Remarks by Secretary Eric K. Shinseki
Paralyzed Veterans of America Annual Convention
August 26, 2010
Doug Vollmer, thank you for that kind introduction.
President Gene Crayton and past president, Randy Pleva, thanks for your service and your leadership, past and present, of Paralyzed Veterans of America—PVA.
Let me acknowledge all the members of your executive committee, and recognize especially your outstanding executive director, Homer Townsend, who is listening in from his hospital room while recovering from surgery.
Gordon Mansfield—Vietnam Veteran, former VA Deputy Secretary, and long-time leader of PVA, thank you for your years of service to PVA and all Veterans.
Members of PVA, fellow Veterans, other distinguished guests, ladies and gentlemen:
Good morning. I’m honored to be here in Providence with an organization which has, for over 60 years now, been the leading advocate for Veterans with spinal cord injuries and disorders, making a tremendous difference in their lives and the lives of future generations of Veterans.
Over the years, VA and PVA have collaborated to serve Veterans living with spinal cord injuries—SCI. We have been your partners in a broad range of SCI initiatives, especially in the National Wheelchair Games, for 25 years now. We look forward to many more years of collaboration. It takes a concerted effort—hard work—on both of our parts, to address the challenges facing Veterans during this period of extended economic difficulty.
There will always be unfinished work—that’s the nature of this mission. But we have established clear priorities, and with the increased funding provided by President Obama and the congress, we are addressing those concerns. Let me provide some specifics about where we’ve come from over for the past 19 months and where we are headed in the next 24:
- In 2009, a congressionally enhanced budget of $99.8 billion allowed us to begin addressing a range of issues that had accumulated over time. Thanks to the Congress, we were able to establish a framework for much-needed change that will enhance Veterans’ access to VA benefits and services, improve the quality and safety of our health care programs, and re-engineer our business processes to provide accountability, assuring best returns on investments.
- This year’s budget, 2010, of $114 billion, is a $14.2 billion, a 16 percent increase to the 2009 budget. Provided by President Obama, it is the largest single year increase in over 30 years for VA. The President has enabled us to put in place programs and procedures that will serve Veterans well into the next two decades.
- The 2011 budget request of $125 billion, an $11 billion, 10 percent increase over the large increase of 2010, will give us much needed firepower to increase Veterans’ access to our benefits and health care services, end the disability claims backlog, and eliminate Veterans’ homelessness by 2015.
To deliver all this, VA must be, without hesitation, an advocate for Veterans. We need to make permanent the gains of the past 19 months. Given the economic challenges facing the government and the Nation, the $25 billion increase in VA’s budget over these two years underscores the President’s commitment to transforming VA and fixing persistent problems that have plagued the department for decades. We need a sense of urgency that matches his commitment, and we are developing it.
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.
Last year, we implemented the new, Post-9/11 G.I. Bill, the largest student aid package of its kind since the original G.I. Bill of 1944. To date, we have over 328,000 Veterans and family members enrolled in college, working towards their degrees. When you include the Montgomery G.I. Bill and Chapter 30 and 35 programs, that number goes up to nearly 600,000 Veterans and family members in classrooms preparing for the next phases of their lives. We need their ingenuity, their leadership, their operational experience, their toughness, their discipline, and their dreams in American business and government today—just like we needed yours. But as I tell them, unless they graduate, there is no payoff. I’ll be checking graduation rates.
We have also worked two issues hard that have been on the back burner for decades—one for 40 years, Agent Orange, and the other for 20 years, Gulf War illness.
Last October, I accepted the Institute of Medicine’s (IOM’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 types of chronic, b-cell leukemia, 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.
I have been invited to testify before the Senate Veterans’ Affairs Committee on 23 September, to explain these decisions. I am happy to do that. 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.
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—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 becomes 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 (TBI), we’ve fielded a new disability rating system to greatly improve how VA evaluates claims. 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.
USA Today recently reported on some of our successes, chronicling the breakthroughs in VA’s four “Emerging Consciousness” programs 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 percent 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. This is your VA, and this is why we don’t accept hopelessness—not among the injured, not among the ill, not among the homeless, and not among Veterans with SCI.
There is much more to be done in 2011. We will focus on the three critical concerns of significant importance to Veterans:
- Increasing access to benefits and services now;
- Eliminating the disability claims backlog;
- And ending Veterans’ homelessness.
