[Joint House and Senate Hearing, 117 Congress]
[From the U.S. Government Publishing Office]





.                                                     S. Hrg. 117-745
LEGISLATIVE PRESENTATION OF THE VETERANS OF FOREIGN WARS OF THE UNITED 
 STATES AND MULTI VSOs: IAVA, WWP, VVA, AMVETS, NCHV, SWAN, BVA, BVEC, 
                                 NASDVA

=======================================================================

                             JOINT HEARING

                                 OF THE

                     COMMITTEE ON VETERANS' AFFAIRS

                               BEFORE THE

                     U.S. HOUSE OF REPRESENTATIVES

                                AND THE

                              U.S. SENATE

                    ONE HUNDRED SEVENTEENTH CONGRESS

                             SECOND SESSION

                               __________

                             MARCH 2, 2022

                               __________

      Formatted for the use of the Committee on Veterans' Affairs
      
      
      
     [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]  
      
      
      
      


        Available via the World Wide Web: http://www.govinfo.gov
        
        
        
                      ______                       


             U.S. GOVERNMENT PUBLISHING OFFICE 
 53-629  PDF           WASHINGTON : 2023 
        
        
        
        
                 SENATE COMMITTEE ON VETERANS' AFFAIRS

                     Jon Tester, Montana, Chairman

Patty Murray, Washington             Jerry Moran, Kansas, Ranking 
Bernard Sanders, Vermont                 Member
Sherrod Brown, Ohio                  John Boozman, Arkansas
Richard Blumenthal, Connecticut      Bill Cassidy, Louisiana
Mazie K. Hirono, Hawaii              Mike Rounds, South Dakota
Joe Manchin III, West Virginia       Thom Tillis, North Carolina
Kyrsten Sinema, Arizona              Dan Sullivan, Alaska
Margaret Wood Hassan, New Hampshire  Marsha Blackburn, Tennessee
                                     Kevin Cramer, North Dakota
                                     Tommy Tuberville, Alabama

                      Tony McClain, Staff Director
                 Jon Towers, Republican Staff Director

                              ----------                              

        HOUSE OF REPRESENTATIVES COMMITTEE ON VETERANS' AFFAIRS

                   Mark Takano, California, Chairman

Julia Brownley, California           Mike Bost, Illinois, Ranking 
Conor Lamb, Pennsylvania                 Member
Mike Levin, California               Aumua Amata Coleman Radewagen, 
Chris Pappas, New Hampshire              American Samoa
Elaine G. Luria, Virginia            Jack Bergman, Michigan
Frank J. Mrvan, Indiana              Jim Banks, Indiana
Gregorio Kilili Camacho Sablan,      Chip Roy, Texas
    Northern Mariana Islands         Gregory F. Murphy, North Carolina
Lauren Underwood, Illinois           Tracey Mann, Kansas
Colin Z. Allred, Texas               Barry Moore, Alabama
Lois Frankel, Florida                Nancy Mace, South Carolina
Anthony G. Brown, Maryland           Madison Cawthorn, North Carolina
Elissa Slotkin, Michigan             Troy E. Nehls, Texas
David J. Trone, Maryland             Matthew M. Rosendale, Montana
Marcy Kaptur, Ohio                   Mariannette Miller-Meeks, Iowa
Raul Ruiz, California
Ruben Gallego, Arizona

                       Matt Reel, Staff Director
               Maria Tripplaar, Republican Staff Director
                            C O N T E N T S

                              ----------                              

                             March 2, 2022

                                SENATORS

                                                                   Page
Tester, Hon. Jon, Chairman, U.S. Senator from Montana............     1
Moran, Hon. Jerry, Ranking Member, U.S. Senator from Kansas......     4
Cassidy, Hon. Bill, U.S. Senator from Louisiana..................    17
Boozman, Hon. John, U.S. Senator from Arkansas...................    19
Sullivan, Hon. Dan, U.S. Senator from Alaska.....................    23
Tillis, Hon. Thom, U.S. Senator from North Carolina..............    27
Hassan, Hon. Margaret Wood, U.S. Senator from New Hampshire......    28
Blumenthal, Hon. Richard, U.S. Senator from Connecticut..........    61

                            REPRESENTATIVES

Levin, Hon. Mike, U.S. Representative from California............     2
Bost, Hon. Mike, Ranking Member, U.S. Representative from 
  Illinois.......................................................     5
Takano, Hon. Mark, Chairman, U.S. Representative from California.    12
Radewagen, Hon. Aumua Amata Coleman, U.S. Representative from 
  American Samoa.................................................    18
Brownley, Hon. Julia, U.S. Representative from California........    18
Rosendale, Hon. Matthew, U.S. Representative from Montana........    20
Pappas, Hon. Chris, U.S. Representative from New Hampshire.......    22
Sablan, Hon. Gregorio Kilili Camacho, U.S. Representative from 
  Northern Mariana Islands.......................................    24
Slotkin, Hon. Elissa, U.S. Representative from Michigan..........    25
Ruiz, Hon. Raul, U.S. Representative from California.............    26
Mrvan, Hon. Frank, U.S. Representative from Indiana..............    29
Banks, Hon. Jim, U.S. Representative from Indiana................    30
Gallego, Hon. Ruben, U.S. Representative from Arizona............    31
Underwood, Hon. Lauren, U.S. Representative from Illinois........    51
Bergman, Hon. Jack, U.S. Representative from Michigan............    55
Cawthorn, Hon. Madison, U.S. Representative from North Carolina..    58
Trone, Hon. David, U.S. Representative from Maryland.............    59

                       INTRODUCTION OF WITNESSES

Ryan Gallucci, National Service Director, Veterans of Foreign 
  Wars...........................................................     6

The Honorable Mike Bost, U.S. Representative from the State of 
  Illinois.......................................................     7

                               WITNESSES
                                Panel I

Matthew ``Fritz'' Mihelcic, Commander in Chief, Veterans of 
  Foreign Wars...................................................     7

  accompanied by

  Patrick Murray, National Legislative Director, Veteran of 
    Foreign Wars

  Ryan Gallucci, National Service Director, Veterans of Foreign 
    Wars

  Jay Hoffman, Legislative Committee Chair, Veterans of Foreign 
    Wars

                                Panel II

Jeremy Butler, CEO, Iraq and Afghanistan Veterans of America.....    33
Michael S. Linnington, Lieutenant General, U.S. Army (Ret.), CEO, 
  Wounded Warrior Project........................................    35
Jack McManus, National President, Vietnam Veterans of America....    37
Greg Heun, National Commander, American Veterans.................    38
Kathryn Monet, Executive Director, National Headquarters, 
  National Coalition for Homeless Veterans.......................    40
Lory Manning, Captain (Ret.), Director of Government Operations, 
  Service Women's Action Network.................................    42
Joseph D. McNeil, Sr., National President, Blinded Veterans 
  Association....................................................    43
Victor LaGroon, Director, Black Veterans Empowerment Council.....    46
Thomas Palladino, President and Executive Director of the Texas 
  Veterans Commission, National Association of State Directors of 
  Veterans Affairs (NASDVA)......................................    47

                                APPENDIX
                          Prepared Statements

Matthew ``Fritz'' Mihelcic, Commander in Chief, Veterans of 
  Foreign Wars...................................................    69
Jeremy Butler, CEO, Iraq and Afghanistan Veterans of America.....   103
Michael S. Linnington, Lieutenant General, U.S. Army (Ret.), CEO, 
  Wounded Warrior Project........................................   116
Jack McManus, National President, Vietnam Veterans of America....   152
Greg Heun, National Commander, American Veterans.................   192
Kathryn Monet, Executive Director, National Headquarters, 
  National Coalition for Homeless Veterans.......................   209
Lory Manning, Captain (Ret.), Director of Government Operations, 
  Service Women's Action Network.................................   216
Joseph D. McNeil, Sr., National President, Blinded Veterans 
  Association....................................................   226
Victor LaGroon, Director, Black Veterans Empowerment Council.....   235
Thomas Palladino, President and Executive Director of the Texas 
  Veterans Commission, National Association of State Directors of 
  Veterans Affairs (NASDVA)......................................   238

 
LEGISLATIVE PRESENTATION OF THE VETERANS OF FOREIGN WARS OF THE UNITED 
 STATES AND MULTI VSOs: IAVA, WWP, VVA, AMVETS, NCHV, SWAN, BVA, BVEC, 
                                 NASDVA

                              ----------                              


                        WEDNESDAY, MARCH 2, 2022

             U.S. House of Representatives,
                                   and U.S. Senate,
                            Committee on Veterans' Affairs,
                                                    Washington, DC.
    The Committees met, pursuant to notice, at 2 p.m., in Room 
210, House Visitors Center, Hon. Jon Tester, Chairman of the 
Senate Committee on Veterans' Affairs, presiding.

    Present:

    Representatives Takano, Brownley, Lamb, Levin, Pappas, 
Mrvan, Sablan, Underwood, Allred, Slotkin, Trone, Ruiz, 
Gallego, Bost, Radewagen, Bergman, Banks, Roy, Cawthorn, 
Rosendale, Miller-Meeks, and Ellzey.

    Senators Tester, Murray, Brown, Blumenthal, Sinema, Hassan, 
Moran, Boozman, Cassidy, Tillis, and Sullivan.

        OPENING STATEMENT OF HON. JON TESTER, CHAIRMAN,
                   U.S. SENATOR FROM MONTANA

    Chairman Tester. I call this Joint Session of the Senate 
and House Veterans' Affairs Committee to order.
    Commander Mihelcic, I want to thank you for being here 
today. I appreciate your advocacy on behalf of our Nation's 
veterans and their families.
    This is a crucial moment. As the veterans emerge from a 
year-long pandemic, Congress and VA must not forget the lessons 
that we have learned. Now we know that, with the right 
resources, coordination, and authorities, we can accomplish 
almost anything. That is why going back to normal can't be our 
goal; we have to do better than normal. That means doing a 
better job of connecting aging veterans to long-term care 
options that suit them the best, including the caregivers 
program. That means ensuring the claims backlog is addressed in 
a way that doesn't sacrifice quality for speed. And it means 
doing absolutely everything in our power to ensure veterans are 
connected to the care and the benefits they deserve in a more 
timely manner.
    Since I introduced the Cost of War Act last year, we have 
seen a lot of progress. VA has created a new presumptive 
process that has added dozens of new presumptions, including 
the nine announced yesterday by the President.
    To put that in perspective, over the previous 8 years, only 
four conditions were added, and three of those--bladder cancer, 
hypothyroidism, and Parkinsonism--were only added because of a 
Tester amendment, interestingly enough, to the 2021 Defense 
Authorization Act, which forced the Administration to do so.
    So, in my view, we can't just rely on the executive branch 
of Congress because we have a constitutional duty to do our job 
as the legislative branch on behalf of our veterans.
    But for us to get comprehensive toxic exposure legislation 
done, which we all want, the political games, the political 
posturing, and the questioning of motives really does need to 
stop. If we are going to fulfill our obligation to veterans, we 
need to roll up our sleeves and we need to do our jobs, and we 
need to work together in a bipartisan and bicameral way to 
deliver the results that you have earned and that you deserve.
    So I look forward to our conversation today and thank you 
again for being there. We await your marching orders.
    I will kick it over to Congressman Levin for the Chairman's 
response.

                        HON. MIKE LEVIN,
              U.S. REPRESENTATIVE FROM CALIFORNIA

    Mr. Levin [presiding]. Well, thank you, Senator Tester. It 
is an honor to join all the members of the House and Senate 
Committees on Veterans' Affairs in person and virtually to hear 
directly from the organizations that represent our Nation's 
veterans about the issues that matter most to them.
    I would like to personally welcome Mr. Fritz Mihelcic, 
Commander in Chief of the VFW, and the leaders of all nine 
organizations on our second panel. I am grateful for your 
tireless work on behalf of our Nation's veterans, their 
families, and survivors.
    The opportunity to hear from our VSO partners is incredibly 
important to me. I was encouraged to see the overwhelming 
support that VFW and other VSOs provided last Thursday in a 
letter to House leadership supporting the Honoring Our PACT 
Act.
    Chairman Takano asked me to express his deep regret that he 
can't be with us today, as he is currently on the House floor, 
fighting to pass the PACT Act, but he asked that I thank you 
all for the tremendous support you have provided during this 
process.
    Chairman Tester, I would like to submit the letter from our 
VSO partners into the record, if there is no objection.
    Chairman Tester. Without objection.
    Mr. Levin. The bipartisan PACT Act will finally provide 
access to VA health care to over three and a half million 
veterans exposed to toxic substances. It requires that VA 
presume certain veterans were exposed to toxic substances 
rather than placing the burden on veterans to prove this link 
themselves.
    Vietnam veterans waited more than 40 years for benefits 
related to Agent Orange exposure because of Congress' piecemeal 
solutions. We cannot allow this to happen again.
    Toxic-exposed veterans have held up their part of the pact 
and now it is our turn. Today, we are keeping our promise, and 
we look forward to working with the Senate to make this law.
    VSO partners like the VFW, and all those who are joining us 
today, represent veterans and their families at all stages of 
life and service. Hearing from these partners allows the 
committees the opportunity to hear directly about what is most 
important to your members and how we can be of service to our 
Nation's veterans.
    In the last Congress, together, we secured several 
important wins for veterans, including passing the Blue Water 
Navy Vietnam Veterans Act, the Deborah Sampson Act, the 
Veterans COMPACT Act, the Commander John Scott Hannon Act, and 
the Isakson-Roe Act.
    We are very proud of these accomplishments, but they are 
only the beginning. We need to build on these achievements and 
continue our fight for better health care and benefits in this 
Congress and beyond.
    I have read your testimony and it is clear that I share 
your priorities.
    The House Veterans' Affairs Committee's top priorities for 
this Congress include creating a more inclusive and welcoming 
VA; building equity for an increasingly diverse veteran 
community; reducing veteran suicide; addressing toxic exposure; 
ensuring student veterans receive quality education; advocating 
for women veterans; modernizing VA; supporting VA's long-term 
care facilities; improving VA's management and oversight; and 
ensuring our legislative accomplishments are implemented 
effectively.
    Our diverse veteran community includes higher numbers of 
women, LGBTQ+, Black, Asian, Hispanic, and Native veterans than 
ever before. Today, we have the honor of welcoming two new 
organizations, Service Women's Action Network and the Black 
Veterans Empowerment Council, to the conversation. This marks 
the first time that these two organizations have participated 
in our spring VSO hearings and continues this committee's new 
tradition of welcoming these voices to the witness table.
    It is our country's diversity that strengthens our Armed 
Forces and veterans communities, and minority veterans deserve 
to feel safe and welcome when they enter VA's doors, with 
outreaching, programming, and solutions that address their 
unique needs.
    Additionally, VA must acknowledge the diversity of its 
workforce to address systemic discrimination in the workplace. 
We must ensure that health care and benefits are fairly and 
equitably distributed to all eligible veterans and, to do that, 
we must ensure a safe and equitable workplace for VA employees.
    Our work to prevent veteran suicide also continues. We must 
relentlessly pursue well-researched and scientifically sound 
policies that are proven to prevent suicide.
    We have big goals, but I know that with your support and 
insight here today, along with the support of the Biden/Harris 
administration, we will be able to deliver on them and fulfill 
the promises we have made to our Nation's veterans.
    I look forward to hearing your testimony today and thank 
you for your continued advocacy and support for the veteran 
community.
    I will yield back.
    Chairman Tester. The outstanding Senator from Kansas, 
Senator Moran.

             OPENING STATEMENT OF HON. JERRY MORAN,
            RANKING MEMBER, U.S. SENATOR FROM KANSAS

    Senator Moran. Mr. Chairman, thank you very much. I welcome 
you and us joining our House colleagues for the hearing today. 
I welcome the Commander in Chief of the Veterans of Foreign 
Wars, and our panelists that follow this first panel, and I am 
all ears and interested in hearing what is said, and how we can 
react and respond to make sure that those requests are honored.
    I welcome all of our witnesses and I welcome all of the 
veterans, and particularly members of veterans service 
organizations, at home, who are watching today's hearing, and I 
highlight the number of Kansans who are doing that and I thank 
them for their input to me on an ongoing basis.
    We have accomplished a lot together in recent years: 
legislation to reduce veteran suicide; improve access and 
choice in health care; resources to improve disability claims 
and the appeals process; educational benefit protection 
expansion; flexibility to assist veterans through the COVID-19 
pandemic.
    I expect these bipartisan efforts to continue. It gives me 
pleasure, Chairman Tester, to tell Kansans when I am home and 
visiting about the partisanship or the divide in the country 
and in this Congress, that while I prefer to be the chairman of 
the committee, you can't tell a lot of difference in the 
outcome and the ability for us to work together whether it is 
Chairman Tester or Chairman Moran, and I am grateful for that. 
And Kansans are assured, reassured that there is a circumstance 
in which maybe the partisanship of this place is set aside--and 
they want that many more places than it exists, but they are 
pleased to know that it is true when it comes to caring for our 
men and women who have served our country, and I appreciate 
that very much.
    And I continue to commit to working with you, Chairman 
Tester, to see that we get outcomes. I always appreciate being 
complimented for my efforts, but I would love to be 
complimented for my results.
    We have a lot yet to discuss on how to appropriately 
address toxic exposure, both on the health care and disability 
compensation side, and I thank the chairman again and 
Representative Ranking Member Bost for our work on the Health 
Care for Burn Pits Veterans Act. And I look forward to working 
with all House members and Senators in whatever party to find a 
solution that is in the best interests of all veterans.
    We need the VSOs' advocacy, their partnership. I appreciate 
the relationships I have with each of you and your 
organizations and your members, and we have a lot that we can 
do with your information and knowledge. I always indicate that 
mostly what I know about what should be my job on this 
committee is what veterans at home tell me should be my job on 
this committee, and it often, unfortunately, comes through what 
we call case work, somebody bringing us a problem that they 
have. We work hard to solve the problem for that veteran, but 
it also is a reminder that other veterans are in similar 
circumstances and we need to fix the system as well.
    Before I yield back, I want to again, as I did yesterday, 
thank all of our U.S. service members currently serving in NATO 
countries, including those from home in the First Infantry 
Division who are in Poland and Romania, and we have had a lot 
of folks recently deployed as well from other places across the 
country. I hope the Ukranian people and I hope that the service 
men and women of the United States of America know that they 
are in our thoughts and prayers and, just as they are serving 
us today, our commitment to them will be the same as those who 
have served us in the past. We will do everything to honor your 
service and make sure that the promises that were made to you 
are kept.
    Again, I thank you for being here. I look forward to your 
testimony.
    And I yield back, Mr. Chairman.
    Chairman Tester. Ranking Member Bost.

              OPENING STATEMENT OF HON. MIKE BOST,
       RANKING MEMBER, U.S. REPRESENTATIVE FROM ILLINOIS

    Mr. Bost. Thank you, Mr. Chairman. And I want to thank you 
and Ranking Member Moran, and I know that Chairman Takano is on 
the floor. I would be on the floor, but the pretest that we had 
to have before we were to go to the State of Union last night, 
Monday, when I did that, they discovered COVID. And I feel 
great, but I am coming to you from a quarantine in a hotel 
room. But it is good to be with you.
    And for those of you that have not met me yet, my name is 
Mike Bost. I know what it is like to put on the uniform and 
serve this Nation, I also know what it is like to take it off 
that uniform and transition back to civilian life. Like many of 
you, the principles I learned in the Marine Corps still have 
application today.
    I also know what it is like to file a claim for benefits, 
and to be denied and denied and denied, and that is why it is 
that I am so passionate. And the other reason I am so 
passionate is, not only am I a veteran, I have a father who 
served in Korea and a grandfather who served in Korea; an uncle 
who served in Vietnam that was a victim of the ultimate 
oxymoron friendly fire, he is doing well today, but he is 100-
percent disabled. And also my son is a Lieutenant Colonel in 
the Corps, and my grandson is a Lance Corporal in the Corps.
    So it is very personal to me the issues that we face and 
these joint hearings that we are doing annually are vitally 
important to get your input, so that we can have it to carry 
your ideas and your concerns to try to correct those problems. 
And it is vital that we meet with the VSO leaders and the 
members from across the country like those that we are meeting 
with today. You understand the complex problems veterans and 
their families face, and what VA can do better to help them.
    Your advocacy here in D.C. and your service throughout the 
country makes a difference.
    The COVID-19 pandemic created a hardship for veterans in 
all walks of life. Volunteer activities suffered during the 
past 2 years. VFW and the members of the VSOs represented here 
today are needing more than ever to be advocates for the 
veterans, understanding their needs and helping them navigate 
the VA bureaucracy.
    I want to thank each and every one of you for your service 
in uniform and your continued service.
    I am proud of what we have accomplished together in the 
first session of this Congress. We expanded VA's ability to 
offer vaccines to veterans and their families; we improved 
veterans job training and education; we increased transparency 
of VA's COVID emergency funds; we provided new mental health 
resources, especially for rural veterans; we strengthened 
security in VA medical centers; we passed the largest veterans 
cost-of-living increase to cushion the impact of rising 
inflation.
    I am also proud that the VA cut through red tape to fill 
thousands of medical positions. And the veterans suicide rate 
went down for the first time in years, but we have a lot more 
to do. But, as you know, our work--and you know our work is 
never over.
    The most important issues we are working on right now is 
supporting toxic-exposed veterans. Each of us have made 
improving care and benefits for toxic-exposed veterans our top 
priority this Congress. I know it is only March, but time is 
getting painfully short. It is time for us to put our heads 
together and work across the aisle and across the Capitol to 
get this done for veterans.
    I understand that passage of a single, comprehensive 
package is preferred by many. I believe we must take action 
where we can and give toxic-exposed veterans health care now. 
With the Senate's unanimous passage of the Health Care for Burn 
Pits Veterans Act in February, we have that opportunity. The 
House should pass the Health Care for Burn Pits Veterans Act 
today; it is the right first step. And then we should work 
together to deliver the other benefits and services toxic-
exposed veterans need and deserve as soon as possible.
    I again want to thank Senator Tester and Moran for their 
leadership and for finding a viable path forward to address the 
health care needs of toxic-exposed veterans. Your organizations 
have also been a critical advocate on toxic exposures.
    I thank you for the work that you have done and I thank you 
for the work I know you will keep doing until we get to the 
finish line. I know that all of you will continue to fight for 
the best interests of this Nation and our veterans, and I 
promise you that I will do it as well.
    And, with that, I will yield back.
    Chairman Tester. Next, I want to introduce Ryan Gallucci, 
who will introduce the VFW team, and then kick it back to 
Ranking Member Bost, who will introduce Commander Mihelcic for 
the opening statement.
    You have the floor, Mr. Gallucci.

