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


                                                    S. Hrg. 118-140

                    LEGISLATIVE PRESENTATION OF THE
               AMERICAN LEGION AND MULTI VSOs: PVA, SVA,
               IAVA, NASDVA, BVEC, VVA, FRA, NCAI, NGAUS

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

                             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

                               __________

                             MARCH 1, 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
        
                               __________

                                
                    U.S. GOVERNMENT PUBLISHING OFFICE                    
53-729 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
Margaret Wood 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

                              ----------                              

                             March 1, 2023

                                                                   Page

                                SENATORS

Tester, Hon. Jon, Chairman, U.S. Senator from Montana............     1
Hassan, Hon. Margaret Wood, U.S. Senator from New Hampshire......     9
King, Jr., Hon. Angus S., U.S. Senator from Maine................    10
Tillis, Hon. Thom, U.S. Senator from North Carolina..............    13
Sullivan, Hon. Dan, U.S. Senator from Alaska.....................    15
Blumenthal, Hon. Richard, U.S. Senator from Connecticut..........    18
Boozman, Hon. John, U.S. Senator from Arkansas...................    19
Moran, Hon. Jerry, Ranking Member, U.S. Senator from Kansas......    43

                            REPRESENTATIVES

Bost, Hon. Mike, Chairman, U.S. Representative from Illinois.....     2
Miller-Meeks, Hon. Mariannette, U.S. Representative from Iowa....    14
Takano, Hon. Mark, Ranking Member, U.S. Representative from 
  California.....................................................    23
Rosendale, Hon. Matthew, U.S. Representative from Montana........    45
Cherfilus-McCormick, Hon. Sheila, U.S. Representative from 
  Florida........................................................    47
Van Orden, Hon. Derrick, U.S. Representative from Wisconsin......    48
Pappas, Hon. Chris, U.S. Representative from New Hampshire.......    49
Luttrell, Hon. Morgan, U.S. Representative from Texas............    50
Crane, Hon. Elijah, U.S. Representative from Arizona.............    52
Mrvan, Hon. Frank J., U.S. Representative from Indiana...........    53

                   INTRODUCTION OF VINCENT J. TROIOLA

The Honorable Susan Collins, U.S. Senator from the State of Maine     4

                               WITNESSES
                                Panel I

Vincent J. Troiola, National Commander, The American Legion......     5

  accompanied by

  Chanin Nuntavong, National Executive Director

  Lawrence Montreuil, National Legislative Director

  James LaCoursiere, Chairman of the Legislative Commission

  Autrey James, Chairman of the Veterans Affairs and 
    Rehabilitation Commission

  Jay Bowen, Chairman of the Veterans Employment and Education 
    Commission

  Joe Sharpe, Director of Veterans Employment and Education

                                Panel II

Charlie Brown, National President, Paralyzed Veterans of America.    24
Jared Lyon, National President and Chief Executive Officer, 
  Student Veterans of America....................................    26
Jeremy Butler, Chief Executive Officer, Iraq and Afghanistan 
  Veterans of America............................................    28
James S. Hartsell, President, National Association of State 
  Directors of Veterans Affairs..................................    30
Shawn L. Deadwiler, Interim Director, Black Veterans Empowerment 
  Council........................................................    32
Jack McManus, National President, Vietnam Veterans of America....    34
Christopher J. Slawinski, National Executive Director, Fleet 
  Reserve Association............................................    37
Angela Pratt, Co-Chair, Veterans Committee, National Congress of 
  American Indians...............................................    38
Brigadier General J. Roy Robinson (Ret.), President, National 
  Guard Association of the United States.........................    40

                                APPENDIX
                          Prepared Statements

Vincent J. Troiola, National Commander, The American Legion......    59
Charlie Brown, National President, Paralyzed Veterans of America.    94
Jared Lyon, National President and Chief Executive Officer, 
  Student Veterans of America....................................   113
Jeremy Butler, Chief Executive Officer, Iraq and Afghanistan 
  Veterans of America............................................   142
James S. Hartsell, President, National Association of State 
  Directors of Veterans Affairs..................................   149
Shawn L. Deadwiler, Interim Director, Black Veterans Empowerment 
  Council........................................................   167
Jack McManus, National President, Vietnam Veterans of America....   170

  Attachment--Vietnam Veterans of America White Paper on Aging 
    Veterans.....................................................   199

Christopher J. Slawinski, National Executive Director, Fleet 
  Reserve Association............................................   211
Angela Pratt, Co-Chair, Veterans Committee, National Congress of 
  American Indians...............................................   222
Brigadier General J. Roy Robinson (Ret.), President, National 
  Guard Association of the United States.........................   227

  Attachment--NGAUS Zero-Cost TRICARE for the Guard and Reserve, 
    Fiscal Year 2024 Fact Sheet..................................   234

                        Statement for the Record

Opening statement of Hon. Jerry Moran............................   237

 
 LEGISLATIVE PRESENTATION OF THE AMERICAN LEGION AND MULTI VSOs: PVA, 
             SVA, IAVA, NASDVA, BVEC, VVA, FRA, NCAI, NGAUS

                              ----------                              


                        WEDNESDAY, MARCH 1, 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, Brown, Blumenthal, Sinema, Hassan, King, 
Moran, Boozman, Cassidy, Tillis, and Sullivan.

    Also present: Senator Susan Collins.

    Representatives Bost, Rosendale, Miller-Meeks, Van Orden, 
Luttrell, Crane, Kiggans, Takano, Pappas, Mrvan, and Cherfilus-
McCormick.

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

    Chairman Tester. I want to call this hearing to order. I 
want to say good morning to all of you, and I would like to 
welcome the national leadership of the American Legion, the 
members here today, and those that are watching on TV across 
this country, including Montana, and I want to welcome our 
Montanans that are in attendance from Big Sky Country, also 
known as the Last Best Place.
    Commander Troiola thank you for being here today and for 
your advocacy on behalf of our nation's veterans and their 
families. The partnership and support that the American Legion 
provides to veterans and their families is absolutely critical 
to ensure that they are connected to the care, to the benefits, 
and to the services they have earned.
    With your support, Congress passed the PACT Act last year, 
providing an unprecedented expansion of VA care and benefits to 
toxic-exposed servicemembers, veterans, and their families. We 
are now charged with the oversight as VA implements the PACT 
Act, to ensure that the Department has the resources and the 
capacity to deliver the timely care and benefits that veterans 
deserve. This is one of my top priorities for this Congress, 
and I will look to the American Legion for your continued 
advice and support.
    Another priority for this Congress includes ensuring 
combat-injured veterans receive the full DoD and VA benefits 
they have earned through a bill called the Major Richard Star 
Act, and I intend to reintroduce legislation to provide parity 
for our National Guard and Reserve members so that they receive 
the same benefits as those on active duty when performing the 
same work.
    We must also address mental health care and continue our 
work to end veteran suicide nationwide, particularly for our 
Native American veteran population. We need to continue to work 
in a bipartisan, bicameral manner to serve homeless veterans, 
support education and employment programs for veterans, and 
ensure all veterans have timely access to health care.
    For the veterans that are in this room today, and there are 
a bunch of them, I want to thank you for your service, and 
thank you for your work on behalf of your fellow veterans. We 
look forward to hearing from each of you.
    I am now going to turn it over to Chairman Bost for his 
opening statement.

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

    Chairman Bost. Thank you, Chairman. Good morning to all of 
you and thank you for being here. And I want to thank you and 
all of our friends over on this side of the Capitol for hosting 
the hearing here, and also it is an honor to join you, 
Chairman, and we know that our Ranking Members will be along 
shortly. It is kind of a busy day around here, if you have not 
noticed. But we do also want to thank you, Mr. Troiola, as your 
position of the Commander of the American Legion, the National 
Commander, and we thank you for being here.
    You know, my home post is the Paul Stout American Legion 
Post 127 in Murphysboro. I am going to add to some of my script 
here because I want to describe the Paul Stout post. Paul Stout 
was a Marine that fought in Belleau Wood and then was killed in 
the battle over Belleau, which was just a day or so later. And 
he was only 18-years-old, but we all know of him there at our 
post. And about 3 or 4 years ago we had the 100th anniversary 
of the post. Now, with a name like Paul Stout and the local 
brewery we made a Paul Stout beer, so we actually shared a beer 
with Paul Stout. At any rate.
    But before I get to the questions--well, by the way, I did 
pay my dues. I just want you to know that.
    But I also want to welcome the second panel in advance 
because they are probably going to call us out for votes.
    Now I have been attending these VSO hearings now 9 years as 
a member of the Committee, but it is the first time I am doing 
so as Chairman, and it is quite an honor. So let me be the 
first to tell you how much of an honor it is. I could have 
never dreamed, as an enlisted Marine corporal from southern 
Illinois, son of a truck driver, that I would be sitting in a 
seat here as Chairman of this Committee, and fighting for our 
nation's men and women in uniform. And it is the greatest honor 
I have ever had to fight for the men and women who have made 
sure that we have stayed free. And I do not take this 
responsibility lightly.
    But as you all know, it is not about me. It is about you 
and the millions of veterans' voices you represent across the 
country, our brothers and sisters in arms, there who we are 
here for and who we fight for. The men and women of the 
American Legion are the greatest advocates here in D.C. and 
across the country. You know better than anyone else that 
veterans community has earned a system that works for them.
    You know, I am proud of all that we have accomplished 
together this last Congress, including the President signing 
the bipartisan PACT Act into law. Now this legislation means a 
lot to veterans and their families. It was a long time overdue, 
and I was proud to see it land on the President's desk. Now we 
will be focused on how the VA implements the law. You know, so 
many times we see the little cartoon for years about Fraggle 
Rock, how a bill becomes a law. Well, when you see the bill at 
the bottom of the step and it is all done in a bill, it is not 
done yet. It is only done whenever it is done correctly, and in 
this case that bill has to be done correctly. We need all of 
you to let us know what is happening out in the field when it 
comes time for toxic-exposed veterans care and claims 
decisions. Boots on the ground testimonies are vitally 
important for our oversight of the PACT Act.
    We have also made great progress to expand mental health 
options through the Fox Grant Program and the STRONG Act to 
support veterans and their families. We want to continue to see 
a decline in veteran homelessness. We want to work to achieve 
that.
    However, it is not finished yet, and so we still have a lot 
of work to do: struggling with the stigma around mental health 
and not sure where to turn, getting health care in facilities 
that were designed for a population in medical practices of 50 
years ago, fighting the VA bureaucracy and access to health 
care when and where it is needed, having their Second Amendment 
and due process rights taken away if they need help managing 
their benefits--which is an issue of mine that I am going to be 
working on and I hope you will join me--waiting on holding and 
jumping through the hoops in order to get simple questions 
answered, and reeling from the impacts of the EHR system, which 
we have to get straightened out.
    This might seem like small things but when it comes down to 
it they impact our veterans every day in their lives, and I am 
focused on making sure that we have smart investments to bring 
the VA into the 21st century, and I have said several times, 
even if they are kicking and screaming while we are dragging 
them there.
    And I want to make sure that the Department's budget always 
reflects the size of the mission and that taxpayer dollars are 
wisely spent. Only then will our veterans get the good care and 
services they have earned. And I look forward to doing this and 
accomplishing this goal alongside of you.
    And with that I want to thank you all for being here, and I 
yield back. Thank you, Mr. Chairman.
    Chairman Tester. Thank you, Chairman Bost. Normally I do 
not do this but I have got to ask you a question. They made 
Paul Stout beer?
    Chairman Bost. Yes.
    Chairman Tester. And was it a stout beer?
    Chairman Bost. It was a stout beer.
    Chairman Tester. All right.
    Chairman Bost. And it was a very good beer.
    Chairman Tester. That is very good stuff. All right.
    Normally we would have Ranking Member Moran and Ranking 
Member Takano speak next, but since they are not here we are 
going to turn it over to a dear friend of mine, somebody that I 
work with, in fact every day, multiple times. The biggest 
project is funding our defense, and is somebody that Maine is 
lucky to have, Senator Collins.

               INTRODUCTION BY HON. SUSAN COLLINS

    Senator Collins. Thank you very much, Senator Tester, for 
those kind words. Mr. Chairman, Mr. Chairman, and members of 
this distinguished Committee, first let me commend you for 
holding this series of joint meetings of the House and Senate 
Veterans' Affairs Committee. It will help ensure that the men 
and women who defend our freedoms receive the care and benefits 
that they have earned through their service. Our debt to our 
veterans is enormous, and it can never be fully repaid.
    Veteran service organizations play a key role in our 
efforts to meet that obligation. Today I am honored to 
introduce Vincent J. ``Jim'' Troiola, a fellow Mainer and the 
National Commander of the American Legion, our nation's largest 
organization of wartime veterans. Needless to say, we in Maine 
are very proud that Jim has been elected as the National 
Commander of the Legion.
    Born in Jamaica, New York, Commander Troiola has served our 
nation and its veterans honorably for more than a half century. 
He enlisted in the United States Navy in 1969, during the 
Vietnam War, served aboard the USS Nitro, an auxiliary 
ammunition ship in the Sixth Fleet, and then went on to the 
Naval Reserves where he remained until he was honorably 
discharged as a third class petty officer in 1974.
    Back in civilian life, Commander Troiola first got involved 
in veterans organizations through the Sons of the American 
Legion based on his father's service during World War II. In 
1993, he joined the American Legion post in New City, New York, 
and helped lead the citizenship, patriotism, and service 
projects that defined the Legion in communities across the 
country.
    The Commander took on greater responsibilities at the local 
and state levels, and in 2016, he was elected National Vice 
Commander. That same year, he and his wife had the wisdom to 
move to Windham, Maine.
    Upon his selection as National Commander last September, 
Commander Troiola embarked upon a challenging schedule--we 
think we have challenging schedules--of 330 days on the road 
during his first year in office, that will take him to Legion 
posts in all 50 states and overseas. And I am delighted that 
his travels last fall included posts in Aroostook County, 
Maine. That includes Post 15 in my hometown of Caribou, where I 
am a member of the Auxiliary based on my father's service in 
World War II.
    A special focus of Commander Troiola's tenure is the 
American Legion's ``Be the One'' campaign to end veteran 
suicide. Be the One encourages family members, veteran 
servicemembers and others to take action when they believe a 
veteran is at risk of suicide. The goal is to destigmatize 
asking for mental health support, provide peer-to-peer 
resources, and educate everyone on how they can be the one to 
reach out to a veteran in distress.
    I have had the opportunity to meet with the Commander 
several times over the years to discuss a wide range of veteran 
issues. I am certain the Committee members will find him to be 
an informed, insightful, and totally dedicated individual.
    It is a great pleasure that I introduce the American Legion 
National Commander, Jim Troiola. Thank you.
    [Applause.]
    Mr. Troiola. Thank you.
    Chairman Tester. Thank you, Senator Collins. Commander 
Troiola, I will now turn it over to you to introduce your team 
and for you to make your opening statement. And Senator 
Collins, if you wish to stay you are more than welcome. If you 
need to leave, you are excused.

