Transcripts For CSPAN Key Capitol Hill Hearings 20240622 : c

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 subcom >> the brookings institution hosted a discussion about potential applications for military new technology like 3-d printing and lasers to be used by the defense department. we will have that discussion live at 10:00 a.m. eastern on c-span. the issue of school choice in education voucher programs. the godfather of school vouchers is involved. on the next "washington journal" douglas holds aiken on it a new report published in health care. we give comfort -- conservation voters president answers questions about the epa's clean power won't -- rules. later, falling crude oil prices and what they mean for the u.s.. washington journal airlift -- air's life every morning at 7:00 a.m. eastern on c-span. -- live every morning at 7:00 a.m. eastern on c-span. up next, lawmakers reviewing claims against retaliation against whistleblowers. we will hear from doctors who talk about their experiences. from the senate military construction and veterans affairs subcommittee mrs. an hour and a half -- this is an hour and a half. >> 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. -- is failing. the reason we know about the se 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 who have been entrusted with the duty to give that care. mr. kirk: 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 at the heinz v.a. in my home state. they also uncovered 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 veterans a voice. because the system is built to protect whistleblowers and fight corruption has failed them. 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 identify -- to identify themselves but remain confidential or to waive the right of confidentiality and advise them of the potential consequences of that decision. all complaints are evaluated. using our available but limited resources, we must be highly successful -- selective in the cases we accept. we also make case referrals to v.a. in accordance with our complaint referral directive. we make every effort to make sure an official, separate from and at a higher grade than the alleged wrongdoer, is responsible for conducting the review of the allegations. we continue our inquiry until we are satisfied or we will open a case to review the matters further. in many cases, these referrals involve veterans complaints regarding specific episodes of medical care and it is not possible for v.a. to review the complaint without the oig disclosing the identity of the complainant before taking any action. we advise the complainant and request that they provide their written consent to the oig to disclose their identity. if they say no, it goes no further. there is a lot of confusion on the role of the ig regarding whistleblowers and allegations of retaliation. for example the oig does not make a determination as to whether an individual who makes a complaint or provides information to us has made a protected disclosure. this is a legal determination made by the office of special counsel. the merit systems protection board, or the u.s. court of appeals for the federal circuit. these entities have the authority to provide direct whistleblower relief. oig faces many challenges in addressing allegations reported by complainants. vague allegations often present a task akin to looking at a needle in a haystack. for example, it is difficult for us to adequately review a complaint of poor quality of surgical care without details of which clinic is involved. we cannot contact an individual to obtain additional information regarding an allegation if they choose to remain anonymous. similarly, some complainants initially identify themselves but later are unable to or declined to provide critical information that could enable the oig to focus resources more specifically. oig works to protect the identity of complainants who request confidentiality, at times, the complainants become known a some other sources of information. some individuals who have requested confidentiality voice the same complaints to v.a. management coworkers, media outlets, and they have made statements that they are going to come to us or they have come to us. everyone has their own perception as to what is going on. from the whistleblower perspective, they may see the oig coming in and making sure that the eyes are dotted and the teaser crossed. from our viewpoint, we are making sure that all the bases are covered. we have different challenges in verifying allegations especially those complaints that could be criminal. the oig looks to impartially determine the who, what, when where, and why while examining information in a fact-based approach. we need whistleblowers to bring the central issues forward. although whistleblowers perceptions are directly related to their complaint, at times they are not in a position to know all the facts or they overemphasize the viewpoint here it -- viewpoint. mr. chairman, we are not on anyone's side. we are here to find the truth. i appreciate the opportunity to hear from the whistleblowers today and to address these important issues. i am continuing to reevaluate our business processes to ensure that they provide adequate protections for complainants including whistleblowers. this concludes my statement and i would be happy to answer any questions. >> ms. halliday, let me ask you a question. we have danielle here from pogo. when her