[House Hearing, 119 Congress]
[From the U.S. Government Publishing Office]


                       PUSHING VA FORWARD: REVIEW
                       OF VA'S ADAPTIVE PROGRAMS
                         FOR DISABLED VETERANS

=======================================================================

                                HEARING

                               BEFORE THE

                         SUBCOMMITTEE ON ECONOMIC 
                               OPPORTUNITY

                                 OF THE

                     COMMITTEE ON VETERANS' AFFAIRS

                     U.S. HOUSE OF REPRESENTATIVES

                    ONE HUNDRED NINETEENTH CONGRESS

                             FIRST SESSION

                               __________

                        WEDNESDAY, MAY 21, 2025

                               __________

                           Serial No. 119-23

                               __________

       Printed for the use of the Committee on Veterans' Affairs
       
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]


                    Available via http://govinfo.gov
                    
                                __________

                   U.S. GOVERNMENT PUBLISHING OFFICE                    
61-165                     WASHINGTON : 2025                  
          
-----------------------------------------------------------------------------------     
                   
                     COMMITTEE ON VETERANS' AFFAIRS

                     MIKE BOST, Illinois, Chairman

AUMUA AMATA COLEMAN RADEWAGEN,       MARK TAKANO, California, Ranking 
    American Samoa, Vice-Chairwoman      Member
JACK BERGMAN, Michigan               JULIA BROWNLEY, California
NANCY MACE, South Carolina           CHRIS PAPPAS, New Hampshire
MARIANNETTE MILLER-MEEKS, Iowa       SHEILA CHERFILUS-MCCORMICK, 
GREGORY F. MURPHY, North Carolina        Florida
DERRICK VAN ORDEN, Wisconsin         MORGAN MCGARVEY, Kentucky
MORGAN LUTTRELL, Texas               DELIA RAMIREZ, Illinois
JUAN CISCOMANI, Arizona              NIKKI BUDZINSKI, Illinois
KEITH SELF, Texas                    TIMOTHY M. KENNEDY, New York
JEN KIGGANS, Virginia                MAXINE DEXTER, Oregon
ABE HAMADEH, Arizona                 HERB CONAWAY, New Jersey
KIMBERLYN KING-HINDS, Northern       KELLY MORRISON, Minnesota
    Mariana Islands
TOM BARRETT, Michigan

                       Jon Clark, Staff Director
                  Matt Reel, Democratic Staff Director

                  SUBCOMMITTEE ON ECONOMIC OPPORTUNITY

                 DERRICK VAN ORDEN, Wisconsin, Chairman

JUAN CISCOMANI, Arizona              CHRIS PAPPAS, New Hampshire, 
ABE HAMADEH, Arizona                     Ranking Member
KIMBERLYN KING-HINDS, Northern       MORGAN MCGARVEY, Kentucky
    Mariana Islands                  DELIA RAMIREZ, Illinois
TOM BARRETT, Michigan                TIMOTHY M. KENNEDY, New York

Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public 
hearing records of the Committee on Veterans' Affairs are also 
published in electronic form. The printed hearing record remains the 
official version. Because electronic submissions are used to prepare 
both printed and electronic versions of the hearing record, the process 
of converting between various electronic formats may introduce 
unintentional errors or omissions. Such occurrences are inherent in the 
current publication process and should diminish as the process is 
further refined.
                         
                         C  O  N  T  E  N  T  S

                              ----------                              

                        WEDNESDAY, MAY 21, 2025

                                                                   Page

                           OPENING STATEMENTS

The Honorable Derrick Van Orden, Chairman........................     1
The Honorable Chris Pappas, Ranking Member.......................     2

                               WITNESSES
                                Panel I

Dr. Rachel McArdle, Deputy Executive Director, Rehabilitation and 
  Prosthetic Services, Veterans Health Administration, U.S. 
  Department of Veterans Affairs.................................     4

        Accompanied by:

    Dr. Joel Scholten, Executive Director, Physical Medicine and 
        Rehabilitation Service, Veterans Health Administration, 
        U.S. Department of Veterans Affairs

    Mr. Jason Latona, Assistant Director, Loan Guaranty Service, 
        Veterans Benefits Administration, U.S. Department of 
        Veterans Affairs

                                Panel II

Mr. Tom Landwermeyer, Brigadier General, USA (Ret.), President 
  and Chief Executive Officer, Homes For Our Troops..............    23

Mr. Mike Owens, Adaptive Sports Director, Wounded Warrior Project    25

Mr. Craig Schrimsher, President of North American Manufacturing, 
  BraunAbility...................................................    26

Ms. Julie Howell, Associate Legislative Director for Government 
  Relations, Paralyzed Veterans of America.......................    28

                                APPENDIX
                    Prepared Statements Of Witnesses

Dr. Rachel McArdle Prepared Statement............................    39
Mr. Tom Landwermeyer Prepared Statement..........................    40
Mr. Mike Owens Prepared Statement................................    42
Mr. Craig Schrimsher Prepared Statement..........................    53
Ms. Julie Howell Prepared Statement..............................    58

                       Statements For The Record

Homes For Our Troops Prepared Statement..........................    63
National Mobility Equipment Dealers Association Prepared 
  Statement......................................................    64
Disabled American Veterans Prepared Statement....................    64

 
                       PUSHING VA FORWARD: REVIEW
                       OF VA'S ADAPTIVE PROGRAMS
                         FOR DISABLED VETERANS

                              ----------                              


                        WEDNESDAY, MAY 21, 2025

      Subcommittee on Economic Opportunity,
                    Committee on Veterans' Affairs,
                             U.S. House of Representatives,
                                                    Washington, DC.
    The subcommittee met, pursuant to notice, at 10:29 a.m., in 
room 360, Cannon House Office Building, Hon. Derrick Van Orden 
(chairman of the subcommittee) presiding.
    Present: Representatives Van Orden, Ciscomani, Barrett, 
Pappas, McGarvey, and Ramirez.

        OPENING STATEMENT OF DERRICK VAN ORDEN, CHAIRMAN

    Mr. Van Orden. Good morning. In a strange twist of events 
and something that does not normally happen in the House of 
Representatives, we are going to start early. Shocking. We have 
our people here, so this subcommittee will come to order.
    I want to thank our witnesses for being here today to 
examine the U.S. Department of Veterans Affairs (VA) Specially 
Adaptive Housing, Adaptive Automobile, and Adaptive Sports 
programs to ensure these programs are effectively serving 
veterans across the country. I look forward to continuing the 
nonpartisan spirit of the subcommittee with Ranking Member 
Pappas, Chris and I were just talking here about some stuff, to 
ensure the VA's adaptive programs are modernized and work for 
the needs of today's veterans.
    The purpose of today's hearing is to examine how VA 
provides the special adaptive housing program, adaptive 
automobiles, and adaptive sports programs to our veterans. The 
Special Adaptive Housing Program, or SAH, plays an important 
role in providing customizable adaptions for severely service-
connected disabled veterans to adapt their homes to make them 
more accessible, to lead their lives comfortably. The small but 
vital program provides these true heroes with the ability not 
only to stay and live in their home of their choice, but to 
continue to live more independently.
    Additionally, VA's Adaptive Automobile Program provides 
disabled veterans with vehicle modifications. Through this 
program, veterans can safely operate their vehicle 
independently, hopefully getting back to the workforce and live 
fulfilling lives.
    VA's Adaptive Sports Program serves thousands of veterans 
across the country and plays an important role in disabled 
veterans regaining their independence, bettering their quality 
of life and improving their overall mental health and wellness. 
This program also provides opportunities for disabled veterans 
to participate in events such as wheelchair games, golf 
clinics, and many other sporting events that promote a healthy 
lifestyle.
    This Congress, my subcommittee has championed key 
legislation regarding VA's adaptive programs. H.R. 522, the 
Deliver for Veterans Act, championed by my friend from the 
great territory of Guam, Representative Moylan, would cover the 
shipping cost of delivery--excuse me, of the delivery of an 
adaptive automobile. This legislation passed the House in 
April. Additionally, Representative Barrett is leading a bill, 
H.R. 1364, the Automotive Support Services to Improve Safe 
Transportation (ASSIST) Act, which would provide more 
flexibility for veterans to access the specific adaptive 
automobile equipment they might need. Finally, Representative 
King-Hinds will have a bill on our next legislative hearing to 
enhance the SAH program. She is from the Northern Mariana 
Islands. Absolutely beautiful part of the world.
    When President Trump and Secretary Collins stated that this 
is time to end the Biden era and make the VA put veterans 
first, these are the programs we are talking about to improve 
veterans lives. Instead of focusing on political theater, which 
we are just not going to do here, and sound bites, we, me and 
Chris, are going to lead the subcommittee to make sure that we 
accomplish the mission, and the mission is the veterans. It is 
not us and it is not the VA. It is the veterans. I know that 
Secretary Collins shares my sentiments and I am very proud that 
he is there.
    I look forward to hearing more about the VA's adaptive 
program and how the Trump administration plans to keep these 
programs moving forward.
    I now yield to my friend and ranking member, Mr. Pappas for 
his opening remarks.

       OPENING STATEMENT OF CHRIS PAPPAS, RANKING MEMBER

    Mr. Pappas. Thanks very much, Chairman Van Orden.
    The Department of Veterans Affairs offers programs for 
disabled veterans to improve their lives through housing, 
transportation, and whole health sports. These are earned 
benefits and programs designed to improve veterans' overall 
health and independence. That is why I am so pleased that the 
chairman scheduled this hearing today.
    One success story I would like to highlight is New 
Hampshire's Northeast Passage Vet Rec Program (NEP), which is a 
nationally recognized nonprofit that has served more than 300 
pre-and post-9-11 veterans and service members with 
disabilities. Through its affiliation with the University of 
New Hampshire and partnership with VA and local Veterans 
Service Organizations (VSO), it offers veterans and 
servicemembers in my State adaptive sports and recreation 
opportunities including cycling, fishing, climbing, skiing, and 
countless other activities. I have seen the equipment; it is 
endless.
    Granite Staters who participated in the NEP have reported 
improved fitness, decreased depression, help with pain 
management, and improved adjustment to disability, all of which 
supports their path to recovery. Just as important, the sense 
of community and fostering of long-term friendships have 
substantially improved their quality of life. NEP's success is 
just one example of the critical role that VA's Adaptive Sports 
Programs play in helping the physical and mental well being of 
our veterans and servicemembers.
    In addition to adaptive sports, VA offers a spectrum of 
adaptive services encompassing housing grants, vehicle 
modifications, and assistive technologies. However, further 
improvements are necessary to reduce significant barriers that 
impede many veterans' access to these critical resources, 
underscoring the urgent need for legislative solutions to 
streamline eligibility, increase funding, and optimize 
delivery.
    To this end, this committee took bipartisan action in 2022 
with the passage of the Veterans Auto and Education Improvement 
Act, which was signed into law. The this legislation offered 
disabled veterans the ability to purchase a second adaptive 
vehicle. During a full committee markup earlier this month, I 
was proud to support the ASSIST Act to build on this 
legislation, which passed the House earlier this week.
    The next step is passing Representative Sorenson's Autonomy 
for All Disabled Veterans Act to provide veterans additional 
funding for housing modifications. That legislation is 
supported by Paralyzed Veterans of America (PVA), who I know we 
will hear from later to testify on the bill.
    Funding limitations like these constrain the effectiveness 
of VA's adaptive programs. For instance, the Specially Adapted 
Housing, SAH, and Automobile Assistance Programs are subject to 
caps that often fail to align with prevailing real world costs. 
Consequently, veterans with severe disabilities may incur 
substantial out-of-pocket expenses to facilitate necessary home 
or vehicle modifications.
    I want to thank Homes For Our Troops, which is an 
organization in New Hampshire, and their fundraising efforts, 
which help bridge the gap between what an SAH grant covers and 
the actual cost of constructing a brand new adaptive home. 
However, Congress must increase these caps and implement annual 
adjustments to reflect inflation and ensure that veterans can 
take full advantage of these important programs.
    As I mentioned earlier, adaptive sports are also an 
important part for the whole health and well-being of disabled 
veterans. Sports foster physical fitness and mental well-being 
by reducing stress and isolation. They rebuild confidence and 
reintegrate veterans in their communities. Adaptive sports must 
continue to be part of rehabilitation and lifelong care plans 
for veterans.
    To improve accessibility to these programs, Congress should 
increase funding for adaptive sports programs and grants that 
directly support veteran participation. Streamlining the 
process for veterans to access adaptive equipment and 
specialized training is also crucial. Congress should support 
collaborations between VA, community-based sports 
organizations, and veterans service organizations to expand 
program reach and awareness and ensuring that all interested 
veterans and have the opportunity to participate.
    Last, VA needs to simplify the process for accessing these 
benefits. Veterans frequently encounter convoluted paperwork, 
inconsistent communication from VA offices, and ambiguous 
eligibility criteria. Congressional action could mandate a 
unified and transparent system, enabling veterans to apply for 
multiple adaptive sports via a single integrated portal 
supported by case managers with specialized expertise in 
disability-related needs.
    Insufficient outreach from VA also represents another 
critical area for improvement. Many eligible veterans remain 
unaware of available benefits, particularly in rural and 
underserved communities. Congress should prioritize investments 
in proactive outreach strategies, fostering collaborations with 
VSOs, community centers, and healthcare providers to ensure 
that targeted dissemination of information gets to the veterans 
who are eligible.
    As I said, disabled veterans have earned these benefits 
through their service. I hope our work here today will identify 
improvements that we can all agree on to allow these veterans 
and servicemembers that we represent to take full advantage of 
programs that will help them.
    Thank you very much, Mr. Chairman. I yield back.
    Mr. Van Orden. Thank you, Ranking Member Pappas. I will now 
introduce the witness panel.
    Our first witness is Dr. Rachel McArdle, deputy executive 
director, Rehabilitation and Prosthetic Services, Veterans 
Health Administration (VHA) at the Department of Veterans 
Affairs. Dr. McArdle is accompanied by Dr. Joel Scholten, 
executive director of Physical Medicine Rehabilitation 
Services, Veterans Health Administration at the Department of 
Veterans Affairs; and Mr. Jason Latona. Out of the three of 
you, you have the most easily pronounced name, sir, and you are 
a Marine, assistant director, Loan Guarantee Service, Veterans 
Benefits Administration (VBA) at the Department of Veterans 
Affairs.
    I will ask the witnesses to stand and please raise their 
right hand.
    [Witnesses sworn.]
    Mr. Van Orden. All right. The record will reflect that the 
witnesses answered in the affirmative. Please be seated.
    Dr. McArdle, you are now recognized for 5 minutes to 
deliver your testimony on behalf of the Department of Veterans 
Affairs.

                  STATEMENT OF RACHEL MCARDLE

    Dr. McArdle. Chairman Van Orden, Ranking Member Pappas, and 
other members of the subcommittee, thank you for the 
opportunity to discuss how VA fulfills the Nation's promise to 
care for veterans through the administration of adaptive 
programs. VA provides specialty adapted housing assistance, 
home improvement and structural alteration assistance, 
automobile adaptive equipment, and the Adaptive Sports Grants 
Program to maximize veteran independence.
    Joining me today, Dr. Joel Scholten, executive director of 
the Physical Medicine and Rehab Service, and Mr. Jason Latona, 
assistant director, Loan Guarantee Service, Veterans Benefits 
Administration.
    The Specialty Adapted Housing Grant Program offers various 
grants for eligible veterans and servicemembers, helping them 
acquire adapted housing necessary to service-connected 
disabilities. VA also assists if an adaptive home is destroyed 
or significantly damaged by a natural disaster. The program is 
individualized with VA agents guiding veterans through the 
process to contract with builders of their choice. The program 
staff use their expertise in home adaptations to ensure 
projects comply with applicable statutes and meet the 
individual veterans needs. The program has approved over 2,000 
grants annually for 6 of the last 7 fiscal years and 
anticipates similar or higher levels in the future.
    VA is modernizing the Specially Adapted Housing Special 
Home Adaptation System to enhance customer service. This 
multiyear project uses automation to streamline benefits 
delivery and improve oversight with enhanced monitoring from 
application to completion. The first phase of this modernized 
system is expected to begin in July 2025. Individualized 
attention to each Adaptive House grantee ensures oversight.
    In Fiscal Year 2020, VA centralized financial management 
for the Specially Adaptive Housing Grant Program disbursements, 
eliminating third party escrow agents. This change strengthened 
internal controls, improved project management, accelerated 
home adaptations' timelines, and removed a $500 escrow fee for 
veterans. The VA Home Improvement and Structural Alterations 
benefit provides financial assistance for home modifications to 
eligible veterans and servicemembers undergoing medical 
discharge due to permanent disability under certain 
circumstances. Home improvement or structural alteration 
projects are prescribed by VA clinicians based on clinical 
needs and are necessary for the provision of home health 
treatment and maximizing home accessibility.
    VA's Automobile Adaptive Equipment Program reimburses or 
pays for adaptive equipment for eligible veterans and Active-
Duty members with certain disabilities. The equipment is 
prescribed by VA fluent physicians or certified driver 
rehabilitation specialists. VA is authorized to prescribe and 
reimburse or pay for operational and nonoperational equipment. 
VA works directly with--VA does not modify, install, repair, or 
replace such equipment. VA works directly with dealers, 
modifiers, and alterers to ensure all prescribed necessary 
adaptive equipment enable the veteran to safely drive or ride 
as a passenger in their personal vehicles. Examples of 
automobile adaptive equipment include low-effort steering, 
electronic controls, hand controls, wheelchair tie-downs, 
vehicle lifts, and voice command systems.
    VA manages an Adaptive Sports and Equine-Assisted Therapy 
Grants Program to promote the lifelong physical and mental 
health of veterans with disabilities through regular 
participation in physical activity. Through this program, 
grants are awarded to nongovernmental entities experienced in 
managing large-scale adaptive sports programs. These grants 
offer opportunities for veterans and Active-Duty servicemembers 
to engage in adaptive sports, utilizing skills taught by VA 
clinicians and apply them in their daily life in their local 
communities. During the last 9 years, VA has awarded over 119 
million in grants through the Adaptive Sports Grants Program. 
In Fiscal Year 2024, 91 grants, totaling 15.9 million were 
awarded, benefiting over 15,000 veterans and servicemembers.
    In conclusion, VA remains dedicated to providing efficient, 
effective, and meaningful adaptive programs for veterans. Thank 
you for your support and for the opportunity to speak today. We 
welcome your questions.

