Veterans Affairs Markup on Benefits, Health Care, Oversight and Leases

and get their lives back when - when they are struggling. These bills reflect the voices of veterans, VSOs, stakeholders who have asked for exactly that kind of opportunity. Many of these bills are forward-thinking, proposals to make VA work better, and I hope we can advance them in a bipartisan way. With that, let's go and Um, ranking member, uh, you're now recognized for your opening remarks.

Uh.

Do I have any more? Um, uh, thank you, Mister Chairman, I'll save my comments for individual bills and I'll I'll yield back.

Alright, thank you. I now call up the committee print for the H R seven six eight three, the VA Fiscal Management and Modernization Act. The clerk will report the bill.

H R seven six.

The text was circulated in advance pursuant to committee rules and without objection to first reading and dispensed with and the bill is now open.

Well, looks like we're off to a good start here, because I don't see that. Just take a look at this. There's, I just got my remarks on the bill. Yeah. So just, yeah, I have an admin at the desk. That's it. I have an amendment at the desk.

You do. Clerk shall report the amendment in the nature of a substitute.

Amendment in the nature of a substitute.

Ask unanimous consent to further reading of the amendment in the nature of a substitute to suspense with, and uh ask that it be considered bas- base text for the purpose of the mark-up without objection so ordered. I now recognize General Berkman for five minutes to speak on support of his amendment in the nature of a substitute.

Thank you, Mister Chairman. It's nice to be back in the aircraft. Um, accountability matters. especially when it comes to the health and well-being of our veterans. VA manages a budget approaching half a trillion dollars, and veterans deserve confidence that those dollars are being managed responsibly. The VA Fiscal Management Modernization Act designates the Assistant Secretary for Planning and Budget, formerly the Assistant Secretary for Management in the text as introduced. As the department's Chief Financial Officer in statute, with clear responsibilities spanning budget formulation, execution, auditing, reporting, and anti-deficiency act compliance. The title change better reflects the office's core functions and the ANS also adds major acquisition program management as an explicit CFO duty. The bill establishes the dedicated deputy-level leadership for planning and budget and for financial operations and internal controls, and requires VA's financial officers across prisons to report exclusively through the CFO. Not least, it creates a legislative and congressional budget information office with one job, providing Congress accurate, timely and certified budget information, clear authority, a defined chain of command, a direct line to Congress, that is how you build, that is how you build the accountable financial structure our veterans deserve. I urge my colleagues to support this bill and I yield back.

Gentlemen yields back, I now recognize myself in support of the amendment. I would like to thank the general uh for making taking the lead on this VA, uh, fiscal management and modernization act. The bill cements VA's internal uh realignment to modernize va s f- financial management, including how va controls accounts for settles and settles and reports its finances. The bill the b- the biden administration did a terrible job of managing va's uh multi-billion dollar budget and secretary collins is still trying to clean it up. At a hearing in february the secretary stated that va was unable to complete its monthly reconciliation reports, an alarming dis- admit admission for any federal agency, let alone one with an with an annual budget appropriation half appropriat- appropriating half a trillion dollars. That's unacceptable. The VA Fiscal Management and Modernization Act would establish clear roles and responsibilities, strengthen accountability, and ensure VA has the structure necessary to manage taxpayer dollars with the transparency, discipline and seriousness veterans deserve. Do any other members wish to comment on the amendment in the nature of a substitute on H R seven six eight three? Seeing none, are there any amendments to the amendment of the nature of a subst- oh. Representative Sell.

Uh, thank you, Mister Chairman, I just wanna make sure, uh, generally speaking, that these bills have an offset, both mandatory and discretionary, as we go because we're thirty nine trillion dollars in debt and i just wanna uh make sure as we go through this entire uh chart that uh we're we're all assured that they are all offsets

a staff staff and myself have worked continuously to make sure that each one has offsets as we move forward

thank you chairman i yield back

are there any amendments to the amendment in nature substitute to hr seven six eight three i now recognize ranking member to offer an amendment to the amendment in nature substitute for hr seven six

Mister Chairman, I have an amendment to the amendment and nature of substitute to HR seven six eight three at the desk.

The clerk shall report the amendment.

It's a Kano amendment.

I ask unanimous consent to further reading of the amendment and dispense with. Without objection, so ordered, the gentleman is recognized for five minutes to explain his amendment.

