[Senate Report 119-2]
[From the U.S. Government Publishing Office]
119th Congress} { Report
SENATE
1st Session } { 119-2
======================================================================
LEGISLATIVE AND OVERSIGHT ACTIVITIES DURING THE
118TH CONGRESS BY THE SENATE COMMITTEE ON
VETERANS' AFFAIRS
_______
March 12, 2025.--Ordered to be printed
_______
Mr. Moran, 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 118th Congress.
I. HEARINGS AND MEETINGS
A. First Session (2023)
During the First Session of the 118th Congress, the
Committee held 20 hearings. At those hearings, there were 115
witness appearances.
Two hearings (April 26 and July 12) focused exclusively on
legislation pending before the Committee. Testimony offered at
these hearings covered 33 bills.
The Committee held three business meetings, including two
meetings to discharge nominations.
On February 16, nine 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 February 28, March 1, and March 8.
The Committee held one joint hearing with the Senate Armed
Services Committee to examine the military to civilian
transition. This hearing was held on October 18.
B. Second Session (2024)
During the Second Session of the 118th Congress, the
Committee held 11 hearings, including one field hearing. At
those hearings, there were 84 witness appearances.
The Committee held one business meeting.
On May 1, one 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 6, March 7, and March 13.
The Committee held one joint hearing with the Senate
Special Committee on Aging to examine services for veterans and
their caregivers. This hearing was held on June 5.
C. List of Hearings and Meetings Held in the 118th Congress
(1) Thursday, February 16, 2023
Business Meeting: Meeting to Consider Legislation Pending
before the Committee
S. 10, VA Clinician Appreciation,
Recruitment, Education, Expansion, and Retention
Support Act of 2023 (Committee Print)
S. 30, Fiscal Year 2023 Veterans Affairs
Major Medical Facility Authorization Act (Committee
Print)
S. 106, Commitment to Veteran Support and
Outreach Act (Committee Print)
S. 112, 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. 132, Daniel J. Harvey Jr. and Adam
Lambert Improving Servicemember Transition to Reduce
Veteran Suicide Act (Committee Print)
S. 141, Elizabeth Dole Home Care Act
(Committee Print)
S. 185, Native American Direct Loan
Improvement Act of 2023
S. 216, RESPECT Act of 2023
S. 326, VA Medicinal Cannabis Research Act
of 2023
(2) Thursday, February 16, 2023
Nomination Hearing: Pending Nomination of Joshua D. Jacobs,
of Washington, to be Under Secretary for Benefits of the
Department of Veterans Affairs
(3) Tuesday, February 28, 2023
Joint Hearing with the House of Representatives to Receive
the Legislative Presentation of Disabled American Veterans
(4) Wednesday, March 1, 2023
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, Iraq and Afghanistan
Veterans of America, National Association of State Directors of
Veterans Affairs, Black Veterans Empowerment Council, Vietnam
Veterans of America, Fleet Reserve Association, National
Congress of American Indians, National Guard Association of the
United States)
(5) Wednesday, March 8, 2023
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,
Jewish War Veterans of the U.S.A., Wounded Warrior Project,
Tragedy Assistance Program for Survivors, Military Officers
Association of America, American Veterans, Gold Star Wives of
America, Inc., Military Order of the Purple Heart, Blinded
Veterans Association, National Association of County Veterans
Service Officers)
(6) Wednesday, March 8, 2023
Business Meeting: Meeting to Consider Pending Nomination of
Joshua D. Jacobs, of Washington, to be Under Secretary for
Benefits of the Department of Veterans Affairs
(7) Wednesday, March 15, 2023
Hearing: Examining the Future Path of VA's Electronic
Health Record Modernization Program
(8) Wednesday, March 22, 2023
Hearing: Strengthening Methods of Recruitment and Retention
for VA's Workforce
(9) Wednesday, April 19, 2023
Hearing: Veterans Consumer Protection: Preventing Financial
Exploitation of Veterans and Their Benefits
(10) Wednesday, April 26, 2023
Legislative Hearing: Pending Legislation
S. 280, BEST for Vets Act of 2023
S. 291, 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. 350, Fry Scholarship Enhancement Act of
2023
S. 414, Caring for Survivors Act of 2023
S. 498, Veteran Education Empowerment Act
S. 572, Ensuring Access to VA INFO Act
S. 656, Veteran Improvement Commercial
Driver License Act of 2023
S. 740, GUARD VA Benefits Act of 2023
S. 774, Veterans Border Patrol Training Act
S. 897, Expedited Veteran Appeals Act of
2023
S. 1090, A bill to direct the Secretary of
Veterans Affairs to update the payment system of the
Department to allow for electronic fund transfer of
educational assistance to a foreign institution of
higher education
S. 1266, Love Lives On Act of 2023
S. 1309, Student Veterans Transparency and
Protection Act of 2023
S. 1875, Veterans Second Amendment
Protection Act of 2023
(11) Wednesday, May 17, 2023
Hearing: Review of the Fiscal Year 2024 Budget and 2025
Advance Appropriations Requests for the Department of Veterans
Affairs
(12) Wednesday, May 31, 2023
Nomination Hearing: Pending Nomination of Tanya J.
Bradsher, of Virginia, To Be Deputy Secretary of Veterans
Affairs
(13) Wednesday, June 7, 2023
Hearing: An Abiding Commitment to Those Who Served:
Examining Veterans' Access to Long Term Care
(14) Wednesday, June 14, 2023
Hearing: Connections to Care: Improving Substance Use
Disorder Care for Veterans in Rural America and Beyond
(15) Wednesday, June 21, 2023
Hearing: Examining the Effectiveness of the Office of
Integrated Veteran Care
(16) Wednesday, July 12, 2023
Legislative Hearing: Pending Legislation
S. 449, Veterans Patient Advocacy Act
S. 495, Expanding Veterans' Options for Long
Term Care Act
S. 853, VA Zero Suicide Demonstration
Project Act of 2023
S. 928, Not Just a Number Act
S. 1037, Department of Veterans Affairs EHRM
Standardization and Accountability Act
S. 1040, A bill to amend title 38, United
States Code, to prohibit smoking on the premises of any
facility of the Veterans Health Administration, and for
other purposes.
S. 1125, EHR Program RESET Act of 2023
S. 1172, Removing Extraneous Loopholes
Insuring Every Veteran Emergency (RELIEVE) Act
S. 1315, Veterans' Health Empowerment,
Access, Leadership, and Transparency for Our Heroes
(HEALTH) Act of 2023
S. 1436, Critical Health Access Resource and
Grant Extensions (CHARGE) Act of 2023
S. 1545, Veterans Health Care Freedom Act
S. 1612, Reimburse Veterans for Domiciliary
Care Act
S. 1828, Veterans Homecare Choice Act of
2023
S. 1951, Department of Veterans Affairs
Income Eligibility Standardization Act
S. 1954, Improving Whole Health for Veterans
With Chronic Conditions Act
S. 2067, A bill to require the Secretary of
Veterans Affairs to award grants to nonprofit
organizations to assist such organizations in carrying
out programs to provide service dogs to eligible
veterans, and for other purposes.
