Opportunities with VHA Reorganization
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House Veterans' Affairs U.S. House of Representatives
Follow its sittingsSpeaker 2
Thank you. In addition to the many testimonials from his colleagues and veteran patients about Alex's service, I've received a mountain of complaints about the lack of leadership, Mr. Secretary, in response to this tragedy. Your employees are hurting. They have looked to you for leadership, but what they received instead is hostility. The foundation of VA is its people.
Delivering world-class care to veterans depends on the strength of that foundation, the workforce that keeps VA standing strong. Mister Secretary, your foundation is cracking. When you moved in, the house was in good shape. VA had strong bones. It was functioning at record levels, serving millions of veterans every day.
But under your leadership, the house is falling into disrepair from neglect. And when a house like VA needs repairs or renovation, responsible owners don't tear it down. They fix what's broken while preserving what works by reinforcing the structure, upgrading outdated systems, and addressing real problems deliberately and carefully. But that requires a plan, a fully baked plan, not just concepts of a plan. No one would undertake a major home remodel without architectural plans, engineering assessments, and a clear sequence of work.
Yet VA is attempting a total reorganization of one of the largest integrated health care systems in the country with little more than a half page notification right here. A half page is what we got, and a 10-page slide deck. 10-page slide deck. In contrast, when VA was reorganized in 1995, this is the book that was prepared to explain and justify its plans called the vision for change. This 01/1934-page book includes detailed analyses of how care would be improved for veterans.
It also contains significant input from Congress. Input from Congress in the plan that they submitted back in the 1990s, input from veterans, input from VSOs, input from VA employees, and other stakeholders. These do not. You are tearing down the walls before determining whether they're load-bearing, and veterans will be the ones to be crushed if the structure collapses. And like most home renovations, organizations are disruptive, reorganizations are disruptive and time-consuming.
Yet VA is attempting this massive reorganization while simultaneously deploying an unproven electronic health record rife with problems, executing a trillion-dollar community care contract, and grappling with severe staffing shortages and turnover across the system. Any one of these projects would strain an organization, and taken altogether, they would overwhelm it. This reorganization is the third in a series of attempts to shrink and destabilize the VA since the beginning of the Trump administration. First came the chaos of Doge with its reckless keyword searches, data munching, and indiscriminate slashing of contracts for essential services. Over 2,000 VA employees were carelessly fired overnight by email, without an understanding of the consequences for veterans.
Then came the second attempt to shrink VA with a plan to conduct a rift, to lay off 83,000 employees. A plan you tried to convince us was somehow about putting veterans first. Remember this, Mr. Secretary? Remember this? These actions were clearly performative and in service to an extreme ideology.
They provided absolutely no benefit to the VA or veterans, only harm. Both of these attempts failed because courts and Congress held VA accountable. But the disruption was real. The damage was done. Institutional knowledge and valuable employees walked out the door.
And veterans are now left feeling the consequences in terms of access and continuity of care. Now this reorganization marks the third attempt to dismantle the VA. And despite this record, you're coming to us with nothing more than a slide deck and asking congress to trust you. You're asking for deference while withholding basic information about staffing levels and the real world impact on veteran care. Now this lack of trust in your leadership is not theoretical, and frankly, you've earned this distrust.
Veterans are the center of what we do in this committee, but veterans are clearly not the center of this reorganization effort. VA leadership has not proven that a reorganization, especially this reorganization, is the best solution for addressing their stated goals. Now streamlining care does not require a massive and disruptive reorganization of the agency. At a very basic level, streamlining requires having enough clinical and support staff to get veterans in for appointments. However, mister secretary, since you took the helm, the agency has shed a net 20,400 employees across VHA alone.
Let me say it again. VHA alone. We're not even talking about what happened at VAV VBA and the other parts of VA. This represents centuries worth of experience, and these losses include over 1,100 doctors. 100 or 100 left VA in December alone, over 2,300 registered nurses, nearly 700 medical support assistants, nearly 700 social workers, nearly 650 licensed practical nurses, and nearly 300 psychologists, and over 250 police officers.
Yet today, we're going to be told that this plan, which includes making it even more difficult for VA to hire more staff, will streamline care for veterans. Now I listened to the Senate hearing two weeks ago and your remarks on Fox News the other day, where you claimed that you are doing more with less staff. The veterans who call our offices beg to differ. They tell us every day that they cannot get VA appointments or that the provider with whom they had a strong, trusting relationship left. VA whistleblowers bravely contact us and share how their facilities are being pushed to the brink, trying to meet patient demand with less staff and fewer resources.
You're not doing more with less. You and VA are doing more with less. There is a lot at stake, not least the health and lives of the veterans we serve. The reorganization materials also failed to consider the impact on VHA's vital role in health professional training, research, and federal emergency response. Lies are on the line.
You have the chance, the court is correct today, and let's see if you seize the opportunity. And with that, I yield back.
Speaker 1
Thank you, ranking member. Secretary Collins, I will swear you and your group that is accompanying you in at this time, if you would. I ask the witnesses to please stand, and raise their right hand. Do you solemnly swear under penalty of perjury that the testimony that you are about to provide is the truth, the whole truth, and nothing but the truth? Thank you, let the record reflect.
The witnesses have answered in the affirmative. Now I would like to recognize the honorable Doug Collins for ten minutes for his opening remarks.
Speaker 3
Thank you, Mr. Chairman. Ranking member, I appreciate being here with the rest of the committee.
Speaker 1
For purposes of, the chair is in accordance with the committee rules, is asking unanimous consent that representative Scott from Virginia be permitted to participate in today's committee's hearing. Without objection, so move. Second, I'm sorry for interrupting.
Speaker 3
No problem, Mr. chairman. Chairman Rankin, member, thanks to you and the committee for having us here today to present the VA's plan to improve our VHA management structure to strengthen care for veterans nationwide. As you have already mentioned, our undersecretary of health John Bartram is here. Mark Engelbaum from our personnel is here. And, also, Greg Goins, who is our COO, who has also a career as an employee of over 14 years in the VA system.
Before I start, though, I want to begin, as already been expressed, by expressing my deepest sympathies to the family and colleagues of the Minneapolis VA Medical Center nurse Alex Peretti. As you know, his death is currently being investigated. VA is not involved in that investigation, and neither I nor my fellow panelists are able to provide any additional details at this time. I'm here today to address the focus of this hearing, our planned reorganization in the VHA. Let me start really with what I just heard, and it is pretty amazing, addressing some of the misleading and inaccurate descriptions of the hearing about what we're having this effort about today.
It's not a reduction in force. It's not diminished care. It's not anything that I have just heard over the last few minutes that, as accused of performative, as I just saw. What we're here for today is that we are the largest health care system in the country, but we've never acted like it. We've never done it the way it needs to be done, because we have frankly allowed the system to build on itself.
We've allowed the system to come in. We've allowed the system to be riddled with redundancies, slow decision making, sow confusion, have competing priorities, all of which reduce quality of care for veterans. There's no one as a veteran who is more concerned about veteran health care in this country. And so when you look at it from my perspective, I look at it as brothers and sisters in arms, taking care of each other. And we've got to make some honest assessments here.
What is interesting to me is only in Washington DC, and I've been in this town a long time, sitting where you sat, sitting in other places, only in this town can you say something that's been talked about for 30 years, complained about by both democrats and republicans, who GAO, inspector general, every other person, including VSOs, of which we've been meeting with over 20 on multiple occasions already, explaining a lot of what we're doing. We have had multiple meetings with all members up here. Only in this town can it be called rushed. Only in this town can it be called not thought of. Only in this town can it be thought of as an issue that somehow has never had anything thought about.
There is a difference though, mister ranking member, mister chairman. This administration decided to do something about it instead of just griping about it. That's the difference. And instead of having hearing after hearing on saying the reorganizations and the governance structure of VA under both Republicans and Democrats for the last thirty years, we've taken your input. We've taken congressional input.
You know how I know that? Because all I gotta do is look at testimonials before this committee. I've already looked into the OIG reports, the GAO reports, the multiple VSO reports. And, by the way, hundreds of VA employees who had input into the beginning of this process, careers and politics, and also consultants who have to let us look at who we are as the largest health care system in the country. So only in Washington DC can you come to a position of saying that something is rushed or done when over nine months of work has gone into it.
And by the way, also in a different setting as well, and I'll just go ahead and address this now, the reorganization, fully allowed under statute and fully allowed under our appropriated processes, was introduced to you over, right now, two months ago to begin this process of discussion. We've moved no one. When we do get ready to have our reorganization, we will follow all rules of statute that tell us in what we need to report and how we need to report. But you know what? We actually did something a little different.
Unlike some other agencies and some other times it's been hearing before, we actually came to not only VSOs, but members of Congress, and began to outline the plan on what we were looking at and did the issue upfront. So we're here today to talk about it. I would encourage you to make use of not only myself, but the ones that I brought with you. And this idea of slashing, cutting, and burning, I have to address. Because since 2019 to last year, the VA has increased, and this is across the board.
FTE count of 14% across the board. Some areas, it's as high as 30% in some locations, 2 and 3 in other locations. But here's the kicker to that. That's great. In any other issue, you wanna look at in federal government or in private enterprise. But at 14% FTE increase, we've only had a 6% increase in veteran encounter.
Some of our organizations, some of our VAMCs, have had actually 30% FTE increases and decreases in the number of encounters they had with patients. I don't think any of you would go to any local hospital that you have in your community, and find a hospital that operates that way. They don't, and we're the largest. It's time we start putting the resources where they need to be. Not in some amorphous VACO, central office, not in some amorphous, vision level structure that, by the way, started in this committee, Mister Rankin, remember, in the 90s with about 10 in each vision.
They've now morphed over 10,000. And yet our wait times were going up, and yet our customer service was not happening. So we decided to do something a little unique in this town. We decided to do something about it. We've actually seen, over the past year, our wait times stabilize or go down.
We've actually seen VA VBA, which is not part of VHA, but I just need to say this. We had 260,000. When you talk about workforce, we had 260,000, one of the largest workforces in the country in the federal government. 260,000 backlog claims of 125 days plus for disability claims. When I walked in last year this month, it is now under 100,000.
And, by the way, before anybody says, well, the quality is there. The quality is in line with when we were doing far less, the percentage of people who appeal it is about the same. So don't hand me that the quality is bad. We're just doing it better, faster, with the people that we have. That's what a leadership organization does.
As we look ahead today to this, and quoting, the chairman of this committee simply put the outdated structure created in the mid 1990s no longer aligns with the complexity, geographic demands, performance management requirements of the modern VHA. It just doesn't. So as we look at this, we can nitpick. We can go to different places. We can disagree, and we can agree.
And I'm sure we will today. I've been there before. But we'll talk about it. We'll give you answers, and we'll follow up with answers if you need more follow-up. We're committed to making this process, because at the end of the day, I noticed, as always, you have the POW MIA chair here.
But in my office, I have another chair that says we make every decision for the one not sitting there. And the one not sitting here today is the veterans out in the community who need community care, who need direct care, who need their benefits paid, who need to have a workforce that understands that the workforce is committed to one thing and one thing only, veterans first. And for us, I'll stand on the successes we've had. You can talk about the rush. You can talk about other things.
But the one thing you can't deny is what we have done, have helped get care to the communities. 25 new clinics opened, hiring. Let me say one last thing, Mr. Chairman. I said this when I was here a year ago, I'm going to say it again. Let's also take care because I'm sure we're gonna hear about staffing, and we'll talk about that, and we'll talk about where we are.
By the way, we're still up over staffing over the past five years, as I said just a few minutes ago. But, also, please remember, the VA is just like any other health care system. When I was in New Hampshire, we talked about this. I have to compete with the same hospitals in private and public for doctors, nurses, and everybody else. But you know what I have that they don't have?
I have a salary cap, which I've asked this committee and other committees to look at, because that keeps me from hiring doctors. Because when you have starting salaries of 600,000 for anesthesiologists in the community, and I can't pay that, I don't blame them for going somewhere else. That's not a workplace issue. That's a fault of this body and us to not fix it. So when we look at this going forward, we are the largest health care system.
But sometimes we run as if we have one hand or one leg tied behind our back. It's now time to change that. It's now time to modernize it, and it's time to get on with it. Mister chairman, yield back.
Speaker 1
Thanks, secretary, for his opening statement. The written statement of Secretary Collins will be entered into the hearing record. We will now proceed to questions. And before I proceed to questions, I wanna, because not all members were here, we are on a time schedule. 12:30 is a hard out for the secretary.
