a lot of the homeless veterans don't have the stability in their lives. just have a column, supportive place for a time to enable them to get on with their lives is what i saw in this that house. this particular house was created by a nonprofit entity in partnership with money from a grant from the veterans affairs department. so there in the community,

individuals and entities, including home depot, by the way , which is a company has made a huge commitment as i'm sure you know to support veteran programs. but to supply the eds and all of that. and then these veterans are adopted by this community organizations. it was a terrific combination of people coming together, but it also would not have happened without the money from the grant . so these are the kinds a programs that are very much supportive, hands-on. yes, it is veterans, but i figured each one that we help to get on the deposit with their lives, that's worth doing. so i just wanted to let you know that every time i go home, as i'm sure my colleagues to, we visit with veterans. i do feel bad.

thank you very much for your service. of course a look forward to working with my colleagues and to make sure that we provide the kind of support that will enable us to meet the challenges of our veterans. >> thank you very much, senator. we may have some votes cent. we will have to juggle things. people will be leaving in coming. let me begin and request short answer some from the panelists. >> testimony to my new of forgot something. you probably want to say something. >> of tried to be short. >> take your time. >> very supportive comments made by our members here today. chairman, senator isaacson, members of the committee, thank you for this opportunity once again to present to the president's 2015 budget and 2016 advanced appropriations request

for this department of veterans affairs. i am working my sixth budget cycle. it's almost incredible to understand, but it is the sixth budget cycle for me. together all of us here have accomplished a lot. i deeply appreciate all of us appreciate your unwavering support of our nation's veterans does not just occur and testimony but day to day as we engage with you. let me also acknowledged, as others have, the representatives of our veterans service organizations were here today. they're inside and support makes us better at our mission caring for veterans and families and survivors someone. mr. chairman, i'm going to take a few seconds just to introduce the members of my panel here. to my extreme left is the executive in charge for information technology. the executive in charge of the

office of management and also acting chief financial officer. to my right under secretary for health and then undersecretary for benefits. to her right undersecretary for memorial affairs. mr. chairman, i do have are written statement and ask that it be included in the record. >> thank you, mr. chairman. the fy2015 budget and fyi 2016 advanced appropriations request demonstrates once again president obama's steadfast commitment to our nation's veterans. the support of the congress and especially this committee has allows for five years now to answer president lincoln's charge from 149 years ago to care for those who show of won the battle for the families and survivors. i think the members your commitment to veterans and sequence again your support of these budget requests. the president's vision reflected

in this request is about empowering veterans to help lead the rebuilding of the middle class in this country, much as they did after world war ii to quality health care, access to quality health care, benefits, education and training, the original jabot and then employment that enables achieving the american dream. they va 2015 budget request $61,603,000,000,000. 68 billion of that amount is a discretionary funding including medical care collections and increase of 3% above march 2014 in active funding level, this year's budget. it also includes $95 billion in mandatory funding. this budget also requests $58 billion for the fyi 2016 advanced appropriations for medical care, an increase $3 billion or four and a half% above the fyi 2015 request that

i am also cementing today. another strong budget, and your support of it is critical to providing veterans' the care and benefits they have learned through service. it enables the va to further the significant progress of a permit has already made on the top three perris realigned years ago and have been working at. i want us to expand the veterans access to benefits and services. second, eliminate the disability claims back door in 2015 as has been mentioned by a number of members. thirdly, and the rescue of homeless veterans in 2015. since 2009 we focus the resources you provided to address these three key priorities. among other requirements for these three priorities, to best serve veterans and i would say in terms of access your is what we have accomplished. more than 2 million additional veterans of the natural. we opened our 151st hospital,

the first in 17 years commandery of increased a community-based outpatient clinics by 55 per a near total to 820 community-based outpatient clinics today. more than a million veterans and family members have received va educational stick to have assistance. nearly 90 percent of all veterans today have the option within 75 miles of where they live thanks to this great work. we expect that that will increase out through 2017. we have plans to do that at which point we will be at the 96 percent mark. in terms of disability plans the backlog is declined 40%. we are transitioning from paper to digital processing and are on track to end the backlog in 2015. terms of veterans homeless this, the estimated number fell by 24 percent between 2010 and 2013 and we expect another reduction

in this year's time count finally tallied up. these are some of our key accounts bozeman's. i will report to the committee they're making good progress. we assure you that we will continue to leverage every resource of the budget, money, time, people to do what is right for veterans. as i have for five years now we will assure you that we will use these resources that the congress provides effectively, efficiently, and accountable to best care for veterans. again, thank you for this opporunity to appear here today and for your continued support of veterans. i look forward to your questions. >> thank you very much. let me begin by picking up on a point that members have raised and you just discussed yourself. for the last several years there

has been a loud concern about the backlog. general, when you came into position you announced a very ambitious goal, and it was to process all claims in 125 days with 98 percent accuracy in 2015. your goal was to go from of paper system to an electronic system. can you give us some explicit information about where you are in the process? >> certainly, mr. chairman. let me open and i will turn to the secretary for specifics. first, i would say that no veteran should have to wait to have their claims adjudicated. we are committed to doing that as quickly as we can. five years ago we had a standard for what was the backlog. and so we established one at 125

days. every claim, not on average, but every claim handled in the 125 days unless and all of our work done at 98 percent accuracy. that has not changed. what you have seen of the last five or three years was a commitment to do that by investing resources you provided to come up with an automation tool called veterans benefit management system. it has taken us time to design, develop, test, pilot, and make sure we have a good platform that we could hang capability on as we continue to improve it. you have seen all of that over the last three years. the completed fielding in june of 2013. >> if i may. i just want to -- bottom line is you believe you'll are on path to achieve the goal you established. >> we are wrong path. >> you want to add anything?

>> we have taken 237,000 claims out of inventory to reduce the backlog by 40 percent. veterans are now waiting 117 days less on average for claims and are quality in those decisions is. >> let me ask a question, if i might, within the va and throughout our country there has been a concern that we -- the va has timed some cutting its work in terms of using complementary and alternative medicine to treat a variety of problems. my understanding is that you have launched what is called an opiate safety initiative in minnesota. can you tell us a little bit about that and what you see in terms of the future regarding complementary and alternative

medicine? >> yes, mr. chairman. thank you for that question. the actual losses across the entire system. all of our medical sisters are not participating in appeared safety programs which entails five elements. it is an opioid-port which elucidates hyper scribers and high users and then a process by which the users and providers i met with and discussed. to come every medical center has a pain clinic. every medical center uses a a step in process. a revolutionary approach to using the least risky alternative in managing pain. and from your perspective most importantly we require right now that every paint program offer at least one alternative medicine process and that they develop within this year another alternative medicine program. so acupuncture and pain is

