VA Progress Report
President Obama’s charter to transform the Department of Veterans Affairs (VA) into a 21st Century organization has instilled new purpose and urgency within VA. We have reorganized the Office of the Secretary to ensure unified direction. We have instituted numerous practices and policies to strengthen ethical behavior, increase transparency, create accountability, and improve services to Veterans. In addition, as part of transforming VA, we are comprehensively reviewing the organization and programs of our Administration and Staff Offices to provide a basis for moving boldly to acknowledge new times, new demographic realities, and to leverage new technologies to renew our commitment to Veterans – our clients who are the sole reason VA exists.
The activities of the Department during the first 100 days of the new Administration have been driven by a framework to support transformation while seizing opportunities for immediate reform and positive change. This framework has three fundamental principles. We will be people-centric, results-driven, and, by necessity, forward-looking.
First, people-centric. Veterans are the centerpiece of our organization and of everything we do as we design, implement, and sustain programs that serve them. It is our mission to address their changing needs over time and across the full range of support that our government has committed to providing them. Equally essential are the people who are the backbone of VA—our professional and talented workforce. From delivering cutting-edge medical care to skillfully and advising Veterans on benefits and services, we will grow and retain a compassionate, motivated, and client-oriented workforce.
Second, results-oriented. At the end of each day our true measure of success is the timeliness, the quality, and the consistency of services and support we provide. We will be measured by our accomplishments, not our promises. Our processes will remain accessible, responsive, and transparent to ensure we both anticipate and effectively address the needs of a diverse Veteran population dispersed geographically across our country. Success also includes cost-effectiveness. We are stewards of taxpayer dollars, and we will include appropriate metrics to assure quality in our care and management processes.
Finally, forward-looking. We will seek out opportunities for delivering best services with available resources, continually challenging ourselves to look for ways to do things smarter and more effectively. We will aggressively leverage the world's best practices, our knowledge base, and our emerging technologies to increase our capabilities in areas such as healthcare, information management, and service delivery.
The President’s Fiscal Year (FY) 2010 budget provides critical resources as a down payment to transformation into a 21st Century VA. VA’s budget increases to $112.8 billion, up $15 billion, or 15 percent, from the 2009 enacted budget. This is the largest dollar and percentage increase ever requested by a president for providing care and services to our Veterans.
VA will effectively apply these resources to transform VA in FY 2010 and beyond, but we have already made significant progress in key areas. For example, we completed a “quick look” study to validate our plans and procedures for executing the post-September 11th GI Bill, a large, new program of educational benefits. We established a goal to reengineer the claims process into a fully paperless environment by 2012. In conjunction with the paperless initiative, the Department of Defense (DoD) and VA met four times since 21 January to discuss automatically enrolling all military personnel into VA upon entry into the Armed Forces (we call this initiative “uniform registration”). On April 9, 2009, President Obama announced the initiative to create a Joint Virtual Lifetime Electronic Record, and his budget dedicates resources to improving electronic records so that VA can more efficiently link to and collaborate with the DoD to enable all VA care sites to seamlessly access Veterans’ records. Our management decisions will be better, faster, more consistent and fair, and less subject to lost files or destroyed claims.
This report highlights some of the many actions of the Department of Veterans Affairs in the first 100 days of the Obama Administration. It reflects the dedication and hard work of over 280,000 VA employees committed to delivering the care and services our Veterans have earned. The new energy and initiative within VA will be sustained, and future versions of this report will provide new updates. Within the next several months, VA’s vision for the 21st Century will be released and a comprehensive transformation strategy will be unveiled. These are exciting times, and with the continuing support of the Obama Administration. VA will reach new heights in its continuing mission to answer President Lincoln’s call “to care for him, who shall have borne the battle, and for his widow, and his orphan.”
The Obama Administration provided VA with just over $1.4 billion under the American Recovery and Reinvestment Act of 2009 (ARRA). VA is using these funds to directly care for our Veterans in many ways, and the positive impact of ARRA funding will be felt by every State in the Country and our VA workforce as well. VA has committed ARRA recovery resources to four key areas:
1. Health Care. We are investing $1 billion to improve health care facilities across the country, focusing on safety, security and energy conservation. Through $150 million in grants, we will assist States in acquiring or constructing State Veterans Homes and domiciliary facilities and to remodel, modify, or alter existing facilities in order to furnish care to Veterans. Highlights of this investment include:
- 956 construction projects across all 50 states – improving infrastructure, safety, security, and health care delivery. Nearly 70% are estimated to cost $1 million or less, providing significant opportunities for Veteran-owned, local, and small businesses. Nearly $400 million in improvement projects that will directly contribute to greater energy conservation and $64 million in renewable energy studies and projects.
