>> it's not true. you haven't seen anything. epa is reconsidering it to get

greater clarity to reduce the cost of compliance. >> i am correct, the epa is not backing any legislation to change the time limit in the law, isn't that correct? >> that is correct. >> thank you. let me talk about another subject briefly. you have i believe you would agree or that you would feel the epa is doing a better job today than it did in 2001? >> i don't have any feeling on the subject to i believe we're doing a good job today. >> all right. i have a chart here that says that you'll have about 1000 less employees now than you again. am wondering if there's ever a study done to show where there is, it happens in many cases, a diminishing return on investments or some point you just get to me folks and she can't be as efficient or i'm wondering if any study has been done at the epa of exactly how many employees you need to be most efficient in the congress

in your task? >> their happen workload studies done in the past, and we can certainly get those to you. >> if you could get those to me, because look, i know you can go, you can't go down to one employee and be more efficient with your but i do know it appears you are doing a lot more with a lot less already. and i'm just wondering what the breakpoint is. we are trying to find money. i hope you appreciate that. and then, my time is up. i yield back. >> thank you. at this time i recognize mr. dingell of new york for five minutes. >> thank you. thank you, mr. chairman. i want to reiterate, you mentioned some the topics that they mentioned that i want to emphasize, but before did i want to thank you for the job you've done, the actual job you have done. you are on the hot seat. it's a tough job, but the work that you do so important. one of the frustrations that i've had frankly with his

majority in congress is that the attacks on the epa and the attacks on clean air and water, and all these things, are very, very frustrating to me because i believe that the role that you play is such an important role and that we are to be facilitating the things that you do rather than impeding them. i want to thank you personally for the job you have done, and i'm glad your agency is there and i pledge you were doing the work the american people want us to do. people want clean air and clean water and all these other things. i just wanted to state that. i wanted to add my voice to ms. castor, who spoke about the reduction of the 2013 budget of $359 million for the clean water and drinking water revolving fund. i hope there might be way to try to restore some of that money, because my state of new york has received many millions of

dollars to protect our watersheds and make create -- repair source who systems, and epa's most recent drinking water survey indicate new york will require $29.7 billion over 20 years to ensure continued delivery of safe public drinking water. i want to emphasize that and i hope you can find some way to restore those cuts. i want to talk about fracking because that is something in my state that is a hot topic. we have many people who are fearful of fracking, obviously we don't want it to contaminate the drinking water or have fracking by the watersheds. that is a concern that i have. on the other hand, it has the potential to create many jobs in western new york as it is doing in pennsylvania, and i know that ms. degette and mr. green have spoken to you about it with the

study. i think the study is a good idea. i think that we have to know what we're dealing with. i think it's important to wean ourselves off of middle eastern oil and venezuelan oil, quite frankly, countries that don't wish us well. but i do think that the fracking is something that many people remain fearful of am we need to look at, so i wish you well in your study and i hope we can have the results of that soon. >> finally i want to mention a topic that hasn't been mentioned. new york city embarked on a 10 year $700 million plan to replace all the old lights in all of newark city schools over the next decade. could you please explain epa's role in that remediation project

and provide for me an update on its status? could you also please provide update on efforts to address window coping in schools as well? >> certainly. in 2011 epa inspected new york city schools for leaking. the lighting were leaking and they were leaking pcbs. those inspections found numerous leaking valves with concentrations. some exceeding 6000 parts per million. the city stepped up, announce a plan in 2011 to replace all pcb lighting ballots in 772 schools. i believe it is part of the capital budget plan to make schools more energy-efficient. alighting being part it of that. the city has allocated about $708 million in its budget to implement their plan over 10 years. epa review the plan until city officials met five years of be a more reasonable time frame to

address that issue as part of a larger plan. >> i know five years, i know new yorkers have recommended two years, and they know things are difficult to be done in two years. pcv contaminants in our school as you know is widespread and threatens the health of hundreds of thousands of schoolchildren, certainly in new york city. the exposure to children have been found to decrease iqs and increased risk of add, among other things. witwith a tenure timetable -- w, okay, i made the point. it's hard without the clock ticking, but again, i hope you will look into that and again, i want to emphasize, thank you for your very, very good work. >> thank you. >> at this time i recognize the

gentleman from kansas, mr. pompeo for five minutes. >> great, thank you, mr. chairman. thank you for being here today. sector jackson i want to talk about enforcement. we've had a chance to talk about that at all and your enforcement policy. you best for increase for the office of enforcement compliance. or $33.59 increase. and i've heard lots of concerns for my district about all involving the epa. i thought i would do it in a micro today. you mentioned something of general duty of care earlier in answer to question as part of the clean air act. can you tell me give adopted any epa wide guidelines with respect to the definition inside the clean air act related to the general duty of care? >> i'm not aware of any, but we can certainly talk to the office of enforcement on the. >> there's a tremendous called extremely hazardous chemicals,

and you have the risk mitigation plans which require a certain chemicals are stored at manufactures or producers, but as i understand your enforcement policy even if the chemical is not listed as one of those chemicals that requires a risk mitigation plan, you can being to produce or the manufacture under the sort of not very well-defined general duty of care, is that correct? >> i believe that's right. it happened that they added this idea that manufactures have to be proactive in looking to have that extra duty of care. >> right. i would love to work with you all. i really, this isn't congresses fall. they give you these undefined terms, very general authorities and said you need to put some definition to. you chose not to do that. and by regulation or by policy memorandum so you left us wide open. now whether it is acetone or whatever, maybe producers in

warehouses may not have any idea what chemicals you, after them for. i would love to work with you to develop cleaner standard. frank gallagher to get rid of that section. i think of plenty of authority under that program to decide which chemicals are truly dangerous. >> why don't we have our folks talk about the? their specific questions or in general. >> i would be happy to do that. do you reward folks inside your agency for performance for how many fines they get or how successful they are obtaining injunctive relief by value? >> we do track fines and injunctive relief. i think large cases that are very difficult it would not be unusual for manager, i used to run an enforcement program in nba many, many years ago for managers to note hard work and diligence. but not specifically, you know, you are not tied to a much money you bring into the treasury spent all that money does go to the treasure, doesn't? employees don't get it as

compensation. epa doesn't get as part of their budget. because back to general revenue for the treasury? >> penalty money goes back to treasury. there's been lots of discussion about the. >> i will tell you in region seven at the end of 2010 there was a press release issued the satellite, and i were really, this is from region seven, december 2010, and it says enforcement activities conducted by region seven during fy 20 and set a new record securing more than $3 billion in investments in pollution from coal and clean up as result of legal action taken against polluters. it then brag a collective fully 31% of epa's fines all across the country. to thought, one, is that the type of press release you think is appropriate, brag about how much money are taken out of united states economy or second, 31% from single region, region seven, do you think that such as

this differential enforcement or region charges that different? >> enforcement find your often times serendipitous. one region could make all the region. if there's a fine for example, with respect to the ep incident that could make one region's fines look huge. in terms of bragging on investment and cleanup and investments, those are generally injunctive relief where we require a company that has much to pay the fine, but to do the work to come in compliance. we think it's important the american people know there is environmental -- it deters people from violating and that's in the port in part of the program. >> fair enough. i would suggest that when an agency is the term polluters i would get some of those by agreement, some of that was probably with agreement with a particular business or individual, is that probably right? >> but that agreement came as result of an enforcement spent and they probably in their agreement said this agreement

does indicate any wrongdoing. it so this is where willing to cooperate with the ep and yet you use the term polluters which is, i would say in kansas we do that with a negative term. get your agency is the kind of term in a press release whether neutral enforcement powers should i would just suggest you want to talk to folks about not using language like that. >> at this time recognize the gentleman from louisiana, mr. cassidy, for five minutes. >> hello, ms. jackson. you are always well prepared. even though we often disagree that the government on how -- >> i'm worried about the other shoe that is about to drop. >> there is no other shoe. it is truly a complement. >> thank you, sir. >> the care grants, i don't understand this well but i am told these care grants that go to community organizations, the press release they generate is not peer-reviewed science.

the states deq does not look at it. you do not look at it but i can say they get headlines. sometimes in our kind of media driven society that headline has an impact. so one, is that true that when these community groups get grants and epa there's nobody at epa responsible for vetting the validity of their claims? first, is that true? >> well, we certainly don't vet their press releases. we ask them to sound science and respect and hope there will. because they are committed groups would uphold him quite to the same standard we might a government and to i hope ourselves. >> that's a fair statement but on the other hand, does anyone look at the response those of the committee groups in general? are they audited to make sure that the signs are putting out of the claims they're making are justifiable? hyperbole. >> i believe they're more audited to look at their fiscal responsibilities and taking -- >> a fair statement and i

believe that. on the other hand, i will take it when people put these out in the press, people believe it sometimes even if there is no validity. let me just suggest that if we're going to hold you or a state deq or an industry group responsible for the validity of their signs, this group should as well. that influences the debate as much as a major employer would happens have an emission issue, would you agree with a? >> i think it's there that if their being made that someone could ask epa whether whether that we agreed with that data, so in general i see your point. >> thank you. second, the president and the state of the union speech spoke of natural gas be used as a transportation fuel. i'm not aware of any initiative that he is so proposed, serving nothing legislatively. do you know of such an initiative and? >> i don't believe there is a legislative initiative right now. >> is there an administrative and you should?

