▶ 0:27:26order. I would like to welcome the members, witnesses, and audience to this hearing for the subcommittee on oversight and investigations. I appreciate my colleagues on the dis and the witnesses for being here to discuss the chronic issue of improper recruitment, retention, and relocation incentive payments. These are commonly referred to as the three Rs. These incentives are tools provided to the VA by Congress to attract and retain quality staff and positions that are consistently vacant or identified as difficult to fill.
▶ 0:27:54While many federal agencies can use these incentive payments, they are particularly helpful for an agency like the VA whose mission is to provide complex services and quality health care to veterans across the entire country. These incentives are designed to be a part of the of a benefits package for positions in markets that are difficult to hire in like specialist physicians, nurses, and social workers in rural areas.
▶ 0:28:16Congress gave federal agencies the ability to pay these incentives so that government entities like the Veteran Health Administration can be competitive in attracting and keeping quality health care professionals in a labor pool that is facing staffing challenges across the country. As a nurse practitioner, I understand these challenges firsthand. Unfortunately, recent reports have shown that these funds have been proven to be paid out with very little oversight.
▶ 0:28:38While this hearing was organized after the release of the June 2025 report on the VA's poor oversight of these incentive payments, the problems we will discuss today are not new to the VA. In fact, in 2017, the IG released a similar report detailing oversight issues with recruitment, relocation, and retention incentive payments based on the OIG's oversight work stretching back to July The 2017 and tw the 2017 OIG report identified the need to improve controls over the use of these incentives, having found that
▶ 0:29:08the VA did not properly authorize 33% of the retention incentives that were awarded to senior executives. The improper payments found in 2017 totaled more than $158 million in unsupported spending. As a result, the OIG made recommendations that VA develop internal controls to monitor policy compliance and decrease the VA's reliance on retention incentives. Now, here we are in July 2025, confront confronted with the same issues that the VA has failed to improve since the first report.
▶ 0:29:38The only difference is that now there is even more taxpayer dollars involved. For example, between 2020 and 2023, relocation payments grew by 85% and retention payments have grown by While recruitment bonuses have ballooned by a staggering 237%. I believe anyone would agree that these numbers are alarming when there is little data to back up the massive increases.
▶ 0:30:02The 2025 report acknowledged that after the initial report, VA implemented processes to improve authorization and review controls for the payments. However, VA employees inconsistently followed them. This made the good government improvements virtually useless. In response to the 2017 OIG audit, quality assurance teams were created at both the office of human resources and administration operations security and preparedness and the vision level.
▶ 0:30:27However, the 2025 OIG report found that while these teams identified errors, they did not address systemic issues in the request and authorization of incentives did not proactively proactively prevent incentive packages from being processed and paid based on insufficient justifications. Additionally, the OIG found that 28 employees continued to receive annual retention incentives for many years after the initial award period expired.
▶ 0:30:52In one case, an employee continued to receive annual incentive awards for more than 11 years after the initial award period. In total, the VA improperly paid these employees a total of about $4.3 million. Between 2020 and 2023, more than 134,000 employees received incentive payments totaling 1.2 billion. 341 million of those incentives were found by the OIG to be improperly documented.
▶ 0:31:19The lack of documentation also hinders review efforts by oversight bodies like the OIG, the GAO, and this committee. I echo what the OIG said in their report that the required documentation helps provide assurance that incentives are properly used and effective oversight of incentives also require sufficient documentation for review.
▶ 0:31:38In fact, OIG noted that much of the data used in the report relied on projections due to the VA's sparse I found it shocking in the report that when cases of waste fraud and abuse were discovered, the VA's implementation of established processes did not always guarantee that the issues were appropriately resolved. The 2025 report cited an example where VHA awarded $30,000 in relocation payments for an employee who never relocated. The employee was a remote worker teleworking from home.
▶ 0:32:06When someone receives a relocation incentive and never actually relocates, that's wrong and a clear waste of taxpayer dollars. Despite this clear case of impropriy, the VHA declined to recoup the payments that were made to this employee. These are taxpayer dollars set aside for veterans, and for far too long, they have been carelessly handled. I'm excited to hear the Trump administration's plan to not only satisfy the OIG's recommendations, but their plan to make real and necessary improvements and corrections in how the VA manages and oversees their incentive programs.
▶ 0:32:35The status quo is not acceptable and we will continue to push the VA to make improvements that lead to better care outcomes for the veterans that are receiving VA services. I look forward to working with Secretary Collins and his team to write the ship and create real change at the VA. And I now recognize ranking ranking member Ramirez for her opening comments. Thank you, Chair Kiggins. Today's hearing topic is critically important.
▶ 0:32:59We are examining the use and the oversight of the quote unquote three R incentives at VA. Recruitment, retention, and relocation bonuses. The so-called three Rs help VA attract talent. Earlier this month, Secretary Collins celebrated the VA will lose nearly 30,000 employees by the end of the fiscal year. I find that despicable. I want to be clear, every VA employee is mission critical.
▶ 0:33:27Every VA employee ensures veterans get the care and benefits they've earned and deserve. So, if we care about veterans care and services, it is more important than ever that we discuss how the VA keeps employees. As Secretary Collins deconstructs, decimates, and demoralizes the workforce. Veteran care is already being negatively impacted by the destruction of the VA workforce. For instance, we know that doctor appointments for veterans have been cancelled due to staffing shortages. And we know this because veterans have told us themselves.
▶ 0:33:59So, how do we course correct? How do we ensure the VA has a workforce in need to support the care veterans have earned and deserve? First, we have to ensure that the VA is a place where people feel valued, not disposable, and not attacked. As a former executive director of a nonprofit organization, I know that public sector agencies like the VA and nonprofit organizations cannot compete with the private sector in terms of salary.
▶ 0:34:24In many places across the country in tough markets, 3R incentives help make VA offer more competitive wages. They're a tool to attract and retain highly qualified employees to the agency. I understand that this hearing is meant to focus on the VA inspector general's findings from a report released earlier this summer that the VA needs more oversight of three incentives.
▶ 0:34:46I do not disagree that the VA must be a good steward of taxpayer dollars and that we must ensure that the correct employees are receiving the correct pay for the correct period of time. No objection, no disagreement there. At the same time, we must ensure that the VA's oversight of the three Rs incentives does not make them a more burdensome and less useful tool for leaders who need them to recruit and to retain staff. We need to hold two objectives at the same time.
▶ 0:35:16The process must work and it must allow it to be competitive by working quickly and efficiently. If we do not meet both of these goals, I fear that greater layers of bureaucracy may disincentivize leaders from offering three R awards.
▶ 0:35:31I look forward to hearing from our witnesses today about how we can strike a balance to ensure 3R incentives are being used properly, efficiently, and I'm going to show a series of posters with data pulled directly from the VA's workforce dashboard published on June 27th, 2025. Numbers don't lie. We can see here a sharp decline in both recruitment and retention since Secretary Collins took the helm.
