[Senate Hearing 119-60]
[From the U.S. Government Publishing Office]
S. Hrg. 119-60
BRIDGING THE GAP: ENHANCING OUTREACH TO
SUPPORT VETERANS' MENTAL HEALTH
=======================================================================
HEARING
BEFORE THE
COMMITTEE ON VETERANS' AFFAIRS
UNITED STATES SENATE
ONE HUNDRED NINETEENTH CONGRESS
FIRST SESSION
__________
APRIL 29, 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
60-293 PDF WASHINGTON : 2025
-----------------------------------------------------------------------------------
SENATE COMMITTEE ON VETERANS' AFFAIRS
Jerry Moran, Kansas, Chairman
John Boozman, Arkansas Richard Blumenthal, Connecticut,
Bill Cassidy, Louisiana Ranking Member
Thom Tillis, North Carolina Patty Murray, Washington
Dan Sullivan, Alaska Bernard Sanders, Vermont
Marsha Blackburn, Tennessee Mazie K. Hirono, Hawaii
Kevin Cramer, North Dakota Margaret Wood Hassan, New
Tommy Tuberville, Alabama Hampshire
Jim Banks, Indiana Angus S. King, Jr., Maine
Tim Sheehy, Montana Tammy Duckworth, Illinois
Ruben Gallego, Arizona
Elissa Slotkin, Michigan
David Shearman, Staff Director
Tony McClain, Democratic Staff Director
C O N T E N T S
----------
April 29, 2025
SENATORS
Page
Hon. Jerry Moran, Chairman, U.S. Senator from Kansas............. 1
Hon. Richard Blumenthal, Ranking Member, U.S. Senator from
Connecticut.................................................... 2
Hon. Kevin Cramer, U.S. Senator from North Dakota................ 9
Hon. Patty Murray, U.S. Senator from Washington.................. 10
Hon. Marsha Blackburn, U.S. Senator from Tennessee............... 12
Hon. Mazie K. Hirono, U.S. Senator from Hawaii................... 13
Hon. John Boozman, U.S. Senator from Arkansas.................... 15
Hon. Margaret Wood Hassan, U.S. Senator from New Hampshire....... 16
Hon. Angus S. King, Jr., U.S. Senator from Maine................. 18
Hon. Tammy Duckworth, U.S. Senator from Illinois................. 19
Hon. Ruben Gallego, U.S. Senator from Arizona.................... 21
Hon. Elissa Slotkin, U.S. Senator from Michigan.................. 24
Hon. Tommy Tuberville, U.S. Senator from Alabama................. 36
GUEST
Hon. Mark R. Warner, U.S. Senator from Virginia.................. 4
WITNESSES
Panel I
Thomas O'Toole, MD, Acting Assistant Under Secretary of Health
for Clinical Services and Deputy Chief Medical Officer,
Veterans Health Administration, U.S. Department of Veterans
Affairs accompanied by Michael Fisher, Chief Officer,
Readjustment Counseling Service, Veterans Health Administration 5
Panel II
Jim Lorraine, President and CEO, America's Warrior Partnership... 26
Gilly Cantor, MPA, Director of Evaluation and Capacity Building,
D'Aniello Institute for Veterans and Military Families (IVMF),
Syracuse University............................................ 27
Steffen Crow, SSG Parker Gordon Fox Grant Program Manager,
Oklahoma Veterans United....................................... 29
Heather Barr, U.S. Marine Corps Veteran.......................... 30
Austin Lambright, U.S. Marine Corps Veteran...................... 32
Lindsay Church, Executive Director and Co-Founder, Minority
Veterans of America............................................ 34
APPENDIX
Prepared Statements
Thomas O'Toole, MD, Acting Assistant Under Secretary of Health
for Clinical Services and Deputy Chief Medical Officer,
Veterans Health Administration, U.S. Department of Veterans
Affairs........................................................ 47
Jim Lorraine, President and CEO, America's Warrior Partnership... 67
Gilly Cantor, MPA, Director of Evaluation and Capacity Building,
D'Aniello Institute for Veterans and Military Families (IVMF),
Syracuse University............................................ 75
Steffen Crow, SSG Parker Gordon Fox Grant Program Manager,
Oklahoma Veterans United....................................... 80
Heather Barr, U.S. Marine Corps Veteran.......................... 102
Austin Lambright, U.S. Marine Corps Veteran...................... 104
Lindsay Church, Executive Director and Co-Founder, Minority
Veterans of America............................................ 106
Questions for the Record
Department of Veterans Affairs response to questions submitted
by:
Hon. Jerry Moran............................................... 143
Hon. Angus S. King, Jr......................................... 144
Hon. Marsha Blackburn.......................................... 145
Submissions for the Record
(From Minority Veterans of America)
Memorandum to Interagency Task Force on Outdoor Recreation for
Veterans....................................................... 151
Minority Veterans of America resignation from Interagency Task
Force on Outdoor Recreation for Veterans....................... 155
Final Report by Interagency Task Force on Outdoor Recreation for
Veterans, September 2024....................................... 156
Statements for the Record
Hon. Sheri Biggs, U.S. Representative from South Carolina........ 191
American Psychological Association Services, Inc., Katherine B.
McGuire, MSc, Chief Advocacy Officer........................... 196
AMVETS, Joseph R. Chenelly, Executive Director................... 201
Blue Star Families, Brooke Blaalid, Associate Director of Policy. 203
Boulder Crest Foundation, Josh Goldberg, CEO..................... 210
Combined Arms, Mike Hutchings, CEO............................... 215
Community Building Art Works, Seema Reza, Chief Executive Officer 216
Disabled American Veterans, Naomi Mathis, Assistant National
Legislative Director........................................... 219
EveryMind, Ann Marie Mazur, CEO.................................. 228
Modern Military Association of America........................... 230
Paralyzed Veterans of America.................................... 232
The American Legion, Sri Benson, Health Policy Analyst........... 237
The American Legion, Mario A. Marquez, Executive Director,
Government Affairs............................................. 248
Tragedy Assistance Program for Survivors, Bonnie Carroll,
President and Founder.......................................... 249
Veterans of Foreign Wars of the United States, Meggan Coleman,
Associate Director, National Legislative Service............... 251
BRIDGING THE GAP: ENHANCING OUTREACH TO SUPPORT VETERANS' MENTAL HEALTH
----------
TUESDAY, APRIL 29, 2025
U.S. Senate,
Committee on Veterans' Affairs,
Washington, DC.
The Committee met, pursuant to notice, at 10:36 a.m., in
Room SD-106, Dirksen Senate Office Building, Hon. Jerry Moran,
Chairman of the Committee, presiding.
Present: Senators Moran, Boozman, Cassidy, Tillis,
Blackburn, Cramer, Tuberville, Sheehy, Blumenthal, Murray,
Hirono, Hassan, King, Duckworth, Gallego, and Slotkin.
Also present: Senator Mark R. Warner.
OPENING STATEMENT OF HON. JERRY MORAN,
CHAIRMAN, U.S. SENATOR FROM KANSAS
Chairman Moran. All right. Good morning, and welcome.
Before we begin the hearing, I want to highlight that today at
3 o'clock in Emancipation Hall, a Congressional Medal that was
authorized by the Senate and the House will be presented to The
Six Triple Eight, the African American women who in World War
II delivered the mail by the millions.
And we would welcome you to participate, to attend, or at
least honor those women today who served our country, and in it
is a really touching story. I think a number of networks across
the country have carried this story about these women who
rolled up their sleeves and got the mail delivered to service
members during World War II.
Today, we're on the topic of mental health and veterans'
well-being. Nearly 5 years ago, the Commander John Scott Hannon
Veterans Mental Health Care Improvement Act was signed into
law. I led the introduction of this legislation with the help
and support of many of the veterans and advocates that are here
today. I also would indicate that this was a piece of
legislation that Senator Tester was hugely engaged in.
The Commander Hannon Act directed better collaboration
between the VA and the Department of Defense, and made
improvements to the VA's mental health workforce, and directed
cutting edge precision health research. This landmark
legislation also developed an authorized federal funding for
the Staff Sergeant Parker Gordon Fox Suicide Prevention Grant
Program, which focuses on bolstering community organizations
providing nonclinical suicide prevention services to veterans.
It was the goal of Congress, and this Committee,
specifically, for the VA to work more seamlessly with veterans
serving community organizations to provide veterans lifesaving
clinical care and nonclinical support services they deserve.
This morning, we are here to discuss the nonclinical suicide
prevention services and to hear directly what has worked well
and what needs to be altered, with the goal of reauthorizing
this impactful program.
We will hear from the VA to receive the Department's
perspective on implementation of this grant program. We'll also
hear from advocates who represent grantee organizations from
their perspectives, and from veterans who have benefited from
the program.
Additionally, we will be receiving input from the VA and
feedback from advocates on four bills, which include Helping
Optimize Prevention and Engagement, the HOPE Act, which is my
legislation, the Building Resources and Access for Veterans
Mental Health Engagement, the BRAVE Act, sponsored by the
Ranking Member Blumenthal, the bill to reauthorize and modify
Staff Sergeant Parker Gordon Fox Suicide Prevention Grant
Program, sponsored by Senator Boozman and Warner. And Every
State Counts for Vets Mental Health Act, sponsored by Senator
Cramer and Senator Coons.
With that, I yield to the Ranking Member, Senator
Blumenthal for his opening remarks.
OPENING STATEMENT OF HON. RICHARD BLUMENTHAL,
RANKING MEMBER, U.S. SENATOR FROM CONNECTICUT
Senator Blumenthal. Thank you, Mr. Chairman. Thank you for
convening this hearing on this critically important topic.
We're here today to discuss the issue of veterans' mental
health, including their access to care from a safe, reliable
provider. A safe, reliable provider who has the expertise and
trust to provide the best possible care for each individual
veteran.
I welcome our colleague, Senator Warner, to testify on
behalf of the Staff Sergeant Parker Gordon Fox Grant Program.
It's been a game changer for so many veterans. It's geared
toward meeting veterans where they are, providing access to
services from trusted community partners and targeting
underserved communities. And my hope is we'll have bipartisan
support for reauthorizing the Fox Grant Program, and we will
have bipartisan consensus on a couple of really essential
points.
The rate of veterans' suicide, 17.6 a day, is absolutely
intolerable. The level of services to veterans for mental
health is woefully lacking. The efforts underway to address the
lack of mental health are completely inadequate. And my bill on
today's agenda, the BRAVE Act, reauthorizes the Fox Program,
but it goes further, and I hope we'll have bipartisan support
to ensure, not only that this program, but others to address
these issues are fulfilled.
The fact is the Veterans Crisis Line has seen a dramatic
impact in call volume, largely from veterans who are either
terminated from the federal workforce, or who are concerned
about losing their benefits, or both. And at a time when
veterans are uniquely anxious, and apprehensive, and need our
support the most, we're seeing the Trump/Musk/Collins
conglomerate slashing and trashing their way through the
Federal Government.
Employee assistance programs and mental health support
contracts for the VA workforce have been canceled. Some have
been reinstated, but not before employees were left high and
dry, and forced to choose between paying out-of-pocket or
canceling their appointments due to contract cancellation.
World-class researchers studying mental health and substance
use disorders are among the ones who've been terminated. Makes
no sense. It's nonsensical, it is shameful, and disgraceful.
On the issue of privacy, a recent memo obtained by NPR,
recommended VA mental health providers tell their patients,
``While I will do my utmost to maintain your privacy, I cannot
guarantee complete confidentiality.'' They're telling veterans
they can't maintain privacy or confidentiality due to space
limitations caused by a rushed and reckless return-to-office
mandate. Again, disgraceful, shameful. Concerns about privacy
will destroy the hard-won trust VA has spent decades building.
After this memo was disclosed, VA backtracked to say it was
temporarily delaying its return-to-office requirements for
telemental health providers. I want to note these providers
haven't been exempted from the return-to-office mandate. The
facilities have simply been asked to confirm their return-to-
office spaces are private. This strategy of cut first-plan
later, fire first-analyze later, terminate, cut, freeze, ask
questions later apparently is continuing. And this failure of
leadership is at the expense of veterans. And we have yet to
hear in this Committee from the Secretary of the VA, despite my
repeated requests for him to tell us what the rationale and
reason is for these massive cuts and firings.
So, we all know that even before the Trump administration's
crusade against veterans, the VA projected a 59 percent
increase in inpatient and outpatient mental healthcare demand
in the coming years--59 percent increase. The Department was
already suffering from critical mental health staffing
shortages. There were already 40,000 open positions in the VA,
some of them for mental health professionals.
In his confirmation hearing, the Secretary claimed, he
claimed, suicide prevention was a priority. But instead of
bolstering access to life-saving mental health, he's fired
thousands of critical employees, including veterans crisis line
employees. Some have been reinstated, others have found new
employment. That's understandable because they have bills to
pay, they have lives to live and waiting for the administration
to correct yet another unforced error can't be their burden.
We have to make sure that the administration answers our
question. Our responsibility is oversight, and scrutiny, and to
prevent the firing of another 83,000 VA employees over the
coming months. We know from this Committee, we've all been on
it for a while, that outreach is essential to bring veterans
into mental health. We can't rely only on veterans calling a
crisis line or coming to the VA facilities.
There has to be outreach. 10 of those 17 per day average
veterans taking their own lives, 10 of them, have had no
contact with the VA. If we can reach more, we can save more. If
we fire the counselors and others who are doing outreach, it
will cripple efforts to save veterans from suicide, including
the Fox Program.
