Transcripts For CSPAN Key Capitol Hill Hearings 20240622 : c

particular scenario, we did high-level malec there -- molecular analysis. those commercial flocks and backyard flocks were point source introductions. a virus introduced directly or indirectly. it allowed local officials to identify quarantine, and illuminate those before they could spread to other farms. this emphasizes the lessons learned. the identification of infections and farms. the rapid euthanasia timeline is critical. get on top of it as quickly as possible. rep. costa: acknowledge it, eradicate it. swayne: unfortunately the virus changed and they did not have as much time as in california. it took a lot less virus to affect flocks. the spreading was more rapid. we cannot afford to have infected flocks sitting around. we need to get them in a proper disposal method to prevent transmission. rep. costa: two final questions. dr. swayne, i have been told the funding for your facility falls dramatically short of what you believe or is believed to be needed for further efforts. do you agree and could you elaborate? dr. swayne: the research we generate and other partners at universities as well as the cdc and other organizations is essential in developing control policies. that become what is used in the field. those are long-term issues. for our laboratory, staffing has declined from 35 to 20 people. that is a financial reality. research is a long-term process. you have to hire people. they have to be trained. we are aware of the biosafety issues. they have to operate in high containment labs. the issue has become long-term permanent funding has not kept up with mission demands. rep. costa: can you give us an estimate of what is needed? replacing the 15 people who have been cut back, is that a start? dr. swayne: that is a start. there's also an of the do research safely. adding biosafety officers. those are permanent funds we need because you have to have the research. rep. costa: i would suggest the subcommittee considers if there was an interest, submitting a bipartisan letter to the appropriations committee. it is going to be a fragmented approach. when they are considering the final package later this fall, we might want to make a suggestion or recommendation. we can consider that. dr. swayne: the second piece is facility issues. southeast poultry, our facilities are aged. there was a study. southeast poultry was the number one requirement. rep. costa: how close are we from developing a vaccine? dr. swayne: we are near completing the first phase of the research. we are in discussions on the analysis of the data. dr. clifford's office and a mine have begun the statistical analysis. we will have a meeting to determine what that data means. we have additional studies we are working with. some university partners. that is lab data we are generating. we have to work with the field as far as have you possibly implement an effective program. rep. costa: for a layperson's perspective, a poultry farmer, a region with a television station covering this and making the report you are ancient us, dr. clifford to comment. when these things happen, we have to respond. dr. clifford: we will have vaccine availability for the migration time. to dr. swayne's point there are several companies that have vaccines. they are prepared to have available. we will be going out with request for proposal specifically to stockpile vaccines. some of these will come in at different stages. for this fall and spring. rep. costa: thank you for the subcommittee hearing. i want to thank my ranking member, congressman peterson. we want to cooperate to provide support for the poultry injury. >> mr. newhouse. mr. newhouse: thank you for holding this hearing on this important topic. it seems one of the things that is an all hands on deck kind of situation. i appreciate the focus on it and the panel discussing these issues. i appreciate the presence of our state veterinarians. your approach to helping us learn and be cared for what ever happens in the future. it seems to me when the next outbreak occurs, there will be no time for handwringing. in my experience, i appreciate dr. clifford's valuable help dealing with animal health issues. appreciative of you being here. i love the no time restraint. that is very valuable. i appreciate the opportunity to delve into this. a couple of questions to begin with. concerning the national health network. my understanding is the federal funding currently supplies 5% of the cost of operating the lab system. the same is critical to detection, response, recovery to disease outbreaks similar to what we have experienced. for this year, can you tell us how the initial cases in any given state were detected and by whom? to follow up, as part of this year's outbreak, the iowa lab has been open 24/7. do the labs have the support they need to sustain this type of workload? >> thank you, congressman for that question. the national animal laboratory health is an important part of our infrastructure to address not just this issue but a lot of animal health issues. as you are aware, there was language in the farm bill that addressed this issue. that did not come with funding. the laboratories throughout this country are at different levels of funding. we need resources for those laboratories to be able to do the work we so urgently need them to do. to speak to a specific lab in a specific state we would have to defer more to the states themselves and the labs themselves to address those specifically. yes, funding is needed for these laboratories. we do the best we can with the funding we have to provide resources. the house markup had additional resources for the laboratories which was welcomed and appreciated. as far as who does the diagnosis, it will very. in any location or state. a lot of these laboratories are very much involved in this testing. i know for example in minnesota and iowa during the outbreak there has been a huge effort with regard to putting and having personnel available to do around the clock testing. we destroy animals depopulate these animals, based on presumptive positives. those are done by the laboratories. rep. newhouse: another question, dr. clifford, and you touched on this in previous questioning. concerning trade and economic issues and the steps usda is taking in terms of negotiating with foreign governments about vaccines and the potential they hold. as far as the impacts that could have on poultry exports. there is interest in grocery and food producers industries about the flexibilities of poultry products due to shortages experienced. can you talk about progress on that front? dr. clifford: we have had shipments from the european union. recent shipments from mexico into the u.s. now to help address some of the shortages we have. i know of two countries right now, one mexico and the other the netherlands. i'm not sure if we are bringing from other countries in the european union or not off the top of my head, but that is something i can find out. that will continue to help us address some of the shortages we have in the u.s. rep. newhouse: dr. swayne, mr. costa asked you some questions about sex scene. i appreciate your comments there about steps in this process to help stop or spread and eradicate the virus. i hate to about the sky is falling scenario but based on your observations, when you are talking about the spread of this disease and the additional or potential risk to poultry operations around the world, what specifically in other countries, central and south america, europe and asia will these flyaway's go back-and-forth every year? what are we looking at in the future here? are we just keeping our fingers in the dikes, so to speak. dr. swayne: we can look back at data generated in asia, are korean -- our korean colleagues. they have had to bring years of migratory fowl. the second year, it reoccurred but was not as severe. the lesson, when you have an incursion of migratory waterfowl, you have a severe year, then it is mild. for us, the advantage is all the surveillance evidence suggest we do not have the virus in current farms. the risk is what would come through the migratory fly ways. that emphasizes the role of colleagues in wild life health. surveillance programs set up across southern canada in the northern u.s.. even down the atlantic flyway coast. trying to get a handle on whether it is in birds that are migrating. if it is identified, there should be information disseminated within those areas for farmers to be extra vigilant . to quickly report any abnormal signs that might occur. one thing to our advantage, the fly ways we have in north america go north and south. the viruses do not readily go into central and south america from us, nor their viruses coming north. the mixing is small, a small area with a small number of species that cross both hemispheres. that is to our vantage and their advantage. a critical control point. if we can control outbreaks in poultry populations, we reduce the possibility of infections. that would be a way of amplifying it. hopefully the virus will self burn out. surveillance by wildlife services, usgs, university partners is critical. rep. newhouse: going back to the authorization for the national lab network what beyond the diagnostic capabilities should we be considering to enhance this disease prevention? >>dr. clifford: i think probably making sure that we have the proper infrastructure within the laboratories to deal with diseases that are zoonotic. have zoonotic potential. rep. newhouse: that would be your priority. i have a question for mr. kelly from mississippi. >> with the gentleman yield? just for us laypeople, what is zoonotic? dr. clifford: diseases that can cross from animals to people. this one does not, thank goodness. rep. newhouse: good question. mr. kelly has a broiler industry in mississippi. apparently there are no infected herds detected. -- infected birds detected. his question is why having been broilers detected? maybe they just do