humanitarian aid, they have been passed through israel. very little of it has gone to -- t we don't want them to come through the sea. we care about weapons and they can smuggle them. this?-- house shall i say do not encourage avenue and into gaza, but we do. weapons, but we have increased the flow. we used to boast that we have passing, and it is now 900. my position is, let a thousand

economies bloom. that is not in lieu of a percent of -- of a political settlement, but it helps that people in the west bank and people in gaza see that they are not living at the edge of a precipice, that they ave the wherewithal to have real life and businesses. that is easier to do in the west bank. the west bank has been reasonably quiet. let's work to ensure that that continues. say, do weround and and to be like aleppo syria, do we want to be like yemen, like libya? or do we want to have a real life and potential for real solutions down the line? can solve thef we political problem right now. i think president obama has his own thoughts as well.

there are three components here. there is the political component, the political solution, there is security, and there is prosperity. least, we should work on prosperity and security and if we can, include a political solution. for that, we will have to sit down and talk. unilateralism, i suppose that is it would have but to meet israeli security criteria and that would also require a broader international understanding. >> thank you. i think unfortunately we are over time. i really want to thank you for your remarks. are there any final remarks you would like to make? i would like to make a lot of remarks, but i have something to declare. i have a sore throat. >> we are happy that your throat lasted.

we all wanted to move forward because we believe progress is not possible without dialogue, as you said. for you torateful come here and take questions on a whole range of issues. thank you very much. [applause] announcer: ladies and gentlemen, please remain seated as they make their exit. thank you. [captions copyright national cable satellite corp. 2015] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. visit ncicap.org] >> israeli prime minister benjamin netanyahu speaking here at the center for american progress. if you missed any of his

remarks, find them on time -- online any time in c-span's video library. the question is, is peace realistic in the middle east? mack says not while we have this warmongering prime minister in israel. writes, not of one side is dead set on committing genocide against the jewish people. let us know what you think. , ao tonight on c-span2 between candidates to become louisiana's next governor. republican u.s. senator david fincher and john bell edwards, tonight at 8:00 eastern on her .ompanion network, c-span2 >> c-span has a full line of a veterans day programming for you. former first lady laura bush and labor secretary thomas perez on hiring our heroes, conference

about our veterans, organized by the chamber of commerce and the george w. bush institute. on wednesday, veterans day, washington journal from 7:00 to 10:00 eastern with the latest on veterans issues and your input. at 10:00 a.m. eastern, conversations with freshmen members of congress. then representative steve russell, a former army ranger, whose unit helped hunt down saddam hussein. at 11:00 a.m. eastern, live replay of the veterans wreathlaying cemetery. representative rubin gallego, a harvard graduate who decided to join the marines and fight in iraq. watch all of c-span's veterans day coverage on tv, or online at www.c-span.org.

of booknature feature tv's or coverage of book fairs and festivals from across the country. nonfictionshkin -- author talks. we will be live from the 32nd annual miami book fair. our coverage starts on saturday, november 21, 10:00 a.m. eastern. authors include representative "hn lewis discussing his book march: book 2." joinslist judith miller us to discuss her book and ted koppel on his book "lights out." speak with the authors live. p.j. o'rourke takes your calls on his book "thrown under the omnibus."

join us live from miami on tv.an2's book be sure to follow us in tweet us at c-span.and >> a look at robert mcdonald's comments on improvements in veterans health care and decreases in veterans homelessness. this is about an hour. >> welcome to the national press club. my name is john hughes. i am an editor for bloomberg's " first word." i'm president of the national press club. our speaker today is robert mcdonald. he is the eighth u.s. secretary of veterans affairs. he will update us on the status of federal programs for people

who have served in the military. but first, i want to introduce our distinguished head table. this table includes both national press club members and guests of the speaker. from the audience's right, john sgt. shaft. he is a veterans affairs correspondent. veteran andam commander of the national press club american legion post. christine warnke, veterans advocate in host of the next channel 16.tv the past national president of the benevolent and protected order of elks of the united states of america. john donnelly, a senior defense

rollcall and chairman of the national press club's press freedom committee. kami andrews, a military veteran and deputy director of the v.a. veterans health administration office of client relations. bureau chief of the buffalo news, chairman of the national press club speakers committee and a former national press club president. skipping over our speaker for a moment, a captain of the u.s. navy retired and the press club speakers committee member who arranged today's luncheon. thank you, kevin. president ande chief government affairs officer at ymca of the usa. veteran andmy

publisher of stars & stripes. the president of d.c. media connection and mc of the veteran women's rock rally at george washington university this coming veterans day. michael phelps, a vietnam era navy veteran and former publisher of the washington examiner. [applause] in addition to our audience here in the packed ballroom of the national press club, i want to welcome our c-span audience as well as our audience is listening on public radio. you can also follow the action on twitter. live -- #npclive.

robert mcdonnell was confirmed as secretary of veterans affairs in july of last year, but he didn't have time to ease into the job. he came aboard to fix problems at the department with 312,000 employees. agency at the time was facing criminal investigations, congressional outrage, and construction cost overruns. you can remember the media reports from that time as well .s an intern will be a audit it was discovered that more than 120,000 veterans were either waiting for care or had not yet received it or had never received it. schedulers were pressured to use unofficial lists or to engage in other practices to make waiting

times appear more favorable. mcdonnell made it his mission to restore trust with the nation's nearly 9 million veterans and their families. he drew upon his past experience to try to set things right. as the former ceo of procter & gamble, he was no stranger to overseeing large, complex operations. he also had an understanding of military service. he served five years in the u.s. army with the 82nd airborne division. he graduated from the u.s. military academy at west point. he finished in the top 2% of his class. in since hew it has took the job, so how are things going at the v.a.? provided $16

billion in additional funding for the v.a. to pay for some veterans to get medical treatment from other doctors and hospitals and to increase the number of v.a. staff. lawmakers also gave the v.a. secretary more latitude to fire managers. sees much to be positive about at the department. he was quoted telling a house committee recently, "maybe you could hold a hearing on its progress. i would welcome that." please join me in giving a warm national press club welcome to robert mcdonald. mr. mcdonnell: thank you so much. since the civil war, the ymca's

education scholarships for the forerunner of the g.i. bill. today i'm pleased to announce havethe v.a. and the y agreed to continue that legacy by further expanding our partnership. this enhanced agreement makes it easier for local the a facilities and ymca's to collaborate on helping andsitioning service embers veterans connect to the resources and opportunities that they need. neil, thanks to you and the entire organization for your enduring devotion to veterans. the benevolent protective order of l have been friends of veterans for a long time. the reconstruction hospital they built in boston in 1918 and gave to the government was a forerunner of today's v.a. medical centers. last month, the elks committed $4 million over four years to

help in veterans homelessness. further, they are deploying 800,000 members across the country to help end of veterans homelessness in their own communities. elks fornk you and the your generosity and loyalty to our nation's heroes. [applause] the y, the elks, these are the kind of strategic partnerships we are establishing is part of v.a. transformation. let me welcome patty andrews. she is representing more than 106,000 the a employees who are veterans themselves. ask patty why she works at the v.a., and here's what she will

tell you. veterans helping veterans is nothing short of a dream job. patty, thanks for your example and your continued service to the nation and to the v.a.. like john, i would like to recognize all the veterans here today and wish you all an early happy veterans day. thanks to you all for your services and your sacrifices and those of your family as well. several days ago i was in kansas city. i had lunch with a vietnam named larry parrish. larry agreed to let me share his dax.'s is with you. larry is a very active man, but over the last two years, his health has deteriorated -- deteriorated over a hip problem. he said i was 278 pounds. i was walking with a cane and i was in pain, and i was only 61. i was suicidal because of the pain and because nobody seemed

to care. on the advice of a trusted friend, larry turned to the v.a.. here is what larry said about ba's physical therapy. they gave me my life that. they turned it around in 24 hours. they were the most comprehensive, most efficient, and most cordial of any therapist i have worked with, public or private. when his the a doctor recommended a hip replacement, larry chose the a, and for two reasons. first, his private health insurance deductible was about $5,000, more than he could afford. but more important to him was this. i wanted to go to the same place good.e they were so damn every time someone saw me, they would hug me are pat meehan on the back and say thank you for your service, welcome home, brother. that is the v.a. doing it exactly right.