                 INTRODUCTION BY RYAN GALLUCCI

    Mr. Gallucci. Thank you, Mr. Chairman.
    Members of the Senate and House Veterans' Affairs 
Committees, we look forward to the day when once again the VFW 
and our Auxiliary can pack this room to hear from our National 
Commander. But, thankfully, many are still able to join us via 
video link at the Hyatt, Crystal City, and it is my honor to 
introduce them.
    First, from the VFW Auxiliary, National President Jean 
Hamil from Florida. Next, our National Officers of the VFW; 
Senior Vice Commander in Chief Tim Borland from Arizona; Junior 
Vice Commander in Chief Dwayne Sarmiento from New Jersey; our 
past Commanders in Chief, our national officers, our National 
Council of Administration; all our VFW and Auxiliary leaders 
and staff; as well as the VFW and Auxiliary members watching 
around the world, especially our comrades like VFW National 
Staff member Tara Artiaga, our claims representative from San 
Juan, Puerto Rico, who is currently deployed supporting NATO on 
the doorstep of the war in Ukraine.
    Finally, joining here at the table, to my left, Director of 
the VFW National Veterans Service, Patrick Murray from Rhode 
Island; and, to my right, Chairman of the VFW National 
Legislative Committee, Jason Hoffman from Illinois.
    Thank you, Mr. Chairman.
    And now to introduce our Commander in Chief of the Veterans 
of Foreign Wars of the United States, ranking member of the 
House Veterans' Affairs Committee, Mike Bost, representing 
Illinois' 12th District.

            INTRODUCTION BY THE HONORABLE MIKE BOST

    Mr. Bost. Well, thank you. And, once again, it is good to 
have everybody here.
    Yes, I am pleased to introduce my constituent, VFW's new 
Commander in Chief, Matthew M. Fritz--Mihelcic, who is with us 
today from Sparta, Illinois.
    As a lifetime member of Post 2698 in Sparta, Fritz has been 
a member of the VFW for more than 30 years. He has long been a 
leader in our Southern Illinois community and I am grateful 
that he is now leading our veterans on the national stage.
    Fritz served in the United States Air National Guard from 
1989 to 1999, with the 131st Tactical Fighter Wing. He deployed 
overseas from 1990 to 1991, during Desert Shield and Desert 
Storm, as a security policeman. We like to refer to those as 
MPs. And he then went on to hold a number of vital leadership 
positions at the local, State, and national level.
    Fritz, thank you for your service then and now. There is a 
special place for Americans who are willing to dedicate their 
lives to serving a cause greater than one person or a place. 
Veterans across the country are lucky to have you at their 
side, both as an advocate and as a friend, and I am proud to 
count myself among them.
    With that, I will now turn it over to you, Fritz.

                            PANEL I

                              ----------                              


            STATEMENT OF MATTHEW ``FRITZ'' MIHELCIC,

                         ACCOMPANIED BY

         PATRICK MURRAY, RYAN GALLUCCI; AND JAY HOFFMAN

    Mr. Mihelcic. Thank you very much.
    Before I begin my remarks, I would like to point out my 
Legislative Chairman, Jay Hoffman, who is sitting next to me. 
Today, Jay is wearing his Korean War Veteran grandfather's VFW 
cap, and that is very special to Jay and it shows what the VFW 
is all about: family, tradition, and generations of service. 
So, thank you, Jay.
    Chairman Tester and Takano, Ranking Members Moran and Bost, 
members of the Senate and House Committees on Veterans' 
Affairs, it is my honor to be with you today on behalf of the 
1.5 million members of the Veterans of Foreign Wars of the 
United States and its Auxiliary, America's largest wartime 
veterans organization.
    I would like to thank the members of the committee on your 
hard work for veterans in the 117th Congress. During a time of 
divisive partisanship and a global pandemic, you have worked 
across the aisle and across chambers to pass legislation to 
improve the care and benefits for America's veterans, families, 
and caregivers. The House and Senate Committees on Veterans' 
Affairs continue to remain as shining examples of how work 
should be conducted in Washington, DC.
    For generations, veterans have returned home from war with 
an array of unexplained health conditions and illnesses 
associated with the toxic exposures and environmental hazards 
they encountered in service. Today is no different and toxic 
exposure has become synonymous with military service. For this 
reason, the time is now for Congress to change the way veterans 
receive health care and benefits to help save our lives.
    At this joint hearing last year and in hearings in April 
and May 2021, the VFW called upon Congress to work in a 
bipartisan manner and with veterans service organizations to 
develop a comprehensive solution for toxic exposure. You heard 
our message and you took several pieces of VFW-supported 
legislation and put them together.
    The VFW supports Senate bill S. 3003, Cost of War Act of 
2021; and House bill H.R. 3967, Honoring Our PACT Act of 2021.
    We are also encouraged by the bipartisan and bicameral 
efforts to move each component of these larger bills across the 
finish line, such as H.R. 6659 and S. 3541, but these are just 
first steps in a long-overdue process.
    These historic pieces of legislation would help millions of 
veterans exposed to toxins. They would address the still-
lingering conditions and locations for Vietnam War veterans 
exposed to Agent Orange. It would take care of atomic veterans 
and veterans from K-2 base in Uzbekistan. Each has a 
significant focus on burn pits and improving the Department of 
Veterans Affairs disability claims process.
    The time is now to pass these bills and finally address the 
needs of sick and disabled veterans.
    We must work together to reconcile these two comprehensive 
legislative packages and pass a final bill swiftly. We must 
learn from the past and not delay any longer. We must end the 
piecemeal approach of addressing the problem one disease and 
one location at a time. We must fix the process now for all 
veterans of the past, present, and future. This is all the more 
timely as even now our troops who guard the gates of freedom 
face uncertainty in Europe and all around the world.
    In order to utilize the care and benefits veterans have 
earned, they must have faith and confidence in a dependable and 
veteran-focused claims process.
    Due to the chaos of the COVID-19 pandemic, veterans faced 
unprecedented challenges in accessing and understanding their 
rights to competent representation for benefits claims. As a 
result, bad actors seized the opportunity to aggressively 
target veterans online, seeking to charge predatory fees to 
assist with benefit claims. While we never stopped working for 
veterans, the VFW has learned a great deal about how to better 
communicate the right to no-cost, quality representation. And 
we look forward to working with VA to clamp down on those bad 
actors.
    Adjudicating certain claims such as toxic exposure, PTSD, 
and military sexual trauma, also known as MST, requires 
specialty training and regular oversight.
    According to a 2018 VA OIG report, VA incorrectly 
adjudicated half of the reviewed PTSD claims for MST. The OIG 
indicated six specific recommendations for VA to review and 
correct denied claims, and to implement a series of changes 
needed to improve claims processing for MST. Regrettably, the 
most recent OIG report just 6 months ago found that VA had not 
effectively implemented those recommendations.
    The time is now to fix this.
    VA's national screening program screens all patients 
enrolled in VA for MST. National data from this program 
revealed that about one in three women and 1 in 50 men respond 
affirmatively to having experienced sexual trauma while serving 
their country. All veterans who screen positive are offered a 
referral for free MST-related treatment. The VFW believes this 
should start a similar process that refers veterans who have 
experienced MST to also begin the claims process immediately.
    Forcing these veterans to fight again and again for 
treatment and benefits they have earned is not only cruel and 
unnecessary, it creates a duplicative appeals claims process. 
The best way to ensure veterans receive the care and benefits 
they have earned is to get it right the first time.
    To address the current workload of VA disability claims, 
the VFW believes that there is only so much more hiring 
personnel will accomplish, and it will take time to train this 
new influx of hires.
    The VBA also needs significant investment in its IT claims 
processing infrastructure to move to a single, unified system, 
and that includes the latest in automation and artificial 
intelligence technologies. A digital benefits upgrade, similar 
in scope to the GI Bill, would require a significant investment 
in VA's IT budget and a strong collaboration with VSOs that 
provide claims representation.
    We commend VA for embracing technology upgrades such as the 
digital GI Bill, and we look forward to all the positive 
outcomes this new platform will bring.
    Benefits like the GI Bill, VR&E, VA home loans, and VET TEC 
all set up veterans for success. The transformative benefits 
under VBA need to be enhanced, protected, and championed at all 
times, and that is why the VFW calls for the creation of a 
fourth estate, a fourth administration, so the C&P benefits and 
the readjustment benefits currently within VBA can have their 
own under secretaries who can truly focus and grow each 
respective set of benefits.
    The VFW believes a proper and well-rounded transition from 
the military is one of the most important things our service 
members need in order to ease back into our society with 
minimal hardship. To that extent, the VFW places great emphasis 
on ensuring veterans receive the best counseling and mentorship 
before they leave military service.
    The VFW is happy to see some changes that have been made in 
the TAP program in the past years in order to bring a more 
tailored, personalized experience to transitioning service 
members, and increasing access to family members. We are 
pleased to see DOD and VA have finally begun implementing a 
single, unified electronic health record. However, the VFW sees 
additional areas for improvement, such as including accredited 
service officers in the formal TAP curriculum.
    Additionally, we want to see, as the law requires, a proper 
connection between service members and organizations in the 
community that already receive Federal grant funding for this 
critical mission.
    Separating service members need to be informed about all of 
the available care and benefits they have earned through their 
service, and that is difficult to achieve in only 5 days. 
Transition information needs to be pushed to service members 
throughout their time in uniform and TAP classes need to be 
restructured so service members are not, as we have so often 
heard, drinking from a fire hose.
    Specific care and benefits are important for all veterans 
and it is important we highlight the needs of some who in the 
past have been overlooked. Minority veterans' health outcomes 
are affected by real and perceived bias. As the population of 
minority veterans continues to grow, VA needs to adapt to meet 
the need for access to both health care and benefits services.
    Women, LGBTQ+, racial, and ethnic minorities face barriers 
and challenges across different life domains. We need to know 
the specific demographics and needs of that veteran population. 
The VFW urges VA to ensure that all VA forms and research 
capture this valuable basic demographic information to 
correctly track needs, benefits, and services. Until this is 
corrected, inconsistent data hinders proper and inclusive 
research.
    For years, VFW has come to Congress concerned about veteran 
suicide. We have all worked together on a number of innovations 
to try to address this national tragedy. Sadly, without proper 
demographic data and reporting on all aspects of VA usage to 
include benefit usage, it is impossible to know which programs 
are actually helping.
    Our veterans should receive first-rate care in our 
facilities. When COVID-19 hit, the VA health care system was 
the only health care network in the country to not only 
withstand the unprecedented challenge, but to also provide help 
through the fourth mission in towns and U.S. cities across the 
U.S.
    Unfortunately, VA's aging infrastructure needs increased 
attention. VA's aging infrastructure not only causes many 
veterans to wait too long and to travel too far for care, but 
also potentially endangers the health and lives of veteran 
patients and VA personnel.
    To overcome VA's infrastructure challenges, Congress must 
not only provide significantly increased funding to fully 
address these long-standing issues, but also enact 
comprehensive planning, budgeting, management, and oversight 
reforms to ensure more effective use of those funds. The VFW 
recommends VA's construction budget be approximately 3 percent 
of its overall operating budget annually.
    Lastly, the VFW honors our solemn oath to never leave our 
brothers and sisters, our comrades in arms, behind. We must 
never leave any missing or unaccounted-for Americans behind on 
battlefields of the past, the present, or, yes, the future. We 
urge Congress to continue fully funding and supporting the 
critical mission of the Defense Personnel Accounting Agency to 
make sure we bring every American service member home.
    Chairman Tester and Takano, Ranking Members Moran and Bost, 
other distinguished members of these committees, speaking for 
all of the members of the Veterans of Foreign Wars and its 
Auxiliary, and on behalf of millions of service members, 
veterans, and their families around the world, I would like to 
thank you for your time and attention.
    I will leave you with my call to action and remind 
everybody that the time is now to address these critical 
issues.
    Thank you. This concludes my remarks and I am prepared to 
answer any questions you may have.

    [The prepared statement of Mr. Mihelcic appears on page 69 
of the Appendix.]

    Chairman Tester. Commander Mihelcic, thank you very much 
for those comments.
    Before I get to my questions--and, by the way, for the 
members of the House and the Senate, the questions will be 3 
minutes, not 5 as usual--I do want to recognize the VFW members 
that are viewing this hearing via video, I believe in a hotel 
in Crystal City, if I am not mistaken. And so welcome to all of 
the folks that are watching the action here in the hearing 
room. It is good to have you here.
    Commander Mihelcic, thank you very much for your testimony. 
You wrote that any VA presumptive process should be codified so 
that future administrations will continue to be held to the 
same standard. I hear what you are saying and I agree with what 
you are saying, but could you flesh that out a little more and 
talk about what could happen if we don't?
    Mr. Mihelcic. Thank you, sir.
    When it comes to administrative law, we know things can 
change easily with a changing administration or a changing 
viewpoint from the top. When you have that going on, veterans 
are left in a vacuum, they don't know from day to day what is 
going to happen. By codifying these ideas, by codifying this, 
we put it into law, we place it in your capable hands to pass a 
law, and it will stay there. It will not be open to the 
vagaries of politics, but it will be open to what the people 
want, veterans' care.
    Chairman Tester. Thank you very much.
    I would like to get the VFW's general views on VA care. 
Would it be fair to say that most of your members prefer 
getting their health care from the VA?
    Mr. Mihelcic. Through anecdotal evidence, we have found 
that, yes, indeed, we do enjoy VA care. When you go to a VA 
facility for health care, they know you; they know you are a 
veteran, they want to take care of you, they understand what 
you have been through. You don't get that in the private 
sector.
    Chairman Tester. Do you and your members believe that 
community providers should be held to the same standard as we 
hold VA providers?
    Mr. Mihelcic. Of course. We have medical standards all 
over. I would say that, if we have a standard, anyone who 
provides care to a veteran must uphold that standard.
    Chairman Tester. And then, finally, on the VA care front, 
is the VA helping veterans make informed decisions about where 
to get care by comparing quality at the Department and the 
community?
    Mr. Mihelcic. We do need more outreach. I fear that our 
veterans don't really know what is available to them or maybe 
they don't understand, and that is something VFW needs to do a 
better job about. We can reach out to millions of veterans and 
let them know what they can do and what they can't do, but it 
has to be a partnership between the VA, the VFW, and other 
VSOs.
    Chairman Tester. So, in your testimony, you said that 
through advocates like the VFW veterans can get free and 
competent help to file a claim. However, you also warned about 
bad actors targeting veterans with predatory fees for claim 
assistance. What should Congress be doing to protect veterans 
from being exploited?
    Mr. Mihelcic. Well, much like any time when you have bad 
actors exploiting the population in general, such as usury 
laws, you can come out and say we will not stand for this. If 
there is bad advertising, if there is any way that someone 
comes forward and says, you are a veteran, I can assure you you 
will get 100 percent, and, if we don't, don't worry, we will 
take it to appeal, all of this adds up.
    Many of our veterans are not as savvy when it comes to law 
and that is why we come forward and we tell people this is what 
you can do.
    Chairman Tester. Thank you.
    Chairman Takano is now in the house, so I will recognize 
him for his questions.

