Good morning. I am honored to be here, just as I was honored to join you at the National Wheelchair Games in Spokane last summer. For thirty years, Veterans have been overcoming their fears and limitations to compete at this event. VA is proud to partner with you in the Wheelchair Games.
We are particularly proud that Sean Halsted, a member of the U.S. Paralympics team, who will be competing in Vancouver next week, got his start in adaptive sports at the Wheelchair Games in San Juan, Puerto Rico, just over a decade ago. He’ll be competing for the U.S. as a member of our Nordic ski team. I’ll be there with the U.S. delegation, so I look forward to cheering him on.
I appreciate this opportunity to update you on VA’s accomplishments this past year. A lot has happened, a lot more is in motion since I first addressed this mid-winter conference a year ago—and more, clearly, remains to be done.
I mentioned then that we were crafting a first-ever 2010 budget and a 2011 advance appropriations request—something we needed to get right as a model for the future. Thanks to your legislative initiatives, we were given this unique opportunity to build a two-year budget—how many other departments get to do this? I mentioned that we were also implementing the new Post-9/11 G.I. Bill, working to increase Veterans’ access, reducing the claims backlog, and ending Veterans’ homelessness. These initiatives were enabled by President Obama’s charge to me to transform VA into a 21st century organization. Well, 2009 was a good first year.
Let me begin with resources. In both 2008 and 2009, as you will recall, our budgets had been congressionally enhanced, so we wanted to build on them and properly array 2010 and 2011 funding for the long term.
And as I have already mentioned, advance appropriations were part of your legislative initiative and ours, as well, to provide more stable funding for VA—and it has. As you now know, that work paid off. The President fully supported our budget request in 2010, by providing us with a 16.7% budget increase above the 2009 congressionally enhanced budget.
That means that VA is executing a budget of $114 billion in 2010, and has requested a 2011 budget of $125 billion—$60.3 billion in discretionary resources and $64.7 billion in mandatory funding. Our discretionary budget request for 2011 is an increase of 7.6%.These plus-ups amount to a two-year, discretionary funding increase of almost 20% above the 2009 budget. President Obama’s support for Veterans is clear and unwavering.
These two budgets, 2010 and 2011, enable us to begin addressing our three key priorities: increase Veteran access, reduce the backlog, and end Veterans’ homelessness in the next five years.
Now, I didn’t get as much done on reducing the backlog in 2009, as I had hoped, primarily because implementing the Post-9/11 G.I. Bill was an important, no-fail priority. From a standing start last August, we finished the fall semester with 173,000 Veterans in school at 6,500 colleges and universities across the U.S., being paid by VA.
As most know, we got off to a rocky start, lacking any automated tools to expedite processing, but we learned as we went and put in place the necessary adjustments for this spring semester.
As a result, on 1 February 2010, checks began flowing to 170,000 veterans of the 180,000 Veterans enrolled in school at that point, and the remaining 10,000 Veterans received their payments shortly thereafter. Because we are able to process roughly 7,000 enrollment certificates a day, we are able to control this gap. We are on a good glide path with the Post-9/11 G.I. Bill—and we expect to be fully automated by the end of this year.
It’s important to remember—the 180,000 students, who are in school under the Post-9/11 G.I. Bill, are only part of the 565,000 Veterans being educated across our several education programs. This is a tremendous opportunity for Veterans and an even greater investment in the future of our country.
Access: we are expanding access to VA care and services through the activations of new or improved facilities, by expanding eligibility to more Priority Group 8 Veterans, by making greater investments in telehealth, and by opening new cemeteries. The VHA handbook on spinal cord injuries and disorders is being revised at this time, and the linkage between care in a CBOC and the spinal cord injury hub-and-spoke system is being addressed.
Taking a broader view, this time last year, we had 768 CBOC’s—Community-Based Outpatient Clinics; 232 Vetcenters, 50 mobile Vetcenters and 7 mobile outpatient clinics; and 128 national cemeteries. In the past 12 months, we have opened 20 new CBOC’s, 36 additional Vetcenters, purchased 2 more mobile outpatient clinics, and opened 3 new cemeteries. And we’re not done yet—between now and the end of FY 2010, we expect to add over 70 more CBOC’s and 31 more Vetcenters.
