[Senate Hearing 119-6]
[From the U.S. Government Publishing Office]
S. Hrg. 119-6
NOMINATION OF THE HONORABLE
DOUGLAS A. COLLINS
TO BE SECRETARY OF VETERANS AFFAIRS
=======================================================================
HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED NINETEENTH CONGRESS
FIRST SESSION
__________
JANUARY 21, 2025
__________
Printed for the use of the Committee on Veterans' Affairs
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://www.govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
58-631 PDF WASHINGTON : 2025
-----------------------------------------------------------------------------------
SENATE COMMITTEE ON VETERANS' AFFAIRS
Jerry Moran, Kansas, Chairman
John Boozman, Arkansas Richard Blumenthal, Connecticut,
Bill Cassidy, Louisiana Ranking Member
Thom Tillis, North Carolina Patty Murray, Washington
Dan Sullivan, Alaska Bernard Sanders, Vermont
Marsha Blackburn, Tennessee Mazie K. Hirono, Hawaii
Kevin Cramer, North Dakota Margaret Wood Hassan, New
Tommy Tuberville, Alabama Hampshire
Jim Banks, Indiana Angus S. King, Jr., Maine
Tim Sheehy, Montana Tammy Duckworth, Illinois
Ruben Gallego, Arizona
Elissa Slotkin, Michigan
David Shearman, Staff Director
Tony McClain, Democratic Staff Director
C O N T E N T S
----------
January 21, 2025
SENATORS
Page
Hon. Jerry Moran, Chairman, U.S. Senator from Kansas............. 1
Hon. Richard Blumenthal, Ranking Member, U.S. Senator from
Connecticut.................................................... 2
Hon. Tim Sheehy, U.S. Senator from Montana....................... 13
Hon. Patty Murray, U.S. Senator from Washington.................. 15
Hon. Dan Sullivan, U.S. Senator from Alaska...................... 17
Hon. Mazie K. Hirono, U.S. Senator from Hawaii................... 19
Hon. Kevin Cramer, U.S. Senator from North Dakota................ 21
Hon. Angus S. King, Jr., U.S. Senator from Maine................. 23
Hon. Jim Banks, U.S. Senator from Indiana........................ 25
Hon. Elissa Slotkin, U.S. Senator from Michigan.................. 27
Hon. John Boozman, U.S. Senator from Arkansas.................... 29
Hon. Ruben Gallego, U.S. Senator from Arizona.................... 31
Hon. Tommy Tuberville, U.S. Senator from Alabama................. 33
Hon. Bernard Sanders, U.S. Senator from Vermont.................. 35
Hon. Thom Tillis, U.S. Senator from North Carolina............... 37
Hon. Margaret Wood Hassan, U.S. Senator from New Hampshire....... 39
Hon. Bill Cassidy, U.S. Senator from Louisiana................... 41
Hon. Tammy Duckworth, U.S. Senator from Illinois................. 43
Hon. Marsha Blackburn, U.S. Senator from Tennessee............... 45
INTRODUCTION
Hon. Kevin Cramer, U.S. Senator from North Dakota................ 5
NOMINEE
Hon. Douglas A. Collins, Nominee To Be Secretary of Veterans
Affairs........................................................ 6
APPENDIX
Nomination Material
Hon. Douglas A. Collins, Nominee
Prepared Statement............................................. 61
Response to Pre-Hearing Questions for the Record submitted by:
Hon. Jerry Moran............................................. 64
Hon. Richard Blumenthal...................................... 69
Response to Questions for the Record submitted by:
Hon. Richard Blumenthal...................................... 79
Hon. Patty Murray............................................ 81
Hon. Dan Sullivan............................................ 84
Hon. Mazie K. Hirono......................................... 88
Hon. Kevin Cramer............................................ 92
Hon. John Boozman............................................ 93
Hon. Margaret Wood Hassan.................................... 94
Hon. Tammy Duckworth......................................... 95
Questionnaire for Presidential Nominees........................ 96
Questionnaire Addendum......................................... 109
Letters of Support
America First Vets & First Responders Alliance Inc., Jason G.
Loughran, Chairman and New York Chapter President.............. 115
American Veterans (AMVETS)....................................... 116
Avalon Action Alliance, Joe Brennan, et al....................... 117
Blinded Veterans Association (BVA)............................... 119
Luke's Wings, Fletcher Doud Gill Sr., Chief Executive Officer and
Co-Founder..................................................... 120
Military Veterans Advocacy, John B. Wells, Commander USN (Ret.),
Chairman....................................................... 121
National Defense Committee, et al................................ 123
Valor Mission Project, Inc., Jimmy Mac, Executive Director....... 124
Wounded Warrior Project (WWP).................................... 125
NOMINATION OF THE HONORABLE
DOUGLAS A. COLLINS
TO BE SECRETARY OF VETERANS AFFAIRS
----------
TUESDAY, JANUARY 21, 2025
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 10 a.m., in Room
SD-G50, Dirksen Senate Office Building, Hon. Jerry Moran,
Chairman of the Committee, presiding.
Present: Senators Moran, Boozman, Cassidy, Tillis,
Sullivan, Blackburn, Cramer, Tuberville, Banks, Sheehy,
Blumenthal, Murray, Sanders, Hirono, Hassan, King, Duckworth,
Gallego, and Slotkin.
OPENING STATEMENT OF HON. JERRY MORAN,
CHAIRMAN, U.S. SENATOR FROM KANSAS
Chairman Moran. Good morning everyone, and good morning to
my colleagues on the Senate Committee on Veterans' Affairs.
This hearing will now come to order. I welcome everyone to the
first hearing of the Senate Committee on Veterans' Affairs for
the 119th Congress.
I am grateful to have so many of my colleagues returning to
this Committee, and I look forward to continuing our work
together. I am also grateful to have five new Members; Senator
Banks of Indiana, Senator Sheehy from Montana, Senator
Duckworth from Illinois, Senator Gallego from Arizona, and
Senator Slotkin from Michigan. Welcome to this Committee.
I look forward, especially, to working with the new Ranking
Member, that was me before you. You and I have had the
experience of working together previously, and I look forward
to continuing our efforts to work together to see that veterans
are well cared for, and that Members of this Committee have an
opportunity to express their views and make a difference in
this arena.
My work on this Committee is almost always driven by what I
hear from veterans, particularly at home in Kansas, but also
across the country. We will hear from a lot of veterans'
organizations as well, and this is about how do we make the VA
work better. What is it doing well? What is it not doing well?
How do we solve the problems that veterans face in this
country? Sometimes one at a time, but I hope, often, veterans
as citizens in a group.
As Chairman, I will work to solve problems and deliver
results to help veterans access healthcare and benefits they
have earned and achieved in their success in their service. I
want them to be successful after their service, and I expect
the next Secretary of Veterans Affairs to share a similar
focus.
The role of the Secretary of the Department of Veterans
Affairs is critical. America's national security is dependent
upon an all-volunteer military, and a VA that is successful in
helping service members thrive as veterans is key to bolstering
recruitment and keeping our Nation safe. Millions of veterans
and their loved ones rely on the VA to access higher education
and job training, buy a house, open a small business, cope with
service-connected conditions, access healthcare, and more.
Helping veterans achieve those goals is often complicated
by the fact that VA is one of the largest bureaucracies within
the Federal Government with more than 400,000 employees. That
includes a massive physical footprint that spans the globe. Our
facilities are aging, a legacy IT system, and an annual budget,
well over $300 billion.
We must have a VA Secretary who understands the VA mission,
who will help refocus the Department to put Veterans first, and
who recognized the importance of the VA in serving veterans and
contributing to a safe and successful future for our Nation.
I am grateful to have Congressman Doug Collins here today
to testify about his nomination to be the Secretary of Veterans
Affairs. He knows firsthand the benefits and challenges of
military service and many issues facing veterans and their
families. I am grateful for Congressman Collins's interest in
serving in this capacity, and I look forward to hearing today
how he plans to improve and support the lives of his fellow
veterans, if confirmed.
I know that military service is family service, so I want
to recognize and thank Congressman Collins's family, including
his wife, Lisa, daughter, Jordan, and sons, Cameron and
Copelan, who are with us here today. Welcome to your family,
Congressman.
Before yielding to the Ranking Member, I want to recognize
former Secretary of Veterans Affairs, Denis McDonough. I am
grateful to Secretary McDonough for his hard work and his
dedication to veterans and their families, and I wish him all
the best in his next chapter. With that, I yield to the Ranking
Member, Senator Blumenthal, for his opening remarks.
OPENING STATEMENT OF HON. RICHARD BLUMENTHAL,
RANKING MEMBER, U.S. SENATOR FROM CONNECTICUT
Senator Blumenthal. Thanks so much, Mr. Chairman. Thank you
for being here today, Congressman Collins and as well to your
family, Lisa, Jordan, and Cameron, and to all the visitors who
are here today, many of them veterans.
I am thrilled to be the Ranking Member and to have as
Chairman, my friend and colleague, Senator Moran. He and I have
a strong working relationship, and it exemplifies, I think, the
kind of bipartisanship that has characterized the work of this
Committee. In fact, we have been a paragon of bipartisanship in
the face of the buffeting winds of political polarization on
other topics, and I look forward to fighting and advocating for
veterans in the face of some pretty heavy threats.
I was chagrined yesterday that there was no mention in the
inaugural address by President Trump about veterans. I was
disappointed to see in the Executive orders that a hiring
freeze will be imposed, apparently, on the VA. And I am hopeful
that you, Congressman Collins, I'm going to be very blunt, will
be the kind of advocate that the VA and our veterans will need
in this administration.
There will be potentially heavy pressures on you to cut and
slash, to reduce access and eligibility, because the VA,
frankly, is a target-rich environment for cost-cutters, and we
know that there is a Department of Government Efficiency
looking for those kinds of cost-cutting opportunities. I look
forward to supporting you, and bolstering your efforts to
defend and advocate our veterans who must always be a priority.
I want to thank Senator Moran, but also Senator Tester, who
was such a strong advocate, as well as Denis McDonough, and
most particularly, in our joint efforts to pass the PACT Act.
President Biden and Secretary McDonough were instrumental in
providing more care and more benefits to veterans than ever
before when they were exposed to toxic chemicals or burn pits,
not only on the battlefield, but also in training. I think
every Member of this Committee can be proud of that effort.
You mentioned in your opening that, ``timely access to care
and benefits for every eligible veteran is job one.'' I hope
that will be your mantra. It certainly is ours. Unfortunately,
veterans are confronted with losing access to VA's direct care
system in an unprecedented number of referrals going into the
community. As we discussed during our meeting, you and I, and I
appreciate your coming by to talk to me, there certainly is an
important role for community care in the timely delivery of
care to veterans. But it can't be at the expense of the VA
direct care system, which many vets prefer and rely on.
I have two sons who have served. One is a combat infantry
officer in Afghanistan. The other is a Navy SEAL. And most
particularly, my Navy SEAL son has made use of veterans
benefits and facilities on the West Coast in West Haven. So, I
know firsthand, the extraordinary care, really, it's a gold
standard of care that our veterans' facilities provide, and
particularly in the area of mental health. We need to invest as
well as in modernizing infrastructure and facilities such as we
are doing in West Haven.
Today, I want to learn more about your plans to lead the
largest civilian agency in the Federal Government. Literally,
the largest civilian agency. An organization of more than
450,000 employees comprising 20 percent of our whole federal
workforce. That is an awesome responsibility. I am especially
interested in how you plan to build a workforce culture that
encourages employees to speak up with concern, and criticism,
and offer ideas to drive improvements, not one to seek
retribution or demand fealty and loyalty at the expense of the
quality of veterans' care.
If confirmed, it is your duty to treat every VA employee
and veteran regardless of gender, race, religion, or sexual
orientation with the dignity and respect they deserve. You and
I have acknowledged our differences, and we will have
differences of opinion especially on some social policies, but
I will need your assurance that your views will not negatively
impact veterans seeking the care and benefits they have earned.
They have earned those benefits.
In our meeting, I appreciated your commitment to put the
law first and respect the rule of law. With regard to abortion
care and counseling, I expect the administration to consider
the existing rule legally binding, unless it is replaced or
struck down. I believe that rolling back this policy would
unnecessarily risk the lives and health of pregnant veterans in
states with abortion bans and care restrictions in the post-
Dobbs era.
During the last Trump administration, we know outsiders
exerted significant influence on the VA. In fact, GAO looked
into and substantiated that three individuals, private
citizens; Bruce Moskowitz, Isaac Perlmutter, and Marc Sherman,
referred to as the ``Mar-a-Lago Three'', played a key role in
several high-profile decisions outside of the formal VA
decision-making process. These included VA senior level
personnel decisions, and involvement in negotiations for the VA
electronic record system, among other issues.
I hope you will push back. Push back strongly on
inappropriate influences that operate outside of well-
established federal transparency rules, especially when they
are not acting in the best interests of veterans. Whether it's
ideologically minded groups with ulterior motives, or the array
of big tech executives that we saw on the platform yesterday at
the inaugural, including Elon Musk.
Congressman Collins, if confirmed, you must be the
decision-maker at the VA. You must be their advocate and keep
the needs of veterans at the forefront. There will undoubtedly
be pressure on you to scale back and cut costs at every
opportunity, but I can't emphasize how important it will be to
me, and I hope all of us on this Committee, that you fight
those efforts with every fiber in your being.
I am hopeful we have shared priorities, including upgrading
the VA facilities around the country, particularly healthcare
facilities, and suicide prevention, which I know is a priority
of yours. We discussed it when you visited with me. If you are
confirmed, I welcome the opportunity to work with you, to
support you, to advocate with you in this administration, and
to improve services to veterans in Connecticut and across the
country.
Before I turn it over to Senator Moran, I want to just
offer on a personal note, I am incredibly disheartened that the
Trump administration is canceling the flights of nearly 1,660
Afghan refugees who were already cleared by the U.S. Government
to resettle in the United States. These allies aided our troops
in Afghanistan. Whatever you think about the conflict there,
the risk to these Afghan allies are so dire and dangerous, and
many of our veterans groups have been advocates for them.
As you know, in fact, the strongest advocates for
resettling those at risk Afghan allies are the veterans who
benefited from their protection and their service, which
involved putting their own lives and their families on the
line. And yet, those Afghan partner forces and their families
are stuck at the risk of harm in areas around the world.
Our Nation has a sacred promise that we have made to do
right by the men and women who risk their lives for our
freedoms and democracy, and do right for their families. And
that includes those translators, the guards, the others that
put their backs in targets and became our loyal friends. And I
will keep fighting to ensure that they are resettled to the
United States and push back against any attempts by the
administration to renege on those promises to our service
members, veterans, and Afghan allies.
And again, I want to offer thanks to all of the VSOs, all
the individual veterans who came to the defense of those Afghan
at risk allies, and have joined us in urging aid and freedom
for them. Again, thank you, Mr. Chairman.
Chairman Moran. Senator Blumenthal, thank you. I now call
on one of our colleagues who is a Member of this Committee,
Congressman Kevin Cramer is a former colleague in the House of
our witness, the nominee, and I now recognize Senator Cramer.
INTRODUCTION BY HON. KEVIN CRAMER,
U.S. SENATOR FROM NORTH DAKOTA
Senator Cramer. Thank you, Chairman Moran, Ranking Member
Blumenthal. The titles look good on both of you. I am looking
forward to a productive term, and it is a great honor and
really a blessing for me to be able to be here to introduce my
former colleague, friend, Navy veteran, a military chaplain,
accomplished attorney, Doug Collins.
In fact, if we were to write up, you know, there is a lot
of talk these days about people being unqualified for these
positions when the reality is in our great system of self-
governance, the only qualification is that the elected people
want you. But if we were to write up the qualifications for VA
administrator, for VA secretary, Doug Collins picture would
probably be right next to the description.
Working with Doug on big bipartisan things, I remember in
the House, one of the most unlikely things in the world for me
to get involved in was copyright law and looking out for the
rights of songwriters. And yet, somehow, Doug's big personality
and big brain sucked me right in, and I'm glad I did. It was
important work. And it was kind of really precedent setting
work in the area of entertainment. But he's got that kind of a
personality, an engaging personality that attracts people to
what he is working on. And I think that says a lot.
I mentioned he is an accomplished attorney because that is
an important part of both understanding, Senator Blumenthal,
the law and enforcing the law, carrying out the laws, defending
the laws that are passed by Congress and become part of the
bureaucracy.
Obviously, him being a veteran in the Navy and Air Force
Reservist is important. He relates directly to the experiences
of our veterans. He was deployed to Iraq. He knows a thing or
two about the experience of the veteran. I think that is part
of what, to your point Senator Blumenthal, makes the VA care so
special. It's not that they are better doctors, or better
psychiatrists, or better nurses, or technicians, it's that they
are empathetic. That is what I hear from my veterans so
oftentimes; is while they appreciate access to community care,
they appreciate the empathy of a fellow veteran, and Doug
brings that.
But guys, he is a chaplain. I mean, come on. How perfect is
that? Because to me, one of my great frustrations about the VA,
I mean, this is last summer, a $15 billion shortfall is
announced. Where was all the communication before that? Where
was the transparency that we would seek before that? And then
suddenly panic sets in, fear and anxiety, uncertainty, even to
the point where Congress itself passed a supplemental. We all
remember it very well. A supplemental where a single dollar was
never used because, lo and behold, there wasn't a $15 billion
shortfall. How does that happen in a competent agency that's
looking out for the veteran?
And so, Doug brings the legislative experience. He helped
pass the VA MISSION Act, the VA Accountability and
Whistleblower Protection Act, these things that provided the
transparency which we seek. He knows the intent of Congress.
He's a lawyer who understands them, but he's a chaplain who
understands the recipient and the need at the moment, and I'm
just really, really grateful that he's my friend.
I've known many, many good people, Republicans and
Democrats, who've sought a position in the VA, and every one of
them was well intentioned, and every one of them was certain
that they would break through. That they would be the one that
would make the difference. That they'd be the one that would
take the opportunities for care closer to home and put them on
the front page of the website instead of burying them deep so
that they never find them.
