suggested that with recovery as the essential goal to helping veterans with ptsd that perhaps vba and vha were working at cross purposes. let me quote from that report. the advent of the recovery model is central to the treatment of mental health and disorders. the current system fails to support and may even create disincentives to recovery. close quotes. today we're going to move beyond the numbers that simply tell us how many veterans use the system and get into the fundamental question of whether they are on the road to leading full and productive lives. for veterans who don't seek va care we need to know why they're not seeking that care. we need to know if there are inherent disincentives to recovery. we need to know if the quality of treatment provided at va is a reason to c we need to know what is effective and what is not effective. quoting from a recent policy paper from the wounded warrior project, va's focus on the high percentage of veterans who have been treated begs such questions as how effective was that treatment? how many more need treatment but resist seeking it? and i

my question of vha was did you go to the places there would be problems. the answer was yes because we were asked to go figure this out. i would say we got a pretty pure response. what i think we need to do is make sure we take a broader look and make sure we understand across the larger population, what our issues are and where there are opportunities for reallocation or, you know, as it becomes clear to hire more people. i would offer to the chair, i took a look at what we have done in mental health over the last four budgets. if we look at '12 to '13, it is rather unimpressive. it is 5% and it matches the increase in the medical budget. between '09 and '13, our increase is 39% in mental health. if you include the advance, it will go up 45%. >> that is the result of the number of soldiers coming home with the invisible wounds of war which is increasing? >> true. we are anticipating a larger requirement here in the out years if we don't have clarity. we want to do a larger survey here as i indicated. then see what the outcomes are. let me turn to there pe

this is not unlike some of the comments you made about the growth in administrative function within vha. at the same time, advanced appropriation provides for a very substantial decrease in medical facilities. while i understand that some of that is based on the assumption they will transfer a certain amount of money and fte from medical facilities into medical services, it also is contingent on a cut of almost having that account. i think given a lot of discussion in recent years about the impact of funding on maintenance and the effect it's having on facilities, the committee should certainly be interested in looking into that further. and i know my colleague from the vfw will probably touch on this as well. and so with that, i'll leave -- i'll conclude my statement. i'll take any questions you may have. >> thank you. >> ranking member burr, thank you. on behalf of the disabled american veterans and coauthor of the independent budget i'm pleased to be here on behalf of our 1.4 million members on our views and recommendations for the independent budget for fiscal year 2013 as it relate

my question of vha was did you go to the places you thought there would be problems? and the answer is yes because we were asked to go figure this out. so i would say we got a pretty pure response. what i think we need to do is make sure we're going to take another broader look here and make sure we understand across the larger population what our issues are and where there are opportunities for reallocation or as it becomes clear to hire more people. i would offer to the chair, i took a look at what we've done on mental health over the last four budgets. if we look at 12 to 13, it's rather unimpressive. i mean, it's 5%, and it matches the increase in the medical budget, but between 9 and 13, our increase is 39% in mental health. and if you include the 14 advanced appropes it will go up 45%. >> and that's a result of the number of soldiers who are coming home with the invisible wounds of war, which is dramatically increasing, correct? >> true. but we are -- we're trying to anticipate that there's going to be a larger requirement here in the out years even if we don't

back of forces in afghanistan, the department has become inundated. 93,000 troops will enroll with the vhaa 183% increase from just five years ago. >> we see approximately five to 10 new iraqi/afghanistan veterans every day. we also continuously outreach to our veterans to increase that number. >> reporter: to prepare for the surge, the v.a. has increased staffing nationally by 24%. and new postdeployment clinics are being opened. >> these are special clinics that are designed around the returning combat veteran, where the veteran is at the center of care. >> reporter: but the v.a. has been criticized in the past. some say the system is too difficult to navigate and the waiting list to see a professional are long. officials say they are working hard to change that. >> give us another chance. things have changed dramatically, even in the last several years as far as how we're able to deal with the demand for our services. >> reporter: army specialist mika montoya says she has noticed an improvement. >> veterans should reach out to their comrades and encourage them to go to the v.a. or go to

va is requesting $400 million for four of the 21 partially funded vha major construction projects in fy '13. leaving well over $5 million remaining in partially funded projects dating back to fiscal year 2007. these projects include seismic deficiencies, improving spinal cord injury centers, completing a polytrauma-blind rehab and research facility, as well as expanding mental health facilities. this request is too low to sport the ever growing need of veterans. therefore, the id partners request congress provide funding of $2.8 billion to cover all major construction accounts. this will allow va to complete all can kashmir mental health center and fund the four be identified projects for fy '13. although the a's funding request for my construction accounts is lower than the ib's request, this level of funding will allow va to fund more than 120 projects. even though nonrecurring maintenance is funded through these medical facilities account and not to the construction account, it is critical to the is capital infrastructure. the is requesting $774 million in nrm for fy '13, but to k

