[Senate Hearing 118-178]
[From the U.S. Government Publishing Office]






                                                        S. Hrg. 118-178

                        ISSUES FACING VETERANS:
                       ACCESS TO CARE, SERVICES,
                        AND ECONOMIC OPPORTUNITY

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

                                HEARING

                               BEFORE THE

                       SPECIAL COMMITTEE ON AGING

                          UNITED STATES SENATE

                    ONE HUNDRED EIGHTEENTH CONGRESS


                             FIRST SESSION

                               __________

                             TAMPA, FLORIDA

                               __________

                           NOVEMBER 10, 2023

                               __________

                           Serial No. 118-10

         Printed for the use of the Special Committee on Aging






[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]








        Available via the World Wide Web: http://www.govinfo.gov  
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                 U.S. GOVERNMENT PUBLISHING OFFICE
                 
54-249 PDF               WASHINGTON : 2023 
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
                       SPECIAL COMMITTEE ON AGING

              ROBERT P. CASEY, JR., Pennsylvania, Chairman

KIRSTEN E. GILLIBRAND, New York      MIKE BRAUN, Indiana
RICHARD BLUMENTHAL, Connecticut      TIM SCOTT, South Carolina
ELIZABETH WARREN, Massachusetts      MARCO RUBIO, Florida
MARK KELLY, Arizona                  RICK SCOTT, Florida
RAPHAEL WARNOCK, Georgia             J.D. VANCE, Ohio
JOHN FETTERMAN, Pennsylvania         PETE RICKETTS, Nebraska
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               Elizabeth Letter, Majority Staff Director
                Matthew Sommer, Minority Staff Director  
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                
                         C  O  N  T  E  N  T  S

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                                                                   Page

Opening Statement of Senator Rick Scott, Member of the Committee.     1
Statement of Congresswoman Anna Paulina Luna.....................     3
Statement of Congressman Gus Bilirakis...........................     4
Statement of Congresswoman Laurel Lee............................     4

                           PANEL OF WITNESSES

Hon. Jay Collins, State Senator, Tampa, Florida..................     4
Sharon Silas, Director, Healthcare, GAO, Washington, D.C.........     5
Teresa Galgano, Director, Member Relations, Blinded Veterans 
  Association, Ft. Myers, Florida................................     7
Gregg Laskoski, Communications Director, K9 Partners for 
  Patriots, Inc., Brooksville, Florida...........................     8
David Harris, Department of Florida Commander Emeritus, VFW, 
  Tampa, Florida.................................................    11

                                APPENDIX
                      Prepared Witness Statements

Hon. Jay Collins, State Senator, Tampa, Florida..................    29
Sharon Silas, Director, Healthcare, GAO, Washington, D.C.........    32
Teresa Galgano, Director, Member Relations, Blinded Veterans 
  Association, Ft. Myers, Florida................................    50
Gregg Laskoski, Communications Director, K9 Partners for 
  Patriots, Inc., Brooksville, Florida...........................    57
David Harris, Department of Florida Commander Emeritus, VFW, 
  Tampa, Florida.................................................    61

 
                        ISSUES FACING VETERANS: 
                       ACCESS TO CARE, SERVICES, 
                        AND ECONOMIC OPPORTUNITY 

                              ----------                              
                              
                              Friday, November 10, 2023




                                        U.S. Senate
                                 Special Committee on Aging
                                                    Washington, DC.
    The Committee met, pursuant to notice, at 1:50 p.m., at 
Pepin Distributing Company, 4121 North 50th Street, Tampa, 
Florida, 33610, Hon. Rick Scott, Member of the Committee, 
presiding.
    Present: Senator Rick Scott

