receive care from the
Department of Veterans Affairs in the 24-month period preceding the
furnishing of such emergency treatment, and for other purposes.
Under current law, in order to be eligible for reimbursement for
emergency for care at a non-VA facility, enrolled veterans must have
have received VA care within the preceding 24 months. In some cases,
veterans have been denied this reimbursement despite the fact that they
have requested and scheduled a new patient examination, though
excessive wait times have prevented them from receiving the
examination. This legislation would provide VA the flexibility to
provide reimbursement to these veterans, who number as many as 144,000
by some estimates. CVA believes this is a common-sense measure,
particularly at a time when wait times remains a persistent problem in
VA care access.
CVA SUPPORTS this legislation.
s. 1856 (blumenthal)
To provide for suspension and removal of employees of the
Department of Veterans Affairs for performance or misconduct that is a
threat to public health or safety and to improve accountability of
employees of the Department, and for other purposes.
While CVA appreciates this attempt to improve accountability for
incompetent VA employees, we believe that the standard employed in this
legislation sets the bar too low. It goes without saying that VA
employees who threaten public health or safety should not be granted
safe haven in VA. CVA, however, is concerned that this legislation
would fail to hold accountable employees who fail to live up to their
responsibilities to veterans, even if their actions do not rise to the
level of threatening public health and safety. As such, we cannot
support this legislation, and we instead urge support of S. 1082, the
VA Accountability Act.
CVA OPPOSES this legislation.
s. 1938 (blumenthal/tillis), the career ready student veterans act
To amend title 38, United States Code, to improve the approval of
certain programs of education for purposes of educational assistance
provided by the Department of Veterans Affairs, and for other purposes.
CVA has NO POSITION on this legislation.
discussion draft
To make improvements in the laws administered by the Secretary of
Veterans Affairs relating to educational assistance, and for other
purposes.
CVA has NO POSITION on this legislation.
______
Prepared Statement of Adrian M. Atizado, Deputy National Legislative
Director, Disabled American Veterans
Thank you for inviting DAV (Disabled American Veterans) to submit
testimony for the record of this legislative hearing, and to present
our views on the bills under consideration. As you know, DAV is a non-
profit veterans service organization comprised of nearly 1.3 million
wartime service-disabled veterans. DAV is dedicated to a single
purpose: empowering veterans to lead high-quality lives with respect
and dignity.
s. 290, increasing the department of veterans affairs accountability to
veterans act
This bill would make significant changes to the status, working
conditions, incentives, and environment of work of members of the
Senior Executive Service (SES) who work in the Department of Veterans.
Section 2 of his bill would impose reduction in retirement benefits
of a removed member of the SES of the Department of Veterans Affairs
(VA) if that former member were convicted of a felony, provided the
felony influenced the individual's performance while employed in the
previous VA position. The bill would establish a number of procedures
to govern and regulate the retirement reduction and its amount, and
would define the pertinent terms associated with this authority.
Section 3 would establish a new performance appraisal system to be
used in VA for its SES members, and would cap the rating levels of
``outstanding'' and ``exceeds fully successful'' in any year not to
exceed 10 percent and 20 percent of the members of the VA SES whose
performance is appraised, respectively.
This section also would require SES performance evaluations to
include review and consideration of relevant information from the VA
Inspector General (IG), Government Accountability Office (GAO) and the
Equal Employment Opportunity Commission, related to any facility or
program managed by the SES member whose performance is being evaluated
and rated.
This section would also require each member of the VA SES to
relocate each five-year period to a different location that would
exclude the supervision of the personnel or programs managed in the
prior position. The Secretary could waive this requirement in
individual cases by providing notice and explanation to the Committees
on Veterans Affairs of the House and Senate.
This section would require VA to make an annual report to Congress
on SES appraisals and related information, and require VA to contract
with an outside entity to review the SES management training program in
use in VA, compared to that of other agencies and private sector
organizations, and to make associated reports to the VA Secretary and
to Congress.
Section 4 of the bill would impose a 14-day limit on the use of
administrative leave for VA SES members, and would require VA to make
an annual report to Congress on the use of administrative leave by SES
members.
The delegates to our most recent National Convention approved
Resolution No. 214, calling for the imposition of meaningful employee
accountability measures in VA, but with due process for employees
targeted for such sanctions, to strike a balance between accountability
and VA's need to employ the best and brightest to serve veterans. Thus,
we support the sanctions embedded in section 2 of the bill in the wake
of a criminal conviction by a member or former member of the VA SES.
This policy should be made applicable to all Federal agencies.
Regarding section 3 of the bill, we understand the desire to make
VA's performance bonus system more meaningful by statutorily limiting
the number of senior executives eligible to receive top performance
ratings and thus qualify for performance bonuses. However, the VA is
but one of all Federal agencies competing to attract high performing
senior executives; it is important that VA's performance bonus
structure remain comparable to that of other Federal agencies, many of
which award executive bonuses at significantly higher rates than VA.
Any changes to VA's SES compensation structure must properly balance
these sometimes competing concerns to ensure that VA is able to recruit
and retain the most highly qualified executives and managers.
In addition, the mandatory relocation provision in this bill is
vague with respect to defining ``a different location.'' We caution
against forcing individuals and their families to move every five
years, a requirement that may serve as a disincentive for even high
performing employees to continue their careers with VA.
s. 563, physician ambassadors helping veterans act
This bill would require the VA Secretary to employ certain
physicians without regard to civil service or classification laws,
rules, or regulations, on a without-compensation basis in any VA
practice area or specialty for which the average waiting time for
veterans seeking an appointment with a physician exceeds the VA's
waiting time goals, or, at any VA medical facility where the physician
would be employed has demonstrated certain staffing shortages.
The bill would require each VA medical facility to designate a
coordinator of volunteer physicians to establish relationships with
medical associations serving the area, recruit physicians for
uncompensated employment at the VA facility, and serve as the initial
point of contact for physicians seeking uncompensated employment.
The bill would require a physician volunteer to commit to providing
a minimum of 40 hours for the initial year as a condition of receiving
credentials and privileges to practice in a VA facility, and the bill
would require the Secretary to decide whether to grant an uncompensated
physician's request for credentials and privileges to practice in the
VA facility within 60 days of a filed application.
The bill would require the director of a VA medical facility to
approve, and accept the uncompensated services of, any physician who
has made the requisite service commitment and receives credentials and
privileges to practice in the facility.
DAV has received no resolution on this specific matter, but would
offer no objection to enactment. Nevertheless, given VA's struggles
over the past several years in recruiting and employing clinical and
other personnel, but especially physicians, for both full- and part-
time appointments, and considering the priority and resource diversion
this act would impose on VA's limited human resources activities, we
question whether the administrative burden might be too heavy, given
that these physician ambassadors would be committing so little time to
their practices in VA facilities. Also, the credentialing and
privileging procedures are complex and time consuming, and would be as
complicated for these volunteers as they are for full- or part-time VA
physicians. For these reasons, we ask that the Committee carefully
consider the practicality of this bill versus VA's need to ramp up
human resources improvements physician hiring indicated recently by VA
Secretary Bob McDonald, to be one of VA's top priorities.
s. 564, veterans hearing aid access and assistance act
This bill would add authority under title 38, United States Code,
to VA's current authority under title 5, United States Code, to employ
licensed hearing aid specialists. In addition, the measure would
require VA to submit to Congress an annual report on the timely access
of veterans to VA's specialized hearing health services, and on VA's
contracting policies regarding the provision of specialized hearing
health services to veterans in non-VA facilities.
In a previous Congress, VA testified on a similar bill authorizing
hearing specialists to be employed by VA. During that hearing, VA
indicated that direct employment of hearing aid specialists would
potentially fragment VA's well-established national audiology program.
In addition, VA asserted a pre-existing statutory authority to employ
hearing aid specialists should they be determined to meet an unmet
need.
The VA Office of Inspector General's (OIG) 2014 audit of VA's
specialized hearing aid services described the delays in providing such
services as attributable to inadequate staffing to meet an growing
workload, due in part to the large number of veterans requiring
compensation and pension (C&P) audiology examinations. We understand
that these C&P examinations typically take priority over other
appointments, such as those to issue hearing aids, in order for VA to
process C&P claims as timely as possible.
Accordingly, the waiting time report required by this bill would
include the average waiting time for a veteran to receive an
appointment for a disability rating evaluation for a hearing-related
disability. This time would be measured beginning on the date the
veteran made the request.
The vast majority of C&P audiology examination appointments in the
VHA are not made at a veteran's request but rather at the request of
the Veterans Benefits Administration. We believe the no-show rate is
much higher in these instances where an appointment is made without
regard to the veteran's preference.
We recommend amending these provisions to ensure the information
being reported is more meaningful and provides greater granularity,
particularly if VA policy continues to place a higher priority on C&P
examinations over other hearing health appointments.
Moreover, the bill's required reporting of staffing levels and
performance measures related to appointments and specialized hearing
health within VHA should be considered in light of VHA's audiology
productivity standards (due to commence in fiscal year 2016) to provide
a more accurate depiction of utilization rates of audiologists and
hearing aid specialists in and outside of the VA health care system.
We laud the bill's efforts to create more transparency in VA
performance to provide specialized hearing health services; however,
the Committee must also ensure that sufficient funding is appropriated
commensurate with the increase in services this measure would intend to
provide. DAV has not received a resolution from our membership dealing
with the specific matter taken up by this bill; however, DAV takes no
issue with Congress encouraging VA to use all professional avenues
available in order to address the backlog and improve care for veterans
as long as it does not diminish the quality of care and the capacity to
provide such care within the VA health care system itself.
s. 1450, department of veterans affairs emergency medical staffing
recruitment and retention act
The proposed authority would align VA practice with the private
sector, facilitating the recruitment and retention of emergency
physicians and the recruitment, retention and operation of a
hospitalist physician system in VA medical centers.
To accommodate the need for continuity of efficient hospital care,
emergency medicine (EM) physicians often work irregular schedules. This
measure would modify the hours of employment for a full-time physician
or physician assistant to more or less than 80 hours in a biweekly pay
period provided the employee's total hours of employment in a calendar
year would not exceed 2,080. Consequently, VA medical centers would
gain the ability to implement flexible physician and physician
assistant work schedules that could accommodate hospitalist and EM
physicians' schedules and practices.
DAV does not have a resolution calling for this specific
legislation; however, because of the measure's beneficial nature, we
would not oppose its favorable consideration.
s. 1451, veterans' survivors claims processing automation act of 2015
This bill would authorize the VA Secretary to pay benefits to a
qualified survivor of a veteran who did not file a formal claim,
provided the veteran's records contained sufficient evidence to
establish entitlement to survivor benefits to a qualified survivor.
Additionally, the bill would require VA to associate the date of the
receipt of a claim under this authority as the date of the survivor's
notification to VA of the death of the veteran.
Providing a reasonable exemption from standard form-filing
requirements is one way to streamline the claims process, as well as
ease some of the processing burdens a survivor would otherwise
experience. DAV supports this bill in accordance with Resolution No.
091, adopted at our most recent National Convention. This resolution
calls on Congress to support meaningful reforms in the Veterans
Benefits Administration's disability claims process, and this bill is
consistent with that goal.
Furthermore, DAV testified before the Disability and Memorial
Affairs Subcommittee of the House Veterans' Affairs Committee on
June 24, 2015, in support of H.R. 2691, the Veterans' Survivors Claims
Processing Automation Act of 2015, a companion measure.
s. 1460, fry scholarship enhancement act of 2015
This bill would amend title 38, United States Code, to extend the
Yellow Ribbon Post-9/11 G.I. Bill education enhancement program to
cover eligible recipients of the Marine Gunnery Sergeant John David Fry
Scholarship.
Currently, surviving spouses and children are eligible to receive
Post-9/11 G.I. Bill benefits in cases when a servicemember's death
occurs in the line of duty, on or after September 11, 2001, and while
serving on active duty as a member of the Armed Forces. Yellow Ribbon
eligibility currently does not apply to the surviving spouse or child,
but this bill would extend this benefit to the fallen servicemember's
eligible survivor(s).