Mister Chairman, my amendment today would establish a limit on the number of political appointees within the Legislative and Congressional Budget Office, uh, Budget Information Office. Representative Bergman's stated goal of this office is to provide, quote, accurate, timely and certified information regarding the finances and budget of the department, end quote. Just earlier this week, committee staff was briefed by Mark Engelbaum, the Assistant Secretary for the Office of Human Resources and Administration, that VA must start shifting to a more aggressive planning cycle in regard to the budget for staffing infrastructure and other resources. That type of planning requires stability. That stability is often provided by career VA staff, not political appointees. These career staff are often the ones who have spent years in the department and know the intricacies of VA's numerous programs, its government structures, and its employees. This is the kind of knowledge base we should be encouraging in an office such as this. While political appointees may have a role in transmitting the President's wishes as it relates to the budget, the overall the over uh the excessive and over-politicization of planning and financial management is concerning. Over the last nearly year and a half, we have seen a rise in the number of political appointees serving in roles traditionally held by career staff, followed by a subsequent decrease in the accessibility of information to veterans, Congress and the public. I urge my colleagues to join me in supporting the career workforce and vote yes on my amendment. Now before I conclude, I want to note that the text of this bill creates conflicts with another bill that ha- that the majority is moving forward. Representative Barrett's uh HR six three three, the Acquisition Review and Cost Assessment Act, or ARCA uh uh ar- or ARCA, this bill is on the committee's legislative agenda le- legislative hearing agenda next week. Now, if both bills were to become law, they will create conflicts that will make implementation difficult, if not impossible. During the oversight and investigation subcommittee uh subcommittee's s- consideration of this bill, we raised concerns about reconciling this bill with ARCA and encouraged a bipartisan effort to work with Senate the Senate sponsor of ARCA, Senator Moran, to de-conflict the text. But that has not happened. Further, while VA is actively consolidating acquisition activities within the Office of Acquisition, Logistics and Construction, the bill the bill before us today would attempt to consolidate other acquisition functions under the Chief Financial Officer, creating more conflicts. There is a troubling trend by the CFO's office of consolidating uh the the the CFO ho excuse me there's a troubling trend by the CF CFO's office of consolidating financial acquisition and programmatic activities. That this is really this is particular uh but this is particularly true in the case of the community care network next generation contract. I'm deeply concerned by the creation of conflicts of interest between the critical administrative functions at VA, where accountability and transparency are undermined. Thank you, uh and uh I yield back, sir.

The gentleman yields back, and I recognize myself in opposition to the amendment. because it would protect the same budget bureauc bureaucracy that failed to give it Congress the full and accurate picture for the budget shortfall that wasn't in, that wasn't in twenty twenty four. We recognize the need for uh continuin' to con continuing uh of government um but could we cannot uh mean to shield career office officials for accountability when they are slow, unresponsive, or wrong. During the the Biden administration, career officials were responsible for the budget information provided to Congress, and Congress was misled about the VA's budget shortfall. The office that handles budget information for Congress must be accountable. If it fall fails to do so, do its job, there must be someone who can answer for the future failure. The amendment would limit the accountability and leave Congress dependent on the same employees that had already failed veterans and taxpayers. For this reason, I oppose the amendment. Does any other member wish to comment on the amendment? Good and well written.

Uh, well, I appreciate, uh, the ranking members' interest in this bill. I will have to impose the amendment. Let's remember what happened during the most recent budget shortfall scare at the VA a couple of years ago. It was career bureaucrats who came to Congress in twenty twenty four, claiming a three billion dollar shortfall in warning of disruptions to veterans' benefits, only for the VA to carry over more than five billion dollars in unspent funds. Career bureaucrats who are too often insulated from accountability that would prevent that from happening again. This bill is designed to fix that. The Legislative and Congressional Budget Information Office will give Congress accurate, timely and certified budget information. And restricting who can staff it doesn't strengthen that mission. It protects the culture of unaccountability. This bill is trying to change. The office is also capped at six employees, making this restriction unnecessary on its face. I'd encourage my colleagues to oppose the amendment, and I yield back.

