Hearings to examine advancing the mission, focusing on evaluating the future of VA research.

Good afternoon. I don't know how it became four o'clock so quickly, but I uh apologize for being maybe five minutes late. I wanna thank our witnesses for being here this afternoon. Uh, last year the VA research celebrated its centennial anniversary. Over the last one hundred years, the VA's research has revolutionized medicine worldwide from the first successful cardiac pacemaker implantation in nineteen sixty to pioneering the internationally recognized standard for grading prostate cancer with the Gleason score. These historic advancements continue to transform not only the day-to-day lives of millions of veterans but they benefit civilians as well. In twenty sixteen the VA entered into a partnership with the Prostate Cancer Foundation establishing the precision oncology program for cancer of the prostate. The advancements of this program have fast-tracked life-saving FDA approvals and made certain that veterans in rural areas are receiving the same cutting edge cancer therapies as veterans who live near urban research hospitals. The VA has long, a long history of leading the world in medical innovation and I hope they continue to lead that way long into the future. Uh, this is why I look forward to working with my colleagues in passing a piece of legislation that I'm particularly interested in. the VA's precision oncology program for cancer for the prostate. Congress has the opportunity to safeguard uh, this program funding, protect its infrastructure, and make certain that veterans battling prostate cancer continue to receiving access to world-class, uh, care and specially tailored care that they have earned and deserved. I look forward, as I said earlier, to hearing from our witnesses today how we can better equip our research community to serve our nation's heroes. and make the VA research stronger, more sustainable and more successful. Uh, with that I yield to the ranking members, a colleague, uh, the former chairman of this committee, Senator uh Murray, for an opening remark. For you can do more than one.

Just one remark?

You can do more than one, for opening remarks.

OK.

Senator Murray.

Thank you very much, Mister Chairman, and thank you to all of our witnesses for being here today. Look, I I think senators on both sides of this aisle have a real appreciation of VA's research enterprise, been at the forefront of cutting edge science for more than a hundred years. It's led to breakthroughs like the pacemaker, the first successful liver transplant, the nicotine patch, and CT scanning. But I'm not sure that the Trump administration has that same appreciation and I'm very concerned by the actions by this administration that have demoralized a lot of our VA research staff and created instability in research funding, and really put up barriers that has slowed the research process. On the very first day of the Trump administration, all VA research staff became subject to a hiring freeze and probationary firings. As a result, research at the Pittsburgh VA to predict stroke risk was put on hold. Enrollment into clinical trials for advanced cancer was delayed, and a clinical trial in Florida on preventing dementia and heart disease was canceled. Um, and, Mr. Chairman, I I could go on, I've heard a lot of stories like uh but uh and so I'm deeply concerned. In addition, the department also enforced vacancy cuts and staffing caps on its facilities. Though those cuts technically exclude research staff, a study at a VA site in the Pacific Northwest was delayed because staffing caps prevented them from hiring nurses who were needed to administer that study. These workforce actions have taken a toll on employees, a VA central office responsible for getting new research studies up and running. VA researchers now report start-up times for their studies often stretch to more than a year. Those delays are partially due to a wildly inefficient hiring process for VA research staff. Researchers are reporting to us that the time to hire a new member of their staff now often takes up to six months. As a result, a planned study on RSV missed its enrollment window and could not even enroll participants. Another clinical trial closed after it took six months to hire a researcher. The study's principal investigator and its lead clinician both resigned from the VA after that debacle. VA researchers are not only being undermined by delays and cuts at the department, but also by instability and cuts at other federal agencies like the National Institutes of Health which frequently provides funding for our VA researchers. For example, a VA researcher's NIH grant for studying opioid use disorder among minority veterans was canceled. Why? It was deemed DEI. Large VA research sites are also reporting their non-VA federal funding is down a third or more compared to the previous year. And in one final blow to research, the Office of Management and Budget has proposed a or published a proposed rule that would require all federal grants including those for VA research to be approved by political appointees. That doesn't make sense. Let a political appointee overrule a scientist on what research is worth pursuing and funding? So, given the current state of VA research under this administration there there is a demoralized workforce, and they have limited access to non-VA federal funding. So it's really inexplicable to me to request a decrease in funding for VA research for fiscal year twenty seven. I'm speaking here today in in uh place of Senator Blumenthal, but I can tell you right now as Vice Chair of Appropriations, it is my intention to rip Trump's budget up and write a new one. I really hope our VA witnesses will take the concerns raised in this hearing seriously, and commit to taking action to address them. If VA wants to ensure that it can recruit and retain the brightest minds to conduct research and provide clinical care for our nation's heroes, it has to work to restore the trust it's lost with a lot of its research staff. This committee and this Congress should stand up for research. And I, and it should stand up for science and it should stand up for veterans. That's where I am, Mister Chairman.

