▶ 0:12:24>> we have significant time constraints in our hearing today and we will move quickly to go through our agenda. I will make my opening statement. And cut in half. I think the witnesses have done the same. We will proceed with our hearing. I called the meeting to order. Welcome. We will hear from witnesses from the veterans of america.
▶ 0:12:59These issues are facing the veterans community. I am grateful for the sponsors of these bills. I look forward to hearing from our witnesses today about these proposals. Recognizing that the schedule is constraints this afternoon, in the interest of time I will withhold further comment. I will recognize the ranking member when he arrives.
▶ 0:13:29I will now introduce our first panel. Testifying from the department of veterans affairs. He is the acting under secretary for health and clinical services. He is accompanied by the undersecretary for operations management. And the acting principal director and chief acquisition officer. Thank you for being here.
▶ 0:14:00>> before I begin I want to apologize for the delay. Now we are covered. I would like to highlight several the bills we will be discussing today. The v.a. Supports these bills.
▶ 0:14:30But recommends amendments to ensure that effective implementation. It does not support that. We do recommend amendments to certain provisions.
▶ 0:15:09The department is still examining this building is unable to provide comprehensive views. This appears to be the intent. We believe this would be a better way for veterans to receive care.
▶ 0:15:37We support the intent of this bill to improve care coordination. There are certain provisions. We support the intent of this bill.
▶ 0:16:05We would appreciate the opportunity to work with the committee to discuss any concerns we have. And to discuss our research efforts. The v.a. Supports these bills. The v.a. Does not support extending these benefits to children up to age 26.
▶ 0:16:38We support the intent of certain provisions. Which would expand grant programs aiding transportation to veterans. And we are happy to work with the committee on technical assistance for those goals. We are prepared to answer any questions you might have.
▶ 0:17:08Thank you very much for your testimony. I appreciate your support for one of the bills on the agenda. And your willingness to work with me. And avoiding duplication. Between now and potential enactment of this bill, what is the v.a.
▶ 0:17:38Doing to realize these outcomes?
▶ 0:17:40Dr. O'Toole: The concerns we have the this bill are related to addressing many things we are already doing. One of the primary concerns is related to care coordination.
▶ 0:18:05Dr. O'Toole: The added provision of having additional care coordination runs the risk that we could have redundancy. A significant provision to the bill is the information sharing between cms and the medicare providers. This is a long-standing challenge and issue. One we currently have in the community care effort.
▶ 0:18:34Dr. O'Toole: We are in the process of expanding. We expect with more rapid implementation we will have a better system for that.
▶ 0:18:57Dr. O'Toole: >> as we continue to tackle the claims backlog, high-quality medical exams are important. This bill would permanently authorize the v.a. To license new programs for examiners.
▶ 0:19:22Dr. O'Toole: Would you speak to why this is important and what the current hindrance is for veterans receiving medical disability exams in a timely manner? >> thank you for that question. We strongly support those. We are operating under a pilot program that has been in existence since 1996 and we are eager to move to a more permanent structure. We do have a couple of concerns.
▶ 0:19:55Dr. O'Toole: Just with the designation of physicians in the bill. We would prefer to use health-care providers because 86% of our exams are currently conducted by nonphysician health care providers. We have concerns with the submission of evidence to the contract examiners. We would prefer that those records, directly from the v.a.
▶ 0:20:26Dr. O'Toole: >>>> they are all subcontractors. Thank you. I will, question short. I expect senator blumenthal to arrive. There is almost no member of this committee who can remain here past 5:00. So we are trying to be timely.
▶ 0:20:55Sen. King: I have no questions. I commend you for your insight and deep intelligence. >> I think I will make sure you are a cosponsor of every bill that I bring. [laughter]
▶ 0:21:08Sen. King: I know there's some reservations you want to discuss. I'm happy to work with you on those. Those are very important provisions. Thank you. >> thank you very much. It is good to see you again. A few weeks ago we discussed a plan to fire workers.
▶ 0:21:42Sen. King: You said you had not been consulted on how this plan would affect veterans. A couple of weeks ago I asked secretary collins about this. He said the top doctor at the v.a. Had not been consulted. Since we last spoke, has anyone at the v.a.
