▶ 0:08:45Good morning everybody and good morning Mr. Chairman. We're w and we want to you to for your to your first uh meeting with us and and congratulations on your and here you are at your first appearance before the committee subcommittee. Uh we value the opportunity to engage in an open and productive dialogue with you and as we work together to strengthen the mission.
▶ 0:09:15We are here today to discuss the fiscal year 2026 budget. In the in the beginning of May, we received the skinny book skinny budget that outlined what the department's top priorities will be.
▶ 0:09:34While the overview was brief, I'm looking forward to hearing more details I like how these like how these priorities will translate into improved outcomes for our veterans and more effective management across the department.
▶ 0:09:52I appreciate the continued investment in electronic healthc care modernization with a $2.2 billion While I strongly support this effort, I must acknowledge that the imple implementation so far has been challenging to say the least, over budget and behind schedule.
▶ 0:10:19We owe to owe it to our veterans and to the taxpayers to deliver a system successfully. And we hope you can we can uh share how you you can share how the department plans to support the rapid expansion of the effort.
▶ 0:10:37President Trump has surpassed it has surpassed his first 100 days and is working forward working toward cutting federal spending to help address national crisis across this country that is faced by the people. We understand the proposals are being discussed that involve cuts to contracts personnel.
▶ 0:11:07Uh while we support the need inefficiencies, it is critical that such efforts are executed thoughtfully and without compromising the care and services our veterans rely on. I'm sure these proposals will be a large part of today's conversation.
▶ 0:11:32Above all, this subcommittee has and will always remain committed to ensuring veterans receive the benefits and health care they earned. We will always meet our commitment to them. Unfortunately, I know that some of our friends on the other side of the aisle has re have recently used rhetoric and fear-mongering tactics to claim that we aren't fully funding veterans.
▶ 0:12:02But that is not true and created and created unnecessary confusion and chaos for our We cannot continue to play politics with veterans benefits and healthcare. In this re in this recent video release, you simply stated things need to change.
▶ 0:12:28We are here today to let you know we that with a wish to disc uh and a wish to discuss how we are working to transform the Department of Affairs hopefully for the better. Things we need to change.
▶ 0:12:51Prior to the last administration's exit, the notified Congress of a proposed $15 billion shortfall, which we can we now confirm was a gross overestimation, and there are numerous missteps in how benefits and med medical budgets are forecast.
▶ 0:13:15These budgets fluctuations and inaccuracies from the prior administration have shaken Congress's confidence in VA ability to forecast its resource needs.
▶ 0:13:31I know it will be a heavy lift to address this in a quick in a quick manner, but we look forward to working with you on this and everything else. And now I'd like to recognize Miss Wasserman Schulz for her opening remarks. Thank you, Mr. Chairman. I appreciate you yielding and uh welcome, Secretary Collins.
▶ 0:14:00It's nice to see you again. I appreciated our meeting last month and look forward to working together again going forward. We're here today to discuss what very little we know about the fiscal year 2026 budget request for the Department of Veterans Affairs. On May 2nd, the administration sent Congress its quote skinny budget, a 46-page document with highlights and summaries of what we might expect from the full budget request. But this 46-page skinny budget document included just four lines for VA.
▶ 0:14:31And this half a page of information is all we have on the 2026 VA budget request. That's hardly enough information to have a fruitful discussion about the budget request before us today. But what we do have is four months of very troubling actions at VA since the start of this administration. From my view and from the perspective of many veterans that I regularly talk to and that my colleagues talk to all across the country, it has been four months of chaos and repeated decisions that jeopardize fair, reliable quality care to our veterans.
▶ 0:15:01I understand that a presidential transition is difficult. But this changeover is just not normal. In particular, it has challenged in the worst way possible the legitimacy of our institutions, including the role of Congress and the judiciary. The actions taken by this administration have led to fewer services available to our taxpayers, including veterans, services that they paid for and earned.
▶ 0:15:24This long trail of bedum and destruction began with a mass freeze on grant programs across the government which disturbingly did not spare America's veterans. The freeze would have eliminated food security support for our most impoverished veterans, cut community-based suicide prevention resources, stopped the construction of state home facilities, and much more.
▶ 0:15:44Then within a matter of days, this freeze was lifted, causing unnecessarily delays in payments to grant recipients and temporarily halting vital services for our veterans. The chaos continued in a first round of firings that indiscriminately targeted probationary employees. Then a leaked plan showed that up to 80,000 VA employees were also on the chopping block.
▶ 0:16:07Because the FL firings were clearly not well thought out, the courts forced VA to reinstate some some employees, so they were rehired. Yet, some were fired again, causing more disarray and unnecessary disruptions to services to our veterans. It was particularly troubling when it came to the veterans crisis line. When crisis line employees were fired, Mr. Ch Mr. chairman.
▶ 0:16:30The secretary publicly denounced these claims by putting out a YouTube video in which he said, and I quote, "We did not hear we did not hear me clearly lay off any veteran crisis line responder." However, in a letter to Senator Baldwin, the secretary admitted that he did indeed fire 24 employees at the veteran crisis line. There were several days when calls were not answered because there simply wasn't anyone to do it. And I heard that directly from a veteran who trains the frontline staff who answers these calls after she was let go.
▶ 0:17:01Because of course, why would we want to have properly trained staff on the crisis line? We will never know how many veterans called into that line during those days and didn't get an answer because of the chaos of those early days of this administration. I shudder to think of whose calls went unanswered over that The secretary then forced his employees to quickly return to the office where many returned to find out there just weren't enough desks.
▶ 0:17:24You also declared he also declared that his employees were in quote national security positions so that he could take away their collective bargaining rights. Yet somehow that security status didn't protect them from being fired. He claimed as one of his accomplishments that within the first 100 days he opened six new clinics but were all woefully understaffed. He promised to expand health care to our veterans, yet fired staff who ensure that women and minority veterans receive the unique and specialized care that they deserve.
▶ 0:17:54He gave veterans short notice that he was cancelling the VA service servicing purchase program, which helps veterans who face foreclosure keep their homes. Yet, stunningly, there was no real backup plan to address this issue. He canceled contracts, claiming they're duplicative and wasteful. But when we repeatedly asked for details, he did not provide them to explain how that was the case. First, it was 875 contracts. Then it was 585 contracts that we were told. All wrapped in claims of billions in savings.
▶ 0:18:25Yet, no proof, documentation or information has been provided to this committee or to the veterans who are losing these services that any of those claims were true. This shoot from the hip management approach just doesn't work for the veterans that we serve. They deserve far better than what so far looks like a shock doctrine of cruelty, chaos, and indiscriminate cuts. Meanwhile, the real challenges the department faces remain in place. Veteran suicides continue. Staff shortages, especially among physicians, remain unressed.
▶ 0:18:55Homelessness is still too pervasive among our veterans. Veterans still struggle to transition to civilian life. And I know that the secretary will say today that the cuts he's making to VA's budget will go directly into care for veterans. He's told me that himself. But we have yet to see any plan to corroborate that talking point. Where's the proof? It's been over a 100 days and we've yet to see even the concept of a plan to address these real issues facing our veterans.
▶ 0:19:22Instead, all we see are political stunts that pander to Elon Musk and the most extreme in the party on the other side of the aisle. banning the pride flag, ending care for transgender veterans, firing probationary employees, many of which are veterans themselves, banning anything that approaches addressing the needs of diverse veteran populations, and cancelling contracts. It all does absolutely nothing to address the real challenges facing our veterans today.
▶ 0:19:46I look forward to getting specific answers to the questions we've been asking for months, and I look forward to the secretary's testimony. Mr. Chairman, thank you. I yield back. Okay, now we turn to Secretary Collins. Without objection, I your entire written testimony will be included in the record. I will now recognize you for an opening statement and then we will proceed with questions. Well, thank you, Mr.
▶ 0:20:15Chairman, and thank you, ranking member. It's always good to to see you, and it's good to be here to clear up the a lot of uh misconceptions, a lot of things that have been said. In fact, frankly, Mr. chairman and mad rank member. That's all I've done for 100 days is I've fought rumor and innuendo in going through in fact it's the it's the thing that we do the most of and a lot of which was just uh talked about here in uh some of your opening statement but also but especially the ranking members opening statement.
▶ 0:20:38I look forward to to answering those uh questions as we go because you know the one thing I have found in my 100 days which is tomorrow uh coming forward is that we have at the VA have some of the best men and women in the country taking care of the most unique and special group of people and as the people who serve our country those who have served alongside of me and many of you are getting the care that they need. However, there's interesting that what I have found is is the moment you begin to discuss the VA and the moment you begin to go through it in this subcommittee realize the VA is in need of reform.
▶ 0:21:08I've heard it from most of you. I've heard it from many while I was serving in this body. The VA is a place that needs reform and needs to be able to deliver timely care and getting to yes for veterans to the benefits that they have earned and making such sure money the Congress appropriation of the VA is not diverted to non-m missionritical or even wasteful programs. You see, even last year, even going back just to last year, Congress about the need for reform in VA simply many times just came across as a request for more money and more people.
▶ 0:21:38But I think what you're going to see today as we discuss this is that money and people are not the exact answers to all the things that hurt us. In fact, the Biden administration for the last four years didn't address the most serious issues lying before it, such as benefit backlogs and rising healthcare weight times. In fact, the numbers speak for themselves. The VA grew by 52,000 full-time equivalents from at fiscal year 21 to 24. Did all those extra people help make veterans care better? No. In fact, the VA performance metrics got worse.
▶ 0:22:07Healthcare weight times went up. Disability bene benefits backlog increased. And sometimes that something has to change and President Trump is committed to making sure those changes happen at the VA. Our goal is to create a department that works better for veterans, families, caregivers, and survivors. And I've never been shy about addressing tough issues head-on, and I won't ignore the elephant in the room here today. As everyone is aware, we're conducting a thorough review of department structure and staffing across the enterprise.
▶ 0:22:34I've said countless times, the review is aimed at finding ways to improve care and benefits for veterans without cutting care and benefits for those veterans. Our goal is to increase productivity and efficiency, and to eliminate wasting bureaucracy, improving healthcare delivery and benefits to our veterans. We're going to maintain VA essential jobs like doctors and nurses and claims processors while phasing out other non-m missionritical ideas and consolidating areas in which we have frankly overlap and waste.
▶ 0:23:02Our goal is to ensure that deploys where they are needed is put them there and cut necessary unnecessary overhead. Strategically reduce staff to ensure the VA's budget is mostly going directly to veterans and we'll accomplish this without making cuts to healthcare or benefits to VA uh beneficiaries. Year after year, calls for the VA reform come from every corner. Lawmakers, media watchd dogs, this body, Inspector General, even the Government Accountability Office, VSOs, and including veterans across the country. So, guess what?
▶ 0:23:32This year, we're actually going to do it. This area is actually the time that we're actually going to take those calls and say we're going to try and fix something. For 10 years, Mr. Mr. Chairman, as you well know, the GAO has said that the VA is on a high risk list for issues of abuse, of issues of fraud, the issues of of waste. These are the GAO's words, not mine, for patient care, for patient uh accountability. These are their words, not mine. 10 years this has been going on. And every year we just continue to act as if it doesn't exist.
▶ 0:24:01And so when we look at this, my issue is is how do we actually make sure that we have change that actually works? And when you make systemwide changes, yes, there's going to be some issues and how we do it and how we go about it. But I made a commitment on my first day that the VA was no longer about the organization. It was about a service organization that was there for the veteran themselves. Instead of it being about what we're doing internally, it's about how are we delivering the service that we're entitled, they're entitled to, and that we're commanded to give.
▶ 0:24:30So, as we start this, there's going to be a lot of questions. You know, the VA is not a federal jobs program. It's a service organization that is designed to help our veterans. So, in these first hundred days, we have done things that you've heard about. We've actually started looking at our structure, going with career employees, our our consultants, and others to say, how are we actually looking at our employee workforce and how we're spending money? We're doing that in a very concise way. We're looking at contracts, and we're going to talk about those, I'm sure, today. But we're also making sure that the mission act is something that is fulfilled.
▶ 0:25:00The mission act was passed by this body and for many years has been basically ignored and especially the last few years. Disturbing evidence has came up as we began to look at why community care, which many of you hear about from your constituents all the time of not being able to get to their community doctors or not being accessed to community care is why is that happening? Well, a lot of it was because the VA itself was not encouraging it. In fact, was actually discouraging the community care aspect.
