Transcripts For CSPAN2 Veterans Affairs Secretary Nominee Denis McDonough Testifies At... 20240711

Watch booktv this weekend on cspan2. President biden has picked Denis Mcdonough to head the Veterans Affairs department. He previously served as white house chief of staff during the last four years of the obama presidency. His confirmation hearing he was asked about veterans access to healthcare, modernization efforts in the das responds to covid19. This is just over two hours. [inaudible conversations] [inaudible conversations] i i want to call this evening to order. I want to welcome everybody. I appreciate all that are here, all those that are online. The purpose of this hearing is due from the i president s nominate to serve as secretary of Veterans Affairs, Denis Mcdonough. Before i talk about him i just want to say i appreciate this committee all the reasons we sat on this committee thats been bipartisan and its been nonpolitical, and we tried to do the best by our veterans whether you are the republican side for the democratic side of the aisle. I particularly appreciate the relationship i had withio the former chairman johnny isakson, and with my good friend jerry moran. This is not going to change. We will continue to operate this committee in a way that the veterans arere number one, and thats just the way its going to be and were going to continue to Work Together everywhere possible and communicate together and not surprise one another and move forward with policies that work for this countries veterans. Denis, i appreciate your commitment to Public Service and your willingness to step forward. If confirmed, you will be cast with ensuring that our nations veterans have access torm timely Care Services and the benefits they have earned and deserve. Today were here to determine whether you are right for this job i appreciate you taking the time to meet with members of the committee over the past few and for your timely responses to the prehearing questions sent by many of us. At this time i would asking in this consent those questions and responses be made part of the record of this hearing. The transition between administrations can be a time of turmoil and confusion and can generate uncertainty inside and outside in agency. At v. A. Theyre simply too much at stake to let that happen. The coronavirus pandemic is still raging with more than 400,000 americans succumbing to the virus in less than a year. Denis, you will be responsible for ensuring that the v. A. As a fitting it needs to treat our veterans and care for the v. A. Employees. V. A. Has tested nearly 1. 3 million veterans and employees for covid19. Thens agency is tracking nearly 198,000 cases among veterans, staff and others admitted to v. A. For care including nearly 14,000 active veteran cases. And now that more than 8300 veteran families who are without their loved ones including the morere than 3100 v. A. Has cared for within its facilities. Denis come simply put, your chief responsibility during this time will be to save as many lives as possible. That includes advocating within the administration for v. A. s fair share of vaccines and ensuring timely and efficient deployment of those vaccines. It includes efforts to ensure frontline workers have everything they need to take care of our sick veterans and protect themselves from if coronavirus. How you care for your suffering everything. V. A. Reported nearly 3200 staff with active Covenant Team and another 2300 clinical staff staff are quarantined and unable to work. Sadly 118 staff have died from this coronavirus. The virus is taking a toll on those v. A. Heroes who care for veterans and where entrusting you with their safety. I am pleased the administration has asked doctor stone to ensure a smooth, w has kept doctor stoe to ensure smooth transition for vha, Veterans Health administration. But it will be a while before you have a full Leadership Team in place so theres a lot riding on your shoulders. When youre in need of scrutiny is claims processing. Nearly 500,000 claims or pin with more than 200,000 considered to be backlogged. While somewhat focuses on health care we must ensure this important issue gets the attention it needs. Additionally, this committee reaffirms its bipartisan reputation in the last congress, a number of the stork reforms enacted from john scott hannon, Veterans Mental Health improvement act to the Deborah Sampson act to presumptive covered for thousands of additional Vietnam Veterans exposed to agent orange. The implementation of these reforms o must be consistent wih congressional congressional intent and must be swift. Veterans are counting on it. And with the case of Vietnam Veterans, they have already been waiting for decades. There are other Critical Reforms that a bin in the works for years and needs serious attention. From a program that is seen its number speed bumps to Electronic Health record modernization effort that has taken way too long and cost taxpayers way too much and everything in between. You will have your hands full but know that this committee is here to help. If you are transparent and respectful of oversight, we can be your biggest proponents and your best partners. During her predecessors nomination and i told him the Sacred Mission of serving the veterans and their families must always transcend personal agendas or political affiliations. In the end, i believe he lost sight of that and i called him out forn it and i will hold you to the same standard. Theres a great political divide in this nation but veterans across the country in the members of this committee are united by a very basic expectation. The next v. A. Secretary needs be an individual of honesty, integrity and vision who listens to the veterans and puts their wellbeing above all else. If you keep your head down and live up to e that expectation yu will be successful. Ending the end we all want you to succeed because veterans across this country need you to succeed. I look forward to our discussion today. Thank you again for your one instance or on behalf of our nations veterans. Without altering overview, senator moran. Chairman tester, thank you, thank you for the comments, thank you for the working relationship, your care and concern for veterans, the way this committee has operated during my chairmanship and i agree with you that that cooperation t bipartisanship wi, should and will continue. You will be the eighth chairman i have served on the house Veterans Affairs committee under chairman bob stump, chairman krishnamoorthi smith, chairman steve bowyer, chairman bob filner and in the senate under chairwoman patty murray, chairman Bernie Sanders, chairman johnny isakson, and now you and in all circumstances i want to be a productive member of this committee and want to work with my colleagues to see that good things happen for all veterans. And a i have in some instances when we say things like that, we have a sense we are just talking, and im not just talking and you were not just talking. We have no option and no desire to do anything other than wait weve operated in the past and will continue to work with you in that way to serve our nations veterans. Mr. Mcdonough,ur welcome. No mission is nobler than the one you will lead if confirmed, so i thank you and your family for your willingness to reenter government service. We are going into this new congress with new leadership and a new administration. The challenges we aim to address on behalf of our veterans will be a mix of those existing, ongoing issues we still struggle to sort out, alongside new challenges and new opportunities for our country to not only honor veterans for the service they provided, but to harness their values and talents to help them lead again. C mr. Mcdonough, in 2014 your White House Deputy chief of staff, rob nabors, reviewed the nationwide wait time scandal and described the root causes using phrases such as little transparency, corrosive culture, lack of accountability across all grade levels, and l significant and chronic system failures. Six years later, thanks to the collective efforts of three v. A. Secretaries and thousands of dedicated employees, it is fair to say v. A. Looks very different now than it did then. Employee engagement is at itsdi highest level in over a decade. V. A. Ranks 6 out of 17 among large government organizations as a best place to work, a vast improvement in just four years. And Patient Trust in v. A. Health care is now over 90 . Your job, if confirmed, will be to solidify and build off these improvements. W at the same time, several major modernization programs are underway with Electronic Health record modernization, financial business transformation, caregiver expansion, and Community Care networks, just to name a few. These and other modernization efforts will require billions of dollars per year on top of v. A. s regular operations just to catch v. A. Up with the latest best practices. V. A. Needs strong leadership to make certain these investments achieve results and do not waste taxpayer dollars. With the help of our vso partners, congress has enacted several recent reforms to improve Mental Health care, protect educational assistance, enhance disability and survivors benefits, and expand burial benefits. The next secretary of Veterans Affairs must be ready on day one to advance and build on thenc progress that has been made over the last four years, must ensure that the laws are faithfully executed, and must measure results so we know veterans are benefitting as intended. Additionally, the next secretary must continue the fight against covid19, support an alreadystrained workforce, deliver timely vaccinations to v. A. Patients, and be ready to assist the civilian Health Care System in places where it is overburdened. Furthermore, backlogs in health care and benefit claim appointments that have piled up due to the pandemic must be addressed as we return to a more stable operating environment in the coming months. A top concern for me, and for many of my colleagues, is how v. A. Will care for veterans living in rural communities. Before coming to the senate, i represented a Congressional District roughly the size of illinois with no v. A. Medical center. I look at v. A. Through the eyesn of our kansas veterans and the feedback i receive in speaking to them is that Health Care Access has always been a challenge. V. A. Provides Excellent Health care in its own facilities, but those facilities are not in every community. The mission act gives veterans the permanent choice to utilize Community Health care providers when it makes sense for them and not when it is convenient for v. A. Bureaucrats. I asked President Biden and will also ask for your commitment to uphold the law by supporting this commonsense notion that its the veteran who should be at the center of their health care decisions. We know that public healthth measures that reduce the spread of covid also increase the risk of social isolation and Mental Health conditions. V. A. Has tools it can use toia help. Community care authorities, telehealth options, and funding provided by congress can Work Together to mitigate the pandemics impact on veterans physical, mental, social, and economic health. Furthermore, programs like the gi bill, veteran readiness and employment, and the Transition Assistance Program can help veterans transition out of the military successfully and help launch them on what v. A. Terms a solid start entering the civilian world. Research has shown higher incomes likely lead to Better Health outcomes, so investing in these programs doesnt just aid veterans in transition, it helps their longterm wellbeing and can reduce the burden on v. A. s health system. I would ask that you consider not just how v. A. Is doing at delivering the benefits provided by law, but also what outcomes we are trying to achieve forem veterans with these benefits and if we are doing enough to measure those outcomes relative to the benefits v. A. Is providing. Onough congratulations and thank you for our conversations in person and buys him, your commitment to our nations veterans is seemingly, it is sincere and real and i appreciate that very much. Caring for our