a great job in mississippi as far as control? dr. clifford: i think it is age-related. most of the birds infected have been older than that. one of the opportunities for managing the virus has been early marketing of birds, particularly turkeys and parts of the midwest. some have gone to market much sooner than they would ordinarily. those are our thoughts in north carolina. i will defer to my usda colleagues. >> it is interesting to note that did happen in minnesota. we had broilers where there was infection. they were never affected at all. i think chickens are a little harder to be affected. it takes a higher dose and they do not transmit it as much as much. the age factor was there as well. >> if i may make a quick comment, there are two factors that have impacted the lack of euler infections -- broiler infections. there appears to be age susceptibility. older birds are more susceptible than younger birds. broilers are young. in farm operations, there are fewer entry points. most of those have a family taking care of them. fee trucks usually only come on the third or fourth week. few points of entry versus if you look at a layer farm, large farms, lots of people going off. trucks that may be shared a turkey farm. you have a greater chance for moving a iris. rep. newhouse: i will submit my other questions for the record. i appreciate your input. >> i have a series of questions from my producers in minnesota. things that have come up. one of the big concerns growers have, it is the depopulation. you heard it from them. talking about other kinds of methods that could be used the next time around that would speed up that that the population process. you have both talked about the goal of the population in 24 hours. the turkey operation is much simpler. the layer operations, some of these big operations have 2 million or 3 million birds, it took them a couple of weeks or a few weeks to depopulate them. during a time of viruses coming out and so forth. the question is, how are we going to get to a 24 hour depopulation? can we even a compass that? -- accomplish that? >> we have explored a way they are the populating in canada. using co2 gas in the whole barn. i sent one of my employees to a demonstration. i am hoping that is a method we can use in layer barns. one of the issues i have been told may make it not available in the u.s. or at least in minnesota is our operations have five cages high to read in canada, they are three cages high. it is hard to get the co2 to the top level. we are exploring that. the only other method we know is to shut the ventilation down and heat it up. at this point, that is not considered an acceptable manner of depopulation. >> if you let the birds die over three weeks, i'm not sure that is acceptable either. none of these options are very good. >> thank you, congressman peterson. our goal is to get the birds dead as quickly as possible. 24 hours is our goal. we are looking at several options to do that. there are some other things we are looking at as well. besides the co2. i forgot the particular product. we are looking at another product. we care about the humane treatment of the birds and putting them down as humanely as possible. with regards to euthanasia. there is a diff -- a definite distinction between euthanizing versus mass population. all of these things have to be considered with regards to the overall situation. the concern for animal health and human health. we need to look at all of these tools and try to get the birds killed as quickly as possible as humanely as possible, without further spread of the virus. as you indicated, it is important to get that done within 24 hours. if we continue to have more birds dying from the virus there is more in the environment and we know that to be a fact. congressman peterson: we have had disposal concerns, there's not room in the barns. they have been composting them outside which people are concerned this would potentially spread the virus. one thing they are looking at, dr. hartman, are there some kind of bio bags they are using? there have not been agreements with the landfills and that slowed the process down. where is that at? is there going to be a way to deal with the layer operations without doing this outside? if we have another outbreak? dr. hartman: we had one layer operation that did this. if you can depopulate that quickly, within 24 hours of the diagnosis, the composting outside is not as big of a concern. you don't have a lot of virus. you maybe have, in a 2 million bird operation, 50 dead birds that have virus. the rest do not. the key to not spreading the virus that way is you can continue to compost outside but you have to catch the disease quickly and to populate within 24 hours. >> with the gentleman yield for a point of clarification. trying to understand the pathology. from the point of view of a layperson. the shelf life of the organism living in this high path influenza from the time it is detected, the time the flock is terminated, to the disposal. does the bacteria, once the word is no longer alive it does it still live on until the time it is buried? >> it does live on. >> i am just trying to understand this better. dr. swain: the critical issue is the sooner you can stop the birds from living, you stop producing more virus. the influenza virus does not keep growing after the body is dead, after the carcass is produced. whereas in bacteria, bacteria can grow after you remove it from the carcass. the virus, but peak amount of virus is when the birds are lie. if you can euthanize, depopulate the birds come they stop producing virus. over time, it is inactivated to read it is time and temperature dependent. composting is an excellent way to inactivate the virus. the process has microbes that generate heat. the heat kills that virus. also digests the virus. the compost itself is completely innocuous other than it has nutrients that have value. >> it is not just the euthanasia but quickly burying or composting the carcasses. >> if you leave it in the environment, it can be tracked on shoes or close. -- clothes. >> the other related issue that i just heard about a couple of days ago in some of the layer operations it has been a real problem cleaning it up. the bills. this particular grower had heard about the potential of having a 120 day. -- a 120 day time where you wouldn't have to clean everything out. is that the case? >> yes, it is. we are looking at that and evaluating that as well as may be trying to look at heating the buildings up during that process in order to reduce the amount of cleaning and disinfection that has to be done. our primary goal is not to clean the building. we are going to continue to evaluate. one option we are looking at. hopefully, it will work because to me it would save and reduce work and resources that are currently having to be spent cleaning these up. >> this particular producer said he will probably have to be out 120 days anyway. he would be a lot cheaper for everybody. the other thing, as i mentioned in my opening statement, a lot of concern about the paperwork that is being required. it is the federal government so i understand that. as we move forward, i guess you're looking at ways to streamline this. are you looking at things like standardizing the payments based on the square footage of the barns or something so you wouldn't have to have the 80 pages of forms? also, if you did something like that, you might be able to lower the amount that is paid. more competition, people competing to do it. dr. clifford: there are three things we are talking about. one is identification, that is simple. it is not 70-80 pages. it is the other document that they need to sign that deals with the cmd. that document can be very extensive and long. we hope to definitely simplify it. i don't defy into the fact that because we are the federal government, it should be that long and complicated. i believe simplification is better and oftentimes better understood. kind of like having a bio security plan that that nobody reads versus a sheet of paper somebody does read. one of the things we're doing with the industry looking at maybe a square-foot cost or house cost. allowing the producers to handle that themselves. rep. peterson: there has been a discussion about having an insurance system instead of indemnification. i think indemnification works but he well. you can get in there and his depopulate quickly. i think it has worked well. i don't see how you can make the insurance system work. you are going to substitute you guys for insurance companies. i think there might be a role for insurance. maybe like business interruption. i think that indemnification i don't know if we want to change that to some other kind of system. i don't know what you think about that. >> i am very much a believer in indemnification. i'm not sure -- mr. peterson: it was reported he was pushing an insurance -- i don't think that is what he said. dr. clifford: that is more downtime issues. mr. peterson: the impression was, some have talked about cheney system -- changing the system and have it like the livestock disaster system or crop insurance. the crop insurance companies say there is no way to underwrite this. they are not really interested. i think it is good we clarify this. they reported a couple times including yesterday, the secretary was pushing insurance. i don't think he really is in terms of what people think. mr. clifford: if you look at the countries that do a good job of controlling disease, they pay indemnity. those that do not do not have it. mr. peterson: first of all, i want to have -- come lament you. -- i want to complement to you for getting on the ball and setting up the emergency center. i think that is why we had a good response in minnesota. you did it an excellent job responding as best you could. this issue of the consistent case manager, are you able to augment with the usda does in terms of personnel so we can have a situation where these case managers can stay with