Overview The In millions Veterans Population Projections Today, there are 25 million veterans, but in the next 20 years this number will decline by one-third, to 17 million (as shown in the accompanying chart). Although VA is charged with providing services to the entire veteran population, fewer than one in five veterans participate in VA programs. decline in population ultimately will mean that fewer veterans will seek medical care, monthly disability benefits, and burials at VA cemeteries. However, on the immediate horizon, there will be increased usage of some VA benefits and services, as veterans age and more women draw on them. The imperative of recognizing veterans' contributions to the nation means that VA's strategy, business plan, and infrastructure will need to adapt to ensure top-quality services and be flexible enough to handle changing dynamics and waning population. 1990 1995 2000 2005 2010 2015 2020 Status Report on Select Programs The Administration is reviewing the management of programs throughout the government. Poor performing programs that are not mission critical will be eliminated, cut back, or reconfigured so that their funding can be redirected to be more effectively used. The accompanying table rates the performance of some of VA's most important programs. Those with ineffective ratings are targeted for rapid improvement. Guarantee that Veterans' Disability Claims are Processed Accurately and Quickly I must say that I think the VA has the necessary Vice Admiral Cooper (retired) One of the President's top priorities is to make sure that when a veteran submits a claim for a disability, it is processed quickly and accurately. Disability benefits provide a monthly benefit to veterans who are disabled as a result of their military service. Currently, 2.3 million veterans receive these tax-free benefits. The amount awarded to a veteran depends on the severity of the disability. For 2002, the basic monthly benefit ranges from $103 for a 10 percent disability rating to $2,163 for a 100 percent disability rating. Roughly half of veterans receiving compensation are less than 30 percent disabled. Improving the quality of life of the disabled is a national responsibility. And yet, the time and cost of processing disability claims have steadily increased. The average number of days to process a claim has risen from 100 days in 1996 to 181 days in 2001, and the number of claims awaiting a decision has jumped from 343,000 to over 644,000 during that same period. Meanwhile, the level of benefits paid increased by 27 percent in the past five years, while the cost of administering these benefits more than doubled. Average Number of Days to Process a 1996 1997 1998 1999 2000 2001 2002 2003 In October 2001, Vice Admiral Daniel L. Cooper (retired), who led the 14-member Department of Veterans Affairs Claims Processing Task Force, presented a final report to VA. The report concluded that, as a result of basic flaws in organization and communication, VA is unable to handle the effects of judicial decisions and legislative changes on workload. Productivity is poor, and so far management has proven incapable of introducing change and flexibility into the workplace. VA should concentrate on radically changing the way it does business. These changes include identifying practices that work best at VA and enforcing their use across the country; allocating both work and funds to the best regional offices; creating specialized processing centers; and developing a computer system that allows people throughout the country to work on individual claims at the same time. The success of these initiatives must and will be measurable. Speed should not come at the sacrifice of accuracy, or vice versa. VA will use the following two critical performance measures to ensure that its efforts are balanced: • Process disability compensation and pension claims in an average of 165 days in 2003 (ultimate goal is 74 days-given the legal and medical complexities and VA's responsibility to help prepare claims); and • Attain an 88 percent national accuracy rate for core rating work in 2003 (ultimate goal is 96 percent) To deliver services quickly and effectively, it is just as important to establish a relationship between performance and resources, but VA has not done this. The Department cannot, for example, say that for every $500,000 increase in funding, timeliness and accuracy improve by measurable percentages. Until relationships like these are defined, it is impossible to figure out the optimal amount of funding for veterans' services. Improve Health Care Delivery by Coordinating the Medical Care Systems of the Departments of Veterans Affairs and Defense Although VA and the Department of Defense (DoD) both operate very large medical care systems with a combined cost of over $40 billion yearly, historically there has been little cooperation between the Departments. The Departments assert that the most common barriers have been different missions, patient populations, and cultures, as well as differing opinions on who would lead the effort. However, both Departments describe sharing efforts. Only $100 million—or one-quarter of one percent of $40 billion in expenses passes from one to the other. Unnecessary Paperwork All veterans, by definition, were members of the Armed Services. While on active duty their (and their families') information was tracked by a system that covered everything from security clearances, to health care entitlements, to commissary privileges. In an era of rapid high-tech changes, the minute veterans want to apply for VA benefits, they must provide pages of information on paper, that was already on computers at DoD. Likewise, when these same veterans later apply for other VA benefits, they start the process all over again. Sharing information and technology can make a world of difference to the military and veteran communities. It can speed up service, ensure veterans' safety, and inform veterans of entitlements that they are due. In addition, information sharing can transmit important knowledge through the departments' walls-replacing the myth that they have little in common. In many communities, VA and DoD hospitals are close to each other and offer similar services (e.g., primary care, surgery, or eye care). However, traditionally neither has considered the other as an option in determining construction or health delivery needs. In light of the new emphasis on sharing, the DoD and VA are working together to solve mutual problems in the Greater Chicago area, where currently there are five VA hospitals and one DoD hospital as shown in the map. DoD needs more space and had plans to build a new hospital within walking distance of a near-empty VA hospital. Now Failure to Communicate Military retirees can use both DoD and VA medical care systems. Today, many selectively use both. When a retiree goes to VA for services one week and DoD the next, serious errors can result if the doctors do not know what others have done. Despite information sharing efforts within VA, if drugs ordered in each system have adverse interactions, patients may become gravely ill or die. VA and DoD are planning to jointly share this hospital and save a significant amount of money by reducing construction of new buildings. |