Transcripts For CSPAN2 Capital News Today 20120301

received with statistics like these it must be a priority to ensure the initiatives the va is pursuing to get the situation under control will actually be effective. so the veterans, their families have received timely, quality decisions when they seek benefits from the va to another area of the budget i would like to briefly mentioned as the legislative proposal to spend $1 billion over five years on veterans' jobs or programs. while i believe it's important that we held our veterans to find meaningful work, and interested to learn how the va would suggest paying for this program, and about how it would be structured. so i hope that the va will be able to provide us with more details about the program today. madam chairman, the final item i want to highlight before i turn it back to you is the continued increase in staff that the va central office. and quite honestly at this level. for example, since fiscal year 08 of the staff of the be a central office has grown close to 40%. and the office of human resources and administration has seen them 80% increase over the same period. the staff at headquarters has increased by 52% between 08 and 11. i think we need to ask serious questions about whether this increase in staff, starting directly benefit the nation's veterans, whether these employees are central to delivering services to the veterans who use the va system and whether any of the fund could be put to better use. the bottomline is particularly in this time of the record deficits we need to ensure that when we spend the limited money that we have we do it wisely and make certain that the veterans are the ones that receive the benefits and services that had been turned and deserved. the trend lines are troubling to me and should be troubling to this committee and should be troubling quite frankly to the va. i will focus much of my attention on this today and questions to the secretary and his leadership team. i think the chair. >> thank you, senator. we will now turn to the centers for opening remarks in order of appearance and senator akaka, we will turn to you. >> thank you very much, madam chairman. and i want to cielo ha to psychiatry shinseki -- secretary shinseki and his staff at the va i want to thank all of you for your service to the veterans and of course to the country. i don't mean to tell you that what you've been hearing secretary shinseki and the leadership staff has been improving the services because claims have dropped, and that's an indication. the care and treatment which is our duty to provide to the veterans is something we must continually strive to improve and you have been doing that. i have encouraged to see the federal budget request for me was $13 billion above last year. i know we have budgetary constraints when we owe it to our veterans who are sacrificed for the country and you have planned in moving along and have been progress of about meeting those needs. i'm glad to see increases in the budget request mental health prevention in iraq and afghanistan veterans programs. i am also encouraged by major increases in funding for the women's programs. one of the budget increased provide opportunities, we all know that these resources must be utilized with fox and efficiency in order to best serve our veterans and their families. as the defense department continues to reduce its participation in overseas contingency operations, and more veterans come home to their families, the va capacity to treat veterans is sure to be tested even more. mr. secretary, we have talked about this, and i know that you are doing all you can to prepare for the anticipated growth in the number of veterans seeking the services. secretary shinseki come i'm also very pleased to see that an important project for the veterans which i have championed for years is in the budget, a much-needed and the rest of the while that will alleviate at the other medical centers. this proposed lease will certainly help meet the needs of our veterans in hawaii and i have been impressed with all that you and your team have been able to accomplish in the past three years. you have made tremendous strides to improve mental health care and prevention, homelessness and help veterans find jobs among other accomplishments. however, we know that there are areas where we can improve the care and services provided to our veterans which earned and certainly deserve a year from your testimony today mr. secretary and continue to work with my colleagues and help provide the best care that we can to our veterans and their families thank you very much madame chair. >> thank you very much senator. thanks for holding the hearing. very important hearing. let me just start out and offered an observation, mr. secretary. first of all i want to say thank you for stopping by my office a week or ten days ago. as you know, over the past few years while i've been here and you've been in your possession we have had an opportunity to meet on a number of occasions, and i've always appreciated that. i come away from those meetings absolutely convinced that you and your team have the best interest of the veterans in your heart and you're trying to do everything and you can to deal with all of the problems that we are going to mention today. one of the things that we have found in working with the veterans in my senate office and it's the reality that the veterans administration is every veteran has an individual problem that's not easily solved with one sweeping policy approach or whatever. we have found that we really have to sit down with each bet and talk to them and help them work through that problem and even in my senate office, we have found that we have to staff up to do that. i have more people in my senate offices working on the veterans caseload than any other case load that we were gone. so it is just a part of what we have to do. i and you have a great perspective on what the veterans need and you are always willing to bring that to the floor. i've been in your possession before and in the complexities of what you are doing our enormous. so i want to start out on a positive note and tell you i think your heart is in the right direction but i do think as we look at the metrics and the progress we are making it's important to see what's working and what's not working, and just simply acknowledge that and try to figure out is their something we are missing here? i also wanted to mention briefly, and i won't dwell on this long but it's worth a mention to me. as you know, like other areas in the country we are struggling with a va hospital was built decades ago notwithstanding the kind of hero what efforts of the staff and the doctors and nurses at the administrative personnel it is just a very difficult situation. we are very pleased we are on the priority list and we are making our way to the point at which we hope we can solve that problem and replace the facility. we are like 18th if i'm not mistaken. i am aware of the fact that it just does take a while. we are hoping to work with you and your staff. maybe there are some things we can do. there is a serious parking problem. it's right in the middle of omaha. maybe there or some things we can do to move the project forward. i will wrap up with one last -- we are seeing some areas of improvement that i wanted to mention, again, hoping to keep this on a note of look, you are doing some things i think are making a difference. the first is in the processing of post 9/11 jihadi bill benefits. in 2011, we at least don't know about other senate offices we at least received no complaints about the delays or problems of education benefits. i don't know what you're doing with education benefits but from at least our experience, something is working. whatever model affect can somehow be transferred to the disability claims and i appreciate the are much more complicated, that seems to be working, and you have had to ramp up pretty significantly. so, i'm hoping i can hear some thoughts on maybe there are some ideas to what works in other areas of the va system. we are also hearing veterans expressed last that the expanded access to information on the ebenefits system is something that the appreciate, they feel good about. i think all of us have been optimistic and hopeful. maybe that is a better way of putting it, hopeful that that system would pay dividends. we think it is. we think as veterans are getting more used to that it is paying some dividends and saving some staff time for whatever they are meeting. i would rather spend again, thank you madame chair. i do appreciate the opportunity to be here. thank you and you manage your whole team for the work you are doing and i hope we can advance the cost because there is so much more to be done. thank you. >> senator brown. >> i appreciate your leadership on the veterans' issues and thank you, secretary shinseki and all of you who dedicate a big part of your lives. thank you for coming to ohio those of you that have had the service you provide veterans and by state and for all of us. it's a good budget and shows a strong commitment to veterans. when you look at what the advanced appropriations are 140 billion with the 14 request advanced appropriations with a 14 billion-dollar increase, its saying and doing the right thing for people that have earned at and have the understanding we all have about the service to country. i applaud the va for its investments and eliminating the disabilities claims backlog. we are all of course still very concerned about that as senator johanns said we still hear horror stories of the 18 to 24 month delay. we should of course never tolerate them and there are views about that, secretary shinseki and know that we need to continue to push and with better trained staff and the electronic and other processing efficiencies. i also want to on a similar note the disability rating system clearly needs a substantial improvement. a bum knee in charlotte should be treated as in cincinnati and the backlog disability ratings are in many ways makes sense and i know your commitment to wanting to do that and expect to see the results. i know where to that of the funds in this budget to train out reach coordinators' and to provide other services specific to particularly the role veterans but everywhere who simply don't know enough about the veterans services, people from the va, officials from the va join me in a field hearing in malaysia to the completion of ohio in 2010. we talk about everything from applying to benefits. veterans' benefits to liheap to the and the bickel earned income tax credit. veterans don't know enough about those services. the fact that today i believe there are 30 community-based outpatient clinics and ohio and speak to your commitment to going everywhere to reach veterans not just in the va centers in cincinnati and cleveland, but well beyond that i'm very appreciative of that. but the outreach efforts obviously need to be stepped up and targeted, not just the demographic of rural appalachia but other places, too. last point, i remain concerned about the department outsourcing of more and more work. the quality of outsourced workers often subpar. the whole political view that outsourcing, whether it is selling the turnpike's or selling prisons were outsourcing part of the military, the work often is subpar, the cost savings are usually illusory, and often the costs are significantly greater which we learned from outsourcing. the contractors give political campaign contributions without saying you or any part of that to be sure. but that happens too often. we go places with outsourcing that doesn't lead to good government. we also -- i think many contractors lack the dedicated service mentality if you will of the career civil servants and it's always popular to be up federal employees and state employees and all that. we've gone through that politically state after state after state in this country and in the federal government. but, you know, i like the idea. i think an individual motivation to serve our veterans has a career leads to better service uncontested sometimes to services provided by companies that are motivated by profits. some of the most dedicated people that i've ever met provide service to veterans and made that their career. they could make more money somewhere else, but they want to serve and this whole idea that outsourcing saves money, enhances quality is pretty ill founded. the va and our veterans can simply are viewed as just another claim. we see this of the very basic level of services in places like dayton, and i appreciate very much of the secretary's focus on fixing other problems in dayton. but they tell me sometimes it doesn't come back clean. i mean, what is the point of outsourcing if that happens. if the va continues to all sorts more and more activities come at some plants are we going to reach the point where it then be a is a health insurance provider rather than health care provider? and we never should get close to that line. on a lighter note, thank you. earlier this week monday was the first day and i was lucky enough to be there at the parma out based clinic when the va for the reasons which i disagree, but probably needed to do shut down the va hospital part of the deal was that they would put this community and parma is terrific. it was crowded the first day. people would use it. it serves an important population, and i think you for that. >> thank you. senator nunn of massachusetts. >> thank you, madame chair. i want to hear the testimony of the folks and i will be very brief. i agree with senator burr that we are going to be spending a lot of money. i have happy to do it, but also important to see if there is any implication overlap there seems to be a lot of things happening in that field, and when we have these types of issues we threw everything against the wall and see what sticks and i want to make sure we do it efficiently, but that we have programs improving if not, let's get rid of them. concerns still -- bless you, bless you. [laughter] concerned about the obviously the long time frame in a filing claims. i will say i'm very pleased with what's happening in massachusetts with the new people helping and really seemed energized. we are in the same building and we have had some great success and the public and veteran's hearing that we have on this very issue. and i know the big elephant in the room is the 1 million returning veterans and the obligations that we have to keep them and get them whole. and i'm thankful, i know you already met with secretary leon panetta to meet that mission to make sure that we don't just have a million new veterans coming that it's going to be released. the need to be released in a thoughtful and methodical manner so that you are not overwhelmed and really deeply so we can't get out. i will stop at that and look forward to hearing the testimony. i'm glad to be going to the floor, madame chair, to speak but i will be back. thank you. >> why will be brief because i'm anxious to hear from both of you but think you for taking the time to come to my office. second, i have to pieces of news, one is on the jobs front, and you probably have heard about this, but if you have i want to make you aware. lewis jordan, the founder of now southwest has created a foundation called gratitude america, which is a web based platform to match the job needs with veterans and it has the component that links them with training to the job so it makes a full circle aware of the veterans looking for a job he can search on the internet and if it is the kind of job he likes what he's not qualified it matches with the closest training facility where he can get the training i think it is a great idea and it's something that's important and i appreciate you doing it. second, i want to complement director voltmann at dva. i spent a day in georgia last week. he serves a third of the state, 51 counties pivoted and he is trying to partner with the general, the commander of the air force base to merge the clinics in georgia with the base of dod healthcare to utilize the facilities having all of the imaging equipment and everything on the active duty days to not have to have redundant costing an the other clinics which i think is a great idea to make better health care available, but also at a lower cost of the veterans administration and the taxpayers. i want to bring those pieces of good news to your attention. thank you for when you do and for being here. >> thank you. senator boozman. >> thank you, madame chair. and again, i want to thank the secretary for being here, and the team has assembled for your hard work. senator brown mentioned that, you know, there's a lot of individuals in the va that are there because they want to be and could have other opportunities and certainly you are in that category. and, you know, you've let the soldiers and now you are serving veterans, so we do appreciate that very much. the other thing i would say is senator isaacson mentioned