                  HON. MARK TAKANO, CHAIRMAN,
              U.S. REPRESENTATIVE FROM CALIFORNIA

    Chairman Takano. Thank you, Chairman Tester.
    Commander Mihelcic, good to see you again, good to see you 
this morning. I just came off the floor of the House. We 
concluded debate on the PACT Act. We are going to consider a 
couple amendments tomorrow, three amendments tomorrow, but we 
are pretty much done with the debate on the underlying bill, 
but one of the principal objections that was raised to the bill 
was its cost. And, as an example, as a corollary to that 
example, a big sign was posted that veterans are taxpayers too.
    You know, I understand that we are all taxpayers, but do 
you believe, sir, Commander, that--do you believe that your 
members, your veteran members would be willing to use taxpayer 
dollars to provide benefits that we make available in the PACT 
Act to compensate veterans who are ill from exposure to things 
like burn pits?
    Mr. Mihelcic. Veterans stand united in this. The cost of 
war includes the cost of peace. Dollars have to be spent to 
take care of our sick and disabled veterans, and I can assure 
you that veterans will stand behind you 100 percent to get this 
PACT Act across the finish line.
    Chairman Takano. I thank you for that.
    What strikes me is that we have both political parties 
falling over themselves to offer more assistance to Ukraine, 
which I heartily approve of, I side with and I stand with 
freedom-loving people who are being besieged by bullies, but I 
am wondering where is the one-upmanship when it comes to the 
unfinished business of keeping our promise to our veterans? Can 
we not expect a political environment or create one in which 
both political parties fall over themselves to make sure that 
we take care of our veterans who have been exposed to toxic 
exposures?
    Mr. Mihelcic. It is unfortunate that, when the peace comes, 
people forget about veterans. So we have to provide more 
diligence and get out to our veteran community, but Congress 
can also do that. You have the larger voice. We saw that last 
night when the President spent a lot of time talking about 
veterans and veterans' issues. That will get the public's 
attention.
    So we are fully engaged and fully committed to make 
everyone aware that veterans' issues are important, they are 
not going away, and with things going on in Ukraine today, we 
have our troops stationed nearby. Will they be the next people 
downwind from a toxic exposure? This will never go away.
    Chairman Takano. Well, thank you, Commander. I was very 
proud to see our President mention veterans, the word 
``veteran'' many times over, I guess three times more than the 
last three State of the Unions. So I was very pleased that so 
much time was devoted to veterans.
    I yield back.
    Mr. Levin [presiding]. Thank you, Chairman Takano.
    I now recognize Senator Moran for questions.
    Senator Moran. Thank you, Congressman.
    Commander, hello again. I failed in my comments earlier to 
thank you for your presence in Kansas City. It is a little bit 
across the State line, but we are proud to have the 
headquarters of the VFW so close in our neighborhood. And also 
the VFW Auxiliary, I should have mentioned their importance and 
value in serving veterans, and I thank them and their members 
and their leadership.
    The VA provided views on the Cost of War Act in July of 
last year and Secretary McDonough noted that he has, quote, 
``authority to establish regulatory presumptions of service 
connections where no statute expressly provides such 
presumptions,'' end quote.
    I understand the conversation, the testimony in response to 
Senator Tester's question about the value of having Congress 
address these, but I want to again point out that the Secretary 
admits and it is our view he has--a Secretary has the authority 
to do so.
    In the last year and as recently as yesterday, the VA has 
taken action on 12 new presumptions, as we heard last night. 
There are still 20-something diseases across various bills 
being proposed as additional presumptions. The Biden 
administration indicated their support, as the chairman just 
indicated, for the PACT Act. Do you expect the VA to begin the 
rulemaking process to add these presumptions if they are 
supportive of the PACT Act and the Secretary admits that he has 
the authority to do so? While we take care of our legislative 
business, would it be appropriate for the Department of 
Veterans Affairs to proceed in their rulemaking to bring these 
presumptions online as quickly as possible, would that make 
sense?
    Mr. Mihelcic. Not only do I expect it, I demand it.
    Senator Moran. Thank you.
    Do you know any reason that the Administration would be 
reluctant to do that?
    Mr. Mihelcic. I don't see a reason. We can certainly have 
two things going at the same time. We can have VA continuing 
forward, working on new presumptions, which is within their 
right, it is a regulatory matter, but wouldn't it be better if 
society as a whole saw not only the VA, one small part of the 
Government doing that, but also these esteemed bodies in front 
of me coming out and saying we are on board, we are doing it 
too.
    Senator Moran. Commander, I appreciate you using the word 
``esteemed'' in front of these bodies. It is not something that 
is said every day these days. But I also would confirm or 
affirm to you that I too believe that the legislature, the 
Congress has a significant role. We are the lawmakers. In fact, 
I often complain that administrations do things that are in the 
realm of Congress' responsibility under our Constitution, but 
in this case we have granted the Secretary that authority to 
proceed.
    Let me ask a slightly different topic, on a different 
topic. I sent a letter to the President this week regarding the 
need to fill long-standing vacancies in critical positions at 
the Department of Veterans Affairs. Could you speak how the 
absence of an Under Secretary for Health and an Under Secretary 
for Benefits has impacted veterans and their dependents for 
health care and benefits?
    Mr. Mihelcic. These positions are leadership positions 
within the VA. If we don't have leaders, how can we address the 
needs of our veterans? We are fully on board. If people are 
coming up, if people need to be confirmed, we should get on 
that right away, get them in the leadership positions, let them 
do the job that they have been hired to do, and that is help 
veterans.
    Senator Moran. I thank you for both of your answers. I 
would highlight that, in addition to be confirmed, they also 
need to be nominated.
    Thank you.
    Mr. Levin. Thank you, Senator.
    I now recognize Ranking Member Bost.
    Mr. Bost. Thank you, Mr. Chairman.
    So I am going to go down a little different path, if I 
could, Fritz. I need to know because--one of the things you 
brought up that is very much a concern that we have been 
working on and that is the amount of veterans that are 
committing suicide. We know that it held for 20 years--or it 
has held for many, many years at 20 of those--now, it did fall 
in 2019 slightly, but it is still way too many. And of those 20 
that commit suicide a day, only six of them have ever sought 
help from the VA.
    And I am concerned about something, and I am going to guess 
you know too and if you have heard it, many of the veterans 
that I talk with don't seek help quite often because of a rule 
that has been put in place by the previous administrations and 
never been corrected, and that is the fact that if you seek 
help from the VA and you receive a fiduciary, that fiduciary 
being assigned to you automatically triggers that the veteran 
would be turned into the NICS program and they would lose their 
Second Amendment right.
    Are you aware of that?
    Mr. Mihelcic. Yes, sir, I am.
    Mr. Bost. Okay. Well, I have a bill, because I believe many 
of our veterans choose not to go to the VA because of that. How 
is that veterans who served and protect all of our rights in 
the Constitution can have their rights unconstitutionally 
removed and without a--what any person who is not a veteran 
would automatically get the opportunity to go before a judge 
and that judge would then rule if they were a danger to 
themselves or others, and that is the only way they can lose 
it.
    I am carrying a bill at this time and I know you are trying 
to support that, and I would like to have you comment on it, if 
you can, that basically takes that power away from the VA and 
allows it to go to the courts just like anybody else and you 
don't automatically get triggered for a fiduciary taking care 
of the veteran?
    Mr. Mihelcic. I appreciate that, sir. And of course, coming 
from southern Illinois, you know, we do enjoy the different 
rights that are afforded to us and of course the Second 
Amendment being one of those rights.
    We, the VFW, firmly believe that if we do not ask 
questions, we will not get people coming forward to tell us if 
they are contemplating or considering suicide. We certainly 
believe that it is appropriate to ask that question in a non-
mandatory, non-binding way, but to simply say, how are you 
feeling today? Have you had issues? Are there stressors? Is 
COVID-19 causing--do you have thoughts of harming yourself?
    The mere fact that we are asking that question, it is going 
to save lives. If we save one life, we can do that. I am not 
for automatically taking a person's firearms away because they 
are being truthful and they are seeking help.
    We fully support you in your goal and your effort, but we 
have to ensure that we still ask the question. A person can 
certainly decline to answer and that is within their right. But 
I believe, as you are saying, we need to have something going 
forward that VA personnel can talk to people. If we talk to 
them, we can help them.
    Mr. Bost. My time is expired, but I do want to say thank 
you to all of you for what you do because you are that front 
line that can meet with those. And I do thank you and I will 
continue to listen to the debate today, and I thank you all for 
being here.
    Mr. Levin. I thank the Ranking Member. I will recognize 
myself.
    Commander Mihelcic, thank you again for joining us today. 
And I want to give a special shout-out to VFW Post 10577 in 
Oceanside and 9934 in Dana Point, California, which both do a 
wonderful job of serving veterans in my district.
    As chair of the Economic Opportunity Subcommittee, I share 
several of the economic priorities you outlined in your 
testimony, such as ensuring funding for job training programs, 
extending COVID-related protections for student veterans, and 
creating parity between active and Reserve component education 
benefits.
    On that last item, I was thrilled that the House passed 
H.R. 1836, my Guard and Reserve GI Bill Parity Act, in January 
on an overwhelming bipartisan basis, and I want to thank VFW in 
particular. Your support was instrumental to achieving the 
outcome, and I hope that my Senate colleagues will advance the 
legislation soon.
    It is shameful that we have asked Guard and Reserve members 
to step up in response to natural disasters, the pandemic, and 
an attack on our democracy without crediting them for each day 
in uniform, and it is long past time that we provide some basic 
fairness in the way we allow Guard and Reserve members to 
accrue GI Bill benefits.
    Commander Mihelcic, can you speak to the impact this bill 
would have on veterans of the reserve components?
    Mr. Mihelcic. Speaking as a former Air Guardsman, this 
would be a wonderful benefit. When we sign up, we go through 
the same training, we are deployed at the same rates, we are 
put in the same situations as our active duty counterparts. To 
then say you are a second class soldier doesn't sit well. And I 
think since the Gulf War we have seen in this country that 
members of the Guard and Reserve are not second class soldiers.
    So we applaud your efforts in this. Every day in uniform 
should count toward a veteran benefit and we thank you for 
that.
    Mr. Levin. Thank you.
    What would you say to those who might argue that parity is 
unnecessary because service members know their GI Bill 
eligibility when joining the Guard or Reserve?
    Mr. Mihelcic. I can speak personally to that. When I 
enlisted in the Air Guard, I was already a judge in the real 
world. Nobody told me about GI Bills or benefits.
    When I returned from the war and was put back into regular 
Guard status, even as an attorney, I didn't know my benefits. 
Back then, we didn't have briefings for Guard, we didn't have 
TAP for Guard, we were left to our own devices. I say any 
information we can impart to our service members, whether they 
are active, Guard, or Reserve, that will make them better 
capable of understanding their rights and their earned benefits 
we have to do.
    Mr. Levin. And what would you say to those who are 
concerned about the cost of expanding eligibility?
    Mr. Mihelcic. Once again, if someone is willing to put on a 
uniform and go into harm's way on behalf of their country, what 
difference does it make whether they are Guard, Reserve, or 
active? They all go out, they all fight, they all bleed red, 
why should we not take care of them just as they are? They are 
all soldiers; whether they are full-time or citizen soldiers, 
we have to take care of them.
    Mr. Levin. Well, I am out of time, but, Commander, I look 
forward to working with you and VFW to get this across the 
finish line.
    And, Mr. Chairman, I will yield back.
    Chairman Tester [presiding]. Senator Cassidy.

                   HON. SENATOR BILL CASSIDY,
                  U.S. SENATOR FROM LOUISIANA

    Senator Cassidy. Thank you, Mr. Chairman.
    First, let me give a shout-out to all my Louisiana people. 
You survived Mardi Gras, you are up here the day after. So good 
to see you and good to see you kind of surviving the 
celebration.
    Commander, thank you all for all you have done and continue 
to do. I asked the question yesterday, I will ask it again 
today. I have learned that the majority of suicides among those 
who--of veterans are within the first 6 months after 
separating.
    Now, we have been pushing DOD and the VA to kind of 
coordinate their EHRs so that, hopefully, if somebody is 
identified at risk while in the DOD, there will be just a 
wraparound bubble, if you will, placed as this person 
separates.
    But I have also learned that the average time between 
leaving the service and your first appointment at the VA, the 
minimal time is 6 months, and yet most suicides occur within 
the first 6 months. I have asked the VA this. The VA says that, 
listen, they do everything they can to go to that point where 
somebody is separating and to--as you point out, when you 
signed up, nobody told you about benefits; when you left, 
nobody told you about benefits--to do the best they can to tell 
people about benefits and get them lined up with the services 
they need.
    So I guess my question to you--and maybe you will have to 
survey your members and get back to me--is to what degree is 
that working and to what degree--it may not matter what 
somebody does when they depart the service, they are just going 
to have a rocky time--or know the VA could do a better job. 
What are your thoughts on that?
    Mr. Mihelcic. A lot of that is on veterans service 
organizations. We are out there, we get to people. We want them 
to come and join us, see us. We can tell them what their 
benefits are, we can let them know that VA is available. 
However, in TAP, we do not have our own accredited service 
officers. So that is missing. That is the one time we can get 
somebody, right before they leave service, and tell them these 
VA benefits are available, you need to take advantage of them. 
And, again, we do it at no cost.
    If that is not being taught in TAP, if we have a contractor 
who is merely reading a piece of paper and saying, yes, your 
benefits are this, and they drone on and then they go to the 
next topic, that is not going to stick with a separating troop.
    We need to be there, we need to show them that veterans 
service organizations like the Veterans of Foreign Wars care. 
Give us a few moments in that 5-day TAP curriculum to tell them 
we are here, we know what you have been through, we can tell 
you how you can better help yourself.
    So that is on us. Veterans service organizations have to do 
more, but VA needs to meet with us and allow us to do that.
    Senator Cassidy. Thank you for your perspective, your 
honesty, and your offer to continue your service.
    With that, I yield back, Mr. Chairman.
    Chairman Tester. Representative Radewagen.

              HON. AUMUA AMATA COLEMAN RADEWAGEN,
            U.S. REPRESENTATIVE FROM AMERICAN SAMOA

    Mrs. Radewagen. Thank you, Chairman Tester, Chairman 
Takano, and Ranking Members Moran and Bost. Thank you all to 
the VSOs for your testimony. I have been on the Veterans' 
Affairs Committee for four terms now and I cannot understate 
how important these regular joint hearings are.
    Our VSOs are the gatekeepers for our veterans' voices in 
Washington. The work you all do to ensure that our veterans are 
afforded the benefits and services they have earned is so 
important, and I want to thank you for all you do and for your 
service to our Nation.
    I want to extend a special mahalo to the VFW Hawaiian 
delegation for making the effort each year to reach out to my 
office and brief my staff on your work. Thank you for all you 
do on behalf of our Pacific veterans as we move forward with 
the second session of this Congress and continue to address 
veterans' issues. I know that your priorities and goals will be 
at the forefront of our mission to improve the lives of our 
veterans.
    Your priorities are my priorities. We will continue to work 
on comprehensive toxic exposure reform and ensure veterans are 
receiving care and compensation for the health conditions and 
illnesses associated with the toxic exposures and environmental 
hazards they encountered in service. We also aim to reduce and 
eventually eliminate veteran suicide, military sexual trauma, 
and ensure that all of our service members have better access 
to mental health care.
    I hope to continue serving on the Veterans' Affairs 
Committee, and achieve these and all the other legislative 
goals on behalf of our veterans.
    I want you to know that my colleagues and I, on both sides 
of the aisle and in both chambers, value your input and hold 
your efforts in the very highest regard.
    Thank you again for being here today and thank you for your 
service to our grateful Nation.
    Thank you, Mr. Chairman. I yield.
    Chairman Tester. Representative Brownley.

                      HON. JULIA BROWNLEY,
              U.S. REPRESENTATIVE FROM CALIFORNIA

    Ms. Brownley. Thank you, Chairman Tester. And thank you, 
Commander, for being here, and thank you and all the men and 
women that you represent. You know, I thank you for your 
service and really I thank you for your continued service to 
reach out in your communities to help and support veterans that 
need your help. So thank you very, very much for that.
    Commander, I recently introduced a bill that we are calling 
the Elizabeth Dole Act of 2022, and this bill is really about 
addressing long-term care for our veterans, for both our senior 
veterans and for our disabled veterans.
    I think within the veteran population, 50 percent of the 
veteran population is 65 years or older, and still the 
preponderance of care tends to be institutionalized care, 
nursing homes. I am trying to move away from that paradigm. I 
think every veteran, if they can receive care in their home, 
want to receive care in their home. And I think that is where 
we need to go and I think it is a win-win solution because I 
think, by so doing, we can actually save money and provide, I 
think, better care and better quality care. So that money 
savings we can reinvest into other--in other needed programs to 
serve our veterans.
    So I don't know if you are familiar with the bill, but I 
wanted to ask you about it and ask if, you know, you think we 
are moving in the right direction. Do you support the bill and 
are we moving in the right direction, and how do you think your 
members are feeling?
    Mr. Mihelcic. Thank you, ma'am. I am familiar with your 
bill and the VFW fully supports that bill. It is our opinion 
that veterans serve with dignity, they have lived with dignity, 
and they have the right to care with dignity at their home. We 
really appreciate you putting that forward and our team is to 
help you in any way to move that bill further.
    Ms. Brownley. Well, thank you for that, Commander. That is 
music to my ears and I look forward--I really look forward to 
working with you on it. I agree with you, I think it is 
extremely important and I think we need to make sure we get it 
through the House and through the Senate, Mr. Chairman, and 
signed by our President.
    So, with that, I will yield back, and thank you for the 
opportunity.
    Chairman Tester. Senator Boozman.

                       HON. JOHN BOOZMAN,
                   U.S. SENATOR FROM ARKANSAS

    Senator Boozman. Thank you, Mr. Chairman. And thank you all 
so much for being here and all you represent.
    The last several years, we have been able to enact a lot of 
legislation, realizing that these are gimmes, these are earned 
benefits, but we simply wouldn't have gotten that done without 
our veterans service organizations and nobody does a better job 
than you all. So give yourselves a pat on the back and we 
especially thank you.
    We also want to thank the Auxiliaries. In reality, we know 
who does all the work. My wife reminds me also that they are 
also not only the worker bees, the ones who get all the work 
done, they are also the brains many times. So we do appreciate 
them also.
    The MISSION Act was essentially essential for providing 
veterans with timely and quality health care. As I traveled 
across Arkansas, particularly in rural areas, I have heard that 
care, being referred and scheduled in community care takes 
longer than before.
    Are you hearing from veterans that care being referred to 
the community is taking longer to get scheduled and, if so, why 
do you think that is, Commander?
    Mr. Mihelcic. Empirically, we find that the data show that 
access to health care times is actually doing quite well. 
However, anecdotally, we hear from our veterans who are 
concerned that they are not getting care in a timely manner. I 
believe that is more, again, on veterans service organizations 
to properly assist our veterans, to let them know that, if you 
need something today, if it is not critical, you may not get in 
today, but nonetheless, when you go through the VA system and 
you use the MISSION Act, you are going to get care faster than 
if you went out into the private sector.
    So I think it is a matter of changing public opinion and 
you do that one person at a time by reaching out and explaining 
what the system is and how it really works.
    Senator Boozman. We appreciate that. I am an optometrist by 
training and it is difficult to access care in the community. 
So, again, that is very helpful.
    One of the most common concerns I also hear from veterans 
in Arkansas is how long it takes the National Personnel Records 
Center in St. Louis to respond to requests from veterans for 
records. I understand some of this was caused by COVID and the 
workforce capacity limits placed by local officials. Have you 
heard also that this is an issue among your members and how big 
of an issue has this become?
    As the country returns to its pre-pandemic normalcy, what 
recommendations do you have for us to try to help expedite the 
records process and going forward to prevent something like 
this from happening again?
    Mr. Mihelcic. First, if a veteran can't access military 
records, then we are all doing a disservice to that veteran. 
How can they access VA health care and benefits if they can't 
prove they were in the service? To that end, we are doing 
everything we can and, because this is a critical thing to me, 
I would like Mr. Murray to enlighten.
    Mr. Murray. Senator Boozman, until very recently that 
center was working at about 25 percent capacity. Some of the 
veterans who need those records right now are some of our older 
veterans who don't have the time to wait. It is also continuing 
to grow the current backlog by not being able to take care of 
those. We need to make sure that that center is working at all 
full capacity, obviously, as safely as possible, but we need to 
get that job done. They need to be working at a hundred percent 
to take care of the veterans who need it now.
    Senator Boozman. Well, I agree totally. Again, thank you 
all. Thank you so much for all that you represent and just the 
wonderful work that you do. I appreciate it.
    Chairman Tester. Representative Rosendale.

                    HON. MATTHEW ROSENDALE,
                U.S. REPRESENTATIVE FROM MONTANA

    Mr. Rosendale. Thank you, Mr. Chair. I appreciate it.
    Commander Mihelcic, the bad actors that you were referring 
to earlier that are taking advantage of our veterans and making 
these phone calls and getting them to invest in things that 
probably aren't giving them much of a return, unfortunately, 
the Veterans Administration is subject to the same type of 
deception and lost investment as those veterans are.
    For example, are you familiar with the Cerner system that 
has been contracted by the Veterans Administration for the EHR?
    Mr. Mihelcic. Yes, sir, I am.
    Mr. Rosendale. Okay. Are you aware that they have been 
working on this system for approximately 18 months at the 
Spokane Veterans Hospital?
    Mr. Mihelcic. Yes, sir.
    Mr. Rosendale. Are you aware that there are 500 safety 
violation claims that took place there?
    Mr. Mihelcic. I am aware of the violations, yes, sir.
    Mr. Rosendale. Okay. Are you aware of the poll that was 
conducted of their entire staff where 80 percent of their staff 
said they were considering other employment opportunities as a 
direct result of the Cerner program that is being implemented 
there?
    Mr. Mihelcic. I have heard that, yes, sir.
    Mr. Rosendale. Okay. Did you know that after 18 months and 
$2.7 billion that we still don't have a fully functional system 
at that one facility, which we were supposed to be rolling out 
to all 179 VA hospitals across the nation?
    Mr. Mihelcic. Yes, sir.
    Mr. Rosendale. Okay. It doesn't sound like a great 
investment. We had assurances from Secretary McDonough that he 
was not going to move forward until that system was fully 
functional in Spokane, and yet right now we have a schedule to 
start rolling this out at the Columbus facility and in Walla 
Walla. Would you say that, if this is not fully functional, can 
I receive from you assurances that you would give us in writing 
your opposition to rolling it out in any other facilities?
    Mr. Mihelcic. At this time, I can't say that, sir. The 
reason being, a lot of these violations were missed referrals 
or erroneous medications. We look at that as insufficient 
training and missed opportunities. The mere fact that this is 
not working at this one location in Spokane should not hinder 
us from beginning this at another location. Use the lessons 
learned, plus and minus, to create another system at another 
location and we continue to move forward. If we wait on one 
location to determine whether it is going to pass or fail, we 
will never get the proper systems in place to help veterans.
    Mr. Rosendale. So you think that it is wise to roll out a 
system that is not working, that we have spent $2.7 billion on, 
on other facilities?
    Mr. Mihelcic. If we look at DOD using the same system, it 
works there. And that is what I was talking about the training 
and the missed opportunities. We do not throw the baby out with 
the bathwater.
    We have to look at it holistically. If it is working 
somewhere else, then it must be working somehow. Let's put that 
together. Again, best practices from DOD, worst practices from 
Spokane. Let's move together and get something working. But if 
we wait and do nothing, people die.
    Mr. Rosendale. Mr. Chair, I see I am out of time. I yield 
back.
    Chairman Tester. Representative Pappas.

                       HON. CHRIS PAPPAS,
             U.S. REPRESENTATIVE FROM NEW HAMPSHIRE

    Mr. Pappas. Thanks very much, Mr. Chairman. And I want to 
thank, Commander, you and your team for your presentation today 
and your ongoing partnership, which I think really makes a 
difference and helps point our committees in the House and 
Senate in the right direction.
    I also want to thank any of my friends from the New 
Hampshire VFW that are watching in Crystal City. I always 
appreciate hearing from them.
    So, Commander, I wanted to ask you a question. I have heard 
from some constituents about a really disturbing practice, it 
is the issue of unaccredited claim consultants, I would refer 
to them as claim sharks, that are charging veterans thousands 
of dollars just for filing disability benefits claims, a 
service that we know otherwise can be free or provided by VSOs 
or other advocates.
    So, because they are unaccredited, these claim sharks 
aren't subject to VA standards and they avoid regulatory 
oversight, they target veterans with exploitative practices, 
financial exploitation, they engage in predatory and other 
unethical practices.
    So I am just curious if VFW shares concerns about these 
claim sharks and if you think it is a problem that Congress 
should be addressing?
    Mr. Mihelcic. Well, I thank you very much for that. Again, 
being an attorney, I see the ads all the time on the 
television, and it makes me cringe how these predatory 
practices, they do prey on unsuspecting victims when it comes 
to unaccredited claims people--I am sorry, I lost track--when 
it comes to unaccredited claims servicers. Why can't we go 
after them? Do we have a law that says we will only pull over a 
person who has a valid driver's license? No. We pull them over. 
If they don't have a valid driver's license, they can get a 
penalty. So let's open the aperture. Let's go after anybody, 
whether they are unaccredited or accredited. If they are 
involved in predatory practices that involve veterans' claims, 
we should be able to go after them and put them out of 
business.
    The VFW provides no cost veteran service. That is what we 
should be shouting from the rooftops.
    Mr. Pappas. Thanks for highlighting that work, and I know 
we are planning a hearing in our committee in the House, and we 
would love to keep you apprised of that, and hopefully can 
continue to work with you on that issue.
    One final thing I have, you talked a little bit about 
parody. And I just know from my experience in New Hampshire, 
the Guard has served us in tremendous ways, especially over the 
last few years, we have seen their sacrifice on full display. 
And we know that during times of national emergency the are 
called upon, relied upon, but aren't always credited for those 
activations as they should be.
    I have got a bill I am introducing. It is the Record of 
Military Service for Members of the Armed Forces Act. It looks 
to ensure that all members of the Reserve components, including 
the Guard, are provided the same DD-214 form as other members 
of the Armed Forces. So just if you have any quick thoughts on, 
you know, Reserve components without a standardize DD-214 and 
why this legislation potentially could be important.
    Mr. Mihelcic. I firmly believe that total force means total 
force, not separate force. We should not have different pieces 
of paper for different components. If you served, you should 
get the document. We talked about a DD-214. Whatever we call 
it, anybody who serves in any capacity should have the same 
document so when they show it to somebody, they don't have to 
explain, ``Well, I was in this branch. I did this. That is why 
my form looks different.''
    Let's standardize. Let's modernize. And let's get with it.
    Mr. Pappas. Thanks, Commander. I yield back.
    Chairman Tester. Senator Sullivan.