▶ 0:22:01Sen. King: Asked for your input or analysis or asked you to oversee any analysis done by the clinical services department regarding how firing these employees would affect veterans care?
▶ 0:22:16Dr. O'Toole: Thank you. I appreciate the opportunity to respond. There is a larger process here. There are several clinicians and physician senior to me who are actively involved in this. It is very much predecisional. I do not know the answers to the questions you asked.
▶ 0:22:47Dr. O'Toole: I would have to take it for the record and respond. I'm happy to speak to the legislation that we have.
▶ 0:22:52Sen. Hassan: That would be excellent. Who were the doctors that are involved in this analysis? >> I would like to get back to you on those specific names.
▶ 0:23:05Sen. Hassan: Part of our job is oversight. There is bipartisan concern about this. It is really important that we understand what kind of analysis is being done. I expect them to do an analysis and consult with you and other clinicians to understand what the interplay is.
▶ 0:23:35Sen. Hassan: We are running out of time here. You cannot tell me who they are consulting. I hope you will take us back to the secretary and their team. That we lay out what is happening.
▶ 0:23:57Sen. Hassan: The president recently signed an executive order that requires the secretary of the ba.2 commissioned a feasibility study in an action plan to expand services to support a full medical center in new hampshire. This is a good first step. We have needed this for a long time. We are the only state that does not have its own full-service medical center. I want to make sure this gets the attention it deserves.
▶ 0:24:29Sen. Hassan: It is critically important. To get their feet put -- feedback and input. To make sure the veteran care is not disrupted.
▶ 0:25:00Sen. Hassan: How will the v.a. Decide what nucleic's and services to provide to veterans in new hampshire at the hospital and how will the v.a. Age with people to ensure they meet the needs of our veterans?
▶ 0:25:17Dr. O'Toole: Thank you. I agree with the points you are making. I do not know and I am not prepared to speak to the specifics to that.
▶ 0:25:36Sen. Hassan: I appreciate that. From what I am hearing on the ground no one has heard anything from the white house. That makes me wonder how much of this is window dressing how much of it is real. We really would appreciate outreach. If you could take that back to the secretary's office. That would be very help will. I have more questions that I will submit for the record. Thank you.
▶ 0:26:05Sen. Blumenthal: I apologize. I have another subcommittee which is ongoing. It is still ongoing. I do apologize. I want to enter a recent new york times article about the push to defund harvard.
▶ 0:26:39Sen. Blumenthal: >> without objection.
▶ 0:26:41Sen. Blumenthal: Thank you. I don't know if you are familiar with this article. It shows there are multiple contracts between the v.a. And harvard university that are planned to be canceled. Including contracts involving suicide prevention efforts. V.a.
▶ 0:27:11Sen. Blumenthal: Officials are quoted saying that canceling these contracts would result in more veteran suicides that could have been prevented. They are pleading with v.a. Leadership not to cancel these highly critical contracts. Are you aware of the situation? >> I have seen the article. I have heard that as well.
▶ 0:27:41Sen. Blumenthal: I would have to take for the record any specifics on the status of those deliberations.
▶ 0:27:47Sen. Blumenthal: Those research contracts are important. Are they not? >> absolutely. I am not disputing that.
▶ 0:27:58Sen. Blumenthal: Do you agree with their cancellation? >> I am not here to discuss those specifics. I'm not prepared to discuss those. I am happy to take for the record with the status of those considerations is.
▶ 0:28:15Sen. Blumenthal: I don't mean to be disrespectful but veterans may be dying as a result of these contracts being canceled. You have been involved in the v.a. For some time. I am disappointed that you will not express perhaps a more critical view of what is happening here.
▶ 0:28:40Dr. O'Toole: Thank you. As someone who has done research , I can fully appreciate that. I just don't want to get ahead of myself here. I do need to take it for the record.
▶ 0:28:55Sen. Blumenthal: You are here on behalf of the v.a.. I will be really direct. We have been asking the v.a. About these contract, including the harvard contract, for more than a month. And we have received no response. So when people come to me and say why are you holding these nominations? I say it is because the v.a.
