▶ 0:12:51Good afternoon. Uh, the committee will come to order. Without objection, the chair may declare recesses at any time. And before we begin, I ask unanimous consent that all members have five legislative days in which to revise and extend their remarks and include any extenduous material. Hearing no objections, so ordered. Uh before we begin, I want to thank uh Secretary Collins for being here today.
▶ 0:13:17You know, this is uh his first time to testify before our committee, but not his first time in the house. So, welcome back. Um I want to ensure that we have a productive hearing today. Uh to have a productive hearing, I want to ask that all members be respectful to other members and the witnesses and let's follow the house rules on doc decorum. Uh we are here to review the department's veteran affairs budget request for fiscal year 2026.
▶ 0:13:46One couple other things I want to add to that is is what we're going to do is is rather than five minute we're going to have seven minutes for the questions. So we know that uh we're also uh I and the ranking member will wait and ask our questions probably at that no last and the reason we're doing that is we know that probably two hours into this which odds are it'll take more than two hours we will be called for votes and I know many of you will want to catch a flight if you can.
▶ 0:14:15Uh so that's the idea and intent is to try to get the members that have to have uh flights out have an opportunity to ask questions. So let's get right to it. Uh the president has requested 187.2 billion for VA for next year. That includes 134.6 billion in uh discretionary funding and another 50 billion from the toxic exposure fund.
▶ 0:14:44That's an increase of more than 17% over last year. Now, that's a serious proposal and a clear reflection on the priorities, I believe, of this administration. While it seems there is not much common ground to be found in Congress these days, one issue does unite us, and that's the belief that VA should be fully funded to provide top-notch care to our veterans and their families. House Republicans will continue to ensure that promise remains true.
▶ 0:15:13And while I'm optimistic about the propos proposal so far, I am hoping that this administration can avoid uh the total chaos and financial mismanagement that we we witnessed during the end of the Biden administration. Despite receiving the largest VA budget in history, the department reported an alleged shortfall late last year, not because of underfunding, but because of poor internal accounting and a lack of fiscal discipline. and that's putting it nicely.
▶ 0:15:44Uh Biden VA officials misused the hire hiring and pay authority Congress provided. Then when the numbers didn't add up, they turned around and tried to shift the blame. They needlessly alarmed veterans and accused Republicans of putting their care at risk. All while refusing to take responsibility for the decisions that got them there in the first place. I was It was political theater at its worst.
▶ 0:16:10And while doing that, the department budget practices have become harder, not easier to follow. It makes you wonder if it was some if if it was on purpose. Key obligations were shifted between accounts. Basic funding needs were moved around. That's not the what Congress intended. It's not what veterans deserve. I would also like to take a moment to address and recognize efforts underway at the VA.
▶ 0:16:40Over the last few months, I've heard baseless accusations from my colleagues on the other side of the aisle about how Duck Doge Boogeyman and the Secretary Collins are planning to reduce VA's workforces by 83,000 employees. This is simply not true. As we have heard countless times from the secretary, VA is currently reviewing its organizational structure to find reforms that best suit the needs of our veterans today.
▶ 0:17:09And by the way, this review is long overdue. The one reoccurring theme that we have constantly hear from the VA in our hearings is that VA bureaucracy poses a greater danger to the health of our veterans than the illnesses they seek treatment for. And I applaud the Trump administration for conducting this necessary review to change course and ensure veterans have access to the care they deserve.
▶ 0:17:40We will also hear from the other side that Secretary Collins refused to answer their questions and will not communicate with Congress. That is also not true. On several occasions, the Secretary staff have come up the hill to brief the committee staff in both the House and the Senate on the status of the reorganization efforts.
▶ 0:17:59So to tell my fellow veterans when my colleagues try to catch a soundbite and tell you that Secretary Collins and the Trump administration are uh dismantling the VA, do not take the bait.
▶ 0:18:14I would also like to remind my colleagues about the lack of transparency under the previous Last last Congress, our committee sent countless letters and inquiries to Secretary Mcdana and that were simply went unanswered. In fact, Secretary Collins office uh took when when he took office, VA's mailbox was full of our un open letters for oversight requests.
▶ 0:18:44That's not a way to run a department and it's certainly no way to work with Congress. So to my colleagues, I would say those who live in glass houses should not throw stones. From un from my position as chairman, I look forward to Secretary Collins efforts to restore transparency and accountability. Because that, that makes VA work better and I know he shares that goal.
▶ 0:19:10Our obligation to veterans demands proper leadership in ensuring that this budget is applied to veterans care and benefits. This is a more disciplined budget request focusing on delivery, not distraction. That said, we know this is just the beginning of the process.
▶ 0:19:30We still haven't received the full detailed budget and I along with many of my colleagues on both sides of the aisle have questions about the VA plans to spend these funds, how those decisions will be will improve care for veterans and their families. We we are all ready to do our part.
▶ 0:19:50We appreciate Secretary Collins being here today and I look forward to the productive conversation uh not fear-mongering, not political posturing, but to deliver to the men and women that we serve. Ranking member Tano, I now recognize you for the your opening statement. Well, thank you, Chairman Bost, Mr. Secretary. Good afternoon.
▶ 0:20:13Uh when I first heard of your nomination to this position, I recall saying to my staff, I think we'll be able to do some good work at VA with Doug Collins. I had optimism based on your time as a member of this chamber that you would uh have an appreciation for our duty to perform oversight. When a new secretary is confirmed, every member of this committee, Republican or Democrat, wants to see them succeed.
▶ 0:20:40And because veterans deserve leadership, not chaos. Well, I've have to say this is why I'm incredibly uh it's incredibly upsetting and frustrating to me that the questions my colleagues and I have about decisions you have made in your short tenure at VA remain unanswered.
▶ 0:21:00You came in with an opportunity to build trust across this institution and across the aisle, but instead you've undermined it not just with me, but with VA staff and with the veterans who rely on VA every day. I reviewed your Senate testimony and uh any reasonable viewer would have to would conclude that you were evasive and not transparent with your answers. So, I I hope you will not do that with us today.
▶ 0:21:28that uh and I would say to you, you have the power to change course. Veterans need answers, excuses. We'll need we'll see today whether you're ready to lead or just continue to blame. This hearing is the first time we have met in person since you were sworn in. You haven't so much as called me since your confirmation 99 days ago.
▶ 0:21:52My experience with your predecessor was that he would proactively call both me and the chairman before major news broke about VA so that our first time finding out about it wasn't from reading the paper or seeing it on television. For instance, he would have called us before cancelling a program as important as VASP where the consequences for veterans are as dire as foreclosure on their own homes.
▶ 0:22:19This is the basic transparency that I expect from the secretary so that we can work together on the challenges facing VA. Now VA is not perfect. It's never been perfect. I we are not satisfied with the status quo at VA and that is what brought all of us to work on this committee.
▶ 0:22:44But we are not just going to blindly support your changes at VA without you giving us all the facts or any semblance of a plan. You have not earned our trust, at least not yet. And that is what I will be listening for today. Answers that contain facts and plans that are based on those facts.
▶ 0:23:07Last week before the Senate, you failed to answer questions asking for details about decisions you have made as secretary. Senator Hurono asked you the exact dollar amount that VA claims to have saved from firing staff. You rather flippantly threw out a culture war statement about DEI instead of answering her question.
▶ 0:23:30Senator Boseman raised questions about VASP and you g you gave a rather incomplete Questions about how many clinical trials are on pause and how many veterans are affected by that pause on on clinical trials were also unanswered.
▶ 0:23:49This morning in the Milcon VA appropriation subcommittee, you admitted that VA shifted over $300 million to fi private for-profit community care without following the law. That money was meant to support care and capacity inside VA. Instead, it was siphoned away from veterans hospitals and clinics and handed off to the private sector. Now, the law is very clear.
▶ 0:24:17If VA needs more funding for community care, it must ask Congress not illegally raid funds meant for direct VA care. Both the chair uh chairman Carter and ranking member Wasman Schultz of the appropriation subcommittee agree agree with what I just said and uh you know so does the chairman of the full committee.
▶ 0:24:46So, I chair a full full appropriations committee and I hope Chairman Bost joins me and joins joins the the appropriation uh four corners uh in demanding accountability on this very point. Now, this morning before the Milcon VA appropriation subcommittee, you also gave very disturbing answers to questions about the effects of pauses on clinical trials.
▶ 0:25:11You said that having clinical trials uh paused is not affecting veterans health care, that it's above and beyond health care. Is that really what you are saying to veterans with cancer whose hopes are pinned on clinical trials that they can no longer access?
▶ 0:25:31All of the questions we are going to ask today are ones that you should have come prepared to answer, and I will be disappointed if you're not We have already asked many of them in letters and many of them have already been asked in your previous appearances before the Senate and before the House um appropriation subcommittee. This is basic congressional oversight.
▶ 0:25:55The members and staff on both sides of this committee collectively have cent centuries of experience working on uh VA policy and serving our nation. We have written some of the most consequential pieces of veteran legislation in history, including the Honoring Our Pact Act. We can only carry out our oversight responsibility as mandated in the Constitution, if you answer our questions fully and truthfully.
▶ 0:26:21We have serious concerns about your plans related to the VA workforce, and this hearing is an opportunity uh for you to put our minds at ease. VA is comprised of over 400,000 dedicated employees who show up every day motivated by the call to service to deliver the care and benefits veterans have earned. The majority of veterans are satisfied with their VA care. Let me say that again.
▶ 0:26:49The majority of veterans are satisfied with their VA care. Yet many have expressed to me the weight of the chaos and turmoil they have witnessed during Trump's first 100 days and are left wondering what will happen to the care they rely on and love. They are worried that their provider with whom they have spent years building rapport and trust could lose their job. Now I have a poster behind me.
▶ 0:27:16Uh we have heard from a veteran from uh for whom this fear sadly became a reality. This veteran lost her whole health coach who said who who she described as quote the only person really making a difference in my life. We have heard countless stories of the trauma and harassment VA staff have endured at the hands of Trump's senior adviserss and political appointees since day one of this administration.
▶ 0:27:45I want to hear directly from you today whether you agree with the director of OM Russell vote that the trauma is the point. Does this administration want to traumatize public servants into submission or into quitting their jobs so the work can be farmed out to Trump's billionaire friends? Let me tell you one clearly, Mr.
▶ 0:28:10Secretary, VA is not for I am truly worried about the combative tone you have taken in addressing VA staff. You have instilled a culture of fear by making them sign non-disclosure agreements and accusing them of rumors innuendo.
▶ 0:28:28Frankly, it's insulting and demeaning that you continue to accuse VA staff and veterans of lying about their experiences, their concerns, and the things they're seeing with their own How are the veterans supposed to be inspired uh excuse me, how are employees of VA supposed to be inspired to fight for a better VA with you if you are constantly positioning yourself against them as if they are the enemy?
▶ 0:28:55I I would say fear as a tactic for leadership is not effective. Uh as one clinician put it and behind me I have it up in print. quote, "I have felt harassed by and have diminished faith in the leadership of the VA secretary who continually throws VA employees under the bus and has th shown no interest in learning about the concerns of his frontline staff. His line about VA now putting veterans first particularly irks me.
▶ 0:29:24In my 15 years of working at two different VA medical centers, I know we have always put veterans first." End quote. And that's from a VA psychiatrist. We need more answers about your plans for VA. These plans directly affect veterans, staff, and the economy in all our districts. You have set a goal to fire 83,000 employees.
▶ 0:29:47It is a goal, and it's been publicly stated, leaving VA staff waking up every morning with the torture of not knowing if that day is their last one with a job. You took away veterans last lifeline to keep their homes when they face foreclosure. When you ended the VASP program, you are doing all these things during a time of financial turmoil for families in America while we deal with the impacts of Trump's chaotic tariffs and economic policies.
▶ 0:30:16We're all trying to make sense of it all so that we can better serve veterans. Mr. Mr. Secretary, I hope that this hearing today is an opportunity to build some trust and I want to have confidence in your leadership and as the leader of VA, you owe it to VA staff and you owe it to veterans to be transparent and forthcoming and to take some accountability. You have the opportunity to answer our questions fully and truthfully, and I hope that you will seize that opportunity. And with that, I yield back. Thank the ranking member for yielding back.
▶ 0:30:46And now some housekeeping things. Uh uh in accordance with the committee rules, I ask unanimous consent that Representative Duzio uh from Pennsylvania be permitted to participate in today's committee hearing. Without objection. So ordered. All right.
▶ 0:31:10Uh if the uh if Secretary Collins would please stand and raise his right hand, do you solemnly swear under penalty of perjury and the testimony that you're about to provide is the truth, the whole truth, and nothing but truth? Thank you. Let the record reflect that the witness has answered in the affirmative. Now, I would like to recognize people, as I said, seven minutes uh for each person.
▶ 0:31:36We're going to hold stick to that seven minute rule uh uh because we are under the pressure of of votes later on. So with that, I now recognize General Burkeman. Oh, I'm sorry. Was that wrong? Oh, wait a minute. I I How about How about you? How about you give an opening statement? That'd be really good. Mr. Secretary, you are recognized for your opening statement. Thank you, Mr. Chairman. Thank you, ranking members. If we didn't want to go through that, we can uh go.
▶ 0:32:04Um I I think it is interesting to set the tone for our opening statements and and I think that you know the tone has sort of been set here and I think the undeniable aspect of this is that I have one purpose and one purpose alone and that is to make the VA exactly what it's supposed to be and that is to take care of our veterans and do so in the most efficient and effective way through whether it be in our VHA, our VBA or NCA. And the one thing that I've had to do for the first and I'm glad to be here today and to answer all the questions uh that you might have.
▶ 0:32:32I'll be frank with you and what I have found over the last little bit is I can answer questions but if we don't like the answers then we just say I'm not answering the question. That's just simply not always uh the case and we're going to deal with that as we go forward today. So specifically, you know, and just as I've just had to sit through, I will say that the VA psychiatrist that you just uh referenced is exactly the kind of employee that I want to see at the VA.
▶ 0:32:53someone who's putting the veteran first, somebody who is concerned about taking care of that, they have absolutely nothing to be concerned about when it comes to restructuring of the VA or looking at our VA health care systems because when you look at what we do, the VA doctor is exactly the person that has been protected from day one in this. We have put 300,000 positions off limits. In fact, they're being hired as of this day.
▶ 0:33:17If you're in a hospital, as I told just told the folks in Minneapolis when I was just there this week, if you're in a hospital taking care of veterans, you are the ones that we want and want to have and be a part of. You're the ones that should be the most uh happy in the sense of you're getting to do your job now because you have a secretary who actually wants to cut the red tape, wants to cut your decisions and so that we don't have to continually get in our own way.
▶ 0:33:39The VA unfortunately over the years has become the absolute at many times frustrating point for many of our veterans of what is known as red tape of going through the process of trying to get things to happen and yet it being denied.
▶ 0:33:54And the sad part about it is is for the last number of years and I have been in this body as well and I voted for some of those uh pieces of legislation, the mission act, also our accountability act and other issues that came before this body as we've looked forward to how do we actually better serve our veterans. But over the last few years, it seems that as we've looked at this issue and we've looked at it from a a far even as far as back that we began to believe that the only issues in VA could be solved by simply giving more money and giving more employees.
▶ 0:34:22In fact, we've actually increased 52,000 full-time equivalents from 21 to 24, and things still have not gotten better. In fact, to be honest, according to the metrics of the VA that was established before I ever got there, they've gotten worse. So, you have to simply ask yourself the question, is what we're doing and how we're doing it the same way, the same way making a difference? And the answer is no. when your weight times go up, your backlogs go up, and you're not fulfilling the mission to the veteran, that is an issue that we have.
▶ 0:34:52Now, when we look at these as we go forward, I'm not going to be a shy addressing the issues that we do and will in this room address today. And that is that we are looking at our structure of our workforce. And we're looking at a structure, by the way, as has been said, we have 465,000. It goes up actually a little bit depending on the day because we still in our VHA organization have 409,000 employees. We have over 28,000 physicians, 91,000 nurses.
▶ 0:35:18But what is also not said and has not been said in this room today is is many of those doctors and many of those nurses do not see patients on a regular basis if at all. But yet we still have doctor shortages, nurse shortages in clinics and hospitals in which we're hiring for every day. So my question is simple.
▶ 0:35:36when I look at a a organization plan is why are we simply looking at numbers that aren't affected and why are we keeping a bureaucracy level that has grown tremendously over the last little bit with billions of dollars and with people but yet the very metrics that this committee under both Republicans and Democrat uses to judge efficiency at the VA are going the wrong way just to let you uh see and one of the things that concerned me from the moment I stepped into this job was 10 years ago the GAO said that the VA was on the high-risisk this the
▶ 0:36:06GAO not Doug Collins not Democrats or Republic the GAO said that and they've renewed that every year in fact February we got our ne our last needs improvement and also risk and the answer has simply been many times to just let's just add more and add a little money and add this to it to see if we get any better and it's not worked many things of what we have tried so far and when it comes to the workforce and it comes to what we're doing is actually not having chaos but actually
▶ 0:36:36freeing up our doctors and our nurses and our disability claims adjusters to actually do their jobs to give them the tools. I found a department that could not even tell me how many employees we actually had. It took a week and a half. Where has oversight been on that?
▶ 0:36:50I think a an organization that looks at it from a perspective of the bales that have been passed and we have been looking at mission act pact which is being implemented although put together rather quickly we're now getting it in underway in fact the numbers are pretty good in the sense that we have already had 6 million over 6 million exposure screenings we've 985,44 total enrolles for healthcare on the PAC act since it was signed in law that's over a two-year period and over 6 million6 PAC act disability
▶ 0:37:21claims approved. When we look at what we have going on, we're addressing as many things as we possibly can. But when we come at it at this, I'll also say this, and I hope to answer your questions today, I hope we will can find some common ground. And to the ranking member, if we can't find common ground, we'll attempt to find common ground. You and I came in together. We've been here a while. And I commit to that.
▶ 0:37:46I will not say that we'll see everything the same, but to a VA workforce out there who has had to endure a 100 days of false rumors and innuendo and what somebody from behind a payw wall says, that's what scares veterans. That's what scares employees.
▶ 0:38:01But I ask anybody on this committee today as we go through these questions, as we look at what we're trying to do and how we're trying to do it, if you're cutting away the red tape, if you're trying to get a doctor to be able to be seen or have more doctors in the clinics and more nurses in the clinics, that is the things we need. If you're wanting more and quicker disability claims and our backlog dropped, which by the way, Mr.
▶ 0:38:23Chairman, I'm happy to report that when it was I took office just 99 days ago almost, it was 260,000 in the backlog. It is now at 200,000. We have cut it 21% in less than 100 days. So, when we look at this going forward, I look forward to your questions. I look forward to honest answers as we go forward from both sides because what we cannot do is deny that VA needs to change.
▶ 0:38:50The VA has things that need to be fixed, but we cannot continue to do the same things and call it a victory. And so, as we go through today, I look forward to your questions, and I appreciate the opportunity. The written statement of Secretary Collins will be entered into the hearing record. Uh, now we will proceed to questions. General Burkeman, you're recognized for seven minutes. Thank you, Mr. Chairman. U, Mr. Secretary, good to see you. I'll cut right to the chase.
▶ 0:39:16I was encouraged by your recent comments at a cabinet meeting highlighting the importance of advancing research into psychedelic treatments to improve care for our veterans, actually breakthrough therapy care. Last January, VA issued a request for application for for proposals from VA network researchers to study such treatments. And in December, VA announced 1.5 million in funding for MDMA assisted therapy.
▶ 0:39:43The first VA funded study for psychedelic assisted therapy since the 1960s. Question. Could you talk a bit even if a little bit about the studies being supported by these funds? Do you have any visibility on that yet? We're getting there. Uh, Congressman, and I think that is one of the things that I've started to look at. I'm also probably one of the first and of the secretaries who've actually decided that we will take a look at it.
▶ 0:40:07We're not uh simply putting it off and we're going to do everything we possibly can under the uh you know rules given to you us by Congress to actually continue that uh look. What we're seeing so far is positive. What we're seeing so far in some of the studies that are related to VA and also outside of VA as well is that there has been especially when it comes to PTS and also traumatic brain injury and others we're seeing some actual positive uh outcomes there especially when it is coupled with intense counseling and I think that's the one of the keys that we look forward to.
▶ 0:40:37There's 11 current studies uh that are either uh with VA or around VA and that we're going to continue to look at and I'm committed to working with the administration but also uh in what we're doing across uh the lines with Health and Human Services and and also at DoD to say how can we actually uh make this a possibility. Now, I will say this, I do not believe it is a magic cure. I do not believe that it will work for everyone, but it is something that could work for some and we're going to continue to look at it.
▶ 0:41:07Thank you. And Congressman Koreah and I lead the path caucus here in Congress and I'd like like basically to consider you you consider committing to incorporating congressional voices in some of these important conversations because over the last couple of years we as the caucus have had some really spectacular research speakers come in. So, if we can be included as appropriate, that would be great. Of course, Congress. Um, secondly, choice for veterans.
▶ 0:41:35Uh, I appreciate you your acknowledgement that VA is in desperate need of reform. For too long, veterans have been forced into a onesizefits-all bureaucracy that fails to deliver to them the earned care and benefits in a timely manner. Under the Biden administration, the agency experienced huge backlogs and rising care wait times. Something has to change and it's our job to make the change. The VA committee recently approved the Choice for Veterans Act here last week in this room.