>> i seem to recall he talked about a corridor in california that could be made to be natural gas from the, and i thought that was voluntary with the state of california but i can check. >> now, one thing that has been proposed for the use of natural gas is to produce methanol as a fuel additive so i pursue this because it seems like it would be a wonderful way to come up with a low-cost way to supplement oil and gas, particularly with the ratio of cost to natural gas and oil. and i went so far as to meet with people with entergy, ferry high research, they told me it would be 15 years conservatively for something such as methanol to be thoroughly vetted through epa's regulations as to being safe for use. it's not methanol per se but the agency to make it okay with dazzling. that said, this is someone who has been carded working on ethanol so he kind of knows that

which he speaks because this is the process they're going through with ethanol. if we are trying to use our natural gas as another way of transportation fuel, is there anyway we can make that, so daunting to me it's never going to have and? >> sure, offputting. happy to meet with or have my experts, you don't want them to meet with me, but my experts, to talk to them about methanol in particular and, of course, natural gas in and of itself other transformation i believed what the president is directly addressing. >> no offense, i'm not interrogative, there's just no initiative on it so i think it's good, just nothing has happened. methanol could be fuel additive as much as ethanol is, but again until that the regulatory process is again so long as to mean it will never happen. which is a potential denied if you will.

>> i think it's worth having discussion with those who are pursuing methanol. >> you have been very responsive to me in the past but if you don't mind i would like to meet with you, frankly my industry groups are afraid of you. >> afraid of me? >> afraid of your agency. they will -- for time and time i will use back and i can thank you. >> thank you. >> we do have one vote on the floor, but 400 people still have not voted so recognize you for five and. >> thank you, mr. chairman. i want to thank the administrative are coming, and want to specifically thank administrator jackson for your support for our efforts to restore the gulf of mexico as it relates to dedicating the bp fines to the gulf coast states but as you know we passed a portion of the restore act here out of the house just a few days ago and we're working with her senate counterpart to try to get the entire piece of legislation, restore a, truly want bipartisan

legislation. through the entire process, i don't want to make any comments on the restore act, by want to thank you for your efforts their. >> i will simply say it's actually important those resources return to the gulf of mexico, so thank you for your leadership. >> i want to talk about your budget. i know there's been some talk about the president's proposal and whether its reduction from current level. i want, if you look at what we were given, the view over the four-year period, since you came in, of course there was a big spike from the stimulus bill in fiscal year 2010 we should be, represent about a 35% increase in your budget, and then it is tailing that all but over the years. but even with the president's budget request was to represent about a 9% increase from when you took office. i don't know if you want to make sure that these numbers are the same that you're using, because under these numbers that i am looking and you start off with

about $7.6 billion budget, you go to $8.3 billion budget which reps and still $709 increase over that four-year period. just wanted to point it out and make sure that was an accurate number. >> two things, maybe three. we continue increase the amount of money that's going to states even in the budget has done 1.2%. large part of that big jump you saw was for srs which was directly to the states, 2,000,000,400 for the great lakes. what happened is an erosion of those increases backwards we've heard a lot about infrastructure funding. >> but i just want to point a, some people are suggesting there are cuts, there's been a $700 increase over a four-year period. i think that's an increase. in fact, a 9% increase. >> they are that's from prior-year budgets but it's important to point out that the agency itself, 40% of our dollars went to state and tribal

grant programs. we are doing that at the expense of other agency operations. >> again, when you look at, when the agency started your second tier i guess with a 35% increase, that came at a time when many states and businesses were cutting back their budget. just want to keep that in a perspective. on the hydraulic fracturing issue, my colleague from texas brought this up with you, i would strongly encourage you agency to allow the states to do what they been doing so well for decades, and that is due to state regulation of hydraulic fracturing. i know it's gone very well in louisiana and protecting not only the aquifers underlie for dramatic increase with this new technology in the amount of natural gas that a country can provide, not only to our states, which we pretty much self-sufficient on natural gas production in america, but with all these new fines, not only provide opportunity for us to

pull other vehicles off gasoline and increase american energy security but it's created thousands of new jobs. so there is a real concern amongst the community in the natural gas industry that epa is looking at getting into very with the states have been very successful in regulating that process. so i just wanted to mention that. on a local issue, i know you've worked with nucor, which has built a plant in south louisiana. they are currently pending a permit from the epa, and that one permit alone would equate to about 700 plus jobs. and i wanted to know if you can get the status of the permit, do you have any kind of timeline when that could be approved? about 750 jobs are waiting. >> i believe we have approved the permit and then it was, there was litigation that was filed but i believe that is correct but i will check on a. i seem to recall we issued the greenhouse gas permit for nucor.

>> i think there's another permit what they're waiting on right now. i think there may be another one they are waiting on right now that will be a second part of the expansion, which that alone would be over 700 jobs. if you could give me timeline with the likelihood of approval of that would be, and i know my time is unsure so finally, on refineries are you planning on regulating greenhouse gases at refineries? >> there are no current rules under development on that issue. we have said in the past as part of our overall greenhouse gas strategy that are first in his utility at refineries are next, but we are not at this point -- >> refineries are next to if you could keep in mind, some small business administration did a study that showed the average cost per family regulation as hell comes out to about $18,000 a year per family. for the cost of regulations. this isn't just your agency but when i talk to small businesses many of them cite epa as the

worst offender in essence of his $15,000 per family calls. so if you could keep that in mind. thanks to come and i yield back. >> the gentleman's time has expired. spent today a discussion on nuclear proliferation and rogue states. scholars discuss the challenge of dealing with iran and north korea as these countries look to build nuclear arms. live coverage from the brookings institution starting at 10 a.m. eastern on c-span. >> a person who is a senator, even a person now who is president of the united states faces a predicament when they talk about race. they face also to predicament. they face the fact that there are some an appreciable number of americans were racially prejudice. they face the fact that a much larger portion of the american populace wants to deny the realities of race, even now.

>> sunday, harvard law professor and former law clerk to justice thurgood marshall randall kennedy on racism, politics and the obama administration. the roads go is the author of five books and he will take your calls, e-mails and tweets for three hours live on "in depth" on book tv on c-span2. >> veterans affairs secretary eric shinseki appear before a senate committee wednesday to talk about the department $140.3 billion budget request for 2013. it is a 10.5% increase over current levels with additional funds to care for veterans returning from iraq and afghanistan. this hearing is to in half hours. >> good morning, and welcome to this morning's hearing on the fiscal year 2013 budget and the fiscal year 2014 advance

appropriation is for the department for the department of veterans affairs. i want to welcome all of our panelists today and really appreciate your coming and helping us work our way through these critical issues for our veterans. as i do most weeks when i'm home, last week i convened a roundtable discussion with veterans across my home state of washington. i heard from the very men and women whose lives this budget is actually going to touch. while some of the veterans praised the care and act they were receiving from the va, many of them did lay out concerns that must be addressed in this budget and in future budgets. i heard from veterans who still face unacceptably long wait times for mental health care, are still making the type of mental health care that they need in their own community. i heard from women veterans who are struggling to receive specialized care, and heard from veterans who are just really fed up with a new function of the claims system.

