Your podcasts. Cspan, your unfiltered view of politics. Up next Veterans Affairs secretary Denis Mcdonough talks about expanding Healthcare Benefits for eligible veterans and their families. During his address, secretary mcdonough also discusses Building Trust in the v. A. , workforce challenges and modernizing the agency. Good afternoon and welcome to the National Press club, a place where news happens. I am eileen a riley, the president of the National Press club and the managing editor of standards and training the axios. Thank you for joining us both here and online for our headliner event with Veterans Affairs secretary Denis Mcdonough. We are happy to accept your questions, and after secretary mcdonoughs opening remarks, ill ask as many as time permits. To submit a question online, please email headliners press. Org and put v. A. In the subject line. For our cspan and public radio audiences, please be aware that in the audience today are members of the general public, so any applause or reaction you hear is not necessarily from the working press. It is now my pleasure to introduce this distinguished head table, please stand when your name is called. Starting on my far right is tom young, commander of the American Legion post 20 which is affiliated with the National Press club. Briana camara, visit one Patient Experience officer for the new England Healthcare system. Carla bham, pentagon correspondent for v. O. A. News. Kevin wensing, managing director of wensing enterprises and retired u. S. Navy veteran and organizer of todays luncheon. Well get to you in a moment. Lori russo, president of santin communications and colead of mpc headliner steam. To my left, jen jedson, land warfare reporter foredefense news and the 115th president of the National Press club. Lynn zhem, assistant director of Customer Experience for the Veterans Benefits administration. Senior associate of resources and consultant to the v. A. Richard barbada, client and Employee Experience officer of the vha readjustment counseling service. And max letter, publisher of stars and stripes. [ applause ] when our guest was sworn in today as the 11th secretary of Veterans Affairs on february 8th, 2021, he pledged to increase veterans access to care and benefits and to improve outcomes for them. He identified three core responsibilities as his highest priorities, providing veterans with timely, worldclass healthcare, ensuring that these veterans and their families have access to benefits they have earned and honoring our veterans with a final resting place that is a lasting tribute to their service. But secretary mcdonough also faces a host of challenges that would require vast amounts of time and resources, the persistent and worrisome problems of veterans homelessness, untreated Mental Health issues and an uptick in suicides, structural issues at the v. A. That create backlogs of claims and long waits for benefits, reports of serious side effects from exposure to burn pits that was common among Service Members overseas, i. T. Problems that land the v. A. On the d. O. A. s highrisk list for cybersecurity issues. And just this weekend, the New York Times released an investigation that describes how many of the troops sent to bombard the Islamic State with tens of thousands of high explosive shells which may have also sent shockwaves through the crew members, including their brains are now reporting severe headaches, memory loss, hallucinations and strange behaviors. But despite being only the second civilian leader of the v. A. , mcdonough has a long career of tackling tough issues. He served as the white house chief of staff in the obama administration, and prior to that, Principal DeputyNational Security adviser. Hes also served in Senior Leadership and policymaking positions in the u. S. House of representatives he graduated from st. Johns university in minnesota and received his masters degree from georgetown university. And his efforts are causing some headway at the v. A. Already. According to the military times this morning, v. A. Leaders say they set alltime records in healthcare, benefits, delivery and veteran outreach efforts in fiscal 2023. As veterans day approaches, it is both a time to honor our veterans for their Great Service and sacrifice and a time to take stock. By the way, if you are a veteran, please stand up. Thank you for your service. [ applause ] thank you. Today we are eager to hear from secretary mcdonough about the progress he has made on his stated priorities and what remains to be done. Please join me in a warm press club welcome to secretary Denis Mcdonough. [ applause ] eileen, thank you for the nice introduction. Its great to be here with everybody. Good afternoon. Its great to see old friends. Stakeholders, partners, veterans, this year marks the 50th anniversary of americas withdrawal from vietnam. This year and every year we remember the 58,220 american patriots who were killed or are still missing in that war. And we honor the 9 million americans who raised their right hands and committed to serve and defend our constitution as members of the armed forces during that tumultuous period in our countrys history. One veteran, Everett Alvarez, from his a4 skyhawk on august 5th, 1964, shot down over north vietnam. He landed in the water among a fleet of vietnamese fishing boats where he was quickly taken captive and became the first of 766 american prisoners of war in vietnam. Lieutenant alvarez endured over eight years of captivity in the infamous hanoi hilton, marking the passage of time on the walls, celebrating his own catholic mass each sunday. He chose to hang on to every motivation