probably the most common thing. you will find that we have about 90 acupuncture programs around the country. >> i you finding veterans gravitating to those kinds of therapies? >> absolutely. people want to use the least risky way to manage there pain. this is something that they come within general out of their experiences in combat. it can be a terrible burden for them. they want to find ways without using opioids or narcotics to manage the pain. >> my last question, whether they want to answer it. the health care budget. as i understand it, mr. secretary, the va anticipates an increase of approximately one arm thousand patients in the coming year. you know, we are delighted that more veterans are accessing va healthcare. but i am concerned whether the 3% increase in medical care that

is in the budget will be sufficient to care for these new users, existing users, expand available services and keep pace with all the issues that we have. it sounds like it's not. >> mr. sherman, i tell you that we have for several years now been working to understand how our patient group may change when they arrived at the point that they are going to make a decision about down sizing. i believe that decision has been made. we are working with them now to understand the plan. this budget request is prior to that plan being provided. we continue to work democrats. we believe the anticipated what moneys will be. then again, this will depend on what the downsizing plan entails .

>> senator, i will run and vote and be back as soon as i can. >> to we have any body has not voted yes? all right. we think senator isaacson will be back soon and he will take over. >> i was just going to offer, it looked like i had taken control. [laughter] >> let me focus on capital improvement. the fy15 budget request is for 561 million. as i understand the way that request is put together is actually for for ongoing projects that are in some state of construction. so the first question i have on that is, does that 561 represent

a sufficient amount of money to get those projects to the finish line? are they done at the end of that ? do we see this again next year? >> senator, the four construction projects -- and i will list them. seismic corrections on long beach, mental health and community living center fess to my outpatient facility, community living center, san diego spinal cord and size of a deficiency. these are all projects that are on the execution last under the major construction program. >> my question is does the 5,601,000,000 complete those projects this year? >> yes, they do. >> it does. okay.

>> the concern i have is probably going to be obvious your. 561 checks the box on those four projects. as you know, we have been working our way somewhere through the list. you know, i don't want to come there are a lot of other states out there, many of which are ahead of us. and so what i am looking at is all of these projects, there has been an estimate -- it is probably a pretty rough estimate 23 billion is necessary to address what is on the waiting list. how do we -- and if, is that far down the list, i can only imagine the problems ahead of this. tell me how we can best put a process in place to address what you're dealing with them what

we're dealing with. it's a lot of money, very hard to come up with force. i don't think we would want some projects on going at once. that stretches everybody pretty than. how do we move these projects in more aggressive ways? >> i would say, senator, we have done our best to prioritize these projects so that the very top of the safety and security issues that we have to address for safety of employees use in veterans. when we do that, of course, then you can see. secondly, the priority would be to ensure that what we have today is kept at a good standard therefore, for atlanta construction, not just major but atlanta construction on refracted of nonrecurring gains those funds in addition to the five modern 61 million, we have

$4,905,000,000. another for under the $60 million for non-recurring maintenance. these are the funds that keep us as a standard in the facilities we have today. our commitment is as we work toward getting to an omaha, for example, what we have today and, will be kept at a safe, functioning, and a standard that veterans will see as their hospital delivering high-quality care. >> you know, i see the work. i was just out that the medical center recently said. i see the work. they're talking to me about the minor construction of there doing. i receive it as a bit of a mixed blessing. yes, i want the facility to be safe and do the things for veterans. on the other hand, no one is going to argue that the facility should have longer-term futures.

so all these millions we are putting into these facilities across the country, i just hope we are not chasing good money with that money if you know what i'm saying. i am sure it is a dilemma for you. there is a point at which the buildings have just serve their useful life. >> we do have facilities that are underutilized and are vacant. with those we do our very best to take them down so that we can husband resources that would ordinarily go to some level of maintenance, husband those resources to put in new facilities where needed. i would also say, senator, besides our major, minor, and nonrecurring maintenance, we also have a leasing program. it is important to us and primarily does not come out of a construction budget and other medical care count. it is a powerful tool for us to

be able to provide income communities where community-based outpatient clinics may be needed, we stand it up very quickly, provides services needed, and we are not going through a long term development process. and i would add a fifth component here. that would be -- or six components which would be hard to allow health telemedicine capability. we have invested heavily so not only do you see hundred and 51 medical centers and 820 community-based outpatient clinics, there are all linked through tella health telemedicine, especially important in rural areas where just travel and access is important to, but if we can provide in those communities a clinic where veterans can find access and even if we don't have

a kidney expert there, through ourself means we can give them access. so when we're talking about the construction program, i'd like to see it as access. that is, the law can access. how the weak link is through technology to provide the best quality care and try to level the playing field here so that a veteran, no matter where they live, will be able to insure the quality that we can provide. >> we will continue this discussion. and going to head to the floor so i can cast my vote before the close that. thank you. >> the rest of the team will be back in a little bit. i just passed and coming back. mr. warren, did i understand correctly the you're the information technology person? >> yes, sir. i have that role. >> i'm about to demonstrate that i'm not, but i have a question

of like to get an answer to. i've been reading about the veterans benefit management system. i understand it's fully deployed now but is not operational. is that right? >> senator, it is fully deployed that was completed last june 6 months ahead of schedule. it is being used, but it is not the only means of processing a claim today. this is probably the big crossover your. we still have claims. the great work for us, they have to be able to do paper today because that is the legacy system. everyday less paper and sometime later this year we will be only digits. they have to do digits at the same time today. it is functional, but we are not totally reliant upon just that today. >> from what i read that think it's about 44 and a half million

for the continued installation of that. >> let me turn to mr. warren on that. >> the number is actually $137 million. we appreciate your support. >> here comes my question that will illustrate my ignorance probably. it said then you that you are using an agile approach in terms of the installation. you are deploying different patches and that this will take time to complete. would you tell me what kind of patches you're talking about or that they're referring to? >> agile is an approach. instead of putting all your requirements together and in many years down the road you bring capability on line, as the secretary mentioned, every 90 days we put more capability, more function in hands of the employees so that they can keep processing more.

processing every 90 days, major functionality is deployed. in between if there are things we need to adjust to tweak we had that capability in. high-frequency, high cyclically it making sure reporting capability on the grounds that the folks can drive ourselves to that of come. >> senator, if i can try to -- let me try to put it in our terms. the two ways to approach a large 90 project. a large i t project, you can wait to design the entire elephant and then try to field that whole thing at once. what sometimes happens is you will find something does not work in this large project. and then it is difficult to find it because everything is out there. the agile approach is being described, we have an idea where we want to go, but we know where we want to start.