Thank you, Senator Mark. Uh, testifying on today's first panel is Dr. Mm-hmm. Acting Executive Director for Discovery Education Affiliate Networks. He's accompanied by Ms. Latoya Prieur, Chief Human Capital Management, VHA, and Dr. Michael Kelly, Executive Director, National Oncology Program. Doctor, you are uh welcome to now testify and you're recognized.

Chairman Moran and distinguished members of the committee, thank you for the opportunity to discuss VA's research enterprise and its impact on veteran lives. The standard governing our work is simple. Every dollar VA invests in research must be directly tied to veterans' health and well-being. I am joined today by Miss Latoya Prieur, Chief of Human Capital Management, and Doctor Michael Kelly, Executive Director of the National Oncology Program. I am currently serving as the Acting Executive Director of the Office of Discovery, Education, and Affiliate Networks, or DEEN. I lead the Veteran Veterans Health Administration's research, innovation, and clinical training programs. For one hundred years, VA research has produced advances that change clinical practice well beyond VA, including the first implantable cardiac pacemaker, the nicotine patch, and the foundational work that created the modern CT scanner. That same principle shapes what we do not pursue. VA research is not a general purpose science portfolio. It is a targeted investment in questions that matter to veterans. Enforced through peer review, institutional review boards, and the Office of Research Oversight. This administration has taken a disciplined, veterans first approach to research. The President's fiscal year twenty twenty-seven budget requests over four hundred and eighty billion dollars for VA, including over one hundred and fifty billion in discretionary funding, and over fifty-four billion through the Toxic Exposures Fund to expand care for veterans impacted by environmental and occupational exposures. Within that investment, VA has sharpened its research enterprise to prioritize measurable clinical benefit, accountability, and faster translation of discovery into care. And this strategy is already producing results. We have grown the cancer clinical and research network to more than one hundred VA medical facilities, giving veterans access to cutting-edge clinical trials closer to home. Our lung cancer precision oncology program has delivered more than one million lung cancer screening scales. helping identify cancers earlier when treatment is most effective. And the Million Veteran program now includes more than one million enrolled veterans, an unparalleled resource for advancing precision medicine. We measure success not by the number of projects funded, but by the number of veterans whose lives are improved. President Trump's accelerating medical treatments for serious mental illness executive order fourteen four O one recognizes that not all veterans respond to standard mental health treatments. In response, VA announced a randomized placebo-controlled trial of MDMA-assisted therapy for PTSD and alcohol use disorder, with plans to enroll approximately eighty veterans through the VA Providence and VA Connecticut healthcare systems. This is part of a broader psychedelic research portfolio of nineteen additional active trials supported by more than twenty-three million dollars in external funding, all conducted under rigorous federal safety protocols. VA also continues to lead research on toxic exposures, including burn pits and Agent Orange, and on traumatic brain injury and blast overpressure following large veteran cohorts to develop next generation brain health biomarkers and conducting a national clinical trial for mild TBI treatment. Looking ahead, our strategy is built on three priorities. expanding access to high-quality clinical trials, delivering real-world clinical impact, and leveraging VA's data for veterans' benefit. These priorities are executed through several programs. The Cooperative Studies program, which is leading a landmark trial comparing non-invasive colorectal cancer screening with colonoscopy with deliberate outreach to rural veterans. The Quality Enhancement Research Initiative, which speeds translation of evidence-based research findings into routine care for veterans. And a million veteran programs continue research into the genetic underpinnings of PTSD, cardiovascular disease, and cancer. VA is also responsibly integrating artificial intelligence under human control into research and clinical care, including suicide prevention, opioid safety, oncology, and diagnostic imaging, under our trustworthy AI framework, which prioritizes privacy, security, and clinical validation at every stage. In conclusion, VA's research legacy is one of groundbreaking discovery, benefiting veterans and the American public alike. We will continue strengthening the oversight and mission focused discipline that keeps this enterprise veteran-centered and aligned with our strategic priorities Mr. Chairman thank you and the committee for this opportunity and we welcome any questions.

