    [Senate Hearing 119-334]
    [From the U.S. Government Publishing Office]

                                                          S. Hrg. 119-334

                  LEGISLATIVE PRESENTATION OF THE AMERICAN
                   LEGION AND MULTI VSOs: PARALYZED VET-
                   ERANS OF AMERICA, AMVETS, NATIONAL ASSO-
                   CIATION OF STATE DIRECTORS OF VETERANS
                   AFFAIRS, WOUNDED WARRIOR PROJECT, TRAG-
                   EDY ASSISTANCE PROGRAM FOR SURVIVORS,
                   NATIONAL GUARD ASSOCIATION OF THE
                   UNITED STATES, MISSION ROLL CALL
    =======================================================================

                                 JOINT HEARING

                                     OF THE

                         COMMITTEE ON VETERANS' AFFAIRS

                                   BEFORE THE

                              UNITED STATES SENATE

                                    AND THE

                            HOUSE OF REPRESENTATIVES

                        ONE HUNDRED NINETEENTH CONGRESS

                                 SECOND SESSION

                                   ----------

                                 MARCH 4, 2026

                                   ----------

           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
    63-116 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

                                  ----------

                            HOUSE OF REPRESENTATIVES
                         COMMITTEE ON VETERANS' AFFAIRS

                         Mike Bost, Illinois, Chairman

    Aumua Amata Coleman Radewagen,       Mark Takano, California, Ranking
        American Samoa                       Member
    Jack Bergman, Michigan               Julia Brownley, California
    Nancy Mace, South Carolina           Chris Pappas, New Hampshire
    Mariannette Miller-Meeks, Iowa       Sheila Cherfilus-McCormick,
    Gregory F. Murphy, North Carolina        Florida
    Derrick Van Orden, Wisconsin         Morgan McGarvey, Kentucky
    Morgan Luttrell, Texas               Delia Ramirez, Illinois
    Juan Ciscomani, Arizona              Nikki Budzinski, Illinois
    Keith Self, Texas                    Timothy M. Kennedy, New York
    Jennifer A. Kiggans, Virginia        Maxine Dexter, Oregon
    Abe Hamadeh, Arizona                 Herb Conaway, New Jersey
    Kimberlyn King-Hinds, Northern       Kelly Morrison, Minnesota
        Mariana Islands
    Tom Barrett, Michigan

                           Jon Clark, Staff Director
                      Matt Reel, Democratic Staff Director

                                C O N T E N T S

                                  ----------

                                 March 4, 2026

                                                                       Page

                                    SENATORS

    Hon. Jerry Moran, Chairman, U.S. Senator from Kansas.............     1
    Hon. Richard Blumenthal, Ranking Member, U.S. Senator from
      Connecticut....................................................     3
    Hon. Thom Tillis, U.S. Senator from North Carolina...............    14
    Hon. Margaret Wood Hassan, U.S. Senator from New Hampshire.......    17
    Hon. Tim Sheehy, U.S. Senator from Montana.......................    18
    Hon. Angus S. King, Jr., U.S. Senator from Maine.................    19
    Hon. John Boozman, U.S. Senator from Arkansas....................    20
    Hon. Patty Murray, U.S. Senator from Washington..................    21
    Hon. Elissa Slotkin, U.S. Senator from Michigan..................    25
    Hon. Jim Banks, U.S. Senator from Indiana........................    26
    Hon. Tommy Tuberville, U.S. Senator from Alabama.................    28
    Hon. Ruben Gallego, U.S. Senator from Arizona....................    45

                                REPRESENTATIVES

    Hon. Mark Takano, Ranking Member, U.S. Representative from
      California.....................................................     4
    Hon. Chris Pappas, U.S. Representative from New Hampshire........    15
    Hon. Kimberlyn King-Hinds, U.S. Representative from Northern
      Mariana Islands................................................    16
    Hon. Morgan McGarvey, U.S. Representative from Kentucky..........    23
    Hon. Herb Conaway, U.S. Representative from New Jersey...........    24
    Hon. Kelly Morrison, U.S. Representative from Minnesota..........    43

                                   INTRODUCER

    The Honorable Jerry Moran, U.S. Senator from Kansas..............     6

                                   WITNESSES
                                    Panel I

    Dan Wiley, National Commander, The American Legion...............     7

      accompanied by

      Joseph Sharpe Jr., Director, Veterans Employment and Education

      Paul Espinoza, Chairman, Veterans Employment and Education

      Mario Marquez, Executive Director, Government Affairs

      Cole Lyle, Director, Veterans Affairs and Rehabilitation

      Linden Dixon Jr., Chairman, Veterans Affairs and Rehabilitation

      Matthew Jabaut, Chairman, National Legislative Commission

                                    Panel II

    Robert Thomas Jr., National President, Paralyzed Veterans of
      America........................................................    28

    Paul Shipley, National Commander, AMVETS.........................    30

    Terry Prince, President, National Association of State Directors
      of Veterans Affairs............................................    32

    LTG Walter E. Piatt, U.S. Army (Ret.), Chief Executive Officer,
      Wounded Warrior Project........................................    33

    Anita Sullivan, surviving spouse of U.S. Navy Petty Officer First
      Class
      Michael Sullivan, Tragedy Assistance Program for Survivors.....    35

    Major General Frank McGinn, U.S. Army (Ret.), President, National
      Guard Association of the United States.........................    36

    Jim Whaley, Chief Executive Officer, Mission Roll Call...........    38

                                    APPENDIX
                              Prepared Statements

    Dan Wiley, National Commander, The American Legion...............    55
    Robert Thomas Jr., National President, Paralyzed Veterans of
      America........................................................    94

    Paul Shipley, National Commander, AMVETS.........................   119

    Terry Prince, President, National Association of State Directors
      of Veterans Affairs............................................   130

    LTG Walter E. Piatt, U.S. Army (Ret.), Chief Executive Officer,
      Wounded Warrior Project........................................   149

    Anita Sullivan, surviving spouse of U.S. Navy Petty Officer First
      Class
      Michael Sullivan, Tragedy Assistance Program for Survivors.....   188

    Major General Frank McGinn, U.S. Army (Ret.), President, National
      Guard Association of the United States.........................   236

    Jim Whaley, Chief Executive Officer, Mission Roll Call...........   244

                           Statements for the Record

    Air Force Sergeants Association, Keith A. Reed, Chief Executive;
      Jon Nutman, Legislative Policy Advisor.........................   251

    Berry Law, Jerusha S. Hancock, Esq., Chief of Legal Operations...   268

    Hire Heroes USA, Ross Dickman, Chief Executive Officer...........   303

    Military Order of the Purple Heart of the USA, Tracey Brown-
      Greene,
      National Commander.............................................   311

    Military-Veterans Advocacy, John B. Well, USN (Ret.), Executive
      Director.......................................................   326

    Veteran Alliance for Leadership, Outreach, and Recovery (VALOR)
      Coalition......................................................   337

    Veterans Education Success.......................................   341

        LEGISLATIVE PRESENTATION OF THE AMERICAN LEGION AND MULTI VSOs:
     PARALYZED VETERANS OF AMERICA, AMVETS, NATIONAL ASSOCIATION OF STATE
        DIRECTORS OF VETERANS AFFAIRS, WOUNDED WARRIOR PROJECT, TRAGEDY
      ASSISTANCE PROGRAM FOR SURVIVORS, NATIONAL GUARD ASSOCIATION OF THE
                        UNITED STATES, MISSION ROLL CALL

                                  ----------

                            WEDNESDAY, MARCH 4, 2026

                               U.S. Senate, and
                         U.S. House of Representatives,
                                Committee on Veterans' Affairs,
                                                        Washington, DC.

        The Committees met, pursuant to notice, at 9:45 a.m., in
    Room SD-G50, Dirksen Senate Office Building, Hon. Jerry Moran,
    Chairman of the Committee, presiding.

        Present from the Senate:

        Senators Moran, Boozman, Cassidy, Tillis, Tuberville,
    Banks, Sheehy, Blumenthal, Murray, Hassan, King, Gallego, and
    Slotkin.

        Present from the House:

        Representatives King-Hinds, Takano, Pappas, McGarvey,
    Conaway, and Morrison.

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

        Chairman Moran. [Raps gavel three times.] Good morning.
    [Laughter.] What did we do? Commander, I need an explanation.
    What did I do wrong?
        [Laughter.]
        Mr. Wiley. You rapped the gavel and for us, that is to
    stand three times.
        Chairman Moran. Ah.
        [Raps gavel again.]
        Chairman Moran. There is a fourth one.
        [Laughter.]
        Chairman Moran. Thank you for the explanation. With the
    sound of the gavel, I call this hearing to order this morning.
    Good morning and welcome to everyone. I would like to thank
    Chairman Bost along with Ranking Members Blumenthal and Takano
    and the rest of the Senate and House colleagues for joining us
    here today in this year's final joint hearing between the House
    and Senate Committees on Veterans' Affairs in this year, 2026.
        And I want to specifically welcome Commander Dan Wiley and
    his wife Sonia from my home State of Kansas, along with the
    leaders of the other veterans service organizations who will be
    testifying later this morning.
        I also would like to extend a special hello, as my
    colleagues will do for their home states, but particularly
    today with Commander Wiley as the lead witness today, I want to
    express my gratitude to the Kansans who are present here, who
    are watching at home, and who have been in my office numerous
    times, including this week. I appreciate the Kansans' presence
    in the room and I am grateful for my relationship I have with
    American Legion members from across my state.
        I am grateful for the work that veterans service
    organizations do every day to support veterans and their
    families, caregivers, and survivors to advocate for timely,
    high-quality health care and benefits that they have earned and
    deserve.
        The work we do in our Committees, in these Committees,
    would not be possible without the tireless work and dedication
    of organizations like the ones here today and the ones we will
    be hearing from this morning. I look forward to hearing from
    Commander Wiley and his fellow veteran leaders how your
    legislative priorities advance veteran success and what more
    these Committees, the Committee that I chair and the others,
    can do to make certain that VA policies translate into real
    improvements in the well-being of veterans we are all here to
    serve.
        With the Commander from Kansas's presence, I would like to
    take a sidenote and express my appreciation and gratitude for
    everyone's service. I am not a veteran. This is not what I
    normally say at a hearing in this room. I was in high school
    when Vietnam was occurring. I watched what happened when you,
    those who served in Vietnam, returned home and how they were
    treated. If you are a year older than I am, and certainly if
    you are two years older than I am, you served in Vietnam. And I
    saw how my classmates at home in Kansas were treated upon their
    return to the United States shores following their service,
    their honorable service in Vietnam. And I told myself, as a 16-
    year-old kid, I am going to do everything I can to pay my
    respects and honor those who served.
        I never expected, fellow Kansans, to ever be a Member of
    Congress, to serve in the House of Representatives, to serve in
    the United States Senate. And with that responsibility of that
    service came doing something more than just saying thank you.
    Something comes more than just saying I respect you.
        So I take it seriously, as do Members of this Committee,
    Members of the Senate, Members of the House of Representatives,
    Republicans and Democrats, we take it seriously to try to make
    certain we do the things that keep our promises to those who
    served in Vietnam and those who served elsewhere, around the
    globe and in the United States.
        So I am honored to have the opportunity to be here with a
    fellow Kansan, now the National Commander of the American
    Legion.
        I yield to the Ranking Member, Senator Blumenthal, for his
    opening statement.

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

        Senator Blumenthal. Thank you, Mr. Chairman, and thank you
    to Commander Wiley and the American Legion leadership who are
    here today. I am a proud member in Connecticut, and I know we
    have some Connecticut members here. Welcome to you and thanks
    for visiting with me yesterday. Your perspectives and your
    advocacy are invaluable to what we do. You are the reason that
    we have the PACT Act today, just to take one example.
        Yesterday I went to the floor of the United States Senate
    and asked for unanimous consent to pass the Major Richard Star
    Act.
        [Applause.]
        Senator Blumenthal. Unfortunately, it was blocked. I asked,
    as a fallback, for a simple vote on the bill before August. It
    was blocked, as well. The individual Senator blocking unanimous
    consent is part of a small minority in the United States
    Senate. The vast bipartisan majority of my colleagues support
    the Richard Star Act, because they know it is unacceptable that
    tens of thousands of combat-injured veterans are denied the
    full military benefits they deserve.
        The Chairman just talked about promises. Promises are
    meaningless unless they are kept. We made a promise to these
    veterans that they would receive both retirement and disability
    benefits. We owe them both, and I promise you, I will not stop
    fighting until we pass the Richard Star Act in this Congress.
        [Applause.]
        Senator Blumenthal. And I want to add that support for it
    is bipartisan. I thank the Chairman, Senator Moran, for his
    support, as well as others on this Committee, including the
    House Ranking Member, Mr. Takano.
        Yesterday The New York Times published an article entitled
    ``Despite Promises, Veterans Affairs Department Cut Thousands
    of Roles for Doctors and Nurses.'' In fact, thousands of
    positions have been left vacant. The numbers of doctors and
    nurses, physicians, has declined by significant percentages,
    which is a disservice to all of you here and the many, many
    veterans around the United States who depend on the VA for
    their medical care.
        At our hearing last month, Secretary Collins said the VA
    needs more doctors, and yet he has eliminated thousands of
    physician jobs.
        We need your help. We need your advocacy. We need your
    voices and your faces, which is why it is so important you are
    here today, so that we can maintain, restore, and even grow the
    numbers of doctors, nurses, counselors, psychiatrists, all of
    the team at VA health care that is so important to making sure
    that we have sufficient workforce to serve the needs of our
    veterans. Our veterans deserve nothing less than the best
    world-class medicine. Thank you all for being here today.
        Chairman Moran. Senator Blumenthal, thank you.
    Representative Takano, the Ranking Member.

