[Senate Hearing 119-13]
[From the U.S. Government Publishing Office]
S. Hrg. 119-13
NOMINATION OF THE HONORABLE
PAUL LAWRENCE TO BE
DEPUTY SECRETARY OF VETERANS AFFAIRS
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HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED NINETEENTH CONGRESS
FIRST SESSION
__________
FEBRUARY 19, 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
59-383 PDF WASHINGTON : 2025
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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
----------
February 19, 2025
SENATORS
Page
Hon. Thom Tillis, U.S. Senator from North Carolina............... 1
Hon. Richard Blumenthal, Ranking Member, U.S. Senator from
Connecticut.................................................... 2
Hon. Tommy Tuberville, U.S. Senator from Alabama................. 10
Hon. Mazie K. Hirono, U.S. Senator from Hawaii................... 12
Hon. Tim Sheehy, U.S. Senator from Montana....................... 14
Hon. Margaret Wood Hassan, U.S. Senator from New Hampshire....... 15
Hon. John Boozman, U.S. Senator from Arkansas.................... 18
Hon. Ruben Gallego, U.S. Senator from Arizona.................... 19
Hon. Angus S. King, Jr., U.S. Senator from Maine................. 21
Hon. Marsha Blackburn, U.S. Senator from Tennessee............... 23
Hon. Tammy Duckworth, U.S. Senator from Illinois................. 25
Hon. Patty Murray, U.S. Senator from Washington.................. 27
Hon. Jim Banks, U.S. Senator from Indiana........................ 29
Hon. Elissa Slotkin, U.S. Senator from Michigan.................. 30
NOMINEE
Hon. Paul Lawrence, PhD, Nominee To Be Deputy Secretary of
Veterans Affairs............................................... 5
APPENDIX
Nomination Material
Hon. Paul Lawrence, PhD, Nominee
Prepared Statement............................................. 43
Response to Pre-Hearing Questions for the Record submitted by:
Hon. Jerry Moran............................................. 47
Hon. Richard Blumenthal...................................... 52
Response to Follow Up Pre-Hearing Questions submitted by:
Hon. Richard Blumenthal...................................... 58
Response to Questions for the Record submitted by:
Hon. Richard Blumenthal...................................... 60
Hon. Bernard Sanders......................................... 62
Questionnaire for Presidential Nominees........................ 65
Submissions for the Record
List of Unanswered Requests for Information...................... 87
List of Unanswered Letters....................................... 91
Hiring Freeze; Letter to President Donald J. Trump, dated January
23, 2025....................................................... 92
Firing of VA Inspector General, Michael J. Missal; Letter to
President Donald J. Trump, dated January 31, 2025.............. 96
Submissions for the Record (cont.)
Day One Commitments; Letter to VA Secretary Douglas A. Collins,
dated February 4, 2025......................................... 98
DEI Executive Order; Letter to President Donald J. Trump, dated
February 5, 2025............................................... 100
Department of Government Efficiency (DOGE) at VA; Letter to VA
Secretary Douglas A. Collins, dated February 6, 2025........... 101
Resignation Offers; Letter to VA Secretary Douglas A. Collins,
dated February 7, 2025......................................... 105
Telework and Remote Work; Letter to VA Secretary Douglas A.
Collins, dated February 10, 2025............................... 107
Federal News Network article ``Despite exemptions, VA employees
still feeling impact from policies shaking up federal
workforce''.................................................... 109
NOMINATION OF THE HONORABLE
PAUL LAWRENCE TO BE
DEPUTY SECRETARY OF VETERANS AFFAIRS
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WEDNESDAY, FEBRUARY 19, 2025
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 9:36 a.m., in
Room SR-418, Russell Senate Office Building, Hon. Thom Tillis,
presiding.
Present: Senators Tillis, Boozman, Cassidy, Blackburn,
Tuberville, Banks, Sheehy, Blumenthal, Murray, Hirono, Hassan,
King, Duckworth, Gallego, and Slotkin.
OPENING STATEMENT OF HON. THOM TILLIS,
U.S. SENATOR FROM NORTH CAROLINA
Senator Tillis. This hearing will come to order. I'm going
to be filling in for Senator Moran who had logistics issues
getting back to DC today, and I'm looking forward to
considering the nomination of Paul Lawrence for Deputy
Secretary of Veterans Affairs.
The role of Deputy Secretary of Veterans Affairs is
important. Serving as the second in command, chief operating
officer, and co-chair of the VA/DoD Joint Executive Council.
The Deputy Secretary also oversees Electronic Health Record
Modernization, and works with Secretary Collins to make certain
that VA is high performing, accountable, fiscally responsible,
and veterans-focused.
Dr. Lawrence was raised in an Army family, and is an Army
veteran who knows firsthand what military service means, and
the necessity of supporting veterans throughout their civilian
lives. He's also familiar with many of us, given his prior
service in the VA. He's familiar to many of us because he was
the Under Secretary for Benefits, a position he held from 2018
until 2021.
During that time, the Veteran Benefits Administration had
the lowest disability claims backlog in history and underwent
significant reform as a result of legislation like the Forever
GI Bill, the Appeals Modernization Act, and the Blue Water Navy
Vietnam Veterans Act.
I'm grateful to Dr. Lawrence for his willingness to once
again step up and serve his fellow veterans in a leadership
position at the VA, and I look forward to his testimony today.
I also want to acknowledge the family members accompanying Dr.
Lawrence this morning, which include his wife, Anne, his son,
Gregory, and his brother, Chris. If you can raise your hands?
Thank you-all for being here.
And on a final note, there's a certain amount of pride that
comes from the fact that we did cross paths not directly
working together at PricewaterhouseCoopers, what I would
consider to be an extraordinarily good experience for the sort
of perspective that Mr. Lawrence should bring into the VA. And
I look forward to seeing this engagement, Mr. Lawrence, like so
many engagements you and I oversaw back in our time at PW.
With that, I'll yield a Ranking Member Blumenthal for his
opening remarks.
OPENING STATEMENT OF HON. RICHARD BLUMENTHAL,
RANKING MEMBER, U.S. SENATOR FROM CONNECTICUT
Senator Blumenthal. Thank you, Senator Tillis. And thanks
for chairing this Committee, probably on short notice. Welcome,
Dr. Lawrence, welcome to your family, and thank you for your
willingness to serve in this very, very important position, for
a second time, in a position critical to our Nation's veterans.
As you know, the Deputy Secretary is the department's
second highest official tasked with executing VA's Electronic
Health Record Modernization program, strengthening VA's
collaboration with the Defense Department on the VA/DoD Joint
Executive Committee, and many, many other critical
responsibilities. While these formal roles are important, I'm
more focused on your fitness to serve as the VA's chief
operating officer, and your willingness to push back against
recent directives that harm veterans and the mission of the VA.
During the nomination process for Secretary Collins, this
Committee was assured veterans would always come first, and we
were promised transparency and consultation even when we
disagree with decisions being made. Now, the Chairman and I
learn of far-reaching decisions after the fact, and almost
always directly from the press, from VA employees, or from
veterans, never from the VA leadership. And when we ask for
reasonable questions about those decisions and their potential
impact, we are directed toward non-answer press releases. But
we get no responses at all.
Mr. Chairman, I would like to submit for the record a list
of 22 unanswered requests for information that I've submitted
to the VA since January 20th.
Senator Tillis. Without objection.
[The list referred to appears on page 87 of the Appendix.]
Senator Blumenthal. I would also like to submit for the
record seven letters on urgent issues facing veterans care and
benefits that I've sent to the administration, most with many
of our colleagues joining, and that includes three to President
Trump, four to Secretary Collins. None of these letters have
received a response.
Senator Tillis. Without objection.
[The letters referred to appear on pages 92-108 of the
Appendix.]
Senator Blumenthal. Thank you. We've been told everything
will be fine and no harm will come to veterans from the Trump
and Musk slash and trash policies. But despite these vague
assurances, we know it's not the reality. In fact, because of
the actions of this administration, we've been made aware of
numerous detrimental developments across the country.
Openings for new clinics have been delayed because they
can't hire the necessary staff to open their doors. Service
lines at VA hospitals and clinics have been halted. Beds and
operating rooms at VA hospitals have been reduced. Support
lines for caregivers have been cut down. Veterans' crisis line
employees have been fired. And suicide prevention training
centers, that's right, suicide prevention training sessions
have been postponed or canceled. It's incredible.
Transportation options for disabled veterans have been reduced
because volunteer drivers can't get credentialed.
The Secretary has also said Elon Musk has not and will not
be granted access to veteran's personal information, but we
know that is simply not true. Not only does Musk and his team
have access to that information at Treasury, they have the
ability to alter, yes, alter, that information. And it's only a
matter of time until they access additional information on
veterans from the VA or another agency.
This weekend, we learned the White House is attempting to
grant access for a Musk employee to the IRS tax systems
containing personal identification numbers and bank information
of up to 150 million Americans, including veterans. Meanwhile,
VA employees have been told there is nothing to fear. Nothing
to fear as long as they work hard, but we know that's not true
either.
Many have been pressured to abandon their jobs by Musk and
his resignation offers that aren't based on reality or the law.
More than 1,000 employees, including a substantial number of
veterans, and those with exemplary performance records, were
abruptly and illegally fired in a move that was publicly
celebrated by the VA Secretary. This action was part of last
week's broad purge of tens of thousands of workers across
almost every government agency.
All employees should have options to appeal these
decisions, but the President just illegally fired the chair of
the Merit Systems Protection Board, the independent agencies
established to protect the rights of federal employees. A
district court judge reversed that termination, at least
temporarily, just last night. They could appeal to the
Independent Office of Special Counsel that spends one-third of
its caseload on VA oversight and protecting whistleblowers. But
the President fired its Senate-confirmed leader.
That dispute is now before the Supreme Court, but the
President seems insistent on having the VA Secretary run that
office in his spare time, running that office in addition to
the VA, unacceptable. And they could flag potential ethic
conflicts to the Office of Government Ethics. But that once
independent agency is now also run by the VA Secretary. Another
clear conflict of interest to all VA employees.
And I know a third of you are veterans. I know you've had
your lives and your careers completely upended. We will keep
fighting for you. You chose a career of serving veterans, and
you deserve better than to be casually and unlawfully discarded
by an administration that places greater priority on political
loyalty than on fitness to serve. And to the veterans watching
today, including any who have contacted us directly and are
anxious about losing your access to VA healthcare or your next
benefits check, we hear you, we're going to keep fighting for
you.
This administration may define collaboration as standing
silently on the sidelines while they dismantle the VA, but we
need to remind them that this Committee, this bipartisan
Committee, has traditionally embodied the word collaboration
coming from both sides of the aisle to pass historic
legislation like the PACT Act on behalf of veterans and their
families, standing up for their best interest every single
time, and performing robust and vigorous oversight no matter
who was in the White House.
I'm here for this fight, and I know my democratic
colleagues are here for this fight. I just hope my Republican
colleagues will join us before it's too late. I know oversight
and transparency can be seen as threatening, especially when
you're on the wrong side of the law and the wrong side of
history, but the stakes are too high for any of us to be
silent.
Dr. Lawrence, it's this context in which your nomination
will be considered. We need to know how you plan to navigate
these waters and whether you will actually put veterans first,
stand up for them, and make sure that they receive what they
have earned. It's not a gift, it's what they have earned. This
Committee, VA employees, and the veterans across the country
will be listening to you today.
Thank you, Mr. Chairman.
Senator Tillis. Mr. Lawrence, before I start with you. I
want to respond, in part, to what my friend and Ranking Member
has expressed. We're going through a transition now and there
are decisions being made about probationary employees.
It's my understanding a good number of the people who have
decided to leave were probationary employees. I've asked to get
to the facts. I don't know about your training at
PricewaterhouseCoopers, but mine taught me to be very fact-
driven and boring. I like to focus on the specifics of the
allegations, and I have done that over the past almost four
weeks since some of the personnel moves have been made. And
quite honestly, some of the reports or allegations on day one
are disproven on day two.
