[Senate Report 118-3]
[From the U.S. Government Publishing Office]


118th Congress}                                           { Report
                                 SENATE
 1st Session  }                                           { 118-3

======================================================================
 
 LEGISLATIVE AND OVERSIGHT ACTIVITIES DURING THE 117TH CONGRESS BY THE 
                 SENATE COMMITTEE ON VETERANS' AFFAIRS

                                _______
                                

                 March 27, 2023.--Ordered to be printed

                                _______
                                

          Mr. Tester, from the Committee on Veterans' Affairs,
                        submitted the following

                              R E P O R T

    Pursuant to paragraph 8 of rule XXVI of the Standing Rules 
of the Senate, the Committee on Veterans' Affairs (hereinafter, 
``Committee'') submits its report on legislative and oversight 
activities during the 117th Congress.

                        I. HEARINGS AND MEETINGS


A. First Session (2021)

    During the First Session of the 117th Congress, the 
Committee held 19 hearings. At those hearings, there were 119 
witness appearances.
    Four hearings (April 28, June 23, October 20, November 17) 
focused exclusively on legislation pending before the 
Committee. Testimony offered at these hearings covered 82 
bills.
    The Committee held six business meetings.
    On May 26, six measures were favorably reported out of 
Committee; on July 28, 13 measures were favorably reported out 
of Committee; on December 15, twenty-five measures were 
favorably reported out of Committee.
    The Committee held three joint hearings with the House 
Committee on Veterans' Affairs in order to receive legislative 
presentations from veterans service organizations. These 
hearings were held on March 3, March 4, and March 18.

B. Second Session (2022)

    During the Second Session of the 117th Congress, the 
Committee held 14 hearings, including 2 field hearings. At 
those hearings, there were 106 witness appearances.
    One hearing (July 13) focused exclusively on legislation 
pending before the Committee. Testimony offered at this hearing 
covered 13 bills.
    The Committee held 3 business meetings.
    On February 2, 1 measure was favorably reported out of 
Committee.
    The Committee held three joint hearings with the House 
Committee on Veterans' Affairs in order to receive legislative 
presentations from veterans service organizations. These 
hearings were held on March 1, March 2, and March 8.

C. List of Hearings and Meetings Held in the 117th Congress

    (1) Wednesday, January 27, 2021
    Nomination Hearing: Pending Nomination of Denis R. 
McDonough, of Maryland, to be Secretary of Veterans Affairs
    (2) Tuesday, February 2, 2021
    Business Meeting: Meeting to Consider Pending Nomination of 
Denis R. McDonough, of Maryland, to be Secretary of Veterans 
Affairs
    (3) Wednesday, February 24, 2021
    Hearing: Vaccines for Vets: Our Best Shot at Ending the 
COVID-19 Pandemic
    (4) Wednesday, March 3, 2021
    Joint Hearing with the House of Representatives to Receive 
the Legislative Presentation of Multiple Veterans Service 
Organizations (Disabled American Veterans, Blinded Veterans 
Association, National Association States Directors of Veterans 
Affairs, Military Officers Association of America, Student 
Veterans of America, Minority Veterans of America, and National 
Coalition of Homeless Veterans)
    (5) Thursday, March 4, 2021
    Joint Hearing with the House of Representatives to Receive 
the Legislative Presentation of Multiple Veterans Service 
Organizations (The American Legion, Vietnam Veterans of 
America, Paralyzed Veterans of America, Jewish War Veterans, 
Military Order of the Purple Heart, Wounded Warrior Project, 
Iraq and Afghanistan Veterans of America)
    (6) Wednesday, March 10, 2021
    Hearing: Military Toxic Exposures: The Human Consequences 
of War
    (7) Thursday, March 18, 2021
    Joint Hearing with the House of Representatives to Receive 
the Legislative Presentation of Multiple Veterans Service 
Organizations (Veterans of Foreign Wars of the United States, 
American Veterans, Fleet Reserve Association, Gold Star Wives 
of America, Inc., National Congress of American Indians, 
National Association of Black Veterans)
    (8) Wednesday, March 24, 2021
    Hearing: Coping during COVID: Veterans' Mental Health and 
Implementation of the Hannon Act
    (9) Wednesday, April 14, 2021
    Nomination Hearing: Pending Nomination of Richard A. 
Sauber, of the District of Columbia, to be General Counsel of 
the Department of Veterans Affairs
    (10) Thursday, April 22, 2021
    Business Meeting: Meeting to Consider Pending Nomination of 
Richard A. Sauber, of the District of Columbia, to be General 
Counsel of the Department of Veterans Affairs
    (11) Wednesday, April 28, 2021
    Legislative Hearing: Pending Legislation

          S. 89, Ensuring Survivor Benefits During COVID-19 Act 
        of 2021
          S. 189, Veterans' Disability Compensation Automatic 
        COLA Act of 2021
          S. 219, Aid and Attendance Support Act of 2021
          S. 437, Veterans Burn Pits Exposure Recognition Act 
        of 2021
          S. 444, AUTO for Veterans Act
          S. 454, K2 Veterans Care Act of 2021
          S. 458, Veterans Claim Transparency Act of 2021
          S. 565, Mark Takai Atomic Veterans Healthcare Parity 
        Act of 2021
          S. 657, A bill to modify the presumption of service 
        connection for veterans who were exposed to herbicide 
        agents while serving in the Armed Forces in Thailand 
        during the Vietnam era, and for other purposes
          S. 731, Department of Veterans Affairs Information 
        Technology Reform Act of 2021
          S. 810, Fair Care for Vietnam Veterans Act of 2021
          S. 894, Hire Veteran Health Heroes Act of 2021
          S. 927, TEAM Act
          S. 952, Presumptive Benefits for War Fighters Exposed 
        to Burn Pits and Other Toxins Act of 2021
          S. 976, Caring for Survivors Act of 2021
          S. 1031, A bill to require the Comptroller General of 
        the United States to conduct a study on disparities 
        associated with race and ethnicity with respect to 
        certain benefits administered by the Secretary of 
        Veterans Affairs, and for other purposes
          S. 1039, A bill to amend title 38, United States 
        Code, to improve compensation for disabilities 
        occurring in Persian Gulf War veterans, and for other 
        purposes
          S. 1071, VA AID Act of 2021
          S. 1093, A bill to amend title 38, United States 
        Code, to establish in the Department the Veterans 
        Economic Opportunity and Transition Administration, and 
        for other purposes
          S. 1095, Colonel John M. McHugh Tuition Fairness for 
        Survivors Act of 2021
          S. 1096, Fry Scholarship Enhancement Act of 2021
          S. 1188, SFC Heath Robinson Burn Pit Transparency Act

    (12) Wednesday, May 12, 2021
    Hearing: Supporting Disabled Veterans: The State of Claims 
Processing During and After COVID-19
    (13) Wednesday, May 19, 2021
    Nomination Hearing: Pending Nominations

          Donald M. Remy, of Louisiana, to be Deputy Secretary 
        of Veterans Affairs
          Matthew T. Quinn, of Montana, to be Under Secretary 
        of Veterans Affairs for Memorial Affairs
          Maryanne T. Donaghy, of Pennsylvania, to be Assistant 
        Secretary of Veterans Affairs for the Office of 
        Accountability and Whistleblower Protection
          Patricia Ross, of Ohio, to be Assistant Secretary of 
        Veterans Affairs for congressional and Legislative 
        Affairs

    (14) Wednesday, May 26, 2021
    Business Meeting: Meeting to Consider Legislation and 
Nominations Pending before the Committee

     Donald M. Remy, of Louisiana, to be Deputy 
Secretary of Veterans Affairs
     Matthew T. Quinn, of Montana, to be Under 
Secretary of Veterans Affairs for Memorial Affairs
     Maryanne T. Donaghy, of Pennsylvania, to be 
Assistant Secretary of Veterans Affairs for the Office of 
Accountability and Whistleblower Protection
     Patricia Ross, of Ohio, to be Assistant Secretary 
of Veterans Affairs for congressional and Legislative Affairs

     S. 89, Ensuring Survivor Benefits During COVID-19 
Act of 2021 (Committee Print)
     S. 189, Veterans' Disability Compensation COLA Act 
of 2021 (Committee Print)
     S. 894, Hire Veteran Health Heroes Act of 2021 
(Committee Print)
     S. 1031, A bill to require the Comptroller General 
of the United States to conduct a study on disparities 
associated with race and ethnicity with respect to certain 
benefits administered by the Secretary of Veterans Affairs, and 
for other purposes
     S. 1095, Colonel John M. McHugh Tuition Fairness 
for Survivors Act of 2021
     S. 3003, Comprehensive and Overdue Support for 
Troops of War Act of 2021

    (15) Wednesday, June 9, 2021
    Hearing: A System to Better Serve America's Veterans: 
Investing in VA's Infrastructure
    (16) Wednesday, June 16, 2021
    Hearing: Review of the Fiscal Year 2022 Budget and 2023 
Advance Appropriations Requests for the Department of Veterans 
Affairs
    (17) Wednesday, June 23, 2021
    Legislative Hearing: Pending Legislation

          S. 372, Ensuring Quality Care for Our Veterans Act
          S. 539, A bill to direct the Secretary of Veterans 
        Affairs to submit to Congress a report on the use of 
        video cameras for patient safety and law enforcement at 
        medical centers of the Department of Veterans Affairs
          S. 544, A bill to direct the Secretary of Veterans 
        Affairs to designate 1 week each year as ``Buddy Check 
        Week'' for the purpose of outreach and education 
        concerning peer wellness checks for veterans, and for 
        other purposes
          S. 612, Improving Housing Outcomes for Veterans Act 
        of 2021
          S. 613, PAWS for Veterans Therapy Act
          S. 727, CHAMPVA Children's Care Protection Act of 
        2021
          S. 796, Protecting Moms Who Served Act of 2021
          S. 887, VA Supply Chain Resiliency Act
          S. 951, PAWS Act of 2021
          S. 1040, A bill to amend title 38, United States 
        Code, to expand eligibility for hospital care, medical 
        services, and nursing home care from the Department of 
        Veterans Affairs to include veterans of World War II
          S. 1198, Solid Start Act of 2021
          S. 1220, United States Cadet Nurse Corps Service 
        Recognition Act of 2021
          S. 1280, Veteran Families Health Services Act of 2021
          S. 1319, VA Quality Health Care Accountability and 
        Transparency Act
          S. 1467, VA Medicinal Cannabis Research Act of 2021
          S. 1863, Guaranteeing Healthcare Access to Personnel 
        Who Served Act
          S. 1875, Veterans' Emergency Care Claims Parity Act
          S. 1965, Planning for Aging Veterans Act
          S. 2041, Department of Veterans Affairs Provider 
        Accountability Act
          S. 2102, Supporting Expanded Review for Veterans in 
        Combat Environments (SERVICE) Act
          S. 2172, Building Solutions for Veterans Experiencing 
        Homelessness Act of 2021

    (18) Wednesday, July 14, 2021
    Hearing: VA Electronic Health Records: Modernization and 
the Path Ahead
    (19) Wednesday, July 28, 2021
    Business Meeting: Meeting to Consider Legislation Pending 
before the Committee

          S. 372, Ensuring Quality Care for Our Veterans Act 
        (Committee Print)
          S. 612, Improving Housing Outcomes for Veterans Act 
        of 2021 (Committee Print)
          S. 887, VA Supply Chain Resiliency Act
          S. 1040, A bill to amend title 38, United States 
        Code, to expand eligibility for hospital care, medical 
        services, and nursing home care from the Department of 
        Veterans Affairs to include veterans of World War II 
        (Committee Print)
          S. 1198, Solid Start Act of 2021 (Committee Print)
          S. 1220, United States Cadet Nurse Corps Service 
        Recognition Act of 2021
          S. 1319, VA Quality Health Care Accountability and 
        Transparency Act (Committee Print)
          S. 1863, Guaranteeing Healthcare Access to Personnel 
        Who Served Act (Committee Print)
          S. 1875, Veterans' Emergency Care Claims Parity Act
          S. 1965, Planning for Aging Veterans Act (Committee 
        Print)
          S. 2041, Department of Veterans Affairs Provider 
        Accountability Act (Committee Print)
          S. 2102, Supporting Expanded Review for Veterans in 
        Combat Environments (SERVICE) Act
          S. 2172, Building Solutions for Veterans Experiencing 
        Homelessness Act of 2021 (Committee Print)

    (20) Wednesday, October 6, 2021
    Nomination Hearing: Pending Nominations

          Guy T. Kiyokawa, of Hawaii, to be Assistant Secretary 
        of Veterans Affairs for Enterprise Integration
          James D. Rodriguez, of Texas, to be Assistant 
        Secretary of Labor for Veterans' Employment and 
        Training

    (21) Wednesday, October 20, 2021
    Business Meeting: Meeting to Consider Pending Nominations

     Guy T. Kiyokawa, of Hawaii, to be a Assistant 
Secretary of Veterans Affairs for Enterprise Integration
     James D. Rodriguez, of Texas, to be Assistant 
Secretary of Labor for Veterans' Employment and Training