                       HON. DAN SULLIVAN,
                    U.S. SENATOR FROM ALASKA

    Senator Sullivan. Thank you, Mr. Chairman. And, Commander, 
thank you to you and your team. I really appreciate all the 
great work and guidance you provide this committee. I want to 
do a shout-out to some of my fellow veterans from Alaska, who I 
am sure are watching. You know, we have more veterans per 
capita than any State in the country. We are very proud of 
that. The committee knows that because I say it in every 
hearing. But I am also a proud member of the VFW Post 9785 in 
Eagle River, Alaska. Any of you gentlemen ever been there? Had 
a beer there? Yes?
    Mr. Mihelcic. I had a Coke there, sir.
    Senator Sullivan. Okay.
    Mr. Mihelcic. It is a beautiful post.
    Senator Sullivan. Well, you know, next time you are in 
Alaska, come on out. We will have a Coke, or a beer, or 
whatever you and your team want to have.
    So I want to talk about two issues in my time here. I think 
it was--at the State of the Union last night, I will be honest 
here, there were some areas that I wasn't fully supportive of 
the President's vision or ideas. But I will tell you this, I 
think it was very appreciated the amount of time he spent on 
the toxic exposure and burn pit issue. This is a topic I have 
actually discussed at length with the President himself. I know 
he cares about it. This is something Senator Manchin and I have 
been working on for quite some time, our bill S. 437, which was 
one of the first that kind of got out there and looked at the 
issues of liability.
    Can you just explain briefly why you think this is such an 
important issue for all of our veterans, but the VFW in 
particular? Not focused on any one particular bill, but the 
need to get on it, address it, and get in front of it so we 
don't have an Agent Orange type of situation like we had in 
Vietnam, you know, a generation ago?
    Mr. Mihelcic. I am going to let Mr. Murray take this one, 
only because I am not quite sure what you are asking and I 
don't want to mislead you in any way.
    Senator Sullivan. Great. Mr. Murray.
    Mr. Murray. So, Senator, we support that bill, as we do----
    Senator Sullivan. S. 437?
    Mr. Murray. Yes, sir. But amongst others. But the reason it 
is important, and the VFW, I believe, represents it very well. 
We are a multi-generational organization. Some of these 
comprehensive bills cover folks from Iraq, and Afghanistan, and 
K2, and the Gulf War----
    Senator Sullivan. Right.
    Mr. Murray [continuing]. And Vietnam. It is needed because 
this is long overdue. Service and toxic exposure are 
synonymous. Your service, our service, it is something that 
every single day we could wake up and be exposed to some kind 
of nasty substances. That is why these bills--the comprehensive 
bills that take care of everybody: foreign, domestic, past, 
present, and future is incredibly important.
    Senator Sullivan. Great. Thank you for that. Real quick, 
because I am almost out of time here, but you did mention, 
Commander, in your testimony the importance of telehealth, 
particularly serving rural veterans. Our committee has been 
very focused on that. Can you expand just a bit more on your 
focus and your testimony on the importance of telehealth for 
our rural veterans. I think it is a great area of focus for the 
VFW, because a lot of our veterans live in rural communities, 
rural States.
    Mr. Murray. This is the 21st century. Why aren't we using 
telehealth? The recent pandemic has shown us that we can do 
things using computers, using telehealth. Why not? People who 
want to say let's go back to the old ways, they are just wrong. 
And people who live in rural areas who can't drive 50, 100 
miles for a checkup, this is going to save lives. If we can't 
use technology, then we are lost. There is no reason for us to 
go back to the way we did things before. Let's learn our 
lessons from COVID-19. Let's increase the use of telehealth. 
Let's get more people involved in the VA system who never were 
able to get involved before because it was too far. This is one 
way, using outreach, that we can get more people in. They will 
get their earned health benefits and their earned claims 
benefits.
    Senator Sullivan. Great. Thank you. Thank you, Mr. 
Chairman.
    Chairman Tester. Representative Sablan.

              HON. GREGORIO KILILI CAMACHO SABLAN,
       U.S. REPRESENTATIVE FROM NORTHERN MARIANA ISLANDS

    Mr. Sablan. Yes. Thank you very much, Mr. Chairman. I would 
like to welcome all of our witnesses. I have truly enjoyed this 
annual convening of hearings to listen to our VSOs because, you 
know, as a veteran, and many of us at times know what your 
veterans want, and I am particularly fond of today's hearing 
because VFW is the only VSO in my district, in the Northern 
Marianas. And I would like to give a shout-out and a welcome to 
Washington, DC. to retired lieutenant colonel and former--
prisoner of war, Mr. Peter Callahan. So welcome to DC, and I 
understand you are in Crystal City.
    I want to thank again VFW. I have a question, if I may, 
Commander. You mentioned several times the importance of 
communicating, whether it is between DOD, VA, or between a 
veterans and his or her provider, and you may--I think you 
would agree with me that some of the need for communication 
rests with those veterans who are in the most remotest part of 
this world.
    So I have introduced a bill, H.R. 3730, that would 
establish a VA advisory committee for veterans residing in the 
U.S. territories and the--States. I would appreciate it if you 
would--you and your colleagues would look over that legislation 
and see if you could support it. It really makes a lot of 
difference for the veterans in these parts of the world.
    Mr. Mihelcic. Thank you, sir. I can tell you that we 
unequivocally support your bill. This is the 21st century. 
There is technology. The world is getting smaller. We can reach 
any portion of this earth using satellites, using 
communications. There is no reason we can't reach somebody in 
the Northern Marianas and get them a VA appointment in a timely 
manner. We do support----
    Mr. Sablan. Thank you, Commander, again. And thank you to 
VFW for being the first--VSO and the--in the Northern Marianas. 
Chairman Tester, I yield back.
    Chairman Tester. Representative Slotkin.

                      HON. ELISSA SLOTKIN,
               U.S. REPRESENTATIVE FROM MICHIGAN

    Ms. Slotkin. Well, thank you for being here. Thank you for 
addressing both the House and Senate on issues that we know are 
really important. And in Michigan, we are recovering--I am from 
Michigan, we are recovering from punch key day, not the New 
Orleans version, but the Michigan version, which is a very 
heavy Polish donut that we all eat.
    Thank you for all that you all do. I think we were all 
happy to hear the amount of time the President talked about 
veterans issues, and the one that is personal to me is burn 
pits. I am a former CIA officer. I served three tours alongside 
the military and lived near a burn pit, as we all--almost all 
of us did in Iraq. And myself and Congressman Meyer, a 
Republican from Michigan, who also served in Iraq, we have this 
Veterans Burn Pit Exposure Recognition Act.
    And we are basically trying to make sure, I think all of us 
are trying to make sure, that burn pits don't become the Agent 
Orange of the post-9/11 generation, right? That we don't wait 
40 years to recognize the exposure as we did with our Vietnam 
veterans, and we do better.
    Can you talk to us about what we need to do. Obviously, the 
legislation is critical. But what else can we do to raise 
attention, to get the focus on this issue so that we don't have 
that clock going for 40 years?
    Mr. Mihelcic. First, ma'am, I can tell you we support you 
and your bill 100 percent. There is no reason that any veteran 
should have to wait the 40 or 50 years that our Vietnam 
veterans had to wait. That was a travesty. And we here today 
can work to say that will never happen again. We know what is 
going on. We know that it wasn't just Vietnam veterans. It is 
veterans of all ages, all times.
    As far as recognition, I have 1.5 million members of my 
organization. And it is very easy for me through our VFW action 
corps to send a notice out, and it reaches all of those 
veterans instantly and tells them about your bills.
    So we, and all of the other VSOs have a captive audience. 
We will work with you. My colleagues at the table will reach 
out to you. We will find out the particulars, and we will work 
with you to get the voice out. When you have a lot of people 
behind it, we all vote, and we will reach out to our 
representatives and ask them to support your bill.
    Ms. Slotkin. I appreciate that. I think the VFW is an 
amazing organization, and it is just very clear to me. 
Sometimes I talk to folks who aren't veterans and they just--
when I talk about burn pits, they--just a little bit of a blank 
stare. You know, it hasn't really seeped into the bloodstream 
the way Agent Orange has.
    And anything we can do together collaboratively to get the 
word out and make it more of a public issue, I would 
appreciate. With that, Mr. Chairman, I yield back.
    Chairman Tester. Representative Ruiz.

                        HON. RAUL RUIZ,
              U.S. REPRESENTATIVE FROM CALIFORNIA

    Mr. Ruiz. Thank you, Mr. Chairman. How long is long enough? 
How long must our servicemembers wait before their suffering 
from exposure to burn pits and other toxins is recognized? How 
long must they shoulder the burden to prove their pain or 
illness is real and a result of their service.
    For our Vietnam veterans, the answer was nearly 20 years 
before the VA granted a presumption of service connection for 
many illnesses and diseases. And shockingly, they are still 
fighting. It has now been over two decades since 9/11, and the 
VA has estimated that 3.5 million of our post-9/11 veterans 
served in areas where they may have been exposed to burn pits 
and other toxic substances. And yet the VA is still not 
covering the health care veterans who sustained these injuries 
while serving our country. Why is that? What--have we not 
learned our lesson?
    We cannot afford to repeat history by denying our 
servicemembers proper benefits and care. Congress must act now. 
Studies on the health effects of open air waste burning can be 
traced back to the 1990s, when concerns about health risks 
began to rise from returning Gulf War veterans. Yet we continue 
to argue that more studies are needed before we can prove our 
veterans' illnesses are related to their service.
    As a physician and public health expert, I understand the 
necessity for studies and the importance of understanding the 
science behind illness and disease, but that has been done 
here.
    The evidence has shown us time and time again that there is 
a connection between the illnesses veterans are being diagnosed 
with and their service near burn pits. It doesn't take research 
to understand that carcinogens cause cancer. And carcinogens 
are found in the burn pits' toxic smoke. Years later, the 
veterans are becoming delayed casualties of war, as they 
develop long term respiratory illnesses and cancers because of 
their exposure. We don't need more studies to understand where 
the illness and cancers are coming from. We need service. We 
need to follow the evidence that presumes service connection 
for all 23 illnesses listed in the Honoring Our PACT Act.
    My first question, Commander Fritz, can you explain why it 
is imperative that any legislation passed by Congress includes 
a presumption of service connection, and why anything less is a 
dereliction of our duty?
    Mr. Mihelcic. Yes, sir. Why should we put the burden on a 
veteran to show that something they breathed caused them harm? 
It is so easy for Congress right now, and as a medical 
professional, you know, you can tell that causation and effect, 
you know what is there. If something happens to a veteran, we 
can tell that. And I say the time is now to pass the PACT Act, 
so we put these presumptions in, so when a veteran comes 
forward and says I served in this location, the VA must say we 
will presume that you have these conditions, and we will take 
care of you.
    Mr. Ruiz. Thank you very much.
    Chairman Tester. Senator Tillis.

                       HON. THOM TILLIS,
                U.S. SENATOR FROM NORTH CAROLINA

    Senator Tillis. Thank you, Mr. Chairman. And thank you for 
the work, and are committed to get a bill passed out that had 
elements of the TEAM Act that my office worked on. It was 
great. Unanimous bill. Glad to get it out of the Senate, and 
looking forward to getting it to the President's desk.
    I think when we are talking--incidentally, I was pleased to 
hear what President Biden had to say last night about 
presumptions. I do believe that we need to provide clarity and 
certainty by codifying some of these presumptions moving 
forward.
    I think most people if they are watching, they don't know 
what a presumption is. And what people need to understand is 
when you have got a veteran who is going in, thinks they have 
got an illness, knows that they had some sort of exposure, they 
are already in a crisis situation.
    We do need to flip the script and make it easier for them 
to get the care they deserve. So I will continue to work on 
that.
    I want to talk a little bit, first off, about telehealth 
and what we saw during COVID times. You know, we took emergency 
measures, expanded access to telehealth, and I for one think 
that we found some really good uses for it that I believe 
should be a part of standard operating procedure.
    Can you all give me any sense of where you are on that? Any 
specific areas that we should focus on?
    Mr. Mihelcic. Mr. Gallucci is our expert on that. And I 
wanted to give him some time to speak.
    Mr. Gallucci. Thank you, Comrade Commander, and thank you 
Senator Tillis. This is something that we think a lot about. 
The VFW is one of the pilot organizations for VA's Project 
Atlas. All five of our sites are operational and have been for 
quite some time.
    We have seen the most patience through Project Atlas, but 
we have only seen 100 patients. What we are asking VA now is, 
is there a more efficient way to deliver this telehealth.
    You know, one of our strongest assets in the Veterans of 
Foreign Wars is the physical infrastructure we have around the 
country. We truly believe in a program like this, and we want 
to lean forward with that infrastructure to help deliver 
telehealth, but is there an easier way to do it? Is there a 
better way to get that message out to the veterans who can use 
it?
    You know, our posts have leaned forward throughout the 
pandemic, offering--you know, coming together and sewing masks 
for veterans, or even hosting VA for things like vaccination 
clinics and also mobile vet centers, or whatever it took.
    I think we can lean forward with that infrastructure 
similarly to reach veterans where they need that help. But 
also, there are the broadband deserts for highly rural 
veterans. And we are really looking forward, VA is convening a 
meeting of organizations here very shortly about what we can do 
about that. And the VFW is proud to come to the table there.
    Senator Tillis. Well, hopefully with our bipartisan support 
of the infrastructure bill and $65 billion going into broadband 
in particular that will also see some benefit to the unserved 
or underserved areas across the country. I am about to run out 
of time. I did want to also say that we are having a hearing, I 
am the ranking member on personnel subcommittee. And a part of 
this discussion about toxic exposures, we have got to do better 
at actually predicting when we are exposing servicemen and 
women to toxic substances a lot earlier in the life cycle.
    So we are having a hearing this week to talk about what we 
should do to make sure that we are capturing information in the 
electronic health record, that we are doing a better job of 
setting up protocols if we even suspect that something could 
actually result in a bad outcome for a service member, long 
before they become a veteran. And I think if we do that, we get 
ahead of the curve, then we are going to be much more likely to 
be in a position to provide treatment, and then maybe even look 
out to veterans and identify them as being at risk long before 
they know they may have been.
    And hopefully through that, we cannot have to go through 
Agent Orange, burn pits, and the next potential disaster for 
our veterans. And you can count on me to continue to work for 
it. Thank you, Mr. Chair.
    Chairman Tester. Senator Hassan.

                   HON. MARGARET WOOD HASSAN,
                U.S. SENATOR FROM NEW HAMPSHIRE

    Senator Hassan. Well, thank you, Mr. Chair, and ranking 
members for this hearing and this panel. And thank you to our 
witnesses for your service and the work that you do to support 
our veterans. Before I ask a question, I want to recognize the 
testimony provided already by our witnesses on veterans exposed 
to toxic substances, as we have just been talking about.
    I was glad to hear the VA announce yesterday that it will 
propose adding rare respiratory cancers as a presumed service 
connection condition, a measure that my colleagues and I have 
pushed for in response to the needs of veterans.
    The VA and Congress need to continue to work together so 
that veterans exposed to toxic substances have the health care 
and disability benefits that they have earned, and that they 
deserve, and I will continue with working with my colleagues to 
ensure that Congress passes bipartisan legislation.
    Now, I did want to start with a question, Commander, to you 
about the home loan guarantee program. This Congress, I led a 
bipartisan call for improvements to the VA home loan guarantee 
program. I consistently hear from--State veterans about how the 
current housing market affects their ability to use this 
program.
    I was certainly glad to see that VFW's written testimony is 
consistent with my push for conducting further outreach to 
lenders, real estate agents, and veterans on how to best 
utilize the VA home loan guarantee program. But, Commander, 
what further recommendations does VFW have for Congress so that 
we can support veterans who want to buy a home using this VA 
program, but are currently unable to do so?
    Mr. Mihelcic. Well, the first thing, you do need to make it 
easier.
    Senator Hassan. Yes.
    Mr. Mihelcic. As a recipient of a VA home loan many years 
ago, I had trouble getting through that. Nobody understood it. 
There was extra paperwork. Why do we have to do this? Why can't 
we charge you more? All of those issues are problems.
    Senator Hassan. Yes.
    Mr. Mihelcic. And we can fix this, and it is all a matter 
of information, enlightening, getting people to understand what 
is going on. My feeling is there is no problem that can't be 
solved if you put more information out to people so they can 
understand what the problem is.
    Senator Hassan. Right. And simplify the process, though, as 
well. So I appreciate that. One more question in my remaining 
time, again for you, Commander. A New Hampshire National 
Guardsman and Reservist swear to defend the constitution and 
this country, just as their active duty counterparts do, and 
they deserve the same respect and recognition. That is why I 
introduced bipartisan legislation with Senators Shaheen, 
Cramer, and Hoeven to reform the Veterans Cemetery Grants 
program, to ensure that all members of Reserve components and 
the National Guard are eligible to be buried in State veterans 
cemeteries.
    I was glad to see the VFW note their support of this 
legislation in today's written testimony. Commander, can you 
speak to VFW's support for this bill and why burial eligibility 
should not restrict State cemeteries from receiving critical VA 
cemetery grant funding?
    Mr. Mihelcic. Yes, ma'am. We do support you 100 percent. 
Again, it goes back to total force.
    Senator Hassan. Right.
    Mr. Mihelcic. If someone joins the military, whether they 
are in the Guard, the Reserve, or the active component, they 
have served. They deserve all of the rights available to them. 
And that includes being able to be buried in the hallowed 
ground of a veteran cemetery. We fully support that. Some 
people don't get activated. That is great. Thank God they 
didn't have to go into harm's way. But nonetheless, they put 
the uniform on and they served. So we need to take care of 
them, not only in life but in death also.
    Senator Hassan. Thank you very much. Thank you, Mr. Chair.
    Chairman Tester. So we have Representatives Mrvan, Banks, 
and Gallego. And that will be that for this panel, because we 
have got another one to get to. So Representative Mrvan, go 
ahead.

                       HON. FRANK MRVAN,
                U.S. REPRESENTATIVE FROM INDIANA

    Mr. Mrvan. Thank you, Chairman. Commander Mihelcic, VFW is 
a current user of the Veteran Benefits Management System, and 
we know from Independent Budget recommendations for VA that 
modernization of this system is a priority for you.
    I have two questions. What is the current state of the 
system, and how is that impacting your ability to assist 
veterans with access to benefits? And then secondly, is VBMS 
technologically equipped to handle the anticipated influx of 
toxic exposure claims on anticipated congressional action on 
this issue today?
    Mr. Mihelcic. I could certainly answer that, but I have an 
expert sitting right next to me on my left, and he is going to 
provide you with more information than you could ever want on 
this topic.
    Mr. Murray. Thank you, Commander. I will keep the every bit 
of information possible to a minimum. But the VBMS system is 
not an entirely comprehensive system to take care of benefits 
management. It is also about a dozen years old. It is time for 
a revamp of that system.
    In terms of IT, 12-years-old is a lifetime. So it is time 
that we invest heavily into the IT infrastructure of VA to 
improve the Benefits Management System. And to your question 
about is VBMS capable of handling the workload if we were to 
suddenly flip the switch for the PACT Act, for example, we 
can't hire enough people to adjudicate those claims in a timely 
fashion, without also an IT upgrade for that system.
    We believe similar to what happened with the digital GI 
bill, a digital benefits upgrade is necessary in order to make 
the people that are doing that work more efficient every single 
day.
    Mr. Mrvan. I thank you very much. I appreciate that. And as 
the chairman of Technology Modernization, the subcommittee 
chair, we will do everything in our power to make sure that 
that infrastructure is moving in the right direction to be able 
to get the tools necessary to be efficient when we come to 
processing those claims.
    I thank you for you opinion, and with that, I yield back.
    Chairman Tester. Representative Banks.

                        HON. JIM BANKS,
                U.S. REPRESENTATIVE FROM INDIANA

    Mr. Banks. Thank you, Mr. Chairman.
    Commander, as you know, many of us are concerned about the 
mental health of our veterans, and I am concerned that the 
endless COVID lockdowns have forced many of our veterans into 
isolation, cost them their jobs, and diminished many of their 
health care opportunities.
    Commander Mihelcic, how has COVID affected veteran mental 
health from your perspective; and what can we do more of to 
alleviate some of those concerns and problems?
    Mr. Mihelcic. Well, certainly isolation will bring a person 
down. And if they are not able to get out to get--see a 
physician, see their doctors, they don't get asked those 
questions of how you were feeling.
    I am very proud to say that our VFW posts are opening now. 
We are open. We are available. We are pockets of patriotism. We 
are there for a person to come in, and sit down, and talk to a 
VFW member about how things are going, because it doesn't make 
any difference what war you served in or what uniform you wore. 
The fact is, we all went through the same thing. And if a 
person is not feeling right, they can come in and sit down. 
Maybe they go to Eagle River and have a Coke. But when they do 
that, they are sharing, and they are talking. And when they can 
do that, we can help with their mental health. I am not sure 
what more VA can do, but we can do it on our side of the fence 
by reaching out to our fellow veterans and say we understand. 
Come sit down with us. We can help you.
    Mr. Banks. Thank you for that. I think that is very 
important. Can you also talk for a minute about how COVID has 
affected veteran employment, and what we can do more generally 
to support veterans finding employment coming out of the 
pandemic?
    Mr. Mihelcic. Well, the great program Vet Tech has come 
about. Instead of them going to a 4-year school and using your 
GI bill benefits, you can go to a shortened school to learn a 
quick skill, a digital skill, information technology skill, in 
a few short months, you can come out and studies have shown 
that within 7 months of graduating with a certificate, our 
veterans are making over $60,000 a year on average.
    So that is how we come out of the pandemic. That is how we 
get veterans back into the workforce. Don't force them to go to 
a 4-year degree. Let them go and take a program that will get 
them a skill--a life skill that they can use immediately, 
because when a person works, they have worth. And when they 
have worth, they don't kill themselves.
    Mr. Banks. Thank you for that. As a proud VFW member, I 
appreciate your feedback and your attendance here today.
    Mr. Chairman, I yield back.
    Chairman Tester. Representative Gallego.