▶ 0:25:24In fact, I was just in Arizona with a veteran, a student who actually told me, he said, 'The only concern I have, he said, Mr. Secretary, he said, I've been waiting for about three months or more on my appointment and I can't get one. And I asked him, I said, have you been offered any other alternative such as community care? And this veteran looked at me and said, "What is that?" By the way, the medical center director was sitting right next to me and quickly perked up at that. This is the kind of things we face.
▶ 0:25:54This is something we can actually come together on. This is not something that necessarily needs to be a a divisive issue, but there is ways that we can fix this. But after 10 years, I think the GAO is said it's time to get to work. So, as we talk about this today, Mr. Chairman, I'm looking forward to answering these questions. I'm looking forward to talking about how we have come together to make already changes in our VA. There's places we'll agree and there's places we'll disagree, but I'm amazed at what I have found.
▶ 0:26:20I found some great folks and I found some veterans that again deserve the best treatment. But I've also seen a system that unfortunately has been talked about reform so long but not gotten it. Now's the time to make the reform. And with that, I yield back. Thank you, Mr. Secretary. Uh I'm going to start off uh we're going to we're going to stick strictly to the five minute rule.
▶ 0:26:46last week a bunch of people and I got a lot of long wait because we had a lot of conversation. Uh this should be better a much better hearing today. You recently just recently the department of off of the office of inspector general released its final report on VBA and VHA budget shortfalls from last year.
▶ 0:27:11Congress provided $3 billion in emergency funds for VBA to ensure benefits were delivered on time, but ultimately knew knew after the law's enactment that they would not need the funding for compensation and pensions.
▶ 0:27:34As for VHA, their request boil down to $6 billion instead of the original amount of $12 billion, which we provided TEF in the FY25 CR.
▶ 0:27:54After reviewing the OIG's report and recommendations, I hope that you are seriously examining the VA's forecast it needs for the how VA forecast its needs so this doesn't happen again.
▶ 0:28:18I know you are new in this role and we are do not have a full budget yet but we need to make sure that you will do your due diligence in restoring VA's physical man uh management what will be the VA what will VA be doing differently to project its needs in the pre in the president's thank you Mr.
▶ 0:28:46Chairman, that is one of the questions I think that really highlights really where we're at as a problem with the VA. When I came in, this was uh forced upon the Congress last year and after the uh frankly after the bills were passed, you get this all of a sudden request that we've uh were short and has it come to pass as you saw in the IG report and others that that most of those claims were just false. They were not and but they were came out of a mis allocation of budgeting and a uh misappropriation of how far in advance on what they're projecting the spends were going to be.
▶ 0:29:17A lot of that actually came out of especially from the VHA side and some others uh community care lowering where they did not anticipate uh higher numbers then also in the some of this came a little as their anticipation on packed act benefits uh were being met and as we were fulfilling the role of the pact. Now this is a previous administration. However, the problem was is there seemed to be no checks and balances on how these numbers were being calculated because the projections going forward were not there.
▶ 0:29:42For us, what we're doing right now is I promised uh during my confirmation and I'm promising here is we're going to send numbers that we have checked. We're going to make sure that our projections are giving us enough room for growth and also the areas that we need to look at so that when you get the numbers from us even if it's and I've I've said this before, I'm not going to send someone up here to talk to you about numbers or or u you know give the impression that we're right where we need to be if we're not sure of the numbers ourselves.
▶ 0:30:06So those are the kind of things of checks and balances that we're reinstituting into our budgeting process so that you'll have accurate Uh, we know that the PAC Act has increased claims due to its expanded eligibility.
▶ 0:30:22How many veterans do you anticipate will enroll in the VA healthc care and benefits within the next 10 Over the next 10 years, I think when you look at where we're at right now, we've had 6 million uh a little over 6,100,000 that have been uh completed their toxic exposure screening. a million6 have actually had their PAT act disability approved. And that leaves us with actually 985,000 new enrolles since the law came into effect.
▶ 0:30:51So that's about a two-year number. Um if you look at that over time, we expect that number to probably go down as more and more people are screened. We've screened about 6 million so far. I know the law requires us to screen all 14 to 15 million veterans. That's a frankly that was a is a stretch for any uh organization to do. um by having 6 million of the screenings completed, we're well on our way, by the way, to 9 million is currently enrolled in VHA. So, in our healthcare system. So, we're getting closer and closer.
▶ 0:31:18So, I think you'll see probably uh in this next coming year, if you go to the 985, we've had about 2 to 300,000 a year that have come in. That'll probably continue as we're looking at it for the next maybe couple of years and then begin to trail off over the next 10. Thank you, Miss Wiseman Schulz. Thank you, Mr. Chairman.
▶ 0:31:38Secretary Collins, uh, you've made some bold claims about cutting staff and programs while redirecting so-called savings to medical care and other benefits for veterans, but so far that's all been blanket assertion without any evidence or proof to this committee or the to the veterans that you've made these claims to. First, you claimed that $14 million saved from cancelling DEI programs would go towards medical care, but our committee has not seen any evidence of this. The committee did not receive a reprogramming request on this, and our follow-up questions remain unanswered.
▶ 0:32:07Second, you claimed that $1.8 billion saved from canceled contracts would go towards medical care. Again, no proof, no data, no evidence, no reprogramming requests on this either. And once more, our follow-up questions went unanswered. Third, you claimed $98 million saved from firing the first round of probationary employees and redirecting those funds to support healthcare benefits. And once again, no evidence, no reprogramming request or even notification of it or and our follow-up questions remain unanswered.
▶ 0:32:35And fourth, you claimed as one of your accomplishments in the first 99 days that you and I quote redirected hundreds of millions of dollars from non-m missionritical efforts to healthcare benefits and services that directly support VA beneficiaries. Again, this is yet another claim made without any real evidence, notification, reprogramming requests, or even answers to the many questions our committee has asked. My question to you directly is, have any of the funds I've referenced been moved to new accounts?
▶ 0:33:05in taking I I've tried to keep up with your four questions. I'll start at the end. The reprogramming especially of contracts that was announced and was sent to Congress on April 24th was regarding the intent to transfer funds generated from our form as 343 million that were went to support VA community care and to ensure veterans have healthcare choices promised under the bipartisan mission act of 2018. That was sent like I said in notification was made on April 24th going forward. If we can just address one at a time.
▶ 0:33:33So, you're required to send us a reprogramming request, not a notification. You are required to seek our approval. You were a member of Congress. You're aware of that. And you have not done that. You still owe us answers on why you sent a notification instead of a route programming. You didn't send us a plan. We're asking you you for a plan. Um, a two-page notification with one briefing does not give us any real information on what exactly you'll be doing with these funds. Remember, we're happy to continue our conversation.
▶ 0:34:02No, I would like an answer. We have sent everything we're supposed to send you. We sent notification on April 24th reclaiming my time. That's fine. You are required to send us a reprogramming. I will cite the sections of our appropriations act to ensure that you can be clear on that. I encourage you to look at sections 227, 229, 230, and 231, which provide very clear guidelines for when and how you need to involve this committee when you decide to move funding around.
▶ 0:34:29We have several provisions, all included there, in our annual appropriations act, that details our transfer and reprogramming requirements. It's the law. So, what I want to know today is, can I get your commitment that you will work with this committee to request approval through reprogramming requests? If you've moved these funds and are you confirming today that you've moved those funds? We have moved that as we sent to you on April that we have uh done that. We gave the notice and following OM guidance and also qualifying uh as we go forward.
▶ 0:34:59That is our commitment and that is what we're required to do. No, you are not insving that which is most administrations have followed. The chada is said we will give you the our approval. We will show you. We do not have to come. We're giving you notice. We're claiming my time. You do have We're disagreeing here. It's not a lot of this is not a reprogramming. So So it is a reprogramming request with it is and we gave you notice you can't okay the law that we the law is chada which we do noting my chance not claiming my time Mr.
▶ 0:35:29Secretary the law under the appropriations act in sections 227 229 230 and 231 give you very clear guidelines. The law requires you to ask Congress's approval through a reprogramming request. This shouldn't be a difficult thing to get you to agree to. I'm just asking you to follow the law. So I I'll ask you again. Will you follow the law that is written out clearly in the appropriations act?
▶ 0:35:55I'm reminding the ranking member of the law as well under CHA and following OMB guidance and giving you pass reclaiming my time. Okay, we're going we're just we're at impass. We're going to get we'll be happy to work with you. This isn't I just want to make clear that the committee understands that the way this secretary and this administration has interacted with Congress on moving hundreds of millions of dollars from one account to the next is unprecedented.
▶ 0:36:19They are required under appropriations law to request through a reprogramming to move those funds. I have not in all the time that I have been on this committee and in every year I've been on this committee, I've been in a leadership role experienced a secretary who has not submitted reprogramming requests and just seems to think that they all they have to do is let us know. That is ridiculous. And we need we will continue we will will pursue this vigorously, Mr. Secretary. And and I agree with the lady.
▶ 0:36:48We expect that is the way we'll continue to give you what uh we give the following our guidance. the chairman and I done the way it said. She has just said it's been done that way. I've been on this committee for 20 years. It's been that done that way 20 years. We're not going to change it now. Thank you, Mr. Chairman. Thank you, Mr. Chairman. I yield back. Thank you, Mr. Chairman, and thank you, Mr. Secretary, for being with us this morning.
▶ 0:37:18One of the highest honors I have is rep representing Oklahoma's fifth district, which has over 40,000 veterans who reside in my community. We have one of the highest rates of veterans per capita. Around 8% of Oklahoma's population has served our nation's military. Nationwide, the rate is about 6%. Uh I'm proud that veterans are moving to Oklahoma because it's a welcoming and a patriotic environment along with a high quality of life and a low cost of living.
▶ 0:37:47our local VA director, WDE Vloic, has done a tremendous job at the Oklahoma City VA, and I hope that you'll get the chance to see uh the facility soon uh firsthand, as well as some of the challenges that they're currently facing. Mr. Secretary, um thank you for taking the time to speak with me uh this last week. During our conversation, you mentioned that under the previous administration, the VA was experiencing a tremendous amount of increases of backlogs and weight times.
▶ 0:38:13And in your opening statement, you talked a bit about this um that even though the full-time equivalents had increased, um there were still significant backlogs and weight times. Could you elaborate a little more um on this and give me your perspective as how do we address the the issue here? I thank you, Congresswoman. I appreciate that because you've actually hit at the whole problem that we have here. And I think this is one of the issues that we can again we can agree and disagree on on issues of how it comes about.
▶ 0:38:40But there is no denying that after adding literally thousands upon tens of thousands employees and hundreds of billions of dollars to the VA's budget, the metrics are not getting better. And I think that's a concern that should concern everybody, not just here at the VA, but also and let me just be specific about that. As we look at these 52,000 employees and decisions in the last few years, weight times went from on primary care rose from 15.7 days to 24.3 days. Weight times for mental health rose from 14.7 to 20.4.
▶ 0:39:10Weight times for specialty care rose from 24 days to 38 days. And then the here's the one that really was interesting. the VA disability backlogs uh claim increased in the last four years from growing from 211,000 on January uh of 18 of 2021 to 264,000 on January 20, 2025. When I took office uh in February, it was at 260. I can bring to you, Mr. Chairman, and others. Here is some good things to know that as of this morning, it's at 200,000.
▶ 0:39:39We have dropped at almost 21% of the disability backlog in just under a 100red days. That's something we can be proud of. And by the way, we didn't add any employees and we didn't add any more money to do that. We just got it done because this is the problem that we're seeing. So again, it's okay to have the understanding of differences of what we need to do. But when you're looking at the numbers, and by the way, there was a comment made about a week ago when I I testified across the way that said these numbers were changed. Well, they were changed under Biden, the calculation of weight time.
▶ 0:40:05And so let's just understand here the way they calculated the wait time they uh made it from when the uh actually the veteran themselves actually made the uh cons call instead of it being when the uh VA got to it. So what we're doing is it appeared that we were hiding the numbers so we could wait and shorter the time frame. This is actually showing a more truthful aspect of when the veteran was asking for their uh care. Thank you Mr. Secretary. Additionally, um we talked a little bit about your plans to restruct restructure VA staffing. Um, can you talk a little bit about the plan?
▶ 0:40:35I know that there's been a request for specific information, but you are only 100 days into the new administration in your role and uh, it takes some time to restructure an agency that has such a large budget and a huge number of employees and contractors. So, can you talk a little bit about um, what you're looking to do with restructuring of the VA and and uh, what that will look like for our veterans? I would I would love to.
