▶ 0:22:49>> this hearing will come to order. I will be filling in for senator moran who had logistics issues getting back to D.C. today. I'm looking forward to the nomination of paul lawrence for deputy secretary of veterans affairs. The role is important, serving as chief operating officer and cochair of the v.a.-deity jointing state of counsel -- dod joint executive council.
▶ 0:23:20They oversee electronic health record modernization and works with secretary collins to make certain v.a. Is high-performing, accountable, fiscally responsible, and veterans focused. Dr. lawrence was raised in an army family and is army veteran who knows firsthand what military service means and the necessity of supporting veterans throughout their civilian lives. He's familiar with many of us given his prior service in the v.a.
▶ 0:23:51He's familiar to many of us because he was the undersecretary for benefits, a position he held from 2018 until 20 to anyone -- 2021. The admin attrition had the lowest this ability claims backlog in history and underwent reform as a result of legislation like the forever g.I. Bill, the appeals modernization act, and the blue water navy vietnam veterans act. I'm grateful to Dr.
▶ 0:24:19Lawrence for his willingness to step up and serve his fellow veterans in a leadership position at the v.a. Probably forward to his testimony today. I want to acknowledge the family members accompany Dr. lawrence this morning, which include his wife anne, son gregory, and brother chris. If you can raise your hand. Thank you all for being here.
▶ 0:24:44On a final note, there's a certain pride that comes in the fact we did cross paths, not directly working together at price waterhouse, but an extra nearly good experience for the sort of perspective Mr. lawrence should bring to the v.a. I look forward to seeing this engagement, like so many engagements you and I oversaw back at our time at pw. I will yield to ranking member blumenthal for his opening remarks.
▶ 0:25:13Sen. Blumenthal: Thank you, senator tillis. Thank you for chairing this committee on short notice. Welcome, Dr. lawrence. Welcome to your family and thank you for your willingness to serve in this very, important -- very, very important position for a second time critical to the nation's veterans.
▶ 0:25:38Sen. Blumenthal: It is the department's second-highest official, tasked with executing v.a.'s electronic health record modernization program, strengthening v.a.'s collaboration with the defense department on the v.a.-dod joint executive committee and many other critical responsibilities.
▶ 0:26:02Sen. Blumenthal: While these formal roles are important, I'm focused on your fitness to serve as the v.a.'s chief operating officer and your willingness to push back against recent directives that harm veterans in the mission of the v.a. During the nomination process for secretary collins, we were assured veterans would always come first.
▶ 0:26:27Sen. Blumenthal: We were promised transparency and consultation, even when we disagree with decisions being made. Now the chairman and I learn of far-reaching decisions after the fact. Almost always directly from the press. From v.a. Employees were from veterans. Never from the v.a. Leadership.
▶ 0:26:51Sen. Blumenthal: When we ask for reasonable questions about those decisions and the potential impact, we are directed toward nonanswer press releases or we get no responses at all. I would like to submit a list of 22 unanswered requests for information I to the v.a. Since january 20.
▶ 0:27:15Chair Tillis: Without objection.
▶ 0:27:17Sen. Blumenthal: Also seven letters on urgent issues facing veterans care and benefits I have sent to the administration, most with many colleagues joining. That includes three to, 40 secretary collins -- four to secretary collins.
▶ 0:27:37Chair Tillis: Without objection.
▶ 0:27:37Sen. Blumenthal: We have been told everything will be fine. No harm will come to veterans from the trump and musk l from the trump and musk slash and trash policies. Despite these big assurances, we know it is not the reality. Because of the actions of this administration we have been made aware of numerous detrimental developments across the country.
▶ 0:28:06Sen. Blumenthal: Openings for new clinics have been delayed because they can't hire the necessary staff to open their doors. Service lines at v.a. Hospitals and clinics have been halted. Beds in operating rooms at v.a. Hospitals have been reduced. Support lines for caregivers have been cut down. Veterans crisis line employees have been fired. Suicide prevention training centers -- that's right.
▶ 0:28:37Sen. Blumenthal: Suicide prevention training sessions have been postponed or canceled. It is incredible. Test rotation options for disabled veterans -- transportation options for disabled veterans have been canceled because they cannot get credentials. Elon musk will not be granted access to veterans personal information, but we know that is simply not true.
▶ 0:29:07Sen. Blumenthal: Not only does musk and his team have access to the information at treasury, they have the ability to alter -- yes -- alter that information. It's only a matter of time until they access additional information on veterans from the v.a. Or another agency.
▶ 0:29:26Sen. Blumenthal: This weekend within the white house is attempting to grant access for a musk employee to the irs tax systems containing personal identification numbers and bank information up to 150 million americans, including veterans. V.a. Employees have been told there is nothing to fear -- bless you. Nothing to fear, as long as they work hard. We know that is not true either.
▶ 0:29:57Sen. Blumenthal: Many have been pressured to abandon their jobs by musk and his resignation offers that aren't based on reality or the law. More than 1000 employees, including a substantial number of veterans and those with exemplary performance records, were abruptly and illegally fired in a move that was publicly celebrated by the v.a. Secretary.
▶ 0:30:28Sen. Blumenthal: This action was part of last week's broad purge of tens of thousands of workers across almost every government agency. All employees should have options to appeal these decisions. The president just illegally fired the chair of the merit systems protection board which was established to protect the rights of federal employees.
▶ 0:30:53Sen. Blumenthal: A district judge reversed that termination, at least temporarily, last night. They could appeal to the independent office of special counsel. It spends one third of its caseload on v.a. Oversight and protecting whistleblowers, but the president fired its senate confirmed leader. That dispute is now before the supreme court. The president seems insistent on having the v.a. Secretary run that office in his spare time.
▶ 0:31:24Sen. Blumenthal: Running that office in addition to the v.a. Unacceptable. They could flag conflicts to the office of government ethics, but that once independent agency is also run by the v.a. Secretary. Another conflict of interest. To all v.a.
▶ 0:31:45Sen. Blumenthal: Employees, and I know a third of you are veterans, I know you had your lives and careers completely upended. We will keep fighting for you. You chose a career of serving veterans.
▶ 0:32:03Sen. Blumenthal: You deserve better than to be casually and unlawfully discarded biden administration that places -- by an administration the places more importance on loyalty than fitness to serve. For the veterans watching today, including any who have contacted us directly and are anxious about losing your access to v.a. Health care or your next benefits check, we hear you. We will keep fighting for you.
▶ 0:32:35Sen. Blumenthal: This administration may define collaboration as standing silently on the sidelines while they dismantled the v.a., but this committee -- this bipartisan committee has traditionally embodied the word collaboration coming from both sides of the aisle to pass historic legislation like the pact act on behalf of veterans and their families, standing up for their best interests every single time and performing
▶ 0:33:08Sen. Blumenthal: Robust and vigorous oversight, no matter who was in the white house. I am here for this fight. I know my democratic colleagues are here for this fight. I just hope my republican colleagues will join us before it is too late. I know oversight transparency can be seen as threatening, especially when you are on the wrong side of the law and the wrong side of history.
▶ 0:33:37Sen. Blumenthal: The stakes are too high for any of us to be silent. Dr. lawrence, it is this context in which your nomination will be considered. We need to know how you plan to navigate these waters and whether you will actually put veterans first, stand up for them, and make sure that they receive what they have earned. It is not a gift. It is what they have earned. This committee, v.a.
▶ 0:34:07Sen. Blumenthal: Employees, and veterans across the country will be listening to you today. Thank you, Mr. chairman.
▶ 0:34:14Chair Tillis: Mr. lawrence, before I start I want to respond in part to what my friend and making member have expressed. We are going through a transition. There are decisions being made about probationary employees. A good number of people have decided to leave were probationary employees. I have asked to get to the facts. I'm very fact driven and boring.
▶ 0:34:44Chair Tillis: I like to focus on the specifics of the allegations. I have done that in the past almost four weeks since some of the personnel moves have been made. Honestly, some of the reports are allegations on day one are disproven on day two. One example. If you remember in the first week, there was a discussion about elon musk having access to detailed payments data. That is not true.
▶ 0:35:11Chair Tillis: They were looking at code and the payment system to determine -- in the payment system to determine efficiency or proper payments. I have had specific request for that access. I have seen nothing to substantiate the allegations. This is a large organization. It has critical positions and it has desirable but maybe not critical positions.
▶ 0:35:35Chair Tillis: If we are suggesting we have had mass terminations of technicians, nurses, critical positions, that would be concerning and if there is evidence I would like to see it. We are dealing with a lot of transition. A lot of new way of looking at personal management which occurs when you have a transition in the white house. I think we are talking about problems with the v.a. We are more than 20 days ago.
▶ 0:36:05Chair Tillis: I think some of these problems are because there was a pact act that my office spent time working on that did not get the commitment before it was passed out and it resulted in a $3 billion shortfall last year and multibillion this year. These are decisions made by congress that are undermining some of our ability to actually live up to repaying or making another installment on a debt we can never fully repay for veterans who need our services. U.S. veteran, Mr.
▶ 0:36:32Chair Tillis: Lawrence -- you as a veteran, Mr. lawrence, you bring perspective of a veteran and the kind of perspective is needed to address some of the legitimate concerns we some of the legitimate concerns expressed by the ranking member. Let's move to your testimony. If you will please stand and raise your right hand. Dr. lawrence, do solemnly swear or affirm the testimony you are about to give to the U.S.
▶ 0:37:02Chair Tillis: Senate committee on veterans affairs will be the truth, the whole truth and nothing but the truth, so help you god? Thank you, Mr. lawrence. You may proceed with your testimony.
▶ 0:37:16Dr. Lawrence: Senator tillis ranking member blumenthal, , distinguished members of the committee, thank you for the opportunity to be here today and for considering my nomination. I would also like to thank president trump for the honor of this nomination and his trust in me. My objective is to earn your trust as well. I am joined by my wife of 39 years, and my brother chris, also an army veteran and airborne ranger.
▶ 0:37:45Dr. Lawrence: I also want to thank my 100-year-old mother who is watching at home right now. I wouldn't be here without all of their love and support. The senate committee on veterans' affairs has a long history of bipartisan accomplishments on behalf of america's veterans. Your commitment to taking care of the men and women who have worn the uniform is above approach. I want you to know I share that commitment. I grew up in an army family. My father served 24 years, with deployments in the korean and vietnam wars. He taught me many valuable lessons about leadership and what it means to serve.
