S.Hrg.119-73

1[Senate Hearing 119-73]2[From the U.S. Government Publishing Office]34                                                         S. Hrg. 119-7356                       VETERANS AT THE FOREFRONT:7                 SECRETARY COLLINS ON THE FUTURE AT VA8=======================================================================910                                HEARING1112                               BEFORE THE1314                     COMMITTEE ON VETERANS' AFFAIRS15                          UNITED STATES SENATE1617                    ONE HUNDRED NINETEENTH CONGRESS1819                             FIRST SESSION2021                               __________2223                              MAY 6, 20252425                               __________2627       Printed for the use of the Committee on Veterans' Affairs2829[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]3031        Available via the World Wide Web: http://www.govinfo.gov32                                __________3334                   U.S. GOVERNMENT PUBLISHING OFFICE3560-335 PDF                  WASHINGTON : 202636-----------------------------------------------------------------------------------3738                 SENATE COMMITTEE ON VETERANS' AFFAIRS3940                     Jerry Moran, Kansas, Chairman41John Boozman, Arkansas               Richard Blumenthal, Connecticut,42Bill Cassidy, Louisiana                  Ranking Member43Thom Tillis, North Carolina          Patty Murray, Washington44Dan Sullivan, Alaska                 Bernard Sanders, Vermont45Marsha Blackburn, Tennessee          Mazie K. Hirono, Hawaii46Kevin Cramer, North Dakota           Margaret Wood Hassan, New47Tommy Tuberville, Alabama                Hampshire48Jim Banks, Indiana                   Angus S. King, Jr., Maine49Tim Sheehy, Montana                  Tammy Duckworth, Illinois50                                     Ruben Gallego, Arizona51                                     Elissa Slotkin, Michigan5253                     David Shearman, Staff Director54                Tony McClain, Democratic Staff Director5556                           C O N T E N T S5758                              ----------5960                              May 6, 20256162                                SENATORS6364                                                                   Page65Hon. Jerry Moran, Chairman, U.S. Senator from Kansas.............     166Hon. Richard Blumenthal, Ranking Member, U.S. Senator from67  Connecticut....................................................     368Hon. Tommy Tuberville, U.S. Senator from Alabama.................    1269Hon. Patty Murray, U.S. Senator from Washington..................    1470Hon. Marsha Blackburn, U.S. Senator from Tennessee...............    1671Hon. Mazie K. Hirono, U.S. Senator from Hawaii...................    1872Hon. Thom Tillis, U.S. Senator from North Carolina...............    2173Hon. Margaret Wood Hassan, U.S. Senator from New Hampshire.......    2374Hon. Bill Cassidy, U.S. Senator from Louisiana...................    2675Hon. Angus S. King, Jr., U.S. Senator from Maine.................    2876Hon. John Boozman, U.S. Senator from Arkansas....................    3077Hon. Bernard Sanders, U.S. Senator from Vermont..................    3278Hon. Kevin Cramer, U.S. Senator from North Dakota................    3579Hon. Tammy Duckworth, U.S. Senator from Illinois.................    3780Hon. Dan Sullivan, U.S. Senator from Alaska......................    4081Hon. Elissa Slotkin, U.S. Senator from Michigan..................    4282Hon. Jim Banks, U.S. Senator from Indiana........................    448384                                WITNESS8586The Honorable Douglas Collins, Secretary, U.S. Department of87  Veterans88  Affairs........................................................     58990                                APPENDIX91                           Prepared Statement9293The Honorable Douglas Collins, Secretary, U.S. Department of94  Veterans95  Affairs........................................................    579697                       Submissions for the Record9899From Senator Blumenthal:100101  ProPublica article ``Internal VA Emails Reveal How Trump Cuts102    Jeopardize Veterans' Care, Including To `Life-Saving Cancer103    Trials' ''...................................................    65104105  Statement of Darren J. Petite, President, AFGE Local 0025......    69106107  The New York Times article ``V.A. Mental Health Care Staff,108    Crowded into Federal Buildings, Raise Patient Privacy109    Alarms''.....................................................    71110111  List of 41 Unanswered Requests for Information and Briefings...    85112113  List of 19 Unanswered Letters..................................    92114115  Health Care Wait Times, Staffing Snapshot, and Claims Backlog116    charts.......................................................    97117118  The New York Times article ``What Elon Musk Didn't Budget For:119    Firing Workers Cost Money, Too''.............................    99120121  List of Recent Collins References to the RIF...................   104122123From Senator Tuberville:124125  VA Budget and Veterans Population graph........................   103126127                        Questions for the Record128129Department of Veterans Affairs response to questions submitted130  by:131132  Hon. Mazie K. Hirono...........................................   107133134  Hon. Angus S. King, Jr.........................................   109135136  Hon. Jerry Moran...............................................   111137138  Hon. Richard Blumenthal........................................   113139140  Hon. Ruben Gallego.............................................   133141142                       Attachment for VA Response143144Department of Veterans Affairs response to Question 1 from145  Senator King: List of Contract Terminations....................   139146147                       VETERANS AT THE FOREFRONT:148                 SECRETARY COLLINS ON THE FUTURE AT VA149150                              ----------151152                          TUESDAY, MAY 6, 2025153154                                       U.S. Senate,155                            Committee on Veterans' Affairs,156                                                    Washington, DC.157    The Committee met, pursuant to notice, at 11:41 a.m., in158Room SD-106, Dirksen Senate Office Building, Hon. Jerry Moran,159Chairman of the Committee, presiding.160161    Present: Senators Moran, Boozman, Cassidy, Tillis,162Sullivan, Blackburn, Cramer, Tuberville, Banks, Sheehy,163Blumenthal, Murray, Sanders, Hirono, Hassan, King, Duckworth,164Gallego, and Slotkin.165166             OPENING STATEMENT OF HON. JERRY MORAN,167               CHAIRMAN, U.S. SENATOR FROM KANSAS168169    Chairman Moran. Good morning, colleagues. Good morning, Mr.170Secretary. Welcome, and welcome to those in the audience, as171well.172    We have two votes starting at 11:30. I think most of us173have now cast that first vote, so we will be interrupted on a174rolling basis, I would guess, for the second vote.175    Mr. Secretary, thank you. Thank you for testifying before176this Committee. It is the first time in front of our Committee177since you were sworn in to become confirmed as the Secretary of178Veterans Affairs, and I thank you for your acceptance of my179invitation and your willingness and the ease with which you180agreed to come before the Committee at the appropriate time.181    While the VA is operated by many hardworking and caring182staff members--many of whom are veterans themselves--the183bureaucracy at the VA has hampered some of the Department's184successes. The current way of doing business at the VA is not185always working for every veteran or military family.186    I hear from Kansans, as I assume we do as Members of187Congress. We talk to Kansas veterans regularly. We talk to188their loved ones--as well as Kansans who work for the VA, in189the medical facilities, regional offices, and veterans'190cemeteries--about the challenges that they are facing. I look191forward today to hosting you in Kansas and sometime in the near192future where we will visit with those veterans and those VA193employees.194    This Committee has worked to improve the VA, to improve its195services for the millions of men and women around the country196who rely on the health care, benefits, and services that VA197provides. Most of the time we have done that in a bipartisan198way, and we have made progress.199    The MISSION Act made the VA care more accessible and200enabled veterans, particularly those in rural areas, to receive201care closer to home. The MISSION Act improved what we started202out as the CHOICE Act.203    The PACT Act expanded health care and benefits to millions204of veterans who were exposed to burn pits and other toxins205during their military service.206    Yet, as we always say in this Committee, more work remains207to make this agency, this Department--the second largest208bureaucracy in the Federal Government--perform to the levels209that veterans, their families, and VA staff members deserve.210    I believe that we share many of the same priorities, Mr.211Secretary, including eliminating waste and reforming the VA to212better serve our Nation's veterans.213    During the last three months, there have been announcements214about significant changes across the Department, including215employee terminations, contract cancellations, and plans for216large-scale reductions in force that could see the VA return to217the top-line workforce numbers in place six years ago. That has218caused understandable concern among veterans and VA staff, as219well as many of us here on the dais. Mr. Secretary, I look220forward to you addressing those concerns this morning. I think221how this process is completed or how this process occurs is222hugely important. And I have told you on the phone that it223ought not be a set number that you are trying to reach, it224ought to be about rightsizing the Department of Veterans225Affairs.226    The Department is at a critical juncture--perhaps that is227always true--and I want to hear from you that the changes228underway at the VA are backed by data, informed by veteran229demand, focused on improving outcomes for the men and women230that the VA serves, and will be carried out in close231coordination with this Committee as well as with veterans, VA232staff, and veterans' organizations.233    As the VA undergoes restructuring, the Department must be234well-staffed by a quality, accountable workforce and any235efforts to rightsize the workforce must be done carefully and236in a manner that treats the men and women who entered public237service to care for veterans with gratitude and respect.238    I believe that we can work together to achieve lasting and239positive changes at the VA, that best serves our veterans,240staff members, and survivors, done in a way that is the right241way to do it.242    Mr. Secretary, I indicated in one of our last conversations243that if you are rightsizing the Department of Veterans Affairs,244whether the numbers go higher or lower, that is not the issue,245the issue is about the right size for taking care of those who246served our country.247    I thank you for being here this morning, as I said earlier,248and with that, I yield to Ranking Member Blumenthal for his249opening remarks.250251         OPENING STATEMENT OF HON. RICHARD BLUMENTHAL,252         RANKING MEMBER, U.S. SENATOR FROM CONNECTICUT253254    Senator Blumenthal. Thank you, Mr. Chairman, and I want to255thank you, Senator Moran, for again bringing us together for256the bipartisan work that you and I have done together. This257Committee has been more bipartisan than any in the United258States Senate, so far as I am concerned, and it will continue259to be so, in championing measures like the PACT Act, which,260Secretary Collins, by the way, I just noticed is not mentioned261once in your written testimony, which mystifies me.262    Let me say at the very outset, I would like to enter a few263items into the record. The first is an article published this264morning by ProPublica, supported by hard evidence and in-depth265conversations with VA staff. It outlines a number of examples266of real-life impacts to veterans caused by the firings,267freezes, and cuts in this Administration. It also outlines268disturbing warnings of what is to come, documents with269recommendation from DOGE, the DOGE tech boys--I call them the270``DOGE Dopes''--that outline cutting 100,000 employees and271closing as many as 17 VA hospitals.272    I would also like to enter into the record a statement from273Darren J. Petite, President of the AFGE Local 0025. His274statement is a summary of the dozens of impact statements from275VA employees that were provided to my office this morning. And276in addition, The New York Times article on mental health care277diminishing and degrading privacy available through telemental278health care that is absolutely unacceptable. In Mr. Petite's279words, his statement represents, quote, ``the collective voices280of frontline public servants who have endured significant and281unjustified hardships stemming from recent policy changes,282management decisions, and failures to honor basic labor283protections.''284    Finally, I want to submit for the record an updated list of28541 requests for information and 19 letters of inquiry that have286been sent to this Administration without substantive response,287any sufficient response, or any response at all. If that is288okay, Mr. Chairman, without objection.289    Chairman Moran. Without objection, so ordered.290291    [The information referred to appears on pages 65-98 of the292Appendix.]293294    Senator Blumenthal. We are here about accountability, which295so far has been totally lacking. The absence of responses to296our inquiries are simply unacceptable. You inherited, Mr.297Secretary, a VA that was delivering a record amount of health298care. Last year wait times decreased, despite a record increase299in new patient appointments. You claimed the disability300backlogs got worse, but the percentage of backlog claims301actually is about the same, but increasing challenges in302numbers. And the VA has decreased the time to process each303claim, setting new records for productivity.304    You inherited a VA that was setting new records for305burials, and that is important to the servicemembers, the306families that sadly have to provide those burials. The VA has307been delivering more care, more services, more benefits, to308more veterans, and doing it faster than ever before when you309took over, and that is in no way to deny the importance of310improvement. Call it reform. Call it revision. Improvement is311absolutely necessary. But it should not be done with a312chainsaw.313    The head, the Commander of the Veterans of Foreign Wars,314came before us, and he drew this analogy. When he was wounded315in combat, the surgeon used a scalpel. He took the shrapnel out316of his arm. He did not use a meat ax. He did not use a317chainsaw. And that is the kind of improvement that we should318work to achieve, with the input of those skilled and dedicated319caregivers who are working hard in the VA right now, a third of320them veterans, thousands of them already fired, and others321potentially losing their positions in the future.322    You have announced the cancellation of 800 contracts worth323an alleged $2 billion, only to rescind that statement once the324harmful impacts of the cancellations were made public, and we325protested. You arbitrarily fired thousands of VA employees,326including Veterans Crisis Line employees, only to subsequently327reinstate a number of them after public backlash, or after you328learned that they were fired by mistake, and we protested. You329have delayed the opening of facilities across the country, only330to announce they would open in phases because of insufficient331staffing. You have equated them to restaurants. You claim that332is how it has always been done. But that is not true.333    And so far as that 83,000 number is concerned, apparently334you want to go back to the 2019 numbers, because since then335some 80,000 VA workers have been added to the rolls. You should336know, two-thirds of them are health care workers. If you slash337those health care workers, VA quality and access will diminish.338A number of them are VBA claims processors, a third of them. If339you slash them, the times for PACT Act benefits will be340delayed.341    I think that oversight is absolutely necessary and342improvement is always possible. But it should be done343positively, without the slashing and trashing that right now344you have advocated.345    In the real world we know that support personnel are346absolutely necessary--answering the phones, cleaning the347surgical equipment, preparing the operating rooms, scheduling348the appointments or fixing the IT systems. Those burdens will349fall to others, or they will simply fall through the cracks if350you slash and trash the VA.351    In Connecticut, the VA is operating without a locksmith,352because that position is not exempt from your hiring freeze.353And the VA has ignored local requests for that exemption. There354is no way for a VA facility to operate reliably and safely355without good locks on the doors. Now that position may seem356like a minor or trivial one, but every member of the VA team is357necessary to make the team effective and efficient.358    Now, we have already begun seeing the results and local359impacts of staffing shortages. We have heard directly from360veterans--my office has, colleagues have--service lines at361numerous VA hospitals and clinics have been reduced. Mammogram362appointments have been postponed. Prosthetic employees have363been fired and services reduced. The availability of VA364operating rooms as well as inpatient, recovery, emergency room,365and long-term care beds have been reduced. Probationary staff366in logistics and procurement have been fired, meaning critical367medication and equipment deliveries have stalled. In some VA368hospitals, senior and clinical staff are now helping stock369supplies. Medical center employees who manage research grant370applications have been fired, leaving hospitals unable to apply371for new research funding.372    Countless employees are being driven away. You have 40,000373openings right now that you are recruiting to fill at the same374time as you are firing 80,000. It makes no sense. How do you375expect to recruit qualified, skilled, dedicated, new workers,376whether they are physicians or counselors, nurses, when you are377firing our probationary employees who are the future of the VA378workforce or who have been promoted because they are performing379with such excellence? Nonsensical.380    So I think that you owe this Committee some explanation.381You have refused to do it so far, in response to the 19 letters382that I have written, along with colleagues, and the 21 other383inquiries. There needs to be accountability. We need to avoid384the potential disaster that is looming. And make no mistake--it385is a disaster that is on the horizon, approaching us, as surely386as a thunderstorm in the Nation's capital. And we need to avoid387it. It will be a self-inflicted wound that disastrously affects388all of our VA beneficiaries, whether they use health care or389the PACT Act, and that is one reason why I have advanced the390Putting Veterans First bill that would mandate rehiring all391those fired VA employees and all the veterans who have been392fired from the Federal workforce in other agencies. Give them393the right to individual, personal determination, which should394be their right under current law.395    We need to make the VA a place that works better for396veterans and their families. They deserve nothing less.397    Thank you, Mr. Chairman.398    Chairman Moran. Senator Blumenthal, thank you.399    Mr. Secretary, we now recognize you. Thank you for your400presence, and we recognize you for your testimony.401402               STATEMENT OF HON. DOUGLAS COLLINS,403         SECRETARY, U.S. DEPARTMENT OF VETERANS AFFAIRS404405    Secretary Collins. Thank you, Mr. Chairman. I appreciate406that. And Ranking Member Blumenthal, and distinguished Members407of the Committee, it is good to be back here.408    Chairman Moran. Mr. Secretary, would you pull the mic409closer, please?410    Secretary Collins. It is on.411    Chairman Moran. That is better.412    Secretary Collins. So I am going to have to swallow it.413Okay. There we go.414    Since becoming VA Secretary, I have met many of the men and415women who show up every day to work. It has been one of the416greatest experiences of my life to see the deep dedication that417they have to the veterans that they serve. And I have also418listened to those VA employees and others who have expressed419their concerns about what is going on and the stuff that they420need to be able to do to perform their job. Most of those are a421bureaucracy that has been out of control and a bureaucracy that422has not been tamed in years.423    You know, also, though, in the same period of time, since I424have come to learn what many of you on this Committee realize:425the VA is