House Veterans Affairs Hearing On Challenges Facing Veterans - Nov 29 2018

good morning and the oversight hearing of the Subcommittee on disability assistance memorial Affairs will now come to order I'd like to welcome you on the secretary of benefits Paul Lawrence since this is your first appearance before this subcommittee before we began this hearing I would also like to yield to the full committee chairman Phil role understand the Chairman role would like to a few moments to clarify something discussed during the economic opportunity hearing a couple weeks ago and with that chairman roll Thank You mr. chairman I want to thank chairman Bhaskar give me just a few minutes of the hearing time today to ask a question regarding a topic that's been prominent the news and is of the utmost importance to our student veterans dr. Lawrence thank you for being here to testify today I understand that the question I'm about to ask is not on today's topic but I feel like it's very important that we clarify these things yesterday secretary Wilkie released a statement on his plan to address GI bill payment and system rollout delays and that statement said in part quote during this time VBA will pay monthly housing allowance rates for the post 9/11 GI bill at the current academic year uncapped Department of Defense basic housing allowance rates the VBA will also correct retro actively any under payments resulting from section 107 and 501 implementation problems in quotes on number 15 on November 15th you and director of education services mr. Worley testified before this committee regarding GI bill payment and system delays at that hearing mr. Earley stated quote we will not go back and try to recover the overpayments once the IT fixes in and where we have underpaid our beneficiaries we will make them whole at the time the IT fix goes in in quote my staff received information yesterday which appears to be an apparent conflict with what previously and publicly was stated so my question dr. Lawrence is this will the new effective date of section 107 be when the system is ready or will you go back and you and mr. Worley promised a few weeks ago ensure that all students be made whole who are underpaid since the August 1 2018 deadline stated in the law thank you um let me clarify we're gonna go back and for the fall of 18 recompute the payments using the 18 rates as you indicated and we will make those people whole okay so overpayments if there any will be disregarded under payments will be adjusted and those will those those veterans will get a check in January when the new law goes into effect in the spring of 2020 we will use the new rates going forward so basically the the students the students are going to be held harmless either way that's a question I have because there's and and I won't go take too much more of the committee's time but we've got to we've got to have a whole new system I think that as I understand it that system is that we've got with currently it's not going to be used it's going to be rebid is that correct certainly you're right so the announcement yesterday reflected our fundamental thinking about what the options are going forward that we need to really address all the learning we've had and do something different that's not right and I agree with that and it is that going to create a problem look back because we're going to have hundreds of thousands of these to go through within a year because I think what I'd heard by the end of December of 29 next year December 19 would be when it would be fully operational I think that's the date certain that we were given that's correct for the spring of 2020 we will be ready in December of 2019 okay thank you I yield back Thank You chairman roll okay so we're gonna move back to our planned hearing today we're going to focus on how the VA develops and carries out the new policies and procedures most of you know that I ran a family trucking business for more than 10 years I know that in order to make successful changes to our company you have to sit down and create a plan to carry out the changes for instance you have to decide whether employees will be needed and need new training or if we're going to have to update computer software you also have to think about how many modifications would impact the rest of the business especially whether there will be unintended consequences that will cause problems down the line finally you have to design and execute and the implementation plan and figure out whether the changes are working as well as you'd hoped unfortunately according to the IG it looks like the VA does not take these common-sense steps when it develops new programs in the last few months the IG has released at least three reports that document the problems that that arose when VA implemented new policies or initiatives VA had these problems because it doesn't appear that the VBA took the time to consider what they needed to do successfully and put the new procedures into place such as adequately updating the IT systems or training employees prior to implementation it also looks like the VA wasn't taking the time to have it evaluate whether they were working as intended in one report the IG discovered that when in nwq went into effect claims based on military sexual trauma or MST were assigned to any employee even if that employee did not have specific MSE MST training in this case the IgE estimates that about 1300 are almost 50% of the MST claims were not properly developed before VA issued a denial although I am troubled by these cases many by these cases they may not have been decided properly we have to remember that this does not necessarily mean that all of these cases were improperly denied but it does mean that the VA did not and didn't follow all of the safeguards to ensure that these particularity –zz this this particular sensitive issue and these particular sensitive cases were handled in the way they should have been I think I can safely speak for all of my colleagues when I say the claims involving said military sexual trauma are some of the most sensitive that the department handles these veterans have gone through an unimaginable unimaginable ordeal and VA owes it to them to ensure that the cases involving an alleged MST are processed correctly dr. Lorenson I look forward to hearing from you about the VBA intends and what it tends to move forward based on this report the IG also reviewed how the VA handles claims that include an intent to file form VA developed the intent to file initiative to allow veterans to preserve an early effective date even if they don't have enough information to file the formal claim however VA didn't think to update VB MS to flag when the veterans submit an intent to file form as a result the IG estimates that as many as 23 thousand veterans may have gotten the wrong effective date on their claim even worse these IG reports expose another major issue with in VBA poor quality control if the IG had not reviewed these three programs I don't know how the VBA would have ever identified the problem and taken corrective action I wish I could have say say these were isolated incidents but we haven't seen it that we haven't seen before I think one reason so many bas new initiatives fail or cause serious problems is because VA is so anxious to find a silver bullet that painlessly solves all the problems but the VBA repeatedly rolls out new initiatives before fully testing them or considering the downstream impact the changes will have on or how it will affect the VA and and how they can better serve the veteran I was encouraged that the undersecretary for benefits Paul Lawrence met with me and my staff and he shared with us that he recognizes the BBA has to refocus on the improving services for veterans rather than making employee's job easier I also appreciate the fact the under secretaries commitment to read to to reassessing how the VBA does business so that there is more care and consideration to how the VBA rolls out new programs instead of rushing to get out a product that we may not be ready that may not be ready to go live that is a step in the right direction I look forward to the hearing and how he and hearing from the secretary on how he intends to change the VA s culture and adopt good management practices we all want the same thing to ensure that the veterans receive the benefits they have earned now I'm going to turn over to our distinguished ranking member misty for her opening statement Thank You mr. chairman for scheduling today's hearing on three reports issued in recent months by the Office of the inspector general at the Department of Veterans Affairs and you will see a great deal of consistency between the Chairman's remarks and mine and I think you have come to know that this committee works in a very bipartisan way and we all share the same mission but share some of the same concerns about what we see happening each one of these IG reports raises serious questions about inadequate processing of veterans disability compensation claims by the veterans benefit administration I want to thank start by thanking dr. Lawrence and his team for being here today to respond to these findings to describe what you are doing in response to this and again for meeting with the chairman and with me at length prior to today's hearing though this hearing is setting on the reports on military sexual trauma processing in accuracy in unnecessary medical exams there's an additional IG report on the processing of ALS claims that points to similar issues and I do want to make a brief aside it looks like we've reached some accommodation on ALS and I hope you'll have a chance to describe that which i think is indicative of what is encouraging to me about the attitude you are bringing to changing culture and going that extra mile I'm grateful to the VSO representatives in all parts of the country who raised the alert on some of these issues and who must play a direct role in the development and implementation of remedial policy initiatives and procedures recommended by the IG and with which VA has concurred let me be clear when the report on military sexual trauma came to my attention in August I was disappointed and disturbed I had expected that after VBA provided liberalised guidance in 2011 and VBA's concurrence in the recommendation of the eye of the GAO report in 2014 that veterans who filed disability compensation claims for PTSD as a result of military sexual trauma would be finding an easier path establishing service connection required for accurate compensation claim ratings and that access to VA mental health care and treatment programs would be with that are so important to recovery but for too many this is apparently still not the case the IG has reported that 50 percent of the denied claims that they examined from 2017 involved processing errors I know that dr. Lawrence as well was taken aback with the report when it was issued because he immediately put into place a plan of action including reviewing to your two years of claims but to be blunt however there are patterns in all of the reports that need to concern all of us this committee and you as well I see a pattern of not sharing and disseminating best practices as an ongoing basis and update when VBA is getting reports back that needs to be part of a continuous improvement as chairman vas talked about as we can learn from the private sector with the National work queue in place this should facilitate that but there needs to be a mission to disseminate those back best practices when we learn them that will help address continuing inconsistencies in regional offices that just with the national work queue we shouldn't be seen that kind of variability that we are seeing it's of particularly concern on the military sexual trauma claims and look forward to hearing your responses on that as the chairman has noted at length a real concern with inadequate planning you are very responsive but you need to take time to step back and figure out how best to implement there are several instances in the report where it's clear that there were secondary impacts that were not properly assessed or at least not communicated back to us if more time was needed or resources we need to be informed of that it's not enough to respond to an IG report and tick the box because that's not necessarily achieving the mission and this really is my