oversight

Veterans Benefits Administration: Progress Encouraging, but Challenges Still Remain

Published by the Government Accountability Office on 1999-03-25.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                           United States General Accounting Office

GAO                        Testimony
                           Before the Subcommittee on Benefits, Committee on
                           Veterans’ Affairs, House of Representatives




For Release on Delivery

Expected at 10:00 a.m.     VETERANS BENEFITS
                           ADMINISTRATION
Thursday, March 25, 1999




                           Progress Encouraging, but
                           Challenges Still Remain
                           Statement of Cynthia A. Bascetta, Associate Director
                           Veterans’ Affairs and Military Health Care Issues
                           Health, Education, and Human Services Division




GAO/T-HEHS-99-77
Veterans Benefits Administration: Progress
Encouraging, but Challenges Still Remain

                Mr. Chairman and Members of the Subcommittee:

                We are pleased to be here today to discuss long-standing challenges facing
                the Department of Veterans Affairs (VA) in administering programs that
                provide financial and other benefits to veterans, their dependents, and
                survivors. These benefits programs, which are administered by VA’s
                Veterans Benefits Administration (VBA), include disability compensation
                benefits, disability pension benefits, education assistance, life insurance,
                housing loan guaranty, and vocational rehabilitation and counseling
                services. Among these programs, the disability compensation and pension
                programs are the largest, accounting for about 90 percent of VBA’s cash
                outlays in fiscal year 1998 (about $20 billion out of about $23 billion) and
                requiring about half of VBA’s staff-years to administer.

                The disability programs have been the subject of concern and attention
                within VA and by the Congress and veterans’ service organizations for
                many years. The concerns have included outmoded processes, long waits
                for disability decisions, and decisional quality—all of which affect the
                quality of service provided to veterans and the effective use of taxpayer
                dollars. As a result, the Congress has sponsored three studies that focused
                heavily, if not solely, on the disability programs. These studies were
                conducted by the

                • Veterans’ Claims Adjudication Commission,
                • National Academy of Public Administration, and
                • Congressional Commission on Servicemembers and Veterans Transition
                  Assistance.

                Also, in recent years we have issued a number of reports on some aspects
                of VBA’s operations, including a report issued earlier this month, at the
                request of Representative Evans, on the accuracy of VBA’s adjudication of
                disability claims. 1 As a result of such studies and the requirements of the
                Government Performance and Results Act of 1993 (the Results Act), 2 VBA
                itself has established a framework for addressing issues raised by the
                various study groups and has been exploring ways to reengineer its
                business processes.


                1
                  Veterans Benefit Claims: Further Improvements Needed in Claims-Processing Accuracy         (GAO/HEHS-
                99-35, Mar. 1, 1999).

                2
                  The Results Act requires agencies to clearly define their missions, set goals, measure performance, and
                report accomplishments.




        Leter   Page 1                                                                                 GAO/HEHS-99-77
                     Veterans Benefits Administration: Progress
                     Encouraging, but Challenges Still Remain




                     Drawing on the studies sponsored by the Congress as well as our own
                     work, today I will highlight

                     • recent progress VBA has made,
                     • areas in which progress is lacking, and
                     • changes in program design that could hold potential for greater gains.



Background           VA’s compensation program pays monthly benefits to veterans with service-
                     connected disabilities (injuries or diseases incurred or aggravated while on
                     active military duty). Veterans with service-connected disabilities are
                     entitled to compensation benefits even if they are working and regardless
                     of the amount they earn. In contrast, the pension program pays monthly
                     benefits to wartime veterans who have low incomes and are permanently
                     and totally disabled for reasons not connected to their service. In
                     compensation cases, the payment varies according to the degree of
                     disability; in pension cases, the amount varies according to financial need.

                     The disability claims adjudication process begins when the veteran submits
                     a claim to one of VBA’s 58 regional offices where counselors are available
                     to answer questions and assist in completing forms (see fig. 1). VBA also
                     maintains a nationwide toll-free telephone number to answer questions
                     concerning application forms, and veterans’ service organizations’
                     representatives are often colocated in regional offices to help claimants
                     prepare applications and to act as the claimants’ representatives. The
                     majority of claims are submitted through the mail to the 58 regional offices,
                     which develop evidence and adjudicate veterans’ claims.




