Office of Public and Intergovernmental Affairs
Remarks by Secretary Robert A. McDonald
AMVETS National Convention
August 10, 2016
Good afternoon, AMVETS.
You’re in Reno. I’m in Salt Lake. I really regret that I couldn’t be with you all in person. Glitches in airline computers simply wouldn’t allow it. But I’m very grateful to the folks at the Salt Lake City VA Medical Center for quickly offering their studio and their experts to help us meet virtually.
Let me begin by congratulating AMVETs National Commander Jim Pidgeon for his leadership of “Team AMVETS.” Jim, thank you for your long commitment to our fellow Veterans—more than three decades of hard work for all of us—and, most especially, thank you for your courageous service in Vietnam.
Let me also acknowledge General Lee Hsiang-Chou—Good afternoon, sir.
And Director Chenelly, thank you for AMVET’s strong leadership on the Veterans First Act. AMVET’s united front with other Veteran Service Organizations is critical to Veterans First. That bipartisan omnibus includes many of the legislative solutions for Veterans that we’ve been after, and nine of our top legislative priorities. So thanks, Joe, and thanks to all AMVETs members.
And my best wishes to Ladies Auxiliary President Kathy Berning.
My fellow Veterans, colleagues, distinguished guests, ladies and gentlemen:
Last month in the East Room of the White House, I watched President Obama present the Medal of Honor to Vietnam Veteran and helicopter pilot Charles Kettles. Major Kettles is one of the countless courageous American Veterans who, as Lincoln most aptly described, has “borne the battle.” In 1967, he volunteered to lead his flight of Hueys into the middle of a vicious firefight—to carry reinforcements in, and carry the wounded out. His flight made the trip three times. And then he went back once more, alone.
Single ship. No cover. Overloaded. Leaking fuel. Tail damaged, main rotor damaged, and windshields gone.
What a man of indomitable courage, resolve, and grit. What a story of duty and of honor.
Those stories are powerful reminders to any who would forget—Veterans are the only ones who really know what it means to stand on that dangerous ground between freedom and tyranny.
Some people miss that, but it’s the heart of the matter.
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. The next week, I met you in Memphis, and here’s what I said: “Coming face-to-face with the reality some Veterans have endured isn’t a disaster. It’s a great opportunity, and it’s a rare opportunity we cannot miss, nor underestimate.”
We haven’t missed it. We haven’t underestimated it. We’re taking full advantage of it.
Across 23 cities, I consulted thousands of Veterans, VA employees, other stakeholders, and VSO leaders—AMVETS among them. 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. It’s important you know that. 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.
They’re Veterans like Major General Joe Robles, President and CEO of USAA after 30 years in the Army. The 17th Surgeon General of the United States, Dr. Richard Carmona, a Special Forces Veteran of Vietnam. Navy Veteran Dr. Connie Mariano, the first military woman to serve as White House Physician to the President. Altogether, Connie’s cared for three Presidents. She was the first woman Director of the White House Medical Unit. And she’s the first Filipino American promoted to Navy Rear Admiral.
These are innovative and respected leaders. They know business. They know customer service. They know Veterans.
It’s important you know that we’re collaborating with world-class institutions like Johnson & Johnson, USAA, Starbucks, NASA, Kaiser Permanente, Hospital Corporation of America, Virginia Mason, among others. We’re partnered with respected organizations like the YMCA, the Elks, the PenFed Foundation, LinkedIn, Coursera, Google, Walgreens, academic institutions, and many more.
It’s important you know that over the last two years, we’ve helped build a new national network of 68 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.
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. Those partnerships are why 28 communities and two states have achieved an effective end to Veteran homelessness. Those partnerships are why over 360,000 Veterans and family members have been housed, rehoused, or prevented from falling into homelessness.
In Los Angeles, the worst city in the country for homelessness, we cut Veteran homelessness by more than 30 percent last year—about four times the rate of decline of previous years. Veteran homeless nationwide is down by 47 percent since 2010, based on numbers President announced in Atlanta. We’ve cut it in half. That means more kids getting moms and dads back.
Rudy’s combat in Iraq and Afghanistan wracked him with PTSD, and he ended up in jail, then homeless. Now, Rudy’s working on his Bachelor of Arts in social work. And he says life with his family is the best it’s ever been.
Lonnie went from serving his country to sleeping in cars. Now, Lonnie has a job, a home, and hope. And because of Lonnie’s success, his company is hiring other formerly homeless Veterans.
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 9 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? Sports therapy, music therapy, writing and art therapy? 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.
Let me talk about access to VA healthcare. You should know we’re changing our system to proactive, holistic healthcare and wellness. It’s time we get beyond just reacting to disease when it happens.
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 2 million appointments for Veterans in the months ahead.
Ninety-seven 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. 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. And by December, you can expect same day access in primary care and mental health care.
So we are making important progress—advancing along all these lines, and many others. But you rarely see 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 percent.
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. Department-wide leader training is instilling lasting change. And private-sector leadership experts are teaching VA teams Lean Six Sigma and Human Centered Design.
These are cutting-edge business skills for the 21st century long overdue at VA.
This is all the work of some industrious, devoted people—VA employees and leaders, many Veterans among them. They’re the ones building the high-performing, Veteran-centric, customer-centric enterprise Veterans deserve.
But you never read about that.
Listen to some people and we’d never know there’s a decent person working at VA—Veteran or otherwise. Well, these last two years I’ve met and talked with thousands of VA employees in over 325 locations and 130 cities—many of them Veterans, like us.
They’re people like Victor Vasquez, a grounds-keeper at Fort Bliss National Cemetery. Victor put a tree right where an older Veteran wished to see one . . . shading his wife’s grave.
James Barger’s a cemetery technician at Mountain Home National Cemetery in Tennessee. One rainy day, James gave a visitor the boots off his feet so she could get to her grandfather’s grave. He was a Veteran of WWII.
Cathy DeNobile is a nurse with our D.C. Home-Based Primary Care Office. A Veteran Cathy serves suffers from severe PTSD; he can’t get out much. So she takes him a holiday dinner every Thanksgiving and Christmas.
Chuck Malden’s an Emergency Room Nurse at Salisbury VAMC in North Carolina. Chuck literally gave a Veteran the shoes off his feet to help heal the Veteran’s blisters.
Patrice, Marissa, and Grace are VA social workers in Atlanta. They didn’t just house their homeless Veterans. They worked on their own and reunited Veteran families that had been separated for decades.
Why do VA employees do that?
Because they care. Because Veterans need them. Because that’s what we’re about. Listen, our employees are good people. I’m proud of them. They care about us. They want to serve us well. And we’re equipping them for success.
They’re not all 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 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.
But 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, AMVETS, other 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.
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. We’ve urged ambitious action by Congress, and we need them to pass the law.
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 VSOs can make it happen.
Ninety-five years ago yesterday, VSOs made the Veterans Bureau happen.
Nine years later, VSOs made the Veterans Administration happen.
VSOs got us the GI Bill. You got us the Montgomery GI Bill. You got us the post-9/11 GI Bill. You’re 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 lots of recommendations for VA’s future.
You have to 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 your service your sacrifice. to that sense of duty and honor that Veterans represent, and only Veterans understand.
It is your VA, AMVETS. It always has been.
I’ll close today the way I closed two years ago.
Thank you, AMVETS, for your work, your commitment, your enduring devotion to Veterans. And thank you, AMVETS, for being a friend to the Department.
God bless you and your families. God bless Veterans. And God bless the United States of America.
I wish I could be there with you in Reno.