Appointment wait times is that correct . . I think i said the investigation didnt conclude. Before the investigation was able to conclude they retired from federal service. But this involves fraud and fraud is a criminal issue. How many criminal referrals occurred of people who were involved in this scandal . My understanding, i dont know whether the Inspector General can help us with this. Was we dont have i think h was senator blumenthal ask that the department of justice come in to look at this and they ended up declining on looking at most of these cases. But i know there are referrals from the ig to the criminal division. Could someone comment on that . There are referrals and i know in every case where we suspect something well make the referral. I can tell you and this is not my area of expertise but i think a lot of the money that youre referring to, the bonuses, while inappropriate is not necessarily a high dollar amount and theres not a lot of attraction so fraud is okay if its a low dollar amount . Is that what were saying today in. Not for me. Really . The department of justice, i think theres not a lot of traction if its a small amount. Thats disappointing under this administration that that would occur. Let me state what is current law and that is if somebody commits fraud but is awarded a bonus, there is no claw back provision in current law. Is that not correct . Who can answer that . Im not aware of the answer. There is no provision. In fact there is legislation before the congress and the position of the va is neutral on that which i find is appalling as a taxpayer and a veteran that when somebody gets a bonus that they clearly did not earn, should not have been given, that the only provision that the va is able to claw it back is if it is given administratively to the wrong person. But if it is given to the person that is the subject matter of the bonus, even if they didnt earn it, there is no provision or clawback. That law needs to change and the secretary needs to take a position affirmative for that legislation. This is about cleaning up the va. And the secretary was giving a speech in denver last weekend, i think its two weekends ago they was at where he said that the fundamental problem in terms of the appointment wait time scandal was a lack of training of va personnel. Is that correct . Was it due to a lack of training . I think what the secretary most likely meant was, was that our system was complex and we werent spending enough time training. I dont think he would have that was the only factor. There were many factors. It had nothing to do with a lk of training. It had everything to do with people that were fairly skilled at manipulating the system. What they did was to make the numbers look smaller to get the cash awards is they pushed veterans out on these secret waiting lists who did not get health care. And there are veterans who died on the secret waiting lists. And you know, i dont know how we ever clone up problems in the va if we dont acknowledge their existence. And i really dont believe that the leadership of the va has acknowledged the depth of the problems that exist here and thats why theyll never been cleaned up under current leadership. I yield back. Youre recognized. Thank you, mr. Chairman. I have to ask specifically, in the individual va medical facilities, administrators and or directors basically have the ability to monitor this with their own facilities . Correct. Make sure theyre the ones that are in charge of doing that. Monitor the wait time . The wait times, theyre the ones that do that. Yes, sir. The problem is i see right now st. Louis is one of our facilitie facilities. In the last 34 months every 120 days or 280 days, depending on 240 days by your rule, we keep circulating directors in and out. I ran business for years and if in 120 days i couldnt get all of my employees names down. I definitely couldnt figure out where the problems were. And whenever i thought this was only in the st. Louis facility. But our Research Found out theres 40 facilities that are actually interim directors that are cycling through like this. Its very hard to have oversight if someone isnt there for a long period of time and they understand thats their job. Is there anything being done right now to try to cure those problems . Yes. First off i couldnt agree more. You cant solve the problems of the va unless you have the right leaders in place and they need to be permanent leaders. So were on the same page. St. Louis very unfortunately pe actually named a permanent leader who were coming from sh the. No longer available. Coming from hawaii and because of personal issues he retired from federal service. So now youre back in a National Search and we have some candidates. So i am very focused on getting a leader in st. Louis. But i dont count 40. I count 34. Thats 34 too many. And so we have national recruitments out in place. Its one of the reasons why weve asked for you support for title 38 legislation. We need not only accountability in this va but we also need market rates that will help us attract the very best tool come to take these jobs. Right now there arent enough people who want to come take the jobs. Because of salary . I think the pa bad press that va is getting, the applications are down 78 from the date of the crisis. These are known to be very tough jobs and the salary is not anywhere near where the market rates are for these jobs. Im pretty sure that nobody wants to jump on a ship thats sinking and thats the problem. Our maybe needs to be sealed up and then bailed out in the condition that it is right now. And i think, i think this is a possible this just causes a downward spiral and i think it needs to be cured. Now im willing to work with you on that. And understand the legislation that were pushing forward gives the secretary 120 day to look over proposals on what it is that we can do and move forward to try to cure the problems. With that mr. Chairman i yield back. Thank you. Im going to yield myself five minutes to ask a few questions. Doctor w as you know weve been aware of this problem with the trainers and procedures with the schedulers since 2005 when it was first reported on 37 and the independenter general stated in its august 14 phoenix report