Vocational Rehabilitation: Opportunities to Improve Program Effectiveness
(Testimony, 02/04/98, GAO/T-HEHS-98-87).

GAO reviewed the past problems that the Veterans Benefits Administration
(VBA) has faced and the progress it has made in helping disabled
veterans obtain suitable employment.

GAO noted that: (1) the vocational rehabilitation program has not
emphasized its mandate to find jobs for disabled veterans; (2) in 1984,
1992, and again in 1996, GAO reported that the vocational rehabilitation
program primarily focused on sending veterans to training, not on
finding veterans suitable employment; (3) for example, GAO found that
VBA placed over 90 percent of eligible veterans directly into training
programs, while less than 5 percent went directly into the program phase
designed to find them jobs; (4) VBA program officials stated that staff
focused on providing training services because, among other reasons, the
staff lacked adequate training and expertise in job placement; (5)
similarly, GAO found that VBA placed few veterans in jobs; (6) for
example, GAO reported in 1992 and 1996 that VBA rehabilitated less than
10 percent of veterans found eligible for vocational rehabilitation
services; (7) VBA program officials stated that the primary reason for
the low percentage of rehabilitations was the lack of focus on providing
employment services; (8) furthermore, GAO found that VBA has not focused
on assessing program effectiveness; (9) VBA's vocational rehabilitation
and counseling service established a design team in 1995 to radically
restructure the program; (10) in 1996, the design team made specific
recommendations aimed at improving program effectiveness; (11) during
recent discussions with program officials, GAO found that VBA is in the
early stages of implementing the design team's recommendations; and (12)
program officials stated that they are currently developing a strategic
plan that they believe will address prior recommendations and set forth
a plan of action for improving program effectiveness.

--------------------------- Indexing Terms -----------------------------

 REPORTNUM:  T-HEHS-98-87
     TITLE:  Vocational Rehabilitation: Opportunities to Improve Program 
             Effectiveness
      DATE:  02/04/98
   SUBJECT:  Veterans
             Vocational rehabilitation
             Veterans employment programs
             Persons with disabilities
             Education or training
             Strategic planning

             
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Cover
================================================================ COVER


Before the Subcommittee on Benefits, Committee on Veterans' Affairs,
House of Representatives

For Release on Delivery
Expected at 2:00 p.m.
Wednesday, February 4, 1998

VOCATIONAL REHABILITATION -
OPPORTUNITIES TO IMPROVE PROGRAM
EFFECTIVENESS

Statement of Cynthia M.  Fagnoni, Associate Director
Veterans' Affairs and Military Health Care Issues
Health, Education, and Human Services Division

GAO/T-HEHS-98-87

GAO/HEHS-98-87T


(105761)


Abbreviations
=============================================================== ABBREV

  VA - Department of Veterans Affairs
  VBA - Veterans Benefits Administration

VOCATIONAL REHABILITATION: 
OPPORTUNITIES TO IMPROVE PROGRAM
EFFECTIVENESS
============================================================ Chapter 0

Mr.  Chairman and Members of the Subcommittee: 

We are pleased to be here today to provide our views on efforts the
Veterans Benefits Administration (VBA) has made to help disabled
veterans obtain suitable employment through its vocational
rehabilitation and counseling program.\1 VBA is responsible for
administering the Department of Veterans Affairs' (VA) nonmedical
programs that provide financial and other benefits to veterans and
their dependents and survivors. 

Millions of veterans have disabilities resulting from their service
in the military.  As a result, some need help in obtaining and
maintaining employment.  Since the 1940s, VA, previously the Veterans
Administration, has provided training to veterans with
service-connected disabilities to help improve their employability. 
In 1980, the Congress enacted the Veterans' Rehabilitation and
Education Amendments, which changed the focus of the vocational
rehabilitation program from just providing training to improve the
employability of disabled veterans to helping them find and maintain
suitable jobs.  In fiscal year 1997, VBA spent about $388 million to
provide vocational rehabilitation benefits to about 59,000 disabled
veterans. 

My statement today will focus on the past problems that VBA has faced
and the progress it has made in helping disabled veterans obtain
suitable employment.  The information in this statement is based on
reviews we conducted of the vocational rehabilitation program as well
as recent discussions with program officials.\2 Because of time
constraints, we did not attempt to update information on the services
veterans received or the outcomes they achieved. 