There's also a possibility that votes will be called at 12:15. Every member will receive, in the order that they come in, the normally do, five minutes if you can keep it less than that. But I will gather you down in five minutes because every other member does need to ask questions. So I'll try to lead by example to get my questions out. And with that, I recognize myself for five minutes.
Mister secretary, your team received a written legal opinion from the office of general counsel defining that title 38 section 510 applies to this reorganization. Will you provide that opinion to this committee?
Speaker 3
I can provide what we have to back set up. Yes. And, again, as I said in my opening statement, mister chairman, every targeted requirement of 5 10 b will be followed when those targets are met. At this point, they have not been met.
Speaker 1
Well, that'll bring up my other part of this question, which is asked, if VA begins to implementation before congress receives the detailed plan, how does VA ensure it is not effectively circumventing that statute?
Speaker 1
Mister secretary, I'm reck I commend the department for proposing this reorganization to better the VHA with how care is going to be delivered. Do you agree that as a veteran needs health care, delivery continues to change? VHA's structure will need to keep evolving as well.
Speaker 3
Yes, mister chairman. It's gotta evolve because what we have right now is not a system that actually works. We're a top-down system. I had this unbelievable conversation in the senate three weeks ago that they believe that this plan was a top down plan. This you can't read this plan or hear that, and say it's top down.
We're putting our VAMC directors and our leaders on the field, Clint directors in charge. They actually have to be senior leaders now. They've never had to be senior leaders before. They just put everything up and now they never got answered. Can I also, on that point, Greg Goins was a vision director as well, hospital director?
Real briefly, can you explain how this actually affects that, what we just talked about right there?
Speaker 4
Yes, sir. So what Secretary Collins is referring to is our oversight structure and the bodies that, ultimately, support the field operations, the medical center directors, and the staff that actually are delivering direct care, has been created over the years, to really be kind of a self-fulfilling prophecy. We set up oversight requirements, and then we hire a bunch of people to do it. And in reality, some of that stuff is important. Much of it is, but we've created far too much resource intensity at the top, and we have taken away resources in doing so from the very front lines of being able to deliver care to our veterans.
So as an example, in the vision, oftentimes, we have a compliance requirement, which is good, but there's also a similar compliance requirement in the DC and a similar one at the facility level. Why do we need three people checking the exact same process? In fact, what should happen like everywhere else is we have an evaluation for self inspection at the front line, and then we have someone removed from the process, typically at a VACO level, to do compliance. Right now, we have three or four, in some cases even parties, doing that. That's an incredibly resource-intensive oversight that ultimately is not contributing to quality execution.
Speaker 1
Mister secretary, I've got one more question. As a former member of congress, do you support congress' reauthorization and modernization of VA's statutory structure, including BHA and other major functions like construction, procurement, and research, so that the law reflects the needs of today's veterans.
Speaker 3
Oh, Mr. Chairman. Yeah. And I know that we have talked many times before, but you're singing out of my choir book, Minimal, here. We've got to have some of that reorganization help from this body. I can't, I can only do, and I promise this, we're only gonna do what we statutorily can do.
But, look, when it gets to construction, yeah. I'm not gonna hit construction. I've mentioned it before. This group, this committee, needs to set aside some time to discuss this. For those of us who are here when we had to pass the construction issues about a dozen years ago, which I was voting on, this was out of the disastrous rebuilding Aurora, Colorado, Phoenix, Arizona, where the ballooning cost ten years.
I hate to tell you this, but you're not going to be shocked. After this past, and we're all going up on ten years now, at least when we pass this, we're still looking at 10 years to build a VAMC. We're still looking at times it takes, there's a in the budget, which you just approved, the Saint Louis VAMC should be building two and a half years minimum. It's gonna take almost 6 to 7 years under the current structure because, frankly, Corps of Engineers needs to be out of this process. They got other issues they need to deal with, but you had to put in a structure at the time.
I get it. But now we've got to change it. So anything structurally that I'll come back to you with that we need to change, I would appreciate it. We'll give you any help we can because, one, we're not being very good stewards of taxpayer dollars by building a 1.6 billion VAMCs that could be built for 800,000,000 in two years in the private sector.
Speaker 1
Thank you. And by leading by example, I yield back my time, and recognize the ranking member for the
Speaker 2
bank. Thank you, mister chairman. Mister secretary, isn't it true that you, sir, created the widespread belief that VA is conducting massive employee cuts, what federal agencies call a reduction in force or RIF?
Speaker 3
When I came before this committee last year, we were discussing an overall reduction of force across the government as a whole. At that point, as I told you in this committee, that our target would have been 83,000. We ended up with about 30, you either.
Speaker 2
Mister secretary, we're coming to my time. On 03/04/2025, your former chief of staff, Christopher Saric, put out a rift memo saying that VA was initiating plans to cut 83,000 employees. And you yourself posted a video on x saying that, quote, our goal is to reduce VA employment, not employment across the government, but VA employment levels. That's pretty clear here and here. And after spending the last year pushing out thousands of employees, stifling hiring, and eliminating vacant positions that medical facilities will never recover, you are now asking us to suspend belief about the true nature of this so-called reorganization and to disregard what happens to thousands of VA employees and the workforce that cares for veterans.
I'm not gonna do that. Now let's go on to priorities. You went on Fox and Friends and said that VA needs to do more with less. And I don't even know why you're talking about doing less, talk less when it comes to veterans. Are you aware that ICE has been recruiting thousands of new employees and offering up to $50,000 in signing bonuses?
Why isn't VA doing the same for nurses?
Speaker 3
Yeah. The buck stops with me, but you and, really, there's not a question in there. And I'm glad you watched all.
Speaker 2
The questions. Why isn't VA doing the same for nurses? Why aren't you doing a signing bonus for nurses?
Speaker 2
We already yell at, oh, we already have it. Okay. Yes. We did pass the raise out. Are you here to ask us for more money for doctors, signing bonuses for doctors?
Are you asking us for that?
Speaker 2
Okay. I'll be glad to authorize legislation to get you more money to hire more doctors. None. We're good. Okay.
You
Speaker 2
Do we need more doctors? Yes. Your testimony today is that VA is not fully staffed.
Speaker 3
Who came up with that question? No. We're not fully staffed, and we haven't been for 50 years.
Speaker 2
We have a today every week. So I, you know, Alex Pretty worked for you. Was I just want to know something. Alex Pretty worked for you. Can you just tell me, was he a good employee?
Speaker 3
As far as I know everything about it, I've already said what I'm gonna say about Alex Freddie, and I'm not gonna be brought into anything else. Well, I'm not gonna I provided you the reports that you've asked for. You make this. Did he?
Speaker 3
Head of the VAIC. I've answered your question. I'm not gonna get pulled in. Do you wanna call it a reward?
Speaker 2
Why don't you stand up for him and correct your cabinet colleagues when they call him an assassin and a terrorist?
Speaker 3
Because I am here today to talk about the VHA reorg. I've expressed my condolences to the family. We have made every last available.
Speaker 2
Day of law. Unwilling to defend the reputation of a VA nurse who dedicated his career to veterans. Mister secretary.
Speaker 2
When you're secretary, I just think it's not my opinion. It's what you just showed us.
Speaker 2
When your employee, Alex Pretty, was attacked publicly and falsely by your own colleagues. You had a choice to defend him or to stay silent. And you chose silence. And that silence is deafening. Leadership is who you defend when it costs you something.
And you did not defend him when it mattered, and you still won't. Mister Goins, you've been called the face of the VA reorganization, but you're the VHA chief operating officer, not a Senate confirmed official. Who among the four of you is the accountable official?
Speaker 3
Is it Mr. Bartram? Say, define the question. Well, I mean, this is, I mean, if we're gonna get queued here, I'm the senate confirmed. John's Senate confirmed. He doesn't have to be Senate confirmed because he's a point out.
And gentlemen's time has expired.
Speaker 1
Gentlemen, time has expired. To the five minutes. Representative Van Orton, you are recognized for 5 minutes.
Speaker 6
Thank you, Mr. Chairman. The ranking member made a point to hold up a book. And, as opposed to the slide deck that you have, I would just like to point something out. The Magna Carta was one page. The declaration of independence was one page.
The constitution, four pages. The Bill of Rights, one page. So what I've noticed in the three years I've been in Congress is that we often confuse quantity with quality, and we often confuse motion for progress. So I'd like to show people what we're talking about has been referred to. This is the current structure.
Right? And what's great about this chart is you can look at it upside down. It still doesn't make any sense at all. It just doesn't matter. Right?
And then if you look at this, this is what you're striving to get to. Right? Okay. So I'd just like to, mister chairman, I'd ask unanimous consent to enter this into the record.
Speaker 6
Okay. So we're trying to go from here to there. This is the I got six bosses Bob program. This is the I actually know who I work for, and I can be held accountable program. Is that what you're striving for, sir?
Speaker 3
That's correct, Miss Van Orden. You hold that other one up right there for a second. The first one or the second one? No. The sec, the first one you showed up.
Speaker 3
Yeah. This is what's been defended for almost thirty years by every, you know, the same, well, we just don't need to work on it. We'll work on it. We'll patch it. We'll patch it.
We'll patch it. That's what you get when you patch it. It's time for us to go to something that actually works.
Speaker 6
Right. So what we're trying to do here, and, you know, please correct me if I'm wrong. You know, I've been here, like, as I said for three years, and I chair the subcommittee on equal opportunity or, excuse me, economic opportunity. And I have yet to see anyone at the VA being held accountable for the billions of dollars wasted for lack of planning and just throwing money at a problem. And so I think that if we can actually hold people accountable, their job performance will improve.
That's my experience as a Navy SEAL. Is that what you're trying to accomplish, sir?
Speaker 3
Yeah. Would you let me, and I appreciate the question, and it goes to the heart of what I was trying to get at here. And if you allow me for just a second. Last year, when I came in, I told the chairman right now. Told everyone in this committee that we didn't have a manning document.
And some of you have rightfully so been concerned about what was reported in the press wrongly about empty positions, and Mark Englebaum will be happy to describe what we did to get our manning document right. For, by the way, as you're not sure what a manning document is, we didn't know where our people were or where they were supposed to work. We now have a manning document that allows us to actually hire in ways that we get more doctors and nurses where we're at, instead of trying to move them between different places. But then I got another one for you, and I shared this one just this week. Up until we were able to consolidate our CFO and get a CFO in and actually working through this, we had no monthly reconciliation.
I don't care what side of the aisle you're on here. How do you run a business without having a monthly reconciliation of what you're spending? We just got to the end of the year and said, wow. We got enough money. Well, we're good.
This is the kind of stuff that we're trying to deal with to get it to where we can actually put the people in the places that need to be, instead of just putting people. Here's your question. You said a minute ago. There's this idea that the more is better. Right.
Well, when I got here, we had 480,000 employees. We had 260,000 plus in a backlog. We had wait times that were going up. And, by the way, for those who are concerned, the vacancy rate for doctors and nurses over the past four years has stayed consistently between 19-14%. By the way, the 19% was in '22 under Biden.
We're at 14. So we stay consistent.
Speaker 6
I just have a minute left. No worries. I do wanna talk about the salary cap issue.
Speaker 6
I know that's statutory. That's something we could work on. And then you said something that's actually deeply disturbing, that the Army Corps of Engineers are responsible for building our VA facilities?
Speaker 3
They are because of a certain amount. It's a threshold amount that they have to be involved in. And they that get them involved actually in C Box as well.
Speaker 3
They don't need to be there. I have good folks, but they don't need to be there.
Speaker 6
I have a great relationship with the Army Corps of Engineers, but they do think they're the fourth branch of government. And so if we can work together, mister chairman, and with ranking member to see if we can move that around, that'd be great. Because, again, the Veterans Affairs Administration, and you've stressed this in your leadership, it's about the veteran. It's not about the Veterans Affairs Administration. So I greatly appreciate your efforts.
Speaker 3
No. Let me finish it real quick. The reason the core is problematic and there's something I didn't mention a minute ago. VA developed its own building standards. We don't use national building standards.
We developed our own standards because we had nothing better to do, I think. And then we take it to the Corps of Engineers, who have their own.
Speaker 8
Thank you, Mr. Chairman. Thank you, Mr. Secretary, for being with us today. As you know, this committee's job is to make sure the VA is working for veterans. Not that it's working for political appointees, not that it's working for career employees, not that it's working for a small group of insiders who are making decisions behind closed doors. What you are proposing, it's very likely the biggest shakeup of the VA in 30 years.
And I think our veterans deserve to know what the VA is planning. Now I wanna tell you, I'm not opposed to change. I'm opposed to making that change in the dark. I'm not opposed, I'm not sure this. I'm not opposed to change, but I do wanna make sure that change actually improves the care our veterans receive.