▶ 0:29:24Sen. Blumenthal: Is denying is essential information that is nessus terry for our oversight. We want accountability. Here is exhibit a. Saving lives. The v.a. Has no more foundational and essential purpose than stopping veteran suicide.
▶ 0:29:55Sen. Blumenthal: It has denied this and refused to provide information purposefully. It cannot be an accident. I know you are on the receiving line of this complaint. Make no mistake, I know you not responsible.
▶ 0:30:20Sen. Blumenthal: When you take this message back and you get back to us, you should make clear that this is the reason why we are putting a hold on these nominees and why we are extremely disappointed. With the response so far. There is a lot of great legislation.
▶ 0:30:50Sen. Blumenthal: The children's care put section act and other measures that are important to protect the v.a.. We still another number of fired employees. We have no idea when or if or ever we will have the v.a. Lift its freeze on rulemaking. That is important to legislation.
▶ 0:31:20Sen. Blumenthal: Legislation cannot be implemented until the rules are in place. And we have no idea when that freeze will be lifted. Here we are talking about new laws. Laws are dead letter if there are no rules and regulations. They are also dead letter if there is no workforce to implement them.
▶ 0:31:47Sen. Blumenthal: If we cannot enforce them and carry them out, they have no meaning. The v.a. Is planning its goal to cut thousands of employees. The laws that we have passed already, grade bipartisan measures.
▶ 0:32:15Sen. Blumenthal: They will be dead letter if we do not provide the resources for them. If that approach is carried forward. My time is expired. Thank you.
▶ 0:32:28Sen. Moran: You are welcome. >> no questions at this time.
▶ 0:32:36Sen. Moran: Thank you.
▶ 0:32:39Sen. Murray: Thank you for being here. Women veterans who have suffered from ptsd or sexual assault tend to experience menopause much earlier than women who did not serve in the military. One v.a. Study showed that 50% of women veterans experience menopause before the age of 40. That is 10 years earlier than most women.
▶ 0:33:07Sen. Murray: It is very important that we strengthen research so we can provide better care for women service numbers. That is why I was proud to join my colleagues in introducing this research act last month to do that. Can you tell me today what resources are available right now the v.a. For women veterans who are experiencing menopause?
▶ 0:33:36Sen. Murray: Are there any plans to expand that?
▶ 0:33:37Dr. O'Toole: Thank you. I fully appreciate and agree with what you're saying. I do not have that information readily available. I would have to get it for the record.
▶ 0:33:53Sen. Murray: How long will that take you?
▶ 0:33:55Dr. O'Toole: We will get it as quickly as we can.
▶ 0:33:58Sen. Murray: Ok.
▶ 0:34:00Dr. O'Toole: We strongly support the bill.
▶ 0:34:03Sen. Murray: Thank you. During a hearing earlier this month I asked about the 90 day pause on clinical trials. That right now is putting a halt to ongoing clinical trials. Everything from predicting stroke risks to addressing substance abuse. Secretary collins said there was no information on that.
▶ 0:34:39Sen. Murray: I asked what will happen after this 90 day pause. Where will you do this? >> I will have to take it for the record.
▶ 0:34:57Sen. Murray: You don't have any idea? >> I do not.
▶ 0:35:00Sen. Murray: Can you provide my office with a list of clinical trials that were canceled? >> I don't have that available but I can get that information to you.
▶ 0:35:15Sen. Murray: If you care about transparency, I see no reason why this information will be secret. People are in trials. For the next 10 years they're not supposed to know? When will you get that to us?
▶ 0:35:33Sen. Murray: What does that mean. I have seen -- or that from so many people in the last few weeks.
▶ 0:35:40Dr. O'Toole: I would defer to our legislative team.
▶ 0:35:45Sen. Murray: It is a disappointing response, I have to tell you.
▶ 0:35:48Dr. O'Toole: I would imagine we would be able to get it to you within the next few weeks.
▶ 0:35:53Sen. Murray: Let me try one more. Women are the fastest-growing demographic within the veteran population. You know that. The v.a. Was not initially built for women. It is our collective responsibility to honor women who have bravely served our country by taking action to remove barriers that for too long have restricted the axis to the benefits they have earned.
