underway there. as i describe working with the indian health service, which would open a lot of processes for especially for alaska native veterans. but in the meantime, based on my visit to alaska, the alaskan native con c. >> consortium. whatever project that progresses, that we're ready to provide help to the veterans. >> do you feel that's going in the right direction, with the travel direction? >> thank you, mr. secretary,

senator begich, while we're waiting for the mou to be finished, alaska is one of two places where we are succeeding in tribal interactions, i hesitate to use the word pilot, to get specific agreements within a tribal unit. in alaska, i think it's the southeast alaskan tribal association and we are progressing in getting some arrangements with them. it wou and that we could work out the reimbursement arrangements and i think that's what we're trying to do in alaska and we have another program going on in

nevada. >> senate big 914 authorizes a waive for telehealth, telemedicine, i guess there's already 100 or so in this program. telehealth is a huge winner in a lot of ways, it actually works very successfully. we have asked that to be waived through this legislation to eliminate the co-pate. can either one of you give us a thought of supportive -- i know any time you take dollars away, but in my view, the mental health is a money maker. this is a way to solve and meld and create a solution. >> neither dr. petsel or i are familiar with that legislation. if i may, i'll provide you with

that for the record. >> the last comment if i can, if i can just add to my concern, we actually our last call was friday for someone who couldn't get through on the 1-800 call problem. we had to go through a whole revamping of the system, but our metrics that we had been measured by, that you can see -- you can see the metric of success. wait time, call time, i don't want to echo what my colleague on the side said i just anxiously want to see that. this is our number one work around the va issue, and the

second is the 1-800 is cat. this is very current and customer service is the name of the game. how to make sure these veterans have everything they need. >> i think the only solution to your issue on the it is, your whole department should be a two-year budget process, versus a one-year and a two-year. that's my opinion, that you would solve a lot of problems. >> i just have a couple of concerns, the budget request includes operational efficiencies, the rest of that you could save $1.2 million and that's been done in the past by various administrations. last year's budget request also

included operational efficiencies that were just over a billion. in the past, gao has really questioned whether or not those savings come about. if they don't come about, how are you planning for the risk? what's your contingency plan if we don't see a billion dollars in savings. >> instead of paying the rates we were charged previously, 2 hung million in improper payments because we reduced

those. through the program management accountability program office and it, about $200 million in savings because we terminated projects that were not going to deliver. and then about another $100 million, first notice of death on which we stopped payment on veterans accounts when they transpir transpired. in the past this has been an issue, sometimes as much as $100 million in overpayments. and for the future, we are agreed to provide, as a minimum, $173 million in savings. cost of reducing waste in 2012 and 2013. so that's part of our effort to get at the savings and

efficiencies. and i'll let dr. pitsel add more detail. >> the savings, let's just get a little bit of what went on, we saved a large amount of money, the gao revieweded that and we're still actually negotiating with them about what they actually found. the essence is going to bea we indeed can validate the savings we have claimed from the various operational efficiencies. they do have a general criticism about the way they measure things. for 2013, as the secretary mentioned, we are going to save a large amount of money in dialysis, we have got blanket purchase agreements of every dialysis that they use that is going to save us hundreds of

thousands. charge medical rates for both the professional fee and the facility fee is going to save us about $800,000 and that's money we know we would have spend otherwise, and the efficiencies with v care, it's going to be over $200 million. acquisition fees, about $375 million in savings, it's a long list, and i'm not going to go through them, but i'm convinced that we can save money on vha. >> i have cautioned us that in the end we have to focus on what makes sense for veterans and i'll use dial cyst for example, we're after the best prices we can get. and if you just look at that, you may be encouraged to

outsource all of it. i have argued that dialysis is something we have to retain a handle on. we should do a certain amount, a certain portion of it in-house. why do i say that? i'm just concerned that if we provide funds and let somebody take care of dialysis, we ignore what a medical profession is supposed to do, and that is, as long as we're doing dialysis, we have to ask ourselves, what causes it, we need to do our best in preventing diabetes -- the medical profession is the best at asking those questions and that's why i think, within va, we need to retain a piece of that operation. >> the president's proposed a

