|FY 1993 (Actual)||FY 1996 (Budgeted)|
|$36.019 billion||234,428||$38.608 billion||223,727|
VA reinvention labs set the pace for NPR innovation early on. The New York VA Benefits Office launched a major effort to focus on customers. Employees surveyed customers and benchmarked against commercial businesses to redesign benefits processing and delivery procedures. When Vice President Gore presented his very first Hammer Award to the New York VA office, he said, "Veterans are happier... The employees are also happier." As Gale Noble, a VA case technician, put it, "The satisfaction is in greeting the veteran, actually seeing first-hand these men and women who served this country so that we all would be here... Now, I actually can talk to them, make them laugh, give them a friendly smile, and they leave very happy." Since then, VA facility and program office reinvention teams have been honored with 46 of the Vice President's Hammer Awards for leading the way in creating a government that works better (for veterans) and costs less.
Creating a Customer Focus. VA published department-wide customer service standards in September 1994 to put both veterans and VA employees on notice that nothing is more important to our success than veterans' satisfaction. These were quickly followed by specific standards of service for each VA operational branch and service facility. VA customers were told the maximum amount of time they should expect to wait for service at each facility; the steps VA employees would take to ensure their understanding and satisfaction with VA response to their needs; and the avenues open to them for comment, complaint, and follow-up.
Reinventing VA's Health Care. The Veterans Health Administration's (VHA's) 22 new Veterans Integrated Service Networks (VISNs) have streamlined middle management and positioned VA to focus its resources on maintaining veterans' health rather than maintaining veterans' hospitals. The VISN concept is a result of benchmarking against private-sector hospitals, health care systems, and health maintenance organizations. VISN will take a far more active role than former regional offices in assessing VA field resources against customer needs and distributing resources accordingly. As in the private sector, VA health care resource allocation decisions soon will be totally driven by customer demand rather than facility maintenance budgets, as VISNs adopt capitated budgets by 1998.
VA medical facilities, in line with private sector health care providers, are shifting emphasis from hospital-based to outpatient care and to more customer-focused primary health care teams. The veteran receives all basic health care from a team of doctors, nurses, and other health-care providers who work with the veteran on a continuing basis to maintain his/her health. All VA facilities will use primary care teams by the end of 1996.
The need for costly inpatient hospital beds is decreasing as VHA expands outpatient care to reduce costs of medical care delivery while increasing access to that care. Customer access has been aided through administrative innovation as well. The basic medical care application form is being reduced from 93 to fewer than 20 questions, and VA has eliminated 887 other redundant forms to improve timely access to care for veteran patients. A Veterans Universal Access Identification Card is currently being piloted at six VA medical centers. Among this state-of-the-art "smart" card's features are a bar code and a magnetic strip containing basic patient data such as name, Social Security number, date of birth, veteran status, and service-connected indicator, as well as a photo of the veteran. Use of the card will eliminate a significant amount of paperwork and reduce waiting times for veterans. Access is also being increased through more VA sharing agreements with Department of Defense (DOD) and community health care providers.
Patient Maurice E. Lewis was inspired to send a letter to the editor of the Arkansas Democrat-Gazette in which he wrote, "The positive changes in VA services are too numerous to mention and the attitude and morale of VA employees have improved drastically. I know this to be true because I have used the VA medical system for the past seven years. I have never been treated better by any medical system, hospital, or doctor."
Reinventing Veterans Benefits. The Veterans Benefits Administration (VBA) began its reinvention effort by conducting employee-customer focus groups and customer satisfaction surveys to evaluate core services and provide data to monitor and refine VBA customer service standards. Loan Guaranty Service used similar tools to evaluate service to both veterans and business clients in the banking industry. Early results were used to improve communication with lenders, reduce the need for them to contact field facilities, and cut the time needed to close VA home loans.
