Front line defenders on the war on sexual assault, ill say. They report to me overwhelmingly that they think were making progress on all fronts but one. And here comes the hardest of all, i think. Were definitely not satisfied. And that is the issue of retaliation. So, retaliation, by the way, can be if you report sexual assault, the boss takes some action against you, which is or feels like retaliation. Ill call that official retaliati retaliation. The other form is just when your peers in the unit kind of find out whats happened or what allegedly happened and they take sides and maybe they treat you differently or maybe people who are your friends now shun you. Ill call that unofficial retaliation. Our piggest problem is on that unofficial part, people who rush to swrujudgment to and take si who is going to replace dr. La plant as acquisition czar . Rich lombardi is now in the acting capacity. Thats dr. La plants deputy, who has floeeted up to the actig role. Beyond that well have to work our way through it and see who the permanent person will be. Is that your call or does the white house make that call . Ultimately all of these positions are president ial appointments. I have some housekeeping. National press club is the worlds leading professional organization for journalists and we fight for a free press worldwide. To learn more about the club, go to our website press. Org. To donate, visit press. Org institute. I would like to remind you about upcoming events. Friday, december 4th, prince ali al husse nichlt, fifa president ial hopeful and son of king hussein of jordan will address a National Press club luncheon. Also on friday at 7 00 am, the press club will publicly read articles by Washington Post reporter jason rezion for 24 consecutive hours to draw attention to the 500 days he has been unjust ly detained in an iranian prison. And on tuesday, december 8th, the new secretary of the Smithsonian Institution will address a press club luncheon. I would now like to present our guest with the most valuable and sought after National Press club mug. All right very cool. Thank you. Very close to air force colors. Well just say thats air force blue today. Excellent. Final question, you were recently spotted at the air force Navy Football game in annapolis and you were wearing an air force jersey with the number 23 on it. I assume the 23rd because you are the 23rd secretary. Right. So thats your number on the jersey. So we would like your assessment right from the top how is the air force Football Team looking . Whats the future looking for this team . Is there hope . Give your assessment from the very top level on that Football Team. My top level assessment is we are going all the way. And dont believe any statistics or any talk to the contrary. That is my favorite team. Youre right, my jersey is 23. Im lucky 23 because im the 23rd secretary of the air force. All the way weve had the commander in chief trophy for two years and even if the navy takes it away from us we may have misplaced it. Im not even sure where it is. How about a round of applause for our speaker . [ applause ] i would also like to thank the National Press club staff, including journalism of institute and Broadcast Center for organizing todays event. If you would like a copy of todays program or to learn more about the National Press club, visit our website, press. Org. Thank you. We are adjourned. On the next washington journal, congressman darin lahood on the deal reached on transportation funding. After that, congressman brad sherman of california on the u. S. Military effort against isis, iraq and syria. Congressional debate over syrian refugees. Washington journal, live every morning at 7 00 am eastern on cspan. And you can join the conversation with your calls and comments on facebook and twitter. Federal reserve chair swrja yellen will testify on the hill thursday morning. Watch it live at 10 00 am eastern here on cspan 3. Attorney general loretta lirc lynch will meet with muslim advocates. Well have it for you live 8 30 eastern on cspan. In an effort to improve veterans access to treatment and increase their Health Care Services, Veterans AffairsDepartment Plans to consolidatity Health Care Programs. They met to review the plan today. Deputy va secretary Sloane Gibson and va undersecretary for health dr. David schulkin. They were joined by advocacy groups who gave their recommendations on the plans. This is just over 2 1 2 hours. Call this meeting to order. Welcome, everybody. Hope yall had a great thanksgiving and hope everybody has a wonderful Holiday Season coming up. This is a very important hearing for the United States senate. On november 4th, if my memory is correct, we had a meeting at the va. Sloane gibson, dr. Schulkin and some others were in the room. In terms of Va Health Service delivery to our veterans, veterans choice, consolid dms ating programs, reimbursement rates so there wasnt any preference over another. A reality in our lifetime and in their lifetime. This will not be the first time i heard most of this information. We had that meeting before. It will be the first time a lot of people have heard it. This is a critical there are a critical number of decisions we will have to make to make my va work. The new veterans choice work and make sure that va does what it does best well but doesnt get itself into things it has proven in the past it doesnt