the facility and to collaborate with the department of veterans affairs in doing so. one of the main responsibilities required in the 2008 ndaa for the operation of the vce was to, quote, enable the secretary of veterans affairs to assess the registry and add information pertaining to additional treatments of surgical procedures and eventually visual outcomes for veterans who were injured into the registry and subsequently received treatment due to the veterans health administration. ..

>> one compared to 20,000. notably, in an october 2013 briefing, va staff stated that the one entry was just a test case to insure that the transfer of information would work. so, essentially, va had not entered in any veterans' information into the registry which precludes va from meaningfully contributing to very purpose the registry was created, quote: to collect the diagnosis, surgical intervention, operative procedures and related treatments. and follow up on each

significant eye injury incurred by members of the armed forces while serving on active duty. we will hear from a veteran today who will articulate the importance of va fulfilling its obligation to contribute to the registry. another major issue we will address today is va's continued failure to bring its information systems into full compliance with section 508 of the americans with disabilities act. the two separate -- section 508 addresses access for people with physical, sensory or cognitive disabilities in various types of technologies. two separate memoranda dated july 26, 2012, issued by then-assistant secretary for information and technology roger baker illustrated the ongoing

problems with va regarding section 508 compliance. both memoranda reference how recent audits conducted by va show that most of the content and information on va web sites was not section 508 compliant. further, in a 2012 va dashboard summary analysis every site reviewed showed a status of less than 50% compliance with section 508. some notable examples include va jobs, e-benefits and va forms. va jobs at 80% critical, e-benefits at 95 critical, and va forms 100% critical. the rating of critical in the analysis states that the listed percentage is the amount of that

web site that is completely inoperable. we will hear today in va's testimony that they are making great strides in bringing va systems into compliance with section 508. however, we will also hear from a blinded veteran who must actually navigate these pages himself. he may be inclined to disagree. with that, i now reck these ranking member kirkpatrick for her opening statement. >> thank you, mr. chairman. i'm ranking member ann kirkpatrick there congressional district one in arizona. the hearing topic today is an important one, and i look forward to an in-depth discussion with our witnesses. today we are examining the department of veterans affairs' role in the operation of the vision centers of excellence and section 508 of the rehabilitation act of 1973 compliance. as they relate to proper access and services for blinded

veterans. we will also hear the testimony of mr. glenn minney from the blinded veterans association on h.r. 1284, a bill introduced by my colleague, ms. brownlee, a member of the house committee on veterans affairs. this bill will expand the va's beneficiary travel coverage program for some veterans who are not currently eligible for beneficiary travel but who are in need of treatment at one of the blind rehabilitation centers or spinal cord injury locations. mr. min three, i look forward -- minney, i look forward to hearing your testimony, ask as a result of being a cosponsor of h.r. 1284, i believe this bill will help remove another access to care obstacle within the va medical system for our veterans. many of our visually-disabled veterans would greatly benefit and become capable of living

independently in their own homes if able to receive rehabilitation. however, some of these veterans are not able to receive these treatments because of high travel costs and ineligibility for beneficiary travel under the va programs. and this is a special problem in my district which is a very rural district in arizona, and my veterans have to go to three different veterans' hospitals depending on where they live and travel hundreds of miles. this bill will expand eligibility for beneficiary travel so that more veterans are able to receive rehabilitative treatment. i understand that in the current conflicts eye injuries have accounted for approximately 15% of all battlefield traumas. we also know that as as 75% -- as many as 75% of traumatic brain injuries in patients, those patients also suffer

visual disfunctions that can affect their quality of life. when the vision center of cleanse was envisioned -- excellence was envisioned and established through the 2008 national defense authorization act, the department of defense in collaboration with department of veterans affairs was tasked with prevention, diagnosis, mitigation, treatment and rehabilitation of eye injuries. while it took some time, i understand that the center is now functioning although problems such as staffing, funding and clear policy remain challenging. in addition to the center, the 2008 national defense authorization act also required the establishment of a vision registry. i look forward to hearing from our witnesses today on the progress of that collaboration, especially enrollment and seamless transfer of va vision care data to the vision registry.

mr. chairman, while the wars may be winding down, we know that the need for research, treatment and rehabilitation will remain for eye injury veterans for decades to come. today we are also looking at the department of veterans affairs' compliance with section 508 of the 1973 rehabilitation act. section 508 addresses access for the disabled to different types of technology. according to va testimony, va systems are still not compliant with the law. one of our witnesses today described the difficulty of navigating through the va web sites because they are not 508 compliant. causing him frustration and a lot of extra time to get the information he is looking for. eye-injured veterans are already challenged, and we should be working as fast as we can to insure that their next encounter

on the va web site will not be so difficult. i would like to hear from our va panel what they are doing to become compliant, why is it taking so long, and what resources are needed, if any, to aid in becoming compliant. we need to get this right sooner rather than later. thank you, mr. chairman, i yield back. >> thank you, ranking member kirkpatrick. i ask that all members waive their opening remarks as per this committee's custom. with that, i welcome the first panel on the witness, at the witness table. on this panel we will hear from mr. travis fugate, kentucky national guard, retired. mr. terry kebbel, united states army retired, and mr. glenn minney, director of government relations for the blinded veterans association. all of your complete written

statements will be made part of the hearing record. mr. fugate, you are now recognized for five minutes. >> thanks, chairman and ranking member, for inviting me here to speak again. it was over five years ago that i came here to speak about the vce. it had been the creation had been mandated the year prior to the time that i spoke before which was march 2009. only a week before the day that i spoke i'd been told that my vision was totally gone, i wouldn't see again. most people who reviewed the case agreed that the vision that

i had lost -- let me explain something further. when i was injured, i had some remaining vision. and i had it for three years, and then i got an infection, went to the va, and the doctors didn't have access to the proper medical data. so they failed to do preventative surgeries, and when i had an emergency situation, they didn't have access to the medical documentation which may have led to the vision loss that resulted. after the surgery. since i was here before, i've went on, i've went to school, i've worked to improve myself, my life. i've been active in the va and the blinded veterans association

trying to help other blinded veterans. i meet new, young blind men kind of from the wars every year. i'm interested in hearing you ask questions about how things have changed since the testimony in march 2009 in which i participated. if some young man went to va tomorrow, as i did, would his doctors be able to have access to electronic data that allowed them to perform preventative surgeries and see all the surgeries he had in the past, or she?

i'm open for questions. >> [inaudible] mr. fugate. mr. kebbel, you are now recognized for five minutes. >> as a blinded veteran, i've had an opportunity to assist other blinded veterans on how to use web sites. we've done a good job of describing what 508 is, compliance. we've done a good job of stating that we need to do something about it. i want to talk about what we haven't done yet, okay? as i was asked to investigate ten web sites or ten web pages for this testimonial.