S. 2259, Leveraging Integrated Networks in
Communities for Veterans Act
S. 2263, Rural Vital Emergency
Transportation Services (VETS) Act
S. 2649, Making Community Care Work for
Veterans Act of 2023
(17) Thursday, July 13, 2023
Business Meeting: Meeting to Consider Pending Nomination of
Tanya J. Bradsher, of Virginia, To Be Deputy Secretary of
Veterans Affairs
(18) Wednesday, July 26, 2023
Hearing: Implementing the PACT Act: One Year Later
(19) Wednesday, September 20, 2023
Hearing: Invisible Wounds of War: Improving Mental Health
and Suicide Prevention Measures for Our Nation's Veterans
(20) Wednesday, October 18, 2023
Joint Hearing With the Senate Armed Services Committee:
Military to Civilian Transition: Ensuring Success After Service
(21) Wednesday, October 25, 2023
Hearing: VA Accountability and Transparency: A Cornerstone
of Quality Care and Benefits for Veterans
(22) Wednesday, November 1, 2023
Hearing: Foundation of Care: Examining Research at the
Department of Veterans Affairs
(23) Wednesday, November 15, 2023
Hearing: VA's Fourth Mission: Supporting Our Nation's
Emergency Preparedness and Response
(24) Friday, January 26, 2024
Field Hearing, Augusta, Maine: The State of Veterans' Long-
Term Care in Maine
(25) Wednesday, January 31, 2024
Hearing: Vet Centers: Supporting the Mental Health Needs of
Servicemembers, Veterans and Their Families
(26) Wednesday, February 28, 2024
Hearing: Sacred Mission: Honoring America's Veterans and
Their Families at VA Cemeteries
(27) Wednesday, March 6, 2024
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,
Paralyzed Veterans of America, Wounded Warrior Project,
National Association of State Directors of Veterans Affairs,
Mission Roll Call, Blue Star Families, Iraq and Afghanistan
Veterans of America, Blinded Veterans Association, Service
Women's Action Network, Student Veterans of America, American
Veterans)
(28) Thursday, March 7, 2024
Joint Hearing With the House of Representatives To Receive
the Legislative Presentation of Disabled American Veterans
(29) Wednesday, March 13, 2024
Joint Hearing With the House of Representatives To Receive
the Legislative Presentation of Multiple Veterans Service
Organizations (The American Legion, Jewish War Veterans of the
U.S.A., Tragedy Assistance Program for Survivors, National
Coalition for Homeless Veterans, Military Officers Association
of America, National Association of County Veterans Service
Officers, National Congress of American Indians, Vietnam
Veterans of America, National Guard Association of the United
States, Fleet Reserve Association)
(30) Wednesday, April 10, 2024
Hearing: Caring for All Who Have Borne the Battle: Ensuring
Equity for Women Veterans at VA
(31) Wednesday, May 1, 2024
Hearing: Review of the Fiscal Year 2025 Budget and 2026
Advance Appropriations Requests for the Department of Veterans
Affairs
(32) Wednesday, May 1, 2024
Business Meeting: Meeting To Consider Major Medical Lease
Committee Resolution
PSC-01-VA24: Charleston, SC, Research Lease;
PTX-02-VA24: Conroe, TX, Community Living
Center Lease;
PTX-03-VA24: Conroe, TX, Outpatient Clinic
Lease;
PPA-04-VA24: Cumberland County, PA, Hospital
Lease;
PFL-05-VA24: Gainesville, FL, Consolidated
Outpatient Clinic, Residential Rehabilitation Treatment
Program, and Research Lease;
PTX-06-VA24: Katy, TX, Community Living
Center Lease;
PTX-07-VA24: Katy, TX, Outpatient Clinic
Lease;
PFL-08-VA24: Port Saint Lucie, FL,
Outpatient Clinic Lease;
PNJ-09-VA24: Southern New Jersey, NJ,
Hospital Lease; and
PDE-10-VA24: Sussex County, DE, Hospital
Lease
(32) Wednesday, May 15, 2024
Hearing: Frontier Health Care: Ensuring Veterans' Access No
Matter Where They Live
(33) Wednesday, June 5, 2024
Joint Hearing With the Senate Special Committee on Aging:
Heroes at Home: Improving Services for Veterans and Their
Caregivers
(34) Wednesday, September 18, 2024
Hearing: Providing for Veterans: Addressing Current and
Future VA Budget Challenges
II. LEGISLATION
A. First Session (2023)
During the First Session, the Committee met in open session
on February 16, 2023, and ordered favorably reported nine
pieces of legislation to the full Senate.
S. 10, VA Clinician Appreciation,
Recruitment, Education, Expansion, and Retention
Support (CAREERS) Act of 2023 was ordered favorably
reported with an amendment in the nature of a
substitute by the Committee on February 16, 2023.
S. 30, Fiscal Year 2023 Veterans Affairs
Major Medical Facility Authorization Act passed the
Senate on March 21, 2023, with an amendment, by
unanimous consent. It was signed into law as Public Law
118-8 on July 18, 2023.
S. 106, Commitment to Veteran Support and
Outreach Act passed the Senate on November 16, 2023,
with an amendment, by unanimous consent on November 16,
2023.
S. 112, 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 passed the Senate on July 13, 2023, without
amendment, by unanimous consent. It was signed into law
as Public Law 118-18 on October 6, 2023.
S. 132, Daniel J. Harvey Jr. and Adam
Lambert Improving Servicemember Transition to Reduce
Veteran Suicide Act was ordered favorably reported,
with an amendment in the nature of a substitute, by the
Committee on February 16, 2023.
S. 141, Elizabeth Dole Home Care Act was
ordered favorably reported, with an amendment in the
nature of a substitute, by the Committee on February
16, 2023. It was signed into law as Public Law 118-210
on January 2, 2025.
S. 185, Native American Direct Loan
Improvement Act of 2023 was ordered favorably reported,
without amendment, by the Committee on February 16,
2023.
S. 216, RESPECT Act of 2023 was ordered
favorably reported, without amendment, by the Committee
on February 16, 2023.
S. 326, VA Medicinal Cannabis Research Act
of 2023, was reported, without amendment, by Senator
Tester on March 23, 2023. A motion to proceed to
consideration of S. 326 was made on April 20, 2023. On
April 26, 2023, cloture was not invoked by a vote of
57-42.
During the First Session, the Committee discharged numerous
bills by unanimous consent, as follows:
S. 777, the Veterans' COLA Act of 2023, was
discharged by the Committee on March 30, 2023, by
unanimous consent, and passed the Senate on the same
day without amendment, by unanimous consent. It was
signed into law as Public Law 118-6 on June 14, 2023.
S. 475, a bill to designate the clinic of
the Department of Veterans Affairs in Gallup, New
Mexico, as the Hiroshi ``Hershey'' Miyamura VA Clinic,
was discharged by the Committee on July 13, 2023, by
unanimous consent, and passed the Senate on the same
day without amendment, by unanimous consent. It was
signed into law as Public Law 118-16 on October 2,
2023.
S. 1096, Department of Veterans Affairs
Office of Inspector General Training Act of 2023, was
discharged by the Committee on July 13, 2023, by
unanimous consent, and passed the Senate on the same
day with an amendment, by unanimous consent.
H.R. 3672, to designate the clinic of the
Department of Veterans Affairs in Indian River,
Michigan, as the ``Pfc. Justin T. Paton Department of
Veterans Affairs Clinic'', was discharged by the
Committee on July 13, 2023, by unanimous consent, and
passed the Senate on the same day without amendment, by
unanimous consent. It was signed into law as Public Law
118-12 on July 28, 2023.
S. 2854, A bill to require the Secretary of
Veterans Affairs to enter into an agreement with the
city of Fargo, North Dakota, for the conveyance of
certain land of the Department of Veterans Affairs at
Fargo National Cemetery, and for other purposes, was
discharged by the Committee on October 19, 2023, by
unanimous consent, and passed the Senate on the same
day without amendment, by unanimous consent.
