National Press Club

Date:

Denis McDonough Washington, DC

This year marks the 50th Anniversary of America’s withdrawal from Vietnam. This year and every year, we remember the 58,220 American patriots who were killed or are still missing from that war. And we honor the 9 million Americans who raised their right hands and committed to serve and defend our Constitution as members of the Armed Forces during that tumultuous period in our country’s history. 

One Veteran, Everett Alvarez, ejected from his A-4 Skyhawk on August 5th, 1964, shot down over North Vietnam. He landed in the water, among a small fleet of Vietnamese fishing boats, where he was quickly taken captive and became the first of 766 American Prisoners of War in Vietnam. Lieutenant Alvarez endured over eight years of captivity in the infamous Hanoi Hilton, marking the passage of time on the walls, and celebrating his own Catholic Mass every Sunday. He chose to hang on to every motivation he could muster—thoughts of home, the strength of faith, trust in his country, and a deep sense of duty to his fellow POWs. On February 12th, 1973—shortly after the US signed the Paris Peace Accords—Lieutenant Alvarez was finally freed.

His service didn’t end when he came back home. He remained in the Navy, retired as a Commander, and continued serving the Nation out of uniform—as Deputy Administrator at the VA, and as an advocate for his fellow Vets and their families. But my favorite part of Commander Alvarez’s story is what happened while he was recuperating after coming home. He met a wonderful woman, Tammy, and asked her on a date. That date—their first date—was at the White House, at an event honoring Commander Alvarez and his fellow Vietnam War POWs. Just a few months later, on October 27th, 1973, they married. And just last week, they celebrated their 50th year of marriage. Commander Everett Alvarez and Tammy are on another date—here this afternoon. Congratulations, and thank you for your courageous service to the Nation, your enormous sacrifice, and the high example of duty to country.

Veterans Day is Saturday. It’s a day we remember the millions of brave men and women—just like Everett Alvarez—who fought our nation’s wars and stood guard over our country during the periods of restless peace in between. It’s a day to reflect on what Veterans and their families have done and on what they’ve sacrificed for our country, for all of us. Because here’s the thing. When someone signs up to serve our country in the military, we make them a promise. If you fight for us, we will fight for you. If you serve us, we will serve you. If you take care of us, we will take care of you when you come home. Our country as a whole makes that promise. At VA, it’s our privilege and our honor to keep that promise.

So I’ll start with an update on what we at VA are doing to keep our promise to Veterans.

Since President Biden took office, VA has delivered more care and more benefits to more Veterans than ever before. When it comes to the benefits Vets have earned and deserve, we’re processing their claims faster than ever before.

Here’s an example. Just over a year ago, President Biden signed his historic legislation designed to care for Veterans who were exposed to toxins in Vietnam and in thirty years of war in Central Command. The PACT Act. Sergeant Major Kenneth Erickson is one of those Vets. Sergeant Major Erickson served in the Army for nearly 30 years, with combat tours spanning from the jungles of Vietnam to the deserts of Operation Desert Storm. Last May, the Sergeant Major was diagnosed with esophageal cancer, and he filed for those new toxic exposure benefits. Our VA benefits team expedited the review of his claim. In less than a week, Sergeant Major Erickson was granted 100% service connection. And his benefits were backdated to August 10th, 2022, the day President Biden signed that bill into law. Because of that law, Sergeant Major Erickson has one less thing to worry about during the toughest battle of his life.

That’s what we mean when we talk about keeping the promise. Altogether, VA processed nearly 2 million claims in 2023—shattering last year’s record by 16%. That meant 1.5 million Veterans and their survivors received over $163 billion in earned benefits. We’re also providing more care to Veterans. This year VA delivered more than 116 million health care appointments to Veterans, exceeding last year’s numbers by more than 3 million appointments. And it’s not just more care, it’s better, world-class health care. Study after study shows we’re delivering better health outcomes for Veterans than the private sector, which is a big reason nearly 90% of Vets who come to VA now trust us to deliver their outpatient care. 5.4 million people—including 4.1 million Veterans—are taking their final rest in VA national cemeteries. And we’ve doubled our online Veterans Legacy Memorial program to nearly 10 million Veterans—a digital platform keeping Veterans’ stories alive long after they’re gone.