So, while we're here today, I hope to hear from our
witnesses about the importance of outreach and how it can be
bolstered and strengthened. Thank you, Mr. Chairman.
Chairman Moran. Ranking Member, thank you. We are now
delighted to have before the Veterans Committee, on a temporary
basis, the Senator from Virginia, Senator Warner, one of our
esteemed colleagues. And this is a rare occasion when other
Senators not on the Committee appear before us. But you are
welcome to be here, Senator Warner.
STATEMENT OF HON. MARK R. WARNER,
U.S. SENATOR FROM VIRGINIA
Senator Warner. Well, thank you, Mr. Chairman, and Ranking
Member Blumenthal. This is obviously a very important topic.
You've given me 4 minutes. I'll try to get it under 4 minutes,
so I actually get asked back. But very much appreciate the work
of this Committee. I know the issue of mental health of our
veterans is extraordinarily important.
And this is something I think we all realize is part of a
core commitment. This is not a nice to do. This is an
obligation we owe to the men and women who've served us. It is
not charity. It is something that we must fulfill. And
unfortunately, as the Chair and the Ranking Member, and I know,
all the Committee members realize, veterans' suicide is a
scourge that has to be addressed.
For the past several years, Staff Sergeant Fox Suicide
Prevention Grant Program, I think, has been an invaluable tool
for the VA to use. Senator Boozman and I came up with an
initial legislation back in 2019, a number of Members on this
Committee were firm supporters. That turned into an effort that
ultimately led to the Staff Sergeant Fox Grant Program.
In that time, $150 million has gone out in my home State of
Virginia. $4.5 million of that has gone out to organizations
who are providing the kind of critical outreach to make sure
that veterans who are in duress know that the services are
available as Ranking member Blumenthal mentioned. We have a
huge concentration of veterans down in Hampton Roads, and the
fact that of these 17 suicides today, the fact that literally
10 of those never interact with the VA, is a challenge that we
have to overcome.
This program was a temporary grant program. It is time for
its permanent reauthorization. I've joined again with Senator
Boozman on legislation to do that. I know the Chair, and the
Ranking Member, and others on this Committee have similar
legislation. I just want to add my voice that this is something
we have to get done. The sooner, the better. Literally,
veterans' lives depend upon it. And if any, in any way, I can,
as an off-Committee member helping these efforts, please count
me as one of your allies.
I appreciate the opportunity, and I will note Mr. Chairman,
that I'm seating back a minute and 40 seconds.
Chairman Moran. A message. It's an opportunity for Senators
to learn from Senator Warner. A message well delivered under
the time allowed.
Senator Warner. Thank you, Mr. Chairman.
Chairman Moran. Thank you, Senator Warner. Thank you for
joining us today. I remember the hard work that you and Senator
Boozman did early on to get this legislation in place.
Testifying on today's first panel is Dr. Thomas O'Toole,
the Acting Assistant Under Secretary of Health for Clinical
Services of the Veterans Health Administration. He's
accompanied by Michael Fisher, Chief Officer of Readjustment
Counseling Service of the Veterans Health Administration. Thank
you both for being here.
Dr. O'Toole, you're now recognized for your testimony.
PANEL I
----------
STATEMENT OF THOMAS O'TOOLE, MD, ACTING ASSISTANT UNDER
SECRETARY OF HEALTH FOR CLINICAL SERVICES AND DEPUTY CHIEF
MEDICAL OFFICER, VETERANS' HEALTH ADMINISTRATION, U.S.
DEPARTMENT OF VETERANS AFFAIRS ACCOMPANIED BY MICHAEL FISHER,
CHIEF OFFICER, READJUSTMENT COUNSELING SERVICE, VETERANS HEALTH
ADMINISTRATION
Dr. O'Toole. Thank you, Chairman Moran, Ranking Member
Blumenthal, and Members of the Committee. Thank you for
inviting us here today to present our views on several bills
that would affect VA programs and services, particularly the
Staff Sergeant Parker Gordon Fox Suicide Prevention Grant
Program. Joining me today is Mr. Mike Fisher, Chief Officer of
the Readjustment Counseling Service.
The Staff Sergeant Parker Gordon Fox Suicide Prevention
Grant Program enables VA to provide resources toward community-
based suicide prevention efforts to meet the needs of veterans
and their families through outreach, suicide prevention
services, and connections to VA and community resources.
In alignment with VA's National Strategy for Preventing
Veteran Suicide, this grant program assists in further
implementing a public health approach that blends community-
based prevention with evidence-based clinical strategies
through community efforts. The grant program is part of the
Commander John Scott Hannon Veteran Mental Health Care
Improvement Act of 2019, that was signed into law on October
17th, 2020.
The Staff Sergeant Parker Gordon Fox Suicide Prevention
Grant Program began on September 19th, 2022 when VA awarded
$52.5 million to 80 community-based organizations in 43 states,
the District of Columbia, and America Samoa. Since its launch
in September '22, VA has awarded $157.5 million to 95
organizations across these 43 states, U.S. territories and
tribal lands.
Early results show that 33 percent of participants are new
to VA services, and 75 percent of participants who complete
services show improvement in mental health status, well-being,
social supports, and financial stability, as well as a decrease
in suicide risk. All of the bills on today's agenda would hold,
or in part, mend the authority for the Staff Sergeant Parker
Gordon Fox Suicide Prevention Grant Program.
VA strongly supports the reauthorization of this program as
it is critically important for sustaining and expanding the
progress we have made so far. The initial grants have already
shown promising results, and continued congressional support
will be essential for ensuring that we can reach even more
veterans in need.
We greatly appreciate the Committee's interest in
continuing this program and stand ready to implement the
extension of this authority as soon as possible, because it's
important to continue this work in fiscal year 2026. We welcome
the opportunity to meet with the Committee to ensure that any
amendments to the terms of the grant do not interrupt
operations or delay these awards. The Department's position for
each bill is detailed in my written statement.
This concludes my statement, and we are happy to answer any
questions you or other Members of the Committee may have.
[The prepared statement of Dr. O'Toole appears on page 47
of the Appendix.]
Chairman Moran. Doctor, we'll begin a round of questions by
the Members of the Committee. Let me start by asking you, as
Congress looks to reauthorize, it's really pleasing, I think
this has broad support in Congress and certainly strong support
from the Department. But as we do this process and work to
improve this program, what's the VA learned about grantee
performance and outcome data so far? And what are the lessons
that have been learned in shaping your approach to suicide
prevention?
I would add before you answer that, one of the challenges
highlighted in the Hope for Heroes Act is a lack of awareness
among VA staff about the Fox Grant Program. And I would ask,
how is the VA working to make certain its own employees, and
especially those in high needs areas, are fully aware of the
program and collaborating with grantee organizations making
this program even better?
Dr. O'Toole. Thank you, Senator. As noted, the 3-year
authorization for this grant program has really allowed us to
be on a learning curve to try to do a better job. As has been
noted, any suicide by a veteran is one too many. And so, we
very much view this grant as an important part for reaching
those veterans that we are not reaching.
The lessons learned to date, and much of this is captured
in the MITRE report that provided a snapshot view of early
experiences, highlighted several areas that we need to continue
to improve on. Obviously, enhancing our outreach and
engagement, particularly for those disconnected veterans is
critical. And I think ensuring that our grantees have all of
the services they need as well as the expectations and skills
that they require to be able to effectively engage not only in
outreach, but in the services is critically important.
The other area that I think is essential is making sure
that the VA is there, ready, and has capacity, and a clear path
for ensuring that mental health care is available to those
veterans who need it. And obviously, that incorporates several
different elements, but one of which you mentioned, which is an
awareness of the programs by the grantees. It's something that
we acknowledge, and I know it's addressed in several of the
bills going forward as well.
Chairman Moran. Let me ask you. You used the word capacity,
clear path. So, how would you indicate that the Department of
Veterans Affairs is prepared and capable on a clear path to
reduce suicide by veterans in the country just more broadly
than this legislation? Tell me about the capacity and
capabilities.
Dr. O'Toole. So, the capacity is we have a very robust
mental health services program within VA that incorporates
tiered levels of care, including screening throughout the
agency and in our healthcare settings, not only just in mental
health; integration of mental health care within our PACT or
primary care teams through the PHMI program, behavioral health
teams providing more intensive care as well as specialized
services for higher need, higher risk veterans, including
inpatient care and residential treatment programming.
It's a continuum of care and continuum of services that,
you know, as noted in Senator Blumenthal's statement, requires
maintenance, requires an ongoing, you know, capacity to
effectively serve the veterans in need. But it is also, I
think, a more robust service than oftentimes we can find
elsewhere. And it's one that, you know, I think our veterans
benefit from greatly.
Are there things we can do better? Absolutely. Are there
things we need to be improving on? Absolutely. And, you know,
I'm not here to try to defend things that aren't working, but
more importantly, you know, be here to commit to our ongoing
work with the Committee to do a better job.
Chairman Moran. What would be those things that you could
do that you see you can do a better job aside from what we've
talked a lot about, which is outreach?
Dr. O'Toole. Right. I think that, you know, the Veteran
Crisis Line, I think has been a lifeline for a lot of veterans.
We need to continue to be able to support that and do the best
we can. What's critically important is clearly making sure that
we have pathways to treatment and to ensuring safety for those
veterans who do screen positive. And we actually do well in
that capacity and support.
Our ability to reach those veterans who are transitioning
from the military is a critically important focus and capacity
and interest. And I know it's one that our agency is working on
several different efforts to try to improve and enhance. That
becomes, I think, a critical piece, an element to it.
It's also important to note that suicide risk extends
beyond strictly a mental health approach and status.
Oftentimes, there are economic drivers, there are social
drivers, and others. And taking a whole-health approach to the
veteran is critical to really ensuring that not only the
immediacy of a suicide risk is addressed, but sometimes the
underlying issues and drivers of that suicide are also being
considered.
Chairman Moran. I would note that I have utilized Senator
Warner's extra minute and a half, and I now recognize Senator
Blumenthal.
Senator Blumenthal. Thanks, Mr. Chairman. I want to begin
by thanking you both for being here, and for your service to
our country and to the veterans of America. I know that this
time in your professional careers is probably one of the most
challenging that you have encountered, not because of anything
you've done, but because the leadership at the VA is slashing
positions, and freezing hiring, and cutting funding that is
necessary for you to do your jobs and accomplish the mission
you've devoted your lives to doing. And to you and all of the
professionals at the VA, just offer my thanks for continuing to
persevere in this very difficult time.
Dr. O'Toole, you would agree with me that outreach is
critical in preventing veteran suicide, and enabling them to
what you have called a pathway to treatment.
Dr. O'Toole. Yes, sir.
Senator Blumenthal. And that takes human beings on the
phone or in a meeting. It can't be done by an automated message
machine. Correct?
Dr. O'Toole. Yes, sir.
Senator Blumenthal. What rationale, what reason could there
be to cut those positions as is now happening?
Dr. O'Toole. Well, thank you, Senator, and I appreciate
one, your kind words as well as the attention that you're
focusing on this issue. I am happy to report that, actually,
the Veteran Crisis Line staffing numbers have gone up and not
down since this last January. This is a, as you know, an
exempted position from both return-to-office and along with
300,000 other direct care positions exempt from any hiring
freeze, or any hiring, or any firings.
Senator Blumenthal. Those returns or reinstatements were
done after vocal protest from myself, others on this Committee,
in Congress, and across the country. So, yes, that's good news,
but it's not just the crisis line, it's positions in the West
Haven facility outreach counseling. There already were 40,000
vacancies before this administration took over. Would you agree
with me that a lot of those positions in the field are open
now, and some people in those positions have been terminated?
Dr. O'Toole. Thank you. And I'm just up the road from you
in Providence, Rhode Island. So, I can appreciate the
challenges of local staffing and local issues. Quite honestly,
our challenges in maintaining the workforce in healthcare
extend beyond this administration. The challenges that we're
facing now, a lot of them----
Senator Blumenthal. Well, I'm going to interrupt because
I'm going to run out of time if I don't interrupt, so I
apologize. But the fact is there are challenges in recruitment.
Correct?
Dr. O'Toole. Yes, sir.
Senator Blumenthal. And those challenges in recruitment are
deeply and dramatically aggravated when the prospect of firing
83,000 employees is raised. Why I go to work for an institution
that's about to fire probationary employees, the newest among
them, when there are opportunities in the private sector where
you get paid more, I mean, duh, you know, I know you're not in
charge of personnel, but isn't that a recipe for disaster?
Dr. O'Toole. Well, sir, I can't say that 300,000 positions,
which are the direct care positions, are exempted from any
hiring freeze. And this is a critically important element to
trying to ensure that we are retaining and ideally growing our
workforce as best we can.
Senator Blumenthal. I am about to have my time expire, but
I just want to say that we know that there have been firings of
researchers, counselors, outreach personnel. There is simply no
way to save veterans. And I've heard nothing here that would
convince me otherwise if we engage in this slash and trash
approach to the VA. And again, my thanks to all the
professionals, to you, Mr. Fisher, and Dr. O'Toole, for what
you're doing. And I have not gone over my time.
[Laughter.]
Chairman Moran. Only by 3 seconds. Senator Cramer.
HON. KEVIN CRAMER,
U.S. SENATOR FROM NORTH DAKOTA
Senator Cramer. Thank you, Mr. Chairman, Ranking Member,
for this important hearing. And thank you to our witnesses as
well for your service, and for being here.
