Transcripts For CSPAN Veterans Administration Health Care Wa

My predecessor at the fed, chairman ben bernanke, demonstrated such courage, especially in his response to the threat of the financial crisis. To stabilize the Financial System and restore economic growth, he took courageous actions that were unprecedented in ambition and scope. He faced relentless criticism, personal threats, and the certainty that history would judge him harshly if he was wrong. But he stood up for what he believed was right and necessary. Ben bernankes intelligence and knowledge served him well as chairman. But his grit and willingness to take a stand were just as important. I hope you never are confronted by challenges this great, but you too will face moments in life when standing up for what you believe can make all the difference. Having dwelt for a moment on failure and grit, let me turn to the deeper meaning that underpins grit and can carry us beyond failure. The hard work of building a life that makes a difference is much easier to sustain when you are passionate about what you pursue. When i first came to the Federal Reserve 37 years ago, i was struck by the passion of my colleagues for the mission of the fed. And these many years later, each day at work, i see the importance of that passion to carrying out the feds duties effectively. If there is a job that you feel passionate about, do what you can to pursue that job; if there is a purpose about which you are passionate, dedicate yourself to that purpose. Finally, i hope that you can find joy in the lives you choose. You are completing one important phase of your life today and embarking on an amazing new adventure. Serious decisions about life surely lie ahead, but take the time to savor the joys, large and small that come along the way. Share those joys with others, and share a laugh when you can. In closing, thank you again, on behalf of myself and the other honorees. Thank you for the opportunity to members will be back for legislative business on june 9. The senate will be in for general speeches. At 5 30 senators will hold a procedural vote on the nomination of keith harbour to be a representative to the uns human rights council. It is also possible the senate could begin work on a bill that would adjust that would issues. Mental health the Senate Judiciary committee will be holding a hearing on Campaign Finance and the First Amendment. Both the majority and minority leader on the senate will be testifying. Mitch mcconnell will be testifying. Senate leaders are scheduled to testify on the same panel to consider the First Amendment and how on supremediscussion Court Rulings that did away with limits on contributions and how those are ready how those relate to the First Amendment. It successfully argues against donor limits. House hearing with the a officials testifying about the v. A. s failure to deliver emails from a facility in phoenix. The committee issued a subpoena a few weeks ago after allegations of misconduct. A preliminary report from the acting Inspector General was released the same day as the hearing. The findings concluded veterans weighed an average veterans waited an average of 115 days for an appointment. Is 2. 5 hours. This hearing is 2. 5 hours. First i want to ask unanimous representative Sheila Jackson from the state of texas be allowed to join us on the day us tonight. She said she will be a little bit late. Hearing no objections to order as i am sure many of you are aware the v. A. Office of Inspector General issued an that confirmed appointment scheduling manipulation discovered by this thatttee and substantiated significant delays and access to care have negatively impacted the quality of care at the phoenix of the a Medical Center. Though it has indicated it has in it has expanded its investigation in open cases regarding 42 v. A. Medical founds, the oig clearly inappropriate scheduling practices are systemic throughout the v. A. It is all the more urgent for v. A. To come clean and fully comply with our subpoena. Veterans health is at stake. I will not stand for a department coverup. Further, to fulfill our congressional oversight duties is absolutely essential to receive the documents that we have requested from the department of Veterans Affairs. The scope of the subpoena was very narrow. Tailored tociently provide a reasonable time to produce the documents in full. The subpoena simply demanded betweenon of emails the ninth of april and eighth of may regarding the destruction or disappearance of alternate or interim waitlist at the v. A. Medical center. Was told that the committee would only be receiving a partial response on the original due date and the v. A. Would produce additional documents on a rolling basis over an indefinite and undefined. Of time undefined period of time. Perpetuate the belief that selected compliance with committee request is acceptable and would allow them to continue its perceived mission to prevent this committee from doing its job. What they we received purport to be the last of the three sets of documents that they are going to produce for this committee. The v. A. Has claimed they have searched 27 different record custodians and they have produced over 5500 pages of documents. Point, given their pattern of stonewalling Committee Requests i am not at all convinced that they have conducted a thorough and comprehensive search for responsive records. Know they are withholding documents relating to at least three Relevant Communications by claiming attorneyclient privilege. Producev. A. Failed to the log demanded by the subpoena or provide any explanation whatsoever, which is necessary for us to consider whether we will accept the insertion of the privilege. Committee deserves a complete explanation of the interim Document Destruction at generaland for its failure to respond to ongoing requests related to delays in care. Last week i invited dr. Thomas lynch and michael huff to explain the incomplete record production to the committee. They did not come. Dr. Lynch was in phoenix. We prepared three additional subpoenas for dr. Lynch, ms. Mooney, and mr. Huff to compel them to put up here before us if they decided to to compel them to appear before us if they decided to decline the invitation. Unfortunately it takes repeated requests and threats of compulsion to get the v. A. To bring their people here. I look forward to hearing what they have to say. I now recognize the Ranking Member for any statement he would like to make and then we will proceed with questioning. Thank you very much mr. Chairman. Tonight we find ourselves in a very difficult position. I do appreciate the witnesses appearing before us this evening and for the additional production push of materials that came overnight. Unfortunately, as you heard from the chairman, those materials and the release of the interim i. T. Report today did not provide the answers we saw but rather just grazed additional raised additional questions. I share your passion for getting to the bottom of this issue. Sohave been bipartisan on many things within this committee. Continueful we can that, even as the situation gets increasingly difficult and emotionally charged. I am not completely satisfied with the v. A. s response to our inquiries and the compliance with the subpoena. Feel over the past few days there has been a shift towards increasing responsiveness and offers to try to work harder to satisfy our requirements. The key take away from you tonight will be hearing the v. A. Response to our request for information and what the reasonings are today for failing to do so in a timely manner. Let me be clear, i am not happy. I am not wholly satisfied with the v. A. Responses we have seen. Answers. Ect we will get to the bottom of this and ensure that a solution is implemented that never allows Something Like this to happen accountability for every failure that has every a veteran and for individual print i was strongly urge the ig to diligently but swiftly provide a comprehensive final report so we can take action and hold people accountable. Goal tohave the same make sure that our veterans receive the highest quality care in treatment possible. They deserve nothing less. Canlieve National Leaders rise above politics and emotion and act pragmatically to achieve the best outcomes for our that for our veterans. We must take our responsibilities seriously. I look forward for an opportunity to get some substantive answers from the v. A. This evening. I yield back. Prior to beginning our questions this evening i would like to ask unanimous consent that the Ranking Members and myself be allowed to have 15 minutes each for questioning forowed by five minutes members. If necessary we will have a second round of questioning as well. Hearing no objections, so ordered. Dr. Lynch, ms. Mooney, mr. Huff. Thank you for attending. Would please stand and raise your right hand. Do you solemnly swear under penalty of perjury that the testimony you are about to wholee is the truth, the truth, and nothing but the truth, so help you god. Thank you, please be seated. Lynch, just today the v. A. Office issued an interim report lists,ying multiple other than electronic waiting lists and multiple types of scheduling practices that are not in compliance with v. A. Policy. When you went to phoenix after the hearing in this committee, did you identify these same or didduring your review you take merely the word of those in charge that everything was fine . Mr. Chairman, i have made three visits to date. The visit after which i reviewed my findings with your Committee Standards was an initial visit. We had Little Information to go on at the time. Identify and i did share with your Committee Staffers that we thought we had identified an intermediate work that was used to identify veteran appointments that had been canceled for the purpose of rescheduling those veterans. Timeo indicated at that that it was my impression that the document had been appropriately destroyed when the veterans had been rescheduled. I also made it very clear to the Committee Staffers that this was an iterative process, that we were going to continue our review. I returned about a week and a half later with two additional staff. Scheduling expert. V. A. ,nt a week at the understanding the process of scheduling that had been going on. Late 2012. I will be happy to outline a process for you. Beginning actually in october of 2012 the facility committed to identifying veterans who had been scheduled more than three months in the future. They identified more appropriate slots to see these individuals sooner. I apologize but we are not going to be able to have longwinded comments. You said you told the staff that theas your impression that list was destroyed. Is that what you are saying today . That is what i am saying. You were in the room at the time. Did he say it was his impression that the list was destroyed . You are under oath. I believe that is what he said. You believe or you know . I believe that is what he said, from my memory. Notes . Did not take any i took notes. And i dont have those in front of me today. Notes at that those notes havent been provided to this committee as part of the subpoena for all records talking about the destruction of the list, including notes, phone calls, emails, letters, and memos . I turned over all of my documents to the office of counsel general. Does anybody at the table know why those notes have not been delivered . The office of the general because this is a legal issue the office of the general counsel has the lead for the department. My understanding is upon receipt of the subpoena on may 8 the office of the general counsel the subpoenaing to and dedicating a significant number of employees and resources to that effort in pulling responses and email records. Excuse me, let me interrupt you. I will read you the definition in the subpoena. The term document means any written record regardless of how classified or unclassified him how recorded, and whether a regional or copy. Toluding but not limited memoranda, working papers, notes, letters, notices, confirmation, telegrams, in other words, everything. Why have we not received all of the documents requested in the subpoena even though we got a letter from the general counsel late last night that said the v. A. Was done. I understand the general counsel has held a very small number of documents for attorneyclient privilege. They have been in communication with your staff and ongoing discussions related to those documents. Are the records from a reefing part of the protected notes that the general counsel is claiming attorneyclient privilege about . Vista chairman, i would defer to the office of the general counsel for that. Again, is hasn, to v. A. Complied with the terms of the subpoena . It is my understanding that the v. A. Has complied with relevant information in response to the subpoena. Can you say anything without repeating without reading your prepared notes . This is within the office of the general counsel. The general counsel would be the appropriate party to ask. And we did ask the office of general counsel to come brief members last week and the general counsel declined. He said he declined because he did not want to brief the members, he wanted to brief the staff. Theres not a Single Person sitting up here in this room that voted for the subpoena. The members did. Understands that we are deadly serious you can expect us to be over your shoulder every single day. While i have your attention can you please explain to me why we in fact have 100 and 10 outstanding requests for information, some dealing with this issue specifically . And if you want a specific one, why have you not told this committee yet who was disciplined enough gusto, georgia and Columbia South carolina, where nine veterans died because they were on a waiting list for colonoscopies. Chairman, inw, mr. The last five years the office of congressional maam maam, veterans died. Get us the answers please. I understand that, mr. Chairman. And i will look that is what you said three months ago. This has been going on since january. Since january. , wease you dont know what put on our website every week what we ask for. And did nothing changes from week to week. We have an oversight responsibility in this congress and we cannot do our job appropriately if you dont provide us the information that we request. Dr. Lynch. Even the fact that you declare the issue a misunderstanding in the first brief, as staff has related it to me, and the office of Inspector Generals report issued today substantiated inappropriate scheduling and said it was systemic throughout the dha, do you believe you have the credibility now necessary to identify and fix the problems . Mr. Chairman, i believe i used the term is understanding with respect to the references that were being made to a secret list. I did not make any qualifications or statement as to whether i thought the actions occurring or appropriate. Is your contention still that there was no secret list . It is my contention there were a number of documents, three of which were identified. One of which we identified earlier that were working documents used to provide information about patients in addition to the waiting list or for rescheduling of patients. I did not think they were secret list. I think they couldve easily been misunderstood. I would remind the committee we discussed this last week as well. Lynch came back from phoenix and asked to brief the four corners in which a matter of hours we were able to have the four corners come together of the staff and in that you said and i would like to know what gave you the impression that the list had been destroyed. It had been conveyed to me second hand by one of the members who had been with us on that the center was using