H.R: 6733, The “VISN Reform Act of 2025”

inflation, they're also continuing to grow even as the veterans' population declines. So where exactly is the money going? Well, within the budget function that covers veterans' benefits and services there are five major categories, income security, education, training and rehabilitation, hospital and medical care, housing, and other general benefits and services. Of the total three hundred and seventy-seven point two two billion, going to everything in this function, more than half is spent on income security programs. The vast majority of this is for disability compensation and pension programs, which, while they are important, do also need to be reevaluated for fraud, waste, abuse, and any dollars that are going toward bureaucratic overhead rather than veterans themselves. This is followed by nearly a hundred and fifty billion for hospital and medical care for veterans. Knowing that money is currently being spent in the only in so far as Congress actually acts on this without worsening the national debt. The need for oversight and sustained reauthorization is absolutely key. If you are not looking at where the dollars are going now, you will not know how to better spend them in the future. There are challenges today that were not present in the nineteen seventies or eighties. For example, perhaps housing should be getting a bigger slice of that pie, or education and training. Perhaps we should be reevaluating mental health research and making sure that outcomes are matching up with where dollars should be going rather than following the trend of the seventies eighties and nineties prior to the global war on terror. I'm running low on time here so I'll just finish up by saying that GAO has consistently ranked several VA programs as high risk that payment accuracy has noted that the VA comprises only six percent of the entire federal budget, but is responsible for the

I would. I'd now like to recognize Mister Stratton for uh Stratton for his five minutes Stratton for uh

Mm.

opening remark.

Good morning uh good morning, Mister Chairman, Ranking Member, and members of the committee. Thank you for having me testify today. My name is Tim Stratton and I am the Director of the Congressional Oversight Initiative at the Project on Government Oversight, or POGO. POGO is a non-profit uh independent watchdog that investigates, exposes, and champions reforms on systematic corruption, abuse of power, and waste. Since two thousand six, the Congressional Oversight Initiative has trained nearly six thousand congressional staffers, from both parties and both chambers on the best practices of oversight in investigations. I'm honored to be here today to talk about the importance of congressional oversight, especially at the Department of Veterans Affairs. As the Article-one branch of government, Congress has a constitutional responsibility to conduct oversight. The Supreme Court recognized this nearly one hundred years ago when it stated, "Congress cannot legislate wisely or effectively in the absence of information." To fulfill that constitutional role, Congress must ensure the executive branch responds to oversight requests either through uh request letters, briefings, and peer-net hearings, and it remains accountable to the public it serves. Strong oversight can uncover waste, fraud, abuse, mismanagement, before problems escalate into larger failures. It can in- also inform future legislation. Oversight depends heavily on whistleblowers and bipartisan both of which strengthened Congress's ability to hold agencies accountable. This under- this committee understands those stakes very well. The twenty fourteen VA waitlist scandal demonstrated the serious consequences that can occur when accountability breaks down. At that time, Pogo collected nearly a thousand responses from veterans and VA employees, revealing a troubling culture of retaliation against whistleblowers. As Pogo has testified before this committee, on several occasions, uh, and the need to reform the VA's Office of Accountability and Whistleblower Protection to ensure whistleblowers are protected, and the office functions independently and a- as effectively as Congress intended. Today, the need for oversight at the VA remains substantial. Congress has not reauthorized key components of the department for nearly th- uh, three decades, with many programs continuing to operate under expired authorizations. At that time, the VA's fiscal year twenty-seven budget requests totals more than four hundred eighty-eight billion dollars, a seven point seven percent increase over last year's enacted levels. Investments on that scale demand sustained congressional oversight to ensure laws and programs are operating effectively in delivering intended outcomes for veterans. As you said, Mister Chairman, outcomes are meaningful. The top line figure, however, is just the tip of the iceberg. In fiscal year twenty fifteen alone, the VA made made nearly two hundred eighty-eight billion dollars in awards, including ninety billion dollars in contracts. Pogo has spent decades conducting oversight of federal contracting, an area historically vulnerable to waste, fraud, abuse, and mismanagement. Last year the VA awarded more than six billion dollars in contracts without competition and another nearly ten billion dollars in contracts were made, when only a single bid was received. Congress should continue ensuring agencies use robust competition and sound contracting practices. Strong oversight also depends on strong um oversight institutions. Mister Chairman, you mentioned Inspectors General and the Government Accountability Office. Those are among Congress's most important partners in conducting effective oversight. As of this month, the VA's Office of Inspector General has more than five hundred fifty open recommendations for the department. and the GAO has another hundred and seventy more, including more than twenty listed as high priority and high risk. These recommendations present a clear opportunity for congr- congressional oversight and a potential road map for legislative reforms. I should add that while the VA does have a permanent IG in place, dozens of IG positions across the government are vacant, with most of them still waiting for a nominee, and the GAO is also without a permanent head and is also waiting for a nominee since December.

Mm-hmm.

Finally, as a close, I'd like to stress congressional oversight should not depend on which party controls the White House. Oversight is one of Congress's core constitutional responsibilities as the Article One branch of government. Effective oversight protects taxpayer dollars, improves government performance, ensures existing laws are being implemented properly, safeguards veterans and whistleblowers, and preserves the system of checks and balances envisioned by the framers. Thank you again for the opportunity to testify today, and I look forward to your questions.

Thank you, Mister Stratton, and um also for the both the written statement of Miss Madney and Mister Stratton will be entered into the hearing record. Uh, I would now like to recognize Mister Ritchie uh for five minutes uh for his opening remarks.

Chairman Bost, Ranking Member Takano. members of the committee, thank you for the opportunity to testify today. My name is Mark Ritchie and I am on the board of the National Federal Development Association or NFDA. The nonprofit NFDA represents the private sector partners who have in who have invested billions in the infrastructure essential to the VA mission. We are not just vendors, we are the bridge between private capital and the public service of our nation's veterans. We understand the mechanics of the federal real estate leasing market better than most, and we are here today to express our strong support for H R sixty-five nine nine, the uh Leasing and Infrastructure Act of two thousand twenty-five. The bill provides for common sense solutions by adopting modern standards and if I leave you with anything today, it is by uh adoption of these reforms we will be able to deliver timely cost effective medical facilities for use by our nation's veterans. The testimony should also serve to answer the question, why does VA keep coming back to Congress for additional money to fund these lease projects? The three major takeaways are the methodology the VA utilizes to determine rent for these projects makes no sense. Two, current use of full-service leases for a twenty-year period actually adds to the cost of these important projects. And three, the linear VA GSA approval process adds significant time to the delivery of these important facilities. I think we we can agree the requisite agency's intentions are to protect taxpayers all while serving our vets. In reality, the current VA GSA OMB process is dysfunctional and by maintaining the status quo, these bid busts will continue to haunt us. Why? You will be asked again and again to approve prospectuses that aren't worth the paper they are print print printed on. While my written testimony delves deeper into these three pillars, I believe the best place to start is in the middle of the story. We're on May one, two thousand twenty four, nearly two years after approval of the PACT Act. the Senate Veterans Affairs Committee hosted a business meeting with NVA Secretary McDonough. Among the topics discussed were the thirty-one Pact-Act leases and in his remarks to Senator Tillis Secretary Con- Secretary McDonough commented and I'm paraphrasing, he, McDonough, might need to come back and ask to reauthorize at a higher cost level. We've seen anywhere between sixty and a hundred and fifty above the authorized level. My written testimony details the timeline of this odyssey, so I won't address that now. However, an in an ex an inexperienced industry practitioner can quickly determine the viability of these projects within minutes of review of the initial authorization request I'm not here to castigate VA as the VA does the best it can with the tools provided. Unfortunately, we've provided the VA with a jeweler's hammer when a sledgehammer is required. H R six five nine nine is not just a leasing bill, it is a clinical access bill. When a lease award is delayed by years due to bureaucratic friction, that is time veterans spend waiting for the care they have earned. By removing the government premium and streamlining authority, we ensure that taxpayer dollars go toward veteran health rather than administrative waste. H R six five nine nine provides the VA with the necessary tools to build a responsive, modern health care network while ado- while remaining fiscally accountable. By modernizing cost estimation, adopting market-based leasing sta- structures, and establishing independent authority, the committee can dissolve the gridlock that has stalled veteran care.

Mm.

The NFDA believes its legislation is a prudent way to ensure that taxpayer dollars are used efficiently to build the twenty-first century facilities the VA mission requires we urge the committee to move forward with these essential reforms to ensure our veterans receive the high quality facilities they have earned and deserve. Chairman Boss, thanks to in your committee for your laser focus on this important issue. I look forward to your questions.

