Seal of the Department of Veterans Affairs
Flag of the Department of Veterans Affairs
Washington, D.C. Headquarters
|Formed||March 15, 1989|
|Jurisdiction||United States federal government|
|Headquarters||Veteran Affairs Building|
810 Vermont Avenue NW
Washington, D.C., U.S.
|Motto||"To care for him who shall have borne the battle and for his widow, and his orphan."|
|Annual budget||$200 billion (FY2019)|
The United States Department of Veterans Affairs (VA) is a federal Cabinet-level agency that provides near-comprehensive healthcare services to eligible military veterans at VA medical centers and outpatient clinics located throughout the country; several non-healthcare benefits including disability compensation, vocational rehabilitation, education assistance, home loans, and life insurance; and provides burial and memorial benefits to eligible veterans and family members at 135 national cemeteries.
While veterans benefits have been provided since the American Revolutionary War, an exclusively veteran-focused federal agency, the Veterans Administration, was not established until 1930, and became the cabinet-level Department of Veterans Affairs in 1989. In 1982, its mission was extended to providing care for non-veteran military members and civilians in case of disasters and emergencies.
The VA employs[when?] 377,805 people at hundreds of Veterans Affairs medical facilities, clinics, benefits offices, and cemeteries. In Fiscal Year 2016 (1 Oct 2015 - 30 September 2016), net program costs for the department were $273 billion, which includes VBA Actuarial Cost of $106.5 billion for compensation benefits. The long-term actuarial accrued liability (total estimated future payments for veterans and their family members) is $2.491 trillion for compensation benefits; $59.6 billion for education benefits; and $4.6 billion for burial benefits.
In May 2014, it was revealed that veterans experienced extended delays in getting care at the Veterans Health Administration. An investigation found that VA personnel falsified scheduling data, making it seem as if they had met scheduling targets.
The Continental Congress of 1776 encouraged enlistments during the American Revolutionary War by providing pensions for soldiers who were disabled. Direct medical and hospital care given to veterans in the early days of the U.S. was provided by the individual states and communities. In 1811, the first domiciliary and medical facility for veterans was authorized by the federal government, but not opened until 1834. In the 19th century, the nation's veterans assistance program was expanded to include benefits and pensions not only for veterans, but also their widows and dependents.
After the end of the American Civil War in 1865, many state veterans' homes were established. Since domiciliary care was available at all state veterans homes, incidental medical and hospital treatment was provided for all injuries and diseases, whether or not of service origin. Indigent and disabled veterans of the Civil War, Indian Wars, Spanish-American War, and Mexican Border period as well as discharged regular members of the Armed Forces were cared for at these homes.
Congress established a new system of veterans benefits when the United States entered World War I in 1917. Included were programs for disability compensation, insurance for service persons and veterans, and vocational rehabilitation for the disabled. By the 1920s, the various benefits were administered by three different federal agencies: the Veterans Bureau, the Bureau of Pensions of the Interior Department, and the National Home for Disabled Volunteer Soldiers.
The establishment of the Veterans Administration came in 1930 when Congress authorized the president to "consolidate and coordinate Government activities affecting war veterans". The three component agencies became bureaus within the Veterans Administration. Brigadier General Frank T. Hines, who directed the Veterans Bureau for seven years, was named as the first Administrator of Veterans Affairs, a job he held until 1945.
The close of World War II resulted in not only a vast increase in the veteran population, but also a large number of new benefits enacted by Congress for veterans of the war. In addition, during the late 1940s, the VA had to contend with aging World War I veterans. During that time, "the clientele of the VA increased almost five fold with an addition of nearly 16,000,000 World War II veterans and approximately 4,000,000 World War I veterans." Prior to World War II, in response to scandals at the Veterans Bureau, programs that cared for veterans were centralized in Washington, D.C. This centralization caused delays and bottlenecks as the agency tried to serve the World War II veterans. As a result, the VA went through a decentralization process, giving more authority to the field offices.
"The United States government began serious consolidated services to veterans in 1930. The GI Bill of Rights, which was passed in 1944, had more effect on the American way of life than any other legislation - with the possible exception of the Homestead Act."
Further educational assistance acts were passed for the benefit of veterans of the Korean War, the Vietnam Era, the introduction of an "all-volunteer force" in the 1970s (following the end of conscription in the United States in 1973), the Persian Gulf War, and those who served following the attacks of 11 September 2001.
The Department of Veterans Affairs Act of 1988 (Pub.L. 100-527) changed the former Veterans Administration, an independent government agency established in 1930, primarily to see to the needs of World War I veterans, into a Cabinet-level Department of Veterans Affairs. It was signed into law by President Ronald Reagan on 25 October 1988, but actually came into effect under the term of his successor, George H. W. Bush, on 15 March 1989.