Because one thing we do well on this committee is we actually understand the mission to take care of our veterans. We do it in a bipartisan way. For the nearly 40,000 veterans in my district, we're here to take care of them. For the veterans in Mister Luttrell's district and every representative's district on this day, as we are here to take care of them, to make sure that we honor the promise we made to them for their service. We might not always agree on the path, but we all want the exact same outcome, which is a stronger VA that delivers the highest quality of care for our veterans.
So the experts who help design the Veterans Integrated Service Network or the VISNs, we're calling them, they've warned for 30 years that you don't fix policy failures or culture failures by redrawing an organizational chart. They've said that large reorganizations are disruptive, expensive, and almost never solve the real problems, which are unclear roles, inconsistent oversight, and lack of accountability. Both GAO and GIO have been saying that same thing for more than a decade, as you alluded to earlier. So, again, I wanna point out I am not opposed to change, but here's the problem you're hearing, and the frustration you're getting from this committee. We don't know what those changes are.
Mister Secretary, the federal law requires a report to Congress on any proposed VHA reorganization. And what you've provided to us is a half-page letter and a 10-page slide deck, a PowerPoint. It's not much. So given how this committee operates, I hate that I'm even asking this question, but I do want the honest answer. Have you provided my Republican colleagues on the other side of this dais with any additional materials, documents, memos, reports, data about this reorganization that you have not shared with the people on our side of the dais?
Speaker 3
Well, first off, congressman, I'll never, I will not never intentionally or, you know, otherwise give you dishonest information. An honest answer is what you're gonna get from me. I've given nothing. We've briefed both sides of the dice on this, multiple times, and had multiple phone calls with us.
Speaker 8
So that's then the problem, I mean, the problem is no matter how you answer that question, it wasn't going to be a great answer. Because what we have is very little information on what is going on here. Again, it's not that we're supposed to change. We want the VHA to work. We know that it can work better for our veterans, but we need to know what those changes are.
And when you are proposing a reorganization of this size and this scale, and our veterans don't know what's coming, that concerns me. Because our veterans, as you know, some of them are worried about these changes. Right now in Louisville, Kentucky, we're undergoing a change in our VA. Robley Rex serves about 45 veterans across the Commonwealth. We are moving to a new building.
They're in the middle of this full facility move. And what worries me is that this reorganization adds yet another layer of disruption for the people who have risked everything to serve our country. So when talking about how we're ensuring that veterans continue to get the care and that it doesn't slip through the cracks during the transition, which you proposed, and we don't know enough about. Do you all have a continuity of care plan? Yes or no?
Speaker 3
We always have it. I want you to hear from Greg Goens, who's actually from your area, who actually was the visitor and that. He can describe exactly what we're talking about to you right now. And this is why we're doing this hearing.
Speaker 8
Yeah. And only because I have a minute and nine seconds left. Do you guys have a continuity of care plan? And I need it to be yes or no.
Speaker 4
Yes. The plan we do. Continuity of care plan is the fact that we're not touching frontline facilities whatsoever.
Speaker 4
And the other thing I wanna say about Louisville and the hospital, the biggest issue is running off the challenge.
Speaker 8
And maybe even get a little extra time. This is we're trying not to be combative, Mr. Secretary. And I heard, okay. Okay. Perfect.
But if you have a continuity of care plan, we have not received it. This goes to the lack of transparency that we are talking about. This is a massive reorganization. It's going to impact our veterans, and we on this committee don't know how. What we care about is the veterans.
We care about doing right by the veterans, what doing the right thing is having this out in the open.
Speaker 1
And once time has expired. Back. Representative King Heinz, you are rep yes. You are. You're recognized for five minutes, too.
Speaker 9
Thank you, Mr. Chairman. And, thank you, Secretary Collins, for making time to be with us today to talk about this reorganization. I think you took ten minutes to describe how getting in or seeing change in DC is like watching molasses roll down a hill on a cold winter's day. And since my time here, right, that's kind of how it feels. And one of the things that I've noticed really when it comes to change is that, you know, everybody wants change, but for the most part, they want change when it doesn't affect them, or they want change in their pocket.
Right? And that seems to be a common theme around this town. We have been having multiple hearings over different programs, to include the DIGB rollout, for example, modernization rollout, for example. And one thing, you know, has been very apparent is that it's very difficult to get folks from the VA to be able to say who is accountable, who is responsible. And, you know, I think, representative Ben Orden said it best the other day that, like, some of these hearings feel like Groundhog's Day.
But I think that the reorganization chart, right, or, I'm sorry, the old organizational chart, speaks to that. Is, you know, the line of business is very, it's not clear. And so I'm very glad that something is being done about that so that we can actually hold somebody responsible and accountable for some of these mishaps. Right? Because right now, it's not clear who's in charge based on the organizational chart.
The one thing that I do want to raise to your attention because I was looking at the slides that you shared. And I'm concerned that in the map of the VICNs, right, or the Visins, that there is no representation of any of the territories. And I'm gonna tell you this, you know, it had me in my feelings a little bit, because that's all that I talk about with regards to just trying to get basic care. So, can you speak to that, please?
Speaker 3
I'll speak to the one who's over it and been working it to get the area that you're talking about done, and John can address that for you.
Speaker 9
Referring to territories in general? So there's COFA. Right? Right. They're not US citizens.
Right. There are people who live in the territories, like the people of the Northern Mariana Islands who have one of the highest per capita enlistment rates in any territory or any state who get no care. Right? We don't have a CBOC, and now we are going from a map that used to actually identify the Marianas as part of this, but now we're just focused on the Continental United States. And that kind of upsets me.
Right? Because it feels like we're going backwards.
Speaker 4
All the American territories are aligned exactly how they are in the current state. That map is reflective of what is going to be the biggest change, which is the overall vision boundaries within the Continental United States. The care for those veterans that you're talking about is remaining unchanged, and associated oversight is still with Southern California as it is currently. Okay. And The Atlantic, sorry.
The Caribbean is still with what's current day visit eight states of Florida.
Speaker 9
So I so I wanna, I guess, wanna ask that in terms of the reorganization, what data was analyzed when making the determination to consolidate from 18 visits into five? I mean, I ask this question because we are having challenges with access to basic care. Right? And I wanna make sure that when we do this reorganization, that they are not further shortchanged.
Speaker 4
Yes. I completely agree. So this is a fundamental shift in the way which we currently do things in the VA at the Visen level. The Visen directors and the Visen teams currently have to participate in national-level business functions. Know, you, I'm gonna use a loose term here, the bureaucracy aspect of what's necessary in addition to those oversight and coordinating functions for care delivery.
So when you look at the big picture, if you just went from 18 to 5 and had the same scope, that would be a big problem. In the new structure that was completely based on market research for all kinds of entities to include public and private, for profit, not for profit, it was very clear that we needed to have an entity within each one of our vision structures that focused directly on the care delivery and those coordinated needs at the care level without competing priorities against some of that bureaucratic stuff. So each division in the current five structure has three health service areas. Their only focus of scope is care delivery.
Speaker 1
Gentlemen, the timing has expired. The general woman representative Brownlee is recognized for five minutes.
Speaker 11
Thank you, mister chair, and thank you, mister secretary, for being here. I wanted to focus on women veterans for a moment. So women veterans are the fastest growing group of veterans treated at the VA. And, when I looked at the organizational chart from, you know, the current organizational chart to the reorganized chart, the Department of Women's Health is not included anywhere. And in the Deborah Samson bill, and that was signed into law in 2021, codified and required that there be a department of women's health, I think, reporting to the undersecretary, which is in the new reorganization, is not there.
So that's a concern for me. I'm not sure how one is gonna monitor the improvements that the Deborah Sampson Act demanded in making sure that we are working towards equity for our women veterans compared to men veterans in terms of access to their health care.
Speaker 3
Yeah. Thanks for that. I wanna address that, but I wanna address something upfront, because I agree with you. And also, by the way, sorry to see you go. We came in together, and, seeing you go, you've been a great voice in this committee.
So I do appreciate that. You. Look. Women's health has been very something I put on the forefront, and we're gonna take care of it in the structure. I'll talk about that, but I wanted to highlight a couple of things.
We've actually are opening more of our women's health care clinics so they think they have better access.
Speaker 3
Well, the other thing is too, is I had this year, I made the change last year in which we were making our women veterans, if you weren't aware of this, go through their primary care doctor to get to their OB GYN. I was too late. We did away with that. They can now go straight to it. Okay.
With that, I just want you to know that. Okay. John to see where this is at in the structure.
Speaker 10
So women's health is there, the women's health programs under our national programs, and it's on our enterprise side of the reorganization in that report.
Speaker 11
Okay. Okay. I wanna, I'm having a hard time with reproductive health, obviously, as part of women's health care within the VA. And I'm having a hard time reconciling when women now make up 20% of the active duty military and reserves. If you're in the military, woman's in the military, in uniform, she has access to abortion in the cases of rape, incest, or the health of the mother.
When she leaves the military, takes off her uniform, comes to the VA, now she does not have access to abortion in the cases of rape and incest. And I must say a very confusing definition of her life being in danger. So talking to women veterans across the country, this is what women veterans want, yet it's being taken away. They serve the military. They have the benefit.
They come to the VA. The VA is taken away. I'm having a hard time reconciling that. If you could comment.
Speaker 3
Yeah. I'm not having a hard time at all, Congresswoman. I appreciate it, but this is something that's been talked about in this committee. The VA up until three years ago didn't do abortions, period, anyway. It's the same happened for both presidents, Republicans, and Democrats.
It didn't, it's not in our, it's not in.
Speaker 3
Again, that's a political difference it will have in that regard, but it's also a legal difference in the sense that the Department of Justice found that what was done does not follow the current law on what the VA can do, and that is what we're following.
Speaker 11
Okay. I would like to have this argument with you off the dice. It would probably be
Speaker 11
So the other thing I would just want to point out too, with regards to the physician's ability to counsel women around abortion. So, just to have a complete prohibition and gag order that a physician, even if they're talking to a woman patient who is seriously ill and perhaps the option of an abortion might save her life or make sure that she has a higher quality of life later on in her life. Yet there's a gag order. A physician can't do that. It's against their HIPAA obligations.
So I just, again, I don't understand why you would do that. Even giving the woman the opportunity if she needs an abortion to go outside of the VA, if the VA is not going to provide it. But not to be able to have the physician advise her just seems, you know, outrageous to me.
Speaker 1
You know, one time, True. You know, one time that's expired? Representative Barrett, you're recognized for 5 minutes.
Speaker 12
Thank you, Mr. Chairman. Appreciate it. Secretary and, gentlemen, thank you for being here for testimony in front of the committee. Mister Goings, I wanted to allow you had mentioned, in one of the earlier questions about some of the changes in how these visions typically operate today where they have a lot more of a focus perhaps on the organizational apparatus as it relates to expectations coming out of Washington, the management of the organization that way, and less about the actual care delivery for veterans. As I look at the new organization chart, I think the health service areas are going to be the ones that are directly engaged with the management of health outcomes for veterans.
Is that true in that sense?
Speaker 4
Yes. That's exactly true. So the current state of affairs, a visiting director and their team would be responsible for that plus, as you said, the organizational apparatus requirements that I refer to as bureaucracy.
Speaker 4
Yes. The challenge is it pulls you physically away from the space as well. It's an important need. Organization of this size, largest integrated health system in the country, we need those functions. Different than Procter and Gamble or any other organization of this complexity and size.
At the end of the day, it also requires you to come to DC to be part of some of these larger group decisions through governance, etcetera. And for every day or minute you're involved with those kinds of things, it's less time you can be engaged with VSOs, local community hospital partners.
Speaker 12
to DC every week. Yeah. You know? So you get to feel it, man. Yeah.
I completely get that. And allowing people to be basically assigned to the health delivery outcomes of and managing the staff in that sense and the hospitals that are within that, I think, is a great way of elevating that role to the most important piece that they have, is ultimately the health outcomes of these veterans. I mean, we hear from a lot of folks about, oh, you know, we wanna make changes, but we don't wanna make changes in a fashion that we didn't come up with ourselves or something like that, or perhaps we have a pride of ownership of who came up with these ideas or how the structure's going. A chronic frustration I have here in Congress is that we never seem to be ready to make changes. It's not always the right time to do it, or we're gonna wait and do it a different time.
These things have been talked about, as you pointed out, for decades to bring about real and systemic change to veterans for their health outcome. I can tell you candidly, I have been a veteran for 23 years now, since I was 21 years old. If you had asked me when I was 25 what a vision was, I would have had no idea, because I didn't need to know. It wasn't relevant to my actual interfacing with the VA. It's relevant to the management of the organization, but our veterans deserve to be able to walk into a VA, get the care that they need without being fatigued by which vision they're in and which, you know, process is being followed.
