▶ 0:08:35>> good morning and good morning to my colleagues on the committee on veterans affiars. This hearing will come to order. Welcome to the first meeting for the committee on veterans affiars. I'm grateful to have so many of my colleagues returning and look forward to continuing our work together. I am also grateful to have five new members, senator banks of indiana.
▶ 0:09:05Senator sheehy of montana and the senator of michigan, welcome to this committee. I look forward to working with the ranking member and that was me before you.
▶ 0:09:23We have had the experience of working together previously and I look forward to continuing our efforts to work together to see that veterans are were killed for -- are well cared for and that members can express their views and make a difference in this arena. My work is almost always driven by what I hear from veterans, particularly in kansas but also across the country.
▶ 0:09:52We will hear from a lot of veterans organizations as well. This is about how we make the v.a. Work better. What is it doing well. What is it not doing well? How do we solve the problems that veterans face in this country. Sometimes one at a time but I hope often veterans as citizens and a group.
▶ 0:10:15As chairman I will work to solve problems and deliver results to help veterans access healthcare and benefits they have achieved in their success and their service. I want them to be successful after their service. I expect the next secretary of veterans affiars to share a similar focus. The role of the secretary of the department of veterans affiars is critical. America's national security is dependent upon all voluntary military and v.a.
▶ 0:10:43Is key to helping veterans thrive. Millions of veterans and their loved ones rely on the v.a. To access higher education and job training, buy a house, open a's business, access healthcare and more. Helping veterans achieve those goals is often complicated by the fact that the v.a. Is one of the largest bureaucracies within the federal government with more than 400,000 employees.
▶ 0:11:13That includes a massive physical footprint that spans the globe. Our facilities are aging. A legacy I.t. System and an annual budget well over $300 million. We must have a secretary who understands the mission, who helped refocus the department to put veterans first and who recognizes the importance of the v.a. In serving veterans and contributing to a successful future for our nation.
▶ 0:11:43I am to have congressman douglas collins here today to testify about his nomination to be secretary of veterans affiars. He knows the benefits and challenges of military service first and will be many issues facing veterans and their families. I am grateful for his interest in serving in this capacity and I look forward to hearing today how he plans to improve we support the lives of his veterans if confirmed.
▶ 0:12:10I know military service is family service so I want to recognize his family including his wife lisa, daughter jordon and his sons who are with us here today. Before yielding to the ranking member, I want to recognize dennis mcdonough. I am grateful for his hard work and his dedication to veterans and their families and I wish him all the best in his next chapter.
▶ 0:12:38With that, I yield to senator blumenthal for opening remarks. >> thank you so much Mr. chairman. Thank you for being here today conrgessman collins and to your family, lisa, jordan and cameron and to all the visitors who are here today, many of them veterans. I am thrilled to be the ranking member and to have as chairman my friend and colleague senator maranda.
▶ 0:13:05We have a strong working relationship and it exemplifies the kind of bipartisanship that has characterized the work of this committee. We have been a paragon of bipartisanship in the face of the buffeting winds of political pluralization -- polarization. I look forward to advocating for veterans in the face of some pretty heavy threats.
▶ 0:13:37I was chagrined that there was no mention in the inaugural address by president trump about veterans. I was disappointed to see any executive orders that a hiring freeze will be imposed on the v.a.. I am hopeful that you, conrgessman collins, will be the kind of advocate that our veterans will need in this administration.
▶ 0:14:09There will be potentially heavy pressures on you to cut and slash and reduce access and eligibility because the v.a. Frankly is a target-rich environment for cost gutters. We know there is a department of government efficiency looking for those kinds of cost-cutting opportunities.
▶ 0:14:34I look forward to supporting you and bolstering your efforts to defend and advocate are veterans who must always be a priority. I want to thank senator moran and senator tester who was such a strong advocate as well as dennis mcdonough and joint efforts to pass the pack act.
▶ 0:15:08President biden and secretary mcdonough were instrumental in providing more benefits to veterans than ever before. When they were exposed to toxic chemicals or burn pits not only on the battlefield but also in training. I think every member of this committee can be proud of that effort. You mentioned in your opening that timely access to care and benefits for every eligible veteran is job number one. I hope that will be your mantra. It certainly is ours.
▶ 0:15:40Veterans are confronted with losing access to v.a.'s direct care system in an unprecedented number of referrals going into the community. As we discussed during our meeting and I appreciate you coming to talk to me, it is an important role for community care in the timely delivery of care to veterans. But it cannot be at the expense of the v.a. Direct care system which many vets prefer and rely on.
▶ 0:16:12I have two sons who have served. One is a combat entropy officer. The other is a navy seal. Most particularly, my navy seal son has made use of veterans benefits and facilities on the west coast, in west haven. So I know firsthand the extraordinary care, really it is a gold standard of care, that our veterans facilities provide. Particularly in the area of mental health.
▶ 0:16:42We need to invest as well as in modernizing infrastructure and facilities such as we are doing in west haven. Today I want to learn more about your clients to lead the largest civilian agency in the federal government, literally the largest civilian agency. An organization with more than 450,000 employees comprising 20% of our whole federal workforce. That is an awesome responsibility.
▶ 0:17:09I am interested in how you plan to build a workforce culture that encourages employees to speak up with concern and criticism and offer ideas to drive improvements. Not 1, 2, seek retribution or demand loyalty at the expense of the quality of veterans care. If confirmed, it is your duty to treat every v.a.
▶ 0:17:37Employee and veteran regardless of gender, race, religion or sexual orientation with the dignity and respect they deserve. We have acknowledged our differences and we will have differences of opinion, especially on some social policies. But I will need your assurance that your views will not negatively impact veterans seeking the care and benefits they have earned. They have earned those benefits.
▶ 0:18:06In our meeting I appreciated your commitment to put the law first and respect the rule of law with regard to abortion care and counseling. I expect the administration to consider the existing rule legally binding unless it is replaced or struck down.
▶ 0:18:25I believe that rolling back this policy would unnecessarily risk the lives and health of pregnant veterans in states with abortion bands and care restrictions in the post-dobbs era. During the last trump administration we know outsiders exerted significant influence on the v.a..
▶ 0:18:48We looked into and substantiated that three individuals, private citizens, bruce moskowitz and mark sherman, refer to as the mar-a-lago three, played a key role in several high-profile incidences outside of the formal v.a. Decision-making process. These included v.a.
▶ 0:19:12Senior level personnel decisions and involvement in negotiations for the v.a.'s electronic records system among other issues. I hope you will push back strongly on an appropriate influences that operate outside of well-established federal transparency rules, especially when they are not acting in the best interest of veterans.
▶ 0:19:37Whether it is ideologically-minded groups with alterior motives or the array of big tech executives that we saw on a platform yesterday at the inaugural including elon musk. Conrgessman collins if confirmed, you must be the decision-maker for the v.a. You must be their advocate and keep the needs of veterans at the forefront.
▶ 0:20:02There will undoubtedly be pressure on you to scale back and cut costs at every opportunity. I cannot emphasize how important it will be to me and I hope all of us on this committee that you fight those efforts with every fiber in your being. I am hopeful we have shared priorities including upgrading the v.a.
▶ 0:20:29Facilities around the country, healthcare facilities and suicide prevention which I know is a priority of yours. We discussed it when you visited with me. If confirmed, I welcome the opportunity to work with you to support you, to advocate with you in this administration and to improve services to veterans across the country.
▶ 0:20:54Before I turn it over to senator moran, I want to offer on a personal note, I am incredibly disheartened that the trump administration is canceling the flights of nearly 1660 afghan refugees who were already cleared by the U.S. government to resettle in the united states.
▶ 0:21:24These allies aided our troops in afghanistan. Whatever you think about the conflict there, the risk to these afghan allies are so dire and dangerous. Many of our veterans groups have been advocates for them as you know.
▶ 0:21:48The strongest advocates for resettling those at risk afghan allies are the veterans who benefited from their protection and their service which involved putting their own lives and their families online -- on the line. Yet those afghan partner families are stuck at risk of harm in areas around the world.
▶ 0:22:16Our nation has made a promise that we are to do right by the men and women who risk their lives for our freedoms and democracy and do whi democracy and do whright for their families and that includes translators, the guards, others who put their backs in targets and became our friends. I will fight to ensure that they are resettled in the U.S.
▶ 0:22:42And push back against any attempts by the administration to renege on those promises to our service members, veterans and afghan allies. I want to offer thanks to all of the individual veterans who came to the defense of those afghan at risk allies and have joined us in urging aid and freedom for them. Thank you. >> senator blumenthal, thank you.
▶ 0:23:11I now call on a member of this committee, congressman kevin cramer is a former colleague in the house of our witness, the nominee. I recognize senator cramer. >> thank you senator moran and ranking member blumenthal. The titles look good on both of you. Looking forward to a productive term.
▶ 0:23:32It is a great honor and really a blessing for me to be able to be here to introduce my former colleague, friend, navy veteran, military chaplain, accomplished attorney, doug collins.
▶ 0:23:51If we were to write up, there's a lot of talk about people being on qualify for these positions when the reality is in our great system of self-governance, the only qualification is that the elected people want to. If we were to write up the qualifications for v.a. Administrative, v.a. Secretary, doug collins's picture would probably be next to the description.
▶ 0:24:18Working with doug on big bipartisan things, remember in the house, one of the most unlikely things to get involved in was copyright law. And looking out for the rights of songwriters. Somehow doug'd big personality sucked me right in. It was important work. It was really setting work in the area of entertainment.
▶ 0:24:50He has that kind of personality, an engaging personality that attracts people to what he is working on. I think that says a lot. I mentioned he is an accomplished attorney because that is an important part of understanding the law and enforcing the law, carrying out the law, defending the laws that are passed by congress and become part of the bureaucracy.
▶ 0:25:21Him being a veteran in the navy and the air force reserve is important. He relates directly to the experiences of our veterans. He was deployed to iraq. He knows a thing or two about the experience of a veteran. That is part of what makes the v.a. Care so special.
▶ 0:25:47It is not that they are better doctors or better psychiatrists are better nurses or technicians. It is that they are empathetic. That is what I hear from my veterans often times. They appreciate access to community care. They appreciate the empathy of a fellow veteran. Doug brings that. He is a chaplain. Come on. How perfect is that?
▶ 0:26:16One of my great frustrations about the v.a., this was last summer. A $15 billion shortfall was announced. Where was all the communication before that? Where was the transparency that we would seek before that? It was a little cya I think. Suddenly panic sets in. Fear and anxiety, uncertainty.
▶ 0:26:44Even to the point where congress passed the supplemental we all remember, a supplemental where a single dollar was never used. There was not a $15 billion shortfall. How does that happen in a competent agency that is looking out for the veteran? So doug brings first legislative experience. He helped pass the v.a. Mission act, the v.a.
▶ 0:27:11Accountability and whistleblower acts, these things that provided the transparency we seek. He knows the intent of congress. He is a lawyer who understands them. But he is a chaplain who understands the recipient and the need at the moment. I am just really grateful that he is my friend. I've known many good people.
▶ 0:27:40Republicans and democrats who have sought out a position in the v.a. And every one of them was well-intentioned and every one of them was certain that they would break through, that they would be the one that would make the difference. That they would be the one that will take the opportunities for care closer to home and put them on the front page of the website instead of burying them deep so that they never find them.
▶ 0:28:04But we do have now in the commander-in-chief and the cabinet he is picking people who will put the veterans first, not to bureaucracy. Bureaucracy is important. The service provided is important. But the most important person is a veteran and that is who doug collins will account for and I am really grateful that he is my friend, that he is willing to step into this gap. I am ready to support him in every way possible.
▶ 0:28:32So I introduce to you congressman doug collins. >> thank you for your statement and your introduction of the nominee. Thank you for your membership and efforts and hard work on this committee. Douglas a. Collins, you will rise and I will ask you to take an oath. Will you raise your right hand?
▶ 0:28:58Do you conrgessman collins solemnly swear or affirm that the testimony you are about to give before the committee on veterans affiars will be the truth, the whole truth and nothing but the truth, so help you god? >> I do. >> thank you. Congressman, thank you for being here. We will now await your testimony. >> thank you Mr. chairman. Ranking member blumenthal.
▶ 0:29:32The rest of this committee, seeing people I have worked with before. It is good to see you. I am honored to be sitting here to be the nominee of the next secretary of the v.a.. I thank my friend kevin cramer for that kind introduction. I appreciate his work and I appreciate your work as well. He hit it perfectly. I would also like to thank president trump for his nomination and willingness to have confidence in me and the veterans of this country.
▶ 0:30:03I appreciate the chairman and ranking member mentioning my family because I would not be here without them. My wife of 36 years is here with me, lisa. I have my son copeland and his wife holly. I have my son cameron and his fiancee mattie. On the end we have the one who glues us all together and that is jordan. There is also one that is probably watching right now that I would be remiss if I did not mention.
▶ 0:30:28It is my 86-year-old father who spent 31 years is a state trooper. I am here because of you and mom and I love you. America is the greatest nation on earth. I believe it is because of the men and women we serve. It is the men and women who step up to protect the freedoms we hold dear. Throughout my decades of service I have witnessed this first hand.
▶ 0:30:52I have watched men and women go at their best even when they did not want to and they served and stood up for our freedoms and they earned the benefits of being in our great veterans system. The v.a. Is there for them. In addition to being a navy veteran, I have been in the U.S. air force for over 23 years. Serving at the warner robins air force base and I have been able to watch over the years leadership. Leadership is about listening. It is also about leading.
▶ 0:31:23It is also about taking the men and women and you put their needs first. When you are in the military it is about the mission. For me, if confirmed, the v.a. Will be my mission. It will lead the mission to take care of our veterans and to make sure they get the benefits they deserve. I am in iraq war veteran. I understand burn pits because I slept next to one for many months.
▶ 0:31:51I understand this generation that went for time and time again deployment after deployment in a different way than we had seen many times before in our past wars and the needs that they have. But also being a veteran I also bring something that is unique to this position almost since it became a position, I will be the first member of this house or senate to serve by this body which brings a different perspective to my service here.
