The former home of this United States senator. I hope you dont consider me rude for saying it was dank and depressing. T was the prison also known as hanoi hilton, and it is not a nice hotel like this. The son of an admiral, our guest was offered Early Release from the p. O. W. Camp but turned it down. He endured torture and hardship for nearly six years. He continued his navy career and retired as a captain in 1981. He has represented arizona in the u. S. Senate since 1987. Best known as the 2008 republican nominee for president of the United States, he boldly embraces the American Legion pillar of a Strong National defense, a graduate of the u. S. Of l academy and member america legions post two and is armedairman of the Senate Forces committee. Here is the honorable senator, john s. Mccain. [applause] senator mccain i say thanks for mentioning that i lost for running for president of the United States. I appreciate that. [laughter] senator mccain after i lost, i slept like a baby, sleep two hours, wake up and cry, sleep two hours [laughter] senator mccain and did not match the number of takeoffs, but thats ok. Could i tell you one brief steer. Before i retired, i was at the bar, at the club and a guy standing next to me and real oldlooking guy and looked a lot like charles and he was wearing one stripe on his sleeve. And i said to him, how are you . I said how long have you been in the navy. You were never promote snd no. He said i was at the first squadron, one japanese airplane used to fly over and we called him washing machine charlie and get out of our beds and into our airplanes and the allclear siren would go off. So he said i got tired of it. He said i wasnt getting sleep and i caught this monkey and i trained him and he would get into my airplane and start the engine and he would shut down the engine and go pack in the jungle. And sure enough, it wasnt washing machine charlie and it i saw that id and monky taking off in my airplane. I said why you were not promoted. He said the monkey retired as an admiral last week. [laughter] most admirals dont enjoy that joke. Want to thank you friends and comrades. There was recently an effort in yemen and we lost an airplane and a brave american and several wounded. All of us here at one time or another probably lost a comradee and nothing worst rn that. And it doesnt have anything to do with the bravery, courage and sacrifice that those brave americans made. [applause] and it does not in any way, when we judge the mission, have any way of diminishing their courage. My friends, 55,000 names are in black granite not far from here. And because of a failure of leadership, because of a failure of leadership out of those brave americans who are omissions that didnt succeed, micro management from the basement of the white house. But we honor their sacrifice every single day of their lives. And to somehow equate whether a mission succeeds or not with their bravery is the failure to understand the courage and sacrifice because these brave americans when they are told to go, they go. And thats what america is all about. [applause] senator mccain we are living in a very dangerous world, my friends. We are probably in the most dangerous world probably in 70 years. We are seeing a breakdown of the new world order after two of the bloodiest wars in history. Thanks to the service and sacrifice of ourselves and our allies. It was shaped around the rule of law and freedom of the press and shaped around to elect our leaders, the funnel principles of democracy and freedom that we have throughout the world. And my hero always will be Ronald Reagan who won the cold war in the words of Margaret Thatcher without firing a shot. He stood what we pleeved in. He stood for spremssi. When he said turn down that world. That was a call for freedom. And we heard from people they said, we heard Ronald Reagan and heard him on voice of america and Radio Free Europe and they were grateful not because of our military power, because that was essential, they loved us for the message for freedom, democracy, human rights, freedom from the ghoul ogs. And now we are being tested again and being tested in the South China Sea and china is filling in islands that they have no business doing. And we now have six million refugees out of syria, 400,000 dead. Putin dismembering ukraine, occupying crimea. And he will be testing this new administration. And so we are in very challenging times and we are seeing, of course, the possible breakup of the europe union and, by the way, we are seeing russian interference in the French Election and probably in the german election. Effect our to leadership, he is destroying the fundamentals of democracy. And thats why we have to [applause] senator mccain its a lot easier to attack than defend. We have to address this issue on attacks on everything we hold dear, our privacy, our secrets, our capabilities and thats an area that i know that you are concerned with. So we are now in an era where there is more strains on that coalition, that new world order that was formed did he end of world war ii that was won at the sacrifice of so many brave americans. We dont know where they are, but they lie in islands in the pacific and lie in battlefield go in europe and now we have a challenge that we have to meet. And i want to talk about a couple more issues. Ptsd. My friends, it is an issue. Every day as we speak, a veteran is committing suicide, more than one. And we passed a bill called the clay hunt act, which was named suicide for hunt prevention of suicide. He committed suicide in march of 2011. And so, we have had problems with addressing this issue. We have an obligation to identify, resource and make available effective forms of treatment to eliminate veteran suicide. We must eliminate veteran suicide. We owe it to every one of our veterans. [applause]. Senator mccain the v. A. Has turned to arizona to address