                      HON. RUBEN GALLEGO,
                U.S. REPRESENTATIVE FROM ARIZONA

    Mr. Gallego. Thank you. Mr. Mihelcic, your testimony 
discusses the need to improve suicide prevention, not only 
among veterans, but on active duty servicemembers too. That is 
why I join my colleague, Representative Miller-Meeks, in 
introducing the Save Our Servicemember Act, which includes some 
of the recommendations in your testimony, such as evaluating 
the effectiveness of DOD's suicide interventions and improving 
coordination with DOD. Can you expand why it is important for 
DOD to streamline its own suicide prevention efforts, and how 
that could help improve outcomes for veterans down the line as 
well. And also, can you also share any additional 
recommendations you have in this space?
    Mr. Mihelcic. DOD is the employer of these servicemembers. 
If we find that our--if our employees, our servicemembers are 
committing suicide, we owe it to our service members to get 
better training. I was in the service. I worked as a civilian 
in the Department of Defense. We did have a lot of suicide 
awareness training, but it was the same training every 6 
months. You just click through. There was nothing new. We need 
to revamp that training. We need to get people to understand 
that this is serious, this is not just an oh, I have to get 
this done. How fast can I push the button?
    If we push this to the side and make it just another 
ancillary training thing, people won't take it seriously. If we 
take it seriously, we will reduce veteran and active duty 
suicide.
    Mr. Gallego. Thank you. As you know, the House is taking up 
the Honoring Our PACT Act this week to provide comprehensive 
services to those veterans who were exposed to burn pits and 
other toxins while serving. I, myself, was exposed to burn pits 
in Iraq, and I know many of your members have also suffered 
from this exposure and waited too long for care. I just want to 
ask you today, what is your message for Members of Congress 
that are on the fence about this important piece of 
legislation, or those who say we can't provide this care 
because it is too expensive?
    Mr. Mihelcic. I will take the last part first. This is not 
an expense. This is taking care of veterans who have earned 
their benefits. This is taking care of sick, and wounded, and 
injured veterans. There is just no sense. How could any right 
thinking American not vote for this PACT Act? I spoke about it 
this morning. I spoke about it here. This is what we call the 
no-brainer. How could you not honor America's veterans?
    They went in harm's way for you. They came home. Don't 
forget them. There is nothing more I can say other than if you 
are on the fence, you need to get off the fence. You need to 
pick a side. History does not like people who do not decide. 
History will recall this week when the House is working on the 
PACT Act, and history will remember those people who did not 
vote to pass the PACT Act.
    Mr. Gallego. I could not have said that any better. Thank 
you so much. I yield back my time.
    Chairman Tester. That is the end of panel one. I want to 
thank the VFW for being here. And I want to say, Commander 
Mihelcic, to my memory, I can't think of a national commander 
who has done a better job than you did today. So I want to--
appreciate you all and your input.
    Now, we will introduce the second panel. I will relieve you 
guys of your spots, and we will set up the second panel, which 
is an incredibly important panel, where we have multiple 
veteran services and advocacy organizations who represent and 
assist the diverse cross-section of veterans from around the 
country.
    I want to tell the presenters here today, you have 5 
minutes, and there are nine of you, I believe. And so time is 
money, as always. But as concise as you can be, the better off 
it is going to be because we want to hear your input.
    And I am going to list these in the speaking order that is 
there. First, we are going to start with Jeremy Butler, Chief 
Executive Officer of the Iraq and Afghanistan Veterans of 
America, otherwise known as IAVA. Jeremy is here in person.
    Next up to speak will be Michael Linnington, Chief 
Executive Officer of the Wounded Warrior Project, who is also 
here in person.
    The third person to speak is going to be Jack McManus, who 
is here virtually. He is the president of the Vietnam Veterans 
of America.
    Then, Gregory Heun, the National Commander at AMVETS, and 
he is here in person.
    Next up, we have Kathryn Monet, the Chief Executive Officer 
of the National Coalition of Homeless Veterans, that is here 
virtually.
    Next up is Lory Manning, Director of Government Operations 
at the Service Women's Action Network, otherwise known as SWAN. 
She is here in person.
    Next up is Joseph D. McNeil, National President of the 
Blinded Veterans Association, otherwise known as BVA, and 
Joseph is here virtually.
    Next up, we have Victor LaGroon, the Director of the Black 
Veterans Empowerment Council. And he is here in person.
    And last, but certainly not least, we have Thomas 
Palladino, President of the National Association of State 
Directors of Veterans Affairs and Executive Director of the 
Texas Veterans Commission. That is a mouthful. And he is here 
virtually.
    We will start with you, Jeremy, as I said earlier, 5 
minutes. We appreciate you guys, appreciate all you guys, and 
we look forward to your testimony. Go ahead, Jeremy.

                            PANEL II

                              ----------                              


                STATEMENT OF JEREMY BUTLER, CEO,
            IRAQ AND AFGHANISTAN VETERANS OF AMERICA

    Mr. Butler. Chairman Tester, Chairman Takano, Ranking 
Member Moran, Ranking Member Bost, and distinguished members of 
the committees. On behalf of Iraq and Afghanistan Veterans of 
America, thank you for the opportunity to testify today. My 
submitted written testimony covers several IAVA priorities, but 
for my opening statement, I will focus on the one which is 
literally closest to all of us in terms of a path to success: 
the overdue need for comprehensive toxic exposure legislation.
    This is my fourth year on the road, testifying before this 
joint body as CEO of IAVA, and every year, I have discussed the 
needs to address the health issues brought on by 20 years of 
burn pit usage in Iraq and Afghanistan. Small steps have been 
made, but like the incremental moves taken to address Agent 
Orange, we are much too late in the government owning up to 
this self-inflicted wounds.
    Veterans are sick and too many have already died. Even 
though IAVA has been discussing this for more than 4 years, by 
no means were we the first or the loudest to raise this issue. 
In fact, the danger burn pit exposure was raised nearly from 
the beginning. In 2004, Dr. Robert Miller from Vanderbilt 
University began one of the first studies into the links 
between burn pits and illnesses when several seemingly fit 
soldiers were sent to him from Fort Campbell after failing 
fitness tests and presenting unexplained respiratory issues on 
their return from Iraq.
    After performing lung biopsies, he found that dozens were 
suffering from constrictive bronchiolitis, which didn't show up 
on regular exams. The Army's fix to this problem was to stop 
sending soldiers to see him.
    In 2006, an Air Force officer, back from serving his bio-
environmental flight commander for Joint Base Balad wrote, ``In 
my professional opinion, there is an acute health hazard for 
individuals. There is also the possibility for chronic health 
hazards associated with the smoke.'' Another officer, back from 
serving as chief of aeromedical services for the 332nd Air 
Expeditionary wing at Balad wrote, ``In my professional 
opinion, the known carcinogens and respiratory sensitizers 
released into the atmosphere by the burn pit present both an 
acute and chronic health hazard to our troops and the local 
population.
    Their writing was in reference to the burn pit at the 
largest U.S. base in Iraq, home to 25,000 U.S. military 
personnel and several thousand contractors, where even though 
the military had three clean burning incinerators operating, 
officials acknowledge that the burn pit was still taking in 147 
tons of waste per day. Significantly more than half the daily 
output at Balad.
    And what was being burned included Styrofoam, unexploded 
ordinance, petroleum products, plastics, rubber, dining 
facility trash, paint insolvents, and medical waste that 
included amputated limbs. All resulting in likely exposure to 
contaminants that included benzine, arsenic, freon, carbon 
monoxide, ethyl benzine, formaldehyde, hydrogen cyanide, 
nitrogen dioxide, sulfuric acid, and xylene.
    In 2012, a former epidemiologist for VA testified before 
Congress that VA officials were manipulating or hiding data 
that supported veterans' claims of illnesses related to burn 
pits. We know that the DOD contracted management of the burn 
pits out to private companies, such as KBR, even though the 
military's rules prohibited long-term use of burn pits. And 
when veterans tried to sue KBR because of the illnesses they 
believed were caused by the burn pits, US judges ruled that KBR 
had little discretion in how to dispose of the waste, as they 
were under military control, and the use of the burn pits was a 
military decision.
    The judges further referred to the issue as a ``political 
question'' that Congress and the President should resolve, not 
the courts. And we know that in January 2019, the Supreme Court 
rejected those veterans' appeals--the circuit court ruling, and 
decided that more than 60 separate burn pit related lawsuits 
could not move forward.
    Which brings us to today, and this body having the 
opportunity to do what the court stated Congress needs to do 
and resolve this political question. Passing the Honoring Our 
PACT Act in the House and the Cost of War Act in the Senate are 
how that is accomplished.
    Half measures, phased approaches, and anything short of 
comprehensive toxic exposure legislation would leave this issue 
unresolved, leave countless veterans responsibility for 
continuing to fight their own government for what they were 
promised, and leave a gaping, self-inflicted wound to continue 
those who served honorably.
    We know that we have already lost veterans to toxic 
exposure induced illnesses. We know that many others are sick. 
And we know that more will die. What we don't know is how much 
longer Congress will delay and make excuses. The only reason 
that comprehensive toxic exposure legislation has not passed is 
because of the financial cost. But there was virtually no 
debate by this body during the 20 years that the country sent 
millions to war, where they were repeatedly exposed to the 
hazards of burn pits. Burn pits that were banned from use in 
the United States as far back as the 1970s.
    The Pact Act is not partisan legislation. It was not 
created by politicians of either party. It was, in fact, a 
result of a coalition of veterans groups, representing the 
broad diversity of America's veteran population, who came 
together to create legislation that would address the unmet 
needs of those suffering from toxic exposure related illnesses.
    So on behalf of the 3.5 million veterans who were exposed 
to burn pits and other airborne hazards, and on behalf of the 
veterans behind the nearly 70 percent of burn pit related 
claims that were denied by the VA, I implore you to pass the 
comprehensive toxic exposure legislation supported by nearly 
every veterans' group in the country, and finally keep 
America's promise to take care of those who fought to defend 
us. Thank you.

    [The prepared statement of Mr. Butler appears on page 103 
of the Appendix.]

    Chairman Tester. Wounded Warrior Project, Michael 
Linnington.

                STATEMENT OF MICHAEL LINNINGTON,

             LIEUTENANT GENERAL, U.S. ARMY (RET.),

                  CEO, WOUNDED WARRIOR PROJECT

    Mr. Linnington. Thank you, Chairman Tester. Chairmen, 
Ranking Members, and distinguished committee members, thank you 
for today's hearing.
    Wounded Warrior Project was founded in 2003 with a simple 
and clear message: to honor and empower wounded warriors. For 
nearly 20 years, the servicemembers, veterans, families, and 
caregivers who we serve have been our inspiration for 
transforming the way America's veterans are empowered, 
employed, and engaged in our communities.
    And just as so many of us are inspired by the brave spirit 
of Ukrainians fighting to preserve their freedom, we are 
reminded of the privilege we have to serve so many Americans 
who have done the same to protect the liberties we cherish.
    Today, we are honoring their service by providing more that 
a dozen programs that promote mental, physical, and financial 
health and well being. We challenged ourselves to explore new 
ways to offer care and support to tens of thousands of wounded 
veterans, families, and caregivers. We did so through programs 
like our Warrior Care Network and Project Odyssey, where we 
connected warriors to more than 43,000 hours of PTSD treatment, 
find jobs, and social connection at a time when so many people 
had felt the stress of an uncertain economy and isolation.
    We also reached out to more than 33,000 warriors who served 
in Afghanistan to offer care and support to any who needed it. 
We are also committed to raising awareness on policies most 
relevant to those we serve. Last week, that advocacy was 
delivered to many of you by warriors participating in our 
virtual operation advocacy. I am here to reinforce their 
efforts by speaking to those issues.
    This year, our top priority is to support legislation that 
will guarantee access to health care, and improve the 
disability benefit process for veterans who suffered toxic 
exposures in service. In our most recent survey, over 70 
percent of warriors who served in Iraq and Afghanistan reported 
burn pit exposure, and the vast majority say it occurred on a 
daily basis.
    Now, many of them are suffering from serious respiratory 
conditions, cancers, and other illnesses. Alarmingly, two-
thirds of them say their exposure-related disability claims 
have been denied, and some of them have died because of their 
illnesses. We cannot let this continue, and we were pleased 
last night to hear the President announce efforts to address 
the challenges of toxic exposures.
    Providing care and benefits to these warriors must be 
viewed as part of the cost of sending them to war. For this 
reason, Wounded Warrior Project strongly supports Chairman 
Tester's Cost of War Act and Chairman Takano's Honoring Our 
PACT Act, which would guarantee access to VA health care that 
does not expire, creates a presumption that certain diseases 
are related to exposure, and concedes that exposure occurred. 
Finally, providing post-9/11 veterans parody with what Congress 
has done for previous generations of exposed veterans. This is 
the comprehensive solution that warriors need and have earned.
    Secondly, I would like to speak to the concerns being 
shared by many warriors and caregivers who have participated in 
VA's comprehensive caregiver program. This program recently 
began its long overdue expansion to pre-9/11 veterans and 
caregivers, expansion that we were proud to support. But new 
regulations have put this critical program beyond the reach of 
many who need it.
    As predicted, many post-9/11 veterans and caregivers are 
expected to be removed from the program. Highly personal 
reassessments of legacy participants are well underway. And 
while VA should be commended for ensuring no sudden loss of 
benefits for these families, this year should invite a candid 
discussion on whether new regulations and new requirements are 
set in the right place to extend care and support to our most 
seriously injured warriors.
    We appreciate Secretary McDonough's recent commitment to 
ensure program decisions are accurate, consistent, and clearly 
communicated. In the end, our vision is to work with VA to 
ensure that this critical program continues to support veterans 
who require great care and attention.
    I will close by touching on two other key priorities for 
the remainder of the 117th Congress. The first is to continue 
support for the growing population of women veterans. Congress 
can do this by expanding access to gender-specific care, 
fostering ongoing connection and support, building safe and 
welcoming VA environments, and providing coordination of care 
and benefits for survivors of military sexual trauma.
    The other priority is on mental health, which remains one 
of the most important challenges we face for post-9/11 
veterans. Our most recent annual warrior survey shows that 
nearly 1 in 4 responding warriors had thoughts of suicide in 
the last year. This is a startling reminder that the VA must be 
a leader in evidence-based treatment and research, and a 
champion of wider community efforts to prevent veteran suicide.
    The post-9/11 Veteran Mental Health Care Improvement Act 
and the Strong Veterans Act are two initiatives that have our 
strong support. Ladies and gentlemen, it is my distinct honor 
to be here with you today, and I look forward to your 
questions.

    [The prepared statement of Mr. Linnington appears on page 
116 of the Appendix.]

    Chairman Tester. Next, we have Jack McManus from the 
Vietnam Veterans of America.

                   STATEMENT OF JACK MCMANUS,
        NATIONAL PRESIDENT, VIETNAM VETERANS OF AMERICA

    Mr. McManus. Good afternoon. I wanted to thank you all for 
the good work that you are doing for the American people, 
particularly for our veterans and their families. This is not 
VVA's first time presenting the joint hearings of the 
congressional committees on veterans affairs. We have been the 
old guys on the hill for a long, long time. We are them old 
Vietnam vets. You see us walking your halls for many, many 
years.
    You know who we represent, and more importantly, you know 
what we stand for, as citizens first and for all generations of 
veterans next. One of our missions is to ensure that the 
experiences of the Vietnam veteran generation is never repeated 
by our Nation.
    Just as you know all about VVA, let it be said that we know 
all about you. We know that you work hard on these committees, 
and you are motivated by your love of our country, and your 
real and honest concern for those who chose to wear the uniform 
and sacrificed in so many ways for our still very young 
country.
    It is you, our noble congressional leaders, that will 
assure the spirit learned from our Vietnam experiences will 
forever guide consciousness, the respect, and the future way 
veterans have valued and treated by our country.
    There are other organizations who we continue to work with 
after many years, to help change the perception of the American 
military service members and their brave families. The Vietnam 
Veterans Memorial Foundation is celebrating the 40th 
anniversary of the wall dedication this year. After many years, 
all of us old Vietnam veterans are long gone, the 58,318 names 
etched on the big, black marble slab will be there to remind 
future generations of Americans no, never again.
    For over a century, our country has honored our military 
heroes who made the ultimate sacrifice under combat conditions 
or during battle. Their families are awarded the privilege of 
wearing the gold star pin to honor their lost child, lost 
spouse, or lost parent.
    VVA supports Congress in creating a means for recognizing 
and honoring the families of anyone who was lost during 
military service. We believe that this goal can be 
accomplished, and we will work with you to support the creation 
of a new honor, provided it does not diminish the traditions, 
criteria, and unique circumstances of the current gold star 
program.
    For four decades, VVA has kept the fullest possible 
accounting for all POWs, MIA servicemembers as our solemn 
priority. We continue to support and collaborate with the 
National League of Families, the DPAA, and the Vietnamese 
veterans who are also working to identify their missing 
comrades in arms.
    Time is of the essence. The fullest possible accounting of 
American POWs has long been our solemn priority. We must insist 
that Congress fund the defense POW/MIA accounting agency was 
what it is required to investigate all of the potential crash 
and burial sites, and to recover and identify remains.
    We are amazed at the comprehensive way that this Congress 
has worked--with many of our veterans' wounds caused by 
exposure to toxic substances while serving our country. Thank 
you for including Vietnam and Agent Orange issues in the 
Honoring Our PACT Act. Some of the lingering life and death 
issues attributable to Agent Orange exposure are still 
unresolved for so many of our Vietnam vets after more than 50 
years.
    Obviously, we are delighted with the possibility of seeing 
some relief and care for those still living toxic-exposed 
veterans of Thailand, Cambodia, Laos, Guam, and the American 
Samoas.
    The presumption of hypertension as an illness associated 
with Agent Orange exposure is long overdue, and was previously 
mandated by previous legislation. VA's own research confirms 
this presumption, yet it still stonewalls those who are 
seriously afflicted. Many have died without care or treatment 
to existing laws, have determined they should have received 
this care and treatment.
    This bill is so remarkable by the inclusion of a real 
structural process for determining the conditions of 
presumptive illness. It removes the burden from the shoulders 
of the individual veteran. It respects them to the point of 
providing immediate care. And it neither disrespects nor 
devalues the veteran in need of assistance.
    If Congress truly wants to provide solutions to the entire 
menu of toxic exposure issues, then VVA recommends from both 
our history and experience that piecemealing through phase 
legislation will never achieve a comprehensive solution. And 
unfortunately, many veterans will die waiting for the promise 
of future legislative phases to be approved or implemented.
    Since we are limited to 5 minutes, I want to close up by 
saying that VVA invites and VVMF invited the honorable members 
of both committees and fellow VSOs to join us at the wall on 
National Vietnam Veterans Day, March 29th, for a ceremony and 
reception to honor Vietnam vets. Thank you very much.

    [The prepared statement of Mr. McManus appears on page 152 
of the Appendix.]

    Chairman Tester. Thank you. Next, from AMVETS, we have Greg 
Heun

                    STATEMENT OF GREG HEUN,
             NATIONAL COMMANDER, AMERICAN VETERANS

    Mr. Heun. Thank you, Chairman, ranking members, and members 
of this committee. As the largest veteran service organization, 
representing all of American veterans, AMVETS is honored to 
provide our legislative priorities for the remainder of the 
117th Congress.
    Last Memorial Day weekend, AMVETS hosted our first Rolling 
to Remember pro veterans demonstration ride here in Washington 
DC. This is the Nation's largest veterans event, which brings 
together tens of thousands of veterans and supporters from 
across the United States.
    Riding their motorcycles to demand continued and increased 
action for the 82,000 servicemembers still missing in action, 
as well as raising awareness of the many veterans who died by 
suicide each day. This year's event will take place on May 29, 
2022.
    We will never forget our POWs and our MIAs, and we won't 
stop fighting for real solutions to a suicide crisis. 2021 was 
a tough year for veterans, and we expect it to have lasting 
repercussions. First, the disastrous withdrawal from 
Afghanistan increased the number of veterans approaching our 
heel team for assistance. Second, COVID has continued to kill 
and sicken many of our population, isolate others, stress our 
VA medical care employees, and leave many unemployed.
    Sexual assault survivors watched as senior senators on the 
Senate Armed Service Committee stripped language from Military 
Justice Improvement Act that would have removed sexual assault 
from the oversight of their chain of command. A betrayal from 
the leaders who are in positions to protect our troops.
    For the first time ever, the Pentagon denied veterans a 
permit for the annual Rolling to Remember Memorial Day ride. 
Most recently, our veterans and servicemembers are watching the 
situation in Ukraine unfold. Our prayers our with the people of 
Ukraine, our troops, and our NATO allies.
    A fellow Kentuckian once said I am a firm believer in the 
people. If given the truth, they can be depended upon to meet 
any national crisis. The great point is to bring the real 
facts. That was Abraham Lincoln.
    Here are the facts. We continue to average more than 6,000 
veteran suicides every year, despite spending $15 billion a 
year on VA medical--mental health and suicide programs. 50 to 
90 percent of our veterans walk out of VA programs and services 
never completing the recommended number of visits. No business 
or non-profit losing 50 to 90 percent of its customers would 
call that a success. Nor would they scale that model.
    AmVet's number one priority has and continues to be 
encouraging Congress to create and fund defective programs and 
services that significantly reduce suicide. Congress worked 
diligently to pass the John Scott Hannon Veterans Mental Health 
Care Act--Improvement Act of 2019. Nearly 2 years later, 12,000 
veterans lost their lives in nothing but a static VA webpage.
    Is this what we call progress? Is this what the VA and 
Congress calls urgency? With the $15 billion annual budget for 
mental health, we could fund 60 Wounded Warrior Projects or 
DAVs. Does anyone feel like this funding is having the impact 
of 60 of our largest veteran non-profits? We don't.
    We have scaled overpriced, underperforming models, tens of 
thousands of veterans have died. Yet, Congress continues to 
support scaling broken options. Many Members of Congress have 
continued to argue on behalf of this broken model, while 
failing to do due diligence on the available alternatives, 
failing to look into the extraordinary drop out rates of VA 
programs and services, failing to hold meaningful hearings that 
include researchers that have highlighted the poor outcomes 
occurring at VA, failing to hold hearings that include 
individuals who have presented robust longitudinal data on new 
and novel approaches that are resulting in veterans living high 
quality lives. Failing to conduct significant oversight, travel 
to better understanding the available alternatives.
    Roughly four congressional committee staff are left to 
tackle this issue that results in more than 6,000 dead every 
year and 15 billion spent. That is four staff.
    Members of this committee, you are the board members that 
oversees the notoriously underperforming mental health system 
with a budget of 60 DAVs. Our veterans' lives are counting on 
you to hold VA to act with a sense of urgency. We need a 
culture that demands better data-driven outcomes. We need a new 
model that immediately drives down suicide rates significantly 
and not marginally. We need a Congress that allocates serious 
staff and resources to this issue.
    In our written testimony, we have outlined numerous 
approaches that Congress can take to get more proactive. We 
need you to take serious action.
    Chairman, Ranking members, members of these committees, 
this concludes my testimony, and I am happy to take any 
questions you may have.

