 Check one two three four five six seven eight nine ten check one two Moving on Ladies and gentlemen, please take your seats. The seminar is about to begin. Thank you Good afternoon everyone And welcome to the benefits protection team seminar It's been another extremely busy and productive year for the legislative department And I'd like to start by recognizing and thanking my staff for their hard work throughout the year Deputy National Legislative Director Adriana Osado Assistant National Legislative Directors Paul Varela Shironda Love and Lee Roya Costa Senior Executive Advisor Peter Dickinson and not here with us today But very much a part of the team senior advisor John Bradley senior legislative support Specialist Lisa Bogle and legislative support specialist Karen Mully Since we met in convention last year DABS testified at 18 congressional hearings and commented on over 90 bills and draft legislative measures We've continued to focus our efforts on DAV's key legislative priorities expanding caregiver support benefits to all areas of veterans improving healthcare programs and services for women veterans Finding a long-term solution for reducing the appeals backlog and most importantly Strengthening the BA healthcare system for the next generation of injured and ill veterans Our progress on these key legislative priorities were bolstered by our legislative interim committee members Chairman Al Abel, Jim Percunier, Laird Culver and Richard DeGloria Please give them a well-deserved round of applause Just as important as important to our cause is our grassroots Participants those loyal followers of DAV social media the commander's action network and our newly appointed benefits protection team leaders I want to thank each of you for your continued support to our collective voice Everything we achieve is built on the strength of our members Auxiliary and supporters and together we're recognized as the premier organization and voice for our nation's injured and ill veterans with the presidential and congressional elections in the months ahead and Only a short window of opportunity exists for Congress to pass its funding measures and all of the veterans bills that are pending and While it is extremely important. This work is completed before the lawmakers leave town for their political campaigning There's a much bigger issue on the horizon that impacts us all the future of the VA healthcare system Unlike traditional policy debates about how to strengthen and expand veterans programs for the first time in a generation There have been open calls by some for reducing or even dismantling the VA system entirely an outcome that would be devastating for disabled veterans Others propose giving all veterans unrestricted choice But don't offer a way to pay for the enormous associated cost Which has been estimated to run in the billions even up to a trillion dollars over the next 10 years Next year we'll have a new president and Congress who will have to make critical decisions about the future of the VA healthcare system The use of community care and the role of choice Today there are two very different paths forward that would produce two very different futures Now more than any other time. We must ensure our voices are heard as an organization We support a health care system that can deliver timely high quality integrated care and specialized services one that is focused on veterans as Secretary McDonald said this morning as disabled veterans We should have a say in the future of VA a system designed specifically to meet our unique health care and rehabilitative needs The decisions made over the next several years will determine VA's future and what new generations of veterans can count on if They're wounded or injured or become ill as a result of their military service So in the months ahead, I urge you to get involved learn more about the issues What's at stake and most importantly take action? Let the candidates know what is important to you as a disabled veteran or a caregiver of one We've provided a virtual handout with updates on DAV's key legislative priorities and current proposals for VA health care reform They're available on DAV's website and please sign up for our commander's action network So you could keep up to date on what's happening in Washington Now I'm very pleased to introduce our special guest speaker this afternoon Someone who can tell you firsthand about the changes underway and the progress made to reform the VA health care system Dr. David J. Shulkin the Department of Veterans Affairs under secretary for health Dr. Shulkin hit the ground running and has worked tirelessly since his appointment at VA just over a year ago He brings a wealth of experience and as the chief executive of the Veterans Health Administration He leads the nation's largest integrated health system with over 1,700 sites of care serving nearly nine million veterans each year Previously Dr. Shulkin served in chief executive roles at Morristown Medical Center Goreeb Children's Hospital The Atlantic Health System Accountable Care Organization and Beth Israel Medical Center in New York City He is a board certified internist and a fellow of the American College of Physicians and Practices Medicine at the New York Harbor VA health care system Please give us a give a warm welcome to VA under secretary for health. Dr. David J. Shulkin Well, thank you, Joy. Joy does such a great job and we are so Honored and privileged that she represents us on so many important issues. I just Wanted to thank all of you for having the opportunity to speak a little bit before you about what's going on in VA health care I know all of you care a lot about that and I wanted to Particularly thank all of the leadership in DAV Gary Augustine, of course who does a fantastic job I want to acknowledge the secretary being here as well and thank joy and mark and Moses all of the leaders of DAV We really couldn't do what we do in VA health care without all of you Your ability to help get veterans to and from their appointments there really wouldn't be ways without the work that you're doing and your dedication and So much of