Committee for q a. Let me say at the outset, this meeting is not about whats happened in the past, its whats happening right now to correct some of the things that happened in the past. This is an accountability hearing. I told the secretary we want to take the legislation we passed last year on accountability, on appeals, all the things that we passed to give them the tools to address the significant problems confronting the veterans of america, vsos of america and this committee to begin moving away from the problems of the past and towards the solutions of the future. In particular, on appeals, in particular on accountability, in particular on the g. I. Bill, in particular on all those things that are important to the veterans and their family. And particularly on the leadership of the v. A. As well. And i want to thank secretary shulkin. Ive always been complimentary of him. A lot of people say youre too nice to him. Im not too nice to him. Hes been good to the veterans. He has been a forthright leader that the administration is lucky to have. I believe the veterans are lucky to have and i feel this committee is lucky to have. But we are at the time where there are no excuses, no excuses for why we dont correct the problems weve had with hiring, i. T. , no excuse for the problems with veterans appeals and all those areas. This is it all about accountability, all about standing forward, looking at the past and what we did and looking for the results that are to come in the future so that we do a good job for the veterans of the United States of america. Is he still coming . Mr. Secretary, im going to swear you in for purposes of this hearing. If you raise stand and raise your right hand. Do you solemnly swear or affirm that the testimony youre about to give before the Senate Committee on Veterans Affairs will be the truth, the whole truth, and nothing but the truth, so help you god . I do. You may be seated. Mr. Secretary, im going to recognize you for your five minutes and well get to the Ranking Member when he shows. Welcome. Thank you. Chairman isaacson, senator more an, senator bozeman, thanks for inviting me here to talk about the v. A. s progress. More importantly, on behalf of the veterans that we serve, thank you for your staffs tireless bipartisan work, its been great. We certainly appreciate and respect your leadership, mr. Chairman, and partnership in establishing those issues that were trying to tackle at the v. A. Headon. Some of them, as you said, we know have lingered for years. Ive always said i think we have the best committees in congress and thats in large part due to leadership. We agree with that, by the way. Well, i wouldnt say it if it wasnt true. I took an oath, so joining me today, seated behind me, i just wanted to introduce you in case i need a lifeline today. Peter shelby, our secretary for Human Resources administration. Sharon masson, chairman of the board of veterans appeals. Our acting deputy undersecretary for health for Community Care. Our director of appeals management. Peter orourke, the executive director of accountability and whistleblower protection and mr. Robert worely, our director of education services. A year ago at my confirmation hearing before this committee, i testified that id seek major reform and transformation of v. A. Today, the v. A. Transform and reorganization were focused on five priorities. The first, to provide greater choice for veterans. Second, to modernize our systems. Third, to focus our resources and whats most important to veterans. Fourth, to improve the timeliness of how we deliver our services, and, fifth, to prevent veteran suicide, which is our top clinical priority. The president s executive order, transitioning veterans with Mental Health issues during the first year is a critical step. Thanks in large part to your leadership which helped us pass legislation in 2017, the legislation i hope well be discussing today, were making progress on all five of those priorities. Modernizing antiquated systems and focussing resources while giving veterans more Timely Services and greater choice. Accountability and whistleblower protection is essential to our unwavering commitment to honoring veterans. It, too, is about sensible responsive modern systems that process and support our people to make the v. A. Better. The forever gi bill gives veterans more choice. More profoundly, its about greater opportunity, especially veterans returning to communities to pursue careers and fulfill dreams. Beyond the reforms, weve announced same day services for primary care and Mental Health at every v. A. Facility across the country. Weve extended Mental Health to veterans with other than honorable administrative discharges. So far, weve disposed of 111 out of 130 vacant or underutilized buildings. Published data on wait time, quality data, Customer Satisfaction data and last week we published our opioid prescription rates across the country. There are no other Health Systems in the country that publish this type of data. And because of that i hope its because of that were earning our Veterans Trust back. At the end of this last year, 70 of veterans who responded to our survey said that they felt like valued customers at v. A. Thats up from 46 in 2014. Mr. Chairman, members of the committee, were deeply grateful for your role and support in all of those changes and others like them. Theyre immensely important, but when i look back over this year, were still largely managing through incrementalism. Patching and repairing old systems and processes and reacting to crises. V. A. Still is far short of the kind of bold transformation at change that we need to serve veterans in the decades ahead. From health care to benefits, we have to fundamentally and wholistically change our Service Delivery paradigm. My objective when