I’m especially honored to be with you this morning. The Blinded Veterans Association has long been known for its significant contributions on behalf of America’s visually impaired Veterans. Equally important, you have been a driving force behind the many important gains made by Americans disabled by vision loss for over 60 years now.
“In valor, there is hope,” according to the Roman historian Tacitus. Your members live courageously each and every day just going about their routines. In doing so, they give hope to so many others—fellow blinded Veterans, other visually impaired Americans. Your visits to Walter Reed and Bethesda medical centers lift spirits of severely eye-injured OIF and OEF service members and their families.
You once served America in uniform, and you are serving her again through your efforts on behalf of blinded Veterans. Your leadership here is crucial, if we are to get things right. There is legitimacy to your voices that’s different from everyone else’s. We salute your leadership in the family of Veteran service organizations.
Your field service programs, scholarships, volunteers, regional groups, and legislative advocacy provide the bedrock for your support of blinded Veterans and their families. Our partnership has been substantial and productive. I look forward our continuing collaboration.
Over the past seven months, I have visited VA facilities—large and small, urban and rural, complex and simple—all across the country. I’ve spoken with leaders, staffs, and Veterans. I also invited each of our 21 VISN directors to share with me their requirements; their priorities; their measurements for performance, quality, and safety; and their need for resources—people, money, time. I took the final, four-hour VISN presentation last Friday. This was time well invested—an invaluable learning experience.
Every day, 288,000 people come to work at VA to serve Veterans. We have only one mission—to care for our nation’s Veterans, wherever they live, by providing them the highest-quality benefits and services possible. We must do this faster, better, and more equitably.
VA’s legacy of service is an unwavering pursuit of President Lincoln’s charge “to care for [those], who shall have borne the battle.” These words are as compelling for us today as when they were first delivered during Lincoln’s second inaugural address.
The Veterans I’ve met in my travels have been uplifting. Many struggle with conditions inevitable with old age; others live with uncertain consequences from exposures to environmental threats and chemicals; still others have recently returned from Afghanistan and Iraq bearing the fresh wounds of war—visible and invisible.
Out of my encounters with Veterans, three concerns kept coming through—access, the backlog, and homeless Veterans.
Access: Of the 23.4 million Veterans in this country, roughly eight million are enrolled in VA. Five-and-a-half million have used our medical services at least once; three-and-a-half million visit our medical facilities regularly. Why have over 15 million Veterans never enrolled with us? Whatever the reason, VA will continue reaching out to them to explain our benefits, services, and the quality of our healthcare system.
A major initiative which will expand access is the President’s decision to welcome back some 500,000 Priority Group 8 Veterans, who lost their entitlements in 2003. We began registering them in July, and we expect 266,000 enrollments this first year, through 2010.
Another initiative to expand and improve access is the evolution of our healthcare delivery system. VA’s 153 medical centers are the flagships of our nationwide integrated healthcare enterprise. About a decade ago, VA brilliantly decided to move away from the concept of “here are our flagships; come visit us” to one that endeavors to deliver healthcare to wherever Veterans live.
To do that, we have created a system of 768 Community-Based Outpatient Clinics, 232 Vet Centers, outreach and mobile clinics, and when necessary, contracted specialized healthcare locally.
Our next major leap in healthcare delivery will be to routinely connect flagship medical centers to distant Community-Based Outpatient Clinics and their even more distant mobile counterparts via an IT backbone that places specialized healthcare professionals in direct contact with patients via telehealth and telemedicine hook-ups.
Today, we are even piloting connectivity from medical centers to the homes of the chronically ill to provide better monitoring and the prevention of avoidable acute episodes. This means that Veterans will drive less to receive routine healthcare, but they will have better access day to day. It will be higher quality and more convenient, especially for Veterans challenged by long distances—and prevention will mean healthier lives.