veterans has bee during my time in congress, its my great hope that it will continue to be that that continues to be the case if you are confirmed as secretary. Mr. Mcdonough, i look forward to hearing your statement and look forward to these questions and conversation during the remainder of our hearing and i thank the chairman. Thank you, senator moran and before we get to Denis Mcdonoughs statement. We have the incredible pleasure and honor to have our chamber graced by the senior senator from minnesota, senator klobuchar. Thank you Ranking Member moran and chairman, and distinguished members, the work that you do, thats the all mark of this. Im proud to introduce my friend and fellow minnesotan Denis Mcdonough as President Bidens nominee for secretary of Veterans Affairs. Today denis is joined by his wonderful wife carry along with two kids. He grew up on the wisconsin border, and he is the grandson of irish immigrants. The son of devout Catholic Parents and mother to 10 siblings. He attended st. John college in collegeville, minnesota and in addition to graduating summa cum laude, he played safety on the proud championship st. Johns football team. Ive been privileged to call denis a friend for years and i know he will serve our country so well as the secretary. As he has done his whole life, he will honor the promises our country has made to our veterans and their families. Denis commitment to our nations veterans was clear during his time as president obamas chief of staff. When he made sure that every decision impacting our Service Members, veterans and their families was befitting of their sacrifices, showing respect and gratitude is not something he prioritizes, its a value for him. Hes an adept manager who understands how to tackle complex for our government which is violent for our text secretary. As you mentioned, Ranking Member, the va a facing challenges to help veterans stay safe during the pandemic and around the country and you note great improvements have been made thanks to all of you and many others. These are not simple problems and these are not simple challenges, and they will require true leadership and vision, which have been, again, the hall mark of denis time in Public Service. I also know he will work with you tirelessly to find Bipartisan Solutions which has never been more important as we move our country forward. So much of our work with veterans is about keeping our promises and showing respect, not just in our words, but in our actions. When you get to know denis, for those of you who are just getting to know him, you will see the qualities of honor and loyalty in his commitment to his family, which also includes his family in minnesota. I know this firsthand. You see it in how hes treated everyone that he works with. When he worked in the senate, when he worked as president obamas chief of staff. You see it in that loyalty. And he puts our country first. During his distinguished career, hes approached each and every job with respect, honesty and collaboration and a willingness to make himself accessible to his colleagues and to his team. Members of the committee, i know he will do the same with you in this job. He is deeply committed to supporting his work force. One of the things i want to tell our veterans is i know he will do two things so well. Ellissen, and then he will get things done for you. One of my favorite stories about denis involves this. We were having a lot of trouble in northern minnesota with mines closing down because of steel dumping from china and denis was president obamas chief of staff and he went up to northern minnesota, i think it was very cold, i will add, and met with about 50 people and it was this long, long table and denis sat and listened to every single one of them and the very last person to speak was a guy named dan hill who is a minor, an iron ore minor and dan told the story how at his sons preschool when he graduated the teacher asked him what he wanted to be when he grows up, and kids were saying, an astronaut, a basketball player and dan hills son said i want to be a minor. Joe can relate to this, i want to be a minor like my daddy. And in the end the minor takes the Steel Workers tshirt throwing it down the long table to denis, make it come true, mr. Mcdonough. And i said, you were a football star, catch the tshirt, and he did. And he not only did, but he put dan back to work and so many minors back to work and came back to washington and passed and implemented things through the bureaucracy of government by getting many different cabinet secretaries and others to hold hearings and the like. I tell that story because i believe in my heart this is the guy youre going to get as Veterans Affairs secretary, hes actually going to follow through and listen and get things done. Im going to end with the word of a poet who President Biden happens to love, shamus haney and given denis irish roots, anyone with gumption and a sharp mind will take the measure of two things, whats said and whats done. He will not just say the word as your secretary, he will get things done. I urge the committee to support his nomination. Thank you. Thank you, senator klobuchar. Before we get to your statement, mr. Mcdonough, i would ask you to rise as i administer the oath. Do you oh, raise your right hand please, do you Denis Richard mcdonough solemnly swear or affirm that the testimony youre about to give in vant of the senates Veterans Affairs will be the truth, the whole truth and nothing, but the truth so help you god . The record should reflect this nominee stated in the affirmative. You have the floor, denis. [inaudible] today. I do so with Great Respect for your constitutional obligations to advise and consent, to fund and to oversee the department of Veterans Affairs, and the bipartisan tradition of this committee in service to our nations veterans. At a moment when our countrys needs must come together, the partnership between the chairman, senator moran, the members of this committee is inspiring. If given that honor of serving as secretary of Veterans Affairs, i will strive to emulate that partnership in my work with you as individual members and as members of the committee. We can meet today peace and freedom because generations of Service Members have stepped forward and sacrificed in our name and though only a small percentage of americans have served in our armed forces, the president has called on every american to embrace our responsibility, to support our veterans and their families. President and dr. Biden take this duty can seriouslily and personally as i know each of you do. Perhaps especially since they, like so many of you, are members of a proud military family. If confirmed, i will dedicate myself with every fiber of my being, to fulfilling what President Biden rightly refers to as our countrys sacred obligation to prepare and equip our troops that we send into harms way and care for them and their families when we return. Its true that im not a veteran, but in my years of Public Service ive had the privilege afford today relatively few americans. Ive seen up close and been deeply moved by the excellence, talent, dedication, of our men and women in uniform. When visiting our soldiers, sailors, airmen, marines, and coast guardsmen in our bases in afghanistan and iraq, ive witnessed the heavy burdens of long deployment away from their families. Beside their hospital beds when they come home, ive seen their resilience in the face of wound, visible and invisible that can last a lifetime. Standing there at dover when our Fallen Heroes come home one final time, ive seen the unimaginable grief of military families to whom we owe a debt that cannot be repaid, and whom we will stand with forever. Inside and outside of government ive been inspired how our veterans continue to strengthen our communities and our country out of uniform, as teachers, coaches, first responders, public servants. Most of all like every american i owe a profound debt of gratitude to those who have worn the cloth of our nation, it would be a tremendous honor to serve veterans and families, care givers and survivors by leading the va. To ensure our nation serves our veterans as well as they have served us. If confirmed, i will make it my mission to fight for our veterans with a relentless focus on three core responsibilities to the department. Providing our veterans with timely worldclass health care, ensuring our veterans and their families have timely being a cess to benefits and honoring our veterans with their final resting place and lasting tributes to their service. At the same time, the president has directed me to focus on getting our veterans through this pandemic. Helping our veterans build civilians lives of opportunity with the education and jobs worthy of their skills, talents, and service. Ensuring that the va welcomes all of our veterans, including women. Veterans of color and lbgtq veterans. Working to eliminate veterans homelessness and reducing suicide, and keeping faith with our families and care givers. In short, if confirmed, i will work tirelessly to build and restore va trust as a premier agency for ensuring the wellbeing of americans veterans. After all, theres no more sacred obligation, nor noble undertaking to uphold the promise of our veterans whether they came home decades ago or days ago. Im ready for this mission. As a former white house chief of staff, i bring a deep Extensive Knowledge of government. I understand how to untangle and solve large complex challenges, both across and within large agencies. Ive seen firsthand that when our government is at its best, it can help the american people, including our veterans and allow them to live in security and dignity. This wont be easy. The department of Veterans Affairs faces great challenges. Challenges made more daunting by the coronavirus pandemic. Its capabilities have not only risen to the needs of our veterans. If confirmed, i promise to fight every single day to ensure that our veterans have the access to worldclass Compassionate Care that theyve earned. I look forward to being a true partner with the men and women of the va dedicated, highly skilled professionals, many veterans themselves. Veterans serving veterans, who deserve our profound respect and support. I will also build strong partnerships with the Veterans Service organizations who devote themselves to their fellow veterans, to their communities and to our country. Ive been given a Clear Mission by President Biden to be a fierce, staunch advocate for veterans and their families. If confirmed i will embrace that assignment with the solemnity that it demands. This is not a mission i take on alone. Everyone has a role and if that confirmed ill make that happen. With our veterans, every american has a role to play. Thank you again for the opportunity to appear before you today and for the opportunity to join you in caring for our veterans who have served and sacrificed so we can live in freedom today. May good bless our troops and as a nation give them our very best. I look forward to your questions. Thank you for your statement, denis, appreciate that. Amy, youre able to leave, or you can stay and watch the best senate committee. I will just start out, denis, out of the top jobs of this administration of which youd be well qualified for, why this one . Mr. Chairman, im a fighter and im relentless, and im particularly relentless about things i have a passion for and having had the professional experience of the last 20 years since september 11th, 2001 and having witnessed up close the tremendous service, excellence, and sacrifice of our military and our veterans, i have great passion for making sure that we treat them as well as they treated us. So when the president called me to talk about this assignment, i could not have been more excited, more humbled and more committed to seeing it through. And if confirmed, ill apply that fight and that passion to ensure that we do live up to our promises. Okay. Thank you, do you have the autonomy to do what you believe is best for this nations veterans, even when you disagree with the president . I do. Id also say i have a very Good Relationship with the