Thank you, Mr. Ritchie, and Mr. Ritchie's statement uh the written statement of Mr. Ritchie will be uh entered in the hearing record. And finally, we want to recognize uh Miss Ken uh but not before we say uh welcome back after the delivery of your daughter and this is our first time appearing before us,

Thank you, Mister Chairman, Chairman Bost, Ranking Member Takano, and members of the committee. On behalf of the men and women of the veterans of foreign wars of the United States and its auxiliary, thank you for the opportunity to present the VFW's views on pending legislation. The VFW's feel full written statement addresses nearly all the bills on today's agenda but I would like to briefly highlight four piece key pieces of legislation. The VFW appreciates Chairman Boss's leadership in bringing attention to the governance issues caused by VA's VISN structure by introducing H R sixty-seven thirty-three, the VISN Reform Act of twenty twenty five. After years of Inspector General reports, documenting inconsistencies in health care delivery and serious patient safety concerns across the VISN structure, we strongly believe that reform is necessary. However, since VA has already begun restructuring and consolidating its eighteen VISNs, the VFW would like to better understand the impact of those ongoing efforts, before fully endorsing large-scale statutory changes. We want to ensure that reforms improve accountability and consistency without reducing flexibility at the local level, or negatively affecting veterans' access to care. We look forward to continuing to work with the committee on this important issue. The VFW supports H R sixty eight forty three, the establishing the Veteran Ec- Veterans Economic Opportunity and Transition Administration Act of twenty twenty five. This legislation would create a fourth administration within VA, dedicated to the economic opportunity and transition programs. This would include education benefits, voc rehab and employment, housing loan programs, and transition assistance. The VFW believes these programs deserve focused leadership and resources to help veterans successfully transition to civilian life, while allowing VBA to focus on disability compensation claims and appeals. The VFW supports forty-one fourteen, the Ensuring Veterans Smooth Transition, or EVEST, Act. This legislation would automatically enroll transitioning service members into the VA health care system within sixty days of VA receiving the necessary information from the Department of Defense. It would also preserve veterans' ability to opt out. The VFW strongly supports efforts to create a seamless transition from DOD to VA. Too many veterans leave military service without immediately connecting to the benefits and health care that they've earned. The first year after service often brings challenges surrounding mental health, employment, housing stability, and increased risks for suicide. Automatic enrollment helps create a warm handoff and reduces barriers to critical services. Veterans should not have to navigate unnecessary hurdles, simply to access the health care that they've earned. Finally, the VFW supports the discussion draft to establish an office for toxic exposure implementation and oversight. and an Assistant Secretary for Toxic Exposure Coordination within VA. The implementation of the PACT Act and toxic exposure policy now touches nearly every part of VA including health care, disability compensation, research, outreach, and workforce planning. The VFW supports creating centralized leadership to improve coordination and accountability across these efforts. We also encourage the committee to consider transparency measures as part of this proposal. Veterans deserve greater visibility into how VA evaluates toxic exposures and presumptive conditions. We would like to see clearer public communication regarding which exposures and conditions are under review, estimated timelines for presumptive evaluations, and how scientific evidence is being assessed. Veterans exposed to toxins should not be left uncertain about whether their conditions are being considered or where the progress stands. Chairman Voss, Ranking Member Tocano, this concludes my remarks. I am prepared to answer any questions you or the members of the committee may have.

Thank you, Miss Keenan. The written statement of Miss Keenan will be re- entered into the hearing record. We now will proceed to questions and I will yield myself five minutes. Um. Miss Manning, can you explain the importance of authorizing appropri uh appropriate funds?

Absolutely, Mister Chairman. I think I could talk to you about the generalities of why Congress has an oversight responsibility but perhaps it's more effective to start with an example. In two thousand one multiple things of significant importance to the VA happened. Of course, in September of that year, We had the start of the global war on terror, given nine eleven. We also had the expiration of the centers for mental illness, research, education, and clinical activities at the VA. That program is continuing as an expired authorization that is con- receiving appropriations around six and a half million dollars.

Mm.

That mental illness research that was expired but continuing to be an unauthorized appropriation in two thousand one, is not sufficient for veterans' needs. And I'll explain how we know this. In two thousand one, well, even take the next year, two thousand two, to be generous, the rate of suicide deaths for veterans per one hundred thousand was twenty-four point two veterans, already far too high. Twenty-four point two back then. Now, the latest data we have is from twenty twenty three, the rate of suicides per hundred thousand is thirty five point two veterans. We've gone up from twenty three, twenty four veterans dying by suicide per hundred thousand.

Could, could I ask you something there?

Yes, sir.

Uh, so where were your numbers from on that? Because that's not the same numbers that we're lining up with. I don't think, but okay, I d- on the amount of suicides this last report.

It, this is per hundred thousand.

Oh, per hundred thousand. Okay, thank you, thank you.

Yes, sir. Yeah.

Let me know. Thank you. I was going per day, sorry.

Um. No, no, I I thought that might be where you were going. It is actually the same data set, but I've adjusted it.

Okay, thank you.

Um, so per hundred thousand we've gone up significantly. Well, what else has happened during that time? The mental health research and underlying programs at the VA have been receiving unauthorized appropriations. Now, that doesn't mean that we shouldn't be funding mental health research for veterans. What it means is that we need to be re-examining program so it is properly tailored to the needs of today's veterans. As you mentioned during your opening statement, Mister Chairman, uh what is going on now is really focused on an entirely new generation of the veterans' population. Well, that new generation needs attention just as much as previous generations.

Right. Thank you. Uh, Mister Jaretten, uh VA has repeatedly asked uh this committee for increased flexibility in our legislative proposals. How would continuing to give B A the flexibility hurt accountability and Congress's oversight capabilities?

Uh thank you Mister Chairman. Flexibility is, you know, critically important, especially with programs like this. However, any time an uh agency or department, you know, asks for these things, they should be up before the committee answering questions on their plans for implementation. uh, once it's implemented, the progress of that, uh, they should be up here, you know, they should be in briefings, they should be answering, you know, in public hearings on the status of, you know, implementing laws and their plans to improve such programs. If they're asking for money and flexibility, they should be answering your questions and telling the you how they plan to spend them.

Thank you. Mister Ritchie, can you walk us through why OMB's current cost methi- methodology is insufficient uh estimating va infrastructure projects today

thank you for that question and and that is really the crux of everything um in regards to sixty five nine nine um basically on day one when the va looks to develop these clinics the first thing they do is figure out where the veteran census is then they figure out how much it is going to cost or how much rent that they can pay the uh omb has a directive or a dictate in regards to they must use a specific piece of software or product that only calculates office rents and if you've been to a clinic, these are nothing like office buildings um so day one they effectively are given a bad road map, then they go out to the market with their lease prospectus numbers that as we know from Last year we were between sixty and a hundred and fifty percent below the actual rental costs so something is wrong there but using this um software product, it just isn't appropriate, it just doesn't work for general purpose medical buildings or medical facilities.

Thank you. Thank you. Think I'm a little over on time but I would still want to ask you and can you share with us why OMB uh score keeping guidelines might need to be re-evaluated?

I don't know the context of your questions, I I don't have any comments at this time. Thank you.

Okay, all right. I will yield five minutes to ranking member.

Thank you, Mister Chairman. Um, Mister Keenan, I'd like to uh begin, Miss Keenan, I'd like to begin with you, Craig. Also congratulations on uh the arrival of your uh child. Um, the chairman removed H R seventeen thirty-two uh, Mister Pappas's Guard VA Benefits Act from today's agenda, meaning it will no longer be considered. Uh, VFW spoke strongly in favor of that legislation at a joint VSO hearing uh at joint VSO hearings earlier this year. Do you believe that the Guard uh, VA Benefits Act uh should be considered by this committee, marked up and brought to the House floor for a vote? Um, that's one question, and what is the importance of getting this legislation done for the VFW?

Uh, thank you, Rican member, for that question. Yes, we, the VFW strongly wants to see the Guard Act move forward. Um, and every day that it, that it doesn't, um, you know, unaccredited claim sharks continue to exploit veterans and their benefits. So the longer that this, this waits, the more veterans are gonna be subject to some of this exploitation.

Yes, thank you. It's, you know, it's my, you know, the states are Some states are moving ahead with strong protections, others more permissive protections that allow veterans to be targeted. So there really is a a need for um the federal government to uh enforce protections, um establish protections for our veterans from being targeted. Uh would you agree with that?

Yes, a federal solution is probably the best way to solve this problem.

Thank you. Mister Stratton. Your testimony highlights the need for robust congressional oversight, uh and I couldn't agree with you more, um but I noticed your testimony didn't speak to the uh to any of the individual uh any of the individual bills on the agenda today. Do you think that any of these bills will actually enhance our ability to oversee VA? Uh because these bills seem to be focused on bringing more private interests into policy making than holding the administration accountable. That's kind of where I see things.

Yeah, thank you. Uh, POGO hasn't taken a position on any of the pieces of legislation. A lot of this is beyond our um expertise. Um, however, we do support um Congress looking at programs more broadly and assessing if they're currently the department's currently meeting the needs of benef- um veterans and if some of these bills are you know needed. So we're supportive of the process overall, but not any of the underlying pieces of legislation.

Alright, well thank you. Um, Mister Ritchie, uh, study after study, whether by GAO, VA, OIG and others have found the problem with VA's delayed or failed procurements lie with VA itself. Inadequate funding to conduct planning activities, multi-layered project development and governance structure, unnecessarily detailed solicitations, and a failure to gauge market pricing have made it more challenging for VA to open new medical facilities on time and on cost. Uh, Mister Ritchie, would you support a proposal that would give VA a leasing authority, um, independent of the General Services Administration, so there would be even fewer guardrails?

Yes, that is yes.

So you would support, um, a VA leasing authority independent of the of the of the of the GAO.