I'll give you one example. If you remember in the first
week, there was a discussion about Elon Musk having access to
detailed payments data. Now, we know that's actually not true.
That they were looking at code and the payment system to try
and determine either efficiency or improper payments. I have
done specific requests for access to that information. I
haven't found anything to substantiate the allegations of two
or three weeks ago.
This is a large organization. It has critical positions,
and it has desirable, but maybe not critical positions. If
we're suggesting here that we've had mass terminations of
physicians, technicians, nurses, critical positions, then that
would certainly be concerning. And if there is evidence to that
effect, I would like to see it. But in the meantime, I think
we're dealing with a lot of transition, a new way of looking at
personnel management, which occurs when you have a transition
in the White House.
I also think that we're talking about problems with the VA
that were here more than 20 days ago. I think some of these
problems are because there was a PACT Act that my office spent
a lot of time working on that didn't get the commitment to get
it right before it was passed out. And it resulted in a $3
billion shortfall in budgeting last year, and multi-billion
this year. These are all decisions that were made by Congress
that are undermining some of our ability to actually live up to
repaying or making another installment on a debt that we can
never fully repay for veterans who need our services.
And you as a veteran, Mr. Lawrence, I think you bring
perspective based on your tenure in the VA. You bring the
perspective of a veteran and you bring the kind of perspective
that I believe is needed to even settle down and address,
maybe, some of the legitimate concerns that were expressed by
the Ranking Member.
But now, let's move on to your testimony. Before I do, if
you'll please stand and raise your right hand. Dr. Lawrence, do
you solemnly swear or affirm that the testimony you're about to
give to the U.S. Senate Committee on Veterans' Affairs will be
the truth, the whole truth, and nothing but the truth, so help
you God?
Dr. Lawrence. Yes, I do.
Senator Tillis. Thank you, Dr. Lawrence. You may be seated.
You can continue and proceed with your testimony.
STATEMENT OF HON. PAUL LAWRENCE, PHD, NOMINEE TO BE DEPUTY
SECRETARY OF VETERANS AFFAIRS
Dr. Lawrence. Senator Tillis, Chairman Moran, Ranking
Member Blumenthal, and distinguished Members of the Committee,
thank you for the opportunity to be here today and for
considering my nomination. I would also like to thank President
Trump for the honor of this nomination and his trust in me.
Today, my objective is to earn your trust as well.
As Senator Tillis has pointed out, I'm joined by my wife,
Anne, for 39 years, and my brother, Chris, also an Army Veteran
and Airborne Ranger. I also want to thank my 100-year-old
mother who's watching at home right now. I wouldn't be here
without all their love and support.
The Senate Committee on Veterans' Affairs has a long
history of bipartisan accomplishments on behalf of America's
veterans. Your commitment to taking care of the men and women
who've worn the uniform is above reproach. I want you to know
that I share that commitment.
I grew up in an Army family. My father served 24 years with
deployments in the Korean and Vietnam wars. He taught me many
valuable lessons about leadership and what it means to serve.
My middle name, Reynold was given to me in honor of my uncle
who was killed fighting in Normandy. My family's love of
country and tradition of service compelled my brother and I to
join the Army where we were both commissioned through ROTC.
During my tenure in the military, I graduated from the Army's
Airborne School, earned the Meritorious Service Medal, and rose
to the rank of captain. My service taught me the value of
leading with integrity, honor, and respect, but most
importantly, instilled in me a dedication to serving my fellow
veterans that has shaped my life's work.
As Senator Tillis indicated, I spent many years as a
consultant bringing efficiencies to large organizations. Then,
I had the opportunity during the first Trump administration to
serve as VA's Under Secretary for Benefits, one of the most
rewarding experiences of my career. In that role, I led 24,000
employees as they administered the range of benefits including
disability compensation, pension, education, home loans,
veterans' readiness, and employment, and life insurance.
During my time at VA, our Veterans Benefits Administration
team made great strides in increasing productivity, customer
service, and convenience for veterans. Here are a few
highlights of which I'm particularly proud. As Senator Tillis
pointed out, during my time at VBA, the disability claims
backlog was reduced to its lowest level ever. VBA guaranteed a
record 1.2 million home loans to veterans in FY 2020,
surpassing the previous record of 700,000. We successfully
launched the GI Bill, the Appeals Modernization Act, and the
Blue Water Navy Vietnam Veterans Act. We successfully launched
Solid Start and the Veterans Benefits Banking Program. BVA
reduced improper payments by more than $350 million. And in
2020, during the pandemic, I conducted 110 telephone town halls
that reached 5.7 million people, and I took more than 1,500
unfiltered questions about how we are serving veterans.
If I have the privilege of returning to VA, I will work to
build on the many bipartisan successes of this Committee. To
that end, I pledge to work with you to get VA's Electronic
Health Record Modernization effort back on track. Ensure VA
provides veterans with the healthcare choices and options
Congress promised them as part of the MISSION Act. Properly and
faithfully implement the PACT Act. And put veterans at the
center of everything the department does, and make
accountability, customer service, and caring the cornerstone of
service among the department's workforce.
If confirmed, I'll be a tireless advocate for the men and
women who fought for our liberty. And I will work to ensure
every eligible veteran and VA beneficiary gets the benefits and
services they've earned.
Thank you, and I'm happy to take your questions.
[The prepared statement of Dr. Lawrence appears on page 43
of the Appendix.]
Senator Tillis. Well, you've already proven to be efficient
by yielding back one and a half of your five minutes even after
introducing your family members. So, you may have won some
right there.
Mr. Lawrence, when I went up to say hello to you, you
mentioned that you were going to take me up on my offer to get
a little bit more engaged in the electronic health record
implementation. I mean, this has transcended Republican and
Democrat administrations. Now, for the life of me, I can't get
my head around the amount of money that's been spent versus the
value that's been derived. I mean, it's barely even
implemented. And the initial VISNs, it looks like it's
suboptimal and it's certainly not a best practice that the
entire VA is benefiting from.
So, tell me, based on your past experience in the VA and
any knowledge that you have now, what do you think we--where
have we made mistakes, and what do we need to do differently to
get this behind us and give the incrementing and care this is
going to provide veterans?
Dr. Lawrence. Certainly, Senator. Thank you for the
question. I mean, I think when Secretary Collins was here last
month describing his vision for what had to take place it was
very sound. Convening all the players as he described, figuring
out the best thinking and what can be done to get be
efficiencies to as many veterans as possible as quickly as
possible. I echo that.
I think I would probably, foot stomp urgency, that we can't
spend months again studying what's going on and figuring out.
Now, what I will tell you from my time as Under Secretary, I
dealt with technology and multiple things. You heard me talk
about the GI Bill Appeals Modernization and Blue Water Navy.
All of those had a technology component.
I focused in on three things. One was accountability. I was
always surprised how accountability was a challenge. And I
think that led to trouble in decision-making. There was a sense
of the right contractors, the right roles, the right contracts,
as well as additional oversight the VA gets from other
contractors to help check and monitor things. So, I would
probably start there, but as this--as the Secretary pointed
out, everything's on the table to sense--to come up with a plan
that can be implemented. And, if confirmed, I will work with
him to implement that plan.
Senator Tillis. Tell me a little bit about what you learned
about drawing down the backlog for VA benefits and what may be
able to be applied, not only to the health record
implementation, but generally, the cleaning out the plumbing
and getting things done sooner and better for veterans.
Dr. Lawrence. Certainly. Well, when I showed up, the
backlog was pretty low, but we drove it down. In fact, in
November 2019, just before the pandemic, we were actually
worried about running out of work. We were moving so fast
through disability claims.
Senator Tillis. It's a good problem by the way----
Dr. Lawrence. Yes, I know.
Senator Tillis [continuing]. Don't never worry about that.
Dr. Lawrence. Part of it was measurement and driving
accountability to the people who were processing claims to the
levels of management that were processing claims. Along the
way, I learned that the technology that supported the claims
processing effort needed to be improved. So, I spent a lot of
time improving the technology, and quite frankly, I spent a lot
of time in--actually, this is something that came from Senator
Isakson the first time I met him, which was, you know, stop
having VA do things that get in its own way.
So, untangling some of the things that didn't need to be
done and really were just there because really increased
efficiency. So, it was a lot of things you would remember from
your consulting life people, process, and technology. It was
all there, but measurement really helped move things along. And
when things started to go well, the pride in the employees was
really pretty important.
Senator Tillis. Well, since you yielded back one and a half
minutes of your introduction, I'll yield back my time. Senator
Blumenthal.
Senator Blumenthal. Thank you. I'm happy to take those one
and a half minutes.
Dr. Lawrence, this is a critical day, not just for you, but
for our veterans. Accountability begins today. Do you commit to
responding to the request for information that I have
submitted, along with my colleagues, numerous requests for
information and accountability within one week of your
confirmation, if it occurs?
Dr. Lawrence. Senator, as you know, I'm not at the VA----
Senator Blumenthal. That's a yes or no answer. Do you
commit to responding?
Dr. Lawrence. Senator, I commit to receiving your questions
if confirmed. To looking at them, to understanding the
information you request. To meeting with you, to understand
that information, determine how best to provide you that
information.
Senator Blumenthal. I'm going to hope that's a yes answer.
I'm going to hope, for our sake, but more important, for our
veterans, that you will be responsive and transparent, as so
far, this administration has utterly failed to be.
Let me ask you, since January 21st, we've seen everything
from a hiring freeze to arbitrary firings of more than 1,000 VA
employees, to unelected, unaccountable individuals at the DOGE
Musk transition team, accessing IT systems that include
veterans' private information, and taking action that is
contrary to the interests of our veterans.
The Chairman referred to a transition. Elon Musk seems to
regard veterans as roadkill on this so-called transition. And
as to the facts here, we're hearing facts directly from
veterans, VA employees, and others who have direct evidence of
the impacts, the human impacts, of these draconian cuts in
funding and staff. Do you support the administration's actions
so far?
Dr. Lawrence. Thank you very much for the question,
Senator. Let me see if I can pull this apart. The information
as I understand it the DOGE employee at VA is accessing, is
limited to contracts, general operation, and management of the
IT system. This person does not have access to veterans' health
information, nor veterans' benefits information.
Senator Blumenthal. Do you support the firing of 1,000 VA
employees?
Dr. Lawrence. Senator, as described, I'm not there now, and
I do not know how this came about.
Senator Blumenthal. So, you're not willing to answer that
question?
Dr. Lawrence. What I am willing to talk about, sir, is what
I read in the press release. And what I read in the press
release about this activity appeared to be a very thoughtful
approach to determining who would be laid off in the sense that
it was not mission-critical. It was designed not to affect the
provision of healthcare and benefits. And there was a safeguard
where first level SES supervisors could opt somebody out of
that process.
It was further described by the Secretary that the savings
generated by these layoffs, $98 million, would be used to
provide better care for our veterans. Consistent with what I
spoke.
Senator Blumenthal. Well, I just want to submit to you,
respectfully, that firing VA employees who provide critical
services to veterans is mission-significant, and that the
unfairness and illegality of the actions take so far have
direct impacts on VA healthcare, on veterans who are
potentially suicidal. If you close the kinds of training
sessions and other direct help to veterans who say they're
going to take their own lives, that's mission-critical.
Wouldn't you agree?
Dr. Lawrence. Sir, I can only tell you what I read and what
you're describing is inconsistent with what I read. That being
said, if confirmed----
Senator Blumenthal. Well, it is inconsistent with what
you've read from the VA press releases. I challenge you, as the
person who's going to be chief operating officer, to learn
exactly what is happening and to be transparent with us.
Let me ask you another question. Transportation for
disabled veterans have been reduced. Is that fair?
Dr. Lawrence. Senator, thanks for the question. If
confirmed, I will look in that to understand how that's
happening, why it's happening.
Senator Blumenthal. Service lines at VA hospitals and
clinics have been halted. Is that fair?
Dr. Lawrence. Again, Senator, if confirmed, I will look
into that to understand why that's happening. Again, it's
inconsistent with what I read about the intent of the layoffs.
