[House Hearing, 119 Congress]
[From the U.S. Government Publishing Office]
U.S. DEPARTMENT OF VETERANS AFFAIRS
BUDGET REQUEST FOR FISCAL YEARS
2026 AND 2027 ADVANCE APPROPRIATIONS
=======================================================================
HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED NINETEENTH CONGRESS
FIRST SESSION
__________
THURSDAY, MAY 15, 2025
__________
Serial No. 119-21
__________
Printed for the use of the Committee on Veterans' Affairs
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via http://govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
61-163 WASHINGTON : 2025
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COMMITTEE ON VETERANS' AFFAIRS
MIKE BOST, Illinois, Chairman
AUMUA AMATA COLEMAN RADEWAGEN, MARK TAKANO, California, Ranking
American Samoa, Vice-Chairwoman Member
JACK BERGMAN, Michigan JULIA BROWNLEY, California
NANCY MACE, South Carolina CHRIS PAPPAS, New Hampshire
MARIANNETTE MILLER-MEEKS, Iowa SHEILA CHERFILUS-MCCORMICK,
GREGORY F. MURPHY, North Carolina Florida
DERRICK VAN ORDEN, Wisconsin MORGAN MCGARVEY, Kentucky
MORGAN LUTTRELL, Texas DELIA RAMIREZ, Illinois
JUAN CISCOMANI, Arizona NIKKI BUDZINSKI, Illinois
KEITH SELF, Texas TIMOTHY M. KENNEDY, New York
JEN KIGGANS, Virginia MAXINE DEXTER, Oregon
ABE HAMADEH, Arizona HERB CONAWAY, New Jersey
KIMBERLYN KING-HINDS, Northern KELLY MORRISON, Minnesota
Mariana Islands
TOM BARRETT, Michigan
Jon Clark, Staff Director
Matt Reel, Democratic Staff Director
Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
hearing records of the Committee on Veterans' Affairs are also
published in electronic form. The printed hearing record remains the
official version. Because electronic submissions are used to prepare
both printed and electronic versions of the hearing record, the process
of converting between various electronic formats may introduce
unintentional errors or omissions. Such occurrences are inherent in the
current publication process and should diminish as the process is
further refined.
C O N T E N T S
----------
THURSDAY, MAY 15, 2025
Page
OPENING STATEMENTS
The Honorable Mike Bost, Chairman................................ 1
The Honorable Mark Takano, Ranking Member........................ 3
WITNESS
Panel 1
The Honorable Douglas Collins, Secretary, U.S. Department of
Veterans Affairs............................................... 6
APPENDIX
Prepared Statement Of Witness
The Honorable Douglas Collins Prepared Statement................. 73
Statements For The Record
National Association of Veterans' Research and Education
Foundations Prepared Statement................................. 77
Housing Policy Council Data for the Record Submitted by The
Honorable Chris Pappas, U.S. House of Representatives, (NH-1).. 79
U.S. DEPARTMENT OF VETERANS AFFAIRS
BUDGET REQUEST FOR FISCAL YEARS
2026 AND 2027 ADVANCE APPROPRIATIONS
----------
THURSDAY, MAY 15, 2025
Committee on Veterans' Affairs,
U.S. House of Representatives,
Washington, DC.
The committee met, pursuant to notice, at 2 p.m., in room
360, Cannon House Office Building, Hon. Mike Bost (chairman of
the committee) presiding.
Present: Representatives Bost, Bergman, Mace, Miller-Meeks,
Murphy, Van Orden, Luttrell, Ciscomani, Self, Kiggans, Hamadeh,
King-Hinds, Barrett, Takano, Brownley, Pappas, Cherfilus-
McCormick, McGarvey, Ramirez, Budzinski, Kennedy, Dexter,
Conaway, and Morrison.
Also present: Representative Deluzio.
OPENING STATEMENT OF MIKE BOST, CHAIRMAN
The Chairman. Good afternoon. The committee will come to
order without objection. The Chair may declare recesses at any
time. Before we begin, I ask unanimous consent that all members
have five legislative days in which to revise and extend their
remarks and include any extraneous material. Hearing no
objection. So ordered.
Before we begin, I want to thank Secretary Collins for
being here today. You know, this is his first time to testify
before our committee, but not his first time in the House.
Welcome back. I want to ensure that we have a productive
hearing today. To have a productive hearing, I want to ask that
all members be respectful to other members and the witnesses.
Let us follow the House rules on decorum. We are here to review
the Department of Veteran Affairs budget requests for Fiscal
Year 2026. One couple other things I want to add to that is
what we are going to do is rather than 5 minutes, we are going
to have 7 minutes for the questions. We know that. We are also-
I and the Ranking Member-will wait and ask our questions
probably last and the reason we are doing that is we know that
probably 2 hours into this, which odds are it will take more
than 2 hours, we will be called for votes. I know many of you
will want to catch a flight if you can. That is the idea and
intent is to try to get the members that have to have flights
out have an opportunity to ask questions.
Let us get right to it. The president has requested 187.2
billion for (VA) U.S. Department of Veterans Affairs for next
year. That includes 134.6 billion in discretionary funding and
another 50 billion from the Toxic Exposure Fund. That is an
increase of more than 17 percent over last year. Now, it is a
serious proposal and a clear reflection on the priorities, I
believe, of this administration. While it seems there is not
much common ground to be found in Congress these days, one
issue does unite us, and that is the belief that VA should be
fully funded to provide top notch care to our veterans and
their families. House Republicans will continue to ensure that
promise remains true. While I am optimistic about the proposal
so far, I am hoping that this administration can avoid the
total chaos and financial mismanagement that we witnessed
during the end of the Biden Administration. Despite receiving
the largest VA budget in history, the department reported an
alleged shortfall late last year, not because of underfunding,
but because of poor internal accounting and a lack of fiscal
discipline. That is putting it nicely.
Biden VA officials misused the hiring and pay authority
Congress provided then when the numbers did not add up, they
turned around and tried to shift the blame. They needlessly
alarmed veterans and accused Republicans of putting them their
care at risk, all while refusing to take responsibility for the
decisions that got them there in the first place. It was
political theater at its worst. While doing that, the
department budget practices have become harder, not easier to
follow. It makes you wonder if it was on purpose. Key
obligations were shifted between accounts; basic funding needs
were moved around. That is not what Congress intended. It is
not what veterans deserve. I would also like to take a moment
to address and recognize efforts underway at the VA. Over the
last few months, I have heard baseless accusations from my
colleagues on the other side of the aisle about how Department
of Government Efficiency (DOGE), ``Boogeyman'' and Secretary
Collins are planning to reduce VA's workforces by 83,000
employees. This is simply not true.
As we have heard countless times from the Secretary, VA is
currently reviewing its organizational structure to find
reforms that best suit the needs of our veterans today. By the
way, this review is long overdue. The one reoccurring theme
that we have constantly hear from the VA in our hearings is
that VA bureaucracy poses a greater danger to the health of our
veterans than the illnesses they seek treatment for. I applaud
the Trump Administration for conducting this necessary review
to change course and ensure veterans have access to the care
they deserve.
We will also hear from the other side that Secretary
Collins refused to answer their questions and will not
communicate with Congress. That is also not true. On several
occasions the Secretary staff have come up the Hill to brief
the Committee staff in both the House and the Senate on the
status of the reorganization efforts. To tell my fellow
veterans when my colleagues try to catch a sound bite and tell
you that Secretary Collins and the Trump Administration are
dismantling the VA, do not take the bait. I would also like to
remind my colleagues about the lack of transparency under the
previous administration.
Last Congress, our committee sent countless letters and
inquiries to Secretary McDonough and that were simply went
unanswered. In fact, Secretary Collins office when he took
office, VA's mailbox was full of our unopened letters for
oversight requests. That is not a way to run a department, and
it is certainly no way to work with Congress. To my colleagues,
I would say those who live in glass houses should not throw
stones. From my position as Chairman, I look forward to
Secretary Collins' efforts to restore transparency and
accountability. Because of that, that makes VA work better and
I know he shares that goal. Our obligation to veterans demands
proper leadership in ensuring that this budget is applied to
veterans' care and benefits. This is a more disciplined budget
request, focusing on delivery, not distraction. That said, we
know this is just the beginning of the process. We still have
not received the full, detailed budget. I, along with many of
my colleagues on both sides of the aisle, have questions about
the VA plans to spend these funds, how those decisions will
improve care for veterans and their families.
We are all ready to do our part. We appreciate Secretary
Collins being here today, and I look forward to the productive
conversation. Not fear mongering, not political posturing, but
to deliver to the men and women that we serve. Ranking Member
Takano, I now recognize you for your opening statement.
OPENING STATEMENT OF MARK TAKANO, RANKING MEMBER
Mr. Takano. Well, thank you, Chairman Bost. Mr. Secretary,
good afternoon. When I first heard of your nominations at this
position, I recall saying to my staff, I think we will be able
to do some good work at VA with Doug Collins. I had optimism,
based on your time as a member of this chamber, that you would
have an appreciation for our duty to perform oversight. When a
new secretary is confirmed, every member of this committee,
Republican or Democrat, wants to see them succeed, and because
veterans deserve leadership, not chaos. Well, I have to say,
this is why I am incredibly. It is incredibly upsetting and
frustrating to me that the questions my colleagues and I have
about decisions you have made in your short tenure at VA remain
unanswered.
You came in with an opportunity to build trust across this
institution and across the aisle, but instead, you have
undermined it, not just with me, but with VA staff and with the
veterans who rely on VA every day. I reviewed your Senate
testimony, and any reasonable viewer would have to would
conclude that you were evasive and not transparent with your
answers. I hope you will not do that with us today. I would say
to you, you have the power to change course. Veterans need
answers, not excuses. We will see today whether you are ready
to lead or just continue to blame. This hearing is the first
time we have met in person since you were sworn in. You have
not so much as called me since your confirmation 99 days ago.
My experience with your predecessor was that he would
proactively call both me and the Chairman before major news
broke about VA, so that our first time finding out about it was
not from reading the paper or seeing it on television. For
instance, he would have called us before canceling a program as
important as Veterans Affairs Servicing Purchase (VASP), where
the consequences for veterans are as dire as foreclosure on
their own homes. This is the basic transparency that I expect
from the Secretary so we can work together on the challenges
facing VA.
Now, VA is not perfect. It has never been perfect. We are
not satisfied with the status quo at VA and that is what
brought all of us to work on this committee. We are not just
going to going to blindly support your changes at VA without
you giving us all the facts or any semblance of a plan. You
have not earned our trust, at least not yet. That is what I
will be listening for today. Answers that contain facts and
plans that are based on those facts. Last week before the
Senate, you failed to answer questions asking for details about
decisions you have made as Secretary. Senator Hirono asked you
the exact dollar amount that VA claims to have saved from
firing staff. You rather flippantly threw out a culture war
statement about Diversity, Equity and Inclusion (DEI) instead
of answering her question. Senator Boozman raised questions
about VASP and you gave a rather incomplete answer. Questions
about how many clinical trials are on pause and how many
veterans are affected by that pause on clinical trials were
also unanswered.
This morning in the Military Construction, Veterans
Affairs, and Related Agencies (MILCON-VA) Appropriation
Subcommittee you admitted that VA shifted over $300 million to
private, for-profit community care without following the law.
That money was meant to support care and capacity inside VA.
Instead it was siphoned away from veterans hospitals and
clinics and handed off to the private sector. Now the law is
very clear. If VA needs more funding for community care, it
must ask Congress not illegally raid funds meant for direct VA
care. Both the Chair, Chairman Carter and Ranking Member
Wasserman Schultz of the Appropriations Subcommittee agree,
agree with what I just said. You know, so does the Chairman of
the full Committee-Chair of full Appropriations Committee-and I
hope Chairman Bost joins me and joins the appropriation four
corners in demanding accountability on this very point.
Now this morning before the MILCON-VA Appropriation
Subcommittee, you also gave very disturbing answers to
questions about the effects of pauses on clinical trials. You
said that having clinical trials paused is not affecting
veterans health care, that it is above and beyond health care.
Is that really what you are saying to veterans with cancer
whose hopes are pinned on clinical trials that they can no
longer access? All of the questions we are going to ask today
are ones that you should have come prepared to answer and I
will be disappointed if you are not prepared. We have already
asked many of them in letters. Many of them have already been
asked in your previous appearances before the Senate and before
the House Appropriations Subcommittee. This is basic
congressional oversight.
The members and staff on both sides of this committee
collectively have centuries of experience working on VA policy
and serving our Nation. We have written some of the most
consequential pieces of veteran legislation in history,
including the Honoring Our PACT Act. We can only carry out our
oversight responsibility as mandated in the Constitution if you
answer our questions fully and truthfully. We have serious
concerns about your plans related to the VA workforce, and this
hearing is an opportunity for you to put our minds at ease. VA
is comprised of over 400,000 dedicated employees who show up
every day motivated by the call to service to deliver the care
and benefits veterans have earned.
The majority of veterans are satisfied with their VA care.
Let me say that again. The majority of veterans are satisfied
with their VA care. Yet many have expressed to me the weight of
the chaos and turmoil they have witnessed during Trump's first
100 days and are left wondering what will happen to the care
they rely on and love. They are worried that their provider,
with whom they have spent years building rapport and trust,
could lose their job. Now I have a poster behind me. We have
heard from a veteran for whom this fear sadly became a reality.
This veteran lost her whole health coach, who she described as,
quote, the only person really making a difference in my life.
We have heard countless stories of the trauma and harassment VA
staff have endured at the hands of Trump's senior advisors and
political appointees since day one of this administration. I
want to hear directly from you today whether you agree with the
director of Office of Management and Budget (OMB), Russell
Vought, that the trauma is the point. Does this administration
want to traumatize public servants into submission or into
quitting their jobs so the work can be farmed out to Trump's
billionaire friends?
Let me tell you one thing clearly, Mr. Secretary. VA is not
for sale. I am truly worried about the combative tone you have
taken in addressing VA staff. You have instilled a culture of
fear by making them sign non-disclosure agreements (NDA) and
accusing them of rumors and innuendo. Frankly, it is insulting
and demeaning that you continue to accuse VA staff and veterans
of lying about their experiences, their concerns, and the
things they are seeing with their own eyes. How are the
veterans supposed to be inspired? Excuse me. How are employees
of VA supposed to be inspired to fight for a better VA with you
if you are constantly positioning yourself against them as if
they are the enemy? I would say fear as a tactic for leadership
is not effective. As one clinician put it behind me, I have it
up in print. Quote, I have felt harassed by and have diminished
faith in the leadership of the VA secretary who continually
throws VA employees under the bus and has shown no interest in
learning about the concerns of his frontline staff. His line
about VA now putting veterans first particularly irks me. In my
15 years of working at two different VA medical centers, I know
we have always put veterans first. That is from a VA
psychiatrist.
We need more answers about your plans for VA. These plans
directly affect veterans staff and the economy in all our
districts. You have set a goal to fire 83,000 employees. It is
a goal and it has been publicly stated. Leaving VA staff waking
up every morning with the torture of not knowing if that day is
their last one with a job. You took away veterans last lifeline
to keep their homes when they faced foreclosure, when you ended
the VASP program. You are doing all these things during a time
of financial turmoil for families in America while we deal with
the impacts of Trump's chaotic tariffs and economic policies.
We are all trying to make sense of it all so that we can better
serve veterans.
Mr. Secretary, I hope that this hearing today is an
opportunity to build some trust and I want to have confidence
and your leadership. As the leader of VA, you owe it to VA
staff and you owe it to veterans to be transparent and
forthcoming and to take some accountability. You have the
opportunity to answer our questions fully and truthfully, and I
hope that you will seize that opportunity. With that, I yield
back.
The Chairman. Thank the Ranking Member for yielding back. I
know some housekeeping things. In accordance with the Committee
rules, I ask unanimous consent that Representative Deluzio from
Pennsylvania be permitted to participate in today's committee
hearing. Without objection. So ordered.
Alright, if Secretary Collins would please stand and raise
his right hand. Do you solemnly swear under penalty of perjury
and the testimony that you are about to provide is the truth,
the whole truth, and nothing but the truth. Thank you. Let the
record reflect that the witness has answered in the
affirmative.
[Witness sworn.]
The Chairman. Now, I would like to recognize people, as I
said, 7 minutes for each person. We are going to hold sticks to
that 7-minute rule because we are under the pressure of votes
later on. With that, I now recognize General Bergman. Oh, I am
sorry. Was I wrong? Oh, wait a minute. How about you give an
opening statement? That would be really good. Mr. Secretary,
you are recognized for your opening statement.
STATEMENT OF DOUGLAS COLLINS
Secretary Collins. Thank you, Mr. Chairman. Thank you,
Ranking Member. If we did not want to go through that, we can
go. I think it is interesting to set the tone for our opening
statements, and I think that, you know, the tone has sort of
been set here. I think the undeniable aspect of this is that I
have one purpose and one purpose alone, and that is to make the
VA exactly what it is supposed to be, and that is to take care
of our veterans and do so in the most efficient and effective
way, whether it be in our Veterans Health Administration (VHA),
our Veterans Benefits Administration (VBA) or National Cemetery
Administration (NCA). The one thing that I have had to do for
the first, and I am glad to be here today and to answer all the
questions that you might have, I will be frank with you, and
what I have found over the last little bit is I can answer
questions, but if we do not like the answers, then we just say
I am not answering the question. That is just simply not always
the case. We are going to deal with that as we go forward
today.
Specifically, you know, and just as I just had to sit
through, I will say that the VA psychiatrist that you just
referenced is exactly the kind of employee that I want to see
at the VA, someone who is putting the veteran first, somebody
who is concerned about taking care of that. They have
absolutely nothing to be concerned about when it comes to
restructuring of the VA or looking at our VA healthcare
systems, because when you look at what we do, the VA doctor is
exactly the person that has been protected from day one in
this. We have put 300,000 positions off limits. In fact, they
are being hired as of this day. If you are in a hospital, as I
told just told the folks in Minneapolis when I was just there
this week, if you are in a hospital taking care of veterans,
you are the ones that we want and want to have and be a part
of. You are the ones that should be the most happy in the sense
of you are getting to do your job now because you have a
Secretary who actually wants to cut the red tape, wants to cut
your decisions, and so that we do not have to continually get
in our own way.
The VA, unfortunately, over the years has become the
absolute, at many times frustrating point for many of our
veterans of what is known as red tape, of going through the
process of trying to get things to happen, and yet it being
denied. The sad part about it is, for the last number of years,
and I have been in this body as well, and I voted for some of
those pieces of legislation, the John S. McCain III, Daniel K.
Akaka, and Samuel R. Johnson VA Maintaining Internal Systems
and Strengthening Integrated Outside Networks (MISSION) Act,
also our Accountability Act and other issues that came before
this body as we look forward to how do we actually better serve
our veterans. Over the last few years, it seems that as we have
looked at this issue, and we have looked at it from afar, even
as far as back that we began to believe that the only issues in
VA could be solved by simply giving more money and giving more
employees. In fact, we have actually increased 52,000 full-time
equivalents from 21 to 24. Things still have not gotten better.
In fact, to be honest, according to the metrics of the VA that
was established before I ever got there, they have gotten
worse.
You have to simply ask yourself the question is what we are
doing and how we are doing it the same way, the same way,
making a difference. The answer is no. When your wait times go
up, your backlogs go up, and you are not fulfilling the mission
to the veteran, that is an issue that we have. Now when we look
at these as we go forward, I am not going to be shy addressing
the issues that we do and will in this room address today. That
is that we are looking at our structure of our workforce and we
are looking at a structure, by the way, as has been said, we
have 465,000. It goes up actually a little bit depending on the
day because we still in our VHA organization have 409,000
employees. We have over 28,000 physicians, 91,000 nurses. What
is also not said, and it has not been said in this room today,
is many of those doctors and many of those nurses do not see
patients on a regular basis, if at all. Yet we still have
doctor shortages, nurse shortages in clinics and hospitals in
which we are hiring for every day.
My question is simple when I look at an organization plan
is why are we simply looking at numbers that are not affecting?
Why are we keeping a bureaucracy level that has grown
tremendously over the last little bit with billions of dollars
and with people. Yet the very metrics that this committee,
under both Republicans and Democrat uses to judge efficiencies
at the VA are going the wrong way, just to let you see. One of
the things that concerned me from the moment I stepped into
this job was 10 years ago, the Government Accountability Office
(GAO) said that the VA was on the high-risk list. The GAO, not
Doug Collins, not Democrats or Republicans. The GAO said that
and they have renewed that every year. In fact, February we got
our last needs improvement and also high risk. The answer has
simply been many times to just, let us just add more and add a
little money and add this to it to see if we get any better. It
is not worked. Many things of what we have tried so far. When
it comes to the workforce and it comes to what we are doing is
actually not having chaos, but actually freeing up our doctors
and our nurses and our disability claims adjusters to actually
do their jobs, to give them the tools. I found a department
that could not even tell me how many employees we actually had.
It took a week and a half. Where has oversight been on that? I
think an organization that looks at it from a perspective of
the bills that have been passed. We have been looking at
Mission Act, The Sergeant First Class Heath Robinson Honoring
our Promise to Address Comprehensive Toxics (PACT) Act, which
is being implemented, although it was put together rather
quickly. We are now getting it underway. In fact the numbers
are pretty good in the sense that we have already had 6
million-over 6 million exposure screenings. We have added
985,404 total enrollees for health care on the PACT Act since
it was signed in law. That is over a 2-year period and over 6
million 6 PACT Act disability claims approved.
When we look at what we have going on, we are addressing as
many things as we possibly can. When we come at it at this, I
will also say this, and I hope to answer your questions today.
I hope we will can find some common ground and the Ranking
Member if we cannot find common ground, we will attempt to find
common ground. You and I came in together, we have been here a
while and I commit to that. I will not say that we will see
everything the same. To a VA workforce out there who has had to
endure 100 days of false rumors and innuendo and what somebody
from behind a paywall says, that is what scares veterans, that
is what scares employees. I ask anybody on this committee today
as we go through these questions, as we look at what we are
trying to do and how we are trying to do it, if you are cutting
away the red tape, if you are trying to get a doctor to be able
to be seen or have more doctors in the clinics and more nurses
in the clinics, that is the things we need. If you are wanting
more and quicker disability claims and our backlog drop, which
by the way, Mr. Chairman, I am happy to report that when it was
I took office just 99 days ago almost, it was 260,000 in the
backlog, it is now at 200,000. We have cut it 21 percent in
less than 100 days.
When we look at this going forward, I look forward to your
questions. I look forward to honest answers as we go forward
from both sides. What we cannot do is deny that VA needs to
change. The VA has things that need to be fixed, but we cannot
continue to do the same things and call it a victory. As we go
through today, I look forward to your questions and I
appreciate the opportunity.
[The Prepared Statement Of Douglas Collins Appears In The
Appendix]
The Chairman. The written statement of Secretary Collins
will be entered into the hearing record. Now. We will proceed
to questions. General Bergman, you are recognized for 7
minutes.
Mr. Bergman. Thank you, Mr. Chairman. Mr. Secretary, good
to see you.
Secretary Collins. Good to see you, too.