for example, it is estimated that some 93,000 troops will enroll with the vha this year alone.crease from just 5 years ago. as for savings, veterans face a number of unique challenges, compared to those of the past. many have done multiple deployments overseas and more are returning home with ptsdrks or post traumatic stress disorder. so the v.a. increasing in staff size by more than 24% and the programs have been changed. new offices have been opened across america and new post deployment clinics have been established to provide the best care possible to meet the needs of our heros and not just the physical ones. >> we offer speech therapy and we offer marital therapy and they will need help with substance abuse issues and we have a mood disorder as well as substance abuse program here in our clinic, so veterans can get help for a number of issues itch the president's budget has been very helpful to us, in allowingitous expand that care. we have really been working for the last several years to expand the range of services that are available. >> reporter: now, many veterans ha

my question of vha was, did you go to the places we thought there would be problems, and the answer was yes because we were asked to figure this out. i would say we got a pretty pure response. i think we need to make sure we're going to take another broad look here and make sure that we understand, across the larger population, when our issues are and where there are opportunities for relocation or, you know, as it becomes clear, to hire more people. i would offer to the chair, i took a look at what we have done in mental-health over the last four budgets. if we look at 2012 to 2013, it is rather unimpressive. i mean, 5%, and it matches the increase in the medical budget. but between 2009 and 2013, our increase is 39% in mental health. if you include the 2014 advance to purge, it will go up 45%. >> a result of the number of soldiers coming home needing services, which has dramatically increased. >> it is true, but we're trying to anticipate that there is going to be larger requirement here in the count years, even if we do not have clarity. we are trying to prepare for that. we want to

my question of vha was with did you go to the places we thought there'd be problems, and the answer was yes because we were asked to go figure this out. so i would say we got a pretty pure response. what i think we need to do is make sure, we're going to take another broader look here and make sure we understand across the larger population what our issues are and where there are opportunities for reallocation or, you know, if as it becomes clear to hire more people. i would offer to the chair i took a look at what we've done in mental health over the last four budgets. um, if we look at '12-'13, it's rather unimpressive. i mean, it's 5%, and it matches the increase in the medal budget, but -- medical budget, but between '09 and '13 our increase is 39% in mental health. and if you include the '14 advanced approach, that'll go up 45%. >> and that is a result of the number of soldiers who are coming home with the invisible wounds of war which is dramatically increasing, correct? >> true. but we are, we're trying to anticipate that there's going to be a larger requirement here in the outye

my question of the vha was did they go to the places we thought there were problems and the answer is yes. i would say we got pretty pure response. what i think we need to do is make sure. we are going to take a broader look and make sure we understand across the larger population what our issues are and where there are opportunities for reallocation or you know, as it becomes clear to hire more people. i would offer to the chair, i took a look at what we have done with mental health over the last four budgets. if we look at 12 to 13 as rather unimpressive. it's 5% and matches the increase of the medical budget but a tween nine and 13, are increase is 39% in mental health and if you include the 14 they will go up 45%. >> as a result of the number of soldiers coming home is dramatically increasing, correct? >> chirla but we are trying to anticipate that those are going to be a larger requirement and the argument is even if we don't have clarity we are trying to prepare for that. we want to do a larger survey here as i indicated and then see what the outcomes are but let me talk with dr

my question of vha is did you go to the places we thought there would be problems and the answer was were asked to go figure this out. i would say we got a pretty pure response. what i think we need to do is take in a broader look to make sure we understand across the larger population what our issues are and where there are opportunities for reallocation or you know, as it becomes clear to hire more people. i would offer to the chair, i took a look at what we have done in mental health over the last four budgets. if we look at 12 to 13, it's rather unimpressive. i mean it's 5% and it matches the increase in the medical budget, but between 09 and 13, our increases 39% in mental health. if you include the 14 advance it will go up 45%. >> that is the result of a number of soldiers coming home, which is dramatically increasing, correct? >> true, but we are trying to anticipate that there is going to be a larger requirement in the out-years even if we don't have clarity. we are trying to prepare for that. we want to do a larger survey here, as i indicated, and then see what the outcomes

take the time to go through that but i am absolutely confident we'll be able to save that money in vha. >> madam chairman, if i may, one last comment here. we'll look at all this and work it hard. i cautioned us that, in the end we have to focus on what makes sense for veterans. and i will use dialysis as an example. we're after the best prices we can get and you know, just look at that, you may be encouraged to outsource all of it. i've argued that dialysis is something we have to retain a handle on. we should do a certain amount, a certain portion of it in-house. why do i say that? i'm just concerned that if we provide funds and let somebody else take care of dialysis we ignore what a medical profession is supposed to do and that is, as long as we're doing dialysis we'll have to ask ourselves what causes it? why do we have to do this? what are the things on the front rend that that allow us preventing diabetes so dialysis doesn't become a fact we have to live with. i think the medical profession is the best at asking those questions and that's why i think within va we need to retain