i had the opportunity to design with some help from some other blind veterans a form that helped us to evaluate each of those web pages. in my opinion, each of those web pages failed. each of those web pages failed in different areas, some very major and some very minor. when i get the opportunity to read a web page, i would like to be able to navigate properly. and i can do that with headings. and headings is a way for a nonvisual person like myself to navigate a web page. one of pages i evaluated had no heading on the page which means that i have to navigate the whole web page to find out what

the purpose of that web page is. a sighted person can visualize it and see what that purpose is right away. the, another page that i had the opportunity to evaluate was one with link robs, and -- problems, and i was kind of interested when you said that the forms page failed 100%. well, i'm in total agreement with that one. i had -- you know, when i went to the web page, i listed the links on the page, and there was 217 of them. and these are links to forms. every one of those links were named by a numerical number, had no description on what that form was. another one was, another one i evaluated is where i went to it, the web page. first one i downloaded, it was a

tomorrow to fill in, okay? the first thing i noticed was that was an image file. well, for those of us who use a screen reader and who are blind, we know that we can't look at pictures, and that is an image file. so i cannot read that image file. the second thing is that it was a form i was supposed to be able to fill out. well, if it's an image file and there are no formal edit boxes on that page, i can't fill in the information needed to fill out that form. so when i, when i hear that we're making progress on it, it's difficult for me to believe. i would like the same opportunity to read a web page as a sighted person. and i can to -- i can do that on web pages. i can go to open culture which is a web site from stanford university and access all their information. i can take courses there, i can,

you know, do a lot of things on that lahr web page. i can go to the library of congress and do is the same thing. i can go to the national federation of the blind which is probably one of the best web sites that i know of and read as if i was a sighted person. what concerns me the most is that we're sitting here arguing about are we compliant or not. of when i went to vietnam, i went to vietnam as a volunteer. i didn't go was it was the law, you know? i went pause be i thought it was the right -- because i thought it was the right thing to do. and as we sit here now, i think the right thing is to do is to make it compliant. whether it's not the law or not. i just think it's an issue of that you have the right to do it. as i look back, you know, in the

20th century the law became in effect, okay? we're now 13% into the 21st century, and as far as i'm concerned we have not made any progress. of -- [laughter] i just, and i'm not going to be around for the 22nd century, so i don't think i'm really going to see anything happen. thank you. >> [inaudible] care is really no different than a denial of care. mr. minney, you have five minutes for your remarks. >> chairman coffman, ranking member kirkpatrick and other distinguished members of the house relate vans affairs -- veterans affairs subcommittee on oversight and investigation, thank you for allowing the blind veterans association and its

members to appear before you today. the blind veterans association is here to express our views and concerns regarding specific bva issues. the issue i'm going to discuss is h.r. 1284, the beneficiary travel. as the director of the government relations for bva, i've already spent many hours and days with members of the house committee on veterans affairs regarding this bill. for veterans who are currently ineligible which are non-service-connected veterans, section 111 does not cover the cost of travel for those nonservice-connected veterans to one of the 13 blind rehab centers. or to any of the 28 spinal cord injury locations. if the law continues to stay as written, the nonservice-connected veteran hues bear the financial hardship of purchasing their own mode of travel to one of these rehab

centers. the cost will certainly continue to discourage the nonservice-connected veteran from traveling to a blind rehab center or spinal cord injury center. at this time most of the nonservice-connected veterans are of the age of 67 years old, and their blindness or vision impairment is due to age-related conditions. they have to live on social security which is approximately $1450 a month. ask with that -- and with that, having that limited income and is requiring them to pay for their own mode of travel to a rehab center, that's really going to pay dividends and be detrimental to their monthly income. the chief business office has scored this bill, h.r. 1284, as $3 million which, to be honest, i don't think that is true.

because as the language states in title 38, what we want changed is for it to say that it covers nonservice-connected veterans. we're not wanting $3 million, we are just wanting the wording, the language to state 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 spike cord injury -- spinal cord injury facilities. in a letter dated may 21, 2013, undersecretary of health, dr. robert jesse, clearly stated: va supports the intent of broadening travel l jilt for those who can most benefit there the program. it also states the va welcomes the opportunity to work with this committee to craft appropriate language so that those who are not service

connected can have access to those rehab treatment facilities. one thing i've ran into with several other members, speaking with them, is the word the pay for 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 billion through the medical care collection fund. well, money that they've collected. and i sat up last night listening to last height's hearing. $1.1 billion returned two years ago, $1 billion returned last night and a half billion dollars returned just this year. well, 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 the rehab that they

so dearly deserve. so there is no pay for or pay go. the money's 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've been collecting data, and right now i've got 14 of those state veterans' homes which is 10%. and of those, that 10% the state veterans' 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 a day per vet, per day. you add that up, 266 vets, 365

days a year, that's just 10%. now let's add, make it 100%. and to be honest, that total is $97.5 million annually we're paying to house veterans in state veterans' homes just payoff blindness. if we can -- because of blindness. if we can send them to a blind rehab center, get them the rehab that they so dearly deserve, how many of them could we offer the opportunity to live independently? not 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. what there is is rehab for those who are blind and visually impaired. and getting that rehab will allow them to enrich their

lives, become independent and be active members of their community. so let's not city, well, you're -- say, well, you're not service connected, so we won't send you to a rehab, you know? blindness does not discriminate between service-connected and nonservice-connected, it doesn't know. blindness is blindness. let's eliminate service connected, nonservice connected. let's send the blind veteran to the rehab that the va is providing. and then lastly, i want -- i'll make in this quote. george washington once stated the willingness to which which our young people are likely to serve in any rule shall be directly provincial to how they perceive the veterans of early wars were treated. as generations pass, will this great nation continue to see young people volunteer to join the armed forces knowing that their future health care issues will not be covered by the va?

are we willing, are we all aware of the issues surrounding what's 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 rehab center? are you willing to cosponsor 1284, push it up and see to it that it's voted on? thank you, ladies and gentlemen. >> mr. anyone knee, thank you for -- minney, thank you for your testimony. i've got a few questions with. again request, this is mike coffman. mr. fugate, unfortunately, your story is not likely a unique one. have you found that other blind veterans have gone through similar experiences with va's tail your to -- failure to populate the vision registry? >> it's really, it's really hard for me to say that i know

individuals who have had situations that match to hi own, but i'm sure that they exist. >> okay. mr. fugate, again, mike coffman. this your opinion -- in your opinion, what would have been the benefits during your past surgeries had the va contributed to the vision registry? >> if, 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 r cuments, they would have had access to, better access to the information. they would have seen that the dod doctors wanted me to have

a preventive surgery within the year. 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. >>some 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, help us all much better. >> thank you. again, this is mike coffman.