My under- yes, and my understanding prior to two thousand eleven two thousand twelve v a had its own leasing authority

um how will giving v a more power and taking the actual federal real estate experts out of this process be an improvement

so i would argue that um at least in construction facilities management you have many executives there that had come from the v a so we're just trained they were trained in v a processes one two um at least the third parties or the private sector partners um believe that the process that the VA undergoes is very uh very rigid and uh basically uh they believe the process is very rigid and uh you know we don't necessarily we don't necessarily see problems with having VA oversight.

Okay, moving on, uh how does this legislation improve the institutional challenges as identified by VA's OIG which have led to project delivery failures and repeated bid busts

Okay so uh very multi-layered question I'll try to do the best I can the time you know I have seventeen seconds to answer that um that that'd be difficult to answer in seventeen questions seventeen seconds

Okay well we'll we'll have to get it to you from uh maybe a written response uh

Oh

that that would be fine

Okay I yield back to Mister Chairman.

Gentlemen yield back, uh, Representative Van Orten, you're recognized for five minutes.

Thank you, Mr. Chairman. Uh, Ms. Keenan, I've for years now had the pleasure of calling you my fellow veteran and my friend, and now it's great to call you mom. That's so awesome. I'm so happy. It's just wonderful. Um, I'd like to speak briefly on a bill, uh, H. R. s- sixty-eight forty-three that's been introduced by my dear friend, uh, Mister Siskamani from Arizona. And I think it's incredibly important, being the chairman of the subcommittee for economic opportunity, that um we actually have a group of folks at the VA that are gonna focused specifically on transition. Uh, it's critically important. Most of our veterans that unfortunately uh commit suicide do it within about twenty-four months after retiring. And uh I got a commitment from the CNO uh yesterday we've got a commitment from the secretary of of war and also of the VA that uh they're gonna focus more on this and it's gonna be a more seamless transition from active duty uh to being a veteran. And I'm very proud of them, uh Mister Collinson and Mister Hegseth for doing so. So uh Mister Siskamani uh is a great patriot, he has a huge um active duty uh, population in this district, and he is focusing on them as he should. I'm very proud also to call him my friend. So I would just urge all my colleagues to support HR sixty eight forty three to make sure that we can continue to have a fantastic uh group of American patriots, not just veterans, and without a yield back.

Gentleman yields back. Representative Brownlee.

Thank you, Mister Chairman, and um before I ask a question or two I just wanted to make note in this meeting that I'm disappointed that my Bill HR forty eight seventy six, the Reproductive Freedom for Veterans Act, was removed from today's legislative hearing. It addresses an important issue that impacts veterans' health, certainly veterans' equity to health care, and I will continue to urge this committee to include it in future hearings. So with that, I uh Miss Keenan, congratulations. I don't wanna be the only member on the dais that doesn't congratulate you today, so congratulations. Um so I wanted to ask um a question a around dental care. Uh between October twenty twenty four and September of twenty twenty five, nearly eight hundred and eighty eight thousand veterans received dental care, which is just about one third of eligible uh veterans to receive dental care. The VA operates approximately um one thousand three hundred and eighty health care facilities but dental care is available at just over two hundred of those sites um which just represents about fifteen percent of all VHA uh locations. What have your members experienced when seeking uh dental care services at the VA uh given the limited number of dental care providers.

Uh thank you for the question. Veterans using VA care experience hurdles with accessing dental care. Um even when they have a service-connected injury related to their dental care um it still is very um location specific and facility specific if they can get their care within their VA.

Has transportation been a also a barrier to that or

Transportation can always be a barrier, especially for rural veterans,

Yep.

so access to that care can be limited depending on where they live.

So, um, also, twenty-five percent of younger veterans have uh dental insurance and only a third of uh one third of older veterans have dental insurance. Uh, older veterans have worse oral health outcomes than non-veterans and younger veterans are less likely to have dental insurance than older veterans. So, um, h h how has these age-related differences in dental health dental care access affected members that you serve?

Well, I think the b- the biggest difference is some of the health conditions that our older veterans are experiencing, and dental care is part of health care. It can be a preventive um, care, but it can also impact s veterans with serious health conditions. Um, so the conditions that our older veterans are experiencing may be different than some our younger veterans, but the dental care in combination with some of their serious health conditions can can make things worse.

Thank you. Um, and I will um just end on just wanting to weigh in on this uh leasing issue and taking it out of GSA and putting it back uh into um the decision making of the VA. I spent, I don't know, the first six years since I've, you know, been uh uh in Congress working on this issue, trying to get it out of the VA to the GSA where their the experience lies, and I think the process has moved uh a lot smoother since that happened. Um, I will tell you in the first six years or so, I can't remember exactly the time frame, but nothing moved I mean it just went on and on and on and I know this particular bill says oh well it will have to be done within a one year time frame I can assure you that the VA is not gonna be able to meet that requirement he you know absolutely they will not be able to so I I think it's where it needs to be and with that I yield back

The gentlewoman yields back uh Representative Barry you're recognized for five minutes.

Thank you, Mr. Chairman. Thank you all for being here. Of course, uh, congratulations on your, uh, newfound status as a, as a mom. I will warn you, I have four kids of my own, so I have to give you unsolicited parental advice, of course. And, uh, all I can tell you is this is a life sentence. So, uh,

All right.

and if you doubted that, I am recently turned forty-five years old and my mom still worries about me. So, um, so, so it's a great, it's a great thing. Um, and thank you to our panel for being here today. Um, I uh wanted to just open up and um kind of lay out a foundation of some of the work that we're doing. Um, I I had introduced uh HR sixty eight thirty-three, the acquisition reform and cost assessment act, known as the ARCA act for short, topic of conversation today. Really kind of tackling this issue of chronic bureaucracy and how that can delay implementation and get lost in the weeds of what our actual mission is, which is to deliver care and benefits to veterans who've earned that. Um, but the VA has a really poorly structured acquisition and contracting process, um, and it really does bog down the progress we're trying to make. Um, it fails to provide real accountability for underperforming contractors. Some of these contracts get needlessly delayed. When that happens, the costs go up for taxpayers and that cuts into the services that ought to be preserved for our veterans. When more is going out the door in one way, it takes less, uh, than that we are delivering to actual veterans. Um, one way that we just saw this very recently, the the DOJ just indicted a former executive at the VA who was responsible for a huge portion of this electronic health record modernization effort, something that has plagued the VA for years, something that falls squarely within the, um, portfolio of what this subcommittee that I have the privilege of leading is really looking at is this electronic health record modernization that's so critical for veterans across the country. Um, you know, we were saddened to see this, uh, indictment. I don't want to presume anyone's guilt or innocence from here. Of course, we have a process for playing that out, but I think it does certainly raise the alarm bells of what we ought to be looking at as far as accountability within the VA. And having an acquisition process I think is really important to that. Um, now with that being said, I'd like to hear some of your all thoughts on on this effort, um, starting with Miss Madney, did I say that correctly?

Yeah.

Very good. Um, can you talk a little bit more, explain to us a little bit more about how ballooning contracts and acquisitions have continued to increase overall spending without increasing benefits for veterans uh you know it's one thing if we're spending more money to increase benefits and outcomes but if we're just spending more money without doing that, I'd I'd be curious on your take on those.

Well, we shouldn't be doing it.

Yes, absolutely.

Um, no, you you put it very well, sir. If you are increasing funding without improving outcomes, then what you're actually doing is making outcomes worse.

Mm-hmm.

And I know that might seem counter-intuitive, shouldn't it just be a net neutral? But the reality of the situation is no. As I mentioned in my, uh, written testimony, as spending increases, you increase inflation, you increase unaffordability, And so what ends up happening is that the overall market prices are driven up by, uh, transfer payments, inflationary pressures, et cetera, which means when you do eventually get to, uh, following through on some of these contracts, they will be expensive. They will be even more expensive.

Yeah.

So you actually have this multilayered, multitiered problem. The only way to fix that is to perform regular oversight and hold the VA accountable. And I think your bill is an an excellent first step to that. I would also suggest perhaps having a series of more uh robust oversight hearings to see their steps and whether or not they're following through.

Yeah. I um thank you for that. I I think I learned years ago I worked uh in Michigan for the uh for the state treasurer uh probably fifteen or so years ago. And we had this um point that I learned which is separating the difference between outputs and outcomes.

Mm-hmm.

you can spend a lot of money on outputs that don't actually change the outcomes.

Mm. Mm.

And especially the work that we do on this committee should be focused really heavily on the outcomes for veterans that, you know, instead of looking at how much we spend on something specifically, well, what was the outcome of that, not just the outputs within it. Um, Miss Keenan, if you wouldn't mind, uh, I had a question for you.

No.

