The departments’ bureaucracies have resisted efforts to integrate records.
The bureaucracies in the Defense and Veterans Affairs departments hobble joint efforts to care for veterans, Secretary of Defense Leon Panetta told lawmakers at a House hearing Wednesday.
Panetta, testifying at a joint hearing of the House Armed Services and Veterans Affairs committees along with VA Secretary Eric Shinseki, said the cultures in the government’s two largest departments “resist change. They resist coordination. They resist trying to work together.”
Later in the hearing -- the first time both secretaries have appeared at such a joint session -- Panetta said he was frustrated by the lack of cooperation on key projects such as the integrated disability and health records systems and said, “we’ve just got to kick ass and try to make it happen . . . and that’s what we’re going to do.”
Shinseki said the departments have developed separate programs to care for wounded soldiers and to manage their transition from Defense to VA and those programs “don’t quite harmonize.”
At the top, Shinseki said he and Panetta have a close working relationship to spearhead development of what he considered the departments’ key joint project, the integrated electronic health record, and they have regular quarterly meetings and a strong commitment to make it happen.
Rep. Bill Johnson, R-Ohio, a VA Committee member, told Panetta and Shinseki, “I’m not sure that all members of your organizations share that commitment and will follow through.”
President Obama jump started the joint records project in 2009 but Defense and VA do not plan to fully deploy the iEHR until 2017. Johnson said “another five years is unacceptable to me . . . fix it.” Armed Services Committee Chairman Rep. Howard “Buck” Mckeon, R-Calif., said Congress first mandated a joint health record over a decade ago.
The two departments launched an Integrated Disability Evaluation System in 2007 to speed the process to determine whether wounded troops remain on active duty or, if they are discharged, their level of benefits. Panetta told lawmakers that the system remains hobbled by “unneeded bureaucratic delays” but is still speedier than when troops had to navigate through separate Defense and VA systems.
In his written testimony, Panetta said “our departments have decreased the time it takes after military discharge until receipt of VA disability compensation by over 70 percent, from 240 to the current 63 days. The overall time it takes to receive disability compensation has been reduced from 540 days under the separate DoD and VA legacy systems to the current 396 days.” Shinseki said the two departments plan to reduce processing under IDES to 295 days, but did not provide a date when that goal will be met.
Shinseki echoed complaints made by Allison Hickey, undersecretary for benefits at VA, at a hearing of the House Oversight and Government Reform Committee on July 18. Hickey said processing time lengthened due to the fact Defense sends VA paper and not electronic files.
Rep. Joe Heck, R-Nev., an Armed Services Committee member who also serves as a physician in the Army Reserve, said that he viewed IDES as still “too complicated and convoluted.” Rep. Jon Runyan, R-N.J., a VA Committee member, told Panetta and Shinseki that a medical evaluation summary in IDES, which is used to determine disability benefits, “lacks a clear diagnosis.” If wounded service members want to challenge that diagnosis, they must do so within seven days, a time Runyan viewed as too short.
Panetta told the hearing he has serious concerns that the systems operated by the two departments could become “overwhelmed” as the drawdown in Afghanistan continues and more troops return to civilian life, an increase he pegged at 100,000 a year. If Defense is hit with automatic budget cuts next year due to the sequestration process, that would mean the discharge of an additional 100,000 troops in 2013, Panetta said.