their constituents can find a home. you have to walk and chew gum at the same time. >> she has a plane to catch and i do not know how she is going to get it in 45 minutes. i apologize to our audience. we will have to have you back. >> thank you so much. thank you for coming. >> thank you all. [captions copyright national cable satellite corp. 2014] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] >> on the next "washington journal," look at the history of the lame duck session and what might get passed before the

114th congress begins in january. then american legion executive director discusses veterans' issues including employment and access to health care. vice president biden will participate in the annual replaying ceremony today at the tomb of the unknown at arlington national cemetery. we'll have that live at 11:00 a.m. eastern on c-span. later in the day, arizona nator john mccain who served in conflicts ranging from the revolutionary war to the wars in iraq and afghanistan. t's a topic of his new book.

veterans' affair secretary roble mcdonald yesterday announced the creation of a new customer service organization led by a chief customer service officer who would report directly to him. after ward, he spoke to reporters about some of the challenges facing the v.a. this one hour forum was hosted by the christian science monitor. >> good morning, thanks for coming. our guest this morning is robert mcdonald. this is his first visit with our group and we thank him for aking time in his busy reveterans' day.

he later earned an m.b.a. from the university of utah. he spent five years in the army serving as an airborn ranger attaining the rank of captain before joining the proctor and gamble company. during his 33 years, our guest roast to a variety of increasingly responsible positions, working in canada, the phil peterson, japan and belgium before becoming the firm's chairman president and c.e.o. in 2007. in addition to his p & g management appearance, our guest served on the board of zee rocks and u.s. steel. he left them in 2013 and was confirmed by a vote of 97-0 as secretary of veterans' affair of july of this year. please no live blogging or tweeting, in short, no filing of any kind while the breakfast is underway to give us time to

actually listen to what our guests says. there's no embargo when the session ends. to help you resist that urge we will email several pictures of the session to all reporters here as soon as the breakfast ends. the v.a. tells me that they will distribute a transcript of the breakfast later today. as regular attend yis know, if you would like to ask a question, send me a subtle, nonthreatening signal, raised eyebrow, hand wave and i'll happily call on one and all in the time we have available. let me note that i'm a veteran and have two sons in the military. no one in the cook clan is collecting veterans' benefit. with that cleansing disclosure behind us we'll start off by offering our guest the opportunity to make some opening comments then we'll move to questions around the table. >> my pleasure. please call me bob. i'm encouraging everyone at veterans' affairs to do that.

and please feel free to enter into the discussion after i conclude my remarks, i look forward to our discussion this morning. since being sworn in and getting confirmed and being sworn in, we have embarked on something we call the road to veterans' day, which is our first 90 day plan. actually today is my 100th day since swearing in. in those 100 days i've been to 21 different cities. i visited over 41 different vfrlt a. facilities. we did that strategically, meaning i visited every kind of facility center, i've spoken at 11 different medical schools, and with 11 different deans of medical schools in an attempt to recruit the health care professionals that we need. i've met with every veteran service organization, i've spoken to most of their national conventions, a few my ised because of the timing of my

confirmation. i've spoken with members of congress before i was confirmed, i spoke with 67 i think it was senators. all of this was designed to depather as much information as i could possibly get as to what that road to veterans' day plan should look like. that 90 day plan is focused first and foremost on rebuilding trust. that is the first stratdepi of that plan. we know that trust has been compromised with the v.a., and we know that we're going to have to earn back that trust one veteran at a time. at v.a. i think our mission is very clear. it's to care for the veterans of this country. they are our customers, and everything we do should be looked at through the lens of the veterans. we also have another responsibility, which is to make sure we are good share holders,

good users of taxpayer money. so we balance those two, we balance caring for veterans and making sure we're good stewards of shareholder money and trust. our values i think are the right values. many of us now have started wearing these pins with the acronym i care. that's an acronym that not only can notes how we care about our veterans but also is an acronym that represents the different values of the organization. i stands for integrity, c is for commitment, a is for advocacy for our veterans. r is for respect for our veterans and for each ore. and e is for excellence. the kind of program, kind of health care kind of benefits that we wanted to provide. not surprisingly with what had happened in the past that created the crisis, the first thing i did was i asked every leader in our organization to