    (22) Wednesday, October 20, 2021
    Legislative Hearing: Pending Legislation

          S. 1342, National Green Alert Act of 2021
          S. 1779, Veterans Preventive Health Coverage Fairness 
        Act
          S. 1937, DOULA for VA Act of 2021
          S. 1944, Vet Center Improvement Act of 2021
          S. 2283, REACH for Veterans Act
          S. 2386, Veteran Peer Specialist Act of 2021
          S. 2526, A bill to authorize the Secretary of Defense 
        and the Secretary of Veterans Affairs to enter into 
        agreements for the planning, design, and construction 
        of facilities to be operated as shared medical 
        facilities, and for other purposes
          S. 2533, MAMMO for Veterans Act
          S. 2624, Fiscal Year Veterans Affairs Major Medical 
        Facility Authorization Act
          S. 2720,Veterans' Prostate Cancer Treatment and 
        Research Act
          S. 2787, A bill to amend title 38, United States 
        Code, to clarify the role of doctors of podiatric 
        medicine in the Department of Veterans Affairs, and for 
        other purposes
          S. 2852, Long-Term Care Veterans Choice Act
          S. 2924, Vet Center Outreach Act of 2021
          S. 3004, Improving Care for Veterans Act
          S. 3017, Veterans Dental Care Eligibility Expansion 
        and Enhancement Act
          S. 3020, Veterans State Eligibility Standardization 
        Act
          S. 3025, Servicemembers and Veterans Empowerment and 
        Support Act of 2021
          S. 3128, A bill to amend title 38, United States 
        Code, to reorganize the Chaplain Service of the 
        Department of Veterans Affairs, and for other purposes

    (23) Wednesday, October 27, 2021
    Hearing: Success After Service: Improving Veterans' 
Employment, Education, and Home Loan Opportunities
    (24) Wednesday, November 3, 2021
    Hearing: VA and DOD Collaboration: Improving Outcomes for 
Servicemembers and Veterans
    (25) Wednesday, November 17, 2021
    Legislative Hearing: Pending Legislation

          S. 1296, Daniel J. Harvey Jr. and Adam Lambert 
        Improving Servicemember Transition to Reduce Veteran 
        Suicide Act
          S. 1564, Veterans Legal Support Act of 2021
          S. 1607, Student Veterans Transparency and Protection 
        Act of 2021
          S. 1664, Department of Veterans Affairs Post-
        Traumatic Stress Disorder Processing Claims Improvement 
        Act of 2021
          S. 1838, Building Credit Access for Veterans Act of 
        2021
          S. 1850, Chaplains Memorial Preservation Act
          S. 1881, Veteran Education Empowerment Act
          S. 1936, GI Bill National Emergency Extended Deadline 
        Act of 2021
          S. 2089, Burial Equity for Guards and Reserves Act of 
        2021
          S. 2329, BEST for Vets Act of 2021
          S. 2405, Commitment to Veteran Support and Outreach 
        Act
          S. 2431, Department of Veterans Affairs Office of 
        Inspector General Training Act of 2021
          S. 2513, Brian Neuman Department of Veterans Affairs 
        Clothing Allowance Improvement Act of 2021
          S. 2644, GRAD VA Educational Assistance Parity Act of 
        2021
          S. 2687, Strengthening Oversight for Veterans Act of 
        2021
          S. 2761, Every Veteran Counts Act of 2021
          S. 2794, Supporting Families of the Fallen Act
          S. 3047, Veterans Pro Bono Corps Act of 2021
          S. 3094, Reaching Every Homeless Veteran Act of 2021
          S. 3163, RURAL Exams Act of 2021
          S. 3388, Veterans Benefits Improvement Act of 2021

    (26) Wednesday, December 1, 2021
    Hearing: An End-of-Year Look at the State of VA
    (27) Wednesday, December 8, 2021
    Nomination Hearing: Pending Nomination

          Kurt D. DelBene, of Washington, to be Assistant 
        Secretary of Veterans Affairs for Information and 
        Technology

    (28) Wednesday, December 15, 2021
    Business Meeting: Meeting to Consider Legislation and a 
Nomination Pending before the Committee

     Kurt D. DelBene, of Washington, nominee to be 
Assistant Secretary of Veterans Affairs for Information and 
Technology
          S. 731, Department of Veterans Affairs Information 
        Technology Reform Act of 2021 (Committee Print)
          S. 1607, Student Veterans Transparency and Protection 
        Act of 2021 (Committee Print)
          S. 1664, Department of Veterans Affairs Post-
        Traumatic Stress Disorder Processing Claims Improvement 
        Act of 2021
          S. 1850, Chaplains Memorial Preservation Act
          S. 1936, GI Bill National Emergency Extended Deadline 
        Act of 2021 (Committee Print)
          S. 1944, Vet Center Improvement Act of 2021 
        (Committee Print)
          S. 2089, Burial Equity for Guards and Reserves Act of 
        2021 (Committee Print)
          S. 2431, Department of Veterans Affairs Office of 
        Inspector General Training Act of 2021
          S. 2513, Brian Neuman Department of Veterans Affairs 
        Clothing Allowance Improvement Act of 2021 (Committee 
        Print)
          S. 2514, A bill to rename the Provo Veterans Center 
        in Orem, Utah, as the ``Col. Gail S. Halvorsen `Candy 
        Bomber' Veterans Center''
          S. 2533, MAMMO for Veterans Act (Committee Print)
          S. 2624, Fiscal Year Veterans Affairs Major Medical 
        Facility Authorization Act
          S. 2627, Rural Veterans Travel Enhancement Act of 
        2021 (Committee Print)
          S. 2644, GRAD VA Educational Assistance Parity Act of 
        2021 (Committee Print)
          S. 2687, Strengthening Oversight for Veterans Act of 
        2021
          S. 2720, Veterans' Prostate Cancer Treatment and 
        Research Act
          S. 2761, Every Veteran Counts Act of 2021 (Committee 
        Print)
          S. 2787, A bill to amend title 38, United States 
        Code, to clarify the role of doctors of podiatric 
        medicine in the Department of Veterans Affairs, and for 
        other purposes
          S. 2794, Supporting Families of the Fallen Act
          S. 2852, Long-Term Care Veterans Choice Act
          S. 3025, Servicemembers and Veterans Empowerment and 
        Support Act of 2021 (Committee Print)
          S. 3094, Reaching Every Homeless Veteran Act of 2021
          S. 3163, RURAL Exams Act of 2021 (Committee Print)
          S. 3293, Post-9/11 Veterans' Mental Health Care 
        Improvement Act of 2021 (Committee Print)
          S. 3388, Veterans Benefits Improvement Act of 2021

    (29) Wednesday, February 2, 2022
    Business Meeting: Meeting to Consider Legislation Pending 
before the Committee

     S. 3541, Health Care for Burn Pit Veterans Act

    (30) Tuesday, March 1, 2022
    Joint Hearing with the House of Representatives to Receive 
the Legislative Presentation of the Disabled American Veterans
    (31) Wednesday, March 2, 2022
    Joint Hearing with the House of Representatives to Receive 
the Legislative Presentation of Multiple Veterans Service 
Organizations (Veterans of Foreign Wars of the United States, 
Iraq and Afghanistan Veterans of America, Wounded Warrior 
Project, Vietnam Veterans of America, American Veterans, 
National Coalition for Homeless Veterans, Service Women's 
Action Network, Blinded Veterans Association, Black Veterans 
Empowerment Council, and National Association of State 
Directors of Veterans Affairs)
    (32) Tuesday, March 8, 2022
    Joint Hearing with the House of Representatives to Receive 
the Legislative Presentation of Multiple Veterans Service 
Organizations (The American Legion, Paralyzed Veterans of 
America, Student Veterans of America, Military Officers 
Association of America, Gold Star Wives of America, Inc., 
National Guard Association of the United States, Tragedy 
Assistance Program for Survivors, Modern Military Association 
of America, and American Defenders of Bataan and Corregidor 
Memorial Society)
    (33) Wednesday, March 23, 2022
    Hearing: Honoring Our Commitment: Improving VA's Program of 
Comprehensive Assistance for Family Caregivers
    (34) Tuesday, March 29, 2022
    Hearing: Honoring Our Promise to Address Comprehensive 
Toxics Act of 2021
    (35) Thursday, April 21, 2022
    Field Hearing, Manchester, New Hampshire: Supporting 
Service Members during their Transition to Civilian Life
    (36) Wednesday, April 27, 2022
    Nomination Hearing: Pending Nominations

          Shereef M. Elnahal, of New Jersey, to be Under 
        Secretary for Health of the Department of Veterans 
        Affairs
          Raymond M. Jefferson, of Hawaii, to be Under 
        Secretary for Benefits of the Department of Veterans 
        Affairs

    (37) Tuesday, May 3, 2022
    Hearing: The VA Workforce: Assessing Ways to Bolster 
Recruitment and Retention
    (38) Wednesday, May 4, 2022
    Business Meeting: Meeting to Consider Pending Nomination

     Shereef M. Elnahal, of New Jersey, to be Under 
Secretary for Health of the Department of Veterans Affairs

    (39) Wednesday, May 11, 2022
    Hearing: Examining Quality of Care in VA and the Private 
Sector
    (40) Tuesday, June 14, 2022
    Hearing: Review of the President's Fiscal Year 2023 Budget 
and 2024 Advance Appropriations Requests for the Department of 
Veterans Affairs
    (41) Wednesday, July 13, 2022
    Legislative Hearing: Pending Legislation

          S. 3372, A bill to amend title 38, United States Code 
        to strengthen benefits for children of Vietnam veterans 
        born with spina bifida, and for other purposes
          S. 3548, Veterans Hearing Benefits Act of 2022
          S. 3606, A bill to amend title 38, United States 
        Code, to eliminate the requirement to specify an 
        effective period of transfer of Post-9/11 educational 
        assistance to a dependent, and for other purposes
          S. 3994, Restoring Benefits to Defrauded Veterans Act 
        of 2022
          S. 4141, A bill to amend title 38, United States 
        Code, to establish in the Department of Veterans 
        Affairs an Advisory Committee on United States Outlying 
        Areas and Freely Associated States, and for other 
        purposes
          S. 4208, Improving Access to the VA Home Loan Act of 
        2022
          S. 4223, Veterans' Compensation Cost-of-Living 
        Adjustment Act of 2022
          S. 4308, Veterans Marriage Recognition Act
          S. 4319, Informing VETS Act of 2022
          S. 4458, Ensuring the Best Schools for Veterans Act 
        of 2022
          S. 4505, Native American Direct Loan Improvement Act
          S. 4949, National Cemeteries Preservation and 
        Protection Act of 2022
          S. ___, No Bonuses for Bad Exams Act

    (42) Wednesday, July 20, 2022
    Hearing: Examining the Status of VA's Electronic Health 
Record Modernization Program
    (43) Wednesday, July 27, 2022
    Nomination Hearing: Pending Nominations

          Anjali Chaturvedi, of Maryland, to be General Counsel 
        of the Department of Veterans Affairs
          Jaime Areizaga-Soto, of Virginia, to be Chairman of 
        the Board of Veterans Appeals

    (44) Wednesday, August 3, 2022
    Business Meeting: Meeting to Consider Pending Nomination

     Jaime Areizaga-Soto, of Virginia, to be Chairman 
of the Board of Veterans Appeals

    (45) Wednesday, September 21, 2022
    Hearing: Ensuring Veterans' Timely Access to Care in VA 
Facilities and the Community
    (46) Wednesday, October 5, 2022
    Field Hearing, Honolulu, Hawaii: The State of VA Services 
in Hawaii
    (47) Wednesday, November 16, 2022
    Hearing: Department of Veterans Affairs Implementation of 
the SFC Heath Robinson Honoring our PACT Act
    (48) Wednesday, November 30, 2022
    Hearing: Native American Veterans: Ensuring Access to VA 
Healthcare and Benefits

                            II. LEGISLATION


A. First Session (2021)

    During the First Session, the Committee met in open session 
on May 26, 2021, and ordered favorably reported six pieces of 
legislation to the full Senate.

     S. 89, Ensuring Survivor Benefits during COVID-19 
Act of 2021, passed the Senate on July 21, 2021, with an 
amendment, by unanimous consent.
     S. 189, Veterans' Compensation Cost-of-Living 
Adjustment Act of 2021, passed the Senate on July 21, 2021, 
with an amendment and an amendment to the title, by unanimous 
consent. It was signed into law as Public Law 117-45 on October 
8, 2021.
     S. 894, Hire Veteran Health Heroes Act of 2021, 
passed the Senate on July 21, 2021, with an amendment, by 
unanimous consent. It was signed into law as Public Law 117-67 
on November 30, 2021.
     S. 1031, a bill to require the Comptroller General 
of the United States to conduct a study on disparities 
associated with race and ethnicity with respect to certain 
benefits administered by the Secretary of Veterans Affairs, and 
for other purposes, passed the Senate on August 6, 2021, 
without amendment, by unanimous consent. It was signed into law 
as Public Law 117-66 on November 30, 2021.
     S. 1095, Colonel John M. McHugh Tuition Fairness 
for Survivors Act of 2021, passed the Senate by voice vote on 
June 24, 2021, without amendment. It was signed into law as 
Public Law 117-68 on November 30, 2021.
     S. 3003, Comprehensive and Overdue Support for 
Troops of War Act of 2021, was reported by Senator Tester on 
October 19, 2021.

    During the First Session, the Committee met in open session 
on July 28, 2021, and ordered favorably reported 13 pieces of 
legislation to the full Senate.