we put a segment and, let it run for 90 days, see what hiccups. we fix that because we can find it. then we realize that we need to add more capability and do that. over time it sounds like these incremental approaches will take longer but they're actually faster which has been our experience. >> what i want to be sure of leading up to what i'm about to ask you, i had one experience with a statewide installation of a computer system. i had to fix a bad problem that was related to patches when they tried to custom make the software to be site specific rather than systems pacific. the passes were used to correct that. i take it that you or phasing in the installation of the software but it is universal. your patchy in for the universal system. >> that is the case. it is a national deployment. only rollout capability every regional office would get the capability and will be able to

use it the next day. >> you are not correcting the problem. what you're doing is phasing in an activity. >> we're adding more capability every time we bring new functions of one to the benefits >> during it the right way because i did it the wrong way in the state of georgia. you can't do that site specific stuff. you have to do it universal. >> yes, sir. >> doctor, i want to correct something that was in the record and it was reported that you inferred but i don't think probably did because i have talked to you about this before. you had a hearing in february with the house veterans' affairs committee. you stated -- it says and i am quoting, the ig report related to mismanagement did not connect deaths to mismanagement. i believe you have stated before my hearing in atlanta as well as personally to me that there was mismanagement that contributed to the suicides in atlanta. >> you're absolutely right.

i had misspoken. i was referring to the review of the contract, not the review of the care on the facility. the contract review, they did not directly connected but they did definitely connect this, activities on that board with a suicide death. >> because of what you have done on the sub wanted the record to reflect accurately what you said and i want to publicly air ignores the fact that you have come to atlanta and met personally with survivors of some of the victims of the suicides. the great service and a great sacrifice and it is very much appreciated. on this issue of suicides, one of the big questions that is being asked to my and they're is a lot of press in this. i'm sure it will be something one of these days. what -- are their contractual limits or union limits?

what kind of limits to you have to reprimand or correct for otherwise dismiss an employee for an appropriate activity, mismanagement, or contributing to the failure to deliver what it is supposed to deliver? explain to me what you have to do to discipline or reprimand or move or fire and employee? >> senator, i would say that i believe we have the tools that we need. first of all, employees, by and large -- 30 percent of us of veterans ourselves. we have familiarity with the issues veterans face. we are deeply committed to our mission. and these discussions, transparency and accountability counts when we are trying to establish and maintain trust. i would say that in 2012 we

dismissed in voluntarily removed over 3,000 employees. in 2013 we did the same thing. >> just medical service? >> this is all of va. a large part of us is the veterans' health a administration. they account for 70 or 80 percent of our workforce. we are talking about a percent of our workforce. six senior executives were also dismissed over the past two years. i think what i would also like to add here is many of these incidents were discovered by va employees, raised by them for our attention. we then, as transparently as we could did our investigation,

shared the information so others to learn from a and then set about preventing -- correcting and preventing future occurrences. an important part of this is the courage and willingness of va employees to stand up and report and in some cases on themselves of them made a mistake. that allows us to take the corrective actions we have been able to. and i for one value that. i would never want to see us lose that. so this is part of an environment of trust that we are trying to retain. it is unfortunate anytime a suicide happens. it's a terrible tragedy. any time we lose a patient under our care. the important thing is to never let it happen again or at least commit to never letting it happen again. to do that we have to find out what happened and go about correcting action and then holding people responsible

weather performance did not meet our standards. as i say, i think we have done that year over the past two years. >> i appreciate that answer. i have run over on my time. before i do, briefly, 3,000 per year have been dismissed for various different failures how long does it take from the time you initiate an action to dismiss an employee for cost? can you actually dismiss them? >> that's a good question. the burly of to just go ahead. >> it is coming to you from our reporter out of atlanta. i want to be able to have the right answer when they call me. >> let me provide you a good answer. >> senator murray. >> thank you very much. secretary, thank you for being here as well. several times you and i have

discussed my concerns about getting medical centers the resources that the need to provide top-quality care for our veterans the spokane medical center recently prepared a draft response to questions from the network about their budget and talk about the significant challenges of declining budgets, numerous staffing vacancies and leaving the network in the veterans' pensions. they said also -- and i will quote it. overall senior management is very aware of the budget shortfall and is taking actions to limit the deficit. however, most actions will significantly limit staffing levels and access to care. these actions will have, have had a significant negative impact on morale and will drive satisfaction among patients. i ask you a similar question about a similar budget problem

in indianapolis at our hearing back in 2012 budget. you tell me there was no evidence that any medical center would be unable to provide the care that we all expect. unless your view has changed, the assessment seemed to disagree. i wanted to ask you what you in the networker going to do to get the resources that they do need. >> let me turn to the doctor for details. >> senator, thank you. i am assuming that that is some employees assessment of the situation, not the senior leaders. >> it is the senior assessment. >> i am not aware of this. we do believe and the budget was distributed back in october. at that time there was a consensus of the network directors and the facility directors that they have sufficient funds. >> the questions were asked to them and they responded back.

saying very clearly, they do not have the dollars to be able to do the duties that they need. >> we will have to go back and talk with both the network. this is information that is new to me. >> okay. they're draft response also calls for a discussion about the mission of the medical center and asks if they're going to remain a full-service medical center and whether programs and services should be eliminated. that is deeply concerning to me. other plans to reduce services? >> we have no plans to do so. >> okay. well, i need you to follow-up on that and let me know what's happening that they are facing such a budget shortfall. it was clear the documents we have seen that there are facing an extreme budget shortfall. >> we will follow. >> i also wanted to ask both of you about the veterans home. as you know, i'm very concerned

about that especially because the budget request proposes reducing funding for state veterans. these veterans of been waiting a very long time for this facility. we have more than 1,000 veterans in need care. i want to ask whether the system that we currently have is correct to prioritize the state home projects character we have enough flexibility? how will we ensure that we have the funds? >> senator, you and i have discussed on numerous occasions. i share your hanks about that particular project. we are looking at whether they're is a solution that will allow us to use the 2014 money in order to accomplish that construction, what we are not finished looking at the alternatives. obviously after we have done

that and disgusted we will get back to you. >> we need to know where that is going. overall, not just that one buy all of them, how will we deal with these veterans homes? at think that as members of congress will need to know what the need is and figure out to find it rather than just being told everything is okay. finally -- and i know we have another vote, though more in afghanistan is drawing close. more and more veterans are coming home and seek care. there will be seen in the years ahead. we all have the stock that when the war is over we don't have to worry about spending. the exact opposite is true. a lot of veterans will come for the very first time. sometimes the conditions that they have are dramatically worse i am very concerned about the budget request reduction in

funding for specific health care and research. wire you proposing to reduce spending when we know that as the service numbers come home when their conditions worsen they're going to be seeking care for the first time. >> that is an excellent question . if you look at the money spent to in 2011, 12, and 13 there is a slight decline in that which is projected to continue. the specific reason for that is that we have had an almost 70 percent decline in the number of severely injured dramatic break injury patients the going in there are trauma centers. the number of people with mild and moderate has continued to increase. the cost of taking care of those people is much, much less than it is providing care for the patients that end up in our