To have somebody that is assigned to their health outcomes in a much more focused and exclusive manner should bring about better outcomes for them, and I certainly hope that it does. I did wanna touch on, though, secretary or either of your panelists joining you. I gotta bring up the, EHRM rollout and how that will interface with this realignment of visions and what type of expectation we have there and if we can be satisfied that will go on unencumbered with this change that you're talking about as well.
Speaker 3
That is one of our most important pieces as we go forward, not only for direct care, but also community care in the future, is getting an EHRN, which, again, will go live April 1 in the fourth eleventh. Yeah. In Michigan. But it's on track, and I think it aligns with, we've aligned it with the business structure as we change. And the rollout hopefully is we're successful as it looks like we are gonna be in these 13 this year.
We'll actually help with momentum getting into the other areas as well, possibly quicker.
Speaker 4
That just so you're perfectly clear. We have worked with the deputy secretary's office as the one designated as the owner for EHR and
Speaker 4
Yes. On the operations side, we have made an agreement through the undersecretary Bartram that we will make sure that the schedule that's already been published is completely considered and unencumbered as we do the reorganization. Again, this is an iterative, phased approach, and we are not in a hurry to just blow things up.
Speaker 12
So even though we're doing EHRM by the current vision structure rollout, it will not be impeded or affected by the change that you're proposing?
Speaker 4
Correct. In addition to the continuity of care priority, that is our second highest priority for the reorg.
Speaker 12
Okay. Thank you. I'm almost out of time, but I wanted to share briefly with you the reason why this is so important. My father-in-law came to visit from Oklahoma to Michigan over Christmas. He gets his health care through the VA.
He had a diabetic sensor on his arm that the battery died or something. Think you all helped us with that, but they couldn't coordinate between the two VA hospitals to get him that very easily. Gentlemen, Thomas Barrett. Looking forward to that rollout. Thank you so much.
Speaker 13
Thank you very much, Mr. Chairman. Mister Secretary, it's good to see you, and I appreciate the recent visit to New Hampshire. I know that veterans appreciated the fact that you were on the ground and getting familiar with some of the unique circumstances that we face at our medical facility in Manchester. It's obviously an old facility. It has infrastructure that has failed on many occasions, that have put whole areas of that facility out of commission.
And during your visit, we talked about the ongoing action plan and feasibility study to talk about delivering a full-service VA hospital for the veterans of New Hampshire. We're the only state in the Lower 48 without a full-service hospital, a designation that we lost over 20 years ago. It was due to the president on November 5, and I'm really interested to know if that plan was delivered to the president, and where things stand. Veterans in New Hampshire are really interested in getting a read on that.
Speaker 3
It is good. It was good to be with you. And is also, I think, one of the things that, and I'm just gonna make this as a blanket statement. If I just say this with just a heart. If you've not visited a VAMC or a facility in your own, the committee, please do so.
Okay? I'm not, I'm just saying it's Republicans and Democrats because you get a better understanding of what's going on. I've done over 30 states and almost 75 of our facilities, various from VAMCs to vet centers. By the way, go to the vet centers. They need to be.
VAMC in yours is a unique situation that goes to an earlier comment about our construction issues, and why it's taking so long. That has been delivered to the White House. It is at the White House now for the final processing, and we hopefully have an answer out of that in the very near term.
Speaker 13
Can you characterize it at all and let veterans and the nature know? Is this a menu of options? Is it one recommendation? And is the president the decision-maker on this, or is it the department?
Speaker 3
Well, I we're gonna let the process, the White House process, go through it. I'd rather do that than have to come back and then be accused of saying something that, you know, wasn't true or that wasn't as a plan that came out. So it's with them, we'll get that out.
Speaker 13
You've been waiting a long time, and I appreciate understanding what's going on here at the earliest moment that you can provide.
Speaker 13
Ray, I wanna move on to another issue that we've been dealing with on our economic opportunity subcommittee. It's the issue with chapter 35 education benefits and a gap that occurred last fall, that was very severe. We were hearing from veterans in our office, people who had trouble paying their rent and paying their prescription costs because their tuition bill wasn't paid. And so I'm just wondering if you can provide some more insight into the breakdown there. It was a month and a half where veterans were in the dark.
Congress was also left in the dark. We had letters that went unanswered. I appreciate we received a letter yesterday that we sent over to you on December 15, I believe, initially asking for some further detail. But it's inexcusable for veterans not to have this basic information about where these payments stood. And, again, you know, you talk about the shutdown.
That's the excuse that we received. But the anti deficiency act is pretty clear that in situations that involve the protection of property and life, and making sure that veterans get access to benefits, that they should have been receiving an answer on this. So I'd like you to address that.
Speaker 3
Happy to on that. Yes. That was a problem, frankly, that was that we received. We dealt with it. It came from a manual issue from basically going back to '24, that rolled into '25.
We understand that. At this point, that has been transferred over, and most are getting there almost the same day on GI benefits. They're getting the GI Bill is working.
Speaker 3
Of it. Look. I don't disagree that all these communication on any level from both sides could be better, okay, on anything. And I've faced this every day in this job that I take because I have to get the same information. I have to ask sometimes multiple times to get it.
The issue that we have here, though, is, and I know that it was a concern, and I understand your issue with the shutdown, but it did hamper us. We were getting benefits out. But when you're down to one or two people, when you normally have a lot more people to do it, it does slow the process down. And we were doing what we were supposed to under law, but we had to do it also under the burden of a shutdown that lasted longer than any in history.
Speaker 13
Well, you eventually, during the shutdown, did communicate with veterans in late October. But, again, this was a month and a half after the problem was discovered, and veterans were left in the dark, coming to us for answers that we couldn't get out of the department. And, I just know that there are gonna be other instances in the future where there are systems that are migrated, where there are gaps and disruptions to benefits, and veterans deserve answers at the very least. I wanna move on to one final issue, and this is an issue that I raised with you in your last appearance before this committee around VASP and the partial claims program. You said at that time, I think the first step is that Congress needs to act upon this.
So we took your advice. We passed a bipartisan bill, but it's been six months since the partial claims program was signed into law, and it hasn't been stood up yet. I've got veterans that are asking when they can get relief. Can you give us an answer on when we're gonna be able to see that program put into place?
Speaker 3
Yes. That is being done now. We've got it, it is to be done, and it should be done shortly. We did have to integrate it with the current system that we had. You'll be getting an answer on that very shortly.
Speaker 1
Gentlemen, time is expired. The representative may be recognized for five minutes.
Speaker 14
Thank you, Mr. Chairman. I wanna thank the secretary for being here this afternoon as well. The Ralph Johnson VA Medical Center, in partnership with the Medical University of South Carolina, continues to play a crucial role in improving the lives of veterans throughout the low country. And I kid you not. I had a call this morning from a veteran praising the Ralph H.
Johnson, VA facility in Charleston, South Carolina, as being a model facility that they get about 70% of their care there, and they're a cancer survivor. And they're just truly grateful for the example that the Ralph Johnson VA Center in Charleston is for other veterans' facilities and medical treatment around the country. The location of the Ralph Johnson Medical Center has been critical to improving outcomes for veterans in conducting high-quality medical research. After a 60 year track record in Downtown Charleston, I was deeply disappointed by the BA's decision in 2024 to deny a floodplain waiver for the lease of a replacement research facility. We get a lot of flooding in Charleston.
If it sprinkles, it's flooding. We wanna make sure that veterans have access to the care they need. So last year, Secretary Collins, I wrote to you asking you to reconsider this denial, and you declined to do so. So may I ask you today what led you to make that decision to deny the waiver?
Speaker 3
Congresswoman, I think the biggest thing is we, one of the things you brought up, one of our best is not just in the top few percentage. It's probably in the top two or three of the whole system Charleston is in. The same things that denied the first time are the same things that we go back on as the issues that we have to deal with when you look at long term and where we have to build and how we have to build in a floodplain or not building a floodplain. This is but there are other options that are available, and we're looking at those other options, then going back into this area.
Speaker 14
So without this waiver, I mean, care potentially could be interrupted for veterans.
Speaker 3
I would disagree with that characterization. It could be disruptive for many reasons, not this one in particular.
Speaker 14
But you don't think this is just a simple tweak we can do right now, temporarily even?
Speaker 3
In the congresswoman, I understand the situation here, but here, I'm just gonna play it out. Are you?
Speaker 3
That's not to say. Let's deal with the point of your, here's the issue. Let me just take it a step further. I issue we issue a waiver, and then five years from now, floods. Okay?
I have to look at the long-term process.
Speaker 14
But if we're talking about, like, ingress and egress of a facility, you know, that to me seems like not a major, you know, infrastructure issue. It's not, you know, my biggest concern is getting quality care for our veterans in South Carolina. Secretary Collins, Ralph Johnson Medical Center, hasn't experienced the staffing shortages per se as other facilities have. To what do you attribute the success of Ralph Johnson?
Speaker 3
I think it's just its leadership, and that's what we're looking striving for across the board. One of the things that has happened is the standards have been set on our leadership. We've allowed our many times our VA medical centers, which oversee also our clinics, have been paralyzed into being non-senior leaders. Okay? The fortunate for Charleston is they have acted like senior leaders.
They've made decisions, and they put those first. We have not seen that across the board. Greg Goins, who was a visiting director, saw this firsthand. He's had a lot of input across with secretary as well. Mhmm.
Because we just, again, we're now putting it back into the place where we have leadership. That one of the things we have right now is a dashboard that allows every hospital to see how they rank with every other hospital. So if they're down in something, they can go to a Charleston and say, hey. How do you do this? How can we get better?
Speaker 4
I love that. Add to that. I can tell you definitively, based on my experience. The secret in Charleston is the leader. Scott Isaacs has been in place for a long time.
We have a lot of really good leaders in the VA, frankly, but we don't have a lot of really good leaders with longevity. So the issue that has been so prevalent in Charleston is because of the longevity of Scott and a vision he's been able to set and execute.
Speaker 14
Scott, Isaac, he's been wonderful, actually. He was the one that told me that the VA does outpatient care with our geriatric patients. And he actually put my father and one of my family members in a program and outfitted the bars in the hallway and the scooter and the walker and all those things that I didn't know veterans could get, as they're aging. And I have been amplifying and spreading that to every aging veteran that I know, to get that high quality care throughout South Carolina. So I wanna thank you, Secretary Collins, for being here today, answering my questions.
Thank you so much.
Speaker 1
General, one more time expired. The representative chef Liz McCormick, you are recognized for five minutes.
Speaker 15
Thank you, mister chairman, and thank you, secretary Collins, for being here. Before we talk about innovation and administrative restructuring, I really want to point out what's at stake. Recently, last week in my district at RVA, we actually had a veteran suicide. One of the workers went outside and shot himself in the parking lot. For every veteran who's watching, for every veteran who came to my office yesterday crying and scared about what's going on and our responsibility to protect our veterans, it increases my responsibility to scrutinize this restructuring.
I think we all understand that. Right now in Florida, when we look at the vision, it actually adds Florida and five more states. And so there's a lot of concern there that our veterans are gonna be able to get the help that they need. Right now, wait time is 31 days. There's a lot of concern about this grouping.
And I've heard your explanation already of how this is supposed to work. But for our veterans who are watching right now who are very scared, could we say it in layman's terms of how this is gonna get better as we're grouping a complex state like Florida with five extra states?
Speaker 3
One, I'm gonna answer it from the top level, and let Greg or John, whichever wants to answer this. The top level aspect is with the HSA structure, they're actually gonna get more care. But, also, the biggest part about this reorg I think is missing sometimes when we talk about this, and I appreciate your discussion, is that we're missing that this is not affecting how the hospitals and the visits and hospitals and clinics operate. We're giving them more freedom, more latitude. Y'all have some of the best programs for food down there.
I'm championing that all over the country with the food. If you've never seen this, I encourage you to talk to her. They have Amazon boxes, basically, where they get food. So suicide, I mean, because you brought it up. Let me write.
I get those reports. There's nothing that bothers me more than those reports. That's why we have redone the entire suicide prevention program. That's why we're now looking, we're actually doing outreach to those who are not being cared for in the others. John Let.
Speaker 10
Pass it over to Greg in a minute. But, ma'am, you're absolutely right that we have to do this reorganization to make sure that it's consistency across the facilities. Right now, when you saw the org chart that my friend from the navy had put up at the congressman, that showed all the disjointedness. So if you're running a facility right now, you don't get consistent information. And so we've all heard the adage, if you've seen one VA, you've seen them all.
