[House Hearing, 118 Congress]
[From the U.S. Government Publishing Office]


                                                    S. Hrg. 118-139

                      LEGISLATIVE PRESENTATION OF
                       DISABLED AMERICAN VETERANS

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

                             JOINT HEARING

                                 OF THE

                     COMMITTEE ON VETERANS' AFFAIRS

                               BEFORE THE

                              U.S. SENATE

                                AND THE

                     U.S. HOUSE OF REPRESENTATIVES

                    ONE HUNDRED EIGHTEENTH CONGRESS

                             FIRST SESSION

                               __________

                           FEBRUARY 28, 2023

                               __________

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


        Available via the World Wide Web: http://www.govinfo.gov
        
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                    U.S. GOVERNMENT PUBLISHING OFFICE                    
53-728 PDF                  WASHINGTON : 2023                    
          
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                 SENATE COMMITTEE ON VETERANS' AFFAIRS

                     Jon Tester, Montana, Chairman

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

                      Tony McClain, Staff Director
                 Jon Towers, Republican Staff Director

                              ----------                              

        HOUSE OF REPRESENTATIVES COMMITTEE ON VETERANS' AFFAIRS

                     Mike Bost, Illinois, Chairman

Aumua Amata Coleman Radewagen,       Mark Takano, California, Ranking 
    American Samoa                       Member
Jack Bergman, Michigan               Julia Brownley, California
Nancy Mace, South Carolina           Mike Levin, California
Matthew M. Rosendale, Sr., Montana   Chris Pappas, New Hampshire
Mariannette Miller-Meeks, Iowa       Frank J. Mrvan, Indiana
Gregory F. Murphy, North Carolina    Sheila Cherfilus-McCormick, 
C. Scott Franklin, Florida               Florida
Derrick Van Orden, Wisconsin         Delia C. Ramirez, Illinois
Morgan Luttrell, Texas               Christopher R. Deluzio, 
Juan Ciscomani, Arizona                  Pennsylvania
Elijah Crane, Arizona                Morgan McGarvey, Kentucky
Keith Self, Texas                    Greg Landsman, Ohio
Jennifer A. Kiggans, Virginia        Nikki Budzinski, Illinois

                       Jon Clark, Staff Director
                  Matt Reel, Democratic Staff Director
                            
                            
                            C O N T E N T S

                              ----------                              

                           February 28, 2023

                                                                   Page

                                SENATORS

Moran, Hon. Jerry, Ranking Member, U.S. Senator from Kansas......     4
Tester, Hon. Jon, Chairman, U.S. Senator from Montana............     5
Murray, Hon. Patty, U.S. Senator from Washington.................    13
Blackburn, Hon. Marsha, U.S. Senator from Tennessee..............    15
Hassan, Hon. Maggie, U.S. Senator from New Hampshire.............    16
Tuberville, Hon. Tommy, U.S. Senator from Alabama................    17
King, Jr., Hon. Angus S., U.S. Senator from Maine................    19
Boozman, Hon. John, U.S. Senator from Arkansas...................    20

                            REPRESENTATIVES

Bost, Hon. Mike, Chairman, U.S. Representative from Illinois.....     1
Takano, Hon. Mark, Ranking Member, U.S. Representative from 
  California.....................................................     2
Rosendale, Hon. Matthew, U.S. Representative from Montana........    14
Budzinski, Hon. Nikki, U.S. Representative from Illinois.........    16

                    INTRODUCTION OF JOSEPH PARSETICH

The Honorable Jon Tester, U.S. Senator from the State of Montana.     6

                               WITNESSES

Joseph Parsetich, National Commander, Disabled American Veterans.     7

  accompanied by

  J. Marc Burgess, National Adjutant

  Barry Jesinoski, Executive Director, National Headquarters

  Edward R. Reese Jr., Executive Director, Washington 
    Headquarters

  Jim Marszalek, DAV National Service Director

  Joy Ilem, DAV National Legislative Director

  John Kleindienst, National Director of Voluntary Service

  Ryan Burgos, National Employment Director

  Darlene Spence, Auxiliary National Commander

                                APPENDIX
                           Prepared Statement

Joseph Parsetich, National Commander, Disabled American Veterans.    29

 
                      LEGISLATIVE PRESENTATION OF
                       DISABLED AMERICAN VETERANS

                              ----------                              


                       TUESDAY, FEBRUARY 28, 2023

                           U.S. Senate, and
                     U.S. House of Representatives,
                            Committee on Veterans' Affairs,
                                                    Washington, DC.
    The Committees met, pursuant to notice, at 10 a.m., in Room 
SD-G50, Dirksen Senate Office Building, Hon. Jon Tester, 
Chairman of the Senate Committee, presiding.

    Present:

    Senators Tester, Murray, Brown, Blumenthal, Hassan, King, 
Moran, Boozman, Blackburn, and Tuberville.

    Representatives Bost, Rosendale, Miller-Meeks, Takano, 
Pappas, Ramirez, Deluzio, and Budzinski.

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

    Chairman Bost. Good morning. Just so you know, Chairman 
Tester, he will be along in a little bit but we are going to go 
ahead and start today.
    I want thank all of you for being here, and I want to thank 
our friends on the other side of the aisle in the Capitol for 
hosting our first joint hearing of the 118th Congress. It is 
our honor to be joined by friends, as I said, Chairman Tester 
will be along later, Ranking Member Moran, Ranking Member 
Takano, and welcoming you to today's joint VSO hearing.
    And before I begin I want to welcome Commander Joe 
Parsetich--I want to make sure I get it right--and the whole 
DAV team who are with us today. I also want to welcome his 
wife, Meg, and thank you for your service as well to this 
nation, ma'am.
    I also want to welcome the DAV members that are here from 
Illinois, and if I can I would like for the Illinois members, 
if you could please stand. I want to recognize you.
    Absolutely no one here from Illinois. How about that.
    [Laughter.]
    Chairman Bost. There are some from Tennessee. All right. 
Just so you know.
    So I have been attending these VSO hearings for 9 years now 
as a member of the Committee, but this is the first time I am 
doing so as Chairman. Let me first off say that it is very 
humbling and an honor to do that. I could have never dreamed 
that an enlisted Marine, corporal by the way, from Southern 
Illinois would be sitting in a seat today that is the Chairman 
of the Committee charged with fighting for our nation's men and 
women in uniform. You know, it is a deep honor, and it is not a 
responsibility that I take lightly. But as you all know, it is 
not about me. It is about you and the millions of veterans and 
voices you represent across this country, our brothers and 
sisters in arms.
    You understand the struggles veterans and their families 
face. You know where VA is falling short. The DAV's superb 
advocates in D.C. have made a tremendous difference, and we 
thank you for that. You have my commitment that we will fight 
for you, and that the voices of the Representatives just as 
hard as you fought for us. And you know better than anyone else 
that the veteran community has earned a system that works for 
them.
    And I am proud of all that we have accomplished together 
this last Congress, including the President signing the 
bipartisan PACT Act into law. The legislation means a lot to 
veterans and their families, and it was long overdue, and I was 
extremely proud to see it land on the President's desk. Now we 
will be focusing on how VA implements that law. We will need 
all of you to let us know what is happening out there in the 
field when it comes to wait times for toxic-exposed veterans 
care and claims decisions. Boots-on-the-ground testimonials are 
vitally important for our oversight of the PACT Act.
    We have also made great progress to expand mental health 
opportunities through the Fox Grant Program and the STRONG Act 
to support the veterans and their families, and we continue to 
see a decline in veteran homeless nationwide.
    However, our work is not finished. Veterans are still 
fighting a VA bureaucracy to access health care they want and 
when and where they need it; being discriminated against and 
having their Second Amendment rights taken away from them; if 
they need help managing their health benefits, enduring long 
wait times for either access to earned benefits or getting a 
simple question answered; dealing with underperforming VA 
employees who do not have the veteran's best interest in mind; 
and reeling with the impacts of a flawed implementation of a 
new electronic health record system.
    These might seem like small things, but when it comes down 
to it they add up, and they impact veterans every single day.
    I am focused on bringing a VA into the 21st century, even 
if I'm going to do it kicking and screaming, to ensure 
generations of veterans have access to good care and services 
that they have earned. And I will ensure the VA getting the 
budget it needs to complete its mission. And I look forward to 
accomplishing that goal alongside of you, and I thank you all 
again for being here today.
    And with that I want to turn it over to Mr. Takano, the 
Ranking Member, for his comments.