organization set up a hotline for v.a. employees, she got 800 complaint. you hit pogo with a subpoena asking for all those names. it would seem that you wanted to retaliate against all of pogo's whistleblowers. why did you issue that subpoena? >> i did not issue that subpoena. i think there might be a communications breakdown. from what i understood, the concern of the ig was to understand all of the issues with relation to the manipulation of wait times/. to make sure we have the sites identified and we had all of the sites where potential patient harm could occur. that was the method used. certainly, we understood that pogo did not have the authority to investigate these and we did. >> do you understand the feeling that based on this record that the subcommittee has received ur -- you were subpoenaing pogo to make sure you could retaliate against those 800 people? >> i do not think that was the perception of the ig. we had 98 sites identified where there was potential manipulation of data. v.a. had approximately 150 sites plus we were not sure if we had all the information. something that pogo may have received and we do not even care if we had the names as far as i knew. we just needed to know the site and should we look at it, what is the egregious nest of the complaint. i do think there might have been some communication issues here. >> is the situation is as ms. halliday says, that confidentiality is the cornerstone of oig's work then they have no interest in getting the identities of the people who complain to pogo. >> thank you for an opportunity to clarify. there was no confusion. it is true that ms. halliday was not there at the time, but a counselor of her office contacted pogo's general counsel and we told them right away we were very happy to work with them to give them any information that we were getting without having to give any identifying information about the individuals with whom we were speaking. we had every interest and we wrote that in an e-mail to them, saying give us a second we are overwhelmed, but as soon as we get capacity to let us know what we are finding and where it is we are happy to talk to you hear it the next day we received a subpoena specifically asking for the identities of the people who had contacted us. >> ms. halliday, if i ask you to withdraw that subpoena, what would you say back to me? >> at this point, i would hope that there is no information at pogo that would have resulted in patient harm that we wouldn't know about to go take a look at. i would like to ask maureen reagan to come. >> within 24 hours of complaining to the ig,, her identity was disclosed to her workmates. it seems that confidentiality breaches are routine. >> i would like to speak to that. i definitely heard dr. mitchell. i believe the confusion is, her complaint went from senator mccain's office to v.a. it did not come directly to us. as a result, it is very hard for us to protect confidentiality and i do not believe that the reprisal actions came from our office. based on the fact that i am looking at now. however, it did go to v.a. and it came down the tree from v.a. headquarters to the visn to the medical center and i can understand some of the frustration that dr. mitchell has. >> danielle, i would expect -- could you talk about this subpoena and the work on that? i would expect that if you gave the information to the ig's office those 800 employees would receive severe retaliation or it >> -- retaliation. >> the purpose of our organization is to protect the people coming to us so there was never a question that we were going to turn over the identities. i agree with you, sir. >> could you describe the prospects of not complying with the subpoena? >> it has expired and we are waiting because they have not withdrawn the subpoena. what the ig would need to do is go to a court and have the court enforce it. there have been a number of senators like yourself who have questioned the ig on why they have done this and would they withdraw and they have not been willing to do so. i believe this matter has been turned over to this -- to the integrity committee. >> it would seem to me, ms. halliday, that your predecessor made a mistake by issuing the subpoena. i would add you to withdraw it -- i would ask you to withdraw. >> i will take that under strong consideration. >> thank you. ms. lerner. >> chairman kirk and members of the subcommittee, thank you for the opportunity to testify today about the u.s. office of special counsel and our work with the v.a. whistleblowers. my statement today will focus on just three areas. first, our role and whistleblower disclosures and whistleblower retaliation cases. second, an overview of progress made in the past year. finally, some areas of ongoing concern. starting with our role. we help employees who make disclosures of wrongdoing and those who ask.'s retaliation for doing so. there are separate processes for these types of cases. if an employee poses a health or safety concern and it meets a very high standard of review, i send the matter to the agency for investigation. after investigate and, the agency had must submit a report to my office. the whistleblower is given an opportunity to comment on that report. i determine whether did -- report contains the information required by statute and whether the findings of the agency appeared to be reasonable. this includes weather appropriate corrective action including discipline, has been taken. i