S.Hrg.119-13

1[Senate Hearing 119-13]2[From the U.S. Government Publishing Office]34                                                         S. Hrg. 119-1356                      NOMINATION OF THE HONORABLE7                          PAUL LAWRENCE TO BE8                  DEPUTY SECRETARY OF VETERANS AFFAIRS910=======================================================================1112                                HEARING1314                               BEFORE THE1516                     COMMITTEE ON VETERANS' AFFAIRS17                          UNITED STATES SENATE1819                    ONE HUNDRED NINETEENTH CONGRESS2021                             FIRST SESSION2223                               __________2425                           FEBRUARY 19, 20252627                               __________2829       Printed for the use of the Committee on Veterans' Affairs3031[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]3233        Available via the World Wide Web: http://www.govinfo.gov3435                                __________3637                   U.S. GOVERNMENT PUBLISHING OFFICE3859-383 PDF                  WASHINGTON : 20253940-----------------------------------------------------------------------------------4142                 SENATE COMMITTEE ON VETERANS' AFFAIRS4344                     Jerry Moran, Kansas, Chairman45John Boozman, Arkansas               Richard Blumenthal, Connecticut,46Bill Cassidy, Louisiana                  Ranking Member47Thom Tillis, North Carolina          Patty Murray, Washington48Dan Sullivan, Alaska                 Bernard Sanders, Vermont49Marsha Blackburn, Tennessee          Mazie K. Hirono, Hawaii50Kevin Cramer, North Dakota           Margaret Wood Hassan, New51Tommy Tuberville, Alabama                Hampshire52Jim Banks, Indiana                   Angus S. King, Jr., Maine53Tim Sheehy, Montana                  Tammy Duckworth, Illinois54                                     Ruben Gallego, Arizona55                                     Elissa Slotkin, Michigan5657                     David Shearman, Staff Director58                Tony McClain, Democratic Staff Director5960                           C O N T E N T S6162                              ----------6364                           February 19, 20256566                                SENATORS6768                                                                   Page69Hon. Thom Tillis, U.S. Senator from North Carolina...............     170Hon. Richard Blumenthal, Ranking Member, U.S. Senator from71  Connecticut....................................................     272Hon. Tommy Tuberville, U.S. Senator from Alabama.................    1073Hon. Mazie K. Hirono, U.S. Senator from Hawaii...................    1274Hon. Tim Sheehy, U.S. Senator from Montana.......................    1475Hon. Margaret Wood Hassan, U.S. Senator from New Hampshire.......    1576Hon. John Boozman, U.S. Senator from Arkansas....................    1877Hon. Ruben Gallego, U.S. Senator from Arizona....................    1978Hon. Angus S. King, Jr., U.S. Senator from Maine.................    2179Hon. Marsha Blackburn, U.S. Senator from Tennessee...............    2380Hon. Tammy Duckworth, U.S. Senator from Illinois.................    2581Hon. Patty Murray, U.S. Senator from Washington..................    2782Hon. Jim Banks, U.S. Senator from Indiana........................    2983Hon. Elissa Slotkin, U.S. Senator from Michigan..................    308485                                NOMINEE8687Hon. Paul Lawrence, PhD, Nominee To Be Deputy Secretary of88  Veterans Affairs...............................................     58990                                APPENDIX91                          Nomination Material9293Hon. Paul Lawrence, PhD, Nominee9495  Prepared Statement.............................................    439697  Response to Pre-Hearing Questions for the Record submitted by:9899    Hon. Jerry Moran.............................................    47100101    Hon. Richard Blumenthal......................................    52102103  Response to Follow Up Pre-Hearing Questions submitted by:104105    Hon. Richard Blumenthal......................................    58106107  Response to Questions for the Record submitted by:108109    Hon. Richard Blumenthal......................................    60110111    Hon. Bernard Sanders.........................................    62112113  Questionnaire for Presidential Nominees........................    65114115                       Submissions for the Record116117List of Unanswered Requests for Information......................    87118119List of Unanswered Letters.......................................    91120121Hiring Freeze; Letter to President Donald J. Trump, dated January122  23, 2025.......................................................    92123124Firing of VA Inspector General, Michael J. Missal; Letter to125  President Donald J. Trump, dated January 31, 2025..............    96126127                   Submissions for the Record (cont.)128129Day One Commitments; Letter to VA Secretary Douglas A. Collins,130  dated February 4, 2025.........................................    98131132DEI Executive Order; Letter to President Donald J. Trump, dated133  February 5, 2025...............................................   100134135Department of Government Efficiency (DOGE) at VA; Letter to VA136  Secretary Douglas A. Collins, dated February 6, 2025...........   101137138Resignation Offers; Letter to VA Secretary Douglas A. Collins,139  dated February 7, 2025.........................................   105140141Telework and Remote Work; Letter to VA Secretary Douglas A.142  Collins, dated February 10, 2025...............................   107143144Federal News Network article ``Despite exemptions, VA employees145  still feeling impact from policies shaking up federal146  workforce''....................................................   109147148                      NOMINATION OF THE HONORABLE149                          PAUL LAWRENCE TO BE150                  DEPUTY SECRETARY OF VETERANS AFFAIRS151152                              ----------153154                      WEDNESDAY, FEBRUARY 19, 2025155156                                       U.S. Senate,157                            Committee on Veterans' Affairs,158                                                    Washington, DC.159    The Committee met, pursuant to notice, at 9:36 a.m., in160Room SR-418, Russell Senate Office Building, Hon. Thom Tillis,161presiding.162163    Present: Senators Tillis, Boozman, Cassidy, Blackburn,164Tuberville, Banks, Sheehy, Blumenthal, Murray, Hirono, Hassan,165King, Duckworth, Gallego, and Slotkin.166167             OPENING STATEMENT OF HON. THOM TILLIS,168                U.S. SENATOR FROM NORTH CAROLINA169170    Senator Tillis. This hearing will come to order. I'm going171to be filling in for Senator Moran who had logistics issues172getting back to DC today, and I'm looking forward to173considering the nomination of Paul Lawrence for Deputy174Secretary of Veterans Affairs.175    The role of Deputy Secretary of Veterans Affairs is176important. Serving as the second in command, chief operating177officer, and co-chair of the VA/DoD Joint Executive Council.178The Deputy Secretary also oversees Electronic Health Record179Modernization, and works with Secretary Collins to make certain180that VA is high performing, accountable, fiscally responsible,181and veterans-focused.182    Dr. Lawrence was raised in an Army family, and is an Army183veteran who knows firsthand what military service means, and184the necessity of supporting veterans throughout their civilian185lives. He's also familiar with many of us, given his prior186service in the VA. He's familiar to many of us because he was187the Under Secretary for Benefits, a position he held from 2018188until 2021.189    During that time, the Veteran Benefits Administration had190the lowest disability claims backlog in history and underwent191significant reform as a result of legislation like the Forever192GI Bill, the Appeals Modernization Act, and the Blue Water Navy193Vietnam Veterans Act.194    I'm grateful to Dr. Lawrence for his willingness to once195again step up and serve his fellow veterans in a leadership196position at the VA, and I look forward to his testimony today.197I also want to acknowledge the family members accompanying Dr.198Lawrence this morning, which include his wife, Anne, his son,199Gregory, and his brother, Chris. If you can raise your hands?200Thank you-all for being here.201    And on a final note, there's a certain amount of pride that202comes from the fact that we did cross paths not directly203working together at PricewaterhouseCoopers, what I would204consider to be an extraordinarily good experience for the sort205of perspective that Mr. Lawrence should bring into the VA. And206I look forward to seeing this engagement, Mr. Lawrence, like so207many engagements you and I oversaw back in our time at PW.208    With that, I'll yield a Ranking Member Blumenthal for his209opening remarks.210211         OPENING STATEMENT OF HON. RICHARD BLUMENTHAL,212         RANKING MEMBER, U.S. SENATOR FROM CONNECTICUT213214    Senator Blumenthal. Thank you, Senator Tillis. And thanks215for chairing this Committee, probably on short notice. Welcome,216Dr. Lawrence, welcome to your family, and thank you for your217willingness to serve in this very, very important position, for218a second time, in a position critical to our Nation's veterans.219    As you know, the Deputy Secretary is the department's220second highest official tasked with executing VA's Electronic221Health Record Modernization program, strengthening VA's222collaboration with the Defense Department on the VA/DoD Joint223Executive Committee, and many, many other critical224responsibilities. While these formal roles are important, I'm225more focused on your fitness to serve as the VA's chief226operating officer, and your willingness to push back against227recent directives that harm veterans and the mission of the VA.228    During the nomination process for Secretary Collins, this229Committee was assured veterans would always come first, and we230were promised transparency and consultation even when we231disagree with decisions being made. Now, the Chairman and I232learn of far-reaching decisions after the fact, and almost233always directly from the press, from VA employees, or from234veterans, never from the VA leadership. And when we ask for235reasonable questions about those decisions and their potential236impact, we are directed toward non-answer press releases. But237we get no responses at all.238    Mr. Chairman, I would like to submit for the record a list239of 22 unanswered requests for information that I've submitted240to the VA since January 20th.241    Senator Tillis. Without objection.242243    [The list referred to appears on page 87 of the Appendix.]244245    Senator Blumenthal. I would also like to submit for the246record seven letters on urgent issues facing veterans care and247benefits that I've sent to the administration, most with many248of our colleagues joining, and that includes three to President249Trump, four to Secretary Collins. None of these letters have250received a response.251    Senator Tillis. Without objection.252253    [The letters referred to appear on pages 92-108 of the254Appendix.]255256    Senator Blumenthal. Thank you. We've been told everything257will be fine and no harm will come to veterans from the Trump258and Musk slash and trash policies. But despite these vague259assurances, we know it's not the reality. In fact, because of260the actions of this administration, we've been made aware of261numerous detrimental developments across the country.262    Openings for new clinics have been delayed because they263can't hire the necessary staff to open their doors. Service264lines at VA hospitals and clinics have been halted. Beds and265operating rooms at VA hospitals have been reduced. Support266lines for caregivers have been cut down. Veterans' crisis line267employees have been fired. And suicide prevention training268centers, that's right, suicide prevention training sessions269have been postponed or canceled. It's incredible.270Transportation options for disabled veterans have been reduced271because volunteer drivers can't get credentialed.272    The Secretary has also said Elon Musk has not and will not273be granted access to veteran's personal information, but we274know that is simply not true. Not only does Musk and his team275have access to that information at Treasury, they have the276ability to alter, yes, alter, that information. And it's only a277matter of time until they access additional information on278veterans from the VA or another agency.279    This weekend, we learned the White House is attempting to280grant access for a Musk employee to the IRS tax systems281containing personal identification numbers and bank information282of up to 150 million Americans, including veterans. Meanwhile,283VA employees have been told there is nothing to fear. Nothing284to fear as long as they work hard, but we know that's not true285either.286    Many have been pressured to abandon their jobs by Musk and287his resignation offers that aren't based on reality or the law.288More than 1,000 employees, including a substantial number of289veterans, and those with exemplary performance records, were290abruptly and illegally fired in a move that was publicly291celebrated by the VA Secretary. This action was part of last292week's broad purge of tens of thousands of workers across293almost every government agency.294    All employees should have options to appeal these295decisions, but the President just illegally fired the chair of296the Merit Systems Protection Board, the independent agencies297established to protect the rights of federal employees. A298district court judge reversed that termination, at least299temporarily, just last night. They could appeal to the300Independent Office of Special Counsel that spends one-third of301its caseload on VA oversight and protecting whistleblowers. But302the President fired its Senate-confirmed leader.303    That dispute is now before the Supreme Court, but the304President seems insistent on having the VA Secretary run that305office in his spare time, running that office in addition to306the VA, unacceptable. And they could flag potential ethic307conflicts to the Office of Government Ethics. But that once308independent agency is now also run by the VA Secretary. Another309clear conflict of interest to all VA employees.310    And I know a third of you are veterans. I know you've had311your lives and your careers completely upended. We will keep312fighting for you. You chose a career of serving veterans, and313you deserve better than to be casually and unlawfully discarded314by an administration that places greater priority on political315loyalty than on fitness to serve. And to the veterans watching316today, including any who have contacted us directly and are317anxious about losing your access to VA healthcare or your next318benefits check, we hear you, we're going to keep fighting for319you.320    This administration may define collaboration as standing321silently on the sidelines while they dismantle the VA, but we322need to remind them that this Committee, this bipartisan323Committee, has traditionally embodied the word collaboration324coming from both sides of the aisle to pass historic325legislation like the PACT Act on behalf of veterans and their326families, standing up for their best interest every single327time, and performing robust and vigorous oversight no matter328who was in the White House.329    I'm here for this fight, and I know my democratic330colleagues are here for this fight. I just hope my Republican331colleagues will join us