     S. 372, Ensuring Quality Care for Our Veterans 
Act. This measure was ordered favorably reported, without 
amendment, by the Committee on July 28, 2021.
     S. 612, Improving Housing Outcomes for Veterans 
Act of 2021. This measure was ordered favorably reported, 
without amendment, by the Committee on July 28, 2021.
     S. 887, VA Supply Chain Resiliency Act. This 
measure was ordered favorably reported, without amendment, by 
the Committee on July 28, 2021.
     S. 1040, a bill to amend title 38, United States 
Code, to expand eligibility for hospital care, medical 
services, and nursing home care from the Department of Veterans 
Affairs to include veterans of World War II. This measure was 
ordered favorably reported, without amendment, by the Committee 
on July 28, 2021.
     S. 1198, Solid Start Act of 2022, passed the 
Senate on September 19, 2022, with an amendment, by unanimous 
consent. It was signed into law as Public Law 117-205 on 
October 17, 2022.
     S. 1220, United States Nurse Corps Service 
Recognition Act of 2021. This measure was ordered favorably 
reported, without amendment, by the Committee on July 28, 2021.
     S. 1319, VA Quality Health Care Accountability and 
Transparency Act. This measure was ordered favorably reported, 
without amendment, by the Committee on July 28, 2021.
     S. 1863, Guaranteeing Healthcare Access to 
Personnel Who Served Act. This measure was ordered favorably 
reported, without amendment, by the Committee on July 28, 2021.
     S. 1875, Veterans' Emergency Care Claims Parity 
Act, passed the Senate on April 7, 2022, with an amendment, by 
unanimous consent.
     S. 1965, Planning for Aging Veterans Act of 2021. 
This measure was ordered favorably reported, without amendment, 
by the Committee on July 28, 2021.
     S. 2041, Department of Veterans Affairs Provider 
Accountability Act. This measure was ordered favorably 
reported, without amendment, by the Committee on July 28, 2021.
     S. 2102, Dr. Kate Hendricks Thomas SERVICE Act, 
passed the Senate by voice vote on March 24, 2022, with an 
amendment. It was signed into law as Public Law 117-133 on June 
7, 2022.
     S. 2172, Building Solutions for Veterans 
Experiencing Homelessness Act of 2021. This measure was ordered 
favorably reported, without amendment, by the Committee on July 
28, 2021.

    During the First Session, the Committee met in open session 
on December 15, 2021, and ordered favorably reported twenty-
five pieces of legislation to the full Senate.

     S. 731, Department of Veterans Affairs Information 
Technology Reform Act of 2021. This measure was ordered 
favorably reported, without amendment, by the Committee on 
December 15, 2021.
     S. 1607, Student Veterans Transparency and 
Protection Act of 2021. This measure was ordered favorably 
reported, without amendment, by the Committee on December 15, 
2021.
     S. 1664, Department of Veterans Affairs Post-
Traumatic Stress Disorder Processing Claims Improvement Act of 
2021. This measure was ordered favorably reported, without 
amendment, by the Committee on December 15, 2021.
     S. 1850, Chaplains Memorial Preservation Act. This 
measure was ordered favorably reported, without amendment, by 
the Committee on December 15, 2021.
     S. 1936, GI Bill National Emergency Extended 
Deadline Act of 2021. This measure was ordered favorably 
reported, without amendment, by the Committee on December 15, 
2021.
     S. 1944, Vet Center Improvement Act of 2021. This 
measure was ordered favorably reported, without amendment, by 
the Committee on December 15, 2021.
     S. 2089, Burial Equity for Guards and Reserves Act 
of 2021. This measure was ordered favorably reported, without 
amendment, by the Committee on December 15, 2021.
     S. 2431, Department of Veterans Affairs Office of 
Inspector General Training Act of 2021. This measure was 
ordered favorably reported, without amendment, by the Committee 
on December 15, 2021.
     S. 2513, Brian Neuman Department of Veterans 
Affairs Clothing Allowance Improvement Act of 2021. This 
measure was ordered favorably reported, without amendment, by 
the Committee on December 15, 2021.
     S. 2514, a bill to rename the Provo Veterans 
Center in Orem, Utah, as the ``Col. Gail S. Halvorsen `Candy 
Bomber' Veterans Center,'' passed the Senate by unanimous 
consent on December 18, 2021, without amendment. It was signed 
into law as Public Law 117-134 on June 7, 2022.
     S. 2533, Making Advances in Mammography and 
Medical Options for Veterans Act, passed the Senate by voice 
vote on March 23, 2022, with an amendment. It was signed into 
law as Public Law 117-135 on June 7, 2022.
     S. 2624, Fiscal Year 2022 Veterans Affairs Major 
Medical Facility Authorization Act. This measure was ordered 
favorably reported, without amendment, by the Committee on 
December 15, 2021.
     S. 2627, Rural Veterans Travel Enhancement Act of 
2021. This measure was ordered favorably reported, without 
amendment, by the Committee on December 15, 2021.
     S. 2644, GRAD VA Educational Assistance Parity Act 
of 2021. This measure was ordered favorably reported, without 
amendment, by the Committee on December 15, 2021.
     S. 2687, Strengthening Oversight for Veterans Act 
of 2021, passed the Senate by voice vote on April 7, 2022. It 
was signed into law as Public Law 117-136 on June 7, 2022.
     S. 2720, Veterans' Prostate Cancer Treatment and 
Research Act. This measure was ordered favorably reported, 
without amendment, by the Committee on December 15, 2021.
     S. 2761, Every Veteran Counts Act of 2021. This 
measure was ordered favorably reported, without amendment, by 
the Committee on December 15, 2021.
     S. 2787, a bill to amend title 38, United States 
Code, to clarify the role of doctors of podiatric medicine in 
the Department of Veterans Affairs, and for other purposes. 
This measure was ordered favorably reported, without amendment, 
by the Committee on December 15, 2021.
     S. 2794, Supporting Families of the Fallen Act, 
passed the Senate by voice vote on March 23, 2022, without 
amendment. It was signed into law as Public Law 117-209 on 
October 17, 2022.
     S. 2852, Long-Term Care Veterans Choice Act. This 
measure was ordered favorably reported, without amendment, by 
the Committee on December 15, 2021.
     S. 3025, Servicemembers and Veterans Empowerment 
and Support Act of 2021, was reported by Senator Tester with an 
amendment in the nature of a substitute on March 1, 2022.
     S. 3094, Reaching Every Homeless Veteran Act of 
2021. This measure was ordered favorably reported, without 
amendment, by the Committee on December 15, 2021.
     S. 3163, RURAL Exams Act of 2021. This measure was 
ordered favorably reported, without amendment, by the Committee 
on December 15, 2021.
     S. 3293, Post-9/11 Veterans' Mental Health Care 
Improvement Act of 2021. This measure was ordered favorably 
reported, without amendment, by the Committee on December 15, 
2021.
     S. 3388, Veterans Benefits Improvement Act of 
2021, was reported by Senator Tester without amendment on 
December 6, 2022, and passed the Senate on December 19, 2022, 
with an amendment, by unanimous consent.

    During the First Session, the Committee discharged numerous 
bills by unanimous consent, as follows:

     S. 344, Major Richard Star Act, was discharged by 
the Committee on March 17, 2021, by unanimous consent.
     S. Res. 143, a resolution to honor and recognize 
the patriotism and service to the United States provided by 
Veterans Service Organizations during the COVID-19 pandemic, 
was discharged by the Committee on April 21, 2021, by unanimous 
consent and passed the Senate on the same day without 
amendment, by unanimous consent.
     S. 957, Dump Opioids Act, was discharged by the 
Committee on April 22, 2021, by unanimous consent and passed 
the Senate on the same day with an amendment, by unanimous 
consent. It was signed into law as Public Law 117-29 on July 
29, 2021.
     H.R. 711, West Los Angeles VA Campus Improvement 
Act of 2021, was discharged by the Committee on May 28, 2021, 
by unanimous consent and passed the Senate on the same day with 
an amendment, by unanimous consent. It was signed into law as 
Public Law 117-18 on June 23, 2021.
     H.R. 2523, THRIVE Act, was discharged by the 
Committee on May 28, 2021, by unanimous consent and passed the 
Senate by voice vote on the same day without amendment. It was 
signed into law as Public Law 117-16 on June 8, 2021.
     H.R. 2441, Sgt. Ketchum Rural Veterans Mental 
Health Act of 2021, was discharged by the Committee on June 24, 
2021, by unanimous consent and passed the Senate on the same 
day without amendment, by unanimous consent. It was signed into 
law as Public Law 117-21 on June 30, 2021.
     S. 1910, Major Medical Facility Authorization Act 
of 2021, was discharged by the Committee on July 21, 2021, by 
unanimous consent and passed the Senate on the same day without 
amendment, by unanimous consent. It was signed into law as 
Public Law 117-30 on July 29, 2021.
     H.R. 1448, Puppies Assisting Wounded 
Servicemembers for Veterans Therapy Act, was discharged by the 
Committee on August 6, 2021, by unanimous consent and passed 
the Senate by voice vote on the same day without amendment. It 
was signed into law as Public Law 117-37 on August 25, 2021.
     S. 544, a bill to direct the Secretary of Veterans 
Affairs to designate 1 week each year as ``Buddy Check Week'' 
for the purpose of outreach and education concerning peer 
wellness checks for veterans, and for other purposes, was 
discharged by the Committee on October 7, 2021, by unanimous 
consent and passed the Senate on the same day without 
amendment, by unanimous consent.
     S. 796, Protecting Moms Who Served Act of 2021, 
was discharged by the Committee on October 7, 2021, by 
unanimous consent and passed the Senate on the same day, with 
an amendment, by unanimous consent. It was signed into law as 
Public Law 117-69 on November 30, 2021.
     H.R. 2911, VA Transparency & Trust Act of 2021, 
was discharged by the Committee on October 28, 2021, by 
unanimous consent and passed the Senate on the same day without 
amendment, by unanimous consent. It was signed into law as 
Public Law 117-63 on November 22, 2021.
     H.R. 3475, to name the Department of Veterans 
Affairs community-based outpatient clinic in Columbus, Georgia, 
as the Robert S. Poydasheff VA Clinic, was discharged by the 
Committee on October 28, 2021, by unanimous consent and passed 
the Senate on the same day without amendment, by unanimous 
consent. It was signed into law as Public Law 117-56 on 
November 12, 2021.
     H.R. 4172, to name the Department of Veterans 
Affairs community-based outpatient clinic in Aurora, Colorado, 
as the Lieutenant Colonel John W. Mosley VA Clinic, was 
discharged by the Committee on October 28, 2021, by unanimous 
consent and passed the Senate on the same day without 
amendment, by unanimous consent. It was signed into law as 
Public Law 117-57 on November 12, 2021.
     H.R. 1510, to direct the Secretary of Veterans 
Affairs to submit to Congress a report on the use of cameras in 
medical facilities of the Department of Veterans Affairs, was 
discharged by the Committee on November 2, 2021, by unanimous 
consent and passed the Senate on the same day without 
amendment, by unanimous consent. It was signed into law as 
Public Law 117-64 on November 23, 2021.
     H.R. 2093, Veterans and Family Information Act, 
was discharged by the Committee on November 2, 2021, by 
unanimous consent and passed the Senate on the same day without 
amendment, by unanimous consent. It was signed into law as 
Public Law 117-62 on November 22, 2021.
     S. 1760, a bill to designate the community-based 
outpatient clinic of the Department of Veterans Affairs planned 
to be built in Oahu, Hawaii, as the ``Daniel Kahikina Akaka 
Department of Veterans Affairs Community-Based Outpatient 
Clinic,'' was discharged by the Committee on December 18, 2021, 
by unanimous consent and passed the Senate on the same day 
without amendment, by unanimous consent. It was signed into law 
as Public Law 117-131 on June 7, 2022.

    During the First Session, the Committee also advanced the 
following bills without having the bills referred to Committee:

     H.R. 1276, SAVE LIVES Act, passed the Senate with 
an amendment on March 17, 2021, by unanimous consent. It was 
signed into law as Public Law 117-4 on March 24, 2021.
     H.R. 5293, Department of Veterans Affairs Expiring 
Authorities Act of 2021, passed the Senate without amendment on 
September 23, 2021, by unanimous consent. It was signed into 
law as Public Law 117-42 on September 30, 2021.
     H.R. 5545, REMOTE Act, passed the Senate without 
amendment on December 15, 2021, by voice vote. It was signed 
into law as Public Law 117-76 on December 21, 2021.

    During the First Session, the Committee also incorporated 
provisions within the Committee's jurisdiction into broader 
legislation.

B. Second Session (2022)

    During the Second Session, the Committee met in open 
session on February 2, 2021, and ordered favorably reported one 
piece of legislation to the full Senate.