How does the lack of congressional oversight over the VA acquisition process hurt veterans in in your opinion.

a day later because of their national

Uh thank you for the question. I I think our main concern is um

were there for

failures um to to properly modernize systems effectively, efficiently, and using the funding appropriately. So additional oversight, we we're totally on board with some of the provisions in the bill, and sort of the efforts to try to rein in um and and oversee some of these major projects um to avoid any kind of uh delays and waste of of taxpayer money um i think that's the goal with with this kind of proposal

thank you Mr. Chairman yield back thank you gentlemen yield back Mr. Garb- Mr. McGarvey you are recognized for five minutes

thank you Mr. Chairman i think maybe we should make a motion to have everyone congratulate Miss Keenan but until that happens until that happens i have to also

uh-huh

say congratulations so Uh, but my my guess is you're gonna keep getting them, so congratulations uh on on the birth of your daughter. So um uh thank you for being here today and I think, you know, one thing about this committee is we are focused on a mission, right? We are focused on the mission of serving our veterans. These are the men and women who put on the uniform quite literally willing to sacrifice everything to keep us safe and keep us free. In exchange for that service, we do make a promise. We make a promise that we're gonna take care of you. So when we talk about veterans' benefits, we are not talking about something we are giving to someone. We are talking about something they have earned. And we are talking about a promise, both a moral and a legal promise we have made. So when veterans are trying to get the benefits they have earned and they are denied those benefits, they necessarily have the right to appeal that decision. It is part of the promise we make in exchange for service. Now one thing that I hear about all the time in Louisville, and I know you all hear about across the country, how long it takes to get a decision on these appeals from our veterans. This is more than just some, you know, bureaucratic maze or some statistic. Every single veteran who is waiting for a decision on their appeal is waiting on something that might help them keep a roof over their head, put food on the table, get the treatment they need. So how do we speed these up? Now, I know as a recovering lawyer myself that lawyers are oftentimes punching bags, uh and sometimes deserve to be. But in the veteran space that we're talking about right here with getting those appeals to get the benefits you've earned it is lawyers in the VA who make those decisions they are the ones writing those opinions and we are having trouble keeping lawyers in place to do that that is partly responsible for the backlog which is hurting veterans they're not able to have that roof over their head they're not able to get that decision they're not able to get the benefit they have earned there is a simple fix we have proposed to make. better not to completely fix the problem but to make it better so our veterans get these results faster and that is a bill i've introduced hr twenty three O three the board of veterans appeals attorney retention and backlog reduction act which is a really long name to just say we're trying to keep more attorneys here to get our veterans what they need and get it to them faster it would allow us to promote veterans to the g s fifteen spot it is a way of retaining talented individuals, and most importantly getting our veterans what they need. So, Miss Keeney, you noted in your testimony that attorney attrition at the board directly contributes to the appeals backlog. Can you talk a little bit about what that backlog means for the veterans you serve at VFW?

So the backlog of appeals, you know, can take years, many times for veterans, and so that weight can cause a economic, financial, um difficulties for those veterans that are waiting to get the disability benefits or other benefits that they've earned um we do appreciate um and support your legislation I think particularly because um there are other units within VA that have this promotion ability so retaining some of those attorneys within the board of veterans appeals is gonna help with that backlog.

Yeah I mean two things you said there one years right we're not talking about weeks we're not even talking about months we're talking about years. until veterans can get a decision on the benefit they have earned from putting on the uniform. Uh, I will also say, you s- you mentioned that that only the Board of Veterans' Appeals d- they don't have this ability to go to GS fifteen. Others do. In fact, the Board of Veterans' Appeals is the only agency within the VA who doesn't have the ability to promote to a GS fifteen, and this would help with that retention. So I appreciate you bringing up those points. I'll ask you, um, you know, do you think that keeping these experienced attorneys

Absolutely.

Okay. Well, everybody take note. That's how you answer our question. Um Uh uh other VA offices you had on this, they uh they already allow these nonsupervisory attorneys. Um do you think that the board can realistically keep the attorneys it needs without this authority or do you think that passing a bill is a step in the right direction to make sure that veterans

Um, I do think it it it would be an important change because if there are incentives for attorneys to go elsewhere, even within the department, um, that that's gonna be tempting for anyone who wants to have a better income. So, uh, stability within the Board of Veterans' Appeals is important. This would be an important, a a key way to do that.

Thank you for saying that. And I just point out, this is not about pay grades. This is not about internal VA bureaucracy. This is about getting veterans the benefits they've earned in a timely way. So I appreciate your testimony, Mister Chairman, I yield back.

Gentlemen, you're back yield it back, Doctor Murphy, you're recognized for five minutes.

Yes, thank you. I just wanna say to my good friend, Mister McGarvey, as an attorney coming from a physician, you missed uh April fourteenth, that was Be Kind to Lawyers Day. And I and as I said when I was in the General Assembly of North Carolina, I said be kind to lawyers because they are people too. So, thank you. I'll continue the litany of congratulations. Motherhood is the greatest calling. of any woman, congratulations. Uh, you know, children are gonna bring you a heartbreak, but they're gonna have the greatest love in your life. So congratulations. Uh, I just wanna chat about a couple things. I applaud the oversight. You can't run a business without oversight. And sadly enough, our government tends to not do oversight very well, um, and to continue, uh, unnecessary levels of haphazard bureaucracy, which in this case leads to harm, delay, et cetera, just for our veterans. So I appreciate everybody's a concerted effort to try to cut through the morass of the uh of the ridiculous bureaucracy that we have just wanna give a a a plug for my bill hr sixty five eighty three which would establish a VA centralized research data system integrated with electronic records we'll talk about that for a second to track major research projects, funding progress, and outcomes across the VA we don't need a haphazard system um in the VA to do this, we actually have a perfect model to be able to have a really concentrated system within the VA to do good research, have it tracked, and make sure it's concerted effort and, uh, and that, uh, we do it well. The bill also will create a tiered review-based system for research. So I'd appreciate everybody's, uh, support for that. I'm a researcher, done it, you know, a lot. Been a scientist, et cetera. It's very important that we do good research within the VA. Um, it was brought up a few minutes ago about our electronic health care system, and I never miss a chance to beat on the fact of the absolute ineptitude negligence of what the VA has done with the electronic medical record system, what for now fifteen years, fifteen years, billions of dollars, and I can't, I I think it's six or seven places, um, that we have a a a system that actually works for electronic health care system. But guess what? Help is on the way. And I think this is where the advent of artificial intelligence, the good part of this, will be able to be helpful at the VA. Speaking with a gentleman, a f- a fellow physician, uh this past weekend who wants to get in and talk with the VA about streamlining a system where artificial intelligence will have uh the ability to speak directly with the veteran have a catalog of fifteen twenty-five thousand uh questions be able to answer veterans so there aren't calls that go unanswered and there's the patience of Job when listening to an artificial intelligence we have uh we have this documented within the private system already for pre-op visits when patients call and say hey I c- I don't understand this," and - and they go on and on and on. If we can institute this system that will then be able to query um that veteran's electronic medical record, pull data from this, and really take out the massive bureaucracy, streamline this. Th- uh I think this will be actually earth shattering uh for the veteran and for our - our future systems to be able to cut through needless human bureaucracy get our veterans what they need. So I look forward to actually coming back in front of this committee, uh speaking with our VA about what would literally be the good use of AI for our veteran to cut through the uh the human bureaucracy that has become our VA in so many different ways so um thank you Mister Chairman I'll yield back but I think that's actually an envelope and a sunrise of hope for our veterans in the future to use technology to really help our guys na- and gals and guys and gals navigate, uh what is a challenging system.

Thank you. Doctor Dexter.

Thank you, Chair Bost.

Notice all the doctors have stayed around, it's really neat.

What's that?

All the doctors have stayed around, it's really neat.

We're we're diligent.

No attorneys though.

We are diligent, that is true. Um, thank you, Chair Bost, for holding this hearing,

Well won.

and Miss Keenan, congratulations, I I know you're surprised to hear that, but I deeply, deeply value um how hard it is to do good work and be a mom, so thank you for doing that. Um. And I also appreciate the ability I have today to speak on my bill, the Every Veteran Housed Act. I appreciate and share everyone's commitment here, um, to tackling veteran homelessness and hope that we will continue to work together on this issue. In Oregon and across the country, preventing and ending veteran homelessness is a top priority. Our communities believe that honoring service means ensuring every veteran has a safe and a stable place to call home. So that's why we introduced the Every Veteran Housed Act. It's to remove barriers and streamline eligibility standards across VA homelessness programs. It'll make it easier for veterans experiencing homeless to access the full range of services that they've earned. Critically, it also expands access to those who have served in the National Guard and the Reserve, helping eliminate another obstacle, um, that they are facing. This legislation is a practical, targeted step that will help more veterans access housing, stabilize their lives, and reconnect with the support systems they need. It reflects a broader commitment to treating veteran homelessness as an ethical as well as public health issue. Ms. Keenan, you can you speak to the existing gaps in the veteran homelessness system, and why it's so critical that this bill helps reach those who have historically been left behind?

Yes, thank you for that question. Um, so currently, um, discharges other than dishonorable don't count for these programs. So that's that's what this would hope open up um eligibility to - to additional veterans um and that's similar to access to VA health care and disability benefits so we see this as a a way to reach more veterans that may be in need of some of these programs.

Thank you so much and I just wanna also point out that some of those less than honorably discharged veterans are struggling with exactly the issues that lead to homelessness, mental health challenges, um addiction, history Um, it is absolutely our obligation, I would say, to close those gaps that we've created for them. And, Ms. Keenan, you also highlighted in your testimony the connection between stable housing and mental health, um, stabilization as well as suicide prevention. How do you see the Every Veteran Housed Act advancing those goals?

I think the more veterans that we can reach with some of these, um, homelessness programs, um, the better that veterans that are in need can have that stability not only for themselves, for their physical and mental health, but for their families as well.