president. He encouraged me to be very candid with him in the event there is a disagreement im confident that id have an opportunity to vigorously make my case, draw on the experience and the expertise in the department, to bolster that case and to work with you all to fulfill that case. Many, if not all of us on this committee believe the importance of the inspector general, the igs. If confirmed will you commit to not interfere with the independent work of the ig. Yes, i will commit. Weve passed a number of bills and if youre not familiar with them, you can certainly ask, but two of the bills that weve passed, and weve passed many of them, need a timeline for implementation. The John Scott Hannan Veterans Mental Health bill that senator moran was so gracious to cosponsor, and the debra that senator bosman cosponsored. Would you agree to a timeline for implementation of both bills. And if so, would you provide regular updates to the committee on implementation . I will provide an implementation timeline on those bills. I will keep you updated on the progress of that, more than that, mr. Chairman, i have discussed these bills at length both with you, with senator moran and senator boozman. And my commitment is to update you, consult with you, and work with you in bipartisan consulting fashion to make sure that were implementing them, that the department implements them if confirmed with the intent of this committee. Coming into the most senior role at the va, how are you going to approach vas Covid Response to date and if changes need to be made. Thank you, mr. Chairman, every question that i approach, if confirmed at the department, will be around a question, two questions. Will it give greater access to veterans and will it ensure Better Outcomes, as you and senator moran both laid out in your opening statements. As it relates to a review on covid19, ill review what our performance to date has been as good as it can be on those two questions for our veterans. The questions are going to be around communication, around access, both to vaccines, but then access to care in the case of infections. Similarly, we have to be serious about communicating clearly with the work force, ensuring that the work force has access to vaccinations and protection and the work force has, as you said in your opening remarks, access to all the material that theyll need to do their job safely. And numerous reports show that Sexual Harassment and assault remains key across the department. Creating a welcoming environment for staff and guests at the va is critical. Defense secretary austin issued a memo to the pentagon leadership requiring an expedited of dods Sexual Harassment and assault prevention and accountability measures. As head of the va do you plan on doing something similar . I do, chairman. If confirmed on day one, i will lean into this issue to try to set a culture that underscores that such activity will not be tolerated that the department has to ensure that not only the departments work force, but also importantly, the Fastest Growing cohort of veterans, namely women veterans, have confidence that they will be treated with respect and given the access that theyve earned. Thank you, Denis Mcdonough. Senator moran . Chairman tester, thank you. Mr. Mcdonough, ive been a critic of what i describe as executive overreach, protesting that article 1 to give congress a significant and important responsibility and administrations over a long period of time have chipped away at that balance that i think would be better if the executive branch was less aggressive in the and the congressional and legislative branch was more aggressive. And you were involved in an administration i criticized for being so aggressive in executive orders, for example, but i always tried to balance that by saying part of the problem is that congress doesnt do its job so it leaves this wide space open for an executive of either party to advance their agenda. And id love to see this Congress Work better than it does and i want to try to make certain that i do my part that that occurs. But where i would find fault is in the area in which agencies, the executive branch, the department of Veterans Affairs and others, when there is clear legislation and clear legislative intent, so both language and intention, that then that language and intention is not followed. In our conversations na that you and ive had that id love for the record for you to confirm your understanding. Let me give you a couple of topics in which that will become important. The president s campaign, President Bidens campaign and your own response to my prehearing questions mentioned rebalancing Community Care. Im concerned that these plans may, depending on what those word mean, may erode the core tenants the mission Community Care program and that would cross a red line for me. Access standard if particular are the cornerstone of the Community Care program and veterans have come to rely on those standards over the past two years. One of the difficulties weve had, as we move from choice to mission, things change, veterans get accustomed to something and then it was something new and i take serious issue with any effort to change those access standards or restrict veterans eligibility for the program. If confirmed, will you uphold the current access standards that veterans, my notes here say universally understand, i wish that was the case, but understand and do you plan to change those standards as part of that rebalance . Thank you, senator moran. Its let me be very clear that Community Care will continue to be a key part of how the department cares for our veterans, full staff. I intend to implement the statutes that you all have enacted consistent with your intention and to do that in consultation with you on any of decisions that come before me. And as it relates to access standards, i will treat those sets of questions in exactly that same way, which is that i will work on those fully in consultation with you. Let me highlight a reason that i have the concerns that i am expressing to you. One of your responses to my prehearing question, you promised to work with congress as you just did to ensure that veterans are the center of their own health care decisions. However, one of the proposed Community Care updates in the Campaign Plan would allow the va to send veterans back to the va when Community Providers failed to meet the access in quality standard. This directly contradicts the Mission Intent by enabling the va to override the veterans choice. I hope you had that the mission act is designed, in fact, written for the veteran and his or her provider at the va to make a choice about where to receive care based upon whats in the best interest of the veteran. Is there anything there that in your view or the biden administrations plan that i should have concern about overriding that decision between the va provider and the veteran . No, senator. There is not. The same would be the same theme i would have with the john hannan act that senator tester and i introduced and got passed through this committee and the senate and house and signed by the president , will you faithfully commit that you will faithfully implement the john hannan in that manner. Yes, senator, i will. Will you commit your Committee Staff and my staff to me, that congressional intent is met with each of the implementations of that bill and other legislation . Yes. So mr. Mcdonough, one of the complaints that ive had for a long time is that when congress does act on the occasions in which we get our act together and succeed in passing legislation, that the va in particular, but i assume its true in other departments, the va in particular seems to ignore the things that weve just talked about. And what i think youre telling me is that that i should be less concerned about with you in charge than what ive experienced over the eight, 1, 2, 3, 4, 5, 6, 7, 8, 9 secretaries that have been in office while ive been in the veterans committee. Is that a Fair Assessment that i can trust you to fill the that the executive has in implementing legislations passed by congress . Yes, senator, and id elaborate on that in the following way. One is that i believe, as you do, that and as my as i said earlier, everybody has a role to play in supporting the veterans. The constitution actually divvies that up quite clearly for you all and for the executive in articles one and two. So its a constitutional question. Secondly, i also believe its a question of best outcome. When the executive works closely with congress in a collaborative and consultive way, thats the best way to ensure more durable policy and durable outcome, especially when were working with the fundamental premise that every decision should answer is this Getting Better access and better outcome for our veterans. Mr. Mcdonough, thank you. Your comments remind me about durability, what that really means is that a veteran can come to expect a certain outcome or a response to a question and its not different from one day to the next, one week to the next or one location to the next. Correct. And the point i would make is that in so many instances over a long period of time no particular administration, to be specific about the conversations i had with the secretary for his or her team result in assuring me that this problem is being taken care of and this is our plan. What i discover when im home, thats never communicated to those implemented for care at home in kansas. Theres communication in this. And you can assure me of implementing with congressional intent, but it has to be told and insisted to those providing services to veterans at home and i would encourage you to make certain when you tell me and other members of congress that this is the policy at the department, that that policy is then known and implemented by those across the country. Understood. Thank you very much, thank you, mr. Chairman. Were going by seniority order so next we have senator murray remotely. Mr. Mcdonough, delighted to see you today. Welcome and we appreciate you being with us today. You know, the va is the largest integrated Health Care System in the country, so it really demands a strong, effective leadership. We appreciate your willingness to take this on. And you and i had a chance to talk about some issues in december and i wanted to ask you about some of those in the record. Let me just start as part of the mission act, Congress Expanded eligibility for the Caregivers Program to make sure that veterans of all eras suffering from the connected illnesses would have access to the caregiver support. However, under the previous administration, regulations were imposed that limit that eligibility and there were many veterans leading assistance from that Caregivers Program. Those restricting regulations, requiring 70 rating and fills the need for assistance each time adl is performed, unduly restricts eligibility in a way Congress Never intended and make it harder for veterans to get care. If confirmed would you take action to roll back those recently imposed restrictions and make it a top priority to fully implement the caregivers law as congress intended. Thank you, senator, i appreciate the question and our discussion of it. My commitment as i indicated earlier is to immediately begin to address this issue upon confirmation, to work closely with you and the rest of the members of this committee, as it relates to implementation of that act. And to ensure that we do it consistent with the expectation and the attention of congress. Thank you very much. Let me turn to another part of our promise to take care of our veterans after they return from duty, which is allowing them to fulfill their dream of having a family. Congress has given the va authority to appropriations to provide ivf and other necessary fertility treatments to veterans and spouses. Ive been working for decades to fix this. The womens and Family Health Care Services act will permanently authority fertility treatment for veterans and spouses, and we empower veterans when the time is right for them. Would you work with me to make sure that veterans have ease of access to ivf and other fertility