travel program. while we're going to be taking care of more people my absolutely true, we will be doing it at less cost because we are not going to be dealing with people that are so severely injured. the second thing is that the mild to moderate patients call much of their care is of jordan and seen in the mental health budget. dahlia talking about ptsd can a depression command of the mental health conditions there is no relaxation of our concern. >> i just want to make sure we stay focused on that and if we do see that the cost is not being met that we are aware of the situation. >> yes. >> senator, and of the vote has been called and we need to get to the floor. i appreciate your time. >> we are about the same age. i will keep this going. if he runs out of gas we will adjourn the hearing. have another question we

apologize for the gymnastics. secretary, your implement -- implementation of several initiatives regarding the transformation process, mandatory overtime, veterans' benefit management system, e- benefits, can you tell us which of those initiatives have proven successful and beneficial ? >> certainly. i think i would just cap it all and say all of those have been successful. in some cases the delivery came in an earlier point. we have had more time to assess them. let me turn to the secretary for some details. >> senator, i would counter by saying the following, we implemented and the secretary has said on a staggered approach. i can tell you that many of them contributed to our record-breaking one-half million

claims production and high quality and accuracy level. i will tell you, we are a 26% ahead of where we were even last year and record-breaking levels of production. by example our working employees or 52% veterans themselves are, as you said, working overtime 20 hours a month to produce. in the month of them during alone double the production of we have put in a month of february before. we are seeing all of these different efforts producing good values for our veterans in terms of timeliness and accuracy. what, one in particular. are fully developed claim process where sense that you're have last year we have gone from 3% of claims being fully developed to over 28% to plans being fully developed. that will do nothing but add to the benefits to a veteran as we move forward. >> thank you. will turn it back over to the

chairman. >> thank you very much, senator. i apologize for not knowing. but let me go to an issue that think is on the minds of many americans and people and the veterans community. is the overall issue about mental health in general. the country above and beyond the va faces a crisis and lack of quality and affordable access to mental health can't. the several hundred thousand folks coming back, dealing with tb hire ptsd certainly is problem. can you give us an overview of how we're doing in dealing with these serious problems? and also deal with another issue of concern to all of us, the issue of suicide.

>> let me start -- then i will ask the secretary to provide some detail. start on mental-health. i would say it is a discussion we have had with you, mr. mr. chairman, and other members of the committee. frankly, we have been at war for over a decade. we have small professional formations, smaller than when i served who have carried camellia know, this responsibility for carrying on is to operational missions now for this long. and so because of the size of the force they're rotated a number of times, multiple times. we compound the issues, especially in mental health. over these five years, six budgets now we have worked and increase the mental health budget by over 60 percent because of this discussion. we will -- the best we can

provide. budging is a little bit reactive we look at what showed up in our medical facilities and then ask for resources to take care of the next population if, in fact, there has been an increase. we are working to try to anticipate what our requirements will be, trying to understand what the mental health piece of that is. with that, let me ask the doctor to address some of the details. >> i want to have, senator, with the secretary has said, this is a very important consequence of what we have seen. a small force, repeated deployments. a very recognizable number of people, perhaps 15 or 20 percent returning from that conflict

with depression, ptsd, anxiety disorders, chemical dependency, sleep disorders, things that very much have a bearing on the mental health. in 2015 we are expecting to treat about one-half million people with our specialty mental health services and spend about $7 billion on mental health services. let me go through a few of the things that have been done over the last several years. first of all, since march of 2012 be a far 2400 additional mental health clinical providers so that we now have on board over 20,000 political professionals delivering mental health services. an impact on number of things, the access measures of improved. they're not perfect or where we wanted to be. >> we heard this morning, if i can interrupt got there is still unacceptably long wait times in

certain facilities. >> and that is absolutely true. there are places where we are having difficulty with wait times, primarily because they have difficulty recruiting people into the position is that we need to my individual psychotherapy as an example is something that in some parts of the country we have to wait a long time for. however, established patients across the country, 95 percent of them are being seen for in a point within 14 days. most important to patients that are new to the viejo and knew to mental health, 90 percent of those patients are being seen within 14 days. if someone walks into an urgent care, walks into the emergency room there are seen immediately. >> you had to leave. >> thank you, mr. chairman. i want to thank you all for being here today. i very much appreciate your service. the background is always a big

thing. we will be talking about it until we get it to a park or we don't have too many more. can you give us an idea on what the shut down to it? >> say that again. >> what the government shut down did. >> frankly, the impact was less than we were concerned about, apparently because our employees went into high gear and just worked overtime anticipating that it would grow. it will solve a stable. since last year we have greatly reduce the backlog. the big concern at the end of october was a live the shut down continued we would put at risk all the benefits. we are not going to bail the cut

those checks and distribute them . >> thank you. i want to talk a little bit about the electronic medical record. you're running both right now. hal has the department of defense spend as for as making the transition? are they still -- by now we have a meeting with the chairman of appropriations about a year ago. >> the problem the defense has its own electronic health records, just as we do. >> to they interface? >> they do not interface in no way that we think is the future, but we have created a joint your, developed by our people which will reach into the database or reach into our straw poll opposing those green, either can care for patients in them those decisions reside in their respective data bases.

right now there are acquiring the next electronic health record. we are tracking with them. we have our electronic of record with the support of the congress to release some dollars that are on hold and allow us to get up to a level for. >> it would seem to me that part of the backlog has to do with two different medical records. >> it has been. we have worked to try to mitigate some of that. >> let us know what we can do to help. i think we can push. it should be seamless. i think -- >> senator, after the good work between both our staffs in january the department of defense began sending us service

treatment records electronically we are beginning to get those records electronically. >> good. just for some statistics, there's 3 million veterans, about 36 percent of those enrolled. out of the total request 567 million, i'm talking about 73 going to grow. that's about 13%. it seems like it's about a third of order should be tommy why the amounts where it is. >> let me ask for some detail. in addition we also have rural health care accounts that provide money. >> senator, providing adequate

and good health care and accessible health care to world veterans as a high priority for us, as you know. that's a large percentage of the people in this country. the tell a health program primarily serves rural america. i would -- i don't know where you got to figure. >> i have my glasses now. >> if we put all the equipment that is in our tertiary care medical facilities focused on providing consultation to more rural areas -- i would like to, if you don't mind a back and look at that. >> i would appreciate that. i would just say, i was down and sell the city and saw the booth where the folks up there were delivering servers, very impressive and that think it's got tremendous upside. i say that as somebody who was opposed fermenta of conditions. you have turned me around on it,

although i do think you have to look gobbles once in awhile. >> thank you, mr. chairman. >> thank you, senator. let me get back to the issue -- are sorry. and apologize. >> thank you, mr. chairman. mr. secretary, during the break here we had an opportunity to take a look at the funding on these projects that you mentioned. >> so have i, senator. >> to you wanted to five. >> correct the record books as i see it the new york facility is requesting 150 million. >> i believe that's correct. >> long beach, one of the 61. san diego 21. west los angeles about 300. so for a total of four under and