what you advocate for is so important And we just want to make sure that you understand how grateful we are how much we appreciate it And we don't take it for granted. I can't tell you the amount of times that after I read a Story in a paper or hear something on TV. I tell people go to the DAV site See setting the record straight. That's where you're really going to get true facts and information and for you to be Advocating to try to educate the American public about what the real issues are Again is just something that I think nobody does as well as DAV So thank you for everything that you do what I wanted to do in a brief period of time is to set The record straight about what's really happening in VA health care and to let you know About what we're trying to do the secretary spoke this morning about the transformation that's underway And so I wanted to give you some of the specifics of the transformation. So I'm going to go through very quickly 25 Items about VA health care that you need to know about what's happening But also the American public needs to know because the VA health care system is Leading American medicine in many of these areas and has a lot that the rest of the country can benefit from So the very first and most important aspect that differentiates VA health care is you the veterans and We are so privileged to have the mission to be able to take care of all of you American heroes And we know that we have the best patients in the world and that's really why people come to work every day our 330,000 employees That come to work every day at the VA medical centers consistently say they're there because of you and This morning what a what a fantastic program that DAV has put on I mean it's been inspiring to me Bobby body lots of great American heroes that we saw But I need to remind much of the American public about what people are that Serve this country and how special they are So I was just going to share with you what I share with many people who aren't as educated as DAV members So why don't we just roll the first video just about the people that we serve? This is a state this is the State of the Union address. I first met Corey Rimsburg a proud Army Ranger At Omaha Beach on the 65th anniversary of D-Day Along with some of his fellow Rangers he walked me through the program in the ceremony He was a strong impressive young man. They had an easy manner. He was sharp as a tack And we joked around and took pictures and I told him to stay in touch a few months later on his 10th deployment Corey was nearly killed by a massive roadside bomb in Afghanistan His comrades found him in a canal face down underwater shrapnel in his brain For months. He lay in a coma The next time I met him in the hospital he couldn't speak Could barely move over the years. He's endured dozens of surgeries and procedures Hours of grueling rehab every day even now Corey is still blind in one eye Still struggles on his left side But slowly steadily With the support of caregivers like his dad Craig and the community around him Corey has grown stronger Day by day. He's learned to speak again and stand again and walk again He's working toward the day when he can serve his country again My recovery has not been easy. He says Nothing in life that's worth anything is easy Corey is here tonight and like the army. He loves Like the America he serves Sergeant first-class Corey Remsburg never gives up and he does not quit Okay, so I had the privilege the secretary actually introduced me to Corey and his family and It is people like Corey people like Bobby body that keep us going that make us fight for this health care system And it really is a privilege to be able to Help and to serve people like this just amazing people the second reason why VA health care is different is our definition of how we help people as physicians and as health care professionals is Different in the VA than it is outside the VA and our definition of health isn't just trying to take care of the physical Aspects of health, but really all the things that it takes to get somebody's well-being back peer support Transportation like you do here at DAV our crisis lines caregivers finding people's homes as the secretary was talking about And so we have a much more holistic approach to health care I can tell you now that I practice as a physician in the VA I understand that that what we do is very very different than what you would get in the private sector and One of those examples is frankly what DAV does with the winter sports clinic I was out at snow mass this past year was the secretary and Seeing 400 people get out of their wheelchairs or with their prosthetic arms and legs down the mountain and Regaining that joy in their life and giving them purpose you can see how important these things are to a person's Well-being that aren't what we traditionally think of as health care, but that is VA health care The third is is how we perform Are we actually taking good care of veterans in the VA health care system? And every time that you read that VA health care isn't as good as what you find in the private sector I would tell the people that are saying that go back to the medical literature Go back to the scientific peer-reviewed journals because here's what it says VA health care actually performs better than the private sector in mortality in the common ways that we measure Quality in health care in patient safety better than the private sector and certainly in pharmacy benefits Just about two weeks ago the RAND corporation one of the most prestigious organizations that studies quality in the country came out with a new study that says that the quality of VA Health care once again better than what you find in the private sector and here's what it says we actually measure 47 different types of measures on the quality of care VA is better in 45 of them the same in two worse in none That's pretty strong scientific evidence to support that we're doing some things pretty well The fourth is is that VA is leading in many of the public health issues that are important to this country Hepatitis C we have the ability in the next two years