           OPENING STATEMENT OF SENATOR RICK SCOTT, 
                    MEMBER OF THE COMMITTEE

    Senator Rick Scott. Good afternoon. First off, I want to 
thank everybody for being here. It is a real honor to be back 
in my home State and get to do something like this.
    I want to thank you, everyone, for being here today and I 
want to welcome you to a field hearing of the United States 
Senate Special Committee on Aging in Tampa. It is not every day 
that we get to hold these Committee hearings outside the 
Capitol in Washington, D.C. As a matter of fact, it is almost--
it is really rare that it happens.
    As a Floridian, I am working to bring these hearings to you 
so we can see and hear about the issues facing Florida seniors. 
My experience, I am a business guy, and my experience is if you 
find a problem, if you can solve that person's problem, you 
solve it for probably more than one person.
    This is the second field hearing I have hosted in Florida, 
and it is a real privilege and honor to be in the Sunshine 
State, to be here in Tampa. Which my daughter lives here and I 
got to go to Grandparent's Day today and see three of my 
grandsons. I have five grandsons here, so I get to see three of 
them. They are all in different schools. It wasn't the easiest 
thing.
    Hillsborough County is also home to the most veterans of 
any county in the great State of Florida. I want to thank 
Chairman Casey and Ranking Member Braun for allowing us to host 
a hearing down here and everyone who helped make this hearing 
possible. There is a lot of rules in the Senate, so just to get 
to hold a hearing is a lot of work.
    This hearing is our opportunity to address critical issues 
facing veterans like scheduling delays, the transition from 
active duty to civilian life, and access to resources and 
facilities by disabled veterans.
    As a Navy veteran, the son of a World War II veteran, I 
know firsthand the sacrifices made by military members and 
their families. I have an adopted father who fought in the 
Second World War.
    There are 3,000 people that did all four jumps with the 
82nd Airborne and fought in the Battle of the Bulge, and he 
told me how great the food was in the Army, the foxholes, the 
Germans.
    I joined the Navy. My dad had a sixth-grade education. He 
joined as a teenager. He fought in all those battles. I 
couldn't get him to go back. I am sure it was--for anybody that 
has been in combat, I was on a destroyer, so I didn't see 
combat, but anybody that has gone through that, I am sure it is 
very difficult.
    He wouldn't talk about his service often, but he was really 
proud. I don't know if you have seen all the reels on--it must 
be on the public television. He would watch those things for 
hours about that. He loved his time in the service. He was 
proud to wear the uniform and defend our freedoms.
    None of the opportunities and freedoms we have as Americans 
would be possible without the dedicated service of our great 
heroes, like my father, those who have served and put their 
lives on the line.
    Throughout my time as a Governor--my goal as Governor is to 
be--to make sure Florida was the opposite of what it was like 
when I got out. When I got out of the Navy at the tail end of--
after Vietnam, I guess, you couldn't--first off, you couldn't 
wear your uniform off duty. It didn't help you get a job, hurt 
you to get a job if you had served.
    Right where I was stationed, my first ship had signs, dogs 
and sailors get off the grounds. They were not very happy with 
us, so my goal was to make sure this is the State that 
everybody wanted to serve, and everybody wanted to retire in.
    We, with the Florida Legislature, which was a great 
partner, we made this the active-duty member and veteran--most 
friendly State in the country. We have a whole book, and we 
prove it to everybody, and we passed that out. Fighting for our 
heroes continues to be one of my top priorities as U.S. 
Senator.
    I am always going to do everything I can to support our 
veterans. One thing I had to do when I was Governor, we 
created--as Governor, you can create all the medals you want, 
so I got to create a lot. I created the Governor's Veterans 
Service Medal, and I gave out 14,500 of them individually.
    The real key to that is there is a bunch of people who came 
back from Korea. There is a lot more people who came back from 
Vietnam. No one ever thanked them. Now, these people come up 
and they would almost be crying because nobody had ever thanked 
them for their service.
    I think, you know, the people that go serve are not the 
ones who get to decide whether they are put in harm's way. Our 
Commander-in-Chief is, and so, if you have done that, you have 
done your duty.
    You need to be thanked, whether it ends up being a popular 
war or not. Every day, families across the Nation wake up and 
have the opportunity to enjoy the freedoms that generations 
fought to protect.
    Just think about what people are thinking in Israel right 
now. I mean, they woke up on October 7th, thinking they were in 
a normal country, and 1,400 have lost their lives. I was in 
Kibbutz in 2019 with my wife, and that is where--there were 
some of the pictures where you see the babies beheaded and you 
just--the lady that gave us the tour, she happened to be out of 
the country, so she is still alive, but she said everybody on 
her street is dead, and we don't want that to ever happen here.
    Each Veteran's Day serves as a chance to celebrate our 
veterans and recognize the courage and dedication of those who 
have served and those gone but never forgotten. I am proud to 
be a co-sponsor and supporter of dozens of veterans related 
bills in the Senate, including the Elizabeth Dole Homecare Act, 
the Major Richard Star Act, and the PACT Act.
    Our veterans show up for our Nation, so we need to make 
sure that we show up for them. We have got to support them 
every day we can. My oldest grandson is 11. He is clearly going 
to go in the service, and we took him--we just took him to 
Annapolis, and I am trying to, you know, I am trying to 
brainwash him, but we will see if that happens. He loves the 
Army, so, as a member of the Armed Services Committee and the 
Special Committee on Aging, I am going to keep fighting for our 
veterans.
    I want to recognize our constituent services team here. We 
have--so the speakers that are in the House, they haven't been 
here long enough to be number one yet, but we won for the best 
constituent services team of every House and Senate member in 
this country and so I am really proud of them. They have done a 
great job.
    We got some of my good friends here to come give us--to 
open this up for us. We have got Congressman Gus Bilirakis, and 
by the way, when I was Governor, I think I did more things for 
Gus than anybody in the Congress. He had more things he wanted 
to get done because he was a--he is a hell of a constituent 
services person, and we got--one of my health care guys came 
from Gus's office, and I think he spends half his time still 
helping Gus. Then we have got Laurel Lee, who I had the 
opportunity to appoint as a judge and then eventually was the 
Secretary of State, and Anna Paulina Luna, which I got to see 
her the other day with her brand new, is it George, right?
    Ms. Luna. George Henry, yes.
    Senator Rick Scott. Yes, George Henry. Just saw him the 
other day, so first I know Anna Paulina has something she has 
to go to, so Anna Paulina, if you want to come up first.
    Ms. Luna. [Inaudible.]
    Senator Rick Scott. Thank you. She hasn't been up there 
long, but she has got a great start, and thanks for your 
service, and your husband's service.
    Ms. Luna. Thank you.
    Senator Rick Scott. Now, let me introduce Congressman Gus 
Bilirakis, Vice Chair of the House VA Committee for 14 years, 
all right. He had an active role in developing many of the VA's 
policy improvements, like streamlined benefits processing, 
expanded options for care, improved transition assistance, 
innovating homeless prevention, and suicide prevention 
initiatives, and enhanced education benefits. Congressman Gus 
Bilirakis, my friend.
    Mr. Bilirakis. [Inaudible.]
    Senator Rick Scott. Gus has got a great team. His chief of 
staff is wonderful, and he has been a really good partner in 
getting things done, and it is--you know, you can't do anything 
done up there if you don't have the House pass it and the 
Senate pass it, so on all this stuff, I mean, Gus's team has--
they have just been unbelievable partners, and he has got a 
great family too. We had the opportunity to be together with 
his dad like three or four months ago. I can't remember when.
    Thank you. Next, Laurel Lee. Laurel is the daughter of a 
two star general in the Air Force, so ensuring the best care 
for our veterans is important to her, but she was a great--she 
did a great job as a judge here in the State and did a great 
job as Secretary of State for, I guess, what, four, three, 
three and a half years, so, Laurel Lee.
    Ms. Lee. Well, thank you so much, Senator Scott. 
[Inaudible.]
    Senator Rick Scott. Laurel has hit the ground running. She 
is a really hard worker, but what she said is really true.
    The way it has worked up there--I have a big office staff 
just because I represent the State, so what we try to do is we 
try to have all of our teams work together because somebody 
might become an expert in something and somebody else might 
become an expert in something else, and all three, all three 
Congressmen and women in our office, they work well together, 
so we are here--our job is to represent you, so, thanks for 
being here, Laurel. Okay, the first witness, State Senator Jay 
Collins, a U.S. Army veteran and Green Beret, and current State 
Senator for the 14th District, which represent part of 
Hillsborough County. Jay, thank you for being here.

                STATEMENT OF HON. JAY COLLINS, 
                 STATE SENATOR, TAMPA, FLORIDA

    Mr. Collins. Thank you. I appreciate the time and the 
opportunity very much, Senator. All right. Well, I am Senator 
Jay Collins. It is my privilege to represent Hillsborough 
County, you know, a place where I get to grow old. My kids are 
going to grow up. I am a 23 year retired Army Green Beret, and 
I am also married to a----
    [Applause.]
    I was also adopted by my grandparents. He was a D-Day mist 
drop as well, and probably going to talk about those a little 
bit. Some interesting stories.
    It instilled in me the values that I had worked with and 
grown up with throughout my life. In my time in the military, 
we experienced many things. I am an amputee, having been shot 
and blown up in Afghanistan and experienced many issues because 
of that.
    I also had the opportunity to requalify as a Green Beret to 
continue to serve for five and a half years after losing my 
leg. When I got out, we had an opportunity to use our voice and 
serve our community and make a difference.
    I come at this with a unique approach as a veteran, as a 
spouse of a veteran, having seen my wife go through many of the 
same things, albeit different injury cascades, and I had to 
come at it as a State Senator in a community that is that has 
100,000, just under, veterans in Hillsborough County. It is 
dynamic.
    We have MacDill Air Force Base, SOCOM, CENTCOM, and many 
other smaller organizations within there, but people want to 
retire here. We have almost 800 people a day coming into 
Hillsborough, from Hillsborough down to Sarasota, and they want 
to be here, but we have to come across this and start solving 
problems for our community now with our veterans as they are, 
but we also have to get out ahead of the post-9-11 veterans. 
Our war on terror veterans have different injury cascades, 
different problems, and access to medical care, access to 
transition skills, and understanding the complexities of 
civilian life are all things that we have to come together on, 
and it all starts with the veterans and their families, making 
sure they have those tools.
    I am looking forward to this panel, sharing some of my 
experiences as we go through this, and I will stop one of my 
gums here and let the next person talk. Thanks.
    Senator Rick Scott. Our second witness Sharon Silas. Sharon 
is currently serving as a Director for Health Care at the U.S. 
Government Accountability Office in Washington, D.C. I mean, 
here is the--the GAO does unbelievable job.
    They are basic like the referee. They will go in, and they 
try to give you the best information you can so the agency can 
do a good job, but on top of that, as a Senator, as a Congress 
man or woman, we can do better oversight, so my experiences 
with the GAO is they do an unbelievable job. Sharon go ahead.

             STATEMENT OF SHARON SILAS, DIRECTOR, 
               HEALTHCARE, GAO, WASHINGTON, D.C.