DAV does not have a resolution pertaining to this issue, but we
would not oppose this legislation.
s. 1693, a bill to expand eligibility for reimbursement for emergency
medical treatment to certain veterans that were unable to receive care
from the department of veterans affairs in the 24-month period
preceding the furnishing of such emergency treatment
Section 1725, title 38, United States Code, was enacted in the
Millennium Health Care and Benefits Act, Public Law 106-117, and took
effect on May 29, 2000. The statute authorizes the Secretary to
reimburse an eligible, non-service-connected veteran the reasonable
value of emergency treatment furnished in a non-Department facility.
To be considered an active Department health-care participant at
the time of the emergency treatment, a veteran must be enrolled in the
VA health care system and have received care under chapter 17 of title
38, United States Code, within the 24-month period preceding the
furnishing of the emergency treatment.
DAV has a long-standing resolution to eliminate the provision that
requires enrolled veterans to have received care from VA within the 24-
month period prior to the date of the emergency care. However, we note
Congress has passed legislation over the years to address numerous
issues veterans with which veterans have had to contend due to rules
limiting eligibility to VA's emergency care benefit. While we support
the intent of this legislation, this approach allows many other
existing restrictions to remain in place. These restrictions force
veterans to choose between seeking life-saving emergency care or facing
financial hardship.
It is for this reason the delegates to our most recent national
convention adopted DAV resolution No. 125, calling for a more
comprehensive legislative solution to integrate emergency care as part
of VA's medical benefits package and allow veterans to receive the
full-continuum, including emergency care, of holistic patient-centered
services. Thus, DAV supports this bill.
s. 1856, a bill to provide for suspension and removal of employees of
the department of veterans affairs for performance or misconduct that
is a threat to public health or safety and to improve accountability of
employees of the department
If enacted, this bill would establish new procedures to govern the
suspension and removal of employees of the VA for performance or
misconduct that is determined to be a threat to public health or
safety, or, to suspend or remove an employee in the interests of public
health or safety.
Section 2 of the bill would empower the VA Secretary on a
discretionary basis to suspend or remove an employee in the above
circumstances, without pay; the employee so affected would be provided
a written statement of charges, and would be given not less than seven
days to provide a response to them. A suspended employee pending
removal would be entitled to a formal review by a designated VA
official, and could be represented by an attorney or another party. In
the case of an affirmed removal recommendation, the Secretary would be
required to review the case, and VA would provide the employee a
written statement of the Secretary's decision.
An individual suspended or removed under this authority would be
entitled to appeal to the Merit Systems Protection Board (MSPB), and
would retain the right to seek judicial remedy of MSPB's decision.
The bill would provide back pay restoration to an employee
suspended or removed whose case was later determined to be not
warranted or constituted a prohibited personnel practice as that term
is defined by law, rule, regulation, or collective bargaining
agreement.
The bill would require an annual report by the VA Inspector General
(IG) to Congress on VA's use of this authority, its various elements,
and any associated IG recommendations made to the VA Secretary.
Section 3 of this bill would create a requirement for the VA
Secretary to establish performance plans for political appointees
similar to those which already exist for career appointees.
Section 4 would require all VA managers who supervise probationary
employees to provide them not less than 30-day notices on whether they
have demonstrated successful performance during their probationary
periods. This section would also require VA to add to the performance
plans of all managers of probationary employees a requirement to
provide effective feedback to probationary employees, and to make
timely determinations regarding these employees' probationary status.
Section 5 of the bill would require VA to include in all VA
managers' performance plans measures that focus on taking action in the
case of poor performance and misconduct, as well as improving
performance and sustaining employee engagement.
Section 6 would require VA to provide periodic training to all
managers in dealing with their employees, including training in the
rights of whistleblowers, motivating and rewarding employees, and
effectively managing poor performers.
Section 7 of the bill would establish a requirement for VA to
create a new career field of ``technical experts,'' who would gain the
means to advance their careers without needing to become VA managers.
Section 8 of the bill would add performance evaluations of VA
employees to the definition of ``personnel action'' as described in
section 2302 of title 5, United States Code.
Sections 9 and 10 of the bill would restrict recently terminated VA
employees who had previously made or influenced significant acquisition
decisions in employment with VA contractors under certain
circumstances, and would place additional requirements on such
contractors who hire these former VA employees.
Section 11 would impose a 14-day limit on the use of administrative
leave for certain VA employees, and would require VA to make an annual
report to Congress on the use of administrative leave.
Section 12 of the bill would require the Office of Medical
Inspector to provide an annual report to Congress, as well as to
provide Congress individual reports of problems or deficiencies in the
Veterans Health Administration observed and reported internally by the
Medical Inspector.
Section 13 of this bill would require the Government Accountability
Office to report to Congress on the implementation of section 713 of
title 38, United States Code (enacted in Public Law 113-146), focused
on performance and accountability of VA employees, and on recruitment
and retention of Senior Executive Servicemembers in the VA.
Delegates to our most recent National Convention approved
Resolution No. 214, calling for the imposition of meaningful employee
accountability measures in VA, but with due process for employees
targeted for such sanctions. Parts of this bill meet the intent of
DAV's resolution; therefore, DAV supports enactment of sections 2
through 6. Nevertheless, with respect to section 2, DAV recommends that
the term ``public health'' and ``public safety'' either be defined in
bill language or be reconsidered as the foundation for the authority
proposed.
The World Health Organization defines public health as `` * * *
refer[ring] to all organized measures (whether public or private) to
prevent disease, promote health, and prolong life among the population
as a whole. Its activities aim to provide conditions in which people
can be healthy and focus on entire populations, [emphasis added] not on
individual patients or diseases. Thus, public health is concerned with
the total system and not only the eradication of a particular disease.
The three main public health functions are:
The assessment and monitoring of the health of communities
and populations at risk to identify health problems and priorities.
The formulation of public policies designed to solve
identified local and national health problems and priorities.
To assure that all populations have access to appropriate
and cost-effective care, including health promotion and disease
prevention services.''
Public safety carries a looser definition but generally means the
responsibility of a state, Federal or local governmental subdivision
that protects the safety of the public. Those who work in public safety
are typically members of organizations such as emergency medical
services, police and fire departments, and other governmental functions
that are intended to keep the public safe.
By these definitions, arguments could made that, except in a few
instances (biomedical researchers handling hazardous toxins, or armed
VA police officers, for example) VA employees play no role in public
health or public safety--rather, VA employees work in, conduct, and
manage programs to deliver services and benefits to a fraction of the
public. On the other hand, perhaps these terms could be applied to any
number of activities or events in which VA employees might have been
involved or managed, and could be held accountable (contaminated food;
poor water quality; inadequate snow removal from parking lots; wet or
slick waxed floors that constitute a falling hazard, etc.).
We believe the Committee should clarify the intent of the bill with
respect to the use of the concepts of public health and public safety,
to avoid misinterpretation or misapplication of its meaning if this
bill is advanced. We suggest consideration of concepts adapted from the
Uniform Code of Military Justice such as ``gross negligence,''
``incompetence,'' and ``willful misconduct'' as actionable behaviors.
These terms might serve as a stronger foundation to reflect the intent
of this measure to root out VA employees who should not be serving
veterans for specific and justifiable reasons.
s. 1938, career ready student veterans act
This bill would ensure that VA education benefits are paid for duly
recognized educational and employment programs and courses.
VA and state approving agencies are authorized to approve
applications of institutions providing veterans non-accredited courses.
Approval is authorized when institutions and their non-accredited
curricula are found to meet criteria specified in law.
This bill would add two new standards for such approvals. First,
approval could be granted in cases of programs designed to prepare
individuals for licensure or certification in a state when programs
meet any instructional curriculum, licensure or certification
requirements of the state concerned. Second, approval could be given in
cases of certain programs if they are designed to prepare individuals
for employment.
The bill also would provide the Secretary with waiver authority
when warranted and also require the Secretary to disapprove certain
courses, unless the educational institution providing the course of
education publicly discloses any conditions or additional requirements,
such as training, experience, or examinations required to obtain
licenses, certifications, or approval for which the course of education
is designed to provide preparation.
On June 2, 2015, DAV testified before the Economic Opportunity
Subcommittee of the House Veterans' Affairs Committee regarding H.R.
2360, the Career-Ready Student Veterans Act, the companion bill. At
that hearing, we noted DAV did not have a resolution from our
membership on this particular issue, but would not oppose passage of
this bill; our position remains unchanged.
discussion draft, to make improvements in the laws administered by the
secretary of veterans affairs relating to educational assistance
This bill seeks to make changes in educational programs authorized
in title 38, United Stated Code. If enacted into law, these changes
would affect the Post-9/11 GI Bill program and require additional
reporting and survey responsibilities. The legislation also addresses
when certain entities petition the VA for recognition as a qualified
program of education for VA benefits purposes. Furthermore, the bill
would make changes to the amounts payable to certain public
institutions, including institutions of higher learning when specific
contractual agreements are formed.
DAV does not have a resolution pertaining to the issues outlined
within this bill and takes no position on the proposed legislation.
Mr. Chairman and Members of the Committee, this concludes DAV's
testimony. We thank the Committee for inviting DAV to submit this
testimony for the record of this hearing. DAV is prepared to respond to
any further questions by Committee Members on the positions we have
taken with respect to the bills under consideration.
______
Prepared Statement of John L. Stonecipher, President and CEO,
Guidance Aviation
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
______
Prepared Statement by Elizabeth Welke, J.D., Legislative Associate,
Iraq and Afghanistan Veterans of America
------------------------------------------------------------------------
Bill # Bill Name or Subject Sponsor IAVA Position
------------------------------------------------------------------------
S.290 Increasing the Sen. Moran Supports
Department of
Veterans Affairs
Accountability to
Veterans Act of 2015
------------------------------------------------------------------------
S.563 Physician Ambassadors Sen. Moran/Tester Supports
Helping Veterans Act
------------------------------------------------------------------------
S.564 Veterans Hearing Aid Sen. Moran/Tester Supports
Access and
Assistance Act
------------------------------------------------------------------------
S.1450 Department of Sen. Hirono Supports
Veterans Affairs
Emergency Medical
Staffing Recruitment
and Retention Act
------------------------------------------------------------------------
S.1451 Veterans' Survivors Sen. Hirono Supports
Claims Processing
Automation Act of
2015
------------------------------------------------------------------------
S.1460 Fry Scholarship Sen. Brown/Tillis Supports
Enhancement Act of
2015
------------------------------------------------------------------------
S.1693 A Bill to Expand Sen. Hirono Supports
Eligibility for
Reimbursement for
Emergency Medical
Treatment to
Veterans
------------------------------------------------------------------------
Chairman Isakson, Ranking Member Blumenthal and Distinguished
Members of the Committee, on behalf of Iraq and Afghanistan Veterans of
America (IAVA) and our more than 425,000 members and supporters, we
would like to extend our gratitude for the opportunity to share our
views and recommendations regarding these pieces of legislation.
While there are many important bills before the Committee today,
the most pressing topic our members and the veteran community continue
to urge action on is accountability at the Department of Veterans
Affairs (VA).
Just under a year and a half ago, whistleblowers revealed a wait-
list at the Phoenix VA hospital that rocked the veterans community and
the Nation. It was revealed some employees engaged in the manipulation
of wait times. The scandal did not stop in Phoenix; 110 VA facilities
across the country also kept secret lists in order to hide wait times.
Congress responded with the Veterans Access, Choice and Accountability
Act (VACAA) in order to empower VA to clean up its personnel problems.
In addition to VACAA, IAVA supported the House-passed VA
Accountability Act (H.R. 1994), which expands the firing authority
authorized in VACAA from SES employees to the greater VA workforce.
IAVA believes the vast majority of VA employees perform their job
properly and to the utmost of their ability, but it is the occasional
bad actor that needs to be held accountable so our veterans do not have
to endure another Phoenix-like episode again.
In a recent health care survey, 50 percent of IAVA members reported
utilizing VA services, so IAVA understands the need for reform at the
VA, and we believe reform begins with accountability of all VA
employees. Ranking Member Blumenthal's bill (S. 1856) is a step in the
right direction in getting VA accountability legislation passed in the
Senate. However, IAVA takes no position on this bill at this time
because we believe certain provisions of this bill lack the strength
necessary to actually hold VA employees accountable.
