▶ 0:07:15Morning everyone. Committee will come to order and without objection the chair may declare a recess at any time. Now before that we begin today I would like to take a moment of silence for the service members currently serving in the Middle East as well as the families of the service members who recently gave their lives and uh they're in our prayers.
▶ 0:07:37So take a Thank you and I also want to take a moment uh and pray for the VA employee who was shot yesterday in Jasper, Uh we're asking for strength and healing and full recovery uh for them.
▶ 0:07:59We're thinking of the family and VA colleagues who are impacted by the incident during this difficult time and we we stand with them and hope for their quick recovery. Now today's hearing is about one central responsibility of this committee, ensuring VA works for the people it was created to serve our nation's The Constitution places a responsibility squarely on Congress under Article 1.
▶ 0:08:26Congress writes the laws, authorizes the programs, and exercises oversight over how these policies are carried out. That authorization that authority exists to make sure VA remains accountable to veterans and the American taxpayer. When programs fall short it is the duty of this committee to ask questions, demand answers, make the legislative changes necessary to fix the problem.
▶ 0:08:55Reauthorization is not simply a procedural exercise. It is how Congress evaluates whether programs are working as intended or whether the department is using its authorities responsibly. In many cases statutes and policies governing VA have not been meaningful meaningfully updated since the Well before the post-9/11 generation of veterans began their service.
▶ 0:09:26Reauthorization also provides Congress with the means to modernize VA so it can better meet meet the needs of veterans today and in the future. I am not uh I do not expect the members of this committee to agree with every policy proposed before us today. I know there are some proposals that on their face I do not support.
▶ 0:09:48But that is precisely why as chairman I called this hearing to debate the merits of each and determine where improvements are needed. As chairman, I also want to recognize Secretary Collins for the work he has undertaken to improve and reform The legislation we are considering today is not about placing obstacles in the way of the department. It's about strengthening it.
▶ 0:10:15These bills are intended to ensure that Secretary and future secretaries have the tools necessary to deliver the care, benefits, and services veterans have earned and are eligible for. Today, we will examine several proposals introduced by members of this committee on both sides of the aisle and that are designed to restore accountability, improve transparency, transparency, and ensure that VA remains the focus and focused on veterans.
▶ 0:10:44For example, my legislation addresses the vision structure by aiming to improve how VA organizes and manages its health care systems across the country. The goal is simple. Better coordination, stronger accountability, and better outcomes for veterans. Other bills will be discussed today address a wide range of reforms across the department.
▶ 0:11:08General Bergman VA Contracting and Procurement Act would strengthen congressional oversight of a major VA contracts by using the large procurement agreements receive proper review and from Congress before significant taxpayer dollars are committed. Dr.
▶ 0:11:27Miller-Meeks VA National of Formulary Act would codify key elements of VA's national drug formulary process into statute improving transparency, consistency, and congressional oversight over how medications are managed. Dr.
▶ 0:11:49Murphy's VA Research Reform Act would modernize how VA manages and tracks its research programs through a centralized data system designed to improve coordination and accelerate translation of research into better care for veterans. Several of my colleagues also have proposals that aim to improve accountability, strengthen benefits administration, and streamline the VA.
▶ 0:12:16Taken together, these proposals reflect a shared goal of this committee in making sure VA programs are transparent, accountable, and responsible to the veterans they serve. However, VA must also recognize that response responsiveness to Congress is part of that accountability. When this committee conducts oversight or requests information, we are fulfilling our constitutional responsibility under Article 1.
▶ 0:12:46It is a task, not an ask. And with that, I want to thank our witnesses for appearing before the committee today. I look forward to today's discussions on how we can continue strengthening VA for the veterans we are here to serve. Right Ranking Member, are you You are now recognized for your opening statement. Did you lose your button? I did lose it. The button that is.
▶ 0:13:16Uh Well, thank you, Mr. Chairman. Uh the Department of Veterans Affairs has announced numerous initiatives, plans, and regulations very publicly, but when we ask questions, the department has become very opaque. Uh when we manage to get VA witnesses before us for hearings, the responses to our questions have been inadequate.
▶ 0:13:37This has become deeply frustrating and unacceptable, and I don't know uh that this specific exercise proposed by the chairman will improve this, but I'm certainly willing to try. I welcome an effort by this chamber, by our house, and by this committee to reclaim its authority and reaffirm our Article 1 powers by doing the real oversight that VA so desperately needs.
▶ 0:14:03Uh VA is the second largest federal agency, and it has a critical mission. VA's mission will continue to be underscored by every military action the US takes part in. The Trump administration's choice to attack Iran has consequences for service members, veterans, and this committee.
▶ 0:14:25And as such, we need to ensure that VA is prepared to serve a new generation of veterans that will come through its The process being undertaken by this by the committee started starting today has been billed as something akin to the Armed Services Committee's work on its annual National Defense Authorization. Now, this would be a big undertaking for a committee that has never done anything like that before, and our timeline here is very compressed given where we are in this Congress.
▶ 0:14:56As the chairman knows, the Armed Services Committee must pass an annual reauthorization for three reasons. First, to meet Congress's Article 1 Section 8 responsibilities to {quote} raise and support the military. Second, to make sure that the department can continue to function. And third, because the Armed Services Committee really only passes one bill a year, so it replaces all other authorizing work for the year.
▶ 0:15:24Now, if it is the chairman's intent to do that here, this process would signify a dramatic shift in how this committee However, the more I review our agenda, the more questions I have regarding next steps, not only for our witnesses, but for this committee. Of the 27 bills we are reviewing today, none are strictly reauthorizations of existing programs. Many are wholesale rewrites of ongoing VA efforts or entirely new proposals.
▶ 0:15:56I think it is going to take more than just this hearing to get a sufficient understanding of the impacts and costs of these proposals and fundamentally whether they will improve care and services for veterans, which should be the guiding principle for the consideration of any piece of legislation in this committee. Furthermore, unlike our colleagues on the Armed Services Committee, we don't yet have a chairman's mark to evaluate, and there have been no subcommittee hearings or markups.
▶ 0:16:24In fact, the only work this committee has done that reflects a larger annual reauthorization process is the joint VSO hearings held over the last month. We heard directly from stakeholders about their priorities, and it will be important to compare what is on this agenda with their with the the prior those with the priorities enunciated by the VSOs.
▶ 0:16:47More Most importantly, we will need significant feedback from stakeholders on this agenda and whether it is again meeting the guiding principle of improving care and services for I would like to believe we can still operate in a bipartisan manner and get things accomplished on behalf of veterans, but I'd also like to believe that we can still work together to hold VA accountable and to demand transparency about its outcomes about about its operations.
▶ 0:17:14Now, we should not consume months of committee work with an exercise that does not result in real oversight or meaningful improvement for Now, I do have one bill on the agenda, and I'm also shepherding two discussion drafts that I'll speak on now. Now, first, I am the sponsor of the Ensuring Veterans Smooth Transition Transition or EVEST Act, a bill that I've championed for many years.
▶ 0:17:41Now, there's absolutely no reason that veterans who are eligible should shouldn't be automatically automatically enrolled in VA health care. None. Veterans earn this care through their service to our nation, and for us to gatekeep their access to that care does nothing to improve their medical outcomes. Further, we know that months following the transition out of the military can be stressful, and risk factors are evaluated, including for mental health. Excuse me.
▶ 0:18:08Risk factors are elevated, including for mental Now, VA's testimony claims that this legislation overlaps with existing efforts. I'm going to say I'm going to say this right now uh to the witnesses before us today. This is frankly not true. Nothing any of us would inhibit VA's existing goals and efforts. And that is why DAV, PVA, VFW, and many more VSOs are endorsers of this bill.
▶ 0:18:35The time for automatic enrollment is Second, I want to call my colleagues' attention to two bills on the agenda related to toxic exposure and the unfinished work of the PACT Act. Mr. Chairman, I hope we can all agree that almost 4 years after its passage, the PACT Act has been a success. Millions of veterans have received care and benefits because of its provisions.
▶ 0:18:59Its continued success depends on those responsible for its implementation, but sadly, under this administration, we have seen progress stall. Therefore, it falls to us to continue to legislate to improve implementation and our oversight of the PACT Act. Now, one of the administration's and Secretary Collins' very first acts was to dissolve the PACT Act Project Management Office. This office was responsible for overseeing the department's implementation of the law.
▶ 0:19:29And to this day, we have no explanation for VA's decision to deemphasize the PACT Act. And that is why we have a bill to create a new office focused solely on toxic exposure and to evaluate uh the head of that office uh excuse me, to to excuse me I to elevate to elevate the head of that office to the rank of assistant secretary. Addressing a toxic exposure is simply that important. Now, Mr.
▶ 0:19:58Chairman, it's also an unfortunate reality that this administration views communication and collaboration with veteran service organizations as an afterthought or an obstacle to be overcome. Time and time again, we've seen the voices of VSOs marginalized or outright ignored.
▶ 0:20:15One-way communication that is shallow, perfunctory, and increasingly And the results of that poor communication are numerous policy shambles Secretary Collins continues to Now, if the department can't see fit to elevate the voices of veterans, then we in Congress must mandate it. And to that end, we are proposing a bill to create an advisory committee on toxic exposure to help guide the department in its work on addressing this issue.
▶ 0:20:44The PACT Act created a framework to develop new presumptions of service connections for toxic exposed veterans. But the department isn't using that process to its fullest extent. Including listening to veterans about how to make continued progress on addressing toxic exposure. This advisory committee would create a venue for veterans to be heard and require their ideas to be taken seriously. Thank you, Mr. Chairman, and I yield back. Thank you, Ranking Member Takano.
▶ 0:21:13And now we will turn to our witnesses testifying before us today. We have Dr. or Mr. Phil Christie. Uh Chief Ed Acquisition Officer. Say that again? We will be recognizing members to speak on their bills first.
▶ 0:21:42It wasn't in my script, but by golly, I'll get it straightened out now.
▶ 0:21:48Mr. Barr, you're recognized to speak on your proposal. Thank you, Mr. Chairman. Appreciate it. And to you and to the Ranking Member and all the members of this committee, I was proud to introduce HR 6833, the Acquisition Reform and Cost Assessment or ARCA Act for short.
▶ 0:22:04It's no secret that acquisition acquisitions and contracting processes at the VA are often disjointed and lack congressional oversight, which is a main focus of this congressional hearing Uh I've been privileged to chair for the last 15 months or so the Technology Modernization Subcommittee here in this And I've routinely seen the large IT and medical system contracts acquired by the department balloon in cost while being riddled with delays and speed bumps.
▶ 0:22:31We've seen that with the EHRM rollout and other large projects that the department has taken on. This leads to congressional hearing after hearing where it's clear that then the past these systems often lacked and necessary oversight from Congress. Uh these inefficiencies at the VA directly and too often negatively affect the level of services and standards of care that veterans receive.
▶ 0:22:54On top of that, every dollar that we spend on overpriced and inefficient technology is a dollar that we're not spending helping the men and women who defend our nation transition back home to the greatest possibility that they have. Meanwhile, delayed projects and failing IT systems are compromising the benefit and health care Americans promise them. My bill would create a process at the VA for procurement and contracting under a newly established Office of Acquisition.
▶ 0:23:21This office would better define major acquisition programs at the VA, streamline oversight and contracting processes, increase congressional oversight, and enhance accountability through independent evaluations. This act is long overdue to streamline purchasing and strengthen accountability so the VA can achieve its mission of putting veterans first while preserving taxpayer dollars. I look forward to hearing from the VA about my bill and discussing how this legislation will better support our nation's heroes. And thank you, Mr. Chairman. I yield back.
