▶ 0:09:28Chair Moran: We are starting a bit early. Senator blumenthal is on his way. We will work through the agenda as expeditiously as we can to make certain the witnesses have an opportunity to tell what they want to tell and the members of the committee have an opportunity to ask what they want to ask. This afternoon we will consider 25 pieces of legislation, sponsored somewhat by me in the ranking member, and certainly senators from both sides of the aisle.
▶ 0:09:53Chair Moran: Today's agenda includes forgoes I introduced, the disabled veterans dignity act, the national veterans strategy act, the stand act, and the optimizing veterans for workforce act. It reflects a collection of bipartisan parties to expand and streamline access to high-quality health care and irna benefits for veterans, their survivors, and their families. Improving lives for those who served is not a partisan issue.
▶ 0:10:20Chair Moran: It is a shared mission that involves every member of this committee. Whether we are addressing health care resources or claim processing, our focus is on those who served and sacrificed for our nation. I am grateful to our witnesses for offering their perspectives on these proposals and for work on this legislation.
▶ 0:10:42Chair Moran: I appreciate the department for providing technical assistance, guidance, and cost estimates on these proposals, and I'm grateful to our veterans service organizations, our partners, for their advocacy and collaboration to make certain we are meeting the evolving needs of the veteran community. I will give the opportunity for the ranking member to make his opening statement upon his arrival. We will move to those who are testifying today, and we begin with the department of veterans affairs.
▶ 0:11:08Chair Moran: Margarita devlin, principal deputy for under secretary for benefits, accompanied by david barrans, deputy vice chairman and click of the board of veterans appeals, mark clevenger, acting assistant under secretary for health for patient care and service. Thank you for your service to veterans. Ms. devlin, you are recognized for your testimony.
▶ 0:11:32Ms. Devlin: Chairman moran, and when he arrives, ranking member blumenthal, and other members of the committee, thank you for the opportunity to testify on 25 bills that cover a broad range of veteran topics. Joining me from the veterans health organization is Dr. mark winek are --Dr. mark koeniger, and Mr. david barrans, debbie vice chairman of the board.
▶ 0:11:55Ms. Devlin: I would like to take this opportunity to highlight our work implementing secretary collins's veterans first strategy, reducing the disability claims backlog after a record year in 2025 processing more than 3 million claims. V.a. Is on a similar pace this fiscal year, completing more claims without sacrificing quality. It is the highest rate it has been in two years.
▶ 0:12:22Ms. Devlin: We are committed to encouraging apprenticeship opportunities come with 15,000 beneficiaries participating in apprenticeship programs through the g.I. Bill. While I cannot address every bill on today's agenda, I will highlight a few and v.a.'s full views are detailed in my written statement. Thank you for advancing two of v.a.'s legislative proposals. The provide essential long-term stability for key programs. S.
▶ 0:12:46Ms. Devlin: 3992, the joint medical facilities fund, would provide permanent authority for the fund and ensure uninterrupted operations at the federal health care center in north chicago. Making this authority permanent with support efficient planning, responsible use of resources, and reduce administrative burden. S.
▶ 0:13:05Ms. Devlin: 4043 would similarly codify v.a.'s authority for the program, and limiting the ongoing risk of interruption, enabling sustained planning, and ensuring veterans experiencing homelessness receive essential health care, mental health services, substance use treatment, and community support. We appreciate the three bills introduced by the ranking member britt however, we do have some concerns -- by the ranking neve member.
▶ 0:13:36Ms. Devlin: However we have some concerns. V.a. Considers the use of medication in many areas of the schedule. Our hypertension criteria account for when medication is required to control the condition. As we update other systems, we will continue following the same approach to ensure the schedule remains consistent with the spirit of the ingram ruling. S.
▶ 0:13:56Ms. Devlin: 3098, the presumptive clarity act of 2025 -- while we support the underlying goal of transparency, we have concerns with the implementation, is the bill would introduce substantially overlapping requirements. The mammography access for veterans act of 2025, we have concerns that this bill could limit veterans access to breast imaging services through the veterans community care program. Mr. chairman, we do not have our mca or human resources partners available today to discuss s.
▶ 0:14:29Ms. Devlin: 1127 or the optimizing the v.a. Workforce for veterans act. I can take those questions for the record. We defer views on s. 3591, veterans access to resources in the workplace act, to our colleagues at the department of labor. We look for to continuing this work as these proposals advanced. Thank you for your support and the ship, and we appreciate the opportunity to testify today, and my colleagues and I welcome your questions.
▶ 0:14:55Chair Moran: Thank. --thank you very much. With you, Dr. --let me start with you, Dr. koeniger. [inaudible] -- due to a nursing, staffing issue. I was not notified or informed of this until a week later, and I'm still waiting for all of the relevant details -- to learn those relevant details.
▶ 0:15:24Chair Moran: I hope that the circumstance will be different and I will be notified. I would hope that we would have answers more quickly. This situation, I raise it today for that complaint, and I raise and also because it provides another example of why the workforce legislation I introduced with senator king is sorely needed. It would require the v.a.
▶ 0:15:44Chair Moran: To develop and maintain and provide congress with a strategic capital plan that allows staffing levels for current and future projected demands for v.a. Services and increase the transparency with congress in advance of significant staffing changes or a reduction in force. Will you commit today to working to make certain that the v.a. Is staffed appropriately to satisfy patient demand? I assume your answer will be yes.
▶ 0:16:14Chair Moran: An 11 with specifically, will you let -- and on level with specifically, we let the secretary know that I expect a full briefing to review video --the details of how this developed and how it can be prevented going forward?
▶ 0:16:28Dr. Koeniger: Senator, thank you for that. We absolutely will work to make sure that staffing is such that we can support all veterans, that staffing issue at leavenworth was a temporary issue. What we found is that with a decrease in staffing, we had to close some medical surgery beds to ensure patient safety.
▶ 0:17:01Dr. Koeniger: And clearly medical facilities at times the staffing fluctuates, and I can assure you that the facility is working very diligently at this time to hire the appropriate nurses and support staff so that we can open those beds again.
▶ 0:17:21Dr. Koeniger: Yes, sir.
▶ 0:17:24Chair Moran: This week senator king and I introduced the optimizing v.a. Workforce for veterans act to require the v.a. To develop and implement a five-year human capital plan to make certain the v.a. Is adequately staffed. This bill makes clear that the v.a. Staffing strategy cannot be arbitrary and should track veteran demand. Do you agree that the v.a. Staffing should not be arbitrary and should align with demand? I assume the answer is yes, but I would like to hear it from you.
▶ 0:17:52Dr. Koeniger: Yes, sir, we absolutely look at the demand and then we do our best to make sure that we can take care of that demand.
▶ 0:18:01Chair Moran: How would the v.a. Ensure that the results-oriented performance measured which showed that seven tokens were not just met, but that veterans experienced that her access to care and higher quality of service as a result of the staffing plan?
▶ 0:18:18Dr. Koeniger: Sir, I would have to get back to you, look at the specifics of that. Our goal is to optimize health outcomes for all veterans.
▶ 0:18:29Chair Moran: I thank you, and I'm happy to have you get back to me. With more members here than when I made this announcement can we started a few minutes early with the expectation, and in fact the insistence that we complete our work by the time the 4:45 series of votes require our presence. I started a little bit early, and I know you're disappointed you didn't hear my opening statement. [laughter] >> [inaudible]
▶ 0:19:01Chair Moran: And both of my questions to the witnesses involved a bill that senator king and I are involved in. I am going to defer my 48 seconds left and recognize senator hassan.
▶ 0:19:15Sen. Hassett: Thank --
▶ 0:19:18Sen. Hassan: Thank you, Mr. chair and thank you for this hearing. Ms. devlin, I want to start with a question specific to new hampshire. We are the only state in the continuous united states without a full-service v.a. Hospital. Last may the president issued an executive order wrecking the secretary of the v.a.
