Yountville VA Home

SACRAMENTO – The U.S. Veterans Administration has been a font of scandal in recent years, with various reports showcasing the way the agency charged with caring for our nation’s veterans has fallen down on the job. A new report from California’s official watchdog agency, the Little Hoover Commission, shows that the California Department of Veterans Affairs, known as CalVet, fails to provide adequate help, as well. The heart of the report is not about scandal – but about a set of priorities that hasn’t changed much in a century.

In particular, the report spotlights California’s $306 million program to provide housing to those veterans and their spouses who cannot take care of themselves. The commission took a 16-month look at the state’s eight homes and concluded that “fewer than 1 percent of the state’s 1.7 million veterans benefit from the 2,610-bed program … .” It points to a variety of measures that could stretch that funding to help a larger pool of needy veterans.

As the report points out, the current budget amounts to a “staggering” per-bed cost of $117,241, with the state footing the bill for $71,000 per bed each year when Medicaid and Medicare revenues are figured in. Although most of the people who are in the state-home system are veterans of World War II and the Korean War, an increasing number are Vietnam War veterans, and they tend to have more complex “physical and mental health needs.” The homes also are serving a larger percentage of veterans from more recent conflicts such as Iraq and Afghanistan.

The report finds that residents typically are admitted on a first-come, first-served basis rather than being admitted based on their financial hardships and health needs, although there are some priorities for homeless veterans and Medal-of-Honor recipients.

Basically, California runs an aging bricks-and-mortar system at odds with current trends in long-term care, which focus more on community settings rather than large institutions, according to the commission. Those newer local-oriented models “generally cost less than institutional care, and also allow families to avoid potential hardships stemming from separation that is unavoidable in institutional-care settings.”

This “opportunity cost” issue is key. If the state is spending the bulk of its funding on large veterans’ homes that serve a small number of people, it’s unable to spend those dollars on other services targeting a more broad-based clientele. “California’s veterans home beds come at a cost, both in terms of the high price tag of health care, as well as the opportunity cost of not investing elsewhere,” according to the report. A New Approach to California’s Veterans Homes offers a wide-ranging reform plan.

The first recommendation would require legislative action. The commission calls for legislators to amend the Military and Veterans Code to ensure veterans’ homes are able to provide first access to the neediest veterans. It calls for developing an admission system that ranks disabilities, financial status and other admission factors. It also calls for the Legislature to amend the code to end “domiciliary care” – i.e., supervised living arrangements – and focus instead on providing “high-level medical care, such as skilled nursing care.”

Veterans homes built with federal funding must operate for 20 years, but the commission calls for CalVet to evaluate these facilities as that 20-year mark approaches and consider whether to keep them in operation. The state can immediately stop building new homes, however, as it moves toward a different service model. As the agency “repurposes” these buildings, the commission argues savings should be redirected toward home and community-based services.

The report’s main recommendations share the theme of moving away from the existing institutional model and moving toward community care. It also calls for more transparency in CalVet’s budgetary reports, and calls for amending current regulations “to specify consequences for residents who do not maintain adequate insurance coverage or otherwise pay their share of the costs.”

The goal is to serve a larger number of needy veterans, as summed up by Little Hoover Commission Chairman Pedro Nava’s statement: “We must start questioning assumptions and past decisions about what kind of care veterans want and need and how it is best delivered.” That fits with the commission’s charge of helping the state take a fresh look at how its bureaucracies are operating.

CalVet is trumpeting a new rating from the Centers for Medicaid and Medicare Services giving its Chula Vista and Yountville veterans’ homes a four-star rating, “placing them among the highest performing facilities throughout the state.” That’s good news, but the Little Hoover Commission’s latest effort is focused less on the quality of care provided at any of the state’s facilities, and more on the way to stretch the department’s resources to help other veterans.

The commission also wants the veterans’ homes to become more self-sufficient and less dependent on the general fund. In some cases, the report argues, veterans’ homes could operate without any general-fund support whatsoever. The commission last reviewed the veterans’ homes in 2013.