the operation the whole time and not be shifted every week? dr. clifford: at one point, we had to manage 110 sites. we were relying on usda employees. they rotate in for three weeks at a time. that was the reason for the inconsistencies. we are getting down to the point where about 50-50 minnesota case managers and usda case managers. we continue to improve on that. somebody told me they had 12 different case managers. that is not good. some of them get a different story from everybody who comes in. something that is of great concern to us and we are moving in the direction of having all minnesota people working on it. they can stay with the person the whole time. dr. clifford: i agree. we are working to this fall and winter migration time. if we have the outbreaks, we want to try our best to provide one case manager per producer. having said that, a lot of this is because of the rotation of people. it is hard to lead somebody away from their home for 10-12 weeks. that is not fair to them as individuals. we are looking for ways to do this better. mr. peterson: one of the other concerns we had when this was going was getting these flux tested. -- flocks tested. people having to drive to minneapolis or some of them drove to south dakota. where is the situation of beef up, move some of the testing? is that being considered? he would make a much better situation if we had had that availability this time. >> congressman yes the legislature. with that. the governor signed a bill for $8.5 million for renovation of the laboratory. the technology to do the tests. i was very encouraged, they put it on the fast track. i just got a note that the state of minnesota slow the process down. i don't understand exactly the mechanism of that. incident of february, they are talking next summer. anything you can do to encourage that to move quicker would be encouraged. we had to hire careers to -- careersouriers. it costs a lot of money. mr. peterson: there was trouble keeping up with so many potential positives. once they got the thing into the lab, they still had a backup. dr. hartmann: our laboratory hired new technicians. they were working nights and weekends. laboratory technicians are not used to doing that. we are going to have a meeting with the airasia minnesota to talk about that for the fall. -- with the university of minnesota to talk about that for the fall. mr. peterson: we appreciate you saying you are going to be commercializing this and stockpiling it. did i understand you to say you will do it even if it is not 100%? i thought that was that you were wanting to have the vaccines be 100%. dr. hartmann: we want the best vaccine possible that matches with this particular virus. it doesn't mean vaccines that may be don't match up cannot be effective. hoping to build immunity with the birds. it can be. it might be a combination. i think dr. swain can give you -- mr. peterson: you have a hundred percent positive on the chickens? a vexing that tested 100%? -- of vaccine that tested 100%? >> that virus as reported by the secretary, in chickens, we can prevent mortality in chickens. it is being done in turkey's. mr. peterson: next week? dr. swayne: the data will be available. the other issue, not just an experimental setting does it protect the birds in the laboratory. we have to take the vaccines and say, how can you use them in the field? there are different ages and types of words. the other part, we call this effectiveness. how can you use vaccines in combination in the field? the experience we have in countries like vietnam indonesia, china, to have an effective program in the field, you have to have a minimum of two vaccinations separated by three weeks. that makes it a little more different ledges tickly. if you have birds on the ground a longer than six months, you have to give a booster. breeders and layers may have to have a booster. these are questions we are working with university partners negotiating with them, them helping us do some of these studies in an experimental protocol that we can control to see how effective we can use vaccines. one last digression. if you look globally, the countries that have eradicated it most quickly, they have the best veterinary services and extcellent poultry veterinar ians. another thing, it is a targeted of vaccination. not everybody. who needs it the most and has the highest risk. mr. peterson: that goes to my final question. on this trade issue. my people, we have this discussion. they are very pleased you are going to be stockpiling. a very good positive situation. the practicalities of the trade situation and push back. in our part of the world they are trading some. they think and are part of the world, the vaccine they would give up their trade if they could get the vaccine from what i am hearing. when you are talking to these other countries, part of the discussion whether it would be possible to do it in a targeted area make that less of a trade issue? easier to get this done? >> that is the idea i made earlier. using it in targeted areas at higher risk. in minnesota, as dr. hartmann said, there is a lot of waterfowl. you certainly need that criteria. that is the idea, to get them to accept that and not shut off the entire u.s. mr. peterson: is that the discussion going on with other countries? mr. clifford: that is the discussion. i am visiting five countries. talking to them about that. also visiting countries like china, just to get our markets reopened. we are also going to be going to other countries in europe. as well as the americas. mr. peterson: thank you. i want to thank you all. as i said, things have not been perfect. but do you have had concerns. we appreciate it. i also think the secretary and your people. i talked to a number of your folks at the emergency center from maine oklahoma all over the place. they were away from their families and working seven days a week. it is a tremendous effort. we appreciate it. look forward to working with all of you to get through this fall. hopefully we will not have a similar situation. if it does a rear up, hopefully we will have a similar response ready to go. i yield back. >> i suppose i have the right to ask one more question if my staff will allow me. otherwise, i might be fired. sitting here thinking about the questions and testimony, it occurred to me, we can get this 100% correct. we have a growing market for somewhat may call free range or organic, locally grown, locally produced. what is the nature of our outreach to the small mom and pop organically grown locally produced? it strikes me we could get it completely right on the commercial side but we may have a gap here with a lot of small individual producers throughout all of our states? just curious what our plan of action has been contemplated there. >> thank you. we have been doing outreach in this area for years. we have an active, what we refer to as bio security which targets this sector of the industry. we also reach out through the poultry associations and groups. through the national poultry improvement plan and other groups to reach this sector of the industry. i know that the states, do a lot as well with outreach. backyard type birds or organic birds raised outdoors. there is quite about of -- quite a bit of outreach. >> we are in the process of seeking to discern the location of all of our backyard flocks. we have about 4000 we are aware of. we have asked individuals within the state of north carolina to please contact our office. register with them. the desire is to adequately convey information to them in the event of a disease outbreak. i liken it to the red sticker in your children's window for the firemen to see. we can convey needed information to individual bird owners and smaller flock owners. >> this age of instant communication, we got an e-mail a message from one of our growers watching the hearing. they got the impression, because of the discussion we had about the far east and japan the usda was not doing anything now. the question is, why isn't you di the usda talking to trading partners? my impression is, you are. >> we are. we just had an international meeting in baltimore. a lot of partners were invited and were present. this is a topic that was discussed. mr. peterson: you are not the only person at the usda. >> i am not. i get a lot of kudos for things done by a lot of others. we appreciate it. the department has been on this. >> we are on this. >> i would like to thank our witnesses for appearing before the subcommittee. i think this has been helpful and informative. those who traveled longer distances than others, thank you particularly. under the rules, the record will remain open for 10 bang days. the subcommittee on livestock and foreign agriculture hearing is adjourned. >> the brookings institution hosted a discussion about applications for the military. like 3-d printing and lasers. we will have that discussion live at 10:00 a.m. eastern on c-span. the heritage foundation will examine the future of school choice on what would have been milton friedman's 10 third birthday. he is considered the godfather of vouchers. my coverage on c-span. >> c-span gives you best access to congress. the u.s. house. bringing you events that shape of the policy. every morning, washington journal's life with elected officials and journalists. your comments by these book and twitter. c-span. created by cable companies and brought to you as a public service. >> on the next washington journal, douglas holtz eakin on a new report. league of conservation voters jean answers questions about the clean power ruilele. and a discussion on falling oil prices. washington journal is live every morning at 7:00 a.m. eastern on c-span. up next, lawmakers reviewing claims of retaliation against whistleblowers. we will hear from doctors talk about their experiences and also the deputy general who talked about what her office is doing. from the subcommittee, this is 1.5 hours. >> thank you all for being here. the american people rightly