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In iraq, we were there on the ground collecting so we had data bases to use. The concern is in syria, the lack of our footprint on our ground in syria, that the data bases wont have the information we need. It is not the lack of process, it is the lack of information. And is there ways that you could suggest we go about trying to get this information . I just dont think you can go and get it. You are talking about a country that is a failed state. It does not have any infrastructure so to speak so all of the data sets, the police, the Intel Services that you would go and seek that exist dont exist. And that raises grave concern as being able to do proper background checks of the individuals coming into the country. Yes. All right. Now, mr. Taylor, thank you for your testimony as well. And as a member as chairman of the subcommittee on transportation and i look forward to working together for the Mutual Benefit of everybody. And looking at your written transmission and so i can better understand the foreign fighter issue. One of the things that you mentioned was that the secretary johnson has ordered or is conducting an immediate shortterm review to determine if additional security measures are needed at domestic and foreign departures and what is the status of that and when can we get information on that. The brief is this week by tsa. And the idea behind this the thing secretary johnson has charged us all with is thinking outside of the box. I like that. We apply secretary directors and see the affect of those secretary directors every week when we have our counterterrorism meeting. And his last question is are we thinking out of the box and what else could we be doing to be more effective . And that is what he has charged tsa to give him some ideas back that he will decide in terms of how those things might be better implemented to across both domestic and internationally. So that is a shortterm. And then of course youll report to us at the appropriate time. Absolutely. And we appreciate that. And in the longterm, you are exploring the possibility of expanding to preclearance operations. Could you explain in more detail why that would be beneficial. Simply put in the football an alogy, we would rather play defense on our one yard line and not their one yard line. And we would like for it to happen at their one yard line and not over here. So we can put Homeland Security personnel in those airports and conduct the screening using the data base at their one yard line and be more effective from people getting on airplanes and coming to our country and rather than finding them here and having to send them back. Thank you for that. And lastly, with respect to tracking the foreign fighters, there was a reference in your written report to enhancing oren abling of cbp to conduct security vetting of suspected vwp travelers to determine if they have low Law Enforcement security risk. When you say enabling cvp. What do you mean by that. That . We mean expanding of theesta and the dating requirements and weve expanded that by six. We are looking at whether we should expand it even further so we have better data upon which to vet against our daisa base aa data bases. Maybe im being my former prosecutor too much. Enabling the cvp to conduct the vetting. Does that mean it is optional for them to do that . No. It expands to your capacity to do it with the more data elements. It is part of the mix when they screen someone . Yes. Okay. And i would add that every person that comes to the United States on an aircraft or ship is vetted against our holdings. There is no no one that comes here that doesnt get that kind of screening. Whether it is a visa screening or an esta screening determining whether there is an interview conducted but everyone gets screened according to the data bases of our country. Thank you very much. From new jersey, mrs. Watson coleman is recognized. Thank you, gentlemen. Im sorry i wasnt here the beginning of your testimony and i spent last night reading it and i found it fascinating and im very appreciative of what your agencies are doing and identifying to keep us safe here and how you have expanded your interaction and your information sharing and methodology and creativity and including Foreign Countries so we can all be safe. That is very important to me. Particularly struck by Homeland Security and i want to associate myself with mr. Keating and mr. Paines remarks about our responsibility to ensure that as you are the protector of the homeland, that you have the resources necessary to be flexible to be responsive and proactive to do what you need to do to keep me safe without engaging in the political wranglings of whether or not we should hold the president s foot to the fire because congress couldnt see fit to do. But nonetheless, my question is more narrowed and similar to mr. Lauder milks question. Im concerning about terrorists here. Taking who we think are everyday young people, having them exposed to the way these radical organizations use the social media and the other recruitment resources and how what is it that we can do to sort of cut it off at the pass. What should we be doing in terms of accessing young students, vulnerable College Students . Are there resources that we should be putting in educating and counteracting some of this negative propaganda, this ideologyspewing that is taking place with how do we help our communities and families see signs . Are there any commonalities or characteristics that seem to be most vulnerable that are homegrown, that seem most vulnerable to this radicalization and can you share with me where you think our greatest threat is in terms of the security . Is it on the southern border of the United States and mexico . Is it some other borders that were talking about . For someone like me, i consider myself spongebob. I want to soak up as much understanding as i can get. And whoever is able to answer it, i would appreciate it. I will start and anyone can add pieces to this, maam. You are absolutely right. The focus of one one of the focuses of our effort at the federal level is for communities to develop their own intervention strategies because that is what it takes. There is not a federally led intervention in a family or community or social setting that will be the tipper that turns someone off from radicalization. But it is the local community, the families, schools, churches, mosques, they are the ones that recognize Behavioral Changes at a point when behavior can be still addressed and potentially not end up at the worst Case Scenario of someone having to traveled overseas. So the precise information you are asking for is what we are trying to share in a series of Community Briefings that give kids, parents, schools, teachers to say this is what is happening and now i have to do something about it. Now the do something about it part has to be very much a Community Decision or a local decision. But the other frustrating piece and it gets to the last part of your question is that there isnt a single place that you say we need to be worried about it here and not here. Like our other previous foreign fighting episodes, like during the period when a large number of americans were going to somalia to engage in the fighting in africa, there we had great concern because of the somaliamerican population and their vulnerability to recruitment there. And here, im sure mike would echo this, we do not have a pattern that says yes in this community, but in this community we are okay. We cannot step up the efforts because the isil propaganda is having a reach far beyond ethnicity, it is not iraqi americans or syrian americans it cannot be narrowed in that way. That is a challenge and frustrating to us. And maam, i would add and certainly associate myself with all of the comments that have been made, we believe that one of the empowering organizations is our Fusion Centers and training of our state and local Police Officers who are the First Responders who are going to be the first level of defense, if you will and in spotting some of this behavior in addition to what happens in the Community Awareness area. So it is a combination of empowering the community in terms of what to look for and having our Police Officers better understand this phenomenon and what they may see on the street on a day to day basis and their encounters with citizens, Community Policing officers who are involved in daytoday activities within communities across our country. Also they need to have that kind of understanding. And i think as director steinback mentioning it, it is like the d. A. R. E. Program, of where everybody understanding what the issue is and filling the Knowledge Base so people when they see it, that is where you see something and Say Something can make a difference and in identifying these sorts of issues before they become bigger problems. Thank you. The gentlemen from georgia is recognized. Thank you mr. Chairman, thank you gentlemen, thank you for what you do to protect our homeland. Let me ask you, this is the kind of report that you read through and you are concerned about everything. And not one thing more so than the other. But one of the things that struck me was about the foreign fighter travel. And i just want to know what we can do to better control that . From what i understand, were not using all of our resources. I dont know that the administration is even identifying a lead agency to combat this, is that true . No, i would say that is not true. So foreign fighter travel, travel to a conflict zone in support of terrorist organization is against the law. So the fbi has the lead on that. And when you look at the broken travel, as mr. Herb brought up and when you look at the way legitimate citizens travel abroad is not something we choose to curtail. So if you take travel to