    [The Prepared Statement Of Rachel McArdle Appears In The 
Appendix]

    Mr. Van Orden. Thank you, Doctor. Your testimony will be 
entered, written testimony--excuse me, statement will be 
entered into the hearing record.
    We are going to proceed to questioning. Everyone knows the 
deal here. We are doing 5 minutes.
    I now recognize Ranking Member Pappas for 5 minutes to 
question the witnesses.
    Mr. Pappas. Thank you very much, Mr. Chairman. I thank you 
for the testimony. This is really an important subject here for 
veterans that I represent in New Hampshire and this is all 
about improving quality of life, giving them the best health 
outcomes, but also allowing them to live with the independence 
that they deserve.
    I want to get to you first, Mr. Latona. I want to ask about 
the Specially Adaptive Housing Grant Program. I am wondering if 
you can tell me more how veterans find out about this 
particular program.
    Mr. Latona. Yes, sir, and thank you for your question. We 
have several mechanisms by which we communicate the program. We 
have outreach efforts that cover from our internal systems. 
Veterans, once they are determined to be eligible through VA's 
compensation service, they are contacted immediately by a 
representative from the Specially Adapted Housing Program. They 
are also put it on an automated letter schedule where they will 
get annual letters notifying them of their eligibility or 
remaining entitlement.
    We also work closely with other VA programs, like my 
colleagues sitting here at the table, to make sure they have 
fact sheets and information about our grant programs in case 
they have veterans who they feel would benefit from any of 
those programs.
    Then last, we work with external partners, nonprofits, 
veteran service organizations. We meet with them regularly, as 
regularly as possible, to make sure they are aware of the 
programs, too, so they can help steer veterans toward not just 
the Specially Adapted Housing Grant Program, but any of the 
other programs that also provide the same types of features 
from VA.
    Mr. Pappas. Well, I appreciate how you are getting the word 
out. We have heard from some veterans that the process can take 
as long as 18 months because of staff turnover, losing 
paperwork, and some of the veterans who suffer from Amyotrophic 
Lateral Sclerosis (ALS) or Lou Gehrig's disease do not have the 
kind of time to get through the approval process and get the 
work done on their home. How is eligibility determined and how 
long does that process take?
    Mr. Latona. The eligibility process happens from VA's 
compensation service, and I would say on average it is probably 
3 to 6 months, depending on the complexity of the case. Every 
veteran is unique, their service-connected disabilities are 
unique. Once they are determined to be entitled and they 
receive their eligibility, that is when Specially Adapted 
Housing is contacted and that is the point at which we reach 
out to them.
    To your point as well, we also understand it can be kind of 
complex having to navigate a recent disability as well as the 
paperwork required. For veterans who have certain disabilities 
like ALS, we have an expedited process where we will focus on 
fewer serious adaptations rather than the entire project scope 
to try to speed along the grant approval process.
    Mr. Pappas. Dr. McArdle, if I could turn to you. How do 
veterans find out about Adaptive Sports Programs?
    Dr. McArdle. We have focused on outreach throughout the 
last several years. There are several reasons--several ways 
that they can find out about our Adaptive Sports Programs. At 
our national rehab events, we hold a variety of outreach 
opportunities such as health and wellness expos, informational 
tables that check in for the events, educational sessions, and 
we encourage veterans to attend to learn about not just what 
the adaptive sports portfolio offers, but also what other 
benefits and healthcare services they are entitled to.
    They can--we also use outreach through social media, VA 
news blogs. We have an adaptive sports website that is open to 
the public that we constantly update. We do emails to 
clinicians so that clinicians are aware of all of our offerings 
because the clinicians are our Ambassadors out in the field 
across the enterprise, who are letting their veterans know we 
do not just target recreation therapists or adaptive sports 
clinicians in these emails. We target all of our rehab teams so 
that all rehab providers are aware of what we have to offer.
    Mr. Pappas. Oftentimes, veterans themselves can be the best 
validators and evangelists for these Adaptive Sports Programs 
to let their peers and community know about the benefits of 
them.
    I am wondering if you can talk about staffing and whether 
you feel there is enough staffing to support all of the 
programs and special events that VA offers.
    Dr. McArdle. Currently, the VA is committed to ensuring we 
have enough staffing to have no impact on veteran care.
    Mr. Pappas. Have we seen any positions specifically related 
to Adaptive Sports Programs be impacted by any of the hiring 
freeze or any of the resignation offers to VA employees?
    Dr. McArdle. Not to my knowledge. I would have to take that 
back for the record for specifics.
    Mr. Pappas. Okay. If there is any more information there, 
we would love to hear about that. How many grants were awarded 
and what was the total amount in Fiscal Year 2024?
    Dr. McArdle. Just one moment. There were 91 grants awarded 
in 2024. The total amount was 15.9 million.
    Mr. Pappas. Okay. Are you getting annual reports back from 
all the grantees?
    Dr. McArdle. Yes, sir.
    Mr. Pappas. Okay. One recommendation that came out of a 
2021 Inspector General (IG) report was on adequate staffing, 
and we want to ensure that experienced staff are still 
providing the oversight.
    I see my time is up here, so maybe we can have a second 
round, but thanks very much. Okay.
    Mr. Van Orden. Too many buttons back here. The gentleman's 
time has expired. Chris, if you want to do a second round, 
absolutely. We are here to make sure we get all the answers we 
want.
    The chair now recognizes my friend, Mrs. Ramirez from the 
great State of Illinois, for 5 minutes. Oh, excuse me, I stand 
corrected. I now recognize Representative Barrett from the even 
greater State of Michigan for 5 minutes.
    Mr. Barrett. Not your great friend. Thank you, Mr. 
Chairman. Appreciate it. Thank you to our panelists for being 
here today. Appreciate the work that you put into this. I did 
have a few questions for you.
    Dr. McArdle, we have heard from, I have personally heard, 
too, from some of the automotive adaptive equipment providers 
that the VA has been delayed in rendering payment for already 
approved adaptive equipment for veterans that are seeking to, 
you know, certainly have that provided. I have heard it can 
even take more than 6 months to pay a provider back. Again, 
these are things that have already been approved through the 
VA, but the actual final payment to the vendors is taking a 
substantial amount of time that can really impact their ability 
to, you know, run their businesses effectively. Can you give me 
an update as to why that is taking place and what we are doing 
to correct that?
    Dr. McArdle. The Automobile Adaptive Equipment Program is a 
joint program that collaboratively VBA and VHA work together. I 
am going to defer to my colleague, Mr. Latona, to start off.
    Mr. Barrett. Sure.
    Mr. Latona.Yes. Thank you for your question, sir.
    As Dr. McArdle stated, the process begins with the veteran 
being rated. That is a VBA process, after which it turns over 
to VHA, who determines which type of equipment they 
specifically need and they are going to prescribe. Then it 
comes back to VBA for payment. As far as the payment goes, the 
payment process is not a national process currently within VBA, 
so local offices handle them themselves. We are aware of that 
there is a number of people, of vendors who have claimed the 
late payments. We have not gotten that data, but we are looking 
forward to looking at it and being able to address it at that 
point, once we have cases that we can dig into.
    Mr. Barrett. Sure. I have, you know, I have heard that VA 
is like, well, we have not seen that, and maybe it is anecdotal 
here and there, but I have had providers show me a list of 
pretty substantial delayed payments that is not a one-and two-
off situation. I think I heard that there were a multitude of 
instances where this was happening and it was taking more than 
6 months on average to process payments, sometimes far longer 
than that, over 200 or 250 days even. That is very hard for 
those vendors to continue to offer that service. The concern 
that I have is that they are going to no longer contract with 
the VA for that. That will lead to a scarcity of available 
vendors, and veterans will have to go farther and search harder 
to find one that will accept their VA benefits. It is something 
that I think we need to fix. Is there a single point person 
that would be responsible for correcting this?
    Mr. Latona. There is currently an IPT, integrated product 
team, that is put together to actually investigate this exact 
problem.
    Mr. Barrett. Okay.
    Mr. Latona. There is leadership from VHA and from VBA 
getting together to discuss it and come up with resolutions. We 
would love to follow up with the court.
    Mr. Barrett. Yes. Who is in charge of that team, that team 
that you described?
    Mr. Latona. I am not sure who the specific point person is, 
but several leaders across both. We can provide you that 
information as well.
    Mr. Barrett. Okay. What I do not want is for this to just 
be like, you know, six people are in charge of it, and no one 
is really in charge of it. Then it kind of--everybody, you 
know, does not have ownership. If there is a specific person 
that is responsible for this, I feel like that would help work 
through some of the challenges that exist. If there is a way 
to, you know, identify whom that person or whatever role that 
is, to really figure out a way to work through this, that would 
be something that I think would be useful. I think it is fair.
    You know, we provide this for veterans as we should. It is 
an expectation that we have. Then on the other end of that, 
there is a vendor that builds that equipment, that needs to 
have that payment to make their own payroll and pay their own, 
you know, overhead as well. We are going to lose that, that 
vendor relationship with the VA and, ultimately, veterans are 
going to suffer if it goes too far that way.
    Mr. Latona. Right, sir. I agree. Yes, these are trusted 
partners of ours. They are not--we do not want to take 
advantage of them. We need to pay them for the service that 
they are providing fairly.
    Mr. Barrett. Right.
    Mr. Latona. That is the intention of the IPT, and we will 
definitely be able to provide you specific names.
    Mr. Barrett. Okay. Yes, I appreciate that. If we can meet 
with that team, I would like to just hear about their progress 
and what they are doing and really stay on top of this. Thank 
you.
    Thank you, Mr. Chairman.
    Mr. Van Orden. The gentleman yields back.
    Now I recognize my dear friend, Mrs. Ramirez from the great 
State of Illinois.
    Ms. Ramirez. The greatest, thank you. Thank you, Chairman.
    Mr. Van Orden. That is not true.
    Ms. Ramirez. I want to thank the witnesses for being here 
with us today.
    Last week, I had a chance to ask Secretary Collins about 
his commitment to serving all our veterans, not just the ones 
the administration may recognize worthy. I also asked him how 
he intended to continue providing services to veterans after 
the dismantling of offices, like the Office of Equity Assurance 
and programs that serve diverse veterans. My questions went 
mostly unanswered. In fact, on the record, he stated that the 
VA workers, many of whom are veterans, who followed his 
directives, were maliciously compliant.
    Blaming workforce, cutting services, and drastically 
limiting programs veterans can access is, to me, a page out of 
the Musk-Trump administration. I think it is really important 
to say on record, all veterans still face barriers to accessing 
housing, healthcare, and basic support. It is why this 
committee hearing is so important.
    The providers and their services are not just under strain. 
They are being actively undermined by their leader and then 
blamed on systemic shortcomings. Unfortunately, one of the 
programs at risk due to the VA's leadership and decision-making 
is the Specially Adapted Housing Program, and as you just 
mentioned, SAH. Veterans who need accessible homes, those with 
serious injuries and life-changing disabilities should not be 
facing delays or administrative confusion.
    Mr. Latona, my question is for you. Do you currently have 
enough staff in place to process SAH grants and carry out 
timely inspections? Yes or no?
    Mr. Latona. I would answer that question by saying the 
Department is following all court orders regarding staffing and 
reporting on staffing, ma'am.
    Ms. Ramirez. You would say you do have enough staff right 
now to process the grants?
    Mr. Latona. I would say that the--our mission is critical 
and we will never have enough staff, in my opinion. We always 
need more staff to perform this critical mission.
    Ms. Ramirez. Mr. Latona, is the staff training for that 
staff consistent across the board? Is it pretty much the same 
uniformity and training?
    Mr. Latona. We have national training for all agents. It is 
a very complex job. Our specially adapted housing agents need 
to be counselors and they need to be well versed in 
construction and all different kinds of elements. We spend a 
lot of time with veterans in their homes. We have to have 
sensitivity training as well. We do have national training. The 
most effective training we get is our on-the-job training with 
more senior level employees.
    Ms. Ramirez. Got it. Just follow up on that, understanding 
the comprehensive approach and spectrum and the training, can 
you tell me who in the VA is responsible for delivering the 
training itself?
    Mr. Latona. Yes, the individual operations assistant 
directors across the country deliver the training locally. Then 
we have a deputy director in Loan Guarantee Service who is in 
charge of operations, who is overall in charge.
    Ms. Ramirez. The deputy director is overall responsible for 
the training----
    Mr. Latona. For Specially Adapted Housing agents.
    Ms. Ramirez [continuing]. and then, obviously, the staff. 
Okay. We all agree that balanced budgets are important. Mr. 
Latona, I want to talk a little bit more about this. How does 
the VA calculate the amount of each SAH grant?
    Let me follow with the second question because I know I am 
limited on time. When determining grant amounts does the VA 
account for inflation?
    Mr. Latona. Yes. We have several mechanisms that we use. We 
have the cost of construction index that were authorized each 
year based upon the industry performance of construction, we 
are able to raise the grant amounts to kind of keep pace with 
the cost of construction across the industry. We also 
implemented the Ryan Kules Act recently which increased grant 
amounts and also provided a bunch of other very essential 
benefits for these veterans.
    We do track that and we are doing our best to keep up with 
it. Right now, our SAH grants, the maximum grants cover about 
20, 25 percent of the average cost to housing.
    Ms. Ramirez. Got it. What about other rising costs, like 
labor shortages or tariffs? Has the VA elevated concerns about 
how broader Federal policy, like arbitrary tariffs or rolling 
back labor regulations or immigration crackdowns, can affect 
some of the construction costs for adaptive housing?
    Mr. Latona. Well, from our role, the increased costs of 
labor and materials has a significant impact on the ability of 
the veteran to stretch their grant funds, which is really what 
we are trying to do.
    Ms. Ramirez. Got it.
    Mr. Latona. Once we identify what the veteran needs, we 
want to pay for all those, if possible. We also have the 
ability to stack different benefits. The Veteran Readiness and 
Employment (VR&E) Housing Adaptation Grant and the SAH Grant 
can be used together if needed to help stretch those dollars.
    Ms. Ramirez. I just got 30 seconds, so let me just 
transition really quickly. I want to talk to you a little bit 
about vehicle adaptation benefits, and this could be for Dr. 
McArdle or Dr. Scholten, whoever is best positioned. How many 
adaptive vehicle applications does the VA receiver receive 
annually, and how long, on average, does it take to determine 
eligibility?
    Dr. Scholten. I believe that question should be directed to 
Mr. Latona.
    Mr. Latona. Right.
    Ms. Ramirez. Mr. Latona.
    Mr. Latona. Thank you. I think it falls within the scope of 
the Veterans Benefits Administration, who determines 
eligibility.
    Ms. Ramirez. How many applications annually?
    Mr. Latona. I have to take that back and find out exactly 
how many numbers, but I do know that we delivered over 1,040 
adaptive equipment grants last year, and 620----
    Mr. Van Orden. The gentlelady's time has expired.
    Ms. Ramirez. Chairman, if I can just have it for the 
record, if I can get that information.
    Mr. Van Orden. Oh, 100 percent. We are going to do a second 
round, too.
    Ms. Ramirez. Perfect. Thank you.
    Mr. Van Orden. You are welcome. The gentlelady yields back.
    The chair now recognizes a very good friend from the great 
State of Arizona, Mr. Juan Ciscomani.
    Mr. Ciscomani. Thank you, sir. Thank you, Mr. Chairman. 
Thank you to our witnesses for coming today. Primary purpose of 
the VA is to ensure veterans are not only receiving benefits on 
healthcare when they need it, but to ensure their quality of 
everyday life can also be improved. Thank you for the work that 
you do there.
    Now, a question here, Dr. McArdle. Did I get that right? 
Okay, close enough. Please correct me on that one. I want to 
get it right. In your testimony, you mentioned the special 
Adaptive Housing Grant Program has approved more than 2,000 
grants, grant awards annually in 6 of the last 7 fiscal years. 
What do you attribute to the higher usage of this program, and 
do you think this will continue?
    Dr. McArdle. I am going to turn it over to my colleague, 
Mr. Latona.
    Mr. Ciscomani. Okay. Sir?
    Mr. Latona. Thank you for the question, sir. Yes, 
definitely it is true. Yes. In Fiscal Year 2024, we approved 
over 2,300 grants, over $150 million, 96 percent of those were 
our larger grant, called the Specially Adapted Housing Grant, 
$121,000.
    As far as the volume goes, one of the reasons, I think, is 
outreach. We have word of mouth is very popular among our 
veterans. Once they find out you can get a grant, I would say 
they will share that information. I would also say these 
partnerships that we have with our other VBA programs, like my 
colleagues here at the table and the folks who are going to be 
on this next panel, our nonprofit partners, VSO partners, they 
spend a lot of time performing outreach and helping to carry 
the water for us to our veterans.
    Mr. Ciscomani. Excellent. Thank you for that. Now, do the 
programs you oversee interact with or serve veterans 
experiencing homelessness?
    Mr. Latona. Not directly. Veterans for our program will 
usually either own a home or be residing with a family member.
    Mr. Ciscomani. Okay. Do you think there are some 
opportunities for partnership with other VA services, agencies, 
or even the private sector on this?
    Mr. Latona. Definitely. We partner with many programs 
within VA, many folks who are here today to make sure that we 
are providing comprehensive benefit. We understand that these 
are lifelines to a lot of veterans. A veteran who is coming to 
Specially Adapted Housing for a housing adaptation may not know 
about the automobile grant or may not know about another grant. 
We try to make sure we spread the word of all those, and we are 
Ambassadors for all the programs in VA when we meet with them.
    Mr. Ciscomani. Do you have any example you can give me on 
how that is working in terms of the partnerships with local 
agencies or even the private sector?
    Mr. Latona. Absolutely.
    Mr. Ciscomani. Maybe, you know, a good model that is 
working somewhere that we could replicate somewhere else.
    Mr. Latona. Absolutely. We will pull an example out of 
someone who is on the second panel. The Homes For Our Troops 
nonprofit organization provides homes for veterans who have 
been injured following 2001. In order for those veterans to be 
able to get that benefit from Homes For Our Troops, they need 
to be eligible for specially adapted housing. This requires us 
to work together. We review house plans to make sure that their 
home plans meet the requirements so we can expedite grant 
delivery.
    Mr. Ciscomani. Where is this happening?
    Mr. Latona. All across the country.
    Mr. Ciscomani. All across the country. Any Arizona good 
examples you could point me to so that I can----
    Mr. Latona. We have many grants in Arizona. I do not have 
any in front of me right now, but I can definitely provide 
examples.
    Mr. Ciscomani. Yes, I would love to get that just to know 
what is in our community, and my district specifically, in 
Congressional District 6 (CD6), and we can--love to go and pay 
more attention to that and go see it. Can you, with the time I 
have left here, can you explain what the VA is doing to 
eliminate fraud, waste, and abuse, and specifically in the SAH 
program, to ensure that severely disabled veterans are getting 
what they need and bad actors are not taking advantage of the 
program?
    Mr. Latona. Definitely, and thank you for that question. 
That is a very important area, too.
    One of the big steps we took recently was to remove third 
party escrows. What happens when a veteran receives their 
grant, a third party escrow company or the VA would hold onto 
the money and disperse the funds as the project was completed 
to make sure that we were not paying for work that was not 
completed. Rather than having third parties do this, which 
sometimes led to some funds being dispersed too quickly before 
work was done, and then we would have to try to recoup those 
funds, what we are doing now is VA holds those funds. We 
require a letter of satisfaction from the veteran and we 
perform a compliance inspection before any funds are dispersed.
    Mr. Ciscomani. That is interesting. Who were these third 
parties doing this before?
    Mr. Latona. Third parties, it was the veteran's choice.
    Mr. Ciscomani. Veteran's choice, Okay.
    Mr. Latona. Veteran was able to choose whatever attorney or 
bank they wanted to use and they would usually be charged a 
fee. This change also reduced that--eliminated that fee.
    Mr. Ciscomani. Less money flowed down to the final purpose 
with all the different steps on that. With a little time I have 
left here, 15 seconds, with the bringing this back in house, 
did that add a additional staff member within the VA network or 
how did that impact----
    Mr. Latona. No, we performed with the existing staff.
    Mr. Ciscomani. Okay. All right. Thank you, Mr. Chairman. I 
yield back.
    Mr. Van Orden. The gentleman's time has expired.
    The chair now recognizes my friend, Mr. McGarvey, from the 
great State of Kentucky.
    Mr. McGarvey. Thank you, Mr. Chairman. I want to thank you 
and I want to thank everyone who is here today for taking the 
time to dig into this really important issue. This is something 
that enables our veterans to live full lives, complete lives, 
happier, healthier lives. It gives them that sense of purpose 
that they so desperately oftentimes need, as we talk about in 
this committee.
    Dr. McArdle, I want to start with you a little bit. The VA 
is special. VA is special because its mission is to serve 
veterans. It is to make veterans lives better. It is not for 
profit. It is for our veterans. As a result of that, we get 
amazing results coming out of your office. The artificial limbs 
you all are making, the wheelchairs that are built for speed 
and for maneuverability, the tactile devices for visually 
impaired athletes, these are so important. They are not just 
meeting our veterans and our veteran athletes where they are. 
They are making their lives better. These devices provide 
purpose, they provide activity, they provide community and 
belonging. Our veterans should not lose that just because they 
lose part of what they had before they entered the service.
    Adaptive sports are so incredibly important. We got to see 
it firsthand in Louisville this year. In February, Louisville 
hosted the annual Wheelchair Rugby Invitational. There were 20 
teams all over competing in a round robin style tournament to 
get the prestigious Code of Honor Cup. This was more than a 
display of athleticism. This was determination, this was joy, 
this was happiness, this was belonging. It is something that 
our veterans need. Need. Not just something they want, it is 
something they need.
    I want to talk about this. What kind of technological 
innovations is your office investigating or investing in right 
now for the next generation of adaptive equipment to keep going 
forward, to keep our veterans having the sense of purpose and 
belonging? Are you able to partner with any outside researchers 
or manufacturers in that work?
    Dr. McArdle. Thank you for your question. It is a very 
exciting area for us as well and we feel just as passionately 
about it as you do. I am going to defer the question to my 
colleague, Dr. Scholten.
    Dr. Scholten. Yes, thank you for your question and also 
your enthusiasm. We as a rehab provider, I feel that adaptive 
sports and any efforts we can provide to help veterans 
reintegrate into their community is essential in not only their 
rehab plan, but their wellness plan. The Adaptive Sports 
Program partners very closely with our clinicians throughout 
our system of care. Relying on those clinicians to stay 
advanced or up to date with any technological advancements in 
prosthetic development, training opportunities through physical 
therapy and physiatry, and additionally pain management 
techniques that allow veterans to function at a higher level.
    We have a very robust research portfolio within VA that 
looks at a variety of musculoskeletal issues as well as 
traumatic brain injury and amputation-related research that 
help to continually push forward advancements to enhance 
veterans recovery.
    Mr. McGarvey. I think, you know, innovation is key all over 
the VA. We have to continue to innovate to find the best 
treatment and care for our veterans and we have the opportunity 
and the ability to do so.
    Are you all partnering with any outside groups really to 
kind of to help with this effort as well?
    Dr. Scholten. We are partnering with a number of academic 
institutions through our research grant portfolio to connect 
with the brightest minds across the country to further 