he could muster, thoughts of home, the strength of faith, trust in his country and a deep sense of duty to his fellow pows. On february 12th, 1973, shortly after the United States signed the paris peace accords, lieutenant alvarez was finally freed. Service didnt end when he got back home. He remained in the navy, retired a commander, continued serving the nation out of uniform as deputy administrator of the v. A. And as an advocate for his fellow vets and families. But my favorite part of commander alvarez amazing story is what happened after he recuperated after coming home. He met a wonderful woman, tammy. He asked her out on a date. That date, their first date was at the white house at an event honoring commander alvarez and his fellow vietnam war pows. Kind of a big date. [ laughter ] just a few months later on october 27th, 1973, they were married. And just last week, that means they celebrated 50 years of marriage. , but that 50 years of history, since the end of the vietnam war marks our veterans having continued to make this country strong. Commander Everett Alvarez and tammy are on another date here this afternoon. So congratulations and thank you for your Courageous Service to the nation. [ applause ] veterans day is saturday. Its a day we remember the millions of brave men and women, just like Everett Alvarez, who fought our nations wars and stood guard over our country during the periods of restless peace in between those wars. The data reflect on what veterans and their families have done, what theyve sacrificed for our country and for each of us because heres the thing, when someone signs up to serve our country in the military, we make them a promise. If you fight for us, we will fight for you. If you serve us, we will serve you. If you take care of us if you take care of us when you come home, well take care of you. Now, our country as a whole makes that promise. And ill say more about that in a minute. And at v. A. , its our privilege, and its our honor to keep it so ill start, as eileen said, with an update on what were doing at v. A. To keep our promise to veterans. Since President Biden took office, v. A. Has delivered more care and more benefits to more veterans than ever before. When it comes to the benefits vets have earned and deserved, were processing their claims faster than ever before. Heres an example. Just over a year ago, the president signed his historic legislation designed to care for veterans exposed to toxins in vietnam and in those 30 years of war in Central Command. Sergeant major erickson is one of those vets. He served in the army for nearly 30 years, combat tour spanning from the jungles of vietnam to the deserts of operation desert storm. Last may the Sergeant Major was diagnosed with esophageal cancer, and he filed for those toxic exposure benefits. Our v. A. Benefits team expedited the review of his claims at direction of the president. In less than a week, Sergeant Major erickson was granted 100 service connection, and his benefits were back dated to august 10th, 2022, the day the president signed that bill into law. Because of that law, Sergeant Major erickson has one less thing to worry about in what may be the most demanding battle of his life. Thats what we mean when we talk about fulfilling that promise. All together v. A. Processed nearly 2 million claims in 2023, shattering the previous years record, to that point, the highest ever, by 16 . That meant 1. 5 million vets and their families and importantly survivors received over 163 billion in earned benefits. Were also providing more care events. This year v. A. Delivered more than 116 million healthcare appointments, exceeding last years number by more than 3 million appointments. Its not just more care, its better care, world class care. Study after study shows we deliver Better Health outcomes than the rest of the Healthcare System for our vets which is a big reason why nearly 90 of vets who come to v. A. Now trust us to deliver their outpatient care. 5. 4 million people, including 4. 1 million veterans are taking their final rest in v. A. National cemetery, and weve doubled our online veteran legacy Memorial Program to nearly 10 million veterans, a digital platform, keeping veterans stories alive long after theyre gone. Now, behind all these statistics are veterans, veterans like commander Everett Alvarez and like Sergeant Major kenneth erickson. Theyre our neighbors, our friends, theyre teachers, civic leaders, coaches, loved ones. Theyre continuing to serve america to defend and to strengthen our democracy long after they take off the uniform. And all our work at v. A. Adds up to the single statistic that matters most, veterans lives improved, veterans lives saved by the work that we do together. Now, thats what weve done. I want to talk a minute about how weve done it and who, importantly, does it. The v. A. Work force has been delivering for vets during a period of rapid change, teaching us 75 id lessons that have forever altered the way that v. A. Does business. First, while the covid19 Public Health emergency came to an end six months ago, lets not forget that v. A. s clinicians and front line staff provide a worldclass care through what has been a devastating onceinacentury pandemic. From the moment that pandemic hit, v. A. s Public Servants mobilized around one connector mission, saving and improving the lives of veterans, their families, caregivers and survivors. They worked long hours, sacrificed precious time with their families, risked their own lives, and by extension, the lives of their loved ones to serve veterans because, you see, thats the promise we make. And