destinations like europe, where you can then take from down to turkey, it is identifying the multitude of ways that these individuals in the u. S. Are committed to travel using a good investigative process, are they going to canada or down to mexico, how are they getting and using lawful process or ways to get to these locations. It is not the function of not having the tools, they have just as many creativity as we do and they have support. So they read it on social media and platforms and talk to people who have done it and made it and follow the travel routes so we have to stay on top of that and use trip wires and the Intelligence Community and the tribal and Law Enforcement agencies so develop an understanding of what the landscape is. So the message im getting here today is we feel we have that under control or doing the best we can. We dont have it under control. We are doing the best we can. If we had it under control, i could say we know every person traveling and i dont know every person there or coming back. It is not even close to being under control. It continues to be a challenge. We have to be as creatively as frank said to think outside of the box and figure out how to combat this and we spend a lot of time figuring this out and try to develop processes and daisa bases to data bases for this problem. And lets talk about the Visa Waiver Programs and there are certain people that are eligible for this and it is good for 90 days and it expires in 90 days . Actually, sir, the period of esta approval can be upwards of three years depending in the country. So once an esta is submitted the period that it is valid is between 13 years. But the countries that are most concerned with is up to 90 days, generally . In terms of in terms of the waiver . Right now we have a visa waiver with 28 countries across the world. And in each of those cases, we have bilateral relationship with those countries about how we Exchange Data and for what purposes. More broadly, other countries have to get visas through the state department for the purposes of traveling. Let me ask you this. What happens when it expires . Do we have someone who checks up on these people to make sure they are not still here . Absolutely. That is the job of our immigration and customs enforcement. And part of being in the Visa Waiver Program is the requirement that your visa overstays be somewhere in the less than 1 level. So were pretty confident in the countries that we have Visa Waiver Programs with that the level of this type of activity by their citizens in our country is minimal compared to the level of activity that may be evident in other countries where visa overstays are a bigger issue. As i can imagine, you have a tickler file set up and somebody exceeds that 90 days and they havent left, then you go looking for them . We have processes to try to make sure those people in this country for longer then their visa period are tracked down and escorted away. Okay. Mr. Chairman, i yield remaining time. Thank you, gentlemen. Chair recognizes the gentleman from texas, mr. Jackson wade. Let me thank the chair and the Ranking Member for this very important hearing and let me state to the witnesses, i was delayed because we were holding a crime subcommittee in judiciary in which im a Ranking Member. This is an extremely important hearing and it is issued in the back drop of several worthy comments. The president has now released his aumf, which is a singular notice to the congress of the importance of addressing the question of isis and the potential of the United States engaging in some form of military action to be able to secure this nation. I indicated in remarks earlier today on the floor that the department of Homeland Security provides a domestic armor, National Armor of security and that is the responsibility of that. For many of us on this committee, weve had the privilege of serving since the horrendous act of 9 11. Often i make the comment certainly not proudly that i was on or at ground zero during the moments of the extended time of looking for remains. It will always be a potent and striking moment in my life. And i take seriously the responsibilities of this committee. For that reason, i believe it is crucial that we do not hold hostage this department. We have seven days to make amends on the funding of the department of the Homeland Security and i remind my colleagues that the issue of unaccompanied children or the president s executive actions do not pose the kind of heinous threat we are talking about today. I frankly think this is an important discussion and many frontline dhs employees will be in essence hindered from their work without the full funding of this committee. I ask you mr. Taylor, just a simple question, that in the midst of your jurisdiction and employees under your jurisdiction, without funding for this department, will some of them not be paid or some of them have to be furloughed or some issue may come up regarding their service . Maam, we are in the process of reviewing the procedures for an orderly shutdown of the department. I cant say specifically the number of people since people who work for me are primarily in the National Security arena and are exempt from this, but there will be an impact in terms of people who are not directly involved in National Security. And also i would reinforce a comment i made earlier, there are going to be people working but not paid. That is the point that i made. You didnt hear me say that. There is a challenge in a department that is morale challenged going forward. But the main point is you are in the process of having that as a responsibility which is surveying your department and determining what will happen without the funding . Absolutely. And that is taking your attention away from important Security Issues of securing the nation which i assume, that is a statement that i believe is accurate. Is that not accurate . Im not personally involved, but our departmental management folks are working . But that is staff persons dealing with those issues that would not ordinarily being dealing with them at this time . Absolutely. And let me offer and pursue my questioning to make this point. I do want to offer sympathy. Weve come to it has come to our attention that three members of a muslim family were murdered in chapel hill. These were students at the university of North Carolina in chapel hill. We understand the culprit was arrested and charged with first murder and had some issues dealing with religious questions. One of the individuals was, in fact, speaking against the murder of people, meaning one of the Muslim Students was speaking against that. Let me go straight to the gentleman from the fbi and ask the question regarding cyber and the internet and soliciting and counter, in terms of ideology can be best used to fight this . We can fight with arms andin intelligence but there are other ways of stop organize getting in the stopping or getting in the way of solicitation of our young people . Absolutely, maam. I think there are a variety of ways that we can talk about in open session or information behind closed doors in a classified setting. I think it starts to go back we have to understand that the path to radicalization and mobilization, it starts with intellectual curiosity and there can be Community Based efforts to turn people away. Once an individual gets to the point where he or she has an intent to conduct an attack and it turns into an enforcement peace, there can be efforts from a counter radicalization narrative from a disruptive and intervention perspective and it is a multipronged approach that involves the state department and the counter messaging piece and it involves a counter radicalization piece and the use of trip wires and disruption to prevent acts of terrorism. So it is a widespread approach that we have to utilize all of those. Well let me just say that i hope that this committee, that we have overlapping jurisdiction will ramp up the dollars that will intervene in that radical heinous ideology. I consider isis barbaric. And i want to offer my deepest sympathy to the family of Kayla Mueller who was a true mesh and want american and wanted to do nothing but help people in need and wanted to do nothing than help people. And there are people in this nation that warranted and brought about the death of three Muslim Students or individuals in North Carolina, none of this should be tolerated and however we can disrupt and interrupt this, i think it requires ault of our resources, working together in bipartisan, funding the dhs to be able to make a difference and i, for one, would like to be engaged in the writing of legislation and or to find out more in an instructive matter how do we stop our young people from something as heinous as what isis represents and i would like to thank King Abdullah and jordan for their committed work along with our allies on this effort and my sympathy to them for the losses they have experienced throughout the mideast and throughout europe. With that, i yield back my time. Your time is experienced. And from arizona, mrs. Mcsally is recognized. Thank you gentlemen, for your testimony to you. To look at you while im talking to you with my colleague on my right. I appreciate the work youve been doing. I was 26 years in the military and worked especially, dr. Rasmussen with your organization and my last assignment at u. S. Africa command running Current Operations there to include our counterterrorism operations. And im aware of yall dealing with the foreign fighting issue before people paying attention to it but we were watching it even back then, 20072010 where we had foreign fighters flowing from many places but into areas for al shabab Training Camps and aqap and north africa and ungoverned spaces as you know. And someone in the military, it caused great frustration as much as what weve been