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800 | onal office, for example, said that his office used its full 20 hours to provide training on new and emerging issues that are not covered by the core technical training topics, as well as training to address error prone areas. An official in another regional office said the core requirements satisfied staff training needs in fiscal year 2007, possibly because this regional office had a large proportion of new staff and the core topics are focused on the needs of new staff. Regional offices must develop trai |
801 | ning plans each year that indicate which courses will actually be provided to staff to enable them to meet the 80- hour training requirement. The training plan is a list of courses that the regional office plans to offer throughout the year, as well as the expected length and number and types of participants in each course. In the regional offices we visited, when managers develop their training plans, they solicit input from supervisors of VSRs and RVSRs and typically also consider national or local error |
802 | trend data. Regional offices must submit their plans to the VBA central office at the beginning of each fiscal year for review and feedback. Central office officials review the plans to determine whether (1) the regional office will deliver at least 60 hours of training on the required core topics, (2) the additional topics identified by the regional office are appropriate, and (3) staff in similar positions within an office receive the same level and type of training. According to central office officials, |
803 | they provide feedback to the regional offices on their current plans as well as guidance on what topics to include in the next year’s training plans. Regional offices can adjust their training plans throughout the year to address shifting priorities and unexpected training needs. For example, a regional office may add or remove courses from the plan in response to changing trends in errors or policy changes resulting from legal decisions. (See app. III for excerpts from the fiscal year 2007 training plans |
804 | from the regional offices we visited.) While regional offices have discretion over the methods they use to provide training, the four offices we visited relied primarily on classroom training in fiscal year 2007. In each of these offices, at least 80 percent of the total fiscal year 2007 training hours completed by all claims processors was in the form of classroom instruction (see fig. 3). Officials in two of the regional offices we visited said they used lesson plans provided by the Compensation and Pensi |
805 | on Service and adapted these plans to the needs of their staff; one regional office developed its own courses. An official in one office said they sometimes invite guest speakers, and an official in another regional office said that classroom training is sometimes delivered as part of team meetings. The offices we visited generally made little use of other training methods. Only one office used TPSS for its training more than 1 percent of the time. Two offices used self-instruction—such as reading memos fro |
806 | m VBA central office—for about 10 percent of their training, and no office used videos for more than 1 percent of their training. The central office usually communicates immediate policy and regulatory changes through memos called Fast Letters, which may be discussed in team meetings or may just be read by staff individually. Because the agency has no policy outlining consequences for individual staff who do not complete their 80 hours of training per year, individual staff are not held accountable for meet |
807 | ing their annual training requirement, and at present, VBA central office lacks the ability to track training completed by individual staff members. According to VBA officials, however, the agency is in the process of implementing an automated system that should allow it to track the training each staff member completes. Officials reported that this system is expected to be implemented during fiscal year 2008. VBA officials reported that this system will be able to record the number of training hours and th |
808 | e courses completed for each individual, staff position, and regional office. One official said the central office and regional office supervisors will have the ability to monitor training completed by individual staff members, but that central office will likely not monitor the training completed by each individual staff member, even though it may monitor the training records for a sample of staff members. Furthermore, despite the absence of a VBA- wide tracking system, managers in two of the regional offi |
809 | ces we visited reported using locally developed tracking methods to determine the number of training hours their staff had completed. While individuals are not held accountable, VBA reported taking some steps to ensure that staff complete the required number of training hours. VBA central office periodically reviews the aggregated number of training hours completed at each regional office to determine whether the office is on track to meet the training requirement. According to a VBA official, managers in o |
810 | ffices where the staff is not on track to complete 80 hours of training during the year can be reprimanded by a higher-level manager, and if their staff do not meet the aggregate training hours at the end of the fiscal year, managers could face negative consequences in their performance assessments. VBA is taking steps to strategically plan its training for VSRs and RVSRs including the establishment of a training board to assess VBA’s training needs. VBA has also made some effort to evaluate its training fo |
811 | r new staff, but does not require regional offices to collect feedback from staff on any of the training they provide. Although some regional offices collect some training feedback, it is not shared with VBA central office. Both new and experienced staff we interviewed did, in fact, report some problems with their training. A number of new staff raised issues with how consistently their training curriculum was implemented. Experienced staff differed in their assessments of the VBA’s annual training requirem |
