    [Senate Hearing 119-73]
    [From the U.S. Government Publishing Office]

                                                             S. Hrg. 119-73

                           VETERANS AT THE FOREFRONT:
                     SECRETARY COLLINS ON THE FUTURE AT VA
    =======================================================================

                                    HEARING

                                   BEFORE THE

                         COMMITTEE ON VETERANS' AFFAIRS
                              UNITED STATES SENATE

                        ONE HUNDRED NINETEENTH CONGRESS

                                 FIRST SESSION

                                   __________

                                  MAY 6, 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
    60-335 PDF                  WASHINGTON : 2026
    -----------------------------------------------------------------------------------

                     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

                                  ----------

                                  May 6, 2025

                                    SENATORS

                                                                       Page
    Hon. Jerry Moran, Chairman, U.S. Senator from Kansas.............     1
    Hon. Richard Blumenthal, Ranking Member, U.S. Senator from
      Connecticut....................................................     3
    Hon. Tommy Tuberville, U.S. Senator from Alabama.................    12
    Hon. Patty Murray, U.S. Senator from Washington..................    14
    Hon. Marsha Blackburn, U.S. Senator from Tennessee...............    16
    Hon. Mazie K. Hirono, U.S. Senator from Hawaii...................    18
    Hon. Thom Tillis, U.S. Senator from North Carolina...............    21
    Hon. Margaret Wood Hassan, U.S. Senator from New Hampshire.......    23
    Hon. Bill Cassidy, U.S. Senator from Louisiana...................    26
    Hon. Angus S. King, Jr., U.S. Senator from Maine.................    28
    Hon. John Boozman, U.S. Senator from Arkansas....................    30
    Hon. Bernard Sanders, U.S. Senator from Vermont..................    32
    Hon. Kevin Cramer, U.S. Senator from North Dakota................    35
    Hon. Tammy Duckworth, U.S. Senator from Illinois.................    37
    Hon. Dan Sullivan, U.S. Senator from Alaska......................    40
    Hon. Elissa Slotkin, U.S. Senator from Michigan..................    42
    Hon. Jim Banks, U.S. Senator from Indiana........................    44

                                    WITNESS

    The Honorable Douglas Collins, Secretary, U.S. Department of
      Veterans
      Affairs........................................................     5

                                    APPENDIX
                               Prepared Statement

    The Honorable Douglas Collins, Secretary, U.S. Department of
      Veterans
      Affairs........................................................    57

                           Submissions for the Record

    From Senator Blumenthal:

      ProPublica article ``Internal VA Emails Reveal How Trump Cuts
        Jeopardize Veterans' Care, Including To `Life-Saving Cancer
        Trials' ''...................................................    65

      Statement of Darren J. Petite, President, AFGE Local 0025......    69

      The New York Times article ``V.A. Mental Health Care Staff,
        Crowded into Federal Buildings, Raise Patient Privacy
        Alarms''.....................................................    71

      List of 41 Unanswered Requests for Information and Briefings...    85

      List of 19 Unanswered Letters..................................    92

      Health Care Wait Times, Staffing Snapshot, and Claims Backlog
        charts.......................................................    97

      The New York Times article ``What Elon Musk Didn't Budget For:
        Firing Workers Cost Money, Too''.............................    99

      List of Recent Collins References to the RIF...................   104

    From Senator Tuberville:

      VA Budget and Veterans Population graph........................   103

                            Questions for the Record

    Department of Veterans Affairs response to questions submitted
      by:

      Hon. Mazie K. Hirono...........................................   107

      Hon. Angus S. King, Jr.........................................   109

      Hon. Jerry Moran...............................................   111

      Hon. Richard Blumenthal........................................   113

      Hon. Ruben Gallego.............................................   133

                           Attachment for VA Response

    Department of Veterans Affairs response to Question 1 from
      Senator King: List of Contract Terminations....................   139

                           VETERANS AT THE FOREFRONT:
                     SECRETARY COLLINS ON THE FUTURE AT VA

                                  ----------

                              TUESDAY, MAY 6, 2025

                                           U.S. Senate,
                                Committee on Veterans' Affairs,
                                                        Washington, DC.
        The Committee met, pursuant to notice, at 11:41 a.m., in
    Room SD-106, Dirksen Senate Office Building, Hon. Jerry Moran,
    Chairman of the Committee, presiding.

        Present: Senators Moran, Boozman, Cassidy, Tillis,
    Sullivan, Blackburn, Cramer, Tuberville, Banks, Sheehy,
    Blumenthal, Murray, Sanders, Hirono, Hassan, King, Duckworth,
    Gallego, and Slotkin.

                 OPENING STATEMENT OF HON. JERRY MORAN,
                   CHAIRMAN, U.S. SENATOR FROM KANSAS

        Chairman Moran. Good morning, colleagues. Good morning, Mr.
    Secretary. Welcome, and welcome to those in the audience, as
    well.
        We have two votes starting at 11:30. I think most of us
    have now cast that first vote, so we will be interrupted on a
    rolling basis, I would guess, for the second vote.
        Mr. Secretary, thank you. Thank you for testifying before
    this Committee. It is the first time in front of our Committee
    since you were sworn in to become confirmed as the Secretary of
    Veterans Affairs, and I thank you for your acceptance of my
    invitation and your willingness and the ease with which you
    agreed to come before the Committee at the appropriate time.
        While the VA is operated by many hardworking and caring
    staff members--many of whom are veterans themselves--the
    bureaucracy at the VA has hampered some of the Department's
    successes. The current way of doing business at the VA is not
    always working for every veteran or military family.
        I hear from Kansans, as I assume we do as Members of
    Congress. We talk to Kansas veterans regularly. We talk to
    their loved ones--as well as Kansans who work for the VA, in
    the medical facilities, regional offices, and veterans'
    cemeteries--about the challenges that they are facing. I look
    forward today to hosting you in Kansas and sometime in the near
    future where we will visit with those veterans and those VA
    employees.
        This Committee has worked to improve the VA, to improve its
    services for the millions of men and women around the country
    who rely on the health care, benefits, and services that VA
    provides. Most of the time we have done that in a bipartisan
    way, and we have made progress.
        The MISSION Act made the VA care more accessible and
    enabled veterans, particularly those in rural areas, to receive
    care closer to home. The MISSION Act improved what we started
    out as the CHOICE Act.
        The PACT Act expanded health care and benefits to millions
    of veterans who were exposed to burn pits and other toxins
    during their military service.
        Yet, as we always say in this Committee, more work remains
    to make this agency, this Department--the second largest
    bureaucracy in the Federal Government--perform to the levels
    that veterans, their families, and VA staff members deserve.
        I believe that we share many of the same priorities, Mr.
    Secretary, including eliminating waste and reforming the VA to
    better serve our Nation's veterans.
        During the last three months, there have been announcements
    about significant changes across the Department, including
    employee terminations, contract cancellations, and plans for
    large-scale reductions in force that could see the VA return to
    the top-line workforce numbers in place six years ago. That has
    caused understandable concern among veterans and VA staff, as
    well as many of us here on the dais. Mr. Secretary, I look
    forward to you addressing those concerns this morning. I think
    how this process is completed or how this process occurs is
    hugely important. And I have told you on the phone that it
    ought not be a set number that you are trying to reach, it
    ought to be about rightsizing the Department of Veterans
    Affairs.
        The Department is at a critical juncture--perhaps that is
    always true--and I want to hear from you that the changes
    underway at the VA are backed by data, informed by veteran
    demand, focused on improving outcomes for the men and women
    that the VA serves, and will be carried out in close
    coordination with this Committee as well as with veterans, VA
    staff, and veterans' organizations.
        As the VA undergoes restructuring, the Department must be
    well-staffed by a quality, accountable workforce and any
    efforts to rightsize the workforce must be done carefully and
    in a manner that treats the men and women who entered public
    service to care for veterans with gratitude and respect.
        I believe that we can work together to achieve lasting and
    positive changes at the VA, that best serves our veterans,
    staff members, and survivors, done in a way that is the right
    way to do it.
        Mr. Secretary, I indicated in one of our last conversations
    that if you are rightsizing the Department of Veterans Affairs,
    whether the numbers go higher or lower, that is not the issue,
    the issue is about the right size for taking care of those who
    served our country.
        I thank you for being here this morning, as I said earlier,
    and with that, I yield to Ranking Member Blumenthal for his
    opening remarks.

             OPENING STATEMENT OF HON. RICHARD BLUMENTHAL,
             RANKING MEMBER, U.S. SENATOR FROM CONNECTICUT

        Senator Blumenthal. Thank you, Mr. Chairman, and I want to
    thank you, Senator Moran, for again bringing us together for
    the bipartisan work that you and I have done together. This
    Committee has been more bipartisan than any in the United
    States Senate, so far as I am concerned, and it will continue
    to be so, in championing measures like the PACT Act, which,
    Secretary Collins, by the way, I just noticed is not mentioned
    once in your written testimony, which mystifies me.
        Let me say at the very outset, I would like to enter a few
    items into the record. The first is an article published this
    morning by ProPublica, supported by hard evidence and in-depth
    conversations with VA staff. It outlines a number of examples
    of real-life impacts to veterans caused by the firings,
    freezes, and cuts in this Administration. It also outlines
    disturbing warnings of what is to come, documents with
    recommendation from DOGE, the DOGE tech boys--I call them the
    ``DOGE Dopes''--that outline cutting 100,000 employees and
    closing as many as 17 VA hospitals.
        I would also like to enter into the record a statement from
    Darren J. Petite, President of the AFGE Local 0025. His
    statement is a summary of the dozens of impact statements from
    VA employees that were provided to my office this morning. And
    in addition, The New York Times article on mental health care
    diminishing and degrading privacy available through telemental
    health care that is absolutely unacceptable. In Mr. Petite's
    words, his statement represents, quote, ``the collective voices
    of frontline public servants who have endured significant and
    unjustified hardships stemming from recent policy changes,
    management decisions, and failures to honor basic labor
    protections.''
        Finally, I want to submit for the record an updated list of
    41 requests for information and 19 letters of inquiry that have
    been sent to this Administration without substantive response,
    any sufficient response, or any response at all. If that is
    okay, Mr. Chairman, without objection.
        Chairman Moran. Without objection, so ordered.

        [The information referred to appears on pages 65-98 of the
    Appendix.]

        Senator Blumenthal. We are here about accountability, which
    so far has been totally lacking. The absence of responses to
    our inquiries are simply unacceptable. You inherited, Mr.
    Secretary, a VA that was delivering a record amount of health
    care. Last year wait times decreased, despite a record increase
    in new patient appointments. You claimed the disability
    backlogs got worse, but the percentage of backlog claims
    actually is about the same, but increasing challenges in
    numbers. And the VA has decreased the time to process each
    claim, setting new records for productivity.
        You inherited a VA that was setting new records for
    burials, and that is important to the servicemembers, the
    families that sadly have to provide those burials. The VA has
    been delivering more care, more services, more benefits, to
    more veterans, and doing it faster than ever before when you
    took over, and that is in no way to deny the importance of
    improvement. Call it reform. Call it revision. Improvement is
    absolutely necessary. But it should not be done with a
    chainsaw.
        The head, the Commander of the Veterans of Foreign Wars,
    came before us, and he drew this analogy. When he was wounded
    in combat, the surgeon used a scalpel. He took the shrapnel out
    of his arm. He did not use a meat ax. He did not use a
    chainsaw. And that is the kind of improvement that we should
    work to achieve, with the input of those skilled and dedicated
    caregivers who are working hard in the VA right now, a third of
    them veterans, thousands of them already fired, and others
    potentially losing their positions in the future.
        You have announced the cancellation of 800 contracts worth
    an alleged $2 billion, only to rescind that statement once the
    harmful impacts of the cancellations were made public, and we
    protested. You arbitrarily fired thousands of VA employees,
    including Veterans Crisis Line employees, only to subsequently
    reinstate a number of them after public backlash, or after you
    learned that they were fired by mistake, and we protested. You
    have delayed the opening of facilities across the country, only
    to announce they would open in phases because of insufficient
    staffing. You have equated them to restaurants. You claim that
    is how it has always been done. But that is not true.
        And so far as that 83,000 number is concerned, apparently
    you want to go back to the 2019 numbers, because since then
    some 80,000 VA workers have been added to the rolls. You should
    know, two-thirds of them are health care workers. If you slash
    those health care workers, VA quality and access will diminish.
    A number of them are VBA claims processors, a third of them. If
    you slash them, the times for PACT Act benefits will be
    delayed.
        I think that oversight is absolutely necessary and
    improvement is always possible. But it should be done
    positively, without the slashing and trashing that right now
    you have advocated.
        In the real world we know that support personnel are
    absolutely necessary--answering the phones, cleaning the
    surgical equipment, preparing the operating rooms, scheduling
    the appointments or fixing the IT systems. Those burdens will
    fall to others, or they will simply fall through the cracks if
    you slash and trash the VA.
        In Connecticut, the VA is operating without a locksmith,
    because that position is not exempt from your hiring freeze.
    And the VA has ignored local requests for that exemption. There
    is no way for a VA facility to operate reliably and safely
    without good locks on the doors. Now that position may seem
    like a minor or trivial one, but every member of the VA team is
    necessary to make the team effective and efficient.
        Now, we have already begun seeing the results and local
    impacts of staffing shortages. We have heard directly from
    veterans--my office has, colleagues have--service lines at
    numerous VA hospitals and clinics have been reduced. Mammogram
    appointments have been postponed. Prosthetic employees have
    been fired and services reduced. The availability of VA
    operating rooms as well as inpatient, recovery, emergency room,
    and long-term care beds have been reduced. Probationary staff
    in logistics and procurement have been fired, meaning critical
    medication and equipment deliveries have stalled. In some VA
    hospitals, senior and clinical staff are now helping stock
    supplies. Medical center employees who manage research grant
    applications have been fired, leaving hospitals unable to apply
    for new research funding.
        Countless employees are being driven away. You have 40,000
    openings right now that you are recruiting to fill at the same
    time as you are firing 80,000. It makes no sense. How do you
    expect to recruit qualified, skilled, dedicated, new workers,
    whether they are physicians or counselors, nurses, when you are
    firing our probationary employees who are the future of the VA
    workforce or who have been promoted because they are performing
    with such excellence? Nonsensical.
        So I think that you owe this Committee some explanation.
    You have refused to do it so far, in response to the 19 letters
    that I have written, along with colleagues, and the 21 other
    inquiries. There needs to be accountability. We need to avoid
    the potential disaster that is looming. And make no mistake--it
    is a disaster that is on the horizon, approaching us, as surely
    as a thunderstorm in the Nation's capital. And we need to avoid
    it. It will be a self-inflicted wound that disastrously affects
    all of our VA beneficiaries, whether they use health care or
    the PACT Act, and that is one reason why I have advanced the
    Putting Veterans First bill that would mandate rehiring all
    those fired VA employees and all the veterans who have been
    fired from the Federal workforce in other agencies. Give them
    the right to individual, personal determination, which should
    be their right under current law.
        We need to make the VA a place that works better for
    veterans and their families. They deserve nothing less.
        Thank you, Mr. Chairman.
        Chairman Moran. Senator Blumenthal, thank you.
        Mr. Secretary, we now recognize you. Thank you for your
    presence, and we recognize you for your testimony.