But we do have now in the commander in chief and a cabinet
that he's picking, people who will put the veteran first, not
the bureaucracy. Bureaucracy is important. The service
providers are important, but the most important person is the
veteran. And that's who Doug Collins will look out for. And I'm
really, really grateful that he's my friend, that he's willing
to step into this gap, and I'm ready to support him in every
way possible. And so, I introduce to you, Congressman Doug
Collins.
Chairman Moran. Senator Cramer, thank you for your
statement and support, your introduction of the nominee. And
thank you for your membership, and efforts, and hard work on
this Committee.
Douglas A. Collins, you and I need to rise, and I'm going
to ask you to take an oath. Would you raise your right hand? Do
you, Congressman Doug Collins, solemnly swear or affirm that
the testimony you're about to give before the United States
Senate Committee on Veterans' Affairs will be the truth, the
whole truth, and nothing but the truth, so help you God?
Mr. Collins. I do.
Chairman Moran. Thank you. Congressman, thank you again for
being here, and we will now eagerly await your testimony.
STATEMENT OF HON. DOUGLAS A. COLLINS,
NOMINEE TO BE SECRETARY OF VETERANS AFFAIRS
Mr. Collins. Thank you, Mr. Chairman, Ranking Member
Blumenthal, the rest of this Committee, and looking around this
Committee, seeing people that I've worked with before on both
sides of the aisle. And it's good to see you and especially to
the new Members as well.
I am honored to be sitting here to be the nominee for the
next Secretary of the VA. I'd like to thank my friend, Kevin
Cramer for that kind introduction. I appreciate his work, and I
appreciate your work as well. He hit it perfectly; it's about
the vet, and I thank him for that.
I'd also like to thank President Trump for his nomination,
and for his willingness to have not only confidence in me, but
also the veterans of this country. I'm privileged today, and I
appreciate the Chairman and Ranking Member mentioning my
family, because I would not be here without them.
My wife of 36 years is with me, Lisa. She's right here. I
have my son, Copelan, and his wife Holly. I have my son,
Cameron, his fiancee, Maddie. And then on the end, we have the
one that glues us all together, and that is Jordan. She is our
daughter. But there's also one that probably is watching right
now that I'd be remiss if I didn't mention, and it's my 86-
year-old father who spent 31 years as a Georgia State Trooper.
Dad, I'm here because of you and mom, and I love you.
You know, America's the greatest nation on earth. And it's
the greatest nation on earth, I believe, because of the men and
women who serve. It's the men and women who serve and
willingness to take the step up to protect the freedoms that we
hold so dear. And throughout my two decades of service, I've
witnessed this firsthand. I have watched men and women go at
their best, even when they didn't want to. And they served and
they stood up for our freedoms, and they earned the benefits of
being in our great veterans system. And the VA is there for
them.
In addition to being a Navy veteran for a while, I've now
been in the United States Air Force for over 23 years. I'm a
colonel serving at the Warner Robins Air Force Base Reserve
Command, and I have been able to watch over the years,
leadership. Leadership is about listening, but it's also about
leading. It's also about taking the men and women that you
serve with and making sure that you're putting their needs
first. When you're in the military, it's about the mission. For
me, if I'm confirmed by this body, the VA will be my mission.
It'll be the mission to take care of our veterans and to make
sure they get the benefits that they deserve.
I am an Iraq War veteran. I understand burn pits because I
slept next to one for many months. I understand this generation
that went time and time again, deployment after deployment, in
a different way than we'd seen many times before in our past
wars and the needs that they have. But also, being a veteran, I
think I also bring something that is unique to this position
almost since it became a cabinet position.
I'll be the first Member of this Hill, House or Senate to
serve, if confirmed by this body, which I think brings a
different perspective to my service here. Because over the
years, we've all had our differences in this body, and Ranking
Member, I appreciate you mentioning, yes, we have differences.
But we can agree because I have worked across this aisle to
pass major legislation.
Thanks to President Trump and this body, we passed the
First Step Act, giving real criminal justice reform with my
partner, Hakeem Jeffries, in the House. Music Modernization
Act, which Senator Cramer mentioned, Defend Trade Secrets Act
with Chris Coons and many others. These are the kind of things
that make big differences when you cross and you give good
ideas. For me, it is about having respect for the Members. It's
about having respect for this Committee. And that is what I
believe this Committee is; one of the most bipartisan here I
have learned and worked bipartisanly to make things happen in
this country. Because, also, I believe that we have a lot we're
in common with, on both sides of this Committee's eyes.
I believe also that there is timely access and care for our
veterans, for every eligible person. I believe that we're
actually supposed to reach out. And the MISSION Act provides
that template that we passed here, that I was a part of,
passing the VA Accountability and Whistleblower Protection Act,
which passed, by the way, in this body unanimously, that holds
our veterans' workers and the workers who touch our veterans to
the highest standards possible.
I will tell you right now, the veterans, VA will not have a
stronger fighter for the employees in the workforce than this
Secretary, if confirmed. And, also, one that will make sure
that we're held accountable because good work begets good work,
and others need to be held accountable. We will do that to make
sure that we get the best for our veterans.
The PACT Act, which was mentioned by the Ranking Member,
something that I think we're still developing and making sure
everybody gets the treatment. Just passed the Elizabeth Dole
Act, something we're going to have to look at next, and I'm
looking forward to.
But as we look at this, I do bring one thing. It's going to
require your help. It's going to require our mission. I bring
to you today two things that will be at the forefront of my
service. These are my dog tags. They are a reminder, just like
every other veteran who served, that we're part of a bigger
unit. And I also bring this bracelet that was made for me by a
young airman. She was keeping watch each night, and I'd go by
and see her, and we'd talk.
I was a flat line chaplain at Balad, and she had said one
night, she said, ``I've got something for you.'' And she ran
back into her guard shack and she came out with this. She said,
``You're always bringing us something and listening.'' She
said, ``I want to give you something.'' Well, what she didn't
know is, now, about 15 years later, if confirmed by this body,
this bracelet will be sitting in the Secretary of the VA's
office reminding me every day of the men and women that we
serve.
And with that, Mr. Chairman, I yield back.
[The prepared statement of Mr. Collins appears on page 61
of the Appendix.]
Chairman Moran. Congressman Collins, thank you for your
testimony. We'll have a round of questions. I'll start and then
ask a couple of questions, and then yield to the Ranking
Member.
It would be unexpected if I didn't open my questioning of
you in regard to the MISSION Act. I was involved in the
creation of the CHOICE Act. We then attempted to improve it,
make it more certain with the MISSION Act. And my views are
highly framed by my days as a Member of the House of
Representatives, in which I represented a congressional
district, the size of the State of Illinois with no VA
hospital. So, I care about rural and the distance that those
rural veterans face.
So, I want to ask, if confirmed, will you make certain that
the letter and spirit of the MISSION Act is followed by every
employee in every VA facility, and that the veterans are aware
of their rights to advocate for themselves and to receive care
when they need it, where they want it?
Mr. Collins. Mr. Chairman, as we spoke in your office,
there's no greater asset, and really, you've hit at the very
issue of why the VA exists. The VA does not exist in and of
itself, it exists for the veteran. It exists, and that is why
over the past 10 to 15 years in this body, the MISSION Act was
passed. And the intent of that was to make sure that in the
delivery of services to the veteran is first and foremost.
And look, you have veteran services that are being
delivered in our VA system as it has existed. We also, as
you've mentioned, Mr. Chairman, there are VA benefits that are
doing through our caregiver and our community care program. At
the end of the day, the veteran is getting taken care of. VA
care is going to happen. VA care will be there. They'll always
be the VA healthcare system for the veteran.
But the way that we express that is just like we do in this
body. There's different expressions on how we make it better.
We don't do the same things 40 years ago that we still do today
if we're still wanting to stay current with what's going on.
And our newer veterans deserve every access to finding care
where they can. Or in your case, if they have a long way to go,
they need to find the care if they want to. But always have the
VA as a backup.
For me, the intent of the MISSION Act, at the end of the
day, was about how do we make veteran care available to the
veteran who needs it and not have the battles over how they get
it, because they want to be able to have that choice. We're
going to continue to do that and following the intent of the
Congress, in which I passed, that was my intent as well.
Chairman Moran. And Representative, is that a commitment in
answer to what I asked you?
Mr. Collins. Yes, it is. We're going to be following the
MISSION Act, we're going to have the intent. We're going to
follow that up, and it's going to be day one. Understanding
that that's why we're there and that nothing's going to hold
that up.
Chairman Moran. And let me highlight, that while I
mentioned geography and the distance, there's lots of other
concerns in veterans accessing care----
Mr. Collins. Yes.
Chairman Moran [continuing]. And I would highlight the
importance that the MISSION Act can play with high risk mental
health and addiction issues. We do not have enough care in the
VA or outside the VA, and we need to make certain that wherever
that care comes from, it's available when it's needed. True?
Mr. Collins. Yes, Mr. Chairman, I think that is a key, and
you're seeing this all across. And you just hit on something
very close to my heart, and that is especially the mental
health aspect of this. As you can see, and Jordan and I have
talked about this a lot. Jordan has a physical disability. She
can't walk. And people would look at Jordan and they would have
immediate sympathy. But if someone was to come in and say, I'm
having trouble thinking clearly, or my brain's not working
right, we tend to repulse.
I want a condition which the VA and our community
caregivers are drawing near because suicide prevention is one
of our biggest issues, and we've got to be able to draw the
best and brightest. This is an issue healthwide, not just in
the VA, but also in our communities as well. So, I want to make
sure we're getting the opportunity. So, as you just said, Mr.
Chairman, that that member who needs it can find it, and find
it quickly and efficiently.
Chairman Moran. Let me talk about, for a moment, transition
to civilian life. One of the most dangerous circumstances in
the well-being of a member of our military who is soon to
become a veteran, occurs at that point in transition. It is a
time in which there is a sense of loss of belonging, of
comradery, of mission, of purpose. It is a time in which
suicide ideation is more prevalent. And we have a requirement
that the Department of Veterans Affairs and the Department of
Defense cooperate in a program to properly assist military men
and women as they depart active duty.
I want to hear how much you value this process, and in
fact, how much you value the requirements. Because the
Department of Defense and the Department of Veterans Affairs
have failed to appropriately and adequately implement that
caregiving time and to provide the necessary transition
support. It is hugely important. It certainly is important to
the life of that service member. It's also important to our
recruitment and retention of future members of the military.
Comments?
Mr. Collins. Mr. Chairman, you've hit it perfectly. I mean,
this is not just taking care of our military, our veteran
coming out from DoD and then transitioning to a VA care as they
choose. But it's also, if you go back even further, to me, this
is a recruiting issue. This is part of the whole life cycle of
a veteran. And if you have good experiences in the DoD, they
have bad experiences for some reason in VA, or vice versa,
you're having people who serve then telling their children and
others, ``I don't want you to serve.''
This to me, is the all-encompassing issue that we've got to
work on. And as someone, especially as you talked about
earlier, transitioning becomes that time in which for some they
don't have that grounding anymore. They need that connection.
And we've not done a good job of connecting the dots.
One of the things that should disturb all of us on this in
this room today is the 17 number that is often used--17
veterans who die by suicide. And when we understand that,
here's what we have found, that over 40 percent of them had
never connected with the VA. So, Mr. Chairman, you have my
complete assurances that not only are we going to be a
priority, it is going to be an extra priority for me because I
believe we can use all assets, not just DoD and VA, but state
veterans association as well. I'm willing to look at any way we
can make the connection to make those transitions as easy as
possible.
Chairman Moran. Mr. Collins, thank you. I now recognize
Senator Blumenthal.
Senator Blumenthal. Thank you, Mr. Chairman. I know that
you are exceedingly generous in allotting time for us to ask
questions, but I'm going to try to stay within the five
minutes.
Chairman Moran. Were you suggesting that I did not?
[Laughter.]
Senator Blumenthal. I would never suggest anything of the
sort. I hope we'll have a second round of questions, though?
Chairman Moran. I anticipate that.
Senator Blumenthal. Thank you. Let me start with some easy
questions. Congressman Collins, will you commit to respond
promptly to any inquiry from Members of this Committee to
request information and be fully transparent with this
Committee?
Mr. Collins. That is my intention. I will do for this
Committee, make sure you have every information that you need.
Senator Blumenthal. Thank you. And will you commit to
working with the Veterans Service Organizations and other
stakeholders in making decisions at the VA?
Mr. Collins. I look forward to working with this Committee
and the Members of both House and Senate, and any other
organizations out there willing to help us help our veterans.
Senator Blumenthal. And including the Office of Inspector
General, the Government Accountability Office, and the Office
of Special Counsel?
Mr. Collins. I think you've laid out the very essence of
accountability, not only from this body, but others that
actually give us insight into what we're doing and how we're
doing it. So, yes, I look forward to those and making sure that
we look at those recommendations, we work on them where we can.
Senator Blumenthal. Thank you. Last week, at a hearing of
the Homeland Security Committee, I gave Russell Vought, the
nominee for OMB Director, the opportunity to renounce a
proposal that he made, and it's included in Project 2025 to
impose a means test for VA disability compensation benefits.
I also asked him about his proposal to claw back benefits
from service-disabled veterans. He has advocated that anybody
with less than a 30 percent disability receive no benefits. He
refused to renounce either proposal. I need from you a
commitment that you will oppose any such efforts by the
administration.
Mr. Collins. Well, Senator Blumenthal, I've made a habit up
here, being here. I'll never answer for someone else. And the
question was asked of him. I will say this, I'm going to--I've
not been a part of Project 2025, haven't even read it. My issue
is, is I'm going to take care of the veterans. That means that
we're not going to balance budgets on the back of veterans'
benefits. We're not going to do that. We're going to put the
veteran first. And for me, that decision comes to the
Secretary. That's in our budgetary oversight. That's what I'll
be coming to you for.
As we talked about in your office, if there are issues that
I need, I'm going to come with you with the issue of the
solving. If there's issues that I say that you want to see, but
the law doesn't allow it, then I'm going to say here's where we
changed the law because that's what we've done before. So, my
commitment is to the veteran and making sure that we have our
budget and sufficiently fund it so that our veterans receive
their benefits.
Senator Blumenthal. I'm going to interpret that as a yes?
Mr. Collins. Mr. Ranking Member, you interpret it.
Senator Blumenthal. In his first term, President Trump
attempted to go down this road by trying to eliminate
individual unemployability benefits for retirement age
veterans. In my view, a very ill-conceived proposal that was
later retracted. And I hope that you will oppose any such
proposal during this administration.
Mr. Collins. Ranking Member, I'm not familiar with that
discussion. What I am familiar with is what President Trump did
advocate during the first of his four years. And that was the
MISSION Act, the Accountability Act, the things that put
veterans first. In fact, his words were, ``I want to take care
of the veterans.''
So, as we look forward to this, I look forward to carrying
out his vision of taking care of our veterans. Putting them
first, making sure the VA is in a situation where it is
actually doing that and having the resources it needs, but also
having the efficiencies it needs to make it better. So, I look
back to what he's already done, and I know that was putting the
veteran first, and I'll be doing the same.
Senator Blumenthal. Thank you. As you know, for far too
long, across administrations of both parties, frankly, the VA
major and minor construction projects for hospitals, nursing
homes, and other critical infrastructure priorities, these are
the nuts and bolts, the facilities depended upon by our
veterans for care have been dramatically underfunded. For
years, I had to fight for funding to modernize the VA facility
in West Haven. Finally, it's underway.
There are thousands of other projects I would bet in every
one of my colleagues' districts that need that kind of funding.
It's a bipartisan issue that's good for veterans and good for
local economies in red states and blue states. And the longer
we wait, the more expensive construction becomes.
If confirmed, will you commit to me that you will work with
us to make those kinds of investments a priority?
Mr. Collins. Mr. Ranking Member, I think what you've just
hit is bigger than buildings. It's about the future of the VA.
It's about how we actually take care of our veterans. So, when
you frame the question is funding these projects, I look at it
as, am I funding a project that helps a veteran? And that's
going to be in every district, as you just said.
So, yes, I'm looking forward to using the limited dollars
that are going to be coming from the Congress and how we spend
those to make sure that we're prioritizing those needs in areas
such as, you mentioned, you're talking about your home state as
well. But these are areas that I'm wanting to look forward to
make sure that our construction products not only are done
efficiently and on time, and also have the proper oversight
that we don't see them drag on for years.
I've heard too many times in many of your offices, and I
met with almost 60-plus Senators on both parties. This has been
an issue that comes up consistently, that we have to be better
stewards of our building projects so that at the end of the
day, it's the veteran who gets served.
Senator Blumenthal. Thank you. Thank you, Mr. Chairman.
Chairman Moran. I almost gaveled you at the time 43 seconds
ago, just to make sure that you know the order of things.
Senator Blumenthal. I knew that was coming.
Chairman Moran. Yes, sir. Senator Sheehy is going to be
recognized next. One of our colleagues was kind enough to allow
him to go instead because he presides at the Senate at 11
o'clock. Senator Sheehy, welcome to this Committee. Well, thank
you for your service to the country, and you're recognized.
HON. TIM SHEEHY,
U.S. SENATOR FROM MONTANA
Senator Sheehy. Thank you, Chairman. Congressman, thank you
for being here. Thanks for bringing your family. It's great to
see them all here. As we know, the military is a family
business. When we leave for months or years on end, it's them
that carries the weight.
You know I come from a very large state, not a whole lot of
people, and a lot of our veterans have to travel many, many
hours to get to VA care. And to that end, I'd be curious to
hear your thoughts on how we are going to actually expand
access to community care. Because as Senator Blumenthal and
others discussed, it's been press released, it's been talked
about, but I think we know from experience, it's actually been
very, very hard for our veterans to effectively mesh their
veterans' healthcare benefits with being able to seamlessly go
to the community and get their care.
