“Legislative Hearing on: H.R: 6733, The “VISN Reform Act of 2025”; H.R.6580, The “VA National Formulary Act of 2025”; H.R.6599, The “Leasing and Infrastructure Act of 2025”; H.R.6583, The “Research Reform Act of 2025”; H.R. 6549, The “VA Contracting and Procurement Act”; H.R.6740, The “VA TRUST Act”; H.R. 6764, The “Veterans Affairs Advisory Committee Oversight Act of 2025”; H.R. 6904, The “Veterans Readiness and Employment Improvement and Accountability Act of 2025”; H.R. 6843, The “Establishing the Veterans Economic Opportunity and Transition Administration Act of 2025”; H.R. 6833, The “Acquisition Reform and Cost Assessment Act of 2025”; H.R.2303, The “Board of Veterans’ Appeals Attorney Retention and Backlog Reduction Act”; H.R.210, The “Dental Care for Veterans Act”; H.R.3183, The “SAFE STEPS for Veterans Act of 2025”; H.R.5203, “To direct the Secretary of Veterans Affairs to update directives of the Department of Veterans Affairs regarding the management of acute sexual assault, and for other purposes; H.R.4114, The “EVEST Act”; H.R.3869, The “Every Veteran Housed Act”; H.R.2722, The “VA Funding and Workforce Protection Act”; H.R.1391, The “Student Veteran Benefit Restoration Act of 2025”; H.R.8044, The “Get Justice-Involved Veterans BACK HOME Act”; Discussion Draft: The “Toxic Exposure Advisory Committee Establishment Act”; Discussion Draft, “To amend title 38, United States Code, to establish the Advisory Committee on Toxic Exposure of the Department of Veterans Affairs”; Discussion Draft: The “Honor Vets Act”; Discussion Draft, “To provide for the modernization of the electronic health record system and other health information technology activities and systems of the Department of Veterans Affairs, and for other purposes.”
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House Veterans' Affairs U.S. House of Representatives
Follow its sittingsSpeaker 3
Congress should continue ensuring agencies use robust competition in sound contracting practices. Strong oversight also depends on strong oversight institutions. Mister chairman, you mentioned inspectors general and the Government Accountability Office. Those are among Congress's most important partners in conducting effective oversight. As of this month, the VA's office of inspector general has more than 550 open recommendations for the department, and the GAO has another 170, including more than 20 listed as high priority and high risk.
These recommendations present a clear opportunity for congressional oversight and a potential roadmap for legislative reforms. I should add that while the VA does have a permanent IG in place, dozens of IG positions across the government are vacant, with most of them still waiting for a nominee. And the GAO is also acting without a permanent head, and is also waiting for a nominee since December. Finally, as I close, I'd like to stress congressional oversight should not depend on which party controls the White House. Oversight is one of Congress's core constitutional responsibilities as the Article One branch of government.
Effective oversight protects taxpayer dollars, improves government performance, ensures existing laws are being implemented properly, safeguards veterans and whistleblowers, and preserves the system of checks and balances envisioned by the framers. Thank you again for the opportunity to testify today, and I look forward to your questions.
Speaker 2
Thank you, Mr. Stratton. And, also for both the written statement of Miss Madney and Mister Stratton will be entered into the hearing record. I would now like to recognize Mister Ritchie for five minutes for his opening remarks.
Speaker 4
Chairman Bost, ranking member Tacano, members of the committee, thank you for the opportunity to testify today. My name is Mark Ritchie, and I am on the board of the National Federal Development Association, or NFDA. The nonprofit NFDA represents the private sector partners who have invested billions in the infrastructure essential to the VA mission. We are not just vendors. We are the bridge between private capital and the public service of our nation's veterans.
We understand the mechanics of the federal real estate leasing market better than most, and we are here today to express our strong support for HR 6599, the Leasing and Infrastructure Act of 2025. The bill provides for common-sense solutions by adopting modern standards. And if I leave you with anything today, it is by adoption of these reforms we will be able to deliver timely, cost-effective medical facilities for use by our nation's veterans. The testimony should also serve to answer the question, why does VA keep coming back to Congress for additional money to fund these lease projects? The three major takeaways are the methodology the VA utilizes to determine rent for these projects makes no sense.
Two, current use of full service leases for a 20 year period actually adds to the cost of these important projects. And three, the linear VAGSA approval process adds significant time to the delivery of these important facilities. I think we can agree the requisite agencies' intentions are to protect taxpayers, all while serving our vets. In reality, the current VA, GSA, OMB process is dysfunctional, and by maintaining the status quo, these bid busts will continue to haunt us. Why?
You will be asked again and again to approve prospectuses that aren't worth the paper they are printed on. While my written testimony delves deeper into these three pillars, I believe the best place to start is in the middle of the story. We're on 05/01/2024, nearly two years after the approval of the PACT Act. The Senate Veterans Affairs Committee hosted a business meeting with VA secretary McDonough. Among the topics discussed were the 31 packed act leases.
And in his remarks to senator Tillis, secretary McDonough commented. And I'm paraphrasing, he McDonough might need to come back and ask to reauthorize at a higher cost level. We've seen anywhere between 60 and 150% above the authorized level. My written testimony details the timeline of this odyssey, so I won't address that now. However, an experienced industry practitioner can quickly determine the viability of these projects within minutes of review of the initial authorization request.
I'm not here to castigate VA as a VA does the best it can with the tools provided. Unfortunately, we've provided the VA with a jeweler's hammer when a sledgehammer is required. HR 6599 is not just a leasing bill. It is a clinical access bill. When a lease award is delayed by years due to bureaucratic friction, that is time veterans spend waiting for the care they have earned.
By removing the government premium and streamlining authority, we ensure that taxpayer dollars go toward veteran health rather than administrative waste. HR 6,599 provides the VA with the necessary tools to build a responsive, modern health care network while remaining fiscally accountable. By modernizing cost estimation, adopting market-based leasing structures, and establishing independent authority, the committee can dissolve the gridlock that has stalled veteran care. The NFDA believes this legislation is a prudent way to ensure that taxpayer dollars are used efficiently to build the 21st century facilities the VA mission requires. We urge the committee to move forward with these essential reforms to ensure our veterans receive the high-quality facilities they have earned and deserve.
Chairman Boss, thanks to you and your committee for your laser focus on this important issue. I look forward to your questions.
Speaker 2
Thank you, Mr. Ritchie. And mister Ritchie's statement, the written statement of mister Ritchie, will be entered into the hearing record. And finally, we wanna recognize Miss Ken, but not before we say, welcome back after the delivery of your daughter. And this is our first time appearing before us since then, and congratulations. Now you're recognized for five minutes for your opening statement.
Speaker 5
Thank you, Mr. Chairman. Chairman Bost, ranking member Takano, and members of the committee. On behalf of the men and women of the Veterans of Foreign Wars of the United States and its auxiliary, thank you for the opportunity to present the VFW's views on pending legislation. The VFW's full written statement addresses nearly all the bills on today's agenda, but I would like to briefly highlight four key pieces of legislation. The VFW appreciates Chairman Boss's leadership in bringing attention to the governance issues caused by VA's vision structure by introducing HR 6733, the Vision Reform Act of 2025.
After years of inspector general reports documenting inconsistencies in health care delivery and serious patient safety concerns across the VA structure, we strongly believe that reform is necessary. However, since VA has already begun restructuring and consolidating its 18 visions, the VFW would like to better understand the impact of those ongoing efforts before fully endorsing large-scale statutory changes. We wanna ensure that reforms improve accountability and consistency without reducing flexibility at the local level or negatively affecting veterans' access to care. We look forward to continuing to work with the committee on this important issue. The VFW supports HR 6843, the Establishing the Veteran Act, the Veterans Economic Opportunity and Transition Administration Act of 2025.
This legislation would create a fourth administration within the VA dedicated to the economic opportunity and transition programs. This would include education benefits, voc rehab and employment, housing loan programs, and transition assistance. The VFW believes these programs deserve focused leadership and resources to help veterans successfully transition to civilian life, while allowing VBA to focus on disability compensation claims and appeals. The VFW supports 4114, the Ensuring Veterans Smooth Transition or E VEST Act. This legislation would automatically enroll transitioning service members into the VA health care system within 60 days of VA receiving the necessary information from the Department of Defense.
It would also preserve veterans' ability to opt out. The VFW strongly supports efforts to create a seamless transition from DoD to VA. Too many veterans leave military service without immediately connecting to the benefits and health care that they have earned. The first year after service often brings challenges surrounding mental health, employment, housing stability, and increased risk for suicide. Automatic enrollment helps create a warm handoff and reduces barriers to critical services.