                   STATEMENT OF HON. DOUGLAS COLLINS,
             SECRETARY, U.S. DEPARTMENT OF VETERANS AFFAIRS

        Secretary Collins. Thank you, Mr. Chairman. I appreciate
    that. And Ranking Member Blumenthal, and distinguished Members
    of the Committee, it is good to be back here.
        Chairman Moran. Mr. Secretary, would you pull the mic
    closer, please?
        Secretary Collins. It is on.
        Chairman Moran. That is better.
        Secretary Collins. So I am going to have to swallow it.
    Okay. There we go.
        Since becoming VA Secretary, I have met many of the men and
    women who show up every day to work. It has been one of the
    greatest experiences of my life to see the deep dedication that
    they have to the veterans that they serve. And I have also
    listened to those VA employees and others who have expressed
    their concerns about what is going on and the stuff that they
    need to be able to do to perform their job. Most of those are a
    bureaucracy that has been out of control and a bureaucracy that
    has not been tamed in years.
        You know, also, though, in the same period of time, since I
    have come to learn what many of you on this Committee realize:
    the VA is in need of reform, and which I can probably quote
    every Member of this Committee who has stated in the past,
    multiple times, including even last year, that the VA needed
    reform, and needed it badly. We must do a better job serving
    our veterans, and getting to ``yes'' so veterans can get the
    benefits they have earned, and making sure the money Congress
    appropriates to the VA is not diverted to non-mission-critical
    or even wasteful programs.
        Way back in 2024, Congress discussed many times reform in
    the VA, but it often was simply a thinly veiled request for
    more employees. But the Department's history shows that adding
    more employees to the system does not automatically equal
    better results.
        The Biden administration's record is a perfect example. The
    last four years, which, again, I would be happy to talk about
    today, showed that this issue of money and people do not solve
    the problems. In fact, the number of VA employees grew by more
    than 52,000 full-time equivalents from fiscal year 2021 to
    fiscal year 2024. And did all those people make things better
    for veterans? No. In fact, VA performance actually got worse.
    VA wait times for primary care rose from 15.7 days to 24.3
    days. Wait times for mental health care rose from 14.7 days to
    20.4 days. Wait times for specialty care rose from 24 days to
    38 days. And VA's disability benefits backlog increased, and
    was at 260,000 when I took office at the first of February. I
    will say that we have decreased it by 40,000 since we have
    taken office.
        Something has to change, and we are going to have to change
    it. President Trump looked at the problems. He has looked at
    the problems across it and said, ``Let's take care of our
    veterans, and do so in a way that takes care of our veterans,
    families, caregivers, and the survivors that we serve.''
        And also I have never been shy about talking about and
    addressing tough issues, and I will not ignore the elephant in
    the room here today. As has already been discussed and we are
    aware, we are looking at Department's structure and staffing
    across the enterprise. I said countless times, this review is
    aimed at finding ways to improve health care and benefits for
    veterans without cutting care and benefits for veterans. Our
    goal is to increase productivity, eliminate waste and
    bureaucracy, increase efficiency, and improve health care and
    benefits to our veterans.
        We are going to maintain VA's mission-essential jobs like
    doctors, nurses, claims processors, while phasing out non-
    essential roles like interior designers and other things. This
    is savings we can achieve that will be redirected to veteran
    health care and benefits. Our goal--and here is the key word--
    our goal, as we look at it as everything goes forward, is a 15
    percent decrease. It is a goal. As the Chairman said, it could
    be less, it could be more. It is a goal that you have to look
    at. You have to start somewhere.
        Year after year, the calls for VA reform come from every
    corner--the lawmakers, the media, watchdog groups like the
    inspectors general, Government Accountability Office, VSOs, and
    individual veterans across the country.
        This year, we have finally embarked on a historic effort to
    reform the VA. We have been emphatic that we will not be
    cutting benefits and health care--only improving them--and I
    think the budget shows that. And we are engaging career
    subject-matter experts, senior executives, and political
    leadership to restructure the Department so it works better for
    veterans--a scalpel, not a hatchet.
        We are also doing, what all the veteran stakeholders agree
    needs to be done, and there has been some reaction. We have
    been met with a barrage of false rumors, innuendo,
    disinformation, and speculation implying firing of doctors and
    nurses, and forcing staff to work in closets and showers, and
    that there is ``chaos'' in the Department, none of which have
    been backed up, even articles from today. Why? Because we
    canceled some contracts, that work for the VA, that we should
    be doing in-house, and we let go less than one-half of 1
    percent. That is what I am sort of amazed at some things you
    said. We have let go one-half of 1 percent of non-mission-
    critical employees.
        To hear our critics tell it, the Department was absolutely
    perfect before January 2025. Everyone knows that is not true.
    The fact is that VA health care has been on the Government
    Accountability Office's high-risk list for a decade. GAO says
    VA faces ``system-wide challenges in overseeing patient safety,
    access to care, hiring critical staff, and meeting future
    infrastructure needs.'' We are working hard to fix these and
    other issues, and we need your help. We want to work with
    Congress to fix the VA. But our shared goal needs to be making
    things better for veterans, not protecting the Department's
    broken bureaucracy.
        The Department of Veterans Affairs is not a Federal jobs
    program. It is an organization whose sole purpose is to serve
    veterans, and we must never lose sight of that. In just the
    first 100 days we are refocusing our core mission back on the
    veteran, not the VA itself. We are making sure that they
    actually get choice in the MISSION Act, which is what the law
    requires, which we have found over the past few years has been
    actually stifled at the VA. Instead of sending people to
    community care, they were actually encouraged to stay in the
    care inside the VA.
        We brought back people from work. We have accelerated the
    deployment of our Electronic Health Records Management system,
    and yes, we have processed record numbers of disability claims,
    and we are redirecting hundreds of millions of dollars from
    non-mission-critical efforts to support our beneficiaries.
        As we go forward, we are just getting started. There is a
    lot we can agree on. There may be some things that we disagree
    on. But the one thing about it, it will never change for me,
    Mr. Chairman, Ranking Member, and the rest of the Committee, is
    that we have got to take care of our veterans. And obviously
    the numbers that we have seen in the last few years have shown
    that we are not.
        And with that I yield back.

        [The prepared statement of Secretary Collins appears on
    page 57 of the Appendix.]

        Chairman Moran. Mr. Secretary, thank you. So in your time
    as the Secretary and the circumstances that you are under and
    engaged in, what do you assess as your most significant areas
    of concern for the VA, and what do you believe is working? Is
    there anything that you have learned that needs to be done
    differently?
        Secretary Collins. Thank you, Mr. Chairman. I think one of
    the most interesting things for me in the first 100 days is
    constantly fighting rumor and innuendo, much of which I am sure
    we will hear today that I am going to try and put to rest.
        But one of the things is, I had to take it from a
    perspective of both being on the GAO list and looking at the
    past history, as I expressed to many of you during
    confirmation, is what is working right and what is not working
    right. And as we looked at this, what I found was a system, a
    bureaucracy, that was broken.
        Here is an interesting stat for most of you that you may
    not know. I came into the office and it took me a week and a
    half before Human Resources Department could actually produce a
    list of all the employees that we have--a week and a half--
    because our systems were so broken and bureaucratically
    challenged.
        You know, what I found out was we did not address any of
    the major concerns. Wait times, which I just outlined in my
    opening statement, have gotten worse. Backlogs got worse. All
    while we were adding people and all while we were adding money.
        You know, the inefficiencies are interesting. I will just
    show you one example. Under the previous administration they
    were trying to consolidate payroll, and payroll across the
    board, we asked for a number from payroll, and we got 230,000
    is our employee base. It is who we are paying. Well, we know,
    obviously, we had almost 470,000. The reason was we had 50 to
    60 of our hospitals still doing their own payroll instead of it
    all being centralized where it could be done in an efficient
    manner, and make sure that we all have it where we need to go.
        The HR system is in disarray. Our death by suicide number
    has not changed since 2008, yet we are spending $588 million a
    year to look at that, and $2.3 billion in counseling and care.
        These are just the things that we have seen so far, and we
    have actually implemented to go forward and look at the things
    that we have got to fix and more forward on those. But to
    simply say that where we came in was okay and needed tweaks was
    just simply not true, and veterans in this room and other
    places know that.
        Chairman Moran. Mr. Secretary, you mentioned in your
    opening statement inspectors general.
        Secretary Collins. Yes.
        Chairman Moran. I have indicated, I think in many
    conversations, and certainly hearings in which VA staff are
    witnesses, that the return of an inspector general is a high
    priority for me. What is the plan?
        Secretary Collins. We are in favor of that, as well, and
    making sure that the White House--and we have encouraged the
    inspector general to be named, and look forward to that being
    in place. I mean, again, we are looking at it as a metric of
    how we can get better. Over the last 10 years, that has been
    the metric saying that we are at a high risk. So from my
    perspective we welcome the oversight to make sure that we are
    heeding the metrics that we need to do to take care of
    veterans.
        Chairman Moran. And so, Mr. Secretary, the impression that
    you leave is that the White House, the President needs to
    nominate someone. Is that where we are?
        Secretary Collins. That is the next step in that, yes.
        Chairman Moran. Okay. I want to ask a specific question
    about community care. I appreciate your attention to the
    MISSION Act. We have been trying, this Committee, that we
    believe it is particularly important for veterans at risk for
    suicide and mental health issues, veterans who are potentially
    victims of overdose deaths.
        I wrote to the VA in January, urging Mental Health
    Residential Rehabilitation Treatment programs to be included
    under existing community care access standards, to immediately
    expand access to those lifesaving services to veterans across
    the country, in the community. Can you provide me with an
    update on your progress to add Mental Health Residential
    Rehabilitation Treatment programs to the MISSION Act access
    standards?
        Secretary Collins. Yes, and I think that is going through
    right now and adding those as we go forward, making sure that
    the VA and the veteran is going through the programs that are
    suitable for the program it needs to be and also taking care of
    the needs of the veterans. So that is moving forward. We agree
    with you that any opportunity that we can take to give more
    service to veterans, especially in the mental health area.
        Also, Mr. Chairman, there is something else to think about
    here, as well. One of the things that I did not mention
    earlier, is there seems to be, at times, a difference in how we
    deal with the VA as opposed to how we deal with health care, in
    general. And some of that, frankly, needs to change in the
    sense that the VA is the largest health care provider. But also
    we share the same challenges as the community does, as well,
    with doctor recruitment, nurse shortage, doctor shortages,
    mental health workers, and those. So we are working those in
    our areas to make sure that we do have good community partners
    in this regard and also hiring the best that we can. Also, we
    are levering partnerships with DoD, but also looking at our
    nonprofits and our VSOs, to see how they can help, as well. So
    it is a total approach to how we are looking at this and want
    to continue to do that.
        Chairman Moran. Senator Blumenthal.
        Senator Blumenthal. Thanks, Mr. Chairman. You know, I
    listened to you recite those problems that you encountered. Not
    a single one of them will be solved or addressed by slashing
    the VA workforce by 83,000 people. Putting those workers on the
    chopping block fails to address one single aspect of any of the
    problems that you have brought to this Committee, or that you
    encountered.
        Are you aware, Mr. Secretary, that the VA changed the way
    it calculates wait times in 2022?
        Secretary Collins. The information I gave you is as of our
    current VA system.
        Senator Blumenthal. The information you gave us is
    deceptive and misleading because the VA changed the way it
    calculates wait times in 2022. In addition, because it begins
    in 2021, at a time when a lot of VA patients were coming back
    to the VA after COVID in 2022, this information is
    fundamentally deceptive and misleading. I ask you to go back to
    the VA and correct it in a written submission to this
    Committee.
        Mr. Chairman, I ask that we enter into the record an
    article that appeared in The New York Times entitled, ``What
    Elon Musk Didn't Budget For: Firing Workers Costs Money, Too.''
    If there is no objection.
        Chairman Moran. Without objection.

        [The article referred to appears on pages 99-102 of the
    Appendix.]

        Senator Blumenthal. Are you aware of the costs that will
    result from firing those VA workers in compensation that has to
    be paid to them, when they have been wrongfully terminated?
        Secretary Collins. Well, Mr. Ranking Member, if you look at
    that from a perspective, there is cost to moving forward. There
    have been some issues here. I think one of the----
        Senator Blumenthal. You do not have a number for us, do
    you?
        Secretary Collins. No, because we have----
        Senator Blumenthal. Because you have not calculated----
        Secretary Collins [continuing]. Less than one-half of 1
    percent----
        Senator Blumenthal [continuing]. What it will cost to
    fire----
        Secretary Collins [continuing]. Of people we actually----
        Senator Blumenthal [continuing]. Workers, and then
    reinstate them, when the courts tell you, as they will, that
    they have been wrongfully terminated.
        Secretary Collins. We are talking about less than one-half
    of 1 percent, Mr. Ranking Member. You have thrown out numbers
    of thousands. This is exactly what I am fighting against. When
    you use numbers that----
        Senator Blumenthal. It may be a small part of your
    workforce, but they are the physicians.
        Secretary Collins. No.
        Senator Blumenthal. They are the surgeons.
        Secretary Collins. No. No. Mr. Ranking Member, I will not
    let you do that. I will not let you sit here and scare my
    veterans and scare my employees, because there has been no--I
    mean, you must have stuff that, you know, again you are looking
    at, making a prediction in the future because no one has
    discussed firing doctors or firing nurses. We have always said
    that we are going to keep frontline health care.
        Now, if we want to continue to this message that these are
    out there when you have no knowledge of what you have just said
    except speculation----
        Senator Blumenthal. Well, let's begin with facts----
        Secretary Collins [continuing]. And innuendos.
        Senator Blumenthal [continuing]. Right now.
        Secretary Collins. That is facts.
        Senator Blumenthal. Will you submit to us, which you have
    failed to do, specific positions where workers have been fired
    already?
        Secretary Collins. At this point in time----
        Senator Blumenthal. That is a yes or no.
        Secretary Collins [continuing]. We submitted to that. You
    know, you also said something that I need to address real
    quickly.
        Senator Blumenthal. No, wait a second. Please answer my
    question. Will you give us the information?
        Secretary Collins. We have given you the information----
        Senator Blumenthal. We have requested it again and again
    and again, what positions have you terminated and what is your
    plan for terminating in the future.
        Secretary Collins. Okay. First off, we will get you the
    information, that your staff will check back. With the plans
    for the future, this is an interesting thing. I think what we
    are trying to do here is we are going through a process which I
    talked about in my opening statement, that deals with career
    employees, that deals with professional staff, and others,
    outside consultants, to see what is the proper size for our VA.
        Senator Blumenthal. You know, you are running out the
    clock----
        Secretary Collins. Will you let me answer the question?
        Senator Blumenthal. I know what the tactic is.
        Secretary Collins. Let me answer the question.
        Senator Blumenthal. We both know, because you served in the
    United States Congress too. You can fill the air with words.
        Secretary Collins. You can if----
        Senator Blumenthal. What the veterans deserve is action and
    accountability. We have asked for this information repeatedly.
    You have said you are firing 83,000 people. If you fire the
    people who have been hired in the last 5 years, you will be
    firing physicians, nurses, surgeons, counselors, workers who
    are frontline. You cannot slash and trash the VA without
    eliminating those essential positions which provide access and
    availability of health care. It simply cannot be done. And you
    may give us a lot of verbiage here, but you are not giving us
    facts, and facts are essential to accountability. That is why
    you are supposed to be here. But you are not giving us the
    facts that we need.
        Thank you, Mr. Chairman.
        Secretary Collins. With all due respect, can I answer his
    question?
        Chairman Moran. You may answer.
        Secretary Collins. Thank you. With all due respect, there
    is verbiage being said from the dais, as well, and I would like
    to say, as I have said already in this hearing, that there is a
    goal of looking at a 15 percent reduction. You have stated on
    several occasions already that I am saying we are going to fire
    83,000 employees. That is wrong. I would appreciate that being
    corrected, because that is not true. I said we are looking at a
    goal of how many employees we have and how many employees that
    are actually working in the front lines, taking care. I have
    doctors and nurses right now that do not see patients. Is that
    helping veteran health care?
        Senator Blumenthal. Yes, it does.
        Secretary Collins. No. No, it does not.
        Senator Blumenthal. It does.
        Secretary Collins. Not when I need those doctors----
        Senator Blumenthal. A doctor who consults on a case----
        Secretary Collins. Not when I need those doctors in a
    clinic.
        Senator Blumenthal [continuing]. A doctor who consults, a
    doctor who advises, a doctor who looks at radiology reports, a
    doctor who----
        Secretary Collins. You are missing the point.
        Senator Blumenthal [continuing]. Is overseeing and assuring
    quality, absolutely yes.
        Chairman Moran. Senator Tuberville.

                         HON. TOMMY TUBERVILLE,
                       U.S. SENATOR FROM ALABAMA

        Senator Tuberville. Thank you, Mr. Chairman. Thank you,
    Secretary Collins, for being here. And thanks to the veterans
    that are here today. And I want to pass on the thanks from the
    400,000 veterans in the State of Alabama. They have, for the
    first time, in just two months, have seen progress at a lot of
    the VAs in my state.
        We have seen a record number of disability claims
    processed, employees finally returning to work, and an end to
    the DEI programs like treatment for gender dysphoria. You know,
    the days of business, as we all are noticing and hearing today,
    are over, and finally our veterans are being put first.
        Let's talk about the budget a little bit, Mr. Secretary.
    Over the last 10 years, the VA's budget has more than doubled,
    and the number of employees at the VA has increased more than
    100,000. But the number of veterans in our country is
    declining, and VA enrollment has changed.

        [The information referred to appears on page 103 of the
    Appendix.]

