Remarks by Secretary Eric K. Shinseki
Marine Corps League
Falls Church, VA
February 8, 2013
Good morning. Mike [Blum, Executive Director], thank you for that kind introduction. I am honored to be here. Let me also acknowledge Jim Tuohy, your National Commandant and Gerri Tuohy, National President of the Marine Corps League Auxiliary; fellow Veterans, distinguished guests, ladies and gentlemen:
Welcome! "E komo mai!" as we say in Hawai'i. Let me begin by thanking the League for its tremendous volunteer efforts at VA facilities, for its support of our homeless standdowns, its legislative efforts on behalf of Veterans, and your help with Veterans' claims—incredible support for Veterans.
A bit of history: On 4 and 5 September 1952, while volunteering for a second continuous mission on a combat outpost line in Korea, well forward of the main battle area and under constant enemy artillery and mortar barrages, Private First Class Alford McLaughlin, Company l, 3rd Battalion, 5th Marines, 1st Marine Division, successfully defended his position by delivering devastating fires from his two machine guns and carbine against an attacking enemy battalion. Alternating his weapons and laying them on the earth to cool and keep from overheating, Private McLaughlin accounted for 150 enemy killed and 50 wounded that night. For his valorous actions and conspicuous gallantry, Private First Class McLaughlin was awarded the Medal of Honor. Alford McLaughlin passed away in 1977. We are all privileged to serve Americans like him.
Four years ago, President Obama asked me to make things better for Veterans today and then, to put in place those changes that will continue making things better for them for the next 25 years. These two goals do not have the same aim points. Change is hard. Change in large organizations is near impossible. Three hundred and twenty-four thousand good people come to work every day at VA facilities all across this country. And change is impossible, if you can't present a clear, compelling argument. Why are we changing, how are we changing, and will this make things better for Veterans? It requires discipline, determination, and money.
And that's what we've been about for the past four years—creating change that makes a difference for Veterans. During a period of slowed economic recovery and immense budgetary pressure, the President has been unwavering in his support of Veterans' requirements. He increased VA's budget requests from $99.8 billion in 2009, to $140.3 billion in 2013—roughly a 40 percent increase that has enabled us to begin delivering those near-term objectives and framing the long-range ones.
Between 2009 and 2014, our budgeted medical obligations increased for:
- Traumatic brain injury funding by 21 percent;
- Spinal cord injury programs by 36 percent;
- Mental health by 45 percent;
- Readjustment counseling by 49 percent;
- Long-term care by 50 percent;
- Prosthetics by 75 percent;
- Women's Veterans programs by 158 percent;
- OEF/OIF/OND funding by 161 percent.
Funding programs like these is one thing; making them accessible to Veterans is something entirely different. So in the same period we opened 38 community-based outpatient clinics, for a total of 821 CBOCs today, and increased the numbers of mobile outpatient clinics and mobile Vet Centers, serving rural Veterans, to 70.
Last August, we opened a new, state-of-the-art medical center in Las Vegas, our first in 17 years. We also expect to open another new, state-of-the-art medical facility in Orlando this year. New hospitals are under construction in Denver and New Orleans, and two others, Louisville and Omaha, are in design.
Access means making VA's medical care available to Veterans, no matter where they live—not just in these urban settings, but in the rural, highly rural, and remote locations, like Western Alaska, where roads don't exist. We must not let the tyranny of distance force us to settle for substandard medical care for any Veterans.
So access must be more than the ability to walk into a VA medical facility. Telehealth and telemedicine are the major breakthroughs in healthcare delivery in 21st century medicine.
This year we are investing roughly $335 million in virtual access technologies to connect Veterans wherever they can enter our system. This is a 368 percent increase since 2009, connecting our 152 medical centers and their 104 affiliated medical schools with our 821 community-based outpatient clinics, our 300 Vet Centers, and our 70 mobile clinics—over 1300 VA points of care.
We have signed a Memorandum of Agreement with the Indian Health Service and are working with DOD to expand the number of locations where we can partner on behalf of the serving military and our Veterans, especially our Native American Veterans. Our devotion to men and women like Alford McLaughlin must at least equal their devotion to this Nation and to one another.