a documents to record the names of veterans that have canceled whose appointments have been canceled, so that they can be rescheduled. After the patient and veterans had been rescheduled, the list was no longer required and it was destroyed. It did contain patient identifiable information. Staff is telling me it was described to as a transitional document. I guess my question is was the list destroyed before or after this committee requested a preservation order for all documents . Was mya chairman, it impression that those lists were destroyed before your preservation order. I was trying to explain, before he asked me to be brief, that this was occurring between october and november of 2012 and mid2013. Visit weme of my first thought the transfer was occurring to the electronic waitlist. We learned during the course of the second visit that the transfer and use of this document was occurring during the course of rescheduling patients because they were trying to provide care more promptly and never tried to consolidate clinic profiles to make the clinic management more proficient. In that process patient appointments were being canceled. The scheduling system that v. A. Uses automatically generates the list of patients who are canceled and so that list can be used to reschedule patients. Once rescheduling has occurred the list is no longer necessary. It is appropriately destroyed as it does contain patient identifiable information. It is my understanding that this did occur through late 2012, mid 2013. Why didnt we know that if we are not first asked about it . I had only come back from the first visit. If it wasnt until we took back the team and spent a week there, working through the entire process, that we understood what had been going on, mr. Chairman. Written a letter asking for that specific information. Has it been responded to . , hencenever responded to the subpoena. We are trying to get answers, nobody is giving the answers to us. That is why we are here tonight. Real quick before my time runs , according to an internal report in the v. A. An employee reported that the way time at los angeles will Angeles Center was being manipulated. Email a senior official substantiated, there appears to be inappropriate actions by the supervisor in los angeles. Thed you comment for committees behalf what is going on in los angeles . Chairman, the only concerns i am aware of related to Financial System<\/a> and restore economic growth, he took courageous actions that were unprecedented in ambition and scope. He faced relentless criticism, personal threats, and the certainty that history would judge him harshly if he was wrong. But he stood up for what he believed was right and necessary. Ben bernankes intelligence and knowledge served him well as chairman. But his grit and willingness to take a stand were just as important. I hope you never are confronted by challenges this great, but you too will face moments in life when standing up for what you believe can make all the difference. Having dwelt for a moment on failure and grit, let me turn to the deeper meaning that underpins grit and can carry us beyond failure. The hard work of building a life that makes a difference is much easier to sustain when you are passionate about what you pursue. When i first came to the Federal Reserve<\/a> 37 years ago, i was struck by the passion of my colleagues for the mission of the fed. And these many years later, each day at work, i see the importance of that passion to carrying out the feds duties effectively. If there is a job that you feel passionate about, do what you can to pursue that job; if there is a purpose about which you are passionate, dedicate yourself to that purpose. Finally, i hope that you can find joy in the lives you choose. You are completing one important phase of your life today and embarking on an amazing new adventure. Serious decisions about life surely lie ahead, but take the time to savor the joys, large and small that come along the way. Share those joys with others, and share a laugh when you can. In closing, thank you again, on behalf of myself and the other honorees. Thank you for the opportunity to members will be back for legislative business on june 9. The senate will be in for general speeches. At 5 30 senators will hold a procedural vote on the nomination of keith harbour to be a representative to the uns human rights council. It is also possible the senate could begin work on a bill that would adjust that would issues. Mental health the Senate Judiciary<\/a> committee will be holding a hearing on Campaign Finance<\/a> and the First Amendment<\/a>. Both the majority and minority leader on the senate will be testifying. Mitch mcconnell will be testifying. Senate leaders are scheduled to testify on the same panel to consider the First Amendment<\/a> and how on supremediscussion Court Rulings<\/a> that did away with limits on contributions and how those are ready how those relate to the First Amendment<\/a>. It successfully argues against donor limits. House hearing with the a officials testifying about the v. A. s failure to deliver emails from a facility in phoenix. The committee issued a subpoena a few weeks ago after allegations of misconduct. A preliminary report from the acting Inspector General<\/a> was released the same day as the hearing. The findings concluded veterans weighed an average veterans waited an average of 115 days for an appointment. Is 2. 5 hours. This hearing is 2. 5 hours. First i want to ask unanimous representative Sheila Jackson<\/a> from the state of texas be allowed to join us on the day us tonight. She said she will be a little bit late. Hearing no objections to order as i am sure many of you are aware the v. A. Office of Inspector General<\/a> issued an that confirmed appointment scheduling manipulation discovered by this thatttee and substantiated significant delays and access to care have negatively impacted the quality of care at the phoenix of the a Medical Center<\/a>. Though it has indicated it has in it has expanded its investigation in open cases regarding 42 v. A. Medical founds, the oig clearly inappropriate scheduling practices are systemic throughout the v. A. It is all the more urgent for v. A. To come clean and fully comply with our subpoena. Veterans health is at stake. I will not stand for a department coverup. Further, to fulfill our congressional oversight duties is absolutely essential to receive the documents that we have requested from the department of Veterans Affairs<\/a>. The scope of the subpoena was very narrow. Tailored tociently provide a reasonable time to produce the documents in full. The subpoena simply demanded betweenon of emails the ninth of april and eighth of may regarding the destruction or disappearance of alternate or interim waitlist at the v. A. Medical center. Was told that the committee would only be receiving a partial response on the original due date and the v. A. Would produce additional documents on a rolling basis over an indefinite and undefined. Of time undefined period of time. Perpetuate the belief that selected compliance with committee request is acceptable and would allow them to continue its perceived mission to prevent this committee from doing its job. What they we received purport to be the last of the three sets of documents that they are going to produce for this committee. The v. A. Has claimed they have searched 27 different record custodians and they have produced over 5500 pages of documents. Point, given their pattern of stonewalling Committee Requests<\/a> i am not at all convinced that they have conducted a thorough and comprehensive search for responsive records. Know they are withholding documents relating to at least three Relevant Communications<\/a> by claiming attorneyclient privilege. Producev. A. Failed to the log demanded by the subpoena or provide any explanation whatsoever, which is necessary for us to consider whether we will accept the insertion of the privilege. Committee deserves a complete explanation of the interim Document Destruction<\/a> at generaland for its failure to respond to ongoing requests related to delays in care. Last week i invited dr. Thomas lynch and michael huff to explain the incomplete record production to the committee. They did not come. Dr. Lynch was in phoenix. We prepared three additional subpoenas for dr. Lynch, ms. Mooney, and mr. Huff to compel them to put up here before us if they decided to to compel them to appear before us if they decided to decline the invitation. Unfortunately it takes repeated requests and threats of compulsion to get the v. A. To bring their people here. I look forward to hearing what they have to say. I now recognize the Ranking Member<\/a> for any statement he would like to make and then we will proceed with questioning. Thank you very much mr. Chairman. Tonight we find ourselves in a very difficult position. I do appreciate the witnesses appearing before us this evening and for the additional production push of materials that came overnight. Unfortunately, as you heard from the chairman, those materials and the release of the interim i. T. Report today did not provide the answers we saw but rather just grazed additional raised additional questions. I share your passion for getting to the bottom of this issue. Sohave been bipartisan on many things within this committee. Continueful we can that, even as the situation gets increasingly difficult and emotionally charged. I am not completely satisfied with the v. A. s response to our inquiries and the compliance with the subpoena. Feel over the past few days there has been a shift towards increasing responsiveness and offers to try to work harder to satisfy our requirements. The key take away from you tonight will be hearing the v. A. Response to our request for information and what the reasonings are today for failing to do so in a timely manner. Let me be clear, i am not happy. I am not wholly satisfied with the v. A. Responses we have seen. Answers. Ect we will get to the bottom of this and ensure that a solution is implemented that never allows Something Like<\/a> this to happen accountability for every failure that has every a veteran and for individual print i was strongly urge the ig to diligently but swiftly provide a comprehensive final report so we can take action and hold people accountable. Goal tohave the same make sure that our veterans receive the highest quality care in treatment possible. They deserve nothing less. Canlieve National Leaders<\/a> rise above politics and emotion and act pragmatically to achieve the best outcomes for our that for our veterans. We must take our responsibilities seriously. I look forward for an opportunity to get some substantive answers from the v. A. This evening. I yield back. Prior to beginning our questions this evening i would like to ask unanimous consent that the Ranking Member<\/a>s and myself be allowed to have 15 minutes each for questioning forowed by five minutes members. If necessary we will have a second round of questioning as well. Hearing no objections, so ordered. Dr. Lynch, ms. Mooney, mr. Huff. Thank you for attending. Would please stand and raise your right hand. Do you solemnly swear under penalty of perjury that the testimony you are about to wholee is the truth, the truth, and nothing but the truth, so help you god. Thank you, please be seated. Lynch, just today the v. A. Office issued an interim report lists,ying multiple other than electronic waiting lists and multiple types of scheduling practices that are not in compliance with v. A. Policy. When you went to phoenix after the hearing in this committee, did you identify these same or didduring your review you take merely the word of those in charge that everything was fine . Mr. Chairman, i have made three visits to date. The visit after which i reviewed my findings with your Committee Standards<\/a> was an initial visit. We had Little Information<\/a> to go on at the time. Identify and i did share with your Committee Staffers<\/a> that we thought we had identified an intermediate work that was used to identify veteran appointments that had been canceled for the purpose of rescheduling those veterans. Timeo indicated at that that it was my impression that the document had been appropriately destroyed when the veterans had been rescheduled. I also made it very clear to the Committee Staffers<\/a> that this was an iterative process, that we were going to continue our review. I returned about a week and a half later with two additional staff. Scheduling expert. V. A. ,nt a week at the understanding the process of scheduling that had been going on. Late 2012. I will be happy to outline a process for you. Beginning actually in october of 2012 the facility committed to identifying veterans who had been scheduled more than three months in the future. They identified more appropriate slots to see these individuals sooner. I apologize but we are not going to be able to have longwinded comments. You said you told the staff that theas your impression that list was destroyed. Is that what you are saying today . That is what i am saying. You were in the room at the time. Did he say it was his impression that the list was destroyed . You are under oath. I believe that is what he said. You believe or you know . I believe that is what he said, from my memory. Notes . Did not take any i took notes. And i dont have those in front of me today. Notes at that those notes havent been provided to this committee as part of the subpoena for all records talking about the destruction of the list, including notes, phone calls, emails, letters, and memos . I turned over all of my documents to the office of counsel general. Does anybody at the table know why those notes have not been delivered . The office of the general because this is a legal issue the office of the general counsel has the lead for the department. My understanding is upon receipt of the subpoena on may 8 the office of the general counsel the subpoenaing to and dedicating a significant number of employees and resources to that effort in pulling responses and email records. Excuse me, let me interrupt you. I will read you the definition in the subpoena. The term document means any written record regardless of how classified or unclassified him how recorded, and whether a regional or copy. Toluding but not limited memoranda, working papers, notes, letters, notices, confirmation, telegrams, in other words, everything. Why have we not received all of the documents requested in the subpoena even though we got a letter from the general counsel late last night that said the v. A. Was done. I understand the general counsel has held a very small number of documents for attorneyclient privilege. They have been in communication with your staff and ongoing discussions related to those documents. Are the records from a reefing part of the protected notes that the general counsel is claiming attorneyclient privilege about . Vista chairman, i would defer to the office of the general counsel for that. Again, is hasn, to v. A. Complied with the terms of the subpoena . It is my understanding that the v. A. Has complied with relevant information in response to the subpoena. Can you say anything without repeating without reading your prepared notes . This is within the office of the general counsel. The general counsel would be the appropriate party to ask. And we did ask the office of general counsel to come brief members last week and the general counsel declined. He said he declined because he did not want to brief the members, he wanted to brief the staff. Theres not a Single Person<\/a> sitting up here in this room that voted for the subpoena. The members did. Understands that we are deadly serious you can expect us to be over your shoulder every single day. While i have your