there are veterans at home today with their families right now, happy and healthy because of the best work force in the federal government. And i am incredibly grateful, every one of them. Todays Service Members and vets represent the most deployed force in our nations history. And our thoughts are with the brave men and women serving in uniform in this period of heightened readiness and urgent security challenges in the middle east and around the world. Through this 33year intense period, since september 11th, 2021, many have experienced multiple deployments, come home came home gripped by both the visible and invisible wounds of war. All of them, each of them were exposed to particulate matter and toxins from burn pits and other sources. Months or years later, some have developed, and some might yet still develop conditions that followed them home from war. That impact impact on their lives in some cases will continue long after the guns of war are silenced. Its our job as a nation to provide those vets families, caregivers and survivors the benefits and care for those conditions. And thats exactly what were doing. These two developments, these two very important developments, the pandemic and our National Commitment to recognize the need to care for burn pit exposure have catalyzed a dramatic period of reform at v. A. , revolutionizing the way we do business. But one thing hasnt changed, and thats keeping the vets, each of you, at the heart of everything we do. Let me share four lessons weve learned during v. A. s new veterancentric era. First, were fitting our care and service into veterans lives, not expecting veterans to build their lives around us. If were going to keep our promise to vets, we need to meet them where they are when they need us without exception. So weve reached out to vets and listened to what they wanted using a veterancentered design approach. We developed tools to ensure vets and their caregivers have positive, productive experiences when engaging the v. A. We overhauled va. Gov to make it the digital front door for all services v. A. Offers vets. Medical appointments, filing a claim, applying for education benefits all go through that same front door. And the new v. A. Health and benefits mobile app gives vets access to that digital front door, meaning that vets with a smart phone can have all the v. A. Services right in the palm of their hand wherever they are. So while a vet is waiting to pick up a kid from school, out on a lunch break, watching a football game, they can refill a prescription, send a secure message to their doc, take a quick telehealth appointment, access their travel reimbursement and more. Its working. Not perfectly, but its working. Weve seen a staggering 3,000 jump in vet virtual home visits since 2020, nearly 28 million home visits in that time by offering care that thats built into vets lives in the community, via telehealth and alongside focused processes and technology advances, we decreased average wait times in nearly 60 of our facilities. The same is true at vba where away reduced our average time to complete a claim by 15 days in the last year alone. And at the board of veterans appeal, we are using televeterans appeals to set a singleyear record of 103,000 decisions made last year as a result, vets trust in v. A. Has grown stronger. Again, its not 100 , but its stronger. And heres the point, we at v. A. Are about shaping solutions for vets to meet them where you are, that are adopted to you and to your needs, rather than expecting you to adapt to us. Second, not vas, not machines, not buildings, v. A. Keeps our promises to vet, from entering veterans homelessness to delivering toxic exposure benefits, nothing of this happens without the best work force in the federal government. Theyre the most passionate, highestperforming Public Servants in this country. There are folks who want to make a real difference in the lives of vets, service providers, caregivers and families. And i am proud and i am privileged that they consider me their colleague for this brief period i get to work with them. And we owe it to them to have a work force size to meet this mission that can ensure we operate to ensure veteran Patient Safety and highquality claims decisions. So this has been a year since the last time i saw you, a year of hiring at record pace while retaining our excellent staff. And, by the way, not retaining our not excellent staff. This year we strengthened our partnerships with our unions, and both the veteran Health Administration and the Veterans Administration have had their highest growth rates in more than 15 years. Vha now has more than 400,000 employees providing healthcare to veterans, and with 32,000 employees, vba is bigger than its ever been. Weve also increased employer retention, even in one of the hottest labor markets in modern history, a market with profound Healthcare Provider shortages. Why are we able to grow our work force in this context . Because people want to work for you, for our nations heros. People like shelby long, a v. A. Nurse, for her, serving veterans at the bay pines v. A. Center is a family affair. Her brother, a surgical nurse at bay pines, and theyre both following in their moms footsteps, nurse in the bay Pines Community living center. And navy vet krashaun lloyd, Veterans Services representative, what we call a vsr at the chicago regional office. Krashaun was inspired to join v. A. Because of the thorough responsive care his vsr gave him when he was transitioning out of the navy. And then theres hector rodriguez, a marine, marine vet. Hector went from being homeless on the streets of san diego to