Senator Blumenthal. And the kinds of appeals that VA
employees are entitled to take now are to offices that are held
by the VA Secretary himself. In effect, you're appealing your
firing to the person who fired you. Is that fair?
Dr. Lawrence. Sir, again, if confirmed, I will look into
what are the process by which veterans----
Senator Blumenthal. Well, I hope you look into these
questions quickly and equally important that you respond to us
as the Secretary has failed to do. Is that fair?
Dr. Lawrence. Again, sir, if confirmed, I'll look into
this, and yes, I commit to figuring out a way to respond
quickly to requests once I'm confirmed.
Senator Blumenthal. My time is expired. I have a lot more
questions for you, and I hope that you are more responsive, if
you're confirmed, than you have been so far. Thank you, Mr.
Chairman.
Senator Tillis. Mr. Lawrence, I'm going to use about a
minute and a half of the minute and a half I gave up. Were you
advised, or was your opinion sought for any of the personnel
actions that have occurred in the last 20 or the last 30 days
of the new transition?
Dr. Lawrence. No, I'm not employed by VA. I'm not engaged
in any decision-making.
Senator Tillis. Have you in any way been reached, been
contacted to advise on strategy, numbers, positions,
conditions, anything related to the decisions that have been
taken by the administration transition?
Dr. Lawrence. No, I have not.
Senator Tillis. And Mr. Lawrence, you may hear a couple of
times today, there is frustration, and I can understand it from
the perspective of some of my colleagues on the other side of
the aisle. But it wouldn't surprise me as we hear in other
hearings if these allegations are true. I don't think that
Senator Blumenthal used those specific words today, but that is
Senator speak for--I haven't really confirmed it, but it sounds
good--and I think that you're not in a position to make a
commitment or to--I don't think that you've been called on as
an expert for this transition.
Your position, when you get confirmed, is day one for you
at that point. I do believe that you should commit that--any
inquiries from the VA, we've been very frustrated in the Biden
administration, and the prior Trump administration, and the
prior Obama administration--with a lack of response from the
VA. That is not unique. And, hopefully, you and the Secretary
can change that trend. But I also think that it bears repeating
every time that we hear it today, that you're being asked to
opine on things you had nothing to do with, and all you have
are press reports at this time.
Senator Blumenthal. Mr. Chairman, I want to respond since
you've characterized my questions. I don't know what Senator
speak is, but I know what I said, and I want to tell you, Dr.
Lawrence, what I said were the facts. And they sound bad. They
don't sound good. But I know what we've heard.
And what's more disturbing to me is, apparently, you
haven't asked anything beyond reading these press releases in
preparation for your testimony today. Have you asked anyone in
the Veterans Administration for the facts?
Dr. Lawrence. My interactions centered--thank you for that.
So, I can clarify. My interactions with the VA at this point
have been around preparation. They have not been around the
operation of the VA. I've been given public information about a
variety range of subject, but have not been involved in the
details about the decisions that led up to the----
Senator Blumenthal. So, your approach to preparation is
apparently hear no evil, see no evil, just tell me what you
want me to say.
Dr. Lawrence. Senator, I think that mischaracterizes my
approach to preparation. My approach to preparation is to find
all publicly available information that informs me about this
position. I'm guided by my experience from three years in the
first Trump administration, but I'm not involved in a topical
and timely decisions that are taking place in the operation of
VA.
Senator Blumenthal. To a lot of veterans, Dr. Lawrence, and
I say this with due respect, this is going to sound what you've
just said, like bureaucratic gobbledygook, and I hope veterans
receive more facts. I hope you give us more facts. We've
complained, and it's been bipartisan, that government agencies
have failed to be responsive at the VA, and I hope that you do
better. Thank you.
Senator Tillis. Senator Tuberville.
HON. TOMMY TUBERVILLE,
U.S. SENATOR FROM ALABAMA
Senator Tuberville. Thank you very much. Thank you Doctor
for being here today and willing to take this on. As you can
tell, it's pretty volatile. We all care about our veterans. I
grew up in a military family, and my dad spent a lot of time in
the VA. We've got a lot of good VAs across this country. We in
Alabama, we've got a lot of good ones. We've got a lot of bad
ones. But it usually comes down to personnel.
And when I first got here, President Trump had evaluated
and released 4,000 people from the VA. And the Biden
administration rehired them back and with back pay without any
evaluation. We have not had any evaluation from those 4,000
since I've been here for four years. People need to be
evaluated, and if they can't do the job, or they're negligent,
especially in healthcare, they need to be let go. So, I'd hope
that we really look into the people running our VAs, and I know
you'll do that.
One thing I'm concerned about, and since I've been on this
Committee, we have Big Tech that could be very valuable to our
VAs. Big Tech has done a great job in a lot of areas;
hyperbaric chambers. I've been pushing that for years of trying
to get our veterans to be able to use hyperbaric chambers for
PTSD, which are not covered in the VA. Their health, their
insurance will not cover it. We need to grow up in this
business.
There's an ultrasound system that is used now for PTSD that
is very, very successful. One in North Carolina, one in San
Francisco that I've had friends go to that has saved their
life. For the life of me, we cannot get the VA to approve of
this system to be used by veterans, even though we don't have
them in the VAs.
Would you commit that we would really look hard into these
new systems that have come aboard to help our vets? We're
losing 18 veterans a day to suicide. It's ridiculous.
Dr. Lawrence. Thank you, Senator, for that question. And I
enjoyed our visit where you described some of these in detail,
and it really is intriguing. And the answer would be yes. And I
believe that's consistent with the perspective Secretary
Collins shared when he was here a month ago, of looking for
organizations that can help our veterans outside VA, whether
the nonprofits, for-profits or different approaches, and
figuring out how to use them to help our veterans get healthier
receive--receive benefits, you know, pursue their American
dream.
Senator Tuberville. I would hope we'd get the Big Tech
companies really involved in it. You know, I know they're
involved in healthcare just for general public, but the VA, we
need more and more help. And we obviously spend a lot of money,
and I would hope that as we go through this, we'll look at the
money that's being spent. The VA's Office of Inspector General
recently published a report bringing to light failures within
the fiduciary program. 311 veterans had no records within the
Veterans Benefit Management System, and $24 million in benefits
were dispersed without oversight to this. I mean speaking of
leaking oil, considering your background as Under Secretary for
benefits, how will we implement improvements to help this?
Dr. Lawrence. Certainly. Thank you, Senator, for that
question, and you're right, I do know a lot about the fiduciary
program, and one of the things was, of course, who's watching
over the people who are taking care of our veterans' money when
they're unable to do that.
Oversight continued to be a challenge when I was there. So,
if confirmed, I will look into this in more detail and
understand what's taking place. Normally, there are processes
to do this, and so the kind of things you're describing in the
IG report really makes me wonder about the process.
And back to your original point, it makes me wonder about
accountability because there are supposed to be leaders in
managing those processes and for failures, like the ones you're
describing in that report. It's really troubling, and it needs
to be tightened down. So, if confirmed, I'll look into that.
Senator Tuberville. Thank you. And one other thing,
oversight on the PACT Act. As Senator Tillis said, we're
leaking over there, $3 billion already over. It was jerked out
of this hearing room without being finished by the leader of
the Senate. It was a Democrat at the time. And it's
unfortunate, a lot of things have gone wrong because we didn't
have the ability to finish that bill.
So, hopefully, we'll look into that, and we'll get you back
here after you take office and see how we can help with that,
because the PACT Act could be good if done the right way. So,
thank you. Thank you, Mr. Chairman.
Senator Tillis. Senator Hirono.
HON. MAZIE K. HIRONO,
U.S. SENATOR FROM HAWAII
Senator Hirono. Thank you very much, Mr. Chairman. I'd like
to ask the initial two questions I ask of all nominees before
any of my committees. Since you became a legal adult, Dr.
Lawrence, have you ever made unwanted request for sexual
favors, or committed any verbal or physical harassment, or
assault of a sexual nature?
Dr. Lawrence. No, I have not.
Senator Hirono. Have you ever faced discipline or entered
into a settlement related to this kind of conduct?
Dr. Lawrence. No, I have not.
Senator Hirono. Dr. Lawrence, I think the PACT Act was one
of the bipartisan bills that we worked hard on. And the fact
that there was a shortfall in the Act, it says to me that there
were a lot of veterans who needed this kind of care, and to
talk about $3 billion shortfall that had not been anticipated.
And at the same time, I know that the Republicans are gearing
up to provide some $4 trillion or so in tax cuts to the
wealthiest people in our country. Where is the hearing cry
relating to that?
You testified also that you didn't know who consisted of
1,000 or so people working at VA who were let go? Is that your
testimony?
Dr. Lawrence. I testified that I was uninvolved in the
process by which those thousand people were laid off.
Senator Hirono. Would it surprise you to know that these
are people who were on probation?
Dr. Lawrence. No, Senator. That's exactly what's described
in the press release.
Senator Hirono. People who are on probation----
Dr. Lawrence. Yes, ma'am.
Senator Hirono [continuing]. By category. You also
testified that these people are being let go on the basis of
their work. It sounds like it's not by entire category. So,
here they are. You know, the VA has always had a shortfall of
workers to the point where we have had to enact legislation
that enables the VA to more quickly hire people because the VA
was short on everything from physicians, to nurses, to
everybody working at the VA. And that is why this hiring
freeze, we have had to address the particular concerns of VA.
And then you have an entire category of people who are being
let go. And yet you say that you had no knowledge, no part in
doing that when we know for a fact that people on probationary
status are being let go throughout the administration, the
workers.
So, some 200 people have been let go in SBA. Thousands of
people are probably going to be let go in the Department of
Justice. These are all people in probation status who were
hired, being trained to take jobs that are necessary. And if
there's an entity that definitely needs workers, it would be
the VA. And I would think that you would be tremendously
concerned about what's going on in the loss of 1,000 people.
We talk about the importance of transparency. Since his
confirmation, Secretary Collins has also been named the
temporary head of the Office of Government Ethics and the
Office of Special Counsel. I don't know what temporary means.
It could be a year, it could be forever. Who knows.
How do his additional roles impact the delegation of
responsibilities between the two of you, even if temporary.
Don't you have some responsibilities relating to whistleblowers
within the VA? Wouldn't you have some overlap between what
Secretary Collins now is responsible for and what you will be
responsible for?
Dr. Lawrence. Yes, ma'am, thank you for that question. If
confirmed, the Deputy Secretary is the chief operating officer
responsible for a lot of the administrative functions within
the department to include Office of Accountability and
Whistleblower. Secretary Collins and I have had no conversation
about his new duties. And so, you know, if confirmed, I'll
discuss those with him.
Senator Hirono. There is no question that throughout the
administration that the decisions that have been made, and that
had to be revised or explained is rampant. And so, this goes
to, in my view, the chaos, confusion that it is in every--in
every agency.
Let me get to a concern that a lot of veterans have about
what happens in VA. There has been on ongoing concerns about
privatizing at VA and the Veterans Project, the portion of
Project 2025, which you are acknowledged as having had a great
part in writing, recommends outsourcing of various roles at VA
to contractors. Is that something that you are going to push
for, that you're going to begin to privatize VA
responsibilities?
Dr. Lawrence. So, thank you for the question, ma'am. Just
to clarify, I was a small contributor to the section on VA
where I wrote about efficiencies and the benefits process. The
Secretary was very clear, and I echo his comments. We are not
going to privatize the VA. We would push back on any efforts to
do that. We understand, I think the Secretary said this well,
that there's a need for both the VA and also access to
community.
Senator Hirono. Mr. Chairman, there have been ongoing
efforts to privatize segments of the VA, and I certainly am
going to hold you to your commitment that you do not have an
intention of privatizing activities at the VA. Thank you, Mr.
Chairman.
Senator Tillis. Thank you, Senator Hirono. Senator Sheehy.
HON. TIM SHEEHY,
U.S. SENATOR FROM MONTANA
Senator Sheehy. Good morning, Paul, thanks for undertaking
this important duty, yet again, in your life. Is the VA working
right now?
