[House Hearing, 119 Congress]
[From the U.S. Government Publishing Office]
COUNTING THE MONEY: PREVENTING
FRAUD AND ABUSE IN VA'S BONUS
PAYMENT PRACTICES FOR VA EMPLOYEES
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HEARING
BEFORE THE
SUBCOMMITTEE ON OVERSIGHT AND
INVESTIGATIONS
OF THE
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES
ONE HUNDRED NINETEENTH CONGRESS
FIRST SESSION
__________
TUESDAY, JULY 22, 2025
__________
Serial No. 119-32
__________
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
61-506 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
SUBCOMMITTEE ON OVERSIGHT AND INVESTIGATIONS
JEN KIGGANS, Virginia, Chairwoman
AUMUA AMATA COLEMAN RADEWAGEN, DELIA RAMIREZ, Illinois, Ranking
American Samoa Member
JUAN CISCOMANI, Arizona TIMOTHY M. KENNEDY, New York
KEITH SELF, Texas HERB CONAWAY, New Jersey
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
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TUESDAY, JULY 22, 2025
Page
OPENING STATEMENTS
The Honorable Jen Kiggans, Chairwoman............................ 1
The Honorable Delia Ramirez, Ranking Member...................... 3
WITNESSES
Panel I
Ms. Tracey Therit, Chief Human Capital Officer, Office of Human
Resources and Administration, Operations, Security, and
Preparedness, Veterans Health Administration, U.S. Department
of Veterans Affairs............................................ 6
Accompanied by:
Mr. David Perry, Chief Officer, Workforce Management and
Consulting, Veterans Health Administration, U.S.
Department of Veterans Affairs
Mr. Shawn Steele, Director of the Human Capital and Operations
Division, Office of Audits and Evaluations, Office of Inspector
General, U.S. Department of Veterans Affairs................... 7
Dr. Sheila Elliott, President, Local 2328, American Federation of
Government Employees........................................... 9
APPENDIX
Prepared Statements Of Witnesses
Ms. Tracey Therit Prepared Statement............................. 25
Mr. Shawn Steele Prepared Statement.............................. 27
Dr. Sheila Elliott Prepared Statement............................ 36
COUNTING THE MONEY: PREVENTING
FRAUD AND ABUSE IN VA'S BONUS
PAYMENT PRACTICES FOR VA EMPLOYEES
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TUESDAY, JULY 22, 2025
Subcommittee on Oversight and
Investigations,
Committee on Veterans' Affairs,
U.S. House of Representatives,
Washington, DC.
The subcommittee met, pursuant to notice, at 2:08 p.m., in
room 360, Cannon House Office Building, Hon. Jen Kiggans
[chairwoman of the subcommittee] presiding.
Present: Representatives Kiggans, Radewagen, Self, Ramirez,
Kennedy, and Conaway.
OPENING STATEMENT OF JEN KIGGANS, CHAIRWOMAN
Ms. Kiggans. I would like to welcome the members,
witnesses, and audience to this hearing for the subcommittee on
oversight and investigations. I appreciate my colleagues on the
dais and the witnesses for being here to discuss the chronic
issue of improper recruitment, retention, relocation, and
incentive payments. These are commonly referred to as the 3R's.
These incentives are tools provided to the U.S. Department of
Veterans Affairs (VA) by Congress to attract and retain quality
staff and positions that are consistently vacant or identified
as difficult to fill. While many Federal agencies can use these
incentive payments, they are particularly helpful for an agency
like the VA whose mission is to provide complex services and
quality health care to veterans across the entire country.
These incentives are designed to be a part of a benefits
package for positions in markets that are difficult to hire in,
like specialist physicians, nurses, and social workers in rural
areas. Congress gave Federal agencies the ability to pay these
incentives so that government entities like the Veteran Health
Administration can be competitive in attracting and keeping
quality healthcare professionals in a labor pool that is facing
staffing challenges across the country. As a nurse
practitioner, I understand these challenges firsthand.
Unfortunately, recent reports have shown that these funds
have been proven to be paid out with very little oversight.
While this hearing was organized after the release of the June
2025 Office of Inspector General (OIG) report on the VA's poor
oversight of these incentive payments, the problems we will
discuss today are not new to the VA. In fact, in 2017 the OIG
released a similar report detailing oversight issues with
recruitment, relocation, and retention incentive payments.
Based on the OIG's oversight work stretching back to July 2014,
the 2017 and--the 2017 OIG report identified the need to
improve controls over the use of these incentives. Having found
that the VA did not properly authorize 33 percent of the
retention incentives that were awarded to senior executives.
The improper payments found in 2017 totaled more than $158
million in unsupported spending.
As a result, the OIG made recommendations that the VA
develop internal controls to monitor policy compliance and
decrease the VA's reliance on retention incentives. Now, here
we are in July 2025 confronted with the same issues that the VA
has failed to improve since the first report. The only
difference is that now there is even more taxpayer dollars
involved. For example, between 2020 and 2023, relocation
payments grew by 85 percent, and retention payments have grown
by 131 percent, while recruitment bonuses have ballooned by a
staggering 237 percent. I believe anyone would agree that these
numbers are alarming when there is little data to back up the
massive increases. The 2025 report acknowledged that after the
initial report VA implemented processes to improve
authorization and review controls for the payments. However, VA
employees inconsistently followed them. This made the good
government improvements virtually useless. In response to the
2017 OIG audit, quality assurance teams were created at both
the Office of Human Resources (HR) and Administration,
Operations Security and Preparedness, and the Veterans
Integrated Service Network (VISN) level. However, the 2025 OIG
report found that while these teams identified errors, they did
not address systemic issues in the request and authorization of
incentives, did not proactively prevent incentive packages from
being processed and paid based on insufficient justifications.
Additionally, the OIG found that 28 employees continued to
receive annual retention incentives for many years after the
initial award period expired. In one case, an employee
continued to receive annual incentive awards for more than 11
years after the initial award period. In total, the VA
improperly paid these employees a total of about $4.3 million.
Between 2020 and 2023, more than 134,000 employees received
incentive payments totaling $1.2 billion. 341 million of those
incentives were found by the OIG to be improperly documented.
The lack of documentation also hinders review efforts by
oversight bodies like the OIG, the U.S. Government
Accountability Office (GAO), and this committee.
I echo what the OIG said in the report that the required
documentation helps provide assurance that incentives are
properly used and effective oversight of incentives also
requires sufficient documentation for review. In fact, OIG
noted that much of the data used in the report relied on
projections due to the VA's sparse documentation. I found it
shocking in the report that when cases of waste, fraud and
abuse were discovered, the VA's implementation of established
processes did not always guarantee that the issues were
appropriately resolved. The 2025 report cited an example where
Veterans Health Administration (VHA) awarded $30,000 in
relocation payments for an employee who never relocated. The
employee was a remote worker teleworking from home. When
someone receives a relocation incentive and never actually
relocates, that is wrong and a clear waste of taxpayer dollars.
Despite this clear case of impropriety, the VHA declined to
recoup the payments that were made to this employee. These are
taxpayer dollars set aside for veterans and for far too long
they have been carelessly handled. I am excited to hear the
Trump administration's plan to not only satisfy the OIG's
recommendations but their plan to make real, unnecessary
improvements, and corrections in how the VA manages and
oversees their incentive programs. The status quo is not
acceptable and we will continue to push the VA to make
improvements that lead to better care outcomes for the veterans
that are receiving VA services. I look forward to working with
Secretary Collins and his team to right the ship and create
real change at the VA.
I now recognize Ranking Member Ramirez for her opening
comments.
OPENING STATEMENT OF DELIA RAMIREZ, RANKING MEMBER
Ms. Ramirez. Thank you, Chair Kiggans. Today's hearings
topic is critically important. We are examining the use and the
oversight of the ``3R's incentives'' at VA. Recruitment,
retention, and relocation bonuses. The so called 3R's help VA
attract talent. Earlier this month, Secretary Collins
celebrated the VA will lose nearly 30,000 employees by the end
of the fiscal year. I find that despicable. I want to be clear.
Every VA employee is mission critical. Every VA employee
ensures veterans get the care and benefits they have earned and
deserve. If we care about veterans' care and services, it is
more important than ever that we discuss how the VA keeps
employees.
As Secretary Collins deconstructs, decimates, and
demoralizes the workforce. Veteran care is already being
negatively impacted by the destruction of the VA workforce. For
instance, we know that doctor appointments for veterans have
been canceled due to staffing shortages. We know this because
veterans have told us themselves. How do we course correct? How
do we ensure the VA has a workforce it needs to support the
care veterans have earned and deserve? First, we have to ensure
that the VA is a place where people feel valued, not disposable
and not attacked. As a former executive director of a nonprofit
organization, I know that public sector agencies like the VA
and nonprofit organizations cannot compete with the private
sector in terms of salary in many places across the country. In
tough markets, 3R's incentives help make VA offer more
competitive wages. They are a tool to attract and retain highly
qualified employees to the agency. I understand that this
hearing is meant to focus on the VA Inspector General's
findings from report released earlier this summer that the VA
needs more oversight of 3R's incentives. I do not disagree that
the VA must be a good steward of taxpayer dollars and that we
must ensure that the correct employees are receiving the
correct pay for the correct period of time. No objection, no
disagreement there.
