I appreciate this opportunity to update you on VA’s accomplishments this past year. A lot has happened since I first addressed this mid-winter conference a year ago.
I mentioned at that time that VA had inherited and was executing a congressionally enhanced 2009 budget—heavily enhanced. It was a good budget on which to build the truly important work we had to accomplish last year—crafting a first-ever 2010 budget and a 2011 advance appropriations request. Thanks to your legislative initiatives, we have the opportunity to operate under two-year budgets, reducing the constraints of continuing resolutions.
Resources. We worked hard at preparing that 2010 budget and 2011 advance appropriations request. As you now know, our work paid off. President Obama fully supported our budget request in 2010, by providing us a 16.7 percent [enacted] budget increase above the 2009 budget—the largest budget increase in 30 years.
This year, VA is executing a budget of $114 billion. Our 2011 budget request is $125 billion—$60.3 billion in discretionary resources and $64.7 billion in mandatory funding. These increases provide VA two-year, discretionary funding of almost 20 percent above the 2009 congressionally enhanced budget.
Thanks to the President and the Congress, 2010 and 2011 are strong budgets that provide us the resources required to increase Veteran access to benefits and services, reduce the backlog, and end Veteran homelessness within five years.
Before touching on these priorities, let me address the Post 9-11 G.I. Bill—an important, no-fail priority. From a standing start last August, we finished the fall semester with 173,000 Veterans in school at 6,500 colleges and universities, being paid for by VA.
You know that, lacking automated tools, we got off to a rocky start. But we learned as we went and put in place the necessary fixes for this spring semester. As a result, on 1 February 2010, the first day we could flow checks, we had 131,000 checks going to enrolled Veterans. Today, 194,000 of 200,000 enrolled Veterans are receiving their checks. We are processing roughly 7,000 enrollment certificates a day, so the delta in enrollments is being managed on a daily basis. We are on a good glide path here and will be fully automated by the end of this year. Post 9-11 G.I Bill recipients are just part of the 565,000 Veterans being educated through VA’s several education programs.
Access: We are expanding access to our care and services through upgraded facilities, by expanding Priority Group 8 eligibility, by increasing investments in telehealth, and by opening new cemeteries.
This time last year, we had 768 CBOCs—Community-Based Outpatient Clinics; 232 Vet Centers; 50 mobile Vet Centers and 7 mobile outpatient clinics; and 128 national cemeteries. In the past 12 months, we have opened 20 new CBOCs, 36 Vet Centers, purchased 2 additional mobile outpatient clinics, and opened 3 new cemeteries. And we’re not done yet, by 2011, we are projected to have over 70 more CBOCs and 31 more Vet Centers.
Additionally, over the past year, 40,000 chronically ill Veterans, who qualify for remote monitoring, have been provided telehealth connectivity so that they don’t have to travel to our hospitals or clinics to have their conditions checked. With the power of the microprocessor, they can be monitored from their own homes—this is also what we mean by increasing access to VA care and services. We are investing $121 million in teleheath this year to move VA to the head of the line in 21st century health care delivery.
Homelessness: A year ago, we estimated that 131,000 Veterans slept on the streets of this powerful and wealthy country, and we pledged that we were going to end Veteran homelessness over the next five years.
Today, we estimate that 107,000 of those 131,000 Veterans remain homeless—a decrease of 18 percent. It’s a good start—but merely a start. We need a full court press to drive those numbers down. It’s not just about providing beds and shelter to homeless Veterans; it’s also about taking care of their mental health issues—PTSD, depression, TBI. It’s about dealing with their methods of self medication—the abuse of drugs and alcohol. And it’s about giving them hope and reversing suicide ideation. And finally, it’s about education, jobs, and the dignity of being capable of caring for one self. That’s where we’re headed in ending Veteran homelessness. We welcome your collaboration and support in eliminating it.
The Backlog: This is one area in which we did not progress as I would have wanted. Getting the Post 9-11 G.I. Bill program up and functioning, did pull me away from working the backlog. That’s not to say we did not work this hard. Last year we completed 977,000 claims—and then received roughly another 1 million new claims to take their place. Some see that as terrible. I don’t—I see our outreach to and education of Veterans who have never submitted claims before as succeeding.
2010 is my year to focus on finding and breaking the obstacles that deny us faster and better processing, and higher quality outcomes. As a first step, over the past year, we put four pilots into motion: Pittsburgh, where we are designing how to build the best claim possible for each Veteran. In this pilot, VA will partner with Veterans and the VSOs. This is about veterans being treated as our clients and our intent to change the culture inside VA over time to one of advocacy for Veterans. Like building a legal brief, how do we make each claim the best and strongest argument to win the case for the Veteran?
