▶ 0:01:58e e
▶ 0:02:57that's and so the it's
▶ 0:06:28e e
▶ 0:07:28the committee will come to order good afternoon everyone I want to thank you for being here welcome to the house committee on Veterans Affairs first oversight hearing for the 119th Congress now before we start I wanted to recognize and thank my colleagues and friend uh chairwoman Miller Meeks um for her leadership chairman uh woman Miller Meeks originally proposed this hearing topic to be held in a subcommittee But ultimately I decided uh this important
▶ 0:07:59uh this is an important enough issue to discuss that requires full committee attention as chairman I am deeply committed to our shared mission of improving the delivery of care and services to our nation's veterans I look forward to working alongside my colleagues on both sides of the aisle to fulfill this Mission last Congress this committee did meaningful work towards the mission by passing the Dole act the committee also performed
▶ 0:08:30critical oversight of the Biden Administration VA to find where the shortfalls were today we turn our focus on va's Community Care Program which as we know is today it it today was enacted in the VA Mission act the VA Mission Act passed in 2018 with overwhelming bipartisan support it was a promise to Veterans a promise to Ure sure
▶ 0:09:00they would never again face delays in Access the health care they have earned it was a solution born from necessity and on the shoulders of what was the choice act it was designed to uh eliminate barriers to care and expand access for veterans Nationwide it is not a solution to private and it is it is not a solution to privatize VA Healthcare let me say it
▶ 0:09:30again not to privatize Healthcare the VA Healthcare anyone who suggests otherwise should step outside the Beltway and talk to the veterans who live 3 hours from a VA Medical Center Community Care is that that Veteran's Lifeline Health Care decisions are deeply personal and they should be made by veterans themselves they know where and when and need care
▶ 0:10:00to fix needs however under the Biden Harris Administration the program has been hijacked Biden Harrison Administration has prioritized Bure bureaucratic uh limitations and control of a community care over veterans needs scheduling uh practices have been manipulated to distort wait times appointments have been cancelled or rescheduled without vet veterans consent
▶ 0:10:31uh internal VA guidance has actively discouraged uh uh veterans from seeking care outside the VA system that's dead wrong and likely like everywhere else uh like and like every other law that is enacted it is not optional and it's not a suggestion it's the law when VA inserts itself as the sole decision maker and plays politics with veterans Health people get hurt these
▶ 0:11:01actions have real life consequences and we're going to hear some of those consequences today from actual veterans not bureaucrats make no mistake Community Care is VA care it is not a substitute but an essential extension of va's Mission to serve veterans where and when they need it without delay with the Trump Administration in place we have the
▶ 0:11:31opportunity to ensure VA uh adheres to the mission act and returns healthc care decisions to the hands of the only Authority that matters the veteran today we will hear from Witnesses who have experienced these barriers firsthand their stories will remind us that the decisions made by here in Washington have a far-reaching impact on the lives of veterans and families to our veteran or to our Witnesses
▶ 0:12:01first off thank you for the courage and sharing your experiences your experiences matter and we are here to listen now with that I now recognize ranking member Tano for his opening comments well thank you Mr chairman uh today we will hear perspectives from several veterans who have faced barriers in trying to access timely and highquality Health Care from the Department of Veterans Affairs I want to say to our witnesses that
▶ 0:12:31I am truly anguished by the unacceptable delays uh to you and your veteran loved ones um I'm I'm I am anguished by uh what they have faced and what you have faced in getting the care that you and they need your experiences are deeply troubling and I have many questions about how things went wrong unfortunately I'm afraid that today's hearing will not help the committee get sufficient answers to those questions and it will not
▶ 0:13:01enable us to hold those responsible accountable that is because the majority has opted not to invite any Witnesses from VA or the two third-party administrators of its Community Care Program they also opted not to include Witnesses from agencies like va's office of Inspector General or the US government accountability office who could provide us with objective fact-based information about how and why veterans experience delays in accessing Healthcare this hearing was hastily organized
▶ 0:13:32just hours after our committee organizing meeting last Thursday we have six members who are new to this committee uh to Congress three of whom are Physicians and understand better than anyone the importance of proper care coordination and the risks of delayed care Mr chairman today's VA Community Care oversight hearing is the first the first that you have convened since becoming chairman more than two years ago more than 40% of veterans care is now being delivered in the community and VA is on track to
▶ 0:14:02spend more than $42 billion on private sector care this FIS school year when I was chair of this committee from 2019 to 2022 the full committee and the health subcommittee collectively convene six oversight hearings that examine the timeliness of veterans access to healthc care and payments to community providers as well as va's initial implementation of the mission act I'm explaining all this because what I'm about to say May stock members veterans and other stakeholders
▶ 0:14:34today last Thursday we were informed that this one panel hearing will be the only full committee oversight hearing on Community Care before we advance major legislation on the subject and that we had to content ourself ourselves with two closed door committee staff only meetings with stakeholders however since the committee had not formally organized at the time these meetings occurred no members or their staff were present moreover because these meetings were held behind closed doors there is no public record of what
▶ 0:15:04was discussed the minorities only permitted to invite one witness to a hearing and given that the current transition and presidential Administration presents challenges with inviting government officials officials to testify uh so I asked the majority to invite optim serve federal health services one of the thirdparty administrators for VA Community Care Program optim is a subsidiary of United Health Group and has cont tracted with VA since 2019 to establish networks of community providers and process payments
▶ 0:15:34to those providers United healthare also holds a contract with VA to conduct medical disability examinations the exams veterans receive when they are applying for VA disability benefits today United healthc Care's VA contracts are worth more than $72 billion that's billion would that be worse that money is not all spent on providing care to Veterans a considerable amount is going into administrative overhead imagine how many new Hospitals and Clinics VA could build and how many
▶ 0:16:04clinical staff uh could VA that VA could hire with that amount of money however United Healthcare declined the invitation uh declined the invitation to testify citing the lack of sufficient time to prepare for the hearing now I don't know about you but I don't have much sympathy for a company that is receiving tens of billions of tax taxpayer dollars complaining that they need more advanced notice to appear at a hearing ing the chairman staff however apparently do sympathize because they accepted United healthc Care's excuse
▶ 0:16:35now that brings me to Dr sandon Who is appearing today as the minority's witness she serves on the board of directors of the nurses organization of Veterans Affairs otherwise known as Nova Nova is a nonprofit professional association whose mission is to educate communicate and advocate for VA nurses Nova is not a part of va nor is a union Nova managed to do whated Healthcare could not arranged to get Dr sandon to DC to testify with less than two business days notice
▶ 0:17:06so I want to thank Dr sandon for being here today now I know we won't get answers to all our questions in this single hearing veteran stories are an important part of oversight and I thank our Witnesses again for their bravery and cander in participating in today's hearing however oversight is not complete without accountability and there are no accountable individuals here today no accountable indidual individuals are appearing before us today and I want to be clear that I recognize the importance of Community Care however
▶ 0:17:36I also do believe uh any further expansion of Community Care must be met with similar investments in VA direct care the two systems should be complementary in balance with one another to ensure veterans can access the best most timely culturally competent care but that is what is not happening right now Community Care has expanded at the expense of VA direct care and if we continue down this path VA will crumble and this is where I draw the hard line the our veterans cannot afford
▶ 0:18:06for us to dismantle VA direct care in favor of Shifting more care to the community nor by all accounts do they want us to rushing to pass this legislation without sufficient oversight and diligent efforts to uncover the root cause of problems is a recipe for disaster for example in 2014 after news of quote unquote secret VA waiting lists Congress acted quickly to create the veterans Choice program a temporary program that allowed veterans to receive Community
▶ 0:18:36Care when they face long wait times or lengthy travel distances we want from Bill to law in the course of three months as we found out over nearly four years over the few four years that followed the choice program actually resulted in longer wait times confusion about payments and administrative headaches for veterans and staff at VA then in 2018 Congress passed the mission act further expanding Community Care eligibility yet here we are today with veterans and VA staff facing many of those same
▶ 0:19:06issues with access care coordination and transparency all the while VA has been rolling out more policies and contract modifications altering the administration of the Community Care Program how can we address the effect of these administrative changes if we are not conducting proper oversight this committee also needs to conduct more oversight of the quality of care veterans are receiving in the community as we will hear from many of the witnesses today simply getting a referral to the community is only the first step
▶ 0:19:37we must also ensure that these referrals are actually leading to Veterans receiving highquality care furthermore we need to ensure that we are being good stewards of taxpayer dollars as our majority so often reminds us care provided in the community is of often comes at a higher price tag and can be less efficient and less effective than care that VA provide directly and we must also consider the long-term future of va which serves not only the veterans not only our veterans but all
▶ 0:20:07Americans through its role in providing world class uh world class in groundbreaking medical research its fourth Mission emergency preparedness mandate as well as providing residency and fellowship training for More than 70% of all us healthc care providers at some point in their careers as as a committee we must be can we must we must can ly assess the long-term and far-reaching consequences of undermining the VA direct care system in favor of prioritizing Private
▶ 0:20:37health care profits with that I yield back and thank the ranking member for his testimony let me tell you that this is the first of many hearings focused on Commit uh Community Care we are in their very first hearing that gives us an golden opportunity for a lot of them this hearing is solely focused on the hearing the vet veteran stories so that we can work on this but let me explain this to you the VA and I've said it so
▶ 0:21:07times the VA was created not for the VA not for the bureaucracy but providing for the veterans and then this hearing we decided we want to hear from the veterans and as my position as chair let me say this again it is not the majority's position to privatize the VA but to make sure the VA delivers to our veterans at the
▶ 0:21:38level that they need to have their care given to them when and where they need it with less bureaucracy and given in a way so that incident after incident after incident does not occur where someone falls through the crack for whatever reason whether it's in the community or at the VA so with that we will turn our to our Witnesses uh testifying to us before us today uh is Paul mcken M mck mck
▶ 0:22:08say that correctly for me there J major good afternoon chairman B I'm I'm just introducing now I was just trying to pronounce it correctly Paul McKenna McKenna thank you uh now s he's a sergeant major of the Marines traveled for uh from representative Murphy's District uh in Northern uh North Carolina we also have William D a 20-year Army veteran traveling at away from uh Congressman self's District in Texas Miss Lori Willis uh
▶ 0:22:38laer a former VA employee and mother of a Navy veteran Logan Willis traveling from representative Harris's District in North Carolina Miss Britney Damon uh diamon Diamond just Diamond there you go I always wers why they put that out when it were just pretty well spent that way Associated Director of Veterans for for veterans foreign war and Dr Kelly uh sandon uh secretary treasurer of the nurses
