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


                                                         S. Hrg. 118-94

            LEGISLATIVE PRESENTATION OF VETERANS OF 
             FOREIGN WARS OF THE UNITED STATES AND 
             MULTIPLE VSOs: PVA, WWP, NASDVA, MRC, 
             BSF, IAVA, BVA, SWAN, SVA, AMVETS

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

                             JOINT HEARING

                              BEFORE THE

                     COMMITTEE ON VETERANS' AFFAIRS
                          UNITED STATES SENATE

                                AND THE

                     COMMITTEE ON VETERANS' AFFAIRS
                     U.S. HOUSE OF REPRESENTATIVES

                    ONE HUNDRED EIGHTEENTH CONGRESS

                             SECOND SESSION

                               __________

                             MARCH 6, 2024

                               __________

      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                    
55-118 PDF                  WASHINGTON : 2024                    
          
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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
               David Shearman, 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, 
Scott Franklin, Florida                  Florida
Derrick Van Orden, Wisconsin         Christopher R. Deluzio, 
Morgan Luttrell, Texas                   Pennsylvania
Juan Ciscomani, Arizona              Morgan McGarvey, Kentucky
Elijah Crane, Arizona                Delia C. Ramirez, Illinois
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 6, 2024

                                                                   Page

                                SENATORS

Hon. Jon Tester, Chairman, U.S. Senator from Montana.............     1
Hon. Jerry Moran, Ranking Member, U.S. Senator from Kansas.......     4
Hon. Dan Sullivan, U.S. Senator from Alaska......................    15
Hon. Margaret Wood Hassan, U.S. Senator from New Hampshire.......    18
Hon. Tommy Tuberville, U.S. Senator from Alabama.................    19
Hon. Richard Blumenthal, U.S. Senator from Connecticut...........    21
Hon. Mazie K. Hirono, U.S. Senator from Hawaii...................    24
Hon. Thom Tillis, U.S. Senator from North Carolina...............    25
Hon. Angus S. King, Jr., U.S. Senator from Maine.................    28

                            REPRESENTATIVES

Hon. Mike Bost, Chairman, U.S. Representative from Illinois......     2
Hon. Mark Takano, Ranking Member, U.S. Representative from 
  California.....................................................     5
Hon. Julia Brownley, U.S. Representative from California.........    20
Hon. Chris Pappas, U.S. Representative from New Hampshire........    22
Hon. Christopher Deluzio, U.S. Representative from Pennsylvania..    24
Hon. Morgan McGarvey, U.S. Representative from Kentucky..........    26
Hon. Matthew Rosendale, U.S. Representative from Montana.........    27
Hon. Mike Levin, U.S. Representative from California.............    50
Hon. Jack Bergman, U.S. Representative from Michigan.............    51
Hon. Greg Landsman, U.S. Representative from Ohio................    52
Hon. Frank J. Mrvan, U.S. Representative from Indiana............    53

                       INTRODUCTION OF WITNESSES

Ryan Gallucci, Executive Director of the VFW Washington Office...     8

The Honorable Jeff Van Drew, U.S. Representative from New Jersey.     8

                               WITNESSES
                                Panel I

Duane Sarmiento, Commander in Chief, Veterans of Foreign Wars of 
  the United States..............................................    10

  accompanied by

  Ryan Gallucci, Executive Director of the VFW Washington Office

  Patrick Murray, National Legislative Director

  Michael Figlioli, National Service Director

  Stanley Borusiewicz, Legislative Committee Chairman

                             GUEST REMARKS

The Honorable Elizabeth Dole.....................................    29

                                Panel II

Robert Thomas, National President, Paralyzed Veterans of America.    31
Lt. Gen. Michael S. Linnington, USA (Ret.), Chief Executive 
  Officer, Wounded Warrior Project...............................    33
Dennis Wimer, President, National Association of State Directors 
  of Veterans Affairs............................................    35
Jim Whaley, Chief Executive Officer, Mission Roll Call...........    37
Kathy Roth-Douquet, Chief Executive Officer, Blue Star Families..    39
Allison Jaslow, Chief Executive Officer, Iraq and Afghanistan 
  Veterans of America............................................    41
Paul L. Mimms, National President, Blinded Veterans Association..    42
Lorry M. Fenner, PhD, Colonel, USAF (Ret.), Director of 
  Government Relations, Service Women's Action Network...........    44
Jared Lyon, National President and Chief Executive Officer, 
  Student Veterans of America....................................    46
William ``Bill'' Clark, National Commander, American Veterans....    48

                                APPENDIX
                          Prepared Statements

Duane Sarmiento, Commander in Chief, Veterans of Foreign Wars of 
  the United States..............................................    61
Robert Thomas, National President, Paralyzed Veterans of America.    92
Lt. Gen. Michael S. Linnington, USA (Ret.), Chief Executive 
  Officer, Wounded Warrior Project...............................   112
Dennis Wimer, President, National Association of State Directors 
  of Veterans Affairs............................................   151
Jim Whaley, Chief Executive Officer, Mission Roll Call...........   169
Kathy Roth-Douquet, Chief Executive Officer, Blue Star Families..   175
Allison Jaslow, Chief Executive Officer, Iraq and Afghanistan 
  Veterans of America............................................   187
Paul L. Mimms, National President, Blinded Veterans Association..   198
Lorry M. Fenner, PhD, Colonel, USAF (Ret.), Director of 
  Government Relations, Service Women's Action Network...........   213
Jared Lyon, National President and Chief Executive Officer, 
  Student Veterans of America....................................   229
William ``Bill'' Clark, National Commander, American Veterans....   266

                        Statement for the Record

The Honorable Elizabeth Dole.....................................   279

 
  LEGISLATIVE PRESENTATION OF VETERANS OF FOREIGN WARS OF THE UNITED 
STATES AND MULTIPLE VSOs: PVA, WWP, NASDVA, MRC, BSF, IAVA, BVA, SWAN, 
                              SVA, AMVETS

                              ----------                              


                        WEDNESDAY, MARCH 6, 2024

                           U.S. Senate, and
                     U.S. House of Representatives,
                            Committee on Veterans' Affairs,
                                                    Washington, DC.

    The Committee met, pursuant to notice, at 10 a.m., in Room 
SD-G50, Dirksen Senate Office Building, Hon. Jon Tester, 
Chairman of the Committee, presiding.

    Present:

    Senators Tester, Brown, Blumenthal, Hirono, Hassan, King, 
Moran, Boozman, Cassidy, Tillis, Sullivan, and Tuberville.

    Representatives Bost, Bergman, Mace, Rosendale, Miller-
Meeks, Takano, Brownley, Levin, Pappas, Mrvan, Deluzio, 
McGarvey, Ramirez, Landsman, and Budzinski.

    Also Present: The Honorable Elizabeth Dole.

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

    Chairman Tester. I want to welcome everybody to today's 
joint Senate and House Veterans' Affairs Committee hearing with 
the veteran service organizations. We are going to first kick 
things off hearing from the Veterans of Foreign Wars. A special 
thank you to the VFW members who have traveled from every 
corner of our country to be here, particularly the Montanans in 
attendance, which include Joe Fletcher, Tim Peters, Jack 
Hawley, James Layton, and Fred Hamilton. Thanks for being here, 
fellas.
    I am proud to have recently introduced the Fred Hamilton 
Lost Military Records Act, based on Fred's own experiences, as 
a Montana vet trying to get access to his earned benefits. When 
military treatment records are lost after being transmitted to 
the VA by the Department of Defense this bill would allow the 
VA to consider other documentation when determining 
compensation and pension benefits.
    This is a great example of how Congress relies on the VFW 
to keep us updated on the needs of our veterans and their 
families and how we best support these folks. Historic 
achievements like the PACT Act simply would not have been 
possible without your vision, your leadership, and your 
passion. Thank you.
    [Applause.]
    Chairman Tester. And make no mistake about this: it was the 
VSOs and the veterans who put pressure on Congress to do the 
right thing for our toxic-exposed veterans and their survivors. 
You made democracy work, you held us accountable, and you 
flipped the votes to get the job done.
    We now are focused on getting the Major Richard Star Act 
across the finish line, to finally deliver combat-injured 
veterans their full DoD and VA benefits, and passing the 
Elizabeth Dole 21st Century Health Care and Benefits 
Improvement Act to bolster veterans' access to health care 
benefits and services for which they are entitled and for which 
they deserve. We also need to hold claim sharks accountable for 
preying on veterans' hard-earned benefits through the Guard VA 
Benefits Act.
    But just like with the PACT Act, we need your continued 
partnership to be successful. Your advocacy is democracy at 
work, and we are here today to continue taking our cues from 
you on the work ahead. So thank you for being here.
    With that I will turn it over to Chairman Bost.

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

    Chairman Bost. Thank you, Chairman Tester. Good morning. I 
want to say a special hello to all of you and a special hello 
to all those from Illinois. And if you are from Illinois you 
know my part of Illinois is way south. But we want to thank you 
for being here. And thank you to our friends on the other side 
of the Capitol for hosting this first joint hearing during the 
second session of the 118th Congress. It is an honor to join my 
friends Chairman Tester, Ranking Member Moran, and Ranking 
Member Takano, in welcoming you to the VSO hearing.
    I would also like to thank VFW's National Commander in 
Chief, Duane Sarmiento--I want to get that right--and his wife, 
Ellen, for being here today.
    [Applause.]
    Chairman Bost. I would also like to give a shoutout to the 
Illinois State Commander, Mr. Brett Nila.
    If you are joining us from Illinois, if you would just 
wave, will you. Fantastic. A few in the back there. All right.
    [Applause.]
    Chairman Bost. Welcome to Washington, DC, and thank you for 
traveling here from the best state in the union. We knew we 
would get a response.
    As most of you know by now, being a Chairman is not a 
responsibility I take lightly. It is very personal for me and 
my family. Many of you know I am a Marine--oohrah, yes. As a 
third-generation Marine, and my son is a lieutenant colonel at 
this time, and a grandson who is a corporal at this time in the 
Marine Corps. So you can see it is a family thing.
    [Applause.]
    Chairman Bost. With that, our family knows, and each one of 
us up here know the sacrifices you have made. And I know that 
at the end of the day, you just want access to the health care, 
benefits, and services you have earned, without a headache.
    The Veterans of Foreign Wars are great advocates for both 
here in DC. and across the country, in every community. You 
have my commitment that we will continue to fight for you and 
the voices you represent, just as hard as you fought for us. 
That is why we want to make sure we do that.
    I am proud of all that we have accomplished together in the 
last few years, as mentioned by the Chairman, including the 
President signing the bipartisan PACT Act into law. This 
legislation is the largest expansion of health care and 
benefits for veterans and their families in recent history, and 
we are going to make sure VA gets it right. And when they make 
mistakes, I will be the first to hold them accountable and get 
answers for you if they have made those mistakes.
    We need all of you to continue to let us know what is 
happening out in the field when it comes to wait times for 
toxic-exposed veterans' health care and other claims decisions. 
As Chairman, a top priority of mine is to hold VA accountable 
for you, the men and women who serve, no matter what. So please 
call or visit our website, or call us to report any waste, 
fraud, or abuse. We need your help in making VA what you 
deserve.
    Looking ahead, I am focused on making improvements where we 
can to modernize the delivery of care and services at the VA. 
We have made great progress in identifying improvements that 
could be made to the Transition Assistance Program, or the TAP, 
through our oversight efforts. The TAP program, I always tell 
people that whenever I got out of the Corps we had a TAP 
program. The colonel tapped me on the shoulder and said, ``Hey, 
I'll see you later,'' and that was it. So we have actually 
improved quite a bit by having it, and we are working on 
legislation to increase accountability at DoD, as well as 
adding separate TAP courses for National Guard, Reservists, and 
military spouses. We will make sure TAP is a worthwhile 
experience for every single servicemember.
    I am also proud to have led the effort to safeguard 
veterans' Second Amendment rights. As Chairman, a veteran, and 
a sportsman, fixing the VA's discriminatory process toward 
veterans was a challenge--and I am going off script here. But I 
am going to tell you, the frustration I felt when I found out 
that a veteran, all they have to do is seek from the VA--and 
having done this for 30 years--all they do is ask for a 
fiduciary, and if they get a fiduciary, they lose their Second 
Amendment rights, without due process. That is ridiculous. It 
has gone on too long. It has discouraged veterans from going to 
seek the VA, and we are hoping we are getting that problem 
fixed now.
    [Applause.]
    Chairman Bost. We will be working on that through a budget 
that is hopefully passing today.
    I am proud to say that our efforts have drawn attention to 
this injustice, and they have paid off. The language of my bill 
is currently included in the VA appropriations bill and will 
soon become law. As the VFW knows, fixing this is long overdue. 
I thank Senators Moran and Tester for helping us get this 
provision across the finish line, and I believe that Senator 
Moran introduced that bill the first time back in 2009. So it 
is finally coming to fruition.
    Right now, we are in bipartisan negotiation to get a 
package of veterans' bills to the President's desk, as well. 
This comprehensive package includes many of VFW's priorities, 
like expansions to VA's long-term care services to put veterans 
in control of where they want to live out their days; 
strengthening the Community Care Program; expansions to the VET 
TEC education program; support for homelessness programs to 
ensure VA can continue to lift veterans out of homelessness and 
get them back on track; and so much more. I would like to, with 
my colleagues, get this package done as soon as possible.
    But make no mistake. Our work is nowhere close to being 
finished. On my side of the Capitol, we have held over 50 
oversight hearings, brought in more than 100 VA officials to 
answer to the veterans and taxpayers they serve, and connected 
with over 10,000 veterans and their families through in-person 
and telephone town halls.
    My door is always open and will continue to be always open 
to you, because veterans are still fighting a VA bureaucracy to 
access the benefits they want, when and where they need them, 
dealing with underperforming VA employees who do not have the 
veterans' best interests in mind, and reeling with the impacts 
of Bidenomics and rising costs of living which is, in return, 
causing an increase in homelessness across the country, 
including with our veterans. These might seem like small 
things, but when it comes down to it, they impact veterans 
every single day. And I will ensure that VA gets the budget it 
needs to complete its goals.
    I look forward to meeting that mission alongside all of 
you, and I thank you again for being here today. With that, I 
yield back.
    Chairman Tester. I will now recognize Ranking Member Moran.

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

    Senator Moran. Chairman Tester, thank you, and I thank you 
and Chairman Bost for hosting us, and it is good to be here 
with both of you and Ranking Member Takano once again as we do 
our oversight and hear our instructions and suggestions from 
the VFW and many VSO organizations today and tomorrow. I thank 
all of our witnesses for being here, for the members who 
traveled to join us here today, for servicemembers and their 
family members, for veterans, for caregivers, all who are here 
to care and love and see that we do the right thing when it 
comes to those who served our country.
    I highlight the Kansans who are in the office and I 
appreciate the strong relationship and friendship we have. It 
was good to see the VFW in our office yesterday, and DAV 
tomorrow, and others throughout this week.
    None of the work we do here is at all possible without the 
contributions and support, the efforts that are made by the VSO 
community, including those present today. We, in my view, have 
accomplished some major things in recent years. None are 
insignificant, and all are important, but there is more, much 
more, to be done, particularly in making certain that when we 
pass legislation it is not just a high-five and a press 
release. It actually results in the increased well-being and 
welfare of those veterans that we are committed to serving. We 
need to make sure that DC, the Department of Veterans Affairs, 
is implementing correctly, and when we have made errors in our 
legislation we need to make sure those errors are corrected.
    I know that many in this room share priorities together in 
this second session of Congress, including protecting and 
expanding and reinsuring timely access to quality health care, 
both at the VA medical facilities and in the community; 
ensuring proper implementation of the PACT Act to avoid further 
backlog of disability claims; engaging with VA to make certain 
that the PACT Act's presumptive decision process is responsive 
to veterans; increasing and updating benefits for survivors; 
assisting veterans in rural areas with unique challenges they 
face; continuing efforts to prevent veteran suicide; 
strengthening and supporting for transitioning members, 
servicemembers, student veterans, and homeless veterans as well 
as individuals within the caregiver, survivor, Guard, and 
Reserve communities.
    This is a great Committee to serve on. I have served on it 
since my original days in the House, 14 years in the House, 14 
years in the Senate. I have asked for this Committee assignment 
in all of my time in Congress. And I want to take this 
opportunity to continue to express my gratitude for the help by 
those in this room and my commitment to work together this year 
and into the future.
    Thank you all for your tireless advocacy on behalf of 
veterans and survivors across the country. Your efforts are 
critical. They do make a difference, and every American should 
know the value of the veteran service organization, and every 
veteran should see the opportunities to serve other veterans 
through a VSO.
    I look forward to your testimony, and I yield back. Thank 
you, Mr. Chairman.
    Chairman Tester. Thank you, Senator Moran. I will now 
recognize Ranking Member Takano.