                 OPENING STATEMENT OF HON. MARK TAKANO,
          RANKING MEMBER, U.S. REPRESENTATIVE FROM CALIFORNIA

        Mr. Takano. Thank you, Mr. Chairman. Good morning,
    everyone. It is truly great to see all of you here, ensuring
    that my fellow Members of Congress and Americans tuning in from
    the country hear directly from you. So I thank all the veterans
    who have traveled here today, including those who have made the
    trip from my home State of California. Where are you?
        [Cheers.]
        Mr. Takano. Thank you, California. Welcome. And welcome to
    everyone from the American Legion. I would especially like to
    welcome American Legion National Commander Dan Wiley of Kansas.
    Mr. Wiley, Commander Wiley, you and I have had personal
    conversations about how I actually spent time in Lawrence,
    Kansas, one summer, so welcome.
        Auxiliary National President Pam Ray of Illinois, and Sons
    of the American Legion National Commander Bill Clancy of New
    York, and I offer a hearty welcome to the representatives from
    all of the organizations on our second panel of witnesses. Very
    good to see all of you, and I look forward to engaging in an
    enlightening conversation.
        Just two weeks ago, Secretary Collins published an interim
    final rule to cut veteran disability compensation benefits for
    veterans whose service-connected conditions were improved by
    medication. Thanks to a public outcry from VSOs, Members of
    Congress, and many of you here today, Secretary Collins paused
    enforcement and eventually rescinded the rule. Senator
    Blumenthal and I led the effort here in Congress against this
    rule, but our Republican colleagues were unwilling to join us.
    Protecting veterans' benefits should be a bipartisan issue, and
    my colleagues across the aisle should be willing to stand with
    us in holding VA accountable when veterans and their benefits
    are on the line.
        In addition to the Secretary's harmful interim final rule,
    VA is also carrying out a massive--massive--reorganization of
    the Veterans Health Administration. This reorg effort warrants
    bipartisan oversight--oversight. Now, VA does need improvement.
    No doubt about that. But VA leadership appears to be trying to
    align VA with developments in for-profit health care.
        VA is not a business, and it should not mirror business
    models. Following that business mindset, this VA aims to,
    quote, ``do more with less,'' end quote. Now, that approach has
    never really served veterans, in my opinion, and the data
    suggests VA is already struggling with the less. The New York
    Times reported yesterday that VA cut thousands of clinical
    positions that were filled before the Administration and DOGE
    started pushing staff out. VA told us that these were unneeded
    COVID-era positions. But VA's own damning data tells us that
    that is not true.
        As was reported by The New York Times, about 73 percent of
    the 10,500 vacant positions VA just eliminated were filled just
    sometime in 2025 or 2026, well after the COVID era. These were
    recent vacancies, and rather than filling them, Secretary
    Collins just wiped those clinical positions off the books,
    clinical positions that the medical centers said that they
    needed.
        Expanding care and benefits for veterans requires people,
    doctors and nurses, claims processors, social workers,
    researchers, police officers, and support staff. All these
    roles help VA fulfill its mission.
        I know each of you sees the value in securing veteran care
    and improving the VA because each of you has served, and today
    you continue to serve your fellow veterans and their survivors.
    When you raised your hand and put on that uniform, you set
    yourself apart. That commitment came when our Nation promised
    that you and your family would be taken care of afterwards. You
    fulfilled your duty. We must fulfill ours.
        We sit here just days after President Trump committed our
    Nation's most precious resource, our young men and women in
    uniform, to another conflict. Several servicemembers have
    already been killed or wounded. Our servicemembers are carrying
    out difficult and dangerous missions far from home. They
    deserve the full support of a grateful nation. That support
    cannot end when they take off the uniform.
        So I ask, has this Administration planned and budgeted for
    the long-term costs of this conflict? Is VA prepared to provide
    a lifetime of medical care, disability compensation, mental
    health services, prosthetics, and caregiver support to the new
    generation of wartime veterans?
        President Trump and this Republican Congress have added
    $150 billion for the Department of Defense in the so-called
    ``Big Beautiful Bill,'' but it did not include a cent for VA.
    If this Administration is willing to send Americans into harm's
    way, it must be willing to fully fund and strengthen the VA
    system that will care for them for decades. That means passing
    the Caring for Survivors Act. That means passing the Love Lives
    On Act. And that means passing the Major Richard Star Act, as
    well.
        [Applause.]
        Mr. Takano. Just a little bit of history. I was Chairman of
    the House side of the Committee when I passed the Vietnam Blue
    Water Navy Bill out of the House for the second time,
    unanimously. And why I had to do it a second time is that the
    previous Chairman, a Republican Chairman, passed it also. I
    think it was unanimous, as well. But procedures in the Senate
    blocked it. Just a couple of Senators ran out the clock at the
    end of that session.
        And look, the politics in both houses, it is procedure that
    is stopping the Major Richard Star Act. It is the will of the
    majority of both houses of Congress, and I will be damned if we
    allow procedure to stand in the way of passing the Major
    Richard Star Act, and you should be damned as well. Keep the
    pressure on.
        And with that, with that belief, Senator Blumenthal
    yesterday went to the floor to ask for a vote on this bill, and
    shamefully it was blocked. Procedure again. In objecting to a
    vote on the Major Richard Star Act, Senator Ron Johnson of
    Wisconsin lamented how much it would cost, arguing that we
    needed to prioritize funding for ongoing defense capabilities.
    I say this is unconscionable. We are talking about compensation
    for combat-injured veterans. This is a cost of war. And as we
    sit here watching the President drag us into another conflict,
    we must reckon with the long-lasting impacts it will have on
    our servicemembers, our veterans, and their families.
        Paying for the true cost of war means investing in VA now!
        Mr. Chair, I thank you for bringing these organizations
    before us today, and I look forward to frank and fruitful
    discussions, and I thank you, and I yield back.
        Chairman Moran. Ranking Member Takano, thank you.

                   INTRODUCTION BY HON. JERRY MORAN,
                        U.S. SENATOR FROM KANSAS

        Chairman Moran. I now have the honor of introducing a
    Kansan and a friend, the National Commander of the American
    Legion, Mr. Dan Wiley. Dan, of course, has a long history of
    serving veterans, particularly those in the neighborhood of his
    hometown, Leavenworth, Kansas. He has also been a trusted
    advisor to me on issues impacting veterans at home and across
    the country.
        Dan served his nation in the United States Air Force, and
    following his service he obtained a law degree from the
    University of Kansas. He told me this morning he is a K State
    fan. He used all his skills as an attorney to establish the
    Leavenworth County Veterans Treatment Court. He was a district
    court judge in the State of Kansas, and he used that
    opportunity to find a new way to care for veterans who appear
    before his and other courts in Leavenworth and across our
    state.
        During his service with the Legion, Dan has pretty much
    done it all. He has held 24 different positions within the
    American Legion, making certain that veterans have a friend who
    will listen to them and advocate for them. I have seen that in
    my own circumstance at pancake feeds and American Legion events
    in my hometown and across the state as he has been there for
    every veteran of our state.
        Dan, like many veterans, has faced his own challenges and
    hurdles in his life. After service, but rather than hide or shy
    away from the challenges, he has shared them openly, letting
    veterans know that they are not alone. I respect Dan for being
    vulnerable and honest about mental health and using his
    experience to reach out to veterans.
        As National Commander he is a strong advocate for the
    American Legion's ``Be The One'' campaign, to prevent veteran
    suicide. Thank you for working to extend hope to veterans who
    are struggling with their mental health and helping reduce the
    stigma around asking for help.
        Outside the American Legion, Dan is very involved in his
    community back home, where he has worn many different hats,
    helping organize and be the master of ceremonies at the
    Leavenworth County Veterans Day Parade, to serving on his local
    Board of Education.
        Commander Wiley, you have been a friend to me and a friend
    to veterans, and I have no doubt that your vision and
    experience is strengthening the mission of the American Legion
    and making certain that the voices of veterans are heard and
    that their needs are met with honor and with respect. I thank
    you for those things. I thank you for your dedication to
    serving veterans in Kansas and across the country and for being
    here to testify today. I appreciate your family's sacrifice for
    your service in this capacity, and I look forward to working
    together on our shared mission of improving the lives of
    veterans across the country and back home in our home state.
        With that, Commander Wiley, you are now recognized.

                                PANEL I

                                  ----------

    STATEMENT OF DAN WILEY, NATIONAL COMMANDER, THE AMERICAN LEGION
    ACCOMPANIED BY JOSEPH SHARPE JR., DIRECTOR, VETERANS EMPLOYMENT
    AND EDUCATION; PAUL ESPINOZA, CHAIRMAN, VETERANS EMPLOYMENT AND
       EDUCATION; MARIO MARQUEZ, EXECUTIVE DIRECTOR, GOVERNMENT
          AFFAIRS; COLE LYLE, DIRECTOR, VETERANS AFFAIRS AND
     REHABILITATION; LINDEN DIXON JR., CHAIRMAN, VETERANS AFFAIRS
      AND REHABILITATION; AND MATTHEW JABAUT, CHAIRMAN, NATIONAL
                         LEGISLATIVE COMMISSION

        Mr. Wiley. First, thank you, Senator, for that kind
    introduction. Thank you, Chairman Moran, Ranking Member
    Blumenthal, Chairman Bost, Ranking Member Takano, and
    distinguished Members of these Committees. On behalf of the 2.5
    million members of the American Legion family, I appreciate the
    opportunity to discuss our legislative priorities for the
    second session of the 119th Congress.
        I would like to begin by introducing the members of the
    American Legion family here with me today. Please stand if you
    are able as I recognize you. Our National Officers serving with
    me this year, please stand. Our past National Commanders,
    please stand. Pam Ray, National President of the American
    Legion Auxiliary; William Clancy III, National Commander of the
    Sons of the American Legion; and my daughter, Christy, my son,
    Austin, and his wife, Jesse, with their son and my grandson,
    Noah. And of course, the most important person in the room,
    without a doubt, my wife Sonia. Thank you.
        [Applause.]
        Mr. Wiley. Our written testimony contains our complete list
    of legislative goals, and they are all important. With limited
    time, however, I will focus on several critical issues.
        This is a pivotal time for our country. Recent military
    action reminds us of the cost of service, shouldered by a
    shrinking minority of American families. In our all-volunteer
    force, military service has become a family business. And while
    average time in uniform is just 4 to 8 years, the costs can
    potentially last a lifetime. And as we mark the 250th
    anniversary of our Nation's founding, it is essential we
    examine those costs and make sure they are paid in full.
        That is precisely why Congress chartered the American
    Legion after World War I, to promote a strong national defense,
    encourage civic education, and to create a community of
    veterans to support one another, whose voices are heard by our
    Nation's leaders. Since 1919, the Legion has been instrumental
    in landmark changes, like the GI Bill, creation of the modern
    VA, appeals modernization, and the MISSION Act. We created
    programs like the American Legion Child Well-being Foundation,
    legacy scholarships, and Boys Nation. Our mission, every single
    day, is to serve those who served us.
        At the post level, legionnaires serve their communities in
    times of crisis. Just last year, after the tragic floods in
    Kerrville, Texas, Legion Post 208 provided urgently needed
    resources for those who had lost everything, and served as a
    relief point for aid workers who came from across the country.
        American Legion service officers assist veterans with
    disability claims, and in 2025 alone, processed $29.5 billion
    in claims for veterans. This was free of charge, regardless of
    whether they were members of the American Legion or not.
        Nationally, we partner with VA on the Buddy Check Week, and
    our Be The One campaign to reduce stigma, provide critical
    training, and ultimately save lives. Our System Worth Saving
    (SWS) and regional office actuary review programs provide
    policymakers with on-the-ground feedback regarding health care
    and benefits. And we have continued to work with Congress to
    ensure that while the Administration seeks bold change, there
    is no reduction in accessibility of services and benefits to
    any veteran or their family.
        Just two weeks ago, the American Legion spoke against a
    proposed rule that would change the way VA rates a veteran's
    disability based on medication management. We were glad to see
    Secretary Collins listen to the veteran community and
    ultimately rescind the rule. We will remain vigilant, and we
    will give you all of our feedback on what is working and what
    needs to change.
        The Legion's number one priority is ending veteran suicide.
    VA estimates more than 17 veterans die every day by suicide.
    Traditional approaches to this problem, pills and therapy, have
    objectively not worked. We need stronger transition programs,
    innovative therapies, and improved safeguards to medication
    management. That is why we support things like the Fox Grant
    Program, the BEACON Act, the Written Informed Consent Act, and
    other bills that seek to address this problem. It is also why,
    after a decade of legion advocacy, I was proud to be in the
    Oval Office as the President signed an Executive order
    reclassifying cannabis as a Schedule III drug. This allows for
    Federal research on how it can reduce drivers of suicide. The
    American Legion does not support use of illegal drugs, but we
    strongly support research that could result in new, effective
    treatments.
        An important part of suicide prevention, and ultimately
    VA's core mission, is access to timely, quality health care.
    And while most veterans prefer to receive from VA their care,
    because it is a one-stop shop, community care has exploded
    since the passage of the MISSION Act. Congress must provide the
    necessary funding to ensure the VA system remains strong,
    without curtailing a veteran's access to community care if it
    is in the veteran's best interest. It is a difficult balance,
    but one we are committed to helping Congress achieve.
    Ultimately, veterans should get the care they need, when they
    need it. But we must remain the center of all veteran health
    care in the VA.
        As we discuss VHA reorganization, the Next-Gen Community
    Care contract, and acceleration of electronic health record
    deployment, Congress must also address aging infrastructure and
    give the VA authorities and funding it needs to compete with
    the private sector job market.
        As we all know, the veteran population is changing, and so
    are its needs. Women veterans, the largest-growing
    subpopulation in our community, experience homelessness,
    depression, infertility, migraines, and other issues at a
    higher rate than their male counterparts. This is attributed to
    military sexual trauma and domestic violence. Congress should
    pass legislation to improve research on how issues unique to
    women veterans, including menopause, affect outcomes, and
    increase the availability of gender-specific rehabilitation
    programs.
        Enabling veterans to thrive in a civilian life is a huge
    task. Congress can make it easier by ensuring our
    servicemembers do not experience financial uncertainty prior to
    separation. When I served in the United States Air Force, I
    never worried about getting paid on the 1st and the 15th of the
    month. But as government shutdowns become more frequent, that
    is no longer guaranteed. Not long ago, the Legion provided over
    $1 million in grants to Coast Guard families because Congress
    failed to do its job and ensure they were paid on time. We need
    iron-clad protections to ensure uninterrupted pay for all
    servicemembers in our all-volunteer force.
        Finally, consider Major Richard Star, who deployed multiple
    times and was diagnosed with lung cancer linked to burn pit
    exposure. Before his death, he endured the indignity of a
    wounded veteran's tax, an offset of his disability compensation
    against his pension because he was medically retired before 20
    years. This is wrong.
        [Standing ovation.]
        Mr. Wiley. Collecting both benefits is not double dipping.
    Retirement is for time served. Disability compensation is for
    harm caused during service. Congress must pass the
    overwhelmingly supported, bipartisan Major Richard Star Act.
        [Loud applause.]
        Mr. Wiley. Chairmen Moran and Bost, Ranking Members
    Blumenthal and Takano, and Members of the Committees, the way
    America treats its veterans directly influences whether the
    next generation raises the right hand to define our 250-year
    legacy. On behalf of the entire American Legion family, thank
    you for this opportunity to share our priorities, and my staff
    and I welcome your questions.
        [Applause.]

        [The prepared statement of Mr. Wiley appears on pages 55-93
    of the Appendix.]