We need to have the adage that when you go to one VA, it's like all the VAs because we have to have consistency of policy, consistency.
Speaker 15
of application. Brings me to my concern. I don't my time is running out because every VA has been unique. And when we see the uniqueness, we haven't seen any streamlining actually going on before this reorganization. You know, we talk consistently about making sure that we have standardization, and we haven't seen any real standardization being incorporated or successfully incorporated.
So lumping all five is concerning. And before we go to that also, when we look at the VA, the VA is a unique structure. Part of that is learning from the lessons, the past lessons, as we go forward. Such a big reorganization is, it's disruptive, and we all know that. If it could work, if we actually had real steps in place that we can scrutinize, feel comfortable with, I think more people, but that's actually lacking.
So as we shift the conversation and you talk about it, I do wanna see if you've actually incorporated some of the nine steps that the GAO recommended when actually restructuring it to make sure we're learning from our past mistakes.
Speaker 4
So let me say first that, I agree completely with everything you've said as far as the criticality of this, as far as how we do this, how we go about it. One of the biggest pieces in order to make this successful has to be frontline voice, not just from veterans, but more importantly from the frontline employees that are actually caring for veterans, and the frontline leaders. We have done that twice. We had over 300 leaders, every single hospital director in one room at a time. The sole purpose of that is to create a plan that has exactly the details you're looking for.
So, as continuing to develop that.
Speaker 15
As my time is running out, I just wanna know specifically about this GAO document that highlights the GAO reform. It talks about the mergers. It has nine actual policies and steps in here. Have you seen this document? Have you incorporated anything from it?
Speaker 4
As we develop the plan that I just mentioned a second ago, all aspects of those types of reports, GAO, OIG, etcetera, in addition to the original documents when the visions were created, are gonna be part of the action planning that is associated with our future state and how we get there.
Speaker 15
So I'm assuming that you're gonna fully incorporate it, so when we get a plan that's more detailed, that we'll see everything in to have more confidence in it. If as of right now, because we don't have that kind of information, I think it creates an anxiety, not just amongst us as legislators, also with our veterans. And so we would love to have a real plan, so we can actually meet the needs of all of our veterans. Thank you so much.
Speaker 4
An outcome of the work that's been going on to incorporate frontline feedback to it. In addition, we've met with VSOs. We started to work with Congress the way that you've heard the secretary talk. All of that will be incorporated. And in addition to that, there should be references, and there will be in that plan to the things in which we're referring to include the report that you've got in front of you.
Speaker 1
Gentlemen, Simon Squire. Representative Kiggins, you are recognized for 5 minutes.
Speaker 16
Thank you, mister chair, and thank you so much, our panelists and mister secretary, for taking time to be here and for what you're doing to support our veterans. I represent Virginia's 2nd District, so home to a large navy population, a large veteran population. It's so nice to have my neighbor and colleague, congressman Scott, here. Our VA medical center actually sits in his district, so very nice to welcome him. But, you know, I wanted to thank you also for the work you're doing with mental health.
That's certainly a priority of mine. I don't know how many of us who sit on this committee have had the privilege of actually working at a VA facility as a nurse practitioner. I spent 3 months working in Hampton VA when I was a new nurse practitioner. One of the reasons I left was because I didn't touch the patients. I did a lot of administrative work.
I was losing my clinical skills. So I would walk around on my lunch break and see buildings full of people. And I didn't know what those buildings were doing, what those people were doing. I spent some time and would find the one geriatrician who we had on staff and shadow her over my lunch breaks just to keep up my clinical skills. But she was overwhelmed.
The physicians there were overwhelmed. The nurses there were overwhelmed. They were doing the bulk of the work of actually touching patients, talking to patients, and caring for patients. Those are the people we needed more of. I didn't know what was happening in all the other buildings.
I still don't even wanna go back there. So I applaud your efforts with this restructuring. I know change is hard. I know you have to be brave, it takes courage, and you're gonna take some heat for that. But thank you because the picture I saw and, again, I was just a lowly nurse practitioner, but, there was so much room for improvement.
So I think the time is now to do that. I wanted to bring my questions a little bit closer to home, and ask about the Hampton VA. I know we had a lot of leadership changes there over the past couple of years. We still do not have a director position that's filled. It would be great to put new leadership in place.
I know we did a lot of work just to change, you know, the current leadership that we felt was kind of a root part of the problem. But what are you doing, and can you tell me the timeline for that leadership replacement?
Speaker 10
Thank you for that question, ma'am. You're absolutely right. We are in the process of putting out an advertisement. I'm anticipating from our HR team that the advertisement will go out this week or at the latest next week, and then we'll start the process for advertising for a new leader at Hampton and a number of other sites as well.
Speaker 4
So to that end, just so I can try to help quell some of the fear that I can detect in your voice, we do that nationally, so that's what undersecretary is talking about. However, there's a process to get it done. And in the meantime, if there is an issue with Takesha Simmons' detail needing to expire or needing to be extended, we are committed to make sure that we have long term leadership longevity prior to that selection. So it should either be extended, or we will go through a process to find a qualified leader in that place.
Speaker 16
It'd be great to put permanent leadership in place. I think if we're looking for culture shift or looking for just, you know, a direct new direction to solve some of the problems we have there, it's a great facility, but I just want to make sure that permanent change is made.
Speaker 3
Yeah. Congresswoman, I also wanna say, and this is to everybody on the committee, we're one of the things that was disheartening to me when I first came in was how many interims we had sitting around executive leadership teams across the country. I have made a very concerted effort to change that at all of our facilities where you're getting at least the director, the executive director, the chief of staff. Those are permanent, so they can make real changes. And what we're having to do right now, though, is frankly because we've not done a good pipeline, we're having to move some people in to fill gaps while we develop that pipeline.
But that's my top goal is to get those permanent.
Speaker 16
Okay. Thank you. I appreciate prioritizing that. And then my other question is about our great new facility, our North Battlefield Clinic in Chesapeake. And I know, mister secretary, you were there at our ribbon cutting.
Thank you for coming down for that. And I understand why we didn't open our doors and have all the providers in all the places and that we were working on building up that patient base and made sense to me. I know that our goal was January to have it at max, you know, max capacity for staffing and that we're now in February, and we're not quite there. And I know, you know, we we've addressed it. I think my colleague, you know, Congressman Scott addressed it as well.
But can you tell us what the timeline is for adequate staffing or full staffing, I guess I should say, at that facility because it's a beautiful new building. I know that our veterans are using it. I know there's a provider shortage on the nurse and physician side, but what are we doing to make sure that facility is fully staffed?
Speaker 3
Oh, everything we possibly can. And I think that's the issue, that I appreciate what you said there at the very end because that makes it very determined. We'll hire it as we need. There are 534 allocated positions built. We've built those positions out.
There's 335 that are encumbered. A 199 that are vacant out of those 199. 166 are in active recruitment right now. 27 are pending. Five are pending.
Just getting back to us. But let me also state that facility is now doing every service it was provided to do. They're doing the service, and we will ramp up the amount of service as we are able to hire and get away from other, you know, facilities to hire these people. So it is doing what it's supposed to be doing. This is where we're at.
Speaker 1
The gentlelady yield back for advising the committee members. Representative Ramirez, you're gonna get five minutes. Everybody else, we're gonna cut it down to three, so everybody will have the opportunity to at least ask questions before they're gonna call votes, and we've got that hard out. So I've talked with the ranking member, and he's in agreement with that. And so we're gonna do it that way.
You're recognized for five minutes.
Speaker 17
Alright. Thank you, chairman. And ranking member, we'll keep it tight. Mister Secretary, it's good to see you again. So I wanna get straight into some of what we've seen in this past year.
We know that VA workers have been stripped of nearly all their labour rights. The department is struggling to staff and deliver services to veterans. Proven programs have been gutted, while promising new, more effective solutions. And the Department of Homeland Security is kidnapping and deporting veterans and executing VA employees in broad daylight. And yet, folks seem unbothered.
I've come to believe that's because employee retention and satisfaction, quality service delivery, consistent outcomes, and veteran protections aren't actually the goals of the VA. The truth is that it doesn't seem like you care about those things. Your mission, I'll be frank, from what I'm seeing, is you care about pleasing this president and advancing his privatization to profit agenda. Look. I wanna take your words after Alex Petty was executed by DHS.
You used your statement to blame Minnesota state and local officials for a murder perpetrated by federal agents. And at a time when accountability, integrity, honesty, and courage were needed, secretary, you pedal some of the same trash that DHS is pedaling, even though your responsibility is to lead the VA, not to do the job of the DHS. So I wanna ask you a couple of questions. Secretary, did you talk to Secretary Nome or the president or anyone in the administration about Alex Pratti? Yes or no?
Speaker 17
Let me ask you. If you would've, would you have talked to them about how he cared about the nation's veterans as he took care of them in hospitals?
Speaker 17
Let's say you haven't talked to them and you are not going to talk about hypothetical standing up for Alex. So, mister secretary, let's see if there's some care now. Would you call for Secretary Nome to resign given her execution of a VA employee?
Speaker 17
I'm ask questions. About it. Okay. Can answer. Got it.
So I wanna then pivot and talk to you about the port veterans. Let's take your words on VA's role in targeting non-citizen veterans. In a letter dated January 13, at the same time that you recognize that your mission is to serve all veterans, you also admitted that you're sharing noncitizen data consistent with interagency agreements. Has your agency assisted in the deportation of non-citizen veterans, mister secretary? Yes or no?
Speaker 3
That comes from a report that has nothing to do with sharing the legal status of veterans. Actually.
Speaker 3
But you an answer or not, then yes, no is not an answer. And you've been here.
Speaker 17
A while since trying to cover up the phone. Think you are assisting you me. I'm moving on, and I'm reclaiming my.
Speaker 17
So let me ask you another question. Are you ensuring that deported veterans are still receiving their benefits? Are deported veterans still receiving their benefits? That's a pretty simple yes or no. Yes?
No?
Speaker 3
I'll on that question, I'll be frank with you. On that question, they depending on their legal status and everything, how they'd actually get veterans' benefits, we'll have to see what that actually says.
Speaker 17
At the same time that you said VA employees need to be singularly focused on veteran care and services, you dragged VA employees as too often fighting against the best interests of veterans. In your crusade against VA labor, you have illegally terminated collective bargaining rights, ended unpaid parental leave, and terminated the use of FMLA for in-law care, and yet people seem to be running to work at your VA. I almost applauded you for reducing the time to hire a VHA employee from 109 days in 2024 to 47 days as of last month. But look, I took a closer look at it, and I realized that it's smoke and mirrors. Unlike your predecessor who measured the time to hire as the number of days it takes for a new hire to start the job, you are measuring the number of days it takes for an applicant to receive a tentative job offer.
And that is why we can't trust anything that's coming out of your office. It is clear, Secretary Collins, that you don't care about Alex Pretty. You certainly can't even respond to a yes or no basic question about deported veterans or the workforce. You have no commitment to accountability, to integrity, or to honesty, and you cannot be trusted to do the reorg of the VA because just like that time to hire board, you paralyze, have truths, and misinformation. Look.
This is what I'm gonna say to you. I only have two sides.
Speaker 1
Gentleman's time has expired. Gentleman's time has expired. Representative Hammond, you're a rep, you are recognized for, we're gonna go to, I'm sorry. I need to tell the time on this. Staff's conversation, we are going to go back to five minutes.
As staff had agreed back and forth, so we're going five minutes. We'll go as far as we can. You're recognized.
Speaker 18
Thank you, Mr. Chairman. Secretary Collins, thank you for being here today. And first of all, I'd like to say something that you're not hearing enough of. Thank you for your service to our veterans. I hear the great work and the improvements that are happening in my district.
And what you're doing to reorganize the Veteran Health Administration is not, you know, it's necessary. It's responsible, and it's long overdue. Now for years, the committee has been handed report after report by the GAO and the IG from the commission on care, all saying the same thing, that the VHA's management structure is broken. Too many layers, too much redundant bureaucracy, and what should be decisions that take a day becomes ones that take even months. So now you and the administration are finally doing something about it, and certain members of this committee want to pretend like the sky is falling.
Well, mister secretary, let's get some facts on the record. Now this chart behind me compares two lines over the same time period. The VHA's workforce increased by about 14% between the fiscal year 2019 and fiscal year 2024. And the patient encounters, it grew by just 6%. Workforce expanding at more than twice the demand for care.
That's not a staffing crisis. That's an imbalance. Mister secretary, this chart speaks for itself, but I want to give you the chance to speak to it directly. Can you walk through this committee about what this data tells us about the VHA staffing?