No one yields back. Anyone else taking recognition? Representative? So

Uh, thank you, Mister Chairman. I am really concerned about the no score provided for many of the Democrat uh amendments in this uh matrix, because and I want to remind people the CBO is biased uh toward the more progressive bills. Obamacare was supposed to result in a six hundred and thirteen billion dollar reduction in deficits. It cost us one point five trillion over time. Uh, then you go to the Tax Cuts and Jobs Act of twenty seventeen. CBO estimated a one point four trillion increase in deficits. We've actually had a four percent, uh, uh, revenues up in the two years following. So I yield back that's, uh, I I'm really concerned about no CBO scores provided in the Democrat amendments as a whole, and I yield back.

No one yields back. Any other one seeking recognition? The question the n- seeing none, the question now occurs on agreeing to the Takano amendment to amendment in the nature of a substitute to HR seven six eight three. All those in favor say aye.

Aye.

All those opposed, no. No.

No, I think that's clear, yes.

In in the in the opinion of the chair, the no's have it, the the a requi- a recorded vote has been requested, a recorded co- vote has been requested pursuant to committee rules. This vote will be postponed. I now and I now recognize representative Ramirez to offer an amendment to the amendment in the nature of substitute on H R seven six eight three.

Thank you, Mr. Chairman. As you just mentioned, I have an amendment to the amendment in the nature of a substitute at the desk.

Uh, the Tucker shall report the amendment.

Ramirez, amendment two.

Ash and Adam's consent of further reading of the amendment be dispensed with and without objection, so ordered the general la- general lady is recognized for five minutes to explain her amendment.

Thank you, Chairman. Well, it's been fifteen months since Secretary Collins was sworn in, and we're still receiving daily outreach from veterans and VA employees from across the country about how the staffing is impacting veterans, or lack of, it's impacting veterans' ability to receive care. Over those months and even before his appointment, members of this committee have repeatedly requested data from the VA regarding staff attrition so that we can get a full picture of the staffing challenges the facilities are facing. especially as veterans begin feeling the impacts of the deferred resignation program. Those requests, however, have related to our oversight responsibilities, but they've been unacceptably ignored. Case in point, last August, many of my fellow Democratic members sent letters to the secretary asking about workforce data and what the secretary likes to call " natural attrition". But let me be clear. There is nothing natural about his intimidation, disrespect, and harassment of the VA's workforce. And as of today, only one member, just one member, has received even a partial response. This is my colleague, Representative Tim Kennedy, and the information he did in fact receive was pretty damning. Despite the secretary's assertions that those within mission-critical or direct patient care roles were not allowed to take deferred resignation the data from Western New York shows differently. Per the partial data we received, at least two nurses were able to take DRP. And thanks to another data set that we received from the VA, We also know that the VA cut both of these positions during the call last December, where the VA wiped twenty six thousand long-standing vacancies from the books. You see, mission critical roles have been jeopardized, so when the secretary says these cuts won't delay or harm veteran care, the data from his own department is proving that we should not believe him. So, this amendment requires the secretary to share attrition DRP data, desegregated by facility and occupation, And I think it's really important for the VA to give this information for us, and we've been demanding that for nearly a year. And that's why I've introduced this amendment, because I think it's time we assert our Article-one authority and require answers. With that, I hope that my colleagues will join me in supporting this amendment. And, Chairman, I yield back.

General Lady yields back. I recognize myself in opposition to the amendment. I oppose the amendment because it is is not relevant to the bill being considered. Staff reports, uh, on staff who are n- no longer at VA have nothing to do with the establishment of a budget office with the VA. I r- I recommend my colleague vote no on the amendment my colleagues vote no on the amendment because it is a distraction from the accountability this committee needs from the VA's f- uh fiscal uh management. After the shortfall debacle during the Biden administration, I would hope that the Democrat colleagues would support this f- uh fiscal responsibility that our veterans and taxpayers deserve. Uh, if Representative Ramirez, uh, is interested in this information, I'm happy to write a joint letter with her to get the information as I am sure, we would all agree, that is likely faster that that way than it is by getting, uh, uh, putting in information or putting in and passing a law. With that, with that, I call on all my colleagues to vote no. I urge my colleagues to vote no. With me on this amendment, does any other member wish to Comment on the amendment. You know, Markman?