             OPENING STATEMENT OF HON. MARK TAKANO,
      RANKING MEMBER, U.S. REPRESENTATIVE FROM CALIFORNIA

    Mr. Takano. Thank you, Chairman Bost, and it is wonderful 
to see a Marine veteran corporal in the Chairman's seat, so 
congratulations.
    It is great to be back in open format, in person. First of 
all, the most important question of the day is are there any 
Californians in the room?
    [Applause.]
    Mr. Takano. Welcome, California.
    It is an honor to join all the members of the House and 
Senate Committees on Veterans' Affairs to hear directly from 
the National Commander and representatives of Disabled American 
Veterans. The opportunity to hear from our VSO partners is 
incredibly important to me. Partners like DAV represent 
veterans and their families at all stages of life and service.
    And hearing from these partners allows the Committees the 
opportunity to hear directly about what is most important to 
your members and how we can be of service to our nation's 
veterans. For example, for years we have heard from members of 
many VSOs about taking comprehensive action on the effects of 
toxic exposure. I was encouraged to see the overwhelming 
support that DAV and other VSOs provided last Congress, to pass 
my bill, the Honoring Our PACT Act, and get it signed into law. 
Thank you for the tremendous support you provided throughout 
the process. Getting the PACT Act to President Biden's desk is 
a testament to the strong advocacy and support from passionate 
groups like yours.
    I also would like to express my thanks to Chairman Tester, 
Ranking Member Moran, and Chairman Bost for their efforts to 
work with me on passing this law. Our bipartisan bill expands 
VA health care to over 3.5 million veterans living with the 
effects of toxic exposure. Our bill removes the burden of 
proof, which, for too long, has prevented toxic-exposed 
veterans from accessing the care and benefits they need to 
treat their rare conditions. In total, the PACT Act establishes 
a presumption of service connection to 23 respiratory illnesses 
and cancers. Thank you, thank you for your help.
    Blue Water Navy veterans waited more than 40 years for 
benefits related to Agent Orange exposure because of Congress' 
piecemeal solutions. We were not going to let this happen 
again, and thanks to our efforts last Congress we kept our 
promise. Now the hard work begins, and I look forward to 
continuing to work with my colleagues to make sure this 
transformational law is implemented effectively.
    In the last Congress together we secured several important 
wins for veterans, including, as already mentioned, the passage 
of the landmark PACT Act. In addition, passing the Veteran Auto 
and Education Improvement Act, the Military Sexual Trauma 
Claims Coordination Act, the REMOTE Act, the THRIVE Act, and 
the Sergeant Ketcham Rural Veterans Mental Health Act, we were 
also able to wrap up the 117th Congress with packages of 
veterans legislation, including the STRONG Veteran Act and the 
Cleland-Dole Memorial Veterans Benefits and Health Care 
Improvement Act.
    I am very proud of these accomplishments, but we need to 
build on these achievements and continue our fight for better 
health care and benefits in this Congress and beyond.
    In reading your testimony it is clear your priorities align 
with my own. My priorities for this Congress include opposing 
efforts to cut over $31 billion in VA funding, including 
funding for the 3.5 million newly eligible toxic-exposed 
veterans; preserving women veterans' freedoms; delivering a VA 
for all veterans; modernizing VA care for the next generation 
of veterans; ensuring that no veteran is forgotten; and working 
to end veteran homelessness and food insecurity; ensuring 
benefits parity for America's veterans; rejecting efforts to 
privatize VA; conducting critical oversight and implementation 
of suicide prevention and toxic exposure bills; and empowering 
VA to fulfill its fourth mission capabilities.
    So we have big goals, and I know with your support and 
insight here today, along with the support of the Biden-Harris 
administration, we will be able to achieve these goals and 
fulfill the sacred promises we made to our nation's veterans.
    So I look forward to hearing your testimony today, and 
thank you for your continued advocacy and support for the 
veteran community. Thank you, and I yield back the balance of 
my time.
    Chairman Bost. Thank you, Ranking Member Takano, and at 
this time we would like to recognize the Ranking Member of the 
Senate VA Committee, Senator Moran.

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

    Senator Moran. Chairman Bost, Ranking Member Takano, 
welcome to the United States Senate. On behalf of Senator 
Tester and my Senate colleagues we are glad to have you here, 
and congratulations to you, Chairman Bost, on your ascension. I 
can tell you, Congressman Takano, all leadership here is 
fleeting. It can change every 2 years. I have experienced it 
myself. So hang in there, and there is hope.
    [Laughter.]
    Senator Moran. Welcome to our DAV witnesses this morning, 
and I thank all of you across this room and across the country 
who are watching at home for joining us here today. I 
especially thank my DAV members from Kansas who met with me 
earlier this week in my office and had significantly valuable 
and enjoyable conversations. I thank them for their leadership 
at home and here in Washington, DC.
    I want to thank the DAV leaders for being here in person. 
Thank you for your passion and expertise in supporting 
veterans. The knowledge you have of veterans and their families 
are hugely important to us, and the experiences each of you 
have encountered in your lives allow us to fashion legislation 
and to lobby the Department of Veterans Affairs to do things in 
a way that benefit all veterans.
    My view is that we have accomplished a lot working 
together, we have accomplished a lot in recent years, and I 
expect bipartisan efforts to continue in this Congress, and I 
know the DAV will continue to advocate for those legislative 
improvements.
    A couple of things I want to highlight. Next month marks 
two significant anniversaries. March 20th will be 20 years 
since the start of Operation Iraqi Freedom. Millions of U.S. 
servicemembers and their families have, and continue to serve 
and sacrifice to defeat our enemies. We remember all those who 
gave their lives in that conflict, and we commit to taking care 
of their surviving families.
    March 29th marks 50 years since the end of U.S. forces 
combat operations in Vietnam. To all our veterans we say what 
should have been said to every one of them 50 years ago--
Welcome Home. We recognize and honor your service to our 
country and we commit to seeing that you receive the support 
and gratitude that many did not receive those 50 years ago.
    Commander Parsetich, DAV's advocacy and its partnership 
will be vital as we go forward, as we work to make certain that 
veterans and their survivors can access the care and benefits 
they deserve in a timely, effective manner that delivers 
positive, measurable outcomes.
    The legislative accomplishments that you have helped to 
achieve are important. Some receive little attention and some 
receive a lot of attention, but each one of those successes are 
worthy on behalf of our veterans. Now we must all work together 
to see that the VA MISSION Act, the Hannon Mental Health Care 
Improvement Act, and the PACT Act are implemented and adhered 
to in a way that Congress and the legislative intent that you 
helped create is fulfilled.
    I will keep working to make certain the VA has everything 
it needs to deliver the care and benefits under these new laws, 
and we will count on the DAV to help us identify where 
additional resources or legislative changes are required.
    Thank you again, Commander, for your testimony, and I look 
forward to hearing it, and I yield back.