▶ 0:23:51Thank you. Uh Representative Brownley, you would speak on your language. Uh thank you, Mr. Chairman. And um I want to be I want to speak uh briefly uh today about two pieces of legislation I've introduced, the Dental Care for Veterans Act HR 210 and Reproductive Freedom for Veterans Act HR 4876. And why advancing these bills is critical for the health and well-being of our nation's veterans.
▶ 0:24:20First, as many of you know, more than 9.1 million veterans are currently enrolled in the VA healthcare system, yet only a fraction of those veterans are eligible for dental care. Over the years, Congress has taken steps to expand access. Last year, legislation I co-authored with Senator Sanders was enacted to extend dental coverage to veterans diagnosed with diabetes and heart disease. But the reality is that most veterans still do not receive VA dental benefits.
▶ 0:24:51And private coverage is often prohibitively expensive, leaving far too many veterans without the dental care they need. My bill would correct this gap by authorizing the VA to provide comprehensive dental care to all enrolled veterans. Providing comprehensive care, including dental care, honors the commitment we make to every veteran who has served our nation. But this is not only a moral responsibility, it's also fiscally responsible.
▶ 0:25:21VA's own analysis found that expanding dental care would reduce overall healthcare costs, a policy that both improves health outcomes and reflects smart stewardship of taxpayer dollars. Dental care is essential healthcare. It is inseparable from overall healthcare, and our veterans should not be forced to go without it. Another critical part of ensuring veterans receive comprehensive care is addressing reproductive healthcare.
▶ 0:25:51Women veterans are the fastest-growing population in the veteran community, and they deserve a healthcare system that fully recognizes and meets their needs. There is not a single medical condition affecting male veterans for which the VA denies care. Yet when it comes to women's reproductive health, the VA imposes restrictions that are plainly Women veterans already face significant barriers to accessing care.
▶ 0:26:19Limiting reproductive healthcare only compounds those challenges and puts [clears throat] their lives at risk. My bill would ensure that veterans and CHAMPVA beneficiaries have access to abortion services, counseling, and medication when medically necessary.
▶ 0:26:35The Trump administration's effort to restrict access to reproductive healthcare have left women veterans isolated and VA providers uncertain about what care they can legally provide, resulting in dangerous delays and unnecessary suffering. All veterans deserve comprehensive, timely healthcare. Denying women veterans medically necessary care for ideological reasons is indefensible.
▶ 0:27:02Some have argued that these restrictions merely return the VA to prior policy, but past discrimination does not justify present discrimination. Just because inequities were were tolerated before does not make them acceptable today. Women veterans deserve better. We owe them action, not excuses. And I urge this committee to advance both of these bills now. And I thank you uh I thank you, and I yield back, Mr. Chairman.
▶ 0:27:33Dr. Conaway, you are recognized for your
▶ 0:27:48Uh thank you, Mr. Chairman, and Ranking Member Takano for holding this hearing to review legislation that will help support our veterans. I'm thankful for the opportunity to testify on behalf of my bill, Get Justice Involved Veterans Back Home Act.
▶ 0:28:03Recent survey and research shows that veterans with mental health conditions, particularly PTSD, traumatic brain injury, and substance abuse disorders are stemming from combat-related service and trauma, uh and they face a significantly higher risks of entering or reentering the criminal justice system. Veterans with PTSD are 61% more likely to be involved with the criminal justice system than those without PTSD, and 59% are more likely to be arrested for violent offenses.
▶ 0:28:31And while the VA operates programs to support veterans in the community, there remains a critical gap in care for veterans already in the criminal justice system. Since 1986, the VA has not provided healthcare to veterans when they are under the supervision of another government agency with a duty to furnish care, such as prisons or jails.
▶ 0:28:49Uh my work would remedy this uh uh my bill uh would work to remedy this issue and directs the VA to carry out a pilot program to furnish mental healthcare to incarcerated veterans uh via uh telehealth if the facility has the necessary infrastructure or through other means determined as appropriate uh by the secretary, including a mobile health units.
▶ 0:29:11VA is directed to prioritize veterans with a service-connected disability ratings related to PTSD, traumatic brain injury, or military sexual trauma on ensuring these veterans are being seen by VA health providers. We know that VA healthcare providers are equipped with knowledge needed to provide high-quality care to our veterans. This has been shown over and over again.
▶ 0:29:31In addition, uh this bill would bar the VA from collecting copays from veterans participating in the program and require that, upon the date of their release, veterans who have had their disability compensation payments reduced while in custody will have their full payments restored automatically. By ensuring our veterans have access to strong mental health care during their incarceration, we can help uh set them up for success after their release, making it easier for them to succeed in other areas such as securing employment, securing stable housing, and more.
▶ 0:30:01Our veterans need our support and assistance as they serve their time, and we must do right by them. We must enact legislation that will reduce recidivism and address the root cause of the issue. I encourage all my colleagues to support this bill, and I'm particularly pleased that uh Congressman LaChappelle is is uh very much considering joining this effort uh that uh will help our invisible uh veterans, our veterans who are currently serving time at local, state, or federal prison to obtain the support they need to get their lives back on track. Thank you, Mr. Chair.
▶ 0:30:31I uh I yield back. The gentlewoman yields back. Uh Dr. Mr. You are recognized for 3 minutes to your for your proposals. Thank you, Mr. An estimated one in three female veterans and one in 50 male veterans in the Department of Veterans Affairs health care system reported experiencing sexual assault or harassment in the military. For many veterans, military sexual trauma has profound physical and emotional effects with symptoms, reactions, and long-term consequences that are difficult to navigate.
▶ 0:31:01Closely associated conditions like PTSD, depression, other mood disorders, and substance use disorders can further impact veterans as they navigate their personal lives, parenting, relationships, and employment. Understanding the risk veterans face for experiencing experiencing MST and the serious impact we know often follows MST, it's clear this is an important issue to address for every veteran. While by percentage, women are at greater risk, nearly 40% of veterans who disclose MST to the VA are men.
▶ 0:31:32Having trained as as a physician at a VA facility and cared for patients for over 20 years, I'm familiar with the excellence of VA specialized care, as well as the importance of certifying that your facility is prepared for the patients that may walk through the doors of your office. Recognizing the VA has many programs and resources for veterans impacted by sexual assault, there continue to be steps we can and should be taking to combat the prevalence of military sexual trauma and guarantee veterans have access to the care they need.
▶ 0:32:00That's why I appreciate the committee's consideration of my bill, HR 5203, the VA Safe Care Act. This critical legislation would strengthen the VA's guidance for treating veterans seeking care following sexual assault, ensuring that veteran survivors of sexual assault are protected and cared for. Specifically, the bill strengthens the referral process to community providers for facilities without a sexual assault nurse examiner on staff.
▶ 0:32:27It makes sure facilities with SANEs have a supply of rape kits, and it makes sure that veterans receive prophylaxis for STIs or pregnancy when appropriate. It improves mental health and law enforcement referrals, and it improves training for appropriate clinical providers and VA police. This bill recognizes the work VA is already doing to be responsive to acute sexual assault and MST, as well as VA's unique position to provide specialized veteran care.
▶ 0:32:56The VA Safe Care Act is a tailored approach to ensuring the VA has the best practices and protocols in place to respond in the event a veteran is seeking care following an acute sexual assault. I look forward to hearing VA's perspective on this proposal, and I hope my fellow committee members can join me in pursuing the best resources and guidelines to care for those who have sacrificed so much for all of us. Thank you, Mr. Chair. I yield back. The gentlewoman yields back. Representative McGarvey, you are recognized for 3 minutes on your proposal. Thank you, Mr. Chairman.
▶ 0:33:24Today, I'm introducing a simple bill with a very clear goal, and that's to help the Board of Veterans Appeals make better decisions faster so that our veterans get those decisions, get the benefits they deserve. Right now, the BVA faces the same problem we see across the system for veterans. It's backlogs and long wait times.
▶ 0:33:45Veterans who have already waited months or years for an initial decision are are then waiting even longer for their And the board cannot move faster if it cannot keep the attorneys who write the HR 2303, the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act, makes one targeted change to help fix that. It amends federal law to allow BVA to promote high-performing non-supervisory attorneys to GS-15 level. That's it.
▶ 0:34:15One change. It sounds like a lot of government speak, but it matters. And it matters because these attorneys are the backbone of the board. They review the records. They research the law. They draft the decisions that Veterans Law Judges sign. And when we lose those experienced attorneys to other agencies that can pay more because they have GS-15 positions, then the board loses that speed, the the quality, and the institutional knowledge. But it's not the attorneys or the board who pay the price.
▶ 0:34:44It's the veterans who pay the price. Now, VA has raised concerns. They argue that allowing GS-15 promotions for non-supervisory attorneys doesn't align with OPM classification rules, that retention incentives have worked in recent years, and that there is no current operational need for GS-15 They also point to budget pressures. I appreciate these points. I disagree, but I appreciate the points. I disagree because here is the reality.
▶ 0:35:11The board is still losing experienced attorneys, and the backlog is still too big. If we want better, faster decisions for our veterans, we need to make sure the board can compete for legal talent. Other federal agencies already use the GS-15 attorney positions to retain expertise, and veterans deserve a board that can do the same. This will call the cost the VA a very small amount of money, but it's delay that costs so much more.
▶ 0:35:38Every month a veteran waits for a decision is a month they're without It's a month they're without the benefits that they have earned and they This bill is about keeping the people who make the board work. It's about reducing the backlog. And it's about honoring the legal and the moral promises we made to veterans when they right raised their right hand to serve our country. I look forward to working with my colleagues to move this bill forward, and with that, Mr. Chairman, I yield The gentlewoman yields back.
▶ 0:36:07General Bergman, you are recognized for 3 minutes to discuss your proposal. Thanks, Mr. Chairman. Uh at its core, my bill, the VA Contracting and Procurement Act, is about accountability, transparency, and ensuring the Department of Veterans Affairs uses taxpayers' dollars wisely while delivering the care and services our veterans rely on every day.
▶ 0:36:29It has been more than 25 years since Congress last meaningfully updated key parts of the VA's procurement and contracting framework. A lot has changed since then. The VA's operations are larger. Its purchasing is more complex. The stakes are higher, especially with procurement failures. When procurement failures affect medical care, surgical procedures, and other critical services that the veterans depend on. But too much of the system is still operating under outdated rules.
▶ 0:36:58This is a disservice to veterans, and it is a problem for Congress because we have a duty to conduct oversight and ensure federal agencies are responsible stewards of taxpayer dollars. My bill makes several targeted, common-sense reforms. First, it modernizes how the VA procures prosthetic appliances and surgical It requires a more standardized catalog, better alignment with the Defense Health Agency, and more efficient process for manufacturers to propose updates.
▶ 0:37:27It also improves how surgical implants are purchased and billed, reducing duplicate billing and allowing errors to be corrected in real time. It also places guardrails on major VA contracts and agreements. Under the bill, the VA may not enter into a contract worth more than 50 million uh dollars unless specifically authorized by law while preserving clear exceptions for national emergencies, major disasters, and public health emergencies.
▶ 0:37:53This ensures the VA can act quickly when needed, but outside of emergencies, Congress is not cut out of major financial decisions involving taxpayer dollars. Third, the bill strengthens procurement standards for health care items in the VA's emergency inventory by requiring compliance with domestic preference laws uh unless doing so would threaten veteran health or safety.
▶ 0:38:18And if the VA must make that exception, it must notify Congress and explain why. This is not bureaucracy for the sake of bureaucracy. This is basic accountability. This is a practical oversight bill.
