It continues to be sluggish and i cannot give you a reason why that occurred. We are aware that mortgage credit is very tight for a wide range of borrowers and that maybe part of it. We hear about supply constraints builders are facing but i have to say i am surprised. What more do you think the fed can do to help stimulate recovery in the housing sector both for those homeowners who are upside down in the values and those to help new people qualify for homes. Housing prices are continuing to increase. And they have increased substantially and in the markets that saw the worst booms and bust that is the case. So in nevada there are a large fraction of homeowners underwater but if you look at the numbers just the increase in house prices we have seen and i think that is in part reflecting or monetary policy, maybe fewers barrowers are under water. The numbers have declined and i know the Las Vegas Area was one of hardest hit areas. I think we will see greater progress eventually in the Housing Market but there are many impediments they face in the aftermath of the foreclosure problems during the crisis and things havent settled out there. Acting va secretary sloan gibson testified that the Veterans Affairs department has lost the trust of the nations veteran and American People because of widespread medical delays. That hearing is next. And Senate Republicans blocked the democratic bill that would have forced companies to provide Birth Control to their employees regardless of religious belief. It would have negated the recent hobby lobby decision. And doug elder makes questions on the economy and budget at a house hearing later on. July 20th marks the 40th anniversary of the first lunar landing. We talk about the life of the first man to walk on the moon surveillance Transparency Act saturday night at 10 p. M. Eastern. Acting va secretary sloan gibson talks about the changes underway since taking the temporary position in may after Eric Shinseki was forced to resign because of medical delays. Robert mcdonald will become the next secretary if approved by the committee. The committee is chaired by Bernie Sanders of vermont. Lets get to work. Good morning. Welcome, everyone, to what i think will be an important and productive hearing. We look forward and welcome mr. Sloan gibson who is the acting secretary for the department of Veterans Affairs who will be discussing with us what he has been doing and what i perceive to be an active six weeks since you have held that position and we also look forward to hearing from him as to what he perceives the problems facing the va in the months and years to come. I would want to mention to the members of the committee that next week on the 22nd we will be holding a conformation hearing for Bob Mcdonalds the president s nominee for the secretary of va. Last week not last week, last month, despite a partisan environment here in congress, 93 senators put their differences aside to vote in favor of a significant piece of legislation which we hope addresses many of the immediate problems facing the va. It an issue that senator mccain and all of us in the room worked hard on this and i want to thank you for your support. It is my hope that will be completed by the time we leave for the august break. It is clear to all of us that the va faces many, many challenges and they are welldocumented. The concerns that i have that have been well publicized is that we have many veterans unable to access va care in a firearm timely manner, we have accountability issues and we find unacceptable people manipulated data in terms of wait times and people have treated whistle blowers with contention and people have lied and that is not acceptable and we want to hear from mr. Gibson to hear what he is doing to address those problems. But the issue i want to focus on is while we are determined to do everything we can to make the va, which is a huge intuconstitution providing 6. 5 million veterans with health care, we want to do everything we can to make that agency efficient and accountable, there is another issue we have to address that is part of our responsibility and that is what are the real needs facing the 22 million veterans in the country. And how as a congress are we responding to those needs. Number one, the va has to be accountable, efficient and we have to address many of the internal problems we have all heard in the last several months. Secondly, we have also got to ascertain what the problems facing the Veterans Community and their families are and do everything we can to make sure the va is in the position it needs to be to address the problems. Let me mention some of them. Of the 2 million men and women who served our country and put their lives on the line studies suggest that 2030 percent are coming home with ptsd or tbi. That means those wars have created 500,000 mentally wounded American Veterans and as a result very Serious Problems regarding suicide and this committee will be dealing with that issue in connection with ptsd, substance abuse, inability to hold on to a job, divorce, emotional problems for the kids. When you deal with posttraumatic stress disorder is isnt just the soldier it is the wife and kids. The number receiving special Mental Health is up from 900,000 to 1. 4 million in fiscal year 2013. This means in fiscal year 2013 over a quarter of those receiving were being treated for Mental Health conditions. In other words, va currently provides 49, 315 outpatient Mental Health appointments a day a day 49,000 Mental Health outpatient appointments a day. Imagine the challenge if we had endless supplies of money and adequate numbers of doctors in this country this would be a republic. That is the cost of war. Ensuring timely access to medical care is critical for the veterans and their loved ones. The suicide is a tragedy beyond words and not easy to deal with but we have to address it. Like most americans, we are all concerned about these waiting periods and i know mr. Gibson is going to be talking about that in his testimony. But let me go through the numbers to understand the scope. 