Opportunities with VHA Reorganization

Good morning. Committee will come to order. Without objection, the chair may declare a recess at any time. Now, before we begin today, I want to thank my friend, Secretary Collins, for being here today. Secretary Collins, you have testified before this committee on a few times, and we appreciate your appearing here again. He is accompanied by the Honorable John Bartrum, Under Secretary for Health; Mr. Mark Englebaum, Assistant Secretary of Human Resources and Administration; and Mr. Gregory Goins, the Acting Chief of Operations Officer for the Veterans Health Administration. This is a significant purpose of reorganization of the Veterans Health Administration, and I know that members of this committee have serious questions about how it will be implemented and how it will affect veterans with the workforce. Because of that, I want the committee members to have as much time as possible to engage directly with the Secretary, but understand that we are in a situation where it looks like they're going to call votes around 12:15. So we will want to make sure that each member, when we go to questions, that they will get five minutes, but five minutes only, and I'll gavel you down because we've got to stay on the time schedule so that the questions can be asked. Also, know that if we are votes are called at 12:15, the Secretary has a hard stop at 12:30, and this everything must stop by 12:30. So and I—

Mr. Chairman, I understand that since he has to leave at 12:30, that you're asking him to come back in the—

It is. That's later on in my script, yes.

Okay, great.

[Laughter.] I will therefore keep opening statements brief and ask members to direct their questions to witnesses regarding the proposed reorganization. I will also want to ensure a productive hearing today, so I ask that we all respectfully be respectful of each other's members and the witnesses. And before we proceed, however, I want to ask for a clear comment, Secretary Collins, as the reorganization moves forward and as additional changes occur within the VA more broadly, will you commit to making yourself available to testify before this committee as developments occur, not just during the annual submission of budget?

I will, and I'll also follow up this afternoon with a written commitment.

Thank you, Mr. Secretary. With that, we would look forward to your testimony and a productive discussion. And at this time, I'll recognize Ranking Member Takano for his opening statement.

Thank you, Chairman Bost. Yesterday, I had the opportunity to speak at the AFGE legislative conference, and I met with colleagues of Alex Paretti, who shared stories about his service to veterans. I listened to testimonials from veteran patients for whom Alex provided care. It is clear that Alex was exactly the type of employee that VA needs and exemplified the values of a true public servant. I am outraged that Alex was taken from us by the hands of the lawless Trump regime. My heart is with the Paretti family, Alex's VA colleagues in Minneapolis and across the country, and the many friends he leaves behind. I'd ask, Mr. Chairman, that we have a moment of silence for Alex Paretti.

So granted.

[Moment of silence.] Thank you. In addition to the many testimonials from his colleagues and veteran patients about Alex's service, I've received a mountain of complaints about the lack of leadership, Mr. Secretary, in response to this tragedy. Your employees are hurting. They have looked to you for leadership, but what they received instead is hostility. The foundation of VA is its people. Delivering world-class care to veterans depends on the strength of that foundation, the workforce that keeps VA standing strong. Mr. Secretary, your foundation is cracking. When you moved in, the house was in good shape. VA had strong bones. It was functioning at record levels, serving millions of veterans every day. But under your leadership, the house is falling into disrepair from neglect. And when a house like VA needs repairs or renovation, responsible owners don't tear it down. They fix what's broken while preserving what works by reinforcing the structure, upgrading outdated systems, and addressing real problems deliberately and carefully. But that requires a plan, a fully baked plan, not just concepts of a plan. No one would undertake a major home remodel without architectural plans, engineering assessments, and a clear sequence of work. Yet VA is attempting a total reorganization of one of the largest integrated healthcare systems in the country with little more than a half-page notification—half-page is what we got—and a 10-page slide deck. 10-page slide deck. In contrast, when VA was reorganized in 1995, this is the book that was prepared to explain and justify its plans for a—called the Vision for Change. This 134-page book includes detailed analyses of how care would be improved for veterans. It also contains significant input from Congress. Input from Congress in the plan that they submitted back in the 1990s. Input from veterans, input from VSOs, input from VA employees, and other stakeholders. These do not. You are tearing down the walls before determining whether they're load-bearing, and veterans will be the ones to be crushed if the structure collapses. And like most home renovations, organizations are disruptive—reorganizations are disruptive and time-consuming. Yet VA is attempting this massive reorganization while simultaneously deploying an unproven electronic health record rife with problems, executing a trillion-dollar community care contract, and grappling with severe staffing shortages and turnover across the system. Any one of these projects would strain an organization, and taken all together, they will overwhelm it. This reorganization is the third in a series of attempts to shrink and destabilize VA since the beginning of the Trump administration. First came the chaos of DOGE with its reckless keyword searches, data munching, and indiscriminate slashing of contracts for essential services. Over 2,000 VA employees were carelessly fired overnight by email without an understanding of the consequences for veterans. Then came the second attempt to shrink VA with a plan to conduct a RIF to lay off 83,000 employees. A plan you tried to convince us was somehow about putting veterans first. Remember this, Mr. Secretary? Remember this? These actions were clearly performative and in service to an extreme ideology. They provided absolutely no benefit to VA or veterans, only harm. Both of these attempts failed because courts and Congress held VA accountable. But the disruption was real. The damage was done. Institutional knowledge and valuable employees walked out the door. And veterans are now left feeling the consequences in terms of access and continuity of care. Now, this reorganization marks the third attempt to dismantle VA. And despite this record, you're coming to us with nothing more than a slide deck and asking Congress to trust you. You are asking for deference while withholding basic information about staffing levels and the real-world impact on veteran care. Now, this lack of trust in your leadership is not theoretical, and frankly, you've earned this distrust. Veterans are the center of what we do in this committee, but veterans are clearly not the center of this reorganization effort. VA leadership has not proven that a reorganization, and especially this reorganization, is the best solution for addressing their stated goals. Now, streamlining care does not require a massive and disruptive reorganization of the agency. At a very basic level, streamlining care requires having enough clinical and support staff to get veterans in for appointments. However, Mr. Secretary, since you took the helm, the agency has shed a net 20,400 employees across VHA alone. Let me say it again, VHA alone. We're not even talking about what happened at VBA and the other parts of VA. This represents centuries' worth of experience. These losses include over 1,100 doctors, 100 left VA in December alone, over 2,300 registered nurses, nearly 700 medical support assistants, nearly 700 social workers, nearly 650 licensed practical nurses, and nearly 300 psychologists, and over 250 police officers. Yet today, we are going to be told that this plan, which includes making it even more difficult for VA to hire more staff, will streamline care for veterans? Now, I listened to the Senate hearing two weeks ago and your remarks on Fox News the other day, where you claimed that you are doing more with less staff. The veterans who call our offices beg to differ. They tell us every day that they cannot get VA appointments or that the provider with whom they had a strong, trusting relationship left. VA whistleblowers bravely contact us and share how their facilities are being pushed to the brink, trying to meet patient demand with less staff and fewer resources. You're not doing more with less. You and VA are doing less with less. There is a lot at stake, not least the health and lives of the veterans we serve. The reorganization materials also fail to consider the impact on VHA's vital role in the health professional training, research, and federal emergency response. Lives are on the line. You have the chance to course-correct today, and let's see if you seize the opportunity. And with that, I yield back.

Thank you, Ranking Member. Secretary Collins, I will swear you and your group that is accompanying you in at this time, if you would. I ask the witnesses to please stand and raise their right hand. Do you solemnly swear under penalty of perjury that the testimony that you are about to provide is the truth, the whole truth, and nothing but the truth?

I do.

Thank you, and let the record reflect the witnesses have answered in the affirmative. Now I would like to recognize the Honorable Doug Collins for 10 minutes for his opening remarks.

Thank you, Mr. Chairman, Ranking Member. I appreciate being here with the rest of the committee—

Will the gentleman suspend? For purposes of—the chair is in accordance with the committee rules is asking unanimous consent that Representative Scott from Virginia be permitted to participate in today's committee hearing. Without objection, so moved. Mr. Secretary, I'm sorry for interrupting.

No problem, Mr. Chairman. Chairman, Ranking Member, thanks to you and the committee for having us here today to present the VA's plan to improve our VHA management structure to strengthen care for veterans nationwide. As you have already mentioned, our Under Secretary for Health, John Bartrum, is here; Mark Englebaum from our personnel is here; and also Greg Goins, who is our COO, who is also a career employee of over 14 years in the VA system. Before I start, though, I want to begin, as has already been expressed, to begin by expressing my deepest sympathies to the family and colleagues of Minneapolis VA Medical Center nurse Alex Paretti. As you know, his death is currently being investigated. VA is not involved in that investigation, and neither I nor my fellow panelists are able to provide any additional details at this time. I am here today to address the focus of this hearing, our planned reorganization in the VHA. Let me start really with what I just heard, and it is pretty amazing, addressing some of the misleading and inaccurate descriptions of the hearing about what we're having this effort about today. It's not a reduction in force, it's not diminished care, it's not anything that I have just heard over the last few minutes that as accused of performative as I just saw. What we're here for today is that we are the largest healthcare system in the country, but we've never acted like it. We've never done it the way it needs to be done because we have frankly allowed the system to build on itself. We've allowed the system to come in, we've allowed the system to be riddled with redundancies, slow decision-making, sow confusion, has competing priorities, all of which reduce quality of care for veterans. There is no one as a veteran who is more concerned about veteran healthcare in this country. And so when you look at it from my perspective, I look at it as brothers and sisters in arms taking care of each other. And we've got to make some honest assessments here. What is interesting to me is only in Washington, D.C.—and I've been in this town a long time, sitting where you sit, sitting in other places—only in this town can you say something that's been talked about for 30 years, complained about by both Democrats and Republicans, who GAO, Inspector General, every other person, including VSOs, of which we've been meeting with over 20 plus on multiple occasions already, explaining a lot of what we're doing. We have had multiple meetings with all members up here. Only in this town can it be called rushed. Only in this town can it be called not thought about. Only in this town can it be thought of as an issue that in somehow has never had anything thought about. There is a difference, though, Mr. Ranking Member, Mr. Chairman. This administration decided to do something about it instead of just gripe about it. That's a difference. And instead of having hearing after hearing after hearing on saying the reorganizations and the governance structure of VA under both Republicans and Democrats for the last 30 years, we've taken your input. We've taken congressional input. You know how I know that? Because all I've got to do is look at testimony that's before this committee. I've already looked into the OIG reports, the GAO reports, the multiple VSO reports, and by the way, hundreds of VA employees who had input into the beginning of this process, careers and politicals, and also consultants who have to let us look at who we are as the largest healthcare system in the country. So only in Washington, D.C., can you come to a position of saying that something is rushed or done when over nine months of work has went into it. And by the way, also in a different setting as well, and I'll just go ahead and address this now, the reorganization fully allowed under statute and fully allowed under our appropriated processes was introduced to you over right now two months ago to begin this process of discussion. We've moved no one. When we do get ready to have our reorganization, we will follow all rules of statute that tell us in what we need to report and how we will report it. But you know what? We actually did something a little different. Unlike some other agencies and some other times that's been here before, we actually came to not only VSOs but members of Congress and began to outline the plan on what we were looking at and did the issue upfront. So we're here today to talk about it. I would encourage you to make use of not only myself but the ones that I brought with you. In this idea of slashing, cutting, and burning, I have to address. Because since 2019 to last year, the VA has increased—and this is across the board—FTE count of 14 percent across the board. Some areas it's as high as 30 percent in some locations, two and three in other locations. But here's the kicker to that. That's great in any other issue you want to look at in federal government or in private enterprise, but at 14 percent FTE increase, we've only had a 6 percent increase in veteran encounters. Some of our organizations, some of our VAMCs, have had actually 30 percent FTE increases and decreased in the number of encounters they had with patients. I don't think any of you would go to any local hospital that you have in your community and find a hospital that operates that way. They don't, and we're the largest. It's time we start putting the resources where they need to be, not in some amorphous VACO central office, not in some amorphous VISN level structure that, by the way, started in this committee, Mr. Ranking Member, in the '90s with about 10 in each VISN. They've now morphed over 10,000. And yet our wait times were going up. Yet our customer service was not happening. So we decided to do something a little unique in this town. We decided to do something about it. We've actually seen over the past year our wait times stabilize or go down. We've actually seen VA VBA, which is not part of VHA, but I just need to say this, we had 260,000—when you talk about workforce, we had 260,000 in one of the largest workforces in the country in the federal government, 260,000 backlog claims of 125 days plus for disability claims when I walked in last year this month. It is now under 100,000. And by the way, before anybody says, well, the quality is there, the quality is in line with the when we were doing far less, the percentage of people who appeal it is about the same. So don't hand me that quality is bad. We're just doing it better, faster with the people that we have. That's what a leadership organization does. As we look ahead today to this and quoting the Chairman of this committee, simply put, the outdated structure created in the mid-1990s no longer aligns with the complexity, geographic demands, performance management requirements of the modern VHA. It just doesn't. So as we look at this, we can nitpick, we can go different places, we can disagree, and we can agree. And I'm sure we will today. I've been there before. But we'll talk about it. We're going to give you answers, and we'll follow up with answers if you need more follow-up. We're committed to making this process because at the end of the day, I notice as always you have the POW/MIA chair here. But in my office, I have another chair that says we make every decision for the one not sitting there. And the one not sitting here today is the veteran out in the community who need community care, who need direct care, who need their benefits paid, who need to have a workforce that understands that the workforce is committed to one thing and one thing only: veterans first. And for us, I'll stand on the successes we've had. You can talk about rushed, you can talk about other things, but the one thing you can't deny is what we have done have helped get care in the communities, 25 new clinics opened, hiring—let me say one last thing, Mr. Chairman. I said this when I was here a year ago, and I'm going to say it again. Let's also take care because because I'm sure we're going to hear about staffing and we'll talk about that and we'll talk about where we are. By the way, we're still up over staffing over the past five years as I said just a few minutes ago. But also please remember, the VA is just like any other healthcare system. When I was in New Hampshire, we talked about this. I have to compete with the same hospitals in private and public for doctors, nurses, and everybody else. But you know what I have that they don't have? I have a salary cap, which I've asked this committee and other committees to look at. Because that keeps me from hiring doctors. Because when you have starting salaries of $600,000 for anesthesiologists in a community and I can't pay that, I don't blame them for going somewhere else. That's not a workplace issue. That's a fault of this body and us to not fix it. So when we look at this going forward, we are the largest healthcare system. But sometimes we run as if we have one hand or one leg tied behind our back. It's now time to change that. It's now time to modernize it, and it's time to get on with it. Mr. Chairman, I yield back.