i do appreciate the fact that you are very willing to work with congress, and very approachable, and you and your staff, and so that's something that is appreciated. we appreciate all that you have done in the past and are looking forward to you doing a bunch in the future and i yield back madame chair. >> with that i want to welcome again, secretary shinseki. thank you for coming today to get your perspective on the department's fiscal year 2013 budget and fiscal 2014 advanced appropriation request. secretaries shinseki is accompanied by steve muro, allison hickey, undersecretary for benefits, dr. robert petzel as a country for health and and we also have todd grams for the office of management and chief financial officer and roger baker assistant secretary for information technology. thank you all for joining us today. s and secretary shinseki, your remarks will appear in the records and we welcome your opening statement. >> thank you madam chairman and distinguished members of the senate committee on veterans affairs, thank you again, and i look forward to these, this is an opportunity to extend the dialogue we have, but thanks for this opportunity to present as the chairman said, the president's 2013 budget in 2014 advanced appropriations request for the va. this committee has a long history of strong support for the nation's veterans, and i can speak of that first hand having worked personally in the past three budgets with you. the president has demonstrated his own respect and sense of obligation for or 22 million veterans by saying the congress once again another strong budget request for the va. and i thank the members for your on wavering commitment, and i am here to answer your questions, but seek your support on this budget request. i'd also like to acknowledge the representatives from the veteran service organizations who are here today. i would tell you as we did a lot of the budget, their insights, their experience is hopeful as we've put together our arguments for resources, and as we strive to continuously improve our programs, madam chairman, thanks for introducing the members of the panel. i have a written statement which i asked to be submitted for the record. >> this hearing appears at an important moment in our nation's history, and not the only one. there have been others that i can refer to. i'm old yet to have experienced the return from vietnam and to have witnessed personally the end of the cold war. we are another period of transition an important one the troops of returned home from iraq and numbers in afghanistan are likely to decline over time. history suggests as the chair indicated the da requirements from these operational missions will continue to grow for some time long after the last combatant leaves afghanistan. maybe as much as a decade, maybe even more. we must provide access to quality care, the benefits of services and job opportunities for every generation of veterans , and the generation at hand is the one that comes home today from iraq and afghanistan. in the next five years more than a million veterans are expected to leave military service. this generation relies on the va at unprecedented levels. through september 2011 of approximately 1.4 million veterans who deployed and returned from operations enduring freedom and iraqi freedom, 67% had used some be a benefit of service in some way, a far higher percentage than those from previous war but 2013 budget request would allow us to fulfill the requirements of our mission, health care for 8.8 million enrolled veterans, compensation and pension benefits for nearly 4.2 million veterans, life insurance coverage, life-insurance covering 7.1 million active-duty service members and enrolled veterans at a 95% customer satisfaction rating. educational assistance for over a million veterans and family members on over 6,500 campuses, home mortgages and veteran loans with the nation's lowest foreclosure rates. for nearly 120,000 eligible family members and our 151 national cemeteries asserting their service to the nation. the budget request continue the momentum and the priorities you've heard me speak about over the past three years, increasing access to care, benefits and service members, eliminating claims backlog and ending homelessness through effective, efficient accountable use of the resources to provide come access encompasses the va facilities programs and technologies, the broad term but there's a lot that it encompasses. this 2013 budget request allows them to continue to improve access by opening new or improved facilities close to where the veteran's live and providing the telehealth and medicine linkages connectivity, including in some cases where it's needed in the veterans' homes. also with a fundamentally transforming access to benefits for the new electronic tool called the veterans relationship management system this is an effort to get at the telephones by collaborating to turn the current transition assistance programs we both share by trimming the education program that foley prepares the parting service members for the next days of their lives. and by establishing a national cemetery presence and eight rural areas and better serving women veterans and i'm happy to provide details later. we expect more than 1 million veterans will leave them a victory over the next five years potentially all will enroll in the field for 600,000 of them based on the historical trend over 600,000 of them will likely seek benefits and services from va in the out years. regarding the backlog from what we know now, fy 2013 will be the first year in which our claims production going out the door will exceed the number of incoming claims. .. of how we continue to do that. we are now developing a dynamic homeless veterans registry. i think you appreciate that much of what we understand about homelessness is an estimate of real numbers. we are not able to count everyone out there but it's a valid statistically valid process. in the meantime over the past three years we have been building a registry of former and current veterans by name so we know who they are, what their issues are, the individual level of concern that has been expressed here, what their issues are, where they reside and whether they are migratory and move from one va foot work to the next. so as we think about adjusting the foot trend based on what we see day-to-day we want to be careful that we are not doing something that ignores may be an issue that is going to require help. building the veterans registry of over 4000 names of currently homeless veterans allowing us to better see, track and understand the real causes of veterans homelessness. in the years ahead, we think this information will not only help us more effectively prevent it and that is where we are headed, not just for veterans but perhaps for other communities as well where we have partnered in taking on the homeless issue. we looked to develop or visibility of the at-risk veteran population in order to prevent veterans from falling into homelessness and this budget supports that plan. so, madam chairman and members of the committee we are committed to the responsible use of resources you provide and resources we seek in in the 13 -- 2013 budget and that has been a question that some of you have posed that provokes the 2013 budget slashed 2014 request. we are committed to the responsible use up again and thank you for this opportunity to appear before this committee. >> thank you there much mr. secretary and let me begin the questions by getting this one off the table on the issue of sequestration and cut to spending. like i said in my opening remarks i believe at all -- all va programs are exempt from cuts but there is some ambiguity between the budget act and the existing law and when i asked the acting omb director to address this issue during a budget committee hearing two weeks ago, he said omb has yet to make a final determination so i'm concerned that by not settling this issue now we are really failing to provide our veterans with a clarity that they really deserve to have and so while you were here i want to ask you, to believe that all va programs including medical care are exempt from any future cuts? >> i think madam chairman the answer that the omb director provided you is the same one that i understand. they are still addressing the issue. for my purposes, i would tell you i am not planning on sequestration. i am addressing my requirements and presenting my budget as you would expect me to do. i think sequestration on part and on hold is not necessarily good policy and i think the president would argue that the best approach here is a balance of deficit reduction and he believes that the budget he has presented does that and asks that the congress look at that budget and favorably considered. >> we all hope that is the outcome but we want to provide clarity to our veterans and we are very concerned about this issue. secretary last year we talked a lot about mental health care and i think we together and covered a lot of serious issues summed up via veteran high heard from recently that uses the ann arbor medical center had to wait months and months to get into counseling but then he had glowing things to say about the health care providers once he got in. so in order to address those types of issues, the va has to be certain and has enough resources to not only keep up with the increasing number of veterans who are seeking mental health care but also to bring down that unacceptably long wait time. over the course -- a number of iraq and afghanistan veterans who are looking for mental health care went up by about 5%. that is about 18,000 veterans every quarter so i wanted to ask you this morning if you believe the increase in mental health funding in the budget request is to a comp or circles and keep up with this increasing demand? >> i believe that the budget, if you look at the 13 budget request i think it's adequate for us to meet what we understand our requirements. are there issues out there that we will discover between now and execution of the budget? i would say if we do, madam chairman i would be the first to tell you. now you asked us to do a survey and we did it. it was very hastily done. senator burr refer to some of the output conclusions out of that survey. out of 20,000 of our health care, mental health providers, 319 were surveyed and the results were as described. my question of the vha was did they go to the places we thought there were problems and the answer is yes. i would say we got pretty pure response. what i think we need to do is make sure. we are going to take a broader look and make sure we understand across the larger population what our issues are and where there are opportunities for reallocation or you know, as it becomes clear to hire more people. i would offer to the chair, i took a look at what we have done with mental health over the last four budgets. if we look at 12 to 13 as rather unimpressive. it's 5% and matches the increase of the medical budget but a tween nine and 13, are increase is 39% in mental health and if you include the 14 they will go up 45%. >> as a result of the number of soldiers coming home is dramatically increasing, correct? >> chirla but we are trying to anticipate that those are going to be a larger requirement and the argument is even if we don't have clarity we are trying to prepare for that. we want to do a larger survey here as i indicated and then see what the outcomes are but let me talk with dr. petzel for any details. >> thank you mr. secretary. madam chairman as a result of the hearing we had earlier this year, we have now done two things that are a think important and on point with regard to your question. one is that we develop a staffing model. it is the only staffing model that i know that is available about mental health. it is in the beginning stages but it is giving us some information about what it might be but more importantly we are siding all 152 of our medical centers to look at the access to some mental health services both in subsequent appointments for ptsd inpatient programs or individual psychotherapy and what we are finding is that there is, we do meet the criteria for the first appointments in most every instance. we are having some difficulty in some parts of the country making the next appointment in a timely fashion, getting them as you mentioned earlier, into the specialty services. this could be the result of three things. one is do we have enough staff out there? here i we give an enough positions in resources? two is are those positions filled? are we filling those positions up in a timely fashion and the third is are we getting the appropriate level of productivity out of each one of those people? if we do discover as the secretary just mentioned that we do have additional needs i can guarantee you we will be in communication with the committee about those and for discussion. >> that is a top priority. >> i would just share that in fy11, we hired about 897 additional mental health professionals bringing us up to about 20,500 mental health professionals. the interest is there and trying to determine whether requirement is. we are not hesitant about increasing those dollars. >> thank you very much. senator. >> thank you chairman. since the chair just asked about mental health let me ask you if my information is correct. in december the va polled their facilities and they found that there were 1500 open mental health positions. is that accurate? i would like to turn to dr. petzel. >> could you repeat that number? >> in december 2011 the va polled their facilities and found there were 1500 mental health slots that were unfilled. >> out of 20,500, that's true, yes. >> i just wanted to make sure the information i have is correct. mr. secretary want to thank you for something unrelated to this budget hearing. march 31 to north carolina, we will have the first in the country welcome home vietnam vets day and an all-day event and i want to thank you for the das cooperation in making sure that the va presence is there to make sure that we are able to catch those who have fallen through the cracks and work with those who have problems and we will have the fee a mobile presence there as we will from dod and a lot of private sector entities that are working on employment placement. i think this is a very special event that is long overdue and hopefully it will be the first of a total of 50 that are held around this country and they thank you for the va's producer patient. earlier i mentioned a number of performance measures that seem to be heading in the wrong direction when it comes to claims processing. but i want to start by talking about the quality of the va's decisions on disability claims. your goal is to have 90% accuracy but for the past three years nationwide it's been 84% and as of december 2011 the accuracy rate at regional offices around the country vary from 94 to 61. mr. secretary in total how much is va requesting for 2013 budget to carry out all of those quality initiatives including the quality review teams at each of the regional offices? >> thank senator. let me turn to secretary hickey. [inaudible] senator burr thank you for your question i'm glad you are asking about quality because we are focused on production and quality. it's not a trade one for the other. i think it's a very specific cost but i can tell you we expect impacted the significant in our ability to produce a higher accurate and consistent response across the board. it's not just a quality review teams but they are a critical part of this and for those of you who may not be aware of what those are we have taken what is nationally recognized even by a thank you wild members of this committee and your staff are star accuracy teams based out of nashville tennessee. we have replicated their skill level, their training and what they do every single day now inside every single regional office across the nation. they're responsible well not just be to check quality or at the end, but to do a new part of the process that works closely with our employees in and the training environment to check different parts in our process where we make most errors and correct those early. >> at what point on the calendar would you make a determination as to whether those quality initiatives are going to work and what indicators would you look at to make that decision? >> thank you senator for your follow up question i would tell you we have already done that. known issue that we have in our transformation plan of the 40 plus initiative in the people's category and how we are organized we are organized and trained to do our work in the process environment how we have adjusted our environment or technology solutions have not been tried, tested, measured or impacted before we are implementing so in fact on the quality review -- >> but at some point if you have to say we are going to look at it and see if it's working. >> we did, sir. absolutely dead and we did it in local pilots and we