Assemblywoman Jacqui Irwin, D-Thousand Oaks, who chairs the Assembly Veterans Committee, requested the latest review in 2015. She’s pointed to progress over the past few years, but noted a number of ongoing personnel and budgetary problems. She argued that CalVet’s Veterans Services Division, which helps connect veterans with available benefits, only receives 25 percent of the department’s budget “due to the expense of the homes.” The homes are important, she wrote, but only serve a tiny portion of California’s 1.7 million veterans.

In recent years, the Legislature has been more focused on creating new funding sources for the veterans’ homes than rethinking the entire veterans’-home model. This year, Irwin has introduced a bill that would implement the “needs assessment” recommendation in the commission’s report. And bills from other Assembly members would implement other recommendations, including measures promoting fiscal transparency. So perhaps the Little Hoover Commission’s latest report finally will spark a more wide-ranging discussion.

Steven Greenhut is Western region director for the R Street Institute. Write to him at sgreenhut@rstreet.org.

Federal legislation

At the center of the proposals is the Department of Veterans Affairs’ Los Angeles campus, located on the west side of town near the 405 freeway. As the Los Angeles Times reported, a January legal settlement paved the way for the campus to pivot toward housing vets — and away from lease arrangements extended in the past to “corporations, the private Brentwood school and other non-government entities.”

Under the new regime envisioned by Sens. Dianne Feinstein and Barbara Boxer, the VA would receive the authority to “enter into leases with local governments and nonprofit groups to provide veterans with shelter supplemented by medical and other services,” according to the Times. As Southern California Public Radio noted, education and training were among the additional services anticipated.

In recent years, the VA has been wracked by scandals offending Republicans and Democrats alike, with blame cast at the Obama administration, Congress and the VA bureaucracy itself. Now, however, the VA has put its own stamp of approval on the new bill; according to SCPR, it offers the VA — currently mired in a multibillion-dollar funding shortfall and juggling unfinished projects — an opportunity to “create new housing in West L.A. much faster than the agency could on its own.” In a statement, SCPR noted, the VA asserted that passing the Feinstein-Boxer legislation would “greatly enhance” its “ability to end Veteran homelessness in Greater Los Angeles.”

L.A. Mayor Eric Garcetti has vowed to ensure all veterans are off the city’s streets by the end of this year. “In January, the mayor’s office announced 3,375 homeless veterans were housed in L.A. in 2014, and an estimated 3,154 homeless veterans remain on the street,” as the Los Angeles Daily News has observed.

Housing battles

California has recently become emblematic of increasing rates of homelessness in major urban areas, as the two Senators, along with Rep. Ted Lieu, D-Torrance, noted in their letter to the chairmen and ranking members of the House and Senate Veterans’ Affairs committees. “There is a critical need for long-term supportive housing on the West Los Angeles campus, and enhanced use leases would allow the department to work with community and state organizations toward the goal of ending veteran homelessness in Los Angeles,” they wrote, according to the Daily News. “As you may be aware, Los Angeles is home to the largest population of homeless veterans in the country, which is simply unacceptable.”

From Downtown to westside neighborhoods such as Venice, altercations involving homeless persons and police — sometimes resulting in death — have made headlines in Los Angeles. Recently, in San Pedro, controversy erupted over the appearance of small wheeled shacks designed to supply the homeless with shelter that could evade permitting regulations. L.A. City Councilman Joe Buscaino warned “that the city needs more permanent housing” instead of structures that would “ultimately become nuisances,” the Times reported.

In addition to the situation in Los Angeles, events unfolding in other Southland locales have also attracted attention. This month, formerly homeless veterans in Huntington Beach pressed ahead with a lawsuit challenging construction regulations they claim adversely affect prospects for housing. “The litigation comes in response to the Huntington Beach City Council on May 4 adopting an amendment that blocks the development of affordable housing in the Beach-Edinger Corridor,” as the OC Weekly reported. “The veterans, commission and their lawyers contend the Beach-Edinger Corridor Specific Plan is in direct conflict with the city’s own General Plan Housing Element, which was approved by the California Department of Housing and Community Development in 2013.”

SACRAMENTO, Calif. — Covered California is offering a special enrollment opportunity for consumers who did not know or understand there was a tax penalty for being uninsured in 2014 or who learned they may face a penalty for 2015.