meet with and talk about our values and our mission and recommit themselves to their value and that mission. i asked for a report back from all of our leaders. i felt it was fundamentally important to start there, and every year on the day that v.a. was started we are going to have an annual exercise of discussing our values, discussing our mission, and talking about various scenarios where people have either positively exercised those values in the behavior on the job, or negatively done so and we're going to make sure everybody understands what the expectation is. relative to changing the culture, a lot of the culture is about accountability, and i know there's been a lot written about this. you can imagine that if you're in my chair, dave talked about the number of leadership

opportunities i've had around the world. changing culture is one of the most important things a leader can do, particularly coming out of a crisis situation. it's obviously in my best interest to move as quickly and as aggressively as possible in changing that culture. and one of the ways you do that is you hold people accountable for their behaviors, particularly when those behaviors violate the value of the organization. right now we have over 40 disciplinary actions in process with senior leaders. and we have over a hundred investigations going on within the v.a. by the sbector general, by the department of justice, by the f.b.i. when they're complete, we will take aggressive disciplinary action. there's been much written recently about the priority of

various investigations. you know, we need to wait for the f.b.i. to complete their investigations before we can act. he disciplinary action we take is administrative not criminal. and the criminal action needs to be concluded first. the easiest way to mess up a situation is to have multiple people investigating at the same time. so, we're waiting, we're eager to get the files back, and they're coming back every single day. we just got one this week from the f.b.i., from the department of justice. when they feel they cannot prosecute an individual based on criminal behavior, then we do the disciplinary behavior which is the next order of behavior. we're doing it aggressively and we're doing it consistent with the law. at the same time, we've worked with the office of special counsel under their whistle

blower protection certification program to certify the department and we're making sure that all employees know in the department that we want every employee to be critical of our operation, and we're also forming teams of employees for critical, repeatable processing in the operation to help us improve those. so, we actually want our employees to be critical, and we value the feedback that we've gotten from whistle blowers. when i go out on these 41 plus visits, one of the things i do is i meet with whistleblowers individually and collectively, i also meet with union leaders. i want an exclusive organization and i want people working to help improve our operations from the lowest levels to the highest level. we worked closely with the office of special counsel to resolve the whistleblower situations that we have.

there were three individuals in particular from the phoenix situation where they all have new jobs, good jobs and we're making progress. but again, it's important that every employee understand that they have a responsibility to the organization and to our veterans to improve our operation every single day. you can't do that if you're not critical. a road to veterans' day focused on accelerating access to care as well. that was the second strategy. i want to thank my west point classmate and one of my dear friends, sierra leone gibson, our acting secretary for a number of months for the work he did, to lay down the payment on the early part of that road. under that leadership we began the surge resources to places where resources were needed, to get people off the wait list, to drive down the disability claim back log and to reduce homelessness. i heard in facilities all over

the country about how we had expended clinic hours. we had on the weekends, in the evening. we have mobile units that have been brought to various locations like phoenix. we've hired more doctors, we've hired more nurses in order to be ble to extend those hours. we've asked people to work overtime and these results have been effective in getting people off a wait list and in the clinics. the part of the program where i'm rude and say if you could do like another minute or two then we can do questions because -- if they don't get to questions they'll march on me with torches and it's really ugly. > v.a. has scheduled more than 1.2 million appointments in the last two months over the same period a year ago, in total medical centers are scheduled over 19 million veteran appointments. we've thorsed 1.1 million nonv.a. care, that's a 47%

increase versus a year ago of people going to private sector. we've reduced the new patient primary care wait time by 18%. we've completed 98% of employments within 30 days of the desired time, and in phoenix, which was the first place i visited, wait times are own 37%. we are also undertaking the biggest reorganization of the v.a. in our history. we're calling it my v.a. and we can talk more about that in the question and answer period since david is pushing me forward. we're also busy working on the implementation of the new veteran's access choice and the accountability act. that is underway. we are working very hard, yesterday we began sending out cards to veterans who exceed the 40 mile limit from a v.a. facility, so that those