investigate technological advancements. In addition, we partner 
with our VSO partners to include greater participation and 
awareness of these events. Then we stay--try to stay aware and 
open for innovative ideas from our vendor--the vendor community 
throughout the country to better understand any new advances 
that might be coming down the pipeline.
    Mr. McGarvey. We want to keep working to make that 
innovation possible. Switching gears, let us talk about the 
Volunteer Transportation Network for just a second. A 2024 U.S. 
Government Accountability Office (GAO) report shows a 50 
percent decline in rides provided to medical appointments for 
veterans, partly in part because the number of volunteers is 
decreasing. What is VA doing right now to replenish its 
volunteer base and increase the use of this program, getting 
our veterans where they need to go?
    Dr. McArdle. I am going to have to take that one back for 
the record and get you some more information on that.
    Mr. McGarvey. Perfect. Got it.
    With that, I am out of time. Mr. Chairman, I yield back.
    Mr. Van Orden. The gentleman yields back.
    I now recognize myself for 5 minutes.
    Okay. I just have some real serious, like, basic rubber 
meeting road questions here. This subcommittee is also 
responsible for the Transition Assistance Program (TAP). It is 
just baffling to me that any veteran, especially someone that 
is being medically discharged, is unaware of these programs. I 
mean, that is a galactic failure. We are going to fix that.
    These programs will be introduced into the TAP program. For 
someone not to have thought of this earlier is shameful. I do 
not want anybody leaving the service and, ma'am, you said that 
people are being medically discharged and they still do not 
know about these things. Sure, it is great, peer to peer, 
veteran talking to veteran, saying, you know, these programs 
are available, but no.
    Dr. Scholten, how long have you been at the VA?
    Dr. Scholten. I have been working for the VA for 27 years.
    Mr. Van Orden. Dr. McArdle.
    Dr. McArdle. I started as a trainee 30 years ago.
    Mr. Van Orden. Mr. Latona.
    Mr. Latona. Seven years, sir.
    Mr. Van Orden. Seven. We got roughly 60 years' worth of 
experience at the VA and no one thought about talking about 
this in the TAP program? Okay. We will do better.
    Mr. Barrett brought up some very salient points about 
payment. We had one dental clinician in the Network for 
Community Care. I went there. It was an hour drive. It took the 
VA so long to pay him that they dropped out.
    Mr. Latona, we are not going to look into this anymore. We 
are not going to have meetings, we are not going to coordinate. 
We are not doing any of that. I am going to--I request 
unanimous consent to enter this into the record. Hearing no 
objection, so ordered.
    All right. I am going to give you these things, and you are 
going to take them back to the office and you are going to look 
into them, and you are going to pay these people. I am, and I 
am sure, Chris, as we have not talked about it before, we, can 
I speak for him, possibly, we are willing to accept some risk, 
because if you cannot figure out how to pay somebody, they are 
going to leave, and that what Mr. Barrett said will come to 
fruition.
    Then my Marine brother back there, who was grievously 
injured in combat outside of Balad, right? That is right, 2005, 
will not be able to get his house fixed or his vehicles fixed 
because of administrative inertia.
    I am going to give this to you. I am also going to send a 
note to the Secretary. With 60 years' of experience, you can 
figure this out. It is literally signing a check. Mr. Latona, 
that is not a question. I am just telling you what is going to 
happen.
    Mr. Latona. Yes, sir. Thank you.
    Mr. Van Orden. You said, Mr. Latona, that there is an 
expediting process for people with ALS and some other things. 
What is that process?
    Mr. Latona. Yes, sir. Thanks for the question. With most 
projects, we walk through a entire scope of a project. Veterans 
will usually have a little more time. They will want to take 
time to find a builder that they want to work with. We enable 
them to do that, and then we help facilitate that conversation 
to identify which adaptations they might need.
    Mr. Van Orden. Okay, Mr. Latona, stop it. Okay. There 
should be no expediting process. Every process should be 
expedited. Just because a veteran is not going to die within 2 
weeks does not mean you should not be running down the road at 
1,000 miles an hour to get that fixed. It is within your power, 
like it is something you can do and you need to do it.
    The average time is what from the time someone is 
discharged to their home is a place where they can live. What 
is the average time?
    Mr. Latona. Sir, I am not aware of that time, but I know 
from application to delivery could be somewhere between 6 to 12 
months for specially adapted housing projects.
    Mr. Van Orden. Right. TAP is supposed to be done 6 months 
prior and then iterative. Why did not that application process 
start while they are still in the military? Can you answer that 
question?
    Mr. Latona. Well, we do work closely, actually, with the 
services and Wounded Warrior programs when we are identified.
    Mr. Van Orden. That is a civilian organization, sir. You 
are the----
    Mr. Latona. No, no, the, I am sorry, the--within the 
service. Each service has their own Wounded Warrior Program----
    Mr. Van Orden. Yes.
    Mr. Latona [continuing]. within them. That is who we work 
with.
    Mr. Van Orden. Not the Wounded Warrior Project. Okay.
    We are going to do a second round, and I will adhere to my 
own rule. My time is about to expire, and the chair will now 
recognize Ranking Member Pappas for 5 minutes.
    Mr. Pappas. Thanks. Dr. McArdle, if I could go back to you. 
We were in the middle of a discussion when I ran out of time 
before. I just wanted to--I was highlighting this 2021 GAO 
report, which talked about adequate staffing levels, and they 
specifically cited needing more staff with grant management 
experience. I am wondering if you could speak to where we are 
today. What we have been hearing is that, based on this report, 
we were understaffed in 2021 and that we are less staffed 
today. Can you speak to that level of staffing specifically to 
people with grant management experience?
    Dr. McArdle. We have made a lot of progress on a lot of the 
recommendations that were recommended in that 2021 Office of 
Inspector General (OIG) report. Is that what we are referring 
to?
    Mr. Pappas. Yep.
    Dr. McArdle. Thank you. In terms of getting all of the 
recommendations closed, that report has been closed. We have--
we do have a limited number of staff within the grants program, 
but the Department is committed to ensuring that there is no 
interruption in services provided to the grantees or to 
veterans who would be utilizing those grant programs.
    Mr. Pappas. Can you define better ``making progress''? I 
know you spoke about----
    Dr. McArdle. Sure.
    Mr. Pappas [continuing]. the recommendations in the report, 
but specifically as it pertains to staffing, where are we today 
versus when that report was issued?
    Dr. McArdle. I would have to take that for the record.
    Mr. Pappas. Okay. Can you give us the assurance, though, 
that VA currently has adequate staffing with respect to being 
able to properly monitor these grant programs?
    Dr. McArdle. Yes, sir.
    Mr. Pappas. Just going back to what you had told me before, 
I asked you specifically whether positions in adaptive sports 
have been impacted by the administration's hiring freeze or the 
offer for people to resign. You said you did not believe that 
any were impacted. Just talking more with staff in the 
intervening time, we have heard from groups that have told us 
that there are positions--that are people that have left their 
positions that support adaptive sports. I am wondering if you 
can provide any additional clarity now on that or if you can 
come back to us in short order with specific information about 
where we stand with staffing related to adaptive sports.
    Dr. McArdle. I would be happy to take it for the record, to 
get back to you. I do just want to clarify that adaptive sports 
clinicians are in various occupations: recreational therapists, 
physical therapists, occupational therapists. It would be a--we 
will be happy to come back.
    Mr. Pappas. Yes, but you must have an accounting of who 
is--which clinicians are connected to Adaptive Sports Programs. 
Correct?
    Dr. McArdle. They are across the enterprise and they are 
frontline field-based providers who are our coaches for our 
veterans out in the field and across the enterprise. That is 
who we rely on to assist us even with our national rehab 
events.
    Mr. Pappas. Would not you agree that is a pretty important 
element of delivering these programs to veterans?
    Dr. McArdle. Absolutely. Dr. Scholten.
    Dr. Scholten. I would just like to add that, so our 
Adaptive Sports Programs are across the enterprise, as Dr. 
McArdle mentioned. The critical piece about that is our 
rehabilitation staff stationed across every medical center are 
aware of these programs and pursuing not only their working 
with veterans to maximize their rehabilitation potential, but 
also working with community partners to provide adaptive 
sporting activities that are available in the community. This 
is an essential part of that reintegration piece that we--that 
you mentioned earlier from transitioning from the skilled 
rehabilitation part of their care after an injury toward 
reintegrating back into the community.
    We really leverage not just a specific subset of our 
rehabilitation professionals across the country, but every 
rehab individual and, in most cases, every rehab staff member 
contributes or participates part of their time into adaptive 
sporting events, whether it is through support of the actual 
event, recommending to veterans to participate in that, or to 
build onto their rehab and wellness plan.
    Mr. Pappas. Okay, I appreciate that. Just to sum up, I am 
looking for some more clarity with respect to positions that 
have been impacted by the hiring freeze within the adaptive 
sports or under the adaptive sports umbrella, anyone connected 
to that, including clinicians. I am also looking for more 
information in the wake of the IG report on staffing with grant 
management experience, making sure that we have enough and just 
kind of trying to assess what level we are at today. If you can 
follow up with us, we look forward to that information.
    I yield back.
    Mr. Van Orden. The gentleman yields back.
    The chair now recognizes Representative Barrett from the 
great State of Michigan for 5 minutes.
    Mr. Barrett. Thank you, Mr. Chairman. Appreciate the first 
round of questioning.
    Wanted to also ask, so, Dr. McArdle and for the panel, too, 
if there is someone more appropriate to answer this, I know 
that we have seen a significant rise in construction costs 
across the economy. I spoke to realtors in my district and they 
were saying, you know, you cannot buy an affordable home any 
longer and takes too much to build new and all the regulations, 
everything else, you know, tools, equipment, materials have 
skyrocketed, labor costs have gone up. Have our costs through 
the VA and the adaptive programs for living accommodations and 
everything else, have they kept pace with that ramp-up in cost 
of construction for a home? Or are veterans having to make 
decisions, you know, based upon cost overruns and things of 
that sort of.
    Mr. Latona. I can take that question, sir. Thank you very 
much. Cost of materials and labor have both been kind of 
rampant since the pandemic, and it does, as I stated before, 
impact the ability to stretch those grant funds. What we tried 
to do, utilizing the cost of construction index, which allows 
us to keep pace with the cost of construction, I think last 
year we were able to raise the amount by 4.6 percent. Year 
before that it was, I think, it was over 6 percent. We are 
maintaining about a 25 percent comparison between the overall 
average cost of housing. However, veterans, unless they are 
just adapting an existing home, they will almost always have to 
come out of pocket for other costs just because of the cost.
    However, we do have other partner programs I mentioned 
before. Home Improvement and Structural Alterations grant that 
is managed by VHA and we also have the Veteran Readiness and 
Employment Independent Living Track has a grant called the Home 
Adaptation Grant. We are actually able to leverage all those 
collectively to help reduce the amount of money that a veteran 
has to use out of their own pocket to make sure they get the 
necessary adaptations. Then, of course, we lean on nonprofit 
partners as well.
    Mr. Barrett. Sure. Thank you. Typically, if a veteran needs 
substantial account accommodations, they are not retrofitting 
the home that they may already live in. Is that generally true? 
They are usually having to build new?
    Mr. Latona. Majority of times actually they are adapting a 
home. We have several different plan types. What we call the 
plan 3 is remodeling a home that a veteran already owns. That 
is by far the one we use the most. About 85 to 90 percent of 
our projects really are that.
    Mr. Barrett. Okay. If a person, a veteran is, you know, 
substantially mobility limited and like I understand a 
wheelchair ramp for your front steps or something of that sort 
is a smaller modification, but other things for someone who may 
have much more severe mobility restrictions, that probably tips 
the scales toward a new build at that point?
    Mr. Latona. It really depends. I mean, we--a new bathroom 
will run 40-to $50,000 usually for a fully accessible bathroom. 
Those we can usually do, with a proper designer, we can do 
within the existing home. Veterans usually choose to buy a new 
home if they do not own one already or if they own an older 
home, which maybe cannot be modified. At that point, we tell 
them the property is not really suitable for the type of 
adaptations you need, and then they would try to find another 
home.
    Mr. Barrett. Okay. All right. I feel like construction 
costs have gone up by far more than the 4 or 6 percent that you 
are describing. Has that been accounted for? Is there an 
automatic adjustment? You mentioned the construction inflation 
index.
    Mr. Latona. Right.
    Mr. Barrett. Just, you know, anecdotally, you cannot go to 
Home Depot or Lowe's and find the same building materials for 
only 4 percent more than they were, you know, pre-pandemic, for 
example.
    Mr. Latona. True. We use an industry cost of construction 
index. With the authority to increase this, we had a designated 
index we would use. The one we use is currently the Turner 
cost, which actually reflects increased cost across the 
industry. That is the one we have been using.
    Mr. Barrett. Okay. All right. Is that accurate, would you 
say? Or is there work that needs to be done to make that more, 
I guess, more accurate for today's conditions?
    Mr. Latona. I think it covers most of the locations, but 
there are a lot of locations around the country where it is 
more difficult to get equipment and materials that we need to 
think about. Pacific Islands is one. Rural properties on 
Reservations land, Tribal trust lands, things like that is a 
lot harder. That is usually where we come up against projects 
that exceed the grant cost.
    Mr. Barrett. Okay. I would say even, you know, where I 
live, we are not stranded out somewhere. I mean, there are home 
improvement stores, you know, in the drivable area, but the 
costs of materials have just gone up so much. Then the building 
labor costs and then the timeline in which to find a 
contractor, it all really adds to the cost of the program. 
Thank you, appreciate it.
    Thank you, Mr. Chair.
    Mr. Van Orden. The gentleman yields back.
    The chair now recognizes Mrs. Ramirez for 5 minutes.
    Ms. Ramirez. Thank you, Chairman.
    Just wanted to follow up with you, Mr. Latona, on the 
questions around the adaptive vehicle applications. I think you 
said to me that you will go back and try to get me information 
on how many applications you get annually. Is that right? Then 
I think the only second part to that I had was how long on 
average does it take to determine eligibility once they have 
submitted the application?
    Mr. Latona. Thank you for your question, ma'am. Eligibility 
for any compensation whatsoever is performed, that 
determination is performed by the VA's Compensation Service. I 
think they have an average time. I do not have that data with 
me, but I can provide It.
    Ms. Ramirez. Yes, that would be helpful because I am trying 
to find out specifically, as it pertains to vehicle 
applications, what the average amount of time is.
    I want to pivot to another question here. We have heard 
repeated concerns from veterans and dealerships about delayed 
payments. I think it is another question for you, Mr. Latona. 
What is causing some of the backlog? Is there enough staff to 
process these applications?
    Mr. Latona. The payments are done outside of the Specially 
Adaptive Housing Program that I am--where I am here for my 
subject matter expertise for that program specifically. 
However, we can get you an answer on the staffing. I do not 
know if that impacts it currently, but I do know there are many 
variables when it comes to paying any vendors; communication 
between vendors, depending on size, depending on the way they 
invoice. There are a lot of differences in the different 
timelines specifically. I do know that once an invoice gets to 
VBA for payment, we have a time of 15 days to actually deliver 
those payments. The transaction usually takes 1 to 2 days. This 
is one of the areas that we are looking at within the IPT to 
find out where the bottlenecks are.
    Ms. Ramirez. I really appreciate that because I have heard 
repeatedly concerns with constituents about the delayed 
payments and what that means for them.
    One last question around that, and then I will get to my 
last question. Have there been any staff fired responsible for 
this work between the vendors and the processing since January 
20th?
    Mr. Latona. I am not aware. Again, that program is outside 
of my area of expertise.
    Ms. Ramirez. Okay. Can we get on the record, Chairman, that 
there is a number of questions that I do not have information 
on. I would like to be able to follow up and get it.
    Mr. Van Orden. Absolutely.
    Ms. Ramirez. Thank you, Chairman. The last one I have here 
is, how does the VA currently calculate the cost of an adaptive 
vehicle? Yes, answer that, and then I guess there is a second 
part to that.
    Mr. Latona. I am going to actually refer that to Dr. 
Scholten.
    Ms. Ramirez. Great. Someone else answering. Thank you, Dr. 
Scholten. Thank you, Mr. Latona.
    Dr. Scholten. My pleasure. Thanks for the question. That 
depends on the specific adaptation that is required, which is 
going to be uniquely customed for that individual veteran and 
their abilities. The veterans are evaluated by driver rehab 
specialists to develop a specific prescription for what 
modifications need to be placed provided for their vehicle. 
Then those line items on the invoice are processed through our 
prosthetic partners and then selected to a vendor. Once those 
modifications have been made, then Prosthetics looks at the 
line item on the prescription to ensure that each piece is 
appropriately provided on the vehicle or adapted to the vehicle 
before we can--before we sign off on completeness.
    Ms. Ramirez. Got it.
    Dr. Scholten. The payment schedule for each of those items 
is posted on our website. A payment schedule is updated every 
fiscal year. That is based on the Consumer Price Index.
    Ms. Ramirez. That is based on the Consumer Price Index as 
well?
    Dr. Scholten. Yes.
    Ms. Ramirez. Okay, got it. That was actually my follow-up 
question.
    Those are all the questions I have now, Chairman.
    Mr. Van Orden. The gentlelady yields back, and I recognize 
myself for 5 minutes.
    Okay. You just said that when the VA gets a bill, you have 
15 days to pay it, is that right?
    Mr. Latona. That is true, sir. Yes.
    Mr. Van Orden. Okay. Well, on this list that you will have, 
we got Kansas City, Missouri, 501 days; El Paso, 246; Dallas, 
Texas, 362, these are all days; Dallas, 823 days; Phoenix, 256 
days; 530 days for another thing in Phoenix; Waco, 96. I was an 
enlisted guy. You know, math is not my forte, but I am just 
going to say that I think all of those are greater than the 
number 15.
    Mr. Latona. I agree, sir.
    Mr. Van Orden. Okay. Unacceptable, sir. Can you walk me 
through the billing process? What happens?
    Mr. Latona. I can walk you through most of it. Some of it 
might be on the VHA side, but where I will pick it up from is 
once the VHA has identified the specific adaptations that were 
required, they will coordinate with the vendor to make sure the 
vendor understands what is needed and what the cost of those 
are. Once that entire package is complete, it goes to the 
vendor and then it makes its way to VA to pay it.
    Mr. Van Orden. Okay. What does that mean, sir, ``makes its 
way''?
    Mr. Latona. It is emailed. It is emailed from the local 
office. The office that is actually performing the analysis, 
determining what adaptations are required, emails it directly 
to the Support Services Division, which is an office within VA 
that handles the payments. It is a few minutes.
    Mr. Van Orden. How does a check get cut?
    Mr. Latona. The check gets cut. At that point it goes over 
to our Support Services Division who pays all vendors for all 
services.
    Mr. Van Orden. How many people are there?
    Mr. Latona. I am not aware, sir. These are not where the 
better--these are not where the bottlenecks are. Obviously 
bottlenecks are somewhere up or down the stream somewhere, not 
in those little transactions. That is----
    Mr. Van Orden. Sir, I guarantee you, I guarantee you, if we 
had open kimono with your stuff that I could figure this 
problem out in an afternoon, like line and block chart, 
disabled veteran, vendor payment. That is all we are talking 
about. This is bananas.
    I am going to say this again. The Veterans Affairs--or I am 
going to say it, the Veterans Affairs Administration is not a 
jobs program. It is not. Neither is the military. If we have 
nine bosses, Bob, you know, that is a problem. We have to look 
at the structure of the VA through the lens of getting that 
Marine what he needs, not you or you or you.
    Are individual projects capped, like a home? Is there a 
financial cap?
    Mr. Latona. Each grant program has its own maximum grant 
amount available. For specially adapted housing, it is $121,000 
this year.
    Mr. Van Orden. Per home?
    Mr. Latona. Yes.
    Mr. Van Orden. What about for a vehicle?
    Mr. Latona. I would defer to Dr. Scholten on that.
    Dr. Scholten. There is no cap on the vehicle modifications. 
It is based specifically on the required adaptations in the 
prescription from the driver rehab specialist.
    Mr. Van Orden. Okay. Riffing off Mr. Barrett's comments 
about inflation and whatnot, when was that cap of $120,000 per 
unit established?
    Mr. Latona. October 1st. Each year we have the ability to 
raise it based upon the Cost of Construction Index.
    Mr. Van Orden. What was it last October?
    Mr. Latona. A hundred and 17 thousand.
    Mr. Van Orden. You raised it 3,000 bucks.
    Mr. Latona. It is based upon an index, an industry index, 
right.
    Mr. Van Orden. Even though housing costs and construction 
costs have increased by like 30 to 40 percent in the last few 
years. Okay. We need to really look at that. Like, who said you 
are going to use the Consumer Price Index? Is that us or you?
    Dr. Scholten. For the vehicle modifications, that is in our 
regulations.
    Mr. Van Orden. You did that. What about for the homes?
    Mr. Latona. For the homes, the statute directs we use a 
Cost of Construction Index.
    Mr. Van Orden. Right.
    Mr. Latona. We selected the one that we are currently using 
because it was the most competitive.
    Mr. Van Orden. It is not tied to inflation.
    Mr. Latona. Right. It is tied to the cost of materials and 
labor across the country.
    Mr. Van Orden. Okay.
    Mr. Latona. By a third party.
    Mr. Van Orden. Check. I want to see that on paper. I want 
to see that on paper, either yours or ours or whatever. Let us 
fix this.
    Okay. Well, my time has expired. I would like to yield to 
Ranking Member Pappas if he has any closing statements, sir.
    Mr. Pappas. No, I am good. Thank you.
    Mr. Van Orden. Yes, I mean, for this panel, obviously.
    Okay. Well, here is what I am going to tell you. We got to 
do better. These things are--and listen, I am looking in the 
mirror, too. I should have figured out this TAP thing, you 
know, 2 years ago. That is a U.S. Department of Defense (DOD) 
issue. That is clear. Somebody who has been working or a group 
of people for collectively 60 years should have been like, hey, 
Congresspeople, you know, we cannot get the word out. That is 
on me, too. I am not just--I am pointing two fingers, you know, 
one at you and one at me.
    I want you just to--I want you to hyper focus on these 
issues because all of these problems are fixable. If we are 
not--the status quo is not acceptable. Our wounded veterans are 
trapped in a chair for the rest of their lives. You know what I 
mean? They cannot speak, they cannot see, they cannot walk. 
They are grotesquely disfigured, you know, by burns and they 
cannot move well, and they are having mental health issues. All 
of this is about them. I really want you guys to do some soul 
searching and figure out how to do this better, establish 
metrics. I mean, do you guys any--do you have any quantifiable 
metric at all for anything you are doing? You do?
    Mr. Latona. Yes, sir, we do.
    Mr. Van Orden. Okay. I would like to see them.
    All right. With that, thank you very much for your time. I 
appreciate it. You are excused. We are going to empanel our 
second group here.
    This committee will stand adjourned for 10 minutes.
    [Recess.]
    Mr. Van Orden. The committee will come to order.
    On our second panel, we will be hearing from our witnesses. 
The first witness is Mr. Tom Landwermeyer, president and chief 
executive officer at Homes For Our Troops. Our next witness is 
Mr. Mike Owens, Adaptive Support Sports director, Wounded 
Warrior Project. Our third witness is Mr. Craig Schrimsher, 
president of North American Manufacturing, BraunAbility. Our 
final witness is Ms. Julie Howell, my very good friend, 
associate legislative director for Government Relations, 
Paralyzed Veterans of America. I am going to ask you to stand 
and raise your right or left hand, sir.
    [Witnesses sworn.]
    Mr. Van Orden. Let the record reflect that the witnesses 
answered in the affirmative. Please be seated.
    Mr. Landwermeyer, you are now recognized for 5 minutes to 
deliver your testimony.