Dr. Lawrence. As you know, Senator, I'm not there now. I'm
not involved in the decision about what's going on, so it is
really hard for me to talk about something I'm not there. From
afar, I would say veterans continue to get healthcare and
benefits, veterans continue to be able to interact with the VA.
When I go to the building, it works. People are there doing
things. So, from afar, I would say, broadly, yes.
Senator Sheehy. You know, I think we're at $50 billion now,
is the estimated software upgrade costs for the healthcare
system software that's been--you know, we've been talking about
this for almost a decade. The rough estimate for cost for the
VA is it cost the VA about three times as much money to deliver
$1 of care to a patient as it does the private sector or the
DoD healthcare system. How do we reform the VA healthcare
system so it is, for example, as efficient as the DoD
healthcare system can be?
Dr. Lawrence. Thank you, Senator, for those questions. And
I think when Secretary Collins was here, he talked about this a
lot, trying to figure out how we support our veterans as
efficiently as possible.
If confirmed, I think we need to take a hard look at why
things are more expensive relative to other comparable
organizations. I mean, when I talk about providing veterans
world-class service, part of that is comparing how well VA does
to other organizations that do similar things and understanding
what the difference could be. Perhaps it's because the patient
population is different, they're older, but perhaps it's in the
way it operates. So, if confirmed, I would welcome the chance
to sort of dig into this and share observations and insights
with you.
Senator Sheehy. And when we look at the transition, I think
for many veterans on this panel and many veterans, period, one
of the most frustrating parts of the VA journey is that handoff
from active duty to VA. And even parts of the VA that do
function well, and they are there, making sure that that bridge
between active duty and VA is seamless continues to evade our
ability to accomplish it effectively.
So, what can you do as the number two guy at VA to make
sure that as veterans transition from active duty to the VA,
they don't get lost in the shuffle. They don't make the leap
from one end to the other and are lost at sea. How do we help
fix that problem?
Dr. Lawrence. Well, thank you for that question. And don't
forget, sir, I transitioned, too, so I know exactly the
experience you're talking about. As the Deputy Secretary, I'll
be the co-chair of the JEC, the Joint Executive Committee, that
was already mentioned, where we work with DoD to discuss these
issues.
I think the Secretary, when you asked him a similar
question, is he talked about the importance of getting the
transition right. I echo that. I think it's very important that
seamless information transfer to DoD to VA. I cannot tell you
the number of times in past lives veterans complain, ``How many
more times are you going to ask me for my DD214 when you have
it already.'' It's things like that that really set things in a
bad place.
In addition, I feel strongly about connectivity. Making
sure veterans have a job when they transition, make sure they
have a great place to live. As you know, states are actively
competing for our veterans, and we should be helping them do
that. So, I think through the JEC, I'll really be able to align
with Secretary Collins and make sure we're working on the right
things.
Senator Sheehy. VA employee accountability is important. We
see patient satisfaction scores that if the VA was a business,
they'd have a one star on Yelp. And when the patients are
frustrated, they're--I've been in office now for what, seven
weeks as a Senator, and a lot of my time is spent dealing with
VA issues. When veterans reach out to United States Senate
office saying, I can't get a response from the VA, I can't get
my claim processed, I can't get an appointment scheduled.
The fact that we've been able to help solve those issues is
great, but it's extremely frustrating that the best place a
veteran can go to actually get their problems fixed is not the
VA, it's going to the congressional delegation writing letters,
showing up in person saying, ``Can someone please help me get a
response?''
And although many of the reforms we're seeing be undertaken
now are coming under tremendous criticism, it's about time we
change something at the VA because a lot of it is not working.
I think you have a great vision to help fit that, but how do we
make the VA a customer service organization so when our
veterans need something common sense, they can actually call
the VA and not their Senator or their Congressman and get
something done?
Dr. Lawrence. Thank you for that question, Senator. This
came up in numerous meetings with your colleagues on this
Committee when I met with them of the frustration of having to
do the casework you're describing. Part of it is, of course,
the effort to learn as to why these problems are happening and
to resolve them. I found my previous tenure many, many really
good employees, and we should recognize that at the VA.
At the same time, however, one of the ways we have great
customer service is we exit folks who are not serving our
veterans really well, and we would use accountability to do
that. So, the measurement, the understanding of the problems,
the solutions, and understanding where the failures took place
and how we deal with them.
Senator Sheehy. Great. Well, thanks again for your service.
Thanks for taking this yet again.
Senator Tillis. Senator Hassan.
HON. MARGARET WOOD HASSAN,
U.S. SENATOR FROM NEW HAMPSHIRE
Senator Hassan. Well, thank you, Senator Tillis, and
Senator Blumenthal for this hearing. And, Dr. Lawrence, again,
congratulations on your nomination, and thank you and your
entire family for your service to our country.
Before I begin my questions, I want to take a moment or two
to express my concern about recent steps that the Trump
administration has taken that have caused disruption and
confusion throughout much of our country, especially within the
VA.
Last month, the President instituted a federal hiring
freeze, which at first included the VA before the
administration tried to backtrack. The Trump administration
also attempted to institute a federal funding freeze. The VA
later claimed that its programs weren't impacted, though
veterans were rightfully concerned about the impacts on the
services that they need. And just last week we learned that the
Trump administration dismissed over a thousand VA employees,
people who help veterans get the care and benefits that they've
earned and deserve at a time when the VA should be expanding
its workforce, not cutting it down.
Taken together, it is obvious to me that this
administration is making drastic decisions without facts, to
Senator Tillis's point. If you're going to start right sizing
an organization, you gather facts and you do it in a
transparent way. And instead, what we're seeing from Mr. Musk
and Mr. Trump is they're just making stuff up, telling the
public things that then later turn out not to be true, and
they're not thinking through how their actions will actually
affect veterans.
I'm concerned that this reckless pattern of decision-making
will continue. So, it's incredibly important that we have
leadership at the VA who will push back on decisions that could
negatively impact healthcare and benefits for our veterans. So,
Dr. Lawrence, I want to start with a question. It's a question
I'm asking all nominees, in light of recent events. If directed
by the President of the United States to take action that would
break the law, would you follow the law or follow the
President's directive?
Dr. Lawrence. Thank you very much for that question,
Senator. I would follow the law. And I would just also point
out that in my previous tenure, no such situations came up. We
were very much focused on veterans. We never had conversations
like this.
Senator Hassan. I understand that. But the last four weeks
have shown us some new information and new behavior. And so,
that's why I asked the question. If a court issues an order
requiring the VA to take or refrain from taking specific
actions, will you follow the court's order?
Dr. Lawrence. Thank you for the question. Yes, Senator.
Senator Hassan. Thank you. Now, I want to turn to a
different topic. As the Trump administration continues to
indiscriminately cut the federal workforce, how will you ensure
that veterans receive the healthcare and benefits that they've
earned and deserved without disruption?
Dr. Lawrence. Thank you very much for that question
Senator. And just to clarify, the Secretary talked about, you
know, really providing veterans excellent service and caring
for the veterans. And I think the layoffs last Friday sort of
indicate the thinking behind it, right? These were described as
non-mission critical folks who would not affect the provision
of healthcare and benefits.
Senator Hassan. Let me just interrupt you there, because
we've heard this from other agencies, too. Right now, the Trump
administration's trying to rehire people who oversee our
nuclear stockpile because they didn't realize that those were
some of the people they fired. They're trying to rehire people
who are responsible for containing bird flu as the price of
eggs is skyrocketing, but they didn't realize they fired them.
So, you will understand why I don't take the administration's
reassurance about who these employees are at the VA with great
confidence.
Dr. Lawrence. I understand your perspective, and I'm
unaware of the details of those situations. So, forgive me for
that. But I would point out in this situation, though, the VA
had a safeguard, which was an SES supervisor could opt the
person out of the layoff. So, there was an element of detailed
knowledge of what the individual did and their importance in
the organization.
Senator Hassan. So, you are telling me that you would try
to make sure that that kind of system is in place. So, before
somebody is actually laid off, before they are walked out the
door, there is an assessment on the ground at the facility or
entity about whether that person's job is mission-critical to
our veterans?
Dr. Lawrence. What you describe is one variation of that,
but some level as the person closest to their work,
understanding their value in providing healthcare, and
benefits, and other service to our veterans to make sure that
it's consistent with the indication that these are not mission-
critical layoffs.
Senator Hassan. Well, I will hold you to that commitment.
Last week, the VA dismissed more than 1,000 employees. These
dismissals, combined with other steps the Trump administration
has taken, have created a climate of fear and uncertainty for
federal employees.
I'm concerned that these actions will prompt some VA
employees to eventually leave federal service, and will
additionally scare many more potential employees from applying
for VA jobs in the future. If that happens, the VA's going to
have an even harder time hiring the appropriate number of
nurses, doctors, and others to provide the care and benefits
our veterans have earned. If confirmed, what will you do to
help rebuild trust with VA employees and help recruit the new
employees that VA will need moving forward?
Dr. Lawrence. Thank you for the question. If confirmed, one
of the many things I'll do is focus on the importance of the
mission and the very special nature by which we do and what we
do. And in terms of the healthcare providers, in terms of not
only a great environment, but also the access to resources and
research and the like.
However, what I would also point out, ma'am, is that in my
previous tenure, when we exited non-performing employees, the
top performers really liked that. Because they understood as
managers, we could differentiate between their very valuable
contribution and the poor performers, and they understood the
difference.
Senator Hassan. Sure, that's true in every organization.
But there isn't any evidence right now that the approach by
this administration is going after poor performers. They are
using a meat cleaver when they should be using a scalpel. Thank
you, Mr. Chair.
Senator Tillis. Thank you, Senator Hassan. Before I go to
Senator Boozman, I did want to note--I have two things. One,
I'm trying to get the annual attrition rate for probationary
employees over the last four years because there is attrition
within these ranks as they're being onboarded. But I also can
point out, because it was a discussion about every position in
the VA is critical, that the Biden administration intended to
cut VHA workforce by 10,000 employees deemed not in critical
positions. And their strategy to do this was slowing hiring and
allowing increased attrition. Senator Boozman.
HON. JOHN BOOZMAN,
U.S. SENATOR FROM ARKANSAS
Senator Boozman. Thank you, Mr. Chairman. And thank you for
being here, Dr. Lawrence. We had a good visit not too long ago
that I really enjoyed, and I also appreciate the fact that that
you're a proven commodity. You did a great job as Under
Secretary for benefits in the past, and we look forward to
using your expertise as we go forward.
During Secretary Collins hearing before us last month, I
raised the issue of the VA's State Veterans Home located in
Fayetteville, Arkansas. This facility is an excellent resource
for veterans in Arkansas, but it's in dire need of upgrades.
Unfortunately, the facility will not receive necessary fiscal
year 2024 funding. Secretary Collins committed to continue to
work with me on the issue. Do we have your commitments as
you'll also continue to work with us in regard to the Northwest
Arkansas facility?
Dr. Lawrence. Yes, Senator, thank you for the question. If
confirmed, I'll work with the Secretary to better understand
his commitment, and we'll work with you to figure out what
makes sense.
Senator Boozman. Good. Thank you very much. The VA has
approved for GI Bill purposes, a unique vocational transition
school in my state, exclusively for veterans, which emulates
the way they learn during military service.
Notwithstanding, the GI Bill approval and working model
based on military training, previous administration policy bars
non-accredited education institutions access to transition
assistance program sites. I believe the strategy of exclusion
limits the potential of these institutions because it blocks
them from connecting with the soon-to-be veterans at the most
significant period of separation.
If confirmed, will you work with the VA/DoD Joint Executive
Committee that oversees the TAP Executive Committee, will you
commit to working with me on this issue?
Dr. Lawrence. Thank you for the question, Senator. Yes, if
confirmed, I'll look into this. Whether it's through the JEC or
whether it's just one off to better understand the situation
and figure out--I mean, I care greatly about veteran
employment. Obviously, if this is a good training program and
enables that, we should figure out what to make sense and if
these are unintended consequences of rules, we should look into
that. So, yes.
