A joint hearing with the House Committee on Veterans' Affairs to examine the legislative presentation of the American Legion and multi VSOs.

1[Senate Hearing 119-334]2[From the U.S. Government Publishing Office]34                                                      S. Hrg. 119-33456              LEGISLATIVE PRESENTATION OF THE AMERICAN7               LEGION AND MULTI VSOs: PARALYZED VET-8               ERANS OF AMERICA, AMVETS, NATIONAL ASSO-9               CIATION OF STATE DIRECTORS OF VETERANS10               AFFAIRS, WOUNDED WARRIOR PROJECT, TRAG-11               EDY ASSISTANCE PROGRAM FOR SURVIVORS,12               NATIONAL GUARD ASSOCIATION OF THE13               UNITED STATES, MISSION ROLL CALL14=======================================================================1516                             JOINT HEARING1718                                 OF THE1920                     COMMITTEE ON VETERANS' AFFAIRS2122                               BEFORE THE2324                          UNITED STATES SENATE2526                                AND THE2728                        HOUSE OF REPRESENTATIVES2930                    ONE HUNDRED NINETEENTH CONGRESS3132                             SECOND SESSION3334                               ----------3536                             MARCH 4, 20263738                               ----------3940       Printed for the use of the Committee on Veterans' Affairs4142[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]4344        Available via the World Wide Web: http://www.govinfo.gov4546                                ----------4748                     U.S. GOVERNMENT PUBLISHING OFFICE4963-116 PDF                  WASHINGTON : 202650=======================================================================51                                 SENATE52                     COMMITTEE ON VETERANS' AFFAIRS5354                     Jerry Moran, Kansas, Chairman55John Boozman, Arkansas               Richard Blumenthal, Connecticut,56Bill Cassidy, Louisiana                  Ranking Member57Thom Tillis, North Carolina          Patty Murray, Washington58Dan Sullivan, Alaska                 Bernard Sanders, Vermont59Marsha Blackburn, Tennessee          Mazie K. Hirono, Hawaii60Kevin Cramer, North Dakota           Margaret Wood Hassan, New61Tommy Tuberville, Alabama                Hampshire62Jim Banks, Indiana                   Angus S. King, Jr., Maine63Tim Sheehy, Montana                  Tammy Duckworth, Illinois64                                     Ruben Gallego, Arizona65                                     Elissa Slotkin, Michigan6667                     David Shearman, Staff Director68                Tony McClain, Democratic Staff Director6970                              ----------7172                        HOUSE OF REPRESENTATIVES73                     COMMITTEE ON VETERANS' AFFAIRS7475                     Mike Bost, Illinois, Chairman7677Aumua Amata Coleman Radewagen,       Mark Takano, California, Ranking78    American Samoa                       Member79Jack Bergman, Michigan               Julia Brownley, California80Nancy Mace, South Carolina           Chris Pappas, New Hampshire81Mariannette Miller-Meeks, Iowa       Sheila Cherfilus-McCormick,82Gregory F. Murphy, North Carolina        Florida83Derrick Van Orden, Wisconsin         Morgan McGarvey, Kentucky84Morgan Luttrell, Texas               Delia Ramirez, Illinois85Juan Ciscomani, Arizona              Nikki Budzinski, Illinois86Keith Self, Texas                    Timothy M. Kennedy, New York87Jennifer A. Kiggans, Virginia        Maxine Dexter, Oregon88Abe Hamadeh, Arizona                 Herb Conaway, New Jersey89Kimberlyn King-Hinds, Northern       Kelly Morrison, Minnesota90    Mariana Islands91Tom Barrett, Michigan9293                       Jon Clark, Staff Director94                  Matt Reel, Democratic Staff Director9596                            C O N T E N T S9798                              ----------99100                             March 4, 2026101102                                                                   Page103104                                SENATORS105106Hon. Jerry Moran, Chairman, U.S. Senator from Kansas.............     1107Hon. Richard Blumenthal, Ranking Member, U.S. Senator from108  Connecticut....................................................     3109Hon. Thom Tillis, U.S. Senator from North Carolina...............    14110Hon. Margaret Wood Hassan, U.S. Senator from New Hampshire.......    17111Hon. Tim Sheehy, U.S. Senator from Montana.......................    18112Hon. Angus S. King, Jr., U.S. Senator from Maine.................    19113Hon. John Boozman, U.S. Senator from Arkansas....................    20114Hon. Patty Murray, U.S. Senator from Washington..................    21115Hon. Elissa Slotkin, U.S. Senator from Michigan..................    25116Hon. Jim Banks, U.S. Senator from Indiana........................    26117Hon. Tommy Tuberville, U.S. Senator from Alabama.................    28118Hon. Ruben Gallego, U.S. Senator from Arizona....................    45119120                            REPRESENTATIVES121122Hon. Mark Takano, Ranking Member, U.S. Representative from123  California.....................................................     4124Hon. Chris Pappas, U.S. Representative from New Hampshire........    15125Hon. Kimberlyn King-Hinds, U.S. Representative from Northern126  Mariana Islands................................................    16127Hon. Morgan McGarvey, U.S. Representative from Kentucky..........    23128Hon. Herb Conaway, U.S. Representative from New Jersey...........    24129Hon. Kelly Morrison, U.S. Representative from Minnesota..........    43130131                               INTRODUCER132133The Honorable Jerry Moran, U.S. Senator from Kansas..............     6134135                               WITNESSES136                                Panel I137138Dan Wiley, National Commander, The American Legion...............     7139140  accompanied by141142  Joseph Sharpe Jr., Director, Veterans Employment and Education143144  Paul Espinoza, Chairman, Veterans Employment and Education145146  Mario Marquez, Executive Director, Government Affairs147148  Cole Lyle, Director, Veterans Affairs and Rehabilitation149150  Linden Dixon Jr., Chairman, Veterans Affairs and Rehabilitation151152  Matthew Jabaut, Chairman, National Legislative Commission153154                                Panel II155156Robert Thomas Jr., National President, Paralyzed Veterans of157  America........................................................    28158159Paul Shipley, National Commander, AMVETS.........................    30160161Terry Prince, President, National Association of State Directors162  of Veterans Affairs............................................    32163164LTG Walter E. Piatt, U.S. Army (Ret.), Chief Executive Officer,165  Wounded Warrior Project........................................    33166167Anita Sullivan, surviving spouse of U.S. Navy Petty Officer First168  Class169  Michael Sullivan, Tragedy Assistance Program for Survivors.....    35170171Major General Frank McGinn, U.S. Army (Ret.), President, National172  Guard Association of the United States.........................    36173174Jim Whaley, Chief Executive Officer, Mission Roll Call...........    38175176                                APPENDIX177                          Prepared Statements178179Dan Wiley, National Commander, The American Legion...............    55180Robert Thomas Jr., National President, Paralyzed Veterans of181  America........................................................    94182183Paul Shipley, National Commander, AMVETS.........................   119184185Terry Prince, President, National Association of State Directors186  of Veterans Affairs............................................   130187188LTG Walter E. Piatt, U.S. Army (Ret.), Chief Executive Officer,189  Wounded Warrior Project........................................   149190191Anita Sullivan, surviving spouse of U.S. Navy Petty Officer First192  Class193  Michael Sullivan, Tragedy Assistance Program for Survivors.....   188194195Major General Frank McGinn, U.S. Army (Ret.), President, National196  Guard Association of the United States.........................   236197198Jim Whaley, Chief Executive Officer, Mission Roll Call...........   244199200                       Statements for the Record201202Air Force Sergeants Association, Keith A. Reed, Chief Executive;203  Jon Nutman, Legislative Policy Advisor.........................   251204205Berry Law, Jerusha S. Hancock, Esq., Chief of Legal Operations...   268206207Hire Heroes USA, Ross Dickman, Chief Executive Officer...........   303208209Military Order of the Purple Heart of the USA, Tracey Brown-210  Greene,211  National Commander.............................................   311212213Military-Veterans Advocacy, John B. Well, USN (Ret.), Executive214  Director.......................................................   326215216Veteran Alliance for Leadership, Outreach, and Recovery (VALOR)217  Coalition......................................................   337218219Veterans Education Success.......................................   341220221    LEGISLATIVE PRESENTATION OF THE AMERICAN LEGION AND MULTI VSOs:222 PARALYZED VETERANS OF AMERICA, AMVETS, NATIONAL ASSOCIATION OF STATE223    DIRECTORS OF VETERANS AFFAIRS, WOUNDED WARRIOR PROJECT, TRAGEDY224  ASSISTANCE PROGRAM FOR SURVIVORS, NATIONAL GUARD ASSOCIATION OF THE225                    UNITED STATES, MISSION ROLL CALL226227                              ----------228229                        WEDNESDAY, MARCH 4, 2026230231                           U.S. Senate, and232                     U.S. House of Representatives,233                            Committee on Veterans' Affairs,234                                                    Washington, DC.235236    The Committees met, pursuant to notice, at 9:45 a.m., in237Room SD-G50, Dirksen Senate Office Building, Hon. Jerry Moran,238Chairman of the Committee, presiding.239240    Present from the Senate:241242    Senators Moran, Boozman, Cassidy, Tillis, Tuberville,243Banks, Sheehy, Blumenthal, Murray, Hassan, King, Gallego, and244Slotkin.245246    Present from the House:247248    Representatives King-Hinds, Takano, Pappas, McGarvey,249Conaway, and Morrison.250251             OPENING STATEMENT OF HON. JERRY MORAN,252               CHAIRMAN, U.S. SENATOR FROM KANSAS253254    Chairman Moran. [Raps gavel three times.] Good morning.255[Laughter.] What did we do? Commander, I need an explanation.256What did I do wrong?257    [Laughter.]258    Mr. Wiley. You rapped the gavel and for us, that is to259stand three times.260    Chairman Moran. Ah.261    [Raps gavel again.]262    Chairman Moran. There is a fourth one.263    [Laughter.]264    Chairman Moran. Thank you for the explanation. With the265sound of the gavel, I call this hearing to order this morning.266Good morning and welcome to everyone. I would like to thank267Chairman Bost along with Ranking Members Blumenthal and Takano268and the rest of the Senate and House colleagues for joining us269here today in this year's final joint hearing between the House270and Senate Committees on Veterans' Affairs in this year, 2026.271    And I want to specifically welcome Commander Dan Wiley and272his wife Sonia from my home State of Kansas, along with the273leaders of the other veterans service organizations who will be274testifying later this morning.275    I also would like to extend a special hello, as my276colleagues will do for their home states, but particularly277today with Commander Wiley as the lead witness today, I want to278express my gratitude to the Kansans who are present here, who279are watching at home, and who have been in my office numerous280times, including this week. I appreciate the Kansans' presence281in the room and I am grateful for my relationship I have with282American Legion members from across my state.283    I am grateful for the work that veterans service284organizations do every day to support veterans and their285families, caregivers, and survivors to advocate for timely,286high-quality health care and benefits that they have earned and287deserve.288    The work we do in our Committees, in these Committees,289would not be possible without the tireless work and dedication290of organizations like the ones here today and the ones we will291be hearing from this morning. I look forward to hearing from292Commander Wiley and his fellow veteran leaders how your293legislative priorities advance veteran success and what more294these Committees, the Committee that I chair and the others,295can do to make certain that VA policies translate into real296improvements in the well-being of veterans we are all here to297serve.298    With the Commander from Kansas's presence, I would like to299take a sidenote and express my appreciation and gratitude for300everyone's service. I am not a veteran. This is not what I301normally say at a hearing in this room. I was in high school302when Vietnam was occurring. I watched what happened when you,303those who served in Vietnam, returned home and how they were304treated. If you are a year older than I am, and certainly if305you are two years older than I am, you served in Vietnam. And I306saw how my classmates at home in Kansas were treated upon their307return to the United States shores following their service,308their honorable service in Vietnam. And I told myself, as a 16-309year-old kid, I am going to do everything I can to pay my310respects and honor those who served.311    I never expected, fellow Kansans, to ever be a Member of312Congress, to serve in the House of Representatives, to serve in313the United States Senate. And with that responsibility of that314service came doing something more than just saying thank you.315Something comes more than just saying I respect you.316    So I take it seriously, as do Members of this Committee,317Members of the Senate, Members of the House of Representatives,318Republicans and Democrats, we take it seriously to try to make319certain we do the things that keep our promises to those who320served in Vietnam and those who served elsewhere, around the321globe and in the United States.322    So I am honored to have the opportunity to be here with a323fellow Kansan, now the National Commander of the American324Legion.325    I yield to the Ranking Member, Senator Blumenthal, for his326opening statement.327328         OPENING STATEMENT OF HON. RICHARD BLUMENTHAL,329         RANKING MEMBER, U.S. SENATOR FROM CONNECTICUT330331    Senator Blumenthal. Thank you, Mr. Chairman, and thank you332to Commander Wiley and the American Legion leadership who are333here today. I am a proud member in Connecticut, and I know we334have some Connecticut members here. Welcome to you and thanks335for visiting with me yesterday. Your perspectives and your336advocacy are invaluable to what we do. You are the reason that337we have the PACT Act today, just to take one example.338    Yesterday I went to the floor of the United States Senate339and asked for unanimous consent to pass the Major Richard Star340Act.341    [Applause.]342    Senator Blumenthal. Unfortunately, it was blocked. I asked,343as a fallback, for a simple vote on the bill before August. It344was blocked, as well. The individual Senator blocking unanimous345consent is part of a small minority in the United States346Senate. The vast bipartisan majority of my colleagues support347the Richard Star Act, because they know it is unacceptable that348tens of thousands of combat-injured veterans are denied the349full military benefits they deserve.350    The Chairman just talked about promises. Promises are351meaningless unless they are kept. We made a promise to these352veterans that they would receive both retirement and disability353benefits. We owe them both, and I promise you, I will not stop354fighting until we pass the Richard Star Act in this Congress.355    [Applause.]356    Senator Blumenthal. And I want to add that support for it357is bipartisan. I thank the Chairman, Senator Moran, for his358support, as well as others on this Committee, including the359House Ranking Member, Mr. Takano.360    Yesterday The New York Times published an article entitled361``Despite Promises, Veterans Affairs Department Cut Thousands362of Roles for Doctors and Nurses.'' In fact, thousands of363positions have been left vacant. The numbers of doctors and364nurses, physicians, has declined by significant percentages,365which is a disservice to all of you here and the many, many366veterans around the United States who depend on the VA for367their medical care.368    At our hearing last month, Secretary Collins said the VA369needs more doctors, and yet he has eliminated thousands of370physician jobs.371    We need your help. We need your advocacy. We need your372voices and your faces, which is why it is so important you are373here today, so that we can maintain, restore, and even grow the374numbers of doctors, nurses, counselors, psychiatrists, all of375the team at VA health care that is so important to making sure376that we have sufficient workforce to serve the needs of our377veterans. Our veterans deserve nothing less than the best378world-class medicine. Thank you all for being here today.379    Chairman Moran. Senator Blumenthal, thank you.380Representative Takano, the Ranking Member.381382             OPENING STATEMENT OF HON. MARK TAKANO,383      RANKING MEMBER, U.S. REPRESENTATIVE FROM CALIFORNIA384385    Mr. Takano. Thank you, Mr. Chairman. Good morning,386everyone. It is truly great to see all of you here, ensuring387that my fellow Members of Congress and Americans tuning in from388the country hear directly from you. So I thank all the veterans389who have traveled here today, including those who have made the390trip from my home State of California. Where are you?391    [Cheers.]392    Mr. Takano. Thank you, California. Welcome. And welcome to393everyone from the American Legion. I would especially like to394welcome American Legion National Commander Dan Wiley of Kansas.395Mr. Wiley, Commander Wiley, you and I have had personal396conversations about how I actually spent time in Lawrence,397Kansas, one summer, so welcome.398    Auxiliary National President Pam Ray of Illinois, and Sons399of the American Legion National Commander Bill Clancy of New400York, and I offer a hearty welcome to the representatives from401all of the organizations on our second panel of witnesses. Very402good to see all of you, and I look forward to engaging in an403enlightening conversation.404    Just two weeks ago, Secretary Collins published an interim405final rule to cut veteran disability compensation benefits for406veterans whose service-connected conditions were improved by407medication. Thanks to a public outcry from VSOs, Members of408Congress, and many of you here today, Secretary Collins paused409enforcement and eventually rescinded the rule. Senator410Blumenthal and I led the effort here in Congress against this411rule, but our Republican colleagues were unwilling to join us.412Protecting veterans' benefits should be a bipartisan issue, and413my colleagues across the aisle should be willing to stand with414us in holding VA accountable when veterans and their benefits415are on the line.416    In addition to the Secretary's harmful interim final rule,417VA is also carrying out a massive--massive--reorganization of418the Veterans Health Administration. This reorg effort warrants419bipartisan oversight--oversight. Now, VA does need improvement.420No doubt about that. But VA leadership appears to be trying to421align VA with developments in for-profit health care.422    VA is not a business, and it should not mirror business423models. Following that business mindset, this VA aims to,424quote, ``do more with less,'' end quote. Now, that approach has425never really served veterans, in my opinion, and the data426suggests VA is already struggling with the less. The New York427Times reported yesterday that VA cut thousands of clinical428positions that were filled before the Administration and DOGE429started pushing staff out. VA told us that these were unneeded430COVID-era positions. But VA's own damning data tells us that431that is not true.432    As was reported by The New York Times, about 73 percent of433the 10,500 vacant positions VA just eliminated were filled just434sometime in 2025 or 2026, well after the COVID era. These were435recent vacancies, and rather than filling them, Secretary436Collins just wiped those clinical