    [The prepared statement of Mr. Heun appears on page 192 of 
the Appendix.]

    Chairman Tester. Thank you. Next up virtually we have from 
the National Coalition of Homeless Veterans, Kathryn Monet.

                  STATEMENT OF KATHRYN MONET,

           EXECUTIVE DIRECTOR, NATIONAL HEADQUARTERS,

            NATIONAL COALITION FOR HOMELESS VETERANS

    Ms. Monet. Chairs Tester and Takano, Ranking Members Moran 
and Bost, and distinguished members of the committees, thank 
you for the opportunity to share NCHV's priorities with you 
today. We appreciate your leadership and continuing efforts to 
focus on the needs of veterans experiencing or at risk of 
homelessness.
    The support Congress provided has resulted in billions of 
dollars in new resources being utilized nationwide to meet the 
COVID-related needs of veterans by decompressing shelter 
spaces, ramping up rapid re-housing capacity, and focusing on 
individualized housing options in hotels and motels.
    I am going to start with the elephant in the room, and that 
is simply that we know what we know and we don't know what we 
don't know this year on homelessness.
    HUD has recently released 2021--showed a drop of 10 percent 
in the shelter veteran population. But without good data on 
unsheltered veteran homelessness, that information is 
challenging, at best, to interpret. Despite this gap, we remain 
cautiously optimistic that we can continue to reduce veteran 
homelessness if we can maintain enhanced current initiatives.
    As we turn the corner on COVID, we need to reimagine a 
system of care that meets the needs of veteran's basic housing 
and stability and does not leave anyone unsheltered. The 
pandemic has impacted veterans in unprecedented ways, and 
transitional housing programs like GBD are a critical component 
of VA's emergency response capacity for unsheltered veterans.
    VA has recently notified grantees that Department of Health 
and Human Services public health emergency could be lifted as 
early as April. With many programmatic changes set to sunset at 
the end of the declared state of emergency, NCHV has identified 
some program adaptations that should be kept as best practices, 
and extended even beyond this emergency. These include making 
permanent and expanding the Section 4201 spending flexibility 
for SSVF grantees the ability to re-house--rapidly re-house, 
excuse me, veterans into hotels and motels, allowing VA to 
continue offering shallow subsidies to veterans in the SSVF 
program, supporting service providers as they continue to 
decongregate essential transitional housing capacity via 
capital grants, and increasing the permanent reimbursement rate 
for VA's GPD transitional housing program.
    Some new legislative priorities that should be considered 
are creating grant making authority for the HUD-VASH program to 
address the additional acute needs of elderly, rural, and other 
priority populations, such as urban Indians, Alaskan natives, 
and native Hawaiians, expanding HCHV eligibility to veterans 
with other than honorable discharges and Guard and Reserve 
members who have not been called up, and improving the quality 
of HUD-VASH case management and continued congressional 
oversight over case management vacancies, contracting rates, 
and voucher utilization.
    However, the number one challenge that I hear from NCHV 
members is related to planning for the over 60 percent decrease 
in allowable transitional housing reimbursement rates 
anticipated at the end of the public health emergency, if 
Congress fails to act.
    We request that you address this issue immediately for the 
following reasons. One, many providers struggle to offer the 
services required of the program at the rate funded, even 
before the pandemic. But the 300 percent emergency rate allowed 
many to request funding that was more aligned with the actual 
cost of serving the veteran. Two, increases in the rate will 
better support operating costs for those who are reconfiguring 
facilities as the program shifts its inventory toward single 
room options from congregate settings. Three, congregate 
settings are still considered higher risk than a CDC. So many 
providers will still be maintaining COVID safety protocols 
after the end of the public health emergency. Four, non-profit 
organizations that have a heart for serving homeless veterans 
should not be subject to congressionally driven unfunded 
mandates that require the provision of a set menu of services 
at a rate that doesn't even begin to cover them. And five, many 
organizations receive a much higher rate from comparable VA 
transitional housing programs, like HCHV, which is also a 
program that is dramatically underfunded.
    S. 2172 addresses this and other issues. And as such, NCHV 
and over 60 organizations urge prompt legislative action to 
reserve and enhance direly needed COVID-19 related 
improvements. Without a legislative fix, additional VA grantees 
will be forced to make tough financial decisions about whether 
to continue prioritizing COVID safety in congregate settings at 
a financial loss, returning to pre-COVID occupancy levels, or 
discontinuing essential shelter and treatment program 
operations all together.
    This bill would reduce the regulatory burden on funding for 
renovations of shelters for all veterans experiencing 
homelessness, and it would provide organizations nationwide 
with the funding and flexibility to provide adequate services 
to unhoused veterans.
    There are other provisions in this bill, and the slew of 
accompanying House bills that go along with this, that are 
critical to our ability to address veteran homelessness.
    For example, provisions that would allow VA to provide 
adequate training and technical assistance for its homeless 
programs, and provisions that would recognize the impact of the 
Department of Labor's HVRP program in terms of connecting 
veterans with long term, meaningful jobs. We have a renewed 
opportunity to continue reducing veteran homelessness 
nationwide.
    In summation, thank you so much for your continued 
partnership to ensure that every veteran facing the housing 
crisis has access to safe, decent, and affordable housing, 
paired with the support services needed to remain stably 
housed.

    [The prepared statement of Ms. Monet appears on page 209 of 
the Appendix.]

    Chairman Tester. Service Women's Action Network, Lory 
Manning.

                   STATEMENT OF LORY MANNING,

       CAPTAIN (RET.), DIRECTOR OF GOVERNMENT OPERATIONS,

                 SERVICE WOMEN'S ACTION NETWORK

    Ms. Manning. Good afternoon. On behalf of the Service 
Women's Action Network, thank you for the opportunity to share 
SWAN's legislative agenda for 2022.
    Since SWAN members are predominantly women veterans, I am 
going to concentrate on legislative priorities that we believe 
will improve the experiences of women veterans, and men too, 
who use VA services.
    Our priorities are: one, ensuring women veterans feel safe, 
welcome, and well cared for when they visit VA facilities. We 
thank Congress for passing the Deborah Sampson Act as part of 
the Johnny Isakson and David Roe Veterans Health Care Act of 
2021, which tasked the Secretary of Veterans Affairs with 
creating a comprehensive plan to eliminate the sexual assault 
and harassment of women veterans using VA facilities. And we 
stand by to assist VA in any way we can, and to work with your 
committees to ensure that this requirement is met.
    Number two, fix the Veterans Benefits Administration's 
broken system for processing compensation and pension 
disability claims tied to military sexual trauma. Both Congress 
and VA have been working on this for many years. There have 
been congressional hearings, GAO reports, and reports from the 
VA Inspector General. Just over 6 months ago, a VA IG report 
found that 57 percent of denied MST claims were improperly 
processed. This broken system must be fixed.
    Therefore, SWAN strongly supports the passage of the 
Servicemembers and Veterans Empowerment and Support Act of 
2021, and we thank its sponsors in both houses, including 
Senators Tester, Murkowsi, and Congresswoman Pingree.
    Three, reforming the Veterans Benefits Administration's 
character of discharge determination process. Over the years, 
many veterans suffering from post-traumatic stress disorder due 
to combat, military sexual trauma, or other military 
experiences, as well as generations of LGBT veterans have been 
disqualified from VA benefits because they received other than 
honorable or bad conduct discharges tied to service-connected 
conditions, or simply because of who they were.
    VBA has long had a remedy, the character of discharge 
determination so veterans unfairly discharged with either OTH 
or BCDs could receive health care and other benefits, even if 
they had not received a discharge upgrade from their service.
    We would like to see VBA make better use of this process in 
aid of these veterans, and so we strongly support the passage 
of the Unlawful Turn-Aways Act, and we thank Senator Blumenthal 
and Congresswoman Underwood for introducing it.
    We, of course, support the PACT Act and the Cost of War 
Act, and we believe all burn pit and toxic exposure studies 
must examine the effect of such exposures on the development of 
breast cancer and infertility in both men and women.
    Five, the elimination of copays for contraceptives and 
widening access to in vitro fertilization. Most VA users are 
charged a copay for contraception. Considering the provisions 
of the ACA, that is disgraceful. We thank the House of 
Representatives for passing the Equal Access to Contraceptives 
for Veterans Act last June, and we ask the Senate to do the 
same.
    We also ask Congress to expand access to in vitro 
fertilization treatment for all veterans with service-connected 
infertility. Right now, there is a rule limiting IVF treatment 
for veterans suffering from service-connected infertility to 
those in heterosexual marriages, and only if they can produce 
their own gametes and carry a fetus to term. Please open IVF 
treatment to all veterans suffering from service-connected 
infertility.
    I deeply appreciate this opportunity to present SWAN's 
legislative priorities, which are so important to so many women 
veterans. Thank you for your time and consideration.

    [The prepared statement of Ms. Manning appears on page 216 
of the Appendix.]

    Chairman Takano. Thank you, Ms. Monet. Thank you. I now 
would like to turn it over to recognize--excuse me, Captain 
Manning. Excuse me about that. For 5 minutes, Mr. McNeil. Mr. 
McNeil?

              STATEMENT OF JOSEPH D. MCNEIL, SR.,
        NATIONAL PRESIDENT, BLINDED VETERANS ASSOCIATION

    Mr. McNeil. I am here. Thank you.
    I want to present the way a blinded veteran would have to 
present anything in any [Audio malfunction.] Message content, 
[Audio malfunction.] Inbox. Message content. Good afternoon, I 
want to thank the committee for allowing us to present 
virtually and for the members who are watching.
    Chairman Tester, Chairman Takano, Ranking Member Moran, 
Ranking Member Bost, and distinguished members of the 
Committees on Veterans Affairs, on behalf of the Blinded 
Veterans Association (BVA) and its membership, we appreciate 
this opportunity to present our legislative priorities for 
2022. As the only congressionally chartered Veterans Service 
Organization exclusively dedicated to serving the needs of our 
Nation's blinded veterans and their families, BVA first wishes 
to point out March 28 is our anniversary of our 77th year of 
our founding by World War II blinded veterans at Avon Old Farms 
Convalescent Home in Connecticut in 1945.
    BVA hopes that this second session of the 117th Congress 
will productively address the following legislative priorities: 
One, oversight of VA 508 compliance; two, caregiver benefits 
for catastrophically disabled blinded veterans; three, 
renewable VA Auto Grant for service-connected blinded veterans; 
four, support the continued improvement of programs and 
services for women veterans; five, support adequate funding of 
Veterans Health Administration Blind Rehabilitation Service; 
six, request the enactment of adequate protections for guide 
dogs and service dogs on Federal properties; seven, Defense 
Health Agency (DHA)-Blind Rehabilitation Service (BRS) 
Continuum of Care; eight, support the VA fiscal year 2023 
Budget request for prosthetics and sensory aids.
    I will highlight three of our priorities. One, oversight of 
VA 508 compliance. BVA thanks Congress for its continued 
support of our Nation's blind and visually impaired veterans, 
demonstrated most by the passage of S. 3587, the VA Website 
Accessibility Act of 2019. This bipartisan legislation directed 
VA to report to Congress on the accessibility of VA websites. 
This report shows that only 7.7 percent of all 812 VA websites 
are fully 508 compliant, which means they have failed. 
Uncovering a significant barrier that blind and visually 
impaired persons--including veterans and VA employees--have 
known for over two decades, it needs to come down.
    The law requires that all VA websites, medical center 
check-in kiosks, and the new Cerner Electronic Health Record, 
be fully 508 compliant. BVA requests stronger congressional 
oversight and agency transparency on VA's progress of updating 
websites, files, and applications that are still inaccessible. 
BVA urges VA to create an Under Secretary of Accessibility to 
champion with the authority and subject matter expertise to 
lead VA's 508 compliance efforts.
    Two: Caregiver benefits for catastrophically disabled 
blinded veterans. VA reported that 80 percent of all PCAFC 
applications for fiscal year 2021 were denied. BVA is concerned 
that blinded veterans are being discriminated against. Denied 
fair, adequate reasons and bases for PCAFC decisions and being 
denied access to their files has been unfairly and unlawfully 
inhibited their ability to appeal. There are gross violations 
of--[Audio malfunction.] And veterans face an ambiguous 
eligibility standard based on VA's rulemaking, which has made 
them cryptic and--I'm sorry, excuse me.
    1620. Alert. Turn off airplane mode or use settings. OK. 
Button. Seven defense health agency--deep--this bipartisan--the 
law requires that all--The law requires that all VA websites, 
medical center check-in kiosks, and the new Cerner Electronic 
Health Record, be fully 508 compliant. BVA requests stronger 
congressional oversight and agency transparency on VA's 
progress of updating websites, files, and applications that are 
still inaccessible. BVA urges VA to create an Under Secretary 
of Accessibility to champion with the authority and subject 
matter expertise to lead VA's 508 compliance efforts.
    Two: Caregiver benefits for catastrophically disabled 
blinded veterans. VA reported that 80 percent of all PCAFC 
applications for Fiscal Year 2021 were denied. BVA is concerned 
that blinded veterans are being discriminated against. Denied 
fair, adequate reasons and bases for PCAFC decisions and being 
denied access to their files has been unfairly and unlawfully 
inhibited their ability to appeal. These are gross violations 
of due process.
    Further, blinded veterans face an ambiguous eligibility 
standard based on VA's rulemaking, which has made them cryptic 
at most. The subjectivity in the evaluation of their 
disabilities further complicates the adjudication process of 
blinded veteran applications causing their denial.
    Caregivers are the most important component of 
rehabilitation and maintenance for veterans with catastrophic 
injuries and the welfare of their caregiver has a direct impact 
on the quality of care and quality of life they can sustain.
    BVA urges that Congress provide further clarification on 
eligibility standards such as a clear definition of the need 
for supervision, protection, or instruction in order for the 
individual to maintain personal safety on a daily basis, and a 
definition of activities of daily living, which the VA has 
failed to provide in its rulemaking process.
    BVA strongly supports modification of PCAFC eligibility 
criteria regarding activities of daily living to include 
catastrophically disabled blinded veterans. Blinded veterans 
want a fair opportunity to be considered for the PCAFC program.
    Three: Renewable VA auto grant for service-connected 
blinded veterans. Accessible transportation options remain a 
persistent problem for blinded veterans. Public transportation 
is not equal across the country, especially in rural areas. 
This causes issues when veterans are trying to pursue 
employment or reach medical appointments.
    The VA Automobile Allowance makes healthcare and employment 
more accessible to blinded veterans who have a spouse or other 
person who can drive for them. To mitigate this hardship, BVA 
supports the IBVSO recommendation of a renewable Automobile 
Grant for eligible veterans equal to 100 percent of the grant 
maximum amount at the time the grant is renewed. BVA strongly 
supports H.R. 1361 and S. 444, AUTO for Veterans Act.
    Conclusion: Once again, Chairman Tester, Chairman Takano, 
Ranking Member Moran, Ranking Member Bost, and all committee 
members, thank you for the opportunity to present to you today 
the legislative priorities of the Blinded Veterans Association. 
We look forward to furthering our relationships and working 
with you productively during these challenging times.
    I stand ready to answer. Thank you for giving us the 
opportunity to present. I did this in the virtual way so that 
you understand how a blind veteran has to read or see 
documents. I stand ready for any questions.

    [The prepared statement of Mr. McNeil appears on page 226 
of the Appendix.]

    Chairman Takano. Thank you, Mr. McNeil.
    Mr. LaGroon, you are recognized for 5 minutes.

                  STATEMENT OF VICTOR LAGROON,
          DIRECTOR, BLACK VETERANS EMPOWERMENT COUNCIL

    Mr. LaGroon. Chairmen Takano, Tester and Ranking Members 
Bost and Moran, I am pleased to speak before the Joint House 
and Senate Veterans Service Organizations hearing today on 
behalf of the Black Veterans Empowerment Council.
    BVEC is a non-partisan coalition of national, State and 
local veterans organizations seeking to shift long-standing 
racial inequities suffered by Black veterans in the United 
States. Since its inception, BVEC has grown to represent 15-
plus organizations nationally, representing more than 20,000 
members with the ability to reach hundreds of thousands more in 
communities across our Nation, as well as in bases 
internationally.
    The BVEC has been greatly appreciative of the opportunity 
to collaborate robustly with the HVAC, as well as the SVAC in 
advancing sensible and sustainable solutions to the issues 
affecting all veterans.
    As the work of the 117th Congress progresses, we understand 
that that country is at a nexus of crises. Political discourse 
and discord and unrest, rising military conflicts, economic 
recessions, and the tail end of a 2-year pandemic. We must all 
work to ensure no veteran is left behind during these difficult 
times.
    Under benefits and usage, Black veterans disproportionately 
hail from at-risk, low-income, and underserved communities, 
joining the military in the hopes of serving our Nation while 
seeking economic mobility and access to housing, education and 
healthcare benefits often lacking in their respective 
environments.
    Though underserved communities are heavily recruited, many 
Black veterans return to resource-poor neighborhoods and 
withstand frequent denials, deterrence, and misinformation on 
how to appropriately utilize and access the veterans benefits 
they have earned. To that end, BVEC is piloting an initiative 
to train 500 Black service officers across the country to 
ensure veterans benefits are widely understood and adequately 
accessed.
    To address historical disparities, VA must contend with the 
ways dishonorable discharges have adversely affected Black 
servicemembers, impeding their ability to attain crucial 
veterans benefits and job placement post-service. A legacy of 
stark disparities in punishment under the Uniform Code of 
Military Justice continues to fuel a pipeline of Black veterans 
who fall victim to homelessness, joblessness, and mental health 
crises which place undue burden on under-resourced 
municipalities and nonprofits.
    The BVEC calls for the convening of a task force to 
formulate recommendations to confront the legacy of 
discriminatory bad paper discharges with an emphasis on 
disproportionate impact on Black and minority veterans to 
ascertain and codify VA's role in mitigating this harm moving 
forward.
    To fulfill its commitment to diversity, equity, and 
inclusion, VA must also improve micro-targeting outreach across 
the Black veterans community. BVEC and its affiliated partners 
and organizations stand--excuse me--crisis coupled with 
persistent unemployment and underemployment reflect a bleak 
series of crises on the horizon.
    As a host of factors complicate benefit utilization, BVEC 
supports the work of the Black Veterans Project in advancing 
research on racial disparities in access to veterans benefits 
across the Department of Veterans Affairs. The BVP's findings 
to date reveal statistically significant racial disparities in 
disability rates and denials suffered by Black veterans and 
highlights a need for redress and reform. For example, Black 
veterans suffer from a 30 percent disparity in mental health 
benefits approval.
    As it pertains to Black women, the BVEC commends the 
passage of the Deborah Sampson Act which provides much needed 
reforms to VA accommodations to care for women veterans. We 
also applaud the implementation of a zero-tolerance policy 
around sexual harassment at VA facilities championed by 
Chairman Tester.
    Women of color continue to be the fastest growing segment 
of our homeless veteran community. We ask that the VA 
prioritize a plan centered on preventing and aiding our women 
members with stable housing, suitable for them and when 
applicable, their children.
    As it pertains to the 6888 congressional Gold Medal, the 
BVEC commends the passage of a bipartisan legislation to award 
the congressional Gold Medal to the members of the Women's 
Auxiliary Corps, who were assigned to the 6888th Central Postal 
Directory Battalion, the ``Six-Triple-Eight'' during World War 
II. Given the increasing age of surviving 6888 veterans, this 
historic and groundbreaking women's organization deserves to be 
addressed and recognized for their sacrifices and commitments.
    And, finally, under the G.I. Bill Repair Act, the 
introduction of the G.I. Bill Repair Act by U.S. House Majority 
Whip James E. Clyburn and Congressman Seth Moulton, which seeks 
to provide GI Bill benefits to the surviving spouse and 
descendants of Black World War II veterans alive, and those who 
have passed, this bill's enactment is profoundly necessary 
legislation that begins with the process of amending that over 
900,0000 Black World War II veterans and their families who 
were denied access and utilization to those benefits at their 
time of separation from war. I appreciate the opportunity to 
serve before you today and I stand ready to answer any 
questions that you have. Thank you.