“For the first time, health care and taxes now are linked arm in arm,” Covered California Executive Director Peter V. Lee said. “The law requires everyone to be insured, and if you’re not, you may face a significant financial penalty when you file your taxes this year.”

From Feb. 23 until April 30, 2015, consumers are eligible to apply for health coverage during special enrollment by attesting that they did not realize there was a tax penalty. To attest to this fact, they can select “Informed of Tax Penalty Risk” when filling out an application at CoveredCA.com.

The new deadline also comes two weeks after the April 15 deadline for filing income tax forms, and paying any back taxes, to the IRS. Covered CA’s announcement recognizes that this will be a big spur to action:

The new tax penalty for being uninsured — known as the “shared responsibility payment” — motivated many consumers to purchase insurance this year during the Nov. 15-Feb. 15 open-enrollment period via Covered California. Unfortunately, many people who are supposed to purchase insurance may be unaware of the penalty and surprised when they go to their tax preparation professional for help. …

For the first time, consumers who are filing their taxes this year may be paying a penalty for not having health insurance. And the penalty for going without insurance in 2015 will go up significantly: Those who can afford insurance but choose not to buy it will be subject to paying $325 per adult in a household or 2 percent of their income, whichever is greater.

Veterans may be exempt

The Covered CA announcement does not mention it, but there is an exemption for U.S. military veterans. The federal Veterans Administration website advises:

You do not have to pay a fee if you have coverage that meets a minimum standard (called “minimum essential coverage”). VA is required by law to notify the IRS of veterans’ enrollment status in the VA health care system in 2014. Veterans who are not enrolled in the VA health care system and who do not have qualifying medical insurance, unless given an exemption, will be charged a fee beginning on their 2014 federal income tax return, which most people will file in the spring of 2015. The fee is prorated based on the amount of time in the calendar year the Veteran does not have medical insurance that meets minimal essential coverage standards.

Explanations of VA medical benefits, and how to sign up for them, are here.

AB 1637 would stamp a “Veteran” designation on the drivers licenses of Californians who served. It’s by Assembly members Jim Frazier, D-Oakley, and Richard Bloom, D-Santa Monica.

According to the Chronicle:

“The hope, Frazier said, is that the license designation under AB 1637 would make it easier for veterans to access federal, state and local benefits, including employment, education, housing, health and counseling benefits by eliminating the ‘impracticality of carrying around official discharge papers.’ The designation, which most states have already added to their state driver’s licenses, also helps veterans receive hotel and retail discounts when available.”

They mean the DD-214 discharge form. That form includes the veteran’s service number, which for more than 40 years now has been the same as the Social Security number. The rise of computers in recent decades has made identity theft easier. So giving out the SS/service number every time a veteran uses his benefits is not a good idea.

The CA driver’s license number is less sensitive. So using it to prove veteran status would mean greater data and identity security.

There are some piddling costs associated with new DMV forms to include the veteran designation. But the bill’s language actually includes charging veterans a fee — in an amount yet to be decided — to the veterans who want the designation on their licenses.

That makes sense. Non-veteran drivers shouldn’t have to pay for it. Veterans defended freedom and defeated socialism.

As a veteran myself — Russian linguist in the U.S. Army, 1978-82, most of it in West Germany defending the Fulda Gap from Red Army tanks — I wouldn’t mind paying the fee.

It seems a minor change in the law for those who protected our freedoms.

Assemblyman Al Muratsuchi and Assemblywoman Bonnie Lowenthal held a Joint Oversight Committee Hearing at the Capitol last week to discuss the impacts, issues and supportive programs associated with MST. Muratsuchi, D-Torrance, is the chairman of the Veterans Affairs Committee. Lowenthal, D-Long Beach, is the chairwoman of the Legislative Women’s Caucus.

Muratsuchi allowed the hearing to go on for three hours, with no time limits on speakers.

Purpose of the hearing

“There were 3,553 sexual assault complaints reported to the Defense Department in the first three quarters of the fiscal year, from October 2012 through June, a nearly 50 percent increase over the same period a year earlier,” the New York Times reported recently. “Defense Department officials said the numbers had continued to rise.”

“As Chair of the Veterans Affairs Committee, it is my priority to make our veterans’ lives easier and identify areas where the state can provide additional support,” said Muratsuchi.

