Remarks by Secretary Eric K. Shinseki
VFW Annual Convention
July 24, 2012
Senior Vice Commander-In-Chief [John] Hamilton, thank you for that kind introduction, and congratulations on your election as the next Commander-in-Chief. I look forward to working with you on making things better for Veterans.
Commander-in-Chief [Richard] DeNoyer, thank you for your many years of devotion to Veterans, and for your significant leadership of the VFW this past year. Godspeed to you and your family as you turn over leadership to John.
Let me also acknowledge National Adjutant "Gunner" Kent, National Executive Director Bob Wallace, National Service Director Bill Bradshaw, and other members of your leadership.
To Gwen Rankin, President of your VFW National Ladies Auxiliary, let me offer my thanks for the unwavering support the Auxiliary has provided to Veterans and their families for 100 years now. Congratulations to you and your members—past and present—on reaching such a distinguished milestone of service on behalf of America's Veterans!
Other members of the VFW, fellow Veterans, VA colleagues, distinguished guests, ladies and gentlemen:
I am greatly honored to be addressing an organization that has been, for well over a century now, a powerfully important voice for Veterans' rights in the halls of Congress, in the Oval Office, and across the country. Bob Wallace has been your diligent representative and our reliable partner in doing what's needed.
I am especially honored to be following President Obama, who addressed you yesterday, to thank you and your families for your patriotism and service to the Nation. The President's commitment to Veterans was clear from our first meeting. It is genuine, it runs deep, and it is unwavering. His vision to transform VA resonated with me when we first met in November of 2008. His initiatives to provide Veterans and families better transitions from the military; better healthcare—especially mental health; faster and more accurate processing of compensation claims; better educational opportunities, jobs counseling, employment opportunities—that's why I am proud to be here today to report to you on the state of your VA.
Let me review how things looked three and a half years ago, what changes we have put into motion since, and where we are headed in the future.
Three and a half years ago, the country was heavily engaged in two operations—the first major war of the 21st century being fought by a smaller, all-volunteer force. Repeated deployments of that force have created issues that don't show up until later deployments. It takes a superb, disciplined fighting force to handle this kind of strain. The men and women who wear our Nation's uniforms today are magnificent. More of them are surviving catastrophic injuries because of improved body armor, better combat lifesaving skills, and rapid medical evacuation from battle zone to state-side hospitals.
But higher battlefield survival rates also mean more complex casualties—the compounding effects of post-traumatic stress disorder (PTSD), traumatic brain injury (TBI), and multiple amputations—five quadruple amputees from this war—with complications of blindness and deafness and genitourinary injuries. We had to create a word for this—polytrauma—and we have since built five polytrauma centers of excellence, the best in the world, and an entire system of polytrauma care to treat these patients and enable them to go home.
Three and a half years ago, we were also still grappling with unresolved issues from two past wars—the Gulf War, over 20 years ago, and the Vietnam War, nearly 50 years ago now. We didn't take care of business back then, when we should have, and some Veterans were dying without benefits.
Three and a half years ago, 107,000 Veterans were estimated to be homeless in this rich and powerful country. The President has said, "[We won't] be satisfied until every Veteran who has fought for America has a home in America." But this rich and powerful country had suffered an economic downturn the likes of which we had not seen since the Great Depression—certainly, not in my lifetime. In spite of a collapsing economy, the President was determined not to let Veterans homelessness spiral out of control.
In 2009, there were over 23 million living Veterans in this country, but only 7.4 million of them were enrolled in VA healthcare and only 3 million were receiving compensation and pension benefits from VA. With less than a third of the Veteran population enrolled in VA, we had an outreach problem: Many didn't know about VA or their possible benefits. We had an access problem: Even if they knew about us, they had difficulty getting the services they needed. And we had, even then, a backlog in disability claims, one which had been there for decades.
Well, that was the landscape in 2009, and we needed to put things into motion. We immediately focused on three key priorities that came out of my talks with a variety of stakeholders. Bob Wallace and I, and the executive directors of the five other major VSO's, still meet near monthly today. Those priorities are unchanged:
- Increase Veteran access to VA benefits and services—one-third market penetration is not good enough;
- Eliminate the backlog in disability claims in 2015;
- And end Veterans homelessness in 2015.