        The VA has become a bloated bureaucracy. I think most of us
    will agree with that.
        Secretary Collins, why has the VA budget become so bloated
    over the last 10 years if the veteran population has remained
    stagnant?
        Secretary Collins. Senator, I appreciate the question
    because it is also another number that we are leaving out
    there, as well, is that veteran population of actually enrolled
    in the VA has stayed steady at 9.1 million. And again, we can
    try and talk about numbers all we want here, but it has been
    9.1 million steady for the last, you know, 10 years we look at
    this. So we are also losing veterans as a total population, but
    we are also not gaining in the enrollment of the VA.
        What we tend to forget, and some people will say, well, we
    have had an increase in different programs. We have, but we
    also lose about 400,000 veterans a year to death, you know,
    natural causes. So, I mean, it is a priority of function. So
    what we are looking at here is there have been programs that
    have been increased, there has been a mandatory spending
    increase, and those have been the things that we look at.
        I think what we are actually looking at here, though, is
    there has been a decision that it is easier to just put money
    and people toward issues without looking at is there any real-
    world aspect to that. Is there a return on investment?
        I think as you talk to veterans, and I go out and talk to
    veterans, one of the things that we are having is that those
    amount of numbers and people are not equating into how we can
    actually function.
        I mean, I appreciate the Ranking Member's service and I
    appreciate we just disagree on this, that when we have doctors
    and nurses and other clinicians who are not actually being
    clinicians and not reading charts or doing anything else, they
    are actually, you know, formulating policy or doing
    administrative work, when I have these many folks that need to
    be more in the clinics, then we are not helping the veteran.
    That is just something that is not happening.
        When you are taking time to process disability claims that
    went up, and also not having the proper, you know, computer,
    the AI technology to help us do that. We are also putting out
    the issues that are slowing up. And then also we get in our
    way, because we are such a bureaucratic organization. We have
    rules over rules over rules.
        I had a gentleman tell me just the other day--and this is,
    again, I have seen this before from my own daughter--he
    actually said--he is a double amputee. He actually said, ``I
    have to go to the VA. If I need a new wheelchair, I have to go
    to my primary care, a PT, and an OT, before I can get a seating
    clinic appointment.'' Explain to me why we are having to go
    through that kind of mess to get straight to a seating clinic,
    which we know where they need to be to start with.
        Senator Tuberville. Thank you. I often hear a lot about the
    large amounts of paperwork and administrative burden VA doctors
    are forced to navigate when seeing patients. This leads to VA
    doctors seeing less patients per day. Where do you see the
    opportunity to reduce all these administrative processes?
        Secretary Collins. I think there are plenty of
    opportunities there, and again, this has nothing to do with
    employees. It has nothing to do with money. It is simply, are
    we doing it most efficiently in the process.
        I made a statement to every hospital that I go to, every
    clinic that I go to, every Veteran Benefit Office that I go to,
    to say this. I use a proverbial 10 sheets of paper. If you have
    10 sheets of paper to get a veteran the services that they
    need, or 10 sheets of paper to do the next thing, can you do it
    with 5? I mean, I will show you an example.
        To apply for benefits in our VBA, there is a sheet on there
    that has a full listing of the veteran as far as just basic
    information about their military service. And this, for older
    veterans, could be a problem actually to go back and remember
    dates. If the veteran served, and we could do that with their
    name, their Social Security number, their ID number using their
    DD-214, we can gain all the records that we need to confirm
    that they are a part. But yet we are making them go through
    this process of filling out a form that many of our veterans,
    who may or may not have computer capabilities, are having
    trouble with. So it makes it difficult.
        Senator Tuberville. I hear from some of the supervisors in
    the VAs, and they say we use two coding systems, one a hospital
    coding system that is very, very effective, and the other one
    is from the W-H-O, which is a useless piece of crap, that has
    come from them. Why do we use both of those?
        Secretary Collins. That is something I am looking at now,
    again, to try and streamline the issues that we have in our
    system. Again, it is interesting. A lot of times we end up
    talking about processes and plans here and not talking about
    actual care and actually what the veteran experiences when they
    go in. Most of the veterans, I will tell you, a lot of times
    when they get through the labyrinth of stuff to get there, they
    are happy with the service that they get. They are glad that
    they are getting the service and they appreciate that. They
    enjoy the choice.
        But when we actually put restrictions on our employees and
    put restrictions on veterans getting in, it just makes it all
    the worse.
        Senator Tuberville. Thank you.
        Chairman Moran. Thank you. Senator Murray.

                           HON. PATTY MURRAY,
                      U.S. SENATOR FROM WASHINGTON

        Senator Murray. Thank you, Mr. Chairman. Secretary Collins,
    thank you for being here. Thank you for taking the time to talk
    with me yesterday morning about the new policies that you now
    have related to congressional engagement. For all of my
    colleagues, this new policy will limit our ability to interact
    with veterans on a VA campus, as it did when I was denied the
    ability to host a veteran and provider roundtable at the CL VA.
    I will note I have done that many times over my 30 years here
    in the Senate.
        My staff was told it was a new policy, which had not been
    put into writing at the time that I got denied. And I just want
    to reiterate my request, Mr. Secretary, that you share that
    newly written policy with every single Member of Congress.
        Secretary Collins. Senator, we definitely, as you and I
    talked yesterday, this had been an unwritten policy for years.
    It had been----
        Senator Murray. No.
        Secretary Collins [continuing]. It had been applied
    differently. And I went back and checked. It had been applied
    differently. And simply, there is no filter that we want you to
    be there.
        Senator Murray. Well, I just have to say, I have never been
    denied before.
        Secretary Collins. That is fine.
        Senator Murray. I do not know anybody else who has. This is
    a new policy, and I think it is important that you have it in
    writing----
        Secretary Collins. It will be.
        Senator Murray [continuing]. To every single member----
        Secretary Collins. It will be.
        Senator Murray. So we all know that. I would also note that
    in our conversation yesterday, as well as in your responses to
    nearly all of the oversight letters I have seen, you are
    relying on this very broad explanation to everything that, and
    I quote it, ``Everything you do is to ensure veterans receive
    the care and services they deserve.''
        I want to take this opportunity, Mr. Secretary, to remind
    you, the people on this dais, both sides, have the same
    purpose. Many of us have been doing this for decades, and
    oversight is both constitutionally required and it is critical
    for all of us to do our jobs. So with that in mind, I would ask
    you to rescind the memo from your Chief of Staff, which allows
    him to personally sign off on any proposed or planned
    engagement with any one of the 535 Members of Congress, which
    really just stonewalls legitimate questions that we have.
        Secretary Collins. Senator, that was a memo that--that was
    a missing characterization. That memo simply was coordinating
    between OM and our Legislative Affairs Office to make sure that
    our OM staff, who actually deals with the budget side, which
    you do, and our Legislative Affairs, were on the same page.
    Just as you would not want to, in your staff, talking to the
    same group and basically not being on the same page.
        Senator Murray. Well, I have the letter and it directly
    says that every request we have has to go through your Chief of
    Staff, from our staff who wants questions, from any of us who
    do. Everything has to be rerouted up to the top. That is going
    to take forever. That denies us the ability for us to do----
        Secretary Collins. We will make sure that all legislative
    inquiries, the stuff that you need, you are getting the
    oversight. I agree with you. I served in Congress, as well.
    Oversight is important. Also getting you good information is
    important, as well.
        Senator Murray. I appreciate that. So is that letter no
    longer in place, no longer applies?
        Secretary Collins. That letter is, the one that I am
    familiar with, is letters to streamline information so we can
    get you actually information quicker.
        Senator Murray. Streamline all the way to the top so our
    questions are never answered. That is how we all read it.
        Secretary Collins. No. That is not the way the letter is
    written.
        Senator Murray. Well----
        Secretary Collins. So it is not the way the interpretation
    is.
        Senator Murray. I would ask you go to back and look at it--
    --
        Secretary Collins. Okay.
        Senator Murray [continuing]. Because again, we have
    oversight responsibility. We all take that very seriously.
        Secretary Collins. I agree with you.
        Senator Murray. We need those responses. We do not need
    weeks and months to go through some, all the way to the top,
    and one guy is sitting there deciding whether or not we get
    information.
        Secretary Collins. Well, there is no weeks and months, and
    the unfortunate part of the VA has been a bureaucracy issue. We
    are trying to actually streamline it to get you information.
        Senator Murray. I have other questions. I mean this. I
    would like you to go back and look at that letter and remind
    yourselves we all need the information.
        Secretary Collins. Thank you, Senator.
        Senator Murray. As you know, fixing EHR and getting it
    right for our veterans is about patient safety. During your
    hearing I expressed my concerns about VA moving forward with
    deploying the new system at four additional new sites when it
    is still experiencing very serious issues at places in my
    state, Spokane and Walla Walla. And you said that when it comes
    to EHR you were going to, quote, ``listen to our clinicians and
    listen to our hospitals.''
        Weeks later, VA announced plans to look at firing a
    staggering 80,000 employees this year. I want to know, did you
    ask these VA clinicians and hospitals about how those cuts
    would affect future EHR deployments?
        Secretary Collins. The issue of the employment and the EHR
    deployments are separate. We are not looking--again, I cannot
    emphasize this enough. None of the reorganization that we are
    looking at deals with frontline workers or frontline employees
    that deal with everything from cleaning a----
        Senator Murray. Okay. That was not my question.
        Secretary Collins. So yes, we have been included. Dr.
    Evans, who runs our program, we have incorporated this. He has
    been working the program for well over a decade.
        Senator Murray. Okay. I have 20 seconds left. I have been
    very vocal--you know this--about VA's troubling decision not to
    renew the terms of researchers who are working on absolutely
    critical projects and clinical trials for our veterans. There
    are planned trials that have not started. There are ongoing
    trials that have been stopped. And there are trials that have
    fallen apart due to staff layoffs.
        Yes or no, would you agree that clinical trials stopping
    would have an impact on the care for our veterans?
        Secretary Collins. I think clinical trials are very
    important, and the good thing about it is, is when we looked at
    it there were trials that were coming due, just as they always
    do. I put a 90-day stop on that so we can examine and make sure
    that everything is going good.
        Senator Murray. Yes, I understand there is a pause on this
    new policy. Has a decision been made about what happens when
    that pause stops?
        Secretary Collins. We are currently in the process of
    examining that now.
        Senator Murray. Clinical trials that are out there have no
    idea. They have got to wait 90 days and pray.
        Secretary Collins. At this point in time, like I said, some
    of those were actually stopped at the end, and we are actually
    keeping some in line so that they can continue if need be.
        Senator Murray. Thank you, Mr. Chairman.
        Senator Blumenthal [presiding]. On behalf of the Chairman,
    I recognize Senator Blackburn.

                         HON. MARSHA BLACKBURN,
                      U.S. SENATOR FROM TENNESSEE

        Senator Blackburn. Thank you, Mr. Chairman, and Mr.
    Secretary, we are delighted that you are here today, so thank
    you for your time.
        I do want to say, I have been so impressed with the way
    that you have tackled the EHRM program and that rollout. You
    and I discussed this in our first meeting and in your
    confirmation hearing and when you were in Nashville, and thank
    you again for making the Nashville VA one of your first stops.
        I know that you are planning to take the EHR program live
    in 13 additional facilities in '26. And I know previously we
    have had an issue with VA employees showing up for the training
    and then utilizing the system. So talk to me a little bit about
    how you are going to continue this rollout and then get the
    employees to actually use the system.
        Secretary Collins. I appreciate that, Senator, and I think
    one of the things that we are looking at in this rollout--and
    Senator Murray is no longer here but we talked about this--this
    rollout is being done, in a sense, when I found the system,
    basically the VA side of the house was sort of, we are not
    going to do anything and we are going to make it all
    individualized. And then you had Oracle side that was saying,
    you know, we could just finish this in a short amount of time.
        So what we have done is we have actually now said put the
    onus back on Oracle to actually provide what they are supposed
    to provide, and we have also cut down on our side the amount of
    delay that was caused, really caused the initial problems in
    the rollout, where we had six different locations doing six
    different things.
        So we have taken eight or nine committees that were all
    having to touch stuff before they could get back to a decision
    and cut that down to one committee, that then can communicate
    directly with Oracle to get this started.
        Dr. Lawrence, which I appreciate everybody on the dais who
    helped get him through as our Deputy, he is now in place to
    actually take care of and work to oversee that, and we are
    bringing in others right now. And I have committed to him to
    whatever help he needs to hire, to bring in, to make sure that
    our system is safe and useful for our clinicians to make sure
    that they have that. And so far we have seen that actually
    occurring as we go forward. So I am looking forward to it.
        Senator Blackburn. Okay. And then the employees that were
    instructed to go through the training, they have shown up and
    done the training?
        Secretary Collins. As far as I know, Senator.
        Senator Blackburn. Okay. That is great. And then let's see.
    How many employees have been released from the VA to date, out
    of your totals?
        Secretary Collins. It would just be out of the probationary
    firings, it was about 1,000.
        Senator Blackburn. About 1,000.
        Secretary Collins. Yes.
        Senator Blackburn. Okay. That is helpful. I want to ask you
    about the budget. The President's budget came out last week.
    How did you view the resources that are in there for
    modernizing the VA, and can you give me some examples of how
    you are going to use these resources, moving forward, so that
    the VA is more responsive, and in a more timely manner for our
    vets?
        Secretary Collins. Yes. I think the budget as presented by
    the President is actually one that fulfills the commitment that
    we have talked about, about making sure our veterans are taken
    care of. And I think that is the big issue here when you look
    at the increases. And for all of the folks who have basically
    been saying and accusing us of, you know, going to cut health
    care and cut benefits and cut all this, it does not add up when
    you look at the budget itself, which has an increase either on
    base budget or also using TAP funds, as well.
        So what we are looking at is how do we then use that,
    combined with the efficiencies we are finding, either through
    our contracts or through our employee base, to make sure that
    we are putting more of those resources to our research, toward
    our clinical care, toward our [response unclear]. Also toward
    our--and I know this is a concern of yours, is also toward
    community care, is how we actually balance the two needs.
        So these are going to provide the resources we need. It
    also provides enough money to continue the EHRM, the Health
    Record Management system.
        Senator Blackburn. And then how do we shorten the time that
    it takes for approval to move into community care? I just left
    a meeting with our rural hospitals, and they are willing to be
    a provider. And it is so much more convenient for our veterans
    to get the health care that they have earned, and to get it in
    their communities, when they want it, where they want it, at
    their convenience. And I think that community care is something
    that should be moved on today.
        Secretary Collins. It is, and we are doing that. I have
    made it clear to every staff that I meet, and especially in our
    hospitals, that community care is part of the law. MISSION Act
    is there if they meet the qualifications. And also there is
    always a catch-fall that if the doctors sees that they could
    get better care in the community they can actually do that.
        What we have found in the last few years is that actually,
    and through memos and others, has actually been not encouraged.
    There was an encouragement to keep everything in the VA. So we
    are actually moving forward with those kinds of things.
        What we are also finding, though, is we have a community
    care group right now that is actually looking at how we do
    community care, and I am looking forward to seeing their
    findings here in the next week or so.
        But what we have actually found is some roadblocks that are
    being put in by our own processes to not get people where they
    need to go. So that is something that is very important to me,
    and we are going to continue to look at it.
        Senator Blackburn. Well, I am going to continue to work on
    that issue, and I appreciate your attention to community care.
    Thank you.
        Senator Blumenthal. Senator Hirono.