individuals can get service, if they choose to, from primary care. another big strategy in the road to veterans day was the blueprint for excellence. it's a new strategic frame work we've put together for the veterans health administration. the former undersecretary of health and the interim secretary of health have both led that effort. it lays out the strategies for regaining a preeminent position, not only as the largest health care system in the country, but the best. as i talked, i've been to universities to recruit doctors and nurses and we're moving forward with that. we've reduced the claims back log and veterans benefit administration by 60%. we've reduced veterans homelessness by 33%. we're going to facilities and identifying best practices and moving those best practices around. one of our key strategies to do that is employs lean six sigma

which is a very obvious technology that's been used in business, not quite as obvious as health care systems in this country. in our national cemetery administration which is the third one of our administration, you have health, benefits, national cemetery. we have an organization that already works quite well. this organization is rated at the top by the american customer satisfaction index. even higher than companies like lexus and google. and we want to take their learnings and expand them across the department. what encourages me about the future moving forward are the mployees that we have. the vast number have worked very hard. i've met the researchers who helped create the shingles virus vaccine. i've met the researchers who are won noble prize winners, other award winners. we've got tremendous capability

within the v.a. and it's a matter of providing the leadership i think we need in order to get us back up to where we need to be. the single metric we're going to use to define success is the satisfaction of our veterans. our customers. how's that david? >> that was good, thank you sir. >> you're welcome. >> the road map is that i'm going to ask just one and we will go to michelle from fox, connor o'brian, mark from the examiner, curt from cnn, josh from the post, ana from the monitor. you've had vast experience in management, but it's a vast hallenge, 150 hospitals, 820 clinics, 317,000 employees.

is this the toughest management challenge you've ever faced? >> it's a tough management challenge, but it's different than the other ones i've faced before. it's tough in the size. as you mentioned, 340,000 employees, that's about three times the size of p & gmp. the largest health care system in the world, health care is a very difficult business, i've been in the health care business before, not in the hospital area, but in product. people die in hospitals. it's unfortunate, but people die in hospitals and adverse outcomes occasionally happen in hospitals. it makes it a very tough business because like they would tell you, you want zero defects. you want everything to go right. when you couple the size with the potential for catastrophic outcomes, that makes it difficult. the one positive thing i would say is that this is a lot different than what i had to do

at proctor and gambel because i'm doing it in english. when you have to do it in japan and you have to do it -- [ speaking foreign language] when you do it in english it's a little bit easier than trying to do it in a different culture, in a different language. but cultural change is a similar initiative. so that would be the way i would describe it. the putty, one of the beauties of it is we had five billion consumers we serve every day, at least on any given day, five being consumers in the world use at least one proctor and gambel product. here i've got 22 million veterans i serve and nine million that use our health care system. so, focus on laser like focus on

customer service. >> michelle in english? >> in english, ok. they've been very critical of the v.a. for failing to react quickly to remove top v.a. officials who were responsible for mismanagement. despite granting greater authority to fire ex tiffs, what are you doing to pull v.a. workers involved in the scandal accountable and will others be fired? >> yeah, as i said michelle, we are moving as aggressively as possible. by the law. by the law. the important thing that i've got to look at, and believe me, i've been involved in disciplinary actions all over the world. one of the things we've got to look at is we've got to make sure whatever action we take sticks. sticks, is fair, that it's fixed and that on appeal, we are successful. let's look at the new power i

was granted. the new power i was granted is the appeal time for a senior executive service employee of the v.a. has been reduced in half. that's the only change in the law. what does that mean? well, senior executive service are less than 1% of all v.a. employees. and, the only change is the appeal time. so, the law didn't grant any kind of new power that would suddenly give me the ability to walk into a room and simply fire people. i wouldn't do that anyway. our constitution provides for due process and we are following the due process. as i said, the f.b.i. is involved in my of these investigations, the department of justice, and the inspector