attention can you please explain to me why we in fact have 100 and 10 outstanding requests for information, some dealing with this issue specifically . And if you want a specific one, why have you not told this committee yet who was disciplined enough gusto, georgia and Columbia South<\/a> carolina, where nine veterans died because they were on a waiting list for colonoscopies. Chairman, inw, mr. The last five years the office of congressional maam maam, veterans died. Get us the answers please. I understand that, mr. Chairman. And i will look that is what you said three months ago. This has been going on since january. Since january. , wease you dont know what put on our website every week what we ask for. And did nothing changes from week to week. We have an oversight responsibility in this congress and we cannot do our job appropriately if you dont provide us the information that we request. Dr. Lynch. Even the fact that you declare the issue a misunderstanding in the first brief, as staff has related it to me, and the office of Inspector General<\/a>s report issued today substantiated inappropriate scheduling and said it was systemic throughout the dha, do you believe you have the credibility now necessary to identify and fix the problems . Mr. Chairman, i believe i used the term is understanding with respect to the references that were being made to a secret list. I did not make any qualifications or statement as to whether i thought the actions occurring or appropriate. Is your contention still that there was no secret list . It is my contention there were a number of documents, three of which were identified. One of which we identified earlier that were working documents used to provide information about patients in addition to the waiting list or for rescheduling of patients. I did not think they were secret list. I think they couldve easily been misunderstood. I would remind the committee we discussed this last week as well. Lynch came back from phoenix and asked to brief the four corners in which a matter of hours we were able to have the four corners come together of the staff and in that you said and i would like to know what gave you the impression that the list had been destroyed. It had been conveyed to me second hand by one of the members who had been with us on that the center was using a documents to record the names of veterans that have canceled whose appointments have been canceled, so that they can be rescheduled. After the patient and veterans had been rescheduled, the list was no longer required and it was destroyed. It did contain patient identifiable information. Staff is telling me it was described to as a transitional document. I guess my question is was the list destroyed before or after this committee requested a preservation order for all documents . Was mya chairman, it impression that those lists were destroyed before your preservation order. I was trying to explain, before he asked me to be brief, that this was occurring between october and november of 2012 and mid2013. Visit weme of my first thought the transfer was occurring to the electronic waitlist. We learned during the course of the second visit that the transfer and use of this document was occurring during the course of rescheduling patients because they were trying to provide care more promptly and never tried to consolidate clinic profiles to make the clinic management more proficient. In that process patient appointments were being canceled. The scheduling system that v. A. Uses automatically generates the list of patients who are canceled and so that list can be used to reschedule patients. Once rescheduling has occurred the list is no longer necessary. It is appropriately destroyed as it does contain patient identifiable information. It is my understanding that this did occur through late 2012, mid 2013. Why didnt we know that if we are not first asked about it . I had only come back from the first visit. If it wasnt until we took back the team and spent a week there, working through the entire process, that we understood what had been going on, mr. Chairman. Written a letter asking for that specific information. Has it been responded to . , hencenever responded to the subpoena. We are trying to get answers, nobody is giving the answers to us. That is why we are here tonight. Real quick before my time runs , according to an internal report in the v. A. An employee reported that the way time at los angeles will Angeles Center<\/a> was being manipulated. Email a senior official substantiated, there appears to be inappropriate actions by the supervisor in los angeles. Thed you comment for committees behalf what is going on in los angeles . Chairman, the only concerns i am aware of related to Greater Los Angeles<\/a> were concerns expressed by an regarding the cancellation of radiology orders, which were felt to be stale. Stale, old, and no longer appropriate. Onis my understanding, based discussions with the chief of staff as low as the chief of radiology, that this was done after a careful review of those iners and a cancellation case they needed to reschedule that request. Single veteran was contacted and have one of their orders canceled. That is what i was told it cooks let me give you a little hint. Told. Let me give you a little hint, the v. A. Wont tell you the truth. Relying solely on the management at these facilities to tell you the truth, youre not going to get it. You are not going to get it. Before my time runs out, very quickly, the complaint is not radiology. It is exactly what we are seeing all over the country. That youd suspect better have somebody go to los angeles quickly before they start destroying secret lists. Much if youman share the documentation with me i would be happy to follow up. I think you know my commitment to veterans. Thank you very much, mr. Chairman. Lynch, on what state did you become aware there were allegations of problems in phoenix . On april 9, 2014. On what date did you travel to phoenix to investigate . I made the first visit to phoenix i believe on april 17. It was the thursday before easter. I was there until tuesday of the following week. Day was that the day he returned back to d. C. . On april 23 it was and i came down to discuss the initial findings with the Committee Staff<\/a> on april 24. Under whose directions did you fly to phoenix . Dr. Robert petzel had this had asked me to go. Who did you travel with . And my wife joined me for the weekend. Can you please explain your role in the initial investigation in phoenix as well as the role of the individuals that you are with. Phoenixitial role in was to get an understanding of what had happened, to get a sense for how the congressional delegations as well as the veteran Service Organizations<\/a> reviewing the allegations. I brought with me to individuals brought with me two individuals who did some initial work in discussing scheduling processes in phoenix. I focused my attention in working with the Quality Assurance<\/a> department to identify what they had, what information they had four deaths they had on deaths that occurred. Praise put in in place a process to match potential delays in care so you can see whether or not any of the deaths they had records of were related to delays in care. You said you talked with mike davis. Mike davis did go down with me. Along with a scheduler. They spent their time talking with the folks in the scheduling office. An understanding of their clinic management models. I thought you answered my question when i asked certain when i asked you who you travel to phoenix with. I flew by myself, they joined me there on the following easter monday. When did you become aware the phoenix facility had used an excel spreadsheet in regards to patient scheduling . Dr. Davies had indicated to me there had been dr. Davies dr. Icated me davies had indicated to me there had been a transferring to allow rescheduling of those patients. We found that spreadsheet reference to be incorrect when we went back to the second week and worked through the process more completely. The second visit occurred during the week of may 5 through may 9. I left on saturday, may 10. During what time was the spreadsheet used . I no longer think it was a spreadsheet. We now believe it was an intermediate product generated by the vista system. A when you when you cancel a patient it generates a document saying these are the patients you canceled. It provides their Social Security<\/a> number, the date of their appointment, and time of their appointment, so you can use the information to reschedule the patient. The day that mr. Davies informed you of the spreadsheet what was the date . At the time with at the time we thought it was. This was an internship process an interest process. I believe he informed me on or 22nd imst sorry, april 21 or 20th. That theform the staff spreadsheet was destroyed at some point. One was that destroyed and who authorized it . That destroyed and who authorized it . It is my understanding that it was destroyed when the patients were rescheduled, which probably would have been late 2012 through mid2013. It is my understanding that the paperweights list paperweights list paper waitlist mating clue to may include did you become aware of any other items that may be loosely considered a paper waitlist . Oururing the course of second week, my second week, we three additional documents. There were also referenced by the Inspector General<\/a>s report. Were the requests to schedule a consult, which was generated from the Emergency Department<\/a>. And they were requests to schedule that were generated one the v. A. Helpline nations called in and asked me for an appointment. Discussionorized the the destruction of the list . Not sure who authorized the destruction . I think the patients entry had been added onto the electronic waitlist or the patient had been scheduled that it was appropriate to destroy that document because it contained patient identifiable information and could potentially have adverse consequences if it was not destroyed. And was at the director of common policy was as common policy that it be destroyed . It is my understanding that we cannot keep a list of personally identifiable information once they have served their useful purpose. If you identified other items that you view as a paperweights list, what were they and when were they used . The only three documents that i identified was the intermediate work product generated by vista, the v. A. s health record, that documented the names and Social Security<\/a> numbers of patients whose. Ppointments were canceled the near list is a document generated by the a in response to an roly requests for appointment. There were documents used to restore the requests for consult the Emergency Department<\/a> and the documents used to transfer information about patients requesting appointments when they call the hotline. Going back to when you first came first became aware of the problems, can you detail what steps were taken in response to these allegations . The steps include the following. Back so we cango develop an understanding of what scheduling processes were going. During the week of the fifth a second team arrived from the office. Their focus was to take the information we had gathered, develop recommendations, and greater efficiency. The week after he left there was a second team that arrived some experts who are working with the clinic to look at their processes and ensure the clinic was functioning so that we are not missing valuable resources that can provide care for veterans. Who was a part of the second team . I do not recall at this time. The name slipping my mind. In charge of the v. A. s response . The v. A. s response was led phoenix. Le i was in if working groups were formed to address the allegations in phoenix, under Whose Authority<\/a> where they formed and on what date . I cant tell you under Whose Authority<\/a> they were formed. The process began to come into play probably late in the first week of may. As he began to develop a way for it. What was your initial assignment when you are first asked to go to phoenix . First assignment was to go down, tried understand what was going on, try to understand the that was present within the organization, and also trying to identify what information is they did have about deaths that may occur in their facility. Surprised by the interim reports released today . Not at all. I would emphasize that i did contact the ig. I shared the information that we found with them. It does not surprise me what they reported. We shared that information with the ig. Nothing there was a surprise . Not looked at the numbers of patients that were on those lists. But Everything Else<\/a> we identified in the course of our visit. Mooney, in looking at the documents the v. A. Has produced in response to the committees , are you aware if the response includes any documents or emails or data prior to april 24, 2014 . The subpoena was responded to by the office of the general counsel. I dont have knowledge of them. Can you please explain the difficulties that you faced entering faced entering the questions posed by the Committee Weeks<\/a> ago . Faced answering the questions posed by the Committee Weeks<\/a> ago . When was the spreadsheet that was mentioned by dr. Lynch destroyed . Dr. Lynch did not provide a response to the committees may 1 letter regarding his statement the april 24 staff reading staff briefing because the office of the Inspector General<\/a>s investigation was ongoing, as well as his own investigation. At the time it was my understanding that there were no facts to respond to the committees respect respect in the letter. Is this unique to the v. A. , when you talk about your attorneys . By the technical difficulties, and among all agencies or specific to the v. A. . Difficulties . Im not sure the current concern i have is the committee asked for very basic questions, very narrow questions that would not interfere with the Inspector General<\/a> reports. We thought it was something we should be able to get without any problem. There seems to be an ongoing delay in getting information to the committee. Anytime we ask for certain information, the standard response is we cannot get that because of legal counsel. What appears to be unresponsiveness from the department were very basic questions that we originally asked for be issued the subpoena. In the case of the subpoena, we have a number of staff in the office of general counsel. I know that they worked weeks to provide the documents in response on a rolling basis. Why didnt you tell us about the ig investigation . Instead of you ignoring us . Why did you not tell us . Therefore, you could not respond. I believe my recollection is we im not sure. Thank you. He was in arizona at the same time we were there. We did talk with them to ensure we were not in their way. Yes. Yes. Thank you. Before you question what is, i must call for the resignation of secretary shinseki. I was waiting for permission to be gathered to make my judgment. Based on the Inspector General<\/a> report that came out today, our veterans in phoenix and maybe other cities have not been treated fairly. This report states our review and a growing number of va medical facilities has confirmed inappropriate scheduling practices are systemic throughout va. The tragic possibility of veterans who died while on the waiting list have died because of the waiting list is still open. It will hopefully answer this in their final report. Even if they do not know in advance of these wrong doings, these violation should not have happened on his watch. I believe success in the military does not automatically translate to success in the policy and political realms. You have a concrete example of failure of policies a failure of leadership. Funding hasnt been an issue. It was a failure. These veterans should not be on waiting lists. They should be seen immediately. Many veterans are on a secret waiting list in phoenix with the average wait time of four months for a visit. We know a similar story is emerging elsewhere. Why are thousands of veterans waiting months when theres a system in place to treat these men and women in the private sector . If care is not available at the va, they can go to any private hospital or clinic and get immediate care. Why is that not being done . Congressman, that is being done. There are plans in place to contact every one of those veterans by a close of business on friday. Their need for care will be assessed and they will be offered services if appropriate. Across vha, theres also a process in place that began approximately a week or so ago. That process is asking each of the facilities to look at their wait list to identify those patients who are waiting for care and to contact those veterans and to offer them services if that is what they request. Im glad you did not say that you are waiting for more money from congress. The money has been given to you. The money is there that money has carried over each of the last five years. 