▶ 0:19:42Sen. Hassan: To develop a feasibility study at the manchester center and submit an action plan to expand services to support a full-service medical center in new hampshire. I have been asking that this action plan be publicly released so that granite staters can review and comment on it. In a recent briefing to staff, v.a. Acknowledge that the feasibility study and action plan were created and that the secretary and white house have decided not to make this plan available for anyone to see can even members of congress.
▶ 0:20:12Sen. Hassan: The v.a. And the white house are presumably using these documents to make decisions about whether or not a full-service va hospital is appropriate for new hampshire. Granite state veterans, the people affected by these decisions, deserve to see these documents and give their input. Ms. devlin, will the v.a. Commit to publicly releasing these documents? And if you aren't involved enough in this decision to provide the answer today, will you commit to provide an answer to me in writing within one week so that the v.a.
▶ 0:20:42Sen. Hassan: Can provide transparency on this issue to my constituents?
▶ 0:20:47Ms. Devlin: Thank you for the question. I think koeniger I think koe Dr. koeniger is betr --
▶ 0:20:54Dr. Koeniger: Ma'am, I haven't been involved in the specifics of that, so I can't speak to that. But I can say that the secretary is working to make sure that that facility isd sized to the population --
▶ 0:21:12Sen. Hassan: I understand that, and I'm going to injure a few in the interest of time for all of us. Look--interrupt you in the interest of time for all of us. Look, the president signed an executive order for a study. Call us crazy, but actual veterans should see the documents that affect their care directly and comment on it and give feedback. Debriefing the v.a. Gave to art -- in the briefing the v.a.
▶ 0:21:39Sen. Hassan: Game to our staff, it was clear the white house was blocking access to these documents. Is that correct?
▶ 0:21:45Dr. Koeniger: Ma'am, I do not know the answer to that. What I can tell you is I will absolutely take her concerns back and make sure that the secretary is aware.
▶ 0:21:54Sen. Hassan: We need to see the documents. My constituents need to understand the rationale and reasoning for any decision this administration is good to make, especially considering the president promised a full-service v.a. Hospital in new hampshire when he was running for office. Let's go back to legislation, Ms. devlin. While it is not on the agenda today, I want to mention my bill with senator boozman to make it easier for veterans to schedule v.a. Appointments.
▶ 0:22:24Sen. Hassan: Our bill passed the senate last december, and I'm hopeful that the house takes it up and passes it soon. Oh deserve access to easy, user-friendly methods--our veterans deserve access to easy, use family methods to schedule v.a. Appointments in one stop. Will the v.a. Commit to working with my office in senator boozman's office to implement it so that veterans can schedule their v.a. Appointments in one place at one time?
▶ 0:22:52Dr. Koeniger: Certainly. The v.a. Would absolutely work with the committee, work with you and the committee, to look at the specific verbiage in the bill. Certainly access to care is at the forefront of what the secretary and the v.a. Is trying to do. We would be more than happy to work with your committee on that.
▶ 0:23:11Sen. Hassan: Well, thank you. Be able to implement this as quickly as possible--we should be able to implement this as quickly as possible so veterans can see on one screen all of her appointments and get to the appointments all at once. I look forward to working with on that with you. Last question for Ms. devlin, I would like to ask about the bill senator blackburn and I have that helps veterans access care specific to their needs without having to go through unnecessary delays or obstacles.
▶ 0:23:42Sen. Hassan: I understand that the v.a. Supports the intent of our bill, but that you have concerns about the specific language. I certainly don't think we need to get into a discussion about the technical language right now. But I would like to work with the v.a. To make sure that we get this right and that we can make sure that women veterans can schedule their appointments without any unnecessary barriers or other issues. Will the v.a. Commit to working with my office and senator blackburn's on finding a way to work on this issue.
▶ 0:24:11Dr. Koeniger: As a family physician myself, I totally support it so they can get the care they need.
▶ 0:24:20Sen. Hassan: Great, thank you, look forward to working with you on that.
▶ 0:24:24Chair Moran: Ranking member, senator blumenthal.
▶ 0:24:28Sen. Blumenthal: Thanks, Mr. chairman. I apologize, I was at a hearing for --
▶ 0:24:37Chair Moran: Chair moran: it is not like you to take the blame for something I did. [laughter]
▶ 0:24:40Sen. Blumenthal: I'm not going to go further on that. I'm going to forgo an opening statement and put it in the record, if that's ok.
▶ 0:24:50Chair Moran: Without objection.
▶ 0:24:52Sen. Blumenthal: I'm hopeful that we will move forward on the major richard starr act. I know that the chairman is sympathetic. I believe we have an opportunity for a bipartisan step forward on an act that is about simple justice for combat-injured veterans.
▶ 0:25:14Sen. Blumenthal: I believe strongly that it is an overdue measure to give him justice. Mr. barrans, quick question for you. The v.a. Budget request estimates of $21,000 increase in appeals received by the board this fiscal year, and this increase is the direct result of the increased number of claims the v.a. Has denied.
▶ 0:25:44Sen. Blumenthal: The appeals modernization act was congress's response to an appeals backlog that was created by v.a.'s effort to reduce the backlog in the early 2010s. It seems now we are heading in the same direction, the budget request estimates an increase in the year-to-year pending appeals inventory for the first time since implementation.
▶ 0:26:05Sen. Blumenthal: My appeals legislation with senator cassidy intends to avoid another appeals backlog by addressing inefficiencies in the appeals process and unintended consequences of the ama. Do you support this legislation? What reforms should congress consider that would improve the timeliness and accuracy of poor decisions? --board decisions?
▶ 0:26:30Mr. Barrans: Thank you for the question, senator. We support provisions. We have concerns some of the provisions. We would be happy to work with the committee on those. I would note that there are some provisions that we think are worth further discussion to gain potential deficiencies. -- efficiencies.
▶ 0:26:57Mr. Barrans: With respect to section seven of the bill, for example, which refers to veterans law judges issuing decisions during the course of the hearing, we had concerns with that and its operability. In the budget submission, there was a legislative proposal that we think would accomplish many of the same efficiencies in a way that would be more operable for v.a.
▶ 0:27:21Mr. Barrans: That would eliminate strict adherence to docket order as the rule governing our issuance of decisions. That would enable u, for example, if a veterans law judge during a hearing would identify a claim is one that is easily decided, quickly decided, we would be able to write up that decision following the hearing quickly and issued without regard to docket order.
▶ 0:27:48Mr. Barrans: There are several other scenarios where relief from the strict docket order requirement would enable us to gain efficiencies, bearing in mind that under our proposal, deciding cases first will always be the default rule.
▶ 0:28:02Sen. Blumenthal: Ms. devlin, my presumptive clarity act requires the v.a. To publish information about conditions and cohorts it is considering for the purpose of removing toxic exposure -related benefits. It requires v.a. To educate veterans on how to participate in the pact act, which I found is desperately necessary, because not enough veterans are aware of it. Do you agree that the v.a.
▶ 0:28:31Sen. Blumenthal: Should provide transparent and proactive notification when it makes significant changes to presumptive benefits and notify more veterans about that?
▶ 0:28:42Ms. Devlin: Thank you, senator, for the question. We agree that transparency is important and outreach is important. We anticipate a number of claims for the act but we have obligations to provide transparency under the act and vha has a directive --
▶ 0:29:03Sen. Blumenthal: Why isn't it happening?
▶ 0:29:06Ms. Devlin: We publish under the federal register and we have listening sessions so we can hear from them during the study.
▶ 0:29:13Sen. Blumenthal: With all due respect, I don't know too many veterans who read the federal register on a regular basis. Kenmore be done?--can't more be done?