i also heard from veterans who still find themselves confronted by obstacles to employment, and who told me they're even afraid to write the word veteran on the job application because of the stigma that they believe employers today attached to that. last year's passage was a great first step in tackling these problems in the high rate of veteran and a plum. but there is a lot of work left to be done. passenger secretary shinseki will talk about now is the time to take advantage of the public-private partnership, and the sea of goodwill that exists in corporate america towards our veterans today. but doing so also requires beating back misinformation about the invisible wounds of war. i am pleased with the administration has shown real leadership and engaging private partners in this area and i will continue to highlight the tremendous skills and leadership abilities and his but in our veterans to bring to the table. i also up for doing more today about va's involvement with the presence proposed veterans job

core. anyway that we get our veterans both employed and more involved in every argument is is a program worthy of investment. if everyone on this committee knows, with the end of the war in iraq and the upcoming withdrawal of troops from afghanistan, the budget challenges will only continue for the va. last year this committee held a hearing to explore the long-term costs of war and what is 100% clear that we have an obligation that will continue long after the fighting is over. today as we review this budget for the our nation's obligation to our veterans that only today but throughout the course of their lives must be our most pressing consideration. now let me say this as a longtime member of the budget committee and as some have seen just a difficult issues budget is for many other agencies, when this budget right now my desk i was or interest. given the current fiscal affirmative he has done a good job putting together budget that reflects a very real commitment

to provide veterans with the care and benefits they have earned. so thank you, secretary shinseki, for your efforts in doing that but i also want to upload these ongoing commitment to end homelessness. this is an area where you are making real strides and i'm encouraged to see that the administration is again requested an increase in funding for homeless programs. i am hopeful we will continue to say significant effort to reduce the number of homeless veterans and prevent those who are at risk from becoming homeless, but i also believe that the has real work to do in the area of serving the meal homeless veterans. but while va has done a good job putting together budget that works to tackle the challenges that our veterans face, there's also clear room for improvement. for the third year in a rope, va has proposed cuts in spending for major construction and nonrecurring maintenance. these continued cuts are deeply troubling given last year was the first time he is budget even outlined the department's vision for a 10 year construction plan

with the price tags that approach $65 billion. despite that plan for the past two years, the has requested only a fraction of the amount that it needs. i am disappointed at the size of the gap between the funding needed to bring facilities up to date and the funding requested from the congress. in addition, this budget request proposes a series of initiatives intended to save money including better controls on contract health care, better strategies for contracting, and cutting administrative overhead i'm pleased to see the va recognizes the importance of efficiency but i have concerns of those proposals. a gao report released on monday showed many of these initiatives and initiatives from last year's budget did not, in fact, generate the savings that the va predicted. i will review each of initiatives in this budget with an open mind but i want to be clear, our first priority, our obligation must be to ensure that we are fulfilling and honoring our commitment to our veterans. the va fails to meet the

proposed cost savings estimate, it will have to find a way to make up the difference so veterans don't end up paying the price. medical care collections is another area where the has to do better job of both predicting targets and collecting funds to it's impossible to build a budget on funding that is not collected. another area of concern to me is mental health care. at a hearing last year that the witnesses acknowledged them in fact need more resource to be the high demand for mental health care. i want a straightforward answer from the va about their actual needs and whether the department proposed 5% increase is enough. last shot as the va to conduct a survey of mental health providers which revealed significant shortcomings. via proposed a plan to fix the problems and the most complete those as scheduled with the va cannot stop with what was outlined in that initial plan. it must continue to work to find ways to make real and substantial improvements. we will continue to be aggressive in our oversight of va mental health care.

not every veteran will be affected by invisible wounds but when a veteran has the courage to stand up and ask for help, va must be there every single time. va must be there with not only timely access to care but also the right type of care. challenges like tps d. or depression aren't natural response. will do everything possible to ensure that those affected by these illnesses can get the help, can get better and get back to the lives. finally, like chairman miller and senator tester and others i remain very concerned about the questions surrounding the effects of sequestration on veterans health care. throughout the budget control act process that established sequestration i made it very clear that including va among most agencies that would receive automatic cuts is unacceptable and repeatedly made clear they should not be the case. although i'm confident that all veterans programs, including

health care, will be protected in event of sequestration i want to make sure you know i will not accept anything else. i believe our veterans deserve clarity on this issue, and if it can't be provided today i will continue to work to get it. in fact, i've already asked the government accountability office to issue a formal legal opinion which will provide some resolution to this issue. secretary shinseki, as you well know budgets are reflection of our values. and thanks to your work this budget request demonstrates a strong commitment to our veterans. while we're in a position to make sure that he has to increase funding it needs we should also be mindful the demand for services is going to continue to increase, no matter the number of troops deployed to i look forward to working with my colleagues on this committee and on the budget and appropriations committee on which i also said, and, of course, with secretary shinseki and his entire team, and the leaders from the veterans community to make sure that we keep this long-term commitment. so i thank all of you for being here today, and my committee

members, and with that i will turn to my ranking member, senator byrd, for his opening statement. >> thank you, madam chairman. secretary, welcome. welcome to your leadership team. as well as welcome to veterans service organizations that are here this been. we are here today to review the president's budget request for the department of veterans affairs for fiscal year 13. which concludes a for a half% increase in discretion been. i continue to believe that it is important that we provide adequate funding so that veterans of all generations will be able to receive the benefits and services they have earned and deserve without hassles or delays. but we also need to analyze the budget request to ensure that we spend the taxpayers money wisely and more important, that the funding will actually lead to better outcomes for veterans, their families, and their survivors.

as we will discuss today, i have questions about whether that is the case for several areas of today's budget hearing. to start with, the budget for mental health care include an advanced appropriations request for fiscal year 2014 of $6.4 billion. if adopted, it will represent a 4% increase over fiscal year 13, a 66% increase over the fiscal year 2008 level. but at hearings last year, the committee heard about the devastating struggles some veterans faced when trying to get the mental health treatment they need from va. in fact, va survey of its mental health providers last year was pretty clear on the problem. 70% of survey respondents indicated they did not have enough mental health staff to

meet the current demand for care. 45% indicated that a lack of off hours appointments as a barrier to care. and 51% said it took 30 days or more for a veteran to be seen for a special deployment, such as post-traumatic stress disorder. clearly, this is an instance where increase funding has not translated to better services for veterans. today, i hope we will get a better understanding of how va plans to address these issues, how the requested funding would be used, and whether it may be time for va to start looking outside the box to find solutions to the barriers veterans face in accessing this needed care. another area of concern is the backlog of disability claims, a pretty common discussion we had in this committee. this budget requests a 41% increase in staff since 2008.

but let's look at what's happened during that time. the number of claims pending at the end of the year has more than doubled. the average number of days to complete a claim has increased by 26%. the quality of decisions has turned it down is now below 84%. according to one performance measure, there's been a 16% decline in the number of claims completed annually by employees. the appeals resolution time is increased from 645 days the 747 days, in va decided hundreds of thousands less claims than it received. with statistics like these, it must be a priority to ensure the initiatives he is pursuing to get this situation under control will actually be effective so that veterans, their families, and their survivors will receive

timely, quality decisions when they seek benefits from the va. another area of the budget i'd like to briefly mention is the legislator global to spend $1 billion over five years on a veterans jobs corps program. while i believe it is important that we help our veterans find meaningful work, i'm interested to learn how va would suggest paying for this program, and about how it would be structured. so i hope that it will be able to provide us with more details about the proposed program today. madam chairman, the final item i want to highlight for i turned back to you is the continued increase in staff that the va central office. and quite honestly at the visn level. for example, since fiscal year '08, the step of the va central office has grown by, close to 40%. and the office of human resources and administration has seen an 80% increase over the

same period. also, the staff at the visn had courses increased by 52% between '08, and 2011. i think we need ask three questions about whether this increase in staff, staffing directly benefits our nation's veterans. whether these employees are essential to delivering systems to the veterans and whether any of the funds could be put to better use. in the bottom line is that, particularly this time of record debt and deficits, we need to ensure that when we spend the limited money that we have our we do it wisely and that we make certain that the veterans are the ones that receive the benefits and services that have been earned and deserved. the trend lines are troubling to me. they should be troubling to this committee, and they should be troubling, quite frankly, to the