In summary, we found that the vocational rehabilitation program has
not emphasized its mandate to find jobs for disabled veterans.  In
1984, 1992, and again in 1996, we reported that the vocational
rehabilitation program primarily focused on sending veterans to
training, not on finding veterans suitable employment.  For example,
we found that VBA placed over 90 percent of eligible veterans
directly into training programs, while less than 5 percent went
directly into the program phase designed to find them jobs.  VBA
program officials told us that staff focused on providing training
services because, among other reasons, the staff lacked adequate
training and expertise in job placement.  Similarly, we found that
VBA placed few veterans in jobs.  For example, we reported in 1992
and 1996 that VBA rehabilitated less than 10 percent of veterans
found eligible for vocational rehabilitation services.\3 VBA program
officials told us that the primary reason for the low percentage of
rehabilitations was the lack of focus on providing employment
services.  Furthermore, we found that VBA has not focused on
assessing program effectiveness. 

In response to our and VA's earlier findings and recommendations,
VBA's vocational rehabilitation and counseling service established a
design team in 1995 to radically restructure the program.  In 1996,
the design team made specific recommendations aimed at improving
program effectiveness.  During recent discussions with program
officials, we found that VBA is in the early stages of implementing
the design team's recommendations.  Program officials told us they
are currently developing a strategic plan that they believe will
address prior recommendations and set forth a plan of action for
improving program effectiveness. 


--------------------
\1 VA defines a suitable job as a position consistent with a
veteran's aptitudes, abilities, and interests. 

\2 A list of related GAO products appears at the end of this
testimony. 

\3 Disabled individuals who obtain and maintain a suitable job for at
least 60 days are classified as "rehabilitated."


   BACKGROUND
---------------------------------------------------------- Chapter 0:1

The mission of the vocational rehabilitation and counseling program
is to provide all services and assistance necessary to enable
veterans with service-connected disabilities to achieve maximum
independence in daily living and, to the extent feasible, to become
employable and to obtain and maintain suitable employment.  Veterans
are eligible for program services if they have a 20-percent or higher
service-connected disability\4 and they have been determined by VBA
to have an employment handicap.  The law defines an employment
handicap as an impairment of a veteran's ability to prepare for,
obtain, or retain employment consistent with his or her abilities,
aptitudes, and interests.\5 A veteran with a 10-percent
service-connected disability may also be eligible if he or she has a
serious employment handicap.\6 The eligibility period generally
extends for 12 years, beginning on the date of the veteran's
discharge.  A veteran found eligible for services can receive up to
48 months of benefits during the 12-year period. 

The vocational rehabilitation process has five phases.  In the first
phase (application), VBA receives the veteran's application,
establishes eligibility, and schedules a meeting with the veteran. 
In phase two (evaluation and planning), a counselor determines
whether the veteran has an employment handicap; if so, the counselor
and the veteran jointly develop a rehabilitation plan.\7 The veteran
then moves into training or education (phase three), if needed, and
on to employment services (phase four) if training or education is
not needed or after it is completed.  During phase four, VBA and
other federal and state agencies may help the veteran find a job.  In
phase five, the veteran is classified as rehabilitated once he or she
finds a suitable job and holds it for at least 60 days. 


--------------------
\4 Veterans are assigned a disability rating ranging from 0 to 100
percent in increments of 10 percent.  The rating represents the
average impairment in earning capacity resulting from a
service-connected injury or a combination of injuries. 

\5 38 U.S.C.  3101. 

\6 VBA determines whether the applicant has a serious employment
handicap after evaluating the veteran's history, including the
effects of disability, prior training and employment, and other
pertinent factors. 

\7 A rehabilitation plan outlines specific services to be provided
the veteran, the duration of services, and a basis for assessing
progress toward the program goal. 


   VBA HAS NOT EMPHASIZED FINDING
   JOBS FOR VETERANS
---------------------------------------------------------- Chapter 0:2

The 1980 Veterans' Rehabilitation and Education Amendments made a
significant change in VBA's vocational rehabilitation program by
requiring VBA to assist veterans in obtaining and maintaining
suitable employment.  However, despite recommendations we made in
1992 that VBA fully implement this amendment and VBA's agreement to
emphasize employment services, staff continued to focus on sending
veterans to training rather than on finding them jobs.  As a result,
we reported in 1996 that few disabled veterans in the vocational
rehabilitation program had obtained jobs.  In addition, VBA has not
focused on assessing program effectiveness as required under the
Government Performance and Results Act of 1993 (the Results Act).\8


--------------------
\8 The Results Act requires agencies to clearly define their
missions, set goals, measure performance, and report on their
accomplishments. 


      VBA HAS NOT EMPHASIZED
      EMPLOYMENT SERVICES
-------------------------------------------------------- Chapter 0:2.1

VBA's vocational rehabilitation program has primarily focused on
sending veterans to training rather than on finding them suitable
employment.  In 1992, VBA issued guidance that emphasized the
importance of finding suitable jobs for veterans and suggested that
field offices begin employment planning as soon as a veteran's
eligibility for program services is established.  However, regional
officials told us that staff generally did not begin exploring
employment options until near the end of a veteran's training. 