talking about today on the defense as youve been talking. But it needs to be a come comprehensive government approach but i would prefer to be on the offense primarily and that includes going after to these people that have decided to become combatants in a struggle against us like going after the core ideology. And you know this, we watched thousands of foreign fighters graduate from the Training Camps because we didnt have the political will to do anything about it on the offense at the time not thinking it was within our interest or wasnt a threat to our country and god knows where those thousands of jihadists who graduated from the Training Camps all over africa where they are now. Who knows where they are today. We watched them and let them go and did nothing about it where we had tremendous opportunity to do some things and we just didnt do it. So weve been focusing on the foreign fighter problem with isis but i do want you to comment on your perspective of the foreign fighter problem in other ungoverned areas that we cant forget about to include many of them in africa just like your perspectives on what were seeing through there. Thank you. And as i talked about in my testimony, the thing that is an order of magnitude different about the foreign fighters phenomenon in this conflict is the scale. But you are right. This is not a phenomenon started yesterday. Those flowing to conflict zones to participate in conflict there is something weve been watching through a series of conflicts in the middle east and north africa. And they have a unifying theme in this area is a lack of governance and so we are trying to intervene using all of the tools available but no one tool being adequate to the task of reaching into a north africa whether that is a mally, or libya or somalia and reaching in to effect to what those fighters are reaching into. We are particularly challenged because of an intelligence deficit and that gives us a really good picture of who the individuals of greatest concern are. As you know, that is where we try to spend most of our effort is trying to determine who most of the individuals are that are try to spend most of our effort engaged in plotting against our interests. Because there is obviously a Huge Population of individuals who are there to participate in localized conflict so we cant devote all of our resources to that picture. And the last thing i would say that particularly concerning about the isil phenomenon is that isil has decided it needs to move beyond syria and iraq and so you have extremist organizations in africa, algeria, egypt and in libya who have raised the flag of isil and claimed affiliate status. And again that creates a sense of momentum and Competition Among extremist jihad groups that has added to our threat concerns and doesnt subtract. You like to see your enemies fighting amongst each other and it creates competition against each other as they try to oneup each other in efforts to go after us. And the next question i have just a little bit of time here left. And you talked about Community Engagement, but this is an islamic extremist problem so what particular is the engagement with the Muslim Community in america and their leaders and where is there an obstacles to admitting them in acknowledging this is a problem of their religion and where do you see them getting on board to stop it. The muslim communities around our country, they are concerned , as are all americans about this kind of behavior among people within their community and they want to address it, they want to understand it better and to have the tools to address it. And ive noted, ive been out with the secretary on a couple of these. There are concerns about discrimination on the part of those communities and how they are treated and certain other ways but there is no lack of commitment in those communities to get at extremism among their children, among people in those communities because they see that as inconsistent with their responsibilities of being americans and living the American Dream in our country. So ive noted, i dont think weve noted a major lack of effort among those communities to recognize this phenomenon and how it impacts those communities and not wanting the tools to help them address them proactively. Great, thanks. My time is expired. Thank you, mr. Chairman. We recognize mrs. Torres from california. Thank you, mr. Chairman. And i apologize for giving you my back but for the unfortunate circumstances of seating arrangements. And i would like to go back to the questions of secretary thompson, without a full year of funding bill, the department of Homeland Security cannot award it is my understanding, 2. 6 million, is that correct . Billion dollars . Billion. Much of which goes to state and local departments. Having served both at the local level as a council member, mayor and served as a state senator in the state of california, these agencies are just beginning to recover from this Great Recession that we have had. They certainly do not have the funding to backbill what we do not send to them and they are dependent on this funding in order to help protect our communities. So what what do you think is the Risk Assessment as it relates to these agencies not being able to pick up the phone and have someone on the other side answer to get feedback on a potential threat risk . Maam, i cant speak to the specific risk. What i can speak to is the fact that Grant Funding and our investment in state and local Community Engagement efforts is a linchpin for how we have structured our country to do Homeland Security. We have believe Everyone Needs to be in the game. Everyone needs to be in power to information what the risk is what the tactics, techniques and procedures are to be looking for and share that information with the fbi, with the i. C. So we can engage before the act happens. So the extent to which these grants make those agencies less effective and in meeting that responsibility, presents a risk for us. Would you consider that a low risk, a high risk and as it relates to not just the agencies, but im sorry, not just as it relates to the local agencies, but the inability of the fbi or the inability of other departments to be able to coordinate and communicate with these agencies . As i said, maam, we had built our Homeland Security enterprise based on a state, local, federal model and any capability that is taken away from that, and in some way diminishes our capacity to face the risks we are concerned with in our country. Thank you, i yield my time back. The chair recognized the gentleman from texas, mr. Radcliff. Thank you, mr. Chairman. Gentlemen, i have very much enjoyed and appreciated your testimony today. As a former terrorism prosecutor and as a former United States attorney, ive had the good fortune to work with each of your agencies on a number of occasions and i very much look forward to the opportunity to do so again as a member of this committee. Mr. Steinbach, i would like to work with you, the director of the fbi jim comby expressed concern about Technology Companies using encorruption meth encryption methods on mobile devices with apple saying it would no longer be able to unlock phones and directing toward child kidnappers, like opening a closet that could never be opening and even if it involved a court order, to me that does not make any sense. As a former terrorism prosecutor, i share the directors concern and can certainly see how the inability to access encrypted devices so my question is what is the fbis plan to deal with this and have you engaged the Technology Industry to address these concerns . First of all, sir, im not going to argue with director comby, so he is of course right. And it is a concern. And quite frankly it is irresponsible for companies to build products and have Software Updates that allow for no lawful capability to unlock their devices. And so to make the argument it is on the cloud and you dont need to have access to the device itself is disingenuous because not all of the information is on the cloud. We have to have the ability, whether we are talking about gangster or authorized crime or terrorists, with lawful ability, court orders to look into and take contact, store communications, whether it is a child pedophile, somebody involved in narcotics trade or trying to conduct a terrorist act, we have to have that ability. So we have put this message out. I know that the director and his staff have gone out and relayed this message on numerous occasions. Weve pushed it out. Weve had interaction with the state, local and federal levels of Law Enforcement as well as had direct contact with those companies and tried to explain through use of examples this is a dangerous precedent to go down, to not have the ability at any means, whether it is an ongoing kidnapping or some other event, not to have the ability to get in there and look at that content or stored communication. Terrific. Thank you very much. Ill throw this out to anyone on the pam that wants to take it. There are numerous reports out there that ask. Fm is one of the common recruitment channels through which a number of American Foreign fighters have formed relations with recruiters and we talked about the teenage girls from colorado. Since they are operating out of lap via, i want to know if there is any interaction between the state department or Law Enforcement with the Government Regarding this . So i cant speak to specific interaction between the state department and the lappian government. I would tell you that ask. Fm. Com is one of the companies that we have seen in our intelligence collection efforts that is being used. That is just one. There are many platforms that reside overseas, like i said earlier, that have shown an unwillingness to work with our government or the host governments. Terrific. Last question. And i apologize if this