        Chairman Moran. National Commander, thank you for your
    testimony. We will now turn to questions of you and your
    colleagues at the desk.
        The Richard Star Act, let's start there, for my first
    question. Would you share perhaps a member's experience, a
    real-world example of a veteran and their family who would
    directly benefit if the Major Star Act was passed? Explain how
    it would change the quality of their life. Give us an example
    of why it matters.
        Mr. Wiley. Thank you, Senator, and without naming the
    individual, you and I both know an individual that suffered
    harm while he was on active duty. He was in a Ghillie suit and
    he was burned by that active-duty service, and because of that
    was medically retired. So he receives that medical retirement
    for that time in service. Also, you would not find surprising
    because of the burns on his body he was entitled to disability
    compensation for the harm caused. However, because of the fact
    that he did not have the 20 years in time and service he has to
    waive dollar-for-dollar his retirement for the disability
    compensation he receives. And quite obviously, this takes funds
    away from his family that would benefit his family for a
    lifetime, and he has got a lifetime of care and a lifetime of
    loss as a result of those injuries.
        I appreciated the opportunity last month, as I said in your
    office, and we talked about the Major Richard Star Act. And you
    know me, I am probably more passionate than I am articulate.
    But to that extent it just frustrates me that Congress cannot
    get this passed, when we have 316 members in the House that
    have signed on, and approximately 75 members in the Senate who
    have signed on, and yet we cannot get it to a vote on the House
    floor. The buck stops with leadership. They need to get a vote
    on this, up or down, because our veterans are entitled to know
    whether your Congressman supports our disabled and wounded
    veterans or your Congressman is against us. That is what we
    believe we are entitled to a vote on this, on the House and
    Senate floor. Thank you.
        Chairman Moran. Commander, thank you for answering my
    question. I would use this moment to again, as I told you in
    our office when we last visited, that I am committed to trying
    to do everything I can to accomplish that. Folks in this room
    probably know, but should know, the jurisdiction of this bill
    does not rest with the Committee on Veterans' Affairs, it rests
    with our Armed Services Committee. But we are working with the
    leadership of the Armed Services, I am working with the
    leadership of the Armed Services Committee to find a path
    forward. And I spoke yesterday on the Senate floor about this
    topic, and I have also spoken to my colleagues in the Senate,
    that there is no opportunity for the sponsoring of a bill that
    you are not willing to vote for when the time comes. Sponsoring
    is insufficient. We want you to do that. But if the time is
    right, we want to make certain that the votes occur, and there
    is no hypocrisy demonstrated by Members of Congress.
        You mentioned community care. It is a topic that I have
    significant interest in. In large part, when I was a
    Congressman, I represented a congressional district the size of
    the State of Illinois. Not a VA hospital in that congressional
    district, and distance was often the enemy of a veteran in
    being able to access quality care at the VA.
        Would you elaborate on--well, let me again say that
    American Legion is a strong supporter of the ACCESS Act, that
    Senator Blumenthal and I are trying to work out our differences
    to see that we get it passed. Would you explain to the
    Committee the importance of the ACCESS Act and why the American
    Legion is supportive?
        Mr. Wiley. Absolutely. Thank you, Senator Moran, for that
    question. Community care is obviously important for our
    veterans. Most of our veterans, as I said in our opening
    remarks, are very happy with the care they get at the VA, and
    they prefer that. But as you know, just like Kansas and much of
    this country, there is a lot of distance between VA hospitals.
    You are in western Kansas you might be four hours from a VA
    hospital, so we have transportation issues. We have issues with
    regard to obtaining care from a specialist. And ultimately, we
    believe that the veteran should receive the care that is in
    their best interest, and we believe that this ACCESS Act will
    provide more oversight. We need to continue to have VA
    oversight of community care, but community care is obviously
    important for the best interest of our veterans. Thank you.
        Chairman Moran. I recognize Ranking Member Blumenthal.
        Senator Blumenthal. Thank you, National Commander, for
    calling attention to some of the most pressing needs of our
    veterans. Obviously, the Richard Star Act is a priority for me,
    not only as the Ranking Member of this Committee but also as a
    member of the Armed Services Committee. And you have correctly
    identified where the point of persuasion has to be with the
    leadership, the leadership of the United States Senate and the
    House of Representatives. So I urge every member here, if you
    think the Richard Star Act ought to be passed, contact the
    leadership of the United States Senate. And again, I thank
    Senator Moran for his advocacy and his support.
        I want to call attention to your advocacy on behalf of
    women veterans. As you say in your testimony, ``they are the
    fastest growing cohort of veterans.'' They are serving right
    now in harm's way in the Middle East. Tragically, one of the
    fallen is a woman National Guard member. We owe them the same
    kind of health care and compensation benefits that our male
    veterans receive.
        What kinds of specific measures, if you could talk about
    them, would you advocate to expand the service that we provide
    to our women veterans?
        Mr. Wiley. Thank you, Ranking Member Blumenthal, for that
    question. And again, I appreciate your time as we had an
    opportunity last month in your office to discuss these very
    issues, and I know they are of concern to you.
        Obviously, the women veterans is the single biggest growing
    demographic. And I can tell you that VA care has improved
    significantly in the 30-plus years I have been a member of the
    American Legion. I have visited VA hospitals throughout this
    country. We now have hospitals--not all; we need to do a lot
    more--that have separate entrances, for example, for women
    veterans. And I know there are a lot of bills that impact women
    veterans, so I am going to ask our Veteran Affairs and
    Rehabilitation Director, Cole Lyle, to expand on that answer.
        Senator Blumenthal. Thank you.
        Mr. Lyle. Thank you, Commander, and thank you, Ranking
    Member Blumenthal. The American Legion has publicly supported
    the SAVES Act, which would expand the evidentiary standard for
    VA to be able to consider non-VA evidence, lay statements,
    nexus letters, things like that, in disability process claims.
    As the Commander alluded to, infrastructure at a lot of VA
    facilities, specific for women veterans, residential
    rehabilitation programs, secure areas in VA facilities for them
    to feel safe if they have experienced military sexual trauma or
    intimate partner violence.
        Also, Congresswoman Brownley has a bill to expand research
    on menopause. There is not a lot of evidence. There is a lot of
    anecdotal evidence. There is not a lot of research on
    menopausal links to certain things that drive suicide. And as
    we know, women veterans experience suicide at a much higher
    rate than their civilian counterparts.
        Senator Blumenthal. That is a great answer, and I want to
    just volunteer my services, my office, on this issue and others
    that you have raised, Commander, most especially the continuing
    scourge of veteran suicide, the need to expand the PACT Act,
    the importance of recognizing the next generation of toxic
    exposures, very, very important.
        And I want to just commend the American Legion for a
    program that is very close to my heart. In Connecticut, and I
    do not know how many of the other states have it, we have a
    Boys State and Girls State program, which fosters future
    leadership. Young people are chosen--it is a very competitive
    program--to participate in a nearly weeklong series of
    sessions, in usually it is a school location. They live in
    dormitories. They participate in mock Senate and House
    sessions. I think their conversations are considerably more
    erudite and informed than I often find around here.
        But I just want to say to the American Legion, providing
    the role models, fostering the leadership, is so important. We
    need to develop our future veterans. My son, who served in the
    United States Marine Corps, as an infantry officer in
    Afghanistan, my other son, who served as Navy SEAL, had you as
    role models. And they, in turn, will be role models for others.
    But you, in the American Legion, whatever your age, are role
    models for our future leadership. Thank you for being there for
    our great country. Thank you.
        Chairman Moran. To what office were you elected at Boys
    State?
        Senator Blumenthal. I did not participate, but my sons did,
    and it had an impact on them.
        Chairman Moran. I am quite certain I was never a Senator at
    Boys State. Representative Takano.
        Mr. Takano. I was at Boys State California. I did not get
    elected to anything, either.
        [Applause.]
        Mr. Takano. Commander Wiley, one thing that I have heard
    loud and clear from the veteran community this month is
    veterans should never be punished for following medical advice.
    When VA issued changes to how medication effects would be
    treated in disability evaluations, did the Legion receive
    advance notice or a chance to weigh in?
        Mr. Wiley. Thank you, Ranking Member Takano, and again, I
    appreciate your time and having the opportunity to meet with
    you last month. The simple answer is no. But I will also tell
    you that was an aberration for this Administration and the VA,
    because we have been fortunate enough in the American Legion to
    have been advised of most things. But we were not advised of
    this, and if we had been we would have told them exactly what
    we told them in the end, and that it was a terrible idea. So we
    are glad they rescinded it. But thank you.
        Mr. Takano. Thank you. Do you think VSOs like the American
    Legion should be brought in early before policies are rolled
    out, so that they are not surprised and trust is not shaken?
        Mr. Wiley. Absolutely. The veteran community is entitled
    and needs to be heard, yes.
        Mr. Takano. There are several important bills pending that
    would radically improve benefits for veterans, their families,
    and their survivors, like the Major Richard Star Act, or
    Representative Hayes's Caring for Survivors Act. Commander, you
    have been very clear that these are earned benefits, not
    favors. I see you are nodding your head. On bills like the
    Major Richard Star Act and survivor reforms, do you agree that
    Congress should not force veterans or survivors into a tradeoff
    where one group's earned benefit is paid for by cutting another
    group of veterans' benefits?
        Mr. Wiley. Yes.
        Mr. Takano. Do you think Congress should put the burden of
    paying for veterans benefits increases on other veterans or on
    the American people as a whole?
        Mr. Wiley. No, not on other veterans.
        Mr. Takano. Not on other veterans.
        Mr. Wiley. There is an obligation to pay for what a veteran
    has earned, and that is incurred at the time of service and
    they time they were put in harm's way. So yes, the American
    people and the American government, when they do that they have
    an obligation, but it should not be put on the shoulders of
    other veterans.
        Mr. Takano. Thank you. That was the point. I think the
    American people are very much willing to honor the obligations
    that we made to them.
        Commander Wiley, I sponsored the PACT Act, which has
    certainly helped many veterans gain access to VA benefits and
    health care that they have earned through their service. But
    even as we were writing the PACT Act, we knew that the PACT Act
    was only a step and that there would be more work left to do in
    the future. Where should Congress push next, and what exposures
    or cohorts are most urgent to address a PACT Act follow-on?
        Mr. Wiley. Thank you again, Ranking Member Takano, and
    obviously the PACT Act, when it was passed, there is a
    mechanism in there for identifying future toxins that has not
    been adequately used. But to further elaborate, I am going to
    call on our VA&R Director, Cole Lyle, to answer.
        Mr. Lyle. Thank you, Commander, and I see time is short so
    I will try to be brief. Yes, the mechanism that the Commander
    was talking about existed because Congress did not want to have
    to legislate individual presumptive conditions going forward.
    That process has been slow, and sometimes the process has been
    opaque. So I think if there were mandatory timelines requiring
    VA to review prospective presumptive conditions within, let's
    say, 180 days, mandate some sort of external review if
    presumptives were removed or an external review right after
    they were finalized, and then codify that presumptives could
    probably only be removed if there is overwhelming evidence that
    contradicts the existing science that was used in the approval
    process.
        Mr. Takano. Well, is the Secretary fully leveraging the
    authorities granted by Congress to establish new presumptives,
    in your view, or could he be more assertive?
        Mr. Lyle. I think Secretary Collins and the VA, as I said,
    there are some conditions, that particularly like with K2
    veterans, Red Hill, that could be advanced more quickly.
        Mr. Takano. What would be more helpful, faster presumptive
    decisions, clearer transparency on where conditions are in the
    process, or better access to exposure record so veterans are
    not left guessing?
        Mr. Lyle. Sir, I would say all three. I think the DoD, the
    ILER, the Individual--I am forgetting what the acronym stands
    for--but basically the individual record of exposures to
    servicemembers while they are on active service, that the DoD
    could track and then give to VA. That was supposed to be made
    available, I think, a year ago, and we are still waiting on
    that. There are definitely things that could improve in that
    process.
        Mr. Takano. Well, thank you. I yield back, Mr. Chairman.
        Chairman Moran. Senator Tillis.

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

        Senator Tillis. Thank you, Mr. Chairman. Thanks, everybody,
    for being here today. I always like it when my colleagues ask
    for people that are from California or whatever state. I would
    like to know if we have got anybody here that either is from
    North Carolina or spent a little quality time there in your
    past, if you will please raise your hands.
        [Hands raised.]
        Senator Tillis. There you go. First off, an explanation on
    the bolo. The Lumbee Tribe in North Carolina got recognized
    after 137 years of racism, neglect, and more recently as a
    target of the casino cartels. The reason I wear this today is
    because they have disproportionately, in spite of all those
    challenges, they are among some of the most courageous and
    disproportionately represented people in Armed Services in the
    State of North Carolina. So I am looking forward to them, now
    that they have been federally recognized, putting a mark in
    Lumbee and Robeson County focused on veterans and all those
    great Native Americans that have served this country, in the
    same way that you did. Thank you for your service.
        You know, as I was looking at the written testimony and my
    staff this week, I was trying to think of what I can do in my
    remaining time here. It is 305 days. Now, some people think I
    am counting the days before I am out of here, but I am a
    project person, and I am always mindful of how much time I have
    left in my budget. So as a U.S. Senator I have got 305 days to
    do everything I can to help you guys.
        One of the ways I want to help you is by having a frank
    conversation about how we address all the things the Commander
    has outlined, but not kill you with kindness. Because what we
    do here a lot of times is we rush to pass a bill, and we get it
    and we high five, and then about a year later we come back and
    figure out why it has failed to be executed properly.
        And quite honestly, I will give you the best example of
    that. You all know that I voted, in spite of being an original
    co-sponsor, and in spite of having the TEAM Act and the Camp
    Lejeune toxics being written out of my office and promoted, I
    voted against the PACT Act. And the reason I voted against the
    PACT Act, even knowing that it was going to pass by
    overwhelming majorities, is because I thought we were going to
    come up short on the execution. And that, by God, is exactly
    what has happened.
        So one of the things that I hope to do in my remaining time
    here, and my time is short on these comments, is to try and
    convene a meeting to figure out how we can get to all these
    priorities, past and future, Mr. Commander, but do it in a way
    that is honest, that is instructed by the reality of resources
    that we have here, to make sure that we can have maximum impact
    on you all. And not only kind of fulfill the promise by passing
    a law, but true to the state motto of North Carolina--it is
    Esse quam videri--it says ``To be, rather than to seem.''
    Instead of seeming to support you all by passing bills that get
    caught up in execution, I want to be somebody that helps you do
    that in my remaining tenure in the Senate.
        So you will be getting a call from me, and we will get
    other veterans service organizations together, and we are going
    to figure out how to make the most out of the 305 days I have
    left to begin to make an installment on a debt we will never
    repay. Thank you.
        Mr. Wiley. Thank you, Senator Tillis, and I will tell you,
    me and my staff are more than happy to contact with your staff
    and work together to accomplish just that.
        Senator Tillis. Thank you.
        Chairman Moran. Senator Tillis, thank you. Representative
    Pappas.

                           HON. CHRIS PAPPAS,
                 U.S. REPRESENTATIVE FROM NEW HAMPSHIRE

        Mr. Pappas. Thank you very much, Mr. Chairman. Commander,
    thank you so much for your testimony here today, and I want to
    thank everyone from the American Legion family who is joining
    this hearing. Thank you for your service and sacrifice. It does
    not go unnoticed by Congress, and we certainly owe you all a
    debt, and have to work to repay that. And I think you have
    given us an important roadmap of how we can pursue our
    obligations to the veteran community and our Nation.
        Thank you for highlighting veteran suicide as your number
    one priority. It is on the minds of every veteran I talk to in
    the State of New Hampshire, and a shout-out to all those from
    the ``Live Free or Die'' State of New Hampshire who are joining
    this hearing today.
        I want you to know that this is important, and we need to
    focus on the kinds of alternative therapies that can help
    veterans manage pain and ensure that they are living with a
    high quality of life. We have got legislation called the NOPAIN
    for Veterans Act that can help reduce reliance on opioid-based
    treatments for veterans. And I am just wondering if you can
    kind of evaluate how we are doing at opening up the doors to
    some of these alternative therapies that can result in a better
    quality of life and less reliance on opioid-based medications.
        Mr. Wiley. Thank you, Representative Pappas. I appreciate
    that question. It is no secret that far too long doctors have
    prescribed opioids, which are destructive and addictive, to our
    veterans. And the American Legion, by resolution, supports
    alternative therapies, which is one of the reasons why we were
    proud to be in the Oval Office on December the 18th when the
    President signed the Executive order reclassifying cannabis
    from a Schedule I to Schedule III. There are a lot of other
    therapies that we believe would be productive for veterans, and
    I am going to ask, again, our VA&R Director, Cole Lyle, to
    address those.
        Mr. Lyle. Thank you, Commander, and thank you, Congressman.
    The NOPAIN for Veterans Act, right now the VA still treats many
    of these non-opioid pain management things, so long-lasting,
    topical pain cream, things like that, non-opioid injectables,
    as non-formulary, so it makes it harder for physicians to
    prescribe. They have got to go through extra red tape to do it.
    And it often costs more to the veteran out-of-pocket.
        So the bill, and why it would fix that problem, is it would
    mandate that VA add these no-opioid alternatives as VA
    formulary, to make it easier for those providers to prescribe
    alternatives, which, as the Commander noted, obviously we had
    an opioid crisis in the United States. As the VA and other
    agencies have worked to kind of lower that or reduce the impact
    of that on the population, veterans still have to find a way to
    deal with things like chronic pain. So without alternatives,
    they turn to self-medication and things like that. This would
    provide realistic alternatives.
        Mr. Pappas. Well, I appreciate those observations. We are
    committed to working with you on this, and on all the other
    priorities on the list. We have got to make some progress here.
    So let's get things moving. Your presence here in Washington is
    a big show of support for priorities that are going to
    positively impact the lives of veterans and their families all
    across our country. So thanks for being here, and let's keep up
    the pressure. I yield back.
        Chairman Moran. Thank you, Congressman. Representative
    King-Hinds.

                       HON. KIMBERLYN KING-HINDS,
           U.S. REPRESENTATIVE FROM NORTHERN MARIANA ISLANDS

        Ms. King-Hinds. First of all, I want to say thank you for
    your advocacy and for your leadership, and I want to thank all
    the members of the American Legions for being here, and for
    your continued work to be able to get Congress to move on some
    of these priority legislation. I appreciate all the hard work.
        I read your testimony, and I appreciate the clarity and the
    urgency in the testimony that you submitted. One of the things
    that I want to get a better understanding of, after reviewing
    your testimony, is from the priorities that you have outlined,
    what do you believe is the single biggest systematic failure in
    how we currently deliver benefits to veterans, and what
    specific legislative action should we be prioritizing to
    address it?
        Mr. Wiley. Thank you, Representative King-Hinds. I am going
    to ask, again, our VA&R Director, Cole Lyle, to address that
    question.
        Mr. Lyle. Thank you, Commander. I think if we are going to
    talk specifics in the benefits process it is the high rate of
    remands from the Board of Veterans Appeals, and that has
    directly resulted from the quality of CMP exams in that
    process. The VA largely utilizes contractors to conduct those
    CMP exams, and there is fairly consistent, in our regional
    office action review site visits we find inadequate DBQs that
    are submitted for CMP exams, that result in appeals, delays,
    things like that. So I would say that is the biggest----
        Ms. King-Hinds. Point of failure?
        Mr. Lyle [continuing]. Point of failure. And there are
    several bills, to include the MDEO--I am forgetting on what the
    specific bill number is off the top of my head--to improve the
    oversight of those contractors and ensure there is quality in
    those CMP exams.
        Ms. King-Hinds. Okay. Where do you see is the widest gap,
    then, between some of these legislation that have been enacted,
    going back to the point that Senator Tillis was making with
    regards to delivery, in terms of connecting legislation and the
    actual delivery and the way that the VA currently does its job?
        Mr. Lyle. It is a great question. From a 30,000-foot view
    perspective, I would say really education and advocacy, and
    educating veterans, many of whom often feel like if they apply
    for disability compensation they are going to be taking
    something away from another veteran. So I would say from a top-
    level view that is the biggest thing, between legislation and
    actual delivery of benefits is educating veterans.
        Ms. King-Hinds. I would like to continue working with the
    American Legion to figure out how to actually address those
    systematic failures. Thank you. I yield my time.
        Chairman Moran. Senator Hassan.