va. i'll focus much of my attention on those today and questions to the secretary and his leadership team. i thank the chair. >> thank you, senator burr. will now turn to centers for opening remarks in order of appearance. senator akaka, we will start with you. >> thank you very much, madam chairman. and i want to say aloha to secretary shinseki and his leadership staff at va. i want to thank all of you for your service to the veterans, and, of course, to our country. and i don't need to tell you what you have been hearing, that secretary shinseki and the leadership staff has been improving the services, because claims have dropped, and that's

an indication. they care and treatment which is our duty to provide the veterans is something we must continually strive to improve. and you have been doing that. i am encouraged to see that the total budget request for va was $13 billion above last year. i know we have budgetary constraints, but we i would to our veterans who have sacrificed for our country. and you have planned and moving along and been progressive about meeting those needs. i am glad to see increases of budget requests for mental health, suicide prevention, and

iraq and afghanistan veterans programs. i am also encouraged by major increases in funding for home -- homeless vets and women that programs. why they provide opportunities, we all know that these resources must be utilized with thought 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 as more veterans come home to their families, va treats 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 va services. secretary shinseki, i'm also very pleased to see that an important project for hawaii's veterans, which i've championed for years, is in the budget, a much and needed care facility that would alleviate some of the overcrowding at our medical center. this proposed lease will certainly help to meet the needs of our veterans in hawaii. mr. secretary, 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 suicide 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 they earned in most certainly deserve. so i look forward to hearing from your testimony today, mr. secretary, and continue to work with my colleagues and va to help provide the best care we can to our veterans and their families. thank you very much, madam chairman,. >> thank you very much. senator johanns? >> madam chair and ranking member burr, thanks for holding the hearing. very, very important hearing. let me just start out and offer

an observation, mr. secretary. first of all i want to say thank you or stopping by my office a week or 10 days ago. as you know, over the past few years while i've been here in japan in your position, we've had an opportunity to meet on a number of occasions. i've always appreciated that. i come away with those meetings absolutely convinced that you and your team have the best interests of veterans in your heart, and you're trying to do everything you can with all the problems that we're going to mention today. but one of the things that we have found in working with veterans in my senate office, and it's the reality of 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 vet and talk to them and help them work through that problem. even in my senate office, we have found that we have to staff up to do that. i have more people in my senate office is working on the veterans caseload than any other caseload that we work on. ..

>> just simply acknowledge that and try to figure out is this something we're missing here. i also wanted to just 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're struggling with a va hospital that was built decades ago, notwithstanding the kind of he row you can efforts of the -- heroic efforts of the staff there. it is just a very, very difficult situation. we're very pleased that we're on the priority list, and we're making our way to a point at which where we hope we can solve that problem and replace the facility. i think today we're, like, 8th if i'm not -- 18th if i'm not mistaken, so i'm aware of the

fact that it just, 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's a serious parking problem. it's right in the middle of omaha, and so maybe there are some things we can do to move the project forward. i'll wrap up with one last thought. 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 that i think are making a difference. the first is in the processing of post-9/11 g.i. bill benefits. in 2011 we, at least -- don't know about other senate offices -- we at least received no complaints about delays or problems with education benefits. i don't know what we're doing with education benefits, but at

least from our experience something's working. whatever model, if that could somehow be transferred to the disability claims, and i appreciate they're much more complicated. but that seems to be working. and you've had to ramp that up pretty significantly. so i'm hoping i can hear some thoughts on maybe there are some ideas that would work in other areas of the va system. we are also hearing veterans express to us that the expanded access to information via the e-benefit system is something that they appreciate, they feel good about. i think all of us have been optimistic and hopeful, maybe that's a better way of putting it, hopeful that that e-benefits system would pay dividends. we think it is. we think as veterans are getting more used to that, it is paying

some dividends, hopefully saving some staff time because people can get information or whatever they're needing there. i'll just wrap up and, again, thank you, madam chair. i do appreciate the opportunity to be here. thank you, you and your whole team, for the work you're doing. my hope is we can advance the cause because there's so much more to be done. thank you. >> thank you. senator brown. >> thank you. i appreciate your leadership on veterans' issues. thank you, secretary shinseki, and all of you who dedicate a wig part of -- big parts of your lives. thank you for the services you provide veterans and all of us if my state. in my state. i think when you look at what the advanced appropriations mark is, 130 billion, the request with the advanced appropriations with the $13 billion increase

it's, it's, um, saying the right thing and doing the right thing for people who clearly have earned it. it reflects the understanding we all have about service to country. i applaud the va for it investments in eliminating the disability claims backlog. we're all, of course, still very concerned about that as senator johanns said. we still hear horror stories of 1 and 18 and 24-month delays. we should, of course, never tolerate them, and i know your views about that, secretary shinseki, and know that we need to continue to push and with better trained staff and improvements in electronic and other processing efficiencies. i also on a similar note disability ratings system clearly needs substantial improvement. a bum knee in charlotte should be treated as the same as a bum knee in cincinnati.

the backlog in disability ratings in many ways relating fixing both at the same time makes sense, and i know your commitment to wanting to do that, and we expect to see results in, as we move forward. i'm aware, too, of the funds in this budget to train outreach coordinators and to operate targeted clinics and provide other services specific to marley rural veterans, but veterans everywhere who simply don't know enough about veterans' services. people from the va, officials from the va joined me in a field hearing in appalachia, two areas of appalachia, ohio, one in 2007, one in 2010. um, we talked about everything from applying for benefits, veterans' benefits to the earned income tax credit. so many low income veterans don't know enough about any of those services. the fact that today i believe there are 30 community-based

outpatient clinics in ohio speak to your commitment to going everywhere to reach veterans, not just in the va centers in cincinnati and chill cost think and cleveland. beyond that i'm very appreciative of that, but the outreach efforts, obviously, need to be stepped up, targeted at not just the demographic of rural appalachia, but certainly other places too. i remain -- last point, i remain concerned about the department's outsourcing of more and more work. the quality of outsourced work is often subpar, this whole political view that outsourcing, you know, whether it's selling turnpikes or selling prisons or outsourcing part of the military that it, you know, the work is often subpar, the cost savings are usually illusory, and often the costs are significantly greater as we learn from outsourcing. the contractors give political campaign contributions. i'm not saying you're any part

of that, to be sure, but that happens too often. and we go places with outsourcing that does not lead to good government. we also, i think many contractors lack the dedicated servicemennalty, if you will -- servicemennalty, if you. we've gone through that politically in state after state after state in this country and in the federal government. but you, i like the idea, i think an individual's motivation to serve our veterans as a career leads to better service, um, contrasted sometimes to services provided by companies that are motivated by profits. and some of the most dedicated people in, that i've ever met provide service to veterans and have made that their career. they could make more money somewhere else, but they want to serve in this whole idea that outsourcing saves money, enhances quality is pretty ill-founded. the va and our veterans can't

simply be viewed as just another client. we see this at the very basic level of services in places like dayton, and i appreciate very much the secretary's focus in fixing other problems at dayton. workers tell me laundry gets outsourced and doesn't come back clean. what's the point? if va continues to outsource more and more activities, are we going to reach the point where the va is a help insurance provider rather than a help care provider? 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 to be at the parma community-based outpatient clinic when the va for reasons with which i needed to do but probably needed to do shut down the va hospital in breaksville. part of the deal was they would put one in parma. it's terrific. it was crowded the first day. people will use it.