▶ 0:29:23Ms. Devlin: It's a valid point. He also use our newsletter and even those unaffiliated with the v.a., we tell them about the listening sessions and how to reach us.
▶ 0:29:34Sen. Blumenthal: I think there is a need to do more, and my time is expired.
▶ 0:29:40Chair Moran: Senator cramer.
▶ 0:29:42Sen. Cramer: Thank you, Mr. chairman. Thank you, ranking member, and all of you for being here. I want to dig in on the piece of legislation that a number of us -- and never have cosponsored with me, including senator king -- a number have cosponsored with me, including senator king, senator boozman, senator slotkin, the veterans outdoor rehabilitation act.
▶ 0:30:07Sen. Cramer: It authorizes $10 million annually for a grant program for state departments and whoever they contract with. Maybe federal government entities, most likely state entities, state parks, game and fishing departments, private outfitters. Anyway, it provides a grant program, as I think you are aware. I was a little bit surprised, although it is the second time it has happened, when I see the v.a.
▶ 0:30:34Sen. Cramer: Opposing legislation after I read the testimony preparing for hearing. That is a little disheartening to me. I would like to get some clarity, because I read some of the testimony from the opposition, the reasons for the opposition. One of them I have to address right away, because I think it might be a misunderstanding. First of all, this is not a mandate on federal land management.
▶ 0:31:01Sen. Cramer: There was a reference, we are not the right agency, it should be the department of interior, except the department of interior is not the only land management agency in the federal government. In fact, a lot of it might not even be on federal lands. Likely wouldn't be, actually. Might be on private farms. But you also raise the assertion that the v.a. Lacks the authority to do this, which is why we passed laws.
▶ 0:31:29Sen. Cramer: It's why we pass laws, to give you authority to do it. Help me understand your opposition. I might also ask, in your answer, can you tell me the secretary suggest you oppose this as an agency, or kid colonel lowder? Who wrote the testimony? Who is -- who gave the direction?
▶ 0:31:52Dr. Koeniger: Senator, I appreciate your question. I am unaware of exactly who gave that -- the viewpoint here. What I can say is it's my understanding that the v.a.
▶ 0:32:10Dr. Koeniger: Is working with your staff to make sure that we understand the language appropriately, and that we get to some kind of agreement here. The v.a. Fully understands that there is potential therapeutic value in outdoor rec activities.
▶ 0:32:37Dr. Koeniger: What we want to be sure is that we are able to measure that therapeutic value and that there are appropriate boundaries that are put in place for such activities.
▶ 0:32:48Sen. Cramer: Do not trust the state veterans organizations, state vso's to come up with criteria suitable for their state or stakeholders?
▶ 0:33:03Dr. Koeniger: It's not that we don't trust the veterans organizations to do that. We would like to work with the state veterans organizations to make sure that all the needs of the veterans are met, and that we are able to measure improved outcomes.
▶ 0:33:22Sen. Cramer: So I hear you. Reading your testimony in opposition, I have to be honest -- first of all, can rather quickly ignores that this is for veterans. Fundamentally we do not believe the v.a. Should be the lead agency for the grant program for states to support our recreation. For veterans! Not for millionaires, not for ducks unlimited donors, not for wealthy visitors from annapolis.
▶ 0:33:53Sen. Cramer: Veterans. And pretty much every veteran organization, including state organizations, support the bill. So I will stress that point. The other thing is I have to say is I read this, it reads like a bureaucrat that doesn't want to do anymore work. Probably worked hard at writing it than the work that would be required --
▶ 0:34:16Dr. Koeniger: Sir, we would be happy to work with you and your staff to get the verbiage so that it's amenable to you and to the v.a. Our goal is tos support veteran -- to support veterans and improve their outcomes.
▶ 0:34:34Sen. Cramer: No, I appreciate that. My view is pretty well written in the bill, to be honest. The language seems quite clear to me. If we pass this in july and signed by the president of the-- into law and signed by the president of the united, I expect you to carry out as written. We would be happy to work with you.
▶ 0:34:55Chair Moran: Senator.
▶ 0:34:58Sen. Duckworth: I am pleased that my bill the maternal health for veterans act is being discussed at this hearing. The duckworth-collins protecting mom's act was signed into law in 2021, codifying the maternity care coordination programs at the v.a. With the aim of ensuring that every veteran in need of perinatal care receives world-class support.
▶ 0:35:22Sen. Duckworth: The population of women veterans continues to grow and it grows faster than any other of a graphic of veterans, and pregnant veterans, especially living in rural areas, and veterans with disabilities, and african-american veterans face unique challenges. They are at high risk of maternal morbidity and mortality compared to nonveterans. The need for sustained investments and continued oversight of the maternity care program is more urgent than ever, and that is why I plan to introduce and why we must pass the maternal health for veterans act.
▶ 0:35:54Sen. Duckworth: Dr. koeniger, in 2024 the gao published a report required by the protecting moms who served act that reviewed maternal health outcomes among veterans, as well as v.a. Maternity care services. In this report, the gao found that the severe maternal mobility rate for veterans almost doubled between 2011 and 2020, with great highest among african american veterans.
▶ 0:36:22Sen. Duckworth: The gao recommended they monitor two things -- one, maternal morbidity on characteristics such as rape and ethnicity, and two, v.a. Monitor screening--race and ethnicity, and two, v.a. Monitor screening of a veterans. How does v.a. Plan to address these fragmentations?
▶ 0:36:41Dr. Koeniger: Senator duckworth, thank you very much for that question. This is a very important topic that we absolutely take serious. The v.a. Has addressed recommendation number one, which was implemented in march 2024.
▶ 0:37:00Dr. Koeniger: The office of women's health began severe maternal morbidity reporting, and it was disaggregated by race, ethnicity, age, rurality, and even severe maternal mortality type. And they do annual reviews. That is recognition number one. Recommendation number two was actually submitted to the gao yesterday.
▶ 0:37:30Dr. Koeniger: And we hope to get feedback from the gao soon. But the v.a. Has already deployed in maternal care coordinator, mental health screening dashboard. That was deployed last month. And attracts required screening -- and it attracts required screening, the results of the screening, facility performance against goals.
▶ 0:37:56Dr. Koeniger: And it also facilitates that facilities need to supplement quarterly reports--submit quarterly reports, and though performing facilities will have to submit action plans so we can see improvement. Again, we take both of those recommendations seriously and are working to continue to roll those out.
▶ 0:38:19Sen. Duckworth: Thank you. As someone who received v.a. Character both my pregnancies, geriatric care, I shudder at that still, I understand firsthand the v.a. Staff puts into it. Would we continue to support maternity care at the v.a.?
▶ 0:38:46Dr. Koeniger: We will do our best to support any care that veterans need. That will also depend upon having the appropriate specialties at the appropriate places.
▶ 0:38:57Sen. Duckworth: Will you continue to work with me on the maternal health for veterans act to make the technical edits to attain v.a. Support and get this bipartisan legislation across the finish line is here?
▶ 0:39:09Dr. Koeniger: Ma'am, the v.a. Will work with you and your office to help.
▶ 0:39:14Sen. Duckworth: Thank you, I yield back.
▶ 0:39:17Chair Moran: Senator blackburn?
▶ 0:39:20Sen. Blackburn: Thank you, Mr. chairman, and thank you to each of you for being here. I think one of the things that my team and I hear the most about from veterans is health care access. I did a telephone town hall tuesday night with thousands of tennesseans, and we had questions about that access.
▶ 0:39:43Sen. Blackburn: What veterans are wanting to see is a simplifying of community care and the ability to go in their communities and get the care that they need. And veterans will tell us that one of the most difficult things they have to deal with with the v.a. When it comes to their benefits is health care.
▶ 0:40:09Sen. Blackburn: And also, understanding everything that they are entitled to. And having to pull all of this together themselves. So I have introduced the veterans bill of rights act, and it would not change eligibility. It would not at any benefits.