Folks tighten up whenever you tag dates to goals, meaning the sense of urgency is probably about right.
The first order of business was to establish closer, more collaborative working relationships with DoD. As I often remind folks, very little of what we do in VA originates in VA—most originates in DoD. It takes both departments to create a seamless transition for separating Servicemembers to return home "career ready" to live, work, raise children, and contribute to restoring the strength of our economy.
The Secretaries of Defense—Bob Gates and Leon Panetta—and I have personally met nine times in the past 17 months. Leon Panetta is a dedicated public servant, who has been insightful, decisive, and a good friend to me and to Veterans, as is Bob Gates. Tomorrow, Secretary Panetta and I will testify together before a joint hearing of the house Armed Services and Veterans Affairs Committees—perhaps for the first time.
Our second priority was to fix VA's budget process. You can't create change without resources, and money is firepower. For the past three and a half years, VA has presented compelling arguments for strengthening VA's budget, and the President has been stalwart in his support.
In 2009, VA inherited a budget totaling $99.8 billion—a good budget, not spectacular, but a good one. In 2010, the President increased our budget to $127.2 billion—a near 30 percent increase in a single year. The President's 2013 budget request, currently before the Congress, is for $140.3 billion—a 40 percent increase since 2009.
During this period of economic downturn, few private-sector businesses and federal departments have sustained this kind of budget growth. In a discussion about values, I was once lectured, "Show me your budget, and I'll tell you what you value." Now, by that standard, there is no question where the President stands. He gets it—he understands our obligation to Veterans. He's provided VA the budgets that allow for meaningful change.
So, what have we put into motion these past three and a half years? First, we took care of some long overdue business:
- For you Vietnam Veterans, we granted presumption of service connection for three new Agent-Orange–related conditions: Parkinson's disease, hairy cell and other chronic b-cell leukemias, and ischemic heart disease.
- For you Gulf War Veterans, we granted presumption of service connection for nine diseases associated with Gulf War illness for Veterans of Desert Storm and Afghanistan. While we must continue to research what might have caused this illness, our responsibility is to diagnose and treat symptoms of these verifiable diseases.
- And for all combat Veterans with verifiable PTSD—World War II, Korea, Dominican Republic, Vietnam, Grenada, Panama, Somalia, Operation Desert Storm, Iraq, Afghanistan, and others—we granted the presumption of service connection.
These three decisions alone have dramatically expanded access to VA medical care for hundreds of thousands of Veterans. In addition, we have mounted an aggressive outreach campaign to educate Servicemembers and Veterans about VA's capabilities and their benefits. Since January 2009, enrollment in VA healthcare is up by nearly 800,000—a 10 percent increase. That's great news—we are expanding access.
And in expanding outreach and increasing access to VA healthcare, we also, understandably, increased the number of compensation claims—also good news. Veterans who previously had no access are now enrolling and submitting claims.
Three and a half years ago, the total claims inventory was roughly 400,000. Today, it's approximately 880,000. The backlog—the number of claims older than 125 days—was about 135,000 in 2009 and is roughly 580,000 today. Growth in these numbers—total and backlogged claims—is what happens when we increase access. But it was the right thing to do—for Vietnam Veterans, for Gulf War Veterans, and for combat Veterans of all wars.
One last snapshot of the claims backlog. In 2009, we completed 900,000 claims decisions—but took in one million claims in return. In 2010, we completed, for the first time, one million claims decisions—and took in 1.2 million claims. In 2011, we again produced a million claims decisions, but took in 1.3 million claims in return. Now look, if the total number of claims in our inventory today is 880,000 and we generated nearly three million claims decisions over the past three years, you know that today's inventory and backlog are not the same claims that were there three years ago, two years ago—not even a year ago. Now, there are sure to be a handful of exceptionally complex cases, but the process is dynamic.