has been covered earlier. Ive been in and out of other hearings today. But when isis specific material is posted on facebook, twitter tumblr, you tube, what are the existing line of communication between Law Enforcement and those entities to provide notice or to facilitate the removal of that material . So the companies themselves have Service Agreements that in many cases violence, criminal acts, if they violate the terms of service, once they are violated, they can take that down. We are looking at it from a different threat. So when we see the radical pieces being used, we look to exploit that and do that through a lawful means, whether it is collecting the information to see what they are communicating about or to look at ongoing communication. So we have an overlapping, i guess, mission, when compared to some of the companies, but at the end of the day, the result is the same, we want to stop the communication through social media platforms. My time is expired. Again, i appreciate you being here. Mr. Chairman, i yield back. We thank the witnesses for being here today. This is a very important topic to our National Security. And i want to thank all three of you for your service to the American People to keep americans safe. And i want to thank also the rank and file within the department of Homeland Security and ctc and the fbi for the job they do day in and day out without much recognition but they are truly the patriots of this country and on behalf of this committee we want to say thank you. The hearing will be open for ten days for additional questioning and without objection, the committee stands adjourned. President hassan were han wednesday the goal of irans negotiations on its Nuclear Program was a winwin outcome. His remarks are next. Six month after taking over as Veterans Affairs secretary Robert Mcdonald testifies about his departments 2016 budget request. On the next washington journal, we talk to a congresswoman, chairman of the Foreign Affairs emerging threats subcommittee. He will suggest the president s request for authorization of military force against isis. Then representative Jerry Mcnerney is here to talk about combating isis the keystone oil pipeline, Net Neutrality and cyber security. Later, our bus tour of historically black colleges and universities continues with Beverly Daniel tatum in atlanta. Washington journal is live every morning at 7 00 a. M. Eastern. You can join in the conversation with your comments on facebook and twitter. Next, iranian president Hassan Rouhani addresses his country on the anniversary of the Islamic Revolution. This is courtesy of the state run press tv. The anniversary of the glorious islamic resolution of iran, i would like to offer congratulations to the great nation of iran. We are happy that this year it is been held even more gloriously across the nation and the people that have participated in the great rally of february 11. So i would like to thank all the iranian people for the glorious participation and my appreciation for that. 36 years past since our people raised their demand for independence freed them and the Islamic Republic of iran. The aspirations of our people is still independence, freedom and the Islamic Republic system. Islamic republic as two aspirations and values. One is democracy and the other is religious establishment. The Islamic Republic of iran is a crystallization of the sharia within the context of a great nation. The Islamic Republic is a manifestation of gods rule and governance, and bodied in a great nation embodied in a great nation. The Islamic Republic of iran is the translation of gods will through a vigilant and awakened nation. It has the roots of the revolution, or the aspirations and goals and principles which will remain unchangeable and implementation, if there is something to be considered, that still will be within the framework of the Islamic Republic of iran and that will be conducted through the ballot boxes and the elections where people vote. In the great way that the great imam said, the republic the Islamic Republic, absolutely. The islamic nation translates into the Islamic Republic and vice a versa. For us to see a man of the people fulfill, the best way to do that is the implementation of the islamic precepts and teachings. For the establishment, the best way is the rule of the people, the will of the people who within islamic rules, the late imam gave legitimacy to the vote of the people and the Islamic Revolution leader said the vote is the right of the people. So, the Islamic Republic of iran is an election based system based on economical and religious jurisprudential services, all of this will respect the establishment and will continue to respect that. In addition to the islamic establishment, was gaining independence. Our people in the course of decades and maybe beyond that throughout centuries are people that fought for independence since the tobacco fatwa, up until the time of fighting against foreigners and cutting off their hands regarding the oil monopoly and regarding the fight against capitulation, all through independence, has been a lofty aspiration of our people and we managed to gain independence. We have not gained independence easily so we cannot let go of it easily. Independence means fighting, it does not mean xenophobia or fighting strangers. Independence means that we stand on our own feet. That is the will of the people. To not allow any superpower when it comes to National Interests will not allow anything to affect that will. So the battlefront, we went to the defense of independence. At the negotiating table we protected and defended our independence and will continue to do so. During the days when our confidants used to fight at the battle fronts, behind our battle fronts, the entire people supported our fighters on the battlefront. No treason goes beyond the treason admitted behind the battlefront. Those who are fighting in the arena of diplomacy, the entire iranian nation as well as the great Islamic Revolution, they all support that front. The front of negotiation. The enemies of the nation who are opposed are the zionists they are trying their utmost and have done whatever they could, but the world today has realized the treason on the part of the zionists, especially after the crimes committed in for the past month in gaza. So the criminals stay criminals in the region. The third demand of the iranian nation has been freedom. A republic system without freedom is meaningless. Islam, also goes together with freedom. National unity, we see an array of different opinions and were Still Standing united. We have a variety of opinions, but that is no problem. When it comes to National Interests, and expediency, all of us are standing united. So today, like 36 years ago, we still raise the cry of independence, freedom and the Islamic Republic. The Islamic Revolution belongs to the entire iranian nation. It does not belong to a certain ethnic group, nor does it belong to any certain walk of life or any faction. People stood up altogether and rose altogether and saw the victory of this revolution. Today, all of us need to stand united and support the interests of the people and those of the Islamic Republic of islam. The revolution did not mean a change in names and labels. It came to change up some norms, the ones that ignored the religious and humanitarian values. Today, the demand of our youths, is the same demand they have had the past 36 years. Last year, our people through casting their votes on the basis of the guidelines that the Islamic Revolution Leader People attend the polling stations and also voted to pick the government of hope and prudence. The people rely on the vote of the people and is faithful to the promises made to the very end. The path will be continued and the promises will be fulfilled one after another. In all fronts, the economic front, cultural, social welfare, a message of strength prudence and wisdom and support with the support of the people through the cooperation of the people, this has been heard. Through the government on behalf of the people. So last year, in the same venue, i was addressing you, great people, i made a promise that this government will, by next year, go through stagnation, and leave it behind. And today, i have the honor to announce the iranian nation that the First Six Months of the year, we had a growth of 4 . So all the world should know that the people of iran is powerful, is efficient and is moving toward the path, on the path of progress. So the calendar 1391 and 92, we listed negative growth and year 93 with the blessing of god we will end the year with a positive growth. In industry, we had 6. 5 growth. Our mines, we had 10. 5 . And the commerce sector, we had a 5. 4 growth. In the First Six Months of the iranian calendar year. When it comes to oil and other economic issues, we have had substantial growth. So we did some things sort of economic bloom, will take off in this country so the first thing to do is facilitating transaction and doing business and removing the obstacles for economic. You know, in the course of the past year, we want to rank 22 in terms of business. There were 22 ranks that we ascended in our ranking. Today, for facilitating exports and imports in iranian calendar 93, we had clearance of goods and customs for the purpose of export from seven days, it just went down to one day for all the basic goods, for the import, that took 26 days, it just takes three days now. So credit lines also for businesses, industry and commerce this year, we have seen a 40 of growth when it comes to offering of credit lines compared to past year. The government of prudence and hope, we have had seven thousands of half finished the government of prudence and hope, we have had seven thousands of half finished projects that were completed. Now they are working on it and this is indicative of the fact that our people has been on the path of resistance economy. Youre aware that in the first 10 months of the year, our completed. Now they are working on it and this is indicative of the fact exports, compared to the same period last year, has seen more than 24 increase. I meant nonoil exports, last year, in the first 10 months of the year, we have 34. 