▶ 0:40:58This is something and this this one knows and and chairman and all of you know this is the largest non-defense uh uh department that we have in the federal government. We have 465,000 employees at this point. Uh 409 of those are found in our VHA uh 34,000 in our VBA. Uh in our cemeteries, which I'm very proud of our cemetery workers, 24,00 here's a number for you. In our central office, we have 16,375. this not only our career employees, we're taking our our folks who've came in.
▶ 0:41:28We're asking for outside help, looking for industry help, standards on how we look at this and go forward in how we can actually utilize this uh to make sure that our workforce is rightsized to where we are now. We have over 28,000 uh physicians. We have 91,000 nurses, but I think most on this committee would realize that not all of those are practicing medicine. Yet, we have shortages in our clinics. And whether it be in your state or Georgia, my home state or others, we have a shortage of doctors and nurses, but yet some of them are being out and administrated.
▶ 0:41:57So, we're looking at the ways that are touching healthcare directly and seeing if we can resize our workforce. One of the things though, and I if I could, Mr. Chairman, just quickly on this, we have a com a a issue that we also look at consolidation. Did you realize that right now 200,000 of our employees get their payroll done through our centralized service, but yet they allowed almost 50 or 60 of our hospitals to maintain their own payroll system, which is hundreds of employees doing a separate example of how we can look at doing this.
▶ 0:42:25Thank you for addressing the duplicative nature of what's happening with the VA. And with that, Mr. Chairman, I yield. Thank you very much, Mr. Chairman. Secretary Collins, uh, thank you for being here today, uh, for your commitment to our veterans.
▶ 0:42:48And while we may have served on opposite sides of the aisle as members of the Georgia delegation, we've always tried to find common ground in supporting our service members and our veterans. I look forward to continuing that spirit of collaboration in your role as VA However, I was struck by your testimony with regard to uh what you perceived as a a very very awful backlog um carried over from the last administration.
▶ 0:43:17But I wanted to ask you if you did not uh take into consideration that last year uh veterans submitted 2.4 million claims which is 39% more than in 2022. uh veterans uh submitted u 2.3 million uh intents to file which is 65% more than in 2022 and FY23 alone uh VBA completed more than 1.9 million disability compensation or pension claims breaking
▶ 0:43:47the previous record by nearly 16%. uh in calendar year 2023, more than 361,000 veterans were newly enrolled in the VA healthcare, which is an increase of more than 73,000 from FY22. The special enrollment period for combat veterans ended in September 23. And in that month alone, VA enrolled 48,763 veterans compared to 26,000 the year before.
▶ 0:44:17So, it would appear to me that uh the VA uh was successful in encouraging uh eligible veterans to apply and uh that they did so and they uh apparently were addressing uh those numbers uh very very effectively.
▶ 0:44:34While we never never can say that it's good enough and we certainly want to see efficiencies and want to see the best use of taxpayer dollars, uh it would appear to me that uh there's a lot of of talk about what the previous administration didn't do, but uh the proof is is in the numbers as you say and apparently uh uh those numbers uh have not been been carefully uh reviewed. I wanted to to go to some of your testimony.
▶ 0:45:04You mentioned in your testimony that DEI initiatives had been phased out. Uh what I'd like for you to to tell me is which specific uh DEI initiatives and what are those uh that were phased out and specifically which line items did they go to and and how much savings uh did that that acrew?
▶ 0:45:26Uh can you identify for me uh uh one, two, three, four uh DEI initiatives which uh were identified that that that that you were referencing? Yeah. The original DEI references was to a the group that was put together to promote DEI across the department. What is DEI? What do you mean? Diversity, equity, inclusion. This is what we and we put aside that and said we're going to put you know back an emphasis on making all veterans inclusive. So what I'm trying to understand is which program can you identify?
▶ 0:45:57The office of DEI the the office of diversity, equity, inclusion, it was found inside the VA. So you're saying that u uh the VA should not be concerned about reaching the diverse populations of veterans that that served our country. Well, unfortunately uh Congressman, you and I have worked together a long time. That's not what always happens in that. It was more for diversity of workforce, not diversity, not diversity of reaching out to veterans in your area.
▶ 0:46:20For a long time, we we we were concerned about making sure that our female veterans uh got adequate treatment that they were not harassed and they were able to get specific treatment uh that that was gender specific for them. And of course uh we placed emphasis on that. Did you uh I'm so glad you brought that up because nothing has been affected to anything of our female veteran outreach or anything else. None of that has affected neither minority outreach as well. So so so diversity that include females. We're in agreement with that.
▶ 0:46:49We're in agreement that we have not that has not been cut. Specific program uh are you referring to and in the aspect of inside and internal for DEI looking internally to our workforces which is which most of the DEI programs were is to diversify work. We're looking for actual quality folks and looking program though our DEI office I've answered the questions congressman. Anything else? We've also touched on DEI contracts.
▶ 0:47:13We also had the uh I mean the office of budget equity uh v the VA vi council those things were all taken out as well. And let me uh my time is about out. Uh the crisis line is a critical lifeline in urgent for veterans in urgent need and uh you're sure that 24 employees that were erroneously terminated have been reinstated. But I'm still concerned about the systems and the oversight that allowed that lapse to occur in the first place.
▶ 0:47:41When it comes to the well-being of the lives of our veterans, we can't afford mistakes of that magnitude. And I think the ranking member referred to that in her her opening statement. What specific safeguards, review protocols, and accountability measures are are being implemented to ensure that essential personnel and programs, especially those tied to life-saving services like the Veterans Crisis line, are not subject to erroneous cuts and administrative oversightes in the future as that happened uh so precipitously.
▶ 0:48:11Y well, Congressman, I think the very fact that we uh put on those non-answering the phone VC line uh back into work as quickly as we did actually shows that there was a uh pot in place that looked at things and said, "Okay, was this something that needed to be done?" We did that. I take exception. I know it was in the ranking members uh earlier testimony and I had this same conversation with the Senate last week. Um there by our own staffing admissions and our own staffing research when we did this there was no one who was answering the phone that was fired.
▶ 0:48:41No one. That is just I mean no matter what has been said that is from our own people. The ones that were laid off in the probation area were staff members or behind the scenes supervisors that were not answering the phones. I would not agree with the assertion that was made earlier that there was lines that were not going no matter who may have told the ranking member or anybody else. the staff and we looked into this and put them back in order. That's how we actually take care of this. No one was put in jeopardy. No one was not answered the phone. Those continued 247 365, but the calls were not answered.
▶ 0:49:11They were Uh the five minute rule, I yield back. My time is expired. And by the way, it's good to see my Georgia friend as well. I'm now going to recognize the the chairman of the full committee, Mr. Cole, for his comments. Thank you very much, Mr. Chairman.
▶ 0:49:37First of all, uh the only reason I was not here at the beginning is we have two former members testifying before this different subcommittees. Lee Zeldon was downstairs, our new EPA administrator. But I I just want to tell you, my friend, having served with you, how pleased I was when your appointment was made. Uh I know your commitment to members of service. You served this country yourself with great distinction.
▶ 0:50:02You served here with great distinction and I think we're very for also were our colleagues here in the house because you guys know how this place works and that that is an enormous advantage and uh and frankly we know you personally and professionally in a way we we don't some of your other colleagues in the cabinet. So, uh, I couldn't be more pleased to have you in this spot and I look forward to working with you.
▶ 0:50:27As I believe my colleague, Miss Wasserman Schultz, mentioned a couple weeks ago, your team sent the House and Senate committees on appropriation to transfer notification indicating the department's transferring unobligated funds from various accounts over to the medical community care. It's my understanding this should have come in the form of a reprogramming request. Obviously, we have authority there and chairman has authority there. So, we just point that out future reference.
▶ 0:50:56Uh I know you've got, as I said in my impromptu remarks, uh the care of our veterans uh at uh at heart and I know that's going to be your main focus. Specifically, I understand the importance of making sure the community care account has the resources it needs as we've had recent issues with this program at the Oklahoma City VA Medical Center.
▶ 0:51:18I look forward to working with you and your team in a more collaborative way and strengthening the relationship with the committee so this confusion does not happen again and we ensure working together that funding is properly allocated. Uh just a couple of quick questions. Can you provide uh me with and the committee with an update on the status of the execution of these The if you're talking about the re the notice that we had sent up they were sent on the 24th.
▶ 0:51:46As you well know, the transfer takes place 30 days later, and that is on May 24th of this year. Okay. Uh and the April 24th letter indicated that no veteran services be impacted by these transfers. That's good to hear. Uh but can you provide a little information on the contracts and personnel cost generated by the action? Uh and those mainly come from contracts. I'll have I'll get have more as as I promised earlier, we'll continue, Mr.
▶ 0:52:12chairman to work with you on these this request and make sure that both uh or you get the information you need and we'll make sure that we follow that with OM as well. I appreciate that. I'm going to make one other impromptu comment and it's really not directed at you so don't take it that way. Um I'm doing this at all of our hearings. Um we've got some guidance from the administration through the skinny budget but we obviously don't have the full presidential budget yet and that by law is supposed to be here February 15th.
▶ 0:52:40No new president ever makes that date. Uh and it has no penalty attached to it. And frankly, I was very understanding when the Biden administration took a little while to get it here as well. And so again, you don't even have your people in place by February 15th. So it's an unreasonable timeline, particularly for a new administration. And frankly, most administrations have trouble doing it throughout their tenure.
▶ 0:53:02But I will say this, we are getting to the point and I've had this discussion and again it's been a professional good discussion with OM uh because we know you have budgetary people that you've got to deal with too. Uh but we've got to have that information if we're to have any hope of getting these bills out on time. It would be my goal to try and get the budgets out of the committee by the August break.
▶ 0:53:28And honestly, if we have any chance of making it by September 30th and not subjecting you to a CR, um we're going to have to be in a position to vote on some of these bills literally in June and July before the August break. Not all of them, but as many as we realistically can. So, I would just ask you, as I've asked others, uh, to urge our friends at OM that, you know, for you to get the what you need out of this committee, we need more detail in the presidential budget.
▶ 0:53:58And I'm I suspect you do, too. Uh so uh the sooner they can get that to us, the sooner we can get our job done and and give you honestly the the budget that that you need and deserve with the care and the thought and hard collaborative work that it goes into creating that document. But last point again I'll I'll end where I started. It is really good to have you there.
▶ 0:54:23very pleased and uh please call on me and I know uh members on both sides of this committee even we have partisan differences we don't differ over how important it is to care for people that put their lives on the line to defend the United States of America that uh we've made commitments and promises to and we intend in a bipartisan way to make sure those commitments and promises are kept.
▶ 0:54:45I know you share that same uh same goal and so I see the the basis here of a very good and collaborative relationship in the months and the years ahead. So good to have you back my friend. Well thank you Mr. Chairman. I appreciate that and and I also and we'll just uh let Mr. Zelda know that you came to see your favorite second. How about that? Okay as we go forward. No but it is good it's good to serve with you and it's good and it's good frankly to have this moment just to say to see members that I have served with and served that and not and it's good to back and forth. I've learned a lot uh from your leadership over the time.
▶ 0:55:15We look forward to continuing that good collaborative relationship because it is going to be something as you said and something you and I have talked offline uh when we were serving together. This is the budget is something um that frankly we've got to get uh on both sides nonpartisan. This is both in any administration we this is something that we should get done. It has people understand that or they don't understand it back home better. Thank you. Thank you Mr. Chairman and thank you Mr. Secretary. I now recognize Mr. Franklin.
▶ 0:55:46That was down there. Yeah, you're it. I don't know if you're going to carry it to the other side, Mr. Chairman. Oh, I'm Thank you, Mr. Chairman. And uh my bad, Mr. Leven. No problem, Mr. Chairman. Uh want to congratulate you, Mr. Secretary. It's great to uh be with you.
▶ 0:56:10And I want to associate myself with Chairman Cole's comments about the work that we do in a bipartisan manner for our veterans. I'm a new appropriator. I was on the veterans affairs committee for six years uh prior to joining the appropriations committee and I was both chair and ranking member of the economic opportunity subcommittee. So I had an opportunity to work with uh lots of different great Republicans and Democrats alike. And we got scores of bills through and and signed into law both by President Trump and and then by President Biden.