1. 1 billion. Even this year, we anticipate half 1 billion being carried over. Money is not an issue. Care is an issue. You need to assure if they had been waiting, we identify them and we provide care in the community if necessary. I would view the type of Disaster Relief<\/a> that veterans are entitled to and the money is there. I recently spoke with the directors of Va Health Care<\/a> facilities in colorado and asked them about whether there are waiting list in colorado. They assured me it wasnt to their knowledge. When the information comes out, a report like this that there are systemic problems throughout the country, we have problems getting the documents that we want. Trust has eroded. What can we say to veterans to restore that trust . I think we have a real problem with broken trust. We are here this evening in good faith to answer the best course of action. We pledge to work with you to get you what you need. Thank you. I yield back. Thank you. Thank you, mr. Chairman. I have been on this committee for 22 years. Before i begin, i am going to put on the record a letter that i am sending to the governor of the state of florida. He is grand standing and indicating that he is suing the va for the fact that he is sending people to the various va facilities around the state of florida and he wants to take a look at the record. This is the most grandstanding i have seen since i have been in congress. The state have absolutely nothing to do with the va. We have over 4 Million People<\/a> that need medical expansion of health care. They are not getting the Quality Health<\/a> care that they need. Can you tell me anything about the lawsuit and whether or not governor rick scott has sent people to the various va facilities throughout florida . Im certain it has never happened in the history of the United States<\/a> of america. Congresswoman brown, i havent heard of anything like that before these instances. I would be happy to take your request to the general counsel and intergovernmental partners. Speaking of partners, i personally went to california. I reported to this committee that we had 400 units that we have built that were standing still for two years and no veterans were in these brandnew facilities. 400 units in los angeles. Were not talking about problems that just started at va. It has been problems for years. Lets be clear veterans were given the runaround from the va system. There were millions additional veterans brought in. He have a responsibility to make sure that they are taking care of. I can tell you we are doing fine in florida. We have a new bill in orlando soon, i hope. I have been working on it. We have a wrapper around in gainesville. We have new cemeteries in florida. We serve almost 600,000 veterans a year in florida. I can truly say i went and i talked to various groups and not one single complaint. We are doing our job. That is what this committee is supposed to do. Make sure that the va is doing what we commit to veterans. Lets forget the grandstanding. I see a lot of it. We do have money for the veterans. For years, it was just talk. It was just talk. Under this president when we have a Democratic House<\/a> and senate, we got the largest va increase in the budget in the history of the United States<\/a>. We do have the money. We have got to know were not just talking the talk, but walking the walk. Is there any Additional Information<\/a> that you want to give me about the overall problems with the va around the country . I know florida is not included. Thank you, congresswoman. I want to make sure that i choose my words carefully. I have thought about this for a long time. Let me begin by saying that i think it is absolutely critical that the va maintains its focus on its mission to serve veterans and its core business to provide for primary health care for our veterans. It is important to the member that we have a good system. I think it is worth stating. The quantity of health care we provided health care to over 2 million new veterans. Our Performance Measures<\/a> however have become our goals. We believe our access numbers, but we undermined the integrity of our data. We were told that the scheduling system was challenged, but discounted the reports and patient concerns as exceptions and not the rule. We could and should have challenged those assumptions. This was an insidious process. It is not apparent will happening. I think having said that, there is a way forward. We must charge our Medical Center<\/a> directors and Network Directors<\/a> to assess the integrity of organizations. We can assign resources appropriately. We will also need to ensure a relationship with congress. This will be essential. Va has faced criticism in the past and is better for it. In the 1940s, omar bradley and others remodeled the be a system and involved academic artist and established a research presence. In the mid80s, there was questions about the quality of surgical care. They developed a risk adjusted care model that has been adopted by the care sector and is being used to assess mortality across the country here in the mid90s, or were concerns about va care and emphasize Outpatient Care<\/a> and began to implement the use of Electronic Health<\/a> records has been used by health care across this country. We have a Good Health Care<\/a> system. We have a good foundation. He have challenges. I recognize that. Working together, we can solve those problems and once again provide evidence of an Excellent Health<\/a> care for our veterans. Thank you for the additional time. Thank you. Could you give me the documents and ill ask for Anonymous Content<\/a> it be entered into the record . Without objection, i also asked for consent for another to be joining. Without objection. Thank you. I appreciate it. Thank you for your strong leadership in this area. I will jump right into the questioning in the interest of time instead of making a statement. In the correspondence sent to our committee it was confirmed that the interim way to list was maintained and destroyed, which are told the house and senate Committee Staff<\/a> in april 2014. Is that correct . That is my understanding. How and when did you become aware . I first became aware of the reference i would correct the concept that this was an interim wait list. This was a work product generated by the vista scheduling system that itself, that it was not a waitlist, but a work product. What about the retention period regarding patient records . Do you know the current policy . I do not have the policy available. It states Disposal Authority<\/a> is obtained from the archive list of the United States<\/a>. The next question for the entire panel what was the reason for the destruction of said documents . I would like to hear from the panel. I will start. It is my understanding that there were intermediate work products. When their usefulness had been served, it it was appropriate to dispose of it. Yes. I have not been involved in that investigation, nor was i present at the staff briefing. I defer to dr. Lynch. Doctor . The records of patient cancellation are preserved in the Overall Record<\/a> system. This was used as a process to ensure they knew who canceled so they could get rescheduled. Were were these documents destroyed . Sometime in late 2012 and may 2013. Did anyone from the va or thirdparty conduct some i dont have knowledge of that. How long was interim list in existence . Are you aware of any documents currently in use . Just like this interim list . To my knowledge, there were list that was used to transfer request for care from the Emergency Department<\/a>, as well as request from the va. I believe there was reference within the ig report should i believe that the ig also referenced information into the electronic waitlist. Who within the va is is possible for the management and maintenance of va policies for record retention . Is anyone on the panel know . I do not know. We will have to take that for the record. Anyone else know . Can you please get back to me. Do you believe whoever it might be, he or she, or be held accountable and penalized under va controlling scheduling guidelines and destroy records without power or authorization . Who can answer that question for me . Congressman anyone else on the panel . Thank you very much, mr. Chairman. I appreciate it mr. Chairman. I yield back. Thank you, mr. Chairman. You know, the v. A. Is a huge and complex organization of many, many facilities. And such a bureaucracy is under siege, people often run for cover. I recall an incident in postapartheid south africa when they were looking for accountability, there was something called the Truth Commission<\/a> to encourage people to tell the truth. I was reminded of this by this New York Times<\/a> oped piece by dr. Sam foot, the retired v. A. Physician who blew the whistle in the Medical Center<\/a> and he suggested an alternative to the secretarys approach to the internal audits. He was skeptical that they were doing with to work and produce good data. He believes that the Government Accountability<\/a> office should conduct a survey of care providers and other Health Professionals<\/a> at v. A. Hospitals to find out what they think the new and returning waiting patient times are and then give the Hospital Administrator<\/a>s a oneweek amnesty period to record report their waiting times. I think we welcome help from any Government Agency<\/a> in informing problems and helping us come to solution. Whether thats the best option, i dont know. But we have certainly valued the reports from the g. A. O. And the o. I. G. In the past. Could you comment . Thank you. We value collaboration and working to provide our veterans the best care. I work hard every day to do my job and provide the information that the committee needs. I took note of this mainly because it was the whistle blower himself that suggested we try another approach in terms of trying to get Accurate Information<\/a> from the v. A. Employees. Is Congress Going<\/a> to get a list of the scheduling practices similar to those at the phoenix v. A. Hospital . I for one would like to know if the hospital that serves my area is using the same practices . I believe v. A. Is conducting a nationwide audit. I dont believe there is any intention not to share that with congress when it is completed. I appreciate that. Again, this audit is the very issue that i am sort of raising about how do we get a good audit . That concludes my question. I yield back. Dr. Row you are recognized. I am a veteran and physician and i trained at a v. A. , some of my training was at a v. A. It is disturbing to me that we have created this uncertainty among our veterans in the country. I think we have lost a lot of trust and i want to ask do you agree with the interim report that the i. G. Just produced that we have today . Do you agree with the findings . I do. And we have a situation where you say 1,700 veterans are going to get care. Why in the world do we have to have hearing after hearing after hearing. We are here on a wednesday night about 1700 veterans. Why wasnt this just done . Let me just read this to you right here. The length of time these 1,700 veterans wait for appointments are added to the electronic weight list will never be captured in any wait time data because the staff had not yet scheduled their appointment or added them to the electronic waiting list. It is the ultimate catch 22. Let me also ask you, here are people out here. This is what troubles me most. Look. I get being overworked, having more work than you can do and patients than you can take care of. I have got that. I understand that completely. What i do not understand is creating a list right here that has people waiting until they can get on another list to show they can get an appointment and then someone gets a bonus, benefits when veterans are suffering. Is that what happened . I think it is. As i mentioned earlier is that what happened . I think we elevated a performance measure to a goal. I think people lost sight of the real goal of v. A. , which is treating veterans. They goon focus on achieving a 14day achieving care within 14 days. I agree with you. Would you say those particular goals right there that the v. A. Set up and obviously you had people playing games with it, hurt veterans. Congressman, they were flawed measures and it should not have happened. It should not have happened. Do you think it is happening around the country in other v. A. Centers . I think the evidence suggested this could be a systemic process. We need to focus and we need to get the veterans seen in timely fashion. What i dont understand as a veteran and a doctor and a practitioner, how you can look at yourself in the mirror and not throw up knowing you have people out there. I cant go to v. A. I make too much money. Im ok with that. I have good insurance. I see some of these people out there. They live in my communities. They cant get in and they are desperate to get in and someone who is making 180,000 a year gets a bonus for not taking care of the veterans. I dont get that. Congressman, what has happened is unacceptable. But i have to go beyond that because i have to figure out how to fix the system and that is my goal and purpose. To understand the problem and ensure it doesnt happen again. I certainly dr. Lynch, thank you for that. The next question i have is to the panel. It is not necessarily you im directing it at. Why would any information we ask for be withheld . That creates an uncertainty among us here. If you dont give us the information, im thinking there is something they are trying to hide. Why dont you just turn over the documents . They are what they are. Just tell the truth. Is there a reason . I cant understand why there wouldnt be one thing they ask for that they dont have right in front of them right now in my mind im thinking right now they are hiding something from me and i have no reason to believe youre not. Congressman, our goal is to be open and transparent. The documents are not coming in. Excuse me, respectfully. If that were the goal, the chairman would have all the documents he asked for. Respectfully, sir, the office of General Council<\/a> responded to the subpoena in accordance with the subpoena document. And we continue to work with staff on the few documents under discussion as well. My time is expired. Maybe we can get a second round. Thank you, mr. Chairman. I would appreciate all of you being here to answer the committees questions this evening. Mr. Chairman, i share your frustration. Im very troubled by the slow pace of