before it's too late. I know oversight332and transparency can be seen as threatening, especially when333you're on the wrong side of the law and the wrong side of334history, but the stakes are too high for any of us to be335silent.336    Dr. Lawrence, it's this context in which your nomination337will be considered. We need to know how you plan to navigate338these waters and whether you will actually put veterans first,339stand up for them, and make sure that they receive what they340have earned. It's not a gift, it's what they have earned. This341Committee, VA employees, and the veterans across the country342will be listening to you today.343    Thank you, Mr. Chairman.344    Senator Tillis. Mr. Lawrence, before I start with you. I345want to respond, in part, to what my friend and Ranking Member346has expressed. We're going through a transition now and there347are decisions being made about probationary employees.348    It's my understanding a good number of the people who have349decided to leave were probationary employees. I've asked to get350to the facts. I don't know about your training at351PricewaterhouseCoopers, but mine taught me to be very fact-352driven and boring. I like to focus on the specifics of the353allegations, and I have done that over the past almost four354weeks since some of the personnel moves have been made. And355quite honestly, some of the reports or allegations on day one356are disproven on day two.357    I'll give you one example. If you remember in the first358week, there was a discussion about Elon Musk having access to359detailed payments data. Now, we know that's actually not true.360That they were looking at code and the payment system to try361and determine either efficiency or improper payments. I have362done specific requests for access to that information. I363haven't found anything to substantiate the allegations of two364or three weeks ago.365    This is a large organization. It has critical positions,366and it has desirable, but maybe not critical positions. If367we're suggesting here that we've had mass terminations of368physicians, technicians, nurses, critical positions, then that369would certainly be concerning. And if there is evidence to that370effect, I would like to see it. But in the meantime, I think371we're dealing with a lot of transition, a new way of looking at372personnel management, which occurs when you have a transition373in the White House.374    I also think that we're talking about problems with the VA375that were here more than 20 days ago. I think some of these376problems are because there was a PACT Act that my office spent377a lot of time working on that didn't get the commitment to get378it right before it was passed out. And it resulted in a $3379billion shortfall in budgeting last year, and multi-billion380this year. These are all decisions that were made by Congress381that are undermining some of our ability to actually live up to382repaying or making another installment on a debt that we can383never fully repay for veterans who need our services.384    And you as a veteran, Mr. Lawrence, I think you bring385perspective based on your tenure in the VA. You bring the386perspective of a veteran and you bring the kind of perspective387that I believe is needed to even settle down and address,388maybe, some of the legitimate concerns that were expressed by389the Ranking Member.390    But now, let's move on to your testimony. Before I do, if391you'll please stand and raise your right hand. Dr. Lawrence, do392you solemnly swear or affirm that the testimony you're about to393give to the U.S. Senate Committee on Veterans' Affairs will be394the truth, the whole truth, and nothing but the truth, so help395you God?396    Dr. Lawrence. Yes, I do.397    Senator Tillis. Thank you, Dr. Lawrence. You may be seated.398You can continue and proceed with your testimony.399400  STATEMENT OF HON. PAUL LAWRENCE, PHD, NOMINEE TO BE DEPUTY401                 SECRETARY OF VETERANS AFFAIRS402403    Dr. Lawrence. Senator Tillis, Chairman Moran, Ranking404Member Blumenthal, and distinguished Members of the Committee,405thank you for the opportunity to be here today and for406considering my nomination. I would also like to thank President407Trump for the honor of this nomination and his trust in me.408Today, my objective is to earn your trust as well.409    As Senator Tillis has pointed out, I'm joined by my wife,410Anne, for 39 years, and my brother, Chris, also an Army Veteran411and Airborne Ranger. I also want to thank my 100-year-old412mother who's watching at home right now. I wouldn't be here413without all their love and support.414    The Senate Committee on Veterans' Affairs has a long415history of bipartisan accomplishments on behalf of America's416veterans. Your commitment to taking care of the men and women417who've worn the uniform is above reproach. I want you to know418that I share that commitment.419    I grew up in an Army family. My father served 24 years with420deployments in the Korean and Vietnam wars. He taught me many421valuable lessons about leadership and what it means to serve.422My middle name, Reynold was given to me in honor of my uncle423who was killed fighting in Normandy. My family's love of424country and tradition of service compelled my brother and I to425join the Army where we were both commissioned through ROTC.426During my tenure in the military, I graduated from the Army's427Airborne School, earned the Meritorious Service Medal, and rose428to the rank of captain. My service taught me the value of429leading with integrity, honor, and respect, but most430importantly, instilled in me a dedication to serving my fellow431veterans that has shaped my life's work.432    As Senator Tillis indicated, I spent many years as a433consultant bringing efficiencies to large organizations. Then,434I had the opportunity during the first Trump administration to435serve as VA's Under Secretary for Benefits, one of the most436rewarding experiences of my career. In that role, I led 24,000437employees as they administered the range of benefits including438disability compensation, pension, education, home loans,439veterans' readiness, and employment, and life insurance.440    During my time at VA, our Veterans Benefits Administration441team made great strides in increasing productivity, customer442service, and convenience for veterans. Here are a few443highlights of which I'm particularly proud. As Senator Tillis444pointed out, during my time at VBA, the disability claims445backlog was reduced to its lowest level ever. VBA guaranteed a446record 1.2 million home loans to veterans in FY 2020,447surpassing the previous record of 700,000. We successfully448launched the GI Bill, the Appeals Modernization Act, and the449Blue Water Navy Vietnam Veterans Act. We successfully launched450Solid Start and the Veterans Benefits Banking Program. BVA451reduced improper payments by more than $350 million. And in4522020, during the pandemic, I conducted 110 telephone town halls453that reached 5.7 million people, and I took more than 1,500454unfiltered questions about how we are serving veterans.455    If I have the privilege of returning to VA, I will work to456build on the many bipartisan successes of this Committee. To457that end, I pledge to work with you to get VA's Electronic458Health Record Modernization effort back on track. Ensure VA459provides veterans with the healthcare choices and options460Congress promised them as part of the MISSION Act. Properly and461faithfully implement the PACT Act. And put veterans at the462center of everything the department does, and make463accountability, customer service, and caring the cornerstone of464service among the department's workforce.465    If confirmed, I'll be a tireless advocate for the men and466women who fought for our liberty. And I will work to ensure467every eligible veteran and VA beneficiary gets the benefits and468services they've earned.469    Thank you, and I'm happy to take your questions.470471    [The prepared statement of Dr. Lawrence appears on page 43472of the Appendix.]473474    Senator Tillis. Well, you've already proven to be efficient475by yielding back one and a half of your five minutes even after476introducing your family members. So, you may have won some477right there.478    Mr. Lawrence, when I went up to say hello to you, you479mentioned that you were going to take me up on my offer to get480a little bit more engaged in the electronic health record481implementation. I mean, this has transcended Republican and482Democrat administrations. Now, for the life of me, I can't get483my head around the amount of money that's been spent versus the484value that's been derived. I mean, it's barely even485implemented. And the initial VISNs, it looks like it's486suboptimal and it's certainly not a best practice that the487entire VA is benefiting from.488    So, tell me, based on your past experience in the VA and489any knowledge that you have now, what do you think we--where490have we made mistakes, and what do we need to do differently to491get this behind us and give the incrementing and care this is492going to provide veterans?493    Dr. Lawrence. Certainly, Senator. Thank you for the494question. I mean, I think when Secretary Collins was here last495month describing his vision for what had to take place it was496very sound. Convening all the players as he described, figuring497out the best thinking and what can be done to get be498efficiencies to as many veterans as possible as quickly as499possible. I echo that.500    I think I would probably, foot stomp urgency, that we can't501spend months again studying what's going on and figuring out.502Now, what I will tell you from my time as Under Secretary, I503dealt with technology and multiple things. You heard me talk504about the GI Bill Appeals Modernization and Blue Water Navy.505All of those had a technology component.506    I focused in on three things. One was accountability. I was507always surprised how accountability was a challenge. And I508think that led to trouble in decision-making. There was a sense509of the right contractors, the right roles, the right contracts,510as well as additional oversight the VA gets from other511contractors to help check and monitor things. So, I would512probably start there, but as this--as the Secretary pointed513out, everything's on the table to sense--to come up with a plan514that can be implemented. And, if confirmed, I will work with515him to implement that plan.516    Senator Tillis. Tell me a little bit about what you learned517about drawing down the backlog for VA benefits and what may be518able to be applied, not only to the health record519implementation, but generally, the cleaning out the plumbing520and getting things done sooner and better for veterans.521    Dr. Lawrence. Certainly. Well, when I showed up, the522backlog was pretty low, but we drove it down. In fact, in523November 2019, just before the pandemic, we were actually524worried about running out of work. We were moving so fast525through disability claims.526    Senator Tillis. It's a good problem by the way----527    Dr. Lawrence. Yes, I know.528    Senator Tillis [continuing]. Don't never worry about that.529    Dr. Lawrence. Part of it was measurement and driving530accountability to the people who were processing claims to the531levels of management that were processing claims. Along the532way, I learned that the technology that supported the claims533processing effort needed to be improved. So, I spent a lot of534time improving the technology, and quite frankly, I spent a lot535of time in--actually, this is something that came from Senator536Isakson the first time I met him, which was, you know, stop537having VA do things that get in its own way.538    So, untangling some of the things that didn't need to be539done and really were just there because really increased540efficiency. So, it was a lot of things you would remember from541your consulting life people, process, and technology. It was542all there, but measurement really helped move things along. And543when things started to go well, the pride in the employees was544really pretty important.545    Senator Tillis. Well, since you yielded back one and a half546minutes of your introduction, I'll yield back my time. Senator547Blumenthal.548    Senator Blumenthal. Thank you. I'm happy to take those one549and a half minutes.550    Dr. Lawrence, this is a critical day, not just for you, but551for our veterans. Accountability begins today. Do you commit to552responding to the request for information that I have553submitted, along with my colleagues, numerous requests for554information and accountability within one week of your555confirmation, if it occurs?556    Dr. Lawrence. Senator, as you know, I'm not at the VA----557    Senator Blumenthal. That's a yes or no answer. Do you558commit to responding?559    Dr. Lawrence. Senator, I commit to receiving your questions560if confirmed. To looking at them, to understanding the561information you request. To meeting with you, to understand562that information, determine how best to provide you that563information.564    Senator Blumenthal. I'm going to hope that's a yes answer.565I'm going to hope, for our sake, but more important, for our566veterans, that you will be responsive and transparent, as so567far, this administration has utterly failed to be.568    Let me ask you, since January 21st, we've seen everything569from a hiring freeze to arbitrary firings of more than 1,000 VA570employees, to unelected, unaccountable individuals at the DOGE571Musk transition team, accessing IT systems that include572veterans' private information, and taking action that is573contrary to the interests of our veterans.574    The Chairman referred to a transition. Elon Musk seems to575regard veterans as roadkill on this so-called transition. And576as to the facts here, we're hearing facts directly from577veterans, VA employees, and others who have direct evidence of578the impacts, the human impacts, of these draconian cuts in579funding and staff. Do you support the administration's actions580so far?581    Dr. Lawrence. Thank you very much for the question,582Senator. Let me see if I can pull this apart. The information583as I understand it the DOGE employee at VA is accessing, is584limited to contracts, general operation, and management of the585IT system. This person does not have access to veterans' health586information, nor veterans' benefits information.587    Senator Blumenthal. Do you support the firing of 1,000 VA588employees?589    Dr. Lawrence. Senator, as described, I'm not there now, and590I do not know how this came about.591    Senator Blumenthal. So, you're not willing to answer that592question?593    Dr. Lawrence. What I am willing to talk about, sir, is what594I read in the press release. And what I read in the press595release about this activity appeared to be a very thoughtful596approach to determining who would be laid off in the sense that597it was not mission-critical. It was designed not to affect the598provision of healthcare and benefits. And there was a safeguard599where first level SES supervisors could opt somebody out of600that process.601    It was further described by the Secretary that the savings602generated by these layoffs, $98 million, would be used to603provide better care for our veterans. Consistent with what I604spoke.605    Senator Blumenthal. Well, I just want to submit to you,606respectfully, that firing VA employees who provide critical607services to veterans is mission-significant, and that the608unfairness and illegality of the actions take so far have609direct impacts on VA healthcare, on veterans who are610potentially suicidal. If you close the kinds of training611sessions and other direct help to veterans who say they're612going to take their own lives, that's