    [Senate Hearing 117-544]
    [From the U.S. Government Publishing Office]

                                                            S. Hrg. 117-544

                    HEARING TO CONSIDER PENDING LEGISLATION

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

                                    HEARING

                                   BEFORE THE

                         COMMITTEE ON VETERANS' AFFAIRS
                              UNITED STATES SENATE

                        ONE HUNDRED SEVENTEENTH CONGRESS

                                 FIRST SESSION

                                   __________

                               NOVEMBER 17, 2021

                                   __________

           Printed for the use of the Committee on Veterans' Affairs

    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]

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

                                   __________

                        U.S. GOVERNMENT PUBLISHING OFFICE
    50-288 PDF                 WASHINGTON : 2023

    -----------------------------------------------------------------------------------

                         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

                                  ----------

                               NOVEMBER 17, 2021

                                    SENATORS

                                                                       Page
    Tester, Hon. Jon, Chairman, U.S. Senator from Montana............     1
    Moran, Hon. Jerry, Ranking Member, U.S. Senator from Kansas......     2
    Hirono, Hon. Mazie K., U.S. Senator from Hawaii..................     8
    Tuberville, Hon. Tommy, U.S. Senator from Alabama................     9
    Manchin, Hon. Joe, U.S. Senator from West Virginia...............    10
    Rounds, Hon. Mike, U.S. Senator from South Dakota................    12
    Brown, Hon. Sherrod, U.S. Senator from Ohio......................    14
    Boozman, Hon. John, U.S. Senator from Arkansas...................    16
    Hassan, Hon. Margaret Wood, U.S. Senator from New Hampshire......    18
    Cramer, Hon. Kevin, U.S. Senator from North Dakota...............    19
    Murray, Hon. Patty, U.S. Senator from Washington.................    20
    Blumenthal, Hon. Richard, U.S. Senator from Connecticut..........    22
    Blackburn, Hon. Marsha, U.S. Senator from Tennessee..............    25

                                   WITNESSES
                                    Panel I

    Brianne Ogilvie, Assistant Deputy Undersecretary for Policy and
      Oversight, Veterans Benefits Administration, Department of
      Veterans Affairs;
      accompanied by Jill DeBord, Executive Director, Care Management
      and Social Work, Veterans Health Administration; and Marjorie
      Bowman, MD, MPA, Chief Academic Affiliations Officer, Office of
      Academic Affiliations, Veterans Health Administration..........     3
    Chris Wilber, Counselor to the Inspector General, Office of the
      Inspector General, Department of Veterans Affairs..............     5

                                    Panel II

    Jeremy Villanueva, Assistant National Legislative Director,
      Disabled American Veterans.....................................    28
    Patrick Murray, Legislative Director, Veterans of Foreign Wars...    30

                                    APPENDIX
                                 Hearing Agenda

    List of Pending Bills............................................    41

                              Prepared Statements

    Brianne Ogilvie, Assistant Deputy Undersecretary for Policy and
      Oversight, Veterans Benefits Administration, Department of
      Veterans Affairs...............................................    45
    Chris Wilber, Counselor to the Inspector General, Office of the
      Inspector General, Department of Veterans Affairs..............    76
    Jeremy Villanueva, Assistant National Legislative Director,
      Disabled American Veterans.....................................    83
    Patrick Murray, Legislative Director, Veterans of Foreign Wars...    97

                            Questions for the Record

    Department of Veterans Affairs response to questions asked during
      the hearing by:
      Hon. Mazie Hirono..............................................   109
      Hon. Marsha Blackburn..........................................   114
      Hon. Kevin Cramer..............................................   117

    Department of Veterans Affairs response to questions submitted
      by:
      Hon. Kyrsten Sinema............................................   112
      Hon. Marsha Blackburn..........................................   115
      Hon. Kevin Cramer..............................................   118

                           Statements for the Record

    Senator Rob Portman..............................................   121
    Tom Wike, U.S. Marine Corps Veteran..............................   122
    Alex Lintner, Group President, Consumer Information Services,
      Experian.......................................................   124
    Brad Thaler, Vice President of Legislative Affairs, National
      Association of Federally-Insured Credit Unions (NAFCU).........   125
    Chauncey L. Parker, Executive Director, Rocky Boy Veterans Center   126
    Jim Nussle, President & CEO, Credit Union National Association...   127
    Matthew Chase, Executive Director, National Association of
      Counties.......................................................   128
    Nichole R. Coleman, President; and Michael L. McLaughlin,
      Legislative Chair; National Association of County Veterans
      Service Officers...............................................   130
    Paralyzed Veterans of America....................................   133
    Student Veterans of America......................................   139
    VantageScore.....................................................   147
    Veterans Education Success.......................................   148
    Wounded Warrior Project..........................................   149

                          HEARING TO CONSIDER PENDING
                                  LEGISLATION

                                  ----------

                          WEDNESDAY, NOVEMBER 17, 2021

                                           U.S. Senate,
                                Committee on Veterans' Affairs,
                                                        Washington, DC.
        The Committee met, pursuant to notice, at 3:04 p.m., via
    Webex and in Room SR-418, Russell Senate Office Building, Hon.
    Jon Tester, Chairman of the Committee, presiding.
        Present: Senators Tester, Murray, Brown, Blumenthal,
    Hirono, Manchin, Sinema, Hassan, Moran, Boozman, Cassidy,
    Rounds, Blackburn, Cramer, and Tuberville.

                  OPENING STATEMENT OF CHAIRMAN TESTER

        Chairman Tester. I am going to call this meeting of the
    Senate Veterans' Affairs Committee to order.
        Good afternoon. Today we will share the views from the
    Department of Veterans Affairs and veterans service
    organizations on 21, that is right, 21 bills pending before the
    Committee.
        Before we get into my complete statement, I would hope that
    the VA can actually comment on the 21 bills and not just say we
    can do this without you. Okay. Good. Thank you very much.
        As Chairman, one of my concerns is the backlog of
    disability compensation claims and appeals not being processed
    quickly enough. My Veterans Benefits Improvement Act of 2021
    will help fix that. For example, without this bill, VA will
    continue to play phone tag with veterans to schedule simple
    disability exams, which is one of the first steps to process a
    claim.
        The bill will help the Board of Veterans' Appeals recruit
    and retain talent. Veterans do not always get the right
    decision first, and an appeal can add months of waiting. We
    need the best and brightest to work our veterans' appeals.
        Today we will also discuss the RURAL Exams Act of 2021,
    which I have also introduced with my good Ranking Member,
    Senator Moran. This bill will offer rural and housebound
    veterans better access to medical disability examinations, and
    it will improve transparency in the disability examination
    process by requiring VA to push exam quality and timeliness
    metrics in a format all veterans can understand.
        Also on our agenda today is the Strengthening Oversight for
    Veterans Act of 2021, which I have introduced with Senators
    Boozman and Manchin. This bill will provide the VA Inspector
    General authority to require former VA employees, contractors,
    and others to answer questions and provide information to the
    IG as part of its investigations. The IG plays a critical role
    in Congress's oversight of the VA, and they have requested this
    tool to help them do their important work.
        And finally, the GRAD VA Educational Assistance Parity Act
    of 2021, which I have introduced with Senator Moran again, will
    allow federally activated members of the National Guard and
    Reserve to receive the education benefits that they have
    earned. The brave men and women in our National Guard and
    Reserve continue to answer the call of duty, but their benefits
    are not keeping pace. This bill rights that wrong.
        I look forward to hearing from the VA and the VSOs about
    these bills and other important legislation on our agenda
    today.
        Now I will turn it over to Ranking Member Moran for his
    opening statement.

        [The pending bills referred to by Chairman Tester appear on
    page 41 of the Appendix.]

                   OPENING STATEMENT OF SENATOR MORAN

        Senator Moran [presiding]. Chairman, good afternoon. Good
    afternoon to you and to our witnesses from the VA and the VA
    OIG and the VSOs. We are pleased that you are with us today,
    and I look forward to hearing what you all have to say
    regarding the legislation that is pending before this
    Committee.
        We are considering 21 bills, most of which deal with
    benefits and services provided by the Veterans Benefits
    Administration. Considering 21 bills on one agenda is a
    challenging task. So thank you to our witnesses for your
    written statements and input, which will also be of great value
    as our Committee tries to move forward on this legislative
    process following today's hearing.
        As this hearing is happening a week after Veterans Day, I
    think it is important to highlight how this Committee continues
    to be an awfully good example of how politics can be set aside
    so that we can put the needs of those who served our Nation
    first. Our veterans and those who are still serving and their
    families who serve have been a tremendous set of heroes for our
    Nation, and we paid tribute to them on Veterans Day, and we
    should do so each and every day thereafter. We can do that by
    doing our work well.
        There are many important bills on today's agenda, including
    legislation that I introduced with the Chairman to provide a GI
    Bill parity for our National Guard and Reservists. He mentioned
    this in his opening statement. I was pleased to see that. I
    think that is one of the pieces of legislation that I am
    anxious to see be enacted into law.
        I also want to thank my colleague, Senator Manchin, for
    joining me in introducing our bill to make certain homeless and
    at-risk-for-homelessness veterans living in every State--in
    every State and territory have access to specialized employment
    and training services.
        And I look forward, as I said earlier, to today's
    testimony. I look forward to working with all of you in a
    continuing partnership, with all my colleagues on this
    Committee, as we work today and every day hereafter to improve
    the lives of our Nation's veterans.
        And, Mr. Chairman, I yield back.
        I would like to welcome our first panel of witnesses.
    Brianne Ogilvie, Assistant Deputy Under Secretary for Policy
    and Oversight of VBA, will provide the statement on behalf of
    the VA. She is accompanied by Jill DeBord, Executive Director,
    Care Management and Social Work at VHA, and Dr. Marjorie
    Bowman, Chief Academic Affiliations Officer, Office of Academic
    Affiliations for the VHA.
        And Chris Wilber, Counselor to the Inspector General, will
    testify on behalf of the VA's Office of Inspector General.
        Ms. Ogilvie, you may begin.