The removal of employees under this bill can only be authorized by
the VA Secretary if the employee's performance or misconduct is a
``clear and direct threat to public health or safety.'' This standard
is extremely high and vague; few could possibly meet this standard,
maybe not even those employees who were responsible for the heinous
actions that occurred at the Phoenix VA. The VA Secretary needs real
authority and the ability to remove actual bad employees, not just
those deemed ``a clear and direct threat'' to the public.
While S. 1856 is not as aggressive as IAVA prefers, we do recognize
value in this bill as a path forward on VA accountability in the
Senate. IAVA is concerned the Senate may come to an impasse when it
comes to VA reform and this bill, and others relating to VA
accountability, will be used as political fodder in the upcoming
election cycle. This would not only be a mistake, it would be a huge
disservice to our Nation's veterans. As a community, we have to find a
strong middle ground going forward when it comes to accountability at
the VA, or our veterans will suffer the consequences.
While accountability at the VA is a top priority for IAVA,
defending the Post-
9/11 GI Bill continues to be of high importance for IAVA and our
members. According to IAVA's 2014 Member Survey, 62 percent of
respondents indicated either they or their dependent have used the
Post-9/11 GI Bill and 42 percent of respondents also indicated they are
currently enrolled in a degree, certification or training program.
IAVA was a leader in driving the passage of the Post-9/11 GI Bill
in 2008 and championed upgrades in 2009 that expanded eligibility to
more than 500,000 veterans. Despite the enormous success of this piece
of legislation, there is a continuous need to protect against fraud,
waste and abuse.
An example of such waste and abuse is in regards to helicopter and
fixed wing flight schools. A loophole in the Post-9/11 GI Bill allows
flight schools to work as contractors for public institutions and train
veterans completely at the expense of the government and at twice the
amount non-veterans pay, which amounts to tens of millions of taxpayer
dollars each year. According to a VA investigation, it costs $1,800 per
hour of flight training and students are required to train for 200 to
300 hours. For one veteran to receive training it could cost up to
$500,000 in Post-
9/11 GI Bill benefits, as reported by the L.A. Times. If this is not an
abuse of the VA benefits system, then there is not much else that will
be considered waste.
On March 24, 2015, IAVA testified in front of the House Veterans'
Affairs Committee Economic Opportunity Subcommittee, where we strongly
supported Chairman Wenstrup's GI Bill Quality Enhancement Act (H.R.
476), which caps flight school training fees at $20,235 per year in
order to prevent exorbitant costs for high-end training programs.
Unfortunately, the Discussion Draft put forth at today's
legislative hearing only serves to further the abuse of Post-9/11 GI
Bill benefits as it places caps on certain programs but purposefully
leaves out flight school programs. IAVA strongly supports capping pay
for flight schools and a bill that leaves out a provision for such
obvious waste does a disservice to all veterans and weakens the intent
of the Post-9/11 GI Bill.
At IAVA, we believe our members, and all veterans, deserve the very
best our Nation can offer when it comes to fulfilling the promises made
to them upon entry into the military. There is no doubt every Member of
this Committee has the best interests of our veterans in mind when
drafting legislation. But we do hope you take into consideration and
implement what we, and our fellow veteran service organizations, have
had to say on these pieces of legislation today.
Thank you for your time and attention. IAVA is happy to answer any
questions you may have.
______
prepared statement from the international hearing society
s. 564, the veterans hearing aid access and assistance act of 2015
Chairman Isakson, Ranking Member Blumenthal, and esteemed Members
of the Committee: International Hearing Society thanks you for the
opportunity to comment on S. 564. IHS stands in full support of the
bill, which would create a new provider class for hearing aid
specialists within the Department of Veterans Affairs (VA), thereby
enabling the VA to hire hearing aid specialists to help deliver hearing
aid services to Veterans. The bill would also require the VA to report
annually to Congress on appointment wait times and the utilization of
providers for hearing-related services, which would make the VA's
efforts to address the backlog more transparent and provide much needed
data to inform Congress about Veterans' experiences in accessing
hearing aid services through the VA.
The International Hearing Society, founded in 1951, is a
professional membership organization that represents hearing aid
specialists, dispensing audiologists, and dispensing physicians,
including the approximately 9,000 hearing aid specialists who practice
in the United States. IHS promotes and maintains the highest possible
standards for its members in the best interests of the hearing-impaired
population they serve by conducting programs in competency
accreditation, testing, education and training, and encourages
continued growth and education for its members through advanced
certification programs.
The VA continues to see a dramatic rise in the demand for audiology
services. According to the VA the number of unique Veterans that
received VA audiology services in FY 2014 was 903,075, an increase of
19% since 2011, with 52,138 new Veterans in 2014 alone (a 5.8%
increase) \1\ \2\. The number of hearing aids ordered per year by the
VA has also dramatically increased with more than 800,000 ordered in
2014,\3\ up 34% since 2011.\4\ With tinnitus and hearing loss being the
two most prevalent service-connected disabilities for veterans
receiving Federal compensation combined with the aging Veteran
population, the demand will continue to rise. And despite clinical
audiologist-hiring within the VA following a similar growth track with
a 26% increase in staffing between 2011 and 2015,\5\ \6\ the high
demand and subsequent backlog continue to affect the VA's ability to
deliver timely and high-quality hearing healthcare.
---------------------------------------------------------------------------
\1\ David Chandler, Ph.D., ``Perspective from Department of
Veterans Affairs,'' Presentation to the Institute of Medicine's
Committee on Accessible and Affordable Hearing Health Care for Adults,
April 27, 2015
\2\ Lucille Beck, Ph.D., ``Meeting the Challenges of VA Audiology
Care in the 21st Century,'' presentation to the Association of VA
Audiologists, March 19, 2012
\3\ Chandler, ``Perspective from Department'' (see footnote 1)
\4\ Beck, ``Meeting the Challenges'' (see footnote 2)
\5\ Chandler, ``Perspective from Department'' (see footnote 1)
\6\ Beck, ``Meeting the Challenges'' (see footnote 2)
---------------------------------------------------------------------------
IHS and its members have a great deal of respect for VA
audiologists. They provide a wide variety of critical services to our
Veterans, including compensation and pension exams (over 151,000
performed in 2012 \7\), programming and providing support for cochlear
implant implantation and use, vestibular (balance) disorder services,
tinnitus services, hearing conservation, hearing aid services and
assistive device use, and advanced hearing testing. They also partner
with several medical disciplines and are part of the Traumatic Brain
Injury and Polytrauma teams, addressing balance and auditory issues.
Further, VA audiologists also responsible for training and supervising
audiology health technicians.
---------------------------------------------------------------------------
\7\ VA Office of Inspector General, ``Audit of VA's Hearing Aid
Services,'' February 20, 2014
---------------------------------------------------------------------------
The high demands on VA audiologists' time and expertise means that
the VA is not currently able to meet all Veterans' needs for hearing
healthcare services. To that point, in February 2014, the VA Inspector
General released a report, ``Audit of VA Hearing Aid Services'' that
found that ``during the 6-month period ending September 2012, VHA
issued 30 percent of its hearing aids to veterans more than 30 days
from the estimated date the facility received the hearing aids from its
vendors.'' The audit also found that deliveries of repaired hearing
aids to Veterans were subject to delay partially due to ``inadequate
staffing to meet an increased workload, due in part to the large number
of veterans requiring C&P audiology examinations.'' Further, in an
April 2015 presentation to the Institute of Medicine's Committee on
Accessible and Affordable Hearing Health Care for Adults, VA
Rehabilitation and Prosthetic Services Department Chief Consultant,
David Chandler, Ph.D., cited that ``nearly half of all patients
awaiting care in the VA are for audiology services.''
In a practical sense, as a result of the backlog and delays, many
Veterans are experiencing long wait times for appointments, shortened
appointments, and limited follow-up care and counseling. Hearing aid
specialists are observing an increase in the number of Veterans who
seek care in their private offices as well. These Veterans request
hearing aid specialists' help with hearing aid adjustments and repairs,
oftentimes because they do not want to wait for the next available VA
appointment, which may be months away, or because the distance to the
closest VA facility that offers audiology services is too far to
travel. There are also many Veterans who choose to purchase hearing
aids at their own expense through a private hearing aid specialist,
rather than using the benefits they've earned and are entitled to,
because they want to work with someone local who they trust and ensure
their hearing aids are properly programmed, address their loss, and can
be adjusted or repaired in a timely fashion. This relationship also
enables them to obtain support from their hearing professional on
demand, which is important to those with daily commitments or who are
employed, and is especially critical to those who are new users of
hearing aids. For a point of reference, in the private market, a new
user would typically see their hearing aid specialist 4-6 times in the
first three to six months to help them to adapt to a hearing world and
optimize their success with hearing aids.
Considering the safety risks involved as well as the impact
untreated hearing loss can have on one's personal relationships and
mental well-being, the VA needs an immediate solution to deal with the
backlog and get Veterans the help they need. We also know that our
working-age Veterans are anxious to contribute to society through
employment, and properly fit and programmed hearing aids are necessary
for their success in obtaining and maintaining meaningful employment.
S. 564 provides the VA a much needed solution by creating a new
provider class for hearing aid specialists to work within the VA.
Hearing aid specialists can help the VA hearing healthcare team by
providing hearing aid evaluations; hearing aid fittings and
orientation; hearing aid verification and clinical outcome
measurements; customary after care services, including repairs,
reprogramming and modification; and the making of ear impressions for
ear molds--just as they are currently authorized to do in the VA's fee-
for-service contract network.
By adding hearing aid specialists to the audiology-led team to
perform these specialized hearing aid services independently,
audiologists will be able to focus on Veterans with complex medical and
audiological conditions, as well as perform the disability evaluations,
testing, and treatment services for which audiologists are uniquely
qualified to provide--thereby maximizing efficiency within the system
and supporting the team-based approach, a common model in the private
market. Adoption of the hearing aid specialist job classification at
this juncture will also be advantageous given the fact that VA
Audiology and Speech Pathology Service management will be developing
staff and productivity standards as a result of the Inspector General's
audit and recommendations,\8\ and would be able to consider the use of
hearing aid specialists as they develop their model.
---------------------------------------------------------------------------
\8\ VA Office of Inspector General report ``Audit of VA's Hearing
Aid Services,'' February 20, 2014
---------------------------------------------------------------------------
Also, by virtue of the report language in S. 564, which would shine
a light on the VA's utilization of hearing aid specialists in its
contract network, it is our hope that the VA would take better
advantage of this willing and able provider type to help address the
need for hearing aid services. To open up additional points of access,
the VA can and should eliminate unnecessary policy restrictions that
impact VA clinics' abilities to utilize hearing aid specialists in the
contract network.
Hearing Aid Specialist Qualifications
Hearing aid specialists are regulated professionals in all 50
states and in the non-VA market, hearing aid specialists perform
hearing tests and dispense approximately 50% of hearing aids to the
public. They are licensed/registered to perform hearing evaluations,
screen for the Food and Drug Administration (FDA) ``Red Flags''
indicating a possible medical condition requiring physician
intervention, determine candidacy for hearing aids, provide hearing aid
recommendation and selection, perform hearing aid fittings and
adjustments, perform fitting verification and hearing aid repairs, take
ear impressions for ear molds, and provide counseling and aural
rehabilitation.
Training for the profession is predominantly done through an
apprenticeship model, an accepted and appropriate path given the hands-
on and technical skill involved in the profession. And while licensure
requirements vary from state to state, in addition to the
apprenticeship experience, candidates generally must hold a minimum of
a high school diploma or an associate's degree in hearing instrument
sciences. These requirements merely create a floor, evident in the fact
that 87% of hearing aid specialists have obtained some college
coursework, or an associates or higher academic degree.\9\ In nearly
every state, candidates must pass both written and practical
examinations, and in many states a distance learning course in hearing
instrument sciences is required or recommended. Ultimately, when making
hiring decisions, the VA will have the ability to determine which
candidates meet their needs.