It's also a big numbers process, and we do most all of it on paper. Paper is what we receive from DoD. With the planned draw-down of up to a million troops over the next five years, the number of new claims will continue to grow. It will take both departments for VA to go paperless. Hence, my close working relationship with Secretary Panetta—he and I are pulling our departments into the future.
You heard the President yesterday—solve the backlog! We are working hard and smart to solve this correctly. We already have a new automation tool called VBMS—the Veterans Benefits Management System—being piloted at two regional offices for over a year now. We'll have it up and running at 16 regional offices by the end of this year, and at all 56 regional offices by the end of 2013. We are also re-directing 1,200 of our most senior claims adjudicators—37 percent of our experienced staff—to the backlog, which ballooned while I asked them to focus on the 250,000 Agent Orange claims they just completed.
I have committed to ending the claims backlog in 2015, by putting in place a system that processes all claims within 125 days at a 98 percent accuracy level. With the President's strong support, we have the resources we need, and we are on track to do it.
To further increase access, we have added 57 new community-based outpatient clinics, 20 more mobile health clinics, and our fifth polytrauma center, opened in San Antonio last year. We have four new hospitals under construction—in Denver, Orlando, Las Vegas, and New Orleans. We will open Las Vegas on 6 August—the first new VA hospital opened in 17 years—and provide Veterans and Servicemembers stationed nearby the state of the art facility they need and deserve. As the President said yesterday, we keep our promises.
We have also invested heavily in new telehealth-telemedicine technologies to overcome the tyranny of distance and extend our reach into the most remote rural areas where Veterans live. Enhanced IT technologies are also making it easier for Veterans to make appointments, access their medical records, and find out about available benefits and services.
We have placed full-time women Veterans' program managers at 144 medical centers to advocate for women Veterans, and named women Veterans coordinators at all 56 regional offices to assist women with their claims. Since 2009, we've opened 19 clinics designed specifically to serve women, and provided training in women's health to more than 1,200 healthcare providers.
We've also increased access to our national cemeteries, opening three new national cemeteries and 14 new state cemeteries. Additionally, five more national cemeteries are planned, as well as five columbaria-only cemeteries in urban areas, and eight burial grounds in rural areas, owned and managed by VA but collocated with non-VA cemeteries. As some of you know, for the past 10 years, NCA has been the top-rated public or private customer service organization in the country, according to the University of Michigan's American Customer Satisfaction Index—outperforming Google, Lexus, Apple, all the others—not a surprise when nearly three-quarters of NCA employees are Veterans.
In 2009, I told you that Veterans lead the Nation in homelessness, depression, substance abuse, suicides, and they rank right up there in joblessness, as well. As I mentioned earlier, 107,000 Veterans were estimated to be homeless in 2009. By January 2011, that estimate was down to 67,500. We believe that when the Department of Housing and Urban Development announces its 2012 estimate before the end of the year, that the estimated number of homeless Veterans will be below 60,000, keeping us on track to break 35,000 in 2013 and moving to end the rescue phase of Veterans' homelessness in 2015.
The prevention phase of defeating Veterans homelessness is ongoing and requires VA to focus all our capabilities to keep an invisible "at risk" population of Veterans and families from slipping into that downward spiral that ends up in homelessness. We have over 900,000 Veterans and eligible family members in training and education today—universities, colleges, community colleges, tech schools, and in the trades. Part of our prevention mission is to see them all graduate. Every one who flunks out in this economy is at high risk of homelessness. So my one-word speech to any student Veteran audience is "Graduate!" If I sound like your dad, I am. I'm paying most of your bills. So, graduate!
In 2005, at the height of operations in Iraq, we had 13,000 mental health professionals handling the healthcare needs of our Veterans. Today, we have over 20,000. We recently announced that we are hiring another 1,600 to increase our ability to address the growth in mental health requirements spawned by a decade of repetitive deployments.
We know that when we diagnose and treat, people usually get better, and the long-term trends of our treatment efforts are good. Among the 8.6 million Veterans enrolled in VA healthcare, the number receiving mental health treatment is up. At the same time, for Veterans who receive treatment, our suicide rates are down—an indication that treatment, including evidence-based therapies, works.