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

    Mr. Takano. Thank you, Mr. Chairman, Chairman Tester. 
Before I begin my comments I would like to just take a moment 
to send well wishes to Rick Weidman. Many of us know and have 
worked with Mr. Weidman over the years, and he has been a 
forceful advocate for veterans on behalf of Vietnam Veterans of 
America. Rick, you are in our thoughts, and I look forward to 
your returning to hold us accountable and ensuring that 
Congress properly supports the next generation of 
servicemembers and veterans.
    Mr. Chairman and Ranking Member Moran, thank you for 
hosting us here on the Senate side. It is a pleasure to be here 
with my colleague, Chairman Bost, and it is great to see all 
the VSO members and veteran advocates here for our annual 
discussion of priorities.
    The first and most important question, are there any 
Californians in the room? California, in my opinion, is the 
best state. So welcome, and I thank all of you who could not be 
with us in person and who are watching us at home.
    So it is an honor to join all the members of the House and 
Senate Committees on Veterans' Affairs to hear directly from 
the commander in chief and representatives of Veterans of 
Foreign Wars. I would also like to welcome the organizations we 
will be hearing from on the second panel. It is great to have 
all of you here, as well, and I look forward to hearing about 
your priorities, and I thank you all for your continued 
advocacy and support for the veteran community.
    As we approach the 2-year anniversary of the Honoring our 
PACT Act, the implementation of that historic legislation 
remains a high priority for both me, personally, and the House 
Veterans' Affairs Committee Democrats at large. We remain 
committed to ensuring that VA has the resources it needs to do 
the job we asked it to do, and that it does that job to the 
best of its ability.
    And I will resist vigorously any attempts to undermine the 
law and shift back to the old funding paradigm of pitting one 
veterans' program against another or against other domestic 
spending priorities by undermining the Toxic Exposure Fund, 
which is used to pay for PACT Act health care and benefits, as 
some have proposed to undermine. Veterans and their families 
deserve better than that, and so I hope VFW and other VSOs will 
join me in opposing any efforts to pull back from the promise 
of the PACT Act.
    [Applause.]
    Mr. Takano. Today VA is receiving and processing more 
claims for disability compensation than ever before. The VA has 
opened its doors in extraordinary ways to more toxic-exposed 
veterans so they can get the care they need. The last I looked 
at the dashboard, 720,000 claims have been approved for the 
PACT Act.
    [Applause.]
    Mr. Takano. And while the PACT Act continues to be a good-
news story, the law is not without its challenges, particularly 
with respect to hiring and training of new staff, modernizing 
the aging medical facilities, and enacting information 
technology updates. So as I said, we will continue to monitor 
VA's progress with this law and push the Department harder when 
necessary. And I will work to build on the success of the PACT 
Act to expand coverage for veterans exposed to toxins, both 
abroad and here at home.
    [Applause.]
    Mr. Takano. But beyond the PACT Act, however, a great deal 
remains to be done on behalf of veterans during this Congress, 
and among my principal priorities are preserving women 
veterans' health care freedoms, including by ensuring that they 
have access to the full range of reproductive care and 
counseling, including IVF, which Julia Brownley has an 
excellent bill on the Veteran Infertility Treatment Act, which 
would codify access to IVF and remove the service connection 
requirement. So reproductive health care is veterans' health 
care, and we must make it the law.
    [Applause.]
    Mr. Takano. Delivering VA for all veterans, irrespective of 
their age, gender, sexual orientation, or race; working to end 
veteran homelessness and food insecurity; ensuring benefits 
parity for America's veterans, whether they be active duty, 
Guard, or Reserve; and rejecting efforts to privatize VA by 
siphoning off more of VHA's budget for private health care.
    Now unfortunately, we have yet to make much progress on 
those issues in the Congress. In fact, we have seen a 
noticeable backslide on a number of key veteran priorities over 
the last year, like veteran homelessness and suicide. We have 
seen issues related to caregivers and survivors get nothing but 
lip service, and we have seen an exponential growth in the 
number and scale of claim sharks, which my colleague, Chris 
Pappas, has been trying to crack down on with his excellent 
GUARD Act.
    [Applause.]
    Mr. Takano. But sadly, the legislative response to those 
issues from this Congress has largely been nonexistent. 
Instead, we have spent time chasing scandals where they do not 
exist, complaining about flags and mottos, and arguing about 
whether it is a good thing that VA is open and welcoming to 
veterans from all walks of life. At best, it has been a 
distraction from the more pressing issues at hand, and at worse 
it has been a case of severely misplaced legislative 
priorities.
    However, I commit to those who are watching today that I 
will continue to fight for real, concrete, actionable solutions 
to the problems veterans currently face. Now I trust that I 
will continue to have the VSOs as a partner in that effort. You 
all have been a tremendous force for good, especially when that 
voice is unified toward the same policy goal. We saw that with 
your collective advocacy for the PACT Act, which was 
instrumental in getting that bill over the hump.
    And so I applaud your past efforts, and I encourage your 
future ones, and I will always be your champion. I will add, 
though, that I am less optimistic, albeit still hopeful about 
the willingness or ability of the House majority to do what is 
right and necessary to address key veterans priorities.
    Case in point, I think everyone in this room, probably in 
this country, views ending veteran homelessness as a key 
priority, and I would posit that this is indeed an eminently 
achievable goal. There are policy tools that we know work, know 
work well, and quickly, to reduce homelessness among veterans. 
Yet we have allowed VA's authority to use those tools to 
expire. And in our efforts to renew them through the HOME Act, 
we have continually heard complaints about cost and complexity, 
not to mention that we have seen the cynical ploy of pushing 
through knowingly flawed legislation, that the Senate cannot do 
anything with, to pretend that the issue has been addressed, as 
was the case with both the HOME Act and the Elizabeth Dole Home 
Care Act. And on top of that, the improved versions of both of 
these bills are now being held hostage to the majority's desire 
to privatize more VA health care.
    So I implore my colleagues to reject the politics of 
scandal and the culture war and focus on the real and actual 
problems that veterans face on a daily basis so that we can 
make real, lasting progress. Veterans deserve better than what 
this Congress is currently delivering, and we can do better, 
and we have to muster up the courage to deliver.
    So thank you, Mr. Chairman, for yielding, and I will 
conclude by simply saying, don't feed the sharks.
    [Applause.]
    Chairman Tester. I do not know if the VFW knows this but 
you have got some fine people back here working in Washington, 
DC, and I want to introduce one of them, Executive Director of 
the VFW Washington Office, Ryan Gallucci, to introduce the VFW 
national officers.

                 INTRODUCTION BY RYAN GALLUCCI

    Mr. Gallucci. Thank you, Chairman Tester. Members of the 
Senate House Veterans' Affairs Committees, I am honored to have 
the privilege of introducing the national officers of the 
Veterans of Foreign Wars of the United States and our 
Auxiliary.
    Mr. Chairman, please allow me to ask those to be introduced 
to please remain standing, and I wish to request the audience 
to hold its applause until all have been introduced.
    From the VFW Auxiliary, our National VFW Auxiliary 
President, Carla Martinez, from Utah; Senior Vice President of 
our Auxiliary, Brenda Bryant, of Missouri; Junior Vice 
President, Lois Callahan, from Arkansas; and the National 
Auxiliary Secretary-Treasurer, Ann Panteleakos, from 
Connecticut; and Commander in Chief's wife, Ellen Sarmiento, 
from New Jersey.
    And VFW national officers, Senior Vice Commander in Chief 
Alfred J. ``Al'' Lipphardt, and his wife Carol, from Georgia; 
Junior Vice Commander in Chief, Carol Whitmore, and her husband 
Brad, from Iowa; Junior Vice Commander in Chief Designee, Tim 
Peters, from Montana; Adjutant General Dan West, from Texas; 
Quartermaster General Marc Garduno, from Delaware; Assistant 
Adjutant General Brian Walker, from Tennessee; Chaplain David 
Frei, from Idaho; Judge Advocate General J. Douglas Whitaker, 
from Mississippi; Chief of Staff Carey Pritchett, from New 
Jersey; Inspector General Peter J. Mascetti, from Germany; 
Surgeon General Curtis ``Doc'' Bohlman, from Oklahoma.
    Now joining the VFW Commander in Chief here on the dais, 
Chairman of the VFW National Legislative Committee Stanley 
Borusiewicz, from Connecticut; Director, VFW National 
Legislative Service, Patrick D. Murray, from Rhode Island; I 
will skip over Representative Van Drew and our Commander in 
Chief; Director of VFW National Veteran Service, Michael 
Figlioli, from Massachusetts.
    Finally, I would like to recognize the tenth class of VFW 
SVA legislative fellows, our past Auxiliary Presidents and past 
VFW Commanders in Chief who are with us, as well as, I do not 
know if they came in, but Tonya Star, the widow of Major 
Richard Star, and Senator Elizabeth Dole, a champion for our 
nation's caregivers.
    Thank you, Mr. Chairman.
    Chairman Tester. Thank you all for being here.
    [Applause.]
    Chairman Tester. Now I want to recognize Representative 
Jeff Van Drew to introduce VFW Commander Sarmiento.

             INTRODUCTION BY THE HON. JEFF VAN DREW

    Mr. Van Drew. Thank you, Chairman. Chairmen, Senators, my 
colleagues in the House of Representatives, it is an honor to 
be here, and it is my honor to introduce Duane Sarmiento, a 
good New Jersey name, right?
    Mr. Sarmiento. Absolutely. Yes, sir.
    Mr. Van Drew. He is a distinguished man, a distinguished 
individual, a man who has spent most of his life dedicated to 
serving his nation, a fellow native of my South Jersey, a 
Commander in Chief of the Veterans of Foreign Wars. Mr. Duane 
Sarmiento is a great man.
    He was born and raised in New Jersey. Duane enlisted in the 
United States Navy in 1988. He served on active duty from 1988 
to 1997, and in the United States Reserve from 2002 to 2006. 
During his time on active duty, Duane deployed in support of 
Operations Desert Storm and Desert Shield, where he earned his 
VFW eligibility. In recognition of his service, he received 
that Navy Achievement Medal, the Navy Combat Action Ribbon, the 
Navy Good Contact Medal, the Southwest Asia Service Medal with 
three campaign stars, Saudi Arabian Medal for the liberation of 
Kuwait, and the Kuwaiti Medal for the liberation of Kuwait 
again, and numerous other medals and ribbons, too many to name 
here today.
    Following his military service, Duane chose to continue 
serving his community of Gloucester County in the State of New 
Jersey. He served as a police officer with the Greenwich 
Township Police Department, and later the Gloucester County 
Sheriff's Department. Yes, he has done a lot of stuff.
    Upon his retirement from law enforcement, Duane served his 
fellow veterans in Gloucester County as the County Director of 
Veterans Affairs. He held that position until his election as a 
VFW national officer. Duane joined the VFW in 1990, at Post 
5579, in Gibbstown, New Jersey, where he maintains his gold 
legacy life membership. He has served in elected and appointed 
positions in the post, district, department, and national 
levels, to include his election as a State Commander of VFW 
Department of New Jersey from 2018 to 2019.
    On July 27, 2023, Duane was elected as the 115th Commander 
in Chief of our nation's most established combat veterans 
organization, the VFW. Since his election, Duane has continued 
connecting with and understanding the experiences of veterans, 
active servicemembers, and their families. Not only has he 
traveled across the country, visiting their families in almost 
all of the 50 states, but has also visited veterans and our men 
and women in uniform living and serving overseas in Europe, 
Central America, and Southeast Asia.
    Duane has made it his mission to advance the VFW's three 
pillars of advocacy, assistance, and camaraderie. He is 
committed to serving those who serve and embrace them, and 
advocating for them wherever he travels. That is why he is here 
to testify on their behalf today.
    You know, just a few brief words on veterans. I served in 
the VA as a dentist, and I saw broken hearts, broken bodies, 
broken minds, and broken souls. There are no words, there are 
no proclamations, there are no resolutions, there are no awards 
that we can give them to suffice for what they have done and 
what they are willing to do.
    I will be happy one day when we do not hear the words 
unemployed veterans, homeless veterans, veterans without health 
care, veterans that do not have educational opportunities, 
veterans with a higher suicide rate than anybody else in the 
United States of America, and veterans and active military that 
do not have to have woke policies forced upon them. We need a 
strong military and strong support for our veterans, period.
    Duane represents that. I am proud to introduce him. God 
bless you, Duane, God bless this VFW, God bless this Committee 
for the work it does. Thank you.
    Chairman Tester. Thank you, Congressman, for that 
introduction.
    [Applause.]
    Chairman Tester. Congressman Sarmiento, I will now turn it 
over to you for the VFW's----
    Unidentified Voice. You called him Congressman.
    Mr. Van Drew. He would be in my district. He would be me. 
He probably could.
    Chairman Tester. He has not told you that he just filed 
yesterday?
    [Laughter.]
    Mr. Van Drew. I have got to check. Come on, Duane. You did 
not tell me.
    Chairman Tester. I will tell you one thing, when I called 
you Congressman I got Bost's attention, I will tell you that.
    [Laughter.]
    Chairman Tester. Commander Sarmiento, I will now turn it 
over to you for VFW's opening statement. Thank you all for 
being here, and we look forward to your statement.

                            PANEL I

                              ----------                              


  STATEMENT OF DUANE SARMIENTO ACCOMPANIED BY RYAN GALLUCCI, 
  PATRICK MURRAY, MICHAEL FIGLIOLI, AND STANLEY BORUSIEWICZ; 
         VETERANS OF FOREIGN WARS OF THE UNITED STATES

    Mr. Sarmiento. Chairmen Tester and Bost, Ranking Members 
Moran and Takano, thank you for the opportunity to represent 
the 1.4 million members of the VFW and our Auxiliary here 
today.
    The 117th Congress passed the PACT Act, which was a 
generational bill that provided care and benefits for veterans 
of all eras. I would like to take this moment to show you just 
who the VFW represents and why the PACT Act was so important to 
us. It provided expanded care for Vietnam veterans exposed to 
Agent Orange. Could my Vietnam veterans please stand.
    [Applause.]
    Mr. Sarmiento. It provided expanded care for Gulf War 
veterans exposed to Sarin and other unknown chemicals and 
toxins. Could my Gulf War veterans please stand.
    [Applause.]
    Mr. Sarmiento. And it provided new presumptive conditions 
and care for veterans who served in Iraq, Afghanistan, Africa, 
Eastern Europe, and other areas where they were exposed to burn 
pits and other airborne hazards. Could my Post-9/11 veterans 
please stand.
    [Applause.]
    Mr. Sarmiento. Thank you. This is who the VFW is and who 
your work is helping today.
    [Applause.]
    Mr. Sarmiento. The men and women in this room are a cross-
section of the VFW, a cross-section of our veteran population, 
and a cross-section of America. This is why I call upon you as 
our leaders in Washington, DC, to continue fighting for those 
who served, are still serving, and to every day meet the 
challenge.
    [Applause.]
    Mr. Sarmiento. Now let's talk about claim sharks.
    [Chorus of boos.]
    Mr. Sarmiento. With the passage of the PACT Act, the VFW 
saw an increase in online advertisements from predatory claim 
sharks that targets veterans' earned VA benefits. They argue 
that the high fees they charge make them more effective in 
assisting veterans than the free services offered by VA-
accredited veteran service organizations. That is false. They 
say that there is no way for them to seek VA accreditation. 
That is also false. Anyone can seek accreditation. But they 
refuse to do so because they would no longer be able to charge 
exorbitant fees, especially for work they did not do.
    Companies that prey upon veterans and disregard the law 
must be held accountable, not rewarded with legislation and 
legalize their predatory behavior.
    [Applause.]
    Mr. Sarmiento. It is distasteful that these claim sharks 
take money from veterans, but it is absolutely disgusting that 
they take money from survivors.
    [Applause.]
    Mr. Sarmiento. The VFW strongly supports the GUARD VA 
Benefit Act, which would only reinstate penalties for charging 
veterans unauthorized fees for VA claims. Claim sharks are 
spending millions of dollars to lobby against the GUARD Act 
here in DC, stalling a Federal fix. So instead, we are working 
in the states to enforce the law. New Jersey and New York have 
already made claim sharks illegal, and bills are moving forward 
through legislatures all around the country. The claim sharks 
have fought our bills in every state and continue to try to buy 
influence. But we will never give up because we have the law 
and the moral high ground on our side.
    [Applause.]
    Mr. Sarmiento. This is why it is so important to the VFW 
because VA claims are the gateway to lifesaving care and 
benefits. We invest heavily in our professional service program 
at two dozen military bases. Every year, VFW-accredited 
representatives assist approximately 20,000 servicemembers with 
their benefits delivery at discharge or BDD claims before they 
leave the military, meaning they can receive benefits almost 
immediately upon separation for free.
    Unfortunately, access to accredited representatives for BDD 
is inconsistent. That is why the VFW highly recommends the 
passage of the TAP Promotion Act, which would ensure all 
servicemembers have direct access to accredited representatives 
during TAP classes. The VFW commends the VA for starting down 
this path in January, but this only reinforces the need to make 
this the law.
    [Applause.]
    Mr. Sarmiento. Transition is an important milestone in a 
servicemember's life, and the VFW believes we need to do 
everything we can to support that journey. That is why the VFW 
works with like-minded organizations like Onward Ops, USO 
Pathfinder, and Wounded Warrior Project to offer data-driven 
resources for transitioning servicemembers. We have also 
partnered with Columbia University to produce a report on 
transition that will come from real-time experiences from those 
exiting the military.
    Recently transitioned former junior enlisted veterans have 
higher rates of homelessness, unemployment, and suicide than 
other veterans. We must do everything we can to help ease that 
transition, especially for those who are at higher risk. Trying 
to stop suicide or homelessness is meaningless if we ignore the 
root causes. The VFW urges Congress to pass the Not Just a 
Number Act to direct VA to report on all its programs and 
veterans in crisis. Preventing crisis requires looking at more 
than, ``When was your last mental health appointment? ''
    We need to look at all VA benefits to know what actually 
works instead of fumbling to react when it is too late. VA's 
own research shows that factors like financial stability, 
housing, and jobs protect against crisis. But if veterans have 
problems accessing benefits like the GI Bill, why would they 
trust the VA with their health care? After years of sounding 
this alarm, VFW is optimistic that VA may finally be listening, 
but we can do more.
    After the Navy I spent 20 years as a police officer. If you 
have got the gun in your mouth, it is too late. We need to 
understand what happens before a veteran gets to that point.
    [Applause.]
    Mr. Sarmiento. Next, we need to make sure our veterans 
receive the full benefits they have earned. Year after year, 
and Congress after Congress, the VFW has advocated to fix 
concurrent receipt, and this year is no different, because 
Congress has yet to finish the work it started and promised to 
finish 20 years ago. Our government says it holds veterans in 
high regard, yet we keep using them as a way to save money.
    Military retirement and VA disability are two fundamentally 
different benefits, earned for two entirely different reasons, 
yet the law calls this double-dipping. The Major Richard Star 
Act gained overwhelming bipartisan and bicameral support from 
the 117th Congress, yet not enough to send it to the 
President's desk. The VFW fears the 118th Congress will end up 
with the same result.
    We must pass the Richard Star Act so veterans receive the 
full benefits they have earned through their blood and sweat 
and service to our country.
    [Applause.]
    Mr. Sarmiento. Another inequity that demands the attention 
of Congress is how we treat our veterans living overseas. I am 
Filipino-Italian American from New Jersey. I know it is an odd 
mix.
    [Laughter.]
    Mr. Sarmiento. I still have many friends and family who 
live overseas. Many are veterans who have earned care and 
benefits through their service. We know there will never be the 
same level of care outside the U.S., but what many overseas 
veterans face is indifference and apathy. Common services like 
direct deposit are not available to overseas veterans. In many 
countries, services like medical care and postal service for 
veterans are being reduced. These are not just veterans who 
retired for a better beach. Many of these veterans are still 
employees who work for the Department of Defense or State, 
supporting interests in the military mission. Cutting off 
service for overseas veterans should be viewed as a national 
security risk, which is why we need to enact common sense 
reforms for veterans living outside the U.S.
    This is why the VFW calls on Congress to undertake 
substantial reform to the VA Foreign Medical Program. I want to 
thank my Congressman, Jeff Van Drew, for his interest in our 
efforts.
    The current foreign medical program is literally a riddle 
wrapped in a puzzle because experiences vary widely depending 
on where you are and who you know. We have to provide 
consistent access to care and support to veterans overseas. VFW 
welcomes the opportunity to discuss these issues with you.
    Lastly, I close my remarks. I feel it is necessary to 
remind everyone of our sacred obligation to make sure we never 
leave a fallen comrade behind. Former President Calvin Coolidge 
stated, `` The nation which forgets its defenders will itself 
be forgotten.'' That not only applies to the men and women who 
made it back home from the fighting overseas but also those who 
never made it home. We must continue to fully fund and 
prioritize DoD's critical mission to make sure all 
servicemembers who went missing or prisoners of war are 
recovered and returned with honor, in their final resting place 
on U.S. soil.
    [Applause.]
    Mr. Sarmiento. Moreover, it is imperative that DoD properly 
recognize the dangerous service of all Americans overseas. I 
have had the chance to visit with servicemembers around the 
world over this last year, whether it is alongside DPAA on a 
mountain in Laos, or alongside decision-makers and care 
providers at SHAPE or Landstuhl. I have heard firsthand about 
the needs of today's force, which is why those who are fighting 
terrorism in the Middle East or deterring aggression on the 
eastern flank of NATO deserve proper recognition for their 
service on behalf of a grateful nation.
    [Applause.]
    Mr. Sarmiento. Chairmen Tester and Bost, Ranking Members 
Moran and Takano, your Committees have done so much over recent 
years to serve our veterans, culminating with the PACT Act. The 
VFW thanks you for all your hard work and work yet to come. 
Thank you for the opportunity to share the VFW's priorities as 
we enter our next 125 years in service to our veterans. We are 
eager to answer any questions you may have.
    [Cheers and applause.]