the v. A. s response to this crisis. What has and in phoenix and what clearly is happening at the other facilities across this country is in my opinion unforgivable. We need Decisive Action<\/a> now. Wellstated and good intentions just wont pass the muster. As the Ranking Member<\/a> stated in his opening remarks, we must have accountability wherever it leads us. I sincerely believe that everyone in this room wants to ensure that our veterans receive the best possible care in a timely manner. But we will only achieve that goal when we have honest and open lines of communication from the v. A. Our veterans deserve nothing less. And from the top down and the bottom up, the v. A. Needs to level with this committee. Needs to level with our veterans across the country and needs to level with the American People<\/a> about what has happened and how we are doing with to fix it. Hiding the truth is absolutely unforgivable. And the damages are compounded when we dont act quickly and decisively to all of the facts so we can then act upon them. We need the truth and need v. A. To be proactive, not reactive, and we need the truth now. I just wanted to make that statement. I will ask my first question to dr. Lynch. The chairman asked a question about the greater West Los Angeles<\/a> facility and you answered some of his questions. I wanted to follow up on that. Given the fact that we are going to have a nationwide audit, i want to know the progress of those audits as particularly as it relates to the west l. A. Facility and im also i want to know the steps that were taken in phoenix with regards to destroying the work product, destroying the documents after patients were inputted into the electronic system. Is that still occurring . Is that still a practice that is occurring in i know not in phoenix, but in other locations across the country and how are we actually handling, you know, patients right now . Who are waiting to be seen. Talked about the 1,700 veterans in phoenix, but what about veterans across the country who are waiting waiting for appointments as well . Congresswoman, let me try to take your questions in order. The audit that has been going on by v. H. A. Across our system began a week ago. The first phase was focused on Medical Center<\/a>s and communitybased Outpatient Clinics<\/a> serving greater than 10,000 patients. It is my understanding that the review at Greater Los Angeles<\/a> has already occurred. I have not seen those results yet. At the secretarys insistence, that review has been extended to all v. A. Care facilities. I believe that second phase has been in place last week and this week. Regarding other veterans across v. H. A. A process has been in place. Medical centers, all Medical Center<\/a>s have been asked to have patients who have been placed on a wait list, patients who are waiting for care, they are charged to submit that list to v. A. And they are then going to be asked to review their resources. Can we provide care internally . If we cant, the plan is to contact those veterans, offer them care, if we can in v. A. , if we cant, offer them care outside of v. A. How long do you think that is going to take . I dont know the time. I cant tell you exactly how long it is going to take but the plan is it should be done quickly. We appreciate your concern that we should not have veterans waiting. How much time are you going to spend assessing the situation before we would the other parts of the i believe the plan is it should be completed in a week or less. So we can begin assessing our resources and contacting veterans. Ok. Thank you. The other question i had and maybe this is for the assistant secretary i apologize. I yield back. Hopefully ill have another chance. Mr. Flores youre recognized. Thank you, chairman. And thank you, panel. When the v. A. O. I. G. Went to phoenix to look at what was actually happening there, they did what auditors do, they took a statistical sample of files to see what was reported and what was actual. The sample set was 226 veterans in this particular case. The original report from the phoenix v. A. Facility was that these 226 veterans waited an average of 24 days for their first primary care appointment and only 43 waited more than 14 days. When the i. G. Did their study of what actually happened on those same 226 cases they discovered they waited an average of 115 days with 84 waiting more than 15 days. Based on what they found in that sample, you have to extrapolate that and assume that all of the appointment process is as broken as those 226 are. Who is responsible for reporting fraudulent numbers to the v. A. Central office . When you look at a v. H. A. Facility, who in that facility is responsible for reporting those numbers up the chain so to speak . Mr. Congressman, i believe the responsibility for reports from the facility lie with the Medical Center<\/a> director and with the network director. Ok. I think you touched on this a minute ago. What is the driver that causes them to engage in that activity . One thing i learned from today based on another article that came out is that 50 of v. H. A. Executive performance reviews are based upon wait times. Is that one of the primary drivers that is causing this misbehavior to occur . Mr. Chairman, i dont know to what percent for the Medical Center<\/a> directors the wait times measures contributed to their bonus. I dont have that information. I will reinforce what i said earlier. I think that while well intended we had a performance measure that became a goal and that created the potential that that information could be misused. The last time i saw an example of this was enron. Where the bonus system drove behavior and we all know what happened at enron. Im not suggesting that the v. A. Is enron, but it is something that i think we need to look at this terms of flawed bonus system and driving bad behavior. That leads us to the next question. We just said we just heard testimony so far in this hearing that veterans really dont have to wait because there is a fee for Service Program<\/a> where the v. A. Will send them out to private sector doctors. If that is the case, the v. A. Can do this, why then do we still have the long waiting list . Is that because they are not really allowed to go out for a fee for service . I think that we had tried prior to the information that we had received, we had felt that our core business was the delivery of primary care. We had tried to keep that one v. A. In retrospect, i think that was not a wise move. I think we did have the potential that patients were waiting and we should have provided feebased services while we were trying to improve the processes so that we could provide that care in house. Ok. There is a publication that i dont read very often called the daily beast. They had a report that ran about 11 00 last night. It said texas v. A. Ran like a crime syndicate. President obama planned to address allegations of corruptions but before the president could deliver on his pledge, the scandal spread even further. New whistle blower testimony implicates the hospital in intersection widespread wrongdoing in what appears to be systemic fraud. The facility they are talking about here is a facility in temple, texas. Are you aware of any similar issues that occurred in phoenix as having occurred in temple . Im not aware at this time. Ok. I would urge you to read this particular offer. They post pictures of the email chains that make it look like there was a coverup. One doctor would cancel appointments and they would have to be rescheduled. Thank you. I yield back. Ms. Titus. Youre recognized for five minutes. Thank you for holding this meeting late to accommodate us who had to fly back from the west coast. We appreciate that. Like my colleagues, i too want to get to the bottom of this waiting list problem in phoenix and across the country and many of my questions have been answered. The i. G. Is not going to release, as i understand it, the names of the other facilities that are being investigated primarily to protect the whistle blowers. Ive asked that nevada be added to that list because i want to be sure that the veterans there are getting the kind of services they deserve and there are not any secret waiting lists. I want to ask kind of a different line of questions because i think they go to the point of priorities. And i think priorities are kind of some of the problem that we are facing here as we look at the waiting list issue. Dr. Lynch, you mentioned that you went to, phoenix to check into the accusations that 40, that people had died as a result of this secret waiting list. You went on to note that you went on thursday, april 17. You spent the easter weekend there with your wife and then you were joined by two staffers on monday april 20 to begin working on the issue and then in your words, understanding the climate. I would just ask you, doctor, to tell me how you could have possibly thought it was appropriate to turn such a capitol hill critical, Serious Mission<\/a> into a personal holiday . Dont you just get that . That you postponing looking into something that should have been looked into right away . And also tell me then, how i can explain your actions to veterans who are worried about getting an appointment for possibly a life saving colonoscopy, not a tee time. Congresswoman, i do not play golf, to begin with. I take my job seriously. It was easter weekend. I thought it was appropriate that my wife could join me. I spent thursday and friday working at the v. A. I spent monday and tuesday working at the v. A. There was nothing i could do over the weekend. I went back to get more information, congresswoman. I think i took the issues in phoenix very seriously. I think what we found was shared and confirmed by the Inspector General<\/a>. I think because of what i did in phoenix, we were able to get people on the ground to begin the process of making recommendations for change. So im sorry you misinterpreted my intentions. My intentions are to help veterans to assure they get good care and understand where our system is failing. That is our intention too. We feel like we need to work 24 hours a day, seven days a week to make this happen. Not taking holidays off. But i appreciate that and i yield back. Thank you very much. Youre recognized for five minutes. Thank you, mr. Chairman. Mr. Lynch, i just want to make sure this is clear. You believe phoenix is an isolated incident or you believe this entire problem is a systemic issue . I believe the Inspector General<\/a> has made it clear this is a systemic issue, congressman. This is something that goes back to 2005. We have had investigations over and over and asked for many different 18 reports have been identified coming back. You said in your testimony of october and november of 2012, there was a report that came back, we were working on this in 2013. You talked about a glitch in the system. This doesnt seem to be a faulty Computer System<\/a> that were dealing with here. Congressman, i think i made it clear that it is important that we need to keep our eye on what is the mission of v. A. I think that we have elevated Performance Measures<\/a> to goals. I dont think that is a glitch. I think that is a mistake. And i think that is something that needs to be corrected. I think we need to use Performance Measures<\/a> for what they should be used for. Management tools to identify where we have demand. Where we dont have capacity and how were going to use our resources. Sir, i dont think anything is clear at this point. Thats why you see so much frustration. The only thing that is clear now is that there are 40 brave soldiers that served their country proudly that died while waiting on a list. That is the only thing that is clear. What is unclear is how much further this goes. How many other v. A. Centers . How many other veterans are waiting . And we expect answers. Thats all were looking for here. So you started audits now, beyond phoenix. 42 audits have been started . Im sorry, sir . 42 audits have been started now . No, sir. We have reviewed i believe all of our 150 Medical Center<\/a>s and additionally, our major k box and now are in the process of reviewing all of our healthcare facilities. How many have been completed thus far . I dont have that number but certainly well over 200. Your intent is not to share that with congress . I dont believe said that. Well, let me ask you then. Is it your intent to share it with congress . I dont know why we would not share it with congress. It is my understanding that palo alto in any area has already conducted their audit. I sent a letter on may 19 asking for not only an audit but a review. Now im told by the palo alto unit that it has been completed but we are unable to receive that information. Ill make sure you get a copy of this letter as well. Every member of this committee and of congress is going to be looking at their local v. A. Centers wanting to know the truth of whats happening in their communities. Im sure they are. That is proper and right. We have a nonv. A. Fee care program. We have implemented a program which used Community Providers<\/a> to provide care. I will share this with you today but i know of doctors in my area that have asked to help out our veteran population. There is no reason. There is money in the system. There is waiting lists. Why we wouldnt be utilizing more doctors to fulfill those claims. And we are going to be doing that. Mr. Chairman, ill present one of these letters for the record and provide mr. Lynch the other one. I yield back. Without objection, ms. Kirkpatrick, youre recognized. Thank you. We all know there is a problem here and i appreciate you making it a priority to fix it and come up with solutions. Im the only arizonan on this committee. Ive been hearing from lots of veterans in arizona. I called for a systemwide audit. I want this fixed in arizona so that we can get the veterans the care that they want and they need in a timely way and thats what im hearing you say. I really think listening to our veterans is key to resolving this issue. So my first question is when you did your assessment at the phoenix v. A. , did that include talking to the veterans who had experienced these delays . Did not talk to any veterans during the course of that visit. I had subsequently received a phone call from one veteran who has had troubles with access and i am working with him to assure that gets the care needs. My i just suggest that we include our veterans maybe a little more in this process . I share somewhat the concern that he expressed about how do we know were getting Accurate Information<\/a> and i sometimes think getting it from a couple of sources helps with that process. Im certainly hearing from a lot of i dont disagree with you. I think the veteran is our customer. I think we can learn a lot by talking to the veteran in the experience they have. And what the record shows in terms of the wait time. You have identified the 1,700 patients wholl be contacted by friday. Can you tell us a little bit more what contact means . Does that mean an email or phone call . What does contact mean by friday . We are going to be using the Central Business<\/a> offers call center out of topeka, kansas. We will make an attempt to contact by telephone every veteran that is on that list. If we cannot contact them, we will be sending them a registered or certified letter to assure that we have gotten in touch with them. That we have determined what their care needs are and we have arranged for those care needs as necessary. You know, i respect a large rural district. A lot of places dont have access to broadband and a lot of places dont have mail delivery. Im concerned that the rural veterans that im hearing from are not going to be contacted in a timely way and maybe i can work with you about