Transcripts For CSPAN3 Veterans 20240706

Live here on cspan three in the Senate Veteran Affairs Meeting testifying on the president s 2024 request for his department. May join this meeting live in progress. I visited there, as you have, as your staff had, you do the right thing. We want to keep working with you. I want to talk about the pact act a little bit. Do you have numbers, up to date numbers of how many veterans are taking advantage of it . I like to say when i do these round tables that this is government and right. This bill passed if, i remember, of august 2022. By january you had it up and running. Hundreds of thousands of veterans were getting care. That is exactly the way governments should run. All of us are proud to be part of that. Do you have an eye to the number of how many people have been served . Yes. Thank you very much. As of may 6th, 251,584 total veterans or survivors have had completed pact act relating claims. We are granting at about 80 . That is the beauty of the presumption we are able to grant at a much higher rate 79. 7 . The average, this is a troubling number, averaged 80s for completing a pact act relating claim right now is 155 days. I think there is a series of reasons for that. The biggest is some claims are filed either really did to our initial presumptive claims are filed shortly after the president signed that law. We did not begin to process the pact act claims until january. We should see that average number of days go down. As i said earlier we have about 77, 000, a little over 77,000 new enrollees as a result of that. We have many more existing enrollees who qualified for greater access to care thank you. I participated as an observer at the toledo event of the screening in march. It was illuminating to see what veterans go through. I know you have been more handson than any va secretary than ive ever seen in regards to going out seeing it in action. Some veterans who need additional screenings. Many of Poorer Health they need to have invasive lung biopsies in order to finish these steps. What steps are being taken to lower the invasiveness of the screenings . The toxic exposure screenings that you talked about, that are enabled by the law, we have now had about 3. 3 million complete those screenings. Very interesting because in somewhere between 35 and 40 , i dont have the most recent numbers. It fluctuates in their, cases of those screenings we have veterans about whom we learned some new exposure that that veteran may have experienced. So, that is allowing us to get to know the veterans already in our care better. There are technological challenges. One of the things that we think most veteran suffer from, just bronchiolitis, which the test for which are so invasive as to make them actually not useful. Potentially harmful, to the veteran. So, that is why we stood up to the pact act enabled us to stand up a special organization focused just on the science of the exposures. As well as new techniques to verify the existence of the technician. That team meets on a regular basis. We just met with them last week on this. Not only did you set up the presumptive process for us, but youve also given us Additional Authority to make sure we are testing new technologies to make the confirmation of these conditions, including bronchiolitis, less invasive. Thank you. Mister chairman, thank you. Mister secretary, you have helped especially since you took office. In cincinnati, in columbus, your help for the National Va Center has been appreciated. Thank you for all of that. [inaudible] thank you mister chairman. Secretary mcdonough. Thank you for your opening statement. Congratulations on your upcoming graduation. That is a fine institution. 15 minutes from my home, davidson college. I want to thank you for their brave thing you gave me back in my office. Probably known to most pokes who voted against the pact act and, in spite of the fact that i worked a lot on, it didnt have anything to do with the numbers. It had to do with operational challenges. I thought we would be able to clear up. You gave me a reason to be optimistic based on the briefing that you gave me in the room. Can you give me a 62nd cliff notes, or give their committee a 62nd clip Snow Committee on some of the rest . I did hear the 104 today. You have to bend that down. Do you have a plan to doing that . Sure. Thank you very much. What we know now after years of watching the benefits process, in particular, the claims filing process is that overwhelmingly is the main tour that that first enter at va. It is a very human intensive process. We need to make assessments about how many events we anticipate filing claims. We need to make sure that we have trained people ready to handle those claims. Starting at the end of the fiscal year 2021, we began hiring. We now have 28,000 professionals. Importantly, they are not only hired, but a good chunk of them are now through the training process, such that they can begin to add to our ability to reduce the backlog of claims that get filed. A good example of this is that, yesterday, we had the single biggest claims of claim completion in the history of of the va. We completed 9245 claims yesterday. We are still getting more claims in any given day than that. But we are able, now, to move many more claims through the process. We can see through the expected surge of claims right now we have a strategy for how to then manage the size of that workforce on the other side. Managing to a peak. Getting down to what you think the future run race is going to be, thats good news. County and to help me go forward. With respect to the discussion about the house bill, the house bill we know that the negotiation is going to come from the president and Speaker Mccarthy is going to produce something different. I think it will be fair to veterans. I wanted to talk about one of the thing. You mentioned 77,000 new people. The pact act was much publicized. We got more people to contacts of ei even of 20 of them are not getting the presumption. Hopefully its positive for people who dont get the news on the presumption. At least they are engaged. We know that the suicide rate among veterans who have no relationship to the va is higher than those who do. There are a lot of reasons we need to get people to the va. Theres also a lot of reasons why im absolutely sick of the camp lajune toxic ads on tv. However, i think that there is a great opportunity there to connect with more veterans. I heard, i think it was in a prior committee, an exchange between senator sullivan and thunder renault are capping fees. Which will be very difficult to get any consensus on. I asked my staff to take a look at drafting a bill that we call the patriots bill of rights. One of the things