▶ 0:38:14Dr. Lawrence: My middle name, reynold, was given to me in honor of my uncle, who was killed fighting in normandy. My family's love of country and tradition of service compelled my brother and I to join the army, where we were both commissioned through rotc. During my tenure in the military, I graduated from the army's airborne school, earned the meritorious service medal and rose to the rank of captain. My service taught me the value of leading with integrity, honor and respect. But most importantly, it instilled in me a dedication to serving my fellow veterans that has shaped my life's work.
▶ 0:38:46Dr. Lawrence: As senator tillis indicated I , spent many years working as a consultant, helping bring efficiencies to large organizations. Then, I had the opportunity during the first trump administration to serve as v.a.'s under secretary for benefits, one of the most rewarding experiences of my career. In that role, I led 24,000 employees as they administered a range of benefits, including disability compensation, pension, education, home loans, veterans' readiness and employment, and life insurance.
▶ 0:39:09Dr. Lawrence: During my time at v.a., our veterans benefits administration team made great strides in increasing productivity, customer service and convenience for veterans. Here are a few highlights of which I'm particularly proud. During my time at vba, the disability claims backlog was reduced to its lowest in ever. Vba guaranteed a record 1.2 million home loans for veterans in fy 2020, surpassing the previous record of 700,000.
▶ 0:39:37Dr. Lawrence: We successfully launched the gi bill, the appeals modernization act, and the blue water navy vietnam veterans act. We successfully launched solid start and the veterans benefits banking program. Vba reduced improper payments by more than $350 million. In 2020, during the pandemic, I conducted 100 telephone town halls that reached nearly 5.7 million people and I took more than 1,500 unfiltered questions about how we were serving veterans.
▶ 0:40:05Dr. Lawrence: If I have the privilege of returning, I will work to build on the many bipartisan successes of this committee. To that end, I pledge to work with you to get v.a.'s electronic health record modernization effort back on track. Ensure v.a. Provides veterans with the health care choices and options congress promised them as part of the mission act. Properly and faithfully implement the pact act, and put veterans at the center of everything the department does and make accountability, customer service, and caring the cornerstones of service among the department's work force.
▶ 0:40:35Dr. Lawrence: If confirmed, I will be a tireless advocate for the men and women who have fought for our liberty. I will work to ensure every eligible veteran and v.a. Beneficiary gets the benefits and services they've earned at . Thank you and I'm happy to take your questions.
▶ 0:40:52Chair Tillis: You have proven efficient by yielding back one half minutes. Mr. lawrence, when I went up to say hello you mentioned you would take me up on my offer to get more engaged in the electronic health record implementation.
▶ 0:41:15Chair Tillis: This is transcended this is transcendeing administrations. I can't get my head around the money that has been spent versus the value derived. It's barely even implemented and the initial -- he looks like it is suboptimal and not a best practice that the entire v.a. Is benefiting from. Tell me based on your past experience at the v.a.
▶ 0:41:42Chair Tillis: And any knowledge you have now, what do you think -- where did we make mistakes and what do we need to do differently to get this behind us and get the incrementing care this will provide veterans?
▶ 0:41:54Dr. Lawrence: Thank you for the question. I think when senator collins was here last month describing his vision for what had to take place, it was sound. Convening all the players as he described, figuring out the best thinking, and what can be done to get efficiencies to as many veterans as possible as quickly as possible. I echo that. I think I would foot stop urgency. We can't spend months studying what's going on.
▶ 0:42:24Dr. Lawrence: What I will tell you, I dealt with technology in multiple things. You heard me talk about the g.I. Bill, the blue not bill, the blue n water navy. I focused on accountability. I was surprised how accountability was a challenge. I think that led to trouble in decision-making. There is a sense of the right contractors, the right roles, the right contracts, as additional oversight v.a.
▶ 0:42:52Dr. Lawrence: Gets the help on check and monitor things. I would probably start their. As the secretary pointed out, everything is on the table. We have to come up with a plan that can be of limited. If confirmed, I will work to implement the plan.
▶ 0:43:07Chair Tillis: Tell me what you learned by drawing down the backlog from v.a. Benefits and what is applied not only to the health record of limitation but generally the cleaning out of the plumbing and getting things done sooner and better for veterans?
▶ 0:43:24Dr. Lawrence: When I showed up the backlog was low but we drove down. In november of 2019, we were actually worried about running out of work, we were moving so fast.
▶ 0:43:35Chair Tillis: That's a good problem. Never worry about that.
▶ 0:43:39Dr. Lawrence: Part of it was measurement and driving accountability to the people who were processing claims to the levels of management that were processing claims. Along the way I learned of the technology to support the claims processing effort needed to be improved. I spent time improving the technology. I spent a lot of time -- this is something that came from senator isaacson the first, met him. Stop having v.a. Do things I get in its own way.
▶ 0:44:06Dr. Lawrence: Untangling some things that do not need to be done and where there because it increased in efficiency. People, process, technology. Measurement really helped move things along. The pride in the employees was really pretty important.
▶ 0:44:24Chair Tillis: Since you yielded back 1.5 minutes I will yield back my time. Senator blumenthal.
▶ 0:44:29Sen. Blumenthal: Thank you. I'm happy to take us 1.5 minutes. Dr. lawrence, this is a critical day. Not just for you, but for our veterans. Accountability begins today. Do you commit to responding to the request for information that I have submitted, along with my colleagues, numerous requests for information and accountability within one week of your confirmation?
▶ 0:44:58Dr. Lawrence: Senator, as you know, I'm not at the v.a. Yet.
▶ 0:45:04Sen. Blumenthal: It's a yes or no answer.
▶ 0:45:06Dr. Lawrence: I commit to receiving your questions if confirmed to looking at them to understand the information you are requesting, to meet with you to understand the information and determine how best to provide you the information.
▶ 0:45:17Sen. Blumenthal: I will hope that as a yes answer. I will hope for our sake and more important for our veterans you will be responsive and transparent as so far this administration has utterly failed to be. Since january 21, we have seen everything from a hiring freeze to arbitrary firings of more than 1000 v.a. Employees to unelected individuals at the doge --musk transition team.
▶ 0:45:53Sen. Blumenthal: Accessing I.t. Systems that include veterans private information and taking action that is contrary to the interest of veterans. The chairman referred to a transition. Elon musk seems to regard veterans as roadkill on the so-called transition. As to the facts, we are hearing fax directly from veterans, v.a.
▶ 0:46:20Sen. Blumenthal: Employees, and others who have direct evidence of the impacts, the human impacts of these draconian cuts in funding and staff. Do you support the action so far?
▶ 0:46:33Dr. Lawrence: Thank you for the question. Let me see if I can pull us apart. The information, as I understand it, the doge employee at v.a. Is limited to contracts, general operation and management of the I.t. System. This person does not have access to veteran health information nor benefits information.
▶ 0:46:55Sen. Blumenthal: Do you support the firing of 1000 employees?
▶ 0:46:59Dr. Lawrence: As described, I'm not there now and I do not know how this came about.
▶ 0:47:03Sen. Blumenthal: You are not willing to answer the question?
▶ 0:47:07Dr. Lawrence: I'm willing to talk about what I read in the press release about the activity. It appeared to be a thoughtful approach to determining who would be laid off in the sense that it was not mission-critical. It was designed not to affect the provision of health care and benefits. There was a safeguard where first level supervisors could opt somebody out of that process.
▶ 0:47:30Dr. Lawrence: It was described by the secretary that the savings generated by these layoffs, $98 million, would be used to provide debtor care for veterans consistent --
▶ 0:47:40Sen. Blumenthal: I want to submit, respectfully, that firing v.a. Employees who provide critical services to veterans is mission significant. That the unfairness and illegality of the actions have direct impacts on v.a. Health care, on veterans who are potentially suicidal.
▶ 0:48:10Sen. Blumenthal: If you close the kinds of training sessions and other direct help to veterans who will take their own lives, that is mission-critical. When you agree?
▶ 0:48:25Dr. Lawrence: I can only tell you what I read. What you're describing is inconsistent with what I read.
▶ 0:48:31Sen. Blumenthal: It inconsistent with what you read from the v.a. Press releases. I challenge you as the person who will be chief operating officer to learn exactly what is happening and to be transparent with us. Let me ask you another question. Transportation for disabled veterans has been reduced. Is that fair?
▶ 0:48:55Dr. Lawrence: Senator, thank you for the question. If confirmed, I will look to understand why that is happening.
▶ 0:49:01Sen. Blumenthal: Service lines at v.a. Hospitals and clinics have been halted. Is that fair?
▶ 0:49:06Dr. Lawrence: If confirmed, I will look into that understand why it is happening. It is inconsistent with what I have read about the intent of the layoffs.
▶ 0:49:14Sen. Blumenthal: The kinds of appeals that v.a. Employees are entitled to take now are to offices held by the v.a. Secretary himself. In effect, you are appealing your firing to the person who fired you. Is that fair
▶ 0:49:31Dr. Lawrence: If confirmed, I will look into the processes by which --
▶ 0:49:35Sen. Blumenthal: I hope you look into them quickly and you respond to us as the secretary has failed to do. Is that fair?
▶ 0:49:45Dr. Lawrence: I have confirmed I will look into this. Yes, I commit to figuring out a way to respond quickly to requests once I am confirmed.
▶ 0:49:53Sen. Blumenthal: I have a lot more questions for you. I hope you are more responsive if confirmed and you have been so far. Thank you.
▶ 0:50:04Chair Tillis: I will use about a minute and a half of the men and a half I gave up. Where you advised -- was your opinion sought for any of the personnel actions that have occurred in the last 30 days of the new transition?
▶ 0:50:17Dr. Lawrence: No. I'm not engaged in any decision-making.
▶ 0:50:22Chair Tillis: Have you been contacted to say or advise on strategy, numbers, positions, conditions, anything related to the decisions taken by the administration?
▶ 0:50:35Dr. Lawrence: I have not.
▶ 0:50:37Chair Tillis: You may hear a couple of times today there is frustration and I can understand it from the perspective of some of my colleagues on the other side of the aisle. It would not surprise me as we hear if these allegations are not true. I do think senator blumenthal used the specific words today but that is senator speak for I have not confirmed it but it sounds good.
▶ 0:51:03Chair Tillis: You are not in a position to make a commitment or -- I do think you have been called on as an expert for this transition. Your position, when confirmed, is day one for you. I do believe you should commit that any inquiry from the v.a. -- we have been frustrated with the biden administered in, the prior trump administration, the obama administration with the lack of response from the v.a. Hopefully you and the secretary can change that trend.