                               PANEL I

                              ----------                              


                STATEMENT OF VINCENT J. TROIOLA

                ACCOMPANIED BY CHANIN NUNTAVONG,

             LAWRENCE MONTREUIL, JAMES LACOURSIERE,

            AUTREY JAMES, JAY BOWEN; AND JOE SHARPE

    Mr. Troiola. I would like to begin by introducing the 
following representatives of our more than 3 million American 
Legion family members. Please stand and be recognized.
    National officers serving with me this year.
    Past national commanders.
    [Applause.]
    Mr. Troiola. Vicki Koutz, President of the American Legion 
Auxiliary.
    [Applause.]
    Mr. Troiola. And Chris Carlton, National Commander of the 
Sons of the American Legion.
    [Applause.]
    Mr. Troiola. Chairman Tester, Ranking Member Moran, 
Chairman Bost, and Ranking Member Takano, it is my honor and 
privilege to share with you and your Committee's the American 
Legion top priorities for the first session of the 118th 
Congress. I am sure you will agree that our next steps are 
critical because last August we made history together. The 
Sergeant First Class Heath Robinson Honoring Our Promise to 
Address Comprehensive Toxics Act became law, the PACT Act. That 
is no ordinary acronym. It is a long-awaited message of 
accountability to veterans who served and suffered military-
connect illnesses, diseases, disabilities, and even death from 
toxic exposure.
    It is also a message to their families, many of whom face 
immense challenges as caregivers or heartbreaking loss as 
survivors due to a loved one's exposure to burn pits, Agent 
Orange, bad water, atomic radiation, or other poisons.
    And it is an important message to young people thinking 
about joining the U.S. Armed Forces. Our nation's ability to 
attract a new generation of protectors, defenders, and 
liberators is ever more dependent on the government's 
willingness, or perception of that willingness, to support them 
when they come home changed.
    A young person who receives military service only through 
the lens of a frustrated veteran who has been rejected, denied, 
or left behind is not likely to enlist. In that way, our work 
to help veterans after service is truly a matter of national 
security.
    Now that the PACT Act has passed to help those who have 
been sickened by toxic contamination, and in memory of those we 
have lost, like Sergeant First Class Heath Robinson himself, we 
must fulfill the bill's deeper pledge to honor our promises. 
The 117th Congress made a commitment that 118th Congress now 
must fulfill, to ensure that the PACT Act's provisions are 
fully implemented, funds are sufficiently allocated, and 
staffing keeps up with the need.
    VA estimates that a backlog of more than 450,000 disability 
claims will be reached by October of this year. Under the PACT 
Act, more than 20 diseases and conditions are newly presumed as 
service-connected. These include over a dozen cancers. VA 
medical facilities are certain to be stretched to capacity and 
hopefully not beyond in the years ahead.
    Recruitment and retention of VA care providers--doctors, 
nurses, specialists and others--has been high in the Legion's 
priority list for many years. Given the demand VA can expect in 
2023, that priority is more critical than ever.
    The same applies to Veterans Benefits Administration. As 
these new claims roll in, we call for regular, accurate, and 
transparent reporting of how the process is working, who is 
getting approved or denied, and the time it takes to receive a 
decision.
    These concerns were not pulled out of thin air. Some in 
Congress may remember the Veterans Health Care Eligibility 
Reform Act of 1996, which the American Legion strongly 
supported. The bill greatly expanded VA health care eligibility 
for honorably discharged veterans. VA aggressively marketed its 
service to unenrolled veterans. They poured into the system. 
Within 5 years, however, VA was overrun.
    But history must not repeat itself with a new generation of 
veterans entering the system for the care they earned and 
deserve. It is our belief that VA has the requisite tools, 
granted to them by Congress in the PACT Act, to meet the needs 
of those they are committed to serving. We urge the members of 
these Committees to continue to fund and provide the necessary 
oversight as VA implements this historic piece of legislation. 
To put it simply, promises must be kept.
    Pact, promise, and honor are terms we also urgently apply 
to the epidemic of veteran suicide. The American Legion's Be 
the One initiative, which raises awareness nationally about the 
problems and seeks to destigmatize asking for help, is our 
organization's highest priority today. To us, suicide 
prevention is a pact we share with our friends and comrades of 
military service, a promise from each of us in the American 
Legion to be the one to save at least one other veteran from 
suicide.
    President Biden acknowledged the importance of veteran-to-
veteran peer support in this mission. We in the American Legion 
are those veterans, those peers, and we look to Congress and VA 
to make full partners of us as measures are taken to strengthen 
VA mental health services and suicide prevention programs.
    We look forward to working with VA on a new national Buddy 
Check Week and to building on the proven success of peer-to-
peer health of our at-risk veterans. We ask Congress to support 
the funding and staffing requests necessary for VA to 
strengthen its role and help us save lives. We all view this 
kind of support for veterans as a promise to fulfill.
    In addition to the men and women now finally getting the 
attention they need for conditions related to toxic exposure, 
our pact with those who have served must extend to men and 
woman facing post-traumatic stress disorder, traumatic brain 
injury, or the effects of military sexual trauma; caregivers 
whose lives are permanently changed by the effects of military 
service; veterans and military families in transition who can 
strengthen our economy and themselves by accelerated programs 
to convert military training hours into credits for specialized 
civilian careers.
    Our pact extends to Coast Guard personnel who serve in the 
only military branch that forfeits pay in the event of a 
government shutdown; National Guard and reserve personnel and 
veterans who have earned and deserve a more level GI Bill 
playing field; military retirees who are wrongly taxed out of 
their pensions because they sustained a service-connected 
disability. And that is why we support reintroduction and 
passage of the Major Richard Star Act.
    And veterans who are preyed upon by companies that charge 
high fees for claims, assistance that the American Legion and 
others provide free of charge; or unscrupulous law firms that 
fleece veterans out of Camp Lejeune Justice Act settlement 
damages through uncapped legal fees.
    And as we examine our promises, we cannot break faith with 
our Afghan allies in the global war on terrorism. They put 
their lives and the lives of their families on the line for us, 
and they continue to do so. Bureaucratic delays in their 
ability to obtain special immigration visas and clear pathways 
to U.S. citizenship are clearly the definition of broken 
promises, and again, a serious matter of national security.
    Members of these distinguished Committees, let us make a 
pact of our own to honor the promises we have made and still 
need to make on behalf of all who have pledged, risked, and 
given their lives for our freedoms.
    Chairman Bost, Chairman Tester, and members of the 
Committees on Veterans' Affairs, on behalf of the American 
Legion I thank you for giving the nation's largest veteran 
service organization the opportunity to share our priorities. I 
welcome any questions you have for me, our commission chairman, 
or national staff.
    And if you will allow me to introduce one person I missed, 
because otherwise I will be in the doghouse for a year, my 
wife, Saveria Troiola, behind me.
    [Applause.]

    [The prepared statement of Mr. Troiola appears on page 59 
of the Appendix.]

    Chairman Tester. Smart move.
    [Laughter.]
    Chairman Tester. So I appreciate your comments. Thank you 
very much. And message delivered and message heard. Thank you.
    Can you tell me, in your assessment, how the VA is 
performing under its current leadership?
    Mr. Troiola. Mr. Chairman, we have, we believe, an 
excellent relationship with VA. We have an excellent 
relationship with the Secretary of the VA. As a matter of fact, 
the Executive Director, Chanin, next to me works with the 
Secretary on a daily basis, and I am going to defer to him to 
speak about this further.
    Mr. Nuntavong. Mr. Chairman, thank you for that question. 
We have a great relationship with the Secretary and the Under 
Secretaries at VA. They respond to every concern or question we 
have. They embrace us as partners, and I would like to say that 
we work together well in helping, as the Secretary says, fight 
like hell for veterans. So I think the partnership is great, 
and they are doing a great job.
    Chairman Tester. Thank you. I appreciate your Be the One 
campaign. I think you hit the nail on the head. This is a huge 
issue amongst our population, particularly our veteran 
population, and I appreciate the work that you do.
    Last Congress we passed a bill called the STRONG Veterans 
Act. It was passed in the Omnibus Appropriations Bill. It adds 
staff to vet centers. It allows for VA training of the 
employees. It has outreach to Native American vets. It adds VA 
scholarships to mental health providers. It is a big bill.
    But my question is, and it just got passed very recently, 
have you been able to use it or do you intend to use it, and is 
it going to be useful in your Be the One campaign?
    Mr. Troiola. Thank you for that question. I am going to 
defer to our VA&R Chairman, Autrey James.
    Mr. James. Good morning, Senator, and thank you for that 
question. I do want to let you know that the intent of the 
American Legion is absolutely to use the STRONG Act. That Act 
itself helps us to make sure that we are making sure that we 
are reaching those veterans in rural areas and ultra-rural 
areas. The idea that we can also ensure that we are getting the 
ability to bring in individuals from local schools, such as 
HBCUs, and other organizations makes it a phenomenal piece of 
legislation that will only strengthen the VA going forward.
    Chairman Tester. Thank you. Thanks to feedback from 
veterans, caregivers, and VSOs, the VA is doing a comprehensive 
review of eligibility requirements for caregivers. It is a big 
issue. VA has also suspended annual reassessments of veterans 
and guaranteed legacy participants could remain in the program 
until 2025.
    From the American Legion standpoint, what recommendations 
would you have for the VA to ensure that the eligibility 
requirements for the caregivers program can work, that they are 
fair?
    Mr. Troiola. I am going to defer again to the VA&R Chairman 
for his remarks.
    Chairman Tester. Perfect.
    Mr. James. Thank you. One of the things that we want to 
make sure of in terms of the caregivers is that the Congress 
and VA ensure that family caregivers are provided better access 
to mental health support. We know that that is a problem with 
our caregivers, particularly when they are taking care of 
veterans with mental health and substance abuse issues. So that 
is one area.
    But we know that oversight is always key in making sure 
that we are meeting the needs of those caregivers. We 
understand that in 2025 there may be some issues on the horizon 
in terms of where VA is currently and where they have to get in 
2025. But we are confident that we can make sure that our 
veterans are going to be taken care of as well as their 
caregivers.
    Chairman Tester. Thank you. Senator Hassan.

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

    Senator Hassan. Well thank you, Mr. Chair, and to you and 
your House Chair and Ranking Members, thank you. More 
importantly, thank you to the veterans here today for your 
service and thank you to your family members as well.
    Mr. Troiola, I want to just touch base with you on the 
importance of peer-to-peer support. As you noted in your 
testimony, peer support programs encourage veterans to reach 
out and connect with one another proactively, which improves 
veterans' mental health and helps prevent suicide.
    The American Legion recognized the importance of these 
programs when it created the Buddy Check Program in 2019. I was 
pleased to help expand this effort through the passage into law 
of the bipartisan Buddy Check Week Act, which calls on the VA 
to support and grow the program.
    Why are peer-to-peer support programs so effective at 
supporting veterans' mental health and what more can Congress 
do to support these programs?
    Mr. Troiola. Well, thank you very much, Senator, for your 
sponsorship of the Buddy Check Week Act. That is very important 
to us.
    The importance of the Buddy Check is that we have veterans 
speaking to other veterans, and I think the camaraderie between 
the two goes a long way, and I think the veterans that are in 
need will hopefully be able to destigmatize them by developing 
trust and relationships with them, and that is easy to do with 
a veteran talking to a veteran.
    Senator Hassan. And we have seen the effectiveness of that, 
right?
    Mr. Troiola. Yes, we have.
    Senator Hassan. I mean, direct evidence that it works, 
right?
    As you noted in your testimony, the average of a VA medical 
facility is approaching 60 years, which limits the ability of 
VA health care to keep up with new technology and respond to 
shifts in veteran demographics. For example, the VA medical 
center in Manchester, New Hampshire, is 73 years old, and has 
had numerous maintenance failures over the past few years, 
including three separate water pipe breaks that resulted in 
canceled appointments for veterans.
    I have called on the Secretary of the VA to prioritize 
long-term solutions for these problems. Can you expand on your 
testimony and discuss why upgrading VA infrastructure is 
important for our veterans to get the health care that they 
need and have earned and deserve?
    Mr. Troiola. One thing that I have seen is that 31 new 
CBOCs were just authorized, so that is a great thing.
    Senator Hassan. Yes.
    Mr. Troiola. And I do know there are some in Maine, and 
Togus is under construction right now with specialty care 
facility being added on. That is a big plus.
    But for further detail I am going to pass it on to our VA&R 
Chairman, Autrey James.
    Senator Hassan. Thank you.
    Mr. James. Yes, Senator, with the issue with respect to 
modernization of the VA in general, we believe that, first, 
yes, new facilities do need to be brought online. We need to 
make sure that those facilities are in the areas where our 
veterans are, where the majority of our veterans are. But we do 
not necessarily believe that the older facilities should just 
be torn down.
    In my state of California, for instance, local hospitals, 
what they did was first they built a new hospital, downsized 
the old hospital and used that for clinical issues, not acute 
care like a hospital might take care of. And I think that is 
one way that the modernization of the VA could be helped.
    Senator Hassan. Well thank you. Focus continues to need to 
be on making sure that the facilities are there for our 
veterans when they need them. Thank you. Thank you, Mr. Chair.
    Chairman Tester. Thank you, Senator Hassan. Now you get hit 
by another Mainer, who is also a really good guy, Senator King.

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

    Senator King. Well, I have already learned something today 
from Commander Troiola, which I think I am going to adopt. When 
a tough question comes you just refer it to somebody down the 
road.
    [Laughter.]
    Mr. Troiola. That is what delegation is about.
    Senator King. Yes. Yes. My leadership motto is ``Hire good 
people and take credit for what they do,'' so I think it is 
working for you.
    The other thing I want to say, you should know this because 
I sat in that chair in the Senate last year. The PACT Act would 
not have passed but for Jon Tester.
    [Applause.]
    Senator King. He was absolutely dogged, both on the floor 
of the U.S. Senate but also person-to-person in the Senate to 
make sure that happened. As you recall, there were some slips 
along the way. It was not easy. And I think you should know 
that that was a serious commitment.
    Two questions. One is, there has been talk about the word 
``buddy.'' One of my principal concerns is the transition from 
active duty to veteran status, and that people talk about a 
warm handoff. One of the ideas my veterans are talking about is 
a buddy system where when someone is leaving active duty a 
notification goes out to the state veterans organization and 
that can then go out to the VSOs. I want somebody to meet that 
veteran at the airport and say, ``Welcome home. We are glad you 
are here.''
    [Applause.]
    Senator King. And I see that--this is not a big, expensive 
new program. I see that as a partnership between the Legion, 
the VFW, the VSOs generally, to work out the logistics of being 
sure somebody is there to meet that person, who is 
knowledgeable about benefits.
    Is that an idea that appeals to you?
    Mr. Troiola. Yes, it does. You know, we do have American 
Legion posts all over the nation that meet active-duty 
servicemembers that are being discharged, at the airports, and 
we hold events for them in the posts, or we have some sort of a 
get-together at the base where they come in.
    But for further detail I am going to pass this over to our 
Veterans Employment and Education Chairman, Jay Bowen. I am 
pretty good at delegation, so there he is.
    Senator King. You are good.
    Mr. Bowen. Thank you, Commander, and thank you, Senator, 
for the question. That brings up a very interesting idea, and 
you should know that we have already starting having those 
discussions around the country with posts. And what we want to 
do is enter into a sponsorship program, and instead of calling 
them buddies they would be that new veteran sponsor when he or 
she first comes home, and helps them get oriented to the 
neighborhood and the community.
    Senator King. Well, I would like you to communicate with us 
what we need to do to make that happen, and it may just be 
poking the VA. It may be some legislation. I do not know. But 
please reach out to Senator Tester, to the Committee, because I 
think this is something where we can make a real difference.
    I am out of time but I just want to suggest one other issue 
that I think we all need to be thinking about, and that is 
long-term care. There is a wave of retirements coming and 
eligibility for long-term care, and as you know it is not 
directly part of the system, but I think it is something we 
need to think seriously about. And again, I will ask you to 
supply us with your thoughts and how we might be able to work 
on that because I would rather deal with it now rather than 10 
years from now, when it is upon us and it is a crisis.
    Thank you all for being here, and thank you for your 
service to the United States.
    Mr. Troiola. Thank you.
    Chairman Tester. Thank you, Senator King. And I was just 
going to say, if you want another 3 minutes after that first 
comment you can have at it. It is fine.
    Look, folks are going to come back, in the House, and 
particularly----
    Senator King. I do have a follow-up.
    Chairman Tester. Sure. Go ahead.
    Senator King. The other issue I am concerned about, and I 
would like your response, is VA staffing. If there is nobody to 
answer the phone that is just not going to work for the 
veteran. Do you have thoughts about that? We just reported out 
the CAREERS Act last week, and I think that is going to help. 
But give me some thoughts on VA staffing and what we can do to 
improve it.
    Mr. Troiola. I am glad you brought that up because I had a 
discussion about this just yesterday. We believe that VA needs 
to come up with some sort of incentives to increase their 
staffing. You know, they have issues with physicians and I 
guess there is a salary cap in there somewhere. But there has 
got to be some sort of an incentive, whether it is the commute 
to the amount of days they work or whatever it is. But this has 
to be solved.
    You know, I travel all over the country, and I visit VA 
hospitals. I visited about eight of them already. And we have 
found out that there is a severe shortage of mental health 
therapists. And it is a real problem because what is going, 
especially with this PACT Act coming on, we are going to be in 
real trouble if we do not solve this problem soon.
    Senator King. Well, and you mentioned there is a salary 
cap, and it makes recruiting physicians noncompetitively, 
basically, with the private sector.
    Mr. Troiola. Yes.
    Senator King. I just learned the salary cap is the 
President's salary. Nobody in the Federal Government can make 
more than the President. When I was Governor of Maine there 
were about 200 people in state government that made more than I 
did, so I think we could live with moving that cap a little 
bit.
    Mr. Troiola. We would like to work together with you to see 
if we could come up with some sort of way to incentivize or fix 
this problem because I think it is only going to get worse 
before it gets better as we have an influx of more veterans 
going in for health care.
    Senator King. Let me ask a detailed question, and this came 
from a veteran in my community who has gone through a PTSD 
program. His suggestion, though, is there ought to be a follow-
up of like a group, like an AA, or somebody to meet with after 
going through the treatment process. Do you have someone here 
who can talk to me about that, because dealing with PTSD, as 
you know, has been a major challenge. The VA is getting better 
at it. But this suggestion is to take it one step further, and 
again, it is not a big, expensive program, but to have some 
follow-up so it does not just end the day you walk out of the 
treatment program.
    Mr. Troiola. I am going to defer to VA and Rehabilitation 
Chairman, Autrey James.
    Mr. James. Thank you, Senator. With respect to additional 
follow-up, one of the best benefits that we have right now 
within the VA system is our vet centers. Now an idea that one 
may have is that perhaps we can open those vet centers up to 
others other than those combat veterans.
    I think that the vet centers and the care that they take 
upon our combat veterans can also be used to ensure that those 
who are suffering from PTSD, triggered by other areas, will be 
extremely beneficial. So I think the American Legion would love 
to see that happen.
    Senator King. Good. Thank you very much.
    I see that our other members have joined us so I will hand 
back the to the Chair. Thank you, Mr. Chairman.
    Chairman Tester. Senator Tillis.