Thank you very much, doctor. Um, Mr. Purier, this committee continues to hear that onboarding essential research personnel routinely takes up to five or six months. Uh, it's a competitive scientific, uh, market. Uh, I have to assume we're losing top-tier researchers because of the VA's centralized hiring process takes so long. Are research personnel included in the thirty-day hiring pilot? If so, how many have been hired through that pilot? What other strategies are being pursued? Or am I just wrong in my assumption?

Senator Moran, thank you for that question. BA researchers are included in the secretary's thirty day time to hire initiative. That initiative was just rolled out nationwide on July thirteenth. So it's too early to provide you with results at this moment. What I can share with you is that physician and nurse hiring has been prioritized. Each morning, my staff pulls a list of all physicians and nurses that have been certified back to us by hiring officials and we make sure those tentative and official job offers are prioritized over all others. While there may be some instances where it took five or six months to hire a researcher, overall the time to hire researchers is seventy seven days. And that is below the Office of Personnel Management's eighty day time to hire metric. And that is how we measure success.

Is that seventy seven days uh less than it uh used to be? Is there a a pattern that uh shows improvement?

That seventy seven days. That seventy-seven days is a bit more than fiscal year twenty twenty five. We were at seventy-four days.

OK. Uh, Doctor Zing, uh, all the research priority areas in the FY twenty-seven budget request see a decrease in funding except for homeless research, which is flat funded. how is the department managing the important research uh for suicide prevention, precision oncology, traumatic brain injury, and other priorities that saw a decrease in requested funding with less money and fewer staff.

Thank you, Senator Moran, for the question. Um, I would say right now that the two percent cut um in our funding for fiscal year twenty uh six president budget is really around the multi-year nature of medical research and contract personnel attrition. But no program cuts have actually occurred. We feel very strongly that we're able to still support the mission with our current proposed funding.

Um. Let me ask a a an additional question, but somewhat related. I raised the concern several years ago with the VA uh about funding research that was not focused on areas likely to achieve improved outcomes for veterans. And so the question is, how is the VA focused on prioritizing what research it funds? And I assume, or please confirm, that there's a component about the places that we're most likely to get the most benefits.

Uh, uh, thank you, Senator Moran, for the question. Um, actually, I think this is actually a place where, uh, VA research has actually done some pretty incredible work already, thinking about this. You know, our organization has really thought about how we become more of an enterprise for research, all through the the view and the mission of supporting the veteran. And the work that I I wish I could take credit for it, but I I just started at this role. Uh, but the work that the leaders across research have already done to prioritize the um, uh, the funding and also the agenda for research, uh, across the organization has really been around this concept called the actively managed portfolios. And these amps are how we try and accelerate the - the issues and topics like traumatic brain injury, precision oncology, and other areas, uh, to accelerate the work much faster. And we have to find a balance between both actively managed portfolios, but also funding the full scope of science and research for veteran benefit. So we also have what's known as broad portfolio broad portfolio strategy to support that as well. So I think we're actually trying to do that, and we're in the process of creating more of a data-informed pathway to get to accountability, get to impact, and really get to a better benefit faster.