    [The prepared statement of Mr. Sarmiento appears on page 61 
of the Appendix.]

    Chairman Tester. Look what you have started. So for the 
information of the folks on the dais, there will be 3-minute 
rounds, and there are going to be a lot of questions to be 
asked, so try to keep it to that.
    I am going to start out, Commander, asking you about mental 
health. Look, Senator Boozman and I introduced the Not Just a 
Number Act. It requires the VA, as you pointed out in your 
opening statement, to more closely examine the association 
between veterans and their benefits and suicide. This bill 
would have the VA look at the veterans' use of disability 
compensation, education, employment benefits, home loans, 
foreclosure assistance, and housing assistance programs.
    So my question to you is this. How could this analysis of 
veterans' use of VBA programs improve VA suicide prevention 
efforts?
    Mr. Sarmiento. Chairman, we fully support this. You know, 
what happens is, and just like I said, when a veteran commits 
suicide it is like when was his last appointment. We need to 
look at the total package with VHA and VBA, what benefits were 
they receiving. Because when it is too late, if we are worrying 
about when their last mental appointment was, it is too late. 
We have to say what is the root causes here.
    You know, suicide and homelessness, I have got to be quite 
honest, Mr. Chairman. A lot of the root causes are the same. 
You know, when you say we would like to have zero veteran 
homelessness, zero veteran suicide, you know, I think in a 
perfect world you are right, that is going to happen. I can 
tell you, as a police officer, if we can save one, if we can 
look in and help out with their transition, because what causes 
the transition? Financial stability, jobs. That is the stat we 
will never know because if they have that they never get to the 
endpoint.
    But when we look back on the data and see what they 
received, that is when we can start making a change. And if we 
can save one out of five, two out of five, that is a home run. 
That is a home run. And that goes the same for homelessness. It 
is the sustained root causes. Because--and I will be done, but 
now you have got me rattled, and I apologize.
    Chairman Tester. It is Okay. You did good. Thank you.
    Look, my friend, Tim Peters, who is sitting right over 
there, who is the VFW's Junior Vice Designee, informed me some 
time ago that veterans are being denied earned VA benefits 
because the Federal Government lost their military records, 
through no fault of their own. We recently introduced 
legislation to address this, named after a Montana veteran by 
the name of Fred Hamilton, who I believe is here today.
    Could you tell me, I know the VA supports this bill, could 
you please discuss how this Fred Hamilton Lost Records Act 
would improve the claims process for veterans?
    Mr. Sarmiento. Absolutely. I would love to. And Fred is in 
the room. I truly believe that, or I know that.
    So the Fred Hamilton which you bring up, I mean, veterans 
are being denied a claim because the VA lost their records. 
This is a no-brainer. I mean, I get it. The government is big 
and bureaucratic. The bureaucracy of the government, I 
understand, and I understand there has got to be tweaks to be 
made. And I appreciate you putting this in, and I hope this 
Committee forwards this out. Because when you get down to the 
bottom line of this, a veteran puts a claim in, they get their 
medical record and service record, and they deny it because 
they lost it. That does not even make sense to me.
    But thank you for taking the initiative on this, and I know 
this is a no-brainer for the Committee, sir.
    Chairman Tester. Thank you, Commander. Chairman Bost.
    Chairman Bost. First off, let me say that there are some 
times that each one of us, when we deal with government, a lot 
of things do not make sense to us, okay. That being said, we 
know the VFW is a staunch supporter of VA's Community Care 
Network, but we know some veterans are still waiting too long 
to get the care they want. What do you think the VA needs to do 
to improve Community Care access?
    Mr. Sarmiento. That is an excellent question, Chairman. It 
is a balancing act with the VA. I use all VA health care. I 
truly do. Everything I do, I use the VA, and there are some 
times I get farmed out to Community Care. But it is balancing 
act. You cannot have too much of one. The VA Secretary was just 
briefing us, saying it is, in some places, up to 40 percent are 
getting sent out, and even he agrees that is not right. It is 
more of a balancing act.
    Because what happens is--and I talk to veterans all the 
time--you get sent out to Community Care, you are on the hook 
to pay the bill, even though the VA sent you, because you are 
the one getting the late notices--where is my money, where is 
my money--and you are being drug into court because the VA sent 
you out.
    There is a fine line here. We have to find it, do this 
balancing act with it. I mean Community Care, we are supportive 
of it. It does help care, especially in rural areas, sir. But 
for the veterans that sit there and be billed, with late 
notices, time after time after time, it creates undue stress. 
And I am hoping that we can find this balancing act.
    Chairman Bost. You know, I was pleased to be working with 
Senator Moran, Senator Tester, Speaker Johnson, and we were 
able to get the language of my bill, H.R. 705, to protect 
Second Amendment rights for veterans, included in the 
appropriations bill, which we will consider this week. And I am 
grateful the VFW passed support of this issue. Is this 
something that the VFW will continue to support?
    Mr. Sarmiento. I absolutely guarantee the VFW will continue 
to support this. What it does--and you know, and sir, you 
brought it up in the beginning--veterans are not asking for 
anything special. All we are asking for is due process, that 
every other agency or any other person that goes to any other 
service in the Federal Government gets, not a VA administrator 
deciding we are taking your guns. All we want is due process. 
However that plays out, then so be it. But that is all we are 
asking for, and thank you for spearheading this.
    Chairman Bost [presiding]. Well, thank you, and my time is 
running short, and there are a lot of others. Senator Sullivan, 
I think you are recognized. There you are.

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

    Senator Sullivan. Thank you, Mr. Chairman. I want to ask my 
fellow Alaskans, if they are in the audience, if you can stand 
and be recognized. Here we go. And I think they get the award 
for traveling the furthest. Maybe a little bit of a dispute 
with the Hawaiians. But we also get the award--no offense on 
Alaska--more veterans per capita. That is a fact. So how about 
a round of applause.
    [Applause.]
    Senator Sullivan. All right. And then I was just going to 
mention, I retired from the Marine Corps last month after 30 
years, and so now I take one title, U.S. Marine, which I am 
very proud of, and now another very distinguished title, an 
American veteran. So I am very excited about that.
    [Applause.]
    Senator Sullivan. Commander, I want to thank you and your 
team and all the other VSOs. Last year you might remember I 
really, really focused on this Camp Lejeune issue. It was a 
priority of so many of our VSOs. We had sick families at Camp 
Lejeune. We gave them the legislation to get funded, to get 
better. Unfortunately, we had some law firms that wanted to 
make sure they got the money and not the sick Marines. 
Everybody came out against that. We finally got an Executive 
order saying that there is a cap on attorney's fees, 20 to 25 
percent, period. The Attorney General of the United States has 
said if a law firm charges sick Marines more than that they 
will be civilly or criminally liable. Okay?
    [Applause.]
    Senator Sullivan. Really important. Some of these law firms 
are charging 60 and 70 percent contingency fees. It is 
disgusting.
    So can I ask you very quickly, and I know when the other 
VSOs come up, can you make sure that we are still getting the 
word out to our veterans that there is now a cap, and this is 
really important. Even if they have already signed a contract 
with a law firm, 70 percent, I have asked the Attorney General, 
that is null and void. And if that law firm tries to charge a 
family of sick Marines, they could be criminally liable.
    So can you, and are you getting the word out so none of our 
Marines and their families are getting ripped off by these 
unscrupulous law firms?
    Mr. Sarmiento. Sir, we are absolutely getting the word out. 
We raised the alarm on this last year.
    Senator Sullivan. I know you did.
    Mr. Sarmiento. I want to thank you for spearheading this. 
We put out to our people, our VFW actually partnered with some 
law firms that already gave us the reduced rate, because before 
this was passed, you are right, 60, 70 percent. It is insanity.
    Senator Sullivan. Crazy.
    Mr. Sarmiento. Absolute insanity. And we are glad this has 
been codified into law. And sir, thank you for being a member 
of the Veterans of Foreign Wars.
    Senator Sullivan. I am, yes.
    [Applause.]
    Senator Sullivan. Well, Commander, I have a reputation on 
this Committee of going way over my time, and I think it ticks 
off a lot of my Senate colleagues. I do not want to tick off 
the House colleagues. So with one second left I am going to 
yield back, Mr. Chairman.
    Chairman Bost. Thank you. Ranking Member Takano, you are 
recognized.
    Mr. Takano. Well, thank you, Mr. Chairman. Commander 
Sarmiento, I know you are not a Member of Congress, but in the 
event you become one I know you are going to join the 
Congressional Asian Pacific American Caucus.
    So with that let me just say, I want to thank the VFW for 
your support for the Guard and Reserve GI Bill Parity Act, and 
I am happy to report that Mr. Levin introduced the bill 
yesterday with Senators Moran and Tester, and I am happy to 
support it again this Congress. And I absolutely echo your 
written testimony--your written testimony--that it is beyond 
time that the National Guard and Reserve servicemembers receive 
GI Bill eligibility for the entirety of their time in uniform.
    So my question to you is this. To be absolutely clear and 
blunt to the other members of these two Committees, when you 
say in your written testimony that the time is now for parity, 
are you calling for Guard and Reserve GI Bill Parity to be 
passed in this Congress?
    Mr. Sarmiento. Chairman Takano, yes, we are.
    Mr. Takano. Well, let's get it done.
    Mr. Sarmiento. Absolutely.
    [Applause.]
    Mr. Takano. Now let me go on. Your testimony discusses how 
the social determinants of health are intertwined with veteran 
suicide prevention work, and you highlight homelessness and 
financial instability, unemployment, and justice involvement. 
And I agree with your push to see better data transparency out 
of VA to address these issues.
    And I guess what I would ask is how you would respond to 
politicians who drag their feet in paying for programs in this 
space or try to cut and defund social safety nets. What are 
they doing to veterans?
    Now, as a follow-up, well, let me just ask you about that. 
What do you think about politicians trying to cut or defund 
social safety net programs?
    Mr. Sarmiento. Mr. Chairman, I am going to turn that over 
to our subject matter expert, Pat Murray.
    Mr. Murray. Mr. Chairman, sorry, Ranking Member, a lot of 
these issues require funding, upfront funding and full funding, 
so that these programs can continue all year long without 
interruptions. The start, stop, start, stop of funding affects 
them, which ultimately trickles down and affects veterans. We 
need to make sure that these programs continue to be fully 
funded all year round, going forward.
    Mr. Takano. And that includes the social safety net 
programs like SNAP.
    Mr. Murray. Yes, sir.
    Mr. Takano. Thank you. Now, as a follow-up, talking about 
homelessness programs, Congress, these two committees that are 
sitting in front of you here today, have failed to extend much-
needed pandemic-era authorities that were proven to be 
effective in reducing housing insecurity while also connecting 
homeless veterans to health care appointments and job 
interviews.
    Your testimony mentions H.R. 3848, the HOME Act, which 
would address these problems. Do you have any thoughts on how 
Congress should proceed and the effects of the delays in 
getting this bill to the President's desk on having housing-
insecure veterans?
    Mr. Sarmiento. Congressman, we are hoping that this moves 
forward. As you know, the HOME Act increases the maximum rate 
of per diem to VA providers. It creates services for shelters, 
food, clothing, I mean, basic necessities of Americans, and 
especially those that are vulnerable.
    We fully support this, and we want to get this passed, get 
it signed, do whatever it is we have to do. And we talked about 
the steps of where do we stop homelessness, this is the 
beginning steps. These are root causes of all those issues. We 
are fully behind this.
    Mr. Takano. Well, thank you very much. Let's get it done 
this Congress. Thank you.
    [Applause.]
    Chairman Bost. Senator Hassan is now recognized.

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

    Senator Hassan. Thank you very much, Mr. Chairman, and to 
you and Chairman Tester and our Ranking Members, thank you for 
this hearing. Commander, thank you for your testimony. To all 
the Granite State VFW and Auxiliary members here, thank you for 
your service. I am very proud of our veterans in New Hampshire. 
And to all the veterans who are here today, regardless of what 
state you are from, thank you for being here. And to our 
Vietnam vets in particular, welcome home. I cannot say that 
enough.
    [Applause.]
    Senator Hassan. Commander, in your testimony you mentioned 
claim sharks, people who are not accredited benefits agents but 
who nonetheless offer to, quote, ``help veterans file their 
benefits claims,'' and then they charge enormous fees. I am a 
strong supporter of the GUARD VA Benefits Act that would help 
crack down on claim sharks who target veterans. But can you 
just please discuss a little bit more the important role that 
accredited agents play in helping veterans access benefits and 
how these claim sharks undermine this important work?
    Mr. Sarmiento. I would absolutely love to. The importance 
of the VSOs, any veteran service organizations, number one, it 
is free. The claim sharks are breaking the law. Ever since the 
PACT Act was signed, we never even heard of a claim shark. 
There have been hustlers and grifters ever since currency was 
invented, and as soon as the PACT Act came out all of a sudden 
we have got attorneys that want to get involved, to sit there 
and prey upon family members that just lost a veteran, to sit 
there and prey on a vulnerable veteran. That is a shark. That 
is why we call them a shark. And it is against the law.
    All we are asking is to reinstitute penalties, put the 
penalties back. Look, I am from New Jersey. I get it. We have 
got the crime in DC--I have got the same in New Jersey. If they 
said carjacking is illegal but there is no penalty, I would 
have to walk everywhere I go in the State of New Jersey. That 
is what I mean. I mean, I hate to use an oxymoron like that, 
but truly, all we are asking is put the penalty back. They prey 
upon us.
    It was totally amazing that before the PACT Act was signed 
you never heard about this.
    Senator Hassan. Right. Right.
    Mr. Sarmiento. They saw the money. They smelled the blood, 
and that is why we are against this, ma'am.
    Senator Hassan. All right. Well, thank you very much for 
that very clear explanation.
    [Laughter.]
    Senator Hassan. Very, very clear. I want to move on to one 
quick topic before my time is up. You mentioned also, 
Commander, the need for the VA to provide easily accessible 
health care and counseling for women veterans at all VA 
locations. To help address issues faced by women veterans this 
Committee has worked on a bipartisan basis to pass into law 
several key pieces of legislation--the Deborah Sampson Act that 
eliminated some of the barriers to care that women veterans 
encounter, and the Dr. Kate Hendricks Thomas SERVICE Act that 
expanded eligibility for breast cancer screening. We need to 
continue building on this work.
    I am out of time, but I would love it if, in the course of 
this discussion this morning, if you can just touch on how we 
can increase access to care for women veterans and fully 
integrate them into the VA care.
    Mr. Sarmiento. Ma'am, Pat Murray has testified in front of 
several subcommittees and committees. I am going to pass this 
on to him to make sure you get exactly the answer you want.
    Senator Hassan. With the Chair's indulgence.
    Mr. Sarmiento. Oh, I am sorry. Is that how it works, sir?
    Senator Hassan. Yes. Thank you. That would be great.
    Chairman Bost. Yes, go ahead.
    Senator Hassan. Yes, go ahead.
    Mr. Murray. Ma'am, one of the things that we are seeing is 
preventive care. It is critically important. Things like 
prenatal vitamins. Veterans who are pregnant are not treated 
that they are pregnant until they actually are positive. Having 
access to prenatal vitamins is incredibly important to prepare 
healthy bodies for that future next step.
    Senator Hassan. Right. Thank you very much. Thanks, Mr. 
Chair.
    Chairman Bost. Senator Tuberville.

