we're just wanting the wording -- the language to stay that 1284 covered nonservice connected veterans as well as service connected veterans. so they can have the access to the rehab centers that the va has out there. the 13 blind rehab centers and the 29 spinal cord injury facilities in a letter, undersecretary of health "d" robert jesse stated va supports the intent of broadening travel eligibility for those who can

most benefit from the program, and says the va welcomes the opportunity to work with this committee to craft appropriate language so those who are not service connected can have access to those rehab treatment facilities. one thing i've ran into with several of the members, speaking with them, is the word, the pay for a or the pay go. well, va travel budget continues to increase every year. and they ask, where are we going to get this $3 million? well, in 2013, the va collected 2.931 bill through the medical care collection fund. there's money they collected. and i sat last night listening to last night's hearing. $1.1 billion returned two years ago 1, billion last night, and half billion returned just this year.

if there's that much money that can be turned back in from the va to congress, well, there's our $3 million to send these nonservice connected veterans to send them to the rehab they dearly deserve. so there is no pay for or pay go. the money is there. it was clearly stated last night in the hearing, that the va is giving the money back. so, if you want to pay for it, there's your pay go. also, the va right now is currently -- there are 147 state veterans homes. i have been collecting data, and right now i have 14 of those state veteran homes, which is 10%, and of those -- that 10%, those state veteran homes house 268 veterans who are there for blindness or visual impairment. each one of those veterans the va pays a per diem of

$100.37 per vet per day. that's 266, 365 days a year, that's 10%. now let's add to make it 100%. and to be hon, that total is $97.5 million annually we're paying to house veterans in state veterans homes just because of blindness. if we can send them to a blind rehab center, get them the rehab they so dearly deserve, how many of them can we offer the opportunity to live independently? not be housed in a state veterans home. but live independently. live on their own. the one thing i did want to mention here is just remember this. there is no cure for blindness. there isn't.

no matter how much research we do. but what there is it rehab for those who are blind and visualry impaired and getting that rehab allows them to enrich their lives, become independent and be active numbers of their community. so let's not say, well, you're not service-connected so we won't send you to a rehab. blindness does not discriminate between service-connected and nonservice-connected and doesn't know. blindness is blindness. let's him nate service-connected and nonservice connected. let's send the blind veteran to the rehab that the va are providing. and lastly, i will make this quote, george washington once stated the willingness to which our young people are likely to serve in any war shall be directly to how they perceive the veteran of earlier wars were treated and appreciated by their nation. ing this quote clearly begs the following question: as generations pass, will this

great nation continue to see young people volunteer to join the armed forces knowing their future health care issues will not be covered by the va? are we willing -- are we all aware of the issues surrounding what is going on right now? are we willing to enrich the lives of hundreds of nonservice connected veterans by allowing them to go to a blind re lab center? are you willing to cosponsor 1283, push it up and see to it's voted on so nonservice-connected veteran can get the same rehab the service-connected veteran gets. thank you, ladies and gentlemen. >> this is mike kaufman. thank you for your testimony. i've got a few questions. again, this is mike kaufman. mr. fugate. unfortunately your story is not likely unique. have you found eye blind veterans have gone through similar experiences with va's failure to populate the vision registry?

>> it's really hard for me to say that other individuals who have had situations that match to not only -- i'm surely they exist. >> okay. mr. fugate. again, mike kaufman. in your opinion, what would have been the benefits during your past surgeries had the va contributed to the vision registry? >> if my information was accessible to the va doctors when i first met them, rather than asking me about the surgeries i had, and thumbing through a two-inch stack of documents, they would have had

access to -- better access to the information. they would have seen that the dod doctors -- needed to have preventive surgery within the year. and i told the doctor that. the doctor -- my word isn't as strong as the military doctors, that had made the suggestion to me at walter reed. >> okay. >> also, i'm a number. i'm a statistic. and it's meaningless. there's no research being done on the numbers. if my information and all of the other blinded veterans' information were in this data set, much more information could be discovered and we could

direct ourselves forward to help us all much better. >> thank you. again, this is mike kaufman. mr. kebbel, thank you for your -- have you had an opportunity to share your findings with the va? >> this is my first opportunity to do that. but i do share my findings with other veterans. i belong to a lot of virtual support groups in which us veterans talk about problems with not -- with veterans web sites. how to deal with the inconsistencies, how to deal with the inaccuracies and how to deal with the problems of filling out forms.

so i do that virtually. >> okay. mike kaufman again. you stated earlier, mr. kebbel -- you stated earlier there enmany good examples of 508 compliant web pages. do you and your team keep repository of best practices and lessens learned? do you have a list of performance matrix that agencies such as the va can strive to achieve? >> yes, we do. it's in various forms. it is not in one form that i would consider accessible and we're in the process of developing that. >> thank you very much. ranking member kirkpatrick. >> thank you, mr. chairman.

mr. fugate. our committee has been focused on making sure there's a seam's transfor of records from dod to va so there's no gap at all in the records that a doctor might see. the day you transition out of the department of defense. so i'm curious, did walter reed have the department of defense records but just not looked through them? can you explain that to me? >> walter reed had my medical records, and it was at the va that i had the complications. it was the transfer between walter reed and the va. >> so did the va have your department of defense records? >> my first meeting with my doctor at the va was surprising. my father drove me three hours to get to the facility. we lived at the time in appalachian mountains of eastern kentucky. once we got to the meeting, the

doctor came and sat with me in and the nurse brought in my records children was a wig, heavy stack of -- a big heavy stack of records. i couldn't see them but i heard the thump, and he said there was something along the lines of, he could do -- he couldn't do anything with that. he would have to review it later. and find the information. and i was sent back home. sent along my way. >> even though you told them that the doctors recommended that you have preventive surgery within a year? >> absolutely. he said, yeah -- i told him that numerous times, and after the -- probably the third time, he said it was better for us to wait until an issue occurred, and

address it then, and i'm not sure -- pretty sure he must have been aware that i was commuting two and a half, three hours. >> so, i'm so sorry that the treatment was not given to you in a timely manner, and i just want to say your positive attitude is an inspiration. i thank you for coming again, and i just wanted to take you up on what you said in your testimony and ask you what changes you have seen since your testimony before the committee in 2009? >> i've been deeply involved in my education that yearly i catch up with my blind veteran friends at bva, and it's every year it gets more discouraging, and so for the last you're or so i've stopped asking about it because it just brought -- it was just depressing to me, and this year

when i got with them, they told me that for the past years the staffing was inadequate and that there were no -- the records weren't being put into the registry and the collaboration wasn't taking place as it was supposed to. i never, never got any positive information about the progress of the vce. >> if there were one thing our committee could do to make a difference in that area, what would that be, in your estimation? >> to ask -- to see what -- to ask the people responsible what

they were asked to do, and which of those tasks they have completed, and how long it took them to complete that task, to just -- just to hold the people responsible for creating this wonderful tool for us. >> mr. chairman, i think that's what our committee should do. mr. fugate, i hurt you're a friend with tim watson, i won't hold that again you, actually, he is an ardent supporter, a passionate advocate for our veterans and you couldn't have a better friend. thank you very much for your courage and testimony here today. i yield back. >> thank you, ranking member kirkpatrick. mr. high schools camp, you have five minutes. >> thank you, mr. chairman, seems like i was just here a few minutes ago, and i do appreciate having more time to discuss

these but i appreciate the tonight. i am tim hills kamp from the state of kansas. mr. fugate, i hope i pronounce your name correctly. mine is often mispronounced. but a little followup on your particular situation. one thing i have seen looking in any few years in congress is accountability. systems do fail. people do fail. i'm curious in your situation you transcribed in written and oral testimony, has the va followed up with you after the fact and determined, yes, this is where we failed in the system? i see a number of things -- electronic medical record didn't happen, and i'll have a followup question for mr. miney about other familiar. did the va ever contact you and say this where is we fail, this is where the system failed for