At the same time, we must ensure that the VA's oversight of
the 3R's incentives does not make them a more burdensome and
less useful tool for leaders who need them to recruit and to
retain staff. We need to hold two objectives at the same time.
The process must work and it must allow to be competitive by
working quickly and efficiently. If we do not meet both of
these goals, I fear that greater layers of bureaucracy may
disincentivize leaders from offering 3R awards. I look forward
to hearing from our witnesses today about how we can strike a
balance to ensure 3R incentives are being used properly,
efficiently, and routinely. I am going to show a series of
posters with data pulled directly from the VA's workforce
dashboard published on June 27th, 2025. Numbers do not lie. We
can see here a sharp decline in both recruitment and retention
since Secretary Collins took the helm. The VA has seen an over
45 percent reduction in job applicants this year compared to
last year. VA saw an over 56 percent reduction in new employees
actually starting jobs. The VA lost 4,144 employees in mission
critical occupations as defined by the VA since the beginning
of this fiscal year. Compare that to the Biden administration
only losing 111 employees in mission critical occupations
during the same period in 2024. As of losing 4,100 employees in
VA designated mission critical occupations was not bad enough,
I want you guys to take a closer look at how many employees
Secretary Collins has lost in some key veteran facing roles. To
be clear, these numbers are not net losses. They are net
losses, not just normal attrition. The numbers we are looking
at account for any new hires. Again, these are positions that
are not subject to the hiring freeze and were exempt from the
Deferred Resignation Program (DRP). What you are seeing is that
since the start of this fiscal year, the VA has lost a net of
1,720 registered nurses, 1,147 medical support assistants, 604
physicians, 193 police officers, 77 psychologists, 358 social
workers, 1,081 veteran claim examiners, 868 custodial workers.
By its own data, the VA has had over 7,500 employees in veteran
facing roles leave their jobs this Fiscal Year and their
positions have not been backfilled.
How can Secretary Collins look at us and at veterans with a
straight face and say that veterans care has not been affected
by staffing changes when he has lost at least 7,500 veteran
facing employees? The numbers we are looking at and their
impact on veteran care is upsetting. If you are not mad yet,
just take a look at our next poster so we can get a sense of
why these employees have left the VA. Reasons for leaving, a
series of concerns, for example, geographical relocation,
desired work schedule not offered, lack of trust and confidence
in senior leaders. Again, lack of trust and confidence in
senior leaders from social workers, medical and dental are
talking about the work schedule offered does not work for their
ability to serve the veterans. Then you see over and over and
over lack of trust and confidence in senior leaders, lack of
trust and confidence in senior leaders. You also see here from
contracting officers unethical behavior on the part of
leadership or the organization. That is why medical and dental,
general administration, psychologists, social workers, HR
specialists, HR assistants, cemetery caretakers, Veterans claim
exam, processing personnel, contracting officers, and
Information Technology (IT) specialists are leaving. Any
quality leader I know who got this feedback in their exit
interview would do some serious self-reflection. The VA has a
failure of leadership crisis and Secretary Collins is to blame.
Secretary Collins accuses us of fear mongering and lying when
we raise the alarm that veteran care is being impacted. But
these numbers do not lie. There is just no possible way that VA
could lose 7,500 veteran facing employees without care being
impacted. The Secretary could turn the ship around to attract
and maintain more employees to care for veterans and the 3R
incentives are one of those tools. He is not because he does
not want to turn the ship around. He is committed to
destructive collision course. Let us look at the dashboard even
closer.
Just take a look at the reduction in the use of The
Sergeant First Class Heath Robinson Honoring our Promise to
Address Comprehensive Toxics (PACT) Act authorities like
recruitment and retention incentives from year 2024 to year
2025. Last year during the Biden administration, retention
incentives were used nearly 20,000 times. This year, under
Collins and Trump, only 7,000 times. Recruitment incentives
were used 6,000 times in year 2024, but they have barely used
them 1,000 times this year. Take a look at this number. Special
Contribution Awards. These are used when a VA employee goes
above and beyond the call of duty when caring for veterans.
When Biden was president, nearly 30,000 special contribution
awards were given to VA employees. Under Collins, barely 7,000
awards have been made. Here is the bottom line. It is not that
VA employees are less meritorious than they were under Biden.
It is that no matter what the VA employees do, they will never
really receive 3R awards because the Trump administration,
through Secretary Collins, wants them to leave. They want every
employee to be pushed out so they can decimate the VA's
workforce and destroy it in order to justify privatizing the
VA. Secretary Collins has made VA employees his target and in
doing so has targeted veterans who rely on VA for their care
and benefits. Yes, it is more important than ever that we do
everything we can to keep VA employees working and caring for
our veterans. Secretary Collins tenure at the VA has been one
of torment. For months, VA employees have worried they would
lose their jobs and livelihood through Reduction in Force
(RIF). Now Secretary Collins promises that a ``Large-scale
RIF'' is off the table for the time being. We all remain
concerned that if he is leaving the door open to eliminate
positions through the reorganization and consolidation, and
veterans worry that their service and care will be impacted by
the changes in the VA workforce. Well, veterans are right. How
can we expect to provide high quality services through a
robust, talented workforce under these kinds of conditions?
Again, the instability, the uncertainty, the volatility is the
point. Veterans deserve a VA that they can rely on. Secretary
Collins is undermining the VA and its workforce at every chance
he gets. It is why I look forward to our conversation today and
hearing for our witnesses.
With that, I yield back.
Ms. Kiggans. Thank you, Ranking Member Ramirez. I will now
recognize the witnesses testifying before us today. We have Ms.
Tracey Therit, chief human capital officer, Human Resources and
Administration, welcome back. Mr. David Perry, chief officer,
Workforce Management and Consulting, Veterans Health
Administration. Mr. Shawn Steele, the director of the Human
Capital and Operations Division, Office of Audits and
Evaluations of the Office of the Inspector General. Dr. Elliot,
Dr. Sheila Elliot, president for the American Federation of
Government Employees (AFGE) Local 2328. Welcome. If the
witnesses will please stand for me and raise your right hand.
Do you solemnly swear that the testimony you are about to
provide is the truth, the whole truth, and nothing but the
truth?
[Witnesses sworn.]
Ms. Kiggans. Thank you. You may be seated. Let the record
reflect that the witnesses answered in the affirmative.
Ms. Therit, you are now recognized for 5 minutes to provide
the VA's testimony.
STATEMENT OF TRACEY THERIT
Ms. Therit. Good afternoon, Chairwoman Kiggans, Ranking
Member Ramirez, and distinguished members of the committee.
Thank you for this opportunity to discuss how VA is improving
governance and oversight of recruitment, relocation, and
retention, 3R's in our incentive payment practices. As pay caps
for healthcare professionals at VA have not kept pace with
rising salaries for healthcare professionals and specialists,
the 3R's program is a critical component of VA's incentive
plan. I am joined today by Mr. David Perry, acting chief, Human
Capital Management, Veterans Health Administration. VA will
always fulfill its duty to provide veterans, families,
caregivers and survivors with the health care and benefits that
they have earned. To ensure all veterans and VA beneficiaries
continue to receive their earned benefits and services, VA is
always recruiting dedicated professionals. As of July 2025,
more than 350,000 critical positions are exempt from the hiring
freeze. While VA has historically offered 3R's incentives to
address occupational shortages and facilities hiring
initiatives, the department must provide greater accountability
and stewardship of taxpayer resources by enhancing our
procedures, documenting requirements, and providing oversight
of these incentives.
Starting in 2017, VA updated department policy on 3R
incentives to establish internal controls and provide
oversight. Specifically, VA began requiring annual
certification of the incentive so it was appropriate and in
compliance with policy and succession plans to reduce long-term
reliance on incentives and established residency before payment
of receipt. In the years since, VA has continued iterating and
implementing additional improvements including the following,
requiring a standard form to capture all the required
information by law, aligning the use of 3R's with shortage and
hard to fill positions, obtaining authorization and
justification before including 3R incentives in job
announcements, tracking unfulfilled service obligations,
improving coordination of debt collection and enforcing debt
collection and reviewing incentives annually and terminating
them in a timely manner when they are no longer needed.
However, there is always room for improvement and VA must
continue to refine its governance of those incentives,
including proper documentation in their use, ensuring correct
signatures are in place, ensuring justification in employing
3R's is sound. VA must develop stronger oversight mechanisms
and discontinue the use of multiyear incentives.
Finally, VHA is implementing a comprehensive strategy to
enhance the management and oversight of the incentives program,
includes continuing to monitor internal control procedures and
guidance to ensure 3R documentation is appropriately maintained
in accordance with VA policy. VHA will also conduct a program
to monitor quarterly and utilize uniform checklists and
templates nationwide. VHA is developing training and materials
to ensure proper documentation for succession plans,
performance ratings and to strengthen the technical review. VHA
is creating oversight plans and a strengthened technical review
program to assess every incentive for technical adherence. At
an enterprise level, oversight monitoring component will act as
a second level check at the national level. VHA aims to support
the compliance with record retention requirements and
furthermore specific performance metrics will be tied to
operational leadership and human resources leadership. They are
being developed and reinforcing the importance of proper
governance and oversight of incentive programs. VA is committed
to addressing these issues that have been identified by the
Inspector General's report and strengthening the process to
support the VA mission. We are confident that the steps that we
have taken and will continue to take will strengthen our
incentives program and the governance and oversight required,
leading to more effective outcomes and better service to
veterans. While the 3R's incentive program is an important tool
for the department in attracting and retaining talent, it is
not enough for the VA to remain competitive with industry. VA
looks forward to working with the committee on strategies to
ensure that VA is an employer of choice for physicians in
critical need specialties.