Uh, thank you for that answer. Uh, Doctor Kelly, I had questions for you, but I've run out of time and I may just submit them in writing. Senator Murray.

Thank you, Mr. Chairman. You know, women, as we all know, are the fastest growing veteran population, but I am still very frustrated by the lack of progress and investment in understanding their really unique healthcare needs. Women veterans actually, especially those with PTSD or military sexual trauma, are more likely to experience early menopause, with one VA study finding that there are three times, they are three more times like likely than any civilian woman to reach menopause before the age of forty. It's really important to make sure that our women veterans receive the evidence-based, high-quality health care that they deserve, but to get there, we need a really strong investment in menopause research at both VA and DOD, which is why I was very proud to introduce the bipartisan Service Women and Veterans Menopause Research Research Act will, which will work to do that. Doctor Zange, I wanted to ask you today, what are the biggest gaps in our understanding of menopause among women veterans?

Thank you, Senator Murray, for that question. Um, you know, just to kind of set the stage, uh, the Office of Discovery Education and Affiliate Networks is really the office that oversees both research academics innovation and partnerships. And, um, I tell you this because I think that women's health, and I agree with you, the women's health and, um, the women population of veterans is clearly growing and gonna be incredibly important, not just for research, but for academics, for innovation, and frankly for partnerships. So, um, to that end, uh, I think that we are gonna try and continue to support that from a research standpoint. Our budget for women's health research remains steady at approximately forty million dollars a year. When it comes to your specific question about where the biggest gaps are, uh, I'd like to take that for the record and get you the actual, um, accurate information as best we can.

OK, if you could get that back to me and, and just tell me why you think. continued investment in menopause research is critical.

I think all investment in areas of um increase uh for veteran care is gonna be important. And although I don't know specifically about um uh that particular component of women's health, clearly given that the increase in women veterans utilizing VA resources is growing, we have to partner and do this work and find the places where we can make an impact and difference.

Well, I think that's why my bill is so important. important is because we clearly have a lack of understanding. Um, but it is really critical and I hope I can work with the chairman to get that passed. Um, now the ba- president's budget proposes a substantial reduction to VA's research program, not only through cuts to dedicated research corporations, but also through reduced support from medical care accounts and lower projected reimbursements that many of our research programs rely on. Those reductions raise very serious concern about VA's ability to sustain its ongoing research and continue developing new innovations that improve our veterans' care. So, Doctor Zeng, if Congress were to cut forty-three million from the budget, that's what President Trump's proposing, which high priority research areas are most at risk? Can you tell us is it cutting toxic re- exposure research or prosthetic research or cancer research? Where would we see the cuts?

Thank you, Senator Murray, for that question. Um, To be very direct, um, I think our goal would be to try and preserve the gem that is VA research as much as we could. Now certainly, um, I do not have direct control of the budget. Uh, so we will do whatever, um, we will take whatever we get.

Well, in your capacity, you know where the money is. Where do you see those kinds of cuts hitting research the most?

Yeah, um, thank you for that question. Uh, I don't know right now i would say that i would look for things that are not our actively managed portfolios which are our key acceleration priorities um and to focus on things that we were exploring at an early stage as the places to make cuts if we had to

so the budget's been proposed but you haven't thought about what the consequences are

uh excuse me sorry i

but the the president sent that budget proposal you see the cuts in it forty three million dollars You haven't thought as an agency about where you're gonna have to put those cuts in?

Oh, I see. Thank you, Senator Murray. Um, so from my our perspective, the uh budget cut is really reflecting the attrition of contracts and also staff that have l- uh left during that time our actual um uh plans and uh support for research have not been affected by those budget cuts.

OK, well, we do know last year nine researchers were terminated. with no warning and their research stopped. So you can't say that cutting personnel doesn't impact research, but I I I just I only have five seconds left. I just wanna emphasize what I made comment I made in the opening remark about the pending OMB rule that would really undermine our current system and allow uh take away decision making power from our experienced scientists and just allow political appointees, whether this administration or in the for future decide where research is gonna go. That is really concerning to VA research is we need decisions based on science, not based on somebody's mad at somebody or political decision in any administration. Thank you.