31 million which is not that far south of what you're getting this year. in no, i looked out there another year. recognizing that those are probably just estimates and there could be higher or lower. my suspicion is there will be higher at the end of the day. we probably won't make any progress on the list next year either. we seem to be stalling year. >> i would not say i am totally comfortable with where we are. this is something we have worked hard on for five years. i would add to the numbers that you just described. we do have this opportunity for growth and security. and we have another four and a millionaire. so if we were able to leverage that it would provide us about

2 billion construction capability. last year -- this year is just under two. as a slight increase. what i can tell you is that the facilities we have today will continue to be maintained in a safe and secure environment. even as we wait on his long-term projects. i will continue to work to try to get more leverage into our major construction account. this year major construction is about a 60% increase over the 14 enterprise. and i will seek your help and tried to do better at getting some of these projects addressed. it is long term. >> yeah. thank you, mr. chairman. >> thank you. >> thank you, mr. chairman. thank you, general. thank you to your team being

here today. thank you for your service to our nation over many years and for providing information to me. at our last meeting your staff was going to provide some of the information relating to connecticut on backlog. if they could do so i would be very appreciative. specific information and in any additional information that you feel will inform us on the trends in those backlogs' nationwide. >> are roughly have not gone those to you yet. we will add it for you today. >> thank you. you know, i want to ask about homelessness. you have made almost as a priority, ending homelessness by 2015 is one of your preeminent polls. you have a number of strategies that have been proposed for ending veterans homelessness, including the use of va had vouchers which keeps veterans in their communities.

we have a facility in rocky hill, conn. that is essentially about half an used. there are more than 450 available dormitory style beds. going to write you a letter about it because only about 250 years so of those beds are used at the moment. it is a facility that includes dormitory style living as well as individual housing, but i am troubled by the lack of usage which may well reflect the need to provide psychiatric care for residents or help, counseling, medical care for people suffering from addiction. whatever the cause, i am hopeful that the federal va, your agency

will help our state in providing this service is necessary to make sure that this the said -- facility is fully utilized. there are unused beds because of issues that really should be addressed. the partnership between our state and federal facilities, i think, is tremendously important maybe i'm not asking you the question now to secure detailed responses to what the va would do but simply number one to ask for your commitment that you will work with me and/or our state va in seeking solutions and number two that you will inform the committee more generally as to whether these kinds of issues are national in scope. just in case i have not made clear what i viewed the issue is being, it is essentially that there are physical facilities

available to provide homes to veterans who are suffering on our streets, in our alleys, under bridges. that cannot be used because of the need for services addressing addiction, psychiatric care, other kinds of issues that i obviously are complex and challenging as you and i have discussed on vacation. and of your commitment to addressing those issues. so really it is a commitment to work with me and our va officials and address the problem more broadly as you see it as a national problem. >> sure. i will make the commitment to work with you. i would say in the past two years we have created a fund called the supportive services for veterans families. it is up find that allows us to

provide grants to a variety of nonprofit, local as well as national agencies who work with us in house and almost. for the last two years we have issued about 300 million. i believe we are looking at if this budget is approved an increase in net to 500 million it is a competitive process. there's not enough to satisfy all the beds that are in, but it is handled in a way that every state gets attention. bear more than happy to work with you on this. >> i very much appreciate that. i know you are also where and the tune to the medical records and dropper ability issue. the senator asked about it. i just want to say to you on the record year as i said privately

in our meetings, if there is anything that i can do as a member of the armed services committee to speed or expedite the department of defense more positive approach on this issue, i would be more than happy to do so. i think our committee is interested in this issue, as you know. >> thank you. i will assure you that secretary hegel and i have discussed this. you know, we meet routinely. this is the topic of discussion between us. so at our level this has priority. >> thank you. my time has expired. >> let me get back to health care. two issues. i am i great believer in primary health care. one of the reasons we end up having the most expensive health care system in the world is we

don't do enough primary care. we do too much specialty care. the viejo has done a good job. we also have a whole lot of federally qualified community health centers. i have worked hard to expand those programs. i know that we have a partnership now that has been piloted, i guess with both the indian health service and federal qualified health centers. in other words, where you have a veteran who may be a distance away from the medical center or a distance away from access they can now get to a clinic. can you talk about what is going on and what you would like to see and the potential? >> thank you, mr. secretary.

chairman sanders, we have two different programs, one with the indian health service which has been very valuable in serving an incredibly needy group of veterans. that is that we will pay the indian health service to provide services. >> so walk into an indian health clinic. >> this is our paying for veterans to be cared for in the indian health service or travel clinics. not non indians. native americans. we pay the bill, they get treated in their own -- >> i see. >> that's correct. it is not program that is involved in the federally qualified health care program. we're piling contracts with 24 of those around the country to see how it works in terms of the a exchanges of money. i fully expect it will expand the program has to prove

successful. >> let me understand. native -- and native american can now go into the indian health service, and that services pay for. >> if they are a veteran, eligible veteran. >> right. and you have no pilot with a number of around the country. >> right. to care for veterans in those communities. >> this is where in near a veteran. >> that's correct. in this case they have to be enrolled with us. we made the referral to the federal clinic. >> and to use see the opportunity to expand that? >> we will be evaluating that pilot project. it looks like it is a success. we will find other places where we can expand. >> bottom line, a veteran lives near a community health center. the va would pay for the care.