the crisis. And by the way, the new secretary of v. A. Has committed to making this one of his highest priorities. Im embarrassed. Im embarrassed that in phoenix arizona, the scandal began and the phoenix v. A. Veterans died. Veterans need the American Legion today more than at any time than ever. We need you. [applause] im honored to be here with you today. Those who i love most and knows best knows that i had the great honor that i was mentioned serving in a hotel far away from here and those people are those who had the great honor and privilege of knowing and some of our fellow Vietnam Veterans left us, but im the person i am today, if there is a small easure of success [know audio] senator mccain we were proud to come home with honor and im honored to be with you today. Thank you. [applause] [applause] senator, we will be in phoenix to visit the v. A. Commander, would you introduce our next guest speaker. It gives me great pleasure to introduce our next speaker. He was confirmed by the u. S. Senate as secretary of veterans ffairs on february 13, 2017. Unanimously. How often do you hear of a senate agreeing 1000 votes. He served as v. A. s secretary for health, leading the nations largest integrated health care ystem with 1,700 sites serving 9 million veterans. He has held numerous roles at morse town medical center, atlanta Accountable Care organization and president and c. E. O. Of bethisrael center in new york city. He has been named as one of the 50 most influential executives by modern health care. Give a warm welcome to the ecretary of the veterans affairs, dr. David shull kin. [applause] the secretary thank you. And its great to see all of you and commander, thank you for that warm welcome. I dont think the commander has been home in a long, long time. No one works harder traveling the country and caring about the people. And thank you for what you are doing and say hello to mary davis and jeff green and bill oxford and mr. Clay. Its great to be here. The American Legion is an Important Organization not only because you are the largest but because your commitment and passion for everything that people do and you do. You have such great leadership and i want to thank verna jones. I cant imagine by being led by a more competent leader. [applause] the secretary i dont think there is anybody who knows more what is going on in washington than lo you ever. And you guys are really so led. I wanted to talk this morning v. A. Odernizing the and as the commander said, i have been secretary for two weeks, two weeks today. And its really important that we get on with this task and we do this very, very quickly because this is long overdo. Let me share a few thoughts with you. It is a tremendous privilege and honor to be able to lead this department with the mission that we have, because it is the best mission in the federal government, obviously one that you share which is making sure that those who have gone and served our country are getting what they deserved and earned. I believe that the v. A. System is a unique system, certainly not only a system worth saving but essential for veterans and the country. Im reminded having come from the private sector how important it is and different that we have a system that cares for veterans. I come from the hospital world and many of you had the chance to see the final salute when somebody passes away to honor and respect the life of a person who served their country in a way that is distinct. And we also have to remind ourselves when you go out into the private sector, that the type of care that you get. Only one of five providers in the private sector actually have military competency and Mental Health, only 13 of those understand the envirlte. So if you are getting treatment for ptsd and say it was as a result of an i. E. D. And they say what is an i. E. D. , that may not be the right environment to get the help in. When i came to the v. A. And i started the practice, i recognized just how different the v. A. Is from what you get in the community. In the v. A. , we have peer support, caregivers, finding veterans homes, all sorts of a gs that frankly are of much more comprehensive approach and these are the reasons that we keep a strong v. A. When i had a chance as under secretary of health to go out and visit our programs, i dont know if you have ever been to these programs where you take people out of wheelchairs and ski down mountains what we are going to do in snow mass near aspen or this summer when i was with the veterans who were out there surfing and you begin to start seeing the activities are to the wellbeing of our veterans, these are unique services. Our use of technology is unique. This is a picture of me practicing for my office in washington where i see patients and grants in pass, oregon, using technology. And i have not done this in the private sector, but this is routine how we deliver care to rural veterans. No one uses technology. Nine million episodes of telehealth. 36,000 visits and intensive care units places that couldnt not have Critical Care docketors, they bring that expertise. So this is something again that is somewhat unique. I think people understand that the v. A system does research and trapes doctors but forget about our fourth mission, which is to be there in case of a catastrophe for the country or a national emergency, whether it is a medical emergency. We are the backbone, that safety net for america. And we are there and we train for this. We deployed eight times this past year in National Emergencies but we are there and practice for this and people forget how vital that is for the country. V. A rms of modernizing the system. Its important to remember that v. A. Has critted to not only health care but to all of america. I date this back to the civil war which you know was the bloodiest war we fought. It was hanttohand combat and the types of injuries that