VADM Jim Zimble—Thank you for that kind introduction. I’m honored to be here today. Let me just acknowledge up front:
Since 1968, the National Association for Uniformed Services has been a strong and consistent voice, here, in Washington for Servicemembers, Veterans, and their families. Over the years, we have worked together to serve Veterans. Our collaboration has never been better, thanks to the leadership of your president, Bill Matz. It takes hard work on both of our parts to address the challenges facing Veterans, especially during this period of extended economic difficulty.
Many see VA as a large healthcare provider, and for the most part, that is true—the largest integrated healthcare system in this country with 152 medical centers affiliated with 107 of the best medical schools in the Nation, 784 Community-Based Outpatient Clinics, 271 Vet Centers, and a number of outreach and mobile clinics, which we roll into highly rural places where Veterans choose to live.
But, here’s what’s also true:
In FY 2009, we implemented the new Post-9/11 GI Bill—the largest student aid package of its kind since the original GI Bill of 1944. To date, over 384,000 Veterans and family members have enrolled in college under the new GI Bill. When you include VA’s other education programs, that number jumps to over 660,000. We need their ingenuity, their leadership, their operational experience, their toughness, their discipline, and their dreams—in American business and government today. But as I tell them, unless they graduate, there is no payoff for them, this program, or the American people. This is Dad speaking—I’ll keep sending the tuition checks, but I’ll also be checking graduation rates.
There will always be unfinished work—that’s the nature of the mission. As some of you may know, we have two children of civil war Veterans still on our beneficiary rolls. We have 151 Spanish-American War beneficiaries we are still caring for. President Abraham Lincoln’s promises are being fulfilled by President Barrack Obama. Likewise, President Obama’s obligations will be continue to be fulfilled by some Secretary of Veterans Affairs a century from now.
So, we have established clear priorities, fought for and gained the President’s support for increased funding, and we are addressing those priorities. Let me provide some specifics about where we’ve come over for the past 22 months and where we are headed in the next 24:
To deliver all this, VA must, without hesitation, be an advocate for Veterans. We need to make permanent the gains of the past 21 months. Given the economic challenges facing the government and the Nation, VA’s $25 billion increase, over these two years, underscores the President’s commitment, and the Congress’ support, for transforming VA and fixing persistent problems that have plagued the department for decades. The department needs a sense of urgency that matches the President’s commitment—and we are developing that.
These fixes require setting clear priorities, challenging the VA workforce to get more and better results out of the funding we’ve been provided, and generating new business processes to track the money and ensure it produces the greatest gains for Veterans.
We have worked two issues hard—Agent Orange and Gulf War illness. A little over a year ago, I accepted the Institute of Medicine’s 2008 Agent Orange update, and based on the requirements of the law and the IOM’s findings, I decided that the evidence was sufficient to award presumptions of service connection to three new diseases—Parkinson’s disease, hairy-cell and other chronic b-cell leukemias, and ischemic heart disease—bringing the total number of Agent Orange presumptions to 15.
The President fully supported these presumptions and the Congress has appropriated $13.4 billion to begin making benefits payments to the 250,000 or so Veterans who are expected to submit Agent Orange claims in the next 12-18 months. It was the right decision, and the President and I are proud to finally provide this group of Veterans the care and benefits they have long deserved. Automated payments began this week.
In the same vein, in March of this year, we provided presumption of service connection for nine new diseases associated with service in the Gulf during Operation Desert Storm. While we must continue to research what might have caused these illnesses, our primary mission is to address Veterans’ suffering by diagnosing and treating the symptoms of the ailments.
Likewise, in July, we simplified claims processing for Veterans suffering from PTSD, or post-traumatic stress disorder. This decision ends decades of focusing on documenting a stressor event, and streamlines the delivery of medical care and benefits to Veterans suffering verifiable PTSD resulting from combat. This is a generational issue—not just Iraq and Afghanistan—and we aim to get it right.
We provided $4.5 billion for mental health programs and hired another 1,000 mental health professionals in 2009. This year, we are spending an additional $379 million on mental health and our mental health staff now totals over 20,000.
Our priority here is to diagnose, treat, and cure—and if cure is not possible—diagnose, treat, and care must be the standard. We are not going to allow our Veterans, who have carried the responsibilities of our national security squarely on their shoulders, to languish for the rest of their lives without hope.
For traumatic brain injury, or TBI, we’ve fielded a new disability rating system to greatly improve how claims are evaluated. And we’ve made enormous advances in treating those Veterans with the most serious head injuries—those who arrive at our polytrauma centers comatose, with injuries that, only a few years ago, were thought to be irreversible and hopeless.
USA Today recently reported on some of our successes, chronicling the breakthroughs in VA’s four “emerging consciousness” centers in Tampa, Minneapolis, Richmond, and Palo Alto. Through innovative care, a tripling of their professional staffs over the past six years, from 78 to 255, increased resourcing, and engaging families as co-providers in treating their loved ones, VA facilities have brought nearly 70% of these comatose patients back to consciousness. This is a rate that far exceeds the national norm according to the highly respected Kessler Institute for Rehabilitation in New Jersey. At VA, we don’t accept hopelessness—not among the injured, not among the ill, and not among the homeless.
In 2011, we are focusing on three critical priorities:
Let me touch on each of them:
Access: First, VA must do much better at reaching out to all Veterans to ensure they are aware of our programs and their entitlements based on service-connection and need. Access includes that system of healthcare delivery I described earlier—152 hospitals, 784 outpatient clinics, 271 Vet Centers, and mobile clinics on wheels. But access also includes telehealth technologies to deliver quality healthcare uniformly across the Nation, extending our reach into the most remote rural areas and even into Veterans homes, where life-saving monitoring is ongoing today for roughly 40,000 chronically ill Veterans. In 2010, we invested $121 million in telehealth technologies. In 2011, those investments go up to $163 million. We see this as the next major breakthrough in high-quality and safe healthcare delivery in this country, and we intend to invest heavily in it.