Thanks, Secretary, for his opening statement, and a written statement of Secretary Collins will be entered into the hearing record. We will now proceed to questions. And before I proceed to questions, I want to because not all members were here, we are on a time schedule. 12:30 is a hard out for the Secretary. There's also a possibility that votes will be called at 12:15. Every member will receive in the order that they come in, the normal we'd do, five minutes. If you can keep it less than that, but I will gavel you down at five minutes because every other members do need to ask questions. So I'll try to lead by example to get my questions out. And with that, I recognize myself for five minutes. Mr. Secretary, your team received a written legal opinion from the Office of General Counsel defining the Title 38 Section 510 applies to this reorganization. Will you provide that that opinion to this committee?

I can provide what we have that backs that up, yes. And and again, as I said in my opening statement, Mr. Chairman, every targeted requirement of 510B will be followed when those targets are met. At this point, they have not been met.

Well, that'll bring up my other part of this question, which is asked if VA begins to implementation before Congress receives the detailed plan, how does VA ensure it is not effectively circumventing that statute?

Because I follow the law, Mr. Chairman.

Mr. Secretary, I commend the department for proposing this reorganization to better the VHA with how care is going to be delivered. Do you agree that as a veteran needs healthcare delivery continues to change, VHA's structure will need to keep evolving as well?

Yes, Mr. Chairman, it's got to evolve because what we have right now is not a system that actually works. We're a top-down system. I had this unbelievable conversation in the Senate three weeks ago that they believed that this plan was a top-down plan. This you can't read this plan or hear about it and say it's top-down. We're putting our VAMCs directors and our leaders on the field, clinic directors, in charge. They're actually having to be senior leaders now. They've never had to be senior leaders before. They just put everything up and know it never got answered. Can I also on that part, Greg Goins was a VISN director as well, hospital director. Real briefly, can you explain how this actually affects that what we just talked about right there?

Yes, sir. So what Secretary Collins is referring to is our oversight structure and the bodies that ultimately support the field operations, the medical center directors and the staff that actually are delivering direct care, has been created over the years to really be kind of a self-fulfilling prophecy. We set up oversight requirements and then we hire a bunch of people to do it. And in reality, some of that stuff is important, much of it is, but we've created far too much resource intensity at the top and we have taken away resources in doing so from the very front lines of being able to deliver care to our veterans. So as an example, in the VISN, often times we have a compliance requirement, which is good, but there's also a similar compliance requirement in D.C. and a similar one at the facility level. Why do we need three people checking the exact same process? In fact, what should happen, like everywhere else, is we have an evaluation for self-inspection at the front line and then we have someone removed from the process, typically at a VACO level, to do compliance. Right now, we have three or four, in some cases even parties doing that. That's an incredibly resource-intensive oversight that ultimately is not contributing to quality execution.

Mr. Secretary, I've got one more question. As a former member of Congress, do you support Congress's reauthorization and modernization of VA's statutory structure, including VHA and other major functions like construction, procurement, and research, so that the law reflects the needs of today's veterans?

Oh, Mr. Chairman, and I know that we have talked many times before, but you're singing out of my choir book hymnal here. We've got to have some of that reorganization help from this body. I can only do, and I promise this, we only going to do what we statutorily can do. But when it gets to construction, I'm just going to hit construction. I've mentioned it before. This group, this committee, needs to set aside some time to discuss this. For those of us who were here when we had to pass the construction issues about a dozen years ago, which I was, voted on this, this was out of the disastrous rebuilding Aurora, Colorado, Phoenix, Arizona, where the ballooning cost 10 years. I hate to tell you this, but you're not going to be shocked. After this passed and we're all going up on 10 years now at least when we passed this, we're still looking at 10 years to build a VAMCs. We're still looking at at times it takes there's in the budget which you just approved, the St. Louis VAMCs should be built in two and a half years, minimum. It's going to take almost six to seven years under the current structure because frankly, Corps of Engineers needs to be out of this process. They got other issues they need to deal with, but you had to put in structure at the time, I get it, but now we've got to change this. So anything structurally that I'll come back with you with that we need to change, I would appreciate it. We'll give you any help we can because one, we're not being very good stewards of taxpayer dollars by building a billion-six VAMCs that could be built for 800 million in two years in the private sector. ...and I'm not going to be brought into anything else about it.

Well...

I'm not I've provided you the reports that you've asked for. You make the you make it.

Did he did he do a good job caring for sick veterans in the VA ICU?

I have heard nothing to the contrary.

So he you're saying he did.

I've heard nothing to the contrary.

But you can't tell me as the head of the VA...

I've heard I've answered your question. I'm not going to get pulled into that. You want to talk about reorg?

Okay. Then why don't you stand up for him and correct your cabinet colleagues when they call him an assassin and a terrorist?

Because I am here today to talk about a VHA reorg. I've expressed my condolences to the family. We have made every available asset...

It seems to me you're unwilling to defend the reputation of a VA nurse who dedicated his career to veterans. Mr. Secretary...

That's your opinion.

...when you're Secretary I just think you just it's not my opinion, it's what you just showed us.

No, it's your opinion.

When your when your employee Alex Preti was was attacked publicly and falsely by your own colleagues, you had a choice to defend him or stay silent. And you chose silence. And that silence is deafening. Leadership is who you defend when it costs you something. And you did not defend him when it mattered and you still won't. Mr. Mr. Goins, you've been... ...called the face of the VA reorganization, but you're the VHA Chief Operating Officer, not a Senate-confirmed official. Who among the four of you is is the accountable official? Is it Mr. Bartrum?

Hold on a second. Define the question. Well, I mean I mean this is I mean if we want to get cute here... ...I'm the Senate-confirmed, John's Senate-confirmed, he doesn't have to be Senate-confirmed because he's appointed out, and Greg...

I just want to know who we should hold accountable if this reorganization fails veterans.

Gentleman's time has expired. We're going to hold to the five minute Representative Van Orden, you are recognized for five minutes.

Thank you, Mr. Chairman. The ranking member made a point to hold up a book and as opposed to the slide deck that you have, I would just like to point something out. The Magna Carta was one page. The Declaration of Independence was one page. The Constitution, four pages. The Bill of Rights, one page. So what I've noticed in the three years I've been in Congress is that we often... ...confuse quantity with quality. And we often confuse motion for progress. So I'd like to show the people what we're talking about because it's been referred to. This is the current structure, right? And what's great about this chart is you can look at it upside down and it still doesn't make any sense at all. It just doesn't matter, right? And then and if you look at this, this is what you're striving to get to, right? Okay. So I'd just like to Mr. Chairman, I'd ask unanimous consent to enter this into the record.

Without objection.

Okay, so we're trying to go from here to there. This is the 'I got six bosses, Bob' program. This is the 'I actually know who I work for and I can be held accountable' program. Is that what you're striving for, sir?

That's correct, Mr. Van Orden. You hold that other one up my dear for a second.

The first one or the second?

No, the second the first one you showed up. Yeah, this is the one that looks like the aftermath of Burning Man. Yeah, this is what's been defended for almost 30 years by every you know, the same, 'Oh, we just don't need to work on it, we'll work on it, we'll patch it, we'll patch it, we'll patch it.' That's what you get when you patch it. It's time for us to go to something that actually works.

Right. So what we're trying to do here and you know, please correct me if I'm wrong, you know, I've been here as I said for three years now and I chair the subcommittee on Equal Opportunity or excuse me, Economic Opportunity. And I have yet to see anyone at the VA being held accountable for the billions and billions and billions of dollars wasted for lack of planning and just throwing money at a problem. And so I think that if we can actually hold people accountable that their job performance will improve. That's my experience as a Navy SEAL. Is that what you're trying to accomplish, sir?

Yeah, would you let I and I appreciate the question and it goes to the heart of what I was trying to get at here and if you allow me for just a second. Last year when I came in, I told the chairman, ranking member, I told everyone on this committee that we didn't have a manning document. And some of you have rightfully so been concerned about what was reported in the press wrongly about empty positions and Mark Englebaum will be happy to describe what we did to get our manning document right. For those who are not sure what a manning document is, we didn't know where our people were or where they're supposed to work. We now have a manning document that allows us to actually hire in ways that we get more doctors and nurses where we're at instead of trying to move them between different places. But then I got another one for you. And I just shared this just this week. Up until we were able to consolidate our CFO and get a CFO in and actually working through this, we had no monthly reconciliation. I don't care what side of the aisle you're on here. How do you run a business without having monthly reconciliation of what you're spending? We just got to the end of the year and said, 'Wow, we got enough money, we'll we're good.' This is the kind of stuff that we're trying to deal with to get it to where we can actually put the people in the places that need to be instead of just putting people. Here's your question. You said a minute ago, there's this all this idea that the more is better.

Right.

Well, when I got here, we had 480,000 employees. We had 260,000 plus in a backlog. We had wait times that were going up. And by the way, for those who are concerned, the... ...vacancy rate for doctors and nurses over the past four years has stayed consistently between 19 and 14 percent. By the way, the 19 percent was in 2022 under Biden. We're at 14.

Please stay consistent. Mr. Secretary, I just I have a minute left. I do want to talk about the salary cap issue.

Yes.

I know that's statutory, that's something we can work on. And then you said something that is actually deeply disturbing, that the Army Corps of Engineers is Army Corps of Engineers are responsible for building our VA facilities?

They are because of a certain amount. It's a threshold amount that they have to be involved in. And they that gets them involved in actually in CBOCs as well.

Okay. Well, I I they don't need to be there. I have a great relationship with the Army Corps of Engineers, but they do think they're the fourth branch of government. And so if we can work together, Mr. Chairman, and with ranking member to see if we can move that around, that'd be great because again, the Veterans Affairs Administration and you have stressed this in your leadership, it's about the veteran, it's not about the Veterans Affairs Administration.

Exactly. Can I answer that real quick on the or you got another question?

No, I just have 14 seconds so I don't want to cut off your...

No, let me finish it real quickly. The reason the Corps is a problematic and there's something I didn't mention a minute ago. VA developed its own building standards. We don't use national building standards. We developed our own standards because we had nothing better to do, I think. And then we take it to the Corps of Engineers who have their own standards.

Gentleman's time has expired. Thank you, Mr. Secretary. Thank you, Mr. Chairman. I yield back. Representative McGarvey, you are recognized for five minutes.

