Answered a few questions from the governors. This is about 45 minutes. It was a classic situation where the host turns to the first speaker and says shall we let our guests enjoy themselves a little longer or would you like to begin your remarks now . Im sorry to interrupt all the conversations going on, but thats why were here. And the secretary has graciously agreed to be with us for this time, so lets take advantage of it. I want to thank governor fallon to agree to being the cochair. I want to thank the secretary for his remarks and for agreeing to remain afterwards to engage in dialogue with all of us. Im a little bit torn because i learned just as we walked in that hes a big Philadelphia Eagles fan who, yeah, governor, yeah, see . Well, im getting over it. But the Veterans Administration needs no introduction, so mine will be brief. The va impacts the lives of our veterans in so many ways, and in addition to its vital services, the va means something deeply special to our veterans. It is the fulfillment of a sacred promise that their country made to them. They stepped forward to protect and defend our country in a time of need. Some returned relatively unscathed from their service. Many, however, carry physical and psychic wounds which will plague them for the rest of their lives. Now they are in need. They need health care services, disability compensation, vocational rehabilitation, education assistance, home loans, life insurance. How well the va provides those and other services defines for them how well their country is upholding its end of the compact that they made when they were inducted. Mr. Secretary, ill begin the introduction initially and ask governor fallon to come up. But want to thank you and acknowledge the enormous responsibility that you undertake to ensure that your some 377,000 employees are providing the services that our 18. 5 million veterans expect and believe they have earned, they have earned and believe they deserve. The secretarys most annual performance report describes fiscal report for the department of Veterans Affairs. We have drafted a new Strategic Plan for fy 2018 to 24 that reimagines our relationship with veterans and how we serve them. As a result, the metrics we track will change significantly in some instances. That statement leaves much to the imagination and has triggered a multitood of reactions and over reactions. When i asked my minnesota Veterans Organization leaders what i should ask the secretary, my number one response was, are you going to privatize the va . So, i hope you, sir, will use this opportunity to provide a clearer picture of what you intend the va to transition to, how it will affect the day to day interface that each veteran will have with your organization, and how it will improve the quality of services they will receive. The but first let me turn it over to cochair governor fallon. [ applause ] thank you, governor day ton, and welcome to everyone. We appreciate you joining us here today for this very important discussion about our veterans in america and how we as governors and appellate can better serve our veterans to make sure they get the care and services they deserve. The men and women that serve in our military put their lives on the line. They give up their holidays, birthdays, and births of their children, anniversaries and miss all kinds of important events in their life and, of course, every time they put on that uniform and they go into harms way, they put their lives at stake. And we owe them as a nation and we owe them as governors and as citizens of our state to take care of our veterans. When theyre finished with their service to our nation. Now, their service doesnt just stop and their harms way doesnt just stop once the person leaves the battle field. It also carries on once theyre home. And many times there are many different issues that our veterans face that they need our help with. And were looking forward to hearing secretary schulkin and his discussion about the administrations plans and his plans as the secretary of the Veterans Department of how we can better care for our veterans and service their needs. Mr. Secretary, we are looking forward to hearing your comments about how we can improve the delivery of health care, how we can improve the delivery of cost that affects our states and our nations, how we can improve our infrastructure with our Veterans Homes and the quality of care that they receive. We certainly are all faced with problems ever homelessness among our veterans, with suicide prevention, which we all care deeply about having sufficient programs. Education and training is also very important to our veterans when they come home and if they enter into the prime sector to be able to work and find a job to support themselves and their families. And, of course, just getting through the system. The timeliness of services and being able to wade through all the paperwork and agencies that they deal with. Health services are certainly critical to our veterans and the care and treatment of issues they may need some extra help with. And of course we cant forget the families, the military spouses that transfer from the military Service Person to different communities and being able to find the right types of jobs and getting the licenses they need. In particular, i had the opportunity to talk with the secretary a few moments ago about Substance Abuse issues. I was telling him we just finished a panel about prescription drugs and Substance Abuse issues many times over the course of this weekend. And im very encouraged the Veterans Department and the secretarys focus on Substance Abuse and veterans courts and how we can help keep our veterans out of the criminal Justice System by