being a caretaker in the Miramar National cemetery thanks to the work program. Hector regularly goes back to his former homeless camp hoping to inspire and support other vets in crisis. Veterans helping veterans, nothing better. Third, v. A. Cant, and, by the way, v. A. Doesnt do this work alone. Each of us has a piece of this puzzle, from the white house to the hill. Faithbased and community groups, the Veterans Service organizations, from private sector to the universities, we all play a critical role. These partnerships are helping us tackle some of our most pressing priorities on ending veteran homelessness and improving access and more. We Just Launched the second round of grantsoned the Staff SergeantParker Gordon fox Suicide Prevention program. These grants go to local organizations, implementing Innovative NewSuicide Prevention programming where veterans live and work, meaning that were funding local people who know their vets, organizations like nations finest which provides transitional and permanent support of housing for vets in Rural Communities across california, arizona and nevada. This team recently helped a pregnant vet fleeing domestic violence. Think of that sentence, pregnant vet fleeing domestic violence. Talk about a phrase that should not exist in the english language. They enrolled her in prenatal care at v. A. , connected her to veteran resources and provided her with temporary housing, just one veteran of hundreds that nations finest helps every year. What were doing with state, local and Community Partners are providing wrap around services for vets, homeless vets and atrisk vets, more of them than ever before. As we did last year, were on pace again this year to exceed our goal of permanently housing 38,000, exceed our goal of permanently housing 38,000 homeless veterans. , permanently housing. And part of the way we provided more care and more benefit more care to more veterans than ever before is through the Community Care program, succeeding in the Community Means scheduling appointments faster. Were doing that. It means paying our bills more quickly. Were doing that too. And it means incorporating the records of that care in the community indoor vets record so we can recognize the full promise of v. A. s integrated Healthcare System, allowing providers and vets to Work Together to build joint plans of treatment and medical interventions of psychiatrists, seeing a vet for ptsd and tbi can see their vets neurological records. And the team can huddle up with a vet and their loved ones to discuss coordinated care, along with a neurologist social workers, clinical pharmacists, primary care providers and any other team member involved in that vets care. Thats the integrated treatment that promotes outcomes, and thats v. A. s promises. If were not getting the record in the veteran community back, we decrease that efficiency. We increase costs, and most importantly, we reduce effectiveness for the vet. So we have to see our Community Partners as just that, partners in our quest to provide integrated care, integrated veterancentury care to high quality outcomes. Now, as i stand before you in this august room, the National Press club, i have to underscore our partnership with the press we cannot keep our promise to vets without you, the journalists who tell veterans stories, journalists like the one whos still working in the back, actually. Patricia. You know, patricias stories make v. A. Better because they trust, thats trust of patricias reporting. Other employees and stakeholders knowing they trust her, talk to her when they see that something is not working the way it should or maybe not working the way we tell them its working. So her reporting and her stories help us better understand what veterans experienced in war, what theyre going through here at home and how we can better help them, oftentimes bringing something to our attention that we didnt even know was happening. A couple months ago patricia noticed a Software Issue on va. Gov website, you know, the one i was just bragging about, preventing some vets from submitting their claims appeals. She asked us for a comment. Alerted to the problem by patricia, we were able to immediately fix the bug, reach out to vets who were impacted, Alert Congress to the issue and prevent similar issues from happening again in the future as i said, patricia is here, so ill speak drefl to her. Your work is having a positive and direct impact on the lives of vets. You make us better to serve vets by holding us to account. You and your mates, people like leo, sitting right here, lawrence, ellen, eric, courtney are helping us serve veterans far better than we ever could on our own and eileen just mentioned, just yesterday investigative reporting from David Phillips in the york times uncovered the unseen tbi faced by soldiers and marines who operated heavy Artillery Weapons in the fight against isis in syria. If you havent read it, you must. Because of his reporting, v. A. Will be reaching out to those vets who served in the Field Artillery units to ensure theyre receiving the care they need, importantly the care they have earned, those vets served in syria and iraq, making them eligible for that care under the pact act. Several of the vets profiled in daves piece are characterized as having received less than Honorable Discharges. We call them oths, other than honorable. While v. A. Cannot change a vets character of discharge, vets are not automatically disqualify from v. A. Services because of discharge status. Are not. In fact, over the last 10 years, v. At has granted benefit os or care to 73 of the veterans with other