the world-class experience veterans earned, and they deserve. living the eighth i care values of integrity, commitment, advocacy, respect, and excellence. those stories are out there in abundance. they are too rarely reported. i want to begin by telling you how the a is improving veterans access to health care and meeting increasing demand with expanded capacity. how we double of capacity required to meet last years demand by focusing on four pillars. ,he first pillar is staffing space, productivity, and v.a. community care. we have more people serving veterans, the veterans health overistration staff is up 15,000. we have activated 1.7 million square feet and increase the number of primary care exam 2014 so fiscal year

providers can care for more veterans every single day. added 2.2 million more square feet in fiscal year 20 teen. accesswake of the crisis, we aggressively increased access to care. in june 2014-june 2015, we completed 7 million more appointments than during the same. the previous year. 2.5 million of these were within v.a.. 4.5 million were in the community. this fiscal year with completed 61.5 million appointments, 3.1 million more than the last fiscal year. more than 2 million more at v.a. inilities, a million more the community. altogether this year, 2.6 million veterans were authorized care in the community. that is a 9% increase over authorizations the year before.

right now, 97% of appointments are within 30 days. days, 87% are 14 within four teen days and 23% are the same day. specially care average wait time is six days. primary care is four days. mental health care is three days. excellent for are most, but if you are the one in the tail of the curve, like a veteran living in a city seeing dramatic veteran population growth, they are not acceptable. so we're going to take advantage of the scale to have a one day stand down to make sure every veteran gets appropriately scheduled for care. we have made significant press addressing veteran homelessness. since 2010, over 230,000 veterans and family members have been permanently housed, rapidly

re-house, or prevented from falling into homelessness. altogether across the country there has been a 33% decline in homeless veterans. 88%, toclaims are down 76,000, from a historic peak of 611,000 in march of 2013. we completed 1.4 million claims in fiscal year 2015, the highest morer history and 67,000 than last year. today's veterans wait about 93 days for claims decisions. that is six months fewer than in march of 2013 and the lowest in this century. -- i met a veteran last week at the washington dc medical center. his father served in vietnam with the first infantry division division and his

grandfather fought rommel in world war ii. he brought up great point that i want to share with you. he said, my personal experience with v.a. has been 95% positive. but some people are not experiencing the same quality of work that i got. keith advised, what we need to work on his can distance he across the board. reason thatnted the isbe a transformation shaping a high-quality veteran customer experience across the entire enterprise and across the entire country. my the egg, this transformation we are within now, will modernize the a's culture, processes and capabilities to put the needs, expectations and interest of veterans and beneficiaries first. it is focused on five main objectives. first, we've got to improve the veteran experience.

second, we have improve the employee experience. third, we have to achieve service support excellence. for, we need to establish a culture of continuous improvement, and fifth, we need to enhance strategic partnerships. two of them are great examples here. i have suggested, as john pointed out, to the chairman and ranking members of our city did house veterans affairs committee that we hold a hearing on the my the a rather than continuing the barrage of hearings we have had on things that occurred two years ago. in the meantime, here are some of the updates on our progress transforming the a. we are realigning to facilitate internal collaboration among business lines. disjointed, disparate organizational boundaries and structures to a single framework. this means downsizing from 21 service networks to 18 that are

aligned in five districts that are defined by state boundaries, with the exception of california. the realignment means opportunities for local level integration and it promotes the consistently effective customer service that keith described. veterans from syracuse to seattle will see one v.a.. our veterans experience office is fielding of the a step of customer service experts that will help us get to keep's vision. every veteran everywhere getting the same world-class service. will be similarly focused on delivering consistent quality and the highest standards of professionalism and integrity. the north office opened at the end of this year. we are following up with the southeast office in february, the midwest office in april, and we're working details on the continent pacific offices. this is about making it easier for veterans and their families

to be v.a. customers. .e've launched the my v.a community model across the country. it brings together advocates and others to improve outcomes for veterans and their families in that community. a -- by not run by the v.a.. i was in connecticut when we established the first veterans community board in august. 37 other communities across the country have adopted the my v.a. model. we kicked off community initiatives. the veterans economic communities remote local collaboration and partnership among organization serving transitioning service members, veterans, and their families. because of the success we have already seen, where doubling down on 25 more economic communities early next year.

we are investing in ba employees, and the last federal employee viewpoint survey results show employee experiences are improving, trending slightly higher than last year. the best customer experience organizations in the world, not surprisingly, are also the best places to work. so we are training leaders in design thinking, great customer service companies use human centered design to understand what customers want and need and then design customer experiences to meet those needs. the processes are effective, efficient, and repeatable. we started training leaders on lean six sigma last month. we intend to have 10% of leaders trained by 2016. we are using a combined top-down and bottom-up approach to train

a contrary of leaders and employees. we started in october and are looking to train 5000 employees over the next year. improving employees experience is inextricably linked to improving veterans experience. there is not a good customer service company in the world that has unhappy employees or untrained employees. we kicked off our leaders developing leaders cascade training model with 300 senior field leaders last month. i was told it was the first time that top leaders of the a had ever gotten together on that scale. toare equipping leaders dramatically improve delivery and care of services to veterans and to create a better work environment for our employees. this month will complete initial training for all senior leaders. so employees are better informed on the broader spectrum of benefits and services so they .a., we areall of v giving them training that we v.a.101.

6000 employees have received this training so far. we will have 170,000 trained by next december. it helps employees better appreciate the value they bring v.a.e a -- notable progress on claims backlog, veteran homelessness transformation. all that is to say we have made undeniable and tangible progress. every health care system has has its faird v.a. share, but some of them are unique tov.a. you may have read the independent assessment of health care delivery systems. you read about the bureaucratic leadership and staffing challenges and failures in access and quality. about cultural challenges employees and leaders in..

houseestified to the committee on veterans affairs in october, the assessment has given us some new ideas and a great deal of information on some known problems. confirms our own analysis and indicates we are heading in the right direction for some time now. as long as one veteran doesn't piercee larry experience, we have more work to do. let me address some challenges before we open things up for questions. improved, but has here is the inevitability. remember, we completed 7 million more appointments in the year following the crisis than we did the year before. that should satisfy the pent-up demand twice over. still, the number of appointments not completed in 30 days has grown from 300,000 to nearly 500,000. why?