overall point the mission is to serve our veterans and is a customer service endeavor and so that requires going that extra mile the IG report sometimes takes several years to produce we know in the case of say military sexual trauma the training materials that we have now are way better than they were two years ago there needs to be constant updating of that training there needs to be dissemination of best practices so if the IG puts forward a plan of action you actually need to be pushing back to say we want to achieve the mission but if there's a better way to do it we're gonna do that way and not just taking the training materials that are noted say the IG says you know best practices from 2013 well that's not good enough in 2018 and so that's a broader issue that's a broader issue of owning the continuous improvement the mission of serving our veterans and being proactive in that as opposed to reactive to this committee the Senate or the IG reports I know everybody here sees themselves as being on Team veteran Team America but but we have to deal with the culture issues that have led to the series of IG reports series of concerns that the mark is being missed and that is not good enough for our veterans it is discouraging and frustrating to the taxpayers and we need to do collectively better but that is going to require you to be proactive in letting us know and looking for ways to do that I know it is important to recognize we have a number of people here today for whom the GI Bill revelations are going to be important but again the purpose of this hearing is in particular to focus on the on these IG reports that we've had over the last couple of months with that i want to thank dr. lawrence ms murphy mr. Clark and the IG mr. missile for being us with us here today and we look forward to your presentations thank you I want to welcome the witnesses who join us this morning and thank you for taking time out of your day and being here today our first witness is the Honorable Paul R Lawrence who is under secretary for benefits for VA he's accompanied by mr. Willie C Clark senior VBA's deputy undersecretary of field operations and Miss Beth Murphy of the director of compensation services for VBA also joining us at the table is the Honorable Michael J missile who is the inspector general for the VA it's oh I G welcome to all of you I want to remind the witnesses that your complete written statement will be entered into the hearing record dr. Lawrence you are now recognized for five minutes good morning chairman Ross ranking member st and members of the subcommittee we appreciate the opportunity to speak on the topic of VBA's development and implementation of policy initiatives but before I get into my opening statement on the subject of this morning's hearing I want to address a misleading NBC news story from late yesterday that gives the false impression that some veterans on the GI Bill will not be made whole with respect to their housing payments based on the announcement VA made yesterday nothing could be further from the truth each and every veteran on the post 9/11 GI Bill will be made 100% whole retro actively if need be for their housing benefits for this academic year based on the current on half DoD rates and beginning in spring 2020 we will be in a position to provide veterans with the new rates where applicable to meet the law known as the forever GI bill once again each and every and I mean every single veteran will be made hold for their housing benefits this year as announced yesterday the rates we are providing for the current year uncap DoD basic rate for housing allowance based on the location of the schools main campus rather than the physical location of the student for many students the DoD ba8 will be equal to or higher than their current payment if a student was overpaid due to the changes in law or because of VBA's challenges and implementing the law the student will not be held liable for the debt and starting in spring term of 2020 ba will have solved as current technology challenges so that the department is in a position to provide post 9/11 GI Bill veterans the new rates were applicable to comply with the forever GI Bill let's move to the topics at hand we recognize the significant role that oversight plays and the importance of the veteran's service organizations we have worked hard to foster our relationship with the office of the inspector general the general Accountability Office and with congressional members and staffers we meet monthly with the OIG to discuss trends and review findings we have also recurring meetings with Gao since June we've held monthly meetings with VSOs to discuss improvement plans to address issues that affect veterans working with these partners insurers together that the right elements as we move forward in developing and assessing our plans for implementation we appreciate the special relationship vba has with the OIG the invaluable feedback and observations the OIG provides to VBA leadership enhance our ability to review our effectiveness and validate our plans we count on this continued collaborative relationship and the feedback that is received we concur with all the findings and recent reports and are executing these recommendations let me begin with the report on military sexual trauma vba is committed to serving our nation's veterans by processing claims to MST in an accurate and caring manner by October 2nd 2018 VBA provided updated training and guide two claims processor additionally VBA developed an action plan that puts us on track to conduct special focus reviews and consistency studies in a timely manner therefore we are returning to the best practices that previously made us effective which includes the designation of specialized claims processor to work these sensitive cases let me turn to the intent to file vba appreciates the acknowledgement by the OIG that the error rate drops steadily to 4% during the course of its review the report also noted that after March 24 2015 VA could no longer grant entitlements to benefits using an informal claim and a new form was required the report highlighted issues identified with this new form it also noted that the form was introduced for quick rollout and insufficient training we have done better with our ITF claims and we were able to fix issues while this report was in motion let me turn to the report on reexaminations while veterans are service-connected for a disability that is likely to improve EBA establishes a plan to review the current severity of the condition many of these reviews result in re-examination oh I G's key findings included reducing the number of unnecessary reexaminations in response to this recommendation vba has provided targeted training to identify where reexamination is needed we have also created tracking systems which allow us to better identify and manage the workload the VA has also developed a phased implementation plan to assess quality each of the phases focuses on a set of business rules that help us identify unnecessary case reviews finally I'll address the most recent report on claims for ALS vba concurred with oh i geez findings and has taken steps to address the recommendations to improve the proficiency of our staff on November 19th 2018 VBA issued guidance and updated training to specialized claims processors assigned to work these complex claims mr. chairman we've heard the concerns that VBA has rolled out many programs too quickly and with insufficient training previously in an effort to address problems we focused on unilateral decisions it did not engage our stakeholders early enough since I arrived we have been more thoughtful and Domanick in our approach i developed three priorities the third of which is fostering a culture of collaboration one example of the difference in management style is my first senior leadership conference where meaningful discussions led to the development of 14 integrated groups with both headquarter and field membership these groups gather data conduct analysis collaborate with stakeholders and map out plans for solutions on topics ranging from performance management to quality improvements to reducing a rework I launched several organizational assessments including Utah utilizing external consultants to survey several functions and offices in VBA to obtain objective insights appraisals and recommendations for improvement based on best practices I'm implementing a deliberative approach to planning consulting executing assessing and then doing course corrections and leveraging best practices with each new initiative or policy change VBA is now focused on continuous improvement and we do this deliberately and collaboratively we look forward to coming back to you as a group or individually to discuss our successes this concludes my testimony I look forward to answering your questions Thank You mr. Lawrence mr. mister you were recognized for five minutes Thank You chairman vos ranking member sd0744 VBA that allows us to better review national policy changes and focus on VBA's high-impact programs and operations previously we largely conducted oversight through inspections of VBA's 56 regional offices in October of 2017 we implemented a new national inspection model for VBA oversight under this new model we now conduct nationwide audits and reviews of high-impact programs and operations within VBA with a focus on identifying the root causes of any problems uncovered and making meaningful recommendations since implementing this new model we have published 15 over reports related to VBA in these reports we made 55 recommendations for improvement identifying nearly two hundred and seventy eight million dollars in potential monetary benefits I want to highlight four recently issued reports related to our oversight of VBA in July we reported on whether VBA required disabled veterans to receive unwarranted medical reexaminations in August we published the report that examined whether VBA staff correctly processed claims related to veterans military sexual trauma prior to denying the claims also in August we published the reports or the results of a nationwide review of whether VBA staff assigned correct effective dates for compensation benefits for veterans using the recently implemented intent to file process and last week we reported on whether VBA accurately decided veterans claims involving service-connected ALS also known as Lou Gehrig's disease these reports identified common systemic issues that contributed to our findings the primary root causes of the problems we found were deficient internal controls inadequate program leadership and monitoring a lack of information technology system functionality and the unintended impacts of VBA's National War Q implementation to be clear we believe that recent VBA initiatives and policy changes were well-intentioned to expedite the benefits delivery process however these reports revealed that VBA leadership emphasis on efficiency has affected the ability to review and process claims accurately as detailed in our reports of my written testimony these recurring deficiencies resulted in the inadequate delivery of services and inaccurate benefits rendered to veterans we understand that VBF leadership has been taken numerous actions for the last several years to address the changing and growing demands for benefits and services and to reduce the claims backlog however the recurring deficiencies we identified are often the result the VBA leadership making management and operational decisions without fully considering and planning for potential unintended consequences resulting from their actions these includes sacrificing accuracy for timeliness rolling out national initiatives after small and short pilot programs and implementing programs that do not have fully developed IT systems and robust internal controls for example VBA is intent to file initiative at a short six-month implementation and delivery period errors generally occurred because VBA did not take the time to set up adequate standard operating procedures before implementing the new initiative additionally VBA's IT system lack the functionality to assist rating personnel in assigning correct effective dates for benefits through poor intent to file claims since nationwide implementation of the intent to file process VBA has taken steps to improve its control activities and IT functionality