>> if they were enrolled with the scent of remain there for all. >> all right. let me ask you another question. we all understand the mental health needs that have arisen. we have heard from you that you have greatly expanded the number of mental health counselors and so forth. at the end of the day -- obviously we need that could be ready to make sure that people have access to mental-health in a timely manner. but how effective are the therapies now being offered in terms of dealing with the very difficult issues of traumatic brain injury and post-traumatic stress disorder. now we making progress? >> thank you, mr. chairman. we are making progress. traumatic brain injury actually

has been quite dramatic. the secretary has frequently talked about the emerging consciousness program where people have been unconscious for three to four months and now have emerged. if you were to casually talk with them you would not know that they have ever had a significant brain injury. so the severely injured individuals, we're making progress. eros and making progress in treating the ptsd. the evidence based therapies have been shown in the literature to be successful in a amelya rating the symptoms of ptsd. but you mentioned something that is important to us to be dealing with this group of veterans in need of services so badly. how do we measure how well we're doing? how can we tell that the $7 billion you are giving is to provide care is actually

improving the health of these people? we have embarked on a series of outcome measures which will be looking at now over this year and being the talk about this time next year that measures the influence of care on the symptoms of ptsd, measure the influence of care on the depression scale administered over time. we will be looking and out comes in anxiety disorders, depression , more carefully at people who aren't risk for suicide have we actually improve the chances. >> you are telling us that you think -- >> we believe that we are having an impact on the mental health of the people we're treating. >> mr. chairman, let me just add to this. this is that tough area for us. we continue to apply. you will see that we are putting

$7 billion against mental health. we have a separate fund in line for traumatic brain injuries. if you think of to be an anti you think about our paula trauma centers for, tampa, richmond, milwaukee, palo alto, california, san antonio, texas. these are the five tier one pauley trauma centers of excellence as they began many years ago. >> in general these are for the more severe cases. >> more severe cases. and once there stabilized then there is that here too, and that think it is about 82 locations. there is even a tier three. all point for this system is as people improve the move closer to home where all to believe it

will be sustained. all of us had a chance to sit in this state of the union address recently. in closing the president introduced sergeant corey rooms for. a graduate of one of our emerging consciousness programs. 70 percent success rate in bringing patients' back from the thomas, comatose. years before people would have given up and said there is no hope. so these are people who were injured in an explosion, became unconscious, remained unconscious for months. now you're saying we're having a 70% rate at bringing people back to normal? whispering back to consciousness . they're return is overtime. we have some tremendously wonderful successes where if you

and i were having a discussion with one of our graduates we would have barred time understanding that. but there are others who are not as far along and there are various stages. >> you see the va making some significant -- >> this is a great contribution. as part of the research, although is being done in one of our trauma centers. it is research that is giving us opportunities. >> my time has expired. >> thank you. it is good to see you. we appreciate all of your hard work. and following up with that, last congress we passed a law that would guarantee veterans that they receive treatment aimed at maximizing quality of life rather than restoring function. i don't think we have really seen the implementation language of that. can you expand on that?

is great to your the stories you're telling. our concerns with these things is that we don't want to have some arbitrary cutoff date when science tells us that you have gone as far as you can go and yet we are learning things. and then we want to restore the quality of life issues rather than dysfunction. >> on going to call on the doctor for specifics. i would say that the program i just described to you is proof of your point, that we know more today than we did five years ago and theirish -- they should not be an arbitrary line drawn. in fact, it is the folks down in tampa who have tried anything and everything to try to get a response. 70 percent of the time they

succeed which is great for the rest of the country, they can benefit from the learning that has been created through this research effort. i think that -- >> and we are not -- you know, we are talking about a finite number of individuals. this is not a tremendous amount of people. it is certainly a very significant amount, but i know that i am an optometrist by training. a year or so ago some of the residents worked at a medical center and also were helping -- rotating through the veterans hospital. just individuals that had things that you really could not -- could not actually quantify as to what was going on but knew from their histories that there were different and having trouble with cognitive this and that. can you elaborate on what we're

doing to make sure that we are dealing with quality of life issues versus some arbitrary function. >> one of the pieces of evidence about our concern over store people to the quality of life there would have wanted had been not been injured, over 75 percent of the people that go through our paula trauma centers actually return home, sometimes with great effort and tremendous amounts of support, but they are back in their homes with their families getting the support services that they need in order to the be able to participate in the community. the people that i think you are referring to, those that are less severely injured have injuries but are not confined to

a bed, are not people that have spent a year and a half an impala trauma center. >> really both. it is one thing to go home with restored function as best we can it's another to go home and be somewhat integrated into society but not fully integrated or integrated. so really a little bit of both. >> and that is our aim with every single one of these patients, to provide them with capacity to do the maximum that they can and want to do in terms of integrating their life back into the society. it used to be that you were happy to get an artificial leg. that isn't true anymore. he lived in minnesota the soldier was to go out and play hockey in function. he wants to be able to play baseball. that is the kind of approach

that we are taking with all of these injured soldiers, sailors, airmen, marines that are coming to us and really wanted to get back into society in doing the things that they had always done >> we have advanced funding on the health care aspect. has that been positive or negative? how has that gone along? >> senator, we first received that advanced appropriation capability of 2012. here we are several years later. we have alarming to go through. having a one-year budget and planning and programming for one year cycle versus two, there is an adjustment. we're pretty much through that, still learning from it. ..

>> you don't know what's going on for several months can you comment but common sense to me the work force provide services anytime we can provide predictability for the sources so this makes pretty good sense i raise the issue as i did

last october there was this discussion in that case of the benefits administration we cannot process a claim within their own, and finds we have to go to use social security to validate or the irs for the threshold income requirements we deal with dot and department of education, a gi bill, labor issues, as so for me to say we can do this without the investment from other departments i would not give you the full picture. as i said in october not to lecture anyone but the best way for us to meet the fold mission is to have a budget every year that would make

our work much easier. >> i apologize for going over. >> fate you for having a second to round and being so forthright with your answers to my questions. let me begin on a local issue. with our facility in west haven is deficient in serious respects of the inspector general. so that you will work with me to seek remedies that have been documented to be forthcoming and responsive to have resources committed with the west haven facility

the next item the good news is you are not a defendant but brought against the secretary of the army and other officials is it is to veterans of the of the and not more one has suffered 40 years from pds steve -- p.t. sd for posttraumatic stress. that was the recognized at the time it died -- not diagnosed and not treated at

all those public and private with the understanding and concern with this issue changing his discharge from less than honorable to honorable is not with did your power. it is the authority of the review board of the department of defense. you mentioned after having meetings with secretary haig go with the armed services hearing i believe there is sympathetic to unsupportive i like the commitment he will raise that privately and publicly with him because there has been no general action as iraq and

afghanistan. >> we approached tod with those discussions and looking for a review of a character discharge but one thing as you point out we did not do well for my generation part of our commitment here is not to repeat it you go back three years eupepsia decision in the the day -- in the va with medically verifiable ptsd we make the connection

to allow the individual to submit a claim as well as treatment and move beyond this discussion with the burden of proof form of veteran to demonstrate how or why was an issue. we have increased awareness with ptsd and increased funding in this area. we're doing better but not enough with the current generation. going back to the vietnam generation in doing our best to make up one for lost time >> i appreciate your support on this issue.