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

        Senator Hassan. Thank you, Mr. Chair, and to you and
    Chairman Bost and Ranking Members Blumenthal and Takano, thank
    you for this hearing. And to everyone here today, to Commander
    Wiley and everyone from the American Legion, including the
    Granite Staters who are in attendance, thank you for your
    service.
        I also just want to note that as the country is at war, our
    troops in harm's way are in all of our hearts today, as are the
    families of our fallen heroes.
        Our country owes all of you a debt of gratitude, not just
    for your service in uniform but also for your service to your
    fellow veterans.
        Commander Wiley, I wanted to start with a question about
    how we are handling services for women who are, of course, the
    fastest-growing group of veterans. They obviously deserve easy
    access to care that is specific to them and their needs.
    Senator Blackburn and I are working on this issue, and we are
    going to introduce a bill soon that would codify the ability of
    women veterans to directly schedule gender-specific care
    without having to get a primary care referral first. But we
    know we need to do more.
        Commander, what else can Congress do to ensure that women
    veterans have easy, reliable access to the care that meets
    their specific needs?
        Mr. Wiley. I think a couple of things that they can do
    specifically. As I suggested, or saw in one of the VA hospital
    visits, is having a separate access for women veterans. It is
    also having a sufficient number of doctors that can treat women
    veterans. You know, 20 years ago you would never have heard of
    an OB-GYN in a VA, and we have, obviously, veterans that are
    having babies. And we need more women physicians and more of
    those types to treat women veterans. So those are the big
    things we can do right off the bat, I think, to help women
    veterans.
        Senator Hassan. Thank you for that, and I look forward to
    working with you and your members on that issue.
        Another question concerning families of veterans. It is not
    just to care for our veterans, we also owe a debt to their
    families. And after a veteran passes, surviving family members
    may encounter financial strains. Some can qualify for monthly
    payments under Dependency and Indemnity Compensation (DIC), but
    those payments can be much smaller than what a veteran was
    receiving for VA disability.
        Commander, what are some potential options that Congress
    should consider to help these families through this adjustment
    period, so that they do not have to immediately worry about
    money while they are grieving for their loved one?
        Mr. Wiley. Thank you again, Senator Hassan. I agree with
    you 100 percent on the premise, and I am going to ask our VA&R
    Director Cole out to address that specifically.
        Senator Hassan. Thank you.
        Mr. Lyle. Thank you, Commander, and thank you, Senator. I
    think the American Legion has supported the Caring for
    Survivors Act and the Love Lives On Act specifically to raise
    the DIC, the Dependency and Indemnity Compensation, because as
    you pointed out, while their servicemember is alive they rely
    on a certain level of income for the quality of life and
    standard of living, and when it gets significantly reduced that
    is a pretty big financial shock.
        Senator Hassan. Sure. Thank you very much. I yield.
        Chairman Moran. Senator Sheehy.

                            HON. TIM SHEEHY,
                       U.S. SENATOR FROM MONTANA

        Senator Sheehy. We are veterans, not victims. Veterans, not
    victims. And we are not entitled to anything. We have earned
    the benefits that we deserve, and we deserve those benefits in
    the form that they should come. And I think the best thing we
    can do for our veterans when we get home from war--and I will
    talk to Mr. Sharpe and Espinoza about this--is make sure that
    they can serve again, and that can be as law enforcement
    officers, that can be as a firefighter, that can be as a small
    business owner, a machinist, a welder. Right now America has a
    skills gap. We do not have enough pilots, police officers,
    firefighters, welders, electricians, and these careers are
    actually well suited for veterans. Probably the best careers as
    veterans even is agriculture. We do not have enough producers,
    ranchers, and farmers, and we are not afraid of getting up
    early and working until the sun goes down. And these jobs are
    important for the future of America. They sustain our economy
    and they feed our Nation.
        So Mr. Sharpe and Mr. Espinoza, I would like to hear from
    you what you think we can do to make sure that when our
    veterans come home and take that uniform off they do not spend
    the rest of their life talking about how great it was to be
    veteran. They spend the rest of their life achieving new great
    heights as veterans and make us proud yet again.
        Mr. Sharpe. Thank you for that question. The American
    Legion has always supported expansion of the TAP program. We
    believe TAP program should be a way for veterans to find
    employment and also be gainfully employed. Currently not all
    our veterans are aware of the various services that are out
    there for veterans as far as finding employment, so the
    American Legion has, for our resolution, we believe that there
    should be a transition app with an AI component to it, to put
    all veterans that are leaving the military on a level playing
    field. Because depending on what installation that you are
    leaving from it may not have all the services for everyone. So
    we believe that transition app is the one thing that will level
    the playing field, keep veterans informed of all the services
    and programs that the TAP office currently has, but also keep
    an eye on what is happening in the private sector, as well.
    Thank you.
        Senator Sheehy. What I say one thing I could use all of
    your help with is one of the requirements to receive your DD
    214 upon discharge should be a full transfer of your health
    records to the VA, a VA disability physical has been completed,
    and you are ingested into VA before the DoD lets go of you.
    That would solve this chasm that too many veterans fall into,
    which is they step off active duty and they spend months or
    years or the rest of their lives trying to get into the VA,
    trying to get the disability claims adjudicated. That should be
    a condition of discharge, and I think the sooner we adopt a
    clear transfer of health records and health status from the DoD
    to the VA will solve that problem. Thank you.
        Chairman Moran. Thank you, Senator Sheehy. Senator King.

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

        Senator King. Thank you, Mr. Chairman. I do not want to
    throw shade at you guys but you were talking about Boys State.
    I was Governor of American Legion Boys State.
        [Applause.]
        Senator King. Now, the tricky part, Boys State was
    Virginia, and later I was elected Governor of Maine, and the
    people of Maine are still trying to figure that out.
        [Laughter.]
        Senator King. And also I want to congratulate you on Matt
    Jabaut being your Legislative Director. But it is pretty sneaky
    because he lives a mile away from me. Having your chief
    legislative guy as my neighbor, I think that is, you know, come
    on, man.
        I want to follow up on Senator Sheehy. There is a bill we
    are hoping to get in markup that would allow, and in fact
    mandate, the registration of people into the VA health system
    before they leave active duty. So I hope that is something we
    can work on together, because I think that is a really good
    idea.
        One of the things I have been focused on since I have been
    here is transition. My rule is very simple. The government
    should spend as much money, time, and effort on transition out
    as they do on recruiting in, and they do not do that. So I hope
    that is something we can work together on. TAP promotion, I
    think we almost made it last year, giving the VSOs access to
    people during the TAP process. The whole idea is to give people
    leaving active duty more information about what is available.
    You are nodding. I hope you agree, Mr. Wiley.
        Mr. Wiley. Senator King, we absolutely agree with you. To
    have the VSOs have access will make that transition to the
    community much easier because we can provide them the
    information necessary so they can make that transition into the
    community.
        Senator King. Something else that I am working on in the
    area of veteran suicide, which is one of the great tragedies of
    this country, is for the VA to provide free lockboxes for
    firearms, to any veteran. Seventy-five percent of veteran
    suicides, almost 75 percent, are with firearms, and as we have
    learned, the data shows that if there is any gap between the
    idea and execution, self-execution, that that can be a real
    help to somebody who is thinking about this terrible act. So I
    hope that is something you can also help us with. It is based
    on a pilot program in Utah that has been very effective. We are
    not taking any names. This is not gun control. This is safety
    for veterans. So I hope you can help us on that one.
        Mr. Wiley. Senator King, we absolutely support that.
        Senator King. And then, finally, staffing issues at the VA.
    We all know that the VA has lost a lot of people in the last
    year. The number, I have heard 30,000. I have heard more. What
    I want from you is reports from the field as to whether or not
    that is having an impact on service for veterans. We have
    gotten the word from the VA. They feel, the Secretary, you
    heard him the other day, everything is good and wait times are
    down. But I would like some feedback from people in the field
    as to whether that is the case. Because you are the ones that
    are actually experiencing this, and we are looking to fix
    problems here, but we cannot fix the problems if we do not know
    what they are.
        So I look forward to working with you on that, as well. And
    thank you very much for your leadership, and I look forward to
    continuing our work together on behalf of American veterans.
    Thank you, Mr. Chairman.
        Chairman Moran. Governor, thank you for your questions.
        [Laughter.]
        Chairman Moran. Senator Boozman.

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

        Senator Boozman. Thank you, Mr. Chairman. Thank you for
    being here. I thank all of you for being here. In the last
    several years, Congress has been able to step forward and
    again, as somebody whose dad did 20 years, I understand that
    these are, as Senator Sheehy just said, ``these are certainly
    earned benefits.'' And we have been able to accomplish a lot,
    but the only reason we have been able to accomplish it is
    because of you all. And so there is nothing more heartwarming
    to sit here and look out and see a full chamber. People on the
    wall, that is a good thing. There is no substitute for you
    being here, talking to the people that represent you, telling
    them how important these things are and why they are needed.
    And because of your help, like I said, we have been able to do
    a lot of good things, and we will continue to do that in a very
    bipartisan way. That is really what it is all about.
        So, the VA recently released its annual Veteran Suicide
    Prevention Report with the date 3/20/23. It shows that veteran
    suicide crisis, as you all know, continues to rage. The report
    highlighted the success of the Staff Sergeant Fox Grant
    Program, making more than 24,000 referrals and 854 lifesaving
    emergency service-connections for veterans.
        Mr. Wiley, what have you heard from your members regarding
    the program and aspects that need to be changed or improved?
        Mr. Wiley. Thank you, Senator. I appreciate the question. I
    think there are several things that can be done with regard to
    the epidemic of veteran suicide. As you know, this is our
    number one mission in eliminating the stigma. But more
    resources, number one, are needed for mental health. We need
    more resources for things to combat homelessness, like the HUD-
    VASH program. And we need basically--I lost my train of
    thought. I apologize.
        I am going to ask Cole Lyle to elaborate on that. Thank
    you.
        Mr. Lyle. Thank you, Commander.
        Senator Boozman. You are just trying to make me feel
    better. That happens to me more often than not [laughter].
        Mr. Lyle. Thank you, Senator Boozman. I think the success
    of the Staff Sergeant Parker Gordon Fox Grant Program, over the
    years we have seen the VA move closer and closer to the
    community, from medical centers to CBOCs to vet centers, and
    now things like the Fox Grant Program, that are not VA
    organizations but leverage VA funding to provide that outreach
    to veterans, which is crucial because less than 50 percent of
    veterans use the VA. The number of veteran suicides with the
    declining population has stayed stagnant, so the rate of
    suicide, if you look at the data, has actually increased.
        And these types of programs are local programs that
    veterans trust, that are in their community, that provide that
    outreach, and deal with the upstream factors of suicide, like
    transportation, relationship issues, acute financial stress,
    any number of different things. So we want to get to the
    veteran before there is a critical mass of despair, and
    programs like that are really helpful.
        Senator Boozman. Thank you, Mr. Chairman. Again, thank you
    all for being here, and the fact that you are pushing hard and
    together, we are getting a lot done.
        Chairman Moran. Senator Boozman, thank you. Senator Murray,
    former Chairman of the Committee.

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

        Senator Murray. Thank you very much, Mr. Chairman. Thank
    you to all of you who are here today and everyone in this
    country who has served our Nation. We all owe you, and we all
    say this, a debt of gratitude for your service, but it is more
    than that. We owe you to keep the promise that when you come
    home we will be there for you in any way, both to the current
    veterans and to the ones who we will see in the future.
        I think it is really important today, Mr. Chairman, and
    this has kind of been glossed over, this point of time that we
    are in, where we have a President who is taking us to war in
    Iran, who seems to have no problem sending other kids off to a
    war but seems to have a problem in picking up the tab when it
    comes right by doing our servicemembers when they come home.
    With a VA right now that has waiting lines, that veterans
    cannot get served, that we see doctors and nurses who are not
    being hired, and no thought has been given to that. What we
    hear from Trump is that he is saying that this bombing campaign
    in Iran could go on indefinitely. He is saying the death of our
    servicemembers in a war of choice is, quote--and he said this--
    ``just the way it is.'' He is saying he will not rule out
    putting American boots on the ground in Iran. I think it is a
    very serious time for our country.
        I have served on this Committee for more than 30 years. I
    know the consequences of war, as each and every one of you does
    in front of me. And to go to war without preparing for the
    future, and making sure that we are there for the men and women
    whose service, and we thank them for that, but when they come
    home, as well. And, Mr. Chairman, we are not ready for that
    today.
        This has to be a consequence that we consider. For numerous
    reasons I am going to be using my voice today to vote ``no'' on
    the war in Iran. But it is the responsibility of this Committee
    and every Member of Congress to think about all the
    consequences of war and take that into account and hold this
    Administration accountable and make that clear when we make our
    choices, moving forward. I felt it was really important to say
    that today, with all of you who have served our country, and
    know what those sacrifices mean.
        So, Mr. Chairman, I only have a few seconds left, and with
    that I want to change the subject and thank you, Commander
    Wiley, for saying the word ``menopause.'' Having been on this
    Committee for more than 30 years, this is the first time I have
    heard it, and I think I counted four times.
        For our women whose service in this country, we know that
    they experience early menopause after having served in the
    military, more than women in the general population. We need to
    know why, and we need to be able to make sure that we are doing
    the right thing for those women. I did introduce a bill last
    year for the VA to do more research on that. That, along with
    all the other things that you were talking about today have as
    serious a consequence today as we are in this time, where a
    President has taken us to war in Iran without congressional
    consent, as any other time.
        And I want to thank every one of you for being here. And my
    promise to all of you is I will fight to make sure, no matter
    what goes forward, that this Committee and this Congress will
    do, for our veterans who serve us, the right thing when they
    come home, and we have to take that cost into account as we
    make these decisions.
        Thank you, Mr. Chairman.
        Chairman Moran. Senator Murray, thank you. Now I recognize
    Mr. McGarvey.

                         HON. MORGAN MCGARVEY,
                   U.S. REPRESENTATIVE FROM KENTUCKY

        Mr. McGarvey. Thank you, Mr. Chairman. Thank you all for
    being here today. Thank you for your continued service to our
    country. Mr. Wiley, thank you guys. The American Legion, you
    all have spent generations making sure that our veterans are
    taken care of when they come home, that they continue to have
    meaningful lives after their service. And I know everyone on
    this Committee shares that same goal of making sure that we get
    our veterans the care that they have been promised, that they
    have earned, and that they deserve.
        I think one area where the VA could be doing much more
    right now is getting innovative ideas off the ground. You heard
    Senator Murray talk about the need for research, particularly
    among our women veterans right now. Look what the VA has at its
    disposal. It is the largest patient population of any hospital
    system in the country, by multiples, 9 million patients. We are
    the largest longitudinal dataset of any health system in the
    country. Think about it. We get you oftentimes when you are 17
    or 18 years old. We keep you until the day you die. Seventy-
    five percent of physicians do some sort of training or work in
    the VA right now. And what are we doing with this treasure
    trove of talent and information? Not enough. Not nearly enough.
        Right now, even really good ideas can sit around for years
    before veterans are able to see them, because the VA does not
    have the tools or the flexibility that other agencies use. We
    have the stuff there but we have structural impediments to it.
    At places like the Department of Defense and NASA, they can
    partner quickly with early stage companies that guarantee a
    market for promising technologies, and they can move these good
    ideas and these research things from concept to real-world use,
    without getting buried in red tape. The VA does not have those
    same authorities. And the veterans are the people who feel the
    impact of that delay and that bureaucracy every day.
        It does not have to be this way. We can empower the
    innovation team at the VHA to conceive and test new solutions
    that go after the hardest problems that our veterans face. And
    think about this, we solve these problems for our veterans, we
    can start solving them for everyone in the country.
        So, I want to go to you, Mr. Wiley, and just say if the VA
    had flexibility and authorities to test and scale these types
    of new care models quickly, what kinds of innovative programs
    would you want them to prioritize first to better meet the
    needs of your members?
        Mr. Wiley. Thank you for that question, and absolutely, we
    are always looking for different methods of treatment to treat
    our veterans that might be more successful than those have been
    in the past, because we believe that is one of the main ways to
    combat the epidemic of veteran suicide.
        But with regard to the specifics, again, I am going to ask
    our VA&R Director, Cole Lyle, to address that.
        Mr. Lyle. Thank you, Commander, and thank you, Congressman.
    I think some basic programs like digital matching tools, I
    think there is a pilot program for identifying substitute
    caregivers that could be directly expanded and utilized
    nationally, so caregivers could have trusted resources for
    substitutes to come and care for their servicemember. Hybrid,
    in-person telehealth type things, where there is a remote
    monitoring with the wearables and home sensors. So for rural
    veterans that have to travel long distances for chronic pain
    management and things like that, they only have in-hospital
    visits for severe issues that are not routine, and they can do
    telehealth appointments for things that are pretty routine. So
    it would reduce readmittance rates, wait times, things like
    that, that the VA could utilize pilot and expand rapidly if
    they had those authorities.
        Mr. McGarvey. Thank you so much. I am out of time, Mr.
    Chairman. I yield back.
        Chairman Moran. Thank you. Representative Conaway.

