Good morning. I'm honored to be here with ACA—the American Correctional Association. Tom [Burns, Senior Vice President, Aramark Correctional Services], thank you for that generous introduction. Let me also acknowledge:
Congratulations to ACA for 143 years of distinguished service to the Nation and our citizens. Founded in 1870, ACA is 26 years older than our oldest Veterans service organization and 60 years older than my own department. Your history, in some ways, parallels the history of our American democracy. In the early 1800's, our Nation's initial prison reforms caught the attention of a young Frenchman named Alexis de Tocqueville, whose study of our prisons inspired a larger study about democracy in America. Through his eyes, Europe and the civilized world received an early look at how democracy was taking form in America.
De Tocqueville's work is a classic and is still read today. He was the first to describe America as "exceptional" and to make the case for what we now call "American exceptionalism." He wrote that "the greatness of America lies not in being more enlightened than any other nation, but rather in her ability to repair her faults." [Democracy in America, I, xiii] He explained that, though Americans often made mistakes in building their new republic, they learned from and quickly corrected them.
ACA was founded to do just that—learn from the past and find better ways to handle the responsibilities for corrections in the future.
Over some of the same years, this country also sought ways to better care for those who, in President Abraham Lincoln's words, "have borne the battle"—the men and women who have fought our wars. Those efforts led to the establishment of the Veterans Administration in 1930, to the passage of the original "GI Bill" in 1944, and to the elevation of VA to cabinet-level status in 1989.
Today, the Department of Veterans Affairs is the largest integrated healthcare system in the country: 151 medical centers, 827 community-based outpatient clinics, 300 Vet centers, and 70 outreach and mobile clinics that deliver healthcare to the most remote of our rural Veterans—over 1,700 healthcare access points nationwide.
But, we are that and more:
Over 331,000 good people come to work at VA every day. One third of us—over 100,000—are Veterans, and the determination, initiative, and leadership they demonstrated in uniform continues to define VA's performance today. But, we are still always looking for better ways to serve Veterans.
hen I took office in 2009, we had an outreach problem—many Veterans didn't know about VA. We had an access problem—even if they knew about us, some couldn't get to us. And we had, and still have, a backlog problem—it takes too long to process Veterans' compensation claims.
Four-and-a-half years ago, we were also dealing with the "unfinished business" from past wars—the Gulf War, over 20 years ago; the Vietnam War, nearly 50 years ago now; and the issues of PTSD—post-traumatic stress disorder—as old as combat itself.
And four-and-a-half years ago, an estimated 107,000 Veterans were homeless on any given night, and another estimated 150,000 of them were also incarcerated.
That was the landscape back in 2009, and so, we set three key priorities for ourselves to better serve Veterans:
Since 2009, with the leadership of the President, the support of the Congress, the advice and assistance of Veteran service organizations, and our partnership with many federal, state, and local agencies, VA has made substantial progress on all three fronts:
Access: Outreach and access initiatives have brought in more than 2 million new healthcare enrollees. We have opened a net total of 62 new community-based outpatient clinics and the first major VA hospital in 17 years, in Las Vegas, Nevada. We have also invested heavily in telehealth and other IT improvements that connect us to Veterans while saving time and money incurred by travel.
Backlog: The backlog is beginning to decline as we predicted in our plan due to a re-trained workforce, re-engineered business processes, and a new automated claims processing system. In March of this year, the backlog reached its high water mark of over 611,000 claims. Today, it is just over 492,000, a drop of about 119,000 claims in roughly 150 days. This number will continue to decline, and VA remains committed to eliminating the backlog in disability claims in 2015.
Homelessness: We have also seen Veterans' homelessness drop by 17 percent from 2009 to 2012, which will drop even further once this year's count is finalized.
Veterans homelessness, in my view, is relevant to corrections. The same factors that spiral people downward—depression, substance abuse, job loss, anger issues, failures in relationships, homelessness—also contribute to incarceration. Our commitment to end Veterans' homelessness is also intended to reduce Veterans entry into the corrections system, and everything we do to assist Veterans in transitioning from corrections back into their communities, reduces Veterans homelessness and the potential for re-incarceration.
The fight against homelessness has two arms: rescue and prevention. Rescue is about getting Veterans who live on the streets today into safe housing. We take the "housing first" approach to get homeless Veterans quickly and safely housed. Once we have them housed, then we turn to meeting their clinical and other needs. We house homeless Veterans by several means, principally a voucher program administered jointly by HUD and VA, a grant program that tries to keep Veterans and families in their own homes, and a grant-and-per-diem program to reserve space in housing activities run by our local partners.
Prevention, on the other hand, involves a wider range of services aimed at providing Veterans with education, employment, and healthcare, especially for mental health. The thinking on mental health has progressed over the years. In the past, people thought in terms of the "normal and healthy," on one hand, and the "mentally ill and unreliable," on the other—creating an obvious stigma against seeking help. If you were among the "normal and healthy," you didn't dare seek professional help for mental or emotional stress, because just seeking help moved you over into the "mentally ill and unreliable" category. And once there, you were afraid of not getting back.
Today, we know that two mutually exclusive categories based on mental health are too simplistic. We know that mental wellness is an issue for many people, and that we all, at times, could use some help in dealing with life's difficulties, including post-traumatic stress. So, at VA and DoD, we make it easier for Veterans and Servicemembers to get treatment without being ostracized for having the courage to seek help.