Speaker 3
I can, and I'm gonna also get you some more color on that. But, also, I wanna say for the committee, first and foremost, and it's been said many times, the only thing that I have on my agenda is a veteran, period. That's what started the change to good at the VA last year when I said the only thing that's gonna come first is Veterans First. And our workers now have a purpose. And our workers know what they're doing, and they've actually improved.
And I'm proud of that. And I'm not gonna take nameless names and programs that have been gutted, supposedly that have not been given a chance to answer to. This is an issue, though, that we have, that is the heart problem of where we are. In this town, it's throw money at people, and everything gets better. And that's just not the way it is.
14% over six. It actually is worse in some areas, and I could go list by list by everybody. Had some that we increased 30% in FTE counts, but yet only they actually went negative in actual touches of people. This is something we faced in the field. Greg has had to deal with this, and these are one of the reasons that we came forward on how we deal with this going forward and why this restructuring is needed.
Speaker 4
Thank you, Mr. Secretary. So one of the things that's very objectively clear, and this goes back to ranking member Takano's question earlier about does the VA have enough employees or enough staff? The short answer is at a totality level, probably pretty close. What is not true is that there is an absolute imbalance. There are places where we do need more physicians, and there are places where we have plenty of staff.
And the short answer is if we don't go through with an evaluation from a demand basis, we do not have the ability at a national level to address resource needs where there are growing veteran populations. That has never been able to be done in the past at an enterprise level.
Speaker 18
So in other words, making sure the tax dollars are not tied up in excessive administration overhead, but instead redirected to frontline service, modern equipment, and facilities that actually serve the better. Now you're undertaking a new request for proposals for the entire Veterans Community Care Network, VCCNs. Correct?
Speaker 3
We are in the process. It's in our RFP now, I can speak to what we had as you had the hearing last week. I'll speak to that realm.
Speaker 18
And what confidence can you provide to this community that the next generation of TPA contracts, the administrators will be held accountable for the basic network integrity?
Speaker 3
I can't tell you how long I've been waiting for that question to come from this committee. And in a very honest way, because many of us have done this for years, and I was a part of this committee, and there's only about four of us on this committee who can say this actually voted for choice and actually voted for mission, which set this up. What we did not know at that time was because we were trying to get help from a bad situation of wait times and issues, we set it up as quickly as possible. And, frankly, I can just say from a bigger perspective, we had very few takers on helping us. We ended up with, Choice Act was a disaster.
Mission Act has put us into two vendors, third party access, and there was nothing in the contracts that was holding account. Well, let me rephrase that. There was. VA just didn't hold them accountable. One of the reasons that I'm confident in this RFP that is out right now, and when it goes through, is that we have basically ten years of failure to learn from.
We have ten years of why this doesn't work that we incorporated those problems into this, so we can hold them accountable, do better management, and make sure that we're doing not only what's best for the veteran, but what's best for the VA as well. So I have full confidence when this comes out that we're gonna have much more participation, but we're also gonna have 10 years. And I'll go back to where we're recommend or not agree on. History does teach us things. This one is what big one where history has taught us things that we need to add onto it.
Thank you, Mr. Secretary.
Speaker 1
Gentlemen, time is barred. Representative Kennedy, you're recognized for 5 minutes.
Speaker 19
Thank you, chairman. Good morning. Mister secretary, you're asking congress to accept a VHA reorganization that had moved 4 to 5,000 employees while the workforce is already strained by the deferred resignation program, attrition, and hiring disruptions. The VA has the data of the workforce. I requested back in August a detailed description of the employment changes and impact in Western New York for the Buffalo VA in the health care system for VAs.
I received a response from you in October that was vague and did not answer any of the questions outlined regarding staffing levels. Will you commit to me today to provide the data that I asked for back in August, to my office?
Speaker 3
We are working that right now, and can discuss that as far as staffing levels go.
Speaker 19
gonna, yes. You will provide me. That is what we're saying. The detailed description I asked for was op occupation, job title, grade level, facility, reason for departure, whether the employee was retirement eligible, participated in the debt deferred resignation program, or whether the employee was terminated. The idea that it's been about six months, Mister Secretary, that I haven't gotten a response, and you're asking us to buy into this reorganization is unacceptable. Please.
Speaker 20
Yes, representative. We can commit to getting the data and the information. One of the things I wanted to highlight and just highlight really the issues that we've been facing collectively, and I think the representative Kagan really kinda mentioned it. There she was, a trained nurse who was doing administrative work. So when you talk about what somebody does and what positions we have, we don't even know what they are doing.
So the ability from a bottom-up delivery of medical centers, actually restructuring and reorganizing and identifying their requirements and outline their personnel, will be able to look and identify. Up to this point, we haven't had the ability to do that. We weren't tracking. People hired, people all over the place. People were nurses not doing nurse jobs.
This is exactly what we're tackling. We'll get you that information.
Speaker 19
Thank you. I would like to enter both of these letters into the record, mister chairman.
Speaker 19
I do wanna focus on the workforce impacts already hitting the Veterans Health Administration. The reorganization again comes at a time where tens of thousands of employees have been lost in the last year. Doctors, nurses, mental health professionals, police officers forcing facilities to close hundreds of beds because of the lack of staff. VA has eliminated vacant positions, pushed full steam ahead with changes that risk driving even more experienced staff out the door, and failed to provide Congress up to this point. We'll take you at your word here today, that you'll provide clear, detailed workforce data.
I'd like all of the data, quite frankly, obviously, for my own purposes in Buffalo at the VA in Western New York. But I think it's important that every member of this committee at least has information regarding their own VA to the same effect as my letter outlines. Secretary counts, for each of the VA's three administrations, the VA, the VHA, NCA, what's the total amount of paid salary, benefits, and terminal leave under the deferred resignation program, and what accounts were used to cover those costs?
Speaker 20
I would just say, representative, the standard personnel accounts were utilized for those folks. So we budget when you look at the, you know, FTEs that are budgeted for personnel throughout the year, that was the resources that were used. Those people remained on VA roles through the end of the year or through the termination, whenever they left the service. So their traditional salary was utilized as far as our standard, personnel budgets.
Speaker 19
So was there money that was diverted from other accounts without informing the committee?
Speaker 20
I think I just answered that it was the standard personnel accounts that would have been used to pay them in any regard. So, yeah, the answer is no. There was no diversion. It was their standard personnel accounts that were already programmed for.
Speaker 19
Okay. Well, we don't have that information because you never provided it. So, again, that information is vital for us to not only make these determinations, but to be supportive of this restructure.
Speaker 3
Consumant, can I answer one part of your question? Your Western, you mentioned your Western New York facility.
Speaker 3
Correct. It had over the past five years, it's had a 7% increase in FTE and a negative 6 encounters. It actually went backwards. That's just one of the ways.
Speaker 21
Thank you very much, Mister Chair, and I thank Secretary Collins for being here as well. Mister secretary, this reorganization is supposed to correct decades of weak oversight and inconsistent leadership across the VHA regions. And as we saw, one of the purposes and the momentum for the mission act was because of VA deaths and waiting lists that occurred, some up to 9 months for diagnosis and treatment of cancer. So that led to reorganization, if you will, or the mission act, implementation of the mission act, but yet there was no accountability. So can you give this committee your word that you will avoid promoting any VA employee with a poor performance history or documented oversight failures into senior roles under the new structure.
Speaker 3
That is one of the things, and I appreciate the discussion here because you're getting I know that everybody believes that we're taking this in a big picture. I'm traveling. I'm this is the multiheaded snake, so to speak. I'm having to address the facility needs. I'm having to address the leadership needs.
Yes. We're putting into place now to where I actually have a structure that can actually do that, that can actually get us to a position where we can have, you know, strong leadership and mentoring as we go forward. That is our intent and purpose of this.
Speaker 21
The reason I asked that question is under the previous administration, under the Biden administration, very early in my time in congress, we had a hearing in this room in February 2024 after a young female whistleblower had contacted the minority party, had not had any action, contacted chairman boss. Chairman boss then requested information from the secretary after 45 days on a personal phone call, had no information. We had to subpoena to get the information. Now the whistleblower was reporting on sexual harassment by her senior leadership. This was senior leadership of the office of resolution management, diversity and inclusion, which has a zero tolerance policy for sexual harassment, and no investigation was taken.
And through emails and texts that came out after being subpoenaed, we found that the secretary had, in fact, arranged for a soft landing for the assistant secretary responsible for ORMID. And, in fact, that person was effectively promoted to another job. So was the senior leadership of ODM one of them, and then another retired. And in testimony, Secretary McDonough said, there is no question that I failed in this instance. None of those individuals were held accountable, and this poor woman was made to suffer and was disbelieved in her allegations of sexual harassment.
So, mister secretary, if this reorganization is truly about accountability, will you commit today that no individual with a substantiated record of mismanagement in prior OIG, GAO, or internal VA reviews will be appointed to lead any offices that have decision-making powers and, therefore, institute accountability at the VA. Yeah.
Speaker 3
My goal as congresswoman is to do exactly that, take into account the entire record and going forward as we go forward.
Speaker 21
Thank you, sir. Mister secretary, in your testimony, you specifically cited OIG reports as a foundation for this reorganization plan. Are you applying the same standard to personnel decisions and reviewing past OIG findings when selecting candidates to lead the new visions, HSA and operations?
Speaker 3
We're taking into account everything that we can to find the best possible people in that regard, as we go forward in this. And I think that's gonna be, you know, our guiding light, are we actually getting the right people in the right places.
Speaker 21
Thank you for that. And prior to what I heard earlier with one of our colleagues on the other side of the aisle, I have worked in the VA both as a nurse and a physician. I've applied for jobs at the VA, so both nurse, physician, and military veteran. And let me just say it took nine months for that application at the VA, by which point in time I had dozens of offers elsewhere. And so let me just say that 47 days is a monumental achievement, and thank you for that.
And thank you for working on hiring at the VA because it is a morass, and we are losing good people at the VA because we, in the previous administration, could not process applicants or give them job offers rapidly enough. And I know of two other physicians who had that same problem.
Speaker 3
That is something we're working on, I appreciate that. That's what we're working on right now. When I was in uniform this week ago, had a lady who got a year later, got her all back. So, hey. We're ready to talk to you now.
We're fixing that in thirty days or less.
Speaker 1
Gentlemen, time expired. Quick piece of housekeeping here. In accordance with the committee rules, I ask unanimous consent that representative Walstrom Schultz from Florida be permitted to participate in today's committee hearing without objections. So ordered. Representative Bezinski, you're recognized for 5 minutes.
Speaker 22
Thank you, Chairman Boston, Ranking Member O'Connor for holding this hearing, and thank you to Secretary Collins and your team for being here. You know, I wanna just kinda cut to the chase here. I really think over this last year, what you've done to the VA is really hollow it out. This is cutting to the bone. It's not trimming fat, and it is really hitting VA employees, union employees the hardest.
You've stripped their collective bargaining rights, damaging their morale and dignity, leaving employees wondering if their jobs will be cut next. And I just wanna point out, none of that is done to serve our veterans. This isn't happening as work is slowing down, of course, within the VA. It's happening while VA experiences the largest expansion of VA health care and benefits in decades, thanks to the passage of the PACT Act. It's happening as VA is restarting one of the largest and most complex EHR deployments in modern history, in just over two months.
And I wanna point out I've been asking when the VA is going to nominate a CIO, something that would be a critical leadership position to ensuring success of this EHRM program. We still don't have that. That's a really important leadership position. And now you're proposing this massive reorganization without consulting Congress first. I have serious concerns with how this reorganization could impact the already ambitious rollout.
I support efficiency, but it should not be, and it should never jeopardize success, and most certainly not at the expense of our veterans or VA employees. Mister secretary, I'm concerned about your plans to initiate a VHA-wide reorganization at the same time as you've accelerated the deployment of EHRM. I'm looking at an email, and I can show it to you from the GAO that says that you've canceled your standing meeting with GAO, an independent body who performs critical oversight on the EHRM program, because, quote, your leadership and resources are strained. Is that true?
Speaker 3
We will take meetings as need be, but we're the things that we get, we'll meet with GAO and we meet with those regularly. We're answering every GAO or every OIG report that we get.
Speaker 22
But they have made recommendations on solutions that will help to make the EHRM deployment successful, and you've decided to just shut down meeting with them.
Speaker 3
I would disagree with that. Most of the GAO reports, in fact, almost all of them dealing with the EHRM, dealt with a system that doesn't exist anymore. They said what was wrong with the system that was rolled out in Washington state, which was, and I'll admit to you right here, an absolute, utter mitigated disaster.
