Remarks by Secretary Eric K. Shinseki
VBA Leadership Workshop
St. Louis, MO
September 12, 2011
Secretary Hickey, thank you for that kind introduction, and more importantly, thank you for your leadership of VBA: Compensation, education, Voc Rehab, insurance, loan guarantees, pensions, fiduciaries—VBA's mission has never been more complex, more challenging, or more essential to Veterans. Your leadership has been strong and purposeful, and the leadership you have gathered here in St. Louis is crucial, not only to VA's transformation and to ending the backlog in disability claims, but also to regaining Veterans' trust and confidence.
I could not be more direct in my message. I have come to this conference to do several things: To thank all of you for your determination and dedication over the past two-and-a-half years; to talk about change and its importance to VA and VBA; and, to seek your continued commitment to finish what we have started in removing the burden of this thing called 'the backlog" from the shoulders of our Veterans and from our image as a caring and competent organization. When we have accomplished these things, we will have transformed VA for the twenty-first century, and we will be well on our way to being a leader in governance.
Let me also welcome representatives of our Veterans Service organizations in attendance, and AFGE National VA Council President , Ms. Alma Lee.
First, my thanks. My confirmation testimony, way, way back on 14 January 2009, led me to assume that, of all of VBA's responsibilities, my first priorities would be to "fix the backlog" and help create a "seamless transition" for Servicemembers departing the military and enrolling in VA. My testimony certainly focused on these two issues. Ok, I've juggled balls before, only two balls to juggle? Piece of cake.
So, shortly after being sworn in on 21 January, I took my first VBA brief—what an education! Some issues associated with VBA's missions were not logical:
- A claim submitted this afternoon would have been part of the backlog at 8:00 am tomorrow morning. That made no sense, and we could change that, so we did!
- Implement the new 9/11 GI Bill by 1 August 2009, without automation, without failure, and without complaint. This was directed, so we implemented. It had warts, as you may recall, but we kissed that frog.
Other stakeholders had their own perspectives about VBA's challenges and priorities and weren't shy about adding them to my early education. Here's some of the input I heard:
- Too many Veterans are not able to access VA's services and benefits. Navigating the claims process was difficult; some said, "near impossible." In fact, a few suggested that VA was waiting for them to die so it wouldn't have to pay them their benefits— pretty strong stuff for a new secretary.
- They also said it was wrong for any Veteran in this country to be homeless, something the President had already called immoral.
- Some told me that VA had an attitude problem—that we didn't always treat Veterans with dignity and respect—and that women Veterans, in particular, were not being well served. We were not being overtly disrespectful, but our entire system was heavily male-oriented. So, women Veterans didn't feel comfortable or welcomed. OK, we needed to do something about both of these perceptions. And that's why we have "I CARE," our five core values.
- Finally, many felt we were too slow to react to real changes in Veterans lives, like the impact of rising gas prices or the cost of medications. Well, three and a half years ago, the beneficial travel rate was 11 cents per mile; today, it is 41.5 cents per mile, and we have controlled co-pay costs on medications to the benefit of all Veterans for the past one-and-a-half years.
So, based on these early observations, we established clear priorities, put a number of initiatives into motion, but concentrated on the select few projects that would give us early momentum:
Priority #1: Stubby-pencil our Veterans and eligible family members into school in the Fall of 2009, without fail, hire the right and the right number of people, train them on a system we would be developing even as they came on board, work with the states and schools to get us their tuition and fees data ASAP, but come first day of school, there will be Veterans in classroom seats. We can deal with a few "slows," but no fumbles.
And as you are doing all this, develop on a separate, parallel, fast track the automation tools we will need to ramp this up in the following semesters as this program grows. And you did. And because you did, I developed enormous confidence in your skills, your toughness, and your agility, as individuals and as a team. From the fall of 2009, this program grew from 173,000 to over 518,000 Veterans and family member students today.
Priority #2: Attacking the backlog will have to wait. Hire enough people to keep the claims inventory under control, but automating the claims process will have to wait a year or more until we have the new 9/11 GI Bill fully implemented. In the meantime, pull the claims process apart into its individual pieces and pilot improvements to these processes, so when we put them back together again, the effect will be synergistic. And you have done that, and that system is called VBMS. But the guidance back then was: bolster and sustain our rate of processing as best you can because I am going to have to add to your stress.