expect our veterans to receive the best health care in america, but the system designed to provide it is failing. the reason we know about the failures is because of people we are going to year from like dr. catherine mitchell. dr. mitchell is going to tell us about the failures of people entrusted to give that care. we quickly realized to the corruption was rampant. a social worker and union president stood up to say the corrupt bonus schemes that brought down the phoenix v.a. was in my home state. another doctor uncovered boxes and boxes of unread echocardiograms leading her to discover dozens of unnecessary surgeries. the truth about corruption in v.a. hospitals was not easy to reveal for catherine mitchell. they have been through hell to give mistreated utterance a voice. -- veterans a voice. the system tilt to protect whistleblowers has failed. the v.a. system is funded by this committee. we are here to ensure those who wore the uniform get the care they deserve. linda, the new acting inspector general of the v.a., is here today. they will tell us why the system is failing our veterans. let me turn it over to senator collins. senator collins: thank you very much. i would note that today, it is national is a lower state. -- whistleblowers day. it is appropriate you have called this important and timely hearing regarding the oversight performed by the office of inspector general. the responsibility we have two protect the invaluable contributions of whistleblowers. it is deeply disturbing the administration continues to drag its feet in filling the inspector general position, vacant for more than 18 months. despite the crisis that exists within that agency. inspectors general are directly responsible for rooting out fraud, waste, and abuse. and affecting cultural change within an organization. the president's nomination is long overdue. i urge the administration to act quickly to fill this vacancy and 2.8 will -- and tioo appoint a well-qualified ig. as the former ranking member of the committee on homeland security and governmental affairs, i focused significant attention on strengthening whistleblower protection. my staff pointed out when president obama signed a bill i wrote with a former senator we had a signing ceremony on november 27. 2012 to sign the whistleblower protection enhancement act into law. it is on the special counsel's homepage. it recognizes a crucial role whistleblowers play in helping to expose mismanagement and threats to public health and safety. as the chairman has indicated, whistleblower disclosures made by courageous individuals have shed light on issues that directly affect the health and well-being of our nation's veterans. the disclosures have saved taxpayer dollars and more important, human lives. they deserve our outmost respect and gratitude for coming forward. i know it is not easy. the department of veteran's affairs faces many challenges that demand our attention, including barriers to access to care. another pressing challenge is restoring the trust and confidence that has been impaired as a direct result of abusive and retell a tory practices which came to light after the phoenix waitlist scannell. we must ensure the ea employees who speak out will be protected. it is not only the law but our moral obligation. thank you so much for holding this important hearing and for your leadership as a veteran yourself. thank you. >> mr. chairman, can i do a short opening? thank you. very appropriate to hold this hearing on whistleblowers day. what happened at last summer was a betrayal of our veterans. my state of new mexico is under the same regional office as the new mexico office. the events eroded the trust they have in the v.a.. our vets put their lives on the line. we have to ensure the recent scandal is not repeated. it is because of a that we were able to work together to address these issues we referred complaints to the ig but this process is eroded when whistleblowers are silenced. when that happensbecause of whistleblowers congress was able to take action. with the accountability act congress is sent a strong message that v.a. employees that manipulated scheduling would be held accountable. new management in new mexico along with new policies have helped to put the v.a. back on course but there is still more to do. so long as mismanagement continues, we must continue to do more. we have a duty to ensure that veterans get the best possible care. when whistleblowers expose problems and problems are fixed it has been a pleasure working with secretary mcdonnell. i have had the opportunity to work through some of these systemic problems and i believe that these helped restore a culture of transparency and accountability. i look forward to him coming before the committee again. thank you. >> a letter here from dr. catherine mitchell. let me briefly introduce you. you trained originally as a nurse so you know er procedures. you are the person that broke the story on the phoenix v.a. let me hear your testimony. dr. mitchell: i want to thank the community for inviting me to testify. i have had exposure to the v.a. process as outlined in my written testimony. my experiences highlight the failures within the system. the i describe those experiences, i want to make the committee aware of two items. first, the process for handling complaints often enables facilities to investigate themselves without oversight. this process exposes whistleblower retaliations because complaints are sent back to the same people who may be retaliating. it is also self-serving to have administrators at all levels who have a vested interest in suppressing negative information. they are consistently suppressed. this information was made available by a person involved in the investigation. the average person would not know the report existed because a list of reports is not publish anywhere. the ig failed to protect my confidentiality in 2013 i submitted a lengthy complaint through my senator's office requesting that my name he cap confidential. the report dealt with life-threatening issues including scheduling delays, police equipment, and inadequate response. within days, the complaint was acknowledged in the retaliation began. i was put on administrative leave for one month. i was quizzed about the suicide names i have turned into the senator's office. i was investigated for many months. i would receive a written counsel for violating privacy rights. even though it is clearly not a violation to provide patient information to a senator's office in support of an oversight investigation. the only way a ministration would have named a victim more important than making my name, is the fact that there was no investigation and no report that i can determine. i absolutely was never interviewed by anybody regarding any of the issues that i brought up in my complaint. the only report that my senator's office could find was a narrative that the ba -- the a concluded that my allegations were false including the ones on the improper scheduling practices. this is ironic because phoenix and become the epicenter for the scheduling scandal. it was full of so many buys it could've easily been contradicted by available facts and multiple individuals with the facility if they had bothered to ask. the second incident of note involves the gross failure to evaluate evidence involving patient death. the report's whitewashed. investigators reviewed the case on the wait list that was brought to the intention by dr. sam farr. the ig was quote unable to assert that the absence of quality care caused the death of veterans. undergrowth, the acting inspector general would eventually admit that it contributed to death. that fact was conveniently left out of the original report and with help from the nation. on my review of cases, based on the information in the report, i saw with a failed miserably to see the cause and effects. for example, one patient had a massive heart attack presumably when he suffered a lethal heart rhythm. been waiting for months for a device to treat the problem immediately and prevent death. they seated that the device may have for soft death. it is the only medically acceptable treatment for that kind of heart rhythm and he would've only been weighted -- lack of appropriate psychiatric admission for a mentally unstable patient with multiple suicide risk factors enabled his death from suicide within 24 hours. they merely stated that psychiatric admission -- would have been a more appropriate management plan. it was the only management plan. it was medical malpractice not to admit this patient. he was in stable. in addition in that same report the team states he was an able to substantiate behavior. they never asked me to describe anybody else. the malignant culture is so pervasive at all levels and a ministration there are only two reasons why a team would fail to substantiate behavior. it deliberately chose not to look for the behaviors or it has such poor investigative training skills that are literally could not investigate out of a paper bag. thank you very much for your time. >> thank you mr. chairman for this opportunity -- >> can you explain those files that are sitting next to you, as i understand, hundreds of on red cardiogram's from patients in the cardiology department. >> these represent the amount that would have been hidden in boxes. this would be the size of the box. >> how many boxes were there? >> that is difficult to calculate because they would bring them one by one. they said they could not tell me where they were hidden. my personal guesstimatesion would be 5-10. >> 10 unread boxes? that would be over 1000 people. >> thank you for this opportunity to address ongoing issues regarding retaliation against truth tellers. and preparation for the hearing i have reviewed countless hours of testimony by those who have attempted to illuminate the dysfunction within the v.a. system. despite significant attention from both congress as well as the media, there has been no meaningful