Now look, behind all those statistics are Veterans like Commander Everett Alvarez and Sergeant Major Kenneth Erickson. They are our neighbors. They’re our friends. They’re teachers, civic leaders, coaches, and loved ones. They’re continuing to serve America, to defend and strengthen our democracy, long after they take off the uniform. And all our work at VA adds up to the single statistic that matters most: Veterans lives saved, or improved, by the work we do, together.

That’s what we’ve done. Now a bit about how we’ve done it, and who does it.  The VA workforce has been delivering for Vets during a period of rapid change, teaching us vivid lessons that have forever altered the way VA does business.

First, while the COVID-19 public health emergency came to an end six months ago, let’s not forget that VA’s clinicians and frontline staff provided world-class care through what has been a devastating, once-in-a-century health crisis. From the moment the pandemic hit, VA’s public servants mobilized around one core mission—saving and improving the lives of Veterans, their families, caregivers, and survivors. They worked long hours. They sacrificed precious time with their families. They risked their own lives—and by extension the lives of their loved ones—to serve Veterans. Because, you see, that’s our promise. And there are Veterans at home with their families right now, happy and healthy, all because of the best workforce in federal government. I am incredibly grateful to every one of them.

Second, today’s servicemembers and Vets represent the most deployed force in our history. And our thoughts are with the brave men and women serving in uniform in this period of heightened readiness and urgent security challenges in the Middle East and around the world. Through this thirty-year, intense period since September 11th, 2001, many have experienced multiple deployments and came home gripped by both the visible and the invisible scars of battle and moral injury. All of them were exposed to particulate matter and toxic fumes from burn pits and other sources. Months or years later, some have developed—and others might yet still develop—conditions that followed them home from war, and impact their lives long after the guns fell silent. And it’s our job as a nation to provide those Vets, their families, and their survivors with benefits and care for those conditions. Because that’s our promise. And that’s exactly what we’re doing. 

These important developments—the pandemic and our national commitment to recognize the need to care for burn pit exposures—have catalyzed a dramatic period of change and reform at VA, revolutionizing the way we do business. But one thing hasn’t changed: keeping Vets at the center of everything we do. So let me share four lessons we’ve learned during VA’s new, Veteran-centric era.

First lesson: we are fitting our care and service into Veterans’ lives, not expecting Veterans to build their lives around us. If we’re going to keep our promise to Vets, we need to meet them where they are, when they need us, without exception. So we’ve reached out to Vets and listened to what they wanted. And using a Veteran-centered design approach, we developed tools to ensure Veterans and their caregivers have positive, productive experiences when engaging with VA. We overhauled VA dot gov to make it the digital front door for all the services VA offers Vets. Medical appointments, filing a claim, applying for education benefits all go through that same front door. And the new VA Health and Benefits Mobile App gives Vets access to that digital front door, meaning Vets with a smart phone can have all their VA services right in the palm of their hands, wherever they are. So, while a Vet’s waiting to pick kids up from school, out on a lunch break, or watching a football game, they can refill a prescription, send a secure message to their doctor, take a quick telehealth appointment, access their travel reimbursement, and more.

It’s working. Not perfectly, but it’s working. We’ve seen a staggering 3000% jump in Vets’ virtual home visits since 2020—nearly 28 million total in that time span. By offering care that’s built into the lives of Vets at VA, in the community, via telehealth, and alongside focused processes and technological advances, we’ve decreased average wait times in nearly 60% of our facilities while still delivering the very best health outcomes for Vets. The same is true at VBA, where we reduced our average time to complete a claim by 15 days. And at the Board of Veterans Appeals, where using tele-appeals helped us set a single-year record of 103,000 claims decisions over the last year. As a result, Vets’ trust in VA has grown stronger. Here’s the point: we at VA are about shaping solutions for Vets that meet them where they are, that are adapted to them and their needs, rather than expecting Vets to adapt to us.

Second lesson, VA’s people—not machines, not buildings, not computers—keep our promise to Vets. From ending Veteran homelessness, to delivering toxic exposure benefits, none of it happens without the best workforce in the federal government. They’re the most passionate, highest-performing public servants in the country. They’re folks who want to make real differences in the lives of Veterans. I’m proud and I’m privileged that they’d consider me their colleague and teammate. We owe it to them to have a workforce sized to meet the mission, that can ensure we operate to ensure Veteran patient safety and high-quality claims decisions. So, this has been a year of hiring at a record pace while retaining our experienced staff. This year, we strengthened our partnerships with our unions and both the Veterans Health Administration and the Veterans Benefits Administration grew at their fastest rates in 15 years. VHA now has more than 400,000 employees for the first time in history. And with 32,000 employees, VBA’s bigger than it’s ever been. We’ve also increased employee retention, even in one of the hottest labor markets in decades—a market with profound health care provider shortages. Why are we able to grow our workforce in this context? Because people want to work for our nation’s heroes.