were happening on the battlefield were quite remarkable because it s close range, bayon ets and the doctors were learning quickly how to manage these types of tralm as, that they were writing their protocols how to treat trauma. That the binder they were keeping on the battlefield and it was to wrap it in red tape. The v. A. Is the originator of red tape. And we brought that to all of america. [laughter] the secretary when you look at history, there have been efforts to modernize the v. A. Lots of commissions and lots of studies and that is often a popular approach how to study something. I counted 140 of these assessments that are sitting somewhere on the desk in v. A. We dont need more recommendations on how to fix the v. A. [applause] the secretary we need to begin the work and execute it. Thats what we are going to be doing. We are going to get rid of the red tape and regulations that prevent from providing us the services that you need and where he are going where doctoral roe and senator mccain talked about is take the best of the v. A. And make that one system that works for veterans and thats our focus. [applause] the secretary my priorities as secretary are going to be these 10. Dr. Roe talked about legislation for accountability. I couldnt agree with him more that when people lose their values and deficient yated from the ethics we hold dearly, they have no right to work in the v. A. And make sure they dont work in the v. A. [applause] [no audio] the secretary need toll see that legislation extended beyond august, because we know those resources to provide the care for veterans that they deserve and we are seeking that extension and working with congress to make sure that happens. But what we want to do is come become and restein the Choice Program so it works for veterans. We know this program was way too complex and too many steps to be able to get the care that veterans needed. Until i can think of a better name, we are calling it choice 2. 0. It clearly means that we are oing to eliminate the 40mile, 30day rule. If i was designing a Health Care System, i wouldnt think picking it on mileage and wait times. That will get done and the president is committed to that as well. [applause] the secretary when you talk about modernizing the v. A. , our facilities are old. They are not representative of what we want the environment that our veterans cared in. We are going to be looking at investments and make some choices. There are some countries where buildings are sitting empty. We will consolidate where it makes sense and invest in worldclass facilities. And we have the commitment to do that. Enhancing our foundational services. By that, i mean what senator mccain was talking about. There are Certain Services that v. A. Does are better than anybody. I want to make sure these are the top services and continue to invest in those. We need to work closer with the department of defense and other facilities. Ill show you a a map. And d. O. D. Needs us and we need d. O. D. And secretary mattis are going to be working closely together to make sure we are maximizing our ability to work together. Our i. T. Systems, as dr. Roe said, we have been a leader, but they need modernization and we will takes to that. Suicide prevention. What senator mccain was talking about. Our top priority is suicide prevention. We are looking for legislation to be reintroduced to get a system fixed and should not be waiting anywhere near the periods of time that people are waiting to get nare appeals heard and until we get a legislative fixed, we are not going to see the progress. And lastly on the benefits side, we still have much more we can do to get faster decisions. I want to highlight a few of these things that are important in modernization, infrastructure, the way we work with the private sector, improving quality, because thats really important and keeping the v. A. Unique. For those who worked with me for years in the private sector when i ran hospitals before coming to the v. A. , i was known as being relatively impatient and i think thats true. I would say to the hospital teams, i said i want this done now, what is it going to take an act of congress . And everything i do now is an act of congress, but im getting used to it. When i talk about the infrastructure, you can see in some of our v. A. s, we have buildings standing from the 1800s. And everyone recognizes that this is going to require a new level of investment to be able to get our facilities to look at the bottom righthand corner hat a contemporary should look like. Able toville family members stay with them. This is our v. A. D. O. D. Map that we look at to work closer with the department of defense. I have talked about our ability for v. A. Hospitals to begin start working together with community providers, this is the integrated aapproach of taking the best of the v. A. And private sector and this is our vision. Whether we are looking at progress, quality of care, whether we provide access and whether we are making progress in suicide and finally and most importantly, what are the veterans saying about what they are experiencing about v. A. When it comes to when it comes to quality, we measure quality very comprehensively. Im pleased to say that last year 82 of our v. A. S made significant progress in the quality of care. And its not just v. A. Who says that. When independent groups look at our quality, like the rand group, they report on this, they find that the quality of care in v. A. Is as good or better than what you would find in the private sector. Thats important for us. V. A. Continues to lead in important issues not only to veterans but all americans. The opioid crisis, v. A. Began work on this well before it was recognized as a national crisis. We have seen 22 reduction in the use of chronic opioids. In hepatitis, im also pleased to say, but by the end of next year we will have been