usause more veterans come to for care and a more veterans that come to us for care, the harder it is to balance supply and demand without additional resources. --'s kind of imbalance failure in any business, public or private. the health care industry is no different. crisis wascess predominantly a matter of a significant mismatch of supply and demand. it was exacerbated by greater numbers of veterans receiving services. you see more veterans like larry harish choose v.a., and for good reason. for many, it is just more convenient. larry, it'sike about quality and cost. the average medicare reimbursement for a knee replacement is $25,000, with a co-pay of 20%. per saves veterans $5,000 knee replacement. veterans do not pay for hearing

aids. would cover all hearing loss, not just service-connected. this.ns noticed hiring challenges will persist for the foreseeable future. private sector health care 30%.ver is about our turnover rate is about 9%, pretty favorable. but we need more than 4300 physicians and 10,000 more nurses. we need to feel 41 senior-level vacancies in the field. that growing shortage of qualified candidates is a national problem. there working closely with deans of medical schools to increase throughput. we are working with congress, asking for more residencies, and asking for scholarships and loan reimbursements from congress. we are working with universities in state governments to create new medical schools. one of our most pressing challenges is the appeals process, delivering timely

decisions in the manner veterans deserve. the processes to complex and confusing for veterans and to link the. 2015 the board of veterans appeals served over 55,700 veterans, more than we have in recent memory. they held over 12,700 hearings. that is a lot, but it's not enough. simply put, our capacity to timely,terans with appeals decisions are encumbered by antiquated laws. they do not well served veterans today with a modern system. we work with veterans service organizations to reengineer the process and now we are working with congress to pass the laws necessary to bring the process into the 21st century. instill have challenges veterans experiences in benefit delivery. last month i received an urgent e-mail from been on veteran mike hughes. he had submitted a correct and

fully developed compensation claim for benefits which was incorrectly rejected. calls to his regional office were unproductive and understandably frustrating or mike. the call center agent could not access the information necessary to answer his questions and to correct the problem on the spot. that is one veteran and one encounter, it's not the kind of customer service we aim to provide. we oh veterans more. employees who serve veterans more. they deserve the tools and training that empower them to give every veteran a world-class experience. we are strengthen customer to be moreels veterans centric. we are empowering call-center agents of process certain claims that the point of the call and to take action while the veteran is still on the phone with them. as of this september we are processing dependency claims at

the point of the call so agents can come up for instance, at a minor child or a spouse to a claim. as we continue to strengthen her service model, call-center agents will begin taking more and more action while the veterans are actually on the phone. other initiatives i've described like human centered design, leader to leader training and time, help usver achieve our customer service goals for veterans. we on these challenges. our are working hard to do part, aggressively tackling issues within our control. period weively short have demonstrated the significant capacity for meaningful change. the independent assessment has and that v.a. opportunity to achieve a place among the highest performing health care systems in the world, and we will. but we know we cannot of bush all we need to do for veterans

without the help of congress. veteran service organizations and many other stakeholders. elks are just to members on a great and growing , from philanthropic organizations to nonprofits to businesses to other federal agencies. let me be clear. while these partnerships are important, our most essential partnership is with congress. congress holds the keys to many of these doors. congress legislates the benefits we provide the veterans. it is congress that has to fund the benefits it legislates. some 25 of the independent recommendations require congressional action. we literally cannot do it alone. not without the right congressional support. here are five specific requirements that will make a significant difference to veterans. i have repeated them during

testimony and that every other opportunity. i don't line reciting them again. first, we need congress to fully fund the president's 2016 budget request. congress to give us the flexibility to align resources with veterans demand for care. third, we need congress to act on the proposal we submitted may 1 to end the uncertainty about aspects of purchased care that are outside the veterans choice program and that complicate 'sovider participation in v.a. other care in the community programs. fourth, we need congress to address the many statutory v.a. with reding tape like the appeals process. we need to consolidate into one program. assessment reiterated this requirement for veterans. for years, a variety of

different authorities and programs have provided care in the community to veterans. difficult to understand. veterans don't get it, our employees don't get it, medical providers don't get it. so we sent the veterans choice program to the hill last friday. it's the long-term vision for delivering timely and high quality community care. veterans need to see congress act on it quickly. this week i had breakfast with the chairmen and ranking members of our senate and house committees. there is tremendous unanimity to pass these measures, to work together to transform the v.a. and to provide more consistent experiences for veterans. hughes. mike that veteran who could not get answers about his claim. a week after he wrote me, he wrote to me again. my e-mail to you, i received a call from a regional office, assuring me

that my complaint had been heard and that my claim was indeed one that would be handled promptly. that's the response mike should have gotten to begin with. we will get there. we are well on our way. i look forward to your questions. [applause] >> thank you, mr. secretary. you mentioned the progress you have made. however, looking back to the problems of two years ago, have you now held everyone accountable at the department who needs to be held accountable, and if not, do you need any additional authorities so that you can hold them accountable? let's talk about accountability. my good friend jim collins talks about the need to get the right people on the bus and get them in the right seats on the bus. my direct reports, my leadership

the 16 direct reports are new since i was confirmed. also, over 90% of our medical centers have either new directors or new leadership teams. 2014, 1100 year people were terminated from the v.a. in 2015, 15 people were terminated. since july 29 when i was confirmed of last year, 20 to 80 people have been terminated from the v.a. with proposed is a very action against 300 people for manipulating scheduling. those, you may have artie seen, an individual in augusta, georgia, was indicted and faces 50 charges of schedule manipulation. it brings with it a $250,000 fine and a potential for five years in jail.

we are working with the office of special counsel and the fbi on other investigations that are ongoing. over the last year, we have had a total of 62 criminal convictions that have been discovered by our inspector general. i have to say that accountability is a lot more than firing people. it's also about giving people the responsibility, giving them the training and then working with them and training them to perform at a high level. one of the things we have done over the last year is into people's performance review plan all of the things i have talked about, improving customer service, the my v.a. transformation, improving our call centers. we have made progress. we have a lot more to do. there are lots of investigations

currently underway and as time goes on, you will see the results of these investigations. >> a question about cost control. what mechanisms have you put in place to control costs? paymentsou ensuring are proper and in line with fair market values? mr. mcdonald: cost control is really important. one of the things that i believed in in the procter & gamble company, there were two things i believed would drive it. one was innovation. the v.a. is a great innovator for this country. we spend $1.68 billion on innovation, research. that research is not only critical to american medicine, but also to the american people. secondly, productivity. productivity is critically important to us. we measure value units, which is a common measurement in the medical industry. it is a measure of productivity. our productivity is up 8% over the last year, versus a budget increase of 2.8%.

i am asking for ways to improve our productivity every day. there is no question that demand is increasing for our services. i do not feel capable of going to congress and asking for more money, unless i can show them that we are trying to save money. if you look at my testimony over the last year, what you see is i told congress that we had 10 million square feet of unused space. unfortunately, it is all in somebody's congressional district. if we could close that space, that would save the v.a. and the american taxpayer $25,000 per year. please look at my testimony. 10 million square feet, $25 million a year. we are eager to work with members of congress to close that space.

and we are going to have more space because we have digitized the claims process. by digitizing the process, we eliminated 5000 tons of paper. 5000 tons of paper. >> standardizing care. how will the v.a. standardized policies nationally so that the veterans will have the same access to care, no matter what v.a. they attend? the example they give is the various and limitations and qualifying criteria of caregivers, post 9/11 veterans to receive a stipend. sec. mcdonald: great question. i think i addressed it in my remarks, but let me add to it the new undersecretary for help, one of the new leaders at v.a., this is his number one job, how to identify the current best practice in the industry and v.a. and bring all the v.a. up to the current best practice while at the same time trying to innovate to improve the best practice.