it comes to health care for our veterans is to have a fully integrated interoperationally Efficient Health care system that is easy for veterans, employees and Community Partners to navigate. A full spectrum of care for veterans that capitalizes on our foundational services, delivering on our promises to provide world class services. We need a consistent, seamless experience for veterans at every v. A. Facility across the country. We need a National Network of modern facilities that meets the changing needs of veterans locally. And simple convenient choice for eligible veterans among a network of highquality Community Providers and a single consolidated program. Mr. Chairman, i applaud your efforts to get this done. Your draft legislation that passed out of this committee is highly responsive to the needs of veterans and were all grateful for the work that you and the committee have done so far to make this a reality. Benefits are a gateway to v. A. Services and we need benefit determinations to be simpler. Veterans should know what to expect and have more predictability. They shouldnt have to endure the burden of filing claim after claim after claim. Benefits should better enable lifetime of independence and success for veterans. Physical and Mental Wellbeing and Financial Security for the severely disabled. In short, we need to begin an earnest dialogue with stakeholders about veterans benefits. Mr. Chairman, in the days and months ahead, i and invite your support and leadership in helping us to find and then pursue the kind of worthy transformational change the v. A. Needs so we can all achieve what we hope to achieve. I look forward to your questions today. Thank you, secretary shulkin. I appreciate those remarks very much. And i hope the Ranking Member is coming. Is he still coming . I beg your pardon. Yes. He is coming, okay. You can start the clock on me. Let me make what somewhat may appear to be an announcement at the beginning of the hearing. The secretary and i have been in a lot of conversations over the last month or so and i want to thank the secretary for his stated support for what the committee passed out of committee. As we all know, we had a 141 vote and we all know we had some differences of opinion on the veterans choice bill and the care bill that we passed out of committee. I did everything i could to bring about a unanimous Common Ground, but i didnt get that totally done. So i made a phone call to the white house and talked with the president. I believe if im not mistaken the secretary was on that phone call as well as a number of other people of interest, and the president , and this is my remember repeating what i remember him saying to me, he said youre all good guys. Youve got Good Solutions on both sides. Yall see if you cant work it out. We tried to get together a couple of meetings to work it out but that didnt materialize one way or the other. My goal as chairman of the committee is to find a positive resolution to no matter what problem i confront. And not because it comes from my wisdom but my persistence to see to it we keep our eye on the goal. And the goal is choice for our veterans, better Quality Health care, more accountable v. A. It is my understanding the president and the administration is going to send our committee in the next couple of days some suggestions that theyre looking for that might help us bring about a resolution. I intend to work with senator more moran and the other members of the committee. To see if we cant take to the floor a unanimously supported bill or a bill that everybody had the chance to support and have their chance to amend on the floor. One way or another, its time our veterans had a better veterans policies that served their choices, gave them the choices they need, funded them so they werent subject to last minute were out of money routines, which this bill, does by the way. We consolidated the stove pipes from seven to one, correct, secretary . And get those things done we have to do. I want to announce that thats forthcoming. When it gets here, ill get it to the committee, well begin work on it and try to get ourselves into regular order to find a bill we can unanimously get to the floor one way or another. If we cant, i know ive made every every effort i have. Whatever the case, our veterans deserve the best of us. The best of us is to pass a bill that we can agree on and the best of us is to find the Common Ground to set up that meeting. So i intend to do that and i appreciate the input that the administration has given us and i look forward to continuing to work with them. Im going to extend ive got a little time left. Three or four things i want to talk about, mr. Secretary. One thing that concerns me, and deeply, are the four positions that remain unfilled at the department. One is your former position. We plucked you out of v. A. Leadership to become the leader of v. A. That was a good idea. The bad idea is it still didnt have anybody in your place in terms of where you were as the secretary of health. The assistant secretary of accountability and whistleblower protection is not in place. That american needs to be in place. The undersecretary for benefits, which is a critical position at the v. A. , needs to be in place. And the secretary for information technology, which is absolutely critical, particular with the new information coming in, its got to be filled somewhat sooner rather than later. Ive asked these questions privately and i know youre trying, but this is one of those things where we a for effort is not good enough. Weve got to find a way to get the best people in the United States of america in these disciplines working for the Veterans Administration and our veterans. Can you tell us what progress you dont have made and what youre doing on those in particular . Yeah, let