                 STATEMENT OF TOM LANDWERMEYER

    Mr. Landwermeyer. Thank you, Chairman Van Orden, Ranking 
Member Pappas, and distinguished members of the Veterans' 
Affairs Subcommittee on Economic Opportunity. My sincere thanks 
for granting Homes For Our Troops, or HFOT as we are known, the 
opportunity to testify before the subcommittee to review the VA 
Specially Adapted Housing, Adaptive Automobile and Adaptive 
Sports Programs to help assess how effectively these programs 
serve veterans across the country.
    To date, Homes For Our Troops has built and donated 409 
specially adapted custom homes in 45 states to the most 
severely injured post 9-11 veterans. We currently have 78 
ongoing projects with over 100 veterans in the application 
process. We use the SAH grant eligibility requirements as a 
screening criterion for our program and are quite familiar with 
the SAH program, but are less familiar with the Adaptive 
Automobile and Sports Programs.
    Over the past 20 years, HFOT has developed a close working 
relationship with the VA SAH office to better assist our 
veterans, enjoying a mutually positive and productive working 
relationship. We communicate often with the SAH office as we 
support our veterans and consistently find their personnel to 
be helpful and responsive. When the COVID pandemic restricted 
VA travel, they were open to accepting HFOT staff photos of the 
adaptations in our homes that the SAH office required for their 
approval process, expediting the SAH process for these 
deserving men and women. When Congress was considering the Ryan 
Kules and Paul Benne Specially Adapted Housing Improvement Act, 
we provided feedback from our veterans to our VA SAH contacts.
    Last month, our staff surveyed the veterans in our program 
about their familiarity and experience with the VA Specially 
Adapted Housing, Adaptive Automobile, and Adaptive Sports 
Programs. Testimony today is based on the survey results. While 
our veterans have a basic understanding of the SAH grant and 
eligibility requirements, roughly half of the veterans who 
responded say they have minimal knowledge regarding subsequent 
uses of the grant and specifically how often they can use it 
and how it actually increases annually.
    Half find the application easy to complete, but 20 percent 
find it difficult. Many veterans experience inconsistent 
procedures and approval standards between agents even in the 
same region. Working nationwide, we have found variances in 
procedures and interpretations across regions and agents and 
have provided that feedback to the SAH office.
    About 50 percent of the veterans report being familiar with 
the Adaptive Automobile Grant Program. Nearly 60 percent of our 
veterans polled struggled with the grant application process, 
finding it complex and difficult to understand. There is also 
much confusion concerning if and when a veteran can apply for a 
second grant and how this relates to the VA program that 
provides reimbursement for adaptations to an automobile.
    Nearly 80 percent of our veterans have little to no 
knowledge of the VA Adaptive Sports and Recreation Program or 
its offerings. Of those who actually compete at the national or 
Olympic level, 90 percent stated they were unfamiliar with the 
Olympic Team and Team USA monthly grant stipend. Veterans also 
noted the need for clear eligibility rules and vendor approval 
processes, as well as more flexibility for choosing adaptive 
gear based on their injuries.
    The VA offers many outstanding programs for injured 
veterans. A focus on consistency across the regions and among 
agents, more streamlined and understandable application 
procedures, and creating better awareness about these great 
programs will enhance the VA support to veterans nationwide. We 
are very grateful for our longtime partnership with the VA and 
appreciate all that they and you do for our veterans.
    Mr. Chairman and members of the committee, thank you for 
the opportunity to speak to you today and I look forward to 
your questions.

    [The Prepared Statement Of Tom Landwermeyer Appears In The 
Appendix]

    Mr. Van Orden. The gentleman yields. The chair now 
recognizes Ms. Howell. Oh, I am sorry. The chair now recognizes 
Mr. Owens for 5 minutes to deliver your testimony, sir.

                    STATEMENT OF MIKE OWENS

    Mr. Owens. Thank you. Chairman Van Orden, Ranking Member 
Pappas, and members of subcommittee, again my name is Mike 
Owens and I am the director of Adaptive Sports at Wounded 
Warrior Project and a Marine Corps veteran.
    In 2005, October, while my second deployment to Iraq, I was 
manning the 50-cal on top of a 7-ton when it rolled over. I 
obviously lost my right arm above the elbow and I also 
shattered both of my legs. As an amputee who is dependent on 
prosthetics and adaptive equipment for sport and recreation, I 
bring almost 20 years of personal and professional experience 
on the issue.
    Wounded Warrior Project was founded to serve and empower 
our Nation's heroes and we offer direct programs and services, 
including adaptive sports opportunities, to over 231,000 
registered warriors across the country. Interactions with 
warriors through our programs inform our advocacy before 
Congress here today.
    An amazing example of this is our Soldier Ride program. 
Soldier Ride is a multiday riding event where warriors never 
ride alone. They move forward together as a unit just as they 
did during their military service. We believe anyone can ride 
and we offer the use of hand cycles, recumbent trikes, road 
bikes, and hybrid bicycles. Soldier Ride empowers warriors to 
find solace, healing, and strength through movement. After 
participating in a Soldier Ride event, more than 90 percent of 
warriors report being more confident in themselves and better 
connected to other veterans.
    While a more complete list of our recommendations is 
provided in our written testimony, I would like to focus in on 
a few key areas where we believe that Congress and the VA can 
take action to expand access, promote participation, and better 
serve our veterans.
    First, we believe that Congress should increase the funding 
provided to the Adaptive Sports Grant Program. This grant 
program is vital to nonprofit organizations who provide 
adaptive support opportunities to serve veterans in their 
communities. More specifically, we feel that the amount 
appropriated for the program should be increased to offset the 
recent changes in mandatory spending related to equine-assisted 
therapy. The $16.5 million amount has not been increased since 
Fiscal Year 2016, and new requirements that approximately 30 
percent of that funding be dedicated to equine-assisted therapy 
will reduce grant funds available for organizations that 
provide all other adaptive sports programming.
    We also feel that the administrative cost allowance 
associated with these grants should be on par with other 
Federal grants in order to allow grantees to accommodate more 
veterans and provide more comprehensive adaptive sports 
programming. This change would prevent nonprofit organizations 
from being forced to use limited donor dollars to cover these 
costs.
    Second, Wounded Water Project believes strongly that the VA 
should be able to connect veterans with Adaptive Sports 
Programs regardless of where they live or the nature of their 
disability and be capable of accommodating all veterans who 
wish to attend national VA Adaptive Sports events. In order to 
meet this challenge, we recommend that VA ensure recreational 
therapists capable of accommodating veterans with all types of 
mobility challenges be accessible to all veterans and that VA 
formalize the currently ad hoc position of Adaptive Sports 
coordinator in order to ensure all veterans, regardless of 
where they live, can be connected to Adaptive Sports Programs 
as well as the six VA national events.
    Finally, we encourage Congress and VA to ensure that 
veterans who want to participate in adaptive sports have access 
to both the opportunities and the equipment needed to achieve 
their goals. Regardless of whether a warrior qualifies as a 
member of Team USA's Paralympic team or if they wish simply to 
be able to play basketball with their family in the driveway, 
VA should have the authority and ability to provide them the 
equipment that they need. Those warrior athletes who do seek 
higher levels of competition should be provided with both 
specialized equipment and the funding support to ensure they 
can reach their goals.
    Additionally, we fully support legislative efforts to allow 
participation in the DOD Warrior Games more than the 1 year 
after separation, a change that will not only benefit the 
Warrior Games, but will also provide warriors with a new chance 
to compete.
    In closing, adaptive sports and physical activity help 
veterans transition from surviving to thriving. Participation 
makes them physically stronger, more mentally resilient, and 
more connected to their peers and communities. Research has 
repeatedly shown consistent physical activity decreases stress, 
anxiety, depression, chronic pain, reduces reliance on 
prescription medication. Furthermore, positive improvements are 
seen in mobility, sleep quality, and psychological well-being.
    Adaptive Sports and Recreation for our Nation's wounded 
warriors, it is not simply a nice addition. They are a critical 
element to enhance both the length and quality of their lives. 
Wounded Warrior Project stands ready to assist on these issues 
and any others that may arise.
    Thank you and I look forward to your questions.

    [The Prepared Statement Of Mike Owens Appears In The 
Appendix]

    Mr. Van Orden. The gentleman yields. The written testimony 
of Mr. Landwermeyer and Mr. Owens will be entered into the 
record.
    Mr. Schrimsher, you are now recognized for 5 minutes.

                 STATEMENT OF CRAIG SCHRIMSHER

    Mr. Schrimsher. Thank you, Chairman Van Orden and Ranking 
Member Pappas, members of the committee, and my fellow 
panelists and the Veterans Administration for their commitment 
to work on these important issues. My name is Craig Schrimsher 
and I lead North American Manufacturing for BraunAbility, a 
global leader in wheelchair-accessible vehicles and mobility 
solutions. I oversee domestic production to ensure high 
quality, safe, and accessible products for our customers who 
are Americans with physical disabilities and their caregivers.
    At BraunAbility, we take veterans' mobility issues 
personally as they represent approximately 17 percent of our 
customers. We believe veterans have sacrificed greatly and they 
have earned these benefits. I am here to talk about three key 
issues. First being changes to the accessible vehicle trade in 
policy, which for decades allowed disabled veterans to trade in 
their vehicle every 2 years. Suddenly and without notice, the 
VA recently changed the policy to once every 4 years without 
any announcement. This has the risk of forcing veterans to pay 
significant out-of-pocket costs for mobility.
    Second issue, which we have talked about in detail today, 
are delayed VA payments to mobility dealers. According to the 
National Mobility Dealers Association, in a study of 89 
dealerships, we found $11 million in past due payments with the 
average delay being 186 days. Really encouraging to hear about 
the commitment to work that through IPT in 15 days. Sounds 
great to us.
    Third issue is around an outdated VA price schedule, so we 
appreciate the transparency. The VA for the first time 
published a price schedule listing the amounts that they will 
reimburse for conversions, equipment, and repair, which is 
great. However, it was based on 2021 data and was not published 
until 2024. We missed approximately 3 years of very real 
inflation in the automotive market, which we would anticipate 
just based on average new car prices moved somewhere from 17 to 
19 percent in that period. We urge the VA to accelerate updates 
to this. This is a significant impact to our larger dealer 
network.
    I would say an even larger problem that we would like to 
highlight beyond policy changes and payment delays is really a 
clear lack of empathy and indifference to our veteran customers 
and dealers and their experience in working with the VA. 
Bureaucratic hurdles are expected, but the dismissive attitude 
toward those who have sacrificed so much is simply 
unacceptable. Veterans and their families should not have to 
fight for fair treatment and transparency from the institution 
meant to serve them.
    I want to share a story of a gentleman I connected with 
recently. His name's John Masson. He is a Hoosier. He is from 
Lake Station, Indiana, enlisted in the U.S. Army in 1989. 
Following a family tradition of service, he served 1st Armored 
Division, 82d Airborne Division, Indiana Army National Guard, 
earning the Ranger tab, Green Beret, and Special Forces tab. 
John was deployed multiple times, including for Operations 
Iraqi Freedom, Operations Enduring Freedom, and in 2010, 
severely injured by an Improvised Explosive Device (IED) in 
Kandahar Province.
    He lost both of his legs, his dominant left hand, and 
thankfully survived, thanks to the immediate intervention from 
fellow soldiers. He underwent, like many, extensive 
rehabilitation at Walter Reed Army Medical Center. Retired in 
2012. Now advocates for accessibility with organizations like 
the Gary Sinise Foundation.
    This story we hear about frequently throughout our network. 
When I spoke with John, he was not aware of the changes to the 
trade in policy. It came as a complete surprise to him. I will 
provide a quote from John, his reaction when finding out, 
``There's nothing like making a combat veteran feel their limbs 
and sacrifices were given in vain like stripping away their 
hard-earned benefits and making life more complicated and 
expensive. I thought leaving the VA in tears was behind me.''
    This lack of communication and transparency is a failure in 
how we support those who have sacrificed so much. Moving 
forward, we are encouraged to see reasonable reform, like House 
Bill 1364. We are here to find solutions. We believe veterans 
deserve more than bureaucracy and policy shifts. They deserve 
respect, empathy, and support. We are open to constructive 
discussions to find solutions that benefit our veterans.
    I look forward to answering any questions and working with 
the VA on meaningful change. I have submitted more detailed 
testimony. Thank you.

    [The Prepared Statement Of Craig Schrimsher Appears In The 
Appendix]

    Mr. Van Orden. Thank you, Mr. Schrimsher. The written 
testimony or statement of Mr. Schrimsher will be entered into 
the record.
    Ms. Howell, you are now recognized for 5 minutes to deliver 
your testimony.