▶ 0:32:15Over the years we have all had our differences in this body and I appreciate you mentioning, yes we have differences, but we can agree. I have worked across the aisle to pass major legislation thanks to president trump and this body, we passed the first step act giving real criminal justice reform in the house. Music modernization act which senator cramer mentioned, the traits the cares act, these things make big differences when you give good ideas.
▶ 0:32:45For me it is about having respect for the members, having respect for this committee and that is what I believe this committee is one of the most bipartisan here I have earned and worked bipartisanly to make things happen in this country. Also I believe that we also have a lot more common on both sides. I believe there is timely access and care for our veterans for every eligible person.
▶ 0:33:08We are supposed to reach out and the mission act provides the template that I passed here, the v.a. Accountability and whistleblower protection act which was passed by this veteran unanimously that holds our veterans to the high standards possible. I will tell you right now, the v.a. Will not have a stronger fighter for the employees will be the work this secretary.
▶ 0:33:35Also one that will make sure we are held accountable because good work begets good work and others need to be held accountable, we will do that to make sure we get the best for our veterans. The pact act, something we are still developing. We just passed an act that we will have to look at next. I am looking forward to it. I do bring one thing. It will require your help and your mission. I bring to you two things that will be at the forefront of my service.
▶ 0:34:05These are my dog tags. They are a reminder just like every other veteran who served that we are part of a bigger unit. I also bring this place let -- bracelet. It was made for me by a young airman who was keeping watch each night. I would go by her each night and one night she said I've got something for you. She came out with this. She said you are always bringing us something so I want to give you something.
▶ 0:34:31What she did not know was about 15 years later if confirmed, this bracelet will be sitting in the secretary of the v.a.'s office reminding me every day of the men and women we serve. With that, I yield back. >> thank you for your testimony, conrgessman collins. We will have a round of questions. I will start by asking questions and then yield to the ranking member.
▶ 0:35:00It would be unexpected if I did not open my questioning with you in regard to the mission act. I was involved in the creation of the choice act. Even attempt to improve it, make it more certain with the mission act. My views are highly framed by my days as a member of the house of representatives in which I represented a congressional district the size of illinois. I care about rural and the distance that those rural veterans face.
▶ 0:35:31I want to ask if confirmed, will you make certain that the letter and spirit of the mission act is followed by every employee, every v.a. Facility and that the veterans are aware of their rights to advocate for themselves and to receive care when they need it, where they want it? >> I have been a few years off. I forgot to push my button.
▶ 0:36:01As we spoke in your office, there is no greater asset and really hitting at the very issue of why the v.a. Exists. It exists for the veteran. That is why over the past 10 to 15 years in this body the mission act was passed with the intent was to make sure the delivery of services to the veteran's first and foremost. You have veteran services being delivered in the v.a. System.
▶ 0:36:29As you mentioned, there are benefits for our caregiver and community care program. At the end of the day the veteran is being taken care of. V.a. Care will happen. It will always be there. There will always be the v.a. Healthcare system for the veteran. The way we express that is just like in this body. There are different expressions of how we make this better. We don't do the same things 40 years ago that we still do today if we want to stay current with what is going on.
▶ 0:36:57New veterans deserve every access to finding care where they can or in your case, if they have a long way to go, they need to find the care but always have the v.a. As a backup. The intent of the mission act at the end of the day was about how we make veteran care available to the veteran who needs it and not have the battles over how they get it because they want to be able to have that choice. We will continue to do that in following the intent of congress. That was my intent as well. >> is that an answer to what I asked you? >> yes.
▶ 0:37:29We will follow the mission act. We will follow that up. It will be day 1 understanding that that is why we are there and nothing will hold that up. >> let me highlight that while I mentioned geography and the distance, there are lots of other concerns in veterans accessing car I will highlight the importance that the mission act can play with high-risk mental health and addiction issues. We do not have enough care in the v.a. Or outside the v.a.
▶ 0:37:56And we need to make certain that wherever that care comes from, it is available when needed, true?
▶ 0:38:05Mr. Collins: That is the key, yes. Is it on something close to my heart. The mental health express -- aspect of this. Jordan has a physical disability. She cannot walk. People will look at her and have immediately sympathy. But when people come to you and say my brain is not working right, we tend to repulse. I want to develop a system where are care is drawing near.
▶ 0:38:36Mr. Collins: This is an issue nationwide. Not just in the v.a.. I want to make sure that we are getting the opportunity that the member who needs it can find it quickly and efficiently. >> let me talk about civilian life. One of the most dangerous circumstances in the well-being of a member of our military who is soon to become a veteran occurs at that point in transition.
▶ 0:39:04Mr. Collins: It is a time in which there is a sense of loss of belonging, of camaraderie, mission and purpose. It is a time in which suicide ideation is prevalent. We have a requirement at the department of veterans affiars and department of defense cooperating in a program to properly assist military men and women as they depart active duty.
▶ 0:39:31Mr. Collins: I want to hear how much you value this process and how much you value the requirements because the department of defense and the department of veterans affairs failed to appropriately and adequately implement that caregiving time and to provide the necessary transition support. It is hugely important. It is important to the life of that servicemember.
▶ 0:39:59Mr. Collins: It is also important to our recruitment and retention of future members of the military. Comments?
▶ 0:40:05Mr. Collins: You hit it perfectly. This is not just taking care of our military veteran coming out and transitioning to veteran care but it is also if you go back further, this is a recruiting issue. This is part of the whole lifecycle of a veteran. If you have good experiences in the d.o.d. Or vice versa, you are having people who served telling their children I don't want you to serve.
▶ 0:40:35Mr. Collins: This is the issue we have to work on. As someone especially as you talked about earlier, transitioning becomes the time in which for some they don't have that grounding anymore. They need that connection and we have not done a good job of connecting the dots. One of the things that has disturbed all of us in this room is the 17 number that is used, the 17 veterans who died by suicide. We understand that. Over 40% of them never connected with the v.a..
▶ 0:41:06Mr. Collins: We have my assurance that not only will we be our priority, it will be an extra priority for me because I believe we can use all assets, not just d.o.d. But the v.a. State veterans associations as well. I am looking at anyway to make those transitions as easy as possible. >> thank you. Senator blumenthal? >> thank you. You are generation in allowing time for us to ask questions.
▶ 0:41:36Mr. Collins: I will stay within the five minutes. >> are you suggesting that I did not? >> I would never suggest anything of the sort. I hope we will have a second round of questions. >> I anticipate. >> thank you. Let me start with some easy questions conrgessman collins. Will you commit to respond promptly to any inquiry from members of this committee to request information and be fully transparent with this committee?
▶ 0:42:06Mr. Collins: That is my intention. I will make sure you have every information that you need. >> will you commit to working with the veterans service organizations and other stakeholders in making decisions?
▶ 0:42:19Mr. Collins: I look forward to working with his committee and members of the house and senate to help our veterans. >> including the office of inspector general, the government accountability office and office of special counsel? >> I think you have laid out the essence of accountability in this body but others that actually give us insight into what we're doing and and how we do it. I look forward to those and making sure we look at those recommendations and work on them. >> thank you.
▶ 0:42:48Mr. Collins: Last week at a hearing of the homeland security committee I gave the nominee for omb director the opportunity to renounce a proposal that he made and it is included in project 2025 to impose a means test for v.a. Disability compensation benefits. I asked about his proposal to clawback benefits from service disabled veterans.
▶ 0:43:19Mr. Collins: He has advocated that anybody with less than a 30% disability will receive no benefits. He refused to renounce either proposal. I need from you a commitment that you will oppose any such efforts by the administration.
▶ 0:43:36Mr. Collins: I have made a habit of being here. I will never answer for someone else. I will say this, I am not a part of project 25. I have not read it. I will take care of the veterans. We will not balance benefits on the back of the veteran. We will put veterans first. That comes from the secretary. That comes from budgetary oversight. That is what I will be coming to you for. If there were issues I need, I will come to you.
▶ 0:44:06Mr. Collins: If there are issues that you want to see, that I will say here is where we change the law because that is what we have done before. My commitment is to the veteran and make sure that we have our budget sufficiently funded so that veterans receive their benefits. >> I will interpret that as a yes. >> you can interpret it.
▶ 0:44:22Mr. Collins: >> in his first term president trump attempted to go down this road by trying to eliminate individual unemployability benefits for retirement age veterans, a very ill-conceived proposal that was later retracted. I hope that you will oppose any such proposal during this administration.
▶ 0:44:42Mr. Collins: I am not familiar with that discussion. I am familiar with what president trump did advocate during his first four years and that was the mission act. The things that put veterans first. His words were I want to take care of veterans. I look forward to carrying out his vision of taking care of the veterans, putting them first, making sure the v.a. It is in the situation where it can do that and having the resources and efficiencies it needs to make it better.
▶ 0:45:10Mr. Collins: I look back at what he has already done and I know that was putting the veteran first and I will be doing the same. >> thank you. For far too long across the administrations of both parties the v.a.
▶ 0:45:24Mr. Collins: Major and minor construction projects for hospitals, nursing homes and other critical infrastructure priorities, these are the nuts and bolts of the facilities, depended upon by veterans have been dramatically underfunded. I had to fight for funding to modernize the veteran facility in west haven. Finally it is underway. There are thousands of other projects.
▶ 0:45:52Mr. Collins: I would bet in every one of my colleagues districts that need that kind of funding, it is a bipartisan issue. It is good for veterans and good for local economies in red states and blue states. The longer we wait, the more expensive construction becomes. If confirmed, will you commit that you will work with us to make those kinds of investments a priority?
▶ 0:46:17Mr. Collins: I think what you just hit is bigger than buildings. It is about the future of the v.a. It is about how we take care of our veterans. When you frame the question as funding the projects I look at it as funding the veteran. I look forward to using the limited dollars coming from congress and how we spend those to make sure we prioritize the needs and areas you mentioned such as your home state.
▶ 0:46:45Mr. Collins: These are areas that I want to look for to make sure that it is not done efficiently but on time, but also has the proper oversight that we do not see a drag on for years. I have are too many times in many offices that have met with, only 60 plus senators, this issue comes up consistently. We have to be better still of our building projects. At the end of the day it is the veteran who gets served. >> thank you. >> I almost gaveled you 43 seconds ago.
▶ 0:47:16Mr. Collins: >> I knew that was coming. >> senator sheehy will be recognized next. One of our colleagues was kind enough to allow him to go stead. Welcome to the committee. >> thank you, chairman. Congressman, thank you.
▶ 0:47:44Mr. Collins: As you know, the military is a business with the family carries the weight. I come from a very large state with not a lot of people and a lot of veterans have to travel many hours to get to v.a. Care. I would be curious to hear your thoughts on how we are going to actually expand access to community care.
▶ 0:48:03Mr. Collins: As senator blumenthal discussed, it has been talked about but I think we know from experience it has been hard for veterans to effectively mesh healthcare benefits with being able to go to the community and get the care. I have heard from montana. It can be a five point 5 hour drive to a v.a. Care facility. I want to make sure we take action to ensure veterans can go to the community and get the care they need so they don't have to drive many hours away.
▶ 0:48:33Mr. Collins: Thank you. Good to see you this morning. I am from north georgia but issues of ruralness is not new to my district. I had the foothills of the appalachian. It is the appalachian trail. Sometimes the distance may be deceiving, even if it a shorter distance, how to get there and that can be a problem especially for older veterans.
▶ 0:49:00Mr. Collins: I had a 90-year-old veteran and they were asking him to drive 90 miles to ask him to get correct of lenses and he was having trouble seeing. I will go a step beyond senator johnny isakson. We got involved in the choice act which became the mission act because we saw these very issues that you speak of. For me it is about making sure that we publicize what is out there.
▶ 0:49:27Mr. Collins: I know that has been a concern for many on both sides of the aisle, making sure veterans understand the benefits they have. We both know that sometimes it is hard to get there in rural areas. I am committed to make sure we use every avenue we can to make sure the benefits that they know about, if they want to use them, they will be there for them. Some do not know. For you and other states and rural states and urban settings, we have to make sure the access is there. In saying that, it also needs to be sure that the v.a.
▶ 0:49:54Mr. Collins: Itself is not standing in the way, that where there is conditions met with and they are eligible for community care, it is not the v.a. Standing in the way to getting the healthcare they need. That can come through because senators -- call centers and everything else. >> as a wounded vet who transferred out, my wife was also active duty, the hardest thing about v.a.
▶ 0:50:22Mr. Collins: Care that I found and most of my peers agree is the handoff from active duty, healthcare, the handoff to the v.a.. I was fortunate enough to have a fantastic handoff. Disabled american veterans helped with my transition. Very few veterans end up in that spot.
▶ 0:50:40Mr. Collins: How can you ensure that we have a seamless handoff from active duty members so when they enter the v.a., medical records are ported over, care is ported over and it happens seamlessly for the veteran?
▶ 0:50:53Mr. Collins: As was previously discussed in the transition, it is the most important for the family. You understand that with your transition and your wife transition. At that point there is on settlement. How can we get that care? How do we get by? There are several things we need to do to make sure that our touch is much better. There are some programs to make sure that the v.a.
▶ 0:51:22Mr. Collins: Touches on occasion. If that is not happening, we need to do better. There is an issue we have not discussed and that is the medical health records issue of the v.a.. That is a program that has gone too many years and cost to many billions of dollars without finding a solution and my commitment is going to be one of the very first priorities which is to figure out why and put this on a bigger timeframe to get this medical health records issue solved.
▶ 0:51:51Mr. Collins: I will say this now and I will probably say it again. The v.a. Is special but it is not unique. Hear me when I say that. It is special in who we trust and take care of. It is not unique in this sense that we do healthcare. Healthcare has gone on in this country every day outside of the v.a. We have to get our health records straight so we have an easy handoff which should be a simple click of the button.
▶ 0:52:18Mr. Collins: I have had in my office when I was in congress up to almost a year to get those records transferred. That leaves uncertainty for the veteran, for the family and makes a very unhealthy experience for those who are serving. >> thanks for your service, thanks for your family service and thank you for stepping up. >> thank you very much. Congressman, very good to see you. Thank you for meeting with me in my office. I appreciated that discussion.
▶ 0:52:47Mr. Collins: I will start with the question in reference to what you just talked about. Back in 2018 under president trump's first administration, the v.a. Signed a no-bid contract to rollout the center of electronic health record to all v.a.'s facilities and the first one went live in my home state in 2020 and it was disastrous.