▶ 0:42:05A bill that Chairman Boston and I had introduced to help veterans secure their disability benefits by expanding access to accredited representation and imposing new penalties on bad actors in that space who are seeking to prey on vulnerable claimants.
▶ 0:42:23Do you believe that expanding the options available to veterans, particularly by allowing them to work with trusted accredited representatives, uh that that could help improve the outcomes they experience when they're pursuing their benefits? So basically all good actors accredited, no bad actors. I think anyone that helps the veterans get what they need is is is something that we need to look at. But I'm going to also take it a different step if if for just a second, Congress.
▶ 0:42:50It is fundamentally flawed in my mind that we have a system in which veterans have earned benefits that they feel like they need to get somebody to help them with to get and I think this is I this goes back to a core statement for whichever you know I think for both sides of the aisle. Why do we have a system in which you have a veteran who has served our country, earned a benefit, have to go through a process in which they feel like that they have to get outside help to do that whether you know accredited, uncredit, I mean have that choice.
▶ 0:43:17What we're looking at right now and I've talked to every regional office I've went to and every other is how do we make this process simpler? I mean, there's a simple there's an interesting page for me that I found the other day that when you're beginning your claim for a disability that do you realize that we have a whole sheet that asks for your entire military history basically and where you served and when you served? We don't need that. We just need their name, their social security number, their date of birth. We can get that. Why are we making them fill that out? This is the kind of stuff we're talking about. And that makes general sense to most everyone.
▶ 0:43:47So, we're looking at, you know, any way we can to help the veteran get the benefit they need, but we're starting internally uh to make sure that we can do the administrative stuff we need so that you can cut through the uh the bureaucracy to get the benefit that you need and get it done quickly. Yeah, absolutely. And the idea that only within the VA can the responsibility reside for really solid exact accreditation on all counts. Who's ever asking to be accredited?
▶ 0:44:14that's in the in the VA's ballpark and that's what we're asking for is that the VA will actually accept that responsibility and that's where the key is I think in the in the um better outcomes for the veterans in the appeals process. Yeah.
▶ 0:44:30And I think that's one of the things I will state that that to get that started with us is in accreditation is sort of outside our scope as far as us accreditating outside individuals, but we're willing to do whatever the Congress ask on that and we're going to f focus it and we'll make sure that the resources are available to make that happen. Can I also hit though you talked about community care because this is actually where this all goes. I I don't agree and this is just a just a difference of opinion. I don't agree that uh community care is a giveaway to uh private physicians and public hospitals.
▶ 0:44:59In fact, I think that's the actual non- intent of the mission act was if you met criteria, you could go outside the system espe or wait times or even the fifth number is where is the best uh uh medical interest of the patient between the doctor and the patient. This is something we've got to deal with as well is that that is the intent of the law and that you know that we're not taking VA care from one and giving it to other. VA care expressed in our hospitals are expressed in through community care and which we're paying for is VA care and we're going to hold it to the highest standards.
▶ 0:45:31Thank you. And with that, Mr. Chairman, I yield back 40 seconds. Gentleman yields back. Represent Pepis Miss Brownley is recognized. Miss Brownley, you're recognized. Thank you, Mr. Chairman. Thank you, SEC, Mr. Secretary, for being here. And um I'm going to start out with u a question, and I don't want you to think I'm being combatant here. I'm not.
▶ 0:45:59I just want to understand what's going on. And it's a question around non-disclosure agreements that I'm hearing. I I have a copy of a non-disclosure agreement here that it appears as though um you're requiring supervisors at VA to sign these non-disclosure statements um as you go through this reduction in force plan.
▶ 0:46:21Um so I I think one of the things in this non-disclosure that seems to be not not in it is uh protection a protection for whistleblowers. Um I think uh title five requires that there needs to be protection uh for whistleblowers. So it that seems to be lacking in this non-disclosure agreement.
▶ 0:46:46But I'm also hearing from employees that um they're saying that spyw wear is being installed in their computers to monitor their emails and teams messaging etc. So, you know, generally my question is this kind of feels as though you're not creating an environment that is where people are motivated to work as hard as they can for our for our veterans.
▶ 0:47:09So, you know, I was elected at the same time you were and you know certainly I would think as a former member as you are, you would be asking similar questions I think and so I'm just asking why are you doing this? Thank you, Congressman. It is good to see you again. we did come in together.
▶ 0:47:27Look, the NDA simply restates uh you know title 18 USC 1905 in which the employees and others are not to discuss and is to keep sensitive information of in any department uh internal and we're dealing with a issue right now that is a dramatic change for the VA and we're looking at workforce and one of the issues uh that we're having to deal with workforce is one of the things and I'm going to just I'll be very upfront with all of you here today before we even go down some of the line of questioning.
▶ 0:47:53Um there is not a time that I'm going to in a public setting uh go into details as far as this group of people being looked at, that group of people being looked at. Not in a setting like this. That's not fair to them and it's not fair to this committee. So this is simply a restatement. But all of the protections that are afforded a whistleblower or uh work with communication with Congress, classified information, any reporting to inspector general, mismanagement, anything else are all protected in that NDA. It does not does not protail them.
▶ 0:48:20This is simply an opportunity for us to have open and honest dialogue about where our work workforce should be shaped. So where does a whistleblower go if they feel the need that officer whistleblower protection we have it inside our own agency. That's where they go. It's still there. It's still operational. It's never went anywhere. Ted is still there. They've signed the non-disclosure I'm not sure what you're saying, but anyway. Anyway. Okay.
▶ 0:48:49Um, so let me let me move on. Um, the Elizabeth Dole bill, I was very involved with the Elizabeth Dole bill and um was wanting to hear from you about when you think um the imp it it will be implemented. It was passed about I think six months or so ago. Um it's certainly something that our veterans and certainly the Elizabeth Dole Foundation is very anxious to see implemented and and get started.
▶ 0:49:19Um so could you speak to when it when the implementation is going to take place? We have already started the meetings and and internal operations on the do act on how to actually we're going to be doing that but we're not rushing through it. One of the things I think that we did learn from the PACTA act was that something even a good idea such as the PACTA act if implemented quickly could lead to um issues of of budgets, issues of staffing and who actually how it's actually rolled out.
▶ 0:49:43So probably over the next couple of months we're going to see we've already been meeting and I think there's actually been some uh uh conversations with the Hill and staff and we can be happy to get you more on where we're exactly at right now, but we're looking to do that and get it online time with the requirements of the Dole app. When our staff was being briefed, uh they they were told that section 120, which is an important section because this is where the um the 65% cap on expenditures for non-institutionalized care is lifted.
▶ 0:50:11And we were told uh that the VA isn't planning on implementing that um until January of next year. And I and I bring this up because we have veterans, ALS veterans, veterans with spinal cord injuries that, you know, need and want their care at home for a quality of life I think that they deserve.
▶ 0:50:34Um, and they can't they're they're they're out there and they can't have it because this cap is on there and there's not enough resources to have them stay at home with dignity and and so they're out there waiting. We've actually heard that some veterans who have been on ventilators have lifted the ventilator because they don't want to go into institutionalized care and really have just taken their own life.
▶ 0:50:59So, they're out there, you know, just uh hoping, praying that this will um be implemented so that they can be taken care of with the dignity as that they deserve. Yeah, thank Congressman. I I agree. We're going to move as fast as we can and make sure that it's actually done properly to get it to everybody so that it's when it implemented it'll be done there. I'll check into the the year there and go back and get you more information on sex. We what we're finding is as we get into it, there may be times we can actually implement things quicker.
▶ 0:51:28I think they want to give a a time frame that may be workable but could be done quicker. So, we'll actually look into that. Well, and I will say to you that the implementation of the Elizabeth Dole, you will save money because getting the care at home is less expensive than it is an institutionalized care. And it's a win-win because that's where veterans want to be cared for is in their homes, particularly aging veterans, disabled veterans, and that's what the Elizabeth Dole bill was really all about.
▶ 0:51:58So, it's, you know, it's a it's a win-win all the way around. And I know you're trying to, you know, use resources as effectively as possible. Well, implementation of this bill is a a road to go down quickly where you can save money and invest in other areas. I I agree and that's also one of the issues that we're making sure that we do have the investment of money uh that was come because some of the the bills is still, you know, we're still determining what the funding Megan is because they were not funded in the uh act as we go through. So those will be issues that we're going to work toward.
▶ 0:52:27Let me just say on a personal note, I understand that completely having a daughter who has spobifida and in a wheelchair. Uh the needs at home sometimes can be uh that is something that you have to prepare for. We've had to do things in our own house over the last 30 years that um I would have never thought I'd have to. Very good. Well, my time is running out, but I did wanted I wanted to ask you I know you've talked about worldclass healthc care for our veterans. Um just hoping that you will uphold the worldclass standard of teambased the team-based model of anesthesia within our within our hospitals.
▶ 0:52:57I think it's really important and with that I yield back. Gentle woman yield back. Dr. Miller makes you recognized for seven minutes. Uh thank you very much uh Chairman Boss, Ranking Member Tano. Uh thank you very much Secretary Collins for uh for being here and as a both a veteran uh and a physician. Uh thank you for uh for your advocacy and support of our veterans.
▶ 0:53:20Let me also just start off before my question echoing uh Miss Brownsley Miss Brownley's last statement about the um about the team-based model in anesthesia care. Uh as both a nurse and a physician uh married to a nurse uh and a veteran um I would echo that sentiment that we want to deliver the best care to our veterans.
▶ 0:53:41Um the committee has heard uh about uh reports of a referral coordination initiative being used as a means to bring back care into the VA once a veteran has been referred to community care. And I'm also going to say that I was a proud veteran delivering community care uh within a community for veterans. Uh so I've been part of that process uh on the delivering end of community care and you made a statement that community care is VA care.
▶ 0:54:08So my presumption would be that it should be left to the veteran to make that determination whether they if they've had initial community care if they want to transfer vax. Could you give me your thoughts on that? Yeah, that's that is exactly right. I think this is a choice that we need to give to the veteran because it's in law and this is the way the law is interpreted. You meet the qualifications, you get to the choice of community care.
▶ 0:54:30Um, and I think that's one of the things that we've seen though unfortunately in the last uh few years is and this is a story I'll tell and it's because it's very concerning to me because we the unfortunately for some the mission act and some with internally in the VA seem to view the mission act as setting up an us against them scenario. The VA care versus community care that the doctors here and the doctors there. In fact, um it was unfortunate this past week.
▶ 0:54:53I was asked a question in when I was traveling in Minnesota in which somebody who was not happy with uh uh with me and that's normal, but um you know, we get it. They actually said to the reporter and the reporter asked me the question, well, why would uh we need to keep all veterans in VA. VA has the quality care and the community doesn't. And I thought to myself, why would somebody who is one protesting us degenerate all the doctors in Minnesota because that's exactly what they did. Whether they meant to or not was irrelevant. That's what they did.
▶ 0:55:23We've got to get over this idea that it's one doctor against another. There's also a thought inside the VA that the VA doctors in some way are supervising the community care doctors and this is slowing uh some of our work down. The other issue with community care that is problematic and we can talk I hope we get to talk about this today is our electronic health records management system which is does not allow us to uh communicate with doctors. So for us it's just about getting the care to where the again veteran first not VA first veteran first. The VA is there to exist to serve the veteran. Uh thank you.
▶ 0:55:52Um this Fox uh grant program is set to set to expire at the end of this fiscal year. What do you see as the long-term role of this program in VA suicide prevention strategy? I think it's a great program because it actually brings in, you know, some different voices into the conversation, but I'm not satisfied at all with where we are in our response to our veteran suicide issue, our death by suicide issue. This is just not something that's is tolerable.
▶ 0:56:17To the folks on this committee and especially if you're new to this committee, uh just understand since 2008, our veteran suicide number has not changed. Understand 2008 our veteran suicide number has not changed. But yet over the past few years, we have added $588 million every year for the last few years to veteran to suicide prevention. It's not working. So I want to use grants and programs like this to reach out beyond the scope of where we're currently reaching to say, how can we actually touch the veteran that's not being touched right now by these programs?
▶ 0:56:48Here's another thing for you. Out of that, whether you use 17 is your number, 22 is your number, whatever number you have, half of those have never had VA connection. half of them we've never had a chance to touch. So, we've got to do better at using the grants, using our programs uh to go outside the normal bubble and use others to help uh you know get the word out. Um you may not hear this question. I agree with that and also General Bergman's comments about emerging breakthrough therapy.
▶ 0:57:14Never thought in my medical career I would be talking about that but uh but yet it does show promise uh in reducing PTSD and uh suicide. Uh the VA's leasing process uh continues to face long delays, uh overruns and cost overruns with outpatient clinic leases and the building for those leases, the construction, I mean often taking years to complete. Um do you have a plan for that? And if not, I would love to meet with you. I've met with people within my district who actually do construction.
▶ 0:57:44They're more than happy to save the VA money at their behest, making less money for them in order to have a more efficient process. Congresswoman, I I I this is going to be the one time I'm looking at the ranking member and the chairman and I and I just as I did this morning with the appropriations committee and everybody in this committee, help me. Our our our procurement system, especially when it comes to construction and new facilities, is broken. I mean, and we're not even at the point to where and and this is not throwing anybody under the bus. It's just they're given a system that doesn't work.
▶ 0:58:14And I was here and many several of you were here when we had the issue first come up. And we started uh one was in Colorado. Then there was others that you know were right now. It's no reason in all fairness that it takes a billion six to build a medical center. There's positions on this panel. Your local hospitals in fact in my hometown just built a hundred plus you know several hundred patient bed uh system. Put an O in it. Put an ER in it. They built it in less than two years and it's a lot less cost.
▶ 0:58:42Our leasing programs need to be streamlined. Our building programs need to be streamlined because right now there is not really, if you would, as I call it, that touch point, that one belly button touch point where I can actually say you're responsible for this or holding them accountable for contracts in which they don't meet their deadlines. So, I'm asking for help here on this one. Be happy to help you with that in our chip and act.
▶ 0:59:03And then this is just a very very minor thing and I know it's minor but I've had um veterans in my district contact me and send me photographs of our VA hospital uh where which show a blank wall and the photographs of the president and the vice president are not there. I know it's a minor issue. Is this something that comes from the VA or how can I help these veterans uh and answer their problem? So if you could just address that quickly and I know you gave me extra time so No, I I appreciate No, they should have the pictures.
▶ 0:59:32There was a delay and I think one of them was that the vice president's picture was one of the delays. My picture, you know, look, it's out there in the president's picture. It is it's very important to our vet. I get those calls all the time. We're doing everything we can to get those pictures out and make and this is a change to any administration. It needs to happen quicker. It didn't it doesn't most of the time. Um but I think it's being done as quickly as possible. Thank you so much. I yield back. Representative Pap. Thank you very much, Mr. Chairman, Mr. Secretary. Thanks very much for your comments.
▶ 1:00:00I want to ask you about an issue that's critically important to veterans in New Hampshire. New Hampshire remains the only state in the contiguous uh 48 states without a full service VA hospital. And so the Manchester VA Medical Center was built in the 1950s. It continues to experience serious infrastructure issues, pipes bursting in the winter, flooding, heating outages, even insects in the operating uh surgical suite.
▶ 1:00:22On May 9th, the Trump administration announced an executive order directing a feasibility study at the VA uh within 180 days of the order submitting a a plan to the president, an action plan to expand services at the Manchester VA into a full service medical center. So veterans have been asking for this for about 20 years now. They're ready to move past the talking stage and to see some action on this.
▶ 1:00:44So, I'm wondering if as uh this study is moving forward, you're going to work to engage with veterans and stakeholders in the state of New Hampshire to make sure you're hearing directly from them and capturing their feedback. Yes, Congressman, I appreciate that and I appreciate you carrying the torch for that. Also, I've talked with your governor about this as well and I can report to you that that feasibility study started this week and we're going to be working with our uh stakeholders in New Hampshire and other places to make sure that this goes through.
▶ 1:01:09So, uh, following through the promise of the president who made the promise, uh, to look at your, uh, facilities up there. Uh, that's what the EEO said and we're already started that, uh, process and we started it this week. I appreciate that. And do you start this process with the commitment to establishing a full service hospital in New Hampshire? I believe that is the desire of the administration as we go forward and we're looking at it from that. You have a you have a an a system in which we're going to look at and make sure that we get the proper needs and the proper care in that area. Thank you. I appreciate your attention to that.
▶ 1:01:38Um before I get to my next questions, uh Chairman Boss to ask unanimous consent to enter into the record uh data received from the housing policy council showing over 80,000 veterans state by state who are at extremely high risk of foreclosure. Without objection. Thank you very much. So I disagree fundamentally with VA's decision to end the VAS program and I want to ask you a little bit about the timing around that because it was extremely unclear who was informed and when.
▶ 1:02:04So VA briefed committee staff on April 9th that VAS would stop accepting applications from lenders on May 1st. I'm wondering when VA first publicly posted the information to the general public uh about its plans to stop accepting VASP applications. As far as an exact date on when published, I would have to get you an exact date. Um I think going the VAS program in general though this is a program that I think many on this committee have strong feelings about should have never started to begin with.
▶ 1:02:32this was not a congressional uh mandate. This was not a congressional program. So, it was stopped and it had already uh got into an area VA didn't need to be in to start with. So, we have the date uh basically April 23rd is when that was posted publicly. So, literally a matter of days before veterans were made aware of the fact that this program was coming to an end. And I ask about this because we heard directly from a constituent who was caught up in this. U he is a veteran who is name is Daniel.
▶ 1:02:59He's 100% service disabled veteran of the first Gulf War. Reached out to our office days before the end of VASP, understanding that he might still have a chance uh to get into this program and to make sure that he could start making payments and stay in his home along with his service animals. So, I'm wondering if you have any guidance for veterans like this who have been caught up in this period of time where VASP is coming to an end. Uh there wasn't clear communication from the department.
▶ 1:03:25What do do veterans like Daniel do to be able to stay in their homes while we wait for Congress to take the important step forward to develop a partial claims program? Well, I think that's what the first step is is Congress needs to act on upon this and this should not have been a program that was taking money away from other things to start and getting the VA into a mortgage uh business. I mean the numbers here I think at this point it stopped on May 1st. No one who is currently in VAS was was taken off VAS. Anybody who currently is working through VAS is still on VAS. We just did not take anymore.
▶ 1:03:54and the So, so respectfully, that's not a good enough answer for my constituent. He's someone, he's someone who understood that the date was coming, May 1st, was trying to work with his lender to get into the program, and now he's not sure he has any other opportunity to protect his home and to stay in his home. And we're facing a housing crisis in New Hampshire, as we are in states across the country. So, would you be open to a foreclosure moratorum in the interim while we await action in Congress to develop a bipartisan plan for a partial claims program?
▶ 1:04:24I'm not going to commit to a program on the fly here in the middle of the hearing. I think I I I understand your concern in looking at it, but again, sort of we set up a problem that was going to end up developing. The reason VAS was stopped was because the VBA, which took money from other programs, reprogrammed from other things to do this program uh came forward and they were now going to ask for multiple billions of dollars out of their mandatory program to go forward, which I'd have had to come to Congress for. And it was just an area that we it had to be a time to cut it. We did it as much as we could.
▶ 1:04:54It's not an answer I know you want to hear or the the veteran may want to hear, but this is just it's a program we should have never gotten into. So So look, I I I disagree with that answer. I think the fact is this was a last resort program that was a should should have been a stop gap while Congress developed something that was more permanent and we're working on that. But we've got to be looking out for constituents like this who number 80,000 across the country. People that are at risk of foreclosure, veterans who deserve our support. And so I want to get to just just a final statement here.
▶ 1:05:23I hear from veterans across New Hampshire that are deeply concerned with some of the moves they see being made by VA. Now I agree with your statement that you made in your testimony that we've got to be looking out for end veterans and I believe that we do that on this committee. I've served here for 6 years now through uh administrations of both parties. But I take exception to the claim uh of what you've you've said which is that quote literally all VA stakeholders agree uh with what needs to be done. um and that's reflected in the action that you're taking.
▶ 1:05:51I don't think that's true because veterans I talked to don't agree with the abrupt ending to VASP. They don't agree that we should put more ri uh veterans at risk of force for foreclosure. Uh they don't agree with the fact that we've seen crisis line employees lose their jobs who are in probationary status. They don't agree with the fact that uh your stated goal is to fire 83,000 workers that would cut deeply into VA's ability to meet the needs of our veterans and provide the kind of care and benefits that they deserve.
▶ 1:06:18So, we've got work to do to make sure that we're improving services at VA, that we're getting things done for veterans. Uh, let's be willing to work together and do what it takes to meet the needs of these heroes who have worn the uniform and have done everything to serve the United States of America. But veterans know that we need more. We need better cooperation. We need better leadership from you to get the job done. And I yield back my time. Mr. Chairman, can I answer? All right. Just That's fine. We can keep it going. Just keep going.
▶ 1:06:45Just real quickly, we are scheduled to pass the partial claims bill next week off the floor over to the Senate. I would encourage everybody to support that so that we can cure those type problems and then go and encourage our senators to do the same as quickly as possible. So with that, uh Dr. Murphy, you're recognized for seven. Thank you, Mr. Chairman, and uh welcome, Secretary Collins. I am very heartened to see someone of your caliber, intellect, and um desire to help our veterans. We appreciate um your service.