                           HON. HERB CONAWAY,
                  U.S. REPRESENTATIVE FROM NEW JERSEY

        Mr. Conaway. Thank you, Mr. Chairman. And I tell you, I
    like Senator King because as it turns out I was Boys State
    Governor, as well, in New Jersey, in 1980.
        [Applause.]
        Mr. Conaway. I have not gone on to become a Governor, but
    it certainly was a very impactful time of my life that
    certainly has paved my way to going into elected office.
        Thank you, Commander Wiley, for your testimony, and thank
    you to the American Legion and this panel for your advocacy and
    leadership. I wanted to take this time to shout-out to my local
    American Legion post, of which I am a member, Slade-Valentine
    Post in Burlington City, 336. Where are you guys? I think they
    are here. New Jersey folks, there you are. I am happy you are
    here with us in the audience, as well.
        As a physician and veteran, I have been extremely
    disappointed with the VA's decision to shrink its medical
    workforce. We all know that in order for the VA to continue to
    provide quality care it must be fully staffed. Just yesterday,
    the VA reported 1,500 vacancies among its physician workforce,
    and 4,900 vacancies with respect RNs in the VA. Our veterans
    depend on these medical professionals. Quality care depends on
    quality, fully staffed workforce.
        What would you say are the biggest barriers, and
    particularly given your emphasis, rightly, on mental health
    services for veterans? And here, I want to thank Senator King
    who is working with us on trying to get telehealth services in
    a pilot to veterans who are incarcerated, and also for his
    effort, and he has mentioned it here today, to lift the cap so
    that we can help the VA recruit more physicians into the
    service. But what would you say are the biggest barriers to
    veterans trying to access mental health services within the VA?
        Mr. Wiley. Thank you. I appreciate that question. And I am
    going to ask our VA&R Director, Cole Lyle, to address that
    question.
        Mr. Lyle. Thank you, Commander, and thank you, Congressman.
    I think, obviously, outreach is a huge thing. The VA's budget
    for mental health and suicide prevention outreach I think is
    hovering around $600 million right now, which sounds like a
    large number. A big portion of that is going to the Fox Grant
    Program, and advertising things like that. That represents less
    than 1/10th of 1 percent of VA's overall budget.
        So outreach could definitely improve. I think utilizing
    VSOs, things like the Fox Grant Program, making it easier for
    local and state-level organizations to access those funds and
    expand those funds, primarily authorize the program, would be
    very helpful.
        Mr. Conaway. Thank you. Mr. Chairman, I yield back.
        Chairman Moran. Thank you. Senator Slotkin.

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

        Senator Slotkin. All right. You are almost done, I think. I
    am Senator Elissa Slotkin from Michigan, a former CIA officer.
    I did three tours in Iraq alongside the military. And I want to
    associate myself with Senator Sheehy's comments, but
    particularly mention a piece of legislation he and I are
    working on, on making sure that the GI Bill gives the same
    benefits for a veteran choosing an apprenticeship versus going
    into education of some kind. Right now you get dinged every six
    months if you are in an apprenticeship, and your benefit just
    does not go as far.
        We have talked to the Legion about this. I think we are on
    the same page. But I just want to put a marker down that at a
    time when our country needs, again, so many specific career
    types--a lot of those career types that Senator Sheehy
    mentioned, especially skilled trades, are apprenticeships, and
    you should not be dinged because you want to go into a
    successful career in the trades versus going to a four-year
    university. So I just wanted to put that marker down.
        But as a part of this kind of post-9/11 generation, I want
    to raise a separate issue, and if not get an answer, get this
    community thinking about this, artificial intelligence in
    deciding what benefits our veterans get or do not get. There is
    a lot of discussion about bringing artificial intelligence into
    the VA. I am working on legislation right now debating this.
    And there are lots of pilot programs being looked at.
        What I am concerned about is that before we hardly know
    what is happening, we are going to let software decide if a
    veteran gets a benefit or not. And I have got a problem with
    that. And we understand that AI can do amazing things and can
    amalgamate data and figure out if a veteran has got all their
    paperwork in, but does the Legion have thinking on this? Who is
    the thought leader that is trying to help our veterans
    organizations think through this new, hot issue that is coming
    to a theater near us?
        Mr. Wiley. Thank you, Senator. I appreciate your question.
    And let me give you an example of a recent visit I had to a
    regional office and explain, in my mind, how artificial
    intelligence can be productive.
        What they do is use artificial intelligence for
    administrative tasks such as organizing records and putting
    those all together for a reviewer or rater. What should not
    happen, and what we cannot allow happen, is for artificial
    intelligence to substitute for judgment.
        Senator Slotkin. Right.
        Mr. Wiley. Judgment has to be a human being that can review
    all of the evidence and make an independent determination using
    everything they know. Artificial intelligence is not a
    replacement for that.
        Senator Slotkin. Yes, so thank you. And, Mr. Chairman, I
    just think this is an issue we are going to have to deal with
    as a Committee, both Chairmen here and Ranking Members, of just
    how much power are we going to give to AI to decide if a
    veteran gets reimbursed for something, if a veteran qualifies
    for something. I just think we are moving very fast and there
    are some real benefits, I know, but a human being needs to be
    in the decision tree before we start making life-and-death
    decisions for veterans.
        So I appreciate everyone's work here, and thank you. I
    yield back.
        [Applause.]
        Chairman Moran. Senator, thank you. Representative Takano
    has an additional question I am going to allow him to ask, and
    then we are going to turn to the Senator, and then we are going
    to conclude this panel. There is a vote that started in the
    Senate, and we will have a change to our second panel during
    that vote. Senator? Representative?
        Mr. Takano. Thank you, Mr. Chairman. You know, with The New
    York Times article yesterday, I wanted to quickly ask a
    question about staffing. Veterans' care does not happen without
    staff, and Commander, are you hearing from legionnaires about
    appointments being pushed out or services getting harder to
    access?
        Mr. Wiley. Anecdotally, the answer is yes.
        Mr. Takano. So anecdotally. For the legionnaires here
    today, I just want a show of hands. Are you experiencing
    delayed care or longer wait time because a clinic, a CBOC, did
    not have enough staff? Just raise your hand, by show of hands.
        [Hands raised.]
        Mr. Takano. All right. So a number of hands have been
    raised. Thank you. I yield back.
        Chairman Moran. Thank you, Ranking Member. Senator?

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

        Senator Banks. Thank you, Mr. Chairman. First of all,
    welcome to the many Hoosier legionnaires who are in the
    audience. I am very proud to be your Senator. I am a member of
    the American Legion Post 98 in my hometown, Columbia City,
    Indiana, and I am very proud of it.
        [Applause.]
        Senator Banks. Our veterans count in the American Legion
    and all of our great veterans service organizations to advocate
    for the very best possible health care, education, and
    disability benefits for our veterans every day, and I want to
    thank all of you for the important work that you do.
        Commander Wiley, I strongly agree that veterans deserve a
    claims and appeals system that is simple, efficient, and worthy
    of their service. I appreciate the Legion's support for my
    Veterans Appeals Efficiency Act that I have introduced, that we
    worked with you on. Can you talk about the bill and why it
    would be helpful?
        Mr. Wiley. Thank you, Senator Banks. It is something that
    is important to us, and I am going to ask our VA&R Director,
    Cole Lyle, to specifically address that.
        Mr. Lyle. Thank you, Commander, and thank you, Senator. The
    act you cited is a great idea. There are a lot of specific
    provisions in there, reporting requirements from the VA, making
    the process more transparent.
        I know there have been concerns in the veteran community
    about aggregation of data. I think obviously, as mentioned
    earlier, there is a high remand rate from the court.
    Aggregation, particularly for presumptive conditions, could be
    a good thing, if granted. I understand we have had
    conversations with your office about an opt-out if they choose
    not to, because one of the big concerns would be the veteran
    losing their individual POA, and that would be particularly
    difficult to deal with if it was an aggregated claim that got
    denied. It would just kind of clutter the system.
        So if we could work with your office on improving the
    language for the bill, just discussing some of the concerns and
    make it more effective, if passed.
        Senator Banks. I am glad to work with you on that. Thank
    you for that explanation.
        Commander, the VA's legal authority to care for homeless
    veterans expired during the government shutdown last fall. We
    can never let that happen again. And I am introducing
    legislation to make the Health Care for Homeless Veterans
    (HCHV) Program permanent, so that it cannot shut down during a
    shutdown. Can I count on the Legion's support to help pass that
    bill?
        Mr. Wiley. Yes.
        Senator Banks. Very good. All right. Well, thank you for
    that. Again, thank you for all that you do, each and every one
    of you in the room, and your leadership. I am a big fan of the
    American Legion. I am proud to be a member. With that, Mr.
    Chairman, I yield back.
        Chairman Moran. Senator Banks, thank you very much.
    National Commander, thank you for you and your team's
    testimony. I will use a moment to recognize the National
    Commander of the Sons of the American Legion. I am a member of
    the Sons of the American Legion, and use this as an opportunity
    to indicate to others like me that there is an opportunity to
    serve veterans and to be a part of the American Legion program.
        With that we close out this panel and transition to our
    second panel. Again, Commander Wiley, thank you. I will see you
    in Kansas at some point in time. But thank you to your entire
    team of American Legion advocates and workers on behalf of our
    Nation's veterans and their families.
        We will take a brief recess to allow the American Legion
    panel and the audience members to depart, and our second panel
    organizations and members to get situated. We are pausing.
    Thank you.

        [Recess.]

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

        Senator Tuberville [presiding]. Welcome, everybody. You can
    take your seats. We will get started. Welcome to our second
    panel of witnesses and audience members. Thanks for being here
    today.
        In our second panel today we have Mr. Robert Thomas,
    National President for Paralyzed Veterans of America; Mr. Paul
    Shipley, National Commander for AMVETS; Mr. Terry Prince,
    President for National Association of State Directors of
    Veterans Affairs.
        [Applause.]
        Senator Tuberville. You have a pretty good contingent here,
    Terry.
        Lieutenant General Walter Piatt, Chief Executive Officer
    for Wounded Warrior Project. Thanks for being here. Ms. Anita
    Sullivan, surviving spouse of Navy Petty Officer Third Class
    Michael Sullivan, testifying for Tragedy Assistance Program for
    Survivors; Major General Frank McGinn, President for National
    Guard Association of the United States; and Mr. Jim Whaley,
    Chief Executive Officer for Mission Roll Call.
        Thank you all again for being here and for your
    organizations' hard work and dedication. You provide tremendous
    value to our Committee.
        So we will start now. Mr. Thomas, you are recognized for 5
    minutes, and we will just go down the line.

                                PANEL II

                                  ----------

     STATEMENT OF ROBERT THOMAS JR., NATIONAL PRESIDENT, PARALYZED
                          VETERANS OF AMERICA

        Mr. Thomas. Chairman Moran, Chairman Bost, and Members of
    the Committees, thank you for the opportunity to speak with you
    today on behalf of the tens of thousands of veterans with
    spinal cord injuries and disorders who rely on VA's benefits
    and care.
        The VA is the best health care provider for veterans with
    catastrophic disabilities. The Department's Spinal Cord
    Injuries and Disorders System of Care provide a coordinated,
    life-long continuum of services. There is no comparable private
    system of care in the community. Thus, preserving and
    strengthening VA's specialty care system remains PVA's highest
    priority, and it should be for you too.
        When I appeared before these Committees last year, I spoke
    about the ways that ongoing staffing deficiencies and
    infrastructure problems were undermining not just VA's SCI/D
    System of Care but VA's specialized services in general. Now,
    much has changed since then, and it is frustrating to have to
    bring up this, year after year, without resolution.
        Unfortunately, the previous administration's practice of
    simply eliminating unfilled positions continues. This is
    extremely concerning because it presents the illusion that
    staffing levels are better than they really are, and I must
    call a ``foul'' on this. Because at the same time positions are
    being eliminated, it could be difficult to fill them due to the
    staffing caps and funding limitations. I urge you to continue
    to press VA for answers regarding how it plans to care for the
    tens of thousands of veterans with SCI/D who are on its
    registries and depend on VA for quality, timely, direct care.
    This cannot be allowed to continue for another year.
        Access to lifelong services and supports continue to be
    crucial for PVA's members. We are very appreciative of
    Congress' passage of the Senator Elizabeth Dole Act. VA says
    the VA's Directed Care program is now available at all major
    facilities. But the feedback we have suggests some programs
    exist in name only or serve few veterans. Congress must ensure
    that the Elizabeth Dole Act's provisions are carried out as
    intended.
        Another important aspect of lifelong support is VA's Bowel
    and Bladder program. For veterans with SCI/D, support for
    neurogenic bowel and bladder dysfunction is a crucial aspect of
    their care. Unfortunately, VA's current Bowel and Bladder
    program is fraught with challenges for caregivers. Timely
    reimbursement and the tax treatment of payments are the two
    chief complaints I hear. Codifying the program would provide
    the opportunity to fix many of these problems. I thank Chairman
    Moran for his bill, the Disabled Veterans Dignity Act, which
    would help to address these issues. We also appreciate the
    interest from the House in introducing a similar bill that
    includes the provisions addressing the taxability issue.
        Another area of concern is transportation to VA care. We
    are very concerned about new VA guidance that ends facility
    prepayment of round-trip common-carrier airfare for veterans
    traveling to VA SCI/D facilities. This change requires veterans
    to arrange and pay for travel up-front and seek reimbursement
    after their appointments, effectively preventing many from
    receiving necessary care. We appreciate that the VA is
    attempting to figure out a solution to this problem, and call
    on Congress to provide VA any resources, including clear
    statutory authority, to ensure veterans can access specialty
    care.
        Finally, Special Monthly Compensation (SMC) is arguably the
    most important ancillary benefit for veterans with severe
    service-connected disabilities. Given the extreme nature of the
    disabilities incurred by most veterans in receipt of SMC, we do
    not believe that the impact on the quality of life can be
    totally compensated for. However, SMC does at least provide
    these veterans a financial resource to help accommodate their
    individual needs.
        In similar fashion, survivor benefits are intended to
    protect veterans' families from impoverishment after the death
    of a service-disabled veteran. Unfortunately, they do not
    always do that, and many survivors who, in many cases, were
    once caregivers, face a financial cliff. Congress established
    the baseline rates for these programs decades ago. They must be
    updated now. We urge Congress to quickly pass the Sharri Briley
    and Eric Edmundson Veterans Benefits Expansion Act.
        Thank you for the opportunity to testify. I would be happy
    to answer any questions.

        [The prepared statement of Mr. Thomas appears on pages 94-
    118 of the Appendix.]

        Senator Tuberville. Thank you, Mr. Thomas. I would like
    everybody to pull your microphone just a little closer. You
    have got people in the back. Make sure that you speak into it,
    because we are a government entity. We do not run real well up
    here, as you all well know.
        Mr. Shipley from American Vets, you have 5 minutes.