             Leter   Page 2                                                         GAO/HEHS-99-77
                                          Veterans Benefits Administration: Progress
                                          Encouraging, but Challenges Still Remain




Figure 1: The Disability Claims Adjudication Process




                                          Note: Cases can be concluded at any point after notification.
                                          Source: National Academy of Public Administration, Management of Compensation and Pension
                                          Benefits Claim Processes for Veterans (Washington, D.C.: Aug. 1997).


                                          The regional office develops each claim by obtaining records from the
                                          military services and information from the veterans, such as medical
                                          records and information on income and dependents. In order to determine



                                          Page 3                                                                     GAO/HEHS-99-77
                     Veterans Benefits Administration: Progress
                     Encouraging, but Challenges Still Remain




                     a veteran’s degree of disability, regional offices often find that they need
                     additional medical evidence and request that the Veterans Health
                     Administration (VHA) conduct a physical or mental examination of the
                     veteran. On the basis of such evidence, the regional office determines
                     whether the veteran’s disability is service-connected and, using VBA’s
                     Schedule for Rating Disabilities, rates (or evaluates) the degree of severity
                     of the disability. The degree of disability is expressed in 10-percent
                     increments up to 100-percent disability. For veterans with multiple
                     impairments, the regional office must rate each impairment separately and
                     then combine the ratings into a composite rating. A veteran can also
                     receive a “zero-percent” rating for a condition that is service-connected but
                     not severe enough to qualify for benefits. If a veteran’s condition later
                     worsens, the veteran may reapply for a higher disability rating.

                     After the regional office notifies the veteran of its decision, the veteran, if
                     dissatisfied, may ask for a hearing before a regional hearing officer. The
                     veteran may also file a notice of disagreement with the regional office and
                     then file an appeal asking for a review of the decision by the Board of
                     Veterans’ Appeals, which makes VA’s final decisions on appeals on behalf of
                     the Secretary. If the veteran disagrees with the Board’s decision, he or she
                     may appeal to the Court of Veterans Appeals, which was established in
                     1989 and is independent of VA. Additionally, both veterans and VA may
                     appeal decisions of the Court of Veterans Appeals to the Court of Appeals
                     for the Federal Circuit.

                     VBA considers a disability claim to have been accurately processed if basic
                     eligibility has been determined correctly, the case file contains all required
                     medical and nonmedical documentary evidence, the regional office’s
                     decision on whether the disability is service-connected and the disability
                     rating given to each medical impairment are correct, the payment amount
                     is correct, and the regional office has properly notified the veteran of the
                     outcome of his or her claim.



Recent Progress in   VBA has taken steps to begin addressing several important issues,
                     including
Major Areas Is
Encouraging          •   measurement of decision accuracy,
                     •   accountability for performance,
                     •   training for decisionmakers,
                     •   reliability of data systems, and
                     •   coordination with VHA on medical examination adequacy.



                     Page 4                                                          GAO/HEHS-99-77
                          Veterans Benefits Administration: Progress
                          Encouraging, but Challenges Still Remain




Measurement of Accuracy   As we reported on March 1, 1999, VBA recently implemented a new
                          accuracy review system that represents an important step forward in
                          measuring the accuracy of the regional offices’ adjudication of disability
                          claims and in providing data to identify error-prone cases and correct the
                          causes of errors. 3 Compared with the previous accuracy measurement
                          system, the new system focuses more on cases likely to contain claims-
                          processing errors, uses a more stringent method for computing accuracy
                          rates, provides more data on performance, collects more data on errors,
                          and stores more review results in a centralized database for review and
                          analysis.


Accountability for        In May 1998, VBA issued its Roadmap to Excellence, in which VBA
Performance               established a baseline for its current operational environment and
                          described a process for evolving into an agency that is customer-focused,
                          team-driven, cost-effective, and responsive to the needs of its
                          stakeholders. 4 In Roadmap to Excellence, VBA stated that it lacked
                          adequate employee accountability. As part of an effort to improve service
                          and accountability, VBA has grouped its 58 regional offices into nine
                          service delivery networks. These networks do not have their own
                          centralized offices or staff. Instead, the regional offices in each network
                          are expected to closely collaborate with one another, provide mutual
                          support, share resources, operate according to team-based principles, and
                          share collective responsibility and accountability for the networks’ overall
                          performance of all work assigned to the regional offices.

