	The IL Track Mainly Serves Older Veterans and Provides a Wide Variety of Benefits

From fiscal years 2008 through 2011, the typical participant in the IL track  was a male Vietnam-era veteran. Of the 9,215 veterans who entered the  IL track in these years, most (67 percent) were male and 50 years old or  older. Regardless  of disability rating level, the most prevalent disabilities among this group  were post-traumatic stress disorder (PTSD), tinnitus (“ringing in the  ears”), and hearing loss. Furthermore, our review of the case files of 182 randomly selected IL  track veterans in fiscal year 2008 shows that they were provided a wide  range of goods and services, from individual counseling and the  installation of ramps to a boat, camping gear, and computers. For all veterans who  entered the IL track in fiscal year 2008, we estimated that VR&E  purchased a total of almost $14 million in goods and services. The  average spent per IL track case that year was nearly $6,000. Most Veterans Were “Rehabilitated” but within Varying Time Frames

We found that most (about 89 percent) of IL track veterans who began  only one plan during fiscal year 2008 were classified by VR&E as  “rehabilitated”—i.e., successfully reaching and maintaining the goals  identified in their IL plan—by the end of fiscal year 2011. At the same  time, about 11 percent of cases were either “discontinued”—i.e., closed  by VR&E because the rehabilitation goals in the veteran’s IL plan were  not completed—or were still active cases. In addition, VR&E’s IL rehabilitation rate was  higher in regional offices with larger IL caseloads. Furthermore, in fiscal year 2008 IL veterans nationwide completed their IL  plans in an average of 384 days (about 13 months); however, we found  that the length of time to rehabilitate these veterans varied by regional  office from a low of 150 days at the St. Paul Regional Office to a high of   At most regional offices (49  895 days at the Roanoke Regional Office. VR&E Exercises Limited Oversight of the IL Track

We identified four key areas where VR&E’s oversight of the IL track was  limited: (1) ensuring compliance with case management requirements, (2)  monitoring regional variation in IL track caseload and benefits provided,  (3) adequacy of policies and procedures for approving expenditures on  goods and services for IL track veterans, and (4) availability of critical  program management information. VR&E has relied on the  information provided through its general quality assurance (QA)  activities and a series of periodic ad hoc studies to oversee the  administration of the IL track. VR&E’s Policy for Approving IL Track Expenditures May Not Be Adequate

VR&E’s current policy for approving IL track expenditures may not be  adequate, considering the broad discretion VR&E provides to regions in  determining and purchasing goods and services. Thus, regional offices have the ability to purchase  a broad range of items without any Central Office approval, resulting in  some offices purchasing goods and services that may be questionable or  costly. In one case we reviewed, VR&E Central Office approval was not required  for the purchase of a boat, motor, trailer, and the boat’s shipping cost,  among other items, totaling about $17,500. Federal  financial accounting standards also recommend that costs of  programs be measured and reported. Types of IL benefits provided: The system does not collect information  on the types of IL benefits provided to veterans in a standardized  manner that can be easily aggregated and analyzed for oversight  purposes. Number of IL veterans served: The system does not provide VR&E  with the information it needs to monitor its statutory entrant cap and  program operations. The law allows VR&E to initiate “programs” of  independent living services and assistance for no more than a  specified number of veterans each year, which, as of 2012, was set at  2,700. In analyzing VR&E’s administrative data, we found that  VR&E counts the number of IL plans developed annually rather than  the number of individual veterans admitted to the track. At the time of  our review, no specific time frames were provided for the CWINRS  redesign, but officials noted it could take up to 3 years to obtain funding  for this effort. Officials told us that they plan to modify CWINRS, and  In conclusion, strengthening oversight of VR&E’s IL track is imperative  given the wide range of goods and services that can be provided under  the law to help veterans with service-connected disabilities improve their  ability to live independently when employment is not feasible.
Why GAO Did This Study

Of the 9,215 veterans who entered the Department of Veterans Affairs' (VA) Independent Living (IL) track within the Vocational Rehabilitation and Employment (VR&E) program from fiscal years 2008 to 2011, most were male Vietnam era veterans in their 50s or 60s. The most prevalent disabilities among these veterans were post-traumatic stress disorder and tinnitus ("ringing in the ears"). GAO's review of 182 IL cases from fiscal year 2008 shows that VR&E provided a range of IL benefits to veterans; the most common benefits being counseling services and computers. Less common benefits included gym memberships, camping equipment, and a boat. GAO estimates that VR&E spent nearly $14 million on benefits for veterans entering the IL track in fiscal year 2008--an average of almost $6,000 per IL veteran.
About 89 percent of fiscal year 2008 IL veterans were considered by VR&E to be "rehabilitated" by the end of fiscal year 2011; that is, generally, to have completed their IL plans. These plans identify each veteran's independent living goals and the benefits VR&E will provide. The remaining 11 percent of cases were either closed for various reasons, such as the veteran declined benefits, or were still active. Rehabilitation rates across regions varied from 49 to 100 percent, and regions with larger IL caseloads generally rehabilitated a greater percentage of IL veterans. On average, IL plans nationwide were completed in 384 days; however, completion times varied by region, from 150 to 895 days.
GAO identified four key areas where VR&E's oversight was limited. First, some regions may not be complying with certain case management requirements. For instance, while VR&E is required to coordinate with the Veterans Health Administration (VHA) on IL benefits, VR&E counselors have difficulty obtaining timely responses from VHA. This has resulted in delayed benefits or VR&E providing the benefits instead of VHA. Second, VR&E does not systematically monitor regional variation in IL caseloads and benefits provided. Instead, it has relied on its quality assurance reviews and ad hoc studies, but these are limited in scope. Third, VR&E's policies for approving IL expenditures may not be appropriate as regions were permitted to purchase a range of items without Central Office approval, some of which were costly or questionable. In one case GAO reviewed, Central Office review was not required for expenditures of $17,500 for a boat, motor, trailer, and the boat's shipping, among other items. Finally, VR&E's case management system does not collect information on IL costs and the types of benefits purchased. VR&E also lacks accurate data on the number of IL veterans served. While the law currently allows up to 2,700 veterans to enter the IL track annually, data used to monitor the cap are based on the number of IL plans developed, not on the number of individual veterans admitted. Since veterans can have more than one IL plan in a fiscal year, one veteran could be counted multiple times towards the cap. VA plans to make modifications to its case management system to address this, but officials noted that it could take up to 3 years to obtain funding for this project.

What GAO Found

The IL track--one of five tracks within VA's VR&E program--provides a range of non-employment related benefits to help veterans with service-connected disabilities live more independently when employment is not considered feasible at the time they enter the VR&E program. These benefits can include counseling, assistive devices, and other services or equipment. This testimony is based on GAO's report issued in June 2013, and describes (1) the characteristics of veterans in the IL track, and the types and costs of benefits provided; (2) the extent to which their IL plans were completed, and the time it took to complete them; and (3) the extent to which the IL track has been administered appropriately and consistently across regional offices.
GAO analyzed VA administrative data from fiscal years 2008 to 2011, and reviewed a random, generalizable sample of 182 veterans who entered the IL track in fiscal year 2008. In addition, GAO visited five VA regional offices; interviewed agency officials and staff; and reviewed relevant federal laws, regulations, and agency policies, procedures, studies, and other documentation.

What GAO Recommends

In its June 2013 report, GAO recommended that VR&E explore options to enhance coordination with VHA, strengthen its oversight of the IL track, and reassess its policy for approving benefits. VA agreed with these recommendations.