46,000 veterans are on list waiting to be scheduled for medical pointments. 8,000 have waited over 120 days. We could have an argument, but i dont think there is much, whether 14 days is an appropriate number, i think that was overerly ambitious. When you have over 8,000 veterans waiting over 120 days to receive an appointment and that is 120 days before they are told they will be seen that is not acceptable. 600,000 veterans have an appointment that is more than 30 days from the date the appointment was requested or desired. That is not acceptable. The numbers are staggering and that is an issue obviously that we are addressing right now and we will hear from mr. Gibson as to how he is going to go forward with that. I think the goal of every member of this committee and i would hope and expect every member of congress and the American People is that the veterans of the country and people who suffered so much deserve Quality Health care and deserve it in a timely manner. What i look forward to hearing from mr. Gibson about is the needs of the va in achieving that goal. We are talking about a Staggering Number of veterans coming home with ptsd how many doctors do you need and how many will you get them . How many primary care physicians do you need . How many specialist do you need . If the goal is to provide health care in a timely and Cost Effective manner we need answers from the va and i hope we get some today from mr. Gibson. Needless to say the other issues i know members of the committee are going to be asking is what actions the department has take to know reprimand employees who have lied and manipulated data, what are they doing to make sure it doesnt occur again, what are they doing to deal with other areas that have been identified by other organizations. Let me give the mike to senator burr, the Ranking Member. Thank you, senator and welcome secretary gibson. Since the last hearing, there have been several developments on the scheduling issues and the problems. The va is taking steps to address the culture that has been identified by several independent sources. These changes will not happen overnight and this committee must provide the oversight to ensure the changes occur and are effective. Even with the steps va has taken, there will continue to be reports and allegations regarding va facilities and workers. These reports will not only highlight critical areas of needed reform, but identify the magnitude and breath of the systemic issues facing the va. The ongoing internal evaluation by the va as well as investigations being conducted by Inspector General and counselor are essential to rebuilding Veterans Trust and stakeholders and employees. The role of the office of special counsel and the Inspector General are more crucial now than ever before. Both offices are essential in identifying systemic issues facing the va and i would like to highlight a few critical reports that have been released since the last meeting. At the time of may 15ths hearing there were several stakeholders who didnt race to make judgments since the phoenix reports were regulated. And since the report there has been a secret wait list and other things. The ig identified 1700 veterans waiting for appointments and were not included on enelecan electronic wait list. They found this wasnt an isolated event. The ig has received numerous allegations regarding mismanagement, inappropriate hiring decisions, sexually harassment and bullying behavior by mid and senior level managers. These allegations seek to the culture that has taken deep root throughout the entire department. The office of special council released a statement on va whistle blowers and sent a letter to the president and described the office of medical inspect inspectors consistent use of harmless errors, i quote. This is there defense. Where the department acknowledges the problem but claims patients were not their cares were not affected. The letter details ten pages of agregious care where they dismiss potential patient harm. Two veterans were admitted in one case to an inpatient Mental Health care and didnt receive evaluations for more than seven years after being admitted to the facility. Another case in the letter describes how doctors copied previous provider notes in more than 1200 patient medical records instead of recording current readings forpations. The culture at va and the lack of management and accountability is no longer going to be tolerated. Secretary gibson you have taken several actionable steps in the last month and a half and i commend the work you have done. However, what happened over the course of the years is a blemish on the vas reputation and much more work will be needed to repair that damage. As the va continues to move forward in improving veterans access to care and changing the culture that has taken deep root within the department this committee has a lot of work to do and needs to take an active, vigorous oversight role to make sure the problems identified over the last several months as a host of ig reports come out they are appropriately addressed and they are not allowed to happen again. Again, secretary gibson, thank you for being here and mr. Chairman i yield. Senator murray. Mr. Chairman, thank you for holding this hearing. This is a critical time for the department. The va is scheduling with systemic parties and there are openings