[Senate Hearing 117-500]
[From the U.S. Government Publishing Office]


                                                       S. Hrg. 117-500

                HEARING TO CONSIDER PENDING NOMINATIONS

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                                HEARING

                               BEFORE THE

                     COMMITTEE ON VETERANS' AFFAIRS
                          UNITED STATES SENATE

                    ONE HUNDRED SEVENTEENTH CONGRESS

                             FIRST SESSION

                               __________

                            OCTOBER 6, 2021

                               __________

       Printed for the use of the Committee on Veterans' Affairs
       
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                     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
                            
                            
                            C O N T E N T S

                              ----------                              

                            OCTOBER 6, 2021
                                
                                SENATORS

                                                                   Page
Moran, Hon. Jerry, Ranking Member, U.S. Senator from Kansas......     1
Hirono, Hon. Mazie K., U.S. Senator from Hawaii..................     2
Blumenthal, Hon. Richard, U.S. Senator from Connecticut..........     8
Tuberville, Hon. Tommy, U.S. Senator from Alabama................    10
Boozman, Hon. John, U.S. Senator from Arkansas...................    11
Tillis, Hon. Thom, U.S. Senator from North Carolina..............    13
Manchin III, Hon. Joe, U.S. Senator from West Virginia...........    17
Cassidy, Hon. Bill, U.S. Senator from Louisiana..................    19
Blackburn, Hon. Marsha, U.S. Senator from Tennessee..............    20
Tester, Hon. Jon, Chairman, U.S. Senator from Montana............    22
Sullivan, Hon. Dan, U.S. Senator from Alaska.....................    25

                    INTRODUCTION OF GUY T. KIYOKAWA

The Honorable Mazie K. Hirono, U.S. Senator from the State of 
  Hawaii.........................................................     2

                               WITNESSES

Guy T. Kiyokawa, Nominee to be Assistant Secretary of Veterans 
  Affairs for Enterprise Integration.............................     5
James D. Rodriguez, Nominee to be Assistant Secretary of Labor 
  for Veterans' Employment and Training..........................     3

                                APPENDIX
                          Nomination Material

Guy T. Kiyokawa, Nominee
  Prepared statement.............................................    33
  Responses to Pre-hearing Questions for the Record submitted by:
    Hon. Jon Tester..............................................    37
    Hon. Jerry Moran.............................................    42
    Hon. Patty Murray............................................    49

  Responses to Questions for the Record submitted by:
    Hon. Richard Blumenthal......................................    51
    Hon. Mazie Hirono............................................    53
    Hon. Mike Rounds.............................................    55
  Questionnaire for Presidential Nominees........................    57

James D. Rodriguez, Nominee
  Prepared statement.............................................    73
  Responses to Pre-hearing Questions for the Record submitted by:
    Hon. Jon Tester..............................................    75

  Responses to Questions for the Record submitted by:
    Hon. Richard Blumenthal......................................    80
    Hon. Mazie Hirono............................................    83
  Questionnaire for Presidential Nominees........................    85

 
                      HEARING TO CONSIDER PENDING.
                              NOMINATIONS

                              ----------                              


                       WEDNESDAY, OCTOBER 6, 2021

                                       U.S. Senate,
                            Committee on Veterans' Affairs,
                                                    Washington, DC.
    The Committee met, pursuant to notice, at 3:01 p.m., via 
Webex and in Room SR-418, Russell Senate Office Building, Hon. 
Jon Tester, Chairman of the Committee, presiding.
    Present: Senators Tester, Brown, Blumenthal, Hirono, 
Manchin, Sinema, Hassan, Moran, Boozman, Cassidy, Tillis, 
Sullivan, Blackburn, and Tuberville.

               OPENING STATEMENT OF SENATOR MORAN

    Senator Moran. [presiding]. Good afternoon, everyone. I 
call to order this hearing of the Senate Committee on Veterans' 
Affairs to consider two nominations pending before our 
Committee.
    Chairman Tester is in Indian Affairs this afternoon and 
will be here shortly. We also have a vote ongoing on the floor. 
But Senator Tester asked me to begin the meeting and we will 
see when he arrives and see how the vote, the next vote, goes 
when it is called.
    Let me read--let me welcome you, the two witnesses. Let me 
thank you for your interest in service, and let me begin by 
welcoming you. Mr. Kiyokawa and Mr. Rodriguez, thank you both 
for your willingness to serve in the roles for which you have 
been nominated and for appearing before the Committee today. 
Service is not new to either of you. You have served your 
country in uniform and in Federal civilian positions, and I 
know you have a personal connection to the mission of 
supporting the Nation's veterans.
    You are both nominated to positions responsible for 
critical components of our national effort to support veterans, 
the VA, our second largest Federal department, and support it 
in its efforts to simultaneously modernize three major core IT 
systems. That must follow a disciplined approach to ensure the 
results, that those efforts work in concert rather than in 
competition. Mr. Kiyokawa, I am pleased to hear your focus on 
strengthening the governance of these efforts across the VA to 
better focus on delivering outcomes for veterans.
    One of the best indicators of overall well-being is 
employment and economic security. Employment not only provides 
for the basic needs for our veterans. It also can be one way in 
which veterans find meaning and purpose after their military 
service. The work of the Department of Labor that it does 
through the Veterans' Employment and Training Service to help 
veterans find meaningful careers is one of the most impactful 
investments our country can make for the success of our 
veterans.
    Our Committee is invested in seeing that our veterans 
achieve success after their military service, and that includes 
supporting the two positions to which you have been nominated. 
I hope that if you are both confirmed we can work together to 
articulate the positive outcomes we want to see for our 
veterans and to align our collective efforts across Congress, 
the VA, the Department of Labor, and others to achieve those 
results.
    I again welcome both of you and thank you for your 
willingness to continue serving your country, and I look 
forward to your testimony.
    Mr. Kiyokawa and Mr. Rodriguez, if you would please stand 
and raise your right hand for administration of the oath.
    Do you solemnly swear or affirm that the testimony you are 
about to give before the United States Senate Committee on 
Veterans' Affairs will be the truth, the whole truth, and 
nothing but the truth, so help you God?
    Mr. Kiyokawa. I do.
    Mr. Rodriguez. I do.
    Senator Moran. Thank you. Let me now call on Senator Hirono 
for an introduction.

         INTRODUCTION BY THE HONORABLE MAZIE K. HIRONO

    Senator Hirono. Thank you, Mr. Chairman.
    I welcome both nominees, and I am very delighted to be able 
to introduce Mr. Kiyokawa who originally hailed from Hawaii. 
But you know what? When you are born in Hawaii, you always part 
of Ohana.
    So I want to welcome Mr. Kiyokawa, and I thank you not only 
for your willingness to serve as the Assistant Secretary for 
Enterprise Integration, but also for your 29 years of service 
to our country in the United States Army.
    And I would also like to recognize Mr. Kiyokawa's family 
members in attendance: his wife and his youngest son, and of 
course in particular, his mother Fusae-san, Fusae Kiyokawa, who 
traveled all the way from Hawaii to attend today's hearing in 
support of her family.
    Mr. Kiyokawa is currently the Deputy Director of the 
Defense Health Agency, a joint agency that supports the Army, 
Navy, and Air Force medical services, and administers the 
TRICARE health plan for more than 9.6 million service members, 
retirees, and their families. His background makes him an 
excellent candidate to serve as Assistant Secretary for 
Enterprise Integration.
    Mr. Kiyokawa was born and raised in Honolulu, where he 
graduated from Iolani School, which is a really fantastic 
private school, but as a public school graduate I will not hold 
that against him. During our conversation earlier this week, I 
was pleased to learn he also has ties to my own public school 
alma mater, Kaimuki High School. In his youth, Mr. Kiyokawa 
served as Kaimuki High School football team's water boy. I 
really enjoyed that.
    He is a graduate of the University of Southern California, 
the U.S. Army Baylor University program, and the U.S. Army War 
College. He served in the Army for 29 years, retiring at the 
rank of Colonel in 2015, at which point he was selected to the 
Senior Executive Service.
    After speaking with Mr. Kiyokawa about his nomination and 
his vision for the Office of Enterprise Integration, I am 
confident he would bring lessons from his experience as both an 
administrator and a beneficiary of the Military Health System 
to this new role. In particular, I appreciated his commitment 
to data-driven decision-making and understanding veterans' 
opinions on the services provided by VA. I know that he very 
much cares that the programs the VA supports and what he is 
working on actually benefits real-life veterans, and for that 
he will get input from them.
    I certainly look forward to working with you, Mr. Kiyokawa, 
to better serve veterans and ask the Committee to move on his 
nomination and for the Senate to swiftly confirm him.
    Thank you, Mr. Chairman. I do apologize for not being able 
to stay for the rest of the hearing, but as we know, there are 
a lot of hearings going on at the same time, and I have to get 
to another one.
    But it is really a pleasure, Mr. Kiyokawa. And to your 
whole family, mahalo nui loa.
    Mr. Kiyokawa. And, Senator Hirono, thank you so much for 
the gracious remarks and the introduction.
    Senator Moran. Senator Hirono, thank you very much.
    Mr. Kiyokawa, welcome.
    Mr. Rodriguez, let me introduce you before you give your 
opening remarks.
    James Rodriguez is currently the Principal Deputy Assistant 
Secretary at the Department of Labor's Veterans' Employment and 
Training. He has also been the Acting Assistant Secretary of 
VETS since January 2021. Prior to his role at the Department of 
Labor, he served as an executive at Deloitte's Government and 
Public Sector Practice and at BAE Systems Government Relations 
Department. He also served as Deputy Assistant Secretary of 
Defense, Office of Warrior Care Policy, from 2014 to 2017 and 
retired as a Marine Corps First Sergeant in 2009.
    Mr. Rodriguez earned a bachelor of arts in political 
science from the University of Maryland University College in 
2009 and a master of arts and international commerce and policy 
from the George Mason University School of Public Policy in 
2013.
    James, if you could please introduce your guests to the 
Committee and then begin with your statement.
    Mr. Rodriguez. Well, thank you, Senator, and thank you for 
the introduction. I would like to just introduce my wife, 
Vanessa, who is behind me, my wife of almost 30 years--in May 
of next year, it will be 30 years--and my daughter, Courtney, 
she is second, and then my youngest daughter, Casey.
    Senator Moran. We welcome your family. Thank you.
    Mr. Rodriguez. Thank you.
    Senator Moran. Mr. Rodriguez, you are recognized.