it serves an important population, and i thank you for that. >> thank you very much. senator brown, massachusetts. >> thank you, madam chair. i'd rather, i want to hear the testimony of the folks, so i'll be very brief. i agree with senator burr on the job issues and the fact that you're going to be spending a lot of money. happy to do it, i want to see how it's going to be paid for. also importantly, see if there's any duplication overlap. there seems to be a lot of things happening in that field, and when we have these types of issues, we usually throw everything against the wall to see what sticks. i want to make sure we do it efficiently, we don't just keep throw thing money out there, but actually we have programs. if they're working, let's improve them, if they're not, let's get rid of them. bless you, bless you -- [laughter] concerned about, obviously, the long time frame in filing claims. i will say i'm very pleased with what's happening in

massachusetts with the new blood out there and new people helping and really seem energized. it helps that we're in the same building, and we've had some great success, and i've made that public in our veterans hearing. and i know the big elephant in the room is the one million returning veterans and the obligations we have to keep them and get them whole. and i'm thankful, i know you've already met with secretary panetta to discuss that mission to make sure we don't just have a million new veterans coming that if they're going to be released, they need to be released in a thoughtful, methodical manner so you're not overwhelmed and really in so deep you can't get out. i'll just stop with that. i look forward to hearing the testimony. i'm going to be going to the floor, madam chair, i have to speak, but then i'll be back. thank you. >> okay. senator isaacson. >> i, too, will be very brief because i'm anxious to hear from each of you. secretary, thank you for taking the time to come to my office two weeks ago. secondly, i have two pieces of

good news. one's on the jobs front, and you probably have heard of this, but if you haven't, i want today make you aware. louis jo done who is the found -- jordan has created a foundation called gratitude america which is a web-based platform to match job needs with veterans, and it has a component that links them with training for the job, so it makes the full circle where if a veteran's looking for a job, he can search it on the internet. it matches him with the closest training facility where he can get the training. i think it's a great idea, and it's something that's very important. i appreciate louis doing it, and i thought you'd want to know. i want to complement director goldman in dublin, va, and he's trying to partner with the commander of robbins air force base to merge the va clinics in perry, georgia, and macon,

georgia, with the base dod health care on the base to utilize the facilities' advantage of having all the imaging equipment already on the active duty base, not have to have redundant cost in staffing two other clinics which i think is a great idea and also at a lower cost to the taxpayers. i wanted to wring those two pieces of good news to your attention. thank you for what you do and for being here. >> thank you. senator bozeman. >> thank you, madam chair. again, very quickly, i just want to thank the secretary for being here and the team he's assembled for your hard work. senator brown mentioned that, you know, that 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're in that category. and, you know, you've led soldiers, and now you're serving veterans, and so we really do appreciate that very, very much. the other thing i would say as

senator isakson mentioned, i do appreciate the fact you're very willing to work with congress and very approachable, you and your staff, so that's something that is appreciated. so we appreciate all you guys have done in the past and are looking forward to you doing a bunch in the future. and i yield back, madam chair. >> all right. thank you very much. with that, i want to welcome again secretary shinseki. thank you for coming here today to give your perspective on the department's fiscal year 2013 budget and the fiscal year 2014 advanced appropriation request. secretary shinseki is accompanied by steve marrow, allison hickey, undersecretary for benefits, dr. robert pets el, and ea also have thod -- we also have todd graham and roger baker, assistant secretary for information and technology. thank you all for joining us today. secretary shinseki, your remarks will, of course, appear in the

record, but we welcome your opening statements. >> thank you, madam chairman. ranking member burr, distinguished members of the subcommittee on veterans affairs, thank you again. i look forward to these. this is an opportunity to extend the dialogue we have in other fora, but thanks for this opportunity to present as the care woman, chairman said the president's 2013 budget and 2014 vabsed appropriations request for va. this committee has a long history of strong support to our nation's veterans, and i can speak to that firsthand having worked the past three budgets with you. the president has demonstrated his own respect and sense of obligation for our 22 million veterans by signing the congress once again another strong budget request for va, and i thank the members for your unwavering commitment, and i'm here to answer your questions, but seek your support on this budget request. i'd also like to acknowledge the

representatives from our veterans' service organizations who are here today. i would tell you as we develop our budget their insights, their experience is helpful as we 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 ask to be submitted for the or record. this hearing occurs in an important moment in our nation's history and not the only one. there have been others that i could refer to. i'm old enough to have experienced our return from vietnam and to have witnessed personally the end of the cold war. we are, again, in another period of transition, an important one. our troops have returned home from iraq, and their numbers in afghanistan are likely to decline over time. and history suggests as the

chair indicated va's requirements from these two 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, timely benefits and 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 va at unprecedented levels. through september 2011 of approximately 1.4 billion veterans who deployed and returned from operations end during freedom and be iraqi freedom, 67% have used some va

benefit or service in some way. a far higher percentage than those from previous wars. the 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 covering 7.1 million active duty service hebbs and -- 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 fore deny closure rates. burial honors and our 131 national cemeteries befitting their service to our nation. this 2013 budget request continues the momentum and are three priorities that you've

heard me speak about over the past three years. increasing access to care, benefits and services. eliminating claims, the claims backlog and ending veterans' homelessness through effective, efficient, accountable use of the resources you provide. access encompasses va's facilities, programs and technology. it's a broad term, but there's a lot that it encompasses. this 2013 budget request allows va to continue improving access by opening new or improved facilities closer to where veterans live and providing telehealth and telemedicine linkages, connectivity including in some cases where it's needed in veterans' homes. also by fundamentally transforming veterans' access to benefits through a new electronic tool called the veterans' relationship management system. this is an effort to get at our telephones. by collaborating with dod to turn the current transition

assistance program that we both share, t.a.p., into a training and education program that fully prepares departing service members for the next fades of their lives -- phase of their lives. and by establishing a national cemetery presence in rural areas and better serving rural and women veterans. we expect that more than one million veterans will leave the military over the next five years, potentially all will enroll in va, over 600,000 of them based on our historical trend, over 600,000 of them will likely seek care, benefits and services from va in the outyears. regarding the backlog, from what we know now fy-2013 will be the first year in which, first year in a long time in which our claims production going out the door will exceed the number of incoming claims. and the paperless initiative we

have been building for the past two years, an automation tool, becomes critical to reversing backlog growth and increasing quality. we must not hesitate. stability in i.t. funding is critical to our success. homelessness, from january 2010 to january 2011 alone the estimated number of homeless veterans declined by 12%. we have created momentum in the homeless program. much remains to be done to end veterans' homelessness by 2015, and the 2013 budget is a presentation of how we continue to do that. we're 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're not able to count everyone out there, but it's a valid, statistically valid process. in the meantime, over the past

three years we've 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 footprint to the next. so as we think about adjusting the footprint based on what we see day-to-day, we want to be careful that we're not doing something that ignores maybe an issue that is going to require help. so building a veterans' registry today over 400,000 names of current and formerly homeless veterans, allowing us to see, track and better understand the real causes of homelessness. and in the years ahead we think this information will not only help us more effectively prevent it -- that's where we're headed

not just for veterans, but perhaps for other communities as well where we have partnered in taking on the homeless issue. we look to develop more visibility of the at risk veteran population in order to prevent veterans from falling into homelessness, and this budget support ors that plan -- supports that plan. so, madam chairman and members of the committee, we are committed to the responsible use of resources you provide and the resources we seek in the 2013 budget, and i know that's been a question some of you have posed. but for both the 2013 budget, 2014 advanced appropriations requests we're committed to the responsible use and be, again, thank you for this opportunity to appear before this committee. >> thank you very much, mr. secretary. let me begin the questions by getting this one off the table. it's on the issue of sequestration and customs spending. like i said in my opening remarks, i believe 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 the clarity that they really deserve to have. so while you're here i wanted to ask you, do you believe all va programs including medical care are exempt from any be future cuts? >> i think, madam chairman, the answer that the omb director provided you is the same one that i understand. they're still addressing the issue. for my purposes i would tell you i'm 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 or in whole is not necessarily good policy, and i think the president would argue that the best approach here is a balanced deficit reduction, and he believes that the budget he has presented does that and asks that the congress look at that budget and favorably consider it. >> well, i think we all hope that that is the outcome, that we want to provide clarity to our veterans who are very concerned about this issue. mr. secretary, last year we talked a lot about mental health care, and be i think we together uncovered a lot of serious issues best summed up by a veteran who i heard from recently who used the ann arbor medical center, had to wait months and months to get into counseling, but then he had glowing things to say about his providers once he got in. so in order to address those types of issues, va has to be

certain it 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 of the last fiscal year, the number of iraq and afghanistan veterans who are looking for a mental health care went up by about 5%. that's 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 sufficient to accomplish the goals 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 in '13. are there issues out there that we'll discover between now and execution of budget? i would say if we do, madam

chairman, i'd be the first to tell you. now, you asked us to do a survey, and we did. um, it was very hastily done. senator burr referred 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 vha was with did you go to the places we thought there'd be problems, and the answer was yes because we were asked to go figure this out. so i would say we got a pretty pure response. what i think we need to do is make sure, we're going to take another broader look here and make sure we understand across the larger population what our issues are and where there are opportunities for reallocation or, you know, if as it becomes clear to hire more people. i would offer to the chair i