progress toward increasing transparency during investigation, implementing accountability for wrongdoing, or improvement in overall health delivery. it is my belief that to make the most of your time and effort, i shall focus on the incongruities between the malignant processes of the v.a. and how most other health care organizations must behave under the law. my experience in the private sector as a nurse and physician encompasses over 20 years of care at various institutions. i have never encountered such overt disinterest in patient care, deliberately organized a richer vision toward employees and disregard for universal guidelines until i encountered leadership. exposure to the corruption at heinz began immediately. as the reality of backlogs were brought to my attention by technicians. the studies were stored in boxes and i was expected to interpret them and not ask any questions or at my shock turned to horror as i realized many veterans had already died from cardiac complications. after the study was performed or prior to being interpreted. after reporting this to many supervisors, the nauseating reality that leadership was not only aware but also complicit with the coverups sank in. if ea inspector general report from 2014 substantiated the back locks. nobody was ever held accountable and no patients were ever informed. in the real world, this malpractice would result in serious repercussions for the physician as well as health care agencies in monetary damages to the patients and families but this is the veterans affairs -- a taxpayer-funded agency which is about to ignore the law and behave with impunity. the next stop on a journey will focus on the veterans office of inspector general's. the oversight agency with a pension for accelerating retaliation against truth tellers while failing veterans. by either ignoring the initial complaints or engaging in the cover-up. i have been on the receiving end of retaliations as well as the ig including remarks made to the public regarding my integrity. more troubling is the pattern to ever -- to every experience. it begins with the ig destroying anonymity and disparaging reputation and finally engaging in various methods of calculated retaliation. as a contrast, the inspector general at the u.s. department of health and human services works with truth tellers with the department of justice to arrest and convict individuals for health care waste, fraud, and abuse. has recovered one $.6 billion in taxpayer funding. to this point, the previously mentioned heinz report substantiated my allegation that patients received unnecessary coronary artery -- and coronary artery bypass surgery but once again, nobody was ever held accountable and patients were never notified. the current department of justice website with numerous cases where cardiologists in the private sector have been indicted for these exact same charges. incentives to federal prison and their employers find as they were made aware of this now duces but failed to act. the press release states quote, the department of justice will not tolerate those who abuse federal health care programs and put the beneficiaries of these programs at risk". in order for anybody to justify this double standard, one must conclude that the men and women that sacrificed their lives for our country do not carry the same value as patients in the private sector. calculus is a marvelous discipline. you begin with the answer and you work backward. this is the v.a. approach to dealing with allegations in malpractice. they need to get to a certain answer to protect the status quo and it matters little whether there is a analysis to justify the outcome. unfortunately, this is inherently corrosive and ultimately deficient. in maintaining the integrity of the health care delivery system. please do not confuse this issue with the claims of lack of resources, or sophomoric accounting practices. it is operational breakdown organized coverups, and absence of accountability, plain and simple. the time is now for veterans and taxpayers to demand transformative action and for congress to respond in a bipartisan manner. thank you. >> let me start off with the question. tell me what behaviors in the cardiology department led you to blow the whistle? >> they are numerous but at the end of the day, it is about patient care. to work in the private sector and realize that this is just a completely different world where the outcome of the patient did not matter in standard of care did not matter -- quality assurance didn't matter, process didn't matter. it is not how things work but it is allowed to happen within the v.a. system. >> i was struck by you comparing civilian medicine to v.a. medicine. in civilian medicine under medicare, you have noted that the department of justice has indicted some cardiologists for the unnecessary procedures that you saw. >> credit. >> he also told me earlier that you had a patient who had multiple -- how many -- >> between 10-11. >> all in the same person? >> correct. >> is that -- if so -- is that immediate malpractice -- grounds for malpractice? >> it depends on the case but if the patient keeps returning and there is no evidence to support that those lesions are significant than they would be no reason. >> thank you. >> since you blew the whistle on the scandal, has anything changed at the v.a.? >> the scheduling practices have changed in that now patients are either being scheduled or they are being referred to choice. the problem is that there is a delay in the community of getting choice appointments as scheduled so they are still encountering delays. from administrative standpoint no, retaliation is alive and well. i have many friends that are scared to speak up. they called me with patient concerns in a report them or i try to assist them. >> thank you. >> if somebody is walking around with 11 -- in their heart, what is likely to happen? >> again, that is difficult. it would depend on why they were placed there in the first place. most of the time, people have multiple arteries that require bypass surgery. the goal is to make sure that the patient gets the proper treatment that they need, not just with the physician wants, nor what looks good and to make sure that patient is in form. if they receive something that they shouldn't have because you can be on medications that would be counterproductive to other procedures or they suffer for unnecessary bypass surgeries. >> have any doctors been held accountable for this practice at the heinz the a? v.a.? >> people were told not to do that again, so that is somebody's definition of accountability. >> none. how many bonuses have been paid out at the heinz v.a.? that is interesting. when i worked there, i was not aware of the bonus system until after i left and had filed an additional report through the osc, and obtained violence is through a request. but i came to find out that i was indeed the lowest paid in the department and every single person that worked in the department received multiple bonuses. i didn't receive anything. christ because of your whistleblower status? >> absolutely. >> senator udall. senator udall: thank you. once again, i want to tell you how much i appreciate you calling mishearing because i think what you are trying to do is get to the bottom of what happened and these two witnesses have exemplified really what the problem is and one of the things i just want to say at the beginning -- i mean -- behavior you have described is just absolutely appalling. the lack of care in terms of really realizing that these patients are veterans and they need the best possible medical care and yet, you came forward and you were treated badly because you were trying to expose the things that were out there that to me this is very, very damaging testimony. when you talk about transformative action, i think that is what we do need to read i don't have any doubt about it. i think we need to change the culture. we need to change the way of thinking about this. have either of you visited with the secretary, secretary mcdonnell, the new secretary that has come in? has he reached out to you? >> i met briefly with him and we had a 30 minute talk. we talked mainly about the issues at the phoenix the a and also the fact that there is no standardized triage nursing protocol for the nursing department in the entirety united states. i would not have a loved one go to an emergency room at that the eight because it is a luck of the draw of the triage nurse realizing that the symptoms were difficult. they are the national leader in training physicians. there is no reason why the v.a. should not establish nursing triage toward a call. they are very common in the community and that was when the issues that we brought up. >> what you think they don't? what you think they don't exact -- establish these protocols? >> i have absolutely no idea. there is very little about the v.a. in terms of quality patient care that i understand. the v.a. consistently reported hundreds of cases where patient care was either compromised or was at risk for being compromised. what that resulted in with my evaluations being dropped, being screamed at by the former chief of staff and being put an unlimited schedules without compensation. things that a reasonable human being if you bring up a patient care issue you would think that they would do everything possible to correct this situation, acknowledge the problem, ankara this situation. that is what normal human beings to actually care about patience. i honestly do not understand the v.a. system. i want to stay with in it to work for change because i think it has the potential to be the premier health care leader in the united states but at this point, it makes no sense and i'm hoping that congress can inspire some common sense within the v.a. system. senator udall: when you talk about staying in touch with the da when you are working as a physician and stayed in touch with the people, you say things have not changed. >> not