812 | ent, with some indicating they struggle to meet this requirement because of workload pressures or that training topics are sometimes redundant or not relevant to their position. VBA is taking steps to strategically plan its training for claims processors, in accordance with generally accepted practices identified by GAO. (See app. I for a detailed description of these generally accepted practices.) VBA has made an effort to align training with the agency’s mission and goals. According to VBA documents, in f |
813 | iscal year 2004 an Employee Training and Learning Board (board) was established to ensure that training decisions within the VBA are coordinated; support the agency’s strategic and business plans, goals and objectives; and are in accordance with the policy and vision of VBA. Some of the board’s responsibilities include establishing training priorities and reviewing regional office and annual training plans. VBA has identified the skills and competencies needed by VBA’s claims processing workforce. VBA devel |
814 | oped a decision tree and task analysis of the claims process, which GAO experts in the field of training told us made it possible to understand and map both the claims process and the decisions associated with it that supported the development of VBA’s training curriculum. VBA is taking steps to determine the appropriate level of investment in training and prioritize funding. According to VBA documents, some of the board’s responsibilities include developing annual training budget recommendations and identi |
815 | fying and recommending training initiatives to the Under Secretary of Benefits. VBA officials also reported developing several documents that made a business case for different aspects of VBA’s training, such as VA’s annual budget and the task analysis of the VSR and RVSR job positions. According to one VBA official, the agency identifies regulatory, statutory, and administrative changes as well as any legal or judicial decisions that affect how VBA does business and issues guidance letters, or Fast Letters |
816 | , which can be sent out several times a year, to notify regional offices of these changes. Also, as a result of Congress authorizing an increase in its number of full-time employees and VBA’s succession planning efforts, VBA has increased the number of centralized training sessions for new staff and has also increased the number of Instructor Development Courses offered to potential centralized training instructors. As a result, VBA is taking steps to consider government reforms and initiatives to improve i |
817 | ts management and performance when planning its training. According to accepted practices, federal agencies should also evaluate their training programs and demonstrate how these efforts help employees, rather than just focusing on activities or processes (such as number of training participants or hours of training). VBA has made some efforts to evaluate its training for claims processors. During the 3-week centralized training session for new staff, VBA solicits daily feedback from participants using form |
818 | s that experts in the training field consider well- constructed and well-balanced. According to one GAO expert, the forms generally employ the correct principles to determine the effectiveness of the training and ascertain whether the instructor effectively presented the material (see fig. 4). VBA officials told us that they have used this feedback to improve centralized training for new staff. Management at one regional office cited the decision to separate training curricula for VSRs on Pre- determination |
819 | teams and VSRs on Post-determination teams as an example of a change based on this feedback. Although VBA evaluates centralized training, it does not require regional offices to obtain feedback from participants on any of the training they provide to new and experienced staff. In a previous GAO report, VA staff told us that new training materials they develop are evaluated before being implemented. However, none of the regional offices we visited consistently collect feedback on the training they conduct. |
820 | Supervisors from three of the regional offices we visited told us that they collect feedback on some of the training their office conducts, but this feedback largely concerns the performance of the instructor. Participants are generally not asked for feedback on course content. Moreover, regional offices we visited that do, to some degree, collect feedback do not share this information with VBA. According to GAO experts in the training field, VBA’s training curriculum for new staff appears well designed. VB |
821 | A’s curriculum for new staff conforms to adult learning principles, carefully defining all pertinent terms and concepts, and providing abundant and realistic examples of claims work. GAO experts also determined that VBA’s training for those who teach the curriculum for new staff was well designed and would enable experienced claims processors to become competent trainers because they are coached on teaching theory and have multiple opportunities to practice their teaching skills and receive feedback. Many o |
822 | f the new staff at all four sites we visited reported that centralized training provided them with a good foundation of knowledge and prepared them for additional training conducted by their regional office. Also, regional office managers from three offices we visited told us that centralized training affords new staff the opportunity to network with other new staff at different regional offices, which imbues a sense of how their positions fit in the organization. However, some staff reported that VBA’s imp |
823 | lementation of their centralized training was not always consistent. A number of staff at three regional offices reported that during their centralized training the instructors sometimes taught different ways of performing the same procedures or disagreed on claim procedures. Regional office officials told us that while centralized training instructors attempt to teach consistently through the use of standardized training materials, certain procedures can be done differently in different regional offices wh |
824 | ile adhering to VBA policy. For example, regional offices may differ on what to include in veteran notification letters. VBA officials also told us that centralized training conducted at the regional offices may not be as consistent as centralized training conducted at the Veterans Benefits Academy. According to these officials, unlike the regional offices, the Veterans Benefits Academy has on-site training experts to guide and ensure that instructors are teaching the curriculum consistently. New staff also |