- 49 grant projects across 23 states – providing vital renovations and several new facilities to support extended care facilities that include Veterans. When complete, these grants will provide more new State Home beds than in the last 5 years combined.
2. Memorials and Cemeteries. We are committing $50 million to our National Cemeteries Administration to repair and improve cemeteries and supporting infrastructure. This involves 395 cemetery projects across 38 states that will dramatically improve those facilities that memorialize our Veterans.
3. Service Delivery to Veterans. We will spend $200 million to hire and train up to 1,500 claims processors and pursue needed information technology systems initiatives that will improve our service delivery to Veterans.
4. Economic Stability for Veterans. We are implementing two one-time payment programs under ARRA: a $250 payment to eligible Veterans, and either a $9,000 or $15,000 payment to eligible Filipino Veterans who aided American troops in World War II.
Delivery of one-time $250 payments to eligible VA beneficiaries (estimated at a total of $700 million) beginning in June 2009. VA is coordinating these payments with the Social Security Administration and Railroad Retirement Board.
Delivery of one-time payments to eligible Filipino Veterans, $9,000 (non-US citizen) $15,000 (US citizen). Over 26,000 claims have been received, with the first 200 payments released by Treasury this month. The total projected expenditure is $1,995,000.
The VA has rapidly, accurately and transparently planned the use of all ARRA funds. Spend plans for each program detail the specific projects and uses of these funds, and these spend plans have been approved by the Office of Management and Budget (OMB). VA has established a Recovery Act Web page (www.va.gov/recovery) to ensure visibility of the Department’s Recovery Act actions. The project list was transmitted to Congress on 19 March 2009. VA spend plans were updated, aggregated by State, and posted on VA’s Recovery Web site on April 2, 2009. Program-specific plans and VA’s overall plan are being prepared for submission to OMB this month and final posting to VA’s recovery.gov Web site by May 1, 2009. Reporting of cumulative obligations and outlays by month will begin April 2009 and continue through September 2010.
The VA has identified and acted quickly on a number of ideas and initiatives to meet the Obama Administration’s call for increased accountability, reduced waste, and greater transparency in government. The following initiatives completed in the Administration’s first 100 days highlight the VA’s efforts to reemphasize stewardship and cost effectiveness in its practices. Several initiatives also demonstrate VA’s commitment to appropriate corporate-level management principles that streamline and strengthening controls and accountability.
Conferences Review. An FY09 Conferences Review cancelled or delayed 24 conferences for a savings of almost $17.8 million. The review considered the justifications, attendance level and locations as well as explored less costly alternatives, such as video conferencing, as ways to complete training requirements. VA is finalizing a policy which clearly outlines guidance and definitions of terms for training, conferences, seminars and any other events in order to better plan for 2010.
Advisory Committees Review. VA standardized policies governing its Advisory Committees to improve committee management by VA program offices and enhance the effectiveness of committee work. These policies will reduce costs by use of “virtual” meetings where practical; limit committee membership unless otherwise stated by statute; limit stipends, except for scientists and medical specialists; and require committee annual operations plans and program office assessments of each committee.
New Emphasis on Ethics. The Secretary of VA placed increased emphasis on ethical conduct through both an open letter (February 20, 2009) to all VA employees and new policy that requires all Senior Executives to sign an ethics pledge upon hiring.
Payroll Initiative. VA successfully completed the transition of payroll servicing for 53,000 employees to the Defense Finance and Accounting Service (DFAS) under a Payroll Modernization (e-Payroll) initiative that will improve services and reduce costs.
New Corporate Management Office. VA is establishing a Corporate Senior Executive Management Office to standardize, streamline and enhance staffing actions for 413 Senior Executive Service and Title 38 positions. We are also developing implementation plans now.