     S. 3541, Health Care for Burn Pit Veterans Act, 
passed the Senate without amendment on February 16, 2022, by 
voice vote.
    During the Second Session, the Committee discharged 
numerous bills by unanimous consent, as follows:

     H.R. 1281, to name the Department of Veterans 
Affairs community-based outpatient clinic in Gaylord, Michigan, 
as the Navy Corpsman Steve Andrews Department of Veterans 
Affairs Health Care Clinic, was discharged by the Committee on 
February 3, 2022, by unanimous consent and passed the Senate on 
the same day without amendment, by unanimous consent. It was 
signed into law as Public Law 117-89 on February 23, 2022.
     S. 2159, a bill to designate the community-based 
outpatient clinic of the Department of Veterans Affairs located 
at 400 College Drive, Middleburg, Florida, as the ``Andrew K. 
Baker Department of Veterans Affairs Clinic'', and for other 
purposes, was discharged by the Committee on February 3, 2022, 
by unanimous consent and passed the Senate on the same day 
without amendment, by unanimous consent. It was signed into law 
as Public Law 117-220 on December 5, 2022.
     S. 3527, a bill to amend title 38, United States 
Code, to authorize the Secretary of Veterans Affairs to 
transfer the name of property of the Department of Veterans 
Affairs designated by law to other property of the Department, 
was discharged by the Committee on February 3, 2022, by 
unanimous consent and passed the Senate on the same day with an 
amendment, by unanimous consent. It was signed into law as 
Public Law 117-137 on June 7, 2022.
     H.R. 3665, to designate the medical center of the 
Department of Veterans Affairs in San Diego, California, as the 
Jennifer Moreno Department of Veterans Affairs Medical Center, 
and to support the designation of a component of such medical 
center in honor of Kathleen Bruyere, was discharged by the 
Committee on March 3, 2022, by unanimous consent and passed the 
Senate on the same day without amendment, by unanimous consent. 
It was signed into law as Public Law 117-98 on March 14, 2022.
     S. 2771, a bill to designate the community-based 
outpatient clinic of the Department of Veterans Affairs in San 
Angelo, Texas, as the ``Colonel Charles and JoAnne Powell 
Department of Veterans Affairs Clinic,'' was discharged by the 
Committee by unanimous consent on March 3, 2022, and passed the 
Senate on the same day without amendment, by unanimous consent. 
It was signed into law as Public Law 117-208 on October 17, 
2022.
     H.R. 2545, to amend title 38, United States Code, 
to clarify the role of doctors of podiatric medicine in the 
Department of Veterans Affairs, and for other purposes, was 
discharged by the Committee on March 7, 2022, by unanimous 
consent and passed the Senate on the same day without 
amendment, by unanimous consent. It was signed into law as 
Public Law 117-96 on March 14, 2022.
     H.R. 4591, VA Electronic Health Record 
Transparency Act of 2021, was discharged by the Committee by 
unanimous consent on May 26, 2022, and passed the Senate by 
voice vote on the same day, without amendment. It was signed 
into law as Public Law 117-154 on June 23, 2022.
     S. 4359, Senator Johnny Isakson VA Regional Office 
Act of 2022, was discharged by the Committee by unanimous 
consent on July 27, 2022, and passed the Senate on the same day 
without amendment, by unanimous consent. It was signed into law 
as Public Law 117-227 on December 9, 2022.
     S. 3369, Max Cleland VA Medical Center Act, was 
discharged by the Committee by unanimous consent on July 28, 
2022, and passed the Senate on the same day without amendment, 
by unanimous consent. It was signed into law as Public Law 117-
226 on December 9, 2022.
     S. 3606, a bill to amend title 38, United States 
Code, to eliminate the requirement to specify an effective 
period of transfer of Post-9/11 educational assistance to a 
dependent, and for other purposes, was discharged by the 
Committee by unanimous consent on August 4, 2022, and passed 
the Senate by voice vote on the same day, without amendment.
     S. 4458, Ensuring the Best Schools for Veterans 
Act of 2022, was discharged by the Committee by unanimous 
consent on August 4, 2022, and passed the Senate by voice vote 
on the same day, without amendment. It was signed into law as 
Public Law 117-174 on August 26, 2022.
     H.R. 5754, Patient Advocate Tracker Act, was 
discharged by the Committee by unanimous consent on September 
8, 2022, and passed the Senate on the same day without 
amendment, by unanimous consent. It was signed into law as 
Public Law 117-175 on September 16, 2022.
     H.R. 5481, to name the Department of Veterans 
Affairs community-based outpatient clinic in Forest City, North 
Carolina, as the ``Master Sergeant Jerry K. Crump VA Clinic,'' 
was discharged by the Committee by unanimous consent on 
December 6, 2022, and passed the Senate on the same day without 
amendment, by unanimous consent. It was signed into law as 
Public Law 117-233 on December 19, 2022.
     H.R. 6722, to designate the Department of Veterans 
Affairs community-based outpatient clinic in French Camp, 
California, as the ``Richard A. Pittman VA Clinic,'' was 
discharged by the Committee by unanimous consent on December 6, 
2022, and passed the Senate on the same day without amendment, 
by unanimous consent. It was signed into law as Public Law 117-
235 on December 20, 2022.
     H.R. 6863, to designate the medical center of the 
Department of Veterans Affairs in Memphis, Tennessee, as the 
``Lt. Col. Luke Weathers, Jr. VA Medical Center,'' was 
discharged by the Committee by unanimous consent on December 6, 
2022, and passed the Senate on the same day without amendment, 
by unanimous consent. It was signed into law as Public Law 117-
236 on December 20, 2022.
     H.R. 7903, to designate the Department of Veterans 
Affairs community-based outpatient clinic located in Canton, 
Michigan, as the ``Major General Oliver W. Dillard VA Clinic,'' 
was discharged by the Committee by unanimous consent on 
December 6, 2022, and passed the Senate on the same day without 
amendment, by unanimous consent. It was signed into law as 
Public Law 117-237 on December 20, 2022.
     H.R. 7925, to designate the Department of Veterans 
Affairs community-based outpatient clinic located in Palm 
Desert, California, as the ``Sy Kaplan VA Clinic,'' was 
discharged by the Committee by unanimous consent on December 6, 
2022, and passed the Senate on the same day without amendment, 
by unanimous consent. It was signed into law as Public Law 117-
238 on December 20, 2022.
     S. 5016, Colonel Mary Louise Rasmuson Campus of 
the Alaska VA Healthcare System Act of 2022, was discharged by 
the Committee by unanimous consent on December 6, 2022, and 
passed the Senate on the same day without amendment, by 
unanimous consent. It was signed into law as Public Law 117-357 
on January 5, 2023.
     H.R. 5943, to designate the outpatient clinic of 
the Department of Veterans Affairs in Greenville, South 
Carolina, as the ``Lance Corporal Dana Cornell Darnell VA 
Clinic,'' was discharged by the Committee by unanimous consent 
on December 14, 2022, and passed the Senate on the same day 
without amendment, by unanimous consent. It was signed into law 
as Public Law 117-284 on December 27, 2022.
     H.R. 2724, VA Peer Support Enhancement for MST 
Survivors Act, was discharged by the Committee by unanimous 
consent on December 15, 2022, and passed the Senate on the same 
day without amendment, by unanimous consent. It was signed into 
law as Public Law 117-271 on December 27, 2022.
     H.R. 6064, to direct the Secretary of Veterans 
Affairs to seek to enter into an agreement with the National 
Academies of Sciences, Engineering, and Medicine for a review 
of examinations, furnished by the Secretary, to individuals who 
submit claims to the Secretary for compensation under chapter 
11 of title 38, United States Code, for mental and physical 
conditions linked to military sexual trauma, was discharged by 
the Committee by unanimous consent on December 19, 2022, and 
passed the Senate on the same day without amendment, by 
unanimous consent. It was signed into law as Public Law 117-289 
on December 27, 2022.
     H.R. 6604, Veterans Eligible to Transfer School 
(VETS) Credit Act, was discharged by the Committee by unanimous 
consent on December 19, 2022, and passed the Senate on the same 
day without amendment, by unanimous consent. It was signed into 
law as Public Law 117-297 on December 27, 2022.
     H.R. 6961, Dignity for MST Survivors Act, was 
discharged by the Committee by unanimous consent on December 
19, 2022, and passed the Senate on the same day without 
amendment, by unanimous consent. It was signed into law as 
Public Law 117-300 on December 27, 2022.
     H.R. 7299, SVAC Act of 2022, was discharged by the 
Committee by unanimous consent on December 19, 2022, and passed 
the Senate on the same day without amendment, by unanimous 
consent. It was signed into law as Public Law 117-302 on 
December 27, 2022.
     H.R. 7335, MST Claims Coordination Act, was 
discharged by the Committee by unanimous consent on December 
19, 2022, and passed the Senate on the same day without 
amendment, by unanimous consent. It was signed into law as 
Public Law 117-303 on December 27, 2022.
     S. 4949, National Cemeteries Preservation and 
Protection Act of 2022, was discharged by the Committee by 
unanimous consent on December 19, 2022, and passed the Senate 
on the same day without amendment, by unanimous consent. It was 
signed into law as Public Law 117-355 on January 5, 2023.

    During the Second Session, the Committee advanced the 
following bills without having the bills referred to Committee:

     H.R. 3967, Honoring our PACT Act of 2022, passed 
the Senate with an amendment on June 16, 2022, by yea-nay vote.
     H.R. 8656, to designate the clinic of the 
Department of Veterans Affairs in Mishawaka, Indiana, as the 
``Jackie Walorski VA Clinic,'' passed the Senate without 
amendment on September 8, 2022, by unanimous consent. It was 
signed into law as Public Law 117-179 on September 30, 2022.
     H.R. 7500, Fiscal Year 2022 Veterans Affairs Major 
Medical Facility Authorization Act, passed the Senate without 
amendment on September 14, 2022, by voice vote. It was signed 
into law as Public Law 117-190 on October 10, 2022.
     H.R. 7846, Veterans' Compensation Cost-of-Living 
Adjustment Act of 2022, passed the Senate without amendment on 
September 22, 2022, by voice vote. It was signed into law as 
Public Law 117-191 on October 10, 2022.
     H.R. 7698, to designate the outpatient clinic of 
the Department of Veterans Affairs in Ventura, California, as 
the ``Captain Rosemary Bryant Mariner Outpatient Clinic,'' 
passed the Senate without amendment on September 28, 2022, by 
unanimous consent. It was signed into law as Public Law 117-199 
on October 11, 2022.
     H.R. 7735, Improving Access to the VA Home Loan 
Benefit Act of 2022, passed the Senate without amendment on 
December 19, 2022, by unanimous consent. It was signed into law 
as Public Law 117-308 on December 27, 2022.
     H.R. 8260, Faster Payments to Veterans' Survivors 
Act of 2022, passed the Senate without amendment on December 
19, 2022, by unanimous consent. It was signed into law as 
Public Law 117-313 on December 27, 2022.
     H.R. 7939, Veterans Auto and Education Improvement 
Act of 2022, passed the Senate with an amendment on December 
20, 2022, by unanimous consent. It was signed into law as 
Public Law 117-333 on January 5, 2023.

    During the Second Session, the Committee also incorporated 
provisions within the Committee's jurisdiction into broader 
legislation.

C. Public Laws

            Senate Vehicle
    S. 189, Veterans' Compensation Cost-of-Living Adjustment 
Act of 2021, is Public Law 117-45.
    S. 796, Protecting Moms Who Served Act of 2021, is Public 
Law 117-69.
    S. 894, Hire Veteran Health Heroes Act, is Public Law 117-
67.
    S. 957, DUMP Opioids Act, is Public Law 117-29.
    S. 1031, a bill to require the Comptroller General of the 
United States to conduct a study on disparities associated with 
race and ethnicity with respect to certain benefits 
administered by the Secretary of Veterans Affairs, and for 
other purposes, is Public Law 117-66.
    S. 1095, Colonel John M. McHugh Tuition Fairness for 
Survivors Act of 2021, is Public Law 117-67.
    S. 1198, Solid Start Act of 2022, is Public Law 117-205.
    S. 1760, a bill to designate the community-based outpatient 
clinic of the Department of Veterans Affairs planned to be 
built in Oahu, Hawaii, as the ``Daniel Kahikina Akaka 
Department of Veterans Affairs Community-Based Outpatient 
Clinic,'' is Public Law 117-131.
    S. 1910, Major Medical Facility Authorization Act of 2021, 
is Public Law 117-30.
    S. 2102, Dr. Kate Hendricks Thomas SERVICE Act, is Public 
Law 117-133.
    S. 2159, a bill to designate the community-based outpatient 
clinic of the Department of Veterans Affairs located at 400 
College Drive, Middleburg, Florida, as the ``Andrew K. Baker 
Department of Veterans Affairs Clinic'', and for other 
purposes, is Public Law 117-220.
    S. 2514, a bill to rename the Provo Veterans Center in 
Orem, Utah, as the ``Col. Gail S. Halvorsen `Candy Bomber' 
Veterans Center,'' is Public Law 117-134.
    S. 2533, Making Advances in Mammography and Medical Options 
for Veterans Act, is Public Law 117-135.
    S. 2687, Strengthening Oversight for Veterans Act of 2021, 
is Public Law 117-136.
    S. 2771, a bill to designate the community-based outpatient 
clinic of the Department of Veterans Affairs in San Angelo, 
Texas, as the ``Colonel Charles and JoAnne Powell Department of 
Veterans Affairs Clinic,'' is Public Law 117-208.
    S. 2794, Supporting Families of the Fallen Act, is Public 
Law 117-209.
    S. 3369, Max Cleland VA Medical Center Act, is Public Law 
117-226.
    S. 3527, a bill to amend title 38, United States Code, to 
authorize the Secretary of Veterans Affairs to transfer the 
name of property of the Department of Veterans Affairs 
designated by law to other property of the Department, is 
Public Law 117-137.
    S. 4359, Senator Johnny Isakson VA Regional Office Act of 
2022, is Public Law 117-227.
    S. 4458, Ensuring the Best Schools for Veterans Act of 
2022, is Public Law 117-174.
            House Vehicle
    H.R. 711, West Los Angeles VA Campus Improvement Act of 
2021, is Public Law 117-18.
    H.R. 1276, SAVE LIVES Act, is Public Law 117-4.
    H.R. 1281, to name the Department of Veterans Affairs 
community-based outpatient clinic in Gaylord, Michigan, as the 
``Navy Corpsman Steve Andrews Department of Veterans Affairs 
Health Care Clinic,'' is Public Law 117-89.
    H.R. 1448, Puppies Assisting Wounded Servicemembers for 
Veterans Therapy Act, is Public Law 117-37.
    H.R. 1510, to direct the Secretary of Veterans Affairs to 
submit to Congress a report on the use of cameras in medical 
facilities of the Department of Veterans Affairs, is Public Law 
117-64.
    H.R. 2093, Veterans and Families Information Act, is Public 
Law 117-62.
    H.R. 2441, Sgt. Ketchum Rural Veterans Mental Health Act of 
2021, is Public Law 117-21.
    H.R. 2523, THRIVE Act, is Public Law 117-16.
    H.R. 2545, to amend title 38, United States Code, to 
clarify the role of doctors of podiatric medicine in the 
Department of Veterans Affairs, and for other purposes, is 
Public Law 117-96.
    H.R. 2724, VA Peer Support Enhancement for MST Survivors 
Act, is Public Law 117-271.
    H.R. 2911, VA Transparency & Trust Act of 2021, is Public 
Law 117-63.
    H.R. 3475, to name the Department of Veterans Affairs 
community-based outpatient clinic in Columbus, Georgia, as the 
``Robert S. Poydasheff VA Clinic,'' is Public Law 117-56.
    H.R. 3665, to designate the medical center of the 
Department of Veterans Affairs in San Diego, California, as the 
Jennifer Moreno Department of Veterans Affairs Medical Center, 
is Public Law 117-98.
    H.R. 4172, to name the Department of Veterans Affairs 
community-based outpatient clinic in Aurora, Colorado, as the 
``Lieutenant Colonel John W. Mosley VA Clinic,'' is Public Law 
117-57.
    H.R. 4591, VA Electronic Health Record Transparency Act of 
2021, is Public Law 117-154.
    H.R. 5293, Department of Veterans Affairs Expiring 
Authorities Act of 2021, is Public Law 117-42.
    H.R. 5481, to name the Department of Veterans Affairs 
community-based outpatient clinic in Forest City, North 
Carolina, as the ``Master Sergeant Jerry K. Crump VA Clinic,'' 
is Public Law 117-233.
    H.R. 5545, REMOTE Act, is Public Law 117-76.
    H.R. 5754, Patient Advocate Tracker Act, is Public Law 117-
175.
    H.R. 5943, to designate the outpatient clinic of the 
Department of Veterans Affairs in Greenville, South Carolina, 
as the ``Lance Corporal Dana Cornell Darnell VA Clinic,'' is 
Public Law 117-284.
    H.R. 6064, to direct the Secretary of Veterans Affairs to 
seek to enter into an agreement with the National Academies of 
Sciences, Engineering, and Medicine for a review of 
examinations, furnished by the Secretary, to individuals who 
submit claims to the Secretary for compensation under chapter 
11 of title 38, United States Code, for mental and physical 
conditions linked to military sexual trauma, is Public Law 117-
289.
    H.R. 6604, Veterans Eligible to Transfer School (VETS) 
Credit Act, is Public Law 117-297.
    H.R. 6722, to designate the Department of Veterans Affairs 
community-based outpatient clinic in French Camp, California, 
as the ``Richard A. Pittman VA Clinic,'' is Public Law 117-235.
    H.R. 6863, to designate the Department of Veterans Affairs 
community-based outpatient clinic located in Canton, Michigan, 
as the ``Major General Oliver W. Dillard VA Clinic,'' is Public 
Law 117-237.
    H.R. 6961, Dignity for MST Survivors Act, is Public Law 
117-300.
    H.R. 7299, SVAC Act of 2022, is Public Law 117-302.
    H.R. 7335, MST Claims Coordination Act, is Public Law 117-
303.
    H.R. 7500, Fiscal Year 2022 Veterans Affairs Major Medical 
Facility Authorization Act, is Public Law 117-190.
    H.R. 7698, to designate the outpatient clinic of the 
Department of Veterans Affairs in Ventura, California, as the 
``Captain Rosemary Bryant Mariner Outpatient Clinic,'' is 
Public Law 117-199.
    H.R. 7735, Improving Access to the VA Home Loan Benefit Act 
of 2022, is Public Law 117-308.
    H.R. 7846, Veterans' Compensation Cost-of-Living Adjustment 
Act of 2022, is Public Law 117-191.
    H.R. 7903, to designate the Department of Veterans Affairs 
community-based outpatient clinic located in Canton, Michigan, 
as the ``Major General Oliver W. Dillard VA Clinic,'' is Public 
Law 117-237.
    H.R. 7925, to designate the Department of Veterans Affairs 
community-based outpatient clinic located in Palm Desert, 
California, as the ``Sy Kaplan VA Clinic,'' is Public Law 117-
238.
    H.R. 8260, Faster Payments to Veterans' Survivors Act of 
2022, is Public Law 117-313.
    H.R. 8656, To designate the clinic of the Department of 
Veterans Affairs in Mishawaka, Indiana, as the ``Jackie 
Walorski VA Clinic,'' is Public Law 117-179.