                          To improve the accountability of these networks and all other VBA
                          organizational units, VBA implemented, at the start of fiscal year 1999, a
                          performance evaluation system called the “balanced scorecard.” This
                          system scores performance on the basis of five factors: claims-adjudication
                          accuracy, timeliness, unit cost, customer satisfaction, and employee
                          satisfaction and development. VBA believes this new approach will drive
                          organizational change; provide feedback to employees on measures they
                          can influence; and link performance appraisal and reward systems to
                          performance measures, thereby providing incentives to managers to work
                          as teams in meeting performance measures.



                          3
                              GAO/HEHS-99-35, Mar. 1, 1999.

                          4
                              VA, VBA, Roadmap to Excellence--Planning the Journey (Washington, D.C.: VA, May 1998).




                          Page 5                                                                             GAO/HEHS-99-77
                         Veterans Benefits Administration: Progress
                         Encouraging, but Challenges Still Remain




                         In March 1998, in testimony before this Subcommittee on VBA’s
                         implementation of the Results Act, we stated that VBA was developing
                         goals and measures for its programs. 5 Since that time, VBA has made
                         progress in setting goals and performance measures for the disability
                         programs, and its success in meeting these performance measures will be
                         assessed as part of the balanced scorecard process. For example, VBA had
                         set a goal of achieving an accuracy rate of 75 percent in the adjudication of
                         disability claims during fiscal year 1999 and a goal of increasing the
                         accuracy rate to 93 percent by fiscal year 2004. However, in VA’s fiscal year
                         2000 budget submission, VBA increased its accuracy goal to 96 percent but
                         did not specify a time frame for reaching that goal. VBA’s new accuracy
                         measurement system will determine the claims-adjudication accuracy rate
                         and will feed the accuracy data into the balanced scorecard for the
                         disability programs. As part of our continuing review of VBA’s progress in
                         implementing the Results Act, we will be assessing VA’s fiscal year 2000
                         performance plan.


Decisionmaker Training   In its Roadmap to Excellence, VBA also acknowledged that its training
                         program had not prepared its workforce adequately to produce accurate
                         disability decisions. VBA acknowledged the need for an effective,
                         centralized, and comprehensive training program. Such training is
                         important not only for current employees but also for the many new
                         employees that will be hired to replace the up to 30 percent of the
                         workforce that may retire by fiscal year 2003. VBA plans to identify the
                         necessary employee skills and work processes for every decision-making
                         position, implement skill certification or credentialing for these positions,
                         and implement performance-based training connected to measurable
                         outcomes. VBA has already developed a computer-based training module
                         for processing appeals and is working on modules for original disability
                         claims, service-connected death indemnity benefits, and pensions. VBA
                         also plans to produce additional modules, including one for training new
                         regional office staff when they begin rating disabilities. VBA estimates that
                         it takes at least 2 to 3 years for a new decisionmaker to be able to operate
                         at a fully productive, independent level.




                         5
                          Veterans Benefits Administration: Progress and Challenges in Implementing the Results Act   (GAO/T-
                         HEHS-98-125, Mar. 26, 1998).




                         Page 6                                                                             GAO/HEHS-99-77
                           Veterans Benefits Administration: Progress
                           Encouraging, but Challenges Still Remain




Data Systems Reliability   Also in our testimony before this Subcommittee last March, we noted VBA’s
                           lack of accurate, reliable data to effectively measure and assess its
                           performance. In Roadmap to Excellence, VBA itself stated that its ability to
                           provide accurate and timely data on program activities is compromised by,
                           among other things, outdated computer systems and databases,
                           unvalidated data collection methodologies, and limited data storage
                           capacity. Because of such restrictions, VBA management has limited
                           access to the types of data needed to adequately describe and analyze
                           program activities and participants, and the lack of data has hindered VBA’s
                           ability to justify resource needs. In addition, the data systems do not have
                           adequate controls to ensure that performance data, such as timeliness and
                           production numbers, are valid.

                           According to its Roadmap to Excellence, VBA’s goal is to develop data
                           systems that enable forecasting and are reliable, timely, accurate, honest,
                           flexible, and integrated across the organization. VBA aims to accomplish
                           this goal by about the year 2002. Toward this end, VBA has completed or
                           has in process a variety of actions, such as establishing an office to manage
                           the process of improving data systems, developing a system for capturing
                           detailed data on regional office disability rating decisions, acquiring
                           actuarial assistance in developing forecasting capabilities, establishing a
                           data inventory, and developing a data validation methodology.