mission-critical.613Wouldn't you agree?614    Dr. Lawrence. Sir, I can only tell you what I read and what615you're describing is inconsistent with what I read. That being616said, if confirmed----617    Senator Blumenthal. Well, it is inconsistent with what618you've read from the VA press releases. I challenge you, as the619person who's going to be chief operating officer, to learn620exactly what is happening and to be transparent with us.621    Let me ask you another question. Transportation for622disabled veterans have been reduced. Is that fair?623    Dr. Lawrence. Senator, thanks for the question. If624confirmed, I will look in that to understand how that's625happening, why it's happening.626    Senator Blumenthal. Service lines at VA hospitals and627clinics have been halted. Is that fair?628    Dr. Lawrence. Again, Senator, if confirmed, I will look629into that to understand why that's happening. Again, it's630inconsistent with what I read about the intent of the layoffs.631    Senator Blumenthal. And the kinds of appeals that VA632employees are entitled to take now are to offices that are held633by the VA Secretary himself. In effect, you're appealing your634firing to the person who fired you. Is that fair?635    Dr. Lawrence. Sir, again, if confirmed, I will look into636what are the process by which veterans----637    Senator Blumenthal. Well, I hope you look into these638questions quickly and equally important that you respond to us639as the Secretary has failed to do. Is that fair?640    Dr. Lawrence. Again, sir, if confirmed, I'll look into641this, and yes, I commit to figuring out a way to respond642quickly to requests once I'm confirmed.643    Senator Blumenthal. My time is expired. I have a lot more644questions for you, and I hope that you are more responsive, if645you're confirmed, than you have been so far. Thank you, Mr.646Chairman.647    Senator Tillis. Mr. Lawrence, I'm going to use about a648minute and a half of the minute and a half I gave up. Were you649advised, or was your opinion sought for any of the personnel650actions that have occurred in the last 20 or the last 30 days651of the new transition?652    Dr. Lawrence. No, I'm not employed by VA. I'm not engaged653in any decision-making.654    Senator Tillis. Have you in any way been reached, been655contacted to advise on strategy, numbers, positions,656conditions, anything related to the decisions that have been657taken by the administration transition?658    Dr. Lawrence. No, I have not.659    Senator Tillis. And Mr. Lawrence, you may hear a couple of660times today, there is frustration, and I can understand it from661the perspective of some of my colleagues on the other side of662the aisle. But it wouldn't surprise me as we hear in other663hearings if these allegations are true. I don't think that664Senator Blumenthal used those specific words today, but that is665Senator speak for--I haven't really confirmed it, but it sounds666good--and I think that you're not in a position to make a667commitment or to--I don't think that you've been called on as668an expert for this transition.669    Your position, when you get confirmed, is day one for you670at that point. I do believe that you should commit that--any671inquiries from the VA, we've been very frustrated in the Biden672administration, and the prior Trump administration, and the673prior Obama administration--with a lack of response from the674VA. That is not unique. And, hopefully, you and the Secretary675can change that trend. But I also think that it bears repeating676every time that we hear it today, that you're being asked to677opine on things you had nothing to do with, and all you have678are press reports at this time.679    Senator Blumenthal. Mr. Chairman, I want to respond since680you've characterized my questions. I don't know what Senator681speak is, but I know what I said, and I want to tell you, Dr.682Lawrence, what I said were the facts. And they sound bad. They683don't sound good. But I know what we've heard.684    And what's more disturbing to me is, apparently, you685haven't asked anything beyond reading these press releases in686preparation for your testimony today. Have you asked anyone in687the Veterans Administration for the facts?688    Dr. Lawrence. My interactions centered--thank you for that.689So, I can clarify. My interactions with the VA at this point690have been around preparation. They have not been around the691operation of the VA. I've been given public information about a692variety range of subject, but have not been involved in the693details about the decisions that led up to the----694    Senator Blumenthal. So, your approach to preparation is695apparently hear no evil, see no evil, just tell me what you696want me to say.697    Dr. Lawrence. Senator, I think that mischaracterizes my698approach to preparation. My approach to preparation is to find699all publicly available information that informs me about this700position. I'm guided by my experience from three years in the701first Trump administration, but I'm not involved in a topical702and timely decisions that are taking place in the operation of703VA.704    Senator Blumenthal. To a lot of veterans, Dr. Lawrence, and705I say this with due respect, this is going to sound what you've706just said, like bureaucratic gobbledygook, and I hope veterans707receive more facts. I hope you give us more facts. We've708complained, and it's been bipartisan, that government agencies709have failed to be responsive at the VA, and I hope that you do710better. Thank you.711    Senator Tillis. Senator Tuberville.712713                     HON. TOMMY TUBERVILLE,714                   U.S. SENATOR FROM ALABAMA715716    Senator Tuberville. Thank you very much. Thank you Doctor717for being here today and willing to take this on. As you can718tell, it's pretty volatile. We all care about our veterans. I719grew up in a military family, and my dad spent a lot of time in720the VA. We've got a lot of good VAs across this country. We in721Alabama, we've got a lot of good ones. We've got a lot of bad722ones. But it usually comes down to personnel.723    And when I first got here, President Trump had evaluated724and released 4,000 people from the VA. And the Biden725administration rehired them back and with back pay without any726evaluation. We have not had any evaluation from those 4,000727since I've been here for four years. People need to be728evaluated, and if they can't do the job, or they're negligent,729especially in healthcare, they need to be let go. So, I'd hope730that we really look into the people running our VAs, and I know731you'll do that.732    One thing I'm concerned about, and since I've been on this733Committee, we have Big Tech that could be very valuable to our734VAs. Big Tech has done a great job in a lot of areas;735hyperbaric chambers. I've been pushing that for years of trying736to get our veterans to be able to use hyperbaric chambers for737PTSD, which are not covered in the VA. Their health, their738insurance will not cover it. We need to grow up in this739business.740    There's an ultrasound system that is used now for PTSD that741is very, very successful. One in North Carolina, one in San742Francisco that I've had friends go to that has saved their743life. For the life of me, we cannot get the VA to approve of744this system to be used by veterans, even though we don't have745them in the VAs.746    Would you commit that we would really look hard into these747new systems that have come aboard to help our vets? We're748losing 18 veterans a day to suicide. It's ridiculous.749    Dr. Lawrence. Thank you, Senator, for that question. And I750enjoyed our visit where you described some of these in detail,751and it really is intriguing. And the answer would be yes. And I752believe that's consistent with the perspective Secretary753Collins shared when he was here a month ago, of looking for754organizations that can help our veterans outside VA, whether755the nonprofits, for-profits or different approaches, and756figuring out how to use them to help our veterans get healthier757receive--receive benefits, you know, pursue their American758dream.759    Senator Tuberville. I would hope we'd get the Big Tech760companies really involved in it. You know, I know they're761involved in healthcare just for general public, but the VA, we762need more and more help. And we obviously spend a lot of money,763and I would hope that as we go through this, we'll look at the764money that's being spent. The VA's Office of Inspector General765recently published a report bringing to light failures within766the fiduciary program. 311 veterans had no records within the767Veterans Benefit Management System, and $24 million in benefits768were dispersed without oversight to this. I mean speaking of769leaking oil, considering your background as Under Secretary for770benefits, how will we implement improvements to help this?771    Dr. Lawrence. Certainly. Thank you, Senator, for that772question, and you're right, I do know a lot about the fiduciary773program, and one of the things was, of course, who's watching774over the people who are taking care of our veterans' money when775they're unable to do that.776    Oversight continued to be a challenge when I was there. So,777if confirmed, I will look into this in more detail and778understand what's taking place. Normally, there are processes779to do this, and so the kind of things you're describing in the780IG report really makes me wonder about the process.781    And back to your original point, it makes me wonder about782accountability because there are supposed to be leaders in783managing those processes and for failures, like the ones you're784describing in that report. It's really troubling, and it needs785to be tightened down. So, if confirmed, I'll look into that.786    Senator Tuberville. Thank you. And one other thing,787oversight on the PACT Act. As Senator Tillis said, we're788leaking over there, $3 billion already over. It was jerked out789of this hearing room without being finished by the leader of790the Senate. It was a Democrat at the time. And it's791unfortunate, a lot of things have gone wrong because we didn't792have the ability to finish that bill.793    So, hopefully, we'll look into that, and we'll get you back794here after you take office and see how we can help with that,795because the PACT Act could be good if done the right way. So,796thank you. Thank you, Mr. Chairman.797    Senator Tillis. Senator Hirono.798799                     HON. MAZIE K. HIRONO,800                    U.S. SENATOR FROM HAWAII801802    Senator Hirono. Thank you very much, Mr. Chairman. I'd like803to ask the initial two questions I ask of all nominees before804any of my committees. Since you became a legal adult, Dr.805Lawrence, have you ever made unwanted request for sexual806favors, or committed any verbal or physical harassment, or807assault of a sexual nature?808    Dr. Lawrence. No, I have not.809    Senator Hirono. Have you ever faced discipline or entered810into a settlement related to this kind of conduct?811    Dr. Lawrence. No, I have not.812    Senator Hirono. Dr. Lawrence, I think the PACT Act was one813of the bipartisan bills that we worked hard on. And the fact814that there was a shortfall in the Act, it says to me that there815were a lot of veterans who needed this kind of care, and to816talk about $3 billion shortfall that had not been anticipated.817And at the same time, I know that the Republicans are gearing818up to provide some $4 trillion or so in tax cuts to the819wealthiest people in our country. Where is the hearing cry820relating to that?821    You testified also that you didn't know who consisted of8221,000 or so people working at VA who were let go? Is that your823testimony?824    Dr. Lawrence. I testified that I was uninvolved in the825process by which those thousand people were laid off.826    Senator Hirono. Would it surprise you to know that these827are people who were on probation?828    Dr. Lawrence. No, Senator. That's exactly what's described829in the press release.830    Senator Hirono. People who are on probation----831    Dr. Lawrence. Yes, ma'am.832    Senator Hirono [continuing]. By category. You also833testified that these people are being let go on the basis of834their work. It sounds like it's not by entire category. So,835here they are. You know, the VA has always had a shortfall of836workers to the point where we have had to enact legislation837that enables the VA to more quickly hire people because the VA838was short on everything from physicians, to nurses, to839everybody working at the VA. And that is why this hiring840freeze, we have had to address the particular concerns of VA.841And then you have an entire category of people who are being842let go. And yet you say that you had no knowledge, no part in843doing that when we know for a fact that people on probationary844status are being let go throughout the administration, the845workers.846    So, some 200 people have been let go in SBA. Thousands of847people are probably going to be let go in the Department of848Justice. These are all people in probation status who were849hired, being trained to take jobs that are necessary. And if850there's an entity that definitely needs workers, it would be851the VA. And I would think that you would be tremendously852concerned about what's going on in the loss of 1,000 people.853    We talk about the importance of transparency. Since his854confirmation, Secretary Collins has also been named the855temporary head of the Office of Government Ethics and the856Office of Special Counsel. I don't know what temporary means.857It could be a year, it could be forever. Who knows.858    How do his additional roles impact the delegation of859responsibilities between the two of you, even if temporary.860Don't you have some responsibilities relating to whistleblowers861within the VA? Wouldn't you have some overlap between what862Secretary Collins now is responsible for and what you will be863responsible for?864    Dr. Lawrence. Yes, ma'am, thank you for that question. If865confirmed, the Deputy Secretary is the chief operating officer866responsible for a lot of the administrative functions within867the department to include Office of Accountability and868Whistleblower. Secretary Collins and I have had no conversation869about his new duties. And so, you know, if confirmed, I'll870discuss those with him.871    Senator Hirono. There is no question that throughout the872administration that the decisions that have been made, and that873had to be revised or explained is rampant. And so, this goes874to, in my view, the chaos, confusion that it is in every--in875every agency.876    Let me get to a concern that a lot of veterans have about877what happens in VA. There has been on ongoing concerns about878privatizing at VA and the Veterans Project, the portion of879Project 2025, which you are acknowledged as having had a great880part in writing, recommends outsourcing of various roles at VA881to contractors. Is that something that you are going to push882for, that you're going to begin to privatize VA883responsibilities?884    Dr. Lawrence. So, thank you for the question, ma'am. Just885to clarify, I was a small contributor to the section on VA886where I wrote about efficiencies and the benefits process. The887Secretary was very clear, and I echo his comments. We are not888going to privatize the VA. We would push back on any efforts to889do that. We understand, I think the Secretary said this well,890that there's a need for both the VA and also access to891community.892    Senator Hirono. Mr. Chairman, there have been ongoing893efforts to privatize segments of the VA, and I certainly am894going to hold you to your commitment that you do not have an895intention of privatizing activities at the VA. Thank you, Mr.896Chairman.897    Senator