Mr. Bergman. I will cut right to the chase. I was
encouraged by your recent comments at a Cabinet meeting
highlighting the importance of advancing research into
psychedelic treatments to improve care for our veterans,
actually breakthrough therapy care. Last January, VA issued a
request for application for proposals from VA Network
researchers to study such treatments. In December, VA announced
1.5 million in funding for 3,4-Methylenedioxymethamphetamine
(MDMA) assisted therapy, the first VA funded study for
psychedelic assisted therapy since the 1960's.
Question would you talk a bit, even if a little bit, about
the studies being supported by these funds? Do you have any
visibility on that yet?
Secretary Collins. We are getting there, Congressman. I
think that is one of the things that I have started to look at.
I am also probably one of the first of the secretaries who have
actually decided that we will take a look at it. We are not
simply putting it off and we are going to do everything we
possibly can under the rules given to us by Congress to
actually continue that. Look, what we are seeing so far is
positive. What we are seeing so far in some of the studies that
are related to VA and also outside of VA as well, is that there
has been, especially when it comes to PTS and also traumatic
brain injury (TBI) and others, we are seeing some actual
positive outcomes there, especially when it is coupled with
intense counseling. I think that is one of the keys that we
look forward to.
There are 11 current studies that are either with VA or
around VA and that we are going to continue to look at. I am
committed to working with the Administration, but also in what
we are doing across the lines with Health and Human Services
and also at U.S. Department of Defense (DOD) to say how can we
actually make this a possibility? Now, I will say this. I do
not believe it is a magic cure. I do not believe that it will
work for everyone. It is something that could work for some. We
are going to continue to look at it.
Mr. Bergman. Thank you. Congressman Correa and I lead the
Congressional Psychedelics Advancing Therapies (PATH) Caucus
here in Congress. I would like basically to consider you
consider committing to incorporating congressional voices in
some of these important conversations because over the last
couple of years, we as the caucus have had some really
spectacular research speakers come in. If we can be included as
appropriate, that would be great.
Secretary Collins. Of course, Congressman.
Mr. Bergman. Second, Choice for Veterans. I appreciate your
acknowledgment that VA is in desperate need of reform. For too
long, veterans have been forced into a ``one size fits all''
bureaucracy that fails to deliver to them the earned care and
benefits in a timely manner. Under the Biden Administration,
the agency experienced huge backlogs and rising care wait
times. Something has to change and it is our job to make the
change. The VA Committee recently approved the Choice for
Veterans Act here last week in this room, a bill that Chairman
Bost and I had introduced to help veterans secure their
disability benefits by expanding access to accredited
representation and imposing new penalties on bad actors in that
space who are seeking to prey on vulnerable claimants. Do you
believe that expanding the options available to veterans,
particularly by allowing them to work with trusted accredited
representatives, that that could help improve the outcomes they
experience when they are pursuing their benefits? Basically,
all good actors accredited, no bad actors.
Secretary Collins. I think anyone that helps the veterans
get what they need is something that we need to look at. I am
going to also take it a different step for just a second. It is
fundamentally flawed in my mind that we have a system in which
veterans have earned benefits that they feel like they need to
get somebody to help them with to get. I think this is, I
guess, goes back to a core statement for whichever, you know, I
think for both sides of the aisle. Why do we have a system in
which you have a veteran who has served our country, earned a
benefit, have to go through a process in which they feel like
that they have to get outside help to do that, whether, you
know, accredited, unaccredited, I mean, have that choice. What
we are looking at right now, and I have talked to every
regional office I have went to and every other is how do we
make this process simpler? I mean, there is a simple.
There is an interesting page for me that I found the other
day that when you are beginning your claim for disability, do
you realize that we have a whole sheet that asks for your
entire military history, basically, and where you served and
when you served? We do not need that. We just need their name,
their Social Security number, their date of birth. We can get
that. Why are we making them fill that out? This is the kind of
stuff we are talking about. That makes general sense to most
everyone. We are looking at, you know, any way we can to help
the veteran get the benefit they need. We are starting
internally to make sure that we can do the administrative stuff
we need so that you can cut through the bureaucracy to get the
benefit that you need and get it done quickly.
Mr. Bergman. Absolutely. The idea that only within the VA
can the responsibility reside for really solid, exact
accreditation on all counts. Who is ever asking to be
accredited. That is in the, in the VA's ballpark and that is
what we are asking for, is that the VA will actually accept
that responsibility. That is where the key is, I think in the
better outcomes for the veterans in the appeals process.
Secretary Collins. Yes. I think that is one of the things I
will state that to get that started with us in accreditation,
it is sort of outside our scope as far as us accrediting
outside individuals. We are willing to do whatever the Congress
asks on that and we are going to focus it and we will make sure
that the resources are available to make that happen. Can I
also hit though you talked about community care because this is
actually where this all goes. I do not agree, and this is just
a difference of opinion. I do not agree that community care is
a giveaway to private physicians in public hospitals. In fact,
I think that is the actual non-intent of the Mission Act was if
you met criteria you could go outside the system or wait times
or even the fifth number is where it is the best medical
interest of the patient, between the doctor and the patient.
This is something we have got to deal with as well is that
that is the intent of the law and that we are not taking VA
care from one and giving it to other. VA care we expressed in
our hospitals are expressed in through community care and which
we are paying for is VA care and we are going to hold it to the
highest standards.
Mr. Bergman. Thank you. With that, Mr. Chairman, I yield
back 40 seconds.
The Chairman. Gentleman, yield back. Representative Pappas-
Ms. Brownley. Recognized. Ms. Brownley, you are recognized.
Ms. Brownley. Thank you, Mr. Chairman. Thank you Mr.
Secretary for being here. I am going to start out with a
question and I do not want you to think I am being combatant
here. I am not. I just want to understand what is going on. It
is a question around non-disclosure agreements that I am
hearing. I have a copy of a non-disclosure agreement here that
it appears as though you are requiring supervisors at VA to
sign these nondisclosure statements as you go through this
reduction in force plan. I think one of the things in this non-
disclosure that seems to be not in it is a protection for
whistleblowers. I think Title V requires that there needs to be
protection for whistleblowers. That seems to be lacking in this
non-disclosure agreement.
I am also hearing from employees that they are saying that
spyware is being installed in their computers to monitor their
emails and teams messaging, et cetera. You know, generally my
question is this kind of feels as though you are not creating
an environment that is where people are motivated to work as
hard as they can for our veterans. You know, I was selected at
the same time you were. You know, certainly I would think as a
former member as you are, you would be asking similar
questions, I think. I am just asking, why are you doing this?
Secretary Collins. Thank you, Congresswoman. It is good to
see you again. We did come in together. Look, the NDA simply
restates, you know, Title 18 USC 1905, in which the employees
and others are not to discuss is to keep sensitive information
in any department internal. We are dealing with a issue right
now that is a dramatic change for the VA and we are looking at
workforce and one of the issues that we are having to deal with
workforce is one of the things. I am going to just, I will be
very upfront with all of you here today before we even go down
some of the line of questioning. There is not a time that I am
going to, in a public setting go into details as far as this
group of people being looked at, that group of people being
looked at, not in a setting like this. That is not fair to
them, and it is not fair to this Committee.
This is simply a restatement. All of the protections that
are afforded a whistleblower or work with, communication with
Congress, classified information, any reporting to Inspector
General, mismanagement, anything else, are all protected in
that NDA. It does not curtail them. This is simply an
opportunity for us to have open and honest dialog about where
our workforce should be shaped.
Ms. Brownley. Where does a whistleblower go if they feel
the need that -
Secretary Collins. Office of Whistleblower Protection. We
have it inside our own agency. That is where they go.
Ms. Brownley. It is still there? It is still operational?
Secretary Collins. Yes. It never went anywhere. Ted is
still there.
Ms. Brownley. I am not sure what you are saying, but
anyway. Okay, so let me move on. The Elizabeth Dole Bill. I was
very involved with the Elizabeth Dole Bill and was wanting to
hear from you about when you think the it will be implemented.
It was passed about, I think 6 months or so ago. It is
certainly something that our veterans and certainly the
Elizabeth Dole Foundation is very anxious to see implemented
and get started. Could you speak to when the implementation is
going to take place?
Secretary Collins. We have already started the meetings in
internal operations only Dole Act on how to actually we are
going to be doing that, but we are not rushing through it. One
of the things I think that we did learn from the PACT Act was
that something even a good idea such as the PACT Act, if
implemented quickly, could lead to issues of budgets, issues of
staffing and who actually how it is actually rolled out.
Probably over the next couple of months we are going to see we
have already been meeting, and I think there is actually been
some conversations with the Hill and staff and we can be happy
to get you more on where we are exactly at right now. We are
looking to do that and get it on time with the requirements of
the Dole Act.
Ms. Brownley. When our staff was being briefed, they were
told that Section 120, which is an important section because
this is where the 65 percent cap on expenditures for non-
institutionalized care is lifted. We were told that the VA is
not planning on implementing that until January of next year. I
bring this up because we have veterans, Amyotrophic Lateral
Sclerosis (ALS) veterans, veterans with spinal cord injuries
that need and want their care at home for a quality of life. I
think that they deserve and they cannot. They are out there and
they cannot have it because this cap is on there and there is
not enough resources to have them stay at home with dignity.
They are out there waiting.
We have actually heard that some veterans who have been on
ventilators have lifted the ventilator because they do not want
to go into institutionalized care and really have just taken
their own life. They are out there, you know, just hoping,
praying that this will be implemented so that they can be taken
care of with the dignity, as I said, that they deserve.
Secretary Collins. Yes, thank you, Congresswoman. I agree.
We are going to move as fast as we can and make sure that it is
actually done properly to get it to everybody so that when
implemented it will be done. I will check into the year there
and go back and get you more information on that and we, what
we are finding is as we get into it there may be times that we
can actually implement things quicker. I think they want to
give a timeframe that may be workable but could be done
quicker. We will actually look into that.
Ms. Brownley. Well, and I will say to you that the
implementation of the Elizabeth Dole you will save money
because getting the care at home is less expensive than it is
an institutionalized care. It is a win-win because that is
where veterans want to be cared for is in their homes,
particularly aging veterans, disabled veterans. That is what
the Elizabeth Dole bill was really all about. It is, you know,
it is a win-win all the way around. I know you are trying to,
you know, use resources as effectively as possible. Well,
implementation of this bill is a road to go down quickly where
you can save money and invest in other areas.
Secretary Collins. I agree. That is also one of the issues
that we are making sure that we do have the investment because
some of the bills is still, you know, we are still determining
what the funding mechanisms were because they were not funded
in the act as we go through. Those will be issues that we are
going to work toward. Let me just say on a personal note, I
understand that completely. Having a daughter who has spina
bifida and in a wheelchair, the needs at home sometimes can be
just something that you have to prepare for. We have had to do
things in our own house over the last 30 years that I would
have never thought I would have to.
Ms. Brownley. Very good. Well, my time is running out but I
did wanted, I wanted to ask you, I know you have talked about
world class healthcare for our veterans. Just hoping that you
will uphold the world class standard of team based the team-
based model of anesthesia within our hospitals. I think it is
really important and with that I yield back.
The Chairman. Gentlewoman yields back. Dr. Miller-Meeks,
you are recognized for 7 minutes.
Ms. Miller-Meeks. Thank you very much Chairman Bost,
Ranking member Takano. Thank you very much Secretary Collins
for being here. As both a veteran and a physician, thank you
for your advocacy and support of our veterans. Let me also just
start off before my question echoing Ms. Brownley's last
statement about the team-based model in anesthesia care. As
both a nurse and a physician, married to a nurse and a veteran,
I would echo that sentiment that we want to deliver the best
care to our veterans. The committee has heard about reports of
a referral coordination initiative being used as a means to
bring back care into the VA once a veteran has been referred to
community care. I am also going to say that I was a proud
veteran delivering community care within a community for
veterans. I have been part of that process on the delivering
end of community care.
You made a statement that community care is VA care. My
presumption would be that it should be left to the veteran to
make that determination or whether they, if they have had
initial community care, if they want to transfer back. Could
you give me your thoughts on that?
Secretary Collins. Yes, that is. That is exactly right. I
think this is a choice that we need to give to the veteran
because it is in law and this is the way the law is
interpreted. You meet the qualifications, you get the choice of
community care. I think that is one of the things that we have
seen, though, unfortunately in the last few years is. This is a
story I will tell, and it is because it is very concerning to
me because we, unfortunately for some, the MISSION act and some
with internally in the VA seem to view the MISSION Act as
setting up an us against them scenario, the VA care versus
community care that the doctors here and the doctors there. In
fact, it was unfortunate this past week I was asked a question
when I was traveling in Minnesota in which somebody was not
happy with, with me and that is normal, but you know, we get
it. They actually said through the reporter and the reporter
asked me the question, well, why would we need to keep all
veterans in VA. VA has the quality care and the community does
not. I thought to myself, why would somebody who is one
protesting us degenerate all the doctors in Minnesota? That is
exactly what they did.
Whether they meant to or not was irrelevant. That is what
they did. We have got to get over this idea that it is one
doctor against another. There is also a thought inside the VA
that the VA doctors in some way are supervising the community
care doctors. This is slowing some of our work down. The other
issue with community care that is problematic and we can, I
hope we get to talk about this today is our electronic health
records (EHR) management system, which does not allow us to
communicate with doctors. For us, it is just about getting the
care to where the-again, veteran first, not VA first, veteran
first. The VA is there to exist to serve the veteran.
Ms. Miller-Meeks. Thank you. This FoxGrant program is set
to expire at the end of this fiscal year. What do you see as
the long-term role of this program in VA suicide prevention
strategy?
Secretary Collins. I think it is a great program because it
actually brings in some different voices into the conversation.
I am not satisfied at all with where we are in our response to
our veteran suicide issue, our death by suicide issue. This is
just not something that is tolerable. To the folks on this
committee and especially if you are new to this committee. Just
understand, since 2008, our veteran suicide number has not
changed. Understand 2008, our veteran suicide number has not
changed. Yet over the past few years, we have added $588
million every year for the last few years to veteran-to suicide
prevention. It is not working. I want to use grants and
programs like this to reach out beyond the scope of where we
are currently reaching to say how can we actually touch the
veteran that is not being touched right now by these programs?
Here is another thing for you out of that, whether you use
17 is your number, 22 is your number, whatever number you have,
half of those have never had VA connection. Half of them we
have never had a chance to touch. We have got to do better at
using the grants, using our programs to go outside the normal
bubble and use others to help get the word out.
Ms. Miller-Meeks. You may not hear this question. I agree
with that. Also General Bergman's comments about emerging
breakthrough therapy. Never thought in my medical career I
would be talking about that. Yet it does show promise in
reducing Post-Traumatic Stress Disorder (PTSD) and suicide. The
VA's leasing process continues to face long delays, overruns,
and cost overruns with outpatient clinic leases. The building
for those leases, the construction, I mean, often taking years
to complete. Do you have a plan for that? If not, I would love
to meet with you. I have met with people within my district who
actually do construction. They are more than happy to save the
VA money at their behest, making less money for them in order
to have a more efficient process.
Secretary Collins. Congresswoman, this is going to be the
one time I am looking at the Ranking Member and the Chairman
and just as I did this morning with the appropriations
committee and everybody in this community, help me. Our
procurement system, especially when it comes to construction
and new facilities, is broken. I mean, and we are not even at
the point where, and this is not throwing anybody under the
bus. It is just they are given a system that does not work. I
was here and many, several of you were here when we had the
issue first come up and we started. One was in Colorado. Then
there was others that, you know, were right now, it is no
reason, in all fairness that it takes a billion six to build a
medical center. There is positions on this panel. Your local
hospitals, in fact, in my hometown just built a hundred plus
you know, several hundred plus bed system, put an Operating
Room (OR) in it, put an Emergency Room (ER) in it. They built
it in less than 2 years and it is a lot less cost.
Our leasing programs need to be streamlined, our building
programs need to be streamlined because right now there is not
really, if you would, as I call it, that touch point, that one
belly button touch point where I can actually say you are
responsible for this or holding them accountable for contracts
in which they do not meet their deadlines. I am asking for help
here on this one.
Ms. Miller-Meeks. Be happy to help you with that in our
Communities Helping Invest through Property and Improvements
Needed for Veterans (CHIP IN) Act. Then this is just a very,
very minor thing, and I know it is minor, but I have had
veterans in my district contact me and send me photographs of
our VA hospital which show a blank wall and the photographs of
the President and the Vice President are not there. I know it
is a minor issue. Is this something that comes from the VA or,
or how can I help these veterans and answer their problems? If
you could just address that quickly. I know you gave me extra
time, so.
Secretary Collins. No, I appreciate you. No, they should
have the pictures. There was a delay and I think one of them
was at the Vice President's picture was one of the delays. My
picture. You know, look, it is out there in the President's
picture. It is. It is very important to our veterans. I get
those calls all the time. We are doing everything we can to get
those pictures out and make and this is a change to any
administration. It needs to happen quicker. It did not. It does
not most of the time. I think it is being done as quickly as
possible.
Ms. Miller-Meeks. Thank you so much. I yield back.
The Chairman. Representative Pappas.
Mr. Pappas. Thank you very much, Mr. Chairman. Mr.
Secretary, thanks very much for your comments. I want to ask
you about an issue that is critically important to veterans in
New Hampshire. New Hampshire remains the only State in the
contiguous 48 states without a full-service VA hospital. The
Manchester VA Medical Center was built in the 1950's. It
continues to experience serious infrastructure issues. Pipes
bursting in the winter, flooding, heating outages, even insects
in the operating surgical suite. On May 9th, the Trump
Administration announced an executive order (EO) directing a
feasibility study at the VA within 180 days of the order,
submitting a plan to the president, an action plan to expand
services at the Manchester VA into a full service medical
center.
Veterans have been asking for this for about 20 years now.
They are ready to move past the talking stage and to see some
action on this. I am wondering if, as this study is moving
forward, you are going to work to engage with veterans and
stakeholders in the State of New Hampshire to make sure you are
hearing directly from them and capturing their feedback.
Secretary Collins. Yes, Congressman, I appreciate that and
I appreciate you carrying the torch for that. Also, I have
talked with your Governor about this as well, and I can report
to you that that feasibility study started this week and we are
going to be working with our stakeholders in New Hampshire and
other places to make sure that this goes through. Following
through the promise of the President who made the promise to
look at your facilities up there, that is what the EO said and
we are already started that process and we started it this
week.
Mr. Pappas. I appreciate that. Do you start this process
with the commitment to establishing a full-service hospital in
New Hampshire?
Secretary Collins. I believe that is the desire of the
administration as we go forward and we are looking at it from
that. You have a system in which we are going to look at and
make sure that we get the proper needs and the proper care in
that area.
Mr. Pappas. Thank you. I appreciate your attention to that.
Before I get to my next questions, Chairman Bost, I ask
unanimous consent to enter into the record data received from
the Housing Policy Council showing over 80,000 veterans State
by State, who are at extremely high risk of foreclosure.
The Chairman. Without a rejection.
Mr. Pappas. Thank you very much. I disagree fundamentally
with VA's decision to end the VASP program. I want to ask you a
little bit about the timing around that because it was
extremely unclear who was informed and when. VA briefed
committee staff on April 9th that VASP would stop accepting
applications from lenders on May 1st. I am wondering when VA
first publicly posted the information to the general public
about its plans to stop accepting VASP applications.
Secretary Collins. As far as an exact date on when
published, I would have to get you an exact date. I think going
the VASP program in general, though, this is a program that I
think many on this committee have strong feelings about. Should
have never started to begin with. This was not a congressional
mandate. This was not a congressional program. It was stopped
and it had already got into an area VA did not need to be in to
start with.
Mr. Pappas. We have the date. Basically, April 23d is when
that was posted publicly. Literally a matter of days before
veterans were made aware of the fact that this program was
coming to an end. I ask about this because we heard directly
from a constituent who was caught up in this. He is a veteran
who-his name is Daniel. He is 100 percent service disabled,
veteran of the first Gulf War, reached out to our office days
before the end of VASP, understanding that he might still have
a chance to get into this program and to make sure that he
could start making payments and stay in his home along with his
service animals. I am wondering if you have any guidance for
veterans like this who have been caught up in this period of
time where VASP is coming to an end. There was not clear
communication from the department. What do veterans like Daniel
do to be able to stay in their homes while we wait for Congress
to take the important step forward to develop a partial claims
program?
Secretary Collins. Well, I think that is what the first
step is, is Congress needs to act upon this. This should not
have been a program that was taking money away from other
things to start and getting the VA into a mortgage business. I
mean, the numbers here, I think at this point, it stopped on
May 1st. No one who is currently in VASP was taken off VASP.
Anybody who currently is working through VASP is still on VASP.
We just did not take any more.
Mr. Pappas. Respectfully, it is not a good enough answer
for my constituent. He is someone who understood that the date
was coming May 1st, was trying to work with his lender to get
into the program, and now he is not sure he has any other
opportunity to protect his home and to stay in his home. We are
facing a housing crisis in New Hampshire as we are in states
across the country. Would you be open to a foreclosure
moratorium in the interim while we await action in Congress to
develop a bipartisan plan for a partial claims program?
Secretary Collins. I am not going to commit to a program on
the fly here in the middle of the hearing. I think I understand
your concern in looking at it, but again, sort of, we set up a
problem that was going to end up developing. The reason VASP
was stopped was because the VBA, which took money from other
programs, reprogrammed from other things to do this program,
came forward and they were now going to ask for multiple
billions of dollars out of their mandatory program to go
forward, which I would have had to come to Congress for. It was
just an area that it had to be a time to cut it. We did it as
much as we could. It is not an answer I know you want to hear
or the veteran might want to hear, but this is just, it is a
program we should have never gotten into.
Mr. Pappas. Look, I disagree with that answer. I think the
fact is this was a last resort program that was a should,
should have been a stopgap while Congress developed something
that was more permanent and we are working on that. We have got
to be looking out for constituents like this who number 80,000
across the country, people that are at risk of foreclosure,
veterans who deserve our support. I want to get to just a final
statement here. I hear from veterans across New Hampshire that
are deeply concerned with some of the moves they see being made
by VA. Now, I agree with your statement that you made in your
testimony that we have got to be looking out for end veterans,
and I believe that we do that on this Committee. I have served
here for 6 years now through administrations of both parties. I
take exception to the claim of what you have said, which is
that, quote, literally all VA stakeholders agree with what
needs to be done and that is reflected in the action that you
are taking.
I do not think that is true because veterans I talked to do
not agree with the abrupt ending to VASP. They do not agree
that we should put more veterans at risk of foreclosure. They
do not agree with the fact that we have seen crisis line
employees lose their jobs who are in probationary status. They
do not agree with the fact that your stated goal is to fire
83,000 workers. That would cut deeply into VA's ability to meet
the needs of our veterans and provide the kind of care and
benefits that they deserve. We have got work to do to make sure
that we are improving services at VA, that we are getting
things done for veterans. Let us be willing to work together
and do what it takes to meet the needs of these heroes who have
worn the uniform and have done everything to serve the United
States of America. Veterans know that we need more. We need
better cooperation. We need better leadership from you to get
the job done. I yield back my time.
Secretary Collins. Mr. Chairman, can I answer? Alright,
that is fine. We will keep going. Just keep going.