in need of reform, and which I can probably quote426every Member of this Committee who has stated in the past,427multiple times, including even last year, that the VA needed428reform, and needed it badly. We must do a better job serving429our veterans, and getting to ``yes'' so veterans can get the430benefits they have earned, and making sure the money Congress431appropriates to the VA is not diverted to non-mission-critical432or even wasteful programs.433    Way back in 2024, Congress discussed many times reform in434the VA, but it often was simply a thinly veiled request for435more employees. But the Department's history shows that adding436more employees to the system does not automatically equal437better results.438    The Biden administration's record is a perfect example. The439last four years, which, again, I would be happy to talk about440today, showed that this issue of money and people do not solve441the problems. In fact, the number of VA employees grew by more442than 52,000 full-time equivalents from fiscal year 2021 to443fiscal year 2024. And did all those people make things better444for veterans? No. In fact, VA performance actually got worse.445VA wait times for primary care rose from 15.7 days to 24.3446days. Wait times for mental health care rose from 14.7 days to44720.4 days. Wait times for specialty care rose from 24 days to44838 days. And VA's disability benefits backlog increased, and449was at 260,000 when I took office at the first of February. I450will say that we have decreased it by 40,000 since we have451taken office.452    Something has to change, and we are going to have to change453it. President Trump looked at the problems. He has looked at454the problems across it and said, ``Let's take care of our455veterans, and do so in a way that takes care of our veterans,456families, caregivers, and the survivors that we serve.''457    And also I have never been shy about talking about and458addressing tough issues, and I will not ignore the elephant in459the room here today. As has already been discussed and we are460aware, we are looking at Department's structure and staffing461across the enterprise. I said countless times, this review is462aimed at finding ways to improve health care and benefits for463veterans without cutting care and benefits for veterans. Our464goal is to increase productivity, eliminate waste and465bureaucracy, increase efficiency, and improve health care and466benefits to our veterans.467    We are going to maintain VA's mission-essential jobs like468doctors, nurses, claims processors, while phasing out non-469essential roles like interior designers and other things. This470is savings we can achieve that will be redirected to veteran471health care and benefits. Our goal--and here is the key word--472our goal, as we look at it as everything goes forward, is a 15473percent decrease. It is a goal. As the Chairman said, it could474be less, it could be more. It is a goal that you have to look475at. You have to start somewhere.476    Year after year, the calls for VA reform come from every477corner--the lawmakers, the media, watchdog groups like the478inspectors general, Government Accountability Office, VSOs, and479individual veterans across the country.480    This year, we have finally embarked on a historic effort to481reform the VA. We have been emphatic that we will not be482cutting benefits and health care--only improving them--and I483think the budget shows that. And we are engaging career484subject-matter experts, senior executives, and political485leadership to restructure the Department so it works better for486veterans--a scalpel, not a hatchet.487    We are also doing, what all the veteran stakeholders agree488needs to be done, and there has been some reaction. We have489been met with a barrage of false rumors, innuendo,490disinformation, and speculation implying firing of doctors and491nurses, and forcing staff to work in closets and showers, and492that there is ``chaos'' in the Department, none of which have493been backed up, even articles from today. Why? Because we494canceled some contracts, that work for the VA, that we should495be doing in-house, and we let go less than one-half of 1496percent. That is what I am sort of amazed at some things you497said. We have let go one-half of 1 percent of non-mission-498critical employees.499    To hear our critics tell it, the Department was absolutely500perfect before January 2025. Everyone knows that is not true.501The fact is that VA health care has been on the Government502Accountability Office's high-risk list for a decade. GAO says503VA faces ``system-wide challenges in overseeing patient safety,504access to care, hiring critical staff, and meeting future505infrastructure needs.'' We are working hard to fix these and506other issues, and we need your help. We want to work with507Congress to fix the VA. But our shared goal needs to be making508things better for veterans, not protecting the Department's509broken bureaucracy.510    The Department of Veterans Affairs is not a Federal jobs511program. It is an organization whose sole purpose is to serve512veterans, and we must never lose sight of that. In just the513first 100 days we are refocusing our core mission back on the514veteran, not the VA itself. We are making sure that they515actually get choice in the MISSION Act, which is what the law516requires, which we have found over the past few years has been517actually stifled at the VA. Instead of sending people to518community care, they were actually encouraged to stay in the519care inside the VA.520    We brought back people from work. We have accelerated the521deployment of our Electronic Health Records Management system,522and yes, we have processed record numbers of disability claims,523and we are redirecting hundreds of millions of dollars from524non-mission-critical efforts to support our beneficiaries.525    As we go forward, we are just getting started. There is a526lot we can agree on. There may be some things that we disagree527on. But the one thing about it, it will never change for me,528Mr. Chairman, Ranking Member, and the rest of the Committee, is529that we have got to take care of our veterans. And obviously530the numbers that we have seen in the last few years have shown531that we are not.532    And with that I yield back.533534    [The prepared statement of Secretary Collins appears on535page 57 of the Appendix.]536537    Chairman Moran. Mr. Secretary, thank you. So in your time538as the Secretary and the circumstances that you are under and539engaged in, what do you assess as your most significant areas540of concern for the VA, and what do you believe is working? Is541there anything that you have learned that needs to be done542differently?543    Secretary Collins. Thank you, Mr. Chairman. I think one of544the most interesting things for me in the first 100 days is545constantly fighting rumor and innuendo, much of which I am sure546we will hear today that I am going to try and put to rest.547    But one of the things is, I had to take it from a548perspective of both being on the GAO list and looking at the549past history, as I expressed to many of you during550confirmation, is what is working right and what is not working551right. And as we looked at this, what I found was a system, a552bureaucracy, that was broken.553    Here is an interesting stat for most of you that you may554not know. I came into the office and it took me a week and a555half before Human Resources Department could actually produce a556list of all the employees that we have--a week and a half--557because our systems were so broken and bureaucratically558challenged.559    You know, what I found out was we did not address any of560the major concerns. Wait times, which I just outlined in my561opening statement, have gotten worse. Backlogs got worse. All562while we were adding people and all while we were adding money.563    You know, the inefficiencies are interesting. I will just564show you one example. Under the previous administration they565were trying to consolidate payroll, and payroll across the566board, we asked for a number from payroll, and we got 230,000567is our employee base. It is who we are paying. Well, we know,568obviously, we had almost 470,000. The reason was we had 50 to56960 of our hospitals still doing their own payroll instead of it570all being centralized where it could be done in an efficient571manner, and make sure that we all have it where we need to go.572    The HR system is in disarray. Our death by suicide number573has not changed since 2008, yet we are spending $588 million a574year to look at that, and $2.3 billion in counseling and care.575    These are just the things that we have seen so far, and we576have actually implemented to go forward and look at the things577that we have got to fix and more forward on those. But to578simply say that where we came in was okay and needed tweaks was579just simply not true, and veterans in this room and other580places know that.581    Chairman Moran. Mr. Secretary, you mentioned in your582opening statement inspectors general.583    Secretary Collins. Yes.584    Chairman Moran. I have indicated, I think in many585conversations, and certainly hearings in which VA staff are586witnesses, that the return of an inspector general is a high587priority for me. What is the plan?588    Secretary Collins. We are in favor of that, as well, and589making sure that the White House--and we have encouraged the590inspector general to be named, and look forward to that being591in place. I mean, again, we are looking at it as a metric of592how we can get better. Over the last 10 years, that has been593the metric saying that we are at a high risk. So from my594perspective we welcome the oversight to make sure that we are595heeding the metrics that we need to do to take care of596veterans.597    Chairman Moran. And so, Mr. Secretary, the impression that598you leave is that the White House, the President needs to599nominate someone. Is that where we are?600    Secretary Collins. That is the next step in that, yes.601    Chairman Moran. Okay. I want to ask a specific question602about community care. I appreciate your attention to the603MISSION Act. We have been trying, this Committee, that we604believe it is particularly important for veterans at risk for605suicide and mental health issues, veterans who are potentially606victims of overdose deaths.607    I wrote to the VA in January, urging Mental Health608Residential Rehabilitation Treatment programs to be included609under existing community care access standards, to immediately610expand access to those lifesaving services to veterans across611the country, in the community. Can you provide me with an612update on your progress to add Mental Health Residential613Rehabilitation Treatment programs to the MISSION Act access614standards?615    Secretary Collins. Yes, and I think that is going through616right now and adding those as we go forward, making sure that617the VA and the veteran is going through the programs that are618suitable for the program it needs to be and also taking care of619the needs of the veterans. So that is moving forward. We agree620with you that any opportunity that we can take to give more621service to veterans, especially in the mental health area.622    Also, Mr. Chairman, there is something else to think about623here, as well. One of the things that I did not mention624earlier, is there seems to be, at times, a difference in how we625deal with the VA as opposed to how we deal with health care, in626general. And some of that, frankly, needs to change in the627sense that the VA is the largest health care provider. But also628we share the same challenges as the community does, as well,629with doctor recruitment, nurse shortage, doctor shortages,630mental health workers, and those. So we are working those in631our areas to make sure that we do have good community partners632in this regard and also hiring the best that we can. Also, we633are levering partnerships with DoD, but also looking at our634nonprofits and our VSOs, to see how they can help, as well. So635it is a total approach to how we are looking at this and want636to continue to do that.637    Chairman Moran. Senator Blumenthal.638    Senator Blumenthal. Thanks, Mr. Chairman. You know, I639listened to you recite those problems that you encountered. Not640a single one of them will be solved or addressed by slashing641the VA workforce by 83,000 people. Putting those workers on the642chopping block fails to address one single aspect of any of the643problems that you have brought to this Committee, or that you644encountered.645    Are you aware, Mr. Secretary, that the VA changed the way646it calculates wait times in 2022?647    Secretary Collins. The information I gave you is as of our648current VA system.649    Senator Blumenthal. The information you gave us is650deceptive and misleading because the VA changed the way it651calculates wait times in 2022. In addition, because it begins652in 2021, at a time when a lot of VA patients were coming back653to the VA after COVID in 2022, this information is654fundamentally deceptive and misleading. I ask you to go back to655the VA and correct it in a written submission to this656Committee.657    Mr. Chairman, I ask that we enter into the record an658article that appeared in The New York Times entitled, ``What659Elon Musk Didn't Budget For: Firing Workers Costs Money, Too.''660If there is no objection.661    Chairman Moran. Without objection.662663    [The article referred to appears on pages 99-102 of the664Appendix.]665666    Senator Blumenthal. Are you aware of the costs that will667result from firing those VA workers in compensation that has to668be paid to them, when they have been wrongfully terminated?669    Secretary Collins. Well, Mr. Ranking Member, if you look at670that from a perspective, there is cost to moving forward. There671have been some issues here. I think one of the----672    Senator Blumenthal. You do not have a number for us, do673you?674    Secretary Collins. No, because we have----675    Senator Blumenthal. Because you have not calculated----676    Secretary Collins [continuing]. Less than one-half of 1677percent----678    Senator Blumenthal [continuing]. What it will cost to679fire----680    Secretary Collins [continuing]. Of people we actually----681    Senator Blumenthal [continuing]. Workers, and then682reinstate them, when the courts tell you, as they will, that683they have been wrongfully terminated.684    Secretary Collins. We are talking about less than one-half685of 1 percent, Mr. Ranking Member. You have thrown out numbers686of thousands. This is exactly what I am fighting against. When687you use numbers that----688    Senator Blumenthal. It may be a small part of your689workforce, but they are the physicians.690    Secretary Collins. No.691    Senator Blumenthal. They are the surgeons.692    Secretary Collins. No. No. Mr. Ranking Member, I will not693let you do that. I will not let you sit here and scare my694veterans and scare my employees, because there has been no--I695mean, you must have stuff that, you know, again you are looking696at, making a prediction in the future because no one has697discussed firing doctors or firing nurses. We have always said698that we are going to keep frontline health care.699    Now, if we want to continue to this message that these are700out there when you have no knowledge of what you have just said701except speculation----702    Senator Blumenthal. Well, let's begin with facts----703    Secretary Collins [continuing]. And innuendos.704    Senator Blumenthal [continuing]. Right now.705    Secretary Collins. That is facts.706    Senator Blumenthal. Will you submit to us, which you have707failed to do, specific positions where workers have been fired708already?709    Secretary Collins. At this point in time----710    Senator Blumenthal. That is a yes or no.711    Secretary Collins [continuing]. We submitted to that. You712know, you also said something that I need to address real713quickly.714    Senator Blumenthal. No, wait a second. Please answer my715question. Will you give us the information?716    Secretary Collins. We have given you the information----717    Senator Blumenthal. We have requested it again and again718and again, what positions have you terminated and what is your719plan for terminating in the future.720    Secretary Collins. Okay. First off, we will get you the721information, that your staff will check back. With the plans722for the future, this is an interesting thing. I think what we723are trying to do here is we are going through a process which I724talked about in my opening statement, that deals with career725employees, that deals with professional staff, and others,726outside consultants, to see what is the proper size for our VA.727    Senator Blumenthal. You know, you are running out the728clock----729    Secretary Collins. Will you let me answer the question?730    Senator Blumenthal. I know what the tactic is.731    Secretary Collins. Let me answer the question.732    Senator Blumenthal. We both know, because you served in the733United States Congress too. You can fill the air with words.734    Secretary Collins. You can if----735    Senator Blumenthal. What the veterans deserve is action and736accountability. We have asked for this information repeatedly.737You have said you are firing 83,000 people. If you fire the738people who have been hired in the last 5 years, you will be739firing physicians, nurses, surgeons, counselors, workers who740are frontline. You cannot slash and trash the VA without741eliminating those essential positions which provide access and742availability of health care. It simply cannot be done. And you743may give us a lot of verbiage here, but you are not giving us744facts, and facts are essential to accountability. That is why745you are supposed to be here. But you are not giving us the746facts that we need.747    Thank you, Mr. Chairman.748    Secretary Collins. With all due respect, can I answer his749question?750    Chairman Moran. You may answer.751    Secretary Collins. Thank you. With all due respect, there752is verbiage being said from the dais, as well, and I would like753to say, as I have said already in this hearing, that there is a754goal of looking at a 15 percent reduction. You have stated on755several occasions already that I am saying we are going to fire75683,000 employees. That is wrong. I would appreciate that being757corrected, because that is not true. I said we are looking at a758goal of how many employees we have and how many employees that759are actually working in the front lines, taking care. I have760doctors and nurses right now that do not see patients. Is that761helping veteran health care?762    Senator Blumenthal. Yes, it does.763    Secretary Collins. No. No, it does not.764    Senator Blumenthal. It does.765    Secretary Collins. Not when I need those doctors----766    Senator Blumenthal. A doctor who consults on a case----767    Secretary Collins. Not when I need those doctors in a768clinic.769    Senator Blumenthal [continuing]. A doctor who consults, a770doctor who advises, a doctor who looks at radiology reports, a771doctor who----772    Secretary Collins. You are missing the point.773    Senator Blumenthal [continuing]. Is overseeing and assuring774quality, absolutely yes.775    Chairman Moran. Senator Tuberville.776777                     HON. TOMMY TUBERVILLE,778                   U.S. SENATOR FROM ALABAMA779780    Senator Tuberville. Thank you, Mr. Chairman. Thank you,781Secretary Collins, for being here. And thanks to the veterans782that are here today. And I want to pass on the thanks from the783400,000 veterans in the State of Alabama. They have, for the784first time, in just two months, have seen progress at a lot of785the VAs in my state.786    We have seen a record number of disability claims787processed, employees finally returning to work, and an end to788the DEI programs like treatment for gender dysphoria. You know,789the days of business, as we all are noticing and hearing today,790are over, and finally our veterans are being put first.791    Let's talk about the budget a little bit, Mr. Secretary.792Over the last 10 years, the VA's budget has more than doubled,793and the number of employees at the VA has increased more than794100,000. But the number of veterans in our country is795declining, and VA enrollment has changed.796797    [The information referred to appears on page 103 of the798Appendix.]799800    The VA has become a bloated bureaucracy. I think most of us801will agree with that.802    Secretary Collins, why has the VA budget become so bloated803over the last 10 years if the veteran population has remained804stagnant?805    Secretary Collins. Senator, I appreciate the question806because it is also another number that we are leaving out807there, as well, is that veteran population of actually enrolled808in the VA has stayed steady at 9.1 million. And again, we can809try and talk about numbers all we want here, but it has been8109.1 million steady for the last, you know, 10 years we look at811this. So we are also losing veterans as a total population, but812we are also not gaining in the enrollment of the VA.813    What we tend to forget, and some people will