Veterans should not have to navigate unnecessary hurdles simply to access the health care that they've earned. Finally, the VFW supports the discussion draft to establish an office for toxic exposure implementation and oversight, and an assistant secretary for toxic exposure coordination within the VA. The implementation of the PACT Act and toxic exposure policy now touches nearly every part of the VA, including health care, disability compensation, research, outreach, and workforce planning. The VFW supports creating centralized leadership to improve coordination and accountability across these efforts. We also encourage the committee to consider transparency measures as part of this proposal.
Veterans deserve greater visibility into how the VA evaluates toxic exposures and presumptive conditions. We would like to see clearer public communication regarding which exposures and conditions are under review, estimated timelines for presumptive evaluations, and how scientific evidence is being assessed. Veterans exposed to toxins should not be left uncertain about whether their conditions are being considered or where the progress stands. Chairman boss, Reiki member Takano, this concludes my remarks. I'm prepared to answer any questions you or the members of the committee may have.
Speaker 2
Thank you, Miss Keenan. The written statement of Miss Keenan will be entered into the hearing record. We now will proceed to questions, and I will yield myself five minutes. Miss Madney, can you explain the importance of authorizing approved appropriate funds?
Speaker 1
Absolutely, Mr. Chairman. I think I could talk to you about the generalities of why Congress has an oversight responsibility, but perhaps it's more effective to start with an example. In 2001, multiple things of significant importance to the VA happened. Of course, in September of that year, we had the start of the global war on terror given 9/11. We also had the expiration of the centers for mental illness research, education, and clinical activities at the VA.
That program is continuing as an expired authorization and is receiving appropriations around 6.5 million dollars. That mental illness research that was expired but continuing to be an unauthorized appropriation in 2001 is not sufficient for the veterans' needs. And I'll explain how we know this. In 2001, we'll even take the next year, 2002, to be generous. The rate of suicide deaths for veterans per 100,000 was 24.2 veterans, already far too high.
Twenty-four point two back then. Now the latest data we have is from 2023. The rate of suicides per 100,000 is 35.2 veterans. We've gone up from 23, 24 veterans dying by suicide per 100,000.
Speaker 2
Sir. So where were your numbers from on that? Because that's not the same numbers that we're lining up with, don't think. But, okay, on the amount of suicides in this last report.
Speaker 2
Oh, per 100,000. Okay. Thank you. Thank you. Let me know.
Thank you. I was going per day. Sorry.
Speaker 1
No. No. I thought that might be where you were going. It is actually the same dataset, but I've adjusted it.
Speaker 1
So per 100,000, we've gone up significantly. Well, what else has happened during that time? The mental health research and underlying programs at the VA have been receiving unauthorized appropriations. Now that doesn't mean that we shouldn't be funding mental health research for veterans. What it means is that we need to be reexamining that program so it is properly tailored to the needs of today's veterans.
As you mentioned during your opening statement, mister chairman, what is going on now is really focused on an entirely new generation of the veterans' population. Well, that new generation needs attention just as much as the previous generations.
Speaker 2
Right. Thank you. Mister Stretton, VA has repeatedly asked this committee for increased flexibility in our legislative proposals. How would continuing to give VA the flexibility hurt accountability and Congress's oversight capabilities?
Speaker 3
Thank you, Mr. Chairman. Flexibility is, you know, critically important, especially with programs like this. However, anytime an agency or department, you know, asks for these things, they should be up before the committee answering questions on their plans for implementation. Once it's implemented, the progress of that should be up here. You know, they should be briefings.
They should be answering, you know, in public hearings on the status of, you know, implementing laws and their plans to improve such programs. If they're asking for money and flexibility, they should be answering your questions and telling you how they plan to spend them.
Speaker 2
Thank you. Mister Ritchie, can you walk us through why OMB's current cost methodology is insufficient for estimating VA infrastructure projects today?
Speaker 4
Thank you for that question. And that is really the crux of everything in regards to 6599. Basically, on day one, when the VA looks to develop these clinics, the first thing they do is figure out where the veteran census is, then they figure out how much it is going to cost or how much rent they can pay. The OMB has a directive or a dictate in regards to they must use a specific piece of software or product that only calculates office rents. And if you've been to a clinic, these are nothing like office buildings.
So day one, they effectively are given a bad road map, and they go out to the market with their lease prospectus numbers that, as we know from last year, were between 60 and 150% below the actual rental costs. So something is wrong there. But using this software product, it just isn't appropriate. It just doesn't work for general-purpose medical buildings or medical facilities.
Speaker 2
Little over on time, I still want Miss Kim. Can you share with us why OMB scorekeeping guidelines might need to be reevaluated?
Speaker 5
I don't know the context of your question. I don't have any comments at this time.
Speaker 8
Thank you, Mr. Chairman. Mister Keenan, I'd like to begin with you. Craig. Mhmm. Also, congratulations on the arrival of your child. The chairman removed H.R. 1732, Mister Pampas' Guard VA Benefits Act, from today's agenda, meaning it will no longer be considered.
VFW spoke strongly in favor of that legislation at a joint VSO hearing earlier this year. Do you believe that the Guard VA benefits act should be considered by this committee, marked up, and brought to the House floor for a vote? That's one question. And what is the importance of getting this legislation done for the VFW?
Speaker 5
Thank you, Ricky Member, for that question. Yes. We the VFW strongly want to see the guard act move forward. And every day that it doesn't, you know, unaccredited claim sharks continue to exploit veterans and their benefits. So the longer that this waits, the more veterans are gonna be subject to some of this exploitation.
Speaker 8
Yes. Thank you. It's, you know, it's my, you know, the states are some states are moving ahead with strong protections, others more permissive protections that allow veterans to be targeted. And so there really is a need for the federal government to enforce protections, establish protections for our veterans from being targeted. Would you agree with that?
Speaker 8
Thank you. Mister Stratton, your testimony highlights the need for robust congressional oversight, and I couldn't agree with you more. But I noticed your testimony didn't speak to any of the individual bills on the agenda today. Do you think that any of these bills will actually enhance our ability to over CVA? Because these bills seem to be focused on bringing more private interests into policymaking than on holding the administration accountable.
That's kind of where I see things.
Speaker 3
Yeah. Thank you. Pogo hasn't taken a position on any of the pieces of legislation. A lot of this is beyond our expertise. However, we do support Congress looking at programs more broadly and assessing if they're currently the department's currently meeting the needs of benefit veterans and if some of these bills are, you know, needed.
So we're supportive of the process overall, but not any of the underlying pieces of legislation.
Speaker 8
Alright. Well, thank you. Mister Ritchie, study after study, whether by GAO, VA, OIG, and others, have found the problem with VA's delayed or failed procurements lie with VA itself. Inadequate funding to conduct planning activities, multilayered project development and governance structure, unnecessarily detailed solicitations, and a failure to gauge market pricing have made it more challenging for VA to open new medical facilities on time and on cost. Mister Ritchie, would you support a proposal that would give VA leased an authority independent of the General Services Administration, so there would be even fewer guardrails?
Yes. That is yes. So you would support a VA leasement authority independent of the GAO?
Speaker 4
My under, yes. And my understanding prior to 2011, 2012, VA had its own leasing authority.
Speaker 8
How will giving VA more power and taking the actual federal real estate experts out of this process be an improvement?
Speaker 4
So I would argue that, at least in construction facilities management, you have many executives there that have come from the VA. So we're just trained, they were trained in VA processes, one. Two, at least the third parties or the private sector partners, believe that the process that the VA undergoes is very rigid. And, basically, they believe the process is very rigid, and, you know, we don't necessarily see problems with having VA oversight.
Speaker 8
Okay. Moving on. How does this legislation improve the institutional challenges as identified by VA's OIG, which have led to project delivery failures and repeated bid busts?
Speaker 4
Okay. So, very multilayered question. I'll try to do the best I can. The time and I have 17 seconds to answer that. That'd be difficult to answer in 17 questions.
Speaker 2
Gentlemen, yield back. Representative Van Orten, you're recognized for five minutes.
Speaker 9
Thank you, Mr. Chairman. Miss Kieman, I've, for years now, had the pleasure of calling you my fellow veteran and my friend, and now it's great to call you mom. That's so awesome. I'm so happy. It's just wonderful.
I'd like to speak briefly on a bill, HR 6843 that's been introduced by my dear friend, mister Ciscamani from Arizona. And I think it's incredibly important being the chairman of the subcommittee for economic opportunity that we actually have a group of folks at the VA that are gonna focus specifically on transition. It's critically important. Most of our veterans that unfortunately commit suicide do so within about 24 months after retiring. And I got a commitment from the CNO yesterday.