I'm going to get right to the specific point that's
addressed in legislation that I've introduced, an amendment to
the Act before we reauthorize it, that I've introduced with
Senator Coons. And to be clear, what resulted in this is the
fact that as important as this program is, and it is important,
and I strongly support it, neither North Dakota nor Delaware
received any of the funds despite a very, very good
application, particularly the one I'm most familiar with; the
State of North Dakota through the North Dakota Department of
Veterans Affairs. Important I stress the North Dakota
Department of Veterans Affairs because of the five criteria
that meets five of them, the five criteria for the grant.
And so, we're a little disappointed, of course, that North
Dakota's application was rejected. I don't know if it was not
qualified, but at least wasn't prioritized. And so, I want to
I'd like to have you, you know, maybe explain to me a little
bit about why that happened. And then, also, you know, we
received the testimony yesterday that the VA is opposing my
language and my amendment, and I just want to give you an
opportunity to explain that before I try to explain my position
better.
Dr. O'Toole. Thank you, Senator. And while I can't speak to
the specifics of that individual grant application and the
decision to it, I think it's important, first, thank you for
your support of this. It's support that we're very appreciative
of, and we share in our need, and want, and desire to really
grow this program and grow these efforts. I think our challenge
and our concern with an approach to increasing the number of
grantees, which we acknowledge is important, and it's an
essential aspect to being able to reach more veterans, engage
more veterans, and get more veterans into care and services, is
going to be--it's a shared objective.
Having two potentially different or a prioritized pathway
would be difficult to logistically administer, if we have two
tiers. Our larger concern is that we want to make sure that all
of the projects and all of the grants that are being approved
are meeting the high-quality universal standard. And our
concern was we do not want to create two standards for how a
grant would be approved.
Senator Cramer. And I appreciate all of that. I would
state, however, that in the case of states and just to be so
that people know what our bill does, Every State Counts Act, it
recognizes that a couple of states didn't receive funds from
the program, and we want to prioritize states that haven't
received funds previously. It's a one-time deal. We want to get
these other states in the loop, so to speak, and then clear the
deck, particularly very rural states.
I mean, North Dakota's a big state, 350 by about 200 miles
rectangle in the middle of the North American continent,
literally, we have a monument to prove it. And a lot of miles
between veterans, but 55,000 of them that need this service. We
think that's pretty important criteria. I've done this before
with other bills that--Senator Heinrich and I did something
similar when the discretionary grant programs at the Department
of Transportation weren't reaching some rural states. We fixed
that, got them back in the loop, and it's worked out very well.
I would just state that, particularly, again, I've read
that the objections, some of them reference, you know, multiple
applicants within the state, the competitive nature, all the
things that you've highlighted. But I think when it comes to an
entire state, regardless of the small population, it is after
all why there are two Senators from every one of them. Every
state does matter. Our Founders made sure that.
I just think it's worth fixing in a way that prioritizes
states that have not received funding previously. And just
adding that as a--it's not complicated. I know that testimony
says it's complicated. It's not complicated. It's very simple.
And we want to make it simple. If we make it simpler, we would
like to do that.
Dr. O'Toole. Thank you, Senator. And we agree we are very
interested in working with the Committee to figure out a good
way to approach it because we share that same----
Senator Cramer. And I suspect more resources would be
helpful.
Dr. O'Toole. Yes, sir.
Senator Cramer. All right. I yield 10 seconds since we're
keeping track.
[Laughter.]
Chairman Moran. Senator Murray.
HON. PATTY MURRAY,
U.S. SENATOR FROM WASHINGTON
Senator Murray. Thank you, Mr. Chairman, and thank you to
both of you for being here. I think it's really important that
in order to improve our mental health care outreach, we need to
hear, all of us Members of Congress, need to hear from both
veterans and VA providers about their experiences and the
issues that they face every day.
However, last week, the Trump administration denied VA
Puget Sound in my state, the ability to both host and
participate in my women veterans roundtable. I held the
roundtable anyway at a local VFW, but VA would not participate.
And the conversation certainly lacked, in my opinion, a much-
needed perspective. I have never seen this sort of blatant
barrier to outreach before in my entire time of Congress.
Dr. O'Toole, can you explain why having both the VA and
veterans together is important for a robust conversation?
Dr. O'Toole. Well, thank you Senator, and I appreciate it.
I'm not familiar with the situation you're describing, so
unfortunately, I can't comment to that and to the specifics, or
to the approval, or lack of. But absolutely, we are informed by
our veterans. It helps us to be a better agency and a better
organization, and it's something we try to encourage in as many
capacities as we can.
Senator Murray. Well, do you know if the new policy that
prevents elected officials from meeting with veterans at VA
facilities comes from within VHA, or does it come from
political leadership at VA central office?
Dr. O'Toole. You know, I would have to defer that to our
leadership in terms of describing it better than I can myself.
Senator Murray. Okay. Well, Mr. Chairman, this is really
important, and I really hope that Secretary Collins, who says
he is running the most transparent VA in history, decides that
VA can be transparent enough to let a Senator hold the
discussion about VA healthcare onsite at the local VA as I have
done for over 30 years, and I know other members have as well.
So, I am not done with this topic.
Let me ask you, though, Dr. O'Toole, even though women are
more likely to seek care through VA, they're also more likely
to be dealing with depression, and anxiety, or sexual trauma.
In 2022, suicide rates for women veterans with histories of
military sexual trauma, were 75 percent higher than those
without. So, getting into contact with these veterans and
providing them the resources they need can truly be life or
death.
However, in February, President Trump and Musk fired more
than 2,400 VA employees, including dedicated health
professionals who staff the phones at the VA's Center Veteran
Crisis Line. What steps is VA taking now to reach out to
survivors of military sexual trauma?
Dr. O'Toole. Thank you, Senator. Well, first, in relation
to the Veteran Crisis Line, that decision was reversed and we
have actually seen a net increase in staff working in the
Veteran Crisis Line. And, you know, I'm happy to report that
outcome.
The outreach and specific efforts for women who are victims
of military sexual trauma has been incorporated into our REACH
VET and REACH VET algorithm so that we are specifically
identifying and engaging those women to make sure that we are
providing better care. I'd like to defer to Mr. Fisher, who can
also speak specifically to some of the efforts at the veteran
resource centers as well.
Mr. Fisher. And thank you, Senator, for the question. So,
Vet Centers have historically gone out and reached out to any
veteran cohort and service member cohort that's eligible for
Vet Center services. That includes women veterans, that
includes individuals who experience military sexual trauma.
We've continued to do this since the change of the
administration.
Our outreach staff, as well as our counseling staff at Vet
Centers are exempted from any hiring freeze. And what we can
say specific to women veterans is that we every year see
increases in the number of women veterans that are coming into
Vet Centers. We also see high trust scores with women veterans
who received Vet Center services. Last year, it was at 93
percent.
Senator Murray. Okay. And I'm running--almost out of time,
but I don't see how 80,000 more employees being removed will
help the VA provide services. I just wanted to ask about the
return-to-office policy. I have been talking to a number of VA
providers who tell us about VA's new rule that forces them to
work in person. Those providers have been working remotely
since before the pandemic, and now instead of being able to
take video calls in private offices, they're speaking with
veteran patients in open floor spaces where there's no privacy.
This is a violation of veterans' privacy. It's a violation of
HIPAA. It is leading doctors and counselors to look elsewhere
for work.
I am almost out of time. I just want to say that the
elimination of telework agreements is really affecting our
veterans access to mental healthcare, and we need to have a
further conversation with you about how we can fix that.
Chairman Moran. Senator Blackburn.
HON. MARSHA BLACKBURN,
U.S. SENATOR FROM TENNESSEE
Senator Blackburn. Thank you, Mr. Chairman, and thank you
for being here and for approaching this subject today. This is
one--the veterans that are a part of our team talk with me
about this access to mental health services all the time, and
the grief that people experience when there is that loss of
life of someone that they have served with. And putting
attention on the mental health needs is something that, we,
each and every one should spend more time doing and making
these services available that our veterans need. This is
something that is also very important.
Dr. O'Toole, I want to come to you because we've talked
about this, and thank you for your testimony. We've talked
about what you're doing to make services available. What you
have not addressed is the fact that there seems to be
inconsistency of access, and there seems to be gaps in this
service. So, if you would build that out a little bit. How are
you addressing those gaps in the inconsistencies and what is
the strategy for moving forward so that people know that at the
VA there is a standard of care that they can expect?
Dr. O'Toole. Thank you, Senator. I appreciate that, and I
appreciate the way you framed it. I think this really
underscores the importance of the Fox Grants. And, you know, I
think it is important to put into context of the 17.6 veterans
that complete a suicide every day, 10 of them have no contact
with the VA, as has been noted earlier.
We need to be doing a better job of engaging those veterans
in care. We need to be able to reach out to them. We need to be
able to meet them on their terms, in their homes, in their home
communities, to be able to provide those services. And this is
what the Fox Grants are providing for us. And this is what the
preliminary evidence of the Fox Grant grantees to date are
showing progress in.
So, I think your question is spot on, but it very much
underscores the strategic public health approach we have to
really using these grants and these grantees to create that
connection. And use then those connections to facilitate the
trust that's needed to break down the barriers that individuals
may have to actually being able to engage in care, which the
Vet Centers are a great example of that occurring.
Senator Blackburn. So, how do you simplify the ability for
individuals to access that care in their communities? Because
we know the telehealth is important. We know that easy access
is important when you're dealing with the mental health issues,
but if you've got to wait on the VA and a caseworker to make up
their mind, then it is something that delays you getting the
care. So, talk to me about simplification of that access.
Dr. O'Toole. Well, I think one of the best examples of
the--there's two points, actually three points, I'd like to
bring up with that. The first, is the issue of outreach and
engagement, which again, is critical to those 10 veterans a day
who are committing suicide without having connections to the
VA. The second, is ensuring that we are effectively screening
those veterans that do receive care in the VA to make sure that
we are determining if they are at risk for suicide. And our
risk ID, you know, universal screening of all veterans is very
much that strategy.
The third issue that is critically important is that when
veterans are in crisis, that we are able to effectively and
meaningfully respond. And this is where I would highlight the
successes of the Veteran Crisis Line that truly provide that
safety net for veterans in crisis.
And, you know, both the uptake and increased utilization of
the Veteran Crisis Line and the responsiveness of the Veterans
Crisis Line to be able to engage individuals in care are great
examples. Is this saying that it's perfect? By no means. Can we
do better? We have to. But I'm saying those are our three
strategic approaches.
Senator Blackburn. Well, I appreciate that. I also am
concerned, and I'll send you a question for the record on the
continuum of care from active duty to veteran status with those
EHRs. And Mr. Fisher, I'm certain you deal with this every
single day, and people trying to make certain they have access
to their records so that they can get the care that they need.
Thank you all for being here.
Chairman Moran. Thank you Senator. Senator Hirono.
HON. MAZIE K. HIRONO,
U.S. SENATOR FROM HAWAII
Senator Hirono. Thank you, Mr. Chairman. So, as you testify
about the need to reach out and provide the kind of services
that you need to--for that, you need workers and the VA has
always had thousands and thousands of positions that have been
needed to fill, to be filled then to the point where we enacted
legislation to make it easier for the VA to hire people faster.
And so, my colleagues have pointed out several, and I'm
going to add to that because does it make sense to you, this is
for Dr. O'Toole, that at a time when there are some 300,000
positions that need to be filled, and you have 2,500 or so
already fired, another 83,000 to be fired. Does it make sense
to you that this is happening to the VA?
Dr. O'Toole. Well, thank you, Senator. And just a
clarification, the 300,000 positions in the VA are positions
that are exempt from any hiring freeze.
Senator Hirono. Well, then, can you tell me how many
positions are needing to be filled in the VA?
Dr. O'Toole. I don't have that information readily
available.
Senator Hirono. But we're talking about thousands and
thousands, I can tell you. So, does it make sense to you that
this is an environment that you have to live with to provide
the kind of services that you're talking about, which need
workers. Does it make sense to you that this is happening to
the VA? Yes, or no?
Dr. O'Toole. Well, ma'am, we are trying to do the best that
we can with the resources that we have. The focus of the cuts
to date have been of administrative personnel and not direct
care providers.
Senator Hirono. Let's face it. There's utter chaos going on
as far as I can see in the VA. So, we know that a lot of
veterans make up the workforce. We know that the slash and burn
of the federal workforce has also impacted veterans. We know
that the VA's 2024 annual report on veteran suicide identify
financial loss as a significant risk factor for suicide.
Do you know which veterans have lost jobs in the Federal
Government, knowing that some 30 percent of federal employees
are veterans, and knowing that loss of a job is a risk factor
for suicide? Do you know the veterans who have lost their jobs
in this administration who have been fired?
Dr. O'Toole. I do not, ma'am. And we can--I can defer that
to leadership that may.
Senator Hirono. Well, it's amazing to me that how are you
supposed to help these veterans with a significant risk factor,
which is a loss of job, if you don't even know who they are.
So, it really concerns me that as you talk about the need to
outreach and suicide prevention, which is an ongoing issue that
with homelessness to the VA, that you don't have the kind of
information that, in my view, you should have to provide the
support that you need to provide.
So, with everything that's going on, and with the tariffs,
and the impact on our communities of the fear that the tariffs
and the potential for tariffs and the impact, do you have a
sense of what the impact will be on the veteran community, of
which we have millions and over 100,000 just in Hawaii? Do you
know what kind of impact the tariffs situation is having on the
cost of everything for the veteran community?