▶ 0:38:31I could say a lot more, but practical oversight and allow us as members of the Congress and the Veterans Affairs Committee to do our job for better services to the veterans and not hamstring the bureaucracy, but also not let it become like weeds to a garden in a garden. And with that, I yield back. The gentlewoman yields back. Representative Schiffles McCormick, you are recognized for your proposal. Thank you, Mr. Chairman.
▶ 0:38:57Today, I'm proud to introduce the Health Care Oversight for Network Operators Rendering Veterans Essential Treatment, the Honor Vets Act of 2025. At its core, this bill is about a simple principle. If we trust someone to care for our veterans, we must ensure that they are prepared to do so. There are roughly 16 million veterans in the United States today. Millions of men and women who have served our country and now rely on us for high-quality, informed care.
▶ 0:39:26And increasingly, that care is happening outside the VA through community But there is a reality. Too often, those providers are not trained in the unique needs of our veterans. And this And that stake could not be higher. We know these statistics. One veteran takes their life every 65 minutes. That is about 17 to 18 lives lost every single day.
▶ 0:39:51Even more concerning about it is that 61% of those veterans were not receiving VA care in the year before their death. That means many of them were interacting with community providers, providers who not who may not have had the training to recognize the warning signs, understand military culture, or intervene effectively. We also know that the outcomes differ depending on where and how veterans receive care.
▶ 0:40:18Studies show that veterans engaged in VA care have significantly lower suicide rates than those outside the system, highlighting the importance of coordinated, and veteran-specific treatment. The Honoring Our Vets Act addresses this gap. It requires four targeted one-hour trainings covering military culture, opioid safety, and suicide prevention. These are not burdensome requirements.
▶ 0:40:45They are essential tools because when a provider understands issues like PTSD, traumatic brain injury, and lethal means safety, they are better equipped to identify risk, respond appropriately, and ultimately save lives. This bill also ensures accountability. It creates a system to track compliance, increase transparency for our veterans seeking care, and establishes clear consequences for providers who do not meet these standards.
▶ 0:41:15This is about raising the standard of care across the board because when a veteran walks into any clinic in the United States, they should not have to wonder whether their provider understands them and understands what they've been through. They should know that their providers are ready. And with this, the Honoring Our Vets Act, we can make that exception a reality. I urge my colleagues to support this legislation and ensure that the care our veterans receive is truly worthy of their sacrifice.
▶ 0:41:45Thank you, and I yield back. The gentlewoman yields Representative Kennedy, you are recognized for 3 minutes for your proposal. Thank you, Mr. Chairman. On January 28th, 2025, the Trump administration sent more than 2 million federal employees an email with the subject line, "Fork in the A deferred resignation program with an Quit now with pay that may never come, or risk being forced out.
▶ 0:42:13Only about 4% accepted, so the strategy shifted from pressuring workers to leave to terminating their employment That shift hit the VA especially hard, where 30% of employees are veterans, continuing their service by caring for fellow veterans. These were not faceless bureaucrats. They were veterans delivering care to their brothers and sisters who've donned the military uniform.
▶ 0:42:40Our veterans deserve dignity and respect for their service. Yet, despite their sacrifices, they were kicked to the curb by Secretary Shulkin and Donald Trump, even after answering the call to active and then serving fellow veterans in receiving their health care. On May 15th, Secretary Shulkin, in sworn testimony to this committee, assured veterans that mission-essential roles would be protected. That was a lie.
▶ 0:43:10In December, the administration made plans to eliminate 35,000 additional positions that month, on top of the 30,000 already lost over the last year. When I worked as an occupational therapist, I saw firsthand how the quality of care of patients' outcomes are impacted by understaffing. I know what it looks like when people don't receive the care that they need.
▶ 0:43:34And when people picture the VA system, they think of doctors and nurses, or maybe a claims processor working in the back office. The reality is that these cuts are also impacting mental health counselors treating veterans with severe PTSD, maintenance workers keeping the lights on, and therapists caring for combat veterans with traumatic injuries. To this administration, they're numbers, but to our veterans and their families, they're lifelines.
▶ 0:44:00My bill, the VA Funding and Workforce Protection Act, reinstates the veterans who were forced out of their positions at the VA since President Trump took office. It also prevents future hiring freezes that weaken the VA's ability to serve our nation's bravest, and protects probationary employees from becoming targets during workforce reductions. And it ensures each dollar Congress appropriates to the VA stays there.
▶ 0:44:27With nearly a third of VA employees being veterans themselves, starving the budget and privatizing veteran health care services hurts the people we're here to help, making it more difficult for veterans to receive the health care they've earned and deserve for serving our nation in uniform. This committee and Congress exist for moments like these. It's time we stand up to this lawless administration. They've impounded funds we've appropriated and decimated the workforce that supports our veterans. Let's stand up for our veterans. I urge my colleagues to support my bill.
▶ 0:44:57I yield back. The gentleman yields back. Representative Ciscomani, you are recognized for 3 minutes to talk about your proposal. Thank you, Mr. Chairman, for holding this hearing and on VA reauthorization, and thank you to our witnesses for being here today. I'm proud to have introduced H.R. 6843, the Establishing the Veterans Economic Opportunity and Transition Administration Act of 2025 because we must do a better job helping veterans transition into civilian life.
▶ 0:45:24Today, my many VA programs related to employment, education, and transition assistance are spread across multiple offices, making them difficult to navigate. This bill takes a practical approach by consolidating these programs into a more unified structure, reducing duplication, improving coordination, and making it easier for veterans to access the benefits that they have earned. This reform will lead to better outcomes.
▶ 0:45:47Veterans will more easily connect with job training, education, and employment While the VA and Congress will have stronger tools to track performance and ensure accountability. As we consider VA reauthorization, this is the type of reform we should prioritize, improving efficiency, accountability, and results for our veterans. With that, I'd like to turn to maybe one or two questions here, whatever time permits. Uh Mr. Christie, I'll start with you on the implementation instruction.
▶ 0:46:12We're not We're not questioning. Oh, we're not allowed No, we're We're just introducing our each of our proposals, our language.
▶ 0:46:17Oh, excellent. Then with that, I yield back, Mr. Chairman. Thank you. A minute and 44. You're welcome.
▶ 0:46:22He yields back. Representative By the way, congratulations on winning your primary.
▶ 0:46:27Thank you. Appreciate it. Right back at Uh Chairman and Ranking Member, I want to thank you for holding today's I also want to thank uh our witnesses that are here today as we're presenting our bills. It is truly the honor of my life to represent Illinois' 3rd Congressional District, and as you just heard from the chairman, uh we had our primary elections last night, and I'm incredibly grateful um for all of the constituents that I get to represent, including the veterans that I serve, and ensuring that every veteran has
▶ 0:46:57access to the benefits that they earned and that were promised to them. Access to affordable, quality education is one of those benefits that I've been talking about since I got here, 3 and 1/2 years ago almost. The GI Bill is a critically important policy that makes education opportunities affordable and accessible to veterans. However, we know that in recent years, student veterans have been the target of bad actors seeking to enrich themselves by exploiting veterans' GI Bill benefits.
▶ 0:47:24Those bad actors have reduced veterans to being just a tuition payment and exploiting them to gain access to a dependable federal disbursement. I find that unacceptable. You see, when a student veteran is defrauded by predatory institutions, it is only right, only just, frankly, that the veteran has a recourse or a way for them to get their benefits back. No student veteran should have to give up on our or have to defer on their dreams of an education because they were a victim of fraud.
▶ 0:47:54And that is why I'm proud to have reintroduced the Student Veteran Benefit Restoration Act of 2025, which would in fact restore the GI Bill benefits to students who have been The bill that I passed last Congress passed the House with bipartisan support, 406 votes in favor. But we also know that the bill moved us just a step closer to having a comparable restoration process to those that govern the federal benefits of non-veteran students.
▶ 0:48:22So, we have more work to do today to protect our veterans from bad faith actors and to ensure that every opportunity that they have is truly meaningful, thriving, and joyful post-service. So, I want to thank you all um that have voted on this bill in the past, and I hope to work with my colleagues to see this bill three bill through. I have not slept much, by the way. Bill through and and truly honor uh the service of our veterans with action. Thank you, and with that, I yield back. The gentlewoman yields back. Dr.
▶ 0:48:51Dexter, you are recognized for 3 minutes. Thank you, Chair Bost, and Ranking Member Takano, for holding this hearing and for the opportunity to speak about my bill, the Every Veteran Housed Act. Ending veteran homelessness is a responsibility we all share, and I'm committed to working with this committee to make meet that obligation with urgency and In Oregon and across the country, our communities understand something Honoring service means ensuring every veteran has a safe and stable place to call home.
▶ 0:49:21That is the standard our veterans deserve, and it is the standard we must meet. My Every Veteran Housed Act would expand the technical definition of veteran solely for purposes of homelessness assistance and to streamline access to get more veterans into stable housing.
▶ 0:49:39In recent years, Congress has expanded eligibility for the largest VA homelessness programs, most notably HUD-VASH, but but not others, creating arbitrary and unnecessary barriers to veterans accessing the full scope of homelessness services by the Veterans with an other than honorable discharge, whose discharge may have been related to mental health or substance use challenges, currently can access HUD-VASH, but not the health outreach program that would connect them to care.
▶ 0:50:10We gave veterans a key to the front door, but then left the gate locked. That approach does not reflect our values, and it does not reflect common sense. My bill fixes that. It expands the definition of veteran for the purpose of homelessness assistance, so eligibility is consistent across housing, health outreach, legal, vocational, and rehabilitation programs.
▶ 0:50:32It ensures veterans can move through the system without hitting arbitrary This approach follows existing precedent within VA programs. It maintains clear boundaries by not extending services to individuals who were dishonorably discharged or court-martialed, and it ensures we are targeting resources where they are intended. The bill also recognizes all who have served, including members of the National Guard and Reserve.
▶ 0:50:58Service takes many forms, and our commitment must match that No veteran should be sleeping on the street in this country. Not after service, and not on our watch. This legislation is a practical, targeted step that will help more veterans access to housing, stabilize their lives, and reconnect with the support systems they need. It reflects a broader commitment to treating veteran homelessness as the urgent public health and moral issue it is.
▶ 0:51:27We have made programs in recent progress in recent years, and we know what works. Now it is on us to remove the barriers that remain and ensure our systems are working for veterans, not against them. I look forward to working with all of you in advance to advance this bill, and to deliver on a simple promise. If you served this country, this country will ensure you have a place to call home. Thank you, Mr. Chair. I yield back. Gentlewoman yields back.
▶ 0:51:53Now we will turn to our witnesses' Uh testifying before us today, we have uh Mr. Phil Christie. He's a chief acquisition officer, Office of Acquisition, Logistics, and Construction for the Department of Veterans Affairs. He's accompanied by uh Ms. Margarita Devlin, uh acting under secretary for benefits for Veterans Benefits Administration, and Dr. Thomas O'Toole, uh acting assistant under secretary for health for clinical service, Veterans Health Administration.
▶ 0:52:24Mr. Christie, I will swear you all in now. If each of you if any one of you will rise. Um do you solemnly swear Do you Do you solemnly swear under penalty of perjury that the testimony you're about to provide is the truth, the whole truth, and nothing but the truth? I do. Thank you for the for the And let the record reflect that witnesses have answered in the affirmative. Now I would like to recognize Mr. uh Christie for 5 minutes for his opening remarks. Mr.