▶ 1:07:14You know, we started off the committee. We talked about what things are different now. It's oversight. It's accountability. Um, personally, I liked our last uh secretary, but I thought it was extremely ineffective. We come in here and we were riddled with a sexual scandal coverup that occupied unfortunately a couple hearings in this committee. We had cost overruns, but they weren't cost overruns. It's time actually for um people to come in.
▶ 1:07:38And as you said, the VA is broken and continuing to pour money and to hire individuals who by the last administration's report overhired. Um, it just is nonsense. It doesn't help our veterans. So, to that point, you've been in this job four months. Can you tell me on a scale of 1 to 10 how good you believe our VA is efficient? Um, an overall number would probably not do justice to everything. I think there are some areas that were completely inefficient.
▶ 1:08:06Um, and then there's other areas that we have uh been able to do things better. Um, so I think it's I'm not going to make a blanket statement on that we're a four or a five. I mean, I don't think a record question, but yeah, I think I think that we're we're probably at a special when it comes to our our IT programs, when it comes to our our employee management, when it comes to to our efficiencies in doing things such as contracting, payroll, uh, HR, we're probably, you know, lower than we need to be, especially when compared to the industry. Yeah.
▶ 1:08:36So, you know, you spoke you spoke a little bit about building a hospital. I I've been intimately involved in a lot of administrative stuff. I still practice. I still see veterans. Um, if the outside world can do things infinitely more efficiently and less cost effective, why can the VA not do it? And this is just emblematic of what, you know, some people feel our government should do is just pour money into a system that doesn't work. So, I appreciate the uh efficiency and accountability that you bring into the office. Um, one thing speaking of which, I'd love to bring up the EHR issue.
▶ 1:09:05Um, I I've sat on this committee now I think close to six years and um, I'm still dumbfounded at the billions and billions and billions of dollars that have been poured into an EHR that should have never been done to in the first place. It's not a system that should be used for the largest health care system in the country. So, I know this is a big um priority of yours and I'd love to know your thoughts about how we can actually implement a system that's only in just a few hospitals and centers at this point. Thank you, uh, Congressman.
▶ 1:09:33This was the one that was dropped on my plate from day one and and frankly, it was just dropped as a as a, you know, just a cold fish, so to speak. It was just nothing was happening. The previous administration, the previous secretary had put a pause and basically it was just sort of a death nail because nobody was talking, nobody was doing anything to to move anything forward. This was after we had poured billions of dollars into the system. Now, I choose to I could go back and I could, you know, talk for days about how it was, you know, probably poorly started, poorly funded, poorly integrated, poorly everything.
▶ 1:10:04But what I chose to do was from day one is walk in with fresh eyes and say, "Okay, here's what I've been given. Here's what we have to do." So, what we did was was we basically took the two positions, the VA position and Oracle position, and we came to see what each said about each other. Then we put them in a room and then they I had them basically talk to each other and then I locked them away and said, "We got to fix this system.
▶ 1:10:24Don't come out until you fix it." What we're at right now is instead of maybe four next year in the Michigan area, we're actually going to be doing 13 across that entire vision. And what let me just tell you what I have control over and also the what I have control over a vendor or a client which I believe Oracle to be. VA is we had almost I think it was eight or nine committees that everything had to go through to determine what standardization would look like.
▶ 1:10:52So in other words, if we wanted to to code something, it had to go through eight different committees differently then to come to a final committee before it then could go to be discussed with Oracle. I did away with every committee except the my final committee when I after they had their meeting. We only have one committee now Dr. Evans talks directly to Oracle. Oracle talks directly uh to Dr. Evans on standardization issues. We're going standardized from here on out, which is what every other hospital in the world does. Yep. We have about 10% that is unique to VA and we're going to work through those again as we go forward.
▶ 1:11:22Uh by doing that, that was able then to allow us to speed up the process and allow us to add the nine more sites that we're going to. This also then takes into account uh looking ahead to gain momentum. Is anybody here in a longer system? And if you go back to DoD and for both sides of the aisle, the DoD did this over the years. they had a pause and they actually came out of the pause and were standardized and got it done. They finished their side of it. Um, and roughly the same time the VA was supposed to be.
▶ 1:11:49So, we're just looking to actually now get the momentum so we can go on to others 20 to 25 to 30 to get this. Yeah. And that's I applaud you at that. It was criminal that nothing more was done. This has been a failed system from the start. It's it's neglect. It's pointblank neglect that this is not already in every VA system. And to your point earlier about being able to communicate with community care doctors, everything, I don't know what the hatred is about community care on this on in this committee sometimes. I swear to God, they just don't I don't understand it.
▶ 1:12:18I've taken care of patients. We want a seamless approach and we want the best physicians and the most readily accessible physicians. And it's nothing a pro or con anything against or for the VA. It's pro veteran. It's what is being done. We need to be able to communicate with those individuals. I don't know how many times I've seen a veteran and I can't get records from hell um about the patient itself. So, thank you for actually doing something about it. I'm going to follow up with one other point um that's already been stated twice. Um anesthesiologists need to be in charge of the operating room.
▶ 1:12:48It's a team approach. There needs to be a quarterback. I don't care if the fullback says that they're as good as a quarterback. They're not. That's what we want. We want the best for our veterans. And that's that's period. And finally, um, an issue that is near and dear to me. You've talked about veteran suicide. We've talked and talked and we've poured money upon money upon money and we haven't moved the needle. I have, uh, scrubbed a particular therapy that I truly believe is moves the needle in the state of North Carolina. It is doing tremendous things to help our veterans, and that's hyperbaric oxygen.
▶ 1:13:19Um, I don't know why this is a partisan issue. They're using it all over in Israel. They're using it in other places in the country. Um, I have a bill HR1 1336, Veterans National Traumatic Brain Injury Act, that here to for the VA has opposed the bill. Um, we want to do everything for those individuals who are at the end of their rope and I'd love to have the VA drop its opposition. This is something our veterans should have in their arsenal.
▶ 1:13:45Uh, Congressman, I look for you working your bill through the Congress and and go and we'll be from our perspective viewing the treatments we've had, the the research that we have to provide you the research that we've seen and where we can find that it might work, they'll be happy to see that come on and we'll follow the lead of this Congress. I appreciate that commitment. Thank you, Mr. Chairman. I yield back. Representative Shifflin Carmick, you're recognized for seven minutes. Thank you, Mr. Chairman. Thank you, Secretary, for being here today. I have a few questions for you.
▶ 1:14:09Um would you agree that housing is an important um priority for our And generalization question I mean is housing important for anyone? I mean I'm I apologize. I'm not sure what do you prioritize veterans benefits when it comes to housing making sure that our I prioritize all the benefits that are veterans earned. No specifically. It's yes or no. Then we can just do yes or no. Well if I I will do that if it actually answers the question. Is it a yes or a no sir? For what?
▶ 1:14:38Do you prioritize veterans housing? I prioritize all veterans benefits. Yes or no, please. Yes or no to what? I just I mean, we can play this game back and forth. Secretary Collins, I'm not interested in that. I'm really getting It seems you are, Secretary Collins. I am not interested in that. We have real concerns, especially in the state with our veterans. So, could you please answer it? Yes or no? If you choose not to answer, just say you choose not to answer and it's not important. Do we prioritize housing for veterans? Yes, we also prioritize healthcare. Thank you.
▶ 1:15:05So, do you prioritize and um fully commit to housing veterans, especially when it comes to flexible assistance to homeless veterans? I'll fully commit to helping the veterans in any way we can through the programs we currently have, but I refuse to get the VA involved in something like VAS that we should have never been involved with to start with. Um, excuse me. Could you please answer my question because we are not talking about VAS.
▶ 1:15:26Once again, the question is, if you would like to listen to the question is, do you support providing flexible assistance to our homeless veterans like access to transportation, hygiene products, blanket support to help our veterans? The answer is is we support our veterans. I mean, yes, but the question I have a question, where are we not? Do you believe that access to lands owned by VA should be in part used to address veterans homelessness?
▶ 1:15:56That's yes or no. If the land is suitable, that's it. Can be used. Yes or no. I can't give you an answer to a question that has a hypothetical that cannot be answered. It's a yes or no. No, it is not. It is. Okay. So, we're not Mr. Chairman. I mean, I I cannot answer. It's my time, sir. It's my time. You don't need to look at the chairman. I'm right here and it's my time. I know exactly where you are because I can't answer your question. So, the respect that I'm giving you, I deserve it also. So, please answer those questions as yes or no because you're taking up my time with this.
▶ 1:16:23So the next question I have for you now, there's so many veterans who are losing their homes, especially in Florida, and we're finding more of them becoming homeless. So my real concern is about the Elizabeth Dole Act. We have a a clause in there that actually deals with that, and you have not been implementing it. So that's why I want to identify if this is actually uh important to you or if it's a priority because my veterans do want to know if this is one of your priorities. Yes, it is a priority. Anything in the Dole app, we will implement.
▶ 1:16:51So why have you not taken it to implement it in these stances? Because this the Dole act was given at the end of last uh administration. It came in and I've been in here over four months. There are 72 total provisions in the Dole act. We've completed nine. We're working on track with 55. U we got two that were still at risk and we're still working. So we're doing everything we can. housing was in fact a priority for you, wouldn't you skim it to find out which priorities or how can you actually make housing accessible?
▶ 1:17:20Because my question is, we looked at and we saw that there was a significant gains were made towards homelessness from January of 2023 to 2024. Right now, we're seeing that we there's a potential for us to lose the momentum that we've been gaining. And in addition to that when we talk about the purchase the service purchase program which you said that you would like to terminate or you're terminating we want to know what are the other the other instances or what do you have in place for our homeless veterans to protect them.
▶ 1:17:48The issue in termination of ASP as we go is that uh we are looking to do everything we possibly can that is already currently there for veterans in the VA for assistance whether it be their mortgage or other things. We also can work with other agencies such as HUD and others to find ways to help them as we go forward. I'm willing to look and move forward anything we can without sacrificing also the bigger picture.
▶ 1:18:11I'm not unfortunately able to just simply pick the the areas especially in ADO act where I want them to get all of it implemented for all of the caregivers as we go forward. And I think the Trump Donald Trump just a few and was in and with Congressman Papus as well that EO also talked about using facilities uh the VA which has been ignored and frankly under previous administrations was allowed land that we had that we could have helped homelessness in in LA was actually farmed out to private schools and uh ball fields.
▶ 1:18:39So I'm trying to look at it from a perspective of you and I actually agree probably more than unfortunately this came off and I apologize for that. we agree on this issue that we need to look at what we can do within the confines of what we have and so how quickly do you believe that you'll start prioritizing or putting this in place because I have to answer to my veterans also to make sure that we see them and we understand that housing is so critically important especially towards their dignity and the contract that we have with our veterans which is to protect them and make sure they live with dignity.
▶ 1:19:08I I agree with you and I'll be happy to work with you and talk about specific instance especially Florida. I have Georgia is my home. I don't get there very often anymore, but it's a very similar situation for us on housing cost and housing quality. Um, any of those information within the Dole Act, we're going to continue to implement. And if there's ways that we can help expand something we currently already have, I'm willing to look at that as well. But I think this is just where we need to make sure that we're doing stuff that help and doesn't either have a negative impact some other place uh with other programs.
▶ 1:19:36And so my last question is going to be really quick even though it's a huge issue. Um it's about the dismantling of the office of equity assurance. We just had a round table where we had many of our minority veterans there who talked about the disparities and them actually drawing down their benefits specifically when it comes to PTSD. Um how are you going to handle handle these situations specifically when that office has been dismantled?
▶ 1:20:01That office again being dismantled has nothing to do with the fact of my commitment to make sure any veteran who's earned a benefit gets their benefit no matter what their background, what their skin color, specifically the disparities I wanted to point to. How are you going to handle the disparities? Because we have years and years of documentation, especially when it came to housing where we saw different generations that were disadvantaged. What do how are you going to do that specifically when this office has actually been um dismantled?
▶ 1:20:24I think it's it's when you're actually supposed to be doing your job, it takes a secretary to lead and make sure that organizations are not doing anything that will you be handling it because you said it takes a second. It takes secretary to give leadership to the organizations that are supposed to be approving our benefits. If and Congressman, if you have somebody who's been uh discriminated against or not getting the benefits they've earned, then I'll be happy to work with you to make sure that's uh rectified. But that is that's something against the law that we're not going to break law. We're going to actually give the benefits that they've earned. Okay. So, specifically, should they contact your office then? because this office has been dismantled.
▶ 1:20:55Who should they reach out to? Well, the question is is not the office that was not a part of the benefits that they weren't getting. Why are they not contacting the office of the benefits in which they were denied? The question specifically is who should they contact contact if if it's which which benefit are they looking for if they should call VBA which is the benefits that that would be the area to call if it's a so there's not going to be the elimination now is going to be shifted to different Thank you. I yield back. Representative Bannard, your Thank you, Chairman. Mr.
▶ 1:21:25Secretary, I want to thank you for getting something accomplished in less than a 100 days that I've been trying to do for two years. And that is to get rid of a program that has never existed since the time someone lent someone seashells to buy a cave. That's the VASP The Veterans Affairs Administration under the previous administration decided to take on $17 billion dollar worth of debt without conferring with Congress.
▶ 1:21:55And to me, that should be unlawful. Let me explain what the VAST program is for those people that are not on me and Chris's subcommittee. The Veterans Affairs Administration in the previous administration decided to start buying home loans and reducing the interest rate. So if it was at 7 and a half% the VA would buy the loan from a lending institution, lower the interest rate to 2 and a.5% for and they spend an average of $360,000 per home. They did this up to the tune of $17 billion.
▶ 1:22:26The amount of money the average veteran was in rear $25,000. So it was a $25,000 problem that was solved with a $360,000 solution. And that's that's how the previous administration ran the VA. And Doug um Excuse me. Dennis Mcdana was a friend of mine and I I actually respect him tremendously. Um, but that was just foolish and wrong. So, in 99 days or whatever the heck it is, you got rid of that and I thank you tremendously for doing that.
▶ 1:22:55That showed really incredibly bold leadership and we're getting arrows from this. Right. Well, guess what? I'm going to give all of my Democrat colleagues the opportunity to help rectify what they're talking about today because HR1 1815 will be on the floor next week. So, I would encourage everyone to put their money where their mouth is and vote for that partial claim thing. You don't want someone to get kicked out of their house, vote for HR 1815 or stop talking. That's all I'm going to say to everybody about that.
▶ 1:23:26So, here's what happened. Mr. Secretary, I had my crack graphics team draw this up so I can explain to some people what's going on. Here it is right there. That's the whole VA. This is the problem with the VA. Okay. This is the increase bureaucrats. These are the doctors. It's almost a flatline. And then we have an increase with the veterans because of the PAC Act. Right? So when we are going to cut the VA and I hope you do, sir, this is where you need to make the cut. Right there in this line right there, sir.
▶ 1:23:55If Mr. Secretary, if you cut this, then this line with the doctors and stuff, the people that are actually touching our veterans and providing care can go like this, right? And then we can match the increase with vets. So, Mr. Secretary, I'm incredibly happy and looking forward to working with you and your administration.
▶ 1:24:18And if if there's anything just if you have a a topline item that we can do from the congressional side, power of the person, all that stuff, if you could, you know, rattle off one or two of them, it'd be great. We will write these down and we'll take it for action. Mr. Secretary, thank you, Congressman.
▶ 1:24:35I think one of the things you mentioned there at the end is is something that's very important because it's also been one of the most misconstrued and also used to scare veterans and also scare employees uh concerning what we're looking at in uh regards to uh a reorganization of of staff and how we look at this. As I stated earlier, we have 465,000 as of today uh in our total VA organization.
▶ 1:24:57What is interesting about that is in VHA there's 400 409,000 there's 34,000 in VBA and there's uh 2400 in NCA which is our cemetery account. You know what's interesting? We have 16,375 in the central office who are not uh you know are doing policy doing other things or and by the way most of them are not actually showing up at 810 Vermont or somewhere else they're they're not showing.
▶ 1:25:21Um so what the question becomes secretary I'm sorry will you say that number again just so people can understand the scope of this the ludicrousness of this bureaucracy at just at central office and this has nothing also to do with some of the other levels that are built into these numbers that I've talked about is the 16,375 yeah so as we look at this the question becomes is not are we you know where are we at with our our programs as I stated earlier we have 28,000 physicians we have 91,000 nurses but also one of things I did
▶ 1:25:52not mention on the GA report was this veteran numbers not changed. We're still looking at 9 million veterans every year. That's the enrollment 9 million for the last 10 years. It's been the same. Yes, PACAC shot up. Pact gave us some more. But here's the interesting. We got total number 985,000 that came to new enrolles in PATC. And that's not just for PAC. That's all enrolles. 985,000 in the last couple of years. Uh and our number still stayed at 9.1 million.
▶ 1:26:19The reason is is because over two years we also lose 400,000 veterans in this country every year. So you may add 900,000 but you're also decreasing 400,000 each year on two years. So 44 you're basically drawing even here. Our total veterans in this country have dropped from uh about 4 million in the last 10 years. We're dealing in a in a in a circumstance here in which you can't really justify the layers of bureaucracy. And let me give an example if you don't mind congressman about this.
▶ 1:26:47One of the issues that we have and just to show you where it's again when somebody says, "Oh, you're going to cut doctors." I actually saw this article again today and somebody thinks that in one hospital we're going to cut 15% of everybody in that hospital. That's just stupid wrong and I don't want to hear it again. Okay? That's just not the way this goes about. You're looking at organizational structure. But here's the interesting issue. I told you earlier we when I first came in, I couldn't get an actual count of our employees because our HR system was not set up the way we could to get an employee count.
▶ 1:27:14And nobody in here has been in the military could understand that concept, but that's what happened. The other issue that we had is we had then we went to payroll and said payroll how many people do we have? Payroll came back at centralized which is our centralized payroll system which was supposed to be implemented again this is all oversight stuff that has not been you know for the last few years is looking at it was supposed to be centralized. They said we had 230,000 employees and I said and even our guy said we got more than 230,000 employees.
▶ 1:27:43Come to find out that there was a permissive attitude that allowed 60 or roughly 60 of our hospitals to continue to do their own payroll with multiple hundreds of people involved in that process. We have contracting that is all over the country. None of it centralized. All of it doing different things and you have differences of of opinion between uh even hospitals on how they actually do pursing. Again, tens of thousands of people. We also have human resources. It is all done in this. Mr. Secretary, I just have a couple seconds. Yeah. Um, I want to say one thing.
▶ 1:28:12I want every single person that has served this country, is serving this country, or feels like they want to serve in the future to have access to the Veterans Affairs Administration Home Loan Guarantee Program. And by shutting down this disastrous, VAS program, you accelerated that. So, thank you very much for that, Mr. Chairman. I yield Representative McGard. Thank you, Mr. Chairman. Thank you, Mr. Secretary, for being with us today.
▶ 1:28:39Uh we have our differences on this committee like any committees but the thing I love about this committee in particular is that it's mission centered. Despite those differences we often come together and try to do what is best for our veterans. That's what we're here to do. That's what we try to do. Uh now I can tell you as someone on this committee and from Louisville, Kentucky, I hear a lot of complaints from veterans. But those complaints are very rarely about the care they receive.
▶ 1:29:07They're far more about how long it takes to get that care, how far they have to go to get that care, how they access their benefits that they have earned, earned by putting on the uniform. And I will tell you, we have to do better about that. I think everyone would agree we have to do a better job of doing that.
▶ 1:29:22I will also tell you that because of that, I'm concerned about some of the things that I have heard you and this administration say over the last few weeks, like the stated goal of cutting 15% of the VA's workforce, which is roughly 83,000 jobs, or or possibly terminating nearly 600 contracts, which no one can tell us what the contracts are or what the actual number is.
▶ 1:29:46or even just ending the VAS program in such a way that it could leave a thousand veterans in my home state of Kentucky without a home. I personally believe the term homeless veteran shouldn't exist. But I want to use my questions today to focus on an issue that I actually hope we can agree on because right now there is a part of VA that is decreasing weight times. It's improving medical outcomes. It's reducing costs. It's making the department more efficient.
▶ 1:30:17And it's not Doge. It's the VHA in-house innovation ecosystem. And I know you know about some of this, but let's just outline some of their work for everyone else. Uh, this is like Vet Text, which sends text reminders to veterans about upcoming appointments, decreasing missed appointments by 10% and reducing weight times for our veterans. The VHA Uber collaboration, which has provided veterans with ride shares across a hundred facilities, saving VA nearly $200 million.
▶ 1:30:44There is a remote diabetic foot ulcer smart mat. I know that might not sound like the most exciting thing in the world, but it has cut hospitalizations in half and it has saved the VA almost $100 million. And again, hospitalizations in half. It's saving veterans lives. Uh Vion, it's a physician created initiative that helps VA in deprescribing unnecessary medications and improving patient safety. It saved VA over $300 million annually.
▶ 1:31:13And I say I think we can agree on this because I actually I read your op-ed on May 2nd with interest when you went to Michigan and talked about some of the cardiology care there and praised this highquality, high techch and veteran centered care. So I want to keep this innovation going in the VA.
▶ 1:31:32And what I'd like to know from you today that with all the cuts that are ongoing is a commitment that while you're secretary, the Trump administration will not eliminate the VHA innovation Congressman, I'm not sure where it got uh out there that anything that I have said or done or misconstrued by anybody that wants to is to take away anything good that the VA is doing. In fact, we're not going to do that. We're going to implaud that. I tell our employees all the time, go make mistakes.