▶ 0:23:08organization of Veterans Affairs will the witnesses please stand and raise their right hand do you solemnly swear that the testimony you're about to provide is the truth the whole truth and nothing but truth thank you and let the record reflect you may say that thank you and let the record reflect that the witness uh answered in the affirmative uh I now recognize sergeant major mcken uh for the 5 minutes to deliver your testimony
▶ 0:23:39major good afternoon chairman Bose and for the record of retired chairman Bose ranking member Tano and members of the House committee on Veterans Affairs thank you for inviting me to testify for the record of today's hearing on Veterans experiences using the Department of Veteran Affairs Community Care Network I'm here today as a voice for countless veterans in eastern North Carolina who continue to struggle
▶ 0:24:09to effectively and efficiently utilize the critical part of the va's Health Care system as the committee is aware the VA Mission act became law in 2018 and was intended to improve access to health care for veterans my aim today is to illustrate the gaps and seams within the pillars of this legislation that are present in eastern North Carolina with specific attention on access to care
▶ 0:24:40the Community Care Network and the Education and Training of the VA Workforce that coordinates access to care in the community my hope is that my testimony will offer the committee some insight to the real challenges that veterans face when using the Community Care Network in eastern North Carolina additionally and what may sound anecdotal is to share with you my experiences with using the services of the VA Community Care Network in two
▶ 0:25:10different geographical locations and the experiences of many veterans I have talked to who must utilize community-based Services my name is Paul McKenna I retired in 2021 after 36 years of active duty service in the United United States Marine Corps I learned many lessons life lessons from my nearly four Decades of service as a US Marine and at the very top of that list is that no American
▶ 0:25:41can afford to be disinterested in any part of their government County city state or Nation one of the great lessons the Marine courp taught me was to never take for granted of being in the presence of other Marines and their greatness for 36 years I walked amongst Giants I will forever cherish those relationships especially the relationships of those American Heroes that never came home
▶ 0:26:12I truly hope that my actions and words today bring honor to their memory and their sacrifice thank you Mr McKenna uh Mr you're recognized for 5 minutes thank you chairman Bose ranking membo for inviting me to testify on my frustrating experience with the VA Community Care specifically Dallas Texas Veterans Affairs Medical Center I sit here today as a veteran father
▶ 0:26:43husband and cancer patient I apologize for my appearance and any speech deficiencies that I may have while reading my statement I finished my final chemo treatment a week ago and I'm still having several single several side effects I'll start from the beginning of my cancer journey in September of 2023 I voiced my concerns for symptoms while a regular scheduled doctor's appointment in November of 20123 I voiced my concerns Again by scheduling a doctor's appointment for these same symptoms in bonom Texas I completed a sample submission for the
▶ 0:27:13doctor and he ordered a colonoscopy I was told by the scheduling that they were backlogged and Community Care would be my best route to get care I was referred to Community Care in December of 20123 I was matched with the community care provider Jenny saying at the time my community care provider informed me that May 20th 2024 was her first available for the colonoscopy I was scheduled for a colonoscopy 9 months after I voiced my concerns with my primary physici and 5 months after being referred to Community Care Program on May 20th I received the colonoscopy and woke up with the dreaded words
▶ 0:27:43you have cancer and need surgery immediately multiple phone calls from myself and my wife to the Veterans Affairs resulted in almost no movement forward I was told it be September before I would receive the cancer testing required prior to surgery I was told I had cancer and the best they could do is get me tested in four months this was not acceptable Community Care was my best option to survive we scheduled my first appointment with UT Southwestern Oncology with the assistance from UT Southwestern we were able to get scheduling for all required tests set up the following week not four months Community Care was no
▶ 0:28:13assistance and we used our personal insurance for the doctor visit we eventually received referral and approval from the required testing and received approval for cancer treatment at UT Southwestern this was only after reaching out for assistance from representative self's office unfortunately after the testing was conducted it was revealed that I did not have stage one cancer and due to too many too much time passing for the original colonoscopy I was currently stage three cancer and my lmod system had been compromised at this point I was informed by the oncologist that s surgery first was not an option and that a very aggressive chemotherapy and radiation
▶ 0:28:44treatment was my best option survivability the treatment would consists of eight rounds and two types of chemotherapy and five rounds of concentrated radiation followed by successful treatment I be evaluated to determine the level of surgery required I was informed in August after receiving several bills that the treatment I received was not covered this was due to the referral for cancer treatment not including chemotherapy or radiation I was informed that of this unit because the billing was rejected only once again we reached out to represent self's office for assistance I do not believe
▶ 0:29:14we would received this approval without the assistance from his office three major problems I encountered during this process first the Community Care Program does not communicate directly with the provider other than the original scheduling this leads to confusion for the veteran adds possibility of poor case management and the treatment for the veteran in my case the community care worker could have uh could have assisted by contacting me and letting me know if 5 months weight was the only option or if other care providers had availability sooner second the approval of one of the procedures but not the others
▶ 0:29:44is is known to be required together cancer treatments for us non doctor non-d doctors usually comes in three forms and in most times all three are used surgery chemotherapy and radiation why is a standard procedure to approve surgery but not the other two is very confusing to need three separate referrals for the same treatment plan it adds to the confusion for billing and for referral management especially when all three have different expiration dates at no point did my caseworker have direct contact with the provider to discuss the issue and how to resolve it any attempt to call my casew worker and
▶ 0:30:14facilitate a three-way call resulted in leaving a message and waiting for a call back this was due to my caseworker being a remote employee and not being provided a direct phone number to her third is a lack of professionalism and compassion from the VA employees from the beginning of this journey we have been side at told to wait told to be treated with disdain by the employees we encountered I was treated like I was asking for charity and not treated as a disabled veteran that was trying to receive life-saving treatment case manager displays some of the worst incompetence I've seen in decades one of the most occas
▶ 0:30:45on one of the occasions the response that I received from the VA was intertwined with mistru and blatant lies about timeline and what happened this was very concerning at no point has anyone taken ownership or conducted an assessment of what could have done differently the respons was deny deny and counter accused accountability for poor performance and low proficiency is not a strong point of Veterans Affairs all these problems were shown last Friday after my submission of my written testimony on Friday I received a phone call from the Veterans Affairs it was my primary health healthc care provider the message
▶ 0:31:15was primary healthc care provider asking if I had been scheduled for treatment for the two referrals for chemotherapy and radiation I just found finished eight rounds of chemotherapy and five rounds of radiation they' been scheduled of a 5-month period and paid po by the ba but my primary care provider had no idea if IID even started chemo or radiation and still doesn't today this shows the direct breakdown in any communication between Community Care my primary doctor and the community care provider a lot of these questions and concerns could easily be fixed if someone cared
▶ 0:31:45enough to do their job as a case manager the upper level bureaucracy and lack of accountability for poor performance in the Veterans Affairs has become just as much as a cancer as what courses through my body today I can work on working on work on fixing my personal health but I'm asking you to work on fixing the Veterans Affairs because it's unhealthy and full of cancer I appreciate the time and opportunity to share my story more detailed information with names and dates has been provided in my official written statement I look forward to any questions you may have this time thank you Mr Dy Miss Willis ller you
▶ 0:32:15are recognized for five minutes hello chairman boast and ranking member Tano and the House of Representatives committee on Veterans Affairs my name is Lori Willis loer first I want to thank God for getting us here thank you for the opportunity to speak on behalf of my son Logan F Willis who served in the United States Navy from August 2017 until December 2018 Logan was our only child and his dad Raymond F Willis was an
▶ 0:32:45Army veteran I was a VA employee for 12 years Logan spent his Summers volunteering at the VA his father passed away in 2015 from lung cancer it was very difficult on us both he graduated from high school in 2014 and the University of North Carolina at pimbrook in 2016 Logan wanted to further his education so he enlisted his first Duty station was saso Japan aboard the USS Wasp and it was during that time that Logan's mental health began to decline and he attempted suicide
▶ 0:33:16multiple times on the ship and later in San Diego Logan received an honorable discharge on December 31st 2018 and returned home I noticed many changes in LAN demeanor and behavior he was not the same person as a VA employee I directed Logan to seek help from the VA but was told we can't help you at this point he developed a distrust for the VA system Logan was so distraught with the lack of support he had received at the VA one day I
▶ 0:33:46came home and Logan had packed up all his belongings and left later he stated he could no longer live in a place where he felt unsupported the saddest part for me as a mother is that Logan saw me as VA unfortunately loogan could not see that I was working as hard as possible to help him I was a mother of a veteran and an employee but the mother always came first in the fall of 2019 he entered the master's program at Wake Forest University he was still struggling with depression and anxiety
▶ 0:34:16but he was focused on earning his degree he was receiving counseling that he paid for himself and his medications as we all know 2020 was the year of covid and everything shut down his classes were all online there were times when Logan would not leave his home for weeks I checked on Logan visited encouraged him constantly he became more isolated as a VA employee I saw a veteran who was in trouble and needed help with no trust in
▶ 0:34:46the system he would rather suffer than seek help sadly we see this so much with too many of our veterans who have served their country Logan graduated on May 14th 2022 with a master's degree in Divinity after graduation he was unable to find a job and had to move back home as his mother I encouraged him to seek the services he was eligible for but once again he was skeptical but decided to reach out to the local local veteran service center for help in June
▶ 0:35:17at the meeting with the veteran service officer he seemed encouraged as a pharmacy technician I feared that Logan was overmedicated on September 1st 2022 I requested a session for Logan to speak with their pharmacists so he could be so he could ask questions about his meds and their side effects afterwards I sent Logan to check in and request a mental health provider he said later that he had been given an appointment however I learned after Logan's death that his appointment was until was not until five months later
▶ 0:35:48for February 2023 Logan's mental health issues needed immediate help and again was not met he was met with a broken system the Community Care Act to my knowledge was not offered protocol at that time was a veteran request if a veteran requested a mental health provider they were to be seen or sent to Community Care within 20 days Logan died 63 days later he was contacted November came and
▶ 0:36:18there was still no action in regards to the Logan had requested to my knowledge again he was disappointed in the VA and and as a result his anxiety and depression increased as his mother I was still working to help find help for my son on November the 4th 2022 my worst nightmare occurred Logan was found in the bathtub at my home by his stepfather with a plastic bag over his head and a helium
▶ 0:36:48tank with a hose him I returned to two week I returned two weeks after Logan's burial I was very un stable and not well but I knew I had to go back to work and report a suicide after doing so I waited for weeks and I was never contacted as an employee or a veterans family member it wasn't till February 23rd I contacted director to make sure she was aware she stated she did not have knowledge of said