have announced this week -- this be a year from now when we get to the 2014 budget of the quality is not improved or the timeliness down it will have failed? >> no sir. i don't expect the quality do not have improved. we have significant decisions and initiatives. >> my point is what have you done? >> sir we will adjust as necessary and find the reasons why and we will tackle that hard but i don't do that to be the case. i expect to see improvement in both quality and production. >> the senator, quality is a function of trained people with the right tools. and we are working on both items right now. >> my question is simple mr. secretary. at what point will we determine what we have implemented is working? >> we will be happy to provide that. we set a target of ending this issue with backlog of 2015. we begin fielding the automation tools and of the building for two years, the fourth quarter of this fiscal year. we expect that the tool will be rolled out nationally throughout 2013, this budget and as we do that we expect both speed and quality to go up. >> if i could asked the chair for one additional question on this round and i would call up the second slide. va made this projection last year at the budget hearing. productivity impact of the overall transformation plan, which will rise from annual claims per direct labor in 2012 to 120 and 2000 teen. as you can see from the chart, and we talked about productivity per fte last year at 79.5%, this year we are looking at 73.5%. what her sanity increase in individual productivity do you expect from the veterans benefit management system and what percent do you expect from other initiatives that are underway? >> well i will turn to secretary hickey for details. i would say with these charts don't reflect senator is that in the last three years, we have taken on some other projects that are not accounted for here. the g.i. bill requirement to get that the program up and running and today we have over 600,000 youngsters in college under an automated system that didn't exist in 2009 and i think we all recall the first semester we had to do everything manually and it was not the prettiest processing event. but we did that manually and got 173,000 youngsters in a school and on their past to the future and the same time we began building this automation tool for the g.i. bill. by april we had the first part of that tool out and we have added four or five more programs to make it more productive. we will get better over time. is hard for me to give you a day and a month when this quality factor will meet any of our expectations, but we set 2015 as the date in which we would have it that log solved in the quality of 98%. that is what we are focused on. i will give you the best way points that we can figure out and that will be a product of what we are doing to train our workforce and what we are doing to give them the right tools. we are talking about the right tools now but in the same time, your question about the growth in our human resource investments for the department, we have trained nearly 300,000 of our workers. many of them who have never been trained on their jobs so they can produce what we expect and they can leverage these tools when they arrived. >> thank you senator burr. i would like to first start by saying thank you to you and to chairman murray and your leadership and the members of this team on this committee for and i'm precedented level of budget increases that the cba has enjoyed in the last few years. any to put that in a little context. that 36% was used to tackle a 40% increase in claims over the same period of time. that was to support nearly 12 million servicemembers, veterans, their families and survivors and that is including a net increase in the last year of half a million dollars new veterans to our roles that did not exist and are using our benefits and services. so we did also for the second year in iraq complete more than 1 million claims using those resources. that is 16% more claims per year than we did in 2000 in reviewing some of those things. would tell you and put frankly frank fama table we put more than $3.3 billion i thank you for celebrating of vietnam veterans. we put more than $3.3 billion into the hands of 117,000 of those vietnam veterans out there in the last year. that had an impact on that line. that impact was for 260,000 other claims in backlog we did not -- that had an impact on fte because we put, to do those this right and well, we put two times the fte associated with each one of those claims on a very difficult complex 50-year-old claimed. in addition we stood up in the same period of time and put four times the level of fte to our most wounded, ill and injured and are integrated disability and evaluation system to give those folks taking care of right and well the first time. so that also had an impact on their line that you have laid out in front of us. the positive news about all of that is, we are done. we are down to the tens of tens level of doubled digit levels of the agent orange neighbor cases. 99.9% donned through those 250,000 cases. we are now capable of shifting all those 13 resource centers but we had across the nation that for hunker down during those name are agent orange. we are shifting that back into normal backlogged caseloads that will be focused on our benefits at discharge veterans. be focused on our quickstart veterans and it will provoke us on her oldest cases we have on the books. >> thank you senator burr. >> thank you adam chairman. e., as you know we often face challenges in treating our veterans who lived in many rural and remote areas. this is especially true in places like alaska and hawaii, where you just can't get through some places by jumping in a car and driving there. i know that you are working on an mou with the indian health service. you find solutions to help provide services to our native american veterans and i commend you and all of your involvement in these efforts. ms. secretary can i get your commitment to look into possible ways of working with the native hawaiian health care system and the native american veterans to provide services for in this case native hawaiian veterans who lived in many of the rural parts of the state of hawaii? >> senator, you have my assurance that we will do our utmost to provide for many of our veterans, wherever they live, the rows -- most rural in remote areas, the same access and quality to health care health care and services as we provide to someone living in a more urban area. there is a challenge with that but we are not as sensitive to that challenge and we are working hard to provide va provided services and where we can, to make arrangements where if quality services exist in those areas, making arrangements for veterans to be able to participate with those local opportunities. clea are i think you know, working and have been now for some time on signing in mou with indian health service so whatever they have facilities and we have a vested interest, a veteran eligible veteran going to an indian health service facility will be covered by va payments and we are in the stages of trying to bring that mou to conclusion. we intend to do that, and where tribes approach us prior to the signing of that mou and want to establish from a tribal nations would be a direct relationship because they have a medical facility and would like us to provide the same coverage. we are willing to do that but that would be on a case-by-case basis. >> thank you. secretary shinseki, staffing shortages continue to be a problem, although there has been progress but some clinics are seeing staffing levels below 50%, causing excessive waiting times for veterans that need care. i understand this is an issue you have been working on. as you know the number of veterans needing services is growing yearly. it shows that you have been making progress. can you provide an update to the department's progress to address staffing levels? >> mr. secretary thank you for the question. we have addressed and we have talked about mental health earlier and the efforts we are making to try to assess whether there is adequate staffing. i think you're probably talking about primary care, which is our largest outpatient clinic operation and we treat 4.2 million veterans in our primary care system and it accounts for the lions share of our budget expenditures. we assess staffing three years ago when we began to implement what we call the patient aligned care team or pat program and have done it again recently and we are finding that we are now able to bring up the support staffing and a physician staffing to reasonable levels associated with the standards around the country. i would be -- i would like to take off record, off-line, and the information you have about specific places where there's a 50% vacancy rate. i am not aware of the fact that we have this around the country so i would be delighted to meet and talk with your staff and find out where these areas might be so we can address them specifically. >> of my time has expired, but secretary shinseki as we face budget constraints, we must all work to improve our efficiency and to redouble efforts to look for ways to get the most from our budget. my question to you, can you talk about any steps you are taking to improve the acquisition process at va and any efficiencies you have been able to realize in the area? >> senator i would tell you that we have been working for several years now on restructuring our acquisition business practices. three years ago the position was spread throughout the organization analogous consolidated to two centers. one comes directly under dr. petzel, gloves, masks, aprons. we have to be able to leverage that into a good try some those kinds of things. for everything else we have an office of acquisition and logistics and construction. we have a director who heads that office and everything else governing acquisition is consolidated under his review. both offices work, the work of both offices then come up to my level to the deputy secretary as part of our monthly oversight review process. >> thank you very much. senator johanns. >> thank you. mr. secretary, let me if i might visit with you about the national cost -- call-center. this is something that i think we have high hopes for and you might have had high hopes for it. but i have to tell you what is not working well. here is what we are running into. the complaints kind of fall into two separate categories. the first category would be people that called the call-center and no one answers. i mean it just rings and rings and rings and there is no one there. i will tell you in my own senate office my staff is running into this problem where we just can't get a live person on the other end of the line. the second area is, you finally get somebody, to live person to answer the phone and you get connected with them and they don't have the information. somebody is calling in, what is going on with my claim or whatever it is and you are just not getting a response or human being on the other end of the line. i'm guessing what it is they just don't have access to the information that we are seeking and so it seems to me that we are creating an expectation of service when really there isn't much service there. i would like to hear your thoughts or whoever's thoughts on your team about the call-center, what are the prospects for that, are you hearing these problems, and if we are still committed to the call-center, what is in place or what will be in place to try to solve the issues that i have raised? >> thank you senator. i have tested the system myself. sometimes i am pleasantly surprised and other times disappointed but that has been something i have done for three years now. and then demanded that we go out and fix it. so we are in the process of putting a fix in place called the veterans relationship management system. if the concerns you are expressing our anything six months the experience occurred six months ago and older, i would offer that we have put this tool in place and changes are occurring weekly and i will ask secretary hickey to provide some detailed. but i, like you, you think when a veteran picks up the phone and calls va, there ought to be someone there that answers or if years she chooses to cut an on line that they ought to have information that is useful to them that is easily discovered so they don't have to run through a series of traps to find that they are looking for. we owe them, and that is the first up in any service organization, and that is our intended use and let me call and secretary hickey. >> senator johanns thank you for your question i appreciate your comment earlier but benefits. that is actually part and parcel of our fall two-prong approach in our veteran relationship management capability about being able to converse with that veteran by the time and the method that they choose and we have surveyed our veterans and 93% of them want to meet is on line so ebenefits is partly that solution. but let me talk to specifically your question first about no one answers, no life versed and let me tell you about the two new pieces of unction audit we have that we have measured out -- outcomes on tour veteran survey. the first of which is virtual hold. that means the veteran causes and there's a long waiting time, they can elect to hold or hang up the phone and continue feeding the baby, getting ready for work, doing whatever it is they need to do and we will call them back on cue. 92% of our veterans have elected that option and we have connected with them as well. the second one is our schedule callbacks meaning i can't wait on the line with you now but can i schedule a time that i can talk to you and you will guarantee to call me back? we have just implemented that one in december. between those two our veterans, 1 million veterans have elected those options. as a result we have seen clear demonstrated measurable performance. we have a 15% improvement in overall satisfaction on the ability of our veterans to get through and we have seen a dropped call rate reduction of 30%. deserve both part and parcel of the new technology and the new ways we are working our veteran relationship management capabilities. in terms of another initiative in terms of a don't have the right information. yesterday, not today, yesterday our colleges would have had to cycle through 13 different databases we had to get to that veteran or family member or survivor the information you needed. today as we deployed and is critical for our i.t. budget in a fight desk top puts all 13 databases worth of critical information you want to know on one screen making them much more effective in delivering a good outcome. also built into this is world-class call recording, call tracking, data analytics into this package that we are using every single day to improve our service into our environment. >> i'm out of time but if i could just ask as these things are being implemented, as we are going down the road here, if periodically you could give us on the committee and update as to the progress you are seeing because i do think there is real hope for the call-center. the veteran at least can get somebody who can answer their question etc.. so i would just like to have it stated how you are doing. >> i would be happy to do that. >> thank you ring much. senator tester. >> thank you madam chairman. i appreciate seeing secretary shinseki and all the folks on the panel today. a special thank you to you general for coming to montana last summer. our veterans are very appreciative that as myself and thank you very much for being there and listening and hearing so thank you buried very much. i want to talk a little bit about what the senator talked about very quickly and that is the kind of strategies that va is using to recruit folks. this is in an area that is much more difficult to my opinion and gp is not easy and that is the need for mental health professionals. we have as you know mr. petzel you were there i'd at think when we opened up the facility and we need, it's a great facility, but we don't have staffing at this point in time as far as from a psychiatric standpoint. do you have the adequate amount of flexibility to be able to go out and recruit and it can go to the secretary or mr. petzel, to be able to go at them recruit and get folks and because i am not sure we are there yet. >> thank you mr. secretary and thank you senator tester. i am aware of the issues at fort harrison. we have for psychiatric psychiatrist vacancies. in general we can recruit around the country very successfully for psychiatric social workers, for psychiatric nurse clinicians and for clinical psychologist. the most typical recruitment for us is the m.d. psychiatrist. we are not unique. this is an issue that all systems around the country faced. we are very competitive however in terms of wages, in terms of working conditions and the other kinds of things that are appropriate and are needed for recruitment so i think we are in