                                PANEL I

                                  ----------

              STATEMENT OF BRIANNE OGILVIE ACCOMPANIED BY

                    JILL DEBORD AND MARJORIE BOWMAN

        Ms. Ogilvie. Good afternoon, Mr. Chairman, Ranking Member
    Moran, and members of the Committee. We appreciate the
    opportunity to appear before you today to discuss pending
    legislation. Accompanying me from the Veterans Health
    Administration are Jill DeBord, Executive Director of Care
    Management and Social Work, and Dr. Marjorie Bowman, Chief
    Academic Affiliations Officer.
        Before we discuss this important legislation, I want to
    touch on an evolving crisis. The COVID-19 pandemic exposed
    global and U.S. supply chain weaknesses, and we expect the
    manufacturing and distribution disruptions to continue for some
    time. As the virus spread, overall consumer demand decreased,
    and industrial activity, in turn, decreased due to the lower
    consumer demand and effects of COVID-19. With the increasing
    level of vaccination globally and the end of lockdowns in many
    nations, consumer demand increased dramatically while supply
    chains continue to face big challenges, including worker
    shortages and limitations and access to raw materials and key
    components.
        VA is actively addressing these challenges, implementing
    near-term methods to ensure internal VA supply chain
    resiliency, including increased demand signal monitoring,
    identification of alternatives for preferred products, and
    treating medical products as enterprise assets.
        Effective national response requires a resilient public
    health supply chain anchored in domestic manufacturing
    capabilities so that care and preventative measures can reach
    patients. Sustaining the resilience of the supply chain is
    critical for ensuring the health and wellness of the Nation as
    well as for national security, and VA is working with the White
    House and executive branch agencies to develop and implement
    the actions identified in the National Strategy for a Resilient
    Public Health Supply Chain.
        VA offers support for much of the proposed legislation
    before us today. VA is focused on providing exemplary benefits
    and services for veterans, servicemembers, and their families,
    and is committed to modernization. While VA's views on all
    bills are detailed in my written testimony, to include areas of
    concern and support, I would like to highlight a few areas
    related to our proposed legislation which would have profound
    effects on modernizing our delivery of service.
        First, I would like to address certain sections of the
    Veterans Benefits Improvement Act of 2021 that support our
    common goal to modernize benefits delivery. VA supports Section
    302 of this bill, which would provide the general authority for
    electronic notification as this would enhance the efficiency
    and timeliness of the claims adjudication process. We recognize
    that the way veterans and beneficiaries prefer to engage with
    VA is changing, and VA has already initiated an effort that
    will enable us to provide electronic notifications along with
    this necessary legislative support.
        VA also supports Section 303 and understands the intent of
    Section 303(a) is to allow VA contractors and vendors access to
    Federal tax information for the purpose of administering
    certain types of benefits. This would improve the efficiency of
    VA claims adjudication. However, VA is concerned that the bill,
    as written, could be interpreted to limit its contractors' or
    vendors' ability to perform some key functions such as
    processing mail and maintaining information technology systems.
    We would appreciate the opportunity to work with the Committee
    on technical changes to ensure we are not impacting service
    delivery to our veterans.
        I would like to address another bill related to
    modernization of benefits delivery, S. 2794, Supporting
    Families of the Fallen Act. VA supports this bill that will
    increase servicemembers' group life insurance and veterans'
    group life insurance, which aligns with modern cost of living
    increases that have occurred.
        Lastly, I would like to address S. 1296, Daniel J. Harvey
    Jr. and Adam Lambert Improving Servicemember Transition to
    Reduce Veteran Suicide Act. This bill is focused on the
    vulnerable time of transition between military and veteran
    status, ensures servicemembers are educated about the impact of
    transition on psychological health and have early connections
    to VA clinicians who provide a safeguard against loss of direct
    access to care coordination which is personalized to the
    servicemember's unique needs. Suicide prevention is VA's top
    clinical priority, and we welcome the opportunity to work
    through technical amendments to this legislation together.
        VA is committed to working together toward our common goal
    of improvement and modernization. We are grateful for the
    resources provided to us and thank you for the opportunity to
    appear before you today to discuss this important legislation.
        Mr. Chairman, this concludes my testimony. My colleagues
    and I are prepared to respond to any questions that you or
    other members of the Committee may have.

        [The prepared statement of Ms. Ogilvie appears on page 45
    of the Appendix.]

        Senator Moran. Thank you very much. First of all, I want to
    thank the Department for their technical assistance while we
    crafted--oh, I am so sorry. Chairman Tester would not have made
    this error.
        Inspector General.

                       STATEMENT OF CHRIS WILBER

        Mr. Wilber. Ranking Member Moran and members of the
    Committee, thank you for giving the Department of Veterans'
    Affairs Office of Inspector General the opportunity to discuss
    our support for two bills that would strengthen our ability to
    conduct fair and comprehensive oversight.
        S. 2687, the Strengthening Oversight for Veterans Act of
    2021, would provide the Inspector General the ability to
    require the testimony of individuals who are not currently
    employed by VA or its contractors. The OIG supports this bill
    as drafted. We thank Chairman Tester, Senator Boozman, and
    Senator Manchin for introducing this much needed bill.
        We also support, as drafted, S. 2431, the Department of
    Veterans Affairs Office of Inspector General Training Act of
    2021. This legislation would require VA employees to be trained
    on how and when to report wrongdoing to, and cooperatively
    engage with, OIG staff. We appreciate Senators Hassan and
    Boozman for sponsoring this bill.
        S. 2687 is important because the VA OIG currently cannot
    compel non-Federal individuals and entities with potentially
    relevant information to provide testimony in support of our
    oversight of VA operations. Presently, we can obtain documents
    and other materials from VA and non-Federal individuals and
    entities, and VA employees and contractors must speak with OIG
    staff subject to the constitutional protection against
    compelled self incrimination. S. 2687 would enable us to obtain
    sworn statements from others, including former Federal
    employees, former employees of current Federal contractors, and
    others who do not have an employment or contractual
    relationship with VA.
        We are committed to using this authority responsibly and
    support the procedures Congress has included to ensure that we
    do, which include providing the witness with notice of our
    intent to issue a subpoena and an opportunity to testify
    voluntarily, authorizing the Attorney General to object if the
    testimony may interfere with an ongoing investigation,
    endeavoring to arrange an interview conveniently for the
    witness, and requiring a Federal district court order to
    enforce the subpoena if challenged.
        Additionally, our semi-annual report to Congress will
    contain information on our use of the authority. This authority
    is comparable to that of other OIGs that conduct oversight of
    extremely large contracting and healthcare organizations,
    specifically, the Department of Defense, the Department of
    Health and Human Services, and the newly created Pandemic
    Response Accountability Committee.
        Our written statement discusses several healthcare
    inspections where we were unable to interview healthcare
    providers who left Federal service before or during our
    reviews. For example, a dentist and the Chief of Dental
    Services left Federal service during our review of improper
    dental infection control practices at the Tomah VA Medical
    Center. As a result, we were unable to learn more about the
    lack of supervision that potentially exposed 592 veterans to
    bloodborne pathogens.
        In our healthcare inspection conducted subsequent to the
    criminal investigation into veterans' murdered by Reta Mays at
    the Clarksburg VA Medical Center, an individual with knowledge
    of the hiring of Ms. Mays was not questioned due to their
    having left VA employment.
        Our effective oversight also depends on VA employees
    promptly reporting suspected wrongdoing to the OIG and
    cooperating with OIG staff. Early and effective reporting can
    save lives, recover or save millions of dollars per year, and
    help ensure veterans are receiving the benefits and services
    they deserve.
        S. 2431 would require VA employees to receive training on
    their responsibilities to report wrongdoing to, and cooperate
    with, the OIG. While the VA Secretary recently directed staff
    to take this training, codifying the training into law would
    ensure this needed training is maintained regardless of who is
    leading the Department. The legislation would also give the
    Inspector General access to VA's e-mail system, which could be
    used for fraud alerts and other direct communications with VA
    staff.
        Unfortunately, we have found that employees have not
    reported suspected wrongdoing either due to lack of knowledge
    of OIG's authorities or fear of retaliation or the mistaken
    belief that they need supervisor approval. These failures can
    have direct consequences for veterans. Dr. Robert Levy, a
    former pathologist at the VA medical center in Fayetteville,
    Arkansas, misdiagnosed about 3,000 veterans, with errors
    resulting in death or serious harm to many of them, and is
    currently imprisoned. Staff concerns about his impairment were
    not heard by management and festered for years before the OIG
    was alerted.
        The OIG appreciates the strong steps Congress takes to
    support the OIG's mission by providing appropriate authority to
    conduct our oversight.
        Chairman Tester, Ranking Member Moran, this concludes my
    statement. I would be happy to answer any questions you may
    have.

        [The prepared statement of Mr. Wilber appears on page 76 of
    the Appendix.]

        Senator Moran. See why I tried to go earlier in asking my
    questions. The Chairman has returned.
        Chairman Tester [presiding]. You know what, Senator Moran?
    I will go totally out of order. I will ignore my Democratic
    colleagues and let you go first. Please, go ahead.
        Senator Moran. Please, Mr. Chairman.
        Chairman Tester. No. I insist.
        Senator Tuberville. [Inaudible.]
        Chairman Tester. No. Then it will be Senator Hirono and
    then you.
        Senator Moran. Well, Mr. Wilber, let me start with you
    then. In your testimony, in talking about the IG Training Act,
    you indicate that the training required in the bill will test
    staff knowledge of when to report misconduct to OIG and when to
    report to other entities like VA's Office of Accountability and
    Whistleblower Protection or the Office of Special Counsel.
        My staff have heard from VA employees that there has been
    confusion among the workforce on where to report wrongdoing,
    including misconduct and poor performance. Would you clearly
    explain to the Committee in what instance wrongdoing should be
    reported to the OIG and when it should be reported elsewhere?
        Mr. Wilber. Yes. Wrongdoing in the sense of fraud, waste,
    abuse or other potentially criminal acts should always be
    reported to the OIG. The OIG has the broadest authority to
    address those issues of any of the organizations you
    identified. I think where we want to explain to VA staff about
    reporting in terms of our training is that the OIG, as I said,
    is available to deal with these issues of fraud, waste, abuse,
    and other things.
        One of the things principally that we do not have--that we
    do not take on is whistleblower retaliation claims that staff
    may have, in part because we do not have the statutory
    authority to provide them any relief. So if they make the claim
    to us, we might be able to investigate it, but we would not be
    able to provide them any relief whereas OAWP and OSC have that
    authority.
        With respect to whether employees should report to OAWP,
    one of the things that OAWP has authority to do is, one, deal
    with whistleblower retaliation, but also deal with issues of
    poor performance as opposed to improper conduct or fraud,
    waste, and abuse. And so if an employee has concerns that their
    manager really is not performing their job in an acceptable
    way, that would be an appropriate disclosure to make to OAWP.
        Senator Moran. Thank you. I will check with my staff and
    see if they have other questions, and I may come back to you
    and see if there is anything else that needs to be filled in.
        Ms. Ogilvie, I want to thank the Department for their
    technical assistance while we were crafting the National Guard
    GI Bill Parity Act earlier this year.
        I do have a question regarding the VA's assertion that it
    would take 18 to 24 months to update your system and adjust the
    information sharing with DOD to incorporate those newly covered
    under this statute. Congress has expanded the eligibility to
    additional duties status in the past, and we have also
    appropriated money for VBA in the past to update your IT
    systems so that you can properly adjudicate these GI Bill
    claims under the new eligibility requirements.
        So in my mind, this would just be an additional expansion
    of what the VA has already undergone in the past when it comes
    to the GI Bill. Why then would it take nearly two years to make
    these updates before the National Guard and Reservists can
    receive these earned benefits? What VBA IT enhancements are not
    being prioritized within the Department?
        Ms. Ogilvie. Thank you for that question. So the actual
    concern comes down to some of the DOD records. So a lot of--we
    already have an information data exchange with DOD through the
    VADIR system, but some of the National Guard and Reserve
    records are kept more locally and they are not as centralized.
    So we would need to ensure that DOD could get those records
    incorporated into VADIR to be able to share that with VBA.
        One other thing we would need to do is make sure that the
    records are programmed into the Digital GI Bill and the Post 9/
    11 GI Bill long-term solution to be able to calculate the
    certificates of eligibility as quickly as possible. Right now,
    with the Digital GI Bill, we are able to provide a certificate
    of eligibility very quickly for veterans, and we would want to
    be able to provide that for veterans who served in the National
    Guard and Reserve as well.
        Senator Moran. So is the challenge relying upon the DOD to
    provide additional information? That is where the delay would
    come from?
        Ms. Ogilvie. Yes. That is what we believe. We would need to
    work closely with DOD to make sure that we had quick access to
    the Reserve and Guard records which, as I mentioned, are
    sometimes kept in a local--more locally. Especially if we are
    looking at any sort of retroactivity with this bill, which I
    think was being considered, that is something that we would
    want to make sure that we get the full scope of the records
    that we would need to ensure that we can get that certificate
    of eligibility.
        Senator Moran. I serve on the appropriations committee that
    funds the Department of Defense, but I know someone who is the
    Chairman of that subcommittee, and maybe we should have
    conversations quickly with those who might be able to speed up
    this process at the Department.
        Chairman Tester. We can do that.
        Senator Hirono.