If you're from Plentywood, Montana, it can be a five-and-a-
half-hour drive to a VA care facility. So, I want to make sure
that we actually take action to ensure that veterans can go
into the community and get care they need so they don't have to
drive many, many hours away.
Mr. Collins. Senator, I thank you and welcome to the
Senate. It's good to see you this morning. I may be from North
Georgia, but issues of ruralness is not new to my district. I
have the foothills of the Appalachian Mountains. In fact, I
start and Senator King's, it ends. So, the Appalachian Trail.
So, I get the fact that sometimes the distance may be
deceiving, even if it's shorter distance, how to get there. And
that could be a problem for veterans, especially older
veterans. I remember a time in which I had a 90-year-old
veteran trying to--they were asking him to drive 90 miles to
get corrective lenses, and he was having trouble seeing. Not
the best position we need to be in.
The intent, and I was here for the MISSION Act. In fact,
I'm going to go a step beyond Senator Johnny Isakson was a dear
friend of mine, and we got first involved in this. He was a
mentor of the CHOICE Act, which became the MISSION Act as we're
moving forward, because we saw these very issues that you'd
speak of.
For me, it's about making sure that we publicize what is
out there. I know that's been a concern for many on both sides
of the aisle, is making sure veterans understand the benefits
that they have. You and I both know in rural areas, sometimes
it's hard to get there. I'm committed to making sure we're
using every avenue we can to make sure the benefits that they
know about, if they want to use them, great, they'll be there
for them. But some do not know. So, for you and other states
and rural states and even urban settings, we've got to make
sure that the access is there.
In saying that, it also needs to make sure that the VA
itself is not standing in the way that where there is
conditions met, whether the precondition met, and they are
eligible for community care, it's not the VA that's standing in
the way to getting them that healthcare they need. And that
could come through call centers, doctor visits, pre-clearance,
and everything else. So, we're going to be working with that.
Senator Sheehy. Great. And then as a wounded vet who
transitioned out, my wife was also active duty, we served
together at the same time. The hardest part about VA care I
found, and most of my peers from the GWOT generation, I think
agree is, is the handoff from active-duty healthcare the
handoff to the VA. I was fortunate enough, I had a fantastic
handoff. Disabled American Veterans helped with my transition,
but very, very few veterans end up in that spot. How can you,
as the VA Secretary, ensure that we have a smoother and
seamless handoff from active-duty members so when they enter
the VA, medical records reported over, care is ported over, and
it happens seamlessly for the veteran.
Mr. Collins. Senator, as we just discussed it was
previously discussing this and that transition with the
Chairman and all it, it's a very it's the most important for
the family itself. I think you understand that with your
transition, your wife's transition. Because at that point,
there's that unsettledness; where do we go? How do we get care
if we need care? Especially, if there's a preexisting or
something that's been treated in DoD. How do we get by?
There are several things that we need to make sure that our
touches are much better. There's been some programs to make
sure that we touch the VA, touches on occasions, making sure
they get the transition care. If that's not happening, we need
to do it better.
But there is an issue that we've not discussed yet. I'm
sure it's going to come up many more times, and that's the
medical health records issue of the VA. That is a program now
that has went too many years and cost too many billions of
dollars without finding a solution. And my commitment is one of
the very first priorities of this, if confirmed, is to get in
and figure out why, and put this on a bigger timeframe to get
this medical health records issue solved.
I've said this, I'll say this now, and I'll probably say it
again. The VA is special, but it's not unique. And hear me when
I say that. It's special in who we keep, and who we trust, and
who we take care of, and that is our veteran. But it's not
unique in the sense that we do healthcare. Healthcare is done
in this country every day outside the VA, as well as the
largest system, which is the VA.
We've got to get our health records straight so that we can
have an easy handoff. What should be a simple click of the
button is many times taken--I've had in my office when I was in
Congress up to almost a year to get those records transferred.
That leaves uncertainty for the veteran, that leaves
uncertainty for the family, and makes a very unhealthy
experience for those that are serving.
Senator Sheehy. Well, thank you, Congressman. Thanks for
your service to the country in the war. Thanks for your
family's service, and thanks for stepping up to serve again.
Chairman Moran. Senator Murray.
HON. PATTY MURRAY,
U.S. SENATOR FROM WASHINGTON
Senator Murray. Thank you very much, Mr. Chairman.
Congressman, very good to see you here. Thank you for meeting
with me in my office. I appreciated that discussion.
And I'm going to start with the question in reference to
what you just talked about because back in 2018, under
President Trump's first administration, the VA in Cerner, which
is now Oracle Cerner, signed a no bid contract to roll out the
Cerner Electronic Health Record to all VA facilities. And the
first site went live in my home state in 2020, and it was
disastrous. VA and Oracle endangered patients by rushing the
deployment, not making sure the system was technically sound,
not working with the clinicians on the ground and not providing
sufficient training. And veterans and providers in my home
state are still paying the price for that.
Last month, VA announced that it would be moving forward
with pre-deployment activities at the next four sites for the
Electronic Health Record. You said, you referenced it here,
that you plan to make EHR a priority. I want to know what
specifically that means. Are you going to prioritize it by
rushing the implementation, or are you going to prioritize it
by getting this system right and focusing on veteran safety and
clinical productivity as you move forward?
Mr. Collins. Thank you, Senator. Indeed, I did enjoy our
time together in your office. There's the old saying that
there's never a more perilous issue than to be on the tip of a
new idea. And I think it goes back a long way. And that's very
true what happens here.
When I say that we're going to make this a priority, it
means that we're going to see--for me, it's going to be taking
it as a full, all right, I'm taking the first step and I'm
going to look at it from fresh eyes. I've not been there for
what even this Committee would have to say, it has been too
long and cost too much money. We're going to talk about the
vendor from Oracle. We're going to make sure that we're finding
out what's their issue. We're going to listen to our
clinicians. We're going to listen to our hospitals.
And as I said just a few minutes ago, we're special in who
we care for, but we're not unique. There's no reason in the
world we cannot get this done. And I think that's the concern
that I have because this body, and you in particular, have done
such a great job with the appropriations process of making sure
that we're funding a system that we're now sitting here six to
eight years away and nothing's happened.
And that causes, just as the Senator was talking about, not
only the transition, but it affects the patients internally.
We've got to get better health records so that we cannot only
have the issue with our one-on-one doctor interaction, we can
move faster, they can see the information ahead, and it's safer
for the patient.
So, for me, as soon as possible in the very early stages,
if confirmed, I'm going to gather together members of my staff
that will be specifically tasked to, as soon as possible within
the first days of this administration, see what is the issue,
why is it waiting, and why did the previous administration who
just left say that they may try to start it back in '26.
I'm not sure why a year would take here. I believe that we
can do it and do it properly, not rushed. There's enough
information there that I believe we can actually get it done
quicker. But it's going to take looking at it.
Senator Murray. So, the first step would be to bring Oracle
Cerner in along with your staff. Please make sure that you talk
with those people on the ground that have been dealing with
this to understand what has gone wrong, why it's been such a
problem as you take on those next steps. And I would also ask
that you please stay in touch with me. This has been a--this
Committee knows my top priority, and I have just been so
frustrated with it. So, I want to stay in touch with you.
Mr. Collins. Senator, you would be amazed at how many
conversations I've had and we've had as well with this. We
can't overemphasize enough of why it needs to get done. But
being on the Hill in positions like you are, it's also an
understanding that this has become too normal for projects that
come out of the Hill--too normal, that we appropriate billions
of dollars and yet see no results in six to eight years.
I think President Trump and the administration, when he
started this, had the right idea. And we're going to continue
that. So, we're going to have to work together. At this point,
the finger pointing is done. It's time to get it done for one
reason and one reason only. As I said earlier, the mission is
the vet. It's the veteran who has earned the benefit. And if
we're not giving the right tools for that, then the doctor, the
clinician, the nurses are not able to mesh.
And I will not accept, ``We can't do it.'' I will not
accept, ``I don't know.'' I will not accept, ``We don't have
enough money. We don't have time.'' You've had eight years and
billions of dollars. So, I'm with you on this. We'll definitely
work together.
Senator Murray. Okay. Thank you. And quickly, in my last 30
seconds, reference something that Senator Blumenthal mentioned
in his opening remarks. And that is, I care deeply about our
women veterans and that they have the services they need. So, I
want to just ask you, do you believe a veteran who lives in
Texas, who has been raped and becomes pregnant, should be able
to get abortion care at her local VA?
Mr. Collins. Senator, that is an issue that is very
sensitive in this body. It is something that has been looked
at. Here's what the law actually says in the original law from
1992, says the VA does not do abortions. Two years ago, that
was a decision that was looked at and decided. I will tell you
this, we will be looking at that issue when I get in there to
confirm that the VA is actually following the law.
Senator Murray. So, do you plan to modify that law then?
Mr. Collins. I'll repeat just what I just said. When we get
in, we're going to look and make sure that the law is being
followed from the 1992 law where it said they couldn't and the
revision that just happened.
Senator Murray. Okay. Well, I want you to know that I'll be
following this very closely. I want to make sure that women
veterans get the healthcare they need.
Mr. Collins. Thank you, Senator.
Senator Murray. Thank you.
Chairman Moran. Senator Sullivan is recognized.
HON. DAN SULLIVAN,
U.S. SENATOR FROM ALASKA
Senator Sullivan. Thank you, Mr. Chairman. And
congratulations to you and the Ranking Member on your new
positions. Looking forward to working with you. And Congressman
Collins, congratulations to you. Thank you to your wonderful,
beautiful family there behind you. It's great that you're doing
this.
I certainly agree with my good friend Kevin Cramer, in his
opening remarks. I think you are imminently qualified,
imminently qualified as a veteran yourself and as a chaplain. I
agree with Senator Cramer. That brings some real unique
insights. I think that's going to be great. And I look forward
to strongly supporting your confirmation. I'm a big fan, and I
certainly hope that we have bipartisan support for your
confirmation while given your qualifications. So, thanks for
your willingness to serve.
I appreciate our meeting. As you know, I focused a lot on
Alaska, for really important reasons. My state has more
veterans per capita than any state in the country. So, a real
patriotic place, way up north. And we're big talking about big
states. I won't even get into the size of Alaska because I
don't want to embarrass anybody. But it's really, really,
really, really big. You know, Tim Sheehy, I think we're five or
six times bigger than Montana, and we don't have one full-
service veteran hospital. Not one. It's us and New Hampshire.
That's it.
So, we have really big challenges. For all those reasons,
good, because we have so many veterans challenging because
we're big and we don't even have one full-service hospital. So,
we've had many disasters, in my view, with the VA. You and I
talked about some of them.
In 2015, right, when I came to the Senate, the VA system in
Alaska collapsed. That was the first big thing I dealt with as
a brand-new Senator. It collapsed because they realigned these
VISNs. They took the VISNs in Alaska, and the call center in
Alaska, out of Alaska. And we had people making appointments
for Alaska veterans based in the Lower 48 who didn't have a
clue about our state. The system collapsed. We had a giant
backlog. And last year, believe it or not, the backlog was up
to 12,000 veterans, which is a lot for my state because we
still have call centers based in the Lower 48.
So, a veteran in, let's say, Ketchikan, Alaska, says,
``Hey, I need to get to the Anchorage Hospital.'' The call
center will say, ``Okay, drive to--well wait, it's an island.''
They don't even know Ketchikan's an island. So, I need to get a
commitment from you in the MISSION Act. I was able to get
legislation that said, if you don't have a full-service
hospital, and by the way, again, only us and New Hampshire,
then you can go immediately to community care.
Why wouldn't you? The call centers don't allow that.
Because they don't know about Alaska, they don't know the bill,
they don't know the law. So, it's still kind of a disaster for
my veterans. So, can I get your commitment to work with me on
all the Alaska challenges, but this call center issue in
bringing--we need a call center back in my state for people who
understand what the state's all about and to help bring down
this very big backlog.
So, can I get your commitment on that, Congressman, to help
our veterans, and of course, to get your commitment, come up to
Alaska, you bring the whole family, come in the summer if you
want. We can go fishing after, or come in the winter maybe see
what it's like to be in a state that's dark and 50 below zero.
So, either way, your choice. People pick August as opposed to
February.
Mr. Collins. I appreciate it. You make it sound so much
more attractive there. The last part as an Air Force chaplain,
actually puts our chaplains up in your beautiful state. That is
one of our issues, though, is that long winter.
Look, you brought out a point when you were talking about
this in the uniqueness of Alaska, and New Hampshire, and not
having the full-service hospitals. So, they do go to--you know,
it's very much of a user of community care. It is really
disturbing to me.
As we talked about, you had about 5,000, I believe it was
last time we had talked----
Senator Sullivan. Yes.
Mr. Collins [continuing]. Of veterans waiting for health
benefits. This is not a benefit backlog. This is a healthcare
backlog. That means there's 5,000 souls that are there not
getting the healthcare.
Senator Sullivan. By the way, last summer was up to 12,000.
I think the outgoing Secretary was trying. But 12,000 just
waiting to get an appointment because we got someone in the
Lower 48 who's never been to Alaska trying to make an
appointment for an Alaska veteran. It's a disaster.
Mr. Collins. Yes, no, I agree. It's something when you told
me that, it surprised me, and it's something we got to look at.
Sometimes things get lost in bureaucracy and you think it looks
good, but then after their actual real-world application, you
have to go back and make changes. I'm willing to commit to you
to look at that and see if we can make it better so that they
understand that Ketchikan's an island and they can't drive to
Anchorage.
Senator Sullivan. Let me ask one final question very
quickly. We talked about it. Our Alaska Native community is
also incredibly patriotic. Alaska Natives serve at higher rates
in the military than any other ethnic group in the country. So,
super patriotic. Live in a lot of our rural communities, and
our Alaska Native healthcare organizations have reached into
the rural parts of the state that, you know, no other place
does.
The VA has a long history of working with our Alaska Native
health organizations to extend the reach of care into very
rural parts of America, very rural parts of Alaska, and partner
to get Alaska Native veterans, but also non-Natives who live in
these rural communities to go to an Alaska Native health
organization to get care because they've partnered with the VA.
Can I get your commitment to continue that good
relationship? Sometimes it's a little contentious on, you know,
negotiating the agreements, but they're really worth it, to
expand and extend VA healthcare for Native Alaskans, non-Native
Alaskans in the most rural parts of our state?
Mr. Collins. Senator, yes, we're willing to commit to do
that, also in any other district across this country where we
can partner to make sure our veterans are getting healthcare
that they need. And especially, in a unique situation like
that, of course.
Senator Sullivan. Great. Thank you. Thank you, Congressman.
I look forward to supporting you, and I'll have more questions
for the record. Thank you very much.
Chairman Moran. Senator Hirono.
HON. MAZIE K. HIRONO,
U.S. SENATOR FROM HAWAII
Senator Hirono. Thank you, Mr. Chairman. It's nice to see
you. Congratulations on your nomination.
As part of my responsibilities to ensure the fitness of any
nominee who comes before any of my committees, I ask the
following two initial questions. Since you became a legal
adult, have you ever made unwanted request for sexual favors,
or committed any verbal or physical harassment or assault of a
sexual nature?
Mr. Collins. No, I have not.
Senator Hirono. Have you ever faced discipline or entered a
settlement related to this kind of conduct?
Mr. Collins. No, I have not.
Senator Hirono. I would just like to note that how Hawaii
also does not have a full-service VA hospital, and like Alaska,
has access issues with seven inhabited islands and veterans
living on all of them. So, those are all issues that we're
going to need to continue to address. Congressman, you are very
close to President Trump, both as a Member of the House and
since that time. Under what circumstances, would you say no to
a request or order from President Trump?
Mr. Collins. Senator, we're dealing in hypotheticals of
saying, this President would actually ask me to do something
illegal. I'm not going to a hypothetical because this President
has put veterans first. He's not going to ask me to do anything
illegal or outside the current law. And I think the question
implies something that's not happened, and----
Senator Hirono. I think we need to----
Mr. Collins [continuing]. I don't need to worry about a
hypothetical.
Senator Hirono. Excuse me. I think we need to make sure
where, what your priorities are and you are saying that you
will not say yes to what you consider an illegal order.
Mr. Collins. Senator----
Senator Hirono. Next question. During your time in public
life, you have been very outspoken against pregnant people's
right to their own reproductive choices. In the role of
Secretary, you would be overseeing care for veterans and their
loved ones across the entire ideological spectrum. Would you
rescind the interim final rule enacted under the Biden's
administration that allows VA to provide abortion counseling
and abortions in the case of rape, incest, or where the life or
health of the veteran would be endangered?
Mr. Collins. Thank you, Senator. As we just discussed this
just a moment ago, the VA Act in 1992, specifically forbid the
VA from doing abortions. I plan on----
Senator Hirono. Well, you do--excuse me.
Mr. Collins. I plan on----
Senator Hirono. Let me just clarify something for you.
Mr. Collins. Senator, I'll be happy to answer your
question----
Senator Hirono. You refer to a law that actually is being
pretty much clarified by this interim final rule. And there is,
as you know, debate regarding what the law allows. I believe
the law allows this rule to be enacted. And my question to you
is whether you would rescind this interim rule that would allow
the providing of abortions----
Mr. Collins. And Senator----
Senator Hirono [continuing]. To veterans who under the
circumstances of rape, incest, or where her life is endangered,
would you rescind the rule?
Mr. Collins. Senator, as I was answering your question, we
will look at this rule and see if it complies with the law. As
you just said in your own answer, it is a debatable issue.
We're going to look at it and make sure that the VA is
following the law.
Senator Hirono. Well, of course, if you provide these kinds
of services, you are providing all the veterans the full range
of care for reproductive services as needed, regardless of your
ideological position.
Mr. Collins. Senator, my ideological position is based in
the law, and I will follow the law in this regard. And if your
questions, as I would have loved to have sat down and talked
with you before this hearing, and we could have explained this
because I believe the law is clear.