Senator Boozman. Very good. Thank you. As you're aware, the
VA faced significant questions around its budget last year,
with many issues that have yet to be answered. Do you still
believe the VA's fiscal year 2026 advance appropriation request
to be accurate or will greater funding be required? Much of the
issues we experienced last year came due to the breakdown in
communication between the VA and Congress. How do you plan to
revamp VA's congressional affairs to improve communication and
prevent future breakdowns?
Dr. Lawrence. Thank you, Senator, for those, both
questions. Let me break them apart. In terms of the budget, at
this point, my knowledge is not that detailed. So, if
confirmed, I will dig into this and have a more precise
response, and I'll work with the chief financial officer to
really understand and provide information.
In terms of your second question about communication, in
almost every one of my visits to your colleagues, this came up,
and I believe Secretary Collins addressed it in his
confirmation hearing as well, where he talked about the need to
not only receive information to do constituent services, but to
get ahead of that and to talk to your teams, just get a sense
of what's going on in advance.
So, yes, it was pretty clear about the desire for more
information from VA, and quite frankly, a two-way street, not
only to assist you with constituent service, but to better
understand what you're hearing so we can get ahead of the
problem so they don't turn into issues. So, yes.
Senator Boozman. Very good. In our previous conversations,
we discussed the importance of addressing veteran suicide. We
agreed that the VA must do things differently as the status quo
is simply not acceptable. Last Congress I co-led the Not Just a
Number Act, which requires VA to examine and identify key data
about veteran suicides and analyze which factors have the
greatest impact on preventing suicide. How can the VA use the
information collected as a result of this legislation to
prevent veteran suicide, and how should the VA's suicide
prevention efforts evolve?
Dr. Lawrence. Certainly, Senator, thank you for that
question. I agree with your sentiment, which is for a long time
we've been talking about this. A great deal of energy and a
great deal of efforts been spent on this, and it seems like the
number doesn't change. So, I think the sentiment about can we
do things differently? What can we learn? What can we learn
from data? If confirmed, I will look into this and try to
figure out if there isn't a new path, if there aren't other
successes somewhere that we could bring to bear on this really
tragic issue.
Senator Boozman. Very good. Thank you.
Senator Tillis. Senator Gallego.
HON. RUBEN GALLEGO,
U.S. SENATOR FROM ARIZONA
Senator Gallego. Thank you, Mr. Chair. One of my things I'm
very proud of is passing the PACT Act. Those people don't know
the PACT Act, it was burn pit legislation that in fact, in many
of us Iraq and Afghanistan veterans. I, myself slept next to a
burn pit for one month and hit Iraq. And, unfortunately, have
seen some of the marines that I served with die from diseases
related to the burn pit.
So, the burn legislation was a big win for veterans, first
of all. And it's bipartisan in nature. And it is really one of
the largest expansions of care and eligibility in VA history,
considering it was a 20-year war and considering how many men
and women were exposed to burn pits and other very dangerous
chemicals. So, it's a very important step forward to really
right the years of wrongs.
And when I say wrongs, a lot of my friends, some of them
died before they got even closer getting claimed. Some of them
actually ended up having to pay out of pocket because the VA
didn't recognize their sickness as related to their service.
And many of them still don't even know that they have access to
these benefits.
So, with everything that's happening right now, I am
concerned that while we are constricting and reducing who we're
hiring, we at the same time want more people to apply for the
PACT Act benefits, and want to hear what are your plans about
how to increase awareness for the PACT Act so we know that a
lot of these men and women can start getting benefits now?
Because if not, they will get benefits, as you know and you've
served in this role before years later, but we'll end up having
to back pay their service plus interest.
Dr. Lawrence. Thank you very much for that question,
Senator. I agree that more communication needs to be put out
there for veterans about what their benefits and healthcare
could be under this. I think that we tend to think about
communication as, well, let's just put something on the
internet. What I learned from my previous experience before was
that low tech communication is invaluable. Town halls are
invaluable to go and explain this. So, I would expect to do
more in-person communication.
I know the Secretary talked about that, but he'll be very
busy on lots of important issues. So, I assume as the Deputy
Secretary, a lot of this will fall on me. I'm a big believer in
communication. We probably can't over communicate on this, but
I think it's very important we tell veterans, you must come now
to the VA even if you think you are fine because years from
now, something will happen and you'll wish you came when we
better understood it. So, yes, I completely agree.
Senator Gallego. And kind of in the vein of over
communication. One of the things that concerns me about the
President's EOs against DEI, and in some regards, yes, DEI did
go too far. But one of the things that it may impact is
culturally competent communication.
What does that mean? So, Arizona, we have 22 federally
recognized tribes. We have an over-representation all over the
country. There are more tribal members that serve in the
military than the ratio of their population. And as well as we
have, for example, growing female veteran population that
sometimes wants to seek services specifically from women or
women that have been in their experience. And these types of
EOs sometimes are not going to allow best practices and best
methods of communications.
What's the balance you're going to be able to strike on
that? Or are you going to be stuck to the EO because, for
example, some female service members that have survived rape,
and by other service members, want to only speak to women and
will only feel comfortable speaking to women. Some of the EOs
are going to go so far that they may not even have the
specialized programs for survivors of rape.
Dr. Lawrence. Yes, thank you for that question, Senator.
What I learned from my previous tenure was the value of
listening to and talking to veterans, and if not veterans
directly, the organizations that represent them. I found those
invaluable in terms of communicating things for us.
So, I would hope that, if confirmed as Deputy Secretary,
I'll work with the Veteran Experience Office to really
understand how we access the individual groups you're talking
about and engage them effectively.
Senator Gallego. And part of the problem is that this EO
may not even allow you to. Will you try to find a waiver to
this, or speak to the President's cabinet, whoever it is to get
that? Because for example, there are great groups that are
better at outreach for Latinos. There's some Latino veterans
organizations. For African Americans, there's African American
veterans organizations that could be very good at reaching out
to these groups that sometimes don't necessarily listen to
other lines of communication. But I'm not sure that the
executive order will actually allow that to happen.
Dr. Lawrence. Certainly. I appreciate the question and
understand your perspective. If confirmed, I'll look in to see
whether that is actually accurate. That if we can engage them.
I completely agree, these groups are invaluable in terms of
communicating with veterans and understanding. I mean, it was
through groups who represented older veterans that I learned
telephone communication was so valuable. So, absolutely,
they're great sources of information about how we engage our
veterans.
Senator Gallego. Thank you. I yield back.
Senator Tillis. Senator King.
HON. ANGUS S. KING, JR.,
U.S. SENATOR FROM MAINE
Senator King. Thank you, Mr. Chairman. Congratulations on
your elevation. First, I want to agree with Senator Sheehy.
Transition, I think is one of the most important areas that we
can work on. I've always felt that the Defense Department
should put as much money and effort into the transition out as
they do to the recruiting in.
One of the initiatives of the first Trump administration
was a pre-registration of active-duty veterans in the Veterans
Administration. So, that was one step they didn't have to take.
I think that's a good idea. I've got a bill to essentially
continue and expand that. Is that something you could help us
move forward with?
Dr. Lawrence. Thank you, Senator, for the question. I think
that's a very good idea. And whether as Deputy Secretary, I
would work with JEC, yes, I think that's something I could
support.
Senator King. Thank you. On the layoffs, here's the
problem. You've testified, and the press release has been this
was done in a thoughtful way with reviews and all those. I'm a
great advocate of Ronald Reagan's admonition, ``Trust, but
verify.'' I'd like to see some data about that that verifies
that in fact, that took place. It's hard for me to believe that
1,000 people were laid off in a matter of weeks with that kind
of thoughtful process that you're defining.
I should also mention that given average attrition rates in
the Federal Government approximately 2,000 people have left the
VA, if the rates at the VA are the same as the rest of the
government. So, we're really not talking about 1,000 empty
positions. We're talking about 3,000 just in the last month.
2,000 a month is about the rate that would apply to the VA. So,
we're talking about a diminution in the number of people.
And I know that some effort has been made to not, for
example, apply the hiring freeze to medical personnel, direct
providers. But I would argue that if nobody's there to answer
the phone when a veteran calls for an appointment, and I think
Senator Sheehy mentioned this, the difficulty of getting
appointments, that's a denial of benefits.
So, it worries me that we're not really focusing on what
exactly the role of those people are, and that the steps so far
seem likely to diminish the availability of services to
veterans. Your thoughts?
Dr. Lawrence. Thank you for the question, Senator. I agree,
and thanks for the visit where you shared your experience with
Governor and how you went about doing something similar. So,
thank you. That was very important perspective. I think----
Senator King. Did it in eight months instead of four weeks.
That was one difference.
Dr. Lawrence. Yes. No, I took away that. Back to your
question, I think that, if confirmed, I would also like to look
at the data and see that it did in fact follow what I saw in
the press release. And I think the Secretary committed to being
very transparent about this. I don't want to speak for him, but
I would talk to him about following through on that and sharing
the information as well so folks have a sense of trust in what
took place.
I also would go back to, as we talked about yesterday, the
safeguard in place, which the person answering the phone, an
SES supervisor should be able to say, yes, they are critical,
they should be opted out of this layoff. So, hopefully, that's
where that took place.
Senator King. By the way, I was agreeing with Senator
Sheehy. I disagree with him on one thing, and that is
electronic medical records. The original sin of the electronic
medical records fiasco was a no bid contract in the last Trump
administration of a brand-new system instead of going to the
marketplace and seeing what was available in terms of proven
existing systems that are operating all across the country.
The other piece that worries me is that everybody in the
VA, except apparently direct service providers, got the famous
early retirement letter that, you know, if you quit by
September 30th, you'll get paid. Nobody can convince me that
was thoughtful.
In other words, that went to everybody. What if the best
people leave, which is what a lot of people I've talked to said
is going to happen. The people who can get good jobs
immediately. The good people are going to leave. That there's
no way to define that letter that everybody in the Federal
Government got, including shipyard workers at Portsmouth Naval
Shipyard, the CIA, the Defense Department, and the VA.
How do you defend that as a thoughtful process for
redefining the federal workforce?
Dr. Lawrence. Thank you for that question. And I'm sorry to
disappoint you, I wasn't there. I do not know the process under
which it--you know, if confirmed, I'll look into it to better
understand. But I have nothing to add.
Senator King. I understand that, and I understand that you
weren't there, but you're the nearest thing we have to somebody
to question on these issues today. So, your bad luck to be
here.
A couple of provisions from Project 2025, which I
understand you had a limited contribution to, but I'm sure
you're aware of. One of them is a suggestion for the VA
increase automation. The best way to provide benefits faster
and more accurately is by using technology to perform most of
the work. We're already learning in the private sector
insurance companies that giving AI the decision about making
these kinds of decisions doesn't work very well. Do you think
increased use of technology and artificial intelligence in
claims processing is a good idea?
Dr. Lawrence. Thank you for that question, Senator. If you
notice, it said, ``most of the work.'' The way a claim comes
about is there's a lot of work where you gather information.
It's what's called development. That's what's takes so long, is
getting all the veteran information. To get it in front of
somebody to make a decision. Technology can be used to gather
that information faster so a government employee and a claims
adjudicator can make the decision.
Senator King. So, you're testifying that you're not talking
about AI making the decision, we're talking about simply
automating the collection of data.
Dr. Lawrence. It's what's called development. That's
correct, Senator. I think that the decision should be made by
an individual, a VA employee, as required by law, I believe,
but also to bring judgment into things. I think technology is
great, but it's not the end-all and be-all.
Senator King. Continuing--I guess I'm over my time. Thank
you, Mr. Chairman.
Senator Tillis. Mr. Lawrence, just a clarification, it was
a Cerner platform that was ultimately decided for the
electronic health record. Is that correct?
Dr. Lawrence. That's correct.
Senator Tillis. And is it a Cerner platform that's also the
baseline for the DoD system?