Thank you, Mr. Chairman. I have to oppose this amendment as well. This bill is about financial management structure at the VA. I repeat, financial management structure at the VA. This amendment would require a report on every employee who separated from the department since January first of twenty twenty five. That has nothing to do with what this bill does. it's not relevant. And if my colleague wants to pursue this reporting requirement, it should be done through its own legislation, not tacked onto this bill. I'd encourage my colleagues to oppose this amendment, and I yield back.

The gentleman yields back. Does anyone else speak wish to speak on the amendment? Seeing none, the question now occurs on agreeing to the Ramirez's amendment to the amendment in the nature of a substitute on H R seventy-six, eighty-three. All those in favor say aye. All those opposed say no. No. Uh.

I support the vote.

Sir Chairman, I'd like a recorded vote.

The no's have it and and uh a recorded vote has been requested pursuant to committee rules. This this vote will be postponed. I now call

I

Wait, wait, wait. Okay. Are there any further amendments in the nature of a substitute to H R seven six eight three? Hearing none, we now move to the next bill, it will because votes will be pending on that bill. Now we can go here. Um, I now rec- I now call up committee print for H R six nine nine three, the Bacon Act of two twenty s- The Bacon Act, not bacon, that would be a member of our, but it's not here today.

Breakfast.

Um,

Or breakfast.

uh, our for breakfast, Bacon Act of twenty twenty six, the clerk shall report the bill.

H R six nine nine three, to direct his

The bill is was circulated in advance for student committee rules and without objection the first reading is dispensed with the bill is now open for amendments at any point I now recognize General Berkman to uh support to speak on his bill.

Thank you, Mr. Chairman. Since two thousand, hundreds of thousands of veterans have sustained a traumatic brain injury and for too many the effects don't subside. affecting mental health, daily functioning, and long-term recovery. The consequences are devastating. The VA's own twenty twenty-five National Veteran Suicide Prevention Report found that veterans with TBI diagnoses have a suicide rate of seven seven point six per one hundred thousand that's seventy-seven per one hundred thousand people a sobering reminder of what's at stake. We know effective care is possible. The National Intrepid Center of Excellence at Walter Reed has already demonstrated significant improvements in PTSD, depression, anxiety, sleep dysfunction, and behavioral outcomes through interdisciplinary intensive outpatient care precisely the kind of care the Beacon Act seeks to make more widely available to our veterans. But demand for this care among our veterans is outpacing capacity. The Beacon Act closes that gap by supporting, not supplanting, what VA is already doing. It creates two targeted, time-limited grant programs that fund clinical evaluation of neural rehabilitation treatments and independent research to identify what works and what warrants broader VA adoption. Funded approaches must go through randomized control trials, rigorous outcome measurement, and regular reporting at both programs sunset after three years. This is a responsible investment in building the evidence-based VA needs to better serve veterans living with the lasting effects of TBI. I urge my colleagues to support this bill and I yield back.

Gentleman yields back and uh I support the the bill. I fully support the intent of my friend General Berkman's bill to address the issue of traumatic brain injury in an efficient, community-focused way. The Beacon Act would create two targeted grant programs focused on supporting academic institutions and community organizations to research, innovative treatments for th- for brain health. Addressing the issue of TBI is a top priority for House Republicans, and I'm sure it is for the House Democrats as well. This good bipartisan bill would continue expanding the reach of VA's brain injury treatment efforts and help ensure veterans can access care that works best for them. I want to thank the work uh done by the minority and their efforts toward our community goal of helping veterans and making this an even better build. These shared efforts are meant to sup- s- supplement, not sur- supplant the b- the department's work. It is our responsibility to get better answers for veterans living with the lasting effects of TBI. This bill would help us do that. I want to thank General Berkman for his strong bipartisan work on this issue. On behalf of the veterans, it would reach and I urge the members to support it. Does any member wish to comment on the bill? The ranking member.