send that information and our findings to the president and congress. that's a process for disclosures. we also protect federal workers from prohibited personnel practices, especially retaliation for whistleblowing. unlike disclosure cases where we do not have independent investigative authority in retaliation cases, we conduct the investigation and determine if retaliation has occurred. we can get relief for the employee, including a stay of any disciplinary action, reversing a termination, and damages for any losses they may have suffered as a result of retaliation. that in a nutshell is our process for whistleblower disclosures and whistleblower retaliation complaint. over the past year, there have been a tremendous surge of cases from the v.a.. i will talk now about how our agency is addressing them. osc has about 140 employees. we are stretched pretty thin. we have reallocated our resources to prioritize our work on v.a. cases. perhaps most vividly, we implemented an expedited review process for retaliation cases. this process allows osc to prevent -- present strong cases to the v.a. at an early stage, sick -- saving significant time and resources and getting quicker relief for employees. in the past year, we have obtained 22 corrective actions for ba whistleblowers through this expedited process, include a settlement on behalf of dr. catherine mitchell who you heard from earlier and two other phoenix v.a. employees who were at the heart of the wait time scandal. my written testimony summarizes a number of the other cases we resolved through this expedited program including three v.a. whistleblower complaint settled last week. it's a sign of progress that the v.a. leadership agreed to the expedited review process and also agree to resolve many more cases through our regular processes, including mediation. 99 to be exact. we are also encouraged v.a. leadership has enlisted our assistance in training at counsel in retaliation law. on the disclosure site our work has led to important improvements at the v.a., as well as discipline for over 40 officials with many more cases pending. these disciplinary actions include the termination of employees who failed to properly safeguard patient information and a suspension of four employees who improperly handled and restocked expired prescription drugs. these are some of the positive steps we are seeing. there are, however, certain ongoing areas that require more attention. a particular concern is the accessing of employee medical records. in many instances, v.a. employees are themselves veterans and receive care at v.a. facilities. in several cases, their medical records have been as sex -- have been accessed -- accessed without adequate permission. i have notified the v.a. that it should consider systemwide corrective action which could deter these types of breaches. finally, i want to comment briefly on the two whistleblowers who testified in the first panel. osa recently received the v.a. reports generated in response to the disclosures made by doctors mitchell and nee. after our review, the doctors have the opportunity to comment on those reports. we will formerly transmit the information to congress and the president. given we are in the process, i cannot provide details of these matters at this time. however, i can say that doctors mitchell and nee exhibit five the courage and tenacity that are necessary to overcome obstacles to change in an organization like the v.a. while work still is to be done, their efforts will lead to improved care in phoenix and i want to thank them both. in conclusion, we appreciate the committee's interest in our efforts to protect v.a. whistleblowers. thank you for this opportunity to testify and i happy to answer any questions you may have. >> thank you. we would like you to go into detail. the method of retaliation you are describing is that the retaliate or for the v.a. goes in to the employee's medical records. maybe that employee has been a veteran and has socked here inside the hospital and will use that information to retaliate against the employee. >> yes. >> that sounds particularly heinous. >> that is one thing we are seeing. it may not necessarily just always be someone who is interested in retaliating. it could be a colleague. >> i understand. about 40% of your case log at the osc is from v.a. employees. >> that's correct. both the disclosure side and the retaliation side. >> what was the worst case where the access of the whistleblowers medical records to retaliate that your office dealt with? >> i'm a little hard pressed to say the very worst, but what i can tell you is this is a really important issue. my written testimony provides more detail on it, but i want to stress to steps that the v.a. should take. one, they should make it much harder to access these medical records. they need a better lock on the system. doctors need to have access to medical records. coworkers and colleagues do not. they shouldn't. it seems like a pretty easy technological fix to put a lock on the system so that only those who have a need to know get into those medical records. the second thing in the bigger picture that i think the v.a. can do is evaluate how it stores information and stop commingling the medical information with the demographic information. for example, what we are hearing sometimes from the v.a. is that we need the employee's address to mail them a w-2 or a pay stub. so we go into their medical records. there