Financial roadblocks. This is an hour and ten minutes. Mr. Chairman, are you ready to begin . Yes. Please begin your fivesecond countdown. 5, 4, 3, 2, 1. Good afternoon. I call this hearing to order. A quorum is present. Without objection, the chair is authorized to call a recess at anytime. I would like to go over items. If you are experience connectivity issues, please contact your staff. It is committee and Sub Committee, participating members will be muting when not recognized and its out of courtesy so that background noise did not interfere with another member recognized to speak. When you are recognized you need to unmute your microphone and pause before speaking so we can hear everything you say. In order to ensure that everything members say is captured on the live stream of the hearing members are asked to pause for two to three seconds before beginning to speak. If you wish to have a document inserted in the record please ask for unanimous consent and have your staff email the documents. Please keep in mind you will need to refresh the repository page as it does not automatically update. Without objection, members will be recognized. Does any member have a question about the conduct of this hearing with members participating remotely . Seeing none, i now recognize myself for an opening statement. Welcome, everybody. We will examine the department of Veterans Affairs medical supply chain. One important question is, what lessons have we learned from the pandemic. Unfortunately vas purchasing and Inventory Management system long faced many serious problems, just last year the Government Accountability office added the acquisition to the high risk list, and it has chronicled many instances of supply problems even before the pandemic. For example, the Va Medical Center in washington, d. C. Canceled and rescheduled medical procedures between 2015 and 2018 because it did not have the needed medical supplies on hand. And Va Medical Centers have experienced back orders for as much as 22 of medical supply items that are generally provided including needles, alcohol pads and tissues and even garbage bags when centers needed them. First, the va struggled to get a handle on which hospitals were facing shortages. Because of the inventory system, the va established a new system for gathering supplies to its hospitals, and they used spread sheets. When some were unable to fill orders, supply deliveries were delayed. Its important to point out that va hospital staff and leadership work tirelessly to procure the needed supplies as the severity of the pandemic grew. We also saw many other examples of dedicated people helping veterans during the pandemic. I can record with prime in my home state of New Hampshire we stepped up. Since the pandemic began we arranged 15 shipments. Ten of the shipments included ppe specifically for the va, one with 400,000 masks and one with 400,000 gowns and the lists go on. It made a big difference to our virginia employees, and its one of the many examples where many went the extra mile. However our veterans deserve a permanent solution. The Department Needs a modern and effective acquisition. It has been grappling with the issue for sometime. It faced many problems and short falls. Va then tried the medical surgical prime vendor next Generation Program in 2016 and things did not go as well as hoped. The va is planning the 2. 0 program which is supposed to launch in 2021. You heard that correctly. Va has made three attempts seupbsince 2004. And v already is take steps to replace its medical surgical prime vendor 2. 0 program before the program has started. Va has plans to transition all of the Medical Centers to the inventory tool but this transition is scheduled to take up to seven years. All of the virginia supply chain memberships cause confusion. During todays hearing we will examine steps by the va to address medical supply shortages during the pandemic. I phraud this attempt to put in place important lessons that were learned during the pandemic however i understand the centers will not be fully operational until july of 2021, which seems too far off into the future. I look forward to hearing from our witnesses during todays proceedings, and veterans and hospital staff should have the confidence that vas medical supply chain is modern, effective and saw fishant. I would like to recognize mr. Bank for any comments he may have. I want to welcome our Witnesses Today to discuss strengthening the va medical supply chain. I know mrs. Brazil, ms. Kramer have been working around the clock to support the pandemics response. Thank you again. I would also like to recognize ms. Oakley and her team for their great work going back a number of years on improving virginia contracting. Lastly i would like to express my appreciation, mr. Chairman, for your support in calling mr. Waldron to testify, and i think we will all benefit from his expertise in government procurement. Many americans have never given much thought to our supply chains. Our over reliance on china was obvious, but the National Security implications were rarely discussed outside of think tanks. The fukushima earthquake was an International Warning for many companies, but its impact was more limited. Today is different, the covid pandemic has upended supply chains across the country, and many are still considering a soaring demand. The va relies on the same battered medical supply chains as private health care providers, state and local governments and other federal agencies. While