▶ 0:37:19death I continued to work for as long as I could um I missed most of 23 from my job I was not able to function I took an early retirement I had to go home um the years the next year I contacted everybody and anybody that would honestly would speak to me and no one wanted to talk to me and I was treated like a whistleblower and so today I feel like a whistleblower and so
▶ 0:37:49that's all I have to say first off thank you for your testimony thank you for the three of you we're going to um come back um a vote has been called in the house uh the committee will stand uh and I hate to do this right in the middle of this but it is what happens here okay uh this a very serious subject and and if the members would please uh go to the floor we have two votes um and then return as quick as possible but the committee will stand in recess at the subject the call the
▶ 0:38:20chair uh we expect to re reconvene about 10 minutes after the last vote has been called so thank you than
▶ 1:18:53e e
▶ 1:19:52committee will come to order I do want oliz to our Witnesses um it is part of what we do around here but the timing was was not well anyway uh Miss Diamond you are recognized for five minutes to provide your testimony chairman Bost ranking member Tano and members of the committee on behalf of the men and women of the BFW and its auxiliary thank you for the opportunity to provide our remarks on this critical topic the VFW believes the VA Community
▶ 1:20:22Care Program in its network of providers are a vital component of VA Healthcare however it doesn't always work as Congress intended my story is just one example of a negative experience that could have been avoided for 10 years I exclusively received DOD and VA provided Mental Health Care not only did DOD not diagnose me with PTSD the VA did but VA providers also failed to identify the complexity of my PTSD diagnosis resulting in
▶ 1:20:53treatments that didn't fully help despite consistent care I battled crippling emotional numbness and had come to blame myself for being defective I also started experiencing passive suicidal ideations in late fall 2021 I was referred to a civilian therapist through VA Community Care and she diagnosed me with complex PTSD the first time I recall a mental health professional using that term in May 2022
▶ 1:21:23based on my trauma history symptoms in her clinical expertise she recommended a PTSD inpatient program with very specific treatment criteria however dcva staff would not authorize a referral to the program because it was in Utah and its physical location was in Community Care 4 we were told to choose a local program instead following a service connected surgery I Revisited the inpatient treatment discussion with my therapist
▶ 1:21:54this time around however I had done extensive personal research which indicated that in addition to a method called EMDR a relatively rare therapy called ifs was effective in treating PTSD my therapist and I decided to try to get approval for an Arizona program that was also in Community Care Network 4 in the on the west coast but offered both EMDR and ifs in July 2023 frustrated with the seeming lack of urgc Mercy
▶ 1:22:24on va's part I physically went to the Washington DC VA and spoke with a social worker who promised to advocate for a referral on behalf again the referral was denied due to its geographic location but the social worker promised that he would trying unfortunately he went on emergency medical leave and my request for inpatient treatment fell through the cracks for over a month in September 2024 VA staff tried helping me find East Coast treatment options
▶ 1:22:55however so much time had passed since my initial request in July I would have to wait until January 2024 for my next opportunity to enter treatment I tried finding Utah and Arizona comparable programs while the VA employees offered in network options on the East Coast it felt like trying to find a needle and a hay stack and va's suggestions generally fell short some programs were too long While others were part-time some had poor reput ations
▶ 1:23:26While others did not offer the correct treatments or they were primarily focused on mental health conditions I didn't have like eating or substance use disorders one facility was for patients who were dangerous to themselves or others which was inappropriate for me while another was co-ed and did not understand why I would want to go to a women only treatment program after weeks of searching we found a comprehensive program or sorry a compromised program in Pennsylvania that met some of my criteria
▶ 1:23:56but did not offer the EMDR or ifs treatment modalities that I needed I agreed to go there and fortunately my assigned therapist was able to help me understand my complex PTSD symptoms and she ensured my follow- on care was with a qualified professional who did provide those needed treatments I am lucky to have landed with the civilian therapist that I did and for the resources family friends co-workers and accommod employer that I have
▶ 1:24:26not all veterans can say the same however getting the right Mental Health Care should never hinge on luck I've since learned that suicidal ideations are actually a product of the fight element in one's fight ORF flight response essentially giving out had I not been knowledgeable and advocated for my treatment needs and as a result been sent to a treatment program that couldn't truly help me it could have been my last attempt at getting better VA must stop its practice of rationing inpatient mental health care based
▶ 1:24:56on arbitrary seemingly thoughtless guidelines arbitrary location rules should never be the only factor in determining which veterans have access to life-saving care providing veterans with the correct Mental Health Care the first time means lives chairman Boston ranking member Tano this concludes my testimony again the VFW thanks you for the opportunity to testify on this critical issue I'm prepared to take any questions you or members of the committee May may have thank you Miss Diamond
▶ 1:25:26Dr sandom uh you are recognized for five minutes to provide your testimony chairman Bost Rank and member Tano distinguished members of the committee on behalf of the members of nurses organization of Veteran Affairs or Nova thank you for allowing us an opportunity to present our views on the topic restoring Focus putting veterans first in community care as a VA nurse I want to begin by expressing my sincere sorrow hearing the stories from these the witnesses at this table it's important that we learn from
▶ 1:25:57these cases improve care and the veteran experience throughout the VA Nova understands and supports Community Care when access to VA is not readily available the distance is too far or the VA does not provide the needed care we recognize and acknowledge that we cannot serve everyone everywhere our priority is to ensure veterans receive the highest level of care within the VA and utilize Community Care as needed to enhance the healthcare experience since the passage of choice and Mission acts Community Care has rapidly
▶ 1:26:28expanded Community Care referrals have risen by approximately 20% annually and 44% of VHA Healthcare funds are spent on Community Care while the mission acts expanded Community Care it was not meant to replace va's integrated healthc care system the legislation was meant to Pro provide a balance between nonv care when necessary while bolstering VA direct care we're beginning to see Shi shifts in care and Staffing that risk diminish in the Superior
▶ 1:26:58Care that VA provides veterans provider shortages and budgetary constraints continue to affect VA care and Community Care the constriction and closure of Community Health Care Systems have raised concerns about how and when veterans can be referred to the community the Community Health Care Systems are saturated and cannot absorb the continued increased demand for veteran care in the community despite Innovation and Improvement focused on efficiency for community care coordination the policy driven steps remain
▶ 1:27:28laborious inconsistency in scheduling and authorizations across the system create confusion for veterans and for our Partners a public face in site that provides detailed information about Community wait times quality metrics provider credentials and provider training is imperative for veterans to make informed decisions about their healthare VA clinicians are more likely to have experience and specialized training in recognizing diagnosing and treating conditions often encountered by veterans they are uniquely
▶ 1:27:59trained not only on Military culture but on veteran exposures the standards for our community providers should be no different the oversight of care in the community is inac inadequate at best we recommend Congress implements strong action and enforcement of mechanisms to increase quality and oversight of Community Care failure to meet quality expectations should result in removal from the network it is vital that VA facilities have more control over Services provided in the community
▶ 1:28:30records must be received promptly so the VA can direct further care including any necessary diagnostic testing without proper coordination between VA and Community providers regarding the timely return of medical records veterans may not receive the necessary information to make informed Healthcare decisions for example this vulnerability is especially important with lung cancer screening lung nodle fall up mammograms and colonoscopies stories from our membership include VA Community Care staff
▶ 1:29:00requesting records three or four times to the community provider with no response this leaves the veteran at risk for serious and in some cases life-threatening poor outcomes we recommend the Community Care Network have prescriptive guidelines for record sharing current practice leaves much risk for healthcare decision delays we encourage Congress to implement business rules that permit payment upon receipt of medical records Studies have consistently shown that vaare equals or exceeds the quality care provided by the private
▶ 1:29:30sector recent star rating reviews demonstrate that VA hospitals score higher than non-va facilities in both patient satisfaction and quality of care my Hospital White River Junction Vermont received a fstar overall hospital and five star quality rating in 2024 it was the only facility in Vermont in New Hampshire to earn the top rating a 2024 VFW survey showed overwhelming support for VA to remain the primary deliverer of care for
▶ 1:30:00veterans with most of them saying they prefer using VA medical facilities for their Healthcare needs the VA must remain the primary provider and coordinator of veterans Healthcare using Community Care as a supplement when VA services are unavailable authorizations and referrals should follow access and eligibility standards requirement for both VA and Community Care should include consistent quality and training standards listening to Veterans stories helps us understand their needs Nova is committed to
▶ 1:30:30working with Congress Community Partners and VA leaders to ensure veterans receive timely access to the highest level of care thank you again for this invitation to testify I'm happy to answer any questions the committee may have thank you um and before we get started um some I'd like to uh thank representative Harris he'll uh who represents uh Miss lir uh in Congress he will be joining us later on but we need to make sure that in accordance with committee rulle number
▶ 1:31:015e unanimous consent that representative Harris from North Carolina be permitted to uh participate in today's Committee hearing without objection so ordered I recognize myself for five minutes in questions Miss ler uh you shared how your son struggled um to access mental health care if VA had told Logan about his community care eligibility early on do you think it would have made a
▶ 1:31:32difference Logan died and I got some bank statements his last bank statements I have bank statements that shows he spent $ 800 and some dollars in like two months for his uh Mental Health Care um he called me one day at work frantic saying Mom I'm out of my medications what am I going to do what am I going to do I said Logan you know I I directed to go to his local pharmacy I said no pharmacist is going to withhold your mental health meds from you to you can get a new prescription he did so he came
▶ 1:32:03home he had bought $288 worth of medication that day and I looked at the receipt and I was like Logan he said Mama I that's what they said it was I just paid it and I was like that's and that is one of the reasons why I brought him into our facility set him down with their pharmacist and because they I they knew the meds he was on and they said Lori these drugs he's on are dangerous and so that's reason after we had that discussion I said check
▶ 1:32:33into the check in I told him I said if I could get you into my facility I can help manage and take care of your mental help with your mental health needs and $288 that he that he paid for out of his pocket my son was going into a hole trying to take care of his mental health and he didn't any didn't know that it was available to him he knew it was available and but I mean he he had no faith in the VA and then when he when I finally talked them into
▶ 1:33:03it there was error after error after error that was done in paperwork he checked in he got a five-month appointment mental health if he had came home and told me that they had given him a five-month appointment I have said come you come right back to the VA tomorrow I'm going to go down there with you you I would have questioned him why are you given a mental health a young man if you looked at his record he had tried to attempt suicide multiple times in the military
▶ 1:33:34I don't understand why he didn't uh have an appointment when they allowed him to to an honorable discharge in December why wouldn't he given a mental health appointment right then why wasn't he locked into a facility right then from um Mr McKenna you testified the VA counselors and parents advocate in your written testimony were unable to provide clear guidance on your care op options how how do you think va
