Remarks by Secretary Robert A. McDonald
Blinded Veterans Association
Milwaukee, Wisconsin
August 24, 2016
Dale Stamper [BVA National President] thank you for that kind introduction.
Governor Scott Walker, Mayor Tom Barrett, Senator Ron Johnson, Senator Tammy Baldwin, in her absence, and Congresswoman Gwen Moore: Thanks to all of you for your leadership and commitment to America’s Veterans.
And to BVA members helping bring Veterans’ challenges to national attention—thank you for your service and your sacrifices, and for those of your families, as well.
Even before I became Secretary, one of the first questions I had to answer—for myself and for Congress—was, “Why VA?”
Let me share a great story. It’s about how VA’s improving the lives of our blinded Veterans. And, it answers that question, “Why VA?”
During Otto Catalan’s tour in the Persian Gulf with the Navy, he started experiencing problems with his vision. After several visits to specialists, Otto was diagnosed with Retinitis Pigmentosa, or RP. He was 23 years old.
While in rehab at the West Haven Connecticut Blind Rehabilitation Center, Otto spent most of his time crying—feeling sorry for himself. Then he met a Vietnam Veteran.
This Veteran had lost both his arms and both his legs while serving his country.
Otto couldn’t see him, but he could hear his laughter—laughter that gave Otto the courage to find fulfilment in life without sight.
That was the last time he complained about being blind.
Last November, a VA surgeon restored Otto’s sight with the Argus II Retinal Prosthesis—you may know of it as the Bionic Eye. Bionic Eye technology converts images through a camera and transmits it wirelessly to an implant in the eye, and that implant sends the image to the brain.
But here’s what it really does. After 19 years of total blindness, Otto could see the light outside and the sidewalk. After 19 years of total blindness, Otto could see his 20 year old son.
Amazing.
That’s the power of research.
It’s VA research that helped pioneer the implantable cardiac pacemaker. VA researchers conducted the first successful liver transplants. VA researchers are credited with the nicotine patch to help smokers quit. VA researchers designed artificial limbs that move naturally when stimulated by electrical brain impulses.
And it’s researchers like Dr. Ninel Gregori—who restored Otto’s sight. Ninel Gregori is the Chief of Ophthalmology at Miami’s VA Medical Center. She performed Otto’s surgery.
Dr. Gregori and her team are singularly committed to increasing Veterans’ access to this FDA approved prosthetic. It will be a big step forward for blinded Veterans suffering from RP and a big step for American medicine.
This time two years ago, people who’d cut their teeth on Washington politics were asking me, “Why do you want to be VA Secretary?” I told them, there’s no higher calling. There’s no more noble mission—making a lasting, positive difference in the lives of my fellow Veterans.
After confirmation, my first stop was Phoenix. Then, Las Vegas. Then Memphis, Reno, and Palo Alto. Across 25 cities, I consulted thousands of Veterans, VA employees, other stakeholders, and VSO leaders. We talked about how to shape our MyVA transformation strategy so VA would best serve Veterans.
I tell you this because it’s important you understand: this isn’t my strategy, it’s yours.
It’s not about me, it’s about all of you. It reflects your ideals, your insights, and your innovations.
You’ve heard many times that VA is broken.
So I’ll answer one question: Can the Department of Veterans Affairs be fixed—can it be transformed? The answer is yes. Absolutely. Not only can it be transformed, it’s being transformed. Transformation is well underway, and we’re already seeing results.
Changing VA has meant changing leadership. So it’s important you know that 14 of our top 17 executives are new since I became Secretary. These are world-class, enthusiastic business leaders and healthcare professionals—eight of them Veterans like us.
It’s important you know that since early last year our new MyVA Advisory Committee has been helping guide transformation. Committee members have brought extensive experience in medicine, government, Veteran advocacy, customer service, and organizational change.
These are innovative and respected leaders. They know business. They know customer service. They know Veterans.
It’s important you know that over the last two years, we’ve helped build a new national network of 76 Community Veterans Engagement Boards—CVEBs. CVEBs are local partnerships meeting Veterans needs with both community and VA assets. Our goal is 100 CVEBs across the country by year’s end. And if your community doesn’t have A CVEB, let’s get on it.
It’s important you know that to transform VA, we’ve partnered with world-class, respected public and private institutions.
Think partnerships aren’t important to Veterans? Partnerships are why Veteran unemployment has dropped by half in the last 5 years. Unemployment for Post-9/11 Veterans has dropped by more than 70 percent.
To end Veteran Homelessness, we’ve been working closely with 4,000 public and private partners. We launched our 25 Cities Initiative in March, 2014. A few months later, First Lady Michelle Obama announced the Mayors Challenge to End Veterans Homelessness. Over 880 mayors, governors, county and city officials accepted. These partnerships are why 28 communities and two states have achieved an effective end to Veteran homelessness. They’re why over 360,000 Veterans and family members have been housed, rehoused, or prevented from falling into homelessness.