Thank you, Mr. Chairman. Thank you, Mr. Secretary, for being with us today. As you know, this committee's job is to make sure the VA is working for veterans. Not that it's working for political appointees, not that it's working for career employees, not that it's working for a small group of insiders who are making decisions behind closed doors. What you all are proposing, it's very likely the biggest shakeup of the VA in 30 years. And I think our veterans deserve to know what the VA is planning. Now, I want to tell you, I'm not opposed to change. I'm opposed to making that change in the dark. I'm not opposed, for real, I'm not opposed to change, but I do want to make sure that that change actually improves the care our veterans receive. Because one thing we do well on this committee is we actually understand the mission: to take care of our veterans. We do it in a bipartisan way. For the nearly 40,000 veterans in my district, we're here to take care of them. For the for the veterans in in Mr. Luttrell's district, in every representative's district on this dais, we are here to take care of them to make sure that we honor the promise we made to them for their service. We might not always agree on the path, but we all want the exact same outcome, which is a stronger VA that delivers the highest quality of care for our veterans. So the experts who helped design the Veterans Integrated Service Network, or the VISNs as we're calling them, they've warned for 30 years that you don't fix policy failures or culture failures by redrawing an organizational chart. They've said that large reorganizations are disruptive, expensive, and almost never solve the real problems... ...which are unclear roles, inconsistent oversight, and a lack of accountability. Both GAO and GIO have been saying that same thing for more than a decade, as you alluded to earlier. So again, I want to point out I am not opposed to change, but here's the problem you're hearing and the frustration you're getting from this committee. We don't know what those changes are. Mr. Secretary, the federal law requires a report to Congress on any proposed VHA reorganization. And what you've provided to us is a half-page letter and a 10-page slide deck, a PowerPoint. It's not much. So given how this committee operates, I hate that I'm even asking this question, but I do want the honest answer. Have you provided my Republican colleagues on the other side of this dais with any additional materials, documents, memos, reports, data about this reorganization that you have not shared with the people on our side of the dais?

Well, first off, Congressman, I'll never I will not ever intentionally or any otherwise give you dishonest information, so an honest answer is all you're going to get from me. I have given nothing. I we have briefed both sides of the dais on this multiple times and had multiple phone calls with.

So that's then the problem I mean the problem is no matter how you answer that question, it wasn't going to be a great answer because what we have is very little information on what's going on here. Again, it's not that we're opposed to change. We want the VHA to work. We know that it can work better for our veterans, but we need to know what those changes are. And when you are proposing a reorganization of this size and this scale and our veterans don't know what's coming, that concerns me. Because our veterans, as you know, some of them are worried about these changes. Right now in Louisville, Kentucky, we're undergoing a change in our VA. Robley Rex serves about 45,000 veterans across the Commonwealth. We are moving to a new building. They're in the middle of this full facility move. And what worries me is that this reorganization adds yet another layer of disruption for the people who have risked everything to serve our country. So when talking about how we're ensuring that veterans continue to get the care and that it doesn't slip through the cracks during the transition which you've proposed and we don't know enough about, do you all have a continuity of care plan, yes or no?

We always have a I want you to hear from Greg Goins, who is actually from your area, who actually was the VISN in that. He can describe exactly what we're talking about for you right now. And this is why we're doing this hearing, by the way.

Yeah, and only because I only have a minute and nine seconds left, do you guys have a continuity of care plan? And I need it to be yes or no.

Yes, the plan we do. The continuity of care plan is the fact that we're not touching frontline facilities whatsoever. That's the biggest issue. And the other thing I want to say about Louisville and the hospital, the biggest issue that's running into challenge is the federal and state level officials having to address the traffic issues.

Okay, I got sorry, I got we got really little time. If you have a continuity of care plan, one of you said yes, one of you said no. What I need...

No, no, no, no, no. Let's make this Mr. Chairman, stop the clock. I reclaim my time, Mr. Chairman. I reclaim my time, Mr. Chairman. I need to make this clear. Stop the clock and give him his time. I said no to yes. Mr. Chairman, I reclaim my time. I said yes no to I did not say no to the answer that he gave. I said no to yes question.

Mr. Chairman, I got to reclaim my time here. You've reclaimed your time. And maybe even get a little extra time. This is we're trying not to be combative, Mr. Secretary, and I heard okay, okay, perfect. But if you have a continuity of care plan, we haven't received it. This goes to the lack of transparency that we are talking about. This is a massive reorganization, it's going to impact our veterans and we on this committee don't know how. What we care about is the veterans. We care about doing right by the veterans. And what doing the right thing is having this out in the open. Gentleman's time has expired. I yield back.

Representative King-Hinds, you are recognized for five minutes too.

Thank you, Mr. Chairman. And thank you, Secretary Collins, for making time to be with us today to talk about this reorganization. I think you took 10 minutes to describe how getting or seeing change in DC is like watching molasses roll down a hill on a cold winter stay. And since my time here, right, that's kind of how it feels. And one of the things that I've noticed really when it comes to change is that everybody wants change, but for the most part, they want change when it doesn't affect them or they want change in their pocket, right? And that seems to be like a common theme around this town. We have been having multiple hearings over different programs to include the DIGB rollout, for example, modernization rollout, for example. And one thing, you know, has been very apparent is that it's very difficult to get folks from the VA to be able to say who is accountable, who is responsible. And you know, I think Representative Van Orden said it best the other day that like some of these hearings feel like Groundhog's Day. But I think that the reorganization chart, right, or I'm sorry, the old organizational chart speaks to that. Is you know, the line of business is very it's not clear. And so I'm very glad that something is being done about that so that we can actually hold somebody responsible and accountable for for some of these mishaps, right? Because right now it's not clear who's in charge based on the organizational chart. The one thing that I I do want to raise to your attention because I was looking at the slides that you shared. And I'm concerned that in the map of the VISNs, right, or the VISNs, that there is no representation of any of the territories. And I'm going to tell you this, you know, it had me in my feelings a little bit because that's all that I talk about with regards to just trying to get basic care. So can you speak to that, please?

I will speak to the one who's over it and been working it to get the the area that you're talking about done and John can address that for you.

So with are you referring to COFA, just so we're or territories in general?

So there's COFA, right? They're not US citizens. There are people who live in the territories like the people of the Northern Mariana Islands who have the highest one of the highest per capita enlistment rates in any territory in any territory or any state who get no care, right? We don't have a CBOC and now we are going from a map that used to actually identify the Marianas as part of this VISN, but now we're just focused on the continental United States. And that kind of upsets me, right? Because it it feels like we're going backwards.

We're not, we do. It is still there, Greg.

All the American territories are aligned exactly as they are in current state. That map is reflective of what is going to be the biggest change, which is the overall VISN boundaries within the continental United States. The care for those veterans that you're talking about is remaining unchanged and associated oversight is still with Southern California as it is current day.

Okay.

And in the Atlantic, sorry, the Caribbean is still with what's current day VISN 8, state of Florida.

So I I want to I guess I want to ask that in terms of the reorganization, what data was analyzed when making the determination to consolidate from 18 VISNs into five? I mean I I ask this question because we are having challenges with access to basic care, right? And and I want to make sure that when we do this reorganization that they are not further shortchanged.

Yes, I completely agree. So this is a fundamental shift in the way in which we currently do things in the VA at the VISN level. The VISN directors and the VISN teams currently have to participate in national level business functions, you know, I'm going to use a loose term here, the bureaucracy aspect of what's necessary in addition to those oversight and coordinating functions for care delivery. So when you look at the big picture, if you just went from 18 to five and had the same scope, that would be a big problem. In the new structure that was completely based on market research for all kinds of entities to include public and private, for-profit, not-for-profit, it was very clear that we needed to have an entity within each one of our VISN structures that focused directly on the care delivery and those coordinated needs at the care level without competing priorities against some of that bureaucratic stuff. So each VISN in the current five structure has three health service areas, their only focus of scope is care delivery.

All right, thank you. I'm out of time.

Gentlewoman's time has expired. Representative Brownley is recognized for five minutes.

Thank you, Mr. Chair. And thank you, Mr. Secretary, for being here. I wanted to focus on women veterans for a moment. So women veterans are the fastest growing group of veterans treated at the VA. And when I looked at the organizational chart from you know, the current organizational chart to the reorganized chart, the Department of Women's Health is not included anywhere. And in the Deborah Sampson bill in that was signed into law in 2021, codified and required that there be a Department of Women's Health, I think reporting to the Under Secretary, which in the new reorganization is not there. So that's a concern for me. I'm not sure how one is going to monitor the improvements that the Deborah Sampson Act demanded in making sure that we are working towards equity for our women veterans compared to men veterans in terms of access to their healthcare.

Yeah, thank for that and I'm going to address that, but I want to address something up front because I agree with you and also by the way, sorry to see you go, we came in together and seeing you go, you've been a great voice in this committee, so I do appreciate that. Look, women's health has been very something I put on the forefront and it we're going to take care of it in the structure, I'll talk about that in a second, but I wanted to highlight a couple of things. We've actually are opening more of our women's healthcare clinics so they have better access.

No, I understand that was required in Deborah Sampson.

Well, the other thing is too is though is I had this year I made the change last year in which we were making our women veterans, if you wasn't aware of this, go through their primary care doctor to get to their OBGYN. They were delayed, we did away with that. They can now go straight to it.

I'm aware.

So with that, I just wanted you to know that and let John see where this is at in the structure.

And quickly, I want to take advantage of my time here.

Yeah, so so women's health is there and the women's health program is under our national programs and it's on our enterprise side of the of the reorganization and that reports...

Okay. Okay. Okay. I want to I'm having a hard time reproductive health obviously as part of women's healthcare within the VA. And I'm having a hard time reconciling when women now make up 20 percent of the active duty military and reserves. If you're in the military, woman's in the military in uniform, she has access to abortion in the cases of rape, incest, or the health of the mother. When she leaves the military, takes off her uniform, comes to the VA now, she does not have access to abortion in the cases of rape and incest and I must say a very confusing definition of of her life being in danger. So talking to women veterans across the country, this is what women veterans want, yet it's being taken away. They serve the military, they have the benefit, they come to the VA, the VA's taken away. I'm having a hard time reconciling that, if you could comment.

Yeah, I'm not having a hard time at all, Congresswoman, and I appreciate it, but this is something that's been talked about in this committee. The the VA up until three years ago didn't do abortions period anyway. So it's the same same happened for under both presidents, Republicans and Democrats. It didn't it's not in our it's not who we are.

We finally did the right thing by changing the regulation.

I would disagree. Again, that's a political difference that we will have in that regard, but it's also a legal difference in the sense that the Department of Justice found that what was done does not follow current law on what the VA can do and that is what we are following.

Okay. I would like to have this argument with you off the dais because it's a longer argument. So the other thing I just want to point out too with regards to the physician's ability to counsel women around abortion. So just to have a complete prohibition and gag order that a physician, even if they're talking to a woman patient who's who is seriously ill and perhaps the option of an abortion might save her life or make sure that she has a higher quality of life later on in her life, yet there's a gag order, a physician can't do that, that it's against their you know, their HIPAA obligation. So I just I again, I don't understand why you would do that, even giving the woman the opportunity if she needs an abortion to go outside of the VA if the VA's not going to provide it, but not to be able to have the physician advise her just seems outrageous to me.

Gentlewoman's time has expired. Cruel. Gentlewoman's time has expired. Representative Barrett, you are recognized for five minutes.

Thank you, Mr. Chairman. Appreciate it. Secretary and gentlemen, thank you for being here for for testimony in front of the committee. Mr. Goins, I wanted to allow you you you had mentioned in one of the earlier questions about some of the changes in how these VISNs typically operate today where they have a lot more of a focus perhaps on the organizational apparatus as it relates to expectations coming out of Washington, the management of the organization that way and less about the actual care delivery for veterans. As I look at the new organization chart, I think the health service areas are going to be the ones that are directly engaged with the management of health outcomes for veterans. Is that true in that sense?

Yes, that's exactly true. So the current state of affairs is a VISN director and their team would be responsible for that plus, as you said, the organizational apparatus requirements that I referred to as bureaucracy.

Yeah, the bureaucracy. Yeah. Yeah, the things that fatigue people to death.

Yes. And the challenge is it pulls you physically away from the space as well. It's an important need, organization of this size, largest integrated health system in the country, we need those functions, no different than a Procter & Gamble or any other organization of this complexity and size. At the end of the day, it also requires you to come to DC to be part of some of these larger group decisions through governance, etc. And for every day or minute you're involved with those kind of things, it's less time you can be engaged with VSOs, local community hospital partners, etc.