    Ms. Silas. Thank you for that introduction, Senator. Thank 
you for the opportunity to be here today to discuss GAO's 
review of VA's efforts to improve their appointment scheduling 
processes and veterans' timely access to health care.
    I am particularly honored to participate in this hearing as 
we celebrate Veterans Day and want to say a special thank you 
with gratitude to our many veterans for their years of service 
to the American people.
    My remarks today are primarily based on our findings from a 
January 2023 report. However, I would like to note that there 
have been longstanding concerns GAO and others have had 
regarding VA's appointment scheduling processes and veterans' 
timely access to care, especially through VA's V-CARE Program.
    The Veterans Health Administration is one of the largest 
health care delivery systems in the United States, and during 
Fiscal Year 2022, VHA provided health care to approximately six 
million veterans. In addition, in the last five years, Congress 
took steps to expand access for eligible veterans to receive 
care from providers in their community, and while most veterans 
still receive the majority of their care from VA providers, in 
Fiscal Year 2022, about one-third of the appointments were with 
non-VA providers participating in VA's community care program. 
In recent years, GAO has identified challenges VHA has had in 
ensuring veterans receive timely care, both at VA medical 
facilities and through the community care program.
    Specifically, GAO has made recommendations that VHA 
establish timeliness standards for various steps in their 
appointments scheduling process to help with monitoring and to 
ensure appointments for veterans are being processed, 
scheduled, and occurring in a timely manner whether a veteran 
is seeing a VA provider or a non-VA provider through the 
community care program.
    In 2020, VHA updated its process and established new 
procedures for scheduling specialty care appointments with both 
VA and community care providers. The new process includes 
internal changes that are meant to help expedite referrals and 
appointments for specialty care providers, such as a 
cardiologist or an ophthalmologist.
    As part of this new process, VHA included timeliness 
standards for when an appointment should be scheduled. 
Timeliness standards for the steps in processing referrals and 
scheduling appointments can help VHA monitor the effectiveness 
of their appointment scheduling process, including identifying 
potential points in the process that may be problematic.
    As cited in our January 2023 report, VHA staff had three 
days to schedule a veteran's appointment for the VA provider, 
and seven days to schedule a veteran's appointment through the 
community care program.
    However, based on our analysis in that report, we found 
that while most VA medical facilities met the three-day 
standard for scheduling appointments with VA providers, most of 
those facilities were not meeting the seven-day standard for 
scheduling appointments with community care providers.
    In addition to having standards for when an appointment 
should be scheduled, GAO has also made recommendations for VHA 
to establish a timeliness standard of when a veteran's 
appointment should occur. In our January 2023 report, we made a 
recommendation for VA to establish a timeliness standard within 
which a veteran's specialty care appointment should occur at a 
VA medical facility.
    VA agreed with that recommendation and since has 
established a timeliness standard of 20 days for primary and 
mental health care appointments, and 28 days for specialty care 
appointments.
    However, VHA has yet to develop a similar timeline standard 
for when a veteran's appointment should occur with a community 
care provider. In 2018, and then reiterated again in our most 
recent report, GAO made a recommendation that VHA establish 
timeframes for when an appointment should occur with a 
community care provider.
    Although VHA agreed with this recommendation, it still has 
not been addressed. Looking forward, GAO will be monitoring 
VHA's actions, working with individual medical centers to meet 
appointment scheduling timeliness standards, and their efforts 
to address points in the process that may be problematic.
    However, until VHA has a timeliness standard for when 
community care appointments should occur, VA will continue to 
be missing a crucial data point in understanding how long it is 
taking veterans to receive care in the community, and without a 
complete picture of how long it takes veterans to receive care, 
whether that care is delivered through the VA or through a 
community provider, it will continue to be difficult for the VA 
to know whether it is achieving its goal of providing veterans 
with timely access to care.
    That concludes my prepared statement. Thank you very much.
    Senator Rick Scott. Thank you. Thank you for--what 
everybody at the GAO does. You guys, your reports are really 
helpful.
    Ms. Silas. Thank you so much.
    Senator Rick Scott. Next, we are going to hear from Teresa 
Galgano, joined by her guide dog, Donald. Teresa works for 
Blinded Veterans of America as a Strategic Advisor focusing on 
Program Development and Social Media and is an Army veteran. 
Thank you for being here, and you came all the way up from Fort 
Myers, I think.
    Ms. Galgano. Yes, sir, I did. Thank you.
    Senator Rick Scott. Thank you for being here.

             STATEMENT OF TERESA GALGANO, DIRECTOR,

               MEMBER RELATIONS, BLINDED VETERANS

                ASSOCIATION, FT. MYERS, FLORIDA

    Ms. Galgano. Thank you, on behalf of the 60,000 plus 
blinded veterans and the 1.1 million veterans who suffer from 
low vision. I thank you for this opportunity on behalf of the 
Blinded Veterans Association.
    My journey with my loss of vision started on active duty, 
but it wasn't until about three years ago that I became legally 
blind, and I decided to use the Veterans Readiness and 
Employment Program to be able to set myself up and work with a 
veterans service organization once I lost my other job.
    The VRE program required me to take an online skills 
assessment test, which was not accessible. It was timed, and 
the results showed that I was below average in verbal, written, 
and math skills. It was humiliating and demeaning, and only 
highlighted my disability to me further.
    The journey of blindness is a long road with many dark 
turns, and that event was one of them, VA programs that are 
inaccessible to people with disabilities. They allowed me to 
take one course at the University of Florida.
    I wanted to go on for a master's in social media, and they 
allowed me to take one course, mainly because of those results, 
but a little over two years later, in August, my guide dog led 
me across the stage of the University of Florida, where I 
received a master's in social media with a 4.0 GPA.
    [Applause.]
    Senator Rick Scott. The test was off----
    Ms. Galgano. Pardon me?
    Senator Rick Scott. I guess the test was off a little bit, 
right?
    Ms. Galgano. Yes. I think so. I think so, but the VA--VA 
programs should be accessible to people with disabilities. It 
should not be part of those dark turns in their journey of 
blindness, and the VA should be there to heal and strengthen 
veterans. Thank you.
    Senator Rick Scott. Thank you. Next, our witness is Gregg 
Lasko--Laskoski. Greg serves as the Communications Director of 
K9 Partners for Patriots. Thank you for being here, and it is a 
great program, by the way.