▶ 1:34:04va needs to fix this chairman if I understand the question correctly um it talks about the dichotomy of the two experiences I've had first uh when I've my wife and I retired we moved to Northwest Florida specifically in the Pensacola region um very similar uh with respect to Services as it is in eastern North Carolina meaning uh the main VA Hospital Center for Northwest Florida is located
▶ 1:34:34in buuy Mississippi that's about two and a half hours from our home um same situation when I went to the VA clinic in Jacksonville after relocating a year later in eastern North Carolina the main VA Clinic is in fville North Carolina and that's again 2 and a half hours from my residents in Richland's North Carolina these two uh VA clinics both in Pensacola and Jacksonville North Carolina are completely different in the fact that
▶ 1:35:05one this the process in Pensacola Florida was seamless uh the quality of care I I received from that VA Clinic from meeting with Dr sandal and his team um to talking to VA counselors in the network uh Community Care Network to actually seeing providers out in the community that entire process from flash to bang was about 10 to 15 days depending on what that Specialty Care conversely
▶ 1:35:36in eastern North Carolina same Specialist Care I need one I can't be seen at that VA clinic by either a doctor or a nurse because they don't have that capability or capacity there additionally they're not taking any new patients so they in turn set me up with care in the community to a um Clinic a med first Clinic it's a primary and energent Care Clinic uh only thing on staff there are nurse practitioners no doctors no nurses
▶ 1:36:07um good people but uh probably been from drawing your blood to basic Medical Care like a flu shot it's beyond the scope of their capability they in turn will put a referral in now unfortunately they have to use a third-party vendor to do this third party vendor puts that referral into the VA again delaying the process I think uh to answer your question more directly the the friction point in eastern North Carolina lies with the third party vendor there
▶ 1:36:37appears to be no oversight either from the VA or from Med First when I tried to advocate for my own Health Care by saying hey can I get an email or a phone number to talk to this thirdparty vendor I was told both by the VA and Med First that they're not authorized to provide me that information to be able to communicate to to understand why this process is taking so long and then finally when um you do try to or at least when I try to understand what is causing these
▶ 1:37:07delays and when you talk to the VA counselors either on the telephone or through my healthy vet online um I get responses like that's just the way it is here or um we didn't receive the required paperwork from your primary care provider out in town now to the latter statement I personally watched that nurse practitioner at medfirst in Richland's North Carolina fax that form to the VA and then when I followed up the
▶ 1:37:37next day having a fax receipt of that I was basically told quote I don't know what to tell you end quote so again sir to answer your question more directly more oversight on that third party vendor and then better training and education to the VA Workforce that works the Community Care Network thank you my I'm way over time but I remember you're recognized well with that Mr chairman I'm very glad to hear that you intend to
▶ 1:38:07hold more oversight hearings and I hope you do that before we rush a bill to the floor that purports to be a solution um and who's precisely missing on this panel is the third party administrator and anyone from VA so I want to change my question uh to uh Miss sandon um you know I find it curious that my majority counterparts want to see VA function more like a private sector uh actor but they force VA to abide by standards
▶ 1:38:38that no one in the private sector would ever accept for example can you imagine that United Healthcare um would pay claims without receiving a patient's health record or any proof of medical necessity Medical medical necessity and yet through the thirdparty administrator in this case optim which is in reality United Healthcare renders payment on behalf of va without requiring their providers to transmit Veterans Medical Records back
▶ 1:39:08to VA now Dr singon do you think that va's contracts should require Network providers to submit medical records as a condition of payment on behalf of the membership at NOA yes absolutely we've discussed this at nauseum it's a huge threat for good coordination of Veteran care um we are aware that the contract is the next generation of the contract is imminent and we strongly advise Congress to consider modifications
▶ 1:39:38to that where payment is issued upon receipt of those medical records and we have countless examples of how healthc care has failed those Veterans as a result of not having those medical records accessible thank you for that answer and again I would point out that optim otherwise known as United Healthcare is not here uh they were given a pass for not being here and they are an accountable party and they're a third party administrator I hold VA accountable
▶ 1:40:09also for not having contracts written so that this is part of how you do business but VA is forced to operate not as a private sector company would be for would would not think of operating I we any any private healthcare Network would would would make this a condition of of reimbursement how does not having these records affect va's ability to properly coordinate veterans care countless ways yes
▶ 1:40:39significantly um it poses a real threat to good coordination of care um a good example of this is veteran gets referred out to a community network provider as a result of a special that they may need and have a followup with primary care provider a week later two weeks later whatnot the veterans information yet has still come over to the VA from the community provider so that puts the VA providers in a
▶ 1:41:09real problem situation unable to determine what recommendations what were the treatment plans Etc yeah so I I would have loved to have VA and and United Healthcare here to explain why this has gone on and why it continues to go on so um there are kinds of care that Dr Dr Z that private sector care is simply not equipped to provide they're just not going to invest the money or the resources or Research into it it's unwilling to provide because there's no profit to be made no profit so
▶ 1:41:40that's why the public backs up our veterans when the private sector is just there's not the incentives to do it for example VA has invested billions of dollars to provide care for veterans with complex spinal cord injuries traumatic brain brain injuries limb loss and prosthetic needs what will happen to this very Specialized Care if we continue down this path of Community Care expenditures outpacing investments in the VA direct system so community care
▶ 1:42:10for these specialized services that you just mentioned are just simply not available um more so in the rural settings and the care is not comparable and if there is a spare resource in the community for that specific special Specialized Care it's too finite to take care of our veterans adequately well thank you you know in your testimony you highlight the anticipated National shortage of primary care physicians uh that the National Health
▶ 1:42:40Care system will face in the coming years that's not just VA doctors but the the national can you elaborate on why this makes it more important than ever to invest in a strong Direct Care Network at VA so no is incredibly proud of our educational Mission we train 70% of healthc Care Professionals Nationwide in other words if you ask a health care provider if they've had any type of training or step foot in a VA during the course of their training you will hear a lot of the yeses
▶ 1:43:10there um our goal is to grow our own maintain those trainees support training the health care infrastructure as it relates to um providers and robust scholarships incentives um continuing education opportunities is a way that we could incentivize that and Nova strongly supports considering those options but but but not having a strong Direct Care Network at VA will definitely impact
▶ 1:43:41the training of our future professionals absolutely we've already seen it in fact um there's gross shortage of Educators in the healthcare industry as well as pre and the front lines in the field um limiting our ability to take student training placements and if we continue to budgetary and or with veteran care access to veteran care we will have to continue to limit our capabilities of taking
▶ 1:44:11traine placements which will ultimately collapse Healthcare thank you I yield back Dr Murphy thank you Mr chairman and and thank you all um for coming today thank you for the service to your country and these are some real difficult stories to hear from somebody who has taken care of va patients for 35 years and actually continues to do so um I find it somewhat ironic the the ranking member brings out the stories that we're talking about
▶ 1:44:41the failures of the VA over the last good Lord I don't know how many years but especially over the last Administration where they continue in an electronic medical record system that is outdated incompetent inefficient doesn't communicate and I can say this on the front end and the back end it doesn't cost a penny a penny for me to H to click a button and send something a medical record as a community care provider to uh uh to the VA doesn't cost a penny we do it all the time when we communicate with all the other doctors so that's not true it's
▶ 1:45:11not anything has to do with profit it has to do with the fact that we have a inefficient organization that is becoming more and more inefficient and I'm so optimistic that uh with the next Administration we're going to crack it down and actually make it like a private organization would be efficient and for the people who actually should benefit from this our veterans you know I've said this many times here I have veterans show up and I have no records in front of me nothing and I'm Community Care is
▶ 1:45:41supposed to take care of them Community Care exists because the VA doesn't have the medical expertise or the Physicians to take care of it we have our National Institutes of Med that govern our medical schools now which are absolutely being negligent in how they're creating doctors so this Situation's not getting any better it's going to get much worse and as Specialties occur the VA I just tried to get on a website here to see what urologists were needed in the VA they're all over the place and if you want if a a veteran needs Urologic Care they're either going to not get it at
▶ 1:46:12all or they're going to have to go out into the community it's just a fact and Specialty Care as I've said this before costs more than other care anyway enough of that rent you know I I'm happy I'd love to see you United Healthcare come in here I would love to see that and I look forward to that day because they're killing people out in the regular community and they're by denying care and they're doing the same thing with our veterans so the third party stuff I'm looking so much forward to creating some true efficiency within the VA sergeant major McKenna thank you for your service
▶ 1:46:43um uh welcome to I love you know eastern North Carolina um we got a little snow today by the way out of the blue um I want you to tell your experience because you were in Florida and you thought you had a efficient Community Care System you've come to North Carolina and it's not can you tell me the pros cons what you think that is about thank you Dr Murphy and uh just to pile on your point if I may um what would further assist the VA is building
▶ 1:47:13that Electronic Bridge with respect to Medical recors from our service members whether they do four years or 40 years they be able to have those VA doctors and even the care in the community doctors access ala or other VA medical and dental records would again bring us into the 21st century yeah I've gone on about how broken the system is and continues to be inefficient but back to your question sir uh you know my wife and I initially resided in Northwest Florida upon my retirement in 2021
▶ 1:47:44and uh there were several factors that drove us to that geographical location to retire number one my wife michella who's a federal employee uh took a job in government service at Naval Air Station Whiting Field in Milton Florida number two um the quality of Cardiac Care in Northwest Florida um michellea received a mechanical heart valve after being diagnosed and Trea treated for
▶ 1:48:14endocarditis in 2013 and then finally the word from my fellow retired Marines uh that the VA healthc care system was first rate in that location um Michelle's Health Care is covered by Tri care for life um as you all are well aware that that insurance Ser moror I don't mean to interrupt my time's limited but if you can talk about about the six months versus the year referral AB get so um the process and I think I already alluded to it in an earlier statement that in Pensacola
▶ 1:48:45um from seeing the a doctor at the VA to getting a referral to see to be in care in the community was a to being actually seen in the community 10 to 15 days conversely uh eastern North Carolina uh to seeing a doctor not at the VA out in the community to getting a referral and I'm talking about for Specialty Care needs TBI you know mental health Orthopedics Urology um I am waiting personally
▶ 1:49:15nine months still for that referral to be approved let me repeat that I'm waiting nine months for that referral to be approved now my fellow veterans in eastern North Carolina this this story is not unique we're talking 6 to n months to get any type of specialty care in eastern North Carolina um despite my best efforts to advocate for my health you know contacting the VA uh Advocate those calls go UNR returned you know I've got to close