Tell me, I come to DC every week. You know, so I feel it, man. I completely get that. And allowing people to be basically assigned to the health delivery outcomes of and and managing the the staff in that sense and the hospitals that are within that, I think is a great way of of elevating that role to the the most important piece that they have, which is ultimately the health outcomes of these veterans. I mean we hear from a lot of folks about, 'Oh, you know, we want to make changes, but we don't want to make changes in in a fashion that that we didn't come up with ourselves' or something like that. Or perhaps we have a pride of ownership of who came up with these ideas or how the structure's going. A chronic frustration I have here in Congress is that we never seem to be ready to make changes. It's always not the right time to do it. Are we going to wait and do it a different time? These have been things that have been talked about, as you pointed out, for decades to bring about real and systemic change to veterans for their health outcome. I can tell you candidly, I I have been a veteran for 23 years now. Since I was 21 years old. If you had asked me when I was 25 what a VISN was, I would have had no idea because I didn't need to know. It wasn't relevant to my actual interfacing with the VA. It's relevant to the management of the organization, but our veterans deserve to be able to walk into a VA, get the care that they need without being fatigued by which VISN they're in and what you know, process is being followed. To have somebody that is assigned to their health outcomes in a much more focused and exclusive manner should bring about better outcomes for them and I certainly hope that it does. I did want to touch on though Secretary or either of your panelists joining you, I got to bring up the EHRM rollout in how that will interface with this realignment of VISNs. And what type of expectation we have there and if we can be satisfied that that will go on unencumbered with this change that you're talking about as well.

That is one of our most important pieces as we go forward, not only for direct care but also community care in the future is getting a EHRM, which again will go live April 1st in the four April 11th. Yeah, in in Michigan. But it's it's on track and I think that it aligns with we've aligned it with the VISN structure as we change. And the rollout hopefully is it's we're successful as it looks like we are going to be in these 13 this year will actually help with momentum getting into the other areas as well, possibly quicker.

Okay. I think...

Can I just add to that just so we're perfectly clear. We have worked with the Deputy Secretary's office as the one designated as the owner for EHRM rollout. Secretary Lawrence? Yes. And on the operation side, we have made an agreement through the Under Secretary Bartrum that we will make sure that the schedule that's already been published is completely considered and unencumbered as we do the reorganization. Again, this is an iterative phased approach and we are not in a hurry to just blow things up.

So even though we're doing EHRM by the current VISN structure rollout, it will not be impeded or or affected by the the change that you're proposing.

Correct. In addition to the the continuity of care priority, that is our second highest priority through the reorg.

Okay. Thank you. I I'm almost out of time, but I wanted to share briefly with you the reason why this is so important. My father-in-law came to visit from Oklahoma to Michigan over Christmas. He gets his healthcare through the VA. He had a diabetic sensor on his arm that battery died or something. I think you all helped us with that, but they couldn't coordinate between the two VA hospitals to get him that very easily.

Gentleman's time has expired. So looking forward to that rollout. Thank you so much. The gentleman from I'm sorry, Mr. Pappas, you are recognized.

Thank you very much, Mr. Chairman. Mr. Secretary, it's good to see you and I appreciate the recent visit to New Hampshire. I know that veterans appreciated the fact that you were on the ground and getting familiar with some of the unique circumstances that we face at our medical facility in Manchester. It's obviously an old facility, it has infrastructure that has failed on many occasions that have put whole areas of that facility out of commission. During your visit, we talked about the ongoing action plan and feasibility study to talk about delivering a full-service VA hospital for the veterans of New Hampshire. We're the only state in the lower 48 without a full-service hospital, a designation that we lost over 20 years ago. It was due to the President on November 5th of last year. And I'm really interested to know if that plan was delivered to the President and where things stand. Veterans in New Hampshire really interested in getting a read on that.

It is good it was good to be with you and it's also I think one of the things is and I just say this as a blanket statement. If you've not visited a VAMSI or a facility and you're on the committee, please do so. Okay, I'm not I'm saying that to Republicans and Democrats because you get a better understanding of what's going on. I've done I've done over 30 states and almost 75 of our facilities, various from VAMSIs to Vet Centers. By the way, go to Vet Centers, they need to be. VAMSI in yours is a unique situation that goes to an earlier comment about our construction issues and how it's why it's taking so long. That has been delivered to the White House. It is at the White House now for the final processing and we hopefully to have a an answer out of that in a very near future.

Can you characterize it at all and let veterans in New Hampshire know? Is this a menu of options? Is it one recommendation? And is the President the decision-maker on this or is it the department?

Well, we're going to let the process the White House process go through it. I'd rather do that than have to come back and then be accused of saying something that you know wasn't true or it wasn't as a plan that came out. So it's it's with them and we'll get that out.

They've been waiting a long time and I appreciate understanding what's going on here at the earliest moment that you can provide that.

The gentleman I work for actually made the promise, so it's coming.

Great. I want to move on to another issue that we've been dealing with on our Economic Opportunity Subcommittee. It's the issue with Chapter 35 education benefits and a gap that occurred last fall that was very severe. We were hearing from veterans in our office, people who had trouble paying their rent and paying their prescription costs because their tuition bill wasn't paid. And so I'm just wondering if you can provide some more insight into the breakdown there. It was a month and a half where veterans were in the dark. Congress... ...was also left in the dark. We had letters that went unanswered. I appreciate we received a letter yesterday that we sent over to you on December 15, I believe, initially asking for some further detail. But it's inexcusable for veterans not to have this basic information about where these payments stood. And again, you talk about the shutdown, that's the excuse that we received, but the Anti-Deficiency Act is pretty clear that in situations that involve the protection of property and life and making sure that veterans get access to benefits that they should have been receiving an answer on this. So I'd like you to address that.

Happy to on that. Yes, that was a problem, frankly, that was that we received, we dealt with it. It came from a manual issue from basically going back to 24 that rolled into 25, we saw that. At this point, that has been transferred over and most are getting there almost same day on GI benefits. They're getting the GI Bill is working.

But it's really the communication that I think...

Well, the communication was, look, I don't disagree that always communication on any level from both sides could be better, okay, on anything. And I face this every day in this job that I take because I have to get the same information, I have to ask sometimes multiple times to get it. The issue that we have here, though, is, and I know that it was a concern and I understand your issue with the shutdown, but it did hamper us. We were getting benefits out, but when you're down to one or two people when you're normally having a lot more people to do it, it does slow the process down. And we were doing what we were supposed to under law, but we had to do it under also the burden of a shutdown that lasted longer than any in history.

Well, you eventually during the shutdown did communicate with veterans in late October. But again, this was a month and a half after the problem was discovered and veterans were left in the dark here coming to us for answers that we couldn't get out of the department. And I just know that there are going to be other instances in the future where there are systems that are migrated, where there are gaps and disruptions to benefits, and veterans deserve answers at the very least. I want to move on to one final issue, and this is an issue that I raised with you in your last appearance before this committee around VASP and the partial claims program. You said at that time, I think the first step is that Congress needs to act upon this. So we took your advice, we passed a bipartisan bill, but it's been six months since the partial claims program was signed into law, hasn't been stood up yet. I've got veterans that are asking when they can get relief. Can you give us an answer on when we're going to be able to see that program put into place?

Yes, that is being done now. We've got the it is being done and it should be done shortly. We did have to integrate it in with the current system that we had. You'll be getting an answer on that very shortly.

Thank you. I yield back.

Gentleman's time has expired. Representative Mace, you are recognized for five minutes.

Thank you, Mr. Chairman. I want to thank the Secretary for being here this afternoon as well. The Ralph Johnson VA Medical Center, in partnership with the Medical University of South Carolina, continues to play a crucial role in improving the lives of veterans throughout the Lowcountry. And I kid you not, I had a call this morning from a veteran praising the Ralph H. Johnson VA facility in Charleston, South Carolina as being a model facility that they get about 70 percent of their care there, and they are a cancer survivor and they're just truly grateful for the example that the Ralph Johnson VA Center in Charleston is for other veterans facilities and medical treatment around the country. The location of the Ralph Johnson Medical Center has been critical to improving outcomes for veterans and conducting high-quality medical research. After a 60-year track record in downtown Charleston, I was deeply disappointed in the VA's decision in 2024 to deny a flood plain waiver for the lease of a replacement research facility. We get a lot of flooding in Charleston. If it sprinkles, it's flooding. And we want to make sure that veterans have access to the care that they need. So last year, Secretary Collins, I wrote to you asking you to reconsider this denial and you declined to do so. So may I ask you today what led you to make that decision to deny this waiver?

Congresswoman, I think the biggest thing is we one of the things you brought up, one of our best, it's not just in the top few percentage, it's probably in the top two or three of the whole system Charleston is. The same things that denied the first time are the same things that we go back on is the issues that we have to deal with when you look at long-term and where we have to build and how we have to build in a flood plain or not build in a flood plain. This has been there's other been other options that are available and we're looking at those other options then going back into this area.

So you won't reevaluate this decision?

Not at this point, no.

Okay. Can you assure that care for our veterans won't be affected?

I mean, that's the first and foremost thing we do.

Or be interrupted?

First and foremost thing we do.

So without this waiver, I mean, care potentially could be interrupted for veterans.

I would disagree with that characterization. It could be disrupted for many reasons, not this one in particular.

But you don't think this is just a simple tweak we can do right now temporarily even?

In the Congresswoman, I understand the situation here, but here I'm just going to play it out.

Are you going to move the Ralph Johnson VA facility? Or I mean...

No, that's not necessarily let's deal with the point here. Here's the issue. Let me just take it out a step further. I issue we issue a waiver and then five years from now it floods. Okay, I have to look at the long-term process of how we do this.

And five years from now what? Five I missed that.

Five years it could flood in the flood plain where we put it.

It could flood tomorrow.

It could. That's why we don't put it there.

But if we're talking about ingress and egress of a facility, you know, that to me seems like a not a major, you know, infrastructure issue that it's not my biggest concern is getting quality care for our veterans in South Carolina. Secretary Collins, the Ralph Johnson Medical Center hasn't experienced the staffing shortages per se as other facilities have. To what do you attribute the success of the Ralph Johnson?

I think it's just it's leadership, and that's what we're looking striving for across the board. One of the things that has happened and as the standards have been set on our leadership, we've allowed our many times our VA medical centers, which oversee also our clinics, have been paralyzed into being non-senior leaders. Okay, the fortunate part at Charleston is they have acted like senior leaders, they've made decisions and they put those first. We've not seen that across the board. Greg Goins, who was a VISN director, saw this firsthand. He's been had a lot of input across with Secretary Bartrum as well because we just again, we're now putting it back into the place where we have leadership so that one of the things we have right now is a dashboard that allows every hospital to see how they rank with every other hospital. So if they're down in something, they can go to a Charleston and say, hey, how do you do this? How can we get better?

I love that.

Can I add to that? I can tell you definitively based on my experience, the secret in Charleston is the leader. Scott Isaacs has been in place for a long time. We have a lot of really good leaders in the VA, frankly, but we don't have a lot of really good leaders with longevity. So the issue that has been so prevalent in Charleston is because of the longevity of Scott and a vision he's been able to set and execute.

Scott Isaacs, he's been wonderful, actually. He was the one that told me that the VA does outpatient care with our geriatric patients, and he actually put my father and one of my family members in a program and outfitted the bars in the in the hallway and the scooter and the walker and all those things that I didn't know veterans could get as they're aging, and I have been amplifying and spreading that to every aging veteran that I know to get that high-quality care throughout South Carolina. So I want to thank you, Secretary Collins, for being here today and answering my questions. Thank you so much.

Gentlewoman's time has expired. Representative Cherfilus-McCormick, you are recognized for five minutes.

Thank you, Mr. Chairman, and thank you, Secretary Collins, for being here. Before we talk about innovation and administrative restructuring, I really want to point out what's at stake. Recently, last week in my district at our VA, we actually had a veteran suicide. One of the workers went outside and shot himself in a parking lot. For every veteran who's watching, for every veteran who came to my office yesterday crying and scared about what's going on, and our responsibility to protect our veterans, it increases my responsibility to scrutinize this restructuring. And I think we all understand that. Right now in Florida, when we look at the VISN, it actually adds Florida with five more states. And so there's a lot of concern there that are our veterans going to be able to get the help that they need. Right now the wait time is 31 days. So there's a lot of concern about this grouping. And I've heard your explanation already of how this is supposed to work, but for our veterans who are watching right now, who are very scared, could we say it in layman's terms of how this is going to get better as we're grouping a complex state like Florida with five extra states?

One, I'm going to answer it from the top level and let Greg or John, whichever one wants to answer this. The top-level aspect is, is with the HSA structure, they're actually going to get more care. But also the biggest part about this reorg I think that's missing sometimes when we talk about this, and I appreciate your discussion, is that we're missing that this is not affecting how the hospitals in the VISNs themselves the hospitals and clinics operate. We're giving them more freedom, more latitude. Y'all have some of the best programs for food down there. I'm championing that all over the country with the food. If you've never seen this, encourage you to talk to her. They have Amazon boxes basically where they get food. And suicide, let me because you brought it up, let me right. I get those reports. There's nothing that bothers me more than those reports. That's why we have redone the entire suicide prevention program. That's why we're now looking we're actually doing outreach to those who are not being cared for in the others. John, you want to jump in real quick?