---------------------------------------------------------------------------
\9\ International Hearing Society, Health Policy and Payment
Survey, June 2013
---------------------------------------------------------------------------
Hearing aid specialists are already recognized by several Federal
agencies to perform hearing healthcare services. The Standard
Occupational Classification (SOC) identifies hearing aid specialists
within the Healthcare Practitioners and Technical Occupations category
(29-2092), and the Federal Employee Health Benefit program and Office
of Policy and Management support the use of hearing aid specialists for
hearing aid and related services. And while Medicare does not cover
hearing testing for the purpose of recommending hearing aids (a policy
that applies to all dispensing practitioners), hearing aid specialists
provide hearing testing, hearing aids, and related services for state
Medicaid programs around the country. Further, most insurance companies
contract with hearing aid specialists to provide hearing tests and
hearing aid services for their beneficiaries.
Finally, evidence shows that there is no comparable difference in
the quality and outcomes of hearing aid services based on site of
service or type of provider (audiologist or hearing aid specialist). A
well-respected industry study found that instead the best determinant
of patient satisfaction is whether the provider used best practices
like fit verification, making adjustments beyond the manufacturer's
initial settings, providing counseling, and selecting the appropriate
device for one's loss and manual dexterity.\10\
---------------------------------------------------------------------------
\10\ MarkeTrak VIII: The Impact of the Hearing Healthcare
Professional on Hearing Aid User Success, The Hearing Review, Vol 17
(No.4), April 2010, pp. 12-34
---------------------------------------------------------------------------
VA Strategies to Address Demand
To address the demand for audiology and hearing aid services, the
VA has been relying on the use of teleaudiology, audiology health
technicians, and contract audiologists outside the VA setting. While
IHS applauds the VA for its efforts to better serve the needs of
Veterans, each of these strategies has its limitations. Though
teleaudiology can make audiological services more available in remote
settings, the cost of staffing and facilities are needlessly high,
especially given that hearing aid specialists have fully-equipped
offices, oftentimes operate in rural settings, and perform home and
nursing home visits. Audiology health technicians have a very limited
scope of duties, which does not include hearing aid tests or the
fitting and dispensing of hearing aids, and they must be supervised by
audiologists. Hiring hearing aid specialists to work as health
technicians, as the VA currently does, significantly limits their role
and effectiveness. Finally, increased reliance solely on audiologists
may also limit access as there are not enough audiologists to fill the
current and future need for hearing care services. In order to fill the
need, the number of licensed audiologists needs to double in size
within the next 30 years to 32,000; however only about 600 are entering
the profession annually. Even the best case scenarios for increasing
the number of graduates and reducing attrition still fall short.\11\
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\11\ Demand for Audiology Services: 30-Yr Projections and Impact on
Academic Programs, Journal of the American Academy of Audiology, Ian A.
Windmill and Barry A. Freeman, 24:407-416, 2013
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In a June presentation, VA Deputy Chief Patient Care Services
Officer for Rehabilitation and Prosthetic Services, Dr. Lucille Beck,
Ph.D., cited several barriers to the delivery of hearing health care
services for the VA, including ``Some VA sites having space constraints
that challenge expansion of current audiology services,'' ``Some
veterans are very old or sick and cannot travel outside of the home,''
and ``Lack of developed hearing health care networks and standards for
VA to partner with the community.'' In each of these areas, hearing aid
specialists, both internally and through their expanded use in the fee-
for-service network can help.
As the Federal Government seeks to become more efficient and cost-
effective, we urge the Subcommittee to pass S. 564, which will round
out the VA hearing healthcare team to mirror the private-market model,
and increase Veterans' access to care, improve overall quality, and
reduce cost. Again, using hearing aid specialists as health technicians
is not the answer; this limits service delivery and underutilizes the
skills and expertise hearing aid specialists can offer to the VA
hearing healthcare team. Now is the time to embrace hearing aid
specialists in the role they are trained and licensed to play to help
meet the hearing healthcare needs of our Veterans, which will only
continue to rise in the coming years.
Thank you for your consideration and for your service to our
Veterans. With questions, please contact government affairs director
Alissa Parady at 571-212-8596 or [email protected].
______
Statement from Travis Warthen, Vice President,
Leading Edge Aviation, Inc.
Chairman Isakson, Ranking Member Blumenthal and Members of the
Committee: Thank you for the opportunity to provide a statement for the
record regarding Leading Edge Aviation's position on H.R. 475 and the
current Discussion Draft as it relates to flight training programs
under the GI Bill.
Leading Edge Aviation (LEA) has been providing flight training
services for Central Oregon Community College (COCC) since 2006. We
currently have 128 Veterans enrolled in flight programs at COCC and our
overall ratio is 76% Veterans. The COCC program was the first to enroll
students in flight programs using the Post-9/11 GI Bill and has
successfully graduated many veterans who are now enjoying very
lucrative careers in professional aviation. The cost of this program
has only increased incrementally (an average of 5%/year), which is
consistent with the costs associated with providing this training. Our
program has, and always will be, completely focused on the best
interests of the student. Our company is owned and run by Veterans and
we strongly believe these men and woman have earned the right to choose
the career that best fits their personal interests. We believe both
H.R. 475 and the Discussion Draft, as written, threatens the ability of
Veterans to continue to afford this level of education.
issue
The Post-9/11 GI Bill became available for eligible Veterans on
August 1, 2009. This new GI Bill allowed Veterans to receive fees
associated with a degree which allowed those public schools with
aviation degree programs to incorporate flight training fees into their
program.
In order for any degree program to receive VA benefits the State
Approving Authority (SAA) must approve that degree program. The
approval criteria between different SAA's varies greatly across the
country and the Oregon SAA established conditions for approval for
flight training degree programs in 2010. In Oregon, the institute of
higher learning seeking approval for a flight training degree has to
clearly show how they are in compliance with all the applicable laws
and regulations in order to receive VA benefits.
problem
Due to lack of VA oversight, and inconsistent conditions for
approval from the SAA's, some schools have received approvals for
programs that are not in compliance with existing laws and regulations.
The costs of these programs have increased exponentially, raising
concerns inside the VA regarding the overall cost of these programs.
Based on VA's own internal audit of the program, the national average
annual per student cost for flight training programs is now nearly
$240,000/year, far exceeding rational cost/student milestones (nearly
one fourth that amount).
In recent months, due to external scrutiny by the press and
increased congressional pressure, the VA has finally begun to enforce
the existing regulations and has capped enrollment of several schools
that were found to be non-compliant with one of the two following
criteria for the program:
(1) 38 CFR Sec. 21.4201--Restrictions on enrollment; percentage of
students receiving financial support--clearly establishes an enrollment
limit of no more than 85% veterans in any degree program. It requires
programs be delineated by ``educational or vocational objective'' and
the 85/15 ratio be calculated separately; and
(2) 38 CFR Sec. 21.9600--Overcharges--prohibits the institution of
higher learning from charging an individual an amount for tuition and
fees that exceeds the established charges that the institution of
higher learning requires from similarly circumstanced individuals
enrolled in the same course
The intent of both of these regulations is to ensure costs are
equitable for Veteran and non-Veteran students and at a level the
market will support. If costs escalate to the point a school cannot
attract the 15% non-Veteran students the ability to receive Veteran
benefits will be suspended until the ratio is within the limitations.
The schools who are abusing the system have grouped together a
large pool of students in a very generic degree with several different
education objectives, which do not include flight training and are not
calculating the ratio separately as required by the regulations. They
are also allowing the student to choose the type of aircraft they fly,
creating a sometimes-significant cost differential for Veteran and non-
Veteran students.
Another potential challenge with the regulations is many students
participating in the non-compliant programs are being trained in very
expensive aircraft which comes with its own set of challenges: (1) it
further skews the cost of an already non-compliant program; and (2) it
undermines the intent of the program in that when trained in this
aircraft, Veterans lack the necessary experience to find a job in the
field without further training, experience and expense.
current congressional approaches
H.R. 475--Equates degree programs from public institutions that
include flight training to that of private institutions, thereby
establishing an annual cap for tuition and fees, which adjusts
annually.
The cap is just over $20,000/year, far below a reasonable
average cost/student and limiting the opportunity for flight operators
to continue to serve the Veteran population as they do today.
Veterans would have to self-fund (or apply for loans) to
make up the difference in programmatic costs.
Senate Bill Draft Language--Public institutions who contract
educational services with private entities will be subject to tuition
and fee cap of a private institution.
Unlike H.R. 475, this draft does not limit the scope to
just flight training. Therefore there is less opportunity to adjust the
cap to address the over 1,800 veterans enrolled in flight training
programs without greatly increasing the expense to the VA for all
private institutions.
The Draft would require public institutions to outlay
significant funds for capital expenditures to continue to offer degree
programs which currently include some element of contracted educational
service.
The draft fails to address the lack of State Approving
Authority/VA oversight for programs that have had considerable cost
increases, well above industry standards.
a better solution
While it is clear the current flight training program has fallen
victim to a few unscrupulous providers, the overly-punitive nature of
the current language in H.R. 475, and now the follow-on Discussion
Draft serves only to disenfranchise students who may seek to pursue a
flight program at a public institution. Instead of officially managing
the cap under which operators have to operate, one of the two following
Congressional solutions would ensure that ``bad actors'' are disallowed
from abusing the program AND the viability of future flight programs is
maintained:
(1) Make clear to VA, either legislatively or publicly, that
renewed oversight WILL be exercised by Congress in the area of flight
training programs and that continuous internal cost analyses will be
required as well as a timeline developed for their delivery to
Congress. This will ensure that overall costs will begin to migrate to
the middle, preventing outlier flight operators from escaping scrutiny
and enforcement actions; and/or
(2) Establishing a cap closer to the median cost of a two-year
flight program ($50,000-60,000 per year). This will, almost by natural
selection, ``weed out'' the operators who have historically abused the
program for their own financial gain, AND allow those committed to the
program to continue to provide opportunity for those who have rightly
earned it.
Establishing an unrealistic cap for flight training programs
punishes Veterans who are enrolled in schools that are in compliance
with the regulations and providing a viable option for our men and
women who have earned these benefits. Since the VA has started to
enforce the existing regulations, we believe time should be given for
these rules to work and ensure sufficient enforcement action is taken
by the VA when operators run afoul.
Let's not take this option away from our veterans and give them
every opportunity to re-enter the civilian workforce at a living wage
with opportunities for real, sustainable long-term success.
Thank you again for the opportunity to present our position on
these important issues and please consider Leading Edge a resource as
you continue your deliberations on these issues.
______
Prepared Statement of Military Officers Association of America
Chairman Isakson, Ranking Member Blumenthal: The Military Officers
Association of America (MOAA) is pleased to present its views on the
following legislative measures under consideration at the legislative
hearing of September 16, 2015.
MOAA does not receive any grants or contracts from the Federal
Government.
S. 1938. Career-Ready Student Veterans Act of 2015 (Senator
Blumenthal, D-CT and Senator Tillis, R-NC). S. 1938 is a much needed
bi-partisan bill that would:
Modify the requirements for approval of courses for
enrolled veterans using Department of Veterans Affairs (VA) educational
assistance by requiring that educational programs meet instructional
curriculum licensure or certification requirements of the state.
Require that programs are approved by the appropriate
board or agency in a state if an occupation requires approval or
licensure.
Authorize the VA Secretary to waive this requirement only
under limited, clearly defined circumstances.
Under the legislation the VA would be required to disapprove a
course of education unless the educational institution providing the
course publicly discloses any conditions or additional requirements,
including training, experience, or exams, required to obtain the
license, certification, or approval for which the course of education
is designed to provide preparation.
Institutions of higher learning (IHLs) may meet regional or
national accreditation standards. But some IHLs do not meet
programmatic requirements that enable graduating veterans to meet state
criteria for licensing or certification in a specific field of study.
Degree programs that require state-level approval include, for
example, teaching, nursing, criminal justice and dental assistant.
Specialized or programmatic accrediting is required for professional
qualification in fields such as law and psychology.
S. 1938 closes a gap that has left some veterans ``holding the
bag''--veterans who believed they were studying toward proficiency in a
field of study and who graduated or completed the required coursework
only to learn they could not sit for the licensure exam or meet the
certification requirement because the program failed to meet state,
regional or programmatic requirements.