3 billion but the first 10 months, we have 42. 6 has been the figure for export of our commodities in the oil and gas sector despite all the sanctions and the pressure, we have made substantial progress. Our Oil Production in the past year from 2. 7 million a day, went up to 2. 9 Million Barrels a day. The production of gas, as youre also aware, there are five phases that have come to fruition in the south and today compared to last year we have daily 100 million cubic meters of gas more than what we fruition in the south and today produced last year. And hopefully by next year well have another 100 million cubic meters of increased production next year so in the field of agriculture, despite the water shortage and all the problems, when it comes to wheat, we have had two million tons in production of wheat, and in the year that past we had 6. 8 million tons of wheat that weve purchased. When it comes to mechanization of agriculture, we have also managed to pull off some Great Success in that sector. The number this year compared to past year has seen an increase of 250 . The number of agricultural combine mission has seen 300 increase, 550 hectares of land we have started working, revival of land, also greenhouse agriculture has been increased. Last year in the same place i just promised you that the inflation of 35 that we just talked about last year, i said that next year, that is now, this year, we will take it down to 25 . With the blessing of god, his assistance, our inflation rate today is below 17 . So the government has been able, with the support of the people, our youths, our entrepreneurs, the government has been able to take strife in line with the growth and progress of the country when it comes to size and technology as well as culture. Well, today, you are witness to a very substantial increase in all the universities, Research Centers and scientific centers. Incidentally, our universities today are much calmer, of Higher Quality and standards pursuing activities, and you know that this government, after a few years, you know, we had the law supporting the science based corporations and companies. This government is trying to implement that law. During that period that the law has been, being implemented, the science based companies and corporations, the number has come to 1,300 companies. That means, in course of one year and a few months, the growth in the science based companies has been more than 22 times as many. We have established the Innovation Fund and the capital for next year will be two thousand billion. Weve increased that amount. In terms of scientific rank, our country, compared to last year, we have gone up two tiers. We are now standing, we are now ranking 14 in the world. So in nanotechnology we have acquired the seventh ranking. That means we have gone one step further up compared to last year. In biotechnology, we are standing 14, that means two steps higher. The leader of the Islamic Revolution has always played great stress on the growth of science and technology and today, on the anniversary of the Islamic Revolution victory we are proud to say that our respected youths, boys and girls, in universities Economic Centers and Research Centers, they have been pursuing their scientific operations activities more actively, and the government has been supporting, will continue to do that. So it comes to social welfare, the judicial security, the government has 14 million as members of the lowincome families being covered by the government. Since the beginning of the year, commodities basket has been distributed among the 14 million lowincome people. Also, the Health Insurance, as was promised during the electoral campaign, that Insurance Coverage was also spread out to the entire nation and this year more than eight Million People who have had no insurance, theyre now all insurance, theyre now all covered by Health Insurance this year. In terms of health and development therein, the government has done just started a great thing and that is the people, the money people are being charged at medical centers. It was 27 last year. Its now gone down to 6 is what people are paying to hospitals this year. All the entire equipment, and paraphernalia and the tools that are being used, consumed at a high rate, they have been provided to the people, foreign equipment has had a 22 decrease in price to the public. Peoples access to medicine has increased to 750 medicines. That means there has been 134 the consumables from 1,800 has reached more than 2,100, that means an increase of 44 . So the government this year was determined to have 1,945 Health Centers in villages across the nation that will try to establish. We have managed to open 1,100 of such centers and the rest will be launched in the spring thats around the corner. Now, regarding the war veterans and handicapped, we highly respect and we respect goes to their families, too. For the first time, this government has this comprehensive law for war veterans and the handicapped and to all the what the government had as its debt they were all paid to them. A big issue of ours today is the issue of the environment the ecosystem, both in megacities and smaller towns. We have the problem of air pollution and particles. We have taken measured steps in the past year. We have distributed gasoline and also gas, which is higher in standards, and we have tried to reduce the amount of pollution in cities. This year, the liquid fuel and power lines, 46 , their share was reduced to 30 . And this was actually, this contributes to the reduction of air pollution in large cities. 200,000 old cars have been put out of service. With these polluting particles. We need to do something especially in our western province, but you know this is a great task and its time consuming. They usually find this way into iran from our neighboring countries through the seasonal winds. They start coming our way and they usually find this way into they find a way in our cities. So the government has done whatever it can in that connection but we still need the help of our western neighboring countries to be able to have this longterm project in order to do something about bringing under control these polluting air particles. Also, regarding the utilization of new dams. There are seven new dams that this government has launched and also more than 53,000 hectares of water and Distribution System has been put into operation. When it comes to foreign policy, the government has acted upon and is sticking to its slogan and that is constructive interaction with the world while at the same time maintaining our interests, principles and revolutionary goals and aspirations. The government managed to get out of the deadlock and break the deadlock on Nuclear Talks and through a new approach, the government managed to continue with negotiations so what we were we are seeking to gain in the course of the negotiations is coming up with a winwin agreement. That would mean that transparency in Peaceful Nuclear activities would in international law. This is what iran has been doing. And the other side should also do something about the antihuman and illegal sanctions that need come to an end. This would be in the interest of two sides. Where the sanctions are lifted it would benefit iran and the other side because they, too are in need when they say that for the sake of sanctions, that iran has thats because of sanctions that iran has come to the negotiating table. What they are lying, its not been because of the pressure of the sanctions. Iran has been going to the negotiating table because of wisdom in order to create peace and stability in the region, in the world is why iran has come to the negotiating table. If the way you claim its been the sanctions that have forced iranian people to surrender, so why did you keep imposing more sanctions . Why have you kept the negotiating table so that the sanctions are lifted . So you better do away with lying. Negotiating table so that the top lying, and talk to your people honestly, honestly. Tell them that, in the face of the great nation of iran, there is no way for the world except interaction. So you should let so with a loud voice, for the whole world to hear, you should say that in the middle east region, if there is going to be any peace and stability restored, if theres going to be any uprooting of terrorism, there is no way other than the presence of the Islamic Republic of iran. So you have seen in iraq and syria, in lebanon, in yemen, the power that managed to stand against terrorist groups and to is no way other than the help the people of iraq, syria it was the Islamic Republic of and lebanon. The hearing will come to order. We are here to discuss the president s fiscal year 2016 budget request for the department of Veterans Affairs. Mr. Secretary, welcome to the committee. Understand that your testimony will be a little bit different today than what we are accustomed to with reference to chart to help us better understand what you are seeing in terms of the challenges that lay ahead and i would say that is indeed a welcome change. So too is the open as you have had with me with members of this committee and this congress about your plans to change the culture at the va. As your testimony illustrates you have been extremely active in visiting va facilities. I think its well over 90 at this point, talking with employees veteran groups in your private sector colleagues with one aim in mind, putting everyones focus squarely on the needs of