▶ 0:36:01The VA has seen an over 45% reduction in job applicants this year compared to last year. VA saw an over 56% reduction in new employees actually starting jobs. The VA lost 4,144 employees in missionritical occupations as defined by the VA since the beginning of this fiscal year.
▶ 0:36:25Compare that to the Biden administration only losing 111 employees in miss missionritical occupations during the same period in And as if losing 4,100 employees in VA designated missionritical occupations wasn't bad enough, I want you guys to take a closer look at how many employees Secretary Collins has lost in some key veteran-facing roles. To be clear, these numbers are not net losses.
▶ 0:36:56They're net losses, not just normal attrition. The numbers we are looking at account for any new hires. And again, these are positions that are not subject to the hiring freeze and were exempt from the DRP. So, what you're seeing is that since the start of this fiscal year, the VA has lost a net of 1,720 registered nurses, 1,147 medical support assistants, 604 193 police
▶ 0:37:26officers, 77 psychologists, social workers, 1,081 veteran claim examiners, 868 8 custodial workers. So, by its own data, the VA has had over 7,500 employees in veteranfacing roles leave their jobs this fiscal year and their positions have not been backfilled.
▶ 0:37:53So, how can Secretary Collins look at us and at veterans with a straight face and say that veterans care has not been affected by staffing changes when he's lost at least 7,500 veteran-facing employees? The numbers we're looking at and their impact on veteran care is upsetting. And if you're not mad yet, just take a look at our next poster so we can get a sense of why these employees have left the VA.
▶ 0:38:22Reasons for leaving a series of concerns. Uh for example, geographical Uh desired work schedule not offered, lack of trust and confidence in senior leaders. Again, lack of trust and confident senior leaders from social workers. Medical and dental are talking about the work schedule offered doesn't work uh for their ability to serve the veterans.
▶ 0:38:51And then you see over and over and over lack of trust and confidence in senior leaders. Lack of trust and confidence in senior leaders. And you also see here from contracting officers unethical behavior on the part of leadership or the organization. That's why medical and dental, general administration, psychologists, social workers, HR specialists, HR assistants, cemetery caretakers, veterans claim exam processing personnel, contracting officers, and IT specialists are leaving.
▶ 0:39:22Any quality leader I know who got this feedback in their exit interview would do some serious self-reflection. But the VA has a failure of leadership crisis, and Secretary Collins is to blame. Secretary Collins accuses us of fear-mongering and lying when we raise the alarm that veteran care is being impacted. But these numbers don't lie. There's just no possible way that VA could lose 7,500 veteran facing employees without care being impacted.
▶ 0:39:48The secretary could turn the ship around to attract and retain more employees to care for veterans. And the three incentives are one of those tools. But he isn't because he doesn't want to turn the ship around. He's committed to destructive collision Let's look at the dashboard even closer. Just take a look at the reduction in the U in the use of packed act authorities like recruitment and retention incentives from year 2024 to year 2025.
▶ 0:40:18Last year during the Biden administration, retention incentives were used nearly 20,000 times. this year under Collins and Trump only 7,000 times. Recruitment incentives were used 6,000 times in year 2024, but they've barely used them 1,000 times this year. And take a look at this number. Special contribution awards. These are used when a VA employee goes above and beyond the call of duty when caring for veterans.
▶ 0:40:48When Biden was president, nearly 30,000 special contribution awards were given to VA employees. Under Collins, barely 7,000 awards have been made. Here's the bottom line. It's not that VA employees are less meritorious than they were under Biden. It's that no matter what the VA employees do, they will never really receive three R awards because the Trump administration through Secretary Collins wants them to leave.
▶ 0:41:14They want every employee to be pushed off so they can decimate the VA's workforce and destroyed in order to justify privatizing the VA. Secretary Collins has made VA employees his target and in doing so has targeted veterans who rely on VA for their care and benefits. So yes, it is more important than ever that we do everything we can to keep VA employees working and caring for our veterans. Secretary Collins's tenure at the VA has been one of torment.
▶ 0:41:40For months, VA employees have worried they would lose their jobs and livelihood through a riff. Now, while Secretary Collins promises that a quote unquote large-scale riff is off the table for the time being, we all remain concerned that if he is leaving the door open to eliminate positions through the reorganization and consolidation and veterans worry that their service and care will be impacted by the changes in the VA workforce. Well, veterans are right.
▶ 0:42:07How can we expect to provide highquality services through a robust talented workforce under these kind of conditions? But again, the instability, the uncertainty, the volatility is the point. Veterans deserve a VA that can rely on that they can rely on. And Secretary Collins is undermining the VA and its workforce at every chance he gets. It is why I look forward to our conversation today and hearing from our witnesses. And with that, I yield back.
▶ 0:42:37Thank you, Ranking Member Ramirez. I will now recognize the witnesses testifying before us today. We have Miss Tracy Theorit, Chief Human Capital Officer, Human Resources and Administration. Welcome back. And Mr. David Perry, chief officer, Workforce Management and Consulting, Veterans Health Administration. Mr. Sean Steele, the director of the human capital and operations division, Office of Audits and Evaluations of the Office of the Inspector General. And Dr. Elliott, Dr.
▶ 0:43:02Sheila Elliot, present for president for the American Federation of Government Employees Local 2328. Welcome. So, if the witnesses will please stand for me and raise your right hand. Do you solemnly swear that the testimony you are about to provide is the truth, the whole truth, and nothing but the Thank you. You may be seated. Let the record reflect that the witnesses answered in the affirmative. Miss Theit, you are now recognized for five minutes to provide the VA's testimony.
▶ 0:43:33Good afternoon, Chairwoman Kaggin, Ranking Member Ramirez, and distinguished members of the committee. Thank you for this opportunity to discuss how VA is improving governance and oversight of recruitment, relocation, and retention three incentive payment practices. As pay caps for health care professionals at VA have not kept pace with rising salaries for health care professionals and specialists, the three program is a critical component of VA's incentive plan. I am joined today by Mr.
▶ 0:44:02David Perry, acting chief human capital management, Veterans Health VA will always fulfill its duty to provide veterans, families, caregivers, and survivors with the health care and benefits that they have earned to ensure all veterans and VA beneficiaries continue to receive their earned benefits and services. VA is always recruiting dedicated professionals. As of July 2025, more than 350,000 critical positions are exempt from the hiring freeze.
▶ 0:44:32While VA has historically offered three R incentives to address occupational shortages and facilities hiring initiatives, the department must provide greater accountability and stewardship of taxpayer resources by enhancing our procedures, documenting requirements, and providing oversight of these incentives. Starting in 2020 2017, VA updated department policy on 3R incentives to establish internal controls and provide oversight.
▶ 0:45:02Specifically, VA began requiring annual certification of the incentive that it was so it was appropriate and in compliance with policy and succession plans to reduce long-term reliance on incentives and established residency before payment of receipt. In the years since, VA has continued iterating and implementing additional improvements, including the following. Requiring a standard form to capture all the required information by law.