                   STATEMENT OF JULIE HOWELL

    Ms. Howell. Chairman Van Orden, Ranking Member Pappas, and 
members of the subcommittee, Paralyzed Veterans of America is 
grateful for the opportunity to testify today about the 
critical role that VA's adaptive programs play in the lives of 
PVA members.
    For almost 80 years, PVA has been a voice for veterans who 
have experienced catastrophic injury or illness. We regularly 
engage with many of the VA programs being discussed today. 
These programs help deliver veterans with catastrophic 
disability--excuse me. These programs help veterans with 
catastrophic disabilities modify their homes, receive adapted 
vehicles, and find camaraderie through adaptive sports, which 
supports them on their journey to find a renewed sense of 
purpose and hope.
    Jason, a Marine Corps veteran and PVA member, recently 
affirmed the role adaptive fitness plays when he said, being 
able to push barriers, that helps people know that there is 
more to life. Adaptive fitness can help save a life. It gives 
you a great sense of purpose.
    Now, I would like to discuss some of the specific VA 
programs that help PVA members and other disabled veterans 
regain their independence. First, VA's home modification 
programs are crucial for veterans with catastrophic 
disabilities. They provide essential support to help them adapt 
their homes to better accommodate their needs. While we 
appreciate the significant improvements Congress has made in 
recent years to the Specially Adapted Housing Grant, we are 
concerned with recent changes to the program's administration 
and that it will make it more difficult to navigate as VA is 
less able to provide veterans with direct support throughout 
the modification process.
    Another essential program is VA's Home Improvements and 
Structural Alterations, or HISA grant. Unfortunately, HISA 
rates have not increased since 2010 despite the cost of 
construction increasing around 50 percent in the same 
timeframe. H.R. 2245, the Autonomy for Disabled Veterans Act, 
and H.R. 3309, the Autonomy for All Disabled Veterans Act, both 
seek to increase the amount available to veterans through the 
HISA grant, while also tying the grant to an inflationary 
index. PVA strongly supports improving this benefit so that it 
more closely aligns with the needs of eligible veterans.
    Second, the Automobile Adaptive Equipment, or AAE, Program 
exists to increase access to safe and reliable transportation 
for service-connected, catastrophically disabled veterans. 
Recent regulatory and policy changes made by VA have created 
barriers for some PVA members. As an example, current law 
states that adaptive equipment includes but is not limited to 
power steering, power brakes, air conditioning, and other 
features. However, in 2024, VA issued a final rule which 
basically ignores the statutory requirements enlist these items 
at a reimbursement rate of $0. The Department has effectively 
made it impossible for veterans to be reimbursed for these 
necessary features, creating significant roadblocks and 
increasing the financial burden faced by disabled veterans.
    VA lacks the authority to implement a final rule that is 
counter to the statutory requirement for the delivery of this 
benefit, and veterans often appeal these decisions, which are 
consistently reversed by the Board of Veteran Appeals. It is a 
waste of taxpayer dollars to deny veterans their earned 
benefits, which then requires them to file an appeal.
    Finally, many of our members find camaraderie and community 
thanks to adaptive sports. For example, the VA's Adaptive Sport 
Grant helps allow PVA to host more than 60 free year-round 
Adaptive Sport and Recreation events across the country, which 
provide an opportunity for PVA members to explore adaptive 
sports and find new path passions. For many veterans, their 
introduction to adaptive sports is a direct result of VA--
excuse me, of VA rehabilitation programs facilitated by 
recreational therapists. VA rec therapists provide direct care 
to veterans and help them bridge the gap between clinical 
rehabilitation and community reintegration, which le which 
leads to decreased suicidal ideation and improved clinical 
outcomes. VA must prioritize and protect recreational 
therapists as they have done with other direct care provide 
providers.
    Funding for adaptive sports as well as ensuring access to 
recreational therapists are essential in upholding the promise 
made to our Nation's veterans that we will care for them after 
their service and their sacrifice. More than 50 years ago, a 
PVA president testified before the Senate Veteran Affairs 
Committee on the importance of adaptive sports and rec 
therapists. He said, for the average person this is of no 
consequence, but to a man who has recently suffered an injury 
is to make him question the value of life, the result can be 
more crippling than their paralysis.
    It is a proven fact that the greatest number of failures in 
rehabilitating a person occur in the evening hours and on 
weekends when they are away from work. It seems senseless to 
throw away the efforts, money and most important, that 
individual's life because of the failure to teach that person 
how to cope with their leisure time. This statement remains as 
true today as it was then. Catastrophically disabled veterans 
deserve no less.
    Thank you for allowing PVA to testify at today's hearing 
and I welcome any questions you may have.

    [The Prepared Statement Of Julie Howell Appears In The 
Appendix]

    Mr. Van Orden. Thank you, Ms. Howell. Ms. Howell's written 
statement will be entered into the record.
    We are going to proceed to questioning now. I recognize 
Ranking Member Pappas for 5 minutes.
    Mr. Pappas. Thanks very much. I appreciate all of your 
testimony and the way that you and your organizations stand up 
for veterans each and every day. I am really grateful for the 
work that you do and I think you gave us a good roadmap of how 
we can help make sure that our veterans and their service are 
honored and that we are improving the kind of coordination that 
sometimes sees a breakdown over at VA in terms of 
communication, transparency and some of the other ideas that 
you all put on the table.
    Ms. Howell, if I can start with you. I appreciate you 
highlighting sports at the end of your testimony. I have got an 
organization in my State, Northeast Passage, that does a great 
job offering veterans and servicemembers access to sports and 
recreation. You talked a little bit about barriers. I am 
wondering if you can highlight those as they pertain to sports. 
What are some ways that we can encourage and identify this as 
an opportunity for more veterans to pursue?
    Ms. Howell. Thank you for that question, sir. I think as 
has been highlighted by several people today, a big barrier is 
understanding and even knowing about a program. Most of PVA's 
events are in partnership with chapters, so they are within or 
near hubs where we have a high member population. Many of our 
members were introduced to adaptive sports through their rec 
therapist, which is a direct provider in their delivery of care 
team through a spinal cord injury center.
    I think as many efforts are made from the top down, there 
is going to be breakdowns in that communication flow. I think 
VA can do better to engage with all of the grant recipients for 
the sport grant program. I think earlier today it was mentioned 
that there is 15,000 organizations that are dedicated to this 
type of work. It is just going to require greater community, 
greater engagement, reaching across maybe more local lines and 
just creating that network so that that awareness and that 
information can be shared.
    Mr. Pappas. Maybe I can open that up to the panel. Whether 
it is sports or other adaptive programs through VA, I am 
wondering if you could give me some observations in terms of 
how VA is doing with outreach and communication, giving 
veterans the information and knowledge that they need about the 
opportunities that are available to them. Mr. Owens.
    Mr. Owens. Yes, sir. Thank you for the question. First of 
all, I will add down in San Antonio area, you know, we are 
definitely blessed. The VA has done an amazing job. As they 
say, if you have been to one VA, you have been to one VA. We 
have great benefits there in Military City, USA, for example, 
access to local parks. We have over 100 miles of concrete path 
that is being built just for people to have access and be--have 
recreation outside.
    There, the benefits that we see are not always the case, 
especially for those individuals that End of Active Service 
(EAS) and get out of the service and go back home to the middle 
of nowhere. Maybe they are 3, 4 hours away from the closest VA 
and that means they have almost no resources available in their 
local area. We have seen that many times.
    Additionally, in the program that I mentioned within 
Soldier Ride, we have seen on multiple occasions almost every 
event, at least one veteran that attends that would benefit 
from the adaptive equipment and it could definitely be used to 
improve their mobility, their pain, reduce pain, all of that, 
but they do not meet the eligibility requirements to receive 
that equipment through the VA.
    Mr. Pappas. Thank you. Anyone else? Mr. Schrimsher.
    Mr. Schrimsher. Thank you. I would just highlight that we 
have a decades-long precedent for a trade-in policy that is 
written pretty plainly in policy that changed suddenly. You 
know, when I think of communication, and we are hearing this 
frequently, we have Vietnam veterans that have been in the 
trade cycle every 2 years for decades, finding out from their 
dealerships that they no longer qualify. I want to underline, 
there are a lot of great people in the VA that mean well and 
are doing great things. Right? This is an example of some 
recent changes that are really, really impacting and surprising 
veterans, and we just do not think that should be the case.
    Mr. Pappas. Thank you. Mr. Landwermeyer.
    Mr. Landwermeyer. Thank you, sir. Sir, about 70 percent of 
the veterans that come to us annually already have their SAH 
grant eligibility figured out. They have already applied, been 
approved. About 30 percent have either been denied or do not 
know how to do it, and we will help them. Again, quite a few 
already know about it when they come to us.
    Mr. Pappas. Thank you. Ms. Howell, maybe in the time I have 
left, you mentioned need to protect recreational therapists. 
Could you expound on that a little bit?
    Ms. Howell. Yes, sir. Thank you. As far as we are aware, 
recreational therapists are not on the exempt list for 
retaining VA staff. We believe that as a direct care provider 
and as a critical component of a care team for a 
catastrophically disabled veteran that they should be added to 
that exempt list.
    Mr. Pappas. Thank you. I yield back.
    Mr. Van Orden. The gentleman yields back.
    The chair now recognizes Mr. Barrett for 5 minutes.
    Mr. Barrett. Thank you, Mr. Chairman. Appreciate it and 
appreciate each of you and the work that you are doing to move 
forward with our veterans in a really meaningful way. Thank you 
all for being here.
    Ms. Howell, special appreciation for you. I know you were 
very helpful in the ASSIST Act, and we were able to get that 
through the House earlier this week. Genuinely appreciate your 
work in crafting that bill and adding improvements to it along 
the way. Thank you for that.
    Mr. Schrimsher, had a question for you. I know you have 
brought the issue before the committee about payment and prompt 
payment from the VA and what that has looked like and how that 
has affected local dealers and others that are, you know, 
rendering these vehicles for veterans and how that can affect 
them. I looked at the list that you provided of past due 
payments, and, you know, many of--frankly, all of them are 
concerning and some of them are deeply concerning with the 
amount of time, more than a year in some instances, more than 2 
years in other instances.
    Can you help me understand what is the industry standards? 
Outside of the VA, I am sure your company provides vehicles for 
others in a lack of mobility condition as well, what is the 
current, you know, kind of industry standard for payment?
    Mr. Schrimsher. Thank you, Congressman Barrett, for the 
question. The industry standard for payment, typically in 
private pay is upon delivery.
    Mr. Barrett. Okay.
    Mr. Schrimsher. That is through banking, you know, finance 
typically, or, you know, a check in some cases. Yes.
    Mr. Barrett. Mm-hmm. Let us say a person's insurance, 
whether that is medical or automobile insurance, you know, they 
were catastrophically injured in an automotive accident maybe, 
and their insurance covered that as a benefit. How long would 
that typically take if the person purchasing was not the 
ultimate payer?
    Mr. Schrimsher. I do not have a data point on that handy. I 
could follow up on that, would be glad to. I know that that 
does vary significantly across geographies.
    Mr. Barrett. Okay. Then payments for adaptive vehicles are, 
I guess, done at the local VA level, not a--there is not like a 
centralized clearinghouse for this. It appears that some 
process quicker. I do not know if they are on the list because 
they have had more adaptive vehicles approved and that is why 
they are on the list or if just some local VAs are quicker than 
others. What is kind of your experience with that?
    Mr. Schrimsher. We would like to understand that as well. 
You know, what we know is that there is consistent variability 
within our dealer network. It is typically known which VAs are 
habitual offenders on late payment.
    Mr. Barrett. Yes.
    Mr. Schrimsher. Right? Yes, lack of consistency across the 
network is a major concern.
    Mr. Barrett. What percent of your business, if you are 
willing to share with us, is VA-related, would you say?
    Mr. Schrimsher. BraunAbility, approximately 17 percent. 
However, I would say within our dealer network it can range 
from 20 to 40 percent, you know, depending on the geography. So 
significant.
    Mr. Barrett. So substantial. Then do you believe it would 
be better or more useful if we did have a centralized, you 
know, processing for rendering payment for these vehicles?
    Mr. Schrimsher. I know that we cut cars in half and put 
them back together in 3 days. You know, anything that would 
drive an improvement from this 189-day average would be 
welcomed. Consistency across the network would be appreciated.
    Mr. Barrett. Sure, yes. If you can make the car in a few 
days, we should not take, you know, 100 times that amount to 
get the payment through to you. Okay, I do appreciate that. As 
I know you can tell from the committee testimony today, this is 
something we want to really genuinely work on, so.
    Mr. Schrimsher. Thank you
    Mr. Barrett. Again, appreciate each of you for being here 
and the work that you are doing.
    With that, Mr. Chairman, I yield back.
    Mr. Van Orden. The gentleman yields back. I recognize 
myself for 5 minutes.
    I tell you what, I have been getting progressively angrier 
as these hearings are going on because this is just completely 
unacceptable. There is no other way to describe this. It is 
unacceptable. You are never getting your arm back, Marine. For 
a bureaucrat to, you know, blow that off is not okay.
    My veterans are not beggars and they will not be treated as 
such. Hey, Dutch, that is--Schrimsher, that is my personal cell 
phone number. You give it to that Green Beret, tell him to call 
me. If he ever has another issue with the VA, I swear to God, I 
will go down there and strangle somebody.
    Mr. Schrimsher. Thank you.
    Mr. Van Orden. You are welcome.
    Good. On that note, Mr. Owens, when is this next Soldiers 
Ride, and where is it?
    Mr. Owens. Actually, we have them all over the Nation. The 
next one would--I think they just had DC and the next one that 
they will be having is Chicago.
    Mr. Van Orden. Okay. Well, I know the vice chairman of the 
congressional Motorcycle Caucus. His name is Van Orden. I do 
not know why I have not got an invite yet, buddy, but that 
better happen. Is that clear?
    Mr. Owens. Yes, sir.
    Mr. Van Orden. Okay. I got a bike here. I do not have a car 
in DC, man. I will go real heavy with you cats. That is really 
important.
    You have been involved in the VA system for quite a while, 
since 2005. Got blown up outside of Balad, you know, rolled 
over and stuff. Have you seen an increase--I would like to have 
some positive things here. Have you seen an increase in the 
VA's delivery of services, availability of services?
    Mr. Owens. Yes, 100 percent. They have done an amazing job 
over the years to improve the care, access to care, and the 
opportunities or options available. I will say, I am in 
Military City, USA. There is a lot of resources in that area, 
so----
    Mr. Van Orden. Right.
    Mr. Owens [continuing]. it is definitely not the same 
across the board.
    Mr. Van Orden. Okay. Ms. Howell, you said recent changes to 
policy or recent policy changes, 2024, in reference to the 
ability to deliver care through the VA, is that correct?
    Ms. Howell. Sir, the policy change that I mentioned was an 
internal policy decision made by VA when it comes to what the 
reimbursement rate is when it comes to certain features of a 
vehicle.
    Mr. Van Orden. Okay. The Board of Veterans Appeals, where 
do they reside?
    Ms. Howell. Down the street.
    Mr. Van Orden. What is that?
    Ms. Howell. Down the street.
    Mr. Van Orden. Okay. I would like to maybe pay him a visit 
and see what their rate of refusing claims is.
    Ms. Howell. Sir, if I may.
    Mr. Van Orden. Yes.
    Ms. Howell. No. The VA denies the reimbursement rate, at 
which point the veteran files the appeal to the Board. The 
Board overturns that denial.
    Mr. Van Orden. They are a force for good or a force for 
bad?
    Ms. Howell. When it comes to the reimbursement schedule 
rating, they are a force for good.
    Mr. Van Orden. Well, then I would like to go see him and 
bring them a cup of coffee then. That would be wonderful, too. 
Good news story. Thank you for that.
    Mr. Landwermeyer, you said that you provide feedback to the 
SAH office. How responsive have they been to you?
    Mr. Landwermeyer. Thank you, sir. Actually, pretty 
responsive, sir. As I mentioned, COVID, they were not able to 
travel. The agents were not able to travel, go out and inspect 
our homes.
    Mr. Van Orden. Yes.
    Mr. Landwermeyer. We offered to take photos and ship those 
back in, and they took those. Then we also were able to call 
them up at any time. We have, usually probably twice a year, 
Zoom calls with the leadership of the SAH branch. We can give 
them the pluses and minuses, good, bad, and ugly that we have 
been running up against as we go through the process. Some 
regions do really well, others are not quite as fast. Then 
sometimes within regions, you have fast ones and slow ones. We 
do provide them all that feedback.
    Mr. Van Orden. Okay. That is another good news story.
    Mr. Schrimsher, so for a domestic powered side-entry in-
floor vehicles, $39,498, it should be $46,212. Structurally 
modified pickup truck, $38,601. It should be $45,163. 
Wheelchair back-lift, 6,819 bucks, would be $7,980.
    Hey, so check it out. What you guys witnessed without 
knowing it was bipartisanship taking place because me and Chris 
just hatched a plan to fix this. We are going to write some 
legislation to catch you guys up. That will be--we will 
introduce it together. It will be a bipartisan effort because 
this, again, is wholly unacceptable.
    Last thing, my time has expired, so I am going to recognize 
the ranking member for any closing statements he may have.
    Mr. Pappas. Well, thank you, Mr. Chairman, for holding this 
session. I want to thank our panel for their contributions to 
this conversation. Clearly, we have got a lot of work to do on 
the legislative front to make sure that we are improving 
eligibility, that we are increasing funding, that we are 
ultimately optimizing the delivery of programs that serve our 
veteran communities. Really grateful for the feedback that you 
have presented us with today. I think we have got some good, 
clear action items that are going to come out of this hearing.
    I yield back.
    Mr. Van Orden. The gentleman yields back.
    I just want to say a couple things before we are out of 
here. Look, I get letters from the VA all the time. I am 100 
percent service-connected disabled vet. You can sign up for 
emails, they call you. Right? Why in the hell do our disabled 
veterans not know about these programs? We know where they all 
are, sir and ma'am. Sitting in the third row back there, we 
know where they are. We know their names, we know their 
addresses. We know their email addresses. We know their phone 
numbers. For a single disabled veteran to not know that these 
programs exist or that you can get reimbursed, you can do 
trade-in, and stuff like that is just stupid.
    It is 2025. We know where all of these people are. We 
literally can assign a geographic point to their house. I am 
making the strongest recommendation possible to fix this 
problem. Fix it. Email them, write them, and call them. You 
know what their disability rating is. You know where they live.
    No more we are going to talk about this. We are excited 
about that. We are having a planning session on this. We are 
going to write their moms and--call them. Stop it. I guarantee 
you the Secretary is either unaware of this or he does not 
understand how large this problem is. We operate on scale. The 
scale for a veteran not knowing about this is one, it is not 
two, it is not five, it is one. If one of my veterans who got 
blown up overseas or, God forbid, something else happened to 
him does not know about this, it is your fault. It is. Fix it.
    I want to thank you all for coming. I do, all of you. I 
want to thank you, Mr. Owens, for your continued sacrifice to 
our country. I want to thank--are you married?
    Mr. Owens. Yes, sir.
    Mr. Van Orden. How is she doing?
    Mr. Owens. Oh, she is doing great.
    Mr. Van Orden. All right.
    Mr. Owens. Been with me through everything.
    Mr. Van Orden. All right, that is cool. That is wonderful 
to hear. Well, we are going to keep working together. You just 
figured out. I mean, we literally just hatched a plan to help 
fix this. That is what we are going to do. We will continue to 
consult with the Veterans Affairs Administration. I am glad we 
got some really good, good news stories out of the VA because I 
love the VA. I mean, I love the VA. It is very simple.
    With that, I would like to ask unanimous consent that all 
members only have 5 days, legislative days, to revise and 
extend the remarks and include any extraneous materials. 
Without objection, so ordered.
    This hearing is adjourned.
    [Whereupon, at 12:23 p.m., the subcommittee was adjourned.]
     
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                         A  P  P  E  N  D  I  X

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                    Prepared Statements of Witnesses

                              ----------                              


                  Prepared Statement of Rachel McArdle

    Chairman Van Orden, Ranking Member Pappas, and other members of the 
Subcommittee, thank you for the opportunity to appear before you today 
to discuss how VA fulfills the Nation's promise to care for Veterans 
through the administration of adaptive programs. To maximize Veteran 
independence when performing daily tasks or participating in 
therapeutic activities, VA provides Specially Adapted Housing (SAH) 
assistance, Home Improvements and Structural Alterations (HISA) 
benefits, Automobile Adaptive Equipment (AAE), and the Adaptive Sports 
Grant Program (ASGP). Joining me today is Dr. Joel Scholten, Executive 
Director, Physical Medicine and Rehabilitation Service, and Jason 
Latona, Assistant Director, Loan Guaranty Service, Veterans Benefits 
Administration.

SAH Grant Program

    The SAH grant program administers several types of grants for 
eligible Veterans and Service members under 38 U.S.C. Ch. 21. The 
program assists eligible individuals in acquiring adapted housing made 
necessary by their service-connected disability. VA also provides SAH 
assistance if an adapted home has been destroyed or significantly 
damaged by a natural disaster.
    VA's approach to the SAH grant program is individualized. Congress 
set the maximum aggregate amount of assistance for each grant type and 
directed VA to adjust these amounts annually in accordance with 
increases in the residential home cost-of-construction index. An 
assigned VA SAH agent guides the eligible individual and their family 
through the home adaptation process to meet the individual's unique 
needs. The individual ultimately contracts with the builders of their 
choice, and SAH grant program staff use their expertise in home 
adaptations to ensure the-project is completed and is consistent with 
applicable statutes and the individual's adaptive housing needs.
    The SAH grant program has approved more than 2,000 grant awards 
annually for 6 of the last 7 fiscal years (FY). VA anticipates similar 
or higher usage levels in the future. As of the end of March, 1,643 SAH 
grants have been approved $ 85 million in Fiscal Year 2025.