a position to do the best job that we can of recruiting. i don't know what we could add right now to the basket if you will of things that we have to offer. it's a matter of identifying this, the people that want to come to places like helena which is beautiful by the way. >> thank you. >> in an environment where they are just not that many of them. >> well i just think it has been an ongoing problem particularly in rural areas like montana and it's not a problem that i think bodes well for the veteran who has issues that revolve around mental health. we all know if we have professional help quality of life advances in the cost goes down. i want to talk about health i.t.. can all agree that i think it would be more efficient and more effective to deliver quality health care for our veterans however it is my understanding exclusion of health care-related i.t. funds puts a person somewhat of a fine. it's hard to deliver quality care for and you cannot make corresponding investments in systems that connect the veterans, electronic health records allowed to be better coordinate. can you speak about this issue and how the inclusion of health care-related i.t. funds could improve the quality of health for our veterans? >> thank you senator. i would just begin by saying congress provided us a unique mechanism called the advanced appropriation and it's a gift to the va because it really gives us continuous opportunities for continuous budgeting ever hear. it gives us two looks at our budget so we submit what we understand our estimate is as an advanced appropriation and then we come back a year later and submit the actual budget so we can make adjustments. the advanced appropriation applies primarily, solely to health care and so doctors petzel has his continuous budget. everyone else is else's on annual budgeting. under advanced approach we have to budget for medical services, medical compliance and reporting, medical facilities and what happens is when we have a delay in cr the rest of the budget where i.t. resides, he has his authorization to start building facilities and standing them up and then we have to wait as sometimes happens or more than sometimes, a delay until the i.t. budget gets released so now it can catch up to him and in a case last year i think the budget is cr -- so a pretty significant. not. we are a bit off start here and i'm trying to figure out how we can get this together and link up the authorities you provide along with a budget to do his business and get him the tools that allow him to see patients. there is no separation between medical i.t. and medicine. it's all one treatment discussion. >> well i just want to, let us know how we can help you be more effective in the i.t. area and i think chairman murray and ranking member burr will help on this too. i think it's really important in this day and age and -- >> and i had very quickly madam chair i would just add that was sometimes happened as last year the i.t. budget is released in april and it's a big number says it is i.t.. really in it you have the paperless system that goes with secretary hickey' operation and medical i.t. with doctors petzel. i'm just trying to be clear here. i am concerned about medical i.t. so when you link decision to do things for veterans in the medical sense along with you know the tools to be able to do that. what happened last year as sometimes happens, this large i.t. budget gets identified in april and we can now go forward. an assessment is made that they can't possibly spend that before the end of the year so we lose $300 million at a time when we have really need it. he can now not deliver what we have our ready approved a year before and we are doing that so i think there is a timing issue. i think there is a mechanism on both ideas and we would be happy to work with you on a. >> thank you and i want to thank everybody for being here today. i will get into the cemetery thing with mr. monroe but we will post those questions at thank you very much. >> senator moran. >> madam chairman thank you very much. mr. secretary, in 2008 congress passed the rural veterans access to care act. this is a piece of legislation i was involved with in my days in the house. at the signed into law in the program is now referred to as project arch, access received closer to home. and that legislation set certain criteria that a veteran with a certain number of miles from an outpatient clinic or from a va hospital. the va would provide those services using a local physician or local hospital. my legislation was broad in its initial form and narrowed by congress as to create pilot programs and the vision that was included as one of those pilots. i expressed my complaint to the va before because when the va then implemented its pilot program it did not choose a vision as a pilot project. it shows a community. in my view we have taken legislation to create a pilot program and created a pilot program within a pilot program in we now have a project on going in kansas to demonstrate whether or not this idea works. i would love to hear a report of progress being made but also use this moment as an opportunity to get again encourage the department to expand this pilot so that you can take more than one community. what happens in pratt kansas which is less than an hour from wichita come is significantly different from what happens in at what kansas which is five hours from wichita and they the access to providers is totally different between those communities so while i'm certainly please the pilot program is ongoing i am not certain, in fact i am completely uncertain, completely certain that va has not chosen wisely as it has narrowed the project to a very small scope to judge determine how it works. in that regard along this main topic of the sea bass we have an ongoing problem similar to what has been expressed with regard to mental health with senator tester and i'm to stand the doctor's testimony about the inability to attract and retain professionals but it's becoming clear to me we have that same problem outside of mental health. our ability to retain physicians in cbot across world kansas and ice them across the country is a huge problem and more and more we have nurse practitioners physician assistants that the availability of a physician is been very limited and we have many with no position is generally present. i understand the secretary's testimony about i.t. as a potential solution. we certainly have offered to our vision to make certain and we do everything as a member of the senate now to provide the va with the resources to provide the necessary personnel and my assumption is my answer will be similar to what you told senator tester and the same one that i hear from folks in kansas is it's not really a resource issue. we can pay sufficient amounts of money to attract professionals but we are struggling like everyone else to attract those professionals and i've heard that answer for a long time that you said it again today doctors petzel. in some fashion that can be the final answer. just because everybody else is struggling to attract professionals to take care of patients we cannot afford to allow the va to have the same. understand and i don't mean to be critical but there has to be something more than everybody's experiencing this problem. there has to be at path to a solution. >> i'm going to ask doctors petzel, i guess a question. i would say senator, in the rural areas it's a challenge because of the availability and i think doctors petzel said that. our tools are really reaching out. we want highly qualified and we want talent and our tools are what we are able to compensate, what we are able to award and recognize in the performance of good people doing outstanding work and retaining to bonuses, the high-quality high-quality so our tools are limited. but we owe you the best efforts we can to go after that talent and the biggest challenges are in rural communities. >> mr. secretary i appreciate that you always that and i understand your veterans that but i would tell you that congress, iou every tool possible to help you meet that criteria and the complaint or concern i have is that i am not eating asked to do something to solve the problem. so what i'm asking for is tell us what we can do to provide the assistance so that when we have a hearing six months from now where we are back here talking about the budget, the answer to whether or not there is a doctor at cbot or that we are meeting the mental health needs of veterans particularly in rural areas is not every health care provider come every community, every rural state having the same struggle we are. help us help you solve this problem. thank you. >> try to respond very quickly. >> i will try to be quick. thank you senator moran. the other issue first, you're absolutely right that we all have difficulty in rural parts of the country. i would say if you look at our end the situation across the whole system, it's very important that we focus on the fact that it is rural america. two things we would like to do. one is that we need to expand our tuition reimbursement program to be able to provide an incentive to go to rural areas by reimbursing tuition. the second one was an idea the secretary had and i don't want to get into the details but it's something like the military does with their uniformed services, met up of school and that is people pay for their medical with an obligation to follow to work with us in a particular parts of the country. those are two areas we are trying to explore. >> thank you senator. i would put a finer point on what the -- said. i thought if we went into areas, the rural areas and found a highly talented youngster, a great potential and target that individual and got them through the college and medical process, they would be going home. so in the long run we would not be facing the retention bonuses and those kinds of things. you would have provided someone for the long-term as a solution to that requirement. that is part of the discussion here. >> appreciate your thoughts and please consider me an ally in we can follow up with the arch question at a later time. >> thank you. senator baker. >> thank you very much and i want to add to the comments of senator moran. i like some of the comments and i would like to participate. and one of our hospitals in alaska they give a bonus to employees, a significant bonus up to $10,000 to recruit and retain -- retain nurses because of the high capacity and needs of thank you for those ideas. let me also say thank you mr. secretary for the trip to alaska, last week or the week before. chair and murray, it's important as you know to come up to alaska to understand what rural is all about. thank you for your visit and your teams visit. it makes a difference to the people there but also i think opens the eyes to a lot of folks as to how we have to deliver health care into the most remote rural areas of this country so thank you for that commitment. let me if i can and i know we have had conversations secretary in regards to the idea of the -- and the idea of trying to weave through this access issue in parts of the country that have limited access to veterans care in alaska specifically. with we have talked about the roadless areas, those areas of 80% of the communities in alaska that do not have access by road. i heard her testimony about internet connect and there is no mobile band possible. the mobile van is there and that's the only way to get it so i know we have talked in a very positive way about how to create this access and i just want to check in with you on the update of that. i know we have talked about the quality of care in health services which is superior to much care that has been given across the country and its high-quality care. tell me kind of where you are at this point. you have been very responsive and i known we have been badgering you and your team on a pretty regular basis because as you have seen the veterans all they want to do is go across the street to the health clinic to get their regular check-up as a choice, not as a requirement and they choose to go to the va hospital so be it but when it's across the street, let's make that happen. in some cases we would argue the services of the va so what is your latest on that? >> as he went i discussed i think you will recall that we have put in a policy that would allow veterans from alaska to go locally and reduce the amount of veterans having to travel to the lower 48. it's a rather robust program underway there. as i described working with indian health service to establish a lot of processes for especially alaskan native veterans, in the meantime based on my visit to alaska, the alaskan native consortium, medical consortium, we have also established discussions with them and trying to ensure that, however the ihs and mou progresses, and we are ready to provide help to veterans who are being seen now. >> that is going in the right direction. >> let me turn to.or petzel since his people are in negotiations with them. >> thank you mr. secretary. senator begich i do sympathize with what you are talking about in terms of the ruralness of alaska and other parts of the country. while we are waiting for the mou to be finished alaska is one of the places where the opportunity with tribal interactions and i hesitate to use the word pilot but to get specific agreements within a tribal unit. in alaska i believe it is the south alaskan tribal association and we are progressing and getting some arrangements made. it would be wonderful from my perspective if a veteran could make a choice and access tribal clinics if indeed that was more convenient and care was successful and that we could work on the reimbursement rates. i think that is what we are trying to do in alaska and we have another going on in south dakota. >> and you feel it's moving in the right direction? >> absolutely. >> i have two quick ones in one is, senate bill mine 14 authorizes a waiver that i introduce on collection of co-payments for telehealth and telemedicine. i guess the general comment as i know we have about 200 veterans and 100 are at in the program and others across the country. the idea is, telehealth is a huge winner and a lot of it and it works very successfully. it increases the capacity of telehealth. can either one if you give me your thoughts and mr. secretary are you supportive? i know anytime you take dollars a way, my view is telehealth is a money saver and a specialist with the shortage mental health services this is a potential way to create a solution. >> senator neither.org petzel or i are familiar with this legislation so if i may, i will provide that for the record. >> absolutely and that is senate bill mine 14. the last comment if i can madam chair if i could just add to my concerns, we actually -- so it is not bold. i know when i was chair of the student loans corporation we had a call center and as you can imagine when their loan rates change or they didn't get their payment or whatever it might be we have to go through a hole revamping of the system by the metrics we measured on a regular basis reports of the could see what the possibilities are. you mentioned you're going to have for you have a system where you can see the metrics of success, wait time, call time, whole time, response, all those. i want to echo what my colleague on the other side said that i would anxiously want to see that because this is our number one problem. the 800 number and, lack of response or inadequate response i should say and that is current, not six months ago or a year ago. this is very current and customer service is the name of the game, how to make sure these veterans have the services they need. it says something you could provide sooner or later so i could get a better understanding? >> i will dive into those numbers today. >> very good. thank you and i think the only solution on your issue to the i.t. is your whole department should be into the budget process instead of one-year and two-year. that is my personal opinion. that would solve a lot of problems. >> thank you are in much. in much. >> thank you madam chair. i just have a couple of concerns. the budget request includes operational efficiencies that are estimated to save $1.2 billion. that has been done in the past via you know various administrations. last year's budget request also included operational efficiencies of just over $1 billion. in the past, i guess if they don't, about, how are you planning for the risk and what is your contingency plan if we don't see a billion dollars in savings? >> i'm going to call on dr. petzel to respond since this, they looked at his budget for the savings, anticipated savings but i can tell you that right off the top, $362 million saved because of dialysis using medicare standard pay rate instead of paying the rates we were being charged previously. $200 million in improper payments because we reduced those. through the program management accountability program office in i.t., about $200 million