▶ 0:53:12Mr. Collins: It endangered patients by rushing the deployment, not making sure the system was technically sound, not working with the clinicians on the ground and not providing sufficient training. Veterans and providers in my home state are still paying the price for that. Last month of the v.a. Announced it would be moving forward with pre-deployment activities for the electronic health record. You said that you plan to make it a priority. I want to know what that means.
▶ 0:53:45Mr. Collins: Will you prioritize it by rushing the implementation or will you prioritize it by getting this system right and focusing on veteran safety and clinical productivity issues moving forward?
▶ 0:53:56Mr. Collins: Thank you senator. I enjoyed our time together in your office. There is never a more perilous issue than to be on the tip of a new idea. It goes back a long way. It has reassured what happens here. What I say that we will make this a priority, it means that for me it will be taking it as I will take the first step and look at it for fresh eyes.
▶ 0:54:26Mr. Collins: I have not even been there for what this committee says has been too long and cost too much money. We will talk to the vendor to make sure we find out what their issue is. We will listen to our clinicians and hospitals. As I said, we are special in who we care for but we are not unique. There is no reason in the world we cannot get this done. I think that is the concern I have because this body and you have done a great job with the appropriations process and making sure that they were funding a system that we are sitting here six to eight years away and nothing has happened.
▶ 0:54:56Mr. Collins: That causes not only the transition but it affects the patient internally. We have to get better health records so that we not only have the issue with our one on one doctor interaction, we can move faster, they can see the information and it is safer for the patient.
▶ 0:55:13Mr. Collins: For me, as soon as possible in the very early stages if confirmed, I will gather together members of my staff that will be specifically taxed as soon as possible within the first days of this administration to see what is the issue, why is it waiting and why did the previous administration say they will try to start back in 26. I am not sure why it would take a year. I believe we can do it properly and not rushed. There is enough information that I believe we can get it done.
▶ 0:55:43Mr. Collins: >> the first step would be to bring it in along with your staff. Please make sure you talk with those people on the ground to understand what is going on and why it has been such a problem as your take on those next steps. Please stay in touch with me. This has been my top priority and I have been so frustrated.
▶ 0:56:10Mr. Collins: You would be amazed at how many conversations I have had. We cannot over emphasize why it needs to be done. Being on the heel -- on the hill, this has become true normal that we appropriate billions of dollars and we have seen no results. I think president trump had the right idea and we will continue to that. We will have to work together. The finger-pointing is done.
▶ 0:56:40Mr. Collins: It is time to get it done for one reason. The mission is the vet. It is the veteran who has earned the benefit and if we are not giving the right tools for that, then the doctor and the nurses are not able to manage. I will not accept that we cannot do it. I will not accept I don't know. I will not accept, we don't have enough money. They have eight years and billions of dollars. We will definitely work together.
▶ 0:57:06Mr. Collins: >> my last 30 seconds, reference something that senator blumenthal mentioned in his opening remarks and that is I care deeply about our women veterans and that they have the services they need. I want to just ask you do you believe a veteran who lives in texas who has been raped and becomes pregnant should be able to get abortion care at her local v.a.?
▶ 0:57:28Mr. Collins: That is an issue that is very sensitive in this body. It is something that has been looked at at what the law actually says and the losses the v.a. Does not do abortions. Two years ago that decision was looked at and decided. We will be looking at that issue when I get in there to confirm that the v.a. Is actually following the law. >> do you plan to modify that law?
▶ 0:57:51Mr. Collins: When we get in we will make laws being followed. >> I want you to know that I will be following this very closely. I want to make sure that women veterans get the healthcare they need. Thank you. >> thank you and congratulations to you and the ranking member on your new positions. Looking forward to working with you and congressman collins. Congratulations to you.
▶ 0:58:22Mr. Collins: Thank you to your beautiful family behind you. It is great that you are doing this. I agree with my good friend kevin cramer. I think you are eminently qualified. As a veteran yourself and as a chaplain. I agree with senator cramer, that brings unique insights. I think that will be great. I look forward to supporting your confirmation. I am a big fan.
▶ 0:58:51Mr. Collins: I certainly hope that we have bipartisan support for your confirmation, given your qualifications. Thanks for your willingness to serve. I appreciate our meeting. I focused a lot on alaska for really important reasons. My state has more veterans per capita than any state in the country. A real patriotic place way up north. We are big. I will not even get into the size of alaska because I don't want to embarrass anybody. It is really big.
▶ 0:59:24Mr. Collins: I think we are five or six times bigger than montana. We do not have one full-service veteran. It is us and new hampshire. That is it. We have really big challenges for all of those reasons. It is good because we have so many veterans. It is challenging because we are big and we don't have one full-service household. We have had many disasters with the v.a.. We talked about some of them. In 2015 before I came to the senate the v.a. System in alaska collapsed.
▶ 0:59:55Mr. Collins: It was the first big thing I dealt with as a brand-new senator. It collapsed because they took, they took the vispon and the call center out of alaska and we had people making appointments for alaska veterans based in the lower 48 who do not have a clue about our state. The system collapsed. We had a giant backlog.
▶ 1:00:24Mr. Collins: Last year the backlog was up to 12,000 veterans, which is a lot for my state because we still have call centers based in the lower 48 so a veteran in alaska says, I need to get to anchorage hospital. The call center says, drive to -- but it is an island. I need to get a commitment from you.
▶ 1:00:49Mr. Collins: I was able to get legislation that said if you don't have a full-service hospital, then you can go immediately to community care. Why wouldn't you? The call centers do not allow that because they don't know about alaska. I don't know the bill. They don't know the law. It is still kind of a disaster for veterans. Can I get your commitment to work with me on all of the alaska challenges, this call center issue? We need a call center back in my state.
▶ 1:01:21Mr. Collins: For people who understand what the state is all about and to bring down this backlog. Can I get your commitment on the , to help our veterans and to get your commitment to come to alaska and bring the whole family? Come in the summer if you want or go fishing or in the winter to see what is like to be in estate that is dark and and 50 below zero. Your choice. Pick august as opposed to february.
▶ 1:01:49Mr. Collins: You made it sound so attractive. We put chaplains up in your beautiful state. One of those issues is the long winter. You brought out a point when you were talking about this and the uniqueness of alaska and new hampshire that having a full-service hospital so they are a user of community care. It is really disturbing to me.
▶ 1:02:17Mr. Collins: We had about 5000 veterans waiting for health benefits. This is not a benefits backlog. This is a healthcare backlog. This means there are 5000 souls that are there not getting the health care they need. >> last summer it was 12,000. We were trying. 12,000 just waiting to get an appointment because we have someone in the lower 48 who has never been to alaska trying to make an appointment for an alaska veteran. It is a disaster.
▶ 1:02:44Mr. Collins: I agree. When you told me that, it surprised me. Sometimes things get lost in bureaucracy and you think it looks good but then you have the application and you have to go back and say I am willing to commit you to look at that to make it better. They cannot drive to anchorage. >> let me ask one final question. We talked about it. Are alaska native community is also incredibly patriotic.
▶ 1:03:12Mr. Collins: Alaska natives serve at higher rates of the military than any other ethnic group in the country. Super patriotic. They live in a lot of rural communities and our alaska native healthcare organizations have reached into the rural parts of the state that no other place does. The v.a.
▶ 1:03:27Mr. Collins: Has a long history of working with our alaska native health organizations to extend the reach of care and a very rural parts of america and very rural parts of alaska and partner to give alaska native veterans but also non-natives who live in these rural communities to go to an alaska native health organization to get care because they partner with the v.a.. Can I get your commitment to continue that good relationship?
▶ 1:03:57Mr. Collins: Sometimes it is contentious on negotiating the agreements but they are really worth it to expand and extend v.a. Health care for native alaskans, non-native alaskans in the most rural parts of our state.
▶ 1:04:10Mr. Collins: Yes, we will commit to do that and any other district across this country where we can partner to make sure our veterans can get the healthcare they need and especially in a unique situation like that. >> thank you. I look forward to supporting you and I have more questions for the record. >> senator hirono. >> thank you. It is nice to see you. Congratulations on your nomination.
▶ 1:04:40Mr. Collins: As part of my responsibilities to ensure the fitness of any nominee who comes before my committees, I will ask the following two questions. Since you became a legal adult have you ever made unwanted requests for sexual favors or committed any verbal or physical harassment or assault of a sexual nature?
▶ 1:04:57Mr. Collins: No, I have not. >> have you ever face discipline or entered a settlement related to this conduct?
▶ 1:05:04Mr. Collins: No, I have not. >> hawaii also does not have a full-service va hospital and like alaska, has access issues with islands. Those are all issues we will need to continue to address. Congressman, you are very close to president trump both as a member of the house.
▶ 1:05:31Mr. Collins: Under what circumstances would you say no to a request or order from president trump?
▶ 1:05:36Mr. Collins: Senator, we are dealing with hypotheticals. Saying this further would actually asked me to do something illegal. The president has put veterans first. He will not ask me to do anything illegal.
▶ 1:05:53Mr. Collins: The question of why something has not happened -- >> we need to make sure what your priorities are and you are saying that you will not say yes to what you see as an illegal order. During your time in public life you have been very outspoken against pregnant peoples rights to their own reproductive choices.
▶ 1:06:17Mr. Collins: In the role of secretary you would be overseeing care for veterans and their loved ones across the entire ideological spectrum. Would you resend the final rule enacted under the biden administration that allows the v.a. To provide abortion counseling and abortions in the case of rape, incest or where the life and health of the veteran would be in danger?
▶ 1:06:47Mr. Collins: As we just discussed a moment ago, the v.a. Act of 1992 forbids the v.a. From doing abortions. >> let me clarify something for you. You refer to a law that is actually being pretty much clarified by this interim final rule. There is debate regarding what the law allows.
▶ 1:07:12Mr. Collins: I believe the law allows this rule to be enacted and my question to you is whether you would rescind this rule that would allow the providing of abortions to veterans who under circumstances of rape, incest or where the life is endangered?
▶ 1:07:29Mr. Collins: As I was answering your question, we will look at this rule and see if it complies with the law. As you just said in your own answer, it is debatable. We will make sure the v.a. Is following the law. >> if you provide these services, you are providing the veterans the full range of care for reproductive services as needed. Regardless of your ideological position.
▶ 1:07:57Mr. Collins: My ideological position is based in the law and I will follow the law in this regard. I would love to have talked with you before this hearing. >> I am asking you under oath. To believe that world-class care includes a full range of reproductive services?
▶ 1:08:18Mr. Collins: The range of care provided at the v.a. Is following the law and the intent of this body as it is set forth in the law. >> if the way you interpret the law will disallow services to 2 million veterans in the U.S. including 15,000 in hawaii, you will do so? That's what you just testified.
▶ 1:08:37Mr. Collins: As I have just in looking at this, I will take a look at where the law stands. And as you testified in your questioning come of the law was just changed two years ago. We will look at that.
▶ 1:08:52Sen. Hirono: There is a rule that actually interprets the law a particular way and you say it depends.
▶ 1:08:58Mr. Collins: I understand.
▶ 1:09:00Sen. Hirono: You are not responding to whether or not you will rescind that rule which provides care for thousands of female veterans.
▶ 1:09:08Mr. Collins: Senator, I am trying to answer your question.
▶ 1:09:12Sen. Hirono: Over 50,000 employees and contracts with hundreds of thousands of private providers across the country. Can you explain what roles you have held would have prepared you for leading such a large organization?
▶ 1:09:28Mr. Collins: I would love to. I have been part of this body in which I have overseen working through votes that affect the v.a. Operation. I understand the policy of the v.a. By being a member like you. I spent time with members who served at the air force base and our chaplain's office with personnel working across different comms.
▶ 1:09:55Mr. Collins: I have also been a leader in many other ways, and I believe leadership is how you deal with this. Leadership is putting people in position.
▶ 1:10:04Sen. Hirono: Thank you.
▶ 1:10:06Chair Moran: Senator cramer.
▶ 1:10:10Sen. Cramer: I am just compelled to ask this question. I think the implication was, would you carry out an illegal order by the president of the united states? Which he has never done. It is so hypothetical to be silly.
▶ 1:10:33Sen. Cramer: But I am compelled to ask, would you consider rescinding an illegal rule by the previous administration? Because it seems to me that illegal rule, or at least one that is debatable, is worthy of significant legal consideration before you do it just because you felt like doing it.
▶ 1:10:56Mr. Collins: I appreciate the way that is worded because that is exactly the way I tried to word it to the senator. That is the law was specifically stating the v.a. Was to not be doing abortions. We look at each situation that came up in 2022 in which they were told to look at a rule that would get around that. To me, it is time for us to look at that rule and make sure just as in every other area of v.a.
▶ 1:11:23Mr. Collins: Life we are dealing with what the law and the intent of this body is. This is going forward on all the issues. If it is just a matter -- I have great respect for this body. I have served in this body. And what we pass actually means something. The minute it is not mean something is the minute the rule of law falls down. For me, yes, I will be looking into this.
▶ 1:11:51Sen. Cramer: Thank you. I wanted to give you that opportunity to uninterrupted explain yourself and you did very well. You are hearing a lot about community care obviously. I will spare you all of my horror stories. I think senator sheehy did a remarkable job as because those are big rural states -- as senator sullivan did because those are big rural states.
▶ 1:12:21Sen. Cramer: It is my intention to work with my colleagues to further clarify in the mission act what access to community care is. In other words, we still hear horror stories from veterans live 300 miles from the va hospital or maybe 100 miles from the nearest who may be live across the street from a critical access hospital, which we have 36 spread throughout our wonderful state.
▶ 1:12:50Sen. Cramer: 36 critical access hospitals that operate on the thinnest of margins. And it is tragic for me to think there is a veteran waiting for paperwork that is being slow walked by a bureaucrat more interested in the v.a. Than they are the veteran. All the while, there is a hospital barely hanging on across the street, and I am not even exaggerating it little bit when I say that.
▶ 1:13:18Sen. Cramer: And perhaps my question is would you work with me and colleagues on this committee to find ways to not just streamline the process but to guarantee it? In other words, the default is not have you checked all the boxes on enough pieces of paper to qualify for a care somewhere else before you die trying to get far away, but rather you do that first and then the reimbursement comes after that?
