Wednesday, February 1, 2017

Veteran’s Perspective and Partial Breakdown on the Veteran’s Health Care and Benefits Improvement Act

By: Lois Matteis
January 11, 2017

           Being a veteran and sifting through what is and is not available to us through the Veteran Administration can be a very daunting task, especially considering all the new laws coming out and the current reputation the VA has among the military population. We have all heard the horror stories regarding the VA and how some of their more vile practices have cast a very dark spotlight over the organization (Why hello, Phoenix Scandal). It has been covered extensively in the media, and the trust for the organization is just become nearly nonexistent.
     This, on top of trying to translate 20 or more pages on what Congress wants to currently change can be incredibly confusing and time consuming. Reading the Veterans’ Health Care and Benefits Improvement Act required an entire day in the office reading and translating several existing laws and how they were to be amended. Overall, however, this enactment appears to be a set in the right direction for veterans and their families. Time will tell, as always, how well the new law will be implemented, but the law itself is a step in the right direction for veteran’s rights. Most importantly are the laws and reports being implemented in order to improve the accountability of the Veterans’ Administration, veteran’s Health Care, and homeless veterans’ policies in the future. In the following paragraphs, there will be a breakdown of highlighted sections involving these categories and what the pros/cons of each section are. A link to the full text of the act will also be displayed at the end of this post.

“SECTION 104: COMPTROLLER GENERAL REVIEW OF CLAIMS PROCESSING PERFORMANCE OF REGIONAL OFFICES OF VETERANS BENEFITS ADMINISTRATION”

What it is: This section is the first to start to address accountability issues within the Veterans’ Administration.  This has to do with reporting on regional offices to determine what separates the outstanding from the subpar and work from there on how to make what the outstanding offices do the norm around all regional offices.

Why I love it: Getting input from successful regional offices who seem to have figured out how to make the system work is incredibly beneficial to helping veterans in every region. They are identifying some key factors in the report like management and employee practices, effectiveness of communication, and processing of claims for disability compensation. If this report can help translate these stellar performance practices to those who need to work on performance, then veterans across the country will see a dramatic improvement in when they receive benefits and how they can receive further assistance after they have left the military.

What could have been better: This section covers some good points, but the time frame involved is arguably longer than it should be. Directly stated in the law is “No later than 15 months after the effective date specified in subsection (e)… EFFECTIVE DATE. - This section shall take effect on the date that is 270 days after the date of the enactment of this Act.” This, it seems, is their very long winded way of stating that no one will see any reports until around December 2019 at the earliest. It is important to understand that change and writing reports takes time. Waiting two years to report on existing practices, however, could translate this section to be for bureaucratic and political reasons more so than making veterans a priority. The time frame is also concerning because it could cause this law to lose momentum and significance as time goes on, especially through ever changing leadership and opinions on how to solve this problem.

“SECTION 105: REPORT ON STAFFING LEVELS AT REGIONAL OFFICES OF DEPARTMENT OF VETERANS AFFAIRS UNDER NATIONAL WORK QUEUE”

What it is: This section requires the Secretary of Veterans Affairs to submit a report to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives “on the procedures the Secretary will use to determine appropriate staffing levels at the regional offices of the Department under the National Work Queue for the distribution of claims processing workload.”

Why I love it:  Back in the beginning of 2016, the Veterans’ Administration made the much needed switch from all paper records to the electronic system called the National Work Queue in order to process claims. While this system has come with some of its own unique set of problems, implementing this law to report on it will be a great step in ensuring the efficiency of the website and breaking the bad habits which might have formed with trying to understand navigating the system early on. Also, they plan on submitting this report in a little over a year, so the wait for a report will not be nearly as long as the previously mentioned section.

What could have been better: The law is incredibly vague on what they will be required to report about the system, and literally only state “a report on the criteria and procedures.” One could assume they mean to report on the existing procedures in place, but changes in procedures down the line may make reporting more complicated then intended. The law also does not specify whether or not they even can change the current procedures, so again, this could skew the results of the report if the requirements of the report are not more directly specified.

SECTION 106: INCLUSION IN ANNUAL BUDGET SUBMISSION OF INFORMATION ON CAPACITY OF VETERANS BENEFITS ADMINISTRATION TO PROCESS BENEFITS CLAIMS

What it is: This section goes on to announce how it will be analyzing each employee and on average, how many claims each can process in a given year. The section goes into further detail explaining how this will be a “time and motion study” and how the Secretary himself will provide a description of how he plans to improve the processing of claims.

Why I love it: Processing claims has been a big issue within the Veterans Administration and wait times can be astronomical when waiting for benefits, depending on when the claim was submitted. Measuring the average number of claims a single employee can do in a year will be a productive step in determining whether this problem stems from an employment shortage or a work ethic shortage. This report would allow those who write policies and procedures to curtail a very detailed and thorough mandate to the problem that would actually address the roots of the issue, not just surface issues.