▶ 1:49:46up with my time but the the bottom line is my understanding it is the bureaucracy is not allowing you to see the doctor when in a timely fashion and as Mr douly uh has shown us that can have up to lethal consequences so thank you for your service thank you for your testimony M thank you Dr Murphy M brownley thank you Mr chairman uh and thank you uh to the panel for being here and uh sharing your stories and and I'm you know deeply sorry that the VA did
▶ 1:50:16not provide the services and the the quality of Health Care that that each and every one of you um and miss lle or in your son's case uh that they earned and deserve so we um I'm sorry to hear that I have to say um I've been on this committee for 12 years and um for for over that 12E period I've heard over and over and over again that a very large percentage of veterans say they prefer uh receiving their Health Care at
▶ 1:50:46the at the VA over Community Care and they believe that the quality of care within the VA is very good and in some cases Superior so what we have to kind of wrestle with here on the committee is the more we invest in Community Care the less we invest in VA care um and I think you know we have been wrestling with that and we need to continue to find where that balance really is and I I believe in Community
▶ 1:51:16Care I've for 12 years on this committee I have advocated for um better equality for healthare care for our women veterans women veterans have to receive a large portion of their health care um outside of the VA so uh it it's clear that to provide those services to our women veterans uh we have to have Community Care and that's that's a true phenomena in you know beyond one one population
▶ 1:51:47meaning women veterans so um you know I think in in many cases also that weight times um are largely longer in the community than in the VA now I know Mr McKenna you've talked about the processing and the sort of the bureaucracy that goes on and I think that is certainly part of the problem when we talk about longer uh wait times uh in the community um but it's uh but it is also true
▶ 1:52:18that in most circumstances wait times in the commun in the in Community Care are just they're just simply longer it's just it's it's just a fact so um so I the way I see it the facts that I see is that and and although every V hey is not the same um and Mr McKenna you you've pointed you've pointed that out or was it um I'm sorry uh Mr duly were you the one that said you got good health care one place and not so good
▶ 1:52:48or that was actually Mr uh M Mr McKenna so Mr McKenna has pointed that out that not every VA is uh is not the same but if you receive Health Care in the VA I think this is a fair fact to say that if you receive Health Care in the VA it's usually Quality quality Care the care is also less expensive the National Bureau of economic research re recently came out with a working paper that found that VA also reduces total spending by 21%
▶ 1:53:19relative to nonv providers so the care is less expensive in the VA and if we invest more in the VA weight times will improve and it's what the veterans want they want their hair the large propensity the larger percentage of veterans they want their Healthcare within the VA so that's I think that's in essence what we kind of have to to wrestle with here um you know where is the right balance but I think it's
▶ 1:53:49um I don't know whether All of You Are advocating ating for it sounds to me like you're advocating I'm not sure whether you're advocating for more Community Care or Better Community Care I'm not sure which one it is um if it's better Community Care I'm with you all the way if it's more community care I'm not sure that we have found the right balance so that's that's kind of where I am and so um uh uh Miss Diamond can you re
▶ 1:54:19just respond to what I've what I've just said absolutely and thank you for the question um I would say absolutely Better Community Care there are many holes which have been Illustrated um by know the panel and including myself and I think there just need there needs to be more meaningful effort put behind how veterans are assisted in accessing that Community Care um a lot of the pressure is put on the veteran
▶ 1:54:49themselves to do the work so were handed off to I should speaking for myself I've been handed off what I've Illustrated here and in other experiences uh interactions I've had with Community Care where an overwhelming amount of the pressure is put on me to figure out what care I need and find the correct providers because VA is not doing it um on on their own um it's it's it's really tough so so so absolutely well my time is out
▶ 1:55:19but I will just say Mr chairman I'm happy to work with you to improve the process by which we get veterans community cares when we need it I'm not willing to to you know have a large conversation about just increasing increasing increasing increasing commun not what the conversation is the conversation is providing the best for our veterans and doing it correctly and right now the system is broken and we've got to fix it because of things like this
▶ 1:55:50but it is a quality and the thing is obviously BBA getting paperwork right and all of that but we we we've got to quit arguing on whether it's I'm right or you're right or who's Republican who's Democrat and start arguing for the veterans and that's what we're trying to do and I have told and I will tell you this we'll also bring the other ones that the ranking member has asked for and to say that we didn't bring them in because we were trying to do some kind of ridiculous thing about arguing over the community and over VA
▶ 1:56:20I think that what we have to do is make sure the veterans get what they want when they need it where they need it at the level that they need and I agree with you that there are a tremendous amount of people that have a tremendous experience at VA if they can get where they when they need it and if I'm not traveling five hours to get there so we've got to keep working on it together we can't just all of a sudden say well you believe this and you believe this and we've got to start working on it together we've got to I believe we have to work on it together too and I
▶ 1:56:50but I think we have to I I think we have to have more hearings around this debate a lot more issues around it and make sure that we're working off common facts and when our staff writes our script maybe what they should also pay attention to is the fact we are trying to work together and quit trying to make look like it's a partisan act just saying so I yelled back all right um Mr ham Hamond thank you Mr chairman and as
▶ 1:57:21a veteran I understand the obligations we owe to our fellow veterans now president Trump got it right when he signed the bipartisan Mission act putting veterans in charge of their healthc care decisions yet today we're seeing bureaucratic roadblocks that prevent veterans from accessing timely care especially with mental health services now the stories we heard today are deeply troubling I want to commend president Trump's incoming Veteran Affairs secretary Doug Collins who many
▶ 1:57:51here know very well when he served in Congress for his commitment to accountability at the VA but we must do more to ensure veterans can choose where they receive care the VA system should work for the veteran not the other way around when a veteran needs help they shouldn't face a maze of Prior authorizations and arbitrary denials the data is clear expanding Community Care access doesn't increase cost it increases quality we must codify
▶ 1:58:21access standards to guarantee veterans rights to seek care outside the VA when needed but I want to thank all of the witnesses for coming today and for their service and for being sharing your Brave stories as well now Mr douly my first question is for you you waited nine months for critical treatment and if you could redesign the va's authorization process for veterans seeking Urgent Care like Cancer Treatments what specific changes would ensure veterans get immediate access to the nearest qualified provider
▶ 1:58:52whether VA or Community Care I think to start that off the the first thing would be to know how fast they can get it from the VA that's the first thing to know and inform the the veteran of that of when they could um get that treatment and the second would be going into community care if that's the decide the route that they decide to go being able to reach out to different Care Community Care Providers and finding what amount of time that they could actually get it done in in my case um if it could be done in the VA in say three months um that's too long let's see what Community Care can do and then if
▶ 1:59:22Community Care is 5 months obviously the the service member being allowed to know that and then make a choice um but then also going back and seeing what other care providers may be available they could get it done earlier and that would provide me with the earliest treatment I could and then also the knowledge of knowing which one would provide that so I can make an educated decision thank you now would you support eliminating prior authorization requirements entirely for certain urgent medical services similar to how we handle Emergency Care without knowing
▶ 1:59:52the full specifics of that I can't say that I would um recommend one thing or the other but what I could say is I would have liked the opportunity to um cut through the red tape and allowed to get my my um screening prior to that it could have made all the difference so if anything that would be cutting through the red tape and getting the service member to that type of um treatment PRI as soon as possible I would recommend thank you now miss loir you witnessed firsthand tragically how delays and mental health affected your
▶ 2:00:22son's trust in the VA system now shouldn't veterans have the immediate right to seek Mental Health Care from any qualified provider in their Community without jumping through bureaucratic yes and how would this have impacted your family differently if that were to have been the case well Logan did that I mean he took it upon himself to get the care that he needed because of his distrust in the VA um but un fortunately for Logan
▶ 2:00:53I think he got a provider that just she she just continued to prescribe a medications and he was so desperate to to get better to honestly get better and so I think she was overmedicating him and I found out recently just a few days ago I knew he had went into the er um and I found out he was in the ER because he had lithium toxicity she had put him on lithium and when I spoke to my pharmacists about it they said
▶ 2:01:23Lori That's A Dangerous Drug it's old it I can't believe it's even being used but he was on it and he had to go to the emergency room because he it became toxic but I would like to say something in regards to what you're already saying if you let me do that 60 days to get crit uh Community Care okay um but when Logan checked in and by the time it took Community Care to sign off on what he needed was two days prior to his death well in those two days he still didn't
▶ 2:01:53get so and at the time Co when Co came in we had staff that left her her hospital to went home to work remote they never came back they worked from they worked from home the entire time still working from home Trump telling these the employees to come back to work they need to come back to work I don't know that that didn't take part and why it took 60 days for someone to look at my child's ch and say he's already tried
▶ 2:02:23to commit suicide a number of times he's depression we might need to go ahead and get him taken care of as soon as possible that didn't happen thank you Mr chairman are you back thank you Dr Conway uh thank you Mr chairman and um thank you uh to the witnesses for bringing forward their experiences uh for the edification of this committee um we as a nation should be deeply grateful for
▶ 2:02:54the sacrifices that our veterans have made on behalf of all of us and their families have made on behalf of all of us and as a physician and Veteran myself and someone who spent the last um 25 years trying to figure out how to expand access to Quality Care in my own state of New Jersey as I listen uh to your testimony I I can easily point out uh the many failes on a bipartison basis that have occurred and advancing access to Quality Care for
▶ 2:03:24members of our society and it's particularly troubling and concerning uh when we're seeing these problems among our veterans to whom uh we owe so much uh there are faes to invest uh in the technology uh that will allow us to understand what's going on if we don't understand data um about who's being seen when they're being seen what uh paperwork is um and information needs to flow from those experiences so that care can be examined and improved then we are failing
▶ 2:03:54and this is um anytime you put more and more bureaucracy in a situation in healthcare and we see this all over the place where there be prior authorizations which has been mentioned all of this paperwork flowing back and forth someone goes to see The Physician they get a referral they follow up to make sure that referral is taken care of you don't need a lot of Technology around that so this idea of exploring how we get rid of all this paperwork and all these hurdles uh it's certainly a very valuable exercise but understand as I hope everyone in this room does that
▶ 2:04:24these these hurdles have been put in place because of a concern about the spend um every person who works in healthcare every person receives the service there's a dollar behind that and uh and so our concern right concern uh about how much we're spending in a particular line item for veterans Healthcare depending on what our priorities are and again and my view uh the veterans uh Administration has not been properly funded it has not uh have does not have the staff it should and that says in my view