▶ 1:13:42Sen. Cramer: So anyway, I just asking if you would help me, if you have some thoughts, and you would commit to working with us on something like this.
▶ 1:13:51Mr. Collins: You hit the whole heart of what I want to do this. I heard some say congratulations and some say, what are you doing? It is a large undertaking. I am doing this because I care for people. It is what you see as you look to make it better. To m the service organization called the v.a. Is about service. It is about the veteran. It is not about the v.a. The v.a. Is there.
▶ 1:14:21Mr. Collins: I am looking forward to being the secretary that motivates and unleashes the power of this wonderful workforce, which I believe is the most wonderful workforce we have that want to do a good job. They need the leadership and encouragement to say that's fine yes instead of no, answers instead of technicalities. Let's find the hope in people instead of the reason this is delayed. For me, it is about getting veterans access to care that you and I on this committee voted for. That is why we do what we do, because they deserve it.
▶ 1:14:50Mr. Collins: For me, as duckworth, crosses party lines and I appreciate the making member talking about bipartisan. We had a discussion in her office talking about locating them with hospitals if that is a possibility. Can we do that? I committed to the senator of illinois that is something I am willing to look at because it helps both sides. We have to get back to the part where it is about the betterment itself.
▶ 1:15:17Mr. Collins: I will empower a workforce that wants to get up every day and say I am getting to yes, I am getting to this veteran to get the help they need.
▶ 1:15:24Sen. Cramer: Use are a leader with a servant's heart.
▶ 1:15:27Chair Moran: Thank you. >> congratulations on your ascension to chairman of the committee. I want to emphasize what is quickly important, and there are a number of bills out there. I suspect you are familiar with them.
▶ 1:15:54Chair Moran: I just want to hear you reiterate your commitment to this transition and working with the department of defense because it is a partnership that has to happen to make that warm handoff. Is that going to be a priority for you?
▶ 1:16:06Mr. Collins: Yes, senator. There are so many priorities. This one that you hit about making this transition is so important to me because it transcends just getting them into the service. It transcends that benefit they earned. It goes to the very heart of making sure they are taken care of and feeling loyal.
▶ 1:16:26Mr. Collins: As we started a while back, I believe it starts at a recruitment issue all the way through a retirement issue because if they feel like they are being taken care of in dod, they will have a better opportunity if v.a. Reaches out with a hand to say this is what you wanted to participate in, that they have a place there at a facility for them. The concern I have is making sure that in dod, and I already had some look at this, how we could do cooperative work with the dod and the v.a.
▶ 1:16:55Mr. Collins: Also bringing into account the state veterans locations as well.
▶ 1:17:01Sen. King: I want to emphasize the last point. I had a proposal that got in the senate and knocked out of the house to communicate a veteran's transition status to the state veterans facility so this person can be greeted at the airport. It is the kind of handoff we want. Do you agree?
▶ 1:17:20Mr. Collins: I agree. It is exactly what you said. It is how you are perceived. I view the service part of the v.a. Is this most important part. There are sometimes you have to tell somebody k tell somebody no, we cannot do something. But there is always time to make the veteran feel like they are being cared for. I think the transition time you are talking about, as you said, that warm hug is a thing we need to look at.
▶ 1:17:46Sen. King: The critical element as it is a time of heightened risk of suicide for example.
▶ 1:17:51Mr. Collins: Yes.
▶ 1:17:51Sen. King: Let me move on. You had some discussions. I think this points out one of the fundamental flaws of the federal government procurement process, particularly in national security areas. We feel like we have to buy our own custom brand-new shiny product rather than something sitting on the shelf. There is an electronic health records system that thousands of hospitals use across the country.
▶ 1:18:20Sen. King: Instead, we are trying to invent our own system, which frankly has not worked and has cost billions of dollars. I hope you look at the option of saying, hey, let's go with something that works, that we know it works, and can be modified to meet our needs rather than continuing down the road of billions of dollars of a system that has so far not proven itself.
▶ 1:18:40Mr. Collins: Senator, I think what you just hit is what I am committed to is making sure what we have and looking at all options on the table. I will bring in what others like oracle have had facilities already running the program. It is the issue I went back to. The v.a. Is special but not unique. We have to get out of this uniqueness status. How is it different from the largest health care organization like this that there are not better ways to do it?
▶ 1:19:12Mr. Collins: It is not just medical health partners. We have to look all across.
▶ 1:19:14Sen. King: That is exacting my point. A lot of discussion this morning about the mission act and community care. I am all for it under the appropriate circumstances but not at the expense of creeping elimination of the veterans health care system. I believe I heard you say earlier you remain committed to v.a. Health care in addition to community care where appropriate. Is that correct?
▶ 1:19:36Mr. Collins: Senator, you heard correctly. I believe that we have to do is make sure we are adapting and making sure we are giving the care as authorized by this body to make sure we do it in the ways that are appropriate to the veteran. It is no longer time and the situation especially in different parts of the country where we have to have the veterans to do the mission.
▶ 1:19:59Sen. King: You mentioned you had not read project 2025. Are you familiar with it? There are some suggestions in it that I find pretty frightening.
▶ 1:20:09Mr. Collins: I have not except for when somebody says it on tv.
▶ 1:20:12Sen. King: For example, there is a provision that new managerial approaches should be currently used in the private sector to improve the existing activities. I am afraid that might be code for sharks, for claim sharks. Are you supportive of the guard v.a. Act?are you familiar with that bill?
▶ 1:20:32Mr. Collins: I am familiar, yes.
▶ 1:20:38Sen. King: I hope you familiarize with it. It is a bipartisan bill to protect veterans from what is colloquially referred to as claim sharks. I will have some additional questions later in the hearing. Thank you, Mr. chairman.
▶ 1:20:49Chair Moran: You are welcome, senator king. Senator banks, welcome to the committee. You are recognized for questioning.
▶ 1:20:56Sen. Banks: Thank you. Great to see you. We served together in the house. Those four years of president trump's first term were four great years. We did great things expanding them mission act, greater accountability for v.a. Employees. We loosened standards for the g.I. Bill. President trump sent us down a path to modernize electronic health records. The list goes on and on from the v.a.
▶ 1:21:25Sen. Banks: Crisis hotline to other issues that were priorities for him that you and I had a chance to work on in the house as among the greatest accompaniments in the eight years I have served in congress. Now we have another four years. You will be a great secretary working with a great president. I cannot wait to work with you to do things for america's heroes.
▶ 1:21:46Sen. Banks: I do have some concerns about the condition of our medical facilities. You and I talked about this in my office. The indianapolis medical center is due for a total replacement. It is in the v.a.'s five-year development plan meeting. It is a project that you have on the books but do not have funding to do it.
▶ 1:22:16Sen. Banks: Will you commit today to working with me to get that project started next year as the v.a. Plans call for?
▶ 1:22:22Mr. Collins: Thank you, senator. Working with this body to get the funding needs for all of our construction and priority needs are going to be there. If you allow me to spin off of that, the average age is 60 plus years old. This is beyond when you look at the hospital side and privatized hospitals or even public hospitals averaging 15 to 20 years.
▶ 1:22:50Mr. Collins: It is a whole different, which goes into different problems. Construction and project like that will be important, but also as we just discussed and senator king brought up, the electronic health care records system, some of our systems will have to have major work just to hold the computer systems to make that happen. It is something we will work toward to make sure we get offended. Look forward to working with this body for funding for that.
▶ 1:23:19Sen. Banks: I look forward to working with you on that. The v.a. Has struggled with construction and maintenance and leasing for years. In indianapolis and a lot of other projects around the country, they are facing significant delays which is harming our veterans. How are you going to prioritize reforming the office to handle these functions within the v.a.?
▶ 1:23:37Mr. Collins: Senator, I think what we have been looking at here is making sure we have what I am hoping to find as I don't want to saying slimmed-down but a focused vision on our acquisitions, construction projects, so we are not going through multiple layers. At the time, if this person has to sign, making it applicable. We have to go with the army corps of engineers.
▶ 1:24:05Mr. Collins: We have the project in aurora, colorado, which we are here for. That is why we have to make sure we have the right people in those positions and bring in help when we need to to say, how can this project be built more cost-effectively? If I could say one thing, one of the reasons I looked at this job and wanted to do it was the four years you just mentioned, because I knew president donald trump would actually want to take care of veterans and not just say it but show it with what we did and worked on.
▶ 1:24:34Sen. Banks: I would add to that that the last four years have been different. It has not been the priority of the administration, and I look forward to changing that very quickly. When I served on the house appears committee, there was a lot of confusion of where the v.a. Was going to put new clinics and why those counties or towns or cities were chosen, and immediate really hard for me as a congressman -- can it made it really hard for me as a caucus meant to explain why this town was chosen for a clinic and another was in. Do you think v.a.
▶ 1:25:02Sen. Banks: Should know in advance when a lease gets awarded?
▶ 1:25:08Mr. Collins: I believe we should have a much better working relationship with congress in regards to all aspects of this. We discussed a conversation I had when senator duckworth about how we locate those. If you allow me a moment, there is something I want the whole body to hear. I believe after listening to over 60 plus conversations, we have to have a better working relationship with the v.a.
▶ 1:25:34Mr. Collins: And the members of this committee and the body through legislative affairs. Legislative affairs undermine the ship will be proactive, not reactive. They will still be there for this committee to enter policy questions and do those things, but I want to have legislative affairs people, boots on the ground here on the hill talking to you not just about their concerns but hearing from your constituent service workers. 60% among all of your constituent services fall under v.a. Whether it is benefits or health care.
▶ 1:26:05Mr. Collins: I want our folks to know that up front so your people can know who to talk to and relay the reports to me so if indiana we have a problem coming from your office, we will have a chance to react to that much quicker, so I will have the information so we are not seeing something in the paper six much later or having you to call. I made a promise to everyone here that I do not come into this with rose-colored glasses. I think this is a large undertaking I feel called to.
▶ 1:26:38Mr. Collins: When a member of the military, a veteran has to call our office, a congressman or a senator's office to get the care they already earned, it is a mark of failure in our department. It is not something we cannot overcome and there are plenty things to do but until we get to that mark, we are not taking care of veterans as fully as we can and will encourage all of our employees to get to that standard.
▶ 1:26:59Sen. Banks: Thank you.
▶ 1:27:05Chair Moran: I better check and make sure I got it right. Thank you for your questions.
▶ 1:27:12Sen. Slotkin: Thank you, Mr. chairman. I am pleased to be on this committee. Sorry, Mr. gallego. Missed it by an inch. And I think veterans issues should be bipartisan issues. You and I served together in the house. We overlapped. I am very proud to be the first cia officer in the U.S. senate.
▶ 1:27:38Sen. Slotkin: I am a 9/11 baby as they say it was recruited by the cia after 9/11 ended three tours in iraq armed alongside the military and would proudly for democrat and republican administrations. I am also a democrat that just got elected on the same ballot as donald trump as we talked about. I certainly understand that Mr. trump has the right to nominate his own people and have policies that differ from my own beliefs.
▶ 1:28:03Sen. Slotkin: I think what I care about the most is just making sure our veterans get the care they need and we do not strip essential programs for the sake of cutting the workforce. We talked about the pact act when you were in my office. I work hard on that bill.
▶ 1:28:22Sen. Slotkin: The house of veterans affairs committee, the potential to expand care to 3 million 9/11 era veterans who lived near burn pits, and then the elizabeth dole act that a number of folks in this committee worked on as well, which really does amazing things for mental health and expanding programs on long-term care.
▶ 1:28:44Sen. Slotkin: So can you just give me assurances that while I know it is a mandate from president trump to cut the size of the government that you will always speak up on behalf of veterans, not just do the bidding of someone who may be somewhere else, sees your numbers, and burn dish and starched -- and starts to slash and burn?
▶ 1:29:11Sen. Slotkin: If we just start slashing numbers, we will be hurting the betterment who we just all voted and said we wanted to care for. A simple answer.
▶ 1:29:17Mr. Collins: That is an easy one because I was told by the president we should take care of our veterans. I said earlier in this hearing we will not sacrifice that veterans benefits to do the budget. Efficiencies can be found everywhere. As you and I talked about in the office. We have to make sure we are doing it to the mission. The mission is the bette vetera- the mission is the veterans.
▶ 1:29:44Sen. Slotkin: I know you will have to push back and say this is what it will do and you will pledge an oath to the constitution soon, not to any one president. On the issue of veterans benefits, do you believe that you have the ability to change, as v.a. Secretary, would have the ability to change the discharge status of any one veteran.
▶ 1:30:10Mr. Collins: That is not under my preview to change.
▶ 1:30:13Sen. Slotkin: Yeah. And do you believe a veteran's benefits can be cut based on personal or political beliefs?
▶ 1:30:22Mr. Collins: No, senator. That is not a criteria for cutting a benefit. A benefit is earned based on the criteria set before us. There is not a litmus test.
▶ 1:30:32Sen. Slotkin: I really hope we stand for that because even when we deeply disagree with the veteran's actions, their service and discharge status is determined based on their moment that they served the country, whether we like their views are not. That is why we never have the veterans benefits taken away from people like the january 6 protesters even when they were convicted. Similarly we are watching right now senior people from the U.S.
▶ 1:31:03Sen. Slotkin: Military coast guard be removed from their jobs on Mr. trump's first day. I just want your assurances you are not going to change their veteran benefits that they earned if the discharge status is what it is from the department of defense.
▶ 1:31:17Mr. Collins: I think encouraging and not going down a path we talked about of hypotheticals, the dod is that when it comes to the v.a. Itself, the veteran comes with the benefits they earned through their service and how they get to us. We will make sure the veteran is taken care of with their status one they get here. The issues you talk with dod, we will take care of them.
▶ 1:31:42Sen. Slotkin: Ok, I just think we go down a dangerous road as a country that a veteran that served, they get their discharge papers, they have done their service to the country, and regardless of what political views they have, whatever they say or do after their service, they are then retroactively punished through their pension, through their v.a. Benefits. I think that is a dangerous path for democrats and republicans and I don't want you to be the first v.a. Sec.
▶ 1:32:07Sen. Slotkin: To go down that so I will rely on you to stand in the breach on that one. With that I yield back my time.
