George —thank you for that kind introduction. I'm honored to be here. Let me also acknowledge:
America's immediate response was limited, but vigorous, defiant, and courageous. Army Air Corps pilots from Hale'iwa airfield, outnumbered and outgunned, launched a mix of two P-40s and three P-36As, which took out nine attacking enemy aircraft. The guts, determination, and skills of those young pilots are an important legacy that has populated your cockpits in all the years since.
A quarter century later, those who served on the ground in Vietnam relied on the guts, determination, and skills of close air support and search and rescue pilots, whose presence was comforting and whose professionalism kept many of us alive.
Air crews paid a heavy price for their courage in Vietnam. The walls of the Hanoi Hilton testify to the incredible sacrifices by those who defied a cruel enemy and endured unspeakable horrors.
Among them, Lieutenant Colonel Leo Thorsness—Medal of Honor recipient for heroic aerial achievement that saved the lives of fellow airmen at great risk to himself. In April 1967, then-Major Thorsness was piloting an F-105F on a Wild Weasel mission to destroy SAM sites near Hanoi. After successfully attacking two targets, his wingman was hit and the crew forced to eject. For nearly an hour, Thorsness fought off half-a-dozen MiG-17s to protect both the downed crew and their rescuers. He shot down one MiG and damaged another. Even after expending all ammunition, he remained on station, combating the enemy, offering himself as a target to divert enemy aircraft from the rescue mission. Major Thorsness finally disengaged and returned to base, landing with empty fuel tanks.
Just two weeks later, he was shot down on his 93rd mission and taken prisoner. When commanded to bow to his captors, he refused—and spent the next year in solitary confinement. After six years as a POW, he emerged unbroken in faith, spirit, or love of country. I marvel at his strength, his character, and his will.
Lots of people talk about American exceptionalism. Leo Thorsness, like you in Air Force blue, and all those who serve and have served this Nation in uniform, are, for me, the faces of American exceptionalism.
The Department of Veterans Affairs—VA—as we are called, exists to care for men and women like Leo Thorsness—honoring their courage, strength, and patriotism by keeping faith with President Abraham Lincoln's promise to "care for [those] who [have] borne the battle."
Most people know VA as a large healthcare provider—the largest integrated healthcare system in this country: 152 medical centers, 817 community-based outpatient clinics, 300 Vet Centers, and outreach and mobile clinics that deliver healthcare to the most remote of our rural Veterans—over 1,300 healthcare access points nationwide.
But here's what's also true about VA:
Over 316,000 good people come to work at VA every day. One third of us—over 100,000—are Veterans. The determination, initiative, and leadership they demonstrated in uniform continue to define their performance today, as we transform VA into a 21st century organization.
This country has been at war for more than decade now, and the repeated deployments of our formations have created issues that don't show up right away. More are surviving catastrophic injuries, but higher survival rates also mean more complex casualties—the compounding effects of PTSD, TBI, multiple amputations—five quadruple amputees from these wars—with added complications of blindness, deafness, and genito-urinary injuries.
In 2009, of over 23 million living Veterans in this country, only 7.4 million were enrolled in VA healthcare and only 3 million were receiving compensation and pension benefits—roughly 30 percent "market penetration." 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 also dealing with unresolved issues from past wars—the Gulf War, over 20 years ago, and the Vietnam war, nearly 50 years ago now.
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."
Well, this was the landscape in 2009. And given VA's capabilities, we set three key priorities for ourselves—and they remain unchanged today:
Nothing rivets the attention like ambitious targets on short timelines with names attached to deliverables.
Achieving these priorities required a closer, more collaborative working relationship with DoD. Very little of what we do in VA originates in VA—most of what we work on originates in DoD. So, increasing access, eliminating the backlog, and ending Veteran homelessness are all inherently tied to how Servicemembers depart the military. Seamless transitions become crucial. Warm handoffs of transitioning Servicemembers with issues require the synergy of both departments.
Secretaries of Defense Bob Gates and Leon Panetta and I have met personally ten times in the last 19 months, most recently on 10 September. In July, Secretary Panetta and I testified together for the first time before a joint hearing of the House Veterans Affairs and Armed Services Committees.
Among our accomplishments, we have underwritten joint VA-DoD medical facilities where they make sense, begun reviewing how to harmonize our acquisition decisions, and committed both of our departments to a single, common, joint, integrated electronic health record, IEHR—open in architecture, non-proprietary in design. We expect initial operating capability for IEHR in 2014, and full operating capability in 2017. We intend that transitions from DoD to VA will be mandatory, seamless, effortless, and productive for all Veterans.
So, DoD-VA collaboration was an important first priority. Priority two was fixing VA's budget process. Creating change requires stable, predictable budgets—and as you all can appreciate, funding is firepower when it comes to change.