do very well. Information technology and Network Building i specifically want to ask. As someone who ran a Company Every time you Start Talking about Information Technology or Start Talking about building networks, you talk about inf infrastructure and costs, raising management people and take an agency that already has 314,000. If you grow that some more youre probably making a big mistake. Ill be very interested in the testimony of what all of you have to say on those particular points. Were delighted that with the progress we made at the va im symptomed all the time in georgia and they say youre the chairman of the va committee, arent you . Are you frustrated with how screwed up the va is . I said the problem is that we see every day the successes weve made, weve got a good secretary, good team, making Good Progress on veterans choice and for all the bad storyies yo hear about, theyre mostly stories that happened in the past that were trying to correct, not things that are happening today. This is to address a number of previous shortcoming of the Va Health Care system to improve it for the veteran in terms of access and coordination of their care and va in terms of the delivery of the system. But to ensure that we magnify choice and not minimize choice so we can deal with the challenges of the 21st century. I recognize Ranking Member senator blumenthal. Thank you. Welcome to our witnesses and thank you for your good work on behalf of our nation. This task of consolidating and reorganizing community in the care and patchwork of programs we have now is certainly an urge enter one and apparently a very expensive one, 1. 9 billion is a lot of money to spend on organization. I want to know how that money is necessary and what specifically it will be used to do. I also want to know about Consumer Rights. How do we protect Consumer Rights and educate both providers and individual patients, your consumers as to their rights and responsibilities. And i want to make sure that this plan for care and community is implemented as well as possible. I know thats your goal, too. Thank you for being here. We have two panels today. First panel will be made up of honorable Sloane Gibson, secretary of the Veterans Affairs. Accompanied by david schulkin, who i want to commend this committee on the rapid approval to his confirmation to take over a job that will help him. Doctor im going to mess this up. No, no, dont cheat. Dr. Joe dapias. Yall can correct me. No doctor. No doctor . Take it if you can get it. And with that well your testimony keep it within five minutes if you can. If you go a little bit over as long as its factual, important and relevant, were happy to hear from you. Sloane, thank you for being here. The program is yours. Thank you, mr. Chairman. Ill offer a bit more elaborate introduction. David has been at va for all of four months now. He comes to us from a career in the Health Sector managing systems. Dr. Valleu, brilliant young Infectious Disease doctor. And with va for over 30 years, Medical Center director and he has spent most of the past several months working with this team on this report and addressing Community Care issues. Were facing an extraordinary opportunity by consolidating and streamlining means of providing care in the community. Veterans get the best possible care no matter where they receive it. Were determined to seize that opportunity and make the most of it. Va is already in the midst of an enterprise you alluded to. Our proposal to consolidate Community Care programs is part of that overall effort. Care in the community has been and will always be a vital component for health care for veterans. When they live too far from a va facility, when they need care only in the community and when increasing command for care. Were saddled with the confusing array of programs, authorities and mechanisms that greatly complicate the task of ensuring veterans get the care they need, when and how they need it. Project arch, pc 3, choice, two different plans for emergency care, affiliations. Each has different requirements, eligibility rules, different methods of payment. Its all too complicated, for veterans, Community Providers and va staff as well. It will improve the process and make it easier for veterans to use. Providers will be encouraged to participate and provide Higher Quality care and va employees will be able to serve both better while being good stewards of taxpayer resources. Veterans, independent assessment, va employees, federal stakeholders, best practice of the private sector and we proesh many discussion s weve had with your staff. Single set of Eligibility Criteria based on distance to va provider, wait time for care and availability of services with va with expanded access to emergency and urgent care. Streamlined rules to simplify the process. Third, highperforming network. Partnering with federal and comunity to offer a network that will allow va to better monitor Health Care Quality and utilization. Fourth, better information. And fifth, prompt payment, improving billing, claims. Allowing faster more accurate payment. These efforts wont just improve the way we do Community Care. They will make Community Care part of the fabric of va care, making va truly an integrated Health Care System. Getting there will take time. Even as we work toward the longer time, were improving veterans experience of care in the