the culture, people are still afraid to speak up. i have friends within the emergency room that have reported to me strokes that have gone unnoticed by the triage nurse, that stroke protocols are not being filled, that elderly patients with potential blood infections are being left in the waiting room, that the er is overwhelmed at times even with all of the new physicians that they have hired. i reported that the new ca emergency room expansion is dangerous -- it is a waste of taxpayer money to build a facility as they are currently building it. i have reported so many violations, so many things that needed to be improved urgently and yet, the administration locally or nationally is not addressing it. i came forward mail enough for the retaliation against me but to improve patient care at the level of the emergency department. in all of this time, there has been no effort to standardized triage nursing protocols. they have protocols for telephone triage -- i heard they have them in the ambulatory care clinic but i have not independently verified that. again, it is sure with the luck of the draw when you walk into an emergency room if that triage nurse has the expertise and training to recognize subtle symptoms that need to be reported to a physician immediately. senator udall: that is appalling, appalling. did you have a chance to visit with secretary mcdonnell? >> i did. at a meeting with him here in washington. mostly to address the concern i had with the report in the oig retaliation against people who come forward. he stated he would look into it and get back to me, which he has not. >>senator udall: did you stay in touch with -- i know you are not still a part of the v.a. now and you are in private practice -- >> i'm in the private sector. senator udall: have you stayed in touch with folks to see if there any changes? >> i actually have an it has gotten worse at times for the initial allegations that brought forth. the osc wanted the oig to look into these -- again -- i was interviewed in chicago in a two-hour interview by the oig but they have refused to provide me with the transcripts i came up with the same conclusion that they did the first time. and subsequently, the office of medical inspectors regarding. interestingly, the office of medical inspector has preliminarily substantiated some allegations. unfortunately, the people who came forward at heinz to be witnesses during the office of medical inspection are now being retaliated against and saying that there is nothing that is going to happen at heinz nothing has ever happened, and now people came forward are fearing for their jobs. it's a scary message to have three separate investigations by oversight agencies and nothing happen except now your job is threatened. i mean, it really is a harrowing experience to go through and quite frankly, if you want people to come forward to give veterans good care. senator udall: from both of your perspectives, if you were there and were able to be in in a top management position, what would be the first things you would do to try to change the culture as you have described it? >> there is only one thing that needs to change should you have to have accountability and deterrence. human nature is that people are going to try to gain through the system or may try to do things not to the best of their ability. i am not saying physicians are not good in private practice, they are inherently good people but people work with an assistant because they know if they don't, there is accountability for their actions. >> i would agree. right now, the in ministry under said retaliating against individuals need to be disciplined. they need to be made examples. that type of behavior is rewarded. in fact, the sufficient change of command a retaliated against me is still in place. even though physicians told him that the nurses were withholding reports for me slowing down my orders he absolutely refused to investigate. that is not an administrator who needs to be in a position of power making decisions of life and death for patient care. right now, behavior like that is totally -- you are immune to punishment if you and act that behavior. what happens if the v.a. settles whistleblower claims settles eeo discrimination claims and there is absolutely nothing that happens to the person that actually an actor that his condition? that has to stop. that has to stop immediately. once you send that message that clearly, that behavior will stop. senator udall: let me conclude by saying, you both chose rather than the anonymous route to put your names forward which is a much more difficult route but i think through that, you have been able to really bring out some horrifying stories that i think have had an impact. for example, the law that was passed. i appreciate your courage in terms of what you have done and i just want to thank you very much. >> i would like to state, when i reported it, i reported it to keep my name confidential from the people because i feared for my job. i expected that they would keep my name confidential or a they didn't. i'm actually concerned with the oig latest statement encouraging whistleblowers to come forward. the oig routine hotline process even if you keep your name confidential, the report is sent down to the level who sends it to the facility or a portion of the facility -- the facility has full access to the whistleblowers main anchorage held it against them with impunity. unless the oig explains itself and can say how it is going to enforce confidentiality at all levels they should retract their statement. >> i agree. when i made my first report to the oig hotline, i had already known that i was leaving. but within 24 hours, the chief of staff told me that if i went forward with any patient information that he would bring me up on patient privacy violations. so not only did i not have anonymity, i could not come forward with allegations regarding patient care as a physician, and that is a pretty harrowing thought to think about is how we are treating people who only want to get care. >> there is the option to report anonymously. but what happens is if he report anonymously, there is nobody the investigators can get the information from so you have to give your name if you really want a valid investigation. unfortunately, the ig chose not to interview me at all. in fact, noting from this facility >> i am truly stunned by your testimony today and what you have endured. in order to do the right thing for the patients at the v.a. the system is totally backwards. those who are not providing adequate care are the ones who should have been disciplined and held accountable. instead, both of you who came forward with your complaints concerns, deep caring for the patients at the v.a. centers were the ones who have paid the price. this is just completely an acceptable. -- unacceptable. as someone who has worked hard to strengthen whistleblower protections, it is discouraging and a polling -- appalling to hear the retaliation that occurred against you. dr. mitchell, you have just talked about the importance of being able to file a confidential complaint. or concern is really the better word. in the testimony today of the acting inspector general, there is a section saying that the hotline submission process has been improved to an sure anonymity -- ensure anonymity and confidentiality. have you reviewed the changes that have been made and you have any confidence they would prevent what happened to you? dr. mitchell: they wrote a sentence on a piece of paper but they did not explain how they would protect confidentiality. currently, the process is when you file a hotline complaint, it goes into the ig. the ig sends the complaint to the veterans integrated service network. a copy of the medical review services onto the e-mail. they look at the complaint decide whether to investigate of themselves, give it to a third party, or whether to send it to the facility. because of the sheer volume of complaints there are a significant portion investigated by the facility. the facility sets up its own investigation and writes its own report. i can say at mine, the quality people tried really hard to verify the accuracy and completeness of the report. they do an outstanding job. however, i cannot verify that in all of them. what happens with confidentiality is if that report is sent anywhere other than the ig, there is the potential for the name to be leaked, even sending it to the medical review services. i would want to know specifically how the ig is going to prevent the names from being released. many times, it's important for the investigators to have the name of the person who filed the complaint because that person has a tremendous amount of evidence and that evidence is necessary to substantiate the allegations. unless the ig can state specifically how it is going to protect the confidentiality while still allowing the investigation to move forward, i would not believe a single word they said. i would -- dr. nee: i would then want to know if you're anonymity is disclosed, what type of repercussions is that supervisor going to have to you with a cousin that which should be written in the policy. ask very -- >> very important question. did either of you go to the office of special counsel for assistance? dr. mitchell: i filed a complaint to the office of special counsel. dr. nee: i also did and i am still working with them. i truly believe that office works as hard as it can. that is not the office for patient care. so they get mired and drag down into that and then somehow, this unfair responsibility gets placed on them. that is not their responsibility. >> let me go to the issue of patient care. i find it astonishing, dr. mitchell, that after you brought forth this information that you were not even interviewed. i also find it incredible that a facility would be asked to essentially investigate itself when there are physicians or other medical personnel there who are the subject of the