Dr. O'Toole. I do not have that information. No, ma'am.
Senator Hirono. Well, you can see that this is the kind of
information that I would think that you would have to prepare
for this hearing.
For again, for you Dr. O'Toole. So, as I mentioned, veteran
suicide and homelessness is an ongoing issue for the VA. And
knowing that the loss of economic security would increase
homelessness among the veteran community, do you think that
what is happening to the veterans in terms of loss of their
jobs, et cetera, that homelessness among veterans will
increase? And what are you doing about it?
Dr. O'Toole. Well, thank you, ma'am. So, this obviously
shifts gears a bit to the Homeless Program Office. I'm happy to
speak to some of the different----
Senator Hirono. Well, I would say the homelessness also has
an impact on veteran suicide.
Dr. O'Toole. Absolutely, it does. And as a social
determinant of health and economic stability, it's critically
important. We do have several programs in place for those
veterans. I think our supportive services for veterans and
families, and the bridge support that provides our vocational
rehab programming, and others are clearly intended to provide
greater economic supports for those veterans who are at risk.
And clearly there is an overlap between suicide risk and
economic instabilities associated with homelessness.
Senator Hirono. Oh, the thing is, Mr. Chairman, with all
the chaos that is going on, not just to the VA, but every
single department, except for possibly the DOD, which is
actually seeing increase in potential funds, there's going to
be an increase in the risk factors that would lead to veteran
suicides, I have to say so. So, there you have it. Thank you.
Chairman Moran. Senator, thank you. Senator Boozman.
HON. JOHN BOOZMAN,
U.S. SENATOR FROM ARKANSAS
Senator Boozman. Thank you, Mr. Chairman, and thank you,
Senator Blumenthal, for calling this hearing. I was really
proud to have partnered with Senator Warner years ago to
introduce legislation that would eventually become the Staff
Sergeant Fox Suicide Prevention Grant program. This program
created out of a dire need to improve community-based resources
to address the veteran suicide crisis.
While veteran suicide remains a critical issue, the VA's
work and success with the Staff Sergeant Fox Suicide Prevention
Program deserves recognition. Veterans who battle mental health
challenges respond best to support from those that they know,
and trust, and needs this program is critical in meeting. I
look forward to discussing how we can reauthorize and update
this support for veterans and communities across the country.
Dr. O'Toole, it's great to hear from VA how successful the
program's been. In your testimony, you mentioned that VA
supports increasing the authorized funding for the program.
What kind of an impact would this funding increase have on the
program, and what results should we hope to see?
Dr. O'Toole. Thank you, Senator, and thank you for your
work and efforts to get this legislation passed. Initially, our
hope with a reauthorization and appropriations is that we would
be able to expand the number of grantees that that expansion of
the grantees would both cover all of our states and geographic
need areas, particularly those where access to care, access to
VA care may be particularly thinned. And also, to ensure that
the grantees are able to effectively engage specific population
groups that may be at higher risk for suicide as well. And that
is our hope and aspiration with the reauthorization and
appropriations.
Senator Boozman. What aspects of the program do you think
have made it such a success story, and where do you see the
program going?
Dr. O'Toole. I think the fact that these are community
groups that have credibility in the communities where veterans
live. These are peers. These are also organizations that are
engaging families of veterans are all critical to this. The
wraparound and holistic approach to really supporting those
veterans is complementary to what VA does, and it really,
again, creates a public health strategy and complements a
public health strategy for how we're looking at suicide in a
way that reflects the complexity of all that goes into it.
Senator Boozman. The legislation that Senator Warner and I
introduced included reporting requirements for VA. What metrics
would VA likely identify as important to collect and share with
Congress?
Dr. O'Toole. I think the measurement dynamic is obviously
critical. We need to be good stewards of the resources that
Congress provides to us, and make sure that the money is going
where it needs to go and is having an effect.
The key as we see it, is not just in terms--it's obviously
important that as many veterans are being reached as possible,
but we also want to make sure that it's not just a throughput
for lots of veterans, but without also looking at the quality
of the care that they are getting, the comprehensiveness of the
screening so that the care and the services they are getting is
matched to the need. And also, that we are outcome driven.
We have to be focused on using this grant mechanism to be
making a difference in these communities. How many of those
veterans are doing better as a result? How many of those
veterans are connecting in VA for VA services, or in the
community for community services as healthcare would require?
But these are the accountabilities. These are the trackable
metrics that we need to be really looking at.
Senator Boozman. Very good. Well, that's good to hear. I
agree with you 100 percent, I think, as does to the rest of the
Committee. Thank you, Mr. Chairman.
Chairman Moran. Senator Hassan.
HON. MARGARET WOOD HASSAN,
U.S. SENATOR FROM NEW HAMPSHIRE
Senator Hassan. Well, thank you, Mr. Chairman, and Ranking
Member Blumenthal for this hearing. And thank you, Dr. O'Toole,
and Mr. Fisher for the work that you do to serve our veterans.
Dr. O'Toole, over the past few months, I've been asking VA
officials and nominees if they can guarantee that the Trump
administration's plan to fire 80,000 VA employees will not
result in longer wait times for veterans to get appointments
and receive care.
In response, the administration's nominees have told me
that wait times at the VA have been increasing and reform is
necessary, but they've never explained how firing 80,000
employees will help solve that problem. That's indicative of
the way the administration has approached things these past few
months. They have been making drastic changes without, as far
as any of us can tell, any analysis or plan.
Dr. O'Toole, you've worked at the VA for almost 20 years,
and you're currently the VA's top doctor. Has anyone asked for
your analysis on how firing 80,000 employees will affect
veterans care?
Dr. O'Toole. Thank you, Senator. And I appreciate the
question. I do not--I am not involved in that--those
discussions. And it is--I will say that we actively monitor and
track wait times. We actively monitor and track access.
Senator Hassan. I understand that. And, again, my time is
short, but the answer to my question is no, they haven't asked
you for your analysis. And, obviously, wait times is a piece of
this, but affecting veterans care, you know, if somebody's been
laid off who orders supplies, and a doc runs out of critical
supplies, that affects veterans' care. Right? So, have you seen
or been provided with any analysis as to how firing 80,000 VA
employees might affect veterans care?
Dr. O'Toole. I have not, ma'am.
Senator Hassan. Have you been directed to perform or
oversee any analysis as to how firing 80,000 VA employees might
affect veterans care?
Dr. O'Toole. Well, again, ma'am, I will say, you know, I am
prepared here to be able to speak to this grant. I don't have
the information you're asking to that.
Senator Hassan. Right? But I'm taking that you would know
if you have been directed to perform or oversee an analysis.
So, I'm going to take that as a no as well.
Last year, the VA's Inspector General released a report on
several occupational staffing shortages within the VA. These
are jobs that the VA was having the hardest time filling. The
IG's report stated that the top clinical job in the VA with a
severe staffing shortage was psychology. A whopping 61 percent
of Veterans Health Administration facilities reported having
such a shortage. Psychiatry came in third place; 47 percent of
Veterans Health Administration facilities reported psychiatry
as a shortage.
As a career VA doctor, can you please discuss the role that
mental health professionals, like psychologists and
psychiatrists, play in supporting our veterans?
Dr. O'Toole. Thank you, ma'am. They are critical. I think
that goes without saying. And the complex needs and care
requirements of our veterans, obviously, require the engagement
of a very robust mental health service.
Senator Hassan. Yes. I continue to be concerned then about
the Trump administration's policies of hiring freezes, firings,
and general disruption. You've talked about the exemption for
about 300,000 employees, but it's really difficult to see how
the chaos that is churning is going to help recruit and retain
mental health professionals that our veterans really deserve
access to. And you've just acknowledged, and Mr. Fisher, too,
has, about how important they are to our veterans.
Last question Dr. O'Toole. You were the founding director
of the VA's Homeless Patient Aligned Care Teams program, HPACT.
This program utilizes clinics with co-located medical staff,
social workers, mental health, and substance use counselors,
nurses and homeless program staff that form a team to provide
veterans with comprehensive individualized care. I really want
to thank you for your leadership on this important work.
Can you please discuss the benefits of holistic wraparound
care like this, and how this model utilizes expertise across a
variety of fields within the VA?
Dr. O'Toole. Well, thank you, Senator. I appreciate those
kind comments. And I think the hosting of that initiative in
the VA speaks to a culture in the VA of trying to reach the
veteran where they are, and meet them and their comprehensive
needs on their terms, not necessarily our terms. And I think
the HPACT successes in engaging those veterans, and really
providing that stability that allowed them to move on with
their lives, and engage more fully in programming reflects it.
And it reflects, I think, a culture of the VA that I'm very
proud to have been a part of.
Senator Hassan. And I think it does, too. And I think one
of the things we could really work on with that culture in
place with so many veterans being willing to do peer-to-peer
outreach, is reaching those veterans who haven't engaged with
the VA who we are especially concerned about as we look at the
suicide statistics. So, thank you very much. Thank you, Ranking
Member Blumenthal.
Senator Blumenthal [presiding]. Thanks, Senator Hassan.
Senator King.
HON. ANGUS S. KING, JR.,
U.S. SENATOR FROM MAINE
Senator King. Thank you, Doctor O'Toole, and thank you for
your long service, and your dedication to veterans. One of my
mottoes in life is that implementation is as important a
vision. And we're talking about the vision now of the Fox
Program, but the question is, what are the implementation
steps, and how is it working?
One of the things I've heard from the field is that the
intake process is intrusive and burdensome, and we're losing
veterans who are just basically dropping out of the process.
For example, in Maine, we've had 311 veteran screened since
they started the program. 96 of those 311 refused to
participate because of burdensome paperwork or the required VA
connection. Veterans who make it through the initial screening,
5 percent have stopped partway through because of the intrusive
questions.
Here's a practical implementation. One of the feedback I've
gotten is, don't ask all those questions at the first
interview. Let the professional establish a relationship. And I
understand the screening is important, but we're losing some
very at-risk people through the implementation process. Can you
discuss this problem?
Dr. O'Toole. Well, thank you, Senator, and I appreciate the
perspective you bring to this, because obviously implementation
is the--you know, a great vision. But if it can't be
implemented, it doesn't do as much good. I think it's important
to put in context these findings. You know, this program was
established as a 3-year temporary grant program to really learn
from this. And those types of observations are critical.
You know, we need to find that balance between ensuring
that we are asking the right questions to determine risk, and
to match those needs to the services, and be able to engage as
much as possible. But being able to do so without scaring
people away and without turning them off from those care and
services is critically important.
And, you know, I would defer to my colleague, Mr. Fisher,
because I think the Vet Centers have been working in that space
for quite some time. But these are the lessons we have to be
using to learn to get better and do better.
Senator King. That's my suggestion. We are talking about
reauthorization. Let's talk about examining. And, I mean, this
isn't a malicious process. It's to try to determine the risk
factors and the qualification. But if that in itself ends up
knocking somebody out of the process, that seems to me that's a
problem, should be considered and addressed as we're talking
about reauthorization, and then re-implementation.
I would suggest, and this has been discussed to some
extent, outreach is critically important. If 10 out of the 17
suicides are people with no connection to the VA, that tells
you something. And we need to connect those people, and we need
to reach out to them. And for whatever reason, they're not
reaching out themselves. So, again, it just hits me. That's a
piece of data.
I want to turn to one other point. 74 percent of veteran
suicides involve firearms. With female veterans, it's even
higher. Senator Sheehy from Montana, and I, have a bill that
basically would have the VA provide a free lockbox to veterans
who ask for them. They don't have to be connected to the VA,
they just have to be veterans.
It's a voluntary program. But the whole idea is, I'm sure
you realize, is to have some space between the idea of suicide,
and I almost said the execution, that's not the right word, but
going through with it, and lockboxes are one way to do that. Is
this something that makes sense to you?
Dr. O'Toole. It is, Senator, and I think anything we can do
to create space between the idea and the action is critically
important. And the literature and the data support that. I know
that's not one of the bills that we're here to discuss today,
but the notion of lethal means safety and strategies for how to
best facilitate that, including the use of lockboxes, is
something that the VA is very interested in working with the
Committee to identify.
Senator King. I'm hoping to get that bill in the next, in
the next round. But it just seems to me that the glaring
number, 74 percent, involve firearms that gives us a place
where we need to focus, it seems to me.
Dr. O'Toole. Fully agree.
Senator King. Thank you very much for your testimony, and
for your hard work on behalf of America's veterans. Thank you.
Senator Blumenthal. Thank you, Senator King. Senator
Duckworth.
HON. TAMMY DUCKWORTH,
U.S. SENATOR FROM ILLINOIS
Senator Duckworth. Thank you, Mr. Chairman, Ranking Member.
Three months of unjust, unconstitutional attacks on our
veterans and against critical services of the United States
Department of Veterans Affairs have divided this traditionally
bipartisan Committee, sadly. I hope that today's focus on a
matter that should transcend Presidential loyalty; ensuring
that our veterans have access to robust mental health and
suicide prevention resources will reflect a new, renewed
commitment that this Committee will once again faithfully
fulfill its constitutional responsibility to serve as an
independent check on any Presidential administration.