825 | gave mixed assessments about how training was conducted at their home office after they returned from centralized training. While some staff at all of the regional offices we visited told us that the additional training better prepared them to perform their jobs, with on-the- job training identified as a useful learning tool, others told us that the training could not always be completed in a timely manner due to regional office priorities. Some management and staff at two of the regional offices we visite |
826 | d reported that, because of workload pressures, some of their RVSRs had to interrupt their training to perform VSR duties. Also, a few new staff indicated that VBA’s TPSS was somewhat difficult to use. Although TPSS was developed to provide consistent technical training designed to improve the accuracy of claims ratings, a number of staff at all of the regional offices we visited reported that TPSS was too theoretical. For example, some staff said it provided too much information and no practical exercises |
827 | in applying the knowledge. Some staff also noted that certain material in TPSS was out-of-date with policy changes such as how to order medical examinations. Some staff at three of the regional offices also reported that TPSS was not always useful in training staff, in part, because TPSS does not use real cases. Three of the regional offices reported using TPSS for less than 1 percent of their training and VSRs at one regional office were unaware of what TPSS was. At all of the regional offices we visited, |
828 | staff we spoke with generally noted that training enables them to keep up-to-date on changes in laws and regulations as well as provides opportunities for obtaining refresher training on claims procedures they perform infrequently. However, regional office staff we spoke with differed in their assessment of the 80- hour requirement. Some regional office staff said the number of training hours required was appropriate, while others suggested that VBA adopt a graduated approach, with the most experienced staf |
829 | f being required to complete fewer hours than new staff. VBA officials told us that, in 2007, the Compensation and Pension Service reviewed their annual training requirements and determined the 80-hour annual training requirement was appropriate. However, the officials we spoke with could not identify the criteria that were used to make these determinations. Furthermore, VBA management does not systematically collect feedback from staff evaluating the usefulness of the training they must receive to meet thi |
830 | s requirement. Consequently, when determining the appropriateness of the 80-hour requirement, VBA has not taken into account the views of staff to gauge the effect the requirement has on them. Experienced staff had mixed views on training provided by the regional office. Staff at three regional offices said the core technical training topics set by the Compensation and Pension Service are really designed for newer staff and do not change much from year to year, and therefore experienced staff end up repeati |
831 | ng courses. Also, a number of staff at all of the regional offices we visited told us some regional office training was not relevant for those with more experience. Conversely, other regional office staff note that although training topics may be the same from year to year, a person can learn something new each time the course is covered. Some VBA officials and regional office managers also noted that some repetition of courses is good for several reasons. Staff may not see a particular issue very often in |
832 | their day-to-day work and can benefit from refreshers. Also, regional office managers at one office told us that the core technical training topics could be modified to reflect changes in policy so that courses are less repetitive for experienced staff. Many experienced staff also reported having difficulty meeting the 80-hour annual training requirement due to workload pressures. Many of the experienced staff we spoke with, at each of the regional offices we visited, told us that there is a constant strugg |
833 | le between office production goals and training goals. For example, office production goals can affect the availability of the regional office’s instructors. A number of staff from one regional office noted that instructors were unable to spend time teaching because of their heavy workloads and because instructors’ training preparation hours do not count toward the 80-hour training requirement. Staff at another regional office told us that, due to workload pressures, staff may rush through training and may |
834 | not get as much out of it as they should. The elements used to evaluate individual VSRs’ and RVSRs’ performance appear to be generally aligned with VBA’s organizational performance measures, something prior GAO work has identified as a well-recognized practice for effective performance management systems (see app. I). Aligning individual and organizational performance measures helps staff see the connection between their daily work activities and their organization’s goals and the importance of their roles |
835 | and responsibilities in helping to achieve these goals. VSRs must be evaluated on four critical elements: quality, productivity, workload management, and customer service. RVSRs are evaluated on quality, productivity, and customer service. In addition, VBA central office requires regional offices to evaluate their staff on at least one non-critical element. The central office has provided a non-critical element called cooperation and organizational support, and although regional offices are not required to |
836 | use this particular element, all four offices we visited did so (see table 2). For each element, there are three defined levels of performance: exceptional, fully successful, or less than fully successful. Table 2 refers only to the fully successful level of performance for each element. Three critical elements in particular—quality, workload management, and productivity—are aligned with VBA’s organizational performance measures (see table 3). According to VA’s strategic plan, one key organizational perform |