Additionally, over the past year, 40,000 chronically ill Veterans who qualify for remote monitoring have been provided telehealth connectivity so that they don’t have to travel to our hospitals or clinics to have their conditions checked. Through the power of technology, they can be monitored in their own homes from a distant station—better monitoring 24 hours a day without exposure to the risks one encounters in hospital emergency rooms. This is part of what we mean about increasing access to VA care and services.
In FY09, over $3 million was used to purchase telehealth equipment for the care of SCI/D Veterans. This year, we are ironing out details to fully implement this program. We are investing $121 million in teleheath in FY 2010 to move VA to the head of the line in 21st century health care delivery. We will enhance access to medical specialists for conditions related to spinal cord injuries for Veterans residing in rural areas or for those who find travel very difficult.
Homelessness: In January 2009, we estimated that 131,000 Veterans were sleeping on the streets of this powerful and wealthy country—substantially fewer are homeless today. I have pledged that we are going to end Veteran homelessness over the next five years.
Our current estimate for 2010 is that 107,000 Veterans remain homeless— an 18% decrease from last year. While that is a good start, we need a full-court press to keep driving those numbers down. It’s not merely about providing beds for 131,000 homeless Veterans. It’s also about treating them for PTSD, TBI, depression, substance abuse, suicide ideation—and about education and jobs, and the dignity of being thought capable of caring for one’s self. So that’s where we’re headed in ending Veteran homelessness, and we welcome your collaboration and support in eliminating it.
The backlog: As I mentioned, this is one area in which we did not progress as I would have wanted. Getting the new Post-9/11 G.I. Bill education program up and functioning caused some distraction, but not enough to use as an excuse. That’s not to say that we did not work claims hard—last year we completed 974,000 claims, but then received nearly 1 million new ones in return. Some see that as a problem. I don’t. I see outreach to Veterans working. As I’ve mentioned before, there are 23 million Veterans in this country. Only 8.1 million of them are enrolled in VA for health care. We will continue to outreach to Veterans wherever they live.
2010 is my year to focus on the backlog—as I did on the Post-9/11 Bill last year— to find and break longstanding obstacles to faster and better processing, and higher quality outcomes. As a first step, over the past year, we put four pilots into motion: Pittsburgh, where we are designing how to build the best claim possible for each Veteran. Here the claim is our claim, and the Veteran is our client. Like building a legal brief, how do we make each claim the best and strongest argument to win the case for the Veteran? Advocacy is the bottom line.
Pilot #2 is in Little Rock, Arkansas. Business process re-engineering— when that “best possible claim” arrives for adjudication, who touches it first, how many others have to touch it, and what are the organizational and spatial relationships that make this a most efficient process?
Pilot #3, Providence, Rhode Island. What automated tools are needed to increase speed, accuracy, efficiency, and security? The goals are no lost claims, and highest accuracy in claims processing. We didn’t want to automate bad processes and just get lousy decisions faster, so we broke the complex, convoluted claims process down into its component pieces to improve each part before putting them back together again.
And finally, Pilot #4 pulls together all these efforts to create the virtual regional office of the future. We’re conducting this pilot in cooperation with the Social Security Administration in Baltimore. Our intent is to replace the systems in use at our 57 existing RO’s and eliminate the entire claims backlog by 2015.
Why 2015? Why so long, if you are working this as a priority? Because in October of last year, we made a decision that affects Vietnam Veterans, who have been dealing with the toxic effects of Agent Orange for the past 40 years. It was the right decision. Logically, the overall number of claims is expected to grow, as will the backlog and processing times due to these new Agent Orange claims. But with these four pilots and the 27% increase we have provided to VBA’s budget in 2011, I expect that over the next several years, we will shape and control that growth in claims—so that by 2015, we will be well on our way to eliminating the backlog.
Our long-term solution to claims processing is to operationalize the concept of “seamless transition” between DoD and VA as military service members step out of their uniforms and enroll with VA. “Seamless transition” is our joint DoD-VA concept of universal registration, where service members’ personnel and medical records are duplicated in VA, even as those electronic service records are being populated, while they still serve in uniform. That way, there is no air gap in the transfer of those records when the uniforms come off at the end of their military service.