▶ 0:36:19Sen. Murray: I believe the goal should be a system that offers women conference of care at every stage of life. My home state of washington so I 7% increase. I am appreciative of this. Can you give me any update on the progress?
▶ 0:36:53Sen. Murray: For a timeline? >> I do not have the specifics. I can get back to you on that.
▶ 0:36:59Sen. Murray: I would appreciate answers to those questions as soon as you can. This critical information. >> thank you. I have one more question. I strongly support senator murray's act. It is a great piece of legislation.
▶ 0:37:32Sen. Murray: Another example of how a hiring freeze and firings are chipping away at research. Let me turn to the elizabeth dole act.
▶ 0:38:04Sen. Murray: Our committee is still waiting to learn how or when the v.a. Will implement dozens of sections of the bill. This is what I'm talking about. Implementation, rulemaking. Expanding home and community-based care.
▶ 0:38:38Sen. Murray: This will impact the most vulnerable veterans we serve. They were top of mind when our committee and our senate passed this measure overwhelmingly. How can the department adequately implement this additional legislation that we are considering today?
▶ 0:39:10Dr. O'Toole: Thank you and I would first acknowledge that the provisions in that act that they are actively working to have them at this. I am happy to report back to your staff on these updates.
▶ 0:39:46Sen. Blumenthal: In the interest of time I will submit my questions for the record.
▶ 0:39:54Sen. Moran: At least half of the bills I have introduced today, you are the primary cosponsor. I look forward to seeing rate success in my efforts. [laughter] they loved every one of his bills. Thank you all very much for your presence here today. As you can see the committee has a lot of questions broader than the scope of this hearing.
▶ 0:40:39Sen. Moran: Thank you. I welcome our second panel. I will go ahead and introduce you. Testifying with us today is the national legislative director for the paralyzed veterans of america. The director of government affairs for the wounded warrior project.
▶ 0:41:11Sen. Moran: And the deputy national director for disabled american veterans. We thank all three of you for being here and for the work you do for veterans. We will recognize you first. >> thank you Mr. chairman.
▶ 0:41:44Sen. Moran: We certainly appreciate the opportunity to appear before you today to discuss some of these bills. I would like to take a moment and recognize the fellows who were here from the elizabeth dole foundation. We have had the privilege of spending some time within the past couple of days. I know they have been out visiting some of the congressional offices.
▶ 0:42:31Sen. Moran: I will limit real brief comments. Over the last five decades, congress has spent a considerable amount of time passing legislation to federal facilities.
▶ 0:43:09Sen. Moran: Despite all of this effort and these legal requirements, our members routinely face disability access. Within the community. We have appeared before the committee before. We have discussed some of the problems we have encountered.
▶ 0:43:33Sen. Moran: Senator murray mentioned the fact that a lot of facilities were not originally fitted for health care. They did not have the handicap controls so members could enter that facility. The office staff was positioned in a way where they could see anybody at the door.
▶ 0:44:10Sen. Moran: Those are the types of barriers we are talking about. Because of the complex nature of injuries and illnesses, they tend to access v.a. Care more so than other veterans. We are strongly supporting this bill which directs the v.a. To create an advisory committee on this issue.
▶ 0:44:44Sen. Moran: We need to make sure there is greater emphasis on accessibility. You are familiar that the v.a. Pays eligible veterans and caregivers mileage and travel expenses to approved health care appointments. The current reimbursement rate is too low. 15 years ago congress set the rate at $.41 per mile.
▶ 0:45:13Sen. Moran: That was based on the federal rate at the time. Since an overall rate housing based significantly. Even though costs have increased dramatically. We support this bill which ties the veterans mileage rate to the ga gsa rate. We think this will improve access.
▶ 0:45:47Sen. Moran: We support the children's care protection act. This is a bill that would allow the surviving spouses, family members to remain in the program until age 26.
▶ 0:46:06Sen. Moran: Back in 2011, after the aca extended this health care to all the other federal programs and health insurance programs, the dod made the change. The v.a. Did not. These are family members of veterans who were worse to be removed from the program.