“MST survivors and support organizations agreed that one of the greatest inadequacies in addressing this issue is that military justice penalties are far less severe than civilian justice penalties,” Muratsuchi’s Assembly website said. “And while support organizations for victims are available through the state, county and non-profits, they often seek additional legislative support.”

“Survivors deserve justice, and they deserve support,” Lowenthal said. “We can’t sit on our hands waiting for the federal government to act. California can, and will, take steps to prevent these assaults and help survivors and their families heal.”

Several sexual assault survivors spoke at the hearing and said one of the biggest issues victims face is that many times their offenders outrank them. And they said many times the offender does not receive any penalty and often repeats the crime.

Survivors told stories of MST and said it leads to physical and mental health problems, relationship issues, alcohol and drug abuse, and often homelessness.

Several of the MST survivors who testified said they were assaulted decades ago. One woman told of being assaulted during the Vietnam War more than 40 years ago.

Government redefined ‘sexual assault’

However, the large increase in MST numbers in recent years mainly is due to changes in its definition since 2007; and to the increasing role of women in the military.

According to a March 28, 2013 Instruction from the Pentagon, the Department of Defense “uses the term ‘sexual assault’ to address a range of crimes including rape, aggravated sexual assault, wrongful sexual contact, non-consensual sodomy, abusive sexual contact, aggravated sexual contact, and indecent assault. The annual report includes case synopses, case dispositions, and punishments imposed in cases involving unrestricted reports.”

The DOD Instruction describes what happened, and why the assault statistics now are inflated:

“For incidents that occurred prior to the changes made to the UCMJ on October 1, 2007, the term ‘sexual assault’ referred to the crimes of rape, nonconsensual sodomy, indecent assault, and attempts to commit these acts. For incidents that occurred between October 1, 2007 and June 27, 2012, the term ‘sexual assault’ referred to the crimes of rape, aggravated sexual assault, aggravated sexual contact, abusive sexual contact, wrongful sexual contact, nonconsensual sodomy, and attempts to commit these acts. 
For incidents that occur on or after June 28, 2012, the term ‘sexual assault’ refers to the crimes of rape, sexual assault, aggravated sexual contact, abusive sexual contact, nonconsensual sodomy, and attempts to commit these acts.”

“Abusive sexual contact” was added to the definition of sexual assault, so people who touch someone’s posterior are now equated with serial rapists. For that reason, some media accounts inaccurately have labeled the results of the military’s recent survey of sexual assaults and “unwanted sexual contact” as “sexual assaults.”

Assemblywoman Melendez

Assemblywoman Melissa Melendez, R-Riverside, a veteran of 10 years in the U.S. Navy, also spoke at the hearing. She pointed out the big difference between unwanted touching and actual sexual assault. The new definition can interpret an “assault” as someone telling an off-color joke. Even touching someone’s thigh, waist or behind is now lumped in with serial rapists.

“I know all about what goes on,” Melendez said. “I served in the military.” She told the story about an inappropriate remark made to her by a superior officer in the Navy. But she said it did not cause her trauma.

“I’m concerned about some of the data suggesting sexual trauma,” Melendez said. “Sexual harassment and off-color remarks are not trauma. Trauma is trauma.”

“Are we going to act on anything we heard here today?”

“There is not a policy problem,” said Melendez. “There is a leadership problem.” She said the MST problem with the military is weak leaders who look the other way on sexual assault accusations, rather that dealing with them immediately. “The policy is in place,” she said, but needs to be enforced.

“I’m curious if we are going to act on anything we heard today,” Melendez said at the end of the hearing, directing her comment to Muratsuchi. “It is not helpful to have people come forward and then do nothing. This is not supposed to be a testimonial.”

“Each of us in the Legislature can put up a bill and run with it,” Muratsuchi said. “I want to thank Assemblymember Lowenthal and the Women’s Caucus for making this a priority. We will follow up on this.”

In its recently released report, “An Agenda for Veterans: The State’s Turn to Serve,” the bi-partisan Little Hoover Commission critiques the California Department of Veterans Affairs for its “inconsistent leadership” and inability to fully take advantage of funds set aside for veterans.