▶ 0:52:53Christie, you are recognized. Good morning, Chairman Bost, Ranking Member Takano, and members of the committee. Thank you for the opportunity to testify today on 27 bills focused on various VA programs and benefits. Joining me today are Ms. Margarita Devlin, principal deputy under secretary for benefits, performing the delegable duties of the under secretary of benefits, Veterans Benefits Administration, and Dr.
▶ 0:53:20Thomas O'Toole, acting assistant under secretary for health for clinical services, Veterans Health Administration. My colleagues and I would like to thank the chairman's staff for engaging in a very productive working session with VA before this hearing.
▶ 0:53:35The discussions we had on the proposed legislation legislation were substantive, enlightening, and very We are encouraged and hopeful that we can continue to hold these types of important engagements to work collaboratively on the legislation so they can best serve veterans. Before I turn to the bills in this hearing, I would also like to address the motivation for many of these bills. VA strongly supports congressional oversight and engagement.
▶ 0:54:03However, the department is concerned about the reauthorization of very uh VA uh programs, much like the NDAA, and could cause serious disruption to VA benefits and services. VA believes that a clear accounting of programs and services could be achieved through additional avenues, such as additional requests for information, briefing requests, additional oversight hearings, or requiring additional justification materials in the annual budget request.
▶ 0:54:30The department is happy to work with the committee on developing the best ways to provide Congress with more oversight and authority engagement with the VA. For the record, my written test testimony has been transmitted to the committee, and due to its length, I will not attempt to capture all of its content in the verbal opening statement. I would like to affirm that my colleagues and I are are pleased to be here and work with you and to answer questions you may have regarding the proposed legislation, and to improve the services the veterans have earned.
▶ 0:55:01Of note, two legislative proposals, the acquisition reform and cost assessment act, and the leasing and infrastructure act, represent well-developed efforts that the department supports. Several other proposed legislations have strong intent, but we recommend additional coordination and stakeholder engagement occur. In closing, again, we appreciate the opportunity to discuss these important issues, and remain committed to working with the committee to advance solutions for veterans. Thank you.
▶ 0:55:31Thank you. The written test statement of Mr. Christie will be entered into the hearing record, and we will now proceed to questions, and I will yield myself 5 Mr. Christie, um how would establishing a dedicated veterans leasing fund improve VA's long-term infrastructure planning and physical accountability? Yeah, uh this is the bill again, as I said in my verbal statements.
▶ 0:55:59It This is has a really positive benefit for veterans, and let me walk you through that independent fund for the entire bill in itself. Uh yes, we need to work through some mechanical things, but what it does is it brings it independent authority to the VA. Uh for those who aren't tracking, that is tied to currently with the GSA process. So, there's a bunch of levels of of coordination that must occur.
▶ 0:56:20The bill shortens those coordinations, brings independence, uh dedicated funding, as you mentioned in the question here, that allows a lot more flexibility for the VA and Congress uh to act on those requirements and to get capabilities uh in into veterans' uh hands quicker, faster, uh and just shortens down the whole process a lot, and a lot of efficiency. Also, with that is the risk sharing.
▶ 0:56:44Uh when we do that calculation with that independent fund, uh construction versus a rental calculation, again, brings down risk, increases speed, allows a lot more flexibility for the VA and Congress to actually go from flash to bang on delivering real property solutions. Uh and also part of that bill is the uh congressional oversight. I know a lot of the comments this morning were about the oversight. That bill and that fund allows that.
▶ 0:57:11Uh Congress will be in complete control of that uh allocation of those funds in a single funding uh stream like that. Uh and lastly, I just want to hit one more beautiful point about this, uh the 1-year timelines that's incorporated into the bill. This shortens uh again, flash to bang time in delivery of a critical capability to VA and ultimately veterans. Thank you. Ms.
▶ 0:57:34Devlin, uh if the department believes broader regulatory authority is needed to oversee uh entities providing claims assistance services, wouldn't it be more appropriate for VA to seek explicit uh statutory authority from Congress, rather than continuing to use the Biden era guidance that goes beyond the scope of the existing statutes that are like section 5 5901 in title 38?
▶ 0:58:02Thank you for the question, and we appreciate the opportunity to continue to engage with you on on conversations like this. We don't have I don't have an opinion to render right now on that specific recommendation. Okay. Dr. O'Toole, uh VA operations uh operates one of the largest uh integrated health service systems in the world.
▶ 0:58:23Would establishing a centralized research data system improve oversight by allowing Congress and VA to track research projects, funding, and outcomes more effectively? Uh thank you, Congressman.
▶ 0:58:37And I think we have a lot We have a tremendous research enterprise, and uh much to be proud of, um but it is a um enterprise and effort that can clearly be improved, that can clearly have more transparency associated with it.
▶ 0:58:54Um I think the issues involved um extend beyond the um dynamics of of having a a registry and more available regist- registry, and potentially looking also at our review process, looking at our data management sharing. Um it's something that we clearly would like to work with the committee further on to uh further refine, and we think improve the bill. Mr.
▶ 0:59:19Christie, does VA currently have the ability to independently evaluate the full cost and performance risk of major acquisition programs before they're So, this there's a lot of variability in this assessment and I think this ties back to very specifically the Arca bill where it's called out about having centralized or an enterprise focused to independent verification and validation.
▶ 0:59:45At the moment though, it is very fractured and I'll say not holistically managed for It's in an ad hoc kind of status at the moment, but
▶ 0:59:56So, Arca does a really good job of bringing clarity to that function. So, do you think it is needed the additional statutory structure? Yeah, there's a lot of value to both parties here, Congress and its oversight and the comments that have made this morning, but also additionally at the VA so we have that enterprise perspective on where are these programs, what should they be doing and have they met their gates or have they met their independence validating that they're achieving the capabilities and
▶ 1:00:26the things that they're called out to do. Okay. I've got a few more questions, but we'll submit them for the record so so we can get those answered and ranking member, you're now recognized for 5 Uh thank you, Mr. Chairman. Dr. O'Toole, I'd like to start with you. VA's testimony says it does not support HR 4114, the E-VEST Act quote unquote as written.
▶ 1:00:49And that VA is working with DOD to quote unquote automatically register each transitioning service member rather than enroll them. Are registration and enrollment the same Thank you, Congressman. And first, this is important legislation and I think it underscores the vulnerability and challenges for transitioning veterans. So, we clearly appreciate the intent and and goals to it.
▶ 1:01:19We have registration and enrollment are considered separate and we are currently in the process of developing automatic enrollment processes and capacities which clearly streamline automatic enrollment subsequent to that.
▶ 1:01:35So, what I'm hearing is that enrollment and registration registration and enrollment are not the same thing. My question is does registration alone allow veterans to get VA health care? No No, they do not, sir.
▶ 1:01:49it doesn't. So, if someone is registered in VA's VHA's systems, how many more steps does it take for them to be formally enrolled and able to access care? I I'd have to get back to you with that
▶ 1:02:02back to me.
▶ 1:02:03So, you don't see you see no benefit to removing the administrative burdens for veterans to access their care? Well, sir, the automatic registration does several of the burdens to getting veterans um So, I mean So, you you do concede that there are tremendous benefits to removing these administrative barriers to actually getting health care to our transitioning Yes, sir. Okay. So, you do.
▶ 1:02:31As I noted in VA's testimony, there is a concern about the impact to the ACA tax credits and I think a simple amendment would address this. If I were to make it clear that automatic that auto enrollment doesn't affect access to ACA credits for veterans or their dependents, would this eliminate VA's main objections to the bill? It would definitely eliminate a major concern to it.
▶ 1:02:55The other dynamic that we would just need to be careful of is ensuring that we are able to use the We have other concerns related to the priority groups and associated copays with this and how automatic enrollment would potentially impact the different categories or priority status.
▶ 1:03:15Well, could I get your you know, commitment to work with me in untangling and those those concerns? Yes, absolutely. We we strongly are in favor of seeing something like this go go forward and look forward to working with So, you would like to get to the place where we can automatically enroll, not just register veterans so that transitioning service members so that they can get access to health care. With the concerns that we have noted in our testimony, absolutely, sir. Well, thank you. I'd appreciate that testimony.
▶ 1:03:45Um Dr. O'Toole, HR 676733, the VISN Reform Act of 2025 would set forth in statute that VA can have eight VISNs and limit each VISN to 50 full-time employees. It seems to me this bill isn't this this bill hasn't accounted for how many VISN level positions are already mandated by law or VHA directive. Do you have any sort of estimate on the number of positions?
▶ 1:04:14I don't have Thank you, sir. I do not have the specific number of VISN positions right now within each VISN particularly mandated. Although we I can speak to the fact that we have several programs for instance that do have um mandated roles that are VISN based thinking specifically about our care and
▶ 1:04:34Well, it would seem to me that the chairman's bill is not in alignment with the reorganization VA is already carrying out. How would the rigid limitations within HR 6733 in terms of the number of VISNs and the number of VISN level employees hamper VHA's ability to adapt to the evolving needs of veterans and VHA and the VHA health care system? Well, thank you, sir.
▶ 1:04:59You know, as you know, we are currently undergoing a reorganization effort that includes the number of VISNs as well as the development of HSAs. I would note that when we start when I started in the VA, we had 23 VISNs. We're now down to 18. Yeah.
▶ 1:05:15The actual number of VISNs that are needed and are optimized are driven by regional health care demands, the concentration of veterans in those forces and so forth and we are preferences to be able to have the flexibility in determining the number of VISNs. So, you would rather have the flexibility not something rigidly defined in the chairman's bill. Again, we are
▶ 1:05:41Sir, we are more than happy and encourage the opportunity to work with the committee and with the chairman.
▶ 1:05:47But you just said you would prefer flexibility, not the rigidity. Is that
▶ 1:05:50That that is correct, sir.
▶ 1:05:51So, you're in basically in disagreement with the chairman's bill.
▶ 1:05:56You are. Is that a yes? Um I'm watching you and the chairman and so I'm I'm trying to thread that needle carefully, sir, but uh His bill is rigid. You would prefer flexibility. So, you're in Thank you. I Thank you for your And I thank you for being being able to disagree without being disagreeable. So, with that, General Bergman, you're recognized. Thanks, Mr. Chairman. It's always interesting.
▶ 1:06:24I feel like I'm watching some kind of a you know, uh It's not a sitcom, but it's some lawyer show sometimes where you know, which one of you is William Just remember Shatner Shatner led led Star Trek. You certainly are. And I am not. Okay, enough.
▶ 1:06:55Mr. Christie. I commend the VA Prosthetic and Sensory Aids Service Office for working to implement a continuous product add cycle. But I'd like to make it a permanent policy, not a goal.
▶ 1:07:14So, cuz improved technology improves patient outcomes and if we don't have it at the rate of change of I think the VA I know the VA can be more responsive to what's out there in the marketplace that is is viable.
▶ 1:07:30So, what is the Department's objection, if any, to codifying a minimum of two annual submission windows for FDA cleared prosthetics and medical implants with a requirement to move to a continuous product add cycle within 3 years? General Bergman, thank you.
▶ 1:07:53That uh Concept-wise, no problems there and I think a lot of this was patterned off of the great work in the pharmacy uh space where we have that almost identical formulary add. You have the group, you have the formulary um group that comes together and and does that multiple times a year. There's goodness in that, right? Bringing a capability to the VA that can be used in veteran care. The faster we do it with the best products, there's good there.
▶ 1:08:21The one caution I would just put on the part of the prosthetics part of the contracting and accountability act is resources, right? So, there is going to require some resources to formalize that process and to execute that process. Uh there are some things in the front part of the prosthetics called out in that bill about, you know, directing a very uh pinpointed way of executing the contracts, I e.