837 | ance measure for VBA is overall accuracy in rating disability claims. This organizational measure is aligned with the quality element for VSRs and RVSRs, which is assessed by measuring the accuracy of their claims-processing work. An individual performance element designed to motivate staff to process claims accurately should, in turn, help VBA meet its overall accuracy goal. Two other key performance measures for VBA are the average number of days that open disability claims have been pending and the avera |
838 | ge number of days it takes to process disability claims. VSRs are evaluated on their workload management, a measure of whether they complete designated claims- related tasks within specific deadlines. Individual staff performance in this element is linked to the agency’s ability to manage its claims workload and process claims within goal time frames. Finally, a performance measure that VBA uses to evaluate the claims-processing divisions within its regional offices—and that, according to VBA, relates to th |
839 | e organization’s overall mission—is production, or the number of compensation and pension claims processed by each office in a given time period. Individual VSRs and RVSRs are evaluated on their productivity, i.e., the number of claims-related tasks they complete per day. Higher productivity by individual staff should result in more claims being processed by each regional office and by VBA overall. Providing objective performance information to individuals helps show progress in achieving organizational goa |
840 | ls and allows individuals to manage their performance during the year by identifying performance gaps and improvement opportunities. Regional offices are supposed to use the critical and non-critical performance elements to evaluate and provide feedback to their staff. Supervisors are required to provide at least one progress review to their VSRs and RVSRs each year, indicating how their performance on each element compares to the defined standards for fully successful performance. In the offices we visited |
841 | , supervisors typically provide some feedback to staff on a monthly basis. For example, VSRs in the Atlanta regional office receive a memo on their performance each month showing their production in terms of average weighted actions per day, their accuracy percentage based on a review of a sample of cases, and how their performance compared to the minimum requirements for production and accuracy. If staff members fall below the fully successful level in a critical element at any time during the year, a perf |
842 | ormance improvement plan must be implemented to help the staff member improve. Performance elements related to collaboration or teamwork can help reinforce behaviors and actions that support crosscutting goals and provide a consistent message to all employees about how they are expected to achieve results. VSR and RVSR performance related to customer service is evaluated partly based on whether any valid complaints have been received about a staff member’s interaction with their colleagues. And performance |
843 | related to the cooperation and organizational support element is based on whether staff members’ interaction with their colleagues is professional and constructive. Competencies, which define the skills and supporting behaviors that individuals are expected to exhibit to carry out their work effectively, can provide a fuller assessment of an individual’s performance. In addition to elements that are evaluated in purely quantitative terms, VBA uses a cooperation and organizational support element for VSRs an |
844 | d RVSRs that requires supervisors to assess whether their staff are exhibiting a number of behaviors related to performing well as a claims processor. Actively involving employees and stakeholders in developing the performance management system and providing ongoing training on the system helps increase their understanding and ownership of the organizational goals and objectives. For example, VA worked with the union representing claims processors to develop an agreement about its basic policies regarding p |
845 | erformance management. Also, VBA indicated that it planned to pilot revisions to how productivity is measured for VSRs in a few regional offices, partly so VSRs would have a chance to provide feedback on the changes. Clear differentiation between staff performance levels is also an accepted practice for effective performance management systems. Systems that do not result in meaningful distinctions between different levels of performance fail to give (1) employees the constructive feedback they need to impro |
846 | ve, and (2) managers the information they need to reward top performers and address performance issues. GAO has previously reported that, in order to provide meaningful distinctions in performance for experienced staff, agencies should use performance rating scales with at least three levels, and scales with four or five levels are preferable because they allow for even greater differentiation between performance levels. If staff members are concentrated in just one or two of multiple performance levels, ho |
847 | wever, the system may not be making meaningful distinctions in performance. VA’s performance appraisal system has the potential to clearly differentiate between staff performance levels. Each fiscal year, regional offices give their staff a rating on each critical and non-critical performance element using a three-point scale—exceptional, fully successful, or less than fully successful. Based on a VA-wide formula, the combination of ratings across these elements is converted into one of VA’s five overall pe |
848 | rformance levels: outstanding, excellent, fully successful, minimally satisfactory, and unsatisfactory (see fig. 5). Regional offices may award financial bonuses to staff on the basis of their end-of-year performance category. Prior to fiscal year 2006, VA used two performance levels—successful and unacceptable—to characterize each staff member’s overall performance. To better differentiate between the overall performance levels of staff, VA abandoned this pass-fail system in that year, choosing instead to |
849 | use a five-level scale. However, there is evidence to suggest that the performance management system for VSRs and RVSRs may not clearly or accurately differentiate among staff’s performance. VBA central office officials and managers in two of the four regional offices we visited raised concerns with VA’s formula for translating ratings on individual performance elements into an overall performance rating. These officials said that under this formula it is more difficult for staff to be placed in certain ove |