veterans. Thank you for your willingness to take the job of secretary and thank you for putting everything you have into that job. Turning to the business of examining the va budget request i see some very positive things but also there are some areas where we will have considerable question marks. The committees task will be to learn as much as possible in order to inform our views and estimates letter that is due next friday. On the Positive Side mr. Secretary you have boldly tackled a very sensitive issue of vas aging infrastructure coupled with a more realistic budget request for vas Major Construction program addressing the closure of unsafe vacant or underutilized facilities begins an important conversation about the future alignment of vas infrastructure. I have long argued that we needed a strategic reinvestment of vas construction program. That is in part what the independent assessment of the Veterans Health Care Commission established the last summers choice act tasked with examining. You have my commitment and this committees commitment to work with you as this conversation begins in earnest. I have several areas of concern that but i hope you and our second panel can address. First, and im going to be frank as i have in the past with you on this particular issue. The proposal to reallocate any portion of the 10 billion appropriated for the Veterans Choice Program is a nonstarter. I understand theres a great degree of uncertainty about the programs utilization but in appropriating the money the congress had to work with the best estimates we had at the time to stretch those dollars including limiting Eligibility Criteria for veterans. So if there is going to be anywhere up reallocation is going to be to further improve and strengthen the program itself and not address other needs. Secondly the budget requests an additional 1. 3 billion for va medical care on top of the advanced appropriation for fiscal year 2016 bringing the total proposed increase to 7. 4 . At a threshold level i do not understand how this request interacts with a 15 billion that congress provided last summer for nonva care and infrastructure as part of the veterans access choice and accountability act. It would appear that there are considerable unknown variables in this area such as the degree to which the Choice Program alleviates the workload and resource pressure on va, the productivity standards of va should expect from clinical workforce and the ability for va to hire professionals in an already large vacancy rate in a National Shortage of health care professionals. I hope to expand on this a bit more during questioning. Thirdly i know that the 6. 5 increase for the Veterans Benefit Administration principally to hire additional staff to address the workload. Mr. Secretary there are several of us on this committee Ranking Member included, who have long memories on this issue. We know that disability claims staffing has doubled in 10 years and nearly tripled since i arrived in congress in 2001. We have invested over half a trillion dollars in vbms and millions more and other systems and we provided tools to encourage veterans to file fully developed claims which in turn enables a quicker decision. All of these investments were made with a the promise that productivity would markedly improve and shift the department away from the usual torrent of relying on an everincreasing workforce and over time to deal with the workload. Although another production improvement and backlog over the last two years its a far cry from saying individual worker productivity improve given the resources that have always been provided to the department. Again this is another area i hope to address in questioning. Finally the big Lesson Learned last year that veterans are better served with constant and aggressive oversight. Mr. Brown and i have asked for a larger Committee Budget towards that end. One thing that you and i have talked about is the office of inspector general. I too believe that they need an increase larger than the. 3 increase provided in the budget. The proposed amount is not enough to cover inflationary costs let alone be increased oversight we all rely so heavily. Again mr. Secretary thank you for what you are doing and i look forward to your testimony and i look forward to hearing from the Veterans Service organizations on the second panel. The va system is for them and those they represent southern put on budgetary matters is critical in informing the committee on the congress on vas budget request and without i recognize ms. Brown for her opening remarks. Cnet thank you mr. Chairman and welcome mr. Secretary. I want to say that im very happy you are here this morning and im looking forward to hearing how this budget request will meet the needs of our veterans. The president has given a large increase to the va but the president has proposed an 8 increase in funding or Va Health Care personnel Construction Research and processing. Given this large request i am looking forward to our discussion today and how it will assist our work as a committee to make sure that this proposed budget gives you the dollars that you need but also assures us how in congress that every dollar you receive will be spent wisely. I am certain h. R. S. To 216 the department of Veterans Affairs reform act of 2015 was the lava lamp. It is an important tool to assist us and you in matching resources to the needs of our veterans and ensuring that we are planning for the future to make sure that we dont let our veterans down. Mr. Secretary the first question i will ask is does your proposed budget give you all of the dollars you need to fix the problems that you face meet the goals and the initiatives the department has laid out keeping in mind that funding provided by the choice act i hope we can discuss whether you have enough resources to ensure that veterans did not place an intolerable delays to getting access to health care and i hope you will discuss how you are looking down the road to ensure that veterans have the access to meet va care in the future. I always hear from veterans how they prefer va care when its available. I hope we are going to all Work Together to make sure that health care our veterans prefer is available to them when they need it. This is the first year that va benefits programs will be fully funded on the advanced appropriation. Veterans wont have to worry about what we are doing in congress and it wont affect how we operate. Finally i want to hear about your reform and reauthorization efforts and how this budget request will support these efforts. I also want to hear about how you are making progress in an effort to reform and regenerate and invigorate the va. Too often all we care about is the problem the va is having. I would like us to also consider what we can do to fix those problems and to point out what va is getting right. Im pleased with this budget request and i hope these dollars can fix what is wrong and strengthen what is right that the va and with that mr. Chairman i yield back the balance of my time. Thank you very much ms. Brown. I would like to welcome our first panel to the table this morning. Accompanying the honorable Robert Mcdonald was secretary of the department of Veterans Affairs is in german secretary for health the honorable Alison Hickey undersecretary for benefits mr. Ronald walters interim undersecretary for moral affairs, ms. Helen tierney executive in charge for the office of management in va chief and Financial Officer and mr. Steffen warren executive in charge and chief Information Officer within the office of them permission and technology. Mr. Secretary again thank you for being here and please proceed with your statement. Thank you. Ranking member brown chairman miller with members of the Committee Thanks for the opportunity to discuss b. A. S 2016 budget and advance appropriations requests. Thank you as as well are joining maine and vermont last week for groundbreaking breaking town hall meeting. We deeply appreciate appreciate the president sent congress a steadfast support for veterans, their families and survivors as well as the advocacy of Veterans Service organizations. Our nation is emerging from the longest word in its history. The va is emerging from one of the most serious crises the department has ever experienced. We now have before us the greatest opportunity we have ever had to improve care for veterans and to build a more efficient and more effective system. With your support bea intends to take full advantage of this remarkable timely opportunity. Members of this committee and vso share my goal to make the va model agency with respect to customers experience in stewardship of taxpayer resources. An example for other governmental agencies. With efficient and effective operations would like to be comparable to the top private sector businesses. This is how we best meet the nations obligations to all veterans. The cost of fulfilling those obligations to our veterans grows and we expect it will continue to grow for the foreseeable future. We know that services and benefits for veterans do not peak until roughly four decades after conflict ends. This chart demonstrates the number of veterans receiving Service Connected disability benefits from world war i peaked in 1958. For world war ii it peaked in 1985. For korea it peaked in 1993 and for Vietnam Veterans it was just last year and 2014 when it peaked. Its worth remembering that today almost 150 years after the civil war ground to a hault b. A. Is still providing benefits to children of a civil war veteran. We still have troops in both iraq and afghanistan and in the last decade we have already seen dramatic increases in the demand for benefits and care. This chart shows how for 40 years from 19,622,000 the percentage of veterans receiving compensation from va was stable at a. 5 but in the last 14 years since 2001 the percentages have dramatically increased to 19 more than double. Simultaneously the number of claims and the number of medical issues in related claims that va has completed has soared. As this chart shows and 2009 bba completed almost 980,000 claims. In fiscal year 2017 we project we will complete over 1. 