Administration Seeks $58 Billion for VA

WASHINGTON — Seeking to improve the timeliness and accuracy of claims processing and to enhance access to high-quality  health care, Secretary of Veterans Affairs Anthony J. Principi announced details today of President Bush’s proposed $58 billion budget — the largest increase ever for the Department of Veterans Affairs (VA).

“Our nation’s veterans have earned the best health care and the fairest compensation system that we can provide,” Principi said.  “President Bush has given us a budget that will honor that commitment, enabling VA to give valuable services to today’s veterans, while continuing the research and realignments necessary to serve the needs of future veterans.”

Overall, the budget would provide VA with $6.1 billion more than in 2002 to help disabled veterans, provide annuities for widows, offset the educational and housing expenses of veterans, honor veterans when they die and operate the nation’s largest health care system.  In fact, the new budget would give VA the largest increase in health care spending in its history — an 8.2-percent hike.

Principi said the budget request for fiscal year 2003 furthers VA’s three highest priorities – improving the timeliness and accuracy of claims processing, ensuring that veterans receive high-quality health care, and meeting the burial needs of veterans while maintaining VA’s cemeteries as national shrines.

To address the Secretary’s priorities, the budget requests: $25.5 billion for medical programs, a $2.7 billion increase; $31.5 billion for veterans’ benefits programs (including administrative costs), a $3.4 billion increase; and $138 million to operate the national cemetery system, a $17 million increase.  The budget also includes the largest request for capital programs (construction and grants) since 1996, a total of $537 million.

Improving the Claims Process

The President and VA Secretary have promised to improve the timeliness and quality of claims processing.  VA already has taken major steps in this direction.  Before recent reforms, VA processed approximately 40,000 claims a month.  Today, VA is processing more than 62,000 monthly.

The $1.2 billion budget request for the administration of veterans benefits reaffirms VA’s goal of reducing the time veterans must wait to get a decision on their claims.   It also supports an on-going effort to resolve about 81,000 of the oldest claims for disability compensation and wartime VA pensions through a streamlined administrative process.

Supporting veterans’ benefits programs would be 13,139 full-time employees, an increase of 125 over fiscal year 2002’s level.  The budget also provides $50 million in funding for initiatives to improve the timeliness and accuracy of VA’s claims processing system.

Proposed funding for VA-administered entitlement programs includes an estimated cost-of-living adjustment of 1.8 percent in compensation and pension programs that would take effect Dec. 1, 2002.  The actual amount will be determined by changes in the Consumer Price Index.

Another key issue is the mandate to ensure that the Montgomery GI Bill educational benefits succeed in assisting veterans’ readjustment.  In 2001, more than 400,000 veterans attended school with GI Bill educational benefits.  In 2003, VA will continue to improve the accuracy and timeliness of education awards. 

Also part of the budget is a proposal to establish a new program in which VA will usecompetitive grants to help create, expand or improve employment and training programs for veterans.  It would consolidate some of the Veterans Employment and Training Service (VETS) programs now administered by the Department of Labor into VA. The emphasis will be on serving those veterans who most need employment assistance, including recently separated disabled and homeless veterans.

Caring for Veterans

This year’s budget request continues the President’s commitment to provide veterans quality health care and services by allocating $25.5 billion for its health care system, a figure that includes nearly $1.5 billion collected from third-party health insurance and co-payments from veterans.  This is a $2.7 billion increase in estimated spending for health care compared to this year’s budget.

“VA provides better care than ever before.  That’s a big reason so many more veterans are coming to us for their health care,” said Principi.  “We have doubled the number of veterans enrolled in VA health care since 1995.  Today, we serve 6 million enrollees, with 25,000 fewer employees than just six years ago.”  

VA’s efficiency has also climbed.  Since 1994, VA’s bed days of care are down 62 percent, inpatient admissions have dropped 32 percent, and the cost of treating an individual veteran has decreased 24 percent while improving quality. 

“With this explosive growth we continue to lead the nation in areas like spinal cord injury, blind rehabilitation, severe psychological conditions and geriatric care,” said Principi.

Additionally, the budget proposes $409 million – a $38-million increase from this year’s spending — to support medical and prosthetics research.  It enhances many of VA’s strategic goals such as timely access to health care, refocusing medical care on service-connected and low-income veterans, improving response in the event of national emergency and providing support to community and faith-based organizations who care for our nation’s homeless veterans.

In support of VA medical centers in earthquake-prone California, the budget requests approximately $94 million in funding for four seismic projects: two in Palo Alto, one in San Francisco and one in West Los Angeles.