850 | rall performance categories than others, even if staff’s performance truly does fall within one of those categories. Indeed, at least 90 percent of all claims processors in the regional offices we visited were placed in either the outstanding or the fully successful category in fiscal year 2007. (Fig. 6 shows the distribution of overall performance ratings for claims processors in each office.) Central and regional office managers noted that, in particular, it is difficult for staff to receive an overall ra |
851 | ting of excellent. Managers in one office said there are staff whose performance is better than fully successful but not quite outstanding, but under the formula it is difficult for these staff to be placed in the excellent category as the managers feel they should be. An excellent rating requires exceptional ratings in all the critical elements and a fully successful rating in at least one non-critical element. However, according to staff we interviewed, virtually all staff who are exceptional in the criti |
852 | cal elements are also exceptional in all non-critical element(s), so they appropriately end up in the outstanding category. On the other hand, the overall rating for staff who receive a fully successful rating on just one of the critical elements—even if they are rated exceptional in all the other elements—drops down to fully successful. Managers in one regional office commented that the system would produce more accurate overall performance ratings if staff were given an overall rating of excellent when th |
853 | ey had, for example, exceptional ratings on three of five overall elements and fully successful ratings on the other two. An official in VA’s Office of Human Resources Management acknowledged that there may be an issue with the agency’s formula. Although neither VBA nor VA central office officials have examined the distribution of VSRs and RVSRs across the five overall performance ratings, VA indicated it is considering changes to the system designed to allow for greater differentiation in performance ratin |
854 | gs. For example, one possible change would be to use a five-point scale for rating individual elements—probably mirroring the five overall performance rating categories of outstanding, excellent, fully successful, minimally satisfactory, and unsatisfactory— rather than the current three-point scale. Under the proposed change, a staff member who was generally performing at the excellent but not outstanding level could get excellent ratings in all the elements and receive an overall rating of excellent. This |
855 | change must still be negotiated with several stakeholder groups, according to the VA official we interviewed. In many ways, VBA has developed a training program for its new staff that is consistent with accepted training practices in the federal government. However, because VBA does not centrally evaluate or collect feedback on training provided by its regional offices, it lacks the information needed to determine if training provided at regional offices is useful and what improvements, if any, may be neede |
856 | d. Ultimately, this information would help VBA determine if 80 hours of training annually is the right amount, particularly for its experienced staff, and whether experienced staff members are receiving training that is relevant for their positions. Identifying the right amount of training is crucial for the agency as it tries to address its claims backlog. An overly burdensome training requirement needlessly may take staff away from claims processing, while too little training could contribute to processin |
857 | g inaccuracies. Also, without collecting feedback on regional office training, VBA may not be aware of issues with the implementation of its TPSS, the on-line training tool designed to ensure consistency across offices in technical training. Setting aside the issue of how many hours of training should be required, VBA does not hold its staff accountable for fulfilling their training requirement. As a result, VBA is missing an opportunity to clearly convey to staff the importance of managing their time to me |
858 | et training requirements as well as production and accuracy goals. With the implementation of its new learning management system, VBA should soon have the ability to track training completed by individual staff members, making it possible to hold them accountable for meeting the training requirement. As with its training program for VSRs and RVSRs, the VA is not examining the performance management system for claims processors as closely as it should. VBA is generally using the right elements to evaluate it |
859 | s claims processors’ performance, and the performance appraisals have the potential to give managers information they can use to recognize and reward higher levels of performance. However, evidence suggests the formula used to place VSRs and RVSRs into overall performance categories may not clearly and accurately differentiate among staff’s performance levels. Absent additional examination of the distribution of claims processors among overall performance categories, VA lacks a clear picture of whether its |
860 | system is working as intended and whether any adjustments are needed. The Secretary of Veterans Affairs should direct VBA to: Collect and review feedback from staff on the training conducted at the if the 80-hour annual training requirement is appropriate for all VSRs and RVSRs; the extent to which regional offices provide training that is relevant to VSRs’ and RVSRs’ work, given varying levels of staff experience; and whether regional offices find the TPSS a useful learning tool and, if not, what adjustmen |
861 | ts are needed to make it more useful; and Use information from its new learning management system to hold individual VSRs and RVSRs accountable for completing whatever annual training requirement it determines is appropriate. The Secretary of Veterans Affairs should also examine the distribution of claims processing staff across overall performance categories to determine if its performance appraisal system clearly differentiates between overall performance levels, and if necessary adjust its system to ensu |