                             III. OVERSIGHT

    In accordance with its mandate, the Committee engaged in 
oversight of VA health care facilities, VA regional offices, VA 
construction sites, State veterans homes, veterans cemeteries, 
and other entities within the Committee's jurisdiction, and 
entities that coordinate with VA in serving veterans. Summaries 
of various oversight activities follow.

A. First Session (2021)

    From April 8, 2021, to April 9, 2021, Committee minority 
staff conducted oversight travel to Kansas. Staff accompanied 
Department of Veterans Affairs (VA) Secretary Denis McDonough 
in touring the Dwight D. Eisenhower Department of Veterans 
Affairs Medical Center (VAMC) in Leavenworth, the Colmery-
O'Neil Veterans' Administration Medical Center in Topeka, the 
Lieutenant General Richard J. Seitz Community-Based Outpatient 
Clinic (CBOC) in Junction City, the Newman Regional Health 
Medical Center in Emporia, the Robert J. Dole Department of 
Veterans Affairs Medical and Regional Office Center in Wichita, 
and the Hunter Health Clinic in Wichita.
    From August 8, 2021, to August 12, 2021, a bicameral group 
of Committee staff conducted an oversight trip to Vicenza and 
Aviano, Italy, regarding O-CONUS Transition Assistance 
Programs, including changes made in the Fiscal Year NDAA. They 
met with Major General Rohling, Commander of US Army Southern 
European Task Force Africa, and received a mission brief from 
post leadership, including Colonel Matthew Gomlak, Garrison 
Commander.
    On August 28, 2021, Committee minority staff conducted an 
oversight visit to Arizona to speak to The American Legion 
National Legislative Commission during the 102d National 
Convention. The Commission is made up of Legionnaires from 
approximately 35 Departments and guests from 50 States and 5 
foreign countries. Staff spoke about legislative priorities and 
answered questions about toxic exposure legislation that, if 
enacted, would affect thousands of Legion members all over the 
world.

B. Second Session (2022)

    From February 22, 2022, to February 25, 2022, Committee 
majority staff conducted an oversight visit to several VA 
facilities in Montana, including: the Cut Bank CBOC; Merril 
Lundman CBOC in Havre; Miles City CBOC; and the Glasgow CBOC. 
Other visits were conducted to the Fort Harrison VAMC in 
Helena, the Plentywood VA Clinic, Glendive VA Clinic, and the 
Eastern Montana State Veterans Home in Glendive.
    From February 28, 2022, to March 3, 2022, Committee 
minority staff traveled to eastern Kansas to visit with 
veterans and learn more about toxic exposures to influence 
toxic exposure legislation. Committee staff coordinated with 
State staff to visit with veterans and advocates from all 
generations in the form of town halls and roundtables. Staff 
held 11 meetings and traveled to six cities to identify 
problems, solutions, and themes to be used during the 
policymaking process.
    From March 14, 2022, to March 18, 2022, Committee majority 
staff conducted an oversight visit to Montana. The visit 
included stops at the Missoula CBOC to meet with clinic staff, 
a Veteran Homelessness Roundtable in Missoula, and the Great 
Falls VA clinic. Other visits were conducted at the University 
of Montana to meet with the university's director of military 
and veteran services, and the Lewistown VA clinic to meet with 
staff.
    On March 18, 2022, Committee majority staff conducted a 
trip to Montana for the grand opening of the new Travis W. 
Atkins CBOC in Bozeman.
    On March 26, 2022, Committee minority staff conducted an 
oversight visit to Salina, Kansas, to speak to the Vietnam 
Veterans of America Chapter 809 town hall. During the speech to 
more than 50 people and throughout conversations during the 
town hall, staff spoke about the VA process to acquire care and 
benefits associated with toxic exposure, needed legislative 
reform for toxic-exposed veterans, and legislative priorities 
associated with toxic exposure.
    From August 15, 2022 to August 18, 2022, Committee majority 
staff conducted an oversight visit to Montana. Staff attended a 
meeting with DogTag Buddies staff and a meeting with Horses 
Spirit Healing staff in Billings. In Bozeman, staff visited the 
Travis Atkins VA Clinic, and in Missoula, staff met with 
researchers studying cognitive therapy outcomes in veterans at 
the University of Montana.
    From August 15, 2022, to August 20, 2022, Committee 
majority and minority staff conducted an oversight visit to Los 
Angeles, California, to tour the West LA VAMC Campus with VAMC 
leadership and conduct meetings with VA staff about 
construction and veteran homelessness.
    From August 17, 2022, to August 19, 2022, Committee 
minority staff conducted an oversight visit to Kansas. Staff 
visited the Dole VA Medical Center in Wichita and the 
Eisenhower VA Medical Center in Leavenworth. At each facility, 
staff met with executive leadership, frontline employees, and 
labor representatives to learn about operations and challenges 
the facilities face. Staff also met with veterans at 
Sojourner's Coffeehouse in Wichita, KS to hear directly from 
veterans about their experiences with the VA and how the 
Committee could better address their needs.
    From August 18, 2022, to August 20, 2022, a bicameral group 
of Committee staff conducted oversight visits to Santa Rosa, 
California, and San Francisco, California. In Santa Rosa, staff 
visited the Santa Rosa VA clinic and the Veterans Home of 
California in Yountville. In San Francisco, staff visited the 
Polytrauma and Blind Rehabilitation Center in Palo Alto and the 
California Central Coast Veterans Cemetery in Monterey.
    From August 28, 2022, to September 1, 2022, Committee 
majority staff conducted an oversight visit to Montana. In 
Bozeman, Montana, staff visited the newly opened Bozeman CBOC. 
In Helena, Montana, staff visited the Helena Vet Center 
Outstation and the Fort Harrison VAMC. In Kalispell, Montana, 
staff visited the Columbia Falls State Veterans Home and the 
Kalispell Vet Center.
    From August 30, 2022, to September 2, 2022, Committee 
majority staff conducted an oversight trip to California, 
Idaho, and Montana. In California, staff visited Veterans 
Benefits Administration (VBA) contractor medical disability 
examination facilities. In Idaho, staff visited the Boise 
Regional Office. In Montana, staff visited the Fort Harrison 
Regional Office, and veteran groups and VBA sub-contractors in 
Kalispell.
    On September 20, 2022, Committee minority staff traveled to 
Houston, Texas, for a VBA Leadership Symposium focused on 
implementation of the PACT Act. Staff participated in 
thoughtful dialog, and provided perspective on congressional 
intent of the legislative text included in the PACT Act.
    From September 30, 2022, to October 9, 2022, Committee 
majority and minority staff conducted an oversight visit to 
Honolulu, Hawaii, during which a field hearing was held 
regarding the state of veterans' services in Hawaii. Staff 
visited the Spark Matsunaga VA Medical Center, the Windward VA 
Clinic, the National Memorial Cemetery of the Pacific, the 
Hawaii State Veterans Cemetery, and the construction sites of 
the Daniel K. Akaka State Veterans Home and the Daniel Kahikina 
Akaka Department of Veterans Affairs Community-Based Outpatient 
Clinic.
    From October 5, 2022, to October 8, 2022, Committee 
majority staff conducted an oversight visit to Montana to meet 
with veteran service organizations and discuss general 
disability compensation issues and the recently passed PACT 
Act.
    From October 24, 2022, to October 26, 2022, a bicameral 
group of Committee staff conducted an oversight trip to VA's 
Muskogee Regional Office in Muskogee, OK, including the claims 
processing center and the education call center. They met with 
regional leadership, including Director Jason McClellan, toured 
the facilities, spoke to employees, and listened in on some 
calls made to the call center.
    On October 26, 2022, Committee majority and minority staff 
conducted an oversight trip to Tulsa, Oklahoma, on VA's CHIP IN 
project, converting a State office building into a 58-bed VA 
hospital. Staff met with John Stephens, President of OSU Center 
for Health Sciences, and Courtney Knoblock, Executive Director 
of VHiT LLC, the corporate entity overseeing the development 
and construction project, to discuss progress and funding of 
the project.
    From October 30, 2022, to November 2, 2022, Committee 
majority staff conducted an oversight visit to several cities 
in Montana to meet with local veterans and field questions 
about the recently passed PACT Act.
    From November 1, 2022, to November 3, 2022, Committee 
majority staff conducted an oversight visit to California. In 
Long Beach, California, Committee staff met with Veterans 
Integrated Service Network (VISN) 22 human resources 
supervisors and leadership VA staff to discuss staffing issues 
and other human resources topics including provisions in the 
recently passed PACT Act and the RAISE Act. In Los Angeles, 
California, Committee staff met with VBA Regional Office 
leadership to discuss staffing and other operational needs.
    From November 3, 2022, to November 5, 2022, Committee 
majority staff conducted an oversight visit to Denver, 
Colorado, to meet with VISN 19 staff to discuss staffing and 
human resources issues and planning.
    From December 9, 2022, to December 12, 2022, Committee 
majority staff conducted an oversight visit to Montana. Staff 
traveled with Chairman Tester for meetings in coordination with 
Under Secretary for Health Shereef Elnahal, MD, visit to the 
State, meeting with providers at the Benjamin Charles Steele VA 
Clinic to discuss hiring and retention and holding a town hall 
in Billings. In Miles City, majority staff traveled with 
Chairman Tester and Under Secretary Elnahal to hold a mental 
health roundtable with local veterans and community providers 
and a rural hospital provider roundtable to discuss care for 
veterans in the community.
    On December 12, 2022, Committee minority staff conducted an 
oversight visit to Baltimore, Maryland, for a VBA hosted PACT 
Act Leadership conference. Staff met with Senior Advisor--
Performing the Delegable Duties of the Under Secretary for 
Benefits and other VBA senior leaders and external partners to 
discuss VBA's PACT Act implementation plan and identify 
initiatives for continued success.