to completely eliminate veteran Hepatitis C in Veterans across the country We now have a drug that can with more than 95 percent precision Reduce and eliminate hepatitis C and we have the resources to be able to eliminate this among all veterans in the country in The next two years there is no other health care system in the country that should be able to say that in Important public health issues like opioid abuse VA is leading the way our rates of opioid abuse going down The rest of the country still climbing in suicide such an important issue again VA Taking a lead in showing new ways of impacting and reducing veteran suicide and we know when we can get veterans in the VA health care It makes a difference we can save lives We had a conference on this in February of this year. You can see the secretary there I think chairman Isaacson was also at this Urgent summit and we came out of it with new ideas Working to try to reduce veteran suicide that we're implementing now that are going to make a big difference in the months to come I Just wanted to show one of the issues with veteran suicide We're trying to get veterans to come to VA to get help And so I want to show you this video if we could start this I'm good. I'm good. I'm good. I'm good But I have a story and I don't know where to start. I'm good But I feel Alone in a crowd. I'm good But nobody understands I'm good But the past keeps coming back that I can't get out of bed, but I can't sleep. I'm good But I feel overwhelmed. I'm good, but I don't feel safe But I don't even know who I am anymore, but I still have nightmares, but I don't need any help. I'm good But I don't feel anything anymore. I'm good But I can't live like this anymore. I'm really not so good, but are you ready to listen? and that's what VA does we're there for people and We want to connect as many people who need help into our system our veterans crisis line our medical centers our suicide prevention counselors Are there for our veterans? The fifth of these points is our poly trauma centers if you've not seen these amazing places where People come after they're being injured You can see this is actually from our Tampa, Florida poly trauma center There's the secretary with a veteran who's actually up walking for the first time This is called the exoskeleton getting them up and moving and does that make a difference in terms of their overall health? So these centers aren't replicated anywhere else besides in the VA health care system The sixth of these 25 points is the way that we actually practice in the VA health care system We practice in teams health care professionals I think you know when you come and you get your primary care You have your doctor, but you have an entire team around you nurses social workers pharmacists Mental health counselors all part of an effort to try to provide you with the type of care that you need in primary care The seventh of the 25th is our commitment to fixing the access issues in the VA health care system We've done that by actually adopting what we call the my VA declaration of access similar to the declaration of independence where we have nine principles With sustainable fixes to improving the wait time issues in the VA health care system And every one of our medical centers has signed on to this with their physical signature and has it outside their office To show the commitment that they have to fixing the wait time issues I think we all know that when you try to get an appointment Outside of VA that there are challenges with that too and sometimes it seems like the wait time issues are focused only on VA As the secretary said no other health care system even measures wait times the way that VA does But as you can see from this study that was recently done Outside of VA only about 30% of the time do people are they able to get the appointments with their doctors that they want? We do far better than that right now today We have 39 medical centers that you can get same-day access to primary care same-day services and mental health And as the secretary said earlier this morning by the end of this year Every one of our medical centers will have same-day services available to veterans in primary care and mental health So this is our priority. This is what we're working on and we're making great progress on that Number eight telehealth nobody else in the country is providing telehealth services With the scale or the size that VA does 2.1 million telehealth visits 677,000 veterans able to receive telehealth services Telemental health 336,000 appointments So we're using this technology to help make sure that we get access to veterans across the country Number nine our spinal cord injury centers again No other health system in the country has the type of commitment and expertise That VA does when it comes to spinal cord injury and this expertise is making great advances every year The VA making progress and homelessness the secretary gave some statistics tomorrow The president will make some another other announcements about homelessness This is an effort where you can see tremendous progress and again VA making sure that we are working tirelessly to take all veterans off the streets number 11 as an innovation center VA was named in the world number 12 in all Organizations across the world in innovation as measured by the number of patents number of publications and number of new discoveries Just to name a few of them VA was first earlier this year to Begin a surgical procedure called osteo integration to help those who have lost their limbs Be able to actually wear prosthesis So it gives them much greater comfort and much greater functionality when they have the prosthesis on we believe this will come the standard of care across the country as Others learn about how to do that type of procedure. This is another example of innovation Mobile hearing aids and being able to be fit not by having to go in to see your audiologist But to be able to do it from home from your smartphone VA is bringing this technology to VA and then across the country number 12 is our relationships with every major academic center across the