you? >> no, no one ever -- from that i can recall explained to me where the failure occurred or held themselves accountable or provided an apology. i've stuck with the va, and i've had great medical care, and met and became friends with a lot of medical professionals within the va. the system clearly, clearly failed, and in my case, and no one ever has explained to me what happened. >> do you still travel two and a half hours to va center for your current care with the va or aree

you found one closer they would letter -- can you describe that a little bit more in i come from a rural district. plenty of veterans have to drive 200, 300 miles one way for care they often times could get next door almost, literally, and the va says, no, you have to drive, and i'm just curious in your situation. >> i moved out to california to go to school, california state monterey bay. luckily, there's a va in palo alto -- a branch of the palo alto system, right next to my campus. so that was very helpful for me. i've came back home to eastern kentucky to spend some time with my family, and we now have a branch of sorts. it's an office and a medical

facility. they don't -- i can't get my medications there. i still have to travel or get them by mail. so i've seen improvements in trying to get centers or branches into rural areas. >> i appreciate that. and appreciate your testimony today. mr. minney, the medical records issue which has been plaguing the va and the dod attempting to communicate. my understanding that often actually happens in the private world, they actually do communicate fairly regularly, but the va and dod cannot do that, it's my understanding. can you describe the situation that occurred with travis, given the current scenario, would that likely occur again when a veteran walks in and says here's my medical reports and it's just paper?

is that still the situation? >> yes, it is. travis was unique because he actually did have a copy of his health records, but i spent 21 years in the navy as a corpsman in the medical field, and once i retire from there i actually went to work for the va. so, i can tell you right now, dod health records are not being transferred into the va health care system. if you take a young o311 marine that gets injured and gets surgery and lunch, when he gets back home and goes into a va healthcare system and a doctor will ask him, what surgeries decide you have, he is not going to know the names of these surgeries. so, right there the va has to start from scratch and build a health profile on him. if there was a transfer of those health records or a joint health

record, the va could access his dod health records and see exactly what surgery he has had. what medications he is on or what therapies he has needed. that's where the benefit would come into play. but not everybody was as fortunate as travis to actually have a copy. some of the injured show up at the va with nothing, no documentation at all. >> thank you, mr. minney, mr. fugate. i yield back. thank you. >> mr. takano. >> thank you, mr. chairman. mr. high huelskamp, that last question brought up some very, very bitter memory us. one of my first committee hearings was about this issue of the medical records. not being able to be transferred from dod into va,, and i can

barely contain the anger i feel about this situation and the millions and millions of dollars spent trying to solve this situation, and to hear in the interim months between my first hearing and now, that there seems to be no way to bridge this gulf between the two departments. it's bad enough to see a casualty of war, but it's even worse to see that casualty of war made even more tragic by this systemic failure between these two departments. i don't know what to do about this. it is frustrating to be a member of congress and not be able to say, fix this thing, and have it fixed. that being said, i do want to say to mr. fugate and mr. kebbel

that i'm proud to have started the first vet caucus in the congress and it has put me in touch with the disability community. one of the useful things that has come out of that, we made a commitment to have an intern from the deaf community from the state university. it's my belief that some of the disability communities are not well represent bid advocates here on the hill compared to the other very strongly represent interests here. i want to ask mr. fugate, you're a young man and you're getting an education at cal state. i'm proud to call you a californian now. have you guff much thought to what direction your life might take at this point? >> i was really excited after having the opportunity to speak here back in 2009, and it was --

it felt great to be heard, and -- but as the year went on and then a couple more years passed and things didn't happen, it was just very discouraging. so i was really happy i -- that i picked a career in computer science where i could talk to computers instead of asking people for help. computers are much easier to talk to. they gave you the answers you want. so my path is in technology. >> well, i'm wondering if there might be some individuals in your capacity, the same situation, that might be the

only enter on the hill -- the only intern on the hill to be a reminder to the members of the challenges and might be a way for us to have a pipeline of veterans in this situation, might facilitate that. this is going to take a long -- it's been several -- i don't know how much time it's taken to get attention focused on dod and the veterans affairs department, the va, on this records issue, the health records issue, and seems like it's going to take us several more months if not years of focus. might be helpful to have a way to get some of these service members to intern or even to have staff positions here on the hill. >> i think it would be an absolute wonderful thing to have a few blind veterans here up on

the hill for the simple fact, as members of congress are walking the halls, their staff, or even individuals from the out coming in, if they see the blind veteran maneuvering the halls, getting around, and seeing that their disability isn't hindering them from being an active member of society or the community, then i'm all for having some blind veterans doing internships here on the hill, and i would advocate for that. >> mr. kebbel, do you think we could understand -- members might understand your struggles with web sites if we had to upgrade our systems to be able to accommodate blind interns, bottom line veteran interns here on the hill, if our systems had to have the kind of software that would make it possible for

them to work here and advocate on behalf of their brothers and sisters in arms? >> there is no question about it, that it would help. there are some serious issues that have to be overcome first, is that some of the legacy software that the va uses, no matter how much work you do on it, won't be accessible for a screen reader. it would be valuable for someone to sit down and evaluate the process of using a web site or even just documents to do that. as we look at it a little bit, though, right now the va doesn't even have -- i think they're self-audited as far as if a web page is usable. the automation systems are fine,

okay? and that may give you an indication that it's quote-unquote accessible. but until you have someone who sits down and uses a screen with a reader, i don't think you'll have a very good result. >> thank you. mr. chairman? >> mr. rowe -- dr. rowe, tennessee. >> i'd like to introduce someone before i start. timothy dennis, 19 years of aim, is here with us today. this is foster youth shadow day on the -- and, tim, if you would stand up. he spent six years in foster care in tennessee and he is here as many of his other friends are, with the hill today. so let's give him a round of applause. [applause] so, travis, i remember your testimony very well, and i remember you being here and it was powerful then, it's powerful

now, and thank you for coming back and i'm your neighbor just south of you in east tennessee, so i'm just -- where in kentucky are you from? >> i'm from a small town in knot county, kentucky. we border virginia. the closest city is hazard, kentucky. >> so i know exactly where you live then. first of all i appreciate your testimony, and one of the things you brought up is extremely important. five years ago, last year we had the va and dod come in and they just burned a billion dollars, a billion -- we're worried about three million? we burned a billion dollars trying to make the dod and the va healthcare records speak to each other, and they can't. they quit. so, $3 million is nothing, and i've been to great lakes, illinois, twice, to look at the

system, where they tried to get it to interact. it hasn't worked. i dent know, travis, whether you're finding that information out but it would certainly have been nice if they had found that information. whether it would prevent what happened to you, god only knows that but it would have been nice of the doctor had all the information available to be able to make those decisions, and just a commentary, when you go to california, don't let them mess you up. you're just fine. out there in california. and i think, mr. kebbel, what you said, tomorrow i go back -- i'm a veteran as you are, as all of you are, and i'm going to back to vietnam tomorrow, and what you just said when you made your testimony is the right thing to do, is absolutely correct. not because you have to do these things, because it's the right thing to do. and one of the things i do every

year, we have about january or february, we have our sight impaired folks come to the hill and put a blindfold on for an hour and try to walk around my condo, which is very small and get around. it isn't easy, and we need to do everything we can for our veterans who have been -- who are sight-impaired. and i agree with you, whether it's service-connected or not, if there are veterans -- and i completely agree with that. i have a question that may be better for the next panel but i'll miss it. gawk -- potentially blinding diseases in the veteran population, what procedures are processes are in place to ensure that veterans with advanced sight threaten can eye diseases have been soon by an ophthalmologist? >> i had trouble hearing you, sir. >> what procedures or processes

are in place to ensure that veterans with advanced sight-threatening eye diseases have been soon by an ophthalmologist. do you know that in the va hospital system? >> i know once they're first diagnosed with the first stages, that they're put on like a screening program where they monitor it, three months, six months, but then that's really all they do is monitor it, because macular degeneration, there is medication to slow the progress but there's no cure. glaucoma medications, no cure. they can only monitor it. >> one other thing. your comment here on your testimony, i'm disappointed after the past three years while on dod side they already have over 23,450 eye-injured records in the vision rem registry, but