Yeah, and to my colleagues on the committee, I just wanna be clear that this is not going this bill would not impact um dishonorably discharged or court-martialed veterans. This is really less than honorable discharges which happens to people who are serving in good faith and and just can't um finish their service for differing reasons to my um colleagues um here who are advocating for transparency and accountability very much appreciate that and and fully support that i also wanna make sure that we are not um removing regulations and oversight to a degree that just opens the door for further um waste fraud and abuse and i think this is a balancing act that we all need to be diligent in um addressing together so thank you mister chair i yield back

The gentleman yields back. Doctor Conaway, you're recognized for five minutes.

So, with help would be

Uh, thank you, Mister Chairman, uh, for recognizing me and, uh, thank you for holding this very important hearing. I am thankful for the opportunity to testify in behalf of my bill, H. R. eighty-fourty-four, the Get Justice Involved Veterans Backed Back Home Act. Recent research shows that veterans with mental health conditions, particularly PTSD, traumatic brain injury and substance uh abuse uh disorders, uh stemming from their combat or service-related trauma, face significantly higher risk of entering or re-entering the criminal justice system. Veterans with PTSD, for example, are sixty-one percent more likely to be involved with the criminal justice system uh than those without PTSD and fifty-nine percent more likely to be arrested for violent offenses. And while the VA operates uh programs to support veterans in the community, there remains a critical gap for care for veterans who um who are in the criminal justice system. Since nineteen eighty-six, the VA has not provided health care to veterans when they are under supervision of another government agency with a duty uh to furnish care, such as prisons or jails. Uh, a study from twenty sixteen estimated that one hundred, seven thousand, four hundred veterans are s- serving were serving in in state and federal prison at the time um in twenty sixteen. While these veterans served uh their time, it is important that veterans or rather the VA provides the necessary services to ensure that these veterans can heal rebuild and successfully re-enter other communities. My part of by my bipartisan bicameral bill would direct VA to carry out a pilot program to furnace mental health to incarcerated veterans via telehealth if the facility has the necessary infrastructure or through other means determined uh appropriate by the secretary including mobile mental health units. Now this is a pilot program that will occur over over five institutions within the uh within the uh prison system in the in the United States uh so that we can see how it works and then uh and I as I believe it will, and then move it forward uh to uh increase its reach. Um the bill uh directs uh the VA to prioritize veterans with service-connected disability ratings related to btsd, traumatic brain injur injury or military sexual trauma, while ensuring these veterans uh that those veterans are being seen by uh VA uh health care providers. Um, note that this bill would bar a VA from collecting co-pays from veterans participating in the program, and require that upon the date of their release, veterans who had their disability compensation payments reduced while in custody have their full payments restored automatically. By ensuring our veterans have access to strong mental health care during their incarceration, uh, we can help set them up for success after their release, making it easier for them to succeed uh in other areas such as securing employment, uh securing stable housing and more. I am pleased to have my colleague, uh, Representative Luttrell co-leading this bill with me uh in the house, and I appreciate his work on this, and I'm grateful for the support of the american legion uh vietnam veterans of america with honor the american uh correctional association the american uh psychological association and the american psychiatric association uh miss keenan uh what are the gaps in care for incarcerated veterans and how best can we address them certainly i hope uh that you'll uh find and and that this measure is an important part of filling that gap but i'd appreciate your comments on uh on this question

Uh, thank you for the question. Um, you know, obviously there is a lack of access that incarcerated vet- veterans are gonna experience um to their their VA health care. Um, so we, you know, generally like this pilot program idea. Um, we do have some technical um s- suggestions on how it could be improved to really look at uh the full gamut of mental health conditions that these veterans may be experiencing outside of PTSD and the various conditions related to military sexual trauma.

Well, thank you for that, and - and um, i- we are prioritizing certain conditions, but the full gamut of um - of mental health challenges that veterans face certainly ought to be addressed. It's part of comprehensive mental health care, and to the extent that um uh we need to uh emphasize that, then I'll certainly work on that as well. Um. Uh, do you believe that by, uh, and anyone can answer, that providing a one-on-one mental health counseling to justice involved veterans who find themselves within the criminal justice system, um, uh, could reduce, uh, recidivism and help the veterans succeed after they serve their time?

Absolutely. I think VA provides some of the best mental health care for veterans. It's, um, veteran-specific and, you know, they offer it through in-person appointments but also through telemedicine and so I think the more veterans that we can reach regardless of their circumstances the the better off that will be.

Thank you, Mr. Chairman, I yield back.

Gentleman yields back. Thank you to the first panel uh witnesses you're excused and I appreciate you being here, and uh thank you so much. And I'd like to invite the second panel of witnesses to come up and uh we'll get started as soon as they switch over the name tags.

thank you mr. chair

mmm

All right. We would like to get started with our second panel, and on our second panel we will hear from the following witnesses. Mister Cole Lyle, the Director of Veteran Affairs for Rehabilitation Division, in the Washington DC office of the American Legion. Mister Mike Desmond, strategic director of government affairs and advocacy for mission roll call uh mister john ritzer uh national legislative director of disabled american veterans and mister morgan brown national legislative director for paralyzed veterans of america if you would each could who could stand and would stand uh we ask you to raise your right hand I ask the witnesses to yeah do do you solemnly swear under penalty of perjury that the testimony you're about to provide is the truth the whole truth and nothing but the truth. Thank you and let the record reflect that the witnesses have answered in the affirmative. Now I would like to recognize Mister Lyle for five minutes for his opening remarks.

Well thank you Mister Chairman, uh ranking members Kano, distinguished members of the uh committee. On behalf of National Commander Dan K. Wiley, and more than one point five million dues paying members of the American Legion, thank you for the opportunity to appear before you today. The American Legion is a grassroots resolution-based organization. Every p- every position we take begins at the local post level, uh where we offer you the lived experiences of those who have worn the uniform. The bills before us today represent a meaningful effort to modernize the Department of Veterans Affairs improve efficiency, close long-standing gaps in care and benefits, and strengthen accountability at a time when demand for VA services continues to grow. The American Legion supports the majority of these measures today because they directly or indirectly advance the priorities set by our members. We are especially encouraged by efforts to make VA's health care delivery more responsive and consistent. The Visin Reform Act, for example, seeks to streamline the network structure after years of bipartisan concern with Visin organization and management. We support the bill and urge targeted amendments to safeguard rural and highly rural veterans, ensure thoughtful staffing decisions, and prevent any disruption in care during what is already a period of significant reorganization. Similarly, the VA National Formulary Act would ease access to necessary medication, and the Leasing and Infrastructure Act would give VA tools it needs to expand facilities more quickly and cost-effectively, while protecting taxpayer dollars. However, both of these bills run the risk of significant implementation challenges should VA not be properly resourced. We also strongly back the VA Research Reform Act, which would reduce administrative burdens on research, speed the translation of discoveries into better care, and expand partnerships that bring new resources into the system. On benefits and care, several bills would close gaps that rec- that veterans have waited far too long to see addressed. The Dental Care for Veterans Act recognizes that oral health is inseparable from overall health. The EVEST Act would automatically enroll eligible transitioning service members into VA care removing one of the most frustrating bar- barriers they face when they leave the military the Ever- Every Veteran Housed Act would extend critical homelessness prevent- preventative services to veterans and with other than honorable discharges who have been unfairly excluded for too long and the legislation addressing acute sexual assault response would ensure every VA facility is equipped to treat survivors with dignity. We are also pleased to support the VA Trust Act to resp- restore accountability around executive bonuses, the Board of Veterans' Appeals, Attorney Retention and Backlog Reduction Act, to keep talented lawyers serving veterans, and several of the discussion drafts on toxic exposure, justice-involved veterans, and EHR modernization. That said, we must be candid where we have concerns. We oppose the Veterans Affairs Advisory Committee Oversight Act, because consolidating and sun- sunsetting specialized committees risks removing focused voices on issues that matter deeply to specific veteran populations. We also oppose the Veterans Readiness and Employment Improvement and Accountability Act as written, particularly provisions that could penalize veterans or strip away TDIU uh b- during VRNE programs. And we oppose the bill that would shift key transition and employment responsibilities away from the Department of Labor where we believe they belong. Our full written testimony, including an executive summary of positions, has been submitted for the record. The American Legion stands ready to work with this committee, VA, and our fellow stakeholders to refine these proposals so they deliver the strongest possible outcomes for the millions of veterans who rely on VA every day. Thank you again for your leadership and the opportunity to testify. I look forward to your questions.

Thank you, Mister Lyle, and m- written statement of Mister Lyle will be entered into the hearing record, At this time I would like to recognize Mr. Desmond for five minutes for his opening remarks.