Benefits: in 2009, we completed 975,000 Veterans claims and took in—for the first time—over one million new claims. Disability claims have more than doubled since 2000 [up 106%, from 578,773 in 2000 to 1,192,346 in 2010]. We now average over 99,000 new disability claims each month.
We’ve launched an aggressive campaign to attack the claims backlog problem on multiple fronts, and we have set an ambitious objective: no claim over 125 days in processing and a 98-percent accuracy rate—not just faster, but also better and more accurate decisions.
In the past two years, VBA, our Veterans Benefits Administration, expanded its workforce by over 4,500 people, began accepting on-line applications for initial disability benefits, initiated an innovation competition, launched over 40 pilot programs and initiatives to identify best practices, and invested over $138 million in a paperless Veterans benefits management system that will be deployed in fiscal year 2012.
We must automate quickly and well. Today, we have 15,000 people authorized to adjudicate claims—the 82nd Airborne Division without parachutes. And to go faster, hire more people. That cannot be our solution as the number of incoming claims increases geometrically each year.
A week ago today, last Saturday, VBA began processing claims associated with our Agent Orange presumption decisions of October 2009, using a new “fast track” system that automates this claims process. We must do the same for the rest of VBA.
To enable VBA to meet its aggressive targets, the President’s 2011 budget request provides $2.1 billion in discretionary funding, an increase of $460 million, or 27%, over the 2010 level. The budget also includes $145.3 million in information technology funds to support the ongoing development of a smart, paperless claims processing system. We intend to break the back of the backlog this year.
Homelessness: Roughly 643,000 Americans remain homeless on any given night. Nearly one in six of America’s homeless is a Veteran—107,000 of them. The President has stated that no Veteran should be living on the streets of this rich and powerful nation. If you wonder what I will be working on for the next several years, this is it. We will end Veteran homelessness by 2015.
National Cemetery Administration: In FY 2010, NCA performed over 111,000 interments of Veterans and eligible family members, up from 106,000 in FY 2009. This June, we began offering bronze medallions, signifying Veteran status, for attachment to personal headstones or markers in private cemeteries.
VA expanded its burial policy, resulting in a plan to develop new state and national cemeteries. Ten grants, totaling $40 million, were awarded to fund five new state Veteran cemeteries, and VA opened five new national cemeteries for a total construction cost of over $89 million.
The President’s proposed 2011 budget request seeks $251 million for cemetery maintenance and operations to support an estimated 114,000 interments next year—a 3.8% increase over 2010. We are providing final resting places for the heroes of our Nation, and we want those cemeteries to represent the national shrines those heroes deserve.
So, what is the point of my detailing for you these programs and initiatives? Because every dollar in additional resources, every step forward toward improving care, increasing access, eliminating the backlog, and ending homelessness has been a fight for resources. We have succeeded with your help and support. We have also succeeded because the President has thrown his weight behind caring for Veterans and their survivors. It has had a profound effect on my negotiations in the budget process.
On 1 October 2009, 13 months ago, a roadside bomb, on the outskirts of Kandahar, Afghanistan, targeted a patrol of nine Army Rangers out of 1st Batt. Ranger SSG Cory Remsburg was blown into a nearby canal, the right side of his head shattered and caved in. Other members of his patrol were killed or severely wounded.
Following medevac, six surgeries at military hospitals in Afghanistan, Germany, and at Bethesda, Maryland, Ranger Remsburg was sent to the Tampa VA Medical Center last November. He was fully comatose—in a state doctors described as vegetative. The odds for recovery—any recovery—were slim.
But Cory, his family, VA therapists, doctors and nurses never gave up. They rallied to his side, working and massaging his limbs, keeping his body limber, using a wide variety of medications, aromas, television—anything which might stimulate his senses, everything they could think of to bring him to consciousness.
For long days, weeks, months—nothing. But three months after his injury, doctors recognized that he had awakened—Cory Remsburg had regained consciousness. Through sheer determination on his part, mirrored by the unwavering efforts of those who love and care for him, his progress has been agonizingly slow but miraculously steady. He communicated first with a computer keyboard, but has now, slowly, regained his ability to speak. He is one of VA’s 70 percenters—one of those, who was comatose with severe, traumatic brain injury, that VA’s doctors and therapists, along with the love of his family and Cory’s own fighting spirit, brought back from the darkness. In June, he returned for a visit to Hunter Army Airfield in Savannah, Georgia—home of the 1st Ranger Battalion—to shake hands with his Ranger buddies.
As President Obama recounted in a recent speech, Cory is just what we’d expect of a Ranger staff sergeant. When someone at the VA hospital told him, “Cory, some day you’re going to walk out of here,” he replied, “No. I’m going to run out of here.”
Staff Sergeant Cory Remsburg embodies the fighting spirit that has made our Nation great. “Rangers lead the way” is the slogan of the Rangers. And whatever service you come from, I think all Veterans can relate to the importance of these words from the Soldier’s Creed:
Staff Sergeant Cory Remsburg’s life—from his 10 deployments since 9-11, to his rescue by other Rangers, to his fight for life—epitomize that creed. He will not give up—period. And VA will not give up on him, or on any other Veteran who needs us and the care and benefits promised by President Lincoln in 1865. That promise defines my mission. It is the purpose of the funding update I just gave you. And it is the mission of VA’s 300,000 employees. We will always look to the members of the National Association for Uniformed Services for assistance, advice, and advocacy to fulfill it.
May God bless our Veterans, our men and women in harm’s way, and the United States of America. Thank you.