Before we proceed to todays hearing id like to take a moment to recognize last monday was memorial day. It was a different memorial day for me and other americans than normal and it was more difficult for us to gather together. But last monday gave us an opportunity, an opportunity that we should take every day to pause and remember the brave americans who gave their lives in defense of our country. And we honor the sacrifices they made to keep us free. While let me start by saying that the veterans we honored on memorial day, they served our country and that peaceful protests are a demonstration of the freedom our veterans served to safeguard and protect. And while we reject the defacing of our National Monuments i would take another moment to express my gratitude the National Park service, its employees and volunteers who quickly restored our memorials. All of them but especially those that recognize the service of our men and women particularly the world war ii memorial. I know that this committee will continue to further our nationll pledge. One nation under god indevisibility for all. We use this committee to pay our regards and respect to veterans who lost their lives to protect our freedoms. Todays hearing is on the vas fiscal year 2021 budget request and the supmental appropriations contained in the cares act to respond to the covid19 outbreak. We welcome secretary wilkie as well as dr. Stone, dr. Paul laurchs, under secretary for benefits and john, assistant secretary for management and chief initial officefinancial o. I appreciate your presence here today. Weve certainly done a job to socially distance. Despite the distance between me and your team theres nothing but covid19 that causes that to occur, and i look forward to continuing to work closely with you at every opportunity. I look forward to discussing with you all today how we can Work Together to improve outcomes for veterans in our country. Id also like to acknowledge the passing of veterans and va personnel who lost their lives due to covid19. Part of our discussion food to make tour had the va has every tool. And id like to thank our doctors and nurses and support staff. In addition to serving veterans the va has executed its Fourth Mission to support the American Health care system struggling during this National Emergency. And this response from these Health Care Professionals has been and continues to be admiralable and important and necessary. While the va continues to devoted resources to suppress the pandemic veterans will continue to rely on the va for their needs such as education, Home Financing and transition services. To this end the pursuit of the wellbeing of our nations veterans must continue unabated. Between the release of this budget and this hearing Congress Passed legislation to support federal agencies responding to the pandemic. Following a supplemental appropriations by the president Congress Passed the cares acts. Cares provides 19. 6 billion for telehealth services, equipment and supplies, personal protective equipment, emergency room and urgent care. Cares also sets aside 2. 2 billion for i. T. Retrospectively did cares act appropriately fund the right places and prospectively given the shifting health care demands does the president s fiscal year 2020 budget address the budget needs. The president s fiscal year 2020 budget request includes a proposed increase of 22. 8 billion in funding from the va for a total of 243. 4 billion. This represents an increase in active levels. I look forward to hearing from you how the proposed budgetary increase will create Better Outcomes for our nations veterans. Iest pleased to see it includes an increase for medical care as the va includes the mission act. As we have discussed states like kansas depend upon Community Care providers for timely care. It is strongly supported by every Veterans Service organization, and you have been a champion, mr. Secretary to ensure its proper implementation. We all want veterans to receive the care they need in the va or in our community and i look forward to discussing the mission act today. Addressing another of the committees Health Priorities i request the additional funding for Mental Health and suicide provention. Mr. Secretary, i know you share our priority. In january this committee unanimously reported the commander in the Mental Health care improvement act to provide grants for Community Partners and improved coordination to quell the rates of veterans who die by suicide. It is my hope you will continue working with us to get this bill signed into law soon. Mr. Secretary, as always i thank you for being here. I appreciate the difficulty of your job. As the administration works to find a whole government solution to the pandemic i look forward to hearing your views on the fy 21 budget and i now turn to my colleague and the Ranking Member from this committee the senator from montana, senator tester for his opening remarks. Thank you, chairman. I want to thank you for having this. Before i get into the prepared statement i do want to say ten days ago was memorial day and it was a different memorial day than ive ever experienced, but the bottom line is it did give me an opportunity to really think privately quite frankly the things veterans have given us in this country, the freedom and the promise to live with liberty and justice for all. And i think its appropriate as weve all said that every day is vettens in this conbecause quite frankly without the sacrifices, without the job our military has done over generations this country would certainly be a different country than it is today. And i hope with all my heart, quite frankly, that we keep in our mind that this country is about liberty and its about justice. And its about liberty and justice for all. So thank you