In 1992, we reported that 92 percent of veterans who received a plan
between October 1983 and February 1991 went from the evaluation and
planning phase directly into training programs, while only 3 percent
went into the employment services phase.  The remaining 5 percent
went into a program designed to help them live independently or were
placed in a controlled work environment.  These figures remained
virtually unchanged for the period we examined in our 1996 report. 
For example, from October 1991 to September 1995, 92 percent of
veterans who received a plan went from the evaluation and planning
phase into training programs, while 4 percent went directly into the
employment services phase.  The remaining 4 percent entered an
independent living program or were placed in extended evaluation. 

Moreover, our 1996 analysis of national program data on program
participants showed that the vast majority of veterans in training
were enrolled in higher education programs.  For example, about 91
percent of such veterans were enrolled in a university or college.\9
The remaining 9 percent were enrolled in vocational/technical schools
or participating in other types of training programs, such as
apprenticeships and on-the-job training. 

VBA regional officials we visited during our 1996 review offered
several reasons for emphasizing training over finding veterans jobs. 
First, VBA officials told us that staff found it difficult to explore
employment options early because many veterans entering the program
expect to be able to attend college.  Veterans had this expectation,
according to VBA officials, because the program was often marketed as
an education program, not as a job-oriented program.  This image of
the program was also evident among some VA management.  For instance,
the director at one regional office described the vocational
rehabilitation program as the "best education program in VA."

A second reason for emphasizing training over employment, according
to VBA officials, was that staff generally lacked adequate training
and expertise in job placement activities.  At one office, for
example, a counseling psychologist told us that he and other program
staff were not equipped to find veterans jobs because they lacked
employer contacts and detailed information on local labor markets. 
In fact, counseling psychologists at the regional offices we visited
during our 1996 review described the employment services phase as
"the weakest part of the program."

Third, VBA officials told us that large caseloads made it difficult
for program staff to spend time exploring employment options with
veterans.  As one counseling psychologist responsible for managing
over 300 cases told us, "with such a large caseload, it's easier to
place veterans in college for 4 years than it is to find them a job."
VBA's Vocational Rehabilitation Service's Chief of Program Operations
told us that the optimal caseload per staff person is about 125. 


--------------------
\9 VA's national database captures the number of veterans enrolled in
college or vocational/technical schools.  However, several regional
office staff told us that a significant number of veterans classified
as attending college are actually enrolled in a vocational/technical
training program provided by a community college.  VA officials were
not able to estimate how many veterans belong in this category. 


      VBA HAS PLACED FEW DISABLED
      VETERANS IN JOBS
-------------------------------------------------------- Chapter 0:2.2

The vocational rehabilitation program has not been effective in
placing veterans in suitable jobs.  VBA program officials told us
that the primary reason for the low percentage of rehabilitations was
the lack of focus on employment services.  In our 1992 report, we
noted that approximately 202,000 veterans were found eligible for
vocational rehabilitation program services between October 1983 and
February 1991.  About 62 percent dropped out of the program before
ever receiving a rehabilitation plan, and an additional 9 percent
dropped out after receiving a plan.  VBA rehabilitated 5 percent of
the eligible veterans, while the remaining veterans (24 percent)
continued to receive program services. 

In our 1996 report, we noted that 201,000 veterans applied to the
vocational rehabilitation program between October 1991 and September
1995.  VBA classified approximately 74,000 (37 percent) veterans as
eligible.\10 Of these veterans, 21 percent dropped out before
receiving a plan, and another 20 percent dropped out or temporarily
suspended their program after receiving a plan.  VBA rehabilitated 8
percent of the eligible veterans, and the remaining eligible veterans
(51 percent) were still receiving program services at the time of our
review. 


--------------------
\10 Of the 201,000 veterans who applied to the vocational
rehabilitation program, 55,000 (27 percent) were classified as
ineligible, 11,300 (6 percent) were awaiting an eligibility
determination, and 60,400 (30 percent) dropped out of the program. 


      VBA HAS NOT FOCUSED ON
      ASSESSING PROGRAM
      EFFECTIVENESS
-------------------------------------------------------- Chapter 0:2.3

In testimony before this Subcommittee last June, we noted that VA's
June 1997 draft strategic plan for fiscal years 1998 through 2003
included measures of veterans' progress in completing each
rehabilitation phase of the vocational rehabilitation program.\11
However, the plan did not describe how VBA plans to assess the
program's effectiveness in helping veterans get and keep suitable
employment.  In subsequent testimony, we noted that VA's August 1997
draft strategic plan was an improvement over the earlier version and
observed that it contained possible results-oriented goals, such as
increasing the number of disabled veterans who get and keep suitable
employment and are considered to be rehabilitated.  However, VA's
strategic plan, which was formally issued on September 30, 1997,
lacks a detailed discussion about how VBA plans to measure the
overall effectiveness of its vocational rehabilitation program. 


