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Honoring U.S.

Keeping Americas Promises to Those Who Have Served
At the core of Americas military strength are the men and women who volunteer to
serve in our Armed Forces. We have no greater asset than our service members or
greater responsibility than ensuring they are well provided for while they are in uniform
and throughout their lives.
Recent revelations of grave conditions at facilities throughout the Department of
Veterans Affairs health care system have brought to light the failed leadership of the
Obama Administration to serve those who have served our nation.
Reforming the Department of Veterans Affairs (DVA), fixing the Veterans Health
Administration (VHA), and improving services to veterans across the board must be a top
priority for the next President of the United States.
Jebs Florida Record:
Florida has the third largest veterans population in the country.i As Governor, Jeb made
military families and veterans a signature issue. He increased the number of state
veterans homes from two to six.ii He increased property tax exemptions for disabled
veterans (from $500 to $5,000) and eliminated the fee to get a disabled parking permit. iii
Governor Bush and the Florida Legislature created an employment advocacy and
assistance program for military spouses and dependents.iv
He also passed laws that provide free undergraduate tuition at state colleges and
universities to Florida recipients of the Purple Heart (and combat-related decorations
ranked superior in precedence to the Purple Heart) and their children.v
Jeb can reform veterans services and care and expand opportunities for them because
hes done it before.
Jebs Seven-Step Plan to Keep Americas Promises to Our Veterans:

Improve the Veterans Hospital Administration by Enhancing Care and Expanding

Veterans Choice

Hold Government Accountable for Providing Quality Services

Modernize the Department of Veterans Affairs

Create More Opportunities for Veterans

Restore Military Troop Levels

Improve Healthcare for Female Veterans

Honor Veterans Service


Overhaul the Veterans Hospital Administration to Expand Veterans Choices

and Enhance Care
Taxpayers entrust the Veterans Hospital Administration to care for our returning warriors.
Unfortunately, the VA is long overdue for reform and a recommitment to its core mission.
Veterans should be treated by a doctor and at a clinic of their choosing, not at the
discretion of federal bureaucrats. Those who choose to use the VA system must have
timely access to top-notch medical services.
Jebs Plan
Currently, only certain veterans are allowed to choose their doctor those who cant get
an appointment within 30 days and those living 40 miles or more from a VA health That number should be broadened and limitations to private access reduced. If a
veteran wants to see a neighborhood physician, he or she has earned that choice. The
VA must remain the guarantor of that choice and that care.
The challenge in expanding the choice program is in the cost and outreach.
Approximately 30,000 veterans have opted to use the program, a paltry number given
the nearly 9 million veterans who use VA hospitals.vii Though the program is still new, the
VA has not sufficiently encouraged veterans to participate. Cost is also a problem.
Although total VA funding grew by nearly 73 percent since 2009, the VA ran out of
money in 2015.viii While it is unconscionable that the VA still cant afford to provide
reasonable options for veterans, the fact remains that choice is expensive and there
needs to be a way to pay for it.
With budgetary concerns in mind, increasing choice cannot come at the expense of
veterans receiving care at the VA. Despite well-documented problems with VA
administrators, many veterans prefer to receive their care at VA hospitals. And many VA
facilities specialize in care like post-traumatic stress, traumatic brain injury, and
We dont have the money is not an acceptable answer when it comes to providing
choice and care to veterans. This is a problem of priorities, not funding.
The solution is to reform the VA, and redirect those savings into veterans care. This
includes cutting excess administrators (not caregivers) through Jebs 3-out, 1-in
proposal, and improving practices so that we eliminate billions of dollars in waste, fraud,
and abuse. For example, we must fire bureaucrats who refuse to make bidding for VA
contracts competitive (as required by law), improve whistleblower protections --by
accelerating the conferring of whistleblower status and disciplining bosses who retaliate
against whistleblowers-- and remove the VA from missions unrelated to veteran services,
such as construction. A whistleblower said that the VA misspent as much as $5 billion in
outside care contracts that did not meet requirements for competition. Those funds were
misspent in violation of federal law, and included gross overpayments in
pharmaceuticals, services, and procurement.