positions off the books,437clinical positions that the medical centers said that they438needed.439    Expanding care and benefits for veterans requires people,440doctors and nurses, claims processors, social workers,441researchers, police officers, and support staff. All these442roles help VA fulfill its mission.443    I know each of you sees the value in securing veteran care444and improving the VA because each of you has served, and today445you continue to serve your fellow veterans and their survivors.446When you raised your hand and put on that uniform, you set447yourself apart. That commitment came when our Nation promised448that you and your family would be taken care of afterwards. You449fulfilled your duty. We must fulfill ours.450    We sit here just days after President Trump committed our451Nation's most precious resource, our young men and women in452uniform, to another conflict. Several servicemembers have453already been killed or wounded. Our servicemembers are carrying454out difficult and dangerous missions far from home. They455deserve the full support of a grateful nation. That support456cannot end when they take off the uniform.457    So I ask, has this Administration planned and budgeted for458the long-term costs of this conflict? Is VA prepared to provide459a lifetime of medical care, disability compensation, mental460health services, prosthetics, and caregiver support to the new461generation of wartime veterans?462    President Trump and this Republican Congress have added463$150 billion for the Department of Defense in the so-called464``Big Beautiful Bill,'' but it did not include a cent for VA.465If this Administration is willing to send Americans into harm's466way, it must be willing to fully fund and strengthen the VA467system that will care for them for decades. That means passing468the Caring for Survivors Act. That means passing the Love Lives469On Act. And that means passing the Major Richard Star Act, as470well.471    [Applause.]472    Mr. Takano. Just a little bit of history. I was Chairman of473the House side of the Committee when I passed the Vietnam Blue474Water Navy Bill out of the House for the second time,475unanimously. And why I had to do it a second time is that the476previous Chairman, a Republican Chairman, passed it also. I477think it was unanimous, as well. But procedures in the Senate478blocked it. Just a couple of Senators ran out the clock at the479end of that session.480    And look, the politics in both houses, it is procedure that481is stopping the Major Richard Star Act. It is the will of the482majority of both houses of Congress, and I will be damned if we483allow procedure to stand in the way of passing the Major484Richard Star Act, and you should be damned as well. Keep the485pressure on.486    And with that, with that belief, Senator Blumenthal487yesterday went to the floor to ask for a vote on this bill, and488shamefully it was blocked. Procedure again. In objecting to a489vote on the Major Richard Star Act, Senator Ron Johnson of490Wisconsin lamented how much it would cost, arguing that we491needed to prioritize funding for ongoing defense capabilities.492I say this is unconscionable. We are talking about compensation493for combat-injured veterans. This is a cost of war. And as we494sit here watching the President drag us into another conflict,495we must reckon with the long-lasting impacts it will have on496our servicemembers, our veterans, and their families.497    Paying for the true cost of war means investing in VA now!498    Mr. Chair, I thank you for bringing these organizations499before us today, and I look forward to frank and fruitful500discussions, and I thank you, and I yield back.501    Chairman Moran. Ranking Member Takano, thank you.502503               INTRODUCTION BY HON. JERRY MORAN,504                    U.S. SENATOR FROM KANSAS505506    Chairman Moran. I now have the honor of introducing a507Kansan and a friend, the National Commander of the American508Legion, Mr. Dan Wiley. Dan, of course, has a long history of509serving veterans, particularly those in the neighborhood of his510hometown, Leavenworth, Kansas. He has also been a trusted511advisor to me on issues impacting veterans at home and across512the country.513    Dan served his nation in the United States Air Force, and514following his service he obtained a law degree from the515University of Kansas. He told me this morning he is a K State516fan. He used all his skills as an attorney to establish the517Leavenworth County Veterans Treatment Court. He was a district518court judge in the State of Kansas, and he used that519opportunity to find a new way to care for veterans who appear520before his and other courts in Leavenworth and across our521state.522    During his service with the Legion, Dan has pretty much523done it all. He has held 24 different positions within the524American Legion, making certain that veterans have a friend who525will listen to them and advocate for them. I have seen that in526my own circumstance at pancake feeds and American Legion events527in my hometown and across the state as he has been there for528every veteran of our state.529    Dan, like many veterans, has faced his own challenges and530hurdles in his life. After service, but rather than hide or shy531away from the challenges, he has shared them openly, letting532veterans know that they are not alone. I respect Dan for being533vulnerable and honest about mental health and using his534experience to reach out to veterans.535    As National Commander he is a strong advocate for the536American Legion's ``Be The One'' campaign, to prevent veteran537suicide. Thank you for working to extend hope to veterans who538are struggling with their mental health and helping reduce the539stigma around asking for help.540    Outside the American Legion, Dan is very involved in his541community back home, where he has worn many different hats,542helping organize and be the master of ceremonies at the543Leavenworth County Veterans Day Parade, to serving on his local544Board of Education.545    Commander Wiley, you have been a friend to me and a friend546to veterans, and I have no doubt that your vision and547experience is strengthening the mission of the American Legion548and making certain that the voices of veterans are heard and549that their needs are met with honor and with respect. I thank550you for those things. I thank you for your dedication to551serving veterans in Kansas and across the country and for being552here to testify today. I appreciate your family's sacrifice for553your service in this capacity, and I look forward to working554together on our shared mission of improving the lives of555veterans across the country and back home in our home state.556    With that, Commander Wiley, you are now recognized.557558                            PANEL I559560                              ----------561562STATEMENT OF DAN WILEY, NATIONAL COMMANDER, THE AMERICAN LEGION563ACCOMPANIED BY JOSEPH SHARPE JR., DIRECTOR, VETERANS EMPLOYMENT564AND EDUCATION; PAUL ESPINOZA, CHAIRMAN, VETERANS EMPLOYMENT AND565   EDUCATION; MARIO MARQUEZ, EXECUTIVE DIRECTOR, GOVERNMENT566      AFFAIRS; COLE LYLE, DIRECTOR, VETERANS AFFAIRS AND567 REHABILITATION; LINDEN DIXON JR., CHAIRMAN, VETERANS AFFAIRS568  AND REHABILITATION; AND MATTHEW JABAUT, CHAIRMAN, NATIONAL569                     LEGISLATIVE COMMISSION570571    Mr. Wiley. First, thank you, Senator, for that kind572introduction. Thank you, Chairman Moran, Ranking Member573Blumenthal, Chairman Bost, Ranking Member Takano, and574distinguished Members of these Committees. On behalf of the 2.5575million members of the American Legion family, I appreciate the576opportunity to discuss our legislative priorities for the577second session of the 119th Congress.578    I would like to begin by introducing the members of the579American Legion family here with me today. Please stand if you580are able as I recognize you. Our National Officers serving with581me this year, please stand. Our past National Commanders,582please stand. Pam Ray, National President of the American583Legion Auxiliary; William Clancy III, National Commander of the584Sons of the American Legion; and my daughter, Christy, my son,585Austin, and his wife, Jesse, with their son and my grandson,586Noah. And of course, the most important person in the room,587without a doubt, my wife Sonia. Thank you.588    [Applause.]589    Mr. Wiley. Our written testimony contains our complete list590of legislative goals, and they are all important. With limited591time, however, I will focus on several critical issues.592    This is a pivotal time for our country. Recent military593action reminds us of the cost of service, shouldered by a594shrinking minority of American families. In our all-volunteer595force, military service has become a family business. And while596average time in uniform is just 4 to 8 years, the costs can597potentially last a lifetime. And as we mark the 250th598anniversary of our Nation's founding, it is essential we599examine those costs and make sure they are paid in full.600    That is precisely why Congress chartered the American601Legion after World War I, to promote a strong national defense,602encourage civic education, and to create a community of603veterans to support one another, whose voices are heard by our604Nation's leaders. Since 1919, the Legion has been instrumental605in landmark changes, like the GI Bill, creation of the modern606VA, appeals modernization, and the MISSION Act. We created607programs like the American Legion Child Well-being Foundation,608legacy scholarships, and Boys Nation. Our mission, every single609day, is to serve those who served us.610    At the post level, legionnaires serve their communities in611times of crisis. Just last year, after the tragic floods in612Kerrville, Texas, Legion Post 208 provided urgently needed613resources for those who had lost everything, and served as a614relief point for aid workers who came from across the country.615    American Legion service officers assist veterans with616disability claims, and in 2025 alone, processed $29.5 billion617in claims for veterans. This was free of charge, regardless of618whether they were members of the American Legion or not.619    Nationally, we partner with VA on the Buddy Check Week, and620our Be The One campaign to reduce stigma, provide critical621training, and ultimately save lives. Our System Worth Saving622(SWS) and regional office actuary review programs provide623policymakers with on-the-ground feedback regarding health care624and benefits. And we have continued to work with Congress to625ensure that while the Administration seeks bold change, there626is no reduction in accessibility of services and benefits to627any veteran or their family.628    Just two weeks ago, the American Legion spoke against a629proposed rule that would change the way VA rates a veteran's630disability based on medication management. We were glad to see631Secretary Collins listen to the veteran community and632ultimately rescind the rule. We will remain vigilant, and we633will give you all of our feedback on what is working and what634needs to change.635    The Legion's number one priority is ending veteran suicide.636VA estimates more than 17 veterans die every day by suicide.637Traditional approaches to this problem, pills and therapy, have638objectively not worked. We need stronger transition programs,639innovative therapies, and improved safeguards to medication640management. That is why we support things like the Fox Grant641Program, the BEACON Act, the Written Informed Consent Act, and642other bills that seek to address this problem. It is also why,643after a decade of legion advocacy, I was proud to be in the644Oval Office as the President signed an Executive order645reclassifying cannabis as a Schedule III drug. This allows for646Federal research on how it can reduce drivers of suicide. The647American Legion does not support use of illegal drugs, but we648strongly support research that could result in new, effective649treatments.650    An important part of suicide prevention, and ultimately651VA's core mission, is access to timely, quality health care.652And while most veterans prefer to receive from VA their care,653because it is a one-stop shop, community care has exploded654since the passage of the MISSION Act. Congress must provide the655necessary funding to ensure the VA system remains strong,656without curtailing a veteran's access to community care if it657is in the veteran's best interest. It is a difficult balance,658but one we are committed to helping Congress achieve.659Ultimately, veterans should get the care they need, when they660need it. But we must remain the center of all veteran health661care in the VA.662    As we discuss VHA reorganization, the Next-Gen Community663Care contract, and acceleration of electronic health record664deployment, Congress must also address aging infrastructure and665give the VA authorities and funding it needs to compete with666the private sector job market.667    As we all know, the veteran population is changing, and so668are its needs. Women veterans, the largest-growing669subpopulation in our community, experience homelessness,670depression, infertility, migraines, and other issues at a671higher rate than their male counterparts. This is attributed to672military sexual trauma and domestic violence. Congress should673pass legislation to improve research on how issues unique to674women veterans, including menopause, affect outcomes, and675increase the availability of gender-specific rehabilitation676programs.677    Enabling veterans to thrive in a civilian life is a huge678task. Congress can make it easier by ensuring our679servicemembers do not experience financial uncertainty prior to680separation. When I served in the United States Air Force, I681never worried about getting paid on the 1st and the 15th of the682month. But as government shutdowns become more frequent, that683is no longer guaranteed. Not long ago, the Legion provided over684$1 million in grants to Coast Guard families because Congress685failed to do its job and ensure they were paid on time. We need686iron-clad protections to ensure uninterrupted pay for all687servicemembers in our all-volunteer force.688    Finally, consider Major Richard Star, who deployed multiple689times and was diagnosed with lung cancer linked to burn pit690exposure. Before his death, he endured the indignity of a691wounded veteran's tax, an offset of his disability compensation692against his pension because he was medically retired before 20693years. This is wrong.694    [Standing ovation.]695    Mr. Wiley. Collecting both benefits is not double dipping.696Retirement is for time served. Disability compensation is for697harm caused during service. Congress must pass the698overwhelmingly supported, bipartisan Major Richard Star Act.699    [Loud applause.]700    Mr. Wiley. Chairmen Moran and Bost, Ranking Members701Blumenthal and Takano, and Members of the Committees, the way702America treats its veterans directly influences whether the703next generation raises the right hand to define our 250-year704legacy. On behalf of the entire American Legion family, thank705you for this opportunity to share our priorities, and my staff706and I welcome your questions.707    [Applause.]708709    [The prepared statement of Mr. Wiley appears on pages 55-93710of the Appendix.]711712    Chairman Moran. National Commander, thank you for your713testimony. We will now turn to questions of you and your714colleagues at the desk.715    The Richard Star Act, let's start there, for my first716question. Would you share perhaps a member's experience, a717real-world example of a veteran and their family who would718directly benefit if the Major Star Act was passed? Explain how719it would change the quality of their life. Give us an example720of why it matters.721    Mr. Wiley. Thank you, Senator, and without naming the722individual, you and I both know an individual that suffered723harm while he was on active duty. He was in a Ghillie suit and724he was burned by that active-duty service, and because of that725was medically retired. So he receives that medical retirement726for that time in service. Also, you would not find surprising727because of the burns on his body he was entitled to disability728compensation for the harm caused. However, because of the fact729that he did not have the 20 years in time and service he has to730waive dollar-for-dollar his retirement for the disability731compensation he receives. And quite obviously, this takes funds732away from his family that would benefit his family for a733lifetime, and he has got a lifetime of care and a lifetime of734loss as a result of those injuries.735    I appreciated the opportunity last month, as I said in your736office, and we talked about the Major Richard Star Act. And you737know me, I am probably more passionate than I am articulate.738But to that extent it just frustrates me that Congress cannot739get this passed, when we have 316 members in the House that740have signed on, and approximately 75 members in the Senate who741have signed on, and yet we cannot get it to a vote on the House742floor. The buck stops with leadership. They need to get a vote743on this, up or down, because our veterans are entitled to know744whether your Congressman supports our disabled and wounded745veterans or your Congressman is against us. That is what we746believe we are entitled to a vote on this, on the House and747Senate floor. Thank you.748    Chairman Moran. Commander, thank you for answering my749question. I would use this moment to again, as I told you in750our office when we last visited, that I am committed to trying751to do everything I can to accomplish that. Folks in this room752probably know, but should know, the jurisdiction of this bill753does not rest with the Committee on Veterans' Affairs, it rests754with our Armed Services Committee. But we are working with the755leadership of the Armed Services, I am working with the756leadership of the Armed Services Committee to find a path757forward. And I spoke yesterday on the Senate floor about this758topic, and I have also spoken to my colleagues in the Senate,759that there is no opportunity for the sponsoring of a bill that760you are not willing to vote for when the time comes. Sponsoring761is insufficient. We want you to do that. But if the time is762right, we want to make certain that the votes occur, and there763is no hypocrisy demonstrated by Members of Congress.764    You mentioned community care. It is a topic that I have765significant interest in. In large part, when I was a766Congressman, I represented a congressional district the size of767the State of Illinois. Not a VA hospital in that congressional768district, and distance was often the enemy of a veteran in769being able to access quality care at the VA.770    Would you elaborate on--well, let me again say that771American Legion is a strong supporter of the ACCESS Act, that772Senator Blumenthal and I are trying to work out our differences773to see that we get it passed. Would you explain to the774Committee the importance of the ACCESS Act and why the American775Legion is supportive?776    Mr. Wiley. Absolutely. Thank you, Senator Moran, for that777question. Community care is obviously important for our778veterans. Most of our veterans, as I said in our opening779remarks, are very happy with the care they get at the VA, and780they prefer that. But as you know, just like Kansas and much of781this country, there is a lot of distance between VA hospitals.782You are in western Kansas you might be four hours from a VA783hospital, so we have transportation issues. We have issues with784regard to obtaining care from a specialist. And ultimately, we785believe that the veteran should receive the care that is in786their best interest, and we believe that this ACCESS Act will787provide more oversight. We need to continue to have VA788oversight of community care, but community care is obviously789important for the best interest of our veterans. Thank you.790    Chairman Moran. I recognize Ranking Member Blumenthal.791    Senator Blumenthal. Thank you, National Commander, for792calling attention to some of the most pressing needs of our793veterans. Obviously, the Richard Star Act is a priority for me,794not only as the Ranking Member of this Committee but also as a795member of the Armed Services Committee. And you have correctly796identified where the point of persuasion has to be with the797leadership, the leadership of