Remarks by Secretary Eric K. Shinseki
Paralyzed Veterans of America 66th Annual Convention
New Orleans, Louisiana
August 14, 2012
Doug Vollmer, thank you for that kind introduction, and for your long and loyal service to PVA.
Let me also recognize:
- Gordon Mansfield, former Acting Secretary of VA. It's good to see you;
- Bill Lawson, National President;
- Al Kovach, Senior Vice President, and Homer Townsend, National Executive Director, who could not be here. We wish them both a speedy recovery;
- Other members of PVA's leadership;
- PVA members; your families; fellow Veterans; VA colleagues; distinguished guests; ladies and gentlemen.
I am honored to be here today. For more than 65 years, PVA has been the clear and consistent voice, unwavering in your advocacy of veterans with spinal cord injuries and diseases. In your diligent service to paralyzed Veterans, you have promoted medical research, education and awareness, civil rights, and such premier rehabilitative events as our jointly-sponsored Wheelchair Games—a demonstration of the importance of keeping hope alive and of celebrating the dignity of the human spirit.
You, yourselves, have demonstrated that there are lots of challenges, lots of living, and lots of triumph left to experience. We are indebted to you for these lessons in living, and we all salute your unwavering devotion to SCI Veterans and their families.
No one appreciates the value of your good works more than the President. Veterans have no greater advocate than President Obama. His commitment to Veterans runs deep; it is genuine; it is unwavering. He provided me this privilege of serving Veterans, and I am proud to report to you this morning on the state of your VA: How things looked three-and-a-half years ago, what changes we've put into motion, and where VA is headed in the future.
We've been at war for about a decade now—a decade. It takes a superb, disciplined fighting force to handle the intensity of that kind of strain. The men and women who wear our Nation's uniforms, today, are magnificent—just as they have been throughout time. But repeated deployments of this force have created issues that don't show up until the later deployments. More of them are also surviving catastrophic injuries because of improved body armor, better battlefield combat life-saving skills, and strategic medical airlift.
Those higher 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 added complications of blindness and deafness and genito-urinary injuries. We had to create a word for this kind of medical complexity—polytrauma. We have built five polytrauma Centers of Excellence, the best in the world, to care for our seriously injured. We've extended those centers into an entire polytrauma system of care, enabling those patients to go home.
Three-and-a-half years ago, we were 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 decades ago when we should have, and some Veterans were dying without benefits.
Three-and-a-half years ago, an estimated 107,000 Veterans were 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." The economic downturn of 2008 threatened to compound this homeless situation for Veterans. In spite of all this, the President was clear—it is immoral for anyone who has defended this country to be homeless in America.
In 2009, of over 23 million living Veterans, only 7.4 million were enrolled in VA healthcare, and only three million were receiving compensation and pension benefits. We had an outreach problem. Many didn't know about VA. We had an access problem because even if they knew about us, they couldn't get in. And even then, we were carrying a backlog in compensation claims.
That was the landscape in 2009. After consulting with key stakeholders, among them the executive directors of the six major VSO's, we settled on three key priorities, which remain unchanged today:
- Increase Veterans access to VA benefits & services;
- Eliminate the backlog in compensation claims in 2015;
- And end Veterans' homelessness, also in 2015.
None of these are achievable without the Department of Defense because very little of what we do in VA originates in VA. Most of what we do originates in DoD. So, the first order of business had to be establishing closer, more collaborative working relationships with DoD, at all levels. It takes both departments to create that seamless transition which will return separating Servicemembers to their home communities "career-ready" to work, raise children, and strengthen our economy.
Secretaries of Defense Bob Gates and Leon Panetta, and I have personally met nine times in the past 18 months. Both of them are dedicated public servants who have been insightful, decisive, and good friends to me and to Veterans. A few weeks ago, Secretary Panetta and I testified, for the first time together, before a joint hearing of the House Armed Services and Veterans Affairs Committees.