S. 1938 Builds on the National Defense Authorization Act (NDAA) for
FY 2014. The Fiscal Year 2014 NDAA, Public Law 113-66, established new
requirements for colleges and universities that wished to continue
participation in certain Defense Department (DOD) educational
assistance programs including military tuition assistance (TA) and My
Career Advancement Account (MyCAA) for military spouses.
In reporting out the NDAA, the Senate Armed Services Committee
recommended a provision that became Section 541 of the final bill
noting that schools that wished to continue to participate in TA or
MyCAA must ``comply with program participation agreements under Title
IV of the Higher Education Act, and to meet certain other standards.''
The Secretary of Defense could waive these requirements in certain
cases.
Section 541 was intended to address the growing concern in DOD that
some IHLs were promising civilian credentials to military members when
in some cases, the program of study being offered was not approved by
an appropriate accrediting body.
The result was a wasted investment in professional development for
the military member and an adverse impact on morale and promotion
potential.
MOAA strongly supported the NDAA provision. Since enactment MOAA
has met with officials in the Defense Department who oversee policy for
DOD tuition assistance programs to receive updates on the
implementation of the statute. (In our view, DOD has done a commendable
job in developing and promulgating policy for Section 541 of the NDAA
for FY 2014).
The Career-Ready Student Veterans Act of 2015 addresses the same
need for transparency and accuracy regarding the actual outcomes that
IHLs propose to deliver for students using VA GI Bill programs after
separating from military service. The proposed provisions in S. 1938
are similar to those contained in Section 541 of Public Law 113-66.
DOD and the VA have a common objective in ensuring that military
and veteran students become ``career ready'' in a wide variety of
civilian disciplines that require a license or certification.
Some military members begin the journey toward civilian licensure
while still in uniform and complete the requirements when they separate
or retire using GI Bill eligibility.
Numerous lawsuits brought by states' Attorneys General and the
Federal Trade Commission against certain proprietary IHLs point to the
need for common sense, practical rules that simply say schools must
deliver on what they promise.
For example, in May, the Federal Trade Commission (FTC) announced a
settlement with Ashworth College for misleading students about programs
that ``failed to meet the basic educational requirements set by state
licensing boards for careers or jobs'' in numerous states because they
lacked the proper accreditation. FTC noted that Ashworth's programs
were eligible for GI Bill dollars, but not for Federal student loans,
and that Ashworth targeted veterans and servicemembers for recruiting,
including through recruiters posing as ``military advisors.''
At a press conference announcing the introduction of the Career-
Veterans Student Veterans Act of 2015 on August 5, 2015 Senators
Blumenthal and Tillis emphasized that their bi-partisan bill is
intended to protect the investment made by our Nation in the future
employment of our veterans.
Senator Blumenthal said, ``Only accredited school programs should
receive GI benefits, because our Nation's heroes deserve the best, not
the dregs, of American education. Federal funding for substandard
programs is a disservice to veterans as well as taxpayers--and this
safeguard is long overdue. Valid, approved education and training are
necessary for veterans to have the right credentials required by
employers.''
MOAA strongly supports S. 1938, the Career-Ready Student Veterans
Act of 2015.
S. 1460, the Fry Scholarship Enhancement Act of 2015 (Senators
Sherrod Brown, D-OH and Tillis, R-NC). S. 1460 would ensure that
surviving spouses and children of service women and men who have died
in the line of duty receive the same educational benefits as the family
members of servicemembers who elect to transfer their benefits.
Private colleges and universities who volunteer to participate in
the Post-9/11 GI Bill ``yellow ribbon'' matching program may elect to
offset some or all of the difference in tuition and fees between their
schools and public colleges and universities in the same state. The VA
matches up to half of any delta in cost that a private college agrees
to match.
Unfortunately, however, Yellow Ribbon matching is not authorized
for dependent children who lost a parent in the line of duty since
Sept. 10, 2001 and who thereby become eligible for the Gunnery Sergeant
John D. Fry Scholarship program.
MOAA worked very closely with lawmakers in the Senate and House to
advance enactment of the Fry Scholarship program for surviving spouses
and their children.
MOAA is very pleased to extend our full support for enactment of
S. 1460, the Fry Scholarship Enhancement Act of 2015.
S. 1451, Veterans' Survivors Claims Processing Automation Act of
2015 (Senator Hirono, D-HI). S. 1451 would authorize the Secretary of
Veterans Affairs to expedite the payment of benefits to a survivor of a
veteran who has not filed a formal claim if the Secretary determines
there is sufficient evidence to establish the survivor's entitlement to
such benefits.
The intent of this legislation as we understand it is to permit the
VA to process and pay survivor benefits to survivors of military
members who die in the line-of-duty. In such cases, the official
announcement of the death of the servicemember by the military service
department should be sufficient prima facie evidence that survivor
benefits should be processed promptly. Requiring such survivors to
apply to the VA for their survivor benefits is burdensome, time-
consuming and unnecessary.
MOAA supports S. 1451 the Veterans' Survivors Claims Processing
Automation Act of 2015.
______
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
______
Prepared Statement of Max Stier, President and CEO,
Partnership for Public Service
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
______
Prepared Statement of Paralyzed Veterans of America
Chairman Isakson, Ranking Member Blumenthal, and Members of the
Committee, Paralyzed Veterans of America (PVA) would like to thank you
for the opportunity to submit our views on legislation pending before
the Committee. We appreciate the Committee focusing on these critical
issues that will affect veterans and their families.
s. 290, the ``increasing the department of veterans affairs
accountability to veterans act''
PVA understands the intent of S. 290, the ``Increasing the
Department of Veterans Affairs (VA) Accountability to Veterans Act of
2015.'' This legislation would presumably give the Secretary more
leverage as he continues his campaign to improve the VA health care
system. This legislation would allow the Secretary to reduce benefits
of Senior Executive Employees that have been convicted of certain
crimes.
However, we believe that Section 3, the Reform of Performance
Appraisal System for Senior Executive Service Employees, establishes a
troublesome precedent. This section limits the recognition of employees
that have contributed more than a position requires while maintaining a
personal goal of improving service to veterans. While the forced
distribution of the various levels in performance evaluations would
seemingly limit the number and amount of bonuses paid to senior
employees, we believe these provisions would punish those employees
that are overachievers. Similarly, we believe that mandating that no
more than a certain percentage of SES employees receive a given rating
in a year ignores the important work that these individuals produce on
a daily basis. We believe this circumstance will severely limit the
number of individuals who are willing to consider SES employment at VA.
Last, we believe that forcing SES employees to move every five years is
unnecessarily punitive. We do not believe it makes sense to move
management employees simply for the sake of doing it, particularly if
they are doing an outstanding job.
s. 563, the ``physician ambassadors helping veterans act''
PVA has no official position on S. 563, the ``Physician Ambassadors
Helping Veterans Act.'' As we understand it, this bill would presumably
direct the VA to allow volunteer physicians to serve in VA medical
facilities struggling with wait times or staff shortages. It is our
understanding that this is an authority the VA already exercises and
that in areas where volunteer support is limited, physicians have
chosen not to navigate the cumbersome administrative process that
allows them to become a volunteer physician. The VA also often fills
gaps through direct hire authority rather than rely upon volunteer
support. We appreciate the interest of those physicians who are willing
to volunteer to cover the access gaps that may exist in VA facilities.
s. 564, the ``veterans hearing aid access and assistance act''
PVA supports S. 564, the ``Veterans Hearing Aid Access and
Assistance Act.'' This legislation would amend title 38, United States
Code, to clarify the qualifications of hearing aid specialists of the
Veterans Health Administration of the Department of Veterans Affairs.
Hearing loss and tinnitus are the most common service-connected
disabilities treated by VA healthcare. Demand for hearing services has
increased, dramatically, over recent years. This is due to the large
cohort of aging veterans compounded by a newly returned veteran
population from the most recent conflicts. With limited resources VA
cannot meet the demand in a timely manner. Currently, hearing aid
specialists are not authorized by VA as an approved care provider, and
as such, VA can only procure hearing services from an audiologist.
Authorizing hearing aid specialists would expand VA's network of
providers and reduce veterans' need to travel long distances.
s. 1450, the ``department of veterans affairs emergency medical
staffing recruitment and retention act''
PVA also supports S. 1450, the ``Department of Veterans Affairs
Emergency Medical Staffing Recruitment and Retention Act.'' This bill
would allow the Secretary to modify the hours of employment of
physicians and physician assistants employed on a full-time basis by
the Department of Veterans Affairs. Currently, VA emergency room
physicians work inflexible 12-hour shifts within the required 80 hours
per pay period that denote full-time status. This rigidity does not
exist in the private sector. Irregular work schedules are needed to
provide high quality patient care. Additionally, the Veterans Health
Administration (VHA) antiquated system interferes with recruitment and
retention efforts.
s. 1451, the ``veterans' survivors claims processing automation act of
2015''
PVA supports S. 1451, the ``Veterans' Survivors Claims Processing
Automation Act of 2015.'' The legislation allows VA to pay benefits to
a survivor who for whatever reason didn't file a claim as long as
sufficient evidence of record existed to grant the claim. For example,
in the case of a veteran who was known to have been exposed to Agent
Orange and died of lung cancer, the VA could establish entitlement to
DIC in the absence of a properly filed claim. In such a case the
notification of death would become the date of claim. While this may
not be the intent of the legislation, this could protect a date of
claim which could otherwise be untimely and will ensure the survivor
receives benefits their loved one earned. This is appropriate
legislation that will pay benefits to a veteran's survivor as quickly
as possible and streamline the process. In many cases, the benefits a
disabled veteran receives may be the only family income.
One change that PVA would like to see in the language is in Section
2(B)(ii) that states ``* * * the date on which a survivor of a veteran
notifies the Secretary of the death * * *'' As in many cases with
legislation, PVA believes this should read ``survivor or duly appointed
representative'' to ensure it is clear that veteran service officers or
others that may be assisting the survivor can act on their behalf. It
may also be appropriate to include language referencing VA learning of
the death from another Federal agency such as the Social Security
Administration or the Internal Revenue Service before a survivor may
notify VA. Limiting notification to the survivor strikes PVA as being
too narrowly defined. However, this being said, VA has already
initiated a process to automatically begin payment of DIC to the spouse
of record in cases where the veteran has been rated at 100% for ten
years, without a requirement for the widow to file a claim. This
legislation would better establish that process into law.
s. 1460, the ``fry scholarship enhancement act of 2015''
PVA strongly supports S. 1460, the ``Fry Scholarship Enhancement
Act of 2015.'' The Marine Gunnery Sergeant John David Fry Scholarship
provides Post-9/11 GI Bill benefits to the surviving spouses and
children of servicemembers who have died in the line of duty while on
active duty after September 11, 2001. This legislation would also
expand eligibility for the Department of Veterans Affairs' Yellow
Ribbon Program, which helps students avoid out-of-pocket tuition and
fees for education programs that cost more than the allowance set by
the Post-9/11 GI Bill.
s. 1693
PVA supports S. 1693, a bill ``to amend title 38, United States
Code, to expand eligibility for reimbursement for emergency medical
treatment to certain veterans that were unable to receive care from the
Department of Veterans Affairs in the 24-month period preceding the
furnishing of such emergency treatment, and for other purposes.''
Currently, a veteran who receives emergency care at a non-VA facility
can be reimbursed for those costs only if the veteran had also received
care at a VA facility in the preceding 24 months. This legislation
would authorize VA to reimburse veterans for emergent non-VA care who
were unable to receive care at VA within the 24-month period because of
wait times. The strict 24-month requirement is an unfair burden for
rural veterans and those near facilities with long wait times. For
newly separated veterans, should they have a medical emergency prior to
being seen at a VA facility, their claim for reimbursement will be
denied. Veterans are then burdened with crushing medical bills through
no fault of their own. No veteran should have to choose between
receiving care and financial hardship.
s. 1856
PVA understands the intent of S. 1856. This legislation is meant to
provide greater employment and due process protections for employees
who are suspended for performance. The bill targets individuals whose
actions represent a ``threat to public health or safety.'' We find it
hard to believe that the VA does not currently have the authority to
remove individuals when the conditions covered by ``threat to public
health or safety'' are met. We also believe that the language in
Section 2 should at the very least cover removal for malfeasance or
misconduct that is ``detrimental to the operations of the Department,''
assuming such a circumstance does not already exist. Ultimately, we are
not wholly convinced that this legislation will achieve actual
accountability that ensures that health care is delivered better or
more efficiently.