treatments . Yes, senator, i will. Thank you, look forward to working with you. One of the largest challenges that is facing the va is implementation of the Electronic Health record modernization program. The Medical Center in spokane, my state. Has the project. The process highlighted infrastructure and staffing shortfalls and veterans in spokane have experienced unacceptable delays in getting care, full implementation across every va Medical Center is expected to make at least seven more years. Given that timeline and the scope of this project, if confirmed. How will you protect veterans access to high quality care at the va while ensuring the success of this modernization effort . Thank you, senator. As i indicated, every decision that i am involved in, if confirmed as secretary, will come back to the fundamental premise of whether we, the decision is increasing access and improving outcomes for veterans. This has got to be the case as it relates to the Electronic Health record as well and my commitment to you and to members of this committee is to continue to work in a collaborative, consultive fashion with you and to ensure you that at the end of the day, increased access and Better Outcomes for veterans is the result of that Health Record that the work force understands and can use the Health Record consistent with those principles and that i can continue to confirm to this committee that that is the outcome of that process. Okay. And one final question, improving the information being shared with veterans on the gi bill comparison tool is essential to make sure veterans can get informed choices about their education. I have previously called for va to develop a joint policy to counter aggressive recruiting and misleading marketing aimed at our veterans. And i want to see improved availability of crucial information such an as levels of student debt and transferability of credit. Can you commit to providing thorough oversight of the gi bill fund, fully implementing the gi bill act and making sure when theres evidence of fraudulent conduct youll take steps that the schools are not allowed to recruit veterans. And the president indicated to me a priority for me if confirmed, must be ensuring that our vets have access to employment and Education Opportunities consistent with their experience, skills and talent and consistent with that, i would intend to working collaboratively with you and this committee, ensure that theres appropriate aggressive oversight and measurement on quality outcomes of that programming. Okay. Thank you very much. And thank you, mr. Chairman. I appreciate the opportunity. Senator boozman. Thank you, mr. Chairman, and thank you for being here. You served in a variety of different ways in the executive branch. I know National Security and then also chief of staff to president obama and i had the opportunity to be around the table with you on many occasions and always found you somebody that was willing to listen and then very, very informed on whatever issue that were talking about. Thank you. And then very importantly, i know that the president has a great deal of trust in you and respects your opinion so i think thats good for veterans. So we appreciate your willingness to serve very, very much, and look forward to working with you. We had a good conversation, not too long ago. I want to follow up on something that really is a significant issue facing veterans in the country. Some of these are too large for any one organization or department to solve. Veteran suicide is one of those enormous issues. Last congress we passed a bipartisan bill, commander John Scott Hannan bill that encouraged the va to work more closely with communities in trying to address the issue of veteran suicide. If confirmed, would you describe how you will lead the va to create more partnerships with veterans serving Community Organizations while at the same time incentivizing those same organizations to partner and work with the va . Thank you so much, senator. And theres the crisis facing the country related to suicide is tragic. We face a National Crisis on suicide as well. The first and most important thing that i will do if confirmed is underscore that comprehensive health for our veterans including Mental Health, it includes effective Mental Health, it includes reducing the stigma associated with seeking help and that also includes increasing access to Mental Health services through any number of opportunities and in particular, given the enhanced authorities that you have now made available to the department through Community Organizations. So using those resources and using the networks that are being built in and around Community Care gives the department a unique opportunity to ensure that it is drawing on all the available resources on this National Crisis. No, we appreciate that. The va does a very, very good job and works really hard at this crisis. On the other hand, there are so many entities out in the community that are also doing a very good job and ready and willing. So many of these people fall through the cracks and for one reason arent in the va so if we can get them in a program, and then encourage those programs to get them back into the va, well be in good stead. One of the most common things i hear from veterans in arkansas is regarding the different enrollment processes for vha, nca, when in fact theyre part of the same agency. So theyve got different processes within the same agency. If confirmed, can we Work Together, can we Work Together as a committee and explore a more human centric design approach . In other words, making it simpler to help the enrollment process for veterans, more of a one shop approach . Absolutely, senator. I would look forward to the opportunity to Work Together on that. Very good. And i yield back. Thank you, mr. Chairman. Thank you, senator boozman. Senator brown remotely. Thank you, mr. Chairman. Nice to see you there and call you that, and ink that senator moran for his comments, and mr. Mcdonough, i enjoyed the conversation we had, remotely, roux he remote, whatever is correct. And with the compensation and pension exam because the pandemic is affecting operations at National Personnel record center, i know youll be busy on day one working on that and so many other things. With my staff and i met with veterans, they were concerned about va closing units and Downsizing Services and the facilities especially because of the virus, the va hasnt committed as of now, as of yet, to reopening once the pandemic is over and my concern with that approach is that va starts to close services or facilities and it will push veterans into the community for care, some want to do that others, but most want the option of always going back to the va. Would you commit to reopening those units or service lines, due do covid19 and make sure that va has the services and personnel to reopen those facilities . Thank you very much, senator. Obviously the slowdown and fulfillment of claims processing as a result of the pandemic is a principal concern that i would have if confirmed, and making sure then that we have the resourcing after the pandemic to not fall back into backlog, once the department gets its hands around it, ill take the question of those facilities. I will work with the white house and work with omb on it to make sure that we have the resources to fulfill a critical assignment of timely access to benefits that veterans and their families have earned. Thank you. Weve seen far too many veterans and military families targeted by forprofit institutions post 9 11 g. I. Bill and they misrepresent themselves and often have veterans with mountains of debt. Do you plan additional eversight to root out predatory forprofit institutions that target student veterans . Every decision that i make, if confirmed as secretary of the department, will be asking two simple questions, to advance two simple principles, which is are the decisions were taking increasing access for veterans and improving outcomes for veterans . Outcomes on education programming and employment programming have to be acritical part of how the department implements that and executes those programs so that the short answer is yes. Okay. Thank you. And we know that the protect the gi bill provisions that the Third Party Lead generators and following the law cut off the flow of g. I. Benefits of those schools. Thats obviously important. Let me shift, i hope youll come to date at some point to visit the National History va senator and ill follow up and talk to you about that. And the homeless veterans, ill soon be the chair of the housing committee, veterans homelessness is an important part of my issues too, there. And making sure that the va has adequate staff for the successful hudhousing prachl. Would you work with to make sure that all veterans have a place to call home. Thats a really high priority. Yes, i will. Thank you. Last thing, last va proposed a program that would require military borrowers, forebearance to pay back their payments with interest within 10 years and offering make it more likely that va borrowers will fall behind. And Service Members should not be given worse options than other borrowers with federally backed loans, do you agree with that . I do. Looking under the rule to look with us, and make sure that no va home owner is left with worse options than others in federally backed programs. I will be happy to work with you on that. Good luck with the confirmation. Thank you for being here, i enjoyed our conversation. Some of this will be repeated because i think its so important for my colleagues. We spoke with how close of us in this committee will ask questions of the va, but why use the term ropeadope and youve got it, when we got a reply back off point two months later and we asked for clarification and two months later slightly off point, more than off point and finally just kind of tapers out and you have a different philosophy, so just do you mind sharing with us all your how you intend to share data with us as regards the va itself. Well, thank you for the question, senator. I think free flow of accurate data is the life blood of a wellfunctioning organization. Consistent with that, and consistent with the view ive been espousing of close collaborative consultantive relationship with in committee and congress, i would make sure we have the free flow of information between and among us. I also said when we talked earlier that it could be that because were moving quickly, we provide inAccurate Information and our work will quickly come back with more Accurate Information on that. As i said, the life blood of any well functioning organization is accurate, timely data. You know, you used a couple of adjectives and i want to explore it with you. Quickly and timely. [laughter]. Fair enough. Thats not the va by the way recently anticipated the question quickly, im saying at times it works, and at times it doesnt. Can you give me a sense when you say quickly and timely, like the time frame na you would be considering quick and timely . Welcome, its hard to answer that question well, its hard to answer that question in the abstract. I guess what i would say to that question, senator is that id want it back to you in a time frame that is useful to you. That works. Okay. Thank you. Following up on something that senator brown said that senator murray alluded to, senators lankford, carper, and i will be the to close the 609010 loophole for g. I. Bill are counted as federal fund for purposes. Just kind of background, if a forprofit university is required to get 90 is allowed to get 90 of funds from the federal government and 10 outside of the federal government, veterans berths have been included in that 10 . And so, when senator murray speaks of targeting veterans, yes, theyve been targeted because they would fill up the gap that the free market wouldnt provide, but rather, people with Veterans Benefits would provide, 10 match reminder of the 90. We worked very hard to get a compromise na would protect the veteran, protect the good schools and that would kind of be sense it i have to senseabilities in both the republican and democratic caucus. Again, protecting