New Corporate Operations Center. The department is establishing an Integrated Corporate VA Operations Center to provide a central location for “real-time” synchronization, integrated planning, and coordination of all information and intelligence, and the operational status of all VA facilities and communications systems. The facility will serve as VA’s fusion center to support VA senior leadership requirements for timely, accurate, and relevant information to ensure VA’s ability to deliver services to our Nation’s Veterans and to support an important VA mission: to improve the Nation’s preparedness for response to war, terrorism, national emergencies, and natural disasters.
Acceleration of Program. VA accelerated implementation of its Consolidated Patient Account Centers (CPACs) plan by two years in order to more quickly achieve improved business practices and efficiencies in the collection of Third Party Insurer reimbursements for non-service connected care.
Post-9/11 GI Bill Review. The department conducted an Independent Study of the new Post-9/11 GI Bill Implementation Plan to confirm sufficiency in the areas of training, software development and enrollment tools fielding necessary to meet the 1 August 2009 deadline established in Congressional legislation. The study identified risks and suggested improvements to ensure both the success and cost-effectiveness of the program. Risk mitigation plans have been updated and appropriate improvements made.
Policy Change on Burden of Proof. VA recently relaxed the burden of proof for Veterans by now accepting digitally signed DD Forms 214 or 215 received from DoD, a military service branch, or a State Adjutant General.
Increased Transparency in Recovery Act Contracts. VA is incorporating every non-recurring maintenance project funded by the American Recovery and Reinvestment Act of 2009 into its new Electronic Contract Management System (ECMS). The ECMS greatly enhances transparency, reporting and accountability of projects.
New Claims Initiative. VA has dramatically reduced processing time for radiological exposure claims through an innovative IT network solution in partnership with the Defense Threat Reduction Agency (DTRA). Average processing time for radiological exposure claims was cut by 162 days and backlog reduced by 76 percent. In addition to saving processing time, the new procedures eliminate the need for individual test results for prostate and skin cancer claims.
During this first 100 days, the VA has intently focused on developing the policy and regulations necessary for the implementation of the Post-9/11 GI Bill. We also established policies aimed at improving service to Veterans and simplifying processes and improving access to VA services. The following initiatives highlight VA’s commitment to improving our focus on Client services and support.
VA Participates in Health Reform Discussions. The Secretary of VA was asked to co-moderate a panel on Health Reform as part of the Obama Administration’s efforts to reform health care this year. VA is also participating in various forums to advise and assist in areas where it possesses significant experience and capability, such as in electronic health records, comparative effectiveness studies, and longitudinal care.
Post-9/11 GI Bill Regulation. VA completed the final regulations governing the administration of the Post-9/11 GI Bill, and they were published in the Federal Register on March 31, 2009. Systems and procedures have been developed that will allow VA to begin accepting applications for the Post-9/11 GI Bill in May 2009. VA has also invested in a strategic communications and outreach plan that will reach as many eligible Veterans as possible to inform them of this historic benefit.
Expansion of Health Care Access. On January 21, 2009, VA published a proposed rule to confer eligibility for VA health care to more Veterans. The final rule is expected to be published and become effective on June 15, 2009. This regulation will expand VA-healthcare enrollment opportunities for more than 250,000 “Priority Category 8 Veterans” who had been precluded from enrolling. Those affected do not have service-connected disabilities and have incomes that exceed the current income and geographic-means thresholds by 10-percent or less. This is the first step toward offering VA health care to an additional 500,000 Veterans.
IT Consolidation. VA reaffirmed its commitment to continuing and completing the consolidation of Information Technology assets, staff and programs through a February 12, 2009 letter from the Secretary of VA. This policy re-states the imperative for a coordinated strategy, personnel development, process and technology decisions under the leadership and authority of the VA Chief Information Officer with control of the budget, people and processes required to achieve synergy, agility and responsiveness. Interim implementation and execution guidance has been issued to the Administrations and Staff Offices as well. Service Level Agreement Plans are being expedited and a comprehensive review of IT development programs is underway.
New Office on Sports and Special Events. On Feb. 23, 2009, VA’s existing Office of National Programs and Special Events was renamed and reorganized to meet the expanded scope of new legislative requirements. The new Office of National Veterans Sports Programs and Special Events now reports directly to the Office of the Secretary on its mission to coordinate support to Veterans and support organizations.