▶ 0:40:35Sen. Blackburn: But it is meant to make sure that every veteran has a clear, consistent information portal where they know what they are entitled to, and that they have protections that are there for them as they navigate care and benefits.
▶ 0:40:57Sen. Blackburn: And there was arrest me simple -- and there was a rasmussen poll that had this on it, and our veterans bill of rights had a 94% support among the military population. Ms. devlin, let me ask you, you have raised concerns about implementation on this. But I think we agree that veterans should have a much more clear understanding of their benefits.
▶ 0:41:26Sen. Blackburn: And that it should not be so difficult to access the benefits that they have learned. -- earne.d so are there specific provisions in the bill that would make you happy it would clarify these so that our veterans were able to have to attain this goal of knowing what they are entitled to?
▶ 0:41:52Ms. Devlin: Senator, thank you for the question. Yes, there are specific provisions in the bill we have concerns with. I will start with the most meaningful one, the bill requires v.a. To administer a training module on the bill of rights and the transition assistance program. The v.a. Only has access to service members for one day during the transition assistance week, and in that one day we get them for about six hours, and in that six hours we have to teach them about their health care benefits, disability benefits, all the different things v.a.
▶ 0:42:24Ms. Devlin: Has to offer --
▶ 0:42:24Sen. Blackburn: Well, it seems that a bill of rights that would simplify and aggregate this information might be helpful to that. Would you not think?
▶ 0:42:33Ms. Devlin: I think what we would recommend is to put it into the participant guide and refer to it, because if we took the amount of time it would take to cover the material that is in the bill, it would take away from teaching them about health care and about disability benefits and note education--and about education --
▶ 0:42:51Sen. Blackburn: Can you not online some of this information?
▶ 0:42:54Ms. Devlin: Yes, and that is what we would recommend, that we would refer to it and direct them to it but not teach entire module. The other piece we want to work with your office on his making sure there isn't actually a conflict between some of the information in the bill of rights language as compared to other language that is statutorily required for specific benefits programs and health care, so we can work to deconflict some of that as well.
▶ 0:43:19Sen. Blackburn: Ok. Do either of you have anything you want to add to that? Dr. koeniger?
▶ 0:43:27Dr. Koeniger: No, ma'am.
▶ 0:43:29Mr. Barrans: No, nothing else.
▶ 0:43:33Sen. Blackburn: I know senator hassan mentioned are women's veterans specialty care access act. We are doing a lot of work on this. I really have enjoyed working with her on this legislation. We have handled this in a bipartisan way, women's access to care and specialty care has been so limited. We are pleased with this. Ms.
▶ 0:44:01Sen. Blackburn: Devlin, back to you again, and I'm running out of time what operational safeguards would the v.a. In place to ensure more direct access can work?
▶ 0:44:12Dr. Koeniger: Ma'am, I will go ahead and take that.
▶ 0:44:16Sen. Blackburn: Good.
▶ 0:44:17Dr. Koeniger: The access to care, especially for women veterans, is a top priority. You may realize that back in december, the v.a. Actually rolled out a program where women veterans can directly contact g yn specialty services, and that program continues to expand.
▶ 0:44:49Dr. Koeniger: I've been following the numbers, and every month it continues to grow.
▶ 0:44:57Chair Moran: Thank you, senator blackburn. Sen.,
▶ 0:45:04Sen. King: One of the themes here is notifying veterans of potential benefits, and I happen to have a bill. Senator banks and I have a bill that is very simple. It would require that a post to be posted in the employer's place of business that had more than 50 employees simply saying, veterans come here are the potential benefits, or other numbers you should call, here is going on interstate. -- in your state the kind of information we are talking about with senator blackburn and senator blumenthal. The official position of v.a.
▶ 0:45:34Sen. King: Is deferring to the department of labor. To me, this is a pretty easy one. I don't think there is much in the way of cost involved. One of the themes of this hearing so far is veterans who don't know what their benefits are, what the programs are that are available. Ms. devlin, can unite the department of labor-- you nudge the department of labor or veterans and say this is a good idea?
▶ 0:46:02Ms. Devlin: We note that the bill is addressed to the secretary of labor. However, v.a. Does have a role should this be enacted in administering it. Coordinating across every single state, which has a wide array of differences in the benefits they administer, will require quite a bit of work. The bill requires to update the information twice annually. That does actually mean fte support, full-time equivalent employees --
▶ 0:46:30Sen. King: Have you heard of ai? This could be done in a weekend. And you have got 50 state veterans affairs. You could delegate the design of the poster to the veterans, the state veterans office, which every state has.
▶ 0:46:47Ms. Devlin: The development of artificial intelligence technology require funding.
▶ 0:46:55Sen. King: I'm talking by developing the poster.
▶ 0:46:56Ms. Devlin: Oh, the poster itself. The poster would not be the significant cost. The cost would be coordinating across organizations to get accurate information that would be on the poster.
▶ 0:47:08Sen. King: It seems that is something the state veterans office could you fairly straightforward, and I'm sure they would be delighted to do it. Second question is a bill that the chairman mentioned that he and I are sponsoring. I call it the show us your plan bill. It's as if the v.a. Is going to organize itself -- it says that if the v.a. Is going to reorganize itself into layoffs and significant changes, we would like a five-year capital plan to tell us what the plan is entered notify congress.
▶ 0:47:39Sen. King: We are the outfit that pays the bills. Of significant changes, rif plans, changes in the structure of the agency. That is all we are asking, simply to let us know what you are doing. I don't think that is an unreasonable request, although I know that the department says we do not support the bill is drafted. Tell us how you want it drafted, as long as it has the basic purpose, which is show us the plan.
▶ 0:48:07Ms. Devlin: Thank you, senator, for the question. Our human resources experts are not here --
▶ 0:48:14Sen. King: I realize that you are not the --
▶ 0:48:17Dr. Koeniger: --
▶ 0:48:20Ms. Devlin: I will take it back.
▶ 0:48:23Sen. King: Please do. It is important notify us in the veteran community of what is going on in the v.a. So they are not surprised by changes that take place without any notice. It would be helpful for the agency to develop a five-year human capital plan which would stabilize and give people predictability in terms of the organization of the body. Finally, Dr.
▶ 0:48:45Sen. King: Koeniger, our hospital told us in maine, the oldest veterans hospital in the country, by the way, we have gone from 500 vacant positions to 168, recently told to cut that to 71. That would get us where vacancy rate of 5% or below, which is pretty tight when you are talking about we hiring and trying to move slots around.
▶ 0:49:11Sen. King: Can you comment on the norm in industry, 10% vacancy rate, so give us some thoughts. We don't want our hiring process to be locked up trying to find the right billet.
▶ 0:49:26Dr. Koeniger: Senator, I appreciate the question. I don't have any specifics about your facility, but I can certainly take that back to the secretary and we can get with your office and look at specifics.
▶ 0:49:43Sen. King: I would appreciate it if you would. I don't want this very important hospital, the only one in our state, constrained in their ability to meet veterans' need who come to thems for service.
▶ 0:49:56Dr. Koeniger: Understand that, sir.
▶ 0:49:59Sen. King: Thank you, Mr. chairman.
▶ 0:50:02Chair Moran: Thanks for being here today. Ms. devlin, the apprenticeship bill, a partnership program, gi bill was envisaged after world war ii and focused on undergraduate education. There has been a realization across america that bachelors degree in higher education aren't necessarily for everybody, and often we have a veterans who may be coming home from war or active service and many of them would be better served with trades or training and skill sets -- getting a
▶ 0:50:34Chair Moran: Pilots license, or they can use military ground for immediate employment or trait-based employment. There has been a gap between veterans taking advantage of those programs and those who don't -- aren't aware they exist or are only pursuing the traditional g.I. Bill about. -- route. What can we do as congress and what can you do as the v.a. To ensure we are getting maximum per dissipation in the program? --participation in the program?
