06/27/2002
Veterans News
VA takes aim at backlog of claims
(Based on an article by Laurie Kellman of the Associated Press)
The Department of Veterans Affairs has doubled the number of claims it decides each month and reduced a mountainous backlog of benefit requests dating back years, Secretary Anthony J. Principi said. That backlog generated widespread concern on Capitol Hill and among veterans groups as it ballooned during the 1990s. But it has been cut from 600,000 to 394,000 claims in recent months.
“We decided to really declare war on that backlog and took some rather bold steps to address it,” Principi said in an interview. “We’re really getting this backlog under control, and we did it through sheer focus and discipline, performance measurements and production goals.”
VA claims managers now resolve about 70,000 claims a month, more than double last year’s monthly rate of 29,000, he said. In addition, the department has established a “tiger team” of managers in Cleveland. It ruled on claims for about 28,000 veterans over the age of 70 who had waited more than a year for an answer, he said.
Veterans hailed Principi’s commitment to the issue but said it remains to be seen whether the agency is properly deciding claims.
“We have seen the figures where VA has been increasing their production. I believe Secretary Principi is seriously concerned about the state of the VA backlog and the adjudication process,” said Joe Violante, national legislative director for Disabled American Veterans. “Our concern, however, is that while they are increasing their production, if they are not getting them right the first time they are no better off than if they weren’t processing those cases,” he said.
Principi said he did not have exact figures, but added that most of the processed claims approve benefits for the veterans requesting them.
“It’s a case study that things can, in fact, turn around – not only in private-sector corporations but in government bureaucracy as well,” said Principi, a U.S. Naval Academy graduate and Vietnam War veteran.
The VA, the second-largest government agency with 220,000 people, has been besieged with caseload problems. Last year, Congress blasted the department for training problems that resulted in inaccurate decisions on 4 of every 10 claims for veterans’ disability payments.
Newly confirmed by the Senate last year, Principi told Congress and the General Accounting Office, its investigative branch, that fixing those problems would be one of his top priorities. He implemented GAO recommendations to set up a system to track the outcome of video conferencing and other state-of-the-art training methods.
Looking forward, Principi said he has set up “triage” teams in various regions – Texas, Florida, Washington, for example – to handle massive amounts of claims and prevent future backlogs.
He said the department is not favoring speed over accuracy. “It’s not that we’re just rushing these decisions and forgetting about the quality aspect of it,” Principi said. “We’ve focused on both time lines and quality.”
Restructuring the VA claims processing
The Department of Veterans Affairs has created a pilot program with the goal of reforming its claims processing system. The new program calls for a reorganization at the front lines. The goal is to create specialized teams, who will review the benefits claims for veterans and their spouses and who will refine the day-to-day duties and procedures.
The test pilot calls for an initial, specialized team to perform “triage” on all of the incoming mail, pulling the claims that can be processed within a 2-3 day period. The team will then distribute the more complex claims to the offices of the other specialized teams, who work with particular types of claims, such as appeals, degree of disability/time in service, or customer service issues.
This pilot program has been started in four regional offices and will be instituted to the rest of the 57 regions as soon as all potential bugs have been worked out.
VA launches inventory of cemetery memorials
– Volunteers Sought –
The VA began the first comprehensive inventory of an estimated 300 memorials at about 100 national cemeteries to coincide with National Historic Preservation Week, May 12-18, 2002.
VA is looking for volunteers through September to gather historical information and detailed descriptions of the memorials. Individual headstones and post-1960 text tablets are excluded from the inventory project, which will last through the year.
VA has a great number of cemetery memorials, large and small, beginning with those installed after the Civil War. Historic cemetery memorials include inscribed stone blocks, bronze tablets affixed to boulders, sundials, sarcophagi, obelisks, columns and the ubiquitous soldier standing atop a granite pedestal.
Contemporary memorials are typically a standardized 18” x 24” bronze plaque. Some, however, are substantial buildings, such as the Medal of Honor Memorial (1999) at California’s Riverside National Cemetery and the Pennsylvania Veterans’ Memorial (2001) at Indiantown Gap National Cemetery in Annville, PA. The project will also offer essential information to support VA’s goal of maintaining its cemeteries as the best in the world, an objective VA calls its “national shrine commitment.”
VA is recruiting volunteers from diverse sources, including Civil War organizations, scout groups, veterans’ service organizations and VA employees. Volunteers will be given a cemetery map, survey form, instructions and film to take photographs of each memorial, and are encouraged to conduct some local historical research as part of the project.
The solicitation is based on the model developed by Save Outdoor Sculpture (SOS!), a Washington, DC-based, non-profit organization that uses volunteers to survey public outdoor sculpture nationwide. Information gathered through the SOS! program is publicly accessible through an on-line database managed by the Smithsonian American Art Museum (SAAM), called SIRIS www.siris.si.edu. As part of its educational program, VA will make its findings available to SOS! and SAAM.
VA manages 120 national cemeteries as well as 33 government, soldiers’ and confederate lots in non-federal cemeteries throughout 41 states, the District of Columbia and Puerto Rico. More information about the project and how to volunteer is found at www.cem.va.gov under “What’s New.” Interested individuals or organizations can also email nca.memorials@mail.va.gov or write to:
Sara Amy Leach, Historian
Department of Veterans Affairs
National Cemetery Administration
810 Vermont Ave., NW (402B4)
Washington, DC 20420
VA Cemetery Advisory Committee
The Department of Veterans Affairs has created a 12-person committee that will oversee its 120 national cemeteries. The function of the advisory committee, formally the Advisory Committee on Cemeteries and memorials, is to oversee the grants that support the state veterans cemeteries, the creation of additional cemeteries, the VA burial benefits and the maintenance of the veterans’ cemeteries.