H.R. 366, Korean American Valor Act, was
discharged by the Committee on October 19, 2023, by
unanimous consent, and passed the Senate on the same
day without amendment, by unanimous consent. It was
signed into law as Public Law 118-20 on November 13,
2023.
H.R. 1226, the Wounded Warrior Access Act,
was discharged by the Committee on November 2, 2023, by
unanimous consent, and passed the Senate on the same
day without amendment, by unanimous consent. It was
signed into law as Public Law 118-21 on November 13,
2023.
S. 656, the Veteran Improvement Commercial
Driver License Act of 2023, was discharged by the
Committee on November 2, 2023, by unanimous consent. It
was signed into law as Public Law 118-95 on October 1,
2024.
During the First Session, the Committee also incorporated
provisions within the Committee's jurisdiction into broader
legislation.
B. Second Session (2024)
During the Second Session, the Committee met in open
session on May 1, 2024, and ordered favorably reported a major
medical facility lease resolution to the full Senate.
During the Second Session, the Committee discharged
numerous bills by unanimous consent, as follows:
S. 2181, Keeping Military Families Together
Act of 2023, was discharged by the Committee on May 1,
2024, by unanimous consent, and passed the Senate on
the same day without amendment, by unanimous consent.
It was signed into law as Public Law 118-271 on January
4, 2025.
S. 3126, Mark Our Place Act, was discharged
by the Committee on May 1, 2024, by unanimous consent,
and passed the Senate on the same day without
amendment, by unanimous consent. It was signed into law
as Public Law 118-134 on November 25, 2024.
H.R. 593, To rename the Department of
Veterans Affairs community-based outpatient clinic in
Hinesville, Georgia, as the ``John Gibson, Dan James,
William Sapp, and Frankie Smiley VA Clinic'', was
discharged by the Committee on May 2, 2024, by
unanimous consent, and passed the Senate on the same
day without amendment, by unanimous consent. It was
signed into law as Public Law 118-61 on May 13, 2024.
S. 3249, A bill to designate the outpatient
clinic of the Department of Veterans Affairs in
Wyandotte County, Kansas City, Kansas, as the ``Captain
Elwin Shopteese VA Clinic'', was discharged by the
Committee on May 2, 2024, by unanimous consent, and
passed the Senate on the same day without amendment, by
unanimous consent. It was signed into law as Public Law
118-75 on July 30, 2024.
S. 3285, A bill to rename the community-
based outpatient clinic of the Department of Veterans
Affairs in Butte, Montana, as the ``Charlie Dowd VA
Clinic'', was discharged by the Committee on May 2,
2024, by unanimous consent, and passed the Senate on
the same day without amendment, by unanimous consent.
It was signed into law as Public Law 118-76 on July 30,
2024.
S. 3938, A bill to designate the community-
based outpatient clinic of the Department of Veterans
Affairs in Lynchburg, Virginia, as the ``Private First
Class Desmond T. Doss VA Clinic'', was discharged by
the Committee on August 1, 2024, by unanimous consent,
and passed the Senate on the same day without
amendment, by unanimous consent. It was signed into law
as Public Law 118-200 on December 23, 2024.
H.R. 7333, To name the Department of
Veterans Affairs medical center in West Palm Beach,
Florida, as the ``Thomas H. Corey VA Medical Center','
was discharged from Committee by unanimous consent on
November 13, 2024, and passed the Senate the same day
without amendment, by unanimous consent. It was signed
into law on November 25, 2024, as Public Law 118-128.
S. 3746, the Gold Star and Surviving Spouse
Career Services Act, was discharged by the Committee on
December 2, 2024, by unanimous consent, and passed the
Senate the same day without amendment, by unanimous
consent.
S. 141, the Senator Elizabeth Dole 21st
Century Veterans Healthcare and Benefits Improvement
Act, was discharged by the Committee on December 12,
2024, by unanimous consent, and passed the Senate the
same day with an amendment, by unanimous consent. It
was signed into law as Public Law 118-210 on January 2,
2025.
S. 1299, the Fairness for Servicemembers and
their Families Act of 2024, was discharged by the
Committee on December 17, 2024, by unanimous consent,
and passed the Senate the same day with an amendment,
by unanimous consent.
H.R. 9124, To name the Department of
Veterans Affairs community-based outpatient clinic in
Auburn, California, as the ``Louis A. Conter VA
Clinic'', was discharged by the Committee on December
21, 2024, by unanimous consent, and passed the Senate
the same day without amendment, by unanimous consent.
It was signed into law as Public Law 118-259 on January
4, 2025.
H.R. 8667, To rename the community-based
outpatient clinic of the Department of Veterans Affairs
in Cadillac, Michigan, as the ``Duane E. Dewey VA
Clinic'', was discharged by the Committee on December
21, 2024, by unanimous consent, and passed the Senate
the same day without amendment, by unanimous consent.
It was signed into law as Public Law 118-251 on January
4, 2025.
H.R. 4955, To name the community-based
outpatient clinic of the Department of Veterans Affairs
in Monroeville, Pennsylvania, as the ``Henry Parham VA
Clinic'', was discharged by the Committee on December
21, 2024, by unanimous consent, and passed the Senate
the same day without amendment, by unanimous consent.
It was signed into law as Public Law 118-215 on January
2, 2025.
H.R. 4136, U.S. Congressman Sam Johnson
Memorial VA Clinic Act, was discharged by the Committee
on December 21, 2024, by unanimous consent, and passed
the Senate the same day without amendment, by unanimous
consent. It was signed into law as Public Law 118-214
on January 2, 2025.
S. 2513, the Veterans Benefits Improvement
Act of 2024, was discharged by the Committee on
December 12, 2024, by unanimous consent, and passed the
Senate the same day with an amendment, by unanimous
consent. It was signed into law as Public Law 118-196
on December 23, 2024.
During the Second Session, the Committee also incorporated
provisions within the Committee's jurisdiction into broader
legislation.
C. Public Laws
Senate Vehicle
S. 30, Fiscal Year 2023 Veterans Affairs Major Medical
Facility Authorization Act, is Public Law 118-8.
S. 112, 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, is Public Law 118-18.
S. 141, Senator Elizabeth Dole 21st Century Veterans
Healthcare and Benefits Improvement Act, is Public Law 118-210.
S. 475, A bill to designate the clinic of the Department of
Veterans Affairs in Gallup, New Mexico, as the Hiroshi
``Hershey'' Miyamura VA Clinic, is Public Law 118-16.
S. 656, Veteran Improvement Commercial Driver License Act
of 2023, is Public Law 118-95.
S. 777, Veterans' COLA Act of 2023, is Public Law 118-6.
S. 2181, Keeping Military Families Together Act of 2023, is
Public Law 118-271.
S. 2513, the Veterans Benefits Improvement Act of 2024, is
Public Law 118-196.
S. 3126, Mark Our Place Act, is Public Law 118-134.
S. 3249, A bill to designate the outpatient clinic of the
Department of Veterans Affairs in Wyandotte County, Kansas
City, Kansas, as the ``Captain Elwin Shopteese VA Clinic'', is
Public Law 118-75.
S. 3285, Abill to rename the community-based outpatient
clinic of the Department of Veterans Affairs in Butte, Montana,
as the ``Charlie Dowd VA Clinic'', is Public Law 118-76.
