Mr. Speaker, Honorable Dorcas R. Hardy recently chaired the Vocational Rehabilitation and Employment Task Force of the Department of Veterans Affairs. The Task Force issued its report in March 2004, and furnishes an excellent road map on…
Mr. Speaker, Honorable Dorcas R. Hardy recently chaired the Vocational Rehabilitation and Employment Task Force of the Department of Veterans Affairs. The Task Force issued its report in March 2004, and furnishes an excellent road map on how VA can place a stronger emphasis on long-term sustained employment for disabled veterans who are vocational rehabilitation participants. I was especially impressed with the section entitled, More Challenges Await: A Final Word from the Task Force Chairman, and commend it to my colleagues as an example of Ms. Hardy's wisdom and foresight:
More Challenges Await: A Final Word From the Task Force Chairman
Addressing the benefit, rehabilitation, and employment
needs of persons with disabilities--and especially veterans
with service-connected disabilities continues to be
difficult, and often controversial. One thing is certain: The
Department of Veterans Affairs cannot afford to fail the
veteran who has given so much in the service of our Nation in
previous wars and now in this age of terrorism.
There is no doubt in my mind that VA's Vocational
Rehabilitation and Employment Program can become the best
public rehabilitation program in the country, given
appropriate resources and leadership. The new comprehensive,
integrated 21st Century VR&E Employment-Driven Delivery
System, which is proposed by the Task Force, builds on the
strengths of the past and provides a continuum of service
delivery, from military service to career counseling,
appropriate retraining, and education, to employment or
transitional independent living services with the ever-
present goal of employment. The new system can provide the
answer to a disabled veteran's transition to civilian
society--a job.
Employment program will necessitate a major shift in
attitude and approach. The current reality is that the VR&E
program--despite the legislation of 1980--continues to
operate as a VA education benefit for disabled veterans. It
provides a larger stipend than the GI Bill program, and is
accompanied by some counseling, as necessary. The new
program, on the other hand, addresses the continuum of ``life
cycle'' needs that a veteran with disabilities experiences,
of which education may--or may not--be a necessary part. The
focus will be the rehabilitation and employment needs of the
21st century service-connected disabled veteran.
Because the United States is at war, and will likely be in
conflict situations for the foreseeable future, there must be
a sense of urgency on the part of the entire Department as
well as the Vocational Rehabilitation and Employment Service
to create this new 21st century service delivery system.
I respectfully suggest that no more reports or discussions
are needed, just immediate and concrete actions that are
supported by the Administration, the Department, and the
Congress. If this vital program, with its potential for
becoming the most outstanding vocational rehabilitation
system within the federal government, is unable to quickly
and effectively serve the 21st Century veteran, then one must
consider other options. These options include: (1)
contracting the program out with clear and stringent
requirements to follow the employment intent of the law, or
(2) recognizing that the mandated employment focus of the
program is not possible and reintegrating VR&E into the
Education Service of the Veterans Benefits Administration,
adding an additional stipend for disabled veterans.
Having served in various state and federal governmental
positions, including Commissioner of Social Security and
Assistant Secretary of Human Development Services, I have
worked with numerous social services policies and programs.
Cash benefit services, such as the VA Compensation and
Pension Service or Social Security provide support through
direct payments. These programs require development of
automated claims processing methodologies. Direct and
personal services are those provided by VR&E or social
service agencies. Different skills, personalities, and
approaches are needed for each part of the delivery system.
VR&E stands as an island in the sea of the Veterans Benefits
Administration, a claims processing organization. VR&E is not
connected to the claims processing functions, nor do other
business lines have any particular appreciation or
understanding of its function. Both cash and direct benefits
are needed to support the veteran. Development of a seamless,
integrated delivery system is the challenge.
Many have suggested that the entire VR&E program should
become a part of the Veterans Health Administration, which
has more of a hands-on service delivery focus. Just as the
Task Force rejected the idea of moving the VR&E Independent
Living program to VHA at this time, that same thinking can be
applied to moving all of VR&E to VHA. VR&E needs to address
its own shortcomings first, wherever it is housed, before
participating in another reorganization.