                  STATEMENT OF GREGG LASKOSKI,

              COMMUNICATIONS DIRECTOR, K9 PARTNERS

            FOR PATRIOTS, INC., BROOKSVILLE, FLORIDA

    Mr. Laskoski. Senator, thank you. Our program, K9 Partners 
for Patriots in Brooksville, have been there since 2014, and we 
exist to prevent veteran suicide.
    For veterans with a service related diagnosis of post-
traumatic stress disorder, traumatic brain injury, or military 
sexual trauma, we provide a six-month training program in which 
we teach the veteran how to train a K9 that becomes his or her 
working service dog.
    We provide the training, a dog if needed, all of the 
necessary equipment, and even some veterinary care. We provide 
professional counseling from a licensed clinical social worker 
who is also a veteran working full time on our staff. All of 
this is available at no charge to the veteran.
    K9 P for P was founded by Mary Peter, a certified master 
dog trainer and Executive Director of Training Operations. She 
is a nationally recognized K9 behavior expert who is also--who 
also chairs the Board of Directors of the Association of 
Service Dog Providers for Military Veterans.
    Now, in the interest of brevity, I will just contain my 
comments to the overall transitioning section from active duty 
to civilian life, because that is our wheelhouse. I will tell 
you the challenge of assisting veterans struggling to fill the 
void of purpose, pride, and camaraderie is profound, and it is 
compounded by the fact that those who are most in need of help 
are often the least capable of asking for it.
    How do we help these veterans regain their purpose in a 
civilian world they barely recognize? How do we help them 
regain the confidence of their spouse and family who may not 
recognize the triggers and now tread on eggshells? This is why 
K9 Partners for Patriots exists. This is what we do, and it is 
why we have grown from a handful of veterans in 2014, to 726 
veterans now active in our program.
    They represent 41 of Florida's 67 counties, and we have 
some from out of State as well. While we humbly believe our 
growth reflects the success of our methodology, and certainly 
of Mary Peters' expertise, we know it also reflects the 
relentless need for help.
    How does it work? If a veteran has an honorary discharge, a 
doctor's diagnosis of service related PTSD, TBI, or MST, and no 
felonies, he or she qualifies for our program. They apply 
online and submit the paperwork.
    Our veteran liaison reviews the application and arranges a 
face to face interview at our facility. This is a critical step 
because it lets us hear from the veteran whether he or she is 
ready and truly understands the commitment they are making, or 
whether they are being pushed through the door prematurely by a 
well-intended spouse or family member.
    The face to face interview at our facility also gives us a 
thorough assessment of the veteran's physical and mental health 
needs, and that enables us to find the K9 that our trainers 
believe is the best match for that particular veteran.
    Oftentimes, a veteran will come in and watch a class, and 
they will see a couple of different dogs being trained, and 
they will say, I want to get one of those, and it is never 
that--it never works out that way because they don't understand 
we have got to match the physical and mental health needs, and 
that is a challenge.
    For a dog to qualify, it must pass the basic criteria one 
would apply to any potential pet. We test it for fear, 
aggression, and sociability, but it must also be able to alert 
positively to the scent of cortisol and adrenaline.
    We test for that because that is how a service dog knows 
when its veteran is experiencing stress and anxiety, and the 
dog then takes action to mitigate those experiences. Often the 
dog senses a problem before the veteran does. It then draws the 
veteran's attention to itself, back to the present.
    I can tell you that when a veteran is having a flashback, a 
nightmare, that dog can be asleep on the other side of the 
house. The dog is going to wake up because of the scent of the 
adrenaline rising, and he knows, it is trained to get that 
veteran's attention. He will do whatever it has to do.
    He is going to jump up on the bed, lick your face, do 
whatever it has got to do to get the veteran back into the 
present and focused on that dog, and what happens is that over 
time, the dog is able to reduce both the severity and the 
frequency of those episodes.
    Senator Rick Scott. That is fascinating.
    Mr. Laskoski. Once a veteran is approved and welcomed into 
the family, there is no wait time. We want them to begin by 
making their commitment. That is a period of time where they 
have to come to class once a week for three weeks.
    Our classes are held Monday through Thursday, generally 
from 10:00 in the morning till 11:30. They are welcome to bring 
a spouse, a family member, or a friend, and when veterans are 
making their commitment, they sit in chairs on one side of the 
training facility.
    They can see the class and they see the veterans that are 
in the class directly on the opposite side of the room, so they 
can see how everything, how it is conducted, they see and hear 
how the trainers talk about what they will work on. They will 
also hear the questions that the veterans ask in class.
    Right away, they realize that every veteran and dog fits in 
here, and they all progress at their own pace. By seeing a 
class led by our founder, Mary Peter, and the training team, it 
helps remove much of the apprehension they may have about the 
class of their own and it gets rid of whatever anxiety they 
might have about the unknown.
    They know exactly what they are walking into. Again, 
classes are small. Ten veterans and dogs at the most, and their 
family is always welcome. The veterans are expected to conduct 
two hours of training each day.
    They do this at home with the dog. They can do it in five 
or ten minute increments, and I can tell you that when they 
walk back into class the following week, Mary Peter and the 
trainers can tell just by looking at the dog's posture and 
watching the dog, they can tell.
    The dog gives it away every time. They can tell if the 
veteran was doing the two-hours of homework that they were 
required to do or if the veteran was sitting on the sofa 
watching T.V., they know this immediately.
    Within a few weeks, we see that the veterans start to 
recognize the progress their K9s are making, and that is 
because of their own work. In turn, that builds their self-
confidence and improves their disposition.
    Over time, the progress they make with their service dog in 
our program helps reconnection with family, so people have to 
understand, all of the veterans in this room know this 
immediately, the problem with. PTSD is not just about one 
veteran. The effect hits not one veteran or not ten.
    In our case, it had 726 families of veterans, and that 
reach--you know this better than I do, what that means. If a K9 
has difficulty learning a task or the veteran struggles to 
teach it properly, we offer one on one training whenever it is 
needed. We have their back. Each of the veterans see that every 
day.
    When they complete their training and graduate, many of 
them don't even want it to end. They are upset, and we remind 
them that they are always part of the family, and they can 
return to brush up on training any time they want.
    They can come back four times a week if they want, or they 
can just come back just to have a cup of coffee. We are 
determined to stay connected with these veterans and we do 
that. To continue to keep in touch with each class, we require 
that each veteran recertify his K9 once every--once a year for 
five years, and in addition to that, we ensure the continuity 
because we do something called aftercare events. These are done 
on a quarterly basis in which we invite all of the alumni of 
the program, and now it is going back a ways, to come back with 
their spouses and family. We have a catered buffet. It is a 
gathering at our facility.
    We can only do this on a quarterly basis, and the Christmas 
event is the biggest one of the year. It is a great social 
event, and it gives us a chance to see how our veterans and 
their dogs are doing, and now these are gatherings of 100 to 
150 dogs.
    I can tell you that when they are all seated at these 
circular tables in our facility, you would be stunned, but you 
will not hear a single dog bark. I have a--I should say, I had 
a dog, a teacup Yorkie my wife brought home from New York one 
time, and that dog would bark at the Geckos on the screen on 
the lanai.
    He would bark at the squirrels. These dogs don't bark 
when--in a training class with 150 dogs. One hundred and forty 
of those dogs, they may not have even met before, so what we 
want you to know is that the veterans in this program are not a 
number. We respect their individuality and their dogs.
    That is essential for the work, because each one brings 
unique experiences and triggers which--the frequency and 
severity of which our program can only mitigate. There is no 
cure. Many of the dogs we provide are rescued from shelters.
    They bring their own history and baggage as well, and we 
have no full way of knowing what that may be, but together they 
build a bond and share a purpose, to rescue each other. For our 
veterans and their families, the bond with their service dog 
represents a positive path forward that is transformative. 
Thank you.
    Senator Rick Scott. Thank you. Our fifth and final witness 
is David Harris. David is an honored past Department of Florida 
Commander for the VFW, dedicating the last several years to the 
VFW's Because We Care Program. Thank you for being here.