Ample resources exist within the VA budget to improve the quality and scope of care.
Annual targets for reform savings and choice expansion should be set. Targeted
increases in choice would be tied to savings achieved through reform. In other
government agencies, commonsense reforms have saved billions. The VA must get its
house in order, and send savings into improving veteran choice and veteran care.
Further, steps must be made to address the wait list for care. Congress and Veteran
Service Organizations have put several proposals forth to lower the wait for
appointments, and many of them are worthy of careful consideration. In the short term,
VA pharmacies should be allowed to fill prescriptions from outside doctors. The current
practice requires that all medication be approved in-house, often requiring a VA doctor to
confirm the opinion of a veterans private doctor. This is a redundancy that extends wait
times for veterans in need.
Hold Government Accountable for Providing Quality Services
The VA Secretary said last year, I cant just walk into the room and fire someone.ix If a
VA employee is guilty of incompetence severe enough that a veteran loses his life, the
Secretary should be able to do exactly that.
The problem is that the VA, like the federal government writ large, is beholden to both
complex union contracts and a broken civil service system. These impediments make it
nearly impossible for managers to discipline or fire employees. According to a recent
Government Accountability Office report, it takes an average of six months to a year to
fire a government employee.x And after firing, the employee can appeal that decision to
the Merit Systems Protection Board (MSPB). Then the MSPB process can add many more
months before finality of the employment action.
The Veterans Choice Access and Accountability Act of 2014 created a new way to
remove career Senior Executives (SES), based upon performance or misconduct within
the Department. Unfortunately, the law only applies to Senior Executive Service (SES)
employees -- roughly 370 of VAs 300,000-employee workforce.xi
Jebs Plan
It will take the will of leadership to truly hold employees accountable, which thus far has
not been demonstrated by President Obamas Administration.
The firing authority provided by the Choice Act should apply to all VA employees,
especially those who engage in any conduct that results in a lapse of care for a veteran,
or are responsible for waste, fraud, and abuse. Further, paid administrative leave for
disciplinary investigations should be limited to 14 days per year.
The VA has also treated whistleblowers shamefully. To correct this, the timeline for
deciding whistleblower status should be accelerated, new whistleblower protections
added, and new disciplinary procedures for managers who retaliate against
whistleblowers should be established.

Further reforms to the SES at VA are needed. This should include the ability to rescind an
employees pension if convicted of a felony related to VA, and the authority to rescind a
bonus at any time.
The point is not to simply punish those who fail, but reward the overwhelming number of
VA employees who have devoted their lives to serving veterans. If a VA employee fails in
his or her mission, to care for those who have borne the battle, they must step aside or
be removed so that talented employees can rise up.
Modernize the Department of Veterans Affairs
The VA still operates under archaic practices and procedures, despite spending around
$4Bn on information technology annually. It has struggled to adapt to the 21st century. In
an era of high speed Internet, revolutionary advances in medicine, fiber optics and
interconnectivity, the VA can still take months to deliver care and responses that could
be transmitted in seconds.
Jebs Plan
One of the key problems with the wait-list manipulation scandal in 2014 was that the VA
relied on an antiquated and unreliable scheduling software system. The software was old
and susceptible to falsification. New software is more than capable of eliminating those
vulnerabilities and improving the VA user experience.
In this day and age, veterans should be able to login, make or cancel an appointment,
and check on the status of that appointment with little hassle. The current online system
is difficult to use, especially for older veterans.
There are also obstacles to refilling prescriptions online, a feature available at most
pharmacies nationwide. While the VA does have a system set up for online prescription
refills, it is poorly designed. The VA should explore public-private partnerships to replace
shoddy software.
Veterans have gone too long without a secure online credential that proves their status
as veterans. The current system requires a paper copy of the DD-214, a form used to
verify service and military discharge. The VA should team with the private sector to
create a single, safe credential for veterans that verifies their service and eligibility for
This credential would be provided as they separate from service. Such credentialing
could allow a faster admission to veterans eligible for the choice program, allow instant
access to medical records online, and help the private sector offer military/veteran
discounts online. In person, a veteran should be able to pull out a smart phone and prove
their service with a few touches of the screen.
The problems at the VA are not purely software issues. While it has failed to adapt as
quickly as it should to technological advances, the VA still uses out-of-date practices that

have outlived their usefulness.