Under normal times, the renewal of the Fox Grants Program
will be an important step in enabling the VA to continue
providing critical community-based suicide prevention resources
for veterans, and to reach even more veterans who need this
lifesaving care. However, I am concerned that the Trump
administration's policies continue to undermine the mental
health and well-being of those patriotic Americans who have
served our Nation honorably. For the mass reductions-in-force
of federal workers, including veterans working on the crisis
line, to canceled contracts, and continued attacks on veterans
belonging to underserved communities, Donald Trump and Elon
Musk are intentionally attacking morale and exacerbating the
Department of Veterans Affairs mental health workforce
shortages.
This threatens the ability of the VA to distribute the Fox
grants rapidly. We're talking about real lives, someone's
parents, child, sibling, aunt, or uncle, grandparent, friend.
We cannot endure more chaos at the risk of delaying the
provision of mental health care and suicide prevention
services.
Dr. O'Toole, what specific steps are you taking to ensure
that there are sufficient staff and resources on-hand to
administer the Fox Grant Program and to provide timely care for
veterans seeking Fox Grant resources?
Dr. O'Toole. Thank you, Senator. And thank you for your
service, as well as for your advocacy for our veterans. It's
much appreciated. You're absolutely right. This is about
ensuring that we have resources in place and a commitment to
making sure that the grantees are going to be as effective as
possible.
The Suicide Prevention Program reports to me. I have a
weekly meeting with their leadership team. These are some of
the things that we discuss, and this is a priority for us. You
know, if we're going to have to--if it's going to work, we have
to make sure that we have people in place to work it.
Senator Duckworth. Well, what are you doing to ensure that
they are there? I mean, my own office worked a case of several
folks who work on the Veterans Crisis Hotline who were in that
mass firing. Two of them have gotten their jobs back, but one
of them still hasn't. And we're talking about people who, you
know, may not be the ones answering the phones. We're talking
about the trainers, the people who train the other folks, the
supervisors, some of them still have not gotten their jobs
back. What are you doing to make sure that there's enough
people to work those hotlines and the suicide prevention
programs?
Dr. O'Toole. Well, as I mentioned Senator, with the Veteran
Crisis Line, that is exempt from any hiring freeze. And we've
actually seen a growth in the numbers of employees on the
Veteran Crisis Line, something though that we have to stay
vigilant in ensuring that direct care is not impacted, and
these programs are able to function at their highest
capabilities.
Senator Duckworth. Will you commit to hiring some of those
people back that were fired by Elon Musk?
Dr. O'Toole. Well, we're happy to follow up with you on any
specifics, by all means, ma'am.
Senator Duckworth. Oh, I think it should be more than just
the one people being handled by my office. There are many
people across the country who have now been laid off, who've
worked on veterans' mental health programs. Those people need
to have their jobs back, especially if they themselves are
veterans. Do you commit to safeguarding and strengthening VA
mental health workforce, including making sure they have the
appropriate resources and work spaces?
Dr. O'Toole. Yes, ma'am. I'd like to speak a little bit to
that in more direct terms. It's been referenced several times
in terms of the return-to-office and the impact on
confidentiality. We are very committed, and our leadership
within VHA, has been very committed to ensuring that privacy is
maintained and confidentiality is maintained, including
ensuring that if employees need dedicated private workspace for
engaging in telemental healthcare services and other services
that require confidentiality and HIPAA rules are being complied
with.
When those are not being able to be met, we have processes
in place to work with the facility to ensure that either space
is found or that there are appropriate pauses to the return to
office. This is critically important. We cannot let this
compromise the care we provide to our veterans.
Senator Duckworth. Well, will you commit to advocating for
protecting these mission-critical staff from adverse
administrative actions, especially if they report that they're
not getting the resources that they need?
Dr. O'Toole. Yes, ma'am. And we do that now.
Senator Duckworth. Okay. Because I, again, we've dealt with
people who've had to take phone calls in their cars in the
parking lot because there was no confidential space for them to
do their work, their jobs.
Dr. O'Toole. And we have mechanisms in place to try to
ensure that that is not happening. And if those are happening,
you know, we need to know about it.
Senator Duckworth. Okay. Thank you, Mr. Chairman.
Senator Blumenthal. Thank you, Senator Duckworth. Senator
Gallego.
HON. RUBEN GALLEGO,
U.S. SENATOR FROM ARIZONA
Senator Gallego. Thank you. I was just going to ask, moving
on to Mr. O'Toole, following President Trump's executive order
on the return to work, the VA issued its return-to-work mandate
requiring most employees to return in-person work.
So, kind of following up on the therapists who are hired as
remote workers and kind of what Senator Duckworth had just
said. Have you heard of any instances where therapists have
had, had awkward and/or, I would say, not professional settings
when they're having their healthcare or when they're having
their--the veterans are having the therapy sessions?
Dr. O'Toole. I have not heard specific situations where
that may have occurred. I have obviously heard it second- or
third-hand. We have a mechanism and process in place. Those
work environments and work scenarios are not acceptable to us.
That's not appropriate care standard for the VA. And if they do
occur, we have mechanisms to ensure that they can be
remediated.
Senator Gallego. Okay. And then just kind of along the
lines, there's an 83,000-person cut of VA workers coming. Is
there a standard of who is going to be in that cut? You know,
how many will be therapists? How many are going to be different
professions, because that will also obviously affect the
healthcare outcomes?
You know, it's hard to get some of these therapists into
this job. Some of them can be much better paid in the private
sector. So, losing therapists to these arbitrary cuts, in my
opinion, it's going to be very detrimental to the mental health
of these men and women.
Dr. O'Toole. I do not have specifics on that information.
It would have to defer. And we'll have to get back to you on
that.
Senator Gallego. Yes. I mean, for example, my Phoenix VA,
the VA that I've belonged to, has a memo out that they have to
cut 15 percent. But what does that mean? You know, who is that
that they're cutting?
Mr. Fisher, I'm sorry, I can barely see your name. I have
bad eyesight. So, I placed a blanket hold on all President
Trump's nominees to the VA, especially following the fact that
they're cutting 83,000 jobs because I just don't see how it's
possible for the VA to fire so many of their employees without
it affecting care for veterans, especially in mental health
care.
You lead the office of the VA in charge of helping veterans
transition from military to civilian life, which is extremely
important. Right? If we can make that transition, the
likelihood of people falling into some bad times, you know,
reduces tremendously. So, it's extremely important work.
Now, do these cuts, veterans can lose access to that mental
healthcare and potentially, you know, creating and rising
instances of suicide. What directions have you received
specifically from the Trump administration in order to enact
these cuts to the VA workforce when you commit to ensuring that
the VA mental health providers are not among those fired or
other positions that are very important in kind of keeping that
network together of a very important job that you have and we
all have here?
Mr. Fisher. Thank you Senator for the question. Similar to
what Dr. O'Toole brought up, I have not received guidance. Our
focus at Vet Centers has been the hiring of our counselors as
well as our outreach staff. We continue to do that in locations
where we have a hard time hiring those. We leverage all
existing authorities, whether that's our scholarship program or
other special incentives to be able to ensure we're bringing
those staff into Vet Centers.
Senator Gallego. And just to be clear, you haven't received
any directive and any orders from VA Collins or anyone else
from the VA saying you have to cut X amount of people by X
amount of date from the programs you guys oversee. Is that
correct, Mr. O'Toole?
Dr. O'Toole. That that is correct.
Senator Gallego. Okay. And then, Mr. Fisher?
Mr. Fisher. Same answer. Yes.
Senator Gallego. Okay. And from your general understanding,
what is the deadline that the VA has set for them to cut these
83,000, let's say, positions?
Dr. O'Toole. Sir, I don't know, and I would have to defer
on that.
Senator Gallego. Mr. Fisher, do you know?
Mr. Fisher. I would have to defer as well, sir.
Senator Gallego. Okay. Well, my concern is because in
Arizona, the memo that was laid out was that they wanted cuts
to go into effect by July 1st, and were already in May. And,
you know, such sudden cuts, especially when it comes to kind of
mental health care clinics, VA clinics and suicide prevention,
could be extremely damaging since you're trying to recruit
people into this very hard work. And at the same time, they're
hearing about these firings. It's going to be hard to recruit
and retain.
And I don't know if you've had any conversations with some
of these potential therapists that are asking questions about
whether or not they can come on board with the assurances that
they're not going to be fired or let go later? And Mr. O'Toole,
have you heard anything from potential employees, please?
Dr. O'Toole. I have not. I will note, though, that the
direct care providers of whom therapists are exempted currently
from any of the hiring freezes that are taking place.
Senator Gallego. So, they're exempted from the hiring
freeze, but not necessarily from the attrition or from the
potential elimination?
Dr. O'Toole. I'm not--again, sir, I would have to defer on
that because I'm not aware.
Senator Gallego. Okay. So, I yield back my time. Thank you.
Senator Blumenthal. Thanks Senator, Gallego. I have a few
questions while we're waiting for the Chairman to return and
start the second panel. And I don't know whether--I don't think
anyone has asked about this fact, but the veteran suicide rates
in Connecticut seem to have been highest among veterans who are
over 75 years old, lowest in the age group, 18 to 54. Is that
true nationally?
Dr. O'Toole. I don't know, sir. I'd have to look at that.
There is a bimodal nature to the incidence of suicide. We see
it very high in the 18 to 39 range for different reasons than
we see it in the older populations where chronic disease,
chronic pain, and other factors can play in a more active role.
But I don't have the specific data that you're referencing. I
would have to take it for the record.
Senator Blumenthal. Could you try to provide that data? I
assume that if it's available for Connecticut, it's available
elsewhere. And is there any explanation for disparities between
different parts of the country or different states so far as
you're aware?
Dr. O'Toole. Again, I'd have to defer that to our subject
matter experts. It's an important questions. It has a lot to
do, I think, with levels of engagement, lethal means
availability, and so forth. But I would prefer deferring that
and we can get that information to you.
Senator Blumenthal. I think it's an important question,
both of those are important question. Because if there are
lessons to be learned from some states and what they do in
preventing veteran suicide, maybe they can be adopted more
broadly.
And I want to just finally ask you to have a look at the
BRAVE Act. You know, if we had a few hours more for this panel,
I could go through each of the provisions. The standard
response of the VA to many of these provisions was to oppose it
because they said it was not necessary. Now, an example would
be to give more priority to women's health, mental health care.
And they're saying to me that, for example, the requirement for
the Department of Veterans Affairs to modify the REACH VET
program to incorporate risk factors weighted for women
veterans, it's not necessary because we are already on top of
it. We got that problem.
Well, I'm not so sure that's accurate. If it ever was
correct, it certainly is not. Now, I would ask you, Dr. O'Toole
to please go back and look at the BRAVE Act and perhaps speak
with your colleagues about giving me some more, maybe
different, and more constructive reactions to the BRAVE Act.
Senator Blumenthal. Thanks, Mr. Chairman.
Chairman Moran [presiding]. Thank you, Ranking Member.
Senator Slotkin.
HON. ELISSA SLOTKIN,
U.S. SENATOR FROM MICHIGAN
Senator Slotkin. Thank you, Chairman. And thank you to our
nominees for being here. I'm a former CIA officer. I did three
tours in Iraq alongside the military. I've served very proudly
both Democrat and Republican administrations as a civil servant
before I was elected to Congress. And I think everyone on this
panel, Democrat or Republican, believes that when we make the
choice to send men and women into war, we have a responsibility
when they return, and that veterans deserve the gold standard
of care.
And as I've been on this Committee, and I was on the VA
Committee in the House, it seems like every time there's a
threat to veterans' care or we need to expand veterans care,
it's veterans who are pushing and advocating for that change.
It doesn't happen in a big bureaucratic system just by sitting
there.
I'm concerned that mental health occupations are the ones
where we have significant vacancies across the VA. Over 60
percent of VA facilities report shortages of psychologists, and
nearly half reported shortages of psychiatrists. And I was just
at the VA hospital in Saginaw this past week, and there's
definitely shortages across the mental health architecture. And
there's no way for me to square that with the threat of
potentially cutting 70 to 80,000 VA employees. I don't
understand how we can add by subtracting.
And while I keep hearing from the Secretary of the VA that
we're not going to cut the hospitals and the nurses and all
that kind of stuff, all those support steps, the suicide
hotline, all the folks who process claims so that veterans can
get care, they are quite literally seem to me to be on the
chopping block.
So, tell me, what are you going to do Mr. O'Toole, in this
moment of subtraction from the VA, to actually ensure that our
veterans get the mental health care that they need?
Dr. O'Toole. Thank you, Senator, and I appreciate the
comments and the observation. And it's shared. You know we have
the healthcare workforce, not limited to the VA, is struggling
to fill needed positions across the board. And, you know, long
before this past year, we've actively tried and have been
trying to continue to attract people to work at the VA, which
is, I've been here for 20 years, you know, it's where I choose
to work.
The commitment is to ensure that direct care is provided
and not compromised by these cuts. I am not privy to the
decisions, and the discussions, and would have to defer on the
specifics to that. But just as I mentioned in relationship to
telehealth care, our utmost and absolute commitment is to
providing the best care possible and not compromising it by any
means in the process of the changes underway.
Senator Slotkin. I do not doubt not for one minute your
mission and your belief in this mission. It's my concern is
that you could be overseeing a component of the VA when you say
we don't want to compromise care. In fact, we have an
obligation as a country not to compromise veterans' care. And
yet, we're talking about cuts of potentially 80,000 people.
And the Secretary of the VA refused to dismiss those cuts
when he came to Howell, Michigan a few weeks ago. He was asked
directly and he said, ``well, difficult choices essentially are
going to have to be made.'' So, I'm not seeing how the math is
going to work out there.