the United States Senate and the798House of Representatives. So I urge every member here, if you799think the Richard Star Act ought to be passed, contact the800leadership of the United States Senate. And again, I thank801Senator Moran for his advocacy and his support.802    I want to call attention to your advocacy on behalf of803women veterans. As you say in your testimony, ``they are the804fastest growing cohort of veterans.'' They are serving right805now in harm's way in the Middle East. Tragically, one of the806fallen is a woman National Guard member. We owe them the same807kind of health care and compensation benefits that our male808veterans receive.809    What kinds of specific measures, if you could talk about810them, would you advocate to expand the service that we provide811to our women veterans?812    Mr. Wiley. Thank you, Ranking Member Blumenthal, for that813question. And again, I appreciate your time as we had an814opportunity last month in your office to discuss these very815issues, and I know they are of concern to you.816    Obviously, the women veterans is the single biggest growing817demographic. And I can tell you that VA care has improved818significantly in the 30-plus years I have been a member of the819American Legion. I have visited VA hospitals throughout this820country. We now have hospitals--not all; we need to do a lot821more--that have separate entrances, for example, for women822veterans. And I know there are a lot of bills that impact women823veterans, so I am going to ask our Veteran Affairs and824Rehabilitation Director, Cole Lyle, to expand on that answer.825    Senator Blumenthal. Thank you.826    Mr. Lyle. Thank you, Commander, and thank you, Ranking827Member Blumenthal. The American Legion has publicly supported828the SAVES Act, which would expand the evidentiary standard for829VA to be able to consider non-VA evidence, lay statements,830nexus letters, things like that, in disability process claims.831As the Commander alluded to, infrastructure at a lot of VA832facilities, specific for women veterans, residential833rehabilitation programs, secure areas in VA facilities for them834to feel safe if they have experienced military sexual trauma or835intimate partner violence.836    Also, Congresswoman Brownley has a bill to expand research837on menopause. There is not a lot of evidence. There is a lot of838anecdotal evidence. There is not a lot of research on839menopausal links to certain things that drive suicide. And as840we know, women veterans experience suicide at a much higher841rate than their civilian counterparts.842    Senator Blumenthal. That is a great answer, and I want to843just volunteer my services, my office, on this issue and others844that you have raised, Commander, most especially the continuing845scourge of veteran suicide, the need to expand the PACT Act,846the importance of recognizing the next generation of toxic847exposures, very, very important.848    And I want to just commend the American Legion for a849program that is very close to my heart. In Connecticut, and I850do not know how many of the other states have it, we have a851Boys State and Girls State program, which fosters future852leadership. Young people are chosen--it is a very competitive853program--to participate in a nearly weeklong series of854sessions, in usually it is a school location. They live in855dormitories. They participate in mock Senate and House856sessions. I think their conversations are considerably more857erudite and informed than I often find around here.858    But I just want to say to the American Legion, providing859the role models, fostering the leadership, is so important. We860need to develop our future veterans. My son, who served in the861United States Marine Corps, as an infantry officer in862Afghanistan, my other son, who served as Navy SEAL, had you as863role models. And they, in turn, will be role models for others.864But you, in the American Legion, whatever your age, are role865models for our future leadership. Thank you for being there for866our great country. Thank you.867    Chairman Moran. To what office were you elected at Boys868State?869    Senator Blumenthal. I did not participate, but my sons did,870and it had an impact on them.871    Chairman Moran. I am quite certain I was never a Senator at872Boys State. Representative Takano.873    Mr. Takano. I was at Boys State California. I did not get874elected to anything, either.875    [Applause.]876    Mr. Takano. Commander Wiley, one thing that I have heard877loud and clear from the veteran community this month is878veterans should never be punished for following medical advice.879When VA issued changes to how medication effects would be880treated in disability evaluations, did the Legion receive881advance notice or a chance to weigh in?882    Mr. Wiley. Thank you, Ranking Member Takano, and again, I883appreciate your time and having the opportunity to meet with884you last month. The simple answer is no. But I will also tell885you that was an aberration for this Administration and the VA,886because we have been fortunate enough in the American Legion to887have been advised of most things. But we were not advised of888this, and if we had been we would have told them exactly what889we told them in the end, and that it was a terrible idea. So we890are glad they rescinded it. But thank you.891    Mr. Takano. Thank you. Do you think VSOs like the American892Legion should be brought in early before policies are rolled893out, so that they are not surprised and trust is not shaken?894    Mr. Wiley. Absolutely. The veteran community is entitled895and needs to be heard, yes.896    Mr. Takano. There are several important bills pending that897would radically improve benefits for veterans, their families,898and their survivors, like the Major Richard Star Act, or899Representative Hayes's Caring for Survivors Act. Commander, you900have been very clear that these are earned benefits, not901favors. I see you are nodding your head. On bills like the902Major Richard Star Act and survivor reforms, do you agree that903Congress should not force veterans or survivors into a tradeoff904where one group's earned benefit is paid for by cutting another905group of veterans' benefits?906    Mr. Wiley. Yes.907    Mr. Takano. Do you think Congress should put the burden of908paying for veterans benefits increases on other veterans or on909the American people as a whole?910    Mr. Wiley. No, not on other veterans.911    Mr. Takano. Not on other veterans.912    Mr. Wiley. There is an obligation to pay for what a veteran913has earned, and that is incurred at the time of service and914they time they were put in harm's way. So yes, the American915people and the American government, when they do that they have916an obligation, but it should not be put on the shoulders of917other veterans.918    Mr. Takano. Thank you. That was the point. I think the919American people are very much willing to honor the obligations920that we made to them.921    Commander Wiley, I sponsored the PACT Act, which has922certainly helped many veterans gain access to VA benefits and923health care that they have earned through their service. But924even as we were writing the PACT Act, we knew that the PACT Act925was only a step and that there would be more work left to do in926the future. Where should Congress push next, and what exposures927or cohorts are most urgent to address a PACT Act follow-on?928    Mr. Wiley. Thank you again, Ranking Member Takano, and929obviously the PACT Act, when it was passed, there is a930mechanism in there for identifying future toxins that has not931been adequately used. But to further elaborate, I am going to932call on our VA&R Director, Cole Lyle, to answer.933    Mr. Lyle. Thank you, Commander, and I see time is short so934I will try to be brief. Yes, the mechanism that the Commander935was talking about existed because Congress did not want to have936to legislate individual presumptive conditions going forward.937That process has been slow, and sometimes the process has been938opaque. So I think if there were mandatory timelines requiring939VA to review prospective presumptive conditions within, let's940say, 180 days, mandate some sort of external review if941presumptives were removed or an external review right after942they were finalized, and then codify that presumptives could943probably only be removed if there is overwhelming evidence that944contradicts the existing science that was used in the approval945process.946    Mr. Takano. Well, is the Secretary fully leveraging the947authorities granted by Congress to establish new presumptives,948in your view, or could he be more assertive?949    Mr. Lyle. I think Secretary Collins and the VA, as I said,950there are some conditions, that particularly like with K2951veterans, Red Hill, that could be advanced more quickly.952    Mr. Takano. What would be more helpful, faster presumptive953decisions, clearer transparency on where conditions are in the954process, or better access to exposure record so veterans are955not left guessing?956    Mr. Lyle. Sir, I would say all three. I think the DoD, the957ILER, the Individual--I am forgetting what the acronym stands958for--but basically the individual record of exposures to959servicemembers while they are on active service, that the DoD960could track and then give to VA. That was supposed to be made961available, I think, a year ago, and we are still waiting on962that. There are definitely things that could improve in that963process.964    Mr. Takano. Well, thank you. I yield back, Mr. Chairman.965    Chairman Moran. Senator Tillis.966967                       HON. THOM TILLIS,968                U.S. SENATOR FROM NORTH CAROLINA969970    Senator Tillis. Thank you, Mr. Chairman. Thanks, everybody,971for being here today. I always like it when my colleagues ask972for people that are from California or whatever state. I would973like to know if we have got anybody here that either is from974North Carolina or spent a little quality time there in your975past, if you will please raise your hands.976    [Hands raised.]977    Senator Tillis. There you go. First off, an explanation on978the bolo. The Lumbee Tribe in North Carolina got recognized979after 137 years of racism, neglect, and more recently as a980target of the casino cartels. The reason I wear this today is981because they have disproportionately, in spite of all those982challenges, they are among some of the most courageous and983disproportionately represented people in Armed Services in the984State of North Carolina. So I am looking forward to them, now985that they have been federally recognized, putting a mark in986Lumbee and Robeson County focused on veterans and all those987great Native Americans that have served this country, in the988same way that you did. Thank you for your service.989    You know, as I was looking at the written testimony and my990staff this week, I was trying to think of what I can do in my991remaining time here. It is 305 days. Now, some people think I992am counting the days before I am out of here, but I am a993project person, and I am always mindful of how much time I have994left in my budget. So as a U.S. Senator I have got 305 days to995do everything I can to help you guys.996    One of the ways I want to help you is by having a frank997conversation about how we address all the things the Commander998has outlined, but not kill you with kindness. Because what we999do here a lot of times is we rush to pass a bill, and we get it1000and we high five, and then about a year later we come back and1001figure out why it has failed to be executed properly.1002    And quite honestly, I will give you the best example of1003that. You all know that I voted, in spite of being an original1004co-sponsor, and in spite of having the TEAM Act and the Camp1005Lejeune toxics being written out of my office and promoted, I1006voted against the PACT Act. And the reason I voted against the1007PACT Act, even knowing that it was going to pass by1008overwhelming majorities, is because I thought we were going to1009come up short on the execution. And that, by God, is exactly1010what has happened.1011    So one of the things that I hope to do in my remaining time1012here, and my time is short on these comments, is to try and1013convene a meeting to figure out how we can get to all these1014priorities, past and future, Mr. Commander, but do it in a way1015that is honest, that is instructed by the reality of resources1016that we have here, to make sure that we can have maximum impact1017on you all. And not only kind of fulfill the promise by passing1018a law, but true to the state motto of North Carolina--it is1019Esse quam videri--it says ``To be, rather than to seem.''1020Instead of seeming to support you all by passing bills that get1021caught up in execution, I want to be somebody that helps you do1022that in my remaining tenure in the Senate.1023    So you will be getting a call from me, and we will get1024other veterans service organizations together, and we are going1025to figure out how to make the most out of the 305 days I have1026left to begin to make an installment on a debt we will never1027repay. Thank you.1028    Mr. Wiley. Thank you, Senator Tillis, and I will tell you,1029me and my staff are more than happy to contact with your staff1030and work together to accomplish just that.1031    Senator Tillis. Thank you.1032    Chairman Moran. Senator Tillis, thank you. Representative1033Pappas.10341035                       HON. CHRIS PAPPAS,1036             U.S. REPRESENTATIVE FROM NEW HAMPSHIRE10371038    Mr. Pappas. Thank you very much, Mr. Chairman. Commander,1039thank you so much for your testimony here today, and I want to1040thank everyone from the American Legion family who is joining1041this hearing. Thank you for your service and sacrifice. It does1042not go unnoticed by Congress, and we certainly owe you all a1043debt, and have to work to repay that. And I think you have1044given us an important roadmap of how we can pursue our1045obligations to the veteran community and our Nation.1046    Thank you for highlighting veteran suicide as your number1047one priority. It is on the minds of every veteran I talk to in1048the State of New Hampshire, and a shout-out to all those from1049the ``Live Free or Die'' State of New Hampshire who are joining1050this hearing today.1051    I want you to know that this is important, and we need to1052focus on the kinds of alternative therapies that can help1053veterans manage pain and ensure that they are living with a1054high quality of life. We have got legislation called the NOPAIN1055for Veterans Act that can help reduce reliance on opioid-based1056treatments for veterans. And I am just wondering if you can1057kind of evaluate how we are doing at opening up the doors to1058some of these alternative therapies that can result in a better1059quality of life and less reliance on opioid-based medications.1060    Mr. Wiley. Thank you, Representative Pappas. I appreciate1061that question. It is no secret that far too long doctors have1062prescribed opioids, which are destructive and addictive, to our1063veterans. And the American Legion, by resolution, supports1064alternative therapies, which is one of the reasons why we were1065proud to be in the Oval Office on December the 18th when the1066President signed the Executive order reclassifying cannabis1067from a Schedule I to Schedule III. There are a lot of other1068therapies that we believe would be productive for veterans, and1069I am going to ask, again, our VA&R Director, Cole Lyle, to1070address those.1071    Mr. Lyle. Thank you, Commander, and thank you, Congressman.1072The NOPAIN for Veterans Act, right now the VA still treats many1073of these non-opioid pain management things, so long-lasting,1074topical pain cream, things like that, non-opioid injectables,1075as non-formulary, so it makes it harder for physicians to1076prescribe. They have got to go through extra red tape to do it.1077And it often costs more to the veteran out-of-pocket.1078    So the bill, and why it would fix that problem, is it would1079mandate that VA add these no-opioid alternatives as VA1080formulary, to make it easier for those providers to prescribe1081alternatives, which, as the Commander noted, obviously we had1082an opioid crisis in the United States. As the VA and other1083agencies have worked to kind of lower that or reduce the impact1084of that on the population, veterans still have to find a way to1085deal with things like chronic pain. So without alternatives,1086they turn to self-medication and things like that. This would1087provide realistic alternatives.1088    Mr. Pappas. Well, I appreciate those observations. We are1089committed to working with you on this, and on all the other1090priorities on the list. We have got to make some progress here.1091So let's get things moving. Your presence here in Washington is1092a big show of support for priorities that are going to1093positively impact the lives of veterans and their families all1094across our country. So thanks for being here, and let's keep up1095the pressure. I yield back.1096    Chairman Moran. Thank you, Congressman. Representative1097King-Hinds.10981099                   HON. KIMBERLYN KING-HINDS,1100       U.S. REPRESENTATIVE FROM NORTHERN MARIANA ISLANDS11011102    Ms. King-Hinds. First of all, I want to say thank you for1103your advocacy and for your leadership, and I want to thank all1104the members of the American Legions for being here, and for1105your continued work to be able to get Congress to move on some1106of these priority legislation. I appreciate all the hard work.1107    I read your testimony, and I appreciate the clarity and the1108urgency in the testimony that you submitted. One of the things1109that I want to get a better understanding of, after reviewing1110your testimony, is from the priorities that you have outlined,1111what do you believe is the single biggest systematic failure in1112how we currently deliver benefits to veterans, and what1113specific legislative action should we be prioritizing to1114address it?1115    Mr. Wiley. Thank you, Representative King-Hinds. I am going1116to ask, again, our VA&R Director, Cole Lyle, to address that1117question.1118    Mr. Lyle. Thank you, Commander. I think if we are going to1119talk specifics in the benefits process it is the high rate of1120remands from the Board of Veterans Appeals, and that has1121directly resulted from the quality of CMP exams in that1122process. The VA largely utilizes contractors to conduct those1123CMP exams, and there is fairly consistent, in our regional1124office action review site visits we find inadequate DBQs that1125are submitted for CMP exams, that result in appeals, delays,1126things like that. So I would say that is the biggest----1127    Ms. King-Hinds. Point of failure?1128    Mr. Lyle [continuing]. Point of failure. And there are1129several bills, to include the MDEO--I am forgetting on what the1130specific bill number is off the top of my head--to improve the1131oversight of those contractors and ensure there is quality in1132those CMP exams.1133    Ms. King-Hinds. Okay. Where do you see is the widest gap,1134then, between some of these legislation that have been enacted,1135going back to the point that Senator Tillis was making with1136regards to delivery, in terms of connecting legislation and the1137actual delivery and the way that the VA currently does its job?1138    Mr. Lyle. It is a great question. From a 30,000-foot view1139perspective, I would say really education and advocacy, and1140educating veterans, many of whom often feel like if they apply1141for disability compensation they are going to be taking1142something away from another veteran. So I would say from a top-1143level view that is the biggest thing, between legislation and1144actual delivery of benefits is educating veterans.1145    Ms. King-Hinds. I would like to continue working with the1146American Legion to figure out how to actually address those1147systematic failures. Thank you. I yield my time.1148    Chairman Moran. Senator Hassan.11491150                   HON. MARGARET WOOD HASSAN,1151                U.S. SENATOR FROM NEW HAMPSHIRE11521153    Senator Hassan. Thank you, Mr. Chair, and to you and1154Chairman Bost and Ranking Members Blumenthal and Takano, thank1155you for this hearing. And to everyone here today, to Commander1156Wiley and everyone from the American Legion, including the1157Granite Staters who are in attendance, thank you for your1158service.1159    I also