▶ 1:32:13Chair Moran: Thank you very much. Senator boozman.
▶ 1:32:17Sen. Boozman: Thank you, Mr. chairman. Congratulations on the chairmanship. Look forward to working with you and senator blumenthal as you continue to provide great leadership that this committee has had the last several years. The v.a.'s state veterans home program is a great resource for many senior veterans, including those in arkansas.
▶ 1:32:46Sen. Boozman: The location does an excellent work caring for senior veterans in arkansas but needs of goods to continue to provide their levels of care expected. In fiscal year 24, the facility was ranked number 12 on the home construction grant program priority list after being ranked number nine in fiscal year 23. Unfortunately, the facility will not receive the necessary funding in fiscal year 24.
▶ 1:33:14Sen. Boozman: We worked with the current administration to get the necessary upgrades to the facility. Do I have your commitment that the v.a. Under your leadership will continue working with us on the issue?
▶ 1:33:25Mr. Collins: Senator, thank you. I think this is important. You and I discussed it. We will work with you and the appropriators and this committee to make sure the priorities expressed will be taken care of and work with you to do those as we go forward because at the end of the day, especially what you just brought up, as one of the more critical things with the end-of-life issues we deal with, the later stage issues where more care is needed. Making sure that you have the states across this country and the v.a.
▶ 1:33:53Mr. Collins: Providing that care is frankly something a nonnegotiable. I spent many times in those long-term care facilities. It was humbling and also very critical to understanding so we will work to do what we can to make sure every deed is met. We will not always be able to say here is the answer you want to hear.
▶ 1:34:20Sen. Boozman: Thank you. I am very proud of the committee's work to pass the pact act, which now provides long-overdue care for veterans dealing with the effects of toxic exposure. The v.a. Efforts to reach those impacted and get them support has been great but I remain concerned about the v.a.'s management of the toxic exposure fund and overall budget outlook.
▶ 1:34:50Sen. Boozman: How will you make sure the v.a. 's toxic exposure fund remains viable for years to come while providing the level of care veterans have earned?
▶ 1:35:00Mr. Collins: Thank you, senator. The care is the biggest issue coming out of the pact act and the work we have had. 700,000 new people brought into the system and even more coming. I think the biggest thing we have to do is look at what was passed. You and I spoke about this in your office. Are we at the v.a.
▶ 1:35:23Mr. Collins: Making sure we are getting good information and doing what the intent of the law wasn't so they can continue to get those benefits? That comes from the resources that come to us from this body so I will be looking at it and coming to you with real-world examples. One of the things as I made the comment earlier about our legislative affairs and making sure we are on the hill with that is another commitment I had because I sat where you sent and had questions of an ministrations in the past. Get good information.
▶ 1:35:55Mr. Collins: And you have a commitment from me that when you get information about how we are funding and appropriating that, whoever sits at this table, myself or any other person who comes to the v.a. Will give you good information and numbers so we are not like we were last fall with a number of billions and then goes down and that was not used. We will do that in addition to making sure we are getting good accurate numbers so we can inflate the intent of these acts.
▶ 1:36:26Mr. Collins: The elizabeth knoll act is going to be one I want to make sure we do properly. Under the trump administration with the blue water navy and the mission act was put into play, there were times set in so it could be done properly. Sometimes the great ideas are at the wrong time or not in the best way. You have to make sure you have the great idea done properly.
▶ 1:36:48Sen. Boozman: Very good. Just say again, you served, you were a great member in the house. You understand how important it is what we need information, when we need to talk to you or somebody of importance, it is so frustrating. You have a hearing and who send letters, and the last letters have not been answered.
▶ 1:37:13Sen. Boozman: Just say again very briefly because my time is up and I think it is one of the most important things we can talk about today, how important it is to again be such that you are in constant touch with the members.
▶ 1:37:28Mr. Collins: Thank you for highlighting what I believe will be one of the biggest differences if confirmed by this body at the v.a. In the early stages, the involvement of our legislative affairs on this hill. I am committed to having 535 if you would can it was in a coal mine who can help us and went together to see where there are problems and issues. Not just in policy and funding but also in the actual veteran constituency.
▶ 1:37:58Mr. Collins: Because when I hear from you, and as the chair and I talked, when we hear from the veterans, that is what we hear in home depot and kroger when we are walking around. I want to know where the problems are because I am not a secretary if confirmed that will sit behind a desk. I will be out there and making sure we get it fixed.
▶ 1:38:15Sen. Boozman: Thank you.
▶ 1:38:18Sen. Gallego: Thank you for joining us today, and congratulations on your nomination. This is very personal to me also being a marine iraq veteran, someone who has used v.a. Healthcare services and also receives a disability rating from them, making sure the v.a. Continues to be foremost taking care of our veterans is important to me, especially in arizona. A couple questions on focus.
▶ 1:38:48Sen. Gallego: So the be connected program began as an arizona veteran suicide prevention program and grown to serve the state population by connecting them with mental health resources which sometimes cannot be met within the hospital system. It receives one third of funding and two thirds from the state. The phoenix v.a.
▶ 1:39:13Sen. Gallego: Recently sent and no longer intends to end their into another contract with the program and will stop funding on march 31 due to budget constraints. If confirmed, will you commit to work with me and the other members of the arizona delegation to ensure v.a. Finds alter your -- finds other sources of funding to make sure they received critical services through the program?
▶ 1:39:34Mr. Collins: Yes, senator. It is good to see you in good to see you all here in your seat. We served together. We know that issue coming back from iraq and that transition has been mentioned many times before. It concerns me. I will say what you are bringing up right now, it concerns me that as a v.a.
▶ 1:39:54Mr. Collins: There are concerns about funding a program that actually goes to one of my major concerns, and that is the issue of death by suicide or even taking it to a homelessness issue as well. Those are the kinds of programs that I think our priorities. From my perspective as secretary, it will be about priorities, and what we are seeing today, 17 people not with us anymore, not satisfactory. Over 40,000 or more in homelessness, nonsense factory.
▶ 1:40:26Mr. Collins: A 5000 waiting list in alaska is not satisfactory. Budget items will match up to the priorities I have and I look forward to working with you and getting more information on that issue.
▶ 1:40:33Sen. Gallego: Thank you. Focusing, moving onto the hud program, something important in terms of reducing homeless veterans. We did see a growth in homeless veterans increase from 2022 to 2023, which is for a variety of reasons not just the program. The rental assistance through vouchers targeted at veterans specifically.
▶ 1:41:01Sen. Gallego: If confirmed, what would you do to support the program, increase collaboration between the v.a. And hud?
▶ 1:41:09Mr. Collins: That is something we talked about in the office that is very important because when we look at the areas of disability, we are looking at these and is it enough to provide people the resources to have a home? For me, I will look at the issue of homelessness not just as a v.a. Issue but across the spectrum with hud and any other department we can to make sure that this is something that is not the dark spot on a veteran's service where we have homelessness.
▶ 1:41:39Mr. Collins: I am willing to take whatever we can in the v.a. And outside the v.a. We will have a lot of conversations about this.
▶ 1:41:50Sen. Gallego: You and I talked about this in my office, coaching can help veterans make progress towards health, reduce stress, improve quality of life, and overall bring down the long-term costs for the v.a. Because you have healthier veterans at a younger age and you have healthy veterans at an older age. There are approximately 20,000 to 30,000 health and wellness coach encounters where they have 20,000, 30,000 encounters per month.
▶ 1:42:20Sen. Gallego: The number is expected to increase as veterans demand more coaching when it comes to life and health. As we discussed in our meeting, the v.a. Has serious health coaching vacancies. If confirmed, what would you do to safely remove current barriers to health care professionals interested in becoming health coaches with the v.a.?
▶ 1:42:38Mr. Collins: As we discussed, that is one of the issues I saw and we both saw it in the senate . Why are the regulations keeping us from getting the help we need? That is what I want to take a look at. We will look at this and say, why is getting from ato -- frmo om -- can we remove c and go a, b, d?
▶ 1:43:09Mr. Collins: At the bottom line for me, it will always be about helping the veteran get the help they need in all areas of their life. If we don't do that, we are making a mistake and missing the mark. You and I have seen that unfortunately firsthand. As someone who counseled with those who thought about taking their life, those are serious issues and we have to have every help we can.
▶ 1:43:28Sen. Gallego: Thank you.
▶ 1:43:29Chair Moran: Thank you and welcome to the committee. Thank you for wanting to take this on. The largest health care system in the world. We have a lot of people tackle this job at it is a hard job that is very important. I grew up in a military family and been to many v.a.'s.
▶ 1:43:53Chair Moran: We have some good ones in alabama, but it is amazing to me that we look at this and it is the second largest budget we have in our congress. Second largest behind the dod. It is really not about money. I think about looking at all of this in a different perspective sometimes. It is about people running what you have. We are run by unions.
▶ 1:44:22Chair Moran: Thereby obviously some good and some bad. But we have to find the problem because we have more and more of our veterans adding up. We have almost 500,000 in the state of alabama alone. It is a big problem that we can't take care of all of them. When I first got here and got on this committee four years ago, one of the first things we did, president trump had eliminated 4000 people. He did not care what they were in.
▶ 1:44:50Chair Moran: If they didn't do their job, he sent them out the door. The biden administration came in and the first thing they did was rehired them and back pay and put them in a situation where a lot of them had really breached protocol. Now, I come from a previous profession if you did not do right, you were gone.
▶ 1:45:17Chair Moran: Will you commit to doing what is right for the veteran when it comes to the personnel that are handling these people? We can talk about acts and laws and bills but it will not make a bit of good unless we get the people running these v.a.'s and these homes that take care of our veterans where we don't get the best. Will you commit to that?
▶ 1:45:39Mr. Collins: Senator, thank you for that. Not just your profession but every profession in the world expect accountability and that is what raises the standard, so yes, we will have account ability. The v.a. Passed unanimously out of the senate, intended to make sure the workers not fulfilling their mission were not going to take a job anymore. I intend to make sure this is a promise that I have.
▶ 1:46:09Mr. Collins: If there is someone who is harming or in the way of our veteran, I have no problem in getting rid of that person and making sure we do it properly. I have no problem with the legal repercussions of that because there is no way anybody in the v.a. Will stand in the way. We are not doing it safely and we are putting our veterans in harm's way. I will be the biggest cheerleader for every v.a.
▶ 1:46:37Mr. Collins: Employee out there who is out there getting up every morning, doing it right, making sure we are taking care of our veterans. I believe the only way I can make them better, the only way I can push them is to not allow those not to do it, so we have to have that accountability. This body passed unanimously. It is about raising standards and saying we will expect the best and require the best. If I want to retain doctors, nurses, benefits, you have to set a standard that says I am proud to be here.
▶ 1:47:06Mr. Collins: For me, I want to lead an agency that works and puts our veterans first and hold accountable those that have not.
▶ 1:47:11Sen. Tuberville: In 2023, it was reported to us some of our v.a. 's, especially community care systems, refunding illegal aliens. Health care. Would you please look into that once you take this office?
▶ 1:47:30Mr. Collins: Yes, senator, I will. I don't believe anybody taken outside the mission of the v.a. Is worthy of the cause appropriated for the veteran. We will not be doing that.
▶ 1:47:43Sen. Tuberville: We were given a budget shortfall last july. We were called and told by the administration we are $3 billion short and we had come up with a very, very quickly or we were going to default. In the v.a., you can imagine how frustrated we all got when we found out we had a surplus. I would hope that we take better care of what we do with our money and we know where it is at.
▶ 1:48:11Sen. Tuberville: Also, one thing I know before I go off and I did not get a chance to talk to you about this one we met. Electronic health care. Nobody has told you this, $20 billion on updating our v.a.'s health care records over the last decade. The deferment defense completed their update the v.a. Has nothing to show for the $20 billion. Houston, we have a problem.
▶ 1:48:37Mr. Collins: Houston, atlanta, D.C., everywhere else, we have a problem. That is not acceptable. That is one of the things as we said earlier we will have to get into very quickly, put every player on the table to make sure we are getting it right from the v.a. Perspective and from the oracle perspective. V.a. And dod are very different. We are special but not unique. What we want to do can be done and there are special ways to look at it. Let's do what we can do.
▶ 1:49:07Mr. Collins: We will get it right. Even up here, eight years and that much money and no results, only five places still, not accountable.
▶ 1:49:17Sen. Sanders: Congratulations on your new position. The job you have been nominated for is an impossibly difficult job. I just want to say for the record that I think you gentlemen who came before you has done a very good job in the context of what he had to deal with. Mr.
▶ 1:49:47Sen. Sanders: Collins, in two independent assessments last year, the v.a. Outperformed non-v.a. Hospitals in terms of patient satisfaction and hospital quality. I can tell you that in vermont you talk to the average veteran who accesses the v.a. And they say that care is pretty good.
▶ 1:50:08Sen. Sanders: I think that is probably true in most spots in the country, and that takes place within a health care system which is broken, a private health care system which is largely broken and dysfunctional. It strikes me from what I have heard, there are three approaches to the v.a. There are some folks, extremists come think get rid of the v.a. Completely. Send veterans out into the private sector.
▶ 1:50:36Sen. Sanders: Others including the nominee for defense secretary who have indicated that the v.a. Should be there for specialized care, people with ptsd, people with amputations, the kind of problems veterans have come a specialized care. And there are those of us including myself think that when people are asked to put their lives on the line to defend this country, all veterans are entitled to all the health care that they need. That is my view. Where do you come out on that?
▶ 1:51:06Mr. Collins: Senator, it was going to sit in the office and talk to you, especially with the perspective you have. I have said this before and said to this committee early on, there will always be a v.a. For the veteran. I think what we will do is make sure the v.a. Centers that are stronger can get better but also I have states and other senators that have a facility that is doing well and another that is not. We cannot paint with a broad stroke.
▶ 1:51:34Mr. Collins: Even on the private sector that you mentioned, to say any one in particular is the will for all. I am for making sure we have it.
▶ 1:51:42Sen. Sanders: Ok, here is the problem. There is a limited amount of money. Community care spending went from $8 billion in 2014 to $31 billion in 2024. Ideally what we can say is you are a veteran, want to go to private care, no problem. We have a strong v.a. Don't have enough money to do that.