good schools, but isolating out the bad. So, just to say that were going to be bringing that forward knowing that you have to look at this, but wed love your engagement on this issue because weeping its important that we address it the. Id be happy to work with you on it, and i commit to being engaged if confirmed, absolutely. I appreciate na that. With that, ill yield back. Thank you, senator cassidy. Senator hirono. Thank you, mr. Chairman. Mr. Mcdonough, it was good to talk with you when i had the opportunity. I think my colleague Amy Klobuchar gave one. Best testimonies and you made it very clear that you listen and that you actually do something. You get things done. And you are about to, should been confirmed, the largest agencies and the va actually provides health care across 50 states and territories. So, this is a very unique agency with just ongoing challenges, homelessness, Mental Health, Health Disparity treatments, all kind of things. So not to mention, by the way, when i talked with you, you said from a very pragmatic standpoint that getting the veterans vaccinated and dealing with the pandemic is one of your first priorities. Joe biden said that hes going to have 100 Million People vaccinated within the first 100 days, so should you be confirmed, do you have an idea of would you determine how many veterans you would want to get vaccinated and would you have a way to determine whether youre actually meeting those goals . Would that be one of the ways that you would tackle this pandemic with regards to our veterans . Thank you, senator. In fact, it would be. That a principle priority in helping veterans through the pandemic is ensuring that they have access to care if theyre sick and vaccinations to prevent getting sick. The way i intend to work this question is i will demand a seat at the table and i will, as the president has asked me to do, be a staunch and fierce advocate for veterans getting access to the kind of care and the kind of resources that ensures that kind of outcome that youve just highlighted. I think that you actually have to have numbers, such as, youre going to have x percent of the veterans out there. Youre going to need to find them because theyre not all in the system and make sure that those vaccinations are actually occurring. One of the things i ask for every nominee for these physicians to make sure, i ask the following two questions that i will now ask you, since you became a legal adult have you ever made unwanted requests for sexual favors or committed any verbal or physical harassment or assault of a sexual nature. No, i have not. Have you ever faced discipline or enitered into a settlement relating to this kind of conduct . No, i have not. One of the ways that we can really ensure that our veterans get the health care they need is to create Community Based Outpatient Clinics and ive talked with you about some of the long delays with regard to some of these clinics on oahu and neighboring islands. Each of these are unique and there may be some unique states requirements or limitations that make it really hard for the projects to proceed so it requires somebody within the va to Pay Attention and moving along, whatever the specific concern might be so that these the veterans in these places are not waiting for a decade, as the case with some of the projects in hawaii. So, id just like you to really focus on the need for Community Based clinics where the veterans can have access to the care that they need. Will you commit to making that happen . Senator, i will. If confirmed, i will. So, one of your predecessors made eliminating homelessness among veterans to be a top priority, and he engaged the whole of government kind of approach and yet, homelessness, continues to be a concern and yes, you responded to my questions to you, but truly of what are you going to do that is different. One of your predecessors says i am going to eliminate homelessness among veterans and that didnt happen. What are you going to do to ensure that there will be more measurable success in eliminating homelessness among veterans . Thank you, senator. As the president made clear that this will be a priority of the administration. What i will do to implement that priority is obviously make it an intention intentional priority, one. Two, work with the other agencies in the federal government to increase access to available options. And three, make sure that the va is providing access to all the other services that are important as relates to access to Mental Health, access to Substance Use disorder, treatment. Access to education, employment, and training support and using all of those tools working with other federal agencies and then holding ourselves to account to you to measure that progress is how we fulfill that objective. I think you have a commitment from Sherrod Brown and from marcia fudge to enable you to succeed and ill certainly be wanting to, you know, engage with you on that score because nothing could be as important as to have a roof over their heads. And a job, what is available to them, made available to them. And i cant see the timer, my time is youre over by about a minute and a half. Im sorry. We could have a second round. Thank you very muchments you met, thank you, senator. Senator rounds. Thank you, mr. Chairman and it is truly refreshing to see that we have a chairman and a Ranking Member who are both concerned about our rural veterans as well and i thank you and look forward to working with you. Mr. Mcdonough, first of all, thank you for the phone call the other day, the opportunity to visit with you was good and i appreciated the knowledge that you bring. Your preparation for our visit and your understanding of some of the challenges that the va faces. I also, look, i plan on supporting you in your nomination for this position and i thank you for your service to our country. Mr. Mcdonough, the hot springs va facility in hot springs, south dakota, the critical part of the departments Health Care System. In contact, secretary wilkey rescinded a record of decision on the future of the campus which provides care to not only south dakota, but nebraska, wyoming, so forth. Id like your commitment, if confirmed that work on moving the hot springs facility and literally the black hills facilities themselves up into this sen century with regard to the Services Provided and literally layout a longterm plan for success for veterans in the rural areas. Thanks, senator. I appreciated our conversation on this and i committed to you then and i recommit myself to you now to work closely with you on this and addressing the needs in the hot springs, in and around the hot springs facility. Inasmuch as it is touch a critical piece of the delivery capability, not only in south dakota, but as you say in nebraska, montana, wyoming. The mission act, which is what we operated under now for our health care, its an item that i didnt vote for. I didnt vote for it because it took away guarantees of a veteran to be able to find a physician of their own choice that they couldnt get an appointment within 30 days or if they were more than 40 miles away from a Health Care Facility na the va sponsored. I thought they were making promises in the mission act that we might not be able to keep. I think you step into the administration of this facility, of this agency, this administration in which youre being asked to do a lot of things and youre going to get pulled in a lot of different directions. I dont expect you to be able to see the detail of this chart, but this is a chart of the va and what it has. Youre expected to provide educational students. Youre expected to provide housing, final expenses, a final resting place and youre also expected to provide health care to vas throughout the country. If you go down, you can go down 13 levels until you get to where a real doctor is at or a real hospital is at in the chart. For me that says a lot about the challenge that you face. I dont think thats something that a lot of people realize when they talk about the va and what happens, when you promise everything to everybody and you lay it within an Administration Like this, whether its a republican or a democratic administration, the challenging of handling a bureaucracy are huge. You walk into the bureaucracy with perhaps as many as 380,000 individuals some of which are provide direct care, others of which are trying to find reasons why the care cant be provided. Specifically what my concern is is this right now in the approval process when we ask for someone to participate in the care for the community, its not veteran friendly. Too many of the approvals are made by people who work to make sure that the veteran stays within the va system, regardless of whether or not its good for the veteran or not. Veterans decision is the veterans decision as the senator suggested and always comes back to the va for approval. In my opinion it is tailored for an urban veteran with access and not the one who may have to drive well over 50 miles for access to see a primary care provider. If confirmed what will you do to afford veterans their choices as to where they receive their thank you, senator. And i really appreciated our conversation before on these questions as well. Any credible strategy as it relates to rural care for our vets has to have at least three components. One, Community Care, and Community Care has to ensure that more timely payment of bills. Also asked to ensure a more vibrant network of providers, providers who want to be part of that network. And i think in both of those cases a more active or a higher set of expectations for the third party administrator, for example, is probably wise. The second thing is using access to new platforms. We had a very useful conversation i thought about telehealth as i did with several other members of the committee. Consolidating those gains and growing goes. And then third is getting more aggressive about using the authorities that you have given theen department to recruit ando fill the vacancies in the facilities that v. A. Already has. And so among those three prongs of a strategy, i think are the answers to ensure that the best medical outcome for the vet, which as i read the statute is what you all have demanded, in separate being ends up being the factor. Thank you for your thoughts and take with the one about timely payments for those providers. Senator blumenthal. Thank you, mr. Chairman. Thank you for having the hearing. Thank you, mr. Mcdonough, for your service, youre very extensive service, yourns commitment to veterans, your conversation with me about your dedication to them, and your testimony here today which is been excellent. Ive been following it from afar, and apologize it was in here before now. I want to first of all followup on part of the conversation we had about thehe v. A. Facility in west haven where there were two deaths. Its an aging, in fact, aged facility that is badly a in need of reconstruction like many facilities across the country. It was a build in another century, literally, and we owe it to our veterans to rebuild that infrastructure. There are several critical Construction Projects in the design phase at the west haven v. A. Including a a new Sterile Processing Service building and surgical and clinical space tower. But whats really needed isha a reconstruction of the entire facility. Which does great care for our veterans. Doctors, nurses, administrative staff are supported in and they are really dedicated patriots but they are working with the structure workste in mortar that fails to keep pace with our veterans. So i would like your commitment to work with this committee, ensure that the v. A. Prioritizes infrastructure rebuilding and most especially obviously for the interests of our connecticut veterans, the facility in west haven. Thanks senator. My commitment, my recommitment now as it was in our earlier conversation is to really dig in on these questions. Upon confirmation, to keep a very close collaborative relationship with you on it to ensure that its proceeding consistent with the needs of our fast and consistent with the two principles ive i played oe which is increasing access