                STATEMENT OF JAMES D. RODRIGUEZ

    Mr. Rodriguez. Thank you, Ranking Member Moran, and thank 
you to all the members of the Committee for inviting me to 
speak today and for our conversations in recent days.
    I want to thank President Biden and Secretary Walsh for the 
honor of this nomination. I share their compassion and 
commitment to the employment of our transitioning service 
members, veterans, and military spouses.
    Since the age of 18, I have served our Nation in some 
capacity that was directly related to supporting our men and 
women in uniform and their families. So this has truly been my 
life's work. And none of this could have been accomplished 
without my support system: my wife, Vanessa, who has been by my 
side and my best friend for more than 30 years; my two 
daughters, Courtney and Casey, who are my shining lights; my 
son-in-law, Justin; my mother-in-law and father-in-law, Mike 
and Alice; and the rest of my extended family and friends.
    I grew up in a small town in Texas called Aransas Pass 
along the Gulf Coast. I was raised by my grandmother under very 
modest circumstances and spent most of my youth growing up in 
the projects. There were times when I went without food, 
electricity, and heat, and I was one of the many kids who were 
on the free breakfast and lunch program, which helped our 
family immensely.
    I had every opportunity to find a lot of trouble to get 
into, but instead I started working various jobs and threw 
myself into high school sports. At 15 years old, I worked as a 
deck hand on a shrimp boat in the Gulf of Mexico and then as a 
deck hand on a smaller boat that went out on Matagorda Bay 
every morning at 5 a.m. I worked in fast food during the 
summers so I could save up money to buy my own school clothes 
and help pay utility bills for my grandmother. I graduated high 
school and waited for my ship date to boot camp, working in the 
local shipyard as a welder's assistant inside the steel hulls 
of shrimp boats in the infamous Texas summer heat.
    Fortunately, I found my calling in the United States Marine 
Corps, where I was able to serve at duty stations across the 
country and with allies around the world. As a young enlisted 
Marine, I recognized the power of education. I enrolled in my 
first college course after returning from Desert Storm in 1992, 
and 17 years later, after many duty stations and deployments, I 
finally graduated. Fortunately, completing my graduate degree 
only took two years, and I continue to be a lifelong learner. 
But more importantly, we are thankful to have two daughters, a 
Red Raider and an Aggie, who graduated on time.
    The truth is my story is no different than many other men 
and women who have overcome personal challenges and have 
dedicated their lives to something bigger than themselves.
    For 21 years, I had the honor of serving alongside Marines, 
Soldiers, Sailors, and Airmen who came from communities all 
across this great Nation. I saw the dedication each one of them 
had to each other in and out of uniform. And throughout my 
entire career, I have always tried to lead by example, with 
compassion and dedication to the team and mission. And during 
my six years as a Marine Corps drill instructor, my philosophy 
was that we were not only training these men and women to be 
good Marines, but we were also training them to be good 
citizens.
    This point was driven home to me when I served as the 
company First Sergeant of Wounded Warrior Battalion West at 
Balboa Naval Medical Center in San Diego, from where I 
ultimately retired in 2009. These brave men and women 
sacrificed physical and mental health in defense of our Nation, 
and most would have to transition out of the military before 
their enlistment was complete, which exacerbated their stress. 
This was my first real understanding of the military to 
civilian transition challenge. If I am fortunate to be 
confirmed as the Assistant Secretary, I will continue to work 
with Congress and the truly dedicated DOL VETS team to bring 
the best programmatic resources to these good citizens.
    Thank you, and I look forward to your questions.

    [The prepared statement of Mr. Rodriguez appears on page 73 
of the Appendix.]

    Senator Moran. Thank you, Mr. Rodriguez.
    Mr. Kiyokawa, your opening statement. You are now 
recognized.

                  STATEMENT OF GUY T. KIYOKAWA

    Mr. Kiyokawa. Thank you, Chairman Tester and Ranking Member 
Moran and distinguished Committee members for this great honor 
and opportunity to serve our veterans, their families, and 
caregivers. After meeting with you and your staff, I am even 
more appreciative of your dedication and commitment to 
improving our Nation's support for those who have served. If 
confirmed, I look forward to working with you and your staff.
    I am joined today by my wife, Catherine. We have been 
married for 27 years, and she understands the challenges of a 
military career, moving across the country and overseas, 
raising three children during my 29 years in the Army. I also 
have my youngest son, Ian, who is a high school senior at James 
Madison High School here in Vienna, Virginia, and as Senator 
Hirono mentioned, my 92-year-old young mother from Honolulu, 
Hawaii. She was born and raised in Hilo, Hawaii, which is a 
rural town, otherwise known on the Big Island. Her father was a 
World War I veteran who rests in the State of Hawaii Veterans 
Cemetery.
    Another veteran in our family, Uncle Mits, ran a flight 
school with four planes in Honolulu. When the Japanese attacked 
Pearl Harbor, his planes were taken, and he immediately wanted 
to join the military as a pilot. But the Army would not allow 
him to serve as an officer, so he enlisted. In his wedding 
picture, he is wearing an army uniform with the officer's 
pants, as evidenced by the stripe along his trouser leg. It was 
his small way of saying that he should be an officer.
    When he passed, he was interred at the National Memorial 
Cemetery of the Pacific, ``Punchbowl,'' in Honolulu. I placed 
on his urn my aviation branch insignia I received when 
commissioned a Second Lieutenant. That insignia's design 
originated from the Army Air Corps which would have, and should 
have, been my Uncle Mits's.
    In 1982, I was fortunate to receive a 4-year Army ROTC 
scholarship to the University of Southern California. Every 
cadre member in my ROTC unit was a Vietnam combat veteran. 
These men and their experiences in combat shaped me as an 
officer. Each had their unique story; yet, they all had 
something in common, unending commitment to the Army Corps 
values.
    The values that continued to drive me throughout my Army 
career were selfless service, respect, duty, and integrity. As 
a MEDEVAC pilot, my flight crews developed the trust and 
selflessness that was critical to our ability to carry out our 
missions as a team to save lives.
    Later, I found a niche in integrating functions within 
large matrix organizations, such as Walter Reed and Brooke Army 
Medical Centers. The Army values continued to help me integrate 
complex organizations and understand the challenges of the 
wounded, ill, and injured. At Walter Reed, I was introduced to 
what eventually became known as Gulf War Illness. My 
experiences planning the construction of the first Intrepid 
Spirit Center for TBI at Ft. Belvoir opened my eyes to a 
holistic, soldier-focused path to address TBI and PTSD. These 
experiences, grounded by the Army values, helped me understand 
the unique challenges veterans face.
    If confirmed, the Office of Enterprise Integration would 
provide me the best opportunity to apply these experiences to 
support veterans and their families. My nomination to join the 
VA team is timely as Secretary McDonough addresses strategic 
priorities, including the delivery of care, ensuring benefits 
for toxic exposures, the electronic health record program, VA's 
infrastructure, and committed implementation of the bills 
passed into law by Congress.
    The Veterans Health Administration is, by far, the largest 
organization within the VA, but it is reliant on seamless 
enterprise functions such as IT, acquisition, logistics, and 
construction. If confirmed, I would work to create that 
seamless enterprise using experiences from my work as the 
Deputy Director of the Defense Health Agency. During the past 
six years, I have had the honor and challenge of working to 
bring together functions in the Army, Navy, and Air Force that 
best serve the service member and their family as an enterprise 
instead of four separate entities. These experiences will help 
to gain and keep veterans' trust by helping them to build 
civilian lives of opportunity, keeping the faith with their 
families and caregivers. I will ensure that every person 
entering a VA facility feels safe and free of harassment and 
discrimination.
    I am grateful for the opportunities in my 35 years of 
military and Federal service, supporting multiple generations 
of veterans, from the Vietnam War to the post-9/11 era. Thank 
you for the potential opportunity to continue supporting 
veterans, and I look forward to answering your questions.

    [The prepared statement of Mr. Kiyokawa appears on page 33 
of the Appendix.]