                          SENATOR MAZIE HIRONO

        Senator Hirono. Thank you, Mr. Chairman.
        I would like to first say a few words in support of S.
    2761, the Every Veteran Counts Act, which would fundamentally
    change the way VA handles veterans' demographic data and
    provide new opportunities for this Committee to better serve
    veterans. We regularly discuss the way particular
    subpopulations of veterans are in need of more services--I
    mean, the biggest group would be the growing number of women
    who are veterans, for example--so that we can better tailor the
    care and specialized attention from Congress for these
    subgroups of veterans.
        And over the last decade, as our veterans' population has
    continued to diversify rapidly, it has become increasingly
    important that we are considering the different kinds of
    impacts our policy decisions can have on different groups of
    veterans. In some cases, in particular when trying to reduce
    veteran suicide and address mental and behavioral health
    concerns, being able to understand which community is impacted
    is critically important and potentially life-saving
    information. Hawaii is one of the most diverse States in the
    country, and like many of my colleagues' States, our veteran
    population reflects that diversity.
        It is time that this Committee, our House counterparts, and
    the outside organizations that advocate for veterans have the
    tools we need to ensure the health and success of all veterans.
    I would like to ask for my colleagues' support in continuing to
    advance the goal of more accessible, comprehensive veterans'
    demographic data.
        And while I appreciate VA's willingness to discuss this
    bill, the process has been subject to repeated delays and drawn
    out unnecessarily in my opinion. Moving forward, I expect VA to
    prioritize this and other items that advance equity and support
    for underserved and minority communities of veterans because
    attention to these issues is long overdue.
        I do want to thank the DAV and VFW for their advocacy and
    support on this issue and for this bill, and I certainly look
    forward to continuing to work with them.
        I have a question for you, Ms. Ogilvie. So I note in the
    testimony that you provided on this bill, 2761--and I am
    looking at the bottom part of your page of testimony, and you
    testified that VA is engaged in ongoing discussions on this
    bill with the House Veterans' Affairs Committee and also with
    my staff. And you say that this dialogue is necessary to ensure
    that these efforts are integrated and consistent with existing
    laws and executive orders. And then there is an entire number
    of laws that you cite as having to, I do not know, converge so
    that we can get the kind of information that is requested for
    in this bill.
        So I realize that is all in the implementation side of
    things, seems to me. So can you explain why the concerns you
    mentioned in your written testimony, some of which I just
    referred to, about the Every Veteran Counts Act, cannot be
    addressed in implementation of this law rather than ahead of
    the passage by the Senate?
        Ms. Ogilvie. Thank you for that question. I actually am
    going to have to take this for the record and defer to our
    Office of Enterprise Integration, who is responsible for the
    views on this bill. I know that we can get back to you with an
    answer on that.

        [For VA response to Senator Hirono, see Questions 1 and 2
    on page 109 of the Appendix.]

        Senator Hirono. Mr. Chairman, what started off as whatI
    thought was a pretty simple bill that requests important
    demographic and other kinds of data, especially when it was
    brought to my attention that Asian American-Pacific Islander
    veterans have a higher suicide rate than other veterans--and it
    occurred to me that we ought to have this kind of information
    so that the programmatic support and resources we provide can
    really be effective. And you said that preventing veteran
    suicide, just as one example, is a top clinical priority for
    the VA. So I should think that we would want this kind of data
    so that we can really provide--and I am, at this point,
    repeating myself--the kind of effective support for our growing
    veteran population as we can.
        So what I do not get is why it is taking so long. So you
    should see all of the--it is like the foundation for evidence
    based what? Policy? We have like four or five different laws
    that have to be, I do not know, come together or something.
    There are privacy issues and things like that which I would ask
    that the VA address once we pass this into law.
        Thank you, Mr. Chairman.
        Chairman Tester. Thank you, Senator Hirono. I think your
    request is reasonable, and we ought to figure out if there is
    some holdup on our end. If there is, we will try to rectify it.
        Senator Tuberville.

                        SENATOR TOMMY TUBERVILLE

        Senator Tuberville. Thank you, Mr. Chair. Thank you for
    being here today.
        I do not really have a question. I just want to say a few
    words about my bill, Supporting Families of the Fallen Act,
    which would increase the maximum coverage allowed under
    servicemember and veteran group life insurance plans. The
    current cap of $400,000 has not been modified since 2005, and
    after 15 years I think it is time that the cap be adjusted to
    align with the rate of inflation and provide families the
    financial security and peace of mind that they have chosen the
    best rate of coverage for them in the event if a servicemember
    dies.
        I thank my committee colleagues, Senator Rounds and Senator
    Cramer, for co-sponsoring this legislation, and I do appreciate
    all the help and support.
        Thank you, Mr. Chair.
        Chairman Tester. Thank you, Senator Tuberville.
        Senator Manchin.

                          SENATOR JOE MANCHIN

        Senator Manchin. Thank you, Mr. Chairman, and thank all of
    you for being here today.
        And I want to say, in the past two years, I have spent a
    good amount of time in front of this Committee discussing the
    horrific murders of the veterans that took place at the
    Clarksburg VA. I think you all know about that. I am proud of
    the work colleagues and all of you, Mr. Chairman, and all of
    you have done in helping us fix the specific problems in the
    Clarksburg VA that led to those murders and help prevent them
    anywhere else in the country.
        I have worked to pass legislation to install security
    cameras, fix shortcomings in staff training and accountability
    standards, and give the VA Office of Inspector General the
    authority it needs to conduct the investigations. These are all
    important steps, but I think there is so much more that we need
    to do.
        And I have got two pieces of legislation which I think
    would help you all be able to do the job that you need to do,
    and I think we spoke to that again. So I want to thank the
    Chairman and Ranking Member and the Committee for helping
    improve the quality of service that our veterans receive.
        The one, Mr. Wilber, that you know we are talking about, it
    is a sobering look at the issues that the VA and your office
    investigates on a daily basis. The issues you spoke of with
    hiring practices and quality of care in North Carolina and
    Mississippi sound eerily similar to those we experienced in
    West Virginia. Unfortunately, that confirms my fear that the
    failures that led to the veterans being murdered in West
    Virginia are indicative of systematic VA failures everywhere.
        So I would ask, Chairman Tester, I will be working on
    scheduling a VA patient safety oversight hearing in the very
    near future. I would ask if you would help us set that up, if
    we could, because there are some things I think that can be
    brought to light that would help us very much as far as getting
    to the crux of what our problems would be.
        We have a piece of legislation that allows you all to
    subpoena, which I believe that you all have asked for or felt
    it would be very helpful in getting to the crux. I will tell
    you what happened in Clarksburg. When it came time to really
    get into it, we could not get the person who had basically
    taken either retirement or ran for the hills. Literally, in
    West Virginia, you can run for the hills, and we cannot find
    you. But anyway, he was gone. Had no way of bringing him back.
    So if you would comment on that, Mr. Wilber, and how that might
    be of help to you.
        Mr. Wilber. Yes, sir. I would like to express my
    condolences once again for the families in Clarksburg, to the
    veterans and their loved ones.
        Yes, as you described, that is what occurred when we were
    conducting our healthcare inspection following our criminal
    investigation in Clarksburg. A key individual who was
    responsible for both the review of the credentials----
        Senator Manchin. It was a risk manager, I believe. Does
    every hospital have a risk manager?
        Mr. Wilber. I would not want to answer that question, sir.
    I think it is an important role for each hospital, but I would
    not want to say that each hospital in fact does have one.
        Senator Manchin. Okay. That was a risk manager we were
    trying to get to testify, and I believe the person was gone.
        Mr. Wilber. That person left during the course of the
    investigation. And so, yes, testimonial subpoena authority
    would be important to our ability to reach out to someone like
    that, serve them with a subpoena, and require them to talk to
    us.
        And again, this is to advance our oversight of VA. So, this
    is not about a criminal investigation of that person. This is
    not about putting that person in jail. This is about getting
    critical information from that person so that we understand
    what happened, we understand the root causes of the problem
    that occurred in Clarksburg, and that can allow us to make
    recommendations to the Department on how to fix it.
        Senator Manchin. Senator Tester, you and Senator Boozman
    are both on that bill, and I want to thank you for that.
        And also, I have one more, Ms. Ogilvie, if you will. I
    introduced Senate Bill 2687, Strengthening Oversight for
    Veterans Act of 2021, again with Chairman Tester and Boozman,
    to give the authority to subpoena. And on that there, so my
    question would be: What more can we do to hold these employees
    responsible for failures that happen at the VA so the veterans
    can build the trust back to the VA that we need? Is there more
    than can be done?
        We are trying to get the information. But, is there
    something more that we can do to give you all the ability and
    the power that you need and to prevent this from ever
    happening?
        Let me ask you--I will follow up with another question on
    that. So I can give you two for one. We are continuing to pay
    our retirement benefits to employees like those in Clarksburg.
    I cannot believe that. They are getting full benefits, and
    these are people we know committed horrific, horrific crimes.
    But they could not be proven, I guess, but we know that. But is
    there anything we can do that would prevent that from
    happening?
        Ms. Ogilvie. So I would honestly defer to OIG for his
    comments, but I do agree that the subpoena power and the
    ability to hold people accountable and be able to get the
    witnesses that we need to follow through on, you know, the
    investigation that we are doing is something that is of
    critical importance. So you know, that is all I would say from
    my perspective, but I am not sure if Mr. Wilber wants to----
        Senator Manchin. I know my time is running out, Mr. Wilber,
    but if you have comments to that, I appreciate it.
        Mr. Wilber. Well, with respect to the benefits for
    individuals who have left VA, if those individuals have been
    convicted of a crime, then the ability for the VA to reduce
    their benefits, I do understand, exists. But for those
    individuals, if you mean somebody like the risk manager who
    left VA employ, that person has gone without any disciplinary
    action against them, and now that they are out of Federal
    service----
        Senator Manchin. Let me ask you this, hypothetically. If we
    had been able to subpoena that person and bring him back and
    found out derelict of duty they did not--they were not
    overseeing. They were not monitoring or watching, and they
    could have maybe prevented that. If we could have proven that
    and shown that in the subpoena power that you would have now,
    would that be able to reverse their retirement and pensions?
        Mr. Wilber. No, sir, I do not believe it would.
        Senator Manchin. Oh, boy.
        Chairman Tester. Senator Rounds.