general. and as all of that material is created, it is passed onto us, if they decide not to do criminal prosecution. iminal prosecution has the priority, and then the administrative disciplinary action follows. >> can i do a quick follow up to that? the "wall street journal" quoted the head of house on the commit tear of veteran affairs jeff miller saying the department appears to be giving failing executives an opportunity to quit, retire or find new jobs without consequences. does that mean that's just an unavoidable -- >> again, i respect sherman hiller a lot as i do senators blake and mccain. i'm sure they're familiar with the law. the law says that you cannot claw back the retirement earned over a career unless the person

commits treason or a treason nouse like activity. that is a criminal violation. so, i've got to wait for the f.b.i. and the department of justice to determine if the criminal violation has been committed in which case they would prosecute before i can take disciplinary action. i do not have the authority to crawl back into retirement and i have to pay the private sector. the c.e.o. does not have the authority. that would be violating the constitution property rates. because it's been earned over a long period of time. it would have to be a criminal, egregious behavior that would allow you to claw back. these laws are very clear, and i'm skeptical whether members of congress don't understand the law. what disturbs me is that we're creating, we're trying to create controversy using veterans to do that.

and i don't think that's appropriate. >> connor? you said by december and january that all potentially eligible veterans would have their choice card. do you happen to know how many potentially eligible veterans there are 9.1 million you have in the v.a. and do you have an idea of how many will end up using outside nonv.a. care? >> we have estimates, but i'd prefer not to share those estimates because we're going to learn along the way. one of the things, the reason we're doing the fazed roll out connor is as we work the plan in advance we worked with veteran service organizations, we worked with staff members of congress.

one of the things our veteran service organization groups pleaded with us was not to send out nine million cards immediately. because the implication would be if you received a card that you were eligible to use it. and what we wanted to do was make sure as we roll the cards out we explain to the veterans whose eligible, who's not. we've done a lot of training of the veterans service organization, so that they know how to answer the questions. we have a help line that's set up if you call the help line, you'll hear a recording from me, and then you'll be directed to help. so we've started with those that we believe are above, beyond the 40 mile distance is the criteria. we thought that was the best place to start. then the next group are those who might be waiting longer than 30 days. we thought that was the next best place to go. then we're going to go to veryone.

that's why we're following them. >> since april it's been confirmed that falsify cation of patient record is nationwide, systemic, deliberate, potentially criminal. separate from that, completely separate from that issue, office of special counsel sent you a letter, sent the president a letter in june saying the widespread culture of that time -- yet in you have managed to fire one person. e department of justice says they sent a memo to the house saying they don't have to wait for us. they can fire her anytime they

wanted to. so that what you consider accountability -- >> first of all, at least in what i've read mark, and maybe it wrote it, i don't recall, was an unnamed source at the house committee talking about an unnamed source at the justice department. i've not seen any memo, you're adding more certainly to it than you. perhaps your law degree is more credible than others. but, i would encourage you to talk to someone who's an expert in constitutional law, and federal law, and just check your sources a little bit. secondly, in the case of phoenix, and in the cases where you talked about people violating our values, i've been very clear all along, as i have

been this morning, that we will not tolerate that, and that we will seek the separation of those people. when i talked about the 40 plus cases where we're seeking disciplinary action, the majority of those are senior executive service and higher level leadership employees. but you should know that the veterans affair department separates over 3,000 people a year. and the list of people that i'm currently tracking for potential separation is over 2,000. so i'm just talking about the leadership positions that have been more written about in the news. our inspector general testified at the hearing that he arrested 500 people on average a year from the veterans affair department. so, again, we're just talking to people on top of the

organization. we're currently tracking about 2,000 people for disciplinary action in total of all levels, and the report that i provide to chairman sanders and chairman miller has over 40 people on it. but it meets a very specific criteria that they gave me in terms of level and time. >> has the justice department asked you not to fire them -- >> i cannot comment on a specific case because it's in process. so i can't comment. >> curt? >> they show about 10% of patients are waiting about 30 days -- >> who did that survey? >> that was the data release by the v.a. so the number was 10% are waiting about 30 days more.