today the va has one veterans record and have nod set the up because instead of having the colorado do the work, the va is waiting for contract bids to be settled before getting started. that's now four years ago you were here. i had chance to talk to congressman harold rodgers to make sure the isn't delayed any longer. thank you for that information right there we need -- we'll fine out from the next panel, and the three of you, all of you, sincerely, thank you for your service to our country. [inaudible] >> thank you very much, mr. chairman, and thank you for holding this hearing. great to have you all here again. travis, i know my colleague gave a kind introduction and associated you and i together as friends but hari truman was

right, i know you have a companion at your side. if you need a friend in washington, get a dog. but you've got one. i'm honored and no one i would rather stand with. it's not often you get the opportunity we're going to discuss the intent of congress, the spirit and the letter of the law. today you got the folks in the room that wrote the law. the first in the room that advocated for the funding, and we worked together. i'm reminded and i pulled it up, you would probably appreciate this, travis, a "usa today" story said a military center devoted to treatment of eye care has been -- because of a squabble between dod and the pentagon over who i would pay for it. that was january 28, township, and we hear this, how long this issue of electronic records has been going on and seamless transition, i can say my entire adult life we haved a vote indicated for this, both within the military and then after.

it's an important point itch also think it's important to note, though, because it was mentioned here, february 2013, the new england journal of medicine story made this clear. the private sector, 12.2% of physician use electronic records meaningfully. don't try to pretend there's some type of magic bullet on the other side that it's working. that's nonsend, too. the issue on this is not trying to set up some paradigm here that the private sector is doing this and we're not. we're failing in getting this done here. our purpose is to get this right and i would ask, travis, on this. is your goal to have the vision center up and running and doing what it is supposed to do and get this care or is your goal to go to the private sector to get your eye care? >> my goal is to have the -- i care deeply about the va and all the care they provided, recreational care, therapy, and

mental health counseling, and i've recently came back to kentucky to help my parents, who are getting up there in their years, address some of their medical issues, and they were unable to manage their care in the private sector. it was too complicated. they were -- i couldn't imagine trying to go into the private sector to be honest with you, and one of the failing paints when -- points when i tell young men and women about my military experience, you can avoid the private sector when it comes to medical care. it's so freeing to know i can just take the bus to the va and

be around people who know me and care about me and understand my issues. >> this is an important point because we need to really be careful because fee for service issues are absolutely fair issues. that is a role for atlanta and a goal for that -- role for that and a goal for that but these core mission issues, especially vision impairment and different things, you're not going to get off the hook by not fixing what is here, and i'm angry, too, this communication is not working. i said in 2009 ex-demanding we get this right, but i think collectively together, when there's a role and a mission and a purpose and one that is working for people like travis or other veterans, we need to get that right. so, i agree, with dr. rowe, this is not a funding issue. they have to get this figured out. i represent the mayo clinic and they tell me the vista system in the va is the best medical record in the world. so we have that. dod has david one. keep in mind, understand dod's role is to fight wars but until

this nation understands, when we have our two biggest bureaucracies in government siloed up in dod and va not communicating with one another, you cannot separate travis and these warriors and they're injuries from the war we fought, and now we have the problem of a turf battle fighting whoever will put it in. tom gagliano, an expert in this, talked about i have an eye care center but i don't have any computer and i can't get going. so we have a responsibility to avoid the easy flippant answers of what it does. dig down and hold the accountability, which we heard, get the accountability on this, get this thing up and rung, because as travels -- travis told me, his goal is to get back into technology, get that little place sometime, and you did say tennessee. i have to give dr. roe that. so i would appeal to my colleague, let's let the data,

the oversight, let's drive this and get this going. we chose to do the vision center of excellence, fully knowing it was the best chance to do what they asked us to do and now let's just make it work. i yield back. >> thank you. >> thank you, mr. chairman. gentlemen, thank you very much for being here. i'm dan beneshek from michigan. i'm a physician as well as mr. roe, and i worked within the va name for 20 years as a consultant, and i have a couple of questions for you all. mr. fugate, let me ask you this question. its sounds from your testimony that you're not quite happy with the care you're getting from the va. seems to me you're checking in with them periodically and

that's about all your doing. is that correct? >> it's tough for me because i am very satisfied and happy with the medical professionals in the community that i deal with, that i work with when guy to the va -- when i go to the va. it's a failures in the system and -- that are causing -- that bother me. >> what could deva be doing for you now they're not doing some. >> -- >> was there something you would like them to do? you're not having that close of communication with the va over this tragedy of your loss of sight. it seems to me there should be some ongoing help to you to get your life in order as best as

can be. are you getting anything like that from the va now? >> yes, absolutely. they're serving -- i go to mental health meetings regularly. i've been involved as i said before with the recreational departments. >> what would you like them to do they're not doing? >> well, currently, everything -- they're doing fine by me. that's that they failed and i could see a little bit. i had some vision, some very useful vision, and it was their failure in handling my need when i transferred from the dod to the va, that led to me losing that remaining vision, and what my -- my care is fine now. what i hope to do is prevent other soldiers, veterans, from

being hurt further by a failed transition between the dod and the va. >> right, right. mr. minney do you have any comments? what could the va do, besides avoiding the issues luke mr. fugate talks about, and the whole reason we want this testimony -- . >> the biggest challenge i see that can be fixed is communication across the board. the two agencies need to communicate better. it needs to be a more seamless transition so that no one gets lost in the system. when i was injured, i went -- my injuries required me to get surgery from a german hospital. the military hospital wouldn't touch me. so i had five eye surgeries from a german hospital. well, the german hospital had --

they sent me there but then when me unit was looking for me, the military couldn't tell them where i was at. once they discovered where i was at, had already left hamburg back to my unit and my family were looking in hamburg, hamburg finally got around to tellening them i was at liu unscttol and then i was back at beg this da naval hospital. the same thing went on as far as my purple heart. the purple heart was delivered by the ups man because it wasn't from three different places. everything was a month behind. because no one was communicating. it's the tracking. they need better tracking. that's where i would see improvements being made. >> mr. kebbel, i was intrigued by your statement here about the lack of -- the difficulty for a

blind person to get through the va web site, and i'm not familiar with the technology that involves the blind to deal with the computer, and i guess there's a big lack in the ability of the va to communicate with the blind veteran. you just elaborate on that a little bit more than your testimony? >> i'll be glad to do that. let me just go back in history a little bit. while downscale the situation a little bit. instead of being at a government level. i'll be at the city level, the city of los cruces. they were in the process of redesigning their web site, so i had an opportunity to just sit there with their i. t. department and discussion what that means to us, and the next thing is once the i.t. department had the concept of what to do, sat down and performed training for the city

employees to give them a basic understanding on why we need accessible, and why we need properly tagged elements. once i was able to do that, the city employees were 100% in. so i think right now what i see the problem is, is that we understand what needs to be done, but nobody really understands why it should be done. >> all right. well, i know why it should be done, mr. kebbel, and i appreciate you being here to tell us. thank you all for your testimony. i'm out of time. >> mr. o'rourke from the state of texas. >> thank you, mr. chairman. thank you for the witnesses being here. i wanted to make a comment and then ask a question to

mr. fugate. in the beginningoff your comments you talk about being here five years ago in 2009, and implied in that was what difference did your testimony then make? what progress have

they can bring it to their visit with a va doctor, bring it to their visit with a private medical doctor, they can just have and it refer to it as they need it and you have given us a poignant example of why that is so badly needed. i'll say we have cosponsors that include the chairman of this committee and ranking member of this committee, mr. walz, mr. takano, but as you continue to advocate on this issue, and

mr. minney and mr. kebbel, we encourage you to make sure that members are aware we have a bill that would provide part of the solution to some of these problems. you offered some good advice, mr. fugate, when asked what you would ask other veterans to do who might be in your situation. you said that working within the va you found to be helpful versus working within the private sector, and i really appreciate your even handed description of care. you talked about providers on the physical and mental side, the great call the care you got once you got insuring despite the unfortunate decision that was made initially. so i really appreciate that. what else -- because besides influencing this committee and the va, i think there's a wider public that is listening to your remarks today. the veteran who is returning