The Chairman. Just real quickly. We are scheduled to pass
the Partial Claims Bill next week off the floor over to the
Senate. I would encourage everybody to support that so that we
can cure those type problems and then go and encourage our
Senators to do the same as quickly as possible. With that, Dr.
Murphy, you are recognized for 7 minutes.
Mr. Murphy. Thank you Mr. Chairman and welcome Secretary
Collins, I am very heartened to see someone of your caliber,
intellect, and desire to help our veterans. We appreciate your
service. You know we started off the Committee, we talked about
what things are different now. It is oversight, it is
accountability. Personally, I liked our last secretary, but I
thought he was extremely ineffective. We come in here and we
were riddled with a sexual scandal cover up that occupied
unfortunately a couple hearings in this Committee. We had cost
overruns, but they were not cost overruns. It is time actually
for people to come in and as you said, the VA is broken and
continuing to pour money and to hire individuals who by the
last administration's report over hired. It just is nonsense.
It does not help our veterans. To that point, you have been in
this job 4 months. Can you tell me on a scale of 1 to 10 how
good you believe our VA is efficient?
Secretary Collins. An overall number would probably not do
justice to everything. I think there is some areas that we are
completely inefficient and then there is other areas that we
have been able to do things better. I think it is, I am not
going to make a blanket statement on that we are a four or
five. I mean I was, I do not rating a record but yes, I think,
I think we are probably at a special age when it comes to our
Information Technology (IT) programs, when it comes to our
employee management, when it comes to our efficiencies in doing
things such as contracting, payroll, Human Resources (HR). We
are probably, you know, lower than we need to be, especially
when compared to the industry.
Mr. Murphy. Yes. You know, you spoke, you spoke a little
bit about building a hospital. I have been intimately involved
in a lot of administrative stuff. I still practice, I still see
veterans. If the outside world can do things infinitely more
efficiently, less cost effective, why can the VA not do it?
This is just emblematic of what you know, some people feel our
government should do is just pour money into a system that does
not work. I appreciate the efficiency and accountability that
you bring into the office.
One thing speaking of which, I would love to bring up the
EHR issue. I have sat on this Committee now, I think close to 6
years and I am still dumbfounded at the billions and billions
and billions of dollars that have been poured into an EHR that
should have never been done to in the first place. It is not a
system that should be used for the largest healthcare system in
the country. I know this is a big priority, yours, and I would
love to know your thoughts about how we can actually implement
a system that is only in just a few hospitals and centers at
this point.
Secretary Collins. Thank you, Congressman. This was the one
that was dropped on my plate from day one. Frankly, it was just
dropped as a, you know, just a cold fish, so to speak. It was
just nothing was happening. The previous administration, the
previous secretary had put a pause and basically it was just
sort of a death knell because nobody was talking, nobody was
doing anything to move anything forward. This was after we had
poured billions of dollars into the system. Now, I choose to. I
could go back and I could, you know, talk for days about how it
was, you know, probably poorly started, poorly funded, poorly
integrated, poorly everything. What I chose to do was from day
one is walk in with fresh eyes and say, okay, here is what I
have been given. Here is what we have to do.
What we did was we basically took the two positions, the VA
position and Oracle position, and we came to see what each said
about each other. Then we put them in a room and then I had
them basically talk to each other and then I locked them away
and said, we got to fix this system. Do not come out until you
fix it. What we are at right now is instead of maybe four next
year in the Michigan area, we are actually going to be doing 13
across that entire Veterans Integrated Service Network (VISN).
Let me just tell you what I have control over and also what I
have control over a vendor or a client, which I believe Oracle
to be. VA is, we had almost, I think it was eight or nine
committees that everything had to go through to determine what
standardization would look like. In other words, if we wanted
to code something, it had to go through eight different
committees differently then to come to a final committee before
then could go to be discussed with Oracle.
I did away with every committee except the final committee
after they had their meeting. We only have one committee now.
Dr. Evans talks directly to Oracle, Oracle talks directly to
Dr. Evans on standardization issues. We are going standardized
from here on out, which is what every other hospital in the
world does. We have about 10 percent that is unique to VA, and
we are going to work through those again as we go forward. By
doing that, that was able Then to allow us to speed up the
process and allow us to add the nine more sites that we are
going to. This also then takes into account looking ahead to
gain momentum. Is anybody here in a longer system? If you go
back to DOD and for both sides of the aisle, the DOD did this
over the years. They had a pause and they actually came out of
the pause and were standardized and got it done. They finished
their side of it and roughly the same time the VA was supposed
to be. We are just looking to actually now get the momentum so
we can go into others 20 to 25 to 30 to get this done.
Mr. Murphy. I applaud you at that. It was criminal that
nothing more was done. This has been a failed system from the
start. It is neglect, it is point blank neglect that this is
not already in every VA system. To your point earlier about
being able to communicate with community care doctors,
everything. I do not know what the hatred is about community
care on this, on in this committee. Sometimes I swear to God,
they just do not. I do not understand it. I have taken care of
patients. We want a seamless approach, and we want the best
physicians and the most readily accessible physicians. It is
nothing a pro or con, anything against or for the VA. It is pro
veteran. It is what is being done. We need to be able to
communicate with those individuals. I do not know how many
times I have seen a veteran and I cannot get records from hell
about the patient itself. Thank you for actually doing
something about it.
I am going to follow up with one other point that is
already been stated twice. Anesthesiologists need to be in
charge of the operating room. It is a team approach. There
needs to be a quarterback. I do not care if the fullback says
that they are as good as the quarterback. They are not. That is
what we want. We want the best for our veterans and that is the
period. Finally, an issue that is near and dear to me. You have
talked about veteran suicide. We have talked and talked and we
have poured money upon money upon money and we have not moved
the needle. I have scrubbed a particular therapy that I truly
believe moves the needle in the State of North Carolina. It is
doing tremendous things to help our veterans. That is
hyperbaric oxygen. I do not know why this is a partisan issue.
They are using it all over in Israel. They are using it in
other places in the country. I have a bill, H.R. 1336, Veterans
National Traumatic Brain Injury Act, that heretofore the VA has
opposed the bill. We want to do everything for those
individuals who are at the end of their rope. I would love to
have the VA drop its opposition. This is something our veterans
should have in their arsenal.
Secretary Collins. Congressman, I look forward to working
your bill through the Congress. We will be from our
perspective, giving the treatments we have had, the research
that we have to provide you, the research that we have seen and
where we can find that it might work. They will be happy to see
that. Come on. We will follow the lead of this Congress.
Mr. Murphy. I appreciate that commitment. Thank you, Mr.
Chairman, I yield back.
The Chairman. Representative Cherfilus-McCormick, you are
recognized for 7 minutes.
Ms. Cherfilus-McCormick. Thank you, Mr. Chairman. Thank
you, Secretary, for being here today. I have a few questions
for you. Would you agree that housing is an important priority
for our veterans?
Secretary Collins. In generalization, question, I mean, is
housing important for anyone? I mean, I am apologize, I am not
sure what.
Ms. Cherfilus-McCormick. Do you prioritize veterans
benefits when it comes to housing? Making sure that our -
Secretary Collins. I prioritize all the benefits that are
veterans earned.
Ms. Cherfilus-McCormick. No, specifically, it is yes or no.
Then we can just do yes or no.
Secretary Collins. Well, I will do that if it actually
answers the question.
Ms. Cherfilus-McCormick. Is it a yes or a no, sir?
Secretary Collins. For what?
Ms. Cherfilus-McCormick. Do you prioritize veterans
housing?
Secretary Collins. I prioritize all veterans benefits.
Ms. Cherfilus-McCormick. Yes or no? Yes or no, please.
Secretary Collins. Yes or no to what? I mean we can play
this game back and forth.
Ms. Cherfilus-McCormick. Secretary Collins. I am not
interested in that. I am really getting -
Secretary Collins. It seems you are.
Ms. Cherfilus-McCormick. Secretary Collins. I am not
interested in that. We have real concerns, especially in the
State with our veterans. Could you please answer it yes or no.
If you choose not to answer, just say you choose not to answer
and it is not important.
Secretary Collins. Do we prioritize housing for veterans?
Yes. We also prioritize healthcare.
Ms. Cherfilus-McCormick. Thank you. Do you prioritize and
fully commit to housing veterans, especially when it comes to
flexible assistance to homeless veterans?
Secretary Collins. I will fully commit to helping the
veterans in any way we can through the programs we currently
have. I refuse to get the VA involved in something like VASP
that we should have never been involved with to start with.
Ms. Cherfilus-McCormick. Excuse me, could you please answer
my question because we are not talking about VASP. Once again,
the question is, if you would like to listen to the question is
do you support providing flexible assistance to our homeless
veterans like access to transportation, hygiene products,
blanket support to help our veterans.
Secretary Collins. The answer is we support our veterans.
Ms. Cherfilus-McCormick. Yes or no?
Secretary Collins. Yes. I mean, yes. The question, I have a
question. Where are we not?
Ms. Cherfilus-McCormick. Do you believe that access to
lands owned by VA should be in part used to address veterans
homelessness. That is yes or no.
Secretary Collins. If the land is suitable, it can be used.
Ms. Cherfilus-McCormick. Yes or no?
Secretary Collins. I cannot give you an answer to a
question that has a hypothetical. That cannot be answered.
Ms. Cherfilus-McCormick. It is a yes or no.
Secretary Collins. No, it is not.
Ms. Cherfilus-McCormick. It is. Okay, so.
Secretary Collins. Mr. Chairman, I mean, I cannot answer.
Ms. Cherfilus-McCormick. Excuse me, it is my time, sir. It
is my time. You do not need to look at the Chairman. I am right
here, and it is my time.
Secretary Collins. I know exactly where you are.
Ms. Cherfilus-McCormick. Okay. Thank you.
Secretary Collins. I cannot answer your question.
Ms. Cherfilus-McCormick. The respect that I am giving you,
I deserve it also.
Secretary Collins. I will get it.
Ms. Cherfilus-McCormick. Please answer those questions as
yes or no, because you are taking up my time with this. The
next question I have for you now, there is so many veterans who
are losing their homes, especially in Florida, and we are
finding more of them becoming homeless. My real concern is
about the Elizabeth Dole Act. We have a clause in there that
actually deals with that, and you have not been implementing
it. That is why I want to identify if this is actually
important to you or if it is a priority. My veterans do want to
know if this is one of your priorities.
Secretary Collins. Yes, it is a priority. Anything in the
Dole Act we will implement.
Ms. Cherfilus-McCormick. Why have you not taken it to
implement it in these stances?
Secretary Collins. The Dole Act was given at the end of
last administration. It came in, and I have been in here over 4
months. There are 72 total provisions in the Dole Act. We have
completed nine. We are working on track with 55. We got two
that we are still at risk and we are still working. We are
doing everything we can in the time.
Ms. Cherfilus-McCormick. If housing was in fact a priority
for you, would not you skim it to find out which priorities or
how can you actually make housing accessible? My question is,
we looked at and we saw that there was a significant gains were
made toward homelessness from January 2023 to 2024. Right now
we are seeing that there is a potential for us to lose the
momentum that we have been gaining. In addition to that, when
we talk about the purchase, the Service Purchase Program, which
you said that you would like to terminate or you are
terminating, we want to know what are the other instances or
what do you have in place for our homeless veterans to protect
them?
Secretary Collins. The issue in termination of VASP is we
go is that we are looking to do everything we possibly can that
is already currently there for veterans in the VA for
assistance, whether it be their mortgage or other things. We
also can work with other agencies such as U.S. Department of
Housing and Urban Development (HUD) and others to find ways to
help them as we go forward. I am willing to look and move
forward anything we can without sacrificing also the bigger
picture. I am not unfortunately able to just simply pick the
areas, especially in a Dole Act where I want to get all of it
implemented for all of the caregivers as we go forward. I think
the Trump, Donald Trump, just a few with Congressman Pappas as
well, that EO also talked about using facilities. The VA, which
has been ignored and frankly under previous administrations was
allowed land that we had that we could have helped homelessness
in LA was actually farmed out to private schools and ball
fields. I am trying to look at it from a State of mind.
You and I actually agree probably more than unfortunately,
this came off and I apologize for that. We agree on this issue
that we need to look at what we can do within the confines of
what we have.
Ms. Cherfilus-McCormick. How quickly do you believe that
you will start prioritizing or putting this in place? I have to
answer to my veterans also to make sure that we see them and we
understand that housing is so critically important, especially
toward their dignity and the contract that we have with our
veterans, which is to protect them and make sure they live with
dignity.
Secretary Collins. I agree with you and I will be happy to
work with you and talk about specific answers, especially
Florida. I have Georgia is my home. I do not get there very
often anymore. It is a very similar situation for us on housing
cost and housing quality. Any of those information within the
Dole Act we are going to continue to implement. If there is
ways that we can help expand something we currently already
have, I am willing to look at that as well. Well, but I think
this is just where we need to make sure that we are doing stuff
that help and does not either have a negative impact some other
place with other programs.
Ms. Cherfilus-McCormick. My last question is going to be
really quick. Even though it is a huge issue. It is about the
dismantling of the Office of Equity Assurance. We just had a
roundtable where we had many of our minority veterans there who
talked about the disparities in them actually drawing down
their benefits. Specifically, when it comes to PTSD. How are
you going to handle these situations? Specifically when that
office has been dismantled?
Secretary Collins. That office, again, being dismantled has
nothing to do with the fact of my commitment to make sure any
veteran who has earned a benefit gets their benefit, no matter
what their background, what their skin color.
Ms. Cherfilus-McCormick. Specifically the disparities I
wanted to point to. How are you going to handle the
disparities? We have years and years of documentation,
especially when it came to housing where we saw different
generations that were disadvantaged. How are you going to do
that, specifically when this office has actually been
dismantled?
Secretary Collins. I think it is. It is when you are
actually supposed to be doing your job. It takes a secretary to
lead and make sure that our organizations are not doing
anything away from it.
Ms. Cherfilus-McCormick. Will you be handling that? Will
you be handling it? You said it takes a secretary.
Secretary Collins. It takes a secretary to give leadership
to the organizations that are supposed to be approving our
benefits. Congresswoman, if you have somebody who has been
discriminated against or not getting the benefits they have
earned, then I will be happy to work with you to make sure that
is rectified. That is something against the law that we are not
going to break law. We are going to actually give the benefits
that they have earned.
Ms. Cherfilus-McCormick. Okay, so specifically, should they
contact your office then, because this office has been
dismantled, who should they reach out to?
Secretary Collins. Well, the question is it is not the
office. It was not a part of the benefits that they were not
getting. Why are they not contacting the office of the benefits
in which they were denied?
Ms. Cherfilus-McCormick. Excuse me, sir. The question
specifically is who should they contact?
Secretary Collins. Which benefit are they looking for? If
they should call VBA, which is the benefits, that would be the
area to call. If it is a -
Ms. Cherfilus-McCormick. There is not going to be, the
elimination now is going to be shifted to different offices.
Thank you. I yield back.
The Chairman. Representative Van Orden, you are now
recognized for 7 minutes.
Mr. Van Orden. Thank you, Mr. Chairman. Mr. Secretary, I
want to thank you for getting something accomplished in less
than 100 days that I have been trying to do for 2 years, and
that is to get rid of a program that has never existed since
the time someone lent someone seashells to buy a cave. That is
the VASP program. The Veterans Affairs Administration, under
the previous administration, decided to take on $17 billion
worth of debt without conferring with Congress. To me, that
should be unlawful.
Let me explain what the VASP program is for those people
that are not on me and Chris's subcommittee. The Veterans
Affairs Administration, in the previous administration, decided
to start buying home loans, reducing the interest rate. If it
was at 7.5 percent, the VA would buy the loan from a lending
institution, lower the interest rate to 2.5 percent, and they
spend an average of $360,000 per home. They did this up to the
tune of $17 billion. The amount of money the average veteran
was in arrears was $25,000. It was a $25,000 problem that was
solved with a $360,000 solution. That is how the previous
administration ran the VA. Doug, excuse me. Dennis McDonough
was a friend of mine and I actually respect him tremendously,
but that was just foolish and wrong.
In 99 days, or whatever the heck it is, you got rid of
that. I thank you tremendously for doing that. That showed
really incredibly bold leadership. We are getting arrows from
this, right? Well, guess what? I am going to give all of my
Democrat colleagues the opportunity to help rectify what they
are talking about today because H.R. 1815 will be on the floor
next week. I would encourage everyone to put their money where
their mouth is and vote for that partial claim thing. You do
not want someone to get kicked out of their house. Vote for
H.R. 1815 or stop talking. That is all I am going to say to
everybody about that.
Here is what happened, Mr. Secretary. I had my graphics
team draw this up so I can explain to some people what is going
on. Here it is, right there. That is the whole VA. This is the
problem with the VA, okay? This is the increase in bureaucrats.
These are the doctors. It is almost a flat line. Then we have
an increase with the veterans because of the PACT Act. Right.
When we are going to cut the VA, and I hope you do, sir, this
is where you need to make the cut. Right there in this line.
Right there, sir. Mr. Secretary, if you cut this, then this
line with the doctors and stuff, the people that are actually
touching our veterans and providing care, can go like this,
right? Then we can match the increase with vets.
Mr. Secretary, I am incredibly happy and looking forward to
working with you and your administration. If there is anything,
just if you have a top line item that we can do from the
congressional side, power of the person, all that stuff, if you
could, you know, rattle off one or two of them, would be great.
We will write these down and we will take it for action. Mr.
Secretary.
Secretary Collins. Thank you, Congressman. I think one of
the things you mentioned there at the end is something that is
very important because it is also been one of the most
misconstrued and also used to scare veterans and also scare
employees concerning what we are looking at in regards to a
reorganization of, of staff and how we look at this. As I
stated earlier, we have 465,000 as of today in our total VA
organization. What is interesting about that is in VHA, there
is 409,000, there is 34,000 in VBA, and there is 2,400 in NCA,
which is our cemetery account. You know what is interesting? We
have 16,375 in the central office who are not, you know, are
doing policy, doing other things. By the way, most of them are
not actually showing up at 810 Vermont or somewhere else. They
are, they are not showing. What the question becomes.
Mr. Van Orden. Mr. Secretary, I am sorry, will you say that
number again just so people can understand the scope of this,
the ludicrousness of this bureaucracy?
Secretary Collins. Just at central office. This has nothing
also to do with some of the other levels that are built into
these numbers that I have talked about is a 16,375. Yes. As we
look at this, the question becomes, is not are we, you know,
where are we at with our programs. As I stated earlier, we have
28,000 physicians. We have 91,000 nurses. Also, one of the
things I did not mention on the GAO report was this. Veteran
numbers not changed. We are still looking at 9 million veterans
every year. That is the enrollment, 9 million for the last 10
years. It is been the same. Yes, PACT ACT shot up. PACT ACT
gave us some more. Here is the interesting. We got total number
985,000 that came to new enrollees in PACT Act. That is not
just for PACT. That is all enrollees, 985,000 in the last
couple of years. Our numbers still stayed at 9.1 million. The
reason is, is because over 2 years, we also lose 400,000
veterans in this country every year. You may add 900,000, but
you are also decreasing 400,000 each year on 2 years. 404, you
are basically drawing even here, our total veterans in this
country have dropped from about 4 million in the last 10 years.
We are dealing in a circumstance here in which you cannot
really justify the layers of bureaucracy. Let me give an
example, if you do not mind, Congressman, about this. One of
the issues that we have, and just to show you where it is
again, when somebody says, oh, you are going to cut dollars. I
actually saw this article again today, and somebody thinks that
in one hospital we are going to cut 15 percent of everybody in
that hospital. That is just stupid, wrong, and I do not want to
hear it again, okay? That is just not the way this goes about.
You are looking at organizational structure. Here is the
interesting issue. I told you earlier, when I first came in, I
could not get an actual count of our employees because our HR
system was not set up the way we could to get employee count.
Nobody in here has been in the military could understand that
concept, but that is what happened.
The other issue that we had is we had then we went to
payroll and said, payroll, how many people do we have? Payroll
came back at central office, which is our centralized payroll
system, which was supposed to be implemented. Again, this is
all oversight stuff that has not been, you know, for the last
few years, is looking at. It was supposed to be centralized.
They said we had 230,000 employees. I said, and even our guy
said, we got more than 230,000 employees. Come to find out that
there was a permissive attitude that allowed 60 or roughly 60
of our hospitals to continue to do their own payroll with
multiple hundreds of people involved in that process. We have
contracting. It is all over the country. None of it is
centralized. All of it doing different things. You have
differences of opinion between even hospitals on how they
actually do purchasing. Again, tens of thousands of people. We
also have human resources. It is all done in this.
Mr. Van Orden. Mr. Secretary, I just have a couple seconds.
I want to say one thing. I want every single person that has
served this country, is serving this country or feels like they
want to serve in the future, to have access to the Veterans
Affairs Administration Home Loan Guarantee Program. By shutting
down this disastrous, VASP program, you accelerated that. Thank
you very much for that. Mr. Chairman, I yield back.
The Chairman. Representative McGarvey.
Mr. McGarvey. Thank you, Mr. Chairman. Thank you, Mr.
Secretary, for being with us today. We have our differences on
this committee like any committees, but the thing I love about
this committee in particular is that it is mission centered.
Despite those differences, we often come together and try to do
what is best for our veterans. That is what we are here to do.
That is what we try to do. Now, I can tell you as someone on
this committee and from Louisville, Kentucky, I hear a lot of
complaints from veterans. Those complaints are very rarely
about the care they receive. They are far more about how long
it takes to get that care, how far they have to go to get that
care, how they access their benefits that they have earned.
Earned by putting on the uniform. I will tell you we have to do
better about that. I think everyone would agree we have to do a
better job of doing that.
I will also tell you that because of that, I am concerned
about some of the things that I have heard you and this
administration say over the last few weeks. Like the stated
goal of cutting 15 percent of the VA's workforce, which is
roughly 83,000 jobs, or possibly terminating nearly 600
contracts, which no one can tell us what the contracts are or
what the actual number is. Or even just ending the VASP program
in such a way that it could leave a thousand veterans in my
home State of Kentucky without a home. I personally believe the
term homeless veteran should not exist. I want to use my
questions today to focus on an issue that I actually hope we
can agree on, because right now there is a part of VA that is
decreasing wait times. It is improving medical outcomes, it is
reducing costs, it is making the department more efficient. It
is not DOGE, it is the VHA in house innovation ecosystem. I
know you know about some of this, but let us just outline some
of their work for everyone else.
This is like VetText, which sends text reminders to
veterans about upcoming appointments, decreasing missed
appointments by 10 percent and reducing wait times for our
veterans. The VHA Uber collaboration which has provided
veterans with rideshares across 100 facilities, saving VA
nearly 200 million dollars. There is a remote diabetic foot
ulcer smart mat. I know that might not sound like the most
exciting thing in the world, but it has cut hospitalizations in
half, and it has saved the VA almost $100 million and again
hospitalizations in half. It is saving veterans lives. Vital,
Important, Optional, Not needed and Every (VIONE), it is a
physician created initiative that helps VA in prescribing
unnecessary medications and improving patient safety. It saved
VA over $300 million annually. I say I think we can agree on
this because I actually read your op-ed on May 2 with interest
when you went to Michigan and talked about some of the
cardiology care there and praised this high quality, high tech
and veteran centered care. I want to keep this innovation going
in the VA. What I would like to know from you today that with
all the cuts that are ongoing is a commitment that while you
are Secretary, the Trump Administration will not eliminate the
VHA innovation ecosystem.