862 | re that it makes clear distinctions. We provided a draft of this report to the Secretary of Veterans Affairs for review and comment. In VA’s written comments (see app. IV), the agency agreed with our conclusions and concurred with our recommendations. For example, VBA plans to consult with regional office staff to evaluate its annual 80-hour training requirement and will examine if staff performance ratings clearly differentiate between overall performance levels. VA also provided technical comments that we |
863 | re incorporated as appropriate. We are sending copies of this report to the Secretary of Veterans Affairs, relevant congressional committees, and others who are interested. We will also provide copies to others on request. The report is also available at no charge on GAO’s Web site at http://www.gao.gov. Please contact me on (202) 512-7215 if you or your staff have any questions about this report. Contact points for the Offices of Congressional Relations and Public Affairs may be found on the last page of t |
864 | his report. Key contributors are listed in appendix V. We were asked to determine: (1) What training is provided to new and experienced claims processors and how uniform is this training? (2) To what extent has the Veterans Benefits Administration (VBA) developed a strategic approach to planning training for claims processors and how well is their training designed, implemented, and evaluated? And (3) To what extent is the performance management system for claims processors consistent with generally accepte |
865 | d performance management practices in the public sector? To answer these questions, we reviewed documents and data from the central office of the Department of Veterans Affairs’ Veterans Benefits Administration (VBA) and interviewed VBA central office officials. We conducted site visits to and collected data from four VBA regional offices, and visited the Veterans Benefits Academy. We also interviewed officials from the American Federation of Government Employees, the labor union that represents Veterans Se |
866 | rvice Representatives (VSR) and Rating Veterans Service Representatives (RVSR). We compared VBA’s training and performance management systems to accepted human capital principles and criteria compiled by GAO. We conducted this performance audit from September 2007 through May 2008 in accordance with generally accepted government auditing standards. Those standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to provide a reasonable basis for our findings and conclusi |
867 | ons based on our audit objectives. We believe that the evidence obtained provides a reasonable basis for our findings and conclusions based on our audit objectives. We conducted site visits to 4 of VBA’s 57 regional offices—Atlanta; Baltimore; Milwaukee; and Portland, Oregon. We judgmentally selected these offices to achieve some diversity in geographic location, number of staff, and claims processing accuracy rates, and what we report about these sites may not necessarily be representative of any other reg |
868 | ional offices or all regional offices (see fig. 7). During our site visits, we interviewed regional office managers, supervisors of VSRs and RVSRs, VSRs, and RVSRs about the training and performance management practices in their offices. The VSRs and RVSRs we interviewed at the four regional offices had varying levels of experience at VBA. Regional office managers selected the staff we interviewed. We also observed a demonstration of VBA’s on-line learning tool, the Training and Performance Support System ( |
869 | TPSS), and collected data from the regional offices on, for example, the training they provided during fiscal year 2007. In conjunction with our visit to the Baltimore regional office, we also visited VBA’s Veterans Benefits Academy, where we observed classes for VSRs and RVSRs and interviewed the director of the Academy. To determine whether VBA’s training program is consistent with accepted training practices in the public sector, we relied partly on a guide developed by GAO that lays out principles that |
870 | federal agencies should follow to ensure their training is effective. This guide was developed in collaboration with government officials and experts in the private sector, academia, and nonprofit organizations; and in conjunction with a review of laws, regulations and literature on training and development issues, including previous GAO reports. The guide lays out the four broad components of the training and development process (see fig. 8). The guide also provides key questions for federal agencies to co |
871 | nsider in assessing their performance in each component. (See table 4 for a sample of these questions.) In addition, GAO training experts reviewed VBA materials, including training curricula, lesson plans, and course evaluation forms, to determine if these materials are consistent with accepted training practices. In assessing the performance management system for VSRs and RVSRs, we relied primarily on a set of accepted practices of effective public sector performance management systems that has been compil |
872 | ed by GAO. To identify these accepted practices, GAO reviewed its prior reports on performance management that drew on the experiences of public sector organizations both in the United States and abroad. For the purpose of this review, we focused on the six accepted practices most relevant for VBA’s claims-processing workforce (see table 5). Additional Issue Specific Lesson Plans are under development. (Lesson plans can be taken from the Centralized Training Curriculum found on the C&P Intranet Training Sit |
873 | e. If used as provided they do not require C&P review and approval. These plans can and often should be modified to focus in on a particular narrow issue of training need. Modified lesson plans are to be submitted to C&P Service for review and approval at least 30 days prior to delivery of training. Any Challenge-oriented original lesson plan developed by Station personnel is to be submitted to C&P Service for review and approval at least 30 days prior to delivery of training.) C&P Service Broadcasts that m |