Paperless Appeals Initiative. A Board of Veterans Appeals (BVA) Policy Initiative to adjudicate Paperless Appeals is nearing completion. Staff training on the paperless process is underway and will be completed in May 09. At that time, BVA will be prepared to hold videoconference hearings in a paperless appeal. The BVA also launched an Expedited Claims Adjudication Initiative on February 2, 2009. This pilot program gives representative Veterans the opportunity to participate in faster adjudication of their benefit appeals.
Settlement of class-action litigation. On February 12, 2009, the U.S. District Court for the District of Columbia preliminarily approved a proposed settlement of consolidated class-action litigation arising out of the May 3, 2006, burglary of a VA employee’s home from which a VA computer was equipment containing personal information regarding up to 17.5 million Veterans, some spouses and military personnel. The Court scheduled for July 28, 2009 a final fairness hearing on the settlement. A joint campaign to inform Veterans of their settlement rights began on March 20, 2009.
Denver decision on construction. In March 2009, the Secretary of VA announced a decision to construct a standalone VA Medical Center in Denver, Colorado, ending a decade-long deliberation on the strategy for delivering health care services to Veterans in that area.
Fort Wayne and South Bend, Indiana decision on construction. In April 2009, the Secretary of VA announced a decision to construct Health Care Centers in Fort Wayne and South Bend, Indiana to end a prolonged review of care and facility needs. With this decision, Veterans in these areas will receive greatly expanded health care services much closer to those communities where they live.
The April 9, 2009 Presidential announcement highlighted the centerpiece of VA’s Interagency efforts in the first 100 days of the Obama Administration -- the Department of Defense (DoD) and VA will create a single computerized medical record. VA has been working closely with DoD in a number of areas to ensure quality care to Wounded Warriors, responsive and effective care during the transition from military service to Veteran status, and collaboration on future issues such as electronic records. The following initiatives highlight VA’s commitment to working with our Interagency partners to enhance the security and welfare of our Veterans and our workforce as well as to support Administration initiatives.
- Federal Health Care Center Planning. VA and DoD have completed enterprise planning, analysis, and provision of all necessary Information Management/Information Technology support needed to establish the North Chicago Federal Health Care Center, (FHCC), before opening day, October 2010.
- Cyber-security Collaboration. In the area of cyber-security, VA has recently increased information sharing and collaboration with Department of Homeland Security’s US Computer Emergency Readiness Team (US-CERT) to foster an environment for cooperation and mutual support. This cooperation has enabled VA to effectively respond to security threats, as well as fostering a partnership in the security of the federal government cyber space.
- VA/DoD “Uniform Registration” Initiative. VA and DoD have had multiple discussions on the merits of a policy on “uniform registration” - automatically enrolling all military personnel into VA upon entry into the Armed Forces. This policy would cover both the active and reserve component, who populate both DoD and VA, from the moment they first take the oath of allegiance in uniform, until they are laid to rest. Uniform registration will drive VA and DoD to create a single electronic record that would govern how we acknowledge, identify, track, and manage each of our clients. Such electronic records would have a personnel component and a medical component, thus creating a truly “one life” joint DoD/VA record for the service-member/veteran.
- VA/DoD Data Sharing. VA and DoD continue to enhance their ability to share personnel and administrative data. The “Common Population” program continued to establish unique person identifiers for personnel within Defense Eligibility Enrollment Reporting System (DEERS) and VADIR (added legacy Veterans from VA systems to establish shared population). In support of Post-9/11 GI Bill eligibility requirements, web application changes were completed to display of information for Education claims processors.
- Disaster Assistance Coordination. The VA’s Office of Information Protection and Risk Management has successfully led VA’s integration into the Federal Emergency Management Agency’s (FEMA) Disaster Assistance Improvement Program (DAIP). This mandated program creates one of the first ever consolidated on-line citizen applications designed to better provide federal assistance to all citizens nationwide during times of a national crisis or disasters.
- Contractor Certifications. On April 1, 2009 the Center for Veterans Enterprise launched Phase 1 of the Federal Contractor Certification program. Federal Contractor Certification is a training program for Veteran business owners intended to help them understand Federal contracting, respond intelligently to solicitations and perform successfully once they have won the contract. Phase 2 will launch on July 27, 2009.