from afghanistan today who has sight impairment, what is your advice to that veteran in what would you like them to keep in mind? >> i would hope that they would understand that the va is there for them. it's a veterans community. i've enjoyed sitting in the waiting rooms and meeting veterans from the past wars, and their wives and family, and having coffee with them from down the hall while we're waiting. it's a community, and the system is slow, and you have to reach really deep to find the patience sometimes to allow the system to turn. the system is not turning fast

enough. the people in the va aren't out to get you. they're not against you. the system just is turning too slowly. people care deeply about the returning veterans. >> thank you for saying that. and again, thank you for finding the good within the system we can build upon while also recognizing the frustrations you and others have with parts of the system that do not work. mr. kebbel, i'm about out of time and i may ask you some questions following the hearing but i did want to follow up on a point you're making about inaccessiblity on the va's web site, and really make sure this committee is doing everything it can. m-walz leaned over during your testimony and asked, is this committee's web site fully compliant and accessible to you and others who are sight-impaired. i think the answer we received from staff initially is that it is not. so we need to do our part to

make sure that we're not just blaming the va and not just holding them account able, which we should do, but also holding ourselves accountability. you mentioned the library of congress as an example of a federal agency doing it right. i'm going to have to give my time back to the chairman but i would like to follow up with you after the hearing to find other agencies and federal departments who are doing the job the right way and see what we can learn from them. so thank you, and mr. minnee also for being here. with that i yield back. >> thank you. miss custer, state of new hampshire. >> thank you very much, mr. chair. and thank you to our witnesses here today, both for your courage and articulating the problem but also i want to join my colleagues, mr. o'rourke and his comments because i want you to understand, we are -- i'm also a new member of congress, a new member of this committee,

and mr. fugate, when you say people care deeply within the va but the system is slow, this has been our experience within the united states congress. people care deeply but the system is very slow, and i want to revisit a letter that i led with my colleges, a bipartisan letter that we wrote last summer, july 22, 2003, to secretary of defense chuck haigle and secretary of veterans affairs, eric shinseki, where we raised our concerns about the vision centers of excellence, and asked for information to get a sense -- sometimes around here it's difficult to even get the information about where things stand because obviously we have colleagues on beat sides of the aisle that came before us that care deeply about operating this vision center of excellence, and

one of the parts of the response that i fine troubling -- this is dated january 4, 2014, from secretary shinseki, is there seems to be a number of positions that are open. the va contributed 6.6 full-time equivalent employees for the vision center. that doesn't sound like very many to me, given the scope of this project. 2.6 are currently filled. four are in the hiring process. and then this is also the case with the hearing center of excellence, four fce es, of which w. position was filled and three in the hiring process. and i don't know if anyone on this panel can help us with this but i do want to convey to you, as mr. o'rourke has, that you

have focused our attention on this issue, and that we intend to press this case forward, because the very purpose of setting up the vision center of excellence is to address these concerns. we have so many new veterans from iraq and afghanistan with sight impairment from the war, and then aging veterans, with sight issues. so, could you comment on, if you know, any member of the panel, what is the current progress and do you think there are sufficient resources including people power, to address these concerns about registering the people into the system and the computer issue that you have raised.

mr. minney. >> i know the last word we got was on the va side, there is a blind rehab specialist position that is -- they're interviewing for, and then the va side will have all their ftes filled. but now they're looking -- they're putting bids out for contractors. my question is, the inception was in 2009. what is -- there was $6.9 million that was budgeted for the va side, for 2.6 employees between 2010 and 2014. i would like to have that salary, 6.9 million, split between 2.6 employees, over four years? i don't know where that funding went.

>> right. i also think the comment was well taken about the funds that are returned to the treasury, it's a fine thing in this world to be frugal. we don't see a lot of that around here. but the point is how can funds be returned to the treasury if the are issues like that remain unresolved and not addressed. so, i'm going to close my time and i just want to thank you for coming, and i also want to join dr. roe in addressing -- i have a constituent here, dakota, from berlin high school in the back of the room, and foster -- not child -- young person here to learn more about our congress and mr. fugate, think you have a bright future, and i can just hope and pray you might choose to address it to resolving the computer issues at the va. so, thank you for joining us.

>> thank you. before the panel leaves, i'd like to have mr. handel discuss an issue mr. o'rourke raise relative to the compliance of this committee's web site. >> thank you, mr. chairman. to your question, sir, the committee's web site does use a reader, and it's called browse loud, which is an element by way of compliance. so, have you folks at the panel been able to access that? >> qusay the name again, please? >> browse aloud? >> i never heard that in my life. >> i have nod used it. >> then we'll get with you after dismiss you can walk us through make sure it does address your needs. >> i can make a comment? >> yes, sir. please. >> the standard screen reading software that blind folks use,

and when you introduce a screen reader that a blind person is not accustomed to using, it's hard to expect that they will be able to interact with the information the way they're accustomed to interacting with information on other web pages. so in my opinion, a custom screen-reading solution for a web page isn't adequate. >> can i address that, too? >> yes. >> this is terry kebbel. the problem with an automated system is that it's designed by someone who looks at a script and says, this is what it's supposed to do. so, i would say most of the time it's probably accurate. but there's a lot of times where

it will look at a tag and it will be a description of the tag of the label, and the label won't will say button. but i don't know what the button does. is it a button for searching something? is it a blue button that we're talking about? is it a button that sends me nowhere? so, yes, it will pass the test, but is it effectively labeled? effectively described in you can probably go through the form fields web site on the va web site and look at the link. i get you every one of those links will pass inspection. but every one of those links are numerically described. there's no description of what that form is. so, yes, you can use that, but as i spoke later, that you really snead someone to sit down

and -- need someone to sit downl wait it, who uses a screen reader, if it's designed correctly, nye screen readers will be able to address that. >> mr. takano and then we need to move to the second panel. >> very briefly, mr. chairman. i appreciate that you and your staff are going to work with mr. kebbel after the hearing, but could we not share this information with the house administration committee and our counterparts in the senate? i think it's important that the entire institution of the congress, every member's web site should be able to accommodate blind veterans and the blind community in general. >> we'll certainly do that. and this is the same system that is on the house va committee that the library of congress uses, as i understand it, but i think there's always room for improvement and we'll certainly look at that.

i want to thank you all so much for coming and testifying here today. really appreciate your service to our country. mr. kebbel? >> as a vietnam veteran this concerns me. we're talking not young veterans coming back. what concerns me about us vietnam veterans is agent orange. ...

dr. mccarthy, deputy chief of patient care services for the veterans health administration, and ms. lorraine lance freed, deputy chief information officer for product development for va office of information technology. they're accompanied by doctor mary lawrence, deputy director of the vision center of excellence and mr. pat sheehan, director of das 508 compliance office. [inaudible conversations]

i think will continue for committee members, will continue the process as stating your name so those that are vision impaired in the audience can no who was speaking to her i would ask the panel to do the same. dr. mccarthy, your complete written statement will be made part of the hearing record and your now recognized for five minutes. >> thank you. good morning, chairman kaufman, ranking member kirkpatrick, and members of the committee. i appreciate the opportunity to discuss the department of veterans affairs contributions to the vision center of excellence and the care and services provided to veterans with visual impairment. i am a copy today by doctor mary lawrence, deputy director of the vision center of excellence. vision center of excellence was

established by the national defense authorization act in january 2008. in october 2009, at dod memorandum of understanding defined the roles and responsibilities of the department and the establishment and operation of the vcd. our efforts are directed at improved vision, health, optimize readiness and enhanced quality of life. the national defense authorization act also required the implantation of the defense and veterans i injury and vision registry. the vision registry collects longitudinal data on eye injuries, guys research and clinical education, promotes best practices and informs policy for the treatment of eye and vision related injuries for servicemembers and veterans. i am pleased to share that the vision registry is on schedule and on budget.