An obvious example is that of hospital construction. A new hospital in Denver, Colorado
was estimated at $800 million in construction costs. A new estimate is $1.7 billion
dollars, nearly a billion over budget.xii The VA has no business being in the construction
industry. It should stick to tending to the wounded. The practice is outmoded and would
be better accomplished by more relevant federal agencies.
Create More Opportunities for Veterans
While veterans unemployment has dropped in recent years, nearly 600,000 veterans
were still unemployed in 2014.xiii Almost 550 service-members transition from the
military daily, and approximately one million veterans will rejoin civilian society in the
next 3-5 years.xiv
Jebs Plan
Only 48 percent of working age veterans use their GI Bill benefits, and only 52 percent of
those veterans complete their field of study.xv But veterans are 45 percent more likely to
be self-employed than non-veterans, and $1.2 trillion in sales is generated from 2.4
million veteran-owned businesses which represent nearly 9 percent of all U.S. small
A way to both reduce underuse and misuse of GI benefits is to allow the GI bill to be used
to insure a small business loan. Eligible veterans could borrow against their earned GI bill
benefits to start a small business, in lieu of using it for education.
Restore Troop Levels
While veterans benefits have rightly been protected from the Budget Control Act and
Sequestration, the impact has still been felt at VA facilities. Active duty members of the
armed forces (Army, Navy, Marine Corps, and Air Force) hit a high point in 2010 with 1.4
million members.xvii Under current defense cuts, it is set to drop to 1.2 million by 2019.xviii
Put plainly, that means an additional 190,000 troops will be shed on top of natural
attrition over the next four years. This is a heavy swell of new potential VA users.
Jebs Plan
While the military cuts should be reversed for purely strategic security reasons, the fact
stands that the sheer number of service members leaving service is overwhelming the
VA. The Pentagon needs more soldiers and the VA is inundated with new veterans.
Ending the rapid troop drawdown is a simple, pragmatic solution to both problems.
Improve Healthcare for Female Veterans
Fully 15 percent of active duty and 18 percent of National Guard and Reserves forces are
women, with projections saying those percentages will grow.xix In contrast, the

percentage of women in uniform was just 2 percent in 1950.xx Under modern combat
policies, women are serving in hostile areas in increasing numbers and are incurring
critical injuries at levels similar to their male counterparts.
However, since the VHA has been historically orientated to care for men, women have
received fewer immunizations, fewer cancer screenings, and fewer mental health
screenings than their male counterparts.xxi
Jebs Plan
Its time to improve healthcare services for female veterans. That starts by preparing for
the further growth in the female veterans population with responsive programs in
organization, staff, and training including in obstetrics, gynecology, and specializations
in ovarian and breast cancer.
The agency underwent an assessment in 2012 to measure the quality of care for the
growing population of female veterans.xxii That was a welcome step. However, more must
be done, particularly when it comes to engaging the female veterans population and
making them aware of the care options available to them, including in the area of mental
health services as the long-term behavioral health effects of traumatic brain injury and
PTSD are not yet known.
Military service members will be facing these challenges long after they have separated
and will require care as veterans. The VA needs to ramp their behavioral health services
and resources.
Honor Veterans Service
One obstacle to a successful transition from military to civilian life is the stereotype of
the wounded, helpless vet overcome with issues like anxiety and post-traumatic stress.
Many well-intentioned programs have unintentionally fed into the narrative of the
broken hero. Polling suggests this has had a tangible effect on an employers
willingness to hire veterans, despite the fact that they generally outperform nonveterans in the workplace.xxiii
Jebs Plan
Jeb is committed to using the bully pulpit of a national election and his presidency to
honor the service and character of Americas veterans. Their many virtues commitment,
loyalty, reliability, and integrity will be highlighted, as well as how those merits inject
value into communities and businesses. Organizations like Team Rubicon and Hire Heroes
recognize that the best way to help veterans is to offer them a noble purpose and the
dignity of a rewarding career. They should be acknowledged. Restoring the respect that
veterans have earned requires national leadership, and Jeb is well positioned to offer
precisely that. This will be a priority of his first term in office and beyond.