I'll pass it over to Greg in a minute. But ma'am, the you're absolutely right that we have that we have to do this reorganization to make sure that it's consistency across the facilities. Right now, when you saw the org chart that my friend from the Navy had put up, the Congressman, that showed all the disjointedness. So if you're running a facility right now, you don't get consistent information. And so we've all heard the adage, if you've seen one VA, you've seen one VA. We need to have the adage that when you go to one VA, it's like all the VAs, because we have to have consistency of policy and consistency of application.

So this kind of brings me to my concern. My time is running out. Because every VA has been unique. And when we see the uniqueness, we haven't seen any streamlining actually going on before this reorganization. You know, we talk consistently about making sure that we have standardization. And we haven't seen any real standardization being incorporated or being successfully incorporated. So lumping all five is concerning. And before we go to that also, when we look at the VA, the VA is a unique structure. Part of that is learning from the lessons, the past lessons, as we go forward. Such a big reorganization is it's disruptive and we all know that. But if it could work, if we actually had real steps in place that we could scrutinize feel comfortable with, I think more people, but that's actually lacking. So as we shift the conversation and you talk about it, I do want to see if you've actually incorporated some of the nine steps that the GAO recommended when actually restructuring and to make sure we're learning from our past mistakes.

So let me let me say first that I agree completely with everything you've said as far as the criticality of this, as far as how we do this and how we go about it. One of the biggest pieces in order to make this successful has to be frontline voice, not just from veterans, but more importantly from the frontline employees that are actually caring for veterans and the frontline leaders. We have done that twice. We had over 300 leaders, every single hospital director in one room at a time. The sole purpose of that is to create a plan that has exactly the details that you're looking for. And we're continuing to develop that.

And so as my time is running out, I just want to know specifically about this GAO document that highlights of the GAO reform. It talks about the mergers. It has nine actually policies and steps in here. Have you seen this document and have you incorporated anything from it?

As we develop the plan that I just mentioned a second ago, all aspects of those types of reports, GAO, OIG, etc., in addition to the original documents when the VISNs were created are going to be part of the action planning that is associated with our future state and how we get there.

So I'm assuming that you're going to fully incorporate it so when we get a plan that's more detailed, that we'll see everything in to have more confidence in it. If as of right now, because we don't have that kind of information, I think it creates an anxiety, not just amongst us as legislators, but also with our veterans. And so we would love to have a real plan so we can actually meet the needs of all of our veterans. Thank you so much.

An outcome of of the work that's been going on to incorporate frontline feedback to in addition we've met with VSOs, we've started to work with Congress the way that you've heard the Secretary talk. All of that will be incorporated in it. In addition to that, there should be references and there will be in that plan to the things in which we're referring to to include the report that you've got in front of you.

Gentlewoman's time has expired. Representative Kiggans, you are recognized for five minutes.

Thank you, Mr. Chair, and thank you so much our panelists and Mr. Secretary for taking time to be here and for what you're doing to support our veterans. I represent Virginia's Second District, so home to a large Navy population, large veteran population, and it's so nice to have my my neighbor and colleague Congressman Scott here. Our VA Medical Center actually sits in his district, so very very nice to welcome him. But you know, I I want to thank you also for the work you're doing with mental health, that's that's certainly a priority of mine. I don't know how many of us who sit on this committee have had the privilege of actually working at a VA facility. As a nurse practitioner, I spent three months working in the Hampton VA when I was a new nurse practitioner, and one of the reasons I left was because I didn't touch patients. I did a lot of administrative work. I was losing my clinical skills. So and I would walk around on my lunch break and see buildings full of people, and I didn't know what those buildings were doing, what those people were doing. I spent some time and would find the one geriatrician who we had on staff and shadow her for over over my lunch breaks just to keep up with my clinical skills, but she was overwhelmed. The physicians there were overwhelmed, the nurses there were overwhelmed. They were doing the bulk of the work of actually touching patients, talking to patients, caring for patients. Those are the people we needed more of. I didn't know what was happening in all the other buildings. I I still don't, even when I go back there. So I applaud your efforts with this restructuring. I know change is hard. I know you have to be brave and it takes courage and and you're going to take some heat for that, but thank you, because the picture I saw, and again, I was just a a lowly nurse practitioner, but but there was so much room for improvement. So I think the time is now to do that. I wanted to bring my questions a little bit closer to home and ask about the Hampton VA. I know we had a lot of leadership changes there over the past couple years. We still are do not have a director position that's filled. It would be great to put new leadership in place. I know we did a lot of work just to to change, you know, the current leadership that that we felt was kind of a root part of the problem. But but what are you doing and can you tell me the timeline for that leadership replacement?

Thank you for that question, ma'am. You're absolutely right. We are in the process of putting out a advertisement. I'm anticipating from our HR team that the advertisement will go out this week at the latest next week, and then we'll start the process for advertising for a new leader at Hampton and and a number of other sites as well.

So to that end, just so I can try to help quell some of the fear that I can detect in your voice, we do that nationally. So that's what Under Secretary's talking about. However, there's a process to get it done and in the meantime if there is an issue with Taquisa Simmons' detail needing to expire or needing to be extended, we are committed to make sure that we have long-term leadership longevity prior to that selection. So should there be extended or we will go through a process to find a qualified leader in that place.

It'd be great to put permanent leadership in place. I think if we're looking for culture shift or looking for just, you know, a direct new direction to solve some of the problems we have there. It's a great facility, but I just want to make sure that permanent change is made.

Yeah, Congresswoman, I also want to say and this is to everybody on the committee, we are one of the things that was disheartening to me when I first came in was how many interims we had sitting around executive leadership teams across the country. I have made a very concerted effort to change that at all of our facilities where you're getting at least the director, the executive director, the chief of staffs, those are permanent so they can make real changes. And what we're having to do right now, though, is frankly because we've not done a good pipeline, we're having to move some people in to fill gaps while we develop that pipeline. But that's that's my top goal is to get those permanent.

Okay. Thank you. I appreciate prioritizing that as well. And then my other question is about our great new facility, our North Battlefield Clinic in Chesapeake. And and I know, Mr. Secretary, you were there at our ribbon cutting. Thank you for coming down for that. And and I understand why we didn't open our doors and have have all the providers in all the places and that we were working on building up that patient base and it made sense to me. I know that our goal was January to have have it at max, you know, max capacity for staffing and that we're we're now in February and and we're not quite there and and I know, you know, we've addressed it, I think my colleague, you know, Congressman Scott's addressed it as well. But can you tell us what the timeline is for for adequate staffing or full staffing, I guess I should say, at that facility because it's a beautiful new building. I know that our veterans are using it. I know there's a provider shortage on the nurses and physician side, but what are we doing to make sure that facility is fully staffed?

Everything we possibly can. And I think that's the issue that I appreciate what you said there at the very end because that makes it very determinant we'll hire as we need. There's 534 allocated positions built, we've built those positions out. There's 335 that are encumbered. 199 that are vacant. Out of those 199, 166 are in active recruitment right now. 27 are pending, five are pending just getting back to us. But let me also state that that facility is now doing every service it was provided to do. They're doing the service and we will ramp up the amount of service as we are able to hire and get away from other, you know, facilities to hire these people. So it is doing what it's supposed to be doing, this is where we're at.

Great. Thank you for prioritizing that as well. And I yield back.

Gentlelady yields back. For the advising the committee members, Representative Ramirez, you're going to get five minutes. Everybody else we're going to cut it down to three so everybody will have the opportunity to at least ask questions before they're going to call votes and and we've got that hard out. So I've talked with the ranking member and he's in agreement with that and so we're going to do it that way. You're recognized for five minutes.

All right. Thank you, Chairman and ranking member. We'll keep it tight. Mr. Secretary, it's good to see you again. So I want to get straight into some of what we've seen in this past year. We know that VA workers have been stripped of nearly all their labor rights. The department is struggling to staff and deliver services to veterans. Proven programs have been gutted while promising new more effective solutions. And the Department of Homeland Security is kidnapping and deporting veterans and executing VA employees in broad daylight. And yet folks seem unbothered. I've come to believe that's because employee retention and satisfaction, quality service delivery, consistent outcomes, and veteran protections aren't actually the goals of the VA. The truth is that it doesn't seem like you care about those things. Your mission, I'll be frank from what I'm seeing, is you care about pleasing this president at advancing his privatization to profit agenda. Look, I want to take your words after Alex Preddy was executed by DHS. You used your statement to blame Minnesota state and local officials for a murder perpetrated at the hands of federal agents. And at a time when accountability, integrity, honesty, and courage were needed, Secretary, you peddled some of the same trash that DHS was peddling, even though your responsibility is to lead the VA, not to do the job of DHS. So I want to ask you a couple questions. Secretary, did you talk to Secretary Noem or the President or anyone in the administration about Alex Preddy? Yes or no?

I have not talked to anyone about that in the administration.

Okay. Well, let me ask you, if you would have, would you have talked to them about how he cared about nation the nation's veterans as he took care of them in hospitals?

I'm not going to engage in hypothetical conversation.

Okay. Well, let's so you haven't talked to them and you are not going to talk about hypothetical standing up for Alex. So Mr. Secretary, let's see if there's some care now. Would you call for Secretary Noem to resign given her execution of a VA employee?

I have said all on this issue that I'm going to say and that will be my answer.

Okay. You have nothing else to talk about it. Okay. Got it. So I want to then pivot and talk to you about deported veterans. Let's take your words on VA's role in targeting non-citizen veterans. In a letter dated January 13, at the same time that you recognize that your mission is to serve all veterans, you also admitted that you're sharing non-citizen data consistent with interagency agreements. Has your agency assisted in the deportation of non-citizen veterans, Mr. Secretary? Yes or no?

That comes from a report that has nothing to do with sharing the legal status of veterans. That actually comes...

Secretary, has your agency helped deport veterans? Oh, you're not going to answer the question. Do you want an answer or not?

Do you want an answer or not? Then yes, no is not an answer.

I do, but you don't seem to and you've been here long enough to know that. Then it tells me that you're trying to cover up the fact that you are assisting. I'm moving on and I'm reclaiming my time. Well, I can sit here and talk...

Gentlewoman's reclaiming her time.

Let's continue. Mr. Secretary, so let me ask you another question. Are you ensuring that deported veterans are still receiving their benefits? Are deported veterans still receiving their benefits? That's a pretty simple yes or no.

[Crosstalk.]

Yes? No? [Crosstalk.]

On that question, I'll be frank with you on that question, the depending on their legal status and everything how they'd actually get veterans benefits we'll have to see what that actually says.

So you don't know. Okay. Okay. Then let me move on. I'm not like you, I'm actually answering honestly. I only have a minute and 26 seconds. Actually, I'm being very honest. It was a yes or no and you don't know if they're getting their benefits or not. So I want to talk about VA workers now. Secretary Collins, let's take your words on VA workers. At the same time that you said VA employees need to be singularly focused on veteran care and services, you dragged VA employees as too often fighting against the best interests of veterans. In your crusade against VA labor, you have illegally terminated collective bargaining rights, ended unpaid parental leave, and terminated the use of FMLA for in-law care. And yet people seem to be running to work at your VA. I almost applauded you for reducing the time to hire a VHA employee from 109 days in 2024 to 47 days as of last month, but look, I took a closer look at it and I realized that it's smoke and mirrors. Unlike your predecessor who measured the time to hire as the number of days it takes for a new hire to start the job, you are measuring the number of days it takes for an applicant to receive a tentative job offer. And that is why we can't trust anything that's coming out of your office. It is clear, Secretary Collins, that you don't care about Alex Preddy. You certainly can't even respond to a yes or no basic question about deported veterans or the workforce. You have no commitment to accountability, to integrity, or to honesty. And you cannot be trusted to do the reorg of the VA because just like that time to hire board, you peddle lies, half-truths, and misinformation. Look, this is what I'm going to say to you. I only have two seconds. You will be held accountable.

Gentlewoman's time has expired. Representative Hamadeh, you are recognized for five I'm we're going to go to I'm sorry, I need to tell the timer this. Staff's conversation we're going to go back to five minutes. Staff had agreed back and forth so we're going five minutes, we'll go as far as we can go. You're recognized.