▶ 0:51:02Chair Moran: For veterans who are better suited to the program that undergraduate education?
▶ 0:51:08Ms. Devlin: We appreciate the need to have a workforce in our country and that veterans are well-suited to take on some of those high-demand occupations. One of the things we are working on with the department of labor is making sure we educate veterans about the quality of those careers, the wages they can almost instantly start earning, including ancillary benefits of the g.I. Bill benefits. But making sure they understand that we need them in these jobs and the quality of those jobs.
▶ 0:51:37Ms. Devlin: I will say there is a couple of things we mentioned in testimony about the bill that we would appreciate some consideration too. One is that -- first of all, veterans are -- 8% of apprentices are veterans, whereas 3.7% are undergraduate students. We are representing veterans in those occupations. I will say that the reduction on entitlement, currently it is prorated because when you start a job as an apprentice, earning $18 an hour, the v.a.
▶ 0:52:06Ms. Devlin: Pays the g.I. Go to the difference between that and the journeymen wage. You are the journeymen wage from day one. The reason the g.I. Payments go down is because your wages go up. We just go about 77% up over the course of that veteran--wages go about 77% up over the course of that veteran's career. Reduction in entitlement, since it is prorated they will use more of the entitlement. We don't know if they are using the g.I.
▶ 0:52:34Ms. Devlin: Bill because they want to preserve the entitlement to go to college later, or they have transmitted to a dependent and they want used in that matter. The other pieces of the bill doesn't address the needs, it would not apply to them, it would only apply to g.I. Bill students. We would need time to implement the technology associated with these changes, so we would ask for a period of time to implement.
▶ 0:53:02Ms. Devlin: One more thing I want to mention, the sector 23 jobs, regardless of how many hours the veteran pursues, if enacted as currently written, it would withdraw the entitlement for the full amount of hours, even if they didn't pursue this amount of hours. We think that might have the unintended consequence of then having them not get the benefit of that entitlement if they didn't pursue the hours.
▶ 0:53:28Sen. Sheehy: Well, there was another area -- I know there is an initial focus on this, but we have more farmers and ranchers over the age of 75 then under the age of 35. In a state like montana, ag is our largest economy. There is always input cost challenges for producers, but workforce is becoming one of the most critical challenges can be as families are looking at the cost to pass the operation onto the children. It's getting harder and harder to do that.
▶ 0:53:57Sen. Sheehy: We need more first-generation ag producers. There could be potential for the v.a. To participate in solving that, not just the workforce issue, but using education benefits and even the home alone. You cannot buy agriculture property with a home loan. I went through that myself, trying to do that.
▶ 0:54:19Sen. Sheehy: Commercial ag property and the associated skill sets that go with that could be a good way to create a solution to the agriculture workforce problem and onshore problem we are having, because one of america's greatest superpowers has been our ability to feed ourselves and the rest of the world. If we lose that, it's hard to get back. Our veterans workforce is not afraid a waking up at dawn and getting their hands dirty.
▶ 0:54:44Chair Moran: Thank you, senator sheehy. Senator gallego.
▶ 0:54:50Sen. Gallego: Close enough.
▶ 0:54:54Chair Moran: I was doing two things at one time.
▶ 0:54:56Sen. Gallego: Thank you for joining us today. The vha -- emerging and innovative therapies. I'm a proud sponsor of the legislation with senator sheehy. Emerging therapies like psychedelic assisted therapies offer real hope for veterans for ptsd when nothing else has. How bill makes sure we are exporting every option to support these veterans. Dr.
▶ 0:55:24Sen. Gallego: Koeniger -- did I see that correctly?
▶ 0:55:26Dr. Koeniger: Yes, sir.
▶ 0:55:29Sen. Gallego: Knowing we have the responsibility to deliver the best possible care, can you explain what gaps assist to providing psychedelic assisted therapy for ptsd? What would the v.a. Need to close those gaps?
▶ 0:55:43Dr. Koeniger: Thank you for that question. I would like to start by saying that in terms of the novel therapeutics, the v.a. Already has some experience with that. Just as an example, ketamine, novel therapeutics that v.a. Currently uses -- as a matter of fact, it is offered in 53 v.a. Facilities currently.
▶ 0:56:12Dr. Koeniger: And so we have evidence-based guidelines that help with that. We understand that these novel therapeutics have the potential benefit. What we want to do is make sure that those are rolled out in a very objective and scientific way, because we certainly don't want to injure veterans as we are using those. So I think that there absolutely is opportunity, the v.a.
▶ 0:56:41Dr. Koeniger: Is actually anticipating that some of this will be approved by the fda, particularly in terms of research. We are setting ourselves up to be able to do that rapidly.
▶ 0:56:57Sen. Gallego: We certainly want to make sure veterans have safe access to all therapies. This is why I'm anxious to get this going, because a lot of veterans are going to mexico and other parts of the world and getting unregulated therapies can which can be hit or miss, can be dangerous. We want to give every opportunity to veterans to have a chance at dealing with their ptsd.
▶ 0:57:25Sen. Gallego: Our bill would ensure veterans access to emerging mental health treatments as they become available. The vha novel therapeutics act would establish a dedicated office of novel therapeutics within v.a. And streamlining the process for these promising therapies. Doctor, can you speak to the improved coordination needed between v.a. And researchers to ensure that veterans have access to these innovative therapies, including access to psychedelic assisted therapies for ptsd?
▶ 0:57:53Sen. Gallego: And how would a streamlined process, office of therapeutics within the v.a., increase the access and promising these therapies?
▶ 0:58:03Dr. Koeniger: We understand that one of the major pieces of the legislation is to recommend setting up an office for the novel therapeutics. The v.a. Has already gone a ways down that road. We have integrated project team that is set up that is already dealing with many of the points that are laid out in your piece of legislation.
▶ 0:58:32Dr. Koeniger: We would be happy to work with you and the committee to find out where the gaps are in terms of what you are recommending and what the v.a. Is already doing so that we can go ahead and close those gaps. What we want to avoid is a duplication of activities which would potentially make us less efficient. Be happy to work with you and your staff on making -- getting that language right.
▶ 0:59:02Sen. Gallego: My concern isn't necessarily -- I think the v.a. Is moving in the right direction when it comes to these types of therapies, especially using psychedelics. My concern is we don't codify this into law, should there be a change in administration, everything could go away. This administration has actually been better about working with psychedelics and veterans than the last administration. I can't predict what the next administration is going to be like.
▶ 0:59:30Sen. Gallego: What I can predict is a lot of veterans will always be seeking this type of treatment and would rather it be house, treated, tested, and deployed under the guidance of the v.a. Vs. Them going to parts of the world we would rather them not go to and potentially put their lives in danger. I look forward to you working with us and I would love to get this bill across the finish line to make sure we can solidify this.
▶ 0:59:55Dr. Koeniger: Yes, sir.
▶ 0:59:57Chair Moran: Senator king has a brief final question.
▶ 1:00:01Sen. King: Ms. devlin, you may have noticed me playing with my phone during questioning. I asked claude, what our available benefits and services to veterans inmate?-- in maine?
▶ 1:00:18Sen. King: Key state contacts, crisis and emergency, health care, mental health and counseling, financial benefits, education, employment, outdoor licenses, legal help, and the main bureau of the veteran services. I misspoke, I said it would take a weekend. This took about an hour. Let's get on with it. This is a very simple proposal to get information by veterans. There's nothing complicated about it.
▶ 1:00:45Sen. King: All you got to go is go to claude 50 times, whatever the state is, and you get a comprehensive list with phone numbers for numbers f.
▶ 1:00:55Chair Moran: Senator king, thank you. We will dismiss you and pull the second panel up. The series of votes has been commenced. Thank you.