    Senator Moran. Mr. Kiyokawa, thank you.
    The Office of Legal Counsel at the Department of Justice 
issued an opinion letter in 2017. It stated that oversight 
requests from ``individual Members of Congress, including 
Ranking Minority members,'' do not trigger any obligation to 
accommodate congressional needs. Despite the DOJ's opinion on 
this matter, will you commit to accommodating congressional 
oversight requests regardless of party affiliation or committee 
status of the member making the request, Mr. Kiyokawa?
    Mr. Kiyokawa. Yes, Senator, I do.
    Senator Moran. Thank you.
    Mr. Rodriguez?
    Mr. Rodriguez. Yes, Senator, I do as well.
    Senator Moran. Thank you very much.
    Let me start with you, Mr. Kiyokawa. Please explain; you 
just used the phrase, ``seamless enterprise.'' I think maybe in 
your testimony it was integrating the enterprise. Explain to me 
what those phrases mean in practice. If you are confirmed, you 
have the ability to approve or reject decisions, budgets, 
staffing, or plans, and you have the authority over the 
Veterans Health Administration, Veterans Benefits 
Administration, all program managers.
    Mr. Kiyokawa. Senator, great question. And I know people 
throw out the words, seamless and integrate, and in fact it 
gets overused. I think at the end of the day if we really are 
focused on veterans and their families and caregivers then the 
seamless definition should be to those who are consuming the 
services or need the support. So seamless means to the end user 
and what they are seeing.
    In the Military Health System, with my experience, many 
times as a beneficiary, I feel like I am the one that is 
navigating the complex system. And I think ultimately it should 
be the system that has the complexity, but to those who are the 
beneficiaries it should be seamless.
    Now that is easier said than done. And so if I am given the 
opportunity in the Office of Enterprise Integration, I think 
the real key is to ensure that we bring together the intent 
behind, whether it be systems or programs, and ensure that 
those things are linked together in such a way that we can 
align with the Secretary's priorities and direction.
    Senator Moran. I may come back if I have time and further 
explore that answer.
    Mr. Rodriguez, if appointed and confirmed, you will lead an 
organization that oversees more than a half a dozen programs, 
with a budget over $325 million. With all these 
responsibilities, you may not be able to address everything you 
would like during your tenure. If you could set a goal, one 
goal to accomplish by the end of your time as Assistant 
Secretary, how would you describe that?
    Mr. Rodriguez. Well, Senator, that is exactly right. There 
are a lot of priorities that we currently have, but I think the 
most important goal for us currently is to get the transition 
process correct. We know that the transition is a challenge, as 
I mentioned in my opening remarks. It is a challenge for all of 
our men and women in uniform, myself included when I was going 
through it. So we know that is an important process that we 
have to get correct. I am working closely with the Department 
of Defense, and the Department of Veterans Affairs, to ensure 
that we give the best resources to our service members when 
they are preparing to transition.
    Senator Moran. I appreciate that answer very much.
    And it is clear to me, and in our study of the issue of 
mental health and suicide issues, that transition time is 
hugely significant. You have experience in transition from 
military to civilian. What do you think the greatest challenge 
would be for improving TAP, and how would you address to 
accomplish that?
    Mr. Rodriguez. Senator, one of the greatest challenges we 
have first and foremost is getting the transitioning service 
members to really understand what they want to do when they are 
making that transition from the active duty component to the 
veteran component. That is the first one.
    The second one is ensuring that they have a good, solid 
understanding of what type of resources are available to them 
as they make that transition and getting them to that TAP 
course in a timely manner, first and foremost.
    So we have been very committed to working with our partners 
over at DOD to ensure that our service members are getting to 
TAP on time so they can get the most amount of information to 
help them make a good, solid, and comprehensive decision on 
what their next step is going to be when they transition out.
    Senator Moran. How would you describe the nature of the 
engagement of the Department of Defense and its various 
branches in assisting in that transition for its members, for 
Army, Navy, Marines, and Air Force?
    Mr. Rodriguez. Well, I think the engagement is going well. 
We can always improve it, as we all know. There is always ways 
to improve it. And I think proof of that is during the pandemic 
we were able to pivot from an in-person to a virtual format, 
and so we have continued to use that combination of virtual and 
in-person where we are able to. We are working very closely 
with the Department of Defense again, as I mentioned, to assure 
that service members are able to attend in person so they are 
getting the full value of that transition program.
    Senator Moran. Thank you for your answer.
    My time is expired. Senator Blumenthal.

                   SENATOR RICHARD BLUMENTHAL

    Senator Blumenthal. Thank you, Senator Moran.
    Thank you both for your service to our Nation and your 
willingness to continue to serve in the VA.
    Mr. Rodriguez, as you probably know, the GI Bill is not 
only one of the most vital programs that the VA provides to our 
veterans, but it is also in recent years a target of for-profit 
schools that have been allowed to aim at our veteran population 
with deceptive recruiting practices. They have taken veterans' 
money coming to them under the GI Bill, in effect, and failed 
to provide them with the educational benefits that they need 
and deserve. These predatory institutions leave our veterans 
with a substandard education, meanwhile taking those benefits 
which are, at the end of the day, taxpayer funds.
    For a number of years, I have worked with veterans service 
organizations and advocates in pushing the VA to proactively 
address this issue. In my view, the VA must leverage all of its 
existing statutory processes to try to stop this deceptive 
recruiting and enticement of veterans to go to for-profit 
schools if they fail to provide the real value that veterans 
expect. This is an issue that hampers veterans from obtaining 
the skill training they need, the quality credentials, and 
other benefits to really thrive in their career fields. The 
veteran labor force is weaker as a whole, collectively, as a 
result of these kinds of predatory practices.
    So my question, my first question is: Are you familiar with 
these issues, and what role do you think DOL has during the 
Transition Assistance Program to try to improve veterans' 
awareness and knowledge so they can avoid this problem?
    Mr. Rodriguez. Well, Senator, one of the things we do at 
DOL is we collaborate closely with our counterparts at the VA. 
So that is one of the most important things we do--our 
strategic partnerships in the entire TAP program execution. We 
want to ensure that the veterans, as you mentioned, are getting 
the most amount of resources and the value of those resources 
when they are making their decision to transition out.
    We also want to make sure that if we continue to support, 
or as we continue to support, rather, the apprenticeship 
program, that they can use the GI Bill in the apprenticeship 
program. So we know that is a very valuable resource for our 
veterans when they are making that transition out.
    But with respect to how they are using the GI Bill, we want 
to ensure that they can use those benefits to educate 
themselves as well as prepare themselves for that eventual 
transition out of the military.
    Senator Blumenthal. But how do you prevent them from 
becoming victims of these predatory practices by the for-profit 
schools?
    Mr. Rodriguez. Well, unfortunately, since the GI Bill is 
not under my direct purview, I would have to defer to my 
counterparts at the VA.
    Senator Blumenthal. So you do not think the DOL has a role?
    Mr. Rodriguez. Well, I think every American has a role in 
preventing our veterans from being victims of anything with 
respect to the GI Bill, but I do not have purview over the GI 
Bill, the responsibility of that.
    Senator Blumenthal. Don't you play a role in enforcing the 
statute that is already in our law that bans deceptive 
recruiting? You do not feel you have any role in enforcing that 
statute?
    Mr. Rodriguez. Well, I think our role is ensuring that the 
service members can utilize the GI Bill to help educate 
themselves, as I mentioned, sir.
    Senator Blumenthal. Okay. I guess I am not following. If 
you get complaints from veterans about deceptive pitches to 
them: I went to a school. They did not give me a valid course. 
The course was worthless. They did not have the course that I 
signed up to do. Any number of evidence of deception. And you 
get that complaint. What do you do?
    Mr. Rodriguez. So I would definitely work with our 
Department of Veterans Affairs colleagues. But we also have, as 
you are well aware, compliance responsibilities within the 
Department of Labor. So we work with the Department of Justice; 
we work with other agencies, to ensure that the laws that we 
are responsible for adhering to, that we work with our 
colleagues all across the entire Federal Government to ensure 
that they are being abided by.
    Senator Blumenthal. Do you have any investigative role?
    Mr. Rodriguez. We have investigative roles but not 
necessarily for GI Bill-specific roles. That is Department of 
Veterans Affairs's responsibility.
    Senator Blumenthal. So you would just refer it to them?
    Mr. Rodriguez. Yes.
    Senator Blumenthal. Okay. Thank you very much, Mr. 
Chairman.
    Senator Moran. Senator Blumenthal, thank you.
    Senator Tuberville.