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

    Senator Tillis. Thank you, Mr. Chairman. Thank you all for 
being here. I do not know if any of my other members have asked 
this question but we always like to be proud of folks that come 
from our state or may have been stationed in our state. By a 
show of hands, how many have you all been blessed to be in 
North Carolina for a period of time?
    [Show of hands.]
    Senator Tillis. That is what I am talking about. Thank you 
all for your service.
    Yes, I want to be brief. I am in a Judiciary Committee 
hearing with the Attorney General, but I was waiting to see 
when I could come down and speak with you all. First, thank you 
for your service past and your willingness to continue to 
serve.
    I think in this Congress, after months of working on the 
Camp Lejeune Toxics Act and the TEAM Act, I found myself in the 
difficult position of having to vote against the PACT Act. It 
was not because I did not support the underlying policy. It is 
because I think we need to make sure that we fulfill the 
promise. We are seeing an increase in wait list, wait times. We 
are seeing hundreds of positions that were not filled before we 
made a new promise, and now we have got to make sure that we do 
everything we can to support the VA. I know the Chair agrees 
with this, but we are going to need your help in identifying 
the priorities for things that we can do first.
    I was not against the PACT Act, the legislation. I was 
concerned with the implementation and a number of other things 
that now it is on us to make sure that we fulfill.
    I am also a bit curious. The Camp Lejeune Toxics Act was 
very important. It is something that our office originated here 
on the Senate side, working with our colleagues in the House. 
But I do not like those damn ads.
    [Applause.]
    Senator Tillis. And the reason I do not like them is I go 
back in my mind and think, if you are spending this much money, 
several times in a 30-minute cycle, that is money that is not 
going to the veteran. And now there has been recent reports. I 
believe Bloomberg is doing research on this now, to where some 
of these law firms are being predators. I mean, they are 
charging over 50 percent for benefits that I want to get into 
the pockets of veterans who deserve it.
    So we need to have a serious discussion about how we can 
cap legal fees, how we can make sure--and we also have to make 
sure, through all of your organizations, that folks know the 
first call you make should not be to a lawyer. They are trying 
to make it look like they are the only way you can get your 
benefits. We worked on that bill to provide pathways that do 
not include a lawyer's fee. And we also know that you all play 
an important role in helping avoid those legal fees. I also 
think that the Members of Congress can play a role. So anybody 
in North Carolina, who may see that ad, the first number they 
should call, if it is not a veteran service organization, 
should be my office, because we want to do everything we can to 
take the predators out of this loop. There are some good ones, 
but I see a lot of bad ones, and we need your help to work on 
it.
    But thank you all for your service. I know that the work is 
hard, but I think you know that we have got a bipartisan group 
here in Veterans' Affairs a bicameral group that understands we 
have got several installments on a debt we will never fully 
repay.
    Thank you all for your service.
    [Applause.]
    Chairman Tester. Thank you, Senator. It helps when fully 
one-third of the crowd is from North Carolina, you know.
    Representative Miller-Meeks.

                 HON. MARIANNETTE MILLER-MEEKS,
                 U.S. REPRESENTATIVE FROM IOWA

    Ms. Miller-Meeks. Thank you, Mr. Chair, and thank you, 
Senator Tillis. My husband's family is from North Carolina. 
They were in the Marines. The rest of us were Army and Air 
Force, and I am a 24-year vet myself, and thank you for all 
your efforts. My family is from the Camp Lejeune area, on my 
husband's side.
    The House has been called for votes so I am going to be 
brief. Commander Troiola, can you go into more detail about the 
American Legion's efforts to destigmatize asking for mental 
health support? In Iowa we have a buddy system that works very 
well, and specifically I would like to hear about your peer-to-
peer support efforts through your Be the One program and 
educational outreach.
    Mr. Troiola. Thank you, and thank you for your service. I 
preach all over the country about Be the One so I am pretty 
good on this subject. The destigmatize part of it, you know, we 
want to make sure that a veteran or somebody from our Legion 
post or a member of the Legion or even a community member 
starts a discussion with a veteran in need, and we want to make 
sure that we destigmatize that veteran to the point where we 
can develop a trusting relationship between that veteran and 
us. And as soon as we do that, we feel that not only will that 
start a trusting relationship, but what I ask is that the 
person that is starting the conversation stays with that 
veteran until they start getting their treatments and even 
along the road, so that veteran can call them and get advice if 
they want.
    You know, veterans that do not want to step forward have a 
lot of obstacles in their minds about losing security 
clearances, their families, their children, their jobs, 
whatever it is, and that is a very important part of it. But 
the other part of it is what we do is once we get that veteran 
to step forward, in the Legion posts what we are doing is we 
are setting up resources within the community where that Legion 
post is, so that when that veteran comes forward and they want 
help we can get them immediate help.
    You know, a lot of times, and we talked about this earlier 
today, is about you call the VA and you may have a wait time, 
but maybe somebody in that local community can get help for 
that veteran.
    So they identify all the resources that they have, they 
invite the veteran's family into the post, because sometimes 
even that veteran may still be a little croaky about telling us 
what is going on, and maybe a family member may say something 
that will identify a problem.
    Ms. Miller-Meeks. Thank you so much, and as a fellow 
veteran from a family of veterans I thank you for that, and 
thank the American Legion for all the work it has done in this 
effort. Thank you. I yield back.
    Chairman Tester. Thank you, Representative.
    Before I get to Senator Sullivan I just want to tell you, 
Senator Sullivan, before this hearing started I met a guy that 
is a dead ringer for you. I did not catch his name. Right 
there. That is you, man. He said that you used to work for him.
    Senator Sullivan. Is that General Hartsell?
    Chairman Tester. Yes, it is.
    Senator Sullivan. I thought you were talking about Senator 
Tillis.
    Chairman Tester. No. This guy really does look like you. 
Tillis is just, you know----
    Senator Sullivan. Are you calling on me now, Chairman?
    [Laughter.]
    Chairman Tester. I am.
    Senator Sullivan. All right. Okay. I hope I get extra time 
for that little exchange.

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

    Well, thank you, Mr. Chairman, and I want to thank all the 
veterans here today. I love this hearing. It is so great that 
you guys are back in town. I do not know about you but I had a 
serious case of Zoom fatigue over the last 3 years, so it is 
just great. When you are walking the halls of Congress, there 
is nothing more important. And it is giant honor for me to 
serve on this Committee, representing the state which has more 
veterans per capita than any state in the country. Mr. 
Chairman, that might be the first time you have heard that, the 
great state of Alaska. That is a joke between us because I say 
that in every damn hearing for the last 8 years.
    So if you are from Alaska can you please stand. There we 
go. How about a round of applause for my fellow Alaskans.
    [Applause.]
    Senator Sullivan. And I know General Hartsell is here, so 
great to see you, sir.
    I want to begin by focusing on an issue that we really need 
to solve here soon. It has been the fault of the Congress, and 
I am hoping that this hearing and all of your meetings with 
different members of the Senate and the House can really make a 
strong advocacy of this, and it is the Camp Lejeune Vets Act. 
And I am very honored, Commander Troiola, that you emphasized 
this in your opening remarks.
    But for those who do not know what this is about, all you 
have got to do is turn on the TV. It is really disgusting, in 
my view. You have got the Trial Lawyers of America who are 
working to rip off the veterans and families of sick Marines. 
It is a choice. My bill is a choice between taking care of sick 
Marines and their families or enriching trial lawyers. I think 
the answer of every single one of you is what should we be 
doing? Taking care of the Marines and their families. Okay?
    [Applause.]
    Senator Sullivan. I am going to be a little political here. 
My colleagues on the other side of the aisle sometimes listen 
to trial lawyers too much. Not this goddamn time, all right? 
Not this goddamn time.
    [Applause.]
    Senator Sullivan. I am serious about this. We have had a 
hearing. There has been over $1 billion of advertising. You see 
it. It is still happening. No caps right now on contingency 
fees. There are some of these groups that are going to try and 
rip off people. It is simple. We need to put caps on the fees 
that lawyers are going to get on this Camp Lejeune issue, for 
the sick Marines from Camp Lejeune. It is simple. And I am so 
honored that the American Legion has endorsed this.
    Commander, do you want to speak to this? I know you put it 
in your testimony, and I really appreciate you doing that. But 
just how important it is. I know it is your top one or two 
priorities for the entire Legion. But enough. Enough. Let us 
pass this unanimous consent, Mr. Chairman. This is not hard. 
Not hard. I go down and I try to do unanimous consent. 
Unfortunately, I get some of my colleagues on the other side of 
the aisle who block me. It is baloney. Commander?
    Mr. Troiola. Senator, thank you. We share your concerns 
deeply. It is a disgusting thing every time you turn the TV on. 
But I am going to defer to Lawrence Montreuil. He is our 
Legislative Director in Washington, and he is going to speak to 
you in detail.
    Mr. Montreuil. Thank you, sir. We really appreciate your 
leadership on this issue, and I think we are all well aware of 
the billions of dollars that have been spent on advertising.
    Senator Tillis. By the way, do you think they are spending 
billions to take care of the Marine families?
    Mr. Montreuil. No.
    Senator Tillis. Hell no.
    Mr. Montreuil. Senator Tillis has highlighted as well, and 
when we look at other pieces of legislation that govern 
lawsuits, whether it is accredited representatives representing 
individuals before BVA, they are capped. Lawsuits under the 
FTCA are capped. And we are just asking for the same thing, to 
protect our veterans who have already suffered undue harm. We 
want to make sure they can secure access to legal 
representation, not taken advantage of.
    So we appreciate it and we definitely support it.
    Senator Sullivan. By the way, the Biden administration 
Justice Department agreed with us. Your point is exactly right 
that pretty much all other legislation that has these kind of 
recovery things, you cap the litigation fees. We are hearing 
stories of 60 percent contingency fees. I mean, that is 
criminal. That is stealing. And by the way, these lawsuits are 
not even that difficult because the government does not have 
defenses. If you move it and prove it, it is not like going 
through big discovery.
    This is an abomination of the legal justice system, and I 
have never seen an issue that calls out for more justice. And I 
really hope my colleagues on this Committee--because you know 
who you are--who have been blocking it, because you are putting 
the interest of trial lawyers before the interests of Marines 
and their families. It is disgusting. And I hope you guys raise 
it in every single one of your meetings.
    [Applause.]
    Senator Sullivan. Tell you what. I am going to try and UC 
this. That means unanimous consent. I go down on the Senate 
floor and I try and pass my bill. Then one of my Democratic 
colleagues usually blocks it. Always blocks it. I am going to 
do it again, soon, and I am going to do it on the basis of your 
power and influence, and I am going to say, ``I spoke in front 
of our veterans. They went to all your offices. They all 
support it. It is one of the top priorities.'' The Biden 
administration, for God's sake, supports it. The Secretary of 
the VA was just in Alaska. I hosted him last week, in my great 
state. He supports it. There is no reason that when I 
unanimously consent this next week that anyone should block it, 
and if they block it--Mr. Chairman, you should come down on the 
floor with me and help me move it. Are you going to do that, 
sir?
    Chairman Tester. Uh----
    Senator Sullivan. How about getting the Chairman to come 
and do unanimous consent with me?
    [Laughter and applause.]
    Chairman Tester. Senator Sullivan----
    Senator Sullivan. You are the Chairman of the Committee. 
Take care of our veterans, sir. Come on.
    Chairman Tester. Senator Sullivan----
    Senator Sullivan. You know this is a big issue.
    Chairman Tester. Senator Sullivan, it is a big issue, and 
we need to have access to lawyers. Do I think we need to have 
caps? Yes, we do have to have caps. But they have to be caps 
that allow a veteran to be able to have legal representation if 
they need it.
    And that is the rub. There are people that are working in a 
bipartisan way to get a solution for this, because you are 
right. It is not what we want to have happening to the money 
that we have appropriated, not to go into lining the pockets of 
lawyers, but to line the pockets of the people who sacrificed 
for this country.
    And we do not need to have a debate on this in front of 
this. We are here to hear from the Legion, and we appreciate 
it. And the other question I would just say is, you have used 
more time than King did.
    [Laughter.]
    Senator Sullivan. Well, I thought given the intro that we 
did that you agreed to give me a few additional minutes. So I 
apologize for going over my time limit. Thank you, Mr. 
Chairman.
    Senator King. I have got to say, Mr. Chairman, this is the 
first time I have ever heard him say anything nice about the 
Biden administration.
    [Laughter.]
    Senator Sullivan. That is true.
    Chairman Tester. It is good, but we do need to get----
    Senator Sullivan. All right. I will yield back. Thanks 
again to all my fellow veterans here. It is great to see you. 
Thanks for your great advocacy. And we are going to get this 
done. We are going to get this done. We have got to get this 
done. Thank you.
    Chairman Tester. Thank you, Senator Sullivan.
    [Applause.]
    Chairman Tester. Senator Blumenthal.

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

    Senator Blumenthal. Thank you, Mr. Chairman. Everybody from 
Connecticut, please stand. I am Richard Blumenthal from 
Connecticut. Thank you, fellow members of the American Legion. 
Thank you all for being here today.
    I am proud to be the principal author and sponsor and 
leader on that Camp Lejeune legislation that provides for those 
Marines, and their families, who have been disgustingly the 
victims of contamination, and I want to thank the American 
Legion for being here today and for your support on that 
measure, on the PACT Act, which provides care and benefits for 
all of our military men and women who have suffered the effects 
of the burn pits and toxic chemicals. Two of my sons have 
served during these 20 years, one as a Marine Corps combat 
infantry officer in Afghanistan, the other as a Navy SEAL. And 
so I think we all see these issues, not only through the eyes 
of our generation but also the generation that has followed us 
in service, and the American Legion has stood strong.
    I want to just ask you, first of all, you would support a 
compromise that put caps on compensation for lawyers but still 
enable them to have access to legal representation, would you 
not?
    Mr. Montreuil. Yes, sir. We certainly appreciate that 
question. I think our desire here is to get this legislation 
passed. At the end of the day there needs to be caps. We can 
have negotiations about what that number is. I think that our 
objective at the end of the day is to assure, one, veterans are 
not being abused and taken advantage of and moneys appropriated 
by Congress are not going into the pockets of lawyers with 
nefarious intent, while maintaining the ability to secure 
access to quality legal representation.
    So we are certainly open to discussing what that number is, 
and frankly, it is less of a concern what that exact number is. 
We want to make sure there is a cap and that veterans are not 
being taken advantage of.
    Senator Blumenthal. And just so you know, and maybe it has 
been said already, but I want to emphasize it. There are 
ongoing conversations involving both sides of the aisle, 
including my colleagues who are represented on this Committee. 
What you want at the end of the day are caps that are fair. You 
want a bill. You want legislation. You do not necessarily want 
a speech. You do not need a speech. What is needed is fair 
caps. Correct?
    Mr. Montreuil. Yes, sir. Our desired end state is that 
there is a bill that becomes law and that protects veterans in 
a timely manner, because there are timelines associated with 
when veterans can file these claims. Veterans are feeling 
pressured to file these claims, not only by the law firms but 
the timeline that exists for them to file those claims.
    So a compromise, whatever that may look like, that ensure 
that veterans have access to quality legal representation and 
they are not being taken advantage of is our desired end state.
    Senator Blumenthal. And I hope that the American Legion 
will join us in Connecticut and other states around the country 
in trying to make veterans more aware of their rights, because 
a lot of veterans do not even know they have this right, put 
aside the lawyers and the caps and all the legalese. We need to 
make more veterans aware of their rights, under the PACT Act, 
as well as under the Camp Lejeune care and benefits.
    And I know the American Legion can play a constructive role 
in helping accomplish that goal, as well as improving--and I 
want to make this point very, very emphatically--improving the 
facilities, the hospitals, the infrastructure that is available 
through the VA health care system. I have pummeled our VA 
Secretary with requests and questions about upgrading 
hospitals, rebuilding, renovating, because our veterans deserve 
it and so do the professional staff, extraordinarily qualified 
and dedicated, docs and nurses who work in those facilities. It 
is not the Secretary's fault, necessarily. We need to 
appropriate the money to invest through that infrastructure. We 
are investing in all kinds of infrastructure. Why not our 
hospitals for VA facilities? Our veterans deserve it.
    So my time has expired. I thank you, Mr. Chairman.
    Chairman Tester. Thank you, Senator Blumenthal, and I know 
we would like to debate this, Senator Sullivan. I love debate--
--
    Senator Sullivan. Mr. Chairman.
    Chairman Tester. Trust me. Go ahead. One point.
    Senator Sullivan. Just one point. Again, my bill, which the 
American Legion has endorsed, has 17 percent trial lawyer award 
caps, which is reasonable, 12 percent caps on the filing. So 
the American Legion has endorsed that, and we think that is 
fair, and I hope my colleagues agree with the American Legion 
that that is fair. There is no need for more compromise. The 
higher caps, the less the families of sick Marines, Marines and 
sick Marines get.
    So the compromise has been done. Take 17 percent. Thank 
you.
    Chairman Tester. Thank you for the explanation.
    Senator Boozman has been hard at work on the Ag Committee, 
trying to get a farm bill ready for prime time.