We appreciate the focus on improving management training. Too many
of the problems identified across the VA health care system in recent
years have stemmed from ineffective, or simply poor, management. This
is not to suggest that all of the problems have been the fault of bad
management. We know that there has been substandard performance at
every level of the employee ladder in the VA. Change begins at the top
with management, but it also requires a commitment to doing the right
thing from all employees, a proposition that we believe has not been
enforced strong enough across the VA.
s. 1938, the ``career ready student veterans act''
PVA supports S. 1938, the ``Career Ready Student Veterans Act.''
This legislation would provide protection for veterans using their GI
Bill benefits as they prepare for a career. Since the passage of the
Post-9/11 GI Bill, hundreds of training programs and career schools
have appeared in every state with the intention of securing the
veterans GI Bill funds with little concern for producing a qualified
career-ready prospect. These institutions rely on deceptive marketing
and false promises to recruit veterans. S. 1938 provides protection for
veterans by prohibiting schools lacking appropriate programmatic
accreditation from receiving GI Bill benefits. Although some schools
may have developed a complete training program, the program they
promote may lack appropriate programmatic accreditation, or fail to
meet state-specific criteria required for certification or licensure.
This legislation will protect veterans from squandering their GI Bill
benefits while being mislead about future career possibilities.
draft legislation on educational assistance
PVA supports the changes provided in this draft legislation which
makes adjustments, modifications and some necessary limitations of the
benefits provided to veterans within the educational programs provided
by the VA. Most changes have been previously discussed and approved in
the House Committee on Veterans Affairs.
Once again, we thank you for the opportunity to submit for the
record. We look forward to working with the Committee to see these
proposals through to final passage. We would be happy to take any
questions you have for the record.
______
Letter from Carol A. Bonosaro, President,
Senior Executives Association
Senior Executives Association,
Washington, DC, September 14, 2015.
Hon. Johnny Isakson
Chairman
Committee on Veterans' Affairs,
U.S. Senate, Washington, DC.
Hon. Richard Blumenthal,
Ranking Member,
Committee on Veterans' Affairs,
U.S. Senate, Washington, DC.
Dear Chairman Isakson, Ranking Member Blumenthal, and Members of
the Committee: As you know, the Senior Executives Association (SEA)
represents the interests of career Federal executives in the Senior
Executive Service (SES), and those in Senior Level (SL), Scientific and
Professional (ST), and equivalent positions. On behalf of the
Association, and of the SEA members who serve at the Department of
Veterans Affairs (VA), I write to share the Association's perspective
on two pieces of legislation before the Committee, S. 290 the
Increasing the Department of Veterans Affairs Accountability to
Veterans Act of 2015, and S. 1856 the Department of Veterans Affairs
Equitable Employee Accountability Act of 2015.
In 2014, Congress and the Nation awoke to the realities of access
issues facing the VA with the public revelations from the VA's Phoenix
Medical Center. While the agency Inspector General and the Government
Accountability Office (GAO) had well documented the VA's problems with
access to care and waitlists dating back to the late 1990s, Congress
chose not to act to remedy these well-documented problems until the
eruption of a major ``scandal.'' \1\ The reaction to that scandal was
to pass a hastily and poorly crafted bill that contained what SEA
warned lawmakers to be counterproductive and unconstitutional
provisions relating to VA Senior Executives.
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\1\ http://www.nytimes.com/interactive/2014/05/29/us/reports-on-
va-patient-wait-periods.html?_
r=1
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Since that time, Congress has still not demonstrated an
understanding of and an ability to seriously address the complex issues
facing the VA. Instead, lawmakers continue to promote largely talking-
point legislation centered on Congress' current favorite platitude--
accountability. Accountability is certainly needed for the VA
workforce, but passing statutes with punitive provisions will do
nothing to drive the cultural transformation necessary to turn the VA
and its workforce around.
s. 290
SEA has long called for reforms to the SES performance management
system to ensure it is utilized to incentivize the best performance.
Those reforms have included ensuring greater transparency, timeliness
of establishing performance plans and conducting performance appraisals
and communicating their results, and ensuring political appointees who
often supervise career senior executives understand the system and
their obligation to making it work properly. Problems with the SES
performance management system are highlighted in SEA's report,
Deteriorating Pay for Performance Adversely Impacting Morale and
Retention Within the Federal Career Senior Executives and Professionals
Corps.\2\
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\2\ https://seniorexecs.org/images/documents/
Deteriorating_Pay_for_Performance.pdf
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As you know, the SES is a governmentwide cadre. Consequently, SEA
has concerns about creating a distinct framework for a single agency,
which balkanizes that governmentwide system and creates challenges in
maintaining consistency and providing for appropriate oversight by OPM.
Furthermore, we are concerned that the forced distribution of
ratings at the outstanding and exceeds fully successful levels
challenges an underpinning factor of the SES system that agencies make
meaningful distinctions in performance. Senior Executives face a high
barrier of entry into the corps; therefore a normal distribution of
performance should not be expected nor imposed.
The VA Secretary has authority to sign-off on every SES performance
appraisal. Complaints or reports from various oversight bodies are
already taken into account in assessments of executive performance.
Inspectors General are already consulted prior to issuance of
performance awards. Yet it is important that only substantiated
complaints or reports are used in such assessments--it is unfair for an
individual's performance to be negatively affected by unconfirmed
allegations. It is not unusual that executives seeking to improve
performance may find themselves the subjects of union grievances or EEO
complaints which are later found to have no merit.
SEA does not believe Congress should be in the business of
micromanaging agencies by reviewing every performance appraisal.
However, if the Committee persists in seeking this authority, then any
information on performance appraisals provided to Congress should also
be provided to the employee, along with notice that the information has
been provided to Congress. Additionally, SEA strongly believes that
protections should be put in place that prevents the public release of
such sensitive personnel records by Congress along with strict
penalties for doing so.
SEA suggests adding language under Section 3, subsection (3)(b), to
require that before embarking on any rotations, the Secretary must
develop a comprehensive human capital plan that ensures that rotations
are appropriate, serve a business purpose, and won't negatively impact
agency operations. On a related note, in subsection (b) of the same
Section (review of SES Management Training) SEA also recommends
language be added to include a review of the VA's talent development
pipeline and training programs for rising leaders in the agency, as
well as for training of noncareer executives, including political
appointees.
Regarding Section 2 of the bill, SEA agrees that should an employee
be convicted of a felony related to their job duties, then they should
not receive service credit toward their pension for the year or years
in which the felony was committed. This provision should be narrowly
tailored to ensure that the felony conviction is final (no pending
appeals) and that the conviction is tied to the employee's job (e.g.
embezzlement of agency funds). The legislation should also make clear
that the pension claw back is only for the time period in which the
felony is committed, as determined by the courts and not the Secretary.
Regarding Section 4 of the bill, SEA shares the concern of many
Members of Congress about the misuse of administrative leave at the VA
and across the government. Yet this bill does not put an end to the
ability of agencies to abuse administrative leave, but rather simply
creates new reporting and tracking requirements. SEA is currently
crafting a bipartisan legislative solution with Senators Grassley and
Tester to address the issue of administrative leave abuse.
s. 1856
Last year when Congress passed the Choice Act, very few Members
expressed concern for the constitutional rights of VA Senior
Executives. Neither did President Obama, who welcomed the authority to
more easily terminate VA SES in his signing statement for the bill.
With new legislation (S. 1082/H.R. 1994) broadening the application of
the section 713 authority to the entire VA workforce, albeit in a far
less onerous manner, many lawmakers and the President are now
expressing concern for the constitutional rights and protections
afforded to employees working at the VA.
Yet, Section 2 of this legislation maintains the section 713
authority pertaining to VA SES, while affording a completely distinct
standard for suspension and removal, and more robust due process,
including the ability to appeal to the full Merit Systems Protection
Board (MSPB) and judicial review of a MSPB decision. Such a position
sends the wrong message to the workforce, and to the American people,
namely, that there are two classes of Federal employees (citizens) in
the eyes of congressional representatives--those in unions and those
who are not, and that those represented by unions receive more
favorable attention by lawmakers.
If the cosponsors to S. 1856 believe there are provisions contained
in S. 1082/H.R. 1994 which are unconstitutional and violate the rights
of Federal employees, then SEA implores you to work to retroactively
repeal the far more onerous provisions contained in Section 707 of the
Veterans Access, Choice, and Accountability Act of 2014 that applied to
VA Senior Executives (i.e. the section 713 authority), and not rely on
the courts to mend the errors of congressional action.
Furthermore, rather than waiting on passage of this legislation,
SEA urges the supporters of this legislation to immediately submit to
the Government Accountability Office (GAO) a request consistent with
Section 13 of the bill. At a time when authority similar to that of
section 713 is being considered for the rest of the VA workforce, it is
imperative that Congress and the VA understand the effects of section
713 on the VA SES as soon as possible.
SEA appreciates the intent of Section 3, that political appointees
have performance plans by which they can be held accountable. However,
SEA cautions against micromanaging the elements to be included in such
performance plans, as doing so may restrict needed agency flexibility
to tailor performance plans based on position.
SEA generally supports Sections 4, 5, 6, 7, 8, 9, 10, and 12 of the
bill. Regarding Section 4, it is important that the probationary period
be used appropriately, and SEA supports managers pro-actively
certifying that employees have completed their probationary period. In
Section 5, SEA has concerns with legislating performance management. In
particular, the inclusion of (2) on employee engagement can well be
perceived to be an effort by the Partnership for Public Service,
creator of the annual ``Best Places to Work in the Federal
Government,'' to derive business based on a legislative mandate.
While SEA agrees with Congress that abuse of administrative leave
must be addressed, SEA is concerned that Section 11 may be
unconstitutional. The House and Senate VA Committees are not the
personnel office of the VA. As indicated above, SEA is currently
crafting a bipartisan legislative solution with Senators Grassley and
Tester to address the issue of administrative leave abuse.
conclusion
The singular focus of Congress on providing punitive authorities to
address the issues at the VA belies fundamental truths that all good
employers understand, and which Congress, as the board of directors of
the Federal Government, has an imperative to understand--when employees
know how their job contributes to an organization's mission, their
contributions are recognized and rewarded, and their supervisors and
leaders listen to concerns and feedback and act on it, that the
organization will see heightened employee engagement, and as a result,
improved organizational performance.
Punitive measures and authorities and creating new, unnecessary
bureaucracies will not result in improved organizational performance or
services to our Nation's veterans. Legislation cannot change
organizational culture, nor do culture changes come about quickly.
Sufficient legislative authority already exists to deal with poor
performance and misconduct of VA employees.
What is needed at the VA is a sustained, positive investment by the
Congress in the organization's strongest asset--its people. Employees
need to have the training, resources, and knowledge necessary to fulfil
their duties, whether those duties are providing front-line service to
veterans or managing the workforce. This is an important area for
congressional attention, sorely lacking in the debate around the VA. If
left unaddressed, no amount of new accountability authorities,
whistleblower protections, or any other provisions of these bills will
make a dent in the issues at the VA.
It's time for Congress to move beyond its current focus--
accountability--and have a real conversation with all stakeholders,
including employee groups, about the significant issues facing the VA
and its workforce in order to chart a realistic path toward reform
together. SEA stands ready to work with Members to pursue meaningful,
constitutional reforms to improve the VA and its workforce.
Sincerely,
Carol A. Bonosaro,
President.
______
Prepared Statement of Dr. Scott Wyatt, President,
Southern Utah University
Chairman Isakson, Ranking Member Blumenthal, and Distinguished
Members of the Committee: Thank you for the opportunity to weigh in
through this written statement on the issue of the proposed aviation
education tuition and fee caps within the Post-9/11 GI Bill program.
As President of Southern Utah University, I am proud that our
public institution of higher learning offers students from all over the
world the opportunity to receive professional aviation training as part
of a 4-year bachelors degree program. We are one of the few public
universities in the country to offer this combination of high-quality
education and training, and we are especially proud that so many
veterans chose our school and our aviation program to continue their
education after completing their military service.
