Evidence of meeting #56 for Veterans Affairs in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was benefits.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Robert Reynolds  Deputy Under Secretary, Disability Assistance, United States Department of Veterans Affairs
Michael Missal  Inspector General, Office of Inspector General of the United States Department of Veterans Affairs

3:30 p.m.

Liberal

The Chair Liberal Neil Ellis

I'll call the meeting to order. Pursuant to Standing Order 108(2) and the motion adopted on February 6, 2017, the committee resumes its comparative study of services to veterans in other jurisdictions.

In hour one, we have a 10-minute statement, followed by questions and answers. From the United States Department of Veterans Affairs, we would like to welcome, by video conference from Washington, Mr. Robert Reynolds, deputy under secretary for disability assistance.

Mr. Reynolds, we'll give you the floor for 10 minutes and hopefully then ask you some questions.

3:30 p.m.

Robert Reynolds Deputy Under Secretary, Disability Assistance, United States Department of Veterans Affairs

Good afternoon. Thank you for affording me the opportunity to discuss some of the things we're doing within the Department of Veterans Affairs.

It's been a couple of years since I testified before all of you. I've been up there a couple of times, but usually when I come up, it's January and February, so it's a little colder.

I'm happy to talk about the Department of Veterans Affairs and some of the new initiatives we are doing. First, I'll put it in context so that everybody understands the organizational structure of the Department of Veterans Affairs.

We are the second largest cabinet in the government, the first being the Department of Defense. VA has three administrations under it. It has our benefits side, which I reside in, our health side, and our cemeteries and memorials side.

Our health side has what is probably the largest hospital network facilities in the world. We have over 1,700 facilities, from big brick-and-mortar facilities all the way to what we call community-based outpatient clinics, along with what we're doing more and more of, which is telehealth benefits. We serve nearly nine million veterans in the health care arena.

Our cemeteries and memorials side would be our smaller administration. We oversee cemeteries for about 4.3 million veterans and their family members who reside on our grounds. We inter about 130,000 a year within our memorial affairs side.

On the benefits side, which is what I fall under, we have seven business lines within DVA. Our biggest one would be disability compensation. In our disability compensation, we provide monetary benefits to just over 4.6 million veterans who are in receipt of disability compensation. Our pension and fiduciary program, which is a program for our wartime veterans, is a smaller program, as it's a means-based one, based on your income. That has about 500,000 veterans.

Our vocational rehabilitation and employment program is a benefit program for those veterans who are service connected for disability compensation but who might need further education. That's actually how I got my undergrad degree. It was through vocational rehab, not our education program. For voc rehab, we have about 135,000 veterans who participate in that program as well. It's really to help those with service-connected disabilities to get back to the daily act of living.

I'm sure you've heard about our education program. It's mostly our Post-9/11 GI Bill. We've given that benefit out to 1.74 million, so it's getting close to two million. That would be not only veterans; this benefit allows you to transfer that entitlement to your spouse or dependant as well.

In our home loan benefit, this past year we did over 705,000 guaranteed loans. It's a great benefit that can be used numerous times throughout your life once you're eligible. One of the keys to that benefit is that, as you know, we've been working hard to end homelessness, and part of doing this in the VA home loan program is that if we become aware you're becoming delinquent on a home payment or are in financial problems, whether you have a home loan with VA or not, we will work on your behalf, the veteran's behalf, with the lending institution to try to keep you in that home.

For example, last year we helped 97,000 veterans stay in their homes, without going to foreclosure, to keep them from becoming homeless. This is a huge benefit, because once you lose your home, typically where do you go next? It's a great program within our home loan benefit.

Another part of that is what we call our specially adapted housing benefit. That is for severely disabled veterans who need a benefit to adapt their home to make it wheelchair accessible or whatever that may be. We did almost 2,000 applications last year in the specially adapted housing program.

We have over six million who are covered under our insurance. Our insurance has a huge coverage, with about $1.2 trillion in coverage for those who have opted for our insurance program.

Our benefits assistance service, our last program, is really our outreach. It's the three phases: I can do face-to-face communicating of benefits; I can do it online—and for many of the systems, we're moving toward self-service capabilities—and I can do it over the phone.

Last year we did a huge initiative. We answered about 20 million phone calls last year, but one of the big problems we had was the blocked call rate. We had a 59% blocked call rate. Veterans couldn't get in. To get an answer to the call, there was a hold of five or 10 minutes or even longer. We reduced that to 25 seconds and a 0% blocked call rate. Really, a lot of that is attributed to driving more services online. That's what we're seeing with today's veterans. They want to do things online. They want it fast and quick. We still need to do some work, though, to get into the mobile app arena, which is what we're looking at as well, but that initiative was huge for us.

There are a couple of other big initiatives.