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

    Senator Boozman. Thank you, Mr. Chairman, and again, I am 
in the middle of a hearing right now on conservation, as we go 
forward with the next farm bill, which is so important for so 
many different reasons, for our farmers in rural America.
    But I wanted to come by and give a special shout-out to 
those of you from Arkansas, the tremendous work you do. But 
also in a very bipartisan way, Republicans and Democrats 
working together, have been able to accomplish a lot, but we 
would not have gotten any of it done without you all. And there 
is nothing more pleasing to all of us to sit and see all of the 
hats out there, and this and that, that recognizes you as 
veterans, and that you are up here talking to your 
representatives, telling us how important these things are, 
helping us to push these things along.
    So thank you for your service. I thank you all. Thank you 
for your tremendous staffs that do such a great job. And with 
that I am going back to talk about conservation. Thank you.
    Mr. Troiola. Thank you for your comments. We appreciate 
that very much.
    [Applause.]
    Chairman Tester. Thank you, Senator Boozman.
    I want to talk about the Major Richard Star Act for just a 
minute. You addressed it in your opening comments, Commander 
Troiola, and this is allowing combat-disabled veterans--combat-
disabled veterans--to collect their full DoD retirement pay and 
VA disability pay without an offset. Now this is an instance 
where folks who were injured in combat, they have to retire out 
of the military because of that injury, do not get full 
disability pay and full retirement pay.
    What would you do to make sure that the Legion members are 
addressed that have this issue, and why is it important that we 
get this legislation passed?
    Mr. Troiola. I appreciate your concerns with this and we 
want the Major Richard Star Act to get passed. But for further 
details I am going to pass this off to our VA&R Chairman, 
Autrey James.
    Chairman Tester. Sure.
    Mr. James. Thank you for that, Senator. It is important to 
understand that these are two separate pools here. There are 
individuals who have earned their retirement because of 
service. There are individuals who have sacrificed themselves 
and should be compensated as well. None of that should be taxed 
in any way. There should not be any type of offset or anything 
of that nature. It is important that the work that they have 
done throughout the years that they served is recognized, and 
it is equally important that the work that they have done to 
protect this nation and the sacrifice that they have given is 
also compensated and recognized.
    Chairman Tester. Thank you very much for that answer.
    I want to--and this has been asked a little bit, in a 
little bit different way. Senator King, I believe, addressed 
this issue. It deals with hiring. It deals with the caps. It 
deals with allowing the VA, on the manpower side of things, 
both nurses and docs, and benefits managers, available to hit 
the ground running.
    You had said, Commander Troiola, that you had been around 
to eight different hospitals. I do not want to put you on the 
spot but I am going to. Were any of those hospitals fully 
staffed, first of all?
    Mr. Troiola. None of them were fully staffed.
    Chairman Tester. None of them were fully staffed. And can 
you give me an idea, was the deficiency in nurses or doctors or 
both?
    Mr. Troiola. It was physicians mostly and mental health 
therapists.
    Chairman Tester. Okay.
    Mr. Troiola. And there is also a shortage on--you know, 
there are mental health therapists required for women. A lot of 
women will not talk to a male therapist. So there is a critical 
shortage of women mental health therapists as well.
    Chairman Tester. Very good. By the way, if we get the 
CAREERS Act bill passed, I am not saying it will be the silver 
bullet that will solve all their problems, because we have got 
some workforce issues out there, getting more doctors and 
mental health care professionals into society, but I think it 
will make a difference that you will be able to see on the 
ground when we get it across.
    Senator King.
    Senator King. I just wanted to put a fine point on the 
point I made about long-term care. I just got some figures. In 
the next 25 years the VA estimates the number of elderly 
veterans will double and the number of 85 will go up by 40 
percent. So that just gives us a flavor of how significant this 
issue is about to become.
    The other piece, to go back for a minute to the transition, 
I also serve on the Armed Services Committee so I get to see 
both sides of these issues. One of my problems is that the 
active duty side, the Pentagon, the Defense Department, I do 
not believe put adequate resources and effort into the 
transition out. I have been saying for 10 years that they 
should put as much time, money, and effort into the transition 
out as they do the recruiting in. I think that is just a basic 
way to look at this.
    [Applause.]
    Senator King. So again, my question to you--and you can 
give me an answer now, but also if you could give us in writing 
later, thoughts about specific ways we can improve that so that 
the person leaving--because the suicide issue, the data shows 
us that the first 2 or 3 years after separation is a danger 
period. And that is one of the major reasons I think we need to 
attend to this issue of transition. So whatever ideas you can 
supply us to improve that.
    And I am not now talking about the VA. I am talking about 
the Department of Defense, and I think that is where you can be 
very helpful to us.
    Mr. Troiola. I am going to defer to our Veteran Employment 
and Education Chairman, Jay Bowen.
    Mr. Bowen. Thank you, Commander, and thank you, Senator, 
for the question. You know, the question of the transitioning 
out for veterans or for active duty servicemembers has been 
something of great concern for us. We are working with the 
transition assistance programs all around the country, with all 
the military bases that we can get into, to help them recognize 
that and to reformat some of their curriculum to ensure that 
these things are addressed. And wherever possible, we are 
getting more and more of our veterans and people like the 
American Legion into those programs so that we can help guide 
and steer them toward getting ready to change uniforms.
    Senator King. And do you agree with me that this is 
something we need to continue to work on?
    Mr. Bowen. Absolutely. Yes, sir. This is something that we 
need to continue to work on. And as we learn more then also 
readjust and revamp where it is needed.
    Senator King. Well, given my work on Armed Services I hope 
you will use me as a conduit to that other outfit over there 
across the river.
    Mr. Bowen. I would love to. Thank you.
    Senator King. Thank you very much. Thank you, Mr. Chairman.
    Chairman Tester. Thank you for the question, Senator King. 
It is a fact that the transition seems to be a major issue in 
mental health. And to the military side of things, they are not 
looking to push people out of the military. They are looking to 
keep them. So to have that conversation about them leaving is 
not really what they are about.
    But we certainly have to do a better job, and I think that 
if we can ever get it figured out, the transition piece tricked 
out, I think we will see a lot of the mental health issues 
certainly recede significantly.
    I have one more question, and I am waiting for Chairman 
Bost to come back. Their votes are over in the House. But you 
brought up women veterans, particularly from a mental health 
standpoint. The Deborah Sampson Act was passed--it was a bill 
that Senator Boozman and I worked on pretty hard to get across 
the finish line--to address the fastest-growing veterans 
population that is out there, women.
    Could you just give us your view of how that bill is 
working? Is the VA making the changes it needs to address the 
health care needs that our women veterans have?
    Mr. Troiola. I am going to defer again to Autrey James, 
VA&R Chairman.
    Chairman Tester. You bet.
    Mr. James. Thank you for that question, Senator. And yes, 
we do believe that the VA is moving forward. However, more 
needs to be done. There are barriers to gender-specific, high-
quality care, including not identifying as a veteran, not being 
recognized by VA employees, lack of awareness and understanding 
of VA health care benefits, and the perceptions that VA is all-
male health care system.
    We have to address that, and the way to address that is 
through training, and we have to make sure that VA is properly 
training those who are coming into contact with our women 
veterans to ensure that they are being treated with the same 
care and dignity as any other veteran who enters the system.
    Chairman Tester. Thank you very much for that answer, and 
Chairman Bost is not going to be able to make it back. He 
apologizes for that.
    What I will say is this has been a great hearing, a little 
different than most of them we have had because you guys 
actually got to see a little action up here, which is pretty 
cool.
    [Laughter.]
    Chairman Tester. But I do want to thank the Legion for 
sharing your 2023 priorities with us. Too all the Legionnaires 
in attendance this morning, thank you. Thank you for being 
here.
    We will be taking a break. We have a vote at 11:30 in the 
Senate, and since I am chairing this bad boy we are going to be 
coming back at 11:30. Okay? So we will recess until 11:30, and 
then we will be back to hear from some more groups.
    Thank you all for what you do. God bless you.
    [Applause.]
    [Recess.]
    Chairman Bost [presiding]. I want to thank the second panel 
for being here, and we are going to get started here in just a 
second. We thank you for putting up with us having votes and 
all the other things we have to do here. And we are joined by 
Ranking Member Takano, who was not here for an opening 
statement, but he would like to make that now, and we are 
recognizing Ranking Member Takano.

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

    Mr. Takano. Thank you, Mr. Chairman, Chairman Bost, and I 
know Chairman Tester and Ranking Member Moran are joining us 
shortly.
    It is my honor and pleasure to once again join you and the 
other Committee members of the House and Senate Committees on 
Veterans' Affairs for the second of our three annual VSO 
hearings. Today's hearing features a diverse array of VSO 
partners, representing a wide cross-section of the veterans 
community.
    Higher numbers of women, LGBTQ+, Black, Asian, Hispanic, 
and Native Americans are choosing to serve in our military than 
at any point in America's history, and today's panelists not 
only reflect that diversity but embrace it, because they know, 
as I do, there is strength in diversity, both for our Armed 
Forces and veteran communities, and our country more broadly.
    For example, our first panelist--and I am sorry I was not 
able to be here for the American Legion, is the nation's 
largest VSO representing over 2 million veterans from all walks 
of life, so I am especially keen to have gathered from my staff 
the insights that they presented today. And as I said at 
yesterday's hearing, my priorities for this Congress center on 
making VA more accessible and responsive to all. And the unique 
perspectives shared by National President Troiola and the rest 
of today's panel members, the second panel, will aid us in 
greatly achieving those goals.
    Veterans from underserved communities deserve to feel safe 
and welcomed when they enter through VA doors with outreach 
programming and solutions that address their unique needs. 
Additionally, VA must acknowledge the diversity of its 
workforce, a third of which includes veterans, and must address 
systemic discrimination in the workplace, and ensure that VA is 
a safe, equitable environment for employees and veterans.
    We must ensure that health care and benefits are fairly and 
equitably distributed to all eligible veterans, and further, VA 
must remove barriers faced by aging and homeless veterans 
regarding access to health care and benefits, and continue the 
expansion of care and delivery of benefits to those in rural 
areas.
    But it is important to remember that none of this can 
happen if we subject VA to the large and arbitrary budget cuts 
that my colleagues on the other side of the aisle have 
endorsed. It is imperative that we do everything we can to 
protect VA's ability to deliver on the promise we have made to 
our veterans and avoid pitting veteran against veteran or 
veterans against other Americans in a scramble for a dwindling 
pool of resources. You, our panelists, will be key in how this 
all plays out.
    I look forward to hearing the testimony of all our 
panelists today, and I thank you for your continued advocacy 
and support for the veteran community.
    Thank you, and I yield back. Thank you, Chairman Bost, for 
that courtesy.
    Chairman Bost. Thank you, Ranking Member Takano. So once 
again we want to welcome the second panel of witnesses. On our 
second we have multiple groups of veteran service organizations 
and advocacy organizations that represent and assist a diverse 
cross-section of veterans from across and around the country 
and around the world.
    First of all we want to start with Charlie Brown. Charlie 
is the National President of the Paralyzed Veterans of America, 
and Charlie, you are recognized for your opening testimony.

                            PANEL II

                              ----------                              


        STATEMENT OF CHARLIE BROWN, NATIONAL PRESIDENT,
                 PARALYZED VETERANS OF AMERICA

    Mr. Brown. Thank you. Chairman Tester, Chairman Bost, and 
members of the Committees, thank you for the opportunity to 
speak with you today on behalf of tens of thousands of veterans 
with spinal cord injuries and disorders who heavily rely on the 
benefits and health care available through the Department of 
Veterans Affairs. My written statement addresses the full list 
of PVA's 2023 priorities. In the interest of time I would like 
to focus on two critically important issues that Congress must 
address: protecting access to VA's specialized health care 
systems and expanding access to the VA long-term services and 
supports.
    VA is the best health care provider for veterans with 
catastrophic disabilities. The Department's Spinal Cord and 
Injury Disorder, or SCI/D, system of care provides a 
coordinated, lifelong continuous services for paralyzed 
veterans. There is no comparable system in the private care. 
However, if the VA continues to woefully underfund the system 
and understaff facilities, the Department's capacity to treat 
veterans will be diminished and could lead to the closure of 
facilities and services reductions.
    We are particularly concerned about the VA's current health 
workforce crisis. When I appeared before you last year, the 
SCI/D system of care was short 600 nurses. Today that number is 
relatively unchanged. Staffing shortfalls have a direct impact 
on the SCI/D system. Due to an insufficient number of nurses, 
care at one of VA's SCI/D system units was suspended in 2022, 
and veterans with acute SCI/D needs were admitted to non-SCI/D 
units. Other facilities capped admissions due to the 
insufficient number of SCI/D nurses, and are still working to 
fill vacancies to meet the minimum requirements.
    We urge Congress to conduct oversight to ensure the VA is 
fully utilizing the authorities granted last year to hire 
additional medical professionals, particularly doctors and 
nurses to meet the demand for services of the SCI/D system of 
care. Congress should also provide VA with more tools to 
compete for highly qualified medical professionals and support 
training for current and future VA clinicians, including 
passing the bipartisan VA CAREERS Act.
    The SCI/D system of care has also been affected by the 
design and construction delays inherent to the VA 
infrastructure project funding and delivery system. In 
reviewing VA's infrastructure, VA should place a great emphasis 
on funding facilities that support the types of services like 
SCI/D care, which the Department uniquely provides. Greater 
investment in both SCI/D acute and long-term care would 
strengthen VA's specialty care services and ensure the future 
availability.
    The next issue I will address is the improved access of 
long-term services and supports. In order to be here today I 
had help from my paid caregiver. He helped me get dressed, get 
out of bed, and into my wheelchair. He helped me take my 
medicine and he helped me groom.
    My story is not unique. It is the story of Robert, and 
Tammy, and Josue, who are behind me. Without that care we are 
stuck at home in bed. It is also the story of one PVA member in 
Minnesota. Because of the shortage of direct care workers, he 
is fortunate when he has someone come and get him out of bed 
and help him through his day. He regularly spends weekends in 
bed because no staff is available to assist him, and he is 
depressed, frustrated, and because he cannot find the direct 
care he desperately needs.
    Another PVA member in Ohio is waiting for the Veteran 
Directed Care Program to be available at that facility. Even if 
the program is available, veterans may not be aware or given 
the opportunity to enroll. Although the VDC is available in my 
VA medical center, I was not made aware of this until last 
year. After several attempts to access the program I was told 
that I had not been considered for it. Veterans should be given 
the opportunity and the choice to access the program if and 
when it is available.
    Another major issue is the cap on home care spending. VA is 
currently prohibited from spending on home care more than 65 
percent of what it would cost if a veteran was to be placed in 
a nursing home. When VA reaches the cap the Department can 
either place the veteran into a facility at a much greater cost 
or rely on the veteran's caretakers, often family members, to 
bear the extra burden. Some service-disabled veterans are even 
forced to turn to the state's Medicare programs to receive the 
care they need.
    One veteran with a form of multiple sclerosis, who is 
ventilator dependent and has other medical needs, is on the 
verge of ending up in a facility. His family needs the VA to 
provide 8 hours of care a day for the weekdays, but the VA is 
only able to provide 16 hours per week, due to the cost. 
Congress must allow the VA to cover the full cost of home-based 
care services, and for others like him, without exhausting 
their caregivers and leaving them struggling to cobble together 
the services and supports they need to stay home with their 
families.
    We urge Congress to pass the Elizabeth Dole Home and 
Community-Based Services for Veterans and Caregivers Act, as 
introduced, to improve VA home care for these veterans.
    Thank you again for the opportunity to share our views, 
your commitment to paralyzed veterans and their caregivers. I 
will be happy to answer questions you may have.

    [The prepared statement of Mr. Brown appears on page 94 of 
the Appendix.]

    Chairman Tester [presiding]. Thank you, Charlie Brown. 
There will be questions.
    Next up is Jared Lyon, National President and Chief 
Executive Officer of the Student Veterans of America. Jared, 
you have the floor.

                    STATEMENT OF JARED LYON,

        NATIONAL PRESIDENT AND CHIEF EXECUTIVE OFFICER,

                  STUDENT VETERANS OF AMERICA

    Mr. Lyon. Chairmen Tester and Bost, Ranking Members Moran 
and Takano, and members of the Committee, 2023 marks the 15th 
anniversary of Student Veterans of America. SVA was founded by 
a passionate group of post-9/11 veterans, many of whom had 
returned home from deployments to Iraq and Afghanistan only to 
find a lack of adequate services and support when they returned 
home.
    SVA chapter are the lifeblood of our mission, and many of 
our chapters began as local student veteran clubs who first 
organized 15 years ago as a way to reconnect with those with 
similar lived experiences while advocating for benefits for all 
student veterans, military-collected students, family members, 
and survivors.
    SVA is committed to the empowerment of today's student 
veterans by advocating for their earned benefits, including 
disability and compensation, health care, as well as education 
benefits and employment programs.
    Since this is the first time that SVA chapter members, 
advisors, alumni supporters have been in a hearing in person 
since 2020, I would like to ask that if you are here with SVA 
today to please stand or raise your hand to be recognized.
    [Applause.]
    Mr. Lyon. Thank you all so much for being here.
    Over this past year SVA chapter leaders have emerged from 
the pandemic. They have hosted career fairs, organized suicide 
awareness events, educated their campuses on issues affecting 
veterans, advocated for the creation of student veteran 
emergency funds, conducted food drives, mentored community 
youth, aided in the resettlement efforts of our Afghan 
refugees, and pushed for greater health care access, all to 
ensure that we meet student veterans where they are in their 
educational journey. All in all, these are incredible people 
doing amazing things.
    Before I continue, SVA would like to thank members of these 
Committees for their dedication and perseverance on legislation 
that codified future emergency VA education protection, improve 
National Guard and Reserve members' Federal protections when 
they are activated, and expanded VA vet centers' eligibility to 
include student veterans.
    With the help of Congress we can all embrace the idea that 
the GI Bill is the gateway to VA. For many veterans, the GI 
Bill is their first interaction with the VA, but it does not 
have to be their last. VA will welcome more veterans through 
its doors and outperform their expectations by delivering a 
top-of-the-line experience with the GI Bill first, laying the 
groundwork for future engagement across the entire scope of 
VA's programs and services.
    In my remaining time I will brief some of the most pressing 
issues that we hear from SVA community members. We encourage 
the Committees to review our written testimony for a 
comprehensive list of our policy priorities.
    Even before the pandemic, SVA regularly heard from students 
that current MHA rates do not reflect the reality of their 
living situation, and many took out student loans just to make 
ends meet. Therefore, SVA urges Congress to review certain 
fundamental assumptions that are underlying MHA and include 
VR&E subsistence rates, break pay, overseas institutions, and 
online instruction. Repeatedly, SVA has heard from members of 
the National Guard and Reserve regarding the lack of parity to 
benefits and administrative issues such as completing 
coursework or exams that conflict with short-term military 
training and deployments.
    SVA encourages Congress to make every day in uniform count, 
and coordinate with the VA, Department of Education, and 
Department of Defense to explore ways to reduce barriers so 
that military duty does not negatively impact academic 
progress.
    Access to VA health care for student veterans remains a top 
priority for SVA. The VA VITAL program is a joint effort 
between VHA and VBA that provides seamless access to VA health 
care services and on-campus clinical counseling through 
collaboration with local VA medical centers, the VBA, campus 
faculty and staff members, as well as community resources.
    SVA asks Congress to continue supporting VA health care and 
mental health services and hold VA accountable to ensure that 
those services are reaching student veterans through the 
expansion of the VA VITAL program.
    Next is the idea that financial aid is based, in part, on 
an applicant's income from the prior year. For our nation's 
newest veterans, those numbers reflect what they were paid 
while they were still in the military. As such, SVA asks 
Congress to explore ways that the VA and the Department of 
Education can work to modernize Federal student financial aid 
to account for these unique circumstances by leveraging 
solutions such as notifying recently transitioned veterans 
about the professional judgment option, which allows them to 
appeal financial aid awards with their institutions as needed.
    Finally, SVA would like to highlight that the VA VET TEC 
program has been extremely successful over the last 5 years. 
However, this well-received program will expire next year. SVA 
urges Congress to make VA VET TEC permanent while embodying 
GAO's recent recommendations so that veterans can continue 
leveraging the program to find high-quality, well-paying jobs 
in the technology sector.
    In conclusion, we would like to thank you for your time and 
attention and devotion to the cause of veterans in higher 
education. At Student Veterans of America, we know that 
investing in veterans is not only the right thing to do, but it 
means investing in the future of American leadership.
    Thank you, and I look forward to your questions.