Unlike many post-secondary degree programs today, aviation is one
of the few fields of study and training that enjoys very high placement
rates and leads to significantly higher than average starting salaries
for students who complete the program and acquire the requisite number
of training hours desired by employers in the industry. This is
especially true of turbine-engine rotor-wing (i.e., helicopter)
training.
The education and training required to become a professional
helicopter pilot is certainly more costly than the education and
training required to become a teacher, a mechanic, a banker, or many
other professions that college graduates may pursue. However, rotor-
wing aviation is also a field in which the investment in education and
training yields a very high return on that investment, a qualification
for a high-demand job market, and the potential for graduates to
realistically build a stable career and a better life for themselves
and their families post-service.
Because those who serve in the military are exposed to the various
subfields of aviation in the course of their service at a much higher
rate than are civilians, many veterans either have or develop an
affinity for the field of aviation, and subsequently desire to pursue a
post-service education and career in aviation with the help of their VA
education benefits.
Veterans have used their GI Bill benefits for professional flight
training for decades, dating back to the old Montgomery GI Bill
benefit. As with most post-secondary undergraduate degree programs, the
Post-9/11 GI Bill program, passed by Congress in 2008 and improved upon
with further expansions of the benefit in 2010 and 2014, covers the
full cost of aviation education at public institutions of higher
learning.
Veterans who have served honorably, and especially those who have
borne the burden of fighting the longest wars in our Nation's history,
deserve to take full advantage of this benefit that they have earned,
and many chose to use it to pursue their dream of a career in
professional aviation. This field has always been covered by the GI
Bill program, and it being covered fully at public institutions under
the New GI Bill program is in line with and consistent with the intent
of that benefit program to cover the full cost of a new veteran's
chosen undergraduate program at any public college or university.
Because there have historically been some entities and even some
students that have abused various VA education benefit programs,
Congress and the VA long ago implemented various statutory and
regulatory safeguards that were designed to control the quality and
cost of programs of education without placing arbitrary caps on those
programs or trying to artificially legislate market prices. Instead,
Congress has allowed free market principals to dictate the value of
programs of education to consumers.
Oversight mechanisms such as the 85/15 Rule, the 90/10 Rule, the
Two-Year Rule, and others have effectively and consistently controlled
the cost and quality of higher education programs for decades,
including with aviation education and training programs like the one at
Southern Utah University. However, in the past two years, the
implementation of these long-effective oversight mechanisms by the
Department of Veterans Affairs (VA) has deteriorated. They have
recently been inconsistently and arbitrarily applied and reinterpreted,
often by unaccountable regional and local bureaucrats far removed from
VA Central Office and leadership.
These failures on the part of VA to properly and consistently
enforce these long-standing and highly effective program oversight
regimes have, naturally, recently resulted in several examples, however
rare, of eye-popping tuition and fee bills for flight training, the
fault and responsibility for which have been deflected away from VA and
improperly and erroneously laid at the feet of the public institutions
of higher learning who offer this training.
One example of the frustrations that public institutions such as
Southern Utah University have had in dealing with the VA relates to
satisfactory academic progress. VA is supposed to follow institutional
policies on satisfactory academic progress, in other words on the
number of times a student is allowed to fail and then re-take a course.
However, in several cases VA officials have overruled our institutional
policy, designed to protect institutional resources and student
education benefits, and compelled us allow student veterans who have
repeatedly failed helicopter skills flight labs to repeat those skills
labs four, five, and even six times.
With professional flight training already being one of the more
expensive programs of education, it is not hard to see how five or six
repeats of one single course can quickly drive up a tuition and fee
bill and drain a student veteran's GI Bill entitlement. However, as in
the case of the above-referenced student veteran (who has become the
subject of recent unfair, unbalanced, and incomplete media reporting as
well), these unreasonably high tuition and fee bills are actually the
result of VA deviating from long-established cost-control policies and
not the fault of the institution.
Another example relates to the use of ``incompletes'' to allow a
student to succeed in a course in the most economical way. Most
institutions of higher learning, including ours, allow students to
receive a grade of incomplete at the end of a course if they need a
little extra time to complete an assignment, take an exam, or master a
skill in order to satisfactorily complete a course. In aviation
training, this would mean that a student might need an extra two or
three hours of practice on a particular maneuver in order to be able to
pass the FAA Practical Exam for that course.
If a student is approaching the end of a semester or course period,
our institutional policy allows students to receive an incomplete in
that course, spend a few additional flight hours practicing or taking a
brief tutoring lab, then take and hopefully pass the FAA Practical Exam
for that course. However, in several cases VA has disallowed the use of
incompletes, required our instructors to fail the student, and required
the student to repeat the 40- or 45-flight-hour course in full. And
when students have to pay for use of aircraft by the hour, one can see
how forcing him or her to pay for an additional 35-40 hours of unneeded
flight time is highly wasteful.
Schools like ours do not want students taking up precious flight
time and occupying expensive aircraft unnecessarily. Aviation training
equipment, especially our aircraft, is expensive and in limited supply,
and our desire and goal is to educate and train our students as
efficiently and safely as possible so that other students whose dream
is also to become a professional helicopter pilot are able to use the
equipment to train without unnecessary delays. If the VA were to go
back to following their own well established policies and deferring to
our institutional policies when appropriate, the outlier tuition and
fee bills that have raised red flags and resulted in over-reactive
legislation like Congress is considering again today would simply not
exist.
Solutions already exist to control the cost of programs of
education, ensure the quality of those programs, make sure a student
veteran's GI Bill benefit is being properly utilized, and safeguard the
taxpayer investment in these veterans' careers and futures as a reward
for their honorable service. Legislating additional arbitrary and
misguided burdens and caps on these high-quality programs that have
served as facilitators of veterans' upward socio-economic mobility for
decades is simply unnecessary.
Mr. Chairman, again I thank you for the opportunity to share with
you these views, concerns, and recommendations from the perspective of
a public institution of higher learning with a highly successful track
record of offering professional aviation education and training and of
serving many of America's finest veterans. We are eager and stand ready
to further engage with you, your staff, and the wider stakeholder
community to further educate and work with you on this complex and
highly consequential issue.
Thank you.
______
Prepared Statement of William Hubbard, Vice President of Government
Affairs, Student Veterans of America
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______
Prepared Statement of Michael Saunders, National Deputy Legislative
Director, The Retired Enlisted Association
The Retired Enlisted Association (TREA) believes that it is very
possible that Section 102 of H.R. 475 will slash veteran benefits for
degree programs that include flight training at public colleges and
universities. Section 102 of H.R. 475 seeks to cap the tuition for
flight training at a number that is significantly below the actual cost
to provide the number of flight training hours that are required by the
industry to secure employment.
Although the Department of Veterans Affairs (VA) consistently lists
aviation as a high demand career, its proposal to Congress that is
included in H.R. 475 would essentially serve as a financial impediment
for veterans seeking a career in the aviation industry while the U.S.
faces of one of the worst pilot shortages in history.
Apparently the sponsors of Section 102 in the House of
Representatives believed that imposing a cap on flight training
education for veterans would generate sufficient savings to pay for
other favored legislative initiatives. However, based on CBO's
subsequent score of the overall bill, those assumptions were grossly
inaccurate and the assumed savings from rolling back this benefit fell
short by nearly $150 million.
Finally, we believe Section 102 may also be duplicative and
unnecessary, as the 85-15 and Two-Year rules are already valid and
effective tools for reigning in abusers within this program of
education. There is simply no need for additional legislative action on
this topic. Instead, the VA needs to consistently enforce the
longstanding and valid statutes currently in place that already deal
with this issue.
______
Prepared Statement of Susan Tsui Grundmann, Chairman,
U.S. Merit Systems Protection Board
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
______
Prepared Statement of Michael Mower, Chief Operating Officer,
Upper Limit Aviation
Thank you for the opportunity to submit a written statement on the
draft legislation related to VA education benefits for flight training
that is the subject of this legislative hearing today.
Put simply, the draft bill before you today will slash veteran
benefits for degree programs that include flight training at public
colleges and universities. This bill, as currently written, would cap
the tuition for flight training at a number that is significantly below
the actual cost to provide the training. Although the Department of
Veterans Affairs (VA) consistently lists aviation as a high demand
career, this proposal would essentially serve as a financial impediment
for veterans seeking a career in the aviation industry while the U.S.
faces one of the worst pilot shortages in history.
The intent of this bill is to prevent schools from taking advantage
of GI Bill reimbursements. However, it is ill-conceived and
duplicative, since valid and effective rules and regulations already
exist that curtail potential abuses by schools seeking to take
advantage of student veterans and the taxpayers. In the end, this
legislation will destroy well-planned degree programs at public
institutions of higher learning across the country that offer flight
training to deserving veterans and will eliminate aviation careers for
veterans in an industry that is in desperate need of well-trained
pilots.
pilot shortages
Demand for pilots will increase at a rapid pace over the next
several decades, as the United States is currently facing its worst
pilot shortage since the 1960's.\1\ As global economies expand and tens
of thousands of new aircraft come online, the aviation industry will
need to supply more than 500,000 new pilots by 2033.\2\
---------------------------------------------------------------------------
\1\ Wall Street Journal
\2\ Boeing Study
---------------------------------------------------------------------------
Nevertheless, total pilots holding Federal Aviation Administration
(FAA) certificates fell at a CAGR of 0.36% from 2004-2013 (see chart,
``FAA Estimated Total Pilots'').\3\ In 1989, a total of 110,541 FAA
flight tests were conducted in the United States, compared to only
42,440 FAA flight tests in 2014.\4\ Adding to the pilot shortage will
be the aging U.S. pilot population, as pilots over the age of 50 years
old currently hold approximately 42% of FAA pilot certificates (see
chart, ``FAA Certificates by Age'').\5\
---------------------------------------------------------------------------
\3\ FAA Airmen Certificate Statistics, http:/www.faa.gov/data--
research/aviation_data_statistics/civil_airmen_statistics.
\4\ FAA Designated Pilot Examiner (DPE) Program Under Watch
\5\ FAA Airmen Certificate Statistics,
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
__________
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Moreover, a study conducted by a subgroup of collegiate aviation
researchers, including professors from Embry Riddle and 5 other
universities, explains that a sharp increase is occurring in the
training of foreign pilots in the United States.\6\ Using data provided
by the FAA's certification branch, the study determined that in 2004
the ratio of U.S. citizens to foreign citizens training in the United
States for their commercial pilot certificate was 4.80 to 1.00. In
2012, that ratio had dramatically declined to 1.19 U.S. pilots trained
to every one foreign pilot trained (see chart, ``US and Foreign
Citizens Completing the Commercial Written''). This fact is staggering
because many of these foreign pilots will take jobs outside of the
U.S., further intensifying the current pilot shortage.
---------------------------------------------------------------------------
\6\ An Investigation of the United States Airline Pilot Labor
Supply,
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
the 85-15 and two-year rules
The ``85-15'' and ``Two-Year'' Rules are valid exercises of
Congress' power intended to curtail abuses by schools seeking to
capitalize on veterans and American taxpayers. While the Two-Year Rule
bars VA education dollars from going to institutions that have been
open for less than two years, the 85-15 Rule prohibits VA education
dollars from going to schools unless at least 15% of enrolled students
are not using GI Bill funds to pay for the cost of their education at
the school. These rules have been in place for decades, and when
enforced correctly and consistently by the VA, the rules effectively
allow the open market to determine worthwhile and valuable programs--
and program prices--for veterans. This bill, which seeks to
artificially and arbitrarily legislate a cap on flight training, is
unnecessary and flies in the face of the longstanding and legitimate
purposes of the 85-15 and Two-Year Rules.
congressional budget office (cbo) report
The sponsors of this legislation in the House of Representatives
believed that imposing a cap on flight training education for veterans
would generate sufficient savings to pay for other favored legislative
initiatives. However, based on CBO's subsequent score of the overall
bill, those assumptions were grossly inaccurate and the assumed savings
from rolling back this benefit fell short by nearly $150 million.