▶ 1:01:10Chair Moran: Testifying on the second panel is brian dempsey, the government affairs director for the wounded warrior project, joseph chenelly, and jennifer and dale for the military officers association of america. -- jennifer goodale, director of government relations for the military officers association of america.
▶ 1:01:41Chair Moran: Ma'am, gentlemen, thank you very much for being here. Mr. dempsey, if you are prepared to commence, please do.
▶ 1:01:51Mr. Dempsey: -- blumenthal and singers committee members, thank you for inviting us to testify on an agenda of bills intended to improve how our nation provides care and support for veterans, families, and survivors. In the interest of time, I will speak to several bills on today's agenda that will help us meet our priorities for the service members we have been serving for over 20 years. As part of our efforts to end veteran homelessness, we urge the committee to pass s. 4043.
▶ 1:02:23Mr. Dempsey: This bill strengthens the stability of effective programming by making permanent v.a.'s long-standing health care for homeless veterans program, which has provided services for more than three decades. Removing the statutory sunset provision will emanate uncertainty that can disrupt care and hinder services for the most vulnerable veterans. As part of our efforts to help veterans pursue fulfilling careers outside traditional higher education pathways, we are pleased to support s.
▶ 1:02:51Mr. Dempsey: 3993, reducing arbitrary barriers to apprenticeship act. This removes unfair benefit penalties that can discourage veterans from pursuing apprenticeship and on-the-job training, particularly in high demand, skilled trades. By reducing structural barriers, it will help veterans avoid financial strain and make full use of earned benefits and the skilled labor pipeline.
▶ 1:03:17Mr. Dempsey: To serve and support and most severely wounded veterans, we encourage passage of the veterans stand act, and s. 3647, disabled veterans dignity act. The former would help veterans with spinal cord injuries received checkups where they may be evaluated for innovative treatment that can increase quality of life.
▶ 1:03:38Mr. Dempsey: The latter would codify the bowel and bladder program, which is essential to standardize all associated processes and procedures while guaranteeing that the program functions as it should for those who need this heightened level of care. To help us end veteran suicide, congress can continue his work with v.a. To increase veterans access to emerging mental health therapies by passing s. 4220, the novel therapeutics preparedness act.
▶ 1:04:06Mr. Dempsey: While we urge coordination alongside the proposed vha we organization in a recent executive order related to psychedelic assisted therapy, this legislation would ensure that v.a. Has the leadership,, infrastructure and processes in place to implement new models of care if and when the scientific evidence supports their use. To strengthen alignment and coordination across the spectrum of military and veteran health care, we support s. 3992, the joint medical facilities fund act.
▶ 1:04:33Mr. Dempsey: This would provide a consistent funding mechanism to improve coordination, resource sharing, and interoperability between dod and health care systems which would improve the quality of care available to those who have served and are currently in uniform. Lastly, we encourage further discussion and evolvement of s. 3726, the national veterans strategy act of 2026.
▶ 1:04:54Mr. Dempsey: Four years, incremental solutions touching on health, disability compensation, education, and other important topics have brought improvements to countless veteran lives, but a whole of government approach has been lacking. Formalizing a national approach will improve coordination, accountability, leadership, and help more veterans elevate quality-of-life. It is my honor to be here on behalf of wounded warrior project. Thank you for letting us do our part to keep the promise.
▶ 1:05:23Mr. Dempsey: This concludes my testimony, and I look forward to your questions. Thank you. >> chairman moran, ranking member blumenthal, thanks for the opportunity to be here. We thank you for your bipartisan leadership on the priorities of veterans and their families.
▶ 1:05:44Mr. Dempsey: The bulls under consideration align closely with amvets' top priorities, including access to timely, high-quality care, establishing a coordinated veterans strategy, expanding whole health and neurohabilitative services for tbi, supporting survivors and women veterans, improving economic opportunity, enhancing accountability across the v.a. System.
▶ 1:06:08Mr. Dempsey: Taken together, these proposals recognize that veteran success requires a comprehensive approach that supports long-term health, stability, and quality of life. Amvets strongly supports many of the bills before the committee, particularly those that events a more coordinated approach to veteran success. Establishing a national veterans strategy is long overdue. Too often come efforts across federal, state, and community systems remain disconnected.
▶ 1:06:34Mr. Dempsey: A unified framework will share metrics, improve coordination, accountability, and outcomes for veterans. We stood by dispensable for several years and are proud to see move forward. We also support efforts to strengthen survivor benefits and ensure veterans are honored with dignity.
▶ 1:06:53Mr. Dempsey: Legislation addressing inequities to families of veterans who passed away from als, removing updated restrictions on memorial recognition are important steps towards fairness for surviving families. The most difficult times of their lives, these initiatives should be something we can come together on. Expanding access to rehabilitative and whole health care is another critical opportunity. Veterans living with traumatic brain injuries and other complex conditions need flexible long-term support.
▶ 1:07:25Mr. Dempsey: Bills that improve access to assistive technologies and strengthen services to support daily living will have a meaningful impact on quality of life. We support innovative approaches such as outdoor rehabilitation and nutrition-based interventions, recognizing that long-term health outcomes are shaped by more than clinical care alone. Addressing homelessness remains essential.
▶ 1:07:46Mr. Dempsey: Our team works daily through the amvets veteran services center in southwest pennsylvania and throughout two new department of labor grants in phoenix, arizona, and salt lake city to address the needs of these veterans, particularly those facing serious mental health conditions and other compact barriers to care. These veterans need hands-on support and strong legislative action to rebuild their lives. We see that everyday.
▶ 1:08:11Mr. Dempsey: Making permanent the v.a.'s authority to provide treatment and rehabilitation services for veterans who are seriously mentally ill and experiencing homelessness will ensure continuity of care for some of our most at risk veterans. Regarding economic opportunity, we support efforts to improve access to information about benefits in the workplace and remove barriers to apprenticeship and on-the-job training. Veterans should be able to pursue meaningful careers without being limited by outdated policies or lack of awareness about available resources.
▶ 1:08:42Mr. Dempsey: We also strongly support advanced care for women veterans. Improving access to specialty care, expanding breast cancer screening, strengthening maternity care coordination are necessary steps to ensure that women veterans receive timely, comprehensive care. Women veterans remain the fastest growing veterans population and the fastest growing membership within amvets. There needs have to be put on the -- there needs have been put on the back burner for far too long. It is time to support them where they need it most.
▶ 1:09:13Mr. Dempsey: Finally come improving access and accountability within v.a. Remains a top priority. Reducing barriers to communication, strengthening oversight processes, and improving coordination between -- between the department of war and the v.a. Are essential to building a system veterans can trust and rely on. This is at the core of what we believe in and promote among veterans we work with. In a written testimony, we offer targeted recommendations on several proposals to ensure they are implemented in a way that protects access and avoid unintended consequences.
▶ 1:09:45Mr. Dempsey: Efforts to address fraud, improve transparency, and modernize appeals must be carefully structured so it does not create new barriers for veterans navigating the system. This morning, amvets stood with 34 other the soc in support of the regent informed consent act preventing veteran suicide and improving lies unites all of us --improving lives unites all of us. This hearing serves as another opportunity to come together.
▶ 1:10:15Mr. Dempsey: We are here, we are ready to work with you to ensure all of these policies deliver measurable improvements in the lives of veterans and their families. Thank you, and I look for to your questions.
▶ 1:10:25Chair Moran: Ms. goodale?
▶ 1:10:27Ms. Goodale: On behalf of the military officers association of america and the more than 350,000 members we represent, thank you for the opportunity to testify on legislation impacting veteran health care, benefits, caregivers, and survivors. We appreciate this committees long-standing bipartisan commitment to assisting veterans after service. The remarks I will offer today focus on measures where we believe our advocacy experience can be most helpful to the committee.