The Department of Veterans Affairs was created due to nearly one third of the population being eligible for veterans benefits. Its proponents argued that due to the large number of Americans affected by the VA, it needed an administrator who had direct access to the president.
In their major reform period of 1995-2000, the Veterans Health Administration (VHA) implemented universal primary care, closed 55% of their acute care hospital beds, increased patients treated by 24%, had a 48% increase in ambulatory care visits, and decreased staffing by 12%. By 2000, the VHA had 10,000 fewer employees than in 1995 and a 104% increase in patients treated since 1995, and had managed to maintain the same cost per patient-day, while all other facilities' costs had risen over 30% to 40% during the same period.
In May 2014, critics of the VA system reported major problems with scheduling timely access to medical care. As of May 2014, one retired doctor said that at least 40 United States Armed Forces veterans died because of delays getting care at the Phoenix, Arizona Veterans Health Administration facilities. An investigation of delays in treatment throughout the Veterans Health Administration system was conducted by the Veterans Affairs Inspector General of 3,409 veteran patients, including the 40 patients, who found that there were 28 instances of clinically significant delays in care associated with access or scheduling. Of these 28 patients, 6 were deceased. The same OIG report stated that the Office of Investigations had opened investigations at 93 sites of care in response to allegations of wait time manipulations, and found that wait time manipulations were prevalent throughout VHA. On 30 May 2014, Secretary of Veterans Affairs Eric Shinseki resigned from office due to the fallout from the scandal, saying he could not explain the lack of integrity among some leaders in VA healthcare facilities. "That breach of integrity is irresponsible, it is indefensible, and unacceptable to me. I said when this situation began weeks to months ago that I thought the problem was limited and isolated because I believed that. I no longer believe it. It is systemic. I was too trusting of some and I accepted as accurate reports that I now know to have been misleading with regard to patient wait-times," Shinseki said in a statement.
In response, on April 27, 2017 President Trump signed an executive order creating an Office of Accountability and Whistleblower Protection (OAWP). In the following years, the office was repeatedly criticized for allegedly retaliating against whistleblowers and failing in its mission to hold executives accountable.
In September 2017, the VA declared its intent to abolish a 1960s conflict of interest rule prohibiting employees from owning any stock, performing any service, or doing any work at for-profit colleges; arguing that, for example, the 1960s rule prohibits VA doctors from teaching veterans at for-profit universities with special advantages for veterans.
On 26 September 2018, Secretary Wilkie testified to Congress that the agency was still using a 50-year-old computer to process benefits.
On June 26, 2020, the VA reported 20,509 cases of COVID-19 and 1,573 deaths among patients, and over 2,000 cases of COVID-19 and 38 deaths among employees.
The VA's primary function is to support veterans in their time after service by providing benefits and support.
Providing care for non-veteran civilian or military patients in case hospitals overflow in a crisis was added as role by Congress in 1982, and became known as the VA's "fourth mission" (besides the three missions of serving veterans through care, research and training). It can provide medical services (reimbursed from other federal agencies) to the general public for major disasters and emergencies declared by the President of the United States, and when the Secretary of Health and Human Services activates the National Disaster Medical System. During disasters and health emergencies, requests for VA assistance are made by state governors to the Federal Emergency Management Agency or the Department of Health and Human Services, which then relay approved requests to the VA.The VA is also allowed to provide paid medical care on an emergency basis to non-veterans. The VA made public, March 27, the COVID-19 Response Plan it is executing within its medical facilities to protect Veterans, their families and staff.
A current[when?] initiative in the Department is to prevent and end veterans' homelessness. The VA works with the United States Interagency Council on Homelessness to address these issues. The USICH identified ending veterans' homelessness by 2015 as a primary goal in its proposal Opening Doors: Federal Strategic Plan to Prevent and End Homelessness, released in 2010; amendments to the 2010 version made in 2015 include a preface written by U.S. Secretary of Labor Thomas E. Perez that cites a 33% reduction in veteran homelessness since the creation of the Opening Doors initiative.
The Secretary of Veterans Affairs is Robert Wilkie who was selected by President Donald Trump and sworn in by Vice President Mike Pence on 30 July 2018. The Deputy Secretary of Veterans Affairs position is currently vacant with the retirement of Thomas G. Bowman on 15 June 2018. The third listed executive on the VA's official web site is its Chief of Staff (currently Pamela J. Powers); the Chief of Staff position does not require Senate confirmation. In addition to Secretary and Deputy Secretary, the VA has ten more positions requiring presidential appointment and Senate approval.