    [The prepared statement of Mr. Lyon appears on page 113 of 
the Appendix.]

    Chairman Tester. Thank you for your statement, Jared, and 
as with your group and all, the written testimony will be 
looked at. Thank you for that.
    Next up is Jeremy Butler, who is the Chief Executive 
Officer of Iraq and Afghanistan Veterans of America. Jeremy--I 
hope this is public information--will be departing IAVA soon. I 
just want to take a minute and say I appreciate the working 
relationship we have had during your tenure as Chief Executive 
Officer, and we look forward to continued great things from 
you, Jeremy.

                  STATEMENT OF JEREMY BUTLER,

                    CHIEF EXECUTIVE OFFICER,

            IRAQ AND AFGHANISTAN VETERANS OF AMERICA

    Mr. Butler. Thank you, sir. I appreciate that. Now it is a 
spoiler alert for my entire testimony.
    [Laughter.]
    Mr. Butler. I will just focus on that. But it is all right. 
You said it brilliantly so I appreciate that.
    Chairman Tester, Chairman Bost, Ranking Member Moran, and 
Ranking Member Takano, and members of the Committees, on behalf 
IAVA thank you for the opportunity to share our views on our 
policy priorities for the 118th Congress.
    As mentioned, today is a bittersweet day for me because it 
is the last time that I will join you here as CEO of IAVA. 
However, I am excited because I am honored to be joined by our 
IAVA staff, members who flew in from around the country to 
advocate on our priorities, and also by Allison Jaslow, who was 
announced on Monday as the next leader of IAVA and one whom I 
know will carry our mission forward and build on the successes 
we celebrated throughout the years.
    It has been an incredible honor to be a part of the IAVA 
team, and I want to take a moment to thank all of those who 
have supported us in our work.
    And we genuinely do have much to celebrate but also still 
work to be done, and IAVA will continue to be ready to work 
with you and the Administration to execute recently enacted 
legislation and to develop and pass new measures.
    With significant recent victories for IAVA-backed 
legislation addressing military toxic exposures, combatting the 
suicide crisis, defending the GI Bill from abuse, and filling 
gaps in care for female veterans, what is needed from the 118th 
Congress is energetic oversight to ensure the proper and timely 
implementation of these new laws.
    IAVA commends the hard work and tough decisions made by 
members of your Committees and congressional leaders, resulting 
in the passage of the PACT Act. We thank you for getting it 
done and for getting it done right.
    Secretary McDonough and the VA have done an incredible job 
informing veterans of their new benefits, but the DoD also has 
a substantial responsibility to ensure that those still on 
active duty but who were exposed during our 20 years of war are 
aware of the PACT Act and the dangers of toxic exposures.
    The VA must also reach out to Native American tribes, 
Native Hawaiians, and Alaska Natives through the Indian Health 
Service, Bureau of Indian Affairs, Tribal veteran service 
organizations, and others suitable organizations and agencies. 
Additionally, a concerted effort must be made to reach veterans 
throughout rural America, as they are often more disconnected 
than others.
    Sexual assault and related trauma remain a crisis in our 
military and many of us worked for years for passage of the 
Military Justice and Increasing Prevention Act to make critical 
reforms to military law in the fiscal year 2022 and 2023 NDAAs. 
IAVA eagerly awaits the implementation of the sweeping new 
provisions and encourages strong bipartisan oversight to ensure 
that full intention of the legislation is met by DoD.
    More than 40,000 veterans are homeless on any given night, 
and approximately twice that many experience homelessness 
throughout the year. To combat this problem, IAVA worked 
closely with other VSOs to enact the Building Solutions for 
Veterans Experiencing Homelessness Act to permanently cut red 
tape on capital grants provided by VA for organizations 
assisting veterans experiencing homelessness. But more needs to 
be done, and IAVA strongly encourages oversight of VA and HUD 
homeless programs to ensure existing funds are effectively and 
fully utilized, based on need, and ensure that VA provides 
technical assistance and adequate training to grant recipients 
who assist homeless veterans.
    The Deborah Sampson Act, developed to fill gaps in care for 
women veterans, became law in January 2021, but we remain 
frustrated with the slow rate of updates on its implementation 
and are seeking Committee support in receiving a comprehensive 
written report on progress toward VA full implementation.
    Separate from this legislation but also vital is the need 
to change the VA motto to one that recognizes the service of 
all Americans who have served. Secretary McDonough pledged to 
make this important change, and IAVA would like to ensure that 
it is completed without further delay.
    For years IAVA and our VSO partners have defended and 
strengthened the GI Bill. In 2021, we celebrated passage of 
legislation after many years of work to finally close the 90/10 
loophole, and now IAVA calls on Congress to closely monitor the 
implementation of this legislation and ensure that veterans and 
military families are protected.
    As you know and as we have discussed, the Major Richard 
Star Act would end the unjust tax on the 42,000 retirees whose 
military careers were cut short due to combat-related injuries, 
and allow them to collect the entirety of their earned 
benefits. IAVA strongly believes that DoD retirement pay and VA 
disability compensation are two separate benefits established 
by Congress with two different legislative intents. Receiving 
both benefits concurrently should never be considered double-
dipping, and no combat-injured medical retiree should be 
subject to this unjust offset.
    Following the chaotic exit by the U.S. and our allies from 
Afghanistan in the summer of 2021, the U.S.-backed government 
essentially collapsed overnight and America left behind nearly 
all of the Afghans who partnered with us during the war. To 
right this wrong, the bipartisan Afghan Adjustment Act 
establishes a legal adjustment process for Afghan evacuees who 
have been resettled across the U.S. Although your Committees do 
not have jurisdiction over the AAA, it is critically important 
for the veterans you serve to know that their advocates on 
Capitol Hill are working on their behalf to bring to safety 
those who had their backs in Afghanistan.
    Eighty-eight percent of IAVA members support the research 
of cannabis for medicinal purposes, and veterans consistently 
and passionately have communicated that cannabis offers 
effective help in tackling some of the most pressing injuries 
faced when returning from war. We thank Senators Tester and 
Sullivan and Representatives Bergman and Correa for 
reintroducing the bipartisan and bicameral VA Medicinal 
Cannabis Research Act to increase the research, and we applaud 
the Senate VA Committee's passage of the bill from your panel 
last month. We encourage Congress to quickly pass it into law.
    Finally I want to express our significant concern as we 
observe conflicts on Capitol Hill over the level and scope of 
Federal Government spending. Veterans and military families 
have sacrificed, and are sacrificing, as a direct result of our 
nation's national security needs, and political disagreements 
over spending should never result in diminished care and 
benefits for our community. We ask you to stand against any 
spending cuts impacting veterans and military families or any 
effort that will make such cuts easier to enact. Wars are 
expensive, and the costs do not stop when the servicemembers 
come home.
    Thank you for your time, your service to our veterans, and 
for giving me the honor to speak with you on behalf of IAVA. 
Thank you.

    [The prepared statement of Mr. Butler appears on page 142 
of the Appendix.]

    Chairman Tester. Thank you, Jeremy.
    Next up we have James Hartsell, President of the National 
Association of State Directors of Veterans Affairs.

           STATEMENT OF JAMES S. HARTSELL, PRESIDENT,

           NATIONAL ASSOCIATION OF STATE DIRECTORS OF

                        VETERANS AFFAIRS

    Mr. Hartsell. Thank you, Chairman Tester, Chairman Bost, 
Ranking Member Takano, and distinguished members of the 
Committees on Veterans' Affairs. My name is James S. Hartsell. 
I am the President of the National Association of State 
Directors of Veterans Affairs, known as NASDVA. I also have the 
honor of serving as the Executive Director of the Florida 
Department of Veterans' Affairs. Joining me today is the former 
NASDVA President, Les Beavers, who currently serves as our 
association's Legislative Director.
    NASDVA was founded more than 75 years ago to bring together 
the state directors, commissioners, secretaries from all 50 
states, U.S. territories, and the District of Columbia to 
encourage communication, facilitate discussion, and promote 
best practices in order to successfully advocate for our 
nation's veterans, their families, and their survivors. Our 
association's work is vital, and we are committed with passion 
and purpose to address these key issues for our respective 
veterans.
    State Departments of Veterans Affairs are comprehensive 
service providers, and we are prominent veteran advocates. We 
serve as the primary intersection on veteran issues between the 
U.S. Department of Veterans Affairs and our respective state 
and territory governments, as well as with veteran service 
organizations, community partners, and nonprofit entities. We 
deliver efficient, effective, veteran-focused services, and we 
closely partner with the VA in outreach and advocacy for our 19 
million veterans in our nation.
    The collaborative relationship between the VA and NASDVA 
was just reinforced with the renewal of a memorandum of 
agreement that I signed last week with VA Secretary Denis 
McDonough at our NASDVA Midwinter Training Conference right 
here in D.C. At our conference last week, we were very 
encouraged and very motivated to hear Secretary McDonough tell 
us there is no more important partner to the VA than NASDVA.
    As an association we applaud Congress' concerted efforts to 
improve VA funding for health care, benefits and claims appeals 
processing, and homeless veteran programs. NASDVA also 
recommends Congress' renewed attention on VA's aging 
infrastructure, on caregiver support, and on women veterans 
issues. We support Congress' efforts to hold both the VA and 
Oracle Cerner fully accountable for evolutionary upgrades to 
the VA's electronic health record system. It is essential that 
VA address both current system challenges and also future EHR 
development.
    To support our veterans impacted by toxic exposure, NASDVA 
both applauds and fully supports the timely implementation of 
the PACT Act and accelerated hiring of VA staff to address the 
resulting increase in medical examination-associated claims. We 
also recommend continued emphasis by the VA to ensure veterans 
are provided timely community care referrals and appointments. 
Reimbursement to providers for community care services should 
also be prompt.
    In promoting our collective state and territories veteran 
suicide prevention efforts, NASDVA applauds the implementation 
of the COMPACT Act and recommends additional resources be 
provided through the Governor's Challenge and Mayor's Challenge 
on veteran suicide prevention.
    NASDVA supports the VA as they seek to continue telehealth 
prescribing of controlled substances to ensure veterans retain 
access to critical treatments and health care professionals.
    For our nation's state veteran nursing homes, both NASDVA 
and the National Association of State Veteran Homes recommend a 
new grant per diem scale to address our chronic health care 
professional shortage. Both of our associations also support a 
funding increase of the VA's underfunded State Veterans Home 
Construction Grant Program.
    In addition, VA's current budget does not allow its 
National Cemetery Administration to establish new state or 
tribal cemeteries. We strongly recommend increasing funding 
support for both expansion and establishment cemetery projects.
    To serve all veterans, NASDVA applauds the recent MOU 
between the VA and Indian Health Service and supports the 
recent proposed rule by the VA waiving copayments incurred for 
eligible American Indian and Alaska Native veterans.
    NASDVA commends VA's emphasis on ending homelessness among 
veterans, especially women veterans with children. And NASDVA 
recommends continued funding for specialized homeless programs 
and commends VA's and HUD's increasing the number and value of 
HUD VASH vouchers.
    Finally, it is a significant challenge for transitioning 
servicemembers to connect with their earned state services, 
benefits, and support, and NASDVA recommends that all state 
Departments of Veterans Affairs be included in the Department 
of Defense Transition Assistance Program and also be allowed to 
connect with servicemembers who will be heading to our 
respective states and territories.
    Distinguished members of Committees on Veterans' Affairs, 
both the House and Senate Committees, we sincerely respect and 
appreciate the vital work and leadership you have done and that 
you continue to do to improve the well-being of our nation's 
veterans. I would like to reemphasize, we are government-to-
government partners, and that we are second only to the United 
States Department of Veterans Affairs in delivery of earned 
benefits and services to those who served in the defense of our 
nation. With your help and your continued support, we ensure 
that our veterans and their needs are adequately resourced and 
remain a national priority.
    Thank you for letting us share our state and territory 
needs and priorities with the Committees today. Thank you.

    [The prepared statement of Mr. Hartsell appears on page 149 
of the Appendix.]

    Chairman Tester. Thank you for your statement, Mr. 
Hartsell.
    Up next is Shawn Deadwiler, Interim Director of the Black 
Veterans Empowerment Council.

       STATEMENT OF SHAWN L. DEADWILER, INTERIM DIRECTOR,
               BLACK VETERANS EMPOWERMENT COUNCIL

    Mr. Deadwiler. Chairman Tester and Chairman Bost, Ranking 
Members Moran and Takano, members of the Senate and the House 
Veterans' Affairs Committees, I am pleased to speak before the 
Joint Senate and House Veterans' Affairs Committee hearing 
today on behalf of the Black Veterans Empowerment Council, 
Inc., BVEC.
    BVEC is a nonprofit organization registered in the state of 
Maryland, and I am honored to be leading the re-energized 
evolution of our organization, executive team, staff, and 
volunteers to continue providing impact across the broader 
community with transparency.
    Currently BVEC is working on comprehensive plans to 
strengthen both the collaboration and transformation of our 
efforts as we continue to shift longstanding racial inequities 
suffered by Black veterans in the United States through our 
nonpartisan coalition made up of national, state, local veteran 
service organizations and the Black veteran community.
    BVEC is appreciative of the work that the SVAC and the HVAC 
have completed in the 117th Congress, and we look forward to 
our continued collaboration in the 118th Congress. We also look 
to continue advocating to advance sensible and sustainable 
legislative solutions affecting all veterans, including GI 
benefits, particularly underutilization of and inadequate 
access to benefits for Black and minority veterans and 
discharges for Blacks and minorities more broadly.
    As a host of factors complicate benefit utilization, BVEC 
supports the work of the Black veterans-centered organizations 
in advancing research on racial disparities in access in 
veterans benefits across the Department of Veterans Affairs. 
These findings reveal statistically significant racial 
disparities in disability grant rates and denials suffered by 
Black veterans, and highlight a need to redress and reform.
    Economic. The Department of Defense and the Federal 
agencies contracting to veteran-owned small businesses is one 
of the largest issues that veteran business owners face today. 
We know underserved communities are heavily recruited, and many 
Black veterans return to resource-poor neighborhoods and 
withstand frequent denials, deterrence, or misinformation on 
how to appropriately utilize the veterans benefits they have 
earned.
    Startup capital for veteran-owned small business is 
critical. There are a number of regulations made by agencies 
that require significant upfront capital just to be registered 
to do business. It is cost prohibitive in a lot of cases for 
veterans to go into business within the DoD and the Federal 
agencies.
    Housing. Particularly, significant, and in some cases 
increased, numbers of homelessness amongst veterans. To fulfill 
its commitment to diversity, equity, and inclusion, VA must 
also improve micro-targeting outreach across the Black veterans 
community. BVEC and its affiliate organizations stand willing 
to assist the VA leadership in this effort.
    The VA Housing Loan Forever Act of 2022, discussion draft 
from the 117th Congress, the BVEC supports this piece of 
legislation and looks to work with Congress on it.
    Enforcement. Many Black veterans hail from at-risk, low-
income and underserved communities, joining the military in the 
hopes of serving our nation while seeking economic mobility and 
access to housing, education and health care benefits often 
lacking in their respective environments. Unfortunately, a lack 
of effectiveness exists due to the speed of agencies 
implementing this new legislation. Further, an issue lies on 
how the Federal agencies subagencies interpret and implement 
legislation intent without a streamlined process across other 
agencies and divisions of those agencies.
    A perfect example is Chairman Tester's quote from the U.S. 
Senate Committee on Veterans' Affairs site, article dated 
November 30, 2022. ``I am disappointed VA has not implemented 
the law we passed two years ago to end copays for VA health 
care for Native veterans.'' Why is it taking so long?
    Black veterans are experiencing similar issues and we want 
to start working toward establishing a VA Advisory Committee on 
African American Affairs. I personally testified to Ranking 
Member Takano during the Veteran Voices of Color roundtable of 
this need in July and September 2020. We, as the founders of 
BVEC, did not do enough to pursue this effort in the 117th 
Congress. I ask the 118th Congress today to work with the BVEC 
on this advisory committee.
    As the work of the 118th Congress progresses, we understand 
that the country is at a nexus of multiple crises--real 
challenges around care for our veterans, global and national 
security threats, possible economic recession, and the tail end 
of a two-year pandemic. Now more than ever, we must all work 
together to ensure the needs of veterans are being addressed 
during these difficult times. With that in mind, I and the BEV 
stand ready and willing as partners in the journey toward 
sustainable, sensible solutions for veterans.
    I thank you for your time, sir.