The dysfunction becomes more pressing every day. California’s population of veterans — already at 1.8 million, the largest of any state — will see annual growth of about 35,000 in the coming years.

CalVet and its flaws

CalVet’s vision is simple. Its Website promises, “CalVet will be the state’s leading advocate and resource so veterans can achieve the highest quality of life.” The department employs 2,600 workers and has an annual budget of $405 million. The CalVet Veterans Homes Division, which provides long-term care for homeless, disabled and retired veterans, consumes nearly 80 percent of the department’s budget.

The Farm and Home Loan Program consumes $66 million a year. Yet the results are low. According to the report, “The program issued 81 loans totaling $8.8 million in the 2012-13 fiscal year. The program also has collaborated with Habitat for Humanity to build, through a sweat equity program, homes for veterans.”

But a weak Veterans Services Division, charged with outreach and educating veterans about their access to certain federal benefits, is undermining the department’s ambitious goals—and hurting the state in the process.

“The overriding problem for California is that many California veterans are eligible for federal benefits that they need, but they are not enrolled to receive them,” the report says.

The Texas population of veterans, comparable in size to California’s, drew down an average of 30 percent more in veterans' benefits than California’s. Florida’s drew down 16 percent more.

“Texas and Florida each have a very aggressive outreach program. They also have a fairly good veterans service representative core,” J.P. Tremblay, deputy secretary for communications and legislation, said in an interview. (He added that Florida’s large retiree population and Texas’ many military bases are also natural advantages.)

In fact, CalVet has based one of its marquee efforts — the implementation of a 36-person strike team to lessen the backlog of soldiers waiting for benefits — on a Texas program.

According to the report, encouraging veterans to seek benefits may actually be fiscally responsible (bold emphasis added):

“Some who do not draw down their federal veterans benefits instead turn to public aid programs. Veterans experts told the Commission that California leaves between $500 million and $1 billion a  year in federal money untapped because California veterans are not  signed up for benefits and services to which they are entitled and have  earned. Getting more California veterans signed up for their federal Veterans Administration benefits could improve their lives, bring more money into the state economy and reduce demand on state services.”

The chair of the state Senate Veterans Affairs Committee is Sen. Ben Hueso, D-San Diego. He told U-T San Diego that the report contained “important insight on how we can improve our veteran services and invest in ways that will allow us to effectively leverage federal dollars to benefit California veterans.”

The report also notes that CalVet has “suffered through long stretches of turnover at the secretary level, often when strong leadership was needed to implement needed change.”

This has made the department slow to adapt to changes, according to the report, and has prevented CalVet from harnessing “the potential of the state’s many non-profit partners, including the main veterans organizations.”

Said CalVet Secretary Peter J. Gravett in a written statement, “[T]he department now has a new strategic imperative to refocus its efforts on the needs of our state’s veterans and the continuum of services available to them.” Gravett and CalVet did not contest any of the report’s findings.

Practical solutions

The commission also spells out several concrete recommendations for CalVet.

Since the Legislature has already provided $6 million in one-time funds to review and clean up benefits claims, the report says, it “should monitor the department’s results to determine whether additional funding is warranted.”

Also, the report suggests sending operational savings to a litany of services that help veterans file benefit claims and pursue referrals for services. (Currently, savings from operational efficiency are sent to California’s general fund.) The report also suggests several strategies — such as investing more heavily in social media marketing — as a means of engaging the community of veterans.

The commission also suggests that the Legislature and governor “review and update the Military and Veterans Code” of the state, which was described in a Little Hoover Commission press release as “confusing, contradictory and misaligned with current CalVet practices and veterans’ needs.”

Most salient, though, was the commission’s recommendation that California’s state and federal representatives “work with and press federal agencies to obtain up-to-date information from veterans and relay it to appropriate state agencies through electronic means.”

Such a program would enable California to develop a database of veterans and to reach veterans sooner after their departure from the military, helping veterans file faster and more accurately.

Tremblay said that CalVet has already begun to use the Defense Personnel Records Information System. According to its Web site, DPRIS “provides a conduit for the secure electronic retrieval of document images” from military personnel records. (Access to these records is often necessary for veterans applying for benefits.)

But in a frustratingly complex bureaucracy, the state often works against itself while trying to help.