Secretary Collins. Congressman, I am not sure where it got
out there that anything that I have said or done or
misconstrued by anybody that wants to is to take away anything
good that the VA is doing. In fact, we are not going to do
that. We are going to applaud that. I tell our employees all
the time, go make mistakes. You are not going to get in trouble
at the VA for making a mistake if you are trying to do good,
because I am going to pick you up and put you back out there
and try again. What we do not want to have is issues where we
get in our own way. I think that is the biggest thing I am
trying to emphasize, just as I emphasized just a second ago,
things that take away time, effort and money from the very
things that you are talking about are the things that I am
looking at trying to change. Look, we are on the same page. You
and I can agree on this. Believe me. When I was here, I was on
Judiciary Committee. We did not come close to congeniality most
of the time on the Judiciary Committee. This is actually good
with it, with what we have here.
Mr. McGarvey. I like the agreement, although that was not a
yes or a no answer on whether the innovation ecosystem is going
to stay. I hope it does.
Secretary Collins. I agree with you.
Mr. McGarvey. Okay, perfect. I mean, I say this, we have
such possibility there. When you look at the VA, we have 9
million patients, largest patient population by a multiple of
any hospital system in the country. Nearly 75 percent of
physicians do some of their training at the VA. We have the
largest longitudinal data set of any hospital system in the
country. We are not putting enough focus into research, into
innovation. I really believe we have the ability not just to
take care of our veterans, but forward our resources so that
maybe we find a cure for PTSD or TBI or a spinal cord injury
that then benefits everybody in America. Then of course, of
course we know those are service connected injuries. What
happens if somebody comes in with Parkinson's cancer, heart
disease, and we find a cure for that? We could change
healthcare not just for our veterans, but for everybody in this
country.
I want to switch gears a little bit while staying on
healthcare though. The fastest growing group of veterans in
this country are our women veterans. We know that they have
different healthcare needs. On February 18th of this year, the
President, who once referred to himself as the fertilization
president, signed an executive order instructing the Domestic
Policy Council to identify ways to reduce barriers to In Vitro
Fertilization (IVF). We know that women veterans do not have as
much access to the service. We also know that their infertility
rates are higher than their civilian counterparts. Secretary
Collins, are you and the VA right now working on a plan to
improve IVF access for women veterans?
Secretary Collins. Yes, we are fully implementing the
Executive Order from the President. We fully intend to.
Mr. McGarvey. When can we get an update on that?
Secretary Collins. We will get with your office and tell
you the updates that we have at this point. Again, working with
administration as they roll out their positions as well.
Mr. McGarvey. Thank you. Again, shifting topics on you
again. I am not scared about technology. I think technology can
be used for a lot of good things. We are advancing in
Artificial Intelligence (AI) rapidly. One of the things I have
heard from my veterans is they are worried about the AI systems
potentially going into place, particularly in making the final
decisions on benefits. I know you cannot forecast way into the
future, but while you are Secretary of the VA can, you commit
that there will always be a human who is making the final say
on a veteran's eligibility for their claims?
Secretary Collins. I think, yes, the issue there, because
there is such differences in somehow these disability claims
are actually adjudicated out. One of the things I think we both
can agree on, though, using technology, is that there are
simple claims that should not have to go through the long,
tedious process that we have that we can automate and automize.
It gets them their benefit quicker. I think that is the big
thing. If there is always a concern about a disability
diagnosis or something, we are going to have somebody
adjudicating that.
Mr. McGarvey. Thanks. Only because I have 13 seconds left.
I want the claims resolved quicker. I want them faster. I do
want to make sure that a veteran knows that it is another
person who is ultimately making that determination for them.
Thank you, Mr. Chairman. I yield back.
The Chairman. Representative King-Hinds, you are next.
Recognized for 7 minutes.
Ms. King-Hinds. Thank you, Mr. Chair. Thank you, Secretary
Collins, for your time today. I have the privilege and great
pride actually of representing the CNMI Commonwealth of the
Northern Mariana Islands. We have hundreds of veterans who lack
essential VA health care and VA resources because we are a
smote remote community. With your help and the help of my
colleagues in this committee, I hope we can start affecting
serious change and improvement for many of our veterans. One of
whom is here today who flew 8,000 miles for some other
business. He is back in the back row. Mr. Brad Rosala, who is
the local Veterans of Foreign Wars of the United States (VFW)
representative for Saipan.
You know, with the help of the Chairman and his amazing
team, I have been pushing to fill the only VA administrative
role in the entire CNMI, a position that has been vacant for
over 18 months. The administrative specialist position is a
critical resource for our community of underserved veterans. It
is the only person in the CNMI actually, that is responsible
for assisting our vets by answering questions, providing
information, giving guidance, and, you know, given your earlier
statement about, you know, our veterans do not need to hire
somebody or, you know, get somebody to be advocating for them.
Right. That position has been very critical, a critical
lifeline to getting our vets to be able to get the help they
need. Is there any way you can provide us an update with that?
Secretary Collins. I appreciate that and thank you for your
work. I mean, you are in an area that is, again, remote. As you
said, it is very difficult, but in working with you, and our
folks have been talking about this, we recognize the vacancy in
that position and have worked with that to make sure it was not
affected in any hiring freeze or anything else. I am here also
as your one who has traveled 8,000 miles that your new
administrative specialist will be on the job June 16th of this
year.
Ms. King-Hinds. Oh, my gosh. That is amazing news. Very
much welcome. You know, God forbid that you wake up a little
late, right? A lot of times to be able to get the, for our vets
to be able to get the service, they have to call Guam, and then
Guam has to go through Honolulu. If you missed that time
period, you just do not get the service at all for that day.
Thank you, much appreciate it.
Secretary Collins. Well, I want to thank you and the
Chairman and the Ranking Member and all on this, who have
actually helped through this and get this done, and I
appreciate that work. Again, sometimes it just takes, you know,
we got to push, and there is in just an area that is very
difficult to find work in, but hopefully you will be able to
have good success starting in June of this year.
Ms. King-Hinds. Thank you very much. Just one other thing.
In December 2023, the VA announced the establishment of a vet
center, outstation in the CNMI, a smaller satellite office
aimed at improving access to counseling services for veterans
and service members. This was incredibly welcome as there is
currently a significant lack of services available to the
veterans in the CNMI. However, a year and a half later, the
outstation has yet to be established. The most recent update we
have is that the outstation is in the leasing phase with no set
date for its opening. Can you please provide an update on the
status of the VA's effort to open the Vet Center outstation in
the CNMI? Specifically, at what stage is the process and when
can we expect it to be operational? I know you have mentioned
some challenges with procurement and leasing processes, so any
update would be very welcome at this point.
Secretary Collins. I wish I could go two for two here, but
I cannot on this one. I can give you at least a little bit. 500
is it least better than none? It is still in that lease
process. As I said earlier, this is the part that I really wish
we could have some change on. We have got to get this better.
It is still in that leasing process. I want to go ahead and
say, what are we doing to look ahead? That is that the
readjustment counseling service is currently recruiting for
counseling positions and expect selection and onboarding in the
next several months, and it is dependent on available. We are
actually already looking for folks to fill that position, and
we will continue to look for a place to put them and, you know,
to get your help that you need.
Ms. King-Hinds. Alright, thank you. I yield the remainder
of my time, Mr. Chairman. Thank you very much for your time.
The Chairman. Thank you, Representative Ramirez.
Ms. Ramirez. Thank you, Chairman and Ranking Member, and
Secretary Collins it is good to meet you. As Ranking Member of
the Oversight and Investigation Subcommittee, I made a
commitment to honor the service of veterans in this country
with action. That includes 20,727 veterans that live in my
district. When I talk about veterans, I talk about all
veterans. That includes women, that includes people of color.
That includes first generation, low income, LGBTQ veterans and
also deported veterans. I know we do not talk about it enough
here, but there are veterans who have fought for this Nation,
have now been deported. Because every veteran is entitled to
the full benefit they earned and were promised, I want to make
sure that we have a conversation today about where we are on
diversity, equity, and inclusion.
When you, Secretary Collins, and my Republican colleagues
celebrate turning your backs on a commitment to diversity,
equity, and inclusion at the VA, it feels like you are turning
your back on veterans. I will tell you why I say that I do not
believe that any administration and any secretary has the
authority to decide which veteran is worthy of the services and
care that they are entitled to and which is not. Secretary,
given the VA's mission to serve every single veteran, is
meeting veterans where they are a priority for you? Yes or no?
Thank you. If that is the case, why has the VA paused all
outreach efforts? Let me explain to you. We have been
attempting to work with the VA to do outreach services with the
veterans and meet veterans. Sometimes veterans cannot make it
to a VA center, sometimes they cannot make it to a Veterans
Service Organization (VSO). There is outreach, there are fares.
We have been told that outreach services have been put on
pause. My question has been, how has halting outreach improved
access for veterans?
Secretary Collins. That is not true. We have been at
events, and I can give your office plenty of events. I was just
in Detroit where we are doing outreach events in bus stations,
we are doing outreach events, at sporting events, we are doing
outreach events all over.
Ms. Ramirez. Secretary, I am really glad you said that,
because now I am more concerned. I am going to tell you why. On
March 6th, I sent a letter asking about Paul's outreach
programs on behalf of veterans in my district who were confused
and frustrated. We invited the VA to participate in some of the
fairs and events that we do in outreach, and they told us that
services had been paused. Did you receive the letter that we
sent on March 6th?
Secretary Collins. I am sure we did.
Ms. Ramirez. We have not heard back from your office. When
can I expect an answer?
Secretary Collins. You are going to expect an answer right
now because what you have just described is malicious
compliance, and it is not tolerated. That is not what is
happening. For a VA employee to tell you that they could not
come to a fair or outreach is taking what was done and said. I
have had to already face this, so I appreciate your question. I
am as upset about it as you are. That is malicious compliance.
What they wanted to be able to do was say we could not do
outreach, although they can do outreach.
Ms. Ramirez. Well, Secretary, let me just tell you then for
the record here in the letter that you have from March 6th. On
Wednesday, March 5th, 2025, we received correspondence from
Chicago community leaders of the Jesse Brown VA Medical Center
noticed that they were temporarily pausing any comprehensive
outreach programs, effective March 7th. I am going to make sure
that we enter this into the record, Secretary, after you and I
can have a conversation about it, because obviously there are
concerns there that I know you want to address.
Secretary Collins. Could I have a, could I get a copy of
that letter as well?
Ms. Ramirez. Yes, actually, we have a letter for the copy
of the letter here. We will be sure to get it to you.
Secretary Collins. Look, I am. This is something that
frustrates me. Even if I had to pause and wait for this, I do
not want you to feel like you are losing time, Mr. Chairman,
because this one is upsetting to me, because I am having to
deal with this a lot.
Ms. Ramirez. That is why we bring this here. That is why
members of.
Secretary Collins. I am so happy you did. Thank you so much
for bringing it, because that is exactly. Malicious compliance
right now is hurting our veterans. If our VA employees are
doing that, it is wrong.
Ms. Ramirez. Thank you for saying that, Secretary, because
outreach, making sure we are meeting veterans where they are,
is so incredibly important, making sure that they access the
resources they need. You and I agree, necessity to ensure that
outreach is being done in every part of the country is
critical. I will say to you, I find it even more critical
because sometimes I know that there are veterans that can make
it to certain places. Black and brown veterans are placed in
housing at lower rates. We know that by fact. We know that
women veterans face greater barriers to care, and we know that
trans veterans are living authentically, still face
discrimination inside the very system meant to serve and honor
them.
Secretary, just this morning I heard from diverse veterans
who said going after diversity, equity and inclusion programs
feels like an excuse to not to serve all veterans. You said
earlier you are committed to our veterans, but I did not hear
you clarify when my colleague asked you about the Office of
Equity, how these disparities are going to be confronted and
how you are going to make sure that disparities are addressed.
Can you talk a little bit more about it?
Secretary Collins. Yes, I am happy to. It does not need an
Office of Equity Inclusion to actually make sure that veterans
are treated properly. That is something that we have developed
and I understand something, there are offices for you, me,
anybody, no matter where their service is, if, if they have
earned the service, if they have earned the benefit, they are
going to come.
Ms. Ramirez. Secretary, where would they go if they have
experienced discrimination? Who should they be calling?
Secretary Collins. The same place you would, in the same
Office of Whistleblower Protection. They can call their
Congressman, they can call. There is several outlets for them
to do that. I will tell you right now, no matter what
background they are, male, female, gender, it does not matter
if they have earned a benefit and they have something at the VA
that they feel like they are not getting, then you personally
call me, and I will walk into the clinic.
Ms. Ramirez. I am glad you say that, Secretary. I have a
follow-up question to that. Trans veterans are veterans. They
wore the uniform. They serve this country. Gender affirming
care is health care. It is suicide prevention. It is dignity.
Last time I raised this with your team, the responses were
unsatisfactory. Mr. Secretary, gender affirming care is shown
to reduce suicide risk and ends veteran suicide. Ending veteran
suicide is a VA priority. Will you defend and expand access to
gender affirming care, yes or no?
Secretary Collins. We are going to continue those that are
in the VA system to receive the care that they were currently,
but we are not adding sex change in the VA. That is just not
what we are going to do. They will get every benefit they have
earned.
Ms. Ramirez. Thank you, Secretary. I just have 47 seconds
left. I am disappointed in hearing that, but I am not
surprised. This administration and my colleagues keep
supporting a divisive agenda for the VA that harms our
veterans. American veterans are diverse and we do not get to
decide who is worthy of a promise to honor their service with
action. The reality is that in this moment, we have veterans
who do not believe they will be able to get care under this
administration. I want to make sure, for the record and in the
work that we do in oversight, that when we talk about every
single veteran, we mean every single veteran. That means gender
affirming care as well. With that, Chairman, I yield back.
The Chairman. Representative Barrett, you are recognized
for 7 minutes.
Mr. Barrett. Thank you, Mr. Chairman and Secretary, great
to see you again. I want to start by thanking you for coming to
Michigan last month, spending time with veterans in my
district. We deeply appreciated that and appreciate your
commitment to fulfilling the mission we have to every single
one of our veterans across the country and the interest you
took to come to Michigan. We really appreciate and appreciate
your willingness to step up and serve in this role. I know that
it is not always easy to step into the management role of such
a large organization with a lot of political pressure and a lot
of spotlight on you. Thank you for being willing to do that.
I wanted to ask you specifically about the electronic
health record modernization (EHRM) and the increased funding in
the budget proposal before us and wanted to ask how this
enhancement and funding is going to be used to ensure that we
have a success in the electronic health record rollout, knowing
that we have had challenges with the program in the past.
Secretary Collins. Thank you, Congressman. I do appreciate
the commitment, especially in your area, because of, you know,
April next year, the four sites will be going live in Michigan.
I think it is just a restart is what we have to sort of look at
here. This was a system that had been broken in the sense that
nobody was working with it. They were not. They just sort of
went to their corner and just held the ball and money was being
wasted all the time. What we did is restarted the system from
minute one. One of the biggest issues that I would heard that
was a concern not only from a perspective of patient safety,
patient quality, dealing with these health records. It did put
my understanding, at least looking back on some of the stuff in
Washington State and Oregon, is that it was not working
properly and was actually giving some bad results. That is just
an issue there.
Most of that came from the situation in which we did not
standardize what we were doing. They just sort of were allowed
to do whatever they wanted to do. One of the ways going forward
is, is we are holding accountable on a very short timeline on
our end to make sure that all of our employees are trained.
Everybody is going to be up to speed, and we are expediting up
that integration process. We are also holding Oracle
accountable for realistic time--time limits and also bidding
the equipment in and also adding things such as AI and others
on top of that to help our doctors in their treatments and the
nurses as well, practitioners going forward, which is something
they see in the private sector right now if they just walked
across the street and went into a private care facility.
We believe that we are putting in the safeguards to make
sure that going forward, this is going to be something that can
actually work, but also giving it the tools to expand in a
quicker fashion.
Mr. Barrett. Thank you. I appreciate that. I chair the
Technology Modernization Subcommittee here, and one of the
issues we have taken up is the external provider scheduling
(EPS) program. One thing that was clear throughout that hearing
we had recently is that provider participation is really
critical in making sure that EPS works for veterans and
reducing that community care appointment wait time in the
seamless integration there. I personally had an experience with
the community care scheduling that was fraught with challenges
and problems. Can you tell us what steps the VA is taking to
encourage community care providers to participate in EPS and
educate them about the program and not delay the implementation
or discourage its use?
Secretary Collins. Yes, and this is something I think that
anybody sitting in my position right now would have this
problem and I do not care which administration it could be
going forward because frankly, the third-party administrating
of this has been a problem in struggle and I am not saying
completely their fault. I think there is a VA component to this
as well on things that we have done to exacerbate the problem
going forward. One of the things, and I do not think I have
mentioned this is my second hearing, but if I have not
mentioned it already, I want to at least emphasize this again
is that when about the second week that I was on the job, I was
brought, it was brought to my attention that we could not put
out the contract Request For Information (RFI) for the third
party administrators this year as we were supposed to because
the work was supposed to have been. Please do not hear me just
trying to say blame, but this is just an honest assessment.
They did not do it last year. They basically, it was supposed
to been done in the fall of last year in the previous
administration. They just did not do it. The groundwork,
legwork to work up to this was, was not done. We had to put it
off a year.
What has given us the ability to do now is spend time
looking at the qualifications for these contracts. Looking at
these things, we. I think one of the latest conversations I
have had with some of our folks on looking at this system is
there is going to be literally hundreds of changes to the RFI
proposal so that we get better work with our community care
doctors and with our VA. Just to let you know on this
committee, if you have not understood this issue, one of the
problems is, and some of the doctors have alluded to this, is
that you have doctors who cannot communicate with our system
and our system does not communicate to them. They are waiting
weeks with, I kid you not, we are faxing information, we are
putting it on compact disc and sending it up. This is something
all of us could, you know, hold hands and say why are we doing
this? This is what is been going on and that is what is
delaying care for our veterans.
Mr. Barrett. Yes, no, I appreciate that. It felt like there
was a bit of a, you know, dragging of feet to get this
integrated and to expand it. One thing I raised in committee
that I am hopeful we can look at is if we are doing the change
management around the electronic health record, modernization
and upgrade and roll out to these facilities, it might be the
appropriate time to put them onto this scheduling program at
the same time so that we are doing that kind of comprehensively
or with some thought there. I am not in your position to kind
of discern that practicality or not, but I do think that we
need to do a far better job of rolling this out in a much more
aggressive fashion to kind of achieve the benefit of getting
these things scheduled in a timely way for our veterans.
Secretary Collins. I agree. It is not just the issue of
inside of our own facilities. It is also the veteran using it
as well. It is a twofold purpose of how we are training and how
we are also rolling this out. I feel good about where we are
now and anything that we can add on. I have already experienced
to Oracle that, you know, we expect compliance, we expect this
to go forward. Fortunately, about 3 weeks ago, the Senate
confirmed my deputy, Paul Lawrence, to be our Deputy Secretary.
That is statutorily under his purview, and I have turned him
loose to do that. He is getting involved now heavily on a
weekly basis and even a daily basis on it. Anything we can add
will be definitely looking forward.
Mr. Barrett. We look forward to working together through
the subcommittee in that effort and appreciate you being here
today. With that, Mr. Chairman, I will yield back. Thank you.
The Chairman. Gentlemen yields back. Dr. Conaway, you are
recognized for 5 minutes or 7 minutes. I am sorry.
Mr. Conaway. Thank you, Mr. Chairman. Thank you, Secretary
Collins, for being here today and answering questions. In the
interest of time, I am going to ask you a series, series of yes
or no questions just in the interest of time. I am very
concerned about what this administration is doing to safety net
programs such as the Supplemental Nutrition Assistance Program,
otherwise called SNAP and Medicaid. The cuts to those programs
that are proposed are, in my mind, completely unacceptable and
will put many people at risk. Many of our veterans rely on
these services to put food on the table and to access
healthcare coverage. If any veteran loses their Medicaid
coverage during this administration, would you allow those
veterans to be eligible for VA health care under Priority Group
6 to receive health care coverage? Yes or no? If you would.
Secretary Collins. At this point in time, I do not foresee
any of that happening. I would have to take it as it came and
look at it as if it happened. If that was an understanding,
that is not something that we have dealt with so far.
Mr. Conaway. I will take that as a no for the moment.
Secretary Collins. Take it any way you need to.
Mr. Conaway. If any veteran loses their nutrition benefit
during this administration due to changes in the law, as you
know, there are some drastic proposals out there, in my view.
Would you be open to directing the VA to provide cash subsidies
for those veterans who have lost that important food security
program?
Secretary Collins. Veterans are exempt from the SNAP work
requirements. They are not included in these issues.
Mr. Conaway. Well, but if the SNAP or the work requirements
are a separate issue on the SNAP, as you know, the SNAP program
itself, if it is cut, that means people are not going to be
able to get the SNAP benefit at all. My, my question is, and I
will ask it again, would you be open to directing to replace
that money? You have the authority to do this with cash
subsidies to make sure that veterans are not food insecure.
Secretary Collins. Veterans are not a part of the program.
That is been described as what is passed.
Mr. Conaway. Yet they are on SNAP. I will move on.
Secretary Collins. They said they will continue to get
their SNAP program.
Mr. Conaway. Well, not if the program is cut by $230
billion. Let me just move on.
Secretary Collins. I appreciate it.
Mr. Conaway. What do you intend to do about veterans who
cannot--let me move on. I have significant concerns regarding
DOGE's access to VA data. Specifically, I am worried about
their access to sensitive personal veteran data. Secretary
Collins, can you ensure this committee that DOGE personnel who
have had access to VA data have not retained any copies of that
data?
Secretary Collins. Yes, and they follow all the personnel
and all strategic information as any employee would at the VA.
Mr. Conaway. Can you commit to this committee that no
personnel, excuse me, or sensitive veteran data such as Social
Security numbers, driver's licenses, medical records, or
financial records have been retrieved or will be retrieved by
DOGE after, I guess, their time in service ends and that those
employees have not stored that data elsewhere or have used it
for personal gain?
Secretary Collins. There is no even resemblance of anything
that would happen in that regard.
Mr. Conaway. The VA is a major player in medical research
and innovation. How many researchers have been fired or
dismissed from the VA?
Secretary Collins. None.
Mr. Conaway. How many research projects and studies have
been impacted due to the firing of researchers? We have a lot
of reports about clinical trials being disrupted or being
canceled or otherwise postponed or paused.
Secretary Collins. Dr. Conaway, I am not trying to evade
your question, but I do need to draw a distinction here. Are we
discussing research trials or are we discussing clinical
trials?
Mr. Conaway. Clinical trials.
Secretary Collins. Clinical trials. This is, there is no
clinical trials has been halted. Now, if there have been other
issues that may have done it, but none has been canceled. The
research trials, I mean the clinical trials. Let me also say
something and I want to get this out because it is important.