I am proud to be part of the noble mission to care for our
Nation's veterans. I look forward to working with each of you
on the committee to more effectively and efficiently provide
enhanced oversight and governance of the incentive payment
practices, ensuring VA can continue to provide the best care
and services to veterans and their families.
It concludes my testimony and my colleague and I welcome
any questions that you may have for us. Thank you, thank you.
[The Prepared Statement Of Tracey Therit Appears In The
Appendix]
Ms. Kiggans. Thank you, Ms. Therit. Mr. Steele, you are now
recognized for 5 minutes to provide the VA's OIG's testimony.
STATEMENT OF SHAWN STEELE
Mr. Steele. Chairwoman Kiggans, Ranking Member Ramirez, and
members of the subcommittee thank you for the opportunity to
testify on the OIG's independent oversight of VHA's management
of recruitment, relocation and retention incentives. These
incentives are meant to help VA entice candidates to accept
hard to fill positions or to retain high quality staff. Our
work focused on identifying whether VHA used incentives
effectively, complied with the law and VA policy, and acted as
strong stewards of taxpayer dollars. As the OIG has documented,
VHA faces significant staffing shortages in key positions, also
known as critical need occupations. This long-standing
challenge affects clinical positions as well as nonclinical
support and security functions. Critical need occupations are
often difficult to fill due to the limited number and quality
of candidates, unfavorable employment trends, and lack of
appeal for the position's duties or geographic location. Our
work shows that despite VHA's ability to hire non-
competitively, they continue to experience staffing shortages
for positions fundamental to the safe and effective delivery of
care to veterans. Other OIG reports highlighted weaknesses in
VA's processes and controls governing the use of pay
incentives.
Our 2017 audit found that VA needed to improve controls
over recruitment, relocation and retention incentives to ensure
they were strategically and prudently used. We also reported in
May 2024 that VA awarded $10.8 million in critical skill
incentives to nearly all VHA and Veterans Benefits
Administration (VBA) central office executives without required
support showing the employee possessed a high demand skill or
skill that is at a shortage. Over 182 senior executives
received payments averaging about $60,000 each. Subsequently,
over 90 percent of those funds had been recouped. We closed the
recommendations for both the 2017 and 2024 reports because VA
provided sufficient evidence to show action had been taken to
implement needed changes. However, the OIG continued to monitor
VA's use of these important staffing tools. Last month, we
published a report that evaluated VA's controls over and
governance of recruitment, relocation and retention incentives.
It focused on awards paid to VHA employees from fiscal years
2020 through 2023 and tested many of VA's actions taken in
response to the 2017 OIG report. Overall, we found that VA used
incentives extensively to address critical staffing needs. In
fiscal years 1922 and 1923, nearly 90 percent of incentives
went to employees and occupations on staffing shortage lists.
However, VA did not effectively govern the process to
ensure that VHA officials consistently captured information
required to support the awards. Key forms were missing or
lacked sufficient justifications and approval signatures. This
information helps confirm incentives are properly used and is
needed to carry out effective oversight. Consequently, we found
that VA's prior corrective actions to implement our 2017 report
recommendations were not sustained as policies were not
routinely followed. Overall, we estimated that the award
justification could not be verified or is insufficient for 30
percent of VHA employees that received incentive payments. This
amounted to about $341 million in incentives that were not
adequately supported. Our team also found 28 VHA employees who
received retention incentive payments long after their award
period had expired. These individuals were improperly paid for
an additional 8 years, on average totaling about $4.6 million.
In conclusion, the OIG's oversight work has highlighted
VHA's ongoing challenges with addressing severe occupational
shortages in essential positions. Our reports have also shown
that attempts to narrow those staffing gaps through
recruitment, relocation, and retention incentives do not
consistently follow requirements. It is also concerning that
these issues are not routinely detected by VA's quality control
measures. VHA must emphasize to responsible personnel the
importance of following policies and procedures to safeguard
against improper payments. OIG teams will continue to monitor
VHA staffing needs and the use of incentive payments. In doing
so, VHA will be held accountable for securing qualified
personnel to provide high quality care to veterans while making
the most effective use of taxpayer dollars.
Chairwoman Kiggins, this concludes my statement. I would be
happy to answer any questions you or members of the
subcommittee may have.
[The Prepared Statement Of Shawn Steele Appears In The
Appendix]
Ms. Kiggans. Thank you, Mr. Steele. Dr. Elliot, you are now
recognized for 5 minutes to provide your testimony.
STATEMENT OF SHEILA ELLIOTT
Dr. Elliott. Thank you, Chairwoman Kiggans, Ranking Member
Ramirez, and members of the subcommittee. AFGE, and the
National VA Council appreciate the opportunity to testify
today. My name is Dr. Sheila Elliot. For the last 35 years, I
have served as Treasurer/Steward at Hampton VA Medical Centre.
I have also served over 15 years as the president of AFGE Local
2328 which represents most direct patient care staff at
Hampton, VA, and the surrounding clinics. On behalf of the
320,000 VA employees AFGE represents, approximately a third
whom are veterans. It is a privilege to offer AFGE's views on
how the VA should improve recruitment and retention, both with
the recruitment, retention and relocation bonus program and
beyond. On June 12, 2025, the OIG released a report on the
recruitment, relocation and retention incentives bonus program.
The OIG highlighted several problems with the administration
and oversight of the program that AFGE agrees with. Chief among
the problems identified is the failure of VA human resources.
While VA did use this tool to recruit and retain clinicians,
there were problems in how the bonus program was managed. AFGE
has previously criticized the HR modernization that the OIG is
citing here, agreeing with the conclusion that it has led to
increased turnover at the VA.
Additionally, AFGE believes that HR not being in the
facilities and lacking familiarity with the workforce and the
veterans they serve increases their turnover. This undermines
the ability of HR to serve employees as well as administer the
bonus program. In preparation for this hearing, when contacting
the Hampton, VA, we could find no repository of data to show
who has received these bonuses. However, after reaching out
directly to 800 bargaining unit members at our hospital, AFGE
had 9 bargaining union members who reported that there were 4
recruitment bonuses, 4 retention bonus, and 1 relocation bonus
awarded between 2021 and 2025. While AFGE is pleased that at
least 9 employees receive these bonuses, we have no way of
knowing if this benefit is properly utilized compared to the
rest of VA.
Regardless, I can say with decades of experience at this
facility that there is significant room for improvement both at
the hospital and the brand-new North Battlefield Outpatient
Clinic which opened this year 27 percent staffed. We urge the
VA to use these bonuses and other tools to increase capacity at
the clinic and the hospital. Beyond the bonus program, AFGE has
other suggestions to improve recruitment and retention. As the
committee is aware of in March, President Trump signed an
Executive Order (EO) eliminating the collective bargaining
rights of 1.5 million Federal employees at agencies including
VA. Continuing to deny large swaths of the VA workforce,
collective bargaining rights will continue to harm recruitment
and retention. As there is a critical shortage of clinicians in
this country, many quality candidates who want to serve the VA
may avoid the agency to receive both union protections and
better salaries in the private sector. This is particularly
egregious as Secretary Collins played favorites when choosing
whom to exempt from the executive order, not by job description
or duties, but by which union represents the employee in
question. AFGE members lost their collective bargaining rights
despite having identical jobs for employees who are exempted
and retained their rights. AFGE urges members of this committee
to support H.R. 2550, the Protect America's Workforce Act,
which would nullify this illegal executive order. AFGE has long
argued for the benefits of telework for employees who can
perform their duties remotely. This is particularly true for
clinicians who practice in whole or in large part through
telemedicine.
However, since most telework has been rescinded by this
administration, many clinicians have had to report to a VA
facility and then have been required to interact with patients
remotely, often in crowded bullpens discussing private matters.
This has harmed morale and retention of mission critical and
hard to recruit clinicians at the VA. This has negatively
affected retention at Hampton and reflects VA's overly broad
approach to telework and telehealth. I hope that my testimony
today leads this committee subcommittee to help improve
recruitment and retention at the VA.
Thank you and I look forward to answering your questions.
[The Prepared Statement Of Sheila Elliott Appears In The
Appendix]
Ms. Kiggans. Thank you, Dr. Elliot. We will now proceed
with questions. However, before I do that, I would like to make
sure the record is clear regarding not just mental health
services that are offered at the Hampton VA. We have pushed and
will continue to push veterans to receive the care we need it.
That is why I have advocated for additional facilities in my
district that provide these services. In addition, and more
specifically that North Battlefield VA Clinic in Chesapeake, I
wanted to clarify and echo Secretary Collins words about that
facility. It is opening in deliberate phases to ensure safe,
effective and high-quality care as services and staffing scale
up responsibly. While some public comments have
mischaracterized this phase rollout, the facts are clear. The
Clinic opened in April 2025. I was at the ribbon cutting with
150 staff and core services including primary care, mental
health, and pharmacy. To quote, Dr. Elliot, that was 27 percent
and it was always intended to expand in waves. In July, dental
and additional mental health services came online and by
January 2026 the facility is scheduled to be fully operational
with radiology, optometry, telehealth and more. This is a
standard and prudent approach for bringing a major healthcare
facility online. As we grow more patients, we grow more staff.