I also want to note that in the 2024 National Veteran
Suicide Prevention Annual Report, which you may have had a hand
in it, said that most veteran deaths by suicide are among
veterans who have not had access to VA care in the prior two
years. Right? That if you're kind of in the system getting
care, you have a better chance of being helped. But if you're
out, you're not connected to the VA.
So, I would actually posit that we need to be getting to
more veterans. We need to be doing better outreach. The VA
needs to be talking to people when they separate and getting
them in the routine of accessing all those services. So, in
fact, on this mission, not only are we understaffed right now,
but I think the mission is greater than what the VA is already
doing. So, I would just note you are going to be the guy in the
room when these cuts come down from on high.
Mr. Collins sat in your very seat and said, ``I'm not going
to let anything compromise care,'' and then seems to be
supportive of 80,000 cuts. I'd ask you to stand up for
veterans. It's bigger than any one administration. We have a
responsibility, and I know you care about that mission. So,
appreciate that and appreciate you being here.
Chairman Moran. Thank you, Senator. Dr. O'Toole, let me
just ask a quick question. It's a bit outside, I think, the
realm, but there's been a lot of conversation about staffing at
the VA from my colleagues and I, and I want to highlight the
importance of community care. The MISSION Act, in the way I
look at things, is a way that in fact choice came about in an
effort to help further staff the VA, and particularly in mental
health, where there's a shortage of mental health providers
everywhere. It would be comforting to me for you to confirm the
value of the MISSION Act and community care.
Dr. O'Toole. Thank you, Senator. And absolutely, community
care provided in settings that are not VA for our veterans is
very much part and parcel of the package of care that we
provide, and needs to be considered because the bottom line is
we want our veterans to get care.
Chairman Moran. Thank you. We'll dismiss Dr. O'Toole and
Mr. Fisher. Thank you for your testimony. Thank you for your
service to veterans, and for your appearance here today. And
we'll call the second panel to the table.
Testifying on today's second panel is Jim Lorraine, the
President and Chief Executive Officer of America's Warrior
Partnership. Gilly Cantor, Director of Evaluation and Capacity
Building, D'Aniello--there's no reason for me to make a fool of
myself one more time, so, thank you for being here. She is with
the Institute for Veterans and Military Families, Syracuse
University.
Steffen Crow, Staff Sergeant Parker Gordon Fox Program
Manager, Oklahoma Veterans United, Heather Barr, U.S. Marine
Corps veteran, assisted by a grantee organization, and Austin
Lambright, U.S. Marine Corps, a veterans assisted by a grantee
organization, and Lindsay Church, Executive Director and co-
founder, Minority Veterans of America. Thank you-all for being
here. And Mr. Lorraine, let's begin with you.
PANEL II
----------
STATEMENT OF JIM LORRAINE, PRESIDENT AND CEO, AMERICA'S WARRIOR
PARTNERSHIP
Mr. Lorraine. Chairman Moran, Ranking Member Blumenthal,
and esteemed Members of the Committee, thank you for the
opportunity to testify today on behalf of America's Warrior
Partnership.
You're considering four important bills that impact the
well-being of all veterans. I'll focus on the impact of the
Staff Sergeant Parker Gordon Fox Suicide Prevention Grant
Program, commonly known as the Fox Grant. At AWP, we view
suicide and deaths of despair prevention, not as a single
program, but as an outcome of veterans restored sense of
purpose and improved quality of life. Our model is rooted in
proactive outreach and engagement, trust building, and
sustained relationships, which we do at scale. We strive to
forge these connections before the crisis begins. That's where
the Fox Grant has been essential.
Of the 545 veterans we've screened who reported suicide
risk, 94 percent were not initially seeking mental health
support. They face challenges such as economic insecurity,
navigating the VA system, and fractured personal relationships.
The importance of asking the right questions early and having
someone listen cannot be overstated. Thanks to the Fox Grant,
we've interviewed or we've intervened early, connected veterans
to local resources and remained a consistent presence.
Just halfway through this grant year, AWP's screened 1,300
veterans, with 10.8 percent disclosing suicide risk. Since the
grant's inception, that number has totaled 2,100, with 25
percent of the people that are veterans that we talked with and
screened, disclosing some level of risk. These are not just
statistics. They are lives saved because someone cared enough
to ask and listen. However, there is room for improvement.
While the HOPE Act makes great strides, outreach must be
reestablished as the program's singular focus. We must get
upstream and follow the data of who is at greatest risk. The
who is so important. Our study, Operation Deep Dive in
partnership with Duke University School of Medicine allows us
to follow the data of the ``who'' is most at risk based on the
community where they live in.
The pathway from community identification to VA must be
more transparent, quicker, and less burdensome. Congress should
require the VA to establish a simplified intake process for
veterans already screened by grantees, one that avoids
redundant questions in respects to the veteran's time in a
critical situation.
We also support codifying the emergent suicide care
section. In many cases, AWP uses the 988 Crisis Line for
veterans for immediate need. Formalizing this connection
enhances safety and saves lives.
Accountability is another key. AWP holds itself to the
highest standards; routine audits, transparent reporting, and a
sharp focus on Title 38 beneficiaries. Title 38 funding must
focus on veterans and their families. We recommend that
Congress require verifiable metrics from all grantees, and a
regular reporting to ensure the taxpayer's trust is upheld, and
that those not meeting the standard are reevaluated.
We support the use of the Columbia Protocol as the sole
requirement screening tool. The current requirement of multiple
follow up assessments is overwhelming and deters engagement.
Let's reduce bureaucracy and focus on care. We strongly support
the provisions in the HOPE Act, and that allow the Fox Grant
funds to be used for transportation. We do a survey every year,
and the lack of transportation is the top barrier veterans
face, especially when those are in crisis.
Grantee funding is another consideration. AWP could double
its outreach efforts if the funding ceiling was increased to
$1.5 million. While this isn't necessary for every grantee,
organizations that have proven outcomes and capacity should be
empowered to do more provided the metrics and reporting
structure are in place.
Regarding the BRAVE Act, we support a deeper analysis of
veteran suicide and its risks factors. Still, discussions also
must address the role of traumatic brain injury, a silent
killer we are not doing enough to confront. Finally, we support
the Every State Counts Act to expand the Fox Grant access to
underserved states. In the meantime, AWP stands ready with our
national network to assist when necessary.
Members of the Committee, thank you for your continued
leadership, and support your efforts to saving lives. At AWP,
we stand ready to keep doing our part to serve, to listen, and
to ensure the vets are known. Together, we can do better.
[The prepared statement of Mr. Lorraine appears on page 67
of the Appendix.]
Chairman Moran. Mr. Lorraine, thank you. Ms. Cantor.
STATEMENT OF GILLY CANTOR, MPA, DIRECTOR OF EVALUATION AND
CAPACITY BUILDING, D'ANIELLO INSTITUTE FOR VETERANS AND
MILITARY FAMILIES (IVMF), SYRACUSE UNIVERSITY
Ms. Cantor. Mr. Chairman, Ranking Member, Members of the
Committee, thank you for the opportunity to offer testimony on
behalf of the D'Aniello Institute for Veterans and Military
Families at Syracuse University.
The IVMF perspective is rooted in research, along with more
than a decade of experience working with 26 communities across
the country. These communities are connected by a common goal,
improving coordination between organizations that provide
clinical and non-clinical care. So, together, we can help
veterans thrive.
So, what have we learned? As we know, the rate of suicide
among veterans remains too high, higher than among civilians.
Data has also shown that each additional non-clinical stressor,
such as financial and housing instability, is linked to
increases in the likelihood of suicidal ideation. States,
counties, and community-based organizations can often best
address these needs.
In a study we conducted with the VA, we found a majority of
veterans served by our partners were also enrolled in VA
healthcare. For these veterans, their stressors were most
effectively addressed when communities and VA medical centers
worked together. At the same time, the study demonstrated that
communities are in fact reaching many veterans not connected to
VA healthcare, a group that represents over half the veterans
that died by suicide.
The Fox Grants Program recognizes and leverages the role
communities play in suicide prevention. It creates new
formalized avenues into clinical care, and it supplements that
care with wraparound services so that we can address root
causes, at the same time. We are grateful to this Committee for
looking upstream as part of the Hannon Act to invest in this
evidence-based coordinated approach.
The reauthorization currently under consideration is
therefore critically important. Since the program's launch, the
IVMF has offered ongoing support for 11 of our partners who
have been awarded these grants. They have stress-tested this
program and identified its strengths and challenges. While
there's always more that can be done, many of the proposed
changes directly respond to their feedback.
There are three main target areas that I'd like to address
today. First, program coverage and expansion. Increased
funding, both overall and for administrative and incidental
costs, will enable grantees to scale and reach more veterans in
a way that builds trust in non-clinical settings. These
individualized peer-based approaches to outreach are both
backed by evidence and just common sense.
A simple gathering over pizza or coffee can open the door
for a veteran to reach out for help. Allowing reimbursement for
transportation and ride-shares to appointments will also be
beneficial. Whenever possible, the cost of an Uber ride should
not be the barrier that stops a veteran from getting the
critical care that might save their life.
Second, screening and eligibility. While some of our
partners support the Columbia Protocol as the main required
screening, others would prefer more nuance on when and how it's
used. The proposed training on the tool will mitigate some of
these difficulties. But overall, we hope that the intake
process can balance evidence-based assessments with burden
considerations for both veterans and program staff.
And third, VA collaboration and compliance. Most
importantly, we strongly support the provisions designed to
hold the VA accountable for their role in making this program
successful. Our partners have routinely experienced
inconsistencies in awareness and compliance by their local VA
medical centers. Once a veteran has been deemed eligible for
the program, VA enrollment must be streamlined with a dedicated
process such as an automatic high priority group assignment.
We also appreciate the proposal to expand emergent suicide
care coverage if the VA is not responsive. This provision will
ensure grantees can effectively help veterans get the care they
need.
In conclusion, the evidence for reauthorizing the Fox
Grants Program is clear, and the proposed legislation aligns
with many improvements sought by our partners. We deeply
appreciate the Committee's steadfast commitment to increasing
our investment in prevention so that this critical program can
reach more veterans before they're in crisis. Thank you.
[The prepared statement of Ms. Cantor appears on page 75 of
the Appendix.]
Chairman Moran. Thank you. Steffen Crow.
STATEMENT OF STEFFEN CROW, SSG PARKER GORDON FOX GRANT PROGRAM
MANAGER, OKLAHOMA VETERANS UNITED
Chairman, Ranking Member, and Members of the Committee,
thank you for the opportunity to testify today. My name is
Steffen Crow, a retired gunnery sergeant of Marines with tours
in Afghanistan, Asia, Africa, Europe, and Central America. I
now serve as the Program Manager for the Staff Sergeant Parker
Fox Suicide Prevention Grant at Oklahoma Veterans United.
Our program exists to prevent suicide among our Nation's
veterans by removing barriers to care. The Fox Grant was
created precisely because the system was not working for too
many veterans. Through the Fox Grant, OKVU has built a
statewide veteran-centric approach that reaches across rural
and urban communities. Over the past three years, we have
engaged over 5,000 veterans and supported or led more than 800
outreach events.
We have formal collaborations with major veteran employers
across the state, consistent engagement at Fort Sill, and we
hosted the first multi-grantee veterans stand down in the
country alongside the Cherokee and Choctaw Nations, drawing
veterans from across Oklahoma and five other states.
At the core of our work is sustained trust and empowerment.
Veterans who succeed often ask, how can they help others,
proving that when we lift one, they turn to lift many. However,
we face significant barriers. Chief among them, is the required
use of the Columbia screening tool. Though well-intentioned, it
often drives veterans away.
At a recent grantee conference, it was reported by one
grantee that 13 veterans died by suicide after either refusing
to complete the Columbia or answering no to every question
despite the clear need these veterans were in. Worse, grantees
are instructed not to track veterans deemed ineligible for the
program, which creates a very dangerous survivorship bias.
Another persistent challenge is the absence of a national
referral process between grantees and the VA. No two facilities
operate the same way, and even within a single state, these can
differ dramatically. Local VA staff often defer to central
office guidance, which is not materialized into actionable
support.
Veterans like Parker found solace in physical activity and
music. Yet, grantees are restricted from funding low-cost gym
memberships or instruments despite VA's own research supporting
these therapies. VA guidance currently prevents us from
delivering the very solutions their studies endorse.
Transportation remains another major barrier. Guidance
recommends Uber and Lyft. Yet, these services are non-existent
in rural communities, and these are the areas that we primarily
serve.
We currently need a national community of practice to unify
efforts, and I can say Oklahoma Veterans United has already
developed internal models for cross-county collaboration, and
is ready to lead this initiative across the Nation. Another
great benefit that would be a good add to this program would be
the ability for grantees to hire an LPC or an LCSW to be that
gap fill whenever there is a wait time for veterans to get care
at their local VAs.
We think that in a 2-month period, four to six sessions
with an LPC or LCSW in our direct team could be a very critical
gap fill that would get someone into VA, and let them have the
patience to wait for those appointments to materialize.
In the military, I was taught, if you see something, say
something. For three years, we have raised these concerns to VA
leadership without meaningful action. Veterans mistrust of the
VA did not happen overnight, and winning it back requires a
real tangible change. If the rate of 17.6 veteran suicides per
day is accurate, then we have lost over 16,000 veterans since
this grant started. Yet when a veteran stabilizes, the first
thing they ask is, ``How can I pay it forward?'' Veterans want
to be the champions of the system, and if the system works for
them, I guarantee they will be.