Four years ago, VA established three key priorities to get things moving quickly: increasing Veterans' access to care and benefits; eliminating the claims backlog in 2015; and ending Veteran homelessness, also in 2015. Since 2009, we've added over 800,000 Veterans to our healthcare rolls. Access! We will continue to expand our outreach to enroll Veterans in VA.
We've also opened six new cemeteries and two annexes in the last four years. Five more cemeteries are planned over the next five years. We have a plan to provide burial services at locations where there are no VA, state, or tribal veterans cemeteries available. Through an innovative partnership with existing public and private cemeteries, our rural initiative will allow us to open eight national Veterans' burial grounds that meet the standards of our existing 131 national shrines. All of this is much needed and long overdue. Again, access!
To be direct, there is little use in talking about access unless we can process Veterans' compensation claims better and faster than we do today. Our goal is to process claims in less than 125 days at 98 percent accuracy, and to end this thing called the claims backlog.
We are not there yet, even though we are processing a million claims each year, 3.9 million claims in the past four years—unprecedented numbers. But incoming claims continue to outpace the number of outgoing decisions. We must automate and get out of paper, and we are in the process of doing just that.
Today, we are fielding the automated tool that we have been developing for the past two years: VBMS, the Veterans Benefits Management System. VBMS has already been deployed to 18 VBA regional offices and will be fielded to all 56 regional offices by the end of this year. That will give us at least two years to take down the backlog in 2015. The faster we field VBMS, the more time we will have to eliminate the backlog; we are after it.
Now the last of our three promises: ending Veterans' homelessness. We have reduced the estimated number of homeless Veterans living on our streets by nearly 17 percent since 2009, estimated today at 62,600. In addition to this rescue effort, we are building a National Homeless Veterans Registry that will allow us to see the population more clearly and insure that we are focusing resources for best results.
The two arms of this war on homelessness are rescue and prevention: Rescue those who are on the streets today, and prevent those at risk of homelessness from starting that downward spiral.
Calls to our National Call Center for Homeless Veterans are up 123 percent in the last fiscal year, and our referrals to VA services are up 132 percent.
We're working closely with 150 community partners in our prevention strategy. In 2011, we awarded $60 million in supportive service grants to assist Veterans and families facing the prospect of life on the streets. In 2012, we increased those grants to $100 million, and for 2013 we are reviewing proposals for the $300 million in grants we will be distributing later this year. Those resources directly helped about 21,000 veterans and over 35,000 household members, including nearly 9,000 children. This year's grants will help up to 70,000 veterans and family members avoid homelessness.
We have to play offense and defense at the same time—rescue the homeless from our streets and prevent a largely invisible at-risk population from ending up there. Nothing magical here—warm handoffs from DOD through a good Transition Assistance Program, successful completion of education and training programs, jobs, and medical treatment for those with issues that come with military service.
Since 2009, VA has paid over $25 billion in Post-9/11 GI Bill benefits to more than 893,000 Servicemembers, Veterans, family members and survivors. We are now working with SVA, Student Veterans of America, to track graduation rates.
I usually have a one-word speech for any of the student audiences I address: Graduate. That's it: Graduate. If I sound like your dad, I am. I'm paying most of your bills. There is no payoff to you, to this program, or to our country, if you don't graduate. So graduate!
For some Veterans, education alone is not enough. We need to help them deal with the baggage they are carrying when they come to us: depression, substance abuse, PTSD, TBI, and other mental health issues.
The number of Veterans seeking VA mental healthcare has increased, and we are increasing staffing levels, growing telemental health capabilities, and employing state-of-the-art, evidence-based therapies.
We will meet the President's directive to increase our mental health clinical staff by 1,600 by 30 June of this year.
We're also hiring and training 800 peer-to-peer mental health specialists, who are Veterans and who have wrestled with the same mental health issues themselves. Credibility and trust are important to service in uniform. Those attributes are equally important to helping bring our comrades all the way home.