▶ 1:32:02You're not going to get in trouble at the VA for making a mistake if you're trying to do good because I'm going to pick you up and put you back out there and try again. What we don't want to have is issues that when we get in our own way. And I think that's the biggest thing I'm trying to to emphasize just as I emphasized just a second ago. Things that take away time, effort, and money from the very things that you're talking about are the things that I'm looking at trying to change. And look, we're on the same page. You and I can agree on this. Believe me, when I was here, I was on judiciary committee.
▶ 1:32:30We didn't come close to most of the time on the judiciary committee. So, this is actually good with it with what we have here. I like the agreement, although that was not a yes or a no answer on on whether the innovation ecosystem is going to stay. And I hope it does. Yeah. Well, I I don't agree with you. I I agree with you. Okay, perfect. Because I mean, I say this, we have such possibility there. When you look at the VA, we have 9 million patients. uh the largest patient population by a multiple of any hospital system in the country.
▶ 1:32:57Nearly 75% of physicians do some of their training at the VA. We have the largest longitudinal data set of any hospital system in the country. Uh and we are not putting enough focus into research into innovation. And I really believe we have the ability not just to take care of our veterans but forward our resources so that maybe we find a cure for PTSD or or TBI or a spinal cord injury that then benefits everybody in America. And then of course we know those those are service connected injuries.
▶ 1:33:26What happens if somebody comes in with Parkinson's, cancer, heart disease and we find a cure for that? We could change health care not just for our veterans but for everybody in this country. I want to switch gears a little bit while staying on healthcare though. The fastest growing group of veterans in this country are our women veterans. Uh and we know that they have different health care needs.
▶ 1:33:43Uh on February 18th of this year, the president, who once referred to himself as the fertilization president, signed an executive order instructing the domestic policy council to identify ways to reduce barriers to IVF. We know that women veterans uh don't have as much access to the service. We also know that their infertility rates are higher than their civilian counterparts. Secretary Collins, are you and the VA right now working on a plan to improve IVF access for women veterans?
▶ 1:34:13Yes, we're fully implementing the the executive order from the president. We fully intend to. When can we get an update on that? Uh we'll get with your office and tell you the updates as we have at this point. Awesome. And again, working with the administration as they roll out their procisions as well. Thank you. And and again, shifting topics on you again. Uh I am not scared about technology. I think technology can be used for a lot of good things, but we are advancing in AI rapidly.
▶ 1:34:37Um, one of the things I've heard from my veterans is they are worried about the AI systems potentially going into place, particularly in making the final decisions on benefits. I know you can't forecast way into the future, but while you're secretary of the VA, can you commit that there will always be a human who's making the final say on a veteran's eligibility for their claims? I I think yes, is the issue there because there's such differences in somehow these disability claims are actually adjudicated out.
▶ 1:35:03One of the things I think we both can agree on the using technology is that there are simple claims that should not have to go through the long tedious process that we have that we can automate and automize that gets them their uh uh benefit quicker. I think that's the big thing. But if there's always a concern about a a di disability diagnosis or something, we're going to have somebody adjudicating that. Thanks. And only because I have 13 seconds left, I want the claims resolved quicker. I want them faster. I do want to make sure that a veteran knows that it's another person who's ultimately making that determination for them. Thank you, Mr. Chairman.
▶ 1:35:34I yield back. Thank you, Representative King Hines. You're next. Recognized for seven minutes. Uh, thank you, Mr. Chair, and thank you, Secretary Collins, for your time today. Um, I have the privilege and great pride actually of representing the CNMI, Commonwealth of the Northern Marana Islands. We have hundreds of veterans who lack essential VA healthcare and VA resources because we are a remote community.
▶ 1:36:00And uh with your help and the help of my colleagues in this committee, I hope we can start affecting serious change and improvement for many of our veterans. One of whom is here today who flew 8,000 miles for some other business. He's back in the back row, Mr. Brad Rosala, who is the local VFW representative for Saipan.
▶ 1:36:22So, you know, with the help of of the chairman and his amazing team, I've been pushing to fill the only VA administrative role in the entire CNMI, a position that has been vacant for over 18 months. The administrative specialist position is a critical resource for our community of underserved veterans.
▶ 1:36:40It's the only person in the CNMI actually that's responsible for assisting our vets by answering questions, providing information, giving guidance and you know given your earlier statement about you know our veterans don't need to hire somebody or you know get somebody to be advocating for them right um that position um has been very critical a critical lifeline to um getting our vets to be able to get the the help they they need. Is there any way you can provide us an update with that?
▶ 1:37:10I appreciate that and I thank you for your work. I mean, you're in an area that is uh again remote as you said, it's very difficult, but uh in working with you and our uh folks have been talking about this. Uh we recognize the the vacancy in that position and have worked with that to make sure it was not affected in any or hiring freeze or anything else. And I am here also as your one who has traveled 8,000 miles that your new administrative specialist will be on the job June 16th of this year. Oh my gosh, that is amazing news. Very much welcome.
▶ 1:37:39Um, you know, God forbid that you wake up a little late, right? Because a lot of times to be able to get the for our vets to be able to get the service, they have to call Guam and then Guam has to go through Honolulu. So, if if you miss that time period, um, you just don't get the service at all for that day. So, thank you much. Appreciate it.
▶ 1:37:58Well, I want to thank you and the chairman and the ranking member and all on this who've actually helped through this and get this done and I appreciate that work and and again, sometimes it just takes, you know, we got to push and there's and it's an area that's very difficult to find uh work in, but uh uh hopefully you'll be able to uh have a good success starting in uh June of this year. Thank you very much. Um, so just one other thing.
▶ 1:38:18In December of 2023, the VA announced the establishment of a vet center outstation in the CNMI, a smaller satellite office aimed at improving access to counseling services for veterans and service members. Um, this was incredibly welcome as there is currently a significant lack of services available to the veterans in the CNIME. However, a year and a half later, the outstation has yet to be established.
▶ 1:38:43The most recent update we have is that the AL station is in the leasing phase with no set date for its opening. Can you please provide an update on the status of the BA's effort to open the bet center outstation in the CNMI? Specifically, at what stage is the process and when can we expect it to be operational? And I know you've mentioned some challenges with procurement and leasing processes. So, um, any update would be very welcome at this point. Congresswoman, I wish I could go one for, you know, two for two here, but I can't on this one.
▶ 1:39:13But I can give you at least a little bit. So 500 is at least better than none. Yeah. Um, it is still in that lease process. And as I said earlier, this is a part that I really wish we could have uh some change on. We've got to get this better. Uh, but it is still in that leasing process. But I want to go ahead and and say what are we doing to to look ahead and that is that the readjustment counseling service is currently recruiting for counseling positions and expects selection and onboarding in the next several months. Um, and it's dependent available wide.
▶ 1:39:38So, we're actually already looking for uh folks to fill that position and and we'll continue to look for a place to to put them and uh you know to get your help that you need. All right. Thank you. I yield the remainder of my time, Mr. Chairman. Thank you very much for your time. Thank Representative Romero. Thank you, Chairman and Ranking Member. Secretary Collins, it's good to meet As ranking member of the oversight and investigation subcommittee, I've made a commitment to honor the service of veterans in this country with action.
▶ 1:40:08And that includes the 20,727 veterans that live in my district. So when I talk about veterans, I talk about all veterans. And that includes women, that includes people of color, that includes first generation, lowincome, LGBTQ veterans, and also deported veterans. I know we don't talk about it enough here, but there are veterans who have fought for this nation have now been deported.
▶ 1:40:32And because every veteran is entitled to the full benefits they earned and were promised, uh I want to make sure that we have a conversation today about where we are on diversity, equity, and inclusion. When you, Secretary Collins, and my Republican colleagues celebrate turning your backs on a commitment to diversity, equity, and inclusion at the VA, it feels like you're turning your back on veterans. And I'll tell you why I say that.
▶ 1:40:55I don't believe that any administration and any secretary has the authority to decide which veteran is worthy of the services and care that they're entitled to and which is not. So, Secretary, given the VA's mission to serve every single veteran, is meeting veterans where they are a priority for you? Yes or no? Thank you. And if that's the case, why has the VA paused all outreach efforts?
▶ 1:41:25So, let me explain to you. Uh, we have been attempting to work with the VA to do outreach services with the veterans and meet veterans. Sometimes veterans can't make it to a a VA center. Sometimes they can't make it to a VSO. And so, there's outreach, there's fairs. We have been told that outreach services have been put on pause. And so, my question has been, how has halting outreach improved access for veterans? That's not true.
▶ 1:41:50We're we're we're at we've been in events and I can give your office the plenty of events in I was just in Detroit where we're doing outreach events in bus stations. We're doing outreach events at sporting events. We're doing outreach all over that. I'm I'm really glad you said that because now I'm more concerned and I'm going to tell you why. Because on March 6, I sent a letter asking about Paul's outreach programs on behalf of veterans in my district who were confused and frustrated.
▶ 1:42:14We invited the VA to participate in some of the fairs and events that we do in outreach and they told us that services had been paused. Uh did you receive the letter that we sent on March 6th? I'm sure we did. So we have not heard back from your office. When can I expect an answer? You're going to expect an answer right now because what you have just described is malicious compliance and it is not tolerated. That is not what is happening.
▶ 1:42:39And for for a VA employee to tell you that they could not come to affair or outreach is taking what was done and said and and and I've had to already face this. So I appreciate your question. I'm I'm as upset about it as you are. That is malicious compliance because what they wanted to be able to do was is say we couldn't do outreach although they can do outreach.
▶ 1:42:55Well, Secretary, let me just tell you then for the record here in the letter that you have from March 6, on Wednesday, March 5th, 2025, we received correspondence from Chicago Community Leaders of the Jesse Brown VA Medical Center notice that they were temporarily pausing any comprehensive outreach programs effective March 7th. So, I'm going to make sure that we enter this into the record secretary after we you and I can have a conversation more about it because obviously uh there are concerns there that I know you want to address. So, could I have a Could I get a copy of that letter as well?
▶ 1:43:25Yeah, actually we have a letter for the copy of the letter here. We'll make sure to get it to you. Look, I I I'm This is something that frustrates me. And even if I had to pause and wait for this, I don't want you to feel like you're losing time, Mr. Chairman, because this one is upsetting to me because I'm having to deal with this a lot. That's exactly why we bring this here. That's why members of Congress, I'm so happy you did. Thank you so much for bringing it because that's exactly malicious compliance right now is hurting our veterans and if our VA employees are doing that, it's wrong.
▶ 1:43:51Well, and thank you for saying that, Secretary, because outreach, making sure we're meeting veterans where they are is so incredibly important in making sure that they access the resources they need. So, you and I agree, necessity uh to ensure that uh outreach is being done in every part of the country is critical. And and I'll say to you, I find it even more critical because sometimes I know that there are veterans that can't make it to certain places. Black and brown veterans are placed in housing at lower rates. We know that by facts.
▶ 1:44:18We know that women veterans face greater barriers to care and we know that trans veterans are living authentically still face discrimination inside the very system meant to serve and honor them. So, Secretary just this morning I heard from diverse veterans who said going after diversity, equity, and inclusion programs feels like an excuse to not to serve all veterans.
▶ 1:44:39And you said earlier you're committed to our veterans, but I didn't hear you clarify when my colleague asked you about the Office of Equity how these disparities are going to be confronted and how you're going to make sure that disparities are addressed. So, can you talk a little bit more about it? Yes, I'd happy to. It doesn't need an office of equity inclusion to actually make sure that veterans are treated properly. That's something that we've developed. And I understand something. There's offices for you, me, anybody, no matter where their service is.
▶ 1:45:06If they've earned the service, if they've earned the benefit, they're going to come. So, secretary, where where would they go if they have experienced discrimination? Who would place you? The same place you would in the same office of whistleblower protection. They can call their congressman. They can call. There's several outlets for them to do that. But I will tell you right now, no matter what background they are, male, female, gender, it doesn't matter. If they've earned a benefit and they have something at the VA that they feel like they're not getting, then you personally call me and I walk into the clinic. I'm glad you say that, Secretary. So, I have a follow-up question to that. Trans veterans are veterans. They wore the uniform.
▶ 1:45:36They serve this country. And gender affirming care is healthcare. It's suicide prevention. It's dignity. Last time I raised this with your team, the responses were unsatisfactory. Mr. Secretary, gender affirming care is shown to reduce suicide risk and ends veteran suicide. Ending veteran suicide is a VA priority. So, will you defend and expand access to gender affirming care? Yes or no? We're going to continue those that are in the VA system to receive the care that they were currently, but we're not adding sex change in the VA. That's just not what we're going to do.
▶ 1:46:06So, they'll they'll get every they'll get every benefit they've earned. Thank you, Secretary. I just have 47 seconds left. I I'm I'm disappointed in hearing that, but I'm not surprised. Uh this administration and my colleagues keep supporting a divisive agenda for the VA that harms our veterans. Americans American veterans are diverse, and we don't get to decide who's worthy of our promise to honor their service with action. Uh the reality is that in this moment we have veterans who don't believe they'll be able to get care under this administration.
▶ 1:46:34And I want to make sure for the record and in the work that we do in oversight that when we talk about every single veteran, we mean every single veteran and that means gender affirming care as well. With that, chairman, I yield back. Representative Barrett, you're rep you're recognized for seven minutes. Thank you, Mr. Chairman and Secretary. Great to see you again. And um want to start by thanking you for coming to Michigan last month, spending time with veterans in my district.
▶ 1:47:02We uh we deeply appreciated that and appreciate your commitment to uh fulfilling the mission we have to every single one of our veterans uh across the country and the interest you took to come to Michigan. We we really appreciate uh and uh appreciate your willingness to step up and serve in this role. I know that it's not uh always easy to step into the management role of such a large organization with a lot of political pressure and a lot of spotlight on you. So, so thank you for being willing to do that.
▶ 1:47:28Um, I wanted to ask you specifically about the uh electronic health record modernization and the increased funding in the uh uh budget proposal uh before us and wanted to ask um how this enhancement in funding is going to be used to ensure that we have a success in the electronic health record roll out knowing that we've had challenges with the program in the past. Thank you, Congressman.
▶ 1:47:53I do appreciate uh the commitment especially in your area because of you know April next year the four sites will be going live in Michigan. I think it's just a restart is what we have to to sort of look at here. This was a a system that had been broken in the sense that nobody was working with it. They were not uh uh they just sort of went to their corner and and just held the ball and money was being wasted all the time. So what we did is restarted the system from minute one.
▶ 1:48:20One of the biggest issues that I'd heard that was uh concern not only from a perspective of uh patient safety, patient quality of dealing with these health records, it did put uh my understanding at least looking back on uh some of the stuff in Washington state and Oregon is that it was not working properly and was actually giving some bad results. That's just an issue there. Most most of that came from the situation in which we didn't standardize what we were doing. They just sort of were allowed to do whatever they wanted to do.
▶ 1:48:48One of the ways going forward is is we're holding accountable on a very short uh timeline on our end to make sure that all of our employees are trained. Everybody's going to be up to speed and we're speeding up uh that integration process. We're also holding Oracle accountable for realistic time zone time limits and also be getting the equipment in and also adding things such as AI and others on top of that to help our doctors in their uh treatments and the nurses as well practitioners going forward which is something they see in the private sector right now if they just walked across the street and
▶ 1:49:18went into a private care facility. So we're believe that we're putting in the safeguards to make sure that going forward this is going to be something that can actually work but also giving it the tools to expand in a quicker fashion. Thank you. I appreciate that. Um I uh chair the uh technology modernization subcommittee here and uh one of the issues we've taken up is the um external provider scheduling program.
▶ 1:49:42Uh, one thing that was clear throughout that uh, hearing we had recently is that provider participation is really critical in making sure that EPS works for veterans and reducing that community care appointment wait time and the seamless uh, integration there. I personally had an experience with the community care scheduling that was fraught with challenges and problems.
▶ 1:50:02Um, can you tell us what steps the VA is taking to encourage community care providers to participate in EPS and educate them about the program and not delay the implementation or or discourage its use? Yeah. And this is something I think that anybody sitting in my position right now would have this problem and I don't care which administration it could be going forward because frankly the third party administrating of this has been a problem uh and struggle and I'm not saying completely their fault.
▶ 1:50:28I think there's a VA component to this as well on things that we've done to exacerbate the problem going forward. One of the things and I don't think I've mentioned it. This is my second hearing, but if I've not mentioned it already, I want to at least emphasize this again is that when about the second week that I was on the job, I was brought it was brought to my attention that we could not put out the uh contract RFI for the third party administrators this year as we were supposed to because the work was supposed to have been and and please don't hear me as trying to say blame, but this is just an honest assessment.
▶ 1:50:59They didn't do it last year. They basically it was supposed to been done in the fall of last year in the previous administration. They just didn't do it. So the groundwork, leg work to work up to this was was not done. So we had to put it off a year. But what has given us the ability to do now is spend time looking at the qualifications for these contracts, looking at these things.
▶ 1:51:16We I I think one of the latest uh conversations I've had with some of our folks on that's looking at this system is there's going to be literally hundreds of changes to the RFI proposal so that we get better uh work with our community care doctors and with our VA. Just to let you know on this committee if you've not understood this issue, one of the problems is and some of the doctors have alluded to this is that you have doctors who cannot communicate with our system and our system doesn't communicate to them.
▶ 1:51:43So they're waiting weeks with I kid you not, we're faxing information. We're putting it on compact disc and sending it up. This is some all of us could, you know, hold hands and say, why are we doing this? But this is what's been going on and that's what's delaying care for our veterans. Yeah. No, I I appreciate that. and it felt like there was a a bit of a you know dragging of feet to get this integrated and to expand it.
▶ 1:52:06One thing I raised in committee that um I'm hopeful we can look at is if we're doing the change management around the electronic health record modernization and and upgrade and roll out to these facilities. It might be the appropriate time to put them onto this scheduling program at the same time so that we're doing that kind of comprehensively or with some thought there.
▶ 1:52:26Um, I'm not in your position to kind of discern that practicality or not, but I do think that we need to do a far better job of rolling this out in a much more aggressive fashion to kind of achieve the benefit of getting these things scheduled in a timely way for our veterans. I agree. And it's not just the issue of inside of our own facilities, it's also the the veteran using it as well. And so it's it's a twofold purpose of how we're training and how we're also laing this out.
▶ 1:52:50Um, I feel good about where we are now and anything that we can add on, I've already experienced to Oracle that um, you know, we expect uh, compliance. We expect this to to go forward. Fortunately, about 3 weeks ago, uh, the Senate confirmed my deputy uh, Paul Lawrence to be uh, our deputy secretary. That is statutoily under his uh, purview and I've turned him loose uh, to do that. He's getting involved now heavily on a on a weekly basis and even a daily basis on it. So, anything we can add, we'll be definitely looking for it.
▶ 1:53:19We uh look forward to um working together through the uh subcommittee and that effort and appreciate you being here today. And with that, Mr. Chairman, I'll yield back. Thank you. Gentlemen yields back. Dr. Conaway, you are recognized for five minutes or seven minutes, I'm sorry. Uh thank you, Mr. Chairman, and thank you, Secretary Collins, for being here today and answering questions. In the interest of time, I'm going to ask you a series of yes or no questions.
▶ 1:53:40Just in the interest of time, um I'm very concerned about what this administration is doing to safety net programs such as the Supplemental Nutrition Assistance Program, otherwise called SNAP and Medicaid. Uh the cuts to those programs that are proposed are, in my mind, completely unacceptable and will put many people at risk. Many of our veterans rely on these services to put food on the table and to access healthcare coverage.
▶ 1:54:06If any veteran loses their Medicaid coverage during this administration, would you allow those veterans to be eligible for VA healthcare under priority group six uh to receive healthc care coverage? Uh yes or no if you would. At this point in time, I don't foresee any of that happening. So I'd have to take it as it came and look at it as it if it happened. If that was an understanding that's not something that we've dealt with so far. I'll take that as a no for the moment. Take it any way you need to.
▶ 1:54:34If any uh veteran loses their um nutrition benefit during this administration due to changes in the law, uh as you know, there are some drastic proposals out there in my view. Uh would you be open to directing the VA to provide cash subsidies for those veterans who've lost uh that important food security program? Veterans are exempt from the SNAP work requirements. They're not included in these issues.
▶ 1:54:57Well, but if the SNAP while the work requirements are a separate issue on the SNAP, as you know, the SNAP program itself, if it's cut, that means people are not going to be able to get the SNAP benefit at all. And so my my question is, and I'll ask it again, would you be opening to directing to replace that money? Um, you have the authority to do this with cash subsidies to make sure that veterans are not food insecure, but veterans are not a part of the program that's been described as what has passed, but yet they're on SNAP. I I'll move on. Uh, so they so they'll continue to get their SNAP program.
▶ 1:55:28Well, they not if the cut if the program is cut by $230 billion. So, I let me just move on. I appreciate um if um uh what uh do you intend to do about um veterans who can't um Well, let me move on. I have significant concerns regarding DOA's access to VA data. Specifically, I'm worried about their access to sensitive personal veteran data.
▶ 1:55:54Uh, Secretary Collins, can you ensure this committee that Doge personnel who have had access to VA data have not retained any copies of that data? Yes. And they follow all the personnel and all strategic information as any employee would at the VA. Uh, can you commit to this committee that no, uh, personnel, personal, excuse me, or sensitive veteran data such as social security numbers, driver's licenses, medical records, or financial records have been uh, retrieved or will be retrieved by Doge after I guess their their time in service ends.