took a look at what we've done in mental health over the last four budgets. um, if we look at '12-'13, it's rather unimpressive. i mean, it's 5%, and it matches the increase in the medal budget, but -- medical budget, but between '09 and '13 our increase is 39% in mental health. and if you include the '14 advanced approach, that'll go up 45%. >> and that is a result of the number of soldiers who are coming home with the invisible wounds of war which is dramatically increasing, correct? >> true. but we are, we're trying to anticipate that there's going to be a larger requirement here in the outyears even if we don't have clarity. we're trying to prepare for that. we want to do a larger survey here as i indicated, and then, and then see what the outcomes are. but let me turn to dr. petzel

for any details. >> thank you, mr. secretary. madam chairman, as a result of the hearing that we had earlier in the year we have now done two things that are, i think, important and on point with regard to your question. one is that we've developed a staffing model. it is the only staffing model that i know that's available about mental health. it's in the beginning stages, but it is giving us some information about what the need might be. but i think more importantly, we're site visiting all 152 of our medical centers to look at the access to mental health services, both the initial appointment and subsequent appointments for, be it for ptsb inpatient program, group program or individual psychotherapy. and what we're finding is that there is, we do meet the criteria for the first appointment in most every

instance. we're 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 of staff out there, have we given enough positions and resources. two is are those positions filled. are they filling those positions up in a timely fashion. and then 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 that are on, i can guarantee you we will be in communication with the committee about those needs and in for discussion. >> okay, i appreciate that. this is a top priority for us this year. >> i would just share that in fy-11 we hired about 897

additional mental health officials bringing us up to about 20,500 mental health professionals. so the interest is there in this trying to term what the requirement is -- determine what the requirement is, and we're not hesitant about increasing those numbers. >> okay, thank you very much. senator burr? >> thank you, chairman. since the chair just with asked about mental health, let me just ask if my information's correct. in december va polled their facilities, and they found that there were 1500 open mental health positions. is that accurate? dr. petzel? >> let me turn to dr. petzel. >> could you repeat that number? >> in december 2007 the va polled their facilities and found there were 1500 mental health slots unfilled -- >> out of 20,500 that's true, yes. >> okay. i just wanted to make sure the information i had was with correct. mr. secretary, i want to thank you for something unrelated to this budget hearing.

march 31st in north carolina we will have the first in the country welcome home vietnam vets day, an all-day event, and i want to thank you for the va's 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, work with those who have problems, and we'll have a va 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, very special event that's long overdue and, hopefully, it will be the first of a total of 50 that are held around this country. and i thank you for the va's participation. i'm going to ask for chart number one to go up. earlier i mentioned a number of performance matrixes that seemed to be heading in the wrong with direction when it comes to claims processing. but i want to start by talking about the quality of va's

decisions on disability claims. your goal is to have 98% accuracy, but for the past three years ration si nationwide -- accuracy nationwide has been about 84%. and as of december '11 the accuracy rate at regional offices around the country varied from 94 to 61. mr. secretary, in total how much is va requesting for '13 budget to carry out all of those quality initiatives including the quality review teams at each of the regional offices? >> thanks, senator. let me turn to secretary hickey to answer that. >> senator, thanks for your question -- [inaudible] thank you. senator burr, thank you for your question, and i'm glad you're asking about quality because we're very focused on both production and quality, if not a trade for one and the other. i can't give you the very specifics on each one of those costs, but we expect the impact

to be significant in our ability to produce a higher accurate and more consistent response across the board. not just the quality review teams, but they are a critical part of this, and for those of you who may not be aware what those are, we have taken what is nationally recognized eby you all -- even by you all and members of your staff our team 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. their responsibility will be not just to check quality at the end of the process or inspect quality at the end, but to do a new part of the process that works closely with our employees in a training environment to check different parts in our process where we make most errors and to correct those early. >> at what point on a 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?

>> so thank you, senator, for your follow-up question. i will tell you we've already done that. no initiative that we have in our transformation plan of the 40-plus initiatives in the people category of those things how we're organized and trained to do our work, in the process of environment how we've adjusted some of our environments or in our technology solutions have not been tried, tested, measured for impact before we're implementing. so, in fact, on a quality review team -- >> but at some point you've got to say we're going to look at it and see if this is working. >> we did, sir. absolutely did. >> so -- >> and we did local pilots, and we just announced this week, in fact -- >> so a year from now when we get together for the '014 budget if quality is not improved or the timeliness down, it will have failed? >> no, sir. i don't expect the quality not to have improved. we have some very significant decisions and initiatives -- >> my point is what if it

doesn't? >> sir, then we will adjust as necessary to find the reasons why. we will tackle that hard. but i don't expect that to be the answer. i expect be us to see improvement in both quality and production. >> thank you. we have -- >> senator, if i might. quality is a function of trained people with the right too toolsd we're working on both, both items right now. >> my question was simple, many secretary, at what point will we determine whether what we've implemented is working? >> fair. we'll be happy to provide that. we set a target of ending this issue with backlog in 2015. we begin fielding the automation tool we've been building for two years fourth quarter of this fiscal year. we expect that the tool will be rolled out nationally throughout '13, this budget, and as we do that we expect both speed and quality to go up. >> if i could ask the chair for just 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 due to the impact of the overall transformation plan which will, which will rise from 89 annual claims per direct labor in 2012 to 129 in 2015. as you can see from the chart we talked about productivity per fte last year at 79.5%, this year we're looking at 73.5%. what percentage 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'll turn to secretary hickey for the details. um, i would say what these charts don't reflect, senator,

is that in the last three years we've taken on some other products that aren't accounted for here. g.i. bill, requirement to get that 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 that first semester we had to do everything manually, and it was not the prettiest processing event. but we did that manually, got 173,000 youngsters into school and on their path to the future. at 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 fielded, and we've added four or five more programs to make it more productive. we'll get better over time. it's hard for me to give you a

day and a month when this quality factor will meet any of your expectations, but we set 2015 as the date in which we would have the backlog solved and the quality at 98 percent. that's what we're focused on. i'll give you the best way points that we can figure out, but that'll be a product of what we are doing to train our work force and what we're doing to give them the right tools. we're 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 train 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 that they can leverage these tools when they arrive.

>> thank you, senator burr. i would just like to, first, start by saying thank you to you and to chairman murray and your leadership and the members of this team, of this committee for, you know, an unprecedented level of increase, budget increases that vba has enjoyed in the last three years. i think we need to kind of put that in a little context. that 36% was with used to tackle a 48% increase in claims over the same period of time. and that was to support nearly 12 million service members, veterans, their families and survivors, and that's including a net increase in the last year of half a million new veterans to our rolls that did not exist and are using our benefits and services. so we did also for the second year in a row complete more than a million claims using those resources. um, that's 16% more claims per year than we'd done in 2008 before that chart started doing some of those things.

i will tell you and put frankly on the table, we've put more than $3.3 billion into the hands of 117,000 of those seat that many veterans out this in the last year -- vietnam veterans out there in the last year. 260,000 other claims in backlog we did not get to that also had an impact on fte because we put to do those right and well, we put two times the fte associated with each one of those claims on those very difficult, complex 50-year-old claims. 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 in our integrated disability and evaluations system to get those folks taken care of right and well the first time. so that also had an impact on the line that you've laid out in front of us. the positive news about all of that is, um, we are done, we're

down to the tens of ten levels, kind of double-digit levels of the agent orange cases. 99.9% done through those 250,000 cases. we are now capable of shifting all those 13 resource centers we had across the nation that were hunkered down nurg -- doing those agent oranges. tomorrow we're shifting that all back into normal backlog case load. it will be focused on our benefits that discharge veteran, it'll be focused on our quick start veterans, and it will be focused, frankly, on our oldest cases we have on our books during the month of march. >> thank you, senator burr. senator akaka. >> thank you, madam chairman. general shin shinseki, as you k, we often face challenges in treating our veterans who live in many rural and remote areas. this is especially true in

places like alaska and hawaii where you just can't get to some places by jumping in a car and driving there. i know that you're working on an mou with the indian health service to find solutions to help provide services to our native american veterans, and i commend you and all your, all your involvement in these efforts. many secretary, can -- mr. secretary, can i get your commitment to look into possible ways of working with the native hawaiian health care systems and the native american veterans systems to provide services for in this case native hawaiian veterans who live in many rural

