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Hearing of Senate Veterans' Affairs Committee - 2013 Budget Request


Location: Washington, DC

U.S. Senator Daniel K. Akaka questioned Secretary Eric Shinseki at a hearing on the Department of Veterans Affairs 2013 budget request yesterday.

Akaka thanked Shinseki for including in the budget a new care facility in Ewa, Oahu that the senator has championed which would allow for more efficiently provided VA services for Oahu veterans by expanding capacity and reducing wait and drive times. Akaka later asked for the secretary's commitment to try to work with the Native Hawaiian health care systems to help improve Native Hawaiian veteran access to care on the neighbor islands.

Senator Akaka's opening statement at Senate Committee on Veterans' Affairs hearing on the Fiscal Year 2013 Budget for Veterans' Programs:

I want to say aloha to Secretary Shinseki and his leadership staff at VA. I want to thank all of you for your service to veterans and, of course, to our country.

And I don't need to tell you what you've been hearing, that Secretary Shinseki and the leadership staff have been improving services, because claims have dropped and that's an indication. The care and treatment, which is our duty to provide to veterans, is something we must continually strive to improve and you have been doing that.

I am encouraged to see that the total budget request for VA was $13 billion above last year. I know we have budgetary constraints, but we owe it to our veterans who have sacrificed for our country.

I am glad to see increases in the budget requests for mental health, suicide prevention, and Iraq and Afghanistan Veterans Programs. I am also encouraged by major increases in funding for homeless vets and women vets programs.

While budget increases provide opportunities, we all know that these resources must be utilized with thought and efficiency in order to best serve our veterans and their families.

As the Defense Department continues to reduce its participation in overseas contingency operations and more veterans come home to their families, VA's capacity to treat veterans is sure to be tested even more.

Mr. Secretary, we have talked about this -- and I know that you are doing all you can to prepare for the anticipated growth in the number of veterans seeking VA services.

Secretary Shinseki, I'm also very pleased to see that an important project for Hawaii's veterans, which I have championed for several years, is in the budget: a much needed care facility in Ewa, West Oahu, that would alleviate some of the overcrowding at the Spark Matsunaga Medical Center at Tripler hospital. This proposed lease will certainly help to meet the needs of our veterans in Hawaii.

And Mr. Secretary, I have been impressed with all that you and your team have been able to accomplish in the past three years. You have made tremendous strides to improve mental health care and suicide prevention, end homelessness, and help veterans find jobs, among other accomplishments.

However, we know that there are areas where we can improve the care and services provided to our veterans which they earned and most definitely deserve. SoI look forward to hearing your testimony today, Mr. Secretary, and continuing to work with my colleagues and VA to help provide the best care we can to our veterans and their families. Thank you.



General Shinseki, as you know, we often face challenges in treating our veterans who live in many rural and remote areas. This is especially true in places like Alaska and Hawaii where you just can't get to some places by jumping in a car and driving there.

I know that you are working on an MOU with the Indian Health Service to find solutions to help provide services to our native American veterans and I commend your involvement in these efforts.

Mr. Secretary, can I get your commitment to look into possible ways of working with the Native Hawaiian health care systems and the Native American veteran systems to provide services for, in this case, Native Hawaiian veterans who live in many of the rural parts of the State of Hawaii.


Senator, you have my assurance that we will do our utmost to provide for any of our veterans wherever they live in the most rural and remote areas, the same access and quality to health care and services as we provide someone living in a more urban area.

There is a challenge with that, but we are not insensitive to that challenge and we are working hard to provide -- V.A. provide its services and where we can't to make arrangements where -- if quality services exist in those areas, making arrangements for veterans to be able to participate in those local opportunities.

We are -- I think you know -- working and have been now for some time on signing an MOU with Indian Health Service so that wherever they have facilities and we have vested interest that a veteran -- eligible veteran going to an Indian health service facility will be covered by V.A.'s payments.

And we're in stages of trying to bring that MOU to completion. We intend to do that -- and where tribes approach us prior to the signing of that MOU and want us (inaudible) from a tribal nation with V.A. a direct relationship because they have a medical facility and would like us to provide the same coverage -- we're willing to do that, but that would be on a case by case basis.


Thank you. Secretary Shinseki, staffing shortages continue to be a problem, although there's been progress with some, still seeing staffing levels below 50 percent causing excessive waiting times for veterans that need care.

I understand this is an issue you've been working on because you know the number of veterans needing services is growing yearly. You have been making progress. Can you provide an update on the department's progress to address staffing levels?


Senator Akaka, thank you for the question.

We've addressed (inaudible). We've talked about mental health earlier in the efforts that we're making to try to assess whether there's adequate staffing there.

I think you're probably talking about primary care which is our largest outpatient clinic operation. We treat 4.2 million veterans in our primary care system and it accounts for the lion's share of our budget expenditures.

We assessed staffing three years ago when we began to implement what we call the Patient Align Care Team or PACT program and have done it again recently. And we're finding that we are now able to bring up the support staffing and the physician staffing to reasonable levels associated with the standards around the country.

I would be -- would like to take off record -- offline, any information you have about specific places where there's a 50 percent vacancy rate. I'm not aware of the fact that we have this around the country.

So I will be delighted to meet and talk with your staff and find our where these areas might be so that we can address them specifically.


Secretary Shinseki, as we face budget constraints, let's all work to improve all efficiencies and redouble efforts, to look for ways to get the most for our budgeted resources.

My question to you is -- can you talk about any steps you are taking to improve the acquisition process at V.A. and any efficiencies you have been able to realize in this area?


Senator, I would tell you that we have been working for several years now on restructuring our acquisition business practices.

Three years ago, acquisition was spread throughout the organization. Now, it's consolidated in two centers -- one comes directly under Dr. Petzel, and that's for all medical acquisition -- gloves, masks, aprons. We ought to be able to leverage that into bulk purchase and get a good price on those kinds of things.

For everything else, we have an office of acquisition logistics and construction and we have a director who heads that office and everything else governing acquisition is consolidated under his review -- both offices work -- the work of both offices then come up to my level to the Deputy Secretary as part of our monthly oversight review process.

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