being able to divert them away from that from Substance Abuse and treatment for some issues that they may have. So, mr. Secretary, i know that our governors are willing and excited to be able to engage with you to work with you. We want to take care of our veterans and give them the type of respect and care that they deserve in the service to our nation. So, we appreciate you taking time away from your very busy schedule. Secretary of one of our most departments in our nation and we ke welcome you to the National Governors association. Please welcome mr. David [ applause ] thank you. Thank you very much. Good afternoon, everybody, and governor dayton, governor fallon, thank you for those comments. I appreciate it. And also i think i want to have a chance to just update you as both our governors have said, but were going to have a chance to hear from you and some questions and some interaction which i really look forward to. Its the way i learn best. Just this past month i had a chance to meet with the directors of your state Veterans Homes and later on this week im going to have a chance to meet with your state directors of Veterans Affairs. So, the more interaction that i can hear and we have a chance to share about whats happening in your states and how we can better support you in both of our support of our veterans, its really important. I always like to start with why we do this, and it really is our mission. As you probably remember or have heard from history, right before his second inaugural address, president lincoln gave the country this mission that it really is our responsibility to care for him or her who have borne the battle and to be able to be there for them when they come back home and their families. Thats what we try to do every day. This past year weve had some really important accomplishments. 11 bills that have passed through congress, the president has signed, are all done in a bipartisan way. We have, i always say, the best committees in congress because they work on the issues. They dont let politics get in the way. They focus on veterans. And because of that, weve done some pretty important things i think for veterans. We are focusing a lot on how we support them. We have a new family care giver Advisory Group and were so fortunate senator Elizabeth Dole has agreed to chair that for us. We launched the 24 7 veterans hot line that goes into the white house and that is an important way for us to get information directly to get the support of the white house. As you know, we have expanded our g. I. Bill now to provide more education benefits thats happening in your states. That was terrific. We changed the appeals law to modernize it. Last time it was updated was 1933. And were making important progress there ill talk about. Were continuing to get our Choice Program working better, and already we have extended and expanded the amount of support to get veterans care in the community. I have expanded care, Mental Health care to those other than honorably discharged. What most people dont realize is 15 of people who leave the Service Leave with an other than Honorable Discharge and they dont have access to health care, particularly Mental Health care. So, we have begun to address that. The president just signed an executive order that 100 of Service Members who leave will have Mental HealthCare Coverage for 12month period of time. Only 40 today who leave the service have access to Va Health Care services. So thats going to be 100 . And weve just released a national i. D. Card for veterans. But really, were here to talk about how we can Work Together better and thats so important to us to be a better partner to you. We understand your role in caring for veterans is essential. 50 of all veterans across the nation are in your facilities in longterm care. We also know that we can work with you using Technology Like telehealth to reach into those facilities and were beginning to do that. We have about 13 states that now have access to our telehealth expertise clinically and we want to expand that to give all of you that type of care. The state veteran homes are working with the federal government in important areas to improve safety, like falls initiatives, to prevent falls in your state Veterans Homes and thats something that we think is going to make a big difference. Some states, and i cant name them all, i dont have the time, Like Washington state is working with us where were putting a clinic right on the state Veterans Home ground so we can provide Mental Health services and this type of partnership i think works really well. And in terms of getting claims faster, texas and california, but many, many others working with us to get that backlog down. I think you probably know about our work with you in the Veterans Cemetery program. We have awarded 766 million to states to help support getting cemeteries, every single state in the country has a va cemetery. And some states, i think that theres five no, four states that have five veteran cemeteries. Arizona, missouri, maryland and maine. We have six more currently under construction throughout the country and two states this year opened up cemeteries. New mexico and mississippi. So, the way that this works is that if you provide us the land, we will be able to provide you support to develop it, open it, and work with you. So, thats an opportunity i think for us to all plan ahead. Theres 109 of them as i said. You can see where your state is, how many there are, but its a very Successful Program this collaboration that we have with you. Were also working with you to end vet ral homelessness. Three states have already ended Veterans Homelessness, more than 50 communities have announced an end to veteran homelessness. Nationally