We've got a commitment from the secretary of war and also of the VA that they're gonna focus more on this, and it's gonna be a more seamless transition from active duty to being a veteran. And I'm very proud of them, mister Collins and mister Hegzeth, for doing so. So Mr. Siscamani is a great patriot. He has a huge active-duty population in his district, and he is focusing on them as he should. I'm very proud also to call him my friend.
So I would just urge all my colleagues to support HR 6843 to make sure that we can continue to have a fantastic group of American patriots, not just veterans, and without a yield back.
Speaker 10
Thank you, Mr. Chairman. And, before I ask a question or two, I just wanted to make note in this meeting that I'm disappointed that my bill H.R. 4876, the Reproductive Freedom for Veterans Act, was removed from today's legislative hearing. It addresses an important issue that impacts veterans' health, certainly veterans' equity to health care, and I will continue to urge this committee to include it in future hearings. So with that, I miss Keenan, congratulations. I don't wanna be the only member on the dais that doesn't congratulate you today, so congratulations.
So I wanted to ask a question around dental care. Between October 2024 and September 2025, nearly 888,000 veterans received dental care, which is just about one third of eligible veterans to receive dental care. The VA operates approximately 1,380 health care facilities, but dental care is available at just over 200 of those sites, which just represents about 15% of all VHA locations. What have your members experienced when seeking dental care services at the VA, given the limited number of dental care providers?
Speaker 5
Thank you for the question. Veterans using VA care experience hurdles with accessing dental care. Even when they have a service-connected injury related to their dental care, it still is very location specific and facility specific if they can get their care within their VA.
Speaker 5
Transportation can always be a barrier, especially for rural veterans. So access to that care can be limited depending on where they live.
Speaker 10
So, also, 25 percent of younger veterans have dental insurance, and only a third of older veterans have dental insurance. Older veterans have worse oral health outcomes than non-veterans, and younger veterans are less likely to have dental insurance than older veterans. So, how has these age related differences in dental care access affected members that you serve?
Speaker 5
Well, I think the biggest difference is some of the health conditions that our older veterans are experiencing, and dental care is part of health care. It can be preventive care, but it can also impact veterans with serious health conditions. So the conditions that our older veterans are experiencing may be different than some of our younger veterans, but the dental care in combination with some of their Sears health conditions can make things worse.
Speaker 10
Thank you. And I will just end on wanting to weigh in on this leasing issue and taking it out of GSA and putting it back into the decision making of the VA. I spent, I don't know, the first six years since I've, you know, been in congress working on this issue, trying to get it out of the VA to the GSA where the experience lies. And I think the process has moved a lot more smoothly since that happened. I will tell you, in the first six years or so, I can't remember exactly the time frame, but nothing moved.
I mean, it just went on. And I know this particular bill says, oh, we'll have to be done within a one year time frame. I can assure you that the VA is not gonna be able to meet that requirement. You know, absolutely, they will not be able to. So I think it's where it needs to be, and with that, I yield back.
Speaker 2
The gentlewoman yields back. Representative Barrett, you're recognized for 5 minutes.
Speaker 11
Thank you, Mr. Chairman. Thank you all for being here. Of course, congratulations on your newfound status as a mom. I will warn I have four kids of my own, so I have to give you unsolicited parental advice, of course. And all I can tell you is this is a life sentence.
So, and if you doubted that, I recently turned 45 years old, and my mom still worries about me. So, it's a great thing. And thank you to our panel for being here today. I wanted to just open up and kind of lay out a foundation of some of the work that we're doing. I had introduced HR 6833, the acquisition reform and cost assessment act known as the ARCA act for short, topic of conversation today, really kind of tackling this issue of chronic bureaucracy and how that can delay implementation and get lost in the weeds of what our actual mission is, which is to deliver care and benefits to veterans who've earned that.
But the VA has a really poorly structured acquisition and contracting process, and it really does bog down the progress we're trying to make. It fails to provide real accountability for underperforming contractors. Some of these contracts get needlessly delayed. When that happens, the costs go up for taxpayers, and that cuts into these services that ought to be preserved for our veterans. When more is going out the door in one way, it takes less than that we are delivering to actual veterans.
One way that we just saw this very recently, the DOJ just indicted a former executive at the VA who was responsible for a huge portion of this electronic health record modernization effort, something that has plagued the VA for years, something that falls squarely within the portfolio of what the subcommittee that I have the privilege of leading is really looking at is this electronic health record modernization that's so critical for veterans across the country. You know, we were saddened to see this indictment. I don't wanna presume anyone's guilt or innocence from here. Of course, we have a process for playing that out, but I think it does certainly raise the alarm bells of what we ought to be looking at as far as accountability within the VA. And having an acquisition process, I think, is really important to that.
Now with that being said, I'd like to hear some of your all thoughts on this effort, starting with Miss Madney. Did I say that correctly? Very good. Can you talk a little bit more, explain to us a little bit more about how ballooning contracts and acquisitions have continued to increase overall spending without increasing benefits for veterans? You know, it's one thing, we're spending more money to increase benefits and outcomes.
But if we're just spending more money without doing that, I'd be curious on your take on those.
Speaker 1
No. You put it very well, sir. If you are increasing funding without improving outcomes, then what you're actually doing is making outcomes worse.
Speaker 1
And I know that might seem counterintuitive. Shouldn't it just be net neutral? But the reality of the situation is no. As I mentioned in my written testimony, as spending increases, you increase inflation, you increase unaffordability. And so what ends up happening is that the overall market prices are driven up by transfer payments, inflationary pressures, etcetera, which means when you do eventually get to following through on some of these contracts, they will be expensive.
They will be even more expensive. So you actually have this multilayered, multi-tiered problem. The only way to fix that is to perform regular oversight and hold the VA accountable. And I think your bill is an excellent first step to that. I would also suggest perhaps having a series of more robust oversight hearings to see their steps and whether or not they're following through.
Speaker 11
I thank you for that. I think I learned years ago, I worked in Michigan for the state treasurer, probably 15 or so years ago. And we had this point that I learned, which is separating the difference between outputs and outcomes. You can spend a lot of money on outputs that don't actually change the outcomes. And especially the work that we do on this committee should be focused really heavily on the outcomes for veterans, that, you know, instead of looking at how much we spend on something specifically, well, what was the outcome of that, not just the outputs within it?
Miss Keenan, if you wouldn't mind, I have a question for you. How does the lack of congressional oversight over the VA acquisition process hurt veterans in your opinion?
Speaker 5
Thank you for the question. I think our main concern is failures to properly modernize systems effectively, efficiently, and using the funding appropriately. So additional oversight, we're totally on board with some of the provisions in the bill and sort of the efforts to try to rein in and oversee some of these major projects, to avoid any kind of delays and waste of taxpayer money. I think that's the goal with this kind of proposal.
Speaker 2
Thank you. Gentlemen, near yield back. Mister Garb, Mister McGarvey, you were recognized for five minutes.
Speaker 13
Thank you, Mr. Chairman. I think maybe we should make a motion to have everyone congratulate Miss Keenan. But until that happens, I have
Speaker 13
Say congratulations. But my guess is you're gonna keep getting him. So congratulations on the birth of your daughter. So, thank you for being here today. And I think, you know, one thing about this committee is we are focused on a mission.
Right? We are focused on the mission of serving our veterans. These are the men and women who put on the uniform, quite literally willing to sacrifice everything to keep us safe and keep us free. In exchange for that service, we make a promise. We make a promise that we're going to take care of you.
So when we talk about veterans' benefits, we are not talking about something we are giving to someone. We are talking about something they have earned. And we are talking about a promise, both a moral and a legal promise we have made. So when veterans are trying to get the benefits they have earned, and they are denied those benefits, they necessarily have the right to appeal that decision. It is part of the promise we make in exchange for the service.
Now one thing that I hear about all the time in Louisville, and I know you all hear about it across the country, is how long it takes to get a decision on these appeals from our veterans. This is more than just some, you know, bureaucratic maze or some statistics. Every single veteran who is waiting for a decision on their appeal is waiting on something that might help them keep a roof over their head, put food on the table, get the treatment they need. So, how do we speed these up? Now I know, as a recovering lawyer myself, that lawyers are oftentimes punching bags, and sometimes deserve to be.
But in the veteran space that we're talking about right here with getting those appeals to get the benefits you've earned, it is lawyers at the VA who make those decisions. They are the ones writing those opinions, and we are having trouble keeping lawyers in place to do that. That is partly responsible for the backlog, which is hurting veterans. They're not able to have that roof over their heads. They're not able to get the decision.