i Employment Situation of Veterans-2014, Bureau of Labor Statistics, March

2015, Table 6A,
ii Florida Veterans Benefits Guide, 2014, Page 12-13,
iii Letter: Jeb Bush supports veterans, The St. Augustine Record, November, 2002, Bush signs $50.4B budget,
Business Journal, June 6, 2002,

iv The Needs of Military Families: How are States and the Pentagon Responding, especially for
Guard and Reservists?, Hearing of Governor Bush, July 2004, Page 3, Bush Announces 2006-2007
Executive Budget, Press Release, February 2006,
Military Family Employment Advocacy Program, Memorandum, Florida Agency for Workforce
Innovation, February 2006

v Governor Bush Signs Series of Bills to Benefit Florida Veterans and Active Duty
Military Troops, Floridas Chief Financial Officer, July 3, 2006,
vi Veterans Choice Program, Frequently Asked Questions, June 2015, Page 1,
vii Far Fewer Using Veterans Choice Program than Expected, VA says, Washington
Post, Feb 13, 2015
viii VA 2016 Budget Request: Fast Facts,
ix VA chief answers critics: I cant just walk into a room and fire people, The
Washington Post, November 6, 2014,
x Federal Workforce: Improved Supervision and Better Use of Probationary
Periods Are Needed to Address Substandard Employee Performance,
Government Accountability Office, March, 2015,
xi Senior Executive Service Facts & Figures, Office Of Personnel Management, April, 2014,
Sizing Up the Executive Branch Fiscal Year 2013 Office Of Personnel Management, April, 2014,
xii New cost estimate for VA hospital in Aurora: $1.73 billion, Business Journal, March 17, 2015,

xiii Employment Situation of Veterans Summary, Bureau of Labor Statistics,

March 18, 2015,
xiv Difficult transitions, The Economist, November 12, 2014,
Collaborative Support to Reintegrate the Military Family, Office of the Chairman of the Joint
Chiefs of Staff, November, 2014, Page 4,

xv Most Veterans Are Satisfied With GI Bill Education Benefits, Gallup, July 3, 2014, Report: Most
GI Bill veterans make good on education benefits, The Washington Post, March 24, 2014,

xvi Veteran-owned Business and their Owners, U.S. Small Business

Administration, March 2012, 45%: Page 6, $1.2
trillion: Page 1, 2.4 million & 9%: Page 14.
xvii 2012 Demographics, Profile of the Military Community, Department of Defense, Page

xviii Long-Term Implications of 2015 Future Years, Congressional Budget Office,

November 2014, Page 19,
xix 2013 Demographics, Profile of the Military Community, Department of
Defense, Active women: Page 16, Reserves: Page 65,
xx The Womens Armed Services Integration Act of 1948 placed 2 percent ceiling on the number
of women in each service.Volunteering For Vietnam: African-American Servicewomen, Women in
Military Service for America Memorial Foundation,

xxi Strategies for Serving Our Women Veterans, Department of Veterans Affairs,
May 1, 2012, Page 6
xxii Strategies for Serving Our Women Veterans, Department of Veterans Affairs,
May 1, 2012,
xxiii Coming Home to Damaging Stereotypes, The New York Times, February 5,
Hiring Heroes: Employer Perceptions, Preferences, and Hiring Practices Related to U.S. Military
Personnel, Apollo Education Group, 2015, Pages 6-7 .