than Honorable Discharge status who have presented to us. So to those vets in that heartbreaking story and any vets watching today, we want to serve you. Please apply now, please reapply if youve been denied before, and we need everybodys help, every Single Person in this rooms help communicating with vets so they get the care they need and the benefits they deserve. Fourth and finally, weve seen again and again that earning Veterans Trust is critical to everything we do. Trust means many things. It means making it easier for vets to get care and benefits, ensuring that their v. A. Services are effective and that they feel respected when they come to v. A. Theres no greater privilege than having that trust, and theres no higher bar to meet, and theres no bigger problem than when we lose it. Since v. A. Began measuring trust in 2016 through something we call the v signal, those three measures of trust and the veteran experience ease, it was easy to get your appointment. Effectiveness. Was it effective . And did you feel respected or emotion . Ease, effectiveness and emotion, each one of them has increased. V. A. Currently has 174 active surveys, bringing in more than 12 million responses over the life of this vsignal, allowing us to hear directly from vets about your experience at v. A. And all of this information is released to the public through our quarterly v. A. Trust reports and at va. Gov trust, tying trust metrics with our performance. Three of the v. A. Teammates who helped manage this intensive survey process that helps us ensure the veteran experience and trust in v. A. s care and benefits join me at this lunch today. They all work in front line veteran experience roles, helping v. A. Measure and learn how to build better trust from our patients, from our customers, from the people we work for. Briana went in to healthcare because her dad was sick, when she was in high school. Her grandpa was an army vet, but he didnt trust v. A. Care when he left the military, and thats her passion, making sure other vets have a good experience at the v. A. Linda comes from a long tradition of Naval Service and while she didnt serve, she often says theres sea water in her familys blood. Well, her son joined the navy as a rescue swimmer, and that is when lynn decided working on thats when lynn was working on digitizing v. A. s paper records. She went on to lead the very first veteran experience project on machine learning. Today she brings her experience to help make help v. A. Make datadriven decisions to our claims process decision. And richard barbada served as an army officer in the 82nd airborne division. Can i get an out of the way here . [ laughter ] he fought in the initial invasion of iraq, and years after, weve lost 40 paratroopers he served with to suicide. , including a best friend. Many of them rest today across the river in section 60 at arlington National Cemetery. Richard came to v. A. To honor them. He says this has never felt like work, its a mission. I wake up every morning because of this mission. You see why im so excited and humbled to be part of this team, to share a deep devotion of keeping our promise to vets that characterizes their colleagues as well. And, boy, do they demand a High Standard from us, their teammates. Our mission is far from over. There are enormous challenges ahead, not least meeting the demand of millions of veterans who have filed claims under the pact act and who will qualify to be enrolled in v. A. Healthcare. But i know that with v. A. Teammates leading the way, Public Servants like briana, lynn, richard, v. A. Will continue serving vets every bit as well as you have served us. And as we look to the future, were not trying to build a v. A. That goes back to some old. Instead were going to do better for vets. Were going to continue to be better for vets, and this future at v. A. Isnt because of me. In fact, it was well under way without me because of the 450,000 v. A. Employees in your communities and neighborhoods across the country who keep vets at the heart of the care that they provide. So, again, to all the veterans here today, and those watching, thank you for everything. And to the press club, my thanks for all that you do Holding Us Accountable to veterans and telling their story in the powerful way that you do. God bless you all, and may god bless our nations Service Members, families, caregivers and survivors. [ applause ] thank you for that. Youre welcome. I tried to filibuster. Is there any time for questions . Well do rapidfire questions. So thank you for addressing the New York Times report. Yes. So i just want to confirm that you said that the pact act should cover those impacted by the high explosive shelling . Yeah. Thank you. Its a really important story. It appeared yesterday. Again, i encourage you to take a very hard look at it. The remember what the pact act says. If you served during 30 years of war in Central Command, and you stepped in that a. O. R. , you that begins your process of eligibility. Now, it also pact act goes a step further and says if you have any of a series of more than 25 conditions, right, then we presume those those conditions to be connected to your service. My point is that not all of the conditions that Dave Phillips reported are covered by the pact act. My point is that having served in Central Command, there is a 10year window during which our veterans qualify for vary care. So we want to make sure that we see them, make sure that we are in touch with them and we want to make sure they file claims so that those conditions they may be experiencing, that well work through with them can get service