that i would like to do is to get support in congress for an informed veteran before they sign a retainer for these attorneys that are spending millions of dollars in ads. I think it represents a great opportunity for the va. I know that they contacted the department of the navy. I wasnt being as something as simple as the document, without a retainer agreement, that said that you need understand what your rights are independently without representation of an attorney. Number one, contact the va. Number two, contact a local congressional representative. We do thousands of va cases every year. Im sure that the other members do the same. Make them aware of the fact that congress members, state offices, help veterans every day. Their case may or may not rise to a level where they need legal representation. But make them aware of the recognized vsos that also have experience in this case let them go through that process before they find out what is wrong with that idea . We talked about this in your office. We, especially our camp lajune, meteorologist eddie publicized week where a veteran had camp lajune as more likely to suffer from parkinsons then nantes. Then one not deployed there. We have a lot of presumptions already about kaplan june. We want to make sure that is understood. You do not have to hire a lawyer to uva benefits we are aggressively using all of our communication tools to do that and we are having some success anything that will allow us to get more of what we call the untethered thats. Those vets not yet in that is a net positive things for as im concerned. Thank you very much, mister chairman. Secretary, good to see you. Welcome. As you know and you told us yesterday the va announce that in agreement with a new hr contract being made with oracle it is really important to see that the va is prioritizing reliability and the patient to Patient Safety across the contract. I appreciate that last week the g. A. O. Released a report indicating the video had not established target goals to a User Satisfaction and the va lack to basis for determining when satisfaction has improved enough for the system to be deployed at any other site. I support the recent period as you know i support the efforts move for but only if you are confident about the safety and effectiveness of the system and have a clear establish satisfaction marker. What matters is the providers on the ground on what they think veteran the nighted to serve as the best health care we can offer. It is our job to make sure the va in oracle really get this right. Have a couple of questions around this. When do you expect to have a revised request for the ehr account in fiscal year 24 . As well as estimates of whether you need the funds requested to support the rollout in the i. T. In medical facilities . First of all, i think i want to make sure that we are absolutely clear that roughly a little bit over 400 million set aside for this year we have communicated with you in the Appropriation Committee that we do not anticipate needing that money this year. I want to be very clear about that. One. Two, the updated request, both for the rest of this year and into next, i think that we need a little bit of time but not much. I do not have a specific timeline for you here. We recognize that one year options that we have just exercise is a great opportunity for us to test whether we can get those five sites working. Not only that, but we have providers on each of those five sites that you have brought to our attention. We have big expectations on those sites and they are tired of waiting. We are not asking for a lot of extra time. But we want to get this right, rather than get it fast. Rather than give your from commitment i can tell you this is a number one issue for us the department to come to the department with a revised request. You have plans to establish target to assess User Satisfaction . You dissatisfaction in a critical part of this. Whether we have these pacific target set, i will get back to you on that one of the principal ways we are going to be able to figure out whether we are working in the five sides is going to be User Satisfaction. That will be part of the evaluation . Correct. Whether we have the specific targets that are laid out in a different timeline is what im not sure about. Are there any changes you made or plan to make . A big part of it is the enhanced Accountability Measures around up time and system reliability which comes directly from the user experience. Thank you as you know we are following this very closely. I really appreciate the vas diligence on that and i want to keep your agreement thank you. Senator boozman . Thank you. Mister secretary, again, thank you for being here today. We enjoy adhering here priorities regarding the budget last week we do appreciate all that youre doing all the homework aiding the men and women who have served. In regard to an hr end. One of the things i hear from the authorizing committee or on the Appropriations Committee is d. O. D. Has successfully gotten a bunch of things going in various installations we are struggling i support the move to back off. I think that was wise of you to do. I think you have really good support for doing that. Can you explain why d. O. D. Is having success . What is the difference . Why are we struggling while they didnt . Another reasons, can you expound on them . I think the number one reason is we have health the storms that are built for different populations and different outcomes. As a general matter our patients wait time is longer. Our veterans have more complicated Health Care System as a result our system is that much more complicated. I think that is the main issue. The other question is, when weve struggled with reliability, oftentimes, in fact, in the last three weeks we have had these two outages. For the first time in 70 plus days. Those outages impacts the entire system. It is not just the va, they also impact dod. My point is because of a pressure on us, we, i think, or making the entire system more reliable, including for d. O. D. I think notwithstanding the fact that a patients are more demanding i think the work to put it through is going to make the whole system, including d. O. D. For quicker that much more effective. When you came and talked about your budget he recognized the growth of the number of Women Veterans seeking care in the va. Which is more than tripled over the last 20 years. The fiscal year 2020 requests includes gender specific requests for Womens Health care. Supporting the Health Program office. Last congress we had legislation that dr. Kay henry thomas saying the service act was signed into law. The eligibility micro screenings to veterans who are exposed to toxic substances. That is