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

    Chairman Tester. Senator Moran, thank you. It is a pleasure 
to be here and I am sorry I am a bit late, but it is great to 
be here with Congressmen Bost and Takano and my good friend, 
Jerry Moran.
    I have got a big advantage today in that Joe Parsetich is 
from the State of Montana, so I get to watch you guys butcher 
his name, up and down the roster.
    [Laughter.]
    Chairman Tester. Not to point anything out, Jerry, but that 
even got a laugh out of Joe, just so you know.
    But good morning to DAV Commander Parsetich. You have come 
a long ways, because I made the same flight yesterday, and you 
have been a good friend and I welcome you to Washington, DC and 
the Joint Committee. And I also want to welcome Ken Weinheimer, 
Chase Natalie, Kevin Grantier, and anybody else from Montana 
who made the trek. I look forward to meeting with all of you 
later in the day.
    You know, Congress relies on the DAV and your team of 
advocates in Washington to keep us apprised of the needs of 
veterans and how we can meet those needs. Nothing more 
important, by the way, than our disabled veterans. Last year 
your support was critical in helping Congress address the 
longstanding priority of caring for toxic-exposed veterans and 
doing right by those who are served this country.
    The Sergeant First Class Keith Robinson Honoring Our PACT 
Act is the largest expanse of VA care and benefits in decades, 
and we could not have gotten it done without the DAV. Now we 
turn our attention to implement of this law and ensuring that 
the Department has the capacity to deliver the timely care and 
benefits that veterans deserve. This means addressing VA 
staffing shortages, offering more competitive salaries and 
benefits. It means fostering a culture that tracks and retains 
the best and the brightest, and it also means building and 
maintaining modern facilities.
    By the way, none of this is going to be done if we roll the 
budget back 5 years. Okay?
    This Congress and our Committee are leading bipartisan, 
common sense efforts to build on historic investments made by 
this PACT Act. The VA CAREERS Act, BUILD for Veterans Act, both 
crafted and supported by the DAV. We must also address an 
injustice that has been impacting medically retired veterans 
for far too long that, as I told the American Legion this 
morning, makes absolutely no sense whatsoever. We need to get 
the Richard Star Act passed. It is a top priority of mine.
    [Applause.]
    Chairman Tester. This bill--you guys are very familiar 
with--ensures that our combat-injured veterans will receive 
full DoD and VA benefits that they have earned. We could not 
have gotten the PACT Act done without you and other VSO 
partners, and the same goes for the Major Richard Star Act. We 
will need your support. We will need your strong support and 
advocacy to get this bad boy across the finish line. Together I 
am confident that we will get this right.
    Commander Parsetich and your team, we have a lot to get to. 
Your voice is invaluable in prioritizing our efforts on these 
two committees, and we thank you. We thank you for your work on 
behalf of disabled veterans, but we thank your membership for 
the sacrifices that they have given to this country, and they 
have been great.
    And with that I will turn the podium over to you, Joe. Good 
luck.
    Oh God, you are right. I screwed up. I have got voluminous 
things to say about Joe Parsetich.
    It is now my pleasure to--I thought everybody knew him, 
right Jerry?----
    [Laughter.]

                INTRODUCTION BY HON. JON TESTER

    Chairman Tester [continuing]. Introduce DAV's National 
Commander, a Montana boy who hails from Great Falls, a stone's 
throw away from my hometown of Big Sandy. He is a Vietnam 
veteran. Joe served honorably in the U.S. Air Force and is 
himself a service-connected disabled veteran.
    Widely known as a champion for veterans of Montana and 
across the nation, Joe was elected this summer to serve as 
DAV's National Commander, and I might say that was a damn good 
choice.
    He understands the challenges rural veterans face and 
conveys the expertise of the VA from his role on the Veterans 
Rural Health Advisory Committee. He has also served on many 
other executive committees and governance bodies, working on 
veteran suicide prevention, addressing veteran homelessness, 
and much, much, much more.
    Joe and his wife Meg have a family that includes 7 
children, 3 foster children, 32 grandchildren, 8 great-great 
grandchildren--I do not know how the hell you do it, man, I 
tell you.
    [Laughter.]
    Chairman Tester. Even with his service commitments and a 
family with more members than this Committee, he finds time to 
serve veterans in his community as a volunteer in DAV's 
transportation network and on the Honor Guard.
    Joe, I cannot thank you enough for being here today. More 
importantly, I want to thank you for your service and your 
tireless commitment to the military and veterans community.
    Joe Parsetich, Commander Parsetich, you may now introduce 
your leadership team and begin with your opening statement. And 
I hope I did not miss anything.

STATEMENT OF JOSEPH PARSETICH, ACCOMPANIED BY J. MARC BURGESS, 
BARRY JESINOSKI, EDWARD R. REESE JR., JIM MARSZALEK, JOY ILEM, 
       JOHN KLEINDIENST, RYAN BURGOS; AND DARLENE SPENCE