Thank you, Mr. Chairman. Secretary Collins, thank you for being here today and first of all I'd like to say something that you're not hearing enough of. Thank you for your service to our veterans. I hear the great work and the improvements that are happening in my district. And what you're doing to reorganize the Veteran Health Administration is not, you know, it's necessary, it's responsible, and it's long overdue. Now for years now the committee has been handed report after report by the GAO and the IG from the Commission on Care, all saying the same thing that the VHA's management structure is broken. Too many layers, too many redundant bureaucracy, and what should be decisions that take a day becomes one that takes even months. So now you and the administration are finally doing something about it. And certain members of this committee want to pretend like the sky is falling. Well, Mr. Secretary, let's get some facts on the record. Now this chart behind me compares two lines over the same time period. The VHA's workforce increased by about 14 percent between the fiscal year 2019 and fiscal year 2024. And the patient encounters, it grew by just 6 percent. Workforce expanding at more than twice the demand for care. And that's not a staffing crisis, that's an imbalance. Mr. Secretary, this chart speaks for itself, but I want to give you the chance to speak to it directly. Can you walk through this committee about what this data tells us about VHA staffing?

I can and then I'm also get you some more color on that. But also I want to say for this committee first and foremost and it's been said many times, the only thing that I have on my agenda is a veteran. Period. That's what that's what started the change to good at the VA last year when I said the only thing that's going to come first is veterans first. And our workers now have a purpose. And our workers know what they're doing and they've actually improved. And I'm proud of that. And I'm not going to take nameless names and programs that have been gutted supposedly that have not but not being given a chance to answer to. This is an issue that we have that is the heart problem of where we are. In this town, it's throw money and people and everything gets better. And that's just not the way it is. 14 percent over over six. It actually is worse in some areas and I could go list by list by everybody's you had some that increased 30 percent in FTE counts but yet only that actually went negative in actual touches of people. This is something we faced in the field. Greg is had to deal with this and he's one of the reasons that we came forward on how we deal with this going forward and why this restructuring is needed.

Thank you, Mr. Secretary. So one of the things that's very objectively clear, and this goes back to ranking member Takano's question earlier about does the VA have enough employees or enough staff?

The short answer is at a totality level, probably pretty close. What is not true, though, is that there is an absolute imbalance. There are places where we do need more physicians and there are places where we have plenty of staff. And the short answer is if we don't go through with an evaluation from a demand basis, we do not have an ability at a national level to address resource needs where there are growing veteran populations. That has never been able to be done in the past at an enterprise level.

So in other words, making sure that tax dollars are not tied up in excessive administrative overhead, but instead redirected to frontline service, modern equipment, and facilities that actually serve the veteran. Now you're undertaking a new request for proposals for entire veterans community care network, VCCNs, correct?

We are in the process. It's in our RFP now so I can speak to what we have as you had the hearing on last week. I'll speak to that realm. And what confidence can you provide to this committee that the next generation of TPA contracts that the administrators will be held accountable for basic network integrity? I can't tell you how long I've been waiting for that question to come from this committee. Um, and in a very earnest way because many of us who have done this for years and I was a part of the this committee and there's only about four of us on this committee that can say this actually voted for Choice and actually voted for Mission, uh, which set this up. What we did not know at that time was because we were trying to get help to a from a bad situation of wait times and issues. We set it up as quickly as possible and frankly, I can just say from a bigger perspective, we had very little takers on helping us. We ended up with Choice Act was a disaster. Mission Act has put us into two vendors third-party access and there was nothing in the contracts that were holding account let me rephrase that. There was, VA just didn't hold them accountable. One of the reasons that I'm I'm confident in this RFP that is out right now and in when it goes through is that we have basically 10 years of failure to learn from. We have 10 years of why this doesn't work that we incorporated those problems into this so that we can hold them accountable, do better management, and make sure that we're doing not only what's best for the veteran but what's best for the VA as well. So I have full confidence when this comes out that we're going to have much more participation, but we're also going to have 10 years and and I'll go back to where the ranking member and I'd agree on, history does teach us things. This one is a big one where history has taught us things that we need to add on to it.

Thank you, Mr. Secretary.

Gentleman's time has expired. Representative Kennedy, you are recognized for five minutes.

Thank you, Chairman. Good morning. Mr. Secretary, you're asking Congress to accept a VHA reorganization that had moved 4,000 to 5,000 employees while the workforce is already strained by the deferred resignation program, attrition, and hiring disruptions. The VA has the data of the workforce. I requested back in August a detailed description of the employment changes and impact in Western New York for the Buffalo VA in the health care system for VAs. I received a response from you in October that was vague and did not answer any of the questions outlined regarding staffing levels. Will you commit to me today to provide the data that I asked for back in August to my office?

Yeah, we we are working that right now and can discuss that as far as staffing levels go.

Is that a yes? You will give me you will give me...

I just said that we will give you yes.

You will provide me the detailed description I asked for? ...was occupation, job title, grade level, facility, reason for departure, whether the employee was retirement eligible, participated in the deferred resignation program, or whether the employee was terminated. The idea that it's been about six months, Mr. Secretary, that I haven't gotten a response and you're asking us to buy into this reorganization is unacceptable. Please.

Yes, Representative. We can commit to getting the data and the information. One of the things I wanted to highlight and just highlight really the issues that we've been facing collectively, and I think Representative Kiggans really kind of mentioned it. There she was, a trained nurse that was doing administrative work. So when you talk about what somebody does and what positions we have, we don't even know what they're doing. So the ability for a bottom-up delivery of medical centers actually restructuring and reorganizing and identifying their requirements and outlining their personnel, we'll be able to look and identify. Up to this point, we haven't had the ability to do that. We weren't tracking. People hired, people all over the place, people were nurses not doing nurse jobs. This is exactly what we're tackling. We'll get you that information.

Thank you. I would like to enter both of these letters into the record, Mr. Chairman.

Without objection.

I do want to focus on the workforce impacts already hitting the Veterans Health Administration. The reorganization again comes at a time where tens of thousands of employees have been lost in the last year: doctors, nurses, mental health professionals, police officers, forcing facilities to close hundreds of beds because of the lack of staff. VA has eliminated vacant positions, pushed full steam ahead with changes that risk driving even more experienced staff out the door, and failed to provide Congress up to this point, and we'll take you at your word here today that you'll provide clear, detailed workforce data. I'd like all of the data, quite frankly, obviously for my own purposes in Buffalo at the VA in Western New York, but I think it's important that every member of this committee at least has information regarding their own VA to the same effect that my letter outlines. Secretary Collins, for each of the VA's three administrations, the VBA, the VHA, NCA, what's the total amount of paid salary benefits and terminal leave under the deferred resignation program, and what accounts were used to cover those costs?

I would just say, Representative, the standard personnel accounts were utilized for those folks. So we budget when you look at the FTEs that are budgeted for personnel throughout the year, that was the resources that were used. Those people remained on VA rolls through the end of the year or through the termination whenever they left the service. So their traditional salary was utilized as far as our standard personnel budgets.

So was there money that was diverted from other accounts without informing this committee?

I think I just answered that it was the standard personnel accounts that would have been used to pay them in any regard. So, yeah, the answer is no. There was no diversion. It was their standard personnel accounts that were already programmed for.

Okay. Well, we don't have that information because you never provided it. So again, that information is vital for us to not only make these determinations but to be supportive of this restructuring.

Congressman, could I answer one part of your question? Your Western, you mentioned your Western New York facility. Right. It had over the past five years, it's had a 7 percent increase in FTE and a negative six encounters. It's actually went backwards. That's just one of the workforce...

Gentleman's time has expired. Dr. Miller-Meeks, you're recognized for five minutes.

Thank you very much, Mr. Chair, and I thank Secretary Collins for being here as well. Mr. Secretary, this reorganization is supposed to correct decades of weak oversight and inconsistent leadership across VHA regions. And as we saw, one of the purposes and the momentum for the MISSION Act was because of VA deaths and waiting lists that occurred, some up to nine months for diagnosis and treatment of cancer. So that led to reorganization, if you will, or the MISSION Act implementation of the MISSION Act, but yet there was no accountability. So can you give this committee your word that you will avoid promoting any VA employee with a poor performance history or documented oversight failures into senior roles under the new structure?

That is one of the things, and I appreciate the discussion here because you're getting, I know that everybody believes that we're taking this in a big picture, but I'm traveling, this is the multi-headed snake, so to speak. I'm having to address the facility needs, I'm having to address leadership needs, but yes, we are putting into place now to where I actually have a structure that can actually do that, that can actually get us to a position where we can have strong leadership and mentoring as we go forward. That is our intent and purpose of this.

The reason I ask that question is under the previous administration, under the Biden administration, very early in my time in Congress, we had a hearing in this room in February of 2024 after a young female whistleblower had contacted the minority party, had not had any action, contacted Chairman Bost. Chairman Bost then requested information from the Secretary. After 45 days and a personal phone call, had no information. We had to subpoena to get the information. Now, the whistleblower was reporting on sexual harassment by her senior leadership. This was senior leadership of the Office of Resolution Management, Diversity, and Inclusion, which has a zero-tolerance policy for sexual harassment. And no investigation was taken. And through emails and texts that came out after being subpoenaed, we found that the Secretary had, in fact, arranged for a soft landing for the Assistant Secretary responsible for ORMDI, and in fact, that person was effectively promoted into another job, so was the senior leadership of ODMI, one of them, and then another retired. And in testimony, Secretary McDonough said, there is no question that I failed in this instance. None of those individuals were held accountable, and this poor woman was made to suffer and was disbelieved in her allegations of sexual harassment. So Mr. Secretary, if this reorganization is truly about accountability, will you commit today that no individual with a substantiated record of mismanagement in prior OIG, GAO, or internal VA reviews will be appointed to lead any offices that have decision-making powers and therefore institute accountability at the VA?

My goal is to, Congresswoman, is to do exactly that, take into account the entire record and going forward as we go forward.

Thank you, sir. Mr. Secretary, in your testimony, you specifically cited OIG reports as a foundation for this reorganization plan. Are you applying the same standard to personnel decisions and reviewing past OIG findings when selecting candidates to lead the new VISNs, HSA, and operations?

We're taking into account everything that we can to find the best possible people in that regard as we go forward in this, and I think that's going to be our guiding light: are we actually getting the right people in the right places?

Thank you for that. And prior to what I heard earlier with one of our colleagues on the other side of the aisle, I have worked in the VA both as a nurse and a physician. I've applied for jobs at the VA, so both nurse, physician, and military veteran. And let me just say, it took nine months for that application at the VA, by which point in time I had dozens of offers elsewhere. And so let me just say that 47 days is a monumental achievement, and thank you for that, and thank you for working on hiring at the VA because it is a morass and we are losing good people at the VA because we can, in the previous administration, could not process applicants or give them job offers rapidly enough. And I know of two other physicians who had that same problem. So thank you so much.

That is something we're working on right now. When I was in uniform just a week ago, we had a lady who got a year later, got a call back and said, hey, we're ready to talk to you now. We're fixing that, 30 days or less.

Gentlewoman's time has expired. Quick piece of housekeeping here. In accordance with the committee rules, I ask unanimous consent that Representative Wasserman Schultz from Florida be permitted to participate in today's committee hearing. Without objection, so ordered. Representative Budzinski, you're recognized for five minutes.

Thank you, Chairman Bost and Ranking Member Takano for holding this hearing. And thank you to Secretary Collins and your team for being here. You know, I want to just kind of cut to the chase here. I really think over this last year what you've done to the VA is really hollow it out. This is cutting to the bone, it's not trimming fat. And it is really hitting VA employees, union employees, the hardest. You've stripped their collective bargaining rights, damaging their morale and dignity, leaving employees wondering if their jobs will be cut next. And I just want to point out none of that is done to service our veterans. This isn't happening as work is slowing down, of course, within the VA. It's happening while VA experiences the largest expansion of VA healthcare and benefits in decades thanks to the passage of the PACT Act. It's happening as VA is restarting one of the largest and most complex EHR deployments in modern history in just over two months. And I wanted to point out I've been asking when is the VA going to nominate a CIO, something that would be a critical leadership position to ensuring success of this EHRM program. We still don't have that. That's a really important leadership position. And now you're proposing this massive reorganization without consulting Congress first. I have serious concerns with how this reorganization could impact that already ambitious rollout. I support efficiency, but it should not and it should never jeopardize success, and most certainly not at the expense of our veterans or VA employees. Mr. Secretary, I'm concerned about your plans to initiate a VHA-wide reorganization at the same time as you've accelerated the deployment of EHRM. I'm looking at an email, and I can show it to you, from the GAO that says that you've canceled your standing meeting with GAO, an independent body who performs critical oversight on the EHRM program, because, quote, your leadership and resources are strained. Is that true?