▶ 0:56:39And I'm hopeful we can continue in that spirit of bipartisan collaboration to find areas of common ground uh in the second Trump administration just as we did uh with Secretary Wilkey uh in the uh in the first Trump administration. I think like everybody else, we're excited to see the the detailed uh budget request.
▶ 0:56:56Uh, and I wanted to just bring to your attention uh the bipartisan veterans package that we passed uh last year had a number of really important programs for veteran homelessness, long-term care, veteran caregivers, included uh three of my bipartisan bills, and I have a parochial interest in making sure those are fully funded.
▶ 0:57:14uh one in particular the CVSO act that's with uh Kathy McMorris Rogers, Brad Finstead, and Chris Papus, which authorized $10 million in funding for grants to states to improve outreach to veterans and increase the number of county veteran service officers. Very important for regions like mine in in San Diego. Uh so, Mr. Secretary, as you develop the final budget request, can you commit to working with your team to fully fund this important grant program? Yes. And and Congressman, I appreciate your words and comments.
▶ 0:57:43I can cuz as most on this committee know that that was my uh hallmark here is working bipartisanly to get stuff done and um we've done that before. Yes. I mean you've also brought up something that's very important to me and I've actually went to our county veterans, our state vet. We've not done a good job I think at the VA over a longterm period of of actually utilizing those state benefits or state partnerships and our county partnerships because they're so important because especially in the county side uh this is where most people go because they know each other. It's it's that veteran knowing veteran.
▶ 0:58:13So for me, yes, this is something that's a priority for me going forward. It's going to be something we can definitely work across the aisle and Miss McMorris Rogers and I was did a lot of things together as well. So it's good to see y'all do that, but we will. Yes, that's great. I appreciate that very much. I also wanted to thank you. Uh I wrote you back on April 2nd about uh call centers and specifically the potential move to automation. Uh we receive I mean you were a member for a long time. You get all kinds of calls from uh disabled veterans, elderly veterans who don't know how to schedule appointments.
▶ 0:58:43They don't know how to navigate VA websites. They don't necessarily know uh how to uh reach out to their primary care providers in some cases and and they rely on those employees at your call centers and they're worried that they won't be able to talk to an actual human being when they call VA to schedule an appointment. So, Mr. Secrettory, can you promise my constituents that when they call VA, they will be able to talk to an actual human being? Yeah, that's our intention.
▶ 0:59:10One of the things that I want to I'm appreciate you asking this because it's important to me because as a someone who deals a lot in my district, most of you did as well with older veterans who are just, you know, looking for answers, especially trying to um what became surprising to me is is we have over it's approximately, and I have to get this number, over 200 approximately 250 call centers associated with the VA.
▶ 0:59:31What concerns me about those is they don't talk to each other is we have 250 almost you know think different call centers across the country that have no connection unlike if you were to call your insurance a or another company they would know okay we see congressman you you wanted to know about this benefit well we could connect you there what we're trying to do is make that more streamliner looking at the possibility of how do we do that so that the veteran can get directly to their care get to somebody who can answer their question but do it without having to dial several numbers.
▶ 1:00:00One of the problems we found was is that they would dial one number, maybe our main 41 number, 411 number, but yet at the end of the day, they're having to get another number to call. So, I I'm with you. Let's make it easy as we possibly can and streamline that so that they can get the help, personal help that they need. But just to be clear, it'll be a human on the other end, not we're making sure that we have as much human interaction as we can. The other week, I had a dishwasher installed. I called the number and it was a AI chat assistant. I was ready to hang up. I I don't want that to happen to our veterans.
▶ 1:00:28Um and in in the letter in the response you said uh quote VA call centers are incorporating selfservice options and quote there is always an option to be connected to a live representative. So again to drill down on this can you be specific about what self selfservice options are because uh in uh in the private sector these are lousy time you I'm sorry use your time. Yes sir. I I have 15 seconds left Mr.
▶ 1:00:57and uh he can answer the question Mr. Yes, he may answer the thing. I'll answer the thing. Yeah, we're going to continue to work. I think the main thing though is there also has to be an understanding of how we also can process efficiently and looking at. So, if there is ways that we can get them if they could say push one to go right to VBA, we'll do that. That's my mind of how we can do this. Or if they can actually leave their information and they can get their information they need sent or set an appointment. Those are kind of things that do work in the private sector as well. But we'll continue to work together. Thank you. I, by the way, will join him.
▶ 1:01:27And I don't want them not talking to a human being. That's one of my pet peeves in life in this modern times. I third that. I think Can we all just get a hand vote? Yes. You know, we're going to work that today. Mr. Franklin, thank you, Mr. Chairman. Thank you, Secretary, for joining us this morning. And I I'm very grateful for for your generosity and the time you've shared in meeting with us. you've got a a monumental task ahead of you in reforming uh the largest government agency beyond the DoD.
▶ 1:01:54So, I I really appreciated your comments about personnel and money and that necessarily more isn't better. Uh you know, unfortunately, and I get it. I understand where it comes from, but too often my colleagues on the other side of the aisle think that more money is a solution to every problem, and it clearly isn't. But I would tell you that as a veteran and one who's charged with representing the veteran interest of of my constituents and those across the country, uh all I care about is the right solution. We want to spend every dollar necessary to make good on our promises, nothing more.
▶ 1:02:24We want as many people as it takes, but no more than that. The the job of the VA is not to employ as many people as it can. It it should only employ what's necessary to deliver for the veterans. But on that, a couple things I want to dive into. I know you're looking at a lot of these, but just to make sure that you're on they're on your radar screen. Uh research funding, for example, uh some inefficiencies we've seen in the clinical trial processes. Uh medical and prosthetic research, great topic, great idea.
▶ 1:02:51Who would not want to spend as much money as is necessary to do the job there? We're spending northwards of $900 million a year. I think some across the aisle would say great, let's spend a billion and a quarter. That would make it better. Unfortunately, from some of the studies I've seen, you may have seen some of these, as much as $550 million of that is wasted each year, not going to its design purpose. And the goal there is is to, you know, to achieve the end in mind. We see excessive spending on recruitment and third party vendors.
▶ 1:03:19Uh in in many cases, we're spending 20 to $30,000 to recruit a veteran into a program, whereas comparable uh studies like that, clinical trials on the private side may be $1,500 to $2,500 a patient. That's a waste. We see a lot of chronic underenrollment in programs. There's, you know, you always hear the highline ones that that are most egregious, but somewhere there's only a handful of participants in studies. These things are on autopilot.
▶ 1:03:44They go year after year after year, and the people that are receiving money have no incentive to fix the system. They're getting their money. They go on about their way. Is that something you're looking at? And how can we reform this? Yes, we are. And and just to go also, though, has been some concern about this. And let me just very clarify because we're trying to get a a a good handle on what we're doing and how we're going about this. There's been no research trials have been cancelled period. That's just it's not happened. But we are looking at how many we have going because you sort of mixed two issues here.
▶ 1:04:11You got research that is going uh on in other areas and then clinical trials which are a little bit different. I appreciate I appreciate you bringing them both up because they need to be talked about. One of the things that concerned me as we started looking into this and is one of the reasons why I put a a pause on our our research in particular from uh digging into this because we're trying to make sure we do it right. They all end at different times at different contracts coming up is we want to get a good handle to make sure what was working and what wasn't working.
▶ 1:04:37Here's a I know this may come as a surprise to some, but we had no especially on the clinical trial side. Let me go over to that side for a sec. We had no good way of managing. In fact, we have no centralized management of our clinical trials. And right now that I believe there's about 1500 clinical trials going on and remember which is a lot. But also I think taking into account here that clinical trials are not separating from healthcare.
▶ 1:05:00There's been some concern concern in the in and some reports and others that VA uh veterans were being denied health care and there was either because they wasn't because they were confusing clinical trials which are extra and above the healthcare normal. So, we're trying to get a handle on what we do have, what's working, what's effective, and how are we make sure of that. Our research side is going to continue because we've had some of the the VA is one of the world's leader, especially in prosthetics and other issues, poly trauma, those kind of things, and we're going to continue that emphasis as well. Okay.
▶ 1:05:30On the personnel side, last Congress, I had the privilege to to serve on the VA authorizing committee, uh, we had whistleblowers coming to us complaining of sexual harassment. As we started digging into this, we were uncovering more and more where uh when whistleblowers would come forward, investigation would start. Rather than get to the bottom of them and get justice for those victims, people were being either allowed to retire or transfer and then the investigations would be shut down. And in many cases, these people would leave the VA and then only to go to another government job in another agency.
▶ 1:06:00I've got a bill and bipartisan bill to try to address that. We're going to go forward with it. But from where you are, are you going to can you give us a commitment that when people do come forward and they're courageous enough that we're going to root out the the evildoers and get rid of them? Yes. That's one of my uh primary concerns right now because there has been a culture unfortunately in many agencies but also at the VA and it's what I call fail up, right?
▶ 1:06:22and that is they failed at a certain job and I have an example of this in in just very specific close to home in which a uh senior leader failed and was documented failing and the answer was is to put them into the vision level in a uh sort of advisory role. When I found that out I said no that's not what we're going to do and we started the proper uh procedures given all that that needs to be to put this person on administrative leave. They're not going to be a part of what's happening.
▶ 1:06:49I think this is the one thing that has been frustrating to all of members of Congress on both sides when we see egregious acts that we cannot take care of without uh going through a process that ends up many times not getting the intended result. But I will just make this commitment to everyone on both sides of this aisle. If you hurt a veteran and you're working for the VA, you will not work for the VA. That is not that is my commitment and I will take I there's a higher cost to keeping bad people in than there is ever a higher cost in getting rid of them. Right. Thank you, Secretary. And I I yield back, Mr.
▶ 1:07:23Thank you, Mr. Chairman, ranking member, and uh Mr. Secretary, congratulations. Uh um it's always good seeing one of our former colleagues. So, I wish you the best and certainly want to work with you in any way that we can improve services to our veterans. I'm going to talk about efficiency, competition, performance, and contract management uh requirements. They're under the law already.
▶ 1:07:50Uh back in 2010, Congress passed uh the government performance and results modernization act and it calls for several things. Uh there's also the other section dealing with contracts about the penalties where you can suspend or debar somebody or or put penalties uh monetary penalties. So everything's under the law.
▶ 1:08:14And I'm hoping that Congress since everybody's been talking about efficiency, effectiveness, and accountability that I'm hoping that Congress can look at some of those provisions and enforce those provisions they're under the law. First one under there's four categories performance and regulatory efficiency reviews. The law already calls that you know you ought to be looking at um annual reviews of major construction etc etc modernization programs. It's under the law uh right now.
▶ 1:08:45Uh Congress needs to provide that oversight. Same thing with looking at um uh you know certain rules or regulations or directives that might be duplicative or inefficient. Uh we ought to be looking at that. The law already calls for that but Congress needs to do its job. Second category is contracting and construction procurement and it's basically having competition and not just giving it to somebody.
▶ 1:09:13But the main thing is looking at on time and on budget. It name me one contract that and and and we've been some of us have been doing appropriations for years. give me one agency and and certainly you know I sit on defense and our members see this everything's not on budget and it's not on time but we don't enforce the penalties that the law calls for. Uh so that's a second uh secondary uh second part.
▶ 1:09:43The third one is quarterly oversight reporting. The law already calls uh for status of agency performance reviews and resulting reforms etc etc. Without going to details there's a lot more. And then finally the development submission of updated performance uh measures or metrics. The law calls for that already and I think you all are doing that but it it's not provided to Congress.
▶ 1:10:09And the problem is if we're going to do our oversight, we have to be able to get uh that work. So I certainly want to work with you on getting uh that uh some of those items uh working with you. And finally, the last question, and this is a question, um there are some reports that show that the VA does provide uh mistaken disability and pension payments, you know, a large amount.
▶ 1:10:38And then uh uh including whether this report is right, $1.4 billion, but then those overp payments because administrative er uh errors. Then they go back to the veterans and the veterans say I don't have the money now. I I I got the money. I know you know you paid it was a mistake should be paid. But if we can prevent those errors at the very beginning, I think that will uh prevent some uh hardship for some of the veterans later. And again, look forward to working with you.
▶ 1:11:06and I used to be speaker promp and I miss your humor on the floor. You have a great sense of humor, Mr. Secretary. Good seeing you again and I wish you the best. Uh thank you, Congressman. It's good to see you again as well. Let me let me hit the last one uh real quick because I know there's a hearing yesterday and or this week I think it was in House Veterans Committee about this overpayment issue. This is not a specifically a VA issue as well because I being been in the military for years, I remember DoD, especially when we first kicked off in Iraq and Afghanistan. Uh there was overpayments for uniforms and other things.