to the veterans out there, and secretary wilkie, i want to thank you and your Leadership Team for being at the hearing today. Today we get to go over the details of the president s budget request. But truthfully in the last four months the world has changed and the va has changed. More than 106,000 americans have died, many of them veterans returned from wars abroad to die fighting a very different battle here at home. I know the va has been focused on saving as many veterans lives as possible with more than 12,000 veterans having being diagnosed with covid19 by the va. And while many are covering the convalescing we should never forget more than 1270 have died. Its deployed staff and supplies to nonva facilities like state veterans Nursing Homes. Vas front line workers and their work force have done an incredible job and deserves more than just a thank you because thats enough for the work theyve done. It has been stellar. We must ensure the va has everything they need to keep the employees we have safe and take care of our veterans in the process. Todays hear sg an opportunity for us to take stock in where we are and where we need to be. Mr. Secretary, at the outset of the nations response to covid19 Congress Fulfilled vas request for nearly 20 billion to support its ability to take care of veterans. We do need a better understanding of how va has spent those funds and whether unspent dollars will be available to address veterans needs whether it be covid19 or otherwise in this next fiscal year. We also need to ensure that the president s budget request for va inhouse care meet the anticipated health care demand of veterans when looked through the lens of of coronavirus. We also need to know whether private sector providers are prepared to administer care given the virus unprecedented effect on American Health care. And we must anticipate the rip 8 effects on industries across the board. Prepare for a potential increase on reliance on va. Weve seen the devastating physical effects coronavirus has had on those who have contracted the disease. But i think we also see large scale negative psychological impacts and not having actecesso traditional in person Mental Health resources. And as weve seen with this covid19 crisis va facilities need more space certainly not less. We wont get there by short changing va emphasis infrastructure. With vettens unemployment on the rise its also critical the va indicate what programs we need to support in order to get vets rnz educated, trained, back to work and able to provide for their families. One way we help veterans provide for themselves and families and ensure their claims are processed timely and accurately. Im truly concerned with the mounting backlog of claims due to deferred and disrupted in person examinations for veterans and how these delays will affect them and their families. So i look forward to todays hearing to learn more details about how this budget request and the departments response to covid19 has gone, and i look forward to our conversation, and once again thank you, mr. Chairman, for having this hearing and i want to thank all the witnesses for being here today. Senator tester, thank you for joining us. I appreciate the relationship you and i have whether we are close or far apart. Maybe sometimes this works better for us. But im delighted youre with us. We have almost every member of the committee present either here in person or remotely. This is a hearing our Committee Members take seriously, and they are participating. While im pleased all of our members are here i also would acknowledge the presence of senator bozeman who chairs the millcon Va Appropriations Committee who has a lot of interest and involvement in your appropriations. Thank you for joining us with your expertise and interest. Mr. Secretary, before i introduce you i would say not only thank you for big here but you have been very kind with your time to senator tester and i tlahroughout the pandemic. I couldnt ask for more opportunities to have conversations with you and your team, dr. Stone and others. And that was very helpful as we explored and hopefully made suggestions and asked questions that were beneficial to you in fulfilling your duties during this pandemic. Mr. Secretary, well sqcome and please proceed with your testimony. Thank you, mr. Chairman, and senator tester. You stole the first line. I intended to say and actually i will say that in my experience working in this institution everywhere from the Majority Office theres no committee with authorization thats been more collaborative or more supportive of the department it oversees than this committee, which is why i do say with a straight face it is a pleasure for me to be here. I also want to pick up on what you and senator tester said about the events of memorial day. Memorial day has been part of my life for as long as i can remember as senator tillis said, i was born in khaki diapers and very proud of it. This memorial day i looked out at the National Cemetery and saw three families scattered amongst the thousands of veterans at that seamitary and realized this really was a different time. But i will say at va we made sure every possible obstacle was moved so on that day those families could be at the cemetery representing the 1. 3 americans that have died since the first shots were fired at lexington 1975. Mr. Chairman you noted last year we presented the largest budget in the history of this department. Thats now been surpassed by the budget presented to this committee this year. But i want to say that your support in that budget reflects trust in va that did not exist six years ago. This is not the va you read about in 2014. Today we are rededicated to lincolns vision that we take care of all who had borne the battle and for their families. And our record of turn around is something that may be unprecedented in the history of the federal government. In just a few short years we have implemented major reforms. Under the mission act we have successfully given veterans real and permanent choice. And while some said that the mission act meant the privatization of Veterans Affairs the numbers show the opposite has happened. In the last fiscal year we completed more than 59. 