Sole Source Contractor With Non-Competitive $16 Billion VA Records Integration Contract Calls It “Immense Challenge”

Image: FCW.com

Editors Note:  Cerner was determined to be the sole source for this requirement because they are running the current system for the Military and after billions in historical failures to connect the VA records system to the military, the military and the VA jointly decided to move the entire VA records system over from its current hosting to the military software.  This company thus became the sole source and competition was waived.  For further details please see:   https://rosecoveredglasses.blogspot.com/2018/06/the-next-10-billion-tax-payer-chapter.html

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MILITARY.COM“

“This won’t be easy,” the prime contractor said of the $16 billion effort to overcome decades of failure and finally make veteran and military health records compatible with a few computer clicks.

We must deploy to 117 sites, train over 300,000 VA employees, collaborate with DoD, interoperate with the community, aggregate decades of clinical data and update technology,” he told a hearing of the House Veterans Subcommittee on Technology. “

“It carries risk, and we don’t take the challenges lightly” in implementing Electronic Health Record Modernization (EHRM) programs across the Departments of Veterans Affairs and Defense”, said Travis Dalton, president of government services for Cerner Corp. of Kansas City.

In addition, the new system will have to link with additional community health care providers expected to come onboard with the June 6 rollout of the VA Mission Act, which will expand private health care options for veterans, said Rep. Jim Banks, R-Indiana, the ranking member of the subcommittee.

“Interoperability with the community providers is still the elephant in the room,” he said.

About 30% of veterans currently get health care at taxpayer expense in the private sector, and they “rightfully expect their records to follow them,” Banks said. He said his main concern is that a “half-baked system” will be rushed into use.

Rep. Susie Lee, D-Nevada, chairwoman of the subcommittee, said that Cerner and partners Leidos and Booz Allen Hamilton are attempting to create “one seamless lifetime record for our service members as they transition from military to veteran status,” but “this effort also has the potential to fail.”

“The VA unfortunately does not have a great track record when it comes to implementing information technology,” she said, “and it threatens EHRM.”

Previous attempts to mesh VA and DoD records have either failed or been abandoned, most recently in 2013 when then-Defense Secretary Leon Panetta and then-VA Secretary Eric Shinseki dropped an integration plan after a four-year effort and the expenditure of about $1 billion.

“This won’t be easy, but it is achievable and we are making progress” in the overall effort to let “providers have access to records wherever they deliver care,” Dalton said.

Jon Scholl, president of the Leidos Health Group and a Navy veteran, said the example to follow is the MHS Genesis system, the new electronic health record for the Military Health System. “MHS Genesis is the solution,” he said at the hearing.

However, Lee said that “a suitable single management structure has yet to emerge” for EHRM since then-Acting VA Secretary Robert Wilkie awarded a $10 billion, 10-year contract to Cerner in May 2018. The cost estimate for the contract has since risen to $16 billion.

At a hearing last month of the House Defense Appropriations Subcommittee, Acting Defense Secretary Patrick Shanahan was challenged on the DoD’s efforts to work with the VA on EHRM.

“I don’t ever recall being as outraged about an issue than I am about the electronic health record program,” Rep. Kay Granger, R-Texas, told him.

“Personally, I spend quite a bit of time on how do we merge together” with the VA on the records, Shanahan assured her.

He said pilot programs on making the records compatible are underway in Washington state at Joint Base Lewis-McChord, Naval Base Kitsap, Naval Air Station Whidbey Island and Fairchild Air Force Base.

The “rollout and implementation” of the fix to the electronic health records has shown promise at those installations, Shanahan said, adding that the next step is to put the programs in place at California installations in the fall.”

