Remarks by Secretary Eric K. Shinseki
Blinded Veterans Association 67th Annual Convention
August 21, 2012
Sam, thank you for that generous introduction and for your leadership of the Blinded Veterans Association. Let me also acknowledge:
Al Avina, your National Executive Director, and other members of BVA's national leadership;
VA's leadership team led by Lu Beck, Gale Watson, John Townsend, Adam Walmus, and including the chiefs of VA's blind rehabilitation centers and clinics;
Colonel Don Gagliano, DoD Vision Center of Excellence;
Other BVA members, especially the 16 OEF/OIF blinded Veterans who are part of "Operation Peer Support" and the blinded British Army Veterans, who are partnering with BVA on "Project Gemini";
Fellow Veterans, other VA colleagues, distinguished guests, ladies and gentlemen:
It's good to be with you here in Galveston. Since its founding in March 1945, BVA has been the clear, consistent, unwavering voice, advocating for America's blinded and visually impaired Veterans. You have pressed for medical research—education and awareness—and civil rights for all visually challenged Americans. You demonstrate daily that there are lots of challenges left to conquer, triumphs yet to achieve, and living left to do—important lessons for us all.
I am pleased to be able 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.
In 2009, of the over 23 million living Veterans in this country, only 7.4 million of them were enrolled in VA healthcare and only 3 million were receiving compensation and pension benefits. We had an outreach problem; many didn't know about VA. We had an access problem; even if they knew about us, some couldn't get in. And even then, we had been carrying a backlog in compensation claims for decades.
Three-and-a-half years ago, we were still grappling with some unresolved issues from 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." Homelessness has been a Veterans' issue for decades. The economic downturn of 2008 threatened to send it spiraling out of control. In spite of all this, the President was resolute, clear, and unwavering: It is immoral for anyone who has defended this country to be homeless in America. We will fix it.
Well, that was the landscape in 2009. After consulting with key stakeholders, we settled on three key priorities, which remain unchanged today:
- A commitment to increase Veterans access to VA benefits and services;
- A commitment to eliminate the backlog in compensation claims—in 2015;
- And a commitment to end Veteran homelessness—also in 2015.
Very little of what we do in VA originates in VA. Most of what we work on originates in the Department of Defense. So delivering these priorities required closer, more collaborative working relationships with DoD—at all levels. It takes the synergy of two departments to transition departing Servicemembers seamlessly.
Secretaries of Defense Bob Gates and Leon Panetta, and I have personally met nine times in the last 18 months. Three weeks ago, Secretary Panetta and I testified, for the first time together, before a joint hearing of the House Armed Services and the House Veterans Affairs Committees. We are focused on making this transition from DoD to VA as seamless and as productive as possible.
Greater collaboration between VA and DoD is especially important 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, for some, the downward spiral that 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. For example, we have committed both our departments to a single, common, joint, integrated electronic health record, open in architecture, non-proprietary in design. We expect initial operating capability in 2014 and final operating capability in 2017.
Collaboration was priority one. Our second priority was to fix VA's budget process. Creating change requires steady, predictable budgets. If we want to go faster, those budgets will have to be robust. For the past three-and-a-half years the President has been stalwart in supporting those requests.
In 2009, the VA budget totaled $99.8 billion. Congressionally enhanced, it was a good budget. In 2010, the President increased that budget from $99.8 billion to $127.2 billion -- a near 30 percent increase in a single year. Even better, the President's 2013 budget request, currently before the Congress, is for $140.3 billion—a 40 percent increase since 2009.
I was once asked, "Mr. Secretary, what do you value?" It was an impromptu question. But before I could answer it, I was being lectured: "Show me your budget, and I'll tell you what you value." By that standard, this 40 percent increase in VA's budget tells you what the President values. He understands our obligation to Veterans, and he has provided robust funding to better care for them and simultaneously transform this department for the 21st century.
So what have we put into motion at VA in 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 a fifth polytrauma center in San Antonio, Texas. We have three new hospitals under construction: Denver, Orlando, New Orleans. We just opened the spectacular, state-of-the-art VA Medical Center in Las Vegas two weeks ago—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.
In 2009, approximately 1.3 million visually impaired Veterans were treated at VA. By 2011, the annual count for treatment had risen to roughly 1.5 million Veterans.
Fifty-five new outpatient blind and vision rehabilitation programs were funded between 2008 and 2010. These clinics treated more than 17,000 visually impaired inpatients in fiscal year 2011. VA also added three new inpatient blind rehabilitation centers in 2011—Long Beach, Biloxi, and Cleveland—bringing us to a total of 13 centers, an important investment in the most modern, intensive care available for blind Veterans and Servicemembers.
In 2011, prosthetics and sensory aids service provided more than $31 million for devices that assist blind and visually impaired Veterans in achieving their rehabilitation goals.
Besides these initiatives to increase Veterans access to VA services over the past three-and-a-half years, we also committed to taking 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. For all combat Veterans with verifiable PTSD—World War II, Korea, Dominican Republic, Vietnam, Grenada, Panama, Somalia, Operation Desert Storm, Iraq, Afghanistan, among others—we granted the presumption of service connection. PTSD is as old as warfare itself. It was time.
These three decisions alone have dramatically expanded access to VA for nearly a million Veterans. Understandably, those decisions also led to an increase in the number of compensation claims. Growth in the number of claims and the backlog is what happens when we increase access. It was the right thing to do, for Vietnam Veterans, for Gulf War Veterans, and for combat Veterans of all wars, and we would do it all over again.