4 million claims. Thats up 47 increase. But there has been even more dramatic growth in the number of medical issues and claims. 2. 7 million in 2009 and a projected 5. 9 million in 2017. Thats a 115 increase over just eight years. These increases were accompanied by the dramatic rise in the average degree of disability compensation granted to veterans. For 45 years from 1950 to 1995 the average degree of disability held steady at 30 but since the year 2000 the average degree of disability has risen to 47. 7 as this chart shows. So while its true the total number of veterans is declining the number of those seeking care and benefits from va is increasing. Fueled by more than a decade of war agent orange related disability claims, and unlimited claims appeal process come increase medical claim issues, far greater survival rate among those wounded more sophisticated methods for identifying and treating veterans medical issues demographic shifts, veterans demand for services and benefits has exceeded the as capacity to meet it. Its important that congress and the American People understand why this is happening. The most important consideration is that americas veterans are aging. As with any Population Health care requirements in the demand for benefits both increase is veterans age and exit the workforce. This chart reveals an astounding shift. In 1975 pierre graduated from west point just 40 years ago only 2. 2 million American Veterans were 65 years old or older. 7. 5 of our veteran population in 2017 here on the far left. We expect 9. 8 million will be 65 or older were 46 of veterans. That is 7. 5 to 46 an astounding increase. Today we serve a population that is older, with more chronic conditions and less able to afford privatesector care. We protect the benefits for veterans in recent conflicts will peak around 2055 assuming afghanistan and iraq are winding down this year. Its fair to imagine the members of congress who are present in the secretary of Veterans Affairs and 2175 will be debating resources that will impart health care for the family members of iraq and afghanistan veterans. Currently 11 million of the 22 million veterans in this country are registered enrolled or use at least one va benefit for service. Veterans are demanding more va services than ever before. The number of all veterans who are seeking va medical care is steadily growing. And Women Veterans is a very important issue for us and Mental Health another very important issue for us have to increase to medically. Over 635 Women Veterans are now enrolled in Va Health Care and over 400,000 actively use va for care. Thats double the number using va care in the year 2000. Please see annual increases in Women Veterans seeking care of 9 and this trend will continue and probably even go higher. Our Women Veterans call center now connects with over 100,000 Women Veterans per year. Over 1. 4 million veterans with the Mental Health diagnoses are enrolled in va an increase of 64 from the year 2015. There were approximately 19. 6 million Mental Health outpatient encounters in 2014. Thats an increase of 72 from 2005. Since its inception in 200722014 the Veterans Crisis line has answered over 1. 6 million calls and assist in over 45,000 rescues. Over 1 million veterans receive services through the primary care Mental Health Integration Program begun in 2007 through november 2014. The annual number of encounters has grown from about 182000 fiscal eight to over 1 million in 2014. Is veterans witnessed the result of the result of a positive change is va is making and regain trust in the va and as the military simultaneously downsizes, the number of veterans choosing va services will continue to rise. In it should end our veterans have earned it. We are listening hard to what veterans congress, employees vsos and stakeholders are telling us and what we hear drives us to an historic unprecedented departmentwide transformation. Changing vas culture and making the veteran the center of everything we do. That transformation we call by va because thats the way they want veterans to think about va. It is they are is personalized and customized and this transformation entails many organizational reforms to better unify the departments efforts. My va focuses on five objectives which i have shown here on the bottom. First improving the veteran experience so every veteran has a Seamless Integrated and Responsive Customer Service experience every single time. Second improving the Employee Experience and eliminating barriers to Customer Service to achieve people excellent so employees can better serve veterans. We have no hope of taking care of veterans if we dont take care of the employees of va. Third, improving our internal support systems and services. Forth establishing a culture of Continuous Improvement is the local level can identify and correct problems more immediately and then replicate Prudent Solutions across their entire network. And fifth in enhancing strategic partnerships. My va revolutionizes vas culture and reorient the department veterans. Measuring success by veterans outcomes as opposed to internal metrics. We intend every veteran to have a Seamless Integrated and Responsive Customer Service experience every single time. Reorganizing the department geographically is the first substantial and important step in achieving this goal. In the past va had nine disjointed Geographic Organization structures, one for each line of business so imagine a business with nine different businesses, nine different sub businesses each having a Different Organization structure and a different middle management. Our new unified organizational framework has won National Structure as shown in this chart. This new structure has five regions aligning vas disparate organizational boundaries into a single framework. This facilitates internal coordination and collaboration among business lines, creates opportunities for integration at a much lower level and promotes effective Customer Service. Veterans will see one va rather than individual disconnected organizations. And last of my va is about ensuring va is a sound steward of taxpayer dollars. We will integrate systems and efficiencies across our operations to make sure we balance veteran Centric Service with operational efficiencies that we need the help of congress. Va cannot be a sound steward of the taxpayers resources with the asset portfolio we are currently carrying. No business would carry such a portfolio. Veterans deserve much better. Its time to close the vas old standard and underutilized infrastructure. Nine va facilities im sorry, 900 va facilities are over 90 years old and more than 1300 are over 70 years old. The va currently has 336 buildings that are vacant or less than 50 occupied. Thats 10. 5 million square feet of excess which costs us an estimated 24 million a year to maintain. These funds can be used to hire roughly 200 registered nurses for a year or to pay for 144 primary care visits for veterans veterans, or to support 41,900 days of nursing home care for veterans and Community Living centers. We need your support and to do the harder right rather than the easier wrong. These might be a reforms will take time but over the long term they will enable us to better provide veterans with the services and benefits they have earned and that our nation promised them. Our 2016 budget will allow us to continue this credible transformation to meet the intent of my va. The 2016 budget for va requests 168. 8 billion Million Dollars and 95. 3 million in mandatory funds for benefit programs. The discretionary request is an increase of 5. 2 billion or 7. 5 above the 2015 enacted level and provides the resources necessary to continue serving the great number of veterans who have selflessly served our nation. The budget will increase access to medical care including im sorry, increase access to medicare and benefits for veterans. Youll address infrastructure challenges including major and minor construction modernization and renovation. It will land a backlog of claims of veterans homelessness by the end of calendar year 2015 beta will fund medical and Prosthetics Research and address the i. T. Infrastructure modernization. We know this is a large request but its not sufficient to meet all the requirements for 2016 or 2017. Therefore the president will transmit a legislative proposal to allow flexibility is necessary to reallocate as needed a portion of veterans choice act, funds to improve va operations within a fiscally responsible budget neutral approach for veterans. As this chart demonstrates this proposal is largely driven by her uncertainty of what resources we need to fund the new Veterans Choice Program. Its difficult to predict. Veterans use the program or its interaction with the medicare base budget because its allnew. We have no longterm data to draw upon yet. Our current estimates of demand range from a low of 4 billion to a high of 13 billion over the threeyear program. We want to need the flexibility to move resources if veterans decide to stay inside b. A. Rather than the outside of va. This is about ensuring every veteran who received the care they have earned and deserves regardless of where they choose to get it from. Mr. Chairman members of the committee we meet today at an historically important time for va in the nation. March will mark the 150th anniversary of president lincoln solemn promise to those who have fought in the most devastating war in our countrys history. He promised that we care for those in the battle and their families and their