Improving Benefits Delivery through Modernization

    To continue delivering world-class customer service to Veterans and 
Service members, VA has initiated a multi-year project to modernize the 
SAH case management system. The modernized system will use automation 
to streamline the delivery of benefits to eligible individuals. The 
upgraded tool will also improve VA oversight by allowing for enhanced 
monitoring of the grant process from initial application to compliance 
inspection upon completion of work. The implementation of the 
modernized SAHSHA system will be conducted in phases; the first phase 
is expected to begin in July 2025.

Eliminating Fraud, Waste, and Abuse

    The individualized attention given to each SAH grantee ensures 
there is a high degree of oversight on each award. In Fiscal Year 2020, 
VA implemented a new financial process to manage SAH grant program 
disbursements using centralized VA financial staff, rather than third-
party escrow agents. This change strengthened VA's internal controls 
and improved overall project management capabilities for SAH grant 
program staff. These oversight measures resulted in improved home 
adaptation delivery and payment timelines, reducing overall project 
timelines by days or weeks, and eased Veteran financial burdens by 
eliminating a third-party escrow fee of approximately $500 per project.

Home Improvements and Structural Alterations

    The VA HISA benefit, under 38 U.S.C. Sec.  1717, provides financial 
assistance to disabled Veterans eligible for medical services under 38 
U.S.C. Sec.  1710(a) who require modifications to their primary 
residence. Service members undergoing medical discharge from the Armed 
Forces for a permanent disability that was incurred or aggravated in 
the line of duty in the active military, naval, air, or space service 
are also eligible for the HISA benefit. HISA projects are prescribed by 
a VHA clinician and medically justified based on the Veteran or Service 
member's clinical needs that support the type of home improvement or 
structural alterations being prescribed. These medically necessary 
improvements or structural alterations allow for continued home health 
treatment of the Veteran or Service member's disability and maximize 
the Veteran's or Service member's access to the home and independence 
while performing daily tasks within their homes. HISA benefits and 
lifetime payments are approved and processed in accordance with 38 
C.F.R. Sec. Sec.  17.3100 through 17.3130.

Automobile Adaptive Equipment Benefit

    The VA AAE program, under the authority of 38 U.S.C. Sec. Sec.  
3901-3903 and 38 C.F.R. Sec. Sec.  17.155-17.159, reimburses or pays 
for adaptive equipment for eligible Veterans and active-duty members of 
the Armed Forces who have certain disabilities. AAE is prescribed by a 
VHA physician or Certified Drivers Rehabilitation Specialist. VA is 
authorized to prescribe and reimburse or pay for operational and non-
operational equipment, but VA does not modify, install, repair, or 
replace the AAE. VA works directly with AAE dealers, modifiers, and 
alterers to ensure all prescribed, necessary adaptive equipment enable 
the Veteran to safely drive or ride as a passenger in their personal 
vehicles. Examples of AAE include low-effort or sensitized steering; 
electronic accelerator and brakes; mechanical hand controls for 
accelerator and brakes; wheelchair tie downs; vehicle lifts; tilt 
steering wheels; voice command systems; raised roofs and doors; and 
tinted windows for burn injury disabilities. In Fiscal Year 2025 
through March 31, 2025, VA has provided AAE to 1,181 Veterans. The 
total value of that benefit is $31,928,405, and the average award is 
$27,035.

ASGP

    VA also manages the ASGP, which provides Veterans and members of 
the Armed Forces with disabilities access to sports and equine therapy 
to encourage a healthy and active lifestyle. As provided by 38 C.F.R. 
Part 77, VA awards grants to non-Federal Government entities with 
significant experience in managing a large-scale adaptive sport 
program. In Fiscal Year 2024, VA's ASGP awarded 91 individual grants, 
totaling $15.9 million in awarded funds. Organizations funded through 
VA's ASGP currently provide resources for more than 15,000 Veterans and 
members of the Armed Forces.

Conclusion

    In conclusion, VA will continue to provide the Nation's Veterans 
with efficient, effective, and meaningful programs centered on meeting 
their adaptive needs. Thank you for your continued support of our 
programs and for this opportunity to speak today. This concludes my 
testimony, and we welcome any questions that you or other Members of 
the Subcommittee may have.

                                 

                 Prepared Statement of Tom Landwermeyer

    Chairman Van Orden, Ranking Member Pappas, and distinguished 
members of the Veterans' Affairs Subcommittee on Economic Opportunity, 
my sincere thanks for granting Homes For Our Troops, or HFOT, the 
opportunity to testify before the subcommittee to review the VA's 
Specially Adapted Housing, Adaptive Automobile, and Adaptive Sports 
Programs, to help assess how effectively these programs serve Veterans 
across the country.
    To date, Homes For Our Troops has built and donated 409 specially 
adapted custom homes in 45 states to the most severely injured post-9/
11 Veterans. We currently have 78 ongoing projects, with over 100 
Veterans in the application process. We use the SAH grant eligibility 
requirements as a screening criterion for our program, and are quite 
familiar with the VA's SAH grant program, but are less familiar with 
the adaptive automobile and sports programs.
    Over the past 20 years, HFOT has developed a close working 
relationship with the VA SAH office to better assist our Veterans, 
enjoying a mutually positive and productive working relationship. We 
communicate often with the SAH office as we support our Veterans and 
consistently find their personnel to be helpful and responsive. When 
the COVID pandemic restricted VA travel, they were open to accepting 
HFOT staff photos of the adaptations in our homes that the SAH office 
required for their approval process, expediting the SAH process for 
these deserving men and women. When Congress was considering the Ryan 
Kules and Paul Benne Specially Adaptive Housing Improvement Act, we 
provided feedback from our Veterans to our VA SAH points of contact.
    Last month, our staff surveyed the veterans in our program about 
their familiarity and experience with the VA's Specially Adapted 
Housing, Adaptive Automobile, and Adaptive Sports Programs. Our 
testimony today is based on these survey results.
    While our Veterans have a basic understanding of the SAH grant and 
eligibility requirements, roughly half of the Veterans who responded 
say they have minimal knowledge regarding subsequent uses, and 
specifically how often they can use it and how it increases annually. 
Half find the application easy to complete, with 20 percent finding it 
difficult. Many Veterans experienced inconsistent procedures and 
approval standards between agents, even in the same Region. Working 
nationwide, HFOT has found variances in procedures and interpretations 
across regions and agents, and has provided that feedback to the SAH 
office.
    About 50 percent of the Veterans report being familiar with the 
Adaptive Automobile grant program. Nearly 60 percent of Veterans polled 
struggled with the vehicle-grant application process, finding it 
complex and difficult to understand. There is also much confusion 
concerning if and when a Veteran can apply for a second grant, and how 
this relates to the VA program that provides reimbursement for 
adaptations to an automobile.
    Nearly 80 percent of our veterans have little to no knowledge of 
the VA Adaptive Sports and Recreation program or its offerings. Of 
those who actually compete at the national or Olympic level, 90 percent 
stated they were unfamiliar with the Olympic Team and Team USA monthly 
grant stipend. Veterans also noted the need for clearer eligibility 
rules and vendor approval processes, as well as more flexibility for 
choosing adaptive gear based on their injuries.
    The VA offers many outstanding programs for injured veterans. A 
focus on consistency across the regions and among agents, more 
streamlined and understandable application procedures, and creating 
better awareness about these great programs will enhance the VA's 
support to veterans nationwide.
    We are grateful for our long-time partnership with the VA, and 
appreciate all that they and you do for our veterans. Mr. Chairman and 
members of the committee, thank you for the opportunity to speak to you 
today, and I look forward to your questions.

                    Prepared Statement of Mike Owens
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

                 Prepared Statement of Craig Schrimsher

Introduction

    On behalf of BraunAbility, I would like to thank Chair Van Orden, 
Ranking Member Pappas, and all the members of the House of 
Representatives Veterans' Affairs Subcommittee on Economic Opportunity 
for the opportunity to testify today. My name is Craig Schrimsher, and 
I lead North American Manufacturing at BraunAbility, the global leader 
in wheelchair-accessible vehicles and mobility solutions, overseeing 
domestic production to ensure top-tier product quality, safety, and 
accessibility for our customers, Americans with physical disabilities 
and those who care for them.

Supporting VA's Mission to Serve Veterans

    BraunAbility seeks to support the United States Department of 
Veterans Affairs' (``VA'') mission to care for those who have served in 
our Nation's military and for their families, caregivers, and 
survivors. BraunAbility and our network of mobility dealers bring 
independence and mobility freedom to people with physical disabilities 
and their caregivers. The Adaptive Automobile Equipment (``AAE'') 
program, which BraunAbility actively supports, provides disabled 
veterans and their caregivers with the adaptive equipment necessary for 
a veteran to access and operate a vehicle, or to have someone operate 
the vehicle for them.
    Larry Dodson, a Vietnam War veteran, sustained a spinal cord injury 
in 1974 that drastically changed his life. When he finally purchased 
his first accessible van, he said, ``Getting that freedom of 
transportation was invaluable.'' It restored a sense of independence 
and dignity during a period in his life marked by despair and 
hopelessness. He went on to own six more BraunAbility vans. He later 
dedicated his career to the Paralyzed Veterans of America (``PVA''), 
advocating for fellow veterans, helping them reclaim their mobility, 
and ensuring they receive the care and benefits they deserve. Of his 
career with the PVA he said, ``As long as I can, I will help.''
    A core part of BraunAbility's mission is to help VA do the same for 
our Nation's veterans. In Mr. Dodson's case and others, our products 
and services keep veterans connected to their families, their careers, 
and their communities. However, recent policy changes and ongoing 
challenges within VA threaten disabled veterans' independence and sense 
of purpose by imposing undue financial and personal hardship. This 
document outlines the challenges presented by certain VA policies and 
calls for necessary reforms, including the restoration of fair trade-in 
policies, timely reimbursements, and updated adaptive equipment 
pricing. By surfacing these issues, BraunAbility seeks to protect 
veterans' mobility rights and advocate for sustainable solutions that 
uphold their dignity and autonomy. Before discussing the AAE program in 
greater depth, I would like to provide some background on BraunAbility.

Ralph Braun: A Legacy of Innovation and Independence

    BraunAbility was built on a commitment to reliable, accessible 
transportation for people with mobility challenges. That mission 
started with our founder, Ralph Braun, who was diagnosed with muscular 
dystrophy as a child. Determined to navigate a world not built for him, 
with his father's help, he created the first battery-powered 
wheelchair--an innovation that launched a lifetime of mobility 
solutions. Eventually, he made a massive breakthrough, designing and 
producing the first wheelchair-accessible vehicle, which changed the 
future for people with physical disabilities. Ralph's vision led to the 
creation of The Braun Corporation. Veterans have been an essential part 
of BraunAbility's story since the beginning. Among Ralph's first 
customers were Vietnam War veterans facing an uncertain road ahead and 
significant mobility challenges resulting from their service. 
Understanding their struggles firsthand, Ralph focused on solutions 
that restored their independence, revolutionizing the adaptive vehicle 
industry and establishing BraunAbility as a global leader in 
accessibility.
    BraunAbility continues Ralph Braun's mission of expanding mobility 
access. For over 50 years, his legacy has fueled the development of 
wheelchair-accessible vans, SUVs, lifts, and adaptive seating, 
transforming the lives of more than a million customers. Today, 
BraunAbility supports over 2,000 American jobs, with its products 
available in more than 50 countries across six continents. Veterans 
remain central to BraunAbility's mission, making up approximately 17 
percent of its customers. In 2024 alone, thousands of veterans regained 
mobility by using BraunAbility's accessible vehicles. These veterans 
deserve policies that respect their service and ensure they have access 
to the mobility products they need to preserve their independence.

Addressing Adaptive Equipment Policy

`Two in Four' Adaptive Equipment Trade-In Policy

    The Automobile Adaptive Equipment policy, encoded at section 
3902(b) of Title 38, United States Code (U.S.C.), requires VA to 
provide eligible veterans with ``the adaptive equipment deemed 
necessary to insure [sic] that the eligible person will be able to 
operate [an] automobile or other conveyance.'' VA implements this 
policy at 38 CFR sections 17.155-17.159. The term `adaptive equipment' 
can cover a wide range of medically necessary vehicle modifications, 
including lowered vehicle floors, mobility device lifts, ramps, and 
kneeling systems, among other modifications. Adaptive equipment 
modifications can increase the cost of a vehicle by thousands or tens 
of thousands of dollars. Without VA covering this cost, it would be 
impossible for many veterans to afford this life-altering equipment.
    Under the AAE program, VA reimburses the eligible veteran or 
registered provider for a sizable portion of the veteran's first 
vehicle and any adaptive equipment required for the veteran to operate 
the vehicle. VA also reimburses the eligible veteran or registered 
provider for adaptive equipment for not more than ``two automobiles or 
other conveyances at any one time or during any 4-year period.''
    Until recently, VA interpreted this `two in four' language to mean 
that an eligible veteran could trade in their older vehicle and be 
reimbursed for new adaptive equipment every 2 years. Commonly, VA would 
reimburse a veteran for a new base vehicle and adaptive equipment, the 
veteran would use the vehicle for 2 years, the veteran would trade the 
vehicle in to cover the cost of a new base vehicle, and VA would 
reimburse the veteran for new adaptive equipment for that vehicle. 
After two more years, the veteran would trade in the vehicle again and 
the cycle would repeat.
    This system meant VA reimbursed veterans for new adaptive equipment 
on two automobiles every 4 years, as regulation and statute suggest is 
appropriate. The system created a virtuous cycle. Because (besides the 
first vehicle) VA only covers the cost of new adaptive equipment, not 
the cost of the base vehicle, veterans are on the hook for the cost of 
new vehicles. However, a veteran could trade in their used vehicle 
after 2 years and the trade-in value would offset the cost of a new 
base vehicle while VA would pay for the cost of adaptive equipment. 
This system protected veterans' mobility independence by providing 
access to adapted vehicles for low or no cost.
    Recently, VA changed its interpretation of this policy, resulting 
in significant hardship for veterans. To our knowledge, this change in 
interpretation occurred without any public comment process or public 
notice in the Federal Register. Under the new interpretation, the 
veteran cannot trade in the adapted vehicle until after 4 years, rather 
than after 2 years like before. Because adapted vehicles depreciate 
significantly more quickly than standard vehicles, this policy change 
means that vehicle trade-ins no longer cover the cost of a new vehicle. 
As a result, to access the VA benefit of new adaptive equipment, 
disabled veterans must spend thousands of dollars out of pocket every 4 
years to cover the cost of the base vehicle. Moreover, because the 
warranty on these vehicles is 36 months and adaptive equipment is 
subject to significant wear and tear, veterans often have to pay out of 
pocket to repair their own vehicles. This is a problem that, by 
statute, VA is supposed to resolve.

      Uncertainty in VA Process Blocks Mobility Access--For 
veterans seeking a modified vehicle, securing one isn't just about 
finding the right fit--it's about waiting for VA's approval, a process 
riddled with delays and uncertainty. Without that approval, out-of-
pocket costs remain unknown, leaving veterans stuck in financial limbo. 
Planning becomes nearly impossible. Should they move forward with 
purchasing a vehicle? Can they afford both the conversion and the car 
itself? With no clear answers until the VA's decision arrives, 
everything grinds to a halt. Veterans are forced to navigate layers of 
bureaucracy before they can even begin the process of regaining 
mobility. The recent change in trade-in policy has only exacerbated 
this issue, and the inefficiencies don't stop there. VA's sluggish 
approach to approving quotes creates additional obstacles: veterans 
must wait to see not just what will be approved, but how much they'll 
be expected to cover themselves. Meanwhile, they can't secure financing 
or even hold a vehicle because approved amounts remain in limbo. 
Instead of streamlining the process to support those who need mobility 
solutions, the VA's current system forces veterans into an endless 
waiting game--one that delays independence and leaves them stranded in 
uncertainty.

    Nothing in statute or regulation suggests that there should be a 
requirement to own a vehicle for 4 years before trade-in, yet VA made 
this change that directly harms disabled veterans. The decrease in 
trade-ins also results in fewer used adapted vehicles on the market for 
other non--veteran disabled Americans who cannot afford the cost of a 
new vehicle. VA's policy is putting true mobility and accessibility out 
of reach for tens of thousands of Americans, particularly veterans who 
were wounded in service of their country.
    VA's altered interpretation of the adaptive equipment allowance is 
in direct contradiction with the doctrine of Gardner deference, also 
known as veterans canon. Gardner deference, rooted in the 1994 Supreme 
Court case Brown v. Gardner, holds that in cases of interpretive doubt 
of a statute or regulation, benefits should be resolved in favor of the 
veteran. Applied to adaptive equipment trade-in policy, even if there 
is interpretive doubt in the phrase from 38 USC 3903, ``An eligible 
person shall not be entitled to adaptive equipment under this chapter 
for more than two automobiles or other conveyances at any one time... 
during any 4-year period,'' that doubt should be resolved in favor of 
the veteran.
    VA's new requirement to have owned a vehicle for 4 years before 
being eligible for a trade-in appears nowhere in statute or regulation. 
VA is interpreting this policy in a way that directly harms disabled 
veterans. VA should reinstate its prior policy of allowing trade-ins 
and providing new adaptive equipment after 2 years, as intended in 
statute.

Prompt Payment

    As discussed above, the adaptive equipment allowance policy 
provides veterans with the vehicles and adaptive equipment they need to 
secure mobility independence. In most instances, veterans receive 
adapted vehicles from government-registered dealers. Dealers are then 
reimbursed by VA upon submission of VA Form 10-1394, an itemized 
estimate before work, and an itemized invoice upon completion of work. 
However, according to the National Mobility Equipment Dealers 
Association (NMEDA), there are almost $11 million in payments to 
dealers that are more than 90 days overdue. Many accounts are over 6 
months overdue with some exceeding a year overdue. This is a 
longstanding, persistent problem with no obvious cause----some VA 
locations make regular on-time payments while others have dozens of 
overdue invoices worth hundreds of thousands of dollars.
    These overdue payments cause disabled veterans and mobility dealers 
significant hardship. At any given dealer, roughly 20 to 40 percent of 
their business is with VA. For these dealers, especially small dealers, 
these delays make it difficult to manage operations, invest in new 
technology, or plan for the future. For veterans directly reimbursed by 
VA, these delays mean that they can be out of pocket tens of thousands 
of dollars for months.
    The Prompt Payment Act states at (31 USC Sec.  3903(a)(1)) that the 
required payment date is ``30 days after a proper invoice for the 
amount due is received if a specific payment date is not established by 
contract.'' The Prompt Payment Act also states at (31 USC Sec.  
3903(7)(B)) that ``any invoice determined not to be such a proper 
invoice suitable for payment shall be returned as soon as practicable, 
but not later than 7 days, after receipt, specifying the reasons that 
the invoice is not a proper invoice.'' Taken together, these provisions 
mean that VA is required to pay dealers within 30 days of receiving a 
completed invoice and, in the case of an unsuitable invoice, inform 
dealers of the unsuitable invoice and how to correct it within 7 days 
of receipt.
    BraunAbility's trade association, NMEDA, is currently tracking just 
under $11 million in payments to dealers that are averaging 187 days 
overdue. It should be noted that this data is submitted from 89 of the 
302 NMEDA member locations and is counted once the payments are 60 days 
past due. Submission of the data to NMEDA by its members is voluntary 
so the actual past due total is most likely much higher. This total 
includes not just wheelchair accessible vehicles but adaptive equipment 
and repairs as well. Moreover, to our knowledge, dealers rarely, if 
ever, receive notice from VA within 7 days that an invoice is 
unsuitable. Recently, VA reported that it had only two invoices over 90 
days overdue. We believe that there is a systemic lack of communication 
within VA that results in the agency processing dealers' reimbursement 
invoices with considerable delay. We ask VA to honor its commitment to 
disabled veterans and prioritize prompt reimbursements to veterans and 
dealers for adaptive automotive equipment.

