we need to use this money in, whether it be education, corrections, whatever it may be. why can't we consolidate here so we have better priorities here or be able to say this is something we can do? that's where it came to me. >> new york is where film is is, democrats line. hi. >> yes, a very important question beginning with president reagan. things started to change in terms of corporations. there was a very big issue about corporate welfare and corporate welfare means that they have been given money throughout the years before president obama got into office, tech dollars which is corporate welfare. and as the individual that calls from indiana was talking about the outsource so they've made their wealth off of tax dollars. the american people and then taken those jobs so they can

make more profits moving overseas and not pay their fair share of taxes. so we have an economic situation where people don't have jobs. people are losing their homes. people are hungry. so thinking about cutting social programs, which are going to help people who a, do not have jobs anymore and losing things and continue the same program of corporate -- corporations, large corporations not paying their fair share, how does that work? how is that helping the american people? >> well, i think it probably was more of a statement than a question in that regard. the simple packet, we go back again, when you hear cut and the friends on the democratic perspective, the first thing

they think of we're cutting social programs. two examples i mentioned have nothing to do with social programs. i think what you've got to do, take the government as a whole your philosophy of government. we've got to do tax reform. the tax system is hurting and government should not be in the business of picking winners and loser,s, we've got to take an honest look at the tax code. as the caller said earlier, common sense. it isn't common anymore. >> i think we can bring it back because there is business and common sense in the sense of saying what is right and how does it affect long term? we've got to get out of washington, d.c. and outside of the cycle inside this beltway. what crisis do we deal with next? >> call from dell in georgia, republican line. >> caller: yes, what i would like to know is why the governor of state of georgia and you can

give your opinion as well, has refused to approve the medicaid so that 600,000 georgians can have free health care? i know it's because he hates obama and i know that it's all political, but tell me, how can you all do that? >> okay. i understand that was the republican line? i think what dell -- look, what governor deal did in georgia by not expanding medicaid was because of the budgetary situation in georgia and cost it would incur on the georgia budget which is already tight and it was a burden that we could not be buried long term physically without calling severe damage to other programs in georgia. i think it goes back to --

again, the decision here and what the caller said, because he hated the president. that is what part of the problem in the country is today. he did it based on his own admission a fiscal reason. he did it for a fiscal reason that could be shown, not because he hated an individual. i think interesting thing here is brought up, so they can get free health care. it is not free. no matter who provides it, it is not free. and to say they can get free health care is a misgnomer. every health care program that comes from the government is paid for out of tax dollars. it is not free. we should not lie to the american people about that. it is not free. >> how did georgia treat health care, open up an exchange? >> did not. we're under the federal exchange programs. >> marlene from columbus, ohio, you're the last call, democrats

line. marlene, go ahead, please. >> caller: i would like to know, and i want an honest answer from you, the amount of money that we spent on each prisoner down there in gitmo, do you equate that with taking care of expenses for your oversight? isn't that too many money to pay on each prisoner. >> i appreciate the call, i'm not trying to be dishonest in me of night comments, we need to sign the long-term solution for that. those are things in questions that need to be handled and i think need to be done by both parties. we need an understanding of what we're going to do with prisoners at guantanamo. using them right now as chips in a tradeoff is not the proper way to do that. i think those are long-term questions that need to be answered. what we have seen and what she's

alluding to was the wrong choice. >> your bill on redundant program, what stage is it. >> it's been introduce and we're working on co-sponsors. >> doug collins of georgia, member of oversight and foreign affairs committee. thank you so much. >> great to be here. reminder, washington journal is live every day at 7:00 a.m. eastern and we are live here on c-span 3. we've been waiting a while for the start of the hearing with the afghanistan special inspector general for afghanistan reconstruction. whole series of votes on the house floor, that's what held things up. it looks like the chairman of the subcommittee, chair of the subcommittee has entered the room. so we'll stay here live on c-span3.

the subcommittee will come to order after recognizing myself and ranking member deutsche for the opening statements, we'll then recognize other members seeking recognition for one minute each. we will then hear from our witnesses and we thank them first of all for your patience and your understanding and that goes for the audience as well.

we had 16 votes so we thank you for the time. the witnesses prepared statements will be made part of the record and members may have five days to insert statements and questions for the record subject that the length limitation in the rules. before we begin, i would like to express my most sincere condolences to the family and friends of the five american troops who were killed in afghanistan. just yesterday recently. no words can express the debt of gratitude that we owe to those brave troops and our thoughts and prayers are certainly with them and their families at this troubling time. the chair recognizes herself for five minutes. last year this subcommittee convened a hearing with special inspector general for iraq

reconstruction, stewart bowen on the lessons learned from the stabilization relief and reconstruction operations in iraq. the purpose of that hearing was to get a better understanding of how the u.s. approaches reconstruction efforts. and where we can improve so that we won't be confronted with the same problems and repeat the same mistakes. the major takeaway from that hearing in addition to the billions of dollars in wasted taxpayer money, was that the united states government was unable to adequately plan, execute and oversea such large scale operations. have we learned any lessons from iraq? have we learned to use our assistance more effectively and more efficiently? while we may have implemented a

few reforms as a result of the recommendations from these oversight entities in front of us, sadly it seems we still have a long way to go. having seen previous gao and cigar reports relating to oversight and accountability of u.s. assistance in afghanistan, several things are strikingly obvious. one, is that gao and cigar have undertaken an important task keeping congress informed on that status of our operations there but now with the troop presence winding down the abilities will be severeliry stricted due to the security situation and lack of access. this makes it difficult for them and subsequently for us in congress, to keep proper tabs on all of the u.s. funded projects in afghanistan.