Tillis. Thank you, Senator Hirono. Senator Sheehy.898899                        HON. TIM SHEEHY,900                   U.S. SENATOR FROM MONTANA901902    Senator Sheehy. Good morning, Paul, thanks for undertaking903this important duty, yet again, in your life. Is the VA working904right now?905    Dr. Lawrence. As you know, Senator, I'm not there now. I'm906not involved in the decision about what's going on, so it is907really hard for me to talk about something I'm not there. From908afar, I would say veterans continue to get healthcare and909benefits, veterans continue to be able to interact with the VA.910When I go to the building, it works. People are there doing911things. So, from afar, I would say, broadly, yes.912    Senator Sheehy. You know, I think we're at $50 billion now,913is the estimated software upgrade costs for the healthcare914system software that's been--you know, we've been talking about915this for almost a decade. The rough estimate for cost for the916VA is it cost the VA about three times as much money to deliver917$1 of care to a patient as it does the private sector or the918DoD healthcare system. How do we reform the VA healthcare919system so it is, for example, as efficient as the DoD920healthcare system can be?921    Dr. Lawrence. Thank you, Senator, for those questions. And922I think when Secretary Collins was here, he talked about this a923lot, trying to figure out how we support our veterans as924efficiently as possible.925    If confirmed, I think we need to take a hard look at why926things are more expensive relative to other comparable927organizations. I mean, when I talk about providing veterans928world-class service, part of that is comparing how well VA does929to other organizations that do similar things and understanding930what the difference could be. Perhaps it's because the patient931population is different, they're older, but perhaps it's in the932way it operates. So, if confirmed, I would welcome the chance933to sort of dig into this and share observations and insights934with you.935    Senator Sheehy. And when we look at the transition, I think936for many veterans on this panel and many veterans, period, one937of the most frustrating parts of the VA journey is that handoff938from active duty to VA. And even parts of the VA that do939function well, and they are there, making sure that that bridge940between active duty and VA is seamless continues to evade our941ability to accomplish it effectively.942    So, what can you do as the number two guy at VA to make943sure that as veterans transition from active duty to the VA,944they don't get lost in the shuffle. They don't make the leap945from one end to the other and are lost at sea. How do we help946fix that problem?947    Dr. Lawrence. Well, thank you for that question. And don't948forget, sir, I transitioned, too, so I know exactly the949experience you're talking about. As the Deputy Secretary, I'll950be the co-chair of the JEC, the Joint Executive Committee, that951was already mentioned, where we work with DoD to discuss these952issues.953    I think the Secretary, when you asked him a similar954question, is he talked about the importance of getting the955transition right. I echo that. I think it's very important that956seamless information transfer to DoD to VA. I cannot tell you957the number of times in past lives veterans complain, ``How many958more times are you going to ask me for my DD214 when you have959it already.'' It's things like that that really set things in a960bad place.961    In addition, I feel strongly about connectivity. Making962sure veterans have a job when they transition, make sure they963have a great place to live. As you know, states are actively964competing for our veterans, and we should be helping them do965that. So, I think through the JEC, I'll really be able to align966with Secretary Collins and make sure we're working on the right967things.968    Senator Sheehy. VA employee accountability is important. We969see patient satisfaction scores that if the VA was a business,970they'd have a one star on Yelp. And when the patients are971frustrated, they're--I've been in office now for what, seven972weeks as a Senator, and a lot of my time is spent dealing with973VA issues. When veterans reach out to United States Senate974office saying, I can't get a response from the VA, I can't get975my claim processed, I can't get an appointment scheduled.976    The fact that we've been able to help solve those issues is977great, but it's extremely frustrating that the best place a978veteran can go to actually get their problems fixed is not the979VA, it's going to the congressional delegation writing letters,980showing up in person saying, ``Can someone please help me get a981response?''982    And although many of the reforms we're seeing be undertaken983now are coming under tremendous criticism, it's about time we984change something at the VA because a lot of it is not working.985I think you have a great vision to help fit that, but how do we986make the VA a customer service organization so when our987veterans need something common sense, they can actually call988the VA and not their Senator or their Congressman and get989something done?990    Dr. Lawrence. Thank you for that question, Senator. This991came up in numerous meetings with your colleagues on this992Committee when I met with them of the frustration of having to993do the casework you're describing. Part of it is, of course,994the effort to learn as to why these problems are happening and995to resolve them. I found my previous tenure many, many really996good employees, and we should recognize that at the VA.997    At the same time, however, one of the ways we have great998customer service is we exit folks who are not serving our999veterans really well, and we would use accountability to do1000that. So, the measurement, the understanding of the problems,1001the solutions, and understanding where the failures took place1002and how we deal with them.1003    Senator Sheehy. Great. Well, thanks again for your service.1004Thanks for taking this yet again.1005    Senator Tillis. Senator Hassan.10061007                   HON. MARGARET WOOD HASSAN,1008                U.S. SENATOR FROM NEW HAMPSHIRE10091010    Senator Hassan. Well, thank you, Senator Tillis, and1011Senator Blumenthal for this hearing. And, Dr. Lawrence, again,1012congratulations on your nomination, and thank you and your1013entire family for your service to our country.1014    Before I begin my questions, I want to take a moment or two1015to express my concern about recent steps that the Trump1016administration has taken that have caused disruption and1017confusion throughout much of our country, especially within the1018VA.1019    Last month, the President instituted a federal hiring1020freeze, which at first included the VA before the1021administration tried to backtrack. The Trump administration1022also attempted to institute a federal funding freeze. The VA1023later claimed that its programs weren't impacted, though1024veterans were rightfully concerned about the impacts on the1025services that they need. And just last week we learned that the1026Trump administration dismissed over a thousand VA employees,1027people who help veterans get the care and benefits that they've1028earned and deserve at a time when the VA should be expanding1029its workforce, not cutting it down.1030    Taken together, it is obvious to me that this1031administration is making drastic decisions without facts, to1032Senator Tillis's point. If you're going to start right sizing1033an organization, you gather facts and you do it in a1034transparent way. And instead, what we're seeing from Mr. Musk1035and Mr. Trump is they're just making stuff up, telling the1036public things that then later turn out not to be true, and1037they're not thinking through how their actions will actually1038affect veterans.1039    I'm concerned that this reckless pattern of decision-making1040will continue. So, it's incredibly important that we have1041leadership at the VA who will push back on decisions that could1042negatively impact healthcare and benefits for our veterans. So,1043Dr. Lawrence, I want to start with a question. It's a question1044I'm asking all nominees, in light of recent events. If directed1045by the President of the United States to take action that would1046break the law, would you follow the law or follow the1047President's directive?1048    Dr. Lawrence. Thank you very much for that question,1049Senator. I would follow the law. And I would just also point1050out that in my previous tenure, no such situations came up. We1051were very much focused on veterans. We never had conversations1052like this.1053    Senator Hassan. I understand that. But the last four weeks1054have shown us some new information and new behavior. And so,1055that's why I asked the question. If a court issues an order1056requiring the VA to take or refrain from taking specific1057actions, will you follow the court's order?1058    Dr. Lawrence. Thank you for the question. Yes, Senator.1059    Senator Hassan. Thank you. Now, I want to turn to a1060different topic. As the Trump administration continues to1061indiscriminately cut the federal workforce, how will you ensure1062that veterans receive the healthcare and benefits that they've1063earned and deserved without disruption?1064    Dr. Lawrence. Thank you very much for that question1065Senator. And just to clarify, the Secretary talked about, you1066know, really providing veterans excellent service and caring1067for the veterans. And I think the layoffs last Friday sort of1068indicate the thinking behind it, right? These were described as1069non-mission critical folks who would not affect the provision1070of healthcare and benefits.1071    Senator Hassan. Let me just interrupt you there, because1072we've heard this from other agencies, too. Right now, the Trump1073administration's trying to rehire people who oversee our1074nuclear stockpile because they didn't realize that those were1075some of the people they fired. They're trying to rehire people1076who are responsible for containing bird flu as the price of1077eggs is skyrocketing, but they didn't realize they fired them.1078So, you will understand why I don't take the administration's1079reassurance about who these employees are at the VA with great1080confidence.1081    Dr. Lawrence. I understand your perspective, and I'm1082unaware of the details of those situations. So, forgive me for1083that. But I would point out in this situation, though, the VA1084had a safeguard, which was an SES supervisor could opt the1085person out of the layoff. So, there was an element of detailed1086knowledge of what the individual did and their importance in1087the organization.1088    Senator Hassan. So, you are telling me that you would try1089to make sure that that kind of system is in place. So, before1090somebody is actually laid off, before they are walked out the1091door, there is an assessment on the ground at the facility or1092entity about whether that person's job is mission-critical to1093our veterans?1094    Dr. Lawrence. What you describe is one variation of that,1095but some level as the person closest to their work,1096understanding their value in providing healthcare, and1097benefits, and other service to our veterans to make sure that1098it's consistent with the indication that these are not mission-1099critical layoffs.1100    Senator Hassan. Well, I will hold you to that commitment.1101Last week, the VA dismissed more than 1,000 employees. These1102dismissals, combined with other steps the Trump administration1103has taken, have created a climate of fear and uncertainty for1104federal employees.1105    I'm concerned that these actions will prompt some VA1106employees to eventually leave federal service, and will1107additionally scare many more potential employees from applying1108for VA jobs in the future. If that happens, the VA's going to1109have an even harder time hiring the appropriate number of1110nurses, doctors, and others to provide the care and benefits1111our veterans have earned. If confirmed, what will you do to1112help rebuild trust with VA employees and help recruit the new1113employees that VA will need moving forward?1114    Dr. Lawrence. Thank you for the question. If confirmed, one1115of the many things I'll do is focus on the importance of the1116mission and the very special nature by which we do and what we1117do. And in terms of the healthcare providers, in terms of not1118only a great environment, but also the access to resources and1119research and the like.1120    However, what I would also point out, ma'am, is that in my1121previous tenure, when we exited non-performing employees, the1122top performers really liked that. Because they understood as1123managers, we could differentiate between their very valuable1124contribution and the poor performers, and they understood the1125difference.1126    Senator Hassan. Sure, that's true in every organization.1127But there isn't any evidence right now that the approach by1128this administration is going after poor performers. They are1129using a meat cleaver when they should be using a scalpel. Thank1130you, Mr. Chair.1131    Senator Tillis. Thank you, Senator Hassan. Before I go to1132Senator Boozman, I did want to note--I have two things. One,1133I'm trying to get the annual attrition rate for probationary1134employees over the last four years because there is attrition1135within these ranks as they're being onboarded. But I also can1136point out, because it was a discussion about every position in1137the VA is critical, that the Biden administration intended to1138cut VHA workforce by 10,000 employees deemed not in critical1139positions. And their strategy to do this was slowing hiring and1140allowing increased attrition. Senator Boozman.11411142                       HON. JOHN BOOZMAN,1143                   U.S. SENATOR FROM ARKANSAS11441145    Senator Boozman. Thank you, Mr. Chairman. And thank you for1146being here, Dr. Lawrence. We had a good visit not too long ago1147that I really enjoyed, and I also appreciate the fact that that1148you're a proven commodity. You did a great job as Under1149Secretary for benefits in the past, and we look forward to1150using your expertise as we go forward.1151    During Secretary Collins hearing before us last month, I1152raised the issue of the VA's State Veterans Home located in1153Fayetteville, Arkansas. This facility is an excellent resource1154for veterans in Arkansas, but it's in dire need of upgrades.1155Unfortunately, the facility will not receive necessary fiscal1156year 2024 funding. Secretary Collins committed to continue to1157work with me on the issue. Do we have your commitments as1158you'll also continue to work with us in regard to the Northwest1159Arkansas facility?1160    Dr. Lawrence. Yes, Senator, thank you for the question. If1161confirmed, I'll work with the Secretary to better understand1162his commitment, and we'll work with you to figure out what1163makes sense.1164    Senator Boozman. Good. Thank you very much. The VA has1165approved for GI Bill purposes, a unique vocational transition1166school in my state, exclusively for veterans, which emulates1167the way they learn during military service.1168    Notwithstanding, the GI Bill approval and working model1169based on military training, previous administration policy bars1170non-accredited education institutions access to transition1171assistance program sites. I believe the strategy of exclusion1172limits the potential of these institutions because it blocks1173them from connecting with the soon-to-be veterans at the most1174significant period of separation.1175    If confirmed, will you work with the VA/DoD Joint Executive1176Committee that oversees the TAP Executive Committee, will you1177commit to