▶ 0:46:31Sen. Moran: We believe this program should allow them to remain until age 26. Thank you.
▶ 0:46:43Sen. Blumenthal: If I could just apologize to the panel, I am obligated to go to the floor of the senate. I would have asked you a question of about how the cutbacks in staff might affect your view of how the department is functioning. I will submit that question for the record.
▶ 0:47:10Sen. Blumenthal: I appreciate the chairman giving me this opportunity to apologize and explain the reasons for my absence. It is not out of lack of interest. Senator king will be here. I yield to him my time. He is regarded as a favorite. I probably will be missed. [laughter]
▶ 0:47:33Sen. Moran: Just because you are associated with senator king doesn't mean you will get your way on everything. [laughter] we both had nothing on our schedules when we chose the time for this hearing. It just not work to that clear.
▶ 0:47:52Sen. Moran: We are still trying to figure out what day of the week is our best opportunity to be most available to most members so we can hear the most amount of testimony and interact with those who come before us. You are recognized. >> thank you. Thank you for inviting wounded warrior project to testify.
▶ 0:48:23Sen. Moran: Today's agenda includes many bills that are aligned with our mission. We want to speak on several that would have a heightened impact on the veterans we serve. We strongly support the precision brain health research activist and that step in federal action. Low-level blast injuries have received increased attention.
▶ 0:48:51Sen. Moran: They have also been these subject of congressional action on the prevention side. The bill would label these activities. To learn more about the long-term effects of blast injuries. Over time the bill would help transport -- transform those affected by brain injury.
▶ 0:49:20Sen. Moran: On a similar note, we support the coordinated care for senior veterans and wounded warrior act. Many veterans are relying on extended care programs earlier in life after being catastrophically wounded in service. Many of them have medicare coverage.
▶ 0:49:48Sen. Moran: For many in these categories, the bill will help with advocacy. There is clearly much that can be learned from this. We are proud to support this act.
▶ 0:50:21Sen. Moran: This is a long-overdue recognition of the evolving needs of female veterans. To help the hidden heroes who have supported the most severely injured borrow -- warriors in our community. Congress can vest in the well-being of caregivers. So they can stabilize their financial futures.
▶ 0:50:50Sen. Moran: I want to highlight our support for the veterans accessibility act. This legislation was passed by the house yesterday. It will help ensure that accessibility is built into all aspects of the v.a. These are critical parts of a system that should provide accessibility groups a seat at the table.
▶ 0:51:19Sen. Moran: Thank you again for the possibility of testifying today. This concludes my testimony. I look forward to your questions. Thank you. >> thank you. For the opportunity to testify today. I know you're all busy. We support 20 of these bills with some recommendations at five we have no concerns.
▶ 0:51:49Sen. Moran: We urge the committee to carefully review the following legislation. This lacks clarity on case management and oversight and training standards. Veterans face fragmented care. Especially since many private sector providers lack expertise.
▶ 0:52:15Sen. Moran: We urge the committee to provide necessary training to ensure seamless, high-quality care. While increasing homecare options, the inclusion of nonmedical roles such as companions and homemakers raises
▶ 0:52:46Sen. Moran: Oversight concerns. Regulatory changes vary across states. We recommend refining the bills language to clearly the five these functions. Ensuring consistency and quality of service. We strongly oppose this measure.
▶ 0:53:16Sen. Moran: While community care is vital, a balanced approach is necessary. By diverting resources from the v.a. Without additional funding widths -- would we can care. Private sector providers often lack expertise. Leading to fragmented and inconsistent care.
▶ 0:53:45Sen. Moran: We encourage congress to invest in infrastructure and research to strengthen the v.a. System and maintain the v.a. As a primary care provider. Members who rely heavily on the v.a. Health care system believe that it remains the best choice. Our nations veterans deserve nothing less. This concludes my testimony.
▶ 0:54:16Sen. Moran: I'm pleased to answer your questions.
▶ 0:54:17Sen. Moran: Thank you for your testimony.
▶ 0:54:23Sen. King: I appreciate the comments today. We will continue to be in touch as we move forward with these bills. Thank you. Very helpful testimony.