country to be able to benefit the Veterans general Omar Bradley to the left was the first to embrace The relationship between medical schools and the VA our current secretary currently embracing that as well So we're strengthening these relationships The VA partners with more than 1800 great American universities. We trained 62,000 medical students. You couldn't train You couldn't have American medicine supported by our doctors without the VA we train up to 70% Of all doctors in the VA before they go out and start seeing other Americans I know my training was in the VA health care system as many many physicians were 23,000 nursing students 33,000 students like pharmacists and social workers who then go out and help the rest of America Number 13 we take a look at the quality of care in the VA unlike any other health care system We measure in such a way that we can define where performance is lacking and where performance is really great This is our system called sale where you can actually see where a medical center is improving and where a medical center Isn't and because of these types of metrics, we're making great progress These are patient satisfaction scores actually standardized patient satisfaction scores And you can see some of the facilities that were that were lagging and you can see where we were in 2014 and you can see where we are now and this is significant progress because this is you the veterans telling us Things are getting better. So we know even in our most challenge sites We're beginning to see performance improvement and we can measure this on a regular basis Our goal is to track outcomes not only in the VA health care system, which we do very very well But to make sure that we're tracking outcomes when you leave the VA health care system when you go into the community This is our care in the community program. So we're hard at work right now I'm building a measurement system that tracks health care wherever the veterans get it so we can improve the performance for you Whether you're in the VA or outside the VA. This is actually NASA's system of how it tracks its work So when they shoot a rocket up into the When they shoot a rocket up, they don't stop tracking it when it leaves the earth's orbit They track it wherever the rocket goes and they make sure that it returns safely to earth This is what we're building now for the VA health care system Number 14 prosthetics and orthotics. We do research We do more of this type of work than any other health care organization in the country You can see here This is actually the arm that was developed between VA and DARPA a Truly advance in prosthetics where you can move all of your fingers lift Suitcase up to a hundred pounds and really get increased functionality this New arm which is being tested is actually going in the commercial production this fall So we can get it out not only to more veterans, but to the rest of America Nobody studies the impact of toxic exposures and then helps people recover from the from the Impact of these exposures wartime exposures than VA. This is an important resource that isn't done To this extent anywhere else in the country our genomics program I hope some of you had a chance to see we have a booth outside The million veteran program where you can sign up and help participate in research that we think it's going to change The lives for the better for veterans and then for all Americans We hope that you'll learn about that and participate. We're well on our way to having a million veterans participate in this Scientific discovery program and I think you'll hear something about this tomorrow from the president as well Our centers for simulation we have a hundred and thirty centers for simulation across the country Nobody else is simulating health care exercises and work the way that VA does what's important about this is You know that when a physician or a nurse comes to take care of you at the VA hospital You're not their guinea pig. They're not learning on you We actually have them learn on robotic simulators and we can tell them how they're doing and they can practice before they actually go out and Work on patients when I trained There weren't simulators, so we had to learn everything by going out and training on patients There was a first time for every doctor, of course, but this is how we're changing American health care 18 of 25 our research $1.8 billion a year all focused on improving the health of veterans Leading the country in fact if it wasn't for VA there wouldn't be many of the things that you know about today We did the first liver transplant. We did the scientific work that led to the CAT scanner We did the work that led to the first artificial hemodialysis machine We did the nicotine patch the cardiac pacemaker the list go on and on and that research continues today So when people say the VA is an important I think they don't understand history because if it wasn't for VA research much of us wouldn't be benefiting today from The type of medicine that we have number 19 off to the left is a book that was published almost 10 years ago where a Investigative reporter found that the best health care in the country was being provided by a VA. That's called best care anywhere We're actually writing a new book now written by the doctors and nurses in VA called best care Everywhere because what we're doing is we're taking what we learn to do best and making sure that every VA does it best We're taking best practices and We're making sure that we now spread them across the country So we do this consistently and we act as an integrated health enterprise This is important work, and it's one of our priorities at VA number 20 We don't talk a lot about VA's fourth mission our three missions clinical care education Research but our fourth mission is to be there in times of national need and to make sure that we are the backbone in case there is a Natural or another type of disaster so that VA hospitals and doctors and nurses stand up and are ready to be there When the Orlando shootings happened when the Dallas Situation happened when there were floods recently in West Virginia VA