and referred to its assets pts verses ptsd because calling it a disorder is not justified post traumatic stress i welcome you making this policy flexible to provide benefits so it cannot be supplemented by other benefits for what the va house to offer because the less than honorable discharge not to mention the stigma that they have suffered 40 years or more. i a agree it is a moral imperative but not to use

cells of lawsuits that i support for people to testify. >> i could just offered to you clearly still remains the dod issues so i know senator hagel is looking at it. to give me a list and under the rules that don't exist like "don't ask, don't tell" for example. behavior issues it could be ptsd so we have 73,000 names thus far we found a 6500 matches to pull those in to our review to provide

benefits and care and those six to 500 cases i think, as 6500 we have written 75,000 letters we will complete that shirley. those that we do not get a response by this summer we will try to follow up on that. to close the loop on those that have been denied benefits and services. >> one last comment. think you for expanding the circle. it is a mark of your leadership to increase the eligibility and enter disability claims rather

than to circle the wagons more closely to increase the availability and access i am very concerned about discrimination. particularly with the unemployment situation. but to be embodied to prepare for it discrimination i can say the odds are against any single piece of legislation with the evidence that i see indicates among a small portion with a small minority but there is

discrimination for whatever reason but perhaps i can work with you and second to to go through it. >> i apologize. >> now my feelings are hurt. i just thought you were over in the. [laughter] that to. thank you for being here. the first one is a program

passed in 2010 with a lurch to receive closer to home that efforts to a state like ours the a hospitals are a long way from veterans we address that with outpatient clinics providing routine services closer to home so with the support of many colleagues weaver's successful to pass legislation to provide services if they lived more than a certain number of miles it became a pilot

program that is in place for over three years with reports that are soon to be on your desk. you have thoughts for the department's plan for continuance? we learned a lot from project arch and put in place other initiatives with the va programs with the lessons out of large. let me call of the doctor to talk about the things we have implemented. and tried to break to those where veterans have no access to health kansas sold

what was done but it was a phenomenon we were able to provide that. but with tela health we are in the position to have special day care than maybe three or four years ago but in addition to that end anticipation with march ending we developed a new program nationwide called

the pc3 to provide specialty care. if somebody lives in a remote area not appropriate to travel so to provide care in the community when the first network was set up when business was booming so to speak with the network used all over the country. we always have the fee based care in the community particularly in places like kansas it is just not up for

free to travel 200 miles of to topeka or wichita. >> we want to continue to work with the va to expand this program although when the legislation passed va narr va which is a significantnty difference with the outcome. to bring up tele medicine but we discovered is the lack of physicians on the oklahoma border has not had a physician for more than two years. they have been recruiting

with no success. but that va recently closed emergency room services claiming a lack of physicians now that va is telling veterans that show up we have no emergency room go to the commercial hospital. the secretary and i had this conversation that he has appeared before this committee with these requests a and i understand the difficulty. i know how difficult it is outside the va but in my view as yet to have a solution to the lack of positions or other professionals in the system. this problem if we delay going to the private sector or community hospital we are exacerbating the problem to provide the necessary level

of care isn't treatment. even the hospital the size of topeka there are not enough to staff the emergency rooms. what are the other aspects? i am speaking beyond my time so i a moving quickly to other questions but one piece of laws -- legislation authored in my day requires of va that chiropractic care to meet the needs but it seems that va has been very slow to implement that there is care available but no systemic system wide effort to provide chiropractic care that could be of value in absence of other officials -- officials as it becomes critical. . . i go further the final thing i would raise with you what has happened in of

wichita there for a space has been working hard we get the project with those two facilities with the va hospital the plan is to combine those to to build a new facility. i need to look at my notes that was included in the list and i asked how to remove that up? not only has it not moved up but no longer of the of less than to to our knowledge no one can explain and why last year it was considered so how do we get to a higher ranking? now it's not. >> i owe you a better answer than the one i will give you

but every year with our priorities we're rehab a safety or security project comes up we have to do something and that will move a project for word. i will go back in research the issue with the project. my guess is is still on our list. you don't see it in the budget because the available funding covered we could cover 1.5 billion and also in the investment account. >> the project was ranked 196. not on the list. >> if it is okay. >> can i give mr. shinseki

el chance to respond on the issue of discrimination? >> you may have been interrupted without having responded. >> i will want to apologize before my friend from kansas that i apologize to him senator for keeping you longer. >> you set the precedent if you take advantage of it. >> our approach has been in did not begin with my rifle to be the unwelcoming place to take care of veterans for many generations now. and if you look at the decisions made over the last

five years it is to provide benefits that they have earned without drawing any walls around that statement. >> i am not talking about va benefits but private employers to discriminate without a reason. >> and i would say this is the area of the un discuss the ball but what i discussed with every opportunity i have with potential employers. i a assure them that when we diagnosing and treat whenever the issue but it's even with pts or ptsd people improving and they should not let a barrier to them

making a hiring decision. our veterans are very capable youngsters coming to us with tremendous experience with the work ethic and discipline we all like to see and will not revert brett making a decision i am happy to work with you with a more compelling argument spinet let me ask one last question we know as a nation recover crisis in areas of kansas beyond the va they cannot access the private care physician. we tripled the affordable care act funding for the national health service corps the president's budget

was very generous to provide forgiveness for the medical school graduates practicing in the a underserved areas. plant types of programs does the va have for scholarships or whatever it may be to attract primary-care physicians to handle the problems that the senator raised? >> mr. chairman, the va has a number of possibilities to bring people into communities retention bonuses, improvement bonuses , the buyouts they can buy out their home in rehab flexibility with some wray they are competitive inflexible. with loan forgiveness educational loans is

$60,000. that could be higher. i will be blunt. there are not many instances where you need to do that and the cost is not expensive but it could be a great incentive they are carrying $200,000 of debt coming at of medical school to have a good portion of that. >> if my memory is correct we will send you to medical school then get x number of years of your life? >> they do. we have a program that is not unlike that but the difficulty is you cannot predict where they will go. >> can't you write that into the contract? >> you don't get anybody to

sign that. dod is a military but you have flexibility. if we want to go to montana you have to write that into the contract and we cannot accomplish that right now. >> can i mention one more thing which is the use of advanced practice nurses that are very first tile and flexible and auction actually helps our patience and we have a reminder that that is you replace in kansas we have trouble interesting way. i have a full complement of providers. >> and people are shocked by liberal kansas. [laughter]

>> i did not realize you were involved with another committee. it is a huge problem. regardless where anybody is that with the health care bill where people are in the system. many providers are our aging and it is something we need to a vote that. we can work hard to make sure the of veterans have benefits promised but if you have the deal with nobody to provide that care, and maybe that is something at some point. >> that is a good idea to get the data from where we are at now. >> this is not just the va but this is something if we are short years from now.