                       STATEMENT OF PAUL SHIPLEY,
                       NATIONAL COMMANDER, AMVETS

        Mr. Shipley. Chairman Bost, Chairman Moran, Ranking Members
    Takano and Blumenthal, and distinguished Members of the
    Committees, on behalf of AMVETS thank you for the opportunity
    to present our legislative priorities and for your continued
    commitment to the men and women who have served our country.
    AMVETS represents more than 20 million veterans, from every era
    of service, including active duty, National Guard, Reserve, and
    those who have transitioned to civilian life.
        This past year marks a new chapter for our organization.
    After more than 80 years in the National Capital region, we
    relocated our National Headquarters to Washington,
    Pennsylvania, where we also established the AMVETS Family
    Service Center. This 35,000 square foot facility will serve our
    homeless veterans and their families. Our veterans will be able
    to remain with their spouses and children while they secure
    employment, permanent housing, and long-term stability.
        Through the Center, we administer Department of Labor
    Homeless Veterans Reintegration Program grants in Salt Lake
    City, Utah, and Phoenix, Arizona, along with workforce programs
    and Veteran Stand Downs across the Nation. These efforts
    reflect what experience has taught us--housing, employment,
    mental wellness, and family stability are interconnected.
    Effective policy must reflect that reality.
        Mental wellness and suicide prevention remain our top
    legislative priority. Despite significant Federal investment,
    suicide continues to take an unacceptable toll on the veteran
    community. We have seen strong, evidence-driven results from
    community-based efforts supported by the Staff Sergeant Fox
    Grant Program, which often reach veterans for whom traditional
    care has not worked.
        As Congress considers reauthorizing the Fox Grants, we urge
    expanding proven models and continuing to focus on measurable
    outcomes. Our current approach spends billion while delivering
    minimal improvement in reducing symptoms and suicide.
        After two and a half decades following 9/11 and more than
    140,000 veteran deaths, the time has come to invest in programs
    where outcomes are front and center. Congress and the VA must
    embrace a proactive, outcome-driven approach and move beyond an
    expensive, reactive system that is not working for the vast
    majority of veterans.
        Wellness interventions must begin earlier and be embedded
    throughout a servicemember's career. The real antidote to
    suicide is not slogans or billboards telling veterans to seek
    help. It is ensuring that the men and women who serve are
    equipped with the tools to build meaningful lives and know
    where to turn when times become difficult.
        A similar forward-looking approach is needed in the
    treatment of traumatic brain injury. Since 2000, more than
    500,000 servicemembers have been diagnosed with TBI. Many face
    lasting cognitive and emotional effects that disrupt
    employment, relationships, and overall health. Legislation such
    as the BEACON Act and the Veterans TBI Adaptive Care
    Opportunities Nationwide Act will allow the VA to evaluate and
    expand innovative, patient-centered therapies. We are also
    thankful to Chairman Moran's leadership on the Precision Brain
    Health Research Act of 2025, which would help broaden our
    understanding of the impacts of repetitive, low-level blast
    injuries on veterans' mental health. Veterans deserve care that
    evolves with science and focuses on meaningful recovery.
        We must also honor our commitments to surviving families.
    Dependency and Indemnity Compensation has not kept pace with
    the comparable Federal survivor benefits. Modernizing DIC
    through the Sharri Briley and Eric Edmundson Veterans Benefit
    Expansion Act, the Caring for Survivors Act, and the Love Lives
    On Act is a matter of fairness and dignity for families who
    have already sacrificed so much.
        Modernization with the VA is equally essential. A fully
    interoperable electronic health record between the Department
    of Defense and the VA reduces duplication, improves patient
    safety, and ensures continuity of care. As the rollout
    continues next month, sustained oversight and disciplined
    execution are necessary for success. Failure is not an option.
        Fairness also requires passage of the Major Richard Star
    Act. For decades the Federal Government has reduced military
    retirement pay simply because a servicemember was wounded badly
    enough to receive disability compensation. This has been framed
    as concurrent receipt, suggesting veterans are double dipping.
    They are not. Military retirement is earned through years of
    service. Disability compensation addresses injuries sustained
    in that service. When the government offsets one against the
    other, it is taking away retirement that was already earned.
        Let me be clear. It is time to stop stealing from our
    servicemembers. Congress needs to immediately end this
    injustice and pass the Major Richard Star Act.
        Finally, AMVETS supports the development of a coordinated
    national veterans strategy focused on measurable outcomes. This
    nation invests hundreds of billions of dollars each year in
    veteran-related programs. Those resources must be expended
    around clear goals, accountability, and results that improve
    health, employment, and quality of life. As the men and women
    who defend our Nation are once again placed in harm's way, we
    depend on this body to ensure that we are cared for when they
    return home. Our veterans and their families deserve more than
    promises. They deserve measurable progress in their health,
    their opportunities, and their quality of life.
        Thank you for your continued commitment to those who have
    served. I look forward to answering any questions you may have.
        [Applause.]

        [The prepared statement of Mr. Shipley appears on pages
    119-129 of the Appendix.]

        Senator Tuberville. Thank you, Mr. Shipley.
        Next is Mr. Terry Prince.

     STATEMENT OF TERRY PRINCE, PRESIDENT, NATIONAL ASSOCIATION OF
                  STATE DIRECTORS OF VETERANS AFFAIRS

        Mr. Prince. Ranking Member Takano, great to see you again
    visiting LaSalle last year. Senator Tuberville and Ranking
    Members, distinguished Members of the Committees, my name is
    Terry Prince. I am a 31-year veteran of the United States Navy,
    Hospital Corpsman, and currently serving as the President of
    NASDVA, the National Association of State Directors of Veterans
    Affairs.
        That crowd in yellow you heard behind me is the
    distinguished members of 50 secretaries, directors, and
    commissioners that lead the states, territories and the
    District of Columbia veterans affairs. Collectively, these
    veteran leaders make up the membership of NASDVA, and together
    they are the second-largest provider of veteran services in our
    Nation, second only to the Federal VA. These are your
    government-to-government partners who have worked together
    since 1946, to serve veterans where they live and work. They
    should be your first point of contact for constituent issues
    and ensuring that the Nation's 18 million veterans and their
    families and survivors receive the benefits and services they
    have earned in order to improve the quality of life and their
    overall well-being.
        In our testimony, we cover a lot in our written testimony.
    A few of important items. One is our State Veterans Homes, that
    provide more than 50 percent on the total VA long-term care in
    175 operational veterans homes and 30,000 beds. We recommend
    $600 million to provide Priority Group 1 construction projects,
    where the overall costs to fund all the necessary need to build
    and maintain our veterans homes is nearly $1.3 billion.
        On a separate note, the State Veterans Homes are having to
    pay for high-cost medications for veterans in their care. This
    needs to be addressed by passing H.R. 1970, so that VA
    reimburses our State Veterans Homes that, for medications that
    exceed 8.5 percent of the per diem rate, which is what the VA
    pays to private nursing homes that are contracted by VA to
    provide health care.
        The other grant program is the National Cemetery
    Administration's Veterans Cemetery Grants Program. One hundred
    twenty-four cemeteries across 47 states. The number far exceeds
    the amount of funding. The establishment just to cover Priority
    1 and 2 for establishment and maintenance of cemeteries is in
    the neighborhood of $220 million, and NASDVA recommends
    addressing at least these groups for fiscal year 2027.
        It was mentioned earlier about VA health care, and for the
    9 million veterans receiving care, we also recommend they
    continue to emphasize enrollment, better access, and quality
    care at the VA. Regardless of gender and whether it is provided
    by the VA or Community Care programs, which accounts for nearly
    40 percent of that care and is, in all essence, is VA care.
        On to health records, we support the need for congressional
    oversight to ensure that the VA modernizes the electronic
    health record. It currently costs nearly $16 billion, with a
    projection of over $40 billion, with full deployment not
    expected until 2031.
        The American Legion mentioned TAP class. As a military
    servicemember I am very familiar with this process, and I can
    tell you that every servicemember describes it in a different
    way. What I do know, as a corpsman and married to a
    psychologist, that transition from anything in life, especially
    the military, is one of the most dangerous periods in a
    servicemember's history, especially toward suicide and other
    things. Our state directors need to be a part of the TAP
    program. They need to be brought in early and often, to ensure
    that these veterans are connected with their state benefits.
        The Major Richard Star Act, it is time. This is a wounded
    veterans tax. NASDVA strongly recommends that this Congress
    pass this critical legislation for these deserving disabled
    veterans.
        Veteran homelessness, we commend what the VA is doing.
    However, we would like them to expand eligibility to any
    veteran who is homeless, at risk of homelessness, or receiving
    assistance through another housing program.
        And I am going to close out my testimony with the number
    one issue that hits home to me and everybody in this room--
    suicide. Every 11 minutes in America, a family loses a loved
    one to suicide, and NASDVA believes that the prevention of
    veteran suicides requires a whole-of-government engagement,
    with fresh ideas and approaches. Your state directors and
    Veterans Affairs play a crucial role in suicide prevention by
    connecting veterans to their earned benefits back home, where
    they live, working with their state and human services and the
    Governor's Challenge.
        We also recommend new treatment modalities to eliminate
    pharmacological intervention and other issues that do not
    allows veterans to explore non-traditional methodologies.
        Your partnership with NASDVA is as important to our
    veterans as it is to us. It is a promise kept to those who once
    stood the watch for all of us, and together we can ensure that
    their service is honored, not just in words but in action,
    through strong policy, sustainable funding, and unwavering
    commitment. All of us sincerely respect and appreciate your
    work to improve the well-being of our Nation's veterans, and we
    are honored to be a part of that noble mission with you. Thank
    you.
        [Applause.]

        [The prepared statement of Mr. Prince appears on pages 130-
    148 of the Appendix.]

        Senator Tuberville. Thank you, Mr. Prince.
        Next we have General Piatt from Wounded Warrior.

       STATEMENT OF LTG WALTER E. PIATT, U.S. ARMY (RET.), CHIEF
               EXECUTIVE OFFICER, WOUNDED WARRIOR PROJECT

        General Piatt. Chairman Moran, Chairman Bost, Ranking
    Member Blumenthal, and Ranking Member Takano, and distinguished
    Members of the House and Senate Committees on Veterans'
    Affairs, thank you all for today's hearing and for the honor to
    join you on behalf of Wounded Warrior Project and the warriors
    and families we serve.
        First, all of us at Wounded Warrior Project are deeply
    saddened by the recent loss of servicemembers, and we stand
    ready to serve all those impacted by current military
    operations.
        Twenty-three years ago, Wounded Warrior Project was founded
    on a promise, a promise to be there, no matter what, for those
    who defend our freedom. It is that same promise that grounds
    the work we do today.
        Our nation's military remains engaged globally, fighting to
    keep the world and our Nation safe. We should never allow the
    strategic purpose for war to mask the toll it takes on those
    asked to fight it.
        For the dangers our military is asked to face, we cannot
    accept the warrior simply coming back as the final tally of
    successful transition out of military service. We must see them
    fully home--mind, body, and soul. This is not captured in one
    moment in time, but through a process of hope, healing, and
    reconnection to a life of renewed purpose.
        Last week, 125 of our warriors visited many of you Members
    of Congress. They were honored to tell you their stories and
    share the living, breathing impact of why your support matters.
        We discuss three priorities with you.
        The first, a passionate plea to do right by our past,
    current, and future combat veterans by passing the Major
    Richard Star Act this year. Finally allowing for those who were
    forced to medically retire due to combat-related injuries to
    receive the benefits they earned in blood.
        Second, on ending veteran suicide. In 2023, we lost more
    than 6,000 veterans to suicide. We must explore advanced
    treatments for those who are suffering. The time is now to push
    forward evidence-based solutions, like psychedelic-assisted
    therapies for PTSD, traumatic brain injury, and substance use
    disorder. We must explore all alternative treatments,
    coordinate research, expand access to clinical trials, and
    ultimately make these treatments accessible to all veterans.
        Third, ending veteran homelessness. VA and supportive
    communities are making historic progress, with nearly 52,000
    veterans moving into permanent housing last year. Let's finish
    the Housing Unhoused Disabled Veterans Act to ensure no
    veteran's disability compensation is counted against them.
        Your time spent with these warriors last week and your
    genuine appreciation for their service touched them deeply, and
    reminded them that their sacrifice is a big reason why our
    Nation remains free. With the continued support of Congress and
    that of our grateful nation, Wounded Warrior Project will
    continue to push the boundaries of what is possible, as we
    pursue the path to save a million more lives, cure PTSD, end
    veteran suicide, and end veteran homelessness.
        Warriors are the foundation of our freedom. They have done,
    and continue to do, their part. It is now time to do ours. We
    must keep the promise and find every warrior, everywhere, and
    bring them home, mind, body, and soul.
        I am honored to be of service to this distinguished
    Committee and for the opportunity to testify. Thank you for
    helping our Nation keep the promise to our veterans, and I
    welcome your questions.
        [Applause.]

        [The prepared statement of General Piatt appears on pages
    149-187 of the Appendix.]

        Senator Tuberville. Thank you.
        Next we have Anita Sullivan from TAPS. Anita.

      STATEMENT OF ANITA SULLIVAN, SURVIVING SPOUSE OF U.S. NAVY
    PETTY OFFICER THIRD CLASS MICHAEL SULLIVAN, TRAGEDY ASSISTANCE
                         PROGRAM FOR SURVIVORS

        Ms. Sullivan. Chairmen Moran and Bost, Ranking Members
    Blumenthal and Takano, and distinguished Committee members,
    thank you for the opportunity to share my family's story.
        Seven years ago, on February 9, 2019, I became a widow, a
    title no one pursues. My husband, the father of our three
    children, Navy Petty Officer Third Class Michael Sullivan, died
    by suicide after faithful service to our Nation and decades of
    physical and mental health battles that plagued him during and
    after his time in the Navy.
        Much has changed in the seven years since he passed, but
    one thing has not. I am, and always will be, his widow. No
    passage of time will change that, not my 55th birthday, or the
    becoming someone else's wife.
        I met Michael in 1999, while he was stationed in
    Jacksonville, Florida. He was funny and captivating, and we
    married quickly. But soon he became seriously ill. He was
    diagnosed with cyclic vomiting syndrome, which landed him in
    the hospital every six weeks, like clockwork. When he returned
    from his last deployment in June 2003, we welcomed our first
    child. His physical health had impacted his career and his
    mental health, and by that July he officially separated from
    the Navy.
        His health worsened, and over the next 16 years he was
    hospitalized approximately 35 times. I became the primary
    breadwinner while caring for our three children and becoming
    Michael's caregiver. I could not leave his side during those
    hospital stays because he wouldn't know where he was, would
    often rip out IVs, and even try to leave the hospital.
        On his good days, he coached our kids' baseball teams,
    volunteered his time to youth activities, was involved in our
    church, but on his bad days he truly suffered, and so did we.
        His suicide, in 2019, ended his physical and mental health
    battles, but it was just the beginning of new challenges for
    our grieving, traumatized family. I was at a TAP seminar when I
    learned that Michael's suicide was deemed service-connected.
    After going for Michael's 100 percent VA disability
    compensation to zero overnight when he died, we would only have
    43 percent reinstated.
        Our eigth-month process was fast by VA standards. The wait
    for DIC is financially devastating for many survivors, and the
    month-to-month stress continues for families, mine included.
    Raising DIC from 43 percent to 55 percent may seem
    insignificant to some, but for surviving spouses like me, who
    struggle to maintain a career, because it always came second to
    military service and caregiving, it makes a meaningful
    difference. Passing the Caring for Survivors Act would provide
    long overdue breathing room and ease financial pressures.
    Surviving families face drastically reduced income, the lasting
    impact of career limitations, ongoing therapy costs, and the
    full responsibility of providing opportunities for our children
    in single-parent households.
        As the only living parent of our now 11-, 16-, and 22-year-
    old, CHAMPVA health benefits are critical to our family's
    stability. Under current law, my oldest son will age out of
    CHAMPVA in just a few months, despite being a full-time college
    student. Unlike most other health insurance programs, CHAMPVA
    does not extend to age 26.
        Seven years after Michael's passing, I am still his widow,
    and we are still dependent on the benefits he earned to support
    our family. After a three-year-and-counting engagement, I am
    still waiting to marry a man that I love, who will never
    replace him as a husband or father, but cares deeply for the
    four of us. My youngest child, Sophia, was just four when her
    Daddy died. She is growing up without a legal father in her
    life, which can be confusing for her and her friends, as she
    goes around and is sharing so much of her life with him. But
    knows that if Love Lives On does not pass, she will be almost
    an adult before she can officially call him her stepdad.
        John is sitting beside her today, here supporting us both
    as we advocate for benefits that were earned through service
    and sacrifice, benefits that dissolve under current law if I
    remarry before age 55. Marrying John does not mean that we
    should become his financial responsibility. He is already doing
    so much, bringing happiness back into our lives. But I will not
    become his financial burden.
        When my late husband joined the military, our country made
    a promise to support his family if anything happened to him.
    There were no restrictions attached to that commitment.
        My family's story is one of many. I hope that my voice is
    loud enough to bring attention to long-overdue legislative
    changes, like finally ending remarriage penalties, treating
    suicide as a presumptive condition, increasing DIC, and
    bringing CHAMPVA in line with civilian insurance.
        Thank you for the opportunity to share my story today.
        [Applause.]

