Remarks by Secretary Denis R. McDonough
Disabled American Veterans Midwinter Conference
February 27, 2022
Hello everyone! Andy [Marshall], thanks so much for that warm welcome, for your service, and for your steadfast leadership of DAV.
It’s great to see so many of you in person again. It’s been too long.
I want to recognize Marc Burgess, Lynn Helms Prosser, Brian Wilner, Joy Ilem, Randy Reese... I could go on and on. You are the glue that makes this great organization run, and that brings our shared mission to life. Thank you, for everything.
And, of course, thanks to all of you for having me here, for your guidance and friendship over the past year, and—most of all—for your partnership in serving Veterans, their families, caregivers, and survivors.
Today, I want to focus on that partnership, because we at VA have no more important partner than you. I never need reminding of that fact—I see it every day—but as I was preparing for this speech, looking through your website, one video caught my eye and reminded me of it anyway. It’s the story of a Veteran named Joseph Lightweis.
After getting out of the Army in the late 60s, Joseph struggled with post-traumatic stress and, eventually, found himself in a situation that no Veteran should ever be in: he was homeless. When asked about being homeless, Joseph described it as “devastating”—saying that it “sucked the life right out of his spirit;” saying that every time he “got a little energy to get out of homelessness... [he] got pulled right back in again. And that [went] on for years and years.”
Specifically for Joseph, it went on for 48 years. That’s 48 years of living in cars and staying in homeless shelters, 48 years of our country failing him, 48 years... until Joseph got connected with DAV. And everything changed.
Because that’s when you got Joseph the help he needed.
You worked with VA to get him the retroactive benefits he deserved.
And, as a result—after 48 long years—we helped him get his first home in his adult life.
You know, there’s a moment at the end of that video, where Joseph looks around his home, proudly, and says, “All of this—all of this—comes from VA and DAV helping me. I would not have any of this,” he says, “if it weren’t for these fine people.”
That’s the type of impact DAV has on Vets—the type of impact you’ve had for more than 100 years. And that’s what our partnership is all about: working together to get the job done for Veterans like Joseph—whether that means providing them with best care in the world, delivering the benefits they’ve earned and so rightly deserve, or guaranteeing a dignified final resting place that’s a lasting tribute to their service.
There’s no more noble mission than that. And it’s our job to execute that mission together.
And look, it’s been a difficult time to execute that mission. Hell, it’s been a difficult time, period.
We’ve lost so many of the Vets we serve, the colleagues we work with, and the family and friends we love. And we’re still not out of the woods after two long years of the pandemic.
But the reality is that—because times have been hard—this is the moment when Veterans, their families, caregivers, and survivors need us most.
I know DAV has risen to that challenge—driving hundreds of thousands of Vets to VA hospitals for free during the pandemic and helping Vets and their families file 150,000 new claims last year alone.
And at VA, with your help and guidance, we have risen to the challenge, too. Just look at what VA’s great public servants did in January, at the height of Omicron:
VHA’s workforce completed nearly three million in-person health care appointments, 827,000 telehealth appointments, and 543,000 community care authorizations—dramatically higher numbers than last January.
VBA’s workforce began a streak of completing more than 7,000 Veteran benefits claims per day for 20 straight business days—the longest such streak by far in VA history.
And NCA’s workforce made sure there was no interruption of memorial services for Vets, their families, and survivors despite nearly 200 NCA employees—about 10% of NCA’s total workforce—being out at one time or another due to COVID.
And that’s just the tip of the iceberg.
Altogether, with you as our partners, we are now providing more care, more services, and more benefits to more Veterans than any time in VA’s history.
But make no mistake: we’re not stopping there—far from it. We still can and must be better—and do better—for the Veterans we serve.
So that’s what I want to dive deep into today: how we’re doing on seven of our shared priorities—and how we can work together to do even better on those priorities, and on everything we do for Vets, their families, caregivers, and survivors.
Number 1: Let’s start with the AIR Commission.
As you know, the AIR Commission recommendations, based on our market assessments, are coming on March 14. And we’ll be communicating with you before then to make sure that you’re read-in on any recommendations that will impact your communities before they’re made public.
Because you’ve been our partners on this from day one, and you’ll be our partners on it every day until this process is finished. But I want you to know now that we came to those recommendations by asking ourselves one question above all else: what’s best for the Veterans we serve?
The result of asking ourselves that question over and over again, in markets across the country, is a set of recommendations that will cement VA as the primary, world-class provider, integrator, and coordinator of Veterans health care for generations to come; that will build a health care network with the right facilities, in the right places, to provide the right care for Veterans in every part of the country—making sure that our facilities are where the Veterans are; that will ensure that the infrastructure that makes up the Department of Veterans Affairs in the decades ahead reflects the needs of 21st century Veterans—not the needs and challenges of a health care system that was built, in many cases, 80 years ago; and that will strengthen our roles as the leading health care researchers in America and the leading health care training institution in America.
Now, there will be changes in markets across the country—but let me underscore that we are leaving no market. VA is here to stay.