VBA outreach services complemented customer service initiatives. Toll-free telephone service (a dozen toll-free services provide information and referral for specific groups, including women veterans and Persian Gulf War veterans) and new electronic bulletin boards and World Wide Web home pages supported VA outreach to a variety of special needs customer groups.
The VA Insurance Center designed a new simplified statement for its policyholders after eva-luating private sector formats and listening to customer feedback. The statement gives a complete status of an individual veteran's policy and reduces the amount of time the veteran spends calling VA for more information -- as well as the staff time needed to respond.
Each of VBA's four regional headquarters consolidated widespread human resources management services into single offices serving each region. Reduced overhead allowed more resources for customer service and benefits delivery while improving the region's employee-supervisor ratio to more than 15-to-1.
Similar benefits are on tap as VBA consolidates specific operational functions into processing centers. This has already been done with Montgomery GI Bill Educational Benefits and Persian Gulf War compensation claims and will continue as new automated data processing networks allow immediate electronic access to records, certifying agencies, and veterans. A recent example is an electronic data interface established with the Social Security Administration (SSA) which greatly improves the timeliness of compensation and pension benefits claims processing requiring SSA data. VBA regional offices can now communicate with SSA on veterans' Social Security numbers and verification of security assistance payments within 24 hours. Such transactions used to take up to 10 weeks by mail. Similar VBA-DOD collaboration streamlined the processing of DOD's death gratuity benefit to survivors. Consolidated processing in the Cleveland VA Regional Benefits Office, collocated with the DOD Defense Finance and Accounting Service, cut award payment time from six months to a few weeks. VA and DOD also are working together on a pilot project to link military discharge physicals with the processing of VA disability compensation claims.
The Muskogee VA Regional Office focused on the implementation of self-directed employee work teams not only to do the work better, but in entirely new ways focused on customer need rather than institutional process. The work team concept has vastly improved performance and customer service: Claims processing time has dropped an average of 50 percent; supervisor-staff ratios have improved and saved $1.4 million a year in salaries; widows' pension claims presented in person are processed within one hour. Muskogee received both a Hammer Award and, this year, a Presidential Award for Quality Achievement for its pioneering work in employee-directed work team implementation.
Cutting Red Tape. VA has moved to reduce red tape, redundancies, and bureaucracy that interfere with the private sector's awareness of and ability to compete for VA contracts. VA's Financial Operations Team received a Hammer Award for designing and implementing a 1994 electronic commerce agreement with the Department of the Treasury calling for enhancement of every major VA benefit, administrative, and vendor payment system. All initiatives were successfully implemented, including the first check intercept system allowing the Federal Reserve to withhold checks to deceased payees, a national direct deposit enrollment program, and electronic linkages for transmission of all payment data between the two departments.
VA continues to expand electronic commerce, from increasing employee and beneficiary use of direct deposit of paychecks to 92-percent participation to developing software that enables small business personal computers to deal with VA on contract information and procurement matters. VA's Vendor Inquiry System allows more than 300,000 VA vendors to access their VA payment data electronically, saving thousands of phone inquiries and associated staff time.
VA developed new distributor agreements under its Medical/Surgical Prime Vendor program, which established 25 regional clusters for contract awards covering 173 VA medical centers. This improved procurement access to contractors around the country -- particularly to small disadvantaged business owners who were guaranteed access to VA contracts under the program.
Listening to Our People. In May 1995, I joined Vice President Gore in announcing far-reaching VA reinvention initiatives that will continue to improve service to our veterans and make VA more efficient. Virtually all of those initiatives have been or are being implemented, and there is more to come as VA employees and their customers listen more intently to each other and work together.
"It's significant," said Vice President Gore at that announcement, "that the very first reinventing government award given any team in federal government was given right here in Veterans Affairs [to the New York Benefits Office]. . . In our effort to reinvent government, we've found one secret that's more important than any other: you've got to listen to the people who actually do the work; in this case, the people who deal first hand with America's veterans. Ask them what's going on; what needs to be changed; what needs to be improved. And they will tell you!"