▶ 1:11:37And then we were actually I mean unfortunately some of my younger enlisted troops were having almost their entire uh pay was docked because they had an overpayment and they couldn't pay it. So this is something that's concerning to us. We're trying to they're going to fix as we go forward. Very quickly, everything you outlined in your first part of your question, we're tr we're actually trying to follow the law looking at this as we go forward. Um competition, duplicating.
▶ 1:12:00Let me just say one of the this shows you the duplication issue we looked at in our contracts and we've looked at almost 16,000 contracts. We actually had a contract that the contract was to manage the small business the office of small and disadvantaged business utilization which was already led by senior VA staff and the contract was 5.8 8 million. We don't know what the staff was doing if we were contracting out the the oversight. So, this is the kind of thing we're looking at.
▶ 1:12:27But I do and I'm glad the chairman is over chairman and both our chairman are here. I need I frankly at some point in time offline and and just in our conversation, we need to talk about construction project at the VA and it may be for everywhere and this is I think something all of us because we've all seen the problems with uh the build. There's no reason it should take $1.6 6 billion to build a hospital. There's no reason for this. But yet, here's the part.
▶ 1:12:54We we budget a little bit and then we'll budget the next year for another little bit. And for instance, I think it's like the St. Louis or Louisville, it takes 10 to 15 years to build a center. Every one of your hometowns, they can build a a healthcare building or center in 24 months and be ready to go and a lot less cost. So, I I know we did this a few years ago when I was here because we had we had the reaction to how it was going. I think it was in Colorado and some others. We brought in uh core of engineers. We added these layers. I'm just telling you, Mr. Chairman, it's not working.
▶ 1:13:24I I I can't It's hard for me to be able to come to this committee and say I have a major construction project, which we desperately need in some areas that I can tell you will get done on time and on budget. I just can't do it. Thank you. Thank you, Mr. chair and ranking member Wasserman Schultz. And uh congratulations, Mr. Secretary. Thank you for being here today.
▶ 1:13:50The Department of Veterans Affairs has profound responsibility to those who have served our great nation. Missouri's fourth congressional district is home to thousands of veterans. Yet, my district, like many others, has heard too many stories of delayed care, bureaucratic obstacles, and a system that sometimes feels more like an adversary than an In the golden age of America, I think the VA should be the gold standard of healthcare.
▶ 1:14:19And I think you have the same vision, Mr. Secretary. In our district, we pride ourselves on our constituent services, have a great team there. We we try to provide concurred service. We look at people as clients, uh, not just constituents. Our lead case worker there, her name is Grace Townson, and she's a veteran. And I have some questions that our staff wrote up here. But you know, I I came up here to be a voice for my people.
▶ 1:14:45And I want to be a voice today for our chief case worker, Grace Townson. She text me a couple of questions to ask you because she deals with this. She deals with this on the front line every day. Sir, I would love to know when he expects the backlog of disability claims to be worked up and caught up. Well, Grace, and I'll speak to the congressman as well. Thank you. One of the things is as most on this know 60% of your calls to your offices are constituent for cause of the VA. Y and I'm telling you upfront that's a failure on our part.
▶ 1:15:14I don't make any excuse for that. You they should not have to call you to get the benefits they've earned. So to speak to Graces, we've had uh we've dropped that almost 21% from 60 from 260,000 to right at 200,000 in the last uh few months. And we're going to continue to see that go back down as we put resources and time to where it needs to go. And we're going to see that go. But also one of the things that Grace would probably also ask about is we we do the wrong metrics sometimes and that's to the end of completion. When do we actually finish it? And right now we're way over the target of of where we need to be.
▶ 1:15:44We're at about 135 days. So as we get the backlog down, that frees up more time to then get on to to the other claims as we go. Very good. VA prescriptions are mailed to veterans with a US Postal Service delays. Is there a better way for veterans to get their medication? There may be and I think that's one of the things we're looking at in our overall projection of care and how we do that. I think this is something that the Congress has also looked at uh concerning uh basically how we deal with our uh generation of prescription, how we actually cut our costs.
▶ 1:16:13Um there's been some concern about uh the pharmacy benefit manager system. There's also been some concerns about how we go about that. It is something that's currently being looked at in our overall look at the HA. Next question from Grace Stson. There's been a decline in receiving responses to congressional inquiries in a timely manner. This kind of ties into the first question. Uh, liaison are not returning responses in reasonable time frames. What used to be a 30-day turnaround time is now between three and five months. What do we do about it?
▶ 1:16:40Well, we're going to that's uh I appreciate her bringing to that attention. We're going to get our staff is going to get with you afterwards and I want to know what's happening. I don't know where she's sending the letters and we're going to uh fix that. And that's that applies to anybody on this this das. if you're not getting timely response. Um I'm trying to right now rework our legislative affairs group that is up here on the hill. Uh it's something I promised in my confirmation and we're going to do that. So we'll be happy to work with you and see what's the problem is and we'll make changes where necessary with any potential cuts to employees. How many behavioral health providers could be cut?
▶ 1:17:11None. I want more as I can get. I think that there remember one of the things we've talked about not talked about today is in any discussion we've had we've had over 300,000 positions that we've exempted. uh and right now are currently hiring uh at the VA at any one time and we need as much and especially in the area of mental health, behavioral health and others uh to help us with our backlog and with our not just our backlog but help us with our uh death by suicide issues, our homelessness issues and uh getting back to work issues. We have a minute left. Those are Grace's question.
▶ 1:17:39Mine is uh dealing with suicide. I lost my best friend to suicide 14 years ago. Um we continue to lose 6,400 veterans each year to suicide. How do we change that? Congressman, I'm sorry for your loss. I have experienced a similar loss, but also been on the phone as my years of service in the Air Force of actually talking to those veterans on the line who have come to that point in life where they want to end their life.
▶ 1:18:07And that's a difficult place to be and it's not something and we look back on and say, "How can we help?" And that's a very hard feeling for the families and others. Here's the sad reality of what we're looking at right now. Why we're going to start a different approach and trying to get to as many people as we can. Since 2008, the number of suicides in this country by veterans have not really changed. 2008, we're still at that 6,500 to about 6,900. It's about 67 depending on how you want to look at the numbers.
▶ 1:18:31And yet in the past few years, this body, and I appreciate the the work, they spent 588 million on prevention for suicide, but yet our numbers aren't changing. We spent 2.3 billion on how do we actually take care of them and that we do counseling for those that are that are struggling, but we're not changing. So I've I've instituted a new we're looking at it completely different.
▶ 1:18:49I'm talking to our folks in the field saying how can we reach more people because here's the disturbing fact for all of us on this dice is that when they look at that that 17 number half of those veterans who take the ch option of death by suicide have never had a contact with the VA. Never had a contact with the VA. So that's why I'm going on podcasts. That's why we're going to any place we can. I'm going interviews. I'm going everywhere I can to encourage our veterans. Please, please, please reach out. And if that's with VA, great.
▶ 1:19:16But I'm also encouraging all of our veterans to have the resources to take care of their airmen, take care of their battle buddies, take care of their wingmen, because we can we can't afford to lose one. We're over time, Mr. Secretary. You have a big job ahead of you, but you're going to do great. We're here for you. Thank you, sir. I yield back. Miss Escobar. Thank you, Mr. Chairman and Madame Ranking Member. Mr. Secretary, good to see you.
▶ 1:19:41This is a very different environment from our judiciary days and it is very good and it's good to see you as well as well and we we we've spent many an hour in rooms like this. Absolutely. Absolutely. It is it's good to see you. Thank you. Uh I have as you know the incredible privilege of representing El Paso, Texas, home to 50 over 50,000 veterans. Home to Fort Bliss, a premier military installation and a an excellent active duty military population.
▶ 1:20:10And so I I am very fortunate that I get to represent all of those folks in my hometown. I have been so alarmed by the Doge attacks on the federal workforce. And as we know, 30% of our federal workforce is comprised of uh United States veterans.
▶ 1:20:30And when we talk about important issues like veteran suicide, um, behavioral health challenges, losing your job from one day to the next with no reason certainly exacerbates the stress that many of our veterans live through. So, I wanted to make sure to put that clearly on the record. Uh, fighting for my community and our federal workforce, uh, comprised of a lot of veterans.
▶ 1:20:57Earlier there was a dialogue about Milcon funding and the lack of guarantee that we're able to provide a community with delivering ontime uh uh procurement or I have a prime example in my community, William Bumont uh Army Medical Center, which was three years uh overdue, over I think it was like $650 million over
▶ 1:21:27budget. That preceded me. But if we want to really tackle waste, fraud, abuse, that's a prime location. That's where we have to really look. not not um firing the work the hardworking federal workforce, but actually looking at where we can make a real difference. And I am so excited about new construction that's happening, a new VA clinic that's uh right next door to William Bowmont, $700 million.
▶ 1:21:56Uh I was proud to fight for that funding and proud to deliver it for El Paso and for our veterans. I am concerned about a repeat with what we saw with William Bowmont. There are lots of ideas that um I'm going to be working with our ranking member and our chairman on in terms of reform.
▶ 1:22:14Uh, but I I would like your commitment that you will work with my team and me on this issue, but in particular our VA clinic and would like to know if you can commit to working with me on ideas like a dashboard to make construction transparent for the community and the veterans that they uh making the the making sure that the construction company that was awarded this incredible bid is accountable to our veterans in our community through
▶ 1:22:44town halls and meetings to provide that kind of level of transparency. But more importantly or in addition equally as importantly the accountability when things don't go right. When I was sworn in in 2019, visited the new facility, got a briefing about I wanted to know why was it over budget? Why did it take so long? And after the briefing, my next question was who was held accountable. No one.
▶ 1:23:13So would love to know your response and whether you would be um open to working with me on this issue. Congresswoman, have you been in my office for the last 100 days? You you asked the same questions that I've asked. Uh that's become in my staff. I I've almost at times felt like as I've reverted back in time to asking why all the time because everything comes across my desk. I ask why. Why are we doing it this way? Why is this up? And accountability starts one with our office, but it also starts with personnel. And so we've asked why.
▶ 1:23:41But when I come to when it comes to construction projects, one of the the you have large headache days in a job like this. And one of mine was when I we were discussing our minor and our major construction projects and began to look at projects and they were just casually saying, "Well, we're going to put 200 more.
▶ 1:23:59We need 200 more million here and we're not finished." And I'm saying, "Well, when is the project going to be finished?" And they said, "Well, that's not the way we we do it because we we get a little money to start it, then another morning to go from there. It's just it's broken, Mr. Chairman. It's just broken." And I know that we want to put it in as being in the seat that you in as well right now. You want to have that sort of accountability. You want to put layers in, but unfortunately I think frankly streamlining it may be the better part of what we need to do and say we have a onepoint accountability.
▶ 1:24:28Um we're looking at that internally to make sure that maybe there's a way that we can do our constructions a little bit more fine-tuned. We have accountability, but it's never enforced seemingly to my satisfaction on how we get these done. So what you've seen is normal unfortunately, but it's not going to be normal in the next few years as we take a look at this because it's not right for you to appropriate the money to get a new hospital, to get a new Seabach, which by the way, Seabbox colllocated with other locations is probably the way that we're going to see a lot of this go.
▶ 1:24:55Do you commit to working with me on those items that I listed, those ideas? Perfect. And I'm out of time, but I I do want to flag for you the decline in home health aid hours. Want to work with you on that as well. Please get in touch with our and we'll happy to do that. Thank you. I yield back, Mr. Guest. Uh, thank you, Mr. Chairman. Mr. Secretary, thank you for joining us uh today. Thank you for your service, both your service in this body, but more importantly, your service uh in the United States Air Force.
▶ 1:25:26Um, want to um highlight a couple of the successes that you've had within the first 100 days. Um, you have redirected funds from non-m missionritical areas to healthcare. Uh, you've ended remote work and brought employees back into the office. Uh, you've canled duplicative and therefore wasteful contracts uh that the VA had entered into. Uh, and you've reduced disability backlogs by 21%.
▶ 1:25:56I think you said 60,000 cases have been resolved in just your 100 days. and that was the the backlog of 60,000. And so want to thank you for those incredible efforts uh in those first 100 days. Uh also want to talk a little bit about the VA in general. Um as I understand the VA has more than 478,000 employees. Um it is actually larger uh than our active duty uh United States Army.