some suggestions. I know that the v. S. O. s would like to be very involved in this process and sometimes they are the point of contact in these Rural Communities<\/a> and offer that as a suggestion. Thank you. At this point, we are open to any suggestions that improve our process and help us contact the veterans. Now, my second question goes back to original purpose of this hearing. Which was responding to our subpoena. So during your first visit to phoenix, which was april 1723, did you receive or spend any interim work product that in any way referenced the destruction or deletion of an alternative patient wait list . To the best of my knowledge, congresswoman i dont believe i communicated any of that via email. I believe i communicated it to v. A. Central office when i came back and i believe i communicated it to the Committee Staff<\/a> the following day. Ok. Thank you. And i yield back, mr. Chairman. Thank you very much. Mr. Runyon, youre recognized for five minutes. Thank you, mr. Chairman. Something i read in the o. I. G. Report today touches on this credibility issue. And i want to ask you a couple of questions about it. And first, im going to paraphrase it. Its the last paragraph of page four. Where it says certain auto controls within vista were not enabled. Does limited v. H. A. And o. I. G. Ability to determine whether or not any malicious manipulation of this data had occurred . To ensure proper oversight ability is not compromised. And the i. G. Asked that it be turned back on. Are they turned back on as of this day throughout the country . I dont know, congressman. Do you know what those switches were the controls would have been . I read the report at 12 30 and not familiar with the auto controls. I can assure you i will find out. I will understand them. They will be activated at the request of the i. G. Following up on those questions, as part of your proprietary software do they have to be turned off or come out of the box in the on position . Was someone asked to do that . I dont know. I would love to know that answer. Those are questions we need to ask. I will extend it and will indicate that not only do we need to understand whether that was occurring in phoenix and whether its been corrected. We need to understand whether that was occurring elsewhere in our system as well. It not only compromises our ability to do our oversight job but your internal ability to do your own thing. Congressman, we are attempting to put in place audit tools and if theres anything that makes those audit tools more effective, we are going to be assured were going to assure that they are functioning. Going back to mr. Huff, your notes were given to the general counsel. They were not destroyed, correct . Correct, congressman. Thank you. Mr. Chairman, i yield back. Thank you very much, mr. Reese. Youre recognized for five minutes. Thank you, mr. Chairman. For holding this hearing. I am deeply disturbed and furious about the recent reports of forged record keeping. And veterans having the quality of their care negatively impacted due to long waiting times at v. A. Facilities. The veterans in my district and across the nation deserve better. To begin the healing process of this broken trust, the v. A. Must answer to this committee and more importantly, to the veterans who served our country. Any v. A. Leader or whoever knew about this breach of public trust and did nothing should be held accountable or resign. Im an emergency medicine doctor and know first hand that delays for much needed care can harm the patient. So lets take care of our patients. And this is the prescription to begin that process and what should be your priority right now. First, do the right thing and immediately ensure that no other forged waiting list exists anywhere else. Second, give our veterans the care they need as soon as possible and without delay. No more harm to our veterans. Third, conduct this systemwide, honest and transparent investigation and hold those found to be dishonest and negligent accountable and help those who serve our veterans with excellence and distinction. Hire and train new employees who will show our veterans the respect and honor that they deserve. As a physician, Public Servant<\/a>, and more importantly, as an american, im committed to ensuring that all veterans receive the medical care they have earned and need when they need it. And that those responsible are held responsible. And as a Public Servant<\/a> and advocate for veterans, i have written a letter to director stan johnson who oversees the loma linda v. A. Health care system to obtain Additional Information<\/a> on how long veterans are waiting for care in my region. Can you assure me that the loma linda v. A. Health care system in my district is included in a system wide, honest and transparent investigation to ensure the veterans in my district are getting the care that they have earned and need . To the best of my knowledge, congressman, loma linda has been included in that process. And from your expectations and performance metrics, can you comment . On whether or not we have any waiting list there . I cannot comment, congressman, at this time. I have not looked specifically at the data from loma linda. Ok. I look forward to working with you to ensure that the veterans in my district and everywhere else will get the care that they need when they need it and we can lower the waiting time so that this never happens again to any of our veterans. I cannot disagree with it, congressman. Thank you very much. And i yield back my time. Thank you, doctor. Dr. Benishek, youre recognized for five minutes. Thank you, mr. Chairman. Dr. Lynch, whats the name of the person who destroyed the waiting lists . First of all, i dont believe they were waiting lists. Well, who destroyed the documents under question here . The name of the person . They were schedulers who were working on the process of do you know their names . No, i dont. Could we find out their names . I dont know whether we can or not, congressman. To me, you talk about the motive for this. And the motive is that were trying to do this right. By complying with the rules and superfluous lists and danger of loss of getting their information. But that may not be the motive. The motive may be theyre complying with some somebody above who wants the waiting list to be short. So i think its important that we identify the people that actually did the destruction of these things. Ms. Mooney, whats the name of the general counsel that recommended that we dont have them the items here we dont have . Our general counsel will gunn is working with the committee on will dunn is the name of the gentleman that says this is a matter of privilege . His name is will dunn, is that what youre saying . Our general counsel is will gunn. Thank you. Have any dr. Lynch, who is your immediate supervisor . My immediate supervisor is at the moment dr. Robert jesse. We do not have a deputy undersecretary for health for operations and management. Have you had any conversation with or any communication at all with dr. Jesse about your testimony here today . Prior to the i met with him briefly this afternoon so that i understood exactly what our way forward was following the release of the i. G. Report. Deaf any recommendation for your testimony . Only to explain where we were going and how we were going to do you have any documentation of your conversation . No, i dont. Ms. Mooney who is your immediate supervisor . Sloan gibson. Did you have any discussion with sloan gibson about your testimony here today . Brief, in passing, in the morning. No documentation of any of that communication . No, sir. Mr. Huff, whos your immediate supervisor . Mr. Mark hone. Ok. Did he have any conversation with mr. Hone about your testimony here today . Yes, sir. And what was the nature of that conversation or communication . To provide clear, accurate, and honest responses to your questions. You know, its very troubling to me that we talk about accountability and making sure we know the facts here. But when you dont know the name of the people that actually did the destruction it seems like that would be the first thing when you went to phoenix youd find out who did it. So congressman, my goal in going to phoenix was to understand the process. I knew that the Inspector General<\/a> was there. They were there to assess intent and to identify if there was responsibility or accountability for without names of people, how does that occur . How does dont you ask the person why did you destroy this evidence . These lists . Why did you do it . These i did not speak to any of the schedulers did anyone on your staff do that . Pardon . Did anybody on your staff . You found out about it through a member of your staff i dont know whether the staff had spoken directly with the schedulers who may have been involved in what was the name of that staff member again . Pardon . The name of the staff i was there with dr. Mike davies. Did mr. Davies talk with anybody at the phoenix staff that may have actually done the destruction . I dont know, congressman. I just dont understand how you can conduct an investigation about the alleged destruction of documents and not actually talk to anybody or know the name of anybody who actually did the destruction. Or their that was the i. G. s function. They were there i thought you went there to figure out what was going on. I was there to understand the process. Wouldnt identifying the person who did the destruction of the documents . I did not didnt you have any interest in doing it . I didnt think that was necessary at the time. It seems to be the first thing you should ask and maybe im simple minded. But theres question about destruction of documents. And you dont even know who did it or their motive . I believe i understood the motive at the time. But your contention is that the motive was just and within the realm of the v. A. And protecting the patients records. Im suggesting to you that theres a possibility that theres motivation within the v. A. That encourages people to shorten waiting lists so that they get bonuses. You understand my concern about that . I understand your concern. Wouldnt that be something that you might be concerned about, that you might question the people that were doing the destruction if they had any communication with their supervisors that they might be pressured to do things that would allow their supervisors to get bonuses . That is a discussion the i. G. Is having. Why wouldnt you have that discussion . Because my goal, congressman, was to understand the process so that we could you cant understand the process if you dont understand who did it and their motivation. I yield back my time. Thank you, mr. Custer, youre recognized for five minutes. Thank you very much, mr. Chairman. And thank you to our witnesses for appearing here this late in the evening. I share the horror, frankly, of the allegations coming from the v. A. Facilities around the country. Including the v. A. Phoenix facility on the long patient wait times. And more importantly, the alleged misreporting of those patient wait times. And whats been referred to in the report is gaming of scheduling. Needless to say, i think this not a partisan issue. I appreciate your attempt to determine what was going wrong responsible and how to move forward, the question that as you raised a number your integrity, and question of accountability, because obviously the inner systemic icates mass problems with long patient wait times and inaccurate reporting this gaming that has been going on. Question is, this has been 2005 ion apparently since assume well before you were in your current position, well secretary shinsheki was position. Rrent and why were the issues ot addressed given this long number of i. G. Reports in the last 10 years. I think that to a certain failed to challenge our assumptions. We believed the numbers. Acknowledge in retrospect that did not happen. People trying very hard with the intentions to identify methods by which we could to v. A. Eteran access care. It has been a challenge. We have tried multiple different models. A challenge for the private sector. We were trying to find a solution. I believe we probably incorrectly assumed we had a solution. Become painfully obvious that we have set our system up informationncorrect and we need ensure that doesnt happen again. And my question about secretary shinshekis role. Is he involve in this . Secretary has been ware. Assure you has been s and directing s to vities to ensure we move a quick resolution on this problem. I want to go back to one of the documents in the report that the department of Veterans Affairs<\/a> memorandum april 26, 2010. Ts one of the attachments, appendix e. Theres a gaming schedule that concerns me. 15ients not checked in 10 to minutes prior to their sked yum time. Eterans think they have an appointment, they go to the appointment, and told they dont if theyappointment even have a card with an appointment. It seems to me that this has issue that gets exacerbated then these people being seen in a timely of in terms of continuity care. Have you had reports from physicians that their treat our trying to veterans in a timely, compassionate, and highquality way. I have not had individual complaints from physicians. Have been a v. A. Physician before i took this position. With valued my encounters veterans. I hope that i had provided good care. I share your concerns about any our system,at games not only because it hurts it veteran, because it doesnt make the position better. Very much. U i yield back my two seconds. Youre recognized for five minutes. 6 the client youre asking for that privilege . I would just defer that to council. E of general for s that been identified the committee, the client the privilege . Ient there has to be a client. Who is the client . Provide using to information to this committee and the American Public<\/a> about this issue . I know that i know its one of the eight people who have been subpoenaed. It to answer your question, is one of the eight people. My understanding about privilege, we get the privilege who the client is and that should have been noted in to supply l refusal the information. I would like to return to mr. As well and returning to your trip to phoenix and youre apparently oiag rprised by the report . No, im not. What actions have you taken weeks since that report if you could describe those since your visit . Well, maybe ts it is five weeks. Phoenixhad two teams in since my visit. One working with the scheduling team. The other working with the their care mprove delivery process. 