Our second priority was to fix VA's budget process. Creating change requires resources and, if you want to go faster, you will need more money. For the past three-and-a-half years, VA has been forceful in arguing its resourcing requirements, and the President has been stalwart and unwavering in his support of VA. In 2009, VA inherited a budget totaling $99.8 billion. Congressionally enhanced, it was a good budget; not spectacular, but good. In 2010, the President increased that budget to $127.2 billion—a near 30 percent increase in a single year. Now, that's spectacular. Even better, the President's 2013 budget request, currently before the Congress, is for $140.3 billion—a 40 percent increase since 2009. The President knows what we owe Veterans, and his sense of obligation is reflected in his budgets.
I was once asked what I valued. But before I could answer the question, I was lectured, "Show me your budget, and I'll tell you what you value." The 40 percent increase to VA's budget demonstrates that the President values Veterans, their families, and survivors. He understands our obligation to those who shoulder the responsibility and risk for safeguarding our country. He won't let them down.
So what have we put into motion to address these issues during the past three-and-a-half years? First, to increase access, we have added 57 new community-based outpatient clinics, 20 more mobile health clinics, and, as mentioned earlier, we opened a fifth polytrauma center in San Antonio, Texas, last year. We have three new hospitals under construction—Denver, Orlando, and New Orleans. We just opened the spectacular, state-of-the-art VA medical center in Las Vegas last week—the first new VA hospital in 17 years. As President Obama remarked recently, "We keep our promises."
We have also invested heavily in new telehealth-telemedicine initiatives to overcome the tyranny of distance. Enhanced IT technologies are also beginning to make it easier for Veterans to make appointments, access their medical records, and find out about available benefits and services.
We've 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 Veterans with their claims. Since 2009, we've opened 19 clinics specifically designed to serve women, and trained more than 1,200 healthcare providers in women's health.
We've also increased access to our national cemeteries, opening three new national cemeteries and 14 state cemeteries. 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. All of this is much needed and long overdue.
Next, you may recall that we made it a point to take care of some long-overdue business:
- For 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. It's been 45 years; it was time.
- For Gulf War Veterans, we granted presumption of service connection for nine diseases associated with Gulf War Illness. It's been over 20 years; it was time.
- Finally, PTSD is as old as warfare itself. For all combat Veterans with verifiable PTSD, we granted the presumption of service connection for World War II, Korea, Dominican Republic, Vietnam, Grenada, Panama, Somalia, Operation Desert Storm, Iraq, Afghanistan, and others.
These three decisions alone have dramatically expanded access to VA care and benefits for hundreds of thousands of Veterans. Understandably, this also increased the number of compensation claims: Agent Orange—nearly 250,000 claims; Gulf War Illness—roughly 145,000 claims; combat PTSD—over 500,000 claims. Veterans who previously had no access, are now enrolling in VA and submitting claims.
The total claims inventory grew, as did the backlog—those claims older than 125 days. Three-and-a-half years ago, the total claims inventory was roughly 400,000. Today, it's approximately 880,000. The backlog went from about 135,000 in 2009, to roughly 580,000 today. Growth in these numbers 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—and I would do it all again.
Here's 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, for the first time, we completed 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. 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 here three years ago, two years ago, or even last year. There may be a handful of very complex cases lingering on, but the process is dynamic. We move claims.
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 DoD and VA to enable paperless processing. Hence, my close working relationship with Secretary Panetta; he and I are pulling our departments into the future.
VA has spent the past two years developing a new automation tool called VBMS, the Veterans Benefits Management System. It's 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. I am committed to ending the claims backlog in 2015. VBMS is key to that strategy. VBMS is here, and it's about to be fielded. Because of the President's strong support, we have the resources we need. We will end the backlog in 2015.
For three-and-a-half years, we've had a full-court press on to rescue homeless Veterans from the streets. As I indicated earlier, in 2009, the estimated number of homeless Veterans in this country was 107,000; by 2011, that estimate was down to 67,500. When the Department of Housing and Urban Development announces the 2012 estimate on homeless Veterans, we believe that the number will be below 60,000, keeping us on track to break 35,000 in 2013, and end the "rescue phase" of Veterans' homelessness in 2015.
The "prevention" phase of Veterans homelessness is ongoing and will continue indefinitely—requiring VA to focus its significant capabilities on keeping "at risk" Veterans from slipping into that downward spiral that ends in homelessness.