Claims are a big numbers process, and we do most all of it on paper. Paper is what we receive from DoD today. 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 VA to achieve 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—a paperless Veterans Benefits Management System. It's being piloted at two regional offices for over a year now. We'll have VBMS up and running at 16 regional offices by the end of the year, and at all 56 regional offices by the end of 2013. VBMS is key to that strategy. It's here; it's about to be fielded. And in 2014, we will expect DoD to begin providing all transition documentation in electrons. Because of the President's strong support, VA has the resources it needs. We'll end the backlog in 2015.
In 2009, I observed that Veterans lead the Nation in homelessness, depression, substance abuse, suicides, and they rank right up there in joblessness, as well. We've had a full-court press on to rescue Veterans from the streets. As I indicated earlier, the estimated number of homeless Veterans in this country in 2009 was 107,000. By 2011, in spite of the extended economic downturn, that estimate had dropped to 67,500. When HUD, the Department of Housing and Urban Development, announces its 2012 estimate of homeless Veterans, we expect that the number will be below 60,000, keeping us on track to break 35,000 in 2013, and ending the "rescue phase" of Veteran homelessness in 2015.
The "prevention" phase of Veteran homelessness is ongoing and will continue indefinitely, requiring VA to focus its significant capabilities on keeping "at risk" Veterans and families 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. Prevention: Stay in school; complete your studies. 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!"
Last year, roughly 86,000 of our 1.3 million Veteran mortgage holders defaulted on their home loans. VA intervened -- working with their financial institutions, lowering payments, extending payment periods -- and kept 73,000 of those Veterans and families in their homes. Prevention! We could say the same things about depression, substance abuse, and suicide ideation. You can't roll your sleeves up and wring your hands at the same time. We've rolled our sleeves up.
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, that number is greater than 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.
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. Treatment 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. So as good as we think we are, we can't help those we don't treat, another reason increasing access and developing a seamless transition between DoD and VA is so important. These are magnificent young people, and we are not going to let them down.
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 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. Younger Veterans are more comfortable with chatting and texting, so in 2009 we added on-line chat, and in 2011, a texting service. We always reach out to Veterans in need of support.
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 challenged private companies to hire or train 100,000 Veterans and military spouses by the end of 2013. 2,100 companies have committed to 175,000 hires, and 90,000 Veterans and spouses have already been hired.
VA has held its own hiring fairs in Washington, DC, and Detroit in the first six months of this year. Over 12,000 Veterans showed up, and over 8,000 interviews were conducted, and more than 1,700 job offers were made on the spot. Job offers continue to flow.
We have also conducted two Veteran-owned small-business training expositions in the past 12 months—our opportunity to educate Veteran small business owners on our procurement requirements and allow the 3,500 who showed up to demonstrate their capabilities and improve their preparation of competitive proposals for government contracts. Bottom line: Veterans hire Veterans, so the more successful Veteran entrepreneurs we cultivate, the better the opportunities for Veterans employment.
So where are we headed? Well, for one thing, I intend to be here to update you next summer, and here's what I intend to report:
- Between 2009 and 2013, we will have increased spinal cord injury funding, TBI funding, mental health funding, long-term care funding, women Veterans funding, OEF/OIF/OND funding. And by 2014, we will have increased funding in each of these categories, yet again.
- Between 2009 and 2013, we will have increased prosthetics funding by 58 percent. By 2014, that increase will likely be 75 percent.
- Funding for vision-related research in 2013-2014, will continue at the 2012 level.
- VBMS, our Veterans Benefits Management System, will be fully operational at most regional offices, and just 40 percent of claims will be older than 125 days. Just as importantly, VBMS and VRM are compliant with both the Americans with Disabilities Act and 508 standards for access.
VA is also collaborating with DoD to create a centralized registry of Servicemembers and Veterans with eye trauma, vision injuries and disorders: the Defense and Veterans Eye Injury and Vision Registry. The registry pilot was deployed ahead of schedule in March 2012 and will provide consolidation of eye injury and vision loss data acquired from the VA eye injury data store and DoD medical systems. This collaborative is the first to combine VA and DoD clinical ocular data and will enable predictive and longitudinal outcome analyses to promote prevention, treatment, and research for servicemembers and Veterans.
Beneficiary travel for blinded Veterans. We understand that transportation is an access-to-care issue for many Veterans. Fortunately, many blinded Veterans meet the eligibility criteria for transportation benefits of the beneficiary travel program and receive VA assistance with transport to and from their VA healthcare. With assistance of Veteran service organizations, including BVA, VA is currently seeking legislative and regulatory relief to expand Veteran eligibility for the beneficiary travel program. We are establishing mobility manager positions at VA healthcare facilities to evaluate Veterans' transportation needs and determine the most appropriate transport method to VA facilities or other community, state, or federal resources. Forty mobility managers have been trained to date, and more training sessions are planned in FY 2013. We remain committed to ensuring that lack of transportation is not a barrier to VA healthcare.
I am honored to have been able to provide you the state of your VA this morning. Mark Twain reminds us that "kindness is a language which the deaf can hear and the blind can see." This was not just about kindness, but about value. "Show me your budget, and I'll tell you what you value."
God bless those who serve and have served the Nation in uniform. God bless our President. And may God continue to bless this wonderful country of ours.