just want to note that as the country is at war, our1160troops in harm's way are in all of our hearts today, as are the1161families of our fallen heroes.1162    Our country owes all of you a debt of gratitude, not just1163for your service in uniform but also for your service to your1164fellow veterans.1165    Commander Wiley, I wanted to start with a question about1166how we are handling services for women who are, of course, the1167fastest-growing group of veterans. They obviously deserve easy1168access to care that is specific to them and their needs.1169Senator Blackburn and I are working on this issue, and we are1170going to introduce a bill soon that would codify the ability of1171women veterans to directly schedule gender-specific care1172without having to get a primary care referral first. But we1173know we need to do more.1174    Commander, what else can Congress do to ensure that women1175veterans have easy, reliable access to the care that meets1176their specific needs?1177    Mr. Wiley. I think a couple of things that they can do1178specifically. As I suggested, or saw in one of the VA hospital1179visits, is having a separate access for women veterans. It is1180also having a sufficient number of doctors that can treat women1181veterans. You know, 20 years ago you would never have heard of1182an OB-GYN in a VA, and we have, obviously, veterans that are1183having babies. And we need more women physicians and more of1184those types to treat women veterans. So those are the big1185things we can do right off the bat, I think, to help women1186veterans.1187    Senator Hassan. Thank you for that, and I look forward to1188working with you and your members on that issue.1189    Another question concerning families of veterans. It is not1190just to care for our veterans, we also owe a debt to their1191families. And after a veteran passes, surviving family members1192may encounter financial strains. Some can qualify for monthly1193payments under Dependency and Indemnity Compensation (DIC), but1194those payments can be much smaller than what a veteran was1195receiving for VA disability.1196    Commander, what are some potential options that Congress1197should consider to help these families through this adjustment1198period, so that they do not have to immediately worry about1199money while they are grieving for their loved one?1200    Mr. Wiley. Thank you again, Senator Hassan. I agree with1201you 100 percent on the premise, and I am going to ask our VA&R1202Director Cole out to address that specifically.1203    Senator Hassan. Thank you.1204    Mr. Lyle. Thank you, Commander, and thank you, Senator. I1205think the American Legion has supported the Caring for1206Survivors Act and the Love Lives On Act specifically to raise1207the DIC, the Dependency and Indemnity Compensation, because as1208you pointed out, while their servicemember is alive they rely1209on a certain level of income for the quality of life and1210standard of living, and when it gets significantly reduced that1211is a pretty big financial shock.1212    Senator Hassan. Sure. Thank you very much. I yield.1213    Chairman Moran. Senator Sheehy.12141215                        HON. TIM SHEEHY,1216                   U.S. SENATOR FROM MONTANA12171218    Senator Sheehy. We are veterans, not victims. Veterans, not1219victims. And we are not entitled to anything. We have earned1220the benefits that we deserve, and we deserve those benefits in1221the form that they should come. And I think the best thing we1222can do for our veterans when we get home from war--and I will1223talk to Mr. Sharpe and Espinoza about this--is make sure that1224they can serve again, and that can be as law enforcement1225officers, that can be as a firefighter, that can be as a small1226business owner, a machinist, a welder. Right now America has a1227skills gap. We do not have enough pilots, police officers,1228firefighters, welders, electricians, and these careers are1229actually well suited for veterans. Probably the best careers as1230veterans even is agriculture. We do not have enough producers,1231ranchers, and farmers, and we are not afraid of getting up1232early and working until the sun goes down. And these jobs are1233important for the future of America. They sustain our economy1234and they feed our Nation.1235    So Mr. Sharpe and Mr. Espinoza, I would like to hear from1236you what you think we can do to make sure that when our1237veterans come home and take that uniform off they do not spend1238the rest of their life talking about how great it was to be1239veteran. They spend the rest of their life achieving new great1240heights as veterans and make us proud yet again.1241    Mr. Sharpe. Thank you for that question. The American1242Legion has always supported expansion of the TAP program. We1243believe TAP program should be a way for veterans to find1244employment and also be gainfully employed. Currently not all1245our veterans are aware of the various services that are out1246there for veterans as far as finding employment, so the1247American Legion has, for our resolution, we believe that there1248should be a transition app with an AI component to it, to put1249all veterans that are leaving the military on a level playing1250field. Because depending on what installation that you are1251leaving from it may not have all the services for everyone. So1252we believe that transition app is the one thing that will level1253the playing field, keep veterans informed of all the services1254and programs that the TAP office currently has, but also keep1255an eye on what is happening in the private sector, as well.1256Thank you.1257    Senator Sheehy. What I say one thing I could use all of1258your help with is one of the requirements to receive your DD1259214 upon discharge should be a full transfer of your health1260records to the VA, a VA disability physical has been completed,1261and you are ingested into VA before the DoD lets go of you.1262That would solve this chasm that too many veterans fall into,1263which is they step off active duty and they spend months or1264years or the rest of their lives trying to get into the VA,1265trying to get the disability claims adjudicated. That should be1266a condition of discharge, and I think the sooner we adopt a1267clear transfer of health records and health status from the DoD1268to the VA will solve that problem. Thank you.1269    Chairman Moran. Thank you, Senator Sheehy. Senator King.12701271                    HON. ANGUS S. KING, JR.,1272                    U.S. SENATOR FROM MAINE12731274    Senator King. Thank you, Mr. Chairman. I do not want to1275throw shade at you guys but you were talking about Boys State.1276I was Governor of American Legion Boys State.1277    [Applause.]1278    Senator King. Now, the tricky part, Boys State was1279Virginia, and later I was elected Governor of Maine, and the1280people of Maine are still trying to figure that out.1281    [Laughter.]1282    Senator King. And also I want to congratulate you on Matt1283Jabaut being your Legislative Director. But it is pretty sneaky1284because he lives a mile away from me. Having your chief1285legislative guy as my neighbor, I think that is, you know, come1286on, man.1287    I want to follow up on Senator Sheehy. There is a bill we1288are hoping to get in markup that would allow, and in fact1289mandate, the registration of people into the VA health system1290before they leave active duty. So I hope that is something we1291can work on together, because I think that is a really good1292idea.1293    One of the things I have been focused on since I have been1294here is transition. My rule is very simple. The government1295should spend as much money, time, and effort on transition out1296as they do on recruiting in, and they do not do that. So I hope1297that is something we can work together on. TAP promotion, I1298think we almost made it last year, giving the VSOs access to1299people during the TAP process. The whole idea is to give people1300leaving active duty more information about what is available.1301You are nodding. I hope you agree, Mr. Wiley.1302    Mr. Wiley. Senator King, we absolutely agree with you. To1303have the VSOs have access will make that transition to the1304community much easier because we can provide them the1305information necessary so they can make that transition into the1306community.1307    Senator King. Something else that I am working on in the1308area of veteran suicide, which is one of the great tragedies of1309this country, is for the VA to provide free lockboxes for1310firearms, to any veteran. Seventy-five percent of veteran1311suicides, almost 75 percent, are with firearms, and as we have1312learned, the data shows that if there is any gap between the1313idea and execution, self-execution, that that can be a real1314help to somebody who is thinking about this terrible act. So I1315hope that is something you can also help us with. It is based1316on a pilot program in Utah that has been very effective. We are1317not taking any names. This is not gun control. This is safety1318for veterans. So I hope you can help us on that one.1319    Mr. Wiley. Senator King, we absolutely support that.1320    Senator King. And then, finally, staffing issues at the VA.1321We all know that the VA has lost a lot of people in the last1322year. The number, I have heard 30,000. I have heard more. What1323I want from you is reports from the field as to whether or not1324that is having an impact on service for veterans. We have1325gotten the word from the VA. They feel, the Secretary, you1326heard him the other day, everything is good and wait times are1327down. But I would like some feedback from people in the field1328as to whether that is the case. Because you are the ones that1329are actually experiencing this, and we are looking to fix1330problems here, but we cannot fix the problems if we do not know1331what they are.1332    So I look forward to working with you on that, as well. And1333thank you very much for your leadership, and I look forward to1334continuing our work together on behalf of American veterans.1335Thank you, Mr. Chairman.1336    Chairman Moran. Governor, thank you for your questions.1337    [Laughter.]1338    Chairman Moran. Senator Boozman.13391340                       HON. JOHN BOOZMAN,1341                   U.S. SENATOR FROM ARKANSAS13421343    Senator Boozman. Thank you, Mr. Chairman. Thank you for1344being here. I thank all of you for being here. In the last1345several years, Congress has been able to step forward and1346again, as somebody whose dad did 20 years, I understand that1347these are, as Senator Sheehy just said, ``these are certainly1348earned benefits.'' And we have been able to accomplish a lot,1349but the only reason we have been able to accomplish it is1350because of you all. And so there is nothing more heartwarming1351to sit here and look out and see a full chamber. People on the1352wall, that is a good thing. There is no substitute for you1353being here, talking to the people that represent you, telling1354them how important these things are and why they are needed.1355And because of your help, like I said, we have been able to do1356a lot of good things, and we will continue to do that in a very1357bipartisan way. That is really what it is all about.1358    So, the VA recently released its annual Veteran Suicide1359Prevention Report with the date 3/20/23. It shows that veteran1360suicide crisis, as you all know, continues to rage. The report1361highlighted the success of the Staff Sergeant Fox Grant1362Program, making more than 24,000 referrals and 854 lifesaving1363emergency service-connections for veterans.1364    Mr. Wiley, what have you heard from your members regarding1365the program and aspects that need to be changed or improved?1366    Mr. Wiley. Thank you, Senator. I appreciate the question. I1367think there are several things that can be done with regard to1368the epidemic of veteran suicide. As you know, this is our1369number one mission in eliminating the stigma. But more1370resources, number one, are needed for mental health. We need1371more resources for things to combat homelessness, like the HUD-1372VASH program. And we need basically--I lost my train of1373thought. I apologize.1374    I am going to ask Cole Lyle to elaborate on that. Thank1375you.1376    Mr. Lyle. Thank you, Commander.1377    Senator Boozman. You are just trying to make me feel1378better. That happens to me more often than not [laughter].1379    Mr. Lyle. Thank you, Senator Boozman. I think the success1380of the Staff Sergeant Parker Gordon Fox Grant Program, over the1381years we have seen the VA move closer and closer to the1382community, from medical centers to CBOCs to vet centers, and1383now things like the Fox Grant Program, that are not VA1384organizations but leverage VA funding to provide that outreach1385to veterans, which is crucial because less than 50 percent of1386veterans use the VA. The number of veteran suicides with the1387declining population has stayed stagnant, so the rate of1388suicide, if you look at the data, has actually increased.1389    And these types of programs are local programs that1390veterans trust, that are in their community, that provide that1391outreach, and deal with the upstream factors of suicide, like1392transportation, relationship issues, acute financial stress,1393any number of different things. So we want to get to the1394veteran before there is a critical mass of despair, and1395programs like that are really helpful.1396    Senator Boozman. Thank you, Mr. Chairman. Again, thank you1397all for being here, and the fact that you are pushing hard and1398together, we are getting a lot done.1399    Chairman Moran. Senator Boozman, thank you. Senator Murray,1400former Chairman of the Committee.14011402                       HON. PATTY MURRAY,1403                  U.S. SENATOR FROM WASHINGTON14041405    Senator Murray. Thank you very much, Mr. Chairman. Thank1406you to all of you who are here today and everyone in this1407country who has served our Nation. We all owe you, and we all1408say this, a debt of gratitude for your service, but it is more1409than that. We owe you to keep the promise that when you come1410home we will be there for you in any way, both to the current1411veterans and to the ones who we will see in the future.1412    I think it is really important today, Mr. Chairman, and1413this has kind of been glossed over, this point of time that we1414are in, where we have a President who is taking us to war in1415Iran, who seems to have no problem sending other kids off to a1416war but seems to have a problem in picking up the tab when it1417comes right by doing our servicemembers when they come home.1418With a VA right now that has waiting lines, that veterans1419cannot get served, that we see doctors and nurses who are not1420being hired, and no thought has been given to that. What we1421hear from Trump is that he is saying that this bombing campaign1422in Iran could go on indefinitely. He is saying the death of our1423servicemembers in a war of choice is, quote--and he said this--1424``just the way it is.'' He is saying he will not rule out1425putting American boots on the ground in Iran. I think it is a1426very serious time for our country.1427    I have served on this Committee for more than 30 years. I1428know the consequences of war, as each and every one of you does1429in front of me. And to go to war without preparing for the1430future, and making sure that we are there for the men and women1431whose service, and we thank them for that, but when they come1432home, as well. And, Mr. Chairman, we are not ready for that1433today.1434    This has to be a consequence that we consider. For numerous1435reasons I am going to be using my voice today to vote ``no'' on1436the war in Iran. But it is the responsibility of this Committee1437and every Member of Congress to think about all the1438consequences of war and take that into account and hold this1439Administration accountable and make that clear when we make our1440choices, moving forward. I felt it was really important to say1441that today, with all of you who have served our country, and1442know what those sacrifices mean.1443    So, Mr. Chairman, I only have a few seconds left, and with1444that I want to change the subject and thank you, Commander1445Wiley, for saying the word ``menopause.'' Having been on this1446Committee for more than 30 years, this is the first time I have1447heard it, and I think I counted four times.1448    For our women whose service in this country, we know that1449they experience early menopause after having served in the1450military, more than women in the general population. We need to1451know why, and we need to be able to make sure that we are doing1452the right thing for those women. I did introduce a bill last1453year for the VA to do more research on that. That, along with1454all the other things that you were talking about today have as1455serious a consequence today as we are in this time, where a1456President has taken us to war in Iran without congressional1457consent, as any other time.1458    And I want to thank every one of you for being here. And my1459promise to all of you is I will fight to make sure, no matter1460what goes forward, that this Committee and this Congress will1461do, for our veterans who serve us, the right thing when they1462come home, and we have to take that cost into account as we1463make these decisions.1464    Thank you, Mr. Chairman.1465    Chairman Moran. Senator Murray, thank you. Now I recognize1466Mr. McGarvey.14671468                     HON. MORGAN MCGARVEY,1469               U.S. REPRESENTATIVE FROM KENTUCKY14701471    Mr. McGarvey. Thank you, Mr. Chairman. Thank you all for1472being here today. Thank you for your continued service to our1473country. Mr. Wiley, thank you guys. The American Legion, you1474all have spent generations making sure that our veterans are1475taken care of when they come home, that they continue to have1476meaningful lives after their service. And I know everyone on1477this Committee shares that same goal of making sure that we get1478our veterans the care that they have been promised, that they1479have earned, and that they deserve.1480    I think one area where the VA could be doing much more1481right now is getting innovative ideas off the ground. You heard1482Senator Murray talk about the need for research, particularly1483among our women veterans right now. Look what the VA has at its1484disposal. It is the largest patient population of any hospital1485system in the country, by multiples, 9 million patients. We are1486the largest longitudinal dataset of any health system in the1487country. Think about it. We get you oftentimes when you are 171488or 18 years old. We keep you until the day you die. Seventy-1489five percent of physicians do some sort of training or work in1490the VA right now. And what are we doing with this treasure1491trove of talent and information? Not enough. Not nearly enough.1492    Right now, even really good ideas can sit around for years1493before veterans are able to see them, because the VA does not1494have the tools or the flexibility that other agencies use. We1495have the stuff there but we have structural impediments to it.1496At places like the Department of Defense and NASA, they can1497partner quickly with early stage companies that guarantee a1498market for promising technologies, and they can move these good1499ideas and these research things from concept to real-world use,1500without getting buried in red tape. The VA does not have those1501same authorities. And the veterans are the people who feel the1502impact of that delay and that bureaucracy every day.1503    It does not have to be this way. We can empower the1504innovation team at the VHA to conceive and test new solutions1505that go after the hardest problems that our veterans face. And1506think about this, we solve these problems for our veterans, we1507can start solving them for everyone in the country.1508    So, I want to go to you, Mr. Wiley, and just say if the VA1509had flexibility and authorities to test and scale these types1510of new care models quickly, what kinds of innovative programs1511would you want them to prioritize first to better meet the1512needs of your members?1513    Mr. Wiley. Thank you for that question, and absolutely, we1514are always looking for different methods of treatment to treat1515our veterans that might be more successful than those have been1516in the past, because we believe that is one of the