there is a lot of work to do. let me give you an example. if you are a veteran and your address changes, you have to change your address nine different times in the v.a. there is not one backbone with every customer listed. we got together a group of people all involved in this, and we are going to go to one data backbone with one list of address, which keeps track of every interaction with each of our customers. that is one example. that will cost money and will take time, but now is the time to do it. we have a new assistant secretary for the office of information technology. her name is laverne council. i recruited her. she was the i.t. leader at johnson & johnson and dell. she knows how to do this. now is the time to get it done. >> how have the changes that you initiated with my v.a. helped to

effect culture change at the department and improve morale? sec. mcdonald: again, i think i addressed that. morale is slightly better but not where we need to be. the all-employee survey was taken this year before we did the leaders developing leaders program. i think our leaders developing leaders program has been a breakthrough. we are working with noel tischi, he was jack welsh's mentor at g.e. and founder of the training university. his daughter works for the v.a. he has helped design a training program which has been outstanding. interestingly, the leaders do the training. i do the training. sloan gibson, my west point classmate and friend of 40 years, does the training. our leaders do the training. we do not hire consultants to do the training, we train them ourselves.

we have done 300. those 300 are going to go back and train their own organizations. we used videos from our 300 training. we put together a packet, a training packet, and they will go train their subordinates. some of our senior leaders will attend that training. i attended one last week in kansas city. i was thrilled with what we were accomplishing there. while i can talk about my vision for the v.a., what i need is for every employee to talk about how their vision for their organization cascades from my vision or the organizational vision. the test for any high-performing organization is, can you walk into a medical center, and ask the person in housekeeping how what they are doing that day contributes to the vision of a larger organization. that is what we are shooting for. it is like if you ask the person sweeping the floor at kennedy

center what they are working on and the answer is i'm putting a man on the moon. >> hillary clinton got some attention recently when she said the v.a. scandal has not been as widespread as it has been made out to be. do you agree with her? sec. mcdonald: i told you, we have made progress, and have more work to do. [laughter] [applause] >> cnn reported that long waits continue for many v.a. patients seeking medical services. in august, more than 8000 requests for care had wait times longer than 90 days at the phoenix v.a. why do these delays continue, and what can be done to cut down on the wait time? sec. mcdonald: 70% of veterans have a choice. they had that choice before. 78% of veterans have medicare, medicaid, their own private health insurance.

78% of veterans have a choice. they exercise that choice. today, on average, the average veteran, and of course there is no average veteran, but the average veteran uses v.a. for 34% of their medical care. only 34%. that 34% might be the hearing aids that save $4000, or the knee replacement that saves $5,000. only 34%. as we have improved our care, as we have improved our culture, as people have learned about the great things that the v.a. does, as we have opened up more facilities, as we hire more providers, more people are coming. more people are coming, and those already in the system are looking for more of their care from the v.a. if that 34% becomes 35%, a 1% increase, i need a $1.4 billion

budget increase from congress. $1.4 billion for a single percentage point. as many of you know, the budget problems we got into last year, because of a miracle hepatitis c drug that was invented in 2014-2015 -- that budget was talked about two years before that. we will have to do something with our committees to create the kind of processes that exist in business for how you have budget flexibility and agility to meet customer demands. otherwise, what will happen is as more people come into the system, if we do not get that budget flexibility, then the appointments might not be within 30 days. maybe the average mental health appointment -- not mental health, that would be about example, but primary care appointment has to go from four days to five days, or six days because the budget is given to us by congress and the benefits are defined by congress.

all we are trying to do is make the two match. >> a question about the v.a. complex in los angeles. admiral mike mullen is investigating issues. some reports suggest decades of mismanagement. how extensive are the problems, and will people be held accountable? sec. mcdonald: mike is a dear friend and he is there on my behalf. i do not quite understand the question. no, we have problems in west l.a. when i became secretary, i discovered there was a lawsuit in los angeles. there were 10 veteran plaintiffs suing the previous secretary. the lawsuit had been going on for over four years. i discovered that that lawsuit was getting in the way of us solving problems in los angeles. i went to los angeles. we have changed the leadership in los angeles. we have hired more providers. we have strengthened our relationships with medical

school affiliates, like ucla, and with new partners like u.s.c. we have created a community partnership and a master plan for the west l.a. facility now on the internet. you are welcome to comment. we have about 390 acres in los angeles. we need to use the land properly for the care of veterans, rather than having it used as a car lot and other things that were done in the past. we are moving in the right direction in los angeles. again, we have a lot of work to do. progress, but a lot of work to do. at least we got the lawsuit, which i was able to settle, out of the way. we have stronger partnerships, and we are moving in the right direction. and mike is being very helpful. >> it was reported that 30 v.a. systems lacked permanent directors. why is it so difficult to fill these jobs? is pay an issue?

do facilities without a director suffer as a result? sec. mcdonald: i said job one is to get the right people on the bus and in the right seats on the bus. the one thing you don't want to do is put the wrong leader in the wrong place. the process does take some time. as i said, 90% of our medical centers have either new leaders or new leadership teams. i can personally vouch for each person we are putting in place. if it takes longer to do that, i'm ok with that. i want to make sure we get the best team in place and do our best to take care of veterans. there is no substitute for leadership, and leadership does matter. >> this is a question about legislation that has been introduced to help world war ii veterans exposed to mustard gas, and help them secure compensation for their injuries if the v.a. does not help them. will it take legislation for the v.a. to compensate these veterans and their families, or

is there something the v.a. can do now? sec. mcdonald: i'm trying to get the names of individuals that have suffered that. we have been collecting names, and we have a short list. i was lucky to meet, i think kimberly -- is she here? from npr? yeah. she is the one that wrote the article. i'm trying to get her list so i can marry it with our list and find out why there is a discrepancy. that is job one could we have to find the veterans that suffer through this. i'm not sure if legislation will be required. we will do everything without legislation. i have a lot of other legislation we need. >> the new plan presented to congress to consolidate community care states explicitly that it requires congressional support and funding. how likely are we to see that plan realized and when? sec. mcdonald: as i said, great unanimity with our committees. ranking members and chairmen

said they understand the plan. the reason there are so many different ways of getting care in the community is over the years, congress has passed so many laws that layered on top of each other. each one had a different reimbursement rate, a different selection criteria, and as a result of that, you had these seven different programs that were very difficult for veterans to understand, and very difficult for our employees to understand. similarly, you had dysfunctional or skewed incentives. i went to montana with senator jon tester, a great guy, and he brought in a room of providers, medical professionals, and they all told me how much they loved one of the seven plans. i whispered to john and said, the reason they love that plan is because the reimbursement rates in montana are the highest for that plan. we have to get to one level of rates.