Senator Murray, thank you. Senator Sheehy.

Uh, thank you, Chairman. Uh, Doctor Zang, recently uh you alluded to some of it uh in your comments. We've seen the MDMA assisted therapy trial and a broader range of other research on novel therapeutics uh for PTSD substance abuse and others. Uh, I know you can't get into specifics, but kind of broadly speaking, uh, you know, what's your assessment of it so far and, and, you know, what do you think the future can look like?

Thank you, Senator Shihai. You know, we're very, as an organization, very excited to support the frontiers of treatment for difficult things like PTSD and substance um abuse, alcohol mis- uh abuse as well, using um tools like psychedelic medicine. Uh, what we are trying to do in research is to support

Um. I think in in the vein of getting the solutions to the field as quickly as possible, Um, we also wanna be prepared for enterprise level rollout of these type of therapeutics, both the care as well as the products themselves. So, has there been any thought given yet to life cycle management? Um, actual rolling out of the novel therapies, uh, training of the staff, and how, how the logistics of that are gonna happen, uh, once we get to FDA approval, once we get to, you know, VA wide enterprise approval? Has that, has that planning process begun?

Yes. Th- thank you, Senator Sheehy. um we we've actually been really thinking about how we and actually i would say this is not just for psychedelics for a lot of lines of our research one of our core goals is how do we rapidly translate that to actual veteran impact so when it pertains to specifically psychedelics we've actually created as an organization an integrated um uh project team to think about this both from a science standpoint but also how do we operationalize this when it's safe when the science supports it uh, to better benefit veterans.

Great, yeah, that's good to hear because, uh, you know, as you know, uh, whether it's twenty-two a day or whether it's veterans paying for them their own trips to Mexico or elsewhere to get these these treatments, uh, the sooner we can roll them out the better. And I th- I think the worst thing that could happen is, is we finish the trials, we finish the double-blind studies and everything comes out great, and then it's another five to ten years of, of bureaucratic rollout. Uh, no offense, but that's generally how the government works. And in that time, we still have veterans in in need. So I think it, it's just as important as we conduct the research that that we also fast track. Uh, without cutting corners, you know, the logistics of how we're gonna physically roll that out when the time comes. And I think a core component of that, uh, will be of course our community care networks, which which, uh, there are existing providers that already do this in the private sector. So, we don't have to reinvent the wheel in every case. There could be times where, uh, we can leverage that community care network, uh, in in this in this, uh, sector as well. So, uh, thanks for your work on this. Appreciate being here.

Thank you, Senator Shih. And I I would just say, um, uh, you know, I think from my perspective, um, you know, I I'm still relatively new, frankly, to the VA, I just joined the organization a little under three years ago. But I'm actually a second generation VA physician. My mom is a primary care doctor at the Erie VA for the last twenty years. So, although I'm not a veteran, um, I've seen and my family has benefited from VA for about half my life. So I understand the value of the organization, what a gem research is at VA, and how it's improved not only veteran care, but American care, and frankly, care for humanity. So that is the pathway and kind of the overarching um direction that I want, I want you all to know we have at VA, it's not just me, it's everyone I work with. And I work with so many researchers that are also veterans. And that's, that's such a incredible thing to see. The mission is so important. And that's why we, we do this work.

Doctor, thank you for your comments, uh, uh, in response to Senator Sheehy's question. Senator Bozeman.