▶ 1:56:24Uh, and that those employees haven't stored that data uh, elsewhere um or um have used it for personal gain. There is no uh, even resemblance of anything that would happen to that regard. Um the VA is a major player in medical research and innovation. How many researchers have been fired or dismissed from the VA? None. Uh how many research projects and studies have been impacted due to the firing of researchers?
▶ 1:56:52We have a lot of reports about uh clinical trials not being disrupted or or being canceled or otherwise postponed or paused. Dr. Conway, I don't I'm not trying to evade your question, but I do need to draw a distinction here. Are we discussing research trials? Are we discussing clinical trials? Uh clinical trials. Okay. Clinical trials. Uh this is there's uh no clinical trials has been halted. Now if there have been other issues that may have done it, but none has been cancelled of the research trials. I mean the clinical trials.
▶ 1:57:20Let me also say something and I and I want to get this out because it's important. There's over 1,500 clinical trials going on right now. And of which this is not hopefully not going to shock you, but did you realize that we have no centralized control over those clinical trials? I have no idea. No one person is overseeing those. So to get those information and to find out what's going on on some of those, we have nobody that's actually over those, but yet we have 1500 that are actually uh going on currently.
▶ 1:57:48I suspect many of those trials uh because I I I work in this area, have worked in this area, are probably being done through research grants from universities that are that are testing various new proposed new drugs and the like and and they're being run there. I take your point that you might not have knowledge of them within the VA itself.
▶ 1:58:07Um uh some of the information just for the record uh I would um uh provide you with some of the estimates stakeholders have given us um since the hiring freeze by the president um and that continues to be in effect. 370 extramural studies and clinical trials will be suspended or canceled at the VA. 10,000 veterans that are relying on these clinical trials and studies will be denied care and the VA will lose $35 million in research funding due to delays and cancellations.
▶ 1:58:38Uh during uh earlier today during a hearing at U Milcon VA appropriations subcommittee uh you stated that clinical trials are not health care for veterans uh that they are um above and beyond health care. And I must tell you that I uh completely disagree with that statement. And if you wish to correct it, that's fine. But um clinical trials are health care.
▶ 1:59:04And uh for those veterans, as has been mentioned earlier by my colleague, uh might be a lifeline for a veteran who is uh who has cancer and is in a trial or perhaps has a neurogenerative disease and is in a trial. uh and those uh potential discoveries uh that treatment that's given during a clinical trial and it is treatment because I have been a an investigator I know that is treatment um that uh any pause or delay and cancellation of such trials is is a delay in cancellation of treatment.
▶ 1:59:33So um are you taking any steps to ensure that veterans who lost access to clinical trials will still receive the care that they need? Yes. And and I would appreciate the opportunity to clarify because my words were taken uh out of context and I think when you have to have proper context what I said was because I'm having to also deal with a lot doctor about people who are lying about what we're doing in all honesty.
▶ 1:59:55And so when you get to the point where it's I've had many people come up and say dealing with research or dealing with clinical trials saying they've lost all access to health care. This was their wording all access to health care. That's just I I'm with you on this. It is not.
▶ 2:00:09it is a part of health care but it is not they didn't lose their access to their primary care physician they didn't lose their access to anything else and and even if it's true we did not cancel uh any of the clinical trials and as we move forward on that we're going to continue to do that because they have actually provided a great deal of of service to not only our veterans but outside that veteran organization as well and the same is uh true with that no research trials have been cancelceled that's one of the reasons we put the pause in uh that we did as well for that thank you Mr. Secretary and thank you Mr.
▶ 2:00:36Chairman, Representative Hemny, you are recognized for seven minutes. Thank you. Thank you, Mr. Chairman, and uh Secretary Collins, it's good to have you here. And I believe happy birthday. Thank you. It is. I've turned 68 today. I'm just doubling my age since I can fit in with my other colleagues over here. I will I will Well, that's it for me, Mr. Chairman. I'm gone. As we all know, the number of veterans in America has declined over the past two decades.
▶ 2:01:06Yet, VA spending continues to skyrocket, and this trend is simply unsustainable. Now, Mr. Secretary, under your leadership, the VA is finally taking long overdue steps to increase accountability, eliminate waste, and refocus the department's mission of serving veterans and not preserving bureaucracy for bureaucracy's sake. Now, as my Democrat colleagues fearmonger, the reality is more than 300,000 jobs have been exempted from the hiring freeze. The focus is on eliminating the administrative fat, not doctors and nurses.
▶ 2:01:37Veterans need the VA bureaucracy to work for them, not the other way around. It should not have taken the VA's chief financial officer two weeks to give a simple set of basic budget accounting information to you. But that is what we had until recently. With more than 60 disperate HR systems, outrageous tales of corruption, and chronically broken veterans, integrated services networks, we have lacked fiscal accountability for decades now.
▶ 2:02:01Phoenix's Carl Hayden VA Medical Center, which is quite infamous, failed so many veterans that it became ground zero for reform efforts. And I know there's been a lot of progress being made over there. But veterans in my district and across Arizona expect the VA's budget to directly support their care, not layers of administrators removed from the mission. I look forward to assisting your continued efforts to refocus the VA on its high-minded mission, taking care of veterans.
▶ 2:02:27The Trump administration's reforms aspire to accomplish this by providing greater oversight, less bureaucracy, and a culture of non-stop effectiveness. Now, Mr. Secretary, we've heard a lot of scare tactics, but I want you to talk about once more list the services and jobs excluded from the hiring freeze. Thank you uh for you know the offering the question and one of the things is can I want there's something you said in your uh in your question that I want to address if I could and I'll get to that part.
▶ 2:02:56You talked about our chief financial officer. I wish I had one right now. Um right now our chief financial officer, our lead uh general counsel and our national cemeteries uh under secretary are being held up in the Senate. These are three veterans who have all served.
▶ 2:03:13one who is going to be Sam Brown who is going to be head of our mortary affairs, our c cemeteries, gave mo some of his own body to service of this country after being blown up and yet is right now being held hostage in the United States Senate by the same people who actually want to say we want you to hire veterans and not fire veterans. Well, now I just got a sense and I've told the senators this as well. It's time to stop that. If you want to hire veterans and I got three of them that need to be approved and need to get on the job working for veterans.
▶ 2:03:40So when you say I have a CFO, I don't have one because I can't get the Senate to approve them. So don't tell me they want to help veterans when they got three of them sitting right there, one who was grievously injured in wartime that they refuse to approve. That's what I'm dealing with right now. In addition to what you're saying and what we're looking at, we're not looking at doctors. We're not looking at nurses. We're not looking at this. And you just look at the numbers in general and you have the the uh your poster there.
▶ 2:04:04I mean, we're looking at issues that I talked about earlier, where we have a payroll that is being done at 60 locations, which was supposed to been centralized a long time ago with hundreds of employees that we're now having to to look to see how we can consolidate to make sure we're running it efficiently and more cost-effective. We don't need them all over the place. We don't need the issues that we have of human resources being run in every location again with hundreds of employees.
▶ 2:04:29We have a system of a vision system which many of you may understand is was put in the 90s to give general oversight over our hospitals. Did you realize that and I talked to some folks from that time frame when they actually put this in that they were supposed to be minimally staffed 10 to 20 people will be in the uh the look at our visions. Right now our vision structure with everything we've added on to it instead of having that number most of them have full-time staff between 60 and 100 but added staff of nearly 16,000.
▶ 2:04:59in the vision structure. These are not also some of them, by the way, some of them said, "Well, they're they're impacting health care because you have some doctors." I have one of my vision directors actually tell me they said, "Yes, we have some of ours who are quote dualheaded. They do four hours a week in a clinic. That's not helping us with our veteran backlog. That's not helping with our weight times. It's still being done from a level that is far up. We have 200 plus call centers in the VA." You want to talk about that one for a second?
▶ 2:05:29These are I mean every one of our VBOs's our our business have one of their own call centers for their mortgage issue. It's like why do we have this? This is the part that is just grown over time and it's not affecting healthcare. We're going to make it easier for a veteran to call on one of these lines and get to talk to somebody on the other end of the line. But we're also going to make it to where we have people who are actually working in these our clinics, working in our disabilities, and working in our cemeteries that actually have firsthand touch.
▶ 2:05:56The last thing that I have to say is is you can say what you want about where we're at and how we got here, but in 10 years, GAO has said, "We got a problem. We've increased money. We've increased." And by the way, before we get into it, someone will say, "Well, the PAT act was why we had the money." Okay, you're right. But if you look at the numbers, we're basically giving some of the same money to the same people that were already there, just in a different capacity. And I I I respect that. They've earned it. As I have said before, I was I am a veteran who served under a burn pit for almost 5 months.
▶ 2:06:27So, I think these are the areas that we've got to look at. But for anybody out there giving and again, I go back to the assessment where you're cutting 15% of doctors, 15% of nurses is frankly just not helpful to do the what we need to do because that's not what we're looking at. Frontline workers should be the happiest at the VA right now because we're going to be freeing them up to do their job and not get bogged down with paperwork. Absolutely. And I hope to see your CFO Senate confirmed very soon. Uh we you need that. You have a tough job right now ahead of you.
▶ 2:06:56And I just want to thank you for your service to our nation's veterans and I appreciate your laser focused outcomes over optics. Now, please know that you have my full support in refocusing the VA on its founding principle, delivering the best care for those who borne the battle. And with that, chairman, I yield back. Thank you, Representative Representative Bazinski. You are recognized for seven. Thank you, Chairman Boston. And thank you, ranking member Tano, and thank you, Mr. secretary for being here today. I appreciate your time.
▶ 2:07:21Um I do want to take a minute to just address the claims um that you've made about the VA's performance has gotten worse from the previous administration uh by many measures and I want to highlight the great work of the VEO, the Veterans Experience Office within the VA um that has been measuring specifically uh veteran trust scores.
▶ 2:07:41They've come up with a veteran trust score which is at an all-time high at 80.4% 24% in 2024, which was an increase of 25% since 2016 when we first started recording this metric. VA employees, many of them veterans as you know, um have been stepping up to meet the demand. You referenced the PAC Act, which was a historic expansion of care.
▶ 2:08:04Um but now with more staffing cuts on the horizon, these public servants are being asked to do more with less is my concern. Almost four in five VA employees are members of unions and collective bargaining rights give them a process to address their concerns in the workplace and ensure sound working conditions. I believe this helps both the employee and the veteran being served. Mr.
▶ 2:08:29Secretary, when you endorse President Trump's executive order stripping VA employees of their labor rights, I believe you devalue their work. and coupled with a threat of significant staff downsizing. I hear from constituents working at the VA in my district that they have increased fear and stress and there are deep morale issues at the workplace where they deeply believe in the mission of serving our nation's heroes. Of course, we agree that improvements can and should be made at the VA.
▶ 2:08:59And I want to say that despite testimony, none of us on this committee believe that the VA is perfect. But improvements and changes I really do believe need to be done in a manner that is thoughtful, legal, and based on the input of stakeholders, which includes us in Congress. And so I'm going to shift gears and talk about one area that you have touched on and um I'm really honored to be the ranking member on the uh tech modernization subcommittee with our chairman uh Mr. Barrett.
▶ 2:09:28Um, and so I want to spend a little time talking about the EHRM as well, which I think is one area that we can all agree is a place that could use improvement. Um, your remarks mentioned an accelerated roll out of this system and I too really do want to see um, EHRM be successful and can acknowledge that there have definitely been stalls and not a lot of success seen to date.
▶ 2:09:54But I think it's worth taking a minute to say, you know, talk about the program and where it started and then where it is today. So this program actually was started during the first Trump administration in 2017.
▶ 2:10:08The VA signed a10 billion sole source no bid contract with Cerner um which some have said the GAO has mentioned that you know influenced by so-called Mara Lago crowd as Cerner struggled with the implementation then Oracle acquired them 2022. So as you know there's a total of 170 VA sites that need to implement the new EHR system.
▶ 2:10:35Since 2020, VA has rolled out and I think we could acknowledge only six sites, which is not that's not great. Uh, now VA has announced plans to roll out EHRM at 13 sites by 2026, which is which is progress, but my concern is that that leaves about 151 sites left. And so, if we're accelerating that to 20 by 2031, how are we going to get there?
▶ 2:11:00Um this is going to be a major undertaking and I'm just very concerned with the staffing levels in particular if we're not fully staffed how we're going to meet this metric. Um and so in the in the midst of what I think is a massive reduction in force and then a barebones IT budget. Um I'm really worried that this is going to set up the VA for failure. I completely agree with you. You mentioned standardization. That is something we've talked about on our subcommittee and something we should be moving to.
▶ 2:11:28But some of the unique challenges as you know is that every VA has their own unique system and trying to get all of them to standardize is is a challenge. But I agree with you that's something we should be committed to looking to. So one of my first questions for you Secretary Collins is to better understand how workforce cuts will help you achieve that. What is your target reduction for OIT workforce?
▶ 2:11:54At this point in time it's not been there's no quota or anything else looking for OIT or any other workforce. It's looking at total picture of who we have where and we're going through that process right now. So, have there been cuts to the OIT workforce? You not at this time? No. No, there's been no. We let less than one half of 1% of employees that were here in January that have let go at the at the Okay. So, there's no plan in the future to reduce the OIT workforce.
▶ 2:12:22I think when you overlook, you know, are there areas of the OIT workforce that may or may not be essential to what is happening? That's I'm not going to say there's not, but I'm also going to say that is essential to us going forward as we look forward in this. Okay. Because I just I mean, I'm just I can't I understand what you're trying to say. I don't mean to be evasive in this, but I just, you know, I'm not going to go that granular. Yeah, I understand.
▶ 2:12:43And I think some of you know I complet I hear what you're saying about the medical staff of the VA, but I think the OIT is a great example of those aren't medical staff, but they're really critical to being missiondriven and to getting a program like the EHRM system really successfully off the ground. These aren't doctors or nurses. These are technicians. These are tech folks. And I just that's why I'm asking. No, no.
▶ 2:13:04And it's a great question because and you've actually opened it up a little bit because also neither are people who clean our rooms and neither are the plumbers and neither are electricians which we've all we've all uh we've protected we protected them as well. So they're part of that 300,000. Okay. Um so I I guess one of the So during your testimony last week before the Senate before my Senate colleagues, you indicated that technologies would help VA to improve efficiencies in the face of work workforce cuts.
▶ 2:13:32But it sounds like and one of my concerns is that we might be using technology to replace people which is a concern of mine. Um because I think quite frankly the VA is not you know we don't want to be installing McDonald's kiosks here. These are actual people we want serving our veterans personto person and so um I just want to make sure can you respond to that and how technology is potentially going to be used? Well, I think technology is is working the how we're taking first-time claims into the our and a lot of this is in our BA benefit side.
▶ 2:14:02We can actually take things that we've seen over and over and over again that we can get a benefit that could take several months under a system. We're actually getting new claim benefits done within literally days so that they're not uh waiting for these things. So, I think you use them in ways that it helps. you don't use it.
▶ 2:14:17You know, techn is not going to solve every issue that you ever have, but it can get us more efficiently, especially in ways that are more uh not hands-off, but they're they're more of a the transactional with our like mortgage benefits, you know, the education benefits, things like that that could could work in that way. Okay. would would love to keep talking. I have time for maybe one more quick question. I did want to ask the VA chief information officer, the OIT, if you that position I don't think has been filled, if you could respond to when you think that position will be filled.
▶ 2:14:48Uh, we're working on that as we speak. I mean, we're still interviewing some folks. It's hard to fill some positions and we're still working to get that filled. Okay. Thank you. I yield back. Mr. Mr. Chairman, the votes have been called and it is the intent of the chair to um go to recess to for the votes. Uh we will have I would like to get everybody back here as quickly as possible 10 minutes after the last vote. Um there's only two votes.
▶ 2:15:17Um and we will carry on. I know that many of you might have flights or whatever, but we will try to get through to everybody. We will come back and uh as I said, Mr. Latrell, you'll be the first one up when we get back. We be in recess till the call chair.
▶ 2:53:30We will come back to order. Um, we'll continuing with the 7m minute uh questions. Um, Mr. Lutrell, you're up. You're recognized for seven minutes. Thank you, Mr. Chairman. Mr. Secretary, welcome back. I'm sure you're used to kind of the eb and flow of this place.
▶ 2:53:54I need to kind of lay out my So, not old everybody. He's from Georgia. Just take notes. Okay. Sorry, I digress. Take the camera off the paper. All right. You good? All right. All right. So n we have 9 million veterans. We have um roughly about 1.3 1.5 plus or minus service members currently.
▶ 2:54:24And of course recruiting is up, recruiting's down. But the transition that will inevitably happen from active duty to our veteran space. Now one of the challenges that I often hear about see about as a veteran myself and have gone through when the veteran enters into the VA space um then the process starts. Now, as easy as that can be for some veterans or as painstaking a process as that can be for uh I'll always say it's it seems to be problematic.
▶ 2:54:54Once the veteran initiates the claim, if you will, then it goes into the VSOs, goes into the rating system, goes into the national work, it disappears into the metaverse, and every sometimes it gets lost, sometimes it gets found. I won't get into the national work with you today. Then we run into systematic problems along the way. Not for every veteran, but for veterans nonetheless.
▶ 2:55:16I I truly and honestly believe if there was a transitional period between leaving active duty service where the the service member's record is buttoned up top to bottom, inside and out, take the veteran more or less out of the equation, almost all the way out of the equation. in the in the record. However, that may transition from this active service to veteran service and then it starts the process on its own. Now, I know we can do that.
▶ 2:55:46My question is, will you not have you, it's too early, but will you will you consider or will you please engage with SECDE? Start these conversations because I've had this conversation with him. I I don't know if you have or not, but everyone understands the problem. Everyone understands that the transition between the two should be seamless. And for decades and decades and decades, we hear about this.
▶ 2:56:16This would be the greatest opportunity that we could have to catch people on the wrong trajectory that we may that may be suicidal ideologies, may have a health care problem, something that we miss. Because when you're in this service and you're on the train, you're front sight focused, laser focused on the problem set that exists in front of you. And that bullet train is traveling down a track 1,000 mph. And it does not stop for us to get off. We jump. And everything that we jump with goes in a thousand different directions.
▶ 2:56:42And then it's our responsibility to try to find it somewhere in every place that we were stationed to put it together to give to the VA. And then the VA's has that. It's their responsibility to help the veterans with that. And we know how painstaking of a process that can be. So my question is, will you, sir, please engage with the DoD and start baseline assessment from the time that we come in through the time that we transition out into time into the veteran space so our veterans are better taken care of.
▶ 2:57:12you know, in looking at an oversight and what we're talking about right here. It's probably one of the most pertinent questions I think we've had and and I appreciate all the questions we have today, but you've hit it something that's very important to me because it it is the trigger mechanism for many of the bad outcomes that we see either uh either not getting care, having a bad experience with care, then leaving the care or not getting the benefits that they have.
▶ 2:57:37Just recently I was at McNeil Air Force Base and we had their medical side there, the Air Force medical side and we had our our veteran benefits office personnel there, some of their senior leadership and I asked the question just because we were talking about how this was transitioning out and they said u I asked our benefits coordinator I said how many of you get people coming in who have no experience or no knowledge of what their benefits are and and to almost to a person they said most everybody. So I've already started that conversation with SECDE.
▶ 2:58:05In fact, we started it before either one of us were confirmed. And because here is the bigger issue that we got to deal with with TAPS and this is our transition assistance program. It is and I say this in a generic form. So any reporter here, please listen to what I'm saying.
▶ 2:58:21Taps is owned by DoD in which they don't really have a good plan because of the way it's positioned as you well know you know to give you 12 months 18 months however you transition out and it goes through this contract not deploying them but this is just their issue. So DoD owns tabs and I'm blamed for it and I think this is the part that we've got to look at as we go forward. There's got to be a more seamless transition for that and we've already started. I think you're going to see something pretty soon about that.
▶ 2:58:51Um I just wanted to let you know that that uh Secretary of Defense and I have talked about it. The last part on that is that question that I think you no matter what we do, one of my priorities is going to be is those that have issues coming out having warm handoffs uh basically straight into VHA, especially those who are having issues with mental health issues, TBI, PTS and those kind of things because DoD has absolute authority to gather all that information and share that with the VA
▶ 2:59:22and just the complexities of the global threat currently that's developing. Mhm. Our generation is coming into the VA. Our our older generation, we're losing them. But if worst case scenario, if we have to go go all in again, it's just the wave is just going to I need the VA to be ready. Yeah, exactly.
▶ 2:59:45We're that's also one of the the emphasis of the president as well is that fourth mission of the VA, which is our disaster natural response and also our we're the actual back. There's not a um without going into classified information, which we would never do here, the VA is always a part of any national contingency that would come up in any any type of scenario that we have. So, we've got to be ready for that. Make sure our workforce is developed.
▶ 3:00:08Um, but I want to real quick if I could, one of the issues that bothers me most about uh our transition part right now is is statistics show us that a shorter time of service, a 3 to six year or 3 to sevenyear time of service is a drastically higher propensity for death by suicide from not just when they get out, not just three or four years later, but upwards of 40 years later. They're seeing statistics to say that shorter time frame. So that's why transition is so important. Correct.