                         HON. MAZIE K. HIRONO,
                        U.S. SENATOR FROM HAWAII

        Senator Hirono. Thank you, Mr. Chairman. Facts are
    important so why don't we get to some facts.
        You were asked how many VA personnel have been let go, and
    you said 1,000, but this Committee had been given information
    that there were some 2,400 who have been let go, and then you
    are trying to get back to 2019 numbers, which would be another
    70,000 to 80,000. So what happened to the other 1,000 or so
    that we have been told have been released by the VA?
        Secretary Collins. Following the court order, they are back
    employed.
        Senator Hirono. I am sorry?
        Secretary Collins. Following the court order, they are back
    employed.
        Senator Hirono. Okay. So in other words, when you fired all
    these people or let them go, you did not follow appropriate
    procedures, and therefore you had to hire them back. That is
    not what I consider a process that is going to determine
    whether or not people are doing their job.
        Secretary Collins. I disagree with that premise. We had one
    judge in one area. This court is still being litigated, so as
    you well know----
        Senator Hirono. We have actually had, in other departments
    where they have fired people and other judges that have said
    you have to follow an actual procedure.
        So getting back to some factual information, on February
    21, you claimed that the VA has saved millions of dollars by
    firing staff. How much have you saved? You said millions. What
    is the amount?
        Secretary Collins. Those millions in the round-out, I would
    have to get back. Especially now with those who have come back
    there is probably a different number that I would have to get
    back with you on.
        Senator Hirono. Aren't you prepared to give us that
    information, knowing that you are testifying, knowing that you
    will probably be asked for factual information such as this? So
    you do not know. Even if you said, in February, that you saved
    millions of dollars by firing staff, and then you said----
        Secretary Collins. Well, let me reclarify there. We did----
        Senator Hirono. Let me finish my question.
        Secretary Collins. We did say $14 million when we did away
    with our DEI.
        Senator Hirono. You saved $14 million.
        Secretary Collins. Yes----
        Senator Hirono. Okay. So then my next question is, where is
    all that money going? I have a series of questions relating to
    your comments on February 21st. So you said millions of
    dollars. Now you are testifying, first you said you would have
    to get back to me, but now you are saying $14 million. Also, by
    cutting unnecessary programs, can you tell me what unnecessary
    programs, specifically, you have cut? And then you have
    redirected those savings, some $14 million, you say today, to
    veterans. And I would like to know specifically where these
    moneys were redirected? Do you have that information?
        Secretary Collins. The number that I gave you just now on
    the DEI, the $14 million those have been directed to those with
    disabilities and prosthetics. We have also had a part of that,
    millions was also contracts that were either terminated or
    renegotiated, that we are in the process of doing, as well.
        Senator Hirono. I think you need to tell us exactly what
    contracts have been terminated, because that is the thing about
    a contract. You know, when you terminate it, you have to have a
    reason for that. Otherwise, you end up having to pay.
        Secretary Collins. Senator, also, in the contracts you also
    have to, when you are going through contracts and renegotiation
    you also have to make sure that you are doing it properly. We
    are going to give you all the information you need when those
    are actually finished.
        Senator Hirono. I would hope that you would have had all
    that specific information today. You have about 500,000
    employees at the VA?
        Secretary Collins. I am sorry. I did not hear you.
        Senator Hirono. Does that sound right? You have 500,000
    employees at the VA?
        Secretary Collins. No, we do not.
        Senator Hirono. What is the number?
        Secretary Collins. About 470,000.
        Senator Hirono. Okay. That is getting pretty close to
    500,000.
        Secretary Collins. Yes. It is a little high.
        Senator Hirono. And what categories are they employed? I
    mean, for example, how many nurses? How many doctors? Do you
    have these 470,000 employees broken down by categories of jobs?
        Secretary Collins. Well, that is part of our problem,
    Senator. I laid that out in my opening statement and also in my
    conversation with----
        Senator Hirono. So you do not know.
        Secretary Collins. No, and----
        Senator Hirono. You do not have that----
        Secretary Collins. Let me say something.
        Senator Hirono [continuing]. You do not have that
    information?
        Secretary Collins. Let me say something. Yes, we have over
    300,000, probably closer to 400,000, position titles. But you
    know what the problem is?
        Senator Hirono. Thank you.
        Secretary Collins. Before I ever got there, we could not
    even find some of these when our HR people started to look at
    it. So we took what we had----
        Senator Hirono. Okay.
        Secretary Collins [continuing]. At that point----
        Senator Hirono. Let me proceed.
        Secretary Collins. Well, if you want a direct answer, then
    I am giving you a direct answer.
        Senator Hirono. You have a lot of people who are working
    for you. I would like to know, because there are questions
    about----
        Secretary Collins. Well, and I am trying to answer your
    questions.
        Senator Hirono [continuing]. Who are you actually going to
    let go when you go to the 2019 numbers, that is your goal?
        But you were asked some questions about the clinical
    trials. That is very important to provide health care services
    to our veterans when they are enrolled in clinical trials. Do
    you know how many clinical trials are on pause, and do you know
    how many veterans are in clinical trials?
        Secretary Collins. I would have to get that number back to
    you.
        Senator Hirono. Is it 10? Is it more than--are we talking
    about 1,000 clinical trials?
        Secretary Collins. No, we are not talking 1,000.
        Senator Hirono. When you put----
        Secretary Collins. But again, here is the question.
        Senator Hirono. Can you give me a ballpark figure----
        Secretary Collins. I will give you--no, I am not going to
    ballpark because it will be used against me next time I am
    here.
        Senator Hirono. So you do not know. You do not know how
    many people that you have put on pause so that they are not
    getting the health care services that they need, because that
    is what a clinical trial is. You are getting medication. You
    are seeing doctors. You put these trials on pause. You cannot
    tell me how many veterans are now being paused in their
    clinical trials. You cannot tell me how many veterans are
    enrolled in clinical trials. You also cannot tell me how many
    clinical trials impact some--well, you have over 9 million
    veterans that you are taking care of. Clinical trials are very
    important, and you said so yourself.
        Mr. Chairman, I have other questions. You know, it is very
    clear that our Secretary has not come with much in the way of
    numbers, and I really do not know how he is going to go about
    eliminating, getting to 2019 figures for cutting employees, and
    he cannot tell us what the categories of employees are, et
    cetera, et cetera.
        So I think we are going to need to hear from Mr. Secretary
    again. Mr. Secretary, would you commit to coming back to this
    Committee to provide us the kind of information we are asking
    for and to respond to questions?
        Secretary Collins. I will get you the information that you
    asked for----
        Senator Hirono. Will you come back to testify, or is this
    it for us, with you, Mr. Secretary?
        Secretary Collins. I will get you the information that you
    are looking for, Senator.
        Senator Hirono. Mr. Chairman, we are not getting any
    commitment from the Secretary that he will come back to this
    Committee to provide us the responses to our questions. Thank
    you. That says a lot.
        Senator Blumenthal. Senator Tillis.

                           HON. THOM TILLIS,
                    U.S. SENATOR FROM NORTH CAROLINA

        Senator Tillis. Good morning, Secretary.
        Secretary Collins. Good morning.
        Senator Tillis. How are you doing?
        Secretary Collins. Having a ball.
        Senator Tillis. I guess it might be afternoon by now, or
    close to it. Thanks for the time, the few minutes we just spent
    in the office.
        You know, I was going to ask you some other questions until
    I ran into some folks at the elevator who are concerned over
    the proposed 83,000 cuts in the VA. And they asked me
    specifically would I publicly oppose those cuts. I said, ``I
    can't.'' They said, ``What do you know about these cuts? What
    do you know where they are? Are they potential cuts that will
    improve access, outcomes, or costs?''
        So my question to you--what I did tell them, though, is I
    do not believe cuts are real unless there is a recissions
    package sent to the U.S. Congress, so that we codify those
    cuts. And so my commitment to the folks that I was talking to
    was when I see that recissions package, if it is at odds with
    what I consider to be in the best interests of the VA, I may
    vote against it. But right now can you give me an idea of how
    you would rack and stack each of those 83,000 jobs, and where
    you are in that process, and can we expect, at some point in
    the future, to have a recissions package?
        Secretary Collins. Yes, Senator. I think the biggest thing
    here is, I think what we have got to understand is when you
    start out in any business, and I do not care what side of the
    aisle you are on, when you go out to look at somebody, you just
    do not go say, ``Just go do something.'' That has been
    happening at the VA and many agencies in the Federal Government
    for a long time. And typically what you get is a spattering of
    this, you get some who are interested, some who are not.
        So when you look and you put a 15 percent number, which
    everybody characterizes, and I have been accused of firing
    80,000 people here, which is not true. Nobody can predict that.
    And also no one on this dais, on either side of the aisle, can
    say that that many people are going to be fired, because this
    is the reason. When you take a 470,000 person organization, and
    you begin to look at its efficiencies, you begin to look at the
    fact that between the hospitals and the Central Office you have
    added significant layers of bureaucracy that go into this, you
    cannot do it. So we are looking at every step we can.
        But also, I am not going to play it out in a public arena,
    because that is the other time, is if we start saying, here is
    everything we are looking at, then you start, in a pre-
    decisional kind of format, you are not working it.
        Senator Tillis. Look, I get it. What I tried to explain to
    them, I asked them, and I think some of them may be in the
    audience. I wanted to note that I heard you. But I asked them,
    ``How do you rack and stack it? Tell me which specific
    positions you are concerned with?'' Obviously, they do not know
    the answer to that because I do not know the answer to that.
        But here is the problem, folks. Is the VA just great? Do we
    just put it on autopilot? Because that is the question. And
    when people say ``don't change,'' I am saying, ``Right. So you
    are happy with the current state. You are happy with a poorly
    implemented PACT Act,'' that I tried to get people to hold off
    on until we got it right. And now we are dealing with a
    shortfall there.
        So look, do not be against something because it is new. And
    by the way, if any of you need it I have got extra copies of
    ``Who Moved My Cheese?'' in the office. We have got to move the
    cheese in the VA folks, because we are not performing. When is
    the last time I have heard people stand at a parade and say,
    ``Appointments are rocking. Boy, they are doing great.'' When
    is the last time I heard that the electronic health record is
    great? Some folks need to lose their job on a poor
    implementation, and I have got your assurance that they are
    moving forward.
        Folks, the VA is not working for veterans. And if we just
    say everything has to stay the same, and you have just got to
    have more money and more people, you are looking at it the
    wrong way. Maybe, at some point, when we prove that we are
    improving access, improving outcomes, or reducing costs, when
    those policies come before me, then I get excited. But in the
    meantime, I am open to anything that is going to improve the
    service to people and make an installment on a debt that we can
    never fully repay. But we need to be honest with these veterans
    and tell them change is necessary to do that.
        And so to the veterans that I met with outside the hallway
    today, you recorded it but you can use this response. This
    response is ``I am open to any suggestion that improves the
    condition for veterans, period.'' And I cannot say no to
    something because it makes me feel uncomfortable. I do not know
    if it is 83,000, 8,000, or 800. But I have confidence in you to
    go through that process. And at the end of the day I will make
    a judgment on your decisions because I would expect a
    recissions package to make sure that those positions are not
    going to be approved in the future. And that is how I will
    complete my job as a U.S. Senator.
        But in the meantime, I am not going to say do not change,
    because we have to change to do a better job for veterans,
    folks. And we have to be a little bit uncomfortable in going
    through it.
        Thank you.
        Secretary Collins. Thank you, Senator. I could not agree
    with you more, and I think the interesting thing that I came in
    here today was, again, hearing some of the comments in opening
    statements and stuff, I would almost have thought that up until
    January of this year there were no problems in the VA.
        Senator Tillis. It is like nothing to see here.
        Secretary Collins. Nothing to see. So the minute we start
    trying, can we make things better, my only criteria that I have
    looking forward in this is making sure that we are taking care
    of the veterans first. That is the only criteria that we are
    looking at, going through that. And if that means we reshape
    the workforce, we do whatever our goal is. But at the end of
    the day, the metric is, are we taking care of veterans.
        Senator Tillis. Never stray off that course. Thank you, Mr.
    Chairman.
        Chairman Moran [presiding]. Senator Hassan.

                       HON. MARGARET WOOD HASSAN,
                    U.S. SENATOR FROM NEW HAMPSHIRE

        Senator Hassan. Thank you, Mr. Chair and thanks to the
    Ranking Member as well. Welcome, Secretary Collins. Thank you
    for being here today and for your own military service.
        Just a note to my colleague from North Carolina, a lot of
    us have been working hard on reform at the VA for a long time,
    and agree that there need to be changes. But that is not what
    my line of questioning is about. This is about whether the so-
    called changes you are already making are being made with
    thought and transparency in a way that will serve veterans the
    best.
        In your testimony, you stated that the VA is an
    organization whose sole purpose is to serve veterans. You have
    also publicly stated that you plan to fire 80,000 VA employees.
    The quote is, ``That is a goal. That is our target,'' close
    quote. Well, roughly 25 percent of VA employees are themselves
    veterans, meaning that if you do follow through with this plan,
    you will likely end up firing thousands of veterans.
        It is also worth noting that the Veterans Health
    Administration accounts for nearly 90 percent of all VA
    employees. So if you are firing evenly across the VA, you will
    end up firing roughly 70,000 VHA employees.
        So Secretary Collins, is your goal to fire thousands of VA
    employees who work to support and provide health care to our
    veterans? Yes or no.
        Secretary Collins. My goal is to make sure that veteran
    care is done in the best possible way, and putting numbers in a
    place that, of course, you have no blueprint for is not helping
    any veteran in this room.
        Senator Hassan. The numbers that I am talking about are the
    numbers that exist at the VA now, and I am basing my remarks
    and my questions on your public statements, because to many of
    the other Senators' points, we are not getting specifics from
    you or your agency.
        Now, how many employees does the VA have that work outside
    of the Veterans Health Administration?
        Secretary Collins. If you divide it up, in the different
    administrations, the vast majority are close to--what was it
    the last time, about 350,000?
        Senator Hassan. So let me answer the question. Outside----
        Secretary Collins. 370,000 in VHA. The rest are all
    [response unclear].
        Senator Hassen. Outside of the VHA there are 54,000
    employees. It is actually impossible for you to fire 80,000
    employees without firing those who help provide health care to
    our veterans. And I am disappointed that in all this back-and-
    forth you seem to be trying to hide that.
        Secretary Collins. Senator, can I ask a question?
        Senator Hassan. So no one----
        Secretary Collins. I mean, I just want to respond to this
    because I have a question for you. When my goal is to actually
    take care of veterans health care, and when you look at an
    interior designer in a hospital, is that actually taking care
    of health care? I do not think so. Those are the kinds of
    positions we are looking for.
        Senator Hassan. My point is----
        Secretary Collins. When you have multiple----
        Senator Hassan. My point is this. My point is this. If
    there are a few hundred here and there. But you are talking
    about 80,000 employees, and 54,000 employees work outside of
    VHA. So you are taking a meat cleaver approach. There is that
    old adage, ``Measure twice, cut once.'' You guys have been
    cutting without measuring.
        Now let me get to another question.
        Secretary Collins. Well, I am not cutting anything yet.
        Senator Hassan. Well, you----
        Secretary Collins. We have not cut anything yet.
        Senator Hassan. You have cut 2,500 employees, randomly.
        Secretary Collins. They----
        Senator Hassan. Secretary, my time is my time. No one in
    the Trump administration has been able to explain how cutting
    nearly 1 in 5 VA employees will not harm health care and
    service for veterans. In fact, just last week, the VA's head of
    Clinical Services, the top doctor in the entire VA, came before
    this Committee and stated that he has not been involved in any
    discussions about how firing 80,000 employees would affect
    veterans' care, and he had not seen or been provided any
    analysis as to how these planned firings might affect care for
    veterans. That is the VA's head doctor, the person in charge of
    primary care, emergency medicine, surgery, mental health, et
    cetera, saying that no one from your team has even bothered to
    once ask him whether firing one-fifth of all VA employees would
    make health care better or worse for our veterans.
        So Mr. Secretary, why have you not asked the VA's top
    doctor whether your plans to fire 80,000 VA employees would
    harm health care for veterans?
        Secretary Collins. I will not speak for anyone else who
    gave that testimony, but I will say this. In VHA, VBA, and NCA,
    they all have working groups. They all have, at the senior
    leadership, have been working on this process.
        Senator Hassan. Well, this doctor told us that he has not
    been involved in any of those discussions.
        Recent reporting states that the Department of Defense may
    cut the Army's active duty force by up to 90,000 soldiers. To
    cut the force by that much we could reasonably expect that
    thousands of soldiers will end up leaving active duty and
    returning to civilian life, meaning that they will lose their
    military health care and will almost certainly turn to the VA.
    How is the VA preparing to care for those soldiers, and how
    does firing 80,000 employees support that preparation?
        Secretary Collins. You know, again, the interesting part is
    that they will be taken care of, as every veteran who has
    earned the benefit, going forward. I cannot state this enough,
    and we can continue this process with everybody who wants to
    ask, and I get it. But there has not been 83,000 people
    targeted for firing. There has been a goal to look at our
    restructuring, and putting 15 percent----
        Senator Hassan. You----
        Secretary Collins [continuing]. It is a nice talking
    point----
        Senator Hassan. Mr. Secretary----
        Secretary Collins [continuing]. But we have not done it
    yet.
        Senator Hassan [continuing]. It is your talking point.
        Secretary Collins. It is 15 percent----
        Senator Hassan. It is your talking point. We are quoting
    you saying that is the goal.
        Secretary Collins. It is our goal.
        Senator Hassan. Now, okay.
        Secretary Collins. A goal is not a fact.
        Senator Hassan. Now, do you want to reach your goal, or
    not?
        Secretary Collins. A goal is not a fact.
        Senator Hassan. Because most people, when they state a
    goal, decide they would like to reach it. If you do not want to
    reach 80,000, revise your goal, and tell us what you want to
    do. Talk to us about the analysis you have performed. You have
    got a lot of knowledgeable people, both sides of this aisle.
    Both sides of this aisle want to serve veterans. It is our
    primary honor and privilege as Americans to do it. And we are
    asking to engage with you in a way to reform the VA, improve
    care, but make sure that that health care and those services
    are there for veterans. And just tossing out big numbers and
    cutting before you are measuring is not the way to do it.
        Thank you, Mr. Chair.
        Chairman Moran. Senator Cassidy.
        Secretary Collins. Can I finish that, because again, this
    is----
        Chairman Moran. Secretary Collins.
        Secretary Collins. Senator Cassidy?
        Senator Cassidy. This is his time.
        Chairman Moran. Secretary Collins.
        Secretary Collins. This is the problem that we have, and
    this is the problem that I saw when I was in Congress and this
    is a problem that I have seen everywhere. When we go into
    something, and you look at it, you have to go in and look at
    the process to start with. You start with a goal, you start
    with what you are looking for, and then you use the data that
    you find from your organizations to make the best choices you
    can, without a meat cleaver approach.
        But when you also start with a premise that is not true, a
    premise that is not going to--and basically saying things that
    we are not looking at--because I am not sure how we get around
    the fact that we are not cutting the primary health care of
    people who are getting it or cutting their benefits. That is
    not helpful in a collaborative process to say are we working
    it.
        The question I have is, the VA is not working in the way
    that it should work. I am trying to get it to a point where it
    can work for all veterans, and the workforce is a part of that.
        So, I mean, the VA is working undoubtedly, as I have heard
    this morning. It was perfect before this year started. That is
    not true.
        Senator Hassan. And, Mr. Secretary, that is unfair to the
    Members of this Committee, and you need to stop characterizing
    it that way, because that is not what a single person on this
    dais thinks.
        Chairman Moran. Senator Cassidy.
        Senator Hassan. So, Mr. Chair, I am just going to say one
    more thing here. I am eager to engage in real numbers and non-
    magical thinking here. But this witness and the VA cannot have
    it both ways. They cannot set out a goal and then get angry at
    us for asking what the impacts of that goal and those cuts
    would be. Thank you.
        Chairman Moran. Senator Cassidy.