really good story in what everyone was able to do. Can you touch on how the implementation for the service act is going . Are there any challenges that youre facing that we can be helpful with you . Let me start by saying that youve been tireless in giving us Additional Authority and additional funding to do the things that you just went through. We are not only very proud of that, but we are very grateful for. That the implementation is well underway. We began providing Breast Cancer assessments in march of this year including the incident with the toxic exposure risk assessment. We can follow along with the implementation of that. We project that in this fiscal year as a result of the service act there will be an additional 52,000 breath cancer incidents across all sites. As we learned last week the new guidance that Breast Cancer screening should start at 40. Pretty clear that here advocacy for the service act was well ahead of even this more cutting edge assessment last week. There is going to be challenges and some facilities where Women Veteran are coming to us on and roll because they have heard about this screening. That is going to create some administrative burden. There is not anything we need from you for that. That will be a challenge. That means more direct in our care. That is absolutely good news. Thank you mister secretary. Senator king . Thank you, senator. Mister secretary, welcome to the committee. One of the issues, i serve on both Armed Services in this committee is the transition. It seems to me, even that we have made great progress, we are still not there. What i would like to get from you is some thoughts about how we can make this a warmer handoff, if you will. The data suggest that that transition, that 2 to 3year transition after the reactive duties a moment of danger. So i wondered if you had thoughts on how we might be able to make this a more effective process in order to protect our veterans. I think your instinct is exactly correct. In my view, a talked about this we are looking at this a lot. I worry sometimes that we think the answer is to overload the transition. The cat program. Handing a veteran a 300page form is not the answer. Right. As you know im not of that but i have found jobs, leaving the white house, i had to sign a lot of different things. I was not gonna go to any extra thing that i didnt want to go to. So, we think very strongly is we need to set our programming and our opportunity into veterans lives to a Customer Experience journey rather than make them fit our stuff on our schedule. That means we are talking to veterans outside of the Program Using that time, as you say, year to three years after the transition in order to establish a tradition with them. One condition of and looking at is an active Duty Service Member has to opt in to have their day to day officer of the state. If we made that an opt out i would probably increase the amount of contact. My vision is, frankly, someone meeting veteran at the airport. Saying, welcome home. Here are some resources. Here is the vas number. We have to be able to contact them. Now if they dont want to be contacted thats fine. We have vsos and people out there that are very willing to help. We have to make that connection easier. We are in conversations with the National Association of the state and veteran affairs. We have not been a first rate partner into our state partners on this. We give them down to. It is not readable. It is not usable. We are trying to make that better. Heres a suggestion, as governor i would call the states 800 number just to see what you would get as a consumer. Think of yourself as the customer, that is a good way to put Something Like that. The state directors of veteran affairs in each state working with each of them and each of your states they are not shrinking violets we are hearing from them that they have not been a good partner we do think that that ready handoff is really important. In a limited time just a couple of points. Im still concerned about on boarding time and the cumbersome notes of the hiring process. It strikes me that decentralizing it to some extent would be good, number one. If you need to hide and a Administrative Assistant he shouldnt have to go through boston and washington. Number two, reciprocity. If you have someone who is in customs and border patrol, they dont have to go through a whole new process of background checks. Reciprocity would speed up the process. I hope that, again, this is one of those things where if we were going to design a hiring process from scratch on a blank sheet of paper what with the look like. I appreciate that very much. We feel like weve had the best to corridors and hiring. And basically two decades. But, onboarding is still a major headache. We are looking at that process from soup to nuts. I talked to a couple of people yesterday but a couple of things in particular. The way that we handle drug testing not make any sense to me for example we are getting into the specifics on this two harassed down that tom to on board. We are losing people because this is an opportunity cost. A massive opportunity cough. These are people who want to come to work. We should not make it so hard. Our time to hire, our time to on board is coming down. It is coming down in some places. From four months you know . No one can take a job and then not be paid for four months we will continue to report to you on it. Some of the things that you are talking about are things that we are looking at. Moving authority to hire two different fields. Simultaneously carrying out the onboarding steps rather than doing it sequentially these are all things we are making Good Progress on. Mister chairman can you indulge me for one more question . Make it short. Thank, you i knew you would understand. The medical records it is short. Accountability is crucial. I think there ought to be targets. If you dont have a destination youll never get there. I think that this contract is very important. You have to have standards and that provide some accountability and some penalties if they are not met. Otherwise this is such a complex, large, process. Ultimately, it has got to work. If it doesnt work people we are contracting with shouldnt get paid. I hope that he will be very tough about accountability. You have something hanging over them. I want you to be very aggressive about that. We are going to do that. I think senator murray is challenging us i want to present a greedy. I think we have improved accountability metrics, including and hans to credit when the system has been down, either have been twice in the past three weeks. I think its twice in the last month. Its maddening. There ought to be a cost. That there is a cost of that. We have to