able to treat every veteran who has hepatitis and wants to receive treatment for that with the 95 cure rate. No other Health Care System will be able to do that. [applause] over all last year a 20 eduction in risk fatality. Our productivity, people working harder, up 12 . Thats a major increase. Even in v. B. A. , where our call centers a year ago, 59 of our calls used to be blocked. In other words, you couldnt get in to speak to somebody, today that number is less than 1 . So were making Important Service improvements. What were trying to do now is make it easier for to you see our progress. So youre going to see much easier comparisons to the private sector rather than complex government reports. Were working to make our results more transparent to you and easier to understand. In terms of access, senator mccain was talking about this, and this started in phoenix, when i came to v. A. About 19 months ago, we had 57,000 veterans that were waiting more than 30 days for urgent consult. That was totally unacceptable. Today that number would be close to zero. We have really focused on making sure when you have an urgent care need, that you get the care. Not in a couple days but right away. We have same day access now in every one of our v. A. Medical centers and primary care and Mental Health. So if you have a medical problem or you have a Mental Health problem, your v. A. Medical center would be able to take care of that issue today. And thats important so that we ont have people waiting for urgent care needs. In terms of access, 96 of appointments are seen within 30 ays. 86 within seven days. So we would compare this to any other private sector setting. We think that were as good or etter. But were not satisfied with where were and were continuing to work on this. When veterans come to see us in our v. A. s, 90 say they are satisfied with their care. That 10 is still our opportunity to do better, but its important to recognize that were asking you how were doing and you are letting us know. In homelessness we saw 46 decrease in veterans homelessness since we start our efforts on this in 2010. Last year our biggest decrease in homelessness, 17 reduction last year. We will continue to focus on this until there are no longer homeless veterans. In v. B. A. , the benefits side, in march of 2013, we had over 600,000 claims waiting more than 125 days. Today that number is less than 100,000, but as i said before, were not satisfied with that. Were going to work to make sure we get that even to a much lower number. Were looking at ways to modernize our benefits system further. He cemetery association, highest Customer Satisfaction in the country by the american Customer Loyalty index. 96 satisfaction rate. Were very proud of the service that is were able to do. I mentioned suicide as our top priority. You are going to see new initiatives come out of v. A. In the next couple weeks. Were going to be working with our Community Partners to do as much as we possibly can. We do need help on this. I just want to im good. Im good. Im good. Mr. Shulkin show this but i have a story and i dont know where to start. Im good. But i feel alone in a crowd. Im good. But nobody understands. Im good, but the past keeps coming back. I cant get out of bed. I cant sleep. Im good, but i feel overwhelmed. Im good, but i dont feel safe. I dont even know who i am anymore. I still have nightmares. I dont need any help. Im good. I dont feel anything anymore. Im good. But i cant live like this anymore. Im really not so good. Are you ready to listen . Secretary shulkin were trying to get the message out. We have added hundreds of new crisis responders. Were looking, this is our top clinical priority right now. We continue to innovate and find new ways to do better jobs. Thats what good organizations o. Were named the 11th most Innovative Organization in the world. As measured by patents and publications and presentations. You are going to see some of these innovations come to you soon. Many of you go to v. A. Medical centers for hearing aids. Were introducing an app on your phone so you may not have to go to get your adjustments. Can you do it right from home on your phone. These are the types of innovations were bringing. I hope some of you have participated in the million veterans program. Its now the largest database in the country. Where it looks at genomic information to find new discoveries, to help veterans and for us to do a better job. Our Research Organizations are doing terrific work. Were taking what we learn at one v. A. And now spreading it across every v. A. This is our best practices initiative. And were beginning to act like a single v. A. Rather than individual v. A. S. This is something you are going to be seeing more of in the future. Our most important way whether were making a difference is whether we have your trust. We know in april of 2014 we broke that trust and thats hard to regain trust once you break t. But in april, 2014, 47 of veterans felt they could trust the v. A. Today that number is above 60 . And were not satisfied with that, but we believe that were slowly rebuilding that trust. And should acting in a way that you should consider giving us back that trust because this is the type of organization that were focused on on becoming. Finally, i just want to say that v. A. Can and must become a top rated Customer Service organization. J. D. Powers measures our pharmacy benefits, the way we deliver pharmaceuticals, as number one in the industry. Above all the private sector benefits Companies Like walgreens and others that do this. So if we can do it in the national cemeteries, and we can do it in our pharmacy benefits area, we know that v. A. Can do this in other areas. So to do that were partnering with the best companies in the country. Notforprofit companies. Certainly American Legion is a very important partner to us, but some of the other companies