                    SENATOR TOMMY TUBERVILLE

    Senator Tuberville. Thank you, Mr. Chairman.
    Gentlemen, thanks for being here today. It is great to see 
your families here. And, Mr. Rodriguez, I do not know what one 
daughter thinks as an Aggie and you have got Texas Tech colors 
on with the other one. There could be a fight at home when you 
get home. But thanks for both of you being here and thanks for 
your service.
    In Alabama, we have over 400,000 veterans that we are proud 
of. I was talking to our Veterans Affairs group yesterday, and 
we have a Veterans Affairs office in every county, in all 67 
counties of the State. I think we have got a pretty good model 
there, and we would love for you to come down and see sometime 
about what we have got going on. And obviously, our veterans 
are growing; the numbers are growing.
    Mr. Rodriguez, you know our current gap in cybersecurity in 
this country. We need more and more. We need more and more 
people trained. I think our service members coming out 
transitioning to possibly cybersecurity in the workforce would 
be phenomenal. What do you think about that?
    Mr. Rodriguez. I agree, Senator. I think one of the most 
important things we could do, obviously, is ensure that our 
transitioning service members understand what types of skills 
that they could use while they are in the military, and how 
they could transfer those skills into the civilian workforce as 
well as get the type of training that is going to set them up 
for success.
    We are currently doing this, actually, with our Employment 
Navigator Partnership pilot. We have various companies, 13 
sites around the country, that we are piloting this program. 
And it is actually identifying and targeting specific 
industries where we can use our skill sets from our service 
members, to transition them into those specific industries. So 
we are doing this very closely right now at those 13 sites, and 
our employment navigators are working with each individual who 
wants to get into those types of fields.
    Additionally, on October 15th, we are actually going to 
open up our Employment Navigator Partnership pilot to 
additional organizations that have requirements of 
cybersecurity, for example. We are going to allow them to come 
in and be participants in our Employment Navigator Partnership 
program so that way they can train our service members and set 
them up for success in cybersecurity and IT.
    Senator Tuberville. Both of you obviously have been through 
the TAP program.
    Mr. Rodriguez. Yes.
    Mr. Kiyokawa. Yes, sir.
    Senator Tuberville. Give me your expert thoughts about TAP. 
Are we getting enough out of it? Are we doing what is right? Do 
some just go through it and then go through the motions? I was 
a coach for 40 years, and we had kind of our TAP program at the 
end of when kids come out, and a lot of times they kind of go 
through the motions. Can we make it better?
    Mr. Kiyokawa. Senator, I think you can always make it 
better, and your example as a coach and the football players is 
exactly the same with service members. Many people, if they 
feel like they already have a job, they might just be going 
through it because, quite frankly, we make them go through it. 
Others see the value of it.
    I think one of the things that when I went through it was 
really good is that you knew there was a resource and as long 
as you knew how to access it easily that was the key. You know, 
you end up with a stack of paper, and you put it on your shelf, 
and if you have to go search through that you will never find 
it.
    With the younger generation, obviously, it is through the 
internet or through social media. So somehow, as we keep moving 
through how to connect with veterans, how do we understand what 
the young kids, like my son here, do to process information? 
The old farts like me, who want to touch pieces of paper, and 
we want to call people and talk to them. And I guess the whole 
point is you have to be able to support the entire spectrum, 
right, because you have people who still want to touch paper 
and talk on the phone, but then you have younger kids that have 
new ways of doing it.
    So I think making that connection with a veteran who is 
leaving the service so that they have a way to access that 
information easily is really a key.
    Mr. Rodriguez. Yes, I would echo what Mr. Kiyokawa said. I 
think one of the challenges is getting the active duty service 
member, especially our younger active duty service members, to 
understand the value of TAP and what resources that are aligned 
there that can actually support them when they are 
transitioning out.
    It could always be improved, to his point. I think there 
are a lot of ways that we are looking at improving it 
currently. We have some new resources that are going into 
improving that program, again working with the Department of 
Defense and the Department of Veterans Affairs, to improve the 
overall experience.
    My experience was a little bit unique in the sense that I 
fortunately had a job when I was getting ready to transition 
out. Most of our young men and women do not have that when they 
are transitioning out. So the resources that we do provide 
them, especially as I mentioned earlier, now with our 
Employment Navigator Partnership, is going to give them more 
information to help them make a more informed decision.
    Senator Tuberville. Thank you.
    Thank you, Mr. Chairman.
    Senator Moran. You are welcome, Senator.
    Senator Boozman.

                      SENATOR JOHN BOOZMAN

    Senator Boozman. Thank you, Senator Moran.
    And again, thank you, Mr. Kiyokawa and Mr. Rodriguez, for 
being here today. We had a good visit not too long ago and 
really enjoyed discussing your priorities, you know, as you 
move into this phase. I think your service backgrounds, having 
such strong service backgrounds will play a big role and help 
you immensely as we face these problems. I appreciate your 
willingness to serve. These are very time-consuming jobs. You 
all are very talented.
    And again, then a shout-out to your families. Being in the 
service, being in the military is certainly a family affair. My 
dad did 20-some odd years, so I understand that. And likewise, 
I think being in the situations that you all will find yourself 
are certainly family affairs also. So thank you.
    Mr. Kiyokawa, in your testimony, you highlighted your work 
as the Deputy Director of the Defense Health Agency and how you 
worked to integrate the services' health functions and data 
into a unified DOD agency. If confirmed, how will you use your 
experiences from DHA to integrate data across DHA, VBA, and 
NCA?
    Mr. Kiyokawa. Senator, thank you for that question. When I 
first started within the Defense Health Agency, we were charged 
to do something called ``shared services,'' which included IT. 
So to answer your question about data, I think one of the key 
parts to it is to ensure that the IT infrastructure is solid; 
it is a solid foundation in order to lay these systems that 
will integrate across not just VA but with DOD.
    I think the other key part to the data strategy that the VA 
has right now is to ensure that the functional pieces behind it 
so in other words, we tend to talk about data management and 
data strategy, but many times it is the operations and the 
functions behind it that really have to be mapped to one 
another. So for example, we talk about the electronic health 
record or the logistics system or the financial management 
system. Quite frankly, the power of the data that comes out of 
those systems is really whether or not those functions behind 
those systems are actually integrated. Well, how do those 
operations come together?
    And I think that was the key for us within DOD as we 
brought together the shared services. It was not about the 
systems. It was about the functions behind those systems and 
how they tied together.
    So I think those are two main points with data strategy and 
management.
    Senator Boozman. No, we appreciate it. It is so important, 
especially considering the size of the investment that we are 
making and have made in the past.
    Mr. Rodriguez, DOL VETS is currently conducting the 
Employment Navigator Partnership pilot across 13 select 
military installations to interested transitioning members and 
their spouses. If confirmed, how will you work to share best 
practices across the different installations and services? What 
is your assessment of the pilot? What data or metrics are you 
using to measure success?
    And finally, in your observation, where do you see 
duplication of efforts between VA and DOL VETS? Where can 
improvements be made going forward?
    Mr. Rodriguez. Well, thank you, Senator, for that question 
because of the fact that we know how important it is to ensure, 
as I have been speaking about already, getting the transition 
correct. And one of those, as I spoke about earlier, was the 
Employment Navigator Partnership and the amount of work that is 
going into that pilot currently. There is some really good data 
that is coming out of there. And again, it is a pilot. So we 
have not compiled all of the data, but there is some good data 
there that is showing that what we are doing there is working 
well.
    And one of the other things that data is informing, is 
that--of our service members who go through TAP--we have 96 
percent survey satisfaction or satisfaction through our survey 
process.
    But using the Employment Navigator, we are finding good 
results for our service members and their spouses. They are 
getting connected with American Job Centers, where they are 
looking to go back to whatever locales that they are 
transitioning to. We are making the warm handoff.
    And one of the other most important things we are working 
closely with our counterparts at Department of Veterans 
Affairs. One thing that we have committed to at the Department 
of Labor is working closely with the Department of Defense and 
Department of Veterans Affairs to ensure that any data we have 
in reference to transition assistance that can be utilized to 
best improve that program we are sharing that immensely.
    As you probably are aware, we are part of the Joint 
Executive Committee, which composes both the DOD and VA and 
other senior members of the Federal Government, responsible, 
and part of that is the TAP Executive Committee. So we work 
closely again through the TAP Executive Committee and through 
other committees. Women's Veterans Committee, we partner with 
them. Native American Committee, we partner with them on that 
as well.
    So we have a history of sharing information and will 
continue to do so going forward.
    Senator Boozman. Good. My time is up, but in our visit I 
appreciated the fact that as we talked that I think we agreed 
how important the spouses' mission is in TAP. You know, they 
are the ones that keep service members together so often and, 
again, the importance of that.
    So thank you, Mr. Chairman.
    Senator Moran. Senator Boozman, thank you.
    Now, Senator Tillis.