in savings because we terminated projects that were not going to deliver and then about another $100,000,000.1 notice of death in which we stopped payment on veterans accounts when they transpired are going to pass this has been an issue. sometimes as much as $100 million in overpayments and for the future, we have agreed to provide as a minimum $173 million in savings, reducing waste in 2012 and 2013, and so that is part of our effort to get at the savings and efficiencies. let me just ask dr. petzel to provide more detail. .. we have got contracts knell for blanket purchase agreements with virtually every dialysis center that we use that will save us hundreds of millions of dollars. what we would have expanded can we not been able to do that. the medicare rate payment change that occurred that the regulations allowing us to charge -- to. >> -- to charge medicare rates both the professional fee and facility fee is joy to save us about $300 million, and that is absolute money that week otherwise would have spent have we not been able to do this. and then the efficiencies, again, something we can measure easily over $200 million. acquisition, about $355 million in savings. there is a long list command and not try to take the time to go through that, but absolutely, said that we will be able to save this money in dasa. >> they give. >> madam chair, if i may, one last comment. we are going to like all this and the credit-card. i have cautioned that in the and we have to focus on what makes sense. the best prices we can get. you know, if you just look at that, you may be encouraged to outsource all of them. i have argued that dialysis is something we have to retain a handle on. we should do a certain amount, a certain portion of it in house. what u.s.s.? i am just concerned that if we provide the funds that lets somebody else take care of dallas's we ignore what the medical professional is supposed to do, and that is, as long as we are doing dialysis we have to ask ourselves what causes it, why do we have to do this, what are the things of the front end that allows us to deal with preventing diabetes so that dallas is does not become a fact that we have to live with. and i think the medical profession is the best and asking those questions, and that is why i think we need to retain a piece of that abrasion. >> rate quickly, the president's has proposed a billion in funding for the veteran conservation corps. he anticipates that will create 2,000 jobs for veterans. you know, we all agree their is a lot of background in the work that mr. dunne and the parts and infrastructure and those kinds of things. i had the opporunity, the chairman and ranking member of the economic a virginity on the house side, and really work very closely with the program, lots of veterans about their dreams and aspirations. i have a lot of concern about spending a billion dollars. that is not dahlia no, the direction that we were going him in the committee, i don't believe. and, i really don't know. a billion dollars a lot of money . at think that that could become a you know, put to good use, but for myself i really don't believe that is the direction that we need. i have never heard a veteran expressed to me that is the route they would like to go, and so, again to my just love to express my concern. >> thank you very much, mr. secretary. obviously we have had all lot of numbers. we have another panel that needs to present today. sufficient time, and i have been called to the capital. i am going to submit the rest of my questions for the record and, did you have any more comments? >> i am going to submit a lengthy set of questions that i ask the secretary and his team for quick responses to in lieu of a nasty a second round of questions and would make four points to you, these are disturbing trends that i see from the information as we analyze the prior year. the viejo to kent 430,000 more plants that were decided. appeals the results today decision took 1123 days to come to fruition. that is disturbing. the central office staffing increased 40% since 08. in that same timeframe human resources administration increase 80%. for a business created in 1995 we envisioned 22, a total of 154-220 employees, and an annual budget of $47 million. today 21, roughly 1340 staff, and $165 million annual cost. many of my questions will be reference to these four areas. i'll look for you and others to discuss some of the trends that i see that should raise and do raise flights from me and hopefully would raise flags for both of us, again, i think. >> may have respond, madam chairman? would be happy to provide details. i, like you, and concerned. there has been growth in the veteran population. there veterans in the enrollment. the viejo headquarters is 1% of our budget today as it was in 2008. and it is a reflection of that growth, and i would be happy to provide the details. >> thank you very much to you and your team for accommodating our committee. appreciate that and ask that when you answer the question is that are submitted as you myself and members of the committee do so in a timely fashion and with that i invite our second panel to join us today. and, as i said, i have been called to the capitol, so i will introduce the panel, let our first speaker go, and i will turn the gavel over in a very bipartisan way to my colleague, not to give you practice, to let you do it today, but i appreciate your accommodating me. [background noises] >> they do for that. thank you very much. [background noises] >> if we can keep the room quieted as everybody changes chair zero really appreciated because i would like to introduce the panel as they're coming up. we are going to be moving now to our second panel. come up and join us. seated in the appropriate places. i want to especially, again, if we could have it quiet in the room. all right. i want to extend a very, very warm welcome to our friend of mine from washington, beth's wire. he, the american legion western region national vice commander. thank you so much for being here today cover carry all the way across the country for the tremendous work you do. your participation on this panel to write a local perspective that i take as a board for almost a year, so i appreciate that. mr. shriver, the company today, the directive and as a legislative commission for american legion. we also have the people here on behalf of the independent budget, at the trough, national legislative director, jeffrey hall, assistant national legislative director for the disabled american veterans, diane zumatto, national legislative director, and at .., finally, what to rod and to the panel, tom tarantino. we are going to begin with mr. shriver and then move down the table in order, the independent budget witnesses will have 15 minutes to overcome and the american legion in iraq in afghanistan will be given five minutes each. i, again, apologize to all of you. obviously we have had tremendous participation in the committee hearings. i know that i and my staff and all the members of committee will be looking in your testimony. the simi important and we will be submitting questions as well even though we don't have a lot of members present. i especially want to thank the senator for accommodating my schedule as well. with that thank you and we will begin. >> chairman, ranking member, members of the committee to my take is submitted to thank you for the invitation to be here before you today and testify on behalf of the american legion, the nation's largest bit erratic wartime veterans associations and about the budgets and the president's proposed budget for the department of veterans affairs. the american legion is grateful for the increased budget to deal with the needs of our nation's veterans. for those who have learned the way of war for this nation we must always are member that a promise made is a promise that must be kept. we would like -- we find like-minded allies to recognize the importance and even duty to ensure that we're keeping the promise to america's veterans. he knows the importance of holding government to the promise made to our veterans committee american legion in washington state knows of tirelessly your thought for the veterans and the vatican army house presented to it in sure that there was a war will not be given the short end of the state in the interest of financial savings. the american league also knows how hard it is end for this committee to have fought the viejo to insure hard work on passing caregivers act and not to narrow -- i'm sorry, madam chair, not lost the implementation. we stood with you in those fights and are here today because your shown their willingness to listen to the needs of america's veterans and fight to make sure we keep this. the department of veterans affairs is dedicated to providing a earned goods for the ones that would serve in the president's budget is an ambitious and certainly an increase in size, especially when government must be seeking ways of saving money. it is a positive step forward for our veterans, the american legion remains uncertain that there are areas where a lot -- lack of foresight our policy putting a liter v-8 -- viejo to not keep promises. we cannot afford this. major and minor distractions. while we're pleased to see mental health services building in seattle moving forward, when viewed as a whole the construction budget fails to meet the needs of even though the a internal strategic building plan. the strategic capitalism as the planning or sc ip provides a 10-year plan to address the most critical and research in aids. the american legion was concerned. it would take close to 40 years for the needs of 18-year plan to be met. we have all heard recently in the importance of investment and empress structure of the kind of those who pay for now and later. when the structure is given the short end of round it becomes more expensive at the back. serious these direct choir billions of dollars in funding. does that we cannot afford not spend. we cannot condone veterans to replace an aging facility that cannot be their most basic needs and fail the construction now and bright promise, once again, it's our veterans. recesses sir funding levels, not only concerns, but must contend with this budget. we must also look closely at the viejo, it intends to spend their money and is sure it is not based upon smoke and mirrors, but real money that will be there when veterans he did most, ambitious prospects in the budget for medical care clashes monday are unfortunately based on promises. the american legion of fears that in the real world of 2018. setting aside concerns will cost-cutting over $110 million annually in revenue. that is a great concern that promotes increases in a billing amounts. the new budget proposes to do private insurance as to pervert provider rather than the current medicare rate. this change building reflects 90% a proposed increase. frankly, this has never been authorized before and even if authorized the viejo will be hard-pressed to be this overly optimistic. kendis fails to generate the necessary revenue the viejo will be forced to find the budget, and that means more broken promises to our veterans. finally, we are concerned about the overall budget prospect as a whole in these times of fiscal stress in government. surely this committee is aware of the pessimism of the iraqi people. regarding the ability of congress to come to terms and to pass a complete budget, while we ignore is that many worked tirelessly to break these budget deadlocks, and surely share the frustration of people, when we cannot reach these this business, continuing resolutions and half measures make from certain planning. avast procreation of relief, there are still progress that languishes, contracts settling writing for approval, an operating budget that the government moves from month-to-month. questions remain about the protection of secrecy of restoration -- sequestration despite protection from previous interpretations a budget controls. va planners need a stable groundwork, more and partly american veterans need to see this for themselves. chairman, that concludes my report, and says we will be taking questions, thank you for allowing me to be here. >> madam chairman, senator, on behalf of the co-op and the individual budget, and pleased to be here today to offer our views of the administration budget request. the advance appropriation for year 2014. in the interest of time i will limit my comments to a couple of concerns with particular issues that are in the budget request. first, let me say a prayer we appreciate the increase to the minister's has provided for in this budget request. that being said, we have real concerns that have addressed by the committee's members hear about the impact of sequestration, simply put we find it absurd that more than six months after the budget control item is passed there is still no definitive position on whether or not the programs in particular health care programs are protected from sequestration . at the the committee and all members of congress have made clear and it is time for a final decision to be made. with regard to specific issues in the was request we echo the concerns that were raised several members of the committee with regards to medicare collections and the roller-coaster ride that exists in reason years in determining the estimates for that. we also agree with the concerns that were raised about perceived management and the program improvements and disease, whether the savings are realized what the impact of not realizing the impacts believe the largest a single biggest concern that we have is with a particular discloses of the president's budget that outlines what they have said the approximately $3 billion excess and resources of provided for fiscal year to 12 and about $2 billion in excess resources for fiscal year 2013. this begs the question, how can the administration clearly stated they have $3 billion in excess resources for this fiscal year, but seven months of the fiscal year left to go. you know, we all hear the stories about shortages and staffing and that prices kirsten certain. bottles of mind that we suddenly have this excess resources and are not talking about a small pot of money to 05 percent of the viejo budget, particularly troubling in light of the fact of the viejo to bed to sleep is a cut of 2%. so certainly encouraging the committee and all the members of congress to really investigate this and get to the bottom of this. this single fact to provide -- pose a bigger problem than any other issue that the viejo is facing in the coming years to miss this year and the coming years. the prospective fiscal year 2014 invest appropriation i would have had a couple of concerns. press with regard to the increase in medical supporting appliance i . to the fact that it is a pretty substantial increase projected. this is not unlike some of the comments you made about the growth of the a minister to function within d.h. a. at the same time addressed appropriations provides for a very substantial decrease and medical facilities. lyle and distance of that is based on the assumption it will transfer certain amount of money to the and the medical services trade also is contingent on a cut in manta remains an almost having an account. i think given a lot of discussion in recent years about the impact of funding and nonrecurring maintenance and the affected is having a facilities, the commission certainly be interested in looking into that further, and i know my colleague will probably touch on this as well. with that i will conclude my statement and be happy to take questions. >> sent you. >> they do, member. thank you. on behalf of the disabled american veterans and as a co-author of the independent bus employees to be here today on behalf of our members to offer our reviews and recommendations regarding the independent budget for fiscal year 2013 as it relates to veterans' benefits to more programs to my judicial review, and the veterans benefits of the station. as you know, we are now in our third year of the latest effort to transform the outdated inefficient claims process system into a modern rules based zillow system. over the next year we will begin to see whether those strategies to transform the people, processes, and technologies will finally results in a cultural shift away from expedia production into a business culture of quality and accuracy which, the customer is really the only way to get the back part of claims under control. although we have been very pleased with the increasing partnership and collaboration, we urge this committee to provide constant and aggressive oversight of the major inspiration activities taking place drought this year. perhaps the most important initiative, as you know, as the veterans benefit management system, which is schedule to begin its worldwide nationally in june of this year with final completion of the rollout in late 2013. cell as they work to complete stall perfect, and deployed is vital new id