connected. So i hope that answers the question. And then speaking of the pact act, amid retention and recruitment challenges, how has the v. A. Handled the unprecedented influx in claims . Its a really good question. We anticipated and hoped that congress would pass a new law on this, but we werent waiting. So in may of 2021, President Biden using his own authority, and i think youve all now seen the reporting of about how strongly and how personally he feels about this issue, began connecting three initial conditions to service in Central Command and exposure to burn pits and toxins, and, importantly, just plain old particulate matter. All you guys who were over there, you remember what that was, right . Youre in a constant sand storm. So just ingesting that amount of sill ka is a problem. So the experience of may, june, july, august of 2021 showed us that we were going to need more people, and to his great good credit, vba career employee tom murphy said, hey, we need to start hiring now. For the three conditions that the president has established and for Anything Congress establishes coming forward. So weve been hiring at vba since september 2021 which is why we have more than 32,000 employees at vba right now. The claims process is overwhelmingly moved by a simple entry point which is more people reviewing claims. So thats one way were adjusting. A second way were meaning, were hiring more people. Thats going to take us a little time to train all those people, but weve been hiring them since september 21. That means were adding fully trained people into the claims review process. Thats the first thing. Second thing is we are also still looking at the process itself and figuring out where can we do away with unnecessary steps, where can we avoid unnecessary cmp exams, compensation and pension exams, and where we need them, lets make sure we have even more personnel, working contract and pension exams. Thats the second way of doing it. The third way were doing is were trying to modernize this process. So weve been undertaking an automation process in our claims process in our claims process at vba where we use an automated Decision Support tool. Its still humans, that make the decision, and thank goodness we do because nobody is more empathetic and more likely to make a decision in the interest of the veterans than our employees who have dedicated their lives to veterans. But the automated process can help do what machines do best which is go aggregate data, consolidate that data, ven that data, and then submit to to the vsr or the rating vsr owe they can make a final addition. That process is proving to work well, but were not betting on massive returns for that in the near term. Thats a longer term effort for us. Please and, look, last thing is we were about to report later this week on this, we are putting out every two weeks how were doing on the claims. Were not hiding this from everybody. We put this out every two weeks on friday morning. You can find that data. Were putting it out there. I want no veteran to be dissuaded from filing their claim. We are going to work through those claims. Were doing it, as i said, 15 days faster per claim this year than last. Still 120 some days on average, but were getting faster, and we will stay at this until we get everyone. Thank you. Theres a couple other questions with the pact act. Can you give us an update on whether theres any process of making constrictive bronchialitis a disability rating . Yeah. I think i got to be really careful what i say here because the way we do this is through rulemaking, and i want to be careful to not, you know, somehow knock out the administrative procedures act. But were aware of this issue, and were trying to get to the bottom of it. Bronchiolitis. Right now its a relatively new condition and the process by which we condition firm the condition is so invasive, a l constrictive bronchiolitis, right now the condition is relatively new, recognized in the medical community and the process by which we confirm the condition is so invasive, as to make it not in the veterans interest to carry out that action. The second question is, how do we categorize that in the vba t system such that the benefits can be paid to the veteran question mark let me underscore that, that is a process we will go through in terms of rulemaking and im not going to say anything to not compromise it, but what i will say is that veterans can still get their benefits, their Compensation Benefits even as we work through this process, so if theres any veterans who are struggling with that, i want them to be in touch directly with us and we will work through. Thank you, can you discuss the impact of the va role change in rates the va pays for special rates of transportation and the impact on medical treatment and emergency transportation for complications stemming from burn pit exposure . Super interesting question, im not sure precisely what the question is, can you just give me are we talking about the rural travel reimbursement rates, or are you talking about the contract for ambulances and air ambulances . Talking about the reduction in rates for air and ground [indiscernible] any complications that may arise as a result of this. Got it, good, let me start from the top, i dont know who is proposing a reduction, but it is not us. What we have said is, if you do not have a contract with va to provide the service you provide, we will have no choice but to contract with you at medicare reimbursement rates. That is what the proposal says. This is designed to ensure that the va addresses a problem that the Inspector General has raised with us