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“Pushing VA Forward: Review of VA’s Adaptative Programs for Disabled Veterans”

House Veterans Affairs Committee, Economic Opportunity Subcommittee Hearing

May 21, 2025 (recording here)

HEARING INFORMATION

Witnesses & Written Testimony (linked) (Panel One):

• Mr. Jason Latona: Assistant Director, Loan Guaranty Service, Department of Veterans Affairs, Veterans Benefits Administration

• Dr. Rachel McArdle: Deputy Executive Director, Rehabilitation and Prosthetic Services, Department of Veterans Affairs, Veterans Health Administration

• Dr. Joel Scholten: Executive Director, Physical Medicine and Rehabilitation Service, Department of Veterans Affairs, Veterans Health Administration

Witnesses & Written Testimony (linked) (Panel Two):

• Ms. Julie Howell: Associate Legislative Director for Government Relations, Paralyzed Veterans of America

• Brigadier General Tom Landwermeyer (Ret.): President and Chief Executive Officer, Homes For Our Troops

• Mr. Mike Owens: Adaptive Sports Director, Wounded Warrior Project

• Mr. Craig Schrimsher: President of North American Manufacturing, BraunAbility

Keywords mentioned:

• Adaptive housing, automobile modifications, adaptive sports, grant programs, eligibility process, outreach efforts, staffing levels, payment delays, construction costs, technological innovations, volunteer transportation, mental health, physical rehabilitation

IN THEIR WORDS

OPENING STATEMENTS FROM THE SUBCOMMITTEE

• Chairman Derrick Van Orden opened the hearing by reviewing the importance of the VA’s Specially Adapted Housing (SAH), adaptive automobiles, and adaptive sports programs. He stated that these programs are essential in helping veterans live more independently and comfortably, including by modifying homes and vehicles to meet disability-related needs. He highlighted legislation that the Subcommittee has advanced, such as the Deliver for Veterans Act, the ASSIST Act, and a forthcoming bill from Rep. Kimberlyn King-Hinds to enhance the SAH program. Chairman Van Orden also praised the Trump administration’s stated focus on veterans and reiterated his commitment to putting veterans, not bureaucracy, at the center of the Subcommittee’s work.

• Ranking Member Chris Pappas noted that VA adaptive programs improve disabled veterans' health, independence, and quality of life. He pointed to New Hampshire’s Northeast Passage program as a model for adaptive sports and detailed its benefits for both mental and physical health. The Ranking Member mentioned funding limitations and caps in VA programs that hinder access and called for legislative action to streamline eligibility, increase resources, and improve delivery. He urged better outreach, simplified application processes, and stronger partnerships with local organizations to ensure that all eligible veterans, particularly in underserved communities, can benefit from these programs.

SUMMARY OF KEY POINTS (PANEL ONE)

• Dr. Rachel McArdle outlined the VA’s efforts to support veterans through adaptive housing, home improvement, automobile modifications, and sports grants. She stated that over 2,000 SAH grants have been approved annually in recent years and discussed modernization efforts, including a new automated system launching in July 2025. She explained that the VA centralized financial management for the SAH program in 2020, improving oversight and removing unnecessary costs for veterans. Dr. McArdle also described how the VA’s adaptive sports grants have awarded over $119 million in the past nine years, supporting thousands of veterans and service members annually.

• Ranking Member Pappas asked how veterans learn about the SAH grant program. Mr. Jason Latona explained that veterans are contacted through automated letters, internal VA referrals, and outreach via VA staff and external partners such as nonprofits and veterans service organizations (VSOs). The Ranking Member noted delays of up to 18 months, asking how eligibility is determined and how long the process takes. Mr. Latona responded that eligibility is determined by the VA’s compensation service within three to six months, and veterans with amyotrophic lateral sclerosis (ALS) can receive expedited assistance focusing on urgent adaptations.