▶ 0:45:30Aligning the use of three Rs with shortage and hard to fill positions. obtaining authorization and justification before including three R incentives in job announcements. Tracking unfulfilled service obligations, improving coordination of debt collection and enforcing debt collection, and reviewing incentives annually and terminating them in a timely manner when they are no longer needed.
▶ 0:45:54However, there is always room for improvement and VA must continue to refine its governance of those incentives, including proper documentation in their use, ensuring correct signatures are in place, ensuring justification in employing three Rs is sound. VA must develop stronger oversight mechanisms, and discontinue the use of multi-year incentives.
▶ 0:46:16Finally, VHA is implementing a comprehensive strategy to enhance the management and oversight of the incentives program includes continuing to monitor internal control procedures and guidance to ensure three documentation is appropriately maintained in accordance with VA policy. VHA will also conduct a program to monitor quarterly and utilize uniform checklists and templates nationwide.
▶ 0:46:42VHA is developing training and materials to ensure proper documentation for succession plans, performance ratings, and to strengthen the technical review. VHA is creating oversight plans and a strengthened technical review program to assess every incentive for technical adherence. At an enterprise level, oversight monitoring component will act as a second level check at the national level.
▶ 0:47:07VHA aims to support the compliance with record retention requirements and furthermore specific performance metrics will be tied to operational leadership and human resources leadership. They're being developed and reinforcing the importance of proper governance and oversight of incentive programs. VA is committed to addressing these issues that have been identified by the inspector general's report and strengthening the process to support the VA mission.
▶ 0:47:36We are confident that the steps that we have taken and will continue to take will strengthen our incentives program and the governance and oversight required leading to more effective outcomes and better service to veterans. While the 3R incentive program is an important tool for the department in attracting and retaining talent, it is not enough for the VA to remain competitive with industry. VA looks forward to working with the committee on strategies to ensure that VA is an employer of choice for physicians in critical need specialties.
▶ 0:48:06I am proud to be part of the noble mission to care for our nation's veterans. I look forward to working with each of you on the committee to more effectively and efficiently provide enhanced oversight and governance of the incentive payment practices, ensuring VA can continue to provide the best care and services to veterans and their families. That concludes my testimony and my colleague and I welcome any questions that you may have for us. Thank you.
▶ 0:48:32Thank you, Miss Thurit. And Mr. Steel, you are now recognized for five minutes to provide the VA's OIG's testimony.
▶ 0:48:40Chairwoman Kiggins, Ranking Member Ramirez, and members of the subcommittee. Thank you for the opportunity to testify on the OIG's independent oversight of VHA's management of recruitment, relocation, and retention incentives. These incentives are meant to help VA entice candidates to accept hard to fill positions or to retain highquality staff.
▶ 0:49:01Our work focused on identifying whether VHA used incentives effectively, complied with the law and VA policy, and acted as strong stewards of taxpayer As the OIG has documented, VHA faces significant staffing shortages in key positions, also known as critical need This long-standing challenge affects clinical positions as well as nonclinical support and security Critical need occupations are often difficult to fill
▶ 0:49:31due to the limited number and quality of candidates, unfavorable employment trends, and lack of appeal for the position's duties or geographic location. Our work shows that despite VHA's ability to hire non-competitively, they continue to experience staffing shortages for positions fundamental to the safe and effective delivery of care to veterans. Other reports highlighted weaknesses in VA's processes and controls governing the use of pay incentives.
▶ 0:49:59Our 2017 audit found that VA needed to improve controls over recruitment, relocation, and retention incentives to ensure they were strategically and prudently used. We also reported in May 2024 that VA awarded $10.8 million in critical skill incentives to nearly all VHA and VBA central office executives without required support showing the employee possessed a high demand skill or skill that is out of shortage.
▶ 0:50:27Over 182 senior executives received payments averaging about $60,000 each. Subsequently, over 90% of those funds had been recouped. We closed the recommendations for both the 2017 and 2024 reports because VA provided sufficient evidence to show action had been taken to implement needed changes. However, the OIG continued to monitor VA's use of these important staffing tools.
▶ 0:50:54Last month, we published a report that evaluated VA's controls over in governance of recruitment, relocation, and retention incentives. It focused on awards paid to VHA employees from fiscal years 2020 through 2023 and tested many of VA's actions taken in response to the 2017 OIG report. Overall, we found that VA used incentives extensively to address critical staffing needs.
▶ 0:51:21In fiscal years 22 and 23, nearly 90% of incentives went to employees and occupations on staffing shortage lists. However, VA did not effectively govern the process to ensure that VHA officials consistently captured information required to support the awards. Key forms were missing or lack sufficient justifications and approval signatures.
▶ 0:51:43This information helps confirm incentives are properly used and is needed to carry out effective Consequently, we found that VA's prior corrective actions to implement our 2017 report recommendations were not sustained as policies were not routinely Overall, we estimated that the award justification could not be verified or is insufficient for 30% of VHA employees that received incentive payments.
▶ 0:52:10This amounted to about $341 million in incentives that were not adequately Our team also found 28 VHA employees who received retention incentive payments long after their award period had expired.
▶ 0:52:25These individuals were improperly paid for an additional eight years on average totaling about $4.6 In conclusion, the OIG's oversight work has highlighted VHA's ongoing challenges with addressing severe occupational shortages in essential positions. Our reports have also shown that attempts to narrow those staffing gaps through recruitment, relocation, and retention incentives do not consistently follow requirements.
▶ 0:52:51It is also concerning that these issues are not routinely detected by VA's quality control measures. VHA must emphasize to responsible personnel the importance of following policies and procedures to safeguard against improper payments. Og teams will continue to monitor VHA staffing needs and the use of incentive payments. In doing so, VHA will be held accountable for securing qualified personnel to provide high-quality care to veterans while making the most effective use of taxpayer dollars.
▶ 0:53:20Chairwoman Kiggins, this concludes my statement. I would be happy to answer any questions you or members of the subcommittee may have.
▶ 0:53:27Thank you, Mr. Steel. Dr. Elliot, you are now recognized for five minutes to provide your testimony.
▶ 0:54:23with the recruitment, retention, and relocation bonus program and beyond. On June 12th, 2025, the OIG released a report on the recruitment, relocation, and retention incentives bo bonus program. The OIG highlighted several problems with the administration and oversight of the program that AFGE agrees with. Chief among the problems identified is the failure of VA human resources.
▶ 0:54:51While VA did use this tool to recruit and recain clinicians, there were problems in how the bonus program was managed. AFGE has previously criticized the HR modernization that the OIG is citing here, agreeing with the conclusion that it has led to increased turnover at the VA.
▶ 0:55:13Additionally, AFGE believes that HR not being in the facilities and lacking familiarity with the workforce and the veterans they serve increases their This undermines the ability of HR to serve employees as well as administer the bonus program. In preparation for this hearing, when contacting the Hampton VA, we could find no repository of data to show who has received these bonuses.