Making VA, DoD Records Compatible Is an Immense Challenge: Contractor

Memorial Day 2019 - A Combat Vet Talks "Cause and Effect"

A young woman lays down on the grave of U.S. Marine Corps Lance Corporal Noah Pier on Memorial Day at Arlington National Cemetery on May 31, 2010, in Arlington, Virginia.  (Chip Somodevilla via Getty Images)

As we honor our fallen this Memorial Day, an observer of our military actions over the last two decades in the Middle East could in no way have predicted the splintered, irrational, “Turn-Your-Back-And-You-Have-Two-New-Enemies”, scenario the US faces today. Perhaps a look back over our shoulder, examining cause and effect relationships along the road is in order.

CAUSE:  The US fights a just and honorable war assisting many Middle East allies and other countries free Kuwait.

EFFECT:  Saddam Hussein is driven from Kuwait and the country is returned to its rightful government.

CAUSE:  The US does not leave the Middle East after rescuing Kuwait, but rather, stays in peripheral countries militarily “To Protect Our Interests” with an imperialist attitude resented by cultures that have an ingrained,religious hatred for that type of presence by foreigners.

EFFECT:  The rise of Bin Laden and many more like him today and the deaths of 3,000 Americans on our soil, attacked in our homeland because we did not leave the Middle East. 

CAUSE:  The US reacts to 911 by setting up an elaborate Homeland Security apparatus and beefing up the National Security Agency by orders of magnitude, technologically, while putting in place a carefully concealed legal apparatus to counter terrorism.

EFFECT: The US has no outside terrorist incidents of a 911 magnitude since the Twin Towers fell in 2001 but Americans develop real concerns about our government and its role in controlling our lives as whistle blower disclosures regarding the apparatus of intelligence operation reveal potential constitutional issues.

CAUSE:  The US invades Iraq fed by false, intentionally staged intelligence, fronted by agencies and industries bent on economic gain. The US sets about war fighting and nation building programs that seek to displace a culture that had evolved through conflict and war lords for hundreds of years and is tied to the absolute requirement that religious practices be part and parcel of government, a principle the US has rejected as unworkable since our Constitution was written

EFFECT:  Failure to build anything substantial in the form of a nation over a 17 year period.  The deaths or crippling of our finest soldiers, dramatic increases in our national debt and a cynicism among our citizens with respect to the $Billions that have gone into the pockets of corporations supporting our huge Military Industrial Complex (MIC) and wasteful USAID Programs by companies that spend more lobbying Congress than they pay in taxes.

CAUSE:  The present Middle East unrest due to ISIS/ISIL and other splinter groups we thought had been scattered to the winds. 

EFFECT:  UN security council meets with many nations talking and less than a half dozen nations carefully and selectively participating in an air war against terrorism while the remainder watch the outcome.   Our military and corporate defense establishment (MIC) shout, “Sequestration to reduce military spending must end!” and estimates more years will be required with more American boots on the ground to train forces that we had already trained for a decade and provide "Stability"). 

CAUSE (PROJECTED):  A political battle like none seen in recent times during the coming US national  elections, driven by concerned American citizens and their view of the US role in the Middle East. As our burgeoning National Debt Clock approaches $23 Trillion the culture in that part of the world has had a very difficult time figuring out how we can help while we near energy independence from oil and require some nation building of our own in the homeland. 

EFFECT (PROJECTED): A leader and a political climate that will permit prudence, tough decisions, carefully avoidance of bad intelligence and overreaction so that we do not continue to sink into the oil and blood soaked desert of Middle East cultural revolutions. 

Global corporations will then cease consuming the MIC and USAID tax payer dollars to prosper, while parking their assets overseas as our young become indebted for generations.



Image: usf.edu/florida

A Veteran Connects the Dots In the Military and Veterans Health Care Systems Maze

PLEASE CLICK ON IMAGE TO ENLAGE

The Massive backlog recently highlighted in the press and in Congress  reveals a dire necessity for simplification, communication and  efficiency in processes, systems and government service contracting in DOD and the Veterans Administration as well as better management of federal government contractors. 

The news media, the auditors and the average American are pointing the finger at the President and the Head of the VA.  One cannot ignore the accountability aspects of these individuals.  