▶ 1:10:58Ms. Goodale: Our mission spans the full arc of service come from the day someone steps on the elephants to the day they receive a v.a. Headstone. That perspective gives us a unique understanding of how health care compensation and survivor benefits are all connected. First, moaa endorses establishing a national veterans strategy as a critical reform to align goals and resources and survivors.
▶ 1:11:22Ms. Goodale: Much like the national security strategy, this would unify national objectives, improve coordination across agencies, and strengthen accountability for the significant federal investment in programs. To establish the long-term viability, moaa recommends clear guardrails, not just individual veteran success. Explicit recognition of families, caregivers, and survivors as essential stakeholders, and measures that support long-term planning and sustained congressional oversight.
▶ 1:11:51Ms. Goodale: We recommend clearly defining the pentagon's role and responsibility to provide coordination without expanding its statutory mission. With these elements in place, the strategy can provide a durable bipartisan framer to strengthen support for the veteran community. We conditionally support the draft on draft o optimizing the workforce for veterans act, provided adequate resources are available for implementation. Veterans cannot receive timely benefits without stable v.a. Workforce.
▶ 1:12:21Ms. Goodale: Hiring freezes and reductions in force should be guided by a long-term strategy, not short-term turbulence. A rolling five-year workforce plan with transparency and oversight with strengthen continuity of care and service delivery. On health care, moaa supports the mammography access for veterans act. Women veterans are among the fastest growing in v.a. Yet too many face barriers to screening. Expanding mammography is a cost-effective way to improve access in rural and underserved communities.
▶ 1:12:51Ms. Goodale: On benefits, moaa supports the justice for als veterans act. The disease is often swift and devastating. Current law can deny and enhance compensation to spouses sadly because the veteran did not live long enough. The existing requirement was created as a broad statutory threshold, not with rapidly terminal illnesses like als in mind. This is an inequity congress should fix.
▶ 1:13:18Ms. Goodale: Families caring for a loved one with criminal a-list should not be penalized by an arbitrary timeline--criminal als should not be penalized by an arbitrary timeline. Veterans deserve a claims process rooted in trust and integrity. Misleading medical evidence harms veterans and undermines confidence in the system. Accountability must target bad actors, not veterans who acted in good faith.
▶ 1:13:45Ms. Goodale: Any final legislation should ensure due process, individualized reviews, and protection against unjust benefits reductions. This aligns with moaa's support for a broader effort to stop those who profit from veterans' earned benefits. Moaa supports the veteran benefits protection act. Earlier this year, the interim final rule consider earning the impact of medication on disability ratings created worry amongst veterans. Moaa appreciates the decision to rescind that rule.
▶ 1:14:17Ms. Goodale: Veterans should never choose between managing health and protecting earned benefits. No veteran with an established disability rating should seek compensation simply because treatment options improved. This bill provides long-term certainty and helps prevent future administrations from revisiting similar changes and restores confidence disability compensation reflects underlying condition, not a medicated snapshot on exam day. These bills differ in scope but share a common principle.
▶ 1:14:46Ms. Goodale: Veterans deserve systems that are fair, moderate, transparent, and worthy of their service. Moaa appreciates this committee's passage of the reeducation, reemployment, and retirement act, and hope to see it enacted into law this congress. Moaa appreciates the bipartisan leadership and stands ready to help advance these proposals. Thank you for the opportunity, and I look forward to your questions.
▶ 1:15:09Chair Moran: Senator blumenthal?
▶ 1:15:10Sen. Blumenthal: Ms. goodale, I take it from your testimony that you believe a measure like the clarity act is important to notify veterans about what their rights are, changes in conditions.
▶ 1:15:25Ms. Goodale: Senator, that's a great point. From v.a.'s first panel, there is always a requirement to publish it to the federal register -- you made kind of a djokovic, but there are not--joke of it, but there are not many veterans checking the federal register. There has got to be a better way to share a clear outlook of what cohorts and conditions when it comes to presumptives.
▶ 1:15:52Sen. Blumenthal: C1
▶ 1:15:58Sen. Blumenthal: I support the legislation to provide notification. My mammography for veterans access act would solve an issue I've heard about in connecticut and around the country, veterans having limited access to mammograms at v.a. Facilities.
▶ 1:16:26Sen. Blumenthal: Most members of these members -- most members of these committees are in states that lack these. Veterans in those states must receive mammograms from community providers and rely on them to transmit records back to
▶ 1:16:56Sen. Blumenthal: The v.a., which is often delayed or never happens. We owe it to our veterans because of exposures and other factors to ensure they can access in-house mammography. You may want to answer or I would welcome answers from the others.
▶ 1:17:24Ms. Goodale: For women veterans, it's difficult. We think this will enhance opportunities to get the screenings that are necessary. As a veteran but also active military duty spouse, even the transition between tricare and getting the information back to the v.a. Is a challenge. There's work to be done and this is a good step forward.
▶ 1:17:56Sen. Blumenthal: Thank you.
▶ 1:18:02Mr. Chenelly: I think we've learned over the years that fragmented health come -- health care does not lead to the best outcomes. Especially for women veterans, it still fragmented rather than have it on one campus, forcing the veteran to run all over town or go to the next town. It's not fair to women veterans and needs to be fixed.
▶ 1:18:34Mr. Dempsey: As I stated earlier , early detection for this life-threatening disease will save lives. It will help more women, there are more options and better options and we are pleased to support the legislative effort.
▶ 1:18:53Sen. Blumenthal: Thank you. As was pointed out, having to run all over town for different tests rather than having them under one roof in one place is very salient. Just getting around for a lot of veterans, the time and expense, may be discouraging for them to get tests that diagnose early conditions which can be treated early with a lot less cost and pain.
▶ 1:19:24Sen. Blumenthal: Thank you all for being here today.
▶ 1:19:30Chair Moran: I'm going to go cast my vote. Senator cassidy will determine when the hearing comes to an end.
▶ 1:19:42Sen. Blumenthal: I apologize I have to go vote as well.
▶ 1:19:47Chair Moran: I will submit some questions for the record. I appreciate your presence here today we take highly into consideration the thoughts and considerations. >> [indiscernible] [laughter]
▶ 1:20:09Sen. Cassidy: I will give it to senator kaine. You went down the list, and you touched on the organizational bill. Could you emphasize or amplify your thoughts about why it's a good idea to have an ongoing picture of the structure of the organization at the v.a.?
▶ 1:20:37Ms. Goodale: Not only for the veterans receiving services but those employed by the v.a., that forecasting nature is important. We saw from the significant turmoil that happened two january's ago, there was a lot of disruption in what people knew what to expect. There are opportunities to say this is the plan.
▶ 1:21:01Ms. Goodale: You go into a plan -- you go into battle and the plan changes right away, but at least you have an idea of what is forecasted and how that will impact services, alongside veterans providing those services and working for the v.a.
▶ 1:21:22Sen. Cassidy: Thank you. What you think about the poster idea?
▶ 1:21:30Mr. Chenelly: Anything we can do to get information to fellow veterans is needed. Every day we get questions from veterans asking about services already available.
▶ 1:21:52Sen. Cassidy: The poster would be available in every workplace. If you have other ideas. This is a huge challenge, we have a huge number of veterans who don't know what's available. Let's work together to improve that. Brian, did you have a comment?
▶ 1:22:16Mr. Dempsey: The only comment I have, the state veterans organizations have an important part to play. We want to make sure as many eyes and ears are on veterans.
▶ 1:22:34Sen. Cassidy: Thank you all for your testimony. >> sorry for being late. The thing I wanted to ask about was a bill on the g.I. Bill and apprenticeships. The deal is we figured out the g.I.
▶ 1:23:01Sen. Cassidy: Bill, which is such a historic and important part of how we get access to education for veterans, has a bit of a bias toward those who do four year college education. If you want to do apprenticeship , something that's not a four year institution, you get less reimbursement. A very happy this is bipartisan.