                          SENATOR MIKE ROUNDS

        Senator Rounds. Thank you, Mr. Chairman.
        Ms. Ogilvie, the GI Bill is an important benefit for our
    veterans, but too often they are targeted for abuse of this
    program. As you know, I am one of the lead sponsors of S. 1607,
    along with Senator Schatz. This is the Student Veterans
    Transparency and Protection Act of 2021. The goal of the
    legislation is to improve veterans' access to information about
    higher education and allow the Department of Veterans Affairs
    to restore benefits that veterans use at schools that become
    subject to civil enforcement.
        I understand based on written testimony submitted to the
    Committee that there are some changes that you would like to
    see in the bill, and I look forward to working with you on that
    so that we can maximize the benefits to our veterans.
        What steps is the Department currently taking to protect
    veterans from institutions that are really working in a
    predatory manner, seeking to take advantage of these veterans,
    and is there anything you need from Congress to reinforce your
    efforts today?
        Ms. Ogilvie. Thank you for that question. VA takes
    seriously predatory practices that are occurring not only in
    the education space but in other spaces as well. So in the
    education space, VA conducts regular and targeted compliance
    actions with--each year at locations that use the GI Bill. And
    we are also in regular contact with the Department of
    Education, and we do a lot of information sharing which helps
    inform veterans.
        Also, maintaining the GI Bill Comparison Tool is a great--
    and as this bill does, it codifies that. It is a great tool for
    veterans to use to be able to ensure that schools, when they
    say what their placement rate is, what they say, you know,
    their employment rates are, that they can hold them accountable
    and make sure that those are actually the statistics that are
    lining up with what the schools are saying.
        Senator Rounds. Is this through civil enforcement?
        Ms. Ogilvie. Yes, I believe so.
        Senator Rounds. So there could be penalties, or there could
    be a punitive action with regard to taking them out of the
    program or restricting the ability of others to participate at
    those institutions. Would that be a fair way of measuring the
    types of penalties that you would impose?
        Ms. Ogilvie. Yes. So under the Isakson and Roe Act, there
    are some penalties for removing schools from the GI Bill
    program if they are using predatory practices or not being
    honest with their information and advertising.
        Senator Rounds. Thank you.
        Mr. Wilber, I was rather surprised that you did not have
    the ability to protect a whistleblower, and I would like to
    talk about that a little bit. Seems to me that if someone were
    going to come to the OIG with a serious complaint their job is
    probably at risk, and yet, it seems to be the logical location
    to come. In your opinion, would it be appropriate for the OIG's
    office to be able to offer protection and assistance to a
    whistleblower coming forth with information from the Department
    of Veterans Affairs?
        Mr. Wilber. Currently, there are several organizations
    already existing that do provide that protection. Our Office is
    focused on taking that information from the whistleblower and
    using that to conduct an investigation into that underlying
    issue the whistleblower has identified.
        We then--when a whistleblower comes to us, and they raise a
    concern that they have been retaliated against, we then advise
    the whistleblower that their best remedy for that is to go to
    the Office of Special Counsel or to OAWP because those
    organizations have statutory authority to protect the
    whistleblower. You know, OSC can go to the MSPB to provide a
    stay of any action against that person, for example, if they
    are going to be terminated or let go. OAWP has similar
    authorities to protect that person's job.
        The OIG is outside of the Department in a sense. It does
    not have the ability to affect management's decisions directly.
    We can make recommendations. And so, for that reason, we are
    not the protector of the whistleblower, but we are the
    organization that will investigate that individual's
    disclosures and try to root out any misconduct at the
    Department that that person has identified.
        Senator Rounds. Would you say that the fact that you are
    not in a position to offer that type of protection would be a
    detriment to someone coming forward to provide information to
    you in an investigation?
        Mr. Wilber. I do not know that I would say it is a
    detriment because those other organizations do have that
    authority and do provide strong protections. For example, OSC,
    the Office of Special Counsel, is very active in protecting
    whistleblowers, and we have worked with them on those cases in
    terms of coordination. Again, the Office of Accountability and
    Whistleblower Protection also has authorities to protect
    whistleblowers.
        We do not, and I do not think--to my knowledge, I could not
    say that whistleblowers have been injured by not having the OIG
    as their protector because they do have these other
    organizations that can protect them. Our focus is really on
    what is the underlying issue this person has identified and
    what can we do to try to identify whether there is a problem
    there.
        Senator Rounds. Thank you.
        Thank you, Mr. Chairman.
        Chairman Tester. Senator Brown.

                         SENATOR SHERROD BROWN

        Senator Brown. Thank you, Mr. Chairman.
        One of the reasons that Senator Tester does this job well
    as Chair but as a Senator from Montana is that he listens to
    people at home and hears about problems that vets face,
    especially the gaps in programs at DOD and VA, and I want to
    explore that. My question is for you, Ms. Ogilvie, but I want
    to make some fairly lengthy comments first.
        A few years ago, Tom Wike, an Ohio veteran, came to my
    office with an idea to improve the transition process for
    veterans so they would know what to expect, especially in terms
    of mental health, as they left their time in service and
    returned to their local communities.
        And, Mr. Chair, you see a request to enter into the record
    his letter?
        Chairman Tester. Without objection.

        [The letter from Mr. Wike appears on page 122 of the
    Appendix.]

        Senator Brown. Thank you. And I would like to just take a--
    do a small little read from Tom's statement. He said: ``I had a
    difficult transition from military to civilian life. I used
    those experiences in conversations with other veterans to begin
    work on this legislation in 2018 while pursuing a bachelor's
    degree in social work. It takes three months to train for a
    civilian to become a Marine, but the servicemember is expected
    to return a normal civilian life after a minimum of five days
    of training.'' Think about that.
        I want to work with VA to address some of those concerns
    with the bill text, but there really is no excuse. And a number
    of us in this Committee--I know Senator Rounds cares about it.
    I know that Senator Hassan cares about it. A number of us have
    continued to point out the problem of transition from DOD, from
    active service, from military duty to VA and especially the
    lack of preparation and screening for our servicemembers and
    veterans.
        November 9th, DOD OIG released a report. An evaluation of
    the Department of Defense's implementation of suicide
    prevention found, quote, ``that DOD did not screen for suicide
    risk or provide uninterrupted mental health care to
    transitioning servicemembers.'' I am incredulous that is still
    the case, that after all this time, when we know that suicide
    is a problem for way too many groups in this country, but
    suicide--veteran suicide especially, and it is something we
    know we could do something about.
        DOD findings highlighted the Separation History and
    Physical Exam does not include a mental health assessment or
    suicide risk screening component. It is the only exam required.
    The SHPE, the Separation History and Physical Exam, is the only
    exam required for transitioning servicemembers. So we must make
    sure that it covers all aspects.
        The report illustrates why we need the bill that Tom and I
    have worked on to prevent veteran suicide, improve mental
    health access. Two of his friends that we are naming the bill
    after, two of his friends who committed suicide, Daniel J.
    Harvey and Adam Lambert, two Marines were living through the
    worst pandemic in a generation. So the problem is almost
    certainly worse today than two years ago. On top of an
    affordable housing crisis, the pandemic, both undoubtedly
    impact the mental health, frankly, of all of us, civilian and
    military alike.
        Ms. Ogilvie, my question to you: I have spoken to Ohio
    veterans who do not know what mental health resources VA could
    offer them or what benefits might help them as they navigate
    mental health concerns.
        So my questions are two. Is it important to you for
    servicemembers to learn how the transition process could impact
    their mental health? That is question number one.
        Number two, do you see value in veterans just receiving a
    call from a mental health professional at their local VA
    facility within the first 90 days of separation?
        Ms. Ogilvie. So I am going to quickly take this one, and
    then I will defer it to Ms. DeBord who has a lot more to say
    about that, about that answer. But what I would like to first
    say is, yes, it is important. And currently, the TAP curriculum
    does cover some social and emotional health resources, some
    integration resources, how to integrate into the community and
    how to use vet centers to get mental health resources.
        Right now we are also doing the Solid Start program, where
    our national call center will contact veterans three times in
    that first critical year, first within the first 90 days. And
    out of the veterans, the 157,000 recently separated veterans
    that we contacted last fiscal year, 26,000 were deemed priority
    veterans who had a mental health appointment within the last
    year of active duty. So we do track those veterans to make sure
    that we are especially reaching out to them.
        So that is just quickly what we are doing on the benefits
    side, and I will defer to Ms. DeBord to talk about the health
    side.
        Ms. DeBord. Thank you, Ms. Ogilvie.
        So thank you, Senator, for your support of this bill. I
    think it gives us an opportunity to really do things
    differently. And so VA would like to propose that we use a well
    established program, the VA Liaisons for Healthcare. They have
    been in effect since 2003. There are 48 of them across the
    country, 43 of them stationed at military treatment facilities;
    five of them are virtual. So all military treatment facilities
    should be able to utilize VA Liaisons.
        But what they do is they are--there is a handoff from case
    managers in DOD to the VA Liaisons for those seriously ill,
    seriously injured, those going through the IDES process as
    well.
        But then there is that whole section of veterans that are
    transitioning who maybe they have just--they have had
    unreported MST, military sexual trauma, they have undiagnosed
    PTSD. They maybe have housing insecurity, food insecurity, all
    kinds of things that they are going to be dealing with as they
    transition out. So they are not really on a radar as far as
    like they might really need the extra help.
        And so this would be an opportunity. We are proposing for
    this pilot. We would have 10 transition assistance centers that
    would have VA Liaisons attached to them during this 5-year
    pilot.
        And we would then--here is--I think the really heartening
    news to this is that rather than 180 days after they transition
    that they would have an appointment the VA Liaisons make
    contact with them before they are transitioning, before they
    discharge. They get them registered in the VA. They get them
    appointments based upon what their needs are. It is a very
    individualized, you know, serviceperson-specific plan.
        And then they hand them off to the military-to-VA case
    manager that is at all VA medical centers, so there is a warm
    handoff. So they are going to be seen by a VA Liaison (RN or
    SW), you know, individually before they are ever transitioned
    out, and then they are--they will have a warm handoff to VA
    case managers and appointments scheduled at the receiving VAMC
    immediately following their military separation date.
        So we really feel like this enhancement might get to some
    of those veterans that just are not on anybody's radar as
    maybe, you know, having higher risk of suicide.
        Senator Brown. Thank you. I guess I do not know why you
    cannot do all this without the Lambert-Harvey bill. One time in
    Banking Housing Committee, which Jon and I sit on, the Chair of
    the Richmond Federal Reserve once said, watch me and make sure
    you know you are watching me. And I know you are good public
    servants. I know you do your best. But this has got to be
    better.
        Ms. DeBord. Yes, sir. And we do not disagree, and we want
    to make it better. And I think suicide prevention is on all of
    our radars. We all want to make this better, and it is going to
    take all of us working together.
        Senator Brown. Thank you.
        Chairman Tester. Senator Boozman.

                          SENATOR JOHN BOOZMAN

        Senator Boozman. Thank you, Mr. Chairman, and thank you all
    for being here very much.
        VA employees do an incredible job and work so, so very hard
    for our veterans and deserve the recognition that they get and
    even more so. Sadly, we have instances periodically that crop
    up that seem to overshadow that. It is important that VA
    personnel are aware of the channels that are available to them
    to report unwanted actions within the VA and ensure the
    violators are held accountable, even if they no longer are
    employed at the VA. And we have been talking about this.
        The VA OIG General Training Act, which I was able to work
    with Senator Hassan, that we introduced, mandates that VA
    employees complete training to ensure they know how to
    recognize and properly report wrongdoing.
        Mr. Wilber, we appreciate your testimony in support of that
    concept and support of the legislation. As you mentioned,
    Secretary McDonough signed a directive mandating this training
    shortly after the introduction of this legislation. Can you
    again highlight the importance that this training be codified
    and not subject to the discretion of whatever sitting VA
    Secretary that we have at the time? And this is really a
    common-sense--you know.
        Mr. Wilber. Yes, sir. Thank you. Yes. I mean, I think in
    terms of having the codification of this requirement, that
    ensures that it will be training that VA employees receive
    going forward----
        Senator Boozman. Right.
        Mr. Wilber [continuing]. And that it is not just something
    that is subject to the discretion or whims of whomever may be
    the VA Secretary at the time, but that it institutionalizes
    this notion and really gets VA employees consistently
    throughout, you know, new employees who join as well as those
    who have been there for some time, to understand the unique
    authorities and reasons why they may need to report to the
    Office of Inspector General.
        Senator Boozman. Right.
        Mr. Wilber. And so we do appreciate your introducing this
    legislation. We do think it is important, particularly that it
    extend the training requirement.
        In addition to the educational aspects of this, there is
    also the access that the Inspector General has then to the e-
    mail system, which allows the Inspector General direct
    communications to all 400,000-some employees of the
    Department----
        Senator Boozman. Right.
        Mr. Wilber [continuing]. Which we currently do not have.
    And so that will give us an opportunity to, you know, alert
    employees to fraud issues or just to educate them, you know, to
    provide some additional information about our office.
        Senator Boozman. No, it is so important. And again, I am
    glad you brought up that aspect of it. But the idea that, you
    know, you could be working there and simply not know, you know,
    what you do in these types of situations that would, you know,
    help avoid some of these situations that we have had in the
    past.
        Your testimony highlights several successes of VA employees
    recognizing and reporting illicit instances like the example of
    the VA Police Department uncovering a potential sale of VA
    equipment on eBay, valued at over $100,000. So as you put the
    directive in place, is there any correlation between staff at
    VA facilities that have completed the training and instances of
    reported misconduct at VA facilities?
        Mr. Wilber. We have not been able to do a direct
    correlation at this point. In part, the directive has been in
    place for about eight weeks, but it gives employees up to a
    year to complete the training. And we do not have updated data
    yet on just how many employees have done that. We will be
    working with VA to get that.
        What I can say is just anecdotally, Inspector General
    Missal happened to be speaking with a senior VA official
    several months ago, and during that conversation, Mr. Missal
    explained to that senior official what it is the OIG does, what
    our authorities are, and that sort of thing. And that official
    had not understood what those were and said to Mr. Missal at
    that time, ``Oh, you may be able to help us. We have this
    suspicious potential sale of PPE.''
        This was during the pandemic. And you know, we looked into
    it. Our criminal investigators got involved, and it turned into
    an $800 million dollar criminal conviction against an
    individual who was trying to sell fake PPE to the Department.
    And, had that conversation not taken place, we may not have
    gotten that referral which, you know, fortunately we did, but
    it just highlights the need for even senior people at the
    Department to understand what the OIG does.
        Senator Boozman. Right. Very quickly because my time is
    running out, but the--I have enjoyed working with Senator
    Tester on the Strengthening Oversight for Veterans Act, which
    gives the VA authority to subpoena individuals that previously
    worked for the Department or other potentially relevant--during
    OIG reviews and investigations.
        I had the opportunity to serve on the House VA Committee,
    and I have been dealing with this a long time. I mean, the idea
    that you can retire or whatever and then be not subject to the
    IG's reach makes absolutely no sense to me at all. You know.
    And I know it has got to--you could probably spend hours
    talking about how that has impeded investigations in the past.
        So I do not really have a question. I just think that this
    would be a tremendous tool in your toolbox as we go forward
    and, you know, hold people accountable that in some cases have
    done just really some terrible acts.
        So thank you, Mr. Chairman.
        Chairman Tester. Senator Hassan.