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

    Senator Tuberville. Thank you, Mr. Chairman. Thanks for 
being here today. My State of Alabama, do we have anybody here? 
We have got a few. Thank you very much.
    Real quickly, under the Trump administration there was an 
evaluation of a lot of people in the VA. It is not just about 
money. It is not about buildings. It is about people who work 
in those buildings. Four thousand people were fired for cause. 
This Administration has allowed them to come back, with back 
pay, and work in the VA. It is a disgrace. Do your job or you 
do not work in the VA. You deserve great care, great care, not 
average care.
    [Applause.]
    Senator Tuberville. Now, unfortunately, the VA has lost its 
way under this Administration. They have gotten caught up in 
the border crisis caused by President Biden and his open border 
policies. While the VA should be leveraging every available 
resource to ensure timely and quality care to veterans, a 
section of the VA Financial Service Center helps process health 
care claims for illegal aliens. VA Community Care providers are 
used by the DHS to provide care for illegal aliens.
    Do you approve, Mr. Chairman, of the Biden administration 
using the VA and our taxpayer dollars to assist with health 
care claims, processing illegal aliens at ICE detention 
centers?
    Mr. Sarmiento. Senator, it is our understanding, from even 
going to Chairman Bost's committee, and speaking to the VA 
Secretary, that there are 10 VA employees on the border 
processing ICE financial claims. They have been doing this 
since 2002. Obviously, we are against any--if VA is using 
resources, medical resources on undocumented immigrants, we are 
against that. But from our understating, and if I am answering 
your question, Senator--I want to make sure I am 
understanding--that we have 10 people--I should not say 
``we,''--the VA has 10 people down on the border doing medical 
billing process, and it is not taking away anything from 
veterans in the VA, sir.
    Senator Tuberville. So that being said, my bill, 3490, the 
No VA Resources for Illegal Aliens Act, would stop any of this 
from happening. Would you support that?
    Mr. Sarmiento. I do not believe we have seen that. We have? 
It is something that, if you would like to speak to our staff 
here in DC, sir, we sure would be willing.
    Senator Tuberville. Thank you. Thank you, Mr. Chairman.
    Chairman Bost. Representative Brownley.

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

    Ms. Brownley. Thank you, Mr. Chairman, and thank you, VFW, 
for being here. I love the energy in this room and your 
determination and commitment and advocacy for getting all of 
this legislation done for our nation's veterans. So thank you 
very, very much.
    Mr. Commander, I wanted to thank you for your support for 
the Elizabeth Dole Home Care Act, and I know that your people 
testified, or sent a statement for the record, in front of the 
House VA Committee, and you wrote about how important this bill 
is, particularly for our veterans who are experiencing early 
onset of dementia, which I think is extremely important. I 
think the Elizabeth Dole bill is very important for our aging 
veterans. I think the Elizabeth Dole bill is very important for 
our disabled veterans.
    So if you could just speak a little bit about why this bill 
is important and why veterans cannot afford to wait any longer 
for its enactment.
    Mr. Sarmiento. Thank you, ma'am. The VFW believes it is 
imperative that we pass this piece of legislation on the 
caregivers, because it is so important. Look around at all the 
blue hats out here, whether they are male or female. They are 
family members. They were caregivers before that term even came 
about.
    So we support this legislation. We want this to pass. We 
are hoping that nobody--sometimes what happens, as you know 
better than I do, when we change regulations or we change the 
law those already on it are getting kicked off, that we be 
mindful of that, and we are more than willing to work with you 
to be sure that does not happen. But we are on board with this.
    Ms. Brownley. Well, thank you very much. I think Ms. Dole 
is going to be here later in this meeting. You know, this is an 
important bill, and at the end of the day it is what veterans, 
I believe, want. And we know that the health outcomes are far 
better with veterans being taken care of in their homes versus 
in institutionalized care. So I really, really do appreciate 
your advocacy around this.
    I have very little time left, but I just wanted to address 
the issues around the challenges, really, that all veterans are 
experiencing in terms of accessing survivor benefits. And VFW 
talked about where Congress should be practicing better 
oversight around this issue.
    I just wanted to say that after we had a hearing in the 
House I followed up with Under Secretary Jacob and his team 
regarding this issue, and the DIC application and the fact that 
it is 20 pages long, very onerous. I looked at it. I mean, I 
cannot do my taxes by myself. God forbid that I could fill out 
this form by myself.
    So I think there are a lot of changes that need to be made, 
and again, I am running out of time but appreciate your 
advocacy around this and really working and engaging with VBA 
to make sure that they follow suit on this. The Under Secretary 
has promised me that they are looking at regulatory or 
statutory changes in this area.
    So thank you.
    Chairman Bost. Senator Blumenthal, you are recognized.

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

    Senator Blumenthal. Thank you, Mr. Chairman. Thank you all 
for being here.
    As a law enforcement commander, as a law enforcement 
officer for many years, I appreciated your very direct comments 
on the need for effective enforcement. And let me talk about 
the PACT Act in that regard. Too often there is exploitation of 
our veterans. I have introduced a measure called the GUARD VA 
Benefits Act. It is bipartisan, with Senator Graham and Senator 
Tester. I wonder if I could ask for the VFW's support for that 
measure, to make sure that individuals accredited by the VA and 
supported by VSOs are not exploited by individuals promising 
them that they will get them benefits when all they need to do 
is apply for those benefits directly.
    Mr. Sarmiento. Sir, we stand behind you about a billion 
percent. As a matter of fact, we would love to give you one of 
our claim shark pins if you would like to wear it, that says 
``Don't Feed the Sharks.'' We are behind that 1000 percent.
    [Applause.]
    Mr. Sarmiento. I was speaking earlier about we have always 
got hustlers and grifters, always. That is why we are against 
this. We provide free--not just us but all the VSOs--provide 
free. Those people sit there and they will tell you they have a 
magic wand, ``I will guarantee you benefits. You are going to 
get X amount of dollars.'' But when the magic don't happen, pay 
me. That is what they want. ``Pay me. We have got a contract.''
    Senator Blumenthal. I would be happy to wear the pin, and I 
also want to thank the VFW and other VSOs for their support for 
the Afghan Adjustment Act. I have been helping to lead that 
effort. Two of my sons, one a Marine and the other a Navy SEAL, 
know firsthand how our at-risk Afghan allies remain in 
jeopardy, and our veterans have been at the tip of the spear in 
championing measures that will enable us to give those Afghan 
at-risk allies a path forward in this country. I am going to 
give you a chance to comment in the time that I have left.
    Mr. Sarmiento. You know, we have been supporting this for 
several years, since it was brought to the forefront. Earlier 
on, when the OIF and OEF vets brought it up, there plenty of 
Afghanistan veterans in this room. They know. They worked 
alongside our allies. Of course we want to support them the 
best way we can. You know, right or wrong how we left, we ain't 
here to debate that. But they were our allies, and we are 
behind this.
    Senator Blumenthal. Thank you. I want to thank the VFW for 
all of its service, very often underappreciated by our 
veterans, but just absolutely vital. And to everyone in this 
room and to the many who are not here today, thank you for your 
continuing service. After you wear the uniform you continue to 
make this country the greatest in the world. Thank you to all 
of you. And I do not know if we have anyone from Connecticut 
here, but thank you all.
    [Applause.]
    Senator Blumenthal. Thanks, Mr. Chairman.
    Chairman Bost. Representative Pappas.

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

    Mr. Pappas. Thank you very much, Chairman Bost. I just want 
to recognize all the veterans from the ``Live Free or Die'' 
State of New Hampshire who are joining us here today. I met 
with them last night in my office. I am really appreciative of 
the priorities that you bring to me each and every time. Also I 
am also appreciative of the Claim Shark pin that you gave me 
last night. So thanks very much for all of your work. I wear it 
proudly.
    And Commander, I do not want to beat a dead shark here, but 
I do want to continue to highlight the need for the GUARD VA 
Benefits Act. And no one could say it better than you did in 
your opening testimony, and I just applaud VFW for your 
continued work here in going after these unaccredited 
representatives that are engaging in predatory practices and 
are taking advantage of our veterans.
    It is really important, especially as we sit in this big 
room, with so many folks that have served our country in a 
variety of different ways, to understand that we work for you, 
that VA works for you, and that it is so critical that we have 
protections and teeth to the law to make sure that no one is 
ripping off our veterans. We have got to make sure that we 
strengthen the accreditation process and ensure that everyone 
is going through it who is assisting veterans with their 
claims.
    I have talked to a number of constituents that have been 
caught up in this. They have reported that they have been 
paying an arm and a leg to these claim sharks companies for 
things and services that are offered for free by VSOs, 
including VFW.
    It is one of the reasons why I am continuing to push, in a 
bipartisan, bicameral fashion, for this GUARD VA Benefits Act. 
As you said, Commander, this would just reinstate the criminal 
penalties, which were taken away somehow a few years back, and 
would make sure that anyone who is assisting veterans with 
claims has to go through this accreditation process and abide 
by the law.
    And it is really important that there is some enforcement 
capability here, because right now when a claim shark company 
is charging veterans whatever they want, there is no recourse. 
This can be reported and flagged for VA, but there is no way 
that the government can go after these bad actors. So that is 
what this is all about.
    Commander, maybe I could get at this from a different way. 
There is a competing proposal that is on the table, a bill 
called the PLUS Act, and it has support from a lot of these 
claim shark companies and lobbyists who have been having a 
flurry of meetings here on the Hill. Could you talk a little 
bit about concern that the VFW has for that legislation? 
Because I see this as legitimizing predatory practices and 
opening the tent to those who are currently violating the law. 
But maybe I could get your take on that bill.
    Mr. Sarmiento. So the PLUS Act that you mentioned, you 
know, the major competing companies that are the sharks wrote 
the bill, and what is pretty offending, at least not from a 
veteran, not for you but that read this, is they wrote it in a 
way that, yes, we will make it illegal for the other people but 
it is okay for us, but if anybody comes behind us, we are good. 
And they put in a law for those that have not jumped on board 
yet, and you get grandfathered in, that it is illegal for them, 
and yes, put them in jail, or whatever you do to them.
    Everybody here knows. I am preaching to the choir. 
Everybody has got their pins on and we love it. We know how 
important this is. We know the money they are throwing at this. 
Look, we are veterans. We do not have no money to do that. We 
are thankful you allow us to come here and speak and give us 
our feeling and give us what our beliefs are. You allow us to 
come into your offices and talk to you and your staff 
personally. That is what we do. But we do not have money to 
throw at this like they have got.
    And I want to thank you for holding the line. Thank you so 
much for that.
    [Applause.]
    Mr. Pappas. Well, thank you. I appreciate your advocacy on 
the state level, but we cannot let Congress off the hook. We 
need to pass this at the Federal level.
    I yield back, Mr. Chair.
    [Applause.]
    Chairman Bost. Senator Hirono, you are recognized.

                     HON. MAZIE K. HIRONO,
                    U.S. SENATOR FROM HAWAII

    Senator Hirono. Thank you, Mr. Chairman. Aloha to all of 
you who are here, all the veteran organizations. Thank you very 
much for all that you do for our country and what you have 
done.
    I particularly, of course, want to give a big shoutout to 
the veterans who have come all the way from Hawaii. They 
probably came before this, from Hawaii. Where are you guys? All 
right. A big shoutout to you.
    And I know that we cover a lot of issues for the veterans, 
but I have to say that I sit on five committees in the Senate, 
and the Veterans Committee is one that really is characterized 
by bipartisanship. And that is why we are able to get a lot 
done that reflects our support for the veterans. And especially 
as we see more women who are serving now and more female 
veterans, and the particular, I think, needs of the women 
veterans are being met by all of you. And I know that all of 
you--by the way, where are the women who are going to be 
testifying? A big shoutout to you folks--that there is support 
all around to make sure that we are meeting the particular 
health care and other needs of the women veterans.
    So thank you very much for all of you being here, and thank 
you, Mr. Chairman.
    Chairman Bost. Thank you. Representative Deluzio.

                   HON. CHRISTOPHER DELUZIO,
             U.S. REPRESENTATIVE FROM PENNSYLVANIA

    Mr. Deluzio. Mr. Chairman, thank you. Well, I am excited to 
see some fellow VFW members in the crowd. I suspect I have got 
some Pennsylvanians in the House. Anybody here? Okay. There we 
go.
    We can beat the dead shark. I am game with that. Commander, 
I am surprised you are able to keep from swearing, talking 
about these guys. I heard ``hustlers'' and ``grifters.''
    I will ask an easy question, and I know the answer because 
I used a VSO when I did my claims with the VA. What do you 
charge?
    [Applause.]
    Mr. Sarmiento. Sir, free.
    Mr. Deluzio. Exactly right. And look, I think that is an 
important message that my fellow veterans maybe do not know. 
There are folks that will help you do this for free. It is not 
just the VFW. There are plenty of VSOs who will serve veterans 
and will help them navigate benefits they have earned. That is 
what we are talking about. That is part of the obligation this 
country has to everyone who wears the uniform, peace, war, 
whatever. You have earned those benefits. It comes from your 
service. No one should hesitate coming to the VA to get it.
    So that is all I wanted to say. I am with you in this 
fight. We have got to take on these sharks. We have got 
bipartisan buy-in, and I hope to get this done, and we are with 
you as long as it takes.
    Thank you. Mr. Chairman, I yield back.
    [Applause.]
    Chairman Bost. Senator Tillis.

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

    Senator Tillis. Thank you, Mr. Chairman. Thanks to 
everybody here. I have to do the obligatory. If you live in or 
have spent some time in North Carolina, can you raise your 
hand? Thank you.
    Thank you all for being here. Just very brief. Commander, 
in your opening statement, I was here for that, we were talking 
about veteran suicide, and I think you are right. You were 
saying if you could reduce one out of five, that is four a day, 
two out of five is 10 a day. It is a big number over time.
    The concern that I have is that the majority of them are 
not connected to the VA. More than half of them are not 
connected to the VA today. And one of the things that I have 
been trying to preach, and hopefully, I think that you all have 
reviewed it and you are okay with it, the Veterans Bill of 
Rights, which is for these people who are going out there and 
convincing them, these attorneys basically taking exorbitant 
fees to actually represent them for Camp Lejeune Toxics Act.
    I want them to read a statement to them, or give them a 
statement that says do you realize that you do not have to pay 
a dime to apply for this? Do you realize that there are VSOs 
out there that will do it for free? Do you realize that you 
have congressional offices that are also tasked with doing this 
every day? Until you have exhausted all these possibilities, 
which will not cost you a dime and net you more benefits, do 
you really want to sign this agreement with an attorney?
    I am going to try to do my best to get that done quickly. I 
want to do it to protect the veteran and not to have these 
people rip off qualified veterans. But I also want to do it 
because I believe, in my heart of hearts, with all of this 
advertising--these damn ads are driving me crazy--but with all 
this advertising that is going on right now, maybe it is a way 
to actually get some of those people who are not connected to 
the VA connected. If they see that they have these rights, if 
they see that they can call a congressional office, what do you 
think about a Veterans Bill of Rights, and what do you all 
think we should do just to get it done?
    Mr. Sarmiento. Sir, I am going to pass this off to Pat 
Murray, our Legislative Director.
    Mr. Murray. Senator, we support this proposal fully. I 
think what we can it done, bring it down to the floor, hotline 
it, I don't know, after lunch. But what we want to do is 
continue banging that drum, that it is not just ``the'' free 
option. There is an entire network out there.
    Senator Tillis. A hundred percent.
    Mr. Murray. It is VSOs. It is county, state, it is 
everybody.
    Senator Tillis. Well, that is why--and a Bill of Rights, 
that is what I am saying. You know, we can work on the wording, 
but here are all the resources you have as a veteran, that you 
should exhaust before you sign a retainer for a law firm that 
is more interested in what they get at the end of the day than 
doing right by the veterans.
    Mr. Murray. Sir, you are absolutely right. There is an 
abundance of choice already out there, and we want veterans to 
go to that first.
    Senator Tillis. Well, we would like you all's feedback on 
maybe some of the details of the Bill of Rights, but I think it 
helps us, I think it puts these folks in their place, and I 
think it gets more veterans connected, which gets to a key 
problem that I want, is fewer men and women taking their lives 
every day. We need to help them. Thank you all.
    [Applause.]
    Chairman Bost. Representative McGarvey.

                     HON. MORGAN MCGARVEY,
               U.S. REPRESENTATIVE FROM KENTUCKY

    Mr. McGarvey. Thank you, Mr. Chairman. If we have any 
veterans here who were ever stationed in or live in Kentucky, 
we are glad to have you all here, so thank you for being here.
    Commander Sarmiento, thank you so much. People sometimes 
tell me they have a hard time understanding what is going on in 
Washington. I hope they listen to your testimony because there 
is no doubt. We appreciate both your thoughtfulness and your 
candor in that regard.
    I am truly inspired listening to so many of these stories, 
observing the strength and the passion with which you all 
advocate for our nation's veterans, the men and women who are 
willing to put on a uniform and sacrifice everything to keep 
this country safe. Your expertise empowers us and the Committee 
members to work together and to do all we can to ensure access 
to the benefits and the services that veterans and their 
families have earned. So again, I thank you guys for being 
here.
    You mentioned in your testimony today several quality-of-
life issues which I like to call social determinants of health, 
that affect veterans and their families. It is issues like 
transitioning out of the military, food security, housing, 
employment, transportation, childcare--the list goes on and on 
and on. I believe this Committee and the VA can and must do 
better to address social determinants, which we know are 
significantly tied to health outcomes. These issues do not 
exist in silos. They all affect veterans' health. So I think we 
have got to start treating them that way.
    Commander Sarmiento, I am getting to my question here. The 
existing benefits and approaches are often disparate and 
require veterans or spouses to navigate several separate and 
unconnected programs, which can be confusing and overwhelming. 
It seems our current system does not approach health from a 
holistic perspective. Do you think it would improve veteran 
health if the VA treated resources like transportation, 
childcare, employment, and stable access to food and housing as 
part of a holistic approach to veterans' health?
    Mr. Sarmiento. Yes. Sir, the simple answer is absolutely 
yes. And we talked about the TAP Promotion Act. When you do the 
transition, once that Act is in, now you are exiting the 
military. It starts there. Then it transfers off to a handoff 
to the VA. And if we can get everybody talking and on the same 
page, it is a win-win. Sometimes you are right and government 
gets siloed. The VA is here, the DoD is here, other people are 
here, and I do not work for you, you do not work for me. If we 
can just get people talking and ease the transition of 
everything you said, it is simple. It sounds simple, I know, 
though you know better than me. It sounds simpler than it is, 
but we are willing to work on this, and we believe starting 
with the TAP Promotion Act, when you are exiting the military, 
to do the handoff to the VA.
    Mr. McGarvey. Thank you, sir. I appreciate all your all's 
service, and Mr. Chairman, I yield back.
    Chairman Bost. Thank you. Representative Rosendale, you are 
recognized for 3 minutes.