▶ 1:26:26Um, and we've seen incredible growth within the VA just in in the last decade. Uh, in the last decade, as I understand, the VA has added uh roughly 114,000 employees. 114,000 uh within a decade, while the number of veterans that they serve has remained fairly constant at roughly $9.1 million.
▶ 1:26:51During that same time period, the budget of the VA during that that 10-year window has grown from $ 160 billion to $394 billion. So, you would expect or I would expect uh that we have an agency that has substantially more money. They have substantially more employees.
▶ 1:27:13uh they are serving the same number of clientele uh that we would have metrics that would show uh that the VA was doing an incredible job. But some of the metrics that that you cited earlier in your testimony and I think a metric which is very important uh to all individuals um who um are using uh the VA uh is weight times uh and claim backlogs uh as it relates to weight times
▶ 1:27:44uh over the last four years. So from FY21 to FY24, the wait times for primary care went up from 15.7 days to 24.3 days. The wait time for mental health care, and we heard earlier about suicide and the need to make sure that our veterans are receiving mental health care. The wait time for mental health care went up from 14.7 to 20.4.
▶ 1:28:10the wait time for specialty care went up from 24 days to 38 days. Uh and the backlog for disability benefits went 65,000 to 232,000 during that four-year window. Again, during that window, we are continuing to add employees. We are continuing to add and increase the budget within the VA.
▶ 1:28:37Uh, but it would seem that our veterans are not getting the care that they need. And I'm a big believer in metrics. We can talk in generality about things, but hey, show me the numbers. And those were numbers that you provided uh to myself and others uh talking about the challenges that that you face.
▶ 1:28:58A and so I I want to ask you Doug a as you take over this role uh and if you've been in now on the job for 100 days and again I think you've done some incredible work in the 100 days uh what can we do uh and and and let me address another rumor uh and then I'll probably run out of time so you probably won't have to say a word at all.
▶ 1:29:17Um, but we have seen rumors uh and we have seen news reports that of the 478,000 employees that you have under your control uh that you're going to cut 80,000 of those employees that those employees are going to be cut and it's going to dramatically in fact impact veterans care. Uh but in the first 100 days, if I understand correctly, there's only been 1,000 employees.
▶ 1:29:45And those employees were employees who were serving um uh at the very beginning. So they were probationary employees that have let go. Some I'm assuming were let go for calls, which is only one half of 1% of non-m mission critical employees. Uh, and so, uh, I just want to put a lot of the false rumors to rest that the allegations that have been made against you, against your leadership team, against the VA are not true.
▶ 1:30:12That the what we saw in the last four years in the VA, we did not see care improve. We did not see our veterans reduce weight time. We saw those increase substantially. And you've got a difficult job ahead of you, Doug. And so, I just want you to know that this committee wants to provide you the resources that you need. Uh, and we want you to be successful because our veterans deserve a VA that serves in. Uh, so with that, Mr. Chairman, I am out of time and I yield back.
▶ 1:30:43Uh, Miss Wasman Schultton, I decided we'll have a second round and I'm going to start it off. And before I close, I want to I'm aware an ongoing issue to construction the community construction for the community-based outpace clinic in Bakersfields, California, which was authorized back in 2010. Wow.
▶ 1:31:10To the frustration of many, the construction of this VA clinic has been delayed due to 15 years of frivolous legislation. While the ability to protest is important to the p to the procurement process, I think we can all agree the current situation is unfair to the veterans living in Bakersville and the surrounding communities
▶ 1:31:41for that fact. Uh who have patiently waited for years for their new and modernized clinic. Mr. Secretary, you know, I know you are just getting uh caught up to speed on this issue, but would you appre I would appreciate any updates you have and to share with us on the status of the Bakersville VA clinic as well as your commitment to do
▶ 1:32:11everything within the VA's ability to bring the a resolution to this situation. Uh thank you Mr. Chairman. Yes we have uh it is something that's been brought to my attention by another member of the committee not on this subcommit.
▶ 1:32:24I was uh congresso as well has talked about this and it goes to show that this is part of the problem that we we're experiencing contracting as far especially in the construction side of because when it goes through it's it's either held up by um you know delays in as you stated in court uh appearances or other things. And so this one here is something that we're looking at. We may be uh after looking at it, there may be a possibility of a solution here fairly soon.
▶ 1:32:52So, we're going to look at that solution and may be able to get back with you on that fairly soon. So, we'll hope to u Thank you. Well, I appreciate that and I'll be looking forward to seeing that and so will Mr. Felo, Miss Wson Mules. Thank you, Mr. Chairman. Um and before the clock begins, I just ask unanimous consent to enter into the record the provisions of public law 118-42.
▶ 1:33:15Uh these are sections that clearly indicate that it is current law that unless the secretary of veterans affairs receives approvals from the committees on appropriations of both houses of Congress that these transfers are not to take place. No objection. Thank you. Okay. Um so Mr. Secretary, in answer to Mr.
▶ 1:33:36Franklin's question um about the cancer research uh and clinical trials concerns and the um accusations that clinical trials in particular and research have been have been cut. Um those were referenced in a very disturbing article about indiscriminate staff firings and planned program cuts having a direct and negative impact on cancer treatment at the VA.
▶ 1:34:02Um, you may recall that I'm a now 17-year breast cancer survivor, so this issue is deeply personal to me. Um, these are leaked emails from VA staff that show that more than a thousand veterans would lose access to treatment for diseases ranging from metastatic head and neck cancers and kidney disease to traumatic brain injuries. These emails further revealed that enrollment in CL clinical trials is stopping, which we all know means veterans lose access to therapies. And I'm talking about enrollment stopping.
▶ 1:34:31Um I've been working hard on this committee along with uh Judge Carter uh and we've successfully increased uh funding for cancer research and clinical trials. So um can you further clarify this? Have clinical trials enrollment stopped?
▶ 1:34:49Have there been any re I know you referenced reorganization but in the process of looking at reorganizing has enrollment in any clinical trial stopped and has any research been halted? Okay, let's take uh the two questions and and again you and I have talked about this as well. No research no VA research trials have been cancelled. So we'll take research that way. the clinical trials and you made mention of one. So I'm I'm assuming you're talking about Pittsburgh because that was the one that seems to have come up.
▶ 1:35:19Um this was one that was a head and neck cancer lung cancer um that officials warned this was the allegation that warned that hiring freezes had still had not started. Here's the interesting thing about that hiring freeze had nothing to do with that because this uh was scheduled to start uh was not started before the hiring freeze. Had not been recruiting uh anybody. There was nobody in. So you can't stop something that hadn't started yet. This was a a trial that had not started. Just to interject, was enrollment in that clinical trial or any clinical trial halted?
▶ 1:35:49No, because you can't start you can't something it wasn't started. Was halted or not begun as planned? No, because this was already been planned. In fact, that particular trial that you're talking about right now, they're going to begin looking for uh participants in that trial this month. Okay. Well, there were dozens of emails. This is not rumor or innuendo.
▶ 1:36:09This is dozens of emails from VA employees in specific multiple locations from Pennsylvania to Detroit to Colorado indicating clearly that there were research projects stop halted and enrollment stopped. So, and I know you were asked these questions by two senators from the Senate Veterans Affairs Committee over a week ago. So, have you been able to get further information in relation to those questions and mine?
▶ 1:36:37And that's what I you know I just answered the sales as far as there's no clinical trial anywhere in the VA where enrollment has halted or research has stopped. There is clinical trials that go on. This is one of our problems that we had and I said earlier there are over 1500 clinical trials going on right now with no centralized supervision for No, I know and I heard your I heard your answer.
▶ 1:36:59there been any clinical trial where enrollment has been halted anywhere in the VA or research that was being conducted or beginning to proceed that has been halted anywhere in the VA and have you looked into that?
▶ 1:37:14I think for any and I'm not here's my question because you just made a very and I'm not trying to avoid your question but I just want to be you made a very open-ended could they have been slowed up or stopped for any reason there may be a there may be and that I couldn't answer the question I'll have to look at your specific because you've now opened the aperture so wide no I'm opening the aperture it's not a Mr. Secretary reclaiming my time.
▶ 1:37:35The aperture was opened pretty wide by this article where there were dozens of emails from doctors and healthcare providers involved in this research and these clinical trials that have specifically said that they were halted. And so I I I mean I'm not just making this up. The these were from VA employees. So it's an aperture that so since the aperture is wide as it should be. I'd like to specifically know the answer.
▶ 1:38:02Have you not looked into that concern since in the week since the Senate VA committee? Yeah, we have looked into it and I think the specific question especially that was a center of this article again was going back to the especially as your concern as well the head and neck cancer and lung cancer was a program that had was talked about was not even started.
▶ 1:38:20So I would like you can't call it on a hiring free I'd like you to get back to me then specifically specifically about has there have there since your tenure began begun any halting of cancer research at the VA that was planned and any enrollment in clinical trials that have ceased for any reason for for this would this be previous last year as well the gentleoman's time is expired by now to give it to but I would like to just make Gentleman
▶ 1:38:50from Florida. Mr. Chairman, I would like the secretary to confirm that he will get me that information. Gentle woman's time has been expired. I You're not going to allow Judge Carter would certainly let me make sure Judge Carter, Madam, the the gentle woman's from Florida has expired. I now give the floor to the gentleman from That's not how this committee is run, Mr. Chairman. It is under me, ma'am. Well, you're not the chairman. Thank you, Mr. Secretary. Appreciate you staying for another round of questions. There were a couple more topics I did want to touch on.
▶ 1:39:20You mentioned community care in your opening testimony. Um, in my district in Central Florida in the northern part, we have the opportunity to avail ourselves to fantastic facilities in Tampa, uh, in St. Pete. I also have a brand new clinic in Lakeland that is wonderful. I've been there a number of times and they're they're doing great work. I also represent a lot of rural counties where it's very difficult for for service members, for veterans to get that care in a timely manner.
▶ 1:39:44Um, we saw what seemed to be in the last administration some gaming on the part of VA with the um, appointment times and things like that to try to make it look like it was working better than it was, but really was just serving to frustrate veterans. I'd like to have you maybe expand a little more on the role you see for community care and to the extent that there may be those within your organization who are trying to resist that, how do you root that out and get them on board? Thanks.
▶ 1:40:08I appreciate that and because really this one is mo probably the simplest one of all because it was overwhelmingly passed by this body years ago and I was a part of it when the mission act was actually put forward coming after the choice act which was in response to wait time issues and scandals that we could not get uh our v veterans in for timely care and timely access. So it should have been something been growing in as an alternative is for alternative ways for a veteran to get care that they need.
▶ 1:40:34they can get all the care they want through the VA or they can get part of that care through the VA and part of the community. What we found concerning as we've went along here is especially in the previous four years is there seems to be more of a concern and I actually heard this from actual VA employees who said we have to sell the VA. In other words, they wanted to keep all veterans internal uh and not send them to community care because there was concerns that if they did not do that then they would actually uh you know not get funding or they would be cut or something of of that nature.
▶ 1:41:03What we're looking at is we actually have seen um emails and and procurement slides for not procurement but actually slides in which the VA itself was actively discouraging community care by overbooking by uh not letting the uh veteran know that they would have an access to that. So those are the kind of things we're trying to root out right now. One other aspect if you would allow me here on community care is it's frankly we have a two-part problem here.
▶ 1:41:32We have a problem with the VA which I'm working to fix and we have also then our thirdparty administrators that we're trying to work with who are our conduit through which our veterans go to community care either for doctors, recruitment, scheduling, uh those kind of things which we have found uh at times probably inadequate in some areas. But the other part is our side of it.
▶ 1:41:52And if we don't have uh things in place that where the doctor can easily uh refer uh someone to community care by either tweaking too much control or asking for more information before they send them, then that slows down this process as well. One of the things we found out uh just recently as we look at our community care aspect is is our doctors tend to think that they're supposed to be supervising at least that's the thought process. They're supervising the community care doctors.
▶ 1:42:19In other words, is if there's a hierarchy of care here and what we want them to do is and I asked many of our doctors this I said what why would you think you would have to supervise a fellow colleague as a doctor? And really they don't have an answer except that's just the way the VA has been doing it. So it slows up everything as you go along. Those are all areas that we're looking at. Another thing for us is is how we do even direct care. Um we ask duplicative stuff all the time.