Uh, thank you, Mister Chairman, very much, and ranking member. Bloom and thaw, bloom and thaw for holding the hearing today and Appreciate our witnesses for being here. Uh, VA research has transformed care for veterans while advancing medicine for all Americans. As healthcare continues to evolve, it is important that VA remain a leader in research and innovation so veterans continue to have access to the best possible care. Mr. Chairman, thank you for your leadership on precision oncology and for recently introducing the precision oncology program for cancer. the Prostrate Authorization Act. I especially appreciate uh your proposal to designate the Little Rock VA Medical Center as a center of excellence for the PopCap program. Arkansas has built a strong partnership between the Little Rock VA and the University of Arkansas. For medical sciences, I believe it's well positioned to become a national leader in precision oncology and research care for veterans, uh, as it has in the past. Dr. Kelly, in fiscal year twenty-four consolidated appropriations act, congress provided five million dollars to expand the precision oncology program for cancer of the prostate to additional VA medical centers and increased academic cancer center partnerships. It's my understanding that VA instead use those funds to establish a broader precision oncology research program covering multiple cancers. Can you please clarify the VA's view on the PopCap program and how VA is ensuring the original congressional intent behind the funding uh has been followed?

Thank you, Doctor Bozeman, for that question. Um, so first I can't comment directly on the legislation speaking to the PopCap, but to answer your,

Doc.

to answer your question, um, when we um were looking at the assignment that was given to us through the Cleveland Dole Act was passed in twenty-two about how to manage um the the pop gap in the future that we looked to our um knowledge that we'd gained from uh other types of systems integration so that we could expand the pop gap effect across the entire enterprise. So we looked particularly to Lpop which is the lung precision oncology program uh which was at a a hundred and fourteen sites um and we said that that was a good model that we knew worked uh that model had done two notable uh goals that i thought were relevant to pop cap uh one was molecular testing uh so for lung cancer the testing rate um had increased uh has most recently up to over eighty percent which is um higher than pretty much everybody else in the country um And, and, and the, so that was one thing, so we noticed that the molecular testing rate was able to go up, and for prostate cancer the molecular testing rate is still struggling. Um, the centers that are identified in the pop-caps, so there were fourteen initial centers that were identified by the Prostate Cancer Foundation, and then the VA in collaboration with PCF identified an additional seven to increase the the geographic um distribution. Um, and so what we saw was that even with those twenty-one sites we could expand to over a hundred sites which is what we've done through the CCRN, the the um cancer clinical and research network. So that was one uh aspect of that and we also saw that Lpop was able to roll out basically from nothing uh to um over a million lung cancer screens. So we could impact every place in the entire country um and we thought that was the best model so that's what we built um the expansion of pop cap on um and then and then we also were able to roll in other programs that we had used in the past um such as the molecular testing program called um pop um n pop which provides the the all of the testing services it also does we also have germline

no we we appreciate that i guess the question is did we use the money was the five million

yeah so the so that money was used

was it used as we as

yeah

according to congressional intent.

I I think it was, so that money was on the research side, I believe. Uh, we used the clinical money to support the clinical operations obviously, but the the five million dollars was for research to be directed in that fashion. Um, and that was what I understand was, um, was the basis for using that money in to expand specifically for prostate cancer. So the CCRN mission in the selection of sites, it identifies only one cancer that they have to do, and that's prostate cancer.

Very good. Thank you. Senator Blackburn.

Thank you, Mister Chairman. Thank you uh to you all for uh being here. Doctor saying I want to come to you. Um, I represent Tennessee and we have uh a wonderful program that takes place between uh Vanderville University and the VA. And of course, as you know, the Tennessee Valley Health Care is right there on the Vanderbilt University campus. And um that system, that VA system there has more than sixty researchers that hold dual appointments at Vanderbilt and at the VA. And they're supporting over fifty million dollars in VA-funded research. And we know, as you were talking with Senator Xi, this benefits veterans all across the country, and we appreciate that. What I'd like to hear from you all is what strategies are you looking at to really increase these partnerships, these centers of excellence, and to build this out further. I, I think that, um, having these partnerships with research institutions like Vanderbilt is uh going to be much more helpful than just trying to stovepipe some of your work.