Let me touch on each of these key priorities, and how they are impacted in the President’s budget:
Access: First, VA must do 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 applying telehealth technologies to extend VA’s reach into the Nation’s 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 have invested $121 million in telehealth technologies. In 2011, those investments will grow to $163 million.
We are working with DoD to enable active duty service members, who have suffered a spinal cord injury, to be transferred to VA as soon as possible, so we can begin providing them the benefit of our world-class programs early.
Thank you for your site-visits to our SCI facilities. You provide invaluable perspective and feedback on our services, and your unique insights have helped us design our new, replacement SCI centers. In particular, your tremendous support and vision over the years for the Center for Neuroscience and Regeneration Research at our West Haven Medical Center has yielded exciting discoveries, improving and allowing a greater quality of life for Veterans living with spinal cord injuries.
Veterans’ health care: In 2011, VA is projected to treat 6.1 million patients—equivalent to the populations of Los Angeles and Chicago, combined. Those 6.1 million Veterans, including 439,000 Veterans of Iraq and Afghanistan, will make 83million outpatient visits, and be treated as inpatients 937,000 times. To address these large numbers, VA has programmed the following resources to care for our Veterans:
- $6.8 billion for long-term care, an increase of 14 percent over 2010;
- $2.6 billion for care for Veterans of Iraq and Afghanistan, a 30 percent increase;
- $5.2 billion for mental health care, up $410 million over 2010, enabling us to expand inpatient and outpatient mental health services;
- $590 million for medical and prosthetic research;
- $538 million for spinal cord injury programs—an 8% percent increase over 2010, and an 18 percent increase over 2009.
- $250 million to improve health care access for the more than three million enrolled Veterans, who live in rural America;
- $217.6 million to meet the growing needs of women Veterans, an increase of more than $18 million over the 2010 budget;
- And, finally, funding for continued development of the Virtual Lifetime Electronic Record—VLER.
Benefits: In 2009, we received, for the first time ever, over one million new claims. Disability claims have increased 75 percent from 2000 to 2009 [578,773 to 1,013,712]. As a result, we now average over 97,000 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 last 18 months, the Veterans’ Benefits Administration (VBA) expanded its workforce by over 3,500 people, began accepting on-line applications for initial disability benefits, initiated an innovation competition, launched over 30 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.
Additionally, VBA awarded a $9 million contract to fast track Agent Orange claims associated with our presumption decisions of last October.
VBA Budget: 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 percent, over the 2010 level. The budget also includes $145.3 million in information technology (IT) 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: In this rich and powerful Nation, roughly 643,000 Americans remain homeless on any given night. We accept that our Veterans, who come from every town and village in this great land, are a vital part of the national landscape. We say that in honoring their service, we keep faith with Abraham Lincoln’s promise to care for those who have borne the battle, and for their families; yet, nearly one in six of America’s homeless is a Veteran, 107,000 of them. This cannot define your VA or our Nation!
If you wonder what this secretary will be working on for the next several years, this is it. Over the past six years, we have reduced Veteran homelessness by nearly 90,000. We will end Veteran homelessness in the next five years.
National Cemetery Administration (NCA): Last year, NCA performed over 106,000 interments of Veterans and eligible family members, and provided over 352,000 headstones and markers worldwide. This June, we began offering bronze medallions signifying Veteran status that can be attached to privately purchased headstones or markers.
VA expanded NCA’s burial policy, resulting in a plan to develop new state and national cemeteries. Ten grants, totaling $40 million, were awarded to states to fund five new state Veterans’ 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 percent 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 relaying to you our successes and the progress we’ve made? I am sharing this with you because every dollar in additional resources, every step forward toward improving care, increasing access, eliminating the backlog, and ending homelessness has a profound impact on Veterans.
On 1 October 2009, less than a year ago, a roadside bomb, on the outskirts of Kandahar, Afghanistan, targeted a patrol of nine Army Rangers out of 1st Battalion, 75th Ranger Regiment. Ranger 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 medical evacuation, 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 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 his limbs and massaging his body, 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; he 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 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 motto of the Rangers. And whatever service you come from, I think all Veterans can relate to the importance of these words from one service’s creed:
- I will always place the mission first.
- I will never accept defeat.
- I will never quit.
- I will never leave a fallen comrade.
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 PVA for assistance, advice, and advocacy to fulfill it.
May God bless our Veterans, and our men and women who serve in harm’s way. May God continue to bless this great country of ours. Thank you.