▶ 1:08:49firm fixed price, and it does take away some of the flexibilities that are already in 8123. But conceptually, this is a good thing. Bring products on, make sure providers have access to the best and greatest things to take care of veterans. So, conceptually, there's goodness in that. It's mechanically, how do we work it out? And I think maybe some more conversation on that.
▶ 1:09:09And a lot of prosthetics have mechanics in them. So, the and the and the rate of improvement of prosthetics mechanics should motivate the VA to work through the mechanics of the of the evaluation and approval process. So, Uh, Mr. Christie, after a surgical procedure, the VA requires multiple purchase orders. One is issued by the local logistics office for certain items used in the procedure. One is issued by the local prosthetics office.
▶ 1:09:39This is duplicative, uh, inefficient, and is not consistent with good health system practices. My bill, VA Contracting and Procurement Act, does not seek to restrict how items are procured, but rather improve the back end business process on how the VA processes and pays the purchase orders.
▶ 1:10:00Will the department commit to working towards a single purchase order, processed and paid by the central prosthetic and sensory aids service office, and shift all prosthetics procedure purchasing to the local prosthetics office? Again, concept, this we want everyone to do this. We don't We want people to get paid immediately. We don't want to handle things twice. We don't want to have companies, we don't want them not getting paid.
▶ 1:10:28I I think mechanically and somewhat within the financial payment rules, we need to work through. Conceptually though, on board with this to make it more efficient for the prosthetics team and the acquisition team to clear the waves for a much more simpler process. Thank you.
▶ 1:10:45And And in the end, if if the VA moves forward with I would suggest that that that veteran receiving that prosthetic will have a better quality of life more quickly, but also the companies doing the research, development, sales of, maintenance of, all of those things will be more motivated to extend extra effort to the VA. So, uh, with that, uh, Mr. Chairman, I yield back.
▶ 1:11:18Dr. Conway, you are recognized for 5 Uh, thank you, Mr. Chairman. Um, and uh, and thank you, uh, members of the administration and VA for presenting yourself to us today.
▶ 1:11:46Uh, in 2016, it's estimated that uh, some uh, veterans are serving time in state or federal prison. uh, they combat exposure, uh, I'm sorry, combat exposure and associated mental uh, and physical health problems such as post-traumatic stress disorder, PTSD, traumatic brain injuries, TBI, mood disorders, and substance use disorders are associated with greatly likelihood of involvement with the criminal justice system among veterans.
▶ 1:12:15A study suggests that PTSD is 61% more likely uh, to be involved uh, veterans with this disorder are 61% more likely to be involved with the criminal criminal justice system than those without PTSD, and 59% are more likely to be arrested with violent offenses. Dr. Artour, what mental health services does the VA currently provide to veterans where they have traumatic brain injuries, PTSD, or have experienced military sexual trauma?
▶ 1:12:42And does the VA provide those same services to justice-involved veterans who find themselves in the criminal justice Thank Thank you, Congressman. And um, thank you also for this bill. It's an important dynamic, and you're absolutely correct in highlighting uh, the mental health issues and concerns uh, when veterans are incarcerated.
▶ 1:13:03Uh, by statute and by authority, the provision of medical and mental health care when somebody is incarcerated uh, falls to the Bureau of Prisons um, in terms of their care. And so, by statute, we as a VA, are not providing care to somebody during their active incarceration.
▶ 1:13:23We do obviously work closely uh, through our veteran treatment courts and through our veteran justice coordinators to try to facilitate facilitate either diversion or post-incarceration ensuring that they're plugged into care as quickly as possible. But, while incarcerated, we do not provide that care. Uh, do you think the VA should provide that care?
▶ 1:13:44Well, you know, I think that the challenge point to it is um, whether that care is integrated to whether that mental health care is integrated in with other care needs they have and not creating fragmentation and isolation.
▶ 1:14:01And that that quite honestly is the uh, a driving concern we have with the legislation is that um, uh, focus specifically on mental health treatment, it does create um, the risk for isol- risk for fragmenting that care and not coordinating it um, with the rest of the health care needs that that veteran may be having.
▶ 1:14:21Well, coordinating the care is obviously very important, and uh, the physicians and other service providers who would be providing the services uh, through the VA, um, do that in their in their regular course of how they operate in in caring for uh, patients. Um, as as this pilot program is set up as directed by this bill, um, uh, that uh, concern that you have will certainly be addressed because that is the professional uh, that's what professionals do when they're providing services.
▶ 1:14:49And um, uh, and so I would just that's my response to what you said, but I appreciate uh, what you have brought uh, in terms of your thought about the bill at this time. And of course, we're at the start of a process um, to be able to produce a legislative project product uh, that will serve those who are critically in need uh, so that we can get them back on their feet, back home, and and integrated in uh, a society.
▶ 1:15:16uh, the telehealth um, program really uh, veterans to access services, as you know, remotely. People are uh, housed uh, under the bill, they have to be housed in in separate areas within the prison if that occurs. And we certainly want to address uh, those veterans whether they're in urban or uh, rural areas to receive the care that they need.
▶ 1:15:38Um, but I look forward to working with you uh, on fixing this bill up, getting it as well or as right as we possibly can to make sure that we're not leaving veterans be- behind, and that we indeed we can do better than that re-integrating them back uh, in uh, to their family life, into the life of the community uh, so that they can achieve their goals. Many of which will be likely continued service uh, to our fellow countrymen. So, thank you uh, for presenting yourself here today and answering these questions. Thank you, Congressman.
▶ 1:16:08We look forward to working with you on that. Thank you, Mr. Representative Self, you're recognized for 5 minutes. Uh, thank you, Chairman. Um, I'm sorry I wasn't here to make my comments, but uh, Ms. Devlin, you and I have both read the the bill, so I'll go directly to questions on HR uh, 6764, the Veterans Affairs Advisory Committee Oversight I understand that you have uh, concerns with it.
▶ 1:16:36Uh, so let's start with do you do periodic reviews of the committees that are operating uh, whether or not they should continue, whether you need to reformat them, uh, or whether they should be terminated. Do you do periodic reviews? Thank you for that question. They are set forth in statute, so we do reviews of their work and their recommendations, and we do provide them with feedback. Um, but any recommendations to Congress on changing statute would go through the budgetary process.
▶ 1:17:05Uh, have When's the last time you made a recommendation to terminate one of the many committees? Advisory committees.
▶ 1:17:12I'd have to get back to you, sir, on that. I don't
▶ 1:17:13Please Please Please do. Uh, so how many of those authorized under Title 38 have uh, not met regularly or produced the reports that they are supposed to? I don't manage all of the committees. I will tell you the ones under my purview have met regularly and produced reports with recommendations to the secretary. Okay.
▶ 1:17:35So, if you think the the proposal is too broad, the proposed act is too uh, what specific subject areas do you think could reasonably be addressed within the broader structure outlined in this bill? How would you What are your recommended changes? Thank you for that question.
▶ 1:17:56First of all, I'd like to say we always appreciate looking at ways to gain efficiencies in our processes, and that would include things like our advisory Uh, some of the some of the issues or concerns that we have with the bill is some specific definitions, for example, around what do we mean when we're talking about marginalized veterans. Um, a little bit more specificity around that. There were some elimination of things that we thought were still important to keep. For example, the specific needs of combat veterans.
▶ 1:18:24That is something that our Disability Committee looks at now, and this this merging of of committees, committee infrastructure, eliminates some important things like that, which we can work with you on your and your staff on to make sure we don't lose the intent of some of these specific things. Um, for example, one of the um, committees is designed to provide feedback on vocational rehabilitation, but it doesn't set forth any individuals with that specific expertise.
▶ 1:18:49We also had a concern about the overlap between the existing committee's sunset date and the new committee's start date. It wasn't really clear whether there would be overlap or whether we would have time to implement the new committees and close out the old committees without there being some overlap. Uh, so all of that sounds like we could work together to make this new structure work. Yes, sir,
▶ 1:19:11your reading? Yes, sir. We would appreciate the ability to do that. Okay. Then, you raised a concern about uh, less subject matter expertise. Could you talk to me more about that? Yes, so some of the the committees as structured now are very specialized. So we invite people with subject matter expertise expertise in specific areas such as combat, such as women veterans, um such as tribal affairs.
▶ 1:19:37And and to try to encompass all of that area of expertise into a smaller group with fewer people can present some I'm not sure I understand that because you can invite in whoever you choose to, but I I I accept the premise. if we work together to do this, how often should you report to Congress? Because these advisory committees are important to reaching those efficiencies.
▶ 1:20:04I I think they're important to reaching those efficiencies that you spoke about. Uh yes, sir. We would invite an opportunity to discuss that in terms of reporting to Congress. Um I'd have to go back and look at what the statute currently says, but we welcome opportunities to share and be transparent and give you information about what recommendations we're getting from the committees and our responses to those recommendations, including which we seek to incorporate and implement and which perhaps we can't because they require statutory changes.
▶ 1:20:32Okay, so I'm going to be submitting these for the record and I appreciate your responses uh because we do need to get this right. With that, Mr. Chairman, I yield back. Dr. Morrison, you're recognized for 5 Thank you, Mr. Chair.
▶ 1:20:50It is my sincere intention for my bill the VA Safe Care Act to be a complementary strengthening effort that integrates updates and best practices in the protocol VA currently pursues when a veteran presents to their facilities following an acute sexual assault. As I shared in my opening statement, I'm eager to hear VA's more detailed perspective on this proposal. In that spirit, uh Dr.
▶ 1:21:11O'Toole, can you walk me through the current policies that govern VA's response to a veteran seeking care following an acute sexual thank you, Congresswoman. And first, thank you also for introducing this and your advocacy on it. It's extremely important. I don't have the specific details to that. I'd have to take it for the record.
▶ 1:21:32And and of note, um our uh congressional team is still reviewing the legislation and we'll have a formal opinion as well to be able to forward back to uh to the committee um uh following our review. Okay, thank you. Are you able to share when the protocols were last updated? I'll have to uh we'll have to get back to you on that. Unfortunately, I just don't know. And can you give us just a general sense of when you might be able to get back to us? I would anticipate within the next few weeks, ma'am. Okay, thank you.
▶ 1:22:03Um in my district, I have a veterans advisory council made up of vets and community leaders who help keep me up to date on the most important issues facing our veterans in Minnesota. We meet regularly and one issue that always seems to come up is claim sharks. I strongly support Representative Pappas's bill the Guard VA Benefits Act, which would reinstate penalties for predatory actors who charge unauthorized fees to veterans filing their disabilities claims.
▶ 1:22:29Um as we kick off this process to begin consideration of a comprehensive VA reauthorization bill, I hope to reiterate my support for this bipartisan legislation and hope it gets strong consideration by this Ms. Dublin, VA's testimony states that it is conducting a comprehensive review of its claims accreditation regime and will be able to provide more information on its views about the bill once it is complete.
▶ 1:22:55Is the proliferation of unaccredited claims consultants part of the review VA is conducting? Thank you for the question. We are reviewing everything top to bottom on our process of accrediting agents. I will say that um there was a GAO report in March of 2025 and we've engaged with MITRE to help us perform this assessment and we will have more information once we've concluded the assessment. So is is it part of this review?
▶ 1:23:24We're reviewing everything within our authorities to operate in terms of accrediting agents, making sure that we're providing timely service in the accreditation process, that we're doing that we're doing right by veterans in that process of accreditation.
▶ 1:23:38I appreciate that. So there's not necessarily a specific review of this claim shark problem. The review is comprehensive. It is not specific to that one issue. I have uh also seen both as a physician and a legislator the impact of VHA's pursuit of its mission to support research to benefit veterans and the public. I've met dozens of constituents personally impacted by the critical cutting-edge research that VA has pioneered.