You might have heard the President and our secretary announce today our electronic health records initiative. We do most everything with DOD in partnership. Today's announcement was a historic one, in that we had worked together to do interoperability with information and data exchange. DOD did a long assessment over a couple of years to determine what application and architecture platform they wanted. They made that decision while VA was still wondering where it was going to go. Today, the secretary and the President announced that we will be going with the same platform and the same software as DOD. That is a huge win-win for service members and veterans, because we will use the same software and the same electronic health record from the moment the service member comes in, all the way through their life cycle, until they use their last benefit, which is memorial affairs.

We have worked on making some huge strides in VBA and VA as a whole. On the benefit side, I know that the last time I testified to you, it was around our backlog. We were really taking a lot on that.... We had a peak inventory of 611,000 claims. That number is down, with the backlog being just under 100,000, at about 95,000 or so. We've made great strides there.

Also, we've automated the process to go completely paperless. We have another initiative now for all of our paper record folders that were in our regional offices. In VBA, we have 56 regional offices, including two in Manila and Puerto Rico. They had paper folders there. We have an initiative now whereby we're taking out the paper folders and sending them to our scan vendor, who is digitizing them and putting them into our application, or what we call the veterans benefits management system, which is what we use to process disability claims.

We've also created a centralized intake claims processing piece, to the point where we no longer accept mail. We learned this from you on our trips up there in terms of how you had centralized your processes. Now, all the mail we receive goes to our intake site, where it is digitized and scanned, and then it becomes electronic for our use. We're looking at doing more OCR technology to pull the data, because you can do a lot more with data than you can with paper.

I've talked about another couple of concepts before, including e-benefits, the joint VA-DOD portal, where we're capturing service members as soon as they enlist and staying engaged with them throughout their life cycle, helping them until they get ready to separate. Also, we had legislation passed in 2011 that now makes it mandatory for all separating service members to attend a separation briefing. We call it the transition assistance program, but it's not just with VA and DOD; it includes the Department of Labor, the Social Security Administration, the Office of Personnel Management, and the Department of Education. It includes our other cabinet organizations, which are all working together to help that service member transition into the civilian sector. We're seeing a lot of benefits from that program.

We still have some work to do. The secretary is really concerned about our suicide prevention efforts. There are too many suicides.

3:40 p.m.

Liberal

The Chair Liberal Neil Ellis

If we could get you to wind up on that, we have some people who want to ask you some questions.

3:45 p.m.

Deputy Under Secretary, Disability Assistance, United States Department of Veterans Affairs

Robert Reynolds

Question away.

3:45 p.m.

Liberal

The Chair Liberal Neil Ellis

Thank you for your excellent testimony. I'm sorry to rush you.

Ms. Wagantall.

3:45 p.m.

Conservative

Cathay Wagantall Conservative Yorkton—Melville, SK

Thank you so much for being with us today.

I was very encouraged to hear about the work being done on your e-health records. We have a real issue here in Canada with the transition from DND to VAC and privacy issues and having that information available so that it is more effectively used.

You were just saying about your new platform that it's new software. Does that mean it's new to VA or new to both departments, and does it mean a transition of information? Are you just starting now with new recruits or do you have a lot of data entry to do in regard to historical information?

3:45 p.m.

Deputy Under Secretary, Disability Assistance, United States Department of Veterans Affairs

Robert Reynolds

For us, it's commercial, off-the-shelf software. I don't know much on that, but I know that it's new for DOD. It's also new for us.

One of the requirements will have to be that we need all the data transferred over. We need to have that historical medical information if they're going to file any type of disability claim with the Department of Veterans Affairs, because we'll need to know that the event happened while they were in service in order to be able to rate them for disability compensation.

3:45 p.m.

Conservative

Cathay Wagantall Conservative Yorkton—Melville, SK

What do you think the timeline is before this becomes operable and effective for you as a tool?

3:45 p.m.

Deputy Under Secretary, Disability Assistance, United States Department of Veterans Affairs

Robert Reynolds

Hopefully before I retire.

3:45 p.m.

Voices

Oh, oh!

3:45 p.m.

Robert Reynolds.

I would say that it's going to be a few years. We're doing interoperability now, but to do it on the same software platform will be huge. I think we'll be able to collectively realize efficiencies, which at the end of the day will be beneficial to the taxpayers, because we pay for duplication right now.

3:45 p.m.

Conservative

Cathay Wagantall Conservative Yorkton—Melville, SK

Okay.

We were down in Washington a few weeks ago. There were comments about the choice program. They were looking forward to giving veterans more say in who they chose as a provider and that type of thing. Can you give me more information on that?

3:45 p.m.

Deputy Under Secretary, Disability Assistance, United States Department of Veterans Affairs

Robert Reynolds

Sure.

