the gap of the funding need and the funding requests from the congress. in addition to this budget request proposes a series of initiatives intended to save money including better controls on contract health care and better strategies for contracting. i'm pleased to see the v.a. recognizes the importance of efficiency but i have concerns with those proposals. a report released showed many initiatives and initiatives from last year's budget did not generate the savings that the v.a. predicted. i will review each of the initiatives in this budget with an open mind but our first priority and obligation must be to ensure that we are fulfilling and honoring our commitment to the veterans. if the va fails for the cost elements. medical care collections is anotherñoño area where v.a. has do a better job of predicting

targets and collecting funds. it is 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 the v.a. witnesses acknowledged they may, in fact, need more resources to meet the high demand for mental health care. i want a straightforward answer from the v.a. about their actual needs and whether the department's proposed 5% increase is enough. i asked for a survey which revealed significant shortcomings. the v.a. cannot stop with what was outlined in the initial plan. it must continue to work to find ways to make real and substantial improvements. this year we will continue to be aggressive in our oversight of health care. not every veteran will be effected by invisible wounds but when the veteran has the courage to ask for help v.a. must be

there every time with timely access to care but the right type of care. challenges like ptsd or depression are natural responses to some of the most stressful experiences a person can have and we will do everything possible to ensure that those effected by the illnesses can get the help. like chairman miller and others i remain concerned about the questions surrounding the effects of sequestration on health care. the established sequestration i made it clear that including v.a. among those agencies that would receive automatic cuts is unacceptable and made clear that this should not be the case. although i'm confident that all veterans programs including health care will be protected in the 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 can't be provided today i will

continue to work to get it. i asked the government accountability office to provide a formal legal opinion. as you well know budgets are a reflection of our values and thanks to your work this budget request demonstrates a strong commitment to our veterans. while we are in the position to make sure the v.a. has the increased funding it needs we have to be mindful the demand for services will continue to increase. i look forward to working with my colleagues on this committee and on the budget and propriations committee to make sure that we keep this long term commitment. i thank all of you for being here today and my committee members. with that i will turn to my ranking member for his opening statement. >> thank you madam chairman. welcome to your leadership team

as well as welcome to the veteran service organization here this morning. we are here today to review the president's budgett request for the department of veterans affairs for fiscal year 2013 which includes an increase in spending. 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 deserved without hassles or delays but we also need to analyze the budget request to be sure we spend the taxpayer's money wisely and more importantly 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. the budget for mental health care includes an advanced appropriations request. if adopted it will represent a 4% increase and a 66% increase over the '08 level. at hearings last year the committee heard about the devastation struggles some veterans face when trying to get mental health treatment they need from the v.a. in fact v.a.'s survey of mental health survivals last year was clear on the problem. 70% indicated they did not have enough mental health staff to meet the current demand for care. 35% say lack of offhour appointmenticize a barrier to

car. 38% said it took 40 days or more for a veteran to be seen for a specialty appointment. clearly this is an instance where increased funding has not translated to better services for veterans. today i hope we'll get a better understanding of how v.a. plans to address these issues, how the requested funding would be used and whether it may be time for v.a. to start looking outside the box to find solutions to the barriers veterans face in assessing this needed care. another area of concern is the back log of disability claims. pretty common discussion we have in this committee. this budget requests the 41% increase in staff since 2008. but let's look at what has 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 has trended down and is below 84%. according to one performance measure there has been a 16% decline in the number of claims completed annually by employees. the appeals resolution time is increased from 645 days to 747 days and v.a. decided hundreds of thousands less claims than it received. with statistics like these it must be a priority to ensure the initiatives v.a. is pursuing to get the situation under control will actually be effective so that veterans, their families and sirrurvivors receive qualit timely visits. the proposal to spend $1 billion over five years over veterans

jobs corps programs. while i believe it is important that we help our veterans find meaningful work i'm interested to learn how v.a. would suggest paying for this program and about how it would be structured. so i hope that v.a. will be able to provide us with more details about the program today. the final item i want to highlight before i turn it back to you is the continued increase in staff at the v.a. central office. and quite honestly at the level. for example, since fiscal year '08 the staff of the v.a. 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 head quarters has increased by 52% between '08 and '11. i think we need to ask serious