                            IV. NOMINATIONS


 
----------------------------------------------------------------------------------------------------------------
                                                                Date of      Date of        Date         Date
                      Name and Position                        Nomination    Hearing      Reported    Confirmed
----------------------------------------------------------------------------------------------------------------
First Session
 
  Denis R. McDonough........................................     1/20/21      1/27/21       2/2/21       2/8/21
    Secretary of Veterans Affairs
  Richard A. Sauber.........................................     2/22/21      4/14/21      4/22/21      4/29/21
    General Counsel of the Department of Veterans Affairs
  Matthew T. Quinn..........................................     4/19/21      5/19/21      5/26/21      6/17/21
    Under Secretary of Veterans Affairs for Memorial Affairs
  Patricia L. Ross..........................................     4/19/21      5/19/21      5/26/21      6/24/21
    Assistant Secretary of Veterans Affairs for
     Congressional and Legislative Affairs
  Maryanne T. Donaghy.......................................     4/19/21      5/19/21      5/26/21      6/24/21
    Assistant Secretary of Veterans Affairs for the Office
     of Accountability and Whistleblower Protection
  Donald M. Remy............................................     4/27/21      5/19/21      5/26/21      7/15/21
    Deputy Secretary of Veterans Affairs
  Guy T. Kiyokawa...........................................     6/23/21      10/6/21     10/20/21     10/28/21
    Assistant Secretary of Veterans Affairs forPEnterprise
     Integration
  James D. Rodriguez........................................     7/20/21      10/6/21     10/20/21       5/4/22
    Assistant Secretary of Labor for Veterans' Employment
     and Training
  Kurt D. DelBene...........................................    11/19/21      12/8/21     12/15/21     12/16/21
    Assistant Secretary of Veterans Affairs for Information
     and Technology
 
Second Session
 
  William Carl Blake........................................     3/10/22
    Member of the Asset and InfrastructurePReview Commission
  Michael Blecker...........................................     3/10/22
    Member of the Asset and InfrastructurePReview Commission
  Shereef M. Elnahal........................................     3/10/22      4/27/22       5/4/22      7/21/22
    Under Secretary for Health of the Department ofPVeterans
     Affairs
  Christina Orzada Hill.....................................     3/10/22
    Member of the Asset and InfrastructurePReview Commission
  Joyce M. Johnson..........................................     3/10/22
    Member of the Asset and InfrastructurePReview Commission
  Lucretia Marie McClenney..................................     3/10/22
    Member of the Asset and InfrastructurePReview Commission
  Patrick J. Murphy.........................................     3/10/22
    Member of the Asset and InfrastructurePReview Commission
  Jose R. Ramos.............................................     3/10/22
    Member of the Asset and InfrastructurePReview Commission
  Jonathan Woodson..........................................     3/10/22
    Member of the Asset and InfrastructurePReview Commission
  Raymond M. Jefferson......................................     3/21/22      4/27/22
    Under Secretary for Benefits of the Department of
     Veterans Affairs
  Jaime Areizaga-Soto.......................................     4/25/22      7/27/22       8/3/22       8/4/22
    Chairman of the Board of Veterans' Appeals
  Anjali Chaturvedi.........................................     6/22/22      7/27/22
    General Counsel of the Department of Veterans Affairs
  Thomas E. Harvey..........................................     6/22/22
    Member of the Asset and InfrastructurePReview Commission
----------------------------------------------------------------------------------------------------------------

                    V. BUDGET FOR VETERANS PROGRAMS


A. First Session (2021)

    Pursuant to the requirements of section 301(d) of the 
Congressional Budget Act of 1974, Chairman Tester of the 
Committee submitted a letter to the Budget Committee reflecting 
the Committee's Views and Estimates on the Administration's 
proposed Fiscal Year 2022 budget for veterans' programs. The 
letter submitted is printed below in its entirety:

                                                     June 10, 2021.
Hon. Bernard Sanders, Chairman,
Hon. Lindsey Graham, Ranking Member,
Committee on the Budget,
U.S. Senate, Washington, DC.

    Dear Chairman Sanders and Ranking Member Graham: Pursuant 
to Section 301(d) of the Congressional Budget Act of 1974, we 
write to provide our views and estimates to the Committee on 
the Budget regarding matters within the jurisdiction of the 
Committee on Veterans' Affairs (the Committee). As the Nation 
begins to recover from the COVID-19 pandemic, the Department of 
Veterans Affairs (VA) must be adequately prepared to mitigate 
the after-effects of this global health crisis and ensure that 
no veteran faces any unnecessary delay in receiving their 
earned care and benefits.
    As Chairman and Ranking Member of the Committee, we have 
enjoyed a productive relationship and expect this to continue 
for as long as we have the privilege of leading this Committee. 
We are pleased to submit these shared priorities in tandem and 
we are committed to working with VA and the Administration to 
ensure that we meet the promises made to those who serve our 
great nation.
    On March 3, 2021, the Committee began a series of hearings 
during which Veterans Service Organizations (VSO) provided 
their legislative priorities as well as their perspectives on 
challenges facing VA and veterans across our Nation. During our 
time on the Committee, these hearings have been invaluable in 
helping us better understand the legislative and budgeting 
priorities on which Congress should be focusing. As Chairman 
and Ranking Member, we have restated our belief that we need to 
take our cues from our Nation's service members, veterans, and 
family members on how best we can honor their service and 
ensure they receive the benefits and services they have earned.
    Accordingly, to assist in preparing these views and 
estimates, we have given careful consideration to the 
``Independent Budget: Veterans Agenda for the 117th Congress'' 
(Independent Budget or IB) prepared by three VSOs--the Disabled 
American Veterans, the Paralyzed Veterans of America, and the 
Veterans of Foreign Wars. This comprehensive budget and policy 
document created by veterans and for veterans is also supported 
by many other organizations that care deeply about veterans and 
their families.
    According to the President's Budget, demand for VA's 
services and programs is expected to continue to rise. While we 
note the increased funding requested in the President's Budget 
for Fiscal Year 2, we will draw your attention to specific 
programs and operations that must receive focused support in 
the budget resolution for VA to succeed. We must demand 
excellence and accountability from VA, but it is our role to 
ensure it has the resources to provide our veterans and other 
beneficiaries with the world-class services and benefits they 
have been promised.

                             VA Health Care


VA Medical Care

    The COVID-19 pandemic placed stress on VA's health care 
system, and we were pleased to see the VA respond 
appropriately. For example, we were pleased with VA's ability 
to reduce the health care provider hiring timeline from months 
to as little as 3 days in certain instances. VA must 
incorporate lessons learned from these hiring changes to reduce 
onboarding times while maintaining the high quality of its work 
force. As of Fiscal Year 1Q1, the Veterans Health 
Administration (VHA) had almost 9,000 vacancies among positions 
funded through regular appropriations, and as of March 31, 
2021, VA reported nearly 8,000 employees onboard under 
temporary, emergency funding through the CARES Act. The 
President's Fiscal Year budget funds the hiring of 17,403 new 
VHA Full-Time Equivalents (FTEs) beyond what was funded in 
Fiscal Year 1. Given VHA's goal to increase staffing funded by 
regular appropriations, while simultaneously funding temporary 
positions via supplemental funding, it is critical VA clearly 
distinguishes between temporary needs driven by the pandemic 
and permanent needs driven by long-term drivers of health care 
usage. We are committed to providing the Department with the 
hiring authorities and resources it needs to meet veteran 
demand for care in the short-term surge and over the long-term 
return to typical demand for care.

Community Care

    The COVID-19 pandemic has also significantly impacted 
health care across the Nation. VA must work with its network 
administrators to ensure there is an adequate network to meet 
the demand for non-VA care. And when veterans opt for care in 
the community, the Department must ensure there is an 
appropriate process in place for veterans to receive high-
quality and timely care in the private sector.

Mental Health

    The President's budget for Fiscal Year includes an increase 
for mental health care, which we expect will assist the 
Department in addressing the effects of the COVID-19 pandemic 
and the ongoing veteran suicide crisis. Fully funding the 
implementation of our bipartisan Commander John Scott Hannon 
Veterans Mental Health Care Improvement Act (Hannon Act) is 
also crucial for meeting Congress' intent and expanding VA's 
tools for suicide prevention and access to mental health care. 
Further, an increase for the Veterans Crisis Line is a 
strategic need given that bolstered staffing and resources will 
be needed for the anticipated increase in demand due to the 
move to 988 as the National Suicide Hotline in July 2022.
    One concern for us is VA's estimated workload for mental 
health in Fiscal Year and Fiscal Year 3. Given the impact of 
the pandemic on mental health, we would expect to see a 
projected increase in veterans utilizing VA mental health care 
services. Instead, VA projects treating nearly 6,000 fewer 
veterans through inpatient mental health care in Fiscal Year 
than in Fiscal Year 1. This raises questions about VA's ability 
to provide veterans with timely access to mental health care, 
especially for acute cases that may require inpatient care and 
we intend to raise this issue with the Department.
    It is also important that VA make a prudent, ongoing effort 
to expand mental health access for veterans in hard-to-reach, 
rural parts of the country, and provide veterans with 
innovative treatments to address veteran mental health and 
suicide.

Telehealth

    Improving access to care, especially for rural and 
homebound veterans, continues to be a top priority for us, and 
telehealth is one of the most useful tools in accomplishing 
this. The requested increase in the Fiscal Year Budget is 
intended to expand and enhance VA's telehealth capabilities, 
which continue to be in high demand due to the pandemic, as 
well as to implement the Hannon Act's telehealth grant program. 
This legislation authorizes VA to establish a grant program to 
develop telehealth access points at non-VA sites, such as the 
ATLAS hubs. We are pleased to see VA focusing on serving 
veterans that may not be close to a VA site and will continue 
to hold the Department accountable to its promise of serving 
all veterans.

Women Veterans

    Women veterans are the fastest-growing cohort of the 
veteran community. Unfortunately, due to this rapid growth, 
women veterans often have a longer wait for primary care and 
some specialty care appointments than male veterans, and 
women's trust in VA is lower than male veterans. We are pleased 
to see the increase in funding for gender-specific services to 
help provide women veterans with equitable access to care. The 
VA is required to offer all women veterans a women's health 
primary care provider (WH-PCP), yet only 82 percent of women 
veterans are assigned to a WH-PCP and approximately 10 percent 
of CBOCs do not have even one WH-PCP on staff. Increased 
funding will be valuable for implementing the Deborah Sampson 
Act requirements, including growing the women's health work 
force at VA. The Department must continue to improve the 
availability, accessibility, and quality of services offered to 
women veterans, and we look forward to working with VA to 
ensure this occurs.

Veterans Experiencing Homelessness

    With a nearly 4.4 percent increase in funding over the last 
Fiscal Year and the emergency funds provided by COVID-related 
legislation last year, we are heartened that veterans 
experiencing homelessness remain a priority, but want to ensure 
that funding is spent effectively and without unnecessary 
delays. In addition to addressing the still unknown economic 
fallout of the pandemic and impact on veterans experiencing 
homelessness with this increased funding, we expect VA to 
continue to tackle pre-pandemic barriers to support including 
insufficient access to safer private transitional housing and 
unstaffed HUD-VASH case management positions. We also hope VA 
will embark on a renewed effort to address the unique 
challenges faced by increasing numbers and needs of unhoused 
elderly veterans, including greater susceptibility to illness 
and the need for more attentive and long-term care not 
typically available through transitional facilities nor 
standard permanent housing. For the existing programs, 
policies, and funding for this vulnerable population, we 
encourage VA to utilize those resources as quickly and 
efficiently as possible so that we can more clearly see what 
gaps are left to be filled.

Veterans with Toxic Exposures

    VA has the unique mission of delivering health care and 
benefits that focus on the toxic exposure-related illnesses and 
injuries incurred by veterans during military service. VA must 
ensure adequate funding across VHA, the Veterans Benefits 
Agency (VBA), and the VA Office of Research and Development 
(ORD) to address the needs of those suffering from military 
toxic exposures. In order to deliver the cutting-edge health 
care that veterans deserve, VHA and ORD must have adequate 
funding to be proactive in their research efforts and flexible 
in their delivery of care to best serve the veterans suffering 
from the effects of toxic exposures. This includes funding to 
adapt the delivery of health care to the particular needs of 
the incoming generation of toxic exposure veterans, and 
research funding to ensure VA is at the forefront of medical 
science when it comes to understanding toxic exposures and 
their effects on veterans. Additionally, VA must provide robust 
funding for disability claims rating staff and the requisite 
training to ensure they can make accurate decisions in a timely 
manner. Adequate staffing and training at VBA are essential to 
providing veterans with timely access to health care and 
benefits.

                            Veteran Benefits


VBA Claims Processing

    Similar to other VA services and programs, VBA operations 
were severely impacted by the COVID-19 pandemic. We are 
concerned about the increase in the backlog of disability 
compensation claims, with more than 200,000 claims pending for 
more than 125 days. The President's Fiscal Year Budget Request 
calls for 429 new FTE for VBA, with 334 FTE to support the 
processing of Agent Orange claims, and 95 FTE to support 
general disability claims processing. While these new personnel 
will be helpful in fighting the claims backlog, new employees 
take time to train, and we encourage VA to continue working 
within VHA, VBA, and with their contract vendors who provide 
medical disability exams (MDE), to do everything it can to 
ensure that veterans do not face lengthy wait times to receive 
an MDE and do not face an extensive backlog before they receive 
their earned benefits and compensation. Last, VBA must ensure 
it is fully utilizing its quality assurance programs. These 
programs, which evaluate the accuracy with which VBA staff 
process compensation claims, identify trends in errors 
committed by claims processors, provide training, and review 
the performance of individual employees are crucial in ensuring 
whether VBA's claims review process is operating at the highest 
possible level.
    Last year, in lieu of the 48-hour pre-decisional review 
period for VSOs to examine a claim, the Department implemented 
the Claim Accuracy Request (CAR) pilot program. The CAR program 
allows for a post-decisional expedited review using the high 
level review practices created by the Veterans Appeals 
Improvement and Modernization Act (AMA). Since this is a pilot 
program, the Committee will continue to review whether or not 
CAR provides sufficient checks and balances in lieu of the 48-
hour review period, so that the program can become permanent if 
it is beneficial to the veteran and their claim.