                           HON. BILL CASSIDY,
                      U.S. SENATOR FROM LOUISIANA

        Senator Cassidy. Hey, Secretary Collins. How are you, man?
        Secretary Collins. I am having a great time.
        Senator Cassidy. Good to see you here. Listen, I was just
    with a press conference back home, with reporters back home----
        Secretary Collins. Okay.
        Senator Cassidy. I was asked one, and if you need to get
    back to me on this, I am okay with that. But they asked me
    about the VA's Servicing Purchase program, or VASP. And there
    was a COVID-era program helping veterans who, because of the
    COVID-era shutdown, needed mortgage support. The Biden
    administration abruptly ended it two years ago, according to
    NPR, leaving veterans in the lurch. There was something put in
    the interim.
        Now, apparently Congress has not filled that void. So I am
    asking you about this, and if you have to get back to me that
    is fine. But also kind of challenging the Members of this dais,
    if Congress needs to step up and do something, then hopefully
    we will be able to do something.
        Let me turn it to you.
        Secretary Collins. Yes. The VASP program is something that
    we do not need to be in the mortgage side that we were with the
    VASP program requires us to take on. So we, on May 1st, did end
    that part. It was a discretionary part. That is not
    appropriated funds. It was used and generated from inside.
        We do not need to be in that business. I know there has
    been a lot of discussion on some legislation that is coming
    through, dealing with more partial claims, that can actually
    give the veteran help in the situations that they are in
    without having to go into the situations that VASP created. So
    that is the story on where we are at right now with that.
        Congress does have a big role to play in that. We look
    forward to seeing how that legislation, especially the partial
    claims, comes through.
        Senator Cassidy. Sounds great. Next, because Senator Hassan
    was saying, okay, we need to have some sort of objective
    analysis, you would agree we need an objective analysis.
    Believe me, I think all of us would say the VA needed some
    improvement, so thank you for taking on that big job.
        One thing I have been proposing is something called VetPAC,
    which would be patterned after MedPAC and MACPAC, which gives
    advice from an independent board objectively to the public and
    to Congress as to how to reform, in the case of these two
    programs, Medicare and Medicaid, preserving benefits, but doing
    it more cost effectively for the taxpayer. Senator Hirono and I
    have suggested something called VetPAC, and we have
    reintroduced that this year.
        My question for you is, we had submitted it for the
    legislative review. Your folks said they liked it. But we have
    not yet gotten the technical assistance. So it is something
    that is bipartisan, that would address a lot of the concerns
    being up here, to give us objective reality, and you guys like,
    but we have not gotten our technical assistance. So just a
    request that, by golly, you walk out of here, you call somebody
    and say, ``Hey, Cassidy and Hirono want that technical
    assistance. Give it to them.''
        Secretary Collins. I think they are hearing that right now,
    Senator.
        Senator Cassidy. That is great. It always helps when you
    say it too.
        Secretary Collins. Okay. We will get the technical
    assistance to you.
        Senator Cassidy. That is great. Thank you, sir.
        Lastly, one thing that I have been concerned about, and to
    see where you are on this. I am doctor and I like the fact that
    veterans, if they are not near a VA facility, can go to the
    private sector. But there has not been a good utilization
    review or prior authorization. Prior authorization can be a bad
    word, but I just know from experience that if someone goes
    someplace and there is no limit on the amount of testing that
    the medical facility can order, there is going to be a lot more
    tests ordered, and sometimes they are inappropriate and
    sometimes they bring on complications. Does that make sense?
        Secretary Collins. It does, and I think that is one of the
    things that we are looking at, especially in the community care
    working group that we have currently going, is making sure that
    we are looking to make sure that those equities are in balance
    as far as making sure the veteran gets what they need, the
    doctor have their authorizations.
        We also have an issue, especially in community care, that
    is something I think you and I have spoken about too, and that
    is our third-party administrator system. It tends to be
    something that is a multiple complaint by many in the system
    because it is the sort of conduit between the VA and the
    community, and it has not been working as it should.
        About my first week when I got there, one of the things
    that I did find out was the groundwork had not been put in
    place to do the renewal of contracts this year on those third-
    party administrators. There was supposed to have been work done
    in the prior. So we had to delay that, go to the extra year, so
    we are sort of stuck in a year here in which we did not ask
    for. But it is not actually being able to get to the part that
    we are putting in questions. We are going to have a contract
    that is going to be much better in that authorization side,
    much better in getting the VA and the community on the same
    page.
        Senator Cassidy. I think you are working at least 80-hour
    work weeks, so thank you for doing that on behalf of our
    veterans.
        Secretary Collins. Thank you.
        Senator Cassidy. I yield.
        Chairman Moran. Senator King.

                        HON. ANGUS S. KING, JR.,
                        U.S. SENATOR FROM MAINE

        Senator King. Thank you, Mr. Chairman. Mr. Secretary, on
    February 24th, you announced, I think there was a video of the
    cancellation of hundreds of contracts, 875 non-mission-critical
    you characterized them as, and then there was a lot of reaction
    to that. So in 24 hours, the Department made an internal
    announcement that you were reconsidering that guidance and
    offered a pause on the cancellations. Then, on March 3rd,
    another announcement, 585 contracts would be canceled. You said
    they were non-mission-critical or duplicative.
        On March 6th, I wrote you a letter asking to have a list of
    those 585 contracts. You mentioned earlier today it is not
    weeks or months. Well, in my case it was two months. I got a
    response on Friday that was a non-response. It did not give me
    the list of the contracts. Why will you not tell us what those
    contracts are?
        Secretary Collins. As those are finished, as you well know,
    and I said earlier to the contracts end, we are doing the
    negotiations. Part of those contracts may be rescoping of
    contracts. They are not completely taken down----
        Senator King. I understand that. But just give us----
        Secretary Collins. When we get to the final we will be
    giving those to you.
        Senator King. Well, I do not understand why you cannot give
    them to us now. I just want a list of the contracts. It has
    been two months, 585 contracts. I want to know what they are. I
    mean----
        Secretary Collins. I understand, sir.
        Senator King [continuing]. I am an optimistic kind of guy,
    and I am not suspicious. But the fact that you will not tell us
    what they contracts are that are being renegotiated makes me
    wonder if there are things in those contracts that maybe you do
    not want us to know about.
        Secretary Collins. Well, I will say that, from my
    perspective, that is not it, and we will work to get you the
    information you need.
        Senator King. When?
        Secretary Collins. We are working through it now. We sent
    the last----
        Senator King. How about by next Friday?
        Secretary Collins. I will get with our folks and see what
    we can provide you at that time, and we will see what we can
    get to you.
        Senator King. Well, that is really not a very satisfactory
    answer. It seems to me this could not be simpler, just a list
    of 585 contracts. Somebody has that list. I do not know why you
    cannot supply it to his Committee. When you were confirmed,
    Senator Blumenthal said, ``Will you commit to respond promptly
    to any inquiry from Members of this Committee to request
    information and be fully transparent with this Committee?'' You
    said, ``That is my intention for this Committee, that you have
    every information that you need.'' Well, this is the antithesis
    of transparency. Again, I cannot imagine anything more simple
    than to just give us, somewhere there exists, this list.
        Anyway, let me go on to another question. There has been a
    lot of discussion today about the firings, and you have talked
    about a goal. What bothers me is the goal. If you are talking
    about restructuring the VA, shouldn't you be talking about
    where you need restructuring and not start with an arbitrary
    number? How did you choose 2019 as the number, as the target
    for your staff size? What is magic about that year?
        Secretary Collins. Well, I think that was, when you go back
    to the actual Executive order, which we were following to go
    through, to downsizing our government, making it more
    efficient, and looking at it, and that was the termination from
    looking at sort of the 15 percent, as we look at the target----
        Senator King. Well, my problem with that is if you have an
    arbitrary number, whether it is 15 percent or 2019, that
    presupposes the result that there are that many unnecessary
    jobs. It seems to me you ought to do an analysis of where is
    the duplication.
        By the way, I am not one that is advocating, in any way,
    shape, or form, that the VA was perfect on January 20, 2025. I
    certainly agree that the staffing should be examined, the
    policies, particularly the red tape that Senator Tuberville was
    talking about. I think those are all very good things that
    should be examined. But it should be done in a thoughtful and
    transparent way. And I just do not understand why the magic
    2019, by the way, there have been seven significant veterans-
    related bills passed since that year, including the PACT Act,
    one of the most significant expansions of VA benefits in recent
    American history. And yet the goal is going back to that
    particular year. A goal should be efficiency, not a quota.
        Secretary Collins. Yes, and that is what we are looking at,
    and that is what a goal is, is looking at it. But one of the
    things, when you look at this, just last year the previous
    administration, and through presentations that they made,
    actually advocated for a 28,000 person decrease in employees at
    the VA.
        Senator King. I am not----
        Secretary Collins. So, I mean, it is not a new thing to
    look at it. But I want to agree with you here, Senator, that we
    are looking at this in a way that says what is the best part.
    One of the things, also, there may be a new application in new
    legislation that has come forward, because also newer
    technologies, also newer ways and quicker ways that we can get
    stuff done.
        Senator King. And I----
        Secretary Collins. So that is the efficiency issue we are
    talking about.
        Senator King. Well, in the memo from your Chief of Staff on
    March 4th it talks about this. It says, there is an
    information-gathering report due March 10th, another report due
    April 10th, and then ``a Department-wide review will be
    completed by May 9th.'' That is three days from now. Will you
    share that data with this Committee, whose responsibility is to
    oversee the implementation of the laws and regulations on
    behalf of veterans?
        Secretary Collins. Yes, those are being worked on right
    now, and they are in the pre-decisional format, so there is not
    something to share with you on those at this point, especially
    the one coming out. In fact, we have actually had an extension
    because our Department is so large, so we are not making quick
    decisions. We are not moving forward on that, at this point.
        Senator King. Well, I will go back to my question then, and
    I will end with this. The reaction to the contracts request,
    which it seems to me is so straightforward, does not fill me
    with the confidence that we are going to truly have a
    transparent relationship here.
        We are all on the same side. The whole goal of everybody
    stated here today is to protect our veterans and to be sure
    that they get the services they have earned and the benefits
    that they have earned. And so to the extent that you can work
    with us and allow us to understand what you are doing, that
    would be helpful to develop a more collaborative relationship.
        Thank you, Mr. Chairman.
        Secretary Collins. Thank you, Senator.
        Chairman Moran. Senator Boozman.

                           HON. JOHN BOOZMAN,
                       U.S. SENATOR FROM ARKANSAS

        Senator Boozman. Thank you, Mr. Chairman. Thank you so much
    for being here, Secretary. The VA owes it to the veterans it
    serves to evolve and provide them with the best possible
    experience. I appreciate your commitment to improving delivery
    of veterans health care and benefits. I know improving the
    veteran experience is a priority that both you and I share, and
    we appreciate your hard work in trying to get that done.
        I want to thank you for submitting your fiscal year 2025
    spending plan in a timely manner. The plan raised some
    questions with the Appropriations Committee and this Committee
    as some of the numbers differ from what we expected. To date,
    none of those questions have been answered, and repeated
    requests for a briefing on the plan have not yet yielded
    results.
        As we are trying to get our appropriations bills done, will
    you commit to sending a team over to brief us as to what is
    going on and give us a little bit more detail, so that we can--
    --
        Secretary Collins. Yes, Senator, we will be happy to do
    that.
        Senator Boozman [continuing]. To get things done? Very
    good. That was easy. 2025 and 2026--your 2026 budget request
    proposes a significant reduction in VA's IT systems. DOGE
    review of the nearly 1,000 unique systems at the VA is not
    complete yet. Would you consider balancing your proposed
    reduction in funding until we actually get that report done, to
    see what they find is needed?
        Secretary Collins. We are looking at that right now as far
    as what we do need, and we will be able to work with you as we
    go forward on that.
        Senator Boozman. Very good. You recently announced the
    ending of the VA Service Purchase program, or VASP, that saw
    the VA take on modified home loans for veterans at risk of
    foreclosure. I support the VA looking for ways to avoid the
    financial risks that VASP exposed the agency to. We are worried
    about the current population of delinquent veterans who are now
    enrolled. It is my understanding that as of May 1st, delinquent
    veterans who are not already enrolled in VASP are now at risk
    of foreclosure.
        Now that VASP is unavailable, how does the VA plan to help
    veterans at risk of foreclosure?
        Secretary Collins. I think one of the things that we are
    looking at is any other programs that are out there, also, that
    we go forward. But I think when you have to look at the
    organization, is this an area that we need to be in? And I
    think those are the kinds of things that the decision there was
    the people that had mortgages that were coming due was becoming
    to be a larger burden because we are not a system that is set
    up to own property. So we are going to be working on that, and
    as I said earlier, to one of the Senator, I think we are also
    looking at it from a perspective. I know there is some
    legislation being talked about, about partial claims and stuff,
    that can help them in the long term.
        Senator Boozman. Good. I would appreciate you looking at
    that. You know, it is one thing, going forward. It is another
    thing for those individuals that are caught up in that now. And
    it makes it really difficult.
        How did the VA make the decision to reduce the VA's Remote
    Temperature Monitoring Program for veterans who have
    demonstrated both clinical benefit and cost savings to the VA?
        Secretary Collins. Could you repeat the question?
        Senator Boozman. Well, the VA's recent changes have
    impacted veterans' access to the Remote Temperature Monitoring
    Program. As you may be aware, this program is critical in
    preventing and reducing amputations required because of ulcers
    and other diabetic foot complications. Effective preventions of
    amputations result in significant cost savings for the VA.
        Again, are you aware of that, and if so, how did we come to
    that conclusion?
        Secretary Collins. Senator, I will have to get back with
    you on that one. I have prepared for a lot of things. That was
    just one I will have to get back to you.
        Senator Boozman. Good. No, I understand. You certainly have
    a lot going on.
        During your remarks at President Trump's April 30th Cabinet
    meeting you mentioned that you and Secretary Kennedy have
    discussed the potential of researching psychedelics as an
    effective tool to combat PTSD, TBI, and other mental issues.
    Can you provide further details on how your team plans to take
    action on this interest? I think the Committee is very
    interested.
        Secretary Collins. I can. I think it is something that I am
    committed to doing whatever we can to provide veterans and
    those who have maybe not responded to traditional care and
    others, especially in the area of PTSD, also TBI, the other
    issues that we are dealing with that lead to a lot of what we
    have seen in suicide and death by suicide. So we are looking at
    it right now.
        I think there are 11 studies that are going on. Most are
    performed outside the VA, with our help. MDMA is another one. I
    just saw a program at Emory University in which they are seeing
    some really good results, a single treatment then followed up
    by two weeks of intensive counseling that actually has lowered
    the score number on the PTS scale.
        I am willing to say this, is I want to work with--and I
    said this with HHS and with others, to make sure that we are
    not closing off any outlet for a veteran who could be helped by
    these programs. And I think we will definitely be working with
    Congress on that if there seems to be something else we need to
    have.
        Senator Boozman. Very good. Thank you, Mr. Chairman.
        Chairman Moran. Senator Sanders.