The VA has good intentions, but they lack timely execution
and consistent communication. We believe that with clear
guidance, national coordination, and policies grounded in real-
world realities, we can save lives and help veterans live lives
worth living. We believe Parker's legacy must guide the future
of this program. If he had access to these tools we propose, he
might have remained with us longer. Let us not waste the
opportunity to honor him through this meaningful change.
And thank you for your time, and your commitment to our
Nation's heroes.
[The prepared statement of Mr. Crow appears on page 80 of
the Appendix.]
Chairman Moran. Thank you. Ms. Barr.
STATEMENT OF HEATHER BARR,
U.S. MARINE CORPS VETERAN
Ms. Barr. Good afternoon, Mr. Chairman, good afternoon,
Members of the Committee, thank you for this opportunity to
share my story about this program and how it helped.
My name is Heather Barr. I was a sergeant in the Marine
Corps, served for just over five years, did two deployments;
one to the Middle East, one to the Indo-Pacific. I was
honorably discharged from the Marine Corps in September 2023. I
went on terminal leave a month before that. So, this was two
months post-deployment. Turned from a deployment next week,
transition seminar, and then was out in two months.
I had no plan, no idea what I was supposed to do. Just was
moved back into my family's home in South Carolina. Felt like I
was back at square one, basically. Living with my mother, no
prospects for the future, and didn't know what I was doing.
I ended up reaching out to the local Vet Center to try to
find counseling and a therapist for mental struggles that hit
me during deployment, and then just were expedited and grown by
transitioning out of the Marine Corps. They then pointed me to
the Upstate Warrior Solutions who are in Greenville, veterans'
organization who are partially funded by the Staff Sergeant Fox
Program.
While I was there, I was screened, found at risk, and they
set me up for success, basically. Made sure I was continuing to
go to therapy and things like that at the Vet Center. Were able
to actually provide a way for me to get a job. Showed me ways
to do that. That was the first employment out of the military,
thanks to Upstate Warrior Solutions.
Part of the big change in transitioning for me was being
completely disconnected from the military lifestyle and people
I had been around for the past five-plus years. Coming back
from a deployment, trying to transition to just normal military
life and then to civilian is what put me in just a tailspin. It
felt like I was just drowning, and was pointless, and
purposeless without any guidance.
So, Upstate Warrior Solutions Staff Sergeant Fox Program
helped provide that to me. They helped me get a job, made sure
that I was engaging with veterans in community where I could
actually relate to, and I could realize that I wasn't actually
completely alone, and there were other people who actually
understood what I had was going through or had been through.
So, I was extremely, extremely grateful for that.
My scenario is an ideal scenario. My family was available
for me to move back in with. Financial struggles were there,
but thankfully, within a few months of getting out of the
military, I was set up with Upstate Warrior Solutions in the
program.
That is not always the case. I know many people who have
gotten out, they do not have families to go back to. They have
either poor relationships, or they're just non-existent. So,
mine is basically the best-case scenario. I had family to go
back to, but not all do. And regardless of if you're an
enlisted officer, female or male, you have dependents, don't
have dependents, all these things add up. Both financial
difficulties, and then some have PTSD, anxiety, stress-related
things that just compound on the already trying time that
transitioning out of the military is.
And the Upstate Warrior Solutions and the Staff Sergeant
Fox Program was definitely a life ring that I was very, very
fortunate to be provided. It did take a lot of searching, but I
was very, very fortunate to be thrown that life ring that not
all people are.
I finished--completed the Staff Sergeant Fox Program in
August 2024. When I left the state, they reached out to me
multiple times, even though I was out of the program, actually
showing they cared, dependent or not, if I was relying on them
for anything, they wanted to make sure that I was taken care of
as a veteran. I'm very, very grateful for that.
Since 2022, UWS has also completed the Staff Sergeant Fox
Program with 20 other veterans, and currently have 164 active
members within their program. And it's just a great outreach
for those who have struggles finding other outlets, or just
need help when they need. So, thank you. I appreciate.
[The prepared statement of Ms. Barr appears on page 102 of
the Appendix.]
Chairman Moran. Heather, thank you for your service to our
country, and thank you for your testimony. Austin.
STATEMENT OF AUSTIN LAMBRIGHT,
U.S. MARINE CORPS VETERAN
Mr. Lambright. Good afternoon, Chairman Moran, and Members
of the Committee. My name is Austin Lambright. I just want to
start by thanking everyone for the opportunity to be here. I'm
deeply humbled not only for the opportunity to serve my
country, the greatest country in the world, but also to be here
and speak on behalf of the veteran community, and offer some
insight on support based on my experiences.
I'm here from South Carolina. In 2006, at the age of 18, I
enlisted in the Marine Corps to serve as an infantry machine
gunner. I did two deployments; to Iraq in 2007, and then 2008
and 2009, and I was honorably discharged from the Marine Corps
in 2010 at the rank of corporal as a squad leader.
During my time in the Marine Corps, I completely engulfed
myself with the mentality of going to combat during the peak of
two wars in the harshest conditions possible that Marines are
sent to. I earned my Combat Action Ribbon when I was 19 years
old in Ramadi. I was just a kid and at the time, I felt about
as close to invincible as I could possibly feel. Although
foolish, that was my feeling.
I had a purpose and a driven focus for my life with the
support from loved ones at home that projected me into being a
successful Marine and squad leader on my second deployment.
Both of my deployments were to combat zones. I'm very fortunate
to have the family that I have at home. Very hardworking
father. He's a deacon at church and a mother that's as close to
an angel as any human that I've ever met.
When I transitioned out of the Marine Corps in 2010, I
moved back to my hometown in Easley, South Carolina, bought my
first house, and I was somewhat of a reckless wrecking ball at
first. I was mad at the world from my experiences, the outcomes
of how the war played out, and just the current state of
Americans in my generation.
In those 18 months' time from my EAS, I had been arrested
three times for driving under the influence. I went to jail a
handful of times on violent-related charges, and I had an
unexpected child who is now 12 years old; my son. During this
time of those 18 months, one of my Marines had committed
suicide. The first experience that I had with a Marine of mine
committing suicide actually happened on my second deployment
where Lance Corporal Robert Ulmer took his own life in our
living quarters.
So, during this time when I was struggling really bad with
some of the decisions that I was making, that 17.6 per day
suicide number really started creeping in the back of my mind
and became an option. In fact, five guys, five Marines that I
deployed with to Iraq since we've gotten out, have committed
suicide to this date.
Moving forward, you know, I said I had an unexpected child.
So, my child, Jackson, he gave me a new purpose, and made
suicide feel like it just couldn't be an option because I would
leave my son alone in this world. My son's birth was a turning
point in my life, and it's when I became connected with Upstate
Warrior Solutions.
I began reaching out for help to better myself because I
wanted to be the best father I could for my son. I quickly made
common connections with other veterans at UWS, for example,
Nate, back here, and another gentleman named Scott Hicks. Both
of them I had strong connection to because of similar
experiences, and they had been through some of the dark tunnels
that I was going through at the time. However, they had made it
through and were living very successful lives, good fathers,
and they had something that I really wanted.
I found a commonality and mindset. I felt as if I was not
just alienated in the general public. I was able to be real
about my problems with these gentlemen and gain advice from
them who have experiences similar to mine, but overcome the
same struggles. I learned that I'm not invincible by any means.
My choices and decisions moving forward directly influenced my
way of life and leadership for my son.
This was the key period in my journey that really turned
the course positive. I would've been suicidal or landed myself
in prison or the grave. Surely enough, had I continued down the
road I was on before my son was born, and I got connected with
UWS. As time progressed, I went through a divorce, job changes
that really got me in the dumps at times. And these times, I
would reach out to UWS for support to keep my head on straight.
I was invited to and participated in golf tournaments, dinners,
hikes, other events that gave me a sense of positive community
that I could take a pride in being a part of.
In October 2022, Upstate Warrior Solutions helped me get
connected to the Vet Center for mental health counseling. I was
in one of my darkest ruts at the time. I was suicidal for
months. And in February 2023, I reached out to Upstate Warrior
Solutions for help again, and agreed to participate in the
Staff Sergeant Fox Program.
As a Staff Sergeant Fox participant, I received inpatient
and outpatient care from both VA facilities and non-VA. I
received care for PTSD and alcohol abuse, with a lot of time
and focus spent on post-combat stress and my personal
experiences. I also participated in Upstate Warrior Solutions's
recreational programs, and received peer support from them.
When I went to get inpatient mental health therapy, I missed my
son's 10th birthday. However, the way I explained it to my son
and the mentality I had was, I can either miss his 10th
birthday, or I can miss all of them.
So, I took that opportunity and it was one of the best
things I ever did. I also want to note that I've always claimed
to be a Christian man since I was saved at 12 years old.
However, I never truly followed the lifestyle and choices that
Jesus had directed me by his actions and words in the Bible.
Last year, in April 2024, I was rebaptized in the presence of
my son, my mother and father, and my life drastically changed.
Seeking God's purpose for my life and putting all my focus
and energy on that cause for myself has been life changing for
the better. The care and help that I received through the Staff
Sergeant Fox Program saved my life. I had been out of the
Marine Corps for 12 years before I asked for help. It took me
12 years to get to rock bottom. And at rock bottom was the
untouched trauma that I experienced while I was in the Marine
Corps, and the losses I experienced since that time as well.
Loss of veteran friends, loss of marriage, loss of purpose.
For over two years, my mental health and well-being were
made a priority by the VA, Upstate Warrior Solutions, and my
community, but most importantly, by me. I exited the Staff
Sergeant Fox Program in April of this year. When families,
friends, local organizations, and fellow veterans actively
participate in creating a supportive environment, it helps
build a strong network of care and understanding. This sense of
connection and shared responsibility makes a profound
difference in the lives of veterans, reminding veterans that
they're not alone, and that our lives really do matter.
Completing the program gave me the tools not only to take
better care of myself, but to be there for my brothers and
sisters in arms. I'm proud to have taken that step because
asking for help is a strength, not a weakness. I hope and pray
that this program, the Staff Sergeant Fox program, will not
only be continued, but also expanded to include other avenues
of resources like legal assistance, financial literacy, that
will also include veterans with eligibility limitations.
Thank you for your time, and God bless.
[The prepared statement of Mr. Lambright appears on page
104 of the Appendix.]
Chairman Moran. Thank you for your presence here today,
your ability to tell us your story, and thank you for your
service to our country. Thank you.
I'm going to go vote. I'm going to call on Lindsay Church,
and then I'm going to yield my time to Senator Tuberville, and
then Senator Blumenthal will chair the meeting until I return
from the vote. So, Lindsay Church.
STATEMENT OF LINDSAY CHURCH, EXECUTIVE DIRECTOR AND CO-FOUNDER,
MINORITY VETERANS OF AMERICA
Ms. Church. Thank you. Chairman Moran, Ranking Member
Blumenthal, and Members of the Committee, thank you for the
opportunity to testify today.
My name is Lindsay Church, and I'm the Executive Director
of Minority Veterans of America. Our organization serves
veterans who have been historically excluded and underserved;
women, people of color, LGBTQ+ individuals, religious
minorities, folks with disabilities, and those living in rural
communities. We're not side stories in American military
service, we're central to it. Yet, when we return home, we face
systems not designed with us in mind.
Today's hearing acknowledges a crisis many of us have been
warning about for years; the growing distance between service
and survival, especially for those at the margins of
visibility. Since October of last year, we know of at least 13
veterans who died by suicide on VA property. Another 13,
transgender, non-binary, and intersex veterans have attempted
suicide compared to just one last year. If this rate continues,
we're on pace to exceed the highest number of veteran suicides
recorded on VA campuses in a single year.
These aren't isolated incidents. They're a reflection of a
system that is not only broken, but actively weakened by policy
choices that erase the unique experiences and barriers faced by
our Nation's most vulnerable veterans. Instead of fostering
trust, transparency, and targeted services, we've watched as
this administration has taken steps that endanger the veterans
most in need.
In the past 100 days, VA rescinded VHA Directive 1341,
eliminating protections for respectful, clinically informed
care for transgender and intersex veterans, as well as access
to crucial life-saving healthcare. Critical language,
acknowledging race, gender, sexual orientation, disability
status, and accessibility was stripped from the forthcoming
congressionally mandated report of the Outdoor Recreation Task
Force for Veterans, which we sit on, effectively erasing
marginalized veterans from national policy recommendations.
Outreach materials, acknowledging LGBTQ+, veterans, women,
veterans of color, and disabled veterans have been sanitized or
eliminated altogether. Efforts to suppress data collection on
sexual orientation, gender identity, race and ethnicity have
intensified making disparities easier to ignore and harder to
address. These aren't bureaucratic oversights. They're
deliberate choices with deadly consequences.
When we erase identity, we erase risk. When we erase risk,
we erase responsibility. When we erase responsibility, veterans
die. We confront these realities every day. Not in theory, but
in lived experience. That's why our organization provides
transitional housing for LGBTQ+ veterans experiencing
homelessness. We deliver flexible financial assistance to
veterans in crisis. We train minority veteran leaders and
providers in culturally competent care, and we create spaces,
indoors and outdoors, where veterans can heal without hiding
who they are.