in positions and veterans are waiting too long for care. Secretary gibson i really appreciate you stepping up during this crisis. The department need strong leadership right now. Rob neighbors review identified several of the issues which we have been discussing here for some time. A corrosive culture has developed in the department and one that is unworthy of many va dedicated providers that do only want to help. Lack of communication is a problem at all levels and va needs more providers, more space and modern it systems. As we continue to work in the Conference Committee to craft a final bill i hope an agreement is reached so we can send it to the president and make the changes so the veterans get into care and we create transparency and hold people accountable. The bill will be an important first step but as more is found we will need additional steps and we cannot lose sight of many other pressing issues. Too many veterans die by suicide, Sexual Assault victims need help, the va has to make progress in eliminating Veterans Homelessness and clearing the backlog. I appreciate your help and finally building the Veterans Home where hundreds of areas will have access to longterm care they need now. As i have said repeatedly, when the nation goes to car it also commits to taking care of the veter veterans when they return. They are a cost of the war. We know several soldiers will need care for several decades and others come years after the service ended. I am looking to hear about solutions to the systemic problem and smart ways to stregthen the va longterm because they need to be for the veter veterans right away. I yield to senator isakson. Thank you for expecting this responsibility. You are a brave and cure ageious man. We have many problems and i want to quote a paragraph here. I remain concerned about the departments willingness to address the whistle blower problems may have had on the health and safety of veterans. The office of inspector has consistently used the term harmless error as a defense where the department acknowledges claims have been uneffe uu unaffected. The letter goes on to delinate cases where Veterans Health suffered because of the Agency Looking the other way. I have become personally convinced this begins and ends with the Senior Leadership of the va for years to overlook manipulate with the numbers and making things look better. I think congress is to blame somewhat for not looking inside. The pervasive culture of cooking the books for personal benefit, such as pay raises, is absolutely inexcusable. Lastly, i hope in your remarks, which i am looking forward to, you have will address the memo written on august 6th, 2010 that talked about the problems we are now discovering. This was four years ago. How could that letter have gone totally unlooked at by anybody in the va and the problems we are trying to fix lasted four more years because there was a culture of looking the other way when there was criticism or accou accountability questions. While i appreciate your work i am not convinced the va has changed at the Senior Leadership and the management of Veterans Administration and health care. A vote has been called so a number of senators are going to leave. Tester, murran and johanns and then the senator will return. I want to thank sanders and burr for their work on this committee. Access to health care for veterans didnt pop up overnight. We have been working on this for years. Solutions must be based on good information and hopefully the conversation today will be straightforward and frank so week we can get down to solutions. It will require folks on the ground in washington that last well beyond the media span. Veterans deserve better than having the folks jump on the latest crisis or two and nen you never hear about it again. They want answers and solutions and they want the benefits that they have earned not press releases. I am approached by veterans every time i go home whether it is the Grocery Store or service station. They are direct and straightforward and give me the best view of what is going on at the va. This friday i am holding another round table to hear from veterans about the va and the services they are getting and the difficulties along with their good things as well. There is a lack of Service Providers and i am looking forward to hear from the va on they action and their followup. The whitehouse has completed review on impacts to access to care and the va provides high Quality Health care once the veteran is in the door. It found out the Scheduling Technology is outdated at 30 years old. And they need doctors, nurses and Health Care Professionals. Physically space is needed and inappropriately trained personal. The Senate Passed a bipartisan bill that will address issues impacting access to timely medical care at the va and it passed by 93 votes and we seldom get 93 votes for anything in the United States senate. We are in the fourth week and there is not much to show for it yet. Those questions would be good to get answered today, too. Some members of the Conference Committee are balking at the cause. We just shipped 800 folks off to iraq and i didnt hear anyone talk about cost. Back in 2003 when he invaded iraq i wasnt hear but i never heard anybody talk about the cost. These folks went to war, they performed incredible well, some came back missing arms and legs and some cake back with mental illness. Health problems they didnt have when they left. It is frustrating when i come from a state where we are 22 doctors down to hear folks on the Conference Committee say what we need to do is schedule more patient for the doctors. That the solve the problem. That will not solve the problem. We need more Health Care Professi