1700ave they identified the individuals that were reveal in the oig report . We did not identify the 1700 . We described the electronic list, which was not secret . You have referenced numerous intermediate e list. Ow many names were on that intermediate list . The list of the patients were printed out and patients were rescheduled. Destroyed. To my knowledge, they were all destroyed. Idea how many were were on the list. Have you seen the list . No. Did you know it exist . Ive seen an example. It existed. U know people told me. Who made the decision to take away her bonus . Im sorry . Was it her bonus removed your visit or resended . That was, i believe, within the last week. Not my decision. Decision. E secretarys it was rescinded. Yes. Not visit at all with the director of the clint sonic. Clinics. Re multiple did you visit with the director of the clinic . I did. Tell us the conversation. His talked to him about process of trying to improve did you discuss the waiting list . No, i did not. Did you know about it . I did. You chose not to bring it up, why . It appeared not to be in his responsibility. His area of responsibility was the clinic. That happened to be the of. Ting list two other items id like to address. Two other things there are other lists. Hank goodness we have the oig, the near tracking reporter, the screen shot paper printouts, the we ult, thats how identified 1700 veterans who were denied care. This was a secret, we were lucky, i guess, that we found those. Lists exist of throughout the entire v. A. System. Medical center could have the near list with another secret waiting list. The list is not secret. Know about ou not the list if its not secret. Sharing the frustration expressed by the committee the rs and the members of panel. But also making clear that my frustration at least does not to the providers. Providers at the l paso vha, doctors, nurse practitioners, psychologists, therapists, counselors, could be working in the private sector more money, the department of defense for more money. Could the r other for more money. They want to help them. Many cases, they themselves are veterans. Message is too often lost in our justified of the management of v. A. Leadership here in washington, d. C. At v. A. The business hin and at some of the local vhas. When i hold town Hall Meetings<\/a> in el paso, i hold one every single month. Hold a veteran specific town hall every quarter, most of the concerns raised in the town about wait times. And it it flew in the face of the data that i was receiving from the el paso which showed the rate times are on par with the National Levels<\/a> and close to the target by the va. Do is hire someone to go and look at the town hall a survey in conduct el paso. Had veterans with an error found that the variance vha was the el paso reporting was wildly different from what our veterans were reporting. 70 of newell pa sew va patients provider in health 14 days. Ur surveys showed 36. 5 of our respondents could not even get an appointment at all. And completely dropped out of the system. N average, Veterans Mental Health<\/a> care appointment when it was set was cancelled once. The respondents completely put off of getting the h care because of difficulty of obtaining the appointment. When we delay care or often denying care, this is at a on average 22 ng veterans taking their own lives every single day. Its a life and death in el paso nd life and death you argue across the country. As much as i would like to get of what happened in phoenix and know who i think what records, its a problem thats much larger than phoenix. Than just el paso, asked and hairman others asked, looking at pecific issues in el paso to provide all of the data that we collected. To look at you allegations heard from el paso hat appointments are set for veterans who request an appointment but the veteran never informed that the set. Intment has been so when the veteran does not show up for the appointment that he did not know about because no him, it shows up on the veterans record that he declined to come in and failed up, and does not harm the v. A. s record in terms of performance on wait times. Weve heard that anecdotally oftentimes in el paso. The oig ing it in report. Hope youre looking into that as like s your system would to audit. We are i would be happy to personally to get the information you have that youve obtained from the veterans. Value looking at that. Thats why phoenix resonates throughout the country beyond the tragedy of apparently 40 lives s losing their because of gross negligence in that facility. Every single at one of us are hearing in our districts. Appreciate the tenacity in facts and reporting it back to this committee. Mooney, on the 29th of april, congressman pete guy yea go and myself sent a to the secretary asking specifically about the el paso v. A. And whether similar there es were conducted and whether a secret wait list was maintained there. A response received to our letter. When can we expect a response . I know the results of the nationwide audit will be forthcoming and those results will be shared with the congress we look forward to answering your response and all of the members responses about facilities at that time in the near future. Dr. Lynch, the office of general said they received allegations of retaliation in whistleblowers in phoenix. What are they doing to make sure it does not engage in prohibited personnel practices. Im sorry, im not quite sure i understand the question. I did not see the allegations regarding retaliation. Ig will give this a complete report about any of those concerns and it would be expectation that if there was inappropriate retaliation, it would be addressed. The who was the name of doctor, the repyred doctor from the phoenix hospital that was a whistleblower. What was his in a im . Dr. Foot . Dr. Foot. With dr. Ur meeting foot . I did not meet with him. You did not . A meeting . For i did not. Why did you ask for one someone at the center of the storm, youre there to understand what the process was. Request a didnt meeting with dr. Foot . Was concerned e it might interfear with the igs investigation. Concern was it might interfere with the truth. And i got to tell you, how far problem goes. Because the fingerprints of you that are at this panel today are all over the problem because i can tell you, youre not being forthright in your testimony. For the he model veterans administration. A lot of good young men and that work all ages for the veterans file. Stration, rank and and they are some of them are the whistleblowers. Them, we would have no idea whats going on. Shishi shiship hiship leadership is not there. If thattragedy there is the impression that you give all three of them today, is that you andhere to serve yourselves not the men and women that have sacrifices tonary serve this country. Nothing will change in the eterans administration until due leadership, not just general shin she can kip, but all of you, youre not doing your job. Yield back. Any relationship, its true in this. Trust in our nation to the veterans, the veterans to the v. A. Congress working in concert together. And i think of being on this committee over the years and this, theres been a. Autiousness that may be as was talking about the audit. Assistant Secretary Health<\/a> of clinical observation list. Ing to get that and there was a pause and cautiousness. He bureaucracy is holding you back. I cant imagine a scenario or a let someoneou would in bureaucracy would not have gotten me that information. Go out on a limb and said ill get it, if they it, too bad. That mentality gets us to where were at today. Trying to solve this problem to provide quality care for the veterans. The folks working, you, us here. O competent leader is going to formulate a course of action with all pertinent data. And i was under the naive parentally, that our constitutionally mandated oversight responsibility is when narrow subpoena, i hope it wouldnt be a subpoena. Ut i was under the impression this is what it would look like. From this date to this date computer, do on my print out i thought there might be a whole bunch of of rns taking snacks emails. Some might say happy birthday were having pie and those would be here and this committee would decide whats important. I was mistaken. Now i know the answer. Tol give you the opportunity do so. But the answer is going to be you should ask the general is there a walls, team of lawyers over there saying this is going to go, this attorneyclient privilege, is there somebody over there putting something in executive stacks . E do any of you know that . Is there an executive privilege stack over there of these the answer . Congressman, i dont know the answer. I can let you know that i met with this ommittee, Committee Staff<\/a>, with this chairman on a number of know ons to share what i about v. A. And vha health care. I, for one, value the congress. Ip with i, for one, am looking for a relationship. Am i wrong weve known each other for quite sometime and worked together. Under the impression that this relationship has been trained for a while, between congress and the v. A. With your congressional . Will. That ssman, that is is not our intent that it be strained. Open, tent is to be transparent, collaborative, and work closely with you. Have you ever heard from on this panel that may felt it might have been strain . Yes, sir, i have heard that. Yes. And many of you talk to us about ssues that you face and we worked to get you information as quickly as we can. P. Worked and ena, we we understand the constraints we 2 1 2 weeks the office of General Council<\/a> to provide the committee with a response. That an unrealistic scenario i truly did expect hat you were going to send a pile of stuff over here. And the staffers with the direction of congress is going o sort through and decide what needed to be done. Is that a naive assumption . Not leading or not passively aggressively. S that naive in terms of subpoenas . I know that this was run out of general e counsel. I would defer to them. I was not part of that process. The t think anyone on panel was i think many of us on the committee have proven ourselves what we want do and the trust and whatever. But im with dr. Roe. But feel something has not been given to me. That may be totally false, but the impression was there. I have no doubt this committee will get that report. I just dont have responsibility for it. But i have no count. The person who is responsible. We might have to bring them in. Whats the job of the congressional liaison. To . Do we talk are you there for us to talk to or should we skip over you and directly to general counselman. In a , congressman, subpoena, thats the matter. We work with the committee and the staffs. That without a subpoena. Every day. Dr. Win strop, youre recognized for five minutes. Veteran and physician, i have serious concerns like this committee. Patients o many cancel . They were cancelled in an effort to reschedule them more timely, first of all. To have them seen sooner . Cancelled to be seen sooner. And rescheduled sooner. New patients or some followup . Historically in phoenix, as i understand it, the management miss helman had used he model where they did not employ the wait list, they scheduled patients where there appointment. It could be six months out, seven months out. New team, there wruz a desire to identify appointment slots, which they did. These nt out, identified patients who had been scheduled in e, four, five months advanc advance. Cancel those and brought them to a new appointment slide. Do doctors weigh in if theyre rescheduling . Do they say, no, that patient is sick. I need to see them tomorrow. Hey need to get here right away. If for any reason in my private practice we reschedule them, it moving them up. But if they needed to because that. Alled, we would do but also we discussed on a patientbypatient basis this right needs to be seen away. They cant wait. Does that ever happen . Or is the doctor out of this all together . I cannot tell you if the were involve in the rescheduling process in phoenix. We dont know if doctors in general in the v. A. Are able to weigh in on the risks associate ver associated with a patient waiting longer for the procedure. Ere talking about people waiting for colonosocopies, they werent scheduled to be up, they delayed. So do doctors get to weigh in and say this patient needs be now . Right thats important . Does that happen . It happened in private practice. I believe it does happen. Can or do they . Can. I imagine they the e they have access to records. Does this take place . Do. In private practice, a clinic going to let a patient on a waiting list. Theyre going to get seen. Their existence depends on that. Thats a different model than at the va currently. Drive to get patients to feebased care come from the problems that have arisen recently. Or is that something thats been energy . With the other question is are those for ving bonuses penalized receiving more base care . Do not believe theyre penalized. Were putting in better tools when we cant provide the service. Performance is access and productivity as well as results of taking care of patients. One other thing. If it comes to the office of counsel, youre turning everything over, you dont think should find out about it, you should be screaming and yelling they have not turned that over reciting time f and time again i defer to them. You should fire them. Yourselfd stand up for and say ive turned everything over and here it is so that you can evaluate it. Have any comments on that on a personal note . Dont you feel youre being let down . People are asking you here tonight, where is this information . You say youve turned it over saying hold it . Doesnt it bother you . Theyre not helping your name tonight . Turned over the information. I havent turned over the theyve gone and pulled my email files. Does that bother you they us. Nt submitted it to i haventry viewed the email files. No, it doesnt bother you, i parentally. Were committed to being collaborative and responsive. The same. I do mr. Chairman . Per committee rule, we continue with memberships, we go to ms. Jacksonlee. So, mr. Cook, colonel, united retired. Rine corps youre recognized for five minutes. Thank you, mr. Chairman. Omar bradley wanted to talk the m16. I told him, its a piece of crap. Its 1967. Most of the people werent even born then. He was 80 ow, something years old. He was taking notes. Suddenly after that there were all kinds of changes to the system to change it so that no one else would die because of a weapons failure. That weapon is still being used today in the u. S. Military, the had. Est weapon we what if general bradley were here now, the last fivestar general we had. Kind of ironic, next week, of june, nvasion, 6th i just dont feel that theres a a sense of mand or urgency. You know, im not going to go over all of the things that have everything like that. But my feeling is whos going to and correct these things and, you know, i know you had a busy weekend, but if its people are dying there, you got to work through the weekend. Its a 24hour day. Its a sevenday you know, theres got to be a sense of urgency. And im coming away from this hearing that the lawyers run everything. There has to be certain made right away to change some of these policies have to ertain people be fired or whether they dont get bonuses. Theres a lot of great people there. Im sure they work for the v. A. But most of them are military. Theyre probably frustrated. To, i think ting up right now, were going to talk about this. This committee will make a report and everything like that. I was going to ask you the chain of command, whos going to this, and this. I just come away from this get the onight and i feeling that no one is in the v. A. Right now is in a position anything. Its no trust and confidence to the people i talked about. Want action. They want it now. And if certain people like if i people thing wrong and died, i would be fired and probably courtmartialed. Hats the nature of the business. We owe that to the veterans, to the military, and we owe that to all of the people who are hard in the v. A. Administration. We have to straighten out this problem right now. Have subpoenas and Everything Else<\/a>, and i havent heard that. I would like to see the down to the v. A. Ospitals and meet with the veterans. I would like to meet if it possible, go down there right now and talk to them. Of stigate, take statements everybody. Weve all done it before, sergeant major. Nd so just very, very frustrated. That im in a position to make a difference and i cant do anything. I cant get across to you or the a feeling of frustration, if im smarter than most people here, i would say this, this, this, and this. Right now, i think you need the discipline to go down there. Ertain people have got to be relieved, theyve got to be fired. These policies have got to be changed almost overnight. Excuses or the fact that the