Senator Hirono. I'm asking you under oath. Do you believe
that world class care quoting you, ``includes a full range of
reproductive services?''
Mr. Collins. I believe that the range of care provided at
the VA is following the law and the intent of this body as it
is set forth in the law.
Senator Hirono. And if the way you interpret the law will
disallow services to 2 million women veterans in the U.S.
including 13,000 in Hawaii, you would do so?
Mr. Collins. As I have just----
Senator Hirono. That's what you just testified.
Mr. Collins. As I have just testified and in looking at
this, I will take a look at where the law stands. And as you
also testified--in your questioning, you said it is a debatable
and that was just changed two years ago----
Senator Hirono. Well, I certainly hope that----
Mr. Collins [continuing]. And we'll look at----
Senator Hirono [continuing]. Interpret the--there is a rule
that actually interprets the law----
Mr. Collins. I understand the rule.
Senator Hirono [continuing]. A particular way and you're
saying that it all depends?
Mr. Collins. I understand the rule.
Senator Hirono. VS has over--and you're not responding to
whether or not you will rescind that rule, which provides care
for thousands of female veterans. VA has over 450,000 employees
and contracts with hundreds of thousands of private providers
across the country. Can you explain what roles you have held
that would have prepared you for leading such a large
organization?
Mr. Collins. I'd love to, Senator. I have been a part of
this body in which I have actually overseen the--and working
through votes and working through bills that actually affect
the VA's operation from a day-to-day operation. I understand
the policy of the VA intimately by being a Member just like
you.
I've also spent time in the military working with many
individuals and currently serve at the Warner Robins Air Force
Base Reserve Command of our chaplain's office with over 656
personnel working across different manage comms, handling
personnel decisions.
I've also been a leader in many other ways, and I believe
that leadership is how you deal with this. You deal with
leadership in putting good people in good positions to make
sure that you have a workforce that knows that they have it.
Senator Hirono. Thank you. Thank you, Mr. Chairman.
Chairman Moran. Thank you. Senator Cramer.
HON. KEVIN CRAMER,
U.S. SENATOR FROM NORTH DAKOTA
Senator Cramer. I'm just compelled to ask this question
because Senator Hirono asked you if you would--I think the
implication was would you carry out an order, an illegal order
by the President of the United States? Which there's no
evidence he'd ever do and he's ever done. And that's why I'm--
it's so hypothetical to be silly.
But I am compelled to ask, would you consider rescinding an
illegal rule by the previous administration? Because it seems
to me that an illegal rule, or at least one that's debatable,
is worthy of significant legal consideration before you would
do it just because you felt like doing it?
Mr. Collins. Senator Cramer, I appreciate the way that is
worded because that is exactly the way I tried to word it to
the Senator. And that is if the law is specifically stated that
the VA was not to be doing abortions, there are other areas
there that we look at. So, we look at a situation that came up
in 2022 in which they were told to look at a rule that would
get around that. To me, it's time for us to take a look at that
rule and make sure, just as in every other area of VA life,
that we're actually doing what the law and the intent of this
body is.
That's not, when you get into that, for me, this is going
forward and looking at all the issues. If it was just to a
matter of--and I have great respect for this body, best served
in this body. And what we pass actually means something. And
the minute it becomes something, it doesn't mean something in
the administration or outside is the minute the rule of law
falls down.
So, for me, yes, I will be looking into this. Yes, I'll be
confirming that it's comports with the law as it is.
Senator Cramer. Thank you. I wanted to give you that
opportunity----
Mr. Collins. Thank you.
Senator Cramer [continuing]. To, uninterrupted, explain
yourself, and you did it very well.
You're hearing a lot about community care, obviously. And I
will spare you all my horror stories. I think Senator Sheehy
did a remarkable job, as did Senator Sullivan, because those
are big rural states. Obviously, your examples are outstanding.
I would just add that it's my intention to work with my
colleagues to further clarify in the MISSION Act what access to
community care is.
In other words, we still hear horror stories from veterans
who live 300 miles from the VA hospital in Fargo, or maybe 100
miles from the nearest, even CBOC, who maybe live across the
street from a critical access hospital, which we have 36 spread
throughout our wonderful little state, 36 critical access
hospitals who operate on the thinnest of margins.
And it's tragic for me to think that there's a veteran
waiting for paperwork that's being slow-walked by a bureaucrat
more interested in the VA than they are the veteran, and all
while there's a hospital that's barely hanging on across the
street. And I'm not even exaggerating a little bit when I say
that.
And, perhaps, I guess my question is, would you work with
me and colleagues on this Committee to find ways to not just
streamline the process, but to guarantee it? In other words,
the default is not, have you checked all the boxes on enough
pieces of paper to qualify for care somewhere else before you
die trying to get far, far away. But rather you do that first
and then the reimbursement comes after that. And so, anyway,
I'm just asking if you'd help me if you've got some thoughts,
and if you'd commit to working with us on something like that?
Mr. Collins. Senator, you've hit the whole heart of why I
want to do this job. I've been asked by doing this job, why do
I want to go into the VA? And it's sort of been interesting.
I've had some say congratulations. I've had some say, oh, what
are you doing? It's a large undertaking. And I said, no, I'm
taking this, number one, because I care for people, and I care
for veterans. It's where I come from. It's what I believe. It's
what I saw from up here. It's what you see as you look at to
make it better. For me, the service organization called the VA
is about service.
It's about the veteran, as you just stated. It's not about
the VA. The VA is there. And like I said, I'm looking forward
to being a Secretary who motivates and unleashes the power of
this wonderful workforce, which I believe most are wonderful
workforce that we have that want to do a good job.
Senator Cramer. Absolutely.
Mr. Collins. They need the leadership and encouragement to
say, let's find yeses instead of nos. Let's find answers
instead of technicalities. Let's find the hope in people
instead of trying to find the reason to hold or delay. To me,
this is about the veteran. This is about getting them the
access to care that you, and I, and many on this Committee
voted for. That's why we do what we do, is because they deserve
it.
So, for me, and Senator Duckworth--and this crosses party
lines, and I appreciate the Ranking Member talking about
bipartisanship. We had a great conversation in her office
discussing how we could look collocate CBOCs with rural
hospitals. If that's a possibility, could it be looked at? I
committed to the Senator from Illinois that's something I would
look at because it helps both sides.
And so, we've got to get back to the fact where it's about
the veteran itself. And I'm going to want to empower a
workforce that wants to get up every day and come to and say,
yes, I'm getting to this veteran so they get the help they
need.
Senator Cramer. You, sir, are a leader with a servant's
heart. Thank you. I yield.
Chairman Moran. Thank you, Senator Cramer. Senator King.
HON. ANGUS S. KING, JR.,
U.S. SENATOR FROM MAINE
Senator King. Thank you, Mr. Chairman. Congratulations on
your assumption of the chairmanship of the Committee and the
Ranking Member.
I want to just emphasize a couple of points you've already
discussed. One is transition with the Chairman--critically
important. And there are a number of bills out there that TAP
Promotion Act, Welcome Home Veterans Act, Combat Veterans Pre-
Enrollment Act. I suspect you're familiar with them, but I just
want to hear you reiterate your commitment to this transition
and working with the Department of Defense, because it's a
partnership that has to happen to make that warm handoff. Is
that going to be a priority for you?
Mr. Collins. Yes, Senator. You couldn't have a--there are
so many priorities in life that you look at, you want to get
started. But this one that you hit about making this transition
is so important to me because it transcends just getting them
into the service. It transcends that benefit that they've
earned. It goes to the very heart of making sure that they're
taken care of and feeling wanted.
As we stated a little while back, I believe it starts at a
recruitment issue all the way through a retirement issue.
Because if they feel like they're taken care of in DoD, then
they're going to have a better opportunity if VA reaches out
with a hand to say, here's the benefits you want to participate
in, that they have a place there, and they have a facility for
them.
The concern I have, Senator, is making sure that in DoD,
and I've already had some look at this as how we can do some
cooperative work with the DoD and the VA. Also bringing into
account the State Veterans Associations as well.
Senator King. I want to emphasize that last point. I had a
proposal in the National Defense Authorization Act, got in the
Senate, got knocked out in the House--to communicate a
veteran's transition status to the state veterans' facility so
this person can be greeted at the airport, for example. That's
the kind of handoff that I think we want. Do you agree?
Mr. Collins. I agree. Look, because it's exactly what you
said, it's how you're perceived. I view the service part of the
VA as this most important part. There are some times that you
have to tell somebody no, there's sometimes you have to tell
them we can't do something in a benefit, or something else. But
there's always time to make that veteran feel like they are
cared for.
And I think the transition time, which you're talking about
right now, that sort of, as you said, that warm hug is the
thing that we need to actually look at.
Senator King. And it's a critical moment, as you pointed
out. It's a time of heightened risk of suicide, for example.
Let me move on. Electronic Health Records, you had some
discussions. I think this points out one of the fundamental
flaws in the Federal Government procurement process,
particularly in national security areas where we feel we've got
to buy our own custom brand-new shiny product rather than
something that's sitting on the shelf.
There's an Electronic Health Records system called Epic
that thousands of hospitals use all across the country.
Instead, we're trying to invent our own system, which frankly
hasn't worked, and as you pointed out, has cost billions of
dollars. I hope that you'll look at the option of saying, hey,
let's go with something that works, that we know it works, and
can be modified to meet our needs, rather than continuing down
the roll of billions of dollars of a system that has so far not
proven itself.
Mr. Collins. Yes. Senator, I think what you've just hit
is--what I'm committed to is making sure what we have and
looking at all options on the table. I want to bring in.
Because Cerner and others have--you know, Oracle has had places
where they already have facilities already running the program.
It's the issue that I went back to earlier, and I think you
heard, it was here, that the VA is special, but not unique.
We've got to get out of this uniqueness status and how is it
different than the largest healthcare organization like this.
That there are not better ways that we can do it? And it's not
just in medical health records. We've got to look for better
ways all across.
Senator King. That's exactly my point. A lot of discussion
this morning about the MISSION Act and community care. I'm all
for it under the appropriate circumstances, but not at the
expense of a creeping elimination of the veteran's healthcare
system. I believe I heard you say earlier, you remain committed
to VA healthcare in addition to community care where
appropriate. Is that correct?
Mr. Collins. Senator, you've heard correctly because I
believe that when there'll always be a VA healthcare for the
veteran who comes out. I believe what we have to do is make
sure that we are adapting and making sure that we are giving
the care as authorized by this body to make sure that we do it
in the ways that are appropriate to the veteran. It's no longer
time in a situation especially in different parts of the
country where we have to have the veterans to do the mission
and what the intent was when we passed it.
Senator King. You've mentioned that you had not read
Project 2025. Are you familiar with it? There are some
suggestions in it that, frankly, I find pretty frightening.
Mr. Collins. I'm not, except for what I've heard when
Senators mention or somebody says it on TV.
Senator King. Well, for example, there's a provision that
new managerial approaches should be currently used in the
private sector to be employed to improve the existing VBA
activities. I'm afraid that might be code for loan sharks, for
claim sharks. Are you supportive of the GUARD VA Benefits Act?
Are you familiar with that bill?
Mr. Collins. I'm vaguely familiar with it, yes. I haven't
touched that.
Senator King. Well, I hope you'll familiarize yourself with
it. I think it's a very important bipartisan bill to protect
veterans from what are colloquially referred to as claim
sharks. I'll have some other additional questions later in the
hearing. Thank you, Mr. Chairman.
Chairman Moran. You're welcome, Senator King. Senator
Banks, welcome to the Committee, and you're recognized for
questioning.
HON. JIM BANKS,
U.S. SENATOR FROM INDIANA
Senator Banks. Thank you, Mr. Chairman. Mr. Collins, great
to see you. We served together in the House, and those four
years of President Trump's first term were four great years for
America's veterans. President Trump was the veterans'
President.
We did great things from; expanding the MISSION Act, to
greater accountability for VA employees, we loosened standards
for the GI Bill, President Trump sent us down a path to
modernize Electronic Health Records. The list goes on and on
from the VA crisis hotline to other issues that were priorities
for him that you and I had a chance to work on in the House is
among the greatest accomplishments in the eight years that I've
served in Congress.
Now we have another four years. And you're going to be a
great Secretary, working with a great President, and I can't
wait to work with you to do even greater things for America's
heroes. I do have some concerns about the condition of our
medical facilities. And you and I talked about this in my
office.
The Indianapolis Medical Center is due for a total
replacement. It's in the VA's five-year development plan
meeting. It's a project that you have on the books, but you
don't have funding to do it. Will you commit today to working
with me to get that project started next year as the VA plans
call for?
Mr. Collins. Thank you, Senator--and is working with this
body to get the funding needs for all of our construction and
priority needs are going to be there. One of the issues that we
have, and if you allow me to spend off of that, because you
haven't experienced it, is our average age of many of our
facilities, especially our hospital, is 60-plus years old. This
is beyond when you look at the hospital side now in private
hospitals and public hospitals, the average 15 to 20 years.
It's just a whole difference, which throws in so many different
problems.
So, construction is going to be something, and the projects
like that are going to be important. But also, as we just
discussed, and Senator King brought up the Electronic
Healthcare Record system, some of our existing facilities that
we're not going to redo are going to have to have major work
just to hold the computer systems and others to make that
happen.
So, it's something we're going to work toward to make sure
that we get it funded. We look forward to working with this
body to get the money for that and would support working
through that.
Senator Banks. Yes. Thank you for that. I look forward to
working with you on that. The VA, as you know, has struggled
with construction maintenance and leasing for years. And
Indianapolis and a lot of other projects around the country are
facing significant delays, which is harming our veterans. How
are you going to prioritize reforming the offices that handle
these functions within the VA?
Mr. Collins. Senator, I think what we'd looking at here,
and we really got to go, is making sure that we have a--what
I'm hoping to find is a more, I won't say slim-down, but a very
focused vision on our acquisitions, our construction projects,
so that we're not going through multiple layers that, as you
well know, add time if this person has to sign off. But making
it applicable.
This body's already said that projects over $100 million
have to go with the Corps of Engineers. We have those other
issues now after the project in Aurora and then Colorado, which
went so far, which we were here for. That's why we've got to
make sure that we have the right people in those positions and
bring in help when we need to, to say, okay, how can this
project be built more cost effectively?
And if I could say one thing. One of the reasons, yes, I
looked at this job and looked at the masses of it, but wanted
to do it, was those four years that you just mentioned. Because
I knew that President Donald Trump actually wanted to take care
of veterans, and didn't say it, but actually showed it and what
we did, and we worked on here in the Hill.
Senator Banks. I would add to that, the last four years
have been very different. Hasn't been a priority of the
administration that you're following, and look forward to
changing that very quickly.
When I served on the House Veterans' Affairs Committee,
there was a lot of confusion about where the VA was going to
put new clinics and why those counties, or towns, or cities
were chosen. And it made it really hard for me as a Congressman
to explain to my constituents why this town was chosen for this
clinic and another location wasn't.
Do you think the VA should let Congress know in advance
where planned clinics are going, not just send us a letter when
a lease gets awarded?
Mr. Collins. I believe that we should have a much better
working relationship with Congress and in regards to all
aspects of this. And I think that includes CBOCs, and we just
discussed in earlier conversation I'd had with Senator
Duckworth about how we locate those, maybe even with others.
But if you would allow me just a moment, there's one area
that I want to this whole body to hear, and it's one of the
main emphasis that I'm going to have, I believe, and after
listening to this over, like I said, 60-plus conversations and
more, that we have to have a better working relationship with
the VA, and the Members of this Committee, and the body through
our legislative affairs.
Legislative affairs under my leadership, if confirmed by
this body, is going to be proactive, not reactive. They'll
still be there for this Committee and the House Committee to
answer policy questions and to do those things. But I want to
have actually legislative affairs people, boots on the ground,
so to speak, here on the Hill, talking not just to you about
your concerns, but hearing from your constituent services
workers.
60 percent of most all of your constituent services work
fall under VA, whether it's benefits or healthcare. I want our
folks to know that upfront so that your people can know who to
talk to, but then they will relay the reports to me so that if
in Indiana we have a problem that is coming from your office
and a couple of the Congressman's office, we're going to have a
chance to react to that much quicker. And so, I'll have the
information so that we're not seeing something in the paper six
months later, or having you to call.
I've made the promise to everyone here that I do not come
in this with rose-colored glasses. I think this is a large
undertaking that I feel called to be at. But I will say this,
for all of you who have it, and I've heard it as well in my
eight years in Congress, when a member of the military or
veteran has to call our office, a Congressman, or a Senator's
office to get the care they've already earned, it is a mark of
failure in our department.
It's not something we can't overcome, and there's plenty of
things to do it. But I believe until we get to that mark, the
VA does itself, then we're not taking care of our veterans as
fully as we can. And I'm going to encourage all of our
employees to get to that standard. Thank you.
Chairman Moran. I better check and make sure I've got it
right. Senator Banks, thank you for your questions. Senator
Slotkin.
HON. ELISSA SLOTKIN,
U.S. SENATOR FROM MICHIGAN
Senator Slotkin. Thank you, Mr. Chairman. And I'm really
pleased to be on this Committee. And I think that veterans'
issues should be bipartisan issues. You and I served together
in the House, we overlapped. I'm very proud to be the first CIA
officer in the U.S. Senate. I'm a 9/11 baby, as they say, and
was recruited by the CIA after 9/11, and did three tours in
Iraq, armed alongside the military, and worked proudly for both
Democrat and Republican administrations. I'm also a Democrat
that just got elected on the same ballot as Donald Trump, as we
talked about. So, I certainly understand that Mr. Trump has the
right to nominate his own people and have policies that differ
than my own beliefs.
I think what I care about the most is just making sure that
our veterans get the care that they need and we don't strip
essential programs for the sake of cutting the workforce. We
talked about the PACT Act when you were in my office. I worked
very hard on that bill on the House Veterans' Affairs
Committee, you know, the potential to expand care to 3,000,000
9/11-era veterans who lived near burn pits. And then the
Elizabeth Dole Act that a number of folks in this Committee
worked on as well, which really does amazing things from mental
health and expanding programs on long-term care.