Thank you, Mr. Chairman. Chairman Bost, ranking member and distinguished members of the committee, thank you for the opportunity and the honor to testify today on behalf of Mission Roll Call and the veterans families and caregivers across the country, whose voices we carry to Washington. Mission Roll Call conducts regular survey research focused on the issues affecting veterans' lives. Our work is grounded in listening to veterans and identifying where policy systems, and lived experience can be improved. Over the past year, Mission Roll Call surveys have shown that veterans do see areas where the VA is improving, particularly in overall quality of care and certain aspects of service delivery. There is a growing sense that the system is moving in the right direction. At the same time, veterans continue to experience some challenges with access, timeliness, and consistency. This reauthorization effort presents an opportunity to build on that progress. and address the structural issues that continue to shape how veterans experience care. What stands out in this reauthorization effort is the focus on improving the parts of the VA system veterans experience directly. In our surveys, veterans consistently identify access delays, inconsistency between facilities, difficulty navigating benefits and care systems, and bureaucratic friction as recurring challenges. The first area where this package strongly aligns with our data is research modernization. Veterans increasingly understand that promising treatments exist, particularly in areas like PTSD and traumatic brain injury. But many believe the system moves too slowly, translating research into practical care. Our polling shows strong support for evaluating innovative therapies, including hyperbaric oxygen therapy. Legislation that improves coordination, standardizes data, and accelerates implementation helps move research closer to veterans. The faster we align the right solution with a veteran's need, the more likely that veteran is to thrive. Second is formulary and access reform. Our TBI and healthcare access surveys consistently identify difficulty accessing specialized care as a major concern. Veterans frequently report that distance and system barriers affect access to appointments medications and treatment options. Efforts that improve transparency and standardize access across the system directly address issues that veterans repeatedly identify in our surveys. Third is infrastructure and regional consistency. In our Veterans and Families survey, nearly half of respondents reported delays in VA health care services, and Veterans reported an average drive time of more than fifty minutes to reach the nearest VA facility. For many rural Veterans, that distance becomes a barrier to care. Modernizing leasing, infrastructure delivery, and regional oversight goes beyond administrative reform and directly affects how quickly Veterans can access care. As we examine reauthorizing multiple aspects of the VA systems, We also want to connect these efforts to the concept of left of clinical. Too often our systems wait until problems can only be solved in clinical settings before meaningful intervention begins. After decades of tracking veteran suicide data, outcomes are not improving. We devote more resources every year, yet the trend remains concerning. We must look at this problem differently. At Mission Roll Call we refer to this as " left of clinical", supporting veterans before challenges escalate into crisis. Our April twenty twenty-six transition survey found many veterans did not fully understand available VA benefits at separation, were not clearly offered enrollment opportunities, and received little meaningful follow-up after leaving service. As a result, too many veterans enter civilian life without a clear path forward, and begin to struggle with housing, employment, housing, employment, identity, and stability. The structure and support network that existed during service is no longer there, and they report difficulty rebuilding it. That gap is where risk compounds. Outside the reauthorization package, Mission Roll Call sees alignment with several bipartisan bills before the committee focused on prevention, transition, and long-term stability. Our data shows that instability during transition overlaps with financial instability, housing insecurity, delayed access to care, and worsening mental health outcomes. The EVEST Act addresses one of the key barriers identified in our surveys. Many veterans do not know where to begin accessing benefits. Automatic enrollment reduces that friction at the point of transition. The Safe Steps for Veterans Act reflects the importance of upstream intervention. Preventive measures, home modifications, and mobility support reduce downstream health decline and help veterans maintain their independence. Mission Roll Call survey data shows significant concerns surrounding housing affordability and homelessness risk among veterans, reforms that can improve access and consistency while engaging veterans earlier

Thank you, Mr. Desmond. The written statement of Mr. Desmond will be entered into the hearing record, and I would like to now recognize Mr. Ritzer for five minutes for his opening remarks.

Chairman Boss, Ranking Member Tucano, and members of the committee, thank you for the opportunity to testify today on behalf of DAV on very important pieces of legislation. First, I want to start off with DAV strongly supports the Dental Care for Veterans Act, which would expand dental care to all enrolled veterans because dental care is health care. Today only two point four million veterans qualify for dental care, leaving millions, including service disabled veterans, without dental coverage to treat gum disease, tooth decay, jaw conditions that cause pain, infection, and a lot of times difficulty eating and even speaking. Untreated oral disease also increases and impacts the risk of service-connected conditions and other conditions like heart disease, diabetes, kidney problems, and even cancer. These are medical issues. They're not cosmetic ones. It's time for Congress and VA to make medical or dental care part of the standard medical benefits package. Because VA's dental clinics are already overloaded, this expansion will require more staff, treatment space, and community care to avoid displacing current patients. So done right though, this bill would close a major gap in care that veterans have earned. DAV also supports the Veterans Economic Opportunities and Transition Administration Act, which would create a fourth administration. Veterans should not have to navigate a disconnected programs while rebuilding their lives after service. Fragmented VA programs for education, training, rehabilitation, employment, entrepreneurship, and even housing create confusion and delays when veterans are trying to stabilize their lives. This bill will bring these programs together under one accountable administration led by the Unders- Under Secretary. A unified structure could improve planning, policy alignment, and service delivery for veterans pursuing education employment, and ultimately long-term stability. DAV opposes the VA the the Research Reform Act, which would make major changes to the VA research enterprise, a system that has operat- operated successfully for more than fifty years. VA's research depends on collaboration among VA medical centers, academic affiliates, and non-profit research groups. This bill would centralize control through new reporting rules, and put sensitive data at risk and deter outside investments. Research quality depends on flexibility, local expertise, and scientific independence. We urge the committee to pursue reforms that strengthen what works. Reduce administrative burdens and invest in workforce infrastructure rather than impose structural changes that could destabilize a proven system that benefits veterans and not just veterans, all Americans. DV has serious concerns with the Veterans Readiness and Employment Act, especially section nine, which would deny individual unemployability benefits to vocational rehabilitation programs that veterans enroll. For many veterans, individual unemployability benefits provide housing and food security needs, while they prepare to enter into or for employment. This legislation would force veterans to lose financial stability before rehabilitation is even assessed as being successful. This is a financial coercion, not rehabilitation. VA has warned that this rule could force veterans to leave the program. Rehabilitation should lead to independence, not harm a veteran or their family. GAV will oppose any bill with this provision or similar proposals that reduce benefits for service disabled veterans. Finally, DV has no resolution on the number of organizations of VISNs, and we have no position on the VISN Reform Act. But we do want to share concerns about the ongoing reorganization of VHA. Last year, VA reduced its workforce by thirty thousand positions, even though it still had more than forty thousand unfilled healthcare positions. VA's new budget proposal makes dramatic shifts, from VA's provided direct care to private sector care, with less than two percent increase in the VA care, but more than fifty percent for community care, even as VA acknowledges a quote " growing demand for direct care." VA reduced its ten year strategic capital investment planning estimate for healthcare infrastructure by more than sixty percent. while moving ahead with ten year, one trillion dollar community care contract. Taken together, these decisions leave VA with less internal capacity and greater reliance on outside care. DAV believes veterans need strong, integrated VA health care system, where community care supports VA but does not replace it. That concludes my statement, Chairman, and I'm pleased to answer any questions you may have.

Thank you, Mr. Ritzer. Uh, the written statement of Mr. Tarr- will be entered into the hearing record. Finally, I would like to recognize Mr. Brown for five minutes for his opening remarks.

All right. Thank you, Chairman Baas, Ranking Member Tucano, and members of the committee. PVA thanks you for the opportunity to testify on some of the pending legislation that is before the committee today. Congress exercises its constitutional Article-one authority through the authorizations and appropriations processes. VA funding and program authorizations are handled by the appropriate committees. However, reauthorization of existing programs does not occur on a regular cadence and program authorization is often decoupled from funding. Last year, this committee embarked on an effort to establish a must-pass authorization bill process for the VA that's similar to the same process used to approve the National Defense Authorization Act. We are generally supportive of efforts to establish a formal process like the NDAA, but we have some concerns about how it will affect access to the services and benefits that catastrophically disabled veterans depend on. Many currently recognize that the current defense authorization and appropriations process is broken. Politization and disagreements over policy have led to delays in passing both the NDAA and the defense appropriations bills. This has resulted in many temporarily authorized programs expiring or being delayed as a result of congressional inaction. So we don't want veterans to be subjected to the same delays that military service members experience. We do feel that veteran service organizations should be included in the conversations leading to the development of a new process, so we greatly appreciate the opportunity to participate in this discussion today. That said, here are some quick thoughts on a few of the bills being discussed today. The VA National Formulary Act creates the statutory direction for VA's national drug formulary and establishes two oversight committees. It standardizes timelines for reviewing non-formulary drug requests and medication additions. PVA supports consistency in timely medication access for veterans, but we are concerned that the new committee structure may add bureaucracy and that tiered copays could increase costs for veterans requiring specialized medications. The VA Research Reform Act creates a centralized VA research management system with tiered review processes and standardized approval timelines. It also establishes clinical research hubs and requires reporting on implementation outcomes. We are confer concerned that this bill could undermine scientific independence and deprior prioritize basic research and disadvantage SEID research serving smaller veteran populations. To be clear, PVA supports improving accountability, ensuring that research translates into real benefits for veterans. Most important, we support creating bench-to-bedside funding mechanisms to move discoveries into clinical care faster. PVA strongly supports the Veterans' Economic Opportunity and Transition Administration Act. This legislation creates a new administration focused on education, employment, transition, VRNE, and housing adaptation programs. We feel this would increase visibility, oversight, staffing support, and innovation for these programs. It would also improve collaboration with other federal workforce and transition programs while allowing VVA to focus better on disability claims processing. PVA opposes much of the veterans' readiness because we believe it adds bureaucracy and could unnecessarily delay the delivery of benefits. The bill could reduce access for catastrophically disabled veterans. We can counsel our expertise standards, create inequities in housing allowances, and potentially harm veterans receiving TDIU. Dental care is also critical to over all health and wellness, so we strongly support the Dental Care for Veterans Act. VA's current eligibility rules leave many veterans without access to needed dental services. The bill would expand VA dental care eligibility to align dental care with broader medical services. And finally, we support the EVEST Act, what auto which automatically enrolls veterans into VA health care. We believe the transition from active duty to civilian life should be seamless, and this legislation helps facilitate that trans Thank you again for the opportunity to testify today and I'll be happy to answer any questions you may have.