questions about whether this increase in staffing directly benefits our nation's veterans, whether these employees are essential to delivering service to the veterans who use the system and whether any of the fund could be put to better use. the bottom line is that particularly in this time of record debt and deficits we need to ensure that when we spend the limited money that we have we do it wisely and that we make certain that the veterans are the ones that receive the benefits and services that had been earned and deserved. the trend lines are troubling to me. they should be troubling to this committee and should be troubling to the v.a. i'll focus much of my attention on those today and questions to the secretary and to his leadership team. i thank the chair. >> thank you. we'll turn to senators for opening remarks and order of

appearance. >> thank you very much madam chairman. and i want to say aloha to secretary and his leadership staff at v.a. i want to thank all of you for your service to the veterans and, of course, to our country. i don't need to tell you what you have been hearing that secretary and the leadership staff has been improving the services because claims have dropped and that's an indication. the care and treatment which is our duty to provide to 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 v.a. was $13 billion above last year. i know we have budget ary constraints. you have planned and have been moving along and progressed about meeting those needs. i am glad to see increases in the budget requests for mental health, suicide prevention and iraq and afghanistan veterans programs. i am also encouraged by major increases in funding for homeless vets and women vets

programs. while budget increases provide opportunities we all know that these 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 more veterans come home to their families va's capacity to treat veterans is sure to be tested even more. we have talked about this and i know that you are doing all you can to prepare for the anticipated growth and number of veterans seeking v.a. services. secretary, i am also very pleased to see that an important

project for hawaii's veterans which have championed for years is in the budget, a much needed care facility that would alleviate some of the overcrowding at the medical center at the hospital. this proposed lease will certainly help to meet the needs of our veterans in hawaii. and mr. secretary i have been impressed with all that you and your team has 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 and most certainly deserved. so i look forward to hearing your testimony today, mr. secretary, and continuing to work with my colleagues and v.a. to help provide the best care we can to our veterans and their families. thank you very much madam chairman. >> thank you very much. madam chair and ranking member burr thanks for holding the hearing, very, very important hearing. let me offer an observation, mr. secretary. first of all, i want to say thank you for stopping my by office a week or ten days ago.

as you know over the past few years while i have been here and you have been in your position we have had an opportunity to meet on a number of occasions. and i have always appreciated that. i come away from those meetings absolutely convinced that you and your team have the best interest of vets in your heart and you're trying to do everything you can to deal with all of the problems that we are going to mention today. but one of the things that we have found in working with vets in my senate office and it is 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 offices working on the veterans case load than any other case load that we work on. so it is just part of what we have to do. i think you have great perspective on what the veterans need and you're always willing to bring that to the floor. i have been in your position before and the complexities of what you are doing are enormous. so i want to start out on a positive note and just tell you i think your heart is in the right direction but i do think as we look at the metrics and the progress we're making it is important to see what is working and what is not working and just simply acknowledge that and try to figure out is there something

we are 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 v.a. hospital that was built decades ago not withstanding the kind of heroic efforts of the staff there and the doctors and nurses and administrative personnel. it is just a very, very difficult situation. we are very pleased that we are on the priority list and we are making our way to a point at which where we hope we can solve that problem and replace the facility. i think today we are like 18th if i'm not mistaken. so i'm aware of the fact that it just does take a while. we are hoping to work with you and your staff, maybe there are things we can do, there is a

serious parking problem. it is right in the middle of omaha. so maybe there are 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 you are doing 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 of education benefits. i don't know what we're doing with education benefits but at least from our experience something is working. whatever model if that can somehow be transferred to the disability claims and i appreciate they are much more

complicated but that seems to be working. and you have had to ramp that up pretty significantly. so i'm hoping i can hear some thoughts on maybe there are ideas that would work in other areas of the v.a. system. we are also hearing veterans express to us that the expanded access to information via the e-benefits system is something that they appreciate. they feel good about. i think all of us have been optimistic and hopeful -- maybe that is a better way of putting it -- hopeful that that benefit system would pay dividends. we think it is. we think veterans are getting more use to that it is paying dividends and hopefully saving some staff time because people can get information or whatever they are needing there.