       STATEMENT OF DAVID HARRIS, DEPARTMENT OF FLORIDA 
            COMMANDER EMERITUS, VFW, TAMPA, FLORIDA

    Mr. Harris. Thank you. Also, thank you, Senator Scott, for 
this Committee and the opportunity to serve on it. We have a 
system with many, many aged veterans. Those veterans who have 
been through trauma, financial situations, and they cannot 
adjust.
    We know that the VA gets money from Congress for every 
veteran that is signed up. It is very important that the VA 
also assist the veterans in living facility because the money 
that they receive, the VA, that money is kept into the VA, but 
yet it is for veterans who need help with their homeless. We 
have a problem also.
    Our lady veterans, they need to be top priority. Many of 
them have suffered from chemical, physically trauma. They are 
here because they have no other place to go. A veteran who is 
70 years old or--that needs help has a problem because that 
help is nowhere to exist.
    When they go to the VA hospital and they need assistance, 
you got three or four people that you have to go through before 
you can even get anybody to help you. The programs that are set 
up for veterans and aged veterans should be strongly recognized 
by the VA who can send you to someone else to make a change.
    You don't--you shouldn't spend a whole day out there trying 
to get help when they are not going to do it. As we go through 
life, we meet a lot of people, but on the Because We Care 
Program that I am the director of, we meet the--[technical 
problems]--people from the State--homeless people, homeless 
female people with children.
    We always like to say that nobody in our room or in our 
meeting wants to see anybody with children sleeping on a 
pasteboard box on the street somewhere. What we like to do is 
pitch out and help them.
    Put a cushion under their arms to make sure that they are 
there so that another organization could pick them up. Suicide 
is one of the biggest things that we have, that affects 
everybody.
    I have dealt with veterans who sit down and tell you how 
they are going to do it. They are going to tie a rope on a tree 
and jump off the back of their truck. They are going to walk in 
and take themselves out. You know what? If I am out there and 
the grenade is on the ground and I jump on the grenade, I am 
going to get probably the Medal of Honor because I saved 
everybody.
    You got some veterans believe if they commit suicide, that 
their family is going to be taken care of better than they can 
do it. It is a job that all of us have to work together to make 
it happen and take care of our aged veterans, and make sure 
that they are really taken care of, and we can only do this by 
one thing, Senator Scott, with less talk and more action.
    Once again, I thank you very much for being on this 
Committee and reaching out to every veteran. Thank you.
    Senator Rick Scott. Thanks for being here.
    It is pretty scary when people think that way, isn't it? 
You know, it is--but you can see how it would happen, right?
    Mr. Harris. Yes.
    Senator Rick Scott. To Senator Collins, we just had a joint 
committee, Armed Services and Veterans, on the Transition 
Assistance Program, so what I talked about, it was my 
experience, when I was Governor of Florida, we have a great 
State veterans organization, and that, you know, your tax 
dollars, your state tax dollars pay for them.
    What they kept telling me is, we don't know what people are 
getting now because there is no coordination between the 
Federal. If they come in, they have to come and tell us that 
they are interested in services, or we can't do anything, so 
can you talk about your experience and what you think we ought 
to be doing?
    Mr. Collins. Yes. Senator Scott, thank you for that 
question, and it is unfortunately still a reality. You know, in 
my transition and in my background as a Green Beret, we have 
our own programs within SOCOM that really cater to many of the 
things we do and circumnavigates that.
    We still have the gap with states being unaware of what we 
were doing, what was going on. One of the things that you have 
heard, that reconnected over and over and over on this panel, 
is a good transition or a bad transition, the primary 
differentiator of those is purpose. It is that purpose driven 
life that drove that veteran day in and day out.
    Reconnecting them with their State programs and those 
Federal programs, ensuring that there is communication between 
the two, is essential to ensuring that we have that purpose 
transcend. Many of the things that we fought, for our family, 
our community, our State, our country, our home, they are the 
same.
    Our purpose remains the same, but it is a manifestation of 
that and how it applies to what we do day in and day out, and 
Senator Scott, many of the things you did as Governor in our 
State have led to where we are today.
    We are the most military friendly State by far, but there 
is so much more that we can do. We have to cast a wider net. We 
have to do more programs, and I would submit that we also have 
to understand the complexities of what goes on in that next 
phase of life while we reach out to them. It is the veteran and 
their family that we have to work together with.
    I will tell you that when I lost my leg, I felt guilt every 
single time that somebody tried to help me and excluded my 
family. I am a provider. I am a protector. I don't want to be 
someone who receives help day in and day out.
    I want to continue to serve. We have to take that same 
ethos, that mindset, and apply in that transition. When we 
provide them purpose to give back and lead and be that voice in 
their community, we helped them in that process.
    I look forward to working with you in our State and with 
the Federal Government to fill these gaps. I know Hammer 
Hartsell is very focused on this as well, and Bob Asztalos, and 
many of the people in our State, so I look forward to this, and 
thank you for your leadership on this matter.
    Senator Rick Scott. Thanks. Yes, we--you know, when I got 
out what the transition was?
    Mr. Collins. I imagine. You know----
    Senator Rick Scott. No one, no one--they didn't tell us 
anything, and actually, when I got out it was during a 
recession. I feel so sorry for people that are having such a 
hard time getting jobs.
    You know, actually, when I won--so, I won in November 2010, 
I went to meet some National Guard members that were coming 
back from overseas. There was 30 percent unemployment, but with 
the Legislature's support, we were able to within probably two 
or three years, we had lower unemployment for our veterans than 
we did--because our, you know, our companies showed up.
    Mr. Collins. You know, Senator Scott, you are hitting on a 
point. Two things, if I may.
    Senator Rick Scott. Yes.
    Mr. Collins. There are two things that we have to talk 
about on, and I think they are worth unpacking. Our National 
Guard deploys, and they are asked to do things at a Federal 
level and at State level. They are busy all the time.
    Our Florida National Guard is manned at the second lowest 
rate across this country. That is something that we have to--
[technical problems], but the transition service is available 
to them.
    Post deployment and post career are almost null in 
comparison, and that is where we as a State can really step in 
and make sure that we take those tools provided by the Federal 
Government.
    [Technical problems]--we do as a State.
    Again, thank you for explaining that, but to your point, 
many of our Vietnam veterans and people from their generation, 
there was nothing. It was a brown paper bag and a ham sandwich, 
I think, is what I was told when I came in by many of our prior 
vets, and I am grateful that people have stepped in like 
yourself to help lead on this matter.
    Senator Rick Scott. No, the other thing people don't know 
about National Guard is--they always think, oh, yes, you hear 
about the National Guard when there is a hurricane. They are 
deployed overseas with active duty military constantly.
    I mean, they are deployed constantly. Since 911, when I got 
elected--they had already been deployed a hundred times. On an 
annual basis while I was Governor, we were deployed four times 
a year. I mean, overseas not just for hurricanes.
    Mr. Collins. Absolutely.
    Senator Rick Scott. Senator Collins, can you also talk 
about your experience with the community care network dental 
process? You know, what was good and the bad, and what we ought 
to get done to fix it?
    Mr. Collins. You know, I appreciate that, Senator Scott. 
Thank you for asking that question.
    As we come at this, when you are injured, there are so many 
things that you learn about upfront, but there are so many 
secondary and tertiary problems you learn about through this 
process.
    Dental care is one of those things we take for granted--
that it is all going to be just like it was and it is all going 
to be okay. When I got injured, many of the feelings I had 
started to fall out and started to have issues, and it 
manifested themselves throughout time in my career. When I 
retired, I lost that military dental care that was there, that 
I could go see.
    Again, I had many of those things happen. One of the 
biggest issues I have had with the community cares and the 
dental program is two-fold. One, it is the cyclic call tree as 
you step into that, not being able to get a human being on 
first blanch, on first conversation.
    If you don't understand where it is at, many times you can 
end up in an endless loop, let alone trying to find those data 
points online to find the right human being. It is problematic. 
Now, compound that with PTSD, or with cognitive disorders, or 
blindness, or any other of those co-morbidities that frankly 
fall on many of our veteran populations.
    That is problem one. Secondary, I would like to note that I 