    Mr. Parsetich. Thank you so much for that kind 
introduction.
    Chairman Tester, Chairman Bost, Ranking Members Moran and 
Takano, and members of the Committees on Veterans Affairs, 
thank you for providing me the opportunity to deliver the 2023 
Legislative Program of DAV, Disabled American Veterans, an 
organization of more than million members, all of whom were 
injured or became ill as a result of wartime service.
    My written statement thoroughly details DAV's key 
legislative priorities for the 118th Congress and reports on 
our many programs and accomplishments, so today I am just going 
to highlight some of more critical policy goals. But first I 
would like to start off by introducing my DAV colleagues 
joining me here today: National Adjutant Marc Burgess; National 
Headquarters Executive Director Barry Jesinoski; Washington 
Headquarters Executive Director Randy Reese; National Service 
Director Jim Marszalek; National Legislative Director Joy Ilem; 
National Voluntary Services Director John Kleindienst; National 
Employment Director Ryan Burgos; and National Auxiliary 
Commander Darlene Spence.
    In addition to those here with me today many more DAV 
members are together watching this hearing from our annual 
Midwinter Conference across the river in Arlington, and there 
are thousands of dedicated DAV members across the country also 
watching and supporting us from their hometowns.
    I also want to recognize the many DAV leaders who have been 
vital to our organization's mission over the course of many 
years, including my Senior and Junior Vice Commanders and 
leaders in our DAV Auxiliary. Let me also extend my gratitude 
to our National Executive Committee and the members of the 
National Legislative Interim Committee as well as my Chief of 
Staff, Danny Oliver, for their continued support.
    And finally I want to thank my wife, Meg, who remains my 
most steadfast supporter and partner.
    Messrs. Chairmen, I am a service-connected disabled Air 
Force veteran of the Vietnam War. At just 17 years old I 
requested assignment in Vietnam, where I served as a military 
policeman with the 377th Security Police Squadron in the guard 
towers at Tan Son Nhut Air Base from 1968 to 1969. And although 
I did not know it them, the truth is my time in Vietnam lived 
with me long after I returned home. I do not have any John 
Wayne stories from my time in theater, and fortunately I did 
not experience any physical injuries. But for many years I 
could not shake the sounds of the enemy rockets whistling past 
my post, and I brought back with me the memories of those who 
lost their lives over there.
    I was honorably discharged in 1972, and carried the burden 
of surviving Vietnam for decades until 2009, when I woke up in 
an intensive care unit. That is because after 59 years on this 
beautiful earth I no longer saw my life as being valuable. I 
saw myself as an unworthy burden to those around me, and I 
attempted to end it all.
    Messrs. Chairmen, I sit before you today with the humble 
admission that I have never been so happy or so fortunate to 
have failed at something.
    So from personal experience I know just how important 
veterans' access to mental health services are. DAV appreciates 
Congress' continued attention to this issue and the significant 
resources provided to support the VA's inclusive array of 
specialized mental health programs and services. As these needs 
continue to grow, it is crucial that Congress provide the VA 
with all the mental health resources, staffing, and support 
necessary to prevent veteran suicide. We appreciate Congress' 
recent enactment of the comprehensive mental health legislation 
aimed at reducing barriers to care for veterans in crisis by 
collaborating with community partners. We all have to play a 
role.
    DAV has a mentorship program that supports alternative 
programming to help veterans overcome difficult transitional 
challenges after deployment is over. Through our Charitable 
Service Trust, the DAV provided $2.2 million in grants to 
support Save A Warrior, a nonprofit organization dedicated to 
providing a unique healing outlet and intensive therapy options 
for veterans combatting mental health issues.
    DAV has also provided nearly $1 million to Boulder Crest 
retreats, where DAV leaders and spouses serve as mentors for 
the latest generation of seriously injured veterans and their 
caregivers.
    DAV has also been a longtime partner in cohosting our 
annual National Disabled Veterans Winter Sports and Golf 
Clinics. We are very proud of these adaptive sports programs 
that directly impact and transform the lives and mental well-
being of our most profoundly injured veterans.
    We can and we must do more to end the national tragedy of 
veteran suicide.
    [Applause.]
    Mr. Parsetich. There is no more fundamental obligation of 
our nation than to care for the men and women who were forever 
changed in wartime service. Over the past decade, the VA has 
experienced unprecedented stress trying to fulfill that sacred 
charge, and they have undertaken historic reforms to ensure 
veterans have timely access to earned benefits and high-quality 
health care.
    The DAV is proud to provide ill and injured veterans free 
representation with filing claims for their service-related 
conditions, and we have the largest and most well-trained 
benefits advocacy initiative in the country, with over 1 
million veterans choosing DAV to represent them.
    Last year our nationwide corps of 3,700 benefits experts 
took more than 2.4 million actions to advocate for veterans and 
their families and file claims for their earned benefits, more 
than any other organization.
    [Applause.]
    Mr. Parsetich. Messrs. Chairmen, DAV is a fierce advocate 
of the VA health care system and its specialized programs. Over 
the past decade, there has been one consistent trend: an 
increasing number of veterans continuing to choose the VA for 
their medical needs. Unfortunately, the rising demand for care, 
coupled with significant staffing shortages and an aging 
infrastructure, continues to outstrip the VA's capacity to 
provide timely and convenient access for all veterans enrolled 
in the VA health care system.
    This is especially critical for disabled veterans who rely 
on the VA for most or all of their care. Congress must ensure 
that VA has the resources necessary to maintain sufficient 
staffing to deliver timely care and serve as the primary care 
provider and coordinator for all veterans using the VA system, 
and that is why we also ask that funding increases, not funding 
cuts, be implemented.
    [Applause.]
    Mr. Parsetich. You know, the VA and Congress must work 
together to modernize, realign, and rebuild our aging medical 
infrastructure to meet the veterans' health care needs both now 
and in the future. In DAV, we call upon you and your colleagues 
to work in concert with the VA to develop a workable 
infrastructure plan and authorize sufficient funding to address 
this long-standing issue. The VA must have modern facilities to 
efficiently deliver quality care to the veterans who have 
earned it.
    [Applause.]
    Mr. Parsetich. To help veterans access VA health care, DAV 
also operates a national Transportation Network, offering 
veterans free transportation to and from VA health care 
facilities. You know, last year, DAV volunteers drove more than 
500,000 hours, transporting more than 200,000 veterans to their 
medical appointments, saving taxpayers more than $16 million.
    [Applause.]
    Mr. Parsetich. Messrs. Chairmen, providing safe, high-
quality health care requires a modern electronic health record 
system. Unfortunately, VA's initial EHR rollout resulted in 
some serious concerns about patient safety and training. We 
know this is a complex issue, but whatever decisions Congress 
makes on the path forward it is essential that veteran safety 
and health outcomes remain the first priority.
    [Applause.]
    Mr. Parsetich. Another DAV critical goal for the 118th 
Congress is to ensure equity in services, benefits, and health 
outcomes for all underserved veteran populations, including our 
women veterans. And despite shifts in policy and increased 
staff training, evidence still suggests that many underserved 
populations are still at higher risk for health disparities and 
suicide. If the VA is to live up to its mission to care for 
those who have the borne the battle, it must rebuild trust, 
tailor programs to meet the unique needs, and ensure a safe and 
welcoming environment for all veterans that it serves.
    [Applause.]
    Mr. Parsetich. Messrs. Chairmen, it is critical to support 
the veterans during their transition from military service to 
civilian life, and DAV is committed to providing veterans and 
their spouses with the tools, resources, and opportunities to 
pursue meaningful careers or even start their own business. 
Last year we hosted over 80 job fairs across the country, and 
our efforts resulted in thousands of job offers to veterans and 
their spouses, and the DAV also now helps veterans and their 
spouses pursue their dreams as entrepreneurs, so they can 
become job creators and benefits providers for veterans.
    [Applause.]
    Mr. Parsetich. Finally, Messrs. Chairmen, we thank you and 
all of your members here today for the historic passage of the 
Honoring Our PACT Act. With the enactment of this legislation, 
millions of veterans exposed to burn pits and other toxic 
substances are now eligible for VA's life-changing benefits and 
health care. Now it is up to Congress to ensure that this law 
is fully and faithfully implemented. We need you to monitor the 
number and type of PACT Act claims filed. We must make certain 
that the VA has the resources and staffing to provide timely 
decisions and benefits to all toxic-exposed veterans and their 
survivors.
    [Applause.]
    Mr. Parsetich. For over 100 years, DAV has been providing 
critical services and support to our nation's ill and injured 
veterans. Through our program's 1 million-plus members, 
volunteers, and supporters, we provide direct help to those who 
need it. That is our mission.
    Film producer, Maria Cuomo Cole, said that we must give 
veterans ``the tools to empower themselves and reclaim the 
self-worth and dignity which comes from occupying a place in 
the American dream. It is a dream they fought so hard to defend 
for the rest of us.''
    If ever there was a need for us to focus our efforts to be 
united, to be the best, and to rise to meet the occasion, this 
is it. Our veterans need us and are worth the fight, and 
together we have the opportunity and the obligation to do 
better.
    Messrs. Chairmen, this completes my testimony. May God 
bless the DAV, the men and women who have served our great 
nation, their families, their survivors and caregivers, and, of 
course, this wonderful country, the United States of America.
    [Applause.]

    [The prepared statement of Mr. Parsetich appears on page 29 
of the Appendix.]