For example, we have roughly 800,000 Veterans and eligible family members in training and education today—in universities, colleges, community colleges, tech schools, and in the trades. They must graduate—anyone who flunks out in this economy is at high risk of homelessness. So my one-word speech to student Veterans, as I did at Boise State University last month, is "Graduate! Graduate! If I sound like your dad, I am. I'm paying most of your bills. So, Graduate!" PVA can help support these terrific young Veterans who are preparing for the next phase of their lives.
Finally, mental health. 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, and we recently announced that we're hiring 1,600 more clinical staff to address the growth in mental health requirements spawned by a decade of tough, high-risk, high-stress, repetitive, combat deployments. These are magnificent young people, and we are not going to let them down.
We know that when we diagnose and treat, people get better. Among the 8.6 million Veterans enrolled in VA healthcare, mental health treatment is up. At the same time, for Veterans receiving VA 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. Most Veterans who commit suicide—perhaps as many as two-out-of-three—were never enrolled in VA. And as good as we think we are, we can't help those we don't treat. Another reason why increasing access and developing a seamless transition between DoD and VA is so important.
One of our most successful outreach efforts is our Veterans Crisis Line. DoD knows it as the Military Crisis Line—the same number, same trained VA mental health professionals answering the phone, no cost to DoD. Since 2007, over 640,000 people have called in, including over 8,000 active-duty Servicemembers. We've made over 99,000 referrals for care and rescued over 23,000 from potential suicide. Younger Veterans are more comfortable with chatting and texting, so in 2009 we added on-line chat, and in 2011, a texting service. We will do anything to reach out to those Veterans in need of our support.
We have worked at 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.
Secretary Gates and I worked these initiatives hard, and Secretary Panetta and I have worked them even harder. We're committed to a fully-operational integrated electronic health record 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 "Hiring our Heroes" campaign. The President and Vice President, the First Lady and Dr. Biden have provided strong leadership in increasing employment opportunities for Veterans and military spouses. The President challenged private companies to hire or train 100,000 Veterans and spouses by the end of 2013. So far, 2,100 companies have committed to 175,000 hires, and 90,000 Veterans and spouses have already been hired.
In January, we, in VA, held our first hiring fair in Washington, DC, with the Departments of Labor, Defense, Homeland Security, and others, attracting over 4,000 Veterans and resulting in over 2,600 interviews and more than 500 job offers on the spot. We followed that successful fair with an even bigger hiring fair in June, in Detroit. Over 8,000 Veterans showed up; more than 5,700 chose to be interviewed; and over 1,200 received job offers. Job offers continue to flow.
Simultaneously, while we were in Detroit, 3,500 people participated in VA's Veteran-owned Small Business Training Exposition—our opportunity for Veteran small business owners to better understand our procurement requirements, demonstrate their capabilities, and improve their preparation of competitive proposals for government contracts. Veterans hire Veterans. So the more successful Veteran entrepreneurs we produce, the better our chances of finding Veterans employment.
So, where are we headed? I intend to be here to update you next summer, and here's what I intend to report was accomplished between 2009 and 2013:
- We will have increased spinal cord injury funding by 28%. By 2014, that increase will likely be 36% as we continue to lead the healthcare community in primary and specialty care, and in seeking out new methods of rehabilitation through SCI research and engineering.
- We will have increased TBI funding by 38%. By 2014, that increase will likely be 51%.
- We will have increased mental health funding by 39%. By 2014, that increase will likely be 45%.
- We will have increased long-term care funding by 39%. By 2014, that increase will likely be 50%.
- We will have increased prosthetics funding by 58%. By 2014, that increase will likely be 75%.
- We will have increased women Veterans funding by 123%. By 2014, that increase will likely be 158%.
- We will have increased OEF/OIF/OND Veterans' funding by 124%. By 2014, that increase will likely be 161%.
- Our Veterans Benefits Management System, VBMS, will be fully operational at most regional offices, and just 40% of claims will be older than 125 days.
Now, who doesn't think the President "gets it" down deep where it counts? Remember: "Show me your budget, and I'll tell you what you value." It's clear from his budgets that our President highly values what Veterans, their families, and our survivors have meant to this country.
Lots of folks talk about American exceptionalism. The faces of American exceptionalism are the faces of the men and women who serve, and have served, this Nation in uniform.
God bless them. God bless our President. And may God continue to bless this wonderful country of ours.