another is that for all of our effort and desire to do good in afghanistan, we have some very glaring deficiencies that must be addressed. the u.s. has allocated over $103 billion to afghanistan relief and reconstruction. however, the afghan government is still not capable of handling such a large infusion of money, of goods and of equipment. and it is incapable of achieving long-term sustainability. this is particularly telling with many of our infrastructure projects like in the health sector where usaid would fund projects way too large and ambitious and leaves the afghans with facilities that are larger and more expensive to operate. like the car dez and care cot

hospitals. these hospitals go unused and unstaffed because the afghans can't find the funds nor the staff to operate them. these efforts are not economical or not practical. as a result it is a waste of taxpayer dollars. the result of this large infusion of money to an incapable afghan system is two fold, a report released this year commissioned by general dun ford and conducted by the joint coalition operational analysis, jcoa, determined that the vast influx of money overwhelmed the afghan government's capacity. this helped foster an environment of corruption that has worked against our interest from the start. as general allen once said, corruption is the existent shal strategic threat to afghanistan. the other result is that it

created an environment in which we are not tackling the root cause of the issue. the only way for afghanistan to maintain and sustain the progress it has made under these relief and reconstruction efforts is to continue to rely on donor contributions to fill the revenue gaps. and that is not sustainable for afghanistan nor is it sustainable for us in the united states or we risk losing all of those gains. in 2009, the administration decided it was going to pledge to provide 50% of the developmental aid to afghanistan in direct assistance and gao reports that we went from 470 million in 2009 to over $1.4 billion in 2010. however, that same year, several reports including one commissioned directly by usaid

cited how decidedly i will equipped the afghan ministries were to receive direct assistance. both gao and cigar raised the warning flags. and recommended that usaid assess the risk associated with direct assistance but they are now reporting that usaid ignored these recommendations and may have approved direct assistance without mitigating these risks. how are we to conduct proper oversight of state to ensure that they are fully complying with the recommendations of cigar and gao and rules and regulations laid out by congress to ensure u.s. taxpayer dollars are put to their best use? they identified several major lessons that should have been learned in iraq that should be

applied in afghanistan and these included the need to implement better interagency coordination and use our funds wiser, more efficiently and more effectively. if we are still running into the same problems in afghanistan, as we did in iraq, now that we are transitioning, it is -- is it time for congress to reexamination how we conduct these operations and consider implementing some much needed reform? the obvious answer is yes. of course, yes. with that i'm pleased to yield to the ranking member, my good friend mr. deutsche of florida. >> thank you, madam chairman. i also would like to extend my condolences to the five troops killed in afghanistan. we spend a lot of time here talking about what our

government does but it is ultimately the men and women who serve our government in tough places like this and we keep in mind their families of the five. today's hearing comes on the heels of the announcement that troops will remain in afghanistan until 2016. after 13 years, trillions of dollars and thousands of american lives lost, this news was met with mixed reaction we've come to expect when we talk about afghanistan. those who cannot bear the thought of even one more american life sacrificed to those who believe it's our responsibility to remain and protect national security interest. recent gallop poll found for first time since the war in afghanistan began, more americans now view the war as a mistake. after the united states has given so much in blood and treasure, what do we have to show for it. have the resources been wisely spent? have we strengthened u.s.

security at home and abroad. the department of defense and state department and usaid have significant civilian presence and projects throughout afghanistan. agencies have done tremendous work in the extremely challenging environment. and the civilians on the groundworking to rebuild and reform put their lives in danger every day. they deserve to be commended for the work they are doing. as our presence in afghanistan draws down, are we putting the necessary measures in place to ensure that the frams we've instituted and infrastructure we've built to strengthen afghanistan's security capability and civil society are sustainable and will remain in place long after we live. accounting for billions of dollars across multiple agencies is no easy task. i believe that the good folks at state and usaid have taken significant steps to deal with corruption in the afghan government and to combat any potential abuses. and additional independent oversight is necessary and welcome to create programs that run as efficiently as possible.

in 2008, congress established a special inspector general for afghanistan reconstruction with a goal of not just talking waste and fraud and abuse but to recommend more efficient and effective methods for completing the enormous task of reconstruction in afghanistan. thanks to the work of oversight investigations con ducked by gao, they identified a number of key challenges to u.s. reconstruction efforts such as the limited capacity of the afghan government and persist and security challenges. it's clear evidence of these challenges can be scene throughout the footprint in afghanistan. gao identified numerous coordination and overlap of funding accounts between d.o.d. and usaid, creating the potential for duplication of projects and programs. it appears that little progress to advance that recommendation that's been made. in 2012, gao went so far as to

recommend that congress take legislative action to require u.s. agencies report information on their development related activities in a shared data base. while usaid agreed, d.o.d. did not. they have also raised serious concerns over state and usaid's ability to determine contractors when contractors are found to have ties to the insurgent or opposition forces. the agencies lack the authorities to swiftly terminate or restrict or avoid a contract awarded to a person or entity identified as supporting the enemy and under existing law the agencies will like have to pay up to the full cost of any contract to complete a termination. implementation of these broad reforms and other recommendations will help maximize our assistance and achieve greater results. unfortunately on a microlevel, they have also found numerous examples of wasted funds like the $12.8 million utility equipment purchased to meet

urgent needs in support of the counter insurgent by the u.s. army corps of engineers. i know our witnesses will high lie other areas of concern but i would like to focus on how to better the accountability going forward. our work will not end when the last american troop leaves in 2016. many of our ongoing programs have been tremendously successful and made great strides in the afghan justice secretary tore, instituting desperately needed hegtd programs and access to