measure in dollars. But it is really measured in vets outcomes. Senator murray is also challenging us to be very deliberate about User Satisfaction measurements. I take that i take about both of you are saying on that and we will get to the bottom of. A thank you. Thank you, mister chairman. Senator jeanne gave such great promotions this morning at prayer breakfast. I was happy to let him move forward and take that time. Secretary mcdonough, very quickly, we have talked a lot about staff and return to works. What percentage of the va d. C. Staff has return to inperson work . I do not have a specific number. I can get you that number. Also, submit to me the agencys official telework policy. Sure. We want to know that. I have legislation called the show up act in order to try to get people back to work in these agencies. The wait times and the backlogs are continuing to grow. I think that that is a problem. Let me ask you, also, some employers have talked about people taking second jobs. Second, remote work, jobs. Do you have any employees that have taken second jobs where they are working two jobs remotely . As that happen . Not that i am aware of. I will take that on and come back to you. I would appreciate knowing that and seeing where you are with those issues. I know you are working on a Work Environment plan. Okay, what is the status on that . The status is we have submitted our first draft to the lawyers in find when im here ill be going to a meeting on that in the inner agency. We are working on that. We feel really strongly on. I feel quite strongly that our work force has done over the past years. Portability the Veterans Agency the highest level its ever been. The telework, the higher productivity rates than we were in 2019. I feel good about that. What about the backlog . The case backlog is about 215,000. A little less irad somewhere that pact act had you were seeing a half million requests for service because of the pact act. Is that accurate . Overall, yeah, we have seen about 500,000 packed specific claims filed. So, but, we will get to the exact data if you want to see that. I would love to see. That how many claims filed . How many claims completed . Average time to completion . Im sure we can get you that . As you know i believe in community care. It is a big part of that. We have more legislation we are working on that we think would help with that. We would appreciate hearing from you. I did want to come to something that, to me, was very troubling. I was reading it last night. Looking through the durham report. I know you were president , obamas chief of staff from january 13th to january 17. As i was reading through some of the, i would like to know, from you, during that time as chief of staff, did you participate in any meetings with the fbi regarding the investigation of the Trump Campaign . Yeah, that has been a long time since i thought about that. I would be more than happy to go back and take a hard look at that and get you an answer. I would appreciate knowing that. I think it is important to know what your involvement was with the fbi in pushing for that. My understanding is that you were in the 2016 meeting in the situation room with president obama, susan reich, and other top officials where they discussed the russia collusion issue. Is that accurate . Im not sure i know which meeting you are talking about. I think it was july of 2016. Again i reported in the report. You were in there. That is of concern to me. You are charged with leading in a very important agency. The work that you do is vital to our veterans. It is of term unders concern to me, as i was reading this report last night it was also a source of disappointment to me that you would have been involved in this process of weaponizing the fbi. This is something that should never happen. People do not want to see two tears of justice. We talk about the va. They want to see a standard of service for everybody. They want to see that consistency. To know that you may have been a participant in this investigation. That you were a part of this meeting details of the situation room that they carried out this. This hoax. They made it all up. A figment of her imagination. To discredit someone. I wouldnt want someone discrediting maggie in that regard. Or the chairman. Or any of us. Or you. It is with great disappointment that iran and all of that. Thank you, mister chairman. Senator hackman. Thank you mister chairman. Thank you and Ranking Member moran for this hearing. Thank you secretary mcdonough for being here today and also for our recent conversations. Just before i talk, a little, bit about with what weve covered in these conversations i just want to reaffirm that it is my understanding that you agree that all americans should be equal before the law. Absolutely. Thank you. So, what weve been talking about in recent weeks is really a major concern to New Hampshire veterans. The condition of our manchester medical center. As you know, the Manchester Va Medical center is 73 years old. The facility made its failures has led to the cancellation of many better ends appointments in just the past few years. I really appreciate you taking the time to walk me and senator shaheen through the plans that you and your team are working on to ensure that these problems do not continue to occur. I know from our conversations that you and i both kara lot about getting these renovations at manchester up to date and completed. We also talked about the importance of transparency and ensuring that veterans know what is being planned and what they can expect with each project. When they can expect each project to be completed. When will you be able to make public a comprehensive plan for the manchester va so veterans will know what to expect . Thank you very much for the question. Thank you for all your work on this. Our goal would be to be able to make something public this summer. Summer of 2023. By that i mean july or august. Okay. I appreciate the. I think it will be very important to New Hampshire veterans, as well as our whole community, to meet that deadline, if not earlier. I appreciate the vas work to complete muchneeded repairs at the manchester va that were caused by flooding when a pipe burst last year. I know that your team has been working hard to get these important pairs don as fast as they can. What are the next steps beyond these initial repairs to ensure that the manchester va is fully renovated to prevent these types of problems in the future . When will the va start on this work . What is the expected timeline for completion . Yeah, so, i will talk through a couple of things here for the record. One is we need many of these renovations to be complete cuttings of these facilities. We are able to