There is over 1,500 clinical trials going on right now and of
which this is not, hopefully not going to shock you. Did you
realize that we have no centralized control over those clinical
trials? I have no idea. No one person is overseeing those. To
get those information and to find out what is going on, on some
of those, we have nobody that is actually over those, but yet
we have 1500 that are actually going on currently.
Mr. Conaway. I suspect many of those trials, because I work
in this area, have worked in this area, are probably being done
through research grants from universities that are testing
various new proposed new drugs and the like and they are being
run there. I take your point that you might not have knowledge
of them within the VA itself.
Some of the information, just for the record, I would
provide you with some of the estimates stakeholders have given
us. Since the hiring freeze by the President and that continues
to be in effect. 370 extramural studies and clinical trials
will be suspended or canceled at the VA. 10,000 veterans that
are relying on these clinical trials and studies will be denied
care and the VA will lose $35 million in research funding due
to delays and cancellations. During earlier today during a
hearing at MILCON-VA Appropriations Subcommittee, you stated
that clinical trials are not health care for veterans, that
they are above and beyond health care. I must tell you that I
completely disagree with that statement. If you wish to correct
it, that is fine. Clinical trials are health care and for those
veterans, as has been mentioned earlier by my colleague, might
be a lifeline for a veteran who has cancer and is in a trial or
perhaps has a neurodegenerative disease and is in a trial.
Those potential discoveries that treatment that is given during
a clinical trial and it is treatment because I have been an
investigator, I know that is treatment that any pause or delay
in cancellation of such trials is a delay in cancellation of
treatment. Are you taking any steps to ensure that veterans who
lost access to clinical trials will still receive the care that
they need?
Secretary Collins. Yes. I would appreciate the opportunity
to clarify because my words were taken out of context and I
think when you have to have proper context, what I said was
because I am having to also deal with a lot doctor about people
who are lying about what doing in all honesty. When you get to
the point where it is I have had many people come up and say
dealing with research or dealing with clinical trials saying
they have lost all access to healthcare. This was their
wording. All access to healthcare. That is just. I am with you
on this. It is not. It is a part of healthcare, but it is not.
They did not lose their access to their primary care physician.
They did not lose their access to anything else. Even if it is
true, we did not cancel any of the clinical trials. As we move
forward on that, we are going to continue to do that because
they have actually provided a great deal of service to not only
our veterans, but outside that veteran organization as well.
The same is true with that. No research trials have been
canceled. That is one of the reasons we put the pause in that
we did as well for that.
Mr. Conaway. Thank you, Mr. Secretary. Thank you, Mr.
Chairman.
The Chairman. Representative Hamadeh, you are recognized
for 7 minutes.
Mr. Hamadeh. Thank you. Thank you, Mr. Chairman. Secretary
Collins, it is good to have you here.
Secretary Collins. I believe happy birthday.
Mr. Hamadeh. Thank you. It is. I have turned 68 today. I am
just doubling my age. I can fit in with my other colleagues
over here.
Secretary Collins. Well, that is it for me, Mr. Chairman. I
am gone.
Mr. Hamadeh. As we all know, the number of veterans in
America has declined over the past two decades. Yet VA spending
continues to skyrocket, and this trend is simply unsustainable.
Mr. Secretary, under your leadership, the VA is finally taking
long overdue steps to increase accountability, eliminate waste
and refocus the department's mission of serving veterans and
not preserving bureaucracy for bureaucracy's sake. As my
Democrat colleagues fearmonger, the reality is more than
300,000 jobs have been exempted from the hiring freeze. The
focus is on eliminating the administrative fat, not doctors and
nurses. Veterans need the VA bureaucracy to work for them, not
the other way around. It should not have taken the VA's Chief
Financial Officer (CFO) 2 weeks to give a simple set of basic
budget accounting information to you. That is what we had until
recently. With more than 60 disparate HR systems, outrageous
tales of corruption and chronically broken veterans integrated
services networks, we have lacked fiscal accountability for
decades.
Now Phoenix's Carl Hayden VA Medical Center, which is quite
infamous, failed so many veterans that it became ground zero
for reform efforts. I know there has been a lot of progress
being made over there. Veterans in my district and across
Arizona expect the VA's budget to directly support their care,
not layers of administrators removed from the mission. I look
forward to assisting your continued efforts to refocus the VA
on its high-minded mission, taking care of Veterans. The Trump
Administration's reforms aspire to accomplish this by providing
greater oversight, less bureaucracy and a culture of nonstop
effectiveness.
Now, Mr. Secretary, we have heard a lot of scare tactics,
but I want you to talk about once more. List the services and
jobs excluded from the hiring freeze.
Secretary Collins. Thank you for, you know, offering the
question. One of the things is I can, I want. There is
something you said in your, in your question that I want to
address if I could, and I will get to that part. You talked
about our Chief Financial Officer. I wish I had one right now.
Right now, our Chief Financial Officer, our lead general
counsel and our national cemeteries Undersecretary are being
held up in the Senate. These are three veterans who have all
served one who is going to be Sam Brown, who is going to be
head of our mortuary affairs, our cemeteries, gave some of his
own body to service of this country after being blown up and
yet is right now being held hostage in the U.S. Senate by the
same people who actually want to say we want you to hire
veterans and not fire veterans. Well, now I just got a sense,
and I have told the Senators this as well. It is time to stop
that. If you want to hire veterans. I got three of them that
need to be approved and need to get on the job working for
veterans. When you say I have a CFO, I do not have one because
I cannot get the Senate to approve them.
Do not tell me they want to help veterans when they got
three of them sitting right there, one who was grievously
injured in wartime that they refused to approve. That is what I
am dealing with right now. In addition to what you are saying
and what we are looking at, we are not looking at doctors, we
are not looking at nurses, we are not looking at this. You just
look at the numbers in general and you have your poster there.
I mean, we are looking at issues that I talked about earlier
where we have payroll that is being done at 60 locations, which
was supposed to been centralized a long time ago with hundreds
of employees that we are now having to look to see how we can
consolidate to make sure we are running it efficiently and more
cost effective.
We do not need them all over the place. We do not need the
issues that we have of human resources being run in every
location again with hundreds of employees. We have a system of
a vision system which many of you may understand is was put in
the 90's to give general oversight over our hospitals. Did you
realize that? I talked to some folks from that timeframe when
they actually put this in, that they were supposed to be
minimally staffed. 10 to 20 people will be in the, look at our
VISNs right now, our VISN structure with everything we have
added onto it. Instead of having at number, most of them have
full time staff between 60 and 100, but added staff of nearly
16,000 in the VISN structure.
These are not also some of them, by the way, someone said,
well, they are impacting healthcare because you have some
doctors, I have one of my VISN directors actually tell me. They
said, yes, we have some of ours who are, quote, dual hatted.
They do 4 hours a week in a clinic. That is not helping us with
our veteran backlog. That is not helping with our wait times.
It is still being done from a level that is far up. We have 200
plus call centers in the VA. You want to talk about that one
for a second? These are, I mean, every one of our VBOs, our
business have one of their own call centers for their mortgage
issue. It is like, why do we have this? This is the part that
has just grown over time and it is not affecting healthcare. We
are going to make it easier for a veteran to call on one of
these lines and get to talk to somebody on the other end of the
line. We are also going to make it to where we have people who
are actually working in these, our clinics, working in our
disabilities and working in our cemeteries that actually have
firsthand touch.
The last thing that I have to say is, you can say what you
want about where we are at and how we got here, but in 10
years, GAO has said, we got a problem. We have increased money,
we have increased. By the way, before we get into it, some will
say, well, the PACT Act was why we had the money. Okay, you are
right. If you look at the numbers, we are basically giving some
of the same money to the same people that were already there,
just in a different capacity. I respect that. They have earned
it. As I said before, I am a veteran who served under a burn
pit for almost 5 months. I think these are the areas that we
have got to look at. For anybody out there, giving. Again, I go
back to the assessment where you are cutting 15 percent of
doctors, 15 percent of nurses is frankly just not helpful to do
what we need to do, because that is not what we are looking at.
Frontline workers should be the happiest at the VA right now
because we are going to be freeing them up to do their job and
not get bogged down with paperwork.
Mr. Hamadeh. Absolutely. I hope to see your CFO Senate
confirmed very soon. You need that. You have a tough job right
now ahead of you and I just want to thank you for your service
to our Nation's veterans and I appreciate your laser focused
outcomes over optics. Now, please know that you have my full
support in refocusing the VA on its founding principle,
delivering the best care for those who born the battle. With
that, Chairman, I yield back.
The Chairman. Thank you, Representative Budzinski, you are
recognized for 7 minutes.
Ms. Budzinski. Thank you, Chairman Bost. Thank you, Ranking
Member Takano. Thank you, Mr. Secretary, for being here today.
Appreciate your time. I do want to take a minute to just
address the claims that you have made about the VA's
performance has gotten worse from the previous administration
by many measures. I want to highlight the great work of the
VEO, the Veterans Experience Office within the VA that has been
measuring specifically Veteran Trust Scores. They have come up
with a Veteran Trust Score which is at an all time high at 80.4
percent in 2024, which was an increase of 25 percent since 2016
when we first started recording this metric. VA employees, many
of them veterans, as you know, have been stepping up to meet
the demands.
You referenced the PACT Act, which was a historic expansion
of care. Now with more staffing cuts on the horizon, these
public servants are being asked to do more with less is my
concern. Almost four in five VA employees are members of unions
and collective bargaining rights give them a process to address
their concerns in the workplace and ensure sound working
conditions. I believe this helps both the employee and the
veteran being served. Mr. Secretary, when you endorse President
Trump's executive order stripping VA employees of their labor
rights, I believe you devalue their work. Coupled with the
threat of significant staff downsizing, I hear from
constituents working at the VA in my district that they have
increased fear and stress and there are deep morale issues at
the workplace where they deeply believe in the mission of
serving our Nation's heroes.
Of course we agree that improvements can and should be made
at the VA. I want to say that despite testimony, none of us on
this committee believe that the VA is perfect. Improvements and
changes, I really do believe need to be done in a manner that
is thoughtful, legal and based on the input of stakeholders,
which includes us in Congress. I am going to shift gears and
talk about one area that you have touched on and I am really
honored to be the ranking member on the Tech Modernization
Subcommittee with our chairman, Mr. Barrett. I want to spend a
little time talking about the EHRM as well, which I think is
one area that we can all agree is a place that could use
improvement.
Your remarks mention an accelerated rollout of this system.
I too really do want to see EHRM be successful and can
acknowledge that there have definitely been stalls and not a
lot of success seen to date. I think it is worth taking a
minute to say, you know, talk about the program and where it
started and then where it is today. This program actually was
started during the first Trump Administration. In 2017, the VA
signed a $10 billion sole source, no bid contract with Cerner,
which some have said the GAO has mentioned that, you know,
influenced by so called Mar-a-Lago crowd as Cerner struggled
with the implementation. Then Oracle acquired them in 2022.
As you know, there is a total of 170 VA sites that need to
implement the new EHR system. Since 2020, VA has rolled out and
I think we can acknowledge only six sites, which is not, that
is not great. Now VA has announced plans to roll out EHRM at 13
sites by 2026, which is, which is progress. My concern is that
that leaves about 151 sites left. If we are accelerating that
to 20 by 2031, how are we going to get there?
This is going to be a major undertaking and I am just very
concerned with the staffing levels in particular if we are not
fully staffed, how we are going to meet this metric. In the
midst of what I think is a massive reduction in force and then
a bare bones IT budget, I am really worried that this is going
to set up the VA for failure. I completely agree with you. You
mentioned standardization. That is something we have talked
about on our subcommittee and something we should be moving to.
Some of the unique challenges, as you know, is that every VA
has their own unique system and trying to get all of them to
standardize is a challenge. I agree with you that is something
we should be committed to looking to. One of my first questions
for you, Secretary Collins, is to better understand how
workforce cuts will help you achieve that. What is your target
reduction for Office of Information and Technology (OIT)
workforce?
Secretary Collins. At this point in time, it is not been,
there is no quota or anything else looking for OIT or any other
workforce. It is looking at total picture of who we have where
and we are going through that process right now.
Ms. Budzinski. Have there been cuts to the OIT workforce?
Secretary Collins. Not at this time, no. No. There has
been. No. We let less than one half of 1 percent of employees
that were here in January that have let them let go.
Ms. Budzinski. Okay. There is no plan in the future to
reduce the OIT workforce?
Secretary Collins. I think when you overlook it, you know,
are there areas of the OIT workforce that may or may not be
essential to what is happening? That is. I am not going to say
there is not, but I am also going to say that it is essential
to us going forward as we look forward in this.
Ms. Budzinski. Okay.
Secretary Collins. I just, I mean, I am just, I understand
what you are trying to say. I do not mean to be evasive in this
and I just. You are not going to go that granular.
Ms. Budzinski. Yes, I understand. I think some, you know, I
complete. I hear what you are saying about the medical staff of
the VA, but I think the OIT is a great example of those are not
medical staff, but they are really critical to being mission
driven into getting a program like the EHRM system really
successfully off the ground. These are not doctors or nurses.
These are technicians. These are tech folks. I just. That is
why I am asking.
Secretary Collins. No, no, it is a great question because
you have actually opened it up a little bit because also
neither are people who clean our rooms and neither are the
plumbers and neither are electricians which we have all, we
have all. We have protected. We protected them as well. They
are part of that 300,000.
Ms. Budzinski. Okay. I guess one of the. During your
testimony last week before the Senate, before my Senate
colleagues, you indicated that technologies would help VA to
improve efficiencies in the face of work workforce cuts. It
sounds like in one of my concerns is that we might be using
technology to replace people, which is a concern of mine
because I think quite frankly the VA is not, you know, we do
not want to be installing McDonald's kiosks here. These are
actual people we want serving our veterans person to person. I
just want to make sure. Can you respond to that and how
technology is potentially going to be used.
Secretary Collins. I think technology is working how we are
taking first time claims into the-a lot of this is in our BA
benefit side-We can actually take things that we have seen over
and over and over again that we can get a benefit that could
take several months under a system we are actually getting new
claim benefits done within literally days so that they are not
waiting for these things. I think you use them in ways that it
helps you do not use it. You know, technology is not going to
solve every issue that you ever have, but it can get us more
efficiently as far especially in ways that are more not hands
off, but they are more of a the transaction with our like
mortgage benefits, you know, the education benefits, things
like that. That could work in that way.
Ms. Budzinski. Okay, we would love to keep talking. I have
time for maybe one more quick question. I did want to ask the
VA Chief Information Officer, the OIT, if you that position I
do not think has been filled. If you could respond to when you
think that position will be filled.
Secretary Collins. We are working on that as we speak. I
mean, we are still interviewing some folks. It is hard to fill
some positions and we are still working to get that filled.
Thank you. I yield back, Mr. Chairman.
The Chairman. The votes have been called and it is the
intent of the Chair to go to recess for the votes we will have.
I would like to get everybody back here as quickly as possible.
Ten minutes after the last vote. There is only two votes and we
will carry on. I know that many of you might have flights or
whatever, but we will try to get through to everybody. We will
come back, and as I said, Mr. Luttrell, you will be first one
up when we get back. We will be in recess until the call of the
Chair.
[Recess]
The Chairman. We will come back to order. We will be
continuing with the 7-minute questions. Mr. Luttrell, you are
up. You are recognized for 7 minutes.
Mr. Luttrell. Thank you, Mr. Chairman. Mr. Secretary,
welcome back. I am sure you are used to the kind of the ebb and
flow of this place. I need to kind of lay out my question. So.
Not--hold. Everybody. He is from Georgia. Just take notes.
Okay, sorry. I digress. Alright, we good? Alright. Alright. We
have 9 million veterans. We have roughly about 1.3, 1.5 plus or
minus service members currently. Of course, recruiting is up,
recruiting is down. The transition will inevitably happen from
active duty to our veteran space. Now, one of the challenges
that I often hear about, see about as a veteran myself and have
gone through, when the veteran enters into the VA space, then
the process starts.
Now, as easy as that can be for some veterans or as
painstaking a process as that can be for veterans, I will
always say it seems to be problematic. Once the veteran
initiates the claim, if you will, then he goes into the VSOs,
goes in the rating system, goes up the national work queue, it
disappears into the metaverse. Sometimes it gets lost,
sometimes it gets found. I will not get into the national work
queue with you today. Then we run into systematic problems
along the way. Not for every veteran, but for veterans,
nonetheless. I truly and honestly believe if there was a
transitional period between leaving active duty service, where
the service members record is buttoned up top to bottom, inside
and out, take the veteran more or less out of the equation,
almost all the way out of the equation in the record, however,
that may transition from this active service to veteran
service, and then it starts the process on its own.
Now, I know we can do that. My question is, will you not
have you. It is too early. Will you, will you consider, or will
you please engage with U.S. Secretary of Defense (SECDEF),
start these conversations? I have had this conversation with
him. I do not know if you have or not, but everyone understands
the problem. Everyone understands that the transition between
the two should be seamless. For decades and decades and
decades, we hear about this. This would be the greatest
opportunity that we could have to catch people on the wrong
trajectory that may be suicidal ideologies, may have a
healthcare problem, something that we miss. When you are in
this service and you are on the train, you are front sight
focused, laser focused on the problem set that exists in front
of you and that bullet train is traveling down the track, 1,000
miles an hour, and it does not stop for us to get off.
We jump, and everything that we jump with goes in a
thousand different directions. Then it is our responsibility to
try to find it somewhere in every place that we were stationed
to put it together to give to the VA. Then the VA has that. It
is their responsibility to help the veterans with it. We know
how painstaking of a process that can be. My question is, will
you, sir, please engage with the DoD and start baseline
assessment from the time that we come in through the time that
we transition out into time into the veteran space so our
veterans are better taken care of.
Secretary Collins. You know, in looking at it in oversight.
What we are talking about right here is probably one of the
most pertinent questions I think we have had, and I appreciate
all the questions we have today. You have hit it something that
is very important to me because it is the trigger mechanism
that for many of the bad outcomes that we see, either not
getting care, having a bad experience with care, then leaving
the care, or not getting the benefits that they have. Just
recently, I was at McDill Air Force Base, and we had their
medical side there, the Air Force medical side, and we had our
veteran benefits office personnel there, some of their senior
leadership. I asked the question just because we were talking
about how this was transitioning out. They said, I asked our
benefits coordinator, I said, how many of you get people coming
in who have no experience or no knowledge of what their
benefits are? To almost to a person, they said, most everybody.
I have already started that conversation with SECDEF. In
fact, we started it before either one of us were confirmed.
Here is the bigger issue that we got to deal with TAPS. This is
our transition assistance program. It is. I say this in a
generic form, so any reporter here, please listen to what I am
saying. TAPS is owned by DoD, in which they do not really have
a good plan, because the way it is positioned, as you well
know, you know, to give 12 months, 18 months, however you
transition out. It goes through this contract, not deporting
them, but this is just their issue. DoD owns TAPS and I am
blamed for it.
I think this is the part that we have got to look at as we
go forward. There is got to be a more seamless transition for
that, and we have already started. I think you are going to see
something pretty soon about that. I just wanted to let you know
that Secretary of Defense and I have talked about it. The last
part on that is that question that I think no matter what we
do, one of my priorities is going to be is those that have
issues coming out having warm handoffs basically straight into
VHA, especially those who are having issues with mental health
issues, TBI, PTS, and those kind of things, because.
Mr. Luttrell. DoD has absolute authority to gather all that
information and share that with the VA. Just the complexities
of the global threat currently that is developing, our
generation is coming into the VA, our older generation, we are
losing them. If, worst case scenario, if we have to go all in
again. The wave is just going to. I need the VA to be ready.
Secretary Collins. Yes, exactly. That is also one of the
emphasis of the President as well, is that fourth mission of
the VA, which is our disaster and natural response. Also our.
We are the actual backstop. There is not a--without going into
classified information, which we would never do here. The VA is
always a part of any national contingency that would come up in
any, any type of scenario that we have. We have got to be ready
for that, make sure our workforce is developed.
I want to real quick enough, if I could. One of the issues
that bothers me most about our transition part right now is
statistics show us that a shorter time of service, a three to 6
year or three to 7 year time of service is a drastically higher
propensity for death by suicide from not just when they get
out, not just three or 4 years later, but upwards of 40 years
later, they are seeing statistics to say that shorter
timeframe. That is why transition is so important. Correct.
Mr. Luttrell. There is no difference with somebody that
served 6 months to somebody who served 60 years, period. Thank
you. I yield, sir.
The Chairman. Mr. Kennedy, you are recognized for 11
minutes.
Mr. Kennedy. Thank you.
The Chairman. 7 minutes.
Mr. Kennedy. Thank you, Mr. Chairman. I will take whatever
I can get here.
The Chairman. Seven.
Mr. Kennedy. Secretary Collins, first of all, thank you for
being here today. Thank you for your service to our country. I
represent the Buffalo Niagara region in New York, home of the
western New York VA system, including the Buffalo VA Medical
Center and one of the Nation's two GI Bill processing centers.
During my time in office, I have had the privilege of meeting
with many VA employees, often veterans themselves, who take
immense pride in continuing their service to support their
fellow veterans. Unfortunately, in these meetings, VA staff at
every level have raised serious concerns, including plummeting
morale and an increased stress due to the threat of sudden
firings and what they feel is a climate of fear, PTSD and
mental health strains stemming from constant job insecurity,
the rollback of collective bargaining rights and attempts to
strip employees of their voice, rigid and poorly thought out,
return to office mandates without adequate infrastructure or
workspace to carry out mission critical duties, and worsening
understaffing, which is leaving teams stretched even thinner
than they were to begin with.
That list does not stop there. Those are just a few. The
issues demand urgent attention from you and your team, Mr.
Secretary. Your testimony claims improvements to veterans'
care, yet you are eliminating positions essential to handling
the increased PACT Act cases, cutting these roles removed
skilled, experienced staff who directly assist our veterans.
Outside consultants and political appointees obviously cannot
do this work. Neither can AI. VA employees in my district work
tirelessly to deliver care and benefits. They are not faceless
bureaucrats. They are honoring our promise to our veterans.
Your testimony states that VA aims to place employees where
they are needed, reduce unnecessary overhead and strategically
cut staff. Now, I have asked this question repeatedly of this
administration. Still have not received a clear answer. How do
you plan to reduce staff without affecting care? Who exactly
are you planning to let go? What are their roles? What
qualifies as unnecessary overhead and what safeguards are in
place to ensure that these cuts do not further strain an
already short-staffed system or reduce access to vital services
for our veterans?
Secretary Collins. Congressman, I appreciate the
thoughtfulness of the question and the overall expansiveness of
it. Let me just answer in the best way possible. As I have said
before and I have made several comments already on concerning
consolidation, we have seen areas of work that being payroll in
our HR systems, those kind of things. The people that you are
speaking to actually handle disability claims, who actually
move forward. These processes are not the people that are
involved. We have exempted 300,000 plus positions to make sure
that those are actually the positions we need that we are going
to keep and that we are hiring. Right now, in any one time we
look at this and going forward, and there is been something
that is been said a couple of times and I want to address it
here. There is no, especially going forward in our look at our
reorganization process, there is no such thing as a sudden
firing because this is a process that is going through and as
we get to the level of where we are able to say here is what
our structure looks like, here is how we are trying to look at
this and here is how we are going to be maybe rolling this out.