is no need to go to employee's medical records to get their home mailing address. if they can stop commingling those two systems, i think it would go a long way to solving this problem. >> i am told that you guys have 316 retaliation open cases now in 43 states. is that true? >> yes, that's correct. that is just on one side. that is not on the disclosure side. >> it shows how widespread this corruption is. >> it's happening nationwide that's right. i can talk more about the numbers if you'd like me to. >> that's great. senator baldwin. >> i want to thank you for holding this valuable hearing and thank you to our witnesses for your time and insight. as i have seen in the wisconsin v.a. facility and in the rest of the nation, the role of whistleblowers is critical to running an effective organization. agencies need to be open to accepting constructive criticism in order to improve, especially agencies such as the v.a. this has been tremendously important to the mission of taking care of our veterans. ms. lerner, i wanted to thank you for mentioning ryan hunnell in your statement. people like ryan truly make a difference and in particular, he helped turn around what was happening at the v.a. in wisconsin. after considering the testimony that witnesses have given and i apologize that i was quite tardy in getting here, but i just have a few questions that i think get to the heart of some of the problems at the v.a. i want to talk about the culture that i have just seen that exists against whistleblowers. ms. lerner, you said that no other federal agency has taken such a proactive approach to training managers on whistleblower protections, yet complaints about reprisals are up. in fact, your statement reads that the osc is on track to receive more than 3800 prohibitive personal practice complaints in this year and that more than 1300 are approximately 35% of those will be filed by v.a. employees. you also make this point. v.a. now surpasses dod in the total number of cases filed with osc despite the fact that dod has twice the number of civilian personnel. i know that secretary mcdonald and his team are working to change the culture at the v.a. yet complaints keep coming. more must be done to change the culture at the v.a. to improve the system so that there is aggressive action against those who retaliate against whistleblowers. the question i have for you is but i would also like to hear what ms. halliday have to say is what specifically do we need to do to change the culture here? >> i think there are several steps that we can take. there are no easy fixes. there are important stacks that the v.a. can take. we have to keep working to change the culture to embrace whittle -- whistleblowers. changing the culture begins with an understanding that we need employees to come forward and report health and safety issues. we don't shoot the messenger, we reward them. we give awards to people who identify problems. deputy secretary gibson came into our public servant of the year ceremony last fall where we honor dr. mitchell and two other v.a. whistleblowers. that's great. they should have their own awards ceremony. i understand the secretary tries to meet with whistleblowers when he goes to visit facilities. that's terrific. but after he leaves, what is happening? the hospital administrators need to be told to recognize and support whistleblowers. they need to keep meeting secretary gibson, secretary mcdonald they need to keep meeting with whistleblowers, listen to them praise them, and repeated over and over again until it takes hold. the second thing is train managers. they are doing a lot of training now but they need to do more. this means hospital administrators and doctors need to get trained in y whistleblowing is important. it may not be intuitive to them as administrators and doctors why whistleblowers are important but they are and the more they are trained, the more it will help. >> i regret cutting you off but i would love the rest of your statement in writing. i did want to give ms. halliday a chance to also respond to that question. >> thank you. i believe you really have to enforce accountability here. when you have reprisals against whistleblowers. it has to be tough. it has to be a point where somebody would take great pause to do that. i think you need training in the v.a. system with regards to the hr personnel practices. you need training in leadership. i think leaders have to step forward and protect whistleblowers. i don't think they always do. maybe they don't have the right tools in their pocket to do that. but it's clear that the need to improve in that area. i personally, in the three weeks i was here, i added a component of training on whistleblower rights when we go out and do our combined program assessment. out of the medical facilities and people in the medical facility at attend these briefings. criminal investigators normally give that. i told them i wanted that piece in their so there is better training. that does not touch everyone in the v.a. system, but it touches a lot of people. those would be some of the things i would look at immediately. >> thank you. >> very quickly, i know we have to vote so i won't take a lot of time. ms. lerner, the 40% of your cases are v.a., so that means 60% are the rest of the federal agencies. >> that's right. >> that's really remarkable. >> we have jurisdiction for most of the civilian workforce. >> we talked about dod and all that, but