Priority #3: Establish an outreach program to educate and inform Veterans about our programs and services. Access is both an engagement and an enablement exercise. Establish better relationships with our Veterans so we can educate—that's engagement, and as we do that, enable their enrollment for the benefits and services they have earned by helping them navigate the shoals—and that's called advocacy. In the past two-and-a-half years, we have added 800,000 Veterans as enrollees to our healthcare rolls.
Priority #4: Clean up the battlefield of lingering issues from previous conflicts—combat PTSD, Gulf War illness, Agent Orange, and similar exposures. These are the stresses I piled onto our antiquated claims processing system. Why? Because I didn't know how to ask Vietnam, Gulf War, and combat Veterans at large to wait one more day after decades of suffering.
Priority #5: Put a plan together to end Veteran homelessness. They are the visible cues of the gaps in our system.
Priority #6: Begin a dialogue on rural, Native American, and women Veterans, different groups who face similar challenges because of smaller populations.
In the process of pursuing these priorities, I found out just how tough and good you folks in VBA are. You didn't blink; you didn't whine. You didn't quit, and you got me enough momentum in these priorities to enable putting together three consecutive budgets that have changed paradigms inside VBA.
I know that most of you and your employees worked longer shifts and gave up weekends and many holidays in the fall of 2009 to implement the GI bill. I also know that you have been working mandatory overtime for months to process the hundreds of thousands of claims I have added as a result of service-connected disabilities, diseases, and conditions I have associated with Agent Orange exposure, verifiable, combat-related PTSD, and Gulf War illness. You and your people have been magnificent in shouldering this load.
Look, your sacrifice and determination has allowed us to put together some incredible budgets to fix these longstanding issues and also provide some much needed and long overdue tools for folks in VBA.
In January 2009, I inherited a congressionally enhanced budget of $99.8 billion, a good budget. The following year, President Obama increased that amount by 16 percent, to $115 billion—the largest single-year budget hike in over 30 years. This year, the 2011 budget grew to $126.6 billion. The President's 2012 budget request for next year, currently before Congress, is for $132.2 billion. Very few organizations—public, private, for-profit or non-profit, have had this kind of resourcing during these tough economic times and every dollar of it is needed to fix the systemic, legacy problems, and issues that have plagued this department for far too long. None has been more pressing than solving the claims backlog.
The President's goals, my goals, depend on getting out of paper and into electronic platforms—something that should have happened decades ago.
If one were to review 20th century history in 10-year snapshots, I have read that the assumptions of one decade rarely held true 10 years later. Well, in 1990, almost no one had heard of the Internet nor appreciated the power of the microprocessor.
In 1997, VHA rolled out its current electronic health record, VISTA, enterprise-wide. Between 1996-2004, VISTA enabled VHA to handle a 69 percent increase in patients, reduce workload by over 35 percent, enhance patients' safety by measurable and significant amounts, and hold the cost of medical treatments flat when the cost of healthcare across the country was climbing significantly. Some suggest that the VA's lower costs of treatment were as much a function of its lean budgets as they were of efficiencies in delivered services. That may be fair, but lean budgets were not just visited on the VA but also on Medicare, where costs rose 26 percent.
VA has a history of rising to challenges. In just one decade, VHA dramatically transformed its healthcare system from a lumbering, paper-based, hospital-centric model to an agile, electronic, patient-focused system that brings medical care closer to Veterans through more than 152 hospitals and 800 community-based outpatient clinics across the Nation. Our healthcare today is second to none.
The greatness that characterizes our healthcare system is also the matrix for our re-energized benefits system. The bold steps we are taking, coupled with your collective skills, knowledge, and attributes, bode well for a future that continues the history of excellence that is VBA's heritage.
We have our work cut out for us over the coming year. The good news is that:
- We have a new, forward-leaning Under Secretary in Allison Hickey—she's no stranger to the demands of transformational leadership.
- We are piloting VBMS at two regional offices and have already processed paperless claims there.
- We're sharing information, gaining momentum, encouraging innovative thinking, seeking outside viewpoints and direction for continued progress toward meeting our goals at conferences, like this one.
- We are answering more than 10 million calls a year leveraging our new national call center capability—answering everything from the status of a claim to detailed benefit information and using state-of-the-art call-center processes and technologies; and,
- We reduced the requirements for second signatures on medical reports, where trained practitioners are fully capable of providing health evaluations;
- We're enhancing the My-e-Benefits portal to add user-friendly features to support lifetime engagement with our Veterans—from filing and tracking claims for various benefits to notifying VA of new dependents. My-e-Benefits is VBA and DOD's seamless, virtual lifetime electronic record for benefits and one of our key Veteran relationship management (VRM) initiatives. Four months ago, there were 250,000 users, today, with your hard work and focus, there are over 800,000 users. Our target by the end of the year is one million users.