There is going to be the notice to the employees. There is
going to be notice as we go forward in this.
It is not an issue of sudden firings. I would hope that
that would get through to especially our employees who are on
front lines. Again, they are not part of what we are looking
at, especially in the duplicative services in looking at this.
I do have one other question if you do not mind for your
second. I appreciate the question. I want to be able to answer
it. The adequate office space----
Mr. Kennedy. You got to move quick. I have more. Please.
Secretary Collins. No, I will. One last thing. Adequate
office space issue. Anybody that is brought back from our work
processes that are not in spaces that fulfill their duty, the
supervisor in that position is not fulfilling the role because
it stated clearly that no one is being brought back into a
position in which they are not able to do their job. If that is
happening, then we will hold supervisors accountable and make
sure that is happening. They are not going to be able to. I
hope that answers.
Mr. Kennedy. The consolidation of space. I will just say
when it comes especially to dealing with our veterans and
mental health services, when you are in confined spaces and you
have practitioners that are providing those services oftentimes
via a virtual space, that is a problem when they are in a
consolidated space. These veterans are not feeling comfortable
sharing privileged, confidential, very personal information.
That is something that has to be dealt with.
I want to also go back because look, we have heard from so
many different veterans that are concerned. I want to just
clarify. You know, in the first week of this administration
there were cuts. There was 1,000 cuts at first, then another
1,400. Then there was your memo talking about going back to
pre-pandemic 2019 levels. I know you have discussed this was
just a goal. 83,000 people would be cut. That is all concerning
all pre-PACT Act as well when those people were hired
specifically to deal with our veterans that have had these
horrific injuries fighting for our country. I think there needs
to be a consistent message. I am very concerned. I know our
veterans are worried, they are fearful and those that are
employees as well.
Mr. Secretary, you talk about over in the Senate those
service-disabled veterans that are waiting to be approved by
the Senate. There are service-disabled veterans that have
served this country and are serving in in the hospitals and the
VA system today that are getting cut and are losing their jobs
because of this administration that is not treating them with
the dignity and the respect that they have earned and they
deserve. You visited multiple VA facilities, Mr. Secretary, and
spoken with non-healthcare staff like VBA employees,
electricians, maintenance workers.
I know we discussed this earlier today. I think we agree
these roles face similar challenges across the country. Why did
the Milwaukee VA preserve these collective bargaining rights
for nurses and facility workers while employees in the Buffalo
VA and Buffalo VA VBA lost theirs even though their job
functions are identical? I will just say that the clear
difference to me is that there is union affiliation and it is
seems like retaliation. The Buffalo VA employees are
represented by three different unions that have filed lawsuits.
Can you please elaborate and discuss how these determinations
were made?
Secretary Collins. I think from that perspective I will be
very simple here because it is going through a process right
now of legal issues. Well, as they were made following the EO
from the President to go forward on this and we are following
that and of course are going through any of the issues that are
currently in under litigation.
The Chairman. Mr. Ciscomani.
Mr. Ciscomani. Thank you, Mr. Chairman. Thank you,
Secretary Collins, for being here. I first want to thank you
for your visit to Arizona and Tucson just a few weeks ago. I
think we had a great time there. You got to see what the VA is
all about there and their needs and the things that we can work
together on. Thank you for spending the time to visit our
districts. I know that is mine is not the first one that you
have done that with. I think you have a very hard job ahead of
you with, with a lot of cleanup to do. Plethora of issues that
I think we have heard about from both sides here. You are
getting to them as fast as you can. At the same time
dismantling a lot of the misinformation and lies that are
coming out regarding the VA and what, what your efforts are and
the President's as well. Thank you for all that you do there.
Now I want to focus on the issue of veteran suicide. You
and I have talked about this. I know that is a passion of
yours. During our meeting in March and then again your visit
last in April, we discussed the Arizona Be Connected program
that I mentioned, which serves my veterans with their mental
health needs and works diligently to forward the goals of the
VA suicide prevention strategy. That was cut under the previous
administration. I was and still am looking forward to working
with you to find a solution to ensure our veterans, and
particularly the ones in Arizona who benefit from this program,
who have told me they personally rely on it for their mental
health needs, continue to receive the assistance. Now,
unfortunately, we do not have full clarity on the status and
the future of the program.
Now I know that this is an important issue to you. It is
your passion as well. We did receive some information last
night from the department in terms of some of our questions and
the answers that you provided there, but still no real clarity
there. I want to talk a little bit on that. Just before I give
it back to you so you can talk about that, I want to make sure
that we all understand, especially the Department, you and your
team, that we are not talking about frivolous partnerships
here. This is a program that specifically serves veterans and
their families, that specializes in mental health and in
suicide prevention for the veterans. Because of the VA scandals
a decade ago that resulted in the creation of this program,
veteran suicide rates in Arizona were 3, 3 to 4 times the
national average with 260 deaths estimated in 2024 alone. This
is a huge issue for Arizona, even more than in other states.
When I was told that the previous administration was
canceling funding for suicide prevention services without
communication or justification, what I hear is that I
potentially have thousands of constituents in the highest
caliber and need being left without care and without the
support that we were promised. I know you agree that veteran
suicide is absolutely the last issue that should experience
delays in communication and care. Can we commit together to
work on this and maybe getting more clarity on the specific
future of the program?
Secretary Collins. Yes, and I think that is the, in the Be
Connected program, Non-Service Connected (NSC), what we are
wanting to do, and I think we talked about this before, is
making sure the programs that we are going through have key
deliverables, things that actually can be measured so that we
can get this done. I am committed to working with you and I
know we sent the response back to you. We are going to continue
to work to make these programs such as Be Connected, have the
measurables that we can make sure that we are getting the
results that you have expressed how those are working. I
appreciate that we also have to look at it as an overview
program, how we are reaching out. It may be something as we put
more emphasis on and more accountability on, that we can expand
as we go forward.
Mr. Ciscomani. Yes, I remember you mentioning how much
money was being spent on suicide prevention and the results
overall of that investment were not yielding the results that
they should based on the amount that is being there. This one
is a public partnership, public-private partnership. It is
yielding results. We love to provide, you know, again, the
information on this because it is something that I think can
serve as an example not only to keep promoting it in Arizona
because our veterans are calling for it, because it has worked,
but maybe even the model for other states as well. I would,
that is really my top priority in terms of comments this
morning. I mean this, what are we afternoon, evening, what
time?
Secretary Collins. I am not sure. I am not sure.
Mr. Ciscomani. Yes, evening, almost. Thank you for being
here that long. That, that I am really passionate about that
because again, Arizona is getting hit at a higher rate with
this. I know this is your passion as well. I hope we can, we
can get even more clarity on answers and then even the last
letter we got last night. Let me just move on to a quick one as
well. I was proud to see some of the recent changes that were
made on the Officers of Survivors' Assistance that I have been
advocating for since last Congress, such as moving Office of
Survivors Assistance (OSA) within the Office of the Secretary
to be direct advising body. Can you speak to the impacts your
reforms for survival survivors will have?
Secretary Collins. Yes, I think that is. I appreciate your
H.R. 1228 on the Prioritizing Act. We just went ahead and
basically moved it. Look forward to you moving the legislation
through. We went ahead and moved that back to the Secretary's
office. These are ways that we can make these things go
quicker. They can go be more compassionately handled in others.
I make the statement as someone who has been a pastor and also
been a chaplain now for many years in the military. One of the
biggest things is how we handle these issues of death and end
of life and how we go from there. I have sort of described it
this way as you have a medical examiner's perspective and you
have a funeral home director's perspective. I do not mean to, I
am not making light of this, but it is really true. You have
the more clinical aspect of a medical examiner says, you know,
your loved one is deceased, they are no longer here, and they
just sort of leave it at that. A funeral home director takes
that same situation and says, how can I help you and how can I
get you through this time, which is so difficult for you and
your family?
What my goal here is bringing this in as sort of the, the
white glove survivor outreach item is to make sure that we are
giving them the due concern that they have in a time of
trouble, in a time of need, but also doing it in a way that
conforms to the law and conforms to the benefits that have
earned. Bringing it back into the office, setting this
structure up actually gives them the ability to feel needed,
feel wanted and feel heard, even if the answers that they may
get are not what they expected. We are making it here where it
is less what I think is less clinical and more compassionate.
Mr. Ciscomani. Excellent. Love to hear that. Again, thank
you for all that you are doing for our veterans. It has been a
little over 100 days and I think that we are seeing this move
in a very sharp, great direction. Keep up the good work and
again, I look forward to working with you specifically on the
suicide preventionsite on the Be Connected program in Arizona.
We will talk more about that. Thank you so much, Chairman. I
yield back with 28 seconds left.
The Chairman. Thank you, Dr. Morrison.
Ms. Morrison. Thank you, Mr. Chair. Mr. Secretary, welcome.
I want to begin by thanking you both for your military service,
for your service in this role as Secretary, and for being here
to testify today. Before I begin, I just want to preface my
questions by sharing with you that my husband is an army combat
veteran and I care deeply about our Nation's veterans, as I
know you do. While we belong to different political parties, I
want you to know that I genuinely want you to succeed in this
role because that is what is in our veterans' best interest.
Now, I know you had the opportunity to visit the
Minneapolis VA earlier this week. I hope you enjoyed your time
there. We are incredibly proud of our VA, which as you know, is
a Centers for Medicare and Medicaid Services (CMS) rated five-
star hospital, one of only two such hospitals in the greater
Twin Cities metro area. I believe that Minneapolis VA can be a
model for the whole system. I have to be honest with you, Mr.
Secretary. The conversations I have had with veterans in my
district and caregivers at our VA have me concerned about its
direction under this administration's leadership. I know there
is been a lot of talk today about Reduction In Force (RIF)
efforts at VA, and I apologize if this feels redundant, but I
just think it is so important. I know you do not want to talk
specifics, but consistent with your testimony, can you commit
to us that any reduction in force at VA will not threaten
veterans' care and benefits?
Secretary Collins. Yes, that has been my goal all of the
long and can I also say this? Minneapolis is great and is a
really an example and for just and I do not mean to say this,
but one of the reasons we have it is we have some longevity of
leadership there. That is something that is I am looking across
our hospitals and others. We have up and down leadership.
Leadership is so important there. I appreciate what is
happening. Leadership, after we had our conversation, was very
frank. They said before hearing we were concerned, and now
hearing it straight from me and hearing what we are trying to
do, I think it gave them a renewed sense of purpose.
Ms. Morrison. I am really glad to hear that. So. I know
this has been asked, but I have to repeat it. Can you commit
that no doctors or nurses will be fired as any part of the RIF?
Secretary Collins. We are not going to fire any. We are not
going to be riffing anybody that is actually taking care of
employees. Not employees, but anybody that is taking care of
our profession in direct care.
Ms. Morrison. Okay. Patient support employees. Sir, can you
commit to us that no housekeepers or environmental health
technicians?
Secretary Collins. No, they are all part of the. In fact,
they are already exempt.
Ms. Morrison. They are pest control and laundry workers.
Secretary Collins. They are part of the 300,000 that we
have already exempted.
Ms. Morrison. I am very relieved to hear that. You know, my
point really is that, you know, I am a physician, and after
more than 20 years of practicing medicine, I can tell you that
it is very much a team sport. The whole team plays a role in
patient care, the physicians and nurses, of course, but the
support staff is incredibly important as well. These people are
mission critical to the delivery of care, and firing them would
affect veteran care. These are people who help ensure their
operating rooms are sterile, the patient's bed sheets are
clean, the medicine and equipment are delivered in a timely
fashion. You have mentioned that you want clinicians returning
to the bedside to provide care. Obviously, if we fire the
support staff, then the clinicians are going to have to fill in
those roles. I am relieved to hear that they will not be
impacted.
I think we will want to hold you to that because I am
concerned that there is a crisis of morale right now at VA. I
was actually really shocked when I spoke with some frontline VA
workers at our Minneapolis VA just the other day. I was pretty
shocked when they said. Two of them said, I question whether
the secretary actually cares about veterans. I was really
devastated to hear that, Mr. Secretary, and I would assume that
you would be, too, because despite our political differences, I
genuinely believe that every person in this room cares about
serving our veterans, including and especially you.
You know what it means to be put on the uniform and serve
our country, Mr. Secretary. I have immense respect for that. I
have to say it is troubling to me that VA providers caring for
my constituents feel this way. These are your employees, Mr.
Secretary. These are the people we trust to care for our
veterans. They are scared right now. If we continue to go down
this road of firings and what they feel like is intimidation,
we are going to lose good people and it is going to be veterans
that pay the price. I know neither one of us wants that. My
question for you is, what are you going to do to improve morale
at VA?
Secretary Collins. Well, first and foremost, being here.
Being in every interview that I have. I have spent 100 days in
which we have tried. We have been, instead of working many
times on issues that we have found, looking at how we can
improve and do this, I have been fighting rumor and innuendo.
This is the problem that I have from day one. There are reasons
that people are scared, and it is not coming from my office, is
coming from folks who actually talk about the things that I
have talked about earlier. When we have reports saying you are
going to fire 15 percent of the doctors at Minneapolis, that is
just a lie.
Ms. Morrison. Well, but Mr. Secretary, respectfully, that
15 percent, 83,000 number came from your people.
Secretary Collins. It did come from my people, but it has
no context to actually firing frontline employees of which I
have talked about. Here is the deal. I have said it many times,
I repeat it every time, that healthcare providers who provide
that frontline care, even the ones that you mentioned earlier,
are not included in this. Yet every time I turn around, there
is another article or there is another someone in the community
or a Member of Congress or otherwise, they are saying these
radical cuts, these radical things. I am having to sit here and
fight about this the whole time when I have actually said it.
My question is, why is the voices of those who say this is
going to hurt being processed and amplified when the very one
from the Secretary of VA who is sitting right before you is
saying, this is the process that we are going through?
Ms. Morrison. Mr. Secretary, we would welcome you to this
committee anytime. Please brief us, give us some transparency
so that we can reassure VA employees. I do want to ask one
other question. The VA center for Women Veterans sent out an
email blast just last night that said it was embarking on an
ambitious goal to enroll 1 million new women veterans in VA. I
think that is commendable. We have discussed today that women
veterans are the largest growing group of veterans and of
course support the effort to bring more women veterans into VA.
Could you share a little bit more about your strategy for doing
so. Surely a significant increase in demand will require more
clinical staff and space, will not it? What is VA's plan for
reaching this milestone that you have set?
Secretary Collins. One I think the milestone is great. I am
glad you recognize that we are looking at that. Encouraging.
Again, it is, this is hard to overcome at this point. I mean,
because without going through the process here of where we are
actually looking at cuts and putting people back in places
where they need to be in which we could actually increase
capacity in some of our clinics and some of our hospitals,
which will not affect and actually would welcome these going
forward. I think that is the fundamental issue that we are
dealing with here, is there is an understanding of what we are
trying to do and how that is actually playing out.
Ms. Morrison. Mr. Secretary, I hope you will come back to
our committee and testify about all of these issues. We would
love to know what your process is. Thank you so much for being
here. Mr. Chair, yield back.
The Chairman. Representative Kiggans.
Ms. Kiggans. Mr. Secretary, it is great to see you. Thank
you so much for being with us. A special thank you for coming
down to Hampton Roads, home to a lot of Navy veterans, a lot of
military veterans. I really appreciate your time, not just
visiting my district, but so many. You have been doing such an
amazing job and, and you are starting to sound like a broken
record, which I guess is good. Over and over again about how we
are not cutting staff and how you are looking out for
physicians and nurses and allied health partners. I think that
is important just to repeat that, and we will try to repeat
that as well on your behalf.
I know that one of the VA's statutory missions is training
for health professionals, and that includes nurses. We have a
nursing shortage right now across the board, not just in the
VA, but on the civilian sector. I am thankful for the VA's
investment in educational opportunities, including residency
programs and clinical opportunities. You have 68 nurse
residency or clinical programs, including 34 primary care
slots, 26 mental health slots, and you have expanded that to
eight geriatric and extended care slots. As a geriatric nurse
practitioner, I am certainly thankful for that. I think that we
have a lot of older veterans, and I know that with aging of
America, just in general, we need to be focused more on
providing geriatric specific health care. Thank you for
recognizing that.
I wanted to offer some comments on behalf of what I
consider to be an underutilized resource. It is no secret that
sometimes physicians sometimes feel encroached upon when we
integrate advanced practice nurses, but their superb care
cannot be overlooked. I think we have talked about that even a
little bit today. Just to present some evidence-based research,
I know that patient safety outcomes are identical regardless of
whether for example, anesthesia is provided by a physician or a
Certified Registered Nurse Anesthetist (CRNA). There is no
secret that we have a shortage of anesthesiologists. We have
nurse anesthetists who are available and there is a lot of
debate about integrating them into VA healthcare. CRNAs are
often the sole anesthesia provider in rural hospitals, ensuring
safe obstetric outcomes. Then we have got 31 facilities in the
last VA Office of Inspector General (OIG) report that cited a
severe shortage of physicians and anesthesiologists, including
my Hampton VA Medical Center. The Trump Administration has
consistently supported the removal of barriers for CRNAs and
other advanced practice Registered Nurses (RNs).
During the pandemic, the administration went even further,
suspending Medicare supervision requirement for CRNAs to allow
them to practice to the full training, their full training to
provide critical care when the Nation needed it the most. At
the same time, the VHA put out a memo calling for facilities to
remove restrictions on CRNAs. These recommendations are all
supported by the National Academies of Sciences, Engineering
and Medicine. Calls to remove restrictions on CRNAs are well
supported by data. I am just a little bit, I would love some
clarification on what your plans are as the new VA secretary to
integrate advanced practice nurses especially we have this lack
of anesthesiologists. We have a group of people that can
provide that care. Just would love to hear from you what your
plans for integration are.
Secretary Collins. Thank you Councilwoman, I appreciate it.
I have enjoyed working with you and also working with, you
know, opening facilities. I think it was really interesting
that one of the issues that we had to deal with early on was in
actually your district in which there was a discussion about
opening a facility and was said because of hiring freezes and
everything else, it was not opening as it should. The reality
was it was opening just as all the others have opened and that
is with a gradual rollout. I appreciate your work there. We are
looking at our scope of practice issues on many fronts. This
was a project that was began a lot before me a couple of
secretaries ago. We are still continuing to look at that as you
have heard even today on this, there is a lot of disagreement,
especially when it comes to certain areas. We are trying to
find what is the best balance, not only for VA, but also for
our employees as well. We are still looking at that issue and
we will be getting more input as we go forward.
Ms. Kiggans. We would love to work with you on that. As one
of two nurse practitioners here in Congress, we fill critical
health care shortages and gaps where I think our care is
valued. I know that the VA is always on the forefront of
wanting to provide the best patient care. Just please do not
overlook advanced practice nurses and the role that we play.
Then just to say, switch gears from healthcare a little
bit. I know we have talked a lot about healthcare and VA
medical centers, but there is a lot of other veteran benefits
that you will oversee now, including GI Bill benefits and even
healthcare. VA home loans, you know what exactly veterans are
entitled to. I know as a veteran with a veteran family, it has
been frustrating sometimes to actually access my benefits and
to understand what that looks like. You and I spoke at a
roundtable briefly just about what that online component looks
like. For example, MIL Connect does not talk to the VA website,
and I feel like there is some technology challenges there. It
creates a lot of frustration on the part of veterans. When I
share with my veteran friends, how hard is it for you to access
your GI Bill benefits or to transfer those to your children?
All of us share the same level of frustration.
With our VA budget that we have, can we or do you have any
plans to dedicate a portion of that into upgrading this
probably outdated technology? I think that investment of trying
to make it a little more user friendly, that website piece, so
veterans can log on in one place, can see their benefits, can
understand how to transfer their GI Bill benefits to their
kids, what even that paper trail looks like. I got a 15-page
letter about my, you know, my son's, it was my husband's GI
Bill benefit, but transferred to my son and that I could not
really decipher. That was frustrating to me, and I am sure I am
not alone. Just would love to hear your plans about that
technology upgrade and if you could add that to your list of
things to do to maybe make that website just a little more user
friendly.
Secretary Collins. Yes, we are looking at every opportunity
we can to streamline our online access, online portals, to make
it easier to understand. It goes back to something in your
comment just now reminded me that when I actually was able to
access my benefit, I used it for my transferred it to my kids
was I did not even know it existed. This, it came to me when I
was at home base 1 day and I had another officer, we were just
talking about it in general and he said, well, you know that
you can use that money. I said, what are you talking about?
Okay, this just shows you that there is an understanding that
needs to happen even more as we go forward.
Yes, anything we can do in that realm, we are going to
continue to do. It is about putting, this is probably as clear
as I can say, it is about putting that veteran first and saying
how can we make that happen for all of our veterans and make it
easier. I said this earlier this morning. I will say it again
and I may have partially said it here. When the VA, when a
veteran has to call any one of Your offices and 60 percent of
your caseload is VA caseload, when they have to call your
office, it is a fail. It is a mission fail for us, it is a
mission fail for VA. It should not be this hard to get benefits
that are already earned, no matter what the bureaucracy says or
anything else.
Ms. Kiggans. Thank you for that. All those benefits are
important health care, but even the education benefits, et
cetera, et cetera. Thank you for prioritizing that as well. I
appreciate your time. I yield back.
The Chairman. Dr. Dexter.
Ms. Dexter. Thank you, Mr. Chair. Secretary Collins, thank
you for joining us and thank you for your endurance. Like many
physicians, I was trained in VA facilities and proudly cared
for veterans at the Denver VA for 7 years. As a critical care
physician for nearly 20 years, I have cared for far too many
families grappling with post suicide attempt repercussions.
They are looking for answers, support and hope. I know you know
and you have expressed your support for our veterans in dealing
with the fact that they are amongst the most vulnerable people
in our communities. Risk for suicide is very high amongst our
veteran population, and it sounds from your multiple comments
today that this is a top priority for you and you have stated
that multiple times. I just want to verify that we are in that
together.
Secretary Collins. We are definitely in that together and
thank you for your word there. One of the things, if I could
just interject here, most people do not realize it is not just
75 percent, it is closer to 80 or 90 percent on 60 some baby
docs who all come through the VA. What I would love to have and
have your help and the other doctors help. How can we keep
them? Some of that is actually, by the way, if you want a bill
recommendation that you might want to carry, let us raise the
caps. Yes, get my caps raised so I can actually hire doctors at
a rate that is better than what we got right now.
Ms. Dexter. Love to work with you on that. Former Inspector
General Michael Missal was dedicated in his work to end
veterans suicide as well. Under his leadership, the Inspector
General's office issued, and I just brought a few report after
report after report laying out steps to better protect veterans
who are at risk for suicide. If we are committed to expanding
with every effort, every dollar to prevent veteran suicide, you
would think our administration would have wanted to keep him
around. Instead, he was fired by President Trump along with at
least 16 other Inspectors General against across the Federal
Government, just days after his taking office. Secretary
Collins, why did President Trump fire Inspector General Missal?
Secretary Collins. I have no idea. You would have to ask
him.