billion dollars in funding for the president's veteran's core. >> we know what needs to be done in the parks and the infrastructure, i happened to be the ranking chairman of economic opportunity on the house side. we visited with lots of veterans about their dreams and aspirations and i have a lot of concern about spending a billion dollars in that direction. that is not kind of the direction we were going in the committee, i don't believe. and like i said, i have visited with lots of veterans and i really don't know, a billion dollars is a lot of money, i think that could be put to good use, but for myself, i don't believe that's the direction that we need. i have never heard a veteran

express to me that that's the route they would like to go. so i thank you very much in this regard. >> we have another panel that needs to present today, we want to give them sufficient time and i've been called to the capitol, so i'm going to submit the rest of my questions for the record. and did you have any more comments before the secretary leaves? >> madam chairman, i am going to get a list of questions together. these are disturbing trends as we analyze the prior year, they took in 400,000 more claims than were decided. appeal that is resulted in a decision, took 1023 days to come

to fruition, that's disturbing. in that same time frame, human resources administration increased 80%. for visions created in 1995, we envisioned 22 visits, a total of 154 to 200 employees and an annual cost of $335 million we now -- many of my questions been lot that. again, i thank you. >> may i respond, madam

chairman? >> yes. >> i would be happy to give you that information. we have added 800,000 veterans to our enrollment. the va headquarters is 1% of our budget today as it was in 2008. and it's a reflection of accommodating that growth and i'll be happy to provide the details. >> thank you very much for accommodating our committee today. we appreciate that and we ask that you answer the questions that will be submitted to you and members of this committee in a timely fashion. i would like our second panel to come forward. i'll introduce the panel and i'll be turning the gavel over

in a very bipartisan way to senator burke. not so you get practice, only to let you do this today. i appreciate your accommodating me with this. if we could keep the room quiet as everyone trades chairs her because i would like to introduce the panel as they're coming up. we're going to be moving now to our second panel and they have come up and join us and are seated in the appropriate places. i want to -- again, if we could have it quiet in the room.

i want to extend a very, very warm welcome to a friend of mine from washington, bill schrier. mr. schrier is the national commander. thank you for the treous work you do and for participating on this panel today to bring a local perspective that's important for all of us to hear. tim tesz is the director for the national commission on -- the independent budget, carl blake, the national legislative director of paralyzed veterans of america, jeffly hall, the assistant secretary of -- diane -- ray man kelly, legislative committee for

veterans for the foreign wars. we're going to begin with mr. schrier and then move down the table in order. the independent budget witnesses will have 15 minutes total and the iraq and afghanistan witnesses will have five minutes. i know that i and my staff will be looking over your testimony and we'll be submitting questions as well. i especially want to than the senator for his accommodating the schedule as well. with that, again, mr. schrier. we'll begin with you. >> i would like to thank you for the -- the nation's largest patriotic wartime veterans service organization and about

the projects and about the president's proposed budget. america ask great with an increase in budget to deal with the needs of our nation's veteran. as those who have bore the weight of the war. we find like minded allies who recognize the importance and even duty to be sure that we're keeping the promise to america's veterans, you know the importance of keeping the promise to the veterans. the american legion also knows how hard it is for this committee to have fought the va and the hard work on the -- not

lost the narrow implementation. we're here today because you have shown a willingness to listen and the fight to make sure that we keep this end of the promise. the department of veterans affairs is dedicated to ensuring veterans get -- it's a positive step forward for our veterans. the american legion remains concerned that there are areas where a lack of foresight or faulty plans may lead the va to have -- while we're pleased to see the needed projects like the mental health services in seattle going forward, when viewed as a whole, the strategic

capital investment planning provides the va -- the american lee june was concerned that under the current budget figures, it would take close to 40 years for the needs of a ten-year plan to be met. we have all heard recently in the investment of infrastructure, these are the kinds of bills that you pay for now or pay for later. when you're ginobi ee're given in the front, you get the short end in the back. we cannot condone veterans to be placed in agent facilities that cannot immediate their most basic of needs.