• Ranking Member Pappas then asked how veterans find out about adaptive sports programs. Dr. McArdle stated that the VA promotes them through health expos, social media, VA news blogs, and clinician outreach, underlining that clinicians are crucial ambassadors. Ranking Member Pappas followed up with concerns about staffing and asked if adaptive sports positions had been affected by hiring freezes or resignation incentives. Dr. McArdle was not aware of any impact but would follow up for the record.

• The Ranking Member also asked how many grants were awarded in FY24 and whether grantees submitted annual reports. Dr. McArdle confirmed that 91 grants totaling $15.9 million were awarded, and all grantees submitted the required reports.

• Rep. Tom Barrett asked about long delays in vendor payments for already-approved adaptive equipment. Mr. Latona explained that payments are handled by local VA offices. He was aware of delays but lacked detailed data. Rep. Barrett emphasized the severity of the issue, citing delays of over 200 days, and warned that vendors may stop working with the VA. Mr. Latona replied that an integrated product team (IPT) has been formed to address the issue and promised to provide its point of contact.

• Rep. Delia Ramirez expressed concern that VA leadership decisions were undermining programs like SAH and asked if staffing was sufficient to process grants and inspections. Mr. Latona responded that while the mission is critical, more staff are always needed. Rep. Ramirez asked whether staff training was standardized and who delivered it. Mr. Latona responded that national training is provided with oversight from assistant directors and a deputy director responsible for operations.

• Rep. Ramirez also asked whether SAH grant amounts are adjusted for inflation and how costs like labor shortages and tariffs are factored in. Mr. Latona said that the VA uses a construction cost index and recent legislation like the Ryan Kules Act to adjust grants, which currently cover 20–25% of average home adaptation costs. He added that stacking different grants helps veterans stretch resources further. Rep. Ramirez then asked about adaptive vehicle application volume and timelines. Mr. Latona reported that over 1,040 grants were delivered in the past year but would follow up with exact figures.

• Rep. Juan Ciscomani asked what accounted for the rise in SAH program usage and whether the trend would continue. Mr. Latona credited strong outreach, partnerships with other VA programs, and VSOs for the increase and expected demand to remain steady. Rep. Ciscomani then asked if these programs serve homeless veterans and whether opportunities exist to partner with other agencies. Mr. Latona said that SAH primarily serves veterans with a home or who live with family but confirmed ongoing partnerships within the VA and with nonprofits like Homes for Our Troops.

• Rep. Ciscomani inquired about how the VA prevents fraud, waste, and abuse in the SAH program. Mr. Latona explained that the VA eliminated third-party escrow agents, now requiring letters of satisfaction and compliance inspections before releasing funds, which has strengthened oversight and eliminated unnecessary fees.

• Rep. Morgan McGarvey praised VA innovations and adaptive sports, asking what technology investments are being made and whether outside partnerships exist. Dr. Joel Scholten replied that the VA works closely with clinicians and academic researchers to advance prosthetic and rehab technology, collaborating with vendors and VSOs. Rep. McGarvey then asked about the Volunteer Transportation Network (VTN) and efforts to address its 50% decline. Dr. McArdle said she would follow up with specific data.

• Chairman Van Orden criticized the lack of integration between adaptive programs and the Transition Assistance Program (TAP), calling it a “galactic failure.” He demanded immediate action to include this in TAP. He then asked the witnesses how long they had been at the VA and expressed frustration that the issue had not been addressed.

• The Chairman also echoed concerns from Rep. Barrett about payment delays, demanded that the VA pay vendors promptly, and warned that losing vendors would harm veterans. He said that ALS cases should not be the only ones expedited and that all veterans deserve rapid assistance. He questioned why grant applications do not begin while veterans are still in uniform and challenged the witnesses to implement changes immediately.

• Ranking Member Pappas followed up regarding the 2021 GAO report on grant staffing, asking whether VA staffing had improved since the report, particularly in terms of grant management experience. Dr. McArdle stated that the VA had made progress and that the report had been closed, but she acknowledged the department still had limited staff. When pressed for a comparison of staffing levels today versus 2021, she said she would take that question for the record.