working with me on this issue?1178    Dr. Lawrence. Thank you for the question, Senator. Yes, if1179confirmed, I'll look into this. Whether it's through the JEC or1180whether it's just one off to better understand the situation1181and figure out--I mean, I care greatly about veteran1182employment. Obviously, if this is a good training program and1183enables that, we should figure out what to make sense and if1184these are unintended consequences of rules, we should look into1185that. So, yes.1186    Senator Boozman. Very good. Thank you. As you're aware, the1187VA faced significant questions around its budget last year,1188with many issues that have yet to be answered. Do you still1189believe the VA's fiscal year 2026 advance appropriation request1190to be accurate or will greater funding be required? Much of the1191issues we experienced last year came due to the breakdown in1192communication between the VA and Congress. How do you plan to1193revamp VA's congressional affairs to improve communication and1194prevent future breakdowns?1195    Dr. Lawrence. Thank you, Senator, for those, both1196questions. Let me break them apart. In terms of the budget, at1197this point, my knowledge is not that detailed. So, if1198confirmed, I will dig into this and have a more precise1199response, and I'll work with the chief financial officer to1200really understand and provide information.1201    In terms of your second question about communication, in1202almost every one of my visits to your colleagues, this came up,1203and I believe Secretary Collins addressed it in his1204confirmation hearing as well, where he talked about the need to1205not only receive information to do constituent services, but to1206get ahead of that and to talk to your teams, just get a sense1207of what's going on in advance.1208    So, yes, it was pretty clear about the desire for more1209information from VA, and quite frankly, a two-way street, not1210only to assist you with constituent service, but to better1211understand what you're hearing so we can get ahead of the1212problem so they don't turn into issues. So, yes.1213    Senator Boozman. Very good. In our previous conversations,1214we discussed the importance of addressing veteran suicide. We1215agreed that the VA must do things differently as the status quo1216is simply not acceptable. Last Congress I co-led the Not Just a1217Number Act, which requires VA to examine and identify key data1218about veteran suicides and analyze which factors have the1219greatest impact on preventing suicide. How can the VA use the1220information collected as a result of this legislation to1221prevent veteran suicide, and how should the VA's suicide1222prevention efforts evolve?1223    Dr. Lawrence. Certainly, Senator, thank you for that1224question. I agree with your sentiment, which is for a long time1225we've been talking about this. A great deal of energy and a1226great deal of efforts been spent on this, and it seems like the1227number doesn't change. So, I think the sentiment about can we1228do things differently? What can we learn? What can we learn1229from data? If confirmed, I will look into this and try to1230figure out if there isn't a new path, if there aren't other1231successes somewhere that we could bring to bear on this really1232tragic issue.1233    Senator Boozman. Very good. Thank you.1234    Senator Tillis. Senator Gallego.12351236                      HON. RUBEN GALLEGO,1237                   U.S. SENATOR FROM ARIZONA12381239    Senator Gallego. Thank you, Mr. Chair. One of my things I'm1240very proud of is passing the PACT Act. Those people don't know1241the PACT Act, it was burn pit legislation that in fact, in many1242of us Iraq and Afghanistan veterans. I, myself slept next to a1243burn pit for one month and hit Iraq. And, unfortunately, have1244seen some of the marines that I served with die from diseases1245related to the burn pit.1246    So, the burn legislation was a big win for veterans, first1247of all. And it's bipartisan in nature. And it is really one of1248the largest expansions of care and eligibility in VA history,1249considering it was a 20-year war and considering how many men1250and women were exposed to burn pits and other very dangerous1251chemicals. So, it's a very important step forward to really1252right the years of wrongs.1253    And when I say wrongs, a lot of my friends, some of them1254died before they got even closer getting claimed. Some of them1255actually ended up having to pay out of pocket because the VA1256didn't recognize their sickness as related to their service.1257And many of them still don't even know that they have access to1258these benefits.1259    So, with everything that's happening right now, I am1260concerned that while we are constricting and reducing who we're1261hiring, we at the same time want more people to apply for the1262PACT Act benefits, and want to hear what are your plans about1263how to increase awareness for the PACT Act so we know that a1264lot of these men and women can start getting benefits now?1265Because if not, they will get benefits, as you know and you've1266served in this role before years later, but we'll end up having1267to back pay their service plus interest.1268    Dr. Lawrence. Thank you very much for that question,1269Senator. I agree that more communication needs to be put out1270there for veterans about what their benefits and healthcare1271could be under this. I think that we tend to think about1272communication as, well, let's just put something on the1273internet. What I learned from my previous experience before was1274that low tech communication is invaluable. Town halls are1275invaluable to go and explain this. So, I would expect to do1276more in-person communication.1277    I know the Secretary talked about that, but he'll be very1278busy on lots of important issues. So, I assume as the Deputy1279Secretary, a lot of this will fall on me. I'm a big believer in1280communication. We probably can't over communicate on this, but1281I think it's very important we tell veterans, you must come now1282to the VA even if you think you are fine because years from1283now, something will happen and you'll wish you came when we1284better understood it. So, yes, I completely agree.1285    Senator Gallego. And kind of in the vein of over1286communication. One of the things that concerns me about the1287President's EOs against DEI, and in some regards, yes, DEI did1288go too far. But one of the things that it may impact is1289culturally competent communication.1290    What does that mean? So, Arizona, we have 22 federally1291recognized tribes. We have an over-representation all over the1292country. There are more tribal members that serve in the1293military than the ratio of their population. And as well as we1294have, for example, growing female veteran population that1295sometimes wants to seek services specifically from women or1296women that have been in their experience. And these types of1297EOs sometimes are not going to allow best practices and best1298methods of communications.1299    What's the balance you're going to be able to strike on1300that? Or are you going to be stuck to the EO because, for1301example, some female service members that have survived rape,1302and by other service members, want to only speak to women and1303will only feel comfortable speaking to women. Some of the EOs1304are going to go so far that they may not even have the1305specialized programs for survivors of rape.1306    Dr. Lawrence. Yes, thank you for that question, Senator.1307What I learned from my previous tenure was the value of1308listening to and talking to veterans, and if not veterans1309directly, the organizations that represent them. I found those1310invaluable in terms of communicating things for us.1311    So, I would hope that, if confirmed as Deputy Secretary,1312I'll work with the Veteran Experience Office to really1313understand how we access the individual groups you're talking1314about and engage them effectively.1315    Senator Gallego. And part of the problem is that this EO1316may not even allow you to. Will you try to find a waiver to1317this, or speak to the President's cabinet, whoever it is to get1318that? Because for example, there are great groups that are1319better at outreach for Latinos. There's some Latino veterans1320organizations. For African Americans, there's African American1321veterans organizations that could be very good at reaching out1322to these groups that sometimes don't necessarily listen to1323other lines of communication. But I'm not sure that the1324executive order will actually allow that to happen.1325    Dr. Lawrence. Certainly. I appreciate the question and1326understand your perspective. If confirmed, I'll look in to see1327whether that is actually accurate. That if we can engage them.1328I completely agree, these groups are invaluable in terms of1329communicating with veterans and understanding. I mean, it was1330through groups who represented older veterans that I learned1331telephone communication was so valuable. So, absolutely,1332they're great sources of information about how we engage our1333veterans.1334    Senator Gallego. Thank you. I yield back.1335    Senator Tillis. Senator King.13361337                    HON. ANGUS S. KING, JR.,1338                    U.S. SENATOR FROM MAINE13391340    Senator King. Thank you, Mr. Chairman. Congratulations on1341your elevation. First, I want to agree with Senator Sheehy.1342Transition, I think is one of the most important areas that we1343can work on. I've always felt that the Defense Department1344should put as much money and effort into the transition out as1345they do to the recruiting in.1346    One of the initiatives of the first Trump administration1347was a pre-registration of active-duty veterans in the Veterans1348Administration. So, that was one step they didn't have to take.1349I think that's a good idea. I've got a bill to essentially1350continue and expand that. Is that something you could help us1351move forward with?1352    Dr. Lawrence. Thank you, Senator, for the question. I think1353that's a very good idea. And whether as Deputy Secretary, I1354would work with JEC, yes, I think that's something I could1355support.1356    Senator King. Thank you. On the layoffs, here's the1357problem. You've testified, and the press release has been this1358was done in a thoughtful way with reviews and all those. I'm a1359great advocate of Ronald Reagan's admonition, ``Trust, but1360verify.'' I'd like to see some data about that that verifies1361that in fact, that took place. It's hard for me to believe that13621,000 people were laid off in a matter of weeks with that kind1363of thoughtful process that you're defining.1364    I should also mention that given average attrition rates in1365the Federal Government approximately 2,000 people have left the1366VA, if the rates at the VA are the same as the rest of the1367government. So, we're really not talking about 1,000 empty1368positions. We're talking about 3,000 just in the last month.13692,000 a month is about the rate that would apply to the VA. So,1370we're talking about a diminution in the number of people.1371    And I know that some effort has been made to not, for1372example, apply the hiring freeze to medical personnel, direct1373providers. But I would argue that if nobody's there to answer1374the phone when a veteran calls for an appointment, and I think1375Senator Sheehy mentioned this, the difficulty of getting1376appointments, that's a denial of benefits.1377    So, it worries me that we're not really focusing on what1378exactly the role of those people are, and that the steps so far1379seem likely to diminish the availability of services to1380veterans. Your thoughts?1381    Dr. Lawrence. Thank you for the question, Senator. I agree,1382and thanks for the visit where you shared your experience with1383Governor and how you went about doing something similar. So,1384thank you. That was very important perspective. I think----1385    Senator King. Did it in eight months instead of four weeks.1386That was one difference.1387    Dr. Lawrence. Yes. No, I took away that. Back to your1388question, I think that, if confirmed, I would also like to look1389at the data and see that it did in fact follow what I saw in1390the press release. And I think the Secretary committed to being1391very transparent about this. I don't want to speak for him, but1392I would talk to him about following through on that and sharing1393the information as well so folks have a sense of trust in what1394took place.1395    I also would go back to, as we talked about yesterday, the1396safeguard in place, which the person answering the phone, an1397SES supervisor should be able to say, yes, they are critical,1398they should be opted out of this layoff. So, hopefully, that's1399where that took place.1400    Senator King. By the way, I was agreeing with Senator1401Sheehy. I disagree with him on one thing, and that is1402electronic medical records. The original sin of the electronic1403medical records fiasco was a no bid contract in the last Trump1404administration of a brand-new system instead of going to the1405marketplace and seeing what was available in terms of proven1406existing systems that are operating all across the country.1407    The other piece that worries me is that everybody in the1408VA, except apparently direct service providers, got the famous1409early retirement letter that, you know, if you quit by1410September 30th, you'll get paid. Nobody can convince me that1411was thoughtful.1412    In other words, that went to everybody. What if the best1413people leave, which is what a lot of people I've talked to said1414is going to happen. The people who can get good jobs1415immediately. The good people are going to leave. That there's1416no way to define that letter that everybody in the Federal1417Government got, including shipyard workers at Portsmouth Naval1418Shipyard, the CIA, the Defense Department, and the VA.1419    How do you defend that as a thoughtful process for1420redefining the federal workforce?1421    Dr. Lawrence. Thank you for that question. And I'm sorry to1422disappoint you, I wasn't there. I do not know the process under1423which it--you know, if confirmed, I'll look into it to better1424understand. But I have nothing to add.1425    Senator King. I understand that, and I understand that you1426weren't there, but you're the nearest thing we have to somebody1427to question on these issues today. So, your bad luck to be1428here.1429    A couple of provisions from Project 2025, which I1430understand you had a limited contribution to, but I'm sure1431you're aware of. One of them is a suggestion for the VA1432increase automation. The best way to provide benefits faster1433and more accurately is by using technology to perform most of1434the work. We're already learning in the private sector1435insurance companies that giving AI the decision about making1436these kinds of decisions doesn't work very well. Do you think1437increased use of technology and artificial intelligence in1438claims processing is a good idea?1439    Dr. Lawrence. Thank you for that question, Senator. If you1440notice, it said, ``most of the work.'' The way a claim comes1441about is there's a lot of work where you gather information.1442It's what's called development. That's what's takes so long, is1443getting all the veteran information. To get it in front of1444somebody to make a decision. Technology can be used to gather1445that information faster so a government employee and a claims1446adjudicator can make the decision.1447    Senator King. So, you're testifying that you're not talking1448about AI making the decision, we're talking about simply1449automating the collection of data.1450    Dr. Lawrence. It's what's called development. That's1451correct, Senator. I