mr. kebbel, thank you for providing a number of findings and observations for improving va's compliance with section 508. 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 this which us veterans -- in which us veterans talk about problems with veterans' web sites, you know? how do 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 coffman again. you stated earlier, mr. kebbel,

you stated earlier that there are many good examples of compliant web pages. do you and your team keep a repository of best practices and lessons learned? associated with that, do you have a list of performance met ricks that -- metrics that agencies such as va can strive to achieve? >> yes, we do. it's in various forms. it is not in one form that i would consider accessible yet, and we're in the process of developing that. >> thank you very much. ranking member kirkpatrick. >> thank you, mr. chairman. mr. fugate, one of the things that our committee has been focused on is creating and making sure there's a seamless transfer of records from dod to va. so that there's no gap at all in

the records that a doctor might see. the day that you transition out of the department of defense. so i'm curious, did walter reed have the department of defense records but just not look through them? can you just 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 the appalachian mountains of eastern kentucky. once we got to the meeting, the doctor came and sat with me, and the nurse brought in my records which was a big, heavy stack of records. i couldn't see them.

but i heard the thump. and and he said there was something along the lines of he couldn't do anything with that, he would have to review it later and find the, you know, information. and i was sent back home, sent along my way. ..

your positive attitude is an inspiration, and 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've seen center 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 every year it gets more discouraging. so for the last year or so i stopped asking about it because it just brought, it was a 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 got any positive information about the progress of the vce. >> if there was one thing that 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've completed, and how long it took them to

complete that task. 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 understand your friends with a colleague, tim walz, i'm not going hold that against you, but -- actually quantitated he is an ardent supporter, a passionate advocate for veterans and you couldn't have a better friend. so thank you very much for your courage and your testimony here today. i yield back. >> thank you, ranking member kirkpatrick. mr. hill scamp, you have five minutes. >> thank you, mr. chairman but it seems like i was just here a few minutes ago. and i do appreciate having more time to discuss this but appreciatively. my name is tim whole's camp and mr. fugate i hope i pronounced

your name or ugly. mine is often mispronounce as well, but a little follow-up on your particular situation and one thing i see lacking in just my two years in congress is accountability. systems to fail. people do fail. i'm curious what your particular situation and described in your testimony, written and oral testimony, has the va followed up with you after this fact and determined yes, this is what we failed in the system? i see a number of things, electronic medical records didn't happen, and i have a follow-up question for mr. minney about other items in that vein, but did the va ever contact you after this or after your testimony and say hey, this is where we failed, this is where the system failed for you? >> no. no one ever from, that i can

recall, explained to me wa where the failure occurred or held themselves accountable or provided an apology. i 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. but the system clearly clearly failed, and in my case, and no one ever has explained to me what happened. >> do you still travel to and a half hours to va center for your current care with the va, or have you found one closer to, they would let you, or can you describe a all a bit more? i comfort of their role district.

money of veterans will have to drive 200, 300 miles one way for care oftentimes they could get next door almost literally. and the va says no, you have to drive. i'm just curious of your particular 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 came back home to feast in kentucky to spend some time with my family, -- to eastern kentucky -- and we now have a branch of sorts. it's an office and a medical facility. 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 i appreciate your testament today. mr. minney, follow-up question on medical records issue which has been plaguing the va and the dod attempting to communicate. my understanding is that often happens in a private world, they actually did commit get through a regular process but the va and the dod cannot do that, my understanding. can you describe the situation that occurs with travis, given the current scenario, would that likely a creek in with a veteran walks in addition my medical records, is that still the situation in many cases? >> yes, it is. travis was a unique individual because he actually did have a copy of this health records.

but i've spent 21 years in the navy as a corpsman in the medical field, and once i retire from their them actually went to work for the va. so i can tell you right now, dod health records, they are not being transferred into the va health care system. if you take a young 0311 lorain that gets injured and he gets surgery -- marine, when he gets back home and he goes into a va health care system and a doctor will ask them, what searchers did you have, he's not going to know the names of these surgeries. so right that 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 surgeries he said,

what medication he's on, or what therapies he is needed. that's what the benefit would come into play. but no, 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, mr. chairman. thank you. >> mr. takano. >> thank you, mr. chairman. mr. huelskamp, that last question brought up some very better better memories. my first, what am i first committee hearings was about this issue of the medical records not being able to be transferred from dod into vista. and i can barely contain the anger i feel about this situation, and the millions and millions of dollars that have

been spent trying to solve the situation, and then to hear in the interim the months between my first hearing and now that there seems to be no way to bridge this fall 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 maybe even more tragic -- made even more tragic by this system ago between these two departments. i don't know what to do about this. it is frustrating to be a member of congress and not to be able to say, fix this thing and have it fixed. with that being said i do want to say to mr. fugate and -- isn't mr. kebbel? mr. kebbel, that i'm proud to have started the first deaf

caucus in the congress. i'm one of the co-chairs and it has put me in touch with the disabilities community. one of the useful things that has come out of that is that we've made a commitment to have an intern from the deaf community from gallaudet university. it's my belief that some of the disabilities the communities -- disability community's are not well represented on the hill. i want to ask mr. fugate, you're a young man and you're getting an education at cal state. i'm proud to tell you a californian now. have you given 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 felt great to be heard.

but as the went on and then a couple more years passed and things didn't happen, it was just very discouraging. so i was really happy that i had picked a career in computer science were i to talk to computers -- where i could talk to computers instead of asking people for help. computers are much easier to talk to you. they give 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 willing to intern on the hill, to be able to kind of a constant reminder to members about just what are the challenges.