say, well, we814have had an increase in different programs. We have, but we815also lose about 400,000 veterans a year to death, you know,816natural causes. So, I mean, it is a priority of function. So817what we are looking at here is there have been programs that818have been increased, there has been a mandatory spending819increase, and those have been the things that we look at.820    I think what we are actually looking at here, though, is821there has been a decision that it is easier to just put money822and people toward issues without looking at is there any real-823world aspect to that. Is there a return on investment?824    I think as you talk to veterans, and I go out and talk to825veterans, one of the things that we are having is that those826amount of numbers and people are not equating into how we can827actually function.828    I mean, I appreciate the Ranking Member's service and I829appreciate we just disagree on this, that when we have doctors830and nurses and other clinicians who are not actually being831clinicians and not reading charts or doing anything else, they832are actually, you know, formulating policy or doing833administrative work, when I have these many folks that need to834be more in the clinics, then we are not helping the veteran.835That is just something that is not happening.836    When you are taking time to process disability claims that837went up, and also not having the proper, you know, computer,838the AI technology to help us do that. We are also putting out839the issues that are slowing up. And then also we get in our840way, because we are such a bureaucratic organization. We have841rules over rules over rules.842    I had a gentleman tell me just the other day--and this is,843again, I have seen this before from my own daughter--he844actually said--he is a double amputee. He actually said, ``I845have to go to the VA. If I need a new wheelchair, I have to go846to my primary care, a PT, and an OT, before I can get a seating847clinic appointment.'' Explain to me why we are having to go848through that kind of mess to get straight to a seating clinic,849which we know where they need to be to start with.850    Senator Tuberville. Thank you. I often hear a lot about the851large amounts of paperwork and administrative burden VA doctors852are forced to navigate when seeing patients. This leads to VA853doctors seeing less patients per day. Where do you see the854opportunity to reduce all these administrative processes?855    Secretary Collins. I think there are plenty of856opportunities there, and again, this has nothing to do with857employees. It has nothing to do with money. It is simply, are858we doing it most efficiently in the process.859    I made a statement to every hospital that I go to, every860clinic that I go to, every Veteran Benefit Office that I go to,861to say this. I use a proverbial 10 sheets of paper. If you have86210 sheets of paper to get a veteran the services that they863need, or 10 sheets of paper to do the next thing, can you do it864with 5? I mean, I will show you an example.865    To apply for benefits in our VBA, there is a sheet on there866that has a full listing of the veteran as far as just basic867information about their military service. And this, for older868veterans, could be a problem actually to go back and remember869dates. If the veteran served, and we could do that with their870name, their Social Security number, their ID number using their871DD-214, we can gain all the records that we need to confirm872that they are a part. But yet we are making them go through873this process of filling out a form that many of our veterans,874who may or may not have computer capabilities, are having875trouble with. So it makes it difficult.876    Senator Tuberville. I hear from some of the supervisors in877the VAs, and they say we use two coding systems, one a hospital878coding system that is very, very effective, and the other one879is from the W-H-O, which is a useless piece of crap, that has880come from them. Why do we use both of those?881    Secretary Collins. That is something I am looking at now,882again, to try and streamline the issues that we have in our883system. Again, it is interesting. A lot of times we end up884talking about processes and plans here and not talking about885actual care and actually what the veteran experiences when they886go in. Most of the veterans, I will tell you, a lot of times887when they get through the labyrinth of stuff to get there, they888are happy with the service that they get. They are glad that889they are getting the service and they appreciate that. They890enjoy the choice.891    But when we actually put restrictions on our employees and892put restrictions on veterans getting in, it just makes it all893the worse.894    Senator Tuberville. Thank you.895    Chairman Moran. Thank you. Senator Murray.896897                       HON. PATTY MURRAY,898                  U.S. SENATOR FROM WASHINGTON899900    Senator Murray. Thank you, Mr. Chairman. Secretary Collins,901thank you for being here. Thank you for taking the time to talk902with me yesterday morning about the new policies that you now903have related to congressional engagement. For all of my904colleagues, this new policy will limit our ability to interact905with veterans on a VA campus, as it did when I was denied the906ability to host a veteran and provider roundtable at the CL VA.907I will note I have done that many times over my 30 years here908in the Senate.909    My staff was told it was a new policy, which had not been910put into writing at the time that I got denied. And I just want911to reiterate my request, Mr. Secretary, that you share that912newly written policy with every single Member of Congress.913    Secretary Collins. Senator, we definitely, as you and I914talked yesterday, this had been an unwritten policy for years.915It had been----916    Senator Murray. No.917    Secretary Collins [continuing]. It had been applied918differently. And I went back and checked. It had been applied919differently. And simply, there is no filter that we want you to920be there.921    Senator Murray. Well, I just have to say, I have never been922denied before.923    Secretary Collins. That is fine.924    Senator Murray. I do not know anybody else who has. This is925a new policy, and I think it is important that you have it in926writing----927    Secretary Collins. It will be.928    Senator Murray [continuing]. To every single member----929    Secretary Collins. It will be.930    Senator Murray. So we all know that. I would also note that931in our conversation yesterday, as well as in your responses to932nearly all of the oversight letters I have seen, you are933relying on this very broad explanation to everything that, and934I quote it, ``Everything you do is to ensure veterans receive935the care and services they deserve.''936    I want to take this opportunity, Mr. Secretary, to remind937you, the people on this dais, both sides, have the same938purpose. Many of us have been doing this for decades, and939oversight is both constitutionally required and it is critical940for all of us to do our jobs. So with that in mind, I would ask941you to rescind the memo from your Chief of Staff, which allows942him to personally sign off on any proposed or planned943engagement with any one of the 535 Members of Congress, which944really just stonewalls legitimate questions that we have.945    Secretary Collins. Senator, that was a memo that--that was946a missing characterization. That memo simply was coordinating947between OM and our Legislative Affairs Office to make sure that948our OM staff, who actually deals with the budget side, which949you do, and our Legislative Affairs, were on the same page.950Just as you would not want to, in your staff, talking to the951same group and basically not being on the same page.952    Senator Murray. Well, I have the letter and it directly953says that every request we have has to go through your Chief of954Staff, from our staff who wants questions, from any of us who955do. Everything has to be rerouted up to the top. That is going956to take forever. That denies us the ability for us to do----957    Secretary Collins. We will make sure that all legislative958inquiries, the stuff that you need, you are getting the959oversight. I agree with you. I served in Congress, as well.960Oversight is important. Also getting you good information is961important, as well.962    Senator Murray. I appreciate that. So is that letter no963longer in place, no longer applies?964    Secretary Collins. That letter is, the one that I am965familiar with, is letters to streamline information so we can966get you actually information quicker.967    Senator Murray. Streamline all the way to the top so our968questions are never answered. That is how we all read it.969    Secretary Collins. No. That is not the way the letter is970written.971    Senator Murray. Well----972    Secretary Collins. So it is not the way the interpretation973is.974    Senator Murray. I would ask you go to back and look at it--975--976    Secretary Collins. Okay.977    Senator Murray [continuing]. Because again, we have978oversight responsibility. We all take that very seriously.979    Secretary Collins. I agree with you.980    Senator Murray. We need those responses. We do not need981weeks and months to go through some, all the way to the top,982and one guy is sitting there deciding whether or not we get983information.984    Secretary Collins. Well, there is no weeks and months, and985the unfortunate part of the VA has been a bureaucracy issue. We986are trying to actually streamline it to get you information.987    Senator Murray. I have other questions. I mean this. I988would like you to go back and look at that letter and remind989yourselves we all need the information.990    Secretary Collins. Thank you, Senator.991    Senator Murray. As you know, fixing EHR and getting it992right for our veterans is about patient safety. During your993hearing I expressed my concerns about VA moving forward with994deploying the new system at four additional new sites when it995is still experiencing very serious issues at places in my996state, Spokane and Walla Walla. And you said that when it comes997to EHR you were going to, quote, ``listen to our clinicians and998listen to our hospitals.''999    Weeks later, VA announced plans to look at firing a1000staggering 80,000 employees this year. I want to know, did you1001ask these VA clinicians and hospitals about how those cuts1002would affect future EHR deployments?1003    Secretary Collins. The issue of the employment and the EHR1004deployments are separate. We are not looking--again, I cannot1005emphasize this enough. None of the reorganization that we are1006looking at deals with frontline workers or frontline employees1007that deal with everything from cleaning a----1008    Senator Murray. Okay. That was not my question.1009    Secretary Collins. So yes, we have been included. Dr.1010Evans, who runs our program, we have incorporated this. He has1011been working the program for well over a decade.1012    Senator Murray. Okay. I have 20 seconds left. I have been1013very vocal--you know this--about VA's troubling decision not to1014renew the terms of researchers who are working on absolutely1015critical projects and clinical trials for our veterans. There1016are planned trials that have not started. There are ongoing1017trials that have been stopped. And there are trials that have1018fallen apart due to staff layoffs.1019    Yes or no, would you agree that clinical trials stopping1020would have an impact on the care for our veterans?1021    Secretary Collins. I think clinical trials are very1022important, and the good thing about it is, is when we looked at1023it there were trials that were coming due, just as they always1024do. I put a 90-day stop on that so we can examine and make sure1025that everything is going good.1026    Senator Murray. Yes, I understand there is a pause on this1027new policy. Has a decision been made about what happens when1028that pause stops?1029    Secretary Collins. We are currently in the process of1030examining that now.1031    Senator Murray. Clinical trials that are out there have no1032idea. They have got to wait 90 days and pray.1033    Secretary Collins. At this point in time, like I said, some1034of those were actually stopped at the end, and we are actually1035keeping some in line so that they can continue if need be.1036    Senator Murray. Thank you, Mr. Chairman.1037    Senator Blumenthal [presiding]. On behalf of the Chairman,1038I recognize Senator Blackburn.10391040                     HON. MARSHA BLACKBURN,1041                  U.S. SENATOR FROM TENNESSEE10421043    Senator Blackburn. Thank you, Mr. Chairman, and Mr.1044Secretary, we are delighted that you are here today, so thank1045you for your time.1046    I do want to say, I have been so impressed with the way1047that you have tackled the EHRM program and that rollout. You1048and I discussed this in our first meeting and in your1049confirmation hearing and when you were in Nashville, and thank1050you again for making the Nashville VA one of your first stops.1051    I know that you are planning to take the EHR program live1052in 13 additional facilities in '26. And I know previously we1053have had an issue with VA employees showing up for the training1054and then utilizing the system. So talk to me a little bit about1055how you are going to continue this rollout and then get the1056employees to actually use the system.1057    Secretary Collins. I appreciate that, Senator, and I think1058one of the things that we are looking at in this rollout--and1059Senator Murray is no longer here but we talked about this--this1060rollout is being done, in a sense, when I found the system,1061basically the VA side of the house was sort of, we are not1062going to do anything and we are going to make it all1063individualized. And then you had Oracle side that was saying,1064you know, we could just finish this in a short amount of time.1065    So what we have done is we have actually now said put the1066onus back on Oracle to actually provide what they are supposed1067to provide, and we have also cut down on our side the amount of1068delay that was caused, really caused the initial problems in1069the rollout, where we had six different locations doing six1070different things.1071    So we have taken eight or nine committees that were all1072having to touch stuff before they could get back to a decision1073and cut that down to one committee, that then can communicate1074directly with Oracle to get this started.1075    Dr. Lawrence, which I appreciate everybody on the dais who1076helped get him through as our Deputy, he is now in place to1077actually take care of and work to oversee that, and we are1078bringing in others right now. And I have committed to him to1079whatever help he needs to hire, to bring in, to make sure that1080our system is safe and useful for our clinicians to make sure1081that they have that. And so far we have seen that actually1082occurring as we go forward. So I am looking forward to it.1083    Senator Blackburn. Okay. And then the employees that were1084instructed to go through the training, they have shown up and1085done the training?1086    Secretary Collins. As far as I know, Senator.1087    Senator Blackburn. Okay. That is great. And then let's see.1088How many employees have been released from the VA to date, out1089of your totals?1090    Secretary Collins. It would just be out of the probationary1091firings, it was about 1,000.1092    Senator Blackburn. About 1,000.1093    Secretary Collins. Yes.1094    Senator Blackburn. Okay. That is helpful. I want to ask you1095about the budget. The President's budget came out last week.1096How did you view the resources that are in there for1097modernizing the VA, and can you give me some examples of how1098you are going to use these resources, moving forward, so that1099the VA is more responsive, and in a more timely manner for our1100vets?1101    Secretary Collins. Yes. I think the budget as presented by1102the President is actually one that fulfills the commitment that1103we have talked about, about making sure our veterans are taken1104care of. And I think that is the big issue here when you look1105at the increases. And for all of the folks who have basically1106been saying and accusing us of, you know, going to cut health1107care and cut benefits and cut all this, it does not add up when1108you look at the budget itself, which has an increase either on1109base budget or also using TAP funds, as well.1110    So what we are looking at is how do we then use that,1111combined with the efficiencies we are finding, either through1112our contracts or through our employee base, to make sure that1113we are putting more of those resources to our research, toward1114our clinical care, toward our [response unclear]. Also toward1115our--and I know this is a concern of yours, is also toward1116community care, is how we actually balance the two needs.1117    So these are going to provide the resources we need. It1118also provides enough money to continue the EHRM, the Health1119Record Management system.1120    Senator Blackburn. And then how do we shorten the time that1121it takes for approval to move into community care? I just left1122a meeting with our rural hospitals, and they are willing to be1123a provider. And it is so much more convenient for our veterans1124to get the health care that they have earned, and to get it in1125their communities, when they want it, where they want it, at1126their convenience. And I think that community care is something1127that should be moved on today.1128    Secretary Collins. It is, and we are doing that. I have1129made it clear to every staff that I meet, and especially in our1130hospitals, that community care is part of the law. MISSION Act1131is there if they meet the qualifications. And also there is1132always a catch-fall that if the doctors sees that they could1133get better care in the community they can actually do that.1134    What we have found in the last few years is that actually,1135and through memos and others, has actually been not encouraged.1136There was an encouragement to keep everything in the VA. So we1137are actually moving forward with those kinds of things.1138    What we are also finding, though, is we have a community1139care group right now that is actually looking at how we do1140community care, and I am looking forward to seeing their1141findings here in the next week or so.1142    But what we have actually found is some roadblocks that are1143being put in by our own processes to not get people where they1144need to go. So that is something that is very important to me,1145and we are going to continue to look at it.1146    Senator Blackburn. Well, I am going to continue to work on1147that issue, and I appreciate your attention to community care.1148Thank you.1149    Senator Blumenthal. Senator Hirono.11501151                     HON. MAZIE K. HIRONO,1152                    U.S. SENATOR FROM HAWAII11531154    Senator Hirono. Thank you, Mr. Chairman. Facts are1155important so why don't we get to some facts.1156    You were asked how many VA personnel have been let go, and1157you said 1,000, but this Committee had been given information1158that there were some 2,400 who have been let go, and then you1159are trying to get back to 2019 numbers, which would be another116070,000 to 80,000. So what happened to the other 1,000 or so1161that we have been told have been released by the VA?1162    Secretary Collins. Following the court order, they are back1163employed.1164    Senator Hirono. I am sorry?1165    Secretary Collins. Following the court order, they are back1166employed.1167    Senator Hirono. Okay. So in other words, when you fired all1168these people or let them go, you did not follow appropriate1169procedures, and therefore you had to hire them back. That is1170not what I consider a process that is going to determine1171whether or not people are doing their job.1172    Secretary Collins. I disagree with that premise. We had one1173judge in one area. This court is still being litigated, so as1174you well know----1175    Senator Hirono. We have actually had, in other departments1176where they have fired people and other judges that have said1177you have to follow an actual procedure.1178    So getting back to some factual information, on February117921, you claimed that the VA has saved millions of dollars by1180firing staff. How much have you saved? You said millions. What1181is the amount?1182    Secretary Collins. Those millions in the round-out, I would1183have to get back. Especially now with those who have come back1184there is probably a different number that I would have to get1185back with you on.1186    Senator Hirono. Aren't you prepared to give us that1187information, knowing that you are testifying, knowing that you1188will probably be asked for factual information such as this? So1189you do not know. Even if you said, in February, that you saved1190millions of dollars by firing staff, and then you said----1191    Secretary Collins. Well, let me reclarify there. We did----1192    Senator Hirono. Let me finish my question.1193    Secretary Collins. We did say $14 million when we did away1194with