Well, thank you, Mr. Chairman. I I must uh oppose the BEACON Act in its current form. I appreciate that we're discussing the importance of expanding research and improving treatment for mild traumatic brain injury, or MTBI, in veterans. I've heard from far too many veterans who experience with MTBI has impacted every part of their physical and mental health. It is clear that we need to do more, and I stand ready to work with my colleagues to give VA the resources it needs to do this work. However, since the start of this year, my Democratic colleagues on the Health Subcommittee have raised numerous concerns about the Beacon Act. In subcommittee hearings and during last month's health subcommittee mark-up, um, both we have raised these concerns. They have not been addressed. Even VA shared a number of concerns with this legislation and its testimony in January that have not been addressed. Several of my colleagues and I will address our most significant outstanding concerns with the However, I would like to briefly highlight a couple of my biggest concerns with the legislation. First, I'm very concerned that this bill includes provisions that could require VA to use existing funds appropriated for PTSD research and general mental health services to fund these grant programs if sufficient funds are not otherwise appropriated. Now given that VA has consistently been asked to do more with less over the last eighteen months, I struggle to imagine a world in which VA will not be required to divert this funding for a new grant pro- for new grant programs that this bill requires. We cannot fund new search, uh, I mean, that that this bill recreates, not just requires. We we cannot fund new research on the backs of veterans already receiving care at VA. and I cannot support a bill that allows even that possibility. Second, this bill creates an inappropriate, and I would even venture to say potentially illegal, structure of for administering one of the grant programs it creates. I cannot support legislation that asks VA to contract with a third-party entity to perform inherently governmental responsibilities of allocating and overseeing the expenditure of grant funding. Third, this bill does not do enough to ensure that the grantees who receive funds to operate clinical trials are required to coordinate with VA about their findings. Finally, the bill does not do enough to ensure robust oversight of the grantees and the outcomes they create using funds from a VA grant uh, VA grant program. Now, my colleagues and I will be offering what we believe are common sense amendments to address these outstanding concerns and ensure that Congress can conduct necessary oversight of the grant programs this bill creates. I urge my colleagues to accept these amendments to improve the bill and ensure that democratic members' concerns are addressed. And with that, I yield back.

The gentleman yields back. Does anyone else seek recognition? Representative Van Orten.

Thank you, Mr. Chairman, um, I would like to enter two studies into the record from Frontiers in Neurology. One is the efficacy of interdisciplinary intensive outpatient program in treating combat related traumatic brain injury and psychological health conditions.

Without objection.

And use of person-centered goals to direct interdisciplinary care for military service members and veterans with chronic uh MTBI co-concurring uh with co-concurring psychological conditions.

Without objection.

Okay. As we learn more about the brain, I'm and my colleague uh Morgan Luttrell is much more familiar with the subject than I am. Um, we're understanding that - that the types of activities that take place in the United States military are causing TBI at a level that we'd never looked at before. Uh, we used to do rocket ranges firing the Karl Gustav, and we got done and we'd go to lunch and couldn't do basic math. I mean, you get rocked hard. There's only five of these facilities in the entire country. And so what we need, including one in Milwaukee, what we need to do is expand these facilities. And is this a - a perfect No. I- is it a very good bill that's gonna help get our veterans the treatment for the injuries that they sustained uh serving our nation? The answer is yes. And I'm always gonna err on the side of yes when it comes to treating our veterans for service-connected injuries. So I strongly urge my colleagues to support this on both sides of the aisle because I I know that th- th- my Democrat colleagues also wanna make sure that our veterans get care and this is a way to uh demonstrate that we really mean what we say. And with that, I yield back.

Yeah, I'm gonna yield back, anyone else speak to be to speak on the base text? Are there any amendments to the committee printed of H R six nine nine three? I recognize Representative Morrison for to offer an amendment to the committee printed on H R six nine nine three.

Thank you, Mr. Chair. I have an amendment at the desk.

Clerk shall report the amendment.

Amendment to H R six nine nine three.

I ask unanimous consent. The further reading of the amendment is dispensed with. Without objection, so ordered. The gentlelady is recognized for five minutes.