survivors. That is vas primary mission. Its our only mission. As the noblest mission supporting the gray assist of any agency in the country and we count on your support to uphold that sacred commitment. Thank you again for your unwavering support for veterans, for working with us on these budget request and for making things better for all of our great nations veterans. We look forward to your questions. Thank you very much mr. Secretary for your testimony and as we approach president lincolns birthday tomorrow we are ever mindful of his commitment to the veterans of this nation and our responsibility as a congress and as an administration. Can you tell me a little bit about how the 15 billion that was appropriated last year in addition to the budget how that is accounted for in this budget . Well sir as you know that money is obligated only when veterans use the program. So so far in terms of Veterans Choice Program we have had nearly a half a million calls from veterans and providers about the program. So far we have roughly 24,000 veterans make appointments on the program and go outside so we obligate that money as it is. Also, we are in the process of leasing 27 new facilities and that work is already underway. We are using the money to hire more doctors. We have more medical professionals. We have a netnet increase of over 8000 medical professionals. That is in the last nine months. November was our biggest month of hiring. We hired over 2000 more medical professionals than we lost. Our turnover rate is about 8 8. 9 . The turnover rate in the industry is about 18 so we are trying everything we can do to maintain the medical professionals. We did have a shift of over 500 million but we think the costs will shift to the Choice Program. Could you explain that a little bit further . I know there was a telephone conference with staff to talk about the shift. Understanding the program is still very new we thought some of the costs we normally see in the fee program would be picked up by the Choice Program. Right now though our actual results where we are seeing much more demand for the fee program on the va side of the budget. I would say that is a critical component to knowing whether this request is adequate or not. That is why the hesitance to do anything mr. Secretary with the choice piece. Again we arrived at the criteria because we wanted to have zero. In a veteran out there had a choice. That number came back from cbo at about 50 billion. We couldnt do that so that is where the 40 came from. There has to be some savings i would suspect that are derived by alleviating some of the pressure within the system by those that are going outside because of the Choice Program. We are going to be looking at that very carefully. What we also dont understand is what level we have from veterans who did want services who werent using these services because of the long wait Times Distance and there is still a lot to understand about choice. Mr. Chairman i dont know that now is the time to make a move of any funds. What im trying to do is subsidize the committee to the fact that there is a lot of uncertainty and in our budget we have roughly 70 line items were we have inflexibility. We cant move money from one might add him to another and what im asking is that we Work Together to have flexibility so no matter where veteran goes we can move the appropriate money they are and make sure that veteran receives care. We will commit to helping you have flexibility mr. Secretary almost anywhere within your agency except within that choice piece. Because of the uncertainty that is there. That is what is interesting about this budget request. You talk about all the uncertainty thats out there yet we are asking for an increase in stds and asking for increases in dollar amounts. Let me get back real quick, have i have one other question that i need to get to ms. Brown. One of the things that i think a lot of us have asked and by no of positions on the committee have asked over and over again and ive never gotten an answer. Is twofold. Number one how much does it cost for a veteran to be seen within the va versus the private sector and the private sector mrs. Secretary you know could answer that right away. You have a hard time answering that within the department and the other issue is what we know whether the clinical workforce is operating at its Maximum Capacity and efficiency based on the workload that is out there . There has been a lot of anecdotal evidence presented to this committee that say it is not and physicians are seen as few as two patients a day which is absolutely unheard of. Let me ask dr. Clancy to comment on that but before she does let me say as you know my first trip was to phoenix and when i arrived in phoenix i discovered we were short 1000 people in each primary care doctor had one clinical room and in the private sector today a primary care doctor has three clinical rooms. We have an issue of stopping which the committee helped with the choice act but we also have an issue on infrastructure. Its an old infrastructure. We have Women Veterans and we dont have currently the situation today. In boston i visited an operating room. Our operating rooms are 35 smaller than they need to be. If you have an operating room which is 90 years old they dont use robots or computers in operating rooms 90 years ago. We need that equipment today to provide her veterans with the best operating surgery can possibly conduct. Is on a productivity issue which i think is incredibly important, we have a tool and we have discussed this with representative wenstrup where facilities can look at productivity of different types of clinics understanding what the clinician is doing in this space issues the secretary Mott Mcdonald just mentioned and also the efficiency and capabilities of the people around them who are supporting them. That tool has been deployed systemwide. We are right now examining some of the data quality issues and very importantly having that externally reviewed. We would be happy to come back and brief you in more depth. We think its a good tool and at this point its more diagnostic than it is in a place where we can give people grades for example but we also want to make sure that some of the best and brightest minds have taken a look at it and kicked the tires and so forth so we are confident as we measure productivity. I just want to reinforce what the secretary said a minute ago. Some of our clinics some of the better clinics would bring tears to your eyes in terms of how well they are doing but they are really landlocked. It almost feels like a gift much less a two or three would see in the private sector. Ms. Brown. Thank you mr. Chairman. Before i begin my questioning mr. Secretary understand you were in our land of last week on wednesday meeting with the nurses association. Can you give us an update of how that went in also he made an announcement about the opening of a hospital in orlando. Can you give us an update on that also . Yes maam. I was in orlando and i spoke to the American Nurses association and i was there to tell them about how exciting it would be to work in the va today and just like you and the chairman went with me to a the medical schools in florida to recruit we were recruiting. We picked up quite a few people who were registered in coming to work for the va. The va is the largest employer of nurses in the country and its important our nurses are very important to us and they do a great job so that is why i was there. Separately i did visit the orlando hospital atlanta medical center. There are now patients being seen. We are in the process of moving in. We expect to have a commemoration ceremony of sorts for memorial day but between now and then there will be new clinics being set up every single week there. Its a fantastic facility and i think the citizens of orlando and the area of florida will really enjoy going there. Thank you. Dr. Clancy is there a discussion on this committee about you know we have doctors on this committee and they talk about this responsibility. Its a little different working with the va because what we expect that of the va physicians is a little more comprehensive. When a person goes and lets say im going into a podiatrist. They cant just go in and deal with a podiatrist that is comprehensive. Its a whole different case work. Can you explain that to us . With that leave that primary care and care for the whole veteran if you will is the foundation of the system so for the most part we dont have people just coming in for podiatry or a hearing aid for example of very popular use of our facilities, without also checking some of their other risks to their health and so forth. We are taking a very hard look because there are two overarching goals for this year getting access right whether its within our facilities whether its virtually by telehealth or Something Like that or with the Choice Program but all of that is seamless and are equally high second goal is exceptional veteran experience. We recognize some veterans actually might choose to simply commend for podiatry and skip the rest so we are going to be looking at different options for doing that by way of maximizing efficiency and frankly making the veteran experience very satisfactory. In general we have an Incredible Opportunity because of the entirety of the department to have an impact on health that no other Health Care System house. A lot of things affect health besides medical care. Its its income comments education whether you have a place to live and so forth in the department has tools through vba and so forth to actually address all of those needs that we take that very seriously. The last question i have what are we doing working with the department as veterans transition to make it seamless and the bumps in the

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