        [The prepared statement of Ms. Sullivan appears on pages
    188-235 of the Appendix.]

        Chairman Moran. Thank you.
        Next we have General McGinn of the National Guard
    Association.

      STATEMENT OF MAJOR GENERAL FRANK MCGINN, U.S. ARMY (RET.),
       PRESIDENT, NATIONAL GUARD ASSOCIATION OF THE UNITED STATES

        General McGinn. Chairman Moran, Ranking Member Blumenthal,
    Chairman Bost, Ranking Member Takano, Senator Tuberville, and
    distinguished Members of the Committees, on behalf of the
    National Guard Association of the United States and the 435,000
    Soldiers and Airmen with the Army Air National Guard, thank you
    for the opportunity to discuss some important issues affecting
    today's National Guard. We appreciate your bipartisan support
    in recognition of the Guard's vital role in our national
    security.
        Over the past two decades, the National Guard has evolved
    from a strategic reserve into an operational force. Guard
    members deploy globally, strengthen alliances through the State
    Partnership Program, and provide key capabilities to the total
    force at less than 4 percent of the defense budget. At home
    they remain the Nation's first military responder, supporting
    disaster response, protecting critical infrastructure, and
    assisting civilian authorities.
        As missions have expanded, policies have not kept pace.
    Today I will focus on three priorities: duty status reform, GI
    Bill parity, and the development of a Reserve Component-
    specific track within the Transition Assistance Program.
        First, duty status reform. As of this week, more than
    40,000 Guardsmen are on orders serving at home and abroad. They
    frequently operate alongside active component forces under
    identical conditions. Yet while their service is equal,
    compensation and benefits are not. The common system of over 30
    duty statuses was created piecemeal over the decades. In fact,
    six additional statuses were created between 1999 and 2013. It
    is overly complex, confusing for servicemembers, and difficult
    for states to administer.
        In the fiscal year 2016 NDAA, Congress directed the then
    Department of Defense to submit a Duty Status Reform
    legislative proposal. While studies and discussions have
    continued over the years, legislative proposals have not yet
    advanced. We are grateful to finally have some momentum this
    year, with bicameral and bipartisan support of the Duty Status
    Reform Act, this bill aligns authorities with how Guard and
    Reserves are employed today and ensures fair treatment when
    members are mobilized. The new framework would provide equities
    in pay and benefits, efficiency in programming and budgeting,
    and streamlined accessibility to the Guard and Reserve.
        Duty status reform is our top priority for fiscal year
    2027. We strongly ask for your support of H.R. 6976, and
    introduction of a Senate companion bill.
        The next point I want to discuss is GI Bill parity. The
    Post-9/11 GI Bill remains one of the most powerful recruitment
    and retention tools. It provides those who serve with access to
    education and the opportunity to build a successful future.
    However, many periods of Guard and Reserve service still do not
    qualify for GI Bill benefits. Title 32, including annual
    training and drill weekends, are left out, which falsely
    implies lesser value. Each day in uniform should count as a day
    of service to our country. The benefits earned should reflect
    that sacrifice.
        The GI Bill Parity Act corrects this inequity. We thank
    Chairman Moran, Ranking Member Blumenthal, Congressmen Takano,
    Levin, and Kelly for leading on this issue, and request swift
    passage of S. 649 and H.R. 1423.
        The third and last issue I want to address is the Reserve
    Component--Transition Assistance Program track. The Transition
    Assistance Program is critical to preparing servicemembers for
    civilian life. However, most Guard members return to their
    civilian employment and normal routine. This presents unique
    challenges not fully addressed in the traditional TAP model.
        Guardsmen receive limited counseling tailored to retirement
    points, TRICARE coverage, GI Bill benefits, and the VA claims
    process. Transition assistance without these topics is a misuse
    of time and resources. We are grateful for your support on this
    issue. The fiscal year 2025 NDAA directed development of a
    Reserve Component-specific track. Continued oversight is
    necessary to ensure that this is tailored to the Reserve and
    not simply a modified active model. We respectfully request
    updates on this implementation and stand ready to assist.
        In closing, thank you for your continued leadership and
    commitment to those who serve. These are not abstract policy
    concepts. They are tangible issues that affect readiness,
    retention, and the long-term well-being of the National Guard
    members and veterans. The National Guard stands ready to meet
    the Nation's needs, and in return our servicemembers ask only
    for fairness, clarity, and recognition of their service. We
    look forward to working with you to address these issues and
    ensure that National Guard service is treated with the equity
    and respect it deserves.
        Thank you for the opportunity to testify today, and I
    welcome your questions.

        [The prepared statement of General McGinn appears on pages
    236-243 of the Appendix.]

        Mr. Takano [presiding]. Thank you, Major General McGinn.
        Mr. Whaley, you are now recognized for 5 minutes.

    STATEMENT OF JIM WHALEY, CHIEF EXECUTIVE OFFICER, MISSION ROLL
                                  CALL

        Mr. Whaley. Chairmen Bost and Moran, Ranking Members Takano
    and Blumenthal, and distinguished Members of both Committees,
    thank you for the opportunity to testify today.
        Mission Roll Call represents veterans by doing one thing
    consistently: listening. We survey veterans, their families,
    and caregivers nationwide, and we bring that data directly to
    policymakers, so decisions are grounded in lived experiences.
        Our 2026 priorities come straight from those surveys.
    Veterans told us four issues should guide the work ahead:
    access to quality health care, support for service-connected
    injuries, suicide prevention, and housing stability.
        For veterans, these priorities are connected. When access
    falters, injuries worsen. When injuries go untreated, mental
    health risk increases. Without stable housing, even effective
    care becomes difficult to sustain.
        First, access to quality health care, both VA and non-VA.
    Veterans define access by timing, distance, and follow-through.
    In May 2025, Mission Roll Call surveyed more than 1,200
    respondents in all 50 states on the ACCESS Act. Sixty-seven
    percent said the legislation would improve health care outcomes
    overall. Among rural veterans, 71 percent said it would improve
    timely access. Mental health access is central to this
    discussion. Sixty percent of veterans told us they are
    comfortable receiving mental health care from a non-VA
    provider. Seventy-nine percent said allowing veterans to access
    mental health or substance use care in the community without a
    VA referral would improve access.
        Veterans are not voting against the VA. In fact, many we
    speak to report very positive experiences. But they are asking
    for options that reduce delays, shorten travel burdens, and
    help them get care before a problem becomes a crisis.
        Second, support for service-connected injuries and
    conditions, including traumatic brain injury.
        In our 2025 TBI survey of more than 2,500 veterans, family
    members, and caregivers, 14 percent reported a TBI diagnosis in
    their household. Among those seeking TBI-related care, more
    than 70 percent said accessing appropriate treatment is
    somewhat or very difficult. Distance, wait times, and
    fragmented care remain consistent barriers.
        Mild to moderate TBI is where we see the greatest gap.
    Symptoms persist, but care pathways are often unclear, and
    coordination between VA and non-VA providers remain
    inconsistent.
        This is the space the BEACON Act seeks to address. The
    legislation creates a structured, evidence-based framework to
    evaluate innovative approaches for veterans with chronic mild-
    to-moderate TBI, with rigorous outcome measurement and
    independent evaluation. Veterans are not asking for lower
    standards. They are asking the VA to test promising therapies
    responsibly, publish results transparently, and expand access
    when evidence supports it.
        This urgency is reinforced by the VA's 2025 suicide report,
    which shows the suicide rate among recent VHA users with a TBI
    diagnosis was nearly 94 percent higher than among those without
    a TBI. Early intervention in TBI care is not separate from
    suicide prevention. It is part of it.
        Third, veterans tell us the current trajectory of veteran
    suicide is unacceptable. In July 2025, Mission Roll Call
    surveyed more than 2,100 veterans, family members, and
    caregivers nationwide. Sixty-seven percent of veteran
    respondents said they have struggled with suicidal thoughts or
    mental health challenges themselves, or know someone who has.
    Nearly one-third described access to mental health care as
    difficult or very difficult.
        Veterans also told us the barriers are not only clinical.
    They pointed to isolation, stigma, and loss of purpose as early
    warning signs.
        We have come to describe this as working ``Left of
    Clinical.'' Not instead of care, but before crisis. Earlier
    engagement. More on-ramps to stability. Fewer veterans reaching
    a breaking point before help arrives.
        Fourth, and lastly, housing stability. Housing is
    foundational. Without stability at home, treatment adherence,
    employment, recovery, and family life suffer. Veterans
    consistently rank housing access and homelessness prevention
    among their top priorities because instability magnifies every
    other challenge.
        Across all of our surveys, veterans are asking Congress to
    do a few consistent things: expand access where delays persist,
    strengthen community care pathways, treat TBI and chronic
    conditions as long-horizon rehabilitation challenges, invest in
    earlier suicide prevention strategies, and protect housing
    stability as a core element of veteran wellness.
        None of these priorities replace the VA. They strengthen it
    by recognizing that veteran wellness is built upstream, long
    before prescription drugs, an emergency room, or an inpatient
    bed is involved.
        Veterans are speaking clearly. We are listening. Mission
    Roll Call is here to ensure their voices remain central to the
    work of these Committees.
        Thank you. I look forward to any questions.

        [The prepared statement of Mr. Whaley appears on pages 244-
    248 of the Appendix.]

        Mr. Takano. Thank you, Mr. Whaley. I will now recognize the
    former Boys State Governor of Virginia and former Governor of
    Maine, Senator Angus King, for questions.
        Senator King. That refers to the prior hearing. Sorry about
    that.
        General Piatt, one of the provisions that I have been
    pushing is preregistering for VA health care before you leave
    active duty. It is called the Servicemember to Veteran Health
    Care Connection Act. Is this something the Wounded Warrior
    Project is interested in?
        General Piatt. Thank you, Senator. We are extremely
    interested in this. I think if we get transition early, we are
    doing a lot of work ourselves, registering members in the
    Wounded Warrior Project while on active duty. We feel if they
    are registered before they transition, the higher success rate
    we will have during transition. So we appreciate this bill. We
    fully support that.
        Senator King. I appreciate that. And my position on
    transition is very simple. The government should spend as much
    money on transition out as they do on recruiting in, because
    right now, I think transition, although it has been improved in
    the last several years, I do not think people realize what a
    dramatic moment that is in a veteran's life. And suicide rates
    are higher among people in the first two or three years.
        Mr. Whaley, I very much appreciate your comments on TBI. We
    had a tragic case in Maine, as you may know, several years ago,
    that involved TBI, and I think that is something we have to
    focus upon.
        Something I have been looking at is a bill that would have
    the VA provide free lockboxes for firearms. No lists. This is
    not a gun control bill. No names taken. But the data shows that
    if there is any gap between the idea and carrying out a
    suicide, that can help. And 75 percent of veteran suicides take
    place by firearms. Is that safe storage something that you
    could support at Mission?
        Mr. Whaley. Senator, yes, it is. I think all of us on this
    panel are concerned about the continuing rise of suicide and
    our inability to really bring those numbers down. So any effort
    to reduce those numbers is something all of our members and all
    veterans and their families can get behind.
        Senator King. Thank you. Mr. Prince, we passed a provision
    in the defense bill last year that will increase the number of
    people who are leaving the service whose contact information is
    shared with your representatives across the country, at the
    State Veterans Offices. It used to be you had to opt in in your
    paperwork. Now you have to opt out. And we expect that will
    significantly increase the people whose contact information is
    made available.
        I hope that your organization and your members are getting
    ready for what I suspect will be a very large number of
    contacts so that the purpose of this law, which is to have
    people met at the airport, to advise them of their rights and
    what options are available to them. I do not want those names
    coming to your offices and sitting in a file somewhere. I hope
    you will work with the VSOs to develop a system whereby
    veterans emerging from service, you will reach out to them, not
    wait for them to reach out to you.
        Mr. Prince. Thank you, Senator, for that very much
    appreciated comment. Our membership is receiving additional
    information. We are getting the VA to work even closer with the
    Department of War. Because the sooner we can get in, even while
    they are on active duty, as a former master chief it was my
    intention to get to sailors a year or two before they got out
    of the military and start the conversation then and connect
    them with services.
        So you can absolutely count on NASDVA to be a player in
    that and making sure that we are at the front of the line when
    it comes to getting that information into the hands of our VSOs
    and our local communities.
        Senator King. Thank you very much. Thank you to all of you
    for the work that you are doing on behalf of our veterans.
        And one final comment. It is about damn time we passed the
    Richard Star Act.
        [Applause.]
        Mr. Takano. Thank you, Senator King. I will now recognize
    myself for questions.
        General Piatt, what is the urgency on, and why Congress
    should pass the Major Richard Star Act, now?
        General Piatt. Because these young warriors have been asked
    to go to war to defend the freedom of this country, and in the
    course of that they were wounded, and they spilled blood in
    foreign countries. The reason we are free is because they
    serve. Most of them, sadly, are young men and women that are
    serving, not even close to retirement years. So they have to
    accept the end of the life they thought they were going to
    have, and it brings a whole different life they did not think
    was possible. And we cannot punish them for their sacrifice on
    combat fields.
        Mr. Takano. I wholeheartedly agree with you. I am very
    moved by your answer. And it needs to happen as soon as
    possible. It needs to happen this Congress, and this Congress
    and its leaders need to be held accountable for getting it
    done.
        Now, do you agree that this is also about fairness? That
    ending a wounded veteran's taxed and that Congress should not
    pay for it by reducing other earned benefits?
        General Piatt. I think veterans should get the benefits
    they earned in combat.
        Mr. Takano. And what about, we should not be asking other
    veterans to pay for it by reducing their benefits.
        General Piatt. I think all veterans deserve the benefits
    they earned in the course of their service.
        Mr. Takano. And so you would agree with me that the
    American people and this Congress, that it is part of our
    obligation to take care of the veterans, not to ask one veteran
    group to pay for another veteran group's benefits.
        General Piatt. We appreciate the service and support of
    this Committee and getting veterans their benefits they
    deserve.
        Mr. Takano. Thank you. Ms. Sullivan, there has been a lot
    of discussion over the past several months on disability
    indemnity compensation, and I read the moving testimony from
    survivors such as yourself in TAP's written statement, about
    the impact a full DIC benefits increase would have on their
    lives. Can you give us a quick snapshot of the reason why
    Congress needs to do this full increase and why it needs to
    happen, now?
        Ms. Sullivan. Yes. Thank you for the question. So our
    military and veteran survivors currently only receive 43
    percent of what 100 percent disabled veteran receives. All
    other Federal survivors currently receive that 55 percent. So
    we are asking for parity. That is simply bringing us in line
    with all other Federal programs, to bring that from 43 to 55
    percent, or an additional $454 per month.
        Our base rate currently, the actual number is $1,699.36.
    And for most of our survivors, myself included, that is the
    only surviving benefit we receive. So that increase could have
    a very large impact on our families.
        And for some of us, it is the difference in providing for
    families in ways that can include keeping their homes, being
    able to really do what is necessary to raise grieving children,
    and to do just critical care for their families. So this is
    something that ultimately we believe is fulfilling a commitment
    to saying that our sacrifice and our loved ones' service is
    just as important as other Federal benefits, Federal employees'
    sacrifice.
        Mr. Takano. I agree with you, and the wait has been long
    enough, and it is urgent we get it done now. Thank you.
        I want to now recognize Mr. McGarvey for his three minutes
    of questioning.
        Mr. McGarvey. Thank you, Mr. Chairman. Thank you all for
    your service, your continued service here today. I want to echo
    something that Senator King said earlier. Right now we have an
    Administration who is coming to us asking for billions upon
    billions of dollars to send people into war again, but are
    unwilling to find the money to take care of those who served in
    those wars prior to this. The money for the Major Richard Star
    Act, the money for widows and widowers--Ms. Sullivan, thank you
    so much for your courage and your testimony--who have
    sacrificed and served. These are benefits they have earned,
    they have deserved. We will keep fighting for them.
        I want to switch gears a little bit, Mr. Thomas, and come
    to you. Talk about your testimony. We were talking about how
    the VA does not have enough staff in the Spinal Cord Injury and
    Disorder System of Care. Many of the buildings are old but they
    are not designed for the care of our veterans that they need
    right now, and that more than a third of the jobs in these
    units are unfilled. That means that beds are staying empty even
    though veterans are waiting for them currently. It is our
    veterans who feel this neglect every single day.
        So what should our VA medical centers be doing right now to
    fill these critical spinal cord injury and disorder positions
    and keep beds open for the veterans who depend on them?
        Mr. Thomas. The VA should prioritize the hiring for the
    SCI/D System of Care as well as the other specialty care
    systems within the VA. Currently there is no other system out
    in the community that can take care of the unique needs that
    you have when you have a spinal cord injury. So they need to
    prioritize hiring that. And also they should, for the
    infrastructure, they should prioritize some of the projects
    within the SCI/D System of Care to ensure that they have the
    most modern equipment to take care of us, with our unique
    needs.
        Mr. McGarvey. Yes. I totally agree. And, of course, part of
    the reason we need to do this is it is both a legal and a moral
    promise we have made our veterans. We said if you come in and
    you serve us and you are willing to sacrifice everything for
    us, we will take care of you. And I think we are falling short
    of that with this issue.
        You also described facilities that are decades old, with
    outdated layouts, with long construction delays. Where do you
    think Congress needs to focus first to modernize spinal cord
    injury and disorder facilities so that veterans are receiving
    care in safe, accessible, and up-to-date spaces?
        Mr. Thomas. Currently there is only one long-term care
    center west of the Mississippi, and the long-term care, as we
    all age, we need to have these long-term care facilities,
    because again, in the community there is no nursing homes that
    can take care of us.
        Mr. McGarvey. Thank you. That is very helpful. Very quickly
    in my remaining time, General, I just want to talk to you.
    Thank you for highlighting the struggles of mental health that
    our veterans are still experiencing, particularly post-9/11.
    Quickly, where should we focus first if we want veterans to
    have timely access to effective mental health treatments
    through the VA, not just in the private sector?
        General Piatt. First, I would say residential
    rehabilitation treatment programs. We need more beds. We need
    more states to have them. And second, I would say pursue
    alternative medication. Do the research. Get the trials going.
    We are seeing real promise here. Warriors should not have to
    travel to other countries to get the treatment that they think
    works. They should get it here. We are the best country in the
    world for medical care. That is where I would start.
        Mr. McGarvey. Thank you so much. I agree with you on that,
    General. I appreciate you bringing it up. Mr. Chairman, I yield
    back.
        Mr. Takano. Thank you, Mr. McGarvey. Now I recognize Dr.
    Morrison for questions.