    [The prepared statement of Mr. LaGroon appears on page 235 
of the Appendix.]

    Chairman Takano. Thank you, Mr. LaGroon.
    Mr. Palladino, you are now recognized for 5 minutes.

STATEMENT OF THOMAS PALLADINO, PRESIDENT AND EXECUTIVE DIRECTOR 
OF THE TEXAS VETERANS COMMISSION, NATIONAL ASSOCIATION OF STATE 
             DIRECTORS OF VETERANS AFFAIRS (NASDVA)

    Mr. Palladino. Thank you very much.
    Chairman Tester, Chairman Takano, Ranking Members Bost and 
Moran, and distinguished members of the joint committee, my 
name is Tom Palladino, President of National Association of 
State Directors of Veterans Affairs, otherwise known as NASDVA, 
and the Executive Director of the Texas Veterans Commission.
    Our association is comprised of the executive leaders 
representing the Veterans Affairs agencies in all 50 States, 
five territories, and the District of Columbia. We are tasked 
by our respective Governors and legislatures to address the 
needs and improve the lives of our veterans, their families, 
and survivors, and to ensure they receive the services and 
benefits they have earned.
    Nationally, we are the second largest provider of veterans 
services after the Federal VA and our roles continue to expand. 
NASDVA, through its members, States, and territories, is the 
single organization that represents and serves all of America's 
19 million veterans and their families. We collectively 
contribute nearly $10 billion each year in support of our 
Nation's veterans.
    NASDVA has a longstanding partnership with the United 
States Department of Veterans Affairs. Since 2012, we have 
entered into a formal memorandum of agreement between the VA 
and NASDVA to increase our direct services to our veterans and 
their families. Last week, VA Secretary Denis McDonough and I 
updated the memorandum of agreement on behalf of our 
organizations, enhancing our cooperative relationship.
    Our written testimony covers a wide range of items, so, due 
to time limitations, I will focus only on a few. So, NASDVA 
requests full congressional support of the President's fiscal 
year 2022 VA budget in order to deliver services to meet the 
needs of our veterans.
    Second, NASDVA fully supports efforts to increase veterans' 
access to VA healthcare under the provisions of the MISSION 
Act.
    While the VA continues to place emphasis on suicide 
prevention, there is still much work to be done, given that the 
rate of suicide is still too high. It is vital that the 
Veterans Health Administration work with the States to address 
this critical issue. NASDVA proposes a creation of outreach 
grants from the VA to the States to increase veteran suicide 
prevention and awareness.
    Third, NASDVA, along with the National Association of State 
Veterans Homes supports a continued commitment to substantial 
funding of the VA's State Veterans Home Construction Grant 
Program, which is the largest provider of long-term care to 
America's veterans.
    We request full funding support for all Priority 1 
projects, increasing the VA budget for State Veterans Homes 
from 90 to $500 million.
    Fourth, regarding veterans benefits services, States and 
territories continue to take on a greater role representing 
veterans filing disability claims and pension. Regardless of 
whether States view State employees, veteran service 
organizations, or county veteran service officers, 
collectively, we are essentially in advocating for veterans and 
working with the Veterans Benefits Administration to 
effectively manage the claims process.
    Given the claims backlog and the number of claims on 
appeal, NASDVA recommends making Federal funding available to 
States for claims, advocacy, and to further reduce the backlog 
and maintain progress on expediting existing and new claims.
    One of the results of the Appeals Modernization Act is an 
increase in veterans choosing hearings at the Board of 
Veterans' Appeals. We commend the VBA for increasing the number 
of virtual hearings; however, the VBA still uses manual 
procedures in the appeal process, so NASDVA supports BVA's 
request for additional funding to automate their processes, 
which will result in an increased number of timely Board 
decisions.
    Fifth, the VA National Cemetery Administration partners 
with States, territories, and tribal governments to manage the 
Veterans Cemetery Grant Program. NASDVA recommends that that 
the Construction Grant Program [Audio malfunction.]

    [The prepared statement of Mr. Palladino appears on page 
238 of the Appendix.]

    Chairman Takano. Senator Moran, I am going to call on you 
for your 5 minutes of questioning.
    Senator Moran, go ahead.
    Senator Moran. Chairman Takano, thank you very much.
    Let me begin with, well, first of all, I want to make 
certain that I express my gratitude for your remarks, Mr. 
LaGroon in regard to the 6888. There was a monument built at 
Fort Leavenworth in honor of these African-American women and 
it caused me to have a knowledge and an interest, and I am 
pleased to have a House Bill--have the House now pass a Senate 
bill that is on its way to the President and allowing a 
Congressional Medal to honor the survivors. And I thank you for 
recognizing their service to our Nation in difficult 
circumstances and I am grateful for that.
    Let me talk to Mr. Butler about our withdrawal from 
Afghanistan. Mr. Butler, let me find you. There you are.
    I have spoken certainly at home and here on the Senate 
floor about my concerns about how we left Afghanistan last year 
and I know that there are many veterans who continue to bear 
the brunt of that, the manner by which we withdrew. We know 
that there were consequences to their mental health and well-
being and concerns about suicide ideation, not just for Iraq 
and Afghanistan veterans; for others, as well.
    Tell me what your experience is in regard, consequences in 
regard to this circumstance, and if you can then, in addition, 
to what it meant to those who served there, what about the 
efforts that you know about or any continuing efforts to get 
others out of Afghanistan.
    Mr. Butler. Yes, sir. Thank you for the question.
    It is something we want to address. It is a priority. I 
touch on it in our written comments. A few things. I don't 
think that there is a more galvanizing issue around which the 
veteran community has rallied with one single voice. Toxic 
exposure, frankly, might be the other one. But the withdrawal 
from Afghanistan, the following effects, the need to get our 
Afghan allies out, that has been something where the veteran 
community has spoken with one voice.
    We saw the response from the military and veteran 
community, the desire to get them out. We saw the impact that 
it had on the military and veteran community. Our program that 
IAVA has a Quick Reaction Force, where it provides direct 
support to veterans. We saw a massive increase in folks 
reaching out for help, mental health care, support, and things 
like that, because of how it was affecting them.
    We applaud Congress for including the Afghan War Commission 
Act in the NDAA. That is going to go a long way to addressing 
the things that went wrong, not just with the withdrawal, but, 
frankly, throughout the 20 years that we were in Afghanistan.
    One of the big things we are pushing for now is the Afghan 
Adjustment Act to make sure that we are taking care of our 
Afghan allies and we continue to coalesce around the need, the 
absolute need to focus on those who are still left behind. The 
situation in Afghanistan is deteriorating. It seems very 
evidence that the Taliban is taking advantage of the fact that 
the world has shifted their attention to Ukraine to do things 
like, literally, not allowing women to leave the country 
anymore. That is something that was just announced by the 
Taliban within the last few days, obviously, because the world 
is not paying attention anymore and we have to make sure that 
that isn't allowed to happen. That we continue to focus to not 
only get our allies out, but then to make sure that they are 
taken care of when they get to the U.S. or whatever country 
they are going to settle in.
    Senator Moran. Just in Kansas alone or at least in our 
office, Kansans provided us with the names of a thousand 
individuals, a thousand-plus individuals of individuals who 
were still in Afghanistan asking for our help for their 
departure and I don't want the focus to not shine as well 
Ukraine is an important issue at the moment, important and 
tragic, but there are people who are still in need of our help. 
And if there are ways that we can help you or you can help us 
in that regard, we volunteer. Thank you.
    Thank you, Mr. Chairman.
    I turn to Ranking Member Bost.
    Mr. Bost. Thank you. You know, this could--whoever would 
want the answer to this, you know, we are hearing concerns in 
our office both, in district and then here, also, through other 
members that know of the position I have with the Veterans 
Affairs' Committee that people are still having trouble getting 
appointments in the VA. We are also hearing that many of them, 
and I will give you an example of one particular legislator 
that brought this to us and tried to deal with this, there was 
a--and, basically, it is not fulfilling the MISSION Act like we 
put it in place to do. We had one veteran who was actually in 
the middle of receiving chemotherapy and received a letter from 
the VA that they need to return to get that chemotherapy at the 
VA, and when they got to the VA, the VA said they didn't have 
room for them and they didn't--wouldn't understand why they 
interrupted that.
    Are you hearing concerns like this, where many of your 
members that might be in rural areas around the Nation, are 
having these same types of problems of still getting care and 
service?
    Mr. Linnington. Ranking Member Bost, this is Lieutenant 
General Linnington from Wounded Warrior Project. Continuing--we 
believe the VA is the best place to get care for veterans and 
that is, as evidenced in our annual warrior survey where the 
majority of our veterans get their healthcare from the VA. And 
even during the period of COVID, 7 in 10 got telemedical 
support, telemedicine from the VA and 81 percent were happy 
with that.
    That said, we do need to continue to provide access to 
veterans in more robust manners through the Community Care 
Program. That was part of the MISSION Act that still needs to 
be enacted in areas where veterans are having difficulty.
    I will tell you that the Staff Sergeant Parker Gordon Fox 
Suicide Prevention Grant Program, as part of the Commander 
Scott Hannon Act needs to be implemented quickly because there 
are a lot of community-based programs where veterans aren't 
able to get care, that they can get care utilizing that grant 
program.
    Mr. McNeil. Ranking Member Bost?
    Mr. Bost. Yes.
    Mr. McNeil. This is McNeil for the BVA.
    There is an issue with the Community Care base program, 
which part of it may relate with the VA. The fact that we 
identify a veteran that is in crisis by a flag when he checks 
in, but when you have an MST veteran or a blinded veteran, you 
can't identify them when they go to the VA or to community-
based plan.
    There was with a recent where a female veteran, an MST, 
went to a C&P and it was a male clinician that was going to do 
the exam. And she ran out of there and I thought it was 
something that should have been looked at.
    If you can identify a troubled veteran that has PTSD, why 
can you not flag the MST ones so they are aware that they are 
there and a blinded veteran that [inaudible] instead of asking 
the question.
    Mr. Bost. Sure.
    Others? Because we don't have much time, let me just say 
thank you to all of you and for the services that you provide. 
You are our front line and you give us the information that we 
need. I appreciate each and every one of you.
    And with that, Chairman, I yield back.
    Chairman Takano. Ms. Underwood?

                     HON. LAUREN UNDERWOOD,
               U.S. REPRESENTATIVE FROM ILLINOIS

    Ms. Underwood. Thank you so much.
    And thank you to our representatives from the VSOs who are 
here with us today. It has been an honor to work alongside you 
on behalf of our Nation's veterans, including via my Protecting 
Moms Who Served Act, which President Biden signed into law last 
November. The Protecting Moms Who Served Act is a historic step 
to provide our veterans with the world-class maternal 
healthcare they have earned and the bill commissions the first-
ever comprehensive study of maternal mortality, morbidity, and 
disparities among veterans, and it also authorizes $15 million 
in new funding to strengthen VA's Maternity Care Coordination 
Programs.
    The Wounded Warrior Project not only endorsed this bill, 
but also worked tirelessly to build momentum for the 
legislation to pass in the House and the Senate, and I am so 
glad that we have Lieutenant General Michael Linnington, the 
CEO of the Wounded Warrior Project with us today.
    Lieutenant General Linnington, as we prepare for the fiscal 
year 2023 appropriations process, can you describe why it is so 
important to fully fund the Protecting Moms Who Served Act 
authorization and ensure that VA's Maternity Care Coordination 
Programs have the staff and resources they need.
    Mr. Linnington. Representative Underwood, first of all, let 
me just say thank you for championing that legislation, 
Protecting Moms Who Served Act. It was a critical piece of the 
legislation. We are very proud to support it.
    And we know that comprehensive maternity care is absolutely 
critical for all women veterans that choose to become moms. We 
also know that women veterans using VA maternity care are more 
likely to experience pregnancy complications and for a variety 
of reasons, because they have been deployed, have PTSD, have 
MST in their background, et cetera.
    I can't think of something more important, next year, as to 
extend that $15 million funding into subsequent years. So, we 
appreciate you letting us know about that legislation. It is 
certainly welcomed, not just from our women veterans, but from 
all of our veterans want to support our women alumni.
    Ms. Underwood. Well, thank you, sir.
    We are looking forward to working with you on that 
appropriations process.
    This week, the House of Representatives is preparing to 
vote on Honoring Our PACT Act, a bipartisan bill that will 
finally provide access to VA healthcare for more than 3 and a 
half million veterans exposed to toxic substances. I am proud 
to be an original co-sponsor of the Honoring Our PACT Act, 
which is a full accounting of the true cost of war. And I 
appreciate the recent comments from Jeremy Butler, the CEO of 
the Iraq and Afghanistan Veterans of America who emphasized the 
need for the Senate to follow the lead of the House and take 
comprehensive action of toxic exposure legislation.
    Mr. Butler, last month you explained on CNN that the 
piecemeal legislation passed by the Senate basically does about 
a third--that is a quote--of what VSOs have been calling for in 
legislation to address toxic exposures. Can you describe why it 
is so important that the Senate pass comprehensive legislation 
like the Honoring Our PACT Act.
    Mr. Butler. Yes, thank you for the question.
    I mean, really, it is for two reasons. One, it is 
completely overdue, and, two, the statistics that I cited in my 
testimony, 70 percent of veterans who are applying for burn pit 
and other toxic-related benefits from the VA are getting 
denied. We need to get beyond this point where we are forcing 
veterans, sometimes literally on their death beds, for VA 
benefits that they were guaranteed when they signed up for 
service.
    The Cost of War Act, the Honoring Our PACT Act, that does 
everything that veterans got together and put down in 
legislation, handed to the VA committees and saying, this is 
what we need to do. That legislation gets this done.
    A piecemeal effort just means we are going to continue to 
have to be back here, not just year after year, but month after 
month, to tell you that the job is not done, veterans are still 
dying, and we are still waiting on you to do what we told you 
needed to be done.
    So, now is the time. Literally, tomorrow, the House of 
Representatives has the opportunity to pass the comprehensive 
bill, send it to the Senate, and get things done.
    Ms. Underwood. Get things done; that is what we are here to 
do.
    Thank you all so much for being here and I am so pleased 
that we have had the opportunity to hear from so many of you.
    I would like to yield 2 minutes to Thomas Palladino in 
order for him to be able to complete his testimony.
    Mr. Palladino. Thank you very much. I really appreciate 
that, Congresswoman. My power went out and I don't know what it 
was, but I got back on and so I will complete the testimony.
    So, I was talking about the VA National Cemetery 
Administration partnering with the States, territories, and 
tribal governments to manage the veteran cemetery program. And 
so, NASDVA recommends the Construction Grant Program budget be 
increased from 45 to $60 million. This modest increase to the 
budget would allow funding of new State cemeteries to bring 
burial benefits to the growing needs of eligible veterans, 
spouses, and families.
    Six. Women now comprise nearly 20 percent of the Armed 
Forces and are the fastest growing veteran cohort. There are 
several areas NASDVA believes VA can work on to close gaps in 
service, ensure continuity of care, and better address the 
needs of women veterans. One is a disproportionate and 
nonstandard availability to access gender-specific healthcare. 
The decision-making and planning for new services must be data-
driven and veteran-centric to ensure all veterans, regardless 
of gender, receive the care they have earned.
    Seven, and the last issue, is the Transition Assistance 
Program, TAP, is a cooperative effort among DoD, DOL, and the 
VA; however, there is no mandate to include the States in the 
TAP curriculum. It is a major challenge for transitioning 
servicemembers to connect with State benefits and services that 
are available to them. This lack of connectivity between 
transitioning servicemembers and the States is not only a 
significant barrier to their employment, but increases their 
mental stress associated with their transition.
    So, NASDVA recommends that all State Department of Veterans 
Affairs be included the TAP at military installation in their 
State and be allowed to connect with transitioning 
servicemembers who are moving to their State, prior to 
separation, to inform them of their specific benefits in each 
particular State.
    Mr. Chairman, distinguishing members of the House and 
Senate Veterans Affairs Committee, with your continued support, 
we can ensure that the needs of our veterans and their families 
are addressed, adequately resourced and remain a priority.
    Thank you for your work on behalf of our Nation's veterans, 
and for including the National Association of State Directors 
of Veterans Affairs in this hearing and allowing me to come 
back online after our EMP disaster down here. So, thank you 
very much. I welcome any questions you have or comments on 
behalf of those we serve. Thank you.
    Ms. Underwood. Well, Mr. Palladino, thank you so much. And 
thank you to the VSO witnesses that have joined us.
    Subject to the call of the chair, this hearing is in recess 
for votes.
    [Recess.]
    Mr. Mrvan [presiding]. I bring the meeting back to order.
    I recognize myself for 5 minutes. I have a question for 
General Linnington. You mentioned the importance of VA's 
successful implementation of the electronic health 
modernization program. Are there any capabilities and services 
that VA is not able to provide veterans with their current 
system that you would like to see provided?
    Mr. Linnington. Representative Mrvan, you know, I am going 
to have to get back with you on that. If you don't mind, I will 
take that one for the record. I am not an expert on VBMS or the 
EHR. I do know that it is 20 years' overdue. I really applaud 
the work of DoD and VA and the Congress to finally collaborate 
on a single solution. But I do not know of any capabilities 
that we would like to add to the current system.
    Mr. Mrvan. Okay.
    Mr. McNeil. Mr. Chair?
    Mr. Mrvan. Yes?
    Mr. McNeil. Joe McNeil, Blinded Veterans Association. Our 
main concern is the accessibility of the systems, getting into 
them. The fact that they are going to create a system that is 
not accessible to blind veterans, it is like kicking the can 
down the road, which we have been doing for 20 years. They say 
they are going to fix it and they keep promising to fix it and 
this is year over year over year. This becomes a decision. They 
have not consciously fixed it so that blinded veterans can use 
kiosks, this new system they have coming out, Cerner, none of 
this helps a blinded veteran.
    You are going to put a system out that you are going to 
turn around and come back and have patches for it. That is job 
security for the people that are creating the system. That is 
not helping us.
    Mr. Mrvan. Thank you very much, Joe.
    If I might follow up with what are some systematic cures 
for what you have seen as it is missing?
    Mr. McNeil. Well, we start with the kiosks. The kiosks are 
not accessible at all. We do everything with audible listening, 
as by my presentation, which was audible. I can't read a 
written document. Most of the veterans that are visually 
impaired or blind can't, so because of that, you have to listen 
to what is going on. If it is not talking to us, we can't do 
anything with it.
    And when you are looking at checking in for a kiosk or 
trying to access a website, if a website is not accessible to 
us, how are we supposed to fill out a form or even process 
something that we can't get to?
    Mr. Mrvan. Okay. Thank you very much, Mr. McNeil.
    At this time, Mr. LaGroon, the promise of the 
interoperability between the Department of Defense and the VA 
health records is the core goal of electronic health record 
modernization. How are the current delays and deployment of a 
new system impacting veteran's care?
    Mr. LaGroon. Well, sir, to be honest with you and frank, 
any delay is significant. Wait lines and wait times for 
veterans have been substantially impacted by COVID and the 
shift of attention and resources to address those needs and I 
think they are extremely important; however, we also see 
significant delays in people having access to mental health 
being qualified, being certified, getting competent care, and 
it also has impacted how people can get not just primary care, 
but specialty care.
    So, if you were a veteran and you were seeking care for 
cancer, for example, and you wanted to get a referral to 
someone who was an oncologist and you were deferred because of 
COVID and some of the other factors, being processed through 
the system has been slagged, it has been dragged down, but it 
also has been delayed, which has further delayed many people 
getting the access that they need in a timely fashion.
    Mr. Mrvan. Okay. Mr. Butler, the Secretary has taken 
several important steps during this past year to--to ensure 
that the Department is welcoming to all veterans. No matter 
what their gender, race, sexual orientation, or background, 
last summer, VA completed the Department-wide review by the 
Inclusion, Diversity, Equity, and Access Task Force, or IDEA 
Task Force, which came up with a number of very useful 
recommendations toward improved inclusion and equity.
    My question for the witness is, how is VA doing? How well 
has the Department been doing in creating a welcoming place for 
all veterans and would you like to see more collaboration and 
coordination between the Department and the VSO community, 
regarding equity and inclusion?
    Mr. Butler. Yes, sir. Thank you for the question.
    And the short answer and to start, really, with your last 
question is, absolutely, yes; more collaboration is the key. We 
were actually talking about that, in between here on the panel, 
and we look forward to not only having more of an inclusive 
panel, as you have done this year, continuing that to give more 
organizations the opportunity to speak directly to you. I think 
Secretary McDonough has been doing a great job of opening 
things up, communicating directly with more of us. We welcome 
more of that.
    One of the things that we have been pushing for, and it was 
great to see an email coming out from the VA just last week was 
on changing the motto to something more inclusive. So, that is 
something that we have been pushing for, for a long time. So, 
there is still always more work to be done, but I think we are 
moving in the right direction.
    Mr. Mrvan. Thank you, Mr. Butler.
    At this time, I would like to recognize Congressman Bergman 
for 5 minutes.