think that the decision should be made by1452an individual, a VA employee, as required by law, I believe,1453but also to bring judgment into things. I think technology is1454great, but it's not the end-all and be-all.1455    Senator King. Continuing--I guess I'm over my time. Thank1456you, Mr. Chairman.1457    Senator Tillis. Mr. Lawrence, just a clarification, it was1458a Cerner platform that was ultimately decided for the1459electronic health record. Is that correct?1460    Dr. Lawrence. That's correct.1461    Senator Tillis. And is it a Cerner platform that's also the1462baseline for the DoD system?1463    Dr. Lawrence. That's correct.1464    Senator Tillis. Was it part of the logic behind that to1465hopefully not modify it so much that they couldn't better1466integrate so that we're carrying data from DoD to the VA?1467    Dr. Lawrence. I just arrived when all that went down, so1468I'm not--I'm going to tell you sort of observations, but yes,1469the idea was----1470    Senator Tillis. Senator King, I think, asked a good1471question. But having been involved in that process and trying1472to minimize the customization of two systems, well they should1473be in that office that integrates. And why I'm so glad to hear1474that you're going to step up your focus on it. If somebody went1475wrong, taking two baseline systems that are precisely the same1476applications and made them less compatible, there's a lot of1477quality time that I would suggest to the Chair and Ranking1478Member considered before this Committee. Senator Blackburn.14791480                     HON. MARSHA BLACKBURN,1481                  U.S. SENATOR FROM TENNESSEE14821483    Senator Blackburn. Thank you, Mr. Chairman. And indeed, we1484have the Center for Medical Interoperability in Nashville, and1485these are precisely the kind of issues that they work on. And,1486of course, what we have learned with healthcare innovation is1487that payment processing can be standardized and efficiencies1488achieved in payment processing, and also, as you said, in1489finding that definable data that is necessary for that claim.1490And we should use every piece of technology that we can to1491speed the claims to our veterans.1492    Mr. Lawrence, first of all, congratulations and thank you.1493And thank you for the time to visit. I want to go first with1494you to the backlog on claims because you got the number down1495the lowest that it has ever been. And you mentioned that in1496your opening remarks. And what we see now is an enormous claims1497backlog. If you look at the claims that are under 120 days, and1498also over 120 days, it is 954,000 claims.1499    So, what I would like to hear from you is what steps you're1500going to take first and foremost to get those claims, those1501numbers down.1502    Dr. Lawrence. Certainly. Thank you for the question, and I1503enjoyed our visit very much. I guess what I'll begin with is1504going back, if confirmed, and talking to the folks over there1505and reviewing what's taking place. Because part of how we got1506it down to such a low number is through a series of process1507activities and technology activities. And I would want----1508    Senator Blackburn. What was that number?1509    Dr. Lawrence. It was less than it was, 64,751.1510    Senator Blackburn. Okay, 64,751. Let me ask you also, and1511we talked about this privately. 80 percent of the VA employees1512are unionized, and they are some of the ones we have heard that1513have fought going to EHRs, and they have fought returning to1514work full-time.1515    So, in order to address this backlog issue, how are you1516going to deal with these unionized employees and get them back1517in the office so that they are processing those claims and have1518them adapt using the EHR system that is there, that now you've1519got Oracle handling that contract.1520    Dr. Lawrence. Certainly. I think the Secretary, when he was1521here, talked about this very directly, which is, we have to1522explain that the mission of the VA is to serve veterans. And1523that is our focus and that is what we need to do. And anything1524that distracts from that has to take second place to that.1525    So, if that means getting back to work, so be it. If that1526means coming to the office, so be it. We have to understand1527that these distractions take away from our ability to deliver1528care and benefits to our veterans, and we need to minimize1529those and refocus activity on what the mission is.1530    Senator Blackburn. Now, last week, Secretary Collins let us1531know that the community care network contracts are going to1532face delays because of some obstacles that were put in place1533during the Biden administration. We've got a lot of veterans in1534Tennessee that prefer community care. We've got 95 counties, 901535are rural counties, and they prefer community care.1536    So, I would like to know that you all are going to continue1537to push to get these contracts back on track for the community1538care network, and I don't want our veterans to see a disruption1539or to be displaced. So, do we have your commitment in that1540regard?1541    Dr. Lawrence. Yes. If confirmed, I'll work with the1542Secretary to follow through on his commitment to you and help1543him in any way.1544    Senator Blackburn. And then, the first hearing we did here1545in the VA Committee was on community care and simplifying this.1546Getting a pilot project in place so that the veteran is making1547the decision on their care and not having to wait on the VA and1548a caseworker there who's working remote, working 5 days out of154910, or 2 days out of 10 in-person to make a decision to allow1550them to have the care they need in the location that they need.1551    And I would like your commitment on providing the veteran1552with that decision-making authority instead of having that land1553with the bureaucracy in the VA.1554    Dr. Lawrence. Thank you very much, Senator. If confirmed,1555I'll work with the Secretary on this. I know that he spoke1556about the importance of choice in his conversations, and so I1557want to make sure I'm aligned with that. But I think we are.1558So, yes, we'll work on this together.1559    Senator Blackburn. Thank you so much. I yield back.1560    Senator Tillis. Senator Duckworth.15611562                     HON. TAMMY DUCKWORTH,1563                   U.S. SENATOR FROM ILLINOIS15641565    Senator Duckworth. Thank you, Mr. Chairman. Dr. Lawrence,1566it's good to see you. Thank you for meeting with me last week.1567I think we had a very productive discussion.1568    I want to go back to the President's illegal and1569unconstitutional executive order to fire people across1570government. And his allowing unelected billionaire Elon Musk as1571DOGE to have the illegal privilege to carry out these mass1572firings. You mentioned that the way it's supposed to work at VA1573is that there's probably an SES who should review all of these1574and to make sure that people are not being fired from critical1575positions.1576    I will tell you that last week, the VA did fire people from1577the Veterans Crisis Hotline, the 24/7 hotline where veterans1578who are thinking of harming themselves who are in crisis can1579call. And my office has personally spoken to some of those1580folks who were laid off. So, let's pause for a moment to think1581about this. The veterans crisis line is where veterans turn1582when they're considering suicide or self-harm. The public1583servants answering the phones are doing some of the toughest1584work imaginable to support people who serve their country in1585their absolute darkest hour.1586    Now, after I raised these cases to the VA and spoke out1587about them, it sounds like thankfully the VA is attempting to1588rehire some of these employees this morning. But we shouldn't1589even be in this position. Will you commit to reviewing what the1590process the VA engaged in and firing those 1,000 employees last1591week, and any future firings to make sure that this process1592that you talked about, supposedly being the ideal process, is1593actually happening as opposed to what has already happened?1594    Dr. Lawrence. Yes, Senator, if confirmed, I will review,1595especially with the crisis hotline, how that came about and1596what it should inform us if or when future layoffs are done.1597    Senator Duckworth. Thank you. I'll also tell you, I have1598read the letters that they received, the emails that they1599received, and it contained no information about any of their1600benefits, their leave days their healthcare benefits. Some of1601these employees were pregnant who would lose their healthcare.1602    And so, I'm deeply concerned that the letters were so1603indiscriminate and also did not provide people with information1604on what their next steps are, and they were immediately locked1605out of their employment systems. I think that we owe the1606veteran community transparent answers and accountability1607without excuses or finger pointing.1608    After this news broke, my office immediately, almost1609immediately, began receiving phone calls from veterans, not1610just from Illinois, but also across the country, who have been1611in federal service across different agencies for years. So,1612these are long-term federal employees, not probationary.1613They've been in long-term employees for years, and they raised1614my concern that veterans who use their veterans' preference in1615their hiring for their positions are coded by OPM as1616probationary. And they have been wrongfully caught up in this1617egregious mass firing sweep.1618    When veterans use veterans preference in the hiring1619process, OPM codes may code them as probationary, even if1620they're long-term federal employees. And so, individuals can1621also be coded as probationary if they have recently been1622promoted. So, they're still in the same agency, but they were1623just promoted to a new position, but they're coded as1624probationary.1625    These veterans with years of federal service should not1626have been fired. Some of the people from the crisis hotline1627that I spoke with, that we spoke to, had 18 years of federal1628service, 5 years of federal service, they should not have been1629fired.1630    Dr. Lawrence, I know that I do not need to remind you that1631veterans make up 30 percent of the federal workforce. They're1632the most patriotic people in our Nation. They served in uniform1633and many turn around and choose to continue to serve in Federal1634Government, especially at VA.1635    We talked about the VA's mission. It's on the wall. It's1636for the clearest mission of any federal agency. Yet the Trump1637administration, filled with some of the most disloyal oligarchs1638of our time, who egregiously invoke the theme of patriotism to1639camouflage their anti-democratic agenda, has disrespected these1640veterans dedicated and enduring service to our Nation.1641    If confirmed, will you both publicly and privately call on1642President Trump and Elon Musk to immediately investigate this1643catastrophic oversight error in terms of firing veterans who1644are coded as probationary, even though they're long-term1645government employees, and rehire these employees who are so1646wrongfully and disrespectfully fired? And will you push the1647Trump administration to exercise transparency and1648accountability for federal employees?1649    Dr. Lawrence. Thank you for that. Thank you for that1650question, Senator, and for clarifying the OPM process. If1651confirmed, I will look into that process to better understand1652how it affects veterans, and based on what I determine, happy1653to share with you and the Secretary, then figure out a course1654of action going forward to correct it.1655    Senator Duckworth. Thank you. Would you carry out an1656illegal or unconstitutional order under the direction of1657President Trump or Elon Musk?1658    Dr. Lawrence. Thank you for the question. No, Senator.1659    Senator Duckworth. Thank you. I yield back.1660    Senator Tillis. Senator Murray.16611662                       HON. PATTY MURRAY,1663                  U.S. SENATOR FROM WASHINGTON16641665    Senator Murray. Thank you, Mr. Chairman. Thank you for1666being here today. I'm going to go back to a topic I know you've1667covered a bit, and that's that the EHR started in 2018 under1668President Trump, and in 2020, it deployed two Washington State1669VA hospitals. Instead of helping to improve our veterans'1670healthcare, that rollout ended up being a complete disaster and1671it endangered veteran patients.1672    Unfortunately, the system still is not working the way that1673the VA, and doctors, and nurses need and veterans are1674continuing to suffer. Last month, the VA announced it would be1675moving forward with pre-deployment activities at the next four1676sites for this electronic healthcare record. You will oversee1677the EHR program.1678    So, if confirmed, I want to know what you're going to do1679differently to hold Oracle accountable, and to make sure we get1680this system right for our veterans.1681    Dr. Lawrence. Thank you, Senator, for the question. And1682thank you for the visit. I was greatly informed by your1683description of what took place in 2018. So, let's start there.1684    If confirmed, I would really like to better understand what1685happened, that what you described resulted. Why we did not1686listen to the employees. Why that was not structured in there.1687In a good implementation of a system, listening to employees in1688training and getting feedback, and going through changes are1689all supposed to happen. So, I would like to know why that1690didn't happen and what happened as a result of that. Hopefully,1691learning has taken place, but I'd like to validate that.1692    If confirmed, as you heard Secretary Collins describe, he1693wants to convene a team of everybody involved to figure out1694what the best path going forward. If confirmed, I want to work1695on that and figure out what the plan should be in terms of1696holding everybody accountable for what's supposed to take1697place, right? To get the most benefits as quickly as possible1698to our veterans within the amount of money we have.1699    Senator Murray. Well, let me make this very clear. We have1700heard that answer from every VA person that's come before this1701Committee for a number of years now. Everybody's looked at it,1702everybody's considered it, everybody's talked about it,1703everybody's convened new panels. It is not working.1704    So, I need your commitment that it's not just convene1705people and take a look at it, but you're going to make changes1706to it, and demand changes, and get those fixed because we have1707spent literally millions and millions of dollars. And worse,1708veterans are still in jeopardy in their care, and doctors, and1709nurses, and VA facilities are really frustrated.1710    I asked you a really important question. What are you going1711to do differently? The answer you gave me, I understand where1712you're coming from, but it is the same one I've heard over and1713over.1714    Dr. Lawrence. Certainly. Well, thank you, Senator, and I'm1715glad you brought that up. So, let me share two observations1716which I didn't put in that. One is, I think that the Secretary1717conveyed a strong sense of urgency that it should be done much1718sooner than later. And the second thing I would point out is in1719my previous tenure at VA as Under Secretary, I dealt with1720technology problems with the GI Bill, with Appeals1721Modernization, and with Blue Water Navy. I implemented1722technology.1723    I suspect the difference, though I don't have the inventory1724of everybody who sat in front of you, the difference is I've1725actually done this. And so that's the difference I will bring1726to this. And I understand the