However, the real root causes lie in the massive volume of war veterans returning from our pointless incursions in the Middle East over the last decade, coupled with the historically poor process and systems work conducted between the Department of Defense and the VA and poorly managed contractors taking home millions on systems specifications that change like the wind blows.  

It is not unlike the Obama Care fiasco.

After returning from two combat tours in Vietnam, I worked in the government contracting environment for 36 years then went through the VA system as a Veteran getting treatment at retirement in 2006

In 2006 I found the VA had a magnificent system capable of handling medical records and treatment anywhere in the world once a veteran was in the system; a key point.  Please contrast the below Time Magazine Story with current events and ask yourself : Why have we had such deterioration?  

http://content.time.com/time/magazine/article/0,9171,1376238,00.html

ANSWER:   We have not experienced deterioration - within the VA itself, except  from pressures due to millions returning from war and from human beings who look for excuses when systems fail.

We have had over 17 years of Middle East incursions, a sudden discharge of veterans and poor management from the DOD to the VA, from the systems contractors to the state veterans homes.  

Veterans fall through the cracks as a result.

 This is an F-35 aircraft, cost plus scenario, revisited in the form of veterans care systems mismanagement and it will cost billions to fix.  THAT IS THE COST OF WAR.

Unlike the F-35 we must have veterans health care or our volunteer army will disappear.

THE TOTAL SPECTRUM MUST BE VIEWED TO MANAGE THE ISSUES. 


BACKGROUND

A recent 3 part special in Time Magazine addresses the serious gaps between treatment,  benefits and services processes and systems between the military  services and the Veterans Administration:

http://nation.time.com/2013/04/22/what-the-hell-is-going-on-with-va/#ixzz2RnspoSM4

"While awaiting  processing, "the veteran’s claim sits stagnant for up to 175 days as VA  awaits transfer of complete (service treatment records) from DoD,":

After years of work to move toward integrated electronic records that would eliminate this sort of delay, Defense Secretary Chuck Hagel recently  conceded that the Defense Department is not holding up its end of the bargain to improve the disability process.

"I didn’t think, we knew what the hell we were doing.":
 
http://www.federalnewsradio.com/394/3288748/Hagel-orders-DoD-to-restructure-path-toward-integrated-health-record 
 

HISTORICAL SIMILARITIES

The above scenario is not unlike the Walter Reed Army Hospital care  fiasco a few years ago, before the facility was shut down and consolidated with the Bethesda Naval facility.

OTHER SYMPTOMS

The VA decided to have those who would  actually use the system (claims processors) work with software  developers. This process took longer but will create a system more  likely to meet the needs of those who actually use it. VA also worked  closely with major Congressional-chartered veterans’ service  organizations.

2013 was the year in which regional offices were to be being transitioned to the new electronic system.  It obviously has not occurred as planned.

ROOT CAUSE

Both DOD and the Veterans  Administration use service contractors to perform this type of systems development.  Government Computer News (GCN)  carried a story on the  difficulties experienced with, "Performance-Based Contracting", which  has been made part of the Federal Acquisition Regulation (FAR) in an  attempt to pre-establish at contract award those discrete outcomes that determine if and when a contractor will be paid.

http://gcn.com/articles/2006/12/01/performancebased-contracting-still-baffles-agencies.aspx 

Interestingly enough, the article splits the blame for the difficulties  right down the middle, stating the government typically has problems  defining what it wants as an end product or outcome and looks to  contractors to define it for them. More than willing to do so, the contractors detail specific end products or outcomes, set schedule  milestones and submit competitive proposals.

The winner is selected based on what the government thinks it needs at  the time to fulfill its requirement and a contract is negotiated. Once underway, the government decides it wants something else (usually a  management-by-government committee phenomena with a contractor growing  his product or service by offering lots of options). The resulting  change of contract scope invalidates the original price and schedule, so  a whole new round of proposals and negotiations must occur with the  winner while the losers watch something totally different evolve than  that for which they competed. The clock keeps ticking and the winner  keeps getting his monthly bill paid based on incurred cost or progress  payments.