concerns. dr. mitchell: the investigation process for the oig hotline needs to be overhauled and changed significantly because there is such a vested interest in suppressing negative information. it's not just the ig that needs to be overhauled. the office of medical inspection has recently infected gated -- investigated my reports of poor public care. they substantiated three of my four allegations. they did such an incredibly poor job of investigation that they missed the depth and breadth of problems. they actually tried to smear my credibility in their report by stating they couldn't find any evidence of retaliation against me. however, when -- i had access to the unredacted witness list. when i spoke to some of them who were my friends and ask them what type of questions they asked them without telling you what they said, they said they never asked us about you. those questions were not asked. -- to have a good strong v.a. system with a good quality oversight, you need to have a strong ig but you also need to have an honest omi and i don't believe that exists today. >> my time has expired. just one very quick question and answer. do you think the inspector general has the expertise to do these kinds of investigations? dr. nee: i would say no. dr. mitchell: i would say absolutely not. or they have the expertise but they are having the same problem within their system in that they are not allowed to legitimately report their findings. >> thank you. >> thank you very much. doctors, thank you for the obvious concern you have demonstrated for your patience by placing your own professional standing and names out front. i appreciate that very much. you now or you have i presume worked in private hospital settings? dr. mitchell: i have never worked in a private hospital setting except during training for my three years of residency and one year of fellowship. >> in terms of a private medical, these problems go up in terms of a doctor wanting to point out divisions in care. do they have a much better system there? dr. nee: when this first came up at the veterans affairs, because i had been in the private sector, i truly thought this was just an oversight and we need to address this and it will never happen again. there are operational processes in place in the private sector. there is quality assurance, a way to bring forth complaints on anyone it does not have to be -- it could be from lower-level positions all the way to higher-level positions because they are not necessarily looking to fix the blame on somebody. they are looking to fix the problem. >> there are models that could be adopted fairly quickly presumably by the veterans administration that are much more effective. to fix the problem, not necessarily to adjudicate or punish anyone else. dr. nee: right. >> one other aspect of this issue, and this might be a tendency to not adjust the problem because resources aren't available to fix it. dr. nee: i would have to disagree with that. >> i don't ask that as a conclusion. is that something you sense? i will ask both of you to respond. i can't fix this, so the problem doesn't exist. that kind of logic. i don't think it's correct. dr. mitchell: i think the issue was that rule number one if you do not let any negative information rise above your level. truly, because your proficiency and annual bonuses are based on whether or not you have problems or not, there is an ingrained tendency to suppress all negative information. it's not just in his last year, it has been in the v.a. system for decades. there are many dedicated employees who try to work around the system because they know if they speak up, they will be fired. dr. nee: i agree. even if there are people who want to work harder even if you didn't want to report something and just say, you know what, i will pick up the rest of the work, that is what is -- that's looked down upon and strongly discouraged and her life is made very difficult. >> one of the disincentives is these compensation schemes. i know there is a problem here, but since i can't fix it, i will make it go away. it is the notion of i can't admit any problems on my watch. dr. mitchell: there is a problem with the way the physicians and other staff are evaluated. they are a value weighted on performance measures and they are artificial. you can be an exceptional physician, do incredible patient care, like in the er, if your weights are above six hours because we didn't have the resources, my evaluations are dropped because our wait for about six hours because we did not have the resources. i was not necessarily evaluated on what a damn good physician i was. >> there is a resource connection in the sense that you are a very good physician but you don't have all of what you need to get the job done efficiently and therefore your downgraded. dr. mitchell: there is a system called just culture. if there is a problem identified, you look at it as a system issue, not as a person issue. many problems on the frontline are related to systems. many problems in the middle and upper management are related to people problems. there is administrative evil within the v.a. they overlook issues with patient care in order to benefit themselves professionally. >> thank you, doctors, for your commitment and care of your patients. i appreciate that very much. >> i have to go upstairs to present a bill to the enter -- energy committee. i just want to knowledge shea wilkes and a whistleblower from shreveport. i want to ask unanimous consent that his testimony be included in record. >> thank both of you for being here, we appreciate your courage and coming forward. i would like to go to the culture. dr. nee, has you get in a situation where you inherit this type of situation? you have people -- how do you get in a situation where you are doing somebody -- somebody is doing tasks and nobody is taking the trouble to read those? is that not having enough staff or is it incompetence? dr. nee: i think if people who don't want to work that hard. there were plenty of staff within the department, certainly people could have pitched in. i was only one person when i arrived. my work ethic from private practice was inpatient ultrasounds were read that day outpatients within 24 to 48 hours, not 12 month. this is not a resource issue, this was people who just did not want to work that hard and you are not going to come in and tell us otherwise. >> so just really laziness and the fact that there was very little care for the individuals involved. dr. nee: i could never imagine looking at those boxes and being ok with that. to this day, i don't know where they were at. many people knew they existed. >> tell me again about the culture of the whole thing. we have a situation where we've got people who are practicing and you are bringing forward facts where the practicing is not very good. again, is that because -- take the boxes aside, but just in basic patient care, is that because, again, they are incompetent? we mentioned incentives. the incentives of a appearance good care is being done but is it a numbers driven game? are people under the guns? dr. mitchell: the v.a. care is more about its public image then patient care. the front line staff i worked with are some of the best in the v.a. but like all systems, there are some that are less than ideal or even should not be working in the v.a. i don't think that mixture is any different than in the private sector, but i do believe the difference is that speaking up and identifying problems the first knee-jerk reaction is not to fix the problem the knee-jerk reaction is not to let the problem be known by anyone else. although people have disparaged the v.a., there are millions of quality care episodes that occur across the nation because the v.a. does do incredible he good work. unfortunately, when they dropped the ball, they do it's a significant leave that people die. >> i think we have to be very careful to not disparage all the people working very hard. there are some tremendous people. the vast majority of people in the v.a. are doing a great job and really do care about patience. it's trying to figure out what in the culture of the v.a. gets us in these situations where you have the experiences that both of you have had. dr. nee: it's the higher-level administration. it's not anybody in the ancillary staff. they wanted to work hard. when you come in from the private sector and you are trying to work those same workloads and they were making fun of it in the sense of you are not going to do well here, if you continue working at that level. it's not because they didn't want to, but they have already been put in their place when they tried to and it's just an acceptance. dr. mitchell: the directed minutes readers that retaliated against me, i actually don't hold that against them because they were between a rock and a hard place. if they spoke up and said that what you are asking us to do to dr. mitchell is wrong, they in turn would be retaliated against by their superiors. in fact, two of my chief of staff are two of the most ethical positions i've ever known and yet, they made decisions i certainly didn't agree with because i felt they were retaliatory. i also knew they had no other choice. in other ways, they try to make it up to me. they try to make sure they did -- made good patient care decisions but their hands were forced several times by senior administration. >> dr., nee, you are pretty scathing in your written -- in your critique of the oig. dr. nee: they wrote a letter to senator kirk that stated i had not presented any evidence to them on multiple occasions which was false. they had evidence the first time and the second time. there are two hours of testimony that they refused. if i truly am lying, then put forth the testimony. but that's not forthcoming. the preliminary office of medical inspector has countered what they said. you have to think about that. someone is putting in a letter to a senator of the united states which goes out on a press release