If implemented with commitment and enthusiasm, the Task
Force's recommendation to rebuild the VR&E Service can be
successful. Building the new service delivery system cannot
be done slowly, nor sequentially. It must be driven with
clear and focused timeframes; and it must be done believing
that each veteran's future depends upon an effective new
approach. Leadership and management will be key; timeframes
that some may deem un reasonable should become standard;
processes must be streamlined and supported by technology;
and veterans must recognize that they, too, have an
individual responsibility to complete their vocational
rehabilitation plan and secure employment in a timely manner.
Future Policy Considerations
Throughout the discussions and deliberations of the Task
Force, several broad policy issues were raised that were not
thoroughly addressed, either because they were not directly
within the scope of this Task Force's work or, in several
cases, they were far more complex than our time permitted.
Some issues were just too controversial at this particular
point in time, but their ``tipping point'' will come and
thoughtful policymakers and managers should be prepared to
consider their breadth, shape, and impact upon VR&E. As the
Veterans Benefits Administration proceeds to modernize VR&E,
these longer term policy considerations, which cross the
business lines of VBA, should be discussed and addressed.
Each issue below will arise in the foreseeable future;
each issue will have a significant consequence for the
successful future of a 21st century VR&E program.
role of counseling and transition assistance in the veterans benefits
administration
Historically, VBA had a focus on personal counseling about
requested benefits and services through face-to-face contact
with the veteran. Today, the Compensation and Pension Service
provides outreach services to veterans through the Veterans
Service Centers but the focus is ``you are entitled to
benefits from the VA and here is the claim to file.'' This is
not counseling in the traditional sense, rather a method to
ensure that veterans receive cash benefits to which they are
entitled. Since the VR&E Program is the only benefit that is
provided face-to-face to the veteran, VR&E, with its
professional counseling staff, should provide all outreach
services to veterans, regardless of whether or not the
veteran is disabled. A veteran with financial or life cycle
or any other issues should be able to access counseling
services at a VR&E office. Such a policy may necessitate
additional resources beyond what is recommended at this time
to rebuild the VR&E program.
need for new programs
This report highlights the need for clear and comprehensive
data about the population that is served by VR&E. Without
such data, as well as research, we will not be able to
project who the service-connected disabled veterans of the
future will be, nor what their needs will be. Questions that
should be addressed include:
Will their injuries and disabilities be considerably
different than those of recent veterans?
Will the technology used on battlefields or in medical
rehabilitation impact more significantly the veteran's future
ability to be a productive member of civilian society?
How will medical advances, as projected by the Institute of
Medicine or the National Institutes of Health, impact the
VR&E program?
The Task Force's analysis of types of disabilities of
veterans entering the VR&E program found that the number of
veterans determined disabled due to neuropsychiatric
illnesses is increasing. The increase in mental conditions is
also being seen by other public benefit programs such as
Social Security Disability Insurance. It appears that the
majority of veterans in the Independent Living program are
those with Post-Traumatic Stress Disorder (PTSD). Yet, as
this report clearly states, Independent Living status within
the VR&E program should not be the sole response to their
needs. An assessment of the impact of an increased number of
mental health disabilities on the VR&E services should be
conducted as soon as possible. The outcome will likely
conclude that new programs should be developed jointly with
VHA to address the needs of these veterans. Of equal
importance will be the development of a methodology that
guides how VR&E interacts with VHA to plan for new solutions
to disabling conditions.
impact of an aging veteran population on services
Every social services delivery policymaker is well aware of
the general aging of the population. The question should be
raised as to the expected impact of the graying of veterans
upon VR&E. Issues such as the aging of the general workforce
could mean less discrimination against older veterans in the
workplace and therefore more older applicants for VR&E
services. As veterans age, many are filing additional claims
for disability compensation, and many may initiate or renew
their requests for VR&E services. VR&E should be proactive in
addressing at least the following questions: Should VR&E
accept all disabled veterans regardless of age? Is age a
criterion for prioritization of expected services? How should
VR&E balance its resources vis-a-vis age of applicant and
number of times services have been requested?
impact of disability determination
The VA disability benefits adjudication system has been the
subject of discussion and controversy for many years.