In 2009, VA's congressionally-enhanced budget totaled $99.8 billion—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. And the President's 2013 budget request, currently before the Congress, is for $140.3 billion—a 40 percent increase since 2009.
Those resource increases have led to increased access: 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, and New Orleans.
We just opened a spectacular, state-of-the-art VA medical center in Las Vegas, Nevada last month. Leaders from Nellis Air Force Base were present because we are partnering with Nellis to provide the best possible healthcare support for their servicemembers, as well as our Veterans, at our first new VA hospital in 17 years.
We have also invested heavily in an already extensive, but growing, telehealth network to overcome the tyranny of distance by electronically linking our more than 1,300 points of care. Enhanced eye-tee technologies make it easier for Veterans to make appointments, access medical specialists located elsewhere in the healthcare system, retrieve their medical records, and find out about available benefits and services -- all without driving long distances. And in roughly 50,000 cases, chronically ill patients do not leave their own homes for most of their healthcare needs. They are monitored 24 hours a day in the environment they are most comfortable and safe in. The President directed VA to move into the 21st century, and it has.
We also fixed those longstanding issues from prior wars I mentioned earlier:
These were the right calls to make for Vietnam, Gulf War, and combat Veterans of all wars. We will not back away from these decisions out of concern that the backlog will grow.
VA has spent the past two years developing a new automation tool called VBMS—a paperless Veterans benefits management system being piloted at four regional offices today. 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 will be key to our dominating this massive claims workload that saw us produce 2.9 million claims decisions over the past 3 ½ years, while taking in 3.5 million claims in return. We still receive paper from DoD. VBMS is about to be fielded. We will be working with DoD and the services to begin providing all transition documents for departing Servicemembers in electrons in 2014 going forward.
In 2009, Veterans suffered disproportionately from homelessness, depression, substance abuse, suicides, and they ranked 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 2009 was 107,000. By 2011, in spite of the extended economic downturn, that estimate had dropped to 67,500. We expect that the 2012 estimate of homeless Veterans which will be released shortly by HUD, the Department of Housing and Urban Development, will keep us on track to end the "rescue phase" of Veterans homelessness in 2015.
"Prevention," the other phase of the battle against Veterans homelessness, will continue indefinitely—requiring VA to focus all our significant capabilities on keeping "at risk" Veterans and families from slipping into that downward spiral that ends in homelessness.
For example, since 2009, VA has issued approximately $21 billion in Post-9/11 GI Bill benefit payments to cover the 802,000 Veterans, Servicemembers, and eligible family members enrolled in universities, community colleges, and technical schools. They must complete their studies; anyone who flunks out in this economy is at high risk of homelessness. Prevention—stay in school; complete your studies; graduate. That's my one word speech to Veteran students wherever I encounter them: Graduate!
Last year, roughly 86,000 Veteran mortgage holders defaulted on their home loans. VA intervened with their financial institutions—lowering payments and extending payment periods. We were able to keep 73,000 of them and their families in their homes. Prevention! And we are working to determine how the ones that went to foreclosure got in so deep financially before we could help. This prevention phase will be on going.
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 resulting from 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 were never enrolled in VA. So, as good as we think we are, we're not helping those we don't treat—another reason why developing a seamless transition and warm handoffs between DoD and VA is so important—and why two secretaries are personally engaged in these discussions.
One of our most successful outreach efforts is our Veterans' Crisis Line. DoD knows it as the Military Crisis Line—a 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. 99,000 were referred for care, and over 23,000 rescued in the midst of crisis. In 2009, we added on-line chat, and in 2011, a texting service. We will always find ways to reach out to Veterans in need.
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 the private sector to hire or train 100,000 Veterans and military spouses by the end of 2013. 2,100 companies responded, and 125,000 Veterans and spouses have already been hired, meeting the President's challenge over a year early.
VA has held its own hiring fairs in Washington, D.C., 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.
Well, this is the state of your VA. Next summer, I expect VA will be able to report that between 2009 and 2013 our budgets reflected:
The author James Michener closes his book, The Bridges at Toko-Ri—a story about pilots, who sacrificed their lives to slow the attack of communist forces down the Korean Peninsula, with the task force commander asking the defining question, which could have been asked at Hale'iwa airfield in December 1941, or at any other location in any other war where danger and the risks were high, but courage and determination were higher still, and valor carried the day—"Where do we get such men as these?" As we would say today, such men and women as these?
The answer is they come from our farms, our villages, and our cities, from both coasts, from our islands and our mountains, and from the American heartland. They also come from the banks of the Hudson [The United States Military Academy at West Point], the Severn [The United States Naval Academy at Annapolis], and from the foothills of Rampart Range [The United States Air Force Academy]. They are Americans, and they are, by God, exceptional.
God bless those who serve and have served our nation in uniform. God bless our President. And may God continue to bless this wonderful country of ours.