system, it's absolutely crucial that sufficient resources are provided. we do know that the budget drops down from $140 million in fiscal year 12 to $128 million in fiscal year 2013. while we don't know the reason for the decrease in budget, we cannot emphasize enough the vital importance of the pbs and the need for the sufficient funding in order to complete the development and implementation. we hope this committee will thoroughly examine whether that level of funding is officials also. in order to sustain the transfer nation efforts, the fiscal year 2018 recommends maintaining current staffing levels and those business plans, even a large increase in the class processor the past few years to more we believe this to be focusing its efforts on properly training new existing employees with an emphasis on quality and accuracy to insure friends are done right the first time. we note that the occasional rehabilitation and diplomas service budget for fiscal year 2013 does request funding for approximately 150 new counselors , designated for these mention of the integrated disability evaluation system and of that success on campus program. we fully support both of these increases in these programs. however, and ordered to reach the target of having one counsellor for every 100 -- veterans served there will need approximately 195 is of councilors in a flood of booktv.org to accomplish this. additionally the independent budget is recommending a staff increase. the board is currently authorized to have 544 full-time employees, the budget deficit huge shortage of fully supports 5302 and for fiscal year 2013 the budget requests that number to 527. bidding at the historical appeals rate in the rising number of original composition claims they've recommended a beeper have provided sufficient funding for unauthorized or force in fiscal year to to 13 of at least 585 full-time employee. and finally there once again call on congress to enact legislation to finally end the unequitable prohibition on concurrent for all disabled veterans and eliminate the unfair offset between the survivor's benefit plan and the dependence on the compensation for veterans and their dependents. raking member, this concludes my statement and then have to answer questions. >> thank you. >> yes. good afternoon. on behalf of the co-authors i think you for your opportunity to share our recommendations with you today. my main focus will be the ncaa with a national cemetery administration. the single most important obligation of the ncaa is to honor the memory, and siemens, and sacrifices of our veterans who suddenly surge in this nation's armed forces. these acts of self sacrifice by our veterans obligate america to not only preserved, but to rehabilitate and expand our national cemeteries system is necessary to meet the needs of american veterans. these venerable and commemoratives bases are part of america's historic material culture. there are museums of art and american history. there are fields of honor and hallowed ground and they deserve and require our most respectful stewardship. this sacred tradition of our national cemeteries began in 1862 with the earliest military graveyards are situated at battle sites, a field or general hospital, and at former prisoner of war sites. since that time more than 3 million burials have taken place within the in see a system. the mca currently maintains stewardship of 131 of our nation's 147 national cemeteries as well as 33 soldiers which are currently located in 39 states in pr. as of late 2010, there were more than 20,000, to 1 acres of historic landscape, funerary moderate to of monuments, and other architectural features included within established in see insights. the viejo estimates that of the roughly 22 million veterans alive today at approximately 14 of them will choose a national or state veterans cemetery as their final resting place. a transition of an additional 1 million service members into veteran status over the next 12 months, this number is expected to continue rising until approximately 2017. in f white 2011b and ca, which is the nation's largest cemetery system invested an estimated $31 million into the national shrine initiative and effort to improve the appearance of our nestle cemetery. in order to adequately meet the demands for determined riverside maintenance and the essential to five essential elements of operation we recommend $280 million for the ncaa operation and maintenance budget in fy2013 as an annual increase of $20 million until the national shrine to read and operational standards and measures goals regarding height and alignment of the markers as well as the appearance of grave sites. finally, they call on the administration and congress to provide the resources needed to meet that defensive will in critical nature of tnc in mission as it fills the nation's commitment to all veterans who have served their country so honorably and faithfully. that concludes my statement and i will be happy to take questions. >> thank you, ms. how are you? >> good. >> good. ranking member, on behalf of the more than 2 million members of the veterans of foreign wars, thank you for the of the genetics testified today. in partnership it is there responsibility to take care of construction accounts, will limit my remarks to that. every effort must be made to insure facilities are six answers embarrassed to deliver care. since it does for utilization has grown from 80% to 141%. facility conditions have dropped from 81% to 71%. this is having an impact on the delivery of health care. to determine and monitor the condition of facilities the viejo connected a facility condition assessment or nfc e -- fc8.. these assessments include inspections of building systems. the fca review team can grant a rating of an eight to f, a-c is an air-conditioned, new facility, or an everest additional facility. and f. man is a condition of the facility here requires immediate attention. to correct the deficiencies of the d and f deck va will need to invest nearly $10 billion. the va is requesting $400 million for for the toy and partially funded major construction projects in fyi 13, leaving well over $5 billion remaining to partially fund the project dating back to fiscal year 07. these projects include for approving seismic deficiencies, improving spinal cord injuries centers, completing rehab and research facilities as well as expanding mental health facilities. this request is too low to support the ever-growing needs of veterans, their for the partners' request that congress provide funding of almost $3 billion to cover all major construction accounts which will allow the va to complete a partially completed major seismic corrections and mental health centers and fund stuff for viejo identify projects for a 413. although the v.a. funding request for minor construction account is lower than the request, this level of funding will allow them to fund more than 100 to projects. even though non-recurring maintenance is refunded three the medical facility account of va and not the construction account, is critical to the va structure. va is requesting $771 million for a 513, but to keep pace with anita reduce the backlog of an arm, a two-part 1 million is needed. the idea is now requesting this about funding. that is the amount needed to reach a strategic goals. enhance used gives the authority to lease land and buildings as long as the lease is consistent with the mission. although enhanced use lease can be used for a wide range of activities to the majority of these leases result in housing for homeless veterans and assisted living facilities. in an fyi 2013 the va has 19 buildings or parcels of land. however, this authority has expired, and we encourage congress to reauthorize. .. has an active duty calvary officer. also my uniform as a student time proud to work with this congress to have the backs of american service members and veterans. why pleased with the recognition that he needs increased resources to adequately care for veterans in iraq and afghanistan we believe that the v.a. health care must be fully funded to the level recommended in the 2013 dependent budget even though the proposed va budget does show a 4.5% increase over 2012 it is more than $4 billion less than what the independent budget recommends. i am also deeply concerned that congress has not passed a regular budget and what actually is years. fortunately, this has maintained funding of current and advanced in the continuing resolution in ad hoc appropriations bills. however, we are concerned of this year regular budget process continues and the security that advanced funding is meant to provide for the health care may erode. when political concerns and dangerous brinksmanship threat in the va, it's the veterans in the service members who can least afford to bury the burden that could be impacted. we are at a critical juncture for both service members and veterans. as the department of defense budget shrinks, threatens to earn benefits like retirement and tricare and active duty reserve component was planning to shed over 90,000 active-duty service members over the next few years the work load on the system is only going to increase so failing to fully fund the va or appropriate the budget of fans will inflict pain and hardship on thousands of veterans. among the most useful programs administered by the va or the educational programs. more than 700,000 veterans and family members have used the post-9/11 g.i. bill to further their education, increase job skills and secure employee ability. one of the single greatest threats to success of the future of the g.i. bill is the lack of useful metrics and subsequent inability of the va and approving agencies to prevent fraud particularly in the realm of the for-profit schools. they recognize the majority of the for-profit schools are honest actors and they provide an invaluable resource for many military members and veterans who do not need or wish to pursue a traditional education however has pointed out in the independent budget many of the for-profit schools are not living up there and. for example the receive more than a third of the g.i. bill funds while accounting for less than a third of the graduates. it does not appear that we are giving veterans the tools they need to make sound educational choices. they recommend a three-pronged approach that is necessary to solve this problem. first we must collect useful data on both student and institutional success. without mandatory uniform data collection across the board, private not-for-profit we will never be able to give students the tools to make the educational choices that need to be made to meet their needs. we also need a comprehensive easily accessible consumer education measure putative having data on schools is useless unless we can present it to the students in a manner they can buy just. it should include both online at this of comparing schools as well as the commitment to increase educational counseling for veterans. finally, we have to ensure that the free and open market can weed out poorly performing schools by changing the 1910 rule to include and classified the dod benefits as government funds. because they are. all of this must be executed with one goal in mind and that is to preserve the g.i. bill. preserving the integrity should be a top priority for every lawmaker on capitol hill. not only provides economic of the dever individuals to participate but it benefits the entire community as a nation and in the nation as a whole in the long run. like the post 9/11 a g.i. bill -- excuse me. will return $7 in taxes and economic output for every dollar spent on the program. like them, the post 9/11 g.i. bill is currently threatened by schools that their whole existence is separating veterans from their hard-earned benefits. the also plays a tough economy and serious employment challenges to begin in 2011 the average was 12.1%. congress took a bold action last year in passing the hero act and we think this body for their work. this year they stand ready to help implement the law so veterans can get back to work but we also hope congress will continue to focus on the veterans who do not choose to go in the workforce but choose to go directly to school so they can get the job training that they need. thank you for your time and attention. >> thank you. on behalf of all the members are would like to think the entire panel for your willingness to the year. let me make every assurance to you all of your testimony is are in their hands. i would also ask you to make yourself available to all members of the committee to the questions will follow as i but like to make a couple comments and then ask one question at the end. mr. tarantino, i agree with what you said, the data is absolutely essential to our ability to evaluate what we are doing. but more importantly, the effectiveness of what we are doing. i might throw a cautionary note out. not all individuals who leave active duty are after a degree but most are after a career and when you start looking at placement, you may find out the assessment and we make about one institution purses another institution is actually reversed , and those that may be dealt to a good job of providing the degree to a good job of providing the tools for a career, and i think that's where we've got to stay focused. many of you have heard me with colleagues at the va as i've questioned them on delivering a project to a veteran. i will work with the secretary and his team if the need plus ups in public relations, where river is, but the only way i will sit still is if i know the core mission of the va which is to deliver that to the individual service members is being fulfilled. you hooked up the national cemeteries. the secretary was here. to notice he didn't get questions. i will speculate because he's doing a damn good job, because the understands what the mission is coming and we've got work to do. i think he would be the first to admit but he's not losing focus of exactly what the threshold of accountability is going to be and i appreciate you pointing that out. i think all people have questions about sequestration. one might don't think it's something we should have entered into. i think that congress is here not to leave it up to individuals that decide. we are required to do one, so a very simple process. you point tell dollars that had been designated as not needed. 3 billion, 2 billion. i have the same concern and then fans come so far we can identify that in the event think back when we start work on the advanced appropriations once one of the concerns you would have a plus up only defendant wasn't needed so i think the chairman is. i know from the standpoint of the intelligence committee, one of the agency that's under our jurisdiction has to get approval from us to program that money. i think that's probably a wise thing coming and we will look at any potential changes that need to be made. some of you mentioned, and i'm sure all of you are concerned about construction and maintenance. i will make a personal observation facilities are crucial to the access and quality-of-care of the veterans receive in the future. we are in the 21st century and medicine is changing were. i won't comment on other states but in north carolina i have two facilities open in the 1950's. they are not constructed in a way to put an mri machine, much less some of the new technology that's going in even the run of the computer network meen drilling through walls that were never intended to have holes much like the capitol of the united states where we have to make the drill bits to actually drove through those. but more importantly they are not conducive to outpatient care. you have to navigate a health care facility to find the room they happen to be doing in postseason that day and by every standard in health care today we ex post somebody to an institution that has a higher likelihood of providing a means of infection and i think it's important and the va is headed on a new course of creating that super outpatient facility that can help of the veterans' needs. it will take a while but we will never get there if we don't build that into our long-term and short-term maintenance request, construction request. i think i could question whether the total votes in the budget this year even comes close to handling just a maintenance needs we have in the existing facilities and you probably agree with me on that. those are some of my thoughts having heard your testimony and try to put it in perspective what we've heard from the administration's budget proposal. and i would just pos one more question to each of you if you want to respond to you can go well. what do you feel should be alarming to the nation's veterans and policymakers, and i will just start down here and going on the line >> they were about ptsd and agent orange. they are in our war today are about ptsd tbi. the lawyer still in uniform is afraid to step forward to remove that, and they are a college and people are currently