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

    Mr. Rosendale. Thank you very much, Mr. Chairman. Thank 
you, everyone, for coming in and attending today, Commander 
Sarmiento and the rest of the Veterans of Foreign Wars of the 
United States for coming to Washington, DC, to testify today. I 
look forward to having representatives from the Montana chapter 
of the VFW in my office later today, and I always appreciate 
your perspectives and insight on all the veterans' issues.
    In your written testimony today you stated, ``Adapting a 
value-based health care model would allow for a patient-
centered system that aligns with the VA's whole health care 
approach.'' I am helping lead the charge on a bill that I would 
establish a pilot program to allow veterans to receive a health 
savings account and use the money to obtain medical services 
through a direct primary care arrangement. The legislation 
would make it easier for veterans to see their doctor and spend 
money on preventative measures to improve their health before 
getting sick.
    I was the insurance commissioner in Montana from 2016 until 
2020, and I am proud to say that I was able to get authorized 
direct primary care agreements between private individuals and 
doctors, physicians, for a very low cost. And not only have we 
received incredible response from the patients themselves but 
from the doctors that are delivering that care. They have a 
much more close and intimate relationship with the physicians. 
So it has been working out extremely well for everyone involved 
and has been able to address some of these issues that are 
chronic conditions, like high blood pressure and diabetes, so 
that we make sure that we have a good maintenance program in 
place.
    What I would like to ask, Commander Sarmiento, is what 
ideas do you have to make the care at the VA more patient-
centric?
    Mr. Sarmiento. Our Executive Director is definitely a 
little better at this than I am. I am going to pass it off to 
Ryan so I do not sit here with an answer and try to dance 
around you. Obviously, you want your question answered.
    Mr. Rosendale. Perfect.
    Mr. Gallucci. Well, thank you, commander in chief, and 
thank you, Mr. Rosendale, for the question. The VFW has had a 
lot of discussion on this very issue. Now first, to be 
perfectly frank, when Phoenix happened almost a decade ago we 
were out there saying, look, community care is part of VA care, 
and that is very important.
    What we have seen over the last 10 years is we have had the 
CHOICE Program, and now you have the MISSION Act, you have had 
other programs here or there.
    Here is what I am concerned about. The Secretary talks 
about how much VA is spending on community care, but you look 
at how much of that is emergency room care. That is the most 
expensive and most fractured care that a veteran can receive. 
Some of the things that we have talked about with Dr. Elnahal 
and VHA and even the Secretary is you need to lean on your 
third-party administrators. You need to lean on your third-
party administrators heavily so that you are integrating this 
community care into VA care when a veteran has chosen VA as 
their care provider.
    We are pushing that very hard because the last thing we 
need is veterans showing up at emergency room receiving that 
fractured care. We think there are ways to do this, and would 
be eager to work with you and the Committees to address that.
    Mr. Rosendale. Thank you very much, and again, I think we 
can establish this relationship. We have a maintenance program 
that we can avoid crisis situations for our veterans in the 
future.
    Thank you, Mr. Chair. I yield back.
    Chairman Bost. Senator King.

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

    Senator King. Commander, I wish you would quit beating 
around the bush, man.
    [Laughter.]
    Senator King. We have gotten less bullshit from you today 
than any witnesses I have ever heard.
    [Applause.]
    Senator King. And, man, we see a lot of that.
    Anyway, it seems to me one of the themes here is common 
sense. Richard Star Act. You earn two separate benefits, you 
should get them, period. Richard Star, common sense.
    [Applause.]
    Senator King. Here is the other one. I am on Armed Services 
and Veterans' Affairs, so I see this from both sides. One of 
the first hearings I was in in Armed Services 10 years ago, I 
made the statement, I said, ``Why don't we spend as much money 
on transition as we do on recruiting? '' In other words, let's 
take care of those veterans when they are coming out.
    And, of course, the third common sense is the GUARD Act. 
Why are we allowing people to take money out of the pockets of 
veterans when you guys can do it more effectively for free?
    So let me talk about transition for a minute. Transition is 
statistically one of the most dangerous moments for veterans. 
That is where there is a high level of suicide, a high level of 
homelessness. It is a real problem. So a couple of bills. The 
Welcome Home Veterans Act. One of the problems is when you sign 
all that paperwork at the TAP there is one little box about 
opting in to notify the state veteran agency. I want to change 
that to an opt out, because right now only 13 percent of 
veterans are known to their state agency. My vision is let's 
get the names to the state agency, they get the names to the 
VA. I want a couple of you guys or women meeting the veteran at 
the airport when they arrive home.
    [Applause.]
    Senator King. So do you support the Welcome Home Veterans 
Act?
    Mr. Sarmiento. Yes, we do, sir. That is a common sense 
approach to a problem that probably got incurred by just, not 
oversight, but overlooked. It was just overlooked. To opt out. 
That is a no-brainer.
    Senator King. And then we will get people's names so they 
can be met and get the services they need right away.
    The second one is the TAP Promotion Act. You have already 
mentioned that. Make VA-accredited representatives like 
yourself at the TAP Day before people leave. You are for that, 
I take it.
    Mr. Sarmiento. We are all in on the TAP Promotion Act.
    Senator King. That is good. All right. The third one is the 
Combat Veterans Pre-Enrollment Act, so a combat veteran can 
enroll in the VA health care before they leave their service, 
so they could get the care they need from the VA on day one. 
Are you in on that one?
    Mr. Sarmiento. Yes, sir, we are in on that one, as well.
    Senator King. Well, you have got it, man. Let's get this 
done. Thank you, Mr. Chairman.
    [Applause.]
    Chairman Bost. I want to thank Senator King for saying what 
we all feel. Of course, there is a statement in deep southern 
Illinois. We appreciate you putting the cabbage down where the 
hogs can eat it.
    [Laughter.]
    Mr. Sarmiento. What does that make us, Mr. Chairman?
    Chairman Bost. Well, I thought Chairman Tester demoted you 
by calling you Member of Congress.
    But we do want to say thank you to the VFW for sharing this 
2024 legislative priorities, and to all the veterans and 
families and caregivers and survivors that are in attendance 
here today.
    Now we are going to switch over to our next panel, which 
will be Elizabeth Dole, and Senator Dole is going to address 
us. But we are going to take a 15-minute break, and then we 
will reconvene.
    [Recess.]
    Chairman Bost. Well, we would like to welcome everybody 
back, and before we begin the second panel I would like to take 
a moment, if we can, to recognize a very special guest, and 
allow her to give a few remarks. Senator Elizabeth Dole, 
welcome. Thank you.
    [Applause.]
    Chairman Bost. We want to thank you for being with us 
today, for your tireless work to provide veterans and their 
caregivers the support they deserve. And the floor is yours.

               REMARKS BY THE HON. ELIZABETH DOLE

    Ms. Dole. Chairman Tester, Chairman Bost, Ranking Member 
Moran, Ranking Member Takano, Congressman Brownley, thank you 
for that wonderful, warm welcome, and thank you for inviting me 
to speak in support of legislation that I believe to be a 
lifeline for America's veterans and their caregivers.
    I am grateful to our many partners here today showing their 
support for this important legislation, particularly my good 
friend, General Mike Linnington. Mike, I know this is your last 
hearing as CEO of the Wounded Warrior Project. Thank you for 
being a transformative leader and advocate, a true partner, and 
for the immeasurable difference you have made in the lives of 
so many veterans and caregivers.
    [Applause.]
    Ms. Dole. Serving as a United States Senator was one of the 
greatest honors of my life, and my beloved husband Bob served 
in these chambers for 35 years. While we never thought 
Washington should attempt to fix all the nation's problems, we 
firmly believed that some of America's greatest challenges 
could only be solved with the leadership, power, and resources 
entrusted to you, our elected representatives.
    I am truly honored that the omnibus of veterans bills and 
the Act for Veteran Caregivers are named for me, though I 
certainly do not feel worthy. I am even more grateful for the 
promises they hold for those who protect our freedom and our 
security and their caregivers. The resources, reforms, and 
improvements contained in this legislation are precisely the 
types of advancements that only this body can provide. And I do 
not see how we can be a nation that truly cares for our 
military and veteran communities if we wait another day to get 
this legislation passed.
    [Applause.]
    Ms. Dole. The Elizabeth Dole Home Care Act, in particular, 
is bipartisan legislation that will make it possible for 
severely injured veterans to spend more time recovering at home 
with their families, rather than at an institutional setting.
    I think of Americans like Lara and Tom Garey, and their 
son, Trey, from Texas. Tom was an Air Force veteran who 
tragically passed away last year due to his service-connected 
ALS. Like so many veterans, Tom wanted to be home with his 
family for as long as possible. As his condition deteriorated, 
Lara had to fight to get the appropriate support in their home 
so Tom could continue to enjoy family movie nights and even 
attend his son, Trey's, makeshift high school graduation in 
their living room. He would have missed all of this if he had 
been housed in the closest medical facility, which was 2 hours 
away.
    By easing access to necessary programs and services, this 
legislation will make the very difficult path of the Gareys and 
so many others much easier. It will allow veterans and 
caregivers to focus on the things that really matter.
    You know, Bob and I always said that the most meaningful 
change happens when our leaders work across the aisle. At a 
time when compromise and consensus are hard to come by, you, 
your colleagues, and your staff have done it. You have come 
together to create a significant package of legislation that 
will impact thousands of veterans' and caregivers' lives for 
the better.
    Now I urge you to remain united, to continue to put 
veterans and caregivers first, and to pass these bills. This 
community has earned it, and they desperately need your 
bipartisan leadership to accomplish it.
    Thank you all for your consideration, and a special thanks 
to the MSO and VSO leaders we work with every day to support 
our nation's veterans, their caregivers, and their military 
children.
    Thank you very much, Mr. Chairman.
    [Applause.]
    Chairman Bost. Thank you, Senator Dole.
    Now on our second panel we have multiple veteran service 
and advocacy organizations that are represented and assist in a 
diverse cross-section of veterans from around the country.
    First, we will start with Robert Thomas, the National 
President of Paralyzed Veterans of America.
    Up next we have General Mike Linnington, Chief Executive 
Officer of Wounded Warrior Project, and as was mentioned, I 
hear he will be retiring at the end of this month, so we want 
to take a minute to say thank you for his hard work.
    [Applause.]
    Chairman Bost. General, you have been working greatly on 
advocacy on behalf of the nation's wounded warriors, and for 
all your work you should be celebrated, and the Committee 
really does appreciate what you have done.
    Next we have Dennis Wimer, President of the National 
Association of State Directors of Veterans Affairs.
    Next up is Jim Whaley, Chief Executive officer for Mission 
Roll Call.
    Next up is Kathy Roth-Douquet, Chief Executive Officer of 
Blue Star Families.
    Next up, Allison Jaslow, Chief Executive Officer for Iraq 
and Afghanistan Veterans of America.
    Next also we have Paul Mimms, National President for the 
Blinded Veterans Association.
    And next, Colonel Lorry Fenner, Director of Government 
Relations for the Service Women's Action Network.
    We also have on the panel Jared Lyon, National President 
and Chief Executive Officer of the Student Veterans of America.
    And last but definitely not least we have William ``Bill'' 
Clark, National Commander of AMVETS.
    Thank you for being here.
    [Applause.]
    Chairman Bost. Mr. Thomas, you are recognized for your 
opening statement.

                            PANEL II

                              ----------                              


        STATEMENT OF ROBERT THOMAS, NATIONAL PRESIDENT,
                 PARALYZED VETERANS OF AMERICA

    Mr. Thomas. Chairman Tester, Chairman Bost, and members of 
the Committees, thank you for the opportunity to speak with you 
today on behalf of the tens of thousands of veterans with 
spinal cord injuries and disorders who heavily rely on the 
benefits and health care available through the VA.
    The VA is the best health care provider for veterans with 
catastrophic disabilities. The Department's system of care 
provides a coordinated, lifelong continuum of services. There 
is no comparable private system of care in the community. Thus, 
preserving and strengthening VA's specialty care system remains 
the highest priority for PVA, and it should be for you.
    Despite the Veterans Health Administration's hiring 
successes last fiscal year and the flexibility gained by 
workforce provisions approved by previous Congress, staffing 
levels within the SCI/D system of care are not improving. We 
continue to see the same staffing deficiencies at the SCI/D 
centers year after year, which affects everything from the 
quality of care received to employee safety and well-being at 
these facilities. We are extremely concerned with the VHA's 
decision to severely limit hiring in 2024. I urge you to 
monitor the hiring practices closely so veterans are not 
adversely affected.
    Another pressing need for PVA's members is increased access 
to VA's home and community-based services. As eloquently 
discussed by Senator Elizabeth Dole, passing her namesake 
legislation, the Elizabeth Dole Home Care Act, would make 
critically needed improvements to VA's home and community-based 
services, such as lifting the Department's cap on the amount 
they can pay for home care, increasing access to the Veteran-
Directed Care Program, and improving support to caregivers and 
veterans.
    The story of Andrew, an Air Force veteran who has ALS, and 
his wife Lisa, illustrates why this legislation must pass now. 
Andrew is currently bedbound, paralyzed, vent-dependent, and 
non-verbal. Lisa has had to work hard to secure the equipment 
and services needed to keep her husband alive and comfortable 
at home. Recently, they had to give up the Veteran-Directed 
Care in lieu of the Family Caregiver Program because expenses 
related to Andrew's care were projected to exceed the cap later 
this year. This unnecessary disruption in the continuity of his 
care highlights the urgent need to eliminate the cap.
    I understand the provisions of the Elizabeth Dole Home Care 
Act are included in a larger package of legislation that is 
currently being considered by Congress. I cannot stress enough 
how important it is to get these provisions enacted into law 
now. Andrew and his family cannot wait longer for the care he 
needs.
    Other veterans with SCI/D need to receive care at a 
specialized, long-term care facility. Despite the grave need, 
the Department's capacity to provide such care is extremely 
limited. There are currently only six VA SCI/D long-term care 
facilities. Thus, veterans continue to remain in acute settings 
for months or years, at a significantly greater cost because 
other placements, including the community, are simply not 
available.
    We call on Congress to mitigate the shortage of long-term 
care beds by funding the six construction projects identified 
in my written statement and ensure existing facilities are 
fully staffed.
    Finally, neurogenic bladder and bowel dysfunction are 
common conditions among veterans with SCI/D, and they can lead 
to complications, rehospitalizations, and even death. 
Therefore, managing them requires ongoing specialized 
attention. The VA could train and reimburse designated 
caregivers to provide this critical care. The Department's 
current Bowel and Bladder Program is fraught with problems like 
reimbursement delays, it lacks due process for the veteran, and 
unlike virtually all other VA payments it imposes tax burdens 
on family caregivers.
    Harry Robinson, caregiver for his wife, PVA National Vice 
President Ann Robinson, pays about $3,500 a year in self-
employment taxes out of his reimbursement for providing her 
with life-sustaining care. Allowing family members to provide 
bowel and bladder care leads to better outcomes for the 
veterans and saves the VA money. But Congress must reduce the 
burden of providing care for veterans' caregivers. Codifying 
the Bowel and Bladder Program will allow Congress to address 
the tax burden and make other needed improvements.
    In closing, I would like to note that these are just a few 
of the many issues affecting catastrophically disabled 
veterans. Others include the need for improved travel support 
to help veterans receive needed medical care, increasing HISA 
grant rates to provide critical housing modifications, and 
better access to inpatient mental health care and substance use 
disorder treatment for veterans with SCI/D. Information about 
these and other issues of importance to paralyzed veterans are 
included in my written statement.
    Thank you again for this opportunity to share our views and 
your commitment to paralyzed veterans and their caregivers. I 
will be happy to answer any questions you may have.

    [The prepared statement of Mr. Thomas appears on page 92 of 
the Appendix.]

    Chairman Bost. Thank you, Mr. Thomas.
    General Linnington, you are recognized for 5 minutes.