Spreading misinformation about staffing levels or service
delays only undermines the hard work being done to provide the
best possible care to our veterans. I remain committed to
ensuring this facility and all our VA healthcare facilities
reach full potential and deliver the timely high-quality care
the veterans in Chesapeake and across Hampton Roads have
earned.
In conclusion and for clarification additionally from
Secretary Collins, I am pleased the department of the VA is not
going to pursue a large-scale reduction of force and have been
reassured that any early retirements will come from redundant
positions and non-essential personnel. This will safeguard
operations of the VA and thus ensure services to our veterans.
I am confident that Secretary Collins will prioritize
maintaining a robust health care workforce at the VA to ensure
veteran care and benefits are not impacted. We can all agree
that giving our veterans the care they need is essential. Under
President Trump I know that our veterans will be put first. In
fact, the VA's performance has continued to improve under his
leadership. With disability claim backlog already down nearly
30 percent, the work Secretary Collins is doing to modernize
the VA's operations and get our veterans the quality of care
they need is a breath of fresh air. By June, the VA had already
processed 2 million disability claims, accelerated the
implementation of the integrated electronic health record
system and made it easier for survivors to get benefits. These
accomplishments on behalf of our veterans deserve recognition.
With that, I have questions, and my first question will be
for Ms. Therit. Ms. Therit, the OIG found that the VISN quality
assurance teams conducted reviews after the incentives were
awarded. Can you explain why the VA's review process appears to
be reactive instead of proactive?
Ms. Therit. Chairwoman Kiggans, regarding the VISN's review
process, I am going to ask Mr. Perry to respond to that
question.
Ms. Kiggans. That is fine.
Mr. Perry. Thank you, Chairman, for that question. We agree
where the VISN is needed to do a more proactive approach. We
are shifting that responsibility over to the compensation
aspect of the VISN to do that on the front end versus the back
end. We recognize that there is a gap in our process that we
are making a modification adjustment until now.
Ms. Kiggans. Will the VISNs be talking to each other then
to come up with a more standard approach?
Mr. Perry. Yes, overall, we are taking that approach to
look at standardization. I think what we saw back in 2017,
where it was down at the facility level, we had about 150 ways
of doing it. We have made improvements, that is 18. We do have
some areas to improve to make sure that the 18 are doing it
consistently. Consistently according to policy.
Ms. Kiggans. That would be great. Consistency would be
helpful. I go back to Ms. Therit, but either Ms. Therit or Mr.
Perry, would you please explain step by step how one of these 3
incentive payments would be approved, starting with the first
step to the actual payment to the employee.
Ms. Therit. Chairwoman Kiggans, I appreciate the work of
the office of the Inspector General because their very
detailed, actionable reporting helps us to improve. We made
improvements from the 2017 report, and we will continue to make
improvements based on the 2025 report. Recruitment and
relocation incentives are one category of 3R's. The recruitment
incentive is to attract individuals into the Federal
Government. The relocation incentive is to help move employees
into locations that are hard to fill or where there is a
specific need. There is a standard form 10016 that is completed
for both of those incentives. One of the deficiencies in 2017
that we rectified in 2025 was that our department policy and
procedures did not align with regulation. Now we have a
department-wide policy. Everybody should follow it
consistently. We have standard forms that every supervisor who
is recommending an incentive, every HR official who is
reviewing an incentive, and every approving official would
utilize. That is for the recruitment and relocation process. We
have a similar 10017 that is used for retention.
Retention incentives are typically shorter-term.
Recruitment and relocation can be up to a 4-year service
obligation. Retention incentives, we typically look at a 1-year
retention incentive service period. The reason being for
retention purposes we are looking at somebody who is likely to
leave Federal service and has a unique skill that we cannot
afford to walk out the door. We need a short period of time to
put that succession plan in place to either develop someone
with those skills to step in when they depart or to be able to
recruit somebody before they leave. That is the process and the
steps from someone recommending an incentive for an individual
under one of those three sets of parameters to then HR
reviewing the requirements based on regulation and then for the
approving official to sign off on it. Once the individual is
identified, then they too have responsibilities. Signing the
service obligation, making sure that they relocate if it is a
relocation incentive, making sure they are new to the Federal
service if it is a recruitment incentive. For retention
incentives, we have a 1-year hard stop where supervisors need
to review and recertify that that is still needed. Otherwise,
it will be terminated automatically.
Those are just some of the steps that we take with
recruitment, relocation, and retention incentives. Some of the
things that we have in place and where the Inspector General
(IG) has identified more steps that we need to take to have
better oversight and compliance that we are willing and
currently in the process of doing that.
Ms. Kiggans. That approving official who is in their next
step in the chain of command, who would they report to?
Ms. Therit. Chairwoman Kiggans, we have delegations of
authority for our 3R's incentives. Typically, in the Veterans
Health Administration, which is the subject matter of the
report. A recommending official would be a medical center
director. Approving official could be up to a network director.
It depends on the percentages of the incentives that are being
offered. Sometimes it is higher, but that is typically how the
delegations of authority flow. Now we also have breach of
agreement procedures that we follow to make sure that if
somebody does not fulfill their obligation that we are going
back and initiating and collecting those debts. Again, these
are taxpayer dollars. We do not want to see these incentives
misused or abused. I know there were instances in the report
that were identified. We do not want that to continue to
happen. The breach process is the individual employee who is
asking for a waiver of repayment will go to their supervisor.
That supervisor will take it the whole way up the chain of
command to the under secretary of health in the Veterans Health
Administration. If they approve that request to waive payment,
then it comes to my office. Our assistant secretary for Human
Resources and Administration Operations Security and
Preparedness would be responsible for that process. That is
just an example of the levels at which these are reviewed and
the seriousness with which we take things like breach of
agreements.
Ms. Kiggans. Thank you for that very thorough explanation.
How long has that exact chain that you just described been in
place? Is that new this year in 2025?
Ms. Therit. I would say it dates back to 2020, when we
revised our departmental policy. We do have statistics, if the
committee is interested in terms of how many cases go through
that process. The percentage that reach my office, it is a
small percentage, maybe 1 a month, and a very low percentage
that is approved because the standard for waiving a breach of a
service obligation is very high. It is stipulated in law as
repayment would be against equity and good conscience or not in
the best interest of the government. When we are paying
individuals and they are not upholding their end of the
agreement, that is something that we want to pursue.
Ms. Kiggans. Thank you. My time has expired. I am sure that
we will have a second round of questioning, but I will yield to
our ranking member.
Ms. Ramirez. Thank you, Chairwoman. Dr. Elliot, I want to
first thank you for being here and taking time away from your
day job as a pharmacist at the Hampton VA Medical Center. I
understand you are also the caregiver of your mother, is that
correct?
Dr. Elliott. Yes.
Ms. Ramirez. Well, you are a superwoman, and I am really
grateful for your participation and your continued dedication
to your VA brothers and sisters at the AFGE. You mentioned in
your testimony that there is a lack of clarity in how and when
3R incentives are used at your facility in Hampton. Do you
think that if 3R incentives were made widely and frequently
used at Hampton, the facility would be able to onboard and keep
more employees?
Dr. Elliott. We used to have a process whereby we had hard
to recruit and hard to fill positions at our facility. I do not
know where that process is at this time. I have not heard
anything of it for the last several years now, especially since
we have been decentralized with respect to the HR staff. That
is supposed to be the--those people on that list are supposed
to be the designees of various recruitment, retention bonuses,
and so forth. In my 35 years there, I have never seen a
relocation bonus for a line staff person, no matter what their
job was. Typically, those had been reserved for top management.
The various relocation bonuses.
Ms. Ramirez. Dr. Elliot, I wanted to ask you if you had any
reactions to how the secretary is characterizing staffing at
North Battlefield Clinic, sincere on the ground, actually
working there?
Dr. Elliott. I can tell you this from the standpoint of a
veteran. I go to--this is what the veteran said during a panel.
I go to the VA at North Battlefield, have my primary care
appointment. However, if I want to receive other services such
as X-ray and those sorts of things, I still have to drive to
Hampton. That is problematic.
Ms. Ramirez. That is, well, thank you, Dr. Elliot. I want
to now turn it over to Ms. Therit. Ms. Therit, how many
employees has VA lost through ``natural attrition'' since
January of this year?
Ms. Therit. Ranking Member Ramirez, we do look at that data
on a regular basis. I believe the last statistics that I saw of
all of the separations, those are voluntary and involuntary
actions, about 20,000 that have occurred over the last few
months.
Ms. Ramirez. Twenty thousand over the last few months, is
that what you just said?
Ms. Therit. Over the last few months since the beginning of
the year?
Ms. Ramirez. I just wanted to make sure I had heard
correctly. How many of those employees are in veteran facing
roles like direct care or benefits counseling? What would you
say?
Ms. Therit. Ranking Member Ramirez, the number that I cited
was the aggregate level, so I would have to go back and break
that down to look more specifically at direct care position.
Ms. Ramirez. Ms. Therit, if you could go ahead and follow
up on that, I would really appreciate it. The follow-up
question I have to that is if you know if those positions were
backfilled.
Ms. Therit. Ranking Member Ramirez, as I mentioned, about
350,000 positions are exempt from the hiring freeze. I do see
data on a bi-weekly basis of the job announcements that are
posted and the individuals that we are bringing on board. I
know we are bringing several thousand a pay period back into
the VA. I know those--that statistic is actually reported on
the workforce dashboard each month as well.