Thank you, Mister Brown, the written statement of Mister Brown will be entered into the hearing record. We will proceed now with questionings and I yield myself five minutes. Um, Mister Lyle, uh, how would coordination not only with the VA but with other agencies drive innovation or innovative research that can scale implementation and outcomes.

Well, thank you, Mister Chairman. Uh, the American Legion has supported the the Research Reform Act because, uh, we believe, uh, it's a important and necessary step to to streamline, uh, inter-agency cooperation. Um, there there is, uh, some question about the research hubs and how that would fit into VISN reorganization. Uh, but overall, any time you can, uh, have the VA work with CDC, NIH on things ranging from uh particular healthcare issues, suicide prevention, things like that, and and have uh notable outcomes. You know, I sh- I share some concern about uh a particular section. Some research does not necessarily have actual outcomes that are that are measurable, much like the um the basic research that's done at DOD that's foundational research. Um, so we would like to see, uh, a amendment to that particular section.

Mm-hmm.

Uh, but other than that, we - we very much support this bill.

Thank you. Mr. Desmond, the leasing and construction bill would exp- uh, expedite the process for building VA clinics and hospitals. Can you discuss what you have seen through the surveys on the impact, the care delays on veterans?

Thank you for the question, Mr. Chairman. Uh, we have not done a survey specific to that question, but we can tell you that when there are challenges for veterans to get to the facilities that they need to find their care, then that is reflected in all of our surveys. So to the degree that we can speed up, which is generally the messaging we get across all of our surveys, is what can we do faster and better on behalf of veterans. So to the degree we can speed up that process and be more effective with it to deliver that care in ways that make veterans' lives easier and more stable, then that's certainly a priority for them.

Mm. Well, Mister Jesmyn, do you believe that the current configuration of the VISN system is insufficient for veterans right now?

Based on our survey data? Absolutely, Mister Chairman, I think so.

Mister Ritzer, um, why is it important for, uh, prosthetic and, uh, sensory aid services to have a contin- tenu- continuous, uh, production and schedule as opposed to one of the new technologies added per uh period?

Thank you for that question. I think it's very important as we look at prosthetics and sensory aid uh devices that they're constantly and steadily moving forward and available to our veterans. As we see the aging veteran population, for example, their needs for uh hearing devices are continuing to increase. So we have to make sure that in- innovation is staying in line with what their needs are and are available at the ready. and you know that they continue the process. And also with prosthetics it's so important cuz GAV, as we continue to do the rehabilitation program in our golf uh uh campaigns and also our winter sports games it's so important that the prosthetics innovations moves forward and to be able to facilitate the various needs not just for the general living but also to be able to have quality of life experiences.

Right. Mr. Brown? How can VA improve its current delivery of infrastructure projects when it c- when it c- uh constantly has to deal with uh i- um the lag that they're dealing with right now.

Uh, I presume that, Mister Chairman, that you mean the insufficient funding

Yes.

uh and and insufficient staff. Um, well, we're seeing the outcome uh right now, as you know, um the average age of a VA facility, I wanna say fifty, maybe it's Might I may be wrong? It may be sixty years. Um certainly many of our facilities, the uh spinal cord injury and disorder centers um fall into that category. Um so the absence of funding um definitely means that the facilities are aging, they're no longer suitable to accommodate um a sufficient number of patients. Uh we still have some uh many facilities with four patient rooms which complicates um the situation the availability of um of beds when we have um like infection control. So

Okay one more quick follow-up to that, what what is the issue with OMB's current cost methodology for VA major medical construction projects?

Ooh um that's a good question, if you don't mind I'd like to take that one for the record.

Okay, thank you very much, I um So I yield back, but I now recognize Representative Ramirez, uh, who is both the ranking member holding spot right now as well as herself, so she can question which ever one she wants to ask.

Thank you, uh, Chairman, and, uh, really grateful for the Illinois representation. Uh, in this moment, Minnesota, you're a little outnumbered here. I just wanna thank the witnesses for being here today and frankly, the work that you do every single day to make sure that everything we do centers veterans. I really appreciate you. Twenty thousand seven hundred and twenty-seven. I've memorized that number and I often say it five, six times a day. That's the number of veterans that I represent. And ensuring that the veterans have every single benefit that's been promised to them is a top priority for me. It's why I'm in this committee. Access to affordable, quality education is also one of those benefits. The GI Bill has been a critical important policy that makes it possible for educational opportunities uh of affordable and accessible education to veterans. However, as we know, in recent years, student veterans have been the target of bad actors, seeking to enrich themselves by exploiting veterans' GI bill benefits. And as we know, these bad actors have reduced veterans to a tuition payment, and exploited them to gain access to a dependable federal disbursement. Not only is that unacceptable to me frankly, it's criminal. When a student veteran is defrauded by predatory institutions, it's only right, only just that the veteran has a recourse, or way to get their benefits back. No student veterans should have to give up or defer their dreams on education because they were defrauded. It's why I proudly reintroduced the Student Veterans Benefit Restoration Act of twenty twenty five, which would restore GI Bill benefits to students who have been defrauded. But we also know that the bill moved up just a step closer to having comparable restoration process to those that govern the federal benefits of non-veteran students. We have more work to do to protect our veterans from bad faith actors and ensure that every opportunity to live a meaningful thriving and joyful life post-service is available for them. It's why I'm glad that we're having this hearing and hearing specifically from veteran service organizations today. When I first introduced the bill back in what feels like a hundred years ago, last Congress and the hundred and eighteenth Congress, I was proud that it included a grandfather clause so that all veterans have a path to recourse. However, as they moved through committee provision, and as we did some of the bipartisan negotiations, we were unfortunately forced to strip away that component. So, Mister Redser, Mister Brown, Mister Lyle, would you support the inclusion of a retroactive clause in this legislation? And if so, why? And I'll start with Mister Lyle.

Thank you for the question. Absolutely, we would support uh an amendment. It's included in our our written statement. um to veterans who have been uh defrauded by these institutions deserve uh restitution.

Thank you. Uh, Mister Desmond.

Thank you for the question.

I guess I do run on the list, but go ahead. Yes, do you, would you support that?

That's fine. I think it handles absolutely uh absolutely what we see education as a component of stability particularly post-service stability so um being able to support a program uh such as this that ensures that Veterans who are defrauded in this situation are being pulled in?

Get to go back to school.

Yep, that's right.

Yeah, that's great. Mister Ratser, Mister Brown?

Yeah, thank you for that question, and yes, uh, we we would support that amendment because obviously when we look at the restoration of these benefits, and we know how the education benefits are, they're timed. They have time limits and there are also caps on the budget. So we want to ensure that our veterans get back all of their benefits and be able to use them.

Thank you, Mister Brown.

I was gonna say I would concur with all the recommendations that been previously given by my peers um the one thing that I would note is that we're acknowledging that that fraud is taking place so why wouldn't we want to uh recover those costs

Mm-hmm.

and that I believe prior versions of the bill uh CBO had scored it as zero cost because we were attempting to recover um and we would support that.

Yeah. Yeah. No Thank you, Mister Brown. I I think that's exactly right uh I heard from a lot of veterans after we passed the bill, some of them very thankful that veterans moving forward would not be defrauded, would have an opportunity to be able to get their benefits back. But I also heard from veterans who are really angry, angry at me, angry at Congress and asking, what about us? I wanna go back to school. I wanna be able to finish my education. It has to be retroactive. That's only the only real way that justice is served for all of us. So I really appreciate your responses and I hear you loud and clear. And I hope to work with with the chairman and with my colleagues here as well, to ensure that the retroactive component be a critical measure that's included in the bill moving forward. So with that, chairman, I yield back.

General Lady yields back. Doctor Morrison, you are recognized for five minutes for your questions.