                         HON. BERNARD SANDERS,
                       U.S. SENATOR FROM VERMONT

        Senator Sanders. Thank you, Mr. Chairman. Secretary
    Collins, do workers in the United States have a right to be in
    unions? Secretary Collins, do workers in the United States have
    a right to be members of unions?
        Secretary Collins. Okay.
        Senator Sanders. Yes or no?
        Secretary Collins. Yes.
        Senator Sanders. Okay.
        Secretary Collins. I did not know that was a question.
        Senator Sanders. Okay. President Trump issued an Executive
    order banning collective bargaining in the VA, eliminating
    union rights to 79 percent of workers there, because of
    security reasons. Do you think that workers in the VA are a
    threat to national security if they are a member of a union?
        Secretary Collins. I do not think that was the purpose of
    the EO, Senator.
        Senator Sanders. That is exactly what he said. Then why did
    you eliminate collective bargaining rights at the VA?
        Secretary Collins. I think the interesting issue is that is
    not what the EO was about. The EO was about our national
    security interests of our fourth mission, and if you look at
    the entire EO it is about making sure that the fourth mission
    is not----
        Senator Sanders. Is a nurse at the VA a national security
    threat by being a member of a union?
        Secretary Collins. Okay. Sir, I cannot answer the question.
    We are on different pages. It is not the fact that the VA is a
    national security threat. It is a national security threat that
    if we cannot perform our fourth mission----
        Senator Sanders. No, no, no. That is----
        Secretary Collins [continuing]. That is what we are looking
    at.
        Senator Sanders. Well, the bottom line is unions, 79
    percent of workers at the VA are union members. They no longer
    are able to engage in collective bargaining. To me that is an
    outrage. I think the courts will overturn that. Next question.
        Secretary Collins. No, at this point that is not true.
        Senator Sanders. Let me----
        Secretary Collins. At this point that is not true.
        Senator Sanders. All right. Let me ask you this. Do you
    believe that every veteran in this country, as I believe and I
    think many Members of this Committee believe, are entitled to
    VA health care?
        Secretary Collins. As a veteran, yes.
        Senator Sanders. Yes, Okay. What are we doing right now,
    what are you doing to improve outreach to bring more veterans
    into VA?
        Secretary Collins. Well, I think, let's go back to the
    question you just said, does everybody have a right to be in a
    union. The answer is yes. Does everybody have a right to, a
    benefit that they have earned, to come to the VA? But I cannot
    force them in.
        Senator Sanders. No, of course you can't. But of course you
    can't.
        Secretary Collins. So I am missing--I mean, maybe I am
    missing the point there. I apologize.
        Senator Sanders. The point is there are a lot of veterans
    out there--I know this; I used to be Chair of this Committee--
    who do not know what their benefits are. And it is our
    obligation to say to veterans all over this country, ``You put
    your life on the line to defend America. Congress has passed A,
    B, and C. We welcome you into the VA if you choose to come
    in.''
        Secretary Collins. Senator, I think this is a great place
    for us to have an honest conversation, because I am concerned
    about this, as well. And part of this goes back to how we are
    actually transitioning out of DoD, into VA.
        Senator Sanders. That is one of the factors.
        Secretary Collins. And I think that is one of the big
    things. And there is an honest conversation here, is it
    properly placed right now----
        Senator Sanders. Good.
        Secretary Collins [continuing]. Transition. So I am wanting
    to do that, and we are doing outreach all the time with our Vet
    Centers and everybody else, to let people know.
        Senator Sanders. Okay. I think we could do a better job.
        Secretary Collins. I agree. I agree completely.
        Senator Sanders. Okay. Question. You know, we talk about VA
    health care, which is what we are here to talk about, but we do
    not put it into a context. We are living in a nation which has
    a broken, dysfunctional, wildly expensive health care system.
    In your judgment, just out of curiosity, how does VA health
    care compare to health care out in the regular world for
    civilians?
        Secretary Collins. I think in certain areas, just like out
    in the regular world, you have some hospitals that are
    performing exceptionally and you have some that are not. I
    think that is the problem that we have in our health care
    systems, in general. I think this is something I said earlier.
    We cannot separate out VA from the health care system as a
    whole.
        Senator Sanders. Sure. That is true.
        Secretary Collins. Though sometimes we do that.
        Senator Sanders. All right. All right. Let me ask you this.
    My understanding is that we have, roughly speaking, a shortage
    of 2,500 doctors, 6,600 nurses. All right. What are you guys
    doing to bring in more doctors, nurses, social workers, into
    VA, where they are desperately needed?
        Secretary Collins. Well, one, I want to move doctors that
    are not working with patients and move them into patient care.
    That would be a good start. Nurses, as well. Also, I would like
    to have help from the Congress, as well. We need to actually
    look at our pay structures and our caps on our doctors and what
    we can pay them. It is very difficult to compete when you are
    offering, at some points, hundreds of thousands of dollars
    less----
        Senator Sanders. That is right.
        Secretary Collins [continuing]. For someone to come work at
    the VA.
        Senator Sanders. All right. I agree with you. Do you
    acknowledge, though, that right now there is a shortage of
    doctors, nurses, social workers in the VA?
        Secretary Collins. I acknowledge there is a shortage for
    everybody in the health care industry on those same issues.
        Senator Sanders. But in the VA. I am not criticizing you.
        Secretary Collins. No, no. I mean, we are the same as
    everybody else. That is why I said, we are the same as every
    other health care system. We are struggling to recruit doctors,
    nurses, and others, just as anybody else. And that is something
    we are constantly in outreach about. Sometimes it is helpful,
    sometimes it is not.
        Senator Sanders. The Department of Defense has a medical
    school. You are aware of that, Uniformed Services Medical
    School----
        Secretary Collins. Yes.
        Senator Sanders [continuing]. Which does a very good job.
    Do you think that one of the problems we have overall is that
    we are not graduating enough doctors and nurses in America?
        Secretary Collins. Yes.
        Senator Sanders. All right. Do you think we can be
    expanding schools like the Uniformed Services Medical School to
    bring more people into DoD and VA health care?
        Secretary Collins. It is an interesting concept. I think we
    have got to go back to a deeper issue, is why are more of our
    young people not going to school to be a doctor, a nurse, or
    other things. I think that is a bigger issue.
        Senator Sanders. All right. Fair enough. But that has to do
    with if I am a working-class kid, I am going to graduate
    medical school $500,000 in debt. Correct?
        Secretary Collins. Right.
        Senator Sanders. Is the idea of entertaining programs
    saying you want to go to medical school, we are going to pay
    for your entire tuition, et cetera, et cetera, to encourage you
    to get to medical school graduation?
        Secretary Collins. I think anything that we can look at to
    encourage that, probably you already have that, when you can go
    into the medical and they will pay for your, in DoD, they will
    pay for your medical school.
        Senator Sanders. But it sounds like we may want to expand
    that.
        Secretary Collins. I think it is something, as an overall
    health care system, Senator, you and I probably agree on this
    probably more than anyone else, that we have got to make sure
    that our pool of workers is adequate for all of our systems,
    not just the VA. And the health care system in our country is
    an issue that we have right now. And I think it is a bigger
    discussion. I appreciate you bringing it up, and it is
    something to look at.
        Senator Sanders. Okay. Thank you.
        Secretary Collins. Thank you.
        Chairman Moran. Senator Cramer.

                           HON. KEVIN CRAMER,
                     U.S. SENATOR FROM NORTH DAKOTA

        Senator Cramer. Well, I was encouraged by that dialogue.
    Thank you Senator and Mr. Secretary. And welcome, Mr.
    Secretary. It is a good thing I have not been here all day or I
    would have way too many things to talk about. But right now I
    want to raise an issue related to the discussion you just had.
        Under the first Trump administration we passed the pilot
    program for Solid Start Act, and then under the Biden
    administration we made it a law, specifically to get at the
    issue that I think Senator Sanders was raising, about how do
    you inform veterans more about the opportunities and the
    benefits that they have at the VA. So I would just encourage
    you to look at that and make sure we are managing that well.
        The other thing I would raise, with regard to the
    workforce, which I think Senator Sanders is right about, and it
    is true. We have a shortage of people in health care
    everywhere, and to the degree we can incentivize it, I think we
    ought to.
        At the same time--and I am just going to give a little
    North Dakota example, and Senator Blackburn spoke to it briefly
    toward the end of her questioning--in North Dakota, in this
    rectangular spot in the middle of the North American continent,
    that is about 350 miles across and about 200 miles up and down,
    there are 36 critical access hospitals in rural communities.
    Now, Fortuna, North Dakota, to Fargo, North Dakota, where the
    only VA hospital is, is 412 miles. It takes roughly 6 hours and
    19 minutes if you do not stop to go to the bathroom, to go from
    one to the other.
        But there are these 36 critical access hospitals that have
    20 hospital beds each, and maybe two or three of them are being
    used at any given time. Senator Blackburn talked about
    community care. We have talked about the shortage of
    facilities, shortage of workers and opportunities. And yet
    there is all of this infrastructure not being used. There has
    got to be a way to utilize existing infrastructure and actually
    save money, both for the VA and then create opportunity for
    these struggling hospitals in rural America.
        Secretary Collins. I do not disagree with you at all, and I
    think, actually, Senator Duckworth and I had this conversation
    a long time ago about actually co-locating CBOCs and stuff,
    that we could actually do that. I think that is a great idea,
    as we look at it. But I think one of the things is how we
    utilize the MISSION Act possibilities that we have, to make
    sure that we are getting people there.
        The other problem we have, and this is found not only in
    some of our facilities but mainly some in DoD facilities, but
    also community facilities, it is also an issue of quality care.
    It is an issue of our doctors seeing enough patients to keep
    their clinical skills up, our nurses seeing enough to keep
    their clinical skills up. That is why I have already been
    looking at several options, and we are doing this in certain
    cities now where we can. I am encouraging every one of our
    facilities to have understanding and agreements with local
    hospitals, with community hospitals, where they can go back and
    forth.
        We can also look at DoD facilities, which is also a big
    issue. We have underutilized DoD hospitals, underutilized DoD
    facilities in which we could be--one of those actually we are
    looking at right now in Jacksonville, Florida, in which we
    could actually save our community care costs because we could
    actually have a DoD facility there.
        So there are a lot of things we can work on here, and I
    think it is just a matter of using all the resources that we
    have.
        Senator Cramer. Right. And that starts with knowing what
    they all are. That is a great illustration, the one you just
    made. One of Cramer's convictions is I reject the notion that
    every transaction requires a loser. We should look for
    opportunities for winners and winners, and I think that would
    be one of them. Congratulations. Thanks for doing that.
        I want to get back to the 80,000 thing, because you have
    been battered about it, I think, without us acknowledging the
    other issue. I am going to stick with a lower number. Correct
    me if I am wrong, but I believe there were 52,000 new positions
    added between 2021 and 2024. Does that sound about right,
    52,000 during the Biden administration?
        Secretary Collins. Yes.
        Senator Cramer. Okay. And how has that improved the health
    care offerings for veterans? Are we seeing a lot more veterans?
    Is it better care? That 52,000, has that saved the day for our
    veterans?
        Secretary Collins. I do not think so because I think if you
    also--I use it in a different way. If you go back to 2015, when
    the GAO put us under the high risk--and again, I have been here
    barely 90 days at this point--you know, looking at this, I am
    using the numbers that we are given. And we can talk about will
    the numbers change or anything. I am using the numbers that we
    currently have at VA. Wait times have increased. Primary care,
    mental health, specialty care all rose. Disability backlogs, it
    is not a secret. It was at 260,000 when I came in. It is about
    220,000 now. These are just honest numbers.
        But I want to go back to something 10 years ago. At 10
    years ago, if I had told this Committee, and I did this at our
    senior staff, this is careers and political. I said, ``if I
    told you that in 2025 you are going to have a budget of almost
    $400 billion, and you are going to a workforce of 470,000,''
    you would have thrown a party, everything would have been
    great, because that would have been the answer to everything.
    Well, we are 10 years later and we are still experiencing the
    same problem.
        Senator Cramer. No, I appreciate that.
        Secretary Collins. Servicing the same amount of veterans.
        Senator Cramer. That is the important point. I appreciate
    all of that. I think everybody on this Committee wants to have
    an honest discussion about how to do better for our veterans.
    And real data can help us, because there is plenty of data
    there to tell us where we have been okay, where we have not
    been so good, and where we have been awful or great.
        Thank you, Mr. Chairman.
        Chairman Moran. Senator Cramer, thank you. Senator
    Duckworth.

                         HON. TAMMY DUCKWORTH,
                       U.S. SENATOR FROM ILLINOIS

        Senator Duckworth. Thank you, Mr. Chairman. I do think it
    is important to acknowledge that we did sign up, just in the
    first year of the PACT Act alone, a million veterans. So that
    increase in personnel is also to deal with the increase in
    veterans coming to VA for care, long overdue because of their
    exposure to toxic substances.
        Secretary Collins. We also lost about 400,000 veterans that
    year, as well. So it does equal out.
        Senator Duckworth. We had rollover of a million in the
    first year, that signed up.
        Secretary Collins, when you testified before this Committee
    in January, you stated that it would be a mark of failure--your
    words, mark of failure--if a veteran must contact a
    congressional office for support with accessing their VA care
    and benefits. My office alone has received 143 casework
    requests from veterans since the start of the Trump
    administration, a consequence of service disruptions worsened
    by DOGE's cruel dismantlement of the VA workforce and of the
    critical programs serving our Nation's heroes.
        I am going to give you some examples. A Vietnam veteran did
    not receive his benefits for three months due to greater than
    usual processing times. A veteran in urgent need of mental
    health services was told that the earliest available
    appointment was 6 weeks away. A veteran's widow and cancer
    survivor had her CHAMPVA-covered prescription canceled without
    notice, forcing her to pay $700 out of pocket. An Iraq war
    veteran needed his records to apply for his disability benefits
    but was met with a 6- to 12-month backlog. Now, backlogs and
    delays are not new to VA. They were there when I was at the VA
    under Secretary Shinseki in the Obama administration.
        And so I think, I would agree that this is indeed a mark of
    failure, and I am requesting your commitment to work together
    to overcome this backlog. This will require the immediate
    reinstatement of all 2,400 VA employees who were
    indiscriminately terminated when Elon Musk and his DOGE cronies
    failed to evaluate civil servants on the basis of merit, and
    failed to use a scalpel to root out the bad apples who are
    failing to effectively execute the mission, and instead chose
    the most wasteful, inefficient, and lazy path in simply firing
    probationary employees en masse, which, ironically, represents
    some of our Nation's most motivated, most idealistic, and most
    energized Federal employees. Those probationary employees who
    had signed up since the PACT Act was passed, for example.
        Those Americans, including thousands upon thousands of
    veterans who made the patriotic decision to serve their country
    and begin their civilian careers.
        Senator Collins, will you commit to reviewing the status of
    all terminated VA employees and promptly reinstating them and
    to protecting the VA workforce against additional
    indiscriminate mass firings?
        Secretary Collins. Well, most of the ones that I have
    already testified, the probationary, were brought back to work
    in that setup, so they are already back at work. And we are
    going to keep looking at our setup and how we do it, because
    nothing we have done so far--we have protected over 300,000-
    plus positions that did not--they protected those that were
    directly with disability care and with health care benefits.
        I just have a question, and I appreciate your concern,
    because I do still think when they have to call your office, it
    is a failure for us. I say that to all of our hospitals, and I
    say it to all of our veteran benefits.
        I have a curious question here. You brought up something
    that is very close to my heart. Was that veteran who was given
    six weeks for an appointment, were they given a community care
    option?
        Senator Duckworth. We could get you that information. But
    if you----
        Secretary Collins. I would love to know, because I want to
    help if we can.
        Senator Duckworth. With all my open cases, I would love to
    work with you.
        Secretary Collins. And also, again, I have acknowledged
    this from day one. You and I have talked about this. The calls,
    they represent something we are not doing right, and I think
    that should overlay everything we are talking about here is,
    why is this a problem? Why are we still there? You know,
    records that take 6 to 12 months, that is possible. I am
    assuming that is probably a DoD issue, trying to get their
    records out of the DoD. These are all issues that I want to try
    and fix.
        Senator Duckworth. They have had access to VA records, as
    well.
        Secretary Collins. Okay.
        Senator Duckworth. Let me just go on to the next thing. In
    an official letter in response to Senator Tammy Baldwin's
    oversight letter on the Veterans Crisis Line, dated April 7,
    2025, you wrote, and I quote, ``While 24 VCL employees
    erroneously received probationary termination notices, all
    notices were rescinded. All terminated employees were
    reinstated, have been rehired into the same positions they
    previously held,'' end quote.
        Secretary Collins, while I appreciate your candor in
    finally acknowledging that, in fact, VCL employees were
    terminated, and clarifying that this was incompetence and not
    malicious intent, I hope you recognize that your work in fixing
    this mistake is not complete. Personally, I know of at least
    one veteran who you still have failed to reinstate, and this
    was a person who did so well that they were promoted to help
    train other VCL hotline employees, the type of person who is a
    supervisor on a shift. They still have not been reinstated.
        Look, the Veterans Crisis Line serves veterans in their
    darkest hour, and it is our responsibility to make certain that
    it operates to the highest standards, just as every military
    commander understands that our warfighters' effectiveness,
    indeed their lethality, depends on a fully resourced, diverse
    network of enablers possessing the capability and capacity to
    support a given mission's requirements. You cannot just invest
    and rehire the pilots of the aircraft and not retain the
    refuelers and the mechanics who fix that aircraft.
        Secretary Collins, do you agree that support staff who
    train, equip, and handle the basic operational and
    administrative functions at the Veterans Crisis Line program
    are mission critical?
        Secretary Collins. That is why we brought them back,
    Senator. And I think there is something, though, that we need
    to also clarify here, and this was clarified not by our senior
    level. It was clarified by career employees that know VCL, who
    answers the phone, who talk to our veterans, was let go.
        Senator Duckworth. Right, but the VCL----
        Secretary Collins. No, no----
        Senator Duckworth [continuing]. Cannot operate without the
    other people, as well, like the supervisors on shift or the
    people who train the VCL. You are parsing your words, and there
    are----
        Secretary Collins. I am not parsing.
        Senator Duckworth [continuing]. Veterans Crisis Line people
    who have been fired, who have not been reinstated, and these
    are people who actually are training the people who are
    answering the phones. These are people who did so well as a
    phone answerer that they are the supervisors of the people. And
    like I said, you cannot just say, okay, we are going to take
    care of the pilots but not the refuelers and the mechanics who
    maintain that jet.
        Secretary Collins. And I think we can actually find common
    ground agreement here that that was why they were brought back.
    But also I will not accept the premise, when it was given, that
    people were not being answered on the call line when they came
    in, which has just been talked about many times in the press,
    by others. That is not true. I will acknowledge the fact that
    we brought back staff to help in those situations, and that is
    why they are not exempted. And we did do that.
        But I will not also let it be put out there that people
    were not getting their phone calls answered because those were
    the ones that were let go. Those were not the ones that were
    let go. And I think we at least need to be honest about the
    situation, as far as I agree with you that is why they brought
    them back. And if you have a situation with one person, please
    let me know. Let my office find out, and we will talk about it.
        Senator Duckworth. There is more than one person being
    affected.
        Secretary Collins. Thank you.
        Chairman Moran. Senator Sullivan.