community. Provider base by including providers based on medicaid. Weve eliminated enrollment date and combat eligibility indicators as factors limiting choice availability. Several new changes were announced yesterday to the productsf our collaboration with this committee and house counterparts for which we are very appreciative. Veterans are now eligible if theres not a va facility within 40 miles if a veteran just needs a flu shot or if they need a round of chemotherapy every two weeks or so they may now qualify for choice no matter where they live. Those are just a few ways were making Community Care for accessible to veterans even while working toward the longer term goal of consolidation. A number of close end consolidation objectives. Standardization of our partnerships with dod and academic affiliates. Critical make versus buy decisions on Information Technology, in contractor support. Successful application of my systems to Community Care coordination. These objectives will be the work of a Community CareTeam Dedicated full time to improving and consolidating Community Care, led by a new deputy undersecretary of health for Community Care. Were eager to move forward but it must be a collaborative effort with congress. Like many of the improvements weve already made is only possible for your support. We need congress to provide ÷u required funding. I know costs are an issue. Critical cost issue right now is the 421 million. We expect to spend this fiscal year on systems redesign and business solutions. Absolutely essential if were to move forward with consolidation and improving critical care. To cover other possible aspects, such as increased demand and expanding emergency and urgent care. We also expect some cost savings from consolidation as well. Weve detailed our specific legislationive proposals in the report, and were happy to work with any member on these items. Finally, mr. Chairman, a word about provider agreements. We need congress to act on the proposal we submitted may 1st and uncertainty about care thats outside the Choice Program and our other Community Care programs. This is especially critical for veterans in longterm care. Were already seeing Nursing Homes not renew their agreements with us, which means veterans will have to find new homes. Thank you for the support youve already shown. We look forward to integrating care in the Community Within the Health Care System. Thank you, secretary gibson. Appreciate your testimony. I want a short answer on this question. You said you made two changes, announced two changes yesterday regarding the 40mile rule and the services a veteran needed to expand choice access. Steps long away to consolidation, i think thats what you said. Yes, sir. In one sentence, describe what that longterm goal is. The longterm goal of consolidation of care is to improve the veterans Care Experience and deliver that at the best possible value to taxpayer taxpayers. In that case when we had the field hearing in gainesville, and i dont think you were there. Secretary mcdonald was kind enough to come. The choice provider for the east coast, i cant remember their name right now. Health net. And a discussion ensued about issue of eligibility of a veteran to get services outside va through choice and it was an arduous process of which meant file after file going to a Third Party Provider before they could determine getting veteran the service. Is that still going on with the Third Party Provider . One of the things we want to see is easy access for the veteran, wherever it comes from, you or the private provider. This eligibility situation you used eligibility in your testimony a lot. Its evidently more cumbersome in practice than it is in words. What are you doing to streamline that process for a veteran to know if they are el inlgble and that it doesnt take a philadelphia lawyer to find out if they are. The way that a veteran can actually access care in the community, there are two of the fundational elements of the report. The process of consolidation is to help streamline eligibility. There are not multiple programs each with different criteria in order to access Community Care. Thats what we outline here, develop a set of criteria easy for the veteran to understand and easy for our Community Providers to also be able to administer and for our employees to deliver that care. So, thats from the eligibility standpoint. When we talk about referrals and authorization, that process is very cumbersome, as you described, mr. Chairman. There is a number of steps that our employees have to go through in terms of transposing information, uploading information, sending that over it our third party contractor, steps that they go through before we can actually make an appointment for the veteran. Thats too long. What were proposing here in the plan is to streamline that so theres less redundancy. We are more automated to accomplish that. What we have done in the meantime, mr. Chairman, is we have modified the contract with both the Third Party Administrators which now allows us to almost immediately send an authorization document to the Third Party Administrator that triggers a call from the administrator to the veteran. Instead of the veteran having to call the administrator, waiting several days before doing that, and getting bounced back and forth between va and the Third Party Administrator, the burden falls on the Thir