lawyers are handling it anymore. Sorry, i should have asked but thats been something thats been bugging me and ill apologize. I yield back my one second. Your service to the country. Were honored to have you at this committee. For the record, there are close 700 attorneys at the department of Veterans Affairs<\/a>. Oure recognized for five minutes. I sit here and i i dont the theres a word in english language that can athink e how frustrated i frustrated is an understatement. Here for 18 months listening to the same answers we tonight. Weve had 20 some people question the three of you. 2 1 2 i know now, hours later what you dont know. Travelled to arizona and didnt meet with anybody who had anything to do with this directly. Took your wife. It was easter weekend. You didnt meet with anybody who of directly involved in all the testimony of the 20 people right here. Would s in your shoes, i describe this as a fivealarm fire and youre rushing to the scene and youre bringing mutual because the house is on fire and nobody is going to survive. Here and listen to the three of you and im thinking to i leave hereestion tonight with, and probably my colleagues, what do you know . We know is that people died. Question i want to ask is on behalf of the arent inhat probably this room tonight, but weve heard from some of them, i heard three rry coates here weeks ago. A death sentence and death warrant for something thats no of his own because he couldnt get a simple died. Scopy, people were sitting here and were asking all of the same questions. But if you have an going give im you an opportunity because youre all three sitting here. This is carried live. You want to say, mr. Lynch . To the families of these people lost veterans . What do you want to say on behalf of the v. A. Heres your opportunity . Congresswoman, on behalf of all, i take t of ersonally every time a veteran is harmed. Does the buck stop with you . Do you accept the responsibility happened . Are you responsible . Congresswoman yes or no. Buck stop with you, dr. Lynch . I dont know if it does, but responsible. Elf buck stop withk you . Can you look at the families and the responsibility. Im the daughter of an atomic veteran. Yes or no. Im responsible for ensuring that our focus at this point, we sorry, mr. Cook, that didnt make it perfectly clear to you, our focus remains on veterans. Our let me interrupt. My time, a limited time. Ive sat here for 18 months as a freshman. Got few answers from anybody i poelzed to you. Im still waiting on answers. O you share this responsibility . Does the buck stop with you . I have a staff level congressional Relations Officer<\/a> a yes or no. And o is a Civil Servant<\/a> also a veteran. Im not a supervisor. Im a stafflevel federal employee. Does the responsibility lie secretary shinsheki . Do you believe in his leadership ability to stand up to a fivealarm fire. Where in the world is the urgency . Is you can i can sense the committee, this democrats and rep pubs. Republicans. Totally ur nation has lost its trust, its our esponsibility to sit here and maintain oversight . And we cant find out where the stops. I asked for secretary shinshekis resignation when the report came out. You heard several people asking the question, does the buck stop you . Do you accept this responsibility . Are you ready to accept this responsibility . And look in the eyes of the American People<\/a> . And our veterans and say, what . You say tonight . I know when you dont know. What do you know that you can the American People<\/a> that they can learn in 2 1 2 hours of meeting . Tee congresswoman, our focus remains on caring for the veterans. If thats the case can i finish . No. Because i have five minutes. Thats been the case, how go to arizona involvedalk to anybody that has anything directly to do with this and 40 unexplained deaths. Report that has fact. And you all seemed to have turned the facts to a general we know less tonight i have more questions tonight than ive had when i walked in here. Learned what you dont know. My question is, and its going to have to go unanswered. What do you know . We know that the facts of that report are utterly reprehensible. Thats what we know. Nd we owe a debt to all of our veterans who served. Every one of them. Responsibility . Ill accept the responsibility. What are you going to do with the responsibility . Stay in your to position . You going to apologize, you going to resign . To stay and fight for veterans and fight for this love working i together and really meaning it, ofking together for the good our veterans. Expects. Hat the public thats not what the public got. This is what the public got . That. Understand we view that report the facts of the report as totally reprehensible. Inexcusable. Expired. Eladys time is thank you. Ms. Jacksonlee, youre recognized for five minutes. Chairman, the Ranking Member<\/a>s of this committee, thank you for also thank you for the service that youre doing for the American People<\/a> and all of the veteran ms. And there after for me and others and extended faith members, neighbors, members and others, theres not a place that we can go that we o not touch a veteran or a veteran does not touch us or a soldier. A place ll its not where wre can go that were not grateful that they have served and are willing to serve. Is overwhelming and i thank you for allowing me to sit here. Im from texas. And there are veterans facilities, including those in of 32,000 veterans in the 18th Congressional District<\/a> alone. So let me just read this into colleagues hich my on this committee have probably immersed themselves in. These ust want to have words. This is about the scheduling practices reporting in phoenix. Finding that inappropriate scheduling practices are a nationwide. Oblem, then just to read this paragraph, schedules going into find an uling program open appointment, ask the veteran if thats acceptable. Scheme one. Uling back out of the scheduling rogram and into the open date as the veterans desired date of time this makes the wait zero days. This is on is, systemic, i heard you say about audit. Nwide while were having a nationwide audit, many of us have sent letters. I sent a letter about the v. A. Hospital in the 18th Congressional District<\/a> or in the neighborhood, which is in texas. , how soon will members of congress, individually could 435, could be 535 letters, be able to get our responses to in our own sis neighborhood. How soon could we get that response . Looking to brief the congress as soon as want ding our letters, we to know about our immediate crisis in our own neighborhood. We get that response . I didnt realize there were 700 lawyers. It will be forthcoming very, soon. I know the results of the audit are being compiled now and we out forward to having them to you. But what the individual hospital reports, is that how its coming . Yes, yes. But are you separating the requests for members from your audit . If a member sends a letter, can they get an answer immediately . Looking to ere release the audit in nationwide at one time. Understanding. That disturbs me only because when we are in our districts, we individual outcries about time. And i want to agree with many have s who have said we very fine providers in the v. A. System. And we should pay tribute to i know in particular, the hospital has a very fine that cares as do others. But i also know that when i travel around, i have i met in the airport an individual who said they months for an elderly veteran for service. You go and get information directly from these hospitals, they have completely numbers. And i guess my concern is, what to believe in . And what crisis we have with it being a nationwide system. No way to take and have what we would call task forces opps in the veterans to target into places besides audit to be able to go into hospitals and fix quickly . The s. W. A. T. Team, of sorts. At the sameight now time the audit is going on, acilities identifying patients on the wait list. We are identifying those facilities that are challenged of clinic efficiency. Were looking at ways to provide are to veterans in timely fashion, using nonv. A. Care, and helping those facilities that in providing e more efficient care processes. Simultaneously with the audit. Let me finish on this note. I appreciate the passion that servants. E public can we please get the kind of from the cry eadership of the veterans standing up,tment claiming responsibility, speaking not to us as members of congress, but speaking to these that we are prepared and ready to prosecute those who have been in a coverup, not a witch hunt. And secondarily saying were happening and is veterans of the United States<\/a> of rest until will not we finish this task on your ehalf and save your lives and provide you with care . Can we hear that . Congresswoman, we will not not rested. Have we will not rest until we provide veterans with care. Congresswoman, we have been working to identify and across nd the problem our entire system and to initiate solutions so that we eliminate wait times and get veterans care when they need it as soon as possible. The chairman for his courtesies and the Ranking Member<\/a> for your courtesies. Thank you. Thank you. Mr. Jolley, youre recognized for five minutes. Thank you, mr. Chairman, i andeciate the understanding the courtesy of the chair. The floor. Endment on ill tell you some of this. Ill tell you my line of questions. I know its getting late. Believe that the department and this congress can identify longterm institutional reforms. That. Get to those are longterm. My concern is whats happening immediately right now to clear list. It dr. Lynch, you mentioned by friday, everybody in arizona in your ontacted and words, if needed, be referred out. My understanding and the question is, please correct me if im wrong in the first place my secondly, ill give you question. My understanding is that thats the current policy. That be if its determined the to go outside of the system, that could occur now . If the veteran requests care, refer to him when we speak with him. Practice. Ive sat with my own Hospital Administrator<\/a> in my district. Understand in practice, the hurdles that are required when that veteran requests to go outside of the system. Actually not an easy task. There will not be hurdles, congressman. Committed to getting eterans who are on the wait list care as they as appropriately and efficient lip and as soon as they need it. Right, so my question is, the current policy is already, if nonva care is available. If were saying now the standard for this friday deadline is if needed, a veteran can go out, how is that any different ther than you suggesting that the department is going to try harder . And secondly, how is that need evaluated . Understand a call center in kansas. But is that need a medical evaluation . A thats going to be conversation with the veteran if there is need for a medical assessment, we will have a call Center Medical<\/a> professional or a a nurse professional available to discuss the and to determine the acuity of his need. Is the standard of review anymore relaxed than it currently is . Congressman, its my nderstanding that were going get the veterans care in the community. I will tell you, this is surprising to me. Ive talked about this every of the way. I dont think this is a political issue. Beginning, the congress and the administration can get to the bottom of reforms. M institutional my department has the authority. You heard it a dozen times tonight. The secretary has the Authority Refer<\/a> people out. Youre indicating youre going to do that by friday. Trust, sking us to however, that the same administration executing the the ifneededicy, policy thats in place is going to have a different result in the next 48 hours. Will tell you this, if so, i will be the first one to go to the well of the house and administration and the president of the United States<\/a>, this goes all the way to president of the United States<\/a>. Thus far, no emergency measures, new personnel, the only indication tonight is that harder and to try open a call center in kansas and apply the same if needed that exists. Go a little further if i may . Please do. With respect to phoenix, we more ed the hiring of 12 physicians. Three of those will be online shortly. We have pproved and a number of new chedulers to increase the efficiency of management p management in the wait list. Well be looking to moving phoenix as well as mobile medical care centers to mprove capacity and to in Capital Resources<\/a> to provide that care. Increase ing steps to capacity and services in phoenix. F we can provide care to veterans who have been identified by the i. G. In fashion, we timely will. If we cannot do that, they will be sent to the community for care. And you indicated other facilities as well will be oing in similar right now, v. A. Is collecting asked each of our facilities to identify patients who are currently on their wait care, ho are waiting for to give us that list so we know numbers. Were going to assess if we can provide that care locally. Move that to the community. I appreciate the response. And i would just express my the record and i wants this very same medical doctors, physicians, medical that who have determined the patients do not need to go outside of the system for nonv. A. Care that are now asking to reconsider whether or not they do. Without a dramatic shift in the that youative judgment can many expect every one of your medical providers to 48hour in this new period, i have grave concern its not going to solve it. The very much appreciate measures are being taken and i hope they are successful. And mr. Chairman, i yield back. Thank you very much, mr. Jolly. Continues toiously have a heightened interest in talking with our witnesses. Numerous requests for a second round. The chair will give a second round of questions. With that, i ask unanimous consent that we have a recess. Nute and we will reconvene in five minutes. [ gavel ] one day after that hearing, was joined bycare others for a press conference to discuss the v. A. Veterans Affairs Department<\/a> the authority to fire individuals at Health Care Facilities<\/a> based on performance. This is 25 minutes. Good afternoon. It goes without saying theres an accountability problem at the Veterans Affairs<\/a>. The report released yesterday on one mning indictment facility within the Department Affairs<\/a> and they a systemic is is problem throughout the countrys v. A. Health care facilities. A theyre trying to make difference in helping va help themselves. Weve had problems time and time its where it appears that much easier to get a bonus at v. A. Than it is to get disciplined or fired. Several of us pass a bill last week. 330,000 ple, out of the mployees at the department of Veterans Affairs<\/a>, this would give the secretary the ability to firing but up also by demoting senior xecutive level individuals which are less than about 450. The secretary says he has the tools do the job. He has not used those tools. Were going to give him more to do what is get the veterans and the the benefits, honor theyve earned. Know d afternoon, i theres attention as to why or ny of my colleagues and secretary shinsheki resign. Its unclear if the v. A. Has up to ed","publisher":{"@type":"Organization","name":"archive.org","logo":{"@type":"ImageObject","width":"800","height":"600","url":"\/\/ia904709.us.archive.org\/30\/items\/CSPAN_20140601_171500_Veterans_Administration_Health_Care_Wait_List\/CSPAN_20140601_171500_Veterans_Administration_Health_Care_Wait_List.thumbs\/CSPAN_20140601_171500_Veterans_Administration_Health_Care_Wait_List_000001.jpg"}},"autauthor":{"@type":"Organization"},"author":{"sameAs":"archive.org","name":"archive.org"}}],"coverageEndTime":"20240619T12:35:10+00:00"}