several times including in a very hard report which i just read last week. That report said that the way va pays for emergency ambulance and air ambulance put that risk taxpayer interest. We are going through a process, va, as far as we can tell, pays for each individual ambulance, cash in that exchange. Meaning, for the number of cases where we have a contract with the provider, we are just paying cash for each run, we cannot find another Hospital System that doesnt that way, which is i think why the head is upset with it. So we are trying through this rulemaking process to get contracts in each individual market, we at the National Level have not set a price and why wouldnt we, we dont know anything about individual markets. Those contracts are being negotiated, i hope, in each of the individual Hospital Systemsh in the va, so i hope we get to g the bottom of this and work this out because getting that tough report in 2018 should have been enough. I think we should make sure we are doing right by our veterans and taxpayers. Thank you, another one, an active duty captain in the air force sent an email, an officer passed away from exposure to toxic burn pits while serving in the middle east, the va declared his Death Service related in 2014 and the family qualifies for chapter 35 va benefits. The captain applied for these benefits last year to help fund the graduate student studies, the va told the captain that they did not qualify due to their active duty status. So, first of all, thank you for an amazing family of service to the veteran is the name attached to the email . Let us reach out to you directly and work the case because i want to make sure that i dont misstate it here. So, lets work the case and we will get to the bottom of it. And part of the reason im not answering the question is im not sure, i guess maybe the question would be, well, im po just not sure, lets get to the bottom of it. Okay. On to other issues. On friday, the federal times report, roughly 40,000 veterans and survivors may owe money because of the errors over the past 12 years regarding pensions. Va officials said they wouldnt collect the debt for now, but this follows a series of other technical issues related to disability claims that affects tens of thousands of veterans and delays the implementation of Electronic Health records in the system. Why does the va continue experiencing these expensive technical issues and what is being done about this . That is a really good question, i think the issue is reported in the federal times on friday. It relates to a question of recordkeeping and Self Certification for a particularly Vulnerable Group of veterans, who get both different kinds of federal stipends or federal assistance and also get va pension. So, the question is, not whether there is a technical failing but, whether we were closely enough, monitoring the Self Certifications about how much those veterans were receding in terms of federal funding and va benefits. This is what i mean when i say l that we want to be a va that works to bring services to veterans, not to have them build their life around us. So, i dont think this was a technical failing as much as it may have been a policy execution failing over the course of more than 10 years. And in that scenario, we are going to study very closely whether that set of policy steps that we are taking should be made whole by the veterans, or whether, if it was indeed va, that made that faulty calculation, whether we should take care of that. So, that is what we mean when we say we are not collecting them for now, we are looking at how we address this in the context of a veteran centric va, and make sure that our programs are built around and into veterans lives and responded to veterans needs. Rather than again being sure they follow our various requirements, which at the end of the day are hours to implement, not the veterans. But, there are also other sure, there are definitely other issues, but i think you raised three, well i volunteered one with the reporting, that is definitely, those are definitely things mb where we are going to make mistakes, and when we find them and when reporters and Congressional Staff members or congressional members of congress or veterans themselves identify them for us, we are going to fix them. So, that is the second batch. The third batch are big, new, technology overhauls like the medical records. And that is something we have been going at it now for more than a decade and it has been difficult to implement. Some of that is difficulty across a national, very complex Healthcare System, so it is because technological advances like that have proven difficult irrespective of the Healthcare System in which you implemented. And because the technology is not in all cases everything you hoped it would be. So we are working through that, but again, i dont think it speaks to the fundamental capacity one way or the other of our providers. And our leaders at va, where i think we are doing positive things, i just call your attention to, as i said, the va benefits and healthcare app, which we have been slowly rolling out. We are north of 1 million users , and the experience, the veteran experience of that, again, not uniformly 100 positive, but the ratings including on the public app site are positive. Overwhelmingly so. So, we will keep implementing these transparently, responsive to the problems that our veterans experience that our stakeholders like the press and like Congressional Staff and congressional members identify for us. And by the way, the essos vsos. Okay, robert card who is responsible for last months mass shooting