So, can you just give me assurances that, while I know it's
a mandate from President Trump to cut the size of the
government, that you will always speak up on behalf of
veterans, not just do the bidding of someone who maybe
somewhere else sees your numbers and starts to slash and burn.
Because in places like Michigan, we have really expanded our
staff on the VA to handle the additional veterans coming in. If
we just start slashing numbers, we're going to be hurting the
veterans who we just all voted and said we wanted to care for.
So, just a simple answer there.
Mr. Collins. That's an easy one, because what I was told by
the President is to take care of our veterans, and we're going
to take care of our veterans. And I said earlier in this
hearing, that we're not going to sacrifice the veteran's
benefits to do a budget. And I think these are the consequences
we have.
Efficiencies can be found everywhere, as you and I talked
about in the office. But we've also got to make sure we're
doing our mission. I wouldn't go to a place in which we're not
doing the mission. The mission is the veterans.
Senator Slotkin. I know there will come a time, there
always is, when we're cutting things that you will have to push
back and say, this is what that's going to do to care. You're
going to pledge an oath to the Constitution here soon, not to
any one President.
On the issue of veterans' benefits, do you believe that you
have the ability to change someone--you as VA Secretary, if
confirmed, would have the ability to change the discharge
status of any one veteran?
Mr. Collins. That's not under my purview to change.
Senator Slotkin. Yes. And do you believe that a veteran's
benefits can be cut based on personal or political beliefs?
Mr. Collins. No, Senator, that is not a criterion for
cutting a benefit. A benefit is earned and based on the
criteria that is set before. It's not a political belief.
There's not a litmus test that we would work there.
Senator Slotkin. I really hope we stand for that because
even when we deeply disagree, right, with the veterans'
actions, their service and their discharge status is determined
based on their moment that they serve the country, whether we
like their views or not. That's why we never had the veterans'
benefits, as I understand it, taken away from people like the
January 6th protestors even when they were convicted.
Similarly, we're watching right now, senior people from the
U.S. Military and Coast Guard be removed from their jobs on Mr.
Trump's first day. I just want your assurances that you are not
going to change their veteran benefits that they earned if the
discharge status is what it is from the Department of Defense.
Mr. Collins. I think encouraging not going down a path that
we've talked about are hypotheticals here. I think the DoD when
it comes to the veteran and coming to the VA itself, the
veteran comes with the benefits that they've earned through
their service and how they get to us. We'll take care and make
sure that the veteran is taken care of with their status when
they get here. The issues you're talking about from DoD, we're
going to take care of them from the veteran perspective.
Senator Slotkin. Okay. I just think that we go down a
dangerous road as a country if we say that a veteran has
served. They get their discharge papers, they've done their
service of the country, and then regardless of what political
views they have, whatever they say or do after their service,
they're then retroactively punished through their pension,
through their VA benefits.
I think that's a dangerous path for Democrats and
Republicans. And I don't want you to be the first VA Secretary
to go down that. So, I'll rely on you to stand in the breach on
that one. And with that, I yield back my time.
Chairman Moran. Thank you very much, Senator Boozman.
HON. JOHN BOOZMAN,
U.S. SENATOR FROM ARKANSAS
Senator Boozman. Thank you, Mr. Chairman, and
congratulations, on the chairmanship. We look forward to
working with you and Senator Blumenthal to provide the
leadership, and continue to provide great leadership that this
Committee's had for the last several years.
The VA's State Veterans Home Program is a great resource
for many senior veterans, including those in Arkansas. Our
Rogers location does excellent work caring for senior veterans
in Arkansas, but needs upgrades to continue providing the
standards of care expected.
In fiscal year 2024. This 96-bed facility was ranked number
12 on the Veterans State Home Construction Grant Program
priority list after being ranked number 9 in fiscal year 2023.
Unfortunately, the facility will not receive the necessary
funding in fiscal year 2024. We've worked with the current
administration to get the necessary upgrades to Rogers'
facility needs. Do I have your commitment that the VA under
your leadership will continue working with us on the issue?
Mr. Collins. Senator, thank you. And I think this is
important. This came up with several of us, and you and I have
discussed it. We're going to work with you, and the
appropriators, and also this Committee, to make sure that the
priorities expressed will be taken care of, and we'll work with
you to do those as we go forward. Because at the end of the
day, especially what you just brought up, is one of the more
critical we have. And that's sort of that end-of-life kind of
issues that we deal with and those later stages issues when
more care is needed.
So, for me, making sure that you have--that the states
across this country and the VA is providing that care is
something that is, frankly, a non-negotiable. As a pastor, it's
been mentioned many times about me being a chaplain, but I was
a pastor for 11 years as well, and had spent many times in
those long-term care facilities. And it was humbling, and also,
though, very critical to understanding.
So, yes, we're going to work to see what we can to make
sure that every need is that. We'll not always be able to say,
here's the best answer you're going to hear, but I'll
definitely work with you.
Senator Boozman. Very good. Thank you. I'm very proud of
the Committee's work to pass the PACT Act, which now provides
long overdue care for veterans dealing with the effects of
toxic exposure. While the VA's efforts to reach veterans
impacted by the legislation and get them support has been
great, I remain concerned about the VA's management of the
Toxic Exposure Fund and overall budget outlook.
How will you make sure the VA's Toxic Exposure Fund remains
viable for years to come while providing the levels of care our
veterans have earned?
Mr. Collins. Thank you, Senator. The care there is the
biggest issue and coming out to the PACT Act in the work we've
had. And it's been, you know, several hundred thousand new
people have been brought into the system and that even more are
coming.
I think the biggest thing we've got to do is actuarially
look at what is passed here, and I promise, and I think you and
I spoke about this in your office, is are we at the VA making
sure that we're getting good information and doing what the
intent was so that they can continue to get those benefits. And
that comes from these resources that are--it comes from us,
from this body.
So, I'm going to be actually looking at it, and I'll come
to you with real world examples. One of the things, as I made
the comment earlier about our legislative affairs and making
sure that we're more on the Hill, so to speak with that, was
another commitment that I have because I sat where you have sat
and had questions of administrations of the past, is that you
get good information.
And you have a commitment from me that when you get
information about how we're funding and how we're
appropriating, that whoever sits at this table, myself and any
other person that comes from the VA, will give you good
information, and they'll give you good numbers. So, that we're
not like we were last fall when it starts off at a high, at a
number of billions, then goes down to another billions, and
then was not even used, as Senator Cramer talked about in the
opening.
So, we're going to be doing that in addition to making sure
that we're getting good, accurate numbers so that we can
reflect the intent of these Acts. The Elizabeth Dole Act, that
was just mentioned just a few minutes ago, is going to be one
that I want to make sure that we do properly. We set it in
under the Trump administration when the Blue Water Navy, and
others, and MISSION Act was actually put into play.
There were times set in so that it could be done properly.
Sometimes the great ideas are at the wrong time are not the
best way. You got to make sure that you have the great idea
done properly, and that's what we're going to do.
Senator Boozman. Very good. I'll just say, again, you
served, you're a great Member in the House. You understand how
important it is that when we need information, when we need to
talk to you or somebody of importance. It's so frustrating you
have a hearing, and you've sent letters, and the last three
letters hadn't been answered. I'll just say again very briefly
because my time is up, but I think it's one of the most
important things that we can talk about today is how important
it is to, again, be such that you are in constant tune with the
Members.
Mr. Collins. Senator, thank you for highlighting what I
believe is going to be one of the biggest differences, and if
confirmed by this body, at the VA in the early stages. And that
is going to be the involvement of our legislative affairs on
this Hill. I am committed to having 535, if you would, canaries
in a coal mine, 100 Senators and 435 Representatives who
actually can help us and work together to see where there's
problems, to see where there's issues.
Like I said, not just in policy, not just in funding
regulating, but also in the actual veteran constituency.
Because when I hear from you, and as Chairman Moran and I
talked, and he mentioned earlier, when we hear from the
veterans, that's what we hear in Home Depot. That's what we
hear in Kroger when we're walking around. Thanks for helping
this. I want to know where the problems are because I'm not a
Secretary, if confirmed, that will sit behind the desk. I will
be out, and I'll be there making sure we get it fixed.
Senator Boozman. Good. Thank you. Thank you, Chairman.
Chairman Moran. Thank you, Senator Boozman. Senator
Gallego.
HON. RUBEN GALLEGO,
U.S. SENATOR FROM ARIZONA
Senator Gallego. Thank you, Chairman. Thank you,
Congressman Collins, for joining us here today, and
congratulations on your nomination. And as you and I talked in
my office, of course, this is very personal to me also being a
Marine Iraq veteran, someone who has used VA healthcare
services and has also received a disability rating from them,
making sure the VA continues to be foremost taking care of our
veterans. It's important to me, especially in Arizona.
So, I have a couple questions more Arizona-focused. So, the
Be Connected program operated by the Arizona Coalition for
Military Families had began as an Arizona veteran suicide
prevention program, and has grown to serve the state's veteran
population and their families by connecting them with mental
health resources and more, which sometimes cannot be met within
the hospital system.
It receives one-third of its funding from the State of
Arizona and two-thirds from the VA, and renews it's contract
with the Phoenix VA annually. The Phoenix VA recently said that
it no longer intends to enter into another contract with the Be
Connected program, and will stop funding on March 31st due to
budget constraints.
So, if confirmed, will you commit to work with me and the
other members of the Arizona delegation to ensure the VA finds
alternative sources of funding so Arizona veterans can continue
to receive these critical services through the Be Connected
program?
Mr. Collins. Yes, Senator. I mean, one of the things--it's
good to see you, and it's good to see you over here in your
seat as we serve together. Look, also touring the same ground
in Iraq, we know that that issue coming back, and that
transition's been mentioned many times here before. It concerns
me, and I'm going to say that what you're bringing up right
now, it concerns me that as a VA, that there would be concerns
about funding a program that actually goes to what is one of my
major concerns, and that is the issue of death by suicide and
looking at the--or taking even to a homelessness issue as well.
So, those are the kind of programs I think are priorities.
So, from my perspective as a Secretary, it's going to be about
priorities. And what we're seeing today, is 17 people not with
us anymore. It's not satisfactory. Over 40,000, I believe, in
of those are more homeless, it's not satisfactory. A 5,000-
waiting list in Alaska is not satisfactory.
So, budget items will match up to the priorities of what I
want to have, and that's what I look forward to working with
you on and look forward to getting more information on that
issue.
Senator Gallego. Thank you. Now, I'm focusing and moving on
to kind of the HUD-VASH program. Something that's very
important in terms of reducing homeless veterans. But we did
see a growth in homeless veterans increase by 7.4 percent from
2022 to 2023, which is for a variety of reasons, not just the
HUD-VASH VA program. The program is you'll rent pairs--pairs
rental assistance through housing vouchers targeted at
veterans, specifically, with case management and other
supportive services.
If confirmed, would you do what would you do to support
HUD-VASH program, increase the collaboration between the VA and
HUD?
Mr. Collins. That is something that I think is, you and I
talked about in the office, very important because we look at
the areas for disability. We look at the VASH, we look at this.
Is it actually enough to provide people the resources to have a
home?
For me, I'll look at this issue of homelessness, not just
as a VA issue. I'm going to look across the spectrum with HUD
and with any other department, which we can to make sure that
this is something that is not the dark spot on a veteran
service where we have homelessness like that is spoken of all
the time.
So, I'm willing to take whatever we can in the VA, outside
the VA, and I'm looking forward to having a good relationship,
if confirmed here and if confirmed, Mr. Turner confirmed, at
HUD, that we're going to have a lot of conversations about
this.
Senator Gallego. Right. And you and I talked about this in
my office, too. The studies have shown that the whole health
coaching can help veterans make meaningful progress toward
health goals, reduce stress, and improve quality of life, and
overall, bring down the long-term costs for the VA. Because
then, you have healthier veterans at a younger age, means you
have healthier veterans at older age.
VA currently employs around 200 full-time health coaches.
But there are about approximately 20,000 to 30,000 health and
wellness coach encounters where they have 20', 30,000 health
and wellness encounters per month. This number is expected to
increase as veterans demand more coaching when it comes to life
and health.
As we discussed in our meeting, the VA has serious health
coach vacancies. If confirmed, what would you do to safely help
remove current barriers to healthcare professionals interested
in becoming health coaches with the VA?
Mr. Collins. Senator, as we discussed that, that's one of
the issues I see, and I think you and I both saw from the
House, and now you over here in the Senate, and myself, is why
are regulations keeping us from getting to the help that we
need?
And I think that's what I want to take a look at, after you
and I conversation, we get confirmed, we're going to look at
this and say, why is getting from A to D, why is B and C
proper--or could we remove C and just go A, B, D? I think those
are the kind of things because what you just talked about,
again, is how do we keep people?
At the bottom line, for me, this chaplain's heart, this
Secretary's heart is always going to be about helping the
veteran get the help that they need in all areas of their life.
And if we don't do that, then we're making a mistake. We're
missing the mark. And you and I have seen that, unfortunately,
firsthand as someone who's actually counseled with those who
thought about taking their life, those who have serious issues.
We've got to have every help we can have.
Senator Gallego. Okay. Thank you. I yield back.
Chairman Moran. Thank you, and welcome to the Committee.
Senator Tuberville.
HON. TOMMY TUBERVILLE,
U.S. SENATOR FROM ALABAMA
Senator Tuberville. Thank you, Mr. Chairman. Thank you,
Congressman, for wanting to take this on, you and your family,
the largest healthcare system in the world. If that's not eye-
opening, I don't know what is. We've had a lot of people tackle
this job, and it is a hard job, and it's very, very important.
I grew up in a military family, been to many, many VAs, and we
have some good ones in Alabama.
But it's amazing to me that we look at this and it's,
again, the second largest budget that we have here in Congress.
Second largest behind the DoD. But it's really not about money.
You know, I think about and look at all this in a different
perspective sometimes. It's about people running what you have.
And we're run by unions and there's obviously some good and
some bad, but we got to find the problem. Because we got to,
more and more of our veterans are adding up. We have almost
500,000 just in the State of Alabama alone, and it's a big
problem that we can't take care of all of them.
Now, when I first got here and got on this Committee four
years ago, one of the first things that we did, President Trump
had eliminated 4,000 people. He didn't care what they were in,
if they didn't do their job, they got fired. And he took 4,000
of them and sent them out the door. With the Biden
administration come in, the first thing they did is they
rehired them, and back pay, and put them in a situation where a
lot of them had really breached protocol.
Now, I come from a previous profession. If you didn't do
right, you were gone. Will you commit to doing what's right for
the veteran when it comes to the personnel that are handling
these people? We can talk about acts and laws and bills and all
this, it isn't going to make a bit of good unless we get the
people that's running these VAs and these homes that take care
of our veterans, if we don't get the best. Will you commit to
that?
Mr. Collins. Senator, thank you for that. I mean, your last
statement is not just your profession, but I think every other
profession in the world expects accountability. And I think
that's what raises the standard. So, yes, we're going to have
accountability. The VA Accountability and Whistleblower Act,
which by the way, passed unanimously out of the Senate, it's
intent was to make sure that those workers who were not
fulfilling their mission, they were not going to take a job
anymore.
I intend to make sure that this is a promise that I have is
if there is someone who is harming, or in the way of our
veteran and taking a veteran's benefit away, I have no problem
in getting rid of that person and making sure we do it
properly. And I have no problem with the legal repercussions of
that because there's no one at the VA going to stand in the way
of a veteran getting the care properly.
And if they're not doing it safely, which we saw many of
those were not doing it safely and putting our veterans in
harm's way. But I will say it, again, and I think you would
agree with me, I will be the biggest cheerleader for every VA
employee out there who is out there getting up every morning
doing it right, making sure we're taking care of our veterans.
But I believe the only way I can make them better, the only
way I can push them is to not allow those not to do it. So, we
have to have that accountability. This body passed it
unanimously. It is about raising standards. It's about saying
that we're going to expect the best and we're going to require
the best. Because if I want to retain doctors, if I want to
retain nurses, if we want to retain benefits people, then you
got to set a standard that says I'm proud to be here. And for
me, I want to lead an agency that works and puts our veterans
first, and holds accountable those that have not.
Senator Tuberville. Awesome. 2023, it was reported to us,
some of our VAs, especially our community care systems, were
funding illegal aliens' healthcare. Would you please look into
that once you take this office?
Mr. Collins. Yes, Senator, I will. I do not believe any
money that's taken outside the mission of the VA to help the
veteran is a worthy cause of the money that has been
appropriated for the veteran. And we will not be doing that.
Senator Tuberville. You know, we were given a budget
shortfall just back last July. We were called and told by the
Administration that we're $3 billion short, and we had to come
up very, very quickly or we were going to default in the VA.
You can imagine how frustrated we all got with that when we
found out that we actually had a surplus. I would hope that we
take better care of what we do with our money and we know where
it's at.
Also, one thing before I go off here, and I didn't get a
chance to talk to you about this back when we met, on
electronic healthcare. Nobody's told you this, $20 billion on
updating our VA's Electronic Healthcare Records over the last
decade. The Department of Defense completed their update, yet
the VA has nothing to show for the $20 billion. Houston, we got
a problem.
Mr. Collins. Houston, Atlanta, DC everywhere else, we have
a problem. That is not acceptable. That's one of the things
that we're going to, as we've said earlier, and we talked about
this earlier, to have to get into very quickly. Put every
player on the table to make sure that we're getting it right
from the VA perspective and from the from Oracle perspective as
it's currently held.
DoD and VA are very different. But also, as I said before,
we're special but not unique. What we can do, can be done, and
there's ways that we can look at that. Let's do what we can do.
We're going to get that right. Even up here, eight years and
that much money and no results, only five places, I believe
actually still is not acceptable.
Senator Tuberville. Thank you.
Chairman Moran. Thank you, Senator. Senator Sanders.