We will take meetings as need be, but we're the things that we get, we'll meet with GAO and we meet with those regularly. We're answering every GAO or every OIG report that we get.

But they have made recommendations on solutions that will help to make the EHRM deployment successful and you've decided to just shut down meeting with them.

I would disagree with that. Most of the GAO reports, in fact, almost all of them dealing with EHRM, dealt with a system that doesn't exist anymore. They said what was wrong with the system that was rolled out in Washington state, which was, and I'll admit to you right here, was an absolute utter mitigated disaster. So here's the issue: if you have a new program coming in in which you've redone and reshaped how you're doing it, there are lessons that we learned, like standardization issues, standard, the problem we had in Washington state was is we allowed every hospital to decide what they wanted to do. Every doctor got to decide how they wanted to...

That's great. I only have two minutes, Mr. Secretary, so out of respect, I just, we just provided you with the email from the GAO. So I'm hoping that what this will shed a light is that it is helpful to re-engage the GAO and work with them on solutions to make sure that the EHRM program is successful.

I look forward when it is rolled out to, I'm sure that they will have plenty of time as it is rolled out because there's nothing really to report on right now.

Okay. There's a lot to ask of your workforce, a workforce that will note I will note has gone through a lot of changes over the last six years. And I do worry, and you brought up some of the cases in Washington state with the EHRM program and the struggles with that. They were not the only ones to identify and deal with many of the issues with this new system. What do you have to say to the hardworking employees who are now facing even more change with this reorganization, especially when many of their problems with Oracle have not been addressed?

That is such an open-ended question that they have been addressed. We have, in fact, my Deputy Under Secretary, my Deputy Secretary is in the facilities this week again. He's there almost every other week. They're addressing this as it goes along. Any issues that come up, we're solving those as we go forward. We've made a situation now in which it is working, it will work because it's not a choice not to work. And I think that's the biggest, when you take the lessons of the past, I agree with you on that. And the lessons of the past were non-standardization, non-looking at it, and now we're looking at how we do it better.

So I'm just concerned that we haven't fully resolved the problems of the past and we're going to be expediting 13 new go-live sites with about 164 more go-live sites within 2031 and you're decimating your own workforce. I think that is a real problem and not setting the VA up for success. Do you know how many IT support specialists you've lost since January of 2025?

Gentlewoman's time has expired.

That's unfortunate.

Representative Self, you're recognized for five minutes.

Thank you, Mr. Chairman. Mr. Secretary, you've told us about the growth of the VISNs, unintended growth of the VISNs in terms of employees. We now have five VISNs and 15 new health service areas. It's not lost on me that equates to the number of VISNs that we have today. So I want to talk about potential unintended consequences of this because I think this is good, and let me preface this, but I want you to talk to us about because there are people on this committee whose worldview is bigger is better, bureaucracy is better. So can you, I hope that we do not have five super-VISNs and 15 VISNs at the end of the day through growth. So how are you going to organize this plan so that that does not happen and it's all in execution so that in the future we don't have these super-VISNs and VISNs? So it's an open-ended question, please tell us.

Yeah, here's the top end and I'm going to let the team finish this. Top end is they do different things. Okay. The HSAs and VISNs do not do the same thing at all, and there's a purpose for that and a reason for that as we go forward. John.

I really appreciate your question, sir. I think this is a great question that gets at the heart of what we're doing here. This reorganization streamlines how we do our operations. So right now, if you look at the current operation, every program office comes up with their own policies and then each VISN comes up with their own policy on top of that and then each facility turns that into their own policy. What we're doing in streamlining this is we're creating not just the HSAs, which will help with the execution of focusing down in the markets, but more importantly and what we've not talked about are the operations center. The medical operations center will ensure consistency across policy. So if a policy is determined on whatever at the senior level of the VHA for a national program, the medical operations center will then put consistency guidelines out that will go down to each of the VISNs, the five VISNs and the HSAs to the facilities so that it's consistently applied so that we don't get one VA is one VA. We get all of VA being the same VA as we move forward. And Greg, do you want to talk about how that challenges our facility directors and our ability to serve veterans?

Yes, sir. And I think there's an element here that has been missing in our discussion that's really important to answer the question you asked directly. We have heard from everyone that has looked at a VISN structure, doesn't matter where you come from or where you sit, that the roles and responsibilities are not clearly defined. The way in which we make sure that our organization does not balloon the way that Congressman Bergman has described bureaucracy as a rosebush, it's a great metaphor, thank you for that, sir, is by clearly defining roles, responsibilities, and boundaries. When we do that, it does not allow those organizational entities like a VISN or an HSA or even a program office, as you heard the Under Secretary say, to define their own roles and responsibilities that then facilitate a massive growth in those units unchecked. The roles and responsibilities are part of this reorganization.

And sir, if I could just add one more thing is this is a conversation, not a final plan that we presented in December. We said this is the structure that we're doing, we're moving out, this is the transition, and as the Secretary committed and we always will do is follow the law. When we get to that final plan, we will be submitting that over as a final plan. And it may look somewhat different than what we've seen because we're getting input and we're continuing to get input from the field as we continue to evolve. It's an iterative process. And so I would just, there's been some assertions here that we identified in December what we were doing and we started the implementation. What we identified in December is the start of a discussion and a dialogue that says we all recognize this needs to change, here's the structure and the framework of how we're going to change it, and we're continuing to have that dialogue today and continuing tomorrow and until we send over the notice, but it is an iterative ongoing developmental process.

So it looks to me like the vital issue here is that the HSAs cannot have their own interpretation of VA guidance.

Correct. That looks to me, Secretary, to be key. Yeah, this was the biggest issue for me is and I'll go back to a something I think I even shared last year. I had a veteran come up to me who moved from Salt Lake to Hampton Roads, actually, Representative Scott, moved over there, was getting treatment, he's an amputee, was getting treatment at Salt Lake, came to Hampton and the Hampton doctor said the VA doesn't do that. And he said this is the VA, correct? And he said yes, he said but we don't do that. That in essence is the whole genesis of thought behind the upper level of why you do it. That's why we do it.

Gentleman's time has expired. Dr. Conaway, you're recognized for five minutes.

Thank you, Mr. Chairman, and thank you, Mr. Secretary, for presenting yourself to this committee today. You know, I'm sorry I'm going to have to start off with a rather pointed topic here. You may know that 90 percent of the people in the country have seen the killing of Mr. Pretti. And a number of statements have been made by the administration about his death that are very concerning, certainly to the family whose loved one has been defamed by members of the administration. And so I'm compelled to ask you, Secretary, does the VA employ domestic terrorists, yes or no?

That's a question that is aimed at an answer that I've already given. I'm not going to indulge in this.

Reclaiming my time. I'm sorry, reclaiming my time. Your colleagues have labeled Mr. Pretti, a VA nurse, one of your employees, a hero to many, as a domestic terrorist. Is he a domestic terrorist?

As I've already answered to this committee, I've answered and made my statements and condolences to the family. I'm not answering and I'm not going to entertain these questions.

Because the Vice President and Kristi Noem and Stephen Miller have certainly mishandled this situation by calling him a domestic terrorist, they've called him an assassin. Did they handle this, his killing, appropriately in your view?

Asked and answered.

And Kristi Noem herself has even walked back this charge that was made. And so, you know, you lead a large organization with employees that are hurting at the wake of this killing. And while you've reached out to the family and that's certainly commendable, it would be helpful to show just some of the courage that our many veterans have shown in their service by standing up and calling out what is wrong, particularly with respect to Mr. Pretti and his life, his life's work. Can you say on the record whether or not Mr. Pretti was a domestic terrorist or an assassin? Will you stand up for him and show just a little bit of the courage that our veterans show every day?

Excuse me. I show the courage of a 27-year veteran sitting in front of you and will not be spoken down to. I've asked and answered the question.

Now, moving on. I think your inability to answer a question about Mr. Pretti and his life is certainly disturbing and I think it's unfortunate. Let's move on to the VA reorganization. Looked at your plan and had some briefings on this. And as I understand it, back in the '90s there was a big reorganization, the last large reorganization that was done, and the VISN system, these integrated service networks, were created, 18 of them. And to deal with the large complex nature of the VA.

There was originally 23, sir, sorry.

23, well thank you, it was even more than that. So you're reducing that 22 down to five. And as I understand it, you're breaking up that five into three administrative areas. Is that right, in each of these five VISNs? Am I describing that the right way?

Clinical oversight areas. And if I can just tell you, when VISNs were first created by the 23 that created it, it was considered an industry best practice. What ends up happening over time in the public sector, unlike the private sector, private sector moves on. They actually started emulating us, but then over time they also recognized there were better ways to do business. We did not do that.

Oh, thank you. I need to reclaim my time. It seems to me we're adding in a layer of bureaucracy and the issue without necessarily doing things better that couldn't be done under the current system. And you are doing so at a time when 30,000 employees have been laid off. In my own county, Burlington County, it takes over two months to get a appointment for just primary care, longer for mental health services. Another county, Hamilton County, they have a similar issue where it takes about a month to get a primary care clinic and about a month and a half to get mental health services. And this is in the wake of a decimation of the employee force. We have a thousand less physicians, we have 3,000 less nurses. And of course you're focusing as rightly on direct care, but how can you get that direct care to people if we don't have the nurses and the doctors to do the care? And it shows up in these numbers, these are your numbers as of February 4th about the wait times there. So how do you justify the cuts to services that are occurring? And I just have to share one story about this issue. I spoke to my colleagues about who work in the VA system. There's an institution out in Colorado. Patient languishing in the emergency room. They had the doctor, they had the OR, but they didn't have were the OR techs and the nurses to actually deal with and definitively treat someone who needed an amputation because they had an infection in their leg.

Gentleman's time has expired.

Oh, gentleman's time has expired. It matters. Employees matter.

General Bergman, you're recognized for five minutes.

Thank you, Mr. Chairman. Anybody here want to offer a definition of what a camel is? It's a horse designed by a committee. Okay, I've seen several parts of the camel displayed today, and since Mr. Goins you referenced my rosebush comment earlier, I want to make sure that when you think about the most majestic animal in the world, it's a horse. Strength, compassion, awareness. Our veterans are those magnificent men and women who serve. Over time, not through necessarily intent but maybe just lack of focus, the Veterans Administration through its organization has begun to look like a multiple-humped camel. In my office, I have the chart that you gave us of the new organization, the chart of the current organization that you're transforming because you're doing it for the right reasons. So those of us I think who ran for Congress, especially as veterans, we served for the right reasons, we serve now for the right reasons. I would like to, because I have three minutes and 40 seconds left, yield the rest of my time to you, Mr. Secretary, to make any comments that you would like in the rest of my time.

General, I appreciate that in the sense of because I think there's been a lot of discussion today that does miss each other as we go forward. The interesting issue is we've talked about one, I want to go back to one that has been said several times that we've laid off or got rid of, however you want to look at it. The 30,000 number was all voluntary early retirement or VERA. We didn't fire any of them. That's a voluntary issue. So let's just keep that where that is. We've discussed the issues of why we're doing this and also this duplicative nature of an HSA and a VISN. I can't describe this possibly any better than to say the HSAs and VISNs are as different as the quarterback and the center. It's not duplicative to have a quarterback and a center on the field at the same time. In fact, it's necessary to have the quarterback and the center on the field at the same time. And to look at this plan and say it's adding layers has really not honestly I think looked at the perception of what we're doing now in the VISN system, which is broken and has been admitted to by most everybody that looks at it over the years. What we're trying to do here is empower center directors, chiefs of staffs, and executive directors, the folks at the base level to make decisions. I spoke to another general recently and I said, sir, let me ask you a question. I said, are you tip of the spear when you're back at headquarters making decisions or is it the units that are in the field knocking on doors? And he looked at me and said, I said dumb question. I said no it's not. I said if you just help me here. He said of course they're tip of spear. I said so you're not. I said well we have that reversed in the VA. Because our center directors right now were ones that would have to end up sending up, I heard this so many times when I would go to hospitals, I'd say well what happened to that idea? They said well we sent it up and they found your camel committee. It never got back to them. They never had an answer. They were paralyzed into what they were doing and thus you developed over 170 different hospitals or ambulatory centers that did it differently because they couldn't get clear answers. The VISN was supposed to add that in, but it didn't because after a while they become so bogged down in the different functions of what they do. So when you look at it from an operating perspective, this is the sort of the opening up. I'll go back to what I said in my opening statement. Part of what we are doing here is giving frankly more information, starting it earlier than is even required under our 510B authority. We're starting this last month, we're still working it as we're speaking here today, we're still looking and making sure that we have the right areas and the right places so that we can give a finalized plan, which we're actually going to give out in pieces probably, we're going to actually show it as we're making progress to give you more transparency into the process. What I will not tolerate though is the status quo. And also to continue this issue of when you look at it like we just said a few minutes ago, we have facilities that FTE counts are higher now after five years than their actual encounters with patients. We have to be able to readdress where we're putting our workforce at the same time as we're working within our system of both direct care and community care.