- Information Security. VA’s Training, Education, Awareness, and Professionalism (TEAP) program, in partnership with the Office of Personnel Management (OPM), is applying to be a "shared service provider" for role-based training. Role-based training is required by the Federal Information Security Management Act (FISMA) and the National Institute of Standards in Technology (NIST) for all staff with significant security responsibilities. This would allow VA to more easily share their existing role-based (or specialized) training courses for those with significant information security responsibilities with other agencies and across VA geographies. The result would be increased efficiencies for providing mandatory standardized IT security training and an enhanced reputation for providing high quality training solutions.
- Affordable Housing. VA is working with other Federal agencies, including the Federal Deposit Insurance Corporation (FDIC), Federal Reserve, Ginnie Mae, Treasury, Housing and Urban Development, and Agriculture, to implement the Administration's Home Affordable Modification (HAM) program. The HAM program is modeled on the mortgage modification program implemented by the FDIC following its takeover of IndyMac Bank in 2008. Modifications under the program involve a combination of reducing interest rates, extending loan repayment terms, and forgiving portions of principal. VA is working to ensure that Veteran-borrowers receive the same benefits under the HAM program as similarly situated borrowers with conventional and subprime loans.
Other Change Initiatives
With over 1,200 points of health care and hundreds of other access points for service, the department has numerous and varied outreach and support activities ongoing each day. From Advisory Committees to Veterans Service Organizations, Military Service Organizations, and State Veterans Affairs Organizations, VA also receives valuable assistance and feedback. Communications remains a critical factor in the support of our Veterans. The following initiatives serve to highlight VA’s outreach and Veteran support efforts in the first 100 days of this Administration.
- Post-9/11 GI Bill outreach to Veterans. In ongoing efforts to inform Veterans of their potential eligibility for Post-9/11 GI Bill benefits, VA began mailing approximately 2 million letters on April 6, 2009. We are also working with DoD to determine the most effective means of disseminating this information to active service members.
- Post-9/11 GI Bill outreach to colleges and universities. VA recently mailed all colleges and universities to advise them of the major provisions of the Post-9/11 GI Bill, most specifically the Yellow Ribbon Program. The Yellow Ribbon Program allows a school to enter into an agreement to pay tuition and fee expenses not covered by the Post-9/11 GI Bill. VA also worked closely with national organizations representing colleges and universities to provide them information and training about the new GI Bill program. VA continues to provide information at Veterans' Service Organizations meetings, Department of Education student financial aid regional and national conferences, and Student Veterans of America meetings.
- Outreach to Veterans on Health Care. VA recently created an on-line tool to help Veterans without service-connected disabilities determine if they are eligible for enrollment into VA’s health care system. The enrollment calculator allows Veterans to enter their household income information, number of dependents, and zip code in order to see if they qualify for VA health care currently or under an anticipated regulatory change that will allow VA to expand enrollment by raising current income thresholds by 10 percent.
- Outreach to Realtors on home loans. VA is conducting active outreach with the National Association of Realtors to develop joint promotional and educational materials on the VA Home Loan program for their member realtors. The materials will explain the many benefits – and ease of use – of our program. This is an important initiative since realtors are usually the first point of contact for a veteran buyer when considering a home purchase.
- Outreach to Veterans on Claims. Approximately 32,000 outreach letters on Traumatic Brain Injury (TBI) were mailed to Veterans with TBI on March 17, 2009. The letter advised recipients of the recent change in regulations concerning the new criteria for evaluating disability levels and the compensation payments associated with the new levels.
- Outreach to returning Veterans. The department launched a new “Returning Veterans” website to welcome home Veterans of the Iraq and Afghanistan conflicts with a social, Veteran-centric site focusing on their needs and questions. The Website features videos, Veteran stories, and a blog where Veterans are encouraged to post feedback.
- Outreach to Veterans on employment. The VA’s “VetSuccess.gov” website was expanded in March 2009 to make it easier for Veterans to navigate, and employers to post jobs and find qualified Veterans to fill their vacancies. VA collaborated with National Association of State Workforce Agencies and Direct Employers to include a Job Central data bank of over 500,000 jobs. Also, three VetSuccess videos were introduced via YouTube. These short, testimonial videos depict three Veterans who successfully completed their programs of rehabilitation and share their inspirational stories.