Thank you, Senator Blackburn. Um, I I wanna first acknowledge that the incredible work happening uh in the Tennessee region particularly when it comes to an incredibly strong VAMSI partnered with an incredibly strong academic affiliate, particularly in fields like informatics and also um in cancer um are really some opportunities to partner and think about what's next

behavioral health also i will add

and behavioral course and of course in nashville there's just so much um expertise in healthcare just in general the business of of medicine really is in is is in nashville um i think that as we think about the future of research and um and frankly academics and innovation at va Um, we have to think about setting foundations in infrastructure. And the first hundred years of research at VA has been pretty incredible. I've heard it time and time again. I've said some of the, um, big wins. We have more. And I think as we think about the future, we have to be flexible and we have to think about how we partner, both with, um, incredible academic groups, uh, but also with others to make the future happen in America. for veterans. So I don't have anything specific to say about how we're gonna do that at Vanderbilt, other than actually just good timing. So, a couple of weeks ago we actually just had a great intro uh conversation with the Vanderbilt University uh senior leaders.

So our, see I think a strategic plan that you're building out would be important. So what are you doing with planning for centers of excellence in different disciplines in healthcare.

Thank you, Senator Blackburn. That's actually what I was gonna get to is that the purpose of that conversation was to talk about that specifically,

OK.

uh and how we could find that synergy between the incredible work happening at Vanderbilt to the incredible work happening with our VAMC_s and also our enterprise of research.

OK. And then how are you engaging uh medical school students when you're on a campus like Vanderbilt So how are you doing that engagement to encourage these that are getting ready to go through a residency and into practice to stay engaged with the VA and Veterans Health?

Thank you for that question, Senator. I think that's a great point. So, um, I don't have the specifics on the exact residencies that we have with our, um, Nash, sorry, our Tennessee VAMC's, but I will say that, um, our academic affiliates We we we have well over uh approximately ninety percent of all medical schools, if not more, affiliated with uh VA.

OK.

So clearly building the pipeline,

Yes.

whether it's for clinicians or researchers or both, we have to leverage these pieces together. And actually that's part of the value, I would say, which is unique to VA, is that our dean organization has both research, academics, innovation and partnerships. altogether into one group.

OK.

And my intention is to utilize those in a synergistic way to build the future.

OK. Uh, Miss. Pryor Emerson, your name right?

Pryor, ma'am.

Pryor.

Yes.

Thank you so much. OK, so you're in charge of human capital management, correct?

Yes.

Does this include the union employees?

Yes, it does.

And how many union employees are there in the VA now?

I would have to take that back for the record, ma'am.

OK. Let's get that for the record. I would like to know, I also want to know how many full-time or full-time equivalents are actually showing up to work and working in person five days a week. One of the biggest complaints that we get in our offices, and I've got six offices in Tennessee, is the fact that VA, um, caseworkers are very slow to get back to the veterans. And I know that the secretary has done an amazing job working that backlog down. It was about a million case backlog when secretary Collins came in, and I think there are under two hundred thousand in the backlog now. But the employees, the rudeness, uh, the lack of caring, the being focused on themselves and not on the veteran, this is something that as a team we need to work on and we need to correct that. The VA is about the veteran, first and foremost, and those employees are there to serve the veteran. So if we could get that information and if we can be helpful, in making certain that we have a service-oriented approach to our veterans, I would be ever so gratefully appreciative. And thank you all for being here and for your work to serve our veterans. Thank you.

Yes, ma'am, happy to take that back for the record and respond to you.

Senator Blackburn. Thank you. Senator King.

Thank you, Mr. Chairman. I apologize for being late. Perhaps we could apply AI to figure out how senators don't have to have three hearings scheduled at the same time.

I'm as you know I'm very sympathetic,

That's a that

cuz I should have been where you were.

that would be a challenge. Um. I guess my first question is, it appears that this year's proposed budget is a over a forty million dollar cut in in various uh research lines. Is that accurate?

Thank you, Senator King. Uh, actually uh from respectfully I think the number is about two percent. which is twenty three million dollars for the fy twenty six presidential budget. And that's largely reflecting the multi-year nature of medical research, and is about contracts and personnel attrition, not program cuts.

So there's, you would argue that, well, a, a two percent cut in a, three and a half percent inflation world is a, really about a five and a half percent cut in in in resources. Am I wrong?