    Chairman Tester. Commander Parsetich, thank you very much. 
A few housekeeping things to begin with. First of all, the 
questions will be 3-minute rounds, so pick your best question. 
And then, Commander Parsetich, questions will be directed to 
you but you can defer to anybody in your leadership team, and I 
will go first.
    Commander Parsetich, about 2 years ago Senator Boozman and 
I sponsored a bill called the Deborah Sampson Act, and we got 
it across the finish line, but we only got it across the finish 
line because the DAV, who has long been a champion for women 
veterans, was a major force in getting that job done.
    Two years ago, post-enactment now of Deborah Sampson, how 
well do you think the VA is doing implementing the law, and 
what gaps still remain?
    Mr. Parsetich. Thank you for that question, Senator, 
because the VA has been working on implementing the Deborah 
Sampson Act. We have a good groundwork laid. There is still a 
lot of work to do, a lot of gaps that we have.
    I am going to direct that question to Director Ilem to 
expound on that a little bit more, if I may.
    Chairman Tester. Okay. Joy?
    Ms. Ilem. Thank you, Commander. We want to thank you 
specifically on the Deborah Sampson Act but everyone working 
together to really make sure that our nation's women veterans 
were a priority. And while the Deborah Sampson Act has so many 
great provisions in it, it does take time for implementation.
    I think that VA still struggles with hiring enough women 
veteran providers that have expertise in women's health. And if 
I had to say one other point it would be to make sure that 
their anti-harassment campaign is, you know, that they are 
fully staffed and they can really work on that issue. I do not 
think that is quite where we want it to be yet, although it has 
got a good start. It is going to take a lot of work to complete 
that.
    But we do appreciate all the work on women veterans that 
has been done. Oversight will be essential, and holding 
hearings and roundtables, I think, to make sure VA completes 
all of the provisions within that bill, that important bill. 
Thank you.
    Chairman Tester. Thank you very, very much.
    The PACT Act has been talked about a bit here this morning. 
DAV and its service officers are eyes and ears on the ground, 
and we need to ensure that the VA implements the PACT Act 
properly.
    For you, Commander Parsetich, or your team, has the VA 
included you, the DAV, in PACT Act implementation?
    Mr. Parsetich. You know, we have been in very close 
communication with the Secretary. He shared with us, as far as 
staffing needs, from a funding perspective as well as 
facilities. DAV is well plugged into VA. Their passion to 
implement this much needed bill is tremendous.
    But I am going to ask Director Marszalek if he can expound 
a little bit further on that, if I may.
    Mr. Marszalek. Thank you, Commander. I appreciate it.
    You know, we have been working very closely with Josh 
Jacobs and his team. We think it is more collaboration now than 
ever. They have really pulled us in, working on overdevelopment 
task force. But it is critical that we ensure they have the 
resources necessary to be able to process these claims, not 
only timely but accurately. We want decisions right the first 
time, so we are paying very, very close attention. We urge 
Congress to make sure that we are taking a look at the number 
of claims that are filed, the decisions that are made, the 
denials, and why they are being denied. So we have got to 
continue to work together.
    Chairman Tester. Thank you all for being here. And by the 
way, it is great to have a crowd meeting in person again. It 
beats the hell out of teleconferencing.
    Senator Moran.
    Senator Moran. Mr. Chairman, thank you. I will call your 
fellow resident of Montana by the name I can pronounce, 
Commander. Good day.
    [Laughter.]
    Senator Moran. Senator Tester may try to demonstrate that 
he is smarter than I am, but I think I can find a way to prove 
that we at least have equal intelligence.
    I am pleased that you are here and I appreciate the 
testimony, and I listened closely. I stepped out to speak to a 
couple of groups of University of Kansas and Kansas State 
University students who are in the Capitol today, and I told 
them of your presentation and why we were here. And I was 
pleased to hear them say what respect they had for veterans, 
and wanted to make sure that they gave me the instructions, 
these 19-, 20-year-old kids, to make sure that we take care of 
those who served our nation, and we want to do that.
    Let me ask, I guess in my 3 minutes, my priority question. 
Congress has never failed to provide the resources that the VA 
needs to care for veterans. Sometimes it takes us a little 
while to get it done. We are not going to miss the opportunity 
to make sure the resources are there. I am an appropriator as 
well as a member of this Committee.
    You can see that in significant budget increases that the 
VA continues to receive year after year, even when we 
supposedly have strict austerity measures in place, than the 
rest of government. But the VA is not immune from waste, fraud, 
and abuse. I heard you testify particularly about 
infrastructure and buildings. What would be your suggestion for 
ways that we can find the necessary resources to put into those 
new structures? It probably takes reducing or eliminating 
structures that are no longer as important, but those are 
difficult priorities to make, and we need your help in trying 
to reach a conclusion about how we can spend less here on 
something that is deteriorating to make sure we have something 
new and available for veterans across our nation.
    So a bit of an infrastructure question but also anything 
that you see in which the VA could do a better job in being 
more efficient.
    Mr. Parsetich. Thank you for that question, Senator, or 
Congressman, because it is critically important, and also thank 
you for your constituents' kind comments.
    But I am glad you brought that up because our men and women 
have already paid the price once to this country. We should not 
have to pay the price a second time as far as having the 
facilities and services that we have earned.
    That being said, however, having updated facilities are 
very important, but not to the extent where we close the other 
ones that exist prior to having the new ones in place so that 
our veterans out in remote areas can still access the health 
care facilities that they need to address their injuries or 
illnesses that they are receiving services from.
    Senator Moran. I thank you for your answer, and I share 
with your state, Kansas shares that rural aspect for access to 
care. Part of that is the MISSION Act, but part of that is 
making sure the facilities, the physical facilities we have in 
the VA are updated, and we ought not discriminate against a 
single veteran by where he or she lives. Thank you.
    Chairman Tester. Thank you, Senator Moran. Senator Murray.

                       HON. PATTY MURRAY,
                  U.S. SENATOR FROM WASHINGTON

    Senator Murray. Thank you very much, Mr. Chairman. 
Commander, welcome. It is great to have you here, and I can say 
Parsetich because I am from the great State of Washington. My 
mother was born in Butte, so Senator Tester has nothing on me 
there, so great.
    Good to have you here and thank you for your comments. 
Thank you to all of your members who are here supporting you 
and all of your team and for all the work that you do.
    I appreciate your answer to Senator Tester on the Deborah 
Sampson Act and know we have more work to do there, as well as 
making sure that we have the resources for the VA to implement 
the PACT Act.
    But in my few minutes I did want to talk about the millions 
of children who are living with a disabled veteran and how we 
make sure we are taking care of them as well. Senator Boozman, 
who just left, and I are introducing the Helping Heroes Act, 
that will help support the families of disabled veterans, 
including those children who are taking on caregiving roles, 
because I really believe that we have a serious obligation to 
support our veterans when they come home, and that includes 
supporting the children and grandchildren of those veterans who 
are helping care for their families.
    So I wanted to ask you today about what else we can do and 
what the VA should be doing to support those families who are 
supporting veterans.
    Mr. Parsetich. Thank you for that question because I think 
that the very start of the solution for that is just what you 
brought out, your compassion and obvious recognition of the 
criticalness of making sure that our veterans' families and 
caregivers do have adequate compensation so that they can stay 
home and take care of their loved ones who came back with 
injured conditions.
    Director Ilem, do you have anything you would like to add 
to that?
    Ms. Ilem. I would just add, you know, we are happy to 
support your bill, and it is important to remember that the 
entire family is impacted, and obviously the children of 
service-disabled veterans, our members are fully aware of that 
and we are happy to support that legislation.
    Senator Murray. Thank you very much, and I will yield back 
my time because there are many members here, but thank you all 
again for all the work you do.
    Senator Moran [presiding]. Senator Murray, thank you. 
Representative Rosendale.