Los Angeles, home to roughly 10 percent of all homeless Veterans in this country, saw a 30 percent decrease in the number of Veterans experiencing homelessness even as their overall numbers increased by 6 percent. Veteran homeless nationwide is down by 47 percent since 2010. We’ve cut it in half.
So all that’s a product of new VA leadership, innovative collaboration, and expanded partnerships.
It’s all important for you to know.
Let me talk about VA healthcare. You already know VA’s the largest integrated health care system in the country. We have a unique lifetime relationship with our nine million patients, and a single electronic health record across the entire enterprise. Nobody else offers that.
Our mental health care is integrated with primary care, with specialty care, and with psycho-social support to minimize barriers and help resolve problems early. Nobody else offers that.
VA healthcare is whole Veteran healthcare—body, mind, and soul, customized to meet Veteran needs. Yoga. Acupuncture. Bionic Eyes. We validate and embrace what works to heal Veterans.
And VA care is integrated with non-medical determinants of health that people often miss. I’m talking about things like education services, career transition support, pension resources, disability compensation, and many others. Nobody else offers all that. Nobody.
We’re the only US healthcare system to completely and seamlessly integrate blind and vision rehabilitation services for patients into its health benefits.
There are about 132,000 legally blind Veterans in the United States. There are more than one million Veterans who have low vision—impacting their ability to perform daily activities. Our Visual Impairment Services Team Coordinators across the country ensure visually impaired Veterans receive all the benefits they’ve earned and deserve, both inside and outside VA. Nobody else does that.
And we’re the only system of care that provides all needed prosthetic devices and cutting edge access technology at no cost for visually impaired Veterans. In fiscal year 2015, we provided nearly 240,000 prosthetic devices and access technology to blind and visually impaired Veterans, totaling more than 34 million dollars. Nobody else offers that.
Let me talk about access to VA healthcare. 97 percent of appointments are now completed within 30 days of Veterans’ preferred date, 91 percent within 14 days, 85 percent within seven days, and 22 percent are completed the same-day.
You should know that the average wait time for primary care is around five days, six days for specialty care, and two days for mental health care. And by December, you can expect same day access in primary care and mental health care. By the way, VA’s the only healthcare system that publicly reports on wait times as a measure of access.
Ninety percent of Veterans we’ve surveyed are “satisfied or completely satisfied” with the timeliness of their care. We won’t be satisfied until we hit 100 percent.
You should know that more Veterans are coming to VA for their care, and waiting less time. You should know that, last year, Veterans had nearly 5 million more appointments than the previous year. Almost 57 million were in VA facilities, over 21 million were VA care in community. Last March Veterans set a record for completed appointments—5.3 million inside VA, 730,000 more than March 2014. Last March Veterans were issued 370,000 authorizations for care in the community—twice as many as March 2014.
Those authorizations represent more than two million appointments for Veterans in the months ahead.
In fiscal year 2015, VA provided high quality eye care services for over 1.7 million Veterans. As more and more Korean and Vietnam era Veterans lose their sight from age-related diseases, like macular degeneration and glaucoma, those numbers will increase.
That’s why we expanded our Blind Rehabilitation Service—so we would be ready to care for all visually impaired Veterans more completely. In fact, since 2010, we’ve grown the number of service providers for blind Veterans by more than 100%.
Now, over 625 full and part-time blind rehabilitation professionals provide a full continuum of care. That care extends from the Veterans’ homes to local VHA care sites to regionally based inpatient and outpatient vision and blind rehabilitation programs.
52 vision and blind rehabilitation outpatient clinics complement 13 comprehensive inpatient blind rehabilitation centers. And, 93 Blind Rehabilitation Outpatient Specialists serve frail and elderly Veterans in their homes and communities.
So we’re making important progress—advancing along all these lines, and many others.
But you rarely read that in headlines.
You’d never know we lead in many fields of research that benefit all Americans—PTSD, traumatic brain injury, spinal cord Injury, prosthetics, genetics.
You’d never know the American Customer Satisfaction Index rated your National Cemetery Administration No. 1 in customer service five times running.
You’d never know J.D. Power rated your mail-order pharmacy best in the country in customer satisfaction six years running.
Not too long ago, all you heard about was our backlog—611,000 claims more than 125 days old. You’d never know that, today, the backlog is down almost 90 percent, and the average time waiting for a completed claim is down 65%.
How’d we do it?
We added staff, adjusted policies, and designed an automated claims processing system. We’re eliminating bureaucracy and unproductive work and encouraging innovative approaches. We’re promoting best practices in healthcare and sharing them across the healthcare system.
But you never read about that.
And we have the right people in the right places to do that.
VA’s Director of 508 Compliance, Pat Sheehan, who is also visually impaired, and his team are committed to increasing your access to the websites and documents you need. Let me ask Pat to stand so I can introduce him. If you have questions about anything related to 508 Compliance, call him at 202-461-5207.
I want to make sure your questions are answered so we keep progressing in tangible, relevant ways.
Marianne Brody who works for Vets.gov is also here. She has a booth set-up outside.
Her job is to make sure that the site is not only accessible but also useable. She’d love to receive feedback from you—so stop by and let her know how we’re doing. If we’re not on track, we’ll fix it.