which has resulted in improved accuracy but the errors that occurred during the initial implementation period will have to be reviewed and corrected requiring the use of additional VBA resources we believe VBA's implementation of our recommendations will help limit the unintended consequences of VBA's policies and programs and better position VBA to provide services to veterans and their families in the most effective and efficient manner possible VBA is generally concurred with the 55 recommendations we have made under our new national inspection model and has provided acceptable action plans VBA must now follow through with the difficult work of implementation if they are to carry out the responsibilities effectively and be good stewards of taxpayer dollars we will of course monitor their progress mr. chairman this concludes my statement I'd be happy in any questions that you or other members of the subcommittee may have thank you vendor missile with that we're gonna begin questioning and I will allow myself our five minutes to start off but let me first off to also say dr. Lawrence that your announcement of making very clear to us and to the public that it is to make all of our GI veterans whole and/or also then not to and hold them harmless for those who may have been overpaid is a good start for this hearing and let me tell you that I believe that it'll also calm down a lot of the questions that would have probably come up here today that being said we do have some real issues that we've got to deal with and I'm gonna I'm gonna go a little off script here because I know the question I want to ask but I want to express it this way I know you came in in May and but the I'm I was a full-time firefighter and I can remember my first night on duty and the fire chief came in and he says Mike I want you to know something he said you are in a job that there's gonna be a lot of problems and you're going to you didn't create the problem you got to fix it though whatever you do don't make it worse whatever you do don't make it worse okay let me let me simply ask how are you planning to change the culture from the VBA from its presence issues that arise from this systemic lack of planning and effects and effectiveness and the imp and how to implement how to implement eight things going forward not only on past projects but on new projects I'm going to change the culture by modeling different behavior well let me explain when I think about these problems I draw on my experience in the private sector just like you sir and what I what I observe and I take away from this is sort of you know other general management perspectives as mr. Missal described you know decisions were made very quickly and probably without the right amount of expertise in the room to really appreciate it I've slowed things down so decisions are made more deliberately I call it go slow to go fast we focus on fewer things and we spend more time thinking about what the risks are and the potential unintended consequences and more importantly or equally importantly we have more people in the room to make sure we have voices I take diversity and inclusivity very serious but to me it's not a skin collar thing is inclusive inclusivity refers to bringing people with different perspectives into the conversation to avoid the things we're just describing so those are the two things that drive my understanding of how we're going to go forward my leadership style that's been demonstrated from the very first time I showed up even in confirmation when I talked about priorities and what we were gonna focus on most importantly heard me make reference to the directors conference the Leadership Conference in September that's where we really did the work on describing where people came into the conference having prepared thoughts around key topics where we had rigorous discussion about what the possibilities were there were no talking heads in this conference there was real work being done till 8 o'clock the two and a half days we were together and at the end of that we put forth ideas about how we would work on things like rework like quality everybody in the room all 76 people got a star and got to go vote on what we thought the best answers forward were those were the projects we took took down and are now working which will be harvested in the spring and beyond so that is the different behavior we are now doing so I think collectively the good ideas in the room you know really make me confident about the Vallot the talent on the team and what we can do differently going forward my next question is for mr. missile yeah you know you mentioned that the VA has historically exhibited systemic problems associated with and how it implements policies initiatives such as such as inadequate training incomplete IT functions deficient risk man mitigation strategies and lacks quality control have you identified other areas where VA can improve its foresight to better plan for the new policies initiatives to avoid potential negative impact on claims processes yes you've mentioned some of the more significant ones that we found one of the other issues that we think is real important is communication within VBA because there's instances where one side involved in an issue may be aware of it and the other side doesn't get that same information it's very hard to properly implement something if everybody is not on the same page as to the information there what the goals are what the processes etc and so what we try to do in our reports we not only try to get it right we try to be fair but we also try to say what the root causes that we find because if the mistake is made we want to be able to point out that mistake so that it doesn't happen again okay I'm I'm gonna go ahead and turn over now to rank you ranking member se for some five minutes thank you very much and I'm gonna have a series of fairly specific questions than submit for the record but I want to continue this line of discussion because I think it's really important about changing the culture things are happening quickly you're being asked to do a lot of new things in VA quickly and we understand that can be a lot especially for an institution that coming out of a military background doesn't always embrace change that quickly so so you've got a mindset change you have to deal with I want to talk about the communication issue how do we ensure that that's happening how do we disseminate those best practices the national work queue was a huge undertaking we should be reaping the benefits of that now but that means that information has to be assessed and it has to be pushed back out to all of the offices so why don't you talk about that as well as specialization I think that's come up on the quality control these more difficult claims ALS being one military sexual trauma being of they require specialization to get right because of the nature of the trauma to the veteran involved the importance of doing those accurately and well it is just not fair or reasonable to think we should be training each and every claims reviewer to do that that is not a good use of time and it should not be done so can you talk about dr. Lawrence how you're going to identify the areas that are going to require specialization what you're doing to make sure that happens so that you are proactively not just in response to an IG report but how are you going to track what are those areas that require specialization how are you going to do that train how are you going to update the training so that we are continuing to have best information and best practices disseminated across the totality of EA so let me start with specialization first ma'am um yes we agree on there should be more specialization the benefits of it are clear and we should do more of it probably early summer unrelated to the report we began to think about how we process claims under the guise to be better for veterans and part of it was efficiency we are identifying which claim should be bundled in a specialized manner like this and so we have local lanes and their specialization for ID virtue of this we are trying to balance the you know efficiency we get the sensitivity the caring and quite frankly the right places we should do this around the country this is something we're already working on and we think the benefits are clear and as we discuss with you leading up to this to build on even some of the things we better understand about the veteran experience so we should do we should do more of that but I want to be careful it won't be the answer to every problem but we see the benefits of specialization and we want to reap those we draw on best practices from some of the leading companies and they caution us to be careful because at some point you can go too far but we don't think we're anywhere near close to that based on the work we've done if I could just answer your other two questions on in terms of communication yes ma'am that was something I thought about a long time in any large organization as you know we have 24,000 people our construct is headquarters and then 56 regional offices around the country we have tiers of people and land levels in between that we need to communicate with this also came up in our directors conference and there's a project this just concluded about how we're going to more formally communicate what the mechanisms are what the vehicles are what the responsibility of everybody is to participate and then pass that information along that will not solve every problem but at least we'll begin to address the awareness of issues pushing it out to everybody so we have greater consistency and your last thing I think was the training to make sure we got it and let me draw on Beth here because I know she's been thinking a lot about this as we deal that thank you sir we've really been empowered under undersecretary Lawrence's leadership to look for different ways to do things as far as training I think in the past we relied on a more one-dimensional aspect of training which is we put out a call or we have a PowerPoint materials someone delivers that or you do that online these days when you want to find out how to do something what I do and I know a lot of folks do is you go online and you look for a video I would rather have someone show me how to do something rather than just tell me how to do something so we're capitalizing on that with new technology and tools and platforms with the intent to file that was part of the solution we used a video to instruct folks how to look for the effective date with the intent to file and we reap the benefits down to a four percent error rate and more recently a two percent error rate we're doing the same thing with the military sexual trauma rather than a PowerPoint it is now a video that says I'm putting myself in the place of the military sexual trauma coordinator where it'll walk through the checklist how to develop for these cases how to make these phone calls so it's a more dynamic three-dimensional training that folks can access at their leisure and it also it's it's mandatory but then you can go back and look at it where for refresher as necessary thank you and I see my time is expired thank you I yield back mr. Kaufman you recognize the chairman mr. uh missile what what is the central problem you're on that we get this all the time that oh how we're going to do things differently and at the end they always fail the VA always fails is it is it that they they never assess the requirements properly they don't manage contracts properly what would you say is the central reason for failure I think there are a number of different reasons why these programs don't operate as effectively and as efficiently as they should you know I think you can start first with the planning phases do they do enough to plan do they take the proper time secondly do they determine whether or not the anyit that's going to go along with the program has the proper functionality as a brim properly tested next is just once it's it's implemented what are the internal because in question of like communication how do we know it's working it's working as if if you're looking at it in hindsight looking at the controls to determine whether or not you have issues there and finally do a root cause analysis that if something hasn't worked as anticipated that you take a look at it again so you don't make the same