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

    Mr. Rosendale. Thank you very much, Mr. Chair. Thank you, 
Commander Parsetich, Joe, and the rest of the Disabled American 
Veterans for coming to Washington, DC to testify before us. I 
enjoyed meeting with your whole delegation yesterday--Ken 
Weinheimer, Kevin Grantier, and Chase Natalie--and I always 
value your insight on veteran issues.
    Commander Parsetich is from my district, and I have my 
first granddaughter there in Great Falls, so I am hoping maybe 
she will grow up with one of your 25 that you have already got 
going there.
    I really appreciate your willingness to speak so openly 
about your own personal battle with PTSD. Your bravery serves 
as an inspiration for other veterans who are facing similar 
challenges, and makes them more likely to come forward and get 
the treatment that they deserve. That is really, really 
admirable and I appreciate it.
    I agree with your written testimony that the Oracle Cerner 
electronic health record system's initial rollout in Spokane, 
Washington, resulted in serious concerns pertaining to patient 
safety, and led to the burnout among staff. It was a really big 
problem.
    As Chairman of the Technology Modernization Subcommittee I 
introduced the Department of Veteran Affairs Electronic Health 
Record Modernization Termination Act, which ends the Oracle 
Cerner EHR system. We must hold the VA to a high standard of 
care promised to our veterans, and be good stewards of taxpayer 
dollars. I welcome the opportunity to work with you to ensure 
that we have an EHR system that works for our veterans. We 
absolutely cannot be putting the safety of our veterans at risk 
by dumping money into a system that has failed and shown that 
it is not functioning properly.
    Can you please touch on some of the problems your members 
have experienced with the Oracle Cerner EHR system.
    Mr. Parsetich. Thank you so much for that question, 
Congressman, because, you know how much I respect you and all 
of the 535 men and women in the body. But I would encourage you 
not to throw out the baby with the bathwater because, yes, it 
had problems when it first came out. But rather than doing away 
with it we just need to dig in and fix those problems because 
it is the start of a tremendous process that is going to enable 
the veterans to get better-quality care by having the 
collaboration between the various physicians, something that 
has been lacking right now, because if they do not get the hard 
copy medical records many times the veteran is finding that 
they are starting over or a contraindication or problem that 
they may have been encountering the first time, the new person 
is not going to know.
    So the electronic record system is so critical, and you are 
right, we need repairs on it. But again, repairs do not come by 
doing away with it completely. So would just ask that we would 
continue to get the support that is going to benefit the 
veterans in a safe and effective manner and enhance physicians' 
capability to give us the best quality care possible.
    Mr. Rosendale. Thank you so much. It seems my time has 
expired. I yield back.
    Senator Moran. Thank you, Congressman. Senator Blackburn.

                     HON. MARSHA BLACKBURN,
                  U.S. SENATOR FROM TENNESSEE

    Senator Blackburn. Thank you, Mr. Chairman, and Commander, 
thank you so much. We appreciate that each of you are here. And 
in Tennessee we really appreciate the work that DAV and the 
VSOs do for our veterans.
    Commander, I want to go back to something you said in your 
testimony about access to care in a timely manner. I agree with 
you that that access to care in a timely manner should be a top 
priority of this Committee, and that is why I have been such a 
proponent of expanding the Veterans Community Care Program, so 
veterans can get that. When you look at wait times in 
Tennessee, sometimes it is 100 days to get a primary care 
appointment, and that is not acceptable. And this program's 
success is going to be vitally important to the proper 
implementation of the PACT Act.
    So I would like to know if DAV has done any outreach to 
educate veterans on the Community Care Program and informing 
them when they are eligible for this care, allowing veterans to 
make informed decisions about how they seek their care, whether 
they want it through the VA system or in their local 
communities. I know many times it is hard to get somebody to 
take off work and get you 180 miles to the VA, and I find it 
inappropriate that many times the VA is the middleman between 
the veteran and that access to care. So if you would speak to 
that.
    Mr. Parsetich. You bet, and thank you for that question 
because, you know, one of the things--and I will answer your 
question first as far as where you asked if the DAV is doing 
anything proactively to get the word out, how to circumvent and 
interact with the community care process. Our NSOs nationwide, 
national service officers, are putting out what is called 
information seminars, where the entire community, not just our 
DAV members, are invited to address these various things, 
questions, procedural type things. Because so many times 
various issues come up where they say, ``Well, should we do 
this? Should we do that?'' and they are listening to their 
neighbors and not knowledgeable people.
    So yes, DAV is very proactive when it comes to getting the 
word out, and also through our commercials that we try to have, 
and our website is very informative. But for those who are not 
part of our members, veterans nationwide are able to access 
that information.
    But also when it comes to a little bit further knowledge I 
am going to see if Director Ilem can expound a little bit.
    Ms. Ilem. I would just add that Community Care Network is 
an important part of VA health care, and while we want to make 
sure that VA can be a primary provider and coordinator of that 
care, we know that VA cannot be in every location, and there 
are often times when veterans have to seek care in the 
community. We want to see improvements in that care, transition 
that process, because we think that is where a lot of the 
delays are occurring.
    So we are on board. We want to help make sure that smooth 
transition, that veterans get care when they need it, where 
they need it.
    Senator Blackburn. Thank you.
    Senator Moran. Thank you. Representative Budzinski.

                     HON. NIKKI BUDZINSKI,
               U.S. REPRESENTATIVE FROM ILLINOIS

    Ms. Budzinski. Thank you, Mr. Chairman, and it is great to 
be with you, Commander, and thank you to all the Disabled 
American Veterans for being here today.
    You know, as well documented, suicide rates for our 
veterans are at a historic high. In fact, veterans are 1.5 
times more likely to die by suicide than non-veterans. We know 
there are many reasons for this, including trauma experienced 
while in service, stress, burnout, isolation, and difficulties 
transitioning back to civilian life. So I want to thank you, 
Commander, for sharing, in your testimony, your personal 
experience and your story, which for me, representing the 13th 
District in Illinois, is not unique for many of the veterans 
that I have the privilege of representing.
    So my question for you, Commander, is in your opinion and 
from your professional and personal experiences, what are some 
of the actions that Congress needs to take to improve access to 
behavioral health services for our veterans? Thank you.
    Mr. Parsetich. You are welcome, and thank you for that 
question. One of the challenges that not just military 
environment with veterans face as well as civilian sectors is 
that many times the invisible traumatic scars of injuries, 
whether it be, like I said, as a child, as a person who has 
been violated, whether it be women or men, but especially our 
military. When they come back many of them that are faced with 
the invisible scars are not getting the support that many who 
have the visible wounds are getting as far as in the way of 
encouragement, validation that is lacking. And after a while, 
those who are struggling with those invisible scars start 
believing, and sometimes we are even given judgmentalism which 
makes you question whether or not, you know, why you should 
even be in that state.
    So I think with the VA's thrust to make more services 
available to the veterans and their families--because they have 
many support groups for veterans who are having suicidal 
tendencies or have dealt with those in the past--the VA has 
come a long way. And we just want to make sure that they have 
adequate funding and staffing to continue with the progress 
that they have been making so far and need to continue to make.
    Ms. Budzinski. Thank you, and I will yield back my time, 
Mr. Chairman.
    Senator Moran. Thank you very much. Senator Hassan.

                      HON. MAGGIE HASSAN,
                U.S. SENATOR FROM NEW HAMPSHIRE

    Senator Hassan. Well thank you, Ranking Member Moran, and 
to Ranking Members and Chairs in both chambers for this 
hearing. Thank you, Commander Parsetich, for testifying before 
us today, and to add to the Congresswoman's comments, for being 
so candid. It is really, really important.
    In New Hampshire, many veterans have to travel significant 
distances for their VA health care, as we have been talking 
about, and in many places there is no public transportation 
available. For disabled veterans or those simply without a car, 
this is a huge barrier to care and can lead to veterans missing 
appointments, among other things. As a result, many Granite 
State veterans turn to DAV's dedicated network of volunteer 
drivers who drive them to their VA health care free of charge, 
and Commander, I understand that you volunteer to do this 
driving as well, so thank you very much.
    The service that DAV drivers are providing is critical to 
veterans accessing care and it provides a lifeline for many 
disabled veterans. So how can the VA better support DAV's 
volunteer drivers, and what could the VA do to ensure that no 
veteran has to worry about finding a ride to an appointment?
    Mr. Parsetich. Thank you for that question because I am 
very passionate about that. This country is not lacking in 
volunteers wanting to serve the veterans by volunteering 
driving, helping out in different facilities, and problems with 
getting volunteers processed and cleared to be able to 
volunteer is not coming from the Federal level. National VA is 
very, very supportive.
    But we find nationwide that the lack of communication 
between the director encouraging the voluntary services, to get 
these applications processed in an expedient fashion, dragging 
out for 3 to 6 months or longer, in many cases, and it is just 
unacceptable.
    So I think it is going to come from, to use a secular term, 
we need to have some coaching going on, first from the VA to 
the directors, saying, ``Hey, you need to get busy with 
coaching your voluntary services people,'' and then voluntary 
services approaching it with the severity and the criticalness 
of getting those drivers cleared, because like you pointed out, 
it is critical to getting these veterans to their medical 
appointments, and many times that can make the difference of 
life or death, in many cases.
    Thank you for that question.
    Senator Hassan. Well thank you so much, and thank you for 
your service. And I will yield back and submit a couple more 
questions, particularly about the caregiver program, for the 
record. Thank you.
    Senator Moran. Senator, thank you. Senator Tuberville.