People like Chelbie Long, a VA Nurse Aide. For her, serving Veterans at the Bay Pines VA is a family affair. Her brother’s a surgical nurse at Bay Pines VA, and they’re both following in mom’s footsteps—a nurse in the Bay Pines Community Living Center. And Navy Vet Crishawn Lloyd, a Veterans Service Representative—or V-S-R—at the Chicago Regional Office. Crishawn was inspired to work at VA because of the thorough, responsive care his VSR gave him when he was transitioning out of the Navy. Then there’s Hector Rodriguez, a Marine Corps Vet. Hector went from being homeless on the streets of San Diego to working as a caretaker at Miramar National Cemetery, thanks to VA’s Compensated Work Therapy program. Hector regularly returns to his former homeless camp, hoping to inspire and support other Vets in crisis. Veterans helping Veterans. There is nothing better.

Third, this work takes all of us. VA can’t—and doesn’t—keep the promise to Vets alone. From the White House to the Hill, from faith-based and community groups to Veteran Service Organizations, from private sector to universities, we all play a critical role. These partnerships are helping us tackle some of our most pressing priorities on preventing Veteran suicide, ending Veteran homelessness, improving health care access, and more.

We just launched the second round of grants under the Staff Sergeant Parker Gordon Fox Suicide Prevention Program. These grants go to local organizations implementing innovative new suicide prevention services where Veterans live and work, meaning that we fund local people who know their Veterans best. Organizations like Nation’s Finest, which provides transitional and permanent supportive housing for Vets in rural communities across California, Arizona, and Nevada. This team recently helped a pregnant Vet fleeing domestic violence. They enrolled her in prenatal care at VA, connected her to Veteran resources, and provided her with temporary housing. She is just one Veteran of hundreds they help every year.

And working with state, local, and community partners, we are providing more housing and wraparound services to more homeless and at-risk Veterans than ever before. As we did last year, we are on pace again this year to exceed our goal of permanently housing 38,000 homeless Vets.

Part of the way we provided more care to more Veterans than ever before is through the community care program. Succeeding in the community means scheduling appointments faster. We’re doing that. It means paying our bills more quickly. We’re doing that, too. And it means incorporating the records of that care in the community into the Veteran’s record so that we recognize the full promise of VA’s integrated health care system, allowing providers and Vets to work together to build joint plans of treatment and medical interventions. A psychiatrist seeing a Vet for PTSD and TBI can see their Vet’s neurological records. Then, the team can huddle up with the Vet and their loved ones to discuss coordinated care plans along with the neurologist, social workers, clinical pharmacists, primary care providers, and any other team member involved in that Vet’s care. This kind of integrated treatment improves outcomes. It saves Vets’ lives. But if we are not getting the records of the Veterans care in the community, we decrease efficiency, increase costs, and reduce effectiveness. So, we have to see our community partners as just that—partners in our quest to provide integrated, Veteran-centric care that leads to high-quality outcomes.

Now, as I stand before you in the National Press Club I have to underscore our partnership with the press. We cannot keep our promise to Vets without you, the journalists who tell Veterans’ stories—journalists like Patricia Kime. You know, Patricia’s stories make VA better. Because they trust Patricia’s reporting, Veterans, VA employees, and other stakeholders talk to her when something is not working the way it should or the way we are telling you it is working. So her reporting and her stories help us better understand what Veterans experienced in war, what they’re going through here at home, and how we can better help them, oftentimes bringing something to our attention that we did not know was happening. For example, a couple months ago, Patricia noticed a software issue on the VA.gov website that was preventing some Vets from submitting claims appeals. She asked us for comment. Alerted to the problem by Patricia, we were able to immediately fix the bug, reach out to Veterans who were impacted, alert Congress to the issue that this important reporting identified, and prevent similar issues from happening again in the future. Patricia’s here today, so I’ll speak to her directly. Your work’s having a direct and positive impact on the lives of Vets. You make us better able to serve Vets by holding us to account.