Adaptive Equipment Schedule

    Under VA's recent Adaptive Equipment Allowance rule (RIN: 2900-
AP39), finalized July 17, 2024, VA established the Adaptive Equipment 
Schedule for Automobiles and Other Conveyances (``Schedule''). The 
Schedule is intended to calculate ``the amount of the monetary 
allowance for adaptive equipment based on industry standards and our 
experience administering this program.'' In its rulemaking, VA 
committed to increasing the reimbursement amounts in the Schedule based 
on the Consumer Price Index (CPI) expenditure category for ``motor 
vehicle parts and equipment''.
    In concept, the Schedule should standardize payment and provide a 
fair valuation for adaptive equipment for the future. However, the 
Schedule--published in July 2024--relies on data from 2021, meaning 
that it significantly undervalues the cost of adaptive equipment. 
Adaptive equipment dealers are currently being reimbursed for 
significantly less than fair market value.
    On average, the CPI for ``motor vehicle parts and equipment'' 
suggests that the prices in the Schedule need to be increased by 17 
percent to reflect the true cost of adaptive equipment in 2025. We 
request that VA rely on CPI data to increase the prices reflected in 
the Schedule for every year since 2021, the year data was collected. 
This will ensure that veterans and dealers are properly reimbursed for 
the real cost of adaptive equipment.

      Essential Mobility Upgrades Denied by VA--Some critical 
mobility modifications never make it into VA's Schedule, meaning they 
simply can't be included for financial assistance--regardless of 
necessity. Essential equipment, like reduced effort steering and 
braking, often falls into this gap, forcing veterans to cover 
unexpected costs out-of-pocket. In one case, VA reviewed a conversion 
quote and arbitrarily cut more than half of the proposed expenses. With 
the remaining costs too high to absorb, the mobility dealer couldn't 
bridge the gap, leaving the veteran without crucial modifications. As a 
result, mobility and independence were put on hold--another example of 
how vague policies place veterans in an impossible position between 
what's required and what's approved. One veteran, relying on a 17-year-
old vehicle, required a new rack and pinion system, but VA refused to 
cover backup braking or steering because they weren't listed on the 
initial evaluation form. With costs totaling $21,000, VA only approved 
$6,000, expecting the dealer and veteran to absorb the remaining 
$15,000--an unsustainable request. VA is frequently unwilling to 
accommodate necessary modifications, leaving veterans and providers to 
shoulder unexpected expenses with little regard for their financial 
realities.

    We are deeply concerned with VA's negligence in delivering prompt 
payment and failure to properly account for inflation in the adaptive 
equipment Schedule. Moreover, we disapprove of VA overturning its 
longstanding policy that veterans may trade in their adapted vehicles 
after 2 years and receive new adaptive equipment, a change made without 
any public comment process or official notice. We call on VA to honor 
its commitment to our Nation's wounded heroes: deliver prompt payment 
to adaptive equipment dealers, update the adaptive equipment Schedule 
to ensure proper pricing, and reverse the harmful change to adaptive 
equipment allowance interpretation.

Call to Action: Protect Veterans' Mobility Access 

Addressing Key Policy Challenges

    Mobility equipment manufacturers like BraunAbility play a vital 
role in ensuring veterans and individuals with disabilities maintain 
their independence. Similarly, mobility equipment dealers provide the 
link between manufacturers and disabled veterans. However, current VA 
policies threaten the ability of these businesses to operate and serve 
veterans. Without action, veterans risk losing access to essential 
mobility solutions.
    To strengthen accessibility for veterans, we respectfully request 
the VA take the following steps:

      Restore the previous vehicle trade-in policy, allowing 
disabled veterans to exchange vehicles every 2 years, as originally 
intended in statute. This will ensure access to updated adaptive 
equipment without undue financial hardship.

      Ensure timely reimbursements for adaptive equipment 
dealers by addressing overdue payments and implementing a system for 
prompt future payments.

      Update pricing schedules for adaptive equipment using 
current Consumer Price Index (CPI) data to reflect 2025 costs. Existing 
rates, based on outdated 2021 data, no longer cover actual expenses.

Partnering to Protect Veterans' Mobility Independence

    These actions are necessary to ensure businesses can continue 
providing essential mobility solutions to disabled veterans. 
BraunAbility encourages VA to work with industry partners to address 
these challenges and implement reforms that protect veterans' access to 
independence and mobility.
ADDENDUM / CASE EXAMPLES

    New Conversion, Old Classification--A veteran diagnosed with ALS 
made the decision to--purchase a pre-owned accessible van, which was 
considered a new conversion on a used vehicle. Given the progressive 
nature of ALS, a pre-owned van was a more practical and economical 
option. However, VA classified the entire vehicle as used, even though 
the conversion and modifications were brand new, making them ineligible 
for necessary financial support. As a result, the only options were 
selling the veteran a new van or nothing at all--creating an 
unnecessary financial hurdle for a veteran in need.

    VA Error Leaves Veteran with $70K Bill--A 78-year-old Vietnam 
veteran received a signed 4502 form from the VA, approving mobility 
modifications. The dealer followed every required step--submitting 
quotes, securing authorization, ordering parts, and delivering the 
vehicle. Yet after final paperwork was submitted, the VA suddenly 
reversed its stance, claiming the veteran was ineligible, despite its 
own signed approval. This error led to a denial of payment, leaving the 
veteran burdened with a $70,340.02 bill. To make matters worse, VA 
instructed the dealer to repossess the vehicle, placing the veteran in 
an impossible financial position. Even after admitting the mistake, the 
regional office still refuses to correct it, insisting on repossession. 
This situation exposes serious flaws in VA's approval process, forcing 
veterans and providers to either second-guess every decision or risk 
devastating financial consequences--all because someone checked the 
wrong box.

    New Upgrades, Old Rules--A modified van should provide freedom and 
mobility, but bureaucratic regulations often create unexpected 
barriers. In this case, a veteran purchased a 2022 van for conversion, 
expecting essential modifications to be covered. However, because VA 
classified the vehicle as 3 years old--despite the conversion and 
customizations being brand new--they only agreed to cover 40 percent of 
the quoted cost. With a remaining balance of $60,000, neither the 
veteran nor the dealer could absorb the expense. Previously, the 
veteran had worked through VA to receive a fully covered vehicle. Now, 
needing electronic mobility control (``EMC'') equipment to drive, he 
followed the same process, believing he was taking the right steps. But 
VA policy dictates that when additional equipment is required, the van 
may be categorized as ``used,'' disqualifying the owner from new 
vehicle assistance under the 4-year rule. Even though the modifications 
are brand new, the depreciation rate applied to used conversions often 
makes the final cost unaffordable. The result? A frustrating situation 
where rigid policy trumps practical necessity, leaving veterans and 
dealers to bear the burden with little flexibility or willingness to 
reconsider the individual needs of those affected.

    Red Tape Stalls Veterans' Driving Evaluations--Navigating the VA 
system for a driving evaluation has become an increasingly time-
consuming and frustrating process. Today's process requires an annual 
driver evaluation--but appointment times continue to stretch months 
into the future due to a shortage of evaluators. Once the evaluation is 
completed, a new obstacle arises: the evaluator's report often doesn't 
align with VA's Schedule, triggering a cascade of administrative 
hurdles. Veterans and dealers find themselves stuck in a cycle of 
revision requests, back-and-forth calls with evaluators, appeals to the 
Prosthetics department, and waiting for the Regional Office to reject 
the evaluation--just to start the process over. What once took just 24 
hours for approval can now drag on for weeks, leaving veterans without 
the mobility solutions they need. Further complicating matters, some VA 
offices prohibit dealers from speaking directly to evaluators, instead 
requiring them to go through the Prosthetics department, adding yet 
another layer of delay. This bureaucratic tangle not only postpones 
essential mobility modifications but also forces veterans into an 
exhausting loop where paperwork precision is prioritized over their 
actual needs. The result? Untold delays that keep veterans waiting for 
the independence they deserve.
    Solutions, Not Indifference: A Path for Partnership to Help 
Veterans--Navigating VA's vehicle policies is difficult enough, but the 
real issue is the lack of compassion veterans feel when problems arise. 
Instead of working toward solutions, VA's default response is often 
repossession--forcing the financial burden onto the veteran rather than 
addressing mistakes collaboratively. If a veteran cannot afford a 
necessary expense, the reaction is often dismissive: ``It's not the 
VA's problem.'' Rather than seeking alternative options or helping, the 
solution is simply to deny the sale, leaving veterans stranded without 
mobility or support. When policy takes precedence over people, and 
problem-solving is replaced with indifference, veterans are left 
without the help they need. For many, the VA no longer feels like an 
ally, but an obstacle. As one veteran put it: ``I used to feel like the 
VA took care of their veterans, and now they simply don't care.'' And 
when the VA won't step up, mobility dealers are left scrambling to fill 
the gap, absorbing costs that should never have fallen on their 
shoulders in the first place. Instead, we call on VA to partner with 
BraunAbility, other manufacturers, and adaptive equipment dealers to 
help veterans in need. BraunAbility believes strongly in VA's mission 
to care for former servicemembers, and we believe that with the right 
reforms, we can ensure that every disabled veteran secures mobility 
freedom.

                                 

                   Prepared Statement of Julie Howell

    Chairman Van Orden, Ranking Member Pappas, and members of the 
subcommittee, Paralyzed Veterans of America (PVA) appreciates the 
opportunity to testify on VA's adaptive programs, which are critical 
for disabled veterans, especially PVA members - veterans who have 
acquired a spinal cord injury or disorder (SCI/D). For almost 80 years, 
PVA has been a voice for thousands of veterans who experienced 
catastrophic injury or illness, ensuring that the Department of Veteran 
Affairs (VA) was prepared to care for our Nation's most vulnerable 
veterans. The VA offers health care and benefits for millions of 
veterans but rarely discussed are ancillary programs like the ones 
being examined today.
    PVA's programs and departments allow our organization to 
collaborate in unique ways with many of the VA programs being discussed 
in this hearing. For example, we have a team of architects on staff who 
review all VA SCI/D construction projects, ensuring new facilities are 
fully accessible to SCI/D and other disabled veterans. We also work on 
VA's design guides for SCI/D health care facilities. In addition to 
working with VA on ensuring that building projects are barrier free for 
disabled veterans, our architects also work with individual disabled 
veterans on accessible home design.
    Our Veterans Benefits Department is staffed with national service 
officers (NSO) around the country who are experts at complex claims 
work and are well versed in the intricacies of applying for programs 
like the Specially Adapted Housing (SAH) grant, the Automobile 
Allowance, the Automobile Adaptive Equipment (AAE) program, and other 
ancillary benefits our members rely on.
    PVA's Sports and Recreation Department offers over 60 free, year-
round adaptive sporting and recreational opportunities in partnership 
with the VA and our 33 chapters across the country. These include 
adaptive cycling, trapshooting, boccia ball, bass fishing, wheelchair 
basketball, wheelchair rugby, and many other events that promote a 
healthy and active lifestyle, all while fostering community and 
independence. Each year, PVA partners with the VA to host the National 
Veterans Wheelchair Games (NVWG), the largest gathering of veteran 
wheelchair athletes in the country. The opportunities made available to 
PVA members because of adaptive sports are endless. Not only does our 
sports programing offer camaraderie, but it also improves the physical 
and mental health of thousands of veterans across the country.

VA's Housing Adaptation Programs

    For catastrophically ill and injured veterans, housing adaptations 
are critical to living a safe and independent life. Although important, 
an adapted home is more than just a wheelchair ramp through the front 
door. Without housing adaptations, veterans with SCI/D may be forced to 
live in homes that don't meet their needs and greatly inhibit their 
ability to travel within them or use the kitchen or bathroom with any 
level of independence.
    VA's SAH grant program provides crucial funding to allow veterans 
with specific catastrophic disabilities to adapt their homes to allow 
them to live independently with their families in their communities. 
The SAH grant can be used to purchase, build, or remodel an existing 
house to an adapted home for veterans who have experienced blindness, 
who have experienced loss of use in their hands or a lower extremity, 
or who have severe burns or respiratory injuries. For Fiscal Year 2024, 
an eligible veteran can qualify for up to $117,014 through the SAH 
grant. Qualified veterans can return to their SAH allowance up to six 
times or until the amount available has been exhausted.\1\
---------------------------------------------------------------------------
    \1\ VA's Handbook for Design: A Guide for Specially Adapted Housing 
(SAH) and Special Housing Adaptation (SAH) Projects, September 2021.
---------------------------------------------------------------------------
    When a veteran acquires a catastrophic injury or illness, they are 
often experiencing a sense of tremendous loss and are navigating 
complex feelings like grief and depression. These veterans generally 
feel like they've lost their independence, yet trained SAH agents are 
experts at having these sensitive conversations. Historically, an SAH 
agent would meet with the veteran and their family, in their home to 
assess their needs and determine which adaptations would best serve the 
veteran. These face-to-face meetings are critical in ensuring that VA 
funds are properly applied to medically necessary adaptations and that 
the work needed is completed by a reputable contractor.
    PVA has heard from many of our members and NSOs across the country 
that there are new barriers in receiving support from SAH agents. Due 
to recent staffing reforms, SAH agents are now expected to cover a 
larger catchment area, they are prohibited from travel on toll roads 
which increases the time it takes to travel to a veteran's home and are 
expected to conduct many inspections virtually. It is highly unlikely 
that an SAH agent is going to be able to perform a virtual home 
inspection with the same level of detail and understanding as an in-
person inspection. This leaves a lot of room for errors and mistakes, 
and therefore begs the question, ``Who will be responsible for subpar 
construction or inappropriate materials, when remote inspections are 
the only option?'' SAH agents have learned the most effective way to 
deliver this benefit is with in-person home inspections that not only 
safeguard taxpayer dollars from misuse but provide an expert on the 
ground to help veterans and their families receive appropriate 
modifications for their homes.
    Recently, PVA's National Treasurer received an email from his SAH 
agent informing him of his early retirement. He wanted to make sure 
that all the veterans he worked with knew he was leaving, and that 
another agent would be in touch soon, but couldn't provide a timeline 
for his replacement. Our members are experiencing this across the 
country, and we fear that without robust staffing of the SAH program, 
as well as administrative support to process all the necessary 
documents, service-connected catastrophically disabled veterans will 
not be able to receive the dedicated attention they need for their 
individual situations. In general, SAH agents are dedicated to 
delivering these benefits in a timely manner, but the high quality of 
service the program is known for may diminish if they experience 
continued staffing decreases.
    Another critical adaptive housing program is the Home Improvements 
and Structural Alterations (HISA) grant. Designed to be nimbler than 
the SAH grant, HISA is often used to make modifications to a home such 
as adding a wheelchair ramp or improving bathroom accessibility. 
Unfortunately, this program is no longer meeting the needs of veterans 
because the grant amounts have not increased since 2010 despite 
construction and material costs rising more than 50 percent over the 
past 15 years. H.R. 2245, the Autonomy for Disabled Veterans Act, and 
H.R. 3309, the Autonomy for All Disabled Veterans Act, would raise the 
HISA amount to better meet the needs of veterans and tie the grant to 
an inflation index, enabling the grant to automatically keep up with 
future needs.
    While PVA members and other disabled veterans rely on these home 
modification grants for their independence, the need for increased 
efficiency around the program is critical. One of our NSOs shared that 
a veteran can submit their VA Form 26-4555, Application in Acquiring 
Specially Adapted Housing or Special Home Adaptation Grant, directly to 
the VA, but it can take months before that veteran receives a response. 
Modernizing the application process for this critical benefit would 
improve the experience for veterans, while minimizing the 
administrative burden for VA staff. Veterans who are eligible for the 
SAH grant and are experiencing barriers and limitations in their homes 
must be able to access these resources in a timely manner for their 
health and well-being.

Vehicle Modifications and the Auto Grant

    Access to safe and reliable transportation is essential to the 
mobility, health, and independence of catastrophically disabled 
veterans. Improving transportation access is a top priority for PVA and 
we were proud to advocate for the Veterans AUTO and Education 
Improvement Act (P.L. 117-333). This life changing legislation 
authorized the VA to issue a second auto grant to an eligible veteran 
starting initially with veterans who received their grant more than 30 
years ago.
    To receive a VA auto grant, a veteran must receive a rating 
decision issued by the Veterans Benefits Administration (VBA) which 
establishes eligibility for the Auto Grant and Adaptive Equipment. A 
veteran must then complete VA Form 21-4502 (application for the Auto 
Grant) and submit it to VBA. Once VBA processes the 4502 and certifies 
it, they send it back to the veteran with an Award Letter letting the 
veteran know their grant has been approved, and with instructions to 
bring the form to the dealer where they intend to purchase a vehicle. 
The dealer and veteran work with the Prosthetics Department at their 
local VA medical center on authorized adaptive equipment, and once the 
vehicle is ready for delivery and a veteran accepts delivery, they sign 
the 4502 indicating they received the vehicle, and the dealer sends the 
4502 to the local VA regional office for payment.
    This process may seem reasonable for able-bodied individuals, but 
it is time-consuming and cumbersome for veterans with catastrophic 
disabilities. There is ample room for the VA to make improvements to 
this process and increase efficiency. For example, the VA should 
dedicate additional resources focused on modernization of this 
application process by evolving to a digital application which can be 
accessed remotely, allowing for e-signatures to reduce the burden 
placed on veterans.
    We have heard several stories from PVA members and NSOs of veterans 
needing to wait months for approval or for VBA to issue grant payments 
at which point the dealership has already sold the vehicle the veteran 
planned to purchase. VA bureaucracy should never impede the delivery of 
benefits for eligible veterans, particularly for something as critical 
as transportation. This process becomes more complicated when a 
dealership has no experience in dealing with the VA or this program.
    The Veterans AUTO and Education Improvement Act not only authorized 
an additional auto grant for eligible veterans, but it also amended the 
definition of ``medical services'' to include certain vehicle 
modifications (e.g., van lifts) offered through VA's medical benefits 
package. Specifically, it amended the definition of ``medical 
services'' under 38 U.S.C. Sec.  1701(6) to include the provision of 
medically necessary van lifts, raised doors, raised roofs, air 
conditioning, and wheelchair tiedowns for passenger use. The change was 
intended to codify VA's existing practice of furnishing certain items, 
like van lifts and wheelchair tiedowns, to catastrophically disabled 
veterans. However, where the Veterans Health Administration (VHA) has 
used these items as examples, the statute defines them as the only 
types of modifications that are permissible. Remember, this is for 
adaptive equipment through the VA's medical benefits package and is 
different from the Automobile Adaptive Equipment (AAE) program for 
eligible service-connected veterans.
    Like the VA, we agree that a technical amendment to 38 U.S.C. Sec.  
1701(6) is needed to give the department greater flexibility in making 
the necessary modifications to veterans' vehicles to ensure they can 
safely enter or exit the vehicle and transport needed equipment, 
including power wheelchairs. The statutory language inadvertently 
limits the scope of an existing benefit. As a result, PVA strongly 
supports H.R. 1364, the Automotive Support Services to Improve Safe 
Transportation Act of 2025, which addresses this oversight to ensure 
that seriously disabled veterans are getting the equipment and 
modifications needed to travel safely. We urge swift passage of this 
legislation.
    Reforms are also needed to the AAE program. The necessary 
adaptations approved by VA through the AAE program are in some cases 
adaptations that the veteran pays for directly and is then reimbursed 
by VBA. Some medically necessary features of a vehicle can be things 
like air conditioning, automatic transmissions, power brakes, and power 
windows. When vehicle manufacturers stopped itemizing these features 
there was no way to determine what kind of reimbursement should be 
issued to the veteran, other than VHA Directive 2011-046 which VA 
Prosthetics and Sensory Aid Services (PSAS) now states has been 
rescinded. The cost for these types of features is now included in the 
base price of the vehicle. Since the items aren't itemized, veterans' 
ability to prove the cost to them has effectively disappeared. The 
applicable statute, 38 U.S.C. Sec.  3901(2), provides in part that the 
term ``adaptive equipment'' includes, but is not limited to, power 
steering, power brakes, power window lifts, power seats,'' and (A) air-
conditioning equipment when such equipment is necessary to the health 
and safety of the veteran and to the safety of others.'' \2\
---------------------------------------------------------------------------
    \2\ 38 U.S. Code Sec.  3901--Definitions U.S. Code US Law LII / 
Legal Information Institute.
---------------------------------------------------------------------------
    In July 2024, VA issued a final rule titled, ``Adaptive Equipment 
Allowance.'' This new rule effectively ignores the statutory 
requirement to reimburse veterans for these items. VA's new form 10-
1394, Application for Adaptive Equipment, does not list items like 
power windows, brakes, and other statutorily listed items. Also, the 
new AAE reimbursement schedule lists these items with a reimbursement 
rate of $0. So, although the new regulation says VA will pay for this 
equipment, VA is making it impossible for veterans to be reimbursed by 
implementing significant roadblocks to this statutory benefit. Even 
prior to changing the rule, VA would deny veterans reimbursement and 
force them to appeal denials. The Board of Veterans' Appeals has 
reversed these denials. It is inefficient and a waste of taxpayer 
dollars to deny veterans' statutorily earned benefits and require them 
to file appeals to receive them.
    In addition, VA's PSAS now maintains that a veteran cannot trade-in 
a vehicle VA paid to adapt until that vehicle has been on a veteran's 
record for 4 years. PVA maintains that this interpretation is not based 
on law. PSAS has cited 38 CFR 17.158(a) to support their new 
``policy,'' but VA did not change the regulation prior to changing its 
policy. This interpretation is quite burdensome for catastrophically 
disabled veterans and has resulted in requests for equitable relief for 
veterans who were in the process of receiving a new vehicle when VA's 
interpretation changed. We believe that VA must end this new policy.
    Finally, we understand that many of the businesses that adapt 
vehicles for use by disabled veterans are waiting on past due invoices 
pending with VA. We are concerned that these businesses may be unable 
to continue to provide services to veterans using VA benefits because 
of the financial burden placed on them as they wait for payment. This 
would cause great harm to catastrophically disabled veterans. Our goal 
is to make sure veterans have access to critical vehicle adaptations 
when needed.