▶ 0:51:34Chair Tillis: I think it bears repeating every time we hear it today that you are being asked to opine on things you had nothing to do with. All you have our press reports at this time.
▶ 0:51:41Dr. Lawrence: I want to respond --
▶ 0:51:44Sen. Blumenthal: I want to respond since you characterized my questions. I don't know is senator speak is. I know what I said. I want to tell you, Dr. lawrence, what I said were the facts. They sound bad. They don't sound good. I know what we have heard.
▶ 0:52:06Sen. Blumenthal: What is more disturbing to me is apparently you have not asked anything beyond reading these press releases in preparation for your testimony today. Have you asked anyone in the veterans administration for the fact?
▶ 0:52:22Dr. Lawrence: My interactions -- my interactions have been around preparation. Not around the operation of the v.a. I have be given public information about a wide range of subjects but not the details about decisions that led up to --
▶ 0:52:40Sen. Blumenthal: He reproaches -- you reproaches apparently hear no evil, see no evil, just tell me what you want me to say?
▶ 0:52:51Dr. Lawrence: I think that mischaracterizes my poster preparation. I find all publicly available information that informs me about this position. I am guided by my experience for three years and the first trump administration. I am not involved in topical and timely decisions taking place in the operation.
▶ 0:53:09Sen. Blumenthal: A lot of veterans, and I say this with respect, what you just said will sound like bureaucratic gobbledygook. I hope that veterans receive more facts. I hope you give us more facts. We have complained and it has been bipartisan that government agencies have failed to be responsive at the v.a. I hope you do better. Thank you.
▶ 0:53:37Chair Tillis: Senator tuberville.
▶ 0:53:40Sen. Tuberville: Thank you for being here and willing to take this on. It is volatile. We all care about veterans. I grew up in a military family. My dad spent a lot of time at the v.a. We have a lot of good v.a.'s across the country. It usually comes down to personnel. When I first got here, president trump evaluated and released 1000 people from the v.a.
▶ 0:54:09Sen. Tuberville: The biden ministry and rehired them back with back pay without any evaluation. We have not had evaluation of those 4000 in the past four years. If they are negligent, they need to be lico. I hope we look into the people running our v.a.'s. One thing I'm concerned about, and since I have been on this committee we have big tech that could be very valuable to the v.a. Big tech has done a great job in a lot of areas.
▶ 0:54:41Sen. Tuberville: Hyperbaric chambers. I have been pushing that for years, getting veterans to be able to use hyperbaric chambers for ptsd which are not covered. Their insurance will not cover it. We need to grew up in this business. There's an ultrasound system that is used for ptsd that is very, very successful. One in north carolina, one in san francisco that I've had friends go through that has saved their lives. For the life of me, we cannot get the v.a.
▶ 0:55:08Sen. Tuberville: To approve this system to be used by veterans. Even though we don't have them in the v.a.'s. Would you commit we would look hard into these new systems that have come aboard to help -- we are losing 18 veterans a data suicide. It is ridiculous.
▶ 0:55:29Dr. Lawrence: I enjoyed our visit were you described some of these in detail. It is intriguing. The answer would be yes. I believe that is consistent with the perspective senator collins shared a month ago. Looking for organizations to help veterans outside v.a., whether nonprofits, for-profits, different approaches and figuring out how to help them get veterans healthier, receive benefits, pursue their american dreams.
▶ 0:55:57Dr. Lawrence: I would hope we can get the big tech companies involved in it. They are involved in health care for the general public but the v.a., we need more health care. We spend a lot of money. I would hope as we go through this we will look at the money being spent. V.a.'s office of inspector general he published a report bringing to light failures within the fiduciary program, 311 veterans had no records within the veterans benefit management system.
▶ 0:56:29Dr. Lawrence: $24 million was dispersed without oversight to this. Speaking of leaking oil. Considering your background, how will we implement improvements to help this?
▶ 0:56:42Dr. Lawrence: Thank you for the question. I know a lot about the fiduciary program. One thing was who was watching over the people taking care of veterans' money when they are unable to do that? Oversight continued to be a challenge. If confirmed, I will look into this in more detail and understand what is taking place. Normally there are processes to do this. The kind of things you are describing in the report mixing wonder about the process. Back to your point, gimmicks me wonder about accountability.
▶ 0:57:12Dr. Lawrence: There are supposed to be leaders managing this processes. For failures like the ones you are describing, it is troubling and it needs to be tightened down. I will look into that.
▶ 0:57:21Sen. Tuberville: Oversight on the pact act, we are leaking oil there. It was jerked out of the hearing room without being finished by the leader of the senate, a democrat at the time. It is unfortunate. A lot of things have gone wrong because he did not have the ability to finish that. Hopefully we will look into that, get you back here after you take office and see how to help with that.
▶ 0:57:49Sen. Tuberville: The pact act could be good at done the right way. Thank you, Mr. chairman. >> I would like to ask the initial questions I ask of all nominees. Since you became an adult, have you made a request for sexual favors or committed any vernal -- verbal or physical harassment or assault of a sexual nature?
▶ 0:58:15Dr. Lawrence: I have not.
▶ 0:58:17Sen. Hirono: Heavy entered into a sentiment related into this kind of conduct?
▶ 0:58:22Dr. Lawrence: I have not.
▶ 0:58:24Sen. Hirono: I think the pact act was one of the bipartisan bills that we worked hard on and the fact that there was a shortfall says they were a lot of veterans who needed this kind of care. To talk about $3 billion and shortfalls that have not been anticipated.
▶ 0:58:48Sen. Hirono: At the same time, I know the republicans are gearing up to provide $4 trillion in tax cuts to the wealthiest people in our country. Where is the cry relating to that? You testified also that you did not know who consisted of the 1000 people working at v.a. Who were let go. Is it your testimony?
▶ 0:59:13Dr. Lawrence: I was uninvolved in the process by which those 1000 people were laid off.
▶ 0:59:18Sen. Hirono: Would it surprise you to know these are people on probation?
▶ 0:59:23Dr. Lawrence: No, senator. That is what is described in the press release.
▶ 0:59:27Sen. Hirono: People who are on probation. By category. You also testified these people are being let go on the basis of their work. It sounds like it is not by entire categories. Here they are. The v.a. Always had a shortfall of workers, to the point where we had to enact legislation that enables the v.a. To more quickly hire people because v.a.
▶ 0:59:57Sen. Hirono: Was short on everything from physicians to nurses to everybody working at the v.a. That is why this hiring freeze, we have had to adjust the particular concerns of v.a. Then you have an entire category of people who are being let go.
▶ 1:00:19Sen. Hirono: You say you had no knowledge, no part in doing that when we know for a fact people on probationary status are being lico -- let go throughout the administration. Some 200 people have been let go. Thousands of people are probably going to be let go and the department of justice. These are people on probation status who were hired, being trained to take jobs that are necessary.
▶ 1:00:49Sen. Hirono: If there is an entity that definite needs workers, it is the v.a. I would think he would be to medically concerned about what is going on in the loss of 1000 people. We talk about the importance of transparency. Since his confirmation, secretary collins has also been named the temporary head of the office of government ethics and the office of special counsel.
▶ 1:01:20Sen. Hirono: I don't know what temporary means. It could be a year, forever. Who knows? How do his additional roles impact the delegation of response ability between the two of you? Don't you have some responsibilities related to whistleblowers within the v.a.? Wouldn't you have some overlap between what secretary collins now was responsible for and what you will be responsible for?
▶ 1:01:48Dr. Lawrence: Thank you for that question. The deputy secretary is the chief operating officer for the administrative functions within the department to include office of accountability and whistleblower. We have had in secretary -- we have had no conversation about his new duties. If confirmed, I will discuss that with him.
▶ 1:02:09Sen. Hirono: There is no question that throughout the administration the decisions made and had to be revised or explained is rampant. This goes to in my view the chaos, confusion that is in every agency. Let me get to a concern a lot of veterans have about what happens at v.a.
▶ 1:02:39Sen. Hirono: There's been ongoing concerns about privatizing v.a. The veterans project and the portion of project when he 25 what you are acknowledged as having had a -- 2025 that you are acknowledged as having written part of his out sourcing part of v.a. To contractors. Will you begin privatizing v.a. Response abilities? -- response billy's? -- responsibilities?
▶ 1:03:10Dr. Lawrence: I wrote about the benefits process. This thie sec. Is clear we will push back on any efforts to privatize v.a. The secretary said there is a need for both v.a. And access --
▶ 1:03:25Sen. Hirono: There have been ongoing efforts to privatize segments of the v.a. I will hold you to your commitment that you do not have an intention of privatizing activities at the v.a.
▶ 1:03:41Chair Tillis: Senator sheehy.
▶ 1:03:47Sen. Sheehy: Is the v.a. Working right now?
▶ 1:03:54Dr. Lawrence: I'm not involved about decisions going on so it is hard for me to talk about something if I'm not there. From afar I would say veterans continue to get health care and benefits. Veterans can interact with the v.a. When I go to the building, it works. From afar I would say broadly, yes.
▶ 1:04:15Sen. Sheehy: We are at $50 billion now, the estimated software upgrade cost for the health care system software. We have been talking about this for almost a decade. The rough estimate for costs is three times as much money to deliver one dollar of care to a patient as it does the private sector. How do we reform the v.a. Health care system so it is as efficient as the dod health care system?
▶ 1:04:45Dr. Lawrence: One secretary collins was here he talked about this a lot. Trying to figure out how to support veterans as efficiently as possible. If confirmed, we need to look at why things are more expensive relative to other comparable organizations. When I talk about providing veterans world-class service, part of that is comparing how well v.a. Does to other organizations that do similar things in understanding what the difference could be.
▶ 1:05:15Dr. Lawrence: Perhaps it is because the patient population is different. They are older. Perhaps it is the way it operates. If confirmed, I would welcome the chance to dig into this and share observations and insights with the.
▶ 1:05:25Sen. Sheehy: When we look at the transition for many veterans on the panel and veterans period, one of the most frustrating part is the handoff from active duty to v.a. Even parts of the v.a. That function well, and they are there, making sure the bridge between active duty and v.a. Is seamless continues to evade our ability to accomplish it effectively. What can you do as the number two guy to make sure as veterans transition to the v.a.
▶ 1:05:55Sen. Sheehy: They do not get lost in the shuffle? They don't not make the leap from one into the other and are lost at sea?