we have to get one plan, easy for the veterans to understand it. we are in the customer service business, but these laws have been layered over the years. we will get this done, and get it done quickly. >> the mental health of veterans suffering from posttraumatic stress and brain injury is one of the biggest challenges that the v.a. faces. with the shortfall in mental health professionals, what alternative methods are being used for veterans? are music and art viable alternatives? sec. mcdonald: when i was going through my confirmation progress, there was a very small number of senators, one or two, who said, why don't we blow up the v.a. and give out vouchers? i thought it was important for me to study that, the business guy. i discovered the v.a. is not only essential for veterans, it is essential for american

medicine because we are on the cutting edge of so many treatments. and therefore, it is essential for the american public. we spent $1.8 billion on research. we did the first liver transplant. invented and did the first implantable cardiac pacemaker. it was a v.a. nurse that had the idea to connect patients with barcodes to records. the first electronic medical record. v.a. doctors invented the shingles vaccine last year. v.a. was the one that came up with the idea of taking an aspirin a day. when you have the largest integrative medical system, you can be on the cutting edge. right now, we are leading the government's effort in precision medicine. we have a project called the million vets project with blood samples of veterans connected to 40 years of medical records, and we are doing the genome mapping of all of those blood samples. imagine the research that can be

done by medical professionals to go back to the genome to understand the causality of that genome and a form of cancer. we are running seven pieces of research to figure that out. more work will be coming. without the v.a., who is going to do that? training -- the v.a. trains 70% of doctors in the country. without the v.a., who will train those doctors? it is the primary source of residency for medical schools. we need more medical schools. we are working to create a medical school at the university of nevada las vegas. the bigger part of the problem is we need the residencies. congress is giving us more residencies with the choice act, but we need more. the v.a. is the largest employer of nurses, the largest trainer of nurses. the third leg of the stool is conical care. to deal with mental health, because we are who we are, and

because we are on the cutting edge of mental health, we will try any technique, any treatment that may work. we found that acupuncture is effective with some people. we are the largest user of acupuncture in the country. we found equine therapy is effective with some users. we have equine centers around the country to use them with veterans. i could go on and on. there are many different techniques that are effective that a for-profit system will never figure out. it is up to us to figure it out, write the reports, write the research, do the literature, and create new standards of care. one of the things we will do coming up this spring is hold a mental health summit here in d.c. we are inviting everybody who is an expert. we have already done one of these, this will be the second. we will invite the nhl, nfl, people suffering similar brain injuries so we can spread knowledge and make sure that we

are all working synergistically to figure these things out, rather than at cross purposes or in a redundant way. >> this question says women veterans are often invisible to the v.a., and also the fastest growing population of the homeless. what is your plan to outreach to women vets nationwide informing them of benefits? sec. mcdonald: the question is correct. women veterans often do not identify themselves as veterans. all veterans feel inadequate because they feel there is someone who has done more than they have. we find some veterans think the word "veteran" means only if you served in combat. some veterans think the word means only male. we are outreaching to female veterans all of the country. we are hiring more providers for female veterans, more obstetricians, gynecologists. we are also setting up women's clinics in most of our major facilities.

if, who ever asked that question is in d.c., ask for the medical director and take a look at our new women's clinic. i'm quite proud of it, and think some good work is going on there same thing in atlanta, georgia. at fort mcpherson, we have set up a women's clinic. the questioner was right -- veterans about 11% of today. not too distant future, 20%. bute are almost out of time before i get to the last question or two, have some housekeeping. press club is the world's leading organization for journalists and we fight for a free press worldwide. to learn more about the club, go to our website and to donate to

our nonprofit institute, visit press.org/institute. i would like to remind you about upcoming speakers -- p.j. o'rourke will discuss his book, "thrown under the omnibus" this coming thursday at 6 p.m.. nightl hold our authors n november 17 at 5:30 p.m. we have more than 100 authors who will be here in the club and there are so many who are noteworthy that i won't even begin mentioning a few of them. debra lee james, the 23rd secretary of the u.s. air force will speak at a club luncheon on december 2. i would now like to present our guest with the traditional national press club mug, the greatest keepsake of the national press club.

[applause] you are here one year ago, so you now have your collection started. we hope you come back in one year for your third because you have to get the full six.'s of the press club mug. mr. secretary, you have been at the v.a. for more than a year. compare the challenges of running such a large government agency with those running an agency like procter & gamble. how are they like and how do the challenges differ? think the thing that is alike is what you can call the burden of egg numbers. 9 million veterans and our health-care system regularly and if you make a mistake .5% of the time, that's a big number. just like i talk about the 7 million more completed

appointments, i talk about the tale. in hampton, virginia, the population is growing rapidly. about the five days for specialty care average -- big numbers is a big deal. lean six, sigma, and design six are critical. is at the differences procter & gamble, while we had a health care business, a with things like over-the-counter remedies. here we have catastrophic remedies. it makes for a difficult situation where there's no room for errors. those are differences. i spent 33 years with the company and have lived and worked all over the world.

brussels, in japan, , and theanila philippines. here, i've just been on the job for a little over a year. how do you compress that in such a short time? got a question i about why does it take so long to fill a leadership vacancy, it was easy when i knew some but he for 33 years. it's a little more difficult today. those are some of the differences. >> more and more veterans are running for elect it office. has this been helpful to you in the v.a.? from hearing a lot candidates on the campaign trail. are you hearing enough discussion of veterans issues out there? gladmcdonald: i'm always when veterans issues are raised.

i just wish there were more fact checking on some of the numbers that are used. what i tried to do today is give you both the good and the bad. i may as well leave it at that. more candidates getting elected, is that helpful? i think it is helpful when you have more who are veterans writing laws, but there's no question we will keep moving in a direction where very few of our elected leaders or at least not as many as in the past were veterans. that's why i think it is quickly important that rather than having veterans at the center of

a political issue and using veterans as a political pawn for one party or another to play president or the administration or the department of veterans affairs, it's better that we work together. we have hearings on what we can do to change the future rather than what happened a few years ago where everyone writes their questions to play gotcha. coming from the business world, i'm not used to this, where somebody behaves in one way privately and in a different way on camera and they work hard to write a question you might answer incorrectly. let's all work together, all of , let's work together to do what's right for veterans and forget the gamesmanship. it doesn't make sense. [applause]

and just to be clear, i think we ,ave tremendous unanimity today but i will tell you i'm not running for political office. i'm in this for only one reason -- that's to do this job. put me here to do it and i'm going to do it to the we are my ability and going to make the changes we need to make and let the veterans decide we have made the changes to do the right thing. [applause] >> thank you, mr. secretary. i would like to thank the natural -- the national press club staff and the broadcast center for helping to organize today's events. if you would like a copy of

today's program, you can find one at a press.org, where you can learn more about the national press club. thank you. if you could stay in your seats until the secretary leaves the room, i would appreciate that. thank you very much. we are adjourned. [applause] >> tonight, as part of c-span's veterans day coverage, the conference on hiring veterans from the u.s. chamber of commerce and the george w. bush institute. here is a preview with laura bush who talks about the pressures faced by veterans families. serviced: while our men and women and deployed, their spouses are the ones who

take care of the families at home. they take care of the children, manage the finances, and they pray their husbands and wives will return home safely. rocky arenasnt and 2014 for2013 the annual warrior 100 bike ride. when marlene talks about rocky's , i say wehe says we served 25 years. i lived every deployment with rocky, every trial and tribulation. but today i said yes to him, i did not realize the impact is going to have on me. that's why it is so important to make sure that while our servicemen and women receive the support we need, we care for their families as well. employment support is the perfect place to start.