I’m convinced that, together, we can take on the toughest challenges and make a difference.
Listen, our employees like Pat Sheehan and Marianne Brody, are good people. I’m proud of ‘em. They care about us. They want to serve us well. And we’re equipping them for success.
None of us are perfect. Not by a long shot. But it’s a gross misrepresentation to cherry-pick the worst and hold them up like they represent VA employees, just like it’s a gross misrepresentation to hold up a bad Veteran to represent all of us. It’s a distortion that sells papers, but it’s a distortion that hurts Veterans, and hurts the good people caring for them.
Some claim there’s no accountability at VA. Tell that to the VA employee in Augusta, Georgia, recently convicted of falsifying healthcare records. He’s facing sentencing that could include years in prison and hundreds of thousands of dollars in fines.
In two years we’ve terminated over 3,750 employees. And some people think everything will be fine if we can only fire more people, more quickly. It’s not true.
We can’t fire our way to excellence. In more than 33 years in the private sector, I’ve never encountered an organization where firing people was a measure of leadership.
Now, consequences for behavior inconsistent with our values are part of effective leadership. But we won’t punish people based on opinions, recycled and embellished media accounts, or external pressure.
It’s not in the best interest of the Veterans we serve.
Excellence is what we’re after. So the right dialogue is about forward-looking leadership, and sustainable accountability. Sustainable accountability gives you positive outcomes.
It’s leaders and supervisors providing routine feedback, just like we remember in well-led, well-trained military outfits. It’s ensuring employees understand how daily work supports our mission, values, and strategy. It’s training leaders to lead and employees to exceed expectations, every day. It’s recognizing what’s going well, and coaching and re-training when improvement’s necessary. And, yes, it’s taking corrective action when it’s warranted and supported by evidence.
These are pretty simple concepts for Veterans. These same principles built the greatest fighting force in history.
We all want to look back at 2016 as the year we turned the corner for Veterans.
And we are doing everything we can with what we’re given. But there are some things we can’t do without the help of Congress.
It’s important you know the Senate Appropriations Committee approved a budget nearly equal to the President’s request. The House proposed a $1.5 billion reduction. The reduction will hurt Veterans and impede some critical initiatives to transform VA into the high-performing organization you deserve. In fact, there are more than 100 legislative proposals for Veterans in the President’s 2017 Budget—many vital to maintaining our ability to purchase non-VA care.
Only Congress can modernize and clarify our purchased care authorities so there’s a strong foundation for your access to Community Care in years ahead.
Only Congress can clear the way for us to streamline our Care in the Community systems and programs. We submitted our plan last October, but we need congressional action to execute it.
Only Congress can enact legislation so we can better compete with the private sector and get the best medical professionals to choose to serve Veterans.
And only Congress can modernize the archaic appeals process. Last year, the Board was adjudicating an appeal that originated 25 years ago. It had been decided more than 27 times.
Under current law with no significant change in resources, the number of Veterans awaiting a decision will soar by 179 percent by 2027—from 500,000 to nearly 1.3 million. So VA, the Veteran Service Organizations, the National Association of State Directors of Veterans Affairs, the National Association of County Veterans Service Officers, and other Veteran advocates shaped a simplified, streamlined, and fair appeals plan.
It’s your plan. It’s my plan.
We’ve urged ambitious action by Congress, and we need them to pass the law.
The legislation costs nothing, and it will be more efficient and less costly over time. In five years, you could have appeals resolved within one year of filing. The alternative? Devote more resources to the broken system and fund more employees to administer it.
And you’ll be waiting 10 years for a final decision on your appeal.
It’s unacceptable to me. I bet it’s unacceptable to you.
These proposals and others require congressional action. And you VSOs are the ones who can make it happen.
95 years ago, VSOs made the Veterans Bureau happen. Nine years later, VSOs made the Veterans Administration happen.
VSOs got us the GI Bill.
VSOs got us the Montgomery GI Bill.
VSOs got us the post-9/11 GI Bill.
VSOs are why President Reagan made VA a Department—giving all of us “a seat at the table of our national affairs.”
And you’re the ones who can keep Veterans in control of how, when, and where they wish to be served.
And that is what MyVA is about.
Some have argued VA can best serve Veterans by shutting down VA healthcare altogether. They argue that closing VHA is the “bold transformation” Veterans and families need, want, and deserve.
I suspect that proposal serves some parties somewhere pretty well. But it’s not transformational. It’s more along the lines of dereliction. It doesn’t serve Veterans well, and it doesn’t sit well with me.
You’ve heard and you’ll keep hearing many more recommendations for VA’s future.
Make sure there’s substance to those discussions. Make sure they’re about Veterans’ interests, and not something else.
Make sure they’re anchored to the service and sacrifice—that sense of duty and honor—that Veterans represent, and only Veterans understand.
It is your VA. It always has been.
And I’m privileged to serve with my VA colleagues as we move forward to strengthen and renew the sacred covenant between America and her Veterans.
God bless you and your families.
God bless Veterans.
And God bless the United States of America.