frustration, and I pledge to work1727as best, as hard as I can to get this done.1728    Senator Murray. Well, I don't want to be sitting here again1729two years from now, same conversation, new person. Last week,1730my offices phones were ringing off the hook because I assume a1731lot of peoples were with really panicked calls from researchers1732at the VA. They had been laid off with zero justification, zero1733warning. And in fact, up until then, the VA had actually1734assured them that they were protected from Trump and Musk's1735mass firings.1736    VA research shouldn't be political and firing VA1737researchers who are in the middle of a process to find1738lifesaving treatment for veterans with conditions like PTSD, or1739opioid addiction, or cancer from toxic exposure is really cruel1740and wasteful. Some veterans are literally in the middle of1741receiving breakthrough treatment through these clinical trials.1742What will happen to them and their care when their lead1743researcher was just fired?1744    Dr. Lawrence, I want to ask you a couple specific1745questions. Were you aware of the Trump administration to fire1746these VA researchers?1747    Dr. Lawrence. Thank you for the question. No, I'm not1748engaged in anything at the department now.1749    Senator Murray. Do you support it?1750    Dr. Lawrence. If confirmed, I will look into this to better1751understand what took place. I don't have enough information to1752comment on that.1753    Senator Murray. Oh, so you won't commit to restoring these1754VA researchers' positions so they can continue that research on1755PTSD, and opioid addiction, and cancer that was caused by their1756exposure to toxic chemicals?1757    Dr. Lawrence. If confirmed, I commit to looking into to1758understand what happened and why.1759    Senator Murray. Well, I hope that's not like every other1760answer we get from people that we are hearing from; that1761they'll look into it and no action is taken. You've just1762promised to look into it. This is critical.1763    Dr. Lawrence. I understand.1764    Senator Murray. Thank you.1765    Senator Tillis. I had the staff look into this, and we will1766include it in the record.1767    Senator Tillis. That somewhere a little bit under 5 percent1768of probationary employees do not continue employment. We have1769about 40,000 to 50,000 new VA employees a year. So, that'd be1770roughly 2,000. We are trying to really normalize and see how1771much of this is a net impact as a result of the President's EO,1772but right now, it sounds like it's tracking unless we see1773significant attrition in the later part of the year. Senator1774Banks.17751776                        HON. JIM BANKS,1777                   U.S. SENATOR FROM INDIANA17781779    Senator Banks. Thank you, Mr. Chairman. Dr. Lawrence, I1780enjoyed working with you in the first Trump term, and look1781forward to working with you again in a bigger way to serve our1782Nation's veterans.1783    The Indianapolis Medical Center is overdue for a total1784replacement. The VA's five-year development plan calls for $2061785million next year to plan and design the project. And I just1786want to ask you, will you commit to working with the VA, CFO,1787OMB, and this Committee to prioritize that project?1788    Dr. Lawrence. Thank you, Senator, for the question. It's1789great to be with you from--and I remember, congratulations on1790your promotion. I remember when you were at the House, you1791asked really hard questions. So, yes, I know you asked the1792Secretary this in his confirmation hearing and he said as much.1793So, I will, if confirmed, work with him to do that.1794    Senator Banks. It means a lot to Indiana, and I appreciate1795that, and look forward to working with you on that.1796    Dr. Lawrence, the Deputy Secretary is traditionally the VA1797chief operating officer, but very little of that responsibility1798is laid out in the law. What will you be responsible for and1799how will you prioritize that important role?1800    Dr. Lawrence. Certainly. Thank you for that question,1801Senator. Yes, that's right. The deputy is the chief operating1802officer. And it's somewhat described in law, so I'll use that.1803The Deputy Secretary is responsible for all administrative1804operations of the VA. Provides governance and oversight, works1805for the Secretary on agendas, special issues, and other things1806the Secretary assigns.1807    Senator Banks. Good. I know we talked a little bit already1808about electronic health records, but EHRM has been going on for1809eight years. In the first Trump term, we worked together1810closely on oversight of the project. But a lot of Senators1811still have basic questions about what's going on with it. Do1812you think the VA has adequately explained the project's1813objectives and how the strategy has changed over the last eight1814years?1815    Dr. Lawrence. Thank you very much for that question,1816Senator. I haven't followed it in detail the last four years.1817However, the fact that every time I meet with one of you in one1818of my meetings, you ask questions about this. It almost seems1819by definition the answer is no. There's too many unanswered1820questions. And I think if you recall Secretary Collins'1821testimony, he talked about the importance of transparency. This1822is one area I think there's much more to do.1823    Senator Banks. As you know, I was the chairman of the EHRM1824Oversight Subcommittee when it was set up in the house in 20181825when the project started. The original plan was for the1826Veterans Health Administration to standardize operations across1827all the medical centers to pave the way for EHR. That never1828happened, and that's why the project continues to fail. How are1829you ever going to implement the Oracle EHR without VHA1830standardizing it?1831    Dr. Lawrence. Thank you very much for that question,1832Senator. If confirmed, I do want to look into this because the1833value of having software is not changing the software, but1834changing the work processes around it, and to the extent you1835configure it to be like something else before you don't get1836those advantages.1837    I'd want to understand if that's going on and why, and what1838to do to--I think when the Secretary was here, he talked about1839things are the same everywhere else. They're unique to VA, but1840things are the same and nobody changes it. These systems work1841elsewhere because they follow the things you're pointing out.1842So, if confirmed, I want to look into that and better1843understand why, and if necessary, how to stop it.1844    Senator Banks. Any other feedback or opinions that you1845developed over the last four years, why this has gotten so off1846the rails?1847    Dr. Lawrence. The same thing I learned from when we worked1848together before. I have questions about, and these are things I1849would confirm when, if confirmed, I would look into; leadership1850and accountability, changes like what you're potentially1851describing happening because somebody let it happen, not1852realizing what's really supposed to happen.1853    I have a lot of questions about the value proposition. I1854mean, these tools are supposed to help us help veterans, but1855yet, I don't hear anybody talking about it this way. Like, this1856will be a great thing for our veterans because all I hear is it1857costs too much and it doesn't work, in frustration. But I1858haven't heard the value proposition, and I think that's1859something we need to talk more about.1860    Senator Banks. Dr. Lawrence, it took the VA 12 years to1861encourage 1 million veterans to provide their DNA samples for1862the Million Veteran Program. I don't know, are you familiar1863with that program?1864    Dr. Lawrence. I'm vaguely, sir.1865    Senator Banks. It has promised groundbreaking discoveries.1866And in reality, it hasn't sequenced most of the DNA samples,1867and it hasn't produced many results. What's holding the Million1868Veteran Program back, and how can it be more effective, and1869will you be committed to taking a strong look at that after1870you're confirmed?1871    Dr. Lawrence. Yes. Thank you for that. That's sad to learn.1872That's really sad to learn, especially given those promises.1873So, yes, if confirmed, I want to look into that. I want to look1874into why that didn't happen, and I want to know who's in charge1875of that and what they've been doing.1876    Senator Banks. Look forward to working with you on that as1877well. Thank you very much. I yield back.1878    Senator Tillis. Senator Slotkin.18791880                      HON. ELISSA SLOTKIN,1881                   U.S. SENATOR FROM MICHIGAN18821883    Senator Slotkin. Thank you for being here. I've heard1884nothing but positive things about you from lots of people that1885we have in common. And so, I don't question at all your1886commitment and experience serving our veterans. And I thank you1887for that.1888    The problem I have as I come into a hearing like this is1889that it feels increasingly more and more common that the senior1890executives at our departments and agencies can want to do the1891right thing, and can have the right values in mind, and then1892people just come in on top of them and make decisions.1893    So, when Secretary Collins was here, someone I served with1894in the House, I supported him. You know, I asked him very1895clearly, will you commit to stand in the breach if someone like1896DOGE or the White House comes in and says, we're going to just1897full sail, start laying off veterans and Veterans Affairs1898folks. That you will stand in the breach, and you will not1899accept cuts to the VA that hurt our veteran care. And he said,1900yes, and I believed him.1901    And then, 1,000 people were laid off last week. Many of1902them veterans. We know because many of us here voted for the1903PACT Act, you know, helping our 9/11-era veterans who were1904exposed to burn pits. We've hired a lot of new people to help1905with veteran care. I can only assume that they are now on the1906chopping block. Not that you would want it, but that someone1907comes in over your head and makes those decisions.1908    Now, you've said here repeatedly that you'll look into it--1909you'll look into it. I just want to know if you're going to--1910you know, if you're going to stand and pledge to protect and1911defend the Constitution, not a President, not a king, but the1912Constitution, that you're going to stand in the breach and push1913back. Will you push back if a continued now, not theoretical1914cuts, but continued cuts continue to be imposed on you that1915hurt the care to our veterans?1916    Dr. Lawrence. Thank you for the questions, Senator. Yes, I1917will push back on things that affect the care and benefits of1918our veterans. I think you heard the Secretary talk about his1919charge, which is taking care of veterans. I do not believe as1920described to me, because I was not there, these cuts on Friday1921affect that.1922    I understand there's been evidence you're receiving that1923might be different, but these were designed to be non-mission1924critical cuts, not in a bargaining unit with a supervisor to1925provide, you know, relief if that isn't true. So, you're right,1926I will push back on mission-critical cuts.1927    Senator Slotkin. Please. And then, you know, again, we're1928told, Mr. Bessent at the Department of the Treasury, you know,1929told us that, don't worry, DOGE and Mr. Musk are only getting1930access to ``read only'' information about taxpayers. And then,1931that was immediately proved false. That now DOGE and Elon Musk1932have access to taxpayer information. So, I asked Secretary1933Collins, what are you going to do when they come for the1934veterans' information? Will you stand in the breach and say,1935``We're not going to give you access, temporary, read-only full1936files for information of our veterans who have served their1937country.'' What are you going to do?1938    Dr. Lawrence. Thank you, Senator, for that question. This1939is a much easier answer. The answer is no you cannot have1940access to that information. Okay? And my understanding right1941now is they do not have access to that information. There's one1942employee, he has access to contract information, general1943operation information, and management of the IT department.1944    Just as an aside from what I know from before, access to1945veterans benefits and health information is strictly guarded.1946There is a restricted process to do that. So, for example, I1947could not look at veterans' information. I cannot look at1948someone on this Committee. The Secretary cannot do that without1949going through a very difficult--and he's assured, I believe1950publicly that DOGE employees will not have access to that1951information.1952    Senator Slotkin. Well, we will be depending on you because1953theoretically taxpayer information would be deeply sensitive1954and no Tom, Dick, and Harry can just go in and take random1955Michiganders' tax information or Medicare, HIPAA health1956information. All these things were considered sacred.1957    All these things were things we were always told would be1958protected, and there's all kinds of restrictions. And then a1959bunch of 25-year-olds come in and get access the same day the1960Secretary is talking to us, Secretary of the Treasury. So,1961whatever what your hopes and dreams are, they don't seem to be1962living up to what the moment here because people come in.1963    So, it is not about your commitment to veterans. I1964understand from lots of people you have it. So, your commitment1965is going to mean fighting some really tough fights with people1966on your same political team on this for the sake of veterans.1967And I'm asking you and imploring you, there's something bigger1968here than living up to doing whatever Trump says. Protect our1969veterans, please.1970    Dr. Lawrence. Thank you, Senator. I understand your1971perspective. I do not know about the tax systems. I do not know1972about Medicare assistance, but I know about the VA personal1973information systems. That cannot happen without permission.1974    Senator Slotkin. Great.1975    Senator Tillis. Thank you, Senator Slotkin. I think Senator1976Blumenthal have a couple of other questions. I've got one or1977two, I'll try to be brief.1978    It looks like this Cerner implementation is going to go1979through the very predictable, the initial--either the initial1980requirements were not well-defined, the complexity of the VISNs1981application portfolios were not well understood. We maybe got1982tempted into more customization than we should have. We may1983have found out data models were more difficult to actually map1984out the typical sorts of things that I would find in a project1985review when something goes sideways.1986    I think it's going to be necessary for you to commit to1987come before this Committee after a reasonable period of time1988and give us a traditional ``stop, start, continue'' of this1989implementation. What practices got us in the ditch. And it's1990not going to be just the vendor or the consultants. It's1991probably going to be because we allowed additional requirements1992to creep in. But what practices have to be stopped? What1993practices have to be started? And what part of the1994implementation is going relatively well and it must be1995continued?1996    Can I get a commitment within 90 days of you being1997confirmed that this Committee gets a report like that?1998    Dr. Lawrence. Thank you very much. I think you're exactly1999right in the description. I will give you almost a commitment.2000The 90-day thing, I just don't know that I can guarantee that2001on, but absolutely. The Secretary talked about doing the kind2002of review you're talking about, you know, I imagine so, yes----2003    Senator Tillis. I think that's