                      SENATOR MARGARET WOOD HASSAN

        Senator Hassan. Well, thank you, Mr. Chairman.
        And I want to thank Senator Boozman because we are both
    sponsoring the OIG Training Act together, and I wanted to just
    follow up on his line of questioning with regard to that. I
    just want to make sure there is not anything else you would
    like to add about both the importance of making sure that this
    is mandatory training regardless of who is in charge at the VA
    and the importance of being able to contact employees directly
    from the IG's office as opposed to having to go through the
    Secretary's office. So is there anything else you would like to
    add? I think Senator Boozman covered a lot of it.
        Mr. Wilber. Just to add again, the importance of making
    this mandatory is to ensure that every VA employee really does
    understand what the OIG does, why we are here and, most
    importantly probably, our independence which is different than,
    for example, OAWP or other organizations to which they may have
    the opportunity to report. The OIG is different. We are
    independent, and we conduct criminal investigations, which is
    something that the other organizations within the Department do
    not do.
        So if--you know, if employees have concerns that there may
    be a crime being committed or something, they need to know that
    they can come to us and that we have the authority and the
    resources to look into that. So I would say that.
        And again, it really is important for the Inspector General
    to be able to communicate directly with the employees, which
    has been something that our office has not been able to do so
    far, just to highlight again the importance of blowing the
    whistle when you see things that you do not think are right.
    And, making sure employees understand they do not have to be
    right about whether it is a problem; they just need to report
    it. We will look into it. We will figure out if it is right or
    wrong or otherwise.
        And so I think those are really the important things that
    this bill will accomplish.
        Senator Hassan. Thank you very much and thank you for your
    work.
        I wanted to turn now to you, Ms. Ogilvie. New Hampshire
    National Guardsmen and Reserve swear to defend the Constitution
    and their country just as their active duty counterparts do,
    and they deserve the same respect and recognition. So that is
    why I introduced bipartisan legislation with Senator Shaheen
    and Senator Cramer, sitting right across from me, and Senator
    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 am glad to hear that the VA supports this legislation.
    Will you all commit to continue your work with my office so
    that we can get this done?
        Ms. Ogilvie. Yes, ma'am. I will speak for the National
    Cemetery Administration and say that we are committed to
    working with you.
        Senator Hassan. Yes. And I will just note that our National
    Guardsmen and women in particular, and Reserves, have been so
    heavily deployed during the War in Afghanistan, the Global War
    on Terrorism generally. The thought that they are not eligible
    to be in our veterans cemeteries is really just outrageous. So
    I appreciate that very much.
        And lastly, Mr. Chair, I will just finish with I really
    appreciated the conversation you all were having with Senator
    Brown about the issue of transition and the impact of
    transition on our veterans' mental health. I am pleased that we
    were able to pass the Solid Start Act, which would make it
    permanent in statute through this Committee.
        I will just note that one of the veterans I talk with a lot
    in New Hampshire has pointed out to me. He said, you know, why
    do we act as if PTSD is something we have to diagnose and maybe
    treat as unusual when in fact given the experience of our
    servicemen and women we should expect PTSD? And we should be
    expecting to need to help people deal with it and treat it
    appropriately.
        And I think that goes for the whole issue of mental health
    generally. So I look forward to working with all of you so we
    can really make sure that the stigma around it is lifted and
    lessened over time and really get the treatment that our
    veterans need so completely, as our active service men and
    women do, too.
        So thanks for you work on that, and thank you, Mr. Chair.
        Chairman Tester. Senator Cramer.

                          SENATOR KEVIN CRAMER

        Senator Cramer. Thank you, Mr. Chairman. Thanks to all of
    our witnesses for being here. And thank you, Senator Hassan for
    supporting that legislation, and I want to drill down on it a
    little bit if you do not mind.
        I, too, am grateful for the support that you all are
    providing in your testimony and today. I am a little perplexed
    why it takes legislation to do the right thing. It does not
    seem to be that complicated a rule. That said, that is why we
    are here. So I appreciate your work on it and your helping us
    get it done but also get it done right.
        I am also glad that General Quinn is coming to North Dakota
    next week to talk about it and hear directly from folks. I am
    disappointed that my schedule was not consulted before. I mean,
    I would love to be there with him, but nonetheless, he is going
    to be talking to the right people. That is good.
        So, Ms. Ogilvie, you mentioned in your testimony that the
    VA published this notice of request for information in the
    Federal Register this past summer, and you go on to say that
    the majority of the responses were supportive of expanding the
    eligibility for burial benefits. I am wondering if you could
    just add a little more color to that response. You know, when
    you say the majority, was it a large majority? What kind of
    comments did you get?
        Ms. Ogilvie. Thank you for your question. I have to take
    this for the record to have the National Cemetery
    Administration get an answer back to you.
        Senator Cramer. Okay. All right. You also mentioned--and
    maybe you are going to give the same answer, but you mentioned
    in your testimony the legislation would create an inconsistency
    between the VA national and the VA grant-funded. Largely,
    former Governors love the grant-funded cemeteries in our
    States. We all do. And you state this inconsistency that would
    also create inconsistencies across States as current State laws
    are different. Right?
        But doesn't that inconsistency exist either way? I mean,
    how is that relevant to the law? Do you know? Or, to the bill.
        Ms. Ogilvie. I am sorry. I am going to have to take this
    for the record as well and have someone from the National
    Cemetery Administration get back to you on that.
        Senator Cramer. Okay. Maybe I will just offer them, you
    know, for the record, and we can get back. And that is fair.
    Then I do not have any other questions.
        I also just want to give a shout-out to S. 2794 that
    Senator Tuberville introduced, the Supporting Families of the
    Fallen Act, and that is supported by Senator Rounds. I know
    that you guys have talked about it. Just kudos to him on doing
    it. It is the right thing, and I am sure we will have success.
    But thank you.
        Thank you, Mr. Chairman. That is all I have.

        [For VA response to Senator Cramer, see Questions 1 and 2
    on page 117 of the Appendix.]

        Chairman Tester. Senator Blumenthal has graciously yielded
    his position, not his time but his position, to Senator Murray
    who is online. Senator Murray, the floor is yours.

                          SENATOR PATTY MURRAY

        Senator Murray. Well, thank you very much, Senator
    Blumenthal, and thank you to all of our panelists today. There
    has been a lot of discussion surrounding how to improve the
    Transition Assistance Program, TAP, along with how to help our
    veterans and their families make the transition as seamlessly
    as possible. This program is incredibly important, with over
    200,000 servicemembers leaving the U.S. Military and
    transitioning back to civilian life every year.
        Senator Brown's bill outlines a pilot program that would
    help counsel servicemembers about mental health and make
    veterans aware of the services that are available to them at VA
    facilities.
        Ms. Ogilvie, I wanted to ask you, what else is VA doing to
    engage with veterans and improve suicide prevention protocols,
    and what other outreach does VA do to make veterans aware of
    the mental health resources that are available to them?
        Ms. Ogilvie. So VA's curriculum for TAP is an eight-hour
    curriculum, and it is one day. The curriculum does cover social
    and emotional health resources, does cover vet centers, how to
    seek help, how to integrate into your community again.
        In addition to that, as I mentioned before, we are doing
    Solid Start. We are contacting veterans three times in the
    first critical year after separation, making sure that we
    connect with them and talk to them about any needs that they
    may have.
        I will also defer to Ms. DeBord to talk a little bit more
    about what is going on from the health and social work
    perspective.
        Ms. DeBord. Thank you, Ms. Ogilvie.
        So, Senator Murray, what I would say is there is obviously
    always a lot of work going on, but over this last year, under
    the Health Executive Committee, they have created a Care
    Coordination Work Group. So--and there is a lot of work being
    done in this space. How can we synergize our work together,
    making sure that we are addressing the needs of these
    transitioning veterans?
        Also, JIF was established, which paid for, which funded the
    virtual liaisons, the five virtual liaisons that cover all of
    the country, that are not covered at the military treatment
    facilities.
        So there is a lot of fairly robust work going across the
    aisle between DOD and VA.
        Senator Murray. Okay. Thank you for that. You know, another
    question I wanted to ask you about is--I have been taking a lot
    of time to talk with student veterans across Washington State,
    and I have heard a lot about the need for improved
    communication from VA around the Veteran Readiness and
    Employment Program and a desire for more support for vet
    centers at our colleges and universities. The Veteran Education
    Empowerment Act by Senator Rosen addresses this concern by
    reauthorizing a grant program to help higher education
    institutions establish and maintain these student veteran
    centers.
        But, Ms. Bowman, if I could just ask you, what differences
    in retention are you seeing when a college or university does
    have a robust program versus a program that is not well funded?
        Dr. Bowman. This is kind of out of what we know and do as
    the Office of Academic Affiliations. I do not know exactly what
    is done at colleges per se in terms of understanding these
    things. We are familiar with the health professions programs,
    particularly those that we support, who rotate at the VA, and
    we do have 120,000 trainees in VHA a year under the training
    supervision of our various VA employees and health
    professionals.
        But I do not have a specific answer to what is done at the
    colleges, and I am not sure simply how to get an answer, but I
    can see what I can find out. And I hope that you----
        Senator Murray. Well, I think it is really important to
    know because a lot of our veterans are really struggling at our
    colleges and universities today, finding a place where they
    feel comfortable, where they feel that they can get the help
    and support that they need, that they have earned, and a lot of
    colleges and universities are not set up to do this. These vet
    centers at a college make a huge difference, but they are not
    uniform.
        And I really would appreciate if you looked at Senator
    Rosen's bill and get back to me with a response.
        Dr. Bowman. We will work on that, and the information will
    probably come from--related to the veteran centers. And I thank
    you.
        Ms. Ogilvie. We deferred that bill to the Department of
    Education for their views. So I would recommend maybe checking
    with the Department of Education on what their views are on
    that. They may be able to provide more information.
        Senator Murray. Okay. I will do that, but I hope you do as
    well.
        So thank you very much, Mr. Chairman. I appreciate the
    time.
        Chairman Tester. Senator Blumenthal.