main ways to1517combat the epidemic of veteran suicide.1518    But with regard to the specifics, again, I am going to ask1519our VA&R Director, Cole Lyle, to address that.1520    Mr. Lyle. Thank you, Commander, and thank you, Congressman.1521I think some basic programs like digital matching tools, I1522think there is a pilot program for identifying substitute1523caregivers that could be directly expanded and utilized1524nationally, so caregivers could have trusted resources for1525substitutes to come and care for their servicemember. Hybrid,1526in-person telehealth type things, where there is a remote1527monitoring with the wearables and home sensors. So for rural1528veterans that have to travel long distances for chronic pain1529management and things like that, they only have in-hospital1530visits for severe issues that are not routine, and they can do1531telehealth appointments for things that are pretty routine. So1532it would reduce readmittance rates, wait times, things like1533that, that the VA could utilize pilot and expand rapidly if1534they had those authorities.1535    Mr. McGarvey. Thank you so much. I am out of time, Mr.1536Chairman. I yield back.1537    Chairman Moran. Thank you. Representative Conaway.15381539                       HON. HERB CONAWAY,1540              U.S. REPRESENTATIVE FROM NEW JERSEY15411542    Mr. Conaway. Thank you, Mr. Chairman. And I tell you, I1543like Senator King because as it turns out I was Boys State1544Governor, as well, in New Jersey, in 1980.1545    [Applause.]1546    Mr. Conaway. I have not gone on to become a Governor, but1547it certainly was a very impactful time of my life that1548certainly has paved my way to going into elected office.1549    Thank you, Commander Wiley, for your testimony, and thank1550you to the American Legion and this panel for your advocacy and1551leadership. I wanted to take this time to shout-out to my local1552American Legion post, of which I am a member, Slade-Valentine1553Post in Burlington City, 336. Where are you guys? I think they1554are here. New Jersey folks, there you are. I am happy you are1555here with us in the audience, as well.1556    As a physician and veteran, I have been extremely1557disappointed with the VA's decision to shrink its medical1558workforce. We all know that in order for the VA to continue to1559provide quality care it must be fully staffed. Just yesterday,1560the VA reported 1,500 vacancies among its physician workforce,1561and 4,900 vacancies with respect RNs in the VA. Our veterans1562depend on these medical professionals. Quality care depends on1563quality, fully staffed workforce.1564    What would you say are the biggest barriers, and1565particularly given your emphasis, rightly, on mental health1566services for veterans? And here, I want to thank Senator King1567who is working with us on trying to get telehealth services in1568a pilot to veterans who are incarcerated, and also for his1569effort, and he has mentioned it here today, to lift the cap so1570that we can help the VA recruit more physicians into the1571service. But what would you say are the biggest barriers to1572veterans trying to access mental health services within the VA?1573    Mr. Wiley. Thank you. I appreciate that question. And I am1574going to ask our VA&R Director, Cole Lyle, to address that1575question.1576    Mr. Lyle. Thank you, Commander, and thank you, Congressman.1577I think, obviously, outreach is a huge thing. The VA's budget1578for mental health and suicide prevention outreach I think is1579hovering around $600 million right now, which sounds like a1580large number. A big portion of that is going to the Fox Grant1581Program, and advertising things like that. That represents less1582than 1/10th of 1 percent of VA's overall budget.1583    So outreach could definitely improve. I think utilizing1584VSOs, things like the Fox Grant Program, making it easier for1585local and state-level organizations to access those funds and1586expand those funds, primarily authorize the program, would be1587very helpful.1588    Mr. Conaway. Thank you. Mr. Chairman, I yield back.1589    Chairman Moran. Thank you. Senator Slotkin.15901591                      HON. ELISSA SLOTKIN,1592                   U.S. SENATOR FROM MICHIGAN15931594    Senator Slotkin. All right. You are almost done, I think. I1595am Senator Elissa Slotkin from Michigan, a former CIA officer.1596I did three tours in Iraq alongside the military. And I want to1597associate myself with Senator Sheehy's comments, but1598particularly mention a piece of legislation he and I are1599working on, on making sure that the GI Bill gives the same1600benefits for a veteran choosing an apprenticeship versus going1601into education of some kind. Right now you get dinged every six1602months if you are in an apprenticeship, and your benefit just1603does not go as far.1604    We have talked to the Legion about this. I think we are on1605the same page. But I just want to put a marker down that at a1606time when our country needs, again, so many specific career1607types--a lot of those career types that Senator Sheehy1608mentioned, especially skilled trades, are apprenticeships, and1609you should not be dinged because you want to go into a1610successful career in the trades versus going to a four-year1611university. So I just wanted to put that marker down.1612    But as a part of this kind of post-9/11 generation, I want1613to raise a separate issue, and if not get an answer, get this1614community thinking about this, artificial intelligence in1615deciding what benefits our veterans get or do not get. There is1616a lot of discussion about bringing artificial intelligence into1617the VA. I am working on legislation right now debating this.1618And there are lots of pilot programs being looked at.1619    What I am concerned about is that before we hardly know1620what is happening, we are going to let software decide if a1621veteran gets a benefit or not. And I have got a problem with1622that. And we understand that AI can do amazing things and can1623amalgamate data and figure out if a veteran has got all their1624paperwork in, but does the Legion have thinking on this? Who is1625the thought leader that is trying to help our veterans1626organizations think through this new, hot issue that is coming1627to a theater near us?1628    Mr. Wiley. Thank you, Senator. I appreciate your question.1629And let me give you an example of a recent visit I had to a1630regional office and explain, in my mind, how artificial1631intelligence can be productive.1632    What they do is use artificial intelligence for1633administrative tasks such as organizing records and putting1634those all together for a reviewer or rater. What should not1635happen, and what we cannot allow happen, is for artificial1636intelligence to substitute for judgment.1637    Senator Slotkin. Right.1638    Mr. Wiley. Judgment has to be a human being that can review1639all of the evidence and make an independent determination using1640everything they know. Artificial intelligence is not a1641replacement for that.1642    Senator Slotkin. Yes, so thank you. And, Mr. Chairman, I1643just think this is an issue we are going to have to deal with1644as a Committee, both Chairmen here and Ranking Members, of just1645how much power are we going to give to AI to decide if a1646veteran gets reimbursed for something, if a veteran qualifies1647for something. I just think we are moving very fast and there1648are some real benefits, I know, but a human being needs to be1649in the decision tree before we start making life-and-death1650decisions for veterans.1651    So I appreciate everyone's work here, and thank you. I1652yield back.1653    [Applause.]1654    Chairman Moran. Senator, thank you. Representative Takano1655has an additional question I am going to allow him to ask, and1656then we are going to turn to the Senator, and then we are going1657to conclude this panel. There is a vote that started in the1658Senate, and we will have a change to our second panel during1659that vote. Senator? Representative?1660    Mr. Takano. Thank you, Mr. Chairman. You know, with The New1661York Times article yesterday, I wanted to quickly ask a1662question about staffing. Veterans' care does not happen without1663staff, and Commander, are you hearing from legionnaires about1664appointments being pushed out or services getting harder to1665access?1666    Mr. Wiley. Anecdotally, the answer is yes.1667    Mr. Takano. So anecdotally. For the legionnaires here1668today, I just want a show of hands. Are you experiencing1669delayed care or longer wait time because a clinic, a CBOC, did1670not have enough staff? Just raise your hand, by show of hands.1671    [Hands raised.]1672    Mr. Takano. All right. So a number of hands have been1673raised. Thank you. I yield back.1674    Chairman Moran. Thank you, Ranking Member. Senator?16751676                        HON. JIM BANKS,1677                   U.S. SENATOR FROM INDIANA16781679    Senator Banks. Thank you, Mr. Chairman. First of all,1680welcome to the many Hoosier legionnaires who are in the1681audience. I am very proud to be your Senator. I am a member of1682the American Legion Post 98 in my hometown, Columbia City,1683Indiana, and I am very proud of it.1684    [Applause.]1685    Senator Banks. Our veterans count in the American Legion1686and all of our great veterans service organizations to advocate1687for the very best possible health care, education, and1688disability benefits for our veterans every day, and I want to1689thank all of you for the important work that you do.1690    Commander Wiley, I strongly agree that veterans deserve a1691claims and appeals system that is simple, efficient, and worthy1692of their service. I appreciate the Legion's support for my1693Veterans Appeals Efficiency Act that I have introduced, that we1694worked with you on. Can you talk about the bill and why it1695would be helpful?1696    Mr. Wiley. Thank you, Senator Banks. It is something that1697is important to us, and I am going to ask our VA&R Director,1698Cole Lyle, to specifically address that.1699    Mr. Lyle. Thank you, Commander, and thank you, Senator. The1700act you cited is a great idea. There are a lot of specific1701provisions in there, reporting requirements from the VA, making1702the process more transparent.1703    I know there have been concerns in the veteran community1704about aggregation of data. I think obviously, as mentioned1705earlier, there is a high remand rate from the court.1706Aggregation, particularly for presumptive conditions, could be1707a good thing, if granted. I understand we have had1708conversations with your office about an opt-out if they choose1709not to, because one of the big concerns would be the veteran1710losing their individual POA, and that would be particularly1711difficult to deal with if it was an aggregated claim that got1712denied. It would just kind of clutter the system.1713    So if we could work with your office on improving the1714language for the bill, just discussing some of the concerns and1715make it more effective, if passed.1716    Senator Banks. I am glad to work with you on that. Thank1717you for that explanation.1718    Commander, the VA's legal authority to care for homeless1719veterans expired during the government shutdown last fall. We1720can never let that happen again. And I am introducing1721legislation to make the Health Care for Homeless Veterans1722(HCHV) Program permanent, so that it cannot shut down during a1723shutdown. Can I count on the Legion's support to help pass that1724bill?1725    Mr. Wiley. Yes.1726    Senator Banks. Very good. All right. Well, thank you for1727that. Again, thank you for all that you do, each and every one1728of you in the room, and your leadership. I am a big fan of the1729American Legion. I am proud to be a member. With that, Mr.1730Chairman, I yield back.1731    Chairman Moran. Senator Banks, thank you very much.1732National Commander, thank you for you and your team's1733testimony. I will use a moment to recognize the National1734Commander of the Sons of the American Legion. I am a member of1735the Sons of the American Legion, and use this as an opportunity1736to indicate to others like me that there is an opportunity to1737serve veterans and to be a part of the American Legion program.1738    With that we close out this panel and transition to our1739second panel. Again, Commander Wiley, thank you. I will see you1740in Kansas at some point in time. But thank you to your entire1741team of American Legion advocates and workers on behalf of our1742Nation's veterans and their families.1743    We will take a brief recess to allow the American Legion1744panel and the audience members to depart, and our second panel1745organizations and members to get situated. We are pausing.1746Thank you.17471748    [Recess.]17491750                     HON. TOMMY TUBERVILLE,1751                   U.S. SENATOR FROM ALABAMA17521753    Senator Tuberville [presiding]. Welcome, everybody. You can1754take your seats. We will get started. Welcome to our second1755panel of witnesses and audience members. Thanks for being here1756today.1757    In our second panel today we have Mr. Robert Thomas,1758National President for Paralyzed Veterans of America; Mr. Paul1759Shipley, National Commander for AMVETS; Mr. Terry Prince,1760President for National Association of State Directors of1761Veterans Affairs.1762    [Applause.]1763    Senator Tuberville. You have a pretty good contingent here,1764Terry.1765    Lieutenant General Walter Piatt, Chief Executive Officer1766for Wounded Warrior Project. Thanks for being here. Ms. Anita1767Sullivan, surviving spouse of Navy Petty Officer Third Class1768Michael Sullivan, testifying for Tragedy Assistance Program for1769Survivors; Major General Frank McGinn, President for National1770Guard Association of the United States; and Mr. Jim Whaley,1771Chief Executive Officer for Mission Roll Call.1772    Thank you all again for being here and for your1773organizations' hard work and dedication. You provide tremendous1774value to our Committee.1775    So we will start now. Mr. Thomas, you are recognized for 51776minutes, and we will just go down the line.17771778                            PANEL II17791780                              ----------17811782 STATEMENT OF ROBERT THOMAS JR., NATIONAL PRESIDENT, PARALYZED1783                      VETERANS OF AMERICA17841785    Mr. Thomas. Chairman Moran, Chairman Bost, and Members of1786the Committees, thank you for the opportunity to speak with you1787today on behalf of the tens of thousands of veterans with1788spinal cord injuries and disorders who rely on VA's benefits1789and care.1790    The VA is the best health care provider for veterans with1791catastrophic disabilities. The Department's Spinal Cord1792Injuries and Disorders System of Care provide a coordinated,1793life-long continuum of services. There is no comparable private1794system of care in the community. Thus, preserving and1795strengthening VA's specialty care system remains PVA's highest1796priority, and it should be for you too.1797    When I appeared before these Committees last year, I spoke1798about the ways that ongoing staffing deficiencies and1799infrastructure problems were undermining not just VA's SCI/D1800System of Care but VA's specialized services in general. Now,1801much has changed since then, and it is frustrating to have to1802bring up this, year after year, without resolution.1803    Unfortunately, the previous administration's practice of1804simply eliminating unfilled positions continues. This is1805extremely concerning because it presents the illusion that1806staffing levels are better than they really are, and I must1807call a ``foul'' on this. Because at the same time positions are1808being eliminated, it could be difficult to fill them due to the1809staffing caps and funding limitations. I urge you to continue1810to press VA for answers regarding how it plans to care for the1811tens of thousands of veterans with SCI/D who are on its1812registries and depend on VA for quality, timely, direct care.1813This cannot be allowed to continue for another year.1814    Access to lifelong services and supports continue to be1815crucial for PVA's members. We are very appreciative of1816Congress' passage of the Senator Elizabeth Dole Act. VA says1817the VA's Directed Care program is now available at all major1818facilities. But the feedback we have suggests some programs1819exist in name only or serve few veterans. Congress must ensure1820that the Elizabeth Dole Act's provisions are carried out as1821intended.1822    Another important aspect of lifelong support is VA's Bowel1823and Bladder program. For veterans with SCI/D, support for1824neurogenic bowel and bladder dysfunction is a crucial aspect of1825their care. Unfortunately, VA's current Bowel and Bladder1826program is fraught with challenges for caregivers. Timely1827reimbursement and the tax treatment of payments are the two1828chief complaints I hear. Codifying the program would provide1829the opportunity to fix many of these problems. I thank Chairman1830Moran for his bill, the Disabled Veterans Dignity Act, which1831would help to address these issues. We also appreciate the1832interest from the House in introducing a similar bill that1833includes the provisions addressing the taxability issue.1834    Another area of concern is transportation to VA care. We1835are very concerned about new VA guidance that ends facility1836prepayment of round-trip common-carrier airfare for veterans1837traveling to VA SCI/D facilities. This change requires veterans1838to arrange and pay for travel up-front and seek reimbursement1839after their appointments, effectively preventing many from1840receiving necessary care. We appreciate that the VA is1841attempting to figure out a solution to this problem, and call1842on Congress to provide VA any resources, including clear1843statutory authority, to ensure veterans can access specialty1844care.1845    Finally, Special Monthly Compensation (SMC) is arguably the1846most important ancillary benefit for veterans with severe1847service-connected disabilities. Given the extreme nature of the1848disabilities incurred by most veterans in receipt of SMC, we do1849not believe that the impact on the quality of life can be1850totally compensated for. However, SMC does at least provide1851these veterans a financial resource to help accommodate their1852individual needs.1853    In similar fashion, survivor benefits are intended to1854protect veterans' families from impoverishment after the death1855of a service-disabled veteran. Unfortunately, they do not1856always do that, and many survivors who, in many cases, were1857once caregivers, face a financial cliff. Congress established1858the baseline rates for these programs decades ago. They must be1859updated now. We urge Congress to quickly pass the Sharri Briley1860and Eric Edmundson Veterans Benefits Expansion Act.1861    Thank you for the opportunity to testify. I would be happy1862to answer any questions.18631864    [The prepared statement of Mr. Thomas appears on pages 94-1865118 of the Appendix.]18661867    Senator Tuberville. Thank you, Mr. Thomas. I would like1868everybody to pull your microphone just a little closer. You1869have got people in the back. Make sure that you speak into it,1870because we are a government entity. We do not run real well up1871here, as you all well know.1872    Mr. Shipley from American Vets, you have 5 minutes.18731874                   STATEMENT OF PAUL SHIPLEY,1875                   NATIONAL COMMANDER, AMVETS18761877    Mr. Shipley. Chairman Bost, Chairman Moran, Ranking Members1878Takano and Blumenthal, and distinguished Members of the1879Committees, on behalf of AMVETS thank you for the opportunity1880to present our legislative priorities and for your continued1881commitment to the men and women who have served our country.1882AMVETS represents more than 20 million veterans, from every era1883of service, including active duty, National Guard, Reserve, and1884those who have transitioned to civilian life.1885    This past year marks a new chapter for our organization.1886After more than 80 years in the National Capital region, we1887relocated our National Headquarters to Washington,1888Pennsylvania, where we also established the AMVETS Family1889Service Center. This 35,000 square foot facility will serve our1890homeless veterans and their families. Our veterans will be able1891to remain with their spouses and children while they secure1892employment, permanent housing, and