                     HON. TOMMY TUBERVILLE,
                   U.S. SENATOR FROM ALABAMA

    Senator Tuberville. Thank you, Mr. Chairman. I want to 
start by saying thank you to Disabled American Veterans for 
everything you do, day in and day out, for veterans across the 
world.
    To address PTSD and TBI, veterans are trying innovative 
alternate treatments and therapies through clinical trials 
every day. Some even leave the U.S. to access these therapies. 
If you hear of effective treatments among your members do you 
raise it to the VA? Anybody. Is that information passed on?
    Mr. Parsetich. You know, with our younger veterans there 
are many effective programs, like CPT, they have electronic 
programs, there are different programs for the younger veterans 
where it is fresh, still in their memory.
    I find that what I am hearing from my era, back not only 
Vietnam, Korea, and even a few World War II stragglers around, 
that we are very honored to be in their presence, is that it is 
not as effective dredging up those old memories.
    I am going to ask Director Ilem to expound a little more 
because she also has her hand on that pulse.
    Ms. Ilem. To address your question specifically, yes, when 
we do hear about new treatments, alternative treatments, we are 
always curious about what VA is doing. Certainly we encourage 
VA to give us briefings on different treatments for PTSD, 
military sexual trauma related PTSD. So we think that is an 
important thing to continue to grow and see what is available. 
And what veterans want to use is often not more of a standard 
treatment but some of these new treatments that are available 
to them.
    Senator Tuberville. Do you encourage members to report 
anything that has helped them, you know, anything that has been 
successful?
    Ms. Ilem. Yes, and we have actually done a couple of 
magazine articles about some of the different new drugs and 
treatments that are being provided that would be considered 
alternative treatments.
    Senator Tuberville. If a veteran claims a certain alternate 
treatment has helped him, what does the DAV consider successful 
enough as a result to share with the VA? Does it have to be a 
certain number?
    Ms. Ilem. Well, we think that research is important. VA is 
very focused on evidence-based treatments, and we courage them 
to expeditiously do any research that is needed. We want to 
make sure treatments are effective not harming in any way.
    Senator Tuberville. Thank you.
    Commander, in your testimony you also mentioned the 
dissatisfaction among veterans with the Community Care referral 
process. I too, and I think we are dissatisfied with the red 
tape veterans go through to get referred to a provider in the 
community, especially as it relates to treatment for substance 
use disorders. What experience have your members have with 
accessing treatment clinics in the community through the 
Community Care system?
    Mr. Parsetich. You know, care in the community process 
where you contact your primary provider first to get the 
referral to other resources available, and understand we 
encourage those being utilized if and only if the VA does not 
have a specialized person that can address that within the 
mileage or time element aspect. That being said, however, you 
are 100 percent right that it is not uncommon for veterans 
being asked to wait 4 to 6 weeks or more just trying to get a 
referral and then get the runaround.
    So we need encouragement when it comes to that because we 
are very grateful and appreciative as far as to have these 
services available to us, but like I said, we have to just work 
on refinement. We have a good foundation. Care in the community 
was a tremendous benefit for the veterans as far as when we 
cannot access other specialists. It kind of like an 
alternative. Sometimes we can get telemed, but telemeds are not 
always going to address the situation where you need a face-to-
face, because many veterans respond better when they are 
sitting across from somebody than looking on a screen.
    But thank you for bringing up the point that, yes, we have 
challenges, but challenges mean that we are doing something in 
the right direction. We just have to refine it.
    Senator Tuberville. Yes. Yes. Are you hearing a lot of 
lengthy wait times? Is there a lot of wait times for our vets?
    Mr. Parsetich. Sometimes, and again, many times it depends 
on the availability of whoever they are trying to access. 
Sometimes it is just with the paperwork glitch. But the VA is 
very much on top of that and the Secretary does have a hotline. 
We have real good relationships with the Secretary, and when we 
find a particular problem area he usually addresses it right 
away to make sure that we can smooth out some of these rough 
edges.
    Senator Tuberville. Thank you very much. Thank you, Mr. 
Chairman.
    Senator Moran. Thank you, Senator Tuberville. Senator King.

                    HON. ANGUS S. KING, JR.,
                    U.S. SENATOR FROM MAINE

    Senator King. Thank you, Mr. Chairman. First I want to 
explain to the DAV members here what is going on. If you think 
the computer system at the VA is inadequate, they have not 
figured out how to schedule committee meetings.
    [Laughter.]
    Senator King. Two floors above us I am in a meeting of the 
Armed Services Committee on Ukraine, a meeting that I think you 
will all agree is worth going to. So Senator Tuberville and I, 
if you see us bouncing back and forth and in and out it is not 
a lack of attention or interest. It is because we are trying to 
do our duty as best we can, to the multiple responsibilities 
that we have. I am sure you are thinking, where are all these 
people going? We are not going out for coffee, I can assure 
you.
    Commander Parsetich, I want to look ahead a little bit. The 
VA estimates that in the next 25 years or so the number of 
veterans over 85 is going to go up by like 40 percent. There is 
going to be a huge demand for long-term care. I do not expect a 
short answer here, but I want to put the DAV's good thinking to 
help us think through this problem that I think is coming at 
us. It is much better to prepare and think ahead rather than to 
react to a crisis when it sweeps over us. Is that something the 
DAV can help us with?
    Mr. Parsetich. You bet there is, Senator King, and thank 
you for that question. But I am going to give you the short 
answer. Director Marszalek, can you address that?
    [Laughter.]
    Senator King. Hey, I like that deal.
    Ms. Ilem. I will take this one, Jim. Yes, we see the 
impending number of aging veterans coming. In fact, it is one 
of DAV's critical policy goals for this and this Congress. And 
we know veterans want to remain at home as long as they can, 
with their loved ones and their families, and that requires 
support.
    When we do need community living centers or nursing homes 
or state veterans home that is key to have that option, but 
there are so many steps in between, from assisted living to 
veteran-directed care, just to having support in the home to be 
able to maintain that. So we want to work with you.
    Senator King. I am a great believer in home care. I have 
never met anybody yet who wants to go to a nursing home.
    Ms. Ilem. Right.
    Senator King. You want to stay home. It is also less 
expensive for the taxpayers, and I just think that is 
something. There is bill that we just reported out, the 
Elizabeth Dole Home Care Act. We want to keep working on that. 
Help us get that through the Senate, would you please?
    Ms. Ilem. Absolutely. We will be 100 percent behind you 
there.
    Senator King. In just a few seconds, the other issue that I 
am really concerned about is the transition, and you mentioned 
that, Commander, in your comments. That is where there is a 
disproportionate number of suicides in the first 2 or 3 years 
after separation. I hope you can work with us to develop a 
program of a truly warm handoff. I have told the Department of 
Defense and the committee upstairs, in Armed Services, I think 
they should spend as much time, money, and effort on the 
transition out as they do on the recruiting in, and I hope that 
is something you can help me with.
    [Applause.]
    Mr. Parsetich. Senator, the DAV would be honored to support 
such legislation because the transition is critical. And giving 
our men and women the encouragement, resources, programs that 
they deserve to make a successful transition--and I am not 
talking from a pharmacological perspective right now. I am 
talking from a peer perspective, where they can help each other 
and be guided by the professionals in a way to where they are 
going to be able to reestablish self-respect, self-esteem, and 
self-worth, that they can be reestablished, not only within 
themselves but within their communities.
    Senator King. My vision is a VSO officer meeting the 
veteran at the airport, saying, ``Welcome back. Here are the 
resources that are available to you.'' Literally. I mean, 
literally meeting them at the airport to know that there is 
that community of veterans in their state. That is the 
direction I want to move in.
    Thank you very much, Commander, for being here. Thank you, 
Mr. Chairman. I have got to go back upstairs.
    Chairman Tester [presiding]. Thank you, Senator. Senator 
Boozman.