                       SENATOR RICHARD BLUMENTHAL

        Senator Blumenthal. Thanks, Mr. Chairman.
        Thank you all for being here and thank you to all of you in
    the VA for your service to our veterans.
        I want to add my voice to the sentiments expressed by a
    number of my colleagues, including Senator Brown, on behalf of
    the Daniel J. Harvey Jr. and Adam Lambert Improving
    Servicemember Transition to Reduce Veteran Suicide Act. You
    know, as long as I have been on this Committee, which is 10
    years, we have worked on this problem, and we are nowhere near
    where we have to go. I am willing to try anything and
    everything that we can to provide the support that is needed by
    our veterans, whether it is using the TAP program or in any
    other arena or concern.
        And I see that you have some concerns about some of the
    technical aspects of this bill, but I urge you to support it
    and provide us as soon as possible specific suggestions so that
    we can move forward with it.
        I must say that I am disappointed with your apparent
    opposition to the Building Credit Access for Veterans Act of
    2021 in contrast to the VFW, and we are going to hear from them
    later. You do not seem to believe there is a problem with
    veterans having access to this type of credit.
        And I am quoting the VFW's written testimony supporting the
    legislation. The VFW describes it as, quote, ``one of the most
    significant measures that provides economic opportunity and
    upward mobility for veterans to establish a stable life for
    themselves after serving.'' That is access to the VA Home Loan.
        And you say in your testimony that you, quote, ``the VA
    does not have data to suggest that creditworthy veterans are
    unable to access the home loan benefit.''
        There is data. Maybe it is not the data that you would look
    to have in specific statistics and numbers, but the reason we
    are proposing it is that we talked to veterans, not only the
    sponsors, but I think many others.
        And your point, I think, is that ``VA regulations and
    policies already contemplate the use of alternative credit
    information and scoring models to be used by lenders when
    underwriting VA-guaranteed loans.'' It is not enough to
    contemplate it. It is to do it that we want.
        And again, we would not be proposing this program if there
    were not solid evidence that it is necessary to consider
    alternative scoring information and scoring models to make
    these loans available. They are one of the main ways that
    veterans can lift themselves up financially, getting this kind
    of loan. And Senator Scott and I--it is bipartisan--feel that
    it is necessary.
        I would be happy to hear your comments.
        Ms. Ogilvie. So VA agrees that alternative credit scoring
    is essential for veterans. What our position on this bill is,
    is that we do not need a pilot program to establish that.
        So VA guarantees the loan, but the lenders underwrite the
    loan. We already encourage lenders to use alternative credit
    scoring means, and this bill would propose a pilot that has the
    Secretary designate what kind of alternative credit scoring
    means are possible. And we already encourage lenders to use any
    credit scoring means that they have.
        Senator Blumenthal. I recognize you encourage it. That is
    like contemplating.
        Ms. Ogilvie. Right.
        Senator Blumenthal. Encouraging lenders may get results and
    just as likely will not get results because the lenders are
    looking for the most secure kind of loans. And I do not need to
    spell it out for you. If there is no credit history, for all
    kinds of reasons, it may seem insecure. So the whole purpose of
    the pilot program is to show that these encouraged alternative
    ways of scoring and assessing credit information actually work.
        Ms. Ogilvie. Right. So unfortunately, VA cannot mandate
    that lenders utilize alternative credit scoring models. If
    Congress's intent is to encourage lenders to utilize those
    alternative credit scoring models, we would propose that the
    best way to get at that is to mandate that the lenders utilize
    them in their automated underwriting processes.
        So lenders use manual--or automated underwriting to be able
    to score veterans and other lenders. I am sorry, other
    borrowers. And if we mandated or if through a pilot a lender
    signed up to work with us, to use alternative credit scoring,
    it would amount to a manual underwriting, and a lot of lenders
    do not like to do that.
        Senator Blumenthal. Here is what we are trying to do. You
    are encouraging the lenders to do something that they are going
    to say does not work. And if we seek to mandate it, they are
    going to tell us the same thing. What we are trying to do is
    show that these alternatives do work, and the best way to do it
    is through a pilot program.
        I hope you will support this legislation. I am out of time.
    But this program is vital to our veterans. And I do not impugn
    your good motives. I know you want to help veterans. I am just
    trying to enable the VA to have a way of proving the system, an
    alternative system that could well work for veterans.
        Thank you.
        Chairman Tester. Thank you. I want to start out my
    questioning with just a statement. Thank you all for being
    here. I appreciate it very much. And I have not got a lot of
    time.
        This is a question that I am just curious about, Mr.
    Wilber. I assume that the Inspector General's subpoena
    authority probably was a result from what occurred in West
    Virginia. Is that a fair statement?
        Mr. Wilber. We had actually been looking for this authority
    for some time even before that had occurred.
        Chairman Tester. Okay. And do you see this authority as
    being able to speed up the investigatory process?
        Mr. Wilber. Well, we primarily see it as a way of creating
    a complete record of what had happened in an underlying matter
    that we may be investigating. Really, we see this as largely
    supporting our health care inspections, some of our audits, and
    some of our special reviews. And so, yes, I think having this
    authority could certainly speed things up in the sense that we
    know we will be able to get access to people. We will be able
    to speak to them. And having that information, particularly if
    we can get it early on in one of our projects, will allow us to
    use that information, yes.
        Chairman Tester. Thank you.
        Ms. Ogilvie, the claims backlog is nothing new, and I do
    not think there is any one solution that can fix it, but there
    are many provisions of the Veterans Benefits Improvement Act
    that I think will cut the timeline for processing these claims.
    For example, this bill is going to require an outreach program
    to explain to veterans how VA contractors will schedule the
    civilian exams and what kind of information they will be asked.
    Can you talk a little bit about this outreach, and will it save
    time? Will it potentially prevent fraud?
        Ms. Ogilvie. Yes, we support this section of the bill. So
    VBA already utilized a government delivery system to e-mail
    veterans to let them know in advance of when the contractors
    are contacting them for exams so that they do not think that it
    is, you know, a spam call or anything like that. And so that
    proactive contact has been very helpful for them.
        We also--once the exams are scheduled, we also e-mail them
    every day to remind them of their exams. But we think that the
    examination scheduling will definitely be improved by involving
    their representatives, who they already know and trust, to make
    sure that scheduling is done.
        Chairman Tester. Do you also use electronic notification
    when it comes to mailing veterans their claim decisions?
        Ms. Ogilvie. At this time, no, unfortunately. So there is
    legislation, or there is a law already in place, that says that
    most decision notices have to be mailed by first class mail. So
    the electronic delivery section would really improve our
    ability to deliver, electronically, notices and decisions to
    veterans who choose to do so in a much more timely manner,
    enabling possibly even same-day delivery for veterans who are
    checking their status tracker online of their appeals and their
    claims. And they will see a decision is made, but if it is
    coming in the mail they may not get it for several weeks or
    even now, with the government printing delays, months.
        Chairman Tester. Yes. Okay. We will just continue on with
    the RURAL Exams Act, Ms. Ogilvie, which would require VA to
    offer performance-based incentives to encourage contractors to
    provide better quality exams for rural veterans as well as
    financial disincentives to discourage contractors from failing
    to provide an exam in a timely manner.
        Okay, Ms. Ogilvie. Can you explain some of the challenges
    VA faces in providing medical disability examinations to rural
    veterans and how the incentives in this bill will help
    veterans?
        Ms. Ogilvie. So VA faces similar challenges with providing
    examinations and providing treatment for veterans who are in
    rural areas. Our vendors already have--they have expanded their
    mobile clinic fleets. So we have some expansion of assistance
    with our vendors to reach rural veterans. A lot of these mobile
    fleets, they provide the specialty type of examinations, such
    as audio, vision, and dental, audio being one of the most
    popular exams that we provide. We also encourage vendors to use
    telehealth, to use the acceptable clinical evidence when
    possible.
        But you know, any challenges that exist with any rural
    veterans, as you would expect--you know, it takes veterans a
    long time, too, if they have to travel to a facility. And you
    know, we try to do what we can to accommodate them, but
    sometimes that--you know, that impacts it.
        So one of the things that we also do right now with a
    modified contract that we just put in place in September is
    that we do provide monetary incentives to contractors, both
    positive and negative, for their performance, for their
    quality, for their customer satisfaction, and for their
    performance requirement levels which are measured by the
    average days pending of the exam request.
        So these additional incentives for rural veterans, we would
    have to create a new metric for that, but that is something
    that--you know, that is something that we would look into.
        Chairman Tester. Okay. Thank you.
        Senator Blackburn, virtually.

                        SENATOR MARSHA BLACKBURN

        Senator Blackburn. Thank you, Mr. Chairman.
        Ms. Ogilvie, I would like to come to you. In 2016, the VBA
    centralized distribution of the disability compensation claims
    workload throughout the National Work Queue, which prioritizes
    and distributes claims to regional offices based on their
    capacity. I understand that you all did this in hopes of
    spreading the workload from one office that may be overworked
    to one that did not have as much work.
        And I know that you primarily use timeliness and accuracy
    measures to assess the regional offices' performance in
    processing disability compensation claims. And I want to focus
    on the accuracy measures because the GAO report that you got in
    October 2018 recommended that VBA develop and implement a new
    regional office performance measure that allows it to better
    measure the accuracy of each regional office's work. So has VBA
    implemented new performance metrics to assess the accuracy of
    each regional office's work and not just the office that
    completes the claim?
        Ms. Ogilvie. So each regional office is assessed on
    timeliness metrics and quality metrics, yes.
        Senator Blackburn. Okay. And talk to me about the watch
    metric so that you are looking at the individual's performance
    and accuracy at each regional office.
        Ms. Ogilvie. I am sorry. Can you clarify that question a
    little bit? Which watch metric are you referring to
    specifically?
        Senator Blackburn. The one that looks at the individual's
    performance accuracy.
        Ms. Ogilvie. So----
        Senator Blackburn. And this is part of your VBA performance
    metric plan.
        Ms. Ogilvie. Right. So we have driving and watch metrics in
    VBA. The driving metrics, you know, depends on the regional
    office. Different regional offices have different performance
    metrics based on what special issues they are dealing with at
    that regional office.
        Senator Blackburn. Okay. Then let us do it this way.
    Explain to me how this new metric would fit into a regional
    office's evaluation and into each individual's evaluation. The
    reason I want to know this is I know that a good number of the
    claims continue to go to appeal and then continue to end up in
    court, end up before the judge. So let us look at this metric
    as how you are looking at that regional office's competencies
    and also the individual's competency and their accuracy.
        Ms. Ogilvie. So as part of our quality program, we do
    look--we can drill down to an individual basis to figure out
    where trends are, what specific employees are causing specific
    errors. I would mention about the----
        Senator Blackburn. Okay. So in that, do you hold these
    employees accountable, and what kind of accountability do they
    face?
        Ms. Ogilvie. Yes, ma'am. The quality metric is part of
    every employee's individual performance plan, and if they are
    not meeting their quality metrics they would be put on a
    performance improvement plan and eventually terminated if they
    did not improve.
        Senator Blackburn. Okay. How many people have been
    terminated under this plan?
        Ms. Ogilvie. I am going to have to take that for the record
    and get back to you.
        Senator Blackburn. Okay. That would be helpful. What I
    would like to know is under this new plan, your performance
    metric plan, how many employees have been put on an improvement
    plan and how many have been removed? How many offices have been
    put on an improvement plan?
        The reason for this, the--once you had that Appeals
    Improvement Modernization Act that was done in 2017, you should
    have had a better review process in place. Now the fact that we
    continue to hear so much from our veterans about the
    dissatisfaction with the way these claims are processed, both
    on accuracy and timeliness, and the fact that there seems to be
    so many of these that go to appeal and then that end up going
    to a judge, would you not agree with me that this says that
    something is wrong with this process?
        Ms. Ogilvie. Actually, I would say that since the Appeals
    Modernization Act passed in 2017 we have been able--in the
    past, there has always been an appeal--historically, 10 to 12
    percent of claims have gone to appeal. Since the Appeals
    Modernization Act, we have been able--because there is a closed
    record in that, in several lanes of that law, we are able to
    actually drill down to specific errors that are being done and
    error trends based on those lanes. And we have integrated work
    groups that work together to address common issues that we are
    seeing and trends that we are seeing as part of the Appeals
    Modernization Act.
        Senator Blackburn. Okay. What total percentage of appeals
    now--or claims go to appeal now?
        Ms. Ogilvie. So it is hard to measure it in the same way
    because there is three separate lanes right now, one of them--
    two of them being claim lanes and one being an appeal. I know
    that out of the ones where a disagreement is filed----
        Senator Blackburn. Okay. Let us do this because my time is
    expired. Why don't you get those numbers for us? I think you
    have heard frustration, not only from me but from others, that
    there seems to be a lack of accountability, individually and in
    these regional offices, and a frustration from veterans with
    accuracy and timeliness when it comes to the VBA. So our goal
    would be to help you improve that.