Thank you, Mr. Chair. This amendment may look familiar to the health subcommittee members as I offered it when this bill was considered at a subcommittee mark-up. I believe the purpose of my amendment addresses an issue that warrants the attention and review of the full committee. My amendment would strengthen oversight requirements throughout the bill. VA and Congress need to be able to perform robust oversight of the grant program to protect VA's investment in mild TBI research. I appreciate that there was some effort to strengthen the oversight requirements in the bill when it was marked up by the subcommittee. However, I believe the need for additional measures in this bill remains. To ensure that the committee can carry out oversight of these two new grant programs, the language in this bill needs to be enforceable, effective, effective, and rooted in evidence-based science. This is especially true when establishing expectations for reporting adverse events related to any clinical trials or care provided outside of VA to veterans. My amendment makes it clear that grantees must track adverse events and report them to VA rather than only doing so if the grantee chooses to collect that data. It also requires grantees to report on any relevant follow-up care provided to ensure that veterans who face adverse events receive proper support. My amendment would also ensure that grantees use accepted clinical standards to evaluate the outcomes of their research, and ensures VA also considers the cessation of the grant program as part of its annual review, if it is demonstrated that the program is not working as intended or delivering on VA's investment. Finally, my amendment also expands the reporting requirements in the bill to ensure Congress and VA receive all the information necessary to evaluate whether the grant program is an effective use of VA resources. I hope my colleagues recognize and agree with my amendment's purpose to further strengthen oversight and transparency for these grant programs with a clear focus on delivering for veterans. Passing this amendment will help ensure that this external research is conducted following the same principles that VA research has successfully pursued for decades I urge my colleagues to vote in favor of this amendment and recognize the value of due diligence when it comes to oversight of taxpayer dollars with that Mister Chair I yield back.

I recognize myself in opposition to the amendment the amendment to the committee print of H R six nine nine three would do nothing but add more layers of unnecessary reporting to the bill Our staff has worked with researchers, stakeholders, clinical professionals to get a good this this good bill to where it is now. It it was not an idea born overnight. I do not believe that the amendment is necessary to accomplish the goals of the Beacon Act. Further, I don't believe this amendment was offered in good faith. Therefore, I oppose the amendment, I urge my colleagues to vote no with me on the amendment. Does any other member wish to comment on the amendment? Um, General Berkman.

Thank you, Mr. Chair. While I appreciate my colleagues' interest in the bill, I have to oppose this amendment. And I will be direct about why. The amendment would impose accepted clinical standards, language throughout the bill, in a field where no universally accepted standard of care for chronic mild TBI currently exists. You can't get there from here. This is not a an oversight in the legislation, it's the reason the legislation exists. Veterans with chronic mild TBI are suffering because too many have spent years in fragmented systems, siloed care, short appointments, and disconnected treatment plans that fail to address the full complexity of their conditions. Requiring accepted clinical standards, in this context, gives entrenched institutions a mechanism to dismiss innovative approaches simply because they're innovative not because the evidence doesn't support them. Further, it weakens the bill's focus on long-term recovery, adds unnecessary reporting burdens, and introduces cessation language that frames a program we haven't even start started around shutting it down. The bill is designed to build the evidence base that will define the future standard of care. Conversely, this amendment would let the absence of that standard be used against the very effort to establish it. I'd encourage my colleagues to oppose the amendment and a yield back.

Does anyone other member seek recognition? Seeing none, the question now occurs on agreeing to the Morrison amendment and the committee print for H. H R six nine nine three. All those in favor say aye.

Aye.

All those opposed no. In the opinion of the chair, the no's have it and the amendment is not is not a. Mister chair, I request a recorded vote. A recorded vote has been requested pursuant to committee rules. The vote will be postponed. I now recognize ranking member Takano to offer an amendment to the committee for H R six nine nine three.

Thank you, Mister Chairman, I have an amendment to H R six

The clerk shall report the amendment.

Amendment to H R six nine nine three.

I ask unanimous consent for the reading of the amendment, is dispensed with, and without objection, so ordered, the gentleman is recognized for five minutes to explain his amendment.