fund those turn on a crime in its projects we have minor construction projects, including the new womens clinic and care addition. We do also have a Major Construction issue on the seismic project on campus. The plan is fully renovate the facility, floor by floor. The facility should remain in u. S. During those sequential upgrades. Those renovations include removal and replacement of all obsolete utilities, that includes plumbing. The installation of exterior walls to prevent the kind of freezing we have seen. Installation of new windows, installation of new modern heating, air conditioning, and ventilation systems. Installation of new finishes, and optimized space lay out for design and clinical use. Now here is our approximate schedule. Fall of 2023, the first floor operating room and the suites will be completed and returned to use. December of 2024, the first floor construction will be completed. Spring 2025, the fourth floor construction will be partially completed. And spring 2025, the second floor construction will be completed. Winter 2027, the fifth floor construction will be completed. The womens clinic is expected to be posted for an award this summer. And the words will be granted in the Fourth Quarter of this year. And for the womens clinic, the award granted in the Fourth Quarter of this year, whats the timeline for completion . The timeline for completion, im just looking to make sure. Can i change that want to get back to you . Were making sure we have the exact number. Im sorry, i just dont have that number. Thats okay. Lets get it so you all have a timeline. Its important to understand only the timeline, but the overall renovations. What do you all are trying to do is make sure that you are repairing this facility to a point where we wont need these kinds of failures, which have really been incredibly disruptive. Senator blumenthal. The chairman is referring to my leg which was broken in the yukon. It might have gotten stuck, thank you for your note and i apologize for i want to focus on health care, and i am hoping that plans for continued work on the facility in west haven are proceeding, and i can touch base with you. Thank you, i also want to follow up on a letter i Center Offices regarding veterans who were stay fish and at a base in uzbekistan. Also known as k2. They have brought the lawsuit to those who were stationed there, and were exposed to sovietera Hazardous Waste including chemical weapons. There is ample evidence that there are toxins. There is a tremendous amount of information and records that ares joe exposed for reasons i dont understand. I would ask you for your commitment, that you will support expanding health care to the veterans who were exposed. Youve got that commitment. I want to take a moment to talk about education benefits because the next generation of veterans is entering civilian marketplace. I strongly believe the dea can play a Critical Role in the dad of two veterans who have helped education benefits. Programs with the employment service. They provide valuable resources to veterans in their families. I believe that the post 9 11 g. I. Bill is one of the most powerful tools that a veteran can have at their disposal right now. The educational landscape has changed significantly since president roosevelt signed a lob eight years ago. In your view, how does the va need to change to meet the needs of the younger veterans . Many of them are a different mindset, they are exiting and want to pursue higher education. And how does the money do you need to change to meet those needs . I think the main thing we have to do is we have to make sure we are meeting veterans where they are. We are expecting them to change their lives to meet the requirement. This is the full suite of support thats available to them. The more that we fit that programming into their lives, the better case we are able to make them about the usefulness of these investments. The better informed we will be to make that decision, its on us to make that. I want to offer a personal testimonial. One of my sons has just gone for a screening at the urging of his dad. Thank you. Thank you. Thank you, mister chairman. And mister secretary, its good to see you again. I want to begin by thanking you for the visit to alaska. I appreciated it. Hopefully you enjoyed state night at the vfw. So i appreciated the broad diversity of meetings that you engaged in. Its very much appreciated. I want to follow up on the meeting you had in the Alaska Native Tribal Health consortium. This is on the 26 different reimbursement agreements with these Tribal Health providers. I know you guys had a good discussion on that, i was part of a lot of that. When you met with a ntac, that was one of the issues you discussed. Can you provide the committee a firm date when Tribal Health providers can expect the agreements to include reimbursement . I know its complicated, but theyre important issues. This is on the campus june victims act and the lack of any contingency cap. I dont know why this is taking so long, weve put forward a bill that is comprised of 17 caps. The vfw supports this, the American Legion supports this. Theres a whole host of reasons why, the 33 from some of my colleagues. It is just too much, and this is literally an example of here is a pot of money. Is it going to go to six marines and their families . Or is it going to go to i can see how it can be helpful in some cases, but not a 33 . We were on the phone with doj folks who agree with our bill, i am trying to get the biden doj to come out officially for that. Some of them think that 17 is actually too high. But they are already talking about this today. Some of these law firms are charging 15 contingency fees. Its robbery. We all know it. Everybody on this committee knows, it every in the Congress Knows its wrong. And here is the problem, the deadline for camp lejeune filings is august 2024. So i am being we all know why. They are going to win in six marines and their families are going to lose. So anyways, your team has been good on this. Theres all these arguments, and we are going to get good lawyers. You are seeing the ads on tv. These guys arent doing it out of the goodness of their heart to help the marines, its to get rich. So when i get your commitment, mister secretary, to sit down with us . The more we delay, you guys wanted it when we were working on the pack act. It got blocked by some of my colleagues here for reasons we all know about. So any thoughts on that . We all know this is wrong and [interpreter] i know what a priority this is. It is for the marines and their families, and in the American Legion im not disputing that either. Let me say two things . You know this because the worst to work downtown to, on the other