▶ 1:06:03Dr. Lawrence: Don't forget, I transitioned too so I know the experience you are talking about. I will be the cochair of the executive committee that was mentioned where we work with dod to discuss these issues. The secretary talked about the importance of getting the transition right. I echo that. I think it is very important that seamless information transferred to dod to v.a.
▶ 1:06:31Dr. Lawrence: I cannot tell you the number of times veterans complained how many more time so you asked me for my ddt-14 when you have it already. That sets things in a bad place. I feel strongly about conductivity, making sure -- connectivity, making sure veterans have a job. States are competing for veterans and we should be helping them do that. I will really be able to align with secretary collins and make sure we working on the right things.
▶ 1:06:58Sen. Sheehy: V.a. Employee accountability is important. We see patient satisfaction scores that are -- if the v.a. Was a business that would have a one star on yelp. I have been in office now for seven weeks as a senator. A lot of my time is spent with dealing with v.a. Issues when veterans reach out to the U.S. senate office sank I cannot get a response from the v.a. I cannot get my claimed process -- claim process or in of women scheduled.
▶ 1:07:27Sen. Sheehy: The fact we have helped to solve those issues is great but it's extremely frustrating that the best place a veteran can go to actually get the problems fixed is not the v.a. It is going to their congressional delegation, writing letters, showing up in person to test eight can someone help me get a response. Although many reforms undertaken our coming under truman's criticism, it is time we changed something at the v.a. A lot of it is not working. You have a great vision to help fix that. How do we make the v.a.
▶ 1:07:54Sen. Sheehy: A customer service organization so when veterans need something common sense they can call the v.a. And not their senator or congressman to get something done?
▶ 1:08:04Dr. Lawrence: This came up in numerous meetings with their colleagues on this committee when I met with them. The frustration of having to do the casework you are describing. Part of it is the effort to learn as to why these problems are happening and resolve them. I found in my previous tenure many good employees, and we should recognize that at the v.a. One way we have great customer service is we exit folks not serving our veterans really well. We use accountability to do that.
▶ 1:08:33Dr. Lawrence: The measurement, the understanding of the problems, the solutions, and understanding where the failures took place and how to deal with them.
▶ 1:08:40Sen. Sheehy: Thank you for undertaking this again.
▶ 1:08:43Chair Tillis: Senator hassan.
▶ 1:08:45Sen. Hassan: Congratulations on renomination and thank you and your entire family for your service to our country. Before I begin I want to take a moment to express my concern about recent steps the trump administration is taking that has caused disruption and confusion throughout much of our country, especially within the v.a. Last month the president instituted a federal hiring freeze, which included the v.a.
▶ 1:09:13Sen. Hassan: Before the administration tried to backtrack. The trump administration tried to institute a federal funding freeze. The v.a. Claimed programs were not impacted all the veterans were concerned about the services they need. The trump administration dismissed over 1000 v.a. Employees, people who help veterans get the care and benefits they earned and deserved at a time when the v.a. Should be expanding its workforce, not cutting it down.
▶ 1:09:42Sen. Hassan: Taken together, it is obvious this administration is making drastic decisions without facts to senator tillis' point. If we going to start rightsizing and organization, you gather facts that you do it in a transparent way. Instead, what we are seeing from Mr. musk and Mr. trump as they are making stuff up. Telling the public things that later turned out to be not to be true. They are not thinking through how their actions will actually affect veterans.
▶ 1:10:12Sen. Hassan: I'm concerned this reckless pattern of decision-making will continue. It is incredibly important we have leadership at the v.a. Who will push back on decisions that could negatively impact health care and benefits for our veterans. Dr. lawrence, I want to start with a question. It is a question I'm asking all nominees in light of recent events. If directed by the president of the united states to take action that would break the law, would you follow the law or follow the president's directive?
▶ 1:10:41Dr. Lawrence: Thank you for that question. I would follow the law. I would point out in my previous tenure no such situations came up. We were very much focused on veterans.
▶ 1:10:53Sen. Hassan: I understand that. The last four weeks have shown us some new information and new behavior. That is why I asked the question. If a court issues an order requiring the v.a. To take or refrain from taking pacific actions, will you follow the court order?
▶ 1:11:10Dr. Lawrence: Yes, senator.
▶ 1:11:12Sen. Hassan: I want to turn to a different topic. As the trump administration continues to indiscriminately cut the federal workforce, how will you ensure veterans receive the health care and benefits they have earned and deserved without disruption?
▶ 1:11:27Dr. Lawrence: Thank you for that question. Just to clarify, the secretary talked about providing veterans excellent service and caring for the veterans. I think the layoffs last friday indicate the thinking behind it. These were described as non-mission-critical folks who would not affect the provision of health care and benefits.
▶ 1:11:46Sen. Hassan: We have heard this from other agencies. Right now the trump administration is trying to rehire people to oversee the nuclear stockpile because it did not realize those were the people they were firing. They are trying to rehire people who are responsible for containing bird flu with the price of eggs skyrocketing but they didn't realize they fired them. You and your standby do not take the administration's reassurance about how these -- who these employees aren't v.a.
▶ 1:12:14Sen. Hassan: With great confidence -- are at v.a. With great confidence.
▶ 1:12:19Dr. Lawrence: In this situation though v.a. Had a safeguard which was a supervisor could opt the person out of the layoffs. There was an element of detailed knowledge of what the individual did and their importance in the organization.
▶ 1:12:35Sen. Hassan: You are telling me you would try to make sure that kind of system is in place so before somebody is actually laid off, before they are walked out the door, there is an assessment on the ground at the facility or entity about whether that person's job is mission-critical to veterans?
▶ 1:12:54Dr. Lawrence: You describe one variation of that. As the person closest to their work understanding the value in providing health care and benefits and other service to veterans to make sure it is consistent with the indication that these are not mission-critical layoffs.
▶ 1:13:10Sen. Hassan: I will hold you to that commitment. Last week the v.a. Dismissed more than 1000 please. These dismissals combined with other steps the administration has taken has created a climate of fear and uncertainty. I'm concerned these actions will prompt some v.a. Employees to leave the federal service and additionally scare many more potential employees from applying for v.a. Jobs in the future. If that happens, the v.a.
▶ 1:13:36Sen. Hassan: Will have a harder time hiring the appropriate number of nurses, doctors, and others to provide the care and benefits our veterans have earned. If confirmed, what would you do to help rebuild trust for the v.a. Employees and recruit new employees v.a. Will need moving forward?
▶ 1:13:52Dr. Lawrence: If confirmed, one of the many things I will do is focus on the importance of the mission and the special nature by which we do and what we do. In terms of the health care providers, not only a great environment but also the access to resources and research and the like, what I would also point out is if my previous tenure when we exited nonperforming performerst because he understood we could
▶ 1:14:23Dr. Lawrence: Differentiate between their very valuable contribution and the poor performers. They understood the difference.
▶ 1:14:28Sen. Hassan: That is true in every organization but there is no evidence the approach by this administration is going after poor performers. They are using a meat cleaver when they should be using a scalpel. Thank you, Mr. chair.
▶ 1:14:43Chair Moran: Before I go to senator boseman I have two things. One I am trying to get the annual attrition rate for probationary employees because there is attrition as they are being on boarded. I will also point out because it was a discussion about every position that it is critical that the biden administration intended to cut the workforce by 10,000 employees deemed not in critical positions.
▶ 1:15:11Chair Moran: And their strategy was slowing hiring and allowing increased attrition. Senator boozman.
▶ 1:15:16Sen. Boozman: Thank you, Mr. chairmanwe had a good visit notg ago that I enjoyed. I appreciate the fact that you are a proven commodity. You did a great job from on -- as undersecretary for benefits in the past and we look forward to using your expertise as we go forward.
▶ 1:15:39Sen. Boozman: During secretary collins' hearing during last month I raised the issue of the state veterans home located in arkansas. This is an excellent resource for veterans in arkansas but in dire need for upgrades. Unfortunately the facility will not receive necessary funding. Secretary collins continued to -- committed to work with me on the issue.
▶ 1:16:04Sen. Boozman: Do we have your commitment that you will also work with us in regards to the northwest arkansas facility?
▶ 1:16:10Dr. Lawrence: Yes. If confirmed I would work with the secretary to better understand his commitment and work to figure out what makes sense.
▶ 1:16:18Sen. Boozman: Thank you. The v.a. Has approved for g.I. Bill purposes a unique vocational transition school in my state exclusively for veterans which emulates the way they learn during military service. Notwithstanding, the g.I. Be -- the g.I.
▶ 1:16:38Sen. Boozman: Bill approval working model based on military training, policy bars, nonaccredited education access to transition systems program sites. I believe this strategy limits the potenti of these institutions because it blocks them from connecting with the soon-to-be veterans at the most significant period of separation. If confirmed, would you work with us -- with the v.a.
▶ 1:17:04Sen. Boozman: And dod joint executive council that oversees the cap executive committee. Would you commit to working with me on this issue?
▶ 1:17:17Dr. Lawrence: Thank you. If confirmed I will look through this whether it is through the jack or a one-off to understand the situation. I care about veteran employment. Obviously the -- if this is a good training program this will make sense. If these are unintended consequences we should look into that, so yes.
▶ 1:17:38Sen. Boozman: As you are aware it facing epic and questions around its budget last year with many issues that have yet to be answered. Do you still believe that the fiscal year 26 advancement appropriation request to be accurate or would greater funding be required? Much of the issues we experienced last year came due to the breakdown in communication between the v.a. And congress.
▶ 1:18:04Sen. Boozman: How do you plan to revamp the congressional affairs to improve communication and to prevent future breakdowns?
▶ 1:18:11Dr. Lawrence: Thank you for those questions. Let me break them apart. In terms of the budget, at this point my knowledge is not that detailed. If confirmed I will have a more detailed response and I will work with the chief financial officer to provide information. In terms of your second question, and almost every one of my visits this came up and I believe secretary collins addressed it in his confirmation hearing.
▶ 1:18:41Dr. Lawrence: He talked about the need to not only receive information to do constituent services but to get ahead and talk to the teams to get a sense of what is going on in advance. It is pretty clear about the desire for more information, but frankly a two way street not only to assist you but better understand so what you are hearing so we can get ahead of the problem so they do not turn into issues.
▶ 1:19:04Sen. Boozman: In our previous conversations we discussed the importance of addressing veteran suicide and that the v.a. Must do things differently as the status quo is not acceptable.