long-term stability.1893    Through the Center, we administer Department of Labor1894Homeless Veterans Reintegration Program grants in Salt Lake1895City, Utah, and Phoenix, Arizona, along with workforce programs1896and Veteran Stand Downs across the Nation. These efforts1897reflect what experience has taught us--housing, employment,1898mental wellness, and family stability are interconnected.1899Effective policy must reflect that reality.1900    Mental wellness and suicide prevention remain our top1901legislative priority. Despite significant Federal investment,1902suicide continues to take an unacceptable toll on the veteran1903community. We have seen strong, evidence-driven results from1904community-based efforts supported by the Staff Sergeant Fox1905Grant Program, which often reach veterans for whom traditional1906care has not worked.1907    As Congress considers reauthorizing the Fox Grants, we urge1908expanding proven models and continuing to focus on measurable1909outcomes. Our current approach spends billion while delivering1910minimal improvement in reducing symptoms and suicide.1911    After two and a half decades following 9/11 and more than1912140,000 veteran deaths, the time has come to invest in programs1913where outcomes are front and center. Congress and the VA must1914embrace a proactive, outcome-driven approach and move beyond an1915expensive, reactive system that is not working for the vast1916majority of veterans.1917    Wellness interventions must begin earlier and be embedded1918throughout a servicemember's career. The real antidote to1919suicide is not slogans or billboards telling veterans to seek1920help. It is ensuring that the men and women who serve are1921equipped with the tools to build meaningful lives and know1922where to turn when times become difficult.1923    A similar forward-looking approach is needed in the1924treatment of traumatic brain injury. Since 2000, more than1925500,000 servicemembers have been diagnosed with TBI. Many face1926lasting cognitive and emotional effects that disrupt1927employment, relationships, and overall health. Legislation such1928as the BEACON Act and the Veterans TBI Adaptive Care1929Opportunities Nationwide Act will allow the VA to evaluate and1930expand innovative, patient-centered therapies. We are also1931thankful to Chairman Moran's leadership on the Precision Brain1932Health Research Act of 2025, which would help broaden our1933understanding of the impacts of repetitive, low-level blast1934injuries on veterans' mental health. Veterans deserve care that1935evolves with science and focuses on meaningful recovery.1936    We must also honor our commitments to surviving families.1937Dependency and Indemnity Compensation has not kept pace with1938the comparable Federal survivor benefits. Modernizing DIC1939through the Sharri Briley and Eric Edmundson Veterans Benefit1940Expansion Act, the Caring for Survivors Act, and the Love Lives1941On Act is a matter of fairness and dignity for families who1942have already sacrificed so much.1943    Modernization with the VA is equally essential. A fully1944interoperable electronic health record between the Department1945of Defense and the VA reduces duplication, improves patient1946safety, and ensures continuity of care. As the rollout1947continues next month, sustained oversight and disciplined1948execution are necessary for success. Failure is not an option.1949    Fairness also requires passage of the Major Richard Star1950Act. For decades the Federal Government has reduced military1951retirement pay simply because a servicemember was wounded badly1952enough to receive disability compensation. This has been framed1953as concurrent receipt, suggesting veterans are double dipping.1954They are not. Military retirement is earned through years of1955service. Disability compensation addresses injuries sustained1956in that service. When the government offsets one against the1957other, it is taking away retirement that was already earned.1958    Let me be clear. It is time to stop stealing from our1959servicemembers. Congress needs to immediately end this1960injustice and pass the Major Richard Star Act.1961    Finally, AMVETS supports the development of a coordinated1962national veterans strategy focused on measurable outcomes. This1963nation invests hundreds of billions of dollars each year in1964veteran-related programs. Those resources must be expended1965around clear goals, accountability, and results that improve1966health, employment, and quality of life. As the men and women1967who defend our Nation are once again placed in harm's way, we1968depend on this body to ensure that we are cared for when they1969return home. Our veterans and their families deserve more than1970promises. They deserve measurable progress in their health,1971their opportunities, and their quality of life.1972    Thank you for your continued commitment to those who have1973served. I look forward to answering any questions you may have.1974    [Applause.]19751976    [The prepared statement of Mr. Shipley appears on pages1977119-129 of the Appendix.]19781979    Senator Tuberville. Thank you, Mr. Shipley.1980    Next is Mr. Terry Prince.19811982 STATEMENT OF TERRY PRINCE, PRESIDENT, NATIONAL ASSOCIATION OF1983              STATE DIRECTORS OF VETERANS AFFAIRS19841985    Mr. Prince. Ranking Member Takano, great to see you again1986visiting LaSalle last year. Senator Tuberville and Ranking1987Members, distinguished Members of the Committees, my name is1988Terry Prince. I am a 31-year veteran of the United States Navy,1989Hospital Corpsman, and currently serving as the President of1990NASDVA, the National Association of State Directors of Veterans1991Affairs.1992    That crowd in yellow you heard behind me is the1993distinguished members of 50 secretaries, directors, and1994commissioners that lead the states, territories and the1995District of Columbia veterans affairs. Collectively, these1996veteran leaders make up the membership of NASDVA, and together1997they are the second-largest provider of veteran services in our1998Nation, second only to the Federal VA. These are your1999government-to-government partners who have worked together2000since 1946, to serve veterans where they live and work. They2001should be your first point of contact for constituent issues2002and ensuring that the Nation's 18 million veterans and their2003families and survivors receive the benefits and services they2004have earned in order to improve the quality of life and their2005overall well-being.2006    In our testimony, we cover a lot in our written testimony.2007A few of important items. One is our State Veterans Homes, that2008provide more than 50 percent on the total VA long-term care in2009175 operational veterans homes and 30,000 beds. We recommend2010$600 million to provide Priority Group 1 construction projects,2011where the overall costs to fund all the necessary need to build2012and maintain our veterans homes is nearly $1.3 billion.2013    On a separate note, the State Veterans Homes are having to2014pay for high-cost medications for veterans in their care. This2015needs to be addressed by passing H.R. 1970, so that VA2016reimburses our State Veterans Homes that, for medications that2017exceed 8.5 percent of the per diem rate, which is what the VA2018pays to private nursing homes that are contracted by VA to2019provide health care.2020    The other grant program is the National Cemetery2021Administration's Veterans Cemetery Grants Program. One hundred2022twenty-four cemeteries across 47 states. The number far exceeds2023the amount of funding. The establishment just to cover Priority20241 and 2 for establishment and maintenance of cemeteries is in2025the neighborhood of $220 million, and NASDVA recommends2026addressing at least these groups for fiscal year 2027.2027    It was mentioned earlier about VA health care, and for the20289 million veterans receiving care, we also recommend they2029continue to emphasize enrollment, better access, and quality2030care at the VA. Regardless of gender and whether it is provided2031by the VA or Community Care programs, which accounts for nearly203240 percent of that care and is, in all essence, is VA care.2033    On to health records, we support the need for congressional2034oversight to ensure that the VA modernizes the electronic2035health record. It currently costs nearly $16 billion, with a2036projection of over $40 billion, with full deployment not2037expected until 2031.2038    The American Legion mentioned TAP class. As a military2039servicemember I am very familiar with this process, and I can2040tell you that every servicemember describes it in a different2041way. What I do know, as a corpsman and married to a2042psychologist, that transition from anything in life, especially2043the military, is one of the most dangerous periods in a2044servicemember's history, especially toward suicide and other2045things. Our state directors need to be a part of the TAP2046program. They need to be brought in early and often, to ensure2047that these veterans are connected with their state benefits.2048    The Major Richard Star Act, it is time. This is a wounded2049veterans tax. NASDVA strongly recommends that this Congress2050pass this critical legislation for these deserving disabled2051veterans.2052    Veteran homelessness, we commend what the VA is doing.2053However, we would like them to expand eligibility to any2054veteran who is homeless, at risk of homelessness, or receiving2055assistance through another housing program.2056    And I am going to close out my testimony with the number2057one issue that hits home to me and everybody in this room--2058suicide. Every 11 minutes in America, a family loses a loved2059one to suicide, and NASDVA believes that the prevention of2060veteran suicides requires a whole-of-government engagement,2061with fresh ideas and approaches. Your state directors and2062Veterans Affairs play a crucial role in suicide prevention by2063connecting veterans to their earned benefits back home, where2064they live, working with their state and human services and the2065Governor's Challenge.2066    We also recommend new treatment modalities to eliminate2067pharmacological intervention and other issues that do not2068allows veterans to explore non-traditional methodologies.2069    Your partnership with NASDVA is as important to our2070veterans as it is to us. It is a promise kept to those who once2071stood the watch for all of us, and together we can ensure that2072their service is honored, not just in words but in action,2073through strong policy, sustainable funding, and unwavering2074commitment. All of us sincerely respect and appreciate your2075work to improve the well-being of our Nation's veterans, and we2076are honored to be a part of that noble mission with you. Thank2077you.2078    [Applause.]20792080    [The prepared statement of Mr. Prince appears on pages 130-2081148 of the Appendix.]20822083    Senator Tuberville. Thank you, Mr. Prince.2084    Next we have General Piatt from Wounded Warrior.20852086   STATEMENT OF LTG WALTER E. PIATT, U.S. ARMY (RET.), CHIEF2087           EXECUTIVE OFFICER, WOUNDED WARRIOR PROJECT20882089    General Piatt. Chairman Moran, Chairman Bost, Ranking2090Member Blumenthal, and Ranking Member Takano, and distinguished2091Members of the House and Senate Committees on Veterans'2092Affairs, thank you all for today's hearing and for the honor to2093join you on behalf of Wounded Warrior Project and the warriors2094and families we serve.2095    First, all of us at Wounded Warrior Project are deeply2096saddened by the recent loss of servicemembers, and we stand2097ready to serve all those impacted by current military2098operations.2099    Twenty-three years ago, Wounded Warrior Project was founded2100on a promise, a promise to be there, no matter what, for those2101who defend our freedom. It is that same promise that grounds2102the work we do today.2103    Our nation's military remains engaged globally, fighting to2104keep the world and our Nation safe. We should never allow the2105strategic purpose for war to mask the toll it takes on those2106asked to fight it.2107    For the dangers our military is asked to face, we cannot2108accept the warrior simply coming back as the final tally of2109successful transition out of military service. We must see them2110fully home--mind, body, and soul. This is not captured in one2111moment in time, but through a process of hope, healing, and2112reconnection to a life of renewed purpose.2113    Last week, 125 of our warriors visited many of you Members2114of Congress. They were honored to tell you their stories and2115share the living, breathing impact of why your support matters.2116    We discuss three priorities with you.2117    The first, a passionate plea to do right by our past,2118current, and future combat veterans by passing the Major2119Richard Star Act this year. Finally allowing for those who were2120forced to medically retire due to combat-related injuries to2121receive the benefits they earned in blood.2122    Second, on ending veteran suicide. In 2023, we lost more2123than 6,000 veterans to suicide. We must explore advanced2124treatments for those who are suffering. The time is now to push2125forward evidence-based solutions, like psychedelic-assisted2126therapies for PTSD, traumatic brain injury, and substance use2127disorder. We must explore all alternative treatments,2128coordinate research, expand access to clinical trials, and2129ultimately make these treatments accessible to all veterans.2130    Third, ending veteran homelessness. VA and supportive2131communities are making historic progress, with nearly 52,0002132veterans moving into permanent housing last year. Let's finish2133the Housing Unhoused Disabled Veterans Act to ensure no2134veteran's disability compensation is counted against them.2135    Your time spent with these warriors last week and your2136genuine appreciation for their service touched them deeply, and2137reminded them that their sacrifice is a big reason why our2138Nation remains free. With the continued support of Congress and2139that of our grateful nation, Wounded Warrior Project will2140continue to push the boundaries of what is possible, as we2141pursue the path to save a million more lives, cure PTSD, end2142veteran suicide, and end veteran homelessness.2143    Warriors are the foundation of our freedom. They have done,2144and continue to do, their part. It is now time to do ours. We2145must keep the promise and find every warrior, everywhere, and2146bring them home, mind, body, and soul.2147    I am honored to be of service to this distinguished2148Committee and for the opportunity to testify. Thank you for2149helping our Nation keep the promise to our veterans, and I2150welcome your questions.2151    [Applause.]21522153    [The prepared statement of General Piatt appears on pages2154149-187 of the Appendix.]21552156    Senator Tuberville. Thank you.2157    Next we have Anita Sullivan from TAPS. Anita.21582159  STATEMENT OF ANITA SULLIVAN, SURVIVING SPOUSE OF U.S. NAVY2160PETTY OFFICER THIRD CLASS MICHAEL SULLIVAN, TRAGEDY ASSISTANCE2161                     PROGRAM FOR SURVIVORS21622163    Ms. Sullivan. Chairmen Moran and Bost, Ranking Members2164Blumenthal and Takano, and distinguished Committee members,2165thank you for the opportunity to share my family's story.2166    Seven years ago, on February 9, 2019, I became a widow, a2167title no one pursues. My husband, the father of our three2168children, Navy Petty Officer Third Class Michael Sullivan, died2169by suicide after faithful service to our Nation and decades of2170physical and mental health battles that plagued him during and2171after his time in the Navy.2172    Much has changed in the seven years since he passed, but2173one thing has not. I am, and always will be, his widow. No2174passage of time will change that, not my 55th birthday, or the2175becoming someone else's wife.2176    I met Michael in 1999, while he was stationed in2177Jacksonville, Florida. He was funny and captivating, and we2178married quickly. But soon he became seriously ill. He was2179diagnosed with cyclic vomiting syndrome, which landed him in2180the hospital every six weeks, like clockwork. When he returned2181from his last deployment in June 2003, we welcomed our first2182child. His physical health had impacted his career and his2183mental health, and by that July he officially separated from2184the Navy.2185    His health worsened, and over the next 16 years he was2186hospitalized approximately 35 times. I became the primary2187breadwinner while caring for our three children and becoming2188Michael's caregiver. I could not leave his side during those2189hospital stays because he wouldn't know where he was, would2190often rip out IVs, and even try to leave the hospital.2191    On his good days, he coached our kids' baseball teams,2192volunteered his time to youth activities, was involved in our2193church, but on his bad days he truly suffered, and so did we.2194    His suicide, in 2019, ended his physical and mental health2195battles, but it was just the beginning of new challenges for2196our grieving, traumatized family. I was at a TAP seminar when I2197learned that Michael's suicide was deemed service-connected.2198After going for Michael's 100 percent VA disability2199compensation to zero overnight when he died, we would only have220043 percent reinstated.2201    Our eigth-month process was fast by VA standards. The wait2202for DIC is financially devastating for many survivors, and the2203month-to-month stress continues for families, mine included.2204Raising DIC from 43 percent to 55 percent may seem2205insignificant to some, but for surviving spouses like me, who2206struggle to maintain a career, because it always came second to2207military service and caregiving, it makes a meaningful2208difference. Passing the Caring for Survivors Act would provide2209long overdue breathing room and ease financial pressures.2210Surviving families face drastically reduced income, the lasting2211impact of career limitations, ongoing therapy costs, and the2212full responsibility of providing opportunities for our children2213in single-parent households.2214    As the only living parent of our now 11-, 16-, and 22-year-2215old, CHAMPVA health benefits are critical to our family's2216stability. Under current law, my oldest son will age out of2217CHAMPVA in just a few months, despite being a full-time college2218student. Unlike most other health insurance programs, CHAMPVA2219does not extend to age 26.2220    Seven years after Michael's passing, I am still his widow,2221and we are still dependent on the benefits he earned to support2222our family. After a three-year-and-counting engagement, I am2223still waiting to marry a man that I love, who will never2224replace him as a husband or father, but cares deeply for the2225four of us. My youngest child, Sophia, was just four when her2226Daddy died. She is growing up without a legal father in her2227life, which can be confusing for her and her friends, as she2228goes around and is sharing so much of her life with him. But2229knows that if Love Lives On does not pass, she will be almost2230an adult before she can officially call him her stepdad.2231    John is sitting beside her today, here supporting us both2232as we advocate for benefits that were earned through service2233and sacrifice, benefits that dissolve under current law if I2234remarry before age 55. Marrying John does not mean that we2235should become his financial responsibility. He is already doing2236so much, bringing happiness back into our lives. But I will not2237become his financial burden.2238    When my late husband joined the military, our country made2239a promise to support his family if anything happened to him.2240There were no restrictions attached to that commitment.2241    My family's story is one of many. I hope that my voice is2242loud enough to bring attention to long-overdue legislative2243changes, like finally ending remarriage penalties, treating2244suicide as a presumptive condition, increasing DIC, and2245bringing CHAMPVA in line with civilian insurance.2246    Thank you for the opportunity to share my story today.2247    [Applause.]22482249    [The prepared statement of Ms. Sullivan appears on pages2250188-235 of the Appendix.]22512252    Chairman Moran. Thank you.2253    Next we have General McGinn of the National Guard2254Association.22552256  STATEMENT OF MAJOR GENERAL FRANK MCGINN, U.S. ARMY (RET.),2257   PRESIDENT, NATIONAL GUARD