dce has achieved many significant accomplishments since its inception. vce has identified and addressed 33 process improvement opportunities through the monthly vce posted worldwide ocular trauma video teleconferences, which connect providers across the continuum from combat support hospitals and coalition providers to be a poly, centers. it has also led the way to initial inclusion of fox protected eye shields in joint first aid kits, and is attempting to expand them into individual first aid kits. in addition, the the sea and collaboration with blindly of the services has designed an educational pamphlet geared towards inpatient care teams and hospitalized settings to assist with the transition. mr. chairman, the consequences

the vision interest or servicemembers and veterans will be with us for decades to come. therefore, va will continue to partner with the dod to provide i care providers, clinical care practitioners and researchers to have access to information needed to develop strategies that will enhance and improve patient care outcomes. mr. chairman, this concludes my testimony. i'm prepared to answer any questions you may have. next i would like to introduce lorraine lance freed, deputy chief information officer for product development, office of information and technology to address issues related to compliance. >> thank you, and good morning chairman coffman, ranking member kirkpatrick, and members of the committee. we appreciate the opportunity to discuss the veterans affairs work to improve access to information technology resources, for visual interdev, stakeholders and employees. accompany me today is mr. pat

she hand, director of our five away program office. since 2001 this office has provided validation testing on the websites and applications using a combination of automated tools and manual auditing. the latter of which is performed by users who have a disability including those with a visual impairment. when va identifies nonconforming applications or websites section five a wait staff work with relevant parties to correct or remedy accessibility issues. as critical as it is for us to audit and improve our existing legislation is just important to sure that all future applications and websites are in conformance with 508 standards as well. to do this we have implemented formal policies requiring all information technologies developed by va to complete a milestone process. this helps us ensure that accessibility is planned for and built in up front rather than trying to inspect it in the future. we also provide training to be a system, providing them with the tools and the know-how to make

the information 508 conformant. we've made progress over the past year. for example, we improve the comp performance of the my healthy web site from 60% to 95% today. we will continue to pursue an aggressive strategy to ensure access to all covert systems and electronic information. we are also intent on working with our veterans stakeholder groups. va will attend the blinded veterans association's upcoming national conference to review recent updates typically used applications and websites and work with them to identify ways that usability can be improved but even in areas where we're technically already section of 508 conformant. mr. chairman, this concludes my prepared remarks and we look for to answering any questions you may have. thank you. >> thank you. are there for the remarks? dr. mccarthy, this is mike

coffman i'm according to testimony they were 23,664 unique patients enrolled in the vision registry. how many of those patients were enrolled by the department of defense? and how many from the veterans administration? >> mr. coffman, that's an important question. the actual entry of the data was primarily done by the department of defense. you heard mention that there was one person injured by va and that was to test the system. i want to explain the registry 40 minute if i could. the registry is a seat at the department of defense, and so it is set up to take information more directly from the department of defense for servicemembers who do receive and eye injury. the va set up the architecture for the registry and over 50% of it was used by the department of defense in order to enter their

servicemembers data into it. va has to go through a two-step process to enter the data into the registry. it's typical with cancer registries and all kinds of registries of that sort that information is harvested from a particular medical record, place in a repository and then entered into the registry. va has contract that you may have heard is currently up for bid, that we, the bid closes june 9. for the completion of the data entry into the registry, first into the repository to go into the registry. so it's a two-step process with va is unaware. we did look at how many veterans -- let me rephrase that. how many people who have been treated in the day because some active duty service member has ended up like rehab program. how many people have actually been treated at the va that

already have data in the registry and currently there are at least 2400 veterans who have data in the registry but you or i could that data by -- >> if we could just go back to the question, and that is that i get the department of defense because they'll have the service, active duty so they will enter that in. but this registry is also for non-service-connected veterans i issues, is it not? >> it's about eye injury. >> so whether it's service-connected or not service-connected, it's about the veteran i injuries. but the fact remains, you have been entered into a single person. so what else is you're not participating. >> i understand why you say that and it is regrettable that none have been injured, but the framework is in place.

the targeted for the registry to be functional is by the end of fy '15, and so the fact that the contract is out for bid this point is progress and we are looking for the data being entered by the end of the fiscal year. >> we had a lot of those definitions of progress last night before the full committee, and it's disconcerting. in das february 2014 response to a letter i wrote in octobe october 2013, i was told that va had not awarded a data instruction contract due to contracting delays. what were those delays, and have the problems that caused them been directed? >> that's actually probably better after to buy dr. mccarthy. >> and mr. coffman, i am not aware of the exact delays but i'd be happy to take up for the record and get back to before the hearing.

i did ask if we did find a timeline for the process of the contract award and what the delays were. i don't have that at this point but we will get back with you. >> mike coffman again. ms. landfried, according to july 26 to 2012 memo from the assistant secretary for information and technology, all va i.t. software was required to be complied with section 508 by january 2013. is all va software compliant at this point in time? >> at this point in time it's not -- we've not achieved 100% conformance with the 508 standard. we've made significant progress since that time. >> what percentage are you at -- mike coffman again. i want to remind people to identify themselves for this hearing before they speak. what percentage are you at right now? >> the percentage is difficult

for me to address right now because the software that we are looking at, particularly on the web and particularly the software that we look at as far as applications are concerned are pretty much in development. i think the important come important point that i want to make here is that the process, what we're doing with the software is working to the processes that we've established so that we can build software in at the beginning of the software lifecycle and through the test -- >> i think a simple and would be you are not compliant at this point in time. thank you very much. ranking member kirkpatrick? >> this is ann kirkpatrick. dr. mccarthy, atlantic about your description about the vce. so it's housed at the dod but does the va have access to the records that are beauty? >> yes. it would be the opportunity for providers to access that record.

>> and does that happen? >> at this point i'm going to defer to dr. lawrence on that. >> okay. yes, ranking member kirkpatrick, the registry is designed so that eventually individual providers from dod or va will be able to access the information in the registry on their individual patient. and the identified data on other patients. so they could, for example, put in some criteria that may be characteristic of a patient they are seeing and look at the identified it and look at the outcome of that identify david to help inform the provider and the patient's biggest i appreciate it. my concern is supposed that military member transitions out today, goes to a doctor tomorrow, technically in the va system will the doctor be able to see that person, records,

regarding the eye injury to his service-connected? >> this is dr. mccarthy speaking. there are multiple opportunities for va doctors to be able to access records from the department of defense in our record system screen. there's an opportunity to use a web-based interface in order to have access to those records. >> so i'm still not clear what your answer is. would that doctor be able to see that patients military medical records the day after they transition out? >> it's my understanding that if those records are electronic, those records can be accessed. most of the records are electronic at this point. >> do you know what percentage? >> i do not have that number but we could check with dod and get back with you. >> so then, the das portion of this is just eye injuries, not necessarily military connected.

and that's where you are contracting out to have somebody enter that information? >> what we are contracting for is for someone to go to our records and pull out information such as eye exams, data from those exams, visual acuity treatment interventions that were made so that over time progress can be tracked by the individuals but look at collaboratively. that's the point of the registry. >> i to question about the funding. dr. mccarthy, again this is ann kirkpatrick. your testimony notes a total of 6.9 million that the va has budgeted for the center from fiscal year 2010 to this coal your 2014 has the funding been consistent each year and can you provide a year by year breakdown of the funding over the past five years? >> thank you, ranking member

kirkpatrick. this is dr. mccarthy speaking. the $6.9 million was allocated in acumen give him out for that period of initially from fy nine to 13, extended to 14. to really over a five to six year period. what happened was an initial kind of ramping up of salary dollars but in addition, kind of thinking of the money towards contracting to enter the data that we're talking about from that va medical record into the repository. so that money has kind of been kept separate, but the money that has been used over time, and i will be happy to provide those dollars for you for the record if you would like, that is a gradual increase over time as salaries have increased and functions have increased. >> i would like to see the breakdown, and you by your breakdown since the funding started and then how much is set aside for the contractor. and thank you, i yield back.