underwent a medical evaluation while training at the u. S. Military academy in new york, the army directed that while on duty, he shouldnt be allowed to have a weapon, handle ammunition or participate in activity, it also declared him to be non deployable. Why do you believe he was still reservist and wasnt discharged, and if this is by the book, what needs to change . Im not in position to comment on the decisions made and they are under the federal agency. Obviously our hearts go out to the victims of this senseless violence in lewiston. We are in very close coordination through our teammates and through our va hospital, in portland, to make sure we are supporting victims, victims families, first responders, and supporting the state in this response. The va four years ago initiated the veterans legacy memorial project meant to be an Online Repository of records, of every veteran now deceased. It began with veterans and expanded and included veterans buried in 87 Different Countries with records dating back to the american revolution. Why did the va embark on this project, what do you see as the role and what does it mean to you . I think it is a really cool project and it means a lot to me because at least in the case of veterans, it has been very important to me and i have been able to go and add my voice on his site about what that veteran has meant to me. And that is the idea of the veterans legacy memorial, the vlm, it is an opportunity , it is developed by the National Cemetery a ministration, we will be communicating about this very aggressively this week. But the idea is that, like our national cemeteries, which are national treasures, where our veterans can be assured a dignified lasting resting place commensurate with their Honorable Service in defense of the constitution of our democracy. This is meant to be a living memorial where survivors, family members, in my case, a former player for my coach, we can update that legacy. So that the country can come to understand the fullness of the work, the sacrifices, the benefits that our veterans have taken on our behalf. So, i encourage you guys to check out the veterans legacy memorial through va. Gov and if you have any problems with that, get in touch with patty and we will fix it. Thank you. Before i ask the last question, let me take a moment to say thank you to the organizers of todays events, todays headliner event coordinator, kevin muncy, the club events coordinator, scott martin, kate hester, and thank you to all of you for participating in our conversation. It is my honor to present you with our National Press mug. And last question is from the audience, this person says my father is a 20yearold army veteran, he did not serve in combat and consequently feels strongly he did not earn va benefits. What would you say to convince him his Service Warns va services warrants va services . Thank you very much, when Congress Authorizes and appropriates funding for those authorized programs every year, they do it pursuant to a very clear definition of who is and who is not a veteran. And what i would say to your dad is that the care and the benefits that va offers are related, are starting at that very important meeting when you raise your hand and swear the oath to protect the constitution against all enemies foreign and domestic, and that is what you did for 28 years. Not only that, as you did that honorably. And that is the first thing i would say, the second thing i would say, if you dont want the benefits, that is okay, but your spouse or your children might also benefit. They also sacrificed for those 28 years. They served honorably and sacrificed at your side. For those 28 years. Lastly, i mentioned a moment ago that one of the things we are doing is automating our decision process so that we can get automated decisionsupport for the great va employees who make these decisions. So what i tell veterans is, look, i know you really want to happen healthier battle buddies and maybe you think you dont deserve it, it could be that the most important thing you can do to help your battle buddy, given how we prosecute these claims now, is to file the claim. Because you know what, that claim might tell us something about what your unit went through, and in 28 years, you did a lot of vigorous training. And in 28 years, you took on a lot of sacrifice. And it could be that we learn something of value, which by the way, and something useful for other people in your units. This is particularly true for those veterans who served in Central Command. We learn about you, we learn about your unit, we learned about the unit you relieved and the unit that relieved you. So these are your benefits that you earned when you swear that oath. And when you served the way you did. These are benefits that may accrue to your spouse and to your children. And, that act of filing a claim with us might be a piece of information that helps us complete the picture for other men and women in your unit. So, please, please file the claim. Thank you. [applause] thank you. Cspan is your unfiltered view of government, funded by these Television Companies and more. Including spark light. The greatest talent on earth is the place you call home and at spark light, it is our home, too. We are facing our greatest challenge, that is why spark light is working around the clock to keep you connected, we are doing our part so it is a little easier to do yours. Spark light supports cspan as a public service, giving you a front row seat to democracy. Be uptodate in the latest in publishing with book tvs podcast about books, with current Nonfiction Book releases, plus best seller