▶ 1:24:07They've emphasized that the VA impact and their leadership in medical research that changes lives. Earlier, I spoke to the importance of my proposal the VA Safe Care Act being a tailored approach well suited to integrating into the existing infrastructure of VA's resources and support for military sexual trauma. As a physician, I'm aware of just how important it is for policy and practice changes to consider existing realities and as it relates to VA authorities.
▶ 1:24:32In your testimony, you raised concerns about proposals that do not align or would conflict with existing authorities, appropriations law, and operational requirements. Um so for HR uh 6583, the VA Research Reform Act of 2025, can you expand on what existing VA authorities and operational requirements this bill would conflict with? Holding up my notes here on it. Excuse me, ma'am.
▶ 1:25:00The um VA supports the overarching intent. One of the challenges that we have or that we see with the legislation is related to overlapping um requirements uh that we follow related to the Common Rule Act as well as HHS registrations and making sure that the would not create any confusion.
▶ 1:25:25You know, as you know, it's uh you know, VA does a tremendous job in the research enterprise. It's something I'm very proud of and I've participated in. VA publishes almost 13,000 journal articles a year based on this research and has been cutting-edge as you noted. We also know though, based on NIH analyses and others, it takes about 17 years for something to go from research to practice.
▶ 1:25:51And we can always do better and we can be more transparent and we can do everything in our power to facilitate it. So again, we would like to work with you. We would like to work with the committee on how we can potentially improve and not create, you know, any potential roadblocks or obstacles to being able to do this important work. Thank you, Dr. O'Toole. I see that my time has expired, so I yield back. Thank you. Mr. Ciscomani, you're recognized for 5 Thank you, Mr. Chairman.
▶ 1:26:19Um This is what I was trying to get to earlier today. Now I'm in the right setting here in the right time. So Mr. Christie, we'll start with you. And I think you um remember the remarks that I just said a little bit about about a bit ago about my bill HR 6843. Uh the Establishing the Veterans Economic Opportunity and Transition Administration Act of 2025.
▶ 1:26:41This is um uh related to many VA programs uh to related to employment, education, and transition assistance that are spread across multiple offices, making them difficult to navigate. So we want to make sure that we tackle that issue and this uh this bill does exactly that. So let me let me ask you regarding that and HR 6843 would create a more unified structure within the VA for transition and economic opportunity programs.
▶ 1:27:09From uh an acquisition and operations standpoint, what challenges or do you foresee in standing up uh this this type of centralized administration? So I think we do want to make sure Margarita gets a chance in here, but you put the acquisition spin on it. So this is something I love to talk about.
▶ 1:27:29Uh if we also uh Representative Barr's introduction to ARCA, a lot of the things if those pass in there and if that were to happen, we're moving to an enterprise approach on everything. So regardless of where the mission sits sits, from an acquisition layer and acquisition strategy, it's irrelevant if there's 10 organizations or two organizations from an acquisition perspective. But I do need to make sure Margarita weighs in on what I would call the operational impact.
▶ 1:27:59But uh acquisition and if we get ARCA passed and if that were to pass, uh we're able to execute that from an enterprise. Thank you. Go ahead, Ms. Dublin. Thank you for the question. I would say operationally, it is um incredibly challenging and we want to make sure we don't negatively impact veterans. But take pulling apart what is currently an integrated regional office operation, for example, where every one of our 57 regional offices has disability compensation and VR&E.
▶ 1:28:27Those are two that are in every office and then some have special missions. We would now have to divide the reporting structure up. We would have to create additional leadership structure. You couldn't have one director report to two different under secretaries. Um that's just one of the pieces.
▶ 1:28:42Also, pulling apart all of the system integrations that we've built between disability compensation and VR&E and LGY, all of those eligibilities are so intertwined that we've done so much work to integrate those systems to create less bottlenecks, less complications in the process for veterans and we would be placing those those integrated systems at risk. Mhm.
▶ 1:29:06Can you elaborate a little bit on that uh looking ahead in in the the reforms that you're talking about here at the bill and then help ensure for are not uh are set up not just for short-term success, but for for the long-term economic mobility as well. I yes, sir. Thank you for that question as well.
▶ 1:29:26We are actually working with the Department of Labor and other entities to make sure from the long-term success standpoint that we equip our veterans who are pursuing education through GI Bill or pursuing their VRNE benefits with information about the jobs that are in highest demand. Right now, our country is in need of specific types of skilled labor. Our country is in need of veterans continuing to serve in occupations like defense industrial base occupations.
▶ 1:29:54We need to make sure our counselors and our veterans are equipped with that knowledge so that they know It also intersects with things like geography where veterans live and where those occupations are. So, we want to make sure that they're training and using their benefits for occupations that will get them a positive sustaining occupational income and and that meet demand of our country right now.
▶ 1:30:16That's highly important for for me for my district. I have roughly about 80,000 in my district. It's a it's a high veteran population and and I So, this is one of the most important things that I can do here in Congress. So, thank you for that as they transition or retire, it's important I have two military bases in the district. Mr. O'Toole, we'll close with you from your perspective. How important is it that transition programs account for our veterans physical and mental health when determining successful outcomes, too?
▶ 1:30:47Thank you, sir. It's extremely important, obviously, and we need to make sure that no veteran is being left behind in that to care and that we are able to connect them to the appropriate health care services as quickly as we can and as seamlessly as we can. Thank you. That's highly important for us as well. I have asked a number of my district as well as rural and that that you know, access at any geographic location is important to Mr.
▶ 1:31:16Chairman, I yield back. One second. You're welcome. You know, time flies. So, is the second gone? Mr. McGarvey, you're recognized for 5 minutes. Thank you, Mr. Chairman. Thank you all very much for being here today and for offering your feedback on my bill, the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act. I'd like to dig into a few points that the VA has raised.
▶ 1:31:42I appreciate you guys pointing out that in the VA the attrition rates have improved between fiscal years 19 and 24. That is something every single person appears probably happy to hear. But, I also believe the picture you painted is a little more rosy and a little less reality than what's going on. So, I have a question. Did that statistic include the attorneys who were in their probationary period when they left BVA? Ms. Devlin, I know you don't have a BVA witness, but ask you that question.
▶ 1:32:10Thank you for the question and no, we don't have a Board of Veterans Appeals witness here and I'm sorry, I don't have that information. Okay. You know, I would like to dig into that with you all soon. Those Those numbers are in the written testimony you guys provided here today. So, I want to figure out how you came up with those numbers and how they're not reflecting what we're hearing and what we're seeing on this committee.
▶ 1:32:34I've seen recent OPM data right now that shows BVA's total staffing numbers went from 1,468 employees in January of 2025 to 1,303 in January of 2026. Decision-making attorneys, that's who gets the veterans their benefits. They make up more than 70% of the BVA staff. So, when we see reductions like that, it is clear that dozens and dozens of attorneys left the BVA in 2025. I've heard even more reports that attorneys have left since January.
▶ 1:33:05So, what are the current staffing levels at BVA and is it now under 1,300? Thank you again for the question and we're happy to work with you on on your bill and also on the outcomes that we want for veterans. The outcomes we want for veterans is that they get decisions quickly, that they get the benefits that they've earned as quickly as possible. I know that the Secretary is is is watching over all of all of the VA, including the Board of Veterans Appeals and that we're looking at ways to make sure that those decisions get made more timely.
▶ 1:33:33I am not the expert on the board and I don't have all of the staffing information that you're looking for, but we are definitely happy to work with you and your staff to to dig into this a little bit more. When do you think I could get that information? I'll have to take that back and and we can answer for the record. Okay. And will I get that information? Can can you put that on the record?
▶ 1:33:54Yes, we can take it for the record and send it in specifically. And and soon? We will do the best we can. Okay. I mean, because this is every day we wait here is a day that we are putting veterans off from getting their benefits. That's that's why this matters. And I do think we share that same goal. I I really do. Now, you talked a little bit about the numbers and that sort of thing and and how you're working on it.
▶ 1:34:17I understand But, the testimony makes it sound like creating this GS-15 position at BVA prevents some insurmountable hurdle and and to me that claim rings hollow and here's why it rings hollow. Setting aside the fact and this is no small fact, but setting aside the fact that Congress has final say on personnel matters regardless of OPM policy, the VA already has non-supervisory GS-15 attorneys in the Office of General Counsel. They're there.
▶ 1:34:44So, we know that it works because some of the attorneys are leaving BVA and going to that spot because they can get promoted and they can get paid more. I said in my opening that this bill starts from a simple premise. You said it. Veterans should get decisions more quickly. They should set higher quality bars to get those higher quality decisions and I think the Secretary does agree with at least the first part and that's why he imposed higher production quotas for the BVA attorneys after joining the department.
▶ 1:35:13But, you don't get faster decisions or higher quality decisions just by raising quotas and especially not if those quotas mean that board attorneys who are already stretched thin are looking for somewhere else in the federal government to go work. So, to me this is not just This is more than than just a quota. This is getting the veterans what they need. So, how do you get not just faster decisions, but faster and better decisions?
▶ 1:35:39That's what we're looking for here and you do that by making sure your most experienced and most skilled employees stick around. A chance at a promotion and a $5,000 raise is a way to do that. We know those promotions to GS-15 matters to VA attorneys because the best GS-14s at BVA consistently leave the BVA for those GS-15 slots at the Office of General Counsel within the VA. The Board of Veterans Appeals is not a big office. We are talking about the smallest part of the smallest part of the VA.
▶ 1:36:10A small raise for a few dozen hard-working public servants, the very best we have with the most experience so that our veterans can have the peace of mind that they will get every single benefit they have earned and they is what we should do. This is not the place to pinch pennies because we shouldn't be nickel and diming our veterans. That's what we have to do. Mr. Chairman, I yield back. Um Representative Lee, you're recognized for 5 minutes. Thank you, Chairman.
▶ 1:36:40Well, Dr. O'Toole, Ms. Devlin and Mr. Christie, I want to thank you for being here today as we're examining today's Look, as the ranking member of oversight and investigations for this committee, I take my responsibility of carefully weighing the impacts of every single piece of legislation very seriously, especially as we're talking about advancing in out of committee and certainly with the hope that it's in fact going to help and benefit our And so, as the Secretary of VA and the administration double down on their promise to reduce the federal workforce
▶ 1:37:10and to begin dismantling the VA, it really feels hypocritical for me that we're discussing bills that attempt to address workforce issues while we're seeing the dismantling of the VA. I want to talk to you specifically about one bill, HR 6740.
▶ 1:37:26It's called the VA Transparency and Reform of the Upper Senior Tenure Trust And it authorizes the Secretary to directly set pay for all senior executive positions across the agency within the limits of the federal executive schedule and the limits delineated in Title 5.
▶ 1:37:45Now, the reason I wanted to bring this bill up is because considering that Secretary Collins' track record, the testimony he has brought into this committee and the data itself from the VA, I'm not confident that he would wield the authority consistently and I'm concerned about the precedent this would set for our civil service Ms.
▶ 1:38:06Devlin, I hear my colleagues' concerns that this bill is meant to try to help with recruitment challenges and to help address some of these pay My question to you is, if implemented, how do you see the Trust Act helping the recruitment of civil service employees specifically in the rural areas? Thank you for that question. We don't have a witness here today, unfortunately, from our human resources, which would be probably the better person to answer that question. Got it.