▶ 3:00:34because there's no difference with somebody that served six months to somebody who served 60 years. Period. Thank you. I yield, sir. Mr. Kennedy, you're recognized for se 11 minutes. Thank you. Seven minutes. Thank you, Mr. Chairman. I'll take whatever I can get here. Seven. Uh, Secretary Collins, first of all, thank you for being here today.
▶ 3:00:54Thank you for your service to our Uh, I represent the Buffalo Niagara region in New York, home of the Western New York VA system, including the Buffalo VA Medical Center and one of the nation's two GI Bill processing centers. During my time in office, I've had the privilege of meeting with many VA employees, often veterans themselves, who take immense pride in continuing their service to support their fellow veterans.
▶ 3:01:24Unfortunately, in these meetings, VA staff at every level have raised serious concerns, including plummeting morale and an increased stress due to the threat of sudden firings and what they feel is a climate of fear, PTSD and mental health strains stemming from constant job insecurity, the roll back of collective bargaining rights and attempts to strip employees of their voice,
▶ 3:01:55rigid and poorly thoughtout return to office mandates without adequate infrastructure or workspace to carry out mission critical duties and worsening under staffing which is leaving teams stretched even thinner than they were to begin with. And that list doesn't stop there. Those are just a few. The issues demand urgent attention from you and your team. Mr.
▶ 3:02:23Secretary, your testimony claims improvements to veterans care, yet you're eliminating positions essential to handling the increased packed act cases. Cutting these roles removed skilled, staff who directly assist our veterans. Outside consultants and political appointees obviously cannot do this work. Neither can AI. VA employees in my district work tirelessly to deliver care and benefits. They're not faceless bureaucrats.
▶ 3:02:53They're honoring our promise to our veterans. And your testimony states that VA aims to place employees where they're needed, reduce unnecessary overhead, and strategically cut staff. Now, I've asked this question repeatedly of this administration. Still haven't received a clear answer. How do you plan to reduce staff without affecting care? Who exactly are you planning to let go? What are the roles? What qualifies as unnecessary overhead?
▶ 3:03:22And what safeguards are in place to ensure that these cuts don't further strain an already short staff system or reduce access to vital services for our veterans? Uh, Congressman, I appreciate the thoughtfulness of the question and the overall expansiveness of it. Let me just ask answer in the in the best way possible. As I've said before, and I've made several comments already on concerning consolidation, we've seen areas of of work that be in payroll and uh our HR systems, those kind of things.
▶ 3:03:48The people that you're speaking to who actually handle disability claims, who actually move forward these processes are not the people that are that are involved. In fact, we've exempted 300,000 plus positions to make sure that those are actually the uh positions we need, that we're going to keep, and that we're hiring. And right now uh in any one time we look at this uh and going forward and there's been something that's been said a couple of times and I want to address it here. There's no especially going forward in our in our look at our reorganization process.
▶ 3:04:17There's no such thing as a sudden firing because this is a process that is going through and is as we get to the level of where we are able to say here's what our structure looks like, here's how we're trying to look at this and here's how we're going to be uh maybe rolling this out. There's going to be the notice to the employees. there's going to be notice as we go forward in this. So, it's not an issue of sudden firings. I would hope that that would get through to especially our employees who are on front lines that again they're not part of of what we're looking at especially in the duplicative services.
▶ 3:04:44Um, in looking at this and I do have one other question if you don't mind for I I appreciate the question. I want to be able to answer it. The adequate office space got move quick. I have more please. No, I will. One last thing. Adequate office space issue. uh anybody that's brought back in from our work processes that are not in spaces that fulfill their duty. The supervisor in that position is not fulfilling uh the role because it's it is stately is stated clearly that no one is to be brought back into a position in which they're uh not uh able to do their job.
▶ 3:05:13So if that is happening then we'll we'll hold supervisors accountable and make sure that's happening. They're not going to be able to. I I hope that answers there the the consolidation of space. I will just say when it comes especially to dealing with our veterans and uh mental health services, when you are in confined spaces and you have practitioners that are providing those services oftent times uh via um a virtual space, that is a problem when they're in a consolidated space.
▶ 3:05:41These veterans are not feeling comfortable sharing privileged, confidential, very personal information. So that is something that has to be dealt with. Um, but I want to also go back because look at we've heard from so many different veterans that have are are concerned. I want to just clarify, you know, in in in the first week of this administration, there were cuts. There was a thousand cuts at first, then another 1,400.
▶ 3:06:06Then there was a your memo talking about uh going back to pre pandemic 2019 levels. I know you've discussed this was just a 83,000 people would be cut. Um that that is all concerning all preacted act as well when we those people were hired specifically to deal with our veterans that have had these horrific uh injuries uh fighting for our country. So uh I think there needs to be a consistent message.
▶ 3:06:36I'm very concerned. I know our veterans are worried. They're fearful and those that are employees as well. And uh Mr. Secretary, you talk about over in the Senate, those service disabled veterans that are waiting to be approved by the Senate.
▶ 3:06:50There are service disabled veterans that have served this country and are serving in in the hospitals in the VA system today that are getting cut and are are losing their jobs because of this administration that is not treating them with the dignity and the respect that they have earned and they deserve. Uh, you've visited multiple VA facilities, Mr. Secretary, and spoken with non-healthc care staff like VBA employees, electricians, maintenance workers.
▶ 3:07:20I know we discussed this earlier today. Um, you know, I think we agree these roles face similar challenges across the country. So why did the Milwaukee VA preserve these collective bargaining rights for nurses and facility workers while employees in the Buffalo VA and Buffalo VABA lost theirs even though their job functions are identical? And I will just say that the clear difference to me is that there is union affiliation and it seems like retaliation.
▶ 3:07:50The Buffalo VA employees are represented by three different unions that have filed lawsuits. you know, can you please elaborate and and discuss how these determinations were made? I think from the that perspective, I'll be very simple here because it's going through a process right now of legal issues as well as they were made following the EO from the president uh to go forward on this and we're following that and of course are going through any of the issues that are currently under litigation. Mr. Cisco money. Thank you, Mr.
▶ 3:08:20Chairman, and thank you, Secretary Collins, for being here. I first want to thank you for your visit to Arizona and Tucson just a few weeks ago. I think we had a great time there. You got to see what the VA is all about there and their needs and the things that we can work together on. Thank you for spending the time to visit our districts. I know that's mine is not the first one that you've done that with. I think you have a very hard job ahead of you with with a lot of cleanup to do. Um plethora of issues that I think we've heard about from both sides here.
▶ 3:08:46uh you're getting to them as fast as you can at the same time dismantling a lot of the misinformation and lies that are coming out regarding the VA and what what your efforts are and the presidents as well. So, thank you for all that you do there. Um now, I want to focus on the issue of of um veteran suicide and you and I have talked about this. I know that's a passion of yours.
▶ 3:09:06During our meeting uh in March and then again uh your visit last in April, uh we discussed the Arizona Be Connected program that I mentioned which serves my veterans with their mental health needs and works diligently to forward the goals of the VA suicide prevention strategy and uh and that was cut under the previous administration.
▶ 3:09:26I was and still am looking forward to working with you to find a solution to ensure our veterans and particularly the ones in Arizona who benefit from this program who have told me they personally rely on it for their mental health needs continue to receive um the assistance. Now unfortunately we we don't have full clarity on on the status and the future of the program. Now I know that this is an important issue to you.
▶ 3:09:50It's it's your passion as well and uh you know we did receive uh some some um information last night uh from from the department in terms of some of our questions and the answers that you provided there but still no no real clarity there. So I want to talk a little bit on that and and and just before um I give it back to you so you can talk about that I I want to make sure that we all understand and especially u the department you and your team that we're not talking about frivolous partnerships here.
▶ 3:10:16This is a program that specifically serves veterans and their families that specializes in mental health and uh in suicide prevention for the veterans. Because of the VA scandals a decade ago that resulted in the creation of this program, veteran suicide rates in Arizona were three to four times the national average with 260 deaths estimated in 2024 alone. So this is a huge issue for Arizona, even more than in other states.
▶ 3:10:40So when I was told that the previous administration was cancelling funding for suicide prevention services without communication or justification, what I hear is that I potentially have thousands of constituents in the highest caliber and need uh being left uh uh without care and without the support that that we were promised. So I I know you agree that veteran suicide is absolutely the last issue that should experience delays in communication and care.
▶ 3:11:04So can can can we commit together to to work on this and and maybe getting more clarity on the specific future of the program? Yes. And I think that is the in the be connected program and see uh what we're wanting to do and I think we has talked about this before is making sure the programs that we're going through have key deliverables, things that actually can be measured so that we can get this done. And and I'm committed to working with you and I know we sent the response back to you.
▶ 3:11:29We're going to continue to work to make these programs such as be connected have the measurables that we can make sure that uh we're getting the results need. You've you've expressed uh how those are working and I appreciate that. Um we also have to look at it as an overview program how we're reaching out and it may be something as we put more emphasis on and more accountability on that we can expand as we go forward. Yeah, I remember you mentioning how much money was being spent on suicide prevention and and the results overall of of that investment weren't yielding the results that that that they should based on the amount that is being there.
▶ 3:12:00This one is a public partnership, public private partnership. It is yielding results. We love to provide uh you know again the information on this because it's something that I think can serve as an example not only to keep promoting it in Arizona because our veterans are calling for it because it has worked but maybe even the model for for other states as well. So I would um that that is really my my top priority in terms of of comments this morning. I mean this what are we afternoon evening? What time? I'm not sure. I'm not sure. Yeah, evening almost already. Thank you for being here that long.
▶ 3:12:30But that that I'm I'm really passionate about that because again Arizona is getting hit at a higher rate with this and and u and I know this is your passion as well. So um I hope we can we can get even more clarity on answers than even the letter we got last night. Let me just move on to a quick one as well. I was proud to see some of the recent changes that were made on the officers of survivors assistance that I've been advocating for since last Congress, such as moving OSA within the office of the secretary to be direct advising body.
▶ 3:12:59Can you speak to the impact your reforms for survival survivors will have? Yes, I think that is and I appreciate your uh HR 1228 on a prioritizing. We just went ahead and and basically moved it. Look forward to you moving the the legislation through. We went ahead and moved that back to the secretary's office. Um these are ways that we can make uh these things go quicker. They can go be more compassionately handled in others. I make the statement is someone who's uh been a a pastor and also been a chaplain now for many years in in the military.
▶ 3:13:28One of the biggest things is how we handle these issues of death and end of life and how we go from there. I've sort of described it this way is you have a medical examiner's perspective and you have a funeral home director perspective. And I don't mean to I'm not making light of this but it's really true. you have the more clinical aspect of a of a medical examiner says, you know, your loved ones is deceased. You're no longer here and they just sort of leave it at that. A funeral home director takes that same situation and says, how can I help you and how can I get you through this time which is so difficult for you and your family?
▶ 3:13:58What my goal here is bringing this in as sort of the the white glove survivor outreach item is to make sure that we're giving them the uh due concern that they have in a time of trouble, in a time of need, but also doing it in a way that conforms to the law and conforms to the benefits uh that have earned. So bringing it back into the office, setting this structure up actually gives them uh the ability to feel needed, feel wanted, and feel heard even if the answers that they may get are not what they expected.
▶ 3:14:24So, but we're making it here where it's less what I think is less clinical and more uh compassionate. Excellent. Love love to hear that. Again, thank you for all that you're doing for our veterans. Uh it it's been a little over 100 days and and I think that we're seeing this move in a very sharp great direction. Um keep up the good work and again I I look forward to working with you specifically on the suicide prevention site on the on the Beconnected program in Arizona. We'll uh we'll talk more about that. So, thank you so much, Mr. Chairman. I yield back with you. 28 seconds left.
▶ 3:14:54Thank you, Dr. Morrison. Thank you, Mr. Chair. Uh, Mr. Secretary, welcome. I want to begin by thanking you both for your military service, um, for your service in this role as secretary, um, and for being here to testify today. Before I begin, I just want to preface my questions by sharing with you that my husband is an Army combat veteran, and I care deeply about our nation's veterans, um, as I know you do.
▶ 3:15:19And while we belong to different political parties, I want you to know that I genuinely want you to succeed in this role because that is what is in our veteran's best interest. Now, I know you had the opportunity to v visit the Minneapolis VA uh earlier this week. I hope you enjoyed your time there. We are incredibly proud of our VA uh which as you know is a CMS rated five-star hospital, one of only two such hospitals in the greater Twin Cities metro area. I believe the Minneapolis VA can be a model for the whole system.
▶ 3:15:48Um, but I have to be honest with you, Mr. Secretary. The conversations I've had with veterans in my district and caregivers at our VA have me concerned about its direction under this administration's leadership. Um, I know there's been a lot of talk today about RIFF efforts at VA, and I apologize that this feels redundant, but I just think it's so important. And I know you don't want to talk specifics, but consistent with your testimony, can you commit to us that any reduction in force at VA will not threaten veterans care and benefits?
▶ 3:16:18Yes, that has been my goal all of all of the long and can I also say this, Minneapolis is great and is a really an example and for just and I and I don't mean to say this, but one of the reasons we have it is we have some longevity of leadership there. That is something that is I'm looking across our our hospitals and others and we have up and down leadership.
▶ 3:16:36leadership is so important there and I I appreciate uh what is happening and and leadership uh after we had our conversation was very frank and they said before hearing we were concerned and now hearing it straight from me and hearing what we're trying to do I think it gave them a renewed sense of of purpose. I'm I'm really glad to hear that. So and I know this has been asked but I have to repeat it. Can you commit that no doctors or nurses will be fired as any part of the We're not going to hire any We're not going to be riffing anybody that's actually taking care of employees.
▶ 3:17:05Not employees, but anybody that's taking care of our veterans in direct care. Okay. And patient support employees, sir. Can you commit to us that no housekeepers or environmental health technicians? No, they're all part of the In fact, they're already exempt. They're part of the pest control and laundry. They're part of the 300,000 that we've already exempted. I am very relieved to hear that. Um, you know, I my point really is that, you know, I'm a physician and after more than 20 years of practicing medicine, I can tell you that it is very much a team sport.
▶ 3:17:35Um, and the whole team plays a role in patient care. The physicians and nurses of course, but the support staff is incredibly important as well. They these people are missionritical uh to the delivery of care and firing them would affect veteran care. These are people who help ensure their operating rooms are sterile, the patients bed sheets are clean, the medicine and equipment are delivered in a timely fashion. Um, and you've mentioned that you want clinicians returning to the bedside to provide care. Obviously, if we fire the support staff and the clinicians are going to have to fill in those roles.
▶ 3:18:05Um, so I'm relieved to hear that they they will not be impacted. Um, and I want I will I think we will want to hold you to that because that I am concerned that there's a crisis of morale right now at VA. Um, I was actually really shocked when I spoke with some frontline VA workers at our Minneapolis VA just the other day.
▶ 3:18:28Um, and I was pretty shocked when they they said two of them said, "I question whether the secretary actually cares about veterans." I was really devastated to hear that, Mr. Secretary, and I would assume that you would be, too, because despite our political differences, I genuinely believe that every person in this room cares about serving our veterans, including and especially you. You know what it means to put on the uniform and serve our country, Mr. Secretary, and I have immense respect for that.
▶ 3:18:58But I have to say, it's troubling to me that VA providers caring for my constituents feel this way. These are your employees, Mr. Secretary. These are the people we trust to care for our veterans and they're they're scared right now. If we continue to go down this road of firings and what they feel like is intimidation, we're going to lose good people and it's going to be veterans that pay the price and I know neither one of us wants that. So I my question for you is what are you going to do to improve morale at VA?
▶ 3:19:26Well, first and foremost being here, being in every interview that I have, I have spent a hundred days in which we have tried every we have been instead of working many times on issues that we have found looking at how we can improve and do this. I have been fighting rumor and innuendo and I this is the problem that I have from day one. There are reasons that people are scared and it's not coming from my office. It's it's coming from folks who actually talk about the things that I've talked about earlier.
▶ 3:19:52When we have reports saying you're going to fire 15% of the doctors at Minneapolis, that's just a lie. Well, but Mr. Secretary, respectfully, that 15% 83,000 number came from your people. It did come from my people, but it has no it has no context to actually firing frontline employees of which I have talked about. Because here's the deal. I've said it many times. I repeat it every time that healthcare providers who provide that frontline care, even the ones that you mentioned earlier, are not included in this.
▶ 3:20:17But yet every time I turn around there's another article or there's another someone in the community or a member of Congress or otherwise they're saying these radical cuts, these radical things. I'm having to sit here and fight about this the whole time when I've actually said it. So my question is why is the voices of those who say this is going to hurt being processed and amplified when the very one from the secretary of VA who is sitting right before you is saying this is the part in process that we're going through. Mr. Secretary, we would welcome you to this committee anytime.
▶ 3:20:47Please brief us, give us some transparency so that we can reassure VA employees. Um, I do want to ask one other question. Uh, the VA Center for Women Veterans Veterans sent out an email blast just last night that said it was embarking on an ambitious goal to enroll 1 million new women veterans in VA. I think that's commendable. We've discussed today that women veterans are the the largest growing group of veterans and of course support the effort to bring more women v veterans into VA.
▶ 3:21:18Could you share a little bit more about your strategy for doing so and surely a significant increase in demand will require more clinical staff and space won't it? What is VA's plan for reaching this milestone that you've set? One I think the milestone is great. I'm glad you recognize it. We're looking at that encouraging, but again, it's this is hard to overcome at this point.
▶ 3:21:38I mean, because without going through the the process here of where we're actually looking at cuts and putting people back in places where they need to be in which we could actually increase capacity at some of our clinics and some of our uh hospitals, which will not affect and actually would welcome these going forward. I think that's the fundamental issue that we're dealing with here is there's is there's an understanding of what we're trying to do and how that's actually playing out. Mr. Secretary, I hope you will come back to our committee and testify about all of these issues. We'd love to know what your process is.
▶ 3:22:08And thank you so much for being here. Mr. Chair, I yield back. Representative Kean. Mr. Secretary, it's great to see you. Thank you so much for being with us and a special thank you for coming down to Hampton Roads, home to a lot of Navy veterans, a lot of military veterans. So, I really appreciate your time, not just visiting my district, but so many. you've been doing such an amazing job and and you're starting to sound like a broken record, which I guess is good, but over and over again about how we are not cutting staff and how you're looking out for physicians and and nurses and allied health partners.
▶ 3:22:37And I think that's important just to repeat that and we'll try to repeat that as well on your behalf. I know that one of the VA's statutory missions is training for health professionals and that includes nurses and we have a nursing shortage right now uh across the board, not just in the VA, but on the civilian sector. So, I'm thankful for the VA's investment in educational opportunities, including uh including residency programs and clinical opportunities.
▶ 3:23:01And you have 68 nurse residency or clinical programs, including 34 primary care slots, 26 mental health slots, and you've expanded that to eight geriatric and extended care slots. And as a geriatric nurse practitioner, I'm certainly thankful for that. I think that we have a lot of older veterans and and I know that with Aging of America just in general, we need to be focused more on providing geriatric specific health care. So, thank you for recognizing that. I wanted to offer some comments on behalf of what I consider to be an underutilized resource.
▶ 3:23:30It's no secret that sometimes physicians sometimes feel encroached upon when we integrate advanced practice nurses, but their superb care cannot be overlooked and I think we've talked about that even a little bit today. But uh just to present some evidence-based research, I know that patient safety outcomes are identical regardless of whether uh for example anesthesias provided by a physician or a CRNA. We we there's no no secret that we have a a shortage of of anesthesiologists. So we have nurse anesthesists who are available and there's a lot of debate about integrating them into VA healthcare.
▶ 3:24:01Uh CRNAs are often the sole anesthesia provider in rural hospitals ensuring safe obstetric outcomes. and that we've got 31 facilities in last VA report that cited a severe shortage of physician anesthesiologists including my Hampton VA medical center. The Trump administration has consistently supported the removal of barriers for CRNAs and other advanced practice RNs.
▶ 3:24:22During the pandemic, the administration went even further suspending Medicare supervision requirement for CRNAs to allow them to practice to the full training their full training to provide critical care when the nation needed it the most. At the same time, the BHA put out a memo calling for facilities to remove restrictions on CRNAs. These recommendations are also ported supported by the Nationalmies of Sciences, Engineering, and Medicine. Calls to remove restrictions on CRNAs are well supported by data.
▶ 3:24:48So, I'm just a little bit I would love some clarification on what your plans are as as the new VA secretary uh to integrate advanced practice nurses, especially we have this this lack of anesthesiologists. We have a group of people that can provide that care. So just would love to hear from you what your plans for integration are. Uh thank you Congresswoman. I appreciate and I've enjoyed uh working with you and also working with uh you know opening facilities.
▶ 3:25:13I think it was really interesting um that one of the issues that we had to deal with early on was in actually your district in which uh there was a a discussion about opening a facility and was said because of uh hiring freezes and everything else it wasn't opening as it should and the reality was it was opening just as all the other SE box have opened and that is with a gradual roll out. So I I appreciate your work there. We're looking at our scope of practice issues on on many fronts. This was a a project that was began begun a lot before me a couple of secretaries ago.
▶ 3:25:43We're still continuing to look at that as you've heard even today on this. Uh there's a lot of disagreement especially when it comes to certain areas and so we're trying to to find what is the best balance not only for VA but also for our employees as well. So we're still looking at that issue and we'll be we'll be getting more input as we go forward. would love to work with you on that.