our DEI.1195    Senator Hirono. You saved $14 million.1196    Secretary Collins. Yes----1197    Senator Hirono. Okay. So then my next question is, where is1198all that money going? I have a series of questions relating to1199your comments on February 21st. So you said millions of1200dollars. Now you are testifying, first you said you would have1201to get back to me, but now you are saying $14 million. Also, by1202cutting unnecessary programs, can you tell me what unnecessary1203programs, specifically, you have cut? And then you have1204redirected those savings, some $14 million, you say today, to1205veterans. And I would like to know specifically where these1206moneys were redirected? Do you have that information?1207    Secretary Collins. The number that I gave you just now on1208the DEI, the $14 million those have been directed to those with1209disabilities and prosthetics. We have also had a part of that,1210millions was also contracts that were either terminated or1211renegotiated, that we are in the process of doing, as well.1212    Senator Hirono. I think you need to tell us exactly what1213contracts have been terminated, because that is the thing about1214a contract. You know, when you terminate it, you have to have a1215reason for that. Otherwise, you end up having to pay.1216    Secretary Collins. Senator, also, in the contracts you also1217have to, when you are going through contracts and renegotiation1218you also have to make sure that you are doing it properly. We1219are going to give you all the information you need when those1220are actually finished.1221    Senator Hirono. I would hope that you would have had all1222that specific information today. You have about 500,0001223employees at the VA?1224    Secretary Collins. I am sorry. I did not hear you.1225    Senator Hirono. Does that sound right? You have 500,0001226employees at the VA?1227    Secretary Collins. No, we do not.1228    Senator Hirono. What is the number?1229    Secretary Collins. About 470,000.1230    Senator Hirono. Okay. That is getting pretty close to1231500,000.1232    Secretary Collins. Yes. It is a little high.1233    Senator Hirono. And what categories are they employed? I1234mean, for example, how many nurses? How many doctors? Do you1235have these 470,000 employees broken down by categories of jobs?1236    Secretary Collins. Well, that is part of our problem,1237Senator. I laid that out in my opening statement and also in my1238conversation with----1239    Senator Hirono. So you do not know.1240    Secretary Collins. No, and----1241    Senator Hirono. You do not have that----1242    Secretary Collins. Let me say something.1243    Senator Hirono [continuing]. You do not have that1244information?1245    Secretary Collins. Let me say something. Yes, we have over1246300,000, probably closer to 400,000, position titles. But you1247know what the problem is?1248    Senator Hirono. Thank you.1249    Secretary Collins. Before I ever got there, we could not1250even find some of these when our HR people started to look at1251it. So we took what we had----1252    Senator Hirono. Okay.1253    Secretary Collins [continuing]. At that point----1254    Senator Hirono. Let me proceed.1255    Secretary Collins. Well, if you want a direct answer, then1256I am giving you a direct answer.1257    Senator Hirono. You have a lot of people who are working1258for you. I would like to know, because there are questions1259about----1260    Secretary Collins. Well, and I am trying to answer your1261questions.1262    Senator Hirono [continuing]. Who are you actually going to1263let go when you go to the 2019 numbers, that is your goal?1264    But you were asked some questions about the clinical1265trials. That is very important to provide health care services1266to our veterans when they are enrolled in clinical trials. Do1267you know how many clinical trials are on pause, and do you know1268how many veterans are in clinical trials?1269    Secretary Collins. I would have to get that number back to1270you.1271    Senator Hirono. Is it 10? Is it more than--are we talking1272about 1,000 clinical trials?1273    Secretary Collins. No, we are not talking 1,000.1274    Senator Hirono. When you put----1275    Secretary Collins. But again, here is the question.1276    Senator Hirono. Can you give me a ballpark figure----1277    Secretary Collins. I will give you--no, I am not going to1278ballpark because it will be used against me next time I am1279here.1280    Senator Hirono. So you do not know. You do not know how1281many people that you have put on pause so that they are not1282getting the health care services that they need, because that1283is what a clinical trial is. You are getting medication. You1284are seeing doctors. You put these trials on pause. You cannot1285tell me how many veterans are now being paused in their1286clinical trials. You cannot tell me how many veterans are1287enrolled in clinical trials. You also cannot tell me how many1288clinical trials impact some--well, you have over 9 million1289veterans that you are taking care of. Clinical trials are very1290important, and you said so yourself.1291    Mr. Chairman, I have other questions. You know, it is very1292clear that our Secretary has not come with much in the way of1293numbers, and I really do not know how he is going to go about1294eliminating, getting to 2019 figures for cutting employees, and1295he cannot tell us what the categories of employees are, et1296cetera, et cetera.1297    So I think we are going to need to hear from Mr. Secretary1298again. Mr. Secretary, would you commit to coming back to this1299Committee to provide us the kind of information we are asking1300for and to respond to questions?1301    Secretary Collins. I will get you the information that you1302asked for----1303    Senator Hirono. Will you come back to testify, or is this1304it for us, with you, Mr. Secretary?1305    Secretary Collins. I will get you the information that you1306are looking for, Senator.1307    Senator Hirono. Mr. Chairman, we are not getting any1308commitment from the Secretary that he will come back to this1309Committee to provide us the responses to our questions. Thank1310you. That says a lot.1311    Senator Blumenthal. Senator Tillis.13121313                       HON. THOM TILLIS,1314                U.S. SENATOR FROM NORTH CAROLINA13151316    Senator Tillis. Good morning, Secretary.1317    Secretary Collins. Good morning.1318    Senator Tillis. How are you doing?1319    Secretary Collins. Having a ball.1320    Senator Tillis. I guess it might be afternoon by now, or1321close to it. Thanks for the time, the few minutes we just spent1322in the office.1323    You know, I was going to ask you some other questions until1324I ran into some folks at the elevator who are concerned over1325the proposed 83,000 cuts in the VA. And they asked me1326specifically would I publicly oppose those cuts. I said, ``I1327can't.'' They said, ``What do you know about these cuts? What1328do you know where they are? Are they potential cuts that will1329improve access, outcomes, or costs?''1330    So my question to you--what I did tell them, though, is I1331do not believe cuts are real unless there is a recissions1332package sent to the U.S. Congress, so that we codify those1333cuts. And so my commitment to the folks that I was talking to1334was when I see that recissions package, if it is at odds with1335what I consider to be in the best interests of the VA, I may1336vote against it. But right now can you give me an idea of how1337you would rack and stack each of those 83,000 jobs, and where1338you are in that process, and can we expect, at some point in1339the future, to have a recissions package?1340    Secretary Collins. Yes, Senator. I think the biggest thing1341here is, I think what we have got to understand is when you1342start out in any business, and I do not care what side of the1343aisle you are on, when you go out to look at somebody, you just1344do not go say, ``Just go do something.'' That has been1345happening at the VA and many agencies in the Federal Government1346for a long time. And typically what you get is a spattering of1347this, you get some who are interested, some who are not.1348    So when you look and you put a 15 percent number, which1349everybody characterizes, and I have been accused of firing135080,000 people here, which is not true. Nobody can predict that.1351And also no one on this dais, on either side of the aisle, can1352say that that many people are going to be fired, because this1353is the reason. When you take a 470,000 person organization, and1354you begin to look at its efficiencies, you begin to look at the1355fact that between the hospitals and the Central Office you have1356added significant layers of bureaucracy that go into this, you1357cannot do it. So we are looking at every step we can.1358    But also, I am not going to play it out in a public arena,1359because that is the other time, is if we start saying, here is1360everything we are looking at, then you start, in a pre-1361decisional kind of format, you are not working it.1362    Senator Tillis. Look, I get it. What I tried to explain to1363them, I asked them, and I think some of them may be in the1364audience. I wanted to note that I heard you. But I asked them,1365``How do you rack and stack it? Tell me which specific1366positions you are concerned with?'' Obviously, they do not know1367the answer to that because I do not know the answer to that.1368    But here is the problem, folks. Is the VA just great? Do we1369just put it on autopilot? Because that is the question. And1370when people say ``don't change,'' I am saying, ``Right. So you1371are happy with the current state. You are happy with a poorly1372implemented PACT Act,'' that I tried to get people to hold off1373on until we got it right. And now we are dealing with a1374shortfall there.1375    So look, do not be against something because it is new. And1376by the way, if any of you need it I have got extra copies of1377``Who Moved My Cheese?'' in the office. We have got to move the1378cheese in the VA folks, because we are not performing. When is1379the last time I have heard people stand at a parade and say,1380``Appointments are rocking. Boy, they are doing great.'' When1381is the last time I heard that the electronic health record is1382great? Some folks need to lose their job on a poor1383implementation, and I have got your assurance that they are1384moving forward.1385    Folks, the VA is not working for veterans. And if we just1386say everything has to stay the same, and you have just got to1387have more money and more people, you are looking at it the1388wrong way. Maybe, at some point, when we prove that we are1389improving access, improving outcomes, or reducing costs, when1390those policies come before me, then I get excited. But in the1391meantime, I am open to anything that is going to improve the1392service to people and make an installment on a debt that we can1393never fully repay. But we need to be honest with these veterans1394and tell them change is necessary to do that.1395    And so to the veterans that I met with outside the hallway1396today, you recorded it but you can use this response. This1397response is ``I am open to any suggestion that improves the1398condition for veterans, period.'' And I cannot say no to1399something because it makes me feel uncomfortable. I do not know1400if it is 83,000, 8,000, or 800. But I have confidence in you to1401go through that process. And at the end of the day I will make1402a judgment on your decisions because I would expect a1403recissions package to make sure that those positions are not1404going to be approved in the future. And that is how I will1405complete my job as a U.S. Senator.1406    But in the meantime, I am not going to say do not change,1407because we have to change to do a better job for veterans,1408folks. And we have to be a little bit uncomfortable in going1409through it.1410    Thank you.1411    Secretary Collins. Thank you, Senator. I could not agree1412with you more, and I think the interesting thing that I came in1413here today was, again, hearing some of the comments in opening1414statements and stuff, I would almost have thought that up until1415January of this year there were no problems in the VA.1416    Senator Tillis. It is like nothing to see here.1417    Secretary Collins. Nothing to see. So the minute we start1418trying, can we make things better, my only criteria that I have1419looking forward in this is making sure that we are taking care1420of the veterans first. That is the only criteria that we are1421looking at, going through that. And if that means we reshape1422the workforce, we do whatever our goal is. But at the end of1423the day, the metric is, are we taking care of veterans.1424    Senator Tillis. Never stray off that course. Thank you, Mr.1425Chairman.1426    Chairman Moran [presiding]. Senator Hassan.14271428                   HON. MARGARET WOOD HASSAN,1429                U.S. SENATOR FROM NEW HAMPSHIRE14301431    Senator Hassan. Thank you, Mr. Chair and thanks to the1432Ranking Member as well. Welcome, Secretary Collins. Thank you1433for being here today and for your own military service.1434    Just a note to my colleague from North Carolina, a lot of1435us have been working hard on reform at the VA for a long time,1436and agree that there need to be changes. But that is not what1437my line of questioning is about. This is about whether the so-1438called changes you are already making are being made with1439thought and transparency in a way that will serve veterans the1440best.1441    In your testimony, you stated that the VA is an1442organization whose sole purpose is to serve veterans. You have1443also publicly stated that you plan to fire 80,000 VA employees.1444The quote is, ``That is a goal. That is our target,'' close1445quote. Well, roughly 25 percent of VA employees are themselves1446veterans, meaning that if you do follow through with this plan,1447you will likely end up firing thousands of veterans.1448    It is also worth noting that the Veterans Health1449Administration accounts for nearly 90 percent of all VA1450employees. So if you are firing evenly across the VA, you will1451end up firing roughly 70,000 VHA employees.1452    So Secretary Collins, is your goal to fire thousands of VA1453employees who work to support and provide health care to our1454veterans? Yes or no.1455    Secretary Collins. My goal is to make sure that veteran1456care is done in the best possible way, and putting numbers in a1457place that, of course, you have no blueprint for is not helping1458any veteran in this room.1459    Senator Hassan. The numbers that I am talking about are the1460numbers that exist at the VA now, and I am basing my remarks1461and my questions on your public statements, because to many of1462the other Senators' points, we are not getting specifics from1463you or your agency.1464    Now, how many employees does the VA have that work outside1465of the Veterans Health Administration?1466    Secretary Collins. If you divide it up, in the different1467administrations, the vast majority are close to--what was it1468the last time, about 350,000?1469    Senator Hassan. So let me answer the question. Outside----1470    Secretary Collins. 370,000 in VHA. The rest are all1471[response unclear].1472    Senator Hassen. Outside of the VHA there are 54,0001473employees. It is actually impossible for you to fire 80,0001474employees without firing those who help provide health care to1475our veterans. And I am disappointed that in all this back-and-1476forth you seem to be trying to hide that.1477    Secretary Collins. Senator, can I ask a question?1478    Senator Hassan. So no one----1479    Secretary Collins. I mean, I just want to respond to this1480because I have a question for you. When my goal is to actually1481take care of veterans health care, and when you look at an1482interior designer in a hospital, is that actually taking care1483of health care? I do not think so. Those are the kinds of1484positions we are looking for.1485    Senator Hassan. My point is----1486    Secretary Collins. When you have multiple----1487    Senator Hassan. My point is this. My point is this. If1488there are a few hundred here and there. But you are talking1489about 80,000 employees, and 54,000 employees work outside of1490VHA. So you are taking a meat cleaver approach. There is that1491old adage, ``Measure twice, cut once.'' You guys have been1492cutting without measuring.1493    Now let me get to another question.1494    Secretary Collins. Well, I am not cutting anything yet.1495    Senator Hassan. Well, you----1496    Secretary Collins. We have not cut anything yet.1497    Senator Hassan. You have cut 2,500 employees, randomly.1498    Secretary Collins. They----1499    Senator Hassan. Secretary, my time is my time. No one in1500the Trump administration has been able to explain how cutting1501nearly 1 in 5 VA employees will not harm health care and1502service for veterans. In fact, just last week, the VA's head of1503Clinical Services, the top doctor in the entire VA, came before1504this Committee and stated that he has not been involved in any1505discussions about how firing 80,000 employees would affect1506veterans' care, and he had not seen or been provided any1507analysis as to how these planned firings might affect care for1508veterans. That is the VA's head doctor, the person in charge of1509primary care, emergency medicine, surgery, mental health, et1510cetera, saying that no one from your team has even bothered to1511once ask him whether firing one-fifth of all VA employees would1512make health care better or worse for our veterans.1513    So Mr. Secretary, why have you not asked the VA's top1514doctor whether your plans to fire 80,000 VA employees would1515harm health care for veterans?1516    Secretary Collins. I will not speak for anyone else who1517gave that testimony, but I will say this. In VHA, VBA, and NCA,1518they all have working groups. They all have, at the senior1519leadership, have been working on this process.1520    Senator Hassan. Well, this doctor told us that he has not1521been involved in any of those discussions.1522    Recent reporting states that the Department of Defense may1523cut the Army's active duty force by up to 90,000 soldiers. To1524cut the force by that much we could reasonably expect that1525thousands of soldiers will end up leaving active duty and1526returning to civilian life, meaning that they will lose their1527military health care and will almost certainly turn to the VA.1528How is the VA preparing to care for those soldiers, and how1529does firing 80,000 employees support that preparation?1530    Secretary Collins. You know, again, the interesting part is1531that they will be taken care of, as every veteran who has1532earned the benefit, going forward. I cannot state this enough,1533and we can continue this process with everybody who wants to1534ask, and I get it. But there has not been 83,000 people1535targeted for firing. There has been a goal to look at our1536restructuring, and putting 15 percent----1537    Senator Hassan. You----1538    Secretary Collins [continuing]. It is a nice talking1539point----1540    Senator Hassan. Mr. Secretary----1541    Secretary Collins [continuing]. But we have not done it1542yet.1543    Senator Hassan [continuing]. It is your talking point.1544    Secretary Collins. It is 15 percent----1545    Senator Hassan. It is your talking point. We are quoting1546you saying that is the goal.1547    Secretary Collins. It is our goal.1548    Senator Hassan. Now, okay.1549    Secretary Collins. A goal is not a fact.1550    Senator Hassan. Now, do you want to reach your goal, or1551not?1552    Secretary Collins. A goal is not a fact.1553    Senator Hassan. Because most people, when they state a1554goal, decide they would like to reach it. If you do not want to1555reach 80,000, revise your goal, and tell us what you want to1556do. Talk to us about the analysis you have performed. You have1557got a lot of knowledgeable people, both sides of this aisle.1558Both sides of this aisle want to serve veterans. It is our1559primary honor and privilege as Americans to do it. And we are1560asking to engage with you in a way to reform the VA, improve1561care, but make sure that that health care and those services1562are there for veterans. And just tossing out big numbers and1563cutting before you are measuring is not the way to do it.1564    Thank you, Mr. Chair.1565    Chairman Moran. Senator Cassidy.1566    Secretary Collins. Can I finish that, because again, this1567is----1568    Chairman Moran. Secretary Collins.1569    Secretary Collins. Senator Cassidy?1570    Senator Cassidy. This is his time.1571    Chairman Moran. Secretary Collins.1572    Secretary Collins. This is the problem that we have, and1573this is the problem that I saw when I was in Congress and this1574is a problem that I have seen everywhere. When we go into1575something, and you look at it, you have to go in and look at1576the process to start with. You start with a goal, you start1577with what you are looking for, and then you use the data that1578you find from your organizations to make the best choices you1579can, without a meat cleaver approach.1580    But when you