Ms. Dexter. Okay. Since Missal's firing, we have been
without a permanent inspector general to hold your department
accountable. It is, as you know from oversight, it is an
important role. You, Secretary of Collins, have taken actions
that have inadvertently put veterans at risk with the firing of
24 direct support line veteran crisis line support staff. I
know it was not the direct answerers of the calls. I know you
have rehired those VA workers, but can you tell me, did you
approve those initial firings?
Secretary Collins. The probationary firings were approved
in my office. I mean, that is what we went forward, is
following the directions that we were given.
Ms. Dexter. Okay.
Secretary Collins. Also, frankly, the way it also the
trigger mechanisms for those that needed to be exempted.
Actually, the crisis line showed that they actually worked
because once notified and that that got caught up, it was
actually put back in place.
Ms. Dexter. Yes. No. Their hiring back is important,
clearly. I think that true to what Congresswoman Morrison was
talking to, there is a lack of trust right now in the VA and a
fear that many of us are hearing about. Nearly 4 months now
after that firing, the President has now nominated a
replacement, Cheryl Mason and Secretary Collins, Ms. Mason is a
current political appointee at the VA who reports directly to
you, is that correct?
Secretary Collins. Yes.
Ms. Dexter. What concerns me, Mr. Secretary, is that we
have reason to believe that Ms. Mason helped transition
President Trump into office and has played a role in cutting
VA's workforce, blocking staff from contacting agency
attorneys. As my colleague Ms. Brownley pointed out earlier,
suggesting or forcing that VA staff sign on to non-disclosure
agreements. When considering her track record, it is clear that
there is a conflict of interest here. She has been part of
executing the Trump agenda and now theoretically will hold that
same administration accountable in an oversight role. Secretary
Collins, veterans and their families deserve leaders who put
them first, especially when stakes of life and death are at
play. Do you agree that we must have someone who can be seen as
impartial and without conflict in this role of Inspector
General?
Secretary Collins. I think the President has nominated
someone who will actually do that, who has actually worked
through two administrations. She actually worked under the
Biden Administration in the VA. She has worked inside the
system for many, many years. If you look at her total work
experience and how she goes about it, I think she will be a
great candidate for that.
Ms. Dexter. Without question, she is a good candidate. I
think the concern for me is her role with the administration
and also as a political appointee serving the people that she
actually is going to be appointed to oversee. Regardless of
whether or not she can do that without partisanship or favor,
the potential conflicts exist or at least people the premise or
the suggestion of conflict exists. For the record, our shared
commitment to advancing an inspector general who can fulfill
their statutory obligation to be independent and objective in
executing their duties is something that we share. Is that
true?
Secretary Collins. Yes. I believe the President's choice,
Ms. Mason is, will fulfill that.
Ms. Dexter. Okay, great. I also appreciate that members of
this committee know from direct outreach, including what we
just heard again from Dr. Morrison, that VA employees have
concerns about the culture of the VA and have shared that there
is a fear of retaliation for people who speak out. Members of
this committee have also experienced a lack of responsiveness
when asking to visit a local VA, which is really quite
unprecedented. Mr. Secretary, how are you going to rebuild
trust in the VA for the employees as well as the veterans that
you serve?
Secretary Collins. Continuing Congresswoman, exactly what I
am trying to do right now is I look, I have freely come up and
talked about issues that are hard and also say just judge what
is actually happening and not what is being talked about. This
has been the issue that I have had to deal with from the day
one that I got in was actually dealing with many times not
accurate information.
Now we can disagree about how some of this is to go about
and there may be some things that we could do differently. Also
having to deal with just the blatant disregard for reporter and
other backlog actually hurts the problem. For me, it is just
having to go forward and tell the truth as I have it, as we are
actually working it and work to just rebuild that visit by
visit by visit that I go to. What is interesting though, and I
was not joking with Dr. Morrison as well, is in Minneapolis and
in other places as well. Once I am there and able to talk to
our hospital staff, talk to our senior leaders, leadership and
see them, they are actually understanding what my heart is. I
just got to do this one at a time and with every member here.
Ms. Dexter. I appreciate that. I certainly appreciate that
showing up is what builds trust and clearly you are doing that
in good honor and spirit. I appreciate that. We will be
watching. We certainly are looking for our veterans to be
served to the best of our ability as a Nation. I hear your
commitment, and we look forward to further conversations. Thank
you, Mr. Secretary
The Chairman. Congressman Self.
Mr. Self. Thank you, Mr. Chairman, and thank you, Mr.
Secretary, for spending so much time with us. First of all, I
have a--I want to thank you personally for, for deciding that
chaplains would be able to minister in the conscience of their
particular dogma in the Coatesville, Pennsylvania VA clinic.
You personally made that decision that they will be able to do
that across the VA, and I appreciate that very much.
I am glad that you are refocusing the VA from an employment
agency and a mortgage company back to veterans. I will tell you
that we are used to in this committee, the VA coming to us and
telling us what inputs they have put, what they have done, what
they have spent, but very little results, very little outcomes.
It is been a breath of fresh air today for you to tell us what
you are actually achieving. I know that you have responded to
what we call the lies of the left multiple times today. They
have used the word fear, they use the word lack of trust, and
you have responded every time to it. You have also had to tell
us what the laws is because we have heard it seems to be an
issue that my colleagues across the aisle have it hard to
understand that there are laws of this land that you are going
to obey as you provide for our veterans. The complexity of the
VA is not worthy of a yes or no answer in most cases, and I
applaud you for working through that with them.
The only question I have for you, and take as much time as
you would like, is you have answered several questions on the
electronic health records, but we have been told that it was
going to be 50 billion versus the 9 billion that we have
already spent. Can you just share with us the plans going ahead
and take whatever time you would like Mr. Secretary.
Secretary Collins. I appreciate that. I wish I could go
into the entire because we are now looking at out years of a
contract that should have been finished in 28 as it was
originally done and that is frankly not going to happen. I do
not think anybody on this committee would take issue with that.
What we are looking at is finishing up the contract under the
terms we have now and we are actually actively renegotiating
and trying to get more out of Oracle and others from their side
to see how we can do it. Actually so far they have stepped up
and agreed to many things as we go forward. Yes, there will be
a time as we look forward in how to implement this past that 28
timeframe as we go forward. I am not at a position right now to
say what those numbers would be, but they will be something
that we will share with the Committee as we go forward.
I really wish we was not here at this point. This is an
issue that it could have been handled a lot differently. I
cannot comment. There was, I know, some discussion that we had
earlier, which I respected on the history of this program. I
had no involvement in that. It may have gotten started bad, but
I have been given the task of finishing it. I have been, I have
been given the task of taking the mess and cleaning the stall.
That is what we are going to do. I appreciate the work. Again,
what was really also very disturbing to me, Congressman, is,
and this probably emphasized more than anything what I am
facing as we try to make change at the VA. That is what I have
always known, is that we have always done it this way before
syndrome, and I have seen it across the board. They come in and
when I ask questions, I feel like that I am have basically
reverted back to childhood. I ask why about everything because
when I see stuff come in like why do we do this? Why is this
happening? Why is this person not held accountable? Finally I
think our folks are getting to realize that I am not just going
to accept the answer that, you know, this is what we need to
do.
We have had issues ranging from West LA. We have had issues
ranging from, you know, how we deal with our community care,
how we actually put in processes to make sure that our
survivors are actually getting the care that they need. All
this may not seem like the health records management system,
but it is combined. When I came into this, we had a VA who was
basically, and I remember my first meeting on this, and I am
trying to be as transparent as I can be here. Like I said, I
just want you to know that when I first sat down with our
people, it was basically, we cannot move forward. We are not in
a position, and we are not going to make changes, and it is,
you know, everything is bad. I said, well, that is not a
workable position. It is not workable for this committee. It is
not workable for the President. It is not working for anybody.
We are wasting billions of dollars here on a program that is
not helping our veterans, and also right now is actually
hurtful in some ways in the original rollout.
It took getting over that hump. I am very pleased to say
that after the initial meetings, our staff and Dr. Evans, who I
cannot speak well enough about because he took on the mantle
and he had been sort of, unfortunately, having to ride this
through the storms, if you would, many times when nobody would
listen, and he was having trouble trying to get it through. He
actually has taken that on. I do appreciate his willingness to
sort of redirect the team to say, how can we now get this to
happen? Your question sort of overlaps everything we have tried
to do at the VA is to say, look, let us take a fresh look at
what we are doing and fresh look at how we are doing it and why
we are doing it. Some things may change, other things may not
change.
Years ago, an older gentleman who was in the church that I
used to pastor made a comment. He said, Preacher, he said, I do
not want you to change. He said, we are making some changes. He
said, just always remember, he said, I will support you and we
will change. He said, but before you move a fence, know why it
was put up? I thought to myself at the time, I was not sure
about what he meant by that. Then it made sense, is, you know,
sometimes you do not know what is on the other side of the
fence. We have tried to do that all along. This EHRM process is
something that, why did we not get to where we are? Why was it
at and what. We are now knowing why the fence was put up, and
we are moving the fence to get it really where it needs to go.
It is an endemic not just to this, but to other things as well.
Mr. Self. Thank you for that, Mr. Secretary. Mr. Chairman.
I yield back.
The Chairman. Representative Mace.
Ms. Mace. Thank you, Mr. Chairman. I would thank the
Ranking Member and Secretary Collins. Welcome. I look forward
to working with you as we refocus the VA on what is always
meant to do serve veterans and not push social experiments. For
the past 4 years, veterans took a back seat to identity
politics, gender ideology, DEI dogma. Every dollar wasted on
the woke agenda was a dollar stolen from real care for real
heroes. President Trump has given you a clear mandate in the
circus, restore the mission. Let us talk biological reality,
something the last administration ignored. President Trump has
made it clear there are two sexes, male and female. They are
assigned at birth, they cannot be changed and taxpayers should
not foot the bill for surgical or chemical mutilation. How is
the VA implementing President Trump's directives to restore
biological reality and end taxpayer funded sex changes?
Secretary Collins. By doing exactly what the EOs call for.
We are no longer doing that. We stopped care. If they were
currently in hormonal treatment, which is or they are coming
off of it for from DoD, they are going to continue that because
there is some health issues associated with that. That is now
being taken care of. We are not starting and we are also not
getting into sex change operations. Those are just not
something that is the VA is going to be doing.
Ms. Mace. Yes, what we do, what these people do to
themselves or doctors is it is crazy and it harms them
physically and mentally. What steps has the VA taken to
redirect money previously spent on gender ideology back toward
actual letter and care?
Secretary Collins. Well, I think where we are redirecting
money back is to our, you know, paralyzed veterans, amputees,
moving the moneys to where it can be best spent. Again, I think
that is the overall function of everything that we do is making
sure that our healthcare system has is just my priorities is
making sure our veterans have the benefits that they have
earned.
Ms. Mace. DEI is out, equal opportunity is in, equity
politics and racial discrimination disguises virtue and virtue
signaling have no place in the VA. How many DEI related
contracts has the VA canceled and what was the price tag on
those savings?
Secretary Collins. There were a number of contracts and the
total value we saw on those contracts was about $6.1 million.
Ms. Mace. How has that freed up resources to be reallocated
to improve veteran care?
Secretary Collins. As we said, it went back toward
allocation toward community care and prosthetics as we were
looking for.
Ms. Mace. As an animal lover, I applaud the VA for ending
painful, unnecessary area experiments on dogs and cats. This is
a bold step under President Trump. Congress has since required
the VA to phaseout primate testing by 2026. What is the current
status on phasing out animal testing, particularly on primates?
Secretary Collins. We are on track to make sure that that
directive is met. In fact, in some instances, we may be even
able to meet that goal sooner.
Ms. Mace. Is the VA exploring any innovative non animal
research methods to replace outdated and inhumane testing on
animals?
Secretary Collins. Yes, we are always looking for ways to
do, to make the research as valuable to those that need it.
Also, the again, we are in an area in which prosthetics and
that kind of information with amputees is something very
central to the VA. It is something we are looking at.
Ms. Mace. Then what can other agencies learn from the VA's
leadership in ending these cruel and obsolete animal
experiments, do you think?
Secretary Collins. Well, I think, you know, judging from
the reaction to Congress also, what the President has also
stated and laid out, I think is just following the rules as we
go forward here.
Ms. Mace. Thanks to your leadership and President Trump's
direction, the VA is finally being restored to its rightful
purpose, delivering world class care to those who serve their
country. I look forward to continuing this mission with you. We
wish you a lot of luck and many blessings to get the job done
and we believe in you. I yield back. Mr. Chairman. Thank you.
The Chairman. Representative Deluzio.
Mr. Deluzio. Thank you, Mr. Chairman. Secretary, long day.
Good to see you here.
Secretary Collins. Good to see you as well.
Mr. Deluzio. Want to talk about clinical trials and some of
the reporting on the impacts of whether it is hiring freeze,
contract terminations, firings, or some combination of those
things. Two Pittsburgh clinical trials, according to reports,
had not started as of May 6th. These were to treat veterans
with advanced head and neck cancers. Have either of those
resumed or started?
Secretary Collins. Well, one, they never started before,
and they are starting now because we are now actually reaching
out to veterans to be a part of this trial. Those were not,
they had not been started before any at this point. You cannot
stop anything that had not started.
Mr. Deluzio. They have started since May 6th.
Secretary Collins. They started in the last little bit.
They are getting ready right now. They are recruiting veterans
this month.
Mr. Deluzio. Okay, so both of those have started. When were
they originally planned to start, because the reporting here is
that these were delayed or stalled because of some combination
of firings, contract terminations, probationary impairments.
Secretary Collins. Yes, not that we are aware of. I think
the interesting thing is here is before any of these other
things got involved is they had not recruited patients for
these trials.
Mr. Deluzio. Just to be clear, when were these supposed to
start? Do you know?
Secretary Collins. I would assume they have been around
before the hiring freeze. It was supposed to start probably
earlier. I would have to get a direct date on that. I am not
going to try and guess.
Mr. Deluzio. I would appreciate a response on that.
Secretary Collins. Okay, no problem.
Mr. Deluzio. There are others that were identified in some
of this reporting, specifically at VA Pittsburgh. I think seven
in total, including those two that I have asked about that the
impact again of whether it was firings, contract terminations,
on and on were that they stopped enrollment in several of these
clinical trials, and these were to treat veterans suffering
from advanced lung cancer, kidney transplantation,
cardiovascular disease and others. The reporting here is that
the planned enrollment was 500, but as of again this reporting
in May, only 75 veterans had been enrolled. Have that, has that
enrollment now continued and are additional veterans being
enrolled?
Secretary Collins. No clinical trials have been stopped. We
have been no cancellations from our decision on clinical
trials. Those are still going on. Any issues in those clinical
trials will be specific to that issue. One of the things is to,
Representative, and I think to understand here we have over
1500 clinical trials going on in the country through the VA, of
which there is no centralized management of that from the VA.
Getting sometimes information about our clinical trials has
been difficult when we started asking these questions because
the VA, as much as we do these clinical trials are working on
them. We have no management of those and how they are started
and where they go forward.
Mr. Deluzio. Secretary so you said they had not been
stopped, which is a little different than what I asked you,
though what I asked you was whether enrollment had been paused.
That is the reporting that 75 folks, 75 of my fellow veterans
have been enrolled rather than the planned 500. Again, the
reporting is that enrollment was stalled during this period of
firings, hiring freeze, contract terminations. Is that true?
Secretary Collins. They have not started, as far as I know.
They are still recruiting people for those trials.
Mr. Deluzio. I understand that, but was the recruitment of
enrollment stalled during this period?
Secretary Collins. Not that I am aware of.
Mr. Deluzio. Okay. I would like to know if you could find
that out for us.
Secretary Collins. I will find out.
Mr. Deluzio. Because my concern, as you can imagine, is
whether it is those first two clinical trials on head and neck
cancer being delayed to start or these other at least five that
I am aware from reporting being stalled. Some veterans may not
have gotten an access to that kind of care in these clinical
trials, some of those veterans may have gotten sicker. God
forbid somebody may have died. We should know whether any of
those things happened. I do not want to guess. I do not want to
put you in the spot to guess, but we should know that.
Secretary Collins. I appreciate the concern there. Also
remember one of the things that I want to make very clear here
is we have talked about this a little bit in going forward. The
clinical trials are used to assess new treatments and new ways
to going about it. These veterans were not, and I say this
simply not because of what you said and I will be frank with
you, but what I have heard from others and they saying these,
that they were kept away from all health care, that is just not
true. They were still getting the health care through the
Pittsburgh. The clinical trials that had not been started,
especially in the head and neck cancer had not started. I think
that is. There is two distinctions here we have. I am willing
to work with you to look at whatever.
Mr. Deluzio. Great. I would love to know for each of those
trials and as you say, you are still getting healthcare. It
might be that that clinical trial could be a life-or-death
outcome. It might not be. I think it is important that someone
is got a chance who is in a horrible situation. Advanced head
or neck cancer.
Secretary Collins. Yes, I would hope that also.
Congressman, I would love to work with anyone on this committee
also as we go forward how we can actually streamline this is
something I am looking at now as we have gotten into these
conversations more and more on clinical trials that we actually
need to have in my opinion a better sort of command and control
system so that we know where these are going on and if there
are any issues that we can help with as we go forward. As you
said, some may have gotten help but also some may not have
worked. Are we making sure that that information is available
across the system wide so that we know this actually worked,
but this did not. We do not have that information.
Mr. Deluzio. Look, and we all know this, the research VA
does has led to some really groundbreaking interventions and
treatments for veterans. We have to continue that. I want to
spend the last minute and a half or so about morale. I have and
my team have heard from physicians and other folks who work at
the VA have heard from veterans. There is been plenty of
reporting and discussion here today about mental health care in
particular and some of the reports of impacts on the return to
work and clinicians being placed in an environment where they
cannot have a confidential discussion with patients. I have
talked to physicians myself and heard some of those concerns. I
will throw out an example of someone being put in a room where
there is another VA employee that would betray confidentiality
with a patient seeking mental health care, asking for
headphones or a headset to be able to have some confidentiality
being told, no. Should that happen? If not, what are you doing
to fix that?
Secretary Collins. No, it should not happen. I think one of
the things is to remember is all of VA centers are secure
facilities and they should not be put back in. If they are
coming back into work, it would go against. I said, I made this
statement earlier, if they are being brought back in an
environment in which they were not supposed to be, then that is
a failure of the leadership to bring them back in because it is
also a direct violation of the policy of bringing people back
to work. This is not something that we have looked at and many
times we have asked for incidences when it is been reported and
then gotten back to it, and it worked.
Let me just be very clear. If they are coming, if there is
an issue, we would love to hear about that. Also, also, it is a
direct violation of the policy coming back to work to not be in
an environment in which they are not supposed to be in. If we
have a supervisor who is doing that.
Mr. Deluzio. In the 10 seconds I have left, Secretary, if
someone is raising those concerns, I would love a commitment
from you that they will not face any consequence for voicing
objection.
Secretary Collins. No. I think that we need to know, and I
think this is what we have proven, and there is been areas in
which there were some concerns and we have actually made
exceptions to say no. The telework continue off with premise
can do.
Mr. Deluzio. Mr. Chairman. I yield back.
The Chairman. Thank you, Ranking Member.
Mr. Takano. Thank you, Mr. Chairman. Thank you, Mr.
Secretary for being here today, Mr. Secretary, you have
testified that, quote, no one has discussed firing doctors or
firing nurses, end quote. No one has discussed this. That the
15 percent figure floating around is just a goal, not a
directive. Then I need you to explain this spreadsheet that I
have behind me. We are handing you a copy of this spreadsheet.
It was circulated by your own Reorganization Implementation
cell. It asks VA staff to calculate the savings from a 15
percent cut to every VHA position, including frontline clinical
roles and it says cutting nearly 4,000 nurses, for example,
would save a billion dollars. Cutting 400 psychologists another
$110 million. The list goes on. Health aides, pharmacists,
housekeepers, et cetera. Now, if your testimony is true that no
one is looking at plans to cut these jobs, why did your team
ask for this analysis?
Secretary Collins. Ranking Member, looking at this right
here, this is exactly why we are here. This is a leaked pre-
decisional document that is not helpful. It is not working
because here is the end of the day--no, no, I am going to
answer this
Mr. Takano. No claiming my time. Mr. Secretary, it is my
time.
Secretary Collins. Well, it is my answer.
Mr. Takano. You have said publicly that no one has
discussed that would be interpreted. No one has discussed this
at all. We have a document, whether leaked or not, that
establishes that these cuts are being discussed.
Secretary Collins. I said that I have made clear we will
not be cutting frontline health care.
Mr. Takano. Your subordinates are discussing this. They
must have gotten the directions from somebody.
Secretary Collins. They did. Well, I have been very public.
It is just like your staff if they talk about something you do
not know about.
Mr. Takano. You understand why there is a lack of
credibility from the public on this sort of.
Secretary Collins. There is a lack of credibility.
Mr. Takano. This is not speculation, Mr. Secretary. It is a
VA document. We have asked your head of HR, Mark Engelbaum for
answers. We have actually asked your subordinates about this.
He promised a follow up and we never got it. I am asking you
now on the record, why did your team request this analysis and
what are you preparing for?
Secretary Collins. Well, if I have to explain this in a way
that makes sense, let me just say this, if you----
Mr. Takano. Do not talk down to me, sir, I am just asking
you a question.
Secretary Collins. I am just answering your question. If
you let me answer it, I will answer it.
Mr. Takano. Please. Time is ticking.
Secretary Collins. This right here is an overlook of our
entire organization. To see what they did here is fine.
Whatever they are looking at is fine. When it comes to the
Secretary of VA, which is me, and the direction that we have
given to make sure that health care is prioritized, to make
sure that our veterans are getting the desire that they need.
When I have told you that when we are talking about this and
exempted 300,000 positions, that is what happens at the VA. Can
they have other conversations that involve other things?
Possibly. Coming from me, it is not.
Mr. Takano. Okay. Well, thank you. Let us move on. I would
like to point out that you have set a goal of 83,000 VA
employees. I know it is not a fact. It is a goal. I just want
to make sure we go over this and we have some agreement without
cutting clinical staff. There simply are not 80,000, 83,000
employees elsewhere in the department. If you look at this
chart over here, you have already cited these numbers yourself.
If we add up all the VBA, NCA, and all the other positions, it
hardly adds up to 83,000. You are going to have to cut deeply
out of the VHA column there.
You know, there is just simply no way that that can be done
without that. I would also like to move on and say it is also
our understanding that on the VA Human Resources SharePoint
there is a document that lists every employee hired since 2019
with their name and occupation. Will you get that document to
us in digital form?
Secretary Collins. I am not familiar with the document you
are talking about.
Mr. Takano. If it does exist, I mean, we know it exists,
would you get it to us? It just.
Secretary Collins. I do not know what you are talking
about. Also, if I can answer your other question.
Mr. Takano. Okay, no, I would like to move on to that. I
would like to move on to the Deferred Resignation Program
(DRP). There is been a lot of confusion about the Deferred
Resignation Program.
Secretary Collins. Okay.
Mr. Takano. It is my understanding that you have made
employees who are in positions that provide direct care exempt
from this program unless there is an additional review by VA
leadership. How many employees who directly provide care or
support or support the provision of direct care have submitted
requests for DRP, early retirement or retirement?