▶ 1:38:36So, I got to make sure that some of these questions are on the record, so I'm going to go through a number of them to follow up, but but these are some of those questions I have Ms. Devlin, over the past year we've seen almost a revolving door of senior leaders in VA programs and I am concerned that this in fact is not addressing the recruitment issues we have, but also the issues of a number of our leadership staff within the VA that are in fact leaving. So, I want to make sure that I have another question on the record.
▶ 1:39:05How does removing pay stability for some of these leaders create better outcomes for veterans specifically if in fact you can in fact answer this, what material changes would our veterans see with this Thank you for the question. First of all, I just want to say thank you for your interest in recruitment of senior leaders. It's it's very important to the administration that we have good leaders in place to run our programs for Um pay is of course one factor.
▶ 1:39:32I think the mission drives typically who comes to VA to work and why they work there and why they take on senior leadership positions. These jobs are hard and they're meaningful. Um so, pay is certainly part of it. I think we could work with you on some technical amendments to the bill. Um for example, it talks about senior leaders, but it's unclear in some places if we're talking just the senior executive service or some of our regional offices, for example, have GS-15 leaders because of their size.
▶ 1:40:00So, we want to make sure that there's some some clarity in some of the aspects of the bill. I appreciate that, Ms. Devlin. And look, I think I absolutely want to work with you on some of aspects of this bill. Our policies have to be data-driven. I think that's how we're able to ensure uh that the agencies are using all of the aggregate or annual SES performance award data in order to ensure that we are creating uh the right systems for this recruitment.
▶ 1:40:25And and that includes for me being able to look at a decade's worth of data that we don't have around some of the performance awards. So, one of the things that I would want to ask um is if we could be working together in getting to the committee some of this aggregate and annual SES performance information since FY 2016 to the committee before we advance the reforms on SES pay.
▶ 1:40:48So, let me ask you, would you be willing to commit to providing this data to the committee as we're working through this bill before we advance this reform? Yes, ma'am. In fact, I believe we already report to Congress all of our um performance award bonuses for senior executives in the VA. What we don't have is the aggregate information of the annual SES performance award. We don't have that for the last 10 years. It would be helpful to get that. So, I do appreciate you getting that to us.
▶ 1:41:16Um so, let me wrap up and say to you I I think it's important that we're having this conversation. I actually look forward to this data and that we use every single piece of data as we're looking at identifying recruitment opportunities to be able to bring more employees into the VA in in these leadership positions. But, I also want to note that it's also important to retain the ones we have and to ensure that we're doing everything we can so that there isn't hostility, there isn't tensions because I do agree with you, Ms. Devlin.
▶ 1:41:42Leader uh senior leadership but all staff that come to work at the VA come in because they care deeply about the mission and want to be able to retain them. So, with that, I look forward to working with you and Chairman I yield back. Dr. Dexter, you're recognized for 5 minutes as we change seats here. Thank you, Mr. Chair. And thank you, Mr. Cristy, Ms. Devlin, and Dr. O'Toole for being here today and for your work on behalf of our veterans.
▶ 1:42:12Um as far as the "Every Veteran Housed" bill goes, I do want to take the opportunity to revisit that with you. Um I recognize the technical edits you raised and and we will work to square them with the significant technical assistance this bill had already received from the VA to ensure we had met our stated goals. We are aligned, I have to assume, on the urgency of ending veteran houselessness.
▶ 1:42:38Um I appreciate your willingness to explore all options and to stay focused on solutions that meet the scale of the Um when this legislation came before the Economic Opportunity Subcommittee in June, the VA raised similar concerns around coordination review and the resources required to move forward. Those are real considerations and and they are solvable. So, I want to be direct, Dr. O'Toole.
▶ 1:43:03If we share the commitment to eliminate veteran homelessness, how much time will it take to complete this assessment and move those changes forward? Well, first, Congresswoman, thank you for advancing this legislation.
▶ 1:43:16It is the priority of um our agency um to end veteran homelessness and having worked in this space for all of my career, I uh am thrilled to see, you know, this legislation and and others moving forward as as important venues and avenues. I would just say though, as you know um yourself and your own background, you know, it's not just housing.
▶ 1:43:42It's also making sure that we're providing the wrap-around services, the clinical services that veterans need both to be able to expedite their um leaving homelessness, but also how do we keep them housed. And uh so, we're very much looking forward to working with you further on this and please view this as a priority for us. No, I appreciate that. And and as I stated in my opening comments, like the the eligibility is in conflict contradiction in some of those things for exactly those reasons.
▶ 1:44:12So, we just want to get it in alignment so we can deliver the services. And if the barrier is funding, which I did not hear you say, but it is always a barrier here, let us name it and work together to meet it. Um what resources do you need to assess what is needed to implement this bill? I I um I know you often hear from us, we'll take it for the record. I'm not entirely sure.
▶ 1:44:36Obviously, we need to be conducting further analyses um as well as ensuring there are not any second or third order consequences to this that might um not help a veteran or create further fragmentation in their care and services. So, um you know, again, I just want to make our commitment very clear that we want to work with you, your staff, and the committee to really get uh this bill moving forward and being able to get the best legislation forward for our veterans who aren't housed.
▶ 1:45:06I appreciate that. And I I'm sure that the term analysis paralysis is not new to you and and I do worry that sometimes we study things and rather than just trying to see what works. And I I do want to make sure that we're centering the veterans as we move things forward. Um I do want to take just a minute to ask some questions about the VA National Formulary Act of 2025, which was brought forward. Um Dr. O'Toole, the VA has a national formulary for over 30 years. It was a joy to practice with.
▶ 1:45:36Um GAO has found that the VA pays on average about 54% less than Medicare Part D for the drugs it purchases. In your testimony, VA states Dr. Miller-Meeks's bill, H.R. 6580, is unnecessary and could worsen care outcomes. Dr. O'Toole O'Toole, from your perspective, is VA currently doing what this bill aims to achieve? Why or why not? Well, I think we are. And uh first, thank you for the question.
▶ 1:46:04And this is an important bill and I think the rationale and basis for trying to codify some of the things that we already have in place um makes a lot of sense. Um I think the concerns we have, particularly in relation to procurement of medications, um and being able to best use the taxpayer dollars in acquiring medications is one where we do have concerns that there may be uh we would lose some of the flexibilities in that space.
▶ 1:46:34But, again, we very much um welcome the opportunity to work with the committee to be able to um advance the best bill forward. We appreciate the importance of codifying what needs to be codified and providing transparency and clearly share the intent. Um but, with the concerns that we noted in our testimony. I appreciate that. And I certainly also know that um science changes, formularies need to be able to uh adapt.
▶ 1:47:02Um I'm worried um that putting things in statute, we here don't do things very quickly and and sometimes we need our clinicians to be able to um pivot more quickly than Congress may allow by having too many oversight um challenges there. Um I know uh I'm already over. So, thank you, Mr. Chair. I yield back. The gentlewoman yields back. Representative Baszinski, uh who also won her primary last night. Thank you.
▶ 1:47:32And you're recognized for 5 minutes.
▶ 1:47:34Thank you. It's very kind of you. Thank you. I appreciate it. And thank you to our ranking member. And I'm hoping to just use my time to speak to my two bills um that I have before the committee. Um first is the Safe Steps Safe Steps for uh Veterans Act and a draft authorization bill for the electronic health record modernization program at the Department of Veterans The Safe Steps for Veterans Act is a bipartisan, bicameral bill that will help protect older veterans from avoidable and often devastating falls by strengthening
▶ 1:48:04falls prevention across the VA. Falls are one of the leading causes of injury for older adults and veterans often face even greater risk because they are more likely to live with chronic conditions and service-connected injuries.
▶ 1:48:19This bill will establish an office of falls prevention within the Veterans Health Administration, creating a dedicated coordinator to lead these efforts, improve screening for veterans at risk of falling, and better connect home modification programs with evidence-based falls prevention services. I want to thank my colleagues on the committee, General Bergman and Congresswoman Kiggans, as well as Representatives Frank Frankel and Bilirakis for bipart for their bipartisan support of this bill.
▶ 1:48:49My other bill that I wanted to highlight would reauthorize or would authorize, excuse me, the VA's EHRM program, which actually has never been authorized by the committee. It has been almost 8 years since the first Trump administration imposed this $10 billion their sole source contract on the department. In that time, VA has only managed to deploy the system at six hospitals.
▶ 1:49:13The program has been plagued by delays, patient safety concerns, and dramatic impacts on veterans access to care, among other issues. It's time that we establish guardrails and expectations for the department um and on this program itself. My bill would require that the department create a baseline of clinical and business workflows, as well as technical requirements, to ensure that the standardization of VA practices and systems.
▶ 1:49:41No longer will they be able to say, "If you seen one VA, you've seen all VAs." Um it would also require the VA establish quality metrics for the program to be based on VA's strategic analytics for improvement and learning sale value model. It also improves public and congressional reporting and requires the VA create a plan for sunsetting EHRM if necessary.
▶ 1:50:08Finally, my bill would require that the department perform an independent verification and validation of all major IT projects and systems, including the EHRM. The bill would also put conditions on which firms could participate in these contracts to ensure quality and prevent conflicts of interest. The IV&V report must be available must be made available to the committees on Veterans Affairs of the House and the Senate.
▶ 1:50:35I hope all my colleagues will support this critical piece of oversight legislation. Thank you, Mr. Chairman, I yield back. The woman yields back. We're going to start in our second round of questions for the ones that are here. General Burton, are you Okay, thank you, Mr. Chairman. So, I'm
▶ 1:51:00trying to you can't the old saying, uh can't tell the players without a program. It's tough to tell who's on the field if you don't have a program that states it. So, you kind of guess sometimes. So, this is an effort uh to begin to understand who's on the field and who's in the game here. Um Ms. Devlin, under current law accredited agents and attorneys generally cannot charge a fee for helping with an initial claim. Is that correct?
▶ 1:51:30Yes. Yes, sir. Okay. So, isn't it true that the current framework effectively blocks many private companies that assist veterans with initial claims from becoming accredited, even if they want to operate in a regulated environment if they can't be involved with an initial claim? Thank you for the question.
▶ 1:51:59I'm not sure why that would prevent them from becoming accredited if they met all of the accreditation standards and could assist veterans with their appeals or supplemental claims.
▶ 1:52:08So, but it um so they can become accredited, but they can't they got to come in after something didn't go right for the veteran in the initial cuz if they if they an initial claim was you know there was no reason to appeal does it bring in the does it put the cart in front of the horse?
▶ 1:52:36So, thank you for the question and this is um you know, something we can certainly talk more about. Uh the accredited agents can if if they do not charge a fee can help veterans with their initial claims. There are many organizations that do so. Okay.
▶ 1:52:51Well, in if a veteran is you know, they're they're trying to go through uh options are available to them for an initial claim is it is it are we helping the veterans eliminating certain parts of the marketplace from being able to help those veterans initially?
▶ 1:53:16I I'm glad you asked what we're doing to help veterans in this regard because one of the things we should be thinking about is how do we simplify the claims process so that it's not so complicated, so that it's not so hard. And we are working on doing that. We've got some initiatives that we're working on to simplify the application process for disability uh compensation to just make it easier.
▶ 1:53:35So, if you simplify it and thank you for trying to do that because you know, if one if one step is good, then two steps must be better, you know, in any in any process. We know how that wouldn't it make sense to to allow folks who are want to make it better along with the VA for the the veterans to to help in the initial process to help the VA
▶ 1:54:05cuz in um I lost my tablet here, but in the your response to a question, you mentioned that veterans need help making civilian career choices. I've kind of switched gears here. Okay. The the okay.
▶ 1:54:24And who is best qualified to help veterans make those next career People who work in the in the in an ecosystem, if you will that may or may not be uh aware of all the career choices and how the veteran might navigate that system or would we want to have a and in the in the military, we have career counselors. Okay?