▶ 1:23:31Sen. Cassidy: It seems like a no-brainer but can I get your thoughts? Am I missing something?
▶ 1:23:44Mr. Chenelly: I think it makes all the sins in the world. We get real-life examples. We are running the department of labor rather than v.a., homeless reintegration programs insult lake city in phoenix. These are veterans that have fallen to the justice system or addiction and we are giving them a hand and guiding them through.
▶ 1:24:15Mr. Chenelly: We are hearing from them constantly that they didn't have other options when they came out of service to better themselves and get themselves ready and the big thing we are offering them now are apprenticeships. We are sending them to trade unions and trade schools, what you are talking about, helping provide training before they get into problems.
▶ 1:24:40Sen. Slotkin: We have a huge gap on skilled trades in this country and apprenticeships are the best way to get into skilled trades. It feels like a win-win. What do think, Mr. dempsey?
▶ 1:24:55Mr. Dempsey: Thank you. We are very appreciative of the bill. The bureau of labor statistics, about 60% of the new jobs created between 2020 and 2030 don't require a college degree. Very much the systems we set up to support veterans in transition have a college first model and I think anything to incentivize veterans toward these trades, skilled labor, would be beneficial.
▶ 1:25:22Sen. Slotkin: Great.
▶ 1:25:26Ms. Goodale: We did not take a formal position on this bill but I think what would be interesting based on the panel before us, having more data on why this problem exists. Is it because of the decreasing benefit amount, is it because the veteran has transitioned -- my husband has given his g.I. Bill to both of our kids, he won't be using it. What are the existing barriers?
▶ 1:25:54Sen. Slotkin: We found that if you go to let's say michigan state university, you can get housing paid for by the g.I. Bill. You can't use it for housing on apprenticeship. If you go get trained. I know we like to study things in the government and do like 15 year studies to do things, it usually is good governance and but I think in this case it's
▶ 1:26:25Sen. Slotkin: Just referencing college. I appreciate everyone's interest and support and I yield back.
▶ 1:27:12Sen. Tillis: :
▶ 1:27:16Sen. Tillis: This would give nonprofits the ability to receive financial assistance under the veteran directed care program to provide caregiving services to veterans living with injuries. So how do we care for the younger disabled veteran living with brain injury?
▶ 1:27:40Mr. Dempsey: Thank you and for your effort to move this forward. Veteran focused nonprofit organizations have a major role to play for those living at home with dramatic brain injury. Bastian has been a wonderful partner and we also support to our independence program. I think the bill highlights the importance of the veteran directed care program and supporting veterans at home.
▶ 1:28:10Mr. Dempsey: It's under the geriatrics and extended care program, which highlights that it pivots more toward an elderly population but there's more we can do to help veterans at home and being supported in some cases by parents, adult siblings, friends, family and other caregivers to bring more organizations who can get involved with their lives and improve their quality of life and make sure they are at home in a safe and stable living environment.
▶ 1:28:39Mr. Dempsey: Their health-care names are tremendously important and we are eager to continue working with you and your team to make sure this becomes law.
▶ 1:28:48Sen. Tillis: Is that irish?
▶ 1:28:53Mr. Chenelly: I like irish but it is an italian last name. My grandfather changed the spelling to avoid discrimination against italians at that time.
▶ 1:29:11Sen. Tillis: So he became irish? Someone should've told him. [laughter] the veterans appeal improvement and modernization act was a major improvement over the legacy and it's been proved timeliness to give veterans more decisions but as you know it's not perfect.
▶ 1:29:41Sen. Tillis: There are limitations and unintended consequences. The modernized system can still be overly technical and difficult to nominate -- to navigate. That's why we have built upon the success of the original. In your testimony you speak about rigid timelines and the need for flexible docket structures.
▶ 1:30:05Sen. Tillis: My bill, our bill, would remove arbitrary blackout periods for cementing evidence and allow veterans to change options without being penalized. Do you think this legislation would address some concerns with the current system?
▶ 1:30:25Mr. Chenelly: Yes, we support the premise and intent. I think there's a lot of good in this bill and we would like to work with your office to ensure it doesn't slow things down unintentionally.
▶ 1:30:43Sen. Tillis: In your testimony you state there should be inefficiency -- there should be efficiency without limiting veteran. Do you think the legislation accomplishes this goal?
▶ 1:30:57Mr. Chenelly: Yes.
▶ 1:31:01Sen. Tillis: In the nick of time, senator banks is here.
▶ 1:31:07Sen. Banks: 30,000 veterans were homeless in january 2024, way too many. What does the v.a. Need to do to find housing for these veterans?
▶ 1:31:25Mr. Dempsey: I think we need to double down on what is working. I appreciate your legislation but there also several others looking at expanding access to programs and making sure veterans can access housing using low income tax credits. Sometimes compensation can get in the way.
▶ 1:31:56Mr. Dempsey: There's a good piece of legislation on there that can codify what's working and make sure we make it a national priority to and veteran homelessness.
▶ 1:32:07Sen. Bank: Can you help me codify the program?
▶ 1:32:11Mr. Dempsey: Yes, again, it's working, delivering care to those that are vulnerable. Disrupting the need to continually reauthorize and do long-term planning and coordination and we are committing to what is working.
▶ 1:32:33Sen. Bank: You can't talk about how disruptive that is, to authorize it rather than permanently authorize it? The disruption to veterans.
▶ 1:32:43Mr. Dempsey: Just making sure there are individuals who know they have the continued federal funding to make sure they can commit to their jobs and reach as many veterans as I can is the utmost importance and disruption to the legislative cycle would hopefully be eliminated or mitigated having permanent authority.
▶ 1:33:08Sen. Bank: Some v.a. And medical services share space but they have to jump through hoops for reimbursements. How would establishing more joint facilities be helpful to veterans?
▶ 1:33:22Mr. Dempsey: A governmentwide effort to make sure servicemembers and veterans are getting the best care possible is a priority. The legislation you've introduced, even when they are collaboration -- collaborating they can be partners. They can have a consistent mechanism and make sure the quality of care is high and uninterrupted.
▶ 1:33:51Mr. Dempsey: We are helping with transition between system and making sure providers are getting the most experience and dealing with the most diverse range of patients possible.
▶ 1:33:59Sen. Bank: Where would it be most helpful to have joint medical facilities?
▶ 1:34:03Mr. Dempsey: Take a hard look at the map and make sure we are mapping where there is a lack of abundance and care to either population. Areas where there are strong academic research communities that coordinate with the government.
▶ 1:34:34Mr. Dempsey: Make sure we are following models of collaboration that are working.
▶ 1:34:40Sen. Bank: The v.a. Doesn't just house homeless veterans, it provides health care, rehabilitation, addiction services and mental health therapy. How does the comprehensive approach help homeless veterans rebuild their lives?
▶ 1:34:59Mr. Chenelly: Homelessness is an extremely complicated issue and many different factors go into causation and certainly the solutions to homelessness in each person is unique and each person has unique issues and being able to take those different issues into account and able to address each issue for our veterans.
▶ 1:35:32Sen. Bank: How well is the v.a. Managing the homelessness programs?
▶ 1:35:39Mr. Chenelly: Very well. Going back to your legislation, knowing v.a. Will continue to make the same efforts. As they work through their strategic planning long-term and right now we've seen a lot of fluctuation through the last few administrations. Sometimes we are not able to plan ahead because of that.
▶ 1:36:09Sen. Bank: Thank you, my time is expired.
▶ 1:36:12Sen. Cassidy: I think our second panel for their testimony and committee members and audience for being here. Senators who would like to submit questions to the record for the witnesses or additional statements have one week to do so. Ask witnesses to respond to any questions for the record received the following a hearing in a timely manner. The hearing is adjourned.