HON. BERNARD SANDERS,
U.S. SENATOR FROM VERMONT
Senator Sanders. Thank you, Mr. Chairman. Congratulations
on your new position----
Chairman Moran. Thank you----
Senator Sanders. Looking forward to working with you.
Chairman Moran [continuing]. Former Mr. Chairman.
Senator Sanders. The job that you have been nominated for
is an impossibly difficult job. I just want to say, for the
record, that I think Denis McDonough, the gentleman who came
before you has done a very good job in the context of what he
had to deal with.
Mr. Collins, in two independent assessments last year, the
VA outperformed non-VA hospitals in terms of patient
satisfaction and hospital quality. I can tell you that in
Vermont, you talk to the average veteran who accesses VA, they
say, you know what, the care is pretty good. I think that's
probably true in most parts of the country, and that takes
place within a private healthcare system, which is largely
broken and dysfunctional.
It strikes me, from what I have heard, there are three
approaches to the VA. There are some folks, extremists, who
think to get rid of the VA completely send veterans out into
the private sector. Others, including the nominee for Defense
Secretary, Mr. Hegseth, who have indicated that the VA should
be there for specialized care; people with PTSD, people with
amputations, particular problems the veterans have--specialized
care. And there are those of us, including myself, who think
that when people are asked to put their lives on the line to
defend this country, you know what? All veterans are entitled
to all of the healthcare that they need. That's my view. Where
do you come out on that?
Mr. Collins. Senator, it's great to sit in the office and
talk to you, especially you were chairman, the perspective you
have. We come out very similar. I've said before, and I said it
to this Committee early on, they'll always be a VA health
system for the veteran. And like we talked about in your
office, I think what we're going to do is make sure that the VA
centers that are strong, can get better.
But also, I have states that I've talked to and other
Senators who have maybe one facility that is doing well and
another facility that's not. So, we can't break paint with a
broad stroke even on the private sector that you mentioned to
say that any one in particular is the rule for all. So, I'm for
getting that and making sure that we have it.
Senator Sanders. Okay. Here's the problem. There is a
limited amount of money. Community Care spending went from $8
billion in 2014 to $31 billion in 2025. Ideally, what we could
say is, hey, you're a veteran, you want to go into a private
care, no problem. You want to go to the VA, no problem. We have
a strong VA and strong private care. They don't have enough
money to do that.
So, in fact, what the debate comes down to is not whether
somebody should be able to access community care, but where are
we going to put our resources? Are we going to allow the VA to
wither on the vine, so to speak? Do you understand where I'm
coming from? Are you willing to tell us you're going to fight
for a strong VA in every state in this country?
Mr. Collins. We're going to, Senator. That's a non-
negotiable. We're going to start to fight for a strong VA. Now,
what I understand your perspective. You didn't vote for the
MISSION Act, which is where community care started. I
understand your perspective, but I also understand the will of
the body and the law. And I understand veterans today. I
believe you can have both. I believe you can have a strong VA
as it currently exists and have the community care aspect.
Senator Sanders. Okay. Vermont issue. You are inheriting an
incredible bureaucracy that is very slow moving at times. There
are two CBOCs in the Vermont area. One in Chittenden County,
our most populated area, one in the southern part of the state,
Keene, New Hampshire--access to both Vermont, New Hampshire
veterans. It has been moving along rather slowly. Will you
assure me that you're going to take a hard look to make sure
that those CBOCs get moving rapidly?
Mr. Collins. Yes, Senator. We were talking about with
Senator Boozman as well. Those are issues that we've got to
look at and make sure the priorities, the money's there. We're
going to look sure that----
Senator Sanders. But it's not just the VSA, it's not just
the VA. The VA works with the GSA----
Mr. Collins. I understand.
Senator Sanders [continuing]. And it is a problem. Take a
hard look at that one. There are massive staff shortages in the
VA, and I am concerned about the hiring freeze that President
Trump has initiated. Will you stand up publicly and say, you
know what, we need every healthcare, every VA health facility
in this country to be adequately staffed. We will not accept
staff shortages, and make sure that we have the people that we
need?
Mr. Collins. I'll advocate to make sure our veterans are
taken care of. But I'll also support in the fact that we'll
take a look at the current levels of employees that we have and
where they're properly located, and we'll work with that. And
the President will work under the Executive order that he has
given.
Senator Sanders. Look, in English, we all understand this.
There are inefficiencies in the VA. There's waste in the VA.
Every government agency. On the other hand, the VA, in general,
in my view, does an excellent job. They need the support. So,
you want to go after waste, inefficiencies, do it, but make
sure that we have the quality of doctors, nurses, staffing,
that we need to take care of every veteran in this country.
Mr. Collins. Thank you, Senator.
Chairman Moran. Senator Tillis.
HON. THOM TILLIS,
U.S. SENATOR FROM NORTH CAROLINA
Senator Tillis. Thank you, Mr. Chairman. And Mr. Collins,
thank you for being here. You and I have a lot in common. We
were both born in August, you, six years after me. We both
entered state legislature at the same time in 2007 in two
different states. And you got a sister that was born in the
same hospital that both of my babies were born in. Am I right?
You also, I have the benefit of me tracking, since I lived in
Atlanta for about four years, tracking Georgia politics. You
are a very good, solid, reasonable Congressman. So, I know all
I need to know about supporting your nomination.
I know you've said multiple times you're not going to
privatize the VA. You're not forcing veterans out. You've done
that. I think you were sworn in in testimony. So, would you
just do a pinky swear or two that you're not going to
prioritize the VA? Here we go. We got about that air pinky
swear.
[Laughter.]
So, the reason that's important is that some people, not
everybody, I think that Senator Sanders is genuine and has
concerns. But folks, there is no--let me just say again what
I've said--every time privatization and forcing veterans out of
the VA to seek private care, there is no serious discussion
among lawmakers to do that.
And by serious discussion, I mean that could ever see the
light of day. I have very few skills. One of them is counting
votes. There is simply not enough to even consider it a threat.
And the reason why I hit this head on is there are veterans who
could be led to believe that that's a risk. It is not a risk.
You don't have to come to Washington because a vote is
imminent.
The VA is the largest healthcare system in the United
States. It does a lot of things good and in many cases, it does
it better than the private care providers could ever imagine
because of the unique status it has. In many cases veterans,
serving veterans. So, again, thank you for that pinky swear.
Now, let's move on to the unpleasant part of my discussion.
It has nothing to do with you. I have supported every VA
nominee who's come before this Committee. And I supported the
Secretary of the VA when I came in the Obama administration.
I've had a great working relationship up to and including with
Secretary McDonough. I have concerns, even some that date back
to VA Secretary Wilkie, who was my MLA before he went on to be
VA Secretary.
The implementation of the Electronic Health Record is a
bipartisan, multi-administration disaster. There is no way on
God's green earth that we should have spent $10 billion to have
only a fraction of the VISNs even touched. So, do I have your
commitment to go through that program, to quickly get it moving
again and get an integrated health chart that also can
integrate with the DoD so that we can finally have a seamless
transition from active status or reserve status, to veteran
status and provide premium care at the VA?
Mr. Collins. Yes, Senator Tillis, for the very reason of
this is; it's what you just said about seamless care. It's a
safety and security issue for my veterans.
Senator Tillis. It absolutely is. The Electronic Health
Record, I've got a real problem. We need to have a review. I
don't know if it's an Inspector General's report or something
else, but folks, I did large scale systems implementation work
for the vast majority of my career. I've done that more than
I've done being a U.S. Senator or a State Representative. This
is a disaster.
And I would like the people involved, not only the
contractors, but having been the contractor before, my guess is
it's rooted in bureaucracy and people responsible for the
implementation within the VA not doing it right. So, will you
commit to me to doing a project review? I'll come to your turf
to do it.
Mr. Collins. Yes. We're looking forward to the project
review. This for me has been one of the--when first looking at
it, you know, only up here would this allow it to go on as long
as it had. So, look, I'm putting on notice today that I'm
committed to everyone here. We're going to bring everyone to
the table, that's vendor, that's VA, everybody in the middle--
--
Senator Tillis. Good.
Mr. Collins [continuing]. And figure out what this problem
is, because it's time to fix it.
Senator Tillis. Well, I'd love to be at the table when you
have some of those discussions, to be honest with you, and lend
you some free consulting advice.
Last thing I want to leave you with, because I say it in
most of the hearings, I did not vote for the PACT Act. In spite
of the fact that my office was responsible for the formulation
of the TEAM Act that was in that bill, which was to provide
care to warriors who were exposed to toxics. And also, the Camp
Lejeune Toxics Act, which my colleague Senator Sullivan has
been trying to work to reduce the compensation.
I didn't vote for it because I was absolutely convinced it
was going to be where it is today. It's $700 billion between
mandatory and discretionary spending, unfunded bill that got
out of the oven too soon. And now, we know you've got
shortfalls that you're going to have to fix and the billions of
dollars because we didn't take the time to actually get the
PACT Act right.
I hated not being able to vote for that bill, but I voted
against it because we promised out of this Committee that we
would fix it before it got a vote on the floor. Now, we've got
to fix it. And you can count me as somebody that will be
helpful.
Mr. Collins. Thanks, Senator. I look forward to that
because that is going to be one of the first issues we've got
to tackle from the budgetary standpoint. But also, and I will
say to the Committee, and we've talked about this in many of
your offices, I'm also looking ahead to the Elizabeth Dole Act,
and our actual implementation, and implementation cost on it. I
think it's something we've got to take care of, but it's got an
implementation cost as well.
Senator Tillis. Thank you
Chairman Moran. Senator Hassan.
HON. MARGARET WOOD HASSAN,
U.S. SENATOR FROM NEW HAMPSHIRE
Senator Hassan. Thank you, Mr. Chairman, and
congratulations on your chairmanship. I look forward to working
with you and Ranking Member Blumenthal. And Congressman
Collins, it is good to see you. It was good to sit down with
you the other day. Congratulations on your nomination. And
thank you to you for your service to our Nation and to your
family as well for their sacrifices because we know when an
individual serves, the whole family serves, and I welcome them
here today as well.
One quick comment to follow-up on what Senator Slotkin was
asking you about. I appreciated your expression that you would
be willing to let the President know, or anybody else in the
administration, know if you thought the budget cuts would hurt
service to veterans.
And I will just say, having done this work at the state
level, and now here, it is tempting for people in your position
to tell their bosses whatever budget you give me will get the
job done, because that's what you want to be able to do. But
cutting direct care people in a healthcare system, cutting
people who coordinate care so that veterans can get integrated
care can really, really harm veterans. So, I will hold you to
your statement that you will stand up for veterans in the
budget discussions because it's going to be real important.
Mr. Collins. And thank you, Senator, I allow on that
question because it is true. I mean, as we've said and brings
the uniqueness, I've been on that side. There's only limited
dollars. And there is consequences, and there's a big thought
up here on Capitol Hill that we vote on ideas. We don't vote on
ideas. We vote on words on paper. And those cost money.
So, yes, I'll stand up. And look, the President has made it
very clear to take care of veterans. And I will say as we look
for efficiencies, we look for the things to run those agencies,
I'll say here's the cost benefit of that, and we'll move
forward with that, making sure we take care of the veteran.
Senator Hassan. Well, I appreciate that. I want to move on
now to a topic that I know Senator Sullivan also touched on.
President-elect Trump supported a full-service VA hospital for
New Hampshire when he was on the campaign trail. I've supported
a full-service hospital in our state for years and will gladly
work with you and the President to make that happen.
In the meantime, though, the current Manchester VA Medical
Center is almost 75 years old and it needs significant
upgrades. The facility's age is showing. Twice over the past
eight years, pipes have burst, temporarily closing parts of the
medical center. And when I say temporarily, we're talking
months. We scheduled surgeries, the whole nine yards. It has
been terrible.
So, following a push from the New Hampshire delegation to
prioritize improvements to the medical center, the VA has begun
implementing a multi-year upgrade plan. Will you commit to
continuing these upgrades to make sure that Granite State
Veterans have the best possible medical facility to receive
their care at, and will you come up to New Hampshire to visit
the facility and meet our veterans?
Mr. Collins. I'll take the last one first. Yes.
[Laughter.]
Senator Hassan. Good.
Mr. Collins. But I assure you not only Granite State
Veterans, but all across the country, they'll will be taken
care of in looking at our needs. The infrastructure needs, I'm
glad we're talking about that today, because it's not just the
new facility, it's not just the new CBOC, it's taking these
older facilities that, as you said, once they're shut down and
then the bureaucratic process to get it fixed. And so, that is
it.
But also, with President Trump's commitment--look, I'm
going to support the President. We're going to look to that
hospital. But I think you've brought up a bigger issue that I
hope all the Committee members will understand is--I wish we
could, as I said before, have this rose-colored old pixie dust
it'll just fix itself. But construction issues are going to be
one of our hardest because of age of facilities.
Senator Hassan. Thank you. Let's talk about rural veterans.
They face several challenges in accessing VA healthcare. For
example, they have to travel long distances to access their VA
healthcare facilities. And that usually means that they're
going to want to schedule multiple appointments on the same day
so they don't have to do all the travel back and forth.
Unfortunately, some VA medical appointments can only be
scheduled by calling the individual clinic directly. Meaning,
veterans often have to make several calls to multiple
disconnected offices just to try to coordinate and schedule
their appointments. And then, they schedule one, then they call
back the other and find out the slot they thought they had is
gone.
So, that's why Senator Boozman and I introduced the
bipartisan Improving Veterans Access to Quality Care Act, which
would require the VA to create a streamlined scheduling system
where veterans can either call or go online to view and
schedule appointments for all of their VA healthcare.
Congressman Collins, will you support this effort and work
with me and Senator Boozman to pass this bill and implement its
change to help our veterans?
Mr. Collins. Well, Senator, I look forward to seeing in
that and looking into it further. But I'm going to tell you
from a conceptual standpoint, the better question for me is,
why haven't we almost got there anyway?
Senator Hassan. Yes.
Mr. Collins. I mean, because of that thing about, if I
can--I mean, and I'm not to reduce appointment times to an app,
but when you can order five people's food in five different
places at the same time on your phone, why can't I go to one
place? And I think for our younger veterans.
And I think we talked about this in your office. For our
older veterans, it is a different way. They need to be
personal. From my dad who's probably watching now, he wants to
be on the phone, but the rest of them pick up the phone, let me
just get my three appointments and be done with it.
Senator Hassan. Yes. And I thank you, Mr. Chair. And I will
follow-up in writing with you about the one last question I
wanted to talk about, which was just the implementation of the
Dole Act.
Home care is incredibly important. It's the way, it should
be, the wave of the future because most people want to age at
home or get their care if they have chronic illness or
disabilities at home. Something near and dear to my heart and
the heart of veterans, and I look forward to working with you
on that.
Mr. Collins. And just briefly, Mr. Chairman, I just want to
be real brief about it. That is something with us, but I'm very
proud of what y'all have accomplished there. But it's going to
now take us implementation to make sure we do it right. If I'm
confirmed, you'll have that commitment.
Senator Hassan. Thank you, sir.
Chairman Moran. Senator Hassan Thank you. Senator Cassidy.
HON. BILL CASSIDY,
U.S. SENATOR FROM LOUISIANA
Senator Cassidy. Hey, Congressman Collins, great job in the
chair. You're going to be a fabulous Secretary of the VA, and
you have my support. You're a Georgia Bulldog fan, but, you
know, that's okay. I mean, not everybody can be a Go Tiger.
Mr. Collins. Go Dogs.
Senator Cassidy. Listen, I've been concerned because
there's such a backlog in terms of people applying for VA
disability benefits from whatever program there is. It just
doesn't happen. And when it finally happens, sometimes the
person's dead. Now, when I speak to people and read about the
use of artificial intelligence, someone says it's the perfect
bureaucrat. That once you set on the facts, it can process in a
tremendous amount of information next to instantaneously, and
come up with the same decision based upon the same set of facts
over, and over, and over.
Now, but I also learn it's only something that happens if
you lean into it. If you just say, well, it's really great,
we'll get there when it happens. It never happens. If you say,
we are going to set up a system in which we ``red team'' it,
and we're going to compare it to our best reviewers, we're
going to then compare the best reviewers to the AI, whichever
is different, we're going to figure out why it's different. And
if the AI is not as good, we're going to continue to refine it
until we can scale it, and a veteran does not need to wait for
his or her benefits. What do you think about that vision?
Mr. Collins. I wish it wasn't being presented as such a
novel concept because it's really true. We can do that. And as
you, from your medical profession, looking at why are we not
using AI and the benefits of IT to actually take, especially
from the benefit perspective, and take the ones that are easy,
the ones that match the box that we can get out the way so that
we can actually still hands-on those that are a little bit more
difficult.
Here's some numbers that I'm sure you're familiar with, and
this Committee is familiar with, and I'm proud of. Under
President Trump and the previous administration that the
backlog on the benefits cases got down to 65,000. I believe in
the past four years, there's been 130,000 added, $1 billion
added to the budget, and almost 70,000 employees. And right
now, there's a 265,000 backlog down from almost, I believe,
double that. We've went up with everything else.
Why are we not able to get out some of these in better
ways? And that means doing efficiency, looking at AI, looking
at other technology, not just from the benefit perspective, but
also from the medical perspective as well. We've got a
healthcare record system that is non-existent right now that
we're going to have to do, as you said, that ``red team''
approaches, your wording.
So, I'm looking for every possible way that I can make it
better. Why would I be satisfied for a system that is old, and
outdated, or non-existent when my goal, and my purpose, and my
mission is to take care of a veteran?
Senator Cassidy. Now, let me suggest because one thing that
happens here is that the agency says, give us the money and
we'll come up with a system. And then two years later, and then
two years later, and then two years until you finally pull the
plug. So, somebody once said, you should go out on your bid and
say, we want the system at least to be run on a pilot method
within six months. Because what you're getting is people who
already know how to do it, indeed are already doing it in one
form and they're adapting their system to yours.