mr. minney, if there might be a way for us to the pipeline of veterans in this situation, might facilitate that. this will take, 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. it seems like it's going to take us several more months, if not years, of focus. might it not be helpful to have a way to get some of the service members to intern or even have staff positions here on the hill? >> i think it would be an absolute amazing -- 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 outside coming in if they see the blind veterans 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 the. >> mr. kebbel, do you think that we could understand, members might understand your struggles with websites if we had to upgrade our systems to be able to accommodate blind in terms, blind veteran interns here on the hill, if our systems had to the kind of software that would make it possible for them to work and to advocate on behalf of their brothers and sisters in arms? >> there is no question about

it, that it would help. there are sensors 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, will be accessible for a screen reader. it would be valuable for someone to sit down and evaluate the process of using a website or even just documents, okay, to do that. as we look at it a little bit though, is right now i think that the va doesn't even have, i think they are self audited as far as if a webpage is usable, okay. the automation systems are fine, okay? and that may give you an indication that it's quote unquote accessible, but into a someone who sits down and uses a

screen with our reader, i don't think you have a very good result. >> thank you. mr. chairman. >> mr. roe, dr. roe, tennessee. >> thank the chairman. but i like to introduce someone before i start, timothy dennis is 19 years of age, is here with us today. this is foster youth shadow day. if he 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] phil roe speaking. travis, i remember your testimony very well, and i remember you being here and it was powerful than it is powerful now, and thank you for coming back and i'm your neighbor just south of you in east tennessee comes on just down -- were in

kentucky are you from? >> i'm from a small town and not county, kentucky, which borders virginia. the closest city to me, people recognize is hazard kentucky spent hazard, i know exactly where you live in. first of all i appreciate your testimony. one of the things that you brought it is extremely important, five years ago, last year we had the va and dod came in and they just build a billion dollars, a built-in but we are worried about 3 million. they burned a billion dollars trying to make dod and va health care 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 try to get to interact but it hasn't worked. i don't know, travis, whether

you would find that information out, but it certainly would've been nice if they had found the information to whether it would prevent that happened, its ability been nice if the doctor would've had all the information available to be able to make those decisions. and by the way, just accommodate, when you go to california, don't let the mess . you are just fine, okay? out there in california. [laughter] and also i think, mr. kebbel, which he said, tomorrow i go back -- i'm a veteran as you are, as all of you are come and gone back to vietnam tomorrow, codel. 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.

i go to my condo and i put a blindfold on for an hour and i tried to walk around my condo, which is very small, and get around to let me tell you, it isn't easy. we need to do everything we can for our veterans who have been through our sight impaired -- i agree with you whether it's service-connected or not. if they are veterans, and i completely agree with that. i've a question that may be better for the next battle but i'm going to have to miss it. glaucoma and diabetic retinopathy potentially blinding diseases that are highly prevalent in aging veteran population, as you mentioned. what procedures or processes are in place as far as you know to ensure that veterans with advanced sight threatening eye diseases have been seen by an ophthalmologist? >> did you -- i had trouble hearing. >> i said what procedures or processes are in place to ensure that veterans with advanced sight threatening eye diseases have been seen by an

ophthalmologist? do you know that in the va hospital system? >> i do know that once they are first diagnosed with the first stages, that they are put on like a screen program where they monitor it three months, six months, but then that's really all that they can do is monitor it. because macular degeneration, there is medication to slow the progress but there is no cure. glaucoma medications, no cure. so the only thing they can do is monitor it. >> travis, one other thing before i have to leave. your comment here come your testimony, i am disappointed after the past three years while on the dod site they've already have over 22004 and 50 i injured a record in division registry but today va has one veteran's record. the va has not set this up because instead of having a clinical electronic data records contract, contract a dod already doing the work, the va from what

we've been told now is waiting for contract bids to be settled before getting started. it was now four years ago. ariza had a chance to talk to my congressman harold rogers to ensure that this isn't to take any longer. thank you for that information right there. we will find out from the next panel, and three view, all of you, sincerely, thank you for your service to our country. >> i think you, dr. roe. >> 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 an associated you and i together as friends. i think your return was right. i know you've got a companion at your site. if you need a friend in washington, get a dog. you've got one. i'm honored.

there's no one i would rather stand with. i say that because, it's not often you get the opportunity we are going to discuss the intent of congress, the spirit and the letter of the law. today you your folks in the room who wrote the law. the first in room who advocated for the funding and we worked together. i'm reminded and ahead here, i pulled it up, you'd probably appreciate this, travis. it was a "usa today" story a "usa today" story that said in a center devoted for new treatment for combat eye injuries has been delayed for a year over who pay the 5 million needed to get it started, according to interviews. that was janitor 28, 2009. so we hear this. mr. takano asked how long the issue of electronic records going on and seamless transition. i can say from my perspective my entire adult life have we advocated for this, both in the military and then after but it's an important point that i also think it's important to note because it was mentioned,

february 2013, new england journal of medicine story made this clear. in the private sector 12.2% of physicians use electronic measures meaningfully. don't try to pretend that there's some type of magic bowl on the other side that it's working, that that's nonsense, too. the issue is not kind to set up some paradigm you that the private sector is doing this and what are not, we are failing in getting this done to our purpose is to get this right and i would ask, travis come on this. is your goal to the vision center of excellence up and running and doing what is supposed to and getting this fair or is your goal to go to the private sector to get your eyecare? >> michael -- my goal is to have, to have -- i care deeply about the va and all the care they provided, recreational care, therapy, mental health counseling. i've recently came back to

kentucky to help my parents, who are getting up there in the 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 points when i'm telling young men and women about my military experience, is that you can avoid the private sector when it comes to medical care. it's so freeing to know that i 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 basis are absolutely their issues. there is a role for that and there's a go for that. but these core mission issues, especially on the issues of vision impairment and different things, you're not going to get off the hook by not fixing what's here. and i'm angry that this communicate is not working. i said in this interview back in 2009 demanding that we get this right but i think collectively together when there's a role and a mission and the purpose and one that is working for people like travis or our other veterans, we need to get that right. so i agree, it this is not a funding issue on the. they've got to get this figured out the represent the mayo clinic and they tell me the vista system in the va is the best medical record system in the world. dod has a different. i understand you do so is to fight wars but until this nation understands when we have our two biggest iraq assist in government silent up and dod and

va not communicate with one another, you cannot separate travis and his warriors and their injuries from the whether we fought. now we have the problem of a turf battle fighting over who will institute. tom gagliano was and as a expert in this and i don't testify to that in this article talk about i haven't eyecare said about it but it have any computer and i can't get going. we've got responsibly to avoid the easy flippant answers of what it's going to do. dig down and hold the accountability in which we heard, get it down to build on this, get this thing up and running. as travis came and told me, his goal is to get back and do the things you enjoy doing, get back into technology, get a little placthat littleplace sometime ct to tennessee. i've got to give dr. roe that at some point in time, going there. but we can do that. i would appeal to my colleagues, let's let the data, let's let the oversight, let's try this and get this going. we chose to do the vision center of excellence fully knowing that it was the best chance to do all

the things that mr. minney, mr. kebbel and mr. fugate asked us to do. let's just make it work. i yield back. >> thank you. dr. benishek. >> thank you, mr. chairman. gentlemen, thank you very much for being here. i'm dan bandish a from michigan. i'm a physician as well as mr. roe. i worked with in the va system for about 20 years as a consultant. i had a couple of questions for you all, mr. fugate you're going ask you this question. it sounds from a testimony that you're not quite happy with the care you getting from the va right now, is that correct. what could the va be doing what it seems to me you're checking in with them periodically and that's about all you are doing, is that correct? >> it's tough for me because i'm

very satisfied and happy with a medical professionals in the community that i deal with, that i work with when i go to the va. it's a failure in the system and, that are causing, you know, that bother me. >> what could be a very doing 40 now that they are not doing -- what could the va be doing for you now that they are not doing? what would you like -- is is something you'd like them to do? it seems 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. are you getting anything like that from the va no? >> yes, absolutely.