We've integrated mental healthcare into the primary-care clinics of our medical centers, and many of our larger CBOCs in order to expand access and reduce the stigma associated with mental healthcare.
Veteran suicides are a priority. Since its inception in 2007, the Veterans Crisis Line has answered over 725,000 calls and responded to more than 80,000 chats and 5,000 texts from Veterans in distress. Twenty-five thousand men and women have been rescued through our intervention. The number of calls is increasing; the percentage of rescues is going down; the number of Veterans entering treatment is going up; and the Veterans' suicide rate has declined slightly. Our suicide profile is the 50-year-old, not the 30-year-old.
We have just completed a 2012 VA suicide data report—our first effort to gain a more comprehensive understanding of Veterans suicides that can inform our prevention efforts. It bears a close reading. The more we all understand these issues, the better we will be at helping solve them. Very little of what we do at VA originates in VA. Much of what we work on begins in DOD.
So for the past four years, we've worked at strengthening our VA-DOD partnership. Secretaries Bob Gates and Leon Panetta and I have personally met 12 times in the last two years—three times since December 2012, alone. This is an important relationship for our Veterans, and we will continue working to bring our two large departments closer together.
For example, VA is investing up to $550 million dollars in DOD's Transition Assistance Program to fund departing Servicemembers' exit physicals. Why? Because each departing Servicemember deserves a baseline physical for the rest of their lives. And we in VA need to be able to service-connect any issues, physical or mental, resulting from military service before the uniforms come off. Documenting their needs is the first, critical step in providing them the care and benefits they have earned. We all need to assure that transitions, to include exit physicals, go well.
VA's transformation is a work in progress. We've accomplished a lot over the last four years, thanks to our dedicated workforce. But much more remains to be accomplished for Veterans.
One of those veterans is a retired Army Sergeant named Brendan Marrocco; you may have read about him recently. On Easter Sunday 2009, about six months into his combat tour, then-Private First Class Marrocco was driving his armored vehicle in a convoy north of Baghdad, when it was hit by an anti-armor IED [improvised explosive device]. The projectile came through the driver's side door and tore off three of his limbs, leaving his remaining leg so badly damaged that doctors had to amputate it.
Brendan was the first of five quadruple amputees from the Iraq and Afghanistan wars to survive. His injuries were so extensive that his father didn't recognize him when he first saw him at Landstuhl Hospital in Germany.
Amazingly resilient and upbeat through over a dozen surgeries, the 26-year-old was an inspiration for others at Walter Reed as he pushed past pain and exhaustion to master his four prosthetics devices. He told the New York Times that, if he had his way, he would be back in Iraq behind a machine gun.
In December 2012, Brendan received a rare double arm transplant at Johns Hopkins University Medical School. At a press conference last week you may have watched Brendan roll his wheelchair into that news conference using his new arms, just six weeks after the surgery.
It will take at least two years of grueling therapy sessions to determine whether his arms will be fully usable, due to the slow pace of nerve regeneration—one inch per year. Dr. Jamie Shores, Director of Hand Transplantation at Johns Hopkins said, "There is no amount of surgery we can do to make something work if patients aren't going to put an incredible amount of effort into this . . . [Brendan] has demonstrated how hard he is willing to work. That's why we picked him. He's got that fighting spirit." And Brendan's mother, Michelle Marrocco, added that Brendan's always been "one tough cookie. He's not changed that. He's just taken it and made it an art form."
Brendan said his arm transplants have given him great hope for the future. He's excited to have a second chance to start over and is looking forward to driving, swimming, and taking part in a hand-cycle marathon. When asked what advice he had for other wounded warriors, Brendan said, "Don't give up hope. Life always gets better. You're still alive. Be stubborn."
Brendan Marrocco has not lost his grip on hope. His grit, determination, and courage are characteristics we have witnessed in every generation of Veterans. You have my word. We will deliver the President's vision of a 21st century VA, worthy of the Alford McLaughlins and the Brendan Marroccos, who, by their service and sacrifice, have kept us a free people.
God bless those who serve and have served our Nation in uniform. And may God continue to bless this great country of ours.