Now these are relatively simple business process and technology changes that carry a big payoff; others are more systemic. As we coordinate and synchronize our 360-degree claims transformation plan, we are leveraging several employee innovation initiatives and other process improvements:
- Simplifying and combining the rating and notification letters our Veterans receive;
- Developing a disability benefits questionnaire that provides all the medical data needed for a rating decision;
- Utlilizing star-trained quality review teams;
- Executing nationally developed challenge training for employees new to their roles;
- Supplying Veterans with newer, simplified disability claims forms.
We're leveraging change across the board. Now, some may not like change, but they'll like irrelevance even less. VBA cannot, must not, and will not become irrelevant. We are standardizing the rating process using automated rules-based calculators. Our new hearing loss and monthly compensation calculators, deployed nationwide, allow VA employees to quickly evaluate hearing loss claims and calculate other special monthly compensation awards.
Our integration laboratory at the Indianapolis service center is at the forefront of change efforts focused on our people and smarter ways to execute the work they do.
By any measure, over the past two-and-a-half years, we've made magnificent strides in redefining VBA. The future is VBMS—our Veterans Benefits Management System. That's where we need to concentrate our efforts, if we are to have the automation edge in delivering benefits. VBMS is people and process coming together through technology. It's a 21st century, holistic approach to the many challenges associated with our disability claims process that have been years in the making.
We have momentum in key areas and clear directions for the future, and we will continue the good fight for resources to finish transformation. By bringing our systems and processes into the 21st century, we are honoring the dedication and selflessness of the men and women we serve today and will serve in the future. Warriors like Army Ranger Joe Kapacziewski, who was severely wounded when an Iraqi grenade shattered his right leg and extensively damaged the right side of his body, severing a nerve and an artery in his right arm.
Doctors didn't expect him to walk without support again, let alone fulfill his wish of returning to the ranger regiment and becoming a squad leader. Then, again, most of us don't fully appreciate iron will. In sergeant Kapacziewski 's words, "I don't like people telling me I can't do something." We need Kapacziewski in compensation!
Kapacziewski had been serving with the Rangers since May 2002. When he was wounded in 2005, he was on his fifth combat deployment. After multiple surgeries, slowly regaining use of his right arm, and enduring unimaginable pain, he made the courageous call to have his right leg amputated below the knee, opting for greater mobility and faster recovery with a prosthetic leg.
In March 2007, the leg was removed. Five months later he was running. After six months, he rejoined the Ranger Operations Company at Fort Benning. Ten months after surgery, Kapacziewski completed an Army PT test, a five-mile run, and a 12-mile road march with 40 pounds of gear. In March 2008, one year after his surgery, he became the only amputee ever to assume combat duties in the Ranger Regiment, as a squad leader. He has since deployed four more times, he's been promoted to platoon sergeant, and he's received a Bronze Star for Valor for helping to save a severely wounded comrade.
Sergeant Kapacziewski is a member of the "9/11 Generation." More than five million Americans have served in the military during the past decade—nearly three million of them joining after 9/11, knowing full well that they would be deploying to combat. Their accomplishments are extraordinary: unseating the Taliban,pushing al Qaeda from its sanctuaries,capturing Saddam Hussein,celivering justice to Osama bin Laden, andtraining Iraqi and Afghan forces to defend their own countries.
The "9/11 Generation" includes more than a million spouses and two million children, many of whom have lived their entire lives in a Nation at war. More military women have served in combat than ever before. Hundreds of thousands of troops have deployed multiple times. They have all borne a heavy burden on behalf of the Nation, but despite the enormous strains of 10 years of continuous operations, our military remains as strong as it has ever been.
Sergeant Joe Kapacziewski 's "9/11 Generation" is defined, just as every previous generation of America's Veterans has been defined, by the virtues of selfless service, sacrifice, and devotion to duty. These men and women, who serve and have served, are the flesh and blood of American exceptionalism—the living, breathing embodiment of our national values and our special place in the world.
We are blessed to have them. They have earned and deserve the very best this country can offer while they're fighting, and the very best VA can offer when they come home. That's our moral obligation. That is our mission. That is why we exist.
I know that you have carried a tremendous load for us for two-and-a-half years now. Don't anyone take a knee yet. We're not on the objective, but we're close. So hang tough, and grip hands as we cross the finish line.
God bless our men and women in uniform, God bless our Veterans, and may God continue to bless this great Nation of ours.