The same CBO cost estimate for the bill also recognized that
aviation training necessarily has a high cost of delivery, stemming
from the costs of aircraft, fuel, insurance, and rigorous FAA-imposed
safety standards. CBO itself determined that reasonable flight training
costs averaged out to around $62,000 per year, per student. But the cap
proposed by this draft is nearly one-third of the real cost for student
veterans to receive this type of advanced professional aviation
training.
conclusion
Mr. Chairman, this bill as currently proposed will not only
eliminate benefits and aviation career opportunities that were earned
through honorable service by veterans, but it will also exacerbate one
of the worst pilot shortages in the history of the United States. The
bill is also duplicative and unnecessary, as the 85-15 and Two-Year
rules are already valid and effective tools for reigning in abusers
within program of education.
There is simply no need for additional legislative action on this
topic. The VA merely needs to consistently enforce the long-standing
and valid statutes and regulations currently in place that already
effectively deal with the issues and concerns that have been raised.
Thank you again for the opportunity to share our views with the
Committee.
______
Upper Limit Aviation,
Salt Lake City, UT, September 20, 2015.
Hon. Johnny Isakson,
Chairman,
Senate Committee on Veterans' Affairs
U.S. Senate, Washington, DC.
Dear Mr. Chairman: Thank you for the opportunity to submit to you a
written statement, as verbally requested by you at the recent Senate
Veterans' Affairs Committee hearing on pending and draft legislation,
regarding some of the inaccurate, false, and misleading information
about veterans education benefits and professional aviation education
and training that was put out to you and other Members of the Committee
in oral and written testimony at this hearing.
We, like you, firmly believe that the only way to properly evaluate
policy proposals and changes is to do so with proper due diligence,
comprehensive and accurate information, and fully informed views from
all of those who may be impacted or have a stake in a given issue.
Thus, as we expressed to you the week prior to the hearing at our
dinner together in Atlanta and the day before the hearing in your
office, the premature consideration of the proposal to degrade the
Post-9/11 GI Bill benefit by essentially slashing professional aviation
training from the program by way of a cap is of grave concern to us
all.
As evidence of the premature nature of some of the positions that
were offered at this hearing, several of the organizations represented
by those testifying at the hearing never sought out the input of either
their members or of those who are experts in the aviation education
industry and who could weigh in on the impact of this proposal on the
programs for which thousands of servicemembers and veterans aspire to
use their hard-earned and well deserved Post-9/11 education benefit. In
fact, while one organization represented on the panel had previously
taken a meeting and spoken to a representative of those who would be
affected, another had not had an opportunity to do so until only three
hours prior to the hearing and yet another had not spoken to those who
would be impacted at all. In addition, other organizations who
submitted written testimony in support of degrading the Post-9/11 GI
Bill did not seek out expert, industry, or their members' views, and at
least one appears to have even misread the nature of the draft proposal
in its entirety.
Furthermore, the Department of Veterans Affairs (VA) itself had not
sought the input of experts in aviation education or of those who would
be impacted by this proposal prior to the development of their
position, and one of the VA witnesses had only engaged with experts and
industry representatives for the first time just five hours prior to
the hearing.
As you can surely understand from the above circumstances at the
time of the hearing, Mr. Chairman, the positions thus presented to you
and other Members of the Committee were certainly not developed
pursuant to due diligence, with comprehensive and accurate information,
nor were they fully informed. As evidence of this, there are
consequential differences in the positions submitted by witnesses in
written form days before the hearing and the positions to which they
testified both at a previous hearing in the House and even orally at
the Senate hearing. Whereas some organizational representatives
testified solidly in favor of the horrendously misguided and uninformed
House version of the proposal, those same organizations backed off on
those positions in their written testimony on the Senate side after
learning more and/or backed off even further on those positions in
their oral testimony before you just days later.
But beyond the critical issue of the views presented at the hearing
being premature and still in development at the time, let me speak to
some of the outright misinformation that was presented orally at the
hearing to you and to other Members of the Committee.
va testimony
In my opinion and experience, as someone who has been intimately
involved in the provision of professional aviation education and
training to veterans for more than a decade, the testimony of the VA
witnesses was particularly egregious and irresponsible. In fact, the VA
itself is the direct cause of many of the issues about which it is
coming before your Committee and complaining, and about which many
stakeholder organizations and even suppliers of professional aviation
training like us, are upset.
For example, the cost overruns that have resulted in the sky-high
tuition and fee bills for a very limited number of students are the
result of two primary failures on the part of the VA to consistently
enforce its own policies to help control Post-9/11 GI Bill costs. The
VA is supposed to respect the policy of educational institutions with
respect to satisfactory academic progress in courses, yet VA
representatives themselves out in the VA's regional offices (in our
case the Muskogee Regional Office) have verbally told schools'
certifying officials that schools must override their policy on course
repeats allow veterans to re-take repeatedly failed courses using their
remaining GI Bill entitlement.
Similarly, the VA is supposed to respect institutions' policies on
the use of ``incompletes,'' which it has not in many cases. In programs
of education that are expensive to being with, forcing a student
veteran to repeat an entire course and re-paying for that entire course
and associated lab fees -instead of simply allowing the veteran to take
an incomplete, top off their skills training with a few hours of extra
practice or a brief remedial lab, and then taking the final exam and
receiving their final grade--is unnecessarily costly, wasteful, in
violation of institutional policy, in violation of VA's own policy of
deferring to institutional policy on ``incompletes,'' and simply
irresponsible.
Our schools do not want to be forced to recycle students over and
over again who are clearly not cut out to be pilots and whose presence
in our limited aircraft with our instructors is both dangerous to our
staff and wasteful of the limited time and equipment we have for other
students who are making reasonable satisfactory progress in their
training. Nor do we want to be putting students through an entire
course again who we know can master a required course skill in only a
few more hours and move on. Mr. Chairman, it is in our interest also--
and reflects on our statistics--to ensure the safety of our students
and staff, ensure the most efficient use of our equipment, and ensure
that our students complete their courses and our program as quickly
(and safely!) as possible.
In addition, the comments within VA's oral testimony regarding the
inability of VA to properly enforce the 85/15 rule was contrary to
reality and practice. In fact, VA completes 85/15 compliance audits on
a per-semester basis. Our school had a stellar record of 100%
compliance for eight consecutive years since our founding, until just
two years ago when VA began the first of several arbitrary and
capricious changes, some again in violation of its own policies and
regulations, to its interpretation of the 85/15 rule.
The truth is, Mr. Chairman, the 85/15 Rule, when properly applied,
has done a fine job of ensuring quality education for veterans and
weeding out bad actors for four decades. It has only been in the past
two years that problems have arisen, and as I explained above many of
those problems are directly attributable to the VA's own incompetence
and arbitrary changes in administering these laws, rules, and
regulations. Yet VA representatives come before you and other Members
of the Committee and, just as VHA bureaucrats did last year when their
mismanagement of VA medical care was just coming to light, mislead,
misspeak, and misrepresent the reality of how VA is administering and
overseeing veterans' education benefits and the quality educational
institutions that proudly and humbly provide programs of education for
veterans and civilians alike in good faith.
Indeed, Mr. Chairman, there are plenty more ways in which the VA
has over the years screwed up the administration of VA education
benefits not only to the detriment of many quality programs, but also
to the detriment of hundreds, if not thousands, of veterans themselves.
In the past, when VA moved away from a less costly and more
administratively efficient pay-as-you-go policy for professional
aviation education and training, overpayments to schools resulted from
this change in payment policy by VA.
Schools like ours have an interest in ensuring that students
complete their programs of education as quickly (but as safely!) as is
possible for them to earn their degree, certificates, and required
flight hours to be competitive in the job market. When the VA began
inadvertently overpaying for the cost of our training as a result this
change, we sent money back to the VA for hundreds of students who
completed their programs without using all of the money the VA paid out
to us.
However, in nearly 200 cases, the VA would not accept this money
back and instead forwarded it directly on to the student. However, in
what was surely an administrative mishap, but mismanagement and
incompetence nevertheless, VA officials instituted a convoluted
recertification regimen to deal with the overpayments and the transfer
of the excess funds by VA directly to the veterans, then ended up
billing veterans for overpayments, sending them to collections, and
ruining their credit records just as they were beginning their civilian
professional lives.
While this is a separate issue that is worthwhile for this
Committee to investigate, I mention it here not only to bring it to
your attention but also to demonstrate the level of incompetence and
mismanagement of veterans' hard earned benefits that also goes on
within the Veterans Benefits Administration. If properly investigated,
Mr. Chairman, I'm sure you and your staff would find that this too is a
crisis that has similarly, while perhaps not lethally, ruined the lives
of countless veterans who were only seeking to use their VA education
benefits in good faith to improve their and their families' lives and
livelihoods post-service.
saa association testimony
Neither we, nor to our knowledge any other expert in aviation
education or representative of the aviation education industry, have
had an opportunity to meet with representatives of the National
Association of State Approving Agencies and educate them on the many
ways in which the administration of the tools and policies in place to
properly regulate and control the costs of flight training are not
being utilized or are being arbitrarily enforced. We would have
graciously welcomed this opportunity prior to this important
organization analyzing the impact of this proposed legislation on the
aviation education industry and on the Post-9/11 benefit, and prior to
the organization developing its position on this proposal. However,
this critical conversation did not occur prior to the hearing, and the
result was not only an uninformed position, but the propagation of some
very unfortunate misinformation by the Association's witness during
oral remarks.
First, the Association's witness claimed that student veterans'
tuition and fee bills had in the past reached as high as $900,000.
While we have heard some absurdly high claims of aviation education
program totals, this was the wildest claim we have heard to date. While
we have seen a few rare outlier bills as high as a few hundred thousand
dollars, as I explained earlier in this statement these bills (at least
the ones that occurred at our institution) were actually the result of
the VA's overrides of policies that are in place precisely to prevent
such high bills and our school absolutely did not want to jeopardize
the safety of our instructors or waste our limited time and equipment
on these repeated student recycles.
While there may have been high flight training bills at other
institutions, we have yet to see evidence of this presented by the VA,
and if so I would strongly suspect that those were due to similar
misapplications and overrides of cost-control policies by other VA
officials as well. Regardless, we find the suggestion of the existence
of even one flight training bill in excess of $900,000 completely
outrageous, and we challenge either the witness or the VA to produce
proof of such an outrageous and irresponsible claim.
Second, Mr. Westcott testified that prior to the more generous
Post-9/11 GI Bill benefit, veterans attending flight schools only
received around $10,000 per year. In fact, this is incorrect. Under the
previous Montgomery GI Bill (Chapter 30), the VA covered 60% of flight
training costs after the private pilot certificate. This meant that the
old GI Bill could cover up to nearly $70,000 for professional flight
training costs alone in one year, not even including the tuition for an
accompanying degree program like we include in our programs to make our
graduates competitively employable and secure. This means that under
the proposed low-ball cap, you would not only be slashing the current
Post-9/11 GI Bill, but you would be rolling it back to be enormously
far less generous than even the old Montgomery GI Bill program.
What the witness was confused about was that when a student attends
private vocational flight training under the New GI Bill benefit, they
max out at $12,000, and for good reason--the amount of flight training
you can receive in a vocational program like these is not anywhere
sufficient to become a professionally trained pilot with enough
training or flight hours to become employable, rendering private
vocational flight training largely a recreational pursuit, for which
the GI Bill program was not intended. But under the private vocational
school standards of the New GI Bill, even beauty schools are given a
much more generous benefit of $24,000 per year rather than the $12,000
currently allocated for vocational flight training.
We maintain, however, that the GI Bill program is best invested in
programs of education, whether public or private, that lead to high-
paying jobs and stable livelihoods for veterans and their families, and
the fact remains that professional aviation education, especially high-
demand, turbine-engine, rotor-wing aviation training, while more costly
than a philosophy degree or beauty school certificate, remains one of
the best returns on investment for veterans, the GI Bill program, and
the American taxpayer.
Thank you again, Mr. Chairman, for recognizing my strong objection
to and disagreement with several witness oral statements to you at this
recent hearing, and for offering me the opportunity to submit
additional information to you in writing. We would be happy to continue
educating Members of the Committee on the nuances of this issue, the
detrimental impact of this proposed legislation on schools and
veterans, and the myriad other issues that necessitate congressional
oversight with respect to VA's administration and management of
veterans' education benefits.
Sincerely,
Lois Reid,
Chief Executive Officer.
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