S. 3938, A bill to designate the community-based outpatient
clinic of the Department of Veterans Affairs in Lynchburg,
Virginia, as the ``Private First Class Desmond T. Doss VA
Clinic'', is Public Law 118-200.
House Vehicle
H.R. 366, Korean American VALOR Act, is Public Law 118-20.
H.R. 593, To rename the Department of Veterans Affairs
community-based outpatient clinic in Hinesville, Georgia, as
the ``John Gibson, Dan James, William Sapp, and Frankie Smiley
VA Clinic'', is Public Law 118-61.
H.R. 1226, Wounded Warrior Access Act, is Public Law 118-
21.
H.R. 3672, To designate the clinic of the Department of
Veterans Affairs in Indian River, Michigan, as the ``Pfc.
Justin T. Paton Department of Veterans Affairs Clinic'' is
Public Law 118-12.
H.R. 4136, U.S. Congressman Sam Johnson Memorial VA Clinic
Act, is Public Law 118-214.
H.R. 4955, To name the community-based outpatient clinic of
the Department of Veterans Affairs in Monroeville,
Pennsylvania, as the ``Henry Parham VA Clinic'', is Public Law
118-215.
H.R. 7333, To name the Department of Veterans Affairs
medical center in West Palm Beach, Florida, as the ``Thomas H.
Corey VA Medical Center'', is Public Law 118-128.
H.R. 8667--To rename the community-based outpatient clinic
of the Department of Veterans Affairs in Cadillac, Michigan, as
the ``Duane E. Dewey VA Clinic, is Public Law 118-251.
H.R. 9124, To name the Department of Veterans Affairs
community-based outpatient clinic in Auburn, California, as the
``Louis A. Conter VA Clinic'' is Public Law 118-259.
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.
Summaries of various oversight activities follow.
A. First Session (2023)
From January 3, 2023, to January 5, 2023, Committee
majority and minority staff traveled to Orlando, Florida, to
attend the national conference for the Student Veterans of
America. During this oversight visit, staff participated in a
legislative panel regarding Congressional efforts to improve
educational opportunities for student veterans and their
families, and attended panels with VA leadership and
individuals in higher education.
From February 17, 2023, to February 25, 2023, Committee
majority and minority staff traveled to Guam, the Commonwealth
of the Northern Mariana Islands (Saipan), and the Philippines
to visit VA medical facilities and veterans' cemeteries in each
location. During these oversight visits, staff met with local
VA staff and conducted public roundtables with local veterans
and stakeholders to discuss the unique needs and challenges of
the veteran populations in these areas.
On February 18, 2023, Committee minority staff traveled to
Russell, Kansas, to participate in the Veterans of Foreign Wars
(VFW) Department of Kansas Veterans Round Up at the Bob Dole
VFW Post 6240. During this oversight visit, staff met with
leaders and service officers from Kansas VFW and with officials
from the Veterans Benefits Administration (VBA) and the
Veterans Health Administration (VHA). Staff also spoke directly
with local veterans about issues related to accessing benefits,
including health care and pension, from VA.
From June 13, 2023, to June 14, 2023, Committee majority
and minority staff traveled to Phoenix, Arizona, to attend the
VA Leadership Summit. During this oversight visit, staff
participated in a legislative panel to provide Congressional
updates and answer questions from attendees including medical
center directors, deputy directors, chiefs of staff, and others
from across the country. Staff also toured the Carl T. Hayden
Veterans' Administration Medical Center.
From June 25, 2023, to July 2, 2023, Committee minority
staff traveled to Kansas and Nebraska to conduct oversight
visits of the Consolidated Mail Outpatient Pharmacy and Dwight
D. Eisenhower VA Medical Center in Leavenworth, Kansas, the
Omaha VA Medical Center in Omaha, Nebraska, and the Lincoln VA
Clinic in Lincoln, Nebraska.
On June 26, 2023, Committee majority staff visited the VISN
6 Mid-Atlantic Office and the Durham VA Medical Center to take
part in a VA PACT Act event and receive a tour of the Medical
Center.
From June 26, 2023, to June 28, 2023, Committee minority
staff traveled to Kansas and Missouri to visit VA medical
facilities and community partners throughout the region. During
these oversight visits, staff toured the Colmery-O'Neil
Veterans' Administration Medical Center in Topeka, Kansas, and
the Community Based Outpatient Clinic (CBOC) in Lenexa, Kansas.
Staff also met with local leaders from the Kansas Commission on
Veterans Affairs, the Veterans of Foreign Wars, and The
American Legion to discuss the needs of local veterans. Staff
further met with leaders from local non-profit organizations
that serve veterans, Horses & Heroes in Leavenworth, Kansas,
and the Veterans Community Project in Kansas City, Missouri, to
discuss their work and partnerships with VA.
On July 19, 2023, Committee majority staff attended a PACT
Act summit in Boston, Massachusetts. Staff updates on VA's
implementation of recent toxic exposure legislation.
From July 29, 2023, to August 3, 2023, Committee minority
staff traveled to Los Angeles, California, and Denver, Colorado
to visit VA facilities and attend the VA Acquisition Workforce
Innovation Symposium. During these oversight visits, staff
toured the West Los Angeles VA Medical Center, the Denver VA
Medical Center, and the Denver Logistics Center.
From August 13, 2023, to August 19, 2023, Committee
majority staff conducted oversight of VA facilities in Montana
and veteran services around the state. Staff met with School
Certifying Officials at the University of Montana, Montana
State University, Carroll College, and Great Falls College to
discuss services and challenges for student veterans using VA
education benefits. Staff met with faculty from the University
of Montana Payne Family Native American Center, staff of the
Great Plains Veterans Services Center, and the Blackfeet
Veterans Alliance to discuss programs and services for Native
American veterans, including coordination between VA and the
Indian Health Service, and implementation of the Staff Sergeant
Parker Gordon Fox Suicide Prevention Grant Program. Staff also
conducted oversight visits at the Fort Harrison VA Medical
Center to discuss services for veteran caregivers in the VA's
Caregiver Support Program and services for women veterans
including mental health care and Military Sexual Trauma
support. Staff also visited the Cut Bank CBOC and the Southwest
Montana Veterans Home. Staff conducted oversight visits at the
Missoula Vet Center and the Great Falls Vet Center, to discuss
services for women veterans, student veterans, staffing
challenges, VA internship programs, and Mobile Vet Center
services. Staff met with leadership from the Fort Harrison
Regional processing center to discuss Veteran Readiness and
Employment claims processing and staffing. Staff visited the
Helena American Jobs Center and the Bozeman American Jobs
Center leadership, including Department of Labor (DOL) Veterans
Employment and Training Service (VETS) State Director Tom
Finch, to discuss employment services for disabled veterans.
Staff visited Malmstrom Air Force Base's Education and Training
Center and Family Readiness Center to conduct oversight on the
Transition Assistance Program and other services for
transitioning servicemembers and military families.
From August 14, 2023, to August 17, 2023, Committee
minority staff traveled to Kansas and Missouri to visit VA and
Department of Defense facilities and speak with local
stakeholders. During these oversight visits, staff toured the
Robert J. Dole VA Medical Center and the Regional Office in
Wichita, Kansas, as well as the CBOC in Junction City, Kansas,
and the Fort Riley Army Installation. Staff also toured the
Kansas City VA Medical Center and Veterans Integrated Service
Network 15 Headquarters in Kansas City, Missouri. Staff further
met with leaders of veteran owned businesses in Wichita and
with local employees from the VA Office of the General Counsel
and Office of the Inspector General in Missouri.