also start with a premise that is not true, a1581premise that is not going to--and basically saying things that1582we are not looking at--because I am not sure how we get around1583the fact that we are not cutting the primary health care of1584people who are getting it or cutting their benefits. That is1585not helpful in a collaborative process to say are we working1586it.1587    The question I have is, the VA is not working in the way1588that it should work. I am trying to get it to a point where it1589can work for all veterans, and the workforce is a part of that.1590    So, I mean, the VA is working undoubtedly, as I have heard1591this morning. It was perfect before this year started. That is1592not true.1593    Senator Hassan. And, Mr. Secretary, that is unfair to the1594Members of this Committee, and you need to stop characterizing1595it that way, because that is not what a single person on this1596dais thinks.1597    Chairman Moran. Senator Cassidy.1598    Senator Hassan. So, Mr. Chair, I am just going to say one1599more thing here. I am eager to engage in real numbers and non-1600magical thinking here. But this witness and the VA cannot have1601it both ways. They cannot set out a goal and then get angry at1602us for asking what the impacts of that goal and those cuts1603would be. Thank you.1604    Chairman Moran. Senator Cassidy.16051606                       HON. BILL CASSIDY,1607                  U.S. SENATOR FROM LOUISIANA16081609    Senator Cassidy. Hey, Secretary Collins. How are you, man?1610    Secretary Collins. I am having a great time.1611    Senator Cassidy. Good to see you here. Listen, I was just1612with a press conference back home, with reporters back home----1613    Secretary Collins. Okay.1614    Senator Cassidy. I was asked one, and if you need to get1615back to me on this, I am okay with that. But they asked me1616about the VA's Servicing Purchase program, or VASP. And there1617was a COVID-era program helping veterans who, because of the1618COVID-era shutdown, needed mortgage support. The Biden1619administration abruptly ended it two years ago, according to1620NPR, leaving veterans in the lurch. There was something put in1621the interim.1622    Now, apparently Congress has not filled that void. So I am1623asking you about this, and if you have to get back to me that1624is fine. But also kind of challenging the Members of this dais,1625if Congress needs to step up and do something, then hopefully1626we will be able to do something.1627    Let me turn it to you.1628    Secretary Collins. Yes. The VASP program is something that1629we do not need to be in the mortgage side that we were with the1630VASP program requires us to take on. So we, on May 1st, did end1631that part. It was a discretionary part. That is not1632appropriated funds. It was used and generated from inside.1633    We do not need to be in that business. I know there has1634been a lot of discussion on some legislation that is coming1635through, dealing with more partial claims, that can actually1636give the veteran help in the situations that they are in1637without having to go into the situations that VASP created. So1638that is the story on where we are at right now with that.1639    Congress does have a big role to play in that. We look1640forward to seeing how that legislation, especially the partial1641claims, comes through.1642    Senator Cassidy. Sounds great. Next, because Senator Hassan1643was saying, okay, we need to have some sort of objective1644analysis, you would agree we need an objective analysis.1645Believe me, I think all of us would say the VA needed some1646improvement, so thank you for taking on that big job.1647    One thing I have been proposing is something called VetPAC,1648which would be patterned after MedPAC and MACPAC, which gives1649advice from an independent board objectively to the public and1650to Congress as to how to reform, in the case of these two1651programs, Medicare and Medicaid, preserving benefits, but doing1652it more cost effectively for the taxpayer. Senator Hirono and I1653have suggested something called VetPAC, and we have1654reintroduced that this year.1655    My question for you is, we had submitted it for the1656legislative review. Your folks said they liked it. But we have1657not yet gotten the technical assistance. So it is something1658that is bipartisan, that would address a lot of the concerns1659being up here, to give us objective reality, and you guys like,1660but we have not gotten our technical assistance. So just a1661request that, by golly, you walk out of here, you call somebody1662and say, ``Hey, Cassidy and Hirono want that technical1663assistance. Give it to them.''1664    Secretary Collins. I think they are hearing that right now,1665Senator.1666    Senator Cassidy. That is great. It always helps when you1667say it too.1668    Secretary Collins. Okay. We will get the technical1669assistance to you.1670    Senator Cassidy. That is great. Thank you, sir.1671    Lastly, one thing that I have been concerned about, and to1672see where you are on this. I am doctor and I like the fact that1673veterans, if they are not near a VA facility, can go to the1674private sector. But there has not been a good utilization1675review or prior authorization. Prior authorization can be a bad1676word, but I just know from experience that if someone goes1677someplace and there is no limit on the amount of testing that1678the medical facility can order, there is going to be a lot more1679tests ordered, and sometimes they are inappropriate and1680sometimes they bring on complications. Does that make sense?1681    Secretary Collins. It does, and I think that is one of the1682things that we are looking at, especially in the community care1683working group that we have currently going, is making sure that1684we are looking to make sure that those equities are in balance1685as far as making sure the veteran gets what they need, the1686doctor have their authorizations.1687    We also have an issue, especially in community care, that1688is something I think you and I have spoken about too, and that1689is our third-party administrator system. It tends to be1690something that is a multiple complaint by many in the system1691because it is the sort of conduit between the VA and the1692community, and it has not been working as it should.1693    About my first week when I got there, one of the things1694that I did find out was the groundwork had not been put in1695place to do the renewal of contracts this year on those third-1696party administrators. There was supposed to have been work done1697in the prior. So we had to delay that, go to the extra year, so1698we are sort of stuck in a year here in which we did not ask1699for. But it is not actually being able to get to the part that1700we are putting in questions. We are going to have a contract1701that is going to be much better in that authorization side,1702much better in getting the VA and the community on the same1703page.1704    Senator Cassidy. I think you are working at least 80-hour1705work weeks, so thank you for doing that on behalf of our1706veterans.1707    Secretary Collins. Thank you.1708    Senator Cassidy. I yield.1709    Chairman Moran. Senator King.17101711                    HON. ANGUS S. KING, JR.,1712                    U.S. SENATOR FROM MAINE17131714    Senator King. Thank you, Mr. Chairman. Mr. Secretary, on1715February 24th, you announced, I think there was a video of the1716cancellation of hundreds of contracts, 875 non-mission-critical1717you characterized them as, and then there was a lot of reaction1718to that. So in 24 hours, the Department made an internal1719announcement that you were reconsidering that guidance and1720offered a pause on the cancellations. Then, on March 3rd,1721another announcement, 585 contracts would be canceled. You said1722they were non-mission-critical or duplicative.1723    On March 6th, I wrote you a letter asking to have a list of1724those 585 contracts. You mentioned earlier today it is not1725weeks or months. Well, in my case it was two months. I got a1726response on Friday that was a non-response. It did not give me1727the list of the contracts. Why will you not tell us what those1728contracts are?1729    Secretary Collins. As those are finished, as you well know,1730and I said earlier to the contracts end, we are doing the1731negotiations. Part of those contracts may be rescoping of1732contracts. They are not completely taken down----1733    Senator King. I understand that. But just give us----1734    Secretary Collins. When we get to the final we will be1735giving those to you.1736    Senator King. Well, I do not understand why you cannot give1737them to us now. I just want a list of the contracts. It has1738been two months, 585 contracts. I want to know what they are. I1739mean----1740    Secretary Collins. I understand, sir.1741    Senator King [continuing]. I am an optimistic kind of guy,1742and I am not suspicious. But the fact that you will not tell us1743what they contracts are that are being renegotiated makes me1744wonder if there are things in those contracts that maybe you do1745not want us to know about.1746    Secretary Collins. Well, I will say that, from my1747perspective, that is not it, and we will work to get you the1748information you need.1749    Senator King. When?1750    Secretary Collins. We are working through it now. We sent1751the last----1752    Senator King. How about by next Friday?1753    Secretary Collins. I will get with our folks and see what1754we can provide you at that time, and we will see what we can1755get to you.1756    Senator King. Well, that is really not a very satisfactory1757answer. It seems to me this could not be simpler, just a list1758of 585 contracts. Somebody has that list. I do not know why you1759cannot supply it to his Committee. When you were confirmed,1760Senator Blumenthal said, ``Will you commit to respond promptly1761to any inquiry from Members of this Committee to request1762information and be fully transparent with this Committee?'' You1763said, ``That is my intention for this Committee, that you have1764every information that you need.'' Well, this is the antithesis1765of transparency. Again, I cannot imagine anything more simple1766than to just give us, somewhere there exists, this list.1767    Anyway, let me go on to another question. There has been a1768lot of discussion today about the firings, and you have talked1769about a goal. What bothers me is the goal. If you are talking1770about restructuring the VA, shouldn't you be talking about1771where you need restructuring and not start with an arbitrary1772number? How did you choose 2019 as the number, as the target1773for your staff size? What is magic about that year?1774    Secretary Collins. Well, I think that was, when you go back1775to the actual Executive order, which we were following to go1776through, to downsizing our government, making it more1777efficient, and looking at it, and that was the termination from1778looking at sort of the 15 percent, as we look at the target----1779    Senator King. Well, my problem with that is if you have an1780arbitrary number, whether it is 15 percent or 2019, that1781presupposes the result that there are that many unnecessary1782jobs. It seems to me you ought to do an analysis of where is1783the duplication.1784    By the way, I am not one that is advocating, in any way,1785shape, or form, that the VA was perfect on January 20, 2025. I1786certainly agree that the staffing should be examined, the1787policies, particularly the red tape that Senator Tuberville was1788talking about. I think those are all very good things that1789should be examined. But it should be done in a thoughtful and1790transparent way. And I just do not understand why the magic17912019, by the way, there have been seven significant veterans-1792related bills passed since that year, including the PACT Act,1793one of the most significant expansions of VA benefits in recent1794American history. And yet the goal is going back to that1795particular year. A goal should be efficiency, not a quota.1796    Secretary Collins. Yes, and that is what we are looking at,1797and that is what a goal is, is looking at it. But one of the1798things, when you look at this, just last year the previous1799administration, and through presentations that they made,1800actually advocated for a 28,000 person decrease in employees at1801the VA.1802    Senator King. I am not----1803    Secretary Collins. So, I mean, it is not a new thing to1804look at it. But I want to agree with you here, Senator, that we1805are looking at this in a way that says what is the best part.1806One of the things, also, there may be a new application in new1807legislation that has come forward, because also newer1808technologies, also newer ways and quicker ways that we can get1809stuff done.1810    Senator King. And I----1811    Secretary Collins. So that is the efficiency issue we are1812talking about.1813    Senator King. Well, in the memo from your Chief of Staff on1814March 4th it talks about this. It says, there is an1815information-gathering report due March 10th, another report due1816April 10th, and then ``a Department-wide review will be1817completed by May 9th.'' That is three days from now. Will you1818share that data with this Committee, whose responsibility is to1819oversee the implementation of the laws and regulations on1820behalf of veterans?1821    Secretary Collins. Yes, those are being worked on right1822now, and they are in the pre-decisional format, so there is not1823something to share with you on those at this point, especially1824the one coming out. In fact, we have actually had an extension1825because our Department is so large, so we are not making quick1826decisions. We are not moving forward on that, at this point.1827    Senator King. Well, I will go back to my question then, and1828I will end with this. The reaction to the contracts request,1829which it seems to me is so straightforward, does not fill me1830with the confidence that we are going to truly have a1831transparent relationship here.1832    We are all on the same side. The whole goal of everybody1833stated here today is to protect our veterans and to be sure1834that they get the services they have earned and the benefits1835that they have earned. And so to the extent that you can work1836with us and allow us to understand what you are doing, that1837would be helpful to develop a more collaborative relationship.1838    Thank you, Mr. Chairman.1839    Secretary Collins. Thank you, Senator.1840    Chairman Moran. Senator Boozman.18411842                       HON. JOHN BOOZMAN,1843                   U.S. SENATOR FROM ARKANSAS18441845    Senator Boozman. Thank you, Mr. Chairman. Thank you so much1846for being here, Secretary. The VA owes it to the veterans it1847serves to evolve and provide them with the best possible1848experience. I appreciate your commitment to improving delivery1849of veterans health care and benefits. I know improving the1850veteran experience is a priority that both you and I share, and1851we appreciate your hard work in trying to get that done.1852    I want to thank you for submitting your fiscal year 20251853spending plan in a timely manner. The plan raised some1854questions with the Appropriations Committee and this Committee1855as some of the numbers differ from what we expected. To date,1856none of those questions have been answered, and repeated1857requests for a briefing on the plan have not yet yielded1858results.1859    As we are trying to get our appropriations bills done, will1860you commit to sending a team over to brief us as to what is1861going on and give us a little bit more detail, so that we can--1862--1863    Secretary Collins. Yes, Senator, we will be happy to do1864that.1865    Senator Boozman [continuing]. To get things done? Very1866good. That was easy. 2025 and 2026--your 2026 budget request1867proposes a significant reduction in VA's IT systems. DOGE1868review of the nearly 1,000 unique systems at the VA is not1869complete yet. Would you consider balancing your proposed1870reduction in funding until we actually get that report done, to1871see what they find is needed?1872    Secretary Collins. We are looking at that right now as far1873as what we do need, and we will be able to work with you as we1874go forward on that.1875    Senator Boozman. Very good. You recently announced the1876ending of the VA Service Purchase program, or VASP, that saw1877the VA take on modified home loans for veterans at risk of1878foreclosure. I support the VA looking for ways to avoid the1879financial risks that VASP exposed the agency to. We are worried1880about the current population of delinquent veterans who are now1881enrolled. It is my understanding that as of May 1st, delinquent1882veterans who are not already enrolled in VASP are now at risk1883of foreclosure.1884    Now that VASP is unavailable, how does the VA plan to help1885veterans at risk of foreclosure?1886    Secretary Collins. I think one of the things that we are1887looking at is any other programs that are out there, also, that1888we go forward. But I think when you have to look at the1889organization, is this an area that we need to be in? And I1890think those are the kinds of things that the decision there was1891the people that had mortgages that were coming due was becoming1892to be a larger burden because we are not a system that is set1893up to own property. So we are going to be working on that, and1894as I said earlier, to one of the Senator, I think we are also1895looking at it from a perspective. I know there is some1896legislation being talked about, about partial claims and stuff,1897that can help them in the long term.1898    Senator Boozman. Good. I would appreciate you looking at1899that. You know, it is one thing, going forward. It is another1900thing for those individuals that are caught up in that now. And1901it makes it really difficult.1902    How did the VA make the decision to reduce the VA's Remote1903Temperature Monitoring Program for veterans who have1904demonstrated both clinical benefit and cost savings to the VA?1905    Secretary Collins. Could you repeat the question?1906    Senator Boozman. Well, the VA's recent changes have1907impacted veterans' access to the Remote Temperature Monitoring1908Program. As you may be aware, this program is critical in1909preventing and reducing amputations required because of ulcers1910and other diabetic foot complications. Effective preventions of1911amputations result in significant cost savings for the VA.1912    Again, are you aware of that, and if so, how did we come to1913that conclusion?1914    Secretary Collins. Senator, I will have to get back with1915you on that one. I have prepared for a lot of things. That was1916just one I will have to get back to you.1917    Senator Boozman. Good. No, I understand. You certainly have1918a lot going on.1919    During your remarks at President Trump's April 30th Cabinet1920meeting you mentioned that you and Secretary Kennedy have1921discussed the potential of researching psychedelics as an1922effective tool to combat PTSD, TBI, and other mental issues.1923Can you provide further details on how your team plans to take1924action on this interest? I think the Committee is very1925interested.1926    Secretary Collins. I can. I think it is something that I am1927committed to doing whatever we can to provide veterans and1928those who have maybe not responded to traditional care and1929others, especially in the area of PTSD, also TBI, the other1930issues that we are dealing with that lead to a lot of what we1931have seen in suicide and death by suicide. So we are looking at1932it right now.1933    I think there are 11 studies that are going on. Most are1934performed outside the VA, with our help. MDMA is another one. I1935just saw a program at Emory University in which they are seeing1936some really good results, a single treatment then followed up1937by two weeks of intensive counseling that actually has lowered1938the score number on the PTS scale.1939    I am willing to say this, is I want to work with--and I1940said this with HHS and with others, to make sure that we are1941not closing off any outlet for a veteran who could be helped by1942these programs. And I think we will definitely be working with1943Congress on that if there seems to be something else we need to1944have.1945    Senator Boozman. Very good. Thank you, Mr. Chairman.1946    Chairman Moran. Senator Sanders.19471948                     HON. BERNARD SANDERS,1949                   U.S. SENATOR FROM VERMONT19501951    Senator Sanders. Thank you, Mr. Chairman. Secretary1952Collins, do workers in the United States have a right to be in1953unions? Secretary Collins, do workers in the United States have1954a right to be members of unions?1955    Secretary Collins. Okay.1956    Senator Sanders. Yes or no?1957    Secretary Collins. Yes.1958    Senator Sanders. Okay.1959    Secretary Collins. I did not know that was a question.1960    Senator Sanders. Okay. President Trump issued an Executive1961order banning collective bargaining in the VA, eliminating1962union rights to 79 percent of workers there, because of1963security reasons. Do you think that workers in the VA are a1964threat to national security if