STATEMENT OF LT. GEN. MICHAEL S. LINNINGTON, USA (RET.), CHIEF 
           EXECUTIVE OFFICER, WOUNDED WARRIOR PROJECT

    Mr. Linnington. Good morning, Chairmen Tester and Bost, 
Ranking Members Moran and Takano, distinguished Committee 
members. Thank you for today's hearing.
    Let me thank Senator Dole for her gracious remarks. She 
remains a friend, a mentor, a role model, and really the 
epitome of a selfless servant leader, so thank you, Senator 
Dole, for your remarks.
    I would like to begin by thanking many of you and your 
staffs for meeting with our Wounded Warrior Project alumni this 
week to discuss our highest legislative priorities. These men 
and women, in the black polos behind me, are the best 
messengers for insight about how we can assist Post-9/11 
veterans in your states and districts.
    Wounded Warrior Project has been serving wounded warriors 
across the country for more than 20 years, interacting with 
thousands of warriors daily and helping them lead healthy, 
fulfilled, and empowered lives in the communities you 
represent. They are the voice of Post-9/11 veterans on Capitol 
Hill, and we are humbled to bring them to Washington, DC, with 
us this week.
    My remarks today will be short, capturing the highlights of 
our written testimony submitted last week and in support of our 
2024 lege priorities. Our priorities are informed by our 
unwavering commitment to honor and empower wounded warriors, 
commitment that led us to provide over 66,000 hours of mental 
health treatment in our last fiscal year alone. That drove us 
to deliver more than 240,000 hours of in-home and local care 
for the most severely wounded warriors, increasing their 
independence, and what inspired us to run over 7,800 events 
across the country, connecting warriors and their families to 
each other and the resources they need to thrive in the 
communities where they live and work.
    And while we empower millions, we also recognize far too 
many Post-9/11 veterans are continuing to struggle with mental 
health challenges, including depression, anxiety, and PTSD 
related to their service. For some, Wounded Warrior Project has 
been a critical stop on their journey of healing and recovery, 
and importantly, a critical link to VA resources designed to 
help those with the greatest mental and brain health needs.
    It is why our first call to action is improving access to 
VA's Mental Health Residential Rehabilitation Treatment 
Programs, or RRTP. As we shared at previous oversight hearings, 
VA's MISSION Act-derived access standards do not extend to 
these critical inpatient programs. Instead, veterans and their 
advocates are left to interpret a VHA directive that, in our 
judgment, provides little predictability about the course of 
their treatment and their options for care along the way. 
Unless Congress or VA acts to address this policy gap many of 
our veterans will continue to face obstacles in connecting to 
the care they need, placing them at heightened risk for 
negative outcomes the longer they wait for treatment.
    We appreciate the Committees' oversight on this issue and 
the introduction of legislation including the Making Community 
Care Work for Veterans Act, the Veterans' Health Act, and the 
Veteran Care Improvement Act, that would address this issue. 
Ensuring that a single solution is included in the forthcoming 
Elizabeth Dole Omnibus Act is indeed our highest priority.
    Our second legislative priority pertains to helping women 
veterans with access to care and employment. Continued 
oversight of the Deborah Sampson Act implementation is still 
critical, particularly on matters relating to women's health 
staffing and childcare that make VA a more attractive option 
for care. Exploring new opportunities, like extended clinic 
hours and cultural competency training for all VA staff will 
also help. In that vein, we encourage support for H.R. 5785, 
the Edith Nourse Rogers STEM Scholarship Improvement Act, which 
would expand education opportunities for all veterans but be 
particularly impactful for women veterans.
    Sadly, the unemployment rate for Wounded Warrior Project 
women warriors is four times higher than the U.S. veteran 
population, and nearly half reported living paycheck to 
paycheck. We can do more, surely, to help these women find 
good-paying jobs in the growing STEM fields, and supporting 
H.R. 5785 would help make an underutilized VA program more 
accessible to women.
    Similarly, we are prioritizing warriors' financial well-
being, and join many of our VSO colleagues and Members of 
Congress by offering our strongest support for the Major 
Richard Star Act, which would end the oft-cited military 
retirement pay against VA disability compensation for veterans 
who were medically retired for combat-related injuries before 
they reached 20 years of service. This is one of the most well-
known bills in Congress and in the veteran community, and I 
appreciate Chairman Tester's press conference yesterday with 
several of the VSO/MSO partners in support of this legislation. 
And certainly Tonya Star's presence was also notable.
    I would also like to highlight, however, a few less-known 
bills that would help place more veterans into Federal jobs 
that value their military experience. The GROW for our Veterans 
Act, the Employing Veterans to Feed America Act, and the 
Veterans Border Patrol Training Act would create new and 
creative opportunities for veterans at the Departments of 
Interior, Ag, Homeland Security, and they all have our full 
support.
    Finally, as I close I would like to share that working with 
Congress and your Committee has made our work of honoring and 
empowering wounded warriors even more impactful. Looking back 
on our collaboration on legislation like the MISSION Act, which 
expanded the caregiver program to all generations, the John 
Scott Hannon Act, which expanded VA's investment in community 
organizations that help prevent veteran suicide, and the PACT 
Act, which represents the largest expansion of health care and 
benefits for toxic-exposed veterans all give me hope, hope that 
anything is possible when we work together in honoring those 
who have served and sacrificed on our behalf.
    And I, too, look forward to your questions.

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

    Chairman Bost. Thank you, General.
    Mr. Wimer, you are recognized for 5 minutes.

 STATEMENT OF DENNIS WIMER, PRESIDENT, NATIONAL ASSOCIATION OF 
              STATE DIRECTORS OF VETERANS AFFAIRS

    Mr. Wimer. Thank you, Chairman Tester, Chairman Bost, 
Ranking Members Moran and Takano, and distinguished members of 
the Committees on Veterans' Affairs. And I would like to thank 
Representative Mrvan from Indiana for being on this Committee 
and being here today. Thank you, sir.
    My name is Dennis Wimer, and I am the President of the 
National Association of State Directors of Veterans Affairs. I 
also have the honor to serve as the Director of the Indiana 
Department of Veterans Affairs.
    NASDVA was founded 78 years ago to bring together the VA 
state directors, commissioners, and secretaries from all 50 
states, 5 U.S. territories, and the District of Columbia, with 
the mission to foster effective representation for those 
claiming entitlements due to their honorable service, to 
provide a medium for the exchange of ideas and information, and 
facilitate discussion, and to successfully advocate for our 
nation's veterans, their families, survivors, and caregivers.
    State Departments of Veterans Affairs are comprehensive 
service providers. We serve our respective veterans as the 
primary intersection on veterans' issues between the United 
States Department of Veterans Affairs and our respective state 
and territory governments, as well as with veteran service 
organizations, community partners, and nonprofit entities. In 
doing so, we closely partner with Federal VA to deliver both 
Federal and State services while conducting aggressive outreach 
and advocacy for our nation's 18-plus-million veterans.
    The collaborative relationship between the VA and NASDVA 
was just recently reinforced with the renewal of the Memorandum 
of Understanding signed last week with Secretary Denis 
McDonough at our Mid-Winter Training Conference here in DC. 
Secretary McDonough told us, VA and our veterans have no better 
partner than NASDVA. It is our privilege to be partners with 
all of you.
    As an association we applaud Congress' concerted efforts to 
improve VA funding for health care benefits, claims and appeals 
processing, and homeless veterans programs. We specifically ask 
that you support the cohort of 50,000-plus combat-injured 
veterans who are medically retired prior to 20 years of 
service, to receive their earned retired pay without offset of 
VA disability compensation.
    Your passage of the PACT Act was a monumental piece of 
legislation. NASDVA supports current emphasis on the 
implementation and the hiring of adequate VA staff to address 
the resulting increases in medical examinations and services 
and disability claims processing. States perform a vital role 
interfacing with the veterans to inform and help with their 
individual needs and claims. It will take time to address the 
resulting backlog.
    NASDVA applauds Congress' renewed attention on VA's aging 
infrastructure, on caregiver support, and on women veterans 
issues. Also, we applaud VA increasing its digital connection 
with veterans, particularly for health appointments, 
prescriptions, and claim status. We also agree with your 
efforts to hold VA fully accountable for development and 
evolutionary upgrades to the VA's electronic health record 
modernization. It is essential for future health care 
transformation.
    We also recommend continued emphasis by the VA to ensure 
veterans are provided timely community care referrals and 
appointments. Reimbursements to providers for community care 
services should also be prompt.
    In promoting our state and territories' collective veteran 
suicide efforts, NASDVA recommends additional resources be 
provided through the Governor's and Mayor's Challenge on 
Veteran Suicide Prevention.
    For our state veteran homes, both NASDVA and the National 
Association of State Veterans Homes recommend increased funding 
for the VA State Veterans Home Construction Grant Program and 
an increase in per diem to enhance care in view of the national 
shortages of health care professionals. The Build America, Buy 
America Act is presenting some challenges in the acquiring of 
certain materials for the construction of homes, where they are 
not available or more costly. For those state veteran home 
projects granted prior to enactment of the law, we are seeking 
waivers from VA under provisions stated in the law, where items 
are unavailable or too costly.
    Additionally, VA's current Veterans Cemetery Grants Program 
budget does not allow the NCA to adequately cover both the 
establishment of new state or tribal cemeteries, while giving 
priority to the expansion and improvement of existing 
cemeteries. Both state veteran nursing homes and state veteran 
cemeteries provide essential health care and memorial services 
to honor those who have served in the defense of our nation.
    To serve eligible American and Alaska Native veterans, 
NASDVA applauds the MOU between the VA and Indian Health 
Service and supports the rule by VA to waive the copayments 
incurred by these veterans. The recent passage of legislation 
for the National Association of Indian Veterans as a charter 
VSO gives proper recognition for these deserving warriors.
    NASDVA commends VA's emphasis on ending homelessness among 
veterans, especially women veterans with children. NASDVA 
recommends continued funding for specialized homeless programs 
and commends VA and HUD for increasing the number and value of 
HUD VASH vouchers.
    It is a significant challenge, as we have heard, for 
transitioning servicemembers to connect with earned state 
services, benefits, and support. NASDVA applauds the Veterans 
Benefit Administration allowing accredited VSOs and states to 
have a 45-minute inclusion in the DoD Transition Assistance 
Program. It is also important that we be allowed to receive 
information and connect with servicemembers retiring and 
separating who are coming to our respective states.
    It is extremely important that we recognize and honor the 
service of our Guardsmen and Reservists, particularly with the 
increased and vital role they perform, not only at the State 
level but in the overall defense of our nation.
    Finally, it is important to highlight that NASDVA's 
membership are government-to-government partners with Federal 
VA, and that we are second only to Federal VA in delivery of 
earned benefits and services.
    Distinguished Committee members, we sincerely respect and 
appreciate your work to improve the well-being of our nation's 
veterans. With your help and your continued support we can 
ensure that our veterans remain a national priority. Thank you.

    [The prepared statement of Mr. Wimer appears on page 151 of 
the Appendix.]

    Chairman Bost. Mr. Wimer, thank you.
    Mr. Whaley, you are now recognized for 5 minutes.

       STATEMENT OF JIM WHALEY, CHIEF EXECUTIVE OFFICER,
                       MISSION ROLL CALL

    Mr. Whaley. Chairmen Tester and Bost, Ranking Members Moran 
and Takano, and distinguished members of the House and Senate 
Veterans' Affairs Committees, on behalf of Mission Roll Call, a 
national nonpartisan, 501(c)(3) and roughly the 1.4 million 
veterans we support, thank you for the opportunity to testify 
today.
    My name is Jim Whaley. I recently came on board as Mission 
Roll Call's Chief Executive Officer. I am a retired U.S. Army 
officer, married to an Army veteran, and a father of three 
daughters, two of which are currently serving overseas on 
active duty, and the other serving active-duty soldiers and 
their families at a nonprofit. My family and I are committed to 
the cause of serving those who served, which is why I was drawn 
to the vision of Mission Roll Call.
    Mission Roll Call brings a unique and dynamic process to 
veteran advocacy. We seek to give veterans an unfiltered voice 
and give policymakers an unbiased view of how veteran community 
feels about issues under consideration by this body.
    Mission Roll Call is a new organization that uses the power 
of technology to represent and advocate for our veterans and 
their families. We are a movement providing veterans with a 
powerful, unified voice that is heard by our nation's leaders 
and communities. We are apolitical and represent the concerns 
that our veterans have across the nation. We believe that every 
veteran has a voice that needs to be heard.
    Almost half of all 18 million veterans within this country 
are not associated with any veteran service organization or the 
VA, which means when our leaders are talking about veteran 
issues half of our voices are not being heard.
    On a regular basis, we ask relevant and timely questions 
through polls and then share that with elected officials, 
policymakers, and the media. We believe using the opinions of 
veterans and their families is a powerful tool to bring to the 
attention of the American people and demand action by decision-
makers in government.
    We have had over 260,000 veterans and their families 
respond to our polls, and we expect to double that number this 
year. Our polls address the subjects that are of interest to 
our members, the veterans and their families. Our recent polls 
range from addressing the level of support from the Veterans 
Administration, suicide prevention, mental health issues, food 
insecurity concerns, and the continuing struggle for a 
successful transition to civilian life, as well as the upcoming 
Presidential election. We will share the direct impact of the 
polls and petitions with all of you.
    We also want the country to know our veterans and what is 
important to them. So we are traveling the country in person 
and virtually, to speak with veterans and share their stories. 
Our strength is in our numbers and our voice being amplified 
over many social media platforms.
    Through our Service-to-Service Initiative we will provide 
our veteran community access through podcasts, videos, and 
articles to address the challenges and concerns they are 
experiencing and give them access to success stories, programs, 
and insightful discussion from other veteran support 
organizations, business leaders, and veteran entrepreneurs.
    Ensuring successful transitions, providing necessary 
healthcare and benefits, and stopping suicide are all more than 
just moral imperatives. Success or failure in these areas has a 
direct effect on national security.
    In one of our recent surveys we asked the American people 
if they would recommend military service to a young friend or 
family member. Only 35 percent of those adults without a 
military connection responded positively. Among those who would 
not recommend it, nearly 40 percent cited transition issues, 60 
percent cited insufficient veteran benefits and concerns about 
VA healthcare.
    Fewer than 1 percent of Americans serve on active duty in 
any given year, and of the estimated 18 million veterans in the 
U.S., 80 percent report having an immediate family member who 
has served. Taken together, this means military service has 
become a family business being shouldered by a shrinking 
minority of American families.
    We need to understand that the quality of life of those on 
active duty, where 24 percent suffer from food security 
challenges according to the DoD, coupled with the lack of 
confidence in VA support, is a national security threat in an 
ever-dangerous world.
    Congress and the VA play an important part to make sure 
veterans have the support, and the VSOs in this room play a 
major part in ensuring they have the community. We must work 
collaboratively across party lines and in conjunction with a 
coalition of veteran support groups to ensure success. Together 
we can help veterans continue their service after the military, 
in their communities, states, and in their country. Mission 
Roll Call is proud to be a part of this effort and we look 
forward to working with you in the future.
    Thank you for the opportunity, and I am open to any 
questions.

    [The prepared statement of Mr. Whaley appears on page 169 
of the Appendix.]

    Chairman Bost. Thank you. Ms. Roth-Douquet.

                STATEMENT OF KATHY ROTH-DOUQUET,
          CHIEF EXECUTIVE OFFICER, BLUE STAR FAMILIES

    Ms. Roth-Douquet. Thank you, Chairmen Tester and Bost, 
Ranking Members Moran and Takano, members of the Committee. 
Thank you for the opportunity, our first opportunity at Blue 
Star Families, to present our priorities.
    We are the nation's largest and fastest-growing military 
and veteran family support organization. Many of you have loved 
ones who serve or have served in the military, so you are a 
Blue Star family, and we are delighted to see you. We are 
growing to 15 chapters across the states, 275,000 members. Our 
programs touch 1.5 million individuals each year.
    Our annual Military Family Lifestyle Survey, which is 
developed with Syracuse University's IVMF, is the largest and 
most comprehensive of its time for active Guard and Reserve 
veterans and their families. Today I want to share with you 
some of our main topics of concern relevant to the Committee--
suicide prevention, toxic exposure, education, and transition.
    In terms of suicide prevention, there is a clear need for 
support, mental health support, for veterans, and given the 
barriers to accessing mental health resources and the tendency 
of veteran families to turn to informal sources, it is very 
important that we elevate the less-formal mental health 
supports such as wellness centers, chaplains, and especially 
friends and families, because this is how people live. These 
supports do not replace mental health care but they can support 
and extend if families and friends are educated and resourced 
about how to talk to someone about their mental health.
    So we were very pleased that in 2022, Blue Star Families 
was awarded the Staff Sergeant Fox Suicide Prevention Grant. 
While most suicide prevention programs for the VA focus only on 
the veteran and are eligible only to the veteran, this is 
really a revolutionary program because it is a national program 
that focuses on the family members as key points of 
intervention, and it is working.
    This matters because the family member is often the one who 
sees the crisis. Often the veteran is not willing to raise 
their hand for help. Excluding anyone but the veteran is a 
mistake. So with our grant we provide a community-based 
outreach prevention program--it is called Support Circles--we 
empower the friends and families, loved ones of veterans, to 
recognize and intervene before the struggle becomes a crisis. 
It is an upstream solution.
    This program offers facilitated, non-clinical, closed-group 
cohorts for supporters of veterans. Over 8 weeks the 
participants engage in both virtual and in-person sessions, 
which foster peer-based connections. They receive evidence-
based training, resources and referral. Every participant also 
develops a crisis plan in the event their loved one becomes 
suicidal. A comprehensive evaluation by the University of 
Alabama concluded that the first year went very well. 
Participants are very satisfied with the program and reported 
that they would recommend it. It offers a safe space for 
families to share experiences and insights.
    And the program works. The evaluation clearly shows that 
the participants feel better equipped to make a difference in 
suicide prevention. This essential shift creates a proactive 
and supportive community that breaks down barriers, reduces 
stigma, and achieve upstream prevention of suicide.
    Blue Star Families recommends the VA facilitate grantee 
networking opportunities to enable the sharing of best 
practices, instead of the existing one-way updates from the VA. 
We encourage oversight of the Fox Grant-funded programs to 
assess the effectiveness of those grantees, and we recommend 
reauthorizing the most effective solutions.
    And finally, we recommend authorization of this program or 
a similar one at DoD, to provide currently serving families the 
same approach to suicide prevention. Every one of those 
servicemembers becomes a veteran. If we can get upstream that 
prevents a lot.
    Then on the PACT Act. The PACT Act marked a huge victory 
for our community. The impact is staggering, and it is personal 
for me. My Chief of Staff, Jenny Aiken, tragically lost her 35-
year-old Army husband, Captain Cooper Aiken, who had 
transitioned to veteran status when he got ill. They were sure 
he would beat his cancer, but they did not. The family would 
have been in financial crisis, literally bankruptcy, if the 
PACT Act had not passed.
    While VA outreach on the PACT Act is commendable, we 
encourage DoD to ensure that all transitioning servicemembers 
are informed of this new benefit and why they should enroll in 
the VA, even if they are not suffering symptoms. We call on you 
to strengthen the PACT Act, provide new VA authorities when 
needs arise, and stand against any attempt to weaken the law.
    In terms of education, thank you for your work on the GI 
Bill and closing the 90/10 loophole. Please oppose all efforts 
to undo the hard-fought gains for our community to protect 
these generous benefits.
    And lastly, with transition, our 2023 survey showed that 
half of veterans described their transition as difficult or 
very difficult, and it is all about time. For those who had 
less than 6 months, they had a difficult transition. Those with 
1 to 2 years had a successful transition. Early engagement with 
TAP is critical.
    Thank you so much for having me.

    [The prepared statement of Ms. Roth-Douquet appears on page 
175 of the Appendix.]

    Chairman Bost. Ms. Jaslow, you are recognized for 5 
minutes.