Between outpatient care, strategic collaborations, and referrals to the community, we will continue to deliver timely access to world-class care to every Vet in every corner of the country. And in the places where there are changes, we will be shifting toward new infrastructure, or different infrastructure, that accounts for how health care has changed, that matches the needs of a market, that strengthens our research and education missions, and that—most of all—ensures that the Veterans who live in that location will have access to the world-class care they need, when they need it.
Because that is our number one goal, today and every day. And that’s what our AIR recommendations are all about.
And let me just say one more thing on this. My wife Kari and I went to the VA Medical Center in Chicago on Christmas morning to deliver donuts to the folks working that day.
And when I was walking down the hallway that morning, I started to feel hot... really hot.
Keep in mind, this is at the height of Omicron, so I began to worry—"do I have a fever? am I getting sick?” But before I got too worked up, I asked the folks I was with if anyone else was feeling the same thing. Turns out they were all hot.
Fortunately, the VA cop I was with, who works in that facility every day, chimed with an explanation, saying, “Oh, don’t worry about that. When it gets cold in Chicago, the heat breaks down in the hospital, and we have to worry about water pipes bursting. So we crank the heat way up to avoid that happening.”
That’s what we’re dealing with right now when it comes to infrastructure: spending extra money to maintain out-of-date facilities, rather than building new, state-of-the-art facilities. That’s what our Vets are dealing with when they come to those old facilities. And that’s what our health care professionals are dealing with when they’re busy trying to save lives... sweating, in a facility in Chicago, on a freezing cold Christmas morning.
You know when that facility was built? 1921, more than a hundred years ago.
That’s not good enough. Vets deserve better. And with these AIR recommendations, and your support, we’re going to give it to them.
Number 2: Veteran suicide, another issue where we can accomplish so much by working together.
A couple things stand out to me from our most recent report on Veteran suicides, which told us that more than 6,000 Veterans died by suicide in 2019—the most recent year for which we have data.
First, that number is far, far too high—too many heroes lost, and too many families left without their loved ones. But second, that number reminds me that preventing Veteran suicide is possible... because it’s 399 fewer Veterans lost than the year before, the biggest improvement in 20 years.
So, we’re looking to build on that momentum, together, in several ways:
We’re moving forward aggressively on implementation of our 10-year National Strategy for Preventing Veteran Suicide.
We’re growing our Vet Center presence in your communities—including via mobile Vet Centers and community access points—to provide Vets, family members, and servicemembers with great, timely mental health care.
And for the first time ever, we’ll be investing millions of dollars in suicide prevention work at your level—in Veterans’ communities—via the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program. These grants will help fund organizations that are making a real difference for Veterans—doing work like providing mental health screenings, emergency clinical services, peer support, and much more. And this spring, we’ll publish the regulations for applying for those grants. So please, encourage the organizations that you know are doing a great job to apply.
Because nobody knows which organizations are truly helping Vets, and saving lives, better than you.
Number 3: Veteran homelessness, a phrase that simply shouldn’t exist in America.
We’ve stepped up our efforts on this, particularly in Greater Los Angeles—where, as I saw firsthand during the Point-in-Time count this weekend, there are more homeless Vets than anywhere else in America.
Last October, we set two clear goals to address Veteran homelessness in LA. Goal One—to get all of the roughly 40 homeless Veterans living in an encampment called Veterans Row into housing by November 1st. Goal Two—to get 500 homeless LA Veterans into housing by the end of the year—home for the holidays.
With the help of partners like you, we not only met those goals—we exceeded them, housing every Vet on Vets Row, and moving more than 700 into housing.
So, we know what’s possible. Now, we need your help—individually, and as a collective group—to take that momentum and channel it across America.
We’re now setting even more aggressive goals, both in Greater LA and across the country, with the topline being that we will place at least—at least—38,000 homeless Veterans nationwide into permanent housing by the end of this year. For context, that’s more than the entire number of homeless Veterans in the country at last count in 2020.
The bottom line is this: We’ve shown that we can successfully attack this problem where it’s at its worst in LA, so I know we can attack it anywhere, we can win, and we can—finally—end Veteran homelessness together.
Number 4: Environmental exposures.
This is a life and death issue for so many Vets who have served our country. They’ve been waiting for the exposure benefits and care that they deserve for far too long—they shouldn’t have to wait any longer.
This has been a top priority of mine from day one. Over the past year, we’ve expedited the presumptive process by getting rid of the old, onerous model that VA traditionally used to determine presumptive conditions—and replacing it with a new pilot model that takes all available science and Veteran claims data into account, that puts the Veteran at the center of the process, and that has one ultimate goal in mind: getting Vets timely access to the benefits they’ve earned.
We’ve already made progress here—including new presumptions of service connection for asthma, rhinitis, and sinusitis—making President Biden the first President to proactively address particulate exposure for the Vets who have fought our wars for the past 30 years, and—more importantly—ensuring that more than 12,000 of those Vets are finally getting the benefits they’re owed.
We’re now in the process of assessing conditions like rare cancers, constrictive bronchiolitis, and lung cancers. And we’ll have answers on at least some of those conditions in the coming days.