Thank you, Mister Chair. An estimated one in three female veterans and one in fifty male veterans in the Department of Veterans Affairs' health care system reported experiencing sexual assault or harassment. Military sexual trauma has profound effects on veterans and risk for sexual assault persists beyond a veteran's time in uniform. With symptoms, reactions, and long-term consequences that are already independently difficult to navigate, additional barriers or gaps to accessing appropriate care following a sexual assault can inflict further harm on veterans receiving care at VA facilities. Additionally, conditions like PTSD, depression, other mood disorders, and substance disorders closely associated with MST and sexual assault, compelled proactive actions to ensure appropriate referrals to mental health providers. I am proud to be leading H. R. fifty-two zero three, the VA Safe Care Act, to continue the work of advancing VA's exceptional care to veterans by equipping VA medical facilities with the appropriate tools to support and care for veterans that have experienced sexual assault. This critical legislation would strengthen the VA's guidance for treating veterans seeking care following sexual assault, ensuring the veteran survivors are protected. Specifically, the bill strengthens the referral processes to community providers for facilities without a sexual assault nurse examiners on staff. It makes sure facilities with, um, sanes have a supply of rape kits, makes sure veterans receive prophylaxis for STIs or pregnancy when appropriate, improves mental health and law enforcement referrals, and improves training for appropriate clinical providers, This bill recognizes VA's unique position to provide specialized veteran care and helps make sure no veteran's physical health, mental health, or safety falls through the cracks as they navigate the incredible incredibly difficult aftermath of a sexual assault. The VA Safe Care Act is a tailored approach to ensuring the VA has the best practices and protocols in place to respond in the event a veteran is seeking care following an acute sexual assault. Uh, so, Mister Lyle, in your organization's experience, working with veteran populations, why is ensuring trust and appropriate care coordination of particular importance in the context of supporting veterans by sexual assault, impacted by sexual assault?

Well, thank you, Congresswoman. Uh, one of the reasons we supported the bill, the seventy-two hour uh requirement, obviously that's critical for uh uh preventative care uh and uh evidence collection. Um, women and men that are going through an acute sexual assault um deserve the best care and the fastest care possible. Um any way that we can streamline that, either to a community provider or for same providers in the VA system, and standardize that care and that training for a trauma informed response is gonna improve outcomes in every other uh avenue of their stability and their health care.

Agreed. Thank you for that response. Uh, Mister Rutzler and Mister Brown, I'd ask both of you a similar question. Why are updated protocols important for survivors of sexual assault seeking care at VA facilities?

Thank you for that question. I think what we see is that too many survivors encounter very inconsistent and inadequate emergency care and they gotta be able to have all the facilities and the staffing that's appropriate with the training and the resources and equipment there available at the time. And then when we're in the world right now trying to address mental health issues, that's another stability point that we have to make sure that we meet that need of that survivor to be able to provide that. So I think timely access as we look at it with the necessary necessary medical um treatments are there, will really have to be sufficient and timely in a sense that it meets the individual's need.

Thank you. Mister Brown?

So I I think I can agree with my my peers' comments here on this bill. One element that um I may not have been considered already, um I'm gonna rely on my prior law enforcement experience that having served as a law enforcement patrolman having standardized procedures, knowing exactly what to do and when,

Mm-hmm.

making sure that the right people were there, having the right qualifications of you know the the counselors to uh to be brought in at the appropriate time. made the job of dealing with the situation much easier and it ensured that the victims' best interests were met.

Thank you, Mister Brown, I I appreciate the support for VA Safe Care Act has received far uh so far from critical partners like the American Legion disabled American veterans Vietnam veterans of America veterans of foreign wars of the United States, and paralyzed veterans of America as the demographics of the country's veteran population have evolved VA and veteran service organizations have worked with Congress to update programs and resources to meet veterans where they find themselves in the present moment. For veterans impacted by sexual assault, this collaboration can continue building on efforts to combat the prevalence of military sexual trauma and guarantee veterans have access to the care that they need. I hope my fellow committee members can join me in supporting this important legislation to ensure the delivery of compassionate, comp- the of the compassionate, comprehensive care that veterans deserve. With that, Mister Chair, I yield back.

I'm gonna hold for just a moment, we understand the ranking member who's gonna deliver his closing statement is in the elevator. Maybe that's clogged right now, I don't know. Give us just a moment, but thank you the lady yields back. I've got some other questions that might - I tell you what, now I'm just gonna go off statements here, just in talking in general. You know, we um - Would you - all of you agree that we do need to move forward with reauthorizations? Since the nineteen nineties, most of it - that was the last time we did it. And would everybody agree with that? But we would seek your advice along with other - those of us that all work together. And that's, why we had this hearing even though it was you know requested uh and that's that's been in the statement that the minority requested we make sure we're gonna have uh uh your input in everything as we always do uh we will agree on most things we may disagree but that's the importance of you representing your members who is who we represent so uh with that i'm gonna recognize the the ranking member for his closing statement Oh, for questions. That's right. I'm sorry.

Thank you.

I was really looking for that quotient segment.

Th- thank you, Mr. Chairman. Uh, thank you very much. I appreciate, uh, your courtesy. Um, I'd like to start off, uh, with Mr. Lyle. Um, Mr. Lyle, um, I appreciated your testimony on HR six seven six four, the Veterans Affairs Advisory Committee Oversight Act of twenty twenty five which would eliminate sixteen advisory committees at VA, and I share your concerns about how consolidating uh advisory committees would greatly diminish the ability of veterans to engage directly with VA about the issues that matter um most uh to them. Uh, Mr. Lau, can you talk about the importance of a few of the advisory committees that this bill would eliminate?

Well, thank you, Ranking Member Tucano. Um, for example, the uh the Women Veterans Advisory Committee, the uh Tribal and Indian Affairs Advisory Committee, Uh, the homeless veteran advisory committee all have very unique, uh, voices in not just the legislative but the regulatory process. Um, and being able to offer those unique needs is important for consideration by VA or by Congress as they're moving forward on on some of the issues that are unique to their populations.

Yeah, yeah, well can you talk specifically about how combining the advisory committees for minority veterans women veterans tribal and Indian veterans homeless veterans, and others could reduce attention on specific issues while lessening representation better representation of VA.

Absolutely. Thanks, sir. Um, you know, there is there is some merit uh to administrative efficiency, but you you risk losing focus on specific issues, like I said, unique to those uh individual populations. So theoretically by consolidating the committees, if you had one person with background in all of those specific areas, um they could speak to those things, but you would lose the individual focus that those advisory committees can provide.

And, you know, each one of those committees, I mean, the issues that are facing each group are numerous and com and complex. And so, uh, just the the number of exp the amount of expertise and experts you can assemble under one committee, um, really can't be a substitute for separate committees that will have more extensive expertise. Um, is that not the case?

Yes, sir. Um, you know, if you consolidate, you could have individuals that represent each of those populations, but that one person that's representing that population in the consolidated advisory committee would not encompass the entire depth and breadth of experience with people on uh an individual committee that that is focused on

I- i- i-

that one particular issue.

So for for women veterans, for example, uh, you have one representative on this uh combined advisory committee versus uh a dedicated uh women advisory committee for on on veterans, women veterans uh which would have uh an array of experts whether it's in the specific challenges that women have women veterans have in getting housing with their children often uh uh you know trauma and abuse uh you know any any number of reasons why and then the specific health needs uh one expert is not gonna be i think sufficient to cover um the complexity and the as you say the depth and breadth. Um does combining these special populations in the single uh uh advisory committee make sense to you um you know I mean we already kinda covered that um Mister Brown I read your testimony on six nine O four H R six nine O four the veteran readiness uh the VR and E accountability act And it sounds like PVA has major concerns with Mr. Van der Orden's legislation, as you pointed out, problems in every section of the bill. Could you highlight a few issues with the legislation that the committee should be aware of?

Yes, I can. Um, first and foremost, we appreciate the increased attention, um, related to VRNE. We still feel that this bill kind of skirts around the edges of the problem. Sections two and three of the bill are unnecessary because VRNE uh or I should say VA already has statutory authority over those suggestions. Um allowing vocational rehabilitation specialists to do the work of a vocation

Sure.

rehabilitation counselor which is covered in section six would never be something that PVA supports um employment counseling for veterans with significant disabilities is a core mission of VRNE and that education level is critical for PVA members in particular. who have a higher level of need than an able-bodied veteran. Um, saying that a regional office should have an unemployment coordinator, um, which is mentioned in section eight without the additional approval of FTE workforce, uh, you know, the workforce to perform the task, uh, would negatively impact the work of counselors. Um, they should be comp- shouldn't be competing positions, they should be working together. And then finally in section nine, uh, which is particularly alarming to us, it is unclear as written if it would bar veterans from applying for VR and E once on individual unemployability or if it would strip them of IU if a veteran were accepted into VR and E either situation would be unacceptable to us.

Yeah, I'm gonna uh yield back and just say but, uh, you know, the the bill doesn't address staffing. The the I mean there's a huge shortage of counselors. Um, that's a big concern, right?

That is correct.

So that doesn't, the bill doesn't even address that. That's the, that's the huge central issue,

Right.

I think, of our our challenge with VRNA. Um, and you would agree with that.

Yes, sir.

Um, thank you, Mr. Chairman. I yield back.

But yield back and let me yield to you if you had any closing

Oh, no closing.

Okay. Thank you.

Thank you.

So I wanna thank the witnesses for joining us today and with their testimony in today's dis uh discussion makes one thing clear. Congress cannot keep operating on autopilot when it comes to the VA programs and the authorities. VA must reflect the needs of today's generation of veterans, and I'm excited to continue to work with my colleagues and with you to bring VA into the twenty-first century. Remember the last time that many of these were reauthorized was um prior to Septem- just after September eleventh, some well before September eleventh. Um, many of our proposals discussed today would do just that by bringing down uh bureaucracy, barriers, uh, clarifying and strengthening existing programs, uh, and reinvigorating the health care system to be the best it can for our veterans. I ask unanimous consent that all members have five legislative days in which to revise and extend their remarks and include extenuous material hearing no objection, so ordered, The hearing is now adjourned. Thank you for being here.