▶ 0:55:43However, after reaching out directly to 800 bargaining unit members at our hospital, AFGE had nine bargaining union members who reported that there were four recruitment bonuses, four retention bonus, and one relocation bonus awarded between 2021 and 2025.
▶ 0:56:06While AFGE is pleased that at least nine employees receive these bonuses, we have no way of knowing if this benefit is properly utilized compared to the rest of VA. Regardless, I can say with decades of experience at this facility, that there is significant room for improvement, both at the hospital and the brand new North Battlefield Outpatient Clinic, which opened this year, 27% staffed.
▶ 0:56:36We urge the VA to use these bonuses and other tools to increase capacity at the clinic and the hospital. Beyond the bonus program, AFGE has other suggestions to improve recruitment and retention. As the committee is aware, in March, President Trump signed an executive order eliminating the collective bargaining rights of 1.5 million federal employees at agencies, including VA.
▶ 0:57:02Continuing to deny large swaths of the VA workforce collective bargaining rights will continue to harm recruitment and retention. As there is a critical shortage of clinicians in this country, many quality candidates who want to serve the VA may avoid the agency to receive both union protections and better salaries in the private sector.
▶ 0:57:26This is particularly egregious as Secretary Collins played favorites when choosing whom to exempt from the executive order, not by job description or duties, but by which union represents the employee in question. AFGE members lost their collective bargaining rights despite having identical jobs to employees who are exempted and retain their rights.
▶ 0:57:49AFGE urges members of this committee to support HR2550, the Protect America's Workforce Act, which would nullify this illegal executive order. AFGE has long argued for the benefits of teleawwork for employees who can perform their duties remotely. This is particularly true for clinicians who practice in whole or in large part through tele medicine.
▶ 0:58:14However, since most telework has been rescended by this administration, many clinicians have had to report to a VA facility and then have been required to interact with patients remotely, often in crowded bullpens discussing private matters. This has harmed morale and retention of mission critical and hard to recruit clinicians at the VA. This has negatively affected retention at Hampton and reflects VA's overly broad approach to teleawwork and teleaalth.
▶ 0:58:43I hope that my testimony today leads the sub this committee subcommittee to help improve recruitment and retention at the VA. Thank you and I look forward to answering your
▶ 0:58:55Thank you Dr. Elliott. We will now proceed with questions. However, before I do that, I would like to make sure the record is clear regarding not just mental health services as they're offered at the Hampton VA. We've pushed and will continue to push for veterans to receive the care we need it. That's why I've advocated for additional facilities in my district that provide these these services. And in addition, uh and more specifically that North Battlefield VA clinic in Chesapeake, I wanted to clarify and echo Secretary Collins words about that facility.
▶ 0:59:23It's opening in deliberate phases to ensure safe, effective, and high-quality care as services and staffing scale up responsibly. While some public comments have mischaracterized this phase roll out, the facts are clear. The clinic opened in April 2025. I was at the ribbon cutting with 150 staff and core services, including primary care, mental health, and pharmacy. To quote Dr. Elliott, that was 27% and it was always intended to expand in waves. In July, dental and additional mental health services came online.
▶ 0:59:52And by January 2026, the facility is scheduled to be fully operational with radiology, optometry, teleaalth, and more. This is a standard and prudent approach for bringing a major healthcare facility online. As we grow more patients, we grow more staff. Spreading misinformation about staffing levels or service delays only undermines the hard work being done to provide the best possible care to our veterans.
▶ 1:00:14I remain committed to ensuring this facility and all our VA healthcare facilities reach full potential and deliver the timely high-quality care the veterans in Chesapeake and across Hampton Roads have earned. In conclusion and for clarification additionally from Secretary Collins, I'm pleased the Department of the VA is not going to pursue a large-scale reduction of force and have been reassured that any early retirements will come from redundant positions and not essential personnel. This will safeguard operations at the VA and thus ensure services to our veterans.
▶ 1:00:42I'm confident that Secretary Collins will prioritize maintaining a robust healthcare workforce at the VA to ensure veteran care and benefits are not impacted. We can all agree that giving our veterans the care they need is essential. Under President Trump, I know that our veterans will be put first. In fact, the VA's performance has continued to improve under his leadership with disability claim backlog already down nearly 30%. The work Secretary Collins is doing to modernize the VA's operations and get our veterans the quality of care they need is a breath of fresh air.
▶ 1:01:10By June, the VA had already processed 2 million disability claims, accelerated the implementation of the integrated electronic health record system, and made it easier for survivors to get benefits. These accomplishments on behalf of our veterans deserve recognition. And with that, I have questions. And my first question will be for Miss Theit. Miss the OIG found that the vis quality assurance teams conducted reviews after the incentives were awarded. Can you explain why the VA's review process appears to be reactive instead of proactive?
▶ 1:01:40Chairwoman Kens. Um, regarding the Vizen's review process, I'm going to ask Mr. Perry to respond to that question. That's fine.
▶ 1:01:48Thank you, Chairman, for that question. We agree where the Vizen is needed to do a more proactive approach. We are shifting that responsibility over to the compensation aspect of the vision to do that on the front end versus the back end. So, we recognize that that is a gap in our process that we're making a modification adjustment to now. And will the visits be talking to each other then to come up with a more standard approach?
▶ 1:02:11Yes, overall we are taking that approach to look at standardization. I think what we saw back in 2017 where it was down at the facility level, we had about 150 ways of doing it. Uh we have made improvements that is 18 but we do have some areas to improve to make sure that the 18 are doing it consistently consistently according to policy.
▶ 1:02:28That would be great. Consistency would be helpful. And I go back to Mr. Rit, but but either Mr. Rit or Mr. Perry, would you please explain step by step how one of these three incentive payments would be approved starting with the first step through the actual payment to the employee employee?
▶ 1:02:42So, Chairwoman Kiggins, I I appreciate the work of the Office of the Inspector General because their very detailed actionable reporting helps us to improve and we made improvements from the 2017 report and will continue to make improvements based on the 2025 report. So, recruitment and relocation incentives are one category of three Rs. Uh the recruitment incentive is to attract individuals into the federal government. The relocation incentive is to help move employees into locations that are hard to fill or where there's a specific need.
▶ 1:03:11There is a standard form 1016 that is completed for both of those incentives. One of the deficiencies in 2017 that we rectified in 2025 was that our department policy and procedures did not align with regulation. So now we have a departmentwide policy. Everybody should follow it consistently. And we have standard forms that every supervisor who's recommending an an incentive, every HR official who's reviewing an incentive, and every approving official would utilize.
▶ 1:03:41So that's for the recruitment and relocation process. We have a similar 1017 that's used for retention. Retention incentives are typically shorter term. Recruitment and relocation can be up to a four-year service obligation. retention incentives. We typically look at a one-year retention incentive service period. And the reason being for retention purposes, we're looking at somebody who's likely to leave federal service and has a unique skill that we can't afford to walk out the door.