CONCLUSION

The present state of the economy and the needs of our servicemen will not allow the aforementioned to  continue. Government agencies are now hard pressed to insure the most  "Bang for the Buck". It is in the long term interests of the politician, the DOD, the VA and astute contractors to assist in that endeavor. 

(1)The only way to achieve such an objective is through sound technical, cost and schedule contract definition via an iterative process of baseline management and control.

http://www.smalltofeds.com/2009/08/contract-baseline-management-in-small.html

(2)  Government civil servants must be trained to report systemic poor service up the line in lieu of hiding bad news from superiors or developing workarounds.  This must be an expectation built into their job description and they must be rewarded and promoted for meeting that requirement just as they are for the other requirements of their jobs. 

The first whistle to be blown must be to the boss when the service issue occurs, not to the press a year from the occurrence. 

Our returning soldiers and those who have served before deserve better"

Veterans Administration Rolls Out New Claims Appeals Process

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"MILITARY.COM”

"In what Department of Veterans Affairs officials are calling the biggest change to its appeals process in decades, the department will launch a new system for veterans challenging their disability claims decisions.

"The new process gives veterans three options for contesting their claims, with an eye toward drastically reducing the time it takes to receive a final decision.

At the height of the VA appeals backlog in 2013, some veterans had waited years for a decision and more than 610,000 claims sat unadjudicated. To tackle the backlog — defined as cases that weren’t decided within 125 days — the VA hired new employees, instituted mandatory overtime and introduced new processing systems.

Still, the problem persisted with an average wait time for a decision reaching up to three years and the number of backlogged appeals climbing to roughly 300,000 by 2017, when Congress passed the Appeals Modernization Act, or AMA.

Under the AMA, veterans will have three choices if they want to appeal the decision on their disability compensation or other VA claim.

The first option is the “supplemental claim lane,” in which they can introduce new evidence in their case and have a regional specialist review it and make a decision.

Or they can choose the “higher-level review lane,” in which they request that their case be reviewed by a senior adjudicator rather than the regional office. This review will consist largely of looking for errors or mistakes made in interpreting VA policies or laws governing the claim. If a problem is found, the senior claims adjudicator can require that a correction be made.

And finally, they can appeal the decision to the Board of Veterans’ Appeals — basically the same as the current system, although there will be several paths to consider if they request a board review. These paths include:

• A direct review, in which they don’t submit any additional information and waive their right for a hearing;
• Submission of extra evidence without a hearing;
• Or a full hearing, in which they can submit more evidence and testify before a judge.

When veterans receive their initial claims decision, they also will get a letter explaining the reasoning for it, as well as the appeal options “in clear language,” said Cheryl Mason, chairwoman of the VA’s Board of Veterans Appeals.

“What the AMA was built and designed to do was create a simplified process for veterans. … [Officials] realized that veterans were confused by the process; it was a complex system and it simply took too long,” she said.

The new system will be used throughout the VA for any claim that requires a decision, according to Dave McLenachen, director of the Veterans Benefits Administration appeals management office.

This includes education and insurance decisions, vocational rehabilitation and caregiver benefits applications, he said.

VA leaders hope that the new system will reduce the time it takes for veterans to receive a decision on their appeal to 125 days.

Currently, the VA’s claims backlog is 265,000 cases, while an additional 136,000 cases are under review by the Veterans Board of Appeals, for a total of more than 400,000 cases. VA officials said Thursday that the goal is to clear the backlog by 2020.

A pilot version of the new system, called the Rapid Appeals Modernization Program, or RAMP, was introduced shortly after the AMA was signed. According to McLenachen, more than 70,000 veterans with 84,000 claims appealed through RAMP. The VA has adjudicated 70 percent of those appeals, awarding about $250 million in retroactive benefits, he added.