they are a member of a union?1965    Secretary Collins. I do not think that was the purpose of1966the EO, Senator.1967    Senator Sanders. That is exactly what he said. Then why did1968you eliminate collective bargaining rights at the VA?1969    Secretary Collins. I think the interesting issue is that is1970not what the EO was about. The EO was about our national1971security interests of our fourth mission, and if you look at1972the entire EO it is about making sure that the fourth mission1973is not----1974    Senator Sanders. Is a nurse at the VA a national security1975threat by being a member of a union?1976    Secretary Collins. Okay. Sir, I cannot answer the question.1977We are on different pages. It is not the fact that the VA is a1978national security threat. It is a national security threat that1979if we cannot perform our fourth mission----1980    Senator Sanders. No, no, no. That is----1981    Secretary Collins [continuing]. That is what we are looking1982at.1983    Senator Sanders. Well, the bottom line is unions, 791984percent of workers at the VA are union members. They no longer1985are able to engage in collective bargaining. To me that is an1986outrage. I think the courts will overturn that. Next question.1987    Secretary Collins. No, at this point that is not true.1988    Senator Sanders. Let me----1989    Secretary Collins. At this point that is not true.1990    Senator Sanders. All right. Let me ask you this. Do you1991believe that every veteran in this country, as I believe and I1992think many Members of this Committee believe, are entitled to1993VA health care?1994    Secretary Collins. As a veteran, yes.1995    Senator Sanders. Yes, Okay. What are we doing right now,1996what are you doing to improve outreach to bring more veterans1997into VA?1998    Secretary Collins. Well, I think, let's go back to the1999question you just said, does everybody have a right to be in a2000union. The answer is yes. Does everybody have a right to, a2001benefit that they have earned, to come to the VA? But I cannot2002force them in.2003    Senator Sanders. No, of course you can't. But of course you2004can't.2005    Secretary Collins. So I am missing--I mean, maybe I am2006missing the point there. I apologize.2007    Senator Sanders. The point is there are a lot of veterans2008out there--I know this; I used to be Chair of this Committee--2009who do not know what their benefits are. And it is our2010obligation to say to veterans all over this country, ``You put2011your life on the line to defend America. Congress has passed A,2012B, and C. We welcome you into the VA if you choose to come2013in.''2014    Secretary Collins. Senator, I think this is a great place2015for us to have an honest conversation, because I am concerned2016about this, as well. And part of this goes back to how we are2017actually transitioning out of DoD, into VA.2018    Senator Sanders. That is one of the factors.2019    Secretary Collins. And I think that is one of the big2020things. And there is an honest conversation here, is it2021properly placed right now----2022    Senator Sanders. Good.2023    Secretary Collins [continuing]. Transition. So I am wanting2024to do that, and we are doing outreach all the time with our Vet2025Centers and everybody else, to let people know.2026    Senator Sanders. Okay. I think we could do a better job.2027    Secretary Collins. I agree. I agree completely.2028    Senator Sanders. Okay. Question. You know, we talk about VA2029health care, which is what we are here to talk about, but we do2030not put it into a context. We are living in a nation which has2031a broken, dysfunctional, wildly expensive health care system.2032In your judgment, just out of curiosity, how does VA health2033care compare to health care out in the regular world for2034civilians?2035    Secretary Collins. I think in certain areas, just like out2036in the regular world, you have some hospitals that are2037performing exceptionally and you have some that are not. I2038think that is the problem that we have in our health care2039systems, in general. I think this is something I said earlier.2040We cannot separate out VA from the health care system as a2041whole.2042    Senator Sanders. Sure. That is true.2043    Secretary Collins. Though sometimes we do that.2044    Senator Sanders. All right. All right. Let me ask you this.2045My understanding is that we have, roughly speaking, a shortage2046of 2,500 doctors, 6,600 nurses. All right. What are you guys2047doing to bring in more doctors, nurses, social workers, into2048VA, where they are desperately needed?2049    Secretary Collins. Well, one, I want to move doctors that2050are not working with patients and move them into patient care.2051That would be a good start. Nurses, as well. Also, I would like2052to have help from the Congress, as well. We need to actually2053look at our pay structures and our caps on our doctors and what2054we can pay them. It is very difficult to compete when you are2055offering, at some points, hundreds of thousands of dollars2056less----2057    Senator Sanders. That is right.2058    Secretary Collins [continuing]. For someone to come work at2059the VA.2060    Senator Sanders. All right. I agree with you. Do you2061acknowledge, though, that right now there is a shortage of2062doctors, nurses, social workers in the VA?2063    Secretary Collins. I acknowledge there is a shortage for2064everybody in the health care industry on those same issues.2065    Senator Sanders. But in the VA. I am not criticizing you.2066    Secretary Collins. No, no. I mean, we are the same as2067everybody else. That is why I said, we are the same as every2068other health care system. We are struggling to recruit doctors,2069nurses, and others, just as anybody else. And that is something2070we are constantly in outreach about. Sometimes it is helpful,2071sometimes it is not.2072    Senator Sanders. The Department of Defense has a medical2073school. You are aware of that, Uniformed Services Medical2074School----2075    Secretary Collins. Yes.2076    Senator Sanders [continuing]. Which does a very good job.2077Do you think that one of the problems we have overall is that2078we are not graduating enough doctors and nurses in America?2079    Secretary Collins. Yes.2080    Senator Sanders. All right. Do you think we can be2081expanding schools like the Uniformed Services Medical School to2082bring more people into DoD and VA health care?2083    Secretary Collins. It is an interesting concept. I think we2084have got to go back to a deeper issue, is why are more of our2085young people not going to school to be a doctor, a nurse, or2086other things. I think that is a bigger issue.2087    Senator Sanders. All right. Fair enough. But that has to do2088with if I am a working-class kid, I am going to graduate2089medical school $500,000 in debt. Correct?2090    Secretary Collins. Right.2091    Senator Sanders. Is the idea of entertaining programs2092saying you want to go to medical school, we are going to pay2093for your entire tuition, et cetera, et cetera, to encourage you2094to get to medical school graduation?2095    Secretary Collins. I think anything that we can look at to2096encourage that, probably you already have that, when you can go2097into the medical and they will pay for your, in DoD, they will2098pay for your medical school.2099    Senator Sanders. But it sounds like we may want to expand2100that.2101    Secretary Collins. I think it is something, as an overall2102health care system, Senator, you and I probably agree on this2103probably more than anyone else, that we have got to make sure2104that our pool of workers is adequate for all of our systems,2105not just the VA. And the health care system in our country is2106an issue that we have right now. And I think it is a bigger2107discussion. I appreciate you bringing it up, and it is2108something to look at.2109    Senator Sanders. Okay. Thank you.2110    Secretary Collins. Thank you.2111    Chairman Moran. Senator Cramer.21122113                       HON. KEVIN CRAMER,2114                 U.S. SENATOR FROM NORTH DAKOTA21152116    Senator Cramer. Well, I was encouraged by that dialogue.2117Thank you Senator and Mr. Secretary. And welcome, Mr.2118Secretary. It is a good thing I have not been here all day or I2119would have way too many things to talk about. But right now I2120want to raise an issue related to the discussion you just had.2121    Under the first Trump administration we passed the pilot2122program for Solid Start Act, and then under the Biden2123administration we made it a law, specifically to get at the2124issue that I think Senator Sanders was raising, about how do2125you inform veterans more about the opportunities and the2126benefits that they have at the VA. So I would just encourage2127you to look at that and make sure we are managing that well.2128    The other thing I would raise, with regard to the2129workforce, which I think Senator Sanders is right about, and it2130is true. We have a shortage of people in health care2131everywhere, and to the degree we can incentivize it, I think we2132ought to.2133    At the same time--and I am just going to give a little2134North Dakota example, and Senator Blackburn spoke to it briefly2135toward the end of her questioning--in North Dakota, in this2136rectangular spot in the middle of the North American continent,2137that is about 350 miles across and about 200 miles up and down,2138there are 36 critical access hospitals in rural communities.2139Now, Fortuna, North Dakota, to Fargo, North Dakota, where the2140only VA hospital is, is 412 miles. It takes roughly 6 hours and214119 minutes if you do not stop to go to the bathroom, to go from2142one to the other.2143    But there are these 36 critical access hospitals that have214420 hospital beds each, and maybe two or three of them are being2145used at any given time. Senator Blackburn talked about2146community care. We have talked about the shortage of2147facilities, shortage of workers and opportunities. And yet2148there is all of this infrastructure not being used. There has2149got to be a way to utilize existing infrastructure and actually2150save money, both for the VA and then create opportunity for2151these struggling hospitals in rural America.2152    Secretary Collins. I do not disagree with you at all, and I2153think, actually, Senator Duckworth and I had this conversation2154a long time ago about actually co-locating CBOCs and stuff,2155that we could actually do that. I think that is a great idea,2156as we look at it. But I think one of the things is how we2157utilize the MISSION Act possibilities that we have, to make2158sure that we are getting people there.2159    The other problem we have, and this is found not only in2160some of our facilities but mainly some in DoD facilities, but2161also community facilities, it is also an issue of quality care.2162It is an issue of our doctors seeing enough patients to keep2163their clinical skills up, our nurses seeing enough to keep2164their clinical skills up. That is why I have already been2165looking at several options, and we are doing this in certain2166cities now where we can. I am encouraging every one of our2167facilities to have understanding and agreements with local2168hospitals, with community hospitals, where they can go back and2169forth.2170    We can also look at DoD facilities, which is also a big2171issue. We have underutilized DoD hospitals, underutilized DoD2172facilities in which we could be--one of those actually we are2173looking at right now in Jacksonville, Florida, in which we2174could actually save our community care costs because we could2175actually have a DoD facility there.2176    So there are a lot of things we can work on here, and I2177think it is just a matter of using all the resources that we2178have.2179    Senator Cramer. Right. And that starts with knowing what2180they all are. That is a great illustration, the one you just2181made. One of Cramer's convictions is I reject the notion that2182every transaction requires a loser. We should look for2183opportunities for winners and winners, and I think that would2184be one of them. Congratulations. Thanks for doing that.2185    I want to get back to the 80,000 thing, because you have2186been battered about it, I think, without us acknowledging the2187other issue. I am going to stick with a lower number. Correct2188me if I am wrong, but I believe there were 52,000 new positions2189added between 2021 and 2024. Does that sound about right,219052,000 during the Biden administration?2191    Secretary Collins. Yes.2192    Senator Cramer. Okay. And how has that improved the health2193care offerings for veterans? Are we seeing a lot more veterans?2194Is it better care? That 52,000, has that saved the day for our2195veterans?2196    Secretary Collins. I do not think so because I think if you2197also--I use it in a different way. If you go back to 2015, when2198the GAO put us under the high risk--and again, I have been here2199barely 90 days at this point--you know, looking at this, I am2200using the numbers that we are given. And we can talk about will2201the numbers change or anything. I am using the numbers that we2202currently have at VA. Wait times have increased. Primary care,2203mental health, specialty care all rose. Disability backlogs, it2204is not a secret. It was at 260,000 when I came in. It is about2205220,000 now. These are just honest numbers.2206    But I want to go back to something 10 years ago. At 102207years ago, if I had told this Committee, and I did this at our2208senior staff, this is careers and political. I said, ``if I2209told you that in 2025 you are going to have a budget of almost2210$400 billion, and you are going to a workforce of 470,000,''2211you would have thrown a party, everything would have been2212great, because that would have been the answer to everything.2213Well, we are 10 years later and we are still experiencing the2214same problem.2215    Senator Cramer. No, I appreciate that.2216    Secretary Collins. Servicing the same amount of veterans.2217    Senator Cramer. That is the important point. I appreciate2218all of that. I think everybody on this Committee wants to have2219an honest discussion about how to do better for our veterans.2220And real data can help us, because there is plenty of data2221there to tell us where we have been okay, where we have not2222been so good, and where we have been awful or great.2223    Thank you, Mr. Chairman.2224    Chairman Moran. Senator Cramer, thank you. Senator2225Duckworth.22262227                     HON. TAMMY DUCKWORTH,2228                   U.S. SENATOR FROM ILLINOIS22292230    Senator Duckworth. Thank you, Mr. Chairman. I do think it2231is important to acknowledge that we did sign up, just in the2232first year of the PACT Act alone, a million veterans. So that2233increase in personnel is also to deal with the increase in2234veterans coming to VA for care, long overdue because of their2235exposure to toxic substances.2236    Secretary Collins. We also lost about 400,000 veterans that2237year, as well. So it does equal out.2238    Senator Duckworth. We had rollover of a million in the2239first year, that signed up.2240    Secretary Collins, when you testified before this Committee2241in January, you stated that it would be a mark of failure--your2242words, mark of failure--if a veteran must contact a2243congressional office for support with accessing their VA care2244and benefits. My office alone has received 143 casework2245requests from veterans since the start of the Trump2246administration, a consequence of service disruptions worsened2247by DOGE's cruel dismantlement of the VA workforce and of the2248critical programs serving our Nation's heroes.2249    I am going to give you some examples. A Vietnam veteran did2250not receive his benefits for three months due to greater than2251usual processing times. A veteran in urgent need of mental2252health services was told that the earliest available2253appointment was 6 weeks away. A veteran's widow and cancer2254survivor had her CHAMPVA-covered prescription canceled without2255notice, forcing her to pay $700 out of pocket. An Iraq war2256veteran needed his records to apply for his disability benefits2257but was met with a 6- to 12-month backlog. Now, backlogs and2258delays are not new to VA. They were there when I was at the VA2259under Secretary Shinseki in the Obama administration.2260    And so I think, I would agree that this is indeed a mark of2261failure, and I am requesting your commitment to work together2262to overcome this backlog. This will require the immediate2263reinstatement of all 2,400 VA employees who were2264indiscriminately terminated when Elon Musk and his DOGE cronies2265failed to evaluate civil servants on the basis of merit, and2266failed to use a scalpel to root out the bad apples who are2267failing to effectively execute the mission, and instead chose2268the most wasteful, inefficient, and lazy path in simply firing2269probationary employees en masse, which, ironically, represents2270some of our Nation's most motivated, most idealistic, and most2271energized Federal employees. Those probationary employees who2272had signed up since the PACT Act was passed, for example.2273    Those Americans, including thousands upon thousands of2274veterans who made the patriotic decision to serve their country2275and begin their civilian careers.2276    Senator Collins, will you commit to reviewing the status of2277all terminated VA employees and promptly reinstating them and2278to protecting the VA workforce against additional2279indiscriminate mass firings?2280    Secretary Collins. Well, most of the ones that I have2281already testified, the probationary, were brought back to work2282in that setup, so they are already back at work. And we are2283going to keep looking at our setup and how we do it, because2284nothing we have done so far--we have protected over 300,000-2285plus positions that did not--they protected those that were2286directly with disability care and with health care benefits.2287    I just have a question, and I appreciate your concern,2288because I do still think when they have to call your office, it2289is a failure for us. I say that to all of our hospitals, and I2290say it to all of our veteran benefits.2291    I have a curious question here. You brought up something2292that is very close to my heart. Was that veteran who was given2293six weeks for an appointment, were they given a community care2294option?2295    Senator Duckworth. We could get you that information. But2296if you----2297    Secretary Collins. I would love to know, because I want to2298help if we can.2299    Senator Duckworth. With all my open cases, I would love to2300work with you.2301    Secretary Collins. And also, again, I have acknowledged2302this from day one. You and I have talked about this. The calls,2303they represent something we are not doing right, and I think2304that should overlay everything we are talking about here is,2305why is this a problem? Why are we still there? You know,2306records that take 6 to 12 months, that is possible. I am2307assuming that is probably a DoD issue, trying to get their2308records out of the DoD. These are all issues that I want to try2309and fix.2310    Senator Duckworth. They have had access to VA records, as2311well.2312    Secretary Collins. Okay.2313    Senator Duckworth. Let me just go on to the next thing. In2314an official letter in response to Senator Tammy Baldwin's2315oversight letter on the Veterans Crisis Line, dated April 7,23162025, you wrote, and I quote, ``While 24 VCL employees2317erroneously received probationary termination notices, all2318notices were rescinded. All terminated employees were2319reinstated, have been rehired into the same positions they2320previously held,'' end quote.2321    Secretary Collins, while I appreciate your candor in2322finally acknowledging that, in fact, VCL employees were2323terminated, and clarifying that this was incompetence and not2324malicious intent, I hope you recognize that your work in fixing2325this mistake is not complete. Personally, I know of at least2326one veteran who you still have failed to reinstate, and this2327was a person who did so well that they were promoted to help2328train other VCL hotline employees, the type of person who is a2329supervisor on a shift. They still have not been reinstated.2330    Look, the Veterans Crisis Line serves veterans in their2331darkest hour, and it is our responsibility to make certain that2332it operates to the highest standards, just as every military2333commander understands that our warfighters' effectiveness,2334indeed their lethality, depends on a fully resourced, diverse2335network of enablers possessing the capability and capacity to2336support a given mission's requirements. You cannot just invest2337and rehire the pilots of the aircraft and not retain the2338refuelers and the mechanics who fix that aircraft.2339    Secretary Collins, do you agree that support staff who2340train, equip, and handle the basic operational and2341administrative functions at the Veterans Crisis Line program2342are mission critical?2343    Secretary Collins. That is why we brought them back,2344Senator. And I think there is something, though, that we need2345to also