[Congressional Record (Bound Edition), Volume 150 (2004), Part 13]
[Extensions of Remarks]
[Pages 17363-17365]
[From the U.S. Government Publishing Office, www.gpo.gov]




     REMARKS BY CHAIRMAN DORCAS HARDY, VA TASK FORCE ON VOCATIONAL 
                     REHABILITATION AND EMPLOYMENT

                                 ______
                                 

                        HON. HENRY E. BROWN, JR.

                           of south carolina

                    in the house of representatives

                        Thursday, July 22, 2004

  Mr. BROWN of South Carolina. Mr. Speaker, Honorable Dorcas R. Hardy 
recently chaired the Vocational Rehabilitation and Employment Task 
Force of the Department of Veterans Affairs. The Task Force issued its 
report in March 2004, and furnishes an excellent road map on how VA can 
place a stronger emphasis on long-term sustained employment for 
disabled veterans who are vocational rehabilitation participants. I was 
especially impressed with the section entitled, More Challenges Await: 
A Final Word from the Task Force Chairman, and commend it to my 
colleagues as an example of Ms. Hardy's wisdom and foresight:

    More Challenges Await: A Final Word From the Task Force Chairman

       Addressing the benefit, rehabilitation, and employment 
     needs of persons with disabilities--and especially veterans 
     with service-connected disabilities continues to be 
     difficult, and often controversial. One thing is certain: The 
     Department of Veterans Affairs cannot afford to fail the 
     veteran who has given so much in the service of our Nation in 
     previous wars and now in this age of terrorism.
       There is no doubt in my mind that VA's Vocational 
     Rehabilitation and Employment Program can become the best 
     public rehabilitation program in the country, given 
     appropriate resources and leadership. The new comprehensive, 
     integrated 21st Century VR&E Employment-Driven Delivery 
     System, which is proposed by the Task Force, builds on the 
     strengths of the past and provides a continuum of service 
     delivery, from military service to career counseling, 
     appropriate retraining, and education, to employment or 
     transitional independent living services with the ever-
     present goal of employment. The new system can provide the 
     answer to a disabled veteran's transition to civilian 
     society--a job.
       Employment program will necessitate a major shift in 
     attitude and approach. The current reality is that the VR&E 
     program--despite the legislation of 1980--continues to 
     operate as a VA education benefit for disabled veterans. It 
     provides a larger stipend than the GI Bill program, and is 
     accompanied by some counseling, as necessary. The new 
     program, on the other hand, addresses the continuum of ``life 
     cycle'' needs that a veteran with disabilities experiences, 
     of which education may--or may not--be a necessary part. The 
     focus will be the rehabilitation and employment needs of the 
     21st century service-connected disabled veteran.
       Because the United States is at war, and will likely be in 
     conflict situations for the foreseeable future, there must be 
     a sense of urgency on the part of the entire Department as 
     well as the Vocational Rehabilitation and Employment Service 
     to create this new 21st century service delivery system.
       I respectfully suggest that no more reports or discussions 
     are needed, just immediate and concrete actions that are 
     supported by the Administration, the Department, and the 
     Congress. If this vital program, with its potential for 
     becoming the most outstanding vocational rehabilitation 
     system within the federal government, is unable to quickly 
     and effectively serve the 21st Century veteran, then one must 
     consider other options. These options include: (1) 
     contracting the program out with clear and stringent 
     requirements to follow the employment intent of the law, or 
     (2) recognizing that the mandated employment focus of the 
     program is not possible and reintegrating VR&E into the 
     Education Service of the Veterans Benefits Administration, 
     adding an additional stipend for disabled veterans.
       Having served in various state and federal governmental 
     positions, including Commissioner of Social Security and 
     Assistant Secretary of Human Development Services, I have 
     worked with numerous social services policies and programs. 
     Cash benefit services, such as the VA Compensation and 
     Pension Service or Social Security provide support through 
     direct payments. These programs require development of 
     automated claims processing methodologies. Direct and 
     personal services are those provided by VR&E or social 
     service agencies. Different skills, personalities, and 
     approaches are needed for each part of the delivery system. 
     VR&E stands as an island in the sea of the Veterans Benefits 
     Administration, a claims processing organization. VR&E is not 
     connected to the claims processing functions, nor do other 
     business lines have any particular appreciation or 
     understanding of its function. Both

[[Page 17364]]

     cash and direct benefits are needed to support the veteran. 
     Development of a seamless, integrated delivery system is the 
     challenge.
       Many have suggested that the entire VR&E program should 
     become a part of the Veterans Health Administration, which 
     has more of a hands-on service delivery focus. Just as the 
     Task Force rejected the idea of moving the VR&E Independent 
     Living program to VHA at this time, that same thinking can be 
     applied to moving all of VR&E to VHA. VR&E needs to address 
     its own shortcomings first, wherever it is housed, before 
     participating in another reorganization.
       If implemented with commitment and enthusiasm, the Task 
     Force's recommendation to rebuild the VR&E Service can be 
     successful. Building the new service delivery system cannot 
     be done slowly, nor sequentially. It must be driven with 
     clear and focused timeframes; and it must be done believing 
     that each veteran's future depends upon an effective new 
     approach. Leadership and management will be key; timeframes 
     that some may deem un reasonable should become standard; 
     processes must be streamlined and supported by technology; 
     and veterans must recognize that they, too, have an 
     individual responsibility to complete their vocational 
     rehabilitation plan and secure employment in a timely manner.