▶ 1:19:17Last Congress I: The not just a number act which -- I co-lead, the not just a number act which analyzes which factors have the greatest impact of preventing suicide. How can the v.a. Use the information collected as a results to prevent veteran suicide and how should the v.a. Suicide prevention efforts evolve?
▶ 1:19:43Dr. Lawrence: Thank you. I agree with your sentiment which is for a long time we have been talking about this for your great deal of energy and efforts. It seems like the number does not change. I think the sentiment about can we do things differently and what can we learn and what can we learn from data. If confirmed I will look into this and see if there is not a new pass will -- path or other successes that we will bring to bear on this tragic issue.
▶ 1:20:11Sen. Boozman: Thank you.
▶ 1:20:17Supper -- Sne Gallego: One thing that I was proud of was the burn pit administration. I slept next to one in iraq and I have seen some of the marines that I served with die from diseases related to the burn pits. So that was a big win for veterans first of all, and it was bipartisan in nature.
▶ 1:20:46Supper -- Sne Gallego: And, it is one of the largest expansions of care and eligibility in v.a. History considering it was a 20 year war and how many men and women were exposed to burn pits and other dangerous chemicals. So it is a very important step forward to really right the years of wrongs. When I say wrongs, some died before they got even close to getting claimed. Some had to pay out-of-pocket, because the v.a.
▶ 1:21:13Supper -- Sne Gallego: Did not recognize they are sickness as related to their service. And, many of them still do not even know that they have access to these benefits. With anything -- with everything that is happening that I am concerned that while we are constricting and reducing who we are hiring, we at the same time once more people to apply for the pact act benefits.
▶ 1:21:36Supper -- Sne Gallego: What are your plans on how to raise awareness for the pact act so we know that a lot of these men and women can start getting benefits. If not, they will get benefits years later, but will end up having to back pay their service plus interest?
▶ 1:21:53Dr. Lawrence: Thank you. I agree that more communication needs to be put out there for veterans about what their benefits and health care could be under this. I think that we tend to think about communication as let us just put something on the internet. What I learned from my previous experience was that low-tech communication is invaluable. Town halls are invaluable to go and explain this.
▶ 1:22:23Dr. Lawrence: I would expect to do more in person communication. I know the secretary talked about that. As the deputy secretary a lot of this will fall on me. I am a big believer in communication and I think we cannot over communicate but it is important that you must -- that we tell veterans that you must come now because years from now something will happen and we wish that you would've, and I completely agree.
▶ 1:22:47Sen. Gallego: In the vein of overcoming occasion, one concerns -- one thing that concerns me about -- against dei, one of the things that it might impact is culturally competent communication. What does that mean? In arizona we have 22 federally recognized tribes and there are more tribal governments -- members that serve in the military and the ratio to population.
▶ 1:23:17Sen. Gallego: As well as we have for example a growing female veteran population that sometimes wants to seek services specifically from women or women that have been in their experience. These types of eo's will not allow best practices or methods of communications. What is the balance that you will strike on that or will you stick to the eo?
▶ 1:23:38Sen. Gallego: For example, some female service members have survived rape by other service members and one to only speak to women and feel comfortable speaking to women. Some of the eo might go so far that they do not have specialized programs for survivors of rape.
▶ 1:23:56Dr. Lawrence: What I learned from my previous tenure was the value of listening to and talking to veterans and if not directly than the organizations that represent them. I found that invaluable in terms of communicating. I would hope that, if confirmed as deputy secretary, I would work with the veteran experience office to understand how we access the individual groups we are talking about and engage them effectively.
▶ 1:24:22Sen. Gallego: Part of the problem is that this might not even allow you to. Would you try to find a waiver or speak to the president's cabinet or whatever it is to get that. For example there are groups that are better for latinos and there are some organizations did -- organizations that could be very good at reaching out to these groups that sometimes do not necessarily listen to other lines of communication. I am not sure the executive order will allow that to happen.
▶ 1:24:53Dr. Lawrence: I appreciate the question. If confirmed I will look into see if that is actuary -- actually accurate. These groups are invaluable in terms of communicating with veterans and understanding. It was through groups that represented older veterans that I you -- that I learned that telephone munication was valuable. They are great sources of information.
▶ 1:25:16Chair Moran: Senator king.
▶ 1:25:18Sen. King: Thank you and congratulations on your elevation. First, I want to agree with senator sheehy, transition is one of the most important areas. I feel like the defense department should do as much effort in the transition as to the recruiting end.
▶ 1:25:39Sen. King: One of the initiatives of the first trump administration was a preregistration of active duty veterans in the veterans administration so that that was one step they did not have to take. I think that is a good idea, and I have a bill to continue and expand that. Is that something you could help us move forward with?
▶ 1:26:01Dr. Lawrence: I think that is a good idea. And I think that is something that I could support.
▶ 1:26:08Sen. King: Thank you. On the layoffs, here is the problem. You have testified, and the press release has been that this is done in a thoughtful way with reviews. I am a great advocate of ronald reagan's admonition trust but verify. I would like to see some data that verifies that that took place.
▶ 1:26:33Sen. King: It is hard for me to believe that 1000 people were laid off in a matter of weeks with a thoughtful process that you are defining. Given the average attrition rates in the federal government, approximately 2000 people have left the v.a., if the rates are the same as the rest of the government. We are not talking about 1000 empty positions but 3000 in the last month. 2000 a month is the rate that would apply to the v.a..
▶ 1:27:03Sen. King: We are talking about a dead munition cut -- dimunintion, munition cut -- dimunintion. And I know effort has been made to not apply them -- apply that to direct providers but if nobody is there to answer the phone, the difficulty of getting appointments, that is a denial of benefits.
▶ 1:27:23Sen. King: It worries me that we are not really focusing on what exactly the role of those people are, and that the steps so far seem likely to diminish the availability of services to veterans. Your thoughts?
▶ 1:27:40Dr. Lawrence: Thank you. Thank you for the visit where you shared your experience as governor and how you went about doing something similar. That was an important perspective.
▶ 1:27:51Sen. King: We did it in eight months instead of four weeks which was one difference.
▶ 1:27:55Dr. Lawrence: I took away that. Back to your question. I think that, if confirmed, I would like to look at the data and see that it did in fact follow the press release and the secretary committed to being very transparent. I do not want to speak to him but I would talk to him about following through and sharing the information so folks have a sense of trust and what took place.
▶ 1:28:19Dr. Lawrence: I would go back to the safeguard in place which the person answering the phone, a ses supervisor should say they are critical and they should be opted out. Hopefully that is where that took place.
▶ 1:28:34Sen. King: I was agreeing with senator sheehy and the one thing I disagree is electronic medical records and the original sin was a no-bid contract of a brand-new system instead of going to the marketplace and seeing what is available in terms of existing systems that are operating across the country. The other piece that worries me is that everybody in the v.a.
▶ 1:29:03Sen. King: Except apparently direct service providers got the famous early retirement letter that if you quit by september 30 you will get paid. Nobody can convince me that that was thoughtful. That went to everybody. What if the best people leave, which is what a lot of people I talked to said it was happen. The people who can get good jobs immediately.
▶ 1:29:25Sen. King: The good people will leave and there is no way to define that letter that everyone in the federal government got including shipyard workers, the cia, the defense department and the v.a.. How do you defend that as a thoughtful process for redefining the federal workforce?
▶ 1:29:43Dr. Lawrence: Thank you. I am sorry to disappoint you. I was not there and I do not know the process. If confirmed, I will look into it, but I have nothing to add.
▶ 1:29:54Sen. King: I understand and I understand that you were not there. But you are the nearest thing we have to somebody to question on these issues today. So, your bad luck to be here. A couple of provisions from project 2025, which I understand you had a limited contribution to what you are aware of. One is a suggestion to increase automation. The best way to provide benefits more accurately is by using technology to perform most of the work.
▶ 1:30:25Sen. King: We are already learning in the private sector insurance companies that giving ai the decision about making these kind of decisions does not work well. Do you think increased use of technology and artificial intelligence in claims processing is a good idea?
▶ 1:30:38Dr. Lawrence: If you noticed it said most of the work. The way the claim comes about is that there is a lot of work where you gather information and it is called development. That was -- that is what takes so long, getting the information to get in front of some need to make a decision. Technology can be used to gather the information faster. So, a government employee can make the decision.
▶ 1:31:02Sen. King: You are testifying that you are not talking about ai making the decision but simply automating the collection of data?
▶ 1:31:10Dr. Lawrence: It is called development. That is correct. The decision should be made by an individual, v.a. Employee as required by law. But also to bring judgment, I think technology is great but it is not the end all be all.
▶ 1:31:25Sen. King: I guess I'm over my time. Thank you.
▶ 1:31:29Chair Moran: Just a clarification. It was the serner platform is that correct?
▶ 1:31:38Dr. Lawrence: It is.
▶ 1:31:39Chair Moran: Is it also the baseline for the dod system?
▶ 1:31:43Dr. Lawrence: That is correct.
▶ 1:31:45Chair Moran: Was part of the logic behind that to hopefully not modify it so much that they could not better integrate so they were carrying data from the dod to the v.a.?
▶ 1:31:54Dr. Lawrence: I just arrived when all of that went down so I will tell you observations.
▶ 1:32:00Chair Moran: Senator king asked a good question. But having been involved in that process and trying to minimize the customization, they should be in that office that integrates, and why am so glad to hear that you will step up your focus on it.
▶ 1:32:19Chair Moran: If somebody went wrong taking two baseline systems that are precisely the same applications and made them less compatible, there is a lot of quality time that I was suggest that the chair and ranking member consider. Senator blackburn.
▶ 1:32:32Sen. Blackburn: Indeed we have the center for medical interoperability in nashville. And these are precisely the kinds of issues that they work on. Of course what we have learned with health care innovation is that the payment processing can be standardized and efficiencies achieved in payment processing.
▶ 1:33:00Sen. Blackburn: And also, as you said in finding that definable data that is necessary for that claim. And we should use every piece of technology that we can to speed the claims to our veterans. Mr. lawrence, I want to first of all congratulations and thank you. Thank you for the time to visit.
▶ 1:33:24Sen. Blackburn: I want to go first with you to the back -- the backlog on claims because you got the number down the lowest that it has ever been, and you mentioned that. In your opening remarks. What we see now is an enormous claim backlog.
▶ 1:33:46Sen. Blackburn: If you look at the claims that are under 120 days and also over 100 tenney -- 120 days it is 954,000 claims. So, what I would like to hear from you is what steps you are going to take first and foremost to get those claims those numbers down?