that--Dr. Lawrence, that's2004fair for you to hold off on the 90-day commitment. But in my2005experience, anybody worth their salt can figure out what's2006wrong with a project within 90 days. But I understand why you2007can't commit to that. But I'd be happy to do it in 90 days.2008Senator Blumenthal.2009    Senator King. Eisenhower retook Europe in 11 months.2010    [Laughter.]2011    Senator Blumenthal. Thank you, Mr. Chairman. I welcome your2012responses to Senator Slotkin about denying access to Elon Musk,2013or DOGE, or others who should not have it. Did I hear you2014correctly on that point?2015    Dr. Lawrence. That's correct. Especially, your last point,2016sir, about anybody who should not have it.2017    Senator Blumenthal. Will you resign if they do have access,2018if they are given access to it?2019    Dr. Lawrence. Thank you, Senator, for that question. It's2020difficult to answer a theoretical question upon which I would2021have no control. So, I'm not going to comment on that.2022    Senator Blumenthal. Well, how would you stop them if you2023have no control?2024    Dr. Lawrence. So, Senator, let me see if I could reframe2025your question.2026    Senator Blumenthal. My question is pretty clear as it is.2027How would you stop them if you're not going to resign and raise2028it as an issue of conscience and conviction?2029    Dr. Lawrence. So, I'm trying to understand, sir. We're2030talking about a hypothetical whereby somebody gets----2031    Senator Blumenthal. It's not a hypothetical,2032    Dr. Lawrence. It's a hypothetical at VA, sir.2033    Senator Blumenthal. It's ongoing or it's on the horizon.2034They are going to the Department of Defense where national2035security is an issue. They're going to the Department of Health2036and Human Services and accessing health records. There are2037reports that they're already in the VA, even if you discount2038those reports. This is not a hypothetical. I'm asking you2039because you stated to Senator Slotkin so clearly that it would2040be a violation of ethics and law for this information to be2041given to Elon Musk or anyone else, unauthorized and uncleared.2042    Dr. Lawrence. Thank you, Senator, for clarifying that. I2043commit to, if confirmed, better understand the situation and2044try to figure out what the leverage I would have to make sure2045it doesn't happen.2046    Senator Blumenthal. I think that response speaks for2047itself. So, I'm not going to ask another question to follow-up.2048I want to put in the record the Federal News Network article2049entitled, ``Despite exemptions, VA employees still feeling2050impact from policies shaking up federal workforce,'' if there's2051no objection.2052    Senator Tillis. Without objection.20532054    [The article referred to appears on page 109 of the2055Appendix.]20562057    Senator Blumenthal. Thank you. You know, just for the2058record since there's been some reference to the Biden2059administration. In fact, President Biden instituted a strategic2060pause allowing facilities and local leadership to make staffing2061decisions as long as it didn't increase costs and to make cuts.2062    As a result, there was bipartisan opposition to that step.2063As a matter of fact, the staffing at the VA grew, not declined,2064by a net of, I think, 10,000 employees because VHA recognized2065that hiring staff actually saves money by bringing VA2066healthcare back in-house from the community.2067    I invite my Republican colleagues to join me in the current2068proposal for cuts just as we joined together to oppose the2069potential Biden cuts in staffing that were not cost effective.2070    Let me ask you, Dr. Lawrence where do you live?2071    Dr. Lawrence. In Virginia, sir.2072    Senator Blumenthal. And what is the VA healthcare facility2073nearest to where you live?2074    Dr. Lawrence. I don't know. I don't use VHA healthcare. I2075believe it is Washington, DC.2076    Senator Blumenthal. Why do you not use VA healthcare?2077    Dr. Lawrence. I'm ineligible. My service was such that I'm2078ineligible for healthcare. In addition, I've always been in the2079private sector, and I've always had private care. And even if I2080were eligible, quite frankly, I would be thinking about those2081who need it more than me, and I probably wouldn't have used it.2082    Senator Blumenthal. You wouldn't use VA healthcare even if2083you were----2084    Dr. Lawrence. I didn't say that. What I said sir, was2085because I had private care, that even if I had access to VA2086healthcare, I wouldn't use it because I'd be thinking people2087who were in much more difficult situations than me because my2088healthcare has been very good, need access to that care more.2089    Senator Blumenthal. Do you have any direct experience? Have2090you ever received healthcare from the VA?2091    Dr. Lawrence. No, I have not.2092    Senator Blumenthal. When's the last time you were in a VA2093healthcare facility?2094    Dr. Lawrence. When I was in the first administration, I2095regularly visited them when I would visit regional benefits2096office, and I would often visit because they were next to the2097healthcare thing. We held claims clinics in VA medical2098facilities.2099    Senator Blumenthal. You haven't been in a VA healthcare2100facility since your service ended in the Trump administration?2101    Dr. Lawrence. That's correct.2102    Senator Blumenthal. When you were Under Secretary of the2103Veterans Benefit Administration, you had 24,000 employees in 562104separate regional offices working for you. Correct?2105    Dr. Lawrence. That's correct.2106    Senator Blumenthal. How many of those employees do you2107think should be fired?2108    Dr. Lawrence. I'm unaware, sir, of what's going on there2109now. When I left----2110    Senator Blumenthal. When you were there, how many did you2111think should be fired?2112    Dr. Lawrence. When I left there, they were producing at the2113highest level they had ever produced in their history. Some2114left through attrition, some left to get better jobs, but it2115was a very solid workforce. And when----2116    Senator Blumenthal. Would you have fired any of those211724,000 when you were there?2118    Dr. Lawrence. I'm sorry, the first part of your question,2119sir,2120    Senator Blumenthal. Would you have fired any of those212124,000 employees when you were there?2122    Dr. Lawrence. So, we didn't really have to, sir. Because by2123measuring performance, the bad ones understood they were bad2124performers, and they generally left before the HR systems had2125to go after them.2126    Senator Blumenthal. So, you didn't think Elon Musk was2127necessary or the DOGE transition operation, the firing that2128they're now doing was necessary, then?2129    Dr. Lawrence. It was many fewer employees. Right now, I2130believe VBA has about 35,000 employees. So, I could be wrong. A2131lot of hiring has taking place since we left, so I don't know2132what those folks are doing.2133    Senator Blumenthal. And as to those 56 regional offices,2134did you recommend at the time you were Under Secretary that any2135be closed?2136    Dr. Lawrence. No, I did not. I began my tenure by2137announcing that we would close no offices, and that during my2138period of time, the number of employees would be equal to or2139greater than when I left.2140    Senator Blumenthal. Dr. Lawrence, do you think the PACT Act2141is working?2142    Dr. Lawrence. So, thank you, Senator for that question. I2143have a lot of observations based on anecdotes, so I don't want2144to comment. You know, if confirmed, I really want to dig into2145this more closely. Some of the things that are very positive,2146as we pointed out, more veterans are coming to get care, more2147veterans are applying for benefits. It's easier to deal with2148burn pits. You could do it one off when I was Under Secretary,2149and I think that was difficult for veterans.2150    At the same time, I worry that the backlog is large and2151growing. I worry also about some of the things we talked, to2152Senator Gallego, about the communication, the like. So, I think2153there's opportunities for improvement, but by and large, when2154you consider the objectives when it was discussed and passed,2155it looks successful.2156    Senator Blumenthal. You think that we should have the PACT2157Act that the presumptions for care and benefits is justified?2158    Dr. Lawrence. Yes. In that one, yes.2159    Senator Blumenthal. And as to that backlog, do you commit2160to trying to end it?2161    Dr. Lawrence. Yes, absolutely. That would be part of my2162charge. If confirmed. As Deputy Secretary, I'm responsible for2163the performance of the Under Secretary for benefits. That will2164be one of the key critical factors they focus on, which is2165processing claims in a timely and accurate manner.2166    Senator Blumenthal. Would you agree that, potentially, more2167VA members are necessary staff and others to make the PACT Act2168work?2169    Dr. Lawrence. Yes. Thank you for that question. Yes,2170potentially, more employees. Potentially, more technology.2171Potentially, more of both. Potentially, more assistance from2172other vendors who know how to do this. Absolutely. We should2173examine----2174    Senator Blumenthal. If the Musk operation is causing a cut2175in those employees, it could be increasing the backlog.2176    Dr. Lawrence. If VA decides to, and this is hypothetical,2177if VA decides to lay off mission critical employees who are2178processing benefits, by definition, it would increase the2179backlog.2180    Senator Blumenthal. Will you resign if that happens?2181    Dr. Lawrence. No, sir. I'll prevent that from happening.2182    Senator Blumenthal. Thank you.2183    Senator Tillis. Senator King for a brief question.2184    Senator King. Yes, thank you. Just two quick. In 2020,2185Project 2025, which you contributed to, I know in a limited2186way, but you were involved in the veterans part. One of the2187points it says, ``Reduce improper payment and fraud. About $5002188million is improperly paid out each year.'' Are veterans2189frauds? Are veterans committing fraud?2190    Dr. Lawrence. No, sir. What that refers to is sort of the2191following. This is what tends to be what happens. When a2192veteran passes, for example, their heirs often don't tell VA2193that the veteran is passed. Their disability compensation money2194continues to be paid.2195    Senator King. So, that would be improper, but they use the2196word fraud.2197    Dr. Lawrence. Well, this is the broad category of fraud.2198Fraud happened----2199    Senator King. I don't see how you're going to ferret that2200out without getting into the individual medical records of2201veterans, which you've testified----2202    Dr. Lawrence. Sure.2203    Senator King [continuing]. Isn't going to happen.2204    Dr. Lawrence. Sure. Let me give you an example of fraud.2205Let me give you an example of fraud. In call centers in the2206world's best companies, you're not allowed to bring your cell2207phone in because you can take pictures of information, which2208can be used to do identity theft. When I arrived at VBA call2209centers, no such rule existed. Vet employees were able to take2210pictures of confidential information and perpetuate identity2211theft. That's fraud at our veterans by poor processes.2212    Senator King. Completely agree. But in order to ferret out2213the $500 million of fraud, which isn't substantiated in any2214way, it's going to be necessary to dig into those medical2215records to see, for example, who died and who didn't. I just2216don't see how you can have it both ways. If you're going to go2217after that, then you can't say we're never going to look at a2218veteran's records.2219    Dr. Lawrence. Certainly, sir. No, I respectfully disagree.2220You get death information from people who scour coroner's2221information. That's provided daily.2222    Senator King. I understand that, but there'll be--let me2223move on. One of the most disturbing things in Project 2025 says2224this, ``The next administration should explore how the reviews2225would be accelerated with clearance from OMB to target2226significant cost savings from revising disability rating2227awards--'' that's a change in benefits for future claimants.2228And listen to this, ``while preserving them fully or partially2229for existing claimants, or partially as a pregnant term.''2230    That means you're talking about potentially reducing2231benefits for people who are getting them now. Do you support2232that provision in this report of which you're one of the2233authors?2234    Dr. Lawrence. No, sir, I do not. Well, let me clarify. The2235rating schedule aligns benefits to your disability.2236    Senator King. Right.2237    Dr. Lawrence. There's an ongoing review. GAO encourages VA2238to do those more regularly, for example. Okay? But any change2239to the rating schedule, I would defer to the Secretary and the2240President. But as we talked about, our intention is not to2241reduce benefits.2242    Senator King. Well, I'm glad to hear you say that, but the2243phrase, ``while preserving benefits fully or partially for2244existing claimants,'' is not very reassuring to the veterans of2245this country.2246    Thank you, Mr. Chairman.2247    Senator Tillis. Thank you, Senator King. And Mr. Lawrence,2248we're at the end. I imposed the Moran rule. I know that Chair2249Moran tended to allow his members to ask follow-up questions.2250So, I hope that I honored his tradition in the hearing versus2251cutting off, which we sometimes do in other committee meetings,2252Senator Blumenthal.2253    But, Mr. Lawrence, you were voted out of Committee with a2254voice vote when you were up the last time. That's a strong2255statement about the qualifications you put forth because2256controversial nominees don't get a voice vote. Not only did you2257get a voice vote in the Committee, but you got a voice vote on2258the floor. And in my examination of your time that you were in2259this position, you got pretty strong marks for being2260forthright, focused, and good on execution. And I believe that2261there's every indication of your past work.2262    There are challenging times. There will be instances where2263HQ may ask you to do things that in your professional judgment2264are not the best way to optimize refining the approach to the2265PACT Act, or any number of policies that only you and the2266Secretary are going to be familiar with. So, you owe it to the2267administration when you believe well-intended ideas for2268efficiency or other objectives are not in sync with your core2269mission of improving care and access to veterans. I have every2270confidence that you'll do that in a professional way, and you2271owe it to the President to look around corners for people who2272may be advising on matters that are on their face, look like a2273good idea, but those in the trenches who have to execute it. I2274think you'll use sound judgment going forward.2275    I look forward to your confirmation. So, if there are no2276other questions, again, I want to thank you for coming before2277the Committee, the Committee members asking very important2278questions. Each member has five legislative days in which to2279revise and extend their remarks. Incidentally, and any member2280who would like to send questions to Dr. Lawrence should send2281them to the Committee clerk as soon as possible, but no later2282than noon tomorrow.2283    Dr. Lawrence, again, I appreciate your response.2284Congratulations to the family for this honor to be nominated.2285And with that, this hearing is adjourned.2286    [Whereupon, at 11:30 a.m., the hearing was adjourned.]22872288                            A P P E N D I X22892290                        Nomination Material for22912292                           HON. 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