Board of Veterans Appeals

    The Board of Veterans' Appeals' (BVA) inventory has been 
growing in recent years as VBA has worked to address its own 
claims backlog. Congress passed the Veterans Appeals 
Improvement and Modernization Act to streamline and shorten the 
appeals process for veterans. While VA has now implemented the 
changes, continued training and build-out of Information 
Technology (IT) functionality will be essential for success. 
BVA must take the necessary steps to address its pending 
inventory, as well as the growth of incoming appeals through 
the new system, and this requires consistent funding for a 
sufficient number of appropriately trained staff, attorneys, 
and veteran law judges to meet current demand. We are pleased 
to see that the majority of the funding increase for BVA in the 
Fiscal Year request will go to hiring additional FTE, which 
will help with the appeals backlog. Again, VA must do 
everything it can to address the appeals backlog and ensure 
veterans do not have unnecessarily long wait times for their 
decisions.

Education Benefits

    Last year, Congress passed two GI Bill COVID relief 
packages to ensure student veterans and their dependents were 
able to continue their education and were not negatively 
impacted by schools' changing their teaching structure or 
closing due to COVID. Even prior to the pandemic, the Committee 
has been concerned about the proper allocation of IT resources 
provided to the Education Service, as they implement the 
various changes in laws Congress has made in recent years to 
education benefits. Earlier this year, VA awarded a $450 
million contract to Accenture to modernize and improve GI Bill 
claims processing through a new Digital GI Bill. The Committee 
will continue to monitor VA's ability to implement the ongoing 
changes to GI Bill benefits; the need for additional funding to 
VA's high technology VET TEC and VRRAP pilot programs; IT 
modernization for Veterans Readiness and Employment; and the 
overall seamless transition to an IT system for education 
benefits that will serve veterans in an efficient and 
productive manner.

                    National Cemetery Administration


Operations and Maintenance

    The National Cemetery Administration (NCA) is nearing its 
goal to provide 95 percent of veterans with access to a burial 
option in a national, State or tribal veterans cemetery within 
75 miles of their homes. We strongly believe that VA national 
cemeteries must always honor veterans, even after cemeteries 
have reached capacity, which is why we support NCA's National 
Shrine Commitment. Additionally, NCA must continue to provide 
greater choice for veterans including in rural and tribal 
areas.

State Veterans Cemeteries

    The State Cemetery Grant Program allows States to expand 
veteran burial options by raising half the funds needed to 
build and begin the operation of veterans' cemeteries. NCA 
provides the remaining funding for construction and operational 
funds, as well as cemetery design assistance. Funding 
additional projects in Fiscal Year in tribal, rural, and urban 
areas will provide burial options for more veterans and 
complement VA's system of national cemeteries. To fund these 
projects, we support investments in this program to help cover 
the increasing costs of operating and maintaining these 
cemeteries, which serve as a final resting place for those who 
bravely fought to protect this country.

                           VA Infrastructure


Construction

    Although funding for both the Major Construction and Minor 
Construction accounts has been increased, it is important to 
view them in context; both of these accounts have experienced 
negative growth over the last 6 years. VA has nearly $71 
billion in unmet infrastructure needs, including an estimated 
$7 billion in outstanding seismic corrections on VA's priority 
lists. These are incredibly important safety issues that cannot 
be overlooked, and they must be at the top of VA's Strategic 
Capital Investment Plan. VA should consider adopting proven 
planning and funding models used for capital infrastructure. 
These models should integrate with the VA's new strategic plan 
detailing where and how VA health care facilities should be 
aligned to meet veterans' future care needs as identified by 
the Asset and Infrastructure Review process mandated by the VA 
MISSION Act and other relevant planning, staffing, and 
budgeting activities of the Department. To further position VA 
to manage its current and future capital portfolio, we 
recommended increased funding and focus on the work force at 
the facility, regional, and VA Central Office level. This will 
assist VA in properly planning, managing, and delivering 
facility projects.

Electronic Health Record

    The President's Fiscal Year request for VA's Electronic 
Health Record Modernization (EHRM) represents the projected 
need for the next phase of deployment of the new system across 
the country. However, a Secretary-directed strategic review is 
currently underway with a conclusion expected in June, so needs 
for this account may change. Additionally, VA's Office of 
Inspector General (OIG) recently found that the EHRM program 
inaccurately and inappropriately hid certain infrastructure 
funding needs, which will likely increase the 10-year cost of 
this program. Until the Secretary presents a plan to correct 
this program, we view this Fiscal Year request as tentative.

Information Technology

    The increased IT funding proposed in the Fiscal Year 
request will be used to continue to replace old equipment in VA 
facilities and help modernize several IT systems including for 
GI Bill programs, Human Resources, and the VA-wide financial 
management system. While this increase is positive and 
significant, it still may under-invest on VA's identified needs 
to improve various IT systems that its employees and veterans 
need. VA's IT accounts, particularly the development accounts, 
are chronically under-invested in. IT underpins the success or 
failure of hundreds of VA operations, including IT equipment in 
medical facilities. These IT systems are needed for employees 
to deliver benefits and services to veterans or to make VA 
operations more effective.

                     VA Oversight and Transparency


Office of Inspector General

    The CARES Act and American Rescue Plan provided more than 
$30 billion in support of VA's COVID-19 response. It is 
imperative there be continuous, prudent oversight over this 
appropriation, and VA's Office of Inspector General is an 
important component in accomplishing this work. We have 
introduced S. 1446, the VA Transparency & Trust Act of 2021, 
which requires VA to submit a spend plan for its COVID-19 
relief appropriations and we will continue to ensure that VA 
operates in a transparent, accountable manner.

                                Closing

    We thank the Committee on the Budget for its attention to 
our views and estimates on the Fiscal Year budget and Fiscal 
Year advance appropriations requests for VA and matters within 
the jurisdiction of the Committee on Veterans' Affairs. We look 
forward to working with you to continue to meet the needs of 
those who have served our country.

            Sincerely,

Jon Tester,                             Jerry Moran,
  Chairman.                               Ranking Member.
                                ------                                


B. Second Session (2022)

    Pursuant to the requirements of section 301(d) of the 
Congressional Budget Act of 1974, Chairman Tester submitted a 
letter to the Budget Committee reflecting the Committee's Views 
and Estimates on the Administration's proposed Fiscal Year 2023 
budget for veterans' programs. The letter submitted is printed 
below in its entirety:
                                                      May 13, 2022.
Hon. Bernard Sanders, Chairman,
Hon. Lindsey Graham, Ranking Member,
Committee on the Budget,
U.S. Senate, Washington, DC.

    Dear Chairman Sanders and Ranking Member Graham: Pursuant 
to Section 301(d) of the Congressional Budget Act of 1974, we 
write to provide our views and estimates to the Committee on 
the Budget regarding matters within the jurisdiction of the 
Committee on Veterans' Affairs (the Committee). The President's 
Budget Request provides a historic increase for Department of 
Veterans Affairs' (VA) spending on veterans programs. These 
funds are largely needed for timely, high-quality delivery of 
veterans' health care and benefits, which is especially 
critical as toxic exposure reforms loom. However, this budget 
includes a concerning projected increase in reliance on 
community care, instead of in-house care, without sufficient 
dedicated funding for the work force and infrastructure needed 
to fully execute the Department's mission.
    On March 1, 2022, the Committee began a series of hearings 
where veterans service organizations (VSOs) provided their 
legislative priorities for this year as well as their 
perspectives on challenges facing VA and the veteran community 
across our Nation. During my time on the Committee, these 
hearings have been invaluable in helping me better understand 
the legislative and budgeting priorities on which Congress 
should be focusing. As Chairman, I have restated my belief that 
I need to be taking my cues from our Nation's servicemembers, 
veterans, and their families on how best we can honor their 
service and ensure they receive the benefits and services they 
have earned.
    Accordingly, to assist in preparing these views and 
estimates, I have given careful consideration to ``The 
Independent Budget: Fiscal Years 2023 and 2024 for the 
Department of Veterans Affairs, Budget Recommendations'' 
(Independent Budget or IB) prepared by three VSOs--the Disabled 
American Veterans, the Paralyzed Veterans of America, and the 
Veterans of Foreign Wars. This comprehensive budget and policy 
document created by veterans and for veterans is also supported 
by many other organizations that care deeply about veterans and 
their families.
    According to the President's Budget Request, demand for 
VA's services and programs is expected to continue to rise. 
While I note the increased funding requested in the President's 
Budget for Fiscal Year 3, there are specific programs and 
operations that must receive focused support in the budget 
resolution for VA to succeed. We must demand excellence and 
accountability from VA, but it is our role to ensure it has the 
resources to provide our veterans and other beneficiaries with 
the world-class services and benefits they have been promised.

                             VA Health Care

VHA Workforce
    During the pandemic, VA was able to expedite the health 
care provider hiring timeline and bolster medical staffing, due 
to CARES Act and American Rescue Plan Act (ARPA) funding and 
flexibilities. Vacancies averaged around 39,000 over the past 2 
years; however, vacancies have sharply rebounded due to trends 
in the larger health care labor market and VA's continued 
difficulties with timely hiring. As of Fiscal Year Q1, the 
Veterans Health Administration (VHA) has more than 59,000 
vacant positions and a higher than usual employee turnover rate 
of 9.9 percent. The President's Fiscal Year budget request 
supports 435,926 FTE, an increase of 10,498 from Fiscal Year 2; 
of that increase, 8,945 FTE are for medical care. I am 
committed to ensuring VHA achieves its full clinical capacity 
and that critical non-clinical positions are also filled so 
veterans can access timely, high-quality health care services 
delivered at VHA medical facilities. To that end, Congress 
passed the RAISE Act as part of Public Law (P.L.) 117-103, the 
Fiscal Year Consolidated Appropriations Act, which was VA's top 
staffing priority and will enable VHA to recruit and retain 
nurses. The President's budget request will support the 
estimated $10.4 million cost of this legislation.
Community Care
    The 2023 revised request includes an additional $4.3 
billion in community care funding. My understanding is this 
funding level is driven in part by a lack of administrative 
staffing and support necessary to execute in-house dollars. If 
care that could be provided in-house is being driven into the 
community for administrative reasons--like a lack of support to 
hire providers or schedule for in-house care--that's a problem. 
P.L. 115-182, the VA MISSION Act of 2018, allows veterans the 
option of care in the community under certain circumstances, 
including VA's inability to provide needed health care services 
in a timely manner. If VA can't execute in-house dollars 
because facilities lack administrative support for hiring and 
scheduling, then veterans aren't being provided an option, 
they're being left with no real choice but to turn to the 
community for their health care needs. VA must work to right-
size community care by filling critical human resources and 
scheduling positions so veterans have a real option when making 
a choice on where to receive care.
    Recent studies have shown veterans have better health 
outcomes at VA than in the community, and health care at VA is 
more cost effective than services provided at private sector 
hospitals. These studies further stress how important it is 
that veterans who want to get care at VA should be able to 
receive that care rather than being given a false choice of 
care.
     A study published in the Journal of the American 
Medical Association comparing outcomes after non-cardiac 
surgery among patients treated in private-sector hospitals with 
veterans treated in VA hospitals found that VA surgical care is 
associated with lower rates of mortality than private sector 
care.
     A study was published in the Journal of the 
American Heart Association evaluating veterans undergoing stent 
procedures at community or VA hospitals that found 1 year after 
the procedure, those treated at a VA facility had an 
approximately 25 percent lower risk of complications compared 
to those treated at a community hospital.
     A study published just a few months ago looked at 
health outcomes of veterans eligible for VA care and Medicare. 
The authors of that study noted a ``significant VA advantage.'' 
That study found a 4.5 percentage point survival gain at 28 
days and a 46 percent reduction in mortality relative to the 
average. And the survival gain was reportedly long lasting. It 
also found 21 percent lower spending when compared to 
facilities that accept Medicare patients.
Mental Health
    The President's budget for Fiscal Year includes an increase 
for mental health care, which is necessary given current and 
projected demand for mental health services, both in-person and 
via telehealth. This funding is also necessary to continue the 
timely and comprehensive implementation of P.L. 116-171, the 
Commander John Scott Hannon Veterans Mental Health Care 
Improvement Act, which bolsters VA's tools for suicide 
prevention and veterans' access to mental health care. Further, 
VA projects an increase in call volume to the Veterans Crisis 
Line due to the move to 988 as the National Suicide Hotline in 
July 2022, which could also increase referrals to and usage of 
VA mental health care.
    I am particularly concerned about the decrease in funding 
for suicide prevention--which is stated to be VA's top clinical 
priority. While the President's budget request justifies the 
lower amount for suicide prevention by pointing out the 
discontinuation of the Trump Administration's PREVENTS 
initiative, those funds could be redirected to fill the 
staffing gap of 159 suicide prevention coordinators across VHA. 
As of March 2022, only 39 percent of VA health care systems are 
meeting the recommended staffing ratio for suicide prevention 
coordinators. The VHA staffing model shows 504 suicide 
prevention coordinators are needed and VA currently has only 
345. The Department must have sufficient funding to recruit for 
and fill these critical roles in order to address the health 
care needs of veterans at-risk for suicide.
Caregivers
    The Caregivers Program reduces the burden faced by family 
caregivers of veterans by providing them with a tax-free 
monthly stipend, reimbursement for travel expenses, health 
insurance, mental health services and counseling, training and 
respite care. Congress mandated expansion of this program to 
veterans of all eras and VA plans to accomplish the last phase 
of this expansion in October 2022. As of March 2022, VA has 
received more than 139,000 unique applications for this program 
since October 2020, and added 18,600 additional veterans and 
their Family Caregivers to its rolls.
    In parallel to expansion, VA has suspended discharges from 
the program and is re-examining its approach to evaluating 
applications. Feedback from numerous stakeholders and results 
of recent reassessments led to concerns that Trump-era 
regulations prevent many veterans with caregiving needs from 
participating in the program. In addition, VA is responding to 
a recent court ruling that allows veterans and caregivers who 
disagree with a decision to appeal to the Board of Veterans' 
Appeals, requiring implementation of entirely new processes 
within the Caregivers Program. The President's Fiscal Year 
budget request seeks $1.9 billion for the Caregivers Program, a 
$433 million increase from the Fiscal Year request. I believe 
the expansion of the Caregivers Program serves as an important 
step in ensuring caregivers of all generations of veterans have 
the resources necessary to provide the best possible care for 
their loved ones.
Women Veterans
    The number of women serving in the military has increased 
dramatically over the years. Women currently comprise nearly 17 
percent of active duty Armed Forces and 19 percent of the 
National Guard and Reserves. Women are now the fastest growing 
cohort within the veteran community and are increasingly 
choosing VA for their health care. Women veterans account for 
more than 30 percent of the increase in veterans enrolled over 
the past 5 years. Unfortunately, due to this rapid growth, 
women veterans often have a longer wait for primary care and 
some specialty care appointments than male veterans, and 
women's trust in VA is lower than male veterans.
    I am pleased to see the increase in funding for gender-
specific services to help provide women veterans with equitable 
access to care. VA is required to offer all women veterans a 
women's health primary care provider (WH-PCP), yet only 82 
percent of women veterans are assigned to a WH-PCP and 
approximately 10 percent of Community Based Outpatient Clinics 
do not have even one WH-PCP on staff. Increased funding will be 
valuable for implementing the requirements of P.L. 116-315, the 
Deborah Sampson Act, including dedicated funding for 
retrofitting facilities, mandating the provision of childcare 
for veterans at all VA Medical Centers by 2026, and expanding 
training programs like the Women's Healthcare Mini Residency 
Program for VA providers. The Department must continue to 
improve the availability, accessibility, and quality of 
services offered to women veterans, and I look forward to 
working with VA to ensure this occurs.
Veterans Experiencing Homelessness
    VA has learned a lot in the past 2 years about what works 
and what needs adjustment in how it tackles veteran 
homelessness, and the investments made must be sustained. The 
Fiscal Year President's budget request maintains pandemic-level 
funding, including essential supplemental funding and 
adjustments for inflation, for successful programs like 
Supportive Services for Veteran Families (SSVF). These programs 
help prevent and end chronic cycles of homelessness by 
providing increased rent subsidies in areas with high costs of 
living and affordable housing shortages that encourage self-
sufficiency and connecting veterans with health care resources 
needed to get back on their feet. SSVF program participants re-
enter the homeless system at a lower or equal rate to veterans 
in poverty expected to experience homelessness, suggesting SSVF 
is having an impact on reducing the risks of homelessness and 
breaking cycles of chronic homelessness.
    However, per the President's Fiscal Year request, many of 
its other homelessness programs will return to pre-pandemic 
base funding levels with slight adjustments for inflation. This 
is despite the fact that though the pandemic-related needs may 
be decreasing, the post-pandemic world is significantly and 
irrevocably different than before. For example, congregate 
Grant and Per Diem (GPD) facilities are largely transitioning 
to individualized facilities, which are safer, more appealing, 
and healthier for veterans, but cost more to operate. I am 
concerned about the decreased funding for GPD in the Fiscal 
Year request. It is encouraging to see VA doubling down in 
programs proven to be highly successful, but I would like to 
ensure VA does not lose momentum in other programs, all of 
which are needed to tackle the complex problem of veteran 
homelessness.
Veterans with Toxic Exposures
    Much like after the Vietnam War, our Nation now has a new 
generation of veterans who suffered toxic exposures during 
military service. VA has a duty to deliver quality health care 
and timely benefits for these veterans, and must resource both 
VHA and the Veterans Benefits Administration (VBA) accordingly. 
Furthermore, because current statutes and regulations may leave 
thousands of toxic-exposed veterans behind, Congress must pass 
comprehensive toxic exposure legislation. Unlike previous 
attempts at toxic exposure legislation, Congress must 
simultaneously provide VA with sufficient resources and legal 
authorities to deliver health care and benefits to veterans 
newly covered by the comprehensive toxic exposure legislation 
and prevent any diminishment of services VA already provides.