• Ranking Member Pappas asked whether the VA had adequate staff to monitor grant programs, and Dr. McArdle affirmed they did. She also agreed to follow up with specific information on staffing related to adaptive sports, especially in light of hiring freezes and resignations. Dr. Scholten added that adaptive sports programs were supported by rehabilitation staff across every VA medical center and were integral to veterans’ reintegration and wellness plans. He explained that many rehab staff contribute part of their time to these programs by supporting events and encouraging veteran participation.

• Rep. Barrett asked whether the VA’s adaptive program costs, especially for home modifications, had kept up with post-pandemic construction cost increases. Mr. Latona responded that while the VA adjusts grant amounts annually using the Turner Building Cost Index, costs have indeed risen significantly, and most veterans still must cover some expenses out of pocket. He reported that about 85–90% of projects involve remodeling existing homes, though some veterans opt for new builds if their current homes are unsuitable.

• Rep. Barrett expressed skepticism that a 4–6% annual increase accurately reflected cost spikes in construction materials and labor, and Mr. Latona acknowledged that costs in certain regions like the Pacific Islands and tribal lands posed additional challenges.

• Rep. Ramirez followed up about adaptive vehicle applications, requesting data on the number submitted annually and the average processing time. Mr. Latona explained that eligibility is determined by the VA compensation service and agreed to provide the data. Rep. Ramirez then asked about delays in vendor payments and whether staffing shortages were contributing to the backlog. Mr. Latona said that the payment process is handled outside of the SAH program and that the VA has a 15-day window to pay vendors once invoices are received, but an IPT is investigating delays.

• Rep. Ramirez asked if any staff had been fired over payment issues since January 2020, and Mr. Latona replied that he was unaware of any terminations. She also asked how the VA calculates adaptive vehicle costs. Dr. Scholten explained that driver rehab specialists prescribe modifications based on veterans’ needs, and payments are made based on itemized invoices reviewed by VA prosthetics staff. He mentioned that the payment schedule is publicly available and updated annually based on the Consumer Price Index.

• Chairman Van Orden questioned the claim that the VA pays vendors within 15 days, citing multiple examples of payment delays exceeding 200 to 800 days in cities like Dallas, Phoenix, and Kansas City. Mr. Latona agreed that those timelines were unacceptable. When asked to explain the billing process, Mr. Latona described how completed invoices are emailed from local offices to the VA’s Support Services Division for payment. Chairman Van Orden argued that the delays were due to systemic dysfunction and demanded accountability, saying the issues could be solved quickly with proper oversight.

• The Chairman asked about funding caps for grants. Mr. Latona confirmed that the SAH grant was capped at $121,000, while Dr. Scholten clarified that adaptive vehicle modifications had no cap and were based solely on medical need. When pressed, Mr. Latona stated that the SAH cap was raised from $117,000 to $121,000 last October, based on the cost of construction index. Chairman Van Orden voiced frustration that this index did not reflect real inflationary pressures and requested documentation on who chose the index and how it was implemented.

SUMMARY OF KEY POINTS (PANEL TWO)

• Mr. Tom Landwermeyer claimed that Homes for Our Troops has built and donated 409 specially adapted homes across 45 states for severely injured post-9/11 veterans, with many more in development. He said that his organization uses SAH eligibility as a core criterion and has a strong working relationship with the SAH office, which he described as responsive and helpful. Based on a recent survey of participating veterans, he reported that while many veterans are aware of SAH basics, there is confusion about ongoing usage, inconsistent approval processes across regions, and a general lack of knowledge about the adaptive automobile and adaptive sports programs. Mr. Landwermeyer recommended improved consistency, clearer applications, and better outreach to ensure veterans understand and can access these valuable programs.

• Mr. Mike Owens shared his personal story of injury and recovery through adaptive sports. He highlighted the Wounded Warrior Project’s Soldier Ride program and discussed the transformative impact of adaptive sports on veterans’ mental health, confidence, and social connection. Mr. Owens urged Congress to increase funding for the adaptive sports grant program, improve administrative cost allowances, and formalize adaptive sports coordinator roles at the VA. He also advocated for better equipment access and continued support for veterans pursuing both recreational and elite-level adaptive sports, including changes to allow broader participation in the Department of Defense’s (DOD) Warrior Games.