side. Its hard for me to get in d. O. D. About their requirements. I will say this, the a is in this question of the right number, and whether or not there are caps, thats not really our thing. But i can tell you that we use caps. Every law uses caps, this is the this is one of the few that has no caps, i think its almost one of the few that exclusively so i think you understand the spot im in, which is the doj is the lead. I want to make sure i am doing my part by them. The doj is a very and how would you recommend we try to resolve this. You guys are obviously playing a role as veterans. The department and the navy, as you mentioned. So its d. O. D. , and by the way, even the numbers we have from the department of the navy, just talking to them today, almost none of these are going through adjudication with the navy. Theyre going to trial, and the reason theyre going to trial is average claims 10 million bucks. So one of the arguments for senator durbin is you want to get good lawyers if its a small contingency fee. You take away 2 million for whats called the health award and health care received, that is 8 million. 17 of 8 million is 1. 3 6 million. Thats a pretty good payday for a lawyer. Thats from the navy today. Doj wants it, and i think you guys want it. Its kind of sickens me that we cant get progress on this. So do you have a suggestion on what we could do . For congress and the committee, those three agencies. Because this is an injustice. The money is going to trial lawyers, 50 contingency fees. And we heard that today, some of your guys testified last fall, its up to 60 . Jeez louise how greedy can you be . My commitment to you is that you let me talk to the attorney general. And to the secretary of the navy, and let me see if i understand precisely what they are doing on this. I dont want to get ahead of them on whatever it is that they are doing. Mister chairman, this is an issue. And Ranking Members, im just kind of baffle that were living this linger. I know why some people want to linger, because august 2024 is the deadline. And then its over. Then the tile lawyers when and the marines get screwed. And thats just wrong. Everybody noise, it and were not doing anything about it. You guys are going to rope me. Youre going to rope a dope me. It really makes me mad. And Everybody Knows its the wrong thing to do. I dont know why were not more urgent about this. Senator sullivan . He brought this up in many different forms, and i appreciate it. I feel passionately about it, but i want to give you a little history so you know. I dont know if you are on this committee, but he is the one who started the campaign. Senator tails took that up. Along with senator blumenthal and it was debated many times. It was introduced and we put it in the pact act. We want to cap, mister chairman. Every one of these hearings i know the truth about caps. And i was in every one of the hearings. Lets be clear. Okay . Then why dont you it is my bill or the highway. Senator durbin also has a bill. Senator durbin also has a bill. And im all about reasonable fees. But also tell you something else. Im about choice, and i dont want the federal government telling me who im going to hire for an attorney. And i dont think we should be telling marines that. You know thats the case. Thats baloney. You know thats exactly the case. Dont give me, that even when you are talking about. Every federal law i am giving you hide mighty because im doing the right thing for the marines. And i want to do the right things for the marines to. I moved from 10 to 17 already. Right now you guys are going to rope a dope this. The deadline happens, and there is no cap. We could have caps tomorrow, we would come to the table. That is ridiculous, ive been working on that mode dont give me that, mister chairman. We are going to move on to the executive affairs committee. This is a dereliction of duty on your part. Right now. It burns me up. I love your claims, but backed them up with facts. I have all the facts in the world. You guys make sure there was no caps. Thats what happened. That is total baloney. Then a great my bill. Total baloney. There are bills out there supported by the va system supports my bill. And by the way, this is an issue that needs to be taken up by durbins committee. Its the jurisdiction of this committee. Where did the camp legion act came from. It came from here. We are talking about legal issues it automatically goes come on, mister chairman, your fumbling ovia words. No im not. You admitted it in front of went all the veterans were here in front of this committee, they worked with me and they all chaired. They support my bill and they support durbins bill to. Theyre taking a chunk out of their awards. I wish you commit right now to work with me on this. Well im trying to do is put caps on awards, which is what every federal bill in the country that we pass has. I think this is one of the few that has no pack. All right, im ready to work. Thank you. Thank you, secretary. And we appreciate your testimony. I would ask that there be other questions by members of the committee, make sure you respond to them in a timely manner. That concludes our first panel, and well start with the second panel now. Interestingly enough, were going to hear from vsos. Each year, the independent Budget Office informed perspective on the promises to those who served our nation. Ive said many times that Congress Needs to take a look forward to hearing your thoughts on this years budget proposal. First, i want to introduce morgan brown, for veterans of america. Lastly, we have patrick murphy, director of the National Legislative services. It i will provide one joint statement on behalf of before you begin, i want to say that we have a nomination hearing coming up. That hearing is going to be held on may 31st. I turned over to three gentleman, and whoever wants to start can. Chairman tester, Ranking Member moran and members of the committee. On behalf of the independent budget, the veteran service organization. Or i want to thank you for the opportunity to offer a comment on the budget request for fiscal year 2024. And advanced appropriation for fiscal year 25. Our recommendation of nearly 140 billion for medical care spending in fiscal year 24 and 157 billion of advanced appropriations for fiscal year 25 represents our best estimates of the funding a va needs to fully end time fully administer programs and Services Benefits to american veterans. We were encouraged by the administrations proposed budget for the va, and believe much of it accurately reflects the rising need for Health Care Benefits by those who serve their families. The medical and Prosthetics Research program generates programs that significantly contribute to the health of all americans. The administration requested 938 million in 2024, compared to the 980 million recommended by the iv. As you know, the va Health Care System has significant challenges in undergoing significant reforms in recent years. To improve veterans access to timely high Quality Health care. While a va has received increased funding levels to support the veterans Health Care System, and increasing number of veterans are seeking a va care, the lack of resources for adequate staffing and Facility Improvements are adversely impacting accessibility should care and benefits, and must be addressed. We urge congress to honor the promise made to the men and women who served our country by continuing your longstanding bipartisan support of those who have borne the battle. This concludes our remarks on health care. Mr. Liermann will not benefits programs. Thank you. The id be the recommended 4. 