I guess I'll go back and just say sounds like you're running a Marine Corps type operation and I'm proud of you for doing that. Thank you. I yield back.

Gentleman yields back. Dr. Dexter, you are recognized for five minutes.

Thank you, Mr. Chairman, and thank you once again Secretary Collins for being here with us. Off the top, I also want to take a moment to acknowledge the murder of Alex Pretti. Throughout my career as an ICU physician, including working at the VA, I've worked with dedicated professionals just like Mr. Pretti. We critical care... ...clinicians are the ones who literally run into rooms when someone is dead or dying and try to revive them or bring them back. Alex Protti until the last moments of his life was protecting people and the principles that this country is built upon. The VAs across this country are understaffed, overstressed, and now grieving. And Secretary Collins, your failure and the failure of the agency to honor his memory and the impact on VA workers is both a disgrace and further undermines trust in leadership for the public servants who are committed to caring for our veterans. The employees of your agency feel threatened, silenced, and now deeply harmed by the lack of acknowledgment that one of their own was murdered at the hands of the U.S. government, the country our patients sacrificed to protect. I ask you to please reflect on the long-term impacts of how you address the murder of Alex Protti for the people working in it and caring for the VAs across this country. Please hold yourself accountable to your overstressed workforce and the veterans who sacrificed to protect this country and the Constitution. And as you know, and I'm sure that whatever you're writing is very important, I hope that...

I'm listening.

Okay. Thank you. As you know, I'm a physician and I also was the chair of the board of the largest multispecialty physician group in the Northwest. So I know how hard it is to run a complicated organization as much as I can, not as complicated as the VA. But I know that changing structure in an organization is challenging and it requires a culture that is dedicated to making that change possible and effective. So I'm worried, deeply worried, that this labor-intensive and costly endeavor that you are embarking upon at a time when the VA is already overstressed and understaffed is destined for failure. Unless you can really lean into the culture and supporting the people who have to make this possible. So I'm going to leave that because I'm going to run out of time and I want to go back to about two weeks ago. Secretary, your colleague Mr. Topping was in front of our committee to testify on the new community care contracts. And during that hearing, I shared that my office is waiting for the VA's response to a September 22, 2025 letter that was urging the department to take action to provide our veterans with better data on wait time and drive times to care in the community as opposed to those through the traditional VA system. Mr. Topping promised a response on where the VA's letter was and my staff is still waiting. So Secretary Collins, do you feel it is appropriate for members of this committee to wait over four months for a response to a simple letter about how we can better serve our veterans?

I think that getting you a timely and proper response is needed by everybody and we're trying, I'm trying my best to do that in all cases. I think the issue here, it was a question directed to him, I'll have to go back and look at that actual letter, but I don't have it in front of me. But I agree with you to get you an answer.

I appreciate that. That is similar to the answer I got from Mr. Topping. I appreciate that my team has stayed on top of this as well. I just have a challenge that if we can't get an answer to a simple letter, that being able to reorganize the entirety of the VA health system is going to be a challenge that we cannot rise to. I also want to believe you that the VHA can undergo a reorganization. I agree with you that the status quo is not acceptable for our veterans. But it has to improve the care for our veterans and while you are losing staff, whether it's because of early retirements or not, it is extraordinarily difficult to get through that. And my skepticism is not because I want your agency to fail, it's because I know that the time and the capacity and the leadership that is necessary may extend past the time that we actually have with this administration and things continue to pendulum. So how are you going to get that done in that amount of time?

Well, I think one of the things is, actually in my conversations with employees and especially getting their input from our directors and center directors, they're actually excited about this because for the first time they're actually having somebody at the top that says what they've been feeling for years and that is they're being over-neglected and looked at. I would also just have to say and as a reminder that the VA is a healthcare system just like the one you used to run as well. And I'm sure you lost employees as well just like we do and we hire employees as we can. That is what we're continuing to do and we've never stopped.

The ability to retain employees is incredibly important and your commitment to them is going to drive that. So I appreciate that and yield back.

Gentlewoman yields back. Dr. Morrison, you are recognized for five minutes.

Thank you, Mr. Chair. Secretary Collins, in May you gave this committee your word that you wouldn't fire any VA staff responsible for providing care to veterans. Since the announcement of this massive reorganization, I've already heard two direct accounts of the impending reorganization leading to canceled promotions for critical support staff and the dismissal of concerns regarding access to care. Under your leadership, applications to work at the VA have fallen 57 percent and a spokesperson for the VA confirmed planned cuts to 25,000 unfilled positions which will strain the workforce caring for our veterans. Trust me when I tell you almost every healthcare worker in America can tell you exactly what it's like to be overworked, short-staffed, and overwhelmed. In August, the VA Inspector General found that the Minneapolis VA had 130 different categories of positions facing severe staffing shortages, including 78 clinical positions. I sent you a letter in September requesting details about the employee departures we've seen since last year, which you still have not responded to. In your testimony, you stated, quote, "staffing and operations at VA medical centers and clinics will not change as part of this reorganization." Given reports of existing severe staffing shortages and negative impacts from this reorganization effort, will you commit to addressing the severe staff shortages that threaten access and quality of care for our veterans? Just a yes or no, please, sir.

There is no yes or no. Minneapolis is 7 percent more in FTEs since 2019 and 2 percent more clinical.

Mr. Secretary, I'm asking you to commit to addressing the...

No, you made the statement that we're overstaffed, understaffed. 7 percent more FTEs since 2019.

I'll take that as a no, sir. I reclaim my time. Mr. Secretary, the crisis of morale in your agency has reached a fever pitch in Minneapolis. Minnesota has been overrun by masked, lawless federal agents who are terrorizing our communities. It has resulted in untold human and economic damage, including the killing of two American citizens. One of the people we lost was VA nurse Alex Protti. And Alex Protti was the best of us. Like his colleagues at the Minneapolis VA, he was a dedicated, hardworking care provider who honored the sacrifice of the veterans he cared for by helping deliver on the promise our country made to our veterans for their service. Alex's parents described him as a kindhearted soul who cared deeply for his family and friends and also the American veterans whom he cared for. Mr. Secretary, you said you have not spoken with ICE, but I have spoken directly with ICE on the ground in Minnesota and they clarified that state and local officials are cooperating with ICE regarding violent criminals and this has been the case long before Operation Metro Surge. In fact, they told me that the idea that there is no cooperation is completely false. Do you dispute ICE's account on the ground in Minnesota? Yes or no?

I have no idea what you're talking about because it's not my department.

That's true, Mr. Secretary. You are responsible for the VA, not immigration operations, not investigating shootings by federal agents, the Veterans Administration. So please help me understand your official statement. What evidence do you have to blame the violent death of one of your employees on state and local officials? Do you have any evidence?

I have stated my statement on Alex Protti and I'm not going into, I mean there's nothing else for me to say.

Do you retract part of your original statement?

Asked and answered.

Senior officials in the Trump administration have slandered Alex Protti as a domestic terrorist and assassin, that he wanted to do maximum damage and massacre law enforcement. No official has retracted those abhorrent and ridiculous statements. Mr. Secretary, it would go a long way for the grieving staff at the Minneapolis VA if you corrected your statement blaming state and local officials, which by the way actively undermines the work of local law enforcement, and made a deliberate effort to honor Alex for his service and care of veterans. Alex Protti was a beloved nurse, son, brother, and friend and will be remembered as an American hero. It's profoundly disappointing that you refuse to correct the record and reject the hateful lies spewed by this administration about Alex and stand up for your employee. Veterans and those that care for them deserve VA leadership that honors their service and sacrifice with words and actions. If you cannot stand up for Alex Protti, how can any VA employee trust that you will stand up for them? Mr. Chair, I yield back.

Gentlewoman yields back. Mr. Scott, you're recognized for two and a half minutes.

Thank you, Mr. Chairman. I appreciate the opportunity to participate. Mr. Secretary, when the Battlefield, North Battlefield outpatient clinic opened in my district in April of last year, I expressed concern that the clinic would be opening with only 150 staff members. You called me a liar. And then in the same article that you called me a liar in, you said that it would be opening with 150 employees. I said it was 150 employees, I'm lying. So I guess you're lying when you say 150. You have indicated in a previous answer that the staffing is still incomplete. Can you give us an idea, you it was supposed to be fully staffed by January, it's now February. When it will be, when will the facility be fully staffed?

Congressman, we started with 150 and we're up to 355 now and as I said earlier, we have 166 in active recruitment. And all and all functions that that facility was supposed to be doing are currently being done.

When do we expect it to be fully staffed?

When we get the 166 hired.

Okay. The Hampton VA psychiatric ward, I've been told, has 40 inpatient beds but only 20 available for veterans due to lack of staff. Is that true? And is there a timetable for full staffing? If you don't know, just if you don't know, just get back to me.

Yeah, I'll have to get back to you, but I do want to offer context. Inpatient mental health wards across the whole country, public and private, have been dwindling for years because most of the care is being delivered on an outpatient basis now as much as it can be. But I don't know the details on Hampton.

You have the beds there. Let's see. Mr. Secretary, do you believe the decisions made by the administration regarding hiring freezes, proposed layoffs in the tens of thousands, termination of collective bargaining agreements and other personnel actions have adversely affected your ability to recruit personnel?

I think the bigger problem of of taking personnel and others into the VA is the same as any other hospital system that you have in your district. I think we face the same struggles as everyone and that is, you know, finding the right people, having enough come out and actually being able to pay a competitive wage for finding them.

Thank you, Mr. Chairman. I appreciate the opportunity to participate.

Can I just say, Congressman, it's good to see you. I haven't seen you in a while.

Time has expired. Representative Wasserman Schultz, you are recognized for two minutes.

Thank you, Mr. Chairman. I really hope I can get an extra minute or so since this will be my only appearance here and I'm asking a straightforward question. Secretary, last week your staff, and forgive me for dispensing with the niceties, last week your staff, including Mr. Goins who's with us here today, briefed our subcommittee on the major elements of this reorganization. And one new piece of information provided to us was a draft cost estimate. It showed that there will indeed be a cost where I was previously told that this would end up being cost-neutral. As the ranking member on the MilCon-VA Appropriations Subcommittee, eventually it'll be mine and Judge Carter's responsibility to find the resources to fund this reorganization if we decide that it is worth funding or to approve any funding that you plan to transfer internally to pay for this reorganization. So I look forward to the report that you are statutorily required to submit to the Appropriations Committee so we can see on paper exactly what your plan entails, including robust and appropriate justifications. Now recognizing that you're in the early stages and that your cost estimates are preliminary, to better understand your assumptions, based on your estimates, there will be a tremendous upfront cost in the first year around $521 million, but with some potential savings along the way, a final net cost of around $312 million over the course of a five-year period. Assuming that you're planning on doing this immediately in this fiscal year, is that correct?

We intend to begin part of this within our current, as I've told you before, within our current authorizations on appropriations.

So in the fiscal year 2026 bill, which has already been signed into law and we didn't appropriate any funding for a reorganization of VHA, where are you proposing that the $521 million comes from?

Yeah, as you've had your briefings with OMB, this is going to come out of our regular account funds. We're just moving people here that's not accounting for this in that situation, but I will have more information as we go forward on this.

Do you expect that you'll be sending the committee a reprogramming request for approval?

For money? Probably, that one is not at this point. We're living within the guidelines that you gave us and we appreciate what you gave us. We don't project that there's a need that that is going to trigger in that.

Will we see an updated cost estimate with detailed justification in the FY 27 budget request?

That is being put together now, yes.

Okay. I want to express concern about the proposed savings of $1.7 billion from personnel actions resulting from this reorganization. Part of it moves administrators into clinical roles, which will result in pay cuts for many...

Gentlewoman's time has expired.

Mr. Chairman, if you can give me an extra couple of minutes, I'd appreciate it.

I would like to do that, but at the very beginning of the meeting, I told them we had a hard stop at 12:30, exactly that. Votes have been called and you can submit them for the record. We're even not going to submit our closing statements for the record. [Crosstalk.] We will have more hearings. We'll have more hearings. I ask unanimous consent that all members have five legislative days in which to revise and extend their remarks, including extraneous material. Hearing no objection, the committee is adjourned. [Gavel sounds.]