--------------------
\11 VA developed this strategic plan pursuant to the Results Act. 


   VBA HAS MADE LIMITED PROGRESS
   TOWARD IMPLEMENTING PROGRAM
   IMPROVEMENT INITIATIVES
---------------------------------------------------------- Chapter 0:3

In response to GAO and VA reports, the director of the vocational
rehabilitation program established a design team in 1995 to radically
restructure the program through improvements in program management. 
To help identify needed program improvements, the design team
consulted with many internal and external stakeholders, including
state and private-sector vocational rehabilitation officials,
veterans' service organizations, the Department of Labor, and private
contractors. 

In October 1996, the design team issued a report that contained 15
recommendations for improving program effectiveness.  Consistent with
our findings and recommendations, the design team's recommendations
focused on the need for vocational rehabilitation staff to emphasize
employment throughout the program.  The recommendations covered four
major redesign areas:  (1) changing the culture of the program, (2)
implementing a strong marketing program, (3) streamlining program
business operations, and (4) automating more of the program's
business processes.  The design team recommended, for example, that
VBA develop an employment assessment model that would include an
analysis of transferable work skills and a needs assessment.  The
model would be designed to give an accurate view of a veteran's
abilities, aptitudes, and interests and help program staff focus on
employment.  Another recommendation was that VBA establish a national
marketing strategy to provide accurate information about the
vocational rehabilitation program, specifically to make clear the
program's emphasis on employment.  Furthermore, the design team
recommended that VBA devise a work measurement system compatible with
the Results Act, VBA work systems, and other information needs. 

Shortly after the design team completed its report, the director of
the vocational rehabilitation program retired, and an acting director
led the program for nearly 9 months.  In part because of this change
in leadership, VBA is only now in the early stages of implementing
the design team's recommendations.  However, the new vocational
rehabilitation program director told us he and his management team
support the need to refocus the program toward the goal of employment
and explained that they have begun to take specific actions to do so. 
He noted, for example, that they are in the process of contracting
out for assistance in reviewing and revising program communications,
including program applications, forms, pamphlets, brochures, and form
letters, to ensure that these documents clearly communicate the
program's focus on employment.  The first stage in a multiyear
rollout of a new automated management information system has also
been completed, according to program officials.  This system is being
designed to help program staff streamline and simplify work
processes, measure program outcomes, and establish new work
measurements nationwide. 

In addition, program officials told us they are developing an overall
strategic plan, which they hope to have completed by the end of this
month, to address our and VA's past recommendations.  This plan is to
serve as a road map for the program--it will describe where the
program is and where it needs to go, to better help disabled veterans
obtain suitable employment.  The plan will also include performance
goals and outcome indicators to measure program effectiveness. 


   CONCLUSIONS
---------------------------------------------------------- Chapter 0:4

Despite a legislative mandate enacted almost 2 decades ago that
required VBA to help program participants obtain suitable jobs and
our prior reports documenting VBA's limited success, we found that
the vocational rehabilitation program has not emphasized employment
services.  As a result, the program has rehabilitated few disabled
veterans.  VBA has recently taken steps that, if continued, could
help the program better emphasize employment.  With new program
leadership in place, VBA has an opportunity to implement
recommendations it has failed to act on in the past.  However, the
concerns addressed in this statement are long-standing, and sustained
efforts will be needed to improve program effectiveness. 


-------------------------------------------------------- Chapter 0:4.1

Mr.  Chairman, this completes my testimony.  I would be pleased to
respond to any questions you or Members of the Subcommittee may have. 

RELATED GAO PRODUCTS

The Results Act:  Observations on VA's August 1997 Draft Strategic
Plan (GAO/T-HEHS-97-215, Sept.  18, 1997). 

Veterans Benefits Administration:  Focusing on Results in Vocational
Rehabilitation and Education Programs (GAO/T-HEHS-97-148, June 5,
1997). 

Vocational Rehabilitation:  VA Continues to Place Few Disabled
Veterans in Jobs (GAO/HEHS-96-155, Sept.  3, 1996). 

Vocational Rehabilitation:  Better VA Management Needed to Help
Disabled Veterans Find Jobs (GAO/HRD-92-100, Sept.  4, 1992). 

VA Can Provide More Employment Assistance to Veterans Who Complete
Its Vocational Rehabilitation Program (GAO/HRD-84-39, May 23, 1984). 


*** End of document. ***