▶ 1:34:07Dr. Lawrence: Thank you for the question and I enjoyed our visit very much. What I begin with is going back and if confirmed, talking to the folks and reviewing what is taking place. Part of how we got it down to such a low number is through a series of process activities and technology activities.
▶ 1:34:26Sen. Blackburn: What was the number?
▶ 1:34:28Dr. Lawrence: 64,751.
▶ 1:34:32Sen. Blackburn: Ok. Let me ask you, also and we talked about this privately. 80% of the v.a. Employees are unionized and they are some of the ones that we have heard that have fought going to ehr's. And they have fought returning to work full-time.
▶ 1:34:57Sen. Blackburn: So, in order to address this backlog issue, how are you going to deal with these unionized employees and get them back in the office so that they are processing those claims and to have them adapt using the ehr system that is there that now you have oracle handling that?
▶ 1:35:19Dr. Lawrence: I think the secretary when he was here talked about this very directly which is we have to explain that the mission is to serve veterans and that is our focus on what we need to do. Anything that distracts from that has to take second place. If that means getting back to work, so be it. If that means coming to the office, so be it.
▶ 1:35:43Dr. Lawrence: These distractions take away from our ability to deliver care and benefits and we need to memorize that and focus activity on what the mission is.
▶ 1:35:50Sen. Blackburn: Now, last week secretary collins let us know that the community care network contracts are going to face delays because of some obstacles that were put in place during the biden administration. We have a lot of veterans in tennessee that prefer community care. We have 95 counties, 90 are rural counties. And they prefer community care.
▶ 1:36:22Sen. Blackburn: So, I would like to know that you are going to continue to push to get these contracts back on track for the community care network and, I do not want our veterans to see a disruption or to be displaced. Do we have your commitment in that regard?
▶ 1:36:43Dr. Lawrence: If confirmed I would work with the secretary to follow through on his commitment.
▶ 1:36:48Sen. Blackburn: And then, the first hearing that we did in the v.a. Committee was on community care. And simplifying it. Getting a pilot project in place so that the veteran is making the decision on their care and not having to wait on the v.a..
▶ 1:37:07Sen. Blackburn: And a caseworker who is working remote, working five days out of 10 428 -- two days out of 10 in person to make a decision to allow them to have the care that they need in the location that they need. And I would like your commitment on providing the veteran with that decision-making authority instead of having that land with the bureaucracy and the v.a.?
▶ 1:37:34Dr. Lawrence: If confirmed I will work with the secretary on this. I know he spoke about the importance of choice in his conversations so I want to make sure that we are aligned. We will work on this together.
▶ 1:37:47Chair Moran: Senator duckworth.
▶ 1:37:49Sen. Duckworth: . It is good to see you and thank you for meeting with me last week. I think we had a productive discussion. I want to go back to the president's illegal and unconstitutional executive order to fire people across government and his allowing unelected linear elon musk's doge to have the illegal privilege to carry out these mass firings.
▶ 1:38:17Sen. Duckworth: You mention the way it is supposed to act as there is an ses who reviews these and make sure that people are not being fired from critical positions. I will tell you that last week the v.a. Did fire people from the veterans crisis hotline. The 24/7 hotline where the veterans who are thinking of harming themselves and are in crisis can call. My office has personally spoken to some of those folks who were laid off. Let us think about this.
▶ 1:38:47Sen. Duckworth: The veterans crisis line is where veterans turn when they consider suicide or self-harm. The public servants are doing some of the pup -- the toughest work imaginable to serve -- to help the people who serve the country. After I raise these cases and spoke out about them it sounds like the v.a. Is attempting to rehire some of these employees this morning but we should not be in this position. Will you commit to reviewing how the v.a.
▶ 1:39:13Sen. Duckworth: -- what process the v.a. Engaged in in firing those 1000 employees in any future firings to make sure this process that you talked about supposedly being the ideal is actually happening as opposed to what already happened.
▶ 1:39:31Dr. Lawrence: Yes, senator. If confirmed I will review especially with the crisis hotline how that came about. And what should inform us if or when future layoffs are done.
▶ 1:39:45Sen. Duckworth: I will also tell you that I have read the letters that they received, and it contains no information about any of their benefits, their leave days, their health care benefits, and some of these employees were pregnant who would lose their health care. I am deeply concerned that the letters were so indiscriminate and also did not provide people with information on what their next steps are and they were immediately blocked out of their employment systems.
▶ 1:40:16Sen. Duckworth: I think that we owe the veteran community transparent answers and accountability without excuses or finger-pointing. After this news broke, my office immediately began receiving phone calls from veterans not just from illinois, but also across the country who have been in federal service across different agencies for years. These are long-term federal employees, not probationary.
▶ 1:40:42Sen. Duckworth: They raised my concern that veterans who use the veterans preference in their hiring for positions are coded by opm as probationary. And they have been wrongfully caught up in this egregious mass firings we. When they use veterans preference opm may probe dashcode them as probationary even if they are long-term employees.
▶ 1:41:07Sen. Duckworth: And so, they could be also coded as probationary they have written that have been promoted to a new position. They are coded as probationary. These veterans should not have been fired. Some of the people from the crisis hotline that I spoke with and that we spoke to had 18 years of federal service, five years, they should not have been fired. I know that I do not need to remind you that veterans make up 30% of the federal workforce.
▶ 1:41:36Sen. Duckworth: They are the most patriotic people in our nation and they served in uniform and many turnaround and choose to serve in federal government especially at the v.a. Mission. It is on the wall and it is the clearest mission of any federal agency. Yet the trump administration filled with some of the most disloyal oligarchs who invoke the theme of patriotism to camouflage their agenda has disrespected these veteran service to our nation.
▶ 1:42:04Sen. Duckworth: Would you both publicly and privately call on president trump and elon musk to investigate this catastrophic oversight error in terms of firing veterans coded as probationary even though they are long-term government probe -- employees and rehire those who are disrespectfully fired? And will you push them to exercise transparency and accountability?
▶ 1:42:26Dr. Lawrence: Thank you for that question and clarifying the opm process. I will look into that process to better understand how it affects veterans and based on what I determine, and I will be happy to share with you in the secretary and figure out a course of action going forward.
▶ 1:42:43Sen. Duckworth: Would you carry on illegal and unconstitutional order under president trump or elon musk?
▶ 1:42:50Dr. Lawrence: No.
▶ 1:42:51Chair Moran: Senator murray.
▶ 1:42:55Sen. Murray: Thank you for being here today. I'm going to go back to a topic you have covered a bit which is the hr, started in 20 president trump under 2020 which deployed two v.a. Hospitals. Instead of helping to improve the health care, that rollout ended up being a complete disaster and it endangered veteran patients. Unfortunately the system is still not working the way that the v.a.
▶ 1:43:24Sen. Murray: Doctors and nurses need and veterans are continue to suffer -- continuing to suffer. They announced they would move forward with lead deployment activities at the next four sites for this electronic health care record. You will oversee the ehr program. If confirmed I want to know what you will do differently to hold horrible cold -- oracle accountable and make sure we get our system right for the veterans?
▶ 1:43:49Dr. Lawrence: Thank you for the question and visit. I was greatly informed by what you took place and 2018. If confirmed, I would like to better understand what happened in what you describe and resulted in why we do not listen to the employees and why that was not structured in there. Listening to employees and training and getting feedback and all that is supposed to happen.
▶ 1:44:15Dr. Lawrence: I would like to know why that did not happen and what happened as a result of that. Hopefully learning has taken place and I would hope to validate that. As you heard secretary collins describe, he wants to convene a team of everyone involved to figure out the best path forward. I want to work on that and figure out what the best plan should be in terms of holding everybody accountable for what is supposed to take place. To get the most benefits as quickly as possible within the amount of money you have.
▶ 1:44:46Sen. Murray: We have heard that answer from every person who has come before the committee for a number of years now. Everybody has looked at it and considered it and convened a panel. It is not working. So, I need your commitment that it is not just convening people and taking a look at it but they will make changes and demand changes and get it fixed.
▶ 1:45:11Sen. Murray: We have spent millions of dollars and worse, veterans are still in jeopardy in their care and doctors and nurses and facilities are frustrated. I asked you an important question, what are you going to do differently? I understand where you are coming from what it is the same one I have heard.
▶ 1:45:30Dr. Lawrence: Let me share two observations. One is that I think that the secretary conveyed a strong sense of urgency that it should be done much sooner than later. The second thing I would point out is that in my previous tenure I dealt with technology problems with the g.I. Bill and appeals modernization and blue water navy. I implemented technology.
▶ 1:45:55Dr. Lawrence: I suspect the difference although I do not have the inventory, the differences I have actually done this. That is the difference. I understand the frustration and I pledge to work as fast and hard as I can to get this done.
▶ 1:46:08Sen. Murray: I do not want to be sitting here with the same conversation and a new person. Last week my office is -- office's phones were ringing off the hook with panicked calls from researchers at the v.a. Who have been laid off with euros -- zero justification in morning. Up until then they had assured them that they were protected from trump and musk's mass firing. V.a.
▶ 1:46:36Sen. Murray: Research should not be political and firing v.a. Researchers in the middle of a process to find lifesaving treatment for veterans with conditions like ptsd or opioid addiction or cancer from toxic exposure is really cruel and wasteful. Some veterans are literally in the middle of receiving breakthrough treatment through these clinical trials. What will happen to them and their care when the lead researcher was just fired?
▶ 1:47:06Sen. Murray: I want to ask you a couple of specific questions. Were you aware of the trump administration's goal to fire these researchers?
▶ 1:47:13Dr. Lawrence: I am not gauged at anything at the department now.
▶ 1:47:17Sen. Murray: Do you support it?
▶ 1:47:18Dr. Lawrence: I will look into this to better understand. I do not have enough information to comment.
▶ 1:47:25Sen. Murray: You will not commit to restoring the researchers positions so they can continue the research on ptsd and opioid addiction and cancer caused by their exposure to toxic chemicals?
▶ 1:47:37Dr. Lawrence: I commit to looking into understand what happened and why.
▶ 1:47:42Sen. Murray: I hope it is not like every other answer from people that we are hearing from that they will look into it and no action is taken. This is critical.
▶ 1:47:50Dr. Lawrence: I understand.
▶ 1:47:52Sen. Murray: Thank you.
▶ 1:47:53Chair Moran: I had the staff look into this and we will included into the record that somewhere a little bit under 5% of probationary employees do not continue employment. We have about 40 to 50,000 new v.a. Employees a year, roughly 2000. We are trying to normalize and see how much of this is a net impact as a result of the president eos.