874 | ay be provided during the course of the FY may be substituted in place of any training scheduled on an hour by hour basis. 60 Hours of the required 80 Hours will be selected from the suggested topics above. The remaining 20 hours will be selected at the Stations discretion based upon their own individual quality review. (Training provided from the above topics can be focused on a particular aspect of the topic; i.e. Cold Injuries and Rating Hypertension from Cardiovascular issues could be separate classes) |
875 | Participation in Agency Advancement Programs (i.e., LEAD, LVA) does not substitute for Required training requirements. Additional Issue Specific Lesson Plans are under development. (Lesson plans can be taken from the Centralized Training Curriculum found on the C&P Intranet Training Site. If used as provided they do not require C&P review and approval. These plans can and often should be modified to focus in on a particular narrow issue of training need. Modified lesson plans are to be submitted to C&P Serv |
876 | ice for review and approval at least 30 days prior to delivery of training. Any Challenge-oriented original lesson plan developed by Station personnel is to be submitted to C&P Service for review and approval at least 30 days prior to delivery of training.) C&P Service Broadcasts that may be provided during the course of the FY may be substituted in place of any training scheduled on an hour by hour basis. Drill Pay Waivers Pension Awards Processing & BDN Hospital Reductions Burial Benefits Death Pension Ac |
877 | crued Benefits Accrued Awards & the BDN Apportionments Special Monthly Pension Helpless Child Incompetency/Fiduciary Arrangements Claims Processing Auto Allowance and Adaptive Equipment Special Adapted Housing Special Home Adaptation Grants Incarcerated Veterans Processing Write Outs FOIA/Privacy Act Telephone & Interview Techniques Telephone Development IRIS Introduction to VACOLS Education Benefits Insurance Benefits National Cemetery VR&E Benefits Loan Guaranty Benefits General Benefits – FAQs Suicidal C |
878 | aller Guidance Non-Receipt of BDN Payments Mail Handling Income & Net Worth Determinations Bootcamp test and review of VSR Readiness Guide (2 HRS Required) Reference Material Training and Navigation (1 HR Required) Appeals and Ancillary Benefits Ready to Rate Development Customer Service FNOD Info and PMC Process Intro to Appeals Process DRO Selection Letter Income Adjustment Materials Income Adjustments 60 Hours of the required 80 Hours will be selected from the suggested topics above. The remaining 20 hou |
879 | rs will be selected at the Stations discretion based upon their own individual quality review. Overview of VA Mission Reference Materials: Manual Training & WARMS C&P Website Claims Folder Maintenance Records Management POA/Service Organizations Compensation Original Compensation Claims Non-Original Compensation Claims VA Form 21-526, App. For Compensation or Pension Establishing Veteran Status Claims Recognition Duty to Assist Selecting the Correct Worksheet for VA Exams Issue Specific Claim Development As |
880 | bestos Claim Development Herbicide Claim Development POW Claim Development Radiation Claim Development PTSD Claim Development Undiagnosed Illness Claim Development Dependency Contested Claims Deemed Valid and Common-law Marriage Continuous Cohabitation Pension Intro. To Disability Pension Overview of SHARE (SSA) Administrative Decision Process Character of Discharge Line of Duty – Willful Misconduct Claims Development Workload Management Utilizing WIPP DEA Training (req. added 4/06) Intro to Ratings Paragra |
881 | ph 29 & 30 Ratings Ratings & the BDN BDN 301 Interface Video PCGL Award Letters PCGL Dependents & the BDN Compensation Offsets Drill Pay Waivers Star Reporter Pension Awards Processing & the BDN Hospital Reductions Burial Benefits Disallowance Processing DIC Benefits Death Pension Accrued Benefits Accrued Awards & the BDN Apportionment Special Monthly Pension Helpless Child Incompetency/Fiduciary Arrangements Claims Processing Automobile Allowance and Adaptive Equipment Specially Adapted Housing and Special |
882 | Home Adaptation Grants Incarceration Processing Computer Write Outs DEA Training (req. added 4/06) Public Contact Team Training: FOIA/Privacy Act Communication Skills Telephone Development Inquiry Routing and Information System (IRIS) Intro to VACOLS Other VBA Business Lines Customer Service Insurance Education (2 hrs) Intro to Appeals Process VACOLS http://cptraining.vba.va.gov/ C&P_Training/vsr/VSR_ Curriculum.htm#att http://cptraining.vba.va.gov/ C&P_Training/vsr/VSR_ Curriculum.htm#iam. Each training p |
883 | lan we reviewed contained the same informational categories, some of which were what courses were offered by the regional office, whether or not the course was conducted, and how many employees completed the training. Although the fiscal year 2007 training plans we reviewed include data on whether and when the course was actually completed, the initial training plans submitted at the beginning of the fiscal year of course do not have this information. The lists provided below include the first 25 courses li |
884 | sted on each plan alphabetically, a small sample of the courses that the regional offices reported they completed for the fiscal year. Daniel Bertoni (202) 512-7215 [email protected]. In addition to the contact named above, Clarita Mrena, Assistant Director; Lorin Obler, Analyst-in-Charge; Carolyn S. Blocker; and David Forgosh made major contributions to this report; Margaret Braley, Peter Del Toro, Chris Dionis, Janice Latimer, and Carol Willett provided guidance; Walter Vance assisted with study design; Ch |
885 | arles Willson helped draft the report; and Roger Thomas provided legal advice. Veterans’ Benefits: Improved Management Would Enhance VA’s Pension Program. GAO-08-112. Washington, D.C.: February 14, 2008. Veterans’ Disability Benefits: Claims Processing Challenges Persist, while VA Continues to Take Steps to Address Them. GAO-08-473T. Washington, D.C.: February 14, 2008. Disabled Veterans’ Employment: Additional Planning, Monitoring, and Data Collection Efforts Would Improve Assistance. GAO-07-1020. Washingt |
886 | on, D.C.: September 12, 2007. Veterans’ Benefits: Improvements Needed in the Reporting and Use of Data on the Accuracy of Disability Claims Decisions. GAO-03-1045. Washington, D.C.: September 30, 2003. Human Capital: A Guide for Assessing Strategic Training and Development Efforts in the Federal Government. GAO-03-893G. Washington, D.C.: July 2003. Results-Oriented Cultures: Creating a Clear Linkage between Individual Performance and Organizational Success. GAO-03-488. Washington D.C.: March 14, 2003. Major |