since july 2005, Inspector General published 20 oversight reports on va patient wait times and the va has been resistant to change. I guess my question is, is about the procedure for responding to and dealing with office of Inspector General reports. Okay . This is something that ive been working on for years in my position here. Is someone actually put in charge of responding to a specific Inspector General report . Yes. I did not do when i came into office, a major reorganization of va leadership because i wanted us focused on this morning fixing the crisis. But the one thing i did do was i established a new deputy undersecretary for Organizational Excellence whose position it is to focus on that. Theres one spern person one office. So that person will be held responsible for making sure that the Inspector General reported deficiency is correct snd. Well, i will be held responsible and the secretary ultimately is held responsible. But its difficult because, you know, weve had so many Inspector General reports where the secretaries agreed with the report and agreed to change it but nothing has changed in 20, 30 years. You realize that, right . I do realize that. Identify the fact thiss no central hiring process for physicians at the va. That was reported i think eight times over 30 years. That problem still exists. No one seems to have fixed that problem. So i want to have where one person is responsible for responding to the Inspector General reports. Let me ask, has there ever been accountable employee assigned to fix the problem if in your history with the Inspector General . So theres always someone assigned but quite honestly and i was involved with one of the first 2005 report and we reported it and until 2014 there was really no priority place to it. We reported it in 05, we reported it in 2007. The right words were said, actions were, you know, changes were made. But when we came back two years later we found that nothing had been put in place. Thats my experience as well. They say were going to fix it but nobody is actually responsible and name of an individual who name it is to make it actually happen never seems to get fixed, you know. You think that legislation mandating that the va assign a specific accountable employee to fix a problem would be an effective strategy . I think the doctor was right that ultimately hes responsible and the secretary we make our recommendations generally to undersecretary of health assigning i wouldnt think legislation would be necessary but thats something certainly by saying there was this problem for 30 years with the ig telling the va they need to have a central plan for hiring physicians, they said that six time over 30 years, the va agreed to them but yet nobody was assigned to fix that problem and it still occurs today that theres no plan for firing physicians in the va. You see what im talking about . This is something thats a procedural the way things are done. Its given to some committee, some department but then theres nobody who is actually in charge other than you and you say well, were all working on it. But what im saying is that is the organizational change i made. I have a brandnew deputy undersecretary whose job it is to do that. And they put together the office of medical inspector, all of the compliance officers, the regulatory officers. Whats his name . Dr. Carolyn clancy. You know dr. Clancy. How many reports has he looked at in that position . Theyve been keeping us busy. Weve looked at 72 on the wait times alone and youve sent over a bunch others over that. Pi would say probably over 100 sk. I would like to see the Inspector General reports that wes looked at what he has done to respond to those reports. Absolutely. Thank you. Im out of time and i think everybody has asked their questions. Were just about ready for the closing. Ms. Brown has a closing statement. I want to ask ms. Draper a question. You mentioned the scheduleder and that perhaps theyre not getting adequate training. We all know that a scheduleder is an entry level job. Do you think that the va kneads to do more to upgrade . Once a person is trained in that position, if they see another opening, they want to move up. Yeah, let me back up a little bit. I think training is an issue but i think its much more complicated than that. Theres oversight. The scheduling system is prone to user error. Theres a lot of things that familiar tore in to the errors. The scheduliers is industry level. Its the number one or two position with turns over each year. Theres not really a good career path for those individuals and what weve heard is that when someone demonstrates a high level capability theyre often scooped up and move somewhere else. I think at one point a couple years ago they instituted in some places a gs 6, there was a career path and my understanding is that doesnt exist any longer. So i do think if you put this much responsibility, a lot of pressure and responsibility on these individuals that it is important that they have the support and the training and you know the oversight. As i said in any opening remarks, if someone continues to do the same errors, wheres the oversight and what happens when that continues to happen. Thats what we sooef seen. It raises the question about oversight and quite frankly whether some of these people pop are able to do the jobs that theyre put into position for. Thank you. Mr. Secretary, ive gone to the medical schools in the orlando area with the secretary and i didnt know that there were some problems because i know we need additional slots. So im hoping youll get back with us and if theres message on our side we need to do, i know we want to do it. We need the official physicians. If they train and have the residents, they will probably stay in the area wed welcome further discussion on that. And in closing, im hoping that the veterans thats listening to what were doing today understand that we are seeing over 2 million additional veterans in 2015 than 2014, over 224 appointments per day. So if veterans need to come to the system, dont be dumbed down by what you hear in here. Go and get assistance. Go to your members office, go to the va. With that, you know, we all need to soldier up and make sure that the veterans are being taken care