they are 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 that they are not doing? >> well currently, everything they are doing fine by me. it'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 knee 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 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 on that question? i mean, what could the va be doing besides avoiding the issues like mr. fugate talks about? and the whole reason we want this testimony here is to -- >> the biggest challenge i see that can be fixed, once again, is communicate 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, my injuries required me to get the surgery from a german hospital. i had five eye surgeries from a german hospital. well, they had no idea -- they fit me there but then when my unit was looking for me, they couldn't tell them why i was at.

once they discovered where i was at, i had already left homburg back to my unit and my family were looking at homburg. tom bird only got around to telling them i was also. i was back at bethesda naval hospital. the same thing went on as far as my purple heart. my purple heart was delivered to me by the ups man because it went from homburg to bethesda -- 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 a reply person to get through the va website. i guess i'm are not the mother with the technology that

involves the blind to do with a computer, and i guess there's a big lack in the ability of the e va teaching indicate with the blind veteran. could you just elaborate on that a little bit more than your testimony before? >> yes, i be glad to do that. led me just go back in history a little bit, and downscale the situation instead of being at a government level. i'll be at the city level in the city of las cruces. they were in the process of redesigning their website. so i had an opportunity to sit there with her i.t. department -- with their i.t. department and discuss what that meant, means to us. the next thing is once the i.t. department had the concept of what to do, i sat down and performed training and for the city employees to give them a basic understanding on why we

need accessibility and why we need properly tagged elements. okay, once i was able to do that, okay, the city employs 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. i know why it should be done, mr. kebbel, i'd appreciate you being here to tell us. thank you all for your testimony. i'm out of time. >> thank you. mr. o'rourke from the state of texas. >> thank you, mr. chairman. i want to thank the witnesses for being here, and i wanted to begin my comments and then ask a question to mr. fugate. you know, in the beginning of your comments you talked about being here five years ago in 2009, and implied in that was what difference did your

testimony they make, what progress had been made since then, what's the value of your appearance here today. and i want to just tell you from my perspective as a member of this committee, you're focused my attention on this problem. i've learned many things today that i did not know before today's hearing. i'm a new member of congress. this is my first session in congress. my first session as a member of this committee, and i am now resolved as another rest of this committee is in ensuring that we correct the mistakes that were made in your individual case and the larger systemic problems that today's hearing has uncovered i in these vision centers of excellence, and other problems for those who are sight impaired and are working with the va. so i first want to begin by thanking you, by telling you what you're doing today is very powerful, very impactful, and it is set up i think some excellent questions that this committee will then ask the va.

you are helping us to hold the va accountable council wanted to tell you that. and i also want to make you aware of a bill that we authored this session of congress, h.r. 3045, which would require the dod to provide every transitioning service member with a portable electronic record so that they have that, they own it and they can bring it to their visit with a va doctor. they can bring it to their visit with a private medical doctor. they can just have it and refer to it as they needed. you've given us a poignant example of why that is so badly needed. i'll say that we have cosponsors that include chairman of this committee, the ranking member of this committee, mr. walz, mr. takano, members from both parties and we welcome additional support. as you continue to advocate on this issue, and mr. minney and mr. kebbel as well, we certainly encourage you to make sure that members are aware, that we have a bill that would provide part of the solution to some of these

problems. you, mr. fugate, offered some good advice when asked what you would ask other veterans to do for might be in your situation. you said that working within the va you found to be helpful versus working within the private sector. and let me also just a i really appreciate your evenhanded description o of the services. you talk about providers both on the physical and mental health side who are there to help you. the great quality care that you got once you got in, 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 was returning from afghanistan today u.s. sight impairment, what is your advice to the veteran? 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 veteran community. i've enjoyed sitting in the waiting rooms and meeting veterans from the past wars and their wives and their 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 are not against you. the system is just turning to

slowly. people care deeply about the returning this to -- veterans. >> thank you for saying that, and again, thank you for finding the good within the system that we can build upon while also recognizing the frustrations that you and others have with parts of that system that do no 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 that you are making about an excessive load on the va's website, and really make sure that this committee is also doing everything it can. mr. walz leaned over earlier during her testimony and asked, is this committee's website fully compliant and accessible to you and others who are sight impaired. edit think the answer we received from step initially is that it is not. so i think we need to do our part to make sure that we are not just blaming the va and not just link them accountable, which we should do, but also

holding ourselves accountable. you mentioned the library of congress as an example of a federal agency that is 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 ring to find other agencies and federal departments were doing the job the right way and see we can learn from them. so i want to thank you and mr. minney also for being here. with that, mr. chair, i will yield back. >> thank you. ms. kuster, 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 colleague, mr. our work, and his comments because i want you to understand -- mr. o'rourke, i'm also a new member of congress, new member of this committee and mr. fugate come when you said 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. i want to revisit a letter that i led with my colleagues, a bipartisan letter that we wrote last summer, july 22, 2003, the secretary defends chuck hagel 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 to it's difficult to even get the information about where things stand, because obviously we have colleagues on both sides of the aisle that came before us and that care deeply about creating this vision centers of excellence. and one of the parts of the response that i find troubling, this is dated january 4, 2014

from secretary shinseki, is that there seems to be a number of positions that are open. the va contributed 6.6 full-time equivalent employees for the vision center. now, and it doesn't sound like very many to me, given the scope of this project. 2.6 are currently filled. for our in the hiring process, and then this is also the case -- 4 are in the hiring process. 4 and cds, of which one position was filled and three were 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 as, that you're focused our attention on this issue and that we intend to present this case forward.