• Mr. Craig Schrimsher discussed three primary concerns: changes to the adaptive vehicle trade-in policy, delayed VA payments to mobility dealers, and outdated VA price schedules. He explained that a sudden shift from a two-year to a four-year trade-in policy created unexpected costs for veterans, while a recent dealer survey found $11 million in overdue payments, averaging 186 days. Mr. Schrimsher also criticized the use of outdated 2021 pricing data published in 2024, which ignored recent inflation in the automotive sector. He emphasized that beyond policy issues, the lack of empathy and poor communication from the VA were harming veterans.

• Ms. Julie Howell testified that VA adaptive programs are vital for catastrophically disabled veterans, supporting independence, mobility, and mental well-being. She praised recent improvements to the SAH grant but expressed concern about administrative changes making it harder for veterans to navigate. Ms. Howell criticized recent VA rule changes that rendered critical adaptive equipment ineligible for reimbursement and illustrated the financial and legal burden this creates. She underscored the importance of recreational therapists and adaptive sports funding, noting that these services prevent isolation, enhance clinical outcomes, and remain as vital today as they were when first championed by Paralyzed Veterans of America (PVA) decades ago.

• Ranking Member Pappas asked about barriers to veteran participation in adaptive sports. Ms. Howell explained that a major barrier was simply awareness, particularly for veterans not near PVA chapters or spinal cord injury centers where recreational therapists typically make initial connections. She reiterated the need for the VA to improve outreach and engagement with local grant recipients and create stronger networks to share information.

• The Ranking Member then invited the full panel to comment on VA outreach across all adaptive programs. Mr. Owens noted that while San Antonio offers strong VA access, many veterans in rural areas have limited resources and often do not qualify for adaptive equipment despite needing it. Mr. Schrimsher criticized sudden changes to the adaptive vehicle trade-in policy, saying veterans—some in long-standing trade-in cycles—were blindsided due to poor communication. Mr. Landwermeyer said that 70% of the veterans his organization works with are already SAH-eligible, but the remaining 30% often need help navigating the system.

• Ranking Member Pappas asked about recreational therapist staffing, and Ms. Howell expressed concern that these essential providers were not on the VA’s exempt list and should be protected as critical direct care providers.

• Rep. Barrett specifically recognized Ms. Howell for her help on the ASSIST Act. He then asked about industry payment timelines and how VA delays compare. Mr. Schrimsher said that standard private pay occurs at delivery, and while he did not have exact data for insurance payments, he noted that VA payment delays—often over a year—are far outside industry norms. He added that some VA facilities are known for habitual late payments and described wide inconsistency across regions, calling for centralized payment processing to reduce delays.

• Chairman Van Orden criticized the bureaucracy veterans face and expressed personal frustration at the stories shared. He gave Mr. Schrimsher his personal cell number and asked him to share it with a veteran he had mentioned. The Chairman then asked Mr. Owens about the timing and location of the next Soldier Ride event. Mr. Owens said that it would be held in Chicago.

• Chairman Van Orden praised improvements at some VAs but emphasized that consistency across the system was lacking. He asked Ms. Howell to clarify her reference to a 2024 VA policy change, and she said that it related to reimbursement rates for vehicle features that the VA had now listed at $0, effectively denying veterans the benefit. She explained that veterans often win appeals at the Board of Veterans Appeals, which Chairman Van Orden called a “force for good” in this case.

• The Chairman asked about responsiveness from the SAH office. Mr. Landwermeyer replied that they were generally responsive and held regular calls to share feedback.

• Chairman Van Orden then presented specific examples of outdated reimbursement rates for vehicle modifications and announced, in real-time, bipartisan legislation correcting this that he and Ranking Member Pappas had agreed to pursue.

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