Coordination With VHA      Our testimony last March also addressed the need for VBA to coordinate its
                           performance goals with VHA, which performs the medical examinations
                           that are necessary for VBA to determine eligibility for disability benefits. 6
                           At the time of our testimony, VBA was working with VHA to improve the
                           quality of these medical examinations because the lack of adequate exams
                           had been identified as a primary reason that appealed disability decisions
                           were remanded by the Board of Veterans’ Appeals to VBA regional offices.
                           According to VBA officials, VBA and VHA have taken several actions to
                           improve the quality of medical examinations. For example, VBA and VHA
                           have jointly designed improved worksheets for every body system to guide
                           physicians in performing examinations that meet adjudicators’ needs.
                           Also, VBA has provided training to VHA physicians.




                           6
                               VA is pilot testing the use of private medical providers to perform examinations of veterans.




                           Page 7                                                                                   GAO/HEHS-99-77
                         Veterans Benefits Administration: Progress
                         Encouraging, but Challenges Still Remain




Progress in Other        Despite progress, VBA still has much to do in addressing issues related to

Areas Is Still Lacking   •   accuracy in adjudicating disability claims,
                         •   timeliness in adjudicating disability claims,
                         •   organization and infrastructure, and
                         •   rehabilitation of disabled veterans.


Accuracy in Claims       As we reported on March 1, 1999, although VBA had been reporting more
Adjudication             than 95-percent accuracy under the previous accuracy measurement
                         system, the pilot test of the new system revealed an accuracy rate of only
                         64 percent. A primary reason for this difference is that the new system
                         focuses on regional office work products that require a disability rating,
                         and these are the most complex and error-prone work products. In
                         contrast, the previous system drew its sample of cases from the entire
                         universe of regional office work products, including those not requiring
                         disability rating decisions and, therefore, less error-prone. The newly
                         implemented accuracy measurement system continues to focus on claims
                         that involve disability ratings.

                         The new system also tends to produce lower, more realistic accuracy rates
                         because it uses a stricter accuracy rate computation method. Under the
                         previous system, VBA categorized each error under one of three areas of
                         the claims adjudication process: case control and development, decision
                         elements, or notification to the veteran. Thus, if a case had one error, VBA
                         would record this error under the appropriate area and show the two other
                         areas as error-free. After reviewing all cases, VBA computed separate
                         accuracy rates for each of the three claims adjudication areas and then
                         determined an overall accuracy rate by calculating the average of the three
                         accuracy rates. In contrast, under the new accuracy measurement system,
                         if a case has an error in any area of the claims adjudication process, the
                         entire case is counted as incorrect for accuracy rate computation purposes.
                         This method tends to result in a lower accuracy rate than under the
                         previous system.

                         Even with the improvements provided by the new accuracy measurement
                         system, VBA’s ability to identify error-prone cases and target corrective
                         actions is constrained by the limited data that it captures on (1) the medical
                         characteristics of veterans whose claims are processed incorrectly and (2)
                         why medical evidence is deficient. Capturing more detailed data on
                         claimants’ medical characteristics could help pinpoint the specific types of



                         Page 8                                                          GAO/HEHS-99-77
Veterans Benefits Administration: Progress
Encouraging, but Challenges Still Remain




claims in which errors occur. Also, capturing more detailed data on why
reviewers find medical evidence supporting regional office decisions to be
deficient could help identify the types of corrective actions that need to be
taken.

VBA also needs to address vulnerabilities in the integrity of performance
data produced by the new accuracy measurement system. The new system
does not adhere fully to internal control standards that call for separation
of key duties or to standards for performance audits that call for those who
review and evaluate a program’s performance to be organizationally
independent of the program’s managers. Under the new system, the
regional office staff who review the accuracy of regional office decisions
are themselves responsible for making such decisions, and they report to
regional office managers responsible for claims adjudication. Both the
regional office reviewers and their managers have an inherent self-interest
in having as high an accuracy rate as possible. This self-interest derives
from the fact that accuracy is one of the five factors that determine regional
office performance scores under the “balanced scorecard” approach. The
potential effect of impaired objectivity on performance data is exemplified
by findings reported by VA’s Inspector General in 1998. The Inspector
General found that regional office staff had manipulated data on the
timeliness of claims processing to make performance appear better than it
actually was. The Inspector General concluded that weaknesses in internal
controls had contributed to lack of integrity in timeliness data.