points of the state of hawaii? >> senator, you have my assurance that we will do our utmost to provide for any of our veterans, wherever they live, the most rural and remote areas the same access and quality to health care and services as we provide to someone live anything a more urban area. there is a challenge with that, but we are not insensitive to that challenge, and we're working hard to provide va-provided services. l -- and where we can't, to make arrangements where if quality services exist in those areas, making arrangements for veterans to be able to participate in those local opportunities. um, we are i think you know working and have been now for some time on signing an mou with

the indian health service so that wherever he was facilities and we have vested interests that a veteran, eligible veteran going to an indian health service facility will be covered by va's payments. and we're in stages of trying to bring that mou to conclusion. we've, we intend to do that. and where tribes approach us prior to the signing of that mou and want to establish from a tribal nation with va a direct relationship because they have a medical facility and would like us to provide the same coverage, we're willing to do that. but that would be on a case-by-case basis. >> thank you. secretary shin shinseki -- shin, staffing shortages continue to be a problem although there's

been progress. some clinics are seeing staffing levels below 50% causing excessive waiting times for veterans that need care. understand this is an issue you've been working on. as you know, the thurm of veterans -- the number of veterans needing services is growing yearly, and it shows that you have been making progress. can you provide an update on the department's progress to address staffing levels? >> mr. secretary, thank you, senator akaka, thank you for the question. we've addressed, we've talked about mental health earlier and the efforts we're making to try and assess whether there's adequate staffing there. um, i think you're probably talking about primary care which

is our largest outpatient clinic operation. we treat 4.2 million veterans, and it accounts for the lion's share of our budget expenditures. we assessed staffing three years ago when we began to implement what we call the patient-aligned care team or pac program and have done it again recently, and we're finding that we are now able to bring up the support staffing and the physician staffing to reasonable levels associated with the standards around the country. i would be, like to take off record, off line any information you have about specific places where there's a 50%, um, vacancy rate. i'm 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 that we can address them

specifically. >> my time has expired, but, secretary shinseki, as we face budget constraints, we must all work to improve our efficiencies and redouble efforts to look for ways to get the most for our budgeted resources. my question to you is can you talk about any steps you are taking to improve the acquisition process at va and any efficiency you've been able to realize in this area? >> senator, i would tell you that we have been working for several years now on restructuring our acquisition business practices. three years ago acquisition was spread throughout the organization. now it's consolidated to two centers, one comes directly

under dr. petzel, and that's for all medical acquisition; gloves, masks, aprons. we ought to be able to leverage that into a bulk purchase and get a good price on those kinds of things. for everything else we have an office of acquisition, logistics and construction, and 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 call center. this is something that i think we had high hopes for.

you might have had high hopes for it, but i have to tell you it's not working well. here, here's what we're running into. the complaints kind of fall into two separate categories. the first category would be people that call the call center, and no one answers. i mean, it just rings and rings and rings, and there's no one there. i will tell you in my own senate office my staff has run 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, a live person to answer the phone, and you get connected with them, and they don't have information, you know? the veteran is, or we're calling in or somebody's calling in, what's going on with my claim or

whatever it is, and you're just not getting a responsive human being on the err end of -- other end of the line. i'm guessing what it is is they just don't have access to the information that we're speaking, and so -- seeking, and so it seems to me that we're creating a, an expectation of service when really there isn't much service there. um, i'd like to hear your thoughts or whoever's thoughts on your team about the call center, what's the prospects for that, are these, are you hearing these problems, and if we're still committed to the call center, what's in place or what will be in place to try to solve the issues that i've raised? >> thank you, senator. i've tested the system myself, sometimes been, you know, pleasantly surprised, other times disappointed. but that's been something i've 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're expressing are anything six months, the experience occurred six months ago and older, i would offer that we have made, we have put this tool in place and changes are occurring weekly. and i'll ask secretary hickey to provide some detail. but i, like you, i think when a veteran picks up a phone and calls va, there ought to be someone there that answers, or if he or she chooses to come in online, that it ought to have information that's useful to them that's easily discovered so they don't have to run through a

series of traps to find what they're looking for. we owe them -- and that's the first step in any service organization. and that's our intent here. so let me call on secretary hickey. >> senator johanns, thank you very much for your question, i appreciate your comment earlier about e-benefits. that is actually part and parcel of our multiprong 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 73% of them want to meet us online, so e-benefits is partly that solution. but let me talk, address specifically your questions, first, about no one answers, no live person, and let me tell you about the two new pieces of functionality that we have that we have measured outcomes on from our j.d. powers voices of veterans survey, the first of which is virtual hold. if a veteran calls us and there's a long waiting time, they can elect to hold option, hang up the phone, continue

feeding the balk by, getting ready for work, doing whatever it is they need to do, and we'll call them back on coup. 9 -- queue. 92 percent of our veterans have elected that option, and we've connected with them as well. the second one is our scheduled callback, can i schedule a time that i can talk to you, and you will guarantee to call me back? and we have just implemented that one in december. between those two our veterans -- one million veterans have elected those options. as a result, we've seen clear, demonstrated, measurable performance. we have a 15% improvement in overall satisfaction on the ability of our veterans to get through, um, and we have seen a dropped call rate reduction of 30%. those are both part and parcel of the new technology and the new ways we're doing and working in our veteran relationship management capability. in terms of another vrm initiative, in terms of if they don't have the right information, yesterday -- not

today, yesterday our call agents would have had to cycle through and different databases we had -- 13 different databases we had. today as we deploy this, and this is critical for our i.t. budget, unified desktop puts all 13 databases worth of that information you want to know on one screen making them much more effective and delivering a good outcome. also built into this is world class call recording, call tracking, data analytics into this package we're using every single day to improve our service in that environment. >> um, i'm out of time, but if i could just ask as your, as these things are being implemented, as we're going down the road here, if periodically you could give us on the committee an update as to the progress you're seeing because i do think there's real hope with the call center. you know, the veteran can at

least get somebody who can answer their question, etc. so i'd just like to stay abreast of how we're doing. >> i'd be very happy to do that, senator. >> thank you very much. senator chester. tester. >> thank you, madam chairman. 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. the veterans are very appreciate ty of that -- appreciative of myself, -- appreciative of that. and you, too, for listening and hearing thank you very much. i want to talk about what senator akaka talked about very, very quickly, and that is the kind of strategies the va's using to recruit folks. this is in an area that's much more difficult, in my opinion, and gp is not easy, and that is the need for mental health professionals. we have, as you know, secretary -- mr. petzel, you

were there, i think, when we opened up the facility in helena, and we need -- it's a great facility. 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 to mr. petzel, to be able to go out and recruit and really get folks in? because i'm not sure we're there yet. >> thank you, mr. secretary. and thank you, senator tester. i am aware of the issues in, at fort harrison. we have four psychiatric psychiatrist vacancies. in general we can recruit around the country very successfully for psychiatric social workers, for psychiatric nurse clinicians and for clinical psychologists.

the most difficult recruitment for us is the md psychiatrist. >> yep. >> we're not unique. this is an issue that all health systems around the country face. 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 it finish i think we're 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, people that want to come to places like helena which is beautiful, by the way. >> thank you. >> in an environment where there just aren't that many of them. >> okay. well, i just, i just think that it's been an ongoing problem particularly in rural and frontier areas like montana, and it's not a problem that i think bodes well for the veteran who has issues or revolve around

mental health. the costs go down, so i want to talk about health i.t. for a second. we can all agree that advance probes have allowed the va, i think, to be more effective and to deliver quality health care for our veterans. however, it is my understanding that the exclusion of health care-related i.t. funds in advanced appropriations have put us in somewhat of a wind. it's hard to -- bind. it's hard to deliver quality of care when you can't make advancements in things like phone systems, electronic health records. can you speak, just speak about this issue and how the inclusion of health care-related i.t. funds in advanced appropriations could improve the quality of health for our veterans. >> thank you, senator. i would just begin by saying congress provided us a very unique mechanism called the advance appropriation, and it's a gift to va because it really gives us continual --