1 billion dollars for pgas operations. We are done with mandatory overtime. The vas already completed 1. 1 million decisions in this fiscal year. This 100 million in overtime will greatly enhanced the vas treatment of claims. Mister chairman, within va call centers, there are approximately 1600 employees. It is estimated that one va claim generates eight separate contacts to vehicle centers. There are over 800,000 pending claims, and they are projecting over 1 million new claims. That means that va could receive over 8 million phone calls to the call centers. That would significantly strain existing workforce. Therefore, we are recommending 50 million for an additional 400 be a call center employees. In reference to the board of veterans appeals, we recommend approximately 325 million. At the beginning of this fiscal year, the board had over 75,000 hearings pending. We recommend an additional 20 f t e and other positions. To assist in driving down the backlog. The estimated cost is approximately 20 million. Thank, you this concludes my remarks and i return to vfws. Mister chairman, although the acid and infrastructure review process broke down last year, many of these recommendations for expansion and construction of new Health Care Facilities include the repairs of existing ones. It was widely supported. The backlog of projects continues to grow faster than va can address them. Either vas office of construction and facilities management, nor the individual va facilities have the staff to oversee the amount of work necessary to decrease the backlog. Addressing the oversight in completion of these critical projects will save be a money in the long term. And potentially save lives of directly. Va must hire additional infrastructure. Adding personnel to facilities to oversee local projects is critical to decreasing this backlog. As stated in previous hearings, they have a backlog of 105 229 billion dollars. Va should be requesting at least 10 to 13 billion dollars annually to address that. If we keep underfunding va infrastructure and meet the necessary amounts, well be talking about 150 billion dollar backlog in projects. The details and the skip last outline the true need for the infrastructure work at va. But va does not match the real need. Thank you for the opportunity, for the authors of the independent budget to provide remarks on these important topics. We are prepared to answer any questions you may have. I appreciate your testimony. Thank you very much for being here, i will start with you, mr. Brown. Last month, we tried to do a package of bills called the elizabeth owe Veterans Program for 2023. These were five bills that were introduced in this committee that we combined. They were sent out in committee in february, anonymously. However many of my colleagues blocked it from advancing. What this bill did, as well you well know, i believe, it improved options for veterans to save money in the long run. And improve quality of life, with the use of Medicinal Cannabis for treating the invisible wounds of war. They would be interviewing veterans and finding out the impact that cannabis has had on them. It would help native americans and alaska veterans to achieve ownership of homes. I know that pva was a supporter of this legislation. Can you tell us what this means for your organization . The members of this committee will know that the number of veterans are going to be needing Long Term Care is expected to significantly increase over the next decade. And its important that va implements policies now to ensure that these veterans can safely age at home and remain active participants in their communities. Unfortunately the services are not offered at all Va Health Care facilities, even though they are desperately needed. The Elizabeth Dole veterans improvement act would have ensured programs like veterans directed care, homemaker home health, and home based primary care or available at all medical centers. Giving a greater number of veterans the ability to receive care in their homes, which is where they would prefer to receive it. Its also instructs them to provide Home Health Aides for veterans residing in communities where there is a shortage of Home Health Aides. And as you know, the shortage of Home Health Aides is impeding access for veterans, as well as many aging americans. To receive needed home care. The eye being the s has been very supportive of efforts like this to help curb the effects of this shortage and bolster the workforce. And although it was not included in the improvement act, we appreciate your commitment to finding the way to raise the cap on the amount that they can pay for home care. This is an extremely important for the veterans whose care is connected to conditions and exceeds the cap. And therefore, they must pay out of there are pocket, rely on medicaid or be placed into situational sitting. As you know the Veterans Service handles employment. This includes tap classes, and labor has included this would affect our veterans. I am particularly concerned because things are misses for Homeless Veterans who need to find living wage jobs. Please tell us about the real world effects of cutting these services and if we return to fy 2022, the levels of funding would hurt homeless, jobless, transitioning veterans. You can start again, morgan. Thank, you mister chairman. This is going to have a huge impact for a lot of reasons, but it is going to hurt their Reintegration Program through the development of labor. It is estimated that it is going to basically take away that potential for up to 5000 Homeless Veterans for job training or job skills. Were also concerned it could potentially have some problems with the d. O. L. And tap specifically, which will impact hundreds of thousands of veterans being separated from service. If you look at that . I can answer a