The Department has three main subdivisions, known as Administrations, each headed by an Undersecretary:
There are Assistant Secretaries of Veteran Affairs for: Congressional and Legislative Affairs; Policy and Planning; Human Resources and Administration; and Operations, Security and Preparedness. Other Senate-approved presidential nominees at the VA include: Chief Financial Officer; Chairman of the Board of Veterans' Appeals; General Counsel; and Inspector General.
The VA, through its Veterans Benefits Administration (VBA), provides a variety of services for veterans including disability compensation, pension, education, home loans, life insurance, vocational, rehabilitation, survivors' benefits, health care, and burial benefits.
The Department of Labor (DOL) provides job development and job training opportunities for disabled and other veterans through contacts with employers and local agencies.
The VA categorizes veterans into eight priority groups and several additional subgroups, based on factors such as service-connected disabilities, and their income and assets (adjusted to local cost of living).
Veterans with a 50% or higher service-connected disability as determined by a VA regional office "rating board" (e.g., losing a limb in battle, PTSD, etc.) are provided comprehensive care and medication at no charge. Veterans with lesser qualifying factors who exceed a pre-defined income threshold have to make co-payments for care for non-service-connected ailments and prescription medication.[dubious ] VA dental and nursing home care benefits are more restricted.
The VA's budget has been pushed to the limit in recent years[when?] by the War on Terrorism. In December 2004, it was widely reported that VA's funding crisis had become so severe that it could no longer provide disability ratings to veterans in a timely fashion. This is a problem because until veterans are fully transitioned from the active-duty TRICARE healthcare system to VA, they are on their own with regard to many healthcare costs.[original research?]
The VA's backlog of pending disability claims under review (a process known as "adjudication") peaked at 421,000 in 2001, and bottomed out at 254,000 in 2003, but crept back up to 340,000 in 2005. Today's[when?] backlog numbers are much lower at 69,626. These numbers are released every Monday. No copayment is required for VA services for veterans with military-related medical conditions. VA-recognized service-connected disabilities include problems that started or were aggravated due to military service. Veteran service organizations such as the American Legion, Veterans of Foreign Wars, and Disabled American Veterans, as well as state-operated Veterans Affairs offices and County Veteran Service Officers (CVSO), have been known to assist veterans in the process of getting care from the VA.
In the 2011 Costs of War report from Brown University, researchers projected that the cost of caring for veterans of the War on Terror would peak 30-40 years after the end of combat operations. They also predicted that medical and disability costs would ultimately total between $600 billion and $1 trillion for the hundreds of thousands treated by the Department of Veterans Affairs.
The 2008 "New GI Bill" authored by Sen. Jim Webb (D-VA) doubled GI Bill college benefits while providing a 13-week extension to federal unemployment benefits. The new GI Bill more than doubled the value of the benefit to roughly $90,000 up from $40,000. In-state public universities essentially are covered to provide full scholarships for veterans under the new education package. For those veterans who served at least three years a monthly housing stipend was also added to the law.
Congress and President Barack Obama extended the new GI Bill in August 2009 at the cost of roughly $70 billion over the next decade. The Department of Defense (DoD) allows individuals who, on or after 1 August 2009, have served at least 6 years in the Armed Forces and who agree to serve at least another 4 years in the U.S. Armed Forces to transfer unused entitlement to their surviving spouse. Servicemembers reaching 10-year anniversaries could choose to transfer the benefit to any dependent(s) (spouse, children).
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In 1973, the Veterans Administration assumed another major responsibility when the National Cemetery System (NCS) (except for Arlington National Cemetery) was transferred to the Veterans Administration from the Department of the Army.
In 1978, Congress established the State Cemetery Grants Program (Public Law 95-476). This act is administered by the National Cemetery Administration to aid States and U.S. territories in the establishment, expansion and improvement of veterans cemeteries. The VA was charged with the operation of the NCS, including the marking of graves of all persons in national and State cemeteries (and the graves of veterans in private cemeteries, upon request) as well and administering the State Cemetery Grants Program. The VA's National Cemetery Administration maintains 131 national cemeteries in 39 states (and Puerto Rico) as well as 33 soldier's lots and monument sites.
The Department of the Army maintains two national cemeteries, the Arlington National Cemetery and the U.S. Soldiers' & Airmen's Home National Cemetery. Many states have established state veterans cemeteries. The American Battle Monuments Commission maintains 25 overseas military cemeteries that serve as resting places for almost 125,000 American war dead; on Tablets of the Missing that memorialize more than 94,000 U.S. servicemen and women; and through 25 memorials, monuments and markers. Fourteen national cemeteries are maintained by the National Park Service.