[inaudible] >> thank you, ranking member kirkpatrick. dr. benishek. >> thank you, mr. chairman. i can't believe it takes five years to get this thing going. what's the story with that? i mean, apparently it's not even all up yet, this center of excellence. why has it taken five years? the entire second world war was four years for us. >> this is dr. mccarthy speaking. i like to respond. there have been processes involved in getting this set up, the joint executive committee -- >> five years? >> that's the target for the registry to be functional. >> five years seems like a really long time. let me get you something of a more pertinent -- dr. mccarthy, it's come to my

attention that there's many issues with our veterans with their eye diseases, glaucoma, diabetic retinopathy, macro degeneration. blinding eye conditions that have left untreated will lead to blindness and they're very prevalent in her aging veterans population. so what procedures are in place to ensure that veterans with these eye diseases are seen by an ophthalmologist? >> sir, this is dr. mccarthy speaking again. what i would be happy to tell you about is some of the processes we have in place. for instance, a patient who has diabetes is at risk for diabetics retinopathy. there are is greening casas is in place in which we use telemedicine and photographs of retina of every patient with

diabetes, are taken and read by anatomic trees or an optimal just and then if needed that patient is referred to a apologist for care. but it's part of the routine screening for diabetics. in addition patients with glaucoma are followed regularly in our eye clinic, and you mention whether the disease, i'm sorry. >> macro degeneration. >> macro degeneration, a tragedy we do have off the most is carefully following people with macro degeneration but i can't speak to the exact screening procedures that are developed for those patients but -- >> i have a concern because you know, i worked in a va hospital and it's tough to staff many of these clinics with ophthalmologist. they have a hard time getting people. are you aware of any of the procedures for hiring local ophthalmologists for staffing va centers on a part-time basis?

are you familiar with any of that? >> i'm a former chief of staff in salem virginia, and it was our experience there that we did try to hire full-time ophthalmologists, or we would ask for people to come in on a contract basis. because we were an academic facility, we have a strong partnership with the university of virginia and were able to recruit people effectively there. but i'm aware that other institutions to have contracts for folks to be hired. >> i'm concerned because some of my friends are optimal just that work at the va, and they are concerned with the fact that padilla limits their ability to work at the va because once they reach a certain dollar amount, then they can't work any mayor -- anymore phobia. so because -- anymore for the year. but, of course, they don't have any full-time offer mulches so the patient then travels 150 miles to milwaukee to get to

see the optimal just. so they say you can't pay them or because would be more efficient to hire a full-time ophthalmologists but yet they don't hire a full-time ophthalmologists for the patient just goes without. whereas if they work for a little longer, continue to provide the care and not have the patient to far. i don't understand the reasoning for the rule. if you say that it's more efficient to hire a full-time ophthalmologists, then hire a full-time ophthalmologists. it seems like kind of a catch-22 problem. let me ask another question. apparently i've also heard that in order to improve access to i care that they're having like i take nations do some of the work rather than physicians, some of the screening work. you mentioned screening, the

retinal pictures. it concerns me when people other than physicians are providing care. i mean, how do we know those patients -- in what the status of that situation is a? >> yes. this is dr. mccarthy speaking again. i can talk about the training like to talk about a typical eye doctor appointment in which there are other nonphysician people that are involved that might check visual acuity might be involved in checking -- >> but i'm talking about things that a physician typically do. i'm always concerned about the quality of care when physicians are doing the things that they're supposed to do. i'm sorry, i guess i'm out of time. maybe we can further that later. >> thank you. >> mr. takano, state of california. >> thank you, mr. chairman.

dr. mccarthy just help me. where is your center located? physically. >> i'm going to defer to dr. lawrence. >> this is doctor mary lawrence. division center of excellence has two locations in the national capital region. one, our headquarters is that walter reed national medical center in bethesda and we also have an office in crystal city, arlington, virginia, and we also have a small office at the army medical center in tacoma, washington,. >> walter reed is under the aegis of the dod, right? but nevertheless the vision of center is located at walter reed, right? >> yes, sir. this is dr. mccarthy speaking again. the vision center for excellence is a joint effort between dod and va, and all the centers of excellence, dod authorize navy

to be involved in this was a partnership between the navy on behalf of dod with -- >> that clears up. i've been to walter reed and i saw the center. is that the same center? but nevertheless we are still having problems with the registry being populated. help me to understand this registry. the registry has not been popular but waiting for the context to be filled and juicing by the end of fiscal year '15 is when we expect this registry work to be done, or begin? >> no, sir. this is dr. mccarthy speaking again. the register contract is out at this point. will have the bits in by mid-june and we expected to be awarded in the data entry to start by the end of the fiscal year. >> all right. and you are saying, i want to clear up the question that was answered to ms. kirkpatrick's question about a provided being able to access a service member's record.

so even without the registry being populated, you're saying that the entire record is still theoretically accessible, if it's electronic. if it's in electronic form at the deity the medical provide on the va site can still access it overnight or the next day? >> it's actually real-time. it's not exactly instantaneous. i have to say does take some time but i would like to yield to the rain to see if she could say more about that. >> i have the operability works? >> ms. kirkpatrick asked the question, service member leaves defense. next day sees a va doctor. and that the doctor access the record? >> as long as it's an electronic record and yes. as was stated earlier most of their records in dod are now in electronic form and their health

records is the. i guess the daylight or the gap is between interoperability and seamless interoperability. so if the dod data then essentially you have to push a button to say go fetch it and bring it to me. it's not stored locally as part of the va system. and that's what a lot of the work recently has been about is to go from interoperability to seamless interoperability. so as you're conducting a clinical workflow that the information that you need is there hand in hand with the step you were doing. >> i have a couple more questions. all try asking them quickly. has to do with accounting for diversity. i know that in certain ethnic groups, asians in particular, that glaucoma can show up much earlier in the patient.

do you have procedures in place to be able to accommodate the different health needs among service members according to their ethnicity? >> va has stood up an office of health care equity and diversity, and i would want to yield to them. so if it's possible i would like to take that for the record and get back. >> i appreciate the. related to mr. cable, he raised the point about agent orange and his connection to his illness. is there anything -- from the point of view of any kind of preventative work we can do? >> this is what i would have to take for the record. i don't have an answer. i get to the about agent orange in general but not specifically towards blindness. >> we can do with that later in written form.

>> mr. woolard, state of texas. >> thank you, mr. chairman. -- overworked. mr. horn work. so for dr. mccarthy, some of these questions you may have already answered and they may be repetitive, but i'm new to the want to make sure i fully understand. you mentioned that january 2000 was the start date for this initiative for the eye injury, and vision registry? >> i mentioned -- us are, this is dr. mccarthy. i mentioned that the act that established it was january 2008. >> that's when it became law. and the funding was appropriated the next year? >> i don't have the date of the funny. i can to the date that the m.o.u. was signed between dod and va and that was october 2009. >> and the back of a received shows at least $5 million of that funding has been spent come and help, speaking about the

same positive, there's a total 6.9 million appropriate to 5 million. what has that 5 million been spent on? in the most plain terms possible. >> we have a 2.8 of the 6.9 been set aside for the contract. so that brings us to 4.1. the 4.1 million has been used for salaries for individuals as we have wrapped up the employment over the past five years, and in addition to education and training events, and i would yield to dr. lawrence for more details about that if you like. >> not just yet. thank you to. you, in responding to earlier question about how long it's taken, you said it's regrettable but that you also mentioned were on schedule and on budget. so when this became law in january of '08 and funding was appropriated in the year

thereafter, was it always understood that you nine of 2014 was when we would go out to bid or make a decision on closing those bids? >> actually it was always understood that by the end of fiscal year 2015 the registry would be operational. >> okay. thank you. and it does just from the lamest perspective seem like a very long time. dr. benishek compared to not the time we spent in one or two in the number of people who are affected by these issues you do not have access to this care. and i'd like to take one that we have as an example today from mr. fugate. based on his testimony from '09 to the extent that you are familiar with it and his testimony today, do you have anything to offer in response to concerns that he raised or the specific case study that is offered and how we are or have not yet learned from it, and are or not yet able to provide the kind of care that might've