They're not able to get the benefit they earned. There is a simple fix we have proposed to make this better, not to completely fix the problem, but to make it better so our veterans get these results faster. And that is a bill I've introduced, H.R. 2303, the Board of Veterans Appeals Attorney Retention and Backlog Reduction Act, which is a really long name to just say, we're trying to keep more attorneys here to get our veterans what they need and get it to them faster. It would allow us to promote veterans to the GS-15 spot. It is a way of retaining talented individuals and, most importantly, getting our veterans what they need.
So, Miss Keene, you noted in your testimony that attorney attrition at the board directly contributes to the appeals backlog. Can you talk a little bit about what that backlog means for the veterans you serve at the VFW?
Speaker 5
So the backlog of appeals, you know, can take years many times for veterans, and so that wait can cause economic, financial difficulties for those veterans that are waiting to get the disability benefits or other benefits that they've earned. We do appreciate and support your legislation. Think particularly because there are other units within VA that have this promotion ability. So retaining some of those attorneys within the Board of Veterans Appeals is gonna help with that backlog.
Speaker 13
Yeah. I mean, two things you said there. One year. Right? We're not talking about weeks.
We're not even talking about months. We're talking about years until veterans can get a decision on the benefit they have earned from putting on the uniform. I will also say, you mentioned that only the board of veterans appeals, they don't have this ability to go to GS fifteen, others do. In fact, the Board of Veterans Appeals is the only agency within the VA that doesn't have the ability to promote to a GS, and this would help with that retention. So I appreciate you bringing up those points.
I'll ask you, you know, do you think that keeping these experienced attorneys instead of constantly training and turning over people will improve decision quality and reduce the errors that force veterans back into the system?
Speaker 13
Well, everybody take note. That's how you answer a question. Other VA offices you hear on this, they already allow these nonsupervisory attorneys. Do you think that the board can realistically keep the attorneys it needs without this authority, or do you think that passing a bill is a step in the right direction to make sure that veterans get timely, accurate decisions?
Speaker 5
I do think it would be an important change because if there are incentives for attorneys to go elsewhere even within the department, that that's gonna be tempting for anyone who wants to have a better income. So, stability within the Board of Veterans Appeals is important. This would be an important key way to do that.
Speaker 13
Thank you for saying that. And I just point out, this is not about pay grades. This is not about internal VA bureaucracy. This is about getting veterans the benefits they've earned in a timely way. So I appreciate your testimony, Mr. Chairman.
I yield back.
Speaker 2
Gentlemen, you're back. Yielded back. Doctor Murphy, you're recognized for five minutes.
Speaker 14
Thank you. I just wanna say to my good friend, mister McGarvey, as an attorney coming from a physician, you missed April 14. That was be kind to lawyers' day. And as I said when I was in the general assembly in North Carolina, I said, be kind to lawyers because they are people too. So, thank you.
I'll continue the litany of congratulations. Motherhood is the greatest calling of any woman. Congratulations. You know, children are gonna bring you a heartbreak, they have greatest love in your life. So, congratulations.
I just wanna chat about a couple of things. I applaud the oversight. You can't run a business without oversight. And sadly enough, our government tends to not do oversight very well, and to continue unnecessary levels of haphazard bureaucracy, which in this case leads to harm, delay, etcetera, just for our veterans. So I appreciate everybody's concerted effort to try to cut through the morass of the ridiculous bureaucracy that we have.
Just wanna give a plug for my bill, H.R. 6583, which would establish a VA centralized research data system integrated with electronic records. I'll talk about that for a second. To track major research projects, funding progress, and outcomes across the VA. We don't need a haphazard system in the VA to do this. We actually have a perfect model to be able to have a really concentrated system within the VA to do good research, have it tracked, and make sure it's concerted effort and that we do it well.
Bill also will create a tiered, review-based system for research. So I'd appreciate everybody's support for that. I'm a researcher, done it, you know, a lot, been a scientist, etc. It's very important that we do good research within the VA. It was brought up a few minutes ago about our electronic health care system, and I never miss a chance to beat on the fact of the absolute ineptitude and negligence of what the VA has done with the electronic medical record system.
What for now, 15 years? 15 years. Billions of dollars. And I can't I think it's six or seven places, that we have a system that actually works for electronic health care system. But guess what?
Help is on the way. And I think this is where the advent of artificial intelligence, the good part of this, will be able to be helpful at the VA. Speaking with a gentleman, a fellow physician this past weekend who wants to get in and talk with the VA about streamlining a system where artificial intelligence will have the ability to speak directly with the veteran, have a catalog of 15, 25 thousand questions, be able to answer veterans so there aren't calls that go unanswered. And there's the patience of Job when listening to artificial intelligence. We have this document within the private system already for pre op visits when patients call and say, hey.
I don't understand this, and they go on and on and on. If we can institute this system, that will then be able to query that veteran's electronic medical record, pull data from this, and really take out the massive bureaucracy, streamlining this. I think this will be actually earth shattering, for the veteran and for our future systems to be able to cut through needless human bureaucracy, get our veterans what they need. So I look forward to actually coming back in front of this committee, speaking with our VA about what would literally be the good use of AI for our veteran to cut through the human bureaucracy that has become our VA in so many different ways. So, thank you, Mr. Chairman.
I'll yield back, but I think that's actually an envelope and a sunrise of hope for our veterans in the future to use technology to really help our guys and gals navigate what is a challenging system.
Speaker 2
Thank you. Doctor Dexter. You. Doctors have stayed around. It's really neat.
What's that? All the doctors have stayed around. It's really neat.
Speaker 15
We are diligent. That is true. Thank you, chair, boss, for holding this hearing. And, Miss Keenan, congratulations. I know you're surprised to hear that, but I deeply, deeply value how hard it is to do good work and be a mom.
So thank you for doing that. And I also appreciate the ability I have today to speak on my bill, the Every Veteran House Act. I appreciate and share everyone's commitment here to tackling veteran homelessness, and hope that we will continue to work together on this issue. In Oregon and across the country, preventing and ending veteran homelessness is a top priority. Our communities believe that honoring service means ensuring every veteran has a safe and stable place to call home.
So that's why we introduced the Every Veteran House Act. It's to remove barriers and streamline eligibility standards across the VA homelessness programs. We'll make it easier for veterans experiencing homelessness to access the full range of services that they've earned. Critically, it also expands access to those who have served in the National Guard and the Reserve, helping eliminate another obstacle that they are facing. This legislation is a practical, targeted step that will help more veterans access housing, stabilize their lives, and reconnect with the support systems they need.
It reflects a broader commitment to treating veteran homelessness as an ethical, as well as public health, issue. Miss Keenan, can you speak to the existing gaps in the veteran homelessness system and why it's so critical that this bill helps reach those who have historically been left behind?
Speaker 5
Yes. Thank you for that question. So, currently, discharges other than dishonorable don't count for these programs. So that's what this would open up, eligibility to additional veterans, and that's similar to access to via health care and disability benefits. So we see this as a way to reach more veterans that may be in need of some of these programs.
Speaker 15
Thank you so much. And I just wanna also point out that some of those less than honorably discharged veterans are struggling with exactly the issues that lead to homelessness, mental health challenges, and addiction history. It is absolutely our obligation, I would say, to close those gaps that we've created for them. Miss Keenan, you also highlighted in your testimony the connection between stable housing and mental health, stabilization, as well as suicide prevention. How do you see the Every Veteran House Act advancing those goals?
Speaker 5
I think the more veterans that we can reach with some of these homelessness programs, the better that veterans that are in need can have that stability, not only for themselves, for their physical and mental health, but for their families as well.
Speaker 15
Yeah. And to my colleagues on the committee, I just wanna be clear that this bill would not impact dishonorably discharged or court-martialed veterans. This is really less than honorable discharges, which happens to people who are serving in good faith and just can't finish their service for differing reasons. To my colleagues here who are advocating for transparency and accountability, very much appreciate that and fully support that. I also wanna make sure that we are not removing regulations and oversight to a degree that just opens the door for further waste, fraud, and abuse.
And I think this is a balancing act that we all need to be diligent in addressing together. So thank you, Mr. Cherry. Yield back.
Speaker 2
The gentleman yields back. Doctor Conway, you're recognized for 5 minutes. So.
Speaker 16
You, mister chairman, for recognizing me, and thank you for holding this very important hearing. I am thankful for the opportunity to testify on behalf of my bill, HR 8044, the Get Justice Involved Veterans Back Home Act. Recent research shows that veterans with mental health conditions, particularly PTSD, traumatic brain injury, and substance abuse disorders, stemming from their combat or service related trauma, have a significantly higher risk of entering or reentering the criminal justice system. Veterans with PTSD, for example, are 61% more likely to be involved with the criminal justice system than those without PTSD, and 59% more likely to be arrested for violent offenses. And while the VA operates a program to support veterans in the community, there remains a critical gap for care for veterans who are in the criminal justice system.