Dr. Lawrence. That's correct.
Senator Tillis. Was it part of the logic behind that to
hopefully not modify it so much that they couldn't better
integrate so that we're carrying data from DoD to the VA?
Dr. Lawrence. I just arrived when all that went down, so
I'm not--I'm going to tell you sort of observations, but yes,
the idea was----
Senator Tillis. Senator King, I think, asked a good
question. But having been involved in that process and trying
to minimize the customization of two systems, well they should
be in that office that integrates. And why I'm so glad to hear
that you're going to step up your focus on it. If somebody went
wrong, taking two baseline systems that are precisely the same
applications and made them less compatible, there's a lot of
quality time that I would suggest to the Chair and Ranking
Member considered before this Committee. Senator Blackburn.
HON. MARSHA BLACKBURN,
U.S. SENATOR FROM TENNESSEE
Senator Blackburn. Thank you, Mr. Chairman. And indeed, we
have the Center for Medical Interoperability in Nashville, and
these are precisely the kind of issues that they work on. And,
of course, what we have learned with healthcare innovation is
that payment processing can be standardized and efficiencies
achieved in payment processing, and also, as you said, in
finding that definable data that is necessary for that claim.
And we should use every piece of technology that we can to
speed the claims to our veterans.
Mr. Lawrence, first of all, congratulations and thank you.
And thank you for the time to visit. I want to go first with
you to the backlog on claims because you got the number down
the lowest that it has ever been. And you mentioned that in
your opening remarks. And what we see now is an enormous claims
backlog. If you look at the claims that are under 120 days, and
also over 120 days, it is 954,000 claims.
So, what I would like to hear from you is what steps you're
going to take first and foremost to get those claims, those
numbers down.
Dr. Lawrence. Certainly. Thank you for the question, and I
enjoyed our visit very much. I guess what I'll begin with is
going back, if confirmed, and talking to the folks over there
and reviewing what's taking place. Because part of how we got
it down to such a low number is through a series of process
activities and technology activities. And I would want----
Senator Blackburn. What was that number?
Dr. Lawrence. It was less than it was, 64,751.
Senator Blackburn. Okay, 64,751. Let me ask you also, and
we talked about this privately. 80 percent of the VA employees
are unionized, and they are some of the ones we have heard that
have fought going to EHRs, and they have fought returning to
work full-time.
So, in order to address this backlog issue, how are you
going to deal with these unionized employees and get them back
in the office so that they are processing those claims and have
them adapt using the EHR system that is there, that now you've
got Oracle handling that contract.
Dr. Lawrence. Certainly. I think the Secretary, when he was
here, talked about this very directly, which is, we have to
explain that the mission of the VA is to serve veterans. And
that is our focus and that is what we need to do. And anything
that distracts from that has to take second place to that.
So, if that means getting back to work, so be it. If that
means coming to the office, so be it. We have to understand
that these distractions take away from our ability to deliver
care and benefits to our veterans, and we need to minimize
those and refocus activity on what the mission is.
Senator Blackburn. Now, last week, Secretary Collins let us
know that the community care network contracts are going to
face delays because of some obstacles that were put in place
during the Biden administration. We've got a lot of veterans in
Tennessee that prefer community care. We've got 95 counties, 90
are rural counties, and they prefer community care.
So, I would like to know that you all are going to continue
to push to get these contracts back on track for the community
care network, and I don't want our veterans to see a disruption
or to be displaced. So, do we have your commitment in that
regard?
Dr. Lawrence. Yes. If confirmed, I'll work with the
Secretary to follow through on his commitment to you and help
him in any way.
Senator Blackburn. And then, the first hearing we did here
in the VA Committee was on community care and simplifying this.
Getting a pilot project in place so that the veteran is making
the decision on their care and not having to wait on the VA and
a caseworker there who's working remote, working 5 days out of
10, or 2 days out of 10 in-person to make a decision to allow
them to have the care they need in the location that they need.
And I would like your commitment on providing the veteran
with that decision-making authority instead of having that land
with the bureaucracy in the VA.
Dr. Lawrence. Thank you very much, Senator. If confirmed,
I'll work with the Secretary on this. I know that he spoke
about the importance of choice in his conversations, and so I
want to make sure I'm aligned with that. But I think we are.
So, yes, we'll work on this together.
Senator Blackburn. Thank you so much. I yield back.
Senator Tillis. Senator Duckworth.
HON. TAMMY DUCKWORTH,
U.S. SENATOR FROM ILLINOIS
Senator Duckworth. Thank you, Mr. Chairman. Dr. Lawrence,
it's good to see you. Thank you for meeting with me last week.
I think we had a very productive discussion.
I want to go back to the President's illegal and
unconstitutional executive order to fire people across
government. And his allowing unelected billionaire Elon Musk as
DOGE to have the illegal privilege to carry out these mass
firings. You mentioned that the way it's supposed to work at VA
is that there's probably an SES who should review all of these
and to make sure that people are not being fired from critical
positions.
I will tell you that last week, the VA did fire people from
the Veterans Crisis Hotline, the 24/7 hotline where veterans
who are thinking of harming themselves who are in crisis can
call. And my office has personally spoken to some of those
folks who were laid off. So, let's pause for a moment to think
about this. The veterans crisis line is where veterans turn
when they're considering suicide or self-harm. The public
servants answering the phones are doing some of the toughest
work imaginable to support people who serve their country in
their absolute darkest hour.
Now, after I raised these cases to the VA and spoke out
about them, it sounds like thankfully the VA is attempting to
rehire some of these employees this morning. But we shouldn't
even be in this position. Will you commit to reviewing what the
process the VA engaged in and firing those 1,000 employees last
week, and any future firings to make sure that this process
that you talked about, supposedly being the ideal process, is
actually happening as opposed to what has already happened?
Dr. Lawrence. Yes, Senator, if confirmed, I will review,
especially with the crisis hotline, how that came about and
what it should inform us if or when future layoffs are done.
Senator Duckworth. Thank you. I'll also tell you, I have
read the letters that they received, the emails that they
received, and it contained no information about any of their
benefits, their leave days their healthcare benefits. Some of
these employees were pregnant who would lose their healthcare.
And so, I'm deeply concerned that the letters were so
indiscriminate and also did not provide people with information
on what their next steps are, and they were immediately locked
out of their employment systems. I think that we owe the
veteran community transparent answers and accountability
without excuses or finger pointing.
After this news broke, my office immediately, almost
immediately, began receiving phone calls from veterans, not
just from Illinois, but also across the country, who have been
in federal service across different agencies for years. So,
these are long-term federal employees, not probationary.
They've been in long-term employees for years, and they raised
my concern that veterans who use their veterans' preference in
their hiring for their positions are coded by OPM as
probationary. And they have been wrongfully caught up in this
egregious mass firing sweep.
When veterans use veterans preference in the hiring
process, OPM codes may code them as probationary, even if
they're long-term federal employees. And so, individuals can
also be coded as probationary if they have recently been
promoted. So, they're still in the same agency, but they were
just promoted to a new position, but they're coded as
probationary.
These veterans with years of federal service should not
have been fired. Some of the people from the crisis hotline
that I spoke with, that we spoke to, had 18 years of federal
service, 5 years of federal service, they should not have been
fired.
Dr. Lawrence, I know that I do not need to remind you that
veterans make up 30 percent of the federal workforce. They're
the most patriotic people in our Nation. They served in uniform
and many turn around and choose to continue to serve in Federal
Government, especially at VA.
We talked about the VA's mission. It's on the wall. It's
for the clearest mission of any federal agency. Yet the Trump
administration, filled with some of the most disloyal oligarchs
of our time, who egregiously invoke the theme of patriotism to
camouflage their anti-democratic agenda, has disrespected these
veterans dedicated and enduring service to our Nation.
If confirmed, will you both publicly and privately call on
President Trump and Elon Musk to immediately investigate this
catastrophic oversight error in terms of firing veterans who
are coded as probationary, even though they're long-term
government employees, and rehire these employees who are so
wrongfully and disrespectfully fired? And will you push the
Trump administration to exercise transparency and
accountability for federal employees?
Dr. Lawrence. Thank you for that. Thank you for that
question, Senator, and for clarifying the OPM process. If
confirmed, I will look into that process to better understand
how it affects veterans, and based on what I determine, happy
to share with you and the Secretary, then figure out a course
of action going forward to correct it.
Senator Duckworth. Thank you. Would you carry out an
illegal or unconstitutional order under the direction of
President Trump or Elon Musk?
Dr. Lawrence. Thank you for the question. No, Senator.
Senator Duckworth. Thank you. I yield back.
Senator Tillis. Senator Murray.
HON. PATTY MURRAY,
U.S. SENATOR FROM WASHINGTON
Senator Murray. Thank you, Mr. Chairman. Thank you for
being here today. I'm going to go back to a topic I know you've
covered a bit, and that's that the EHR started in 2018 under
President Trump, and in 2020, it deployed two Washington State
VA hospitals. Instead of helping to improve our veterans'
healthcare, that rollout ended up being a complete disaster and
it endangered veteran patients.
Unfortunately, the system still is not working the way that
the VA, and doctors, and nurses need and veterans are
continuing to suffer. Last month, the VA announced it would be
moving forward with pre-deployment activities at the next four
sites for this electronic healthcare record. You will oversee
the EHR program.
So, if confirmed, I want to know what you're going to do
differently to hold Oracle accountable, and to make sure we get
this system right for our veterans.
Dr. Lawrence. Thank you, Senator, for the question. And
thank you for the visit. I was greatly informed by your
description of what took place in 2018. So, let's start there.
If confirmed, I would really like to better understand what
happened, that what you described resulted. Why we did not
listen to the employees. Why that was not structured in there.
In a good implementation of a system, listening to employees in
training and getting feedback, and going through changes are
all supposed to happen. So, I would like to know why that
didn't happen and what happened as a result of that. Hopefully,
learning has taken place, but I'd like to validate that.
If confirmed, as you heard Secretary Collins describe, he
wants to convene a team of everybody involved to figure out
what the best path going forward. If confirmed, I want to work
on that and figure out what the plan should be in terms of
holding everybody accountable for what's supposed to take
place, right? To get the most benefits as quickly as possible
to our veterans within the amount of money we have.
Senator Murray. Well, let me make this very clear. We have
heard that answer from every VA person that's come before this
Committee for a number of years now. Everybody's looked at it,
everybody's considered it, everybody's talked about it,
everybody's convened new panels. It is not working.
So, I need your commitment that it's not just convene
people and take a look at it, but you're going to make changes
to it, and demand changes, and get those fixed because we have
spent literally millions and millions of dollars. And worse,
veterans are still in jeopardy in their care, and doctors, and
nurses, and VA facilities are really frustrated.
I asked you a really important question. What are you going
to do differently? The answer you gave me, I understand where
you're coming from, but it is the same one I've heard over and
over.
Dr. Lawrence. Certainly. Well, thank you, Senator, and I'm
glad you brought that up. So, let me share two observations
which I didn't put in that. One is, I think that the Secretary
conveyed a strong sense of urgency that it should be done much
sooner than later. And the second thing I would point out is in
my previous tenure at VA as Under Secretary, I dealt with
technology problems with the GI Bill, with Appeals
Modernization, and with Blue Water Navy. I implemented
technology.
I suspect the difference, though I don't have the inventory
of everybody who sat in front of you, the difference is I've
actually done this. And so that's the difference I will bring
to this. And I understand the frustration, and I pledge to work
as best, as hard as I can to get this done.
Senator Murray. Well, I don't want to be sitting here again
two years from now, same conversation, new person. Last week,
my offices phones were ringing off the hook because I assume a
lot of peoples were with really panicked calls from researchers
at the VA. They had been laid off with zero justification, zero
warning. And in fact, up until then, the VA had actually
assured them that they were protected from Trump and Musk's
mass firings.
VA research shouldn't be political and firing VA
researchers who are in the middle of a process to find
lifesaving treatment for veterans with conditions like PTSD, or
opioid addiction, or cancer from toxic exposure is really cruel
and wasteful. Some veterans are literally in the middle of
receiving breakthrough treatment through these clinical trials.