Speaker 3
So here's the issue. If you have a new program coming in in which you've redone and reshaped how you're doing it, there are lessons that we learned, like standardization issues, standard the problem we had in Washington State was is we allowed every hospital to decide what they wanted to do. Every doctor got to decide how they.
Speaker 22
I only have two minutes. Mister secretary, out of respect. I just provided you with the email from the GAO. So I'm hoping that what this will shed a light is that it is helpful to reengage the GAO and work with them on solutions to make sure that the e r EHRM program is successful.
Speaker 22
There's a lot to ask of your workforce. A workforce that will, I will note, has gone through a lot of changes over the last six years. And I do worry, and you brought up some of the cases in Washington state with the EHRM program and the struggles with that. They were not the only ones to identify and deal with many of the issues of this new system. What do you have to say to the hardworking employees who are now facing even more change with this reorganization, especially when many of their problems with Oracle have not been addressed?
Speaker 3
That is such an open-ended question that they have been addressed. We have, in fact, my deputy's undersecretary, my deputy secretary, in the facilities this week. Again, he's there almost every other week. They're addressing this as it goes along. Any issues that come up, we're solving those as we go forward.
We've made a situation now in which it is working. It will work because it's not a choice to not work. And I think that's the biggest when you take the lessons of the past. I agree with you on that. And the lessons of the past.
Speaker 3
Nonstandardization, nonlooking at it, and now we're looking at how we do.
Speaker 22
Concerned that we haven't fully resolved the problems of the past, and we're gonna be expediting 13 new go live sites with about 164 more go live sites within 2031, and you're decimating your own workforce. I think that is a real problem in not setting the VA up for success. Do you know how many IT support specialists you've lost since January 2024?
Speaker 23
Thank you, Mr. Chairman. Mister secretary, you've told us about the growth of the visions, the unintended growth of the visions in terms of employees. We now have five visions and 15 new health service areas. It's not lost on me that that equates to the number of versions that we have today. So I wanna talk about potential unintended consequences of this, because I think this is good.
And let me preface this, but I want you to talk to us about because there are people on this committee whose worldview is bigger is better, bureaucracy is better. So it can you, I hope that we do not have five supervisions and 15 visions at the end of the day through growth. So how are you going to organize this plan so that that does not happen, and it's all in execution so that in the future, we don't have these supervisions and visions? So I'll, it's an open-ended question. Please tell.
Speaker 3
us. Yeah. Here's the top end, and I'm gonna let the team finish this. Top end is they do different things. Okay?
The HSAs and business do not do the same thing at all, and there is a purpose for that and a reason for that as we go forward. John?
Speaker 10
I really appreciate your question, sir. I think this is a great question. It gets at the heart of what we're doing here. This reorganization streamlines how we do our operations. So right now, if you look at the current operation, every program office comes up with their own policies, and then each visit comes up with their own policy on top of that. And then each facility turns that into their own policy.
What we're doing in streamlining this is we're creating not just the HSAs, which will help with the execution of focusing down in the markets, but more importantly, and what we've not talked about, is the operation center. The medical operation center will ensure consistency across the policy. So if a policy is determined on whatever at this senior letter level of the vehicle for a national program, the medical operation center will then put consistency guidelines out that will go down to each of the visions, the five visions and the HSAs to the facilities so that it's consistently applied so that we don't get one VA is one VA. We get all of VA being the same VA as we move forward. And, Greg, do you wanna talk about how that challenges our facility directors and our ability to serve veterans?
Speaker 4
Yes, sir. I think there's an element here that has been missing in our discussion that's really important to answer the question you asked directly. We have heard from everyone that has looked at a vision structure, it doesn't matter where you come from or where you sit, that the roles and responsibilities are not clearly defined. The way in which we make sure that our organization does not balloon the way that Congressman Bergman has described bureaucracy as a rosebush, it's a great metaphor. Thank you for that, sir.
Is by clearly defining roles, responsibilities, and boundaries. When we do that, it does not allow us organizational entities like a Vizen or an HSA or even a program office, as you heard the undersecretary say, to define their own roles and responsibilities that then facilitate a massive growth in those units, unchecked. The roles and responsibilities are part of this reorganization.
Speaker 10
Sir, if I could just add one more thing, this is a conversation, not a final plan that we presented in December. We said this is the structure that we're doing. We're moving out. This is the transition. And as the secretary committed to, and we always will do, is follow the law.
When we get to that final plan, we will be submitting that as a final plan. And it may look somewhat different than what we've seen because we're getting input, we're continuing to get input from the field as we continue to evolve. It's an iterative process. And so would just there's been some assertions here that we identified in December what we were doing, we started the implementation. What we identified in December is the start of a discussion and a dialogue that says, we all recognize this needs to change.
Here's the structure and the framework of how we're gonna change it, and we're continuing to have that dialogue today and continuing tomorrow and until we send over the notice. And we'll continue to talk even after that point. But it is an iterative ongoing developmental process.
Speaker 23
So it looks to me like the vital issue here is that the HSOs HSAs cannot have their own interpretation of VA guidance.
Speaker 3
This was the biggest issue for me, and I'll go back to a state something I think I even shared last year. I had a veteran come up to me who moved from Salt Lake to Hampton Roads, actually. Reverend Scott. I went to live there. Was getting treatment.
He's an amputee. Was getting treatment at Salt Lake, came to Hampton, and the Hampton doctor said the VA doesn't do that. And he said, this is the VA. Correct? And he said yes.
He said, but we don't do that. That's, in essence, the whole genesis of thought behind the upper left.
Speaker 1
Gentlemen, time is expired. Doctor Conway, you are recognized for 5 minutes.
Speaker 24
Thank you, mister chairman, and thank you, mister secretary, for presenting yourself to this committee today. You know, I'm sorry. I'm gonna have to start out with a rather pointed topic here. You may know that 90% of the people in the country have seen the killing of Mister Pretty, and a number of statements have been made by the administration about his death that are very concerning, certainly with a family whose loved one has been defamed by members of the administration. So I'm compelled to ask you, secretary.
Does the VA employ domestic terrorists? Yes or no?
Speaker 3
That's a question that is aimed at an answer that I've already given. I'm not gonna recall you're claiming my time. I'm not gonna indulge.
Speaker 24
Claiming my time. Your colleagues have labeled, mister Prede, a VA nurse, one of your employees, a hero, to many as a domestic terrorist. Is he a domestic terrorist?
Speaker 3
As I've already answered to this committee, I've answered and made my statements of condolence to the family. I'm not answering, and I'm not gonna entertain these questions.
Speaker 24
Because the vice president and Christie Nome and Steven Miller have certainly mishandled this situation by calling a domestic terrorist that called an assassin. Did they handle this killing appropriately in your view?
Speaker 24
And Christie Nome herself has even walked back and said, walked back this charge that was made. And so, you know, you lead a large organization with employees that are hurting in the wake of this killing. And, while you've reached out to the family, that's certainly commendable. It would be helpful to show just some of the courage that our many veterans have shown in their service, by standing up and calling out what is wrong, particularly with respect to mister Pratty and his life's work. Can you say, on the record, whether or not Mister Pratty was a domestic terrorist or an assassin?
Will you stand up for him and show just a little bit of the courage that our veterans show every day?
Speaker 3
Excuse me. I've thrown the courage of a twenty-seven year veteran sitting in front of you and will not be spoke down to. I've asked and answered the question.
Speaker 24
Now, moving on. I think your inability to answer a question about Mister Pretty and his life is certainly disturbing, and I think it's unfortunate. Let's move on to the VA reorganization. Looked at your plan, and had some briefings on this. And, as I understand it, back in the nineties, there was a big reorganization, a large reorganization that was done.
And the vision system, these integrated service networks were created, 18 of them. And, to deal with the large, complex nature of the VA.
Speaker 24
23. Well, thank you. I was even more than that. So you're reducing that 22 down to five. And as I understand it, you're breaking up that five into three administrative areas.
Is that right? In each of these five visions, am I describing that the right way?
Speaker 4
Clinical oversight areas. And if I can just tell you, when visions were first created by the twenty-third created, it was considered an industry best practice. What ends up happening over time in a public sector, unlike the private sector, is private sector moves on, they actually started emulating us. But then, over time, they also recognized there were better ways to do business.
Speaker 24
I do not need to do that. I need to reclaim my time. It seems to me we're adding a layer of bureaucracy in the issue without necessarily doing things better that couldn't be done in the current system. And, you are doing so at a time when 30,000 employees have been laid off. In my own county, Burlington County, it takes over two months to get an appointment for just primary care, longer for mental health services.
Another county, in Hamilton, they have a similar issue where it takes about a month to get a primary care clinic and about a month and a half to get mental health services. And this is in the wake of a decimation of the employee force. We have 1,000 less physicians. We have 13, 3,000 less nurses. And, of course, you're focusing as rightly on direct care, but how can you get that direct care to people, if we don't have the nurses and the doctors to do the care?
And it shows up in these numbers. These are your numbers as of February 4, about the wait times there. So how do you justify the cuts to services, that are occurring? And I just have to share one story about this issue. I spoke to my colleagues who work in the VA system.
There's an institution out in Colorado, a patient languishing in the emergency room. They had the doctor. They had the OR. But they didn't have the OR techs and the nurses to actually deal with and definitively treat someone Yellowman's.
Speaker 7
Thank you, Mr. Chairman. Anybody here want to offer a definition of what a camel is? It's a horse designed by a committee. Okay? I've seen several parts of the camel displayed today.
And since Mister Goingju referenced my rosebush comment earlier, I wanna make sure that when you think about the most majestic animal in the world, it's a horse. Strength, compassion, awareness. Our veterans are those magnificent men and women who serve. Over time, not necessarily through intent, but maybe just lack of focus. The Veterans Administration, through its organization, has begun to look like a multiple-humped camel.
In my office, I have the chart that you gave us of the new organization, the chart of the current organization that you're transforming, because you're doing it for the right reasons. So, those of us, I think, who ran for Congress, especially as veterans, we serve for the right reasons. We serve now for the right reasons. I would like to, because I have three minutes and 40 seconds left, yield any or all of that to you, mister secretary, to make any comments that you would like in the rest of my time.
Speaker 3
General, I appreciate that in the sense of because I, let's just, you know, I think there's been a lot of discussion today that does miss each other as we go forward. The interesting issue is we've talked about, one I wanna go back to one that has been said several times that we've laid off or got rid of, however you wanna look at it. The 30,000 number was all voluntary early retirement or VERA. We didn't fire any of them. They've all, that's a voluntary issue.
So let's just keep that where it is. We've discussed the issues of why we're doing this and also this duplicative nature of an HSA and a vision. I can't describe this possibly any better than to say the HSAs and a visions are as different as the quarterback and the center. It's not unusual to have a quarterback in the center on the field at the same time. In fact, it's necessary to have the quarterback in the center of the field at the same time.
And to look at this plan and say it's adding layers has really not, honestly, I think, looked at the perception of what we're doing now in the vision system, which is broken and has been admitted to by most everybody that looks at it over the years. What we're trying to do here is empower center directors, chiefs of staff, at the local and executors, the folks at the base level to make decisions. I spoke to another general recently, and I said, sir, let me ask you a question. I said, are you the tip of the spear when you're back at headquarters making decisions, or is it the units that are in the field knocking on doors? He looked at it and said, that's a dumb question.
I said no. It's not. I said, if you just help me here. He said, of course. They're the tip of the spear.
I said, so you're not? I said, well, we have that reversed in the VA because our center directors right now were ones that would have to end up sending. I heard this so many times, when I would go to hospitals. I say, well, what happened to that idea? They said, well, we sent it up, they found your camel committee.
It never got back to them. They never had an answer. They were paralyzed into what they were doing, and thus, you developed over 170 different hospitals, ambulatory centers that did it differently because they couldn't get clear answers. The vision was supposed to add that in, but it didn't. Because after a while, they become so bogged down in the different functions of what they do.
So when you look at it from an operating perspective, this is the sort of the opening up. I'll go back to what I said in my opening statement. Part of what we're doing here is giving, frankly, more information starting it earlier than is even required under our 512b, you know, need. We're starting this last month. We're still working on it as we're speaking here today.
We're still looking and making sure that we have the right areas in the right places so that we can give finalized plans, which we're actually gonna give out in pieces. Probably, we're not gonna actually show it as we're making progress to give you more transparency into the process. What I will not tolerate, though, is the status quo. And, also, to continue this issue of when you looked at it like we just said a few minutes ago, we have facilities that FTE counts are higher now after 5 years than their actual encounters with patients. We have to be able to readdress where we're putting our workforce, at the same time as we're working within our system of both direct care and community care.
Speaker 7
I guess I'll yield back and just say, sounds like you're running a Marine Corps type operation, and I'm proud of you for doing that. Thank you. I yield back.