Thank you, Senator King.

Have less real dollars to spend next year on research than you did on last last year.

You know, uh, I think it it doesn't change the the mission of the Office of Research and Development, which is to support veteran-focused research as best as we can.

I get that, but it's a diminution of resources, is it not?

It's, uh, two percent below last year. And, um, it's largely affecting contracts and uh attrition.

and in three and a half percent inflation it's five and a half percent below last year in real dollars um what's the status of personnel how many uh ftes were engaged in research a year ago and how many or let's say how many ftes were engaged in research in january of twenty twenty five and how many today

thank you senator king so uh at fy twenty five ord funded three thousand five hundred and thirty one researchers out of roughly seven thousand VA researchers total um if you want the actual numbers to your specific question i'd have to take that for the record and get back to you with the actual numbers

i'd appreciate it if you if you would um and i i differ somewhat with senator blackburn i know people that are they are doing research they don't necessarily have to be in an office in a VA facility to do research in fact in some cases that is not where they wanna be or where they should be so i i i i wanna uh uh i wanna note that what's the relationship of va research to nih

thank you senator king um uh i think uh we work with nih and our va researchers uh get funded by nih um uh and uh i think we have a very collaborative uh uh nature with them through both the macro level through large initiatives to just uh individual researcher who can get funded both intramurally through VA funds, um through our research budget or through outside extramurally through things like the NIH.

I know I know that this administration has gone to some lengths to uh end what it calls DEI programs. Would a VA research program regarding women's health, menopause, and women veterans, would that be considered a DEI project?

Thank you, Senator King. Um, I, I can say that, uh, our women's health research continues to be a very important part of our portfolio. Our budget proposed for next year is unchanged. We serve all veterans. Um, so the goal is to focus on taking care of veterans, including our women veterans.

Does that also include black veterans, if there are special health needs that they might, eh, high blood pressure, for example, is would that be a DEI project?

Thank you, Senator King. Um, we serve all veterans. In fact, actually one of the big kind of accomplishments for VA research in our first hundred years is some of the work that uh was fundamental to figuring out that high blood pressure could be treated to save uh and improve people's, uh, risk of getting strokes and heart disease came from VA.

So no VA projects have been canceled because of their perceived relationship to DEI. Is that correct? Is that what you're saying?

I'd have to take that for the record and get back to you.

I'd appreciate it if if if you would.

Um

And to what extent you you you wanted to take for the record the the number of FTEs, but I presume that over the past year well first question, is the hiring freeze still in effect?

Uh, thank you, Senator, the answer is no, but I'm gonna pass it off to my colleague, Miss Preer, for that.

Please.

Doctor Zang is correct, Senator, there is not a hiring freeze in VA.

There was, correct?

There was.

And when was that terminated? When were, when were people allowed to start rehiring?

I would have to take that back. The hiring freeze started with the executive order. I don't have the exact date when it was lifted.

And do you know how many people uh, were how many vacancies were created by the hiring freeze, not and and also how many took the fork in the road letter?

I can take that back. For the record, I can share that our attrition rate for fiscal year twenty twenty five was at eleven percent, and that is significantly higher uh than most years. Right now we're at five point nine percent.

But a eleven percent attrition when there's a hiring freeze is a is a real loss of people, right?

Yes, Senator.

Thank you.

Uh, thank you very much to our panel. Um, we have votes at five thirty, and so I'm going to move to the second panel. Uh, so again, we're grateful for the time you spent with us. I welcome our second panel to the witness table. That panel consists of Ms. Gina Carrithers, President and CEO of the Prostate Cancer Foundation, Doctor Glenn Graham, Founding President of the Association of VA Neurology Services, former va executive director of neurology clinical programs

did uh did an entire choir of witnesses just leave

after gram thank you uh who did

the witnesses that were just here did

why aren't they staying to listen to this

um well there's one there they're

oh ok there she is good ok

alright always uh the the detective um thank you much uh very much uh for being here both of you uh doctor graham you are now recognized for your testimony