                      SENATOR THOM TILLIS

    Senator Tillis. Thank you, Senator Moran.
    Thank you both for being here.
    Mr. Kiyokawa, thank you for your service to the U.S. Army. 
Did you ever spend any quality time in North Carolina?
    Mr. Kiyokawa. Yes, Senator. I was not stationed at Fort 
Bragg, but supporting all of the Army installations in my role 
as the Chief of Facilities I spent a lot of time down at Fort 
Bragg, particularly when we built the new Womack Army Medical 
Center.
    Senator Tillis. Mr. Rodriguez, any time down in Camp 
Lejeune?
    Mr. Rodriguez. That was my very first four years.
    Senator Tillis. Very good. I would guess you all would know 
about that one. I hear people talk about how many veterans they 
have in their State. We actually have as many veterans in our 
State as some States have people, with over a million, and the 
third fastest growing in the Nation, soon to be one of the top 
three military States in the country. And as a result, we spend 
a lot of time--I did when I was Speaker of the House--on what 
more can we do to make North Carolina more hospitable, more 
likely for people who retire to come back there, and I think we 
are doing a good job.
    Mr. Kiyokawa, you and I have common interests and common 
backgrounds. I was a partner at Pricewaterhouse and spent most 
of my career with enterprise integration in the private sector.
    I was happy to see the experience that you have with the 
DOD electronic health system implementation. You know, with 
some of the reviews, we have stubbed our toe a bit with the 
electronic health record in Veterans Affairs, but you know, 
quite frankly, it is not surprising. It is a large, complex 
organization with a lot of systems that are aligned within the 
VISN and even within subunits of the VISN. So you naturally are 
going to stub your toe, and I am glad to see that they did the 
strategic pause to take a look at change management.
    Rather than spend because--and we will spend a lot of time 
together. Senator Tester and I met with a number of people, 
with veterans, over three Veterans Affairs secretaries, to go 
through the change management. I would just like to get your 
commitment to continue to be as successful as three 
administrations have been, or two administrations, in working 
with my office so that instead of an oversight hearing we can 
have regular checkups with a designate from Chairman Tester's, 
to go through the change management. I want to understand the 
implementation, some of the changing of priorities. Can I get 
that commitment from you?
    Mr. Kiyokawa. Yes, Senator.
    Senator Tillis. I should let you know I am going to support 
your nomination.
    Mr. Kiyokawa. Thank you, Senator.
    Senator Tillis. But the other thing I want you to look at 
is in data analytics.
    And, Mr. Rodriguez, you and I have some common background, 
too, I am going to get to if I can have just a little bit of 
extra time.
    But to me, the use of data analytics needs to transcend the 
life of the warrior. It needs to start the day they enlist. It 
needs to seamlessly transfer once they achieve veteran status. 
The needs--and, Mr. Rodriguez, I am going to get to TAP 
program, my vision for the TAP program. But it just needs to be 
continually instructed, continually used, dynamically 
allocated, to understand what more we can do for the veterans.
    And this is not a hard task, particularly if we get the 
electronic health record right. And we have two common 
platforms to where now you are just taking a look at the data 
architecture that can enable so many things that we can do.
    You know, in your prior role, I have said that we need to 
update the information about the warrior to even understand in 
VETS to where we may be able to predict a need before the 
service member or the veteran ever needs it. It reminds me of a 
General Electric commercial from years ago, where the service 
technician knocks on the door and says, ``I am here to repair 
your refrigerator.'' She said, the lady who answered the door 
said, ``it is not broke.'' He said, ``it is about to be.''
    We should have that aspiration for serving active duty and 
veterans members, and I look forward to working on that future 
architecture. I know that we are going to go a little bit 
further. Does that fit roughly within your view of what we can 
do with data analytics and the underlying enterprise systems 
that we will have in place in the VA?
    Mr. Kiyokawa. Senator, I think you are hitting the nail on 
the head on where we head into the future. Just my experiences 
in the Military Health System, we had more agencies and 
contractors come to us because we are sitting on this treasure 
trove of data.
    The challenge is that we have many legacy systems that when 
they were created were never thought to be integrated, and I 
think you have experienced some of that in your business. And 
so what we have done is have to go through a standard process 
to say, which of these legacy systems do we need to sunset and 
then, more importantly, which ones do we continue to develop to 
have that interoperability. That gets to your point. The goal 
is to have that longitudinal data.
    And to your other point, really it gets into a little bit 
of the predictive analytics. Right? How can you predict what 
those requirements will be of our veterans? Because, quite 
frankly, it does take us one or two years at least to set up 
brand new programs and effectively apply them across such a 
broad spectrum of veterans. So if we can get a little bit more 
predictive in what the demand signal might be, then I think we 
will be a little bit more successful in responding ahead of 
time to the veterans' needs.
    Senator Tillis. Thank you for that. I look forward to 
working with you.
    Mr. Rodriguez, I understand that you ultimately graduated 
from University of Maryland University College?
    Mr. Rodriguez. I did, 17 years after my first class.
    Senator Tillis. When you initially enrolled in 1993, was it 
at UMUC?
    Mr. Rodriguez. It was not. It was actually at Coastal 
Carolina Community College.
    Senator Tillis. How many different schools did you go to 
before you ultimately graduated?
    Mr. Rodriguez. Probably about six, I believe.
    Senator Tillis. I was at five. I got my 4-year degree when 
I was a couple months shy of 37 years old, fully a year after I 
had been admitted to the partnership of Pricewaterhouse.
    You also worked at Deloitte; right?
    Mr. Rodriguez. I did. That was my previous employer.
    Senator Tillis. And what kind of role did you have there?
    Mr. Rodriguez. I was a specialist executive there, 
supporting their business lines of Department of Defense, 
Department of Veterans Affairs, and the Defense Health Agency.
    Senator Tillis. We always considered Deloitte a very worthy 
second-tier competitor at Pricewaterhouse. But in all 
seriousness, that is great experience for the role that you are 
going to go into.
    And Senator Blumenthal touched on education and some of 
these for-profit institutions. What I always get concerned with 
when we bring that up is we are casting all in the same lot. 
And when I was pursuing my 17-year journey to get my 4-year 
degree, there were clearly examples of where some of the 
private institutions, if you did your homework, could provide 
the kind of work-life balance options that you needed to 
continue your degree.
    So I think as we talk about bad actors, take them out. 
Absolutely, take them out. But let's not take out every 
opportunity for work skills training and a number of other 
things that we can do to help these service members and 
veterans get to a point to where they can be upward mobile with 
job opportunities. And I know I think you rightfully answered 
who is responsible for that, but I think it is important when 
we hear those statements to put them in the right context.
    The last thing I will leave you with, one thing, in North 
Carolina in particular we have a great network of schools that 
are working together on job skills training. I was just in 
August down in Fayetteville Tech, a consortium of 11 different 
universities and community colleges and a private university 
that have come together on cyber education and technology 
infrastructure. So when you get in the role, that is something 
I would like to bring you down and see what a great job they 
are doing graduating veterans and getting them jobs in North 
Carolina and the region.
    And then I will just leave you with this. I am sorry, 
Ranking Member. But just on the Transition Assistance Program, 
I think that we ultimately have to get to an audience of one. I 
think the problem that we see there--we do so much case work. 
This is the first year because of COVID we have actually 
surpassed veterans case work. But we do tens of thousands of 
cases a year in North Carolina for veterans.
    And I think the problem that we see is that, you know, if 
you are a young--we have this Transition Assistance Program 
that is kind of a one-size-fits-all getting a little bit more 
tailored, but there are vastly different things that you need 
to communicate about the benefits, the support network, VSOs 
and other organizations that could be helpful to these veterans 
when they transition. And we really have to think the same way, 
using analytics, using a better understanding of what the needs 
are, to tune these Transition Assistance Programs to an 
audience of one and to also have continuous contact with the 
ones.
    I am worried most about the at-risk veterans who 
transition. Invariably, if you look at veterans' suicide, you 
look at veterans' homelessness, you look at veterans' 
unemployment, there are very clearly instances along the way to 
where we probably, if we had had that stickier relationship--
[telephone interruption.] Is that how you are trying to get me 
to stop talking?
    So in conclusion, I want to get you down there to look at 
the education opportunities. I want to get you down to the 
Veterans Life Center, which is a transformational opportunity 
that I think could be implemented across the country. I look 
forward to supporting your confirmation. But it is a short trip 
down to North Carolina. I hope I have both of your commitments 
to come down and visit.
    Mr. Kiyokawa. Yes, Senator.
    Mr. Rodriguez. You have my commitment, Senator.
    Senator Tillis. Thank you.
    Ranking Member, I yield back the remainder of my time.
    Senator Moran. [Off microphone].
    Senator Manchin is recognized.