Speaker 1
Gentleman yields back. Doctor Dexter, you are recognized for five minutes.
Speaker 25
Thank you, Mister Chair, and thank you once again, Secretary Collins, for being here with us. Off the top, I also want to take a moment to acknowledge the murder of Alex Pretty. Throughout my career as an ICU physician, including working at the VA, I worked with dedicated professionals just like Mr. Pretty. We critical care clinicians are the ones who literally run into rooms when someone is dead or dying, and try to revive them or bring them back. Alex Pretty, until the last moments of his life, was protecting people and the principles that this country is built upon.
The VAs across this country are understaffed, overstressed, and now grieving. And, Secretary Collins, your failure and the failure of the agency to honor his memory and the impact on VA workers is both a disgrace and further undermines trust and leadership for the public servants who are committed to caring for our veterans. The employees of your agency feel threatened, silenced, and now deeply harmed by the lack of acknowledgment that one of their own was murdered at the hands of the US government, the country our patients sacrificed to protect. I ask you to please reflect on the long-term impacts of how you address the murder of Alex Pretty for the people working in it and caring for the VAs across this country. Please hold yourself accountable to your overstressed workforce and the veterans who sacrificed to protect this country and the Constitution.
And as you know, and I'm sure that whatever you're writing is very important. I hope that. Thank you. As you know, I'm a physician, and I also was the chair of the board of the largest multi-specialty physician group in the Northwest. So I know how hard it is to run a complicated organization as much as I can, not as complicated as DBA.
But I know that changing structure in an organization is challenging, and it requires a culture that is dedicated to making that change possible and effective. So I'm worried, deeply worried, that this labor intensive and costly endeavor that you are embarking upon at a time when the VA is already overstressed and understaffed is destined for failure unless you can really lean into the culture and support the people who have to make this possible. So I'm gonna leave that because I'm gonna run out of time, and I want to go back to about two weeks ago. Secretary. Your colleague, Mister Topping, was in front of our committee to testify on the new community care contracts.
And during that hearing, I shared that my office is waiting for the VA's response to a 09/22/2025 letter that was urging the department to take action to provide our veterans with better data on wait time and drive times to care in the community, as opposed to those through the traditional VA system. Mister Topping promised a response on where the VA's letter was, and my staff is still waiting. So, Secretary Collins, do you feel it is appropriate for members of this committee to wait over four months for a response to a simple letter about how we can better serve our veterans?
Speaker 3
I think that getting your title in proper response is needed by everybody, and we're trying, I'm trying my best to do that in all cases. I think the inter, you know, the issue here, you know, is looking at it. It was a question right to him. I'll have to go back and look at that actual letter, but I don't have it in front of me. But I agree we need to get you an answer.
Speaker 25
I appreciate that. That is similar to the answer I got from Mr. Topping. I appreciate that my team has stayed on top of this as well. I just have a challenge that if we can't get an answer to a simple letter, that being able to reorganize the entirety of the VA health system is going to be a challenge that we cannot rise to. I also wanna believe you that the VHA can undergo a reorganization.
I agree with you that the status quo is not acceptable for our veterans, but it has to improve care for our veterans. And while you are losing staff, whether, you know, it's because of early retirements or not, it is extraordinarily difficult to get through that. And my skepticism is not because I want your agency to fail. It's because I know that the time and the capacity and the leadership that is necessary may extend past the time that we actually have with this administration, and things continue to pendulum. So how are you gonna get that done in that amount of time?
Speaker 3
Well, I think that one of the things is actually in my conversations with employees and, especially getting their input from our directors and senate directors, they're actually excited about this because for the first time, they're actually having somebody at the top that shows what they've been feeling for years, and that is they're being over neglected and looked at. I would also just have to say, as a reminder, that the VA is a health care system just like the one you used to run as well. And I'm sure you lost employees as well, just like we do, and we hire employees as we can. That is what we are continuing to do, and we've never stopped.
Speaker 25
The ability to retain employees, and this is incredibly important, your commitment to them is going to drive that. So I appreciate that, and yield back.
Speaker 1
Yellow moment, yield back. Doctor Morris, you are recognized for five minutes.
Speaker 26
chair. Secretary Collins, in May, you gave this committee your word that you wouldn't fire any VA staff responsible for providing care to veterans. Since the announcement of this massive reorganization, I've already heard two direct accounts: the impending reorganization leading to canceled promotions for critical support staff, and the dismissal of concerns regarding access to care. Under your leadership, applications to work at the VA have fallen 57%. And a spokesperson for the VA confirmed planned cuts to 25,000 unfilled positions, which will strain the workforce caring for our veterans.
Trust me when I tell you almost every health care worker in America can tell you exactly what it's like to be overworked, short-staffed, and overwhelmed. In August, the VA inspector general found that the Minneapolis VA had 130 different categories of positions facing severe staffing shortages, including 78 clinical positions. I sent you a letter in September requesting details about the employee departures we've seen since last year, which you still have not responded to. In your testimony, you stated, quote, staffing and operations at VA medical centers and clinics will not change as part of this reorganization. Given reports of existing severe staffing shortages and negative impacts from this reorganization effort, will you commit to addressing the severe staff shortages that threaten access and quality of care for our veterans?
Just a yes or no, please, sir.
Speaker 3
There is no yes or no. Minneapolis is 7% more in FTE since 2019, and two Mister secretary, I'm asking.
Speaker 3
Made it a statement that we're overstaffed or understaffed. 7% more FTE since 2019.
Speaker 26
I'll take that as a no, sir. I reclaim my time. Mister Secretary, the crisis of morale in your agency has reached a fever pitch in Minneapolis. Minnesota has been overrun by masked, lawless federal agents who are terrorizing our communities. It has resulted in untold human and economic damage, including the killing of 2 American citizens.
One of the people we lost was VA nurse Alex Pretty, and Alex Pretty was the best of us. Like his colleagues at the Minneapolis VA, he was a dedicated, hardworking care provider who honored the sacrifice of the veterans he cared for by helping deliver on the promise our country made to our veterans for their service. Alex's parents described him as a kind-hearted soul who cared deeply for his family and friends, and also the American veterans whom he cared for. Mister secretary, you said you have not spoken with ICE, but I have spoken directly with ICE on the ground in Minnesota, and they clarified that state and local officials are cooperating with ICE regarding violent criminals, and this has been the case long before Operation Metro Surge. In fact, they told me that the idea that there is no cooperation is completely false.
Do you dispute ICE's account on the ground in Minnesota? Yes or no?
Speaker 3
I have no idea what you're talking about, because it's not my department.
Speaker 26
That's true, Mr. Secretary. You are responsible for the VA, not immigration operations, not investigating shootings by federal agents, the Veterans Administration. So please help me understand your official statement. What evidence do you have to blame the violent death of one of your employees on the state and local officials? Do you have any evidence?
Speaker 3
I have stated my statement on Alex Ready, and I'm not going in. I mean, there's nothing else for me to say.
Speaker 26
Senior officials in the Trump administration have slandered Alex Pretty as a domestic terrorist, an assassin, that he wanted to do maximum damage and massacre law enforcement. No official has retracted those abhorrent and ridiculous statements. Mister secretary, it would go a long way for the grieving staff at the Minneapolis VA if you corrected your statement blaming state and local officials, which, by the way, also actively undermines the work of local law enforcement and made a deliberate effort to honor Alex for his service and care of veterans. Alex Pretty was a beloved nurse, son, brother, and friend, and will be remembered as an American hero. It's profoundly disappointing that you refuse to correct the record and reject the hateful lies spewed by this administration about Alex, and stand up for your employee.
Veterans and those that care for them deserve VA leadership that honors their service and sacrifice with words and actions. If you cannot stand up for Alex Pretty, how can any VA employee trust that you will stand up for them? Mister Chair, I yield back.
Speaker 1
Gentlemen, yields back. Mister Scott, you're recognized for two and a half minutes.
Speaker 5
Thank you, Mr. Chairman. I appreciate the opportunity to participate. Mister secretary, when the North Battlefield outpatient clinic opened in my district in April, I expressed concern that the clinic would be opening with only 150 staff members. You called me a liar. And then in the same article that you called me a liar in, you said that it would be opening with 150 employees.
I said it was 150 employees. I'm lying. So I guess you're lying when you say 150, you have indicated in a previous answer that the staffing is still incomplete. Can you give us an idea? You'd it was supposed to be fully staffed by January.
It's now February. When will the facility be fully staffed?
Speaker 3
Congressman, we started with 150, and we're up to 355 now. And as I said earlier, we have 166 in active recruitment. And on all for and all functions that facility was supposed to be doing are currently being done.
Speaker 5
Okay. The Hampton VA psychiatric ward, I've been told, has 40 inpatient beds, but only 20 are available for veterans due to lack of staff. Is that true? And is there a timetable for fully staffing? If you don't know, just get back to me.
Speaker 4
Yeah. I'll have to get back to you, but I do want to offer context. Inpatient mental health wards across the whole country, public and private, have been dwindling for years because most of the care is being delivered on an outpatient basis now, as much as it can be. But I don't know the details of Hampton.
Speaker 5
Beds there. Let's see. Mister secretary, do you believe the decisions made by the administration regarding hiring freezes, proposed layoffs in the tens of thousands, termination of collective bargaining agreements, and other personnel actions have adversely affected your ability to recruit personnel?
Speaker 3
I think the bigger problem of taking personnel and others into the VA is the same as any other hospital system that you have in your district. I think we face the same struggles as everyone, and that is, you know, finding the right people, having enough come out, and actually being able to pay a competitive wage for finding that. Thank you, Mr. Chairman. I appreciate the opportunity to participate. Representative Wasserman, Congressman, can I just say this?
Speaker 3
Congressman, it's good to see you. I haven't seen you in a while. It's good to see you.
Speaker 1
Representative Wasserman, your representative, you are recognized for two minutes.
Speaker 27
Thank you, Mr. Chairman. I really hope I can get an extra minute or so, since this will be my only appearance here. I'm asking a straightforward question. Mister secretary, last week, your staff, and forgive me for dispensing with the niceties. Last week, your staff, including Mister Goens, who's with us here today, briefed our subcommittee on the major elements of this reorganization, and one new piece of information provided to us was a draft cost estimate. It showed that there will indeed be a cost, where I was previously told that this would end up being cost neutral.
As the ranking member on the Milkhound VA appropriations subcommittee, eventually, it'll be mine and Judge Carter's responsibility to find the resources to fund this reorganization if we decide that it is worth funding or to approve any funding that you plan to transfer internally to pay for this reorganization. So I look forward to the report that you are statutorily required to submit to the appropriations committee so we can see on paper exactly what your plan entails, including robust and appropriate justifications. Now recognizing that you're in the early stages and that your cost estimates are preliminary, to better understand your assumptions, based on your estimates, there will be a tremendous upfront cost in the first year around $521,000,000, but with some potential savings along the way, a final net cost of around $312,000,000 over the course of a five-year period. Assuming that you're planning on doing this immediately, in this fiscal year, is that correct?
Speaker 3
We intend to begin part of this with inside our current, as I've told you before, with inside our current authorizations on appropriations.
Speaker 27
So in the fiscal year 2026 bill, which has already been signed into law, and we didn't appropriate any funding for a reorganization of VHA, where are you proposing that the $521,000,000 comes from?
Speaker 3
Yeah. It as you've had your briefings with OM, this is gonna come out of our regular account funds. We're just moving people here, that's not accounting for this in that situation, but I will have more information as we go forward on this.
Speaker 27
Do you expect that you'll be sending the committee a reprogramming request for approval?
Speaker 3
Probably. That one is not. At this point, we're living within the guidelines that you gave us, and we appreciate it.
Speaker 27
Will we see an updated cost estimate with detailed justification in the FY 27 budget request?
Speaker 27
Okay. I wanna express concern about the proposed savings of $1,700,000,000 from personnel actions resulting from this reorganization. Part of it moves administrators into clinical roles, which will result in pay cuts.
Speaker 27
Mister chairman, if you can give me an extra couple of minutes, I'd appreciate it.
Speaker 1
I would appreciate it. I would like to do that. But at the very beginning of the meeting, I told him we had a hard stop at one or 12:30. It's exactly that. Votes have been called, and you can submit them for the record.
We're gonna submit our closing statements for the record. Mister chairman, I.
Speaker 2
I do wanna point out this is only the second time that he's appeared before our committee. The secretary, since he was sworn in.
Speaker 1
We'll have more hearings. I asked you, and Justin said that all members have five legislative days in which to revise and extend their remarks, including extra when we're gonna have continuation not an objection.
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