mistake so I think putting all those together that's sort of a sort of general summary of the issues that we generally find do does va mr. missile bring in outside consultants experts to be able to define it's one thing to have a contractor come in to implement a system it's the other thing to objectively define the requirements and it seems to me that at least certainly when we looked at the issue concerning the post 9/11 GI Bill and the changes and we're going to be doing that in the second round so I don't want to really get into that now but they were unable to assess number one could they do it and said that they could do it and number two even come up with a time line number three they couldn't manage the contract and the contract ultimately failed as my understanding but is it that is that they need professionals from outside the VA to come in and write these requirements and manage the contracts or are they doing that number of situations they do bring in people from the outside VA as thousands of contractors who are working at VA and sometimes it's it's as simple as just working together is to make sure that when you have a contractor working with the VA staff and systems are they all integrated well and that's one thing we find is that sometimes they're the integration is not what you would like it to be and then you're sometimes working across purposes mm-hmm mr. chairman are you back mr. Bergmann yeah you're recognized Thank You mr. chairman thank you all for being here today these hearings are always informative I believe to all of us I'm very appreciative as I know we all are of your proactive nature in this people who serve in uniform have to be proactive by nature because the mission requires movement adaptation and overcoming obstacles in order to succeed and I would suggest to you that any culture whether it be here in the Congress or whether it be in the VA or the Department of Defense or anybody else related to veterans if they don't have that same same culture of adapt and overcome we're gonna have long-term failure okay so having said that dr. Lawrence when you when you talk about if you will revamping revising building a new culture under under your command can you give me an instance of some of the things you might be doing outside a norm that of we've always done it this way kind of thing to to build that culture with those under your command sure one of the things we've done and and I eluded this my opening statement is really searching hard for best practices in industry if you think about what we do for example we maintain an insurance product line we can learn from how insurance the world-class insurance companies learn and copy those behaviors that are relevant so I want to really draw on leverage best practices from around the world I don't mean as good as it gets in government I mean world class elsewhere because we can be that good because the talented VBA is that strong it's not a magic question because you know I appreciate that looking outside your organization for best practices is when I heard do people come to work because they have to or because they want to under your command I don't know the answer for me specifically but I will tell you the survey of why VBA employees come to work every day is the purpose of the mission of serving veterans we've had outside studies don't know that prior to me and consultants come and talk to us all the time and say dad is a very powerful draw to why folks come to work at VBA okay the the use of contractors how do if you have those who are on your payroll if you will as your employees under your command and then you have this adjunct group that melds into your organization for a time but not as permanent employees how then what do you do within the culture that you are trying to create that will make those contractors feel part of that team that they're actually the itch they're just trying to stay because they want to stay working for the veterans what kind of programs or policies or training things that you have in place to bring those contractors in that it's just it's one group you can't tell who's the contractor and who's the employee so we focus on when we use contractors the way you're describing because sometimes we use them for spot solutions right they come they assess something and they leave so they wouldn't quite qualify for what you're describing we focus on integrated product teams and try real hard to get contractors who are also focused on serving veterans as you know there's a requirement that we deal with generally veteran owned businesses and that sets us in a very good position as well many folks have traveled in and out of the VA processes and they get it so really we've seen people working closely together and quite frankly we think VA is a good client to have if you're a contractor or consultant and people come to us and they want to stay for long periods of time through the contractor relations okay one last question because I say I have about a minute left is there any current surge capability that or on the horizon for you as you build your organization here going towards the future again mission oriented we know we have you know we're talking military language here but when you need to surge is there anything in your plan to create some level doesn't have to be a lot necessarily but that idea within your organization if you need to redistribute assets for a short period of time is there anything in your plan that would indicate that that's part of it as well yes sir there is um so for example in the arm in the September October time frame when we were experiencing real difficulties the GI Bill our call centers were overwhelmed we get about we're staffed for 15,000 calls a day we are getting north of 25,000 a day I'm looking at best practices for other call centers to figure out what the surge capabilities are often they have relationships with other external entities for situations like this Christmas for example so yes that's definitely part of our plan cuz I don't think the answer for veterans should be wait okay thank you and I yield back thank you mr. banks you recognized Thank You mr. chairman dr. Lawrence yesterday's news report regarding the forever GI bill was deeply concerning even more than when we heard from you testify last before my subcommittee the technology modern modernization subcommittee a couple of weeks ago your IT systems continue to leave veterans in need the mission of the VA should not continue to be compromised because of a foible like this what was the rationale behind you getting rid of the Booz Allen contract and why would you not just have Booz Allen hire different subcontractors to do the job sir we have not made the decision to get rid of Booz Allen so that's inaccurate that's being discussed right now they do many things for VA broadly and they will continue I think we're trying to figure out how to redirect them to the work they continue to do for VA so that's that's a misnomer um to get to your broader question though basically why don't we why don't we pause with that how much have you paid Booz Allen I don't know I don't administer those contracts we can take that for the record okay please do I think go ahead I'm more broadly I think you know my recommendation forward which the secretary and others turned on and accepted dealt on sort of three three primary tenets and this was pretty clear to me based on my professional experience as well as just traveling through this journey than I arrived in May we had real challenges with accountability and so I stepped forward and said I would be the person accountable for implementing GI Bill we had difficulties with the program management structure so we will engage our FFRDC federal funding research and development center the special relationship we have with in the lighter corporation to provide conflict free advice on the program on integration the schedule and help us manage it and then we will go find a world-class sub a world-class contractor to deal with the following systems integration and software development two weeks ago when I sat here you listened to the contractor say I do software development we need to do systems integration you'll recall I drew the chart with all the boxes that's what he was talking about in his in hindsight we needed a systems integrator and software development corporation to help us ok let me switch gears a little bit one of the issues that came up on the committee staffs trip recently damasc Iggy GI Bill processing office was the problems that processors were having with Microsoft Word and other Microsoft systems it's my understanding that you were given a plan before Thanksgiving from oh I and T to bring in a team to try to address these problems have you acted on that plan and if not why not sure we had a team there all when I visited the next week so yes what have they done what does that team done they've been decon they've been D conflicting the software and identifying workarounds to make it so it does not lock up and that's been dramatically reduced I'm still concerned that we're using workarounds versus a solution so we're trying to figure out whether we need to engage Microsoft for example but again that's been so you're still trying to figure out whether or not to engage yeah um accomplished what what's the what is coming they're about they're about 95% of the way there and the question is you know is it because we have workarounds or we solve the problems and that's still being assessed when do you think we'll be 100 percent of the way there I don't know the answer to I'll be happy to come back and talk to you about it all right I yield back that's right everyone you're recognized Thank You mr. chairman I want to thank the ranking member for holding this important meeting I also want to welcome the panel thank you very much my question is for Inspector General missile are there any of your recommendations in the MST report that VA is not addressing I'm sorry that is not are there any of your recommendations in the MST report that VA is not addressing no they're they've concurred with all the recommendations and are in the process of implementing them and we will review that to ensure that they're fully implemented and dr. Lawrence how are you planning to address the rest of IJ's recommendations and when is the timeline to complete these actions we're gonna address them aggressively we've already started on some so I know let me draw on Willie here because he actually implements the the plans we have good morning we have a several pronged approach to dealing with the MST bethe spoke to earlier the training were updating the modules in a youtube type of an effect we also that we have updated the manual mandating the use of a checklist that all of our claims processes are supposed to use or will use we're mandating a checklist for them to use that way is will improve upon our quality if they're guided into a step-by-step process of what they need to do for the appropriate development of that case and to rate the case we also have identified coordinators for MST for each of our regional offices we have conducted training all of which has happened we had completed some training in September in the end of last month we have another set of training that's supposed to be done it has been completed at the end of this month so every one of the recommendations we have implemented Thank You mr. chairman I yield back thank you I see there are colleagues representative Peters has joined us here and I would like to ask unanimous consent that representative Peters be allowed to set at the Dyess and ask questions hearing no objection so ordered mr. Peters you are recognized Chairman Roland I want to just get a couple of things clarified on and and this this GI bill is complicated so that I understand so that our students out there understand dr. Lawrence is that the when the law went into effect August 1st it contained two sections 107 and 501 and as I understand it the 501 section is a cola as to cost-of-living adjustment the 107 section is where a student would be paid to pretend based on where the bricks and mortar campus is and then lastly the online students are paid at a different rate so am I correct on all that to understand that that's correct okay and I want to make sure that I understand that when the this the law states that this all this goes