Since 1986, the VA has not provided health care to veterans when they are under the supervision of another government agency with a duty to furnish care, such as prisons or jails. A study from 2016 estimated that 107,400 veterans were serving in state and federal prison at the time, in 2016. While these veterans served their time, it is important that veterans or rather the VA provides the necessary services to ensure that these veterans can heal, rebuild, and successfully reenter other communities. My part by my bipartisan bicameral bill would direct VA to carry out a pilot program to furnish mental health to incarcerated veterans via telehealth if the facility has the necessary infrastructure or through other means determined appropriate by the secretary, including mobile mental health units. Now this is a pilot program that will occur over five institutions within the prison in the United States, so that we can see how it works and then, and I believe it will, and then move it forward, to increase its reach.
The bill directs the VA to prioritize veterans with service connected disability ratings related to PTSD, traumatic brain injury, or military sexual trauma while ensuring those veterans are being seen by VA health care providers. Note that this bill would bar VA from collecting copays from veterans participating in the program, and require that upon the date of their release, veterans who had their disability compensation payments reduced while in custody have their full payments restored automatically. By ensuring our veterans have access to strong mental health care during their incarceration, we can help set them up for success after the release, making it easier for them to succeed in other areas such as securing employment, securing stable housing, and more. I am pleased to have my colleague, representative Luttrell, co-leading this bill with me in the house, and I appreciate his work on this. And I'm grateful for the support of the American Legion, Vietnam Veterans of America, with honor.
The American Correctional Association, the American Psychological Association, and the American Psychiatric Association. Miss Keenan, what are the gaps in care for incarcerated veterans, and how best can we address them? Certainly, I hope that you'll find that this measure is an important part of filling that gap, but I'd appreciate your comments on this question.
Speaker 5
Thank you for the question. You know, obviously, there is a lack of access that incarcerated veterans are gonna experience to their VA health care. So we, you know, generally like this pilot program idea. We do have some technical suggestions on how it could be improved to really look at the full gamut of mental health conditions that these veterans may be experiencing outside of PTSD and the various conditions related to military sexual trauma.
Speaker 16
Well, thank you for that. And, we are prioritizing certain conditions, but the full gamut of mental health challenges that veterans face certainly ought to be addressed. It's part of comprehensive mental health care. And to the extent that we need to emphasize that, then I'll certainly work on that as well. Do you believe that, and anyone can answer that, providing one-on-one mental health counseling to justice-involved veterans who find themselves within the criminal justice system could reduce recidivism and help the veterans succeed after they serve their time?
Speaker 5
Absolutely. I think VA provides some of the best mental health care for veterans. It's veteran specific, and, you know, they offer it through in-person appointments, also through telemedicine. And so I think the more veterans that we can reach regardless of their circumstances, the better off that we'll be.
Speaker 2
Gentlemen, yields back. Thank you to the first panel witnesses. You're excused, and I appreciate you being here, and thank you so much. And I'd like to invite the second panel of witnesses to come up, and we'll get started as soon as they switch over the name tags.
Speaker 2
Alright. We would like to get started with our second panel. And on our second panel, we will hear from the following witnesses. Mister Cole Lyle, the director of veteran affairs for the rehabilitation division in the Washington DC office of the American Legion. Mister Mike Desmond, strategic director of government affairs and advocacy for Mission Roll Call.
Mister John Ritzer, national legislative director of Disabled American Veterans, and Mister Morgan Brown, national legislative director for Paralyzed Veterans of America. If each of you who could stand would stand, we ask you to raise your right hand. I ask the witnesses to, yeah. Do you solemnly swear under penalty of perjury that the testimony you're about to provide is the truth, the whole truth, and nothing but the truth? Thank you, and let the record reflect that the witnesses have answered in the affirmative.
Now I would like to recognize Mister Lyle for five minutes for his opening remarks.
Speaker 17
Well, thank you, mister chairman, ranking member Tacano, distinguished members of the committee. On behalf of national commander Dan K. Wiley and more than 1,500,000 dues-paying members of the American Legion, thank you for the opportunity to appear before you today. The American Legion is a grassroots, resolution-based organization. Every position we take begins at the local post level, where we offer you the lived experiences of those who have worn the uniform. The bills before us today represent a meaningful effort to modernize the Department of Veterans Affairs, improve efficiency, close long-standing gaps in care and benefits, and strengthen accountability at a time when demand for VA services continues to grow.
The American Legion supports the majority of these measures today because they directly or indirectly advance the priorities set by our members. We are especially encouraged by efforts to make VA's health care delivery more responsive and consistent. The VISN Reform Act, for example, seeks to streamline the network structure after years of bipartisan concern with VISN organization and management. We support the bill and urge targeted amendments to safeguard rural and highly rural veterans, ensure thoughtful staffing decisions, and prevent any disruption in care during what is already a period of significant reorganization. Similarly, the VA National Formulary Act would ease access to necessary medication, and the Leasing and Infrastructure Act would give the VA tools it needs to expand facilities more quickly and cost-effectively while protecting taxpayer dollars.
However, both of these bills run the risk of significant implementation challenges should the VA not be properly resourced. We also strongly backed the VA Research Reform Act, which would reduce administrative burdens on research, speed the translation of discoveries into better care, and expand partnerships that bring new resources into the system. On benefits and care, several bills would close gaps that veterans have waited far too long to see addressed. The Dental Care for Veterans Act recognizes that oral health is inseparable from overall health. The eVest act would automatically enroll eligible transitioning service members into VA care, removing one of the most frustrating barriers they face when they leave the military.
The every veteran housed act would extend critical homelessness, prevent preventative services to veterans and with other than honorable discharges who have been unfairly excluded for too long. And the legislation addressing acute sexual assault response would ensure every VA facility is equipped to treat survivors with dignity. We are also pleased to support the VA Trust Act to restore accountability around executive bonuses, the Board of Veterans Appeals, attorney retention, and Backlog Reduction Act to keep talented lawyers serving veterans, and several of the discussion drafts on toxic exposure, justice-involved veterans, and EHR modernization. That said, we must be candid where we have concerns. We oppose the Veterans Affairs Advisory Committee Oversight Act because consolidating and sunsetting specialized committees risks removing focused voices on issues that matter deeply to specific veteran populations.
We also oppose the Veterans Readiness and Employment Improvement and Accountability Act as written, particularly provisions that could penalize veterans or strip away TDIU during VR and E programs. And we oppose the bill that would shift key transition and employment responsibilities away from the Department of Labor, where we believe they belong. Our full written testimony, including an executive summary of positions, has been submitted for the record. The American Legion stands ready to work with this committee, VA, and our fellow stakeholders to refine these proposals so they deliver the strongest possible outcomes for the millions of veterans who rely on the VA every day. Thank you again for your leadership and the opportunity to testify.
I look forward to your questions.
Speaker 2
Thank you, Mr. Lyle. And the written statement of mister Lyle will be entered into the hearing record. And at this time, I would like to recognize Mister Desmond for five minutes for his opening remarks.
Speaker 12
Thank you, Mr. Chairman. Chairman Vost, ranking member, and distinguished members of the committee, thank you for the opportunity and the honor to testify today on behalf of Mission Roll Call and the veterans, families, and caregivers across the country whose voices we carry to Washington. Mission Roll Call conducts regular survey research focused on the issues affecting veterans' lives. Our work is grounded in listening to veterans and identifying where policy, systems, and lived experience can be improved. Over the past year, mission roll call surveys have shown that veterans do see areas where the VA is improving, particularly in the overall quality of care and certain aspects of service delivery.
There is a growing sense that the system is moving in the right direction. At the same time, veterans continue to experience some challenges with access, timeliness, and consistency. This reauthorization effort presents an opportunity to build on that progress and address the structural issues that continue to shape how veterans experience care. What stands out in this reauthorization effort is the focus on improving the parts of the VA system veterans experience directly. In our surveys, veterans consistently identify access delays, inconsistency between facilities, difficulty navigating benefits and care systems, and bureaucratic friction as recurring challenges.
The first area where this package strongly aligns with our data is research modernization. Veterans increasingly understand that promising treatments exist, particularly in areas like PTSD and traumatic brain injury. But many believe the system moves too slowly, translating research into practical care. Our polling shows strong support for evaluating innovative therapies, including hyperbaric oxygen therapy. Legislation that improves coordination, standardizes data, and accelerates implementation helps move research closer to the veterans.
The faster we align the right solution with a veteran's need, the more likely that veteran is to thrive. Second is formulary and access reform. Our TBI and health care access surveys consistently identify difficulty accessing specialized care as a major concern. Veterans frequently report that distance and system barriers affect access to appointments, medications, and treatment options. Efforts that improve transparency and standardize access across the system directly address issues that veterans identify in our surveys.