▶ 2:04:55uh that we're not uh paying the kind of attention we need to pay uh to uh the veterans who deserve uh our thanks I am concerned as has been raised here that we don't have and we're going to have more and I take the chairman his word that we're going to have additional uh hearings on this because we certainly need to see and hear from uh the uh tpas that are uh managing this Healthcare we certainly need to hear from the VA about their processes and what they plan to do about these very troubling things we've heard uh today we need to hear
▶ 2:05:25from the office of the Inspector General uh about uh their review of the situation and what uh we can do to ensure that the data uh is made available to us so that we can actually know what's going on and where the failures are um every time we have applied data whether it's in the financial services sending people to the Moon developing the less Technologies it's all developing the right uh plans for healthc care so we get the outcomes we want it's all a datadriven process and we sit here today with a
▶ 2:05:56uh very disturbing lack of the kind of data we need to decide actually what's going on I'm very sorry ma'am for uh the tragic loss of your son it is um um you don't need to have children for that I happen to have a couple of kids I can't imagine uh the pain of losing a child particularly when you've did so much to try to protect that child as parents do uh we have heard from the ad Administration that uh there is a hiring freeze and I've heard from
▶ 2:06:26perhaps some or all of you that there's a real concern and certainly um Miss um Miss s sandan excuse me about uh the Staffing Sor is there um people need to power this system of care we understand that if there's and it has been years that it's been recognized that we don't have enough staff in the VA again because of our lack of invested on a bipartison basis by the way in the VA and so
▶ 2:06:57can you um get shed some insight on how this hiring freeze will impact a situation which is already um dramatically problematic and which if it continues will prevent the kind of improvements that need to be made to ensure the veterans get the care we need so discuss the hiring freeze in the context of the current Staffing shortages that we have and the difficulty that it will um bring to making the kind of
▶ 2:07:27improvements that that clearly need to be made in the provision of care through the VA thank you the hiring freeze was um shocking yesterday for many of our membership there's already been conversations as to what we can do to Advocate to respond to this we are grossly concerned about the impact act it will have on bringing in new nurses bringing in new
▶ 2:07:58providers also are the reputation for the VA so these individuals from what we understand the membership individuals that had been selected and or were in the process for recruitment received automated messages and that's not the way we do business in the VA we like to have conversations with our candidates and our applicants and yesterday they got automated messages from the platform we use in VA USA Jobs saying that the position was rescinded
▶ 2:08:28so we're concerned about our reputation to continue to get the most qualified individuals within the VA system and maintain them um inability to continue to staff at at our ceiling levels or at our approved levels within will impact our ability to provide inpatient care it Willa impact our ability to maintain clinical access and will be a continued need to coordinate care in the community
▶ 2:08:59which is a threat also because that's heavy laborous process um that requires more staff from the VA to support the coordination of care in the community I don't know if anyone wants to answer that to my time Mr chairman I don't want to to go over it but uh if you permit anyone else to answer it I certainly appreciate that and I'll thank you for uh for the time thank you Mr s uh thank you Mr chairman on behalf of the veterans Across America like my
▶ 2:09:29constituent Mr duly thank you so much for making the trip to be here with us and tell us your story I'm ready to turn the page to a bright future uh that last questioning uh we are going to rightsize this stuff and we're going to get it and I'll leave it at that uh thanks to the Trump Administration we are going to be able to our offer our veterans a helping hand after four years of cold shoulders failures and broken promises
▶ 2:09:59from the Biden Administration VA it's unforgivable that the hardworking Americans who served our country honorably paid the price because VA employees choose to serve bureaucracy rather than our veterans there is a new sheriff in town and I assure you that I think the changes are coming uh Mr douly in this Committee in the past I always make the point about the VA wants to talk about inputs we started this new program we
▶ 2:10:29we spent this new money we did this they never want to talk about outputs and I want to thank the four of you for coming to talk about outputs in the VA system because that's what this committee ought to be talking about outputs uh so Mr douly took you nine months to receive a what do you think that did to your body over 9 months any ideas uh
▶ 2:11:00Mr I am not a doctor however uh I do know time matters um especially when it comes to cancer um and I know that from stage one my possibilities of surviving and and remaining a long life with my children um drastically goes down when it goes to stage three um stage three stage one to stage three is literally it got The Mask got big enough and it got into my lymph node system making it stage three um at that case it's a lot better possibility that it'll move to other parts and even if I am cancer
▶ 2:11:30free now um the chances of it moving on and coming to another part of my body um is actually a lot greater so to answer it very shortly um my life and my chances for remaining um and living a longer life got reduced by those nine months um could have taken years off of Life um I understand so what what broke through after nine months what what what broke through to your treatment me waiting um unfortunately um I waited 5 months for the appointment and then once I
▶ 2:12:00found out I had cancer um they said to wait another four um and to be totally honest your office is the only reason that I got seen I want to stop right there Mr chairman and say our veterans should not have to have their member of Congress be the first line of defense with the VA that's my most important point today the member of Congress is not the first line of defense to get an appointment and yet for my constituent it was so that is that to me is a crucial
▶ 2:12:30point in this hearing um the system that you encountered Mr douly do you think it was designed to help our veterans or to put up obstacles and barriers to actual care from what I personally experience it looked like it was um they made incompetence absolutely vulnerable for the area um I saw a lot of people that didn't do their job and there was
▶ 2:13:00no way to hold them accountable for it um that was as very as simple as I wasn't even given a name and a number to call back the number that I would call back would be a hotline and then I couldn't even leave a message for that person my written testimony um doesn't have a lot of names in it and doesn't definitely doesn't have any direct numbers a very good reason for that it's because I wasn't provided any it's really hard to hold somebody accountable when you don't even know who they are uh with that Mr chairman I think those are excellent points and I yield back thank you Dr Morrison
▶ 2:13:31thank you Mr chair uh my sincere gratitude to our Witnesses for joining us today thank you to you and your families for your service to our nation uh I'm glad to be here with all of you today for our first Committee hearing of the year and my first as a member of Congress I'm honored to serve on this committee because military service runs deep in my family my husband John and my father-in-law are both combat veterans both former proud Army Rangers my dad and my grandfathers all served as well I firmly believe it is our
▶ 2:14:01duty here in Congress to provide our veterans with the resources that they deserve and and have earned I'm a physician by trade I'm one of the 70% who received some of my training at a VA um and having had the opportunity to care for these brave men and women I take seriously our congressional oversight responsibilities on this committee and look forward to working in a bipartisan manner to ensure that VA provides the highest quality of care to veterans now I'm admittedly new to the committee but it strikes me
▶ 2:14:31that um we both need Community Care and we need better oversight of Community Care uh it also sounds like we need to invest in a EMR uh and honestly as Dr Conway referenced we are grappling with the same Workforce shortage ages that many sectors of our society are facing so I'm concerned about the hiring freeze uh that you just um
▶ 2:15:02Dr sandon as as you know and referenced um VA clinicians are particularly well equipped to treat conditions that frequently affect veterans such as PTSD substance use disorder and traumatic brain injuries are there currently standards in place to ensure that community care provided ERS are adequately trained to treat these types of conditions this is another frequent topic of discussion among Nova
▶ 2:15:32membership um to our awareness there doesn't exist um Community indication of competencies training or quality and it's concerning that we entrust those providers in the community with our veterans unaware of those data points so thank you for that answer I I assume then that you're concerned that the lack of training and educational
▶ 2:16:02requirements May threaten the standard of care that a beneficiary may receive outside of the VA correct thank you thank you Mr chair I yield my time thank you Dr General burkman thank you Mr chairman and uh thank of all all of you for being here this has been a long hearing when you have the you know the break for vote so we just appreciate your your patience uh and in life you got to be patient you got to be but you got to be persistent
▶ 2:16:33you have to persevere all of those things and some of us who've been on this committee for a while are I'm not going to say getting a little long in the tooth but we're definitely getting a little frustrated okay over the lack of movement of the of the bureaucracy U during the 115th Congress those of us who here were here we was when the mission Act was crafted now I'm going to use a visual example so we put the mission
▶ 2:17:03act into play and since then anybody here not know what the game whacka all is okay that's what it's been because from the committee standpoint and even I would suggest to you from the veterans standpoint you hit one mole and it goes down and another one pops up it's a moving Target it's such that in our roles and responsibilities here we owe it to the veterans and we owe
▶ 2:17:34it to the doctors and the nurses all the health care providers in the VA system to actually eliminate the whacka nature of this so the care can get right to the patient what what we have seen is that the the bureaucrats in the VA have prioritized to a great extent the bureaucracy over the veterans themselves
▶ 2:18:04they they're they're focused on well we let's let's adjust this process or let's do that or let that without concern that the endgame of providing care is not there um we haven't talked about today and then I'm I'm going to ask a couple questions here is that because there's an assumption if you live in an an urban or suburban area you either get in your car get in the VA service officer's van get in a new bird getting on on the transportation and go to
▶ 2:18:34your local veterans you know hospital or wherever the clinic is uh well we got Rural and remote in our country too and especially at a snowstorm I got a hunch there's probably nobody in South Carolina today on the road now in Michigan with snowstorm they're still going to go on the road to get there okay but we have the whole the whole Spectrum here of the urban Suburban Rural and remote to provide the care so um Mr McKenna just a quick reaction here
▶ 2:19:05what is your reaction was your reaction when you discovered that VA counselors were unfamiliar with the basics of the act in in by the way in polite Marine thank you sir and again to use your analogy of wackamo I think if you go back to the mission act itself and to prevent knocking things down that you've already hit before with respect to training and education
▶ 2:19:35training and education must happen continuous so I'm going to cut you off yes sir because my time as you know as marine marine here we we're not going to waste time and you you absolutely right so don't waste time we waste enough money you can recover money but you can't waste time once it gone once it's gone in veterans veterans care but do you think when you mentioned training that the VA employees should be required to undergo periodic training and uh updates to familiarize
▶ 2:20:06themselves in this case with the Community Care Program yes sir um and I'll give you one small example if you ask a VA counselor at least my experience has been can you give me any elements of the mission Act specifically care in the community and you and I'm talking numerous people not just one are completely clueless to this legislation if that's not an indictment on the VA and their training and education program I don't know what is yeah
▶ 2:20:36and it's an indictment quite honestly of the leadership especially in that at mid- level why is the United States military so successful regardless of service our staff NCO Corp our ncos and our staff ncos it's got nothing to do with with the officers it's the staff ncos and those mid-level folks within the system is what is going to make it work and that's where I believe we need to focus bipartisan because it's not democrat or republican it's about getting the care and it's about retooling