▶ 1:52:07Sen. Sanders: So in fact, what the debate comes down to is not whether somebody should be able to access community care, but where will we put our resources? Are we going to allow the v.a. To wither on the vine so to speak? Do you understand where I'm coming from? Are you willing to tell us you will fight for a strong v.a. In every state in this country?
▶ 1:52:32Mr. Collins: Senator, that is a nonnegotiable. We will fight for a strong v.a. I understand your perspective. I understand your perspective, but I also stand the will of the body and the law and veterans today. I believe you can have both. I believe you have a strong v.a. As it currently exists and the community care aspect.
▶ 1:52:54Sen. Sanders: Ok. Vermont tissue. You are inheriting an incredible bureaucracy that is very slow-moving at times. There are two in the vermont area. One in our most populated area, one in the southern part of the state in the new hampshire area. King, new hampshire. Access to vermont and new hampshire veterans. It has been moving along rather slowly.
▶ 1:53:23Sen. Sanders: Will you assure me you will take a hard look to make sure they get moving rapidly?
▶ 1:53:27Mr. Collins: Yes, senator. Those are issues we have to look at and make sure the money and the priority is there.
▶ 1:53:34Sen. Sanders: It is not just the v.a. The v.a. Works with the gsa.
▶ 1:53:40Mr. Collins: I understand.
▶ 1:53:41Sen. Sanders: And it is a problem. Ok? Take a hard look at that one. There are massive staff shortages in the v.a. I am concerned about the hiring freeze that president trump has initiated. Will you stand up publicly and say, you know what? We need every health care, every v.a.
▶ 1:54:06Sen. Sanders: Health facility in this country to be adequately staffed, we will not accept staff shortages, and make sure we have the people that we need?
▶ 1:54:15Mr. Collins: I will advocate to make sure our veterans are taken care of and also support the fact that we will take a look at the current levels of employees we have and where they are properly located at look at that. We will work under the executive order the president has given.
▶ 1:54:32Sen. Sanders: There is waste in the v.a. And every other government agency. The v.a. In my view does an excellent job. They need the support. You want to go after waste and inefficiencies, do it, but make sure we have the quality of doctors, nurses, staffing we need to take care of every veteran in this country.
▶ 1:54:52Mr. Collins: Thank you, senator.
▶ 1:54:54Chair Moran: Senator tillis.
▶ 1:54:56Sen. Tillis: Thank,, Mr. chairman. Mr. collins, thank you for being here. You and I have a lot in common. We were both born in august, both entered state legislature at the same time in 2007 in two different states, and you have a sister born in the same hospital both of my babies were born in. All right?
▶ 1:55:23Sen. Tillis: You also have the benefit of me tracking since I lived in atlanta for four years, tracking. You were a very good, solid, reasonable congressman so I know all I need to know about supporting your nomination. I know you have said multiple times you will not privatize the v.a. You are not forcing veterans out. You have done that.
▶ 1:55:50Sen. Tillis: I think you were sworn in and testimony but would you do a pinky swear that you will not privatize the v.a.? Here we go. Ok, good. Pinky swear. The reason that is important is not everybody, I think senator sanders is genuine in his concerns, but folks, there is no -- let me say again what I have said every time privatization and forcing veterans out of the v.a.
▶ 1:56:15Sen. Tillis: To seek private care, there is no serious discussion among lawmakers to do that. By serious discussion, I mean that could ever see the light of day. I have very few skills. One of them is counting votes. There is simply not enough to even consider it a threat. The reason why I hit this head on it is there are veterans who could be led to believe that is a risk. It is not a risk.
▶ 1:56:46Sen. Tillis: You don't have to come to washington because a vote is imminent. The v.a. Is the largest telco system in the united states. It does a lot of things good, and in a lot of cases it does better than the private care providers can imagine because of the unique status it has in many cases veterans serving veterans. So again, thank you for that pinky swear. Now let's move onto the unpleasant part of my discussion. It has nothing to do with you. I have supported every v.a.
▶ 1:57:16Sen. Tillis: Nominee who has come before this committee. And I supported the secretary of the v.a. When I came in and the obama administration. I have had a great working relationship including with secretary mcdonough. I have concerns, even some that date back to v.a. Secretary wilkie who was my mla before he went on to be a v.a. Secretary. The input magician of the electronic health record is a bipartisan multi-administration disaster.
▶ 1:57:45Sen. Tillis: There is no way on god's green earth we should have spent $10 billion to have only a fraction even touched. Do I have your commitment to go through that program, to quickly get it moving again, and get an integrated health chart that also can integrate with the dod so we can finally have a seamless transition from active status or reserve status to veteran status and provide premium care at the v.a.?
▶ 1:58:16Mr. Collins: Yes, senator. What you just said about seamless care, a safety and security issue for the veterans.
▶ 1:58:24Sen. Tillis: It absolutely is. The electronic health record, I have a real problem. We need to have a review. I don't know if it is an inspector general's report or something else, but I did large-scale systems implementation for the vast majority of my career. I have done that more than being a U.S. senator or state representative. This is a disaster.
▶ 1:58:50Sen. Tillis: And I would like the people involved, not only the contractors, but having been the contractor before, my guess is it is rooted in bureaucracy and people responsible for the implementation within the v.a. Not doing it right. Would you commit to me to doing a project review?
▶ 1:59:10Mr. Collins: We are looking forward to the project review. For me first looking at it, I am putting out a notice today that I am committed to everyone here we will bring everyone to the table. That is vendor, v.a., everybody in the middle to figure out what this problem is because it is time to fix it.
▶ 1:59:30Sen. Tillis: I would have to be at the table when you have some of those discussions to be honest with and lend you some free consulting advice. Last thing I want to leave you with because I say it in most hearings, I did not vote for the pact act.
▶ 1:59:44Sen. Tillis: In spite of the fact that my office was responsible for the formulation of what was in the bill to provide care to warriors who were exposed to toxins, and also the camp lejeune toxins act which senator sullivan has been trying to work to reduce the compensation. I did not vote for it because I was absolutely convinced it will be where it is today.
▶ 2:00:08Sen. Tillis: It is a $700 billion between mandatory and discretionary spending unfunded bill that got out of the oven too soon. And now we know you have shortfalls you will have to fix and the billions of dollars because we did not take the time to actually get the pact act right. I hated not being able to vote for that bill, but I voted against it because we promised out of this committee we would fix it before it got a vote on the floor.
▶ 2:00:37Sen. Tillis: Now we have to fix it and you can count as someone that will be helpful.
▶ 2:00:42Mr. Collins: Thank you because that will be one of the issues we will first have to tackle. Also I will say to the committee and we talked about this in many of your offices, I am looking ahead to the elizabeth no act and the implementation. It is something we have to take care of but it has an implementation cost as well.
▶ 2:01:02Sen. Hassan: Thank you, Mr. chair, and congratulations on your chairmanship. I look forward to working with you and making member blumenthal. Cox mike collins, it is good to see you. It was good to sit down with you the other day. Congratulations on your nomination. Thank you for your service to our nation and your family as well for the sacrifices because we know what an individual serves, the whole family service. I welcome them here today as well.
▶ 2:01:29Sen. Hassan: One quick comment to follow up on what senator slotkin was asking you about. I appreciated your expression that you would be willing to let the president know or anybody else in the administration know if you thought budget cuts would hurt service to veterans.
▶ 2:01:46Sen. Hassan: I will just say having done this work at the state level and now here, it is something for people in your position to tell their bosses whatever budget you give me, we will get the job done because that is what you want to be able to do, but cutting direct care people in a health care system, cutting people who coordinate care so veterans can get integrated care can really, really harm veterans.
▶ 2:02:13Sen. Hassan: I will hold you to your statement that you will stand up for veterans in the budget discussions because it will be real important.
▶ 2:02:20Mr. Collins: Thank you, senator, on that question, because it is true. There is only limited dollars. There are consequences. There is a big fault on capitol hill that we vote on ideas. We don't vote on ideas. We vote on words on paper and that costs money, so I will stand up. The president has made it very clear to take care of veterans.
▶ 2:02:45Mr. Collins: As we look for efficiencies and things to other agencies, I will say here is the cost benefit of that and move forward and make sure we take care of the betterment.
▶ 2:02:53Sen. Hassan: I appreciate that. I will move onto a topic senator sullivan touched on. President trump supported a full-service v.a. Hospital in new hampshire. I supported one in our state for years and will gladly work with you and the president to make that happen. In the meantime, the current manchester v.a. Medical center is almost 75 years old and it needs significant upgrades. The facility's age is showing.
▶ 2:03:22Sen. Hassan: Twice over the past eight years, pipes have breast, temporarily closing parts of the medical center -- the pipes have burst, temporarily closing parts of the medical center. Temporarily meeting months. Terrible. The v.a. Has begun implementing a multiyear upgrade plan. Will you commit to continuing these upgrades to make sure that granite state veterans have the best possible medical facility to receive their care at?
▶ 2:03:52Sen. Hassan: Will you come to new hampshire to visit the facility and meet our veterans?
▶ 2:03:55Mr. Collins: I will take the last one first. Yes.
▶ 2:03:58Sen. Hassan: Good.
▶ 2:03:59Mr. Collins: Not only granite state veterans but all across the country, they will be taken care of. The infrastructure needs, I am glad we are talking about them today because it is not just the new facilities but taking these older facilities once they are shut down, and the bureaucratic process to get it fixed. With president trump's commitment, I am going to support the president. We will look to that hospital.
▶ 2:04:25Mr. Collins: You brought up a bigger issue that I hope all of the committee members will understand. I wish as I said before we could have the rose-colored pixie dust but construction issues will be one of our hardest because of the aging facilities.
▶ 2:04:38Sen. Hassan: Thank you. Let's talk about rural veterans. They face several challenges in accessing v.a. Health care. For example, they have to travel long distances to access their v.a. Health care facilities and that usually means they will want to schedule multiple appointment on the same date so they don't have to do all the travel back and forth. Unfortunately, some v.a.
▶ 2:04:59Sen. Hassan: Medical appoints can only be scheduled by calling the individual clinic directory, meaning betterment often have to make several calls to multiple disconnected offices just to try to coordinate and schedule their appointments. They schedule one and call back the other to find out a slot they thought they had is gone. That is why senator boozman and I introduced the act which would require the v.a.
▶ 2:05:22Sen. Hassan: To create a streamlined scheduling system where veterans can either call or go online to view and schedule appointments for all of their v.a. Health care. Congressman collins, will you support this effort and work with me and senator boozman to pass this bill and implement exchange to help veterans?
▶ 2:05:40Mr. Collins: I look forward to seeing that and looking into it further but from a can stage from that from a conceptual standpoint for me, why have we not gotten that? I am not here to reduce appointment times but when you can send five people's food to five different places at one time on your phone, why can I not go to one place? For our older veterans, it is different.
▶ 2:06:09Mr. Collins: For the rest of them, pick up the phone. I get my three appointments and be done with it.
▶ 2:06:14Sen. Hassan: I thank you Mr. chair and will follow-up in writing with you on the last question I wanted to talk about, which is the limitation of the dole act. Home care is incredibly important. It should be the way of the future because most people want to age at home or get the care if they have chronic care or disabilities at home. Something near and dear to my heart and the heart of veterans.
▶ 2:06:37Mr. Collins: Just briefly come I want to be real brief, that is something I am very proud of what you have accomplished, the limitation to make sure we are doing it right.
▶ 2:06:46Sen. Hassan: Thank you.
▶ 2:06:49Chair Moran: Senator cassidy.
▶ 2:06:50Sen. Cassidy: Councilman collins, great job on the chair. You will be a five of the secretary of the v.a.. An you have my support -- the v.a., and you have my support. You are a georgia bulldog fan but that is ok.
▶ 2:07:09Mr. Collins: Go, bulldogs.
▶ 2:07:12Sen. Cassidy: I have been concerned because there is such a backlog in terms of people applying for v.a. Disability benefits from whatever program there is. It just did not happen and when it finally happens, sometimes a person is dead. When I speak to people and read about the use of artificial intelligence, so much as it is the perfect bureaucrat.
▶ 2:07:36Sen. Cassidy: Once you set all of the facts, it can process in a tremendous amount of information next to instantaneously and come up with the same decision based on the same sent a fax over and over again. But I also learned it is only something that happens if you lead into it. If you say that is great and we will get it when it happens, it never happens.
▶ 2:07:58Sen. Cassidy: If you say we are going to set up a system in which we read team it and will compare into our best reviewers, we are going to then compare the best reviewers to the ai, whichever is different we will figure out why it is different, and if the ai is not as good, we will continue to refine it until we can scale it and a betterment does not need to wait for his or her benefits. What do you think about that?
▶ 2:08:23Mr. Collins: I wish it was not being presented as such a novel concept because it is true. We can do that. Why are we not using ai and the benefits of I.t. Especially on the benefit perspective and take the ones that are "easy" that we can get out of the way so we can be hands-on with those that are a little more difficult? Here are some numbers I am sure you are familiar with and I am proud of.
▶ 2:08:53Mr. Collins: Under president trump and the previous administration, the backlog of benefits cases got down to 65,000 I believe. In the past four years, there have been 130,000 -- 130 billion added and there is a 265,000 backlog. We went up with everything else. What are we not able to get out some of these better and better ways? That means efficiency, looking at ai.
▶ 2:09:29Mr. Collins: We will have to do the red team approach as you worded it. I would look for every way I can make it better. Why would I be satisfied for a system that is old and outdated or nonexistent when my goal and purpose and mission is to take care of veterans?
▶ 2:09:44Sen. Cassidy: Let me suggest because one thing that happens here is the agency says give us the money and we will come up with the system. Two years later, two years later until you finally pull the plug. Somebody once said you should go out and say we want the system at least to be run on a pilot method within six months because what you are getting is people who already know how to do it
▶ 2:10:15Sen. Cassidy: And they are already doing it in one form and adapting their system to yours. I would suggest we work as a team and come up with something that says you have six months to do it and then we will do it. If we see veterans waiting forever to get their stuff getting it quickly and appropriately, not too much or too little, we can take it to scale. But other agencies have taken the money and taken the money and it became a black hole. Thoughts about that?