Ms. Ramirez. Got it. Ms. Therit, when you follow up, if you
can try to get me a little bit more detail, that would be
really helpful. I want to go back to these posters on the VA
workforce dashboard dated June 28, 2024. Last year. There is a
note at the very top that says ``top risk'' and then reads,
``Delays or termination use of PACT Act Title 9 authorities
will have a negative impact and recruitment and retention.''
Now, those PACT Act authorities referenced here included
recruitment and retention incentives, among other bonuses. Is
that correct? Mr. Therit?
Ms. Therit. Yes, it is, ma'am.
Ms. Ramirez. Why was there, why has there been such a stark
downward trend in the use of 3R incentives from year 2024 to
year 2025?
Ms. Therit. As mentioned earlier, there has to be a
justification for using a recruitment or a retention incentive.
In many situations, I know Dr. Elliot mentioned our hard to
fill and our shortage occupations, and I think Mr. Steele has
mentioned it as well, that we are able to post those job
announcements, get qualified candidates and bring them on
without using an incentive.
Ms. Ramirez. Ms. Therit, this is my last question for this
round and we will come back the second round. Is there a delay
or termination of using these authorities having a negative
impact on recruitment and retention at the VA?
Ms. Therit. At this moment in time, we are able to post and
fill those positions that are being vacated in our direct care
positions.
Ms. Ramirez. You are not noticing just yet the negative
impact on recruitment and retention of the VA? Is that what you
are saying?
Ms. Therit. Correct, ma'am.
Ms. Ramirez. Thank you. With that, I yield back.
Ms. Kiggans. Thank you. The chair now recognizes Mr.
Conaway for 5 minutes.
Mr. Conaway. Thank you, Madam Chair. I guess before I ask
my questions, I cannot help but put some more close, if you
will, on the statements of our ranking member. When you hear
about the intention, the leaked intention of the number of
employees that the Secretary intends to cut from the VA, it is
hard to imagine that anyone who might think about entering a
career in public service and working at the VA would look upon
the VA as a place to land and to work and to engage in public
service, taking care of our valuable and hopefully appreciated
veterans. This kind of announcement from the top cannot help
but hurt the effort to retain frontline healthcare
professionals and others who are so critical to the operation
of that facility. People, you know, obviously need nurses, you
need doctors, but you also need someone to make sure that
people get food delivered to them. You need to make sure that
you have got a pharmacy that is working. You need to make sure
that the cleaning services are working and that the building
and the facility is secure. You need people to do all of those
jobs and to want to come to work and have that work
appreciated. It is hard for us on this side of the aisle to
hear and to understand these--these obvious dynamics with
respect to their union rights and their prospects for a career
that is both satisfying, rewarding, and appreciated by their
government, by their employees, that that is not going to have
a profound impact on the ability of the VA to do its work and
to honor our commitment to veterans, and that it is not part of
a grand plan, as ranking members pointed out to privatize these
services. We are seeing this across at least the signs of this
and I think very definite pattern across the Federal workforce
and the Federal Government. I am a physician myself. I have
worked, I have trained at a VA facility for part of my
training. I served on a military base as a physician there. I
certainly treated a lot of veterans even in private practice
after leaving the service because my district is at home of a
military base, Joint Base McGuire.
We have a lot of veterans who live in that area and were
patients of mine. I understand how important the VA is to them
and their ability to use the VA when they need it for their
care. I am disturbed to hear about what is happening with the
physician workforce, the losses there, and particularly the
ability of psychologists and psychiatrists to treat patients
because of the attack on remote work. Just because someone is
being seen remotely does not mean that anything that is said in
the interactions between their physician and someone who is
receiving their care remotely should not be protected. Their
privacy should not be protected there. When you consider people
now being put in cubicles or putting in spaces where their
conversations are not secure and private, that impacts the kind
of care that they wish to give and how they ought to practice
that lifesaving care. As we know, there is so many dislocations
with mental health in the service. I understand, Ms. Elliot,
Dr. Elliot, pardon me, that you have an example of a change in
this retention policy and the loss of remote work. Can you
comment on the impact of that situation at Hampton? At the
Hampton VA?
Dr. Elliott. Thank you. At our facility we have a 43
percent lack of--well, our recruitment is 43 percent behind,
meaning that out of 100 positions, 43 of them are vacant. We
are in the process now of losing a psychologist to another
facility because that particular psychologist lived far away
and could not come to Hampton with no relocation bonus offered.
That psychologist was able to get a relocation bonus from
someplace else. That is where that psychologist is going. I
guess instead of being 43 percent behind the eight ball, we are
44 percent in a couple of weeks when that psychologist leaves.
Now, to add insult to injury there, even though we know that
psychologist is leaving, we do not recruit, begin recruitment
until after the psychologist is gone. Therefore, all of that
psychologist work is borne by someone else or patients are
rescheduled and rescheduled and rescheduled until someone comes
in to fill that post.
Mr. Conaway. Thank you. Madam Chair, I yield back. I see it
is my time.
Ms. Kiggans. Thank you. I have a couple of other questions.
Dr. Elliot, just for clarification, that psychologist you, I am
sorry. Oh, Mr. Kennedy, let us start with, sorry, Mr. Kennedy,
we will recognize you for 5 minutes.
Mr. Kennedy. Thank you very much. Thank you all for being
here today. I have some deep concerns about what is transpiring
at the VA across this country. I know veterans, not only in my
district, but across the Nation are disturbed about the news
that is continuing to come out of the VA that will impact their
care. Just to take a quick trip down memory lane, back in
February, the VA dismissed 1,000 employees outright as February
13th. Eleven days later, on February 24th, the VA cut another
1400 employees. 2,400 people cut from serving our veterans in
this Nation. It was the beginning of a despicable pattern that
we have seen coming out of this administration. In March, this
committee discovered through a leaked memo that the VA planned
to cut more than 80,000 employees, which Secretary Collins then
confirmed. Now we are being told that the VA will not make this
cut, but would reduce the number of employees by nearly 30,000
by the end of the fiscal year. Seventeen thousand already gone,
meaning there is going to be another 12,000. More than 12,000
additional cuts, the largest in VA history.
These reductions will affect critical frontline staff,
including healthcare workers and benefits personnel. I recall
what Secretary Collins told this committee in May, and I am
going to quote the Secretary. ``The VA staffing structure is
aimed at finding ways to improve care and benefits for veterans
without cutting care and benefits for veterans. We are going to
maintain the VA's mission essential jobs like doctors, nurses
and claims processors, while phasing out Michigan mission, non-
mission essential roles.'' That is not what we are seeing. I
want to believe that that would be true, but if it is not true,
then this committee responsible for VA oversight has been
misled. I have a couple of questions. Ms. Therit, you visited
multiple VA facilities and have spoken with a wide range of
employees. Based on what you have seen, similar roles face
similar challenges nationwide. Why were collective bargaining
rights preserved for nurses and facility workers at the
Milwaukee, VA, but stripped from their counterparts in the
community that I represent in Buffalo despite nearly identical
job functions?
Ms. Therit. Representative Kennedy, the executive order
related to labor relations is currently under litigation. There
is a stay related to that executive order. We are complying
with that litigation right now.
Mr. Kennedy. Okay, so no answer. The only clear difference
that I can see is union affiliation. Buffalo workers are
represented by unions that have filed lawsuits against this
administration, unlike those in Milwaukee, that raises serious
concerns about political retribution and retaliation. Can you
explain it all these decisions, how they were made, and whether
the union activity played a role?
Ms. Therit. Representative Kennedy, I am at this point in
time based on the stay in that particular case, I cannot answer
that question.
Mr. Kennedy. Okay, no answer again, thank you. Dr. Elliot,
after having conversations with VA employees in Buffalo, two
things are clear to me. They take deep pride in serving our
veterans and they rely on their union to protect their rights
and help them provide the best possible care. As you know,
President Trump's EO 14251 misused the national security
exemption in Title 5 to remove employees, including those at
Hampton, VA, and Buffalo, from the bargaining unit. You just
mentioned in your testimony that 43 percent reduction in hiring
that you are behind. Based on your experience, has the VA's
approach to collective bargaining helped or hurt your ability
to attract and retain staff?
Dr. Elliott. I would say that it has, we have been, I
guess----
Mr. Kennedy. It has?
Dr. Elliott. It has--it has reduced our ability to recruit
and retain. It has. I also would like to say, if you do not
mind, this situation about the 30,000 employees that are
targeted as far as a number goes. In 1989, I met a nurse named
Ms. Eddie Riggs. She told me that a failure to plan is a plan
to fail. You probably have heard that. When you rely on random
reductions, there can be danger there. You do not know which
critical and which non critical position is going to be
reduced. Let us say, for example, if out of that 30,000, 10,000
of them are doctors, we cannot tolerate that. Or if 15,000 of
them are nurses, we cannot.
Ms. Kiggans. Gentlemen's time has expired.
Mr. Kennedy. Thank you. I yield back.
Ms. Kiggans. We are going to move into a second round of
questioning and we will do 2 minutes for an additional round of
questions. Ms. Therit, do you anticipate the VHA will develop
the necessary guidance regarding quality control checks by the
OIG's recommended completion date in September?
Ms. Therit. Chairwoman Kiggans, I do. I know Mr. Perry has
additional information on that.