                           HON. DAN SULLIVAN,
                        U.S. SENATOR FROM ALASKA

        Senator Sullivan. Thank you, Mr. Chairman. Mr. Secretary,
    thank you for your testimony today. We all want to take care of
    our veterans. And, you know, you and I have talked about it,
    and I want to thank you on a couple of things.
        One of the biggest issues I have seen in my 10 years here,
    one of the biggest scams I have seen in terms of hurting
    veterans, was the implementation of the Camp Lejeune Act that
    we passed here to help Camp Lejeune Marines and their families
    and sailors who were exposed to toxic water. You want to talk
    about taking care of marines and taking care of veterans, I
    worked with my colleagues on the other side of the aisle for
    years, to try to get them to cap contingency fees to the
    lawyers who are advertising billions of dollars on Fox News and
    CNN, and none of my colleagues would do it. None of them. Why?
    We know why. Every one of them knows why.
        So these law firms were charging 60 and 70 percent
    contingency fees to steal money from sick marines and their
    families. That happened. I met a woman outside right there. I
    asked her about it. She said, ``I am paying 40 percent,
    Senator,'' from some ripoff law firm. I tried to get my
    Democratic colleagues--by the way, the former chairman of this
    Committee, who is no longer here, bye-bye, I think, because he
    was screwing veterans and favoring trial lawyers over veterans.
        So when we talk about taking care of veterans, I get a
    little miffed when my colleagues over here bring the show, and
    they would not do it. You know who is doing it? You are doing
    it. You are doing it. Thank you. You put out a scam alert,
    saying if you are getting charged over 25 percent by a law
    firm--and by the way, the attorney general of President Biden
    worked with me to put that 25 percent cap. My colleagues would
    not do it. No, no. No, no.
        So it is a little rich when I hear everybody talking about
    taking care of veterans, and I spent a decade trying to get
    Democrats to help me, and they never did it. You are doing it,
    so I want to thank you for that. You put out a scam alert.
    There are still law firms, who fund Democratic campaigns, who
    are still charging marines and their families 60 and 70
    percent.
        So can you continue to work with me and this Committee to
    put out scam alerts so these patriotic marines and their
    families and sailors--and by the way, this is zero sum. You get
    a million bucks, okay. It is either going to go to the law
    firms or to the marines. And I know what side they were on, and
    I know what side the former chairman of this Committee was on.
    And you are on the side of the veterans. You are the side of
    the marines. You are on the side of sailors. So thank you,
    because you know what? It is a little rich for me to watch all
    this theater when I know that you are taking care of them.
        Do you want to comment on this? I appreciate the scam
    alert, but gosh darn it, I am still seeing these ads on TV. My
    staff calls these law firms, 70 percent. It is the biggest
    injustice I have seen since I have been here as a Senator,
    ripping off sick marines and sailors and their families, and
    nobody on the other side of the aisle helped. None. I worked
    this harder than any other issue since I have been here as a
    U.S. Senator, and you are helping.
        Do you want to just comment on that? Thank you very much
    for the scam alert. And by the way, the former attorney general
    said if you are a law firm and you are charging a sick marine
    more than 25 percent, that is a criminal violation. I have
    talked to Attorney General Bondi, and she is going to bring it.
    Criminal and civil violations if they go over 25 percent, or 20
    percent if they are just doing the administrative filing. So
    thank you on that.
        Secretary Collins. Senator, I appreciate that, and I will
    work with anybody on this Committee. It does not matter the
    side. If you are doing something that should not be done to our
    veterans--I have said this before. I take this personally. I
    take it. We can disagree about things. We can disagree about
    numbers. We can disagree about anything else. But at the end of
    the day, I want to honestly say that I believe all of us are
    trying to get the veterans help. And when you have folks who do
    that, when you have firms that do that, we will continue to put
    the scam alerts. If they are watching today they can get mad at
    me all they want. I really do not care.
        Senator Sullivan. Trust me. They are mad at me. They are
    coming for me, but I do not care, because I know I am doing the
    right thing for United States Marines and veterans and their
    families. It is the right thing. Everybody here knows it.
        Secretary Collins. Yep, it is. I agree with you.
        Senator Sullivan. Let me thank you on another thing. Every
    year, every hearing, I have been coming to this Committee
    talking about the Alaska backlog. My state has more veterans
    per capita than any state in the country. It is a proud
    heritage over the great State of Alaska. And the previous
    administration, the backlog, to just get an appointment,
    ballooned to--it was almost 15,000. We have got 80,000
    veterans. That is like 15 percent. It is over 15 percent. I
    finally went down, and I pressed the former Secretary, to 5,500
    at the end of January, when the Biden administration left.
    Still way too high. Do you know what it is under your
    leadership, Mr. Secretary, right now? I will tell you. It is
    1,361. I do not think I have been here the whole time where
    that backlog has been that low. In three months you did more
    than Biden did in four years on the Alaska backlog. So I want
    to thank you for that, because that is real service for our
    veterans.
        Secretary Collins. Thank you, Senator. We are going to
    continue to do that for all veterans in every state. We want to
    make sure that those numbers are coming down and that the
    veterans are getting the benefits that they deserve and also
    the health care that they deserve.
        Senator Sullivan. And if you can help us finally get a call
    center up there, I know it is an issue that you and I have
    talked about, it will bring that backlog even down further.
        But I want to thank you on both of those things. I will
    submit some questions for the record related to community care
    and some of the other issues you are working on. But on both of
    these issues, I appreciate your focus, because this is what
    taking care of veterans is.
        Chairman Moran. Senator Slotkin.
        Senator Sullivan. Bringing down the backlog and making sure
    our marines and sailors do not get scammed.
        Secretary Collins. Thank you, Senator.

                          HON. ELISSA SLOTKIN,
                       U.S. SENATOR FROM MICHIGAN

        Senator Slotkin. Thank you. First of all, I just want to
    recognize the Chairman. Thank you for holding this hearing. I
    think it is a bipartisan goal to support our veterans, and I
    think it is one of the first hearings I have had where, after a
    confirmation hearing, we have brought the Secretary back in
    short order. So I appreciate that.
        Secretary Collins, during your confirmation hearing you
    assured me and the others here that, quote, ``the mission is
    the veteran,'' and quote, ``that you would not sacrifice the
    veteran.'' I took you at your word, as did many on this side of
    the dais.
        But since you have taken office, you have heard it, you
    moved to terminate VA contracts, offered to buy out VA
    employees that were in already shortage situations in those
    career fields. You placed a hiring freeze on critical VA
    employees serving veterans. Twenty-four hundred recent VA hires
    were let go, and then I think because of the courts, brought
    back. And, you know, you have been here today doubling and
    tripling down on that.
        I have no problem with cutting fat in the VA. I worked at
    the Defense Department. If someone had said to me, ``Cut fat,''
    I would know exactly where I would cut. But it is the nature of
    the cuts. If you are firing someone on a Friday and they are
    being brought back on a Monday, no CEO in America would be
    lauded for that kind of sloppy cuts.
        And then when you came to Michigan, you came to Howell,
    Michigan, I think in the last month and a half, you were asked
    directly about the potential for 80,000 additional employees to
    be cut. And instead of pushing back you just said, quote,
    ``There is going to be a lot of friction.''
        And I understand that you are wordsmithing things to say
    that no nurses or doctors in the VA facilities are going to be
    touched. That is good. But I held a roundtable with veterans,
    these are folks who are in the business. And their concern was
    that if you are a veteran and you walk into a VA, in Iron
    Mountain, and you need to get a claim. You know, you put in a
    claim to get a knee surgery, and there is no claim caseworkers,
    there is no people working on those claims, and it takes you
    two years to get an answer, that is also not access to care.
    The doctors and nurses may be there, but if you cannot go in
    and you are in pain every single day, that is also a problem.
    It is a problem for Veteran Center staff, who have not been
    excluded, primary care administrators, IT staff. I know it is
    wonky, but you have just accelerated the electronic health
    record transition. I think IT staff are important if we are
    going to make sure we do not lose records of our veterans. And
    then benefit claims administrators. These are all people who
    kind of do not meet your criteria to be saved.
        We all want to serve the mission of the veterans, but what
    was really strange was that we had the Deputy Chief Medical
    Officer up here for a hearing, and we said, ``What is the plan
    on cutting this potentially 80,000? Have you been consulted?''
    And they said, very clearly, no.
        So I am having a problem understanding how I am to believe
    that the veterans in Michigan are going to get the same or
    better care, which is what we want, when you seem to be sort
    of--I know you are claiming that these 80,000 are like DEI and
    interior designers. There is no way that all those 80,000 are
    in those job fields. So help me understand how you are going to
    preserve that veteran who needs the knee surgery but there is
    no one to process his claim.
        Secretary Collins. Thank you, Senator. I think there is a
    lot to unpack there, and yes, the mission is the veteran. And I
    want to go back to one of the statements you made earlier. You
    said you worked in DoD. If you want to find it, I would just
    happen to turn the table and say if you came to work at VA you
    would probably be able to do the same thing.
        Senator Slotkin. For sure. I do not have a question with
    that.
        Secretary Collins. So I think that----
        Senator Slotkin. But 80,000 is different than cutting--and
    I think, again, any CEO in America who fires people on a Friday
    and rehires them with back pay a week later, would be fired
    from their job. It is sloppy, and you know it.
        Secretary Collins. I think I will disagree with the judge's
    decision there and continue the appeals process on that. So, I
    mean, look at it from that perspective as we go forward. But
    also, again, when you look at these issues and you look
    forward.
        I mean, it is interesting to me. I would just be curious,
    and I am just playing the scenario out, if you go into DoD is
    20,000 a proper number? Is 50,000 a proper number? Is 10,000 a
    proper number? At the VA, we exempted over 300,000 positions to
    ensure patient care, patient quality, and disability benefits
    were being done.
        Senator Slotkin. So how come there were people fired and
    then rehired from the Veteran Suicide Hotline? Like you have
    acknowledged, I think, even publicly, that some of these things
    were a mistake. It does not give us confidence that an 80,000
    number, which is just a number--you did not say career fields,
    you did not say whatever; you just said 80,000--that that is
    being done with a scalpel and not a sledgehammer. And I think
    for veteran care, again, it is not me that is the only one
    asking these questions. It is veterans who have a very
    different political view than me, who are getting seriously
    agitated back home.
        So I just do not understand the logic behind an across-the-
    board haircut.
        Secretary Collins. Well, I think the biggest thing is, what
    you are looking at here is I think right now there has been,
    because this is what I have had to fight for the whole time, is
    to fight this idea of just being blanket numbers thrown out,
    playing Trivial Pursuit with numbers and others. It has scared
    veterans. So honestly, what are they going to hear? If all they
    hear from people is, ``If you cut this then it is going to
    actually impact my health care,'' then what are they actually
    going to think. Because one, they have not seen a plan, you
    have not seen a plan, because we are still working the plan. I
    am not going to play out a plan in public that would actually
    take employees. You would not do it in your own office.
        Senator Slotkin. And I know I am over, but if you----
        Secretary Collins. So I mean, this is a goal.
        Senator Slotkin [continuing]. But it is playing out in
    public, because you have fired people, and then they have been
    rehired. That is not a secret plan. People in my district--
    marines, veterans--have been fired from their VA jobs, and then
    brought back. So it is not that there is some sneaky plan. You
    are in it. You are living it, and you are living the sloppiness
    of it.
        So I am sorry. I know my time is over, but I cannot agree
    that the 80,000 is going to be a nice, trim scalpel approach.
        Secretary Collins. We will just have to agree to disagree,
    Senator.
        Chairman Moran. Senator Banks.

                            HON. JIM BANKS,
                       U.S. SENATOR FROM INDIANA

        Senator Banks. Thank you, Mr. Chairman. Secretary Collins,
    the President's budget calls for a nearly $5 billion increase
    for the VA, primarily for medical care and for homelessness.
    You have been accused of cutting care and benefits--we have
    heard a great deal of that today--which is obviously a scare
    tactic. How do you plan to target the new funding that you are
    requesting?
        Secretary Collins. Exactly what you just said there, and
    that is to our health care side, I mean community care side.
    Community care is growing, but it has actually been under-
    budgeted in the last few years by the previous administration.
    So we have got to actually make sure that the proper moneys are
    being put into community care. Also looking at how we actually
    need to improve our direct care services.
        We have got a lot of issues out there that range from, not
    only recruitment and retention of employees, but also our
    facilities, the things that we have. Our average age of a
    facility is well over 60 years old. These are the kinds of
    things that we are working right that again, along with a
    reshaping of the force that we are looking at right now,
    looking at our contracts, to make sure that some of the folks
    sitting behind me actually get the care that they have deserved
    and earned.
        It is interesting to me though, again, when we talk about
    here in the last little bit I have had, and some of the
    conversation today is where people have called offices and said
    they have had appointments that are delayed or they cannot get
    it. In all fairness, I just have to ask, that was the same
    thing happening in December. That was the same thing happening
    in November of last year. The only difference right now is I am
    sitting here saying we are looking and going through a
    comprehensive approach on how to size the force at the VA, and
    spend the money that you and the House appropriate to us. That
    is the only difference. And again, I keep seeing veteran after
    veteran after veteran standing here saying, ``I couldn't get in
    to see my appointment. I couldn't get in.'' The problem is,
    when was that? We are still working on that because we have
    issues in our systems, and a bureaucracy is not good. And we
    had hospitals and VAs who are not sending people to community
    care.
        Senator Banks. Cutting bureaucracy means better service for
    our veterans.
        Secretary Collins. Yes.
        Senator Banks. And that is what you are doing. How are you
    planning to reinvest any savings from head count reduction to
    improve services for our veterans?
        Secretary Collins. That will go back into our different
    services, and I think that is what we have already shown and
    had the sign up on taking it back into community care, back
    into improving our IT systems, back into improving our
    prosthetics, back into improving our situations with our mental
    health counselors and others, that we can actually show real
    results in.
        One of the things that is amazing enough, that has not been
    talked about here today, and I think it, for me, has been the
    top line that I have talked about all along, except in a way
    that, frankly, was not truthful in the sense of what we are
    doing, is suicide has not been discussed here today. And the
    issue that we still have, since 2008, have not seen a
    significant decrease in our veteran suicide rate since 2008,
    although we have spent literally billions of dollars on that.
        So when we talked about earlier, we talked about other
    kinds of care, we have talked about how can we tap into
    research into maybe psychedelics or other things that help,
    getting in more with our VSOs and our nonprofits to actually
    make a difference here. I think this is something we have got
    to have. We sometimes get caught up in the overall scheme of
    the VA, believing that the VA, unfortunately being on the Hill,
    is something that is manipulated or brought back into a certain
    way that is special. We are special in the sense that we get to
    treat the veteran of the United States. It is the most precious
    gift that we have.
        But we are not unique in health care. We experience the
    same issues that all of health care, that we got to speak about
    earlier. And we are going to make sure, just as every other
    health care organization goes through this kind of look and
    reorganization of their facilities, they do the same thing.
        Senator Banks. I appreciate that you are focused on that
    very much. Go back to the reduction-in-force, though, and tell
    me, how much do you expect the reduction-in-force to be
    retirements or early retirements versus separations?
        Secretary Collins. We are seeing a good bit of that right
    now, as you always have--that is one of the things, that I got
    accused of from the cuts that we had, that somebody had not
    been able to get their next appointment and the doctor had
    actually just retired out and they were just bringing in the
    new doctor. That is not on reduction-in-force. That is just a
    simple matter of attrition in the hospitals.
        So some of that will be taken care of. Some have taken the
    early retirement possibility, which has been a program that I
    think has worked in a great deal. So some of that will be
    normal attrition like that and also the incentivized attrition.
        Senator Banks. I am almost out of time, but I want to ask
    you, really quickly, reviewing the situation that you
    inherited, the Biden administration's 2025 budget was
    misleading, as you know. They misrepresented the budget
    shortfall that they created. Congress closed the immediate $6
    billion shortfall in March, but are there still budgetary
    problems that we have to clean up?
        Secretary Collins. I think that is what we are trying to
    work through right now. What is interesting is I promised in my
    confirmation, I think you remember, maybe you and I had this
    conversation, I was not going to come to this Committee, or
    even send you information, in which I cannot give you either
    the information because it was not ready yet or we were not
    comfortable with where the numbers are.
        The same thing applies to a lot of the questions I have
    gotten here today. As we move through these processes we are
    going to make sure that we give the information. We are working
    through a budget process right now that does not come and
    surprise you in a political way at the end of the year. So I
    think that is why the President and his budget, which is very
    favorable to the VA in looking at what we need to do, is
    something that we can then build on and give you more
    information as we go.
        Senator Banks. Thank you for what you are doing.
        Secretary Collins. Thank you.
        Senator Banks. I yield back.
        Chairman Moran. Thank you. Mr. Secretary, we are going to
    have another round, but it is only the two of us, Senator
    Blumenthal and I. Senator Blumenthal is committed to 5 minutes.
    I have a constituent waiting in the back room. I am going to be
    back in 5 minutes. I have a couple of questions for you, then
    we will conclude the hearing.
        Secretary Collins. Okay. Thank you.
        Chairman Moran. Senator Blumenthal.
        Senator Blumenthal. Secretary Collins, you have just told
    Senator Banks that you are going to give us the information
    that you have. You have failed to give us the information that
    you should have, or you do have and you are declining to
    provide it--the numbers of specific categories of people whom
    you plan to fire, the contracts that you have canceled or that
    you plan to cancel. I am going to ask you to provide that
    information in written form. I am not going to get into an
    argument with you here. But just so you understand, I think
    that a good portion of the questions that you have been asked,
    frankly, you just have not answered, and I am hoping that you
    will provide those answers.
        Let me tell you one fact that I think we do know, and that
    is that your goal is to fire 15 percent of the VA workforce.
    You have said it again and again and again. I am going to ask
    that a list of your quotes be put into the record, most
    recently to the Arizona Public Media, AZPM, on May 1, that,
    quote, ``I said there was a goal of 15 percent, which if you do
    the math is about 80,000.'' What I take away is you have got a
    goal of slashing 15 percent of the workforce, come hell or high
    water, and you are going to figure out whom to fire as you go
    along. And that means frontline people who have been hired
    among those 50,000 or 80,000 people. And I have a list right
    here, which I am also going to ask be entered into the record,
    they are numbers. They are real people.