                      Future Policy Considerations

       Throughout the discussions and deliberations of the Task 
     Force, several broad policy issues were raised that were not 
     thoroughly addressed, either because they were not directly 
     within the scope of this Task Force's work or, in several 
     cases, they were far more complex than our time permitted. 
     Some issues were just too controversial at this particular 
     point in time, but their ``tipping point'' will come and 
     thoughtful policymakers and managers should be prepared to 
     consider their breadth, shape, and impact upon VR&E. As the 
     Veterans Benefits Administration proceeds to modernize VR&E, 
     these longer term policy considerations, which cross the 
     business lines of VBA, should be discussed and addressed. 
     Each issue below will arise in the foreseeable future; each 
     issue will have a significant consequence for the successful 
     future of a 21st century VR&E program.


 role of counseling and transition assistance in the veterans benefits 
                             administration

       Historically, VBA had a focus on personal counseling about 
     requested benefits and services through face-to-face contact 
     with the veteran. Today, the Compensation and Pension Service 
     provides outreach services to veterans through the Veterans 
     Service Centers but the focus is ``you are entitled to 
     benefits from the VA and here is the claim to file.'' This is 
     not counseling in the traditional sense, rather a method to 
     ensure that veterans receive cash benefits to which they are 
     entitled. Since the VR&E Program is the only benefit that is 
     provided face-to-face to the veteran, VR&E, with its 
     professional counseling staff, should provide all outreach 
     services to veterans, regardless of whether or not the 
     veteran is disabled. A veteran with financial or life cycle 
     or any other issues should be able to access counseling 
     services at a VR&E office. Such a policy may necessitate 
     additional resources beyond what is recommended at this time 
     to rebuild the VR&E program.


                         need for new programs

       This report highlights the need for clear and comprehensive 
     data about the population that is served by VR&E. Without 
     such data, as well as research, we will not be able to 
     project who the service-connected disabled veterans of the 
     future will be, nor what their needs will be. Questions that 
     should be addressed include:
       Will their injuries and disabilities be considerably 
     different than those of recent veterans?
       Will the technology used on battlefields or in medical 
     rehabilitation impact more significantly the veteran's future 
     ability to be a productive member of civilian society?
       How will medical advances, as projected by the Institute of 
     Medicine or the National Institutes of Health, impact the 
     VR&E program?
       The Task Force's analysis of types of disabilities of 
     veterans entering the VR&E program found that the number of 
     veterans determined disabled due to neuropsychiatric 
     illnesses is increasing. The increase in mental conditions is 
     also being seen by other public benefit programs such as 
     Social Security Disability Insurance. It appears that the 
     majority of veterans in the Independent Living program are 
     those with Post-Traumatic Stress Disorder (PTSD). Yet, as 
     this report clearly states, Independent Living status within 
     the VR&E program should not be the sole response to their 
     needs. An assessment of the impact of an increased number of 
     mental health disabilities on the VR&E services should be 
     conducted as soon as possible. The outcome will likely 
     conclude that new programs should be developed jointly with 
     VHA to address the needs of these veterans. Of equal 
     importance will be the development of a methodology that 
     guides how VR&E interacts with VHA to plan for new solutions 
     to disabling conditions.


           impact of an aging veteran population on services

       Every social services delivery policymaker is well aware of 
     the general aging of the population. The question should be 
     raised as to the expected impact of the graying of veterans 
     upon VR&E. Issues such as the aging of the general workforce 
     could mean less discrimination against older veterans in the 
     workplace and therefore more older applicants for VR&E 
     services. As veterans age, many are filing additional claims 
     for disability compensation, and many may initiate or renew 
     their requests for VR&E services. VR&E should be proactive in 
     addressing at least the following questions: Should VR&E 
     accept all disabled veterans regardless of age? Is age a 
     criterion for prioritization of expected services? How should 
     VR&E balance its resources vis-a-vis age of applicant and 
     number of times services have been requested?