personal protective equipment output has increased since march, and many new diagnosic tests have come to market, inventory supplies for still months away. Purchasing must be efficient. And Inventory Management must be nimble. The organization is scattered, and policies and procedures are confusing and the Inventory Software is archaic, and the prime Member Program has been stuck on the launch pad. This was the most recent top to bottom look at the medical supply chain by independent experts and it was largely ignored. The commission on care pointed out that virginia hasa has hard people, and this was the state of affairs as the pandemic struck. There are some significant Reform Efforts under way, like implementing and standing up new Regional Readiness Centers, but given the speed of events i am concerned the va may find itself fighting. While there are excellent commercial products available, closer alignment with the department of events through the common system is valuable. Until the va has a Management System, no other supply chain can improve efficiency or eliminate waste. This project is only in the early pilot stage and completion is years away, even after being accelerated. I am deeply concerned this committee needs to be ready and on Decision Making for the large it projects before the va makes commitments. It remains to be seen how this will be accomplished. Supplies that sit in warehouses and do not move where needed in real time are of no use. Additionally, the Regional Readiness Centers may not commence full operations before the end of the pandemic. Finally, i hope to learn more about the va strategy to increase covid testing. The early decision to maximize Rapid Testing was smart. Va started at the front of the line and secured a large amount of supplies. But vas ability is limited to purchase quantities of test kits as time passed. Laboratory tests are more widely available but processing bottlenecks and staffing constraints limit growth. This is a difficult problem that everybody in the Health Care Sector is competing to resolve. I want to thank our witnesses again for joining us this afternoon, and i look forward to exploring these issues in greater depth. Mr. Chairman, i yield back. Thank you, general, for your comments. I will now recognize our witnesses. First we have from the va, the principal director of acquisition logistics and construction and chief acquisition officer, and the acting assisting secretary for enterprise integration, and shes accompanied by ms. Kramer, and mr. Andrew, executive director of the office of procurement and logistics. You are now recognized for five minutes. Good afternoon, chairman. Ranking member, burgman and distinguished members of the committee. Thank you for the opportunity to testify today about the resiliency of the Department Supply chain. I am a companied today by ms. Debra kramer, vha, and mr. Andrew sentino from vha. The department of Veterans Affairs for vas response to covid19 demonstrated the strength and agility of an integrated Health Care System operating as a single enterprise. Despite global shortages of ppe, the va was able to sustain operations in locations experiencing high demand due to covid surges. Supply chain challenges are not unique to the va. We are experiencing the same challenges as every Hospital System in the country, however the advantage of being the largest integrated Health Care System in the country, one with 170 hospitals, is our ability to share our supply and Personnel Resources between sites based on Immediate Health care needs. To be clear, we prepare year round for all contingencies to include Infectious Diseases and other catastrophic events. However, the magnitude of this Global Pandemic has provided the opportunity for some improvements. Part of this pandemic, the va began transforming our supply chain to increase efficiency, maximize value to clinical customers and deliver realtime analytics capabilities to support fast and accurate enterprise Decision Making. Now more than ever this work is essential, and we are committed to aggressively driving the change required to improve va supplied performance. To achieve greater efficiency, va will strengthen its long standing relationship with the department of defense or dod, leveraging their expertise to modernize the supply chain operations while allowing the va to be fully committed to providing Quality Health care. Dod will implement the standard support on an enterprise wide basis to replace vas legacy systems, some of which were designed and deployed in the 1970s. It will ensure enterprise visibility. We are aggressively preparing to implement medical surgical prime vendor or mspv 2. 0. It will enable expansion and enhancement of future mspv supply availability, and will incorporate a broader ray of supplies and equipment based on clinical requirements and Health Care Operational needs. Va intends to establish Regional Readiness Centers, geographically distributed to support the four veteran integrated network consortiums. They use regional contracts and share full time equivalent employees and material and use joint networks for referring patients and conducting telehealth. Transitioning from our current state to sustainable and flexible supply chain operations requires resiliency in our supply chain. Va is ensuring it has enough storage and capacity for the critical supplies. Its acquiring to enable vha to sustain services to the veterans and the resumption of precovid operations. Veterans care is our mission. We