Pilot #2 is in Little Rock, Arkansas. Business process re-engineering—when that “best possible claim” arrives for adjudication, who touches it first, how many others have to touch it, and what are the structural relationships that make this the most efficient process?
Pilot #3, Providence, Rhode Island. What automated tools are needed to increase speed, accuracy, efficiency, and security? The goals are no lost claims, and highest accuracy in claims processing. We didn’t want to automate bad processes and just get lousy decisions faster, so we broke the complex process down into its component pieces to improve each part before putting them back together again.
And finally, Pilot #4 pulls together all these efforts to create the virtual regional office of the future. This will replace the 57 ROs we have out there now with a target to eliminate the claims backlog by 2015.
Well, why 2015? Why so long, if I’m working this as a priority? Because in October 2009, we made an Agent Orange decision that added three new diseases to the presumptive list for service connection [Parkinson’s, hairy cell leukemia, ischemic heart disease]. It was the right decision for our Vietnam Veterans, who have been dealing with the toxic effects of Agent Orange for the past 40 years.
Logically, the overall number of claims can be expected to grow, as will the backlog and processing times due to these new Agent Orange claims. But with these four pilots and an unprecedented 27 percent increase we are providing to VBA’s budget in 2011, I expect to shape and control this anticipated growth in claims—so that by 2015, we will be well on our way to eliminating the backlog.
Our long-term solution to claims processing is to operationalize the concept of “seamless transition” between DoD and VA as military servicemembers shed their uniforms and enroll with us. “Seamless transition” is our joint DoD-VA concept of universal registration, where servicemembers’ personnel and medical records are duplicated in VA, even as those service records are being populated, while they still serve in uniform. That way, there is no air gap in the transfer of those records when the uniforms come off at the end of their military service.
To enable this kind of seamlessness, a new information system called V-LER, the Virtual Lifetime Electronic Record, is being developed by both VA and DoD. The President mandated V-LER last April 2009, as the future transformational record for all servicemembers and Veterans. When fielded, V-LER will track each member of our military forces—active and reserve component—from the day they first put on the uniform until the day they are laid to rest. This will transform our benefits administration—faster processing, better decisions, fewer errors, no lost records.
We must and will transform VA into the high-performing, well-disciplined, transparent, and accountable organization we all know it’s capable of being. 300,000 good people come to work everyday to serve Veterans. We must focus all of their efforts on providing Veterans the highest quality and safety in benefits and services.
The need to transform VA is, in part, to harmonize two very distinct images of men and women, who have worn our Nation’s military uniforms—two incongruent images that are troubling.
The first image is this—and it is one most familiar to everyone in this audience. Each year, something around 60 percent of high-school graduates go on to colleges, universities, community colleges—some version of higher education. Of the remaining 40 percent or so, some undergo vocational training, and some immediately enter the workforce. Fewer others join the less than 1 percent of Americans, who volunteer to serve in our Nation’s Armed Forces. Most young people today have no memory of a draft Army.
After enlisting, they undergo weeks of rigorous physical training and mental preparation for a disciplined life of values, standards, and accountability. Following graduation from basic training, they join a wide variety of units—platoons, ships, squadrons, and detachments.
When they reach those first units, they quickly become valued and trusted members of high-performing teams—tough, motivated, and extremely dedicated. With excellent leadership, they go forward, each and every day, to perform the complex, the difficult, and the dangerous missions. On some days, they are asked to do the impossible. think of what they’ve been asked to do, and what they’ve accomplished, with unwavering commitment and without complaint, these last eight years in Iraq and Afghanistan.
But there is a second image—Veterans suffer disproportionately from homelessness, depression, substance abuse, and suicides, and they are well up there in joblessness, as well. 107,000 of them sleep on the streets of our Nation. Another 40,000 Veterans are released from prison each year.
What’s wrong with these disparate images? To be sure, there are fewer in the second image than the first, but they are the same youngsters. How did we fail to continue the kinds of successes they achieved while in uniform? How do we keep them from entering that downward spiral of joblessness, depression, and substance abuse that often leads to homelessness and, sometimes, to suicide? It’s not about them; it’s about us.
At VA, our goal is to never allow those in image #1 to become part of image #2, and to return those in image #2 to lives as productive as possible. Our five-year plan is aggressive—but achievable. Can we do it alone? No—we need your help.
Your history of helping Veterans is long and distinguished. From education to employment opportunities to ensuring Veterans understand all of what VA has to offer, you are tireless advocates for the men and women who have worn the uniform. Each year, your members devote more than 15 million hours of service to worthy causes. The quality of life for thousands of Veterans and their families has been enhanced because of your efforts.
Thank you for what you do for Veterans. Thank you for the opportunity to speak with you this morning. I look forward to working with you in the years to come.
May God bless our Veterans and may God continue to bless our country and the men and women who defend her.