▶ 1:04:10And we need a short period of time to put that succession plan in place to either develop someone with those skills to step in when they depart or to um be able to uh recruit somebody before they leave. So that's the the process and the steps from someone recommending an incentive for an individual under one of those three sets of parameters to then HR reviewing the requirements based on recommend recom uh regulation and then for the approving official to sign off on it.
▶ 1:04:39Once the individual is identified, then they too have responsibilities. Signing the service obligation, making sure that they relocate if it is a relocation incentive, making sure they are new to the federal service if it's a re recruitment incentive. And for retention incentives, we have a one-year hard stop where supervisors need to review and reertify that that is still needed, otherwise it will be terminated automatically. So, those are just some of the steps that we take with recruitment, relocation, and retention incentives.
▶ 1:05:08some of the things that we have in place and where the IG has identified more steps that we need to take to be have better oversight and compliance that we are willing and currently in the process of doing that
▶ 1:05:19and that approving official who is in their next step in the chain of command. Who would they report to?
▶ 1:05:24So, Chairwoman Kiggins, we have delegations of authority for our three Rs incentives. Typically in the Veterans Health Administration, which is the subject matter of the report, the a recommending official would be a medical center director. approving official could be up to a network director. It depends on the percentages of the incentives that are being offered. Sometimes it's higher, but that's typically the how the delegations of authority flow.
▶ 1:05:47Now, we also have breach of agreement procedures that that we follow to make sure that if somebody does not fulfill their obligation that we are going back and initiating and collecting those debts. Again, these are taxpayer dollars. We don't want to see these incentives misused or abused. I know there were instances in the report that were identified. We don't want that to continue to happen. The breach process is um the indivi the individual employee who's asking for a waiver of repayment will go to their supervisor.
▶ 1:06:16That supervisor will take it the whole way up the chain of command to the under secretary of health and the veterans health administration. If they approve that request to wave payment, then it comes to my office and our assistant secretary for human resources and administration operations security and uh preparedness would be responsible for that process. So that's just an example of the levels at which these are reviewed and the seriousness with which we take things like breach of
▶ 1:06:43Thank you for that very thorough explanation. How long has that that exact chain that you just described been in place? Is that new this year in 2025?
▶ 1:06:51So I would say it dates back to 2020 when we revised our departmental policy. Um and we do have statistics if the committee is interested in terms of how many cases go through that process. um the percentage that reach my office, it's a small percentage, maybe one a month and a very low percentage that is approved because the standard for waving a breach of a service obligation is very high.
▶ 1:07:13Um it has to it's it's stipulated in law as repayment would be against equity and good conscience or not in the best interest of the government. And when we are paying individuals and they are not upholding their end of the agreement, um that is something that we want to pursue.
▶ 1:07:28Yeah, that too. Thank you. My time is expired. I'm sure that we will have a second round of questioning, but I will yield to our ranking member.
▶ 1:07:36Thank you, Chairwoman. Uh Dr. Elliott, I want to first thank you for being here and taking time away from your day job as a pharmacist at the Hampton VA Medical Center. I understand you're also the caregiver of your mother. Is that Well, you're a superwoman and I'm really grateful for your participation and your continued dedication to your uh VA brothers and sisters at the AFGE.
▶ 1:07:59You mentioned in your testimony that there's a lack of clarity in how and when 3R incentives are used at your facility in Hampton. Do you think that if three R incentives were made widely and frequently used at Hampton, the facility would be able to onboard and keep more
▶ 1:08:18We used to have a process whereby we um had hard to recruit and hard to fill positions at our facility. Um I do not know where that process is at this time. I've not heard anything of it for the last several years now, especially since we've been um decentralized with respect to the HR staff.
▶ 1:08:38But that is supposed to be the um design those people on that list are supposed to be the designates of various recruitment retention bonuses and so forth. In my 35 years there, I've never seen a relocation bonus for a line staff person. no matter what their job was. Um, typically those had been reserved for um top management, the various re relocation bonuses.
▶ 1:09:06And Dr. Elliot, I I wanted to ask you if you had any reactions to how the secretary is characterizing staffing at North Battlefield Clinic since you're on the ground actually working there.
▶ 1:09:18And I can tell you this from the standpoint of a veteran. I go to, this is what the veteran said during a panel. I go to the VA at North Battlefield, have my primary care appointment. However, if I want to receive other services such as X-ray and those sorts of things, I still have to drive to Hampton. That's problematic.
▶ 1:09:44That is Well, thank you, uh, Dr. Elliott. I want to now turn it over to Miss Dared. Mr. Sarah, how many employees has VA lost through quote unquote natural attrition since January of this year?
▶ 1:09:56Uh, ranking member Ramirez, uh, we do look at that data on a regular basis. I believe the last statistics that I saw of all of the separations, those are voluntary and involuntary actions. It's about 20,000 that have occurred over the last few months.
▶ 1:10:1020,000 over the last few months. Is that what you just said?
▶ 1:10:13Over the last few months since the beginning of the year.
▶ 1:10:16Yeah. I just wanted to make sure I I had heard correctly. And how many of those employees are in veteran facing roles like direct care or benefits counseling?
▶ 1:10:26What would you say?
▶ 1:10:27Ranking member Ramirez, the number that I cited was at the aggregate level. So I'd have to go back and break that down to look more specifically at direct care
▶ 1:10:35Mr. E, if you could go ahead and follow up on that, I would really appreciate it. Um, and the the follow-up question I have to that is uh if you know if those positions were backfilled.
▶ 1:10:47So, ranking member Ramirez, as I mentioned, about 350 positions are exempt from the hiring freeze. I do see data on a bi-weekly basis of the job announcements that are posted and the individuals that we are bringing on board. Um, I know we're bringing several thousand um a pay period back into the VA. I know those that that statistic is actually reported on the workforce dashboard each month as well.
▶ 1:11:08Got it. So, Mr. If when you follow up, if you can try to get me a little bit more detail, that would be really helpful. I want to go back to these posters on the VA workforce dashboard dated June 28th, 2024. So, last year, there's a note at the very top that says top risk and then reads quote delays or termination in use of packed act title 9 authorities will have a negative impact on recruitment and retention. End quote.
▶ 1:11:34Now those packed act authorities referenced here included recruitment and retention incentives among other bonuses. Is that correct miss?
▶ 1:11:41Yes, it is. Ma'am,
▶ 1:11:42why was there why has there been such a stark downward trend in the use of three art incentives from year 2024 to year
▶ 1:11:53So as mentioned earlier, there has to be a justification for using a recruitment or a retention incentive in many uh situations. I know Dr. Elliot mentioned our hard to fill and our shortage occupations and I think Mr. Steel has mentioned it as well that we are able to post those job announcements get qualified candidates and bring them on without using an incentive.
▶ 1:12:11So Miss Dared this is my last question for this round then we'll come back the second round but is a delay or termination of using these authorities having a negative impact on recruitment and retention at the VA
▶ 1:12:22at this moment in time we are able to post and fill those positions that are being vacated in our direct care positions. So, you are not noticing just yet the negative impact on recruitment and retention of the VA. Is that what you're saying?