However, too many Veterans still leave the military with mental health issues we never find out about—because the issues weren't noted in their DoD records or because Veterans never enrolled in VA's healthcare system. Most Veterans who commit suicide—perhaps as many as two out of three—were never enrolled in VA. As good as we think our programs are, we can't help those we don't treat—another reason two secretaries meet regularly, and another reason increasing access is so important.
One of our most successful outreach efforts is our Veterans Crisis Line. DoD knows it as the Military Crisis Line—same number, same trained VA mental health professionals answering the phone, no cost to DoD. Since start-up in 2007, over 640,000 people have called in, including over 8,000 active-duty service members. We've made over 99,000 referrals for care and rescued over 23,000 from potential suicide. Some younger Veterans are more comfortable with chatting and texting, so in 2009 we added an on-line chat service and in 2011 a texting service.
We have worked to ensure greater collaboration between VA and DoD, especially in that critical phase before Servicemembers leave the military. We simply must transition them better. We do this best with warm handoffs between the departments—that is key to preventing the downward spiral that often leads to homelessness and sometimes to suicide. Last year we completed expansion of our joint DoD/VA Integrated Disability Evaluation System (IDES) from the original 27 sites to 139 sites—a major improvement towards a seamless transition to Veteran status. But there's still more VA and DoD can do together.
Secretary Gates and I worked these initiatives hard, and Secretary Panetta and I have worked them even harder. We are both committed to a fully operational integrated electronic health record (IEHR) by 2017.
Good jobs are essential for Veterans, and we are proud to have partnered with the First Lady's Joining Forces initiative and the U.S. Chamber of Commerce's Hiring Our Heroes campaign. The President, the First Lady, Dr. Biden have provided strong leadership in increasing employment opportunities for Veterans and spouses of military members. The President challenged private companies to hire or train 100,000 Veterans and spouses by the end of 2013. They have already received commitments from 2,100 companies for 175,000 hires—and 90,000 Veterans and spouses have already been hired.
VA has also joined private companies and other departments, like Defense, Homeland Security, and Transportation, in efforts to hire Veterans and assist others in hiring them.
In January, our hiring fair in Washington, DC, attracted over 4,100 Veterans, resulted in over 2,600 on-the-spot interviews, and more than 500 job offers on one day. We followed that success with an even bigger hiring fair last month in Detroit—in conjunction with our national Veterans small-business exposition. Over 8,000 Veterans participated, more than 5,700 were interviewed, and over 1,200 received job offers on the spot.
Simultaneously, 3,500 people participated in the Veteran small-business training exposition—it was our opportunity to bring Veteran small business owners into direct contact with our acquisition decision makers so they could better understand our procurement requirements, demonstrate their capabilities, and improve their ability to prepare competitive proposals for government contracts. It also increased the opportunity to hire unemployed Veterans—because Veterans hire Veterans.
So, where are we headed? I intend to be here to update you again next summer, and here's what I intend to report:
- We will have increased spinal chord injury funding by 28 percent between 2009-2013. By 2014, that increase will likely be 36 percent.
- We will have increased TBI funding by 38 percent between 2009-2013. By 2014, that increase will likely be 51 percent.
- We will have increased mental health funding by 39 percent between 2009-2013. By 2014, that increase will likely be 45 percent.
- We will have increased long-term care funding by 39 percent between 2009-2013. By 2014, that increase will likely be 50 percent.
- We will have increased prosthetics funding by 58 percent between 2009-2013. By 2014, that increase will likely be 75 percent.
- We will have increased women Veterans funding by 123 percent between 2009-2013. By 2014, that increase will likely be 158 percent.
- We will have increased OEF/OIF/OND funding by 124 percent between 2009-2013. By 2014, that increase will likely be 161 percent.
- Our Veterans Benefit Management System will be fully operational at most regional offices, and just 40 percent of claims will be older than 125 days.
Now, who doesn't think the President gets it down deep where it counts? "Show me your budget, and I'll tell you what you value." There is no question that our President highly values what Veterans, their families, and our survivors have meant to this country.
God bless our country. God bless our President. And may God continue to bless the men and women who serve and have served our Nation in uniform.