This is still just the beginning of our efforts. And I promise you, we will stop at nothing to get Vets the benefits and care they deserve—as fast as humanly possible.
Number 5: Access to care.
As I said earlier, we delivered a tremendous amount of timely, world-class care to Vets in January—far more than last January—and overall, we’re delivering more care to more Vets than ever before.
But the reality is that this is a big system, in the midst of an unprecedented pandemic, and I fear—as I always do—that there may be some places across the country where folks aren’t getting access to care as quickly as they should.
Now, we’re constantly looking into this ourselves, and constantly looking to improve on timeliness. But I also know that if there are any access challenges, you will likely be the first to hear of them. So, what I ask of you is this: if you hear of any access challenges, anywhere, please let me know.
Because if there’s an issue, we’re going to fix it—and get every Vet the timely access to care they need and deserve.
Number 6: Caregivers.
Whenever I think of the incredible work and importance of caregivers, I remember something your former national commander, Dave Riley, said of his wife and caregiver, Yvonne—both of whom, I understand, are here with us today.
Dave said that “people come up to [him] all the time and say thank you for your service.” And he appreciates that. Truly. But he also noted that, “nobody ever comes up to [Yvonne] and thanks her for the service that she’s given to this country by taking care of [him].”
That’s wrong. Full stop. Because caregivers not only provide great care to the Vets they love—they also allow those Vets to age in place, in their homes, where they want to be.
And I know that at times throughout VA’s history, caregivers have been overlooked. Or not included. Or not appreciated for the back-breaking work they do, and the incredible service that they provide. But I’m here to say, to Yvonne, Dave, and any caregiver watching, we’re going to make sure that those days are over. Over.
At VA and in this administration, we see you. We hear you. We thank you for your service. And we will continue to do everything in our power to support you.
In fact, we’re taking several steps right now to make sure we keep that promise:
Most importantly, Deputy Secretary Remy is listening to all stakeholders about the caregiver program, hearing your observations and concerns—which, I want to be clear, are not about the excellent leadership and VA staff working the program, but about the structure and process of executing the program.
In collaboration with you, other stakeholders, and caregiver program leadership, we are in the midst of reviewing the program to ensure that we’re expanding, not limiting, access to caregivers.
We’re also working to improve consistency and standardization of our programs—so that every Veteran and caregiver will get the same application decisions and support, no matter where they live.
We’re dramatically expanding access to home and community-based health care for eligible Vets.
And, perhaps most important of all, we’re orienting all of these efforts around “getting to yes”—around erring on the side of the Veteran and caregiver whenever possible, and being as inclusive in admissions as the regulations allow us to be.
Because supporting the caregivers who support our Nation’s Vets is a top priority for us, and we’ll stop at nothing to do exactly that.
And last but in no way least, number 7.
While you’re in the DC area, I want to highlight two of VA’s top legislative priorities: investing in our workforce and passing the 2022 budget.
First, we need help from Congress to invest in VA employee wages.
This is important not only because VA workers deserve it, but also because it’s critical to the functioning of VA. Here’s why: due to laws that put a cap on how much we can pay VA employees, many folks can literally walk across the street and make 10, or 40, or even 200 thousand dollars more than they can at VA.
That’s unsustainable. It’s led to the highest nursing turnover rate at VA in 15 years. And it’s going to mean more serious losses if we don’t act soon. So, we’re urging Congress to pass legislation like the RAISE Act that would better empower us to recruit employees, and retain them, by paying them every penny they’re worth.
Second, we need Congress to pass the 2022 budget, not a yearlong continuing resolution.
Otherwise, VBA won’t be able to hire claims processors to process new Agent Orange presumptives; NCA won’t be able to fully fund the workload at existing cemeteries; and VHA will have a nearly-billion-dollar shortfall in community care funding.
all of which will directly and negatively impact Vets, their families, caregivers, and survivors.
Look, at the end of the day, we can’t do any of our great work together if our country doesn’t fully fund VA or take care of the employees who make VA run.
That’s why we’re laser-focused on working with Congress to address these priorities and, in doing so, to continue providing Vets with the timely access to world-class care and earned benefits that they deserve.
So, those are seven of our shared priorities that are going to be critical for Vets moving forward. And I know, as you do, that those seven priorities still only scratch the surface of all we need to do for Vets.
But remember: whatever we do, we’re going to need to do it together.
Because that’s what this partnership is all about: fighting like hell, together, to serve Veterans, their families, caregivers, and survivors every bit as well as they’ve served us.
And whether we’re partnering on something that impacts many Vets, like the Winter Sports Clinic—or something that impacts one Vet, like helping Joseph Lightweis get the benefits and the home he so rightly deserves...
I know you’re always there for us, and I hope you know that we’re always there for you. Because that’s how, together, we will always be there for the Vets we serve.
So, from the bottom of my heart, thank you for your partnership, for your magnificent work, and for all we do together. It’s an honor to be in this fight with you.
God bless you, God bless our Nation’s troops, our Veterans, their families, caregivers, and survivors. And may we always give them, and all of you, our very best.
Thank you.