On August 25, 2023, Committee majority staff visited The
American Legion's National Convention in Charlotte, North
Carolina. Staff spoke to The American Legion's National
Legislative Commission about the committee's legislative
priorities.
On August 28, 2023, Committee majority staff conducted
oversight visits to the Baltimore and Annapolis Vet Centers.
On September 6, 2023, Committee majority staff attended the
DOL VETS conference on Transition in Washington, DC, to hear
from stakeholders about the challenges that veterans and their
family members face when leaving military service, and
participated in a panel with a focus on military spouse
employment.
On September 22, 2023, Committee minority staff traveled to
Wichita, Kansas, to speak at the opening of the Sedgwick County
Veterans Treatment Court (VTC). During this oversight visit,
staff spoke about legislative priorities and the importance of
collaborative programs, as exemplified by the VTC, which is
intended to coordinate resources across the federal, state, and
local level to help attain positive outcomes for veterans
involved with the justice system.
On October 13, 2023, Committee majority staff conducted an
oversight visit of the Richmond VA Medical Center. While there,
staff visited the polytrauma center to talk with patients and
staff.
On October 24, 2023, Committee majority staff attended the
Military Officers Association of America's Roundtable
discussion on the Caregiver and Veteran Experience with Respite
Care in Alexandria, VA, to hear from caregivers and veterans
about their experiences in using VA's Respite Care programs.
From October 25, 2023, to October 27, 2023, Committee
majority and minority staff attended the Nurses Organization of
Veterans Affairs Conference in Las Vegas, Nevada. While in
Nevada, Committee majority and minority staff conducted an
oversight visit to the North Las Vegas VA Medical Center.
From November 1, 2023, to November 2, 2023, Committee
majority and minority staff conducted oversight of PACT Act
implementation and education benefit claims processing at the
Buffalo Regional Office in New York. Staff met with executive
leadership, frontline employees, and labor representatives to
learn about operations and challenges with staffing and
processing claims.
On November 17, 2023, Committee majority staff conducted an
oversight visit to Martinsburg, West Virginia. Committee staff
met with staff from VHA's Office of Emergency Management to
better understand the agency's ability to carry out its Fourth
Mission mandate and tour assets gained with funding to address
the COVID-19 pandemic. Staff also visited the dental clinic and
the residential rehabilitation program on campus. In addition,
staff also visited a local Vet Center in Martinsburg to hear
from providers about the services offered and the ongoing
challenges of filling open positions.
From December 4, 2023, to December 6, 2023, Committee
majority and minority staff conducted oversight of PACT Act
implementation at the VBA Leadership and Partners Engagement
Offsite in Kansas City, Missouri. Committee staff heard from
VBA leadership, including Under Secretary for Benefits, Josh
Jacobs, about claims automation and operation, outreach and
engagement, production projections, and process efficiencies.
Incorporating artificial intelligence and machine learning to
help prepare and process claims was also discussed. Staff also
heard from veteran service organizations and labor union
leadership about PACT Act implementation successes and
challenges.
From December 7, 2023, to December 8, 2023, Committee
minority staff conducted an oversight trip to North Chicago,
Illinois, to visit the Captain James A. Lovell Federal Health
Care Center. During this oversight visit, staff assessed the
operations of this joint VA/DOD medical facility and
preparedness for the VA new electronic health record rollout.
From December 8, 2023, to December 9, 2023, Committee
minority staff traveled to Topeka, Kansas, to participate in a
PACT Act outreach event at the Colmery-O'Neill Veterans'
Administration Medical Center. During this oversight visit,
staff met with local leaders from VA and from the Kansas
Commission on Veterans Affairs as well as with numerous
veterans seeking information on, and assistance with, their VA
benefits.
From December 11, 2023, to December 15, 2023, the Committee
majority staff conducted an oversight visit to Montana. In
Butte, staff visited the new CBOC to see the facility and
stopped by the State Veterans Home to check in on the status of
construction delays. Staff visited the VAMC in Ft. Harrison to
hear from acting facility leadership regarding ongoing efforts
to improve care and services locally and across the state.
Staff traveled to Browning to see the site chosen for the CBOC
and better understand the remaining renovations needed to open
the clinic. In Kalispell and Hamilton, staff visited future
CBOC sites. Staff also toured the CBOC in Missoula, hearing
from staff about staffing challenges, and visited with Vet
Center staff to learn about the services offered and the
ongoing difficulties with outreach in such a highly rural
state.
B. Second Session (2024)
From January 3, 2024, to January 5, 2024, Committee
majority and minority staff traveled to Nashville, Tennessee,
to attend the national conference for the Student Veterans of
America. During this oversight visit, staff spoke on a panel to
provide a legislative update regarding the GI Bill and
Congressional efforts to improve education benefits from VA.
Staff also attended panels with staff from VA and DOL and met
with student veterans individually and in focus meetings to
discuss issues and barriers for student veterans and how
resources could be improved to better serve student veterans.
On January 22, 2024, Committee majority staff conducted an
oversight visit of the Alexandria Vet Center to discuss
staffing and veteran trends.
On March 18, 2024, Committee majority staff conducted an
oversight visit of the Baltimore VAMC and also visited the
Baltimore Station, which houses homeless veterans.
On March 21, 2024, Committee minority staff traveled to VA
Central Office in Washington, DC to oversee the VA Operations
Center. During this oversight visit, staff met with VA staff to
discuss VA security and emergency operations, particularly
procedures related to supporting local emergency response and
VA's Fourth Mission.
From April 1, 2024, to April 5, 2024, Committee minority
staff traveled to Kansas to visit VA and DOD facilities. During
this oversight visit, staff met with leaders Transition Program
Managers at Fort Leavenworth and Fort Riley to discuss the
transition program for servicemembers. While on base, staff
connected with the Veterans of Foreign Wars Service Officer for
Fort Leavenworth to discuss challenges the VFW faces when
assisting veterans. Staff also visited the Wichita Regional
Office, the Kansas Veterans Cemetery at Winfield, and the Fort
Scott National Cemetery to discuss issues unique to their
respective facilities and locations.
On May 1, 2024, Committee majority staff attended VA's
Veterans' Family, Caregiver, and Survivor Advisory Committee
meeting in Washington, DC, and heard from Department officials
about end-of-life planning for veterans, the Pension and
Fiduciary Program, the Office of Survivors Assistance, the
Survivor and Memorial Program, and potential recommendations by
the Advisory Committee.
On May 6, 2024, Committee minority staff traveled to
Martinsburg, West Virginia to visit the VA Operations Center.
During this oversight visit, staff discussed VA's plans for
continuity of operations in a disaster scenario.
On May 13, 2024, Committee majority staff attended the
Military Officers Association of America-Quality of Life
Foundation Roundtable in Alexandria, Virginia on VA's Caregiver
Support Program to discuss improvements that should be made to
the Caregiver program.
From June 12, 2024, to June 14, 2024, Committee minority
staff traveled to North Chicago, Illinois, to visit the Captain
James A. Lovell Federal Health Care Center. During this
oversight visit, which was a follow-up to the prior oversight
visit in December 2023, staff discussed the progress of, and
ongoing challenges associated with, the VA new electronic
health record rollout.
From June 24, 2024, to June 29, 2024, Committee majority
and minority staff conducted oversight visits in St.