opportunity for continuous budgeting every year, submitting two budgets. it gives us two looks at our budget. so we submit what we understand our best estimate is as an advance appropriation, and then we come back a year later, and we submit the actual budget, and we can make adjustments. the advanced appropriation applies primarily, solely to health care, and so doctor petzel has his continuous budget. everyone else is on annual budgeting. under advanced approps we have the budget for medical services, medical compliance and reporting, medical facilities. and be what happens is when we have a delay, a 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 that now it can catch up to him. and in a case last year i think the budget cr lasted until april, so pretty significant period. we're a bit off stride here, and i'm trying to figure out how we can get this together and link up the authorities you provide along with the budget to do his business and get him the tools that allow him to see patients. there's no separation between medical i.t. and medicine today. that'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 that chairman murray and ranking member burr will help on this too. i just think it's really important in this day and age. and just -- >> can i just follow up very quickly? madam chair, i just adhere --

add here, the i.t. budget is now released in april, and it's a big number because it's all i.t. well, really in it you have the paperless system that goes with secretary hickey's operation, and you have medical i'm i.t. tt goes with dr. petzel's. i'm just trying to be clear here. the piece i'm concerned about is the medical i'm sorry t. so we -- i.t. so we link decisions to do things in the medical sense along with the tools to be able to do that. what happened last year as sometimes happens, this large i.t. budget gets, you know, identified in april, and we can now go forward. and the assessment is made, well, they can't possibly spend that before the end of the year, so we lose $300 million in a

detriment process at a time when we really need it to marry these two things up. he can now not deliver what we've already approved a year before, and we're delaying that. so i think there's a -- >> timing issue. >> yeah. i think there's a mechanism here to get in stride on both ideas, and we'd be happy to work with you on it. >> well, thank you, and i want to thank everybody for being here today. i would get into the rural cemetery thing with mr. monroe, but we'll propose those questions in writing. thank you all very, very much. >> thank you very much. senator no -- moran? >> madam chairman, thank you very much. mr. secretary, in 2008 congress passed the rural veterans access to care act. this was a piece of legislation i was involved with in my days in the house. it was signed into law, the program is now referred to as project arch, access received closer to home. and that legislation set certain

criteria that if a veteran lived a certain number of miles from an outpatient clinic or from a va hospital, the va would provide those services locally using a local physician, local hospital. my legislation was broad in its initial form, it was narrowed by congress to create pilot programs, and the vision -- the division kansas is in was included in one of those pilots. i've expressed my complaint to the va before because when the va implemented its program it didn't choose a division, it chose a community be. in my view, we've taken legislation that created a pilot program and created a pilot program within a pilot program, and we now have a project ongoing in pratt, kansas, to demonstrate whether or not this idea works. i would, i would love to hear the report of progress being made, but also use this moment

as an opportunity to 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 is significantly different than what happens in atwood, kansas, which is five hours from wichita. and the access to providers is totally different between those kinds of communities. while i'm certainly pleased a pilot program is ongoing, i'm not certain -- in fact, i'm completely uncertain, let me say that differently, i'm completely certain the va has not chosen wisely as it has narrowed the project to a very small scope to determine how it works. and in that regard, along the same topic of the cbox, we have an ongoing problem similar to what has been expressed in regard to mental health by senator tester, and i understand the doctor's testimony about the inability to attract and retain

professionals. but it's sure becoming clear to me that we have that same problem outside mental health. our ability to retain physicians in cbox across the country is a huge problem. and more and more we have nurse practice decision -- practitioners have become limited, and we have many cbox now where no physician is generally present. and i understand the secretary's talk about i'm sorry t. as a potential -- i.t. as a potential solution. we do everything as a member of the senate to provide the va with the resources to provide the necessary personnel. and my assumption is my answer will be very similar to what you told senator tester, and it's the same one i hear from folks in kansas is it's not really a resource issue. we can pay sufficient amounts of money to attract medical

professionals, but we're struggling like everyone else to attract those professionals. and i've heard that answer for a long time. you said it again today, dr. petzel. in some fashion that can't 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 -- i understand the problem. i don't mean to be critical in that sense, but there has to be something more than, well, everybody's experiencing this problem. there has to be a path to a solution. >> i'm going to ask dr. petzel to address your question. i would say, senator, we -- rural areas are particularly the challenge because of the availability, d.petzel -- dr. petzel said that. and our tools are really reaching out to -- and we want highly qualified, we want talent. and our tools are what we are able to compensate, what we're

able to award, recognize performance of good people doing outstanding work and retaining through bonuses the high quality ones. so our tools are limited. but we owe you the best efforts we can to go after that talented, and the biggest challenges are in rural communities, and we have to circle our wagons here. >> mr. secretary, i appreciate your sentence that you owe us that. we owe our veterans that. but i owe you every tool possible to help you meet that criteria, and the complaint or concern that i have is i'm not being 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 or we're back here next year talking about the budget, the

answer to whether or not there's a doctor at a cboc is not that -- or that we're meeting the mental health needs of veterans particularly in rural areas is not every health care provider, every community, every rural state is having the same struggle we are. help us help you solve this problem. >> okay, fair enough. >> thank you. >> senator begich. i'm sorry, do you want to respond really quickly? >> i'll try to be quick. thank you, senator moran. the md issue first. you're absolutely right that we all have this difficulty in certain rural parts of the country. i would say if you look at our md situation across the whole system, we don't have a problem. it's very important that we focus on the fact that this is rural america. two things that we would like to do. one is that we need to expand our tuition reimbursement program to be able to provide an incentive for people to go to rural areas by reimbursing them

for their tuition from medical school. the second one was an idea that the secretary had, and i don't want to get into the details of it, but to do something like the military does with their uniform services medical school, and that is recruit people, pay for their medical education with an obligation to follow to work with us in particular parts of the country. those are two areas that we are trying to explore. >> thanks, senator. i'd just put a little finer point on what dr. petzel said. i thought that if we went into areas, rural areas and found a highly talented youngster with great potential and targeted that individual and got them through the college and the medical process, that they'd be going home. and so in the long run we would not be facing the retention bonuses and this kind of thing. you'd have provided someone for

the long term as a solution to that requirement that community. that's part of the discussion here. >> i appreciate your thoughts and, please, consider me an ally. we can follow up with the arch question at a later time. thank you. >> thank you. senator begich. >> thank you very much. and i also want to echo the same comments that senator moran, and i like some of these ideas you just mentioned, so i'd be anxious to participate. i in one of our hospitals in -- i know in one of our hospitals in alaska they actually give a pretty significant bonus, up to $10,000, to recruit and retain nurses because of the high capacity and the need. so thank you for those ideas. let me also say thank you, mr. secretary, for the two staff that you sent up to alaska, i think it was last week or the week before. chairwoman murray for sending committee staff also. it's important, as you know, to come up to alaska to understand what rural is all about. i know that you have been there, thank you for your visit and your team's visit. it makes a difference to the

people there, but also i think it opens the whereas to a lot of folks -- eyes to a lot of folks how we have to deliver health care in 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 some conversation, mr. secretary, in regards to the idea of the alaska heros' card and the idea of trying to weave through this access issue in parts of the country that have limited access to veterans' care n. alaska specifically as you know we talk about the roadless area, those areas of 80% of the communities of alaska do not have access by road. so when we -- and i noted your testimony about internet connect and then get the mobile van out there. there's no mobile van possible. the mobile van is in the area, and that's the -- air, and that's the only way to get it. 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 kind of the update of that.

i know we have kind of talked about the quality of care through our indian health services which is in, superior to so much care that's being given today across the country, and it is high quality care. and tell me kind of what, where you think we're at at this point. i know we've -- you've been very responsive. i know we've been badgering you and your team on a pretty regular basis because as you've seen the veterans, all they want to do is go across the street to an indian health service clinic to get their regular check-ups as a choice, not as a requirement. if they choose to go to a va hospital clinic, so be it. but if it's across the street, let's make that happen because the quality of care is equal or, in some cases we would argue, better in specialty areas of the va. what's your thinking on that? >> as you and i have discussed, i think you'll 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. there's a rather robust program underway there. as i describe working with the indian health service to establish this mou which would open a lot of processes for, especially for alaska native veterans. but in the meantime, based on my visit to alaska, the alaskan native consortium, we've also established discussions with them and trying to insure that however the ihs mou progresses, that we have, are ready to provide health to veterans who are being seen now -- >> and you feel that's going in the ridi