ASSOCIATION OF THE UNITED STATES22582259    General McGinn. Chairman Moran, Ranking Member Blumenthal,2260Chairman Bost, Ranking Member Takano, Senator Tuberville, and2261distinguished Members of the Committees, on behalf of the2262National Guard Association of the United States and the 435,0002263Soldiers and Airmen with the Army Air National Guard, thank you2264for the opportunity to discuss some important issues affecting2265today's National Guard. We appreciate your bipartisan support2266in recognition of the Guard's vital role in our national2267security.2268    Over the past two decades, the National Guard has evolved2269from a strategic reserve into an operational force. Guard2270members deploy globally, strengthen alliances through the State2271Partnership Program, and provide key capabilities to the total2272force at less than 4 percent of the defense budget. At home2273they remain the Nation's first military responder, supporting2274disaster response, protecting critical infrastructure, and2275assisting civilian authorities.2276    As missions have expanded, policies have not kept pace.2277Today I will focus on three priorities: duty status reform, GI2278Bill parity, and the development of a Reserve Component-2279specific track within the Transition Assistance Program.2280    First, duty status reform. As of this week, more than228140,000 Guardsmen are on orders serving at home and abroad. They2282frequently operate alongside active component forces under2283identical conditions. Yet while their service is equal,2284compensation and benefits are not. The common system of over 302285duty statuses was created piecemeal over the decades. In fact,2286six additional statuses were created between 1999 and 2013. It2287is overly complex, confusing for servicemembers, and difficult2288for states to administer.2289    In the fiscal year 2016 NDAA, Congress directed the then2290Department of Defense to submit a Duty Status Reform2291legislative proposal. While studies and discussions have2292continued over the years, legislative proposals have not yet2293advanced. We are grateful to finally have some momentum this2294year, with bicameral and bipartisan support of the Duty Status2295Reform Act, this bill aligns authorities with how Guard and2296Reserves are employed today and ensures fair treatment when2297members are mobilized. The new framework would provide equities2298in pay and benefits, efficiency in programming and budgeting,2299and streamlined accessibility to the Guard and Reserve.2300    Duty status reform is our top priority for fiscal year23012027. We strongly ask for your support of H.R. 6976, and2302introduction of a Senate companion bill.2303    The next point I want to discuss is GI Bill parity. The2304Post-9/11 GI Bill remains one of the most powerful recruitment2305and retention tools. It provides those who serve with access to2306education and the opportunity to build a successful future.2307However, many periods of Guard and Reserve service still do not2308qualify for GI Bill benefits. Title 32, including annual2309training and drill weekends, are left out, which falsely2310implies lesser value. Each day in uniform should count as a day2311of service to our country. The benefits earned should reflect2312that sacrifice.2313    The GI Bill Parity Act corrects this inequity. We thank2314Chairman Moran, Ranking Member Blumenthal, Congressmen Takano,2315Levin, and Kelly for leading on this issue, and request swift2316passage of S. 649 and H.R. 1423.2317    The third and last issue I want to address is the Reserve2318Component--Transition Assistance Program track. The Transition2319Assistance Program is critical to preparing servicemembers for2320civilian life. However, most Guard members return to their2321civilian employment and normal routine. This presents unique2322challenges not fully addressed in the traditional TAP model.2323    Guardsmen receive limited counseling tailored to retirement2324points, TRICARE coverage, GI Bill benefits, and the VA claims2325process. Transition assistance without these topics is a misuse2326of time and resources. We are grateful for your support on this2327issue. The fiscal year 2025 NDAA directed development of a2328Reserve Component-specific track. Continued oversight is2329necessary to ensure that this is tailored to the Reserve and2330not simply a modified active model. We respectfully request2331updates on this implementation and stand ready to assist.2332    In closing, thank you for your continued leadership and2333commitment to those who serve. These are not abstract policy2334concepts. They are tangible issues that affect readiness,2335retention, and the long-term well-being of the National Guard2336members and veterans. The National Guard stands ready to meet2337the Nation's needs, and in return our servicemembers ask only2338for fairness, clarity, and recognition of their service. We2339look forward to working with you to address these issues and2340ensure that National Guard service is treated with the equity2341and respect it deserves.2342    Thank you for the opportunity to testify today, and I2343welcome your questions.23442345    [The prepared statement of General McGinn appears on pages2346236-243 of the Appendix.]23472348    Mr. Takano [presiding]. Thank you, Major General McGinn.2349    Mr. Whaley, you are now recognized for 5 minutes.23502351STATEMENT OF JIM WHALEY, CHIEF EXECUTIVE OFFICER, MISSION ROLL2352                              CALL23532354    Mr. Whaley. Chairmen Bost and Moran, Ranking Members Takano2355and Blumenthal, and distinguished Members of both Committees,2356thank you for the opportunity to testify today.2357    Mission Roll Call represents veterans by doing one thing2358consistently: listening. We survey veterans, their families,2359and caregivers nationwide, and we bring that data directly to2360policymakers, so decisions are grounded in lived experiences.2361    Our 2026 priorities come straight from those surveys.2362Veterans told us four issues should guide the work ahead:2363access to quality health care, support for service-connected2364injuries, suicide prevention, and housing stability.2365    For veterans, these priorities are connected. When access2366falters, injuries worsen. When injuries go untreated, mental2367health risk increases. Without stable housing, even effective2368care becomes difficult to sustain.2369    First, access to quality health care, both VA and non-VA.2370Veterans define access by timing, distance, and follow-through.2371In May 2025, Mission Roll Call surveyed more than 1,2002372respondents in all 50 states on the ACCESS Act. Sixty-seven2373percent said the legislation would improve health care outcomes2374overall. Among rural veterans, 71 percent said it would improve2375timely access. Mental health access is central to this2376discussion. Sixty percent of veterans told us they are2377comfortable receiving mental health care from a non-VA2378provider. Seventy-nine percent said allowing veterans to access2379mental health or substance use care in the community without a2380VA referral would improve access.2381    Veterans are not voting against the VA. In fact, many we2382speak to report very positive experiences. But they are asking2383for options that reduce delays, shorten travel burdens, and2384help them get care before a problem becomes a crisis.2385    Second, support for service-connected injuries and2386conditions, including traumatic brain injury.2387    In our 2025 TBI survey of more than 2,500 veterans, family2388members, and caregivers, 14 percent reported a TBI diagnosis in2389their household. Among those seeking TBI-related care, more2390than 70 percent said accessing appropriate treatment is2391somewhat or very difficult. Distance, wait times, and2392fragmented care remain consistent barriers.2393    Mild to moderate TBI is where we see the greatest gap.2394Symptoms persist, but care pathways are often unclear, and2395coordination between VA and non-VA providers remain2396inconsistent.2397    This is the space the BEACON Act seeks to address. The2398legislation creates a structured, evidence-based framework to2399evaluate innovative approaches for veterans with chronic mild-2400to-moderate TBI, with rigorous outcome measurement and2401independent evaluation. Veterans are not asking for lower2402standards. They are asking the VA to test promising therapies2403responsibly, publish results transparently, and expand access2404when evidence supports it.2405    This urgency is reinforced by the VA's 2025 suicide report,2406which shows the suicide rate among recent VHA users with a TBI2407diagnosis was nearly 94 percent higher than among those without2408a TBI. Early intervention in TBI care is not separate from2409suicide prevention. It is part of it.2410    Third, veterans tell us the current trajectory of veteran2411suicide is unacceptable. In July 2025, Mission Roll Call2412surveyed more than 2,100 veterans, family members, and2413caregivers nationwide. Sixty-seven percent of veteran2414respondents said they have struggled with suicidal thoughts or2415mental health challenges themselves, or know someone who has.2416Nearly one-third described access to mental health care as2417difficult or very difficult.2418    Veterans also told us the barriers are not only clinical.2419They pointed to isolation, stigma, and loss of purpose as early2420warning signs.2421    We have come to describe this as working ``Left of2422Clinical.'' Not instead of care, but before crisis. Earlier2423engagement. More on-ramps to stability. Fewer veterans reaching2424a breaking point before help arrives.2425    Fourth, and lastly, housing stability. Housing is2426foundational. Without stability at home, treatment adherence,2427employment, recovery, and family life suffer. Veterans2428consistently rank housing access and homelessness prevention2429among their top priorities because instability magnifies every2430other challenge.2431    Across all of our surveys, veterans are asking Congress to2432do a few consistent things: expand access where delays persist,2433strengthen community care pathways, treat TBI and chronic2434conditions as long-horizon rehabilitation challenges, invest in2435earlier suicide prevention strategies, and protect housing2436stability as a core element of veteran wellness.2437    None of these priorities replace the VA. They strengthen it2438by recognizing that veteran wellness is built upstream, long2439before prescription drugs, an emergency room, or an inpatient2440bed is involved.2441    Veterans are speaking clearly. We are listening. Mission2442Roll Call is here to ensure their voices remain central to the2443work of these Committees.2444    Thank you. I look forward to any questions.24452446    [The prepared statement of Mr. Whaley appears on pages 244-2447248 of the Appendix.]24482449    Mr. Takano. Thank you, Mr. Whaley. I will now recognize the2450former Boys State Governor of Virginia and former Governor of2451Maine, Senator Angus King, for questions.2452    Senator King. That refers to the prior hearing. Sorry about2453that.2454    General Piatt, one of the provisions that I have been2455pushing is preregistering for VA health care before you leave2456active duty. It is called the Servicemember to Veteran Health2457Care Connection Act. Is this something the Wounded Warrior2458Project is interested in?2459    General Piatt. Thank you, Senator. We are extremely2460interested in this. I think if we get transition early, we are2461doing a lot of work ourselves, registering members in the2462Wounded Warrior Project while on active duty. We feel if they2463are registered before they transition, the higher success rate2464we will have during transition. So we appreciate this bill. We2465fully support that.2466    Senator King. I appreciate that. And my position on2467transition is very simple. The government should spend as much2468money on transition out as they do on recruiting in, because2469right now, I think transition, although it has been improved in2470the last several years, I do not think people realize what a2471dramatic moment that is in a veteran's life. And suicide rates2472are higher among people in the first two or three years.2473    Mr. Whaley, I very much appreciate your comments on TBI. We2474had a tragic case in Maine, as you may know, several years ago,2475that involved TBI, and I think that is something we have to2476focus upon.2477    Something I have been looking at is a bill that would have2478the VA provide free lockboxes for firearms. No lists. This is2479not a gun control bill. No names taken. But the data shows that2480if there is any gap between the idea and carrying out a2481suicide, that can help. And 75 percent of veteran suicides take2482place by firearms. Is that safe storage something that you2483could support at Mission?2484    Mr. Whaley. Senator, yes, it is. I think all of us on this2485panel are concerned about the continuing rise of suicide and2486our inability to really bring those numbers down. So any effort2487to reduce those numbers is something all of our members and all2488veterans and their families can get behind.2489    Senator King. Thank you. Mr. Prince, we passed a provision2490in the defense bill last year that will increase the number of2491people who are leaving the service whose contact information is2492shared with your representatives across the country, at the2493State Veterans Offices. It used to be you had to opt in in your2494paperwork. Now you have to opt out. And we expect that will2495significantly increase the people whose contact information is2496made available.2497    I hope that your organization and your members are getting2498ready for what I suspect will be a very large number of2499contacts so that the purpose of this law, which is to have2500people met at the airport, to advise them of their rights and2501what options are available to them. I do not want those names2502coming to your offices and sitting in a file somewhere. I hope2503you will work with the VSOs to develop a system whereby2504veterans emerging from service, you will reach out to them, not2505wait for them to reach out to you.2506    Mr. Prince. Thank you, Senator, for that very much2507appreciated comment. Our membership is receiving additional2508information. We are getting the VA to work even closer with the2509Department of War. Because the sooner we can get in, even while2510they are on active duty, as a former master chief it was my2511intention to get to sailors a year or two before they got out2512of the military and start the conversation then and connect2513them with services.2514    So you can absolutely count on NASDVA to be a player in2515that and making sure that we are at the front of the line when2516it comes to getting that information into the hands of our VSOs2517and our local communities.2518    Senator King. Thank you very much. Thank you to all of you2519for the work that you are doing on behalf of our veterans.2520    And one final comment. It is about damn time we passed the2521Richard Star Act.2522    [Applause.]2523    Mr. Takano. Thank you, Senator King. I will now recognize2524myself for questions.2525    General Piatt, what is the urgency on, and why Congress2526should pass the Major Richard Star Act, now?2527    General Piatt. Because these young warriors have been asked2528to go to war to defend the freedom of this country, and in the2529course of that they were wounded, and they spilled blood in2530foreign countries. The reason we are free is because they2531serve. Most of them, sadly, are young men and women that are2532serving, not even close to retirement years. So they have to2533accept the end of the life they thought they were going to2534have, and it brings a whole different life they did not think2535was possible. And we cannot punish them for their sacrifice on2536combat fields.2537    Mr. Takano. I wholeheartedly agree with you. I am very2538moved by your answer. And it needs to happen as soon as2539possible. It needs to happen this Congress, and this Congress2540and its leaders need to be held accountable for getting it2541done.2542    Now, do you agree that this is also about fairness? That2543ending a wounded veteran's taxed and that Congress should not2544pay for it by reducing other earned benefits?2545    General Piatt. I think veterans should get the benefits2546they earned in combat.2547    Mr. Takano. And what about, we should not be asking other2548veterans to pay for it by reducing their benefits.2549    General Piatt. I think all veterans deserve the benefits2550they earned in the course of their service.2551    Mr. Takano. And so you would agree with me that the2552American people and this Congress, that it is part of our2553obligation to take care of the veterans, not to ask one veteran2554group to pay for another veteran group's benefits.2555    General Piatt. We appreciate the service and support of2556this Committee and getting veterans their benefits they2557deserve.2558    Mr. Takano. Thank you. Ms. Sullivan, there has been a lot2559of discussion over the past several months on disability2560indemnity compensation, and I read the moving testimony from2561survivors such as yourself in TAP's written statement, about2562the impact a full DIC benefits increase would have on their2563lives. Can you give us a quick snapshot of the reason why2564Congress needs to do this full increase and why it needs to2565happen, now?2566    Ms. Sullivan. Yes. Thank you for the question. So our2567military and veteran survivors currently only receive 432568percent of what 100 percent disabled veteran receives. All2569other Federal survivors currently receive that 55 percent. So2570we are asking for parity. That is simply bringing us in line2571with all other Federal programs, to bring that from 43 to 552572percent, or an additional $454 per month.2573    Our base rate currently, the actual number is $1,699.36.2574And for most of our survivors, myself included, that is the2575only surviving benefit we receive. So that increase could have2576a very large impact on our families.2577    And for some of us, it is the difference in providing for2578families in ways that can include keeping their homes, being2579able to really do what is necessary to raise grieving children,2580and to do just critical care for their families. So this is2581something that ultimately we believe is fulfilling a commitment2582to saying that our sacrifice and our loved ones' service is2583just as important as other Federal benefits, Federal employees'2584sacrifice.2585    Mr. Takano. I agree with you, and the wait has been long2586enough, and it is urgent we get it done now. Thank you.2587    I want to now recognize Mr. McGarvey for his three minutes2588of questioning.2589    Mr. McGarvey. Thank you, Mr. Chairman. Thank you all for2590your service, your continued service here today. I want to echo2591something that Senator King said earlier. Right now we have an2592Administration who is coming to us asking for billions upon2593billions of dollars to send people into war again, but are2594unwilling to find the money to take care of those who served in2595those wars prior to this. The money for the Major Richard Star2596Act, the money for widows and widowers--Ms. Sullivan, thank you2597so much for your courage and your testimony--who have2598sacrificed and served. These are benefits they have earned,2599they have deserved. We will keep fighting for them.2600    I want to switch gears a little bit, Mr. Thomas, and come2601to you. Talk about your testimony. We were talking about how2602the VA does not have enough staff in the Spinal Cord Injury and2603Disorder System of Care. Many of the buildings are old but they2604are not designed for the care of our veterans that they need2605right now, and that more than a third of the jobs in these2606units are unfilled. That means that beds are staying empty even2607though veterans are waiting for them currently. It is our2608veterans who feel this neglect every single day.2609    So what should our VA medical centers be doing right now to2610fill these critical spinal cord injury and disorder positions2611and keep beds open for the veterans who depend on them?2612    Mr. Thomas. The VA should prioritize the hiring for the2613SCI/D System of Care as well as the other specialty care2614systems within the VA. Currently there is no other system out2615in the community that can take care of the unique needs that2616you have when you have a spinal cord injury. So they need to2617prioritize hiring