i'll just wrap up and again thank you madam chair. i appreciate the opportunity to be 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. chairwoman murray, i appreciate your leadership on veterans issues. thank you, secretary shinseki and all of you who dedicate a big part of your lives. it's nice to see you again. thank you for coming to ohio, those of you that have, and the services you provide for veterans in my state and for all of us. it's a good budget. it shows a strong commitment to veterans i think. when you look at what the advanced appropriations mark is, 140 billion, with the 13 -- the request with the advanced appropriations with the $13 billion increase, it's saying the right thing and doing the right thing for people who clearly have earned it. it reflects the understanding we

have of service to country. i applaud the d.a. for its 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 12 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 the same as a bum knee in cincinnati. and the backlog in disability ratings in many ways related. fixing both at the same time makes sense. and i know your commitment to wanting to do that. and we expect to see results as we move forward.

i'm aware, too, of the funds in this budget to train outreach coordinators and operate targeted clinics and provide other services specific to -- to particularly 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 ohio, of appalachia, ohio, one in 2007, one in 2010. 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, cbocs in ohio, speak to your commitment to going everywhere to reach veterans, not just in the va centers in cincinnati and chillicothe and cleveland.

but well beyond that. i'm appreciative of that. but the outreach efforts obviously need to be stepped up, targeted. 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 the work often is subpar. often the costs are significantly greater as we learned 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. you go places without sourcing that does not lead to good government. i think we also -- i think many contractors lack the dedicated service mentality, if you will,

of career civil servants, and it's always popular to beat up state and federal employees. we've gone through that politically in state after state after state in this country and the federal government. but i like the idea, i think an individual's motivation to serve our veterans as a career leads to better service. contrasted sometimes to services provided by companies that are motivated by profits. and some of the most dedicated people 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 simply can't be viewed as simply

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 on fixing the other problems at dayton. but where laundry was outsourced workers tell me it sometimes doesn't come back clean. i mean, what's the point of outsourcing if that happens? if the va continues to outsource more and more activities, at some point are we going to reach a point where the va's health insurance provider rather than a health care provider? and we never should get close to that line. on a lighter note, thank you earlier this week, i guess today's wednesday. on monday was the first day. and i was lucky enough to be there at the parma

community-based outpatient clinic. when the va for reasons that i -- with which i disagreed but probably needed to do shut down the va hospital in rexville. part of the deal was that they would put this cboc 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 want to hear the testimony of the folks. so i'll be very brief. i agree with senator burr on the job and the fact you're going to be spending a lot of money. also important we 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, see what sticks. and i want to make sure that we do it efficiently, we don't just keep throwing money out there, but actually we have programs. if they're working let's improve them. if not let's get rid of them. concerns still -- bless you, bless you, bless you. and 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. it helps we're in the same building.

and we've had some great success. and i've made that public in our veterans hearing that we've had in this very issue. and i know the big elephant in the room is the 1 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 va d.o.d. mission to make sure we don't just have a million new veterans come in, 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 just in so deep we can't get out. so i'll just stop with that. i look forward to hearing the testimony. i am going to be going to the floor, madam chair. i have to speak. but then i'll be back. thank you. >> senator isakson. >> i do will be very brief because i'm anxious to hear from both of you. secretary, thank you for taking the time to come to my office two weeks ago. second, i have two pieces of good news. one's on the jobs front. you probably have heard about this. but if you haven't, i wanted to make you aware. louis jordan, who is the founder of valujet and airtran, which is now southwest, 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 trains 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. if he finds a job he likes but he's not qualified, 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. second is i want to compliment director goldman at the dublin va. i spent a day in dublin, georgia last week. he serves a third of the state, 51 counties. and he is trying to partner with the general -- the commander of robbins air force base to merge the va clinics in perry, georgia and macon, georgia with the base d.o.d. health care on the base to utilize the facility's advantage of having all the imaging equipment and everything

on the active duty base and not have to have redundant cost and staff at two other clinics, which i think is a great idea to make better health care available but also at a lower cost to the veterans administration and the taxpayers. i wanted to bring those two pieces of good news to your attention. thank you for what you do, and thank you for being here. >> thank you. and senator boozman. >> thank you, madam chair. and again, very quickly, i just want to thank the secretary for being here. and the team that he's assembled for your hard work. senator brown mentioned 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. so we really do appreciate it very, very much. the other thing i would say is senator isakson mentioned, i do appreciate the fact that you're very willing to work in congress and very approachable, you and your staff. so that's something that is