the reality is, 40% of all the agencies, that's remarkable that it's occupying such a significant caseload of yours. ms. halliday, i agree, we need training in leadership and all of those things. but we also need accountability for those that do go after whistleblowers and very strong actions in that regard. the best i can tell is that it is simply not happening. the other thing is, it does appear that in some cases, there appears to be collision with the ig, with the administration, perhaps telling them too much fax -- facts regarding the whistleblowers and you really need to look into that. the other thing is, i think the hippo laws are being used -- hippa laws are being used in an inappropriate way to prevent people from going forward. that's the excuse. i think that's a huge job for you. we have not had a full ig for well over a year. i appreciate you holding this hearing, mr. chairman, i think it's important. if were not going to have a full ig, we are going to have to step forward and try to do that in place of it. thank you, mr. chairman. >> ms. brian, how does the v.a. inspector general to the other 24 inspector general's? >> there are many more ig's across the federal government at this point and i without reservation can say it is the worst shop in the government. simple. >> pretty decisive. [laughter] on that, i will let our members go. we will be in recession. [indiscernible] the senator from maryland. ms. mikulski: thank you very much mr. president. mr. president, i ask unanimous cons ent th able to in morning business for no more than ten minutes. the presiding officer: without objection. ms. mikulski: thank you very much mr. president. i rise today to commemorate the 50th anniversary of medicare. 50 years ago on july 30, 1965, president lyndon johnson signed into law the legislation to create medicare. mr. president, i say "thank god for medicare." it was a great idea 50 years ago. twait was a great idea 50 months ago, 50 weeks ago 50 minutes. and i stand on the senate floor to say we must keep medicare as medicare keep the integrity and solvency of medicare. we cannot turn medicare into a voucher. we cannot dilute it, phase it out, or eliminate it. and i will say to this, until my last vote is cast in the senate, i will defend medicare. i saw what this meant in 1965. that summer i had just graduated from the university of maryland school of social work. change was in the air. the civil rights movement was making its progress towards history and moving forward. there were beginning doubts about the vietnam war. the nation was recovering from the assassination of president kennedy, and president johnson wanted to lead in a bold way having had a landslide victory in which said he he said he wanted to create a great soavment and society. and he knew that a great society had to have a great heart. and when we knew then, as we know today is that people feared financial bankruptcy because of the health care cost. they were terrified that a heart attack that would end up in hospitalization would bankrupt the family. they delayed the idea of getting cataract surgery, which then needed to be done in the hospital because they were afraid not of the surgery; they were afraid of the cost of surgery. for people over 65, if you were a small independent businessperson you often had no health insurance after 65, whether you are in agriculture or an urban small business. medicare changed all that. medicare protected people from two things. number one it protected them so that they could have the doctor that they needed when they needed it and the health care that they needed. the second thing that it did is it protected them from financial disaster. today 55 million americans nearly every senior, has access to medicare, including 1 million seniors. and what was so significant about that bill is it provided universal access to doctors. number two it had no barriers because of preexisting conditions. number three, it was portable because it was national. whether you were in maryland or utah or whatever state medicare was your national program and it was viewed as an earned benefit. america at that time had many things going for it. one, we had a sense of self-confidence that we could really solve problems and meet the compelling needs of our country and that the other it had compassion. one of my guiding principles -- and i believe then that guided the nation -- was the guiding principle that honor thy father and mother. we knew that it was not only a great commandment to live by, but it was a good policy to live by. and, therefore we ensured that all americans had access of health care, regardless of their income. as i said in the 1960's, in 1965 was the year that i actually graduated from the school of social work. you went to the program called responding for the elderly's abilities and sicknesses otherwise neglected. it was old "operation reason." our expwrob a social worker and a nurse one of my longest friends from school, our job was to help elderly people know about the program and sign up for the program and help them use the program. the joy the sheer joy of people hearing about this program where simply because they were american citizens, their needs with a modest premium could be taken care of. part-a was hospitalization. a safety net. and in those days care for significant illnesses had to be done in the hospital. the advances of medicine, medical technology, now where we do less