▶ 2:21:07if you will the bureaucracy I didn't say eliminating it retooling it so it actually functions in a 21st centur century world with electronic health records and all of that data sharing and with that I yeld back Mr chairman mirez thank you chairman I want to start by thanking our witnesses as you heard from other colleagues here I know that between the votes and coming back um schedule was a little um difficult but I want
▶ 2:21:37to thank you for being here I want to especially thank Miss laer for your testimony I want you to know that you're sharing and the pain that you feel was felt by every member here I want to thank you for your courage to to be here and to speak truth to the experience that you've had and the experience you don't want any other parent to have so I just really want to thank you from the bottom of my heart and one of the most pressing issues our veterans are facing
▶ 2:22:08is that Quality Health Care is that access and it's a concern shared by so many everyday Americans really trying to navigate our system of privatized care and in hearings like today I think it's important that we reflect on some of the assumptions that we're making you know I assume we're committed to meeting the healthc care needs of every single veteran I want to assume that caring for every veteran means providing them the full spectrum of services you see I assume we want
▶ 2:22:38our veterans to have the best the most comprehensive the most coordinated the most timely and the most accountable health care we can offer them and I want that for every veteran frankly I want that for every American I assume we mean the same thing when we talk about community care but I am learning that we mean different things and some of my colleagues just mean private care finally there's another assumption operating of which I cannot get behind
▶ 2:23:08and that's increasing access to private care that would automatically result in Better Health Care outcomes for some veterans but not the others the evidence shows that public VA facilities provide higher quality veterans specific care but if you believe that the private sector can do it better which I don't then you may be comfortable with the concerning amount of money being funneled away from the VA into privatized care and folks I'm concerned that we're not asking whether that care is really
▶ 2:23:38leading to healthier and better outcomes because Choice alone is not the point we want choice but we also want quality and that's what we should be after as we've heard from many of my colleagues there are instances when our veterans cannot access a VA Health Care Center due to distances or due to other barriers however the VA Healthcare System is set up specifically to address the needs of veterans so Dr s d did I pronounce it correctly good
▶ 2:24:08good pronunciation is important for me can you tell me how the VA Health Care Providers and clinicians are uniquely prepared to care for our veterans I specifically want you to tell me what trainings are required um for for you to take to ensure that you're providing culturally competent care to veterans every employee is required to do military competence training in addition to that based on the occupation or based on the role of the healthc
▶ 2:24:38care provider at the VA they have a whole slew of different trainings that are specific to meeting the needs of those popul ations that they serve in that role specific and Dr San let me ask you a follow-up question to that are Community Care Providers requireed to take those trainings not that we are aware of additionally are there third-party administrators who manage a network of Community Care
▶ 2:25:08Providers required to ensure that providers and the network complete these trainings membership has spoke about this several times it's in our written testimony we're very concerned that there is no such requirement got it thank you Doctor look Community Care is part of equation that we need to be discussing today and and yes we certainly need to do everything in our power to ensure our veterans are receiving care but we need
▶ 2:25:39to make sure that that care is high quality Care in a timely manner veterans have the best the most comprehensive the most coordinated the most timely most accountable Healthcare that's what we need to be working towards in this place and so as we discuss uh this conversation today about Community Care as we talk about the impact that our veterans are experiencing every single day as we talk about their own families I truly hope that choice and quality are going to go hand inand
▶ 2:26:09I want to thank uh our Witnesses here today I want to thank uh the chairman and the ranking member and the vice ranking member here today as well um I look forward to having a fruitful Conversation Over of the work that we do over the next few months where it's centered on our veterans and their Care thank you with that I yield back thank you Mr van Orton thank you Mr chairman I appreciate being here I'm very sorry I had to step away this place pulls you in 50 different directions but I've read all your testimony and I
▶ 2:26:40want to thank you for coming out here uh I spent my first day in Congress calling the Widow of a veteran the brother of a veteran and the sister of a veteran sister-in-law of a veteran who committed suicide because he didn't get a mental health um mental health consultation I printed that letter it's been sitting on my desk for two years and it's got a note on there it says this is why I'm uh
▶ 2:27:10I've learned a couple things I chair subcommittee learned a couple things over the last two years this is first Congress you I've been in Congress for two minutes or two years and five minutes um I don't want to hear from the VA right now so our ranking member said why isn't the VA here you know why CU they don't tell us anything I've essentially had 10 of the same damn hearings with these guys because nothing changes no one's held accountable at the VA nobody check this out they made a $25
▶ 2:27:41million estimate to do the uh digital GI bill it's going to be a billion dollars 25 million to a no one's being held accountable the cner trash I just got off the phone again with two doctors I just want to check civilians who using this Cerner was sole source to contract to do the electronic medical record 16 billion dollars they spent 14 they want to do 18 they're saying it's and they had to delay it to 2026
▶ 2:28:11because it doesn't work1 14 billion doll into it you know how much they say it's going to cost to get across all the viness take your guess I'll tell you $50 billion no one's being held accountable Mr duly I'm terribly sorry and I'm going to formally apologize to you from the government I am so sorry let me ask you something Mr dly has anybody that had anything to do with the travesty
▶ 2:28:42that has taken place in your life at the VA been held anybody to answer shortly no m loley here my heart breaks with you it does and we talked and I thank you for that um we know what it's like I know what it's like to lose a child um and I don't know where you'd be and how you hold up with this grief knowing that it was much more preventable than the loss of our daughter to your knowledge has anyone been held excuse me your son I apologize was our daughter to your knowledge has anyone been held
▶ 2:29:12accountable at the VA no nobody Miss Murray to your knowledge has anyone been held accountable for dragging you around and treating you like a hobo who's begging for help for injuries and you P PTSD is an injury has anyone been held accountable for treating you like a beggar
▶ 2:29:43and kicking you around the country none to my knowledge sir okay well I personally am looking forward to our new secretary Collins getting in here and the people that are these billions and billions of dollars of waste are held accountable because every single dollar that is wasted
▶ 2:30:14is a dollar that can't go to making sure you can go to a program in in a different region to making sure sir that when the VA cannot possibly help you that you go immediately to Community Care and that you don't have to have 57 different referrals for the same treatment plan and ma'am to make sure that no mother or father or brother or sister ever has to find their child in a bathtub
▶ 2:30:45after they've committed suicide because they didn't get the mental health health care that they needed and I know that the men and women on this committee mean what we say I just believe that some of my Democrat colleagues are misguided I get all my Healthcare through the VA I'm a 100% service connected disabled veteran I get all my Healthcare through the VA the people that treat me in Lacrosse Wisconsin are fantastic that's from the people that are are checking me in to my Primary Healthcare I'm so proud of them at Tomo Wisconsin I'm so proud of them do we have problems
▶ 2:31:15yes but the farther up the chain we get the farther away from reality we get and I want to have some of these people that have been sitting in these offices at the VA collecting a paycheck go out and talk to Ma'am I want them sir to go to a medical appointment with you and your family and let them explain to you and your family why you couldn't get the health care you needed because they're too damn lazy and they're more concerned about protecting your bureaucracy than the veteran
▶ 2:31:46that's what needs to happen and nothing's changed until it does and that's what we're going to do Under the new secretary's leadership and the leadership of this chairman that is my promise to you I yield back you Dr M WIS uh thank you so much uh chairman Bost for this hearing um it's interesting uh my conversation and my thoughts as we've listened to this hearing and listened to both members on this side of
▶ 2:32:16the aisle and the other side of the aisle proper questions so my question are different now than they were when I first came in here first uh sergeant major McKenna U my family my husband's family is all from Richland North Carolina and I know that system well um Miss sidon you mentioned about um you know everything being automated and how concerned you are let me just say that I applied for a job as a physician I'm a nurse and a doctor applied for a job at the VA in 2014 all
▶ 2:32:46of my responses were automated so I'm not sure how that's not how we do things at the VA and as I recall the president at that time was President Obama and all the responses were automated and went through usa.gov that's one of the issues we have with hiring and the four years that I have been on this committee there has not been a lack of funding to the VA as a matter of fact funding has increased every year and even in this hearing room we had a hearing on Mental Health Care and suicide prevention
▶ 2:33:16I as the chair of the subcommittee on health and through that hearing with the VA present found out that the VA did not consider residential mental health care or substance abuse disorder Health Care to fall under the mission act and therefore they did not have to get somebody in a veteran in within 30 days now as a nurse and as a doctor and a person who has
▶ 2:33:47family members who had PTSD and mental health issues if you're at a point where you think you need residential care for substance use disorder or mental health you need mental health care now and we put forward a bill that it had to be within 10 days the first bill that I passed and had signed by a president in 2021 was Brandon conserta who five hours after he visited the VA in Iowa City which is an excellent VA committed
▶ 2:34:18suicide and at as a nurse and as a doctor and as a veteran but most importantly as a mother Miss ler we feel that we are responsible for our children's happiness and success and I know the burden that you bear and it is not your fault and it is a responsibility of this committee and members on both sides of the aisle to make sure that what happened to your son does not happen to any other
▶ 2:34:48sons and daughters and that's why you're here today Miss sidon does the VA send veterans to get Care at Visions far away from where a veteran May reside to my knowledge and membership yes exactly so I'm not sure why it's a problem with
▶ 2:35:18a veteran such as Miss Murray and I don't know you rank Miss Murray my apologies a veteran to get care for a specialized condition at a place because it happens to be out of network that's the type of stuff we hear from private insurers and both of them problems so if their veteran is not able to get the Care at the closest VA to them and there is the care that they need recommended to them by a provider they should be able to get that care
▶ 2:35:49and I don't give a hoot if it's on the East Coast or the West Coast because the VA already sends people to other Visions two or three visions away hundreds of miles away and months away and when we consider the cost of care within the community not private care let me reemphasize this once again but care within the community and let me also say I'm a provider of care I gave Community Care I don't think I had to have training for PTSD as an opthalmologist
▶ 2:36:19to do cataract surgery but miss sidon is it well known that men in age 40 if they have blood in their stool that that's considered cancer unless otherwise you're a doctor nurse practitioner to clarify I'm a dnp doctor of nursing practice not not a prescriber or a provider okay I won't ask you that question let me just say it is common knowledge it is common knowledge we're trained in medical school that if a male has blood in their stool especially under
▶ 2:36:49age 40 which I think uh Master Sergeant duly was if I my math is correct from your testimony that it's cancer unless proven otherwise so how is it quality of care for the VA not to order a colonoscopy from a VI provider that's not quality care and let me say that quality Care is no if no care is provided that's not quality whether it's at the VA or Community Care do you think the cost cost would have