Well, thank you, Mr. Chairman. You know, my amendment requires grantees to share with VA all clinical da- data from the clinical trials funded under this bill. I believe it is important to ensure that VA researchers and clinicians can also access the data generated by this research. This will enable us to ensure coordination of efforts as well as transparency into the uh reported outcomes of grantees' research. I acknowledge that many non-profit organizations and academic affiliates have helped VA make huge strides in areas of research critical to veterans' health. However, Congress and VA have spent more than one hundred years investing in and strengthening VA's research ecosystem. VA's research track record of discovery speaks for itself. Any research to improve treatment for mild TBI must include coordination with VA, including shared clinical data that could allow VA's world-class research ecosystem to develop the next breakthrough. Now, I must point out that some of the very same organizations that have been vocal proponents of this legislation have a track record of not being fully transparent with their research data. Let me repeat that. I must point out that some of the very same organizations that have been vocal proponents of this legislation have a track record of not being fully transparent with their research data for example in twenty twenty four, researchers from the Boulder Crest Foundation, a non-profit organization focused on offering complimentary and alternative interventions to veterans like yoga, Mindfulness and Equine Therapy published an eighteen month longitudinal study about the effects of its programming on improving post-traumatic stress syndrome symptoms. This one million dollar privately funded study could have been massively helpful in informing VA and other entities about new ways to treat veterans. Unfortunately, the published findings reflected outcomes for only a fraction of the overall number of veterans, who participated in Boldocrest's programs without explanation of why some were included while others were excluded. This unfortunate lack of transparency undermines the usefulness of Boldocrest's findings and the ability to apply them to the broader veteran population. Uh, if we're using public funds to conduct research outside VA, we must ensure Congress and VA can evaluate the return on the taxpayers' investment. validate findings and build on the clinical data created with taxpayer funds. I understand this legislation is intended to drive innovative treatments for mild TBI in veterans. I certainly agree with the need for additional research since, as we know, mild TBI mild TBI is one of the most common wartime injuries. However, I'm concerned that if we're not careful, efforts such as this one will only increase fragmentation of research and treatment for veterans. Uh, thank you, Mister Chairman, and I yield back.

Thank you, Ranking Member, I recognize myself in opposition to the amendment. The Beacon Act would create new grant programs at VA which would fund innovative treatments and research to improve the health outcomes for veterans suffering with chronic mild TBI. I oppose ranking mem- the ranking members' amendment because although it may be well-intended, It is unnecessary. This amendment would add duplicative reporting requirements that are already included in the base text. Not only does it this address a problem that does not exist, but it would create new ones. This would slow down the good work meant to be accomplished by the program. I urge my colleagues to oppose the ranking members' amendment and I urge my colleagues to vote no with me on the amendment. Does any other member wish to comment on the amendment? Representative Littrell, your record check.

Thank you, Mr. Connolly. Do you have d- on the Boulder Crest study that you mentioned just then, um, are you f- Are you aware of what the inclusion criteria was for the specific numbers that they provided in that report? Like, for instance, if they're having if a thousand veterans go to Boulder Crest that year, but the study was focused on eighteen to twenty-one year old males, and that was the study they produced,

Miss

will that hold water?

So, Mr. Littrell, I wish I could tell you because But we can't because they didn't publish the study.

No, but the specific study would have said that.

They didn't publish the data. They didn't the the study they would say that, I I would hope it would say that, but the study has not been published. That's one of our They didn't say that it was exclusionary then. I mean, we can look at it. Pardon me?

I got you, I I don't need that to turn into a conversation on the other side,

So so the so anyway,

mister. I I

just the inclusion and exclusionary criteria that you're that you're referring to,

Mm-hmm.

those weren't published.

They would have had to have been for the study if we funded it.

Uh you one would think so. But I'm telling you that they were not published. That's that is our that is kind of the substance of our objection here.

I tell you what, I'll catch the young lady off-line

Want me?

to have that conversation. Thank you, Mister Chairman.

Yep.

Thank you, sir. Thank you.

Does anyone else seek recognition? Seeing none, the question now occurs on ag agreeing to the uh Takano amendment to committee printed for H R six nine nine three. All those in favor say aye. All opposed say no. No. Any opinion?

All right.

Chair, the no's have it.

I request a quarter vote.

A recorded vote has been requested. Pursuant to committee rules, this vote will be postponed. I now recognize Representative Brownlee offering amendment to the committee print on H R six nine nine three.

Mister Chairman, I have an amendment at the desk.

This clerk will report the amendment.

Amendment to H S

I ask unanimous consent that further reading of the amendment is dispensed with and without objection. So ordered. The General Lady is recognized for five minutes to explain her amendment.