    [The prepared statement of Mr. Deadwiler appears on page 
167 of the Appendix.]

    Chairman Tester. Thank you for your statement, Mr. 
Deadwiler.
    Next up is Jack McManus, National President of the Vietnam 
Veterans of America.

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

    Mr. McManus. Good afternoon Chairman Tester, Chairman Bost, 
members Takano and Moran. With me today are veteran advocacy 
champions from each one of your states--not a mistake. We are 
very pleased to be here today to present the highlights of our 
legislative agenda, which has been presented to the Committee 
and it would take me a week of Sundays to read it all. But we 
want to be able to transform and support our American veterans 
with effective policies, initiatives, programs, and benefits.
    A little bit about VVA. VVA, the Vietnam Veterans of 
America, is an organization that never should have had to come 
into existence. We should not have existed at all. We came 
primarily due to refusal of American society to recognize those 
of us who served during the Vietnam War. We are just as much an 
American veteran as those from the previous generations that 
served, particularly World War II and Korea.
    Our war was unpopular to the majority of our citizens, 
including many who served during the Vietnam era. Instead of 
treating those who served during our period in the manner of 
previous generations, with respect and dignity, Vietnam 
veterans were relegated to a lower class in our society. Not 
only was their service and sacrifice not recognized and honored 
by a grateful nation but it was also seen as a mark against 
them. It made very, very difficult things like employment 
almost impossible during that period of time for our veterans.
    Until we, as a nation, stop trying to classify military 
veterans and their unique issues by the popularity of their 
tour of duty or time they served or how we asked them to 
sacrifice themselves, our nation is only going to repeat what 
we Vietnam veterans experienced. We must stop categorizing 
veterans by their service, and then and only then will we stop 
pitting one group of veterans against another, as happened 
during and after the Vietnam War. An American veteran is an 
American veteran, regardless of how and when they served.
    [Applause.]
    Mr. McManus. That is why the biases that were created and 
why PTSD and substance abuse, toxic exposures from Agent Orange 
and the high rates of joblessness, homelessness, suicide, and 
so many other veteran issues of our generation took decades to 
address.
    As technology creates more sophisticated means of warfare, 
our future veterans will face physical and mental challenges 
that we could not imagine or understand today. Try to imagine 
our enemies weaponizing electromagnetic mind control and how 
our veterans will address the inevitable unknown maladies that 
are associated with such a weapon. We have already seen some of 
this in our intelligence community, and there was a rather 
lengthy thing on the TV about how they were using that right on 
the grounds of the White House.
    So if we do not recognize military veteran only as an 
American veteran, then our country experienced by our 
generation upon their return, we cannot let that happen again. 
Veterans should never be the target of situations created by 
Congress and the Administration who have jointly been unable 
for years, if not decades, to meet the Federal Government's 
obligation to pay the debt to those that have served.
    I joined the military to defend and uphold the 
Constitution, the one that each of you, as sworn elected 
leaders, are, and I call on each of you to defend veterans, 
widows, and survivors from any attempt to take away their 
earned benefits.
    Being probably the senior person up I am probably going to 
be in contempt to Congress, but I was going to try to continue 
this here.
    Our POW/MIA issue is really our most solemn priority within 
the Vietnam Veterans of America. We have 1,581 unaccounted for 
American servicemen from our long-ago war, and for us and their 
survivors the pace of recovery is unacceptable. In the past 3 
years, as we reported accounting, 428 U.S. servicemen have been 
accounted for. Of this only 5 are from the Vietnam War. We have 
attached with our priority our white paper on aging veterans 
and the challenges that we have. We lack a clear and 
comprehensive roadmap to address the concerns that VA has and 
will continue to have, and we have not seen demonstrated 
meaningful progress on help for the aging veterans.

    [The paper referred to by Mr. McManus appears on page 199 
of the Appendix.]

    Our same concern is with the rural veterans, and we think 
that there are some programs that would absolutely help and 
continue to address that. That would be increasing the 
availability of community-based care. I know that to some on 
the panel that is a very important issue. We do not believe 
that providing community-based care should be used to dismantle 
the organized structure of the Veterans Health Administration, 
our hospitals and our CBOCs and our specialties, including our 
PTSD programs and our vet center programs.
    We also need to address the legacy of toxic exposures. The 
PACT Act marks one of the greatest expansions of veteran health 
care and benefits in our generation. That was an important 
victory but we still have work to do making sure that the 
implementation is accomplished with the congressional oversight 
verifying the accountability on the regulatory and statutory 
sides.
    Also of particular interest to Vietnam Veterans of America 
is the implementation of the Toxic Exposure Research Act that 
was passed by the Congress of United States and signed by the 
President. We are now asking that the Chair appoint the Ranking 
Member, Senator Moran, who was the champion of that law, to 
hold oversight committee hearings, including with the Secretary 
of the VA as the star witness, to investigate what means and 
metrics he used to empower him not to follow the law.
    Mr. Chairman, we do not seek another study. We would just 
appreciate your support in ensuring that the already agreed 
upon study is conducted and that the VA reconsider their denial 
for the study of the much-needed intergenerational research and 
be in compliance with the law that was passed by this Congress 
and signed by the President.
    In the Public Law 116-23, the Blue Water Vietnam Act of 
2019, VA calls on Congress, in the strongest terms, to amend 
the public law to extend the nautical mile limitation 
sufficient to cover U.S. Navy and Marine Corps Vietnam veterans 
who were assigned to the Vietnam theater of combat operations 
or who received a Vietnam service medal. The current law 
excludes veterans who served further beyond an arbitrary 
boundary of 12 miles seaward of the waters of Vietnam and 
Cambodia, and but they were still exposed or potentially 
exposed to Agent Orange and suffered from its effects.
    Our Gulf War veterans deployed to Southwest Asia during the 
Gulf War, during Operation Desert Shield and Desert Storm were 
exposed to a long list of toxins and are still waiting for 
answers to their long-term effects. VA has an exceedingly high 
rate of Gulf War presumptive claims, 76 percent being 
undiagnosed or denied. VA's presumptive Gulf War claims 
adjudication policies, procedures, and training should be 
remedied, and Gulf War veterans serving at the hands of the 
organizations that are supposed to help them should be serviced 
more effectively.
    We have significant information on addressing the 
Comprehensive Assistance for Family Caregivers, which we 
support.
    We would like to address homeless veterans. While we are 
very appreciative and happy that we have been able to decrease, 
the number of older homeless veterans have increased. The 
extreme shortage of affordable housing has helped create this 
crisis for older generation veterans.
    Tremendous strides have been made by the VA in addressing 
and providing the services, yet the problem exists and it is a 
national disgrace that it continues to persist. It is 
especially disturbing that the number of older homeless 
veterans have been steadily increasing. We find that the same 
issue with homeless veterans carries over to the veteran 
suicide issue. Two or three veteran suicides are over 55 years 
of age. Fourteen of 20 do not get care at the VA. So it is not 
just a VA program and the ability of the VA to touch some of 
these potential suicide victims.
    Chairman Tester. Mr. McManus?
    Mr. McManus. Yes.
    Chairman Tester. I would ask you to wrap because we are 
about--otherwise there will be contempt of Congress.
    [Laughter.]
    Mr. McManus. All right. So on the veteran suicide we will 
wrap up. We have one request, that Congress enact a law that 
will make mandatory the insertion of a single question on a 
death certificate--Did the deceased ever serve in the Armed 
Forces of the United States--so we can do some tracking.
    I would be happy to answer any questions you might have, 
and thank you very much.

    [The prepared statement of Mr. McManus appears on page 170 
of the Appendix.]

    Chairman Tester. You bet. Thank you for your statement, Mr. 
McManus.
    Next up we have Christopher Slawinski, National Executive 
Director of the Fleet Reserve Association. Christopher, you 
have the floor.

             STATEMENT OF CHRISTOPHER J. SLAWINSKI,

                  NATIONAL EXECUTIVE DIRECTOR,

                   FLEET RESERVE ASSOCIATION

    Mr. Slawinski. Thank you, Chairman. Good afternoon Chairman 
Tester, Ranking Members Moran and Takano, and members of the 
Committee. My name is Chris Slawinski. I am the National 
Executive Director of the Fleet Reserve Association. I am here 
today with FRA National President, James ``Robbie'' Robbins, 
Jr. from Orange Park, Florida, and FRA National Vice President, 
John Handzuk from Belleair Beach, Florida. We represent the 
concerns of the oldest sea service association that has been in 
service for over 98 years.
    As one of the leading supporters of the PACT Act that was 
enacted this past session of Congress, FRA is grateful for its 
passage. Military service can require servicemembers to go 
places that may expose them to environmental hazards that cause 
illnesses and disease that cannot be diagnosed for years or 
even decades after their service. The PACT Act recognizes that 
fact. I want to thank Chairman Tester and the Senate Veterans' 
Affairs Committee for allowing FRA to be one of the three 
associations to testify on the comprehensive veterans toxic 
exposure back in March of last year.
    The fiscal year 2023 omnibus appropriations package also 
provides provisions of FRA-supported Veterans' Prostate Cancer 
Treatment and Research Act. Prostate cancer is the number one 
cancer diagnosed in the Veterans Health Administration.
    As I stated in my testimony this past March, I served on 
active duty in the Navy for 4 years. I worked as an aviation 
electronics technician. My primary duties were associated with 
being a final checker and troubleshooter on the flight deck of 
the USS Coral Sea. In September 2021, I was diagnosed with 
stage 4 prostate cancer which has metastasized to my bones and 
other areas. I do not have a family history of this cancer, but 
I have been very fortunate that I have received my treatment in 
the Defense health care system.
    Walter Reed is currently in the process of transitioning to 
the new Genesis electronic health care system, so I am having 
firsthand observations of the changes that are taking place 
there. FRA appreciates both Committees' oversight hearings on 
the electronic health record modernization at the VA. FRA is 
aware of the lingering issues related to the patient safety, 
training, employee morale, and several other deployment 
problems that still exist, though progress is still being made.
    The VA first launched the new electronic health care system 
more than 25 months ago. The program was scheduled to expand in 
July 2022, to the medical center in Boise, Idaho. The expansion 
was delayed. Oversight committees were told that the VA was 
using this pause to make system enhancements and to perform 
tests to ensure that the system is stable, resilient, and 
provides the capabilities that the VA employees and veterans 
need to improve access to quality care.
    Nevertheless, progress has occurred since VA joined with 
DoD in the joint contract to modernize its EHR system in 2017, 
with the Electronic Health Care Transparency Act, which 
requires the VA to submit to Congress quarterly reports that 
evaluate the performance of those records. FRA believes 
congressional oversight of the ongoing implementation of the VA 
technology upgrades is vital to ensuring improvements to the 
system. FRA wants to ensure adequate funding and oversight for 
DoD and VA health care resources delivering seamless, cost-
effective, quality services to personnel wounded in combat and 
others veterans and their families. The costs and the long time 
for implementation notwithstanding, FRA believes there is a 
tremendous opportunity for the two departments using the same 
electronic health records. We are all poor historians of our 
health care without the EHR.
    I want to thank the Committee for my opportunity to speak, 
and I await your questions.

    [The prepared statement of Mr. Slawinski appears on page 
211 of the Appendix.]

    Chairman Tester. Thank you, Mr. Slawinski. I appreciate 
your statement.
    Next up is Angela Pratt, Co-Chair of the Veterans Committee 
for the National Congress of American Indians.

              STATEMENT OF ANGELA PRATT, CO-CHAIR,

                      VETERANS COMMITTEE,

             NATIONAL CONGRESS OF AMERICAN INDIANS

    Ms. Pratt. Thank you. Good morning, Chair Tester, Ranking 
Member Moran, Chairman Bost, and Ranking Member Takano, and to 
all the members of the Senate and House Veterans' Affairs 
Committees. My name is Angela Pratt and I am a member of the 
Osage Nation of Oklahoma. I was a member of the Osage Nation 
Congress from July 2014 until July 2022, and for 4 of those 
years I presided as the Speaker of Congress. I am a proud Army 
veteran--Hooah. I am a long-time member of the American Legion 
Post 198, and as noted earlier, my dues are also paid up for 
life. I just wanted to report that as well. And I have 
dedicated many years to assisting with veterans' organizations' 
issues and efforts.
    Also, in November 2021, I was elected to serve on the 
first-ever Veterans Affairs Advisory Committee on Tribal and 
Indian Affairs. I thank you for that legislation.
    On behalf of the National Congress of American Indians and 
NCAI's Veterans Committees that I co-chair, I want to thank you 
for this opportunity to provide testimony on issues affecting 
Native Americans. And for the record, as I just mentioned, the 
National Congress of American Indians Veterans Committee that I 
co-chair, as you may be aware, NCAI was founded nearly 80 years 
ago and is the oldest, largest, and most representative 
American Indian and Alaska Native organization serving the 
broad interest of tribal governments and communities. On behalf 
of NCAI I want to thank you for letting me speak today.
    And also I would like to note that per capita Native people 
serve at a higher rate in the Armed Forces than any other group 
of Americans, and that they have served in all the nation's 
wars since the Revolutionary War. Native Veterans continued 
their service in our nation's wars long before they were 
recognized as United States citizens and before they had the 
right to vote.
    Given my time, I have submitted my full testimony for the 
record, and I am going focus on three areas that are priorities 
of the NCAI Veterans Committee, which are housing, health, and 
data.
    As a general matter, housing infrastructure in Indian 
Country continues to lag behind the rest of the United States, 
and despite the service they provide to our country, 
homelessness and housing insecurity remains a major concern for 
our Native veterans. While data is scarce--and that is 
something I will return to momentarily--at least one study 
found that Native veterans made up 19 percent of all homeless 
veterans in the study sample, making the Native veteran 
homeless rate almost 10 times the representation in the general 
population. Another study indicated that Native veterans living 
in poverty were twice as likely to be homeless than their other 
non-veteran Native Americans.
    A simple but critically important step to combat this issue 
is to reauthorize and make permanent the Native American 
Housing Assistance and Self-Determination Act. NAHASDA has 
successfully been used by tribal nations across the country to 
focus on the specific housing needs in their own communities. 
However, NAHASDA expired 10 years ago, and we cannot afford to 
let this critical legislation go unauthorized any longer. 
Reauthorizing NAHASDA will also help Native veterans struggling 
with homelessness by improving the Veterans Affairs Supportive 
Housing, or the HUD VASH, program. This program has been a 
nationwide success because it combines rental assistance, case 
management, and clinical services for at-risk and homeless 
veterans. Unfortunately, this program is not fully available to 
Native veterans living on tribal lands.
    NCAI also urges congressional passage of the Native 
American Direct Loan Improvement Act of 2023, which, among 
other things, would also allow veterans who have built homes 
with other sources of construction financing to still use NADL 
as permanent financing and thus improve housing opportunities 
for Native veterans.
    Turning to Native veterans' health care, I want to start by 
noting that obtaining health care for Native veterans often 
means navigating both the VA and the IHS, which is the Indian 
Health Service. The primary health care provider in most Native 
communities and for many of our Native veterans is IHS. Thus, 
one mechanism for improving the health of Native veterans is to 
improve the IHS system, which has long been woefully 
underfunded.
    And even though advanced appropriations for IHS passed at 
the end of the 117th Congress, which is something that NCAI and 
all of Indian Country applaud, there is more to do. While 
historic, the advanced appropriation for IHS is far from 
perfect, and inclusion of advanced appropriations each year is 
not, as of yet, guaranteed.
    We owe it to our veterans to fight for culturally competent 
delivered care, closer to home. Congress must expand and 
sustain advanced appropriations for the IHS funds until funds 
are mandatory for IHS.
    With my final moments I want to return to the issue of 
data. While I have highlighted two critical issues, housing and 
health, impacting Native veterans today, the fact is that data 
on Native veteran housing, health, and a host of other issues 
is scarce, or more often than not, nonexistent. This lack of 
data all too often makes Native veterans and their concerns 
invisible. There is an urgent need for accurate data concerning 
Native veterans in order to develop meaningful policy solutions 
that will address Native veterans' day-to-day concerns. This 
data, which is necessary, must be collected in collaboration 
with tribal nations, must respect privacy concerns, and must be 
shared with tribal nations who are generally in the best 
position to address the needs of their community members.
    I would like to conclude by once again thanking this 
Committee for holding this hearing and allowing me to bring 
attention to Native veterans and the challenges they face in 
their lives. Our Native veterans, like all veterans, have given 
up their time, their health, and in many cases their lives to 
protect this country. For those who have served and are still 
with us, it is imperative that we give them everything they 
need to thrive.
    Thank you again for this opportunity to speak, and I look 
forward to addressing any questions that you may have.