▶ 2:37:19been lower master sergeant douly if when you told your physician what your symptoms were and I'm implying what you were I'm presuming as a physician if it you're you relayed your symptoms they would have ordered a colonoscopy and then they would have allowed you to go for care and had your appropriate treatment do you think maybe the cost would have been less if it was a stage one cancer or stage two rather than a three I'd like the chance to live so I wouldn't have cared what the cost was
▶ 2:37:50um but to answer your question yes I do believe um treating stage one would have been a lot more cost effective and efficient than treating stage three and for the rest of my life as a provider um and someone who knows the Health Care System I'm going to wholeheartedly agree with you that's why we do screening that's why we do colonoscopies and recommend them over age 50 and why if someone presented with the symptoms you had even as an opthamologist at the VA I would refer you for an urgent colonoscopy my point is this
▶ 2:38:20Our obligation is to make sure veterans have access to care if you don't have access to care in a close by VA and your symptoms weren't then you should get care within the community that's our responsibility as an organization and as a committee and as members of Congress you shouldn't have to come to see your member of Congress to get the care you have earned you've earned the care so we're going to make sure that we hold the VA accountable and the community accountable
▶ 2:38:51for getting you the proper care in a timely fashion that you so richly deserve thank you and I yel back representative King hind you're represent you you are recognized for minutes thank you chairman Bose and half a day to all of you thank you for being here today thank you for your service to miss laer my deepest condolences um your is too common to so many families and and and parents Across America
▶ 2:39:22I come from the Northern Mariana Islands it's about 8,000 miles away from Washington DC that is my district it's a chain of islands that you know has a lot of people signing up for the military we have a lot of veterans and our issue basically is just access to service we have one local fa contracted part-time by the VA to treat veterans two days a week uh referrals to available specialists in the district can be
▶ 2:39:52made out prior without prior authorization from VA office in Honolulu which is Thousand Miles Away VHA also occasionally sends specialty care doctors to include neurologists and podiatrists about three times a year we do have emergency care although very limited even to non-veterans um point is is you know access to these Services is an issue in the maranas and I
▶ 2:40:22have always assumed that that issue was limited to our islands and one of the reasons why I went I ran for Congress was to be able to improve the quality of service but as I'm sitting here and I look at all of you and I'm I'm hearing about all these challenges uh I'm crushed because if we're here on the mainland and we are not able to provide the quality of here here in America then how
▶ 2:40:52are we going to be able to be able to address the challenges of our reort Islands um I don't have any questions I just wanted to say thank you um and you deserve better and I truly believe in my heart that through um chairman Bose's leadership in this committee that everybody has your best interest at heart and I'm certainly here
▶ 2:41:23to fight not just for my community but for you as well thank you so much I Y my time Mr chairman and we're glad we have Mr Harris with us today Mr Harris you're recognized for five minutes well thank you Mr chairman for uh the invitation to be a part of your committee today and for the consent to allow me to uh share M ler first of all I want Tok thank you for having The Bravery come in today and to share
▶ 2:41:53your son's Logan story is truly an honor to have the privilege of representing a selfless American such as yourself your willingness to come and share your testimony I really pray is going to help us ensure that what happened to you and to Logan will not happen to Future veterans and to their families your son had to wait five months between his initial contact for a mental health care appointment
▶ 2:42:24and the scheduled appointment date now the law says that a wait time should be no longer than 20 days before referral to the Community Care Program I guess I want to ask you are you aware of any efforts the VA has made to improve weight times or improve awareness among Veterans of the Community Care Program eligibility yes yes I think so well sadly looking at the VA wait time
▶ 2:42:54list last night at the fville VA Medical Center there is currently a 60 day wait time for new patients to get access to individual mental health care you see I'm concerned about what you went through and I just want you to have an opportunity to really help us understand and how this experience has affected you mentally and what this has led to
▶ 2:43:25in your own life I'd worked for the VA for 12 years I believed in the VA system I love the veterans so to have my own veteran that I saw in front of me four years suffering through what he was suffering through I was trying to help him couldn't get him to go when I finally got him to go um the wiek he died I thought it was actually
▶ 2:43:55better that Wednesday before he died I I thought he was doing better and then that Friday when we found him I was crushed so when I went back to my uh facility of course my uh Department knew what had happened they had rallied around me they had taken care of me they had provided for me but I knew I I had the knowledge of a suicide that need to be reported so when I went in to report it they appeared to be very receptive wanted to know what had happened
▶ 2:44:25they want to know how like like I had known for 12 years how do we fix this how did he fall through the cracks but then when I told him that he was my son everything I feel felt like stopped I kept waiting for someone to call me and say how can we can we talk to you how can we fix this what happened all the while I was trying to work and still trying to figure out I didn't understand what was going on I knew my child was gone I didn't know he had wait I didn't know they had given him a
▶ 2:44:56five-month appointment I didn't know that I didn't know that till March of the next year I kept asking you know I just kept waiting finally I just called I just called the director of the facility myself and I asked her about it and she she wasn't she said I wasn't aware of that but from the very beginning I just felt like it became a cover up nobody would speak to me I kept asking you know when I made her aware of it she say she'd get back to me she never did as as the months continued my work
▶ 2:45:26performance continued to fail I worked in the pharmacy Department I have a lot of I had a lot of responsibility in my job in regards to handling medications handling drugs I spent a lot of time the first year after Logan died I was not at work I could not function I could not think um by the half the year I just I had exhausted every opportunity everything that I could use to help me to continue
▶ 2:45:56to work my job and stay where I was at till I finally decided I could I realized I couldn't work there every time I came through the back doors I felt like they were the VA did not help my child and therefore I just in my head I felt like the VA had caused my child's death and I and and it made me feel like I contributed because I was part of the VA so so in my head I had to get away from the VA I I've got to get away from this place so I I have I have I have been
▶ 2:46:26diagnosed with PTSD anxiety depression and all I asked was when my child died I went in and I just said can you help me can you explain to me just just just explain to me what happened what happened to him and no one they just they acted like they didn't see me so now I I I feel like I feel like I'm disabled I I I still I still don't function well well let me say this you said something a
▶ 2:46:56moment ago that the whole attitude had been often times you hear you heard it how did he fall through the cracks how did they fall through the cracks how do they fall through the cracks I hope that you sharing your testimony today is going to help assure that that doesn't happen again and that Mr chairman I yield back my time I now recognize Dr dectar for five minutes welcome to Congress thank you so much Mr chair
▶ 2:47:27um I apologize I just want to let you know this this is every day I I am feeling indoctrinated so thank you um very much appreciate the testimony from all of the guests here and and particularly as a physician as a mother um I want to acknowledge um the challenges that our our sister system faces and having been a VA physician within the system as well as a physician in the
▶ 2:47:57private sector who has taken care of phys or patients from the Veterans Administration system um we have a lot of challenges ahead of us and what Mr dowy went through I've had my own patients go through and that delay in care and the lack of continuity of care from the outside is a frustration as a physician but it is also a failure of the system
▶ 2:48:27we know that building a more comprehensive system that is accessible to the veterans is better care our veterans want to be seen within the VA Administration they want to have the Physicians who know them who understand the challenges of having been a veteran we provide better quality of care more comprehensive care and more timely care in an integrated system when it is appropriately um
▶ 2:48:58resourced and I believe that that is the challenge that we need to rise up to we need to have access for mental health for addiction for cancer services and the answer is not going to the private sector it is building the VA Administration services so that we can build Capac capacity within the system I also speak as somebody who was a leader in a capitated system that provides Coordinated Care and when we were
▶ 2:49:28struggling financially we made margin we made a successful business by bringing um services to within our system to stop paying the bills outside that we have no control over to stop the escalating costs that will continue we understand that we are effectively supporting private practices outside of the VA Administration so respectfully Mr chair and and to our um community
▶ 2:49:58members here who have so bravely and and candidly spoken um for veterans I will fight um for this system and I believe it is in enforcing our need to serve veterans from within and to make sure that we resource it appropriately and with that I yeld back thank you Mr chair thank you as the ranking member does Dr Conway want to have a closing uh thank you uh Mr chairman for holding this oversight uh
▶ 2:50:28uh hearing uh we understand that there is a lot more information we need to collect as a committee in order to ensure that we as a nation are doing right by our veterans and making sure that they get the care that they richly deserve thank you uh to the witnesses for taking your time today and enlightening us with your personal experiences in particular clear thank you to miss ler for uh your bravery uh today it's not easy to come and to talk about tragedy and to be as forthcoming as you have been H we are grateful for that
▶ 2:50:58and we are sorry uh sorry for your loss we look forward uh to working with you in a bipartison way this committee has a by Parson history may it always be so we do better when we work together uh we we do things that are lasting and more sustainable uh so we look forward uh to our future work uh to bring attention to that those things which need fixing and to work to make sure that we uh that our government does the job it needs to do by our veterans thank all and I
▶ 2:51:29want to thank the witnesses for joining us here today it's clear that the previous administration had problem implementing the Community Care Program the Community Care Program and the mission act are law they're not suggestion they're law and there's a reason for that and let me clarify this no Republican and I guarantee you no Republican on this committee has ever said we want to privatize ever Democrats have accused us of wanting to privatize we do not want
▶ 2:51:59to privatize but we do understand that the VA was not created for the bureaucrats at the VA the VA was created for the veterans and if we have people around this nation and Veterans around the that need Services the mission act should be able to do that now unfortunately I think that sometimes the bureaucrats
▶ 2:52:29in the VA for the fear of privatization refuse to do the job which we have assigned to them and that's what things have shown up and that's the problems that's some of the problems we have there's a lot of problems we have trying to get the services to the veteran at the time when they need it and as quickly and efficiently as we can there is waste in the VA there is we need to make sure that it's the
▶ 2:53:02unwaste best medical provider that it can be now remember there's a whole lot more than the medical side of va all those other things that we deal with in this second largest bureaucracy in the world that this committee is over we are going to work to try to correct those this is one issue and I'm going to say say this this is not the last hearing we're having on this and others will be brought before us that
▶ 2:53:32are those people who are the providers and the connection between the patient and the community care provider in in in which they and how they contract and how they communicate and it is a communication problem both between the VA and the community care as representative van Orton said we care about the veteran we've got to figure out how to get that there and not put people in this condition again I want to
▶ 2:54:02say thank you so much for being here I want to thank the members uh for a long meeting uh but with that um we are looking forward to continuing to work on this and at that with that point I want to ask unanimous consent that all members shall have five legislative days to revise and extend their remarks and include extend your material hearing no objection so ordered this hearing is now adjourned