provided for a better outcome in mr. fugate's case? >> this is dr. mccarthy speaking again. i'm happy to get in touch with mr. digit after the ring. i be interested in offering support in that way. i do want to mention the 33 process improvement activities that were identified as part of the vision center for excellence calls in which the people in the field and the people advantage -- vision center for excellence at the people of the polycom centers have worked together to try to solve those kind of communication issues. >> that might be good for myself and the entire committee to understand from your perspective mr. fugate specific case and how that case in 2014 might be handled differently and how the interoperability between dod records and medical recommendations and decisions and those in the va might provide for a better outcome, or might not, where we still have

some ground to make up. so i think it's very important for us if nothing else to learn from his specific expenditure that it is not repeated. i think you'd probably agree with me on that. >> yes. >> then for ms. landfried and section 508 issues. i think this discussion today is happening within the larger context. the american public and congress is a frustration with lack of accountability within the va. and so again just looking at the back of an all of the chances that va had to come into compliance, the waivers that were issued to allow the va to remain out of compliance, the fact that one o of the most critical issues like the ability to fill out a va form that mr. kebbel brought to our attention, it seems like not only would that be a benefit to sight impaired benefit, it would be of benefit to the day to be able to have that information entered there by the veteran by himself or herself instead of having to go to an office. how do you answer, in the

plainest terms possible, what i feel is very justified frustration at the amount of time that the va has had to get it right? you and mr. sheehan spoke earlier of the processes involved all the things you got to do what you really lost on -- i think we just want to know what has taken so long? where is the accountability? when will you be able to assure this committee and the veterans who depend on the services through the web that you be 100% compliant? >> i'd be happy to address that. we are absolutely committed to making sure that all of the information that veterans need about benefits, about health care is able to them and everything else went to offer is available to them as an electronic product through our website and forms. and the memo that was mentioned earlier by the chairman, that was i think a wakeup call and

accountability for is to say there are these waivers out there, what are you doing with them. >> with the chairman's indulgence could ask a really quick pointed question? give us a day by win every single page and every single va website will be 508 compliant. >> the reason we keep talking about the process is that if i'd wanted% compliant tomorrow, new systemsystemssystems will come , edition forms will be added, additional webpages will be outed come additional doctors will be added. so -- >> this does not build confidence in what you're doing and what our veterans can expect. i would hope that you come back to this committee with a set date and from that date, we are one of% compliant and every day forward we will be one of% compliant. i think that's what we're asking. i don't think it's too much to expect i think that's what the veterans that we serve deserve. without i yield back. >> thank you, mr. o'rourke. ranking member kirkpatrick? >> dr. mccarthy, appreciate your willingness to divide the committee with a year by year

breakdown of how the money has been spent. that's part of our responsibility on this committee is to oversee a taxpayer dollars are being spent. someone asked that within that year by year breakdown you also categories that can work with the committee staff on what categories seem to be appropriate. we would get that to you and just like us in dialogue with our staff on the. in other words, i'd like to know how much is spent on salaries, space, how much in other areas just we've got an idea of how that is being spent. and i thank the panel for being here today and thank you, mr. chairman, for having this meeting. >> thank you. our thanks to the panel. second, you are not excuse but again, this is mike coffman. today, we've had a chance to hear about problems that have led to many years passing while virtually, i'm sorry, visually impaired veterans continue to be denied equivalent access to

these services due to be a failures. as such this hearing was necessary to publish a number of items. first, to identify the reasoning rdas lack of progress in implementing the vision registry, despite years of having passed the authorization. second, to receive an explanation on why va has not brought its system into compliance with section 508, the americans with disabilities act, and third, to determine what steps are being taken to correct these issues and improve the care provided to veterans and the ability to access crucial information. i ask unanimous consent that all members have five legislative days to extend the remarks include extraneous material. without objection, so ordered. i would like to once again thank all of the witnesses, and the

audience members, for joining us in today's conversation. with that this hearing is adjourned. [inaudible conversations] >> a live picture from the white house briefing room were coming up shortly, press secretary jay carney will speak with reporters, certainly a number of questions about news today about veterans affairs secretary eric shinseki resigned after reports

of systemic mismanagement that va's health care for those around the nation. we will also from debbie nash is good advisor been roads about the president's upcoming trip to europe next week including the stops in poland and brussels where he'll be talking with world leaders about russia's actions in ukraine. the president will wrap up his trip with a stop in normandy where he will then commemorate the 70th anniversary of d-day. jay carney coming up in just a moment live here on c-span2. [inaudible conversations] >> again waiting for the start of today's white house press briefing with spokesman jay carney. while we wait a discussion on agriculture and farming in the u.s. from this morning's "washington journal." >> we look at america by the numbers we want to turn our attention to america's farming

industry and how it's changed over the last five to 10 years and joining us is with the u.s. department of agriculture. dan generals who covers the issue for npr. thank you both for being with us. let's go to this chart that looks at some the major developers in the agriculture industry over the last five years. expenses and sales have reached record highs in 2012 according to the most recent picture. one out of five farmers and use operate a farm for less than 10 years and the farms are producing much more on farm renewable energy doubling in the last decade. >> that's correct. with an outstanding production year in 2012. there's a backdrop to this you. we also had a drought during 2012 so that have some adverse affects on yields and the like but from a standpoint of prices we saw record prices for a number of commodities. that's the driver behind the average, the total value of

sales, more than $395 billion. >> we have this map on our facebook page, and it's interesting because it points out just how much farmland we still have in this country. 40%. can you explain? >> that's an interesting thing, the snapshot of american agriculture. and this, you know, map of the country with the percentage of farmland by county is fasting to look at. you realize the impact of agriculture. the number of farmers has shrunk a lot. the percentage of the economy has shrunk a lot over the years, but the impact in terms of the landscape is huge. the darkest colors on that map, 90% of the land in those counties is devoted to agriculture in some form. much of the country, the majority of the countryside is either cropland or -- >> and yet small farms are disappearing or evolving, why

and how? >> if you compare 2007 to 2012, overall down a little over 4% in the number of farms. we've seen on the lower and of the economic classes a little bit heavier loss of farms. but again looking at the backdrop, this was a drought year. you have a number of the small producers that can get in and out of agriculture. the other point i'd like to make about that map is that when you look at a sickly where the bulk of that farmland is, the breadbasket of the united states. that's we have most of the corn, soybeans, wheat, halt production in the united states. and that area was affected by drought during 2012 as well. we also very significant production obviously out in the western areas of california, the northwest, and also if you take

a look at florida as a major citrus producing area but even if you don't see it up in the northeast corridor but there's a lot of valuable productive agricultural land in those areas. just not to the extreme intensity of the midwest. >> this next graph has a lot of numbers but i want to highlight some of the most important ones. the overall number of farms has declined by about 20,000 from 2002 and yet you conceived in the principal operators has increased over the last decade, so has been a vision and black and african-american operators. native hawaiian operators has also increased and the age has changed and evolved. back in 2002 the average age was less than 25, about 16,000, almost 17,000 back then. now down to just under 11,000. >> if you take a look at this and remember you're looking at a 10 year span. this is from 2002 compared to

2012. you've seen just a slight decline in number of farms, down 1%. what we are seeing in agriculture is a real diverse snapshot right now where all of the ethnic and racial groups, the number of farms in those areas have all increased, and the other point i'd like to make is we are seeing a very stable situation with farmland across the united states. so agriculture is in a very strong position being able to stabilize the number of acres and production agriculture, and also you'll see some changes as we go through in some of the structure of agriculture. >> and charles, as you look at these numbers, how many are individual farm owners and how much is really a corporate agribusiness we've been seeing over the last 10 to 20 years of? >> most are individual farmers. these are principal operators of farms. but there's one thing that really jumps out at you.