    [The prepared statement of Ms. Pratt appears on page 222 of 
the Appendix.]

    Chairman Tester. Thank you for your statement, Ms. Pratt.
    Last but not least we have Roy Robinson, President of the 
National Guard Association of the United States. Roy, you have 
the floor.

                 STATEMENT OF BRIGADIER GENERAL

               J. ROY ROBINSON (RET.), PRESIDENT,

        NATIONAL GUARD ASSOCIATION OF THE UNITED STATES

    Mr. Robinson. Chairman Tester, Ranking Member Moran, 
Ranking Member Takano, and other distinguished members of the 
Senate and House Committees, on behalf of the almost 45,000 
members of the National Guard Association of the United States 
and nearly 450,000 soldiers and airmen of the National Guard, 
we deeply appreciate this opportunity.
    We also thank you for your tireless oversight to ensure 
accountability and improve services to our nation's veterans 
and their families. The combined efforts of your Committees 
have advanced critical policies which directly impact the 
National Guard, and I thank you for that hard work. From 
passing the PACT Act to expanding and improving access to 
mental health care, we continue to make progress toward 
enhancing the quality of life for our military and veterans.
    The operational tempo for the National Guard has increased 
significantly over the past 20 years, and even more so in the 
last 3. In addition to overseas deployments alongside the 
active component, the National Guard is there for our 
communities during the greatest times of need. Whether it be 
wildfires in California, flooding in Louisiana, or most 
recently shooting down unidentified objects threatening our 
national security, our servicemembers are always ready.
    In my testimony I would like to focus on three specific 
areas key to recruiting and retaining a National Guard force 
that remains prepared to protect our nation: consistent access 
to medical coverage, incentives for civilian employment, and 
increased benefit parity.
    Our number one priority for the 118th Congress is the 
Healthcare for Our Troops Act, which will be reintroduced soon 
in both the House and the Senate. I ask that your Committees do 
all you can to support this critical need. Affording a zero-
cost TRICARE coverage will dramatically increase readiness, 
solve turbulence moving on and off health plans, and ultimately 
save money.
    Guard and Reserve units must be ready at a moment's notice, 
just as the active component. It is imperative that all 
servicemembers have access to the health care needed to meet 
medical deployability requirements. It is unthinkable that an 
estimated 60,000 Guard members currently do not have health 
care coverage. These are the same soldiers and airmen we sent 
into communities to administer COVID testing and vaccinations. 
The same soldiers and airmen we sent down to Puerto Rico to 
help with hurricane aftermath, often serving alongside active 
component members who did have health care coverage. This is 
unacceptable.
    The benefits of zero-cost TRICARE extend beyond medical 
readiness. As a key retention policy, this will help us keep a 
manned and ready force under the all-volunteer force construct. 
Preventive care throughout our servicemembers' careers will 
also reduce medical expenditures when transitioning guardsmen 
to veteran. Furthermore, consistent medical coverage will allow 
those within our ranks to consistently have mental health care. 
I cannot think of any better way to truly put our 
servicemembers first.
    Lastly, this is a significant employer benefit. When a 
company knows a servicemember will not require health insurance 
coverage it will be that extra incentive needed to make the 
hire. Time away from civilian careers continues to increase, 
and we must find a way to better encourage employers. Without 
improved incentives, I worry companies will start to choose 
equally qualified non-military candidates over our 
servicemembers.
    This will revolutionize how health care is delivered to our 
soldiers and airmen. I am convinced it will not only provide 
better health results but will prove cost advantageous in the 
long run. The fact that we have men and women serving this 
nation in uniform who do not have medical coverage is a 
travesty, and we need to do better. Again, I ask for each of 
your support on the Healthcare for Our Troops Act.
    Strengthening servicemember civilian employment. As 
mentioned, the recent increase of the citizen-soldier 
expectations have expanded well beyond the traditional 39-day 
annual training structure. While I cannot anticipate future 
operational demands, it is clear the era of ``one weekend a 
month and two weeks a year'' is over.
    In the wake of this new reality, we ask the Committees 
support continued efforts to assist reserve component service 
members and their employers. Specifically, we encourage the 
reintroduction and passage of the RECRUIT Act. This bill 
authorizes an annual tax credit for small business employers 
who employ Guard and Reserve members and would go a long way 
toward supporting our communities.
    At NGAUS we continually strive for benefit parity on all 
fronts. For the past several years, I have asked for your 
assistance in correcting numerous benefits not afforded to our 
members. Both the Forever GI Bill and the fiscal year 2018 NDAA 
made advancements to close that gap. Now Guardsmen and 
Reservists are eligible for nearly all the same benefits as the 
active component, including tuition assistance, transitional 
healthcare access, and post-9/11 GI Bill benefits. However, 
there is still more work to be done.
    Fortunately, Congress has made great progress toward 
correcting this. During the 117th, the House passed H.R. 1836, 
the Guard and Reserve GI Bill Parity Act. The bill counted all 
days in service, including weekend drills, annual training, and 
specific state active duties such as 502(f), toward the post-9/
11 GI Bill. This is a fantastic step forward and we strongly 
encourage the reintroduction of this bill in the 118th 
Congress.
    I thank you again for allowing NGAUS to testify. Your 
efforts are critical to the well-being of our servicemembers 
and the success of our National Guard. I look forward to 
continuing our work together and sincerely appreciate the 
steadfast leadership from the members and their staffers in 
advocating for the men and women of the National Guard.

    [The prepared statement of Mr. Robinson appears on page 227 
of the Appendix.]

    Chairman Tester. Thank you for your testimony, Mr. 
Robinson, and I want to thank you all for your testimony today. 
I appreciate it.
    I am going to start with the questions. Questions will be 3 
minutes.
    VA has about $88 billion in infrastructure needs out there. 
We are putting about $5 billion toward that. At least that is 
what it was last year. That is not enough.
    Your testimony, Mr. Brown, talks about the highlights for 
need for new and modernized facilities, particularly for spinal 
cord injuries and long-term care. The list goes on. Are you 
familiar with the bill that I have got, the Build for Veterans 
Act?
    Mr. Brown. Personally I am not but I do have my government 
relations with me.
    Chairman Tester. Okay. Good. So what this does, it is going 
to direct the VA to improve how it plans and delivers 
construction projects while it strengthens Congress' ability 
for oversight.
    So, Mr. Brown, or who you want to defer it to, how would 
this legislation speed up the delivery of new facilities for 
veterans with spinal cord injuries or diseases?
    Mr. Brown. Actually, I have a talking point right here in 
front of me. Currently there are 14 SCI centers that use four 
bedrooms. If a veteran comes in and has a particular 
abnormality or disease or comorbidity they cannot put another 
patient in that room. That means three veterans cannot get the 
care they need in that room.
    So with these bills, and I believe what you are 
introducing, will create single rooms for these veterans and we 
will be able to create proper care for the veterans when they 
get to the hospital. They will not be waiting for a bed to be 
available because one veteran takes up four spaces.
    Chairman Tester. I appreciate that answer, Mr. Brown.
    Cannabis has been a big issue for quite a while. Cannabis 
use among veterans continues to rise, especially among the Iraq 
and Afghanistan vets. Despite the continued increased use as an 
alternative treatment for veterans, we still do not fully 
understand the impacts of cannabis use.
    Mr. Butler, do you support VA-led research into the effects 
of cannabis use on veterans?
    Mr. Butler. Absolutely, sir. We have been pushing for this 
for years. Frankly, what you just said is exactly right. At a 
minimum, VA should be doing research. I cannot even keep up 
with the number of states that now have legal use of medicinal 
cannabis. It is well above 33, I think, and with the last 
election's increased beyond that. At a minimum, VA should be 
doing this research so that we can understand just how 
effective it very much seems to be for treating many of the 
injuries that our era of veterans have.
    Research should be a no-brainer, but yet for years we have 
been getting pushback on that. So we certainly hope that this 
is the year we can change that.
    Chairman Tester. Senator Moran and I do too because we have 
a bill to do exactly that. And with that I will turn it to 
Senator Moran.

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

    Senator Moran. Chairman, thank you. Thank you all for your 
presence here today. I walked in at the right moment. Mr. 
McManus, thank you for your comments about the consequences of 
toxic exposure to following generations, to our veterans. This 
issue came to my attention at a Vietnam Veterans national 
conference on the topic in Wichita, Kansas, a number of years 
ago. I am pleased that Senator Blumenthal and I were able to 
get the Toxic Exposure Research Act signed into law.
    But we have learned from the VA and the National Academies 
that there are still significant challenges to research the 
health effects of toxic exposure on veterans' descendants. And 
I will use this opportunity to say I want to work with you and 
VVA and others to make sure that we accomplish that goal of 
science and medicine coming together to tell us what the truth 
is.
    Mr. Hartsell, I could not agree more with your written 
statement about the importance of VA processing referrals for 
care in the community in a timely manner. We have been working 
to get this accomplished, starting with just when does the 
clock begin to run so that we can determine how long that 
period of time is, and even that has been a challenge in 
solving.
    Can you elaborate on the frustrations that you hear from 
veterans across the country and in our states about the VA's 
failure to connect them with community care in a timely manner, 
and give us recommendations you may have for how to improve 
that process.
    Mr. Hartsell. Thank you for the question, Ranking Member 
Moran. Yes, veterans are frustrated when we need care, medical 
care. And we go to our doctor and our doctor tells us, ``We are 
going to refer you.'' That is great news. ``We are going to 
send you to a specialist, someone really good in the 
community.'' I personally experienced this last year myself. I 
was very excited, because I get great care from the VA. They 
give me great care, at my clinics, at my hospital, at James 
Hailey down in Tampa. But there was a test they needed to run 
so they asked me to go to community care, another great 
hospital that is top-notch in our Tampa Bay area.
    Retired Marine two-star general 37 years, President of 
National Association of State Veterans Affairs Directors, 
Executive Director of Florida's Department of Veterans' 
Affairs--it took me months and months to get that test done. It 
was frustrating. I personally experienced this.
    So just put that plus the 1.5 million veterans that I have 
in Florida, we hear this all the time. When they do get the 
care in the community, we are very happy, and we are very 
thankful for the community care.
    So the timeliness of it, the working of it--and again, it 
is a process. It is a business process. I understand that. So 
we applaud the VA's great efforts to make it better, to work on 
it. We have personally talked to the leadership of the VA about 
everything that they are doing to make it work better. But a 
lot of times it is the human factor. The process is in place 
but it is the human factor, those phone calls and the 
connecting. It is hard to connect with these, especially an 87-
year-old Marine veteran like my father was. There is a 
different way to communicate to him about community care, 
making that access, than my 36-year-old Marine son. A different 
way to communicate to him.
    So I understand that VA has a lot of work to do on this, 
and we applaud their efforts on it. But we, as a national 
association, all 50 states and the territories in our district, 
we will do everything we can at our state and territory levels 
to reinforce their work on that, because it is critical.
    Senator Moran. Thank you.
    Chairman Tester. Thank you, Senator Moran.
    Ranking Member Takano.
    Mr. Takano. Thank you, Chairman Tester. You know, the 
budget cuts endorsed by some of my colleagues at the beginning 
of this Congress represent a nearly $31 billion cut to veterans 
programs. I am talking about the talk about keeping to the 2022 
spending limits. And since then, under pressure from the 
President of the United States and his own party, the Speaker 
of the House has declared that the DoD budget and Social 
Security and Medicare should be held harmless in any potential 
austerity measures. But veterans programs have not been 
extended this very same courtesy.
    So once again it appears that veterans will be asked to 
sacrifice on behalf of the nation, in this case their hard-
earned health care and benefits.
    Mr. Butler, can you elaborate on IAVA's position with 
respect to VA budget cuts? What would a cut of that size mean 
for your members and the services they utilize at VA?
    Mr. Butler. Yes, sir. Thank you for the question. I mean, I 
think we can all agree that the government can do a better job 
of managing its finances. I think that is an agreement. Where 
we have an issue is when there are proposals to cut back on 
care and support for veterans who have earned these benefits. 
At the end of the day, we need to keep our promises. In the 
last testimony there was a lot of discussion about keeping 
promises, and that is really what we are talking about is 
making sure that those things that over 20 years of war, when 
funding flew very freely, there were very little efforts to 
finance these things, and to now have to turn around and say, 
``We are going to correct those errors on the backs of those 
who raised their right hand to volunteer to fight these wars,'' 
is where we get very frustrated.
    Mr. Takano. Well, thank you.
    Quickly, Mr. Brown, could you tell us what it would mean to 
Paralyzed Veterans of America?
    Mr. Brown. I ask you all to take a look behind me. These 
veterans that we see, they are specialty cared through the VA. 
That is not found in the community anywhere. The care and 
continuous care we receive. You are going to tell them, ``We 
are sorry. We cannot fund the care you deserve or you earned''? 
What are they going to do? Where do we go?
    Look at all the other veterans in this community out here. 
They feel the same way. It is not just for PVA. It is for all 
veterans. You are cutting the care, the drastic care that we 
need through the VA. You cannot do that.
    Mr. Takano. Thank you, Mr. Brown.
    By a show of hands, who on this panel would agree that 
slashing tens of billions of dollars from VA programs and 
services to veterans is a good idea? Raise your hand. I dare 
you.
    [Applause.]
    Mr. Takano. So let the record show that no one, not a 
single organization testifying here today raised their hand in 
support of these disastrous proposed budget cuts. It is 
imperative that we hold the line on VA's budget so that 
veterans are not once again left fighting each other or the 
general public for benefits they have earned and undoubted 
deserve.
    I yield back, Mr. Chairman.
    Chairman Tester. Thank you, Ranking Member Takano.
    Next we have Congressman Rosendale.

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

    Mr. Rosendale. Thank you very much, Mr. Chair, and thank 
you to all the witnesses for taking time out of your busy 
schedules to join us here today.
    It is a lot to get here, and it is a lot to sit before 
everyone and share your stories, so it is important for 
everyone, not just in the room but across the nation, to be 
able to hear that. And we are trying to make sure that we not 
only provide the proper funding but we provide it in the right 
areas. I think that is also another point that needs to be 
made.
    Your testimonies and commitment to the veterans is 
essential as we continue our work as we go through the 118th 
Congress. Mr. Lyon, I am going to start with you. Thank you for 
sharing all the stories about Student Veterans of America's 
1,600 chapters worldwide and the important work that each of 
the chapters is doing in its community. Can you elaborate, 
please, for me on the importance and the contribution of 
students veterans to the college community in addition to the 
financial benefit that they happen to bring each educational 
facility?
    Mr. Lyon. Yes, sir, and thank you so much for the question. 
When you look at today's student veterans you are looking at 
one of the most representative and inclusive populations of any 
students on a campus, let alone add to that the real-world 
experience that they have had before they have pursued their 
educational journey. Many of us have put our lives on hold to 
serve first, and then when we return home have the opportunity 
to pursue our education.
    We bring leadership to the classroom. We bring leadership 
to group projects. We bring leadership through campus 
organizations, to do something that I think is very important 
and that we have an opportunity, daresay a responsibility, to 
do.
    One in three college students does not themselves know a 
veteran. That means no one in their family served. Likely no 
one in their neighborhood served. That notwithstanding, today's 
student veterans have the opportunity to help bridge the 
civilian and military divide through their integration on 
campus and their inclusion in every aspect and policy that the 
university upholds.
    Mr. Rosendale. So would it be fair to say that they 
oftentimes act as mentors for the younger, more inexperienced 
students that happen to be walking around campus, that do not 
have quite the life skills that you do?
    Mr. Lyon. We are the big sisters and brothers on that 
campus. Yes, sir.
    Mr. Rosendale. Thank you. Thank you very much.
    [Applause.]
    Mr. Rosendale. Yesterday the Supreme Court heard oral 
arguments over President Biden's unilateral decision to cancel 
student loans. The debt forgiveness plan will cost over $400 
billion. Besides the massive cost, Biden's actions, quite 
frankly, are a disgrace to veterans that are sitting in this 
room and are serving across the nation.
    Mr. Lyon, how many more veterans do you think could expand 
or complete their educational or other vocational training 
opportunities with access to an additional $400 billion, which 
is greater than the entire annual budget of the Veterans 
Administration?
    Mr. Lyon. Sir, it is a complex question, and when we look 
at today's student veterans you are looking at just over 70 
percent of the transitioning force is in a college classroom 
within 7 months of returning home. So, you know, by that math 
alone you would say at least 30 percent of veterans that are 
transitioning and not pursuing it.
    But debt is a hard and complex thing because student 
veterans, despite having the GI Bill and full access, are still 
graduating with an average of $27,000 in student loans. We have 
to get better at the entire and complex system.
    Mr. Rosendale. Thank you. Mr. Chair, I would yield back.
    Chairman Tester. Thank you, Congressman.
    Next up we have Representative Cherfilus--sorry about 
that--McCormick.