To enable this kind of seamlessness, a new information system called V-LER, the Virtual Lifetime Electronic Record, is being developed by both VA and DoD. President Obama mandated the development of V-LER last April, as the future transformational record for all service members and Veterans. When fielded, V-LER will track each member of our military forces—active and reserve component—from the day they first put on the uniform until the day they are laid to rest. This will transform our benefits administration—faster processing, better decisions, fewer errors, no lost records.
We must and will transform VA into the high-performing, well-disciplined, transparent, and accountable organization we know it’s capable of being. 300,000 good people come to work everyday to serve Veterans. We must focus all of their efforts on providing Veterans the highest quality and safety in benefits and services.
The reason for this transformational focus at VA is, in part, to harmonize two very distinct images of the men and women who have worn our Nation’s military uniforms—two incongruent images, I might add, which are troubling.
The first image is this—and it is one most familiar to everyone in this audience. Each year, something around 60% of high-school graduates go on to colleges, universities, community colleges—some version of higher education. Of the remaining 40% or so, some undergo vocational training, and some immediately enter the workforce. Fewer others, still, join the less than 1% of Americans who volunteer to serve in our Nation’s Armed Forces. Most young people today have no memory of a draft Army.
After enlisting, they undergo weeks of rigorous physical training and mental preparation for a disciplined life of values, standards, and accountability. Following graduation from basic training, they join a wide variety of units—platoons, ships, squadrons, and detachments.
These young men and women come from every racial, ethnic, religious, and socio-economic background in the country, representing every geographic region of it, as well. When they reach their first units, they quickly become valued and trusted members of high-performing teams—maybe the highest performing teams they will ever be a part of in their lives—tough, motivated, extremely dedicated. With excellent leadership, they go forward, each and every day, to perform the complex, the difficult, and the dangerous missions. On some days, they are asked to do the impossible.
Think of what they’ve been asked to do, and what they’ve accomplished, with unwavering commitment and without complaint, these last eight years in Iraq and Afghanistan. They are, as a group, simply outstanding young people who routinely make the impossible possible. This is not the story of every Soldier, Sailor, Airman, Marine, and Coastguardsman, but it is their collective legacy. It is their narrative of success.
But there is a second image—Veterans suffer disproportionately from homelessness, depression, substance abuse, and suicides, and they are well up there in joblessness, as well. 107,000 of them sleep on the streets of our Nation today. Another 40,000 Veterans are released from prison each year.
What’s wrong with these disparate images? To be sure, there are fewer in the second image than the first, but the same youngsters populate image #1 and image #2. What happened? What did we do or fail to do? Why couldn’t we continue the successes so many of our Veterans achieved while in service? How do we keep them from entering that downward spiral of joblessness, depression, and substance abuse that often leads to homelessness and, sometimes, to suicide? It’s not about them; it’s about us.
At VA, our goal is to never allow those in image #1 to become part of image #2, and to return those in image #2 to lives as productive as possible. Our five-year plan is aggressive—but achievable. Can we do it alone? No—we need your help.
You have a proud history of championing the well-being of men and women, who have selflessly served our Nation in uniform. For over 60 years now, PVA’s advocacy for Veterans with spinal cord dysfunction has brought focus to our VA programs and made tremendous differences in their lives. Your support of our research initiatives into new methods of SCI care and rehabilitation and your site-visits to our SCI hub and spoke facilities provide invaluable perspective and feedback on our important work together. PVA vocational rehab offices at our medical centers continue to provide paralyzed veterans with both hope and help in finding good jobs in this tough economy.
Our comprehensive programs for SCI patients are unparalleled in the world, as are our prosthetics and grant programs. We are also paying close attention to the construction needs for SCI veterans. Several projects currently underway will improve existing SCI centers and create new ones for the delivery of care to Veterans with acute, as well as, long-term care needs.
Thank you for what you do for Veterans. Thank you for the opportunity to speak with you this morning, and I look forward to continuing our work together.
God bless our men and women in uniform. God bless our Veterans, and may God continue to bless this wonderful country of ours.