The backlog: Even though less than 50 percent of the Veteran population receives care or benefits from VA, we have a backlog in disability claims. The total number of claims in our inventory today is around 400,000, and backlogged claims that have been in the system for longer than 125 days total roughly 145,000 cases. In July, we closed out 85,000 claims and received another 89,000 new ones. Regardless of how we parse the numbers, there is a backlog, it is too big, and Veterans are waiting too long for their checks.
In April, President Obama charged Defense Secretary Gates and me to build a fully interoperable electronic records system that will provide each member of our armed forces a Virtual Lifetime Electronic Record that will track them from the day they put on the uniform, through their time as Veterans, until the day they are laid to rest.
VA is already a leader in the development and use of electronic health records. So is the Department of Defense. Between us, DoD and VA have an opportunity to drive the improvement of healthcare through a fully interoperable electronic health record. Our achievements here may go beyond Veterans and service members and could help the nation, as a whole. We are working with the President’s chief performance, chief technology, and chief information officers to harness the powers of innovation and technology. For VA, it will revolutionize our claims process—faster processing, higher quality decisions, no lost records, fewer errors. I am personally committed to reducing the processing times of disability claims. We have work to do here, and we have moved out.
Homelessness: Veterans lead the nation in homelessness, depression, substance abuse, suicides, and they rank up there in joblessness, as well. Here again, this is an accumulation of neglect. We estimate that 131,000 Veterans live on the streets of this wealthiest and most powerful nation in the world—men and women, young and old, fully functioning and disabled, from every war generation, even the current operations in Iraq and Afghanistan. Some of them will sleep on the streets here in Portland tonight.
Six years ago, that number was 195,000, so we think we have the right partners, the right plans, and the right programs in place. We are moving in the right direction to remove this blot on all our consciences.
President Obama and I are committed to ending homelessness among Veterans. We are going to take those 131,000 homeless Veterans off the streets over the next five years. No one who has served this nation, as we have, should ever find themselves living without care—and without hope. I know that there are never any absolutes in life, but unless we set an ambitious target, we would not be giving this our very best efforts. To do this well, we will have to attack the entire downward spiral that ends in homelessness. We must offer education, jobs, treat depression, fight substance abuse, and offer safe housing. We have to do it all—no missed opportunities in going from 131,000 to zero and keeping it there—education, jobs, mental health, substance abuse, housing.
Education: The President and Senators Jim Webb and John Warner just kicked off our new Post 9/11 GI Bill program on 3 August. We expect roughly 150,000 Veterans to take part in this fully funded, degree-producing program at a state college or university of their choice this year. An additional 1,100 private institutions have elected to participate in a special arrangement called the Yellow Ribbon Program. This investment in America’s future will go on for decades to come.
The first time we did this in 1944, after World War II, our country ended up being richer by 450,000 trained engineers, 240,000 accountants, 238,000 teachers, 91,000 scientists, 67,000 doctors, 22,000 dentists, and a million other college-educated Veterans. They went on to provide the leadership that catapulted our economy to world’s largest and our nation to leader of the free world and victor in the Cold War. Lightning is about to strike twice for those who have answered our nation’s call.
Jobs: I recently addressed over 1,700 Veteran small-business owners at the 5th Annual Small Business Symposium on 21 July. I reminded them that Veterans hire Veterans because they know what they’re getting. Customers and partners value their skills, knowledge, and attributes and are eager to work with them.
Just last fall, in a survey conducted by the Society for Human Resource Management, over 90 percent of employers said they valued Veterans’ skills—in particular, their strong sense of responsibility and teamwork.
VA puts Veterans first in our contracting awards because we recognize the on-time, on-budget, quality solutions they bring to our contracting needs. In fiscal year 2008, our unique “Veterans first” buying program resulted in VA’s spending more than $2 billion on Veteran-owned small businesses. That represented 15 percent of our procurement dollars—up five percent from the previous year.
During that time, we also doubled our support to service-disabled Veteran-owned businesses. That means 12 percent of our procurement dollars—$1.6 billion of $2 billion expended—was invested here.