Petersburg, Florida, and San Juan, Puerto Rico. Staff visited
the St. Petersburg Regional Office, Bay Pines VA Medical
Center, San Juan Vet Center, 156th Air National Guard Wing, San
Juan Regional Office, Fort Buchanan, Puerto Rico National
Cemetery, Morovis National Cemetery, San Juan VA Medical
Center, and Endeavors--a Homeless Veterans' Reintegration
Program grant recipient. Committee staff also participated in a
roundtable with local veterans and VSO representatives in
Puerto Rico.
From June 26, 2024, to June 28, 2024, Ranking Member Moran
and Committee minority staff traveled to Kansas to attend the
ribbon cutting ceremony for the new VA Regional Office in
Wichita with VA Secretary McDonough. During this oversight
visit, Ranking Member Moran and staff met with local veterans,
VA staff, VSO representatives and other stakeholders and toured
the new Regional Office. While in Kansas, staff also visited
the Robert J. Dole VA Medical Center in Wichita and met with
the owner of Flint Hills Pain Management Clinic to discuss VA
community partnerships and access to new and innovative pain
management treatments for veteran patients.
From June 26, 2024, to June 30, 2024, Committee minority
staff traveled to Missouri and Arkansas to visit a variety of
VA and community facilities. In St. Louis, Missouri, staff
visited the VA Regional Office, the National Cemetery
Administration's National Training Center, the National
Archives and Records Administration's National Personnel
Records Center, and a local non-profit service dog
organization. In Little Rock, Arkansas, staff visited the VA
Law Enforcement Training Center, the Veteran Villages of
America, the Little Rock National Cemetery, and the Arkansas
State Veterans Cemetery.
On July 30, 2024, Committee minority staff traveled to
Tennessee to VA's Military Sexual Trauma National Training
Symposium. During this oversight visit, staff listened to
speakers, including VA Secretary Denis McDonough, and learned
about efforts VA is undertaking to improve training,
transparency, and the dissemination of best practices among
claims processers and MST coordinators.
From August 5, 2024 to August 12, 2024, the Committee
majority staff conducted an oversight visit to Montana to
assess ongoing needs and improvements following significant
leadership and operational shifts since summer 2023. They
visited VA facilities and veteran homelessness providers, met
with veterans, and held town halls with VA staff in Missoula,
Kalispell, Browning, Helena, and Butte.
On August 7, 2024, Committee majority and minority staff
traveled to Springfield, Illinois, to attend the AMVETS 78th
National Convention. During this oversight visit, staff took
questions and listened to concerns from AMVETS members about VA
health care, benefits, and funding.
On August 12, 2024, to August 14, 2024, Committee minority
staff traveled to Las Vegas, Nevada, to attend the summer
conference for the National Association of State Approving
Agencies. During this oversight visit, staff participated in a
legislative panel on education issues facing veterans and their
families and met with individual State Approving Agencies from
across the country to discuss hurdles they are facing in
current statute as well as VA policies.
From August 23, 2024, to August 26, 2024, Committee
minority staff traveled to Detroit, Michigan, to attend the
National Conference of the National Guard Association of the
United States. During this oversight visit, staff met with
representatives from the Air Force, Army, and other defense
equities to discuss issues unique to the National Guard and
Reserve components. Staff also met with Guardsmen from all 54
states and territories as well as the Acting Chief of the
National Guard Bureau, the Chief of Staff of the Army, the
Chief of Staff of the Air Force, the Acting Director of the Air
National Guard, and the Air Force Assistant Secretary for
Manpower and Reserve Affairs. Former National Guard Generals
were also in attendance, and throughout the engagements, staff
discussed Guard priorities, including employment, transition,
family issues, military duty status reform, and access to
health care.
From August 24, 2024, to August 25, 2024, Committee
minority staff traveled to New Orleans, Louisiana, to attend
the National Convention of The American Legion. During the
oversight visit, staff participated in a legislative panel and
answered questions from Legionnaires. Staff also visited with
veterans from across the country, and globe, to discuss
veterans issues.
From September 3, 2024, to September 5, 2024, Committee
majority staff conducted oversight visits in Minneapolis,
Minnesota, and Chicago, Illinois. Staff visited the Minneapolis
VA Medical Center, Lovell Federal Health Care Center, and the
VA National Acquisition Center.
From September 3, 2024, to September 6, 2024, Committee
minority staff traveled to Kansas to visit VA facilities. In
Topeka, staff toured the Colmery-O'Neil VA Medical Center and
met with representatives from the Veterans Crisis Line call
center and the women's health center in Topeka, Kansas. Staff
also visited the Dwight D. Eisenhower VA Medical Center and the
Leavenworth National Cemetery in Wichita, Kansas, to engage in
discussions about the domiciliary and Enhanced Use Lease on
site.
On September 6, 2024, Committee majority staff attended the
VA's Quadrennial National Women Veterans Summit in Washington,
DC, and attended briefings on PACT Act implementation, VHA's
reproductive health care and services, mental health care and
services, and also heard updates on the MST Operations Center
and the Defense Sexual Assault Database.
On September 17, 2024, Committee majority staff attended
the Wounded Warrior Projects Women Warriors Panel in Arlington,
VA, to hear from women veterans and active duty members to
highlight the many contributions they make to national
security.
On September 24, 2024, Committee majority and minority
staff traveled to Arlington, Virginia, to attend the National
Convening of the Elizabeth Dole Foundation. During this
oversight visit, minority staff participated in a panel with
caregivers and representatives from non-profit organizations
and educational institutions to discuss how to improve services
and support for caregivers of military veterans.
On September 25, 2024, Committee majority staff attended
the Duke University Veteran Transitions Research Lab
Washington, DC, summit and third annual convening to discuss
the latest academic research related to veterans' transition
from military service, and how to apply scientific research to
addressing real world challenges of transition.
From October 6 to October 8, 2024, Committee minority staff
traveled to Dallas, Texas, to participate in meetings at the
George W. Bush Presidential Institute. During this oversight
visit, staff met with representatives from government, private
sector, and nonprofit organizations that focus on serving
veterans to discuss the current needs of American military
veterans and how different organizations work to address
various needs of the veteran population.
On October 10, 2024, Committee majority and minority staff
traveled to Virginia Beach, Virginia, to attend the annual
meeting of the Nurses Organization of Veterans Affairs. During
this oversight visit, staff participated in a panel to provide
Congressional updates and answer questions from VA nurses
across the country.
On October 22, 2024, Committee minority staff traveled to
Roanoke, Virginia, to visit the VA Regional Office. During this
oversight visit, staff met with VA leaders and staff, including
claims processors, to discuss improving the claims process for
veterans who have experienced military sexual trauma.
On October 28, 2024, Committee minority staff traveled to
the Washington, DC, VA Medical Center. During this oversight
visit, staff met with VA staff to discuss issues including
community care, mental health care, suicide prevention,
workforce management, homeless services, caregiver support, and
security and emergency preparedness.
On October 30, 2024, Committee minority staff traveled to
Mountain Home, Tennessee, to visit the James H. Quillen VA
Medical Center. During this oversight visit, staff met with
local VA staff to discuss allegations of misconduct. Staff also
met with employees from the Veterans Integrated Service
Network, the facility, and representatives of the local
American Federation of Government Employees union.
On November 20, 2024, Committee majority staff attended the
Pew Charitable Trusts ``Supporting Veterans' Transition into
the Workforce'' Symposium in Washington, DC, with stakeholders
including DOL VETS, VA, DOD, Syracuse Institute for Veterans
and Military Families, and Hiring Our Heroes to facilitate
greater information sharing and coordination across groups
involved with support veterans' transitions from military
service.