        [For VA response to Senator Blackburn, see Questions 1 and
    2 on page 114 of the Appendix.]

        Mr. Chairman, you were generous with the time. Thank you so
    much.
        Chairman Tester. Senator Moran.
        Senator Moran. Chairman, thank you. I want to use this
    moment while the veterans witnesses are here, while the
    Department of Veterans Affairs witnesses are here. The
    Republican members of this Committee asked Secretary McDonough
    in a letter dated October 27th to provide details about the
    vaccine among VA personnel, compliance of the vaccine mandate,
    VA's operational assessment of the impact of the mandate. We
    asked for a response by November the 5th. We have not yet
    received a reply. It is a month past the VHA's deadline for
    personnel to be vaccinated and five days away from the deadline
    for the remainder of VA personnel.
        And my question is--which I do not expect you to be able to
    answer, Ms. Ogilvie--when can we expect a reply? And so I hope
    that you would take that back to the Department, but perhaps it
    is not even necessary for you to do that. I expect that the
    Secretary will learn of my inquiry. So if you want to respond,
    you are welcome to.
        Ms. Ogilvie. I would just say that I will make sure to
    check in on that for you and make sure that you get a reply
    soon.
        Senator Moran. Thank you for your kindness.
        Ms. Ogilvie. Thanks.
        Chairman Tester. The other thing that I would offer up--and
    I do not know if you have the Secretary's direct line. If you
    do not, I will give you his number.
        [Laughter.]
        Senator Moran. Just a response, but you and I can have this
    conversation among ourselves.
        Chairman Tester. I am just here to help. I am just here to
    help, Jerry.
        So it is good. That concludes our first panel. I would like
    to--so thank you all very much. You are welcome to stay.
        We have another panel up that is very important. It is the
    veterans' advocates. We have Jeremy Villanueva, Assistant
    National Legislative Director for the Disabled Americans
    Veterans, and we have Patrick Murray--get your name right this
    time, Patrick. Patrick Murray, Legislative Director for the
    Veterans of Foreign Wars, which has been referenced already
    today.
        And as soon as you guys get seated, Mr. Villanueva, we will
    let you begin. But thank you both for being here. You have been
    here before, and you will probably be here again. And we value
    your input and look forward to your testimony.
        So, Mr. Villanueva, you are up.

                                PANEL II

                                  ----------

                     STATEMENT OF JEREMY VILLANUEVA

        Mr. Villanueva. Thank you, Chairman Tester, Ranking Member,
    and members of the Committee. Thank you for inviting DAV to
    testify at this hearing before the Senate Veterans' Affairs
    Committee to provide our views on the legislation before you.
        DAV is a nonprofit charity that provides a lifetime of
    support for veterans of all generations and their families, and
    I am honored to be here to discuss these important pieces of
    legislation. Our submitted written testimony addresses all 22
    bills on today's agenda, but I would like to highlight 4 in my
    remarks to you.
        In the 2020 VA Challenge Survey, 6 of the top 10 unmet
    needs for homeless veterans were civil legal assistance. Family
    law court fee and fines, debt collection, expungement of a
    criminal record, and child support issues are common examples
    of civil legal needs expressed by veterans. These legal issues
    can impact income and access to housing, leaving veterans at
    risk of falling into poverty and homelessness.
        In addition, today's veterans are at a higher risk for
    involvement with the criminal justice system. Post-traumatic
    stress disorder has been estimated to affect nearly 20 percent
    of Iraq and Afghanistan War veterans, and the prevalence of
    combat experience leads to higher rates of PTSD and of
    increased severity. PTSD, especially untreated, has shown a
    strong positive association with increased rates of arrest and
    conviction for veterans.
        To help justice-involved veterans, we support S. 1564. This
    bill would authorize the VA to provide law school programs
    grants of up to $2 million a year to help provide free legal
    assistance to veterans. This practice of law schools providing
    legal assistance to veterans is one that DAV has supported, and
    we consider it a key component of eliminating veteran
    homelessness. However, we consider it critical that additional
    funding be appropriated for this and that funding from existing
    VBA programs not be used for this purpose.
        S. 1936 would codify protections ensuring veterans,
    survivors, and their families do not lose access to their
    educational and employment benefits due to natural disasters
    and events such as the pandemic we are currently experiencing.
    By extending delimiting dates for programs such as Veteran
    Readiness and Education and Dependents' Educational Assistance,
    we are ensuring that disabled veterans, their families and
    survivors can finish the program that this Nation promised
    them. It is critical that legislation is passed that extends
    these provisions prior to the December 21st expiration of the
    previous protections. Student veterans and their families
    should never lose their benefits due to forces outside of their
    control.
        S. 2513 would make automatic, reoccurring, annual clothing
    allowance payments to veterans unless that veteran elects to no
    longer receive them or the VA determines that the veteran is no
    longer eligible. This legislation would allow veterans to
    receive five years of clothing allowance benefits before the
    first review of eligibility. It would also require the VA to
    establish a regulatory standard to determine if the veteran's
    disability that requires the allowance is subject to change. If
    it is not, the review will no longer be required such as in the
    cases of amputees and those catastrophically disabled. Veterans
    should not have to take unnecessary steps to access benefits
    they are entitled to, and this bill would streamline and
    improve the clothing allowance process.
        And finally, DAV supports S. 1664, which would require the
    VA to establish an ongoing national training program for claims
    processors who review compensation claims for service-connected
    PTSD. Claims processors would be required to participate in
    this training at least once a year starting in their second
    year of being a VA claims processor. Additionally, the bill
    would require standardization of training at all VA regional
    offices and establish a formal process for conduct of annual
    studies.
        An OIG report from December 2020 focused on PTSD-related
    claims, estimated that claims processors did not follow VA
    regulations and procedures when handling 16 percent of these
    PTSD cases. The majority of errors were due to improper or
    inadequate stressor verification. The report determined that
    these employees do not fully understand the various types of in
    service stressors nor the stressor verification procedures.
    This was the result of a lack of training on PTSD claims after
    the first year of employment coupled with the lack of clear and
    concise guidance.
        We are greatly concerned by the report's findings and the
    negative impact that a lack of proper training has on a
    veteran's ability to obtain the benefits they have earned. The
    VA must prioritize ongoing instruction and quality control of
    training and manuals. Veterans struggling with PTSD face many
    challenges. However, VA training and correct rating decisions
    should not be one of them.
        Mr. Chairman, that concludes my testimony, and I would be
    happy to answer any questions you or the Committee may have.
    Thank you.

        [The prepared statement of Mr. Villanueva appears on page
    83 of the Appendix.]

        Chairman Tester. There will be questions. Thank you for
    your testimony. Appreciate it very much.
        Patrick Murray, from the Veterans of Foreign Wars, the
    floor is yours.

                      STATEMENT OF PATRICK MURRAY

        Mr. Murray. Chairman Tester, Ranking Member Moran and
    members of the Committee, on behalf of the men and women of the
    Veterans of Foreign Wars of the United States and its
    auxiliary, thank you for the opportunity to provide our remarks
    on these important issues.
        The VFW supports the GI Bill National Emergency Extended
    Deadline Act of 2021. This legislation would make permanent the
    extensions of time limits and eligibility periods created for
    students using VA education benefits during the COVID-19
    pandemic. As we continue to face uncertainty, it is critical we
    do not force student veterans to ponder the fate of their
    education benefits in times of national emergency. The VFW
    supports making these extensions automatic and believes that
    all time limits, age limits, periods of eligibility or
    delimiting dates should be removed from VA education and
    employment benefits as these are truly lifelong needs for
    veterans and their families.
        We have also been pleased to hear continued reports from
    VBA on the status of the Digital GI Bill upgrades and continued
    meeting of milestones toward automation. Updating these IT
    services will streamline the process for determining
    eligibility and improve communication between VA and
    institutions. We believe these enhanced technology measures
    will have a direct impact on students' success and prevent
    overpayments that may cause students financial distress.
        The VFW supports S. 2089 and S. 2644. Both of these
    proposals would provide parity for certain members of the
    Reserve component.
        S. 2089 would allow members of the National Guard and
    Reserve, some of whom have access to VA health care, education
    benefits, and VA Home Loan eligibility, to have the eligibility
    to be buried in a State veterans cemetery. States that choose
    to broaden the eligibility of veterans beyond what the NCA
    currently allows should not be restricted from the Veterans
    Cemetery Grants Program.
        S. 2644 would allow all members of the National Guard and
    Reserve to earn eligibility toward the GI Bill for every type
    of duty. As our country increasingly calls upon the service of
    our Guard and Reserve forces in times of national crisis, and
    as the nature of their orders on which these individuals are
    activated varies, it is important their service is recognized
    alongside of their active duty counterparts.
        The VFW supports the Every Veteran Counts Act, which would
    collect, maintain and publish veteran demographic information.
    We suggest making sure the current crop of VA users is also
    specifically identified in this repository of information as
    well. Knowing which veterans are utilizing VA and which
    veterans are not would help inform stakeholders about any and
    all gaps for veterans' care. The VFW believes detailed data
    collection and transparency of which specific veterans are
    affected by which specific issues will help determine how we
    should focus resources and attention in the future.
        The VFW supports the intent of S. 2405 to improve outreach
    to veterans, but we have a few concerns and would like some
    clarification. The VFW believes the language should be
    clarified in this legislation to ensure States have the
    flexibility to fully allocate grant funds, not only to county,
    tribal, and state service officer but also service officers
    from VSOs that are recognized by VA for preparation of their
    claims. Many States do not utilize accredited county service
    officers, and the VFW would like to ensure these States are not
    inadvertently overlooked or underprioritized in this proposal.
    States such as Rhode Island, Kansas, and Montana utilize State
    services officers or have VSOs perform those duties on behalf
    of the State. We would like to see this proposal be all
    encompassing to make sure that veterans in every State could
    benefit from these grants.
        The VFW supports some portions of the draft Benefits Bill
    but have concerns with certain sections of the proposal. We
    believe the VA accreditation portion of this proposal is
    unnecessary. If the intent of this portion is to allow for more
    transparency for veterans and their claims, then we believe
    adding a permission for VSOs accredited in the OGC's data base
    to have read-only access will accomplish that goal. Asking VA
    to accredit, maintain, and oversee their own service officers
    is an unnecessary step in accomplishing that.
        Additionally, while we appreciate the Committee's support
    in restoring and approving notifications to veterans and their
    representatives, we believe any changes are premature at this
    time. The current Claims Accuracy Review Pilot Program is only
    in phase two of implementation, and we believe we should wait
    until we have more information to fully assess the pros and
    cons of this program before making permanent changes.
        Chairman Tester, Ranking Member Moran, this concludes my
    testimony. I am prepared to answer any questions you or any of
    the members may have.