Ms. Kiggans. Thank you. Can you please tell us how VISN
leadership will be involved in monitoring the 95 percent
compliance rate?
Mr. Perry. Yes, Chairwoman. As I previously stated, we are
working now on shifting the responsibility of the oversight to
the compensation side of the VISN to hold that accountability
line to make sure that the proper documentation, technical
review, and approvals are in place. That will be done by the
end of this year.
Ms. Kiggans. How long----
Mr. Perry. This fiscal year.
Ms. Kiggans. How long, okay, so how long do you anticipate
it will take for the majority of VISNs to meet that 95 percent
target?
Mr. Perry. We have already started that now. That includes
my team rolling out the additional training and oversight to
ensure that they do come into compliance by the end of this
fiscal year.
Ms. Kiggans. Okay, thank you. Ms. Therit, do VHA officials
have the authorization to approve exceptions to limitations
placed on incentive payments?
Ms. Therit. VHA officials at the, through the delegation of
authority are able to approve incentives up to a certain
threshold and then those depending on the incentive may have to
come up to the office of the Secretary, depending on the
position.
Ms. Kiggans. Who is responsible for approving the exception
and who provides a check on this person?
Ms. Therit. My office conducts an oversight review of those
incentives and would also be able to work with Mr. Perry's team
to make sure that they are following policy and proper
procedures.
Ms. Kiggans. In your experience, are those exceptions more
frequently approved for administrative positions or clinical
positions?
Ms. Therit. Chairwoman Kiggans, they are more frequently
approved for clinical positions.
Ms. Kiggans. Thank you. Mr. Steele, I was shocked to hear
that the VHA could not provide OIG evidence for recertification
for those recurring incentive payments. Do you believe this is
an issue with HR Smart or a result of inadequate oversight by
the HR servicing teams?
Mr. Steele. We saw a breakdown of both systems and people.
HR Smart lacked the automation to halt the process if certain
requirements were not met. In that situation, it does put more
onus on people to enter data correctly and conduct back-end
oversight to ensure that the process ceases when it should.
Ms. Kiggans. Thank you. My 2 minutes have expired. I yield
to the ranking member.
Ms. Ramirez. Thank you, Chair. Ms. Therit, I want to follow
up again with you. The 8-corner staff have been meeting
routinely with Mark Engelbaum, the assistant secretary for HR.
Our staff has requested a detailed breakdown of data on
employees who have left the VA since January through the DRP,
Voluntary Early Retirement Authority (VERA), or natural
attrition. Unfortunately, the numbers that VA provided as a
follow up fall woefully below the level of detail requested.
Are you able to produce by location, occupation, detailed data
on the number of employees who have taken the DRP, who have
taken VERA, who have resigned, who have retired? Are you able
to get that information for us?
Ms. Therit. Ranking Member Ramirez, yes, I can get that
information.
Ms. Ramirez. Great. What about the number of job offers
that have been declined by applicants since January of this
year? Is that a data point that you have the capability of
pulling?
Ms. Therit. Ranking Member Ramirez, our talent acquisition
system is USA staffing and it does capture some information on
declinations, but it may not provide the detailed information
that you are asking.
Ms. Ramirez. Okay. Please provide me everything that in
fact is being collected? Mr. Therit, can you please commit to
working with us on providing the detailed data in a reasonable
time?
Ms. Therit. Ranking Member Ramirez, I welcome the
opportunity to work with this.
Ms. Ramirez. Great. Thank you, Ms. Therit. I do not imagine
you will have this number on top of your head because I am sure
there is a lot going on and a lot of information you have to
try to memorize for these hearings. I want to bring to you an
answer, I want you to bring an answer back for the record, how
many veteran care appointments at the VA have been canceled
since January of this year due to staffing shortages? If you
have the answer, I will take it now. If not----
Ms. Therit. Ranking Member Ramirez, I do not. I do not know
if Mr. Perry does.
Ms. Ramirez. Do you have that? No?
Mr. Perry. We do not, but we can take that----
Ms. Ramirez. Keeping come back with it.
Mr. Perry. Yes.
Ms. Ramirez. I would really appreciate knowing how many
veteran appointments have been canceled. I am going to leave it
at that. Mr. Steele, I really wanted to ask you a question, but
I am hopeful others can. Thank you.
Ms. Kiggans. The chair now recognizes Mr. Conaway for 5,
for 2 minutes.
Mr. Conaway. I thought we were changing the order, Madam
Chair. Thank you for recognizing me, Madam Chair. Just before I
get to one of my questions, I just want to make a comment about
H.R. 1, the big cruel bill, as I call it. I am very concerned
that medical students going to medical school, very expensive
process, that there is now a cap on those loans that students
may give. It is going to particularly be a problem for those
students who do not come from wealthy families where they are
going to have to try to figure out how to make up that gap.
What do you think that this, that this issue of cutting support
for medical education, how do you think that is going to impact
the VA? You have trained most of the physicians in the country.
Ms. Therit. Dr. Conaway, I would say that when we talk
about 3R's, there are also other incentives and you speak to
scholarship programs, debt reduction programs, and if you look
at the job opportunity announcements that are posted for the
VA, many of our Veterans Health Administration job opportunity
announcement include those benefits. I will ask Mr. Perry to
just----
Mr. Conaway. I am going to reclaim my time because I want
to get another question in. Pardon me for that, but I must push
on. In 2024, the VA reported a loss of 608 physicians. Just a
series of questions. You may not have them, but I want to get
them in before my time is up. How many job postings does the VA
currently have for physicians? Do you know by chance, if you do
not know off the top of your head, I will just leave them for
the record. How many physicians has the VA onboarded in the
past month? What is the VA doing to attract and retain
physicians? Why do you think we are seeing such a loss in
physicians? I will leave it at that. If you have questions, any
of those, I see my time is up, but I look forward to your
answer offline.
Ms. Kiggans. The gentleman's time has expired. The chair
now recognizes Mr. Kennedy for 2 minutes.
Mr. Kennedy. Thank you. I want to just go back to the
Secretary and what he said to this committee in May, that the
VA would maintain mission essential jobs like doctors, nurses
and claims processors. According to the VA's monthly workforce
dashboard, estimated losses for Fiscal Year 1925 are 1,720
registered nurses, 604 physicians, and 1,081 veteran claim
examiners. These are mission critical roles which run directly
against Secretary Collins points that current and future cuts
to the VA will not impact the delivery of care and benefits. As
an occupational therapist, I have seen firsthand on the ground
what happens when health care facilities are short staffed and
that health care is not provided to individuals. Right now, our
veterans are being provided care by American heroes on the
ground in these facilities. You know what? They are exhausted.
Not because they do not care, but because they ultimately are
having trouble keeping up because they are getting cut in
staffing. When that happens in our VA, it is our veterans that
are paying the price. Even though we have been told mission
critical employees are not being cut, evidence on paper is that
in fact there is a different story. We have credibility issues
at the VA and with this administration happening right now.
These cuts are impacting veteran care, and veterans should not
have to wait longer or see fewer specialists or receive delayed
benefits. As members of this committee, we have a sacred
responsibility to uphold this Nation's promise to our veterans.
These cuts are not only shortsighted un-American.
Ms. Kiggans. The gentleman's time has expired.
Mr. Kennedy. I yield back.
Ms. Kiggans. Dr. Steele and Dr. Elliot. Thank you to each
of you for coming to testify today. The solution is not just
identifying weak policies, but following through with the
guardrails that ensure effective oversight. It is clear more
attention needs to be focused on ensuring the VA is following
Congress's intention when paying these incentives. The fact
that we are still having a conversation on this issue after
more than a decade since the OIG's 2017 report on improper
bonus payments indicates we must do something different. It
does not take a rocket scientist to figure out that providing
quality and safe patient care is a better use of tax dollars
and accounting mistakes. These bonuses, when used correctly,
enable the VA to pay attractive salaries to valuable clinical
staff and other VA employees who serve our veterans. These
incentive payments should go to staff dedicated to providing
world class care for our veterans. When the VA cannot retain
its good employees or recruit talented staff, patient care is
the first to suffer. I have seen this firsthand as a nurse
practitioner. I will not allow it to happen while I am
chairwoman of the subcommittee. I am encouraged the OIG
identified better documentation as a means of improving the
bonus payment processes as well. Aside from the waste stemming
from the improper payments, it is not possible to conduct a
thorough review of where processes went wrong when there is no
paper trail. That is why I was happy to vote with my House
colleagues yesterday for Senate Bill 423, the Protecting
Regular Order for Veterans, or PRO Act. This bipartisan bill
would provide additional guardrails on incentive payments paid
to members of the senior executive service and I hope the VA
will take them seriously. I am looking forward to further
collaboration with Secretary Collins and the Trump
administration to assist with our oversight efforts. I am
grateful for the clarity that today's testimony offers. Ranking
Member Ramirez, do you have any closing remarks?