we had close to 50 reduction in the number of Homeless Veterans over the last five years. But still we have 45,000 veterans in this country who are homeless, and so we know that the only way we can tackle this is by working closely with local communities and states to Work Together in a collaborative way. And we are committed. Were putting more money into this in this budget. Were focusing and refocussing our efforts on what we know works and what doesnt work. I dont need to tell you that our veterans are getting older. The population is getting older. You know that by looking at your own data. But that means that its pretty predictable that when people get older theyre going to need our help more in terms of support services. And weve modelled this out that the growth in longterm care and working with you in the states is going to be even higher in the next decade to come. And so we have to do this in a smarter way. The way that were focused on this is that ive identified five priorities and i just want to briefly touch on these so you know where were focusing our efforts and see whether its also hitting on things that you think are important to you, because we may need to make some adjustments. The first of the five priorities is to give our veterans greater choice. And that means that we believe that they should be involved in where they get there are care, decisions about where they get their care, and how they get their care, and how they get their services. And were trying to change our current systems from being very rules based, administrative based, they need to be 40 miles way, wait 30 days before you can get access to the ability to get choice, to a more clinically driven system. The type of system i run as a ceo in the private sector where we focus on whats the right thing to do for our patients and our veterans. And so were working with congress right now. We have 26 rsos avsos to give vs a greater choice. The second of the priorities is to modernize our systems. I was talking to governor fallon and she said, you know, our facilities are pretty old. And more than 50 of our facilities are 60 years old or more. So, were focused on that. One of the decisions that i just recently made was to scrap our home grown old Electronic Health record and select a modern, off the shelf electronic record. It happens to be the same one the department of defense uses which, looking back in history, weve been trying to do for 17 years, get these systems to talk. And weve spent over a billion dollars getting two systems to talk and we still cant do it. So, why dont we just otheuse t system theyre using and get to a modern system. Thats what were doing. Were trying to modernize our facilities. I was telling governor fallon were trying to do do something now in tulsa like this. This is the facility in palo alto. This is the type of facility you and your family want to be in, a place they can stay with you, single rooms, pleasant. We want this for all of our va facilities and now we are beginning to do that. For the first time in over three years, Congress Worked with us to get 28 new leases out in your communities. Were looking at doing business differently by working with the private sector to build with them, not have federal construction be the only way of building new facilities. We think we can do it faster and cheaper by working with the private sector. Im also eliminating old and unused buildings. No sense paying for maintenance of vacant buildings, unutilized buildings. Ive announced 1100 or 1200 vacant unutilized buildings, weve already eliminated a couple hundred but were going to continue to do that. The infrastructure bill that was recently talked about, while it doesnt have money for va, it allows us to take the proceeds from what we get rid of and reinvest it in your facilities that we know veterans need to modernize those facilities. So we think that is an important tool. The third of the 5th priorities is to just improve the timeliness of our services. 97 of all of our appointments are completed within 30 days. 86 within 7 days, 21 are done on the same day basis. We have established same day services for primary care Mental Health in every one of our Va Medical Center facilities now. So, if you have an urgent issue in primary care Mental Health, same day services are available. We also are the only Health System in the country that im aware of and no one has proven me wrong yet, that publishes our weigh wait times. You can see it updated every two weeks in real time. Whether the good, bad, two week. Whether theyre good, bad, need a lot of work to develop, were sharing that data with our veterans so they have information about how to make choices about their decisions and so we can focus on improvement. No other Health System does this. We know from data that has been studied that while v. A. Still has access problems in particular locations, overall, v. A. Wait times are shorter than the private sector. Im sure you get calls saying hey, friend, family is sick. Can you help me get them an appointment at a place . We all know that still is a challenge in the private sector, but v. A. Wait times tend to be up to 40 better than in many parts of the country that struggle with shortages of primary care. Were also doubling down on technology. Nobody is doing more telehealth in this country than the v. A. Over a billion dollars a year. 730,000 veterans getting their health care through telehealth. Im the first secretary that still practices medicine. Im talking to one of my patients on the screen. Hes in oregon. Ive never been there, but thats where i see patients from my office in washington. And using our federal supremacy licensing, we are able to use v. A. Clinicians f