                            Veteran Benefits

VBA Claims Processing
    VBA continues to work down its disability claims backlog to 
pre-2020 pandemic levels. Initially, COVID-related factors 
aggravated this backlog: switching to teleworking, cancellation 
of in-person medical disability examinations (MDE), and onsite 
work restrictions at sites that process veterans' paper 
records. By end of 2021, VBA reported the resolution of those 
issues, but it continued to deal with an increasing backlog. 
This is likely because VBA struggled to deal with new toxic 
exposure-related presumptions of service connection added by 
both Congress and the Secretary. For Fiscal Year 3, the 
President has requested funding for 1,209 more claims 
processors to help with the backlog, but for a sustainable 
long-term solution, VA must also invest in upgrading its 
processes and technology. This includes improving the accuracy 
of claims decisions and MDE, reducing unnecessary MDE, and 
investing in automation.
Board of Veterans Appeals
    BVA's inventory continues to grow alongside VBA's. Veterans 
increasingly wait longer for a BVA appeal, in large part 
because more veterans opt for the most time-consuming appeal 
option. With the passage of the Appeals Modernization Act 
(AMA), veterans can now choose between additional levels of 
review within the particular VA Administration that issued a 
decision, e.g., VBA, or opt for three different types of 
hearings with BVA. Immediately after AMA enactment, more than 
70 percent of claimants opted for quicker reviews with VBA; 
now, more than half opt for the most time-consuming BVA appeal: 
a live hearing in front of a BVA judge. While I am pleased to 
see the President request funding to hire more BVA judges, wait 
times could also be reduced if fewer veterans chose to appear 
before a BVA judge. Therefore, in addition to improving BVA 
resourcing and processes, VA must examine why veterans appear 
to have lost faith with VBA reviews.
Education Benefits
    Last year, Congress extended GI Bill COVID relief to ensure 
student veterans and their dependents were able to continue to 
receive their full benefits and were not negatively impacted by 
schools' changing their teaching structure or closing. The 
Committee continues to monitor the implementation of the 
Digital GI Bill; implementation of provisions from P.L. 116-
315, the Isakson Roe Act, to strengthen oversight of GI Bill 
benefits; VA's high technology Veteran Employment Through 
Technology Education Courses (VET TEC) and Veteran Rapid 
Retraining Assistance Program (VRRAP) pilot programs; IT 
modernization for Veterans Readiness and Employment; and the 
overall seamless transition to an IT system for education 
benefits that will serve veterans in an efficient and 
productive manner.

                    National Cemetery Administration

Operations and Maintenance
    The National Cemetery Administration (NCA) is nearing its 
goal to provide 95 percent of veterans with access to a burial 
option in a national, State, or tribal veterans cemetery within 
75 miles of their homes. I strongly believe VA national 
cemeteries must always honor veterans, even after cemeteries 
have reached capacity, which is why I support NCA's National 
Shrine Commitment. Additionally, NCA must continue to provide 
greater choice for veterans including in rural and tribal 
areas.
State Veterans Cemeteries
    The State Cemetery Grant Program allows States to expand 
veteran burial options by raising half the funds needed to 
build and begin the operation of veterans' cemeteries. NCA 
provides the remaining funding for construction and operational 
funds, as well as cemetery design assistance. Funding 
additional projects in Fiscal Year in tribal, rural, and urban 
areas will provide burial options for more veterans and 
complement VA's system of national cemeteries. To fund these 
projects, I strongly recommend full investment in this program 
to help cover all the current conforming grant requests. Each 
year, many grants go without funding and several have been 
waiting almost a decade, it is time to fully commit to this 
hallowed program. We must provide for the increasing costs of 
operating and maintaining these cemeteries, which serve as a 
final resting place for those who bravely fought to protect 
this country.

                           VA Infrastructure

Construction
    Although funding for Major, Minor Construction, and the 
Non-Recurring Maintenance account within VHA Medical Facilities 
are increased in the Fiscal Year President's request, it is 
important to view them in context. From Fiscal Year to Fiscal 
Year 1, these three accounts have all had a negative growth 
rate. Specifically, a negative compounded growth rate of 6.8 
percent, 1.66 percent, of 0.78 percent respectively. The Fiscal 
Year budget identifies $87.9 billion in unmet infrastructure 
needs across the Department over the next 10 years. This 
includes new facilities, regular and preventative maintenance, 
seismic and safety projects, and improvements to ensure all VA 
facilities are welcoming to women veterans. Yet the Fiscal Year 
request totals $5.5 billion, if the use of the Recurring 
Expenses Transformational Fund (RETF) is included. This is $2.5 
billion short of the $8 billion needed (1/10th of the 
identified need) to allow VA to aggressively and prudently 
manage its current and future infrastructure needs.
    Modern infrastructure is the cornerstone of VA healthcare 
and benefits delivery. In 2021 testimony before the Committee, 
the senior executive of Kaiser Permanente (KP) with 
responsibility over that organization's health care 
infrastructure testified that KP typically invests roughly 3 
percent of overall operating revenue in facilities--a 
comparable amount for VA across Major, Minor, and NRM accounts 
would be a total of $8 billion.
    Congress must take action to do what the executive branch 
under both parties has been unable to do to date--make the 
needed investments in VA infrastructure while demanding 
improvements in performance. This should include increases in 
funding for the relevant infrastructure engineers, planners, 
and all other staff that are critical to making VA's 
infrastructure operation successful.
Electronic Health Record
    The President's Fiscal Year request of $1.7 billion for 
VA's Electronic Health Record Modernization (EHRM) program, 
while a reduction from Fiscal Year 2, still represents a 
significant investment in a program that continues to be 
plagued by several levels of challenges including from the 
technical, operational, contractual, and organizational 
perspectives, even after the Secretary's commendable launch of 
a Strategic Review that produced a long list of needed reforms.
    Nearly a year and a half since the Trump Administration's 
rushed initial deployment at Mann-Grandstaff in Spokane, 
Washington, that facility is still not fully recovered and the 
defects in the Cerner EHR have not been fixed. Outages of the 
system, causing VA to turn to the use of paper records, are re-
ocurring, not to mention an incident of veteran data 
corruption.
    Further, Cerner and VA have taken more than 6 months to 
identify and develop a formal plan, to include estimated costs, 
to fix the well-known pharmacy software and medication 
management deficiencies within the Cerner product that are 
causing patient risk and in at least one case, harm. 
Additionally, VA's Office of Inspector General (OIG) has 
continued to issue reports that find EHRM program challenges in 
a growing list of areas across training and workforce 
management, data migration, interoperability, access to care, 
and more. For all of these reasons, I believe the Fiscal Year 
$1.7 billion request should be viewed skeptically, particularly 
the $1.1 billion to pay Cerner for their performance which has 
not met contractual requirements.

                     VA Oversight and Transparency

Office of Inspector General
    The President's Fiscal Year funding request for VA's OIG at 
the level of $273 million is very important and has my strong 
support. This funding level would allow the OIG to bring their 
total FTE to 1,135 in Fiscal Year 3. Each additional FTE brings 
additional oversight over VA programs and spending. The OIG 
serves a critical function of monitoring VA programs and 
highlighting areas in need of congressional oversight and 
legislative action while also partnering with Federal law 
enforcement entities to bring charges and convict those who 
attempt to harm veterans and/or defraud the government. The OIG 
indicates, on average, they produce a return on investment of 
$36 for every $1 dollar invested in their organization.
    With critical resources provided by Congress, the VA OIG 
has and will continue to focus its reviews in areas such as 
health care fraud in the Community Care program, general 
contract fraud, theft of veteran benefits or VA resources, the 
Electronic Health Record Modernization program, cyber security, 
quality of care at VA facilities, and continued robust 
oversight of the COVID-19-related funding provided by Congress 
to VA. This includes the OIG's work as required by P.L. 117-63, 
the VA Transparency & Trust Act of 2021, which requires VA to 
submit a spend plan and regular updates for its COVID-19 relief 
appropriations and for the OIG to review VA's performance. It 
is important the OIG have resources to conduct both regular and 
routine investigations but also be able to respond to quickly 
emerging areas of concern identified by Congress or brought to 
the OIG's attention from the public or their own 
investigations. This is especially important in the area of 
patient safety reviews.

                                Closing

    I thank the Committee on the Budget for its attention to 
these views and estimates on the Fiscal Year budget and Fiscal 
Year advance appropriations requests for VA and matters within 
the jurisdiction of the Committee on Veterans' Affairs. I look 
forward to working with you to continue to meet the needs of 
those who have served our country.

            Sincerely,
                                                Jon Tester,
                                                          Chairman.

                     COMMITTEE ON VETERANS' AFFAIRS

   JON TESTER, Montana, Chairman
JERRY MORAN, Kansas, Ranking Member  PATTY MURRAY, Washington
JOHN BOOZMAN, Arkansas               BERNARD SANDERS, Vermont
BILL CASSIDY, Louisiana              SHERROD BROWN, Ohio
MIKE ROUNDS, South Dakota            RICHARD BLUMENTHAL, Connecticut
THOM TILLIS, North Carolina          MAZIE K. HIRONO, Hawaii
DAN SULLIVAN, Alaska                 JOE MANCHIN III, West Virginia
MARSHA BLACKBURN, Tennessee          KYRSTEN SINEMA, Arizona
KEVIN CRAMER, North Dakota           MARGARET WOOD HASSAN, New 
TOMMY TUBERVILLE, Alabama            Hampshire
   Tony McClain, Staff Director
   Jon Towers, Republican Staff 
             Director

                                  [all]