9 million internal episodes of care, a record high. And while we were doing that between june 6th and the declaration of the National Emergency we sent almost 4 million veterans into the private sector to fulfill the mission acts mandate. We implemented critical updates to the bill. We took on the new task of caring for thousands of Blue Water Navy veterans, and we continue to make progress in the highly complicated development of the Electronic Health care record that we will share with the department of defense so that people like my father will never be burdened with an 800page paper record ever again. And today we continue to implement those reforms even as we cope with as you and senator tester said an erratically new normal that none of us could have ever seen the last time i appeared before this committee. This depdemic was a shock to Health Care Systems around the planet. But you should be as proud as i am for the thousands of va employees who put themselves in harms way to create an indispensable resource not only for our veterans but for our nation. We continue to perform well because we took steps early on that allowed us to keep serving veterans even when there was so much uncertainty. Those steps included the immediate implementation of Emergency Management procedures in the last week of january. Expanding telehealth access and prohibiting visitors to our va Nursing Homes and spinal cord injury centers. Heres where we stand today. As of this week more than 12,000 veterans nationwide had been diagnosed with the virus. But 80 of those veterans are now at home having recovered. We are caring as we speak for 1,200 veterans with the virus, a number that has fallen in the last two weeks from 2,200. We have currently about 1,100 va employees who have tested positive. But we estimate that our infection rate with 330,000 employees and dr. Stones department to be one of the lowest infection rates of any organization on the planet. It is less than one half of 1 . And our staffing is stable because we have hired in the last seven weeks 16,000 americans who have agreed to join us and serve veterans. That means 3,300 registered nurses, 535 physicians, and 202 nursepractitioners who are with us now full time. And more importantly we have the lowest rate of infection amongst our nursing home residents. The lowest rate of infection amongst any system in the country because early on we took very difficult steps to close off our veterans sadly from their families and friends. Because of that we have 19 veterans in our Nursing Homes, 19 out of the 7,000 who are infected with the virus, and i believe we have set an example how to care for our nations most vulnerable. That stability in operations has allowed us to open our doors for the mission which is back up our Health Care System in times of crisis. We are now in 47 states and territories. By april we were accepting requests to open dozens of our hospitals to nonveterans cross the country. Our expertise in caring for nursing home residents is in the highest demand. Weve deployed 204 va staff to Nursing Homes around america. The crisis as i mentioned was not costless for us. Covid has claimed the lives of 32 of our va family. But in april april brought us irrefutable evidence that the tide at va has turned for it better. On the last day of the month we released a survey showing that a record 90 of veterans across the country now completely trust va care. That is a record high and is a record high even in a pandemic. So that is todays va. It is a learning organization filled with employees who can turn on a dime to keep veterans and nonveterans safe even during this time of incredible uncertainty. Mr. Chairman and senator tester, i again thank you for your many courtesies to me and everything you do for our nations most deserving. Mr. Secretary, thank you very much. Let me begin with a handful of questions and then turn to senator tester. Committee, we will do this by seniority not knowing the presence of every member at the moment. So well work by seniority. Mr. Secretary, can you walk us through why we are seeing a steady growth and increasing funding in both internal Va Medical Services and Community Care. Let me use this opportunity to say that i believe that whether the care is provided in the community or provided internal to the va both are va care. They are both part of the department of Veterans Affairs, and they are not separated. You indicated the hiring of 10,000 medical staff. This in my mind could lead toward a greater capability of seeing people internally within the va and maybe result in less people involved in Community Care. Youve also indicated to me and senator testing over a long period of time the increasing use of telehealth. How does that have a consanyone of the amount of veterans being seen internal and the community . I raise this question in part because we are being requested in this budget for more money in both categories. Internal va care. Let me and answer the telehealth question first. That is separate category because it rests on a priority that i gave to this committee when i had my confirmation hearing. The two communities in this country who serve the nation in higher numbers than any other communities are rural americans and nativeamericans. The two populations that are the hardest for us to reach no matter what the mission