Third is infrastructure and regional consistency. In our veterans and family survey, nearly half of respondents reported delays in VA health care services, and veterans reported an average drive time of more than 50 minutes to reach the nearest VA facility. For many rural veterans, that distance becomes a barrier to care. Modernizing leasing, infrastructure delivery, and regional oversight goes beyond administrative reform, and directly affects how quickly veterans can access care. As we examine reauthorizing multiple aspects of the VA systems, we also want to connect these efforts to the concept of left of clinical.
Too often, our systems wait until problems can only be solved in clinical settings before meaningful intervention begins. After decades of tracking veteran suicide data, outcomes are not improving. We devote more resources every year, yet the trend remains concerning. We must look at this problem differently. At Mission Roll Call, we refer to this as left of clinical, supporting veterans before challenges escalate into a crisis.
Our April 2020 '6 transition survey found many veterans did not fully understand the available VA benefits at separation, were not clearly offered enrollment opportunities, and received little meaningful follow-up after leaving service. As a result, too many veterans enter civilian life without a clear path forward and begin to struggle with housing, employment, identity, and stability. The structure and support network that existed during service is no longer there, and they report difficulty in rebuilding it. That gap is where risk compounds. Outside the reauthorization package, mission roll call sees alignment with several bipartisan bills before the committee, focused on prevention, transition, and long-term stability.
Our data shows that instability during transition overlaps with financial instability, housing insecurity, delayed access to care, and worsening mental health outcomes. The EVEST Act addresses one of the key barriers identified in our surveys. Many veterans do not know where to begin accessing benefits. Automatic enrollment reduces that friction at the point of transition. The Safe Steps for Veterans Act reflects the importance of upstream intervention.
Preventive measures, home modifications, and mobility support reduce downstream health decline and help veterans maintain their independence. Mission roll call survey data shows significant concerns surrounding housing affordability and the homelessness risk among veterans. Reforms that can improve access and consistency while engaging veterans earlier will strengthen trust in the system they rely upon to serve them. Thank you again for the honor and the opportunity to testify today, and for the committee's continued work on behalf of veterans and their families.
Speaker 2
Thank you, Mr. Desmond. The written statement of Mister Desmond will be entered into the hearing record. And I would like to now recognize Mister Richter for five minutes for his opening remarks.
Speaker 6
Chairman, boss, ranking member, Tucano, and members of the committee. Thank you for the opportunity to testify today on behalf of DAV on very important pieces of legislation. First, I wanna start off with DAV strongly supports the Dental Care for Veterans Act, which would expand dental care to all enrolled veterans, because dental care is health care. Today, only 2.4 million veterans qualify for dental care, leaving millions, including service-disabled veterans, without dental coverage to treat gum disease, tooth decay, jaw conditions that cause pain, infection, and a lot of times difficulty eating and even speaking. Untreated oral disease also increases and impacts the risk of service-connected conditions and other conditions like heart disease, diabetes, kidney problems, and even cancer.
These are medical issues. They're not cosmetic ones. It's time for Congress and VA to make medical or dental care part of the standard medical benefits package. Because these dental clinics are already overloaded, this expansion will require more staff, treatment space, and community care to avoid displacing current patients. So done right, though, this bill would close a major gap in care that veterans have earned.
DV also supports the Veterans Economic Opportunities and Transition Administration Act, which would create a fourth administration. Veterans should not have to navigate a disconnect to programs while rebuilding their lives after service. Fragmented VA programs for education, training, rehabilitation, employment, entrepreneurship, and even housing create confusion and delays when veterans are trying to stabilize their lives. This bill will bring these programs together under one accountable administration led by the undersecretary. A unified structure could improve planning, policy alignment, and service delivery for veterans pursuing education, employment, and ultimately long-term stability.
DAV opposes the VA the research reform act, which would make major changes to the VA research enterprise, a system that has operated successfully for more than fifty years. VA's research depends on collaboration among VA medical centers, academic affiliates, and nonprofit research groups. This bill would centralize control through new reporting rules, put sensitive data at risk, and deter outside investments. Research quality depends on flexibility, local expertise, and scientific independence. We urge the committee to pursue reforms that strengthen what works, reduce administrative burdens, and invest in workforce infrastructure rather than impose structural changes that could destabilize a proven system that benefits veterans, and not just veterans, all Americans.
DDV has serious concerns with the Veterans Readiness and Employment Act, especially section nine, which would deny individual unemployability benefits to veterans who enroll in vocational rehabilitation programs. For many veterans, individual unemployability benefits provide housing and food security needs while they prepare to enter into employment. This legislation would force veterans to lose financial stability before rehabilitation is even assessed as successful. This is financial coercion, not rehabilitation. VA has warned that this rule could force veterans to leave the program.
Rehabilitation should lead to independence, not harm a veteran or their family. DAV will post any bill with this provision or similar proposals that reduce benefits for service-disabled veterans. Finally, DAV has no resolution on the number of organizations of visions, and we have no position on the vision reform act. But we do want to share concerns about the ongoing reorganization of the VHA. Last year, VA reduced its workforce by 30,000 positions, even though it still had more than 40,000 unfilled health care positions.
VA's new budget proposal makes dramatic shifts from VA's provided direct care to private sector care with less than 2% increase in the VA care, but more than 50% for community care, even as VA acknowledges a, quote, growing demand for direct care. VA reduced its ten-year strategic capital investment planning estimate for a health care infrastructure by more than 60%, while moving ahead with ten-year $1,000,000,000,000 community care contract. Taken together, these decisions leave VA with less internal capacity and greater reliance on outside care. DAV believes veterans need a strong, integrated VA health care system where community care supports VA but does not replace it. That concludes my statement, chairman, and I'm pleased to answer any questions you may have.
Speaker 2
Thank you, Mr. Ritzer. The written statement of Mister Ritzer will be entered into the hearing record. Finally, I would like to recognize Mr. Brown for five minutes for his opening remarks.
Speaker 18
Alright. Thank you, chairman. Ranking member Takano and members of the committee. PVA thanks you for the opportunity to testify on some of the pending legislation that is before the committee today. Congress exercises its constitutional Article One authority through the authorizations and appropriations processes.
VA funding and program authorizations are handled by the appropriate committees. However, reauthorization of existing programs does not occur on a regular cadence, and program authorization is often decoupled from funding. Last year, this committee embarked on an effort to establish a must-pass authorization bill process for the VA that's similar to the same process used to approve the National Defense Authorization Act. We are generally supportive of efforts to establish a formal process like the NDAA, but we have some concerns about how it will affect access to the services and benefits that catastrophically disabled veterans depend on. Many currently recognize that the defense authorization and appropriations process is broken.
Politicization and disagreements over policy have led to delays in passing both the NDAA and the defense appropriations bills. This has resulted in many temporarily authorized programs expiring or being delayed as a result of congressional inaction. So we don't want veterans to be subjected to the same delays that military service members experience. We do feel that veteran service organizations should be included in the conversations leading to the development of a new process, so we greatly appreciate the opportunity to participate in this discussion today. That said, here are some quick thoughts on a few of the bills being discussed today.
The VA National Formulary Act creates the statutory direction for VA's national drug formulary, and establishes two oversight committees. It standardizes timelines for reviewing non-formulary drug requests and medication additions. PVA supports consistency and timely medication access for veterans, but we are concerned that the new committee structure may add bureaucracy, and that tiered copays could increase costs for veterans requiring specialized medications. The VA Research Reform Act creates a centralized VA research management system with tiered review processes and standardized approval timelines. It also establishes clinical research hubs and requires reporting on implementation outcomes.
We are concerned that this bill could undermine scientific independence and deprioritize basic research and disadvantaged SEID research serving smaller veteran populations. To be clear, PVA supports improving accountability, ensuring that research translates into real benefits for veterans. Most important, we support creating bench-to-bedside funding mechanisms to move discoveries into clinical care faster. PVA strongly supports the Veterans' Economic Opportunity and Transition Administration Act. This legislation creates a new administration focused on education, employment, transition, VRE, and housing adaptation programs.
We feel this would increase visibility, oversight, staffing support, and innovation for these programs. It would also improve collaboration with other federal workforce and transition programs, while allowing VVA to focus better on disability claims processing. PVA opposes much of the Veterans Readiness and Employment Improvement Act because we believe it adds bureaucracy and could unnecessarily delay the delivery of benefits. The bill could reduce access for catastrophically disabled veterans. We can counsel our expertise standards, create inequities in housing allowances, and potentially harm veterans receiving TDIU.