Secretary Collins. The last number I had on that was about
2,500. About 2,500 of which all of them will be probably, all
of them are going to be denied.
Mr. Takano. You are going to deny them. You are telling me
today that you are going to deny all of the clinicians who
applied for DRP?
Secretary Collins. That is what we are looking to do. I
will say this. As we look at this, one of the issues of DRP is
making sure that employees who want to be here are not. We are
not looking to get rid of any clinicians. We are not looking to
get anybody. In fact, we are taking.
Mr. Takano. That is fine. I got it. 2500 clinicians have
applied for DRP. You are going to deny those.
Secretary Collins. We are denying clinicians. That is been
done.
Mr. Takano. Have you thought about why frontline staff are
requesting DRP in the first place? To me, it is an indictment
of your leadership that valuable clinicians that are hard to
recruit, hard to onboard, that that staff who loved serving
veterans now want to leave.
Secretary Collins. Well, have you looked at actually the
ones who may want to leave and how close they are to retirement
to start with? Have you actually looked at where they may be? I
have not looked at those, but we are going to keep them in the
system. Your question may sound like it is ominous, but also
you have not answered the other questions. Who are these people
actually are.
Mr. Takano. Okay, well, so fine, let us move on. Mr.
Secretary, are medical center directors exempt from the hire
and freeze? Medical center directors?
Secretary Collins. Yes.
Mr. Takano. They are? So to be.
Secretary Collins. They are part of the clinician side.
Yes.
Mr. Takano. Okay, well, to be clear, the list you have
provided to Congress does not include medical center directors
as exempt positions. That is not.
Secretary Collins. It is been updated.
Mr. Takano. Now it is. Now, according to a report that VA
just submitted to Congress last week, there are 12 medical
center director vacancies, eight of which cannot be hired due
to the freeze. The chart behind me shows a page from the report
with those vacancies listed and the status, which is that
quote, recruitment is on hold due to hiring freeze, end quote.
Secretary Collins. We are working to fill all those. When
we find those, we are working to get them hired. Those are many
of those were actually predecessor to me.
Mr. Takano. All right, well, this document shows that they
are not. They are empty because of a freeze. You will commit to
exempting medical center directors from the hiring freeze and
prioritize finding leaders for those facilities as soon as
possible.
Secretary Collins. Already have.
Mr. Takano. Wonderful. Well, Mr. Secretary, I just want to
know, can we get a RIF plan before you execute it and not
execute it for 30 days so that the public veterans in Congress
can examine it before it is put into force? 83,000 is a lot of
people to cut.
Secretary Collins. We are going to provide everything we
are supposed to under RIF to make sure you have every
notification you have.
Mr. Takano. Well, that is not the same as providing us with
the draft plan so that we all can discuss it together. That is
83,000 is a huge change.
Secretary Collins. Again, I was not able to answer your
question because you did not allow me to discuss the 83,000.
Mr. Takano. I will take that as non-responsive.
Secretary Collins. I will take yours as not wanting the
answer
Mr. Takano. I yield back.
The Chairman. The gentleman yields back. One thing I have
discovered about today is that normally the Ranking Member and
myself, we ask our questions first. What has happened is I
think we have questioned you to the point that I think we got a
lot of answers of what my questions were going to be. Maybe I
am going to ask you this. What is something that has not been
asked that you feel is vitally important to put on the record?
Secretary Collins. Mr. Chairman, I think it is not what
necessarily has been asked, but I think it is from the
perspective of how it was asked. This is the fight that I, that
you and I have spoken about and I have spoken to many. We just
got through with it. Please hear me. To everyone here, I
consider the Ranking Member a friend. We came in, we vehemently
disagree on this. I think the problem we have here is something
that I refuse to talk about in a setting like this or where we
actually have living proof of pre-decisional documents being
leaked at the, basically even against section. You know, the,
the law of Atlanta. These are not supposed to be leaked. We see
this. If they want to go to Inspector General, whistleblower,
those are all there for them. This is the exact reason I was
asked earlier about NDAs. Okay.
Now what is happening as you sit here and we put up forms,
we are continuing to fester this idea that there is no way we
can do what needs to be done without hurting veteran
healthcare. I refuse to accept that because one thing that was
not accepted and I was not, you know, able to continue. There
are 409 positions in VHA. When we look at that and you look at
some of the areas that we have in VHA, which also includes call
centers, which also includes staffing issues, they also include
procurement, they also include HR. They also include, include
processing of payroll, which these hospitals were not supposed
to be doing. By the way, those numbers add up to significant
amounts.
What was not said just a minute ago is that just last year
the Biden VA in the VHA in their own internal documents stated
that they could get rid of 28,000 people. This is the Biden VA
6 months ago. Have not heard that. 28,000. Now, if you go by
the numbers that I have been told today, oh, you cannot do that
without hurting healthcare. Then we are saying Biden's going to
hurt. The Biden administration will not hurt healthcare. No, I
think they actually looked at the same numbers we did, Mr.
Chairman, and determined that of the frontline healthcare,
frontline disability workers and all, there is a lot of
interest in looking at are we being as efficient as we should
be. I believe that as we look at this, you are going to find
those answers. That is why we have to do this in a very
methodical way.
Everybody wants to run forward and say, here, give me your
plan, because you know what? Then they want to go out and say,
you are going to cut here, you are going to cut here. They are
going to put fear in my employees, and they are going to put
fear in my veterans. That is wrong. It is wrong. You see no
other industry in this country who are making decisions about
their workforce, who do it in a way that we are talking about
being told here. We are doing it in a methodical way, using
career employees who have been there forever. We are actually
looking at-actually using consultants. We are actually using
our political folks to get this into the record to say, here is
how we look at this, looking at the examples of private
industry and knowing that we are not private industry. We are a
veteran's organization that gets to treat the best people in
the world, and that is our veterans. We only have one mission,
the veteran. Over time, we have gotten away from that.
When you look at these numbers, I have a question for
anybody that wants to look at this. Why do we have a middle
management if you order a structure system that keeps our
clinicians out from seeing patients and then saying that if we
look at anything of a doctor or nurse who is not seeing
patients, that we are going to affect healthcare if for some
reason they was not around or if they quit on their own? I
think what we are saying here is there is a large understanding
gap that unfortunately has become political. I could go along
almost every member except the new ones, because there is a lot
of new on this committee, Mr. Chairman. I can go from Ranking
Member to you to everybody else and find quotes on the Senate
side as well. VA needs reform. VA needs efficiencies. VA needs
cost cutting. VA needs all these things, both Democrat and
Republican. Then all of a sudden you have somebody like myself
who is just. I say this in knowing that somebody will use it
against me. I am just a simple country lawyer from North
Georgia who simply says, maybe we actually ought to look at
this and maybe we actually ought to ask the questions on why we
have this and why do the VSOs and why do others always seem to
have issues that they want to get fixed at the VA? All we do is
continually to perpetuate the problem.
I am not willing to do that anymore. We can disagree. The
President told me to do one thing and that is take care of our
veterans. Yet in this timeframe, which was not brought up and
we are going to bring it up even again by the Biden
Administration, they changed the wait time issue to make it
more transparent so that we. In fact, I got this last week when
I said the primary care days. Let me just repeat this, it is
worth repeating. Primary care rose from 15.7 to 24.3. Mental
health rose from 14.7 to 20.4. 24 days for specialty care rose
to 38. The backlog, by the way, interestingly enough in 2019
before the COVID was under 60,000 on the backlog. Of course, it
went up during COVID because we could not get our appointments.
It is still at 260,000. When I came in, in less than 100 days,
we have actually brought that down 21 percent to 200,000 and it
is heading south now.
I was actually accused the other day of, well, you are
using flawed numbers, and the VA wait times flawed because the
VA changed the way it does its wait times. Here is the problem.
It was changed under the Biden Administration to better reflect
calculations because the data reinforced above did not reflect
the adjusted change. It plainly shows that the wait times
increased because here is what you need to hear. Wait time
clocks started only after a veteran was contacted by a
scheduler for appointment under the prior administration. In
other words, we did not even start the clock till we reached
out to them. The veteran may be looking to get their help, but
they did not get it. The new method, which was again done under
the previous administration and adjusted through every number
beforehand so there is no apples to oranges here. This came
from Dr. Lieberman, who is our top doctor by the way, at the
VHA.
The method is now calculated on when the schedulers are
called to reduce so that we actually make a queer time. As we
look at this, Mr. Chairman, I appreciate you allowing me the
time. I appreciate the Ranking Member, I appreciate all the
Committee wanting to do good work. What I cannot have is
spending another hundred days as we go forward here because as
Dr. Morrison and many others say, yes there is from people who
have morale issues because they are having to sit here and
listen through wrong answers out of that yield.
Mr. Takano. Yes, I do. Thank you, Mr. Secretary. You know
you are opining about a so-called leaked document. It is
obvious. It is obvious. We are not mushrooms, we are going to
hear stuff. We are going to hear stuff from employees who are
alarmed about the huge, massive changes that are occurring.
That document. We do not get answers to our questions. When we
do not, when there is no transparency, we are going to rely on
whistleblowers telling us the truth. Look, private industry,
sir, would not have fired 2,400 employees and then hired back
1,000. That was indiscriminate firing. Indiscriminate firing of
probationary employees. A memo went out signed by Tracy Theriot
that said they were being fired because of their performance. I
questioned her, and she could not really cop to the fact that
they were fired because of their performance.
I am not even sure really that you personally authorized
all of that or whether it was someone from the Office of
Personnel Management (OPM). She, in fact, said that, that that
memo was actually not, even though she signed it, was actually
not written by her, but was written by OPM, which does not seem
like it came from the Secretary's office. That, sir, was
entered into evidence, into a Federal court. That judge did
indeed rule that they had to be restored. Those probationary
employees. That 28,000 employee cut that you were talking about
from the Biden Administration, the VHA, you know, is related,
not, not due to necessity, but because of a, a shortfall in the
budget. There was a huge shift and acceleration of expense in
the community care, the community care account.
We need to have some space for some straight talk here. We
are not getting it here. Mr. Secretary, I must say I was
pleased to hear you say that you want to make the disability
claims process easier to veterans. I was listening carefully to
your response. I personally do not want to see claim sharks
legitimized. I am not saying you are taking a side on that
gentleman's bill, but I think we have some meat of the mind
here. We do need to. Maybe we need to talk about some
presumptives that would make the process easier and more
veterans would get through that red tape. I am all for cutting
that bureaucratic red tape. We share that goal. We do need to
make it simpler for veterans to get care and benefits. There
are two really good ways to do that.
One is to increase the number of presumptive illnesses, and
the other is to automatically enroll transitioning service
members into VA health care, as my legislation in the Ensuring
Veterans' Smooth Transition (EVEST) act does. I look forward to
your considering supporting that bill and to VA increasing the
number of presumptions of Service connections. I also think it
is possible for us to work together and help veterans and
ensure that VA is a world class institution. I cannot emphasize
enough that VA's unresponsiveness to my questions and letters
is not acceptable. VA's recent habit of canceling long standing
briefings at the last minute is also not acceptable. VA's
refusal to provide briefing materials to staff is not
acceptable. We cannot have a productive relationship if we do
not have the information we need for our Constitutional
oversight responsibilities.
Now, when you told Ranking Member Ramirez that canceling
outreach was not your intended policy, I take you at face
value. I expect that our follow-up questions about this
outreach problem will receive responses with the same candor
and attention. This research issue is, this outreach issue is
not limited to just one district or facility. Now you blame the
issue on quote unquote, malicious compliance. Sir, the buck
does stop with you. I know that is a phrase that you embrace.
If policy is not being implemented correctly, then I say it is
on you. If veterans and employees are scared and feel like they
have to overcomply with a policy that is on you, that should
cause you to re examine the policy as well, not just black the
staff. If you truly want to lead VA, accountability is where
leadership begins. You cannot expect your employees to be
accountable if you will not be yourself.
Now another thing I just want to say is I have gotten
concerns from my colleagues about this directive that any
Member of Congress wanting to visit their VA facility has to
get it cleared through your Chief of Staff. They are having to
take that very literally. They are taking it very literally
based on all that we are seeing coming out of your first 100
days or so in office, that cannot stand. Members of Congress
need to be able to visit their facilities, talk to their
medical center directors and be able to see what is going on.
My job as an elected official and the Ranking Member of this
Committee is to represent the interest of veterans. We cannot
answer questions from veterans or get them information if we
cannot get answers from VA. We cannot represent veteran
interests if we do not have the full picture of how their
interests will be affected. That is why veterans are scared.
Now let me be clear. Veterans are not scared because I or
any other Member of Congress asks a question. They are scared
because you have made massive changes with no plan, no details,
no accountability and no transparency. You have truly, if you
truly believe it is, quote unquote, fearmongering to ask a
question then you should ask yourself why you, Mr. Secretary,
fear answering our questions?
Now, I am proud of the employees who have bravely shared
their stories with us. We are relying on the courage of
whistleblowers now more than ever. I am grateful to the
veterans who have shared their concerns and I will continue to
fight to ensure that their worries are heard and addressed.
Now, Mr. Secretary, if you want to accuse VA employees of,
quote, unquote, malicious compliance, I say you need to examine
your role in creating a culture where VA employees feel like
your directives to require them to implement policies that harm
veterans. Reconsider the cruelty in your treatment of minority
veterans. Reconsider your termination of collective bargaining
rights for the hard working public servants. Reconsider your
role in ending critical programs like VASP because veterans
will now lose their homes to foreclosure unless you put a
moratorium on those foreclosures until we can ramp up the
partial claims legislation.
Reconsider your pause of clinical trials leaving sick
veterans without the lifeline of hope. Reconsider how you will
have, how you have indiscriminately fired employees only to
hire them back again. Mr. Secretary, I truly hope that you will
go back to the central office today and chart a plan to course
correct. That plan should include complete and truthful answers
to all of the questions you were unable to answer today and a
path to true partnership with both sides of this committee.
With that, I yield back.
The Chairman. Thank you, Ranking Member, for yielding back.
I want to actually thank the Secretary for being here and
joining us today and answering every question that was put
before him. I want to say that, you know, we do stand for our
veterans here and we all talk how we want to stand for our
veterans and that we respect our veterans. Some of us in this
room understand that quite often you do not get the birds on
your shoulder unless you know how to be a leader. I appreciate
you for both jobs that you are doing, especially when people
that question it have never even had a stripe on theirs.
I do want to thank you, and I appreciate the responses and
your leadership during this transition. While this budget
request shows real progress, I remain concerned that the VA is
still working through the consequences of poor budget decisions
made under the Biden Administration. The alleged shortfall last
year was not the result of inadequate funding. It was the
result of poor internal controls and a lack of transparency
around how VA managed its accounts. Congress has always
provided VA with the resources it needs, and we will continue
to do so. We need to understand that the money is being used,
where the money is being used, and we need to be able to
explain to the veterans that are taxpayers how it is being
used.
Some of those budget practices that we have seen in recent
years, terrible account coverage, shifting obligations, have
made it harder, not easier, to figure out where we are at as
far as Congress. In the end, it hurts trust in the system. I
look forward to working with you. I thank you for your service.
I thank the colleagues, for the most part that actually dealt
with the questions at hand. Let you answer. I think a lot has
been explained over things that we have heard in rumors that
have flown around, and you've been able to answer them very
well.
We look forward to continuing to work with you and we want
to make sure. One thing that you say is the same thing I say
with this committee. Remember, our VA Is not about the
bureaucracy of the VA it is about providing for the veterans.
With that, that is the best way to ensure that we can continue
with the care for our veterans. With that, this hearing is
adjourned.
[Whereupon, at 6:08 p.m., the committee was adjourned.]
?
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A P P E N D I X
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Prepared Statement of Witness
----------
Prepared Statement of Douglas Collins
Chairman Bost, Ranking Member Takano, and distinguished members of
the Committee, thank you for the opportunity to testify today on the
state of the Department of Veterans Affairs (VA).
Since becoming VA Secretary, I've met many of the men and women who
show up to work every day at the Department with a deep dedication to
our mission - delivering health care and benefits to millions of
Veterans who've served our Nation. They have my sincere thanks, and I
can't wait to meet more of them in the months ahead.
In this same period, I've come to learn what many of you on this
sub-committee also realize: VA is in need of reform. We must do a
better job delivering timely care to Veterans, getting to ``yes'' so
Veterans can get the benefits they've earned, and making sure the money
Congress appropriates to VA is not diverted to non-mission-critical or
even wasteful programs.
In the old days, way back in 2024, discussions in Congress about
the need to reform VA were often just a thinly veiled request for more
employees. But the Department's history shows that adding more
employees to the system doesn't automatically mean better results.
The Biden Administration's record is a perfect example. During
those 4 years, VA failed to address nearly all of its most serious
problems, such as benefits backlogs and rising health care wait times.
The numbers speak for themselves:
The number of VA employees grew by more than 52,000 full-time
equivalents from Fiscal Year 2021 to Fiscal Year 2024. Did all those
extra people make things better for Veterans? No. In fact, VA's
performance got worse, as health care wait times and the disability
benefits backlog increased.
Something has to change, and it's up to us to make that change.
Under President Trump, we are working to solve problems that have
persisted at VA for decades. Our goal is to create a Department that
works better for the Veterans, families, caregivers and survivors that
we serve.
I've never been shy when it comes to addressing tough issues head-
on, and I won't ignore the elephant in the room here today. As everyone
here is aware, we're conducting a thorough review of the Department's
structure and staffing across the enterprise.
As I've said countless times, this review is aimed at finding ways
to improve care and benefits for Veterans without cutting care and
benefits for Veterans. Our goal is to increase productivity and
efficiency, eliminate waste and bureaucracy, and improve the delivery
of health care and benefits to Veterans.
We're going to maintain VA's mission-essential jobs like doctors,
nurses, and claims processors, while phasing out non-mission essential
roles like interior designers and Diversity Equity and Inclusion (DEI)
officers. The savings we achieve will be redirected to Veteran health
care and benefits.
Our goal is to ensure we have employees where they are needed, cut
unnecessary overhead, and strategically reduce staff to ensure VA's
budget is mostly going directly to Veterans. We will accomplish this
without making cuts to health care or benefits to Veterans or VA
beneficiaries.
Year after year, calls for VA reform come from every corner -
lawmakers, the media, watchdogs like Inspectors General and the
Government Accountability Office, Veterans Service Organizations, and
individual Veterans across the country.
This year, finally, we have embarked on a historic effort to reform
VA. We've been emphatic that we won't be cutting benefits and health
care - only improving them. And we're engaging career subject matter
experts, senior executives, and political leadership to restructure the
Department so it works better for Veterans.
We are doing what literally all VA stakeholders agree needs to be
done. So, what has the reaction been? We've been met with a barrage of
false rumors, innuendo, disinformation, and speculation implying we're
firing doctors and nurses, forcing staff to work in closets and
showers, and that there is ``chaos'' across the Department.
Why? Because we canceled some duplicative contracts for work VA can
and should be doing in-house, and we let go of one half of 1 percent of
non-mission critical employees.
To hear our critics tell it, the Department was absolutely perfect
until we started making changes in January 2025. Everyone knows that's
not true.
The fact is that VA health care has been on the Government
Accountability Office's high-risk list for more than a decade. GAO even
says VA faces ``system-wide challenges in overseeing patient safety and
access to care, hiring critical staff, and meeting future
infrastructure needs.'' We are working hard to fix these and other
issues, and we need your help. We want to work with Congress to fix VA.
But our shared goal needs to be making things better for Veterans
rather than protecting the Department's broken bureaucracy.
The Department of Veterans Affairs is not a Federal jobs program.
It is an organization whose sole purpose is to serve Veterans. We must
never lose sight of that.
We're just over 100 days into the second Trump Administration, and
despite major opposition from many in the media, union bosses, and some
in Congress, we're already making significant progress to better serve
Veterans, including:
We are refocusing on our core mission, which is providing
the best possible care and benefits to Veterans, families, caregivers,
and survivors.
That means we're making sure Veterans get the health care
choices they were promised under the MISSION Act.
We're taking thousands of employees off remote work and
bringing them back to the office, where we can work as a team to better
serve Veterans.
We're phasing out treatment for gender dysphoria.
We're accelerating the deployment of our modern
electronic health record system, after the program was nearly dormant
under the Biden Administration.
We're processing record numbers of disability claims.
We're redirecting hundreds of millions of dollars from
non-mission-critical efforts to health care, benefits, and services
that directly support VA beneficiaries.
We're creating a better system to more quickly and
effectively provide survivors the services, support, and compassion
they've earned.
And we've ended DEI at the department, reversing the
divisive Biden-era policies and stopping more than $14 million in DEI
spending.
But we're just getting started. We have an obligation to make VA
work better for the Veterans, families, caregivers, and survivors that
we are charged with serving. That is exactly what we have been doing
and exactly what we will continue to do.
President Trump sent his Fiscal Year 2026 budget request to
Congress on May 2, 2025. President Trump is committed to balancing the
budget while providing adequate funding for critical nondefense
discretionary priorities--securing our borders, caring for our
Veterans, and continued infrastructure investment. Reaching balance
requires:
resetting the proper balance between Federal and State
responsibilities with a renewed emphasis on federalism;
eliminating the Federal Government's support of woke
ideology;
protecting the American people by deconstructing a
wasteful and weaponized bureaucracy; and
identifying and eliminating wasteful spending.
The budget levels reflect the reforms necessary to enable VA to
fulfill its statutory responsibilities in the most cost-effective
manner possible.
The budget provides increased funding for health care services
tailored to Veterans' needs, both at VA medical centers and in the
community. The budget ensures that the Nation's Veterans are provided
with the world-class health care that they deserve. In addition,
Veterans who qualify for access to care with local community providers
would be empowered to make the choice to see them, rather than having
to drive, in some cases, hours to access the nearest VA facility.
The VA discretionary budget request for Fiscal Year (FY) 2026 is
$134.6 billion, and $52.6 billion for Toxic Exposures Fund (TEF), for a
total request of $187.2 billion. This is an increase of $27.6 billion
(+17 percent) above the Fiscal Year 2025 enacted level.
VA is committed to ending Veteran homelessness. The budget includes
a new effort, Rental Assistance to Homeless Veterans, which will
provide $1.1 billion to support the President's commitment to end
Veteran homelessness. VA will be directly responsible for programs and
financial support to provide rental assistance and other support
services.
The budget request also includes $3.5 billion for the Electronic
Health Record Modernization (EHRM) program. VA's EHRM effort is moving
the Department from a decades-old legacy system to a modern system that
is interoperable with systems at the Department of Defense and other
Federal partners, as well as participating community care providers,
allowing clinicians to easily access a veteran's full medical history
anywhere they seek care. Acceleration of the EHRM rollout is now a top
VA priority effort. The Fiscal Year 2026 funding will enable VA to
complete planned deployments in Fiscal Year 2027.
Further details on the full VA budget request will be available
when OMB releases the complete Fiscal Year 2026 budget.
Thank you for your time and attention, and I look forward to your
questions.
Statements for the Record
----------
Prepared Statement of National Association of Veterans' Research and
Education Foundations
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Housing Policy Council Data for the Record Submitted by Chris Pappas
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