▶ 1:48:22Chair Moran: But right now it is looking like it is tracking. Senator banks.
▶ 1:48:25Sen. Vance: I enjoyed -- Sen.
▶ 1:48:29Banks: I looked -- I enjoyed working with you in the first trump term. The indianapolis medical center is due for a replacement. The v.a.'s five-year development plan calls for a $206 million next year to plan and a site and design the project. Will you commit to working with the v.a. Cfo, omb and this committee to reprioritize that project.
▶ 1:48:58Dr. Lawrence: It is great to be with you and I remember and congratulations on your promotion. I remember that you asked hard questions. So, I know you asked the secretary this in hearing -- in his hearing and I will work with him to do that.
▶ 1:49:14Sen. Banks: We appreciate that and look forward to working with you on that. Dr. lawrence, the deputy secretary is traditionally the v.a. Chief operating officer. But very little of that responsibility is laid out in the law. What will you be responsible for and how will you prioritize that role?
▶ 1:49:33Dr. Lawrence: Thank you. The deputy is the chief operating officer and it is somewhat described so I will use that. The deputy area -- the deputy secretary is responsible for all administrative operations, provides government -- governance and oversight. Works on agendas, special issues and other things at the secretary assigns.
▶ 1:49:57Sen. Banks: I know we talked a little bit already about electronic health records, but ehrm has been going on for eight years and in the first term we worked together on the oversight of the project. But, a lot of senators still have basic questions about what is going on with that. Do you think the v.a. Has adequately explained the objectives and how the strategy has changed over the last eight years?
▶ 1:50:23Dr. Lawrence: Thank you. I have not followed it in detail the last four years. The fact that every time I meet with you you ask questions about it it seems like by definition the answer is no. There are too many unanswered questions. Secretary collins' testimony talked about the importance of transparency. There is -- this is one area with more to do.
▶ 1:50:46Sen. Banks: I was chairman of the ehrm oversight committee in 2018 when the project started. The original plan was for the veterans health administration to standardize operations across all of the medical centers to pave the way for ehr, and that never happened. That is why the project continues to fail. How are you ever going to implement the oracle ehr without the v.a. Standardizing it?
▶ 1:51:14Dr. Lawrence: If confirmed I do want to look into this because the value of having software is not changing the software but changing the processes around it to the extent you configure it to be like something else before you do not get those advantages. I want to understand if that is going on and why. When the secretary was here he talked about the things are the same everywhere else. They are unique to v.a. And things are the same. These systems work elsewhere because they follow the things you are pointing out.
▶ 1:51:45Dr. Lawrence: I want to look into that and understand why and how to stop it.
▶ 1:51:48Sen. Banks: Any other feedback or opinions that you developed over the last four years why this has gone off the rails?
▶ 1:51:55Dr. Lawrence: The same thing from before, I have questions about it and these things I would confirm if confirmed. I would look into leadership and accountability, changes about what you described happening because someone let it happen not realizing that that was not supposed to happen. These tools are supposed to help us help veterans but I do not hear anybody talking about it this way. This will be a great thing for the veterans because.
▶ 1:52:24Dr. Lawrence: All I hear that it cost too much and it does not work. I have not heard the value proposition and that is something we need to talk more about.
▶ 1:52:30Sen. Banks: It took the v.a. 12 years to encourage one million veterans to provide their dna samples for the million veteran program, are you familiar with that?
▶ 1:52:42Dr. Lawrence: Vaguely.
▶ 1:52:43Sen. Banks: It has promised groundbreaking discoveries and in reality it has not sequenced most of the dna samples or produce many results. What is holding the million veteran program back and how can it be more effective and would you be committed to taking a strong look at that?
▶ 1:53:00Dr. Lawrence: That is sad to learn, especially given the promises. If confirmed I want to look into why that did not happen. I want to know who is in charge with that.
▶ 1:53:12Sen. Banks: Thank you very much.
▶ 1:53:14Chair Moran: Senator slotkin.
▶ 1:53:17Sen. Scott: Can I have heard nothing but positive things fro lots of people that we have in common, and so I do not question at all your commitment and experience serving our veterans. And I thank you for that.
▶ 1:53:32Sen. Scott: The problem I have as I come into a hearing like this is that it feels increasingly more and more common that the senior executives at our departments and agencies want to do the right thing and can have the right values in mind. And then people just come in on top of them and make decisions.
▶ 1:53:54Sen. Scott: When secretary collins was here, someone I served within the house and I asked very clearly will you commit to standing in the breach if someone like doge or the white house comes in and says we are just going to full sale start laying off veterans and veterans avails folks -- affairs folks that you will stand in the breach and not accept cuts to the v.a.? That hurt our veteran care. And he said yes. And I believed him.
▶ 1:54:24Sen. Scott: And then 1000 people were laid off last week, many of them veterans. We know because many of us here voted for the pact act, helping the 9/11 era veterans were exposed to burn pips. We have hired a lot of new people to help with veteran care. I can only assume that they are on the chopping block, not that you would want it but someone comes in over your head and makes those decisions. You have said repeatedly that you will look into it.
▶ 1:54:52Sen. Scott: I just want to know if you are going to stand and pledge to perfect and defend the constitution, not a president, the king or -- but the constitution that you will push back. Will you push back if it continues, not theoretical cuts, but continued cuts impose on you and hurt the care to our veterans?
▶ 1:55:15Dr. Lawrence: Thank you for the question. Yes. I will push back on things that affect the care and benefits of our veterans. I think you heard the secretary talk about his charge which is taking care of veterans. I do not leave as described to me because I was not there, these cuts on friday affect that. There has been evidence that you are receiving that might be different.
▶ 1:55:39Dr. Lawrence: These are non-mission-critical cuts not in a bargaining unit with a supervisor to provide you know relief if that is not true. So, you are right. I will push back non-mission-critical cuts.
▶ 1:55:53Sen. Slotkin: Again, we are told Mr. bessent at the department of treasury told us that do not worry, doge and Mr. musk are getting access to read-only information and that was immediately proved false. Now, doge has access to taxpayer information.
▶ 1:56:14Sen. Slotkin: So I asked secretary collins what will you do when they come for the veterans information, will you stand in the breach and say we will not give you access, temporary, read-only, full fire roles for information on the veterans who have served the country and I said what will you do?
▶ 1:56:31Dr. Lawrence: This is an easier answer and that is no you cannot have access to that information. On my understanding right now is that they do not have access. One employee has access to contract and general operation and management of the I.t. Department. Just as aiden -- just as an aside, access to veterans benefits and health information is strictly guarded. There is a restricted process to do that.
▶ 1:56:59Dr. Lawrence: For example, I could not at veterans information or someone on this committee. A secretary cannot do that without going through a difficult program. He has assured publicly that doge employees will not have that in -- that access and for that information.
▶ 1:57:15Dr. Lawrence: Theoretically, taxpayer information would be deeply sensitive and no tom, day, and harry can take random tax information or medicare. Hepa, health information, all of these things were considered sacred and things that we were told would be protective and there all kinds of restrictions and then a bunch of 25-year-olds get access the same day the secretary is talking to us, the secretary of the treasury.
▶ 1:57:44Dr. Lawrence: Whatever your hopes and dreams are, they do not seem to be living up to what the moment is here because people are coming in. It is not about your commitment to veterans. I understand that you have it. Your commitment is going to mean fighting some really tough fights with people on your same political team for the sake of veterans. I am asking and imploring that there is something bigger here than living up to doing whatever trump says, protect our veterans, please.
▶ 1:58:13Dr. Lawrence: Thank you and I understand your perspective. I do not know about the tax or medicare systems but I know about the v.a. Personal information systems and that cannot happen without permission.
▶ 1:58:25Sen. Slotkin: Great.
▶ 1:58:27Chair Moran: Thank you. I think senator blumenthal has a couple of other questions and I have one or two and I will try to be brief. It looks like the implementation is going to go through the very predictable, the initial either the initial requirements were not well defined, the complexity of the applications portfolios were not well understood and we may be got tempted into more
▶ 1:58:59Chair Moran: Customization then we should have. We found out that data models were more difficult to map out. The typical things that I would find in a project review when something goes sideways. I think it will be necessary for you to commit to come before this committee after a reasonable period of time to give us a traditional stop and start.
▶ 1:59:24Chair Moran: What practices will get us into the ditch, it is not usually the vendor or the consultants but usually because we involved other requirements to creep in. What practices have to be stopped and started and what part of the implementation is going relatively well. Can I get a commitment within 90 days of you being confirmed that this committee gets a report like that?
▶ 1:59:46Dr. Lawrence: I think you are right in the description. I will give you almost a commitment. The 90 day thing I do not know if I can guarantee. But the secretary talked about doing the kind of review that you talked about. So, yes.
▶ 2:00:01Chair Moran: That is fair for you to hold off on the 90 day commitment. In my experience, anybody worth their salt can figure out what is wrong with a project within 90 days but I understand why you cannot commit to that. I would be happy to do it in 90 days.
▶ 2:00:19Sen. Blumenthal: Eisenhower retook europe in 11 months. Thank you. I welcome your responses to senator slotkin about denying access to elon musk or doge or others should -- you should not have it. Did I hear you correctly on that point.
▶ 2:00:40Dr. Lawrence: Especially the last point. About anybody who should not have it.
▶ 2:00:44Sen. Blumenthal: Will you resign if they do have access or if they are given access to it?
▶ 2:00:49Dr. Lawrence: It is difficult -- it is -- thank you. It is difficult to answer a theoretical question of who I would have no control. I am not going to comment.
▶ 2:01:01Sen. Blumenthal: Well, how would you stop them if you have no control?
▶ 2:01:09Dr. Lawrence: Senator me see if I can reframe your question.
▶ 2:01:13Sen. Blumenthal: My question is pretty clear as it is, how would you stop them if you will not resign and raise it as an issue of conscience and conviction?
▶ 2:01:23Dr. Lawrence: So we are talking about a hypothetical whereby somebody gets --
▶ 2:01:28Sen. Blumenthal: It is not a hypothetical.
▶ 2:01:30Dr. Lawrence: At the v.a..
▶ 2:01:32Sen. Blumenthal: It is ongoing, or on the horizon. They are going to the department of defense. Where national security is an issue. They are going to the department of health and human services and accessing health records. There are reports that they are already in the v.a. Even if you discount those reports. This is not a hypothetical.