                       HON. JACK BERGMAN,
               U.S. REPRESENTATIVE FROM MICHIGAN

    Mr. Bergman. Thank you, Mr. Chairman.
    First of all, thank you to all of you veterans. Welcome 
home. I can't say that often enough.
    Thank you to all the VSOs present today and, especially 
anyone who might have traveled from Michigan here to DC. We are 
having a wonderfully nice spring day, which we are not in 
Michigan, but that is a different story.
    Commander Heun, I have read your testimony and have heard 
you loud and clear today. I share your frustration. We cannot 
continue to fund the same types of programs and expect a 
different result. We know that is the absolute definition of 
nuttiness, okay.
    I champion the grant program that you are referencing in 
your testimony, because I believe we have to be more innovative 
with veterans' mental health and as you mentioned in your 
testimony, we have to move forward toward an outcomes-based 
model. Fund what works. Fund what leads our veterans toward 
happier, healthier, more productive lives. It seems simple, but 
as you know, the VA seems to really not have a sense of urgency 
in implementing what could be life-saving measures.
    So, what can we do to put pressure on the VA in a positive 
way, hopefully, to act with some sense of urgency?
    Mr. Heun. AMVETS would like to see a roundtable set up in 
the very near future, March or April would be very good, to 
monitor and set goals for the VA. And we would also ask the VA 
to be invited to that roundtable to share of the failures and 
the successes they have seen and, if you would, put a metrics 
on them and, you know, put their feet in the fire, so to say.
    We need to change the goals and the principles of what we 
are doing with veteran suicide. Six thousand a year is just too 
many. It hasn't gone down significantly for the $15 billion 
that we throw into veteran suicide. I believe that, and AMVETS 
believes that if we start monitoring the VA and their successes 
and their failures in this and start outreaching to programs 
that actually work and succeed, because there are programs out 
there, and learn from their successes and their failures, and I 
just don't see that that is happening right now.
    Mr. Bergman. Yes, it is not a simple question and not a 
simple answer. But for at least 5-plus years now with my 
membership on the committee, we have pressed continually, the 
VA to show us some sense of urgency. And there are good folks 
working at the VA, but they need to be led in such a way that 
they know that if they have a good idea, we can get it 
implemented.
    You know, when you mentioned the roundtable, subject-
specific roundtables, back in 115th Congress, we started doing 
roundtables under Chairman Roe's direction and it worked very 
well because we had all the VSOs on one side of the table. We 
had the VA on the other side of the table. And there was a 
subject. And we, as members, just kind of sat there, didn't say 
much; we just listened to the conversation and learned from the 
dialogue between all of you and Veterans Administration.
    So, whatever we can do, especially when it comes to rural 
veterans, and I would suggest to you, rural is not, at least in 
my district, you have got--we don't have any urban in our 
district. We have some, maybe a couple small towns that would 
be considered suburban, but we are rural and remote. So, 
anything that, suggestions that you might have, whether it be, 
you know, procedures, capabilities for the blind veterans, 
especially, when you get into a teleworking situation or, a, 
you know, where you are tapping it out there a synthetic voice, 
or whatever it happens to be, we need those kinds of solutions 
that will work for our veterans who live remotely, because the 
good news is they do. The bad news is when you are remote, you 
are out of contact, which makes you potentially more 
susceptible to suicidal ideations because you don't have that 
human interaction.
    And I just, you know, I appreciate all that you all do. 
Let's keep the dialogue going.
    And with that, Mr. Chairman, I yield back.
    Mr. Mrvan. Thank you, Congressman.
    At this time, I recognize myself for 5 minutes.
    Captain Manning, members of our committee have introduced 
legislation to examine the lasting effects on veterans due to 
past discriminatory Pentagon policies regarding the discharge 
of servicemembers. In past decades, too many servicemembers 
were unfairly discharged under ``Don't Ask, Don't Tell,'' 
because they were suffering from PTSD, due to pregnancy, or due 
to other antiquated reasons, and received ``other than 
honorable'' discharge.
    This has too often resulted in veterans being denied access 
to the benefit that they have earned and need. Can you provide 
your thoughts on the lasting effects of these past and unfair 
discharge policies.
    Ms. Manning. Yes, thank you for that question.
    The first is, particularly when there is an OTH or a BCD 
involved, there are no veterans benefits. There is no G.I. 
Bill. There is no employment and training. There is no 
healthcare, unless you have MST and you can get some minimum 
for that.
    The services right now on the DoD side are doing a lot to 
upgrade some of those discharges, but a lot of these veterans 
have totally lost touch with VA and they don't even know that 
if they have an OTH and if it was military sexual trauma or PSD 
or pregnancy back in the 1950s or 1960s involved, that they can 
even ask for a service discharge upgrade through their service.
    Also, there are a lot of discharges that the services are 
looking at for upgrade and one of the things that we talk about 
a lot is the character of discharge power that VA has. It 
allows them to look at somebody with an OTH discharge or a BCD 
and decide that there were circumstances there and allow them 
to begin to get, at least, some of their benefits. So, even if 
they have tried to get an upgrade through the services, they 
may have to wait a year or two now because they are so 
backlogged and that character discharge power that VA has is 
wasted.
    Most people don't know it exists and there are very few 
statistics on it. When I have looked for statistics on that, 
they seem to do about 3 percent are granted. That is 
ridiculous. And there is no--they don't seem to have any 
transparency, not much that I can find out about the training 
or even what the procedure is.
    So, that whole thing needs to be looked at, and that is why 
we support the bill that Senator Blumenthal and Congresswoman 
Underwood have proposed. That would help.
    Mr. Mrvan. Okay. And I have a follow-up question. Last 
session, we passed the Isakson and Roe Veterans Health Care and 
Benefits Improvement Act of 2020, included the Deborah Sampson 
Act.
    How satisfied are you, thus far, with the VA's 
implementation of these measures and where is there room for 
improvement?
    Ms. Manning. Well, the main thing that VA was charged 
with--well, they were charged with a lot of things on that--but 
specifically, all the best care in the world isn't going to 
help women veterans if they get harassed by their fellow 
veterans or staff members when they go. So, it is clearing up 
that veteran-on-veteran sexual assault and sexual harassment 
that happens at VA. And that is part of the Deborah Sampson 
Act; VA is charged with fixing that.
    You know, Secretary McDonough participated in the 
Independent Review Committee Commission that the Secretary of 
Defense did, but most of the VA participation in that seemed to 
fall away over time. And I think they--I am hoping that they 
will come out with something like an IRC for VA. They need, 
first of all, a system so that a veteran can even report that 
he or she is being sexually harassed or assaulted. It's this 
great stuff laid out if you are a staff member at VA, but there 
is nothing in writing about what a veteran who is a customer 
should do.
    So, they need, and I know they have things going on over 
there, but it is hard to figure out at what stage they are in. 
They do have a special group that meets with the Secretary and 
his staff, but it is hard to get any feedback from where they 
are standing and what they are planning to do. So, transparency 
is the first thing we need and then we can make judgments from 
there.
    Mr. Mrvan. Thank you, Captain.
    At this time, I would like to recognize Representative 
Cawthorn for 5 minutes.

                     HON. MADISON CAWTHORN,
            U.S. REPRESENTATIVE FROM NORTH CAROLINA

    Mr. Cawthorn. Thank you very much, Mr. Chairman.
    And to all of our witness, thank you all very much for 
being here.
    Lieutenant General, in your testimony, you mentioned that 
supporting the expansion of telehealth and telemental health 
would be a net positive. But in Western North Carolina there is 
a dire need for broadband access and it being such a rural 
area, there are so few places. Such a long drive for them to 
get to the VA.
    Do you mind expanding on what Congress can do to ensure 
that we have access for all veterans to telemedicine?
    Mr. Linnington. I can't speak to the broadband issue. I 
will tell you that telemedicine, especially during COVID, was 
something that, I mean, it threw us all on our heels. But we 
quickly translated a lot of our programs to virtual delivery, 
especially in the areas of mental health and our wounded 
warriors did the same. And a large majority of them that took 
advantage of that were women veterans.
    So, that really opened our eyes to the importance of not 
just offering in-person programming, but also offering virtual 
offerings. And as I mentioned in my written testimony, and from 
our recent annual warriors survey, 7 in 10 of our alumni that 
took part in the survey representing all 160,000, took 
advantage of VA telemedicine opportunities during COVID. And it 
had a very high success rate; 81 percent noted that the therapy 
they had received through telemedicine was good, was 
acceptable.
    The broadband issue is a big issue. I am hopeful that, you 
know, some of the infrastructure investments that I see coming 
out now with, you know, with the bipartisan infrastructure bill 
will help with some of the rural areas, establishing those 
broadband areas. And we are working with some of the internet 
providers that are also establishing a broadband islands, a 
thousand of them around the country, to help provide broadband 
access, specifically for veterans, that can allow them to tap 
into some of these virtual offerings.
    Mr. Cawthorn. That is fantastic. Thank you, sir.
    And Lieutenant General, just one follow-up question. You 
know, veterans have ensured that we can all pursue The American 
Dream and I think having the VA loan for veterans to be able to 
achieve The American Dream, to own their own home, it is 
incredible, but what in your opinion can Congress do to make 
entrepreneurship more accessible to veterans with things like 
loans or grant programs or, really, just what are your thoughts 
on that?
    Mr. Linnington. Yes, I think it comes down to training and 
opportunity that the VA and DoD provide at the transition point 
and I think that is key.
    I also know that for veterans to take advantage of an 
entrepreneur program or start their own business, they have to 
have some financial stability to do so and have the 
availability, have the resources to do that. We have found 
that, especially over the past 2 years many of our veterans, 
especially those we serve, wounded, ill, and injured, are in 
financial jeopardy and it is hard to start a business or start 
your own entrepreneurship when you are having trouble putting 
groceries on the table.
    So, I think we have to look at, how do we continue to 
inspire those that can to transition quickly into meaningful 
careers, and then for those that want to pursue the 
entrepreneurship, then you do it with help from the VA, through 
the entrepreneurship program and with organizations like ours 
that can support some of that.
    Mr. Cawthorn. That is fantastic.
    To all of our witnesses, thank you all so much for 
supporting our veteran community so much. It truly means a lot. 
I have got a lot of veterans in my district, and so I really 
appreciate all of your work.
    And with that, Chairman, I yield back.
    Mr. Mrvan. Thank you.
    At this time, I recognize Representative Trone for 5 
minutes.

                       HON. DAVID TRONE,
               U.S. REPRESENTATIVE FROM MARYLAND

    Mr. Trone. Mr. Chairman, thank you very much.
    Last night, I know I was thrilled, and I am sure all of you 
were, to hear President Biden announce his plan for more mental 
health resources during the Save the Union address. I am 
looking forward to working with the VSOs to ensure we can meet 
our promise to provide mental health resources and that they 
are tailored to meet the unique needs of our vets.
    I would like to focus my remarks on the new Staff Sergeant 
Parker Gordon Fox Suicide Prevention Grant Program, which was 
signed into law in 2020. It is part of a broader mental health 
package. Through the important advocacy of the Wounded Warrior 
Project, veterans from across the country have shared how this 
mental health program will support their local communities.
    Right here in my community, Ms. Angela Waller from 
Germantown, Maryland, told us how the increased collaboration 
will help Maryland veterans receive mental health care faster 
in a more coordinated manner.
    When our veterans need care, they need it now and they 
can't be asked to jump through unlimited hoops. So, my first 
question is to Lieutenant General Linnington. It is clear this 
grant program has fantastic potential. What kind of services 
stand out for WWP and what does WWP have any advice for what 
type of programs should be targeted?
    Mr. Linnington. Congressman, first of all, thanks for 
meeting with Angela. I know she was thrilled for having the 
visit with you as part of Operation Advocacy and speaking to 
the issues that we addressed both, in our written statement and 
in our opening comments.
    The grant program under the Staff Sergeant Parker Gordon 
Fox Act is very important to provide communities and community 
programs, community organizations that can provide programs and 
services to veterans to help them connect and heal; heal, both 
physically and mentally, and get back into their jobs.
    Many of these community-based programs don't have the 
resources that government programs have. Certainly, they don't 
have the resources that Wounded Warrior Project has, so 
providing these $750,000 grants as part of the $170 million 
program that was recently approved is very important for those 
organizations to provide community-based programs that help 
that veteran regain the connections and the comradery they had 
when they were in uniform.
    I will also tell you that the best programs are those that 
refer the veteran back into carry-on care at the VA, wherever 
that care is available, because if you don't have that 
continuity of care, then the question is, you know, why?
    So, I am a huge fan of this legislation. Thank you for 
sponsoring it and thanks for getting it off the ground and 
implemented across our country.
    Mr. Trone. It is really important that we handle and deal 
with this area directly and this legislation is one of the 
great first steps. So, thanks for sharing your thoughts.
    I have one last question, which is open to any of the 
panelists. What models of collaboration do you think we can 
create the biggest impact for mental health services? Where 
should be we collaborating to get the most bang for our buck?
    Mr. Linnington. I hate to steal the mike again, but, 
Congressman, I will tell you, we have one right now that we are 
very proud of that we have in partnership with the VA and that 
is our Warrior Care Network. That program is a comprehensive, 
PTSD, intensive outpatient program where any Post-9/11 veteran 
or active-duty servicemembers can go and get 2 weeks of 
intensive outpatient care, individual therapy, group therapy, 
alternate therapy, yoga, tai chi, nutrition. It includes the 
family, includes the service dogs.
    And the VA has a partnership with Wounded Warrior Project 
so that the VA employees are at the site of these four academic 
medical centers at Mass General, Emery, UCLA Health, and Rush 
University. And that, to me, is the best model of collaboration 
in the mental health arena where nonprofit, government, non-
government organizations can work together to get the veteran 
into care and then ensure the continuity of care after the 
veteran completes the program.
    Mr. Trone. Perfect. Well, thank you for your feedback on 
this topic. We have to keep expanding our mental health 
resources for our vets. We owe it to them.
    And with that, I will yield back. Thank you, Mr. Chairman.
    Mr. Mrvan. Thank you, Congressman.
    At this time, I recognize Senator Blumenthal for 5 minutes.

                    HON. RICHARD BLUMENTHAL,
                 U.S. SENATOR FROM CONNECTICUT

    Senator Blumenthal. Thank you so much, Mr. Chairman.
    And thank you to the wonderful representatives of these 
great organizations who are with us on this panel and to the 
earlier panel, the Veterans of Foreign War panel that testified 
so well. I'm sorry, I wasn't able to ask questions then, but I 
was going to mention, as a matter-of-fact, the need or more 
investment in VA infrastructure, which affects all of your 
groups and the veterans we represent.
    There have been a number of incidents that have really 
[inaudible] called for action. One incident related to the 
tragic deaths of a VA employee and a contractor in [inaudible] 
West Haven VA Medical Center and the infrastructure that we 
have at the facility in West Haven desperately needs 
replacement. I suspect that the same is true of your 
infrastructure in many other parts of the country. The kinds of 
structural changes that need to be made, and in some cases, 
rebuilding, are an absolute imperative. And the statement made 
by the VFW and many of you support that point.
    I want to turn to the issue that has concerned many of you, 
and I appreciate your leadership on it from the VSO community, 
we have seen the devastating impact veterans communities from 
invisible wounds of war, including post-traumatic stress, 
military sexual trauma, traumatic brain injuries. We have all 
talked about it. The President did last night.
    Veterans struggling with these burdens really deserve a 
fair opportunity for the character of their discharge to be 
reviewed if they have been discharged without honorable status, 
a bad-paper discharge, so they can receive support and 
treatment for these wounds. In the meantime, they need and 
deserve access to mental health care at the VA, which is 
guaranteed under law.
    My office, my guess is many of your offices, and my 
colleagues have almost all received complaints about unlawful 
turn-away of veterans with ``other than honorable'' discharges 
who are seeking mental health care at the VA.
    I have introduced a measure called the Unlawful Turn-Aways 
Act of 2021 earlier this session to eliminate and remedy 
unlawful turn-aways. I submitted comments and proposed 
regulations to the Federal Register regarding the VA's request 
for information updating [inaudible] discharge regulation in 
this submission. I outline specific ways to close the 
regulatory gaps that allowed too many veterans to fall through 
the cracks, in effect, without the kind of mental health care 
they need and deserve.
    Many of them were discharged less than honorably because of 
the behavioral results of their invisible wounds; the traumatic 
effects of their injuries caused them to act out. So, let me 
ask Ms. Manning, because I know your organization, the Service 
Women's Action Connection Network, SWAN, are supporters of this 
legislation and others are, as well.
    I thank, particularly, organizations that have contributed 
to my understanding of like the Iraq and Afghanistan Veterans 
of America, Jeremy Butler, thank you for being on this panel; 
the Wounded Warrior Project, Lieutenant General Linnington; 
and, of course, I work closely with Jack McManus and those at 
Vietnam Veterans of America.
    But Captain Manning, if you could respond to this question, 
how would this legislation assist women and men veterans who 
have traumatic injuries?
    Ms. Manning. Thank you for asking, Senator.
    And, in fact, I was talking to one of your staff members, 
well, typing with them just yesterday about this legislation. 
We are strong supporters of it. We think of it mainly from the 
military sexual trauma point of view, but, as you said, it has 
a much wider application.
    There are many men and women who have suffered military 
sexual trauma back through the years and we are picking up some 
of them now, some of the younger ones through service discharge 
upgrades and that sort of thing so they can get help from VA, 
but there are two generations of people who suffered this sort 
of trauma that don't know that they can even go to VA for some 
basic mental health care.
    I think one of the problems is that VA is a huge 
organization and they use the VISNs and the regional offices 
have an awful lot of independence, which is necessary in a lot 
of cases, but for something like this, they need a general set 
of procedures laid out when somebody with an OTH, for instance, 
comes and asks for help, you don't just turn them away. You do 
a character of discharge assessment and you have to take into 
account the circumstances under which they were discharged.
    And I don't think that VA is training people properly how 
to do that. You might go to the regional offices and find out a 
lot of people have never even heard of character discharge and 
it should happen anytime an OTH person asks.
    And on the other hand, the people out there, who have been 
out there since the Vietnam War, perhaps, with an OTH 
discharge, don't even know that they can go and ask. So, we 
need a lot of, not just within VA channels, but a lot of 
outreach to veterans who don't use VA so they can learn this is 
a possibility.
    But we would love to work with you on this. We are very 
supportive of it.
    Senator Blumenthal. Excellent answer. Thank you so much, 
Captain Manning.
    Thanks, Mr. Chairman.
    Mr. Mrvan. Thank you, Senator.
    I have one last question for Captain Manning. It was a 
scenario that I had faced as a local elected official. A 
veteran who was assaulted or a survivor of military sexual 
trauma turned to alcohol and drugs to hide from that trauma and 
then was dishonorably discharged based on getting caught on 
that scenario.
    My question to you is, what process is in place for that 
veteran to successfully be able to receive the treatment 
necessary and what recourse might they have going forward?
    Ms. Manning. And there may be something I don't know, but 
if it is a dishonorable discharge, which is awarded by a 
general court marshal, I don't think there is much of anything 
in place, besides getting an appeal up through the court system 
and revoking the discharge.
    Mr. Mrvan. Well, it was discharged based on, and I don't 
remember the facts, based on the alcohol and the drug use.
    Ms. Manning. Then, if it was an OTH discharge or a bad-
conduct discharge, there are processes. They can either go back 
through their service--each service has a discharge review 
board--and Congress has changed the laws over the past 4 or 5 
years, particularly with respect to PTSD and military sexual 
trauma, telling these service boards over at the DoD that they 
have to take that into consideration when they are doing a 
discharge review. And if they get the discharge review done and 
the discharge is upgraded, then they are eligible for a lot 
that they are not eligible for right now.
    The other possibility is to go directly to VA and ask for a 
character of discharge review, what Senator Blumenthal was just 
talking about.
    Mr. Mrvan. Right.
    Ms. Manning. That doesn't upgrade their discharge, but if 
it is granted, they begin to be able to be eligible for VA 
healthcare and can enter into the VA programs for alcohol or 
drug addiction kinds of things.
    Mr. Mrvan. Okay.
    Mr. Linnington. Congressman, if I can jump in real quick 
both, for you and Senator Blumenthal, we have a small team at 
Wounded Warrior Project called a complex case coordination team 
and they handle exactly these cases. And these are largely 
veterans who have suffered trauma, gotten in trouble, and 
discharged because of it and turned to alcohol, drugs. They all 
have issues that need to be addressed through psychiatric 
counseling or traumatic brain injury treatment.
    And we have very close coordination with the VA to get 
these warriors back into care. So, for either you or the 
senator, we take those cases on.
    Our team started out as a team of three and I think we are 
over 15 now, full-time individuals that manage these cases, so 
we would be happy to talk with your staff about how we can 
help.
    Mr. Mrvan. And I welcome that, and the simple fact is 
making sure that there is policy that takes these scenarios 
that are welcoming to make sure that veterans receive the 
mental health care that they need based on those facts. So, I 
do welcome that information.
    With that, I want to thank all of you for being here today 
and for your service and your testimony today. It has been 
enlightening and deeply appreciate your commitment to our 
Nation's veterans, their families and survivors.
    We look forward to working with you and your organizations 
and your members throughout this Congress to make sure that we 
continue to honor their service and sacrifice. Again, I want to 
thank for your commitment to the veterans, to our country, and 
I want to thank you for being here today.
    And with that, all members will have 5 legislative days to 
revise and extend their remarks and include any extraneous 
materials.
    Again, thank you for your presentation and this hearing is 
now adjourned.
    [Whereupon, at 5:49 p.m., the hearing was adjourned.]






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