What could have been better: Again, the time frame of this section leaves much to be desired. This section states that this will apply after fiscal year 2018, which means, at the earliest, we will not even see any potential solutions until fiscal year 2019, and that is at the earliest time frame.
      If this was the first time the Veterans’ Administration was being spoken about, this time frame would be understandable. When, however, you have had multiple issues and instances regarding mishandling claims over several years, the time frame should implicate some hustle to get this solved, or at least establish shorter checkpoints to guarantee they are actually making an effort to ensure this section actually comes to pass.
     As stated before, the VA has lost trust with millions. In order to re-establish this trust, quicker time frames would have been an essential way to illustrate an effort. As this section stands now, it seems this act is asking us to put a lot of trust into this administration doing what it needs to do without them making sure it gets done. Honestly, if they were doing what they needed to do from the beginning this law would not be necessary in the first place.

SECTION 612: ANNUAL REPORT ON VETERANS HEALTH ADMINISTRATION AND FURNISHING OF HOSPITIAL CARE, MEDICAL SERVICES, AND NURSING HOME CARE

What it is: This section states an annual report will be submitted from March 1st, 2018 and every year after until 2022 to the Committee on Veterans’ Affairs of the Senate and House of Representatives concerning:
1)      The furnishing of hospital care, medical services, and nursing home care under the laws administered by the Secretary; and
2)      The administration of the furnishing of such care and services by the Veterans Health Administration.
This report will include an evaluation of the effectiveness of increasing and improving the access of hospital care, medical services and nursing home care to eligible veterans, without increasing the costs incurred for such health care by the Federal Government.

Why I love it: The assessment is incredibly detailed on what they will be evaluating for this report. Everything including: the workload of physicians, patient demographics, physician compensation and productivity, pharmaceutical prices, percentage of care provided to veterans within facilities and third-party health billings owed to the Department.
     This will look at everything. It will give a descriptive look at how doctors spend their time and how much they get paid in correlation. This is a badly needed report to get a good idea on where the Department can actually cut funding and what needs to be worked on. Also, the time frame is very reasonable and gives the Veterans’ Health Administration the time they need to supply all needed information.

What could have been better: Having a third party corporation or nonprofit might have been a better option when it comes to who should submit the report. Granted, the Secretary was just announced recently, so being cautiously optimistic about the finding is not unwarranted, but it does leave a lot in the air. An established consulting firm, however, might have been a better option considering how low the approval is towards the Veterans’ Administration in general.

“SECTION 711: INCREASED PER DIEM PAYMENTS FOR TRANSTIONAL HOUSING ASSISTANCE THAT BECOMES PERMANENT HOUSING FOR HOMELESS VETERANS.”

What it is:  This increases the per diem payments for transitional housing which eventually becomes permanent housing for homeless veterans. The maximum rate offered will now be 150 percent of the rate authorized for State homes for domiciliary care. Along with this, the Secretary of Veteran Affairs also has the ability to increase this amount, depending on the needs of the veteran in question.
Why I love it: The problem of homeless veterans has been a very well-known issue for a significant period of time and has concerned a major portion of the population over time. This not only further addresses the issue, but also rewards the States who make the effort to care for their local homeless veterans.

What could have been better:  While the per diem increase is by far a major improvement, it still is restrictive when it comes to a veteran receiving care, especially for those who live in nursing homes or other special situations related to this one. While the i Veterans’ Administration budget is as limited as it is complicated, some more focus should be dedicated to those who can no longer live on their own or who are homeless. 

“SECTION 712: PROGRAM TO IMPROVE RETENTION OF HOUSING BY FORMERLY HOMELESS VETERANS AND VETERANS AT RISK OF BECOMING HOMELESS.”

What it is: This law allows the Secretary to provide case management services to veterans who have been homeless or who are about to be homeless in order to improve retention rates. In order to fund this program the Secretary will award grants to organizations, which demonstrate the ability to provide case management services.
    Organizations that take priority are those who demonstrate the ability to provide permanent housing that meet quality house standards and those who voluntarily cease receiving grants for homeless veterans with special needs.
    Along with this, no later than June 2020, the Secretary must submit a report on the program to the Committee on Veterans’ Affairs of the Senate and House of Representatives. This report will contain information such as: 
1)      Percentage of veterans who used the case management services who were able to receive permanent housing.
2)      Percentage of veterans who used the case management services who were not able to receive permanent housing.
3)      Comparison of the case management services before and after the services from veterans who have utilized the program
4)      An assessment of the employment status of veterans who received case management services under the program before and after receiving the case management services.

Why I love it: This not only has implemented a possible solution to the problem, but has already also established a detailed report for receiving feedback for the program. They also have established a section getting direct feedback from the veterans themselves, which will provide an in-depth first hand understanding of how effective this program will be.

What could have been better: Again, the period of time does run a little long until the results of this program are confirmed. This, however, is an understandable time frame considering the construction, grant requests and approval will need considerable time to get established.
   An issue somewhat perplexing, however, is organizations must volunteer to cease receiving grants for homeless veterans with special needs.   It is not mandatory to cease receiving the grant, but a higher priority will be given to those who do. Taking care of those with special needs is costly, and may discourage many organizations from trying to receive more grants in order to try and take care of those who need it. It is unclear at this point how long this new grant process will take and asking an organization to stop receiving grants for special needs veterans may not be possible if they have to wait a significant amount of time to receive those funds as replacements.

This is not nearly everything stated within the law, as it also goes over educational benefits, burial benefits, and other matters related to the VA. The link to analyze everything within this law is https://www.congress.gov/bill/114th-congress/house-bill/6416/text#toc-H189A88B1643645908EA229409DBDD3AD