The budget also proposes an almost $366 million increase for pharmaceuticals, bringing the total to $2.9 billion in 2003.  New patients, coupled with increases in ambulatory care resulted in significant increases in pharmaceutical costs last year.  This increase is essential for the system to continue to use the more cost efficient ambulatory care setting rather than hospitalization.

Timeliness of service ensures that medical care is received when it is needed.  The budget sets aside $159 million for initiatives to improve quicker access to health care, work processes, infrastructure modifications, increased telemedicine use and technology enhancements.

VA has set high standards to address waiting time performance.  Called “30/30/20,” the goal is for each veteran to get a primary care appointment within 30 days and if referred to a specialist, it would take no more than 30 days.  Once there, a veteran would wait no longer than 20 minutes for his/her appointment.  

The new funding level would allow VA to provide medical care to about 4.9 million patients, the largest number ever, who are expected to make 43 million outpatient visits and 598,000 hospital visits in 2003.

The total number of patients treated by VA increased by over 11 percent from 2000 to 2001 – more than twice VA’s experience of prior years.  The biggest growth, almost 30 percent, was with higher income, nonservice-connected veterans.

VA welcomes and wants to provide care to all veterans.  But VA’s primary responsibility is to service-connected and low-income veterans.  As such, the budget proposes a policy change that would establish a $1,500 yearly deductible for higher income, nonservice-connected veterans. 

This is not a standard deductible that must be paid upfront and veterans’ insurance may cover all charges.  Veterans insurance companies will be billed for medical services at the rate of 45 percent of VA’s “reasonable charges” each time they receive medical care until they reach the $1,500 annual ceiling for out-of-pocket expenses.  Medication copayments will not count toward the deductible and will be charged at the existing rate of $7 for each 30-day prescription.  After the $1,500 ceiling is reached, veterans would pay the normal copayments charged for outpatient and inpatient care. 

“This initiative denies care to no one.  It does ask those veterans who have the means and who incurred no disabilities on active duty, to pay a larger portion of their health care,” Principi said.  “That seems fair to me and allows VA to provide the best care possible to our higher priority veterans.”  

National Cemeteries as National Shrines

Secretary Principi is committed to maintaining VA’s 120 national cemeteries in a manner befitting their status as national shrines.  VA is in the process of establishing new veterans’ cemeteries and continues to care for the approximately 2.4 million graves under its jurisdiction in 39 states and Puerto Rico.

The budget requests $138 million, or $17 million more than the current level, for operating VA’s national cemeteries.  Additional construction funding is set aside for establishing new national cemeteries near Miami, Pittsburgh, Detroit and Sacramento.  There is also $32 million requested for the State Cemetery Grants Program, a $7 million increase over last year’s budget. 

“VA’s core mission is to care for those who have borne the battle,” said Principi.  “And that doesn’t mean just when they are alive.  VA must assure America that her sons and daughters who so proudly served in times of war and peace will forever be honored in National Cemeteries recognized as national shrines.  Last year, 58,000 veterans were so honored.”

America loses more than 1,100 of her World War II veterans each day.  Reflecting their passing, and the loss of our Korean War veterans, national cemetery interments are expected to peak at more than 107,000 annually in 2008. 

Business Practices

The President’s 2002 Management Agenda requires all agencies to improve government performance in five key areas – human capital, E-government, competitive sourcing, budget and performance integration, and financial performance.  

Restructuring efforts in VA’s health care system will continue in 2003.  Requests include $40 million for a multi-year infrastructure realignment under the Capital Asset Realignment for Enhance Services (CARES) initiative. 

The budget also allows for continued cooperation between VA and the Department of Defense to improve federal health care and benefits delivery services.  The two departments have identified four high priority items for improvement: enrollment, computerized patient records, air-transport of patients and facility sharing.  

As VA moves forward with implementation of the One-VA Enterprise Architecture, management of information technology resources will continue to evolve and mature.  VA will continue efforts to improve its information technology system.  Strong programs are being developed throughout the agency for cyber security, workforce development, performance metrics, telecommunications and project management oversight. 

Additionally, the budget outlines ways for VA to save money.  For example, the VA Procurement Reform Task Force, appointed by the Secretary, established five major goals for improvement in VA’s more than $5 billion acquisition system.  The focus is on leveraging our purchasing power through standardization and more effectively organizing and training our acquisition workforce.  The Secretary has been briefed by the task force and expects the final report in the coming weeks.

“I join the President in presenting this exciting, historic veterans budget,” said Principi.  “I believe as Abraham Lincoln once said,  ‘All that a man hath will he give for his life; and while all contribute of their substance, the soldier puts his life at stake, and often yields up his country’s cause.  The highest merit, then, is due the soldier.’”

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 Department of Veterans Affairs

Budget Authority (In Millions of Dollars)