▶ 1:42:43An example given by a veteran just the other day uh who is a double ampute asked the question why do I have to go to my primary physi primary care to get a referral to an OT to referral to a PT to get to a seating clinic to get a new wheelchair. Those are the kind of things that we're facing. Okay. One other topic and and I was thinking of it um as Mr. Alford had brought up suicide veteran suicide. Clearly, no matter how we bend the curve, one suicide is too many.
▶ 1:43:08Uh what has been kind of a sensitive topic in the past, a little controversial, is the use of PTS or um I'm sorry, psychedelics uh to treat PTSD. Uh there there are studies that show as many as 29% of the post 911 veterans are suffering from PTSD. We know the path that that leads to. I personally have have lost several of my former Navy buddies to suicide and it's it's just it's heartbreaking to see. And I'm for I'm for looking at anything that works. And I wouldn't have been a fa in favor of that.
▶ 1:43:36But I can also tell you I have fellow members of Congress who have told me that the use of psychedelics literally saved their lives. I would be interested to know your thoughts on that and how we can work with you on it. Yes, this is a um I am probably the first secretary who actually said I will I'm willing to look at at the possibility for any of these uh treatments that can work.
▶ 1:43:54Um, and again, we're not just running off saying this is the cure and the answer for everything with PTS or or traumatic brain injury or anything else, but it does go back to the question if there are actually treatments that we can show clinically, which by the way, 11 trials are going on right now in conjunction with the VA on the use of psychedelics. Uh, we've seen some good results there and also other uh treatments as well. So, I I'm looking at that is any way possible. Again, I don't want to say this is the only answer because it's probably not, but is it a possible answer that we can provide for veterans?
▶ 1:44:24I'll be willing to look at that. I appreciate that. And and any anything that would bend that curve and and there's no honor in hooking veterans on on narcotics either. So, Exactly. I mean, so thank you and Mr. Chairman, I yield back.
▶ 1:44:55Yeah. And and I've committed to working and I if I didn't make that clear in the early answer, we'll commit to to working with you on those and getting those answers. Thank you. Both just just to clar reclarify what I was asking because you said, you know, for any and all reasons. Yes, for any and all reasons, but specifically related to the Doge cuts and people who were fired and any terminations or personnel changes, but more broadly across the whole VA. Obviously, we're all interested in making sure that cancer research and clinical trials continues.
▶ 1:45:24So, if you can get me information across the VA on whether okay, planned clinical trials and research has been canceled. Well, we're and also just as a clarification, the Colorado and Detroit were not trials in that that was referenced in that article. They were not trials. Okay.
▶ 1:45:37and also specific question if you got specifics we'll work together in office also this is one I I can't emphasize this enough and it's a it's a personnel issue we don't manage these trials from Veo and so when you actually look at it from a perspective is any I don't care who's sitting here as secretary if you don't know how many trials are going or even there's coordination in them that's a problem no disagreement and we'll talk about that but I will answer that in thank you very much I appreciate it thank you Mr. Chairman I appreciate your miss Escobar thank you Mr. chairman.
▶ 1:46:07Um, and I have to say I so appreciate your collegial nature on this committee. When you stepped out for a moment, we got an example of the exact opposite and it was a little shocking to me. Um, so I want you to know I appreciate you and your leadership, Mr. Chairman. Secretary Collins, I have a question about the VA servicing purchase program or VASP, which has helped about 17,000 veterans avoid foreclosure after falling behind on their mortgages.
▶ 1:46:37And public reports indicate nearly 90,000 VA loans are seriously passed due with approximately 33,000 of those already in the foreclosure process. Can you tell me why was VASP terminated without first instituting an immediately available alternative option to provide foreclosure relief to our veterans? Uh, thank you, Congresswoman.
▶ 1:47:03This is an interesting part because this was a program that was not started from Congress, was not initiated from Congress. It was initiated inside the EBA last year from funds that they redirected at that point. Um, interesting enough, I'm not sure they actually came to you for redirection on that from last year. um because it was obviously something not from this body. The problem it puts us in and we have and there's been vehement kickback from Congress especially the chairman of the House Veterans Comm that says and basically it's indicating this is not something the VA should be in.
▶ 1:47:32We should not be buying or being in the mortgage loan business. In fact, what happened since last year 17,000 atrisisk mortgages were assumed at $5.4 4 billion dollar assumption on the VA um not anywhere else and there was nothing to go. Um there was estimates internal if this program was continuing estimates as high as 17 billion. We're taking property that we have no control over in the sense of how do we get rid of it? how do we manage it or do anything else?
▶ 1:47:59And at the end of the day, it was not helping the situation of veterans who had gotten behind in their payments or other. These were not taking people who had no home and not giving them a chance at a home, which is our mortgage process. This was taking folks who may have uh you know gotten in trouble not being able to pay their their loan payments. They they could resize, re down, and still have access to any other VA benefit uh from our mortgage side of the house as well.
▶ 1:48:23So, this was just a program when you look at when you have to go through the system and it was it was up for renewal which again we were going to have to come to this body and ask for billions of dollars more because they were taking it from mandatory. This was not my program. This was started previously. It was just made the determination that with the stuff that we've got going on the VA that there's other ways that we could help in this situation using other agencies and others.
▶ 1:48:44for us to assume mortgages, it puts us in a really it puts us in a very legally binding issue and also a liability issue going along on these properties if they sit vacant and things like that. So, have you thought through a uh you and your team, have you all thought through a plan for having some of those other agencies, as you mentioned, kind of take this over? There's not necessarily taking it over. I think there's a discussion on what do we need to do to keep this from happening to start with to keep the veteran out of the situations that they're in.
▶ 1:49:12Uh that's a bigger conversation that could be had. I mean this and again I want to make it very clear this has nothing to do with homelessness with and some unfortunately there was a little bit of discussion that does this affect homelessness. This has nothing to do with that program. This has folks who actually purchased the mortgages. Um we're open to it. I know there's some uh legislation going through Congress and especially in the uh Veterans Affairs Committee on a partial claims kind of issue that would give some relief but again not put us on the hook for uh that much liability.
▶ 1:49:43Again, I don't underestimate the the heart necessarily of what's trying to happen, but this was a sort of a an out of the blue kind of thing that VBA who was having enough problems with everything else that they're doing decided to start a program we shouldn't have. And I and I get what you're saying. So I I appreciate that. But I I do want to dig in a little bit. So, I'm gonna ask if you don't mind if you can follow up with me, if you and your team can follow up with me.
▶ 1:50:07I'm interested in knowing how many veterans were waiting uh for VASP assistance, what specific guidance the VA shared with those veterans after VASP was terminated, and also the number of veterans who to y'all's knowledge entered foreclosure or serious mortgage delinquency spanning the date of ASP cancellation to the date of your response. If you wouldn't mind and we'll get that to you in writing. That'd be great.
▶ 1:50:35And can I just say one thing is a problem we had from what we and again these are rough numbers. We'll get you more. There's about 5,000 that had had applied that had not got nobody was under the program was taken off the program. That's also something to understand. We just take we just did we did no more re-entrance after May 1st. And so there's nobody that was in the program that was kicked off the program. This was just saying we're not adding anymore. Okay. But I'll help you get the other information. Perfect. And I want to I'm just about out of time so I'll have to get you my other questions in writing. Thank you. I yield back.
▶ 1:51:08Thank you, Mr. Chairman. I'll use my five minutes wisely. Uh first of all, thank you for stepping up and serving. We serve together and I appreciate you going back the front line. Uh a little discussion on the electronic health uh record monitoriization and thank you uh for your efforts to go at 13 sites live. That hasn't happened in a while. Um but some of the reports suggest that some of the problems in the first run was the employees did not attend the mandatory training.
▶ 1:51:36Uh can you comment on your plan to make sure that your employees attend the training so they can operate the system efficiently? Yes. Uh Congressman, I think one of this is when going back to a whole restart here was a whole understanding that frankly when I first got there we had two sides. You had the VA side, you had Oracle side, and basically they're just staring at each other waiting for the other one to do nothing except for one thing. Oracle was getting paid and so was everybody else and we wasn't getting a system.
▶ 1:52:04So what we did on our side of the house was I said we're going to come to the table and we've already cut out duplicative committees. We already agreed to standardization and there was also the implicit uh direction from myself to um our group that is starting this Dr. Evans and others that we will uh do everything we're possible to make sure not only as attendants there but also this issue of standardization.
▶ 1:52:26The first sites that went live and these were the six out in Washington and Oregon where everybody was sort of given it would be like this committee and I just said okay you do yours you do yours you do yours and they wasn't properly uh functioning together. So what we're doing now is a standardization just as you and I both in the military understand. Here's the way we're going to do it. That'll make sure that we get better attendance and also everything is not a one-off if you would.
▶ 1:52:50So our integrators, the folks who are actually training our employees on this don't have to say, "Well, which hospital am I in today to try and train something?" So if I understand you right, are you are are you going to ensure compliance uh w with employees to make sure they're they're they attend the training? Yeah, this is not an option. This is this is not an option. show up feel like you want to do this isn't happy golucky. This is you will get it done because our veterans need it. Uh secondly, you you released a schedule for the 13.
▶ 1:53:16Do you have any idea you pending that these the next 13 go correct of what a schedule would be through through the next fiscal year? As far as we got right now going to the limited scope ahead, we're looking at probably the addition of 20 to 25 more is our goal or target. If we can do more, we will actually look at our budget because this is coming to the contract side of this. um to what we can do, but there is a plan for momentum. That's the problem that we've been missing, Congressman, is there's been no minimum momentum in this project.
▶ 1:53:45Once you get momentum, you can add more sites as we go. And uh shifting to Tri West, uh my office gets a lot of complaints about Tri Tri West. U lack of lack of response, uh appeals. In one one case, the Tri West said the provider would have to fill out 259 separate appeals uh due to various instances of overpayment of Tri West parts.
▶ 1:54:13uh if you if you would uh would you spend some time and priority on Tri West because uh my office gets it all day long that you can't reach anyone on the phone and then it takes a you know a congressman's office to stimulate action on that and I think it's unfair for for families to have to contact a congressman as a as a part of that chain of command and to get response from from Tri West.
▶ 1:54:38So, it's it's it's a problem and I would appreciate your your priority in that. Congressman, I I look at his mission fail. When they call your office to get help, it's mission fail. And so, we've got to do better making from our end on how we actually help people to get in the system. But I also have to update this committee, which we did uh you know, we made it known earlier this year to to uh the authorizing bodies as well.
▶ 1:55:02The contracts were supposed to go back out this year for both Optum and for Tri West is our third party administrators in this. That groundwork was supposed to have been started last uh fall last year. It was not started. And so when we got time to get ready in one of the first couple of weeks I was here, I was brought to the attention that we can't let this contract, we can't let this RFI process go forward because the groundwork had not been laid. So we're now having to take an extra year and get that started. But what we've done from our end for both all of our providers.
▶ 1:55:33We're looking at what we're doing on our side to make community care easier, but also holding our vendors. We're going to be renegotiating this contract, which of course is is going to be, you know, publicly and and going forward. But with a lot more now that we have a lot more knowledge of the problems we're seeing, we're going to hold it uh to whoever comes in this next contract bidding cycle that it will be a look a lot different than it does now. I thank you, Mr. Chairman. I yield my remaining 15 Mr. 11. Thank you, Mr. Chairman. Uh, Mr.
▶ 1:56:01Secretary, I wanted to ask you about, uh, a few of my favorite old topics from the economic opportunity subcommittee. First is, uh, VR& veterans readiness and employment. Uh, really important program and I think too often it doesn't get the attention and the resources that it deserves and, uh, we're currently seeing pretty significant understaffing at VR&E.
▶ 1:56:24I know this is a problem for example in the San Diego regional office where we do have long wait times and uh the question I have for you is is how can we best help you and and what can you ensure us you're going to do to ensure that these VR& regional offices have the resources they need to provide timely vocational counseling to our disabled veterans. Thanks. Uh yeah, look, you've hit something. I was down in Southern California. I was up in LA, but I was also in Arizona and they're experiencing the same issue here. This was something that's brought to us last week.
▶ 1:56:54It's the reason I go to these places because a lot of times and I just in all fairness, Mr. Chairman and ranking member as well, what we have found is there and this is part of why the reorganization look we're trying to there's a disconnect between our regional offices and our hospitals and policy makers here in DC and I hear it all the time when I go to them that they're they in fact one of them pulled me aside actually in Florida as a matter of fact and said, "Sir, I don't think you're getting what we're telling you.