“There’s a paradox here,” Little Hoover Commission Executive Director Stuart Drown said in an interview. “The more people the state gets to file claims, the greater the backlog becomes.”

Federal backlog

The system for claiming benefits is simple, at least in theory.

Local agencies help a veteran prepare his/her claim, then forward it to the state; which reviews and then submits the claim to the federal Department of Veterans Affairs, which approves or denies the benefits.

Naturally, the process is muddled and lengthened at each step by structural inefficiency, understaffing and confusion.

Earlier this year, the Center for Investigative Reporting, in a report about the federal Department of Veterans Affairs, said “the agency’s ability to quickly provide service-related benefits has virtually collapsed under President Barack Obama.”

The Obama administration attempted to improve the backlog by computerizing processing and hiring more staff. But as the CIR showed, those initiatives “have fallen apart in the implementation.”

In fact, the national average wait-time for benefits is 349.6 days. Meaning the average veteran waits nearly a year before receiving benefits that are considered a right. The average wait times in Los Angeles and Oakland are significantly worse than the national average, at 619.4 days and 617.8 days, respectively.

Many of the delays are caused by veterans who simply fail to fill out the forms correctly. To its credit, CalVet is already working to alleviate the problem.

According to Tremblay, the department will send out strike teams by the end of September or the beginning of October to ensure that all forms are “fully developed,” or correctly filled-out.

Tremblay says the temporary strike teams — 36 people set to work for three years — have “more than enough time to take care of it and deal with the backlog.”

After all, the commission argued that, despite the federal government’s failings, California could still greatly improve its wait times.

The report concluded, “California can do better, and to honor those who have sacrificed for the many, it must do better.”

The worst development for the San Diego mayor was the word from several political pros that they had joined the nascent effort to recall Filner from office. It had seemed like amateur hour until this development.

But nearly as bad was perhaps the most offensive story yet about Filner and women. He hit on rape victims that he met at a conference on sexual assaults in the military!

Given that Filner spent more than half the year from 1993-2012 in Washington D.C. as a congressman, it was only a matter of time before we saw women from the D.C. area joining the hordes in San Diego reporting on the lecherous Democrat’s unwanted advances. But CNN’s report that broke Wednesday was just awful for his reputation.

“[Eldonna] Fernandez, along with Army veteran Gerri Tindley, joins 11 other women who have publicly accused Filner, 70, of making unwanted advances, from groping to verbal passes.

“They are also among at least eight female veterans and members of the National Women’s Veterans Association of America (NWVAA) in San Diego who have made accusations against the mayor. Almost all of the women were victims of sexual assault while they were in the military.

“The women, like Fernandez, say the former chairman of the House Veterans’ Affairs Committee used his significant power and credentials to access military sexual assault survivors, who they say are less likely to complain. …

“Tara Jones, the president of the group, said she’s spoken to seven to eight women who had varying encounters with Filner at the women’s veteran events, from groping to unwanted requests for dates.

“‘He went to dinners, asked women out to dinners, grabbed breasts, buttocks. The full gamut. Everything that is complete violation of what we stand for,” Jones said. “He’s a sexual predator. And he used this organization for his own personal agenda.”

Filner defender claims anti-Semitism

Meanwhile, a high-profile Filner defender has emerged, and she suggests that the mayor is a victim.

“Two weeks ago, noted literary agent Sandy Dijkstra, a longtime supporter of Mayor Bob Filner, sent him a note, advising him to step down amid mounting accusations of sexual misconduct.

“Tuesday afternoon she reversed course, decrying what she called ‘a Scarlet Letter witch hunt’ to drive him from office.

“‘He deserves the chance to clean up his act and be the mayor we thought we elected,’ she said.

“In an email sent Tuesday afternoon to friends, and in a subsequent interview with U-T San Diego, she said she’s grown increasingly alarmed at the nature and tone of the allegations directed at Filner.

“In particular, she said, she was “sickened” by a Steve Breen editorial cartoon in Sunday’s U-T. It showed a leering Filner looking at a copy of Playboy magazine tucked into a sexual-harassment workbook. Dijkstra called it anti-Semitic and ‘a vile caricature right out of Hitler’s playbook.’”

Groan.