am a retired Green Beret and no longer an active duty Green 
Beret, and in the military, people will schedule appointments 
for you. In the VA, that should never happen without first 
having a connection, a conversation with my provider.
    I have missed more appointments in my time with the VA 
because they were scheduled without me having knowledge. That 
is--it is extremely----
    Senator Rick Scott. You don't have knowledge?
    Mr. Collins. I didn't have knowledge. They were scheduled 
because I was trying to seek medical care, and I will tell you 
that running a nonprofit nationally, being a husband, being a 
father, and serving our State, I don't have time to sit on 
those VA systems and nobody call. I had no knowledge.
    There was something sent to me in the mail, but that 
generally came about a day or so before my appointment. That is 
not how I manage my life. I am booked out a month at a time. I 
see that not to chastise the VA.
    I believe our providers and the majority of the people 
there, they want to do the right thing, but what we have found 
is there is a bureaucracy and an ineffectiveness that just 
doesn't allow for a lot of efficacy and mission, patient 
focused care because of all the things.
    I will tell you personally, and this is as a high 
functioning amputee, I have given up and walked away because I 
didn't have the time to deal with that. I have walked away from 
dental care. I have walked away from prosthetic care because of 
those gaps.
    I hear that time and time and time again. The last thing 
that I think we probably need to talk about is who you talk to. 
Once you find a person, if you don't know what to ask, how the 
process works, how the system works--there needs to be more 
information readily available, but it is not just in written 
form or an online form.
    We have to have people nested, invested in talking like 
this. One of the things I see you do all the time is you 
communicate. You have a conversation. You get to the root of 
the cause. We have to ensure those things happen in our 
community cares and in our dental care, and as a sub derivative 
of that, many of the things that once I did get medical care 
lined up, the VA dentist overseeing that would often say, no, 
no, no, those dentists are not correct. You don't need actual 
medical care.
    Nullifying what that career dentist had said. Personally, 
for me, I will tell you that led to two root canals, and one 
tooth having to be extracted. It is now going to be an implant, 
because they could have gotten ahead of this in the community 
cares program, but it wasn't allowed to because of the system, 
and tied into that is many of these dentists don't get 
reimbursed at the full amount that they are getting--that they 
are actually putting into this, and quite often they are not 
getting reimbursed at all because of the complexities. That is 
them talking to us----
    Senator Rick Scott. It is too difficult now.
    Mr. Collins. It is, it is just--it is death by paperwork. 
That is right, and we are losing those resources to the 
community cares program because of it. We don't need less, we 
need more.
    We have to clean up that process. The approach, I think, is 
we have to re-imagine this. One of the things I have heard you 
talk about, and actually many veterans in my community talk 
about, is let's have advisory committees and boards with each 
VA. Let's get from their mouth to God's ears out there in the 
official process and system.
    Let's nest that at the vertical level. Bring that living, 
breathing approach and let's not be afraid to make holistic 
changes if we need to. Ultimately, we have to do what is best 
for our community and our veterans, and I think that--I am 
sorry?
    Senator Rick Scott. Remember our purpose.
    Mr. Collins. That is right. What is our purpose?
    Senator Rick Scott. Right. Thank you.
    Mr. Collins. Yes, sir.
    Senator Rick Scott. A lot of people have complained about 
how the Federal Government works. There is some things that do 
work. I will give you a story.
    We have been working with Ms. Silas' office, with my team 
and others to address a legislative fix for some of the 
concerns outlined in the report they just put out, so I have 
got a bill that I am going to be introducing.
    It is called Scheduling for Community Health and Easy Data 
to Understand for Legislators Evaluate Services Act, but like 
SCHEDULES Act. Just had to find a lot of words to get to the 
schedules.
    It really is--they take what they came up with and say, 
what is a solution that fixes it? Ms. Silas talked about, we 
have got to take care of a lot of people, and I think it is the 
biggest health care delivery system in the world.
    One of the things that GAO mentioned in your report is the 
lack of overall timeliness. What has the VA done since your 
report came out and why is it a problem to not track the 
overall timeliness? Why don't they do it? What's so hard about 
it?
    Ms. Silas. Sure. Yes, since we issued that report on 
January 2023, we had a number of recommendations we made in the 
report. One of the recommendations was for VA to do more of a 
comprehensive analysis of the performance of VA medical centers 
and meeting those timeliness standards that I mentioned for 
scheduling appointments, and, you know, in our review, we found 
that, you know, more than 90 percent of VA medical centers 
schedule the majority of the referrals within that three day 
timeliness period for VA medical centers, but they were having 
a really difficult time meeting the seven-day standard for 
scheduling with community care appointments.
    One of the things that we did is we took a look at that 
seven day time and that standard, and we made a recommendation 
for VA to do a more comprehensive analysis that was to 
establish an achievable wait time standard.
    In following up with them, VA has decided to stick with the 
seven-day standard, but they are working with medical 
facilities, specifically targeting those facilities that need 
support to help decrease the number of days it is taking to 
schedule those appointments.
    The other thing that VA mentioned when we were doing 
follow-up on that recommendation is that they said they were 
looking ahead to implementing some new technologies and 
piloting some new technologies that will help make appointment 
scheduling faster.
    They also are looking into having--making it more widely--
more widely for veterans to directly schedule appointments with 
the community care providers, and so, that would be really 
helpful because a lot of the holdup in the multi-step 
appointments scheduling process is the back and forth that a 
medical center scheduler has to do between the veteran and 
scheduling with the community care provider.
    That is a big--that takes up a lot of time. It can be a 
lengthy part of the process, so those are two things that they 
have talked about addressing some of our open recs with.
    Senator Rick Scott. When I used to be in the hospital 
business, my company. We ran 343 hospitals. I created a system 
that where anything important we measured. What number do you 
want to be? Probably number one, right.
    You were listed somewhere every month from number one to 
number 343, and so, then what we started to do is whoever is 
doing well, you start calling--what in the living daylights are 
you doing. Pretty simple, right, of course, if you are at the 
bottom, it is not, but so, what--do you--why does the VA have a 
system like that?
    Ms. Silas. Well, I think one of the challenges, especially 
with the community care program, is that the medical centers 
are scheduling with these community providers that are also 
part of other health care systems or private practices.
    The VA doesn't have a lot of control over when those 
providers have availability and really kind of insight into 
their schedules, and so, you know, the part of the process that 
is really challenging, which is trying to align the veterans 
schedule with the provider's schedule, it makes it really 
difficult because those providers are also serving the broader 
community.
    In some sense, the veterans are almost competing for the 
same availability of appointments, and so, you know, one of our 
recommendations that is still open is for VA to establish a 
timeliness standard for when a veterans appointment occurs with 
a community provider, because that is going to help them be 
able to better monitor the process and also will help them 
figure out if they are really achieving their goal of timely 
access.
    They do have concerns about being--not having control over 
the provider and the community schedule, and so, but we still, 
you know, our recommendation, we still maintain that that is an 
important recommendation to be addressed because it is one of 
the only ways you are really going to understand whether 
veterans are getting timely access in the community.
    Senator Rick Scott. You know, every hospital CEO always 
said their market was different, right. There is always--so as 
you move people around, the same people were at the top. It 
didn't matter what market they were in, they figured it out, 
and so, that's been my experience in business, because 
everybody can't--everybody can't come up with a reason why it's 
difficult, but some people figure it out and that's what--we 
got to get more of them.
    Ms. Galgano, the Washington Post issued an alarming report 
last year that blinded and disabled veterans can't access 
probably VA websites, which is what you said. Note that only 
eight percent of VA's public facing websites and six percent of 
the internal sites are fully compliant with the Federal 
accessibility law.
    Senator Bob Casey, who is the chairman of Aging Committee, 
and I introduce our Veterans Accessibility Act, so given your 
experiences, work with a Blinded Veterans Association, can you 
speak to the current accessibility of the Department of 