Now, I would suggest as we work as a team, that we come up
with something that we would say, okay, you got six months to
do it, and then we're going to do it. If we see veterans who
have been waiting forever to get their stuff, getting it
quickly, getting it appropriately, not too much, not too
little, then we can take it to scale. But other agencies have
just taken the money, and taken the money, and it has become a
black hole. So, thoughts about that?
Mr. Collins. My main thought about that is someone who's
been on this Hill in dealing with budgets, and it was the merry
thing that most of us go home and do town halls. They do not
understand how we do appropriations up here. They do not
understand how we spend money up here. They don't get to do
that at home. They don't get to do it with their own budget.
So, when we tell them, oh, we're spending money but show
nothing for it, that's something that's a foreign concept. And
I think it's just fostered the distrust that we see. So, for
me, setting deadlines is the only way you get things done.
Setting deadlines, and appropriate measures, and metrics are
the way you get things done. I am going to be one that is
actually going to say, here's the defining aspect of what we've
been given. Let's use the best results. Let's use the best
processes. Let's use the employees we have and the best people.
Senator Cassidy. I like that as opposed to $10 billion,
figure it out. It's going to be, here's a chunk of money. If
you can show you can do it, we'll take it to scale, but if not,
we're pulling the plug and going someplace else. So, anyway,
thank you.
Mr. Collins. Thanks, Senator.
Chairman Moran. Thank you, Dr. Cassidy. Senator Duckworth.
HON. TAMMY DUCKWORTH,
U.S. SENATOR FROM ILLINOIS
Senator Duckworth. Thank you, Mr. Chairman. Congratulations
on your chairmanship. It's good to be on another committee with
you. Congressman, welcome. I really enjoyed our conversation.
I'm not going to speak further on privatization of VA, my
opposition to it, but you know I think that you would agree,
would you not, that VA is uniquely suited to provide the
highest quality of healthcare to veterans? And that privatizing
VA would create a significant challenge wherein veteran care
would be outsourced to providers not equipped for this
specialized training, directly impacting the quality of care
afforded to veterans.
Mr. Collins. Senator, again, it was good to talk to you. I
you would not believe how many times I've used our conversation
in discussions with CBOCs and other things. Of course, I mean,
I think when you look at this issue that the VA is uniquely
positioned to deal with veterans and has the data, which you
and I talked about, that can provide not only help for our
veterans currently in the system, but even outside the system.
Using that data then to help others outside.
We have a unique control group, if you would, that can
actually look at that. So, I think with someone we can
definitely continue to work on, and as I've stated before,
there'll always be a VA healthcare center for those veterans
that come home.
Senator Duckworth. Yes. Just keep VA the medical center
home, and then if they need care for their specialized
treatment, they can go somewhere else. But as long as the VA
know what's happening and is keeping track, I think that's
really important for the veterans' best health.
Mr. Collins. I think as we do it efficiently and we make
sure the veteran is the center of that, that's exactly what we
need to. You and I mentioned this, that I think we need more
veteran--the issue of women's veterans coming in, which are a
large population of our veterans coming in now, making sure
that if they want to receive that care in the VA--for instance,
right now, there's depending on discussion, you know, lack of
mammogram equipment. Those are things that are in large VAs who
satisfy a large number of female veterans. They're having, you
know, to do that. If they wanted to stay in, they couldn't. So,
I think working at both ways is where we need to be.
Senator Duckworth. Yes. I think the medical, what is the
best medical treatment is where we need to go. I mean, in the
case of mammograms, you know, you need somebody who reads
thousands and thousands of mammograms. And if you only take
care of small number of female veterans, I wouldn't want to
have my mammogram read by someone who only reads a hundred
mammograms a year, as opposed to a partner organization like
that rural hospital or somebody who reads thousands of
mammograms so that they can better spot any problems.
Mr. Collins. Exactly. And that brings me to--I'm going sort
of maybe jump ahead of you a little bit. I think it goes back
to your discussion we had in the office about the CBOC and
rural hospital issue. And I think what you made was a very good
point, and I'm going to take it a step further about what you
just said though. It's a sharpening of skills. For those of us
who've been to Iraq, and have been to Afghanistan, and those,
we saw trauma and emergency care at its finest.
Senator Duckworth. Yes.
Mr. Collins. I mean, if they came through the Hero's
Highway at Balad, 98 percent of those made it back home alive.
Now, some of them didn't. You were one that did. There's some
who didn't, but they got back home. And I remember a time that
I sat with a young man who I was with him and prayed with him,
and he had the--I'll never forget him because he had blonde
hair, blue eyes. And I went back later that evening and he was
gone. They had already got him on a plane and got home.
Later, a week and a half later, I looked at ``Stars and
Stripes'' and I saw his picture. But I was comforted by knowing
he was back home when he passed. That is sharpening of skills.
And in the VA we need to have that. We have to make sure that
our veterans are getting that same kind of treatment so that
our skills and their treatment are matching.
Senator Duckworth. Wonderful, thank you. If confirmed, will
you commit to working with myself and my colleagues on this
Committee to strengthen and refine VA policies that improve
wait times and access to VA healthcare rather than resorting to
privatization?
Mr. Collins. Yes. I think that is what we're looking at
right now, is a VA that has the VA healthcare system. And we,
again, it goes back to the service of the veteran. I'll say it
again, I've said it before, I'm say it again; when they have to
call my office when I was in Congress or your office, now that
is a failure from the VA, and it's not a failure on the people.
So, anybody try to twist what I'm saying. That's not what I'm
saying.
The VA has a mission to take care of veterans. If for some
reason the veteran's not able to get that care, then we need to
step up and make sure they answer why. So, yes, trimming down,
wait times, making sure they get that because some of the
things we could be missing are preventative care that could
actually help us long-term in our cost perspective if we're
catching it early.
Senator Duckworth. Thank you. I'm glad you mentioned
preventative care. Right now, preventative healthcare is
something that patients in the Affordable Care Act or other
places do not have to pay for their preventative care. So, your
prostate cancer screening, your mammograms for breast cancer,
colon's cancer screening, your statins for your cholesterol
medication, you don't pay a copay for that, but veterans do.
If confirmed, will you support making a non-controversial
common sense fix to ensure that VA coverage aligns without a
commercial healthcare and TRICARE, and help me eliminate the
copays for veterans for preventative healthcare?
Mr. Collins. I look forward to working with this Committee
on that because I do believe, as you do, that the preventive
aspect of that is very important.
Senator Duckworth. Thank you. I yield back, Mr. Chairman.
Chairman Moran. Senator Blackburn.
HON. MARSHA BLACKBURN,
U.S. SENATOR FROM TENNESSEE
Senator Blackburn. Thank you, Mr. Chairman. And Mr.
Collins, always good to see you. I appreciate that.
As we served in the House, you were known as being a
consensus builder and a problem solver. And I think as we look
at the VA and the situation that is there, we need someone who
can build consensus among the employees and solve some problems
that are existing in the VA.
So, you made a comment about it was important to get the
right people doing the right job. And I agree with that. And as
we have been overseeing the VA, something that has been a
consistent problem is the return-to-work policy, and the lack
of individuals that are working full-time. At one point out of
VA benefits, they were only required, according to Secretary
McDonough, they only had to work in-person 2 out of 10 days.
And then in healthcare, they had to work in-person 5 out of the
10 days.
So, that is a problem. And I fully believe that's why the
backlog, as you mentioned, that long-term backlog is at
265,000. If you put those that are under 120 days on that list,
you are at 956,000. This is because people don't go to work.
So, where are you on that and having that return-to-work
policy?
Mr. Collins. Thank you, Senator. It is good to see you.
It's also good to see you back over here as we've worked
together many times. And I do pride myself, as I mentioned in
my opening statement, about the stuff that we worked on,
bipartisan Music Modernization Act, which you are such a great
champion of as well. And we're going to have to work together
on this.
But I do believe people need to come to work. The President
made it very clear. He made that very clear that people need to
come to work. Now, there is certain issues and times and before
the question is asked that we have a large portion of the VA
workforce is unionized and they're in contracts, but we're
going to work together to get people back to work.
Senator Blackburn. What percentage of those employees are
union?
Mr. Collins. 80 percent. Approximately, 80 percent of 470-
ish thousand.
Senator Blackburn. Okay.
Mr. Collins. And some of them and the telework agreement
stuff. Look, we're going to encourage them to come back to
work. We're going to follow the President's directive in that,
and we're going to make sure that we get people in there.
Because at the end of the day, it's about veterans. My hospital
employees, if I was confirmed, they have to show up every day.
Senator Blackburn. Okay. That is encouraging because you
look at the--we've talked about the health records, the EHRs
and the fumbling, the $15 billion that has been spent on that
not to have those records. The way there is no data transfer
from DoD to the VA on those health records. This is a problem
we can fix. We've got a lot of good health IT experts in
Nashville that could fix this.
And when they hear from people that are in the VA system
about they can't get any care, the wait times, and we've talked
some about the backlog at the Fort Campbell facility, VA
facility, the wait to get a primary care appointment today, and
we've just checked our numbers is 81 days. And in Chattanooga,
it's 110 days. In Murfreesboro, it is 54 days. That is
completely unacceptable.
And if people are going to not show up to work, if they're
beholden to the union and say that it is about them and not
about the vet, that is something that is just completely
unacceptable. And it is one of the reasons we need to
strengthen community care. The suicide rate, that 34.7
individuals per 100,000 of our vets that choose suicide, the
mental health components, and having that community care where
they can access it in their community without having to travel,
having an EHR that they are carrying with them to the doctor,
that will be helpful.
Mr. Collins. Senator, you've hit a multitude of things
there that are all important to the very end and aspect, and
that's the health, and safety, and the wellness of our veteran.
The healthcare record system, I mean, there's nowhere else we
can even point to. I mean, you cannot--if a doctor in the VA
walked out and decided to go take a job in the private sector,
guess what they're going to find when they get there?
Electronic Healthcare Records.
Senator Blackburn. That's right.
Mr. Collins. So, the system that we currently use, I mean,
it still is F1, F2. It is just unacceptable because it creates
what the problem that you've seen going forward. Look, I
believe in all workforces, and I believe that the employees at
the VA, whether union or not, are very valuable. And I respect
that.
I was years ago, five years in the Food and Commercial
Workers Union when I was in a big start grocery store. I get
the issue. But also, I believe we ought to bring people back to
work. That we ought to make it in a way that people are not
only employees, but at the end of the day, we remember it's not
about the VA, it's about the veteran.
Senator Blackburn. That's exactly right. Thank you, Mr.
Chairman.
Chairman Moran. Thank you, Senator Blackburn. We're going
to have a brief second round. I'm going to turn to Senator
Blumenthal to begin that, but I want to ask unanimous consent
at this point to add to the hearing record letters of support
for Congressman Collins' nomination.
They come from the Wounded Warrior Project, AMVETS, Blinded
Veterans Association, Military-Veterans Advocacy, Avalon Action
Alliance, America First Vets, National Defense Committee,
Mission Roll Call, Burn Pits 360, Jewish War Veterans, Military
Order of the Purple Heart, Luke's Wings, and the Valor Mission
Project.
Without objection, those letters of support are entered
into the record.
[The letters of support appear on pages 113-126 of the
Appendix.]
Chairman Moran. Senator Blumenthal, I recognize you for
five minutes.
Senator Blumenthal. Thanks, Mr. Chairman. As we were
talking a little bit earlier. Last night, the White House
issued various Executive orders. Some of them dealt with
federal hiring freeze, freeze on regulations, and other issues.
We're still reviewing them in my office.
The issue of a workforce hiring freeze memorandum claims
that it will not, ``adversely impact the provision of social
security, Medicare, or veterans' benefits.'' I'd like to know
from you, what does that mean in practical terms about the
employees who deliver veterans' healthcare or work in
cemeteries? Does this language exempt all of the VA's positions
from the hiring freeze?
Mr. Collins. I think, Senator, we're still, like you,
examining that, but we support the President's initiative here
in, in the freeze. But also, I take as far as what it says,
I'll take it at the words that it's on the paper, and that's
not going to affect it because we have people doing those
benefits packages right now. We have people working at that.
And the implication would be that adding more people would fix
whatever the problem is. I'm convinced right now that the
workers and the benefits we need to make better efficiencies
with what we currently have, so I support that.
Senator Blumenthal. Yes. That's not reassuring to me
because I'm asking not about the VA employees who work on
benefits. I'm asking about the folks who are in the hospitals,
in the care facilities, at the cemeteries. They're not
dispersing benefits. They're providing care.
And as you well know, there are extraordinary problems in
recruiting and retaining; the doctors, the nurses and filling
their ranks where there are openings right now. So, the
explicit language of that memorandum seems to include them in
the hiring freeze.
Mr. Collins. Going by the way you worded, I'll say this.
So, hiring freeze and the wording that you use, and I do not
have this before me, so I'm not going to comment completely on
it, I do not have it in front of me. I'm going off of the
memory, and we're still examining that as well. I can assure
you, President Trump in this Executive order is to get an
assessment on where we are with our employees. It is not to
take away from anything that is currently there in future.
And the way that your question is worded is implying that
they would not be there to do the veterans' healthcare, the
cemetery work. That's going to continue. This new freeze, new
hire freeze is not there. We may not at this point bring in a
new person tomorrow unless we needed, but this is where we're
at. And I think what he's done is to get an assessment on where
we are.
Senator Blumenthal. Well, you and I are trading a lot of
words. Let me come right to the point. I'm asking you to fight
to fill the openings, not a hiring freeze in the ranks of the
doctors, the nurses, the attendants, everybody who works in
care facilities or in veteran cemeteries, rather than leaving
those positions open because those folks are needed to care for
veterans.
Will you seek an exemption to the hiring freeze for those
positions that concern veterans' care, including the veterans'
crisis line?
Mr. Collins. I'll take everything that you've said in
consideration and understand the freeze and the Executive
order, while at the same time, if confirmed, be willing to make
sure that there's nothing missing in the process. As you said
first, we're sharing words. I think we're saying the same
thing.
Senator Blumenthal. Well, no, we're not. With all due
respect.
Mr. Collins. I respect that.
Senator Blumenthal. This is going to be a first test of
your leadership, whether you fight for an exemption in the
hiring freeze for the non-veterans benefits employees who are
needed to care for veterans at medical facilities and other
places, including the veterans' crisis line, rather than have
them covered by that hiring freeze.
Mr. Collins. Senator, I view this as not as a test of what
I'll do. I believe it is a test of two different assumptions,
and assuming that just because there's opening that there's an
actual need at that point that makes a veteran miss their
benefits of healthcare. I think the two, we're coming at it
from two separate perspectives. There may be openings, but
there was openings yesterday. There was openings last week.
This is simply looking at ahead to say where we're at this
point.
I think we're coming at this as two separate perspectives.
I respect yours, greatly, but I think what we're going to see
is no one on the veteran healthcare side is going to miss their
healthcare provider because of this new hiring freeze. The
President is doing a prudent step as he comes into office to
make sure that we have a good handle on what we've got.
And going forward, I will always fight, Senator, and I've
told you this in your office, and I'll tell you again here for
what we need at our facilities. But I'm also not going to fight
for issues in which I believe that I've not had a chance to
study and make sure that this issue is taken care of. I do not
believe this is going to have the impact that you're having,
because I think we're coming at it from two different
perspectives.
Senator Blumenthal. Well, I will just say, I don't want to
get into an argument here, but there are possible openings
where, let's say, the head of the West Haven VA facility says,
``Oh, well, we don't need to fill that position.''
Mr. Collins. Yes, but----
Senator Blumenthal. There are also openings where the
director of the facility is saying; we need more nurses, we
need more doctors, we need more mental health care. You and I
have talked about this.
Mr. Collins. Yes.
Senator Blumenthal. You can't provide veterans' healthcare
without the people, the skilled professionals to do it.
Mr. Collins. I appreciate that.
Senator Blumenthal. And I hear you saying, if there's an
opening, it means that we don't need somebody for that opening.
Mr. Collins. No. I think, Senator, just a general reminder.
Last week, Secretary McDonough could have filled those
positions. He chose not to or couldn't find anybody.
Senator Blumenthal. Well, he may have wanted to, and you
may have talked to him about it, but it's not easy to fill
those positions.
Mr. Collins. And, Senator, that's why we're taking the
perspective of where we're at. And again, I appreciate that
we'll work on this together, but I also, I respect what the
President's done. I think it's a prudent step looking forward,
and that the healthcare is not going to be compromised in that
process. I support that.
Senator Blumenthal. Let me move on. Will you commit to
expending every effort and every dollar to reach every veteran
at risk of suicide, including those who are not now enrolled in
the VA system?
Mr. Collins. Senator, that's the easiest question you've
asked all day, and I appreciate it. No, yes, I will do
everything possible. This from my heart, and you've heard it
mentioned. There's nothing more sacred to me, or my
perspective, and my faith, and my God, that everyone is made in
the image of God and deserves life and encouragement for that.
I think we need to actually have more, any way we can, to
reach that person. As someone who's been on the other end of
that line, when somebody called me and said, ``Chap, I'm ready
to end it.'' I'm not willing to let anybody go by because I
believe in the inheritance of life and the grace that was given
to me.
Senator Blumenthal. As you know the rate of firearm suicide
is significantly higher among veterans than non-veterans. And
so, will you commit to looking for ways that firearms-related
suicides can be reduced?
Mr. Collins. I'm committed to looking at any
instrumentality that takes the life of one of our veterans.
Senator Blumenthal. On the issue of homelessness. Is there
more that can be done to prevent or address veterans'
homelessness?
Mr. Collins. Yes. There are many things that need to be
done, and I think we've got to look at it from a cross-
government approach. Not only just with the VA, but with HUD,
with also with HHS. There are many aspects I don't think we're
touching at this point. So, for me, it is again, about how do
we make the best resources of the limited funds that come from
our government.