        [The prepared statement of Mr. Murray appears on page 97 of
    the Appendix.]

        Chairman Tester. Thank you, Patrick. To the second by the
    way, I might add, of the testimony. Good job.
        Good job to you both. We appreciate your testimony, your
    input, your suggestions.
        This is a question for both of you. As you are both aware,
    the COVID pandemic has resulted in an increase in the backlog
    of pending disability claims. What are you guys hearing from
    your members about the timeline for getting these claims
    processed?
        Mr. Murray. Senator, right now we are concerned, and we
    think a--we are hearing that it is too long. If you look at
    numbers from 2019 versus today, the average days for complete
    was 82 versus 146 right now. So it has jumped up by almost
    double.
        But a very fast way to reduce the backlog and what we are
    calling workload, not necessarily backlog, is the National
    Personnel Records Center. Last month, up until last month, they
    were only operating at 25 percent. They finally jumped up to
    about 45 percent. That is a place that a lot of elderly
    veterans, who some of them present with more complicated health
    care issues, who need that care and benefits right now--the
    National Personnel Records center, cranking out the records and
    the work that they need to get done, will help some of our
    elderly veterans get the care and benefits right now and drop
    down that backlog immediately.
        Chairman Tester. Mr. Villanueva, do you have anything to
    add from your membership?
        Mr. Villanueva. Yes, Mr. Chairman. Thank you very much for
    that question. And it is--the timeliness of getting the claims
    back to the veterans is, of course, important. And like Patrick
    just said, this is--we are at 146 days now, which is, you know,
    again, you know, quite a bit longer than what it was prior to
    the pandemic.
        That being said, you know, we have not had that many, you
    know, complaints from, you know, our membership about the
    timeliness. However, the quality, to ensure that these are
    claims are done accurately we think would do, you know,
    significant amounts to reduce not just the backlog of pending
    claims but pending appeals. You know, there is 90,000, you
    know, appeals that are backlogged at the board. And as long as
    we can ensure, especially with PTSD claims, that they are done
    right the first time and given back to the veteran, then that
    would significantly reduce this workload.
        Chairman Tester. Okay. Let us talk about the RURAL Exams
    Act for a second. Could you guys explain some of the challenges
    your rural members face when they are trying to schedule a
    disability medical examination and how, and if, the RURAL Exams
    Act would address those challenges?
        Mr. Patrick. Senator, distance is obviously one of the most
    glaring issues that some rural veterans are facing to either VA
    facilities or access to either contracting examiners that can
    perform those. The RURAL Exams Act, one of the key things that
    we really appreciate in there is timeliness. It is something
    that we have been trying to change the way we are talking about
    this.
        In the past, we have talked about the speed of exams.
    Timeliness has a usefulness category in that if exams are done
    in an efficient, quick, and useful manner, that will knock down
    the backlog. Having an exam returned to you and it is
    incorrect, you then put it back in the appeals. Even if
    eventually you get it adjudicated months later, that is not
    timely. We appreciate that this Act has ``timely'' in it. That
    will help us make sure that they are done with an element of
    speed but also an element of usefulness.
        Chairman Tester. Mr. Villanueva?
        Mr. Villanueva. Yes. So one thing that, you know, we have
    to understand about, you know, rural veterans, as I am sure,
    Mr. Chairman, that you know, you know, is that many rural
    veterans are, you know, in a worse health shape, wage-earners a
    lot of times, you know, and elderly. Many of these people
    cannot afford to take the time out to go to the next urban,
    built-up area to go and take these examinations.
        And then when you couple that with homebound veterans, even
    if you are going for an examination for being homebound, it is,
    you know, unacceptable to expect that a homebound veteran
    should get up and move sometimes hundreds of miles away just
    for an examination for a claim that they do not even know how
    it is going to come out.
        So any way that we can get the access to these rural
    veterans, you know, would definitely benefit our membership.
        Chairman Tester. Thank you. The GRAD VA Educational
    Assistance Parity Act would allow Federal active duty performed
    by members of the Guards and Reserve to go toward their GI
    eligibility. Could you folks talk about this legislation, if
    you like it and if you think it is necessary?
        Mr. Murray. Senator, we like it. We think it is necessary.
    We strongly support it. Every day in uniform should count the
    same, making sure that the men and women who are standing next
    to each other, standing next to their active duty counterparts,
    are getting the same equitable benefits as each other.
        Chairman Tester. Anything to add, Mr. Villanueva?
        Mr. Villanueva. No, sir, Mr. Chairman. Of course, we
    definitely understand and, you know, support the intent of this
    legislation. However, we do not have a resolution to support
    it.
        Chairman Tester. Very quick question and then I am going to
    kick it over to Senator Moran. You have heard a lot about the
    Act, the bill, that allows for IG subpoena authority. Do you
    guys have any problem with that?
        Mr. Patrick. Senator, we believe that that might be
    necessary to get to the bottom of some of the issues and will
    only make VA better. If VA is better, it is taking care of our
    veterans in a better capacity.
        Chairman Tester. Okay. Thank you both.
        Senator Moran.
        Senator Moran. I like that answer. Thank you.
        Senator Tester asked about the difference in treatment
    between Active and Reserve and Guard, so he has covered my
    question. I thank you for your support of that legislation.
        Let us talk about the backlog a little bit more. In your
    testimony, Mr. Villanueva, you discussed the benefits, the
    discussion draft mentions that it alleviates some of the
    concerns DAV has had with the current state of VA medical
    disability exams and the claims process and the current
    backlog. Outside of what is included in this bill, what more do
    you think the VA can be doing to reduce the backlog down to
    pre-pandemic levels?
        Mr. Villanueva. That is a great question, Senator. You
    know, A-number-one thing, you know, I think that might not be
    talked about, you know, although it is addressed in one of
    these bills, is of course the training. The training for VA
    employees because, you know, as we look at it, I think that the
    backlog, you know, specifically with say, you know for example,
    PTSD claims. Simple mistakes that get to the veteran and the
    veteran has to disagree with and that that delays the process
    and includes more work for the VA to do fix that.
        You know, we believe that a fully trained and, you know,
    competently trained VA employee puts out good work and quickly,
    and that alleviates the claim on both the VBA side and the
    board side. You know, we used to say in the military, you know,
    slow is smooth, but smooth is fast. You know, as long as these
    folks are competently trained and confident in what they are
    doing, you know, we believe that this would, you know, not only
    speed up the process but also reduce the backlog.
        Senator Moran. Thank you.
        Mr. Murray, anything you would add to that?
        Mr. Murray. As Mr. Villanueva said, accuracy. I had a
    colleague this morning testify before the House on MST claims,
    and the OIG report stated that approximately 50 percent of them
    were being adjudicated incorrectly, which kicks them back into
    the system. That is just another example of clogging up the
    system with claims that should have been done correctly the
    first time. So cultural competency training is important.
        The other thing that we have heard from our members is
    allowing not only feedback to help make sure that there is
    review and oversight of the C&P exams but also allowing for
    veterans to have some agency in the decision about their exams.
    We had a veteran from New Jersey that was assigned a C&P exam
    three weeks later. Well, three weeks later was actually her due
    date for her child. If she was not able to make that exam, then
    it was going to be counted as a missed exam. She called us,
    frantically worried about that, because she did not have any
    say in when to actually schedule that, what is best for her.
    Obviously, giving birth to your child is a very legitimate
    reason for missing an exam.
        But that is the kind of decision we think would help
    improve the system, not just making sure that things are more
    accurate, but so that veterans have more of a say in the
    process.
        Senator Moran. I debated whether to phrase this question
    this way, but you have kind of set the stage for this. I mean,
    you have mentioned a couple of things: training of VA
    employees, accuracy matters, allowing the veteran to have
    engagement in how the--what the timing is of the exam.
        I have been a member of the Veterans' Committee for 25
    years. I cannot imagine I have not supported, endorsed every
    piece of legislation designed to speed up the process, some of
    which became law. First of all maybe, is there examples of
    legislation that we have passed that had a difference in
    reducing the backlog of claims, or have we--in addition to that
    question, have we now ran the gamut of things that we can do
    legislatively to alleviate the backlog and it really now rests
    with the VA and its employees? In some ways, your answer to
    that was, particularly you, Mr. Villanueva, training, attention
    to detail, accuracy.
        How many more bills, or what is the bill we can pass that
    gets us to a position that is different than what we have been
    in for so long?
        Mr. Murray. Senator, I do not want to say that we have
    exhausted all options. Outside-the-box thinking always helps.
        But typically when we face a backlog over time, it is
    hiring new, additional people, like a surge capacity for a
    period of time but also making sure that they are done
    correctly. A fully developed claim, thoroughly reviewed,
    quality the first time reduces that redundancy. So some of it
    does rely on the actual individuals in the process itself. We
    would always encourage more help to speed it up, but you know,
    there are some certain steps that are almost the traditional
    backlog-reducing steps that just need to happen every time that
    there is ebbs and flows of the backlog.
        Senator Moran. Anything further?
        Mr. Villanueva. Yes, Senator. You know. And I would be
    remiss to say that the VA has not, you know, gotten speedier,
    especially in the last 10 years, you know, when it comes to the
    efficiency and getting these claims back to the veterans. That
    being said, we should--we could always be better. We should
    always strive for better and--you know.
        And I know this pandemic did not help things, you know, at
    all, getting things out and--you know, we have had to--you
    know, all of a sudden the VA has had to pivot to, you know,
    telehealth appointments to get the C&P examinations done, which
    of course, you know, I am sure added onto the backlog.
        But you know, like my colleague from the VFW said, yes,
    training should always be a must. We have to strive to get
    better. The moment we start sitting on our laurels and start
    being happy about that there is no more backlog, the backlog,
    as we have all seen, will always just grow. So, always striving
    to be better and staying on the VA and making them accountable
    for when there is deficiencies.
        Senator Moran. Maybe my takeaway from your answers is this,
    which is, while there may be legislative things we should do--
    we ought not foreclose that opportunity--we ought to be focused
    on number of personnel, personnel training, personnel attitude
    approach, and appropriations to make sure the necessary
    resources are there to complete the process. Is that a fair
    summary of where we might be?
        Mr. Murray. Getting it right the first time is going to
    make this process a lot faster, Senator. That is what we really
    hope to have happen. And training, cultural competency, making
    sure that individuals--as I mentioned, the MST example, while
    it is a smaller subset of claims, those are complex claims that
    take up a lot of time, that if you are doing them two or three
    times, that just only gums up the system. Let us get it right
    the first time.
        It also helps that ease of mind of the veterans to make
    sure that their belief, that they have, you know, the faith in
    the system and not have to fight the system. It should be very
    non-adversarial. And getting it right the first time will
    really help with that.
        Mr. Villanueva. Cultural competency, you know, instilling
    confidence, you know, showing the veteran that this can be done
    but also, you know, being relevant with the times,
    understanding that the new advances in technology that are out
    there and taking advantage of them, so that we can reach the
    more rural veterans and that we can--you know, the VA can, you
    know, be there and put the onus not on the veteran to be able
    to provide some of these things that are needed for, you know,
    a basic claim.
        Senator Moran. Thank you. Thank you to the DAV and to the
    Veterans of Foreign Wars, the VFW, for your testimony today and
    for the work you do with your members and other veterans.
        Chairman Tester. I want to echo those comments. I also want
    to thank the Office of Inspector General and the VA for being
    here today. Both panels were valuable because they shared the
    kind of insight that we need to move forward with today's
    agenda.
        We will keep the record open for one week, and with that,
    this hearing is adjourned.
        [Whereupon, at 4:55 p.m., the Committee was adjourned.]

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