                          HON. KELLY MORRISON,
                   U.S. REPRESENTATIVE FROM MINNESOTA

        Ms. Morrison. Thank you, Ranking Member Takano, and thanks
    to Chairman Moran and Chairman Bost and Ranking Member
    Blumenthal for convening our hearing today. Thank you so much
    to all the witnesses for being here today and the work that you
    all do every day, advocating on behalf of fellow veterans and
    servicemembers.
        A special shout-out to any Minnesotans in the crowd today?
    Come on, you all. Are you out there? Well, I met with some of
    them earlier and it was a pleasure to see them here in
    Washington, advocating on behalf of their fellow vets.
        General Piatt, my team has been working with yours back in
    Minnesota to partner on supporting our women veterans, and we
    have been very impressed by all the work that you are doing. As
    you know, women are the fastest-growing group of veterans, and
    as an OB/GYN myself it is important to me that women veterans
    can receive top-quality menopause and infertility care.
        In your view, where can Congress act to ensure that VA is
    equipped to meet the needs of a growing women veteran
    population in 2026 and beyond?
        General Piatt. Thank you for the question and your help
    with our work there. First, I would say women veterans are
    veterans, and our country needs to recognize that. Munitions do
    not discriminate by gender. They need the same care. But their
    medical care is gender specific. We need to meet them where
    they are, allow them to choose the provider of their choice,
    allow them the care they need, where they want it. If it is at
    home, if it is via telemed, but meet their needs. Don't just
    consider their needs the same as the counterpart male veterans,
    because they are very different. And we support going forward
    with more work on the Menopause Care Equity Act. We think that
    is the right way to go. Because their core set of services,
    their medical challenges will be different later in life, and
    we need to get the research now so we can provide them the
    support they need later on in life.
        Ms. Morrison. Thank you, General. I appreciate that answer.
        Ms. Sullivan, thank you so much for being here today. I
    just want to take a moment to recognize the immense sacrifice
    you and Sophia and the rest of your family have made, and I
    just want to share my admiration for your advocacy on behalf of
    survivors everywhere. And I am excited for your future, as
    well.
        It is such an injustice to me that surviving spouses risk
    losing their benefits if they choose to remarry before age 55,
    and that is why we need to pass the Love Lives On Act. Ms.
    Sullivan, can you share a little bit more about what it would
    mean to you to eliminate the remarriage penalty for surviving
    spouses?
        Ms. Sullivan. Thank you so much for your support and the
    question. At its most basic tenet, to myself and to others here
    with us, it would mean that the government is keeping its
    promise. It would mean that it is keeping its promise to myself
    and to Michael and to our children, that if something were to
    happen to him as a result of his service that we would be taken
    care of.
        We did not expect that there would be some limitation on
    that. We did not expect that in the indemnity portion of that,
    that there would be an end to that simply because of a decision
    to not replace him--that could never happen, not as a spouse
    and not as a father--but to choose to also carry on with our
    life and our love, that that could end, and could end some
    things that are very critical to our family.
        So, it would mean that we no longer have to choose between
    doing what feels very right for myself and John or for our
    families and financial security. And in the end, it would mean
    that we would marry fairly soon after it passes and that we
    would really, truly celebrate that love does live on.
        Ms. Morrison. Thank you, Ms. Sullivan, and thanks to all of
    you for your ongoing service.
        [Applause.]
        Mr. Takano. Thank you, Dr. Morrison. I would now like to
    recognize Senator Gallego.

                          HON. RUBEN GALLEGO,
                       U.S. SENATOR FROM ARIZONA

        Senator Gallego. Thank you, Chairman. And, General, I was
    rude. I walked in and you were talking a little bit about the
    veterans being penalized when it comes for their VASH vouchers
    because of a disability. Was that correct?
        General Piatt. Yes, as far as on housing and how veterans
    access it. But we support it, so they will not be disadvantaged
    by their disability compensation.
        Senator Gallego. That is great. So in the ROAD to Housing
    Act, I authored a portion of the bill, which is going to
    permanently exclude veterans' disability compensation from the
    annual income calculations under HUD-VASH programs, so that way
    veterans will not have to make this decision going forward. So
    it is in the bill. It was actually moving through the Senate.
    We just need some friends on the House side to make it.
        But just to assure you that we have thought about this. It
    is in that bill, and I have kept it in both times that it has
    gone over the side. So we are definitely looking into that,
    actually are trying to fix it. Hopefully we will have it fixed
    by next week or so. So I just want to make sure we have some
    progress on that. Obviously it is not everything we need, but
    it is definitely moving in the right direction.
        Mr. Whaley, you also mentioned the American Legion's
    support for expanding innovative therapies for veterans and the
    use of MDMA for treatment of PTSD. As you may know, I am
    working to introduce Innovative Therapies Centers of Excellence
    Act in the Senate. I want to continue to push it to get it to
    the point where it is across the finish line.
        Mr. Whaley, can you please discuss the current use of
    innovative therapies like MDMA at VA, and why centers of
    excellence are important to ensure veterans have access to
    these therapies, with proven success at reducing PTSD symptoms?
        Mr. Whaley. Right. Did you ask me that, sir, or General
    Piatt?
        Senator Gallego. Mr. Whaley. And I am sorry. I need to get
    some readers pretty soon. Whaley. I apologize.
        Mr. Whaley. Yes, no worries. No worries. We support that
    because we know right now that the number of TBIs across the
    Nation, but certainly among veterans, is much higher than we
    think. We do not have the ability right now to treat all those
    TBIs.
        The TBI issue affects not only that servicemember but their
    family, as well. We have a number of children in our country
    that are primary caregivers to veterans because their mother or
    father needs that service.
        We need to make sure that we are partnering with the very
    best in the civilian world, hospitals that are doing cutting-
    edge research when it comes to TBIs.
        Senator Gallego. I do not want to interrupt to be rude, but
    I just want to make sure we communicate that. There are some
    veterans that are actually getting MDMA therapy, but it is not
    necessarily guided. Some of it is overseas. Some of them are
    paying out-of-pocket. Is that correct?
        Mr. Whaley. It is correct, and, of course, I agree with
    General Piatt that that is unfortunate and should not be
    happening in a country such as ours, and we should know that
    these issues have long-lasting effects and we need to make sure
    they get the health care when and how they need it. And we need
    to explore different ways to solve TBI or mitigate it, using a
    variety of different methods.
        Senator Gallego. And General, do you want to jump in on my
    thought. One of my concerns is that whoever gets good MDMA
    therapy now is basically connected to how much money you have,
    if you get to one of those really good programs. I know there
    are a couple programs in Mexico. There are some actually in
    Europe that some veterans that had the wherewithal or can
    bundle the money from donors are able to do.
        But then there are also some veterans, unfortunately, that
    I know personally, that are so desperate that they are using
    any type of program that they hear is good, and, of course,
    when you have desperation you have potential fraudsters,
    peddlers, and people that will try to take advantage of these
    men.
        So by having some kind of regulated, VA-approved therapies
    we could potentially be saving these guys, and saving these
    guys money, and potentially from some damage they may incur.
    Correct?
        General Piatt. Absolutely correct. We have done initial
    research on our Warrior Care Network already on MDMA use with
    already evidence-base to other therapies and seen great
    results. We are going to help with trials next year, and I
    think the more we do that in this country, it will be done
    correctly, we will be able to follow the science. The treatment
    may not be for everybody, but it is showing that it is working
    for some, and we should not send them to a different country
    where we do not know, where it is not regulated.
        But you are seeing great promise here, and we fully support
    the Centers of Excellence Act, because I think that will help
    the VA tie all that science together and promote quicker
    trials, that we can get more in. Our numbers that signed up for
    initial trials that we advertise far exceed the numbers that we
    will be able to do. There is a big appetite there for it, and I
    think the Centers of Excellence will help tremendously. Thank
    you.
        Senator Gallego. Thank you, Mr. Chair, and I really hope
    that we can push this. This is more of an issue of a cultural
    resistance, actually, using this versus an actual medical
    resistance. And with proper therapy, training, licensing, there
    are so many veterans that could actually benefit from this. I
    think people have to get over the ickiness of the idea, MDMA or
    other types of therapies.
        Thank you, Mr. Chairman.
        Mr. Takano. Well, thank you, Senator. I am aware that there
    were some trials done in Loma Linda, which is near me. I have
    not checked into where VA is on it recently. I will have to
    say, also, regarding this whole area of TBI and traumatic brain
    injury and PTSD, I was with some neurologists recently. I am
    concerned about the State of VA research, the number of
    research positions that have been left vacant. That is a topic
    I want to explore further, because it also bears on the
    research capacity of VA to be able to move this forward. But
    thank you. I share your concerns.
        Senator Gallego. Thank you, Mr. Chair.
        Mr. Takano. I now recognize myself for some more questions
    before we conclude. General McGinn, I saw your testimony on
    duty status reform, and I will be following the Armed Services
    Committee's progress closely, as that greatly impacts VA
    benefits for our Reserve Component servicemembers.
        I would like to focus on one benefit specifically, and that
    is the Post-9/11 GI Bill eligibility. National Guard and
    Reservist servicemembers are serving in the same uniform,
    taking the same risks as their active-duty counterparts, yet
    not getting the same GI Bill eligibility. Three out of the four
    Chairs and Ranking Members on the Veterans' Affairs Committee
    are lead sponsors or co-sponsors of the Guard and Reserve GI
    Bill Parity Act, which would fix this inequity.
        As we are watching our country enter another overseas
    conflict, how imperative is it that Congress get this bill
    done?
        General McGinn. Yes, thank you for the question. It is
    imperative. We have been working this issue for years and
    years, and Congress has been great. The GI Bill really
    initiated years ago from Congress. But again, it is an
    inequity. If you are flying a UH-60 Black Hawk helicopter
    during your weekend drill or your two weeks of annual training,
    how is that different service than flying it off an active-duty
    base? It is the same service, it is the same risk, and we think
    a day in uniform, regardless of what your status is, should be
    a day that counts toward Post-9/11 GI Bill, and early
    retirement, as well, early retirement credit.
        So we think it is imperative that this finally gets passed.
    And we appreciate what Congress has done thus far, but we think
    it is time to take it to that next level. And if they are
    serving in whatever status they are in, other than stay at
    active duty, that time should count.
        Mr. Takano. Well, Major General, here is my point. As
    National Guard and Reserve servicemembers are on the front
    lines and under threat right now, that is what I am hearing. So
    that is my point, that there is an urgency now to deal with
    this inequity, because we have Guard and Reserve right now. It
    is not the Guard and Reserve that we knew back in the Vietnam
    War days, right. Sometimes they have been called up for service
    and deployed many, many times. It is not a safe haven. And I
    think Americans understand that, and we need to make sure we
    update how we administer the GI Bill accordingly. Would you
    agree with that?
        General McGinn. I completely agree. I enlisted in 1981 and
    I had a front row seat of the transition of the Guard and
    Reserves from the 1-weekend a month and the 2-weeks in the
    summer, to where we are today. We have got, as you know,
    Guardsmen and women that have done multiple deployments. They
    are coming on and off active duty a lot. And that is why the
    whole TAP issue is a concern, too.
        My colleague here with me today has been through the TAP
    process, I think, four times, and she just comes off active
    duty, comes back to her regular job. But she has to do 12 hours
    of this mandatory transition training. And I just got an email
    from Djibouti, somewhere in AFRICOM, from a servicemember over
    there, having to put his whole unit, brigade-sized unit,
    through the TAP program. And none of it is really relevant to
    what they are going to experience when they come back off
    active duty.
        So we really have got to get these benefits right, rightly
    aligned, and to your point, this is the time to do it. As I
    mentioned, 40,000 of us are deployed today, somewhere, either
    in the homeland or overseas. So it is time to make equities in
    those benefits.
        Mr. Takano. Well, I hope you and the other VSOs and
    veterans themselves will hold the Chairs', Ranking Members'
    leadership accountable to getting this legislation passed and
    signed into law without delay. And, of course, we wish Godspeed
    to all of our servicemembers abroad.
        Commander Shipley, this will be my final question for the
    day and we will bring this to a close. Your written testimony
    highlighted the need to equality the disability indemnity
    compensation rate with that of other Federal survivor programs,
    taking it from the current 43 percent to 55 percent, a monthly
    increase of $450. I am a co-sponsor of Representative Hayes's
    bill, the Caring for Survivors Act, which would do just that.
    We have even offered it as an amendment to a bill last month
    that would only increase the DIC rate by $24. Unfortunately,
    our majority rejected the full increase.
        From my direct interactions with my constituents and
    nationwide polling, I believe that the American people are
    willing to pay for the full increase and are willing to do it
    without taxing other veterans to do so. In other words, without
    creating a pay-for that we diminish the benefits of other
    veterans. I am strongly opposed to doing that.
        Do you think that the American people are willing to pay
    for, or would ask their Members of Congress to pay for the full
    DIC increase and live up to the promises made to our
    servicemembers and veterans?
        Mr. Shipley. Thank you for this question. I absolutely
    believe that the American public would support this. It is
    bringing the fairness of the promise that is made to the
    servicemembers to take care of our families, no matter what,
    especially those that have made the ultimate sacrifice for this
    Nation.
        Mr. Takano. I agree with you. I agree with you 100 percent,
    and I think we ought to apply that in this policy space, that
    we, in order to make sure that we resolve the inequities--and
    here we are talking about the survivors of veterans being paid
    less for their survivor benefits than those that are survivors
    of Federal employees. And that gap simply does not make sense
    when you kind of explain it to the American people. It is kind
    of complicated, this percent versus this percent.
        Mr. Takano. But we need to take care of that inequity, and
    I believe that we need to do it without asking other veterans,
    who will, in many cases, say we want to help other veterans.
    But here is my point about that. We should not be asking
    veterans to do it. We, as Members of Congress, should take it
    upon ourselves to make sure that we find a way to take care of
    these inequities in veterans' benefits.
        And with that I will just say, before we gavel out of this
    hearing today, I want to thank our second panel for everything,
    our second group of panelists, for everything that you do each
    and every day to support not only the members of your
    individual organizations but all veterans and their families.
    Your work and your advocacy does matter, and we thank you for
    that advocacy.
        And with that this hearing is adjourned.
        [Applause.]
        [Whereupon, at 12:29 p.m., the hearing was adjourned.]

                                A P P E N D I X

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