▶ 0:54:36Sen. Moran: Thank you. Your testimony was very compelling and catchy about the v.a. And its incapacity to meet the needs of veterans with disabilities. It seems like one of the last places we would expect to find that a problem.
▶ 0:55:02Sen. Moran: Until you gave your testimony, it was that evident to me there would be such a significant challenge in meeting the needs of all veterans. What impediments does the v.a. Have this problem? What efforts are they undertaking to solve this problem? >> in truth, the v.a.
▶ 0:55:24Sen. Moran: Has made great strides in trying to improve accessibility. One area I did not have a chance because we were attempting to try to shorten things up, but it is probably a good example. It is the accessibility of diagnostic equipment.
▶ 0:55:53Sen. Moran: We are talking about mammograms, the x-ray machines, dental chairs, even x-ray machines. In 2017, the U.S. access board published new accessibility standards for medical and diagnostic equipment. Shortly after that the v.a. Jumped on board. Very proactively.
▶ 0:56:19Sen. Moran: They said they would adopt those pandered to ensure the needs of disabled veterans were met. Since that time we have had no updates. We have heard from members who have been able to receive care at v.a. Facilities. They cannot get their x-rays or mammograms. Clearly there is a problem.
▶ 0:56:46Sen. Moran: I would encourage their committee to do some additional oversight. Not only see how far the v.a. Has, but what else needs to be done.
▶ 0:57:01Sen. Moran: Thank you. What you are doing is making me recognize it is not exactly the automatic door to what we might consider being an impediment. >> sometimes it may be because some of these changes are being made. Or they are not being made with the view of the veteran in mind.
▶ 0:57:31Sen. Moran: It tasted point is we had a veteran who went into the chapel between appointments and was stuck in the chapel because the door did not have a push bar. Or the automatic door opener.
▶ 0:57:55Sen. Moran: If you had this legislation, you have veterans that would serve as providers to the department. I want to follow-up up on exactly that point.
▶ 0:58:26Sen. Moran: Perhaps you could have this project. Give them an inventory. Do you see what I mean? To use your membership to survey the veterans and advise us about where accessibility needs to be.
▶ 0:59:02Sen. Moran: Individuals were not wheelchair-bound do not appreciate that. I think you could be very helpful with that. >> thank you for the recommendation. Item in many cases we have identify these problems. We have notified the facility. We have worked with the department to get those corrected.
▶ 0:59:32Sen. Moran: Sometimes the problem may be identified in one facility but existed others. There needs to be a system internally to wear a problem with -- has been identified. Does this problem exist elsewhere and how this it work? I will take affect my leadership and see what we can do.
▶ 0:59:57Sen. Moran: Thank you. My thoughts are I have visited lots of v.a. Facilities. Thank you for highlighting that. Tell me and tell the committee why it is important to assist family caregivers transitioning back and to the work force?
▶ 1:00:29Sen. Moran: Once they are no longer needed as full-time caregivers?
▶ 1:00:32Mr. Dempsey: Thank you for the question. A recent report found that 36% live below federal poverty levels.
▶ 1:00:59Mr. Dempsey: Particular for those who are leaving the program, there can be additional challenges. Many of the benefits are not portable. This would bundle all of those elements that are essential.
▶ 1:01:28Mr. Dempsey: Making sure that you can enter this.
▶ 1:01:38Sen. Moran: You mentioned dual enrollees. This is a question for any and all. Would you put in the record and educate me and perhaps others that these enrollees face. How do you think this program could be established to address those challenges? >> thank you for that question. If the v.a.
▶ 1:02:08Sen. Moran: Had a system of being in place, to have the providers between the v.a. And medicare to be able to understand the priority of the veterans. They are at the v.a. Medical center. We know those are grandfathered in. When you look at the priorities, they have obligations that fell in the broad-spectrum.
▶ 1:02:39Sen. Moran: Then you look at the aging population. We know that 49% of the veteran population is 65 or older. They are meeting the requirements for medicare. We would have to have training on the v.a. Side where a care coordinator has the expertise and knowledge to be able to understand what the priority groups are within the v.a. System to identify service connections that can be dealt with.