- Outreach for Minority Veterans. On February 12, 2009, the United South and Eastern Tribes (USET), Inc. Board of Directors supported establishment of a Veterans Committee. This was a direct result of the outreach efforts of the VA Center for Minority Veterans. Efforts over several years helped USET realize that Veterans from their 25 federally recognized member tribes could use this committee to obtain vital information of VA services and to provide the organization a voice with VA.
- Outreach for Women Veterans. The VA’s Center for Women Veterans staff recently participated in several major outreach initiatives to promote awareness and education about benefits and services that VA offers to Veterans, specifically women Veterans. Audiences included many who treat, support, or represent women Veterans, including VA offices, Veterans Service Organizations; state Departments of Veterans Affairs, Departments of Defense, Labor, and Health and Human Services; reserve and Guard representatives; Congressional members and their staffers; and the general public.
- Homeless Veteran Programs. The department announced the availability of funding in three Notices of Funding Availability (NOFAs) on January 23, 2009. Funding was made available under the VA Homeless Providers Grant and Per Diem Program, and includes $15 million made available for capital funds to develop transitional housing projects for homeless Veterans; $10 million for the renewal of Special Needs Grants; and $3 million for Technical Assistance Grants. Also, Enhanced-Use Lease public hearings were held for six (6) mission-driven homeless initiatives.
- Nursing School Partnerships with VA. In April, 2009, VA announced new partnerships with five of the country’s finest nursing schools in its efforts to expand education, recruitment and retention opportunities for nurses in our world-class health care system for Veterans. This pilot program has now fifteen partnerships and delivers learning opportunities for nursing students at VA facilities and funds faculty development of VA staff for additional faculty positions to competitively selected school partners.
- VA Electronic Records. The April 2009 issue of the New England Journal of Medicine singles out VA for its successful implementation of a comprehensive system of medical health records. The authors note that VA’s use of such records has significantly enhanced the quality of patient care by noting that “VA hospitals have used electronic health records for more than a decade with dramatic associated improvements in clinical quality.”
- VA Records Program Achievement. The VA’s “HealtheVet” program received the 1st Honors award in the category of Personal Health Records at the 2009 Toward an Electronic Patient Record (TEPR+) conference held in California. A national forum for healthcare professionals, TEPR+ is attended by a broad cross section of private, public, local, state, and federal health care professionals. The department completed against many nationally recognized health care organizations developing and providing PHR systems, including Kaiser Permanente, Microsoft Health Vault, and Google Health.
- Memorial Certificate Production. The VA produced the new Presidential Memorial Certificates (PMC) with the signature of President Barack Obama, and issues approximately 39,000 PMCs per month. President John F. Kennedy started the PMC Program, which provides gold-embossed certificates bearing the President’s signature to the family and friends of deceased, honorably discharged Veterans.
- Health Care “Safety Step-up.” From March 8-14, 2009 VA implemented a Safety Step-Up at all 153 hospitals and 731 community-based outpatient clinics across the nation. Patient appointments were not affected. After issues with proper sterilization of endoscopic equipment required infection-risk notices at four different medical centers since December 2008, VA instituted immediate alerts to all of its facilities to ensure patient safety. The nationwide Step-Up was the culmination of an education and safeguard program VA developed to implement stronger standard operating procedures and accountability practices at facilities where VA provides care. This process is the model for ethical and transparent self identification, notification, and treatment of patients.
- VA’s 20th Anniversary. VA celebrated its 20th Anniversary as a Cabinet-level Department on Sunday, March 15 and Monday, March 16. Sunday’s events involved a wreath-laying at Arlington National Cemetery and cake cutting/reception at the Women’s Memorial with select invitations to Congressional Members, Veterans Service Organization representatives, and Administration Officials. Monday’s events were held at the VA Headquarters building (810 Vermont Ave) and included a cake-cutting and a visit and live broadcast of remarks by the President of the United States. The event was an important first introduction of the president’s vision for a 21st Century VA to the people who must implement it – the employees of the Department of Veterans Affairs.
- Major Contracts. New major contracts awarded by VA (not Recovery Act related) during the Administration’s first 100 days include seven design-related contracts valued at $73 million; thirteen construction contracts valued at $180 million; and one lease valued at $7.5 million.