▶ 3:26:01As uh as one of two nurse practitioners here in Congress, it we feel critical health care shortages and gaps where I think our our care is valued and I know that the VA is is always on the forefront of wanting to provide the best patient care. So, just please don't overlook advanced practice nurses and the role that we play.
▶ 3:26:20Uh and then just to switch gears from healthcare a little bit, I know we've we've talked a lot about healthcare and VA medical centers, but uh there's a lot of other veteran benefits that you will oversee now, including GI Bill benefits and uh and uh even healthcare healthcare but VA home loans. Uh you know, what exactly veterans are entitled to. And I know as a veteran with a a veteran family, uh it's been frustrating sometimes to actually access my benefits and to understand what that looks like.
▶ 3:26:47and and you of I you and I spoke at a at a round table briefly just about uh what that online component looks like. For example, Mil Connect doesn't talk to the the VA website and and I feel like there's there's some technology challenges there. It creates a lot of frustration on the part of veterans and when I when I share with my veteran friends, you know, how hard is it for you to access your GI bill benefits or to transfer those to your children? Uh you know, all of us share the same level of frustration.
▶ 3:27:13So, so with our your our VA budget that we have, can can we or do you have any plans to dedicate a portion of that into upgrading this probably outdated technology? I think that we we that investment of of uh trying to make it a little more user friendly. That website piece so veterans can log on in one place, can see their benefits, can understand uh you know how to transfer their GI Bill benefits to their kids, what even that paper trail looks like.
▶ 3:27:41I got a 15-page letter about my uh you know my my son's it was my husband's v GI Bill benefit but transferred to my son and that I couldn't really decipher and and uh and so that was frustrating to me and I'm sure I'm not alone. So just would love to hear your plans about that technology upgrade and if you could uh could add that to your list of things to do to maybe make that that web that website just a little more user friendly. Uh yes, Carl.
▶ 3:28:05We're looking at every opportunity we can to uh streamline our online access online portals to make it easier to understand. Uh it goes back to something in your comment just now reminded me that when I actually was able to access my benefit when I used it for my transferred it to my kids was I didn't even know it existed and this it came to me when I was at home base one day and I had another uh officer who we were just talking about it in general and he said well you know that you can use that money.
▶ 3:28:32And I said, "What are you talking about?" Okay, this just shows you that that that there's an understanding that needs to happen even more uh as we go forward. So, yes, anything we can do in that realm, we're going to continue to do. Uh it's about putting, this is probably as clear as I can say, it's about putting that veteran first and saying, "How can we make that happen for all of our veterans and make it easier?" I've said this early this morning, I'll say it again, and I may have partially said it here.
▶ 3:28:54When the VA when a veteran has to call any one of your offices and 60% of your case load is VA case load when they have to call your office it's a fail it's a mission fail for us it's a mission fail for VA it should not be this hard uh to get benefits that are already earned no matter what the bureaucracy says or anything else thank you for that all those benefits are important important health care but even the education benefits uh etc etc so thank you for prioritizing that as well I appreciate your time I yield back Dr. Vexure.
▶ 3:29:24Thank you, Mr. Chair. Secretary Collins, thank you for joining us and thank you for your endurance. Um, like many physicians, I was trained in VA facilities and proudly cared for veterans at the Denver VA for seven years. As a critical care physician for nearly 20 years, I have cared for far too many families grappling with postsuicide attempt um, repercussions. They're looking for answers, support, and hope.
▶ 3:29:50So, I know you know and you've expressed your support for our veterans and dealing with um the fact that they are amongst the most vulnerable people in our communities. Um risk for suicide is very high amongst our veteran population and it sounds from your multiple comments today that this is a top priority for you and you've stated that multiple times. I just want to verify that we are in that together. We're definitely in that together and thank you for your word there.
▶ 3:30:16One of the things if I could just interject here, most people don't realize it's not just 75%, it's closer to 80 or 90% on some baby docs who all come through the VA. What I would love to have and have your help and the other doctor's help. How can we keep them? Some of that is actually, by the way, if you want a bill recommendation that you might want to carry, let's raise the caps. Yeah, I'm get my caps raise so I can actually hire doctors at a at a rate that is better than what we got right now. Love to work with you on that.
▶ 3:30:42Um, former Inspector General Michael Missile was dedicated in his work to end veteran suicide as well. And under his leadership, the Inspector General's office issued, and I just brought a few report after report after report laying out steps to better protect veterans who are at risk for um suicide. So, if we're committed to expanding every with every effort, every dollar to prevent veteran suicide, you'd think our administration would have wanted to keep him around.
▶ 3:31:10So instead, he was fired by President Trump along with at least 16 other inspectors general against across the federal government just days after his taking office. Secretary Collins, why did President Trump fire Inspector General Missile? I have no idea. You'd have to ask him. Okay. And since missiles firing, we've been without a permanent inspector general to hold your department accountable. It's, as you know from oversight, it's a it's an important role.
▶ 3:31:38Um, and you, Secretary of Collins, have taken actions um that have inadvertently put veterans at risk with the firing of 24 direct support line veteran crisis line um support staff. I know it wasn't the direct answers of the calls. I know you've rehired those VA workers, but can you tell me did you approve those initial The probationary firings were approved in my office. I mean, that's where we went forward is following the directions that we were given. Okay.
▶ 3:32:06And so and also and also frankly the way it also the trigger mechanisms for those that needed to be exempted actually the the crisis line showed that they actually worked because once notified and that that got caught up uh it was actually put back in place. Yeah. No and their hiring back is important clearly but I think that um true to what Congresswoman Morrison was talking to you there's a lack of trust right now in the VA and a fear um that many of us are hearing about.
▶ 3:32:33So nearly four months now after that firing, the president has now nominated a replacement, Cheryl Mason, and Secretary Collins, Miss Mason, is a current political appointee at the VA who reports directly to you. Is that correct? Yes. Okay. And what concerns me, Mr.
▶ 3:32:50secretary is that we have reason to believe that Miss Mason helped transition President Trump um into office and has played a role in cutting u VA's workforce, blocking staff from contacting agency attorneys, and as my colleague Miss Brownley pointed out earlier, um suggesting or forcing that VA staff sign on to non-disclosure agreements. Um when considering her track record, it is clear that there is a conflict of interest here.
▶ 3:33:16She has been part of executing the Trump agenda and now theoretically will hold that same administration accountable in an oversight role. Secretary Collins, veterans and their families deserve leaders who put them first, especially when the stakes of life and death are are at play. Do you agree that we must have someone who can be seen as impartial and without conflict in this role of inspector general? I think the president has nominated someone who will actually do that, who has actually worked through two administrations. She actually worked under the Biden administration in the VA.
▶ 3:33:46She's worked inside the system for for many many years. If you look at her total uh work experience and how she goes about it, I think she'll be a great candidate for that without question. She is a good candidate. I think the concern for me is her role with the administration and also as a political appointee serving the people that she actually is going to be appointed to oversee.
▶ 3:34:06um regardless of whether or not she can do that um without partisanship or or favor um the potential conflicts exist or at least people the the premise or the suggestion of conflict exists. So for the record, our shared commitment to advancing an inspector general who can fulfill their statutory obligation to be independent and objective in executing their duties is something that we share. Is that true? Yes. And I believe the president's choice and uh Miss Mason is will fulfill that. Okay, great.
▶ 3:34:37Um, I also appreciate um that members of this committee know from direct outreach, including what we just heard again from Dr. Morrison, that VA employees have concerns about the culture of the VA and have shared that there is a fear of retaliation for people who speak out. Members of the of this commun committee have also experienced a lack of responsiveness when asking to visit a local VA, which is really quite unprecedented. Um, Mr.
▶ 3:35:04Secretary, how are you going to rebuild trust in the VA um for the employees as well as the veterans that you serve? Continuing uh Congresswoman, exactly what I'm trying to do right now is is is I look I I have freely come up and talked about issues that are hard and also say just judge what is actually happening and not what is being talked about. I I this has been the issue that I've had to deal with from the day one that I got in was actually dealing with many times not accurate information.
▶ 3:35:31Now we can disagree about how some of this is to go about and there may be some things that we could you know do differently but also having to deal with just the blatant you know disregard for uh you know reporter and other you know backlog actually hurts the problem. So for me it's just having to go forward and tell the truth as I have it as as we're actually working it and work to just rebuild that visit by visit by visit that I go to. And what is interesting though and I and I was not uh joking with Dr. Marson as well is in Minneapolis and in other places as well.
▶ 3:36:00Once I am there and able to talk to our hospital staff, talk to our senior leadership and see them, they're actually understanding what my heart is and that's I just got to do this one at a time and with every member here. I appreciate that. I certainly appreciate that showing up is what builds trust and clearly you are doing that in good um honor and spirit. So I appreciate that. We will be watching. We certainly are looking for our veterans to be served to the best of our ability as a nation. I hear your commitment.
▶ 3:36:29Um, and we look forward to further conversations. Thank you, Mr. Secretary. Congressman Zel. Uh, thank you, Mr. Chairman, and thank you, Mr. Secretary, for spending so much time with us. Uh first of all, I have a uh I want to thank you personally uh for for deciding that chaplain would be able to uh minister in the conscience of their particular dogma.
▶ 3:36:54Uh in the Coatsville Pu uh Pennsylvania VA clinic, you personally made that decision that they will be able to do that across the VA and I appreciate that very much. Um, I'm glad that you are refocusing the VA from an employment agency and a mortgage company back to veterans. I will tell you that we're used to in this committee the VA coming to us and telling us what inputs they have put, what they've done, what they've spent, but very little results, very little outcomes.
▶ 3:37:25So, it's been a breath of fresh air today for you to tell us what you are actually achieving. Um, and I know that you have responded to what we call the lies of the left multiple times today. Uh, they've used the word fear. They you the word lack of trust and you have responded every time uh to it.
▶ 3:37:45Uh you've also had to tell us what the law is because we've heard it seems to be an issue that my colleagues across the aisle uh have it hard to understand that there are there are laws of this land that you are going to obey as you provide uh for our veterans. The complexity of the VA is not worthy of a yes or no answer in most cases. Uh and I applaud you for working through that with them.
▶ 3:38:12Um, the only question I have for you and and take as much time as you would like is you've answered several questions on the electronic health records, but we've been told that it was going to be 50 billion uh versus the 9 billion that we've already spent. Can you just share with us the plans going ahead and and take take whatever time you would like, Mr. I appreciate that.
▶ 3:38:35I wish I could, you know, go into the, you know, entire because we're now looking at out years of a contract that should have been finished uh in 28 as it was originally done. And that is, uh, you know, frankly, not going to happen. I don't think anybody on this committee would uh would take issue with that. Um, so what we're looking at is finishing up the contract under the terms that we have now, and we're actually actively renegotiating and trying to get more out of Oracle and others from their side to see how we can do it. And actually so far they have stepped up uh and agreed to to many things as we go forward.
▶ 3:39:05Yes, there will be a time as we look forward in how to implement this past that 28 time frame. Um as we go forward, I'm not at a position right now to say what those numbers would be, but they will be something that we'll share with the committee as we go forward. I weirdly wish we wasn't here at this point. This is an issue that uh it could have been handled a lot differently. I can't comment and there was I know there was some discussion that we had earlier which I I respected on the history of this uh program.
▶ 3:39:33I had no involvement in that and so it got it may have gotten started bad but I've been given the task of finishing it. I've been I've been given the task of taking the mess and cleaning the stall and so that's what we're going to do. I appreciate the work. Again, what was really also very disturbing to me, Congressman, is and this is probably emphasized more than anything, what I'm facing as we try to make change at the VA.
▶ 3:40:00And that is what I've always known is that we we've always done it this way before syndrome. And I've I've seen it across the board. And they come in and when I ask questions, I I feel like that I'm a you have basically reverted back to childhood. And I ask why about everything? Because when I see stuff come in like why do we do this? Why is this happening? Why is this person not held accountable? And finally, I think our folks are getting to realize that I'm not just going to accept the answer that, you know, this is what we need to do.
▶ 3:40:29We've had issues ranging from West LA. We've had issues ranging from uh, you know, how we deal with our community care, how we actually, you know, put in processes to make sure that our survivors are actually getting the care that they need. All this may not seem like the health records management system, but it is combined because when I came in to this, we had a VA who was basically, and I remember my first meeting on this, and I'm trying to be as transparent as I can be here.
▶ 3:40:55And we, like I said, I just want you to know that when I first sat down with our people, it was basically we can't move forward. We're not in a position and we're not going to make changes and it's, you know, everything's bad. And I said, well, that's not a workable position. It's not workable for this committee. It's not workable for the president. It's not workable for anybody. We're wasting billions of dollars here on a program that is not helping our veterans and also right now is actually hurtful in some ways in the original roll out. So, it took getting over that hump.
▶ 3:41:21And I'm I'm very pleased to say that after the initial meetings the our uh staff and Dr. Evans who I can't speak well enough about because he took on the mantel and he has been sort of unfortunately having to ride this through the storms if you would uh any many times when nobody would listen and he was having trouble trying to get it through. He actually has taken that on. So I do appreciate his willingness to sort of redirect the team to say how can we now get this to happen?
▶ 3:41:47And so your question sort of overlaps everything we've tried to do at the VA is to say look let's take a fresh look at what we're doing and fresh look at how we're doing it and why we're doing it. Um and some things are that we that may change other things may not change. Uh years ago an older gentleman who was in the church that I used to pastor made a comment. He said preacher he said I don't want you to change. He said we're making some changes. He said just always remember. He said I I'll support you and it will change.
▶ 3:42:15He said, 'But before you move a fence, know why it was put up. And I thought to myself at the time, I wasn't sure about what he meant by that. And then it made sense is, you know, sometimes you don't know what's on the other side of the fence. And we've tried to do that all along. And this EHRM process is something that why did we not get to where we are, where was it at, and what? So, we're now knowing why the fence was put up, and we're moving the fence to get it uh really where it needs to go. So, it's an endemic not just to this, but to other things as well. Thank you for that, Mr. Secretary. Mr. Chairman, I yield back.
▶ 3:42:46Representative Mace. Thank you, Mr. Chairman. I want to thank the ranking member and Secretary Collins. Welcome. I look forward to working with you as a re we refocus the VA on what is always meant to do. Serve veterans and not push social experiments. For the past four years, veterans took a backseat to identity politics, gender ideology, DEI dogma. Every dollar wasted on on the woke agenda was a dollar stolen from real care for real heroes. President Trump has given you a clear mandate in the circus.
▶ 3:43:16Restore the mission. So, let's talk biological reality, something the last administration ignored. President Trump has made it clear there are two sexes, male and female. They're assigned at birth. They can't be changed and s taxpayers should not fit the bill for surgical or chemical mutilation. How's the VA implementing President Trump's directives to restore biological reality and end taxpayer funded sex changes? by doing exactly what uh the EOS called for. We're no longer uh doing that. We've we've stopped care.
▶ 3:43:46If they were currently in hormonal treatment, which is or they're coming off of it from DoD, they're going to continue that because there is some health issues associated with that. So, that's not being taken care of. But, we're not starting and we're also not getting into sex change operations. Those are just not something that is the VA is going to be doing. Yeah. What we do what these people do to themselves are doctors is is it's crazy. uh and it harms them physically uh and mentally. What steps has the VA taken to redirect money previously spent on gender ideology back toward actual veteran care?
▶ 3:44:16Well, I think what we're redirecting money back is to our u you know, paralyzed veterans, amputees, moving the monies uh to where it can be best spent. And again, I think that's the overall function of everything that we do is is making sure our health care system has is just my priorities is making sure our veterans have the benefits that they've earned. DEI is out. Equal opportunity is in equity politics and racial discrimination disguised as virtue and virtue signaling have no place at the VA.
▶ 3:44:42How many DEI related contracts has the VA canled and what was the price tag on those savings? There were a number of contracts and the total value of the we saw on those contracts was about 6 $6.1 million. And how has that freed up resources to be reallocated to improve veteran care? As we said, it went back toward allocation toward community care and prosthetics as we were looking for them. As an animal lover, I applaud the VA for ending painful unnecessary experiments on dogs and cats.
▶ 3:45:09This was a bold step under President Trump and Congress has since required the VA to phase out primate testing by 2026. What's the current status on phasing out animal testing, particularly on primates? We're on track uh to make sure that that directive is met. In fact, in some instances, we may be even able to to meet that uh that goal sooner. Is the VA exploring any innovative non-anim animal research methods to replace outdated and inhumane testing on animals?
▶ 3:45:32Yes, we're always looking for ways to do uh to make the research as valuable to those uh that needed and also the again we're in an area in which prosthetics and uh that kind of information with amputes is something very uh central to the VA. So uh it is something we're looking at. And then what can other agencies learn from the VA's leadership in ending these cruel and obsolete animal experiments do you think?
▶ 3:45:55Well, I think, you know, judging from the uh reaction to Congress, also what the president has also stated and laid out, I think is just following the the rules as we go forward here. Thanks to your leadership and President Trump's direction, the VA is finally being restored to its rightful purpose, delivering worldclass care to those who serve their country. I look forward to continuing this mission with you. We wish you a lot of luck and many blessings to get the job done, and we believe in you. I yield back, Mr. Chairman.
▶ 3:46:23Thank you, Representative Thank you, Mr. Chairman, Secretary. Uh long day. Uh good to see you here. And good to see you as well. Want to talk about clinical trials uh and some of the reporting on the impacts of whether it's hiring freeze, contract terminations, firings, or some combination of those things. Uh so two Pittsburgh clinical trials according to reports had not started as of May 6th.
▶ 3:46:51These were to treat veterans with advanced head and neck cancers. Have either of those resumed or started? Uh well, one they never started before and they are starting now because we're now actually reaching out to veterans to be a part of this trial. Those were not uh they had not been started before uh any uh at this point. So you can't stop anything that had not started. So they've started since May 6th. They started in the last little bit. They're getting ready right now to recruiting veterans this month. Okay. So both of those have started.
▶ 3:47:21Um, when were they originally planned to start? Because the reporting here is that these were delayed or stalled because of some combination of firings, contract terminations, probationary. Not not that the that we're aware of. And I think the re interesting thing is here is before any of these other things got involved is they had not recruited patients for these uh trials. But just to be clear, when were these supposed to start? Do you know? I would assume they've been around before the hiring freeze. So, it was supposed to start probably earlier. I'd have to get a direct uh date on that.
▶ 3:47:50I'm not I'm not going to try and guess. I'd appreciate a response on that. Okay, no problem. There are others that were identified in some of this reporting um specifically at VA Pittsburgh. I think seven in total, including those two that I've asked about, uh that the impact again of whether it was firings, contract terminations, uh on and on, uh were that they stopped enrollment in several of these clinical trials.
▶ 3:48:14And these were to treat veterans suffering from advanced lung cancer, kidney transplantation, cardiovascular disease, and others. Uh the reporting here is that the plan enrollment was 500, but as of again this reporting in May, only 75 veterans had been enrolled. Have that has that enrollment now continued and are additional veterans being enrolled? Uh no clinical trials have been stopped. Uh we there's been no cancellations from our decision on clinical trials. Those are still going on.
▶ 3:48:41So any issues in those clinical trials will be specific to that issue. One of the things is too representative and I think to understand here we have over 1,500 clinical trials going on in the country uh through the VA of which there is no centralized management of that from the VA. So getting sometimes information about our clinical trials has been difficult when we started asking these questions because the VA as much as we uh do these clinical trials uh are working on them.
▶ 3:49:10We have no management of those and how they're started and where they go forward. Secretary, so you said they hadn't been stopped, which is a little different than what I asked you though. What I asked you was whether enrollment had been paused. That's the reporting. Uh that 75 folks, 75 of my fellow veterans have been enrolled rather than the planned 500. Again, the reporting is that enrollment was stalled during this period of firings, hiring freeze, contract terminations. Is that true? They've not started. As far as I know, they're still recruiting people for the those trials. I understand that.
▶ 3:49:40But was the recruitment and of enrollment stalled during this period? Not that I'm aware of. Okay. I I'd like to know if you could find that out for us. We'll find out because my my concern, as you can imagine, is whether it's those first two clinical trials on head and neck cancer being delayed to start or these other at least five that I'm aware from reporting uh being stalled. Some veterans may not have gotten an access to that kind of care at these in these clinical trials. Some of those veterans may have gotten sicker. God forbid, somebody may have died. We should know whether any of those things happened.
▶ 3:50:10I don't want to guess. I don't want to put you in the spot to guess, but we should know that. Yeah. And I appreciate the concern there. But also remember, one of the things that I want to make very clear here is we've talked about this a little bit in in going forward. Uh the clinical trials are used to assess new treatments and new ways to going about it. These these veterans were not and and I say this simply not because of what you said and I'll be frank with you, but what I've heard from others and they saying these that they were kept away from all health care. That's just not true.
▶ 3:50:36they were still getting the health care through the Pittsburgh VA, but the clinical trials uh that had not been started, especially in the head, the head and neck cancer area had not started. So, I think that's there's two distinctions here we have. Well, I'm willing to work with you to look at whatever we need. Great. I would love to know for each of those trials and as you say, you're still getting healthcare, but it might be that that clinical trial could be a life or death outcome. It might it might not be. I think it's important that someone's got a chance who's in a horrible situation, advanced head or neck cancer. Yeah.