        [The information referred to appears on page 104 of the
    Appendix.]

        Senator Blumenthal. We are talking about, for example,
    18,000 registered nurses and 5,000 social workers. Those are
    increases of 20 and 25 percent. Those are frontline people who
    have been hired. The total number is an approximately 17
    percent increase in the VA workforce. They are schedulers,
    physicians, police, psychologists, registered nurses, social
    workers, and 31 percent of them are VBA. You fire those people.
    Your goal is to fire 15 percent of the total workforce. They
    are among them. You are going to lose quality. You are going to
    lose time. There is no way around it.
        Now, I welcome your commitment that the savings--you just
    told Senator Banks--will go into care for our veterans, but
    that is not what you said on April 17th. You said that, quote,
    ``That will be up to the President.'' Now, I do not know which
    is true, but I hope that the savings will go into caring for
    veterans, but is that your commitment now?
        Secretary Collins. I think, one, I would like to see the
    context of that quote and where it was actually put. I think
    the issue here today is, look, Senator, I think this is where
    we got--it is not right to stand here today, because I actually
    think there was a quote from others, and I will not say you
    specifically, there have been others, that says we are going to
    take 15 percent of doctors, 15 percent of nurses. That is just
    wrong. It is almost cruel.
        Senator Blumenthal. It would be cruel. It would be cruel if
    it happened.
        Secretary Collins. It is not happening.
        Senator Blumenthal. Let me just----
        Secretary Collins. By even repeating it, though, you are
    letting my workforce know, which are going through a process,
    if you were going to reorganize your office, would you just
    stand up at a staff meeting today and say, ``Here's the 16
    people we are discussing right now.''
        Senator Blumenthal. These are your words. These are your
    words, in Tucson, on April 30th.
        Secretary Collins. Okay.
        Senator Blumenthal. In KOLD News, April 28th. Scripps News,
    April 21. Spectrum, local news, April 9th. Detroit Free Press,
    April 1. Collins told the veteran that cutting 80,000 people
    from the Department is a goal. On April 9th----
        Secretary Collins. What are we doing here, Senator? I have
    admitted that here today.
        Senator Blumenthal [continuing]. 15 percent is a goal.
        Secretary Collins. I have admitted that here today.
        Senator Blumenthal. Let me just go on, because the record
    is there.
        Secretary Collins. It is. Nobody is denying you, Senator. I
    am not sure the point you are trying to make, because I have
    said it is a goal. But I have also said it may not actually get
    to that number. It is what will the process we are going
    through, and I am not going to work out a process in front of a
    committee or anywhere else, in which we are still in the
    deliberative process. Because at the end of the day, with
    470,000 workforce----
        Senator Blumenthal. The goal----
        Secretary Collins [continuing]. That is incompetence. That
    is malpractice for me to do that in front of a committee. I am
    not going to, to scare people. But I have also made the
    commitment that we are going to make sure that our health care
    is provided for, that our people are getting their disability
    benefits. And what we are seeing right now, whether you agree
    with the numbers or not, those failed when we added billions of
    dollars and thousands of employees. That is the part we cannot
    get away from.
        Senator Blumenthal. Let me ask you----
        Secretary Collins. And I am willing to work with you in any
    way to do that.
        Senator Blumenthal [continuing]. You responded to Senator
    Sullivan's question about capping certain attorneys' fees for
    the Camp Lejeune victims. Are you aware of the Ensuring Justice
    for Camp LeJeune Victims Act that Senator Tillis and I have
    offered to put caps on attorneys' fees?
        Secretary Collins. No, but it should have come a long time
    ago. I do not know what took so long.
        Senator Blumenthal. Well, will you support our legislation?
        Secretary Collins. I have not seen the legislation, sir. I
    do not comment on things I have not read.
        Senator Blumenthal. Well, instead of just putting out a----
        Secretary Collins. Why isn't Senator Sullivan on it?
        Senator Blumenthal. Instead of putting----
        Secretary Collins. I am just curious. Why wouldn't Senator
    Sullivan be on that bill?
        Senator Blumenthal. You know what?
        Secretary Collins. I am just curious. Because, I mean, it
    would help me out because we have actually seen this play out,
    and I am not going to let the veterans be duped into paying 70
    percent.
        Senator Blumenthal. Maybe you can talk to Senator Sullivan
    and he will join the bill. But I am asking for your support.
        Secretary Collins. Please, I will take a look at your bill
    and see what we can do.
        Senator Blumenthal. You are not aware of it?
        Secretary Collins. Excuse me?
        Senator Blumenthal. You are doing a scam alert. I would
    suggest that maybe the way to really help veterans is to
    support legislation to put caps on it.
        Secretary Collins. Are you denying that this is happening?
    Because if not, I mean, I have----
        Senator Blumenthal. You know----
        Secretary Collins. You are asking me to support a bill that
    I have never read, sir, and that is just not fair.
        Senator Blumenthal. I am going to take a little more time--
    --
        Secretary Collins. I will be happy to read the bill.
        Senator Blumenthal [continuing]. Because he seems to feel
    that--he is asking the questions here. But I am happy to
    continue the conversation.
        Chairman Moran. Senator Blumenthal, let me see if I can sum
    this up. I think the Secretary has said he will take a look at
    the bill.
        Secretary Collins. Yes, yes.
        Chairman Moran. And it is a bill that you do not know
    anything about, so you cannot say whether you are for it. And
    Senator Blumenthal is happy to have your support after you look
    at it.
        Secretary Collins. Correct. Thank you.
        Senator Blumenthal. Well said, Mr. Chairman.
        Chairman Moran. Thank you.
        Secretary Collins. The Chairman----
        Senator Blumenthal. Let me ask you--Secretary Collins, I
    just have a couple of quick questions for you. Will you commit
    to provide privacy for telehealth professionals doing mental
    health care?
        Secretary Collins. We have already done that, sir. Anything
    in our return-to-work policy, if they are actually put in a
    position where they do not have privacy, it is against the
    policy of return to work, and they will be----
        Senator Blumenthal. Do you deny the accuracy of The New
    York Times----
        Secretary Collins. Oh, very much so. And I will be happy to
    provide you everything. They were contacted. Everything that it
    showed was that our systems were working. And anything that
    they actually reported--by the way, we asked for veterans where
    care had been affected by that. They could not produce a single
    one. In fact, The New York Times even produced, of overworked,
    crowded conditions, they sent our press people to empty rooms.
    So yes, I do deny it.
        Senator Blumenthal. You deny--will you provide us a factual
    refutation of it, not just----
        Secretary Collins. We can, and we also did it--I think we
    are actually putting that out on social media today. So yes, we
    go line by line. I take every one of these seriously, sir. I
    take every one of them seriously. ProPublica, you mentioned it
    earlier, New York Times. And yet we answer them one by one by
    one, and I have the email chains with the reporters that they
    choose to ignore. That is what we get.
        Senator Blumenthal. Well, I welcome that you are committed
    to providing privacy and that you will provide a line-by-line
    refutation of The New York Times article.
        Secretary Collins. We always have, sir.
        Senator Blumenthal. Will you do the same with ProPublica?
        Secretary Collins. We have that, as well.
        Senator Blumenthal. Let me ask you. Have research contracts
    been canceled or frozen?
        Secretary Collins. Research contracts are right now under--
    the ones that are continuing are still continuing. If they were
    running out, then we are on a 90-day policy to see whether they
    need to be continued or not.
        Senator Blumenthal. Is that a yes?
        Secretary Collins. I mean, I cannot answer your question
    any better than that. The continuing contracts are happening
    right now. There were some, by the way, as you well know, that
    they do run out at a three-year cycle. We have actually held
    onto those right now.
        Senator Blumenthal. So you have not canceled any.
        Secretary Collins. No. Not at this point, no. Not that I am
    aware of in that situation. If you want to provide something,
    we will be happy to look at it.
        Senator Blumenthal. Have you frozen any? In other words,
    before the expiration of the three years?
        Secretary Collins. That I would have to look at. I do not
    believe so. Because that is one of the reasons why we put the
    90-day policy.
        Senator Blumenthal. Mr. Secretary, is Medicaid important to
    veterans?
        Secretary Collins. Give me the context, Senator. I mean, it
    is important for anyone.
        Senator Blumenthal. Well, do veterans take advantage of the
    Medicaid program?
        Secretary Collins. That is a conversation that has been
    going on for a while now concerning the Medicaid Advantage
    plans and the ones that are----
        Senator Blumenthal. No. I am talking about Medicaid, not
    Medicare Advantage.
        Secretary Collins. Okay. I am sorry. I will have to--I
    mean, I am not sure where we are going with this.
        Senator Blumenthal. Do veterans use Medicaid? You are not
    aware of that fact?
        Secretary Collins. Yes. Yes. I mean, I understand the
    Medicaid process. I am not sure what your question is.
        Senator Blumenthal. Well, my question is, is Medicaid
    important to veterans?
        Secretary Collins. It is important to everyone who uses it.
        Senator Blumenthal. Okay. Thank you, Mr. Chairman.
        Chairman Moran. Senator Blumenthal, thank you. Just a
    couple of wrap-ups from me, Mr. Secretary. I wanted to give you
    the opportunity, and maybe just to educate me, what are the
    facts with the Veteran Crisis Hotline?
        Secretary Collins. The facts on that is we protected all
    those who actually answered the phones. And this was a concern
    that came up many times, that I started seeing in the press,
    where there were accusations from the Hill and other places,
    that we had actually fired the ones who were actually answering
    the phones. The answer to that, even from career folks, was
    that was not true.
        What we did have is, we found there were some, there were
    staff that were let go. When we immediately looked at that, I
    made the decision that we will make everybody back in. We will
    protect the entire group, because we did not want anybody to
    falsely accuse that we were not answering the lines.
        Chairman Moran. And so today, is the Crisis Hotline any
    less or more--have more or less personnel than it did before
    this?
        Secretary Collins. I think it is at the same lines that it
    has in the last year.
        Chairman Moran. The people that were let go that you
    returned----
        Secretary Collins. They are back.
        Chairman Moran [continuing]. They are back.
        Secretary Collins. Yes, they are back.
        Chairman Moran. Okay. And then you answered my question
    about your interest in an IG and believe in its value. Would
    you also ask the White House for an IG for the Department?
        Secretary Collins. We already have.
        Chairman Moran. Okay. That is my questions. Mr. Secretary,
    anything you want to--I often ask this. It is not just a
    treatment of you, the witnesses--if they have anything they
    want to clarify or correct.
        Secretary Collins. No. Look, I appreciate it, and I
    appreciate the Ranking Member. We have the same goals, I think
    all of us on this dais. We are going to disagree, and we are
    going to disagree about how to go about it. But there are
    several things, Mr. Chairman, that I am not going to do, and I
    do not think it is fair to VA employees, and I do not think it
    is fair to veterans, to take things that are pre-decisional.
    Many of the things that have been discussed today were leaked
    memos, designed to disrupt. They were designed to make the VA
    look bad or make veterans scared.
        I am not going to do that. I am going to challenge anyone
    that is going to hurt or scare veterans or scare employees. We
    are going to give you everything that we can at the time. I
    promise you that, and I continue to do that. We have had
    conversations, you and I have. But when we are doing something
    as large as we are, at an organization as sensitive on this
    Hill, it would not be right for us to do that in public. It
    would not be right for us to just come out and say, ``Here's
    everything that we have got,'' and then have everybody scared
    because in the end it may not be the final decision.
        What we are going to do is come to the best possible
    decision we can, for the veterans in this country, so that they
    have a VA system that actually works. And when we understand
    that, again, the VA has been an issue for a long time. We are
    trying to not make it an issue anymore. We are trying to get it
    to a point to where it is, doing what it is supposed to be
    doing, and taking care of the veterans that have earned it. And
    I appreciate the chance to be here today.
        Chairman Moran. And I would just encourage you, it would be
    a mistake if I did not, to see if your crew can answer our
    team, both minority's and majority's staffs, questions fully
    and promptly.
        Secretary Collins. Yes. Can I say one other thing about
    that? I have been in about 90 days. We have answered, from
    Ranking Member Blumenthal and SVAC minority alone, we have
    responded to 78 RFIs, 11 briefings, 9 technical assistance
    calls, 4 technical assistance are in progress, and many, many
    visits. We have also answered 19 letters from Senator
    Blumenthal and Chairman Moran, 68 letters and RFIs. Now, you
    might not like----
        Chairman Moran. Mr. Secretary, that was----
        Secretary Collins [continuing]. The answers----
        Chairman Moran. That was my mistake, because we are going
    to start this conversation all over again now.
        Secretary Collins. Yes.
        Senator Blumenthal. I just want to make it clear----
        Secretary Collins. And we are going to do that.
        Senator Blumenthal [continuing]. Just so you do not feel--I
    mean, I am just going to be really blunt. I think some of those
    responses are an insult to my intelligence and perhaps yours,
    if you respond by giving us the kind of non-substantive answer
    that I think is inadequate. I am not going to count it as a
    real response.
        Secretary Collins. That is your prerogative, Senator, and
    we will continue to do our best to give you the information.
        Senator Blumenthal. I am asking for facts, not just
    acknowledgement of the questions.
        And I also would encourage you to avoid the use of non-
    disclosure agreements with employees, so that we can get more
    facts from them.
        Chairman Moran. All right. The hearing is about to
    conclude. I thank our Committee members for their participation
    today. You had a full house. I thank the Secretary for his
    presence and his testimony today.
        The hearing record will remain open for 5 legislative days,
    should any Committee member wish to submit additional
    statements or questions for the record. Then, Mr. Secretary, I
    ask you and the Department to respond to any question for the
    record that you may receive, following today's hearing, in a
    timely manner, which I guess will be decided by I hope me, if
    it is necessary.
        With that, our Committee is adjourned.
        [Whereupon, at 2:01 p.m., the hearing was adjourned.]

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