2 million farmers is what the census says, but if you look at that more closely, the majority report that they earn less than 25% of their family and, actually farming. the majority say farming is not the principal occupation. so if you look at that number, 2 million, you have to treat it with a little bit of skepticism because don't think this necessarily as a farmer who is out there spending all of his or her time on a tractor, or raising cattle. the average farmer is actual earning most of his or her income off the farm. so you will have to keep that in mind when you look at these statistics. in fact, more than 80% of all agricultural production in this country comes from just 200,000 farms. the majority of agriculture production in this country just comes from i think 80,000 farms. it's actually, you know, the

large farms are, the number of large farms, really large farms is increasing and they are becoming more significant in the agricultural landscape spent we welcome our listeners on c-span radio. we're focusing on america by the numbers and the latest census information on america's farming industry but our phone line to open and we have a line set aside for those who are farm households. all of these charts are the of on our website to this one, hubert hamer, surprise me. from 1959-2012 and i apologize for radio listeners maybe you can explain what we are looking at. >> you take a look at this span from 1959-2012. you talking about a 53 year period. we are showing a slight downward trend in farmland across that time span. and effect if you compare back to 2070 we're only down a tense

of 1% in farmland between the two senses. looking out over a 30 year time period of we lost 72 million acres in 30 years. that's only down 7%. so this draft says to me that farmland and agriculture is very stable, especially over the last 20-30 years. >> dan charles, your thoughts? >> the farmland actually is, i agree with that, but there has been a transformation going back even much further, 100, 200 years, complete transformation in sort of the overall, sort of structure of the farming economy. the fact that the average farmer these days is a part-time farmer i think is kind of a legacy of an earlier era when, say, 30-50% of the labor force was in farming but that's not the case anymore but an awful lot of people, hundreds of thousands of people keep a foot in agriculture. they run some cattle on the side

while they have a job at the factory or in town somewhere. that is, and the rise of the enterprise with a million or $5 million in annual sales, that's a trend that is really taken hold and then we're seeing -- >> if you are farm household, the number to call is -- you can send us an e-mail at journal at c-span.org. hubert hamer, actually to these numbers, the top five commodities, what are they? >> top five commodities over all, cattle the number one at $76 billion followed by korn, number two at $67.3 billion. and then poultry and eggs, soybeans and very, the fifth largest at $35.5 billion. the overall value of sales is

$395 billion with crops making up about 54% of the total, livestock 46%. in fact, since 1974, this is the first time that crop sales have exceeded livestock sales. >> this is a snapshot on america's agriculture industry but how do we fit in compared to the rest of the world's? >> well, america, the united states is -- >> good afternoon, ladies and gentlemen. how are you? you obviously heard earlier from the president in this room, and he took some of your questions. so perhaps that means this will be a relatively short briefing.

[laughter] might go easy on me maybe? no? i do not have any announcement to make at the top i'll note for you that you should have received a notification that there will be a call later this afternoon during which dan rhodes will preview the president's travel next week. that will serve as our week ahead so i don't have a separate week ahead for today. so with that, let's answer some questions. >> thanks, jay. two topics. one on the va. the president said that some of these problems did not surface to the level where shinseki was aware of it, that these things were troubles that they were hearing while traveling around the country and that we need to see how to get information about

this since they are not working. the ig's report this week noted that there has been 18 reports since 2005 that have gone to the va, that have gone through committees of congress, including the one the president sat on when he was in the senate. how can we say that this was not risen to the level that it is not -- >> i think secretary shinseki both powerfully this morning about some of these issues. i think the nature of the problem here that has been identified by the ig, by some of the reporting on this, and by secretary shinseki's preliminary report is that there were efforts undertaken to misrepresent how long the waiting times were. so that the information that was being provided to headquarters, if you will, here in washington was not accurate in some cases

according to the ig's report. so what the president said today, what secretary shinseki said today is that these reviews, the ig's investigation and the preliminary report, the secretaries review have borne out the most serious concerns that this is a systemic problem and that is why secretary shinseki said what he said today, and why the president made the comments he did today and accepted the secretary's resignation, with considerable regret, given the remarkable service that the general and then secretary shinseki has provided to this nation. >> these issues of delays and veterans getting their appointments or medical appointments has, in fact, --

[inaudible] since 2005. >> i think the president noted as he has in the past, and others have, that there are challenges associated with this issue and other issues in va and have been for a long time predating 2005 even. and what we have learned in recent weeks through this review process, in the investigation, these are deeper and more serious than is even remotely acceptable. and dramatic action has to be taken. secretary shinseki announced today has initiated the process to fire individuals because of thiofhis conduct, and he himself tendered his resignation because he felt that it would be a distraction for him to be an issue remain as secretary, when the focus should be on fixing these problems. and that's ultimately what the

president is focused on. on. >> on ukraine, the u.s. defense officials are now saying that russian troops appear to be moving away from the ukrainian border. what's the president's reaction, confirmation from your own defense department? >> well, there continue to be indications of activity on the border including a number of units that appear to have withdrawn. and that activity has continued, and i would know what you did, statements from the defense secretary that they have increased. we do not have confirmation that this represents a full withdrawal yet. we would welcome a full withdrawal as we have called for now for some time. the presence of the troops coming many thousands of troops on the border, serve to destabilize the situation in ukraine. they were there to intimidate,

and it remains necessary that a full withdrawal take place. that would be a very positive step. we continue to work with the people of ukraine and the president-elect to support their efforts to determine their own future. despite the significant disruptions in regions of eastern ukraine, the efforts of separatists, using buildings, preventing -- >> you haven't seen me enough today. one of jay's favorite lines is i have no personal announcements at this time. but i do, and it's bittersweet. it involves one of my closest friends here in washington your in april, jay came to me in the oval office and said he was thinking about moving on, and i

was not thrilled to say the least. but jake has had to russell with this decision for quite some time. he has been on my team since day one, for two years, with the vice president for the past three and half years as my press secretary. anadded as august he placed a strain on his wife and his two wonderful kids. dela's little league team by the way, i had a chance to see the other day and she's a fine pitcher, but he wasn't seeing enough of the games. jay was the reporter for 21 years before coming to the white house, including a stint as the moscow bureau chief for "time" magazine during the collapse of the soviet empire. so he comes to this place with a reporter's perspective. that's what i believe it or not i think you will miss hanging out with all of you, including the guys in the front row.

[laughter] >> third row. third row. [laughter] >> but jay has become one of my closest friends, and is a great press secretary. and a great advisor. he's got good judgment. he has a good temperament, and he's got a good heart. and i'm going to miss him a lot. i will continue to rely on him as a friend, an adviser after he leaves to spend as much of the summer as he can with his kids before he decides what's next for him, whatever it is. i know he's going to be outstanding at it. of course, that meant i had to make a decision which is who succeeds jay, and we've got enormous talent around here, but i decided that we're going to put in this slot somebody who was also a friend and advisor.

so today, the flag jacket is officially passed to a new generation, mr. josh earnest. [applause] josh is a coach's son from kansas city. he still roots for the royals, i guess. [laughter] as you know, his name describes his demeanor. josh is an earnest guy, and you can't find just a nicer individual, even outside of washington. the country of course knows him for his golden voice and tones on west wing week, the biggest viral internet hit since between two fronts. but josh and i have an incredible history going all the way back to the iowa caucuses.

josh was my iowa communications director, and even when he was in that role comes in that role, you would find spending an extra hour or two helping young staffers make phone calls and knock on doors. there was no task that was too small, no detail, too unimportant for josh to attend to. at the white house his been a mentor to many of the young people here who i know are thrilled for him today. he is of sound judgment, and a great temperament. he is on his and full of integrity, and i'm sure you will at some point get frustrated with him as well. but it's going to be hard, because he's a straight shooter and a great guy. so my request is that be nice to jay on his farewell tour, and be nice to josh during his initiation, which i'm sure will

last two days, or perhaps to questions. .. >> are you going