What will happen to them and their care when their lead
researcher was just fired?
Dr. Lawrence, I want to ask you a couple specific
questions. Were you aware of the Trump administration to fire
these VA researchers?
Dr. Lawrence. Thank you for the question. No, I'm not
engaged in anything at the department now.
Senator Murray. Do you support it?
Dr. Lawrence. If confirmed, I will look into this to better
understand what took place. I don't have enough information to
comment on that.
Senator Murray. Oh, so you won't commit to restoring these
VA researchers' positions so they can continue that research on
PTSD, and opioid addiction, and cancer that was caused by their
exposure to toxic chemicals?
Dr. Lawrence. If confirmed, I commit to looking into to
understand what happened and why.
Senator Murray. Well, I hope that's not like every other
answer we get from people that we are hearing from; that
they'll look into it and no action is taken. You've just
promised to look into it. This is critical.
Dr. Lawrence. I understand.
Senator Murray. Thank you.
Senator Tillis. I had the staff look into this, and we will
include it in the record.
Senator Tillis. That somewhere a little bit under 5 percent
of probationary employees do not continue employment. We have
about 40,000 to 50,000 new VA employees a year. So, that'd be
roughly 2,000. We are trying to really normalize and see how
much of this is a net impact as a result of the President's EO,
but right now, it sounds like it's tracking unless we see
significant attrition in the later part of the year. Senator
Banks.
HON. JIM BANKS,
U.S. SENATOR FROM INDIANA
Senator Banks. Thank you, Mr. Chairman. Dr. Lawrence, I
enjoyed working with you in the first Trump term, and look
forward to working with you again in a bigger way to serve our
Nation's veterans.
The Indianapolis Medical Center is overdue for a total
replacement. The VA's five-year development plan calls for $206
million next year to plan and design the project. And I just
want to ask you, will you commit to working with the VA, CFO,
OMB, and this Committee to prioritize that project?
Dr. Lawrence. Thank you, Senator, for the question. It's
great to be with you from--and I remember, congratulations on
your promotion. I remember when you were at the House, you
asked really hard questions. So, yes, I know you asked the
Secretary this in his confirmation hearing and he said as much.
So, I will, if confirmed, work with him to do that.
Senator Banks. It means a lot to Indiana, and I appreciate
that, and look forward to working with you on that.
Dr. Lawrence, the Deputy Secretary is traditionally the VA
chief operating officer, but very little of that responsibility
is laid out in the law. What will you be responsible for and
how will you prioritize that important role?
Dr. Lawrence. Certainly. Thank you for that question,
Senator. Yes, that's right. The deputy is the chief operating
officer. And it's somewhat described in law, so I'll use that.
The Deputy Secretary is responsible for all administrative
operations of the VA. Provides governance and oversight, works
for the Secretary on agendas, special issues, and other things
the Secretary assigns.
Senator Banks. Good. I know we talked a little bit already
about electronic health records, but EHRM has been going on for
eight years. In the first Trump term, we worked together
closely on oversight of the project. But a lot of Senators
still have basic questions about what's going on with it. Do
you think the VA has adequately explained the project's
objectives and how the strategy has changed over the last eight
years?
Dr. Lawrence. Thank you very much for that question,
Senator. I haven't followed it in detail the last four years.
However, the fact that every time I meet with one of you in one
of my meetings, you ask questions about this. It almost seems
by definition the answer is no. There's too many unanswered
questions. And I think if you recall Secretary Collins'
testimony, he talked about the importance of transparency. This
is one area I think there's much more to do.
Senator Banks. As you know, I was the chairman of the EHRM
Oversight Subcommittee when it was set up in the house in 2018
when the project started. The original plan was for the
Veterans Health Administration to standardize operations across
all the medical centers to pave the way for EHR. That never
happened, and that's why the project continues to fail. How are
you ever going to implement the Oracle EHR without VHA
standardizing it?
Dr. Lawrence. Thank you very much for that question,
Senator. If confirmed, I do want to look into this because the
value of having software is not changing the software, but
changing the work processes around it, and to the extent you
configure it to be like something else before you don't get
those advantages.
I'd want to understand if that's going on and why, and what
to do to--I think when the Secretary was here, he talked about
things are the same everywhere else. They're unique to VA, but
things are the same and nobody changes it. These systems work
elsewhere because they follow the things you're pointing out.
So, if confirmed, I want to look into that and better
understand why, and if necessary, how to stop it.
Senator Banks. Any other feedback or opinions that you
developed over the last four years, why this has gotten so off
the rails?
Dr. Lawrence. The same thing I learned from when we worked
together before. I have questions about, and these are things I
would confirm when, if confirmed, I would look into; leadership
and accountability, changes like what you're potentially
describing happening because somebody let it happen, not
realizing what's really supposed to happen.
I have a lot of questions about the value proposition. I
mean, these tools are supposed to help us help veterans, but
yet, I don't hear anybody talking about it this way. Like, this
will be a great thing for our veterans because all I hear is it
costs too much and it doesn't work, in frustration. But I
haven't heard the value proposition, and I think that's
something we need to talk more about.
Senator Banks. Dr. Lawrence, it took the VA 12 years to
encourage 1 million veterans to provide their DNA samples for
the Million Veteran Program. I don't know, are you familiar
with that program?
Dr. Lawrence. I'm vaguely, sir.
Senator Banks. It has promised groundbreaking discoveries.
And in reality, it hasn't sequenced most of the DNA samples,
and it hasn't produced many results. What's holding the Million
Veteran Program back, and how can it be more effective, and
will you be committed to taking a strong look at that after
you're confirmed?
Dr. Lawrence. Yes. Thank you for that. That's sad to learn.
That's really sad to learn, especially given those promises.
So, yes, if confirmed, I want to look into that. I want to look
into why that didn't happen, and I want to know who's in charge
of that and what they've been doing.
Senator Banks. Look forward to working with you on that as
well. Thank you very much. I yield back.
Senator Tillis. Senator Slotkin.
HON. ELISSA SLOTKIN,
U.S. SENATOR FROM MICHIGAN
Senator Slotkin. Thank you for being here. I've heard
nothing but positive things about you from lots of people that
we have in common. And so, I don't question at all your
commitment and experience serving our veterans. And I thank you
for that.
The problem I have as I come into a hearing like this is
that it feels increasingly more and more common that the senior
executives at our departments and agencies can want to do the
right thing, and can have the right values in mind, and then
people just come in on top of them and make decisions.
So, when Secretary Collins was here, someone I served with
in the House, I supported him. You know, I asked him very
clearly, will you commit to stand in the breach if someone like
DOGE or the White House comes in and says, we're going to just
full sail, start laying off veterans and Veterans Affairs
folks. That you will stand in the breach, and you will not
accept cuts to the VA that hurt our veteran care. And he said,
yes, and I believed him.
And then, 1,000 people were laid off last week. Many of
them veterans. We know because many of us here voted for the
PACT Act, you know, helping our 9/11-era veterans who were
exposed to burn pits. We've hired a lot of new people to help
with veteran care. I can only assume that they are now on the
chopping block. Not that you would want it, but that someone
comes in over your head and makes those decisions.
Now, you've said here repeatedly that you'll look into it--
you'll look into it. I just want to know if you're going to--
you know, if you're going to stand and pledge to protect and
defend the Constitution, not a President, not a king, but the
Constitution, that you're going to stand in the breach and push
back. Will you push back if a continued now, not theoretical
cuts, but continued cuts continue to be imposed on you that
hurt the care to our veterans?
Dr. Lawrence. Thank you for the questions, Senator. Yes, I
will push back on things that affect the care and benefits of
our veterans. I think you heard the Secretary talk about his
charge, which is taking care of veterans. I do not believe as
described to me, because I was not there, these cuts on Friday
affect that.
I understand there's been evidence you're receiving that
might be different, but these were designed to be non-mission
critical cuts, not in a bargaining unit with a supervisor to
provide, you know, relief if that isn't true. So, you're right,
I will push back on mission-critical cuts.
Senator Slotkin. Please. And then, you know, again, we're
told, Mr. Bessent at the Department of the Treasury, you know,
told us that, don't worry, DOGE and Mr. Musk are only getting
access to ``read only'' information about taxpayers. And then,
that was immediately proved false. That now DOGE and Elon Musk
have access to taxpayer information. So, I asked Secretary
Collins, what are you going to do when they come for the
veterans' information? Will you stand in the breach and say,
``We're not going to give you access, temporary, read-only full
files for information of our veterans who have served their
country.'' What are you going to do?
Dr. Lawrence. Thank you, Senator, for that question. This
is a much easier answer. The answer is no you cannot have
access to that information. Okay? And my understanding right
now is they do not have access to that information. There's one
employee, he has access to contract information, general
operation information, and management of the IT department.
Just as an aside from what I know from before, access to
veterans benefits and health information is strictly guarded.
There is a restricted process to do that. So, for example, I
could not look at veterans' information. I cannot look at
someone on this Committee. The Secretary cannot do that without
going through a very difficult--and he's assured, I believe
publicly that DOGE employees will not have access to that
information.
Senator Slotkin. Well, we will be depending on you because
theoretically taxpayer information would be deeply sensitive
and no Tom, Dick, and Harry can just go in and take random
Michiganders' tax information or Medicare, HIPAA health
information. All these things were considered sacred.
All these things were things we were always told would be
protected, and there's all kinds of restrictions. And then a
bunch of 25-year-olds come in and get access the same day the
Secretary is talking to us, Secretary of the Treasury. So,
whatever what your hopes and dreams are, they don't seem to be
living up to what the moment here because people come in.
So, it is not about your commitment to veterans. I
understand from lots of people you have it. So, your commitment
is going to mean fighting some really tough fights with people
on your same political team on this for the sake of veterans.
And I'm asking you and imploring you, there's something bigger
here than living up to doing whatever Trump says. Protect our
veterans, please.
Dr. Lawrence. Thank you, Senator. I understand your
perspective. I do not know about the tax systems. I do not know
about Medicare assistance, but I know about the VA personal
information systems. That cannot happen without permission.
Senator Slotkin. Great.
Senator Tillis. Thank you, Senator Slotkin. I think Senator
Blumenthal have a couple of other questions. I've got one or
two, I'll try to be brief.
It looks like this Cerner implementation is going to go
through the very predictable, the initial--either the initial
requirements were not well-defined, the complexity of the VISNs
application portfolios were not well understood. We maybe got
tempted into more customization than we should have. We may
have found out data models were more difficult to actually map
out the typical sorts of things that I would find in a project
review when something goes sideways.
I think it's going to be necessary for you to commit to
come before this Committee after a reasonable period of time
and give us a traditional ``stop, start, continue'' of this
implementation. What practices got us in the ditch. And it's
not going to be just the vendor or the consultants. It's
probably going to be because we allowed additional requirements
to creep in. But what practices have to be stopped? What
practices have to be started? And what part of the
implementation is going relatively well and it must be
continued?
Can I get a commitment within 90 days of you being
confirmed that this Committee gets a report like that?
Dr. Lawrence. Thank you very much. I think you're exactly
right in the description. I will give you almost a commitment.
The 90-day thing, I just don't know that I can guarantee that
on, but absolutely. The Secretary talked about doing the kind
of review you're talking about, you know, I imagine so, yes----
Senator Tillis. I think that's that--Dr. Lawrence, that's
fair for you to hold off on the 90-day commitment. But in my
experience, anybody worth their salt can figure out what's
wrong with a project within 90 days. But I understand why you
can't commit to that. But I'd be happy to do it in 90 days.
Senator Blumenthal.
Senator King. Eisenhower retook Europe in 11 months.
[Laughter.]
Senator Blumenthal. Thank you, Mr. Chairman. I welcome your
responses to Senator Slotkin about denying access to Elon Musk,
or DOGE, or others who should not have it. Did I hear you
correctly on that point?
Dr. Lawrence. That's correct. Especially, your last point,
sir, about anybody who should not have it.