While VBA needs to collect additional data to pinpoint causes of errors and
to address vulnerabilities in accuracy data integrity, these improvements
alone will not be sufficient for VBA to meet its goal of improving the
accuracy rate from 64 percent to 96 percent. To do this, VBA must meet the
two key management challenges mentioned earlier: establish stricter
accountability and develop more effective training. In its Roadmap to
Excellence, VBA acknowledged that lack of employee accountability and
inadequate training were root causes contributing to quality problems in
the adjudication of disability claims. As mentioned, VBA has begun taking
action to address these issues; however, at this point, it is too early to
determine the extent to which VBA will be successful in improving
accountability and training or the extent to which these actions will enable
VBA to meet its goal for improving accuracy.




Page 9                                                          GAO/HEHS-99-77
                       Veterans Benefits Administration: Progress
                       Encouraging, but Challenges Still Remain




Timeliness in Claims   Slow claims processing has long been a concern. 7 In 1994, processing
Adjudication           original claims took about 7 months on average, and currently, it takes
                       about 5-½ months. However, even this improvement is far from the goal of
                       about 2 months that VBA set in 1997 as part of a business process
                       reengineering effort to redesign the system for processing original
                       disability claims. VBA envisioned a reengineered system that would use
                       advanced technologies to expedite the development of claims and also
                       envisioned it would eliminate unnecessary tasks, reduce the number of
                       hand-offs in the process, make information technology changes, and
                       provide additional training for rating specialists.

                       However, the National Academy of Public Administration observed in its
                       report that VBA’s reengineering program needed better planning and
                       management. Among other things, the report found that VBA had neither
                       documented nor evaluated regional office initiatives, had neither
                       prioritized reengineering initiatives nor developed a master plan for
                       addressing specific problems, had not tested reengineering initiatives
                       before proposing large reductions in staff, and had not tested assumptions
                       on which its budget and process improvement decisions were based. As a
                       result, VBA reexamined its reengineering strategy and plans. VBA is testing
                       some new approaches, such as case management of claims, but the extent
                       to which reengineering efforts will improve claims-processing timeliness is
                       still unclear.


Organization and       In its January 1999 report, the Congressional Commission on
Infrastructure         Servicemembers and Veterans Transition Assistance stated that some VBA
                       regional offices may be so small that their disproportionately large
                       supervisory overhead unnecessarily consumes personnel resources.
                       Excluding stations with insurance functions, the staffing in VBA’s regional
                       offices ranges from as many as 524 to as few as 18. Similarly, in its 1997
                       report, the National Academy of Public Administration stated VBA should
                       be able to close a large number of regional offices and achieve significant
                       savings in administrative overhead costs associated with supporting 58
                       regional office directors and their staffs. The Commission stated that VBA
                       must develop streamlined and efficient processes to replace business
                       practices that are merely adaptations of traditional paper-based processes



                       7
                        Department of Veterans Affairs: Programmatic and Management Challenges Facing the Department
                       (GAO/T-HEHS-97-97, Mar. 18, 1997).




                       Page 10                                                                       GAO/HEHS-99-77
                         Veterans Benefits Administration: Progress
                         Encouraging, but Challenges Still Remain




                         implemented through aged computer systems and applications and
                         administered through a network of disability claims-processing offices at
                         58 sites across the nation.

                         Apart from the issue of closing regional offices, the Commission also
                         highlighted a need to consolidate disability program claims adjudication
                         into fewer locations. VBA has consolidated the education assistance and
                         housing loan guaranty programs into fewer than 10 locations, and the
                         Commission encouraged VBA to take similar action in the disability
                         programs. VBA itself had proposed such a consolidation in 1995 and in that
                         proposal enumerated several potential benefits, such as allowing VBA to
                         assign the most experienced and productive adjudication officers and
                         directors to the consolidated offices; facilitating increased specialization
                         and as-needed expert consultation in deciding complex cases; improving
                         the completeness of claims development, the accuracy and consistency of
                         rating decisions, and the clarity of decision explanations; improving overall
                         adjudication quality by increasing the pool of experience and expertise in
                         critical technical areas; and facilitating consistency in decision-making
                         through fewer consolidated claims-processing centers.

                         While VBA has not consolidated the disability claims-adjudication function,
                         it has, as mentioned, grouped its 58 regional offices into nine service
                         delivery networks. Nevertheless, greater efficiency and effectiveness could
                         potentially be gained from adjudicating disability claims in fewer locations.