veteranshow post 9/11 face higher rates of unemployment than their civilian counterparts and the consequences to that unemployment or underemployment are not only financial. whenf course, once one -- one family member is suffering, the entire family suffers. >> the hiring our heroes conference with laura bush, thomas perez, and a medal of honor recipient tonight at 8:00 eastern on c-span. >> the first debate in the louisiana governor's debate between david fitter and john bell edwards, live tonight at 8:00 p.m. eastern on c-span2. next, a discussion about federal support for suicide prevention, especially among recently deployed service

members. among the speakers is senator joe donnelly from indiana and to veterans advocates. foundation foran suicide prevention, this is about one hour. >> thank you for attending this meeting sponsored by senator joe -- it is my pleasure today to introduce three distinguished panelists that are going to talk about the military and veteran suicide

prevention and dental health issues in our country. suicider goal to reduce 20% by 2025. this, we areo going to have to have to address issues around the suicide prevention that plague our veterans and military communities. currently, 22 veterans as an estimate die by suicide every day. veterans comprise an estimated 20% of suicides in this country every year. , we have thetoday author of "the invisible front -- love and loss in an and ending euro for -- unending era of war." his book was picked as one of the most notable books of 2014 and one of amazon asked books of

2014. he has made more than 12 lengthy trips to iraq and afghanistan and has spent a total of nearly four years on the ground in the two countries. mostly doing frontline combat. than 20eported for more countries, including pakistan, russia, israel, japan, turkey, morocco, and saudi arabia. the clinical director at afghan and iraq veterans of america. development of the annual policy agenda and advocacy campaigns through trust and relationships for government agencies. is a former army major who served 17 months in iraq and his broad experience working with veterans and veterans issues from his work on several major

campaigns to serving as team red white and blue chapter captain for his local community chapter in alexandria, virginia. he has appeared on nbc nightly news, c-span's "washington journal" and the cbs coverage of memorial day 2014. last, we have major general mark graham, the senior director at u the hc national call center and director of that's for warriors. he's lost two sons to two different battles, one to suicide and the other to an ied in iraq. he currently heads the rutgers call center and is the director of that's for warriors with per rides -- which provides pierce support by veterans to active duty national guard and reserve servicemembers, veterans, retirees, and their families and caregivers.

we thank you all for coming today. now i would like to introduce senator donnelly, who as senator from indiana, introduce his first piece of legislation when theame to the senate, military suicide prevention act, has been awarded the allies in action award from the foundation of suicide prevention as a champion of veteran and military mental health and suicide prevention issues. senator. thank you all for being here. to our panel, thank you so much. to john and trevor, thank you. the best way to start off is to talk about the incredible dedication and hard work of all of our men and women who serve. and of the love and devotion of in this country.

then to tell you about a national guard unit in evansville, indiana, my home state. guard wasational 2008 in extraq in nearly difficult circumstances, and when they talk to each other, they said we have each other's back. is a group that was in a truck there -- one was the tover, one was the lookout make sure everyone was safe. they are all working in that truck together. for a year, they had each himr's lives in their hands of the most intense effort you can imagine. streets were lined with people cheering when our national guard group got home. to they did and they began

live their lives back home in indiana. from 2011 through 2015, 4 of the members of that national guard group have taken their lives. it is hardly -- it is heartbreaking and has to end. these wonderful people and all of you are trying to help us do that. we were able to pass the jacob sexton military suicide prevention act. jake was a wonderful young man who served in iraq and afghanistan whose family and he helped provide coats and other things to the kids in afghanistan when it got cold. choices helievable had to make and that's what the military has to do. side or theh, one other. he came back home on r&r from

afghanistan and when he got back home, he took his life. he told his dad before he went on a tour, he said dad, something doesn't feel like it is working. it's not just those who are in combat, it's people back home stresses and family trying to balance the national guard and career and they family and financial stressors. what the jacob sexton military suicide prevention act did was provided annual military health assessment for each and , activervice member duty, garden service member and provided privacy protections so there was the chance to seek able to dond to be

it with privacy. this past year, and we hope we can do it today, is the care package which says we have been able to provide an annual health assessment. now we have to find the providers to do it. private providers all over to country, that they can go places like the military family research institute and get the training needed so that when our service member comes knowhat in our vets, they that this person understands the special challenges they face. they get the service family certification and then there is an online registry to go online and go this person gets it --

somebody i can talk to and feel comfortable with. that the department of defense folks take additional training in suicide risk recognition so they can start to understand. to add additional physicians assistants so we have more frontline providers to help our men and women. think of thisers -- when they finish up, they cannot go to the v.a.. they are not officially allowed to. they cannot go to military treatment facilities. they don't often know about what other available services are out , often times they feel like they are by themselves. transition that takes place when you go from one to the other. we find ourselves with challenges with the formulary as well.

dod, you are in that system and you are struggling, so they give you prescriptions to help and you become a veteran and they completely change what you are on because x, y, z are not on what the v.a. covers, so something you have begun to feel comfortable with and that is working for you completely changes and we have to make this seamless. we have two recognize that we have in a nation at or for such in many ways young people like our guard members come home and there's a complete to the community that loves them so much, to the world that used to be a part of them, went and wheny

they serve, they see things and deal with things that completely change their lives. people count on you for their entire life, you are in a mission and the panel knows much better than i do, you come home and it is just different. help.t to be there to we have an obligation to be there to help. so that if someone has a question, they are there to divide an answer. feeling sideways, they know who they can call. they have the opportunity to talk to somebody. is our job. we lost over 400 young men and women last year to suicide. we lost over 22 veterans

yesterday, the day before, the day before, and the day before. we want to get it to zero. trevor and john, thank you, to our panelists, thank you so much. thanks to your sons who have served and all your family who has sacrificed. we are grateful for your help to trying to provide answers. thank you so much. [applause] senator donnelly for your comments and your true leadership in the united states among to prevent suicide our veterans, military personnel, and provide support to their families. next, i would like to introduce yogis reason. and.gi drees

yogi: it's a pleasure to be with you on this rainy day. senator, your leadership on this is a wonderful thing to see. often you are not so standing by yourself on an issue so often as this one does. i would like to frame the issue a little bit and then turn it over to my friend mark. in 2009, i began to hear from friends who had come back that they would look in the mirror and not recognize themselves. these were military members that i had met -- they could see in the eyes of their wives and husbands that they were scared, in their children, that they were scared. they felt ugly or disfigured by what they had done. they knew they had changed but did not know quite how to change it. werebegan to say they thinking of killing themselves. they don't want to keep feeling what they are feeling. a couple of them i know did kill

themselves. these were guys i had known and had been with in both countries, these were guys who had made it back physically unscathed but came back with something all the same. if they were guard or reservists, there were no support structures. back to a military that wasn't ready to help and a military that was more disconnected than it had ever been. they came back in in or must numbers. up until 2009, the military suicide rate had been steadily rising. but the military response was we have a problem, but you civilians have just as bad of a problem. if you look at the demographic of the military, the suicide

rates were rising at roughly the same rate. 2009 was a horrifyingly important year. that's the first year where the military suicide rate exceeded that of the civilian suicide rate and it has kept growing. rateis when the military pulled ahead and kept going higher and higher. there has been a reluctance to acknowledge what they were seeing, which was a legitimate epidemic. had no way of refusing to acknowledge it because the numbers were so stark and horrifying. did,ng as many people as i i began to ask people at the pentagon if there were people trying to fight this in creative or energetic ways. hearing the name mark brown again and again. people would say the story of at markhis wife, i will

who is a close friend talk about it rather than try to speak for him. it was hard to believe because you don't usually meet generals who have lost children. it seemed an incomprehensible level of loss, especially for a person who has served as long and honorably as a general like mark brown would have. try to find out what it was he had uncovered. what he found was a base with one of the highest suicide rates in the country and one of the highest homicide rates in the country. right before he got there, there unit with a horrifyingly apt name lethal , soldiers- 11 people and warriors in and around the base. this was new and this was were fine. so he got there and had the darkness of suicide and the darkness of homicide and these are things he devoted himself to fighting while he was there.