little bit. If i may, the vas annual report noted that the largest cohort of veterans died by suicide, and those are the ones that are aged 18 to 24. Its important to remember that they are one of the few agencies that engages with this particular group of veterans through employment services. So many of these positions already been impacted by reduced budgeting and cutting them even further could be detrimental to the lives of these men. One final question youve got to hear the conversation between senator sullivan and myself. On caps, can you let us know, i think your organization supports both bills. Can you let us know your thoughts . We do, senator tester. We support putting reasonable caps on any bills that affect camp lejeune. It is similar to are concerned about an claims assistance taking exorbitant amounts of money. We want to see reasonable caps put in place. We hope that our supporters in the house and the senate will come to a compromise to make sure that veterans and marines from years ago or taken care of them. Chairman, thank you. One of the things i think about the pact act that is appreciate its the time to provide some fairness to veterans who are separated from service more than ten years ago. Within the last ten years, excuse me. And what is your view of how well the department is conducting the outreach is conducting the research necessary for veterans . Do we need to be focused on encouraging and reviewing, asking questions of the va about that effort . For 25 years, ive been accredited. I have seen all of the different programs that have come into effect over the last 25 years. I would have to say unequivocally, i have never seen an Outreach Campaign like the va is doing now with the pact act ever before in my career. Never when they added additional funds for Vietnam Veterans not. When they made the changes in the late 90s, or the 2000s. I think its impressive for what theyve already done, and i think that they can do more. But specifically, theyve already conducted 1516y acts around the country. Ive attended several myself, i think va is being more collaborative with the community with a lot of these events and conversations. Mr. Lauren, im happy when i hear complements. One of the problems that we are experiencing, and i understand its a budgetary issue, its one that we raised during the debate about the pact act is that we created the toxic exposure fund. Its been a bit of a battle from time to time in this committee. But it certainly has been successful in setting aside resources. I understand thats important, but it also has unintentionally created new mandatory scoring implications for va legislation that previously rely on discretionary funding only. We saw that in the bill that we talk to the floor that senator tester just passed. We need to find a way that gets in a position where every other bill is not handicapped by us creating the extra rules that are implied with this. Maybe your solution is that we forgo pay go. Thats not a solution that is going to happen these days, but i would suggest that we need some help in figuring out how, without being accused of doing anything harmful to the pact act, i watch to being not accused. We need to move forward with other pieces of legislation for other veterans, as well. Any thoughts . Senator moran, im very glad you brought it up first. But what we really want to do, we received a briefing just last week i believe it was. They talked about some of what we believe are some of the more outrageous things that they are looking at could come from the tax exposure fund. I believe it was the police scheduling system was one of the more outlandish examples they used. We hope that we can clarify that, then we believe this will help these discourse problems. So this is about the education of cbo and scoring information . I believe that will be step one. What was in the law is not a police scheduling system. So some clarification on that would help. I appreciate that answer, and at least the second part of your answer. Because i think this is really important. Its going to be a problem for us time and time again if we dont get this going issue with cbo resolved. And i am pleased that others are doing some of our work in education. Thank you. Mr. Brown, i wanted to follow up on your point on raising the camp for non institutional extended care services. A few want to contradict me, you may. I wont be offended, but my understanding is we are working to fulfill the commitment that we made to work to find a solution. 13 billion dollars was the score for that provision, we dont think that is accurate. And we are trying at this point to get information from the department of Veterans Affairs, so we can go back to cbo, to get something which we believe is more realistic. And what they are currently thinking. So we are trying to educate the cbo, as well. But to do, that we need the departments of Veterans Affairs with information and data, and statistics they. Half of my missing anything . No sir, it sounds like we are in 100 agreement. Thank you all. I too want to thank you for being here, i appreciate what you guys do. I represent your members, and being able to be here with some of you guys, you are here at every hearing. And i appreciate that. We make a promise to those who serve our country to deliver for them, and if the va is going to make good on that promise, they have to have resources to do so. I think both the secretary and you gentlemen have shared valuable insight as we move forward with the process for 2024. This includes an improved care for veterans and all areas. With that we will keep the record open for a week in this hearing is adjourned. Fbi whistleblowers on alleged abuses of power by fbi leadership. Watch live thursday morning at nine eastern on cspan 3, cspan now, our free mobile video app, for online at cspan. Org. Fridays ap am eastern, cspan begins you booked e. V. A. This week, former chairman oscar munoz shares his book, turn around time. He talks about efforts to revive the company and he is joined by watch afterwards, every friday at eight p. M. Eastern on cspan. Book tv, every sunday on cspan two. Features leading authors discussing the latest nonfiction books. At 18 eastern, author and Cnn Supreme Court analyst Joan Biskupic details the political and traditional transformation of the u. S. Supreme court during and after the trump administration. With her book, nine black roses. Then a ten, pamela afterwards, former United Airlines ceo the chairman oscar munoz shares his book, turn around time. Where he talks about his efforts to revive the company. In the future of aviation. He is interviewed by usa today Consumer Travel reporter, zak wicker. 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