▶ 2:10:44Mr. Collins: My mainmr.
▶ 2:10:46Collins: Thought about that is they do not understand how we do appropriations. They don't understand how we spend money up here. They don't get to do that at home with their own money. When we tell them we are spending money but show nothing for it, that is something that is a foreign concept. It is fostering the distrust we see. For me, setting deadlines is the only way you get things done.
▶ 2:11:12Collins: Setting deadlines and appropriate metrics and measures are the only ways to get it done. I will say here is the defining aspect of a we have been given let's use the best results, processes, the employees we have, and the best people.
▶ 2:11:23Sen. Cassidy: I like that. Here is a chunk of money. If you can show you can do it, we will make it to scale or we will pull it. Thank you.
▶ 2:11:34Chair Moran: Thank you. Senator duckworth.
▶ 2:11:38Sen. Duckworth: Thank, Mr. chairman. Congratulations on your chairmanship. Good to be on another committee with you. Congressman, welcome. I really enjoyed our conversation. I am not going to speak further on privatization of the v.a. And my opposition to it. You know. I think you would agree the v.a.
▶ 2:12:02Sen. Duckworth: Is suited to provide care and it would create a significant challenge or veteran care would be outsourced to providers not equipped with specialized training.
▶ 2:12:14Mr. Collins: Again, it was good to talk to you. You will not believe how many times I used our conversation. Of course. When you look at this issue, the v.a. Is uniquely positioned to deal with betterments and has the data that can provide not only help for veterans currently in the system but even outside the system, using that data to help others outside. We have a unique control group.
▶ 2:12:43Mr. Collins: I think it is something we can definitely continue to work on. As I said before, there will always be a health care center for those veterans who come home.
▶ 2:12:50Sen. Duckworth: Just keep the v.a. Veteran center home and if they need specialized treatment they could go somewhere else. As long as we know what is happening and we keep track, that is important.
▶ 2:13:02Mr. Collins: As long as we do it efficiently, that is veterans coming which are a large population of our veterans, making sure that if care, depenn discussion, lack of mammogram equipment. Large v.a.'s who satisfy a large number of female veterans are having to do that.
▶ 2:13:32Mr. Collins: I think working both ways is where we need to be. >> I think what is the best medical treatment is where we need to go. In the case of mammograms, you need somebody who reads thousands of mammograms and if you only take a small amount of female veterans, I would not want mine read by someone who only reads 100 per year as a partner organization that reads thousands of mammograms.
▶ 2:14:02Mr. Collins: I will jump ahead of you. It goes back to your discussion we had in the office about the rural hospital issue. You made a very good point. I will take it a step further. It is the sharpening of skills. For those of us who have been to iraq and afghanistan, we saw trauma and emergency care at its finest. If they came to the hero's highway, 98% of those made it back alive.
▶ 2:14:31Mr. Collins: There were some in year one who did not but they got back home and I remember a time that I sat with a young man, I prayed with him. I will never forget him because he had blonde hair and blue eyes. I went back later that evening and he was gone. They had already put him on a plane. I looked at the stars and stripes and I saw his picture. I was comforted by knowing that he was back home he passed. That is the sharpening of skills and in the v.a.
▶ 2:14:59Mr. Collins: We need to make sure our veterans are getting the same treatment so that our skills and their treatment are matching. >> if confirmed, will you commit to working with this committee to refine the policies that improve wait times and access to v.a. Healthcare?
▶ 2:15:17Mr. Collins: That is what we are looking at right now. The v.a. Healthcare system goes back to the service of the veteran. I will say it again. When they have to call my office when I was in congress, that is a failure from the v.a.. It is not a failure on the people so do not try to twist what I'm saying. The v.a. Has a mission to take care of veterans. If the veterans cannot get that care then we need to answer why.
▶ 2:15:49Mr. Collins: Trimming down wait times because of some of the things we could be missing are there preventive care that can help us long-term in a cost perspective if we are catching it early. >> I am glad you mentioned preventative care. Right now healthcare is something that patients in the affordable care act do not have to pay for preventative care.
▶ 2:16:12Mr. Collins: Your prostate cancer screening, mammograms, colon cancer screening, you do not pay a co-pay for that but veterans do. Will you support to ensure that v.a. Coverage aligns without a commercial healthcare and tricare and help me eliminate the co-pays for veterans?
▶ 2:16:32Mr. Collins: I look forward to working with his committee on that. The preventative aspect of that is very important. >> senator blackburn. >> thank you Mr. chairman. Always good to see you. I appreciate that. As we served in the house, you were known as being a consensus builder and problem solver. As we look at the v.a.
▶ 2:16:57Mr. Collins: And the situation that is there, we need someone that can build consensus among the employees and solve some problems that are existing in the v.a.. You made a comment that it was important to get the right people in doing the right job. I agree with that.
▶ 2:17:26Mr. Collins: As we have been overseeing the v.a., something that has been a consistent problem is the return to work policy and the lack of individuals who are working full-time at one point at a v.a. Benefit they were only required to work in person two out of 10 days.
▶ 2:17:53Mr. Collins: Then in healthcare they had to work in person five out of the 10 days. That is a problem. I fully believe that is why the backlog as you mentioned, that long-term backlog is 260 5000. If you put those who are under 120 days on that list, you are at 956,000.
▶ 2:18:22Mr. Collins: This is because people don't go to work. Where are you on that and having that return to work policy?
▶ 2:18:31Mr. Collins: Thank you. It is good to see you. Good to see you as we have worked together many times. I do pride myself about the stuff that we worked on bipartisan using the modernization act. We have to work together on this. People need to come to work. The president made that very clear. People need to come to work. There are certain issues in times before. We had a large portion of the v.a. Workforce unionized.
▶ 2:19:00Mr. Collins: >> what percentage of those employees are union?
▶ 2:19:03Mr. Collins: Approximately 80% of 470,000. Some of them are in telework agreements. We will follow the president's directive and make sure we get people there. My hospital employees, they have to show up every day. >> that is encouraging because we have talked about the health records and the e.h.r.s.
▶ 2:19:30Mr. Collins: And the $15 billion that has been spent on that not to have those records. The way there is no transfer of data from d.o.d. To the v.a. On those health records. This is a problem we can fix. We've got a lot of good I.t. Experts in nashville that could fix this.
▶ 2:20:01Mr. Collins: When they hear from people that are in the v.a. System about they cannot get care, the wait times, we have talked about the backlog. At the fort campbell facility, the way to get a primary care appointment today and we just checked our numbers is 81 days. In chattanooga, it is 110 days. In murphreesboro it is 54 days.
▶ 2:20:32Mr. Collins: That is unacceptable. If people are going to not show up to work, if they are beholden to the union and say that it is about them and not about the vet , that is something that is completely unacceptable and it is one of the reasons why we need to strengthen community care.
▶ 2:20:54Mr. Collins: The suicide rate, 34.7 individuals per 100,000 of our veterans that choose suicide. The mental health components and having that community care where they can access it in their community without having to travel, having an e.h.r. That they are carrying with them to the doctor, that will be helpful.
▶ 2:21:20Mr. Collins: You have hit a multitude of things that are all important to the union aspect and that is the health, safety and wellness of our veteran. The record system, there is no where else we can point to. If a doctor walked out and decided to take a job in the private sector, guess what they will find? Electronic healthcare records.
▶ 2:21:43Mr. Collins: The system that we currently use is still f1, f2 which is unacceptable. I believe in the workforce and I believe the employees at the v.a. Are very valuable and I respect that. Years ago, five years in the food and commercial zillion when I was in the grocery store. I get the issue. We need to make a way for people to not only be employees but at the end of the day it is not about the v.a..
▶ 2:22:14Mr. Collins: It is about the vet. >> that is exactly right. Thank you Mr. chairman. >> we will have a brief second round. I will turn to senator blumenthal to begin that but I want to ask unanimous consent to add to the hearing record letters of support for conrgessman collins recommendation that come from the wooden warriors -- wounded warriors project, america first
▶ 2:22:46Mr. Collins: Vets, national defense committee, mission roll call, burn pits 360, military order of the purple heart, and the valor mission project. Without objection, those letters of support are entered into the record. Senator blumenthal, I recognize you for five minutes. >> thanks, Mr. chairman. As we were talking earlier, last night the white house issued various executive orders.
▶ 2:23:16Mr. Collins: Some of them dealt with the federal hiring freeze, and other issues. We are still reviewing them in my office. The issue of a workforce hiring freeze memorandum claims that it will not "adversely impact their provision of social security, medicare or veterans benefits."
▶ 2:23:46Mr. Collins: I would like to know from you what does that mean in practical terms about the employees who deliver veterans healthcare or work in cemeteries? Does this language exempt all of the v.a.'s positions from the hiring freeze?
▶ 2:24:05Mr. Collins: We are still examining that. We support the president's initiative but also as far as what it says, I will take it from the words on the paper. We have people doing those benefits packages right now. We have people working on that. The application would be that adding more people would fix whatever the problem is.
▶ 2:24:26Mr. Collins: I am convinced that the workers and the benefits we need to make -- >> that is not reassuring to me because I am asking not about the v.a. Employees who work on benefits. I am asking about the folks who are in the hospitals, in the care facilities, at the cemeteries. They are not dispersing benefits. They are providing care.
▶ 2:25:05Mr. Collins: There are openings right now. Exquisite language of that memorandum seems to include them in the hiring freeze.
▶ 2:25:14Mr. Collins: Going by the way you worded it, the hiring freeze and the wording that you used and I do not have this in front of me. We are still examining that as well. I can assure you president trump in his executive order is to get an assessment on where we are and not to take away from anything that is currently they are in the future. Your question is implying that they would not be there to do the veterans healthcare.
▶ 2:25:46Mr. Collins: That is going to continue. This hiring freeze is not there and we may not bring in a new person unless we need it but this is where we are. What he has done is to get an assessment on where we are. >> we are treating a lot of words. Let me come right to the point.
▶ 2:26:03Mr. Collins: I am asking you to fight to fill the openings, not a hiring freeze, in the ranks of the doctors, the nurses, the attendance, everyone who works in care facilities or veterans cemeteries rather than leaving those positions open because those folks are needed to care for veterans.
▶ 2:26:29Mr. Collins: Will you seek an exemption to the hiring freeze for those positions that concern veterans care including the veterans crisis line?
▶ 2:26:42Mr. Collins: I will take everything you have said into consideration. I will be willing to make sure there is nothing missing in the process. I think we are saying the same things. >> no, we are not. This is going to be the first test of your leadership.
▶ 2:27:04Mr. Collins: Whether you fight for an exemption from a hirin freeze for the nonveterans benefits to employees who are needed to care for veterans at medical facilities and other places including the veterans crisis line rather than have them covered that hiring freeze.
▶ 2:27:25Mr. Collins: I view this not as a test of what I will not do. It is two different assumptions. Assuming that there is an opening that there is an actual need, it makes the veteran Mr. benefits of healthcare. We are coming at it from two perspectives. There were openings yesterday. There were openings last week. This is looking to head to say where we are at this point. We are coming at this from two separate sets.
▶ 2:27:54Mr. Collins: No one from the veteran healthcare side is going to miss their healthcare provider because of this new hiring freeze. The president is doing a prudent step as he comes into office to make sure that we have a handle on what we've got going forward. I will always fight and I have told you this in your office, for what we need at our facilities. I am also not going to fight for issues in which I believe I have not had a chance to study and make sure that this issue is taken care of.
▶ 2:28:19Mr. Collins: I do not believe that this will have the impact that you are having because I think we are coming at it from two different perspectives. >> I don't want to get into an argument here. There are possible openings where they go to the westhaven facility and they say we don't need to fill that position. There are also times where the director is saying we need more nurses. We need more doctors.
▶ 2:28:51Mr. Collins: We need more mental health care. We have talked about this. You cannot provide veterans healthcare without the people, the skilled professionals to do it. I hear you saying if there is an opening, it means that we don't need somebody for that opening.
▶ 2:29:11Mr. Collins: Just a general reminder, last week secretary mcdonough could have filled those positions. He chose not to. He could not find anybody. >> he may have wanted to but it is not easy to fill those positions.
▶ 2:29:26Mr. Collins: That is why we are taking the perspective of where we are. We will work on this together. I respect what the president has done. I think it is an improvement moving forward and that healthcare will not be compromised. I support that. >> let me move on. Will you commit to expanding effort and every dollar to reach every veteran at risk of suicide including those who are not now enrolled in the v.a. System?
▶ 2:29:57Mr. Collins: That is the easiest question you have asked all day. I will do everything possible. This from my heart. There is nothing more sacred to me and my faith in god that everyone is made in the image of god and deserves life. We need to do anything we can to reach that person. As someone who has been on the other end of that line when somebody called me and said, I am ready to end it.
▶ 2:30:25Mr. Collins: I am not ready to let anybody go by because I believe in life and the grace that was given to me. >> the rate of firearm suicide is significantly higher among veterans than nonveterans. Will you commit to looking for ways that firearms-related suicides can be reduced? >> I am committed to looking at any instrumentality that takes the life of our veterans.
▶ 2:30:58Mr. Collins: >> on the issue of homelessness, is there more that can be done to prevent or regress veterans homelessness?
▶ 2:31:06Mr. Collins: There are many things that need to be done and we need to look at it from a cross government reproach -- approach. It is again how do we make the best resources with the limited funds that come from government. >> you have been asked and I think you have answered and I do not want to repeat this issue. Whether you will continue to abide by the v.a.
▶ 2:31:31Mr. Collins: Rule concerning abortion, counseling and care in cases of rape, incest, wife or health endangerment of a pregnant veteran. Will you commit that you will inform this committee if and when you begin reconsideration of the present rule?
▶ 2:31:55Mr. Collins: I will keep this committee informed. The chairman and ranking member will know of any discussions leading toward a decision. >> as you begin consideration, you will let us know?
▶ 2:32:07Mr. Collins: I will keep the committee informed of things we have going on. If confirmed,, we will see what we got when we get there. >> I appreciate the chairman indulging this additional time -- >> despite your earlier commentary about me. >> I don't see anyone waiting. I'm sorry. I apologize to senator king. One more question.