▶ 1:12:34Correct, ma'am.
▶ 1:12:35Thank you. With that, I yield back.
▶ 1:12:37Thank you. The chair now recognizes Mr. Conway for five minutes.
▶ 1:12:42Uh, thank you, Madam Chair. And, um, I guess before I ask my questions, I can't help but u uh put um some more close, if you will, on the statements of our ranking member. when you hear about um the uh intention uh the leaked intention of the number of employees that the um secretary intends to cut from the VA.
▶ 1:13:08It's hard to imagine that anyone who uh might think about entering a career in public service and working at the VA uh would look upon the VA as a place to land and to work and to engage in public service, taking care of our valuable and hopefully appreciated veterans.
▶ 1:13:28This kind of of announcement from the top can't help but um hurt the effort to retain frontline health care professionals and others uh who are so critical to the operation of that facility. People, you know, obviously you need nurses, you need doctors, uh but you also need someone to uh to make sure that people get food delivered to them. You need to make sure that you've got a pharmacy that's working.
▶ 1:13:53You need to make sure that the uh the cleaning services are working and that the building and the facility is secure. Uh and uh you need people uh to do all of those jobs and to want and to want to come to work uh and have that work appreciated.
▶ 1:14:07And it's hard for us on this side of the aisle uh to hear and to understand these these obvious dynamics um uh with respect to um their union rights and their uh prospects for a career uh that is um both satisfying, rewarding, and appreciated by their government, by their employees.
▶ 1:14:29uh that that's not going to have a profound impact on the ability of the VA to do its work and to honor our commitment to veterans and that it's not part of a grand plan as ranking member has pointed out to privatize these services and we are seeing this across um at least the signs of this and I think very definite pattern across uh the federal workforce and the federal government. I'm a physician myself. I I've worked um I've trained at a VA facility for part of my training.
▶ 1:14:59I served on a on a military base as as a physician there and um I certainly treated a lot of veterans even in private practice um after leaving the service uh because of where you know my my district is a home of a military base a joint base McGuire and so we have a lot of veterans who live in that area and were patients of mine um and I understand how important the VA is to them to them and their ability to use the VA when they need it uh for their care.
▶ 1:15:30I'm disturbed to hear uh about what's happening with the physician workforce, the losses there, and particularly the ability of of psychologists and psychiatrists uh to to treat patients um because of the attack on on remote work. Uh just because someone's being seen remotely doesn't mean that uh anything that's said in the interactions between their physician um and someone who is receiving their care remotely shouldn't be protected.
▶ 1:16:00Uh their privacy shouldn't be protected there. Uh and when you consider people now being put in cubicles or putting in spaces where where their conversations are not secure and private that that impacts uh the kind of care that they're that they wish to give and how and and how they ought to practice that life-saving care as we know there's so many dislocations um with mental health in the service. So and I understand Miss uh Elliot Dr.
▶ 1:16:27Australia, pardon me, uh that you have an example of a change in this retention policy and and and the the loss of remote work. Can you comment on the impact of that situation at Hampton at the Hampton VA?
▶ 1:16:41Thank you. Um at our facility we have a lack of well our recruitment is 40% 43% behind meaning that out of a hundred positions 43 of them are vacant.
▶ 1:17:07We are in the process now of losing a to another facility because that particular psychologist lived far away and could not come to Hampton with no relocation bonus offered. That psychologist was able to get a relocation bonus from someplace else. And that's where that psychologist is going.
▶ 1:17:33So I guess instead of being 43% um um behind the eightball, we are 44% in a couple of weeks when that psychologist leaves. Now to add insult to injury there, even though we know that psychologist is leaving, we do not recruit begin recruitment until after the psychologist is gone.
▶ 1:17:57Therefore, all of that psychologist work is borne by someone else or patients are and rescheduled and rescheduled until someone comes in to fill that post.
▶ 1:18:12Thank you, Madam Chair. I yield back. I see it's my time.
▶ 1:18:16Thank you. I have a couple of other questions. Dr. Elliott, just for clarification, that psychologist you I'm sorry. Oh, Mr. Kenny, we'll start with sorry, Mr. Dr. Kenny will recognize you for 5 minutes first.
▶ 1:18:26Thank you very much. Uh thank you all for being here today. I have some deep concerns about what's transpiring at the VA across this country and I know veterans not only in my district but across the nation are disturbed about the news that is continuing to come out of the VA that will impact their care. Just to take a quick trip down memory lane. Back in February, the VA dismissed 1,000 employees outright.
▶ 1:18:56That was February 13th. 11 days later, on February 24th, the VA cut another employees. 2400 people cut from serving our veterans in this nation.
▶ 1:19:14It was the beginning of a despicable pattern that we've seen coming out of this In March, this committee discovered through a leaked memo that the VA planned to cut more than 80,000 employees, which Secretary Collins then And now we're being told that the VA will not make this cut, but would reduce the number of employees by nearly 30,000 by the end of the fiscal year.
▶ 1:19:4217,000 already gone, meaning there's going to be another 12,000, more than 12,000 additional cuts, the largest in VA history. And these reductions will affect critical frontline staff, including health care workers and benefits personnel.
▶ 1:20:01But I recall what Secretary Collins told this committee in May, and I'm going to quote the secretary, "The VA's staffing structure is aimed at finding ways to improve care and benefits for veterans without cutting care and benefits for veterans. And we're going to maintain the VA's mission essential jobs like doctors, nurses, and claims processors while phasing out Michigan mission non-m mission essential roles.
▶ 1:20:33That is not what we're seeing. I want I want to believe that that would be true. But if it's not true, then this committee responsible for VA oversight has been misled. And I have a couple of questions. Miss the you visited multiple VA facilities and have spoken with a wide range of employees. Based on what you've seen, similar roles face similar challenges nationwide.
▶ 1:20:58So, why were collective bargaining rights preserved for nurses and facility workers at the Milwaukee VA but stripped from their counterparts in the community that I represent in Buffalo despite nearly identical job
▶ 1:21:15So, Representative Kennedy, the executive order related to labor relations is currently under litigation. There is a stay related to that executive order. So we are complying uh with that that uh litigation right now.
▶ 1:21:28Okay. So no answer. The only clear difference that I can see is union Buffalo workers are represented by unions that have filed lawsuits against this administration unlike those in Milwaukee. That raises serious concerns about political retribution and Can you explain at all these decisions, how they were made, and uh whether the union activity played a
▶ 1:21:58Representative Kennedy, I'm uh at this point in time based on the stay in that particular case, I can't answer that
▶ 1:22:06Okay. No answer again. Thank you. Uh Dr. Elliott, after having conversations with VA employees in Buffalo, two things are clear to me. take deep pride in serving our veterans and they rely on their union to protect their rights and help them provide the best possible care. As you know, President Trump's EO14251 misuse the National Security Exemption in Title 5 to remove employees, including those at Hampton VA and Buffalo, from the bargaining unit.