▶ 2:01:56Sen. Blumenthal: I am asking you, because you stated to senator slotkin so clearly that it would be a violation of ethics and law for this information to be given to elon musk or anyone else, unauthorized, and unclear.
▶ 2:02:14Dr. Lawrence: Thank you for clarifying that. I commit to, if confirmed to better understand the situation and try to figure out what leverage I would have to make sure it does not happen.
▶ 2:02:26Sen. Blumenthal: I think that speaks for itself. I am not going to ask another question to follow-up. I want to put the record the federal news network article entitled despite exemptions, v.a. Employee still feeling impacts from policies shaking up federal workforce. If there is no objection.
▶ 2:02:45Chair Moran: Without a -- Sen.
▶ 2:02:47Tillis: Without objection.
▶ 2:02:48Sen. Blumenthal: Just for the record, since there has been some reference to the biden administration. In fact, president biden instituted a strategic pause allowing facilities and local leadership to make staffing decisions as long as it did not increase -- as long as it does not increase cots and to make cuts.
▶ 2:03:16Sen. Blumenthal: As a result, there was bipartisan opposition to that step. As a matter of fact. The staffing at the v.a. Grew, not declined by a net of I think 10,000 employees because vha recognize that hiring staff actually saves money by bringing v.a.
▶ 2:03:44Sen. Blumenthal: Health care back in-house from the community. I invite my republican colleagues to join me in the current proposal for cuts, just as we joined together to oppose the potential biden cuts in staffing that were not cost-effective. Let me ask you, Dr. lawrence, where do you live?
▶ 2:04:12Dr. Lawrence: In virginia.
▶ 2:04:15Sen. Blumenthal: And, what is the v.a. Health care facility nearest to where you live?
▶ 2:04:22Dr. Lawrence: I do not know. I do not use vha health care. I believe it is washington, D.C..
▶ 2:04:29Sen. Blumenthal: Why do you not use v.a. Health care?
▶ 2:04:32Dr. Lawrence: I am ineligible. My service was such that I am ineligible. In addition I have always been in the private sector and had private care. Even if I were eligible, I would think about people who need it more than me. So I would not use it.
▶ 2:04:51Sen. Blumenthal: So you would not use it?
▶ 2:04:53Dr. Lawrence: I did not say it. Because I had private care even if I had access I would not use it because I would be thinking of people in much more difficult situations because my health care has been good who need access to it more.
▶ 2:05:08Sen. Blumenthal: Do you have any direct experience, have you ever received health care from the v.a.?
▶ 2:05:14Dr. Lawrence: I have not.
▶ 2:05:16Sen. Blumenthal: When is the last time you are in a v.a. Health care facility?
▶ 2:05:20Dr. Lawrence: When I was in the first administration. I regularly visited them. I would visit regional venice -- benefits offices because they were next to the health care. We held claims clinics in v.a. Medical cities.
▶ 2:05:35Sen. Blumenthal: You have not been in a v.a. Health care facility since your service ended in the trump administration?
▶ 2:05:42Dr. Lawrence: That is correct.
▶ 2:05:43Sen. Blumenthal: When you were undersecretary of the veterans benefit administration you had 24,000 employees in 56 separate regional offices working for you, correct? How many of those employees do you think should be fired?
▶ 2:06:03Dr. Lawrence: I am not aware of what is going on there now.
▶ 2:06:07Sen. Blumenthal: When you were there, how did you think should be fired?
▶ 2:06:12Dr. Lawrence: When I left they were producing at the highest level in history. Some left through attrition and some left to get better jobs. It was a very solid workforce.
▶ 2:06:22Sen. Blumenthal: Would you have fired any of those 24,000 when you were there?
▶ 2:06:28Dr. Lawrence: The first part of your question?
▶ 2:06:31Sen. Blumenthal: Would you have fired any of those 24,000 employees when you were there?
▶ 2:06:35Dr. Lawrence: We did not have to buy because by measuring performance the bad one under -- understood they were bad performers and they left before the systems had to go after them.
▶ 2:06:45Sen. Blumenthal: You did not think that elon musk was necessary or the doge transition operation and the firing that they are now doing was necessary then?
▶ 2:06:59Dr. Lawrence: There were many fewer employees. I believe right now the v.a. Has 35,000 employees and I could be wrong. A lot of hiring has taken place so I do not know what those folks are doing.
▶ 2:07:12Sen. Blumenthal: As to those 56 regional offices, did you recommend at the time that you were undersecretary any be close?
▶ 2:07:19Dr. Lawrence: I did not. I announce that we would close no offices and during that period of time that the number of employees would be equal to or greater than when I left.
▶ 2:07:30Sen. Blumenthal: Dr. lawrence, do you think the pact act is working?
▶ 2:07:34Dr. Lawrence: Thank you. I have a lot of observations based on anecdotes. So, I do not want to comment. I really want to dig into this closely. Some of the things that are positive, more veterans are coming to get care and more veterans are applying for benefits. It is easier to deal with the burn pits, you could do it one-off and I think that was difficult for veterans.
▶ 2:08:01Dr. Lawrence: At the same time I worry that the backlog is large and growing. I worry also about some of the things we talked about like the communication. So I think there are opportunities to improvement but by and large when you consider the objectives it looks successful.
▶ 2:08:18Sen. Blumenthal: Do you think that the presumptions for care and benefits is justified?
▶ 2:08:24Dr. Lawrence: On that one, yes.
▶ 2:08:26Sen. Blumenthal: Do you commit to trying to end the backlog?
▶ 2:08:31Dr. Lawrence: That would be part of my charge. I would be responsible for the performance of the undersecretary for benefits and that is one of the key critical factors that I would focus on which is processing claims in a timely and accurate manner.
▶ 2:08:45Sen. Blumenthal: Would you agree that potentially more v.a. Members are necessary staff and others to make the pact act work?
▶ 2:08:54Dr. Lawrence: Thank you. Potentially more employees and more technology and more of both and more assistance from other vendors who know how to do this, absolutely.
▶ 2:09:05Sen. Blumenthal: So if the muska operation is causing a cut in those employees, it could be increasing the backlog.
▶ 2:09:13Dr. Lawrence: If the v.a. Decides and this is hypothetical. If they decide to leave off -- lay off mission-critical employees it will increase the backlog.
▶ 2:09:27Sen. Blumenthal: Will you resign if that happens?
▶ 2:09:29Dr. Lawrence: I will prevent that.
▶ 2:09:32Sen. Tillis: Senator king for a brief question.
▶ 2:09:35Sen. King: Just two. In 2020 -- in project 2025, which I know you contributed to in a limited way but you were involved in the veterans part. One says and reduce improper payment and fraud. 500 million is improperly paid out each year. Our veterans frauds or are they committing fraud?
▶ 2:09:57Dr. Lawrence: No. What that refers to is the following. This is what tends to be what happens. When a veteran passes they often do not tell -- the heirs often do not tell the v.a. That the veteran has passed. Their disability compensation money continues to be paid.
▶ 2:10:19Sen. King: That would be improper but that is not fraud.
▶ 2:10:23Dr. Lawrence: That is the broad category.
▶ 2:10:27Sen. King: I do not see how you will ferret that out without getting into the individual medical records of veterans which you have testified will not happen.
▶ 2:10:34Dr. Lawrence: Let me give you an example of fraud. In call centers, and the world's best companies you are not allowed to bring your cell phone because you can take pictures of information which could be used to do identity theft. When I arrived at the v.a. Call centers no rule existed. Employees were able to take pictures of confidential information and perpetuate identity theft. That is fraud.
▶ 2:11:02Sen. King: Completely agree. In order to ferret out the $500 million of flawed -- and fraud which is not substantiated in any way it will be necessary to dig into those medical records to see who died and who did not. So, if you are going to go after that, you cannot say we are never going to look at a veteran's records.
▶ 2:11:25Dr. Lawrence: I respectfully disagree. You get destined -- death information for people who scour corner's information.
▶ 2:11:34Sen. King: Let me move on. One of the most disturbing things says this "the next administration should explore how reviews would be accelerated with clearance from omb to target significant cough say zhang's from revising disability rating." that is a change of benefits.
▶ 2:11:56Sen. King: And listen to this, "while preserving them fully or partially for existing claimants." partially as a pregnant term. That means you are talking about potentially reducing benefits for people who are getting them now. Do you support that provision in this report of which you are one of the authors?
▶ 2:12:16Dr. Lawrence: I do not. Let me clarify. The rating schedule ally owns -- aligns benefits to your disability. It is an ongoing review. The v.a. Is encouraged to do them more regularly, but any change to the rating schedule I would defer to the secretary and president. As we talked about our intention is not to reduce benefits.
▶ 2:12:38Sen. King: I am glad to hear you say that but the phrase preserving benefits fully or partially for existing claimants is not very reassuring to the veterans of this country. Thank you.
▶ 2:12:51Sen. Tillis: Thank you. Mr. lawrence, we are at the end. I impose the moran rule. I know he tended to allow the members to ask follow-up questions. So I hope that I honored his tradition versus cutting off, which we sometimes do in other committee meetings. Mr. lawrence, you were voted out of committee with a voice vote when you were up the last time.
▶ 2:13:19Sen. Tillis: That is a strong statement about the qualifications you put forth because controverted -- controversial nominees do not get a voice vote, not only in the committee, but you got a voice vote on the floor. In my examination of the time you are in this position you got pretty strong marks for being forthright, focused, and good on execution. And I believe that there is every indication of your past work, and there are challenging times.
▶ 2:13:48Sen. Tillis: There will be interest -- instances where hq might ask you to do things in your professional judgment are not the best way to refine the approach to the pact act or any number of policies that only you and the secretary will be familiar with.
▶ 2:14:06Sen. Tillis: So you owe it to the administration when well-intentioned ideas are not in sync with your core mission of improving care and access to veterans and I have every confidence you will do that in a professional way and you owe it to the president to look around corners for those who are advising on matters that look like a good idea but those in the trenches who have to execute it, I think you will use sound judgment and I look forward to committing to your confirmation.
▶ 2:14:34Sen. Tillis: If there are no other questions I think you before coming -- for coming before the committee with the members asking very important questions. Each member has five days to extend their remarks and any member who would like to issue questions to Dr. lawrence should send them to the committee clerk as soon as possible but no later than noon tomorrow. Dr. laurence, I appreciate your response and congratulations to the family for this. For this honor to be nominated.
▶ 2:15:06Sen. Tillis: And with that, this hearing is adjourned. [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap.org]