Senator Blumenthal. Will you resign if they do have access,
if they are given access to it?
Dr. Lawrence. Thank you, Senator, for that question. It's
difficult to answer a theoretical question upon which I would
have no control. So, I'm not going to comment on that.
Senator Blumenthal. Well, how would you stop them if you
have no control?
Dr. Lawrence. So, Senator, let me see if I could reframe
your question.
Senator Blumenthal. My question is pretty clear as it is.
How would you stop them if you're not going to resign and raise
it as an issue of conscience and conviction?
Dr. Lawrence. So, I'm trying to understand, sir. We're
talking about a hypothetical whereby somebody gets----
Senator Blumenthal. It's not a hypothetical,
Dr. Lawrence. It's a hypothetical at VA, sir.
Senator Blumenthal. It's ongoing or it's on the horizon.
They are going to the Department of Defense where national
security is an issue. They're going to the Department of Health
and Human Services and accessing health records. There are
reports that they're already in the VA, even if you discount
those reports. This is not a hypothetical. I'm asking you
because you stated to Senator Slotkin so clearly that it would
be a violation of ethics and law for this information to be
given to Elon Musk or anyone else, unauthorized and uncleared.
Dr. Lawrence. Thank you, Senator, for clarifying that. I
commit to, if confirmed, better understand the situation and
try to figure out what the leverage I would have to make sure
it doesn't happen.
Senator Blumenthal. I think that response speaks for
itself. So, I'm not going to ask another question to follow-up.
I want to put in the record the Federal News Network article
entitled, ``Despite exemptions, VA employees still feeling
impact from policies shaking up federal workforce,'' if there's
no objection.
Senator Tillis. Without objection.
[The article referred to appears on page 109 of the
Appendix.]
Senator Blumenthal. Thank you. You know, just for the
record since there's been some reference to the Biden
administration. In fact, President Biden instituted a strategic
pause allowing facilities and local leadership to make staffing
decisions as long as it didn't increase costs and to make cuts.
As a result, there was bipartisan opposition to that step.
As a matter of fact, the staffing at the VA grew, not declined,
by a net of, I think, 10,000 employees because VHA recognized
that hiring staff actually saves money by bringing VA
healthcare back in-house from the community.
I invite my Republican colleagues to join me in the current
proposal for cuts just as we joined together to oppose the
potential Biden cuts in staffing that were not cost effective.
Let me ask you, Dr. Lawrence where do you live?
Dr. Lawrence. In Virginia, sir.
Senator Blumenthal. And what is the VA healthcare facility
nearest to where you live?
Dr. Lawrence. I don't know. I don't use VHA healthcare. I
believe it is Washington, DC.
Senator Blumenthal. Why do you not use VA healthcare?
Dr. Lawrence. I'm ineligible. My service was such that I'm
ineligible for healthcare. In addition, I've always been in the
private sector, and I've always had private care. And even if I
were eligible, quite frankly, I would be thinking about those
who need it more than me, and I probably wouldn't have used it.
Senator Blumenthal. You wouldn't use VA healthcare even if
you were----
Dr. Lawrence. I didn't say that. What I said sir, was
because I had private care, that even if I had access to VA
healthcare, I wouldn't use it because I'd be thinking people
who were in much more difficult situations than me because my
healthcare has been very good, need access to that care more.
Senator Blumenthal. Do you have any direct experience? Have
you ever received healthcare from the VA?
Dr. Lawrence. No, I have not.
Senator Blumenthal. When's the last time you were in a VA
healthcare facility?
Dr. Lawrence. When I was in the first administration, I
regularly visited them when I would visit regional benefits
office, and I would often visit because they were next to the
healthcare thing. We held claims clinics in VA medical
facilities.
Senator Blumenthal. You haven't been in a VA healthcare
facility since your service ended in the Trump administration?
Dr. Lawrence. That's correct.
Senator Blumenthal. When you were Under Secretary of the
Veterans Benefit Administration, you had 24,000 employees in 56
separate regional offices working for you. Correct?
Dr. Lawrence. That's correct.
Senator Blumenthal. How many of those employees do you
think should be fired?
Dr. Lawrence. I'm unaware, sir, of what's going on there
now. When I left----
Senator Blumenthal. When you were there, how many did you
think should be fired?
Dr. Lawrence. When I left there, they were producing at the
highest level they had ever produced in their history. Some
left through attrition, some left to get better jobs, but it
was a very solid workforce. And when----
Senator Blumenthal. Would you have fired any of those
24,000 when you were there?
Dr. Lawrence. I'm sorry, the first part of your question,
sir,
Senator Blumenthal. Would you have fired any of those
24,000 employees when you were there?
Dr. Lawrence. So, we didn't really have to, sir. Because by
measuring performance, the bad ones understood they were bad
performers, and they generally left before the HR systems had
to go after them.
Senator Blumenthal. So, you didn't think Elon Musk was
necessary or the DOGE transition operation, the firing that
they're now doing was necessary, then?
Dr. Lawrence. It was many fewer employees. Right now, I
believe VBA has about 35,000 employees. So, I could be wrong. A
lot of hiring has taking place since we left, so I don't know
what those folks are doing.
Senator Blumenthal. And as to those 56 regional offices,
did you recommend at the time you were Under Secretary that any
be closed?
Dr. Lawrence. No, I did not. I began my tenure by
announcing that we would close no offices, and that during my
period of time, the number of employees would be equal to or
greater than when I left.
Senator Blumenthal. Dr. Lawrence, do you think the PACT Act
is working?
Dr. Lawrence. So, thank you, Senator for that question. I
have a lot of observations based on anecdotes, so I don't want
to comment. You know, if confirmed, I really want to dig into
this more closely. Some of the things that are very positive,
as we pointed out, more veterans are coming to get care, more
veterans are applying for benefits. It's easier to deal with
burn pits. You could do it one off when I was Under Secretary,
and I think that was difficult for veterans.
At the same time, I worry that the backlog is large and
growing. I worry also about some of the things we talked, to
Senator Gallego, about the communication, the like. So, I think
there's opportunities for improvement, but by and large, when
you consider the objectives when it was discussed and passed,
it looks successful.
Senator Blumenthal. You think that we should have the PACT
Act that the presumptions for care and benefits is justified?
Dr. Lawrence. Yes. In that one, yes.
Senator Blumenthal. And as to that backlog, do you commit
to trying to end it?
Dr. Lawrence. Yes, absolutely. That would be part of my
charge. If confirmed. As Deputy Secretary, I'm responsible for
the performance of the Under Secretary for benefits. That will
be one of the key critical factors they focus on, which is
processing claims in a timely and accurate manner.
Senator Blumenthal. Would you agree that, potentially, more
VA members are necessary staff and others to make the PACT Act
work?
Dr. Lawrence. Yes. Thank you for that question. Yes,
potentially, more employees. Potentially, more technology.
Potentially, more of both. Potentially, more assistance from
other vendors who know how to do this. Absolutely. We should
examine----
Senator Blumenthal. If the Musk operation is causing a cut
in those employees, it could be increasing the backlog.
Dr. Lawrence. If VA decides to, and this is hypothetical,
if VA decides to lay off mission critical employees who are
processing benefits, by definition, it would increase the
backlog.
Senator Blumenthal. Will you resign if that happens?
Dr. Lawrence. No, sir. I'll prevent that from happening.
Senator Blumenthal. Thank you.
Senator Tillis. Senator King for a brief question.
Senator King. Yes, thank you. Just two quick. In 2020,
Project 2025, which you contributed to, I know in a limited
way, but you were involved in the veterans part. One of the
points it says, ``Reduce improper payment and fraud. About $500
million is improperly paid out each year.'' Are veterans
frauds? Are veterans committing fraud?
Dr. Lawrence. No, sir. What that refers to is sort of the
following. This is what tends to be what happens. When a
veteran passes, for example, their heirs often don't tell VA
that the veteran is passed. Their disability compensation money
continues to be paid.
Senator King. So, that would be improper, but they use the
word fraud.
Dr. Lawrence. Well, this is the broad category of fraud.
Fraud happened----
Senator King. I don't see how you're going to ferret that
out without getting into the individual medical records of
veterans, which you've testified----
Dr. Lawrence. Sure.
Senator King [continuing]. Isn't going to happen.
Dr. Lawrence. Sure. Let me give you an example of fraud.
Let me give you an example of fraud. In call centers in the
world's best companies, you're not allowed to bring your cell
phone in because you can take pictures of information, which
can be used to do identity theft. When I arrived at VBA call
centers, no such rule existed. Vet employees were able to take
pictures of confidential information and perpetuate identity
theft. That's fraud at our veterans by poor processes.
Senator King. Completely agree. But in order to ferret out
the $500 million of fraud, which isn't substantiated in any
way, it's going to be necessary to dig into those medical
records to see, for example, who died and who didn't. I just
don't see how you can have it both ways. If you're going to go
after that, then you can't say we're never going to look at a
veteran's records.
Dr. Lawrence. Certainly, sir. No, I respectfully disagree.
You get death information from people who scour coroner's
information. That's provided daily.
Senator King. I understand that, but there'll be--let me
move on. One of the most disturbing things in Project 2025 says
this, ``The next administration should explore how the reviews
would be accelerated with clearance from OMB to target
significant cost savings from revising disability rating
awards--'' that's a change in benefits for future claimants.
And listen to this, ``while preserving them fully or partially
for existing claimants, or partially as a pregnant term.''
That means you're talking about potentially reducing
benefits for people who are getting them now. Do you support
that provision in this report of which you're one of the
authors?
Dr. Lawrence. No, sir, I do not. Well, let me clarify. The
rating schedule aligns benefits to your disability.
Senator King. Right.
Dr. Lawrence. There's an ongoing review. GAO encourages VA
to do those more regularly, for example. Okay? But any change
to the rating schedule, I would defer to the Secretary and the
President. But as we talked about, our intention is not to
reduce benefits.
Senator King. Well, I'm glad to hear you say that, but the
phrase, ``while preserving benefits fully or partially for
existing claimants,'' is not very reassuring to the veterans of
this country.
Thank you, Mr. Chairman.
Senator Tillis. Thank you, Senator King. And Mr. Lawrence,
we're at the end. I imposed the Moran rule. I know that Chair
Moran tended to allow his members to ask follow-up questions.
So, I hope that I honored his tradition in the hearing versus
cutting off, which we sometimes do in other committee meetings,
Senator Blumenthal.
But, Mr. Lawrence, you were voted out of Committee with a
voice vote when you were up the last time. That's a strong
statement about the qualifications you put forth because
controversial nominees don't get a voice vote. Not only did you
get a voice vote in the Committee, but you got a voice vote on
the floor. And in my examination of your time that you were in
this position, you got pretty strong marks for being
forthright, focused, and good on execution. And I believe that
there's every indication of your past work.
There are challenging times. There will be instances where
HQ may ask you to do things that in your professional judgment
are not the best way to optimize refining the approach to the
PACT Act, or any number of policies that only you and the
Secretary are going to be familiar with. So, you owe it to the
administration when you believe well-intended ideas for
efficiency or other objectives are not in sync with your core
mission of improving care and access to veterans. I have every
confidence that you'll do that in a professional way, and you
owe it to the President to look around corners for people who
may be advising on matters that are on their face, look like a
good idea, but those in the trenches who have to execute it. I
think you'll use sound judgment going forward.
I look forward to your confirmation. So, if there are no
other questions, again, I want to thank you for coming before
the Committee, the Committee members asking very important
questions. Each member has five legislative days in which to
revise and extend their remarks. Incidentally, and any member
who would like to send questions to Dr. Lawrence should send
them to the Committee clerk as soon as possible, but no later
than noon tomorrow.
Dr. Lawrence, again, I appreciate your response.
Congratulations to the family for this honor to be nominated.
And with that, this hearing is adjourned.
[Whereupon, at 11:30 a.m., the hearing was adjourned.]
A P P E N D I X
Nomination Material for
HON. PAUL LAWRENCE
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Submissions for the Record
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