clarify here, and this was clarified not by our senior2346level. It was clarified by career employees that know VCL, who2347answers the phone, who talk to our veterans, was let go.2348    Senator Duckworth. Right, but the VCL----2349    Secretary Collins. No, no----2350    Senator Duckworth [continuing]. Cannot operate without the2351other people, as well, like the supervisors on shift or the2352people who train the VCL. You are parsing your words, and there2353are----2354    Secretary Collins. I am not parsing.2355    Senator Duckworth [continuing]. Veterans Crisis Line people2356who have been fired, who have not been reinstated, and these2357are people who actually are training the people who are2358answering the phones. These are people who did so well as a2359phone answerer that they are the supervisors of the people. And2360like I said, you cannot just say, okay, we are going to take2361care of the pilots but not the refuelers and the mechanics who2362maintain that jet.2363    Secretary Collins. And I think we can actually find common2364ground agreement here that that was why they were brought back.2365But also I will not accept the premise, when it was given, that2366people were not being answered on the call line when they came2367in, which has just been talked about many times in the press,2368by others. That is not true. I will acknowledge the fact that2369we brought back staff to help in those situations, and that is2370why they are not exempted. And we did do that.2371    But I will not also let it be put out there that people2372were not getting their phone calls answered because those were2373the ones that were let go. Those were not the ones that were2374let go. And I think we at least need to be honest about the2375situation, as far as I agree with you that is why they brought2376them back. And if you have a situation with one person, please2377let me know. Let my office find out, and we will talk about it.2378    Senator Duckworth. There is more than one person being2379affected.2380    Secretary Collins. Thank you.2381    Chairman Moran. Senator Sullivan.23822383                       HON. DAN SULLIVAN,2384                    U.S. SENATOR FROM ALASKA23852386    Senator Sullivan. Thank you, Mr. Chairman. Mr. Secretary,2387thank you for your testimony today. We all want to take care of2388our veterans. And, you know, you and I have talked about it,2389and I want to thank you on a couple of things.2390    One of the biggest issues I have seen in my 10 years here,2391one of the biggest scams I have seen in terms of hurting2392veterans, was the implementation of the Camp Lejeune Act that2393we passed here to help Camp Lejeune Marines and their families2394and sailors who were exposed to toxic water. You want to talk2395about taking care of marines and taking care of veterans, I2396worked with my colleagues on the other side of the aisle for2397years, to try to get them to cap contingency fees to the2398lawyers who are advertising billions of dollars on Fox News and2399CNN, and none of my colleagues would do it. None of them. Why?2400We know why. Every one of them knows why.2401    So these law firms were charging 60 and 70 percent2402contingency fees to steal money from sick marines and their2403families. That happened. I met a woman outside right there. I2404asked her about it. She said, ``I am paying 40 percent,2405Senator,'' from some ripoff law firm. I tried to get my2406Democratic colleagues--by the way, the former chairman of this2407Committee, who is no longer here, bye-bye, I think, because he2408was screwing veterans and favoring trial lawyers over veterans.2409    So when we talk about taking care of veterans, I get a2410little miffed when my colleagues over here bring the show, and2411they would not do it. You know who is doing it? You are doing2412it. You are doing it. Thank you. You put out a scam alert,2413saying if you are getting charged over 25 percent by a law2414firm--and by the way, the attorney general of President Biden2415worked with me to put that 25 percent cap. My colleagues would2416not do it. No, no. No, no.2417    So it is a little rich when I hear everybody talking about2418taking care of veterans, and I spent a decade trying to get2419Democrats to help me, and they never did it. You are doing it,2420so I want to thank you for that. You put out a scam alert.2421There are still law firms, who fund Democratic campaigns, who2422are still charging marines and their families 60 and 702423percent.2424    So can you continue to work with me and this Committee to2425put out scam alerts so these patriotic marines and their2426families and sailors--and by the way, this is zero sum. You get2427a million bucks, okay. It is either going to go to the law2428firms or to the marines. And I know what side they were on, and2429I know what side the former chairman of this Committee was on.2430And you are on the side of the veterans. You are the side of2431the marines. You are on the side of sailors. So thank you,2432because you know what? It is a little rich for me to watch all2433this theater when I know that you are taking care of them.2434    Do you want to comment on this? I appreciate the scam2435alert, but gosh darn it, I am still seeing these ads on TV. My2436staff calls these law firms, 70 percent. It is the biggest2437injustice I have seen since I have been here as a Senator,2438ripping off sick marines and sailors and their families, and2439nobody on the other side of the aisle helped. None. I worked2440this harder than any other issue since I have been here as a2441U.S. Senator, and you are helping.2442    Do you want to just comment on that? Thank you very much2443for the scam alert. And by the way, the former attorney general2444said if you are a law firm and you are charging a sick marine2445more than 25 percent, that is a criminal violation. I have2446talked to Attorney General Bondi, and she is going to bring it.2447Criminal and civil violations if they go over 25 percent, or 202448percent if they are just doing the administrative filing. So2449thank you on that.2450    Secretary Collins. Senator, I appreciate that, and I will2451work with anybody on this Committee. It does not matter the2452side. If you are doing something that should not be done to our2453veterans--I have said this before. I take this personally. I2454take it. We can disagree about things. We can disagree about2455numbers. We can disagree about anything else. But at the end of2456the day, I want to honestly say that I believe all of us are2457trying to get the veterans help. And when you have folks who do2458that, when you have firms that do that, we will continue to put2459the scam alerts. If they are watching today they can get mad at2460me all they want. I really do not care.2461    Senator Sullivan. Trust me. They are mad at me. They are2462coming for me, but I do not care, because I know I am doing the2463right thing for United States Marines and veterans and their2464families. It is the right thing. Everybody here knows it.2465    Secretary Collins. Yep, it is. I agree with you.2466    Senator Sullivan. Let me thank you on another thing. Every2467year, every hearing, I have been coming to this Committee2468talking about the Alaska backlog. My state has more veterans2469per capita than any state in the country. It is a proud2470heritage over the great State of Alaska. And the previous2471administration, the backlog, to just get an appointment,2472ballooned to--it was almost 15,000. We have got 80,0002473veterans. That is like 15 percent. It is over 15 percent. I2474finally went down, and I pressed the former Secretary, to 5,5002475at the end of January, when the Biden administration left.2476Still way too high. Do you know what it is under your2477leadership, Mr. Secretary, right now? I will tell you. It is24781,361. I do not think I have been here the whole time where2479that backlog has been that low. In three months you did more2480than Biden did in four years on the Alaska backlog. So I want2481to thank you for that, because that is real service for our2482veterans.2483    Secretary Collins. Thank you, Senator. We are going to2484continue to do that for all veterans in every state. We want to2485make sure that those numbers are coming down and that the2486veterans are getting the benefits that they deserve and also2487the health care that they deserve.2488    Senator Sullivan. And if you can help us finally get a call2489center up there, I know it is an issue that you and I have2490talked about, it will bring that backlog even down further.2491    But I want to thank you on both of those things. I will2492submit some questions for the record related to community care2493and some of the other issues you are working on. But on both of2494these issues, I appreciate your focus, because this is what2495taking care of veterans is.2496    Chairman Moran. Senator Slotkin.2497    Senator Sullivan. Bringing down the backlog and making sure2498our marines and sailors do not get scammed.2499    Secretary Collins. Thank you, Senator.25002501                      HON. ELISSA SLOTKIN,2502                   U.S. SENATOR FROM MICHIGAN25032504    Senator Slotkin. Thank you. First of all, I just want to2505recognize the Chairman. Thank you for holding this hearing. I2506think it is a bipartisan goal to support our veterans, and I2507think it is one of the first hearings I have had where, after a2508confirmation hearing, we have brought the Secretary back in2509short order. So I appreciate that.2510    Secretary Collins, during your confirmation hearing you2511assured me and the others here that, quote, ``the mission is2512the veteran,'' and quote, ``that you would not sacrifice the2513veteran.'' I took you at your word, as did many on this side of2514the dais.2515    But since you have taken office, you have heard it, you2516moved to terminate VA contracts, offered to buy out VA2517employees that were in already shortage situations in those2518career fields. You placed a hiring freeze on critical VA2519employees serving veterans. Twenty-four hundred recent VA hires2520were let go, and then I think because of the courts, brought2521back. And, you know, you have been here today doubling and2522tripling down on that.2523    I have no problem with cutting fat in the VA. I worked at2524the Defense Department. If someone had said to me, ``Cut fat,''2525I would know exactly where I would cut. But it is the nature of2526the cuts. If you are firing someone on a Friday and they are2527being brought back on a Monday, no CEO in America would be2528lauded for that kind of sloppy cuts.2529    And then when you came to Michigan, you came to Howell,2530Michigan, I think in the last month and a half, you were asked2531directly about the potential for 80,000 additional employees to2532be cut. And instead of pushing back you just said, quote,2533``There is going to be a lot of friction.''2534    And I understand that you are wordsmithing things to say2535that no nurses or doctors in the VA facilities are going to be2536touched. That is good. But I held a roundtable with veterans,2537these are folks who are in the business. And their concern was2538that if you are a veteran and you walk into a VA, in Iron2539Mountain, and you need to get a claim. You know, you put in a2540claim to get a knee surgery, and there is no claim caseworkers,2541there is no people working on those claims, and it takes you2542two years to get an answer, that is also not access to care.2543The doctors and nurses may be there, but if you cannot go in2544and you are in pain every single day, that is also a problem.2545It is a problem for Veteran Center staff, who have not been2546excluded, primary care administrators, IT staff. I know it is2547wonky, but you have just accelerated the electronic health2548record transition. I think IT staff are important if we are2549going to make sure we do not lose records of our veterans. And2550then benefit claims administrators. These are all people who2551kind of do not meet your criteria to be saved.2552    We all want to serve the mission of the veterans, but what2553was really strange was that we had the Deputy Chief Medical2554Officer up here for a hearing, and we said, ``What is the plan2555on cutting this potentially 80,000? Have you been consulted?''2556And they said, very clearly, no.2557    So I am having a problem understanding how I am to believe2558that the veterans in Michigan are going to get the same or2559better care, which is what we want, when you seem to be sort2560of--I know you are claiming that these 80,000 are like DEI and2561interior designers. There is no way that all those 80,000 are2562in those job fields. So help me understand how you are going to2563preserve that veteran who needs the knee surgery but there is2564no one to process his claim.2565    Secretary Collins. Thank you, Senator. I think there is a2566lot to unpack there, and yes, the mission is the veteran. And I2567want to go back to one of the statements you made earlier. You2568said you worked in DoD. If you want to find it, I would just2569happen to turn the table and say if you came to work at VA you2570would probably be able to do the same thing.2571    Senator Slotkin. For sure. I do not have a question with2572that.2573    Secretary Collins. So I think that----2574    Senator Slotkin. But 80,000 is different than cutting--and2575I think, again, any CEO in America who fires people on a Friday2576and rehires them with back pay a week later, would be fired2577from their job. It is sloppy, and you know it.2578    Secretary Collins. I think I will disagree with the judge's2579decision there and continue the appeals process on that. So, I2580mean, look at it from that perspective as we go forward. But2581also, again, when you look at these issues and you look2582forward.2583    I mean, it is interesting to me. I would just be curious,2584and I am just playing the scenario out, if you go into DoD is258520,000 a proper number? Is 50,000 a proper number? Is 10,000 a2586proper number? At the VA, we exempted over 300,000 positions to2587ensure patient care, patient quality, and disability benefits2588were being done.2589    Senator Slotkin. So how come there were people fired and2590then rehired from the Veteran Suicide Hotline? Like you have2591acknowledged, I think, even publicly, that some of these things2592were a mistake. It does not give us confidence that an 80,0002593number, which is just a number--you did not say career fields,2594you did not say whatever; you just said 80,000--that that is2595being done with a scalpel and not a sledgehammer. And I think2596for veteran care, again, it is not me that is the only one2597asking these questions. It is veterans who have a very2598different political view than me, who are getting seriously2599agitated back home.2600    So I just do not understand the logic behind an across-the-2601board haircut.2602    Secretary Collins. Well, I think the biggest thing is, what2603you are looking at here is I think right now there has been,2604because this is what I have had to fight for the whole time, is2605to fight this idea of just being blanket numbers thrown out,2606playing Trivial Pursuit with numbers and others. It has scared2607veterans. So honestly, what are they going to hear? If all they2608hear from people is, ``If you cut this then it is going to2609actually impact my health care,'' then what are they actually2610going to think. Because one, they have not seen a plan, you2611have not seen a plan, because we are still working the plan. I2612am not going to play out a plan in public that would actually2613take employees. You would not do it in your own office.2614    Senator Slotkin. And I know I am over, but if you----2615    Secretary Collins. So I mean, this is a goal.2616    Senator Slotkin [continuing]. But it is playing out in2617public, because you have fired people, and then they have been2618rehired. That is not a secret plan. People in my district--2619marines, veterans--have been fired from their VA jobs, and then2620brought back. So it is not that there is some sneaky plan. You2621are in it. You are living it, and you are living the sloppiness2622of it.2623    So I am sorry. I know my time is over, but I cannot agree2624that the 80,000 is going to be a nice, trim scalpel approach.2625    Secretary Collins. We will just have to agree to disagree,2626Senator.2627    Chairman Moran. Senator Banks.26282629                        HON. JIM BANKS,2630                   U.S. SENATOR FROM INDIANA26312632    Senator Banks. Thank you, Mr. Chairman. Secretary Collins,2633the President's budget calls for a nearly $5 billion increase2634for the VA, primarily for medical care and for homelessness.2635You have been accused of cutting care and benefits--we have2636heard a great deal of that today--which is obviously a scare2637tactic. How do you plan to target the new funding that you are2638requesting?2639    Secretary Collins. Exactly what you just said there, and2640that is to our health care side, I mean community care side.2641Community care is growing, but it has actually been under-2642budgeted in the last few years by the previous administration.2643So we have got to actually make sure that the proper moneys are2644being put into community care. Also looking at how we actually2645need to improve our direct care services.2646    We have got a lot of issues out there that range from, not2647only recruitment and retention of employees, but also our2648facilities, the things that we have. Our average age of a2649facility is well over 60 years old. These are the kinds of2650things that we are working right that again, along with a2651reshaping of the force that we are looking at right now,2652looking at our contracts, to make sure that some of the folks2653sitting behind me actually get the care that they have deserved2654and earned.2655    It is interesting to me though, again, when we talk about2656here in the last little bit I have had, and some of the2657conversation today is where people have called offices and said2658they have had appointments that are delayed or they cannot get2659it. In all fairness, I just have to ask, that was the same2660thing happening in December. That was the same thing happening2661in November of last year. The only difference right now is I am2662sitting here saying we are looking and going through a2663comprehensive approach on how to size the force at the VA, and2664spend the money that you and the House appropriate to us. That2665is the only difference. And again, I keep seeing veteran after2666veteran after veteran standing here saying, ``I couldn't get in2667to see my appointment. I couldn't get in.'' The problem is,2668when was that? We are still working on that because we have2669issues in our systems, and a bureaucracy is not good. And we2670had hospitals and VAs who are not sending people to community2671care.2672    Senator Banks. Cutting bureaucracy means better service for2673our veterans.2674    Secretary Collins. Yes.2675    Senator Banks. And that is what you are doing. How are you2676planning to reinvest any savings from head count reduction to2677improve services for our veterans?2678    Secretary Collins. That will go back into our different2679services, and I think that is what we have already shown and2680had the sign up on taking it back into community care, back2681into improving our IT systems, back into improving our2682prosthetics, back into improving our situations with our mental2683health counselors and others, that we can actually show real2684results in.2685    One of the things that is amazing enough, that has not been2686talked about here today, and I think it, for me, has been the2687top line that I have talked about all along, except in a way2688that, frankly, was not truthful in the sense of what we are2689doing, is suicide has not been discussed here today. And the2690issue that we still have, since 2008, have not seen a2691significant decrease in our veteran suicide rate since 2008,2692although we have spent literally billions of dollars on that.2693    So when we talked about earlier, we talked about other2694kinds of care, we have talked about how can we tap into2695research into maybe psychedelics or other things that help,2696getting in more with our VSOs and our nonprofits to actually2697make a difference here. I think this is something we have got2698to have. We sometimes get caught up in the overall scheme of2699the VA, believing that the VA, unfortunately being on the Hill,2700is something that is manipulated or brought back into a certain2701way that is special. We are special in the sense that we get to2702treat the veteran of the United States. It is the most precious2703gift that we have.2704    But we are not unique in health care. We experience the2705same issues that all of health care, that we got to speak about2706earlier. And we are going to make sure, just as every other2707health care organization goes through this kind of look and2708reorganization of their facilities, they do the same thing.2709    Senator Banks. I appreciate that you are focused on that2710very much. Go back to the reduction-in-force, though, and tell2711me, how much do you expect the reduction-in-force to be2712retirements or early retirements versus separations?2713    