into effect on 1 August of this year 2018 are we saying and maybe I misunderstood you but are we saying that the the 107 provision and the 501 provision will be made whole those students under both those provisions will be made whole as of the law was stated on 1 August am I correct on that we're going to go back into the fall of 18 and make sure they get the DoD on cap rates when whacked back again are we gonna we gonna follow the 107 section of law which says where the bricks like a student for instance let's say that student is going to college in San Francisco has a much higher per diem that if they went to college where I did in Clarksville Tennessee which is a per diem it'd be less and half or a third of that much that student who took the majority their classes in clarksville will be paid a certain per diem am I correct that's correct and then and then the student who would be in San Francisco which is obviously much more expensive to live there we're going to go because we those payments are not made may not be correct right now we're gonna look back and follow the law and pay them going forward then what what's the discussion about changing the statute to December of 2019 that's what I don't understand if we're going to go back and make 107 and 501 we're gonna follow that then what's the point and moving it forward I know it's a lot of work and it is complicated but I want to make sure we get it straight here today for sure so I'm the this fall we're using the 2017 rates we need to use the 2018 rates that's the trip we're doing when we implement the new law the forever GI bill in December of 2019 we will not use the zip code we will be using definition of campus and that's what we use going forward but but the law states now that in August one of now we should be doing that correct that's correct so again why wouldn't we why wouldn't we follow the law cause they're gonna be a group of students that for at least one and a half academic years they're not gonna be paid correctly and they're not gonna be treated up am I right on that know they'll be Trude up for this fall okay it is not clear what the difference will be come the implementation may be none I mean maybe not maybe that's doubt we will have to assess the burden on schools to go back we will have to assess the burden on VBA I'll have to figure out the benefits for folks who are describing it is not clear there will be any difference under the new under this interpretation of what a campus is but again I'm not trying to overdo the point but if if we if we follow the law as is then you've got to go back in and look it creates I've realized a lot of work to do that I understand that to go back and make sure that those students who started class and the fall semester in August of this year are going to be made whole according to the law as it was passed August 1 and and stated in law August 1 20:18 right will seek to work with you and your staff to better understand whether that's in the best interest of veterans given all the work you describe the potential low benefits from doing that quite frankly so I think we need to figure out whether we need to come back to you and ask for a legislative change to push the day to December first or not it's not our intention to harm veterans we also have to think about the broad veteran population and whether what you're describing yields any benefits just work well I think anyway we'll continue this I'll go ahead and yield back but I want to make sure that we off mic work through this and just see how many veterans we're talking about because there could be some that we've underpaid out there and probably our veterans that have been underpaid and we don't we want to make sure that those veterans get what they earn and what the law stated I yield back it's chairs intent to have a second round of questioning the second round of question will be a three minute so the members know so recognizing myself because we really want to focus this justdo I think is been okay and we want to know and I think the people deserve to know because when representative banks ask there was still some confusion on the statements I guess that were made yesterday and you clarified those and I appreciate that that being said how many watch what's our actual number of GIS that are receiving the GI benefit at this time I don't have the exact numbers in front of me but when I was here two weeks ago I said it was 450,000 approximately do we know an approximate error ratio or how many are people who are being affected and and which ones were underpaid no we can't get exact number but know that's part of the problem without the technology we were unable to do anything but estimate that broadly and I'm not so certain those are accurate estimates because of the way the changes were going through again I'll apologize don't have subject matter experts here to kind of do happy to take questions for the records okay yeah I built that's we get to then then then the question I have on top of that is as you go back and try to figure out these air and then live up to the commitment to make someone whole is it going to have to be done through the tech people that you were working with originally because the statement that was opposed and the contractors are they going to have to be able to pull that out or can your staff pull that out and fix your the the toe sorry didn't cut your officer on the technology is in place to do the true up I've described for the fall of 2018 next two weekends will load the 2018 rates will compute them and folks who were short will get a check in January for the difference okay I think I think another concern is where the Chairman was asking as well this confusion about what your home zip code is but where you were actually located and then getting the proper per diem is vitally important especially whenever the law has been written and said that's what we'll do to make sure that that that everything is caught up and done correctly and trying to get I want to know from this committee standpoint that that we have the commitment that that's going to be the case where where your staff is go your group as a whole is going to be aggressive to make sure that anyone that's old is found out that they are old and then made whole any one of the areas so yes generally but let me work specifically on this there's a couple things going on here in the new path for it one of them is returning to the definition in the law of what a campus is it's a building owned by an institution that's different than the zip code thing we explain where students could do in term this is different that difference will go into a place on in place December 1st 2019 for the spring semester of 2020 when we asked to go back it's not clear what the differences will be and that's what we have to figure out and work with your team to figure out is all the processing going to end up with one person getting a check for $1 we don't know that yet it's not our intention to harm veterans but it's also our intention to process the GI bill effectively and accurately going forward ok I'm out of time but Missy Thank You mr. chairman again I think we need clarity on this and this is again an example of we had an intent in the law veterans may have understood that to be a certain way so we may still have an issue you may look at the law and say well we interpret it this way I assure you we are going to have constituents will say that's it's not what we thought that to mean so we need to be in close communication as you look at what is an error to understand they're going to be veterans who believe that they were promised this and we need much greater clarity and that takes me to sort of the second point the IG noted that some of these systemic problems going back and I'm thinking now with our hearing next week we've got Appeals modernization rolling forward so what are we going to do not only on the forever GI bill but on appeals modernization to be looking at that IT capacity and knowing what the requirements are so that we are not faced with exactly the same kind of situation with Appeals modernization where we're having to go back and redo and rerun and rework which is one of the core things we need to stop doing as having so much need for rework so if you can address what is being now are we doing beta testing how are we going to ensure that we understand the needs the system will have from an IT point of view that we aren't you know learning by the seat of our pants having done a national rollout and actually not being ready to do that I don't want to steal the thunder from the team that will appear before you on next week on appeals modernization but they'll tell you a very positive story with technology the system is in place and they're doing end in testing exactly the way you're describing I will tell you that the takeaway from my confirmation hearing were the two things that I should worry about going forward were the GI Bill and appeals modernization and after I was in office for one week I started meeting with both teams every week for an hour to understand the state of what's going on I'll tell you that in terms of Appeals modernization you see a very different experience the team began working together three years ago the systems we used are some of the most mature and the technology we use is new and vintage just for this purpose so far all in the way all tests have been passed I'm very positive they'll tell you more about it you next week I believe well I hope we can take the lessons the are being learned there and makes sure that those are used every time with forward going programs and to the extent we can then put this back into the favorite GI or at least it maybe we cut that off and start over again with with the kind of design we're doing to benefit from from this approach because I think sometimes trying to bootstrap and rework a system that is not working well is not a good way to to go I'm just gonna put that out there was something for you to consider thank you and I yield back mr. Coughlin Sherman dr. Lawrence first of all if you're unable to meet the statutory requirements that are very clear you need to come before the Congress of the United States to have those altered you don't you're can't simply change the law yourself if you're unable to meet the obligations that that your department agreed to and the Congress of the United States mandated through law and the President of the United States signed the let me ask you this how many senior executive service positions do you have in in VBA I don't know the exact numbers approximately a hundred I would guess but I'll get you the exactly you've been there for six months so how many SES positions have you have you let go I think the answer is zero in earlier because I've had a conversation with a prior with or with our new secretary and followed up in writing a tomb that there are about 400 positions in the senior executive service level and in the Department of Veterans Affairs after the the scandal with the appointment wait times the on a bipartisan basis the Congress the United States passed and President Obama signed the ability for you and for the senior leadership of this department the Department of Veterans Affairs to expeditiously let go a senior executive service personnel that were not competent in my discussions with the sector he's unwilling to make that commitment to do that to look through these 400 positions where there's objective failure and the inability to correct that failure by inspector general our reports by Gao reports and yet you will never change the culture of bureaucratic incompetence in the VA unless you're willing to look through those 400 positions and where there's a where there's a lack of competence where problems are unresolved then you're unwilling to make those hard decisions which your which our secretary is not willing to do what you're obviously haven't done then nothing will change this president will fail the country in terms of the commitments that he made to change the VA he changed the secretary but that was on the basis of his his record in terms of personal spending or spending taxpayer dollars on a European vacation it was not on his his competence in terms of running the VA this is the same VA of the prior administration just papered over who is saying how great things are when they're not great I yield