for vets and improving outcomes for vets. I would like to invite you to a statement as it did privately to come visit. They are doing great jobs by the way on vaccines, and i have visited the clinics. They are administering vaccinations. They are increasing the number. Right. I would like to know from you how youw will ensure that there is adequate access to vaccinations by minority veterans, communities of black and brown veterans, and Staff Members in that category. So i thank you very much, senator. The the president has made clr that equity will be a fundamental consideration across the pandemic preparedness and response, and it would be my expectation, if confirmed, that i will assume my seat at the table in those deliberations and i will be the fears, staunch advocate for all thats to have access to care for all veterans take care, treatment and vaccines consistent with the improved access in the improved outcomes that will drive into decision i make as secretary, if confirmed. You are familiar no doubt with the reports about the numbers of veterans who were involved in the assault on the capital, which reflects a phenomenon that probably is no news to a lot of folks that white supremacists, extremists, ideology are often, often find Fertile Ground among veterans just as they do in the general population, regretfully, tragically, and unnecessarily. So i wonder if you could tell us a little bit about how, under your leadership, you will take steps to educate that online about this information and coordinate with other agencies like the department of defense in this effort . Thank you, senator. I will just say i was struck by the activity, the actions that you and your colleagues took, evening of january 6 reconvening the democratic process. I thought that was a very strong statement. I am also struck that both throughout that day and in the days hence there were remarkable stories of veterans associate with washington, d. C. Police force, Capitol Police force, members, veterans who arece members themselves, all taking valiant actionak to defend democracy, a continuation ask with said throughout throughout the day, out of veterans continue to serve outside of uniform. On the question of the threat of misinformation and disinformation its as an important assignment to protect our democracy as any. I could see a variety of opportunities for the v. A. To be an important actor in those efforts to protect vets, to highlight the threats of Online Activity trying to provide for certain disinformation, and he would do my intention to work with my interagency colleagues at nac and others to make sure that that is receiving appropriate consideration. Thank you. My time has expired but i want to congratulate and thank youan again, and i will very enthusiastically support your nomination on the condition that you come to connecticut and visit us there. I will be happy to go to connecticut. Thank you. Thank you, senator blumenthal. Senator tillis. Thank you, mr. Chairman. Mr. Mcdonough, congratulations to you and your families and thank you for years of service including a lot appear on capitol hill. First, i want to apologize for our not being able to talk before the hearing. I think you did have an opportunity to speak with everyone else and i would like to get your commitment between now and the time we reported out of committee to go in and maybe have a discussion so we can drill down on some issues. Happily do so. Thank you. I thinknk in your testimony he made reference to rebuilding trust in theui v. A. And i think that always we take steps forward, we take steps back and weve always got to mix with the trust of our veterans. Just wanted to note i think were at n about 80 interest of the v. A. Overall and about 90 on outpatient healthcare. It seems like were doing something right. One of the things i would be curious if your confirm is that the metrics we are using right now to measure our progress are appropriate, and then if you deem them appropriate thing continue to commit to reporting back so they can to the trendlines move in the right direction. If you dont think they are appropriate and make suggestions on things we can better tailored to make sure that we are doing the for our veterans. Veterans. So i suspect that when you get into this role, and some questions have already been asked, the question of your not being a veteran, im not a veteran. I think there are some that have also not served, but can you talk a little about the experience that you bring and why you think it makes you wellsuited to take on the role of the secretary of the va . Im a fighter and im relentless. Anybody youve talked to that has talked to me will affirm that. Those attributes will serve me well to fulfill the fundamental assignment the president asked me to carry out which is to be a fierce and staunch advocate for our veterans. Number two, i know and understand the federal government from both ends of pennsylvania avenue. I can unstick problems in agencies and across agencies and a especially an agency as large as the va thats an important skill and in fact ive spent a lot of time working with members of this committee on doing just that. And then theres something more. Going back to those attacks on 9 11 for 20 years i have been afforded in my Public Service something relatively few americans are granted which is to see up close the excellence, the execution, the talent of our armed forces and have been deeply moved by that. And ive also seen in trips into the field in iraq and afghanistan on a regular basis the impact of our troops and the deployments effects on their families and ive made it a point to visit at walter reed and to even be at dover on the final arrival home for some of our heroes and im not telling you that im of that but im telling you that ive come to understand the massive sacrifices that theyve made, and ive come to witness the amazing skill with which theyve done it and there is no higher calling than to use my skills to ensure that we make good on our promises to them to serve them as well as they served us. Thank you. Im going to try to keep to time for my other colleagues that are yet to speak, but i actually wanted to thank the chair man for the past i dont know, going back four years with chairman isaacsons approval, he and i have met with two secretaries to track on some of the records, the Electronic Health record system which is something i want to continue to be focused on and im hoping the chair during your lofty role you may want to have somebody else on the Committee Meet with them but to meet with you all on a regular basis i believe in the Electronic Health record implementation. I think the integration and some other members may have eluded to it. Its critical to provide that seamless transition and theres other projects im very interested in when we have a followup discussion i want to talk about the concept of rebalancing Community Care and what that would mean and i look forward to setting up a phone call or in person visit over the next few days. Thank you all again, congratulations to your family. Did you say youve came from a family of ten kids . 11. Were you an altar boy . One of the best jobs. Yes, and honorary every once in a while. Thank you, senator. And we will continue to work on this. Next, we have senator Bernie Sanders remotely. Mr. Chairman, thank you very much and its great to see you again. Im sorry we didnt have a chance to chat before the hearing but i am more than aware of your years of Public Service and i have confidence in your knowledge of the bureaucracy as exactly what we need to head up the va and make it as efficient and useful as it can be so i look forward to working with you. And if its okay with you lets see if we can chat a little bit in the next couple of days. I would be happy to do that absolutely. The trend we have seen in the recent years for privatization in talking to veterans in vermont and then as the former chair of the committee, talking to veterans all across this country, i find veterans by and large with exception deal feel the quality of care that they are getting is very good and they very much appreciate the level of spending and people come from their backgrounds many veterans themselves who understand there are problems veterans face. Can you say a word about trying to maybe reverse the efforts toward privatization and how to fund the va so veterans can get quality care in a timely manner that they deserve . Thank you, senator. Ive indicated that every decision i make will flow from two principals, which is does the decision increase access for veterans and does it improve outcomes for veterans and that at the end of the day has got to be the defining set of principles on every decision. I think as ive discussed with many i do recognize Community Care will continue to be a part of how the va provides care to veterans, so we have to ensure the va is being a good partner, timely paying of bills, maintaining and effective vibrant network and at the same time, we have to ensure that this integrated health model can draw on the success and excellence that is obvious throughout its workforce, so thats how i see this, senator. And i would agree. I just wanted to touch on an issue of concern in vermont and i think nationally when i look at healthcare i see dental care as an integral part of healthcare and yet it isnt available to the average veteran except when its associated with an injury and Service Related injury. What do you work with me in trying perhaps to expand dental care as a basic benefit for the veterans . I will absolutely dig into this question if confirmed and continue to work with you and other members of the committee in a consultative collaborative way to address these concerns, absolutely. Okay. Mr. Chairman, that is all that i have. I think we are looking at somebody that stands the chance of being a very great secretary and i certainly look forward to working with him in the future. Thank you very much and i look forward to chatting with you shortly. Thank you senator sanders. Next we have senator sullivan. Thank you for your conversation and meeting yesterday. As i mentioned, im serving the state with more veterans per capita than any in the country. Its true, sorry. West virginia is close. Patriotic communities, both of ours. Ive reached out to a number of our veterans for questions that they can ask you and i got a lot of course. I would say you could boil them down to a couple things. A secretary that understands what it means to serve who will tackle the benefit and healthcare challenges facing them and listens, who doesnt prioritize the needs of say a veteran in los angeles or a big city over the needs of those in rural communities, who work with congress on finding solutions and not politicizing, and in the spirit of a great marine, former constituent of mine unfortunately we lost him last year, marine Gunnery Sergeant bob toms from wasilla alaska. Six purple hearts, on the cover of life magazine for his silver star valley and heroic efforts during vietnam and the confirmation of the secretary, he asked the question saying he simply wants a va secretary, who quote, will kick ass and take names. So what do you say to my veterans on these issues and can you take a minute, i know you did with senator tellis, to speak directly to legitimate concerns who feel as if military experience is the prerequisite for the va secretary to understand and have a baseline understanding of their needs, their service and experience. If you could address all those i would appreciate it. I appreciate the question and i appreciate the concern at the heart of the question about who is best prepared to be va secretary. Im not a Gunnery Sergeant, butt i am a fighter and im relentless. Anybody whos worked with me knows that. Two, i know how the Government Works, and importantly, i know when and how it doesnt work, and i will fight relentlessly to ensure that it works for our vets. My constituents, their families, they want to know will you have their back. Ive spent the last 20 years involved in decisions about when and where. As a staff person i want to wontoverstate my role but whend where our men