Secretary Collins. We are seeing a good bit of that right2714now, as you always have--that is one of the things, that I got2715accused of from the cuts that we had, that somebody had not2716been able to get their next appointment and the doctor had2717actually just retired out and they were just bringing in the2718new doctor. That is not on reduction-in-force. That is just a2719simple matter of attrition in the hospitals.2720    So some of that will be taken care of. Some have taken the2721early retirement possibility, which has been a program that I2722think has worked in a great deal. So some of that will be2723normal attrition like that and also the incentivized attrition.2724    Senator Banks. I am almost out of time, but I want to ask2725you, really quickly, reviewing the situation that you2726inherited, the Biden administration's 2025 budget was2727misleading, as you know. They misrepresented the budget2728shortfall that they created. Congress closed the immediate $62729billion shortfall in March, but are there still budgetary2730problems that we have to clean up?2731    Secretary Collins. I think that is what we are trying to2732work through right now. What is interesting is I promised in my2733confirmation, I think you remember, maybe you and I had this2734conversation, I was not going to come to this Committee, or2735even send you information, in which I cannot give you either2736the information because it was not ready yet or we were not2737comfortable with where the numbers are.2738    The same thing applies to a lot of the questions I have2739gotten here today. As we move through these processes we are2740going to make sure that we give the information. We are working2741through a budget process right now that does not come and2742surprise you in a political way at the end of the year. So I2743think that is why the President and his budget, which is very2744favorable to the VA in looking at what we need to do, is2745something that we can then build on and give you more2746information as we go.2747    Senator Banks. Thank you for what you are doing.2748    Secretary Collins. Thank you.2749    Senator Banks. I yield back.2750    Chairman Moran. Thank you. Mr. Secretary, we are going to2751have another round, but it is only the two of us, Senator2752Blumenthal and I. Senator Blumenthal is committed to 5 minutes.2753I have a constituent waiting in the back room. I am going to be2754back in 5 minutes. I have a couple of questions for you, then2755we will conclude the hearing.2756    Secretary Collins. Okay. Thank you.2757    Chairman Moran. Senator Blumenthal.2758    Senator Blumenthal. Secretary Collins, you have just told2759Senator Banks that you are going to give us the information2760that you have. You have failed to give us the information that2761you should have, or you do have and you are declining to2762provide it--the numbers of specific categories of people whom2763you plan to fire, the contracts that you have canceled or that2764you plan to cancel. I am going to ask you to provide that2765information in written form. I am not going to get into an2766argument with you here. But just so you understand, I think2767that a good portion of the questions that you have been asked,2768frankly, you just have not answered, and I am hoping that you2769will provide those answers.2770    Let me tell you one fact that I think we do know, and that2771is that your goal is to fire 15 percent of the VA workforce.2772You have said it again and again and again. I am going to ask2773that a list of your quotes be put into the record, most2774recently to the Arizona Public Media, AZPM, on May 1, that,2775quote, ``I said there was a goal of 15 percent, which if you do2776the math is about 80,000.'' What I take away is you have got a2777goal of slashing 15 percent of the workforce, come hell or high2778water, and you are going to figure out whom to fire as you go2779along. And that means frontline people who have been hired2780among those 50,000 or 80,000 people. And I have a list right2781here, which I am also going to ask be entered into the record,2782they are numbers. They are real people.27832784    [The information referred to appears on page 104 of the2785Appendix.]27862787    Senator Blumenthal. We are talking about, for example,278818,000 registered nurses and 5,000 social workers. Those are2789increases of 20 and 25 percent. Those are frontline people who2790have been hired. The total number is an approximately 172791percent increase in the VA workforce. They are schedulers,2792physicians, police, psychologists, registered nurses, social2793workers, and 31 percent of them are VBA. You fire those people.2794Your goal is to fire 15 percent of the total workforce. They2795are among them. You are going to lose quality. You are going to2796lose time. There is no way around it.2797    Now, I welcome your commitment that the savings--you just2798told Senator Banks--will go into care for our veterans, but2799that is not what you said on April 17th. You said that, quote,2800``That will be up to the President.'' Now, I do not know which2801is true, but I hope that the savings will go into caring for2802veterans, but is that your commitment now?2803    Secretary Collins. I think, one, I would like to see the2804context of that quote and where it was actually put. I think2805the issue here today is, look, Senator, I think this is where2806we got--it is not right to stand here today, because I actually2807think there was a quote from others, and I will not say you2808specifically, there have been others, that says we are going to2809take 15 percent of doctors, 15 percent of nurses. That is just2810wrong. It is almost cruel.2811    Senator Blumenthal. It would be cruel. It would be cruel if2812it happened.2813    Secretary Collins. It is not happening.2814    Senator Blumenthal. Let me just----2815    Secretary Collins. By even repeating it, though, you are2816letting my workforce know, which are going through a process,2817if you were going to reorganize your office, would you just2818stand up at a staff meeting today and say, ``Here's the 162819people we are discussing right now.''2820    Senator Blumenthal. These are your words. These are your2821words, in Tucson, on April 30th.2822    Secretary Collins. Okay.2823    Senator Blumenthal. In KOLD News, April 28th. Scripps News,2824April 21. Spectrum, local news, April 9th. Detroit Free Press,2825April 1. Collins told the veteran that cutting 80,000 people2826from the Department is a goal. On April 9th----2827    Secretary Collins. What are we doing here, Senator? I have2828admitted that here today.2829    Senator Blumenthal [continuing]. 15 percent is a goal.2830    Secretary Collins. I have admitted that here today.2831    Senator Blumenthal. Let me just go on, because the record2832is there.2833    Secretary Collins. It is. Nobody is denying you, Senator. I2834am not sure the point you are trying to make, because I have2835said it is a goal. But I have also said it may not actually get2836to that number. It is what will the process we are going2837through, and I am not going to work out a process in front of a2838committee or anywhere else, in which we are still in the2839deliberative process. Because at the end of the day, with2840470,000 workforce----2841    Senator Blumenthal. The goal----2842    Secretary Collins [continuing]. That is incompetence. That2843is malpractice for me to do that in front of a committee. I am2844not going to, to scare people. But I have also made the2845commitment that we are going to make sure that our health care2846is provided for, that our people are getting their disability2847benefits. And what we are seeing right now, whether you agree2848with the numbers or not, those failed when we added billions of2849dollars and thousands of employees. That is the part we cannot2850get away from.2851    Senator Blumenthal. Let me ask you----2852    Secretary Collins. And I am willing to work with you in any2853way to do that.2854    Senator Blumenthal [continuing]. You responded to Senator2855Sullivan's question about capping certain attorneys' fees for2856the Camp Lejeune victims. Are you aware of the Ensuring Justice2857for Camp LeJeune Victims Act that Senator Tillis and I have2858offered to put caps on attorneys' fees?2859    Secretary Collins. No, but it should have come a long time2860ago. I do not know what took so long.2861    Senator Blumenthal. Well, will you support our legislation?2862    Secretary Collins. I have not seen the legislation, sir. I2863do not comment on things I have not read.2864    Senator Blumenthal. Well, instead of just putting out a----2865    Secretary Collins. Why isn't Senator Sullivan on it?2866    Senator Blumenthal. Instead of putting----2867    Secretary Collins. I am just curious. Why wouldn't Senator2868Sullivan be on that bill?2869    Senator Blumenthal. You know what?2870    Secretary Collins. I am just curious. Because, I mean, it2871would help me out because we have actually seen this play out,2872and I am not going to let the veterans be duped into paying 702873percent.2874    Senator Blumenthal. Maybe you can talk to Senator Sullivan2875and he will join the bill. But I am asking for your support.2876    Secretary Collins. Please, I will take a look at your bill2877and see what we can do.2878    Senator Blumenthal. You are not aware of it?2879    Secretary Collins. Excuse me?2880    Senator Blumenthal. You are doing a scam alert. I would2881suggest that maybe the way to really help veterans is to2882support legislation to put caps on it.2883    Secretary Collins. Are you denying that this is happening?2884Because if not, I mean, I have----2885    Senator Blumenthal. You know----2886    Secretary Collins. You are asking me to support a bill that2887I have never read, sir, and that is just not fair.2888    Senator Blumenthal. I am going to take a little more time--2889--2890    Secretary Collins. I will be happy to read the bill.2891    Senator Blumenthal [continuing]. Because he seems to feel2892that--he is asking the questions here. But I am happy to2893continue the conversation.2894    Chairman Moran. Senator Blumenthal, let me see if I can sum2895this up. I think the Secretary has said he will take a look at2896the bill.2897    Secretary Collins. Yes, yes.2898    Chairman Moran. And it is a bill that you do not know2899anything about, so you cannot say whether you are for it. And2900Senator Blumenthal is happy to have your support after you look2901at it.2902    Secretary Collins. Correct. Thank you.2903    Senator Blumenthal. Well said, Mr. Chairman.2904    Chairman Moran. Thank you.2905    Secretary Collins. The Chairman----2906    Senator Blumenthal. Let me ask you--Secretary Collins, I2907just have a couple of quick questions for you. Will you commit2908to provide privacy for telehealth professionals doing mental2909health care?2910    Secretary Collins. We have already done that, sir. Anything2911in our return-to-work policy, if they are actually put in a2912position where they do not have privacy, it is against the2913policy of return to work, and they will be----2914    Senator Blumenthal. Do you deny the accuracy of The New2915York Times----2916    Secretary Collins. Oh, very much so. And I will be happy to2917provide you everything. They were contacted. Everything that it2918showed was that our systems were working. And anything that2919they actually reported--by the way, we asked for veterans where2920care had been affected by that. They could not produce a single2921one. In fact, The New York Times even produced, of overworked,2922crowded conditions, they sent our press people to empty rooms.2923So yes, I do deny it.2924    Senator Blumenthal. You deny--will you provide us a factual2925refutation of it, not just----2926    Secretary Collins. We can, and we also did it--I think we2927are actually putting that out on social media today. So yes, we2928go line by line. I take every one of these seriously, sir. I2929take every one of them seriously. ProPublica, you mentioned it2930earlier, New York Times. And yet we answer them one by one by2931one, and I have the email chains with the reporters that they2932choose to ignore. That is what we get.2933    Senator Blumenthal. Well, I welcome that you are committed2934to providing privacy and that you will provide a line-by-line2935refutation of The New York Times article.2936    Secretary Collins. We always have, sir.2937    Senator Blumenthal. Will you do the same with ProPublica?2938    Secretary Collins. We have that, as well.2939    Senator Blumenthal. Let me ask you. Have research contracts2940been canceled or frozen?2941    Secretary Collins. Research contracts are right now under--2942the ones that are continuing are still continuing. If they were2943running out, then we are on a 90-day policy to see whether they2944need to be continued or not.2945    Senator Blumenthal. Is that a yes?2946    Secretary Collins. I mean, I cannot answer your question2947any better than that. The continuing contracts are happening2948right now. There were some, by the way, as you well know, that2949they do run out at a three-year cycle. We have actually held2950onto those right now.2951    Senator Blumenthal. So you have not canceled any.2952    Secretary Collins. No. Not at this point, no. Not that I am2953aware of in that situation. If you want to provide something,2954we will be happy to look at it.2955    Senator Blumenthal. Have you frozen any? In other words,2956before the expiration of the three years?2957    Secretary Collins. That I would have to look at. I do not2958believe so. Because that is one of the reasons why we put the295990-day policy.2960    Senator Blumenthal. Mr. Secretary, is Medicaid important to2961veterans?2962    Secretary Collins. Give me the context, Senator. I mean, it2963is important for anyone.2964    Senator Blumenthal. Well, do veterans take advantage of the2965Medicaid program?2966    Secretary Collins. That is a conversation that has been2967going on for a while now concerning the Medicaid Advantage2968plans and the ones that are----2969    Senator Blumenthal. No. I am talking about Medicaid, not2970Medicare Advantage.2971    Secretary Collins. Okay. I am sorry. I will have to--I2972mean, I am not sure where we are going with this.2973    Senator Blumenthal. Do veterans use Medicaid? You are not2974aware of that fact?2975    Secretary Collins. Yes. Yes. I mean, I understand the2976Medicaid process. I am not sure what your question is.2977    Senator Blumenthal. Well, my question is, is Medicaid2978important to veterans?2979    Secretary Collins. It is important to everyone who uses it.2980    Senator Blumenthal. Okay. Thank you, Mr. Chairman.2981    Chairman Moran. Senator Blumenthal, thank you. Just a2982couple of wrap-ups from me, Mr. Secretary. I wanted to give you2983the opportunity, and maybe just to educate me, what are the2984facts with the Veteran Crisis Hotline?2985    Secretary Collins. The facts on that is we protected all2986those who actually answered the phones. And this was a concern2987that came up many times, that I started seeing in the press,2988where there were accusations from the Hill and other places,2989that we had actually fired the ones who were actually answering2990the phones. The answer to that, even from career folks, was2991that was not true.2992    What we did have is, we found there were some, there were2993staff that were let go. When we immediately looked at that, I2994made the decision that we will make everybody back in. We will2995protect the entire group, because we did not want anybody to2996falsely accuse that we were not answering the lines.2997    Chairman Moran. And so today, is the Crisis Hotline any2998less or more--have more or less personnel than it did before2999this?3000    Secretary Collins. I think it is at the same lines that it3001has in the last year.3002    Chairman Moran. The people that were let go that you3003returned----3004    Secretary Collins. They are back.3005    Chairman Moran [continuing]. They are back.3006    Secretary Collins. Yes, they are back.3007    Chairman Moran. Okay. And then you answered my question3008about your interest in an IG and believe in its value. Would3009you also ask the White House for an IG for the Department?3010    Secretary Collins. We already have.3011    Chairman Moran. Okay. That is my questions. Mr. Secretary,3012anything you want to--I often ask this. It is not just a3013treatment of you, the witnesses--if they have anything they3014want to clarify or correct.3015    Secretary Collins. No. Look, I appreciate it, and I3016appreciate the Ranking Member. We have the same goals, I think3017all of us on this dais. We are going to disagree, and we are3018going to disagree about how to go about it. But there are3019several things, Mr. Chairman, that I am not going to do, and I3020do not think it is fair to VA employees, and I do not think it3021is fair to veterans, to take things that are pre-decisional.3022Many of the things that have been discussed today were leaked3023memos, designed to disrupt. They were designed to make the VA3024look bad or make veterans scared.3025    I am not going to do that. I am going to challenge anyone3026that is going to hurt or scare veterans or scare employees. We3027are going to give you everything that we can at the time. I3028promise you that, and I continue to do that. We have had3029conversations, you and I have. But when we are doing something3030as large as we are, at an organization as sensitive on this3031Hill, it would not be right for us to do that in public. It3032would not be right for us to just come out and say, ``Here's3033everything that we have got,'' and then have everybody scared3034because in the end it may not be the final decision.3035    What we are going to do is come to the best possible3036decision we can, for the veterans in this country, so that they3037have a VA system that actually works. And when we understand3038that, again, the VA has been an issue for a long time. We are3039trying to not make it an issue anymore. We are trying to get it3040to a point to where it is, doing what it is supposed to be3041doing, and taking care of the veterans that have earned it. And3042I appreciate the chance to be here today.3043    Chairman Moran. And I would just encourage you, it would be3044a mistake if I did not, to see if your crew can answer our3045team, both minority's and majority's staffs, questions fully3046and promptly.3047    Secretary Collins. Yes. Can I say one other thing about3048that? I have been in about 90 days. We have answered, from3049Ranking Member Blumenthal and SVAC minority alone, we have3050responded to 78 RFIs, 11 briefings, 9 technical assistance3051calls, 4 technical assistance are in progress, and many, many3052visits. We have also answered 19 letters from Senator3053Blumenthal and Chairman Moran, 68 letters and RFIs. Now, you3054might not like----3055    Chairman Moran. Mr. Secretary, that was----3056    Secretary Collins [continuing]. The answers----3057    Chairman Moran. That was my mistake, because we are going3058to start this conversation all over again now.3059    Secretary Collins. Yes.3060    Senator Blumenthal. I just want to make it clear----3061    Secretary Collins. And we are going to do that.3062    Senator Blumenthal [continuing]. Just so you do not feel--I3063mean, I am just going to be really blunt. I think some of those3064responses are an insult to my intelligence and perhaps yours,3065if you respond by giving us the kind of non-substantive answer3066that I think is inadequate. I am not going to count it as a3067real response.3068    Secretary Collins. That is your prerogative, Senator, and3069we will continue to do our best to give you the information.3070    Senator Blumenthal. I am asking for facts, not just3071acknowledgement of the questions.3072    And I also would encourage you to avoid the use of non-3073disclosure agreements with employees, so that we can get more3074facts from them.3075    Chairman Moran. All right. The hearing is about to3076conclude. I thank our Committee members for their participation3077today. You had a full house. I thank the Secretary for his3078presence and his testimony today.3079    The hearing record will remain open for 5 legislative days,3080should any Committee member wish to submit additional3081statements or questions for the record. Then, Mr. Secretary, I3082ask you and the Department to respond to any question for the3083record that you may receive, following today's hearing, in a3084timely manner, which I guess will be decided by I hope me, if3085it is necessary.3086    With that, our Committee is adjourned.3087    [Whereupon, at 2:01 p.m., the hearing was adjourned.]30883089                            A P P E N D I X30903091                           Prepared Statement30923093[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]30943095                       Submissions for the Record30963097[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]30983099                        Questions for the Record31003101[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]31023103                       Attachment for VA Response31043105[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]31063107                               [all]