I'm a user of VA health care and DOD health care. I have a choice now to go between VHA or what we call Tricare at the Department of Defense. What we don't have as much is that if I have a specialty or a private physician who I want to use, especially if I'm in a rural part of the country, how do I have that choice to use them and be covered without getting a referral from VHA to say, “Yup, Rob can go see this doctor at this location”?

It's really to help get the treatment and access that much quicker to the veteran, wherever they reside. It's about opening the aperture to the even larger network provider group out there, which includes private. That's what the choice program really is.

3:45 p.m.

Conservative

Cathay Wagantall Conservative Yorkton—Melville, SK

Thank you. I appreciate that.

In Canada a lot of veterans organizations have sprung up where veterans are helping veterans. Often, of course, they know the real needs and quite honestly sometimes the best ways to approach as third party providers. Do you have that same kind of dynamic in your program?

3:45 p.m.

Deputy Under Secretary, Disability Assistance, United States Department of Veterans Affairs

Robert Reynolds

Absolutely. You've probably heard of some of our organizations. It was my privilege and fortune to have been a past national commander for one of our largest ones, Disabled American Veterans, so I know the veterans service organizations quite well. I try to work and leverage that to our benefit.

Like you, we've seen many pop up—for us, after 9/11—and we're trying to see which ones are or are not providing the right service to take advantage of. We include them as trusted stakeholders to help us move this together. One initiative I just kicked off on May 1 in Minneapolis–St. Paul relies on our veterans service organizations to help do the claims process up front for us and submit a fully developed claim that's ready to rate. We guarantee them a decision within under 30 days. Right now our time limit, even though it's a pilot, is at 4.5 days.

3:50 p.m.

Conservative

Cathay Wagantall Conservative Yorkton—Melville, SK

Thank you.

Our National Defence surgeon general just came out with a report with regard to an anti-malarial drug called mefloquine, which the United States issued a black box warning as a last-resort drug in 2013 and we ourselves just did very recently.

Can you give me a follow-up on that? What's happening with mefloquine in the United States in terms of soldiers coming forward, veterans coming forward, and any of the potential treatment? We're hearing more doctors suggest that we need to do more to study and come up with sound practices for the treatment of those veterans.

3:50 p.m.

Liberal

The Chair Liberal Neil Ellis

Mr. Reynolds, I have to apologize, but please make your answer short. We're right at the end of the time limit.

3:50 p.m.

Deputy Under Secretary, Disability Assistance, United States Department of Veterans Affairs

Robert Reynolds

I can't give much on the medical side. I can only talk about the presumption side that we've gotten from Agent Orange and the Camp Lejeune water contamination. I really can't talk specifically to that one.

3:50 p.m.

Liberal

The Chair Liberal Neil Ellis

Thank you.

Mr. Bratina.

3:50 p.m.

Liberal

Bob Bratina Liberal Hamilton East—Stoney Creek, ON

Thank you so much for this opportunity today. Perhaps I can start by asking you about some of the differences we saw in our visit to Washington, when we came across certain facilities aimed strictly at combat veterans as opposed to all of the other people who serve in various capacities. What about the distinction there in the services available?

3:50 p.m.

Deputy Under Secretary, Disability Assistance, United States Department of Veterans Affairs

Robert Reynolds

You're referring to our vet centres, I believe.

3:50 p.m.

Liberal

Bob Bratina Liberal Hamilton East—Stoney Creek, ON

Yes.

3:50 p.m.

Deputy Under Secretary, Disability Assistance, United States Department of Veterans Affairs

Robert Reynolds

Our vet centres were stood up after Vietnam. When our Vietnam veterans came home, they weren't really treated correctly, and didn't trust the government. Their own stood up the vet centres. They have the state criteria of eligibility, which is combat veterans, as you say. They do not share that information with VHA. It's all confidential. It's a trusted location.

Mostly the vet centres have been set up for PTSD. There are over 300 of them in the country, and they're exactly as you saw, completely separate from our health care facilities.

3:50 p.m.

Liberal

Bob Bratina Liberal Hamilton East—Stoney Creek, ON

Thank you.

The question of PTSD and suicide is a problem in both of our countries with our veterans. There's an interesting difference, though, in that we're encountering a higher incidence among younger veterans—Afghanistan and so on. To my understanding, in the United States it's the Vietnam cohort that is suffering more. Is that accurate?

3:50 p.m.

Deputy Under Secretary, Disability Assistance, United States Department of Veterans Affairs

Robert Reynolds

Yes, I would say that's accurate. It's a struggle. You know, one is too many, and I think we're at 20 a day now. We were at 22. Our secretary is getting us to what's called “getting to zero”. How do we get to zero? I think it goes to how we get our community involved to help us get to zero. We the government can't do it all, at that point.