i'm wondering if you see that as acceptable, is that good progress? >> it's a good question, it's a good question. we are going through a process right now of bench marking the private sector on what acceptable wait times are. prior to this job i worked in ohio. dermatology works like that. we're trying to find what the right standards are. would like the n appointment, that is the standard that we are using right now. until we get a more defined

standard, one that works well with the private sector. think that is possible that you could lower? >> some places is already like that. if somebody was to walk into an appointment they can. we have some places where have walking primary care. is other places which might be too high and we are to get those down. the law or veterans, you are going on faces of three rounds. did you tell congress?

who is responsible for the delays? law do not all, the specify. laws are generally not very clear. senate passed the different laws they got together a committee. after the law was passed i meetings with chairman miller. we needed to at correct. -- technical

changes to the law. at the time of the law, our job to execute the law the best we could. have those cars ourselves? got the two committees to talk about what is the best way to do this. what we have t the mplished, by the time law was passed to when the cars think you ing out, i would argue it is nothing short of excellent execution. is a discussion we had with the with the s and veterans organisations, all of fearful that we sent

it will create t chaos. they would have trouble sorting through all the regulations. that is why during the process best way to the execute was still meeting the deadline of november 5, it was relatively unanimous to that point. there was a statement, it wasn't the point but actually his representative, bill, was in our meeting.

>> (inaudible) one nted to know if that is of your concerns, how do you proceed? through this change with t, we have to deal the increasing number of female veterans. now it is 11%. our structures and buildings were built in the 1950's. when i was in the military did too many female soldiers. we have to change.

we have to hire more female specialty doctors. we have to hire more female primary doctors. because female veterans want to who is a female. have to provide day care, we had not do things we considered before. we are working on this. was just in atlanta, we have inherited a building from the department of defence. we're turning it into women's health centre where we can this kind of capability. where they can get women based care. facility rough the

with the dean, we have to do more of it. also in homelessness, we are more to be looking at female disability claims. we're going to need to provide new facilities for homelessness. in boston, new england. particular a homeless female veteran. we contribute money and resources to that site, starting in the new year we are going to read model the whole facility. don't now women veterans have a way to enter the going through ut

the multi space. have their own o in their own floor. it is a very important thing for us. i will be speaking on monday at the white house about this issue. >> about the time you are being congress , the approved $16 million. spending you on the of those resources, you have for hundred job

days -- will take more resources? -- que you going ask for more? >> yes, we need more. we need more money for programme for the homeless. think about a curve aligned that is going north-east. we're getting close to that line but that line is still going north-east. why do have such a need, but we do not have capacity.

things like pstv. that thought in previous wars the science was available. the veteran made six claims after world war ii was won. years after the war is over you don't see the whole consequences. as the age they get more problems. i can attach that that because have 60 parachute jumps and i find a harder harder to sleep long o stand up for periods of time.

40 years from now is going to be the peak need of the veterans in iraq. building the art capability now. we need budget increases in order to do that. >> (inaudible) >> under the present obama the has increased every year. that is good news. but it has to continue increasing, because that curve , goes up. dy

we are still have 100 of the spanish war dependence. 40 years after the war. a lot are still getting claims of the va hospitals. address you doing to the ongoing issues and key anything that has changed? we have any claims we're going to take disciplinary action of somebody we remove them and they're not in the operation.

i went to the site and they blow -- s a whistleblowers is about retaliation. worked in these speak to the f you individuals i think there will be happy with the new jobs. you should check with them. + things are changing pretty quickly. you need to make sure you -- on top of the changes. retaliation against whistleblowers will not be tolerated.