Ms. Ramirez. Thank you, Chairwoman. World class care cannot
be achieved when you have lost 1,720 registered nurses. Cannot
be achieved when 1,147 medical support assistant staff leave or
604 physicians leave. When asked why they are leaving, they say
lack of trust and confidence in senior leaders. The information
contained in VA's workforce dashboard is critical to our
oversight and to showing the public the true picture of what is
happening at the VA under Secretary Collins. It is hard to call
us liars and say our claims are a hoax when we have the data
from VA to back up concerns that veteran care and benefits are
being impacted under Collins leadership. The information for
the public that is listening can be accessed at va.gov/
employee/workforce-dashboard. I urge everyone watching this
hearing to go now and review the data and make a judgment for
yourself on how this administration's actions have and will
continue to impact world class care for our veterans. We know
that this administration has a history of deleting or hiding
files and tampering with information they do not agree with. To
ensure that these documents remain a part of the public record
and are not deleted, removed or hidden, I request unanimous
consent to enter issues 1 through 26 of VA's workforce
dashboard into the dashboard.
Ms. Kiggans. Without objection. So, ordered.
Ms. Ramirez. Thank you, Chairwoman. With that, I yield
back.
Ms. Kiggans. Thank you, Ranking Member, and thank you all
for being here today. Ms. Therit, Mr. Perry, Mr. Steele, Dr.
Elliot, I know you all took time out of your busy schedules and
I appreciate that. I am sure you were prepared to discuss the
real issues at the VA, including the title of our subcommittee,
which just as a reminder was Counting the Money, Preventing
Fraud and Abuse in the VA's bonus payment practices for VA
employees. I appreciate your insight on the issue that is why
we called this hearing today. As a navy veteran and a nurse
practitioner, I know how critical it is for the VA to provide
consistent, high-quality care to those who have served. I am
married to a veteran. I am the mom to future veterans. I
represent tens of thousands of veterans. My own parents are
veterans. It is an issue near and dear to my heart and to my
district.
I am encouraged that the VA has decided against large scale
layoffs and is instead taking a more thoughtful and measured
approach to improving operations. I also worked at the VA for
several years or for several months as a nurse practitioner. It
was a short time because I am a geriatric nurse practitioner
and could not utilize my geriatric skill base as much as I
wanted to. I remember that there were a lot of really good
people doing really hard work. The physicians, the doctors and
nurses, the pharmacists, the allied health professionals, the
people who were in one building taking care of people who
walked through our front door. I also remember on my lunch
break I would take walks and see buildings full of other people
that did not provide patient care. I did not know what they
did, but I knew where I was called to work and where I was able
to touch patients and to impact lives of veterans. I think
there is room. Just as this was before my time in politics,
just looking at what that facility looked like, knowing that
there was room to probably downscale, I want to make sure that
our best resources are going to the patient care.
Reducing 30,000 positions through attrition rather than
eliminating clinical roles is a more reasonable path forward. I
know that is what the Secretary is focused on doing. I support
efforts to streamline the department and I give more decision-
making authority to local medical center directors who are
closest to the veterans they serve. Decentralizing operations
can help VA facilities respond more quickly to local needs and
improve overall outcomes for patients. At the same time, I am
closely monitoring how these changes may impact support staff
who play a critical role in ensuring providers can focus on
delivering care. I believe restructuring can be positive, but
only if it is done transparently, with input from frontline
workers and full oversight from Congress. The lack of clarity
around some of the VA's reorganization efforts is concerning,
and I will continue to push for more communication and
accountability. Congress must be a partner in the process, not
an afterthought, and the VA leadership must work
collaboratively to keep veterans and employees informed. I will
continue advocating for investments in VA services that
prioritize patient care, benefits delivery and support for the
dedicated workforce. Ultimately, this is not a partisan issue.
This is about keeping our promises to those who have worn the
uniform. Veterans deserve a VA that serves them efficiently,
compassionately and without disruption. Again, thank you all
for being here today. I ask unanimous consent that all members
shall have 5 legislative days on which to revise and extend
their remarks and include any extraneous material.
Hearing no objection. So, ordered. This hearing is now
adjourned.
[Whereupon, at 3:19 p.m., the subcommittee was adjourned.]
=======================================================================
A P P E N D I X
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Prepared Statements of Witnesses
----------
Prepared Statement of Tracey Therit
Good afternoon, Chairwoman Kiggans, Ranking Member Ramirez, and
distinguished members of the Committee. Thank you for the opportunity
to discuss how VA is improving governance and oversight of recruitment,
relocation, and retention (3R) incentive payment practices. As pay caps
for health care professionals at VA have not kept pace with rising
salaries for health care professionals and specialists, the 3R program
is a critical component of VAs incentive plan. I am joined today by Mr.
David Perry, Acting Chief, Human Capital Management, Veterans Health
Administration (VHA).
Everything VA does is to ensure Veterans receive the care and
services they deserve while instilling a culture of caring, customer
service, and accountability that always puts Veterans first. This noble
mission, coupled with a variety of hiring flexibilities and incentives,
enables VA to attract and retain a highly qualified workforce. VA also
offers a comprehensive benefits package, generous leave allowances,
state-of-the-art research and innovation programs, as well as top-of-
the-line training opportunities.
VA will always fulfill its duty to provide Veterans, families,
caregivers, and survivors with the health care and benefits they have
earned. To ensure all Veterans and VA beneficiaries continue to receive
their earned benefits and services, VA is always recruiting dedicated
professionals. As of July 2025, more than 350,000 mission-critical
positions are exempt from the Federal hiring freeze. While VA has
historically offered 3R incentives to address occupational shortages
and facilitate hiring initiatives, the Department must provide greater
accountability and stewardship of taxpayer resources by enhancing
procedures, documenting requirements, and providing oversight of these
incentives.
Starting in 2017, VA updated Department policy on 3R incentives to
establish internal controls and improve oversight. Specifically, VA
began requiring annual certification that the incentive was appropriate
and in compliance with policy; had succession plans to reduce long-term
reliance on incentives; and established residency before payment
receipt. In the years since, VA has continued iterating and
implementing additional improvements including the following:
Requiring a standard form to capture all information
required by law.
Aligning the use of 3Rs with shortage/hard-to-fill
positions.
Obtaining authorization/justification before including 3R
incentives in the job announcement.
Tracking unfulfilled service obligations.
Improving coordination on debt collection and enforcing
debt collection.
Reviewing retention incentives annually and terminating
them in a timely manner if they were not needed.
3R incentives help VA fill critical positions providing direct care
and services to Veterans. Moreover, offering these incentives enables
VA to address periods of increased demand or sustained industry-wide
staffing shortages. For example, 3R incentives helped VA rapidly
respond and compete for talent amid the pandemic and continue to aid in
attracting doctors and nurses to areas of growing need because of the
Sergeant First Class Heath Robinson Honoring our Promise to Address
Comprehensive Toxics Act of 2022.
However, there is always room for improvement, and VA must continue
to refine its governance of these incentives, including proper
documentation of their use, ensuring the correct signatures are in
place, and ensuring the justification for employing a 3R incentive is
sound. VA must also develop stronger oversight mechanisms and
discontinue the use of multi-year retention incentives.
Accomplishing this requires VA to build upon current policy and
process, enhancing systems, and training on 3R incentives. The
Department is establishing quality control and accountability measures
and ensuring oversight responsibilities are risk-based and completed in
a timely manner. VA is also identifying ways to improve automation and
technology, which has enabled VA to complete documents in the system,
to centrally store documents, to build in controls and alerts, and to
create dashboards and recurring reports.
Finally, VHA is implementing a comprehensive strategy to enhance
the management and oversight of VA incentive programs. This includes
continuing to monitor internal control procedures and guidance to
ensure that 3R documentation is appropriately maintained in accordance
with VA policy. VHA will conduct program monitoring quarterly and
utilize uniform checklists and templates nationwide. Additionally, VHA
is developing training and materials to ensure proper documentation for
succession plans, performance ratings, and certifications. To better
enforce policy compliance, VHA is creating oversight plans and a
strengthened technical review program to assess every incentive for
technical adherence. An enterprise-level oversight monitoring component
will act as a second-level compliance check at the national level. VHA
aims to support compliance with record retention requirements.
Furthermore, specific performance metrics tied to operational
leadership and human resources (HR) leadership are being developed to
reinforce the importance of proper governance and oversight for VA
incentive programs.
As a part of this Administration's workforce optimization efforts,
VA has identified several ideas for improving VA to better serve
Veterans. One of the proposals being discussed is centralizing HR
functions, which would strengthen the HR structure to process, monitor,
and review 3R incentives. The current structure has been cited as being
too decentralized with multiple layers of bureaucracy. VA will continue
to keep Congress informed through initiatives such as monthly Eight
Corners briefings from Assistant Secretary for Human Resources and
Administration/Operations, Security, and Preparedness Mark Engelbaum as
the Department continues its reviews of organizations and services.
VA is fully committed to addressing the issues identified in the
Inspector General's report, ``Recruitment, Relocation, and Recruitment
Incentives for VHA Positions Need Improved Oversight,'' and to
strengthening our processes in support of VA's mission. To date, we
have closed one of the eight recommendations and are on schedule to
close five more in September 2025. We will complete the final two
recommendations by March 2026. We are confident that the steps we have
already taken and continue to take will strengthen our incentive
program governance and oversight, leading to more effective outcomes
and better service to the Nation's Veterans.
While the 3R incentive program is an important tool for the
Department in attracting and retaining a vibrant and talented
workforce, it is not enough for VA to remain competitive with industry.
VA looks forward to working with the committee on strategies to ensure
VA is an employer of choice for physicians (in critical need
specialties).
Conclusion
I am proud to be part of this noble mission to care for the
Nation's Veterans. I look forward to working with each of you on this
Committee on ways to more effectively and efficiently provide enhanced
oversight and governance of incentive payment practices, ensuring that
VA can continue to provide the best care and services to Veterans and
their families. This concludes my testimony. My colleague and I are
prepared to respond to any questions you may have.