because of 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. 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? >> well, i know the last word that we got was on the va side. there is a blind rehab

specialist position that they're interviewing for, and then the va side will have all their ftes filled. but now they are looking, they are putting bids out for contractors. my question is, the inception was in 2009, want -- no contractors yet? there was a $6.9 million that was budgeted for the va side, for 2.6 employs between 2010-2014. i would like to have that salary, 6.9 million, split between 2.6 employs over four years. so i don't know where that funding went. >> right. >> that's what i would like. >> 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 there are issues like this that remain unresolved and not addressed? so i'm going to close my time, and they just want to thank you for coming, and i also want to join doctor roe in addressing -- i have a constituent here, dakota, from berlin high school who's joining us in the back of her the room, foster -- not child, young person here to learn more about our congress. mr. fugate, i think you have a bright future, and i can just hope and pray that you might choose to address it to resolving the computer issues at the va. so thank you for joining us. >> thank you, ms. custer. before the panel leaves, i'd like to have mr. handel discuss

an issue that mr. o'rourke raised relative to the compliance of this committee's website. >> thank the chairman. to your question, sir, the committee's website does use a reader, and it's called browse allowed which is by no way compliant. so how do folks at the panel been able to access that? >> say the name again, please? >> browse allowed. >> i've not used it. >> then we will get with you after this and you can walk is due to make sure that it does address your needs. >> can i make a comment? >> yes, sir, please. >> their our standard screen reading software that folks use, and when you introduce a screen reader that a blind person isn't accustomed to using, it's hard

to expect that they will be able to interact with the information the way that they are accustomed to interacting with information on other webpages. so in my opinion, a custom screen reading solution for a webpage is not adequate. >> can i addressed that, to? >> this is terry kebbel. the problem with an automated system is that it is designed by someone who looks at a script and says this is what it is supposed to do. >> so i was in most of the time it's probably accurate, okay? but there's a lot of times where it will look at a tag in to be a description of the tag as a label and the label will say button.

it passes. it passes the test about the button, i don't know what the button does. okay, is it a button for searching something? is it a blue button we are talking about? is it a button that sends me nowhere? okay, so yes, it will pass the test, but is it effectively labeled? is it effectively described? you can probably go through the form fields website on the va website and look at the link. i bet you everyone of those links will pass inspection, but everyone of those links aren't numerically -- 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 need someone to sit down and evaluate it, who uses the screen reader. it's voice over or whatever

screenwriter you are using but it is designed currently, many other screen readers will be able to address that. [inaudible] >> mr. takano, and we need to move to the second panel. >> very briefly, mr. chairman. i appreciate 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 the entire institution of the congress, every member's website should be able to accommodate lined veterans and the blind committee in general. >> we will survey do that. this is the same system i think that is on -- certainly do that. on the house the a committee that the library of congress uses, as i understand it. but i think there's always room for improvement and we will certainly look at the. 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, what i hear concerns me. we are talking about all the young veterans coming back. okay, what concerns me about us vietnam veterans is agent orange. i had a catastrophic heart failure that led to a heart transplant, okay? that led to my blinders. there are lots of us vietnam veterans out there who are dying without any health care right now. okay, and i have concern about that and i don't think we addressed that. thank you. >> thank you very much. appreciate your service to our country, all three of you. thank you very much. and now we'll move to the next panel. the second panel. i now invite the second bill to the witness table. on our second panel we will hear from doctor maureen mccarthy,

deputy chief of patient care services for the veterans health administration, and ms. lorraine landfried, deputy chief information officer for product development for va's office of information technology. they are accompanied by dr. mary lawrence in the deputy director of the vision center of excellence, and mr. pat sheehan, director of va's 508 compliance office. [inaudible conversations] >> i think we will continue, for

a committee members will continue the process as stating your name so that those who are vision impaired in the audience can know who is speaking. i would ask the panel to do the same. dr. mccarthy, your complete written statement will be made part of the hearing record, and you are not recognized for five minutes. >> thank you. good morning, chairman coffman, ranking member kirkpatrick, and members of the committee. i appreciated the opportunity to discuss the department of veterans affairs contributions to the visual center of excellence, and the care and services are provided to veterans with visual impairment. i am accompanied today by doctor mary lawrence, deputy director of the visual center of excellence at the visual center of excellence, or vce, was established by the national defense authorization act in january of 2008. in october 2009, the dod and va memorandum of understanding

defined the roles and responsibilities of the department and the establishment and operation of the vce. vce's efforts are directed at improved vision health, optimize readiness and enhanced quality of life. the national defense authorization act also required the implementation of the defense and veterans eye injury and vision registry. division registry collects longitudinal data on eye injuries, guide to 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 the that the vision registry is on schedule and on budget. vce has achieved many significant accomplishments since its inception. vce has identified and addressed 33 process improvement

opportunities through the monthly vce hosted worldwide ocular trauma video teleconferences, which connect providers across the continuum from combat support hospitals and coalition providers to va polytrauma centers. it has also led the way to initial inclusion of fox protected the eye shields in joint first aid kits, and is attempting to expand them into individual first aid kits. in addition dce in collaboration with the va blind rehab services has designed an educational pamphlet geared towards inpatient care teams and hospitalized settings to assist with transitions. trip to the consequences of vision injuries to our servicemembers and veterans will be with us for decades to come. therefore, va will continue to partner with dod to provide eye

care providers, clinical care practitioners and researchers who have access to the information needed to develop a strategy 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 landfried, deputy chief information officer for product development come office of information and technology, to address issues related to 508 compliance spent thank you, and good morning and chairman coffman, ranking member kirkpatrick, and members of the committee. we appreciate the opportunity to discuss veterans affairs worked to improve access to information technology resources, for visually-impaired veterans, stakeholders and employees. i company today is mr. pat sheehan, director of our five await program office. since 2001 this office to provide a validation testing on the websites and applications using a commendation of

automated tools and manual auditing. the latter of which is by uses of it is about including those with visual impairment. when va identifies non-conformant application website, section five oh a step work with the parties to correct or remedy accessibility issues. as critical as it is for us to audit and improve our existing website, it is just as important to ensure that all future applications and websites are in conformance with 508 standards as well. to do this with a limited formal policies requiring all information technologies developed by va to complete a four step milestone process. this helps us ensure that accessibility is planned for and build in on time rather than trying to expected in the future. we also provide training to va system concentrate confronting them with the tools and the know-how to make va information 508 conformant. we've made progress over the past year. for example, we improved the performance of the my healthy website, 16% in november to 95%

today. we will continue to pursue an aggressive strategy to ensure access to all covert systems and electronic information. we're also committed to working with our federal stakeholder groups. he will attend the blinded veterans association's upcoming national conference to review recent updates typically used applications and websites with stakeholders and work with them to identify ways that usability can be improved, even in areas where we are technically already section 508 conformant. mr. chairman, this concludes my prepared remarks, and before to answering any questions you may have. thank you. >> thank you. are there for the remarks? okay. dr. mccarthy, this is mike coffman. according to your testimony, there 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 mentioned that there was one person injured by the and that was to test the system that i want to explain the register you for just a minute if i could. the registry is a seat at the department of defense, and so it is set up to date information more directly from the department of defense for servicemembers who do receive eye injuries. okay, the a 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 of data into it.

equal have been treated in the va because an active-duty service member has been through the program, how many people have been treated to have day in the registry and currently there are at least 2400 veterans who have data in the registry. that data was entered.