Congress recently established, as part of the 2004 Defense
Authorization Act, the Veterans' Disability Benefits
Commission to study the compensation benefit structure and
complete a report in 2005. They are directed to examine the
appropriateness of such benefits and the appropriate benefit
determination standards, compare veterans' benefits with
other public and private sector disability benefits and,
perhaps most important, ``consult with Institute of Medicine
of National Academy of Sciences with respect to medical
aspects of contemporary disability compensation policies.''
Ideally the Commission's deliberations will provide a
framework for many policy decisions related to the VA's
disability criteria that will be updated to reflect the
current state of science, medicine, technology, and labor
market conditions. Such recommendations could be the catalyst
that moves veterans' disability policy toward use of
scientific advances and incorporates economic and social
changes that have already redefined the relationship between
impairments and the ability to work within the private
sector. Such discussion and modern approaches could
significantly impact the workload and processes of VR&E.
For example, currently there are nearly 175,000 veterans
with a 60 percent or more disability rating who have applied
and receive a determination that they are ``Individually
Unemployable.'' The designation of ``Individually
Unemployable'' entitles the veteran to a 100 percent rating
with commensurate compensation. Yet the adjudication process
never includes the views of a vocational rehabilitation
counselor as to whether or not the beneficiary could
participate in the labor force or whether a strong vocational
rehabilitation or counseling program would be effective in
assisting the veteran achieve employment, perhaps using
assistive technology or other types of supports. The
questions that are raised are: Without input into the IU
determination process from a trained rehabilitation expert,
should IU veterans or those applying for IU status be served
by the VR&E program? How can an individual be officially
designated ``unemployable'' (a label that should be an
anathema) and allowed to participate in an employment program
at the expense of another veteran who wants and needs a job?
It is recognized that over the years, the Congress and the
courts have expanded the scope and complexity of veterans'
disability benefits. It is hoped that the Commission will
conduct a thorough review of the benefits schedule and
challenge the status quo. They might begin by asking how a
tender scar, migraine, or mild asthma can be the sole''
disability'' for which a veteran receives compensation
according to a rating schedule and is thereby
automatically eligible for VR&E services, in the same
manner as a severely-disabled veteran.
The GI Bill for the Future
The Task Force learned that more than 75 percent of those
who enter the VR&E program proceed through a rehabilitation
plan that includes a goal of a college degree. Though the
data is not clear, one can assume (given the number of
discontinued and interrupted participants) that most veterans
spend far more than 4 years attaining their degree. Equally
important, most of these ``students'' never exhausted their
GI Bill benefits. One assumes that is because the VR&E
education benefits are considerably more generous than the
current GI Bill. This pattern raises some questions: Does
this mean that deficiencies exist in the current GI Bill? Or
are veterans with disabilities just looking for the best
deal? Should there be changes in the GI Bill that might make
it more appealing to veterans with disabilities? What should
they be?
In 1998, the then Vocational Rehabilitation and Counseling
Program wrote a strategic management document that addressed
the reasons that the program desperately needed to change in
order to provide effective services to disabled veterans. The
reasons for change were:
Inadequate focus on employment,
Customer perceptions and expectations are out-of-step with
the program's intent,
Inability to monitor outcomes and provide feedback to the
program; Inadequate IT support for the program,
Inadequate access for veterans,
Inadequate coalitions with peer organizations and partners,
and inefficient business processes.
Despite such introspection, not much has changed. This 2004
Task Force Report not only urges management to rebuild the
VR&E program but also provides a clear road map as to how to
accomplish the objective. There is no excuse for lack of
success.
The Charge
Unfortunately, there are not as many successful social
service delivery programs as one would like. Positive
outcomes for adults, as measured by an individual's
independence and employment, are often difficult to attain.
But I believe the mighty band of nearly 1,000 VR&E staff has
the resourcefulness and dedication to build a new service
delivery system for veterans with service-connected
disabilities. With leadership, appropriate resources, a broad
and creative approach, and what I term ``cheerleading
support,'' they can reinvent themselves, they can get
energized, and they can be the best program serving the 21st
century rehabilitation and employment program--and just in
time for those 21st Century service veteran. VR&E can become
the model public sector members returning from Iraq,
Afghanistan, or anywhere else in the world where freedom
calls.
It has been a privilege to chair this Task Force and
present our report.
Dorcas R. Hardy, Chairman, VA Vocational Rehabilitation and
Employment Task Force.