You and so many great journalists—people like Leo Shane, Quil Lawrence, Ellen Milhiser, Ben Kesling, Eric Katz, Courtney Kube, Jory Heckman, and Orion Donovan Smith—are helping us serve Veterans far better than we ever could alone.

And just yesterday, investigative reporting from Dave Philipps in the New York Times uncovered the unseen TBI risks faced by Soldiers and Marines who operated heavy artillery weapons in the fight against ISIL. Because of his reporting, VA will be reaching out to those Vets who served in field artillery units to ensure they’re receiving the care they need. Those Vets served in Syria and Iraq, making them eligible for toxic exposure care under the PACT Act. Several of the Vets profiled in Dave’s piece are characterized as receiving less than honorable discharges. While VA cannot change a Vets’ character of discharge, Vets are not automatically disqualified from VA services because of discharge status. In fact, over the past 10 years VA has granted benefits or care to 73% of Vets with Other Than Honorable discharges. So to those Vets in that heartbreaking story and any Vets watching today, we want to serve you. Please, apply now. And re-apply if you’ve been denied before. And we need everyone’s help—every single person in this room’s help—communicating with Vets, so they get the care they need, and the benefits they deserve.

Fourth and finally, we’ve seen again and again that earning Veterans’ trust is critical to everything we do. Trust means many things for Vets. It means making it easier for Veterans to get care and benefits, ensuring that their VA services are effective, and that they feel respected when they come to VA. There’s no greater privilege than having that trust, and there’s no higher bar to meet. Since VA began measuring trust in 2016 through something we call the “V-Signal,” those three measures of trust and the Veteran experience—ease, effectiveness, and emotion—have increased. VA currently has 174 active surveys bringing in over 12 million responses over the life of V-Signal, allowing us to hear directly from Veterans about their experiences at VA. All of this information is released to the public through our quarterly VA Trust Reports and at va.gov/trust, tying trust metrics with our performance at VA.

Three of the VA teammates who help manage this intensive survey process that helps us ensure the Veteran experience and trust in VA’s care and benefits joined me at lunch here today. They all work in front-line Veteran Experience roles, helping VA measure and learn how to build trust better with Veterans. Let me tell you about them.

  • Brianna Camera went into health care because her dad was sick when she was in high school. Her grandpa was an Army Vet, but he didn’t trust VA care when he left the military. And that’s her passion—making damn sure other Vets have a good experience with VA.
  • Lynn Thiem comes from a long tradition of naval service. While she didn’t serve, she often says that there’s “seawater in her family’s blood.” Well, when her son joined the Navy as a rescue swimmer, Lynn was working on digitizing VA’s old paper records. She went on to lead the very first Veterans Experience project on machine learning, and today she brings her expertise to help VA make data-driven decisions to our benefits processes.
  • And Richard Barbato served as an Army officer in the 82nd Airborne Division—All the Way! He fought in the initial invasion in Iraq. And in the years after, we’ve lost 40 of the Paratroopers he served with to suicide—including a best friend. Many of them rest today across the river in Section 60 of Arlington National Cemetery. Richard came to VA to honor them. And, he says, “This has never felt like work. It’s a mission. I wake up every morning because of this mission.”

Now you see why I’m so excited and humbled to be a part of this team. They each share the same deep devotion to keeping our promise to Vets that characterizes all of VA’s people. Our mission is far from over. There are enormous challenges ahead, not least meeting the demand of the millions of veterans who have filed claims under the Pact Act and who will qualify to be enrolled in VA health care. But I know that with my VA teammates leading the way—public servants like Brianna, Lynn, and Richard—VA will continue serving Vets every bit as well as they have served all of us. And as we look to the future, we’re not trying to build a VA that goes back to the old normal. Instead, we’re going to continue to do better for Vets. We’re going to continue to be better for Vets.

And this future at VA isn’t because of me. It’s because of the 450,000 VA employees—in your communities and neighborhoods across the country—who keep Vets at the heart of their care. And it’s because of you, too.

So, again, to all the Veterans here today, and watching, thank you—for everything.

And, to the Press Club, my thanks for all that you do holding us accountable to Vets, and telling their stories in the powerful ways that you do. God bless you all. And God bless our nation’s servicemembers, our Veterans, their families, caregivers, and survivors. Now, Eileen, let’s go to questions.

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