IV. NOMINATIONS
NOMINATIONS
----------------------------------------------------------------------------------------------------------------
Date of
Name and position nomination Date of hearing Date reported Date confirmed
----------------------------------------------------------------------------------------------------------------
First Session
Anjali Chaturvedi........... January 3, 2023
General Counsel of the
Department of Veterans
Affairs
Joshua D. Jacobs............ January 23, 2023 February 16, 2023 March 8, 2023 April 26, 2023
Under Secretary for
Benefits of the
Department of Veterans
Affairs
Tanya J. Bradsher........... April 25, 2023 May 31, 2023 July 13, 2023 September 12, 2023
Deputy Secretary of
Veterans Affairs
----------------------------------------------------------------------------------------------------------------
V. BUDGET FOR VETERANS PROGRAMS
A. First Session (2023)
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 2024 budget for veterans' programs. The
letter submitted is printed below in its entirety:
April 4, 2023.
Hon. Sheldon Whitehouse, Chairman,
Hon. Charles E. Grassley, Ranking Member,
Committee on the Budget,
U.S. Senate, Washington, DC.
Dear Chairman Whitehouse and Ranking Member Grassley:
Pursuant to Section 301(d) of the Congressional Budget Act of
1974, I write to provide 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 for Fiscal Year (FY) 2024 provides a modest
increase for Department of Veterans Affairs' (VA) spending on
veterans programs. The bulk of the increase is for implementing
Public Law 117-168, the Sergeant First Class Heath Robinson
Honoring our Promise To Address Comprehensive Toxics Act of
2022 (the PACT Act), which was enacted in August 2022.
Additional resources are necessary as VA works to provide
timely, high-quality delivery of veterans' health care and
benefits to an expanded population of veterans.
On February 28, 2023, 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.
During my time on the Committee, these hearings have been
invaluable in helping me better understand the legislative and
budgeting priorities. Almost every single VSO who testified
this year noted PACT Act implementation as the top issue of
concern for their organization and members. As Chairman, I have
restated my belief that Congress should be taking its cues from
our nation's servicemembers, veterans, and their families on
how we can best 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 ``The
Independent Budget Veterans Agenda for the 118th Congress:
Budget for Fiscal Years 2024-2025 and Critical Issues''
(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 and for veterans is also supported by many
other organizations that care deeply about veterans and their
families.
The IB notes PACT Act implementation as a top issue for FY
2024, especially as the Administration moves to expand health
care and benefits eligibility to all eras of toxic exposed-
veterans in a more accelerated manner than originally designed
by the legislation. Related key priorities in the FY 2024 IB
include improving VA health workforce recruitment and retention
and modernizing VA infrastructure, which will help build the
Department's capacity to deliver expanded benefits and care
under the PACT Act. In order for VA to provide our veterans and
their families with the world-class services and benefits they
have been promised, PACT Act implementation and capacity-
building measures must receive focused support in the budget
resolution.
PACT Act Implementation
Cost of War Toxic Exposures Fund
The PACT Act represents the most significant expansion of
VA benefits and health care in decades for veterans exposed to
toxic substances during their service. Congress created the
Cost of War Toxic Exposures Fund (TEF) to cover the new costs
of health care and benefits delivery to toxic exposed-veterans
and ensure the care of veterans already in the system was not
disadvantaged by the costs of the new program. VA has a duty to
deliver quality health care and timely benefits for veterans
who were exposed to toxic substances during their service, and
must resource VA accordingly, so the Department can continue
PACT Act implementation and deliver on its promises to veterans
who experienced toxic exposure.
Funding for veterans' medical care within TEF is vital as
more veterans become eligible for VA health care, enroll in the
Veterans Health Administration (VHA) system, or have their
current priority level upgraded because they are diagnosed with
health conditions covered by the PACT Act. Veterans with toxic
exposure may also need more costly and specialized care,
depending on their diagnoses.
Lastly, full funding of the TEF is critical for the
Veterans Benefits Administration (VBA) successful
implementation of the PACT Act. TEF funding will enable VA to
hire 8,466 full-time equivalent (FTE) employees to process
toxic-exposure related claims, enhance automation program to
reduce the time veterans wait for benefits, and digitization of
military personnel files to ease processing of PACT Act claims.
Without this critical funding, VA could not carry out our
nation's promise to the brave men and women who were exposed to
toxic substances during military service. Veterans have filed
more than 424,000 claims for benefits under the PACT Act to-
date. In FY 2024, TEF funding would ensure VA can timely
process the 2.4 million claims the Department is projected to
receive, which is more than double FY 2022 actual levels due to
the expansion of benefits by the PACT Act.
Veterans Health Administration (VHA) Workforce
Thanks to the PACT Act, and VA's renewed focus on
recruitment and retention, in recent months VHA has seen its
first net increases in hiring in nearly 20 years. In 2023,
VHA's goal is to hire nearly 52,000 staff to account for both
vacancies and turnover. However, VA needs additional support
and authorities to meet this goal and maintain momentum. The
Department needs funding to support the provisions in the PACT
Act including expanding access to the Education Debt Reduction
Program, which has become a highly popular retention tool;
offering special salary rates for particularly hard-to-hire
positions; and to hire and retain more human resources staff.
As of February 28, 2023, Human Resources Management and Human
Resources Assistant positions have a 25 percent vacancy rate
across VHA. Filling these positions and offering creative
retention support will be essential to meeting VHA's broader
hiring goals.
In addition to existing programs and flexibilities,
authorizing Committees are considering further adjustments to
pay caps, expanded access to continued professional education
reimbursement, and recalibration of data reporting to provide a
better view of the successes and pitfalls of VA's hiring
process to measure success and address remaining issues. This
pending legislation is entitled the VA Clinician Appreciation,
Recruitment, Education, Expansion, and Retention Support
(CAREERS) Act of 2023. The estimated cost for these provisions
is between one and two billion dollars.
VA Infrastructure
Although the President's FY 2024 Budget requests an
increase in total infrastructure funding compared to FY 2023, a
closer examination shows unstable and inconsistent funding
overall, particularly in the Major and Minor Construction
accounts. With enactment of the PACT Act, it is more critical
than ever to ensure VA is appropriately investing in new
health, benefits, and memorial affairs facilities while also
dedicating funds for renovations, preventative maintenance,
seismic repair, and other safety projects. This includes
directing funding towards improvements to ensure all VA health
facilities are welcoming and can provide needed services to
women veterans who account for over 30 percent of the increase
in veterans served at VA over the past five years. As of
January 2023, VA still has $492 million in unfulfilled women
veteran infrastructure retrofit projects. Congress directed VA
to prioritize this work in the Deborah Sampson Act, which was
enacted in January 2021 as part of P.L. 116-315, Johnny Isakson
and David P. Roe, M.D. Veterans Health Care and Benefits
Improvement Act of 2020.
The PACT Act expanded health care and benefits eligibility
to millions of veterans. While the law did include $6.4 billion
for 31 major medical clinics, research facilities, other
facilities, and investments in enhanced-use lease projects, all
of these funds were narrowly focused and are spread out over
many years. These provisions are no substitute for robust
funding in VA's two base discretionary accounts dedicated to
new facilities or significant modernizations--the Major and
Minor accounts. These accounts are critical to funding projects
in every state in the country, including modernization of VBA
regional offices which are essential for the timely processing
of veterans' disability claims and related VBA services.