are committed to providing high Quality Health care to all our veterans even during this unprecedented times. Your continued support is essential to providing the care for our veterans and their families. This concludes my testimony. My colleagues and i are prepared to answer your questions. Thank you very much for your comments. Our next witness is ms. Shelby oakley for the Government Accountability office. Welcome and you are recognized for five minutes. Thank you. Chairman, Ranking Member burgman and members of the Sub Committee, thank you for having me here today to discuss the vas supply chain and the covid19 response. As the largest integrated Health System in the country, the va is able to effectively manage the supply chain is critical even absent a pandemic. Our tpoet coming report on several va supply chain points to continuing challenges. As i begin i want to take a moment to acknowledge the hard work of vas acquisition and logistics workforce on behalf of our nations pandemic. It has been a real all hands on deck effort. Our work is showing that va is leveraging the workforce to abstain supplies. For example, offices that dont typically purchase medical supplies did so and vas emergency increase to the emergency threshold allowed staff to buy with purchase cards. The va needs could be be met, and va worked with fema to obtain pppe. As i testified in june 2020, when the pandemic hit, tracking supply status at its 170 Medical Centers proved to be a challenge for va. Vas antiquated Management System forced officials to rely on manual daily inputs of ppe inventory from Medical Center staff. Va has since created a tracking tool to enable enterprise wide decisions about ppe, however Medical Center input remains a manual process since inventory from Medical Centers do not communicate with vas tracking tool or each other. Va is aware of the short falls in the supply Chain Management, and before covid hit the va had planned to modernize the system, and the rollout of the system has been delayed by almost a year and full implementation is many years off, although i understand va hopes to speed up this timeframe. Va also has several other supply chain modernization efforts under way. For example, va plans to implement Regional Readiness Centers to address challenges with relying on a just in time Inventory Management system for ppe during national emergencies. And va is developing a new iteration of the Vendor Program, and our forthcoming report identifies challenges with the new program. For example, each of the 12 Medical Centers we visited in 2019 reported back orders of frequently back orders, and medical staff said they were able to get items more quickly with ordering directly through the manufacturer than going through the prime srepb tur program. To help mitigate this back order problem, under 2. 0, va plans to require prime vendors to maintain a 30day stock of regularly ordered supplies. It will take time to recognize the improvements of 2. 0, as the implementation has been delayed to 2021. And 2. 0 will not fully address other identified challenges, such as phapbmanagement for the logistic staff. The va is also piloting the use of one program to determine if its more efficient and effective than its own program, and our work found va lacks methodology to measure work across the centers. It is important to recognize that none of these would have completely shielded va from the supply shortages over the pandemic. Many of the efforts will dramatically change how va does business and are already delayed, making thoughtful planning and execution all the more important. Their goals are commendable and if achieved would go a long way to increasing the efficiency and effectiveness of the acquisition management. Mr. Chairman, Ranking Members and members of the Sub Committee. This concludes my oral statement. I am happy to take questions. Our final witness today is the president of the coalition for government procurement. I will just remind him to pause a few seconds before beginning. You have five minutes. Chairman, members of the committee, thank you for the opportunity to appear before you today to address the challenges the department faces. I am president of the coalition for government procurement. Our association is pleased with the committee focusing on the va supply chain and its role in delivering health care to our nations veterans. Were a nonprofit and nonpartisan association of small, medium and Large Businesses representing more than 145 billion in annual government contract purchases. Today my remarks summarize the comments and i ask it be included in the record. These requirements define the scope of the vas formulary and the commercial medical and Surgical Products available through the msvp program through contracts and through the federal supply schedules. The office serves as the bridge between Program Offices that generate requirements and va contractors. It communicates across the department and to the industry. Given thetr vital the program be managed and led by clinicians. We believe this management requirement will require engagement with the industry. Furthered, this fs should serve as a lead industry point of contract to interface with the industry, as much it would have a clear and direct channel through which it could engage and share the latest developments and rapidly evolving field of the medical and surgical technologies. And it is just one factor in developing a robust formulary. Indeed, the lack of purchase data undermi