▶ 3:51:05I would hope that also and Congressman I would love to to work with anyone this committee also as we go forward how we can actually streamline this is something I'm looking at now as we've we've gotten into these conversations uh more and more on clinical trials that we actually need to have in my opinion a better sort of command and control system so that we know where these are going on and if there are any issues that we can help with as we go forward because as you said some may have gotten help but also some may not have worked and are we making sure that that information is available across the the systemwide.
▶ 3:51:35so that we know this actually worked but this didn't. We don't have that information. And look and and we all know this, the research VA does has led to some really groundbreaking interventions and treatments for veterans. We have to continue that. I want to spend the last minute and a half or so about morale. I've and my team have heard from physicians and other folks who work at the VA. I've heard from veterans.
▶ 3:51:56Uh there's been plenty of reporting and discussion here today about mental health care in particular and some of the reports of impacts on the return to work and clinicians being placed in an environment where they can't have a confidential discussion with patients. I've talked to physicians myself and heard some of those concerns.
▶ 3:52:13Uh, I I'll throw out an example of someone being put in a in a room where there's another VA employee that would betray confidentiality with u patient seeking mental health care asking for headphones or a headset to be able to have some confidentiality being told no. Should that happen? And if not, what what are you doing to fix that? No, it should not happen. And I think one of the things is to remember is all over the uh centers are secure facilities and they should not be put back in. If they're coming back in to work, it would go against and I said I made this statement earlier.
▶ 3:52:44If they're being brought back in in an environment in which they were not supposed to be, then that is a failure of the leadership to bring them back in because it's also a direct violation of the policy of bringing people back to work. This is not something uh that we've looked at and many times we've asked for instances when it's been reported and then gotten back to it and it it worked. So, let me just be very clear. if they're coming if there is an issue, we'd love to hear about that.
▶ 3:53:07But also, it's a direct violation of the policy coming back to work to not be inv I if we have a supervisor who's doing that. And in the 10 seconds I have left, Secretary, if someone's raising those concerns, I'd love a commitment from you that they won't face any consequence for voicing objection. No. And I think that we we need to know and I think this is what we've proven and there's been areas in which there were some concerns and we've actually made exceptions to say no the telework or can continue off what premise can do. Mr. Chairman yel back. Thank you rang a member.
▶ 3:53:37Thank you uh Mr. Chairman. Thank you Mr. Secretary for being here today. Mr. Secretary, you've testified that quote no one has uh discussed firing doctors or firing nurses. End quote. No one has discussed this and that the 15% figure floating around is just a goal, not a directive. Then I need you to explain this spreadsheet that I have behind me. Um, and we're handing you a copy of this spreadsheet.
▶ 3:54:04It was circulated by your own reorganization implementation cell. It asks VA staff to calculate the savings from a 15% cut to every VHA position, including frontline clinical roles. And it says cutting nearly 4,000 nurses, for example, would save a billion dollars. Cutting 400 psychologists, another $110 million. The uh list goes on. Health aids, pharmacists, housekeepers, etc.
▶ 3:54:34Now, if your testimony is true that no one is looking at plans to cut these jobs, why did your team ask for this analysis? Ranking me, I'm looking at this right here. This is exactly why we're here. This is a leaked preddecisional document that is not helpful and it is not working because here's the end of the day. No, I'm going to justified Mr. We claiming my time, Mr. Secretary. It's my time.
▶ 3:55:04You have said publicly that no one has discussed that would be interpreted. No one has discussed this at all. But we have a document whether leaked or not that establishes that these cuts are being discussed. I said that I have made clear we will not be cutting frontline healthcare if they're working. But your subordinates are discussing this. They must have gotten the directions from somebody. They did. Well, I've been very public.
▶ 3:55:28is just like your staff even understand why there's a lack of credibility uh from the public on this sort of lack of this is not speculation Mr. secretary is a VA document. We have asked your head of HR, Mark Engelbomb, for answers. We've actually asked your subordinates about this. He promised a follow-up and we never got it. So, I'm asking you now on the record, why did your team request this analysis and what are you preparing for?
▶ 3:55:55Well, if I have to explain this in a way that makes sense, let me just say this. If you look talk down to me, sir. I'm just asking you a question. I'm just answering your question. If you let me answer it, I'll answer it. Please, time is ticking. This right here is an overlook of our entire organization to see what they did here is fine. Whatever they're looking at is fine.
▶ 3:56:19But when it comes to the secretary of VA, which is me and the direction that we have given to make sure that healthc care is prioritized to make sure that our veterans are getting the desire that they need and when I've told you that when we're talking about this and exempted 300,000 positions, that is what happens at the end. Can they have other conversations that involve other things? Possibly. So, but coming from me, it's not. Okay. Well, thank you. Let's move on. So, I'd like to point out that you've set a goal of 83,000 VA employees. I know it's not a fact. It's a goal.
▶ 3:56:48But I just want to make sure we go over this and we have some agreement without cutting clinical staff. There simply aren't 80,000 83,000 employees elsewhere in the department. If you look at this chart over here, you've already cited these numbers yourself. So, if we add up all the VBA, NCAA, and all the other positions, it hardly adds up to 83,000. You're going to have to cut deeply out of the VHA, uh, column there. So, uh, you know, there's just simply no way that that can be done without that.
▶ 3:57:18So I would also like to move on and say it is also our understanding that on the VA human resources uh uh SharePoint there is a document that lists every employee hired since 2019 with their name and occupation. Uh will you get that document to us in digital form? I'm not familiar with the document you're talking about. But if but it does exist I mean we know it exists. Would you get it to us? It just I don't know what you're talking about. And also if I can answer your other question no I'd like to move on.
▶ 3:57:47I want to move on to I'd like to move on to the deferred resignation program. There's been a lot of confusion about the deferred resignation program. Okay. It is my understanding that you have made employees who are in positions that provide direct care exempt from this program unless there is an additional review by VA leadership. How many employees who directly provide care or support uh or support the provision of direct care have submitted requests for DRP early retirement or retirement?
▶ 3:58:14The last number I had on that was about 2500. About 2500 of which all of them will be probably uh all of them are going to be denied. You're going to deny them. So you're telling me today that you're going to deny all of the clinicians who have applied for DRP? That is what we're uh looking to do. Um and I will say this as we look at this, one of the issues of DRP is making sure that employees who want to be here are not we're not looking to get rid of any clinicians. We're not looking to get anybody. In fact, we're turning That's fine.
▶ 3:58:44I I got it. But but but 2500 clinicians have applied for DIP DRP. You're going to deny those. We're denying clinicians. But have you thought about why frontline staff are requesting DRP in the first place? To me, it's an indictment of your leadership that valuable clinicians that are hard to recruit, hard to on board, um that that staff who loved serving veterans now want to leave. Well, have you looked at actually the ones who may want to leave and how close they are to retirement to start with?
▶ 3:59:13Have you actually looked at where they may be? I've not looked at those, but we're going to keep them in the system. So, your question may sound, you know, like it's ominous, but also you've not answered the other questions where these people actually are. Okay. Well, so fine, let's move on. Mr. Secretary, are medical center directors exempt from the hiring freeze? Medical center directors? Yes, they are. So, to be So, they're part they're part of the clinician side. Yes. Okay.
▶ 3:59:38Well, to be clear, the list you have provided to Congress does not include medical center directors as exempt positions. That is not It's been updated. So, now it is. Now, according to a report that VA just submitted to Congress last week, there are 12 medical center VA director vacancies, eight of which cannot be hired due to the freeze.
▶ 3:59:56The chart behind me shows a page from the report with those vacancies listed and the status uh which is that quote recruitment is on hold due to hiring freeze end quote. We are working to fill all those when we find those we're working to get them hired. Those are many of those were actually predecessor of me. All right. Well, this this document shows that they're not they're empty because of a freeze.
▶ 4:00:21So, you'll commit to exempting medical center directors from the hiring freeze and prioritize finding leaders for those facilities as soon as possible. I already have. Wonderful. Well, Mr. Secretary, I I just want to know uh can we get a riff plan before you execute it and not execute it for 30 days so that the public veterans and Congress can examine it before it it it is put into force? 83,000 is a lot of people to to cut. We're going to get provide everything we're supposed to under Rift to make sure you have every notification you have.
▶ 4:00:51Well, that's not the same as providing us with the draft plan so that we all can discuss it together. That's 83,000 is a huge change. Well, and again, I wasn't able to answer your question because you didn't allow me to uh to discuss the 83,000. I'll take that as a as as nonresponsive. I'll take yours as the answer. The gentleman yields back.
▶ 4:01:12So one thing I've discovered about today is that normally uh the ranking member and myself we ask our questions first. So what has happened is I think we have questioned you to the point that u I think we got a lot of answers of what my questions were going to be. So maybe I'm going to ask you this. What is something that has not been asked that you feel is vitally important to put on the record? Mr.
▶ 4:01:42Chairman, I think it's not what necessarily has been asked, but I think it is from the perspective of how it was asked. And this is the fight that I you and I have spoken about and I've spoken to many and we just got through with it and and please hear me to everyone here. I consider the ranking member a friend we came in.
▶ 4:01:58We vehemently disagree on this because I think the problem we have here is something that I refuse to talk about in a setting like this or where we actually have living proof of preddecisional documents being leaked at the basically even against section you know the the law of land that these are not supposed to be leaked.
▶ 4:02:18We see this if they want to go to inspector general whistleblower those are all there for them but this is the exact reason I was asked earlier about NDAs okay because now what is happening as you sit here and we put up uh forms we're continuing to fester this idea that there's no way we can do what needs to be done without hurting veteran healthcare.
▶ 4:02:44I refuse to accept that because one thing that was not accepted and I was not you know able to to continue there are 409 positions VHA and when we look at that and you look at some of the areas that we have in VHA which also includes call centers which also includes uh staffing issues they also include procurement they also include HR they also include uh processing of payroll which these hospitals were not supposed to be doing by the way those numbers add up to significant amounts what was not said just a
▶ 4:03:14minute ago is that just last year the Biden VA and the VHA in their own internal documents stated that they could get rid of 28,000 people. This is the Biden VA 6 months ago. Haven't heard 28,000. Now, if you go by the numbers that I've been told today, oh, you can't do that without hurting healthcare. Then we're saying Biden's going to hurt the Biden administration wanted to hurt healthcare.
▶ 4:03:43No, I think they actually looked at the same numbers we did, Mr. Chairman, and determined that of the frontline healthcare, frontline disability workers and all, there is a lot of interest in looking at are we being as efficient as we should be? And I believe that as we look at this, you're going to find those answers. And that is why we have to do this in a very methodical way. Everybody wants to run forward and say, "Here, give me your plan." Because you know what? Then they want to go out and say, "You're going to cut here. You're going to cut here." And they're going to put fear in my employees and they're going to put fear in my veterans.
▶ 4:04:14wrong. It's wrong. You see no other industry in this country who are making decisions about their workforce who do it in a way that we're talking about being told here. We're doing it in a methodical way, using career employees who've been there forever. We're actually looking at actually using consultants. We're actually using our political folks to get this into the record to say, "Here's how we look at this." Looking at the examples of private industry and knowing that we're not private industry.
▶ 4:04:42We're a veterans organization that gets to treat the best people in the world and that is our veterans. We have only have one mission, the veteran. But over time, we have gotten away from that. So when you look at these numbers, I have a question for anybody that wants to to look at this. Why do we a middle management if you would or a structure system that keeps our clinicians out from seeing patients?
▶ 4:05:08and then saying that if we look at anything of a doctor or nurse who's not seeing patients that we're going to affect health care if for some reason they wasn't around or if they quit on their own. I think what we're saying here is there's a large understanding gap that unfortunately has become political. I could go along almost every member except the new ones because there's a lot of new on this committee, Mr. Chairman, and I can go from ranking member to you to everybody else and find quotes on the Senate side as well. VA needs reform. VA needs efficiencies.
▶ 4:05:38VA needs cost cutting. VA needs all these things, both Democrat and Republican. And then all of a sudden you have somebody like myself who is just and I say this in knowing that somebody will use it against me.
▶ 4:05:52I'm just a simple country lawyer from North Georgia who simply says maybe we ask you ought to look at this and maybe we ask you ought to ask the questions on why we have this and why do the VSOs and why do others always seem to have issues that they want to get fixed at the VA but all we do is continuing to perpetuate the problem. I'm not willing to do that anymore. We can disagree. The president told me to do one thing and that's take care of our veterans.
▶ 4:06:18And yet in this time frame which was not brought up and we're going to bring it up even again by the Biden administration, they they changed the wait time issue to make it more transparent so that we uh in fact I got this last week when I said the primary care days. Remember just repeat this. It's worth repeating. Primary care rose from 15.7 to 24.3. Mental health rose from 14.7 to 20.4. before 24 days for specialty care rose to 38.
▶ 4:06:45And the backlog, by the way, interestingly enough, in 2019 before the uh CO was under 60,000 on the backlog. Of course, it went up during COVID because we couldn't get our uh appointments and it is still at 260,000 when I came in. In 20 in less than 100 days, we've actually brought that down 21% to 200,000 and it's heading south. Now, I was actually accused the other day of, "Well, you're using flawed numbers." And the VA weight times flawed because the VA changed the way it does its weight times. But here's the problem.
▶ 4:07:14It was changed under the Biden administration to better reflect calculations because the data reinforced above did not reflect the adjusted change. It plainly shows that the weight times increased. Because here's what you need to hear. Wait time clock started only after a veteran was contacted by a scheduleuler for appointment under the prior administration. In other words, we didn't even start the clock till we reached out to them. the veteran may be looking to get their help but they didn't get it.
▶ 4:07:39So the new method which was again done under the previous and adjusted through every number beforehand so there's no apples to oranges here. This came from Dr. Lieberman who is our top doctor by the way at the VHA. The method is now calculated on the schedules are called to reduce so that we actually make a queer time. So as we look at this Mr. Chairman I appreciate you allowing me the time. I appreciate the ranking member.
▶ 4:08:05And I appreciate all the committee wanting to do good work, but what I can't have is spending another 100 days as we go forward here because as Dr. Marson and many others say, yes, there is from people who have morale issues because they're having to sit here and listen through wrong answers. How that yield? Yes, I do. Thank you. Uh Mr. Secretary, know, you're opining about a so-called document.
▶ 4:08:36It's obvious. It's obvious. We're not We're not mushrooms. We're going to hear stuff. We're going to hear stuff from employees who are alarmed about about huge massive changes that are occurring. uh and that docu when we don't get answers to our questions when we don't when there's no transparency uh we're going to rely on whistleblowers telling us the truth.
▶ 4:09:04Look private industry sir would not have fired 2400 employees and then hired back a thousand. That was indiscriminate firing of indiscriminate firing of uh probationary employees. A memo went out signed by Tracy Therret that said they were being fired because of their performance. And I questioned her and she couldn't really cop to the fact that they were fired because of their performance.
▶ 4:09:33And I'm not even sure really that you personally authorized all of that or whether it was someone from uh the Office of Personnel Manage Management. uh and she in fact said that that that uh memo was actually not even though she signed it was actually not written by her but was written by OPM which does not seem like it came from the secretary's office and that sort was entered into evidence into a federal Uh and that judge did indeed rule that they had to
▶ 4:10:03be restored uh those those those probationer employees that 20 thou that 28,000 uh employee uh cut that you were talking about from the B administration of VHA you know is related uh not be not due to necessity but because of a a a shortfall in the budget.
▶ 4:10:25Um and there was a huge shift in acceleration of expense in the community care uh the community care account. So uh you know we need to have uh some some some space for some some straight talk here. We're not getting it here. Now Mr. Secretary, I I must say I was pleased to hear you say that you want to make the disability claims process easier to veterans. I was listening carefully to your response.
▶ 4:10:52I personally do not want to see uh claim sharks legitimized. Um and I'm not saying you're taking a side on that gentleman's bill, but I I think we have some meeting in the mind here. We do need to maybe we need to talk about uh uh some uh some presumptives uh that are that would make the process easier and more veterans would would get through that uh red tape. I'm all for cutting that bureauc bureaucratic red tape. So we we share that goal.
▶ 4:11:23We do need to make it simpler uh for veterans to get care and benefits and there are two really good ways to do that. One is to increase the number of presumptive illnesses and the other is to automatically enroll transitioning service members into VA healthcare as my legislation in the EVEST act does and I look forward to your considering supporting that bill and to VA increasing the number of presumptions of service connections.
▶ 4:11:48I also think it is possible for us to work together and help veterans and ensure that VA is a world-class institution. But I cannot emphasize enough that VA's unresponsiveness to my questions and letters is not acceptable. VA's recent habit of cancelling long-standing briefings at the last minute is also not acceptable. VA's refusal to provide briefing materials to staff is not acceptable.
▶ 4:12:12and we cannot have a productive relationship if we do not have the information we need for our constitutional oversight responsibilities. Now, when you told ranking member Ramirez that cancelling outreach was not your intended policy, I take you at face value. So, I expect that our followup questions about this outreach problem will receive responses with the same cander and attention. This research issue is this outreach issue is not limited to just one district or facility.
▶ 4:12:42Now, you blame the issue on quote unquote malicious compliance, but sir, the buck does stop with you. And I know that's a phrase that you're that you're that you embrace. If policy is not being implemented correctly, then I say it is on you. If veterans and employees are scared and feel like they they have to uh overcomply with a policy, that's on you. That should cause you to reexamine the policy as well, not just blame the staff.
▶ 4:13:12If you truly want to lead VA, accountability is where leadership begins. And you cannot expect your employees to be accountable um if you will not be yourself. Now, another thing I just want to say is I've I've gotten concerns from my colleagues about this directive that any member of Congress wanting to visit their VA facility has to get it cleared through your chief of staff and they're having to take that very literally.
▶ 4:13:38Uh they're taking it very literally based on all that we're seeing coming out of your first uh 100 days or so in office. That cannot stand. Members of Congress need to believe need to be be able to visit their facilities, talk to their medical center directors, and be able to see what's going on. My job as an elected official and the ranking member of this committee is to represent the interest of veterans. We cannot answer questions from veterans or get them information if we cannot get answers from VA.
▶ 4:14:06We cannot represent veteran interests if we do not have the full picture of how their interests will be affected. And that is why veterans are scared. Now, let me be clear. Veterans are not scared because I or any other member of Congress asks a question. They are scared because you have made massive changes with no plan, no details, no accountability, and no transparency. You have truly, if you truly believe uh it is uh quote unquote fear-mongering uh to ask a question, then you should ask yourself why you, Mr.
▶ 4:14:36Secretary, fear answering our questions. Now, I am proud of the employees who have bravely shared their stories with us. We are relying on the courage of whistleblowers now more than ever. I'm grateful to the veterans who have shared their concerns and I will continue to fight to ensure that their worries are heard and addressed. Now, Mr.
▶ 4:14:57Secretary, if you want to accuse VA employees of quote unquote malicious compliance, I say you need to examine your role in creating a culture where VA employers employees feel like your directives to require them to implement policies that harm veterans. Reconsider the the cruelty uh in your treatment of minority veterans. Con reconsider your termination of collective bargaining rights for the hardworking public servants.
▶ 4:15:23Reconsider your role in ending critical programs like VASP because veterans will now lose their homes to foreclosure unless you unless you put a moratorium on those foreclosures until we can ramp up the partial claims legislation. Reconsider your pause of clinical trials. Leave sick veterans leaving sick veterans without the lifeline of hope. Reconsider how you will have how you have indiscriminately fired employees only to hire them back again. So, Mr.
▶ 4:15:53Secretary, I truly hope that you'll go back to the central office today and chart a plan to course correct. That plan should include complete and truthful answers to all of the questions you were unable to answer today and a path to true partnership uh with both sides of this committee. And with that, I yield back. Thank you, ranking member for yielding back. I want to actually thank the secret secretary for being here and joining us today and answering uh every question that was put before him.
▶ 4:16:23Um, and I want to say that, you know, we do stand for our veterans here and we all talk how we want to stand for our veterans and that we respect our veterans. Um, some of us, uh, in this room understand that quite often you don't get the birds on your shoulder unless you know how to be a leader.
▶ 4:16:46and I appreciate you for both jobs that you're doing, especially when people that question it have never even had a stripe on theirs. So, I do want to thank you and I appreciate the responses and your leadership during this transition. And while this budget request shows real progress, I remain concerned that the VA is still working through the consequences of poor budget decisions made under the Biden administration.
▶ 4:17:15The alleged shortfall last year was not the result of inadequate funding. It was the result of poor internal controls and a lack of transparency transparency around how VA managed its accounts. Congress has always provided VA with the resources it needs and we will continue to do so.
▶ 4:17:42But we need to understand that the money is being used where the money is being used and we need to be able to explain to the veterans and that are that are taxpayers how it's being used. some of those budget practices that we've seen in recent years, terrible account coverage, shifting obligations have made it harder, not easier, to figure out where we're at as far as Congress.
▶ 4:18:12In the end, it's hurts trust in the system. I look forward to working with you. I thank you for your service. I thank the colleagues for the most part that actually dealt with the questions at hand uh let you answer. I think a lot has been explained over things that we've heard and rumors that have flown around and you've been able to answer them very well.
▶ 4:18:38We look forward to continuing to work with you and we want to make sure and one thing that you say is the same thing I say with this Remember, our VA is not about the bureaucracy of the VA. It's about providing for the veterans. With that, I that's the best way to ensure that we can continue with the care for our veterans. Uh with that, this hearing is