in the hospital, maybe the idea of cataract surgery and others being done on an outpatient basis wasn't there so that they no longer had to fear the cost of hospitalization. and then there was this program called a part of it called part-b that meant that you had access to see a doctor, to see if you had diabetes, to see if you had high blood pressure, to see why you couldn't see those grandchildren or do your work on the family farm, the small business or the factories when we had them in those days, and what you needed was maybe better eyesight cataract surgery. maybe you were feeling old and slow not because of that but because you had diabetes or other consequences. and then of course there was the cost of the dreaded "c" word of cancer. my colleague and i worked in the neighborhoods to make sure that we took care of how people could get to the facilities, know about those services and know about those barriers. in those days baltimore citizens were struggling. when you retired it was often the end of health insurance. it meant nearly half the seniors were uninsured. they went to clinics standing in very long lines often shut telled back and -- shuttled back and forth from one clinic to another. they looked at your eyes here, your ears here. their concept of primary was fragmented. before medicare millions of seniors, as i said, was one heart attack away from bankruptcy or one cancer diagnosis away from destitution. that was life before medicare. many were skeptical about medicare. once again the other party fought it. they were wondering if medicare was -- what that would mean. people were skeptical. was this a big-government move or was it a big opportunity? my job was to show them that this program was not about big government but about government with a big heart. after four months of operation we had enrolled hundreds of people into this much-needed program. and what has it meant? before medicare, 48% of seniors had no health insurance. today only 2% are uninsured. out-of-pocket costs have decreased. before medicare, seniors paid 56% of health care costs out of their pocket. imagine what that meant if you were hospitalized in a hospital in those days at $500 a day. life expectancy -- life expectancy is now five years longer. death from heart disease has dropped. our elderly poverty rate has declined and seniors have access to more affordable drugs. this isn't about numbers and it isn't about statistics. it's about people. it's about people and what their compelling human needs are. it is about a government that says i am on your side and at your side, and we're going to use our national resources our national brainpower, our national know-how to be able to create a program that you can participate in. and at the end of the day your life will be better and our society will be improved. i'm really proud of what the congress and the president did 50 years ago. i hope we have that same attitude again. it's not about big government. it's about government with a big heart. and i will say this. there are those who continue to talk about ending medicare. this most recently, a presidential candidate who i think has incredible ability -- jeb bush -- said he wanted to phase out medicare. i don't get it. how do you phase out medicare? do you start first with age like do we phase out 90-year olds and then next year we phase out 80-year olds? how do you phase it out? do we phase it out by disease? this year no more diabetics. okay this year no more cancer patients. wow, they really cost a lot of money. what is it, called phasing it out. and what do you phase it out to? medicare cannot be privatized. we must continue it as a guaranteed benefit. do we need to reform it, take a look at it, refresh it? the answer is yes. we have done that, like when we added part-b. but i will say this, no matter what thank god for medicare. and when you go around this country, no matter how they feel about government or about congress people love social security and they love medicare. and you know what? we have to defend it. we have to make sure it is there as we need it. so when this 50th anniversary of medicare, let's come together to make sure we continue to be focused on not big government, but where we have with the sense of self-confidence and a belief in our country to solve big problems that we continue to act like a country with a big heart and we can do it because we've done it in the past. so mr. president i'll conclude by saying thank god for medicare and thank god for [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2015] the children of military veterans generally move six to nine times during their k-12 school years. >> next i have the honor and the pleasure to introduce two individuals who are no stranger to the military child education coalition. this is the fifth year that general dempsey and his wife have joined us and participated with the military child education coalition. gen. dempsey is the 18th chairman of the joint chiefs of staff. he and deedee have been married 39 years. they have raised three children all three of whom have worn the uniform to defend this great nation. day in and day out, they have been stalwart supporters to what we do and what we stand for. and our efforts to support the military child. it is with great honor and pleasure that i introduce two good friends. general marty dempsey and his wife deedee. [applause]

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