RAMP will stop accepting new appeals on Friday. Veterans whose claims were filed through RAMP will continue to be processed.

Veterans whose claims are currently in the system and who don’t apply for a decision through RAMP by Friday can opt into the new system if they receive a statement of case from the VA or supply supplemental evidence and receive a supplemental statement from the VA.

Legislators and veterans service organizations helped craft the new system and have largely been supportive of it, although some have voiced concerns over legacy claims and the information technology infrastructure needed to support the new program.

VA officials said they are ready, having hired 605 new employees to handle the appeals.

Mason called the new system a “veteran-friendly change.”

“It gives veterans a choice and control over their process instead of getting stuck in the legacy system for three to seven years, on average,” she said.”

New VA Claims Appeals Process

Two New Veterans Benefits Bills Now Law

Image: “National Veterans Foundation”

"MILITARY TIMES REBOOT CAMP”

“Here’s what the Veterans Benefits and Transition Act and the Forever GI Bill Housing Payment Fulfillment Act mean for veterans and military families. “

“1. No more punishing GI Bill students for the VA’s mistakes.

Last fall, major technology failures at the Department of Veterans Affairs led to delayed and inaccurate payments for thousands of Post-9/11 GI Bill users, as the agency failed to implement a provision of the Forever GI Bill law that changed the way housing stipends are calculated.

In some cases, students grappling with late rent or mortgage bills as a result of the delays faced another challenge: Their schools charged late fees for tuition bills that VA didn’t pay on time, blocked access to campus facilities or did not allow them to register for the next semester of classes until their balance was covered.

Ashlynne Haycock, deputy director of policy and legislation for the Tragedy Assistance Program for Survivors, said members of her organization were even advised by schools to take out loans to cover tuition costs — even though the payments were late through no fault of their own.

A portion of the Veterans Benefits and Transition Act, signed into law Dec. 31, requires schools to end these practices if they want to keep enrolling students using GI Bill benefits.

“We are very excited to see this finally come to fruition,” Haycock told Military Times as the bill was making its way through Congress. “We wish it would’ve been in place when things happened with the Forever GI Bill that weren’t so great, but clearly that was a sign that this needed to happen.”

2. VA must fix incorrect payments

About those late payments. The new Forever GI Bill Housing Payment Fulfillment Act holds the VA accountable for retroactively fixing payments that were inaccurate as a result of the technology problems.

To accomplish this, the law establishes a so-called “tiger team” to oversee these reimbursements. The team is required to report to Congress every 90 days on the reimbursement plan, and, by July 2020, report how many GI Bill beneficiaries were impacted, and to what extent.

The bill also holds the department to its promise not to collect on any overpayments made to GI Bill users.

“For many student veterans, every dime counts. That’s why the VA needs to get this right and pay student veterans the full amount of money they were promised,” Sen. Brian Schatz, D-Hawaii, said in a statement. The senator co-sponsored the legislation, which also became law Dec. 31.

In a Jan. 4 address to some 2,300 student veterans attending the annual Student Veterans of America National Conference, VA Sec. Robert Wilkie assured students that anyone who was underpaid as a result of the technology issues will be made whole.

“The bottom line is: We owe you every penny that you’ve earned,” he said. “That is what the nation has promised you, and that is what you deserve.”

GI Bill users who did not receive a cost-of-living increase on their fall 2018 payments will get a check in the mail for the difference by the end of the month. The rest of the fixes won’t happen until at least December, when the VA is slated to have its updated technology systems in place.

3. More leverage with landlords

VA is also required to do something else for student veterans under the Veterans Benefits and Transition Act: provide them with electronic proof that they will be receiving housing payments from the VA. Students can then show these to landlords.

Students who live in high-cost areas, especially, can have trouble finding housing without a job to put on their application, according to a House Veterans Affairs Committee staffer familiar with the legislation. The documentation from VA would provide information for landlords, such as how much and how long a veteran will be receiving benefits that help them pay for housing.