                      SENATOR JOE MANCHIN

    Senator Manchin. Am I up?
    Senator Moran. Senator Manchin, you are recognized, yes.
    Senator Manchin. Oh, thank you. I think he broke all the 
records. I have never been in one like that.
    Senator Tillis. Joe, I am sorry. I forgot we had people 
online. I thought I was the last one.
    Senator Manchin. You know what? I knew you were killing 
time, and I appreciate it because you were so informative. I 
learned so much, Mr. Speaker. No problem.
    Mr. Rodriguez, if I could, really I want to touch on a 
couple things that Senator Tillis did touch on that is very 
important, mostly to electronic records, the health records. 
Secretary McDonough came before us and everything and told me 
that he was on top of this and he planned to fix the programs, 
the challenges we had there, and the Mann-Grandstaff rollout 
has not gone the way it was supposed to.
    And I keep thinking about what happened in Clarksburg, West 
Virginia. We lost--just basically, we had veterans that were 
murdered in the VA center there. Just unbelievable. If we could 
have had those records, we could have been able to be on top of 
what was happening quicker, in real time. It would have been 
very, very productive for us and maybe save some lives.
    The other thing I wanted to talk to you about--and I think 
you knew and you answered that for Senator Tillis about the 
high priority you have on this, and I confirm. And I just hope 
you stay on it, sir, because we are definitely going to hold 
you accountable to that.
    Mr. Rodriguez, on the drug abuse and PTSD and all the 
different things that we have challenges with in our military, 
what are your views on how the Department can play a role in 
relieving this crisis? Because I understand that--and I do not 
mean this derogatory at all, but I am understanding that when 
our VA members return from service they get a concoction and 
almost get anything they want without any evaluation. And I 
hope that has changed, but it is still very much of a crisis.
    And that will lead into another question concerning jobs 
placing, and sometimes the stereotype our veterans have with 
PTSD and addiction they may have is preventing a lot of them 
from getting the jobs that they are fighting for.
    So both of you all can answer those questions in that 
dialog, if you would.
    Mr. Kiyokawa. Senator, this is Guy Kiyokawa. I think I can 
address your questions. And I agree with you that the 
challenges of veterans and PTSD and, quite frankly, TBI, having 
spent a lot of time in the Military Health System addressing 
these issues, these are very complex issues. I think the one 
thing that we have learned over the years is while we all point 
toward the evidence base and the research in order to ensure we 
are doing the right thing, at the end of the day, we have to 
make sure that we are addressing the veterans' challenges and 
problems. So addressing the veterans' challenges and problems 
in parallel with that research and that evidence base is very, 
very important.
    You referred to electronic health records, and I think you 
were referring about patient safety and quality. Completely 
agree. I know in DOD it is--and the reason I hesitate is 
because we already have good patient safety and quality systems 
in place. To your point, even in West Virginia, where there are 
lapses, there is a management challenge, and we have to make 
sure we cover down on that.
    But back to the electronic health record, it will provide 
that longitudinal record that is almost the backstop for 
patient safety and quality. I looked at the report that came 
out of the incident in West Virginia, and as you inferred, 
there were many lapses, not only from the management side but 
also in the recordkeeping side. And I think that is where the 
electronic health record can help.
    Senator Manchin. That is what I was talking about, 
absolutely.
    Mr. Rodriguez, if you want to speak to the crisis that we 
have with drug abuse.
    Mr. Rodriguez. Senator, I think as Mr. Kiyokawa said, we 
know that the Department of Veterans Affairs is actually 
addressing this, and they are utilizing their resources to best 
support our fellow veterans. One of the things we do at the 
Department of Labor is focus on employment because we 
understand how employment is critical to the health and well-
being of our service members and our transitioning veterans. So 
we want to make sure that they have good quality employment 
opportunities when they are making that transition out. So that 
way, they can have a sustainable living, they can have 
generational wealth, and that can be supportive of their 
treatment at the Department of Veterans Affairs.
    Senator Manchin. Let me ask you a question on this, and I 
do not know if you all still have the rating system you had. 
Let's say that I, as a veteran, come in, and I want certain 
things that they do not want to give me or do not recognize 
that I need, but I demand it. I had this while I was deployed, 
and I definitely need these types of prescriptions for me to be 
able to function. And you all basically say, no, you do not. 
And I say, well, I am going to call my Congressperson or my 
Senator.
    And there is a rating system, and the rating system 
basically penalizes the person who did not disburse what I 
demanded. I have heard that from the nurses who told me, if you 
would just quit complaining when they come, and you all come 
and call and complain to us about not getting what they demand, 
we would be a lot better off. Has that changed any at all?
    And are you all evaluating the medication you have our 
returning veterans on and those that have still been on long-
term on these prescriptions, to make sure they are not 
addicted? Are you evaluating that?
    Mr. Kiyokawa. So, Senator, I think if confirmed, definitely 
something to look at more closely. To your comments----
    Senator Manchin. Does it make sense what I am saying on how 
this has happened? The nurses brought it to my attention. That 
is all.
    And I am not going to go over five minutes. I am just about 
finished. I am sorry. I see Bill, and I see Marsha there. So I 
will be right off.
    But just, sir, real quickly let me just bring it to you 
attention. It is real. It has happened. And rather than 
fighting the system, they give them what they demand. I am 
praying to the good Lord that you all would evaluate them and 
make sure you are treating with what they need, not what they 
want.
    Mr. Kiyokawa. Yes, Senator, I have that commitment.
    Senator Manchin. Thank you, sir.
    Thank you, Mr. Chairman. I am sorry to go over.
    Senator Moran. It has become a habit.
    Senator Cassidy.
    Senator Manchin. I will cut it down.

                      SENATOR BILL CASSIDY

    Senator Cassidy. Hey, Mr. Kiyokawa and Mr. Rodriguez. Thank 
you very much for offering yourselves to the service of our 
veterans and our country. I thank you.
    Mr. Kiyokawa, I enjoyed our conversation and want to follow 
up on some of the things that we spoke of. One thing I have 
been told, do not know if it is true, what I have been told is 
that when veterans are going to outside facilities that they 
are getting too many tests. Now I am a physician. I know that 
too many tests inevitably means too many complications. You may 
earn a little bit extra, but there is also the potential for 
harm. You do a procedure, you get complications, is a rule in 
medicine.
    How do you envision--and it has been frustrating because I 
have asked this before, but I have never been given an answer. 
How do you envision using the data at your command, if you 
will, to do some sort of utilization review to see if this is 
true, or define those institutions where it appears to be true 
and therefore maybe not broad-brush for all, but kind of a 
surgical strike on those places, number one?
    Number two, let us assume you do find that there is an 
outlier group of facilities that are over-prescribing 
procedures and tests. What tools do you need to do a prior 
authorization program or to otherwise disbar them from 
participating with the VA?
    Mr. Kiyokawa. Senator, you bring up a common problem that 
usually, as you already referred to, a utilization review is 
one of the mitigating steps. I can only speak to the experience 
I have had in DOD with the Military Health System, but if 
confirmed, it is something that I would take a look at within 
the VA.
    With my experiences, depending upon how you set up those 
agreements or contracts with those health systems on the 
outside is critical. If you have utilization management built 
into your contracts, and to your point, if you find over-
utilization, over-prescription, then there are consequences to 
not following those clinical practice guidelines, which are 
based on the evidence. And so I would say that that is probably 
the best way for us to try to manage that potential harm going 
on.
    Senator Cassidy. And you spoke of earlier the redundant and 
legacy systems the VA has, which tells me that you have 
familiarity with their capability. So therefore, to what degree 
do the systems we have now have the ability to look for over-
utilization and/or complications resulting from that over-
utilization?
    Mr. Kiyokawa. Yes, Senator, when I referred to the legacy 
systems and redundancies, I was making a general comment of 
most Federal organizations. Clearly, we have that within DOD. I 
am not familiar with the details within the VA.
    But to answer your question about data, there should be 
ways within the data, within the electronic health record. I do 
know with MHS GENESIS, which is the DOD's new electronic health 
record, there are many more checks and balances that are not 
reliant on the individual to have that check and balance. In 
other words, the system itself throws the flag up, and I think 
becomes the key to catching those things.
    Senator Cassidy. Oh, you are breaking up. You broke up just 
as you said that there are systems which do not rely upon the 
individual to do a check and balance. Could you repeat that? 
Because you were muffled and you gargled at that point.
    Mr. Kiyokawa. Sorry, Senator. What I was saying is that 
within the Military Health System MHS GENESIS has provided that 
system that provides flags when the untoward events occur, and 
so we are not solely reliant on the individual provider to flag 
it themselves. It is still the individual provider's 
responsibility----
    Senator Cassidy. That is for a complication. Excuse me. 
That is for a complication. What about for over-utilization? 
Knowing that the VA is going to be using a system similar to 
that used in the DOD, is there a way to easily look at practice 
patterns to determine over-utilization?
    Mr. Kiyokawa. Senator, I am not aware of that level of 
detail, and it is something that I commit to looking into more 
closely.
    Senator Cassidy. Well, then if I may in advance tell you, 
although I have requested this in the past, I am not sure I 
have ever gotten an answer. It would be nice to know the degree 
to which we have over-utilization, nice to know the kind of 
preauthorization procedure and provision review that currently 
exists in the VA. It has been very difficult to determine, but 
I think it is something which would protect the taxpayer and 
protect the veteran, but protect the wallet of the taxpayer.
    With that, Mr. Chair, I yield back, and I again once more 
thank the two men for volunteering to serve our country. Thank 
you all.
    Senator Moran. Senator Cassidy, thank you very much.
    Now, Senator Blackburn.