VA's own FY 2024 budget identifies $105 to $129 billion in
needed infrastructure projects, including up to $29 billion and
$26 billion for Major and Minor construction, respectively,
over ten years. The Department provided more than 500 pages of
detail for these and other projects; however, VA only requested
a small fraction of the needed amount in the FY 2024 budget
request--not even reaching one-tenth of the required resources.
Specifically, VA's FY 2024 Budget proposes a 39 percent
decrease in base Major Construction funding--down to $881
million from the FY 2023 enacted level of $1.4 billion. Minor
Construction's base funding request of $680 million grew by 9
percent, but this funding level is inadequate given a minimum
$2.6 billion per year need.
The President's budget supplements the Major Construction
request through an additional investment of $600 million from
the Recurring Expenses Transformational Fund (RETF) and a
brand-new mandatory major and minor construction effort funded
at $1.5 billion and $400 million respectively. While I fully
support the use of the RETF to supplement VA's infrastructure
budget and I am open to understanding the Administration's
proposal for major and minor mandatory funding--neither of
these are a substitute for base funding of these critical
accounts.
For a decade or more, VA's critical infrastructure accounts
have not kept pace with the growing need to recapitalize VA's
infrastructure, increased construction costs and inflation, and
the demand for more services from veterans--in addition to laws
Congress enacted adding new programs and benefits for veterans.
VA's data indicates the average VA medical center was built
nearly 60 years ago--compared to just 13 years ago in the
private sector.
Modern infrastructure is the cornerstone of VA health care
and benefits delivery. The longer Congress waits to take
decisive action, the more VA infrastructure upgrades will cost
taxpayers in the long term. And more importantly, those
existing subpar VA facilities will hamper the ability to
deliver world-class health to veterans consistently across the
country. It is time for Congress to make an independent
judgement of the infrastructure investment levels needed to
support our nation's veterans, just as we do each year in the
Defense and Military Construction Appropriations accounts where
Congress regularly provides funding above the President's
request to meet the needs of our military. We must do the same
when it comes to VA infrastructure to best serve veterans as
part of our moral obligation and national security priorities.
For all of the above reasons, I recommend the budget resolution
include an increase of $1 billion for the Major and Minor
Construction base accounts, respectively, while demanding
improvements in VA project execution performance as directed in
my proposed BUILD for Veterans Act. These funding increases
should include increases in resources for the hiring of
relevant infrastructure engineers, planners, and other
pertinent staff that are critical to VA's infrastructure
project execution.
Closing
I thank the Committee on the Budget for its attention to
these views and estimates on the FY 2024 budget and FY 2025
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.
------
B. Second Session (2024)
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 2025
budget for veterans' programs. The letter submitted is printed
below in its entirety:
April 17, 2024.
Hon. Sheldon Whitehouse, Chairman,
Hon. Charles E. Grassley, Ranking Member,
Committee on the Budget,
U.S. Senate, Washington, DC.
Dear Chairman Whitehouse and Ranking Member Grassley:
Pursuant to Section 301(d) of the Congressional Budget Act of
1974, I write to provide views and estimates to the Committee
on the Budget regarding matters within the jurisdiction of the
Committee on Veterans' Affairs (the Committee). While the
President's Budget request for Fiscal Year (FY) 2025 provides a
total request of $369.3 billion for the Department of Veterans
Affairs (VA), representing a 10% increase over FY 2024, I am
concerned by the Department's planned cuts to its medical
workforce in light of unprecedented enrollment growth--spurred
by Public Law 117-168, the Sergeant First Class Heath Robinson
Honoring our Promise to Address Comprehensive Toxics Act of
2022 (the PACT Act).
In 2023, VA served more veterans than ever before. This
included providing more than 118 million clinical appointments
and processing more than 1.9 million disability compensation
and pension claims, breaking the previous year's record by
nearly 16%. Much of this unprecedented growth stems from the
continued implementation of the PACT Act. VA announced in a
recent press release that between March 2023 and March 2024,
enrollment had increased in its health care system by nearly
30% thanks to authorities in the PACT Act. That same release
also noted the PACT Act has allowed more than 746,500 veterans
to upgrade their priority group since being signed into law.
While the topline numbers requested in the President's
Budget appear robust, how they are ultimately arrived at is
concerning. For example, in the smaller accounts that make up
Medical Care there is a growing reliance on transfers and
unobligated balances, frequently called ``carryover,'' to
supplement baseline requests. This is especially apparent in
the Medical Community Care account in FY 2025. Since
implementing Public Law 115-182, the John S. McCain III, Daniel
K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems
and Strengthening Integrated Outside Networks Act of 2018 (the
MISSION Act), VA has witnessed steady double-digit growth in
community care spending. VA's baseline request of $20.4 billion
for FY 2025, unchanged from its previous Advance Request for
Community Care, cannot meet demand based on past obligations.
When transfers from other Medical Care accounts (more than $7.9
billion), carryover ($1.5 billion), and collections ($901
million) are factored in, the baseline request jumps closer to
$30 billion. Additional funds from the mandatory Cost of War
Toxic Exposure Fund or TEF cap off total obligations for the
Medical Community Care account to a more realistic $40.9
billion for FY 2025--more than doubling the at-first-glance
funding for non-VA care.
This is about more than just funding. VA's planned medical
workforce reductions in FY 2025, coupled with its existing
``zero growth'' initiative, which seeks to keep the full-time
equivalent employee (FTE) number flat between FY 2023 and FY
2024, will directly impact the Department's ability to provide
timely, quality care to veterans and consequently expand
eligibility for community care. In FY 2023, nearly 40% of the
total VA health care workload was delivered in the community
despite having a robust workforce. When veterans can't be seen
in a timely manner or have to drive too far for services, they
need to be quickly connected with community care. However,
veterans should not have their choice for VA removed because
the Department isn't appropriately staffed to meet their needs.
Study after study--including findings recently published in The
Journal of General Internal Medicine--shows VA health care is
as good as or superior to what individuals get outside of VA. A
recent nationwide Medicare survey of patients showed VA
outperformed non-VA hospitals in all 10 core patient
satisfaction metrics, including overall hospital rating,
communication with doctors, communication about medication, and
willingness to recommend the hospital. Making sure veterans
have access to the best care available is a no-brainer. That
means VA needs to continue to hire and retain quality
personnel.
On the mandatory side of the ledger, the TEF remains a
vital tool in VA's implementation of the PACT Act. Public Law
118-5, the Fiscal Responsibility Act of 2023 (FRA) provided VA
$24.5 billion for TEF in FY 2025, representing a $4 billion
increase over the previous fiscal year. The increased TEF
funding will cover the growing demand for health care
associated with toxic exposure, maintain more than 6,900 FTE
claims processing personnel, and continue expanding benefits to
toxic-exposed veterans. Congress must maintain support for
robust TEF funding.
With the influx of veterans and survivors applying for PACT
Act benefits, VA expects to significantly increase the number
of disability compensation claim decisions it issues in FY 2025
to 2.4 million, 400,000 more than it completed in FY 2023. In
light of this increase in workload, it is troubling that the
total budget requests for the Veterans Benefits Administration
and the Board of Veterans' Appeals have decreased in FY 2025.
I thank the Committee on the Budget for its attention to
these views and estimates on the FY 2025 budget and FY 2026
advance appropriations requests for VA and matters within the
Committee on Veterans' Affairs jurisdiction. Following this
letter is an appendix with a more expansive assessment of VA's
budget request. 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
ANGUS KING, Maine
Tony McClain, Staff Director
David Shearman, Republican Staff
Director
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