Prepared Statement of Shawn Steele
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Prepared Statement of Sheila Elliott
Chairwoman Kiggans, Ranking Member Ramirez, and Members of the
Oversight and Investigations Subcommittee:
The American Federation of Government Employees, AFL-CIO (AFGE) and
its National Veterans Affairs Council (NVAC) appreciate the opportunity
to testify at today's subcommittee hearing titled ``Counting the Money:
Preventing Fraud and Abuse in VA's Bonus Payment Practices for VA
Employees.'' My name is Dr. Sheila Elliott, and for the past 35 years,
I have and continue to serve as a Pharmacist at the Hampton, VA, VA
Medical Center. I have also, until retiring last month, proudly served
over 15 years as the president of AFGE Local 2328, which represents
most direct patient care staff at the VAMC and its surrounding clinics.
On behalf of the 320,000 Department of Veterans Affairs (VA)
employees AFGE represents, approximately a third of whom are veterans
themselves, it is a privilege to offer AFGE's views on how the VA
should improve recruitment and retention for the VA workforce, both
within the scope of recruitment, retention, and relocation bonus
program, and beyond.
OIG Report
On June 12, 2025, the VA OIG released a report titled
``Recruitment, Relocation, and Retention Invectives for VHA Positions
Need Improved Oversight'' (``OIG report'').\1\ As the report states,
``[t]o address occupational shortages and facilitate hiring efforts, VA
leverages Federal regulations that allow agencies to offer recruitment,
relocation, and retention incentives to encourage candidates to accept
positions that are difficult to fill or to keep high-quality staff who
may otherwise leave.'' \2\, \3\ In this report, OIG
highlighted several problems with the administration and oversight of
this recruitment, retention, and relocation bonus (``RRR bonus '')
program that AFGE agrees with.
---------------------------------------------------------------------------
\1\ ``Recruitment, Relocation, and Retention Invectives for VHA
Positions Need Improved Oversight'' VA OIG 23-01695-94 Page i June 12,
2025
\2\ Id.
\3\ Citing ``Recruitment, relocation, and retention incentives are
authorized under 5 U.S.C. Sec. Sec. 5753 and 5754 are extended to
title 38 employees under the authority of 38 U.S.C. Sec. 7410. Title
38 employees are those individuals appointed under 38 U.S.C. Sec.
7401, which permits the VA Secretary to hire personnel necessary for
the health care of veterans and can include physicians, nurses, and
dentists.''
---------------------------------------------------------------------------
HR Modernization
Chief among the problems identified in this report is the failure
of VA Human Resources (HR). While VA did use this tool to recruit and
retain VHA clinicians, there were clearly problems in how the RRR bonus
program was administered to ensure that the correct employees were
receiving the benefits and that the process was carried out
appropriately. Many of these problems were first identified by the OIG
in 2017.\4\ Unfortunately, the report goes on to note that the ``OIG
team found VHA did not take sufficient steps to sustain or enforce the
updated VA policies to ensure incentive packages were completed
appropriately before payments were initiated. Further, VISN human
resources staff acknowledged they did not always adhere to policy.''
\5\ The report then digs deeper by identifying ``Beginning in Fiscal
Year 2019, VA also consolidated human resources responsibilities from
the facility level to the VISN level, including oversight of
incentives. During this transition, according to human resources
officials, turnover led to a shortage of trained staff to conduct
incentive oversight responsibilities.'' \6\
---------------------------------------------------------------------------
\4\ VA OIG, Audit of VA's Recruitment, Relocation, and Retention
Incentives.
\5\ Recruitment, Relocation, and Retention Invectives for VHA
Positions Need Improved Oversight'' VA OIG 23-01695-94 Page 11 June 12,
2025
\6\ Id at 12.
---------------------------------------------------------------------------
AFGE has continuously criticized the HR centralization or
modernization that the OIG is citing here, agreeing with the conclusion
that it has led to increased turnover at the VA. Additionally, AFGE
believes that HR not being in the facilities, and lacking familiarity
with the workforce and the veterans they serve, exacerbates this
turnover. In aggregate, this undermines the ability of HR professionals
to properly serve employees generally, as well as administering the RRR
bonus program. Furthermore, the OIG's citing of multiple instances of
poor record keeping not only proves that certain employees may have
incorrectly received the reward, but it also makes it harder to
determine who has correctly received RRR bonuses.
In preparation for this hearing, when contacting the Hampton VAMC,
we could find no public repository of data to show who has received RRR
bonuses over the past several years. However, after reaching out to 800
bargaining unit members at Hampton VAMC this month on our own, AFGE had
nine bargaining unit members self-report, from a variety of
professions, that four recruitment bonuses, four retention bonuses, and
on relocation bonus were awarded. These bonuses were awarded between
2021 and 2025.
While AFGE is pleased that at least nine employees received these
RRR bonuses, we have no way of knowing if this benefit is being under,
properly, or over utilized at Hampton VAMC compared to the rest of VHA.
However, regardless of its relative utilization to other facilities, I
can say with decades of experience at this facility that there is
significant room for improvement, both at the VAMC itself and the
brand-new North Battlefield Outpatient Clinic, which opened in 2025
with only 150 of 550 staffing positions filled. While AFGE acknowledges
that medical facilities are not filled overnight, we urge the VA to
use, and this committee to question the VA on how, this RRR bonus
program is being used to fill positions and increase capacity at the
North Battlefield Outpatient Clinic and at the Hampton VAMC?
Other ways to improve Recruitment at Retention:
In addition to improving the RRR bonus program, AFGE has many other
priorities within this committee's jurisdiction that would directly
improve recruitment and retention.
AFGE/NVAC Collective Bargaining Agreement:
As this committee is aware, on March 27, 2025, President Trump
signed the Exclusions from Federal Labor-Management Relations Programs
Executive Order 14251 (EO) eliminating the collective bargaining rights
of 1.5 million Federal employees at agencies including VA. This EO
abuses the National Security exemption in Title 5 to eliminate
collective bargaining rights in agencies that have little or no
national security mission, including the VA workforce. Is strikes down
a central pillar of the 1978 Civil Service Reform Act enshrined in
Title 5 of the U.S. Code that governs the merit-based system of
selecting most Federal employees, protects whistleblowers, and provides
due process to Federal employees who have been unfairly disciplined or
terminated.
Continuing to deny large swaths of the VA workforce collective
bargaining rights, will continue to harm recruitment and retention. As
there is a critical shortage of health professionals in this country,
why would high quality candidates want to serve in the VA, when they
would retain not only union protections, but better salaries in the
private sector? This is particularly egregious, as Secretary Collins
played favorites when choosing whom to exempt from the EO, not by job
description or duties, but by which union represents the employees in
question. AFGE, as well as several of our sister unions, were not
granted an exemption, and our members, despite having identical jobs to
those in other facilities who were exempted from this EO, lost their
collective bargaining rights. AFGE urges members of this committee to
co-sponsor and support H.R. 2550, the ``Protect America's Workforce
Act,'' which would nullify this illegal executive order.
Reforming 38 USC 7422
As AFGE has testified to before this subcommittee, 38 USC 7422 has
had a negative effect on recruitment and retention for Title 38
employees at the VA. Under this statute, the VA can invoke 7422 to deny
a grievance for a Title 38 employee based on ``professional conduct or
competence'' (including ``direct patient care'' or ``clinical
competence''), peer review, or ``the establishment, determination, or
adjustment of employee compensation.''
AFGE is proud to have worked with members of this committee in
bipartisan fashion to craft the narrowly tailored ``VA Correct
Compensation Act'' to better define the compensation language of the
statute. AFGE has also long supported the ``VA Employee Fairness Act''
(H.R. 3261) which would effectively abolish 7422.
Any legislative action to rein in the abuse of 7422 by management
would be a critical step to improve recruitment and retention of the VA
workforce. However, while AFGE and other unions are subjected to EO
14251, there is no contract for affected Title 38 employees to file a
grievance under. AFGE urges, particularly after the result of
litigation or legislation related to EO 14251, for this committee to
reform 7422 to better retain its Title 38 workforce.
Telework
AFGE has long argued for the benefits of allowing telework or
remote work for employees who can perform their duties remotely. Within
the VHA space, this is particularly true for clinicians who practice in
whole or in large part through telemedicine. However, since most
telework has been rescinded by this administration, many clinicians
have had to report to a VA facility, and have been required to interact
with patients remotely, often in crowded bullpens, to discuss private
matters. This has harmed morale and retention of mission-critical and
hard-to-recruit clinicians at the VA. Ironically, one of the RRR
bonuses that AFGE could find was awarded to a former Hampton VAMC
employee who for the last 3 years was a remote mental healthcare
provider who was leaving their position due to the end of remote work.
However, instead of leaving the VA, this employee received a relocation
bonus to move to another facility. This has negatively affected the
capacity of Hampton and reflects VA's overly broad approach to telework
and telehealth.
Conclusion
I hope that my testimony today leads the subcommittees to better
consider ways to improve recruitment and retention at VA for
clinicians. AFGE and the NVAC stand ready to work with the House
Veterans' Affairs Committee and VA to make these recommendations and
better enable VA employees to serve veterans. Thank you, and I look
forward to answering your questions.
[all]