>> exactly. >> a brief follow-up but when asked mr. shinseki when he will receive the output report to wine ashley report to see the results and i was a response to the chairman's question of the array of what we have to offer physicians it may be a long list what is it we can do? what every missing? i never had an answer that we have examined this solution to our problem that does not go way. additional pay or loan forgiveness but maybe more. so the answer is this is all

the things we have but to remind you. >> let me suggest this. and when could we received a report? >> i just asked that question and he said shortly. i assume i will have it before the sun sets today. [laughter] >> thank you for holding his feet to the fire. >> thank you to all of the panel for spending over two hours with us in these very difficult times. with that this hearing is adjourned. [inaudible conversations]

bennett the original plan building a the capital was to tear down the historic capital but the fight to ensued between politicians a of the people of florida and then there was thus saith the capital campaign when the call came not the architect's plan was to demolish the structure but the psittacine campaign to save the capital had prevailed and to the two buildings would coexist as one capitol complex the historic would be restored is now not if we save it but

what time period do we restore it to? it offered great benefits because of three branches written the of one building. the goal was to turn it into a museum as a teaching tool to come to this one site to see the supreme court, the governor's office and house and senate chambers to understand the three branches of government to work together.

>> madam secretary you were before the committee and assured us there would be no more delays in the affordable care act. we have seen eight since you gave us those assurances now with the total at 35. clearly what other delays should we expect? will you delayed the mandate for individuals or pay a tax? >> no sir. >> are you going to delay the open enrollment beyond march 31st? >> no sir. >> is a correct you don't have the authority to extend that deadline? senders of medicare and medicaid agree with that >> i have not seen their statements but there is no delay beyond march 31st. >> the question is the a lot of very clear they makes a

case only individuals were enrolled but two weeks ago in regulation you deem to individuals who have not installed so they're eligible for the tax credits so what specific provision in the affordable care act grants you that authority? >> i can get you the specifics but the authority comes from the of what that a person is eligible for the affordable care act with the exchange process and eligible for a tax credit. we have made it clear through no fault of their own they were unable to win ruled the eligibility extends through delayed enrollment. >> madam secretary the law is very plain there only available for tax credits we

go this section well. maybe. >> your experts are behind you if you would like to ask them but there is no provision there. >> i will get to you this is in writing. there is a provision if the person is eligible the eligibility and the enrollment process. >> a guarantee? i guarantee you will not be getting back to us because it is not there. you have delayed this law because it is not workable for businesses wider you delay because it is not workable for people? how is that fair? >> times our research. >> how is it fair you delayed though bob because it is not workable for businesses but not workable for families why don't they get the same treatment? >> we have not to evade the

implementation across the board. >> not across the board but large medium small businesses. >> 94% of business owners are less than 50 and of the law never applied to them. 2% of business owners are above one digit% they have one year to fill out paperwork. >> okay. according to general joseph the top commander in afghanistan, afghan security forces will deteriorate if the u.s. withdraws at the end of 2014. the remarks came during the senate armed services committee wednesday the.

>> the international security assistance force and u.s. forces in afghanistan to hear testimony on the security situation in lack . thank you, general, for your decades of great service to the nation. the committee has both held regular earrings in afghanistan over the years more than 2200 americans have given their lives and thousands more have been wounded. despite those sacrifices and despite the fact that afghanistan harbored those that attacked the nation in 2001 the recent poll shows that for the first time the plurality of americans be that sending our forces to afghanistan was a mistake. i do not share that view. more importantly, neither do the afghan people. the recent public opinion poll in afghanistan shows that a large majority belief that conditions in the country have improved over the last decade.

our troops in afghanistan working with afghan forces and the coalitions o coalition's ofr countries have taken critical steps to deny safe havens and to ensure that afghanistan does not serve as a sanctuary for terrorists seeking to harm the united states. there are a number of signs of continued progress in afghanistan. during last summer's fighting season afghan forces prevented a telegram from seizing the control of any urban center or district center and we they put this month by the independent center for naval analysis concluded that, quote, for the force that is very much still in its infancy by the afghan security sources performance last year judged on its own merits should be considered a success. and in the poll released last month by the national police.

better security. more than 8 million afghan children are in school. eight times as many as 2001. under the taliban virtually no afghan girls received an education. now, 2.6 million are in school. there were 20,000 teachers all male. today there are 200,000 teachers including 60,000 women. they are refurbished nearly 700 schools across afghanistan. maternal and infant mortality has declined traumatic way. the average afghan has a life expectancy of 62 years compared to 45 under the taliban. only 7% of afghans support a telegram return to power.

how is it a large majority of the afghan people think that conditions in afghanistan are improving when most americans do not? they rarely read about positive developments in afghanistan. instead the media focuses almost exclusively on the negative incidents depriving the american people of the sense of accomplishment that they would receive if they were provided a balanced view and as a result our troops have not received the recognition for the positive changes in afghanistan for which they and their families have sacrificed so much. the positive developments are not the whole story of course. real and daunting challenges lie ahead. the attacks will continue and be the focus of the media. the improving afghan military

has proven its willingness to fight but is still in the early stages of building peace support functions such as logistics and maintenance and air power. power. that are necessary for combat troops to do their jobs effectively. the bilateral security agreement providing protections for the troupe is the essential if even a modest number of divorces are to remain in afghanistan. president karzai has refused to sign a bilateral agreement that he negotiated and received a strong supporter of the convening. president obama decided to look beyond president karzai to the next afghan president following the elections in early april. each of the presidential candidates indicated a willingness to sign the bilateral security agreement and any of them would likely be a more reliable partner than president karzai.

much continues to be at stake for the national security and allies around the world for the regional stability and of course the afghan people. the letter by afghan parliamentarians highlighted the extraordinary changes in the past decade or afghan women. she points out that 12 years ago was prohibited. and the prohibition was enforced here ^-caret. she was nearly abandoned in earth simply because in the afghanistan of that time a female child had no future. in the post-taliban afghanistan she became a senior leader in the afghan parliament. she wrote it has been a difficult journey marked by blood and violence that we have made gains in achievement which

would not have been possible without the generous support of the international community and especially the american people. to tell the band have announced their intention to disrupt the april 5 election. the afghan people will stand up to their threats. they do it every day. only if president karzai and the government permits or perpetrate fraud, permit or perpetrate fraud whether the election failed to be credible. we mustn't lose sight of accomplishmentaccomplishment inr we will risk losing and if we don't maintain a moderate level of support in the years ahead, we also risk losing the games thagainsthat have been made at a high cost. >> i was in afghanistan in

february and i observed the same thing that you did so i won't list of those things. if there's one thing i would mention that was on my list and wasn't on yours. going through that airport there wasn't one empty gate. that is an indication you can see what's happening. there is a lot at stake right now we can't repeat the mistakes where the drawdown resulted in the security situations and increasing violence and the resurgence of the al qaeda group of terrorists. we must ensure that decisions about the mission in afghanistan after 2014 are based on the strategy and effec affect on the ground and to do that we must trust our military commanders on the ground who told me a month ago they hv