Senator Blumenthal. You've been asked, and I think you've
answered, and I don't want to repeat this issue; whether you
will continue to abide by the VA rule concerning abortion
counseling and care in cases of rape, incest, life or health
endangerment of a pregnant veteran. Will you commit that you
will inform this Committee if and when you begin
reconsideration of the present rule?
Mr. Collins. I will keep this Committee informed. The
Chairman and the Ranking Member will know any discussions and
decisions as we can get toward that decision.
Senator Blumenthal. As you begin consideration, yes, you'll
let us know.
Mr. Collins. We'll get into that when we get in there. I'll
let keep the Committee informed of things that we have going
on. I have to get in there first, if confirmed by this
Committee, which I'd hope to earn votes for. We'll see what we
got when we get there.
Senator Blumenthal. And let me just ask you, finally, and I
appreciate the Chairman indulging this additional time----
Chairman Moran. Despite your early earlier commentary about
me.
Senator Blumenthal. Well, I don't see anyone waiting to----
[Laughter.]
Senator Blumenthal. I'm sorry. I apologize to Senator King.
Just one more quick question. The PACT Act, as you know,
established the Toxic Exposure Fund to pay for extended and
expanded benefits without impacting other non-Defense
discretionary spending. If confirmed, do you intend to advocate
for undoing or altering the Toxic Exposure Fund, or would you
like to consider it and continue it in its present form?
Mr. Collins. I think any changes to any program will be
prerendered for me to make policy at this or discuss that. I
think we'll look at it the possibility, but I think the intent
of Congress will be carried out. I know there's some
discretionary with the funding issues with that from the VA.
We're going to look at that as we go forward.
But I'm at this point, I want to see where we're at because
there is a concern that we made proper implementation. It could
have caused some of the budget shortfalls. And we have another
program right on top of it, which is going to be the Elizabeth
Dole that I promised and commit to you that we're going to make
sure that we look at, so that we can properly implement your
intent and the Congress's intent.
Senator Blumenthal. Well, just for the record I hope that
you'll continue this Fund because it provides for a solid
source of benefits for those veterans who are suffering from
diseases relating to toxic exposures, and that you'll continue
the outreach program that Secretary McDonough started. Thank
you, Mr. Chairman.
Chairman Moran. Senator King.
Senator King. Thank you, Mr. Chairman. I want to make
something very clear. I don't want AI to decide if one of my
veterans is entitled to the benefits they've earned. Period.
Kapeesh?
Mr. Collins. Senator, there's no veteran that's going to
miss the benefit that they earned by the position and the way
they process their claims. But I think you and I will both come
to a conclusion that if there are better ways to process a
claim and our veterans can get their benefits quicker, then I'm
willing to look at any opportunity to get their veterans
benefits quicker. And if that involves AI, then I'm not willing
to take it off the payroll.
I'm not willing, though, to have them put in a position
where AI is randomly in a situation, especially with benefits
and others that are more difficult, there'll always be a person
there to oversee that process.
Senator King. Well, the experience thus far with AI and the
insurance industry is not positive. And I don't want our
veterans having to go through a claims litigation in order to
overturn the decision of a machine somewhere. So, I understand
you're not willing to take it off the table, but I certainly
hope it will be handled with great care because it will be very
tempting to reduce staff and replace it with this technology.
But I'm not confident in the technology right now to be making
these life-or-death decisions for our veterans.
Mr. Collins. Yes. I understand and respect your position,
Senator. I do not view this as a life-or-death decision. I
think these are decisions that could be made in how we look at
the best efficiencies. And, look, there'll always be in my
mind, especially when it comes to the veteran and benefits,
someone that overlooks and oversees that as well to make sure
that it is working properly, if went that way.
Senator King. Thank you. You are going to be under
tremendous pressure as we move into this difficult budgetary
situation, and there's a lot of pressure to reduce the budget.
I think has been pointed out here. The Veterans Administration
is one of the largest pots of money in the Federal Government.
It's very easy to focus on the bureaucracy which carries with
it a kind of negative connotation.
But I would point out that in many cases, staff cuts, equal
benefit cuts, because if there's nobody there to answer the
phone, or if the process is delayed to the point where the
veteran dies or just gives up, that's in effect, a benefit cut.
So, as you're under this pressure, and I believe you will be, I
hope you'll take care to balance per necessary efficiencies
against the loss of services.
You said repeatedly, and you said in my office, and I love
it, you don't want us to have to be advocating for our veterans
because they ought to get their benefits without having to come
to a Congressional office. Well, if staff cuts end up having
nobody answer the phone, or answer the phone after only 100
rings, or say we'll have to talk to you six days from now, or
six months from now, that's going to only aggravate the
problem. And you're going to be hearing from us on a daily
basis instead of every other day.
Mr. Collins. I think, Senator, your point is taken, and I
understand. I think the interesting question is, is these very
things arise right now at the staffing levels that we have. I
think there's more of an issue here. Are we doing things as
efficiently in processing as we can with the staffing that we
currently have, whether that's with more or less staff.
I think sometimes you have to look at the process. I mean,
why is it that we're back up at 250,000 backlog of benefits
when we've had $130 billion in increase in funds and 70,000
employees? Something's broken about that.
Senator King. I agree. And I commend you for wanting to
follow-up on that. And, again, I have no problem with
efficiency. And I think I can't complain about a hiring freeze.
I actually signed a hiring freeze in my inaugural address as
Governor. So, I understand that.
On the other hand, I think the point that Senator
Blumenthal was making is the hiring freeze should not apply to
direct care workers. If my Togus Hospital in Maine needs a
cardiologist, and it's been open for a couple of months because
they're hard to find, this hiring freeze should not prohibit
them from continuing to search for, and if they can find a
cardiologist to sign them up. I hope you'll distinguish between
direct care workers and others who serve veterans behind the
scenes.
Mr. Collins. Thank you, Senator. If confirmed, we're going
to always make sure that, as I've said many times before, no
matter what the issue is, I'll always fight for making sure our
veterans are getting the care in the proper way that they need
to.
Senator King. The final point, there's no answer necessary
for this, but one of the things you're going to be having to
face is increasing demands for mental health services and long-
term care. Long-term care as our veterans age is become going
to become a greater and greater issue. Elizabeth Dole Act
starts to address that. But I just commend that to your thought
process. And perhaps you can have people thinking about this;
how are we going to provide those services that are going to
become more and more necessary as time goes on?
Mr. Collins. Thank you, Senator. I appreciate the things
that are already keeping me up at night. If confirmed about
this job, I appreciate you giving me more, but I also look
forward to reaching out to you for help in that as well.
Senator King. I do appreciate that. Thank you. I commend
you for your participation this morning. Look forward to
supporting your nomination.
Mr. Collins. Thank you so much. Appreciate it.
Chairman Moran. Senator King, thank you very much. Let me
just try to wrap up my thoughts and questions to you. And it's
just a miscellaneous of things.
First of all, I would tell you that we work closely with
the Inspector General at the Department of Veterans Affairs. I
find him valuable both to me and to this Committee, but should
be valuable to the Department of Veterans Affairs. Anything
that you want to say in regard to utilization of Inspector
General's reports and how the Department will respond?
Mr. Collins. Yes, sir, Mr. Chairman. When I was Ranking
Member of House Judiciary, this was one of the issues that we
dealt with the Judiciary Committee, but also the Department of
Justice, but also in other committees I served on.
Inspectors General play a vital role. We're not always
possibly going to agree with the outcome, but we can come to a
conclusion because they are always having other eyes on a
situation that is provided. I'm one of those that believes in
gathering a lot of input and then making a decision. So, if
you're having input from an Inspector General who's looking out
for the best interest of what the VA is for, then I'll be
working with them, and I'll look forward.
Chairman Moran. I didn't mean to suggest, and don't think I
did, that you need to agree with the Inspector General. I do
think that that extra set of eyes in the professional way that
that investigation is conducted has value. It certainly gives
us a greater opportunity for oversight. But that same kind of
oversight is what a Secretary of Department of Veterans Affairs
should be looking for, just like we do.
Mr. Collins. Yes, sir.
Chairman Moran. We have a habit here of passing
legislation. And there's lots of bills that are introduced.
Certainly, some of them actually become law. And one of the
things that I think it's important for this Committee to try to
assure is that we don't just take the applause, the pat on the
back with our veterans or veteran organizations because we
introduced a piece of legislation or we passed a piece of
legislation. The real goal is to make sure that the legislative
efforts, when a bill becomes law, that it actually benefits
veterans.
You and that Department of Veterans Affairs have a lot to
say and a lot to determine whether that is the outcome. But I
see it as our responsibility, this Committee's responsibility,
to see that the laws that we pass actually have the outcome,
the intended consequence that we were seeking when we decided
by a majority vote in the House, and a super majority vote in
the Senate, that this is something that matters and make a
difference in veterans' lives and well-being.
So, implementation. I'm saying this perhaps for the benefit
of the Committee more than you. But we ought not be satisfied
with the outcome of our work with the passage of a piece of
legislation. I don't know that that requires any response from
you.
Mr. Collins. Could I respond to that, Mr. Chairman?
Chairman Moran. Please.
Mr. Collins. Because I think it goes back to the uniqueness
of my qualifications for this job is being where you've been.
And it's real easy to go around and say, oh, we passed this. I
was privileged enough to have--I believe it was 19 red lines
actually passed into laws, some big stuff. First Step Act,
criminal justice reform. We did Defend Trade Secrets. I have
some of my former staff that were here with me that I literally
stand on their shoulders. Because they did work and the staff
behind you who do good work.
But now I'm getting to take, hopefully with the
confirmation of this body, be able to step into a role in which
I get to see the other end of it. Those words on paper actually
matter to me. And I believe that carrying that out is one of my
highest callings, working for this President who's had the
trust in me to put me into this position in his administration.
I look forward to this opportunity.
Chairman Moran. I thank you for that response. You
mentioned the staff behind us, and rightfully so. You
compliment and highlight the value and importance of their
work. We have staff inquiries to the Department of Veterans
Affairs that go back six months with no response. And we've
worked with the previous staff at the VA, the previous
Secretary, and there was a great intent to see that the answers
come. It will mean that it has to be prioritized.
And so, you have indicated earlier that you're going to be
very responsive to Congress, those two, like introducing a
piece of legislation, or words that you should say. And I hope
that you can find every method possible to give us the
information that we need to respond to what's going on at the
Department of Veterans Affairs. And most importantly, accurate,
but also timely.
Mr. Collins. Mr. Chairman, there's many things that I've
talked about today, and I've enjoyed this time with this
Committee. But there's one thing that will be true. The way
that we interact with this Hill, as of my confirmation and I've
the ability to sit in that seat, will change. The legislative
affairs office is going to be much more on the Hill. They're
going to be much more involved, and they're going to get you
answers. Six months is not tolerable. Again, I go back to the
fact I've written those letters too, and it's not going to
happen.
Chairman Moran. It has taken way too long in many, many
instances. And QFRs in a hearing in which we ask for Members
the opportunity to ask additional questions at the end of the
hearing, those responses are terribly, terribly slow, and
again, impedes the capability of the Committee doing its work.
One of my experiences is that we bring a problem to the
Department of Veterans Affairs, and at least on a number of
occasions, we're successful in changing the policy or approach
at the Department. So, again, much of what I know about what's
going on with veterans is because they tell me what's going on
with veterans. And we discover there's a problem. We highlight
that problem for the Department. But on many, many occasions,
when the answer comes back from the Department, the central
office of the Department of Veterans Affairs; we've changed it.
You're right. This needs to be different than it's been, and
we're going to conduct ourselves differently.
The challenge becomes when the VISN in Kansas or anybody
else's VISN doesn't know the changes have taken place in the
central office. So, we can have a few high-five moments, we've
solved a problem, but when it gets to the field, they've never
heard of what we have been told in Washington, DC by the
Department.
Mr. Collins. A high-five in Washington, DC is a nothing in
Kansas if it's not implemented. Look, that's one of the things
I'm excited about. I come to this in a new position while I've
been doing--I've been a part of the Hill, but also media and
social media. Look at the applications that are out there now
that we can tell the good.
The Department is going to hear from me directly. It's not
going to come through memos. It's not going to come from me
sitting behind a desk in some central office. It's going to
come from me through videos that are going to be on our social
media. It's going to be through emails that we're going to send
encouraging them to know, this is my direction. They'll hear
from me that if we're still getting the idea that a veteran has
to call their Congressman or their Senator for help, then we're
missing the mark somehow. They're going to hear it directly
from me.
And here's the other thing. They're going to see me.
They're not going to have to wonder what I'm thinking. Because
all of a sudden I may just show up at their hospital. I may
just show up at their CBOCs, and we're going to talk about it,
and we're going to make sure that our veterans are getting
taken care of.
I'm not pie in the sky thinking I can wave my magic wand
and make it happen. But I will tell you this, they're going to
know who their Secretary is. They're going to know who their
Secretary cares about. And it's that veteran that is in the
system now, and that veteran that is to come, and that veteran
that has went, gotten out and for some reason slipped through
the cracks and does not know that they have benefits a lot. And
if they choose to take those, then they're going to be there
for them, or they're going to have a veteran's office that is
waiting for them.
Chairman Moran. I appreciate that to my point, what you're
responding to, is that the assurance from the Department of
Veterans Affairs that the problem has been solved often is not
the circumstance of the field.
One of the things that this is in the management aspect,
and then maybe this is an issue or a challenge because of
employment agreements, but it is not infrequent in which we
bring a specific instance in which bad behavior, malfeasance,
malpractice, insubordination, a list could be long, of errors
and mistakes made by someone at who works at the Department of
Veterans Affairs in the field. And the response, ultimately, if
you ever hear about what happened to that person, that employee
is, we transferred them to another hospital.
That can't be reassuring, shouldn't be reassuring to
anyone. And maybe there's some impediment that makes it--can't
be impossible--makes it difficult to actually fire someone. And
the instances here are not like employee grievances. It's not
like mismanagement in the sense of how do we get along here?
These are egregious circumstances in which terrible things have
happened to veterans. And this response is never the you're out
of here, at least if that's the response. It rarely happens in
the end.
So, my point, which I don't think I explained very well,
but the point is there has to be a better disciplinary
circumstance in those extreme cases other than you are
transferred to another facility. And that is for the well-
being, safety, and importance of the veterans who are served by
the Department of Veterans Affairs.
Mr. Collins. Senator, I couldn't agree with you more. The
concept of failing up is not a concept that I abide by. I'm a
military person. I'm someone who's also employed people outside
the government as well, but failing up is not an option. You
don't fail up. Because what we will do is I'll work within any
agreements, employee agreements, collective bargaining, but if
you're putting a veteran health and safety at harm, I will make
sure the Department will get rid of you. And we are willing to
do whatever it takes to do that.
Because here's the deal, and I don't think there's any
Senator or Congressman who'd disagree. If that happens, you
shouldn't be there. We'll do everything within the agreements
to make sure their processes are followed, but I will not
tolerate it. And that then, in turn, makes our better employees
even better.
Chairman Moran. You highlighted that point, and I was going
to compliment you on it. That a culture, a sense of well-being
of the employee, that it's a safe and valuable job, and that
you're doing good work is hugely important to the success of
the Department of Veterans Affairs. And if other employees see
that some employees get away with bad behavior, it diminishes
the value and joy of working there.
Mr. Collins. Senator, I agree. There's an old saying that
I've ascribed to, there's two, ones that I look at and will be
on my desk, if confirmed. And it says, ``If it goes wrong, it's
my fault.'' ``If it's a little bit okay, it's everybody. And if
it's right, it's everybody else's.'' So, we lift everybody up.
But understand, when you have employees that come to work every
day doing it right, and they feel like they have to carry a
coworker along, after a while, they don't want to carry the
coworker anymore. They just rose to the level. They go to that
level. We're not going to tolerate that.
Chairman Moran. Mr. Collins, it's always my practice, and
almost always my practice in a hearing, to give our witnesses
the chance to take back, to admit a mistake, want to correct
the record, to give a witness before the Committee the chance
to restate or make clear something they felt like they didn't
do in the first two rounds of questioning. Anything you'd like
to add to the record today?
Mr. Collins. No, Senator. I just want to appreciate the
time, Mr. Chairman, Ranking Member, Mr. King, and all who
stayed and come by. I've enjoyed the answers. I've enjoyed the
questions. We're not always going to agree, but I'll guarantee
you, I'll always listen. I'll always be a part, and to take
this job very seriously to make sure that at the end of the
day, our veterans are taken care of.
And, if anything, I'll say the only addition I'll have is
I'm thankful for the ones sitting behind me. For my wife and my
children, my father who's watching. And for those future
employees, if I'm blessed enough to be confirmed by this body.
Let the veterans of the VA know that we're coming to make a
difference, and we're going to be there to support you.
Chairman Moran. Mr. Collins, thank you. Let me see anything
that we're missing. Okay. Each Member will have five
legislative days to revise and extend their remarks. In
addition, any Member who would like to send a question for the
record to Congressman Collins should do so. Well, I don't know
why we say as soon as possible, we actually need it by the end
of business today.
We have an executive session of this Committee scheduled
for Thursday. And so, if there's something that you want to
make sure that has not been asked or answered by a Member of
the Committee, we need you, Mr. Collins, so that our process
can continue with the consideration of your nomination. We need
you to respond immediately.
Mr. Collins. Yes, sir.
Chairman Moran. Thank you.
Senator Blumenthal. I would just join, Mr. Chairman, and
thanking you for the hearing, and thanking Congressman Collins
for your testimony here today, which I think has been very
frank, and forthright, and very helpful to us. And really
appreciate your candor, and look forward to a working
relationship where we're always candid with each other. And,
again, thank you for your service to our Nation.
Chairman Moran. Senator Blumenthal, thank you. I, again,
look forward to working with you in the next two years on this
Committee, and see if we can accomplish good things for those
who serve our country. The meeting is adjourned.
[Whereupon, at 12:44 p.m., the hearing was adjourned.]
A P P E N D I X
Nomination Material for
HON. DOUGLAS A. COLLINS
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Letters of Support
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
[all]