▶ 1:03:10Sen. Moran: Also identifying their demographic somewhere they live. That is where the challenge comes. They are mostly rural. An aging population in a rural community has to be trained on cultural competencies and understanding the social dynamics so they can best facilitate when it is best to leverage medicare when the cost can actually be saved by providing that.
▶ 1:03:40Sen. Moran: There will have to be a very robust training program and oversight to ensure continuity of care is not broken. That is a big component of training.
▶ 1:03:50Sen. King: I wanted to follow-up on your testimony and thank you for your strong testimony about community care not encroaching on the mission of v.a. Provided care. That is something we have to keep our eyes on. There are those who would like to move further and further in that direction. That is critically important.
▶ 1:04:21Sen. King: I take it that you agree? >> I think it is very important to look at what the needs are right now. We have heard concerns around this population. Access to health care the veterans has enrolled and has plateaued. One thing we noticed is a trend that has not been spoken about. Those are episodes of care.
▶ 1:04:46Sen. King: In 2019 to 2023, we sought estimation of 120 million veteran episodes of care provided. In 2023, it was roughly about 130 million of the suits -- episodes of care. One of the things senator murray has sponsored is women's veterans. We have an upper trajectory.
▶ 1:05:16Sen. King: Our veteran population is 49% 65 or older. They need more care. Statistics show us that 70% will require medical assistance. I think it is very important that we look at this. And address the complications and remote areas.
▶ 1:05:43Sen. King: And also in specialized care that is really challenging for women veterans. It is so important that we do some good research.
▶ 1:05:54Sen. King: Does that data breakout community care versus others? >> I would have to go back and look.
▶ 1:06:04Sen. King: To see if there is any trend in that data. >> there are some trends that indicate where community care is and also with rural veterans care. We know how much of their care is and what direction.
▶ 1:06:21Sen. Moran: You caused me to think of another question that you may or may not have an answer to. The veterans who are not enrolled in the v.a., not receiving health benefits, some might be utilizing medicare. Do we know the characteristics of the population that the v.a. Does not serve? You started down a path of some statistics about women.
▶ 1:06:56Sen. Moran: What is the typical veteran who is not utilizing the v.a.? Do we know that? This may not be the panel. >> that is an interesting question. With the data we have. The interesting thing is this may spell out for you where we are at. We have talked about 9 million enrolled veterans. As we look at the reports, the numbers are coming down.
▶ 1:07:25Sen. Moran: We are sitting at about 18 million. That indicates to us that in the general population, half are in the v.a. Health care system. Where are the other half going. It must be the private sector. We are looking further into that to see where the indications are.
▶ 1:07:46Sen. Moran: This is a question for the v.a. As well and they may know these numbers. Is it young veterans who are not taking advantage of services from the department of veterans affairs? People in rural america? People with disabilities? Women? Maybe there is no pattern to this. Who is not being served.
▶ 1:08:15Sen. Moran: In ways we can reach that particular segment of our veteran population. Does that make sense? I have one more thing. Just one moment. There it is.
▶ 1:08:46Sen. Moran: I have the bill, the fallen service members religious heritage restoration act. It would make certain that veterans buried overseas in cemeteries have grave markers that are accurately representing their religious faith. I saw an episode on television about this topic. It was compelling.
▶ 1:09:16Sen. Moran: I am grateful for the support of today's witnesses. I would ask for unanimous consent that we put into the record comments on this legislation from the jewish community regular -- board of kansas city. The republican jewish commission. Veterans of foreign wars. The american legion. Veterans of america. The noncommissioned officers commission.
▶ 1:09:46Sen. Moran: With no objection it is so ordered. Would any of the three of you like taking food? I always try to give our witnesses the chance to add anything to the record or correct anything that you feel needs to be corrected? Any additional comments? Thank you very much for your testimony.
▶ 1:10:23Sen. Moran: I look forward to looking -- working with all of you and your organizations. The hearing record will remain open for five legislative days should any member wish to submit additional questions for the record. I asked that today's witnesses respond to any rations you may receive following to today's hearing. In a timely manner. With that the hearing is adjourned.
▶ 1:10:57Sen. Moran: [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap.org]