At VA, our experience is that Veteran-owned small businesses have high likelihood for creating new jobs, developing new products and services, and building prosperity. As I said earlier, Veterans hire Veterans. So increasing opportunities for Veteran-owned small businesses is an effective way to help address many needs during this economic downturn.
Homeless Healthcare: We will spend $3.2 billion next year to prevent and reduce homelessness among Veterans—$2.7 billion on medical services and $500 million on specific homeless programs. With 85% of homelessness funding going to healthcare, it means that homelessness is primarily a healthcare issue—heavily burdened with depression and substance abuse. The psychological consequences of combat affect every generation of Veterans. VA now employs 18,000 mental health professionals to address our mental health needs. We know if we diagnose and treat, people usually get better. If we don’t, they won’t, and sometimes their problems become debilitating. We understand the stigma issue, but we are not going to be dissuaded. We are not giving up on any of our Veterans with mental health challenges, and definitely, not the homeless.
Homeless Housing: We have approximately 500 partners in nearly every major town and city across the country helping us get homeless Veterans off the streets. With 20,000 HUD-VASH vouchers from the Department of Housing and Urban Development and our $500 million to invest in 2010 to cover safe housing and rehabilitation for Veterans we have been able to coax off the streets, we are going to reduce the number of homeless Veterans next year, and each year thereafter, for the next five.
So, education, jobs, healthcare, and housing: We have work to do here, but we have momentum, and we know where we are headed.
President Obama has charged me with transforming VA into a high-performing 21st century organization. It will be a different organization from the one that exists today.
Five years from now, we intend to be the provider of choice for more of that larger population of 23.4 million Veterans in insurance, in healthcare, in education, in home loans, in counseling, and in employment.
To achieve this kind of status with Veterans, we must make it easier for them to understand their entitlements and then make it much simpler for them to access their benefits and healthcare services.
Beyond the five years, we’re looking for new ways of thinking and acting. We are asking why, 40 years after Agent Orange was last used in Vietnam, this secretary is still adjudicating claims for service-connected disabilities related to it. And why 20 years after Desert Storm, we are still debating the debilitating effects of whatever causes Gulf War illness. Left to our present processes, 20 or 40 years from now, some future secretary could be adjudicating service-connected disabilities from our ongoing conflicts. We must do better, and we will.
If you haven’t already heard, the Institute of Medicine recently released a new study on a possible link between Agent Orange and heart disease and Parkinson’s. We have this study under review now, and I assure you, we will get this right.
My remarks this morning comprise a seven-month progress report on the state of your department. I intend to do this again next year. Much more remains to be done. We need your continued support and assistance, if we are to become the provider of choice. My mission is to serve Veterans by increasing their access to our benefits and services, to provide them the highest quality of healthcare available, and to control costs to the best of my abilities. Doing so will make VA a model of good governance. Doing so will also keep faith with President Lincoln’s charge to care for those who have borne the battle and grant them the dignity and respect they deserve until they are laid to rest. That is my mission.
We count on BVA’s partnership in all of these endeavors. Thanks to you, we now have more blind rehabilitation outpatient specialists providing services for Veterans in areas of the country with the least vision resources. Thanks to you, blinded Veterans in many areas will no longer be required to receive treatment on an in-patient basis, but will be able to visit one of our new 55 out-patient rehabilitative and low vision clinics.
I commend BVA, in particular, for recognizing and supporting coordination between DoD and VA to provide better services for Veterans. We are fully supportive of the Defense and Veterans eye injury registry and the Vision Center of Excellence in Bethesda. We look forward to working with DoD on these very worthy projects.
We are committed to providing a continuum of care for blinded Veterans that meets all their needs. More remains to be done, and for that we will need your continued advice and assistance.
For all that you do, you have my deepest respect and appreciation.
God bless our men and women in uniform. God bless our Veterans, and God bless our wonderful country. Thank you.