that. And also they should, for the2618infrastructure, they should prioritize some of the projects2619within the SCI/D System of Care to ensure that they have the2620most modern equipment to take care of us, with our unique2621needs.2622    Mr. McGarvey. Yes. I totally agree. And, of course, part of2623the reason we need to do this is it is both a legal and a moral2624promise we have made our veterans. We said if you come in and2625you serve us and you are willing to sacrifice everything for2626us, we will take care of you. And I think we are falling short2627of that with this issue.2628    You also described facilities that are decades old, with2629outdated layouts, with long construction delays. Where do you2630think Congress needs to focus first to modernize spinal cord2631injury and disorder facilities so that veterans are receiving2632care in safe, accessible, and up-to-date spaces?2633    Mr. Thomas. Currently there is only one long-term care2634center west of the Mississippi, and the long-term care, as we2635all age, we need to have these long-term care facilities,2636because again, in the community there is no nursing homes that2637can take care of us.2638    Mr. McGarvey. Thank you. That is very helpful. Very quickly2639in my remaining time, General, I just want to talk to you.2640Thank you for highlighting the struggles of mental health that2641our veterans are still experiencing, particularly post-9/11.2642Quickly, where should we focus first if we want veterans to2643have timely access to effective mental health treatments2644through the VA, not just in the private sector?2645    General Piatt. First, I would say residential2646rehabilitation treatment programs. We need more beds. We need2647more states to have them. And second, I would say pursue2648alternative medication. Do the research. Get the trials going.2649We are seeing real promise here. Warriors should not have to2650travel to other countries to get the treatment that they think2651works. They should get it here. We are the best country in the2652world for medical care. That is where I would start.2653    Mr. McGarvey. Thank you so much. I agree with you on that,2654General. I appreciate you bringing it up. Mr. Chairman, I yield2655back.2656    Mr. Takano. Thank you, Mr. McGarvey. Now I recognize Dr.2657Morrison for questions.26582659                      HON. KELLY MORRISON,2660               U.S. REPRESENTATIVE FROM MINNESOTA26612662    Ms. Morrison. Thank you, Ranking Member Takano, and thanks2663to Chairman Moran and Chairman Bost and Ranking Member2664Blumenthal for convening our hearing today. Thank you so much2665to all the witnesses for being here today and the work that you2666all do every day, advocating on behalf of fellow veterans and2667servicemembers.2668    A special shout-out to any Minnesotans in the crowd today?2669Come on, you all. Are you out there? Well, I met with some of2670them earlier and it was a pleasure to see them here in2671Washington, advocating on behalf of their fellow vets.2672    General Piatt, my team has been working with yours back in2673Minnesota to partner on supporting our women veterans, and we2674have been very impressed by all the work that you are doing. As2675you know, women are the fastest-growing group of veterans, and2676as an OB/GYN myself it is important to me that women veterans2677can receive top-quality menopause and infertility care.2678    In your view, where can Congress act to ensure that VA is2679equipped to meet the needs of a growing women veteran2680population in 2026 and beyond?2681    General Piatt. Thank you for the question and your help2682with our work there. First, I would say women veterans are2683veterans, and our country needs to recognize that. Munitions do2684not discriminate by gender. They need the same care. But their2685medical care is gender specific. We need to meet them where2686they are, allow them to choose the provider of their choice,2687allow them the care they need, where they want it. If it is at2688home, if it is via telemed, but meet their needs. Don't just2689consider their needs the same as the counterpart male veterans,2690because they are very different. And we support going forward2691with more work on the Menopause Care Equity Act. We think that2692is the right way to go. Because their core set of services,2693their medical challenges will be different later in life, and2694we need to get the research now so we can provide them the2695support they need later on in life.2696    Ms. Morrison. Thank you, General. I appreciate that answer.2697    Ms. Sullivan, thank you so much for being here today. I2698just want to take a moment to recognize the immense sacrifice2699you and Sophia and the rest of your family have made, and I2700just want to share my admiration for your advocacy on behalf of2701survivors everywhere. And I am excited for your future, as2702well.2703    It is such an injustice to me that surviving spouses risk2704losing their benefits if they choose to remarry before age 55,2705and that is why we need to pass the Love Lives On Act. Ms.2706Sullivan, can you share a little bit more about what it would2707mean to you to eliminate the remarriage penalty for surviving2708spouses?2709    Ms. Sullivan. Thank you so much for your support and the2710question. At its most basic tenet, to myself and to others here2711with us, it would mean that the government is keeping its2712promise. It would mean that it is keeping its promise to myself2713and to Michael and to our children, that if something were to2714happen to him as a result of his service that we would be taken2715care of.2716    We did not expect that there would be some limitation on2717that. We did not expect that in the indemnity portion of that,2718that there would be an end to that simply because of a decision2719to not replace him--that could never happen, not as a spouse2720and not as a father--but to choose to also carry on with our2721life and our love, that that could end, and could end some2722things that are very critical to our family.2723    So, it would mean that we no longer have to choose between2724doing what feels very right for myself and John or for our2725families and financial security. And in the end, it would mean2726that we would marry fairly soon after it passes and that we2727would really, truly celebrate that love does live on.2728    Ms. Morrison. Thank you, Ms. Sullivan, and thanks to all of2729you for your ongoing service.2730    [Applause.]2731    Mr. Takano. Thank you, Dr. Morrison. I would now like to2732recognize Senator Gallego.27332734                      HON. RUBEN GALLEGO,2735                   U.S. SENATOR FROM ARIZONA27362737    Senator Gallego. Thank you, Chairman. And, General, I was2738rude. I walked in and you were talking a little bit about the2739veterans being penalized when it comes for their VASH vouchers2740because of a disability. Was that correct?2741    General Piatt. Yes, as far as on housing and how veterans2742access it. But we support it, so they will not be disadvantaged2743by their disability compensation.2744    Senator Gallego. That is great. So in the ROAD to Housing2745Act, I authored a portion of the bill, which is going to2746permanently exclude veterans' disability compensation from the2747annual income calculations under HUD-VASH programs, so that way2748veterans will not have to make this decision going forward. So2749it is in the bill. It was actually moving through the Senate.2750We just need some friends on the House side to make it.2751    But just to assure you that we have thought about this. It2752is in that bill, and I have kept it in both times that it has2753gone over the side. So we are definitely looking into that,2754actually are trying to fix it. Hopefully we will have it fixed2755by next week or so. So I just want to make sure we have some2756progress on that. Obviously it is not everything we need, but2757it is definitely moving in the right direction.2758    Mr. Whaley, you also mentioned the American Legion's2759support for expanding innovative therapies for veterans and the2760use of MDMA for treatment of PTSD. As you may know, I am2761working to introduce Innovative Therapies Centers of Excellence2762Act in the Senate. I want to continue to push it to get it to2763the point where it is across the finish line.2764    Mr. Whaley, can you please discuss the current use of2765innovative therapies like MDMA at VA, and why centers of2766excellence are important to ensure veterans have access to2767these therapies, with proven success at reducing PTSD symptoms?2768    Mr. Whaley. Right. Did you ask me that, sir, or General2769Piatt?2770    Senator Gallego. Mr. Whaley. And I am sorry. I need to get2771some readers pretty soon. Whaley. I apologize.2772    Mr. Whaley. Yes, no worries. No worries. We support that2773because we know right now that the number of TBIs across the2774Nation, but certainly among veterans, is much higher than we2775think. We do not have the ability right now to treat all those2776TBIs.2777    The TBI issue affects not only that servicemember but their2778family, as well. We have a number of children in our country2779that are primary caregivers to veterans because their mother or2780father needs that service.2781    We need to make sure that we are partnering with the very2782best in the civilian world, hospitals that are doing cutting-2783edge research when it comes to TBIs.2784    Senator Gallego. I do not want to interrupt to be rude, but2785I just want to make sure we communicate that. There are some2786veterans that are actually getting MDMA therapy, but it is not2787necessarily guided. Some of it is overseas. Some of them are2788paying out-of-pocket. Is that correct?2789    Mr. Whaley. It is correct, and, of course, I agree with2790General Piatt that that is unfortunate and should not be2791happening in a country such as ours, and we should know that2792these issues have long-lasting effects and we need to make sure2793they get the health care when and how they need it. And we need2794to explore different ways to solve TBI or mitigate it, using a2795variety of different methods.2796    Senator Gallego. And General, do you want to jump in on my2797thought. One of my concerns is that whoever gets good MDMA2798therapy now is basically connected to how much money you have,2799if you get to one of those really good programs. I know there2800are a couple programs in Mexico. There are some actually in2801Europe that some veterans that had the wherewithal or can2802bundle the money from donors are able to do.2803    But then there are also some veterans, unfortunately, that2804I know personally, that are so desperate that they are using2805any type of program that they hear is good, and, of course,2806when you have desperation you have potential fraudsters,2807peddlers, and people that will try to take advantage of these2808men.2809    So by having some kind of regulated, VA-approved therapies2810we could potentially be saving these guys, and saving these2811guys money, and potentially from some damage they may incur.2812Correct?2813    General Piatt. Absolutely correct. We have done initial2814research on our Warrior Care Network already on MDMA use with2815already evidence-base to other therapies and seen great2816results. We are going to help with trials next year, and I2817think the more we do that in this country, it will be done2818correctly, we will be able to follow the science. The treatment2819may not be for everybody, but it is showing that it is working2820for some, and we should not send them to a different country2821where we do not know, where it is not regulated.2822    But you are seeing great promise here, and we fully support2823the Centers of Excellence Act, because I think that will help2824the VA tie all that science together and promote quicker2825trials, that we can get more in. Our numbers that signed up for2826initial trials that we advertise far exceed the numbers that we2827will be able to do. There is a big appetite there for it, and I2828think the Centers of Excellence will help tremendously. Thank2829you.2830    Senator Gallego. Thank you, Mr. Chair, and I really hope2831that we can push this. This is more of an issue of a cultural2832resistance, actually, using this versus an actual medical2833resistance. And with proper therapy, training, licensing, there2834are so many veterans that could actually benefit from this. I2835think people have to get over the ickiness of the idea, MDMA or2836other types of therapies.2837    Thank you, Mr. Chairman.2838    Mr. Takano. Well, thank you, Senator. I am aware that there2839were some trials done in Loma Linda, which is near me. I have2840not checked into where VA is on it recently. I will have to2841say, also, regarding this whole area of TBI and traumatic brain2842injury and PTSD, I was with some neurologists recently. I am2843concerned about the State of VA research, the number of2844research positions that have been left vacant. That is a topic2845I want to explore further, because it also bears on the2846research capacity of VA to be able to move this forward. But2847thank you. I share your concerns.2848    Senator Gallego. Thank you, Mr. Chair.2849    Mr. Takano. I now recognize myself for some more questions2850before we conclude. General McGinn, I saw your testimony on2851duty status reform, and I will be following the Armed Services2852Committee's progress closely, as that greatly impacts VA2853benefits for our Reserve Component servicemembers.2854    I would like to focus on one benefit specifically, and that2855is the Post-9/11 GI Bill eligibility. National Guard and2856Reservist servicemembers are serving in the same uniform,2857taking the same risks as their active-duty counterparts, yet2858not getting the same GI Bill eligibility. Three out of the four2859Chairs and Ranking Members on the Veterans' Affairs Committee2860are lead sponsors or co-sponsors of the Guard and Reserve GI2861Bill Parity Act, which would fix this inequity.2862    As we are watching our country enter another overseas2863conflict, how imperative is it that Congress get this bill2864done?2865    General McGinn. Yes, thank you for the question. It is2866imperative. We have been working this issue for years and2867years, and Congress has been great. The GI Bill really2868initiated years ago from Congress. But again, it is an2869inequity. If you are flying a UH-60 Black Hawk helicopter2870during your weekend drill or your two weeks of annual training,2871how is that different service than flying it off an active-duty2872base? It is the same service, it is the same risk, and we think2873a day in uniform, regardless of what your status is, should be2874a day that counts toward Post-9/11 GI Bill, and early2875retirement, as well, early retirement credit.2876    So we think it is imperative that this finally gets passed.2877And we appreciate what Congress has done thus far, but we think2878it is time to take it to that next level. And if they are2879serving in whatever status they are in, other than stay at2880active duty, that time should count.2881    Mr. Takano. Well, Major General, here is my point. As2882National Guard and Reserve servicemembers are on the front2883lines and under threat right now, that is what I am hearing. So2884that is my point, that there is an urgency now to deal with2885this inequity, because we have Guard and Reserve right now. It2886is not the Guard and Reserve that we knew back in the Vietnam2887War days, right. Sometimes they have been called up for service2888and deployed many, many times. It is not a safe haven. And I2889think Americans understand that, and we need to make sure we2890update how we administer the GI Bill accordingly. Would you2891agree with that?2892    General McGinn. I completely agree. I enlisted in 1981 and2893I had a front row seat of the transition of the Guard and2894Reserves from the 1-weekend a month and the 2-weeks in the2895summer, to where we are today. We have got, as you know,2896Guardsmen and women that have done multiple deployments. They2897are coming on and off active duty a lot. And that is why the2898whole TAP issue is a concern, too.2899    My colleague here with me today has been through the TAP2900process, I think, four times, and she just comes off active2901duty, comes back to her regular job. But she has to do 12 hours2902of this mandatory transition training. And I just got an email2903from Djibouti, somewhere in AFRICOM, from a servicemember over2904there, having to put his whole unit, brigade-sized unit,2905through the TAP program. And none of it is really relevant to2906what they are going to experience when they come back off2907active duty.2908    So we really have got to get these benefits right, rightly2909aligned, and to your point, this is the time to do it. As I2910mentioned, 40,000 of us are deployed today, somewhere, either2911in the homeland or overseas. So it is time to make equities in2912those benefits.2913    Mr. Takano. Well, I hope you and the other VSOs and2914veterans themselves will hold the Chairs', Ranking Members'2915leadership accountable to getting this legislation passed and2916signed into law without delay. And, of course, we wish Godspeed2917to all of our servicemembers abroad.2918    Commander Shipley, this will be my final question for the2919day and we will bring this to a close. Your written testimony2920highlighted the need to equality the disability indemnity2921compensation rate with that of other Federal survivor programs,2922taking it from the current 43 percent to 55 percent, a monthly2923increase of $450. I am a co-sponsor of Representative Hayes's2924bill, the Caring for Survivors Act, which would do just that.2925We have even offered it as an amendment to a bill last month2926that would only increase the DIC rate by $24. Unfortunately,2927our majority rejected the full increase.2928    From my direct interactions with my constituents and2929nationwide polling, I believe that the American people are2930willing to pay for the full increase and are willing to do it2931without taxing other veterans to do so. In other words, without2932creating a pay-for that we diminish the benefits of other2933veterans. I am strongly opposed to doing that.2934    Do you think that the American people are willing to pay2935for, or would ask their Members of Congress to pay for the full2936DIC increase and live up to the promises made to our2937servicemembers and veterans?2938    Mr. Shipley. Thank you for this question. I absolutely2939believe that the American public would support this. It is2940bringing the fairness of the promise that is made to the2941servicemembers to take care of our families, no matter what,2942especially those that have made the ultimate sacrifice for this2943Nation.2944    Mr. Takano. I agree with you. I agree with you 100 percent,2945and I think we ought to apply that in this policy space, that2946we, in order to make sure that we resolve the inequities--and2947here we are talking about the survivors of veterans being paid2948less for their survivor benefits than those that are survivors2949of Federal employees. And that gap simply does not make sense2950when you kind of explain it to the American people. It is kind2951of complicated, this percent versus this percent.2952    Mr. Takano. But we need to take care of that inequity, and2953I believe that we need to do it without asking other veterans,2954who will, in many cases, say we want to help other veterans.2955But here is my point about that. We should not be asking2956veterans to do it. We, as Members of Congress, should take it2957upon ourselves to make sure that we find a way to take care of2958these inequities in veterans' benefits.2959    And with that I will just say, before we gavel out of this2960hearing today, I want to thank our second panel for everything,2961our second group of panelists, for everything that you do each2962and every day to support not only the members of your2963individual organizations but all veterans and their families.2964Your work and your advocacy does matter, and we thank you for2965that advocacy.2966    And with that this hearing is adjourned.2967    [Applause.]2968    [Whereupon, at 12:29 p.m., the hearing was adjourned.]29692970                            A P P E N D I X29712972                          Prepared Statements2973[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]29742975                       Statements for the Record2976[GRAPHICS NOT AVAILABLE IN TIFF FORMAT]29772978                                  [all]