Another provision of the new law allows the spouse of a service member who dies on active duty to terminate a residential lease for up to one year after the death without being penalized. This expands on the Servicemembers Civil Relief Act, which allows service members to break lease if they deploy or PCS.

4. Local help for transitioning service members

For troops transitioning out of the military, the VA will now post a list of programs and organizations that can help.

The law requires the VA to contract with a non-federal entity to identify these programs, which will include smaller, more community-based organizations, according to the committee aide.

5. Better access to jobs programs for homeless veterans

This provision of the Veterans Benefits and Transition Act is “an absolute game changer” for homeless veterans, said Kathryn Monet, CEO of the National Coalition for Homeless Veterans, which has been advocating for a law like this for five years.

Previously, veterans had to be either on the streets or in a shelter to qualify for employment assistance under the federal Homeless Veterans’ Reintegration Program. But now, veterans have 60 days after moving into housing to apply for these services.

The provision applies to veterans participating in the Department of Housing and Urban Development-VA Supportive Housing program and a similar initiative for Native American veterans, as well as the Supportive Services for Veteran Families program. It also applies to veterans who are transitioning after being incarcerated and other recently homeless veterans, according to a summary of the legislation released by Congress.

“It’s basically the difference between housed and going back to homelessness for some of these veterans,” Monet said, adding later, “We know from our work how important this bill is to fix systemic problems that create unnecessary barriers to housing stability for veterans.”

6. Employment benefits for more reservists

Certain members of the National Guard and reserves called to active duty will have more time to use benefits under the VA’s Vocational Rehabilitation and Employment program, or Voc Rehab.

The program provides job counseling and other services for veterans with a VA disability rating of 20 percent or higher. Veterans that qualify must use the program within 12 years of separating from the military.

The clock gets paused for Guardsmen and reservists called to active duty. So, if they get activated for a year, they will get another year to complete Voc Rehab.

Before the new law, this did not apply to members serving under particular orders relating to national emergencies and combatant commands. As a result, such service members would lose time to use the benefit as they continued to serve. Now, the clock gets paused for them the same way as it does for their fellow Guardsman and reservists.

Daniel Elkins, legislative director at the Enlisted Association of the National Guard of the United States, said the new law will help many of the organization’s constituents. Voc Rehab benefits are “hugely important” for those who are service disabled, and this “is an extremely beneficial expansion to those benefits and long overdue,” he said.

7. Voting changes for military spouses

Military spouses can now elect to use the same residence as their active-duty spouse for state and local voting purposes, regardless of when or where they got married and whether they are currently living in that state because of military orders.

Previously, a spouse had to meet the residency requirements of a state on his or her own merit for the purposes of voting.

8. Enhanced burial rights

The new law allows spouses and children of active-duty service members to be buried in veteran cemeteries, even if they pass away before the service member — something that was previously allowed but only with the VA’s approval.

“We did expedite that,” said Patricia Lynch Watts, director of legislative and regulatory service for the National Cemetery Administration. “We tried not to make that too burdensome on the family, but there is certain information that we had to ask for, and it had to go through the process of being approved here by the secretary or the undersecretary, which could delay plans for burial by the family.”

The law also provides headstones and markers for burials in tribal cemeteries that receive grants from the VA. Watts said this corrects a previous oversight, which granted these for state veteran cemeteries but not those on tribal lands.

There are currently 11 tribal veteran cemeteries across the country and another two under construction, according to information provided by the VA.

Watts said the VA is supportive of both changes."

https://rebootcamp.militarytimes.com/news/transition/2019/01/17/trump-recently-signed-two-veterans-bills-into-law-heres-how-theyll-affect-you/

Happy Holidays from the Ken Larson Free Q&A Reference Library

Quora Questions with Answers by Ken that have undergone over  1 Million Views on Small Business Government Contracting and the U.S. Military Industrial Complex Ken Larson Reference Library on Quora