back mr. Lamie recognized Thank You mr. chairman if it's okay I'm gonna go back to the one of the issues that this hearing was called for having to do with processing of benefits claims in particular our VA is in Pittsburgh process claims involving military sexual trauma and I know well I guess you can confirm for me if I'm correct that each office is supposed to have a specialist dealing with military sexual trauma claims is that true mr. Clark good morning mr. land that is true we have specialized individuals for military sexual trauma at each our oh that is true okay and have you been able to fill all those positions are they full as of right now they should be full yes we have military sexual trauma coordinators that are full if for some reason someone left yesterday that you know that I don't know about but generally our leaders know to keep those positions filled and to make sure that they receive all of the requisite training and quality measures or fill in order to do this work they are not to do the work on an MST claim unless they've had the requisite training and they follow the guidelines that we've set forth with this checklist and then viewing the training materials and the like okay and are they are they overseeing examinations for military sexual trauma done by contractors or more done by VA personnel for the most part contractors okay but there's there are some instances where VHA doctors perform these examinations and again VHA sometimes uses contractors as well have you looked at the outcomes or quality of those examinations to see whether the contractors are doing an adequate job because I think this is an area where the VA doctors kind of particular training and familiarity with this population and this type of claim would really help I will certainly let miss Murphy speak to that so sir I think it's generally been about a 50/50 split overall with exams as far as VHA versus contractors I think we both entities VHA and vba watch closely who's doing the exams and has quality controls checking the reports so I can't in the moment speak to the specifics but yes both sides are watching both sides are engaged in this work okay thank you very much mr. chairman I yield back thank you and mr. Burton when you're recognized you kind of to continue on with my my questioning a long line of building a culture I as we look at the the GI Bill going forward in the payments and the coordination between the VA and the educational institutions not the veteran but the educational institutions about a year ago we had a hearing in here where I brought up the the concept of the in the Marine Corps the sand table exercise and we did a little you know back and forth on that but d the idea of is there and by the way this committee bipartisan is going to be the best partners that we can be with you because we we want results just like you do of course it's our job to to give you the money and then hold you accountable it's your job to execute the mission is there anything that we can do for you to if you will to participate in a I'm going to call it a sand table exercise that the goal of this exercise would be to see where the system can be gamed whether it be accidental or on purpose on either side of the either side of the equation because unless we take what we're about to implement and then put it into exercise to see and put the I know all these minds on all sides of the table are smart motivated and potentially devious okay because I have kids I have grandkids what you know that's how it works and it's up to us to make sure that we make that we if you will close accidental loopholes that cause others pain pain of of loss of dollars or or pain of loss of credits or whatever it happens to be any thoughts on where we can do that or maybe that's already in your game plan um yes and yes absolutely we want your help a couple things immediately come to mind one of them is when we do the user testing to sort of you know get examples of veterans that we think we need to make sure the system works for so I know your staff has been great sort of identifying people who call you and say I'm having trouble so we leave that in addition I'm sure in our the new plan going forward we'll spend a lot of time with you explaining things so I think there's probably you know a reason for engagement is our interpretation so some of the things that require and to make sure that we're coordinating on that as well okay well again I see my time is about to run out but engage this early because the sooner we engage and the sooner we pick it apart the less we're gonna have to have hearings like this after the fact and I yield back thank you mr. Peters you're recognized Thank You mr. chairman dr. Lawrence I'm gonna make sure I'm clear on exactly what you're saying about a section 107 of the forever GI bill which we passed less or this session section 107 is the section dealing with students being paid according to where they're taking the majority of their classes and lament would have been section 107 been in place by the August 1 2018 deadline in the law and if they were underpaid between August 1 2018 and when they the section has finally implemented hey then the difference to make them whole what I'm testifying to is that we'll go back into the fall of 2018 put the right rates in and make sure they get a check in January if they've been underpaid what changes as we go forward and think about December of 2019 is the way we thought about campuses if we recall there was a long discussion about zip codes and practices written that set in motion some expectation of overpayments or underpayments and the like when we return to the definition of campuses defined by the law and our interpretation of it it is not clear there's going to be any changes we've got to figure out what the implications of that are and then go back or not as appropriate so you're suggesting is that there's some you're having an issue with the interpreting to lost whether money is owed um a couple of lots we're not interpreting laws pretty clear to fines campus a certain way we're gonna go execute that all right it is not clear that possibilities what are the possibilities there could be wide scale variation and we have to go back for exactly the way you described there could be no variation and the going back would be energy that would be better spent processing claims going forward that's the unknown we have to figure out and quite frankly work with you on – it's not our intention to harm people the way we're imagining is is our intention to process efficiently just I I want to get the sense of it sounds to me like you're leaving yourself some flexibility as to whether to do that or not maybe you're assessing whether it's worth the trouble to go back and following the law as it's written but we are we'd like to know whether these people are gonna be made whole by that formula and I'm I'm having trouble getting that answer out of you it sounds like we want to make people whole I'm not trying to give you a trouble I'm just trying to not give you a blanket statement that requires tremendous of activity for no gain so if you ask me what what should we spend an extra hour on processing things that yield veterans nothing putting at risk the spring 2020 semester or saying this is does doesn't yield much and we're gonna move forward we just have to figure it out it's not my intention to be evasive is my offer to work with you to make sure we all come away feeling this is the right way horde what are you telling veterans and students now who are going to the process going forward what are you telling them now to do we're telling them that you will get trued up for the fall of 18 with the right rates they will execute the new law in the spring of 2020 okay thank you my time is expired ah you bet jammer oh I want to go back with what mr. Peters the line he was taking and and I'm I'm not trying to be difficult but the law states what we must do on 1 August it's it's not an interview said it's fairly clear what the law states the question is are we gonna follow the law that's the question and if we're not then we got to change the law it's got to be changed to a different time otherwise you're required by statute to go back and implement section 107 and 501 as stated in the law am I correct that's correct and previously I I made a request for your help to do exactly that if that's what we conclude based on the energy that it would take for potentially not much game we come back how will we know I guess that's a question I have I'm putting myself as a student out there it's somewhere sitting there thinking I have a benefit that I've earned am I getting paid correctly for my benefit on my getting unpaid how do we determine it's too much trouble to follow a law let me how is that you follow me I'm not by understand what you're saying and I appreciate that you admit you're not trying to be too cold I don't mean to be difficult here that I'm trying to be precise of my answer when we adjust there we'll have honored the obligation nobody has yet been paid under this system that doesn't exist so there isn't a feeling of I'm owed something unless they've been able to calculate something that we've been quite frankly unable to calculate okay when we put the new system in we will know what that is somewhere along the line is we begin to see it coming into focus we will make an estimate of what you're just describing what is the difference and what should we do about it and that's what we'll have to continue to talk to you basically what we did was just for Claire we stood up a system that didn't work and paid people what we had paid them in the past and we don't know what we should have paid them am I correct that's pretty much what we did because our IT system didn't work that's what happened notionally correct that's correct yeah I yield back I want to thank the panel for being with us we did two rounds of question we have another panel that's coming forward but thank you for being here and thank you for the opportunity to say that you'll come back and try to work with us to strive to straighten this out thank you so we do want to invite the second man over the table okay on our second panel we have mr. Michael figlio Lee the Deputy Director of National Veterans Services for VFW we have mr. Shane Learman assistant national legislative director for Divi DAV and mr. Greg NIM Hardin the deputy director of the Veterans Affairs and rehabilitation division for the American Legion thank you all for being here mr. figley Olli you are recognized to start here and give your testimony for five minutes Thank You mr. chairman chairman basta franking member st members of the subcommittee on behalf of the VFW thank you for the opportunity to testify on vias methods for developing and implementing policy changes for VA claims the VFW Nationals veterans service established in 1919 begins its second century of service VFW is encouraged by vias efforts to modernize the disability claims process VA has a number of challenges to overcome however we feel the process is headed in the right direction our philosophy in dealing with VA is bureaucracy has always been praised when you can be critical when you must lately we have found ourselves more in the critical side than we would like VFW has consistently held the VA speeding to completion of its workload for the sake of reducing volume is precarious for both VA and our claimants it does no good to deliver benefits to veterans faster the decisions made are incomplete or inaccurate it's futile to implement policies for the sake of implementing policy and declare mission accomplished over the last three years VA has rolled out programs that were intended to alleviate a number of claims and appeals related issues VFW in our partner VSOs caution VA on numerous occasions about the pitfalls of rapid development we are appreciative of vias efforts and seeking BSO input for newly developed platforms despite repeated attempts urging VA to assess shortfalls and take corrective action before implementation well you've seen VA forced to play catch-up time and time again VFW has been concerned since the input implementation of the National Work you why do some claims seem to move smoothly through the system while others are bogged down due to misunderstood guidance or improper application of the law we have not discerned why are then