Rehabilitation Program   In February 1998, we testified before this Subcommittee regarding VBA’s
                         vocational rehabilitation program. 8 As we stated then, VBA needs to
                         improve its success in placing disabled veterans in jobs. On the basis of
                         our review of the records for about 74,000 veterans found eligible for the
                         vocational rehabilitation program during fiscal years 1992-95, we found
                         that only 8 percent had successfully completed the vocational
                         rehabilitation process by finding a suitable job and holding it for 60 days.
                         We found that VBA did not focus on finding jobs for participants, even
                         though the law requires that VBA base its rehabilitation program on finding
                         suitable employment for disabled veterans. Instead, VBA focused on
                         sending veterans to training, particularly to higher education programs.
                         Similarly, in its January 1999 report, the Commission on Servicemembers
                         and Veterans Transition Assistance reported that the rehabilitation


                         8
                             Vocational Rehabilitation: Opportunities to Improve Effectiveness   (GAO/T-HEHS-98-87, Feb. 4, 1998).




                         Page 11                                                                                GAO/HEHS-99-77
                        Veterans Benefits Administration: Progress
                        Encouraging, but Challenges Still Remain




                        program continues to concentrate its efforts on sending veterans to
                        training, with about 87 percent of program participants pursuing college-
                        level training in 1997. The Commission concluded that VBA is not
                        achieving its statutory purpose of assisting disabled veterans to become
                        employable and to obtain and maintain suitable employment. According to
                        VBA, it is making progress in this area, but we have not yet evaluated its
                        progress.



Program Design          Our work and the work of others suggest that making dramatic gains in
                        some areas may require changes in the current design of the programs. For
Changes Could Hold      example, a large portion of VBA’s workload in the disability programs
Potential for Greater   consists of “repeat” claims from veterans who have previously filed claims.
                        According to the Veterans’ Claims Adjudication Commission, repeat
Gains                   customers typically outnumber those filing initial claims by about three to
                        one, and as of late 1995, 69 percent of repeat claimants with pending
                        compensation claims were already receiving disability benefits. Over half
                        of the repeat customers were previously rated as 30-percent or less
                        disabled. The Commission questioned whether concentrating claims
                        processing resources on veterans already receiving benefits for relatively
                        minor disabilities instead of more severely disabled veterans is consistent
                        with program intent. The Commission suggested that perhaps the program
                        should be modified to make lump sum compensation payments to
                        “minimally” disabled veterans (defined as those with 10-percent disability)
                        upon separation from military service. This, according to the Commission,
                        would considerably reduce the volume of repeat claims, allowing
                        concentration of VBA processing efforts on claims from more seriously
                        disabled veterans, and, over time, would potentially save taxpayer dollars
                        by reducing administrative and program costs. This course of action would
                        require legislative change.

                        In another instance, the Veterans’ Claims Adjudication Commission
                        recommended simplifying the disability pension program to reduce
                        resource requirements as well as confusion and burdensome reporting
                        requirements for veterans. According to the Commission, only one in four
                        disability recipients is a pension beneficiary, and total compensation
                        payments are almost seven times greater than pension payments.
                        Nevertheless, maintaining recipients’ accounts in the pension program
                        requires almost twice as many staff resources as maintaining compensation
                        recipients’ accounts. Under complex and time-consuming pension
                        program rules, VBA evaluates a claimant’s need on the basis of income and
                        assets available to the claimant’s basic family unit. The Commission



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           Veterans Benefits Administration: Progress
           Encouraging, but Challenges Still Remain




           recommended pension program simplification to reduce confusion and
           burdensome reporting requirements for veterans and to improve VBA’s
           administrative efficiency. While VBA may be able to accomplish some
           simplification through regulatory changes, some measures might require
           legislative action.

           We support further evaluation of the issues we and others have raised, and
           we recommend that the Congress consider taking legislative action if
           necessary to achieve efficiency and effectiveness in VBA’s programs.
           Without the option of altering the current programmatic framework, VBA
           may not be able to find solutions to provide the full measure of
           effectiveness, efficiency, and service that veterans and the taxpayers
           deserve.


           Mr. Chairman, this concludes my prepared remarks. I would be pleased to
           respond to any questions you or Members of the Subcommittee may have.




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Encouraging, but Challenges Still Remain




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