                HON. SHEILA CHERFILUS-MCCORMICK,
                U.S. REPRESENTATIVE FROM FLORIDA

    Ms. Cherfilus-McCormick. Thank you, Mr. Chair.
    My first question is for Mr. James Hartsell, my fellow 
Floridian. Many veterans wish to age in place but do not 
understand how to access the VA benefits and programs that 
would empower them, or are unaware of what services are 
available to them based on their circumstances. While the VA 
has a suite of benefits available to aging veterans, veterans 
face many issues when accessing these benefits.
    How can the VA reach out to the aging veterans so that they 
can access their VA benefits and health care?
    Mr. Hartsell. Thank you for the question, Congresswoman. I 
appreciate it, and yes, we are fellow Floridians. Thank you.
    We work very closely as an association, our 50 states and 
territories and the District of Columbia, with veterans. I call 
it Big VA, the U.S. Department of Veterans Affairs, in 
communicating the need and the opportunity for benefits for 
those who served our nation. They are doing a good job. A great 
job could be done, and we could reinforce it in the states and 
territories, I think, in an ad campaign--you asked a question 
and this is my personal opinion--something that we are pursuing 
in my state.
    We are looking at doing a public awareness campaign for 
veterans, a lot of those older veterans you are talking about, 
those elderly veterans. A lot of them still watch TV and they 
look at TV. So if they saw that commercial, instead of some of 
the commercials we talked about earlier on TV all the time, if 
they saw a commercial about what is available, and they see 
people getting those kind of benefits from the Veterans Affairs 
Administration, that would help, in my opinion. And we would 
support that in our states and territories, an opportunity to 
reinforce their success in that.
    Ms. Cherfilus-McCormick. Thank you so much for your answer.
    My next one is for Mr. Shawn Deadwiler. Mr. Shawn 
Deadwiler, the chief goal of the BVEC is to shift longstanding 
racial inequalities suffered by Black veterans in the United 
States. Since BVEC's inception the organization has grown to 
include 15-plus organizations representing over 20,000 members.
    As it relates to receiving and applying for health care 
benefits in the VA, what issues have your members come across?
    Mr. Deadwiler. That is a good question, Congresswoman. I am 
new to this seat but if I had to tell you a personal story on 
it, Black veterans, when they go to access benefits, are denied 
regularly, the first try, the second try. We are then told to 
go meet with VSOs and lawyers in order to get those benefits. I 
think we need to do some different things and some studies on 
how to get the VVA more involved in helping veterans.
    I will give you a personal story. I have a veteran right 
now that is 82-years-old. He just went through diaphragm 
surgery. He is 160 percent disabled, living alone, widowed. The 
doctor fills out his aid and attendance. It is now 6 months and 
he is still living in that house by himself, and has not gotten 
that benefit. So we can do a better job.
    Ms. Cherfilus-McCormick. Thank you so much, Mr. Chairman. I 
yield back.
    Chairman Tester. Thank you, Congresswoman.
    Next we have Representative Van Orden.

                    HON. DERRICK VAN ORDEN,
               U.S. REPRESENTATIVE FROM WISCONSIN

    Mr. Van Orden. Thank you, Mr. Chairman. Thank you all for 
coming here today. I really appreciate it.
    We have veterans from the Vietnam War here. We have got 
veterans that served in the '80s and '90s, who really trained 
for combat. We have got our post-9/11 guys here, and Eli, my 
buddy here, is a Navy SEAL, and so is Morgan, and so was I. We 
had multiple combat tours.
    I really want you guys to understand something, that we 
have multiple generations concurrently of veterans at all 
times, and what binds us together collectively, other than the 
love of our nation, is really your organizations. And you have 
a tremendous responsibility to make sure that--I am staring 
right at you, General, and I am going to say it--us younger 
folks get to hang out with you guys. And the way that we become 
whole again is by sharing our experiences together, and I truly 
understand that.
    Mr. Chairman, I just want to take one second here to 
recognize Mr. Josh Jones. Will you stand up, please? This is 
Josh Jones.
    [Applause.]
    Mr. Van Orden. He was the student of the year. Well done. 
You guys have no idea how painful that was for me because I am 
in the Navy and you were not, and you are also a flatlander 
from Illinois, and I am from Wisconsin. But you keep up the 
good work, young man. You hear me?
    I chair the subcommittee that is responsible for veteran 
education, homelessness, and the transition from active duty to 
becoming a veteran, so Mr. Lyon, I want to ask you a question. 
My concern is, and my primary legislative priority is that 
transition period because that is when unfortunately we have a 
lot of veterans take a permanent solution to a temporary 
problem and commit suicide. It is terrible.
    So I want to know, have you been invited by the Department 
of Defense or the Veterans Administration to participate in the 
TAP process?
    Mr. Lyon. Yes.
    Mr. Van Orden. Okay. What type of participation do you guys 
have?
    Mr. Lyon. We have got a variety of participation. We are 
often invited to observe and provide recommendations, which is 
the easiest way to answer that.
    Mr. Van Orden. Okay. Is it a formal, programmatic thing, or 
is it ad hoc?
    Mr. Lyon. Both. Formal, programmatic and ad hoc.
    Mr. Van Orden. Okay. I want to talk to you guys again when 
we get out of here. I want to make sure that this is included 
in that.
    Mr. Lyon. I would absolutely love to do that.
    Mr. Van Orden. Okay. I want to make sure that when our 
veterans--you know, people do not understand it who have not 
served that on Monday you are an active-duty servicemember and 
on a Tuesday you are a veteran, and that transition period, you 
go from wearing a uniform and having a purpose, a drive in 
life. They say twice the husband, half the paycheck. Let us be 
honest.
    [Laughter.]
    Mr. Van Orden. That is a Navy wife out there that just 
laughed.
    So all these things are dramatic, and that is why our folks 
make some bad decisions. So I want to make sure that you are 
included in this process formally. So thank you very much, and 
sir, with that I yield back.
    Chairman Tester. Thank you, Congressman.
    Representative Pappas.

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

    Mr. Pappas. Thank you very much, Mr. Chairman. I want to 
thank all the veteran service organizations that are 
represented here for your advocacy, and to all our veterans in 
the room I am grateful for your service.
    Mr. Brown, maybe I could ask a question of you. I had some 
folks from PVA in my office earlier today. The message was well 
received and they were great advocates, and we appreciate what 
your organization does.
    I wanted to ask about the disparity between the rate of 
dependency and indemnity compensation at VA for surviving 
dependents and other comparable government benefit programs, 
with DIC payments being markedly lower. I am wondering if you 
have some thoughts on those DIC payments, if you have any 
recommendations on what an appropriate base rate could be, and 
whether or not an increase would help survivors.
    Mr. Brown. I apologize, but I guess my obvious answer is of 
course it would help. I mean, you look at an ALS patient in the 
VA, they are automatic 100 percent. They barely, rarely make 3 
years of their life. In order to get the DIC kicker they have 
to go 8 years. That right there alone is just an obvious answer 
to say yes, it would make a huge difference in the life of a 
spouse.
    Sorry, that is the obvious answer right there. Everything 
would make a difference in the spouse's life. You go from, on 
average, around $10,000 a month for our compensation. When we 
pass away our spouses barely get $1,200. How do they survive 
after that? Sorry.
    Mr. Pappas. No, thanks for the response. And I am the 
Ranking Member on the Disability Assistance and Memorial 
Affairs Subcommittee in the House, so we look forward to 
staying in touch on that issue.
    And maybe, Mr. Butler, I could turn to you next and just 
kind of build off that. Under existing law a surviving spouse 
loses their DIC benefit if they remarry before age 55, but 
surviving spouses of active duty servicemembers and veterans 
are more likely to be widowed at a younger age than other 
professions. And so on average, the wait period to maintain 
eligibility for surviving spouses is longer for survivors of 
other Federal benefit programs.
    So I am wondering if Congress should be working to address 
this, if you have any thoughts on that, or the DIC issue 
generally.
    Mr. Butler. Absolutely. I will keep it short and sweet and 
say yes, 100 percent. It is one of those things that I hope was 
not an unintentional slight but it is definitely an area where 
there is very much needed reform.
    Mr. Pappas. Thank you. Once again we look forward to 
working with all of you collaboratively. We thank you for your 
service. I yield back my time.
    Chairman Tester. Thank you, Congressman.
    Representative Luttrell.

                     HON. MORGAN LUTTRELL,
                 U.S. REPRESENTATIVE FROM TEXAS

    Mr. Luttrell. Thank you, Mr. Chairman.
    First I would like to make a statement to the panel and to 
all the veterans in the crowd today. I understand that when it 
comes to our electronic health records we are doing everything 
we can to make that our primary effort. And unfortunately, as 
you all know, the government works in silos. Sharing data, 
sharing information is just--it is almost an amendment to the 
Constitution.
    But being veterans ourselves, also understand that we are 
our country's most precious assets, and to lose any of that 
data to nefarious acts is something that we are working hard to 
prevent. And I understand the frustrations, because data 
sharing, information sharing creates results. Results moves 
down and inside the organizations, which helps us long term. So 
I wanted you to hear me say that, as a new member to the 
Veterans' Affairs, which I fought to get on specifically for 
that reason.
    To the General I have a quick question for you. You 
mentioned that the transition from Guard to active--and I know 
that goes back and forth--and you mentioned cost, how much 
costs that would save. Can you provide us those numbers so we 
can see what you are talking about? I do not have those numbers 
specifically, and you may not have them with you now, but that 
is something that I would like to see.
    Mr. Robinson. We will, and it is in reference to the costs 
associated with the readiness part of that medical. We can get 
that for you.
    Mr. Luttrell. Okay. I would appreciate that.
    And Ms. Pratt, thank you for being here. I actually 
represent the Alabama-Coushatta Tribe, and please understand 
that this translates across to our Vietnam veterans, to our 
Black veterans, to our veterans in general. But my question for 
you is--and I served alongside Native Americans out of the Crow 
reservations in the SEAL teams, and unfortunately I lost him. 
And I was able to go up to the reservation and be a part of the 
service and be a part of the tribe for that short period of 
time.
    What I am having trouble with, even with the homeless 
veterans inside the reservations, is the culture prevents me 
from coming in because, number one, I am an outsider, and 
number two, I represent the government. And I would like to 
have a follow-on. This may be a lengthy conversation, but when 
I have the conversations with our tribal elders and our tribal 
leadership on how we can assist not only our veterans but the 
tribes in general, they are almost reluctant to have me come 
because of my representation at the Federal level.
    Are you seeing that? Are you hearing that? And if so, how 
do I crack that nut?
    Ms. Pratt. Yes, sir. Thank you for the question, and yes, 
it is a very long conversation to have, and it has been ongoing 
for quite some time, and that is what we are asking for in so 
many aspects of dealing with Native veterans.
    We heard the Legion speak earlier, and we know veterans 
want to speak to veterans, having that relationship, and tribal 
veterans want to speak to tribal veterans. And that is why we 
are pushing for tribal veteran service officers and cultural 
competency in all that we do, whether it be health care, mental 
health care.
    I agree, and that is where we are at. So many things on 
which there has been a lot of legislative progress, and thank 
you all for being a part of that. So much has happened just 
even in the last 3 years, 5 years, so I really appreciate that. 
But we have to be talking. We have to be communicating. We have 
to be trying to build that relationship between the VA, between 
the government and tribal nations, and that is why we have to 
speak out.
    So I would suggest that you continue to show up, continue 
to reach out to them, continue to try to build that bridge 
because we have a long history of being invisible and not 
counted. And that is the one thing I spoke on is data. We are 
still being considered ``other.'' As indigenous peoples of this 
land, we are still being counted as ``other'' or checking the 
box ``other'' or ``something else.'' And so we need to know our 
own data. We need to know what is happening across because we 
are talking about over 500 tribes that we are dealing with and 
have needs.
    And so I would definitely say that all of us have a lot of 
work to do in continuing to build that bridge.
    Mr. Luttrell. Let us have a follow-on because I know my 
time is up, sir. Because if the tribes are siloed themselves--
like I do not like the Army. I am a Navy guy, so I do not talk 
to the Army.
    Ms. Pratt. We are done here.
    [Laughter.]
    Mr. Luttrell. You know what I mean? I was just curious. 
Okay, a follow-on. So thank you so much for your time.
    Chairman Tester. Thank you, Congressman.
    Representative Crane.

                       HON. ELIJAH CRANE,
                U.S. REPRESENTATIVE FROM ARIZONA

    Mr. Crane. Well, it is a pleasure to be here today. I am 
just going to ask this question real quick. Is it cold in here 
or is it just because I am from Arizona? All right. It is a 
little chilly. It is a little chilly.
    My question today is for Mr. Butler and Mr. Hartsell, if 
you guys could maybe take a minute each. You know, I have heard 
many issues from veterans in my district about issue that they 
have with the VA getting health care in a prompt and sometimes 
professional manner, and I do like to see veterans have options 
out in town. And I know some of the legislation that has been 
passed. Like the MISSION Act, giving veterans access to 
private, civilian health care out in town, I think can be a 
very good thing.
    What have you guys experienced--and I am asking you because 
I see you guys as experts--what have you guys experienced? Why 
are you guys laughing out there?
    Mr. Butler. That is what I just asked.
    Mr. Crane. What have you guys experienced in your 
organizations and with those that you represent when looking at 
whether or not the vets under your umbrellas are able to get 
out in town quickly, especially those that are dealing with, 
you know, sometimes very serious suicidal type issues?
    Mr. Butler. Great. Thank you for the question, sir. Yes, so 
very briefly, we do surveys regularly of our members, and one 
thing that we hear overwhelmingly, and I think this is echoed 
around the line, is our members love the care that they get at 
the VA. They are sometimes frustrated that they cannot get it 
as quickly as they want or at the pace that they need.
    So a short answer to a somewhat complicated question, we 
support the use of Community Care, but at the end of the day we 
feel that it should be used as a bridge to improving the VA, so 
that we can get veterans into the VA, so that we can get 
veterans who are maybe frustrated, who have had bad experiences 
with the VA, get them the care that they need, but do the best 
that we can to get them back in the system. So I see the 
MISSION Act and Community Care as a bridge to improving VA care 
so that we can get the veterans back in.
    Mr. Crane. Thank you.
    Mr. Hartsell. And thank you for your service and sacrifice 
as a Navy SEAL, sir. Thank you.
    Mr. Crane. Thank you.
    Mr. Hartsell. I echo exactly what he just said. From our 
association, again, I speak for 50 voices plus five territories 
and the district. But the issue is awareness. If a veteran is 
not aware, if a veteran's family members are not aware that 
care is available, so if we do not get through that hurdle it 
does not matter. You need awareness first, and then once you 
have the awareness that care is available, that we can help 
you, with whatever issue you have as a veteran, or family 
members of veterans, then what do you do with that information? 
What is the process, so that is an education?
    So there is a multilevel layer of things that need to take 
place here. And then where the frustration typically comes in 
is with the follow-through. It is the access to the care. Once 
you understand it, once you are aware of it, once you have the 
information--and that is why we are working with the VA, the 
Federal VA, to make it more aware and have better understanding 
of the process, because our veterans do deserve, and they need 
that care. And it is great, community care.
    And yes, we fully support, we, as an association, fully 
support the MISSION Act and support the VA's double-down 
efforts to make the MISSION Act accessible and successful for 
all of our veterans.
    Mr. Crane. Thank you, sir.
    Chairman Tester. Thank you, Congressman.
    Representative Mrvan.

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

    Mr. Mrvan. Thank you. As new Ranking Member of the 
Oversight and Investigations Subcommittee, the problems, 
challenges facing employees at the VBA National Call Center 
greatly concern me. These employees, many of them veterans 
themselves, still face the pressures and problems associated 
with talk time, which limits them to 8 minutes and 30 seconds 
on a call in order to receive a fully successful rating. This 
standard does not account for many new and complex questions 
since the implementation of the PACT Act, nor does it take into 
consideration many common but difficult circumstances they 
face.
    With that, an open-ended question to all of you. How 
important is it to you and your members to be able to spend 
time talking about the circumstances to a real person at the VA 
to handle questions about the benefits and challenges that you 
face?
    Mr. Hartsell. I will jump in. For the association, NASDVA, 
it is critical because veterans want to talk to someone. They 
need to talk to someone. It does not matter if it is that 87-
year-old veteran or that 30-year-old veteran, we want to talk 
to people, and we need to talk to people. And we need to have 
the time to do it. We need to be listened to, and we do not 
want to be cutoff. That is the reality, sir.
    Mr. Mrvan. Okay. And the point of me bringing that up is 
because I believe that is also the case. There should not be a 
running clock for our veterans who served, who are trying to 
access benefits, especially as we roll out the PACT Act and 
other benefits.
    My other question, very quickly, to Mr. Brown. Is the VA 
Caregiver Support Program the program for comprehensive 
assistance for family caregivers, as anyone in your networking 
utilized that, and what is the acceptance rate and what are 
your views on that?
    Mr. Brown. The program is good. It works well at times, but 
they are putting people here that have not used the program, 
across our organization. The best way to put it is--I do not 
know how to say it--it works well when it is applied well. It 
all depends on each medical facility and how it is applied in 
each area. Sometimes it is pushed through easily and other 
times you have to go through so many hurdles it becomes a 
problem. The payments are late or delayed. There are all kinds 
of things that happen. But when it works it works great for our 
veterans.
    Mr. Mrvan. Okay. I thank you very much. With that I yield 
back.
    Chairman Tester. Thank you, Congressman, and I want to 
thank you folks all for being here, sharing your 2023 
legislative priorities with us.
    Look, I just want to tell you all that we value and 
appreciate what you do. We appreciate the thoughtfulness you 
put into your opening statements and appreciate you being here 
and fielding questions. We will do our level best to do right 
by the folks who have served us and the folks who have 
sacrificed for us, so thank you.
    We will keep this record open for a week, and with that 
this hearing is adjourned.
    [Whereupon, at 1:09 p.m., the hearing was adjourned.]

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