pointing to inconsistency in the system up until the decision was made to level the playing field we had the ability to mitigate irregularities at the local level since the implementation of national work you VSOs have been restricted more than ever and luckily resolving problems at the regional office such as the example we cited from Pittsburgh where our local advocate was told by our leadership that calling the white house hotline was the only way they could move on a claim that required significant attention in my many years as an accredited VSO this is one of the most absurd responses I've heard from VA staff about an issue that could have been easily resolved to be frank the VFW has been doing this longer than ba we pride ourselves in the advocacy we provide to our claimants but what happens when VA no longer permits its employees to do the right thing locally I fear that the drive to national work you while well-intentioned has only amplified problems with pas and consistency the goal was to level the playing field to ensure veterans receive consistent timely quality decisions the playing field is certainly more level today but not in the way we intended instead we see shoddy work from all corners of the VA with little accountability for what's gone wrong in the process we see our leadership that has hamstrung from doing the right thing because it makes the national system look bad regarding the recent IG reports they all point the sloppy development at the regional office and significant gaps in training none of what the IG found came as a surprise to VFW and this is no way to serve veterans as with any new implementation training is paramount to success this is a persistent shortcoming in VBA across the VA ws field offices our staff see little consistency in the application of law or the code of federal regulation VFW is acutely aware of instances where intent of a regulatory change is crystal clear but applied irregularly at the majority of our OHS whether it's the acceptance of electronic signatures recently updated forms are simply processing dependency claims as we discussed in detail in our written statement if VA is fully committed to establishing a fully electronic and efficient claims process as the total over the past few years they need to ensure consistency across all regional offices and all of the scenarios we outlined in our prepared testimony vo W maintains the proper training or result in better outcomes for VA and his customers VA needs to get it right the first time every time the welfare of our Beck requires it if quality training has not developed implemented and overseen veterans and their families pay the price as said in our opening statement VFW has been embedded in the claims process for longer than PA has existed we've always been able to provide local mediation to assist VA and getting it right I want to be told in the name of efficiency we can no longer do that well the consistencies of the VFW is seen recently it becomes clear the policies innovations the VA seems extraordinarily proud of don't exist in the eyes of veterans and family members who continue to suffer delays and denials and closing the VFW does believe VBA is headed in the right direction in establishing a fully electronic and easily accessible claims process however VA still has significant problems in the system that need to be addressed starting with the unrealized efficiencies of national work queue and the seeming lack of authority for our O's to resolve issues at the lowest possible level we hope this subcommittee takes a hard look at these issues and works to resolve them in a way that truly benefits veterans mr. chairman this concludes my testimony the VFW thank you and the ranking member for the opportunity to testify in these issues and I'm prepared to take any questions you may have Thank You mr. Fiorelli mr. Lierman you're recognized for five minutes Thank You chairman boss ranking member st and members of the subcommittee thank you for inviting DAV to testify today's hearing on VA implementation of policy initiatives and the challenges identified in the three recent OIG reports we are deeply concerned over the findings of the significant deficiencies in these reports from July and August of this year the reason for these substantial errors can be broken down into three main categories training IT systems development and quality review for example the unwarranted medical reexaminations for disability benefits report estimated that during the six-month review period VBA spent over 10 million dollars on examinations not required by VA policy estimated that during the six-month review period VBA spent over 10 million dollars on examinations not required by VA policy the re-examination has resulted in proposed benefit reductions for 3,700 veterans the OIG determined the main reasons for the unwarranted examinations or lack of pre examination review lack of system automation and inadequate quality as reviews the report on processing inaccuracies involving veterans intend to file submissions for benefits found that 97% of the cases reviewed with errors resulted in under payments on a national level this resulted in an estimated 72 million dollars in under payments to veterans and their families the reasons for the ITF processing errors were noted to be an absence of standard operating procedures and inadequate procedural guidance deficient and delayed training lack of quality assurance and a lack of IT development as v BMS lacked functionality in reference to the OIG report on denied PTSD claims related to military sexual trauma VBA staff did not always follow policy and procedures and as a result they incorrectly processed approximately 49% of the MST related claims that were denied during the review period the reasons the MST related claims were incorrectly processed were a lack of previous specialization lack of additional review and discontinuance of specialized focused reviews and inadequate training in all three OIG reports these errors could have been mitigated with the adoption of a vbe a wide strategic formula to apply prior to implementation of any new changes processes benefits or IT systems as demonstrated VBA's erratic training lack of planning for IT systems development and uneven quality review has wasted millions of taxpayers dollars as well as underpaid denied and reduced thousands of veterans VA needs to develop proactive measures to lessen these deficiencies in future projects we recommend VBA to create a systematic strategic review process for new policies and initiatives this could encompass each appropriate VA office potentially impacted by any of the new policies such as VA office of Training VA Quality Assurance and review IT services to include VMs and the national work you however to be truly effective it requires VSOs and other stakeholders as well as v a's frontline subject-matter experts in RVs ours and vs ours a good example is how VB a VA agency's Gao VSOs and other stakeholders were all engaged from the beginning and the development of the Appeals Modernization Act before its implementation VB a and b VA have collaborated to develop IT infrastructure training programs and quality review this type of proactive strategy will lessen the preventable errors noted by the OIG mr. chairman the need for this type of strategic review process is again reaffirmed by the most recent o IG report released just last week the accuracy of claims involving service-connected ALS report projected that 45% of the ALS claims completed during the six-month review had erroneous decisions and once again o IG recommended that vba provide additional training better quality review and add functionality to vb ms a systematic strategic review process would focus on vetting new policies and initiatives to prevent these unintended consequences that negatively impact veterans and their families it would be better for VA to invest time and resources preventing these problems from occurring rather than developing workarounds and patches after veterans have already been harmed this pattern of systemic failures will continue unless action is taken mr. chairman this concludes my testimony I'd be pleased to answer any questions you were any members of the subcommittee may have Thank You mr. chairman mr. nimmer heart you are recognized for five minutes the American Legion remains one hundred percent committed to our veteran community and believe that our nation's heroes should not suffer at the hands of institutions whose existence and mission is to care for them chairman boss ranking member st and distinguished members of the subcommittee on disability assistance and memorial affairs on behalf of our national commander brett rice ted and the nearly two million members of the American Legion thank you for the opportunity to testify on the Department of Veterans Affairs development and implementation of policy initiatives we believe in quality of care at the VA facilities we remain committed to a strong VA and we believe that VA is a system we're saving since 2003 the American Legion has conducted more than 500 nationwide visits to VA medical centers and regional offices to assess the quality in town – of veteran's health care and provide feedback from veterans about the care and service provided by the VA we compile reports from our visits into a publication for distribution to the President of the United States Congress and VA officials the comprehensive report provides an understanding of VA challenges best practices and offers recommendations based on our observations in our nearly 100 years of experience the Department of Veterans Affairs Office of Inspector General recently published three reports addressing unwarranted medical reexaminations processing inaccuracies involving veterans intent to file for benefits and denied post-traumatic stress disorder claims related to military sexual trauma the the VA o IG reports cited inaccuracies timeliness issues lack of specialization inadequate training and overall poor quality of va examinations completed by contracted medical examiners the American Legion wants to protect veterans from these and other inadequacies and urge the VBA to take swift corrective action we believe that a variety of factors caused these shortfalls including lack of funding understaffed VA facilities and contracting companies solely focused on their bottom line at the veteran's expense mr. chairman the American Legion resolution number 87 we support the implementation of policy aimed at ensuring veterans receive adequate comprehensive va examinations the VA oag report regarding intent to file concluded that VBA staff did not always assign corrective effective dates correct effective dates for compensation va led the entire initiative and set the deadlines well before publishing a proposed and final rule time constraints and any subsequent minimally advised a product during the spirit was self-imposed VA must address processing issues associated with intento file to avoid additional costs and inconvenience to veterans and their families VA must VA claims must be processed accurately veterans should not experience additional harm in the process especially when processing MST related claims the improper denial of nearly half the MST related claims submitted to VA is unacceptable finding ways to ensure these veterans receive the services they deserve is one of the highest priorities of the Marique of the American Legion VBA should review all MST related PTSD decisions since 2011 and share the results with Congress and VA souls to ensure accuracy transparency and accountability the growing diversity of veterans mean that a system which primarily provided care to male enrollees must now evolve and adapt to meet the needs of all veterans and to provide them the best possible care va must continue to adjust to the changing demands of the population it serves the American Legion continues to work directly with veterans to help them overcome challenges associated with access to VA health care and claims process we remain committed to a to a VA that is appropriately funded staffed trained and empowered to conduct internal quality reviews and oversight chairman boss'd ranking member st and distinguished members of this subcommittee thank you for the opportunity to share the American legions position on these vital issues impact in the men and women who have