                    SENATOR MARSHA BLACKBURN

    Senator Blackburn. Thank you, Mr. Chairman.
    And thank you to each of you for being with us today.
    Mr. Kiyokawa, I want to come to you first. The enterprise 
program, that integration office, we have talked a little about 
that. And as we look at the integration that needs to happen 
between the financial management business transformation 
program, the electronic health records, and the supply chain 
transformation efforts, how do you best bring all of that 
together so there is transparency and access across the entire 
VA system? How do you accomplish that?
    Mr. Kiyokawa. Senator, thank you for your question. And I 
think the discussion that Senator Tillis started with the data 
becomes critical to that.
    So to answer your question, I think it is not just about 
the systems. And I know the VA is moving forward more than just 
the electronic health record, as you mentioned, the logistics 
system and the financial management system. So I think, if 
confirmed, the Office of Enterprise Integration has the 
opportunity to look at those workflows or processes that go on, 
on the functional side, within the finance or within logistics 
or within the electronic health record and start to map where 
some of those things naturally fit together and then leverage 
those systems in order to make that happen more automatically.
    And as Senator Tillis inferred, having that data flow 
across those different systems cleanly----
    Senator Blackburn. Yes.
    Mr. Kiyokawa [continuing]. And then specifically with the 
electronic health record, then all the way back to DOD where we 
have the same instance.
    Senator Blackburn. Well, I think that is important. And 
when we look at the VA and look at the way they function in 
stovepipes instead of in a flat organization, without access to 
that data, what we find repeatedly in doing the oversight is 
that poor decisions get made because one area has the data but 
another area--and it is relevant in their area--does not have 
the access to that data in a timely manner or they get on the 
back end. So getting this right I think is going to be 
important.
    And related to this, I want to ask you, Leidos has the DOD 
contract to all the electronic health records but Cerner on the 
VA. And to me, from what I have seen, it seems that the Leidos 
platform is much more interactive and flexible than is the 
Cerner. Do you have a comment on that?
    Mr. Kiyokawa. Yes, Senator. To clarify, within DOD we 
contracted with Leidos that then subcontracted with Cerner for 
the actual medical record. Leidos was to bring in the 
integration of the different things that involve the electronic 
health record. What I have seen from the outside with VA, it 
appears that VA is providing that level of integration, which 
is totally appropriate as long as you have the right paths laid 
out and the right integration and management. And I think, if 
confirmed, that is something I could help contribute towards.
    Senator Blackburn. Okay. We just need to get this 
transition from active duty to veteran status. We need to get 
that to operate in a--it needs to be more fluid. It is 
frustrating to our veterans, and in our offices, we deal with 
this so regularly. We have a lot of veterans who choose to 
retire in Tennessee because they have had service at Fort 
Campbell or they have worked with Arnold Engineering over in 
Tullahoma, so they continue to make Tennessee their home. So we 
are really quite concerned about that.
    Mr. Rodriguez, I have listened to your answers about DOL 
VETS and the programs that you would oversee there. At Fort 
Campbell, we have had a very active and successful transition 
program and partnerships that have been quite successful. We 
have been very fortunate to get these partnerships in place in 
Tennessee. But as we move forward and if you are confirmed, 
what I would like to hear from you is a tool box where we can 
have a little bit more transparency into this, look at the 
resources, where they are being utilized, look at how you 
quantify success, what those measurements are, and how our men 
and women who are transitioning out, how they view the program 
and view that success.
    And with that, Mr. Chairman, I will yield back.
    Senator Moran. Thank you, Senator Blackburn.
    We have been joined by the Chairman, Senator Tester, and I 
turn over the reins of leadership, as well demonstrated by 
Senator Tillis and his six-minute extra time, over to the 
Chairman.

              OPENING STATEMENT OF CHAIRMAN TESTER

    Chairman Tester. [presiding]. Well, first of all, Senator, 
I appreciate you taking the hearing today. This has been an 
interesting afternoon for me because I know these are two very 
important nominees, and I really appreciate you filling in very 
aptly, I might add, in the Chair role.
    I am going to start with Kiyokawa. It is no secret that the 
VA is in the midst of deploying a new electronic health record 
system. This program has not rolled out as smoothly as I think 
anybody would have wanted, and we dumped a bunch of money into 
it. You have got some past history with the DOD in electronic 
health records. Tell us what lessons you would bring to the VA 
that you learned from your time at the Defense Health Agency 
and, quite frankly, in your Army career when it comes to EHR 
work.
    Mr. Kiyokawa. Senator, thank you for that question. As I 
mentioned earlier, one of the key things is to have that true 
IT infrastructure backbone. One thing we learned early on, when 
we were bringing the services together to have that single 
backbone, it had to be reliable. If you put the system on top 
of unreliable IT infrastructure, then everybody points at the 
system when it is actually your infrastructure that is 
unreliable. So that would be the first thing that we learned 
right off the bat.
    The bigger thing, though, and it has already been alluded 
to in change management, is everybody points at the system and 
the record. And one of the challenges we had in DOD as we had 
basically systems that we developed on our own, which was 
appropriate because industry had not been at the point that it 
is today, but we kept modifying the system to meet the 
workflows and the way we practice medicine with wide variation 
across our enterprise.
    And the big difference is that we are buying an off the 
shelf medical record from Cerner, where we have to commit to a 
standardized way of doing business, standardized workflow. And 
so that change management in every location, for every workflow 
becomes critical.
    Now the trick there becomes creating that standard workflow 
but then ensuring that those on the ground have some say and 
input into that workflow, and that is where we had a challenge 
when it first kicked off. It was not smooth when it first 
kicked off, and part of it was because we did not invest enough 
training with those who actually were using it from a functions 
perspective. Cerner came up with the training from what is 
called buttonology, how to use the system. But really, where 
was the training for the change management?
    And then, more importantly, how were the guys that were 
actually implemented having feedback into those workflows so we 
could continue to improve the workflows? And instead of 
customizing the system, how do you modify the system? And the 
product that we are deploying today is not the same product 
when we first started.
    And lastly, I would say, once we got it going, we developed 
something called the Pay It Forward Program, where we had 
actual providers who had deployed it at their site actually 
physically go to the next site and sit down with their peers. 
And it is that peer-to-peer relationship that started to get 
the buy-in that is so important with change management.
    Chairman Tester. So we have had people testify in front of 
this Committee before that say, on electronic health records, 
most of them have been train wrecks because the people who are 
running them do not like them. I would assume that getting buy-
in and getting inputs is pretty critical to getting these folks 
to like these systems when they go live. Can you tell me what 
you are going to do different than what has already been done 
to get input from those folks?
    Mr. Kiyokawa. So, Senator, I am not familiar on the details 
of what has already been done, but some of the things that I 
just described are some of the best practices that we found 
within the Department of Defense. Back to----
    Chairman Tester. I got you. Best practices are good. Now 
how are you going to implement those best practices? How are 
you going to get that feedback? How are you going to make sure 
those people feel like they are part of the team? How do you do 
that?
    Mr. Kiyokawa. So a big part of it, Senator, is as you 
implement some of those workflows is that they are part of the 
development of those workflows. And when I say that, you need a 
starting point. So you have the standardized workflow to walk 
in the door with, but then there are definitely unique 
opportunities within certain geographic areas, within certain 
health care organizations.
    And it is back to understanding the difference between a 
customization, which we try to stay away from, versus just a 
modification or configuration that meets those requirements. So 
keeping the ears open and listening to those who are actually 
providing the care and understanding what their requirements 
are and seeing how the reconfiguration of the health record can 
meet those requirements versus wholesale modifications and 
customization.
    Chairman Tester. Thank you.
    Mr. Rodriguez, very quickly. You are a retired Marine Corps 
First Sergeant. You have personally experienced the challenges 
that come with transitioning out of the military as well as 
guiding your own troops during their transitions. How do you 
use that experience to inform your leadership in this new 
position?
    Mr. Rodriguez. Well, Senator, you are exactly right. I 
think having personal experience really allows us a deeper 
insight into the entire transition process. And one of the 
things that I know for certain is getting as much information 
to that individual that he or she can make the most beneficial 
decision for them and their families when they are 
transitioning out is something that we are definitely trying to 
do here at Department of Labor VETS. We know that that is what 
they are taught while they are on active duty is receive 
information and make a decision that is beneficial to you and 
the organization.
    Chairman Tester. Thank you.
    Senator Moran, are you still there in person?
    Senator Moran. I am.
    Chairman Tester. You are. Senator Moran, since I am not 
there, I will turn the gavel back to you because you know who 
is there to be called on; I do not.
    Senator Moran. [presiding]. I can do that. I am told that 
Senator Sullivan may be on his way, but we are going to 
conclude the meeting.
    Mr. Chairman, before I do, I want to take a moment to thank 
you. Last Wednesday, you conducted a roundtable with our VSO 
representatives, and I had asked you to do that. And you did, 
and then I was not here, but I wanted to thank you for your 
pursuit of that opportunity.
    Last week, Wednesday, during that roundtable, I was in 
Kansas for the funeral services, the burial service of Father 
Emil Kapaun, a Medal of Honor winner who, as a Catholic priest 
and chaplain, died in 1951 in Korea. And he was a chaplain who 
remained behind as Americans were evacuating after somewhat of 
a massacre but stayed by to administer rites and to comfort 
those that were dying. In the process of his sacrifice, was 
captured and became a prisoner of war, where he continued to 
minister to those in captivity with him. He ultimately died of 
hunger and starvation and disease as a prisoner of war.
    We had been encouraging the Department of Defense to find 
and identify his remains. They did, and they were returned home 
to Kansas last week. And he comes from a town, Pilsen, Kansas, 
where he was an altar boy before he obviously became a priest. 
And Pilsen is a town of 112 people who love, admire, and 
respect their native son. And Father Kapaun is on a set of 
stages to potential sainthood.
    And I just wanted you to know and wanted my colleagues to 
know the reason for my absence, but more importantly, I wanted 
my colleagues to know the nature of this human being in service 
to his country and to his God, who put others well above his 
own life and in the process sacrificed his. And at a time in 
which we struggle to find, you know, comfort and feel secure 
that the world is all right, it was an opportunity to see 
goodness, the truth in someone's heart, and a reminder of those 
who continue to sacrifice today not just for the well-being of 
our Nation but for the well-being of their fellow men and women 
serving our Nation.
    And so again I apologize for my absence but express my 
gratitude for you, to you for hosting that roundtable and, most 
importantly, bring to the attention of my colleagues and those 
present today the importance of one human being who decided to 
use his life for the betterment of others. Mr. Chairman, I 
thank you for the moment to pay my respects in this setting to 
Father Emil Kapaun.
    Chairman Tester. So the only thing I would respond to that, 
Jerry, is that--or Senator Moran, is that we missed you. It was 
a very, very good roundtable. But there is no better reason to 
miss that roundtable than the reason you missed it for. And so 
I thank you for your commitment to veterans all around this 
country, both alive and deceased. So thank you.
    Senator Moran. Thank you, Mr. Chairman.
    I thank both of our witnesses for appearing before the 
Committee today and for your willingness to continue serving in 
the roles for which you have been nominated.
    Members will have an opportunity to submit to you, to the 
Committee, questions of record that we will submit to you, and 
we ask that those questions be submitted and answered as 
quickly as possible.
    With that concluding--oh, let me say one thing before I 
gavel. In my time as chairman of committees in the Senate, I 
have always asked the witnesses if they have anything they want 
to add, subtract, try to correct, something they said they wish 
they had not have said or something they hoped they had said. 
Anything, Mr. Kiyokawa or Mr. Rodriguez that you would like to 
bring for us before I pound the gavel?
    Mr. Kiyokawa. Nothing, sir, from me.
    Senator Moran. Thank you.
    Mr. Rodriguez. Nothing from me as well.
    Senator Moran. Thank you. The Committee--Senator Sullivan 
is outside. How close is outside?
    Staff. He is down the hallway, sir.
    Senator Moran. Well, having given Senator Tillis more than 
an hour extra----
    Senator Tillis. Can I go for a second round?
    Senator Moran [continuing]. I am reluctant to deny Senator 
Sullivan although I know he is not short in his remarks either.
    [Pause.]
    Senator Moran. Senator Sullivan, you will be recognized for 
five minutes and no more.