was there. We dispatched our mobile centers We were on-site we helped veterans and we helped Americans and that's a very important part of our role that many people don't know about 21 the way that we provide behavioral health care, and we make it part of Primary care is so important. Nobody is doing this across the country last year We did more than 1 million behavioral health care visits as part of primary care This is expanding access and its effectiveness, and it's really terrific work 22 our electronic medical record VA was a leader in developing the electronic medical record close to 30 years ago We now have this across the country so that if you get sick in one town, and it's not where your VA is We can access your medical records. We Actually attested to interoperability earlier this year with the Department of Defense So we can share information because we have this electronic medical record, and it's helping us provide better care And part of the reason why we provide better outcomes Our vet centers 300 of them across the country are based in the community So that you don't have to go to your medical center You can go right to a vet center if you feel like you need to talk to somebody or get some help in dealing with an emotional Issue and these vet centers are really extraordinary unique, and we think part of saving lives every day 24 as the secretary mentioned VA is doing some extraordinary things our pharmacy benefits Ranked number one as the secretary said above all of the private hospitals So if you think VA can't be world-class in service, that's just wrong We can be world-class in service, and we're continuing to do that You can see here in our loyalty scores VA hospitals actually are much higher than many other federal agencies And this again shows and demonstrates that VA can and is valued by you the veterans and Lastly, I just wanted to end by saying that we recognize that we still have a lot of work to do We don't have all the answers and so we've reached out to the best Corporations the best organizations across Americans said if you have ideas and solutions that can help us do a better job Serving veterans we want to be working with you, and so this is a very different VA than it was years ago We are now partnering with whoever can bring us ideas that can help serve you better And I just want to end with one last video where I show you one of these partnerships with Google to be able to demonstrate How one of these partnerships works, so let's roll this video on the 6th of November I would have been 26 years in the army. I was a captain. I was responsible for upwards of 150 soldiers My current level of injury is T4 So I am paralyzed from my chest down I served in World War two and the Korean War and I've been at this extended care facility for Three years last September 28th, and you know, I've never been in the Veterans Day parade I was never able to take a Veterans Day off Rent gotta be paid those gotta be paid Something that I always wanted to do being a Veterans Day parade being my parade Today's Veterans Day, and we're gonna use virtual reality to bring the parade to VA hospitals all around the country I've been at Google for a year and a half, and I'm also a veteran served in the army for 25 years So it's personal. You know, this means a lot So what you're gonna do is when you put these on is you're going to be Transport to the parade in New York City and and that's a parade. We got 360 degrees cameras on several floats So while you're on the float you guys can move around look up look down Yep, I'm down there being that parade. It was just great seeing all these people moving there around me Most exciting part about a parade Since this is my very first one was the enthusiasm from the public It was a great show And it was great that We were a part of it Thank thank you very much Give dr. Shulkin a big round of applause. Thank you I just want to say this is so important that the leaders of the VA are coming to our convention to inform us of what the reality is of what's happening in the VA instead of the stories that you're reading out there in some Newspapers or some on some TV reports They are doing some very positive things and I could tell you I've seen dr. Shulkin since he came into the VA and what he's done to Put his heart and soul into making the changes necessary to make our VA What it needs to be so again, uh, thank you, doctor We appreciate your comment and we'll continue to look forward to work with you. All right now As always what we need from you Is to take this message back to your communities and let them know what you're hearing here Uh through this convention and specifically from these leaders from the VA as to what they're doing To make changes in the VA that need to be made They are very receptive to our suggestions. We are working with them very closely And we look forward to uh continuing that But we need to let The rest of the uh our members that didn't make it to this convention And the people out in uh outside the beltway So they're knowledgeable about what the reality is of what's happening not just these stories that are being thrown out there So here's what we're going to do now as last year we have a opportunity to hear from two Leaders and an informal discussion about the future of the VA I don't want you to leave We're going to dim the lights a little bit. We're going to set the stage. We're going to get them up here We're going to mic them up and then we're going to have uh The secretary i'm yeah the secretary Bob mcdonnell come up and and sit with uh the chairman of the senate veterans affairs committee johnny isakson who is from georgia as you know And uh starting at 130 they're going to uh discuss From a legislative perspective and from the VA's perspective about What has been uh accomplished what needs to be accomplished what needs to be done legislatively And we're going to have a very candid and frank conversation with them about what's going to happen to the VA in the future Uh very important discussion. We had this last year and it went very well with uh chairman uh miller from the house veterans affairs