that you are a liar. >> who signed the letter? dr. nee: richard griffin. >> thank you all very much. >> i want to thank both of you. thank you, mr. chairman. just a quick question. we read consistently about the lack of young professionals going to the v.a. nurses, doctors, shortages. in light of what we have heard today, i think it would be more discouraging for a young physician to want to be a part of a health system that is as dysfunctional as you have described. if we could maybe sort of fast-forward here, what could you tell that next generation of health professional why they would want to work at the v.a. and what kind of hope there would be for them that they would be able to exercise the professional abilities that they have gained? do have any sense of what the next generation is going to want to do in terms of being a health professional at the v.a.? dr. nee: i personally think what i went through, i would not encourage anyone to work at the v.a. currently. there has not been transformation. there has been a lot of talk about reform and that's not what this culture needs. it needs a complete transformation. until that could be put into place, i personally would not encourage anybody to take a job there. dr. mitchell: i stay within the v.a. because the v.a. mission is important to me. i'm willing to stay to make a change. that comes at a personal loss to me because every day i face a sense of frustration and a sense of hopelessness, a sense of when will this madness stop. i would not encourage a young professional to enter the v.a. system on less they fully understood that they were going into a corrupt retaliatory administration. that needs to change. there should be a line drawn clearly that anyone who retaliates against a front-line employee for bringing up will be brought up on charges immediately. it shouldn't be something that takes months or years. until that time, the v.a. has a great infrastructure. they are an amazing teaching facility. they have everything they need except the administrative competence to run it. >> those are very powerful statements from both of you. the next kind of comment i would make is that we passed a bill because recognizing on the heels of what came to light that the bureaucracy and the administrative forces at the v.a., there was no structure to fire people. they were just moved from facility to facility. i think it's come to light that there were maybe 800 administrators that were identified as being deficient and should be moved out of the system. instead, i think only one has actually been fired or very few and the rest have been reassigned. in your statement, you said, dr. mitchell, you said something about if i did that, i would be fired. is it easier to fire a medical professional then it is the higher-ups of the administrative -- obviously it is. dr. mitchell: i don't know about the higher-ups. what i do know is that what you said is correct. if someone is correct or poorly performing, they merely move them off-site. the chief of staff that screamed at me routinely and told me it was my fault patients were dying because i was making nursing mad was moved to another site. i don't know why they decide it's easier to get rid of the people that speak up except that the people that speak up ruined the v.a.'s image of perfect care. again, they are looking at image, they are not looking at patient care. it is much easier to kill the messenger than it is to fix the problem. >> thank you. [inaudible] >> i would call for a temporary recess since we have the vote at noon coming up. >> we can transition and then break later. >> it should be right here. it is right here. they will do their statements. >> why don't you begin. >> thank you chairman kirk and members of the subcommittee for inviting me to testify today. the project on government oversight is a nonpartisan nonprofit watchdog that has been championed -- championing government reforms including whistleblower protection. if it weren't for the brave work of whistleblowers like doctors mitchell and nee that we heard from just now, none of us would know about the problems at the v.a. as the avalanche of problems started last year we held a joint press conference with the iraq and afghanistan veterans of america asking whistleblowers within the v.a. to share with us there inside perspective in order to help us better understand what was going on at the department. in our 34 year history, we have never received as many submissions from a single agency . nearly 800 current and former v.a. employees and veterans contacted us in a little over a month. we received multiple credible submissions from states and the district of columbia. a recurring and fundamental theme became clear. v.a. employees across the country feared they would face repercussions if they dared to raise a dissenting voice. they came forward anyway. i want to emphasize, this means there were extraordinary numbers, hundreds of people who work inside the v.a. system who care so much about the mission of the department that they were still willing to take the risk to come forward in order to fix it. some were willing to be interviewed by us and quoted by name, but others said they contacted us anonymously because they are still employed at the v.a. and were worried about retaliation. v.a. whistleblowers are supposed to be able to turn to the v.a.'s office of inspector general, but many have come to doubt that office. these fears appear to be well-founded. we believe the v.a. eiji is an example of oversight at its worst. last year, the v.a. eiji -- ig demanded all of our records we have received from current or former employees and other individuals or entities. of course, we refused to comply with the subpoena. however, the subpoena was understandably caused for concern for many of the whistleblowers who had come to us. we believe the ig successfully created a chilling effect and the number of whistleblowers coming to us slowed to a trickle. they are hostile to whistleblowers rather than being the haven it should be. last month, the ig sent papers to dozens of offices attacking whistleblowers. senator johnson responded with a letter of his own. he pointed out "in attempting to defend its work, the v.a. eiji criticizes and demeans the very individuals it's health care inspection failed to protect in the first place. the victims and whistleblowers. the paper in p and their motives and offers irrelevant information to discredit their accounts. these arguments are remarkable and unfortunate from an office whose duty it is to work with the office of special counsel and other entities it is supposed to be protecting." we were pleased to see acting eiji griffin -- ig griffin step down. linda holliday is still being advised by the same counsel responsible for that office's past misconduct. as senator collins noted, there is still not a permanent ig after a vacancy of over a year and a half and we believe that is a big part of the problem with that office. in comparison, the office of special counsel has been working to investigate claims of retaliation and getting favorable actions for many of the v.a. whistleblowers who have come forward and we commend their good work. by merely addressing isolated incidents is not enough. the v.a. is struggling with a toxic culture and something more systemic must be done. pogo recommends that secretary mcdonald make a tangible and meaningful gesture to support whistleblowers who have been trying to fix the v.a. from the inside. private meetings with them are not enough. he needs to be elevating their status from bill and to hero with public accolades and awards as holding retaliate or's accountable. congress should also update legislation so that it meaningfully on a five accountability for those who retaliate against whistleblowers. whistleblowers within the v.a. should be able to hold the retaliate or is accountable thomas something that is nearly impossible unless congress lowers the laws. congress should also extend whistleblower protections to contractors and veterans who raise concerns about medical care provided by the v.a. the government has failed in its sacred responsibility to care for our veterans. it is our collective duty to help the whistleblowers who have taken the risks to fix this broken agency. thank you. >> ms. halliday. >> thank you for the opportunity to discuss how the v.a. oig interacts with complainants and whistleblowers. this is my first hearing as the deputy inspector general and i look forward to continuing a working relationship between the oig and the congress. i have testified a can -- at congressional hearings in my previous role as the assisted inspector general for all of the largest line office in the oig and i now welcome the opportunity to share with you the work of all components of our ig. i am accompanied by the counselor to the inspector general and mr. david day, the assistant inspector general for health care inspection. i assumed the position of the deputy inspector general on july 6, 2015. in the past three weeks, i have taken several immediate depth -- steps to strengthen but the oig -- oig's internal was a blur program as well as our whistleblower protection program. these actions are outlined in my written statement or it i took these actions to establish clear expectations and set a tone at the top for our organization regarding the importance of how we protect whistleblowers rights and confidentiality. the oig is the primary oversight body for receiving and reviewing allegations of waste, fraud abuse, and mismanagement in v.a. programs and operations. our hotline serves as the central point of contact for individuals to report allegations. we take this seriously, i was sponsored ability not to disclose the identity of an employee who has made a complaint or provided information here it -- information. when individuals contact us, we advise them of their right to submit their -- complaint anonymously. we

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