▶ 1:22:35You just mentioned in your testimony that uh reduction in hiring that you're behind. Uh based on your experience, has the VA's approach to collective bargaining helped or hurt your ability to attract and retain staff?
▶ 1:22:53I would say that it has. we have um been I guess
▶ 1:22:58it has
▶ 1:22:59have it has it has
▶ 1:23:01it has
▶ 1:23:02it has reduced our ability to recruit and retain it has but I also would like to say if you don't mind this situation about the 30,000 employees that are targeted as far as a number goes in 1989 I met a nurse named Miss Eddie She told me that a failure to plan is a plan to fail.
▶ 1:23:28You probably have heard that when you rely on random reductions, there can be danger there. You don't know which critical and which non-critical position is going to be reduced. So let's say for example, if out of that 30,000 10,000 of them are doctors, we can't we can't tolerate that. or if 15,000 of them are nurses, we can
▶ 1:23:54gentleman's time is expired. We're going to move into a second round of questioning and we will do two minutes for an additional round of questioning.
▶ 1:24:02Mr. Rit, do you anticipate the VHA will develop the necessary guidance regarding quality control checks by the OIG's recommendate recommend recommended completion date in September?
▶ 1:24:12Chairwoman Kagans, I do and I know u Mr. Perry has additional information on
▶ 1:24:16Thank you. Can you please tell us how Vizen leadership will be involved in monitoring the 95% compliance rate?
▶ 1:24:22Uh yes, Chairwoman. Uh as I previously stated, we are working now on shifting the responsibility of the oversight um to the compensation side of the vision to hold that accountability line to make sure that the proper documentation, technical review and approvals are in place. So that will be done by the end of this year.
▶ 1:24:40And how long how long Okay, so how long do you anticipate it will take for the majority of visits to meet that 95% target? We've already started that now. Um, and that includes my team rolling out the additional training and oversight to ensure that they do come into compliance by the end of this fiscal year.
▶ 1:24:54Okay. Thank you. And Miss Thorrett, do VHA officials have the authorization to approve exceptions to limitations placed on incentive payments? U VHA officials um at the del through the delegation of authority are able to approve incentives up to a certain threshold and then those depending on the incentive may have to come up to the office of the secretary depending on the
▶ 1:25:18Who is responsible for approving the exception and who provides a check on this person?
▶ 1:25:23Um my office uh conducts an oversight review of those incentives and would also be able to work with Mr. Perry's team to make sure that they are following policy and proper procedures.
▶ 1:25:34And in your experience, are those exceptions more frequently approved for administrative positions or clinical
▶ 1:25:40Chairwoman Kiggins, they are more frequently approved for clinical
▶ 1:25:44Thank you. Mr. Steel, I was shocked to hear that the BHA could not provide OIG evidence for reertification for those recurring incentive payments. Do you believe this is an issue with HR Smart or a result of inadequate oversight by the HR servicing teams? We saw a breakdown of both systems and people. Uh HR smart lacked the automation to halt the process if uh certain requirements were not met.
▶ 1:26:06Uh in that situation, it does put more onus on people to enter data correctly uh and conduct backend oversight to ensure that the process ceases when it should.
▶ 1:26:15Thank you. And my two minutes have expired. I yield to the ranking member.
▶ 1:26:18Thank you, Chair. Mr. I want to follow up again with you. The aid corner staff have been meeting routinely with Mark Engelbomb, the assistant secretary for HR, and our staff has requested a detailed breakdown of data on employees who have left the VA since January through the DRP, Vera or natural attrition. Or fortunately, the numbers that VA provided as a follow-up fall wolffully below the level of detail requested.
▶ 1:26:43Are you able to produce by location, occupation, detailed data on the number of employees who have taken the DRP, who have taken Vera, who've resigned, who've retired.
▶ 1:26:55Are you able to get that information for
▶ 1:26:57Ranking member Ramirez, yes, I can get that information.
▶ 1:27:00What about the number of job offers that have been declined by applicants since January of this year? Is that a data point that you have the capability of pulling? So, rank member Ramirez, our talent acquisition system is USA staffing and it does capture some information on declinations, but it may not provide the detailed information that you
▶ 1:27:18Okay. So, please provide me everything that in fact is uh being collected and missed, can you please commit to working with us on providing the detailed data in a reasonable time?
▶ 1:27:29Ranking member Ramirez, I welcome the opportunity to work with this group.
▶ 1:27:33Great. Thank you, Mr. Darrett. I don't imagine you will have this number on top of your head because I'm sure there's a lot going on and a lot of information you have to uh try to memorize for these um hearings. But I want to bring to you an answer uh I want you to bring an answer back for the record. How many veteran care appointments at the VA have been cancelled since January of this year due to staffing shortages? If you have the answer, I'll take it now. If
▶ 1:27:56ranking member Ramirez, I do not. I don't know if Mr. Perry does.
▶ 1:27:59You have that? No,
▶ 1:28:00we we do not, but we can take that.
▶ 1:28:01We can come back with it. I would really appreciate knowing how many u veteran appointments have been cancelled. I I'm going to leave it at that. Mr. Steel, I really wanted to ask you a question, but I'm hopeful others can. Thank you.
▶ 1:28:13The chair now recognizes Mr. Conaway for five for two minutes. Sorry.
▶ 1:28:19I thought we were changing the order. Madam Chair, um uh thank you for recognizing me, Madam Chair. Just uh before I get to uh one of my questions, I just want to make a comment about uh HR1, the big cruel bill as I call it. Um I'm very concerned uh that um medical students um going to medical school, very expensive process that there's now a cap on uh those loans uh that students may give.
▶ 1:28:47And it's going to partic particularly be a problem for those students who don't come from wealthy families um where they're going to have to try to figure out uh how to make up that gap. What do you think uh that this um that this issue of cutting support uh for medical education um how do you think that's going to impact the VA? You've trained most of the physicians in the country.
▶ 1:29:16So Dr. Conway, I I would say that when we talk about three Rs, there are also other incentives. And you speak to scholarship programs, debt reduction programs, and if you look at the job opportunity announcements that are posted for the VA, many of our Veterans Health Administration job opportunity announcement include those benefits. And I'll ask Mr. Perry,
▶ 1:29:36I'm going to reclaim my time because I want to get another question in. Pardon me for that, but I I must push on. Um, in 2024, the VA reported um, a loss of 608 physicians. So, just a series of questions. You may not have them, but I want to get them in uh, before my time is up. Uh, how many job postings does the VA currently have for physicians? Do you know by chance? If you don't know off the top of head, I'll just leave them for the record. How many physicians has the VA on boarded in the past month?
▶ 1:30:06What is the VA doing to attract and retain physicians? and why do you think we're seeing such a loss in physicians? And uh I'll I'll leave it uh at that. If you have questions to any of those, I see my time is up, but I look forward to your answer uh offline.
▶ 1:30:23Gentleman's time is expired. The chair now recognizes Mr. Kennedy for two
▶ 1:30:27Thank you. Um, I want to just go back to the secretary and what he said to this committee in May that the VA would maintain mission essential jobs like doctors, nurses, and claims processors.