The Center for Women Veterans (CWA) was established within the Department of Veterans Affairs by Public Law 103-446 in November 1994. The Center's mission is to:
Center for Women Veterans activities include monitoring and coordinating delivery of benefits and services to women veterans; coordinating with Federal, state, and local agencies and organizations and non-government partners which serve women veterans; serving as a resource and referral center for women veterans, their families, and their advocates; educating VA staff on women' military contributions; ensuring that outreach materials portray and target women veterans; promoting recognition of women veterans' service with activities and special events; and coordinating meetings of the Advisory Committee on Women Veterans. CWA has held summits and forums for female veterans and created social media campaigns and exhibits to highlight women's military service. CWA offers a Women Veterans Call Center (1-855-829-6636) to assist female U.S. military veterans with VA services and resources. In 2018, the Center for Women Veterans launched the "I Am Not Invisible" photography project, featuring individual portraits, to highlight and represent the contributions, needs, and experiences of America's two million women veterans.
In a 2015 Center for Effective Government analysis of 15 federal agencies which receive the most Freedom of Information Act (United States) (FOIA) requests (using 2012 and 2013 data, the most recent years available), the VA earned a D by scoring 64 out of a possible 100 points, i.e. did not earn a satisfactory overall grade.
The VA employs[when?] 377,805 people, of which 338,205 are nonseasonal full-time employees. The American Federation of Government Employees represents 230,000 VA employees, with VA matters addressed in detail by the National VA Council.
VA expends a substantial amount of its budgetary resources on medical care for Veterans and also disburses large cash amounts for Veteran's compensation and education benefits programs.
The Government compensates disabled veterans and their survivors. Veterans' compensation is payable as a disability benefit or a survivor's benefit. Entitlement to compensation depends on the veteran's disabilities having been incurred in, or aggravated during, active military service; death while on duty; or death resulting from service-connected disabilities, if not on active duty. ¶ Eligible veterans who die or are disabled from military service-related causes, as well as their dependents, receive compensation benefits. Also, veterans are provided with burial flags, headstones/markers, and grave liners for burial in a VA national cemetery or are provided a burial flag, headstone/marker and a plot allowance for burial in a private cemetery. These benefits are provided under 38 U.S.C., Part 2, Chapter 23 in recognition of a veteran's military service and are recorded as a liability in the period the requirements are met. ¶ The liability for veterans' compensation and burial benefits payable is based on an actuarial estimate of future compensation and burial payments and increased by $477.7 billion in fiscal year 2016. The $477.7 billion increase is primarily attributable to assumption changes and experience. The major actuarial assumption changes and experience impacts include growth in compensation counts, new mortality rates, changes in the discount rate, and an increase in beneficiary counts. ¶ Several significant actuarial assumptions were used in the valuation of compensation and burial benefits to calculate the present value of the liability. A liability was recognized for the projected benefit payments to: 1) those beneficiaries, including veterans and survivors, currently receiving benefit payments; 2) current veterans who will in the future become beneficiaries of the compensation program; and 3) a proportional share of those in active military service as of the valuation date who will become veterans in the future. Future benefit payments to survivors of those veterans in classes 1, 2, and 3 above are also incorporated into the projection. The projected liability does not include any administrative costs. ¶ The veterans' compensation and burial benefits liability is developed on an actuarial basis. It is impacted by interest on the liability balance, experience gains or losses, changes in actuarial assumptions, prior service costs, and amounts paid for costs included in the liability balance.
OIG examined the Electronic Health Records (EHRs) and other information for the 3,409 veteran patients, including the 40 patients, and identified 28 instances of clinically significant delays in care associated with access or scheduling. Of these 28 patients, 6 were deceased. In addition, we identified 17 cases of care deficiencies that were unrelated to access or scheduling. Of these 17 patients, 14 were deceased. We also found problems with access to care for patients requiring Urology Services. As a result, Urology Services at PVAHCS will be the subject of a subsequent report. The 45 cases discussed in this report reflect unacceptable and troubling lapses in followup, coordination, quality, and continuity of care. The VA OIG Office of Investigations opened investigations at 93 sites of care in response to allegations of wait time manipulations. While most are still ongoing, these investigations confirmed wait time manipulations were prevalent throughout VHA.
Section 1. Purpose. This order is intended to improve accountability and whistleblower protection at the Department of Veterans Affairs (VA) by directing the Secretary of Veterans Affairs (Secretary) to establish within the VA an Office of Accountability and Whistleblower Protection and to appoint a Special Assistant to serve as Executive Director of the Office.