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

    Senator Boozman. Thank you, Mr. Chairman, and first of all 
I have got to give a big shout-out to my Arkansas folks. Thank 
you for making the trip and the great job that you do at home 
representing the state, and again, all you do for veterans.
    Commander, thank you. You and your team do an outstanding 
job. We really do appreciate that.
    I had the opportunity to serve in the House on the 
Veterans' Affairs Committee and now in the Senate, and I know 
firsthand that we have been able to achieve a lot, but it 
simply would not have gotten done without your help. So thank 
you for your advocacy. The idea of looking out and seeing so 
many people sitting here, talking to their representatives, 
there is just no substitute for that. So again, that is a big 
deal.
    The VA CAREERS Act is a crucial piece of legislation for 
reducing vacancies and staffing shortages in the VA. VA 
continues to be at a disadvantage when it comes to recruiting 
and retaining those talented medical professionals across the 
country, especially in rural areas. Can you briefly speak to 
what this legislation would mean for the VA and why it is 
important to ensure the VA has the ability to recruit and 
retain the best health care professionals?
    Mr. Parsetich. You bet. You know, I have had the pleasure 
of serving under three Secretaries of the VA right now on 
veterans rural health and that is always the very first topic 
of conversation--what can we do to recruit and retain those 
professionals. But to give you further information I am going 
to defer over to Director Ilem to expound a little bit more.
    Senator Boozman. Thank you.
    Ms. Ilem. DAV is a proud sponsor of that legislation. We 
know right now that it is more critical than ever to be able to 
hire and recruit the best and the brightest for VA. Our 
veterans deserve no less. And the bill is jam-packed with 
provisions that will really help to do that. It is essential 
the VA is able to be competitive for some of these scarce 
medical specialties, and again, our veterans deserve to have 
the very best and brightest, and we are happy to be behind you 
to get that across the finish line.
    Senator Boozman. We appreciate that. And one of the things 
that we were able to get put in it was how do you deal with 
directors being detailed to different positions, being gone for 
long periods of time. Leadership truly does make a huge 
difference. Can you talk specifically about that, about not 
having leadership in place at the medical centers and filling 
those? And it is hard because, you know, we are competing with 
the private sector, and they probably pay them many times more. 
On the other hand, we simply have to get those positions 
filled.
    Ms. Ilem. And we really appreciate that provision 
specifically because we know when there is poor care that 
happens or a problem, it is usually a place where the 
leadership has been lacking, or to move somebody in and out 
that was not able to be there to really advocate and make sure 
that facility is run top notch. And VA has to be able to 
attract those people that have the experience and the ability 
to really run a medical center. It is essential.
    Senator Boozman. Thank you very much. Thank you, Commander, 
and again, thanks to all of your team for the great job they 
do, and for all of you that made the trip and do such a 
tremendous job in your states. Thank you, Mr. Chairman.
    Chairman Tester. Thank you, Senator Boozman. Ranking Member 
Takano.
    Mr. Takano. Thank you, Chairman Tester. Commander 
Parsetich, I just got to personally express my gratitude for 
just the courageous way that you have spoken about your own 
personal struggles and what a great service you are to veterans 
who are struggling themselves, to know.
    But yes, I want to reiterate probably something that has 
already been reiterated here but I think it needs reiteration. 
Republican leadership in the House has suggested funding levels 
for departments and the agency should be capped at fiscal year 
2022 levels while the Department of Defense is held harmless. 
In the case of VA, that would mean a loss of $31 billion, or 
roughly 24 percent of VA's budget, just as Congress is tasked 
with implementing the PACT Act, opening up medical eligibility 
for 3.1 million veterans.
    As members of the independent budget VSOs, DAV has vital 
insight into the annual budget and VA funding. Do you believe 
that this stake, this stance that the House Republicans have 
taken puts veterans' access to care and services in jeopardy?
    Mr. Parsetich. Congressman, thank you for bringing that 
forward because any cuts to our veterans would be devastating 
financial cuts. These men and women have earned the right to 
get the highest quality care, and we are not insensitive to 
budgets and things of this nature, but we have already paid the 
price in full, many times over. Some of whom who did not make 
it back, they paid the ultimate price, and those of us left 
behind.
    I think we deserve the best.
    [Applause.]
    Mr. Takano. Well, I do too, and what was demonstrated in an 
unprecedented way was the way that the political will was 
generated by you, the veteran service organizations, to change 
the way that the Federal Government and this Congress have 
looked at toxic exposure. No longer should you have the burden 
of proof on your shoulders, but you should have the benefit of 
the doubt, in my opinion. You should be given the benefit of 
the doubt. And we created the toxic exposure fund so that 
funding toxic-exposed veterans would not pit you against other 
veterans. There would not be a Hunger Games played by veterans 
having to compete against one another, and more than that, for 
veterans to not compete with programs that benefit all 
Americans.
    And so you can count on me, and I know that you can count 
on Senator Tester, that we are simply not going to stand for 
any kind of talk about returning to 2022 funding levels, which 
would put the VA and all veterans just in an untenable place. I 
hope that as all of you visit folks on Capitol Hill you let 
them know the true skinny on all of this. So thank you.
    Mr. Parsetich. Thank you for that.
    [Applause.]
    Chairman Tester. Thank you, Ranking Member Takano. I 
appreciate those comments, and I do not usually have you speak 
for me but I like those comments. That is fine. That is good. 
We appreciate it.
    Look, I am going to close this out, and I am going to close 
it out by thanking the DAV. You have got some of the best folks 
on the Hill that you could ever get. These folks are straight 
shooters. They tell us what you need. They do not BS around. 
And I am going to tell you because of the DAV's influence up 
here on the Hill we have been able to get some good things 
done. So all you guys' memberships and gals' memberships out 
there, just know that they are doing really, really, really 
good work representing you in Congress.
    I have been here long enough, both as the Ranking Member, 
Chair, and as a member of this Committee to watch people come 
up and give you lip service and then do things like fist bump 
on the Senate floor or vote against a budget that actually 
funds things like the PACT Act or the Deborah Sampson Act. You 
guys see through that stuff, and you guys pull away all the 
chafe from the wheat and make sure that we are doing our job.
    So what I am saying to you is thank God for the DAV. Thank 
you guys for the work you are doing.
    [Applause.]
    Chairman Tester. Thank you very much.
    Joe Parsetich, Commander Parsetich, you make Montana proud. 
We appreciate you being here. I want to thank you for giving 
the 2023 legislative priorities for the DAV and putting them 
out there very clear and forthright. We appreciate that.
    Look folks, we have got a lot of work to do ahead of us. We 
have got a couple of great Committees here, and I will not 
speak for the House side. We have got a great Committee in the 
Senate, and we are going to work together to make sure we do 
right for the veterans. But we have got a lot of work to do, 
and your input is going to be critically important.
    With that we will keep the record open for a week if you 
have additional comments you would like to put forth, and this 
hearing is now adjourned.
    [Whereupon, at 11:13 a.m., the hearing was adjourned.]

                            A P P E N D I X


                           Prepared Statement

     
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