the american lee june fears that these will not bear fruit in the real world of 2013. setting aside concerns that the oig found in the project while the cost cutting for va, the proposed increases in the building amounts, va's new budget opposes to provide insurance at the current provider rate, rather than the new medicare rate. this changed billing repts 90% of proposed increase in this area of the budget. frankly this has never been authorized before and even if it were authorized--when this fails

to meet the necessary revenue, we will have to find it elsewhere in the budget and that means more broken promises to our veterans. as a whole we -- surely this committee's aware of the pessimism of the american people regarding the ability of congress to come to terms and pass a complete budget. while we acknowledge that many work tirelessly to break these budget dead locks and surely share the frustrations. while advanced appropriations offers relief, there's still projects that linger waiting for start dates, waiting for approval. the operating budget that the government uses month to month. whether -- va planners need a

stable environment to ensure seamless benefits for the people they serve. chairman murray, that concludes my report and since we won't be taking questions right now, again, thank you and you senator byrd for allowing me to be here. >> madam chairman, on behalf of the co-authors of the independent budget is pleased to be here today to -- the advanced appropriations for fiscal 2014. in the interest of time, i'll limit my comments to particular concerns. first let me say up front, we certainly -- budget request. that being said, we have real

concerns as addressed also by the committee here about the impact that sequestration may have. we find it absurd that six months after the brought control act was passed, we still do not know if va health programs a are -- with regard to specific issues in the budget request. we echo the -- existed in recent years in determining the estimates for that. we also agree with the concerns that were raised by perceived management and the programs and the efficiencies, whether those savings are ralesing the impact. probably the largest or single biggest concern that we have, however, is with a particular disclosure in the president's budget that outlines what they

have said is approximately $3 billion excess in resources that were provided for fiscal year 2012. and about $2 billion worth of resources in 2013. this begs for the question, how can the administration say they have 3 million dlrsz for increases in this fiscal year. you know, we all hear the stories about shortages in staffing and those questions that were raised earlier and all those different things and it just sort of boggles the mind that we suddenly have these excess resources, we're not talking about a small amount of money, we're talking about 5% of the va budget. particularly in light of the fact that the budget could face a cut of 2%. so we need to really investigate this and get to the bottom of this. this can pose the biggest problem of assuring veterans to

their benefits. in regards to the increase in medical support and come compliance, i would suggest the fact that it's a pretty substantial growth -- at the same time, advanced appropriations provides for a very substantial decrease in medical facilities, while i understand that's based on the fact that they will transfer money from medical -- to medical services. i think given a lot of discussion in recent years about the impact of funding the nonrecurring maintenance and the effect it was having on va facilities, the committee should certainly be interested in

looking into that as well. >> on behalf of the disabled american veterans and as co-author of the independent members to offer our views and recommendations regarding the fiscal budget for 2013 as it relates to veteran's benefits administration. as you know, we're now in our third year of bbas latest efforts to turn the outdated manual system into a computer system. those the only way to get the

back lookings under control. in collaboration with bso stake holders, we urge this committee to provide con stand and direct oversight for -- perhaps the most important initiative is the benefits management system or bbms which is scheduled to begin it's rollout nationally in june of this year, with final completion in late 2013. so as bba works to deplete, defect and deploy. it's absolutely crucial that sufficient resources are provided. the budget for bbms drops down from $148 million in fiscal year 12 to $220 million for fiscal 13. we cannot emphasize the funding for bms.

we hope this committee will examine whether that level of function is sufficient also. the iv for fiscal year 2013 maintains staffing levels even the large increase in claims processors in the last three years, we believe bba should be focusing its emphasis on new and retention of employees to eng sure claims are done right the first time. we know that the vocational and rehabilitation and proposed budget for 2013 does approve funding for approximately 150 new counselors, and the vets success on campus program. we fully support both of increases in rehab. they will need 195 additional

counti counselors in 2013. although the -- adopted budget for fiscal year 2012 only supports 532 and for fiscal year 2013, the budget request would further reduce that number by $527 million. -- authorized workforce of in fiscal year 2013 of at least 585 full tim employee equivalents and we call on congress to enact lettingation that will finally end the national prohibition for all disabled veterans, and will offer -- the depend didn'ts and compensation for -- this concludes my statement, i'll be