suing the nfl because they are suffering from a concussion and goes back 30 or 40 years there now manifesting themselves. what will our lawyers suffer from tbi to the defacing and 20, 30 years. and what are willing to do but to ensure this something. to think about football today many people are getting a baseline they can establish for players said that as you have individuals view of concussions after the baseline to figure out revenue was a brain change. the novel approach, though we are beginning to recognize the importance of that and from our military personnel as well to respect i am afraid my answer is a broadbased idea about the health care services its trends in its budget every year it seems like when they return the next day. which sort of points to my concerns are you end up with access resources when you have a good band. as far as something to think of what in the near short-term one. we have to keep in mind we've drawn down in iraq now and at some point in the near future we are going to draw down in afghanistan and why there is the belief that and will reach a plateau we don't believe that he's got into it point and as you have these individuals who are now out of iraq and maybe lose in bus service and will we returning so we have to make sure we are in a situation where you're able to meet the unique health care demand while continuing to meet the demand of the population in the va service today. >> when i made the comment earlier to the secretary which will be in the form of a question that they took in 430,000 more claims than were decided. it's not to give the va a black eye. it's to say let's make sure our expectations, we can accomplish more rational. it's hard for me to believe you can have for injured 31 more planes this year and within a three-year period we can eliminate the law. on my calculation you have to process 150,000 more planes than you take in every year to eliminate the backlog will will. if you just look at what is in front of us in additional claims to come and i'm not sure you could make a marriage in a statement like that so i hope through the dialogue on the disability side but throughout the va a rational discussion on what expectations should be because we have to have a yardstick, there's got to the matrix and accountability. >> i would like to follow on that point regarding the disabilities claims process. va has a lot of parts in motion were with a complete transformation process that we are looking at over the course of the year. i would like to commend the nba on one aspect and that is it's difficult in the challenging to not only transformed an antiquated system into a modern paperless system at the same time reducing the backlog. so while they are working towards reducing the backlog, that's why we want to ensure that the focus remains on the quality and accuracy. as far as a specific trend, veterans as you know communicating electronically. they are trying to get their with their system and as my comments have mentioned earlier about the system will we hope it gets there as well but we don't know what the outcome is going to be. we know there's positive results coming out of it from the test stations and we will have to wait and see what happens when it goes out nationally but i guess the best would be we are cautiously optimistic about that but veterans demand that modernized system the r-ga -- va is trying to get there. >> i agree, they see the crew -- in the time that we've designed this and have begun to implement it, were the trend you can't ignore is that in 2008 our productivity was 87 to year. today in 2011, 73.5 per year. it's alarming to me. i'm hopeful that the i.t. thing will be the solution. but we have taken our eye off of what we are producing all of the current work force and roughly getting 14 less claims per employee that processes claims. when you get that trend will, that's troubling from the standpoint of if this doesn't work we start at a lower line and the ability to do away with the backlog is that much more. >> thank you. i want to say i appreciate your comments would come and i agree with all of the additional comments made by my partners as far as any alarming issues. i don't think i have the expertise right now to speak to that, but i will be meeting with the folks in the fight come up with something i will let you know. >> i think my testimony pointed out with construction but i want to touch on another issue that we've ignored in the past that has led to the lack of research in other area problems colin agent orange took us 40 years to get to the point we are taking care of the folks affected by agent orange. we can't let that happen to folks exposed. we lack the science to identify it to diagnose it and treat it. we need research dollars. i hear you loud and clear and ask someone getting the same thing done for her for decades, i hear your morning and the frustration. >> we are alarmed by the lack of clarity. we did a pretty good job of tracking active duty but we don't have a clear assessment and the v.a. does a good show or decent job of tracking them in the system but in the ds, that is just how half of iraq and afghanistan veterans never stepped foot in the hospital, and we have no idea. we are looking at the budget and increase telemental health and surface shock and approach to suicide prevention and mental health. we are not doing it in a targeted fashion. it's one thing to increase awareness about stigma and if you don't know where are the problem areas, the methodologies and what are -- what issues are those members facing than you are basically crawling around in the dark. we are proposing the we need a national effort to track suicide in all 50 states. there's a couple ways to do it i'm happy to talk about with you offline. the we will never get our hands around this issue and solve our problem. >> i think i speak for the chairman and know it's committed to do a much better job at understanding the problem and more importantly the trend that finds alarming. i think to speak for the va they take this very seriously. in our last year in relative to the progress we were making one, one individual, and i put this caveat in the, the responsibility was the hot line. evidence by the fact we are getting more calls to the hot line when you look at things from an overall architecture, you get more calls to the hot line, you have a much greater problem out there than what you might have fought. so i think we have to connect these within the administration to understand how to interpret something like an increase in cost, but i feel we are all committed not just in the veterans population but the active duty force to make sure that wherever the pressure points are the we find a way to relieve them long before we reach a suicidal and. let me take this opportunity, you've been patient with us and we had great participation from the members today. i want to think you on behalf of the chairman and myself for your willingness and for the time you put into not only your testimony but your proposals. this hearing is adjourned. [inaudible conversations] defense secretary leon panetta and joint chiefs of staff general martin dempsey testified on capitol hill again wednesday on the president's 2013 budget request. they were before the house budget committee for two hours and 15 minutes. >> the hearing will be in order, the committee will come to order, excuse me. the first off, let me start by welcoming the secretary defense for were budget committee chairman secretary leon panetta will. as you see we are used to your face in the budget committee room and i don't know when it is the last time the secretary has been in this room but you have respect on both sides of the aisle and we want to tell you how appreciative we are of your time. this is a topic that is so much more rigid relevant and we are appreciative of you being here. i want to welcome everybody to today's hearing to examine their budget request for the department of defense and explore how they can meet its highest priority providing for the common defense and strengthening the national security to it as i mentioned we have secretary leon panetta will who is no stranger to this committee. in addition to his extraordinary background, as the secretary defense cia he served as the chairman of the committee. we also want to welcome the other two distinguished witnesses training secretary that that, general martin dempsey chairman of the joint chiefs of staff. in the 38 years since graduating from west point, general dempsey led troops in combat, served as a combatant commanders and most recently the chief of staff to the army thank you for your service, general and welcome to the committee. we also welcome the department of defense comptroller the honorable robert roi hale. again, welcome back, secretary hale. a relative to last year's request, the president's budget calls for a 487 billion-dollar reduction in reduction over the next decade. this comes on top of the already planned spending reduction for the global war on terrorism. the united states remains a nation of war and troops remain engaged in the fierce enemy overseas. it's difficult to square this reality with the steep reduction in the troop levels and funding levels. the timing raise concerns but the decisions are being driven by budgetary concerns as opposed to strategic priorities. mr. secretary, i think you have a unique perspective on the tension between the requirements and getting spending deficits and debt under control. while yet to offer their balanced budget our friends have called for a balanced approach. of course budgeting is about setting priorities such calls assume all the activities are equally important, the proportion of the can substitute for the clear analysis of the priorities and irresponsible these as policy makers. like all categories of government spending, the defense spending should be executed with efficiency and accountability yet many fear the arbitrary reductions the president has proposed in the defense budget would lead to a dramatic reduction defense capability. i commend you for efforts in the rapidly shrinking budget and the predicament is due to failures elsewhere in the federal budget. according to wegmann ferguson of the financial historian, the fall of great nations is the result of their excess of debt burdens, and their path to decline defense spending is always the first casualty. failure by the administration to deal honestly with the drivers of debt specifically when it comes to government spending on health care is a failure that internals economic security and now our national security. with the call for the debt and the kremlin out of defense my entitlement spending the president's budget and my personal opinion charts a path to decline. in addition to examining the defense reductions in the president's budget i hope today's hearing in forms of the consequences to the security the would result from the cuts under the budget control act sequester. congress has a solemn obligation to ensure our troops fighting overseas have the resources the need to successfully complete emissions and adhere to our commitment to their service upon their return. every citizen pose a debt of gratitude to the military families but continue to make untold sacrifices for our security and the freedom that we cherish. we are in deep gratitude and we want to make sure we honor them with the right kind of priorities to the right defense policy and with that before hearing some debate could testimony from leon panetta i would like to yield two ranking member from hollen. >> thank you, mr. chairman. i want to join chairman ryan and welcoming you back, mr. secretary, to the budget committee. welcome, general dempsey, welcome, psychiatry hale, thank all of you for your dedicated service to the united states of america and please extend our thanks and appreciation to the men and women who serve in our mother terrie, our country is secure and free because the sacrifices they and their families make every day. the president, the department of defense, armed services come armed forces along with the state department intelligence community and law enforcement deserve a great deal of credit for the important work they've done over these last many years. we've successfully redeployed our troops from iraq, captured or killed countless terrorists actively planning attacks and greatly diminished al qaeda's capabilities. we forged a coalition to successfully help the people of libya and the dictator's 40 year reign that included the bombings that killed innocent americans. and of course we eliminated the mastermind of 9/11, osama bin laden. these successes have helped strengthen our national security. we must continue to support astrometry the second to none and as president obama has made clear, and i quote, the size and the structure of our military defense budgets have to be driven by a strategy, not the other way around. during this difficult fiscal period, we have to be much smarter and more efficient in how we shape our defense budget. the strength of the war military depends in large part on the strength of our economy and the long-term strength of our economy depends in large part on putting together a plan to reduce the long-term deficits and debt in a credible and predictable way. last year to former chairman of the joint chiefs of staff admiral mike mahlon warned policymakers of this growing risk as people here know the national debt is our biggest national security threat. everybody must do their part from two bills and one to 2010, the base pentagon budget separate from the war effort nearly doubled. in 2010 the united states spent more on defense than the next 17 countries combined, and more than half of the amount spent by the 17 countries was from seven nato countries and four other close allies, japan, south korea, australia and israel. last year admiral mullen argued the defense budget have allowed the pentagon to avoid making difficult choices. he said and i quote with the increase in defense budget which is almost double, it hasn't forced us to make the hard trades, it hasn't forced us to prioritize, it hasn't forced us to do the analysis. we can no longer afford to have taxpayer resources spent without doing the analysis without ensuring every dollar is spent efficiently and effectively invested. we can no longer go with business as usual if we are going to get our fiscal house in order. there is now a wide bipartisan consensus that all spending and cutting spending at the pentagon must be at the table as we figured out how to get our finances back on track even this committee of the agreement is sometimes difficult to come by boat to the last year on the amendment to the budget that the spending should be considered as we strive to bring the deficit under control and last august as our colleagues know the congress codified that consensus bypassing the budget control act which capped the discretionary spending including security spending. today we find ourselves in a hard position facing the prospect of the across-the-board $1.2 trillion sequester beginning january 2nd, 2013. if we do nothing the defense department will be cut by another 500 billion for the next nine years in addition to the cuts under the caps. no one believes across-the-board reduction is the preferred way to get our finances in order. however, any effort to turn off and replaced the sequester must be done responsibly by reaching agreement on the deficit reduction plan that is balanced and leaves the strong foundation for our security. if we give time the president's budget, 2013 budget provides an alternative. i hope will be part of the discussion. i hear in the house the president's plan responsibly places the sequester with even greater deficit reduction to the balanced plan that calls for shared responsibility. it makes key investments in our long-term economic growth that puts a priority on protecting the key investments in defense rather than protecting the tax loopholes for the interest and tax breaks for the very wealthy. the defense budget is built on a forward-looking strategy developed by the top civilian and military leadership. it maintains our unparalleled felker new strength as general dempsey said, it's a military with which we could win any conflict anywhere. some have criticized the cuts in defense as being too deep. i think it is reminding under the president's put the spending levels remain high by historical standards. we will still spend more in 2013 in real terms for defense than during the peak years of the korean war, the vietnam war and cold war. even if you exclude the war funding even if you exclude the funding average annual defense expenditures under the tenure budget would still be the higher in real terms than the average annual expenditure during the korean war, vietnam and cold war period under president ronald reagan. in addition the reduction in the president's defense spending only half of the amount recommended by the bipartisan