Uh, thank you, Mr. Chairman. Uh, my amendment, which I also offered at the health subcommittee mark-up where we considered this bill strikes provisions in the legislation that direct VA to pay for the two grant programs using the existing budgets of VA's National Center for PTSD and VA mental health services if Congress doesn't appropriate specific funds for the two grant programs. My amendment was unfortunately rejected at the subcommittee mark-up. However, as I have explained at several previous hearings, I feel strongly that we cannot risk siphoning money from VA direct care and research to pay for this pilot program. Creating a new pilot program is not a cost-free undertaking for VA. If this bill becomes law, the department will be required to administer not one but two grant programs, even in the absence of appropriated funding. Given that we are an authorizing committee and not an appropriating committee, we unfortunately have no direct control over whether sufficient funds will be appropriated to allow VA to carry out these grant programs. In the unfortunate event that sufficient funding is not appropriated for these two grant programs I worry this bill leaves VA no choice but to divert funding from the National Center for PTSD and Veterans' Mental Health Services to carry out these grant programs. I support investing in new research, but we must ensure we are pursuing these investments in a responsible manner that protects resources for existing VA research and clinical services. I can't recall ever seeing provisions like this in any other legislation we have advanced during my time on this committee and I don't think we should set that precedent now. I'd also note that uh m- uh General Bergman's MilKom VA amendment that draws attention to the importance of VA's research on quote " on areas benefiting veterans such as oncology, traumatic brain uh injury care, psychedelic therapies and assistive d- devices" was made in order, although it does not provide any additional funding for such research. In any case, I'm glad uh, Mister Bergman agrees with me that VA research is critical, and I hope he'll support my amendment to ensure that there is no risk that existing VA research funding will be diverted to administer this grant program. I'd also note that the legislation as amended at sub- at the subcommittee not only includes language authorizing appropriations, But it also includes provisions to extend the authority to collect VA home loan fees to ensure that the cost of this legislation is covered. Given that this legislation provided an offs- uh, uh, given that this legislation provided an offset, uh, to its cost, provisions that direct VA to use its existing funding should no longer be necessary. Removing these provisions will remove all risks of uns- or uncertainty that existing VA funds would be diverted to these programs. I urge my colleagues to support my amendment to project VA's existing funding for mental health services and PDSD research, and I yield back.

General Lady yields back. I recognize myself now in opposition to the amendment. I do not support the intent of the Representative Brownlee's amendment to tie the secretary's hands when it comes to expanding mental health support. The flexibility to use the funds the b- uh, Beacon Act would authorize was made so that these grants could stand up quickly, responsibly, and without delay. I believe this amendment would go against the intent of General Berkman's bill and create funding uncertainty that could slow down the implementation of this new program. Veterans in crisis should not have to wait any longer for more more support options. The goal of the Beacon Act is to create new solutions expand and reach of the expand the reach of VA's mental health services even further. For these reasons, I oppose the amendment and I urge my colleagues to vote no with with me on the amendment. Does any other member wish to comment on the amendment? General Berkman.

Thank you, Mr. Chairman. While I appreciate my colleague's concern, I have to oppose this amendment. As we noted, or as was noted, during the subcommittee mark-up, Nothing in the bill requires the VA to redirect existing funds. It simply gives the department flexibility to use available resources in the absence of a direct appropriation while explicitly requiring that any such use supplement, not supplant, existing programs. Removing that flexibility doesn't improve oversight, it just makes it easier for the department to delay or avoid implementation. Veterans living with chronic mild TBI, PTSD and chronic pain, the very populations that VA's own data identifies as the highest risk for suicide cannot afford more delays. These grant programs were designed specifically to address those overlapping conditions and adding funding barriers slows access to care for veterans already in crisis. The bill already has strong safeguards, reporting requirements, and oversight mechanisms. This amendment adds nothing but another hurdle to care delivery. At a time when we are working to expand treatment options, support research, and improve outcomes for veterans with mild TBI, and we should be focused on enabling progress, not limiting it. I encourage my colleagues to oppose the amendment and I yield back.

Does any other member wish to comment on the amendment? Seeing none, the question now occurs on agreeing to the Brownlee amendment, the committee print for HR six nine nine three. All those in favor say aye. All those opposed, no. No. In the opinion of the chair.

Aye.

The no's have it and the amendment is not agreed to.

Mr. Chairman, I request a quarter vote.

A recorded vote has been requested pursuant to com- to committee rules She's gonna get to the button. Um, this this vote will be without object never mind, we'll move on. Um, I now recognize representative Dexter to offer an am- Doctor Dexter to repr uh offer an amendment to the committee print on H R six nine nine three.

Thank you, Mister Chairman, I have an amendment to H R six nine nine three at the desk.

The the clerk shall report the amendment.

Amendment to H R six nine nine three, subcommittee print, offered by Miss Dexter.

I ask unanimous consent that further reading of amendment is dispensed with and without objection, so