Dental care is also critical to overall health and wellness, so we strongly support the Dental Care for Veterans Act. VA's current eligibility rules leave many veterans without access to needed dental services. The bill would expand VA dental care eligibility to align dental care with broader medical services. And finally, we support the EVEST Act, which automatically enrolls veterans into the VA health care. We believe the transition from active duty to civilian life should be seamless, and this legislation helps facilitate that transition.
Thank you again for the opportunity to testify today, and I'll be happy to answer any questions you may have.
Speaker 2
Thank you, Mr. Brown. The written statement of Mr. Brown will be entered into the hearing record. We will proceed now with questionings, and I yield myself five minutes. Mister Lau, how would coordination not only with the VA but with other agencies drive innovation or innovative research that can scale, implementation, and outcomes?
Speaker 17
Well, thank you, Mr. Chairman. The American Legion has supported the research reform act because, we believe, it's an important and necessary step to streamline, interagency cooperation. There is some question about the research hubs and how that would fit into vision reorganization. But overall, anytime you can have the VA work with CDC, NIH on things ranging from particular health care issues, suicide prevention, things like that, and have notable outcomes. You know, I share some concern about a particular section.
Some research does not necessarily have actual outcomes that are measurable, much like the basic research that's done at DOD that's foundational research. So we would like to see an amendment to that particular section. Okay. But other than that, we very much support this bill. Thank you.
Speaker 2
Mister Desmond, the leasing and construction bill would expedite the process for building VA clinics and hospitals. Can you discuss what you have seen through the surveys on the impact of care delays on veterans?
Speaker 12
Thank you for the question, Mr. Chairman. We have not done a survey specific to that question, but we can tell you that when there are challenges for veterans to get to the facilities that they need to find their care, then that is reflected in all of our surveys. So to the degree that we can speed up, which is generally the messaging we get across all of our surveys, is what can we do faster and better on behalf of veterans. So the degree we can speed up that process and be more effective with it to deliver that care in ways that make veterans' lives easier and more stable, then that's certainly a priority for them.
Speaker 2
Mister Jasmine, do you believe that the current configuration of the vision system is insufficient for veterans right now?
Speaker 2
Mister Ritzer, why is it important for prosthetic and sensory aid services to have a continuous, production and schedule as opposed to one of the new technologies added per period?
Speaker 6
Thank you for that question. I think it's very important as we look at prosthetics and sensory devices that they're constantly and steadily moving forward, and available to our veterans. As we see the aging veteran population, for example, their needs for hearing devices continue to increase. So we have to make sure that innovation is staying in line with what their needs are and is available at the ready, and, you know, that they continue the process. And, also, with prosthetics, it's so important because DAV, as we continue to do the rehabilitation program in our golf campaigns and also our winter sports games, it's so important that the prosthetics innovations move forward and to be able to facilitate the various needs, not just for the general living, but also to be able to have quality of life experiences.
Mister Brown, how?
Speaker 2
Can VA improve its current delivery of infrastructure projects when it constantly has to deal with the lag that they're dealing with right now?
Speaker 18
I presume that, mister chairman, that you mean the insufficient funding. Yes. And insufficient staff. Well, we're seeing the outcome right now. As you know, the average age of a VA facility, I want to say 50. Maybe it's mighty. I may be wrong.
Maybe 60. Certainly, many of our facilities, the spinal cord injury and disorder centers, fall into that category. So the absence of funding definitely means that the facilities are aging. They're no longer suitable to accommodate a sufficient number of patients. We still have some, many facilities with four patient rooms, which complicates the situation, the availability of beds when we have, like, infection control.
Speaker 2
Okay. One more quick follow-up there. What is the issue with OMB's current cost methodology for VA major medical construction projects?
Speaker 18
Oh, that's a good question. If you don't mind, I'd like to take that one for the record.
Speaker 2
Okay. Thank you very much. I, so I yield back, but I now recognize Representative Ramirez, who is both the ranking member holding the spot right now as well as herself. So he can question which everyone she wants to ask.
Speaker 7
Thank you, chairman, and really grateful for the Illinois representation. In this moment. Minnesota.
Speaker 7
A little outnumbered here. I just wanna thank the witnesses for being here today and, frankly, the work that you do every day to make sure that everything we do centers veterans. I really appreciate you. 20,727. I've memorized that number, and I often say it 5, 6 times a day.
That's the number of veterans that I represent. And ensuring that the veterans have every benefit that's been promised to them is a top priority for me. It's why I'm in this committee. Access to affordable, quality education is also one of those benefits. The GI bill has been a critical, important policy that makes it possible for educational opportunities, of affordable and accessible education, to veterans.
However, as we know, in recent years, student veterans have been the target of bad actors seeking to enrich themselves by exploiting veterans' GI bill benefits. And as we know, these bad actors have reduced veterans to a tuition payment, and exploited them to gain access to a dependable federal disbursement. Not only is that unacceptable to me, frankly, it's criminal. When a student veteran is defrauded by predatory institutions, it's only right, only just, that the veteran has a recourse or a way to get their benefits back. No student veterans should have to give up or defer their dreams of education because they were defrauded.
It's why I proudly reintroduced the Student Veterans Benefit Restoration Act of 2025, which would restore GI Bill benefits to students who have been defrauded. But we also know that the bill moved up just a step closer to having a comparable restoration process to those that govern the federal benefits of non-veteran students. We have more work to do to protect our veterans from bad faith actors and ensure that every opportunity to live a meaningful, thriving, and joyful life post-service is available for them. It's why I'm glad that we're having this hearing, and hearing specifically from veteran service organizations today. When I first introduced the bill back in, what feels like, 100 years ago, last congress in the 118th congress, I was proud that it included a grandfather clause so that all veterans have a path to recourse.
However, as a move through committee provision, and as we did some of the bipartisan negotiations, we were unfortunately forced to strip away that component. So Mister Retzer, Mister Brown, Mister Lyle, would you support the inclusion of a retroactive clause in this legislation? And if so, why? And I'll start with Mr. Lyle.
Speaker 17
Thank you for the question. Absolutely, we would support an amendment. It's included in our written statement, to veterans who have been defrauded by these institutions deserve restitution.
Speaker 12
Handles. Absolutely. Absolutely. We see education as a component of stability, particularly post-service stability. So, being able to support a program, such as this, that ensures that veterans who are defrauded in this situation.
Speaker 7
You have to go back to school. Yeah. That's great. That's right. Mister sir, Mister Brown?
Speaker 6
Yes. Thank you for that question. And, yes, we would support that amendment because, obviously, when we look at the restoration of these benefits and we know how the education benefits are, they're timed. They have time limits, and there are also caps on the budget. So we wanna ensure that our veterans get back all of their benefits and be able to use them.
Speaker 18
I was gonna say I would concur with all the recommendations that have been previously given by my peers. The one thing that I would note is that we're acknowledging that fraud has taken place.
Speaker 18
So why wouldn't we want to recover those costs? And that I believe prior versions of the bill, CBO had scored it as zero cost because we were attempting to recover. Yeah. And we would support that.
Speaker 7
Thank you, Mr. Brown. I think that's exactly right. I heard from a lot of veterans after we passed the bill. Some of them very thankful that veterans moving forward would not be defrauded or would have an opportunity to be able to get their benefits back. But I also heard from veterans who are really angry, angry at me, angry at Congress, and asking, what about us?
I wanna go back to school. I wanna be able to finish my education. It has to be retroactive. That's the only real way that justice is served for all of us. So I really appreciate your responses, and I hear you loud and clear.
And I hope to work with the chairman and with my colleagues here as well to ensure that the retroactive component be a critical measure that's included in the bill moving forward. So with that, chairman, I yield back.
Speaker 2
General Lady yields back. Doctor Morrison, you are recognized for five minutes for your questions.
Speaker 19
Thank you, Mr. Chair. An estimated 1 in 3 female veterans and 1 in 50 male veterans in the Department of Veterans Affairs health care system reported experiencing sexual assault or harassment in the military. Military sexual trauma has profound effects on veterans, and risk for sexual assault persists beyond a veteran's time in uniform. With symptoms, reactions, and long-term consequences that are already independently difficult to navigate, additional barriers or gaps to accessing appropriate care following a sexual assault can inflict further harm on veterans receiving care at VA facilities. Additionally, conditions like PTSD, depression, other mood disorders, and substance use disorders closely associated with MST and sexual assault compel proactive actions to ensure appropriate referrals to mental health providers.