Through the strong leadership of the President and the support of the Congress, we continue to improve access to mental health services. The President's budget requests between 2009 and 2014 increased VA mental health funding by nearly 57 percent. For FY 2014, the VA budget request reflects nearly $7 billion for mental health funding.
Mental health staff levels have also increased to keep pace with Veterans' needs. A year ago, the President directed the hiring of 1,600 additional mental health professionals. Since then, VA has exceeded that goal, and we are also hiring 800 peer-support specialists before the end of the year.
At VA, we know that when we "identify and treat," people get better. So to maximize our opportunities for "identification and treatment," we are increasing our collaboration at the local level by hosting mental health summits at each of our 151 VA medical centers.
One of our most successful 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, 24/7—an example of our partnering to deliver optimal care to those in crisis. Since start-up in 2007, the Veterans Crisis Line has answered over 890,000 calls from Veterans in need. Most importantly, 30,000 of those callers were rescued from suicides in progress because our mental health providers were standing by to help.
Chatting and texting appeal to those who are comfortable with technology. So, in 2009 we added an on-line chat service, and in 2011, a texting service. Since then, we've engaged almost 118,000 people in on-line chats and by texting.
We have also developed a new mobile phone app—designed jointly by VA and DoD—called the "PTSD coach" -- to help Servicemembers and Veterans manage their readjustment challenges in real-time and to access mental health assistance anonymously.
Many Veterans just entering the justice system are already dealing with mental health or substance abuse issues. To help them get their lives together and avoid future run-ins with the law, we stood up a Veterans Justice Outreach Program (VJO)—172 full-time specialists, working directly with justice officials, to see that Veterans, in jail or before the court, get the care they need and that courts consider the best possible alternatives to incarceration. Justice outreach specialists already serve about 30,000 Veterans annually, and the plan is to hire another 70 specialists next year for greater outreach.
At the other end of the justice system, we have the Health Care for Reentry Veterans Program (HCRV)—44 full-time specialists with access to over a thousand prisons (about 80 percent of prisons in the U.S.), connecting soon to be released Veterans with a range of VA services available to them on the outside: healthcare, housing assistance, educational assistance, vocational counseling and training—services they will need to become productive, law-abiding citizens.
When our reentry specialists identify Veterans, they meet with them in prison, determine their level of eligibility, develop a reentry plan, and provide contact information for VA and other resources. Of course, inmates often make their own plans for after release, and some want nothing to do with us. But others respond eagerly to our offer of help. Being treated as a Veteran reminds them of a time when their lives made sense and they deserved the respect of others for their discipline, competence, dedication, teamwork, and courage. My ask of you is that you help encourage Veterans to link up with us upon release. We are their best chance for breaking the turnstiles in many of their lives.
We are currently assisting about 9,000 reentering Veterans each year. We know that still leaves a lot of Veterans exiting prison without our help. We don't have hard numbers on Veterans leaving prison, but the best estimate by the Bureau of Justice Statistics tells us that our reentry program is assisting about one in six Veterans released each year.
Our biggest challenge is identifying Veterans about to be released. That's also where we can use your help. Within the past year, we added a new online capability called the Veterans Reentry Search Service (VRSS). Using this service, you can identify all of the Veterans in your system in a matter of hours. All you do is, go to the secure VRSS website and upload your list of everyone you have in custody, identified by name, Social Security number, date of birth, correction ID number, location, and release date. VRSS then compares your list of inmates with our list of over 22 million Veterans, and in three or four hours, it sends you and our outreach specialists a list of Veterans in your system.
With that list, we know who to contact, and you can better manage your Veterans in custody. You might, for example, assign them to the same dorms to create a more disciplined environment, as seven states are already doing. Because inmates tend to under-report their military service, you probably have more Veterans than you realize. In California, less than 3 percent of inmates self-identified as Veterans, but VRSS found that 8 percent had actually served in the military—a difference of 5,000 Veteran inmates.
At present, VRSS is fully in use by five state prison systems, three jail systems, and one court system. Sixteen more systems, including 14 state systems, are in the process of accessing the service. There's no fee involved—VA pays for everything—but we need you to prepare your lists and upload them to the system. I encourage you to do so.
To keep Veterans out of custody as well as off the streets, we need to identify and begin working with them before they leave prison to reenter their communities. We have the tools to do that now, but we need your help.
Bottom line: Veterans, especially those who have been incarcerated and who may also be suffering from PTS, PTSD, TBI, and depression—need and deserve our help. Reentry Veterans need jobs, education, and quality healthcare—a shot at rebuilding their lives.
You see, at VA, we wrestle with harmonizing two very distinct, yet incongruent, images of those who have served. I carry these images with me all the time.
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 12 years in Iraq and Afghanistan.
But there is a second image—Veterans suffer disproportionately from depression, substance abuse, homelessness, and suicides—and they are well up there in joblessness as well. 107,000 of them were sleeping on the streets of our Nation four and a half years ago. And more than 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.
Once again, thank you for the missions you perform on behalf of the Nation. Help me get our justice-involved Veterans back to the productive lives they once led.
God bless all who serve and have served our Nation in all of its uniforms. And may God continue to bless this great country of ours. Thank you.