                      SENATOR DAN SULLIVAN

    Senator Sullivan. Thank you, Mr. Chairman. I guess the real 
Chairman did not want to hold out for his colleague, but let me 
just begin by thanking you, gentlemen, for your willingness to 
serve.
    You know, we all kind of brag about our States a little 
bit. My colleagues have never heard this. My State has more 
veterans per capita than any State in the country. I say that 
every hearing. That is the State of Alaska.
    So, Mr. Kiyokawa, sorry to butcher your name there, sir. I 
want to talk to you about an important issue to me, but I think 
it is an important issue for the country, this issue of DOD-VA 
integration. I know you have a lot of experience in this. We 
have no full-service VA hospital in Alaska, and yet we have a 
lot of active duty military forces.
    So I am sure you have seen it in Chicago, where they have 
actually done this. I was able to get language, unanimous 
language by the way, in terms of being supported by Democrats 
and Republicans, in the NDAA this year that focuses on looking 
at ways for Federal healthcare agencies, particularly in DOD 
and the VA, to integrate joint planning, joint construction, 
joint leasing. Do you have a view on that?
    It is something I am a strong supporter of. I think it is 
something most Senators are supportive of, and I think we are 
going to have an opportunity here with the NDAA likely passing 
and this part of the NDAA having that legislation, which would 
give you and the Secretary and Secretary Austin power to do 
this kind of work.
    And it saves money. It is better for our vets. It is better 
for our active duty forces. It is better for our docs. It 
really makes sense, but hopefully you agree with me on that.
    Mr. Kiyokawa. Senator, it is interesting you bring up this 
point because my background is in health facilities planning 
and construction, in fact, at Fort Wainwright, actively 
involved in building that new hospital up there. I think the 
key is to ensure that we are focused on the veterans and the 
service members and if we can get to that outcome, as you say, 
in a more efficient and effective way, then that should drive 
whether it is a system, infrastructure, that sharing, that has 
to be behind it in a measurable way. So, agree with you if 
those pieces come together and it makes it a best way forward.
    Another part to that is in my history I spent my Army War 
College fellowship at the VA and actually worked on the new, 
now currently opened, William Beaumont Army Medical Center. And 
if you are familiar, at Fort Bliss, the VA facility shares the 
wall with the old medical center. And I worked very hard during 
that one year to try to see if we could not bring that 
together, and it actually led to the continued push for that 
language so that we could actually do that planning together--
--
    Senator Sullivan. Good.
    Mr. Kiyokawa [continuing]. Because we are not able to do 
that planning together. So I have experience in what you 
described.
    Senator Sullivan. You have seen that the VA in Anchorage 
and at JBER, the military hospital, they actually share a wall, 
but it is not fully integrated as well. I am sure you have 
probably seen that.
    Mr. Kiyokawa. Actually, unfortunately, I have not been to 
JBER, but I would love to be able to see that. And having seen 
other situations like that, besides just the sharing of the 
wall and the infrastructure, if we can share the functions and 
so that it is more integrated, so that as veterans come through 
they should not really see: Am I seeing a military doctor, or 
am I seeing a VA doctor?
    Senator Sullivan. Yes.
    Mr. Kiyokawa. It should really be seamless to the veterans 
themselves.
    Senator Sullivan. Great. Thank you for that, and I might 
ask a couple additional questions.
    Mr. Rodriguez, First Sergeant Rodriguez, I believe, thank 
you for your Marine Corps service. I wanted to ask, I chair the 
Congressional Veterans Job Caucus with Senator Manchin, who, as 
you know, is also on this Committee. And I am curious about two 
things: your views on opportunities as it relates to the 
Transition Assistance Program, the TAP program. You know, in my 
experience as a Marine, I have been through that a couple 
times. You know, it is always at the end. Guys are wanting to 
get out. It is not terribly effective, I do not think. Do you 
have any views on that given your Marine Corps experience but 
also in general?
    And then I am a big fan of the building trades. The unions 
in Alaska and across the country, the Laborers, the Teamsters, 
the Operating Engineers, IBEW, all of these unions have really 
good programs with our active duty forces across the country 
and in Alaska. How do we integrate their work?
    We have a couple programs in Alaska where soldiers who are 
getting out can actually start doing apprentice work with some 
of these trades unions before they are even done with their 
active duty service. I actually think it is a great opportunity 
for our young men and women who are getting out and it is a 
much more effective way, in some ways, than a 2-day TAP program 
that, you know, the sergeant is like looking at his watch, 
like, hey, when the hell am I getting out of here?
    So do you have any thoughts on both of those?
    Mr. Rodriguez. I do, Senator. And like you, I was part of 
the 31st Marine Expeditionary Unit.
    Senator Sullivan. Oh.
    Mr. Rodriguez. And I actually went through TAP after I came 
back from the 31st deployment.
    Senator Sullivan. Right.
    Mr. Rodriguez. So----
    Senator Sullivan. And were you looking at your watch? No, I 
am kidding.
    Mr. Rodriguez. I actually was because I was retiring in 
about 9 months.
    Senator Sullivan. That is what I mean. That is what I mean.
    Mr. Rodriguez. So time was on my side at that time.
    Senator Sullivan. Yes.
    Mr. Rodriguez. Because it was my last deployment.
    Senator Sullivan. Right.
    Mr. Rodriguez. With that said, one of the things that I 
have not had the chance to speak about, which is actually 
really exciting for us, with respect to TAP, is our MOU that is 
being finalized with Health and Human Services, that is going 
to give us access to the national data base of new hires.
    Senator Sullivan. Good.
    Mr. Rodriguez. That information, which is the most up to 
date information about the employment of our veterans, is going 
to let us look at unemployment, new employment opportunities, 
gaps in employment opportunities for our veterans, new 
industries, where those veterans are at, what type of wages 
they are earning, those types of things. So we could take that 
information and make a more informative program with respect to 
TAP.
    Senator Sullivan. Good.
    Mr. Rodriguez. So that is some of the things we are 
currently working on now.
    But to your question about the labor unions, we have a 
strong partnership with the labor unions.
    Senator Sullivan. Yes.
    Mr. Rodriguez. We work closely with them in specific trades 
across the entire country, on specific bases as well, and we 
want to continue to build that.
    Senator Sullivan. I find that that works well on some 
bases, not so well on other bases. It is not terribly uniform. 
Right? Is that your experience?
    Mr. Rodriguez. That is correct. And so we are working with 
the Department of Defense because they have the DOD SkillBridge 
program.
    Senator Sullivan. Yes.
    Mr. Rodriguez. And so we work closely with them to expand 
that program, to try to find more opportunities to enhance that 
DOD SkillBridge. And we support it by encouraging our active 
duty service members through TAP to get to those apprenticeship 
programs because we know there is tremendous value there. On 
average, they are earning about $30,000 a year more than 
someone that has a 4-year degree when they complete that 
apprenticeship program. And so we want to get our men and women 
into those programs if they do not use college as their next 
stepping stone.
    Senator Sullivan. Great. Good. Well, I look forward to 
working with both of you, gentlemen, and supporting your 
nominations.
    And thank you, Mr. Chairman. Appreciate the time.
    Senator Moran. Thank you, Senator Sullivan.
    We will now conclude the hearing. And again, I appreciate 
your testimony and your willingness to serve. I was impressed 
with what I heard today, and I am grateful for your willingness 
to help us make certain the Department of Veterans Affairs, the 
Department of Labor, and others are making certain that our 
veterans are receiving the care and treatment that they are 
entitled to and that they are in a position in which their 
lives are made better as they have made ours. Again, I thank 
you.
    And the Committee is adjourned.
    [Whereupon, at 4:27 p.m., the Committee was adjourned.]

                            A P P E N D I X

                        Nomination Material for

                            Guy T. Kiyokawa
[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]

                        Nomination Material for

                           James D. Rodriguez

[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]

                                  [all]