selflessly defended this nation this concludes my remarks and I look forward to answering any questions you may have thank you so we're gonna go to the five minutes questions and I'm gonna start out mr. Learman we're gonna start with you and this is probably the most simple straightforward question but probably a very difficult one to answer but good anyway how about that do you have any recommendations for how the VA can improve how it develops and implements new policies and initiatives yes mr. chairman we do and I think one of the basic recommendations is to get everybody involved whether it's upstream downstream within the VA system make sure all the offices are touching each other and being aware of the changes they're being made for example what happened with the MST related claims when they decided to put them in the national work queue I don't know if everybody was fully aware we lost specialization and prior to that in 2015 they stopped doing the special focused review or quality review of those claims so both of those things happen which created the problem we're currently in so it's like those decisions were made in a vacuum what we need to do is bring everybody in together and discuss how these are going to touch as well as VSOs and I really believe our via SARS and via SARS should be a part of these conversations because they're the ones dealing with this work on the local level so they truly understand what changes will impact them and the choices or decisions they make so I think if we're able to get everybody together maybe not in a formal setting but be able to vet these things up and down with everybody involved so we can see some of these possible unintended consequences in the future and prevent these types of things from happening mr. figure I think the early do you have anything to add to that that you might suggest Thank You mr. chairman no I can only concur with with my colleague something that we have brought up to the VBA bas ba a number of times get everybody in the room listened to all of our experienced opinions we are their partners I had to commend dr. Lawrence since he's been the new undersecretary and being a bit more open and more inclusive we see progress but I would concur with the my colleague named mark Thank You mr. chairman I have to agree with my colleagues here not one a second mr. figlio Lee's comments about dr. Lawrence bringing us to the table we have seen an increase in communication and and meeting with the VBA and we truly appreciate that I think that is the way forward and we that that relationship continues to build all right let me that kind of Springs boards me into the other question I've got for each one of you can you describe the extent to which your ghen organization consulted prior to introduction of the nwq and your organization's suggestions and incorporation incorporated the rollout Thank You mr. chairman I guess when the national worker was rolled out I'm not aware of any consultation now that was specifically done across the board before it was rolled out I think it was brought to us once it was closer to a test subject in and already being tested and piloted I guess what we would have liked to have pointed out at that time is to make sure that anything that a specialized can still be specialized within the system because by removing that it really has created a lot of the problems I'd only with the MST but they ALS so what you're saying when when I ask were you consulted before you work and you're not consulted or talked to until it was already rolled out well mr. chairman that happened before I was on our legislative staff so to answer that confidently I'm not sure but I'm not fully aware that we were we may have been I would have to discuss that with our service department does the VFW or the American Legion either either of you know whether you were well I was not in this in this position at the time mr. chairman but I can get you a more accurate answer to that after this session mr. chairman thank you I too was not in this position at the time national work Hewitt was developed I can only add to that that we did act to the fact bring our concerns to VA there have been improvements made but at the end of the day we still have we still have lost a local advocacy through the system thank you and that I yield back and miss Esther you're recognized for fun thank you very much I want to thank the undersecretary News team for staying it's really important that you're here to hear from the VSOs and I think that I want that on the record and I want that noted because I think that is exactly what the three of you gentlemen are talking about the importance of collaboration of understanding we're all partners in doing better veterans and this is precisely what we always need to be doing and I think what you noted about and I was pleased I'll also note that all three of you concurred with the under secretaries assessment that appeals modernization is proceeding with that kind of input from the beginning and I think that needs to be baked in as what is standard operating procedure I also want to note because I know from my conversation with the undersecretary yesterday to underscore the importance of what you do as VSOs we discussed yesterday he talked to me about how he had reviewed our hearing about the sort of notices veterans receive and the unintelligible language that leads to lots of questions and lots appeals a great deal of work by VSA officers he said he looked at that tape and has begun a complete overhaul of those letters so I think that speaks a lot to the importance of our collective efforts and our collaboration whether it's members of Congress members of the public VSOs those at the VA to genuinely find a better way forward to serve the veterans community and and I think we need to keep those lines of communication open it is accounted babies of course important but the the main mission is really to do it better and get it right the first time what I hear all three of you talking about is is in fact what we have seen which is by taking and the undersecretary acknowledged by focusing so much I think on the National work queue and that backlog and the timeliness issue the the I got taken off of quality quality has to be there and so your input as these processes move forward to make sure we pick back up specialization mr. figlio Lee you mentioned something that has been I think much on our mind is how we utilize the benefits of the National work queue but don't have the siloing and don't have the delay that happens when you can't resolve claims within a single regional office could you expand on that a little bit given that we have the National work queue in place now how can you imagine you mentioned empowering the ability to decide issues closer to that granule level can you talk about what you've seen or concepts you have how we can try to better integrate the best of both worlds right that granular concentration in one office yet the efficiency of how team national work q Thank You ranking member it's been a concern for a while I think my colleagues would also agree before national work q you sat face to face with a veteran you heard their story you've heard their concerns you've built a relationship with them you knew the people in the regional office and you were able to have conversations that as I claimed went through the system as national work q has been implemented the claim may start off and in Boston they will go to New York it can be out in the Philippines all on the same day and at some point that local advocate is lost eyes on what that claim is suddenly we're asking a VSO that's in Houston who had no input in the beginning of the session or the process to review a claim and alert VA 2 what is good better and different about that claim but not know the personal touch of that veteran a veteran personal story then the other process is is going back to get these things corrected since they moved across the country we we no longer had the ability to just you know get in the elevator and go downstairs and talk to somebody we have to send things via email or via a phone call to a to several regional offices and by the time you get a caught up with it it could be moved somewhere else it's highly inefficient and it's just it's just a shame that we have lost that ability to get things resolved at the lowest possible level before they end up in Appeals if anyone else has thoughts on this this is going to be an ongoing issue I think about how to get the efficiency and of those medical records electronic medical records and processing of claims specialization but also that personal touch so so again I want to thank you as we move forward in this committee over in the Senate with our colleagues at the VA how to do a better job and again try to get the best of that efficiency with the quality the timeliness and that human touch you know the hands-on that the VSOs have always provided and I think you need to provide we should not expect our veterans to be experts in Appeals law Veterans Affairs regulations that's not their job it's our job to take care of them so again I want to thank all of you for joining us here today and I want to thank the chairman for his ongoing efforts and all of you for to do better for our veterans thank you I want to thank everyone for being here with that I would recognize ranking member if she has any closing remarks you might want to make I think this is gonna be my last subcommittee hearing on in Congress on this with this really wonderful committee and I want to thank all of you for your partnership your hard work and I am strongly urging my this big new class of freshmen members of Congress whether they serve on this committee or not to honor that commitment to our nation's veterans and mr. newm hard you mentioned a really important issue about the diversity that we see of our veterans now and we need to keep our eye on that moving forward we have a very diverse group of veterans we're serving now world war ii veterans who have certain life experience certain way they want to interface with the VA and we've got brand new veterans coming out who are unprecedented numbers of women much younger much different backgrounds and that is a challenge for all of us but I hope we're all up to the challenge and I hope the 116th Congress and this committee will continue to do its best to be honest brokers and partners in doing better for our nation's veterans and I want to thank the Chairman and the excellent staff on this committee for their hard work and there are bipartisan cooperation to make sure that we are all to the best possible rowing in the same direction and and doing our level best every day for our nation's veterans thank you all and I yield back thank you and before we do adjourn let me say this it has been one of the greatest honors that you could ever imagine being chairman of this committee and let me tell you that what we do as far as our veterans those living and those passed through this committee it's very humbling to work on this committee being the chairman of the subcommittee I I'll tell you I couldn't ask for I want to thank miss Estie we were able to work together and bipartisan manner when quite often in Congress the bipartisanship doesn't occur as often as it should I also want to say a special thank you to the staff and the staff has been wonderful both Republican and Democrat staff hard-working and it is the mission and our mission to make sure our veterans are taken care of with that and and know this as a Marine I as and I will continue to serve in Congress I will still continue to focus on our veterans issues and I thank the American people and my voting people that voted for me in my district that gave me this opportunity and thank you to chairman Roe for giving me the opportunity to be chairman of this subcommittee so finally as I said earlier oh hold on and also two ways to improve with the department and assist any way we can so with that I'm going to say as it did earlier complete written statements for today's witnesses will be entered into the hearing record I ask for unanimous consent that all members have five legislative days to revise and extend their remarks and include extraneous material hearing no objection so ordered this hearing is now adjourned

Author Since: Mar 11, 2019

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