▶ 1:57:18I don't think this the information is getting to you." And I said, "Well, that's something we got to work on." This was one of those areas, the VR& program, um, frankly, it got caught up in the budget issues of last year. And instead of addressing it at central office and making changes that need to be done, which we've now found out didn't need to happen anyway, um, they began a process of telling everybody, well, you can't bring on new VR& folks because it's the hiring freeze. Well, that ain't true because these are exempted positions to start with. They could be hired. But then they, well, it's it goes back.
▶ 1:57:47Well, we were told not to hire anybody in in November. So, it goes backwards. So, we're structurally, it's been clearly stated from my office to the the field now and others, get these people where we can get them hired under the budget constrictions that we had at the time it was given to us, but we're going to make sure that that is an impriority and employment. We had too much of a of a disconnect with, you know, one counselor having too many case loads and that that does slow everything out, but it is on our list. It is something we're taking a look at, especially your area. It was it seemed to be highlighted in your area. Thank you. Thank you, Secretary.
▶ 1:58:17and and you read my mind because that was my next question is whether those uh VR counselors were subject to that hiring freeze. Uh I wanted to ask the same about HUDbash case workers. Um you know obviously this is very important for for our region but for really all over the country and you know if you can't hire the staff that you need to combat homelessness or or any of the rest there's going to be a lot of veterans who will unnecessarily suffer. So are the HUDbash case workers exempt? They are as well confirming. They are.
▶ 1:58:46I just want to confirm because the HUD bash program but they are and that's another program that we're looking at. Uh that's actually a homeless program that actually does work very well and we're looking at that and I know the president is is also committed to that and you see it reflected in our budget. Great. Great. And how about the VBA employees who process the claims? Are they Yes, that's that's good too. Um I was concerned there there have been public reports and I hope to clear this up. Press doesn't always get it exactly right.
▶ 1:59:14uh but uh the reports of delays in hiring health care providers who are exempt uh from the hiring freeze and and the reporting is that uh OPM is blocking agencies across the federal government from accessing new hire records without approval from senior leadership and obviously there's a physician and a nerf nurse uh shortage staffing shortage across VA and want to make sure we don't have any delays when hiring qualified staff who who are dedicated uh to providing care to our veterans.
▶ 1:59:43So the question is what what are you doing and how can we help you to ensure that new hires can start as quickly as possible? Um one is we need to streamline our hiring process and get them through but there's nobody doctors and stuff we're hiring them as quickly as possible. There's no being held up from that. Um any if somebody is getting held up it may be you know just getting them there and getting the job in. But we're making sure that those are all processed. We have over 300,000 plus exemptions in at OPM. It's not an option. They we we move through that process.
▶ 2:00:10And then we I know my chief of staff who is here and others if there's ever been even a hiccup we call over and say approve it and get it done. Well, I appreciate that very much. Um and you know you you are always welcome to the San Diego region. I my hats off to all of our regional employees. Uh and they do tremendous work for our veterans.
▶ 2:00:28I think you know well this has been a stressful time obviously with a lot of the public reporting that's out there a lot of the perception about what's happening and and I think uh you know you're being there physically to to reassure folks on the ground uh that uh you know they're they're secure and and their mission will continue to serve our veterans. I think that would be wellreceived. Well, we definitely do it. That's one of the reasons I have uh unlike when I was in Congress I used to go home every weekend. Now I've been home free time since January.
▶ 2:00:55We're on the road and I'm h by the way I'm happy to have the one day my bride is with me today. We got to see each other so she decided to come with me to a hearing. I'm not sure if that says great things about me or just that she was bored today. So, but um I appreciate that. But yeah, this is something for me. I want to make it very clear for anybody watching this hearing.
▶ 2:01:12Uh we are my full total goal is helping our veterans and our employees have to do that and I want our employees to step up and everywhere I go I make this if you're helping a veteran even first or second level from cleaning a room to help to doing surgery you this is this should be your golden day. We're going to give you every opportunity to perform at the highest level vet from benefits disability folks claims folks we're going to give you every opportunity to get those claims done quicker faster so our veteran gets what they need.
▶ 2:01:39This should be a time in which I want people to come to work for the VA because it's going to be a place in which accountability is had, high performance standards are met, and we're going to do so within the budget that you give us. And we're going to continue to do that. But I want them to understand that's why I do travel all over the country and let them hear it straight from me. Quit reading what may be. Quit reading what might be. Listen to what actually is happening so we can make sure it happens. And I appreciate your comments. Thank you. All right. My vice chair, Mr.
▶ 2:02:09Offred, you're betting clear up. Thank you. Uh, am I last, judge? The last shall be first. All right. I know we're all wanting lunch, right? I know I am. Uh, Mr. Secretary, and I still have one more hearing to go today. Oh my goodness. Well, I got a protein bar. I'll give you. Hey, you know, I I want to get back and and I'm sorry if this has been covered. Uh, you having been in Congress, you know, we're I'm have three hearings today, so I'm kind of like popcorn.
▶ 2:02:34I want to get back to the community care program because that's something when you said that veterans don't even know about it. I mean, this program was really given a charge back in I think 2018 when President Trump saw fit to uh uh and Congress with a big push by him and the mission uh VA mission and modern community care act of 2018. And yet our our veterans don't know about this pro. Do we have a marketing problem with the VA?
▶ 2:03:03How do we uh what kind of marketing budget do you have? How do you reach people? I mean, you got the older veterans, they don't do text. You have younger veterans who do uh older people want stuff in the mail. How do we get the word out about how the the services provided by by the VA? Well, I think you it's sort of a twofold question you have there. I'll take the first one is just how do we get in general? I think we've got to break out of our old mold of this is the way we communicate. And I think we've done a good job of that beginning with our social media platforms.
▶ 2:03:33Our others here from the from my office is something, you know, from my background I was very familiar with. A lot of people, you know, have followed and know. So, we're working uh different angles there for just in general knowing about the VA. But also, we're very careful to say if you want VA benefits, you can yearn that you've earned, we want you to get them, but if you don't want to, we're not going to force them upon you either. But we need to make sure that you know about them.
▶ 2:03:53But the second part I want to talk about is where you sort of hit on here that's really more concerning to me and that is a culture that developed over time in the VA in VHA in particular in that we have to keep people in the system itself and coming to our VA facilities and coming to our SE box um and making it very difficult for them to go and get community care uh even if they fully deserve because they have certain criteria to meet to get
▶ 2:04:23into community care, but there's always an outlet at the end and it's the best it's the decision with the doctor and the patient for the best outcome for the veteran, you know, best medical interest kind of issue, right? But what we were finding was and and I actually experienced this at a hospital.
▶ 2:04:37Um I was in a senior leadership meeting and the this discussion became over and over about we have to sell the VA and I said, "Who are you selling it to?" you know, and they said, "Well, they they well, we need to make sure that the VA knows that we're the best, you know, that we're the best and they got to come here." I'm saying, "That's not your job. Your job is to take care of veterans who show up in the front door. Your job is to make sure they do get the best care they possibly can." And you earn their business simply by doing what you're supposed to be doing. Amen. You don't have to sell it.
▶ 2:05:04And then the other part of it is, and we have some voices on the outside, and I experienced this in Michigan just uh just this past week. No, I'm sorry, Minnesota. And the question came to me and this was from a reporter that said that there were people protesting outside that the that we should not use community care. This is no joke about this question. I can't believe this. Said that the that we ought to keep all the veterans in the VA. The VA has the best quality and community care is substandard.
▶ 2:05:32And I thought to myself, I said, did this person just degenerate every doctor in Minnesota that would didn't work for the VA? Basically, we've got to understand our part in the ecosystem. We're blessed to take care of our veterans. We're blessed to take care of the greatest folks in the world who've earned a benefit with us. But we're going to use every partner we can to make sure they get that benefit. And if it's in our facility, they're going to get the best possible care and the best possible resources they can. But if that means that we can help from the community and especially in rural areas, we can make sure that happens better.
▶ 2:06:01That's what we're going to do. You've talked several times today about misinformation, people getting lied to, gas lit, uh about services are going to be taken away. They're they're living in fear. Uh I don't know if you did town hall meetings when you're in Congress. I still do them. I like talking to people, even people that I don't agree with. I've got one coming up in two weeks and I'm doing 16 in August. There are a lot of questions and a lot of fear out there.
▶ 2:06:29I would love to invite you to come with me on one of my town hall tour stops in Missouri to answer directly to the people of Missouri about the quality of care of the VA and how you're not cutting services. You're trying to improve them. I think look I think what you're doing is is grand because what I've been doing for 100 days, you know, basically is is fighting back against this. Um the perception look at the budget that was you know even it's a skinny budget. We're trying to get that and I'm looking forward to the the getting the whole thing. It has an increase in our funding.
▶ 2:06:58Okay, it's a 4% increase, 17% if you take TE and it's it's an increase in our funding. Our our mandatory spending is still going up. Our discret that's the rise in discretionary funds. We know that the that the president has a committed to making sure our veterans are taken care of. Um but also when you when you talk about things that frankly are are in the process of going on or discussion on how we make things better, there's always unfortunately this desire to say, uh well that can't be.
▶ 2:07:24Well, let's work this out together because my first and foremost priority is the veteran and it's everything we do is going to be focused back to them and that's what we're going to do as we go forward. My time is up. I hear the dinner bell ring. The ham and bean soup is calling my name in the House member dining room and with that I yield back. Ms. Woman wanted to make a a comment. Thank you. Um no, just in closing, thank you Mr. Secretary for uh for joining the the committee today.
▶ 2:07:49Um, we appreciate you and your commitment to veterans and your service as a vet as a uh, veteran yourself. Um, just a few things I want to make sure that I clarify and clear up. Um, you referenced earlier in your remarks um, in your answer to a question in a critical way that the VA grew by 52,000 employees uh, since FY21.
▶ 2:08:12I mean, the PAC Act could not possibly have been in implemented uh in the way that Congress intended uh if we were not ensuring that there were more people to serve the 1 million new veterans that were coming into the system to get either medical care or access to their benefits. So, I wanted to just make sure that I made that point. Um you also uh um referenced community care extensively.
▶ 2:08:38Um, I was in Congress as you as were you when we passed the mission act and the mission act's purpose was to ensure particularly at the time because there was such a backlog both in terms of veterans getting care because it was taking too long for many of them to get partic especially specialized appointments um and because of the distance that some veterans have to travel. uh that was the purpose.
▶ 2:09:05But I if you do any veteran survey that I have ever seen, any commentary I've ever seen from veterans, veterans, as you know, prefer to get their medical care at the VA. And that is because they are ch they are served there by a a uh you know career oriented professional that looks through the lens of a veteran.
▶ 2:09:29Many of them are veterans as you know themselves and they also know how the culture of veterans and how to treat them oftentimes and I'm not disparaging community care but when a veteran goes into the community that's supposed to be a last resort in case they can't get the care in the community and oftentimes veterans actually don't get the kind of care that they would at the VA because they're dealing with someone who's just kind of churning through their patient patients and
▶ 2:09:59they don't necessarily see the signs and cues and understand the culture of veterans. Um, veteran community care hasn't diminished, it's increased. Yes, we've gone from 1.1 million to 2.8 million um since the start of the program of veterans and community care and 7 billion to now $40 billion that we uh have paid out in community care.
▶ 2:10:23Uh so that there there isn't a backlog or a lack of usage of uh community care. Um just wanted to make sure that I I I put that out there. Uh and lastly, I look forward to continuing to work with you, continuing our monthly uh calls so that we can make sure that we can uh not deal with innuendo and agree just talk to each other through the press and can focus on our uh shared uh commitment to working to take care of our veterans. Thank you, Mr. Chairman. and I yield back.
▶ 2:10:53Yeah. And I know that wasn't a question, but I'll I'll you and I'll talk more about it offline because I mean adding a million people, we've also lost a million in that time as well. It wasn't. So, yeah, I appreciate it. Well, thank you very much for uh being here. Uh great job on your first first hearing and uh I commend you. You got a tough job.
▶ 2:11:20Yeah, I bet your hair is white as mine by the time you get through with it. If I'm halfway as handsome, sir, I'll be really good. How about that? Oh, don't don't don't blow that smoke at me, boy. All right. Uh we're we're adjourned. Oh, wait a minute. What? Oh, well, if you uh if you have uh questions that you want to submit for the record, uh we'll do so within the next seven days. How are yarn?