Adaptive Sports Grant Program and Recreation Opportunities

    As previously mentioned, our signature adaptive sports event is the 
NVWG. This event, which PVA hosts in partnership with the VA, brings 
hundreds of veterans together each year fostering team building, 
camaraderie, and independence. For many novice wheelchair athletes, the 
NVWG is the first time they've flown, or stayed in a hotel, or been to 
such a large event since their injury or diagnosis. A separate program, 
the VA's Adaptive Sports Grant Program, is a well-established and 
meticulously administered program for organizations like PVA to offer 
opportunities to improve independence, well-being, and quality of life 
through adaptive sports.
    Adaptive sports are much more than just recreation; they are a 
critical component of healing, rehabilitation, and community 
reintegration. They provide supportive opportunities for veterans to 
regain their confidence and independence while discovering a community 
that understands the complications and challenges faced by wheelchair 
users. Eliminating grants or reducing necessary VA staff, specifically 
recreational therapists, would reduce the number of opportunities for 
veterans and exacerbate barriers to participation and rehabilitation.
    It is difficult to describe how impactful adaptive sports can be on 
an individual veteran's life. PVA members who participate in adaptive 
sport programs improve their cardiovascular health, increase their 
strength, stability, and endurance, all of which lead to a longer and 
healthier life. The benefits of accessible adaptive sports go beyond 
just improved physical health; they can also have a profound impact on 
veteran mental health. James, an Air Force veteran, told PVA, ``I love 
adaptive sports; they saved my life. [They] got me off drugs and 
alcohol and my suicidal ideations stopped. When I first came in 2018, I 
was depressed and suicidal and didn't really want to be here. Another 
veteran I met schooled me, talked to me about the competition and the 
games, and what it's like to have like-minded people being here. I went 
home with three gold medals and a bronze that year.'' Similarly, Jason, 
a Marine Corps veteran, spoke of the power of adaptive sports by 
saying, ``Living in the darkness, living with depression, keeping 
yourself in dark places, you eat yourself away. But being able to push 
barriers, that helps people know there is more to life. Adaptive 
fitness can help save a life; it gives you a great sense of purpose.''
    The VA's Adaptive Sports Grant, and adaptive sports more broadly, 
help change the lives of disabled veterans for the better. It's 
important to note that VA staff are the facilitators of these 
transformational programs. Occupational therapists, physical 
therapists, and recreational therapists work in coordination with each 
other and other providers to offer evidence-based treatment and 
rehabilitation, improve wellness and lifestyle, and ultimately improve 
a veteran's quality of life. Recreational therapists are professionals 
who assist veterans in finding a reason to reengage with the world 
around them post injury or diagnosis in a holistic way. They offer 
individualized care that impacts a veteran's social, cognitive, and 
physical health and help to bridge the gap between their clinical 
rehabilitation and community reintegration.
    The profound impact of recreation and recreational therapists has 
long been debated, as demonstrated in the testimony of PVA Past 
President, Donald H. Broderick, before the Senate Veterans' Affairs 
Committee in 1975. In his testimony, Past President Broderick testified 
that:

        ``Patients are left to their own devices resulting in rampant 
        deviant behavior. Instead of scheduled recreational and 
        cultural activities in the evening hours and on weekends, the 
        patient is forced to seek diversionary interests for himself. 
        For the average person this is of no consequence, but to a man 
        who has recently suffered such an injury as to make him 
        question the value of life, the results can be more crippling 
        that his paralysis. Rather than have young men turn to drugs 
        and alcohol, suffer unnecessary emotional strain, and devoid 
        themselves of motivation and expectations needed to recover 
        from the catastrophic disabilities of paraplegia, blindness, or 
        multiple amputation, we can assist them. Through stimulating 
        severely disabled patients to use their leisure time 
        constructively, as much can be done to guarantee their 
        rehabilitation as by providing educational or vocational 
        training. It is a proven fact that the greatest number of 
        failures in rehabilitating a person, occur in the evening hours 
        and on weekends when they are away from work. It seems 
        senseless to throw away the efforts, money, and most important, 
        individuals' lives, because of the failure to teach that person 
        how to cope with his leisure time. Money and specific programs 
        must be directed in this area, or we shall lose many valuable 
        men to a life of failure, and ultimately, confinement in VA 
        hospitals. You must prod the VA to take action and begin an 
        active and effective program of recreation.''

    Congress and the VA heeded these suggestions and over the years 
have developed robust adaptive sports and recreation programs that 
promote physical and mental health, which offer opportunities for 
collaboration and increased engagement between the VA and veteran 
organizations and ultimately has had a lasting impact on the lives of 
thousands of individual veterans. Several PVA members who discovered 
adaptive sports at the VA, and who participated in the NVWG, have gone 
on to be Paralympians representing Team USA this past year in Paris. 
Marco, a Marine Corps Veteran, was a second time Paralympian, Mason 
competed on the USA Wheelchair Rugby team where they took the Silver 
Metal, and Jason competed in para-archery where he took home the Gold 
for Team USA.
    We urge Congress to reauthorize the VA's Adaptive Sports Grant 
program which is set to expire at the end of the year. When it comes to 
Federal funding having a direct impact on veterans, there are very few 
other opportunities, if any, that have such a positive impact on the 
quality of someone's life. The resources spent on these amazing 
programs and opportunities have a profound impact on veterans, their 
families, their caregivers, and their communities.
    In closing, adaptive programs and benefits are essential in the 
life and well-being of PVA members. Before any of these were available 
to disabled veterans, it was common practice for veterans to languish 
in long-term care facilities or other institutional settings rather 
than living independent lives that allowed them to thrive. Now, 
disabled veterans can live meaningful lives within their communities. 
They can drive themselves to work, their VA appointments, or other 
activities in their local communities. Every one of them is a living 
example how support from the VA can transform the lives of 
catastrophically disabled veterans in a meaningful and lasting way.
    Thank you for the opportunity to share our views on adaptive 
programs offered by the VA. We look forward to working with the 
subcommittee and the VA to ensure the longevity of the programs 
discussed at the hearing today.

  Information Required by Rule XI 2(g) of the House of Representatives

    Pursuant to Rule XI 2(g) of the House of Representatives, the 
following information is provided regarding Federal grants and 
contracts.

                            Fiscal Year 2025

    Department of Veterans Affairs, Office of National Veterans Sports 
Programs & Special Events--Grant to support rehabilitation sports 
activities--$502,000.

                            Fiscal Year 2023

    Department of Veterans Affairs, Office of National Veterans Sports 
Programs & Special Events--Grant to support rehabilitation sports 
activities--$479,000.

                            Fiscal Year 2022

    Department of Veterans Affairs, Office of National Veterans Sports 
Programs & Special Events--Grant to support rehabilitation sports 
activities--$ 437,745.

                     Disclosure of Foreign Payments

    Paralyzed Veterans of America is largely supported by donations 
from the general public. However, in some very rare cases we receive 
direct donations from foreign nationals. In addition, we receive 
funding from corporations and foundations which in some cases are U.S. 
subsidiaries of non-U.S. companies.

                       Statements for the Record

                              ----------                              


               Prepared Statement of Homes For Our Troops
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]

 Prepared Statement of National Mobility Equipment Dealers Association

    The National Mobility Equipment Dealers Association (NMEDA), a non-
profit trade association representing over 300 members across the 
mobility industry, strongly supports the testimony submitted by 
BraunAbility to Chair Van Orden, Ranking Member Pappas, and all members 
of the House Veterans' Affairs Subcommittee on Economic Opportunity.
    For more than 35 years, NMEDA has championed safe, reliable, and 
customized transportation solutions for individuals with disabilities--
including our Nation's disabled veterans. Our membership includes 
mobility equipment manufacturers, dealers, driver rehabilitation 
specialists, and other professionals committed to enhancing the 
independence and quality of life of those we serve.
    NMEDA supports BraunAbility's testimony because it highlights three 
key priorities that are critical to the success and sustainability of 
the VA's adaptive automotive program:

        1. Updating the Adaptive Equipment Schedule: An accurate, 
        modernized equipment schedule is essential to ensuring veterans 
        receive the appropriate mobility solutions they need--
        reflecting current technologies, safety standards, and real-
        world costs.

        2. Prompt Payment: Timely reimbursement to providers is crucial 
        to maintaining uninterrupted access to adaptive equipment and 
        services for veterans. Delays jeopardize both the viability of 
        providers and the continuity of care for those who rely on 
        these solutions for daily independence.

        3. Two-in-Four's Adaptive Equipment Trade-In Policy: The VA's 
        sudden change in the interpretations of the two-in-four 
        regulations significantly burdens our veterans.

    As a long-standing advocate for veterans' mobility needs, NMEDA 
urges the Subcommittee to take these recommendations seriously. 
Ensuring veterans have access to updated equipment and prompt provider 
payments directly supports their freedom, dignity, and mobility.

                                 

            Prepared Statement of Disabled American Veterans

    Chairman Van Orden, Ranking Member Pappas and Members of the 
Subcommittee:

    DAV (Disabled American Veterans) appreciates the opportunity to 
provide testimony for this oversight hearing titled, ``Pushing VA 
Forward: Review of VA's Adaptive Programs for Disabled Veterans''.
    DAV is a congressionally chartered non-profit veterans service 
organization composed of nearly one million wartime service-disabled 
veterans. Our single purpose is to empower veterans to lead high-
quality lives with respect and dignity.
    VA adaptive programs play a crucial role in enhancing the quality 
of life for service-disabled veterans. These programs provide financial 
assistance for essential modifications and specialized equipment, 
enabling veterans to live more independently and safely by enhancing 
their mobility, accessibility, and overall well-being. These programs 
foster veterans' independence while enhancing their mental, emotional, 
and physical health, allowing them to engage more fully in daily 
activities and social interactions. Adaptive sports initiatives 
complement these efforts by promoting physical activity, building 
confidence, and helping veterans lead meaningful and fulfilling lives.
    In partnership with the VA, DAV is proud to co-host two events each 
year focused on adaptive sports initiatives for service-disabled 
veterans. One of these events is the Winter Sports Clinic in Snowmass, 
Colorado, which brings together nearly 400 veterans from across the 
country with spinal cord injuries, amputations, traumatic brain 
injuries, and near blindness. These veterans are introduced to adaptive 
skiing, sled hockey, scuba diving, rock wall climbing, educational 
sessions, and other activities. Various types of adaptive equipment are 
used based on the severity of each veteran's injury, and hundreds of 
ski instructors volunteer their time to support the event. The success 
of this clinic is heavily reliant on the dedication of these 
volunteers. We could not conduct these events without the invaluable 
support of the VA and corporate sponsors. Their contributions are 
essential to making this life-changing event possible for our Nation's 
service-disabled veterans.
    DAV and VA also co-host the National Disabled Veterans Golf Clinic, 
which introduces veterans to the therapeutic benefits of golf and other 
activities, including kayaking, bicycling, bowling and shooting. Each 
year, this event brings together over 200 veterans from across the 
United States to Riverside, Iowa. These veterans, who have serious 
disabilities such as spinal cord injuries, traumatic amputations, and 
significant visual impairments, receive intensive instruction from over 
75 PGA (Professional Golfer's Association) professionals. This event is 
life-changing for both veterans and their caregivers, as they learn 
together how to engage in these activities upon returning home.
    VA Health Systems Research, Management Briefs eBrief-no154, and 
Therapeutic Recreation Journal reviewed the benefits and barriers to 
participation in adaptive sports programs for disabled veterans. The 
reviews found that adaptive sports significantly improve veterans' 
independence, well-being, and quality of life. The results indicate 
veterans make significant improvements in their psychological health, 
and reductions in mood disturbances such as depression and anger. These 
studies highlight the need to expand existing adaptive sports equipment 
programs and create new initiatives.
    In addition to the positive impact of adaptive sports programs, it 
is important to recognize the comprehensive support provided by the 
VA's adaptive equipment programs. The VA administers a range of 
adaptive programs, each with distinct requirements, designed to address 
the diverse needs of different veteran populations. These programs 
encompass both residential modifications and automotive adaptations, 
ensuring comprehensive support for veterans across various aspects of 
daily living.
    The Home Improvements and Structural Alterations (HISA) grant 
program is an initiative that provides veterans with financial 
assistance to make necessary modifications to their homes. These 
modifications, such as installing ramps, widening doorways, and adding 
accessible bathrooms, significantly enhance the safety and 
accessibility of veterans' living environments. By addressing physical 
barriers within the home, this program empowers veterans to live more 
independently and comfortably, reducing the risk of injuries and 
improving their overall quality of life and well-being.
    The Specially Adapted Housing (SAH) grant program is another 
essential initiative that supports veterans with severe disabilities by 
providing housing adaptions to create barrier-free environments for 
veterans with severe disabilities. These adaptations include 
constructing wheelchair-accessible homes, installing specialized 
fixtures, and structural changes to accommodate mobility devices. This 
program's emphasis on creating tailored living environments for 
veterans with significant physical challenges ensures they can live 
safely and independently. By offering substantial financial support for 
these specialized adaptations, the program helps veterans achieve a 
higher level of comfort and functionality in their daily lives.
    The Special Home Adaptation (SHA) grant program helps veterans with 
certain service-connected disabilities to modify or purchase a home. It 
provides allowances for adaptations to accommodate specific 
disabilities with the goal of enabling service-disabled veterans to 
live independently in a home that meets their specific needs. While 
both the SAH and SHA initiatives target improved living conditions for 
veterans, their respective services and financial support vary.
    The Automotive Adaptive Equipment program focuses on providing 
veterans with the modifications to their vehicles, enabling them to 
drive safely and comfortably. These upgrades include hand controls, 
wheelchair lifts, and other assistive devices addressing the needs of 
disabled veterans to ensure that they can maintain their independence 
and engage in community activities without limitations.
    Although the benefits these adaptive programs bring to veterans are 
invaluable, our members have identified several concerns, particularly 
the complexity of the eligibility requirements. Each program has 
similar yet distinct eligibility criteria, which can make it difficult 
for veterans to distinguish between them or they may not be aware of 
their eligibility for more than one program. This lack of clarity can 
hinder veterans from accessing the full range of benefits available to 
them. In some cases, eligibility requires approval from both the 
Veterans Benefits Administration (VBA) and the Veterans Health 
Administration (VHA), further complicating the process and potentially 
delaying access to necessary modifications and equipment. In addition, 
when VA does not verify eligibility properly, it can create an 
overpayment of benefits.
    A significant issue for housing grants is the conflict between 
building code enforcement and the specific needs of veterans. For 
instance, if a veteran requires a larger opening to a room to 
accommodate a wheelchair or other mobility device, an electrical outlet 
may need to be removed. Should the building code mandate a certain 
number of outlets in the room, this modification could render the room 
non-compliant, resulting in serious delays and substantial hardship for 
the veteran. Similarly, modifications such as lowering countertops for 
accessibility may not align with existing building codes, causing 
further delays and complications. These conflicts highlight the urgent 
need for better coordination between VA and local contractors to ensure 
that necessary modifications are implemented as required and in a 
timely manner.
    There are also instances where communication lapses have led to 
significant delays in project completion. For the SAH and SHA programs, 
the failure of VA to maintain regular communication with veterans and 
builders has led to delays and disputes. Similarly, veterans have 
reported challenges with understanding the eligibility criteria and 
navigating the application process for Home Improvements and Structural 
Alterations grants, often stemming from inadequate communication and 
support from VA representatives. These examples underscore the need for 
improved communication and support from the VA to ensure veterans can 
effectively access the benefits from these programs. The VA should 
implement a centralized case management system, assign dedicated 
liaison officers, enhance digital communication tools, improve staff 
training, coordinate with local authorities, and expand outreach 
efforts to ensure veterans receive timely and effective support in 
accessing adaptive equipment and housing programs.
    Improving IT systems for eligibility reviews could also speed up 
the process and reduce unnecessary overpayments. It is essential for VA 
staff to be well-versed in the specifics of each program to reduce 
errors. The VA should collaborate more closely with state and local 
officials to request exceptions to building codes, without compromising 
safety, when applying any of the housing modification programs. 
Training for VA personnel should emphasize the timeliness of 
communication throughout the process. Ensuring that veterans understand 
what is needed from them will help mitigate delays and confusion, 
ultimately improving the efficiency and effectiveness of these vital 
programs.
    Finally, funding shortages present significant challenges for VA 
adaptive equipment programs. Allocated funds often fall short of 
meeting the growing demand and rising costs associated with these 
adaptations. For instance, the maximum grant amounts have remained 
unchanged for years, despite inflation and increasing construction 
costs.
    By addressing both physical and psychological needs, adaptive 
equipment and sports programs empower service-disabled veterans to live 
more independently, engage in their communities, and enjoy a higher 
quality of life. To sustain these efforts, Congress must collaborate 
with the VA to secure increased funding, raise grant maximums, improve 
communication, upgrade IT systems, and enhance VA staff training--
ensuring these programs continue to meet the evolving needs of veterans 
with disabilities and provide the resources and opportunities they 
deserve.
    Mr. Chairman, this concludes my testimony. I would be pleased to 
answer questions you or members of the Subcommittee may have.

                                 [all]