                   impact of disability determination

       The VA disability benefits adjudication system has been the 
     subject of discussion and controversy for many years. 
     Congress recently established, as part of the 2004 Defense 
     Authorization Act, the Veterans' Disability Benefits 
     Commission to study the compensation benefit structure and 
     complete a report in 2005. They are directed to examine the 
     appropriateness of such benefits and the appropriate benefit 
     determination standards, compare veterans' benefits with 
     other public and private sector disability benefits and, 
     perhaps most important, ``consult with Institute of Medicine 
     of National Academy of Sciences with respect to medical 
     aspects of contemporary disability compensation policies.''
       Ideally the Commission's deliberations will provide a 
     framework for many policy decisions related to the VA's 
     disability criteria that will be updated to reflect the 
     current state of science, medicine, technology, and labor 
     market conditions. Such recommendations could be the catalyst 
     that moves veterans' disability policy toward use of 
     scientific advances and incorporates economic and social 
     changes that have already redefined the relationship between 
     impairments and the ability to work within the private 
     sector. Such discussion and modern approaches could 
     significantly impact the workload and processes of VR&E.
       For example, currently there are nearly 175,000 veterans 
     with a 60 percent or more disability rating who have applied 
     and receive a determination that they are ``Individually 
     Unemployable.'' The designation of ``Individually 
     Unemployable'' entitles the veteran to a 100 percent rating 
     with commensurate compensation. Yet the adjudication process 
     never includes the views of a vocational rehabilitation 
     counselor as to whether or not the beneficiary could 
     participate in the labor force or whether a strong vocational 
     rehabilitation or counseling program would be effective in 
     assisting the veteran achieve employment, perhaps using 
     assistive technology or other types of supports. The 
     questions that are raised are: Without input into the IU 
     determination process from a trained rehabilitation expert, 
     should IU veterans or those applying for IU status be served 
     by the VR&E program? How can an individual be officially 
     designated ``unemployable'' (a label that should be an 
     anathema) and allowed to participate in an employment program 
     at the expense of another veteran who wants and needs a job?
       It is recognized that over the years, the Congress and the 
     courts have expanded the scope and complexity of veterans' 
     disability benefits. It is hoped that the Commission will 
     conduct a thorough review of the benefits schedule and 
     challenge the status quo. They might begin by asking how a 
     tender scar, migraine, or mild asthma can be the sole'' 
     disability'' for which a veteran receives compensation 
     according to a rating schedule and is thereby automatically 
     eligible for VR&E services, in the same manner as a severely-
     disabled veteran.


                       The GI Bill for the Future

       The Task Force learned that more than 75 percent of those 
     who enter the VR&E program proceed through a rehabilitation 
     plan that includes a goal of a college degree. Though the 
     data is not clear, one can assume (given the number of 
     discontinued and interrupted participants) that most veterans 
     spend far more than 4 years attaining their degree. Equally 
     important, most of these ``students'' never exhausted their 
     GI Bill benefits. One assumes that is because the VR&E 
     education benefits are considerably more generous than the 
     current GI Bill. This pattern raises some questions: Does 
     this mean that deficiencies exist in the current GI Bill? Or 
     are veterans with disabilities just looking for the best 
     deal? Should there be changes in the GI Bill that might make 
     it more appealing to veterans with disabilities? What should 
     they be?
       In 1998, the then Vocational Rehabilitation and Counseling 
     Program wrote a strategic management document that addressed 
     the reasons that the program desperately needed to change in 
     order to provide effective services to disabled veterans. The 
     reasons for change were:
       Inadequate focus on employment,
       Customer perceptions and expectations are out-of-step with 
     the program's intent,
       Inability to monitor outcomes and provide feedback to the 
     program; Inadequate IT support for the program,

[[Page 17365]]

       Inadequate access for veterans,
       Inadequate coalitions with peer organizations and partners, 
     and inefficient business processes.
       Despite such introspection, not much has changed. This 2004 
     Task Force Report not only urges management to rebuild the 
     VR&E program but also provides a clear road map as to how to 
     accomplish the objective. There is no excuse for lack of 
     success.


                               The Charge

       Unfortunately, there are not as many successful social 
     service delivery programs as one would like. Positive 
     outcomes for adults, as measured by an individual's 
     independence and employment, are often difficult to attain. 
     But I believe the mighty band of nearly 1,000 VR&E staff has 
     the resourcefulness and dedication to build a new service 
     delivery system for veterans with service-connected 
     disabilities. With leadership, appropriate resources, a broad 
     and creative approach, and what I term ``cheerleading 
     support,'' they can reinvent themselves, they can get 
     energized, and they can be the best program serving the 21st 
     century rehabilitation and employment program--and just in 
     time for those 21st Century service veteran. VR&E can become 
     the model public sector members returning from Iraq, 
     Afghanistan, or anywhere else in the world where freedom 
     calls.
       It has been a privilege to chair this Task Force and 
     present our report.
       Dorcas R. Hardy, Chairman, VA Vocational Rehabilitation and 
     Employment Task Force.

                          ____________________