▶ 1:54:52And in most cases, their their first goal is to try to get the the Marine or soldier, sailor, airman, or whoever to reenlist. Once they they fail you know, the the person says, "No, I've I've served honorably. I'm ready to move on. Uh I want to get out, but I the we need to have the best people, regardless of background, available to help veterans on the front end.
▶ 1:55:20Cuz the Veterans Administration is a is an entity that is not really connected necessarily to the everyday civilian market as it changes. I just I I think there's options here going forward that enable better outcomes, initial outcomes for veterans by broadening those who can help them. And with that, Mr. Chairman, I yield back. Gentleman yields back. Ranking member, you're recognized for your second round of questions. Thank you, Mr. Chairman. Dr.
▶ 1:55:50O'Toole you're the executive executive sponsor of Project Safe Harbor, an initiative to develop a guardianship model at VA for veterans experiencing homelessness. Is that correct? Yes, sir. Thank you.
▶ 1:56:07Um isn't it true that Project Safe Harbor is an initiative that was developed to align with the president's executive order on quote ending crime and disorder on America's streets, end quote, which essentially criminalizes homelessness? No, sir. That is not correct. Oh.
▶ 1:56:26this document here titled Safe Harbor Guardianship Pilot Program Placement says that Project Harbor is a high-priority pilot program aligned with the executive order ending crime and disorder on America's streets. Further, this document says that this program is targeting veterans at risk or experiencing homelessness.
▶ 1:56:52Now, the purpose of this program is to seek guardianship of these of of these Dr. O'Toole, you told congressional that VA lacks the legislative authority to petition state courts for guardianship of veterans. Is that That is correct, sir. Okay. And in fact, VA submitted to Congress a proposal to provide that authority. Correct?
▶ 1:57:18Yes, I'm a little troubled by this next thing that the VA did. Isn't it true that you decided to not pursue seeking that authority, to go around Congress and get Attorney General Pam Bondi to sign off on a plan to deputize VA's own attorneys to go into state courts and seek guardianship of veterans?
▶ 1:57:43Well, sir, I I appreciate the question and I appreciate the graphics and um the issue um that we are trying to address with this and if there was a preliminary document, internal document that misrepresented that, I apologize, but it was an internal document. The issue that we are trying to address, sir
▶ 1:58:06just address my question, sir, about whether or not you've abandoned the effort to seek authorization from Congress for this and instead went and entered into urged the secretary to enter into an MOU with Secretary Bondi? I I'm going to need to defer to my OGC colleagues on that and that strategic approach, sir.
▶ 1:58:30So, I would have to take that for the record and I know we do we are meeting with your staff with the four corners next week to be able to discuss that in further detail.
▶ 1:58:40tell me, sir, what population of veterans is VA targeting for guardianship under this MOU? Thank you, sir. The population that we are targeting with this effort are those veterans who are hospitalized um in and who are boarding in an acute care bed in a VA facility because they do not have the mental capacity uh for decision-making.
▶ 1:59:07And right now that constitutes about 700 veterans who are currently in that inpatient facility. It is not intended for outreach. It is not intended as a homeless initiative. Okay, so you're saying it's restricted to the 700 veterans you just Yes, sir. Then why do all these documents about safe Project Safe Harbor or state that at-risk and homeless veterans We're not talking about the 700 veterans.
▶ 1:59:36Will be targeted for guardianship including homeless veterans who are not even connected with VA programs? Again, these are documents internal VA documents. Yeah, that is erroneous and you know, that should never and is not the case or intent of this initiative.
▶ 1:59:53understand my concern here, sir. Disability rights advocates, clinicians, medical mental health experts, and the attorneys all agree guardianship is the last resort uh and should be the last resort and an extreme measure. If VA is going to take away the rights of veterans, VA needs to be transparent about which veterans will lose their rights and why. It is clear from these Project Safe Harbor documents that homeless veterans are the target.
▶ 2:00:21Forcing homeless veterans into guardianship and civil commitment won't solve their homelessness. Homeless veterans need housing and robust My time is running out. So, you're saying that these documents are um and this is your opportunity to correct the record. Um I'm urging you strongly to rethink how VA will use the MOU with D- with with DOJ. And I also urge VA to abandon Project Safe Harbor entirely.
▶ 2:00:52Um and so I'm asking um if these are erroneous, I would like to get that in writing, sir. That what what is the what what is the intent? Like as I say, I think we should abandon Project Safe Harbor entirely. On the record, sir, those are erroneous. Of the 700 veterans that are currently boarding in an acute care bed, about half of them are homeless or at imminent risk of homelessness.
▶ 2:01:17All that Safe Harbor does is to provide legal support and representation for a veteran so that they can proceed through state court proceedings on um receiving a guardian so that they can move to a safer environment that is commensurate with their needs.
▶ 2:01:36Well, These are patients, sir, who are profoundly demented with advanced Alzheimer's who do not have a next of kin and because they do not have a next of kin for decision-making um are forced to stay in an acute care bed for their So, before I yield back, Mr.
▶ 2:01:53Chairman, I would like to enter these documents, these internal VA documents that state that actually Project Safe Harbor was targeting homeless veterans and um veterans that are not actually uh within the VA's health care system. I'd like those to be unanimous consent to enter these into the record.
▶ 2:02:09Without objection. And um sir, I would ask in writing as well um Yes. the scope of Project Safe Harbor. I again I would I urge you to abandon it. And um So, anyway, I yield back, Mr. Chairman. Yeah. Mr. Christie, I'm going to take my 5 minutes right quick and then we had still have Mr. Con- Dr. Conway that will have his 5. Mr.
▶ 2:02:31Christie, the committee has heard concerns current VA GAS GSA leasing processes can delay the delivery of needed medical facilities and clinics. Would you grant Would granting VA independent leasing authority enable you to build up infrastructure more efficiently and quickly? Absolutely. Dr. O'Toole, uh the effectiveness of VA depends heavily on a strong leadership.
▶ 2:03:00Uh would changing the Under Secretary for the health and Under Secretary for uh to a presidential appointee position strengthen transparency and congressional oversight of these critical departments? Sir, I I the Under Secretary of Health is currently a Senate-confirmed position and uh you know, we we believe that's Okay, thank you. Mr.
▶ 2:03:27Devlin, and this is my last one, but how could the BRNE Improvement and Accountability Act improve oversight on the high cost of expenditures and ensure safety uh of the VA employees? Thank you for the question on that bill and for the focus that this committee has on improving the VRNE program. Um we share that that commitment. There are a few things that are that are helpful in in the bill establishing a cap of $250,000.
▶ 2:03:57Currently, I think less than 1% based on the last data I have of veterans in the program, do we spend that much money on? So, that's not a challenge for us. What is the challenge is that the bill language indicates it would include all federal funds that veteran was in receipt of and we think the intent was to capture the Chapter 31 funds. So, um some some language adjustment there would make it more accurate and and help ensure appropriate implementation.
▶ 2:04:23We do have um concerns technical concerns on the bill. I think the intent is there that we can appreciate, but for example, the 25-mile um stipulation that it that a veteran um you know, we have to look at whether they're 25 miles from the school that they're attending. If they live in Woodbridge and they're attending a school in DC, they could be beyond 25 miles. And and I don't think that it's the intent of Congress that that VRNE counselors have to do calculations of the miles.
▶ 2:04:52So, happy to work with with you and the and the committee Yeah. on improving this bill so that it it it achieves the intent um without adding challenges for veterans.
▶ 2:05:02Which is which is why we're having this hearing so we can go back and forth on these issues.
▶ 2:05:06Yes, With that, I I yield back. Dr. Conway, you are recognized for 5 Uh thank you, uh Mr. Chairman, and thank you for teeing up uh my comments on HR uh 6755, the Accountable Leadership for Veterans Act.
▶ 2:05:20As uh I understand the bill, um the uh senior executive workforce would be expanded uh not by uh people persons who are qualified as current law uh requires, uh but would open up uh that workforce uh to uh political appointees. Uh yeah, well, they have to go through Senate confirmation.
▶ 2:05:48Uh the uh the requirements uh for expertise and their particular um uh work stations uh will be um will be very much watered down. It's hard for me to understand how uh reducing the requirements for such an important position would be better uh for the functioning of the VA. Um Dr.
▶ 2:06:12O'Toole, uh how many uh senior executive service uh positions does the VA currently have across its enterprise? I I do not know off the top of my head, sir, and we'd have to take that for the record. And so uh I'm not surprised about that, but I wanted to put that the question on the record and ask uh not only with respect to the VA itself, but also within the VHA. And um Ms. Devlin, I'm going to save you the trouble. I'm going to ask also about uh the VBA as well.
▶ 2:06:42Although, if you happen to know those numbers, I'd be very happy uh to hear them now. Um I know around us, but sir, I wouldn't want to give an inaccurate number on the record. So, um you'll I'll ask that you do so provide that information to the committee. And as my other colleagues have uh have asked as well, uh could you suggest a timeline by which we might be able to receive that information? We should be able to produce that very quickly, sir. Good. Thank you very much. Um I I want to um and do either of you and and from Ms.
▶ 2:07:12Devlin and Dr. O'Toole, uh do you have a concern uh that um uh about a change in the qualifications uh for um those who are going to undertake the position of Under Secretary of Health? And just let me um put some more um close on this.
▶ 2:07:32Currently, uh the Under Secretary of Health uh as appointed without regard to political affiliation or activity on the basis of demonstrated ability in the medical profession, health care administration, and policy formulation or health care fiscal management. Um and uh also on the basis of substantial experience in connection with the programs of the VHA or programs of similar content and scope.
▶ 2:07:57The bill, section 3 in particular, of of uh the legislation in question here, that is HR 6755, would remove all qualifications uh currently described in the code and replace them with language simply requiring that Under Secretaries for Health be appointed by the President with the advice and consent of the President.
▶ 2:08:17Uh do you have the concern for the ability of of and the important work that these um executive offices provide uh will be diminished by removing these very important qualifications and experiential qualifications uh from those who might uh well be appointed uh to the role of Under Secretary? So, thank you for the question. I will point out that neither Dr. O'Toole nor I are involved in the selection process for Under Secretary positions.
▶ 2:08:43Um and we we stated in the department stated in views that we support the intent of the um but do have some concerns. But, I would have to differ to department
▶ 2:08:55guess what the concerns are. And um Dr. Toohey, do you care to comment No, I think Ms. Devlin captured that nicely. Thank you. Uh with that uh I'll leave it there and look forward to an answer to some of the questions I posed to and appreciate again you putting yourself before us to answer question on the legislation this committee is considering. Thank you, Mr. Chairman. I yield back. Gentlemen, yield back.
▶ 2:09:26I want to take the time to thank the witnesses for joining us here today and for their testimony. Today's discussion underscores why the committee's work is so important. The laws that the government VA shape how care and is delivered, how benefits are administered, and how resources are When those laws fall behind the needs of the veteran, it's is Congress's responsibility to review them and make the necessary updates.
▶ 2:09:54The proposals discussed today reflect that responsibility. They aim to strengthen the accountability, improve transparency, and ensure that VA remains focused on serving veterans. This committee will continue to its oversight and legislative work to make sure the department has the tools and structure needed to meet the needs of our veterans today and in the future. I look forward to continuing this discussion as we evaluate these proposals and consider the path forward.
▶ 2:10:23With that, I ask unanimous consent that all members have five legislative days in which to revise and extend their remarks and include any extraneous material. Hearing no objection, so ordered. This hearing is adjourned.