and women go to fight and ive gone and seen and met and witnessed what they are doing and ive gone to visit them when they are injured here at home, and i have seen and internalized their excellence and i know the basic requirement of the secretary is to have their back to ensure that i will fight like hell to take as good care of them as they taken on us. So you will kick ass and take names on behalf of the veterans. Thats important. They need to know it. Yes sir. I also want to get your commitment first year to get up to alaska to meet with the veterans, see our state and challenges. Can i get your commitment . Youve got that commitment. If confirmed, you will be running a big bureaucracy. Can i get your commitment to kind of do a vf are direct with all of us on this committee when we have issues we know directly, not through the 18 layers of bureaucracy you have that commitment. Let me ask one final question. Again, these were concerns from my veterans you served in the Obama Administration my first two years in the senate the last years in the Obama Administration a lot of the issues i was dealing with for some of the big va problems with Choice Programs which in my state the implementation was an utter disaster that actually collapsed the system in alaska. I mean, total disaster. The phoenix wait time scandal. What did you learn from these and do you think that experience is going to help you, is that a liability given your background and can you assure my veterans we are not going to go back to those days which i dont think anyone on this committee thinks were good days for the veterans. Weve made a lot of progress since then and back home in alaska particularly as it relates to putting together an alaska plan that got us out of the whole that the Choice Program put us. Thank you, senator. The lifeblood of wellrun and wellfunctioning organizations is timely, Accurate Information. That was not the case in phoenix. The lifeblood of a wellrun organization is accountability. Accountability happened in phoenix but it was slow. You all have subsequently changed the statute to make that easy here and it will not ever happen again. At the end of the day, the principal that will inform my leadership of the va if i am confirmed is whether any decision increases access and improves outcome for the vets. That is what we owe the veterans and that is what my commitment to you and to them and to the president is that i will deliver if confirmed as secretary. Thank you, senator. Senator joe manchin the third. Hallelujah. [laughter] thank you mr. Chairman and congratulations on your position. First of all, thank you very much. Weve known each other for a while and im glad what my colleagues brought up about sometimes they think we need to be veterans and i never had the honor and pleasure of being able to be. I think that is a void in my life. I was an altar boy, a boy scout for a long time, but never made it to the military and i think that is a special opportunity, but we know it takes a person that cares and has the experience to do the job and thats where you come in. Let me tell you a little bit of what you are facing and what ive faced in the five years on this committee. I came in and the 114th congress in 2015. Since then, they talked about wait times scandals that led to the va choice act, that led to the mission act which needs a lot of repairs as you know, the veterans unemployment and hiring after the financial crisis we had more veterans unemployed, it took longer to get them back employed. We had that campaigns all over r the country. Toxic exposure, i know you are very much aware of those and its really wreaking havoc today. The veteran suicide and Mental Health that we deal with on a daily basis. Veterans homelessness is something i cant comprehend at all how we can have any veterans we wouldnt have better care for. The womens veterans access care were left out and not a high priority and are a part of our military and defense today. The hiring backlog of 40,000 vacancies in the va. Veterans affairs it infrastructure delay, clarksburg va murders. If anything ive ever, ever experienced in my life is knowing that we could have veterans who were murdered in a Veterans Hospital and we have eight confirmed and a woman that will be serving many life sentences over and over and there might be as many as three more. Weve had sexual abuse found in another va hospital. For veterans we know love and probably 40 more over a 25 year span. There is a breakdown somewhere and we are just going to need someone like you that can dig into that. We are not letting people properly or having strict rules to adhere to but more importantly we pass to the accountability and whistleblower protection act. We wanted to make sure we could get rid of the people that were not doing their job. I dont think that thats been exercised much since then and i will give you an example. The people i hold responsible for the va hospital deaths in clarksburg have been moved to other places in the va system. Unheardof, and i knew way back when this happened and meeting with them that someone was either lying to me or totally incompetent and then when i found out, we brought new leadership in and they were moved somewhere. I cant find it and id like to know if we can bring that up to the highest priority. I think to put the credibility back in the va, the care and the desire for the care that they deserve i would ask for one of your first visits to come to clarksburg and sit down with your mission and that could set the tone for the entire system all over the country. Its just totally unbelievable and now families, i have families calling me daily asking did my father, did my grandfather lose their life because someone murdered them when they were there, still not knowing for sure. These are the things we are dealing with today. You can help ease that pain i think. I look forward to you. We need to someone of your ability now more than ever and like i said, i am in all today, all the people that you see today out there guarding this Great Republic of ours and anybody that has, server, to give the greatest care. With that i know the challenges are great and if you would like to comment i know youve probably been following some of this but i dont know to what extent. Thank you very much, senator. I have been following and we had a very good conversation which i appreciated. My commitment as i assured you before which is to work in close consultation and collaboratively with you and the rest of the members of the committee on these questions. The committee thats worked in the most bipartisan way and ive said this before and, i mean, it with all my heart men and women in uniform are the blue of this country that keep us together, talking, finding ways to make sure we are taking care of those who were taking care of us. So, youve got it in your hands now, the cradle basically of the people who made us what we are today and we owe it to them. You will find all this support. If we dont have a piece of legislation that allows you to reorganize and get rid of the people who dont care, my grandmother always said people dont care how much you know until they dont know how much you care. I know how much you care and now you have to show the rest of the world. I look forward to voting for you. Thank you. Put me in the game, coach. Youve got it. Thank you, and remotely we have senator blackburn. Thank you. I appreciate that. And mr. Mcdonagh thank you for the time this week. It was wonderful to visit with you by phone. And i appreciate your commitment. You talk to some about your passion and that relentless commitment to doing the job and the Public Service. Very quickly, what would uniquely qualify you to lead the va with nearly a quarter of a trillion dollars and 400,000 employed and it serves 9 million and rolled veterans . Kind of following on senator manchins question, what is your unique qualification . Thank you, senator. As you indicated, i am a fighter and im relentless and that means i will fight to get our veterans back, and i will ensure relentlessly the resources youve authorized and appropriated are invested wisely and with the veterans at the center of those investments. I also understand how the Government Works from both ends of pennsylvania avenue. That means demanding excellence, that means enforcing accountability, that means being in close collaboration and consultation with members of the committee to ensure that we are using all the Available Power of the u. S. Government to get our veterans backs. Lastly, for 20 years now ive been involved in these decisions about when and where to send our men and women into war. That is a decider. Im not trying to overstate my role but as a staff person, and ive also seen the excellence of our military, and ive seen the challenges of long deployments and the sacrifices, but ive seen the resilience and theres no higher calling than to be able to use my skills and experience to repay and ensure we live up to the promises weve made. Let me jump in there because senator moran and others talked about Community Care and you and i talked a little bit about this. Youve got a choice. Many of these veterans want to get care i would like for you to bring a little bit of clarity to that what do you see as the right balance and would you commit to that youre not going to roll back on standards and waivers the intent and addressing the whole health of the veteran. The Community Care will continue to be a fundamental way that the department provides care to our veterans. The statute is clear on this. It says that the best medical outcome for the veteran is the objective and that will continue to be my priority if confirmed as secretary. Third, every decision i make will come back to this principle which is is that increasing access for veterans and is it improving outcomes for veterans. If the answer to those questions is no, then we wont do it. You and i discussed the Electronic Health records and others have brought that up today. You know my frustration with a 4 billiondollar it budget and they cant seem to get it right and senator tester and i had legislation this year that would have improved the management of that and for the record, we are about out of time, i will send you the management of those programs and you and i also discussed purchasing and for the record i will send you a question delving a little bit more into that purchasing. Thank you for the time today and for your commitment. I will send the time back over to you. Next we have senator cinema. Thank you mr. Chairman. I appreciate you joining us today. My office is increasingly hearing from arizona veterans asking for clarifications on how to receive the covid19 vaccine from the va and when they will be able to receive it. My staff is working to make sure information is getting out to the community and this highlights the importance of having the leadership at the department of Veterans Affairs as quickly as possible. Ive introduced the Survivor Benefits during the rear legislation to address concerns survivors who died from covid may not be granted the earned benefit. If the death certificate only identifies covid as the cause of death without considering the impact of other serviceconnected illnesses. If confirmed, will you work with me to ensure processes are in place to address these concerns . Yes, senator, i will. Thank you. Over the last year my office worked with the va, American Legion to bring an atlas site to arizona. We hope to provide more details about the site in the coming weeks. The atlas would be accessing through local area station programs. To bring the access point to underserved communities. In arizona there may be many that can benefit from this and other initiatives. If confirmed will you continue to work with our office to expand opportunities to rural and tribal communities . Yes, i will. As we consider expansion we have to acknowledge is the challenge of access to broadband. As they continue to expand the Telehealth Initiative what role do you feel they should play in addressing Broadband Access . I think they have a key role to play and in coordinating with other federal agencies and