▶ 2:32:38Mr. Collins: The pact act established the toxic exposure fund to pay for extended and expanded benefits without impacting other nondefense discretionary funding. Do you intend to advocate for undoing or altering the toxic exposure fund or would you consider it, continue it in its present form?
▶ 2:33:05Mr. Collins: I think any changes to this program, we will look at it and the intent of congress will be carried out. There is discretion with the funding issues and we will look at that going forward. At this point, we will see where we are at because there is a concern that we made proper implementation. We have another program on top of it that I promised to commit to you that we make sure we look at so that we can properly implement.
▶ 2:33:33Mr. Collins: >> just for the record, I hope that you will continue this fund because it provides for a solid source of benefits for those veterans who are suffering from disease related to toxic exposures and that you will continue the outreach program that secretary mcdonough started. >> senator king. >> thank you.
▶ 2:34:04Mr. Collins: I want to make something very clear. I don't want ai to decide if one of my veterans is entitled to the benefits they have earned, period. Go to g kapish?
▶ 2:34:19Mr. Collins: There is no veteran that will miss the benefits they have earned by the way that we process their claims. If there are better ways to process a claim and our veterans can get benefits quicker, I will look at any opportunity to get their benefits quicker. If that involves ai, then I am not willing to take it off the table. I am not willing to be in a position where ai is randomly in a situation especially with benefits and others that are more difficult. There will always be a person to oversee the process.
▶ 2:34:45Mr. Collins: >> the experience just far -- thus far with ai in insurance is not positive. I don't want our veterans to go through claims litigation in order to overturn the decision of a machine somewhere. I understand you are not willing to take it off the table. I hope it will be handled with great care because it will be very tempting to reduce staff and replace it with this technology.
▶ 2:35:14Mr. Collins: I am not confident in the technology right now to be making these life or death decisions for our veterans.
▶ 2:35:18Mr. Collins: I understand and respect your position. I view this as life or death. These are decisions that can be made at how we look at the best efficiencies. There will always be especially when it comes to the veterans benefits, someone who oversees that to make sure it is working properly. >> thank you. You will be under tremendous pressure as we move into this difficult budgetary situation. There is a lot of pressure to reduce the budget.
▶ 2:35:46Mr. Collins: It has been pointed out that the veterans administration is one of the largest pots of money in the federal government. It is very easy to focus on the bureaucracy of that term which carries with it a negative connotation. I would point out that in many cases staff cuts equal benefit cuts. If there is no one to answer the phone or if the process is delayed to the point where the veteran dies or just gives up, that is a benefit cut.
▶ 2:36:18Mr. Collins: As you are under this pressure and I believe you will be, I hope you will take care to balance necessary efficiencies against the loss of services. As you have said repeatedly, you don't want us to have to be advocating for our veterans because they have to get their benefits without having to come to a congressional office.
▶ 2:36:42Mr. Collins: If staff cuts end up having nobody to answer the phone or answer the phone only after 100 rings or say we will have to talk to you six days from now or six months from now, that will only aggravate the problem and you will be hearing from us on a daily basis instead of every other day.
▶ 2:36:59Mr. Collins: Your point is taken. The interesting question is as these very things arise right now at the staffing levels, there is more of an issue of are we doing things as efficiently and processing where we can with the current staff that we have with us. Sometimes you have to look at the process. Why is it that we are back at 250,000 backlog of benefits when we have $130 billion increased funds and 70,000 employees? Something is broken about that. >> I agree.
▶ 2:37:31Mr. Collins: I commend you for wanting to follow up on that. I have no problem with efficiency. I cannot complain about a hiring freeze. I signed a hiring freeze at my inaugural address as governor. On the other hand I think the point that senator blumenthal was making, a hiring freeze should not apply to direct care workers.
▶ 2:37:53Mr. Collins: If my hospital needs a cardiologist and it has been open for a couple of months because they are hard to find, this hiring freeze should not prohibit them from continuing to search for and find a cardiologist and sign them up. I hope you will distinguish between direct care workers and others who serve veterans behind the scenes.
▶ 2:38:13Mr. Collins: Thank you, senator. We will always make sure that no matter what the issue is, I will always fight for making sure our veterans are getting the care in the proper way that they need to. >> final point, one of the things you will have to face is increasing demands for mental health services and long-term care. Long-term care as veterans age will become a greater issue. The elizabeth toll act starts to address that.
▶ 2:38:43Mr. Collins: I commend that to your thought process and perhaps you can have people thinking about how we will provide those services that will become more and more necessary as time goes on.
▶ 2:38:52Mr. Collins: Thank you, senator. I appreciate that. Those of the things that are already keeping me up at night. I look forward to reaching out for your help on that as well. >> I commend you for your participation this morning and look forward to supporting your nomination. >> thank you very much. Let me wrap up my thoughts and questions to you. It is just miscellaneous things.
▶ 2:39:20Mr. Collins: First of all, I will tell you that we work closely with the inspector general at the department of veterans affairs. I find him valuable both to me and to this committee but should be valuable to the department of veterans affairs. Anything you want to say?
▶ 2:39:43Mr. Collins: When I was ranking member of the house judiciary this was one of the issues that we dealt with on the committee but also at the department of justice. Inspector generals play a vital role. We are not always going to agree with the outcome but we can come to a conclusion. We are always having other eyes on a situation. I am one of those who believes in grabbing a lot of input and then making a decision. If you are having input from eight inspector general that is looking out for the best way to support the v.a.
▶ 2:40:12Mr. Collins: Going forward, I look forward to working with you. >> I am not suggesting that you need to agree with the inspector general. I think that extra set of eyes in the professional way that investigation is conducted has value. It certainly gives us a greater opportunity for oversight. That same oversight is what a secretary of the department of veterans affairs should be looking for just like we do. We have a habit here of passing legislation.
▶ 2:40:42Mr. Collins: There are lots of bills that are introduced. Some of them actually become law. One of the things that I think is important for this committee to try to assure is that we don't just take the applause, the pat on the back with our veterans or veteran organizations because we introduced a piece of legislation or we passed a piece of legislation. The real goal is to make sure that the legislative efforts, that it actually benefits veterans.
▶ 2:41:11Mr. Collins: The department of veterans affairs have a lot to determine whether that is the outcome. I see it as our responsibility and the responsibility of this committee to see that the laws that we pass actually had the intended consequence that we were seeking when we decided by a majority vote in the house and a super majority vote in the senate that this is something that matters and that will make a difference in the lives of veterans.
▶ 2:41:40Mr. Collins: Implementation, I am saying this perhaps for the benefit of the committee more than you. We ought not be satisfied with the outcome of our work with the passage of a piece of legislation. I don't know that that requires any response from you.
▶ 2:41:53Mr. Collins: Could I respond to that? It goes back to the uniqueness of my qualifications for this job, being where you have been. It is easy to go around and say we passed this. I was privileged enough to have 19 red lines. I had them pass into law. Some big stuff. Criminal justice reform. I have some of my former staff here with me that I literally stand on their shoulders because they did work and the staff behind you who do good work.
▶ 2:42:25Mr. Collins: Now I am getting hopefully with the confirmation of this body being able to step into a role in which I get to see the other end. Those words on paper actually matter to me. I believe carrying that out as one of my highest callings. Working for this president who trust me it and put me in this position and what he has done before, I look forward to this opportunity. >> thank you for that response. You mentioned the staff behind us and rightfully so, you complement and highlight the value and importance of their work.
▶ 2:42:56Mr. Collins: We have staff inquiries to the department of veterans affairs go back six months with no response. We have worked with the previous staff at the v.a., the previous secretary and there was a great intent to see that the answers come. It will mean that it has to be prioritized. You have indicated earlier that you are going to be very responsive to congress.
▶ 2:43:23Mr. Collins: Those two like introducing a piece of legislation are words that you should say. I hope that you can find every method possible to give us the information that we need to respond to what is going on at the department of veterans affairs and most importantly, accurate also timely.
▶ 2:43:39Mr. Collins: Mr. chairman, there are many things I've talked about. I have enjoyed this time with this committee. There is one thing that will be true. The way that we interact with this as of my confirmation, will change. The legislative affairs office will be much more on the hill. It will be much more involved and they will get you answers. Six months is not tolerable. It is not going to happen.
▶ 2:44:07Mr. Collins: >> it has taken way too long in many instances. And qfr's in a hearing in which we asked for members to ask additional questions at the end of the hearing. Those responses are terribly slow. It impedes the capability of the committee doing its work.
▶ 2:44:34Mr. Collins: One of my experiences is that bring a problem to the department of veterans affairs and at least on a number of occasions we are successful in changing the policy or approach at the department. Again, much of what I know about what is going on with veterans is because they tell me what is going on with veterans. We discovered there is a problem. We highlight that problem for the department.
▶ 2:45:05Mr. Collins: The answer comes back from the department, the central office of the department of veterans affairs, we have changed it. You are right. This needs to be different and we will conduct ourselves differently. The challenge becomes when the visit in kansas or anybody else's visit does not know that changes have taken place in the central office. We can have a few high five moments, we have solved a problem.
▶ 2:45:29Mr. Collins: But when it gets to the field, they have never heard of what we have been told in washington, D.C. by the department.
▶ 2:45:36Mr. Collins: A high-five in washington, D.C. is nothing in kansas if it is not implemented. That is one of the things I'm excited about. I have been a part of the hill but also media and social media. Look at the applications out there that we can tell the good. You will see that the department will hear from me directly. It will not come through memos. It will not come for me sitting behind it desk -- behind a desk.
▶ 2:46:05Mr. Collins: It will come from videos on social media, emails encouraging them to know that this is my direction. They will hear from me that if we are still getting, the idea that a veteran has to call a congressman for help, then we are missing the mark. They will hear directly from me. Here is the other thing. They will see me. They will not have to wonder what I am thinking because I may just show up at their hospital. I will just show up and will talk about it and we will make sure that our veterans are being taken care of.
▶ 2:46:34Mr. Collins: I am not up in the sky thinking I can wave a magic want. I will tell you this, we will know who their secretary is. They will know who their secretary cares about and it is the veteran that is in the system and the veteran that is to come will be the veteran that has gotten out and slipped through the cracks and does not know that they have benefits. If they choose to take those, they will be there for them. They will have a veterans office that is waiting for them. >> I appreciate that.
▶ 2:47:01Mr. Collins: My point that you are responding to is the assurance from the department of veterans affairs that the problem has been solved often is not the circumstance. One of the things -- this is in the management aspect. Maybe this is an issue or challenge because of employment agreements.
▶ 2:47:27Mr. Collins: It is not infrequent in which we bring a specific instance in which bad behavior, malfeasance, malpractice, insubordination, a list that could be long of errors and mistakes made by someone who works at the department of veterans affairs in the field and the response ultimately if you ever hear about what happened to that
▶ 2:47:58Mr. Collins: Person, that employee, is we transferred them to another hospital. That cannot be reassuring and should not be reassuring to anyone. Maybe there is some impediment that makes it difficult to actually fire someone. The instances here are not like employee grievances. It is not like mismanagement in the sense of how do we get along here.
▶ 2:48:24Mr. Collins: These are egregious circumstances in which terrible things have happened to veterans. This response is never, you are out of here. If that is the response, it rarely happens in the end. My point, which I don't think I explained very well what the point is, there has to be a better disciplinary circumstance in those extreme cases other than you were transferred to another facility.
▶ 2:48:56Mr. Collins: That is for the well-being, safety and importance of the veterans who were served by the department of veterans affairs.
▶ 2:49:00Mr. Collins: I could not agree with you more. The concept of filing up is not one that I abide by. I am a military person. I have employed people outside the government as well. Failing up is not an option. I will work with any agreements, collective bargaining.
▶ 2:49:21Mr. Collins: But if you are putting veterans health and safety in harm, I will make sure the department will get rid of you and we are willing to do whatever it takes to do that. I don't think there is any senator or congressman who will disagree. I will not tolerate it. That in turn makes our veteran employees even better. >> you highlighted that point and I was going to compliment you on it.
▶ 2:49:50Mr. Collins: A culture and sense of well-being for the employee, that it is a safe and valuable job. As you are doing good work, it is important to the success of the department of veterans affairs. If other employees see that some employees get away with bad behavior, it diminishes the value and joy of working there.
▶ 2:50:07Mr. Collins: I agree. There is an old saying I ascribe to. There are two that I look at. One says if it goes wrong, it is my fault. It if is -- if it is a little bit ok, it is everybody. If they feel like they have to carry a coworker along, after a while, they don't want to carry the coworker anymore. We will not tolerate that.
▶ 2:50:35Mr. Collins: >> it is almost always my practice to give our witnesses the chance to admit a mistake, what to correct for the record, to give the witness the chance to restate or make clear something they felt like they did not do in the first set of hearings, the first two rounds of questioning. Anything you would like to add to the record today?
▶ 2:51:00Mr. Collins: No, senator. I appreciate the time of all who came by. I have enjoyed the questions and the answers. We will not always agree but I will always listen to I will always be a part and I will take this job seriously to make sure our veterans are taken care of.
▶ 2:51:19Mr. Collins: If anything, I will say the only addition I will have that I am thankful for the ones sitting behind me, for my wife and my children, my father who is watching and for those future employees, if I am blessed enough to be confirmed by this body, let the veterans of the v.a. Know that we are coming to make a difference and we will support you. >> thank you. Anything we are missing? Each member will have five legislative days to revise the remarks.
▶ 2:51:49Mr. Collins: In addition, any member who would like to send a question for the record to conrgessman collins should do so. I don't know why we say as soon as possible. We actually need it by the end of business today. We have an executive session of this committee scheduled for thursday. If there is something that you want to make sure that has not been asked or answered by a member of the committee, we need you so that our process can continue with the consideration of your nomination.
▶ 2:52:20Mr. Collins: We need you to respond immediately.
▶ 2:52:21Mr. Collins: Yes. >> thank you. I will join the chairman in thanking you for the hearing and thanking conrgessman collins for your testimony here today, which I think has been very frank and forthright and very helpful to us and really appreciate your candor. We look forward to a working relationship where we are always candid with each other.
▶ 2:52:51Mr. Collins: Again, thank you for your service. >> senator blumenthal, thank you. I look forward to working with you on this committee. We will see if we can accomplish the thing is for those who serve our country. This meeting is adjourned.