part of the cause of what he had seen thomas senator donnelly alluded to the word -- stigma. that's a clinical word i would like to put in human terms to describe what stigma is and how it manifests itself. -- inre a couple of ways an enlisted officer at fort carson who told another enlisted soldier suffering from ptsd, kill yourself and save the paperwork. it manifests in a soldier wanting to kill himself, scrolling with back pain on a white wall what was basically a suicide note. the help hehe got needed and was taken to a hospital and is still alive today. the military response was this man to faced military property, so we will bring him up on charges. is the mother of a son who almost killed himself and said if i come and repaint that wall, can my son go? they said sure was so she came

and spent a saturday repainting an entire wall. nicelyitary look at that painted wall and charged the sun anyway. of thingsthe kinds when we talk about stigma that we are talking about. we're talking about callousness and cruelty, soldiers and ifines, soldiers feeling they seek help, their careers will and and they will be mocked by the people around them. they will be seen as people not worthy of wearing the uniform. people who came back from iraq and afghanistan and are scared, not people with any legitimate struggle to fight against. one case of a kernel getting ready to deploy looked at a soldier who is underperforming and tried to the him up and said this soldier is overweight, there's something off about him, he's getting into

fights and tried to kick him out. mark looked at the same case and thought this is a young soldier whose record before he deployed was perfect. it is different since he got back. this soldier has ptsd and needs help, not to be kicked out. for people in the military, it is the definition of a hierarchy and it is extremely rare for a general to reach down into a specific grade and say to a kernel you are wrong and reversed the decision. popular.ot it was profoundly unpopular. i spoke to the kernel and he's a very good man. one of the problems with this issue is there are not owing no silver bullets but very rarely is a black and white. very rarely is there a villain and very rarely is there a hero. -- andrnel had a point

mark had a point. he needs help. it gives you a sense that -- of what this -- of what they are fighting against. we have to look at the military from outside and say it's its own world that we are not heart of. the military made a gigantic mistake by consolidating itself and deep in kansas where a civilian would never go. if you live in one of the coastal cities, you may not ever see anyone who serves except at the airport. you probably have zero exposure to the military. it's easy to say that it is its own world, but it's not. the military reflects our country and it comes from the country and what impact one impact of the other.

from the moment the car was created until 2010, more people died from car crashes from anything then illness. that was the case from the time the first model t rolled off the assembly line. in 2010, that changed. it's the year the civilian suicide rate, the number of people killing themselves exceeded the number of people dying in car crashes. news, us watching local there are horrible stories of a crash and we see those and kind of shutter. but we see that same day more people total are killing themselves. that is a staggering play. i want to close with that because we know the military more than saying simply think you for your service. military the knowledge that we as a country

understand what it as a part of our country is going through and that we understand what those who serve are going through, whether they are guard, reserve, active duty, it does not matter. afghanistan as we know is not ending. we thought it was and it's not. evenis still going and when these wars and, this is the most chilling thing i found -- even when these wars and, the number of people with ptsd will not end. rate is not going to stop. we would like to believe the people in the military who are fighting this, they know better, but there a hope that when the guns of war fall silent that the suicide rate will stop or at least slow. that's not true. on for decades. 30 years from now, if something

changes, they take their own life. for a long time, the people who killed themselves most frequently were high school and college students. now we see suicide rates among men under 50's skyrocket. some of these men's have lost their jobs -- some of these men have lost their jobs, but it is jumping. -- i should point out that when my wife and i discovered we were having a baby boy, after we spoke to our parents and siblings, first call was to mark and his wife. they areem yearly and family to me. as you're listening to mark and bill, keep that in mind -- these are not people speaking only about or for the military, they are speaking for our country. [applause]

>> senator donnelly, thank you for your leadership. we help many will rally behind what you are doing. thank you and the american society for suicide prevention .very day and thanks to yogi he is family. i've spent a lot of time with him in the last few years as he is writing the book and of course my good friend bill and all the work he and so many others do. today is the marine corps' a, so happy birthday and semper fi. -- but tomorrow is veterans day and we want to thank our great american veterans and families and caregivers for all they continue to do each and every day. who do you call when you are home alone at night and you are

afraid and isolated and you don't know what to do? who do you call? nown a program at rutgers called vets for warriors. 24 hours a day, seven days a week, veteran answers the phone and they are trained in a program called reciprocal peer support. it is set up so veterans answer the call and there's a clinician on site 24 hours today. no matter where you are, no orter what your status is discharges, you can call that number of anonymous or confidentially. we don't care if you tell us your name or where you live, you can call and talk to a veteran who understands what you are going through 24 hours a day.

do you call? who do they call in the middle of the night? i wish my son kevin had a phone number to call. our son kevin took his own life and died by suicide in june of 2003. he was getting ready to go to the army's advance camp having finished his third year of rotc. he was a straight a student, premed student and was going to be an army doctor. he was struggling with depression. didn't even tell his brother and -- i will never forget when we found out one of the kids was in the apartment using the computer and he took the punch out from the medication and said he was on was and it was kevin and he embarrassed. he felt it was a character flaw. deadly.ma is this isn't a simple stigma, it is a deadly stigma.

america can do anything if we put our minds to it and our resources and resorts -- research behind it. our son jeff was a second lieutenant officer who graduated from the university of kentucky. he was killed in iraq by an ied. they were best friends as well as brothers. we have a daughter who is a nurse in new york city and she's married to another veteran. i will talk just a few minutes about vets for warriors and always thinking about if jeffrey came back and had a number to not, he he survived are would have been struggling. many who are not deployed are struggling as well. how do we help those struggling before they are in crisis? lines in thes nation and they are very much needed.

that's for call warriors. veteran who can work through to get you the other side and get you whether it'sher -- you or someone you know, you are going through something. let's help those who are struggling. come in navy, air force and marine corps veterans on staff. we've got every era covered from iraq to afghanistan. -- we can connect you to local resources. we are not looking for rice out of your rice old, but we want to be the soy sauce and all the rice bowls. we want to be out there so we

know we have a call center that you can call anytime day or night. you are never alone. we connect you to local resources if you are struggling. i will give you a couple of examples. we had a veteran in a hotel recently struggling. we don't normally do crisis calls, but we can do them as well. , theya long conversation talked to this veteran and helped convince him and he decided they were right. he went outside and locked his weapon in the trunk of his car. he agreed he needed help after they talked him through it.