▶ 1:30:43According to the VA's monthly workforce dashboard, estimated losses for fiscal year 25 are 1720 registered nurses, 604 physicians, and 1,081 veteran claim examiners.
▶ 1:31:03These are missionritical roles which run directly against Secretary Collins points that current and future cuts to the VA won't impact the delivery of care and benefits. As an occupational therapist, I've seen firsthand on the ground what happens when health care facilities are short staffed and that health care is not provided to individuals.
▶ 1:31:29Right now, our veterans are being provided care by American heroes on the ground in these facilities. But you know what? They're exhausted. And not because they don't care, but because they ultimately are having a trouble keeping up because they're getting cut in staffing. So when that happens in our VA, it's our veterans that are paying the price.
▶ 1:31:56And so even though we've been told mission critical employees aren't being cut, evidence on paper is that in fact there's a different story. We have credibility issues at the VA and with this administration happening right now. These cuts are impacting veteran care and veterans should not have to wait longer or see fewer specialists or receive delayed benefits.
▶ 1:32:22As members of this committee, we have a sacred responsibility to uphold this nation's promise to our veterans. These cuts are not only short-sighted gentle uname yield back.
▶ 1:32:35Steel and Dr. Elliot. Thank you to each of you for coming to testify today. The solution is not just identifying weak policies, but following through with the guard rails that ensure effective oversight. It is clear more attention needs to be focused on ensuring the VA is following Congress's intention when paying these incentives. The fact that we are still having a conversation on this issue after more than a decade since the OIG's 2017 on a report on improper bonus payments indicates we must do something different.
▶ 1:33:03It does not take a rocket scientist to figure out that providing quality and safe patient care is a better use of tax dollars and accounting mistakes. These bonuses, when used correctly, enable the VA to pay attractive salaries to valuable clinical staff and other VA employees who serve our veterans. These incentive payments should go to staff dedicated to providing world-class care for our veterans. When the VA cannot retain its good employees or recruit talented staff, patient care is the first to suffer. I've seen this firsthand as a nurse practitioner.
▶ 1:33:32I will not will not allow that to happen while I am chairwoman of the subcommittee. I'm encouraged OIG identified better documentation as a means of improving the bonus payment processes as well. Aside from the way stemming from the improper payments, it is not possible to conduct a thorough review of where processes went wrong when there is no paper trail. That's why I was happy to vote with my House colleagues yesterday for Senate Bill 423, the Protecting Regular Order for Veterans or PRO Act.
▶ 1:33:57This bipartisan bill would provide additional guards on incentive payments paid to members of the Senior Executive Service, and I hope the VA will take them seriously. I'm looking forward to further collaboration with Secretary Collins and the Trump administration to assist with our oversight efforts and I'm grateful for the clarity that today's testimony offers. Ranking member Mermirez, do you have any closing
▶ 1:34:18Thank you, Chairwoman. Worldclass care can't be achieved when you've lost 1,720 registered nurses. can't be achieved when 1,147 medical support assistant staff leave or 604 physicians uh leave. And when asked why they're leaving, they say lack of trust and confidence in senior leaders.
▶ 1:34:40The information contained in VA's workforce dashboard is critical to our oversight and to showing the public the true picture of what is happening at the VA under Secretary Collins. It is hard to call us liars and say our claims are a hoax when we have the data from VA to back up concerns that veteran care and benefits are being impacted under Collins leadership. The information for the public that is listening can be accessed at va.govmployworkforce-d.
▶ 1:35:10I urge everyone watching this hearing to go now and review the data and make a judgment for yourself on how this administration's actions have and will continue to impact worldclass care for our veterans. We know that this administration has a history of deleting or hiding files um and tampering with information they don't agree with.
▶ 1:35:32So to ensure that these documents remain a part of the public record and are not deleted, removed or hidden, I request unanimous consent to enter issues 1 through 26 of VA's workforce dashboard into the record.
▶ 1:35:48Without objection, so ordered.
▶ 1:35:49Thank you, Chairwoman. And with that, I yield back.
▶ 1:35:53Thank you, ranking member, and thank you all for being here today. Miss Thret, Mr. Perry, Mr. Steel, Dr. Elliott. I know you all took time out of your busy schedules and I appreciate that I'm sure you were prepared to discuss the real issues at the VA including the title of our subcommittee which just as a reminder was counting the money preventing fraud and abuse in the VA's bonus payment practices for VA employees. I appreciate your insight on the issue that why we called this hearing today.
▶ 1:36:20As a Navy veteran and a nurse practitioner, I know how critical it is for the VA to provide consistent highquality care to those who have served. I'm married to a veteran. I'm the mom to future veterans. I represent tens of thousands of veterans. My own parents are veterans. So, it is an issue near and dear to my heart and to my district. I'm courage encouraged that the VA has decided against large-scale layoffs and is instead taking a more thoughtful and measured approach to improving operations.
▶ 1:36:47I also worked at the VA for several years or for several months as a nurse practitioner. It was a short time because I'm a geriatric nurse practitioner and couldn't utilize my geriatric uh skill base as much as I wanted to. But I remember that there were a lot of really good people doing really hard work. The physicians, the doctors and nurses, the pharmacists, the the allied health professionals, the people who were in one building taking care of people who walked through our front door.
▶ 1:37:12I also remember on my lunch break, I would take walks and see buildings full of other people that didn't provide patient care. I didn't know what they did, but I knew where I was called to work and where I was able to touch patients and to impact lives of veterans. So, I think there is room just as as this was before my time in politics, just looking at what that facility looked like, knowing that there was room to probably downscale. I want to make sure that our best resources are going to the patient to patient care.
▶ 1:37:40But reducing 30,000 positions through attrition rather than eliminating clinical roles is a more reasonable path forward. and I know that's what the secretary is focused on doing. I support efforts to streamline the department and I give more decision-making authority to local medical center directors who are closest to the veterans they serve. Decentralizing operations can help VA facilities respond more quickly to local needs and improve overall outcomes for patients.
▶ 1:38:04At the same time, I'm closely monitoring how these changes may impact support staff who play a critical role in ensuring providers can focus on delivering care. I believe restructuring can be positive, but only if it's done transparently with input from frontline workers and full oversight from Congress. The lack of clarity around some of the VA's reorganization efforts is concerning, and I will continue to push for more communication and accountability. Congress must be a partner in the process, not an afterthought. And the VA leadership must work collaboratively to keep veterans and employees informed.
▶ 1:38:35I will continue advocating for investments in VA services that prioritize patient care, benefits, delivery, and support for the dedicated workforce. Multi ultimately, this is not a partisan issue. This is about keeping our promises to those who've worn the uniform. Veterans deserve a VA that serves them efficiently, compassionately, and without disruption. Again, thank you all for being here today. I ask unanimous consent that all members shall have five legislative days in which to revise and extend their remarks and include any extraneous material.
▶ 1:39:06Hearing no objection, so ordered. This hearing is now adjourned.