>> if we could just go back to the question and that is give the department of defense a service connection, as folks are out processing and active duty and in that end. this registry is also for non service connected veteran i s us, is it not? >> it is about eye injuries. >> service connected not service connected it is about veteran i injuries. the fact remains you haven't entered into a single person. what it tells me is you are not participating. >> i understand why you say that ended is regrettable none have been entered but the framework is in place, target dates of the registry to be functional is by the end fiscal year 15. the fact that the contractor is out at this point is progress

and looking forward to data being entered by the end of the fiscal year. >> a lot of those definitions of progress last night, before full committee and it is disconcerting. in va's february response to a letter i wrote in october of 2013, i was told va had not awarded a data abstraction contract due to contract in the lace, what were those delays and have the problems that caused them been corrected? >> that is better entered by dr. mccarthy. >> i'm not aware of the exact delays. i will get back to you before the hearing. i ask if we could find a timeline for the process of the contract awards and what the delays were. i don't have that but we will get back with you.

>> according to a july 26, 2012, memo from the assistant secretary for information technology, all va software was required to the complaint with section 508 by january of 2013. is all va software compliant at this point? >> at this point in time it is not, we have not achieved 100% conformance with the 508 standard and we made significant progress since that time. >> what percentage? this is mike coffman and i want 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 because the software we are looking at particularly on the web and the

software we look at as far as applications are concerned are in development. the important point i want to make here is the process, what we are doing with software is working through the frost thises we established to build software at the beginning of the software life cycle. >> the simple answer would be you are not compliant at this point. thank you very much. the ranking member kirkpatrick. >> back to your description of the cc e, does the the a have records to the access? >> it would be different for the provider to access that record. >> does that happen. >> and that question.

>> ranking member kirkpatrick. the registry is designed, individual providers will be able to access the information in the registry, the individual patients and identify data, another patients, they could for example put in some criteria that may be characteristic of a patient there seeing and identify data and the outcomes of the be identified data to help inform the provider and the patient. >> i appreciate that. suppose military transitions out today, goes through a doctor tomorrow, technically in the va system, will that dr. see that person's records regarding the eye injury or service connected? >> dr. mccarthy speaking, there

are multiple opportunities to access records from the department of defense in the record system screening of and there is an opportunity to use a when based in order to have access to those records. >> still not sure what your answer is. will the doctor see that patient's military medical records the day after they transition out? >> my understanding is if those records are electronic those records can be accessed and most of the records are electronic at this point. >> what percentage? >> i did not have that number but we could check and get back with you. >> the va portion is eye injuries, not necessarily military connected. that is where you are contracting out to have somebody entered that information?

>> what we are contracting for, the records put out information such as exams, data from those exams, visual acuity, treatment intervention that were made so that over time progress can be tracked by the individual that looked at collaborative lee the point of the registry. >> i have a question about funding. $6.9 million, but va budget for fiscal year 2010-2014, has the funding been consistent each year and can you provide a year by year break down over the past five years? >> thank you, this is dr. mccarthy speaking, the $6.9 million is a cumulative amount for that period initially

extended to 14, so over a five to six year period, what happens is an initial ramping above salary dollars but in addition kind of financing the money for contracting to enter the data we are talking about into the repository so that money has been kept separate but the money that has been used over time, i will be happy to provide those dollars for the record and this is the gradual increase over time as salaries increased. >> thank you. i would like to see the breakdown, the breakdown since the funding started and how much is set aside for the contractor? thank you, ranking member, i yield back. >> thank you, ranking member

kirkpatrick. >> i can't believe it takes five years to get this thing going. what is the story with that? apparently it is not even all passed up yet. why has it taken five years? the entire second world war was four years. >> i would like to respond, there have been processes involved in the joint executive committee. >> five years? >> five years seems like a very long time. >> i appreciate that. >> something aid little bit more pertinent. dr. mccarthy, it has come to my attention there are many issues with our veterans with their eye

diseases, glaucoma, macular degeneration, blinding eye conditions that if left untreated will lead to blindness and very prevalent in the aging population. what procedures are in place to ensure that veterans with these eye diseases are seen by ophthalmologists? >> i would be happy to tell you about the processes we have in place with diabetes, the risk further diabetic myopathy. they're screening processes in which we use telemedicine and photographs of the rat not of every patient with diabetes are

taken and read. it is part of routine screening for diabetics, a patients with glaucoma are followed regularly and he mentioned one other disease. >> macular degeneration. >> macular degeneration is -- we do have ophthalmologists following people with macular degeneration. i can't speak to the screening procedures that are developed. >> i have a concern because i went to the va hospital. it is tough to staff many of these clinics, they have a hard time keeping people, i you aware of any of the procedures for hydrating local of the mall adjusts staffing va centers? are you familiar with any of that? >> imac chief of staff in virginia, it was our experience

that we did try to hire full-time ophthalmologists quote we would ask for people to come in on a contract basis because we were an academic facility, we had a strong partnership with the university of virginia and we were able to recruit people effectively but i am aware that other institutions have contracts. >> i am concerned. and the va limits their ability to work of the va, they can't work anymore for of the year and so they think it is more cost-effective, full time ophthalmologists. and you cannot be more efficient

to hire a full-time ophthalmologists. and they work there all longer, provide the care and not have the patient go to milwaukee. i don't understand the reasoning for that rule, you say it is more efficient to hire an all-time ophthalmologists and hire a full-time of demolish just kind of a catch-22 problem. let me ask another question. apparently i have also heard that in order to improve the access to i care they're having technicians do the work rather than physicians, some of the screening work. you mention screening the retina pictures. it concerns me when people other than physicians are providing

care. how do we know they are trained properly? the status of that situation? >> that is dr. mccarthy speaking again. i can talk about training of images or talk about a typical eye doctor appointments, there are other non physician people involved, that might have visual acuity or checking -- >> thing is that physicians typically do. not always concerned about quality of care when physicians are not doing the things they are supposed to do. i guess i am out of time. we can further that later. >> the state of california. >> thank you, mr. chairman. where is your center located?