The new members on the Cemetery Advisory Committee are: Percy Butler, Nancy T. Norton, Leo P. Burke, Robert L. Cardensas, Roland F. Cinciarelli, George R. Cramer, Cooper T. Holt, Mylio S. Kraja, Joseph J. Martory, Robert G. Moorehead, Margaret Murphy Peterson, and Benedict J.
Spardo.
VA begins Phase II of CARES Process
The Department of Veterans Affairs is beginning Phase II of its national initiative to ensure its health care system meets the needs of veterans today and in the future. This initiative is part of VA’s health care planning process called CARES (Capital Asset Realignment for Enhanced Services).
The first phase of the CARES process was conducted in the Chicago area, Wisconsin and the Upper Peninsula of Michigan, and was completed in February 2002. Phase II will include the rest of the VA health care system and is scheduled to be completed within two years.
“VA’s goal is to direct our resources where they are most needed, and at the same time provide the best care possible to more veterans at more locations,” said Deputy Secretary of Veterans Affairs Dr. Leo S. Mackay. Jr. “We will work with veterans, VA employees, university affiliates and local and national elected officials to ensure everyone’s concerns are heard as we enhance the quality of veterans health care.”
VA launched CARES to bring its aging health care system into the 21st century. VA’s health care system was designed and built decades ago when inpatient care was the primary focus, with long admissions for diagnosis and treatment. With changes in geographic concentrations of veterans and new methods of medical treatment, VA’s medical system was not providing care as efficiently as possible and medical services were not always easily accessible to some veterans.
“VA health care is changing now, and for the better,” said Mackay. “We’ve gone from mostly an inpatient setting where we treat illness in its latter stages to a system focused on disease prevention, early detection, health promotion and easier access. VA’s infrastructure, designed a half century or more ago, must be evaluated and updated to meet the needs of veterans today and in the future. That’s what CARES will do.”
To coordinate VA’s 1,300 sites of care, representing the largest health care system in the country, VA’s medical system is divided into 21 regional networks called VISNs (Veterans Integrated Service Networks). VISN 12 (Chicago, Wisconsin and Upper Michigan) comprised the pilot study; Phase II of CARES will include the remaining 20 VISNs.
During the next 18 months, the networks will collect data and facility information for planning initiatives that will provide the best care for veterans today and in the future. Throughout the process, veterans, academic affiliates, unions and employees will be briefed. Stakeholder opinions will be solicited and will be an important part of the decision process, as will be the preservation of special services, such as those provided our paralyzed veterans.
Once completed, an independent commission selected by the Secretary of VA will evaluate the draft National CARES Plan. Members of the commission, who will be chosen in the fall of 2002, will include individuals with special knowledge or interest relating to VA health care, as well as representatives from stakeholders’ groups.
As part of the commission’s evaluation of each VISN’s plans, hearings will be held with, and comments accepted from, local stakeholders. Only after careful evaluation of these comments will the commission then forward its recommendations to the Secretary. The Secretary will make his final CARES announcement in September 2003.
Phase II of CARES will be headed up by Frederick L. Malphurs, who was the VISN 2 Network director for the upstate New York (Albany, Buffalo, Bath, Canandaigua and Syracuse VA medical centers) since October 1995. Since joining VA in 1969, Malphurs has been assigned to nine VA medical centers.
Malphurs will work with an independent actuarial contractor and VA staff to project veteran populations, determine what kind of health care veterans need and where it is best to provide that care. This data will be available to networks within two months.
“Health care is no longer about bricks and mortar. Twenty-first-century health care is about access to local care, early detection and prevention, efficient use of new technologies and home health care,” said Mackay. “CARES is about 21st-century health care.”
Health agreements reached with VA
Pentagon Under Secretary of Defense for Personnel and Readiness David S. C. Chu reached agreements with Deputy Secretary of Veterans Affairs Leo MacKay on a single financial reimbursement methodology between the agencies and on a commitment to conduct joint strategic planning. The reimbursement methodology decision will result in the pursuit of a single regionally adjusted discounted rate structure for DoD-VA medical-sharing agreements. Currently, multiple methodologies are used to set reimbursement rates by the many health facilities of VA and DoD leading to complex and difficult to administer billing and collection processes. Plans call for initial implementation of this rate structure for ambulatory care services during the first quarter of FY03. Implementation for inpatient care, both facility and the professional fee components are targeted to begin in the third quarter of FY03.
Federal Benefits for Veterans and Dependents Handbook
Most of the nation’s 25 million veterans qualify for some kind of VA benefit. These benefits range from health care to burial to home loans. The Federal Benefits for Veterans and Dependents Handbook not only lists and describes the various benefits offered by the Department of Veterans Affairs, but has the rates for certain federal payments and includes the various contact information, such as phone numbers, internet addresses and VA facility locations.
The handbook costs $5.00 for U.S. addresses and $6.25 for overseas shipping. You can call (866) 512-1800 (toll free) or write to: Government Printing Office at Superintendent of Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954 (stock #051-000-00225-3) or download a free copy from the VA’s web site at
www.ve.gov/opa/feature/.
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