commission. the secretary panetta when you were sworn in as the secretary of defense, you said that a choice between fiscal discipline and a strong national defense and false choice i agree and i am confident we can work together to get our house in order to and ensure that we have the strongest military in the world. thank you all and i look forward to your testimony. >> let's start with you, secretary panetta and then you, general dempsey. make sure your microphone is on if you don't mind, put close. >> chairman brian, this man van hollen, members of the budget committee, it's a real honor and pleasure to be able to have this opportunity to appear before you. this is home. i spent 16 years in the congress, and a good chunk of those years in the budget committee. so this is a place that we fought through a lot of the same battles that you are fighting through right now. as a former chairman of the budget committee and omb director, i have a deep appreciation for the very important role that played by this committee in trying to achieve fiscal discipline and helping set the federal government overall spending priorities. as you know, i had the honor of working on most of the budget summit's and proposals during the 80's and 90's of both the republican and democratic presidents, president ronald reagan, president bush and president clinton and the work of all of those efforts ultimately produced a balanced federal budget. believe me, i know firsthand what a tough and critical job you have in this committee particularly given the size of the deficits you are working with that unfortunately face our country again. it is no surprise that there is a vigorous debate here in washington about what steps should be taken to come from these challenges. we went through many of the same debates in the 80's and 90's. thankfully the leadership of both parties were willing to make some very difficult decisions we had to be made an order to reduce the deficit. today you face the same difficult choices and while i know there are differences, the leaders of both the legislative and executive branches of government have a duty to protect our national and fiscal security. i know as elected members of congress particularly the members of this committee, we take this seriously. as i do, as the secretary defense i do not believe as i have been quoted by do not believe that we have to choose between fiscal discipline and national security. i believe we can maintain the strongest military in the world and be part of a comprehensive solution to deficit reduction. the defense budget that we have presented to congress seeks to achieve those goals. the fy 13 budget request for the department of defense was the product of a very intensive strategy review conducted by senior military and civilian leaders at the department with the advice and guidance of the national security council of the president. the reasons for this review are pretty clear. first of all, we are at a strategic turning point after a decade of war and we have been through a decade of war and at the same time during that decade, there was substantial growth in defense budgets. second, congress did pass the budget control act of 2011 which did impose spending limits that impact on the defense budget to the tune of $487 billion over the next decade. we've decided that the fiscal situation that we were confronting presented as the defense department with opportunity to establish a new defense strategy for the future. we develop strategic guidance before any budget decisions were made because we wanted those budget decisions to be based on strategy, not the other way around. we agreed we are at a key inflection point. the the military mission in iraq has ended, we still have a very tough fight on our hands and afghanistan but 2011 did marks significant progress in reducing violence and in transition to an afghan let responsibility for security and beyond our nato allies have committed to continue that transition through the end of 2014. last year successful nato operations did lead to the fall of ghdaffi and terrorism efforts have sickness a complete and al qaeda and decimated its leadership. but even though we have had those successes, unlike past drawdowns, let me stress that, unlike the past drawdowns, and i've been through most of those in recent history where the threats we confronted reseeded. the problem today is we still face a jury serious a ray of challenges, of security challenges. we are still let war of afghanistan. we confront terrorism even though we've reduced the threat in the terrorism exists in somalia, yemen, north africa and elsewhere. and make no mistake, they still threaten to attack this country. we face the proliferation of weapons of mass destruction. we continue to face threats from iran and north korea that destabilize the world. we have turmoil in the least. any one of those situations could explode in terms of conflict. we have rising powers in asia that continue to challenge the international rules and international stability and a growing concerns about cyber intrusion and cyber attacks. we must meet these challenges and at the same time meet our responsibility to fiscal discipline. this is not an easy task. further we do not want to make the mistakes of the past it every time the drawdown have occurred in the past, what has happened is the whole load of the force. the decision as we want to maintain the strongest military in the world, not all about the force buy simply cutting across the board and weakening every element in defense. required to take a balanced approach to the budget cuts and put everything on the table that we have at the defense department and most importantly with troops and their families and those that have deployed time and time again to the war zone. the request is 525.4 billion in fy 13 for the base budget coming and 88.5 billion to support the war effort to read to be consistent with title i of the act, our fy 13 budget date request had to be roughly $45 billion less than we had anticipated under last year's budget plan. over the next five years the defense spending will beach madrid 59 billion last the and was planned for india flight of budget to read a difference of nearly 9% in over ten years starting in fy 12th they will be reduced by 487 billion. to me to these new budget targets, and the national security responsibilities we have to fundamentally reshape our defense priorities based on a new strategy. the department of defense has stepped up to the plate, has met our responsibilities under the budget control act. but with these record deficits, no but it can be balanced on the back of defense spending alone. based on my own experience, i strongly believe all areas of the federal government must be put on the table, not just discretionary alone but mandatory spending and yes, revenue. that is the response will wait to reduce deficits and to avoid the sequester professions and contained in tunnell three. the sequester a acts would cut other roughly $500 billion from defense looking at the next nine years. these were the hollow force in the inflect. the president's fy 15 budget does put forward a proposal to try to avert sequestration miller used 4.4 trillion of for the next decade, and i recognize people didn't agree or disagree with those proposals. what i strongly urges that working with those proposals. instead of coming up with a large packaged savings that have to be achieved reduce the deficit and maintain the strongest national defense in the world. the 47 always improve the way the defense department operates, make it more structured, but reductions comes out of manpower procurement adjustment reform dealing with modernization, what position, and compensation. a difficult area to confront when an area that's grant the defense budget by 90%. let me walk you through these areas. first with regard to the fishing season, secretary gates proposed about 150 in the fishing season just in the budget year implementing some of these but we made the decision we could get another 60 million on top of that primarily from the following, the screen line support functions, consolidating i.t. enterprises, facing military construction programs, consolidating inventories and as we reduce the structure we have a responsibility to provide the most cost-efficient. the president will sequester, addressed to the closure process for 20, 13 and 2015. 20, as someone who went through the reservation close am i is strict about represented. yet as difficult as it is, it still remains the only effective way to achieve the infrastructure savings in the long run. obtain initiative is the apply greater discipline in the use of defense dollars. we do not have a department wants it all the ability. being able to face the american taxpayers and tell them how their funds are being used. but the efficiencies are not enough. budget reductions of this magnitude requires significant adjustments to. those choices reflected the strategic guidance and vision that we worked on and where they could basis? this strategy has. in the presentation of the budget strategy is that i'm about to summarize, one, we know that the force of the future will be smaller in the leni. that's the reality. by virtue of the drawdown we are engaging but we've made the decision must be flexible and ready to be deployed and must be technologically advanced. we knew that coming out of the war that there would be a drawdown the we also knew the force we wanted had to be true the natural and mobile and in addition to that, the structure that we have we wanted to be able to afford to properly train and equip. the definition of calling off the force is to maintain a larger structure and that cut the training and equipment and freakin' the force and that's something we didn't want to do. we are implementing the structure reductions consistent with that strategic guidance for the savings of about $50 billion over the next five years to the adjustments include command you've read these we are resizing the active army coming from about 562,000 as a result of the ramp up during -- after 9/11 pure going to about 490,000 soldiers by 2017 we will transition down in a gradual way and reach a level still player above the level we had prior to 9/11. gradually we will resize the marine corps to about 182,000 to those on and reducing streamline the air force airlift fleet in addition their force will eliminate seven tactical squadron is where we will still retain a force of 54 combat coded fire squadrons and maintain our capabilities on the airlift as well. the navy, one will protect its highest priority and most flexible ships will retire seventh lower the priority naval cruisers that have not been upgraded with ballistic missile defense capabilities. second, we felt we had to rebalance our global posture and focus on those areas that represent the greatest threat to the national security so we will emphasize asia pacific and the middle east. strategic guidance made clear we must protect the capabilities needed to protect our asia pacific and middle east to read these are the areas where we obviously as you know just by picking up the newspaper these are the places that can represent the greatest threat to our security. for that reason we maintain the current fleet and our aircraft carrier fleet and a long-term level of 11 ships and ten air wings and maintain the amphibious fleet. we enhanced the structure presence in the pacific and also made a strong presence in the middle east. third, elsewhere in the world, and we have responsibilities elsewhere we can't ignore europe or latin america or africa, but we have recommended is the we build innovative partnerships and strengthen the key alliances and partnerships in those areas. it makes the strategy makes it clear that even though asia-pacific and the middle east represent areas of growing strategic priority, the united states will strengthen its key alliances, nato, the other alliances we have in the pacific to yield better partnerships, and one of the recommendations is to develop innovative ways surge as rotational deployment using the marines come using the army, using special forces to sustain the u.s. presence elsewhere in the world. fourth, we need to ensure that we can confront and defeat aggression from any anniversary anytime and anywhere. we have to have the capability to defeat more than one enemy at a time. this is the 21st century and our adversaries will come after us using 21st century technology and for that reason we've got to be able to respond with 21st century technology. as we must invest in space and cyberspace and long-range precision strikes and special operations forces to ensure we can still come from and defeat multiple adversaries even with the force structure reductions are now planned earlier bid even with some adjustments to the structure this budget sustains a military that is the strongest in the world. we will have 18 divisions and 65 brigade combat teams and the navy will maintain 285 ships of the marines will have 31 infantry battalions and ten artillery battalions. and the air force will maintain 54 combat squadrons as well as 275 strategic airlift so we will have without mistake the strongest military in the world even after we have made these reductions. the last point i would make is this can't just be about cuts also has to be about investments and so we have targeted our investments in developing that technological leap that we have to have if you're going to be able to get ahead of the rest of the world, we are investing in science and technology and basic research and special operations forces in the unmanned air systems and cyber. at the same time, we recognize the need to prioritize and distinguished urgent modernization needs from those that can be delayed particularly in light of the cost problems we confront. we've identified 75 billion in savings over five years the result from canceled or restructured programs. 15.1 billion from the restructuring joint strike fighter program, 13.1 billion by stretching investment in the procurement of ships, 2.5 billion from terminating expensive version of the global lock and all of these are important steps to try to modernize the force of do it in a cost-effective way. an additional key to the strategy is making sure that we maintain a strong reserve and a strong national guard to read that has been one of the basic support systems for the last ten years of the war to read we relied on the national guard and the reserve, those of you that have been to the battles of know that these individuals are fighting alongside the active duty and the enigma tremendous experience, making tremendous sacrifices but they are inexperienced effective force we need to maintain for the future. also i need to maintain a strong and flexible industrial base. if we start losing that industrial base and it impacts our shipbuilding capability on the construction capability and development if we lose those crafts and skills we will damage our national defense we have to try to maintain that industrial base of the same time we. finally, with compensation, the most fundamental element of our strategy and our decision making process is our people. they come for more than any other weapon system or technology or the great strength of the united states. we are determined to sustain the sick benefits that flow to the troops and their families and wounded veterans. yet at the same time, we have to look at the compensation area because it has grown by 90% since 2001 and would have to implement the cost constraints in this area. for that reason, we have approached it in a way that we think it's fair, transparent and consistent with our commitments to our people. on the military pay there will be no pay cuts and we are going to provide pay raises the next two years but then limit the pay raises in the out years. on the tricare cost for health care we have recommended increased fees, we have not increased those levels since 1990. we look at the retirement commission to look at the retirement area with grandfather benefits so that those that are serving will not lose the benefits that we are promised to them, but at the same time try to look at what reforms can be made on retirement for the future. that's the package that we've presented and this has not been easy. it's a tough and challenging responsibility. but we need your support as someone who comes from the legislative branch and has served in this congress, served in this room and in the congress i believe in the partnership between the executive and legislative branches when it comes to making these kind of decisions. so we need your partnership to try to implement a strategy. please make no mistake there is no way i can reduce the defense budget by half a trillion dollars and not have it impact on all 50 states to read and also not have increased risk. we think they are acceptable risks, but nevertheless, there are risks. we have a le

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