the police officer came and took him to the emergency room and they took cam to the hospital where they admitted him. officer and police the police officer a veteran. he got it. one example. another was a grandmother who called who worried about her grandson who was in korea. he wrote her a note on facebook and said he's struggling. they finally got a hold of one of our peers and started making connections and got a hold of this young guy and the chain of command did a good job and got him some help. his grandma said please don't do day toain but, every matter what the challenges, they are there. you call us once and we

follow-up, as long as it takes. a couple of veterans have been with this more than year. they say i just want to know someone is going to call me back. one of the things we offer is a safety net. transitions are hard. we have over 46 veterans who do this. they are not volunteers. we train veterans to do this great work. prevention is key. we have to do it early. let's not wait until they are in crisis. let's offer to help them now and be that safety net and help them as they transition, whether it is transitioning out of the military or active guard service , there are 70 times they are out there that they can fall through the cracks. i wish my boys had a phone

number to call. i certainly wish my son kevin had. believe in our nation each and every day and i will tell you before i get off the stage, vets for warriors is here to help, not judge. it is stigma free. you are entering a stigma free zone. we are here to help and not judge. we will help them work through it together. many feel like they are going to get with a fire hose or fire hydrant. break it down into garden hoses. how can we help you today and let's work through it together. one veteran at a time, one army, ,avy, air force, marine corps one family member or caregiver at a time, that is how we work through it. i think you again and i thank

you for your leadership and thank you for your great friendship and i love your brother. thanks to all the veterans out there for sticking with them and i and as i always do -- this is the land of the free because of the brave. wait. for warriors, don't call. you are not alone. thank you. [applause] >> i want to start by thanking mark specifically and sharing an attic though before i think anyone else. i know mark because his son-in-law and i graduated at west point together and we were in baghdad together. it was one of those places no

one would go to if they weren't in the military. one of two things may happen. either marry her or go to jail. we are glad he's part of the family now. we have known mark for a while and we also want to thank senator donnelly and your staff. so much for everything you do to change the culture and the stigma and promote community as you do. so much for what you do -- to friends on the panel this sowe talk about often and i just realized i've worn this ties last two or three times we have spoken on the same panel. , and blue andite that is why i gravitate toward it. but i want to tell a couple of

stories -- our number one priority is combating suicide and the first story i want to tell is related to a point that this is a problem for our country, not just the military. i was speaking about the medal of honor recipients from iraq and afghanistan. the most recent recipient, and in anaptain was involved attack not long ago where a friend of mine died. i started to think about it last night. i was thinking of him as the most recent friend i have who has died as a result from these wars. firstmyself who is the person? i started to go through a list of names.

the first person in my class, 2002 west point who died was a cadet who died by suicide before the war started. he was home on christmas leave and he didn't come back and we did not know how to talk about it. that guy needs to think about to things -- community and culture -- it was described as stigma. the culture in this country is such that we don't talk about oneal health or suicide and of the amazing things i --sonally as an army veteran one thing i love about the legislation the senator has sponsored and is going to go out there and make a huge impact in the culture of the military is the idea of an annual checkup. i have a young son who is two years old. he has been to the dentist twice.

very painful visits both times. -- i haveputting embedded he will go to the end this every year. what does it have to do with mental health? it has everything to do with it. in this country, the idea of getting a checkup once the year for mental wellness is foreign to most people. when you start to look at it in that context, and other element was in apriland i of 2007 -- i had been there for about 10 months and i had a rap on my door and my commander, a dear friend of mine and mentor said you have a phone call and i was with joe quinn. it was my father on the line to tell me my oldest sister had

died by suicide and had taken her own life. it got me thinking how did this happen? here i was in iraq and baghdad and i didn't know the signs. no one in my family was prepared, no one where i'd grew up was aware what those signs were. i think it highlights the point that this is a challenge for our nation and our country. when i talk about culture in the community, it truly does impact all of us and i usually ask folks to artists paid. i'm going to ask the folks on -- how-- ask yourself many of you know someone that

you love or care about who is ?ied by suicide all of us know someone. why wouldn't we take action? why would we be more active in it community question mark is a situation we can tackle. i can talk about the idea of policy agenda. we have worked tirelessly and have worked with partners on a , but when we look at the policy component, good policy changes culture while leveraging community. were proud to support -- clay was a marine and that's why when we talk about 'birthdaye marine corps

-- he cannot get the help he needed. then i think about those who have even more difficult time trying to get over the barriers that exist. i feel privileged i have av to go to. the barriers to entry -- to entry are different freight sector but i feel privileged i can go to the v.a. and talk to the folks about the trauma i have experienced that is unique to war. but i think about my sister and the guardsmen in indiana, the reservists who do not have the access to the v.a. and they go and io these small towns felt alone in a very different way when i left the reserve than i did in active duty. uniquely different because i was in the exact and i had thes in

same neighbors, yet you have that aloneness. in closing, from my perspective, tomorrow is veterans day and we are proud to have over 150 events throughout the country tomorrow where individuals are going to come together across the country and tomorrow is veterans day but every day, we should be striving to build community and change the culture. his, readen't read the book. i've read it multiple times even knowing the story. get active in your community and ask how you can help. this is a problem that affects the entire country and we can be leaders on this.

that's what i want to leave everyone with. ?sk your self what can you do when you think back and raise or didn't rage her hand, we all know someone who has been touched by this. we know someone we care and love about an there something we can do about it. so thank you again for being an amazing partner. [applause] >> i can thank you enough for being -- i cannot thank you enough for being here today. at this point, i would like to turn it over to the audience briefly, if there are any questions. >> [inaudible]

>> up was the -- that was the -- thank you for bringing it up. that bill was the first bill passed by this congress and asing mental health military and veteran population. it was named after clay hunt, a proud brain who served in iraq and afghanistan. one of the things it did was provide an incentive for mental health professionals to go to the v.a.. about $30,000 or $40,000 in debt repayment that -- again, this is something that affects all of us. another thing he did was it that wouldwebsite

-- that would allow an individual to go to one place that would know where those resources are. there are so many efforts out there that one of the challenges we have is how do we measure outcomes? for warriors is doing tremendous work. let's try to look at things using a similar assessment. we have called on congress to toe a public hearing and ensure they are informed and have the tools they need to implement. we are confident over -- this is bill, weill -- trial will try to replicate and learn from it across the board. >> if i could add briefly to

obamaone thing president did is something that did not get quite as much attention as , the presidential letters of condolence went only to those who died in service. in war or killed training accidents -- they did not go to those who died by suicide. andident obama changed that started sending letters of condolence to the family members of those who died by their own hand. that was ailies, massive kindness because they would look at the families who had lost someone and they felt the same hold. that letter from the white house meant a lot. it could have been a daughter or wife -- your son served with honor and their death matters and we as a country recognize that.

this was i believe 2009. >> you mentioned calling on congress about the clay hunt act . is there anything else you want congress to do to address this? >> what we would like congress to do is build on the success of clay hunt. -- one of some things the things we talk about his access to care. i'm enrolled at the v.a. as a result of the five-year combat eligibility requirement allowed a to go to the v.a. and enrolled. who experienced trauma, the challenges they have toolder men were starting see an uptick of those individuals having challenges, 2, threeot happen 1,

years after it comes back. we extend that up to 15 years and that is something that can be done. senator donnelly has been a know he has a package on his desk he has been working on. it is a bold and we think sound with tohey are working address the dod site in the v.a. side. there is the culture peace as well. having the president send a letter out, what a tremendous shift in culture. they can go out and be leaders of change in use the right language. i never knew anything about -- theye right language

can speak intelligently about it and share their stories. policy is going to impact the culture and community as well. >> i think the trouble of that whole thing sending letters -- the newspapers don't report it. would be delighted -- delighted is not a good choice of words. we would be -- we do not get notified, so that's the hard part for us. may i ask a couple of other questions? rate fromcide operation desert storm and operation enduring freedom, is to that of the vietnam war korean era? it sounds like we hear more about it, that it is exponentially greater.

>> the honest truth is, the data , because it was not tracked as closely, it is hard to parse. what we now think of as ptsd has existed since people began picking up weapons against other post civil war, half of those were in mental hospitals, people who thought -- fought in the civil war. you had that number during the civil war. in world war ii, you had half a million troops, half a million, discharged because of what were called psychiatric disorders. so these men of the greatest generation, half of them are because they just can't do it anymore. ptsd emerged from the and him. the e