me give you a quick update on that. If our cio candidate, we have made a selection and that person is now going through a vetting process at the white house. Our indications are that thats moving along smoothly. Four, the undersecretary of benefits, we had a commission. As you know, by law we have to form a commission. They selected three candidates. We made our top choice. That person withdrew. Weve now gone on to our second choice. Fortunately, all three candidates are excellent candidates and that persons also going through vetting the the white house. They understand the critical nature of this. On the undersecretary excuse me, on the undersecretary of health, we have this is now going to be our Third Commission. Weve had two commissions prior that did not select a candidate. The Third Commission will be chaired by deputy secretary bowman on january 25th and 26th. We have 11 candidates who have applied for that. We hope to have a successful selection out of that Third Commission process by january 26th. Of which we would then forward three names on to the president for consideration that would go through vetting. On the assistant secretary for accountability and whistleblower protection, mr. Orourke is the executive in charge of the accountability and Whistleblower Protection Office and hes here today. That prompts me to tell you what happened this morning in the health committee. We had testimony on disasters and preparedness and out of the blue one of the chief people in charge of that for our country took a point to compliment the Veterans Administration on what the veterans hospitals and medical personnel did to help in the rescue of Senior Citizens in houston during the terrible flood we had, which magnified for me the importance of remembering that the v. A. Health care system is a huge Delivery System that serves by the nature of its veterans, a more senior population and i want to compliment you and the doctors to do what they did to earn that praise because thats a real good thing to have. Thank you. From a standpoint of accountability, i want to see some accountability with regard to the appeals process. I read your report and i read your remarks. I know youre working on demonstration project on appeals, is that correct . Yes. What timetable do you have or working towards to move away from a demonstration project to a project that is fact of the matter, exactly how were going to handle the appeals in the future to stop the backlog from growing and continue to anticipate the backlog. Today the backlog stands at 470,000 appeals. So we have a lot of work to do. Because of your legislation, were now implementing a new process, of course. That will be fully implemented in early 2019. But weve actually started to make major improvements already. This year, we are on track to do 81,000 appeals. That would be 30,000 more than last year. Just at this period right now of this fiscal year, were at 21,000 appeals. Thats 10,000 more than this time last year. So were Getting Better and faster and weve brought on new staff. Secondly, weve begun, and this was actually because of the feedback that we got the last time that we were together, we begun to offer veterans now the choice in their legacy appeals to opt into the new process. So they dont have to wait. Weve had 3 of veterans opt in. These are people with long appeals. Opt in. This is the Pilot Project to the new process. And heres the good news, theyre getting their decisions within 30 days and 75 of those decisions are going in favor of the veteran. So its actually a pretty good deal. Instead of waiting five or six years, if they opt in, 30day decision, 75 approval rate, and thats beginning to address those legacy appeals. So im hoping through our Veterans Service organizations and through your offices well encourage more veterans to consider, because this is an elective option, to choose to opt into the new process. Theyll get faster decisions and we hope accurate, good decisions for them. My time is up, but as it ends i want to say this, i know our vsos are represented here today. We didnt ask them to testify because this is dr. Shulkins day. The vsos are going to have the chance to address the house and Senate Committees in our annual report and we look forward to their input. I hope the vsos and the agency will do everything they can to disseminate the fact that our veterans who had the pending appeals have the option to opt out and go into the new modernized program, 3 of those have done and s. O. And those have gotten a response in 30 days. That is a light years improvement. I commend you on what you started. Lets help him finish by getting our veterans a timely appeal. Ener moran . Mr. Chairman, thank you very much. Im going to depart our hearing as soon as my questions have been answered, but i would pay honor in this setting to senator dole, who we will all be in the capitol to honor today. In kansas and perhaps the country there is no more esteemed public servant, but in my view, while his Public Service was tremendous, his military service and then his commitment to those with disabilities and the veteran community is exemplary. No one meets that standard. So i pay a tribute to senator dole. Let me just raise a few points and then im going to make a comment and ask a question, mr. Secretary. First, i want to know that your cancellation of contract the contract for region 4, for Community Care, troubles me. I understand that senator helenor is going to raise this topic with you today. You have a request from my subcommittee on appropriations to explain what happened in that regard and i look forward to that answer. Secondly, i will be submitting several questions for the record. Im interested in knowing the v. A. s efforts in regard to full implementation of the Toxic Exposure Research act, so