Veterans Affairs website portal?
    Ms. Galgano. The portal is still inaccessible to many of 
our blinded veterans. It is getting better. We are working with 
the VA in studies where our blinded veterans use different 
screen readers with them, and we go through step by step on the 
different VA portals.
    I recently went through one with the debt relief and it was 
inaccessible to me with my screen reader, so we are working 
with the VA, and it is getting better, but slowly.
    Senator Rick Scott. I mean is it--are we getting better, 
faster? I mean, is it--are they moving quickly, or--what do you 
think they ought to be doing that they are not doing now?
    Ms. Galgano. I think they should--well, again, they are a 
Government system, and they are embroiled in bureaucracy. It 
would be wonderful if they could move much faster, but they 
don't seem to be moving faster. It would be great if they could 
have a screen where it read to you. My Gmail reads my emails to 
me.
    I made this recommendation to them that they should just 
have a button where things are read to you, exactly what is on 
the screen, but they don't seem to be--that is a good question. 
I don't know why they don't. It seems very simple matter. 
Access--there are so many companies working with accessibility 
now.
    With my iPhone, my Mac I can do so much, but the VA is not 
working very quickly with this and with technology, and it is 
frustrating. We have veterans who cannot get reimbursed for VA 
travel because they just can't access these portals properly.
    Senator Rick Scott. Is there a measurement system that says 
how they are doing and how they are?
    Ms. Galgano. I do not believe there is one. I think that 
may be a question for the GAO.
    Ms. Silas. Yes, I don't have a response----
    Senator Rick Scott. How they are going to get there if they 
don't have a set goal to see how you are going to get there. 
You know, like every month--if you know, this was the goal and 
you say, I am going to get there in 12 months, you can measure 
it every day to see how far you have made it, right?
    Ms. Galgano. Yes, and you know, again, Federal agencies 
don't have to comply with the ADA laws, but----
    Senator Rick Scott. Is that hard to believe?
    Ms. Galgano. It is. It is.
    Senator Rick Scott. You should take the train, the tram in 
D.C. The doors shut on you. I mean, if you put your hand in 
there, it is gone, so you can tell that they don't comply with 
OSHA anything. All right, thank you.
    Mr. Laskoski, can you elaborate on the role of 
organizations like K9 Partners in supporting veterans' mental 
health and overall well-being? How do you--so just go through 
of the--how many veterans have you served so far?
    Mr. Laskoski. We have 726 who are active veterans in total.
    Senator Rick Scott. How much, how many--have you had 
failures where it hasn't worked?
    Mr. Laskoski. Yes.
    Senator Rick Scott. What would be the rationale? How would 
that happen?
    Mr. Laskoski. In some instances, we have had veterans come 
into the program who simply were not ready themselves.
    Senator Rick Scott. Were they not committed or just----
    Mr. Laskoski. I can't say they weren't committed. I think 
it was a matter where their spouse was more committed than they 
were.
    Senator Rick Scott. Oh. That never happens in life.
    Mr. Laskoski. As a married man, I won't comment on that.
    Senator Rick Scott. Yes. My wife is right.
    Mr. Laskoski. There are a number of things. Sometimes it 
could be we have a problem with the dog or, you know, if there 
is difficulty training that dog for whatever reason. You know, 
maybe they drop out. Sometimes they move--a veteran could move. 
There could be family issues. There is any number of reasons 
why.
    Senator Rick Scott. Oh, yes. They will have things they 
have to--trying to get done too.
    Mr. Laskoski. Yes, but, you know, I want to say, I am glad 
that you brought up just a minute ago the fact that the VA 
facilities are exempt from complying with the Federal ADA laws, 
because that is one of the most frequent complaints we have 
from veterans going to appointments.
    They complain about the inconsistency going from one VA 
facility to another. At Hailey, they can bring their dog in to 
some physicians. Some don't let them. We were told, for 
instance, at the Gainesville Dental Clinic, they allow veterans 
to bring their service dog, but in other places they refuse to 
even allow them to bring a service dog in training, which the 
ADA law says you are supposed to allow.
    A service dog in training is subject to all the same rights 
and privileges as a fully trained service dog. The complaints 
are frequent, though, and that is something we leave to the 
licensed clinical social worker to deal with.
    Senator Rick Scott. Mr. Collins, did you want to add 
something?
    Mr. Collins. No.
    Senator Rick Scott. Okay. Mr. Harris, can you talk about 
your experience with the TAP Program, the Transition Assistance 
Program, and the people you have talked to? Do you have much 
experience with this?
    Mr. Harris. Transition program?
    Senator Rick Scott. Yes.
    Mr. Harris. This is--talking with different veterans that 
come in, one of the basic problems they have is when they are 
getting out of the military, they go through a physical, but in 
that case, they are not always getting a doctor. It is just 
maybe a nurse, a nurse assistant, and when their paperwork 
comes down and they start getting ready to file a claim, there 
is nothing there.
    Now, you got to go back to the center in Saint Louis to try 
to dig up your medical records, which is sometimes impossible. 
Veterans really need the help so that they can make a 
difference when they get out of the military.
    Sir, our bases don't just turn and welcome the VAS reps--or 
not the VAS, but service officers in to help--[technical 
problems]. I mean, they have different standards and that--
hurts a lot of veterans also, but can I just get on one subject 
here?
    Senator Rick Scott. Sure.
    Mr. Harris. PTSD is really something that hurts everybody, 
but one of the things that hurts the most is the wives, the 
spouse. The veteran can go and get help, but there is nothing 
to cover the spouse.
    The spouse gets beat on, goes through all kind of problems, 
and she has nowhere to turn to. I would ask you, Senator Scott, 
if you could possibly look into vet centers and see if they can 
open up a wife----
    Senator Rick Scott. In a certain way, provide services for 
the spouse.
    Mr. Harris. Yes. Yes. That would be very helpful.
    Senator Rick Scott. Have you seen that anywhere?
    Mr. Harris. I have seen a couple of vet centers and I 
talked with some ladies that run it, and old vet centers do 
take in wives, but not all of them. The one here in 
Hillsborough County does not.
    Senator Rick Scott. Why is there a difference?
    Mr. Harris. I don't know, but you know----
    Senator Rick Scott. Who runs it?
    Mr. Harris. All of them--the vet centers come under the 
same--running under VA. They are paid by the Federal Government 
to assist veterans, but nobody opens their doors up to the 
spouses.
    Senator Rick Scott. It makes sense. Yes. Have you--does the 
VFW have any programs that you feel like, you are really proud 
of, that has worked to help veterans in their transition?
    Mr. Harris. Good question. You know, Senator, Camp Lejeune 
is a hard act because we have had information that the 
qualifications were going to be shut down, shut down.
    Now--yes, a lot of veterans run into the problem, and it is 
the weightiness. We had veterans who have asked that they call 
or text, still waiting on their lawyers to take care of Camp 
Lejeune.
    I do want to thank our Senators and Congressmen up there 
for working hard to change the percentage that lawyers would 
get when they work on a case, so.
    Senator Rick Scott. You know that--did you hear what 
happened last week?
    Mr. Harris. I have seen it.
    Senator Rick Scott. This will be off--and here is my 
understanding of it. There is a cap.
    Mr. Harris. Yes.
    Senator Rick Scott. There--so this was the--a bill, was it 
last year or the year before, extended the benefits--last year, 
yes, and so, the--so we tried to get where there would be caps 
on what the lawyers can get, and we couldn't get it passed in 
the bill, but there is an Act already in place that just put a 
cap on it, and I think the range is somewhere between 17 and 24 
percent, I think. Something like that.
    Mr. Harris. Twenty-five percent.
    Senator Rick Scott. Yes. We will reach out and give you 
that because that would be something--that you can get out to 
all VFW members, but there is now an enforceable cap of what 
the lawyers can take.
    Mr. Harris. Yes.
    Senator Rick Scott. That is based on a prior Tort Reform 
Act----
    Mr. Harris. I just, I need to ask you one other question.
    Senator Rick Scott. Yes.
    Mr. Harris. We know that Camp Lejeune, they exposed 
conditions around Camp Lejeune. I saw they talk about them. 
Fort McClellan, Alabama is just as bad or even worse, and with 
the new Act that says that if you are exposed anywhere in the 
world and can prove it, under the military, you should be 
covered. Well, I know that Fort McClellan is very, very----
    Senator Rick Scott. What is it, Fort--?
    Mr. Harris. I was at Fort McClellan in 1967, 1968----
    Ms. Galgano. McClellan.
    Senator Rick Scott. McClellan.
    Mr. Harris. Fort McClellan, Alabama.
    Senator Rick Scott. It's probably changed, right?
    Mr. Harris. Yes, and I count with many lady veterans who 
are suffering from cancer, all kinds of problem, but they will 
not accept them from Fort McClellan, Alabama exposed 
conditions.
    Senator Rick Scott. I will find out. I will find out, and 
the best--you know--all this stuff, the best thing is--I mean, 