887 | Management Challenges and Program Risks: Department of Veterans Affairs. GAO-03-110. Washington, D.C.: January 1, 2003. Veterans’ Benefits: Claims Processing Timeliness Performance Measures Could Be Improved. GAO-03-282. Washington, D.C.: December 19, 2002. Veterans’ Benefits: Quality Assurance for Disability Claims and Appeals Processing Can Be Further Improved. GAO-02-806. Washington, D.C.: August 16, 2002. Veterans’ Benefits: Training for Claims Processors Needs Evaluation. GAO-01-601. Washington, D.C.: |
888 | May 31, 2001. Veterans Benefits Claims: Further Improvements Needed in Claims- Processing Accuracy. GAO/HEHS-99-35. Washington, D.C.: March 1, 1999. |
889 | Under TRICARE, beneficiaries may obtain health care through either the direct care system of military treatment facilities or the purchased care system of civilian providers and hospitals, including SCHs. SCHs were exempted from TRICARE’s reimbursement rules for hospitals until revised rules were implemented in January 2014. SCHs serve communities that rely on them for inpatient care, and they include hospitals and regional medical centers ranging in size from 9 to 598 beds. The intent of the SCH designatio |
890 | n is to maintain access to needed health services for Medicare beneficiaries by providing financial assistance to hospitals that are geographically isolated. A hospital may generally qualify for SCH status by showing that because of factors such as isolated location, weather conditions, travel conditions, or absence of other like hospitals, it is the sole source of inpatient hospital services reasonably available in a geographic area. In 2014, 459 hospitals were designated as SCHs under the Medicare program |
891 | . A hospital that qualifies as an SCH under the Centers for Medicare & Medicaid Services’s (CMS) Medicare regulations is also considered an SCH under TRICARE. Specifically, a hospital paid under the Medicare Acute Care Hospital IPPS is eligible for classification as an SCH if it meets one of the following criteria established by CMS: The hospital is at least 35 miles from other like hospitals; The hospital is rural, between 25 and 35 miles from other like hospitals, and meets one of the following criteria: |
892 | No more than 25 percent of hospital inpatients or no more than 25 percent of the Medicare inpatients in the hospital’s service area are admitted to other like hospitals within a 35-mile radius of the hospital or, if larger, within its service area; The hospital has fewer than 50 beds and would meet the 25 percent criterion except that some beneficiaries or residents were forced to seek specialized care outside of the service area due to the unavailability of necessary specialty services at the hospital; or |
893 | Because of local topography or periods of prolonged severe weather conditions, the other like hospitals are inaccessible for at least 30 days in each 2 out of 3 years. The hospital is rural and located between 15 and 25 miles from other like hospitals, but because of local topography or periods of prolonged severe weather conditions, the other like hospitals are inaccessible for at least 30 days in each of 2 out of 3 years; or The hospital is rural and because of distance, posted speed limits, and predictab |
894 | le weather conditions, the travel time between the hospital and the nearest like hospital is at least 45 minutes. Under the TRICARE program, beneficiaries can obtain care either from providers at military treatment facilities or from civilian providers. DHA contracts with three regional managed care support contractors to develop networks of civilian providers in their respective regions, including SCHs, to serve TRICARE beneficiaries in geographic areas called Prime Service Areas. Prime Service Areas are g |
895 | eographically defined by a set of 5-digit zip codes, usually within an approximate 40-mile radius of a military treatment facility. These civilian provider networks are required to meet specific access standards for certain types of TRICARE beneficiaries, such as travel times or wait times for appointments. However, these access standards do not apply to inpatient care. Since 1987, DHA has reimbursed hospitals for claims using the agency’s DRG-based payment system, which was modeled after Medicare’s system. |
896 | Under this system, claims are priced using an annual standard amount and a weighted value for each DRG. For example, in fiscal year 2014, the TRICARE annual standard amount was approximately $5,500.00. Payment weights are assigned to each DRG based on the average resources used to treat patients. For example, in fiscal year 2014, a lung transplant had a weight of 8.6099, which would be multiplied by the annual standard payment amount ($5,500.00) for a reimbursement of $47,354.45. TRICARE’s DRG-based paymen |
897 | t system differs from Medicare’s DRG-based payment system in that each program has different annual standard amounts and different DRG weights due to differences in the characteristics of their beneficiary populations. For example, Medicare’s population, which is generally older and less healthy than TRICARE’s population, may require more resources and may require longer inpatient lengths of stay. Also, some services, notably obstetric and pediatric services, are nearly absent from Medicare, but are a much |
898 | larger component of TRICARE’s services. SCHs were exempted from DHA’s DRG-based payment system because they had special payment provisions under Medicare that allowed for payments based on historical costs as well as certain types of adjustments, such as additional payments for significant volume decreases defined as a more than 5 percent decrease in total inpatient discharges as compared to the immediately preceding cost reporting period. Instead, DHA generally reimbursed SCHs based on their billed charges |
899 | for inpatient care provided to TRICARE beneficiaries. However, distinctions were made among providers based on network status. Specifically, nonnetwork SCHs were reimbursed for their billed charges, and network hospitals were reimbursed based on their billed charges less any discounts that they negotiated with the managed care support contractors. Under its revised reimbursement rules for SCHs, DHA’s methodology for TRICARE approximates the rules for Medicare for these hospitals. Specifically, both program |
Subsets and Splits