with the fcc to ensure that the kind of access questions the va can lead on including on telehealth can be expanded by better Broadband Access, more universally available so i think there is a Critical Role to play within the agency and if confirmed that would be precisely what i intend to do. Thank you. In arizona the Navajo Nation has been hit particularly hard by covid. The cdc notes that they are at a disproportionate risk of complications from covid due to health and socioeconomic disparities in the communities. They also experience other inequities such as high instances of homelessness and the challenges accessing clean Drinking Water and sanitation. If confirmed, what steps will you take to ensure the best serving [inaudible] this would be a fundamental priority, consistent with the president s stated priorities on equity and consistent with what i have said throughout the day today which is how are we increasing access and improving outcomes for all bets and third, consistent with the direction to me from the president to ensure that the va is welcoming all veterans including obviously navajo and other native american veterans. So, theres a fundamental role for the va to play and if confirmed i would intend to play that role. I appreciate that. Thank you. Information Technology Modernization has been and continues to be a focus for the va. If confirmed you will be responsible for overseeing these major modernization efforts. As Cyber Security threats continue to increase across the u. S. , what steps will you take to ensure the va is equipped to protect against Cyber Threats and is practicing good cyber hygiene . Thank you, senator. Obviously the range of Cyber Threats that we come front has a country is only growing. Having cybersecurity front and center not only for the major programmatic efforts at the department, but also for individuals in the workforce at the department would have to be a fundamental priority and if that is me i would intend to make that a key priority. Thanks. The va still has a number of legacy systems its supporting. These cannot only be costly but also generally do not follow or accommodate todays Security Best practices. What would be your approach to addressing the systems that if confirmed as the va secretary . There has to be a fundamental focus on cybersecurity across the enterprise and number two, effectively performing on the modernization efforts will allow the va to not only increase security and performance and outcomes for vets, but will also reduce costs over time of these legacy systems, so executing on the modernization has to be a key priority. I see that my time has expired. With your indulgence mr. Chair i will submit the rest of my questions for the nominee and i want to thank him for joining us here today. Thank you, senator. In that regard, the questions need to be in tomorrow by 5 p. M. Last but certainly not least, and ive been in your position before, senator kramer, senator kramer. Thank you mr. Chairman. And i dont mind, frankly. It means i dont have to ask about rural veterans, telehealth, covid19, Community Care networks, we can get right down to the business of the stadium, football and how about that . I like that. We will get to that when you stop on your way to alaska. You and i did have a wonderful discussion i want to tell you how much i appreciate the meeting we had earlier this week. We drilled down on a number of these issues as well as one of my most important issues thats probably a little more unique to me and that is of course alternative forms of therapies, treatments, particularly oxygen treatments and the reason im such a proponent of hydro barrack oxygen treatment and therapies for veterans is because ive seen it work so well. A number of veterans i know have had their lives changed and in some cases saved by this important therapy as well as others that have had injuries that come from sports and particularly head trauma, traumatic brain injuries and so, i am a staunch proponent of it. By the way, very much appreciate the dialogue with senator moran because she was getting to the heart of an issue that i think a lot of us as you could probably tell are challenged by and that is just how large the bureaucracy is and how difficult it can be to maneuver it and how often we will actually pass legislation that signed into law only to have it sort of slow walked or whether intentionally or unintentionally and i happen to believe most of the time its with good intentions, but with regards to this i was able to get language in the john scott legislation youre very familiar with that would authorize the secretary of the va to enter into publicprivate partnerships with researching the effectiveness of these oxygen therapies and it would require, and i stress require, the va to use a test to measure the effectiveness of hydro barrack oxygen therapy and it would do a study both within the va and i think importantly outside organizations as well. I said real benefits, by the way other innovative therapies in the think you and i talked about the Important Role the va has pleaded leadership role in some of very effective alternatives to Traditional Medicine or Traditional Medicine, i really want to guess again, thank you for listening and get a reaffirmation of your commitment to fulfill the letter of the law in the spirit of it in except my invitation to see dan sullivan. Anytime i go to fargo i will take it. And be happy that we dig into the analysis of the therapy consistent with the intent of the statute. In getting with the brass tactic figure out what is the best way best vehicle to deliver the care to our vets that they have earned. I written down a number of things that you had said, i will not repeat all of them but one thing to have said a couple times in response to the question about your credit for this job, i love when you say i know how Government Works. I think its underappreciated skill set and experience. And i believe you when you say that, beverly reason to say, you seen it from both ends of pennsylvania avenue and as an affirmative vote and someone who looks forward to working with you went to arkham from. I yield the rest of my time. Thank you senator cramer before i have my Closing Remarks alternate over to the Ranking Member senator moran. Thank you very much was tolerable to have you in the chair today its not exactly what i wanted but its not a bad deal either, thank you for working with me and my colleagues on the side of the aisle as we commit to you and your colleagues and before i ask you a question i want to point out to the committee that we have a new staff director on the Minority Side who came from the house Minority Side but in the minority and majority staff world in the senate and is returning to the senate, this is his first meeting since his arrival and john towers is behind me and we look forward to having him in his help and we make them available to you should you be confirmed. Would you commit to me your fan of the chiefs. [laughter] senator moran i am a big fan of patrick mahomes, but im a vikings fan and i hate to admit im kind of old school that way. You couldnt of answer the question in a worse way. I thank you for your interest in serving as the secretary of Veterans Affairs and i thank you for your testimony today. I want to know based on what you said and what i learned about you i will vote for your confirmation. And i will ask and ask my republicans to do the same ill look forward to working with you and your commitment is evident to me and i think we can accomplish a lot on behalf of those who served our nation working together. Best wishes to you and your family and i thank them and i know your wife in particular is involved in Veterans Services who i could express my gratitude but publicly for her efforts and as a family we wish you all well in this new endeavor. Thank you very much. Thank you. Thank you so much senator. Senator moran, i dont know if moran had that question that he asked you knew the real impact but not only is jerry maranda toussaint but my Committee Director is a chiefs fan. I guess it does not matter if youre a vikings fan as long as you root for the chiefs in the super bowl. That is all. I want to welcome john towers somebody that jerry and i had the opportunity to work with when he was in the house. As you all know dennis often times the relationship between the principals is important but the relationship between the staff is more important. So i want to welcome you on board john. I also want to thank your wife and family that sit tentatively behind you nodding their heads and paying attention, i cannot see their eyes ill sit enter think they not off very much anyway. The truth is we know the power and the ability for any of us to serve in any of these positions whether elected or staff really relies on the family and how important they are to our ability to do her job. I want to think our committee today for the thoughtful questions and their belief in the way they put across the fact that veterans are number one in this committee and thats where we work on this committee so well. I looked at the fbi report the day before yesterday and i think senator moran will do it tomorrow. And i dont think im out of school saying it was pretty darned stellar. I told the lady that brought it in i would have paid a lot of money to get this many recommendations of what a fine fellow i am. You are highly qualified candidate and i believe you will work with this committee to ensure that we keep the promises to the many women who have served and their families to buy the way. Senator moran visited and we plan to meet again on tuesday to vote on Dennis Mcdonald to be secretary of Veterans Affairs. As well as the Committee Rules in the budget and thats what were going to do, i think the fact that you might have not met with senator tillis and sanders in the fact that the Ranking Member has not seen the fbi report requires us to do it and otherwise they wouldve moved up but im not going to based on that. I would ask as i pointed out to senator cinema any questions be sent to the clerk by tomorrow at 5 00 p. M. And then we will leave those responses back from you before we vote on tuesday. With that i want to thank you and your family for with that, once again of what you think you and your family for being here. Always a pleasure to work with senator moran. This hearing is adjourned. Thank you. [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] next week the full Senate Considers more cabinet nominations for the biden administration. Mandate a confirmation vote for Alejandro Mayorkas to become Homeland Security secretary. On tuesday senators voted in confirming Pete Buttigieg to head the transportation department. Other possible nominations enabled Veterans Affairs secretary and commerce secretary. As always you can follow the senate live on cspan2. You are watching cspan2 your unfiltered view of government. Cspan2 was created by americas cableTelevision Companies and today we are brought to you by these Television Companies who provide cspan2 to viewers as a Public Service. Sunday at 9 p. M. Eastern on after words New York Times oped columnist charles on his book the devil you know, black power manifesto. If black people had not migrated and extended think it but if they had not migrated, it is possible like people could control up to 14 senate seats to be the majority heart of the coalition to do that. It is possible that they could have controlled more Electoral College votes than california and new york state combined. It is possible they would have real power on a state level. So what i am saying to black america, particularly young black americans, i saw you in the streets. I have seen you protesting about this. I have heard you. If you really want a shot at changing the systems that you are protesting against, one of the quickest, most powerful ways to do that is through state power. I am asking that they consider a reverse migration which a lot of people already doing without think about political considerations. I am saying do it with political intentionality. Watch after words with charles blow sunday night at 9 p. M. Eastern on cspan2