physically? >> i want to refer to dr. lyons. the vision center of excellence has two locations in the national capital region, our headquarters at walter reed national medical center in bethesda and we have an office in crystal city, arlington. we also have a small office at the medical center in tacoma, washington. >> walter reed is under the dod but nevertheless the veteran center is located at walter reed, is that right? >> dr. mccarthy again. the vision center is a joint effort between the dod and va. the centers of excellence, dod authorized navy to be involved with this so it is a partnership between the navy on behalf of

dod -- >> actually walter reed, saw the center, is it the same center? nevertheless we are having problems with registry being populated. let me understand this registry. the registry has been waiting for contracts to be filled and by fiscal 15 we expect this registry work to be done or began. >> the registry contractor is on the streets, the bids by mid june and we expect it to be awarded in the data entry to start by the end of the fiscal year. >> and clear for questions. and the provider accessing service members records. and without the registry being populated but the entire record

is accessible and if it is electronic, if it exists in electronic form the provider on the va side access overnight. >> it is real time, instantaneous. i would like to yield to loraine to see if she can say moron that. >> service member, next day the the a doctor can it access the record? >> as long as it is electronic record yes. most of the records are in electronic form and the record system. the daylight, the gap is between

interoperable the end seamless operability. if it is dod data, you have to push a bunt in to bring it to me. it is not stored locally as part of the va system and that is what a lot of work recently has been about to go from interoperable the to seamless interoperable the. as you are conducting a clinical workflow the information you need is there with the stuff you are doing. >> a couple more questions has to do with accounting for diversity. i know that in certain ethnic groups, asians in particular glaucoma can show of much

earlier. >> reporter: i yield to them. of the like to take that to the record and get back further. >> i appreciate that. and related to terry kebbel's point about asian origin, is there anything you have done to deal with this huge agent orange population we are going to address from the point of view of any work we can do? >> i don't have an answer to that. not specifically related to blindness. >> if you can deal with that later in written form. >> okay. >> states of texas. >> el paso, texas, for dr.

mccarthy, many of these questions you have already answered and might be repetitive but i am new to this and wants to make sure i fully understand it. you mention january of 2008 was the start date for the eye injury and vision registry. >> i mentioned that the act that established it was january of 2008. >> that is when it became law. funding was appropriated the next year. >> don't have a date. the funding between dod and va was october of 2009. >> the backup i received shows $5 million of that funding has been spent and hope i am speaking about the same pot of money, a total 6.9 million opprobrious to 5 million that was spent, what was it spent on?

in the plainest terms possible because we are limited on time. >> 10.8 of that 6.9 million set aside for the contract so that brings us to 4.1 million that has been used for salaries, individuals as we ramp of the employment over the last five years in addition to education and training events and i would yield to dr. warrants for more details on that. >> not just yet. you, in responding to an earlier question about how long it has taken you said it is regrettable, on schedule and on budget. when this became law in january of 2008 and funding was appropriated in the year thereafter was always understood that june 9th, 2014, was when we would go out to bid or make a decision on closing of those

bids? >> it was always understood by the end the fiscal year 2015 the registry would be operational. >> from a layman's perspective it does seem like a very long time. compared to the time we spent in world war ii the number of people affected by these issues who do not have access to this care and i would like to take one that we as an example today based on his testimony from 2009 to the extent you are familiar with and his testimony today, do you have anything to offer in response to concerns that he race or the specific case study has offered and how we are or have not yet learned from it or not yet able to provide the kind of care that might have provided a better outcome in travis fugate's case? >> i would happy to be in touch

with travis fugate after the hearing and offering support in that way. i do want to mention 43 process improvement activities that were identified as part of the vision center of excellence, calls in which the people in the field and that vision center of excellence have worked together to try to solve those communication issues. >> that might be good for myself and the entire committee to understand from your perspective travis fugate's specific case in 2014 might be handled differently. and the interoperability with records and medical recommendations and decisions and those in the the a provide better outcome or might not. it is important for us to learn

from his specific case and you can agree with me on that. and section 508 issues this discussion today is happening within the larger context of the american public and congress's frustration with lack of accountability, so looking at the back up and all the chances that the va had to come into compliance, to remain out of compliance, the fact that on the most critical issues like the ability to fill out a va form that terry kebbel brought to our attention it seems not only would that be a benefit to the veteran but to the va to have that information entered by the veteran himself. and in the plainest terms what is very justified frustration at the amount of time the va had to

get it right, you spoke earlier of the processes involved which are lost on me. we really want to know what has taken so long. and we are 100% compliance. >> happy to address that. we are absolutely committed to make shore all of the information veterans need about benefits, health care available to them and everything else we have to offer is available to them as electronic products through our web sites and forms hands what was mentioned earlier by the chairman, that was a wake-up call and accountability, what we doing with them? >> you are really quick with the question, give us a date by

which every single page on every va web site will be compliant? >> we keep talking about the process because if i was 100% compliance tomorrow new systems are online and additional forms are added, additional documents are added. >> this does not build confidence in what you are doing and what our veterans can expect and i hope you would come back with a set date and from that date we are 100% compliance and every day forward we are 100% compliance. i don't think it is too much to expect to what veterans serve. with that i yield back. >> thank you, mr. o'rourke. ranking member kirkpatrick. >> i appreciate your willingness to provide the committee with the year by year breakdown of how the money has been spent. that is part of our responsibility on this committee, to oversee how

taxpayer dollars are being spent so i will ask within that year by year breakdown you also categorize that and work with the committee staff on what categories are appropriate. we get that to you and like to have some dialogue with your staff and how much is spent on salaries and how much is spent on space and how much is spent in other areas so we have an idea how that is being spent and i thank the panel for being here and thank you, mr. chairman for having this meeting. >> our thanks to the panel. second panel you are now excused. today we had a chance to hear about problems that have led to many years passing while visually impaired veterans continue to be denied equivalent access to va services. this was necessary to accomplish a number of items, first, to identify the reasoning for lack

of progress. and implementing vision registry despite years since authorization. and to receive an explanation on why it has not brought its system. and third, to determine what steps are being taken with these issues and the care provided to veterans. and access crucial information. and there are extraneous material, without objection so ordered. and the audience members, thank you for joining us, with that, this hearing is adjourned.

>> to date is primary day in eight states for u.s. senate and health seats. this story from the addresses the target of speeches senator harry reid gives on the senate floor. tea party patriot filed a complaint against harry reid with the senate ethics committee to protest his repeated attacks against charles and david koch. the complaint charges and with unlawfully and ethically targeting private citizens and harry reid has misused city resources to engage in partisan campaign activity in violation of federal law and senate rules. the senate will gavel in in a few minutes for work on the nomination of chief harbor to be human rights ambassador. debate is expected at 11:00 with a confirmation vote at noon. the senate will recess following that vote and reconvene at 2:15. later in the week they're likely

to take of the combination of sylvia burkewell and start work on mental health court bill. live coverage of the senate on c-span2. the president pro tempore: the senate will come to order. the chaplain, dr. barry black, will lead the senate in prayer. the chaplain: let us pray. we praise you o god almighty. let heaven and earth adore you, for we are sustained by your majesty and might. bless our senators, guiding them around the many distractions