i will go to the source to find out about it. >> in may, it went down in flames. was a wounded veteran, he had run the army. could not get it, how could you get it. >> we have communicated with have admiration for him. and i have served in the same committee. i think the skills i need to do job i had not like the i needed to run all the companies in the

world. you don't run one of those companies by being lax and disciplinary actions. why is it my interest to go slow on disciplinary action. a place white you want in political game about veterans. i am now caring for 22 million veterans in this country. 9 millions of which use the health care system. to do this asked job, i immediately said yes. it is not that i need this job, this is a calling for me. take 40 portunity to

years of experiences all over world with different problems and apply it to a very serious problem in the united states. for people who put their lives in danger to save my life. >> the general said that these problems were isolated. if the va bureaucracy. >> when you run an $85 billion you speak multiple languages, and you have to 41 different sites.

>> i am sorry. arizona about in the ig, there is still a feeling that the bureaucracy is years away from being fixed. the are you doing with rebuilding of trust? >> it takes time. give first conference i my personal number. set up a team to help me

contact every of those calls or text messages. because and now five or 10 a day. we reply around 30% text messages. 100% r going to give visibility when they don't deserve it. others have clear issues that need to care about. the veteran calls me, and tells change their life, i have made a difference. and is everything to me it's what counts. going to take time

to change the ng va to somewhere where everybody worries about the veteran. will make it hat worthwhile. >> (question) >> as a leader you to give an my cell for giving i made an example. many people were doing this ahead of time and now use it more broadly. quick follow-up on

disability, nearly 60,000 veterans had a retirement plus disability. average payment $59,000. some received payments of more than hundred thousand dollars. >> some of those are based on the law, so the law needs to be changed. we are working very hard to quality of our disability. are on a 98%. we have a whole organisation that reviews the claims. this is an area where sigma has

helped us. also digitalisation has helped very much. when you do it digitally you can get more fast. want fully develop claims, also doing it digitally. >> congressman from texas get more volunteer doctors.

said they are going to run resistance from the va. can you talk about the issue? the irst of all, one of is a force re making multiplier. preparing for the confirmation, it is online. found in the was a bunker will lity, where partners look more as competitors.

uses the gue baseball world series to call up their support for veterans. we co-operated with them in the building of a installation. the new , the owner of york mets has a programme of all comeback veterans. and the owner of the red sox has another program. they felt like they were not support from the va that they wanted. am all about partnerships, all about strategic partnerships. because it is an opportunity to capability that we have.

as i said before, we don't have the budget we need. so while we returned back helped that is willing to be given) on in the job, i was school wanted w to help de forms veterans fill claims. law students made a lot of claims for us. the law school said we would like to continue doing this. i appreciate collaborations, we the best ections with medical school in the country.

was a massachusetts gen hospital. duke medical school, the doctors that also do the clinical work for va. the reasons why 70% plus of all doctors have trained with the we have the best work. and you can work with are very appreciative patient. they can learn from the work and educate others. i believe, if you want somebody something have it

teach it. another is to research. when i go to this medical meet with the assertions as he we have, with the potential to boost up our operation will be need to. case of las vegas, have air force doctors. they come under the clinical work at the local va, because to keep their practice robust while still serving. relationship that is mutual positive.

you describe the the operations of accountability, filling all the whistleblowers. what we did was bring in a general counsel from outside. from the outside of the va. she was a former general the va years before. that we brought in have been granted and now frankly doing a job.

one of the with veterans service organisations assured in the pages of all the people that we have disciplinary action against. this group is very busy. i know you have all written a lot about the 40 plus. it is a very fluid operation. at the top of the operation there are three people, and i met with two or three yesterday. thank you for this.

all for being here. >> washington journal begins in a moment. veterans day coverage in some moments. in arlington national cemetery we have the ceremony for the veterans at 11 am. matthew mitchell looks at the

lame-duck congress. jones discussing veteran issues. >> good morning everybody, americans will celebrate veterans day today. our camera live at the world war ii memorial. will have several events, joe biden will be at the arlington national cemetery. we will have live coverage of c-span at 11 am. we began here in the washington journal.