These interventions are suicide prevention. We've learned
that connection saves lives. That trust saves lives. That
access to mental care, healthcare that affirms identity rather
than denying it, saves lives. That's why the bills before you
today matter. They offer opportunities to not just bridge gaps,
but repair the foundation of trust that's been so badly
damaged.
That opportunity will be lost if we fail to embed equity at
every step. We must prioritize equity in grant funding, not as
a bonus, but as a core requirement. Mandate cultural competency
training for all providers serving veterans. Require
disaggregated data collection so we can identify and address
the disparities that put minority veterans at greatest risk.
Invest in partnerships with trusted community-based
organizations already doing this work.
Outreach without intention isn't outreach, it's optics.
Access without safety isn't an access, it's abandonment. And
visibility without action isn't progress, it's betrayal. We're
not simply facing an outreach problem when veterans drive onto
VA campuses and take their lives in their cars, or when
transgender veterans struggle to walk into VA clinics because
they're afraid to reveal their identities. It's not just an
outreach problem when women veterans report being re-
traumatized by providers who don't understand gender-based
trauma.
We must acknowledge it that we're facing a systems design
failure, one worsened by political decisions to erase the
identities most in need of protection. We cannot afford half
measures or sanitize language that hides disparities behind
one-size-fits-all solutions. We cannot afford to lose another
life to silence, indifference, or fear. This isn't just a
matter of mental health policy, it's a test of whether our
government is willing to see and serve all who have served.
Veterans deserve more than visibility. We deserve systems
that are worthy of our trust, our lives, and our sacrifices.
This is our chance, right now, to build these systems. To not
only acknowledge veterans like me and those sitting behind me,
but to fight for us regardless of our identities. Not with
empty promises, but with bold action, bold enough to save our
lives.
Thank you for the opportunity to testify. I look forward to
your questions.
[The prepared statement of Ms. Church appears on page 106
of the Appendix.]
Senator Blumenthal [presiding]. Thank you. Senator
Tuberville.
HON. TOMMY TUBERVILLE,
U.S. SENATOR FROM ALABAMA
Senator Tuberville. Thanks Senator. Good morning everybody.
Thanks for being here and thanks for those of you that have
served this great country. Thanks for your service.
Since I've been on this Committee now going on five years,
we have not improved prevention of suicides. Matter of fact, in
a lot of areas it's gotten worse. I know in my State of
Alabama, you know, you can throw all the money at it you want,
but at the end of the day, it's about attitude. It's about the
people that work in these hospitals and these care units that
show care and humility for the veteran.
I've had friends that have committed suicide. I've had
friends that have almost committed suicide. It's a sad state of
affairs. But again, I think it's more about people. We have to
have people that's going to do the right thing. Veterans,
there's no area that we need to concentrate more in our
country, other than obviously our economy and things that are
going on, but the care of the people that have put their life
on the line for our, for our country.
Mr. Lorraine, opportunity for oversight on these grants. Do
we have enough oversight, in your eyes, for the grants that
we're putting out of the Fox Grants?
Mr. Lorraine. Thank you, Senator. I think if there is
oversight, it's not transparent. We do participate. America's
Warrior Partnership participates in all the meetings that the
VA holds. We provide our reports, we just don't know how we
rack up against others, and we don't understand where we are,
you know, how we can improve what we're doing.
So, if the outcome of oversight is to change the process
and improve the process, we're seeing it a little bit. The
technology system that the VA was using previously has improved
greatly, but, I would say it's not exceeding expectations and
oversight.
Senator Tuberville. How can this VA and this administration
stop the bad actors from taking these grants away from people
who actually need these grants?
Mr. Lorraine. Well, sir, you know, there's an example of a
grantee in the Northeast who was prosecuted for taking $50,000
from the grant. I think that type of oversight is needed. We
just went through our audit. We did very well with it. But I
think more audits--I hate to say that, but I mean--I think more
audits for organizations with clear guidelines that don't just
look at how many hours are you spending doing the work, but
what are the outcomes of the work that you're doing?
Senator Tuberville. Yes. And the data that we get, a lot of
it is not accurate. How can we overcome? How can we get better
if we don't get accurate data? Are you seeing, any of you, are
you seeing a better use of data that we're accumulating? Ms.
Cantor? Anybody?
Ms. Cantor. Thank you. I think that the types of measures
that we've historically looked at in similar models, but not
necessarily only models connecting people to VA care, but ones
making referrals to organizations for services, have also
included things like timeliness and accuracy of those referrals
and whether they were referred for the right thing. And then if
they were treated successfully.
So, to me, it's on a continuum of how many people are you
reaching through your outreach, converting to how many people
are you screening, converting to how many people successfully
get to VA, converting to how successful is their treatment? So,
it's really following that path. I think it's possible with a
lot of the systems that many of us have used. I just think it's
not, to Jim's point, as transparent as it could be about what
information is available, particularly as a nongrantee, we know
very little about how things are going.
Senator Tuberville. Yes. I'll ask you this question. Do you
think merit-based system of people that are showing better
data, better accomplishments, you know, more positive
outfluences and influences, do you think they should get more
grants?
Ms. Cantor. You're asking that to a seasoned program
evaluator. So, I'm going to say absolutely, yes. And I think
some of the provisions account for that in the new legislation.
Allowing for potential additional funds to people who, like
Jim, who have demonstrated good performance or like Steffen's
team that could serve more with more funds.
Senator Tuberville. You know, the grant program started
what in 2020, set to expire this fiscal year if we don't re-up
it. Any of you want to answer this question? Are there any
other suicide methods that we've seen? I'll ask the veterans.
Any other suicide methods that we've seen to help to prevent
suicide? Anything that you'd like to suggest in your
experiences? Any of you want to answer anything that you've
seen?
I have personally offered up to this Committee about
hyperbaric chambers. People say that helps in some areas with
PTSD, some people say they don't. Well who cares. If they help
anybody, if they help one person, we should use them. Anybody
want answer that question through experience?
Mr. Lambright. There are a couple of non-conventional ways
that I've experienced personally that have helped. I don't know
if you're familiar with DMT or psychedelics, but those helped
me quite a bit using those, personally, just to be able to get
past the trauma and be able to--you know, it gives you a
supernatural way to kind of look at yourself and get over the
things that haunt you so bad. I think those work in general. I
think anybody could use those to their advantage.
Senator Tuberville. Were they provided by the VA?
Mr. Lambright. No, sir. I don't think it was an option.
Senator Tuberville. Yes, probably not.
Mr. Lambright. While I'm here, I wanted to mention one
thing. You know, there's been multiple comments from Senator
Moran and others about the VA and funding, and the budget cuts
due to the amount of funding. I just want to give you one
example from me personally. When I went to Willingway Hospital
that the VA sent me to in Statesboro, Georgia, I saw the bill
that ended up getting sent to the VA from Willingway Hospital.
It was $90,000 for a 30-day inpatient program. The exact same
person who got the exact same care, but not billed through the
VA, instead billed through their insurance, was $21,500.
So, I think there's a lot of irresponsible, maybe invoicing
or spending. That's just one example. You know, if 50 guys go
to the same program, you're talking about a substantial amount
of money. So, there's--I feel like just the audits, like we
were just talking about that was brought up, I think that'd be
a really good situation just to mitigate all the unnecessary
spending or maybe careless spending that that goes on. That way
there's more funds available for veterans that need and could
use it.
Senator Tuberville. Yes, I think our VA Secretary now is on
top of that. We've got to stop the fraud and the theft. We
don't do that. We don't have money for people that actually
deserve that. Thank you, Senator.
Senator Blumenthal. Thanks Senator. I have a few questions
for Ms. Barr and Mr. Lambright. Both of you as Marine Corps
veterans went to Upstate Warrior Solutions. You didn't call the
VA directly. You didn't call the Veterans Crisis Line. Could
you talk about why you went there and not to the VA directly?
Ms. Barr. Thank you, Senator Blumenthal. So, I, myself,
actually searched through the VA first to reach out to try to
find any type of mental health, anything. Something I had been
trying to get into through the VA while I was in. Just try to
get it worked out prior to getting out, and kept getting phone
numbers for people who were no longer in service, or no longer
connected to the VA, or just stonewalled over and over again
through them.
I thankfully found a Vet Center in town, and they were
actually the ones who pointed me to Upstate Warrior Solutions.
And the Upstate Warrior Solutions were the ones to keep working
through that. I think part of it is partially just due to, like
in our area there in Greenville, South Carolina, there's a very
large veterans presence. And the VA does not reach out very
much nor does it announce its capabilities as often. It's
definitely very much up to the veteran to try to find
resources.
Upstate Warrior Solutions is one that presents itself and
puts itself out there more so than the VA and the Vet Centers
do. So, I think that's most likely the reason most people have
found Upstate Warrior Solutions before the VA, just because
they're out there putting themselves out to help and present
themselves instead of making it a chore or an extreme task to
try to make their way through the VA process of getting help,
so.
Senator Blumenthal. Thank you. Mr. Lambright?
Mr. Lambright. Thank you for your question, Senator
Blumenthal. I think what you had asked was why did I go to
Upstate Warrior Solutions and not the VA. I had in fact went to
the VA first. In South Carolina, there's multiple outpatient
clinics, but there is one main VA hospital in Columbia where
the state capital is.
So, when I was first initially struggling with suicide, I
went through divorce, and I drove myself to Columbia,
unbeknownst to my family or anybody, and checked myself in
where they have a mental health facility there in Columbia. So,
they basically took my clothes, put me in a gown and some foam
slippers. And for five days I played Scrabble, and it was
basically a waste of time.
When I left, I was more upset and in a worse place than
when I got there. I discussed that with Upstate Warrior
Solutions, which provided me the insight and the direction to
use another facility, like a civilian facility if the VA can
direct me there, where I can get the care that I needed.
So, I did in fact, go to the VA first. However, I had a
relationship with Nate and with Scott Hicks, that I mentioned,
and they had experience with other veterans that were in a
similar position that had gotten help from a civilian entity.
So, I chose that route instead, and honestly, it was the best
decision I ever made, and I owe my life to these guys.
Senator Blumenthal. Thank you. Thank you both for your
service and for being here today. Mr. Lorraine, have you seen
evidence yet of the VA cuts in staffing so far as it affects
veterans?
Mr. Lorraine. No, sir, we haven't. We haven't seen any.
Senator Blumenthal. How about other members of the panel?
Have you seen--and when I say evidence of the cuts, I don't
mean only people leaving, I mean also the sense of anxiety,
worry, and so forth.
Mr. Crow. I would say I have heard that just in phone
conversations, following up, trying to build more program
agreeances between us and VA, and just in general asking. I
mean, they're our peers, we care about them as well, so we ask
how they're doing and what's going on. And there's definitely
some mixed anxieties and some fears. We just haven't seen
personally any of that come to fruition yet.
Senator Blumenthal. Have you heard veterans discuss it?
Mr. Crow. It's definitely asked about, sir. I mean,
veterans that come into our programs or that we talk to at
events. They are curious. It's in the news, so they ask about
it. With us just being a grantee, I don't really have the
expertise to tell them anything. I may mainly just direct them
over to like public affairs offices and things like that to
field those questions. But it's discussed.
Ms. Church. Can I jump in, Chairman, or recommend--excuse
me, Ranking Member?
Senator Blumenthal. Thank you.
Ms. Church. First, and anecdotally, you are seeing that the
centralized services that VA relies on for things like their
operator services, you can call--in order to reach the VA
providers, you have to call them main central, like, operator.
Took me seven and a half minutes to get to the operator the
other day. It normally takes 12 seconds. Just sitting there
waiting, on hold, trying to get a hold of anybody to get you to
the dental clinic. You are trying, because that's the only way
that you can call the actual hospital.
You have providers who are worried because their schedulers
are getting cut and are getting riffed. You have providers who
are worried because anybody that helps support them to deliver
the services are starting to get those. While the providers
themselves might be exempt, the people that support them, and
the support staff, and the schedule of the billing, all of
those things are now landing on the provider's desk.
And to the point that was made earlier today, VA does not
pay well enough to make them do three or four jobs in support
of delivering these services. So, there's a ton of anxiety, a
lot of frustrations, people making impossible decisions about
whether or not to take the deferred resignation, to take the
early retirement, to take it and/or to chance whether or not
they're going to have a job in a few months.
So, there's a lot of anxiety, which to the point earlier,
talking about VA employees being veterans themselves, you've
got a dual crisis happening here. You have veterans who in our
community most of us are worried about what's going to happen
with the future of this agency that provides most of our
healthcare.
Then you turn to the actual side of people who work for VA.
They're experiencing the mental health crisis of the VA maybe
being dismantled, but also, they have to work for the agency,
worry about their jobs. Many of them work in billets that are
now outlawed in the agency themselves. You've got a surging
crisis underneath the underbelly of the veteran community that
we are going to see in next year's suicide report.
Senator Blumenthal. Thank you. I want to thank all of you
for being here today. The Chairman, Senator Moran, has another
obligation, so, I'm going to finish the hearing. Thank you for
your participation. Been very meaningful and important to the
Committee.
The hearing record will remain open for five legislative
days should any Committee members want to submit additional
statements or questions for the record. And I'm going to ask
all of our witnesses if there are any questions, to please
respond to them.
And once again, thank you all for being here. This hearing
is adjourned. Thank you.
[Whereupon, at 12:54 p.m., the hearing was adjourned.]
A P P E N D I X
Prepared Statements
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Questions for the Record
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Submissions for the Record
(From Minority Veterans of America)
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Statements for the Record
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
[all]