I am not--I can't guarantee I can get a result, but I can get 
an answer, right, so I got a nice title, so you should take 
advantage of it.
    Mr. Harris. Yes.
    Senator Rick Scott. I will try to get you an answer, so why 
don't we--Senator----
    Mr. Collins. Yes, actually--thank you, Senator. I have 
something to kind of add in on that, so when I was in the 
military, when I first joined up, one of the things that I was 
told that is if the military wanted you to have a family, they 
would have issued you one, right.
    The military family was often looked at as a problem, a 
complication, as opposed to a living, breathing part of that 
veteran and who he was.
    When you look at how we do this, it comes down to 
communication and leadership. At the senior most levels, we 
have to talk about reimagining and re-envisioning our approach 
to veterans. It is not just the veteran and giving them the 
mental or physical care, they need.
    It is understanding the complexities of that veteran, that 
familial unit as a whole. What do they need to continue to 
thrive as an organization? How do we help them transition?
    How do we provide that next layer of education, technical 
skills so they can step into the community, transition 
successfully, and be our best billboards? We are missing 
military recruiting numbers across the board. There is an in 
State and behind the----
    Senator Rick Scott. We are missing----
    Mr. Collins. We are, but it is because people see what is 
going on around the world, but they also hear about the 
complexities of the system. If we want different results, we 
have to reimagine the process, and I think that is the way you 
do it. Integrate those families, get the senior most leaders to 
understand that, and drive that change.
    Senator Rick Scott. My whole family is committed, actually.
    Mr. Collins. That is right. 100 percent.
    Senator Rick Scott. I am a business guy, so in business, if 
you want people to be successful, you have got to understand 
all the issues they are dealing with, right?
    Mr. Collins. That is right.
    Senator Rick Scott. If you have kids or if you have a 
spouse that is sick or parents are sick, I mean, it impacts 
your ability to do your job, so you have got to worry about all 
those issues, and your Government has got to do the same thing, 
especially for people who serve.
    Mr. Collins. You know, Senator Scott, it is something that 
I am so grateful for in my career as--in the SOF enterprise, 
Special Operations, and within SOCOM, and the groups.
    They understood that. From a person to--you know, they 
understood the complexities and they applied us--they gave us 
the time to do that, but I would like to share something, and 
this was just kind of an anecdote of the military at large.
    When I showed up, I was on--in an organization on Fort 
Bragg that we will say it is not in the regular Army's books, 
right. Just talk around that a little bit. I showed up. I don't 
have a leg. I have lost my leg. I want to transition.
    I want to get reestablished physically. I want to requalify 
as a Green Beret. Those are my goals, but I also don't want my 
family to be, you know, pushed aside or have problems. My wife 
was a 20 year veteran at the time, and she ended up having to 
retire because people weren't sure how this was going to go.
    It is very difficult for people like us, but at the junior 
most levels, imagine dealing with catastrophic injury, not 
having your family there, not integrating them into the 
catastrophic natures of what you are dealing with.
    I will tell you, one of the things that horrifies me the 
very most is I am going to step on my children's toes. I have a 
prosthetic leg. That thing is all business. You step on 
someone's toes, it hurts. The learning how to----
    Senator Rick Scott. I was worried about wheelchairs, but I 
never did--need to worry about that.
    Mr. Collins. That is right. Well, and the same thing with 
crutches and wheelchairs. That was that next piece I was going 
to make.
    Senator Rick Scott. I was going to say the same thing.
    Mr. Collins. How do you integrate them? How do you draw 
them in? They need to be a part of that process. When I showed 
up there, you know what the what the first question was, when I 
showed up? It wasn't, do you want to do physical therapy, what 
are your goals? You haven't completed your training online in 
like seven years.
    It is a true story. It is because it didn't connect with 
the books in part of the system we were in, but it is that 
fundamental shift in focus. They were worried about what the 
Army was pushing to them and what the DOD was pushing to them.
    Those same problems exist in the VA systems, in health 
care. We have to re-imagine them.
    Senator Rick Scott. Yes. Ms. Silas, is there anything else 
you want to add?
    Ms. Silas. No, I am good.
    Senator Rick Scott. Thanks for what you do. Ms. Galgano, is 
there anything you wanted to add?
    Ms. Galgano. Yes, sir.
    Senator Rick Scott. This is your chance. We are--our job 
here--this is representative Government. This is--your job--if 
we--I tell people, there is no ESP in Government, right, I tell 
people, I cannot solve a problem that I don't hear about.
    Ms. Galgano. It is the accessibility of community care.
    Senator Rick Scott. Yes.
    Ms. Galgano. We are forced into community care, and it 
isn't accessible. Plus, we are not given as veterans what 
authorizations we have when we go to community care.
    Senator Rick Scott. You don't even know what you have.
    Ms. Galgano. I don't even know, and because of that, I 
injured my knee skiing in January and went to community care.
    With all of the delays, because I didn't know what I was 
authorized, six weeks later, I had micro contusions in both 
bones, and I was put in a wheelchair for six weeks because of 
the delay and the inaccessibility of that issue.
    Senator Rick Scott. Yes. One thing I have always, what I 
don't understand in our Government, is why isn't this like more 
black and white? Right. Like, if you think about it, make your 
life easier, right. Tell people exactly what the rules are, 
right. This is what you do with your kids, right?
    Ms. Galgano. Yes.
    Ms. Silas. More transparency.
    Senator Rick Scott. These are the rules.
    Ms. Silas. Yes. More transparency.
    Senator Rick Scott. Yes----
    Mr. Collins. Accountability.
    Ms. Silas. Yes, accountability.
    Senator Rick Scott. When I was in business, the thing that 
made me the maddest is they wouldn't tell me no, Government 
wouldn't tell you no. They just go on and on. No is an answer. 
Nope, that is not covered. That is--this is covered. This is--
and here is why, right.
    Mr. Collins. You may not like the answer, but that is the 
answer.
    Senator Rick Scott. Yes.
    Mr. Collins. That is right.
    Senator Rick Scott. Anywhere on K9s for----
    Mr. Laskoski. Well, Senator, you said there is no ESP, and 
I can just tell you what we need is funding, funding, funding, 
and I shared with your staff earlier today some of the problems 
we have.
    We have lost the biggest piece of Federal grant funding 
that we had for eight consecutive years, and that is a 
challenge for us right now.
    Senator Rick Scott. You know, one thing--one thing I always 
tried to do when I was in the health care business, or in any 
of my businesses I was in. People come to say, you can save 
money if you do this, all right.
    I could never get people to take the risk, right, and so, I 
always tell people, they--because I would do it in my business 
life. They said, oh, we know we can save money if we do that, 
and so, I said, okay, so we are going to reduce spending over 
here, period. No--wait a minute, right.
    We did it and it worked, and that is--I think that is one 
thing we have got to be doing in Government. We got to pick--we 
got to say we really believe we can do it, because if you did 
believe in it and you would follow the rules, you probably can.
    Mr. Harris, anything else?
    Mr. Harris. Well, yes.
    Senator Rick Scott. This is your chance. Take advantage.
    Mr. Harris. Senator, on dependance. I was reading where the 
last Confederate dependent passed back in 2018, and between 
that time the VA was taking care of her because she was 
dependent of a veteran who was in the Union Army.
    The problem we have with Vietnam veterans are those who 
have been exposed to the herbicides, it is just hard to 
understand how a female that served in Vietnam has about 22 
different childbirth defects and the male has one. It is just 
hard to understand it.
    Senator Rick Scott. Why?
    Mr. Harris. Why? Why does that happen? It looks like if you 
are in the country, you have all the exposed conditions of 
everybody, but--and we have a lot of dependents. We have a lot 
of grandkids who have--whose fathers or mothers--who fathers 
have served over there and they are suffering from this, and 
there's no help out there for them.
    Senator Rick Scott. I will look into it.
    Mr. Harris. It says that the herbicides go down to four 
generations. Well, we also got the Gulf War syndrome and all 
the things that happened in Iraq and Afghanistan, and each one, 
like the Senator said, the Government just do not take care of 
families like they should.
    Senator Rick Scott. I will do everything I can to.
    Mr. Harris. Yes.
    Senator Rick Scott. Thanks for doing this, and I think 
everybody knows how to get a hold of me, so call me. I have a 
good team, Thank you for caring and thank you for being here. I 
want to thank everybody for being here today.
    The Congresswoman Laurel Lee, thank you for being here, and 
I know, probably Anna Paulina's staff is still here, and Gus 
Bilirakis.
    We have a great working relationship together and we will 
keep doing it, so, thank you.
    [Whereupon, at 3:09 p.m., the hearing was adjourned.]


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