of. Thank up. I field back the balance of my time. Thanks to the entire panel for being here. Youre now excused. Today weve had a chance to hear about ongoing problems related to veterans access oh, i guess were going to have the chairman give a closing statement. No, no closing statement. I just confirmed with the Caribbean Health care system that the individual that we were discussing is still on the payroll. Thank you for correcting that. So again, the question is why in the world was somebody who has been convicted of Armed Robbery still be working at the department of veterans affairs. Okay. Well, hard for me to answer that right now. So i think we owe you an answer. Please. Thank you. Thank you, mr. Chairman. Weve had a chance to hear about the vet answer health care that occur today. As weve disquds the va has not taken the steps needed to improve access care for veterans. Until the va stops using the excuse of poor training, begins holding itself accountable, nothing will change. Doctor, it seems to me that the i care in my va access declaration are just 0 words. These ideas speak to an intent but to this committee and veterans, results are what count. Its not good substitution or action. Our veterans will have to hope that the va gets itself squared away. As we know, hope is not a plan. I ask unanimous consent that all members have five legislative day to resize their remarks and include extraneous material and without objection so ordered. I would also like to once again thank all of the witnesses and the audience members for joining us today. And with that, hearing is adjourned. Thursday, the head of customs and border protections testifies. Well have life coverage at 2 00 p. M. Eastern time on cspan3 and cspan. Org. Madam secretary, we proudly give 72 of our delegate votes to the next president of the United States. House Budget Committee chair tom price talked about the federal budget process and how to reform it at an event host bid the committee for a responsible budget. Hes calling for a complete rewrite of the 1974 congressional budget act. Following his remarks, a panel will discuss the issue. This is an hour and a half. Thanks very much for everybody who came today. Very good expert audience that we have with us. Were also filming cspan live. Turn the mike on. Hello, everybody. Again. Okay. So we have cspan with us live which is terrific. We have a broad audience. And thanks to everybody here. I see all of the leading budget experts in the city in the room. Thrilled to have you with us. Our topic today is fixing the broken budget process. This is a topic that anybody who knows the budget or the rules that guide it is familiar with that theres a whole lot of improvement that we can do, even get budgets done, to fiscal outcomes that arent always healthy for the country to the fact that budgeting in our country is separate from any strategic economic thinking you might want to do. Swl whether its the smallest technical areas or the biggest broadest ands the oobjective o the budget, theres white a lot we can do. So we have a great panel of experts today who are going to lead a discussion about a bunch of different topics of where we would look for reforms. But what im thrilled to do is to introduce our keynote speaker today, dr. Price who is not only shepherding the budget process, he is also doing some really deep and important thinking about reforms to the budget and what they might look like in terms of process. So im thrilled that hes joined us today to lead our discussion. So thank you very much, dr. Price. Thank you. Nice to see you. Thank you. Thank you. [ applause ] thanks very much for the opportunity to be with you today and talk about something thats near and dear to everybodys heart, right . Budget reform. How exciting can it get, you know. Probably nothing could be more important and less exciting than budget process reform. So i want to thank all of you for coming out today to discuss and share your ideas about this incredibly important issue as we try to move forward with something that i think has a process right now that clearly is failing not just those participants in the process but failing to country. And that clearly needs to be reformed. So its an exciting prospect for all of us to kind of try to shape the way in which budget process reform moves forward. I also want to commend the panelists who have spent incredible time and toil and labor in trying to assist folks in understanding what the budget process is, either why it works or why it doesnt work. Theyve got some wonderful contributions to make today to this conversation. What id like to do is just kind of lay out where we are right now, what the challenge is. And do so in a way that hopefully highlights the reason for budget process reform, the need for budget process reform and then talk about some of the things that can be done and split the way forward in terms of policy and process. The budget as most of you know does three things in congress. It sets the 302 a number, the number that the appropriators can spend on the discretionary side for the next fiscal year. It lays out in the budget window, the tenyear window. It lays out the vision for the challenges that we face. Whether its the majority budget or whether its the minority budget or the other budget thats offer. Oftentimes its used an and opportunity to say this is how we address the challenges that we face. Finally the third thing that it does is something thats not used terribly often but an incredibly powerful tool, the whole issue of reconciliation. A process that allows the congress to address spending or revenue or debt in a way that doesnt make a whole lot of difference in the house to the process but in the separate it allows us to move a piece of Leng Las Vegas forward with a simple majority. Doesnt require a super majority so you can get around the 60vote margin in the senator. So its pretty straightforward. Ought to be easy to do, right . Last year we passed a budget that balances within a tenyear period of time and agreed to it with a senate that doesnt raise taxes and gets us on a path to paying off the debt for the first time in 14 years. First time in 14 years. So if youre keeping track on a score card now, thats one reason this that is the