I'm proud to be leading HR 5203, the VA Safe Care Act, to continue the work of advancing VA's exceptional care to veterans by equipping VA medical facilities with the appropriate tools to support and care for veterans that have experienced sexual assault. This critical legislation would strengthen the VA's guidance for treating veterans seeking care following sexual assault, ensuring that veteran survivors are protected. Specifically, the bill strengthens the referral processes to community providers for facilities without sexual assault nurse examiners on staff. It makes sure facilities with SANEs have a supply of rape kits, make sure veterans receive prophylaxis for STIs or pregnancy when appropriate, improves mental health and law enforcement referrals, and improves training for appropriate clinical providers and VA police. This bill recognizes VA's unique position to provide specialized veteran care and helps make sure no veteran's physical health, mental health, or safety falls through the cracks as they navigate the incredibly difficult aftermath of a sexual assault.
The VA Safe Care Act is a tailored approach to ensuring the VA has the best practices and protocols in place to respond in the event a veteran is seeking care following an acute sexual assault. So, mister Lyle, in your organization's experience working with veteran populations, why is ensuring trust and appropriate care coordination of particular importance in the context of supporting veterans impacted by sexual assault?
Speaker 17
Well, thank you, Congresswoman. One of the reasons we supported the bill, the seventy-two hour requirement, obviously, that's critical for preventative care and evidence collection. Women and men who are going through an acute sexual assault deserve the best care and the fastest care possible. Any way that we can streamline that either to a community provider or for some providers in the VA system and standardize that care and that training for trauma informed response is gonna improve outcomes in every other avenue of their stability in their health care.
Speaker 19
Agreed. Thank you for that response. Mister Retzer and mister Brown, I'd ask both of you a similar question. Why are updated protocols important for survivors of sexual assault seeking care at VA facilities?
Speaker 6
Thank you for that question. I think what we see is that too many survivors encounter inconsistent and inadequate emergency care. And they gotta be able to have all the facilities and the staffing that's appropriate with the training and the resources and equipment available at the time. And then when we're in the world right now trying to address mental health issues, that's another stability point that we have to make sure that we meet the need of that survivor to be able to provide that. So I think timely access as we look at it, what the necessary medical treatments are there will really have to be sufficient and timely in a sense that it meets the individual's need.
Speaker 18
So I think I can agree with my peers' comments here on this bill. One element that I may not have considered already, I'm gonna rely on my prior law enforcement experience, having served as a law enforcement patrolman, having standardized procedures, knowing exactly what to do and when. Mhmm. Making sure that the right people were there, having the right qualifications of, you know, the counselors to be brought in at the appropriate time made the job of dealing with the situation much easier, and it ensured that the victim's best interest were met.
Speaker 19
Thank you, Mr. Brown. I appreciate the support for VA Safe Care Act has received so far from critical partners like the American Legion, Disabled American Veterans, Vietnam Veterans of America, Veterans of Foreign Wars of the United States, Paralyzed Veterans of America. As the demographics of the country's veteran population have evolved and shifted for decades, VA and veteran service organizations have worked with Congress to update programs and resources to meet veterans where they find themselves in the present moment. For veterans impacted by sexual assault, this collaboration can continue building on efforts to combat the prevalence of military sexual trauma and guarantee that veterans have access to the care that they need. I hope my fellow committee members can join me in supporting this important legislation to ensure the delivery of compassionate comprehensive care that veterans deserve.
With that, mister chair, I yield back.
Speaker 2
I'm gonna hold for just a moment. We understand the ranking member who's going to deliver his closing statement is in the elevator. Maybe that's clogged right now. I don't know. Give us just a moment, but thank you.
The lady yields back. I've got some other questions that might, I'll tell you what. Now I'm just gonna go off statements here, just in talking in general. You know, would you all agree that we do need to move forward with reauthorization since the 1990s. Most of it, that was the last time we did it.
And would everybody agree with that? But we would seek your advice along with others of us that all work together, and that's, you know, why we had this hearing. Even though it was, you know, requested, and that's been in the statement that the minority requested, we make sure we're gonna have your input and everything as we always do. We will agree on most things. We may disagree, but that's the importance of you representing your members who we represent.
So, with that, I'm gonna recognize the ranking member for his closing statement. Oh, for questions. That's right. I'm sorry.
Speaker 8
Thank you, Mr. Chairman. Thank you very much. I appreciate your courtesy. I'd like to start off with mister Lyle. Mister Lyle, I appreciate your testimony on HR 6764, the Veterans Affairs Advisory Committee Oversight Act of 2025, which would eliminate 16 advisory committees at VA.
And I share your concerns about how consolidating advisory committees would greatly diminish the ability of veterans to engage directly with the VA about the issues that matter most to them. Miss Laurel, can you talk about the importance of a few of the advisory committees that this bill would eliminate?
Speaker 17
Well, thank you, Ranking Member Takano. For example, the women veterans advisory committee, the tribal and Indian affairs advisory committee, the homeless veteran advisory committee, all have very unique voices in not just the legislative, but the regulatory process. And being able to offer those unique needs is important for consideration by VA or by Congress as they're moving forward on some of the issues that are unique to their populations.
Speaker 8
Yeah. Well, can you talk specifically about how combining the advisory committees for minority veterans, women veterans, tribal and Indian veterans, homeless veterans, and others could reduce attention on specific issues while lessening veteran representation at VA.
Speaker 17
Absolutely. Thanks, sir. You know, there's some merit to administrative efficiency, but you risk losing focus on specific issues, like I said, unique to those individual populations. So, theoretically, by consolidating the committees, if you had one person with a background in all of those specific areas, they could speak to those things, but you would lose the individual focus that those advisory committees can provide.
Speaker 8
And, you know, each one of those committees, I mean, the issues that are facing each group are numerous and complex. And so, just the number of expert, the amount of expertise and experts you can assemble under one committee really can't be a substitute for separate committees that will have more extensive expertise. Is that not the case?
Speaker 17
Yes, sir. You know, if you consolidate, you could have individuals that represent each of those populations, but that one person that's representing that population in the consolidated advisory committee would not encompass the entire depth and breadth of experience with people on an individual committee that is focused on that one particular issue.
Speaker 8
So for women veterans, for example, you have one representative on this combined advisory committee versus a dedicated, woman advisory committee for veterans, women veterans, which would have an array of experts, whether it's in the specific challenges that women veterans have in getting housing with their children often, you know, trauma and abuse, you know, any number of reasons why, and then there's specific health needs. One expert is not gonna be, I think, sufficient to cover the complexity and, as you said, the depth and breadth. Does combining these special populations into a single advisory committee make sense to you? You know, I mean, we already covered that. Mister Brown, I read your testimony on 6904, HR 6904, the veteran readiness, the VR and E accountability act.
And it sounds like PVA has major concerns with Mr. Van Awards legislation, as you pointed out, problems in every section of the bill. Could you highlight a few issues with the legislation that the committee should be aware of?
Speaker 18
Yes. I can. First and foremost, we appreciate the increased attention related to VR and E. We still feel that this bill skirts around the edges of the problem. Sections two and three of the bill are unnecessary because VR and E, or I should say VA, already have statutory authority over those suggestions.
Allowing vocational rehabilitation specialist to do the work of a vocational rehabilitation counselor, which is covered in section six, would never be something that PVA supports. Employment counseling for veterans with significant disabilities is a core mission of VR and E, and that education level is critical for PVA members in particular, who have a higher level of need than an able-bodied veteran. Saying that a regional office should have an unemployment coordinator, which is mentioned in section eight, without the additional approval of FTE workforce, you know, the workforce to perform the task, would negatively impact the work of counselors. They should be competing positions. They should be working together.
And then finally, in section nine, which is particularly alarming to us, it is unclear as written if it would bar veterans from applying for VR and E once on individual unemployability, or if it would strip them of IU if a veteran were accepted into VR and E. Either situation would be unacceptable.
Speaker 8
Yeah. I'm gonna go yield back into this. But, you know, the bill doesn't address staffing. The I mean, there's a huge shortage of counselors. That's a big concern.
Right?
Speaker 8
doesn't even address that. That's the huge central issue, I think, of our challenge with VR and E. And you would agree with that. Yes, sir. Thank you, Mr. Chairman.
I yield back.
Speaker 2
Thank you. So I wanna thank the witnesses for joining us today and for their testimony. Today's discussion makes one thing clear. Congress cannot keep operating on autopilot when it comes to the VA programs and the authorities. VA must reflect the needs of today's generation of veterans, and I'm excited to continue to work with my colleagues and with you to bring VA into the twenty-first century.
Remember the last time that many of these were reauthorized was prior to September, just after September 11, some well before September 11. Many of our proposals discussed today would do just that by bringing down bureaucracy barriers, clarifying and strengthening existing programs, and reinvigorating the health care system to be the best it can for our veterans. Now I ask unanimous consent that all members have five legislative days in which to revise and extend their remarks and include extensive material. Hearing no objection, so ordered. The hearing is now adjourned.
Thank you for being here.
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