STATEMENT OF ALLISON JASLOW, CHIEF EXECUTIVE OFFICER, IRAQ AND 
                AFGHANISTAN VETERANS OF AMERICA

    Ms. Jaslow. Chairman Tester, Chairman Bost, Ranking Members 
Moran and Takano, and members of the Committee, on behalf of 
Iraq and Afghanistan Veterans of America and our over 425,000 
members and supporters, thank you for the opportunity to 
represent the nation's Post-9/11 generation veterans here with 
you today.
    Now you and your staff are well briefed on our priorities 
for the remainder of this Congress, which are also included in 
my written testimony, so I wanted to use this time to level-set 
on behalf of my generation of veterans and on behalf of America 
at large.
    War changes you. Heck, even the act of making your will at 
22 does, as I had to do on my way to Iraq almost 20 years ago. 
It can change you in some really terrible ways. For instance, 
one of my Basic course buddies served with the Army Special 
Forces after we graduated. He was then asked to deploy over and 
over again, as our nation's leaders chose to overly rely on our 
special operators Post-9/11. And now, after repeatedly 
experiencing the horrors of battle, he has to sleep in a 
separate bedroom from his wife. Why? Because his night terrors 
are too much for her to handle.
    War can also change you in expected ways. Not everyone 
joins the military just to serve their country like I did. 
Serve their country they will, but maybe they just wanted to 
fast-track out of the less-than-ideal circumstances they were 
born into. Maybe they just wanted something as simple as a 
reliable meal three times a day, and perhaps they were willing 
to put on a uniform to do it.
    And they get orders to deploy, to fulfill your commitment 
to support and defend the Constitution of the United States 
against all enemies, foreign and domestic. Whether you are the 
most patriotic citizen when you signed up or not, when you are 
asked to put it all on the line for what we have for America 
that changes you too.
    Many of us who served Post-9/11 are now out of uniform. We 
are trying to live life in a country we risked our lives for, 
and enjoy the way of life we fought for just the same. But many 
of us are struggling with what we see before us in our country 
today.
    In a recent member survey of IAVA veterans, 74 percent told 
us they were dissatisfied with the way democracy is working in 
this country, while only 12 percent said they were satisfied. 
IAVA veterans, on the whole, are therefore even less satisfied 
in the American people at large, whose satisfaction, Gallup 
recently reported, had sunk to 28 percent, as this debate 
continues to dominate our national discourse. To me that has 
less to do with a system that has passed stress tests time and 
time again, but our leadership.
    When I was in the Army, our Army values, as some other vets 
who are in attendance here today can validate, spelled out 
leadership--loyalty, duty, respect, selfless service, honor, 
integrity, and personal courage. I may have left the Army 15 
years ago, but I still carry those Army values with me today, 
and wake up every day trying to live by them.
    And what I want to encourage each and every one of you, 
more than anything, to do today, and in this most important 
year in our nation's history, is to follow our example. Instead 
of pandering to our community, instead of promising to meet our 
every demand, how about you show us you are willing to also put 
it all on the line for what we have here in America. How about 
you demonstrate selfless service, honor, and personal courage? 
Because that is what we really need from you more than anything 
else, more than any benefit we may have earned and deserve.
    Like many other combat vets, I will never be the same after 
going to war. My perspective on life has been reshaped forever, 
and my perspective on what we have here in the United States 
has also changed. I am also fortunate enough to have made it 
home to a newfound appreciation for our country. But like many 
vets, I have buddies who were not as lucky. They gave their 
lives and their families lost a loved one for what we have 
here. And you need to show up for them as much as you show up 
for us.
    When a fellow platoon leader lost is life during my first 
deployment in Iraq, executing the very moves that I would have 
made if I had been assigned the mission he got on that fateful 
day, I made a promise to myself, that I would live a life 
worthy of his sacrifice.
    And so again, in closing, I will encourage all of you who 
serve in this body, that regularly disappoint the American 
people, that cannot figure out a way to fulfill its most basic 
responsibility of funding the government, to not just profess 
that you will do right by our veterans, our troops, and their 
families, to not just promise to help us achieve our 
legislative priorities, but to show us that you share a 
commitment to this country and are willing to work across lines 
of difference to protect and defend what we are so lucky to 
have here, and, by God, that you are willing to live a life 
that is worthy of the fallen sacrifice.
    Thank you for your time.
    [Applause.]

    [The prepared statement of Ms. Jaslow appears on page 187 
of the Appendix.]

    Chairman Bost. Thank you, Ms. Jaslow.
    Mr. Mimms, you are recognized for 5 minutes.

        STATEMENT OF PAUL L. MIMMS, NATIONAL PRESIDENT,
                  BLINDED VETERANS ASSOCIATION

    Mr. Mimms. Thank you, Chairman Tester, Chairman Bost, 
Ranking Member Takano, Ranking Member Moran, and distinguished 
members of the Veterans' Affairs Committee for Congress. The 
Blinded Veterans Association is honored and thanks you for the 
opportunity to present our legislative agenda for the coming 
year.
    The Blinded Veterans Association was formed in 1946, and so 
I want to point you to March 28, which is the anniversary of 
the formation of the Blinded Veterans Association in 1945, by 
some blinded veterans at Old Farms Hospital in Connecticut. 
This is our 79th year of operation.
    As for our legislative priorities, I want to list most of 
them, and give you reasons for some of them.
    One of our priorities is the establishment of a Federal 
Advisory Committee on Equal Access. I will just tell you now, a 
lot of our priorities hang on this committee coming into 
fruition.
    We also support, as many others, the formation and the 
continuing development and furtherment of services for 
America's women veterans. They are, by most knowledge, the 
largest sector of growth in the veteran population, and they 
need the help.
    I want to ask for the enhancement and the continued support 
for adequate protection for guide and service dog handlers on 
VA property. I know personally of incidents where veterans have 
gone to VA with their service dogs, and they have been attacked 
by dogs that are not service dogs, and they have been taken out 
of service, those dogs. We are talking about a $50,000-plus 
investment in that dog and the cessation of that veteran's 
access.
    I want to ask for continuation of the funding for VA blind 
rehab services. Right now, recently, the population of veterans 
that were served by VA blind rehab services more than doubled, 
from around 40,000 to over 81,000. And now, in the wings, we 
have 1.2 million low-vision veterans, veterans whose visual 
acuity is no better than 20/70, as opposed to those that are 
legally blind, with a visual acuity no better than 20/200. And 
so as that population and the demands on that service continue 
to grow, we definitely need increased funding in order for them 
to continue and provide adequate service to America's blind and 
low-vision veterans.
    I want to ask for better mental health care, as many others 
have too. Suicide is on the rise, and it is not lessening, by 
any means, among the population of veterans who have lost what 
is considered to be the most important sensory system that we 
have, our eyesight. And so I want to comment that blinded 
veterans, we served like every other veteran, and yet when we 
come back, where we are now, we cannot even see the country for 
which we fought.
    And so I ask for the preservation of ocular health service. 
We are not in favor of optometrists who are not qualified to do 
so to perform internal eye surgery, invasive eye surgery. They 
are not qualified, and it threatens the health and safety of 
our blinded veterans. And I ask that you work with us to see 
that that does not happen.
    I want to ask for increased, if you will, support for 
honoring our veterans that were disabled on active duty. So we 
support the act that would make sure they do not have to take 
an offset in their disability pay because they take retirement 
pay. They served honorably, and they deserve to be compensated 
honorably after their service.
    I will say here that the Federal Advisory Committee that I 
mentioned, on that hangs almost all of our priorities for us. 
With that committee, hopefully we have a seat at the table, of 
course, and we can have the opportunity to present what are, 
for us, unique shortcomings in VA service. To us it is a shame 
that the organization, the administration, that is supposed to 
represent and present us blind veterans with sensitive, caring, 
informed medical care falls short. And so there is not a reason 
for us to fall short.
    But the VA, like so much of the rest of the world, is a 
very visual environment, and we are asking that you help us in 
pursuing erasure, and if not that then at least diminishment of 
the visual barriers and obstacles that exist in the VA system. 
And we are not talking about billion dollars to do this. A lot 
of, we are already talking about common sense approaches to the 
problems, and some of the solutions do not cost any more than a 
few thousand dollars.
    The VA took the unit out of their new employee orientation. 
That would simply take 5 to 15 minutes to show new employees 
how to guide a blind patient to and from a clinical visit or 
around the medical center. They do not deem that to be 
important. Well, I have been bouncing off door frames, run into 
doors. I have had people that grab my dog's harness or leash, 
or my cane, or simply just pull on my sleeve to lead me through 
a clinic. And if you would like to take that behavior and apply 
it to yourself.
    I think you understand my contention that for many of us 
blind veterans it is very difficult for us to leave a visit at 
the VA medical center and get home with our self-respect and 
dignity and the respect that VA has for us intact.
    So I am asking that, Chairman Takano--I am sorry--Chairman 
Tester, Chairman Bost, Ranking Member Takano, Ranking Member 
Moran, and the distinguished members of the Committee, support 
us in the pursuit of our legislative priorities for the coming 
year. And with that I thank you for this opportunity to 
present, and I welcome your questions.
    [Applause.]

    [The prepared statement of Mr. Mimms appears on page 198 of 
the Appendix.]

    Chairman Bost. Mr. Mimms, thank you.
    Colonel Fenner, you are recognized for 5 minutes.

   STATEMENT OF LORRY M. FENNER, PHD, COLONEL, USAF (RET.), 
   DIRECTOR OF GOVERNMENT RELATIONS, SERVICE WOMEN'S ACTION 
                            NETWORK

    Ms. Fenner. Good afternoon, Chairmen, Ranking Members, 
other distinguished members of the Committee. I am proud to 
represent Service Women's Action Network here today. We are a 
national nonprofit of almost 10,000 members who advocate and 
support currently serving women and women veterans.
    First, we thank Congress for recent legislation, from PACT 
to Deborah Sampson, MAMMO, Protecting Moms Who Served, and 
more. As we continue to work with you on your oversight and new 
legislation we really appreciate when your staffs help share 
the reports that you require so that we can help you some more. 
We also thank the VA for quickly implementing the PACT Act and 
for its expansion, and some other new policies.
    The VA has steadily improved benefits processing and care. 
We are still processing the new VA Equity Action Plan and other 
recently released reports, but we know the devil is in the 
details of the implementation of that, and your oversight will 
be critical.
    We also thank the other VSOs here. We partner with them. 
They make constructive recommendations. They improve many 
lives. If we had more time I would echo all of these concerns. 
Instead, I will focus on very few of the women's complex and 
intersecting challenges that we hear from our members and 
partners every day, and you have our longer testimony.
    We feel invisible or worse. Women face a lack of respect 
often because they did not receive recognition for their 
contributions. This underpins almost every other issue. More 
creative outreach is required to those of us who have been 
insulted, neglected, ignored, especially our elderly, or those 
who are afraid of, or angry at, the VA.
    We do thank the VA for passing the very old and outdated 
new motto. We ask now that you pass the Jax Act Plus to 
recognize all the lioness, female engagement, and cultural 
support teams.
    [Applause.]
    Ms. Fenner. Sexual assault and harassment at the VA must be 
eliminated. It is devastating that we have to add VST to MST. 
The now more than three reporting systems have to be 
rationalized and made consistent nationally to start to get at 
this problem.
    MST claims processing and care must be less traumatizing. 
Congress must pass the SAVES Act. The VA and DoD should 
collaborate even more in the TAPs program that includes 
portions for MST survivors from their transition from service 
to veteran status, and the VA must continue to improve its 
processing of upgrading characters of discharge. ``Bad paper'' 
discharges are related to a host of collateral issues that come 
with MST and other challenges.
    Women's health care must be continually assessed and 
improved. With the increasing number of women veterans, the 
range of care they need and the issues that keep them away from 
the VA must be addressed. This includes reproductive health 
care, fully implement the final IVR, eliminate copays for FDA-
approved contraception, expand eligibility for ART including 
IVF beyond the newly promised policy, expand targeted research 
rather than just classifying women and minorities as ``lesser 
included cases,'' and also abide by Section 1557 of the ACA.
    Now the new DAV report that you will hear about tomorrow, 
and maybe some of you already have, shows that the increase in 
suicides among women veterans is horrific. We applaud the DAV 
for their research and VA's research and task force efforts, 
and we welcome, as well, the commitment to work closely with 
the Women Veterans VSO Working Group. VA must specifically name 
this as a number one priority, allowing Congress to fence 
funding for the program.
    The bottom line is culture change. Further and significant 
culture change at the VA is required in order to make 
meaningful progress. We appreciate congressional actions and VA 
initiatives, but these efforts must be constant and continual 
because these problems have persisted forever. Adding new laws 
and policies and making operational change do help on the 
margins, but they will not meet the promise of the nation to 
all veterans. Thank you.
    [Applause.]

    [The prepared statement of Ms. Fenner appears on page 213 
of the Appendix.]

    Chairman Bost. Thank you, Colonel.
    Mr. Lyon, you are recognized for 5 minutes.

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, members of the Committee, thank you for allowing 
Student Veterans of America to present on our annual 
legislative priorities for 2024.
    SVA recently finalized a new strategic plan, reinforcing 
our commitment to equity for student veterans. Despite being 
exceptionally successful in higher education, veterans face 
unique challenges post military service. Our aim is to 
collaborate with these Committees to alleviate these barriers, 
ensuring a prosperous transition to civilian life.
    SVA chapters are the breathing heart of our mission. Higher 
education research shows that what leads to ultimate success 
for students is a sense of belonging on campus. This is no less 
true for student veterans, and our chapters provide that sense 
of belonging through the shared experience, peer support that 
veterans need after separation from military service.
    With that being said, if you are here today with Student 
Veterans of America, would you please stand or raise your hand 
to be recognized?
    [Applause.]
    Mr. Lyon. Thanks, you all. In the current academic year, 
SVA chapter leaders are leading active and engaged chapters on 
a network that now spans 1,647 chapters throughout the globe. 
They are working with student organizations across the world. 
They are hosting networking and career events. Our chapter 
leaders are leading programs to improve mental health or train 
suicide prevention. They are volunteering in their local off-
campus communities, they are sponsoring new sports teams, and 
they are doing all this while advocating for their members on 
national, state, and local levels.
    SVA chapters help one another and those in their community 
during challenging times, and as a result they are creating a 
sense of belonging for veterans making the difficult transition 
into higher education.
    Before proceeding, SVA would like to thank the members for 
their work on the Senator Elizabeth Dole 21st Century Health 
Care and Benefits Improvement Act, as we continue to support 
making VET TEC permanent and expanding VSOC, Veteran Success on 
Campus. And as a personal note, I would just like to thank 
Senator Dole. Her and her late husband, Senator Bob Dole, have 
served as inspirations and mentors to me, and I had the 
opportunity to serve as an usher at Senator Bob Dole's funeral. 
Senator Elizabeth Dole, I could not think of a better namesake 
for your lasting legacy in our community. Thank you, ma'am.
    [Applause.]
    Mr. Lyon. Further, we would also like to express our 
gratitude for yesterday's introduction of the Guard and Reserve 
GI Bill Parity Act of 2024. As a long-standing policy priority 
for SVA, we are encouraged to see progress here.
    In the time that remains I will briefly outline three of 
our highest policy priorities and the voices of our community, 
today's student veterans, military-connected students, students 
who are family members, caregivers, and survivors, all of whom 
are earning their degrees to better their lives and the 
potential for themselves and their families.
    First, SVA is committed to being an ally of the VA while 
driving accountability measures for VA's efforts to modernize 
its systems and improve customer support in the overall 
experience for users of the GI Bill. The GI Bill is the gateway 
to the VA, and a seamless GI Bill process is key to 
establishing trust and confidence in the agency with every 
veteran served by VA. We urge the Committees and VA to assess 
how these changes can affect GI Bill users. Delays in benefits 
could hinder veterans' education and their mental and emotional 
health.
    Second, SVA is currently investigating the significant 
potential for veterans to experience disparities in their 
economic outlook when compared to their civilian peers. 
Disparities exist, even amongst those veterans with higher 
education degrees, despite earning more annually, and highlight 
the unique challenges faced by veterans in achieving economic 
stability and prosperity. The causes can be attributed to 
variance in employment opportunities, delays in getting wealth 
value from the job market due to military service, and 
obstacles stemming from the military transition experience.
    The prospect of economic disparities for veterans may serve 
as a disincentive for military service and our all-volunteer 
force. Understanding the complex dimensions of these inequities 
is crucial for informing policies and interventions that are 
aimed at fostering economic opportunity and the transition for 
veterans.
    Third, SVA calls for comprehensive review and update to 
monthly housing allowance calculations and gaps in disparities 
such as those related to VR&E, break pay, overseas 
institutions, and online instruction. It is worth noting that 
the DoD has implemented emergency BAH rate corrections for the 
last 2 years to address the financial burden of rising housing 
costs facing servicemembers. Student veterans are facing these 
same financial burdens and rising housing costs in the United 
States, and data shows that despite the generous GI Bill, 
student veterans are taking on student loan debt just to cover 
living expenses. Whether it be the lower subsistence rates for 
VR&E compared to Post-9/11 MHA, the lack of payment periods 
between academic terms, the flat rate for overseas learnings, 
or the inequities in MHA for distance learners, student 
veterans and their families feel the disconnect.
    Thank you for your time, your attention, and devotion to 
the cause of veterans and higher education. At SVA, we know 
that investing in veterans is not only the right thing to do, 
but it also means investing in the future of American 
leadership.
    Thank you, and I look forward to your questions.
    [Applause.]

    [The prepared statement of Mr. Lyon appears on page 229 of 
the Appendix.]

    Chairman Bost. Thank you, Mr. Lyon.
    Mr. Clark, you are recognized for 5 minutes.

              STATEMENT OF WILLIAM ``BILL'' CLARK,
             NATIONAL COMMANDER, AMERICAN VETERANS

    Mr. Clark. Chairmen and Ranking Members, distinguished 
members of the House and Senate Committee on Veterans' Affairs, 
I am honored to speak to you on behalf of AMVETS and present 
our legislative priorities for this year.
    First, we thank you and your staff for your time, efforts, 
and attention throughout the 118th Congress. Having caring 
staff, many of them veterans, working with us to solve complex 
challenges facing our community makes a significant difference.
    AMVETS has consistently presented veteran suicide as our 
top priority for 6 years, yet rates continue to rise as 
evidenced by VA data. Repeated declarations that ``enough is 
enough'' is enough. It falls short of prompting real change. 
Our veterans, their families, and communities suffer as a 
result of this inaction and lack of urgency. We implore 
Congress to truly embrace innovative solutions to significantly 
reduce these numbers.
    The $16 billion currently funneled into existing programs 
has proven ineffective in combatting veteran suicide. Echoing 
the Journal of the American Medical Association's 
recommendation from 8 years ago, AMVETS believes that exploring 
new and novel approaches is imperative. We commend the recent 
funding of innovative nonprofits through grants, and urge the 
VA to closely examine these programs' successes for potential 
scaling.
    However, investment in these innovative efforts remains 
insufficient. In sectors like pharmaceuticals and 
biotechnology, R&D investment is often 10 to 15 percent of 
revenue. However, the VA funding for innovative alternate 
approaches represents about 1 percent of VA mental health 
budget. AMVETS proposes that the VA allocate 10 percent of its 
mental health budget to establish a new program aimed at 
enhancing the mental wellness of transitioning servicemembers. 
This program should focus on preemptive measures to maintain 
physical and mental readiness and add and adopt positive 
strategies for trauma management to lower the risk of future 
suicides.
    Additionally, we recommend increasing the funding for 
nonprofit grants to 5 percent of the VA's mental health budget. 
This increase would bolster the VA's capacity to identify and 
expand upon inventive interventions, potentially reducing 
suicide rates significantly.
    We recognize the shared concern for veterans' welfare among 
the Members of Congress and appreciate your past support. Yet 
we urge you to channel your empathy into actions that 
transcends bureaucratic interests and prioritizes veterans' 
well-being. Without a shift toward a more proactive and 
innovative approach we risk having another 36,000 veterans 
commit suicide. AMVETS calls for renewed urgent commitment in 
saving lives and ensuring veterans lead fulfilling lives.
    AMVETS has many other priorities for this Congress, 
including passing the Major Richard Star Act and increasing the 
dependency and indemnity compensation for our military 
survivors.
    Our survivors should not be punished for choosing to 
remarry, and we encourage all of you to support the Love Lives 
On Act.
    AMVETS and others are advocating for legislation to allow 
all congressionally chartered veteran nonprofits to receive 
tax-deductible donations. Currently, if organizations like 
AMVETS allows honorably discharged, non-wartime-era veterans to 
become members we can no longer receive tax deductible gifts, 
which I am sure you all agree makes no sense at all. The VSO 
Equal Tax Treatment Act rectifies this issue. We are grateful 
to Congressmen Wenstrup and Panetta for their advocacy in 
getting the legislation passed out of the Ways and Means 
Committee.
    We also ask Congress to oversee and support the successful 
completion of the electronic health care record at VA 
facilities so our veterans receive the modernized care they 
deserve. We need all hands on deck here. Failure is not an 
option, and the days of being a political football need to end.
    Despite significantly increasing funds for ineffective 
mental health models at the VA, urgent attention is needed also 
for optometry, the third most-used specialty. Optometrists 
delivering over 70 percent of VA's eye care face low pay and 
potential political challenges to their scope of practice. Poor 
conditions deter recruitment and retention, driving 
optometrists away, and making the VA an employer of last 
resort. Consequently, the VA risks incurring higher costs 
through community care, against veterans' preferences.
    By working together we can ensure that our veterans receive 
the care, recognition, and opportunities they deserve, laying a 
strong foundation for a more resilient and supportive society 
for all who have served.
    Thank you, and I look forward to any questions.

    [The prepared statement of Mr. Clark appears on page 266 of 
the Appendix.]

    Chairman Bost. Thank you, Mr. Clark.
    [Applause.]
    Chairman Bost. I would like to now recognize myself for 3 
minutes for some questions.
    Mr. Clark, in your testimony you mentioned promoting 
readiness and recruiting efforts for the next generation of 
veterans. Do you think improving the TAP program could help 
with retention and recruiting of future generations of 
servicemembers?
    Mr. Clark. I absolutely do. I think it is the way of the 
future, and I think also there are other initiatives we could 
follow that are out there and that would help increase the 
recruitment of new members, new servicemembers, sir.
    Chairman Bost. Thank you. Ms. Roth-Douquet, in your 
testimony you mentioned the GI Bill benefit and that it is a 
great retention tool for veterans and their families. What are 
some ways we can continue to improve the GI Bill, from what the 
families talk about?
    Ms. Roth-Douquet. Well, continuing to allow for the 
transferability of the GI Bill to loved ones is very key. We 
see, in our survey, that the majority of currently serving 
veterans plan to transfer their GI Bill to their child or their 
spouse, and we find a tremendous amount of pride that that 
servicemember has in being able to provide that education for 
their children. So maintaining that and also continuing to work 
against the for-profit schools that erode the benefit.
    Chairman Bost. Well, I am going to tell you, my son is very 
happy to hand his off to his son. He is doing that right now, 
and I think the school that he is qualified for is really 
fantastic, and his parents are just so happy that it is going 
to be taken care of that way.
    Also then, Mr. Mimms, what can you do to ensure that your 
members have equal access to employment after-service?
    Mr. Mimms. I do not know that that is going to happen in 
our lifetime. But the thing that we have to do is constantly 
work on the obstacles and barriers between people with 
disabilities and employment. That has been in place for years, 
and it still has not risen much for the 30 percent rate of 
unemployment.
    So technology, for me, as a blind person, has erased a lot 
of the barriers and obstacles, and I actually had a successful 
career with the VA after I went back to college and got my 
degree. Technology helped me get the degree, technology helped 
me get the job that I got, and it helped me do what I think is 
a very good job while I had it.
    So we need to invest in what will erase these obstacles. 
You know, if it costs a billion dollars, what do we get back? 
We get back billions of dollars in effort from qualified people 
who are giving the best of what they have and what they can do. 
You cannot put a price on it and say it is comparative and so 
it is not worth it because it costs too much.
    Chairman Bost. I appreciate that. My time is almost expired 
so Representative Levin, you are recognized.

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

    Mr. Levin. Thank you, Mr. Chairman. I want to thank 
everybody here for their service, and a particular shoutout to 
everybody from California, if you are out there. All right. You 
are out there. It really is an honor to be part of this 
Committee and to represent our great Marines and Sailors at 
Camp Pendleton.
    I wanted to just go through a few pieces of legislation, 
and Mr. Lyon, I will begin with you. SVA has long supported 
efforts to create GI Bill Parity for Guard and Reserve 
Servicemembers, and we are so grateful for your advocacy on 
this issue which helped us pass the Guard and Reserve GI Bill 
Parity Act in the House last Congress.
    Can you speak just briefly on the importance of this change 
and the need for our communities to get the bill enacted into 
law this Congress?
    Mr. Lyon. Yes, sir, and thank you for your ardent support 
of just making sure that every day in uniform counts. And, you 
know, when we look at the evolving needs of our country, there 
should be no difference in the way one serves from active duty, 
Guard, or Reserve. So by being able to create this parity we 
are making sure that there is true equity in those that choose 
to serve during the all-volunteer force.
    Mr. Levin. Thank you so much for that.
    General Linnington, I will turn to you. I am proud to have 
the Wounded Warrior Project's support for H.R. 1786, the Get 
Rewarding Outdoor Work for Our Veterans, or GROW, Act. This 
bill seeks to ensure that veterans, especially those who have 
recently returned to civilian life, can obtain rewarding 
careers in conservation, resource management, and environmental 
protection at the Department of Interior.
    Can you please describe the impact that working in the 
great outdoors on conservation projects can have on veterans' 
overall well-being?
    Mr. Linnington. Congressman, thank you for that 
legislation. I think it is really important. I think we all 
know the importance of mind-body connection. Veterans, as you 
know, are very comfortable in the outdoors. They have been 
trained. They are very, very comfortable, especially in 
conservation and working with the Department of the Interior.
    In our surveys we know that financial strain is always a 
concern for veterans, unemployment and financial strain. And 
your legislation that you proposed not only alleviates the 
financial strain but it gets our veterans that are in isolation 
into the outdoors where not only are they comfortable but they 
value that camaraderie that comes with serving.
    So we really support the legislation. Of course, it was in 
my opening statement, and we speak more about it in our written 
testimony. But thank you for sponsoring that legislation.
    Mr. Levin. Thank you, and I have got to go quick because I 
only have 3 minutes.
    Colonel Fenner, in your testimony you called for VA to 
expand eligibility for assisted reproductive technology, 
including IVF, to help our veterans serve families when they 
face infertility challenges. I was deeply disappointed by the 
Alabama Supreme Court's recent decision against women's 
personal health decisions to help create families. We must 
enshrine the right to access IVF into law so that everyone who 
wants to start a family can do so.
    [Applause.]
    Mr. Levin. Thank you. And I am out of time, but I will just 
say this is very important for our military and veteran 
families as well, and I urge my colleagues to pass the Veteran 
Families Health Services Act, which will enshrine this coverage 
into law.
    And with that, Mr. Chairman, I yield back.
    Chairman Bost. Thank you. General Bergman, you are 
recognized for 3 minutes.

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

    Mr. Bergman. Thank you, Chairman, and I would like to thank 
all of you. By the way, any Michiganders in the crowd? All 
right. At least there are a couple of us everywhere. I would 
like to thank everybody for your testimony today and for all 
the work that your organizations have done on behalf of our 
nation's veterans, because we would not be a nation without our 
veterans.
    I also greatly appreciate all your advocacy and the support 
that has helped us advance some extremely important veterans 
bills in the House. For example--and I know Senator Dole is 
sitting here--the Elizabeth Dole Home Care Act and Gerald's Law 
that you championed and became reality, we could not have done 
it without you, so thank you.
    You know, when you only have 3 minutes you do not waste 
time, but as a Marine I do not waste time anyway, so let's get 
right to the heart of one thing. You know, Mr. Thomas, I 
greatly appreciate being able to hear PVA's perspective on the 
issues facing paralyzed veterans. I would also like to thank 
you for PVA's work with my office and your endorsement of H.R. 
6373, the Veterans Spinal Trauma Access to New Devices, or 
Veterans STAND Act, which I recently introduced along with 
Chairman Bost, Health Subcommittee Ranking Member Brownley, and 
Congresswoman Debbie Dingell from Michigan.
    We introduced this bill to make it easier for veterans with 
spinal cord injuries and disorders to be evaluated and receive 
assistive technology that they are already clinically eligible 
for.
    Could you just speak, Mr. Thomas, just a little bit about 
what that means to be assisted with new technologies?
    Mr. Thomas. Thank you for that question. So any time that 
we can get any new assistive technology that can help us either 
ambulate, wheel around, function in our homes, it is a great 
thing to have. We know that technology is changing on a daily 
basis, and having new equipment is great.
    Also in your bill we see that it also goes in to talk about 
individuals having annual exams. We feel as though all members 
with SCI/D should have an annual exam yearly.
    Mr. Bergman. You know, and time is short, but you ended 
with a perfect point. Just because we are doing something one 
way today, that does not mean two things could occur. That 
veteran could have issues, plus or minus, depending on how it 
is going, but also the introduction of new and appropriate 
technologies to advance, to continue to advance the personal 
capabilities, especially when it comes to spinal cord injuries.
    So I am honored to be with all of you today. Thank you all 
for being here. And with that, Mr. Chairman, I will yield back 
5 seconds.
    Chairman Bost. Thank you, General. Representative Landsman.

                      HON. GREG LANDSMAN,
                 U.S. REPRESENTATIVE FROM OHIO

    Mr. Landsman. Thank you, Mr. Chairman. Thank you all for 
being here and your incredibly important, helpful testimony. I 
have one question, well, two if I can get to it. But I would 
love to hear, obviously from you, Mr. Lyon, first, but anyone 
else who wants to jump in, we have a really wonderful VA in 
Cincinnati, and one of the things that we are struggling with 
is how we get young people, younger veterans--and many of you 
spoke to how important time is as it relates to any of these 
efforts.
    And so I am curious. What is the one thing you would say to 
a young person that we need to be communicating more to get 
them in? What is the most compelling selling point to get 
somebody engaged in learning about what they are eligible for? 
And then as it relates to engaging young people and getting 
veterans in earlier, what is the one thing that we should be 
doing that we are not?
    Mr. Lyon. Thank you very much for the question. I will do 
my best to answer it succinctly. When we look at the 
transitioning force, the vast majority of those individuals 
will have served in the military for 6 years or less. The vast 
majority of that population will be of the prior rank, like 
myself, E-5 or below. Those individuals, at over 70 percent 
rate, their likely transition strategy includes education and 
training. What I would say to them is they do not realize that 
it is that high, and you belong in higher education, and it is 
for you.
    Second, what we could be doing that we are not is 
understanding that the GI Bill and all VA education benefits 
serve as the front door for the VA. Chronically, the VA 
struggles to reach out to veterans under the age of 45, and the 
transitioning force is under the age of 30. If we use those VA 
education benefits to reach out to the population and both let 
them know what they are eligible for by making it easy but also 
let them know that the Federal Government is an employment 
opportunity, we can fill gaps in two unique ways. Thank you for 
the question.
    Mr. Landsman. Thank you, education and jobs. And on our end 
a piece of advice. I mean, one of the things that seems simple 
enough is we have talked about getting the VA on the website 
and then to spend some money on digital to make sure that it is 
popping up in front of folks. Just a simple, very quick 
benefits, like here is who I am, what am I eligible for. And it 
does not say you are 100 percent eligible for these things, but 
by and large you are probably eligible for these things, click 
here to learn more.
    Mr. Lyon. In Cincinnati, specifically, you could literally 
support the VetSuccess on Campus, so that is VSOC, or then also 
the VA VITAL Program to ensure full access to all that VBA and 
VHA has, but also conduct outreach from that local Cincinnati 
location to every educational institution around you. The 
likelihood that you will find veterans there is better than 
almost anywhere else.
    Mr. Landsman. Thank you. I yield back. Thank you.
    Chairman Bost. Thank you. And we want to thank everyone for 
being here today.
    Let me say this, as Chairmen. As members, all of us, and 
especially as Chairmen and Ranking Members, understand that we 
are going to work to try to move as many of our priorities as 
we can, and even in this environment we are going to try to 
move them. But our job is not only to move legislation and do 
that, but our job is also to make sure we do the oversight that 
we have to, to make sure the VA is delivering on those things 
that we pass, and realize that they are law, not suggestion. 
Sometimes that is some problems we have when you are dealing 
with the second-largest bureaucracy in the world.
    And let me say this. From my position as Chairman I will 
fight for you every day. As I said at the start, it is very 
personal to me. But I want to thank you for sharing your 
priorities, and it is clear we have a lot of work to do.
    And we are going to deviate from adjourning and Mr. Mrvan, 
you are recognized for 5 minutes, or 3 minutes.

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

    Mr. Mrvan. Chairman Bost, 3 minutes, yes. I will be 
concise. Thank you, Chairman Bost, Chairman Tester, Ranking 
Member Takano, and Ranking Member Moran, for holding this 
hearing today. I would also like to thank the VSO presence here 
today to tell us about their respective organizations and 
legislative priorities for 2024.
    I want to first recognize one of the witnesses on this 
panel who is a leader in veterans' advocacy from my home State 
of Indiana, President and National Association of State 
Directors of Veterans Affairs, Dennis Wimer. The National 
Association of State Directors of Veterans Affairs is an 
essential voice for veterans at both the state and Federal 
level. They are responsible for facilitating cooperation 
amongst the VA directors in each state to provide uniform, 
equal, efficient, and effective services to veterans and their 
family members.
    As further testament to Mr. Wimer's commitment to Indiana 
veterans, on top of his duties as President of the National 
Association of States Directors of Veterans Affairs, Mr. Wimer 
also serves as the Director of Indiana Department of Veteran 
Affairs.
    On Monday, I was privileged to spend the entire day with 
Director Wimer and the Dole vets, Assistant Secretary James 
Rodriguez, meeting with the service providers and businesses 
that assist veterans with career exploration, training, and job 
placement, as well as supportive services for veterans 
experiencing or at risk of homelessness. Together we saw the 
WorkOne facility in Hammond, the Homeless Veterans 
Reintegration Program in Gary, Indiana, and the Indiana/
Kentucky/Ohio Regional Council of Carpenters' Joint 
Apprenticeship Training Center in Merrillville, and Operation 
Charlie Bravo in Crown Point.
    I thank you for taking the time to come to my district to 
see the incredible programs we have assisted veterans in 
northwest Indiana. Thank you for your service and your 
commitment to helping veterans in Indiana and across our 
country, and thank you for being here to testify today.
    With that I would also like to ask a question. I would like 
to take this time to ask Mr. Lyon about the education-related 
benefits available to veterans' survivors and dependents. Today 
I introduced the Gold Star Family Education Parity Act, which 
would sunset Chapter 35 and enroll survivors and dependents 
into Chapter 33, ensuring they have the access to the superior 
education benefits provided under the Post-9/11 GI Bill.
    Mr. Lyon, do you believe Chapter 35 is an adequate benefit, 
or is it time to modernize for Gold Star families?
    Mr. Lyon. When we look at the issues--sir, thank you, 
first, for the question and the nuanced understanding of our 
population and community it is greatly appreciated. When we 
look at the needs for Gold Star family members, those survivors 
are often forgotten. We umbrella-term the population and 
suggest that military connected is enough to define folks that 
have lost their connection to the military, often in very 
tragic circumstances.
    By looking at comprehensive reform, we have the ability to 
ensure that not only is no one left behind goes for those in 
the uniform but also for the family members that they do leave 
behind. And I would assume that everybody on this panel would 
agree that we hold it as a sacred obligation to support them 
deeply. Reform is desperately needed. Thank you, sir.
    Mr. Mrvan. Mr. Lyon, thank you for your opinion.
    [Applause.]
    Mr. Mrvan. And with that I yield back, Chairman Bost.
    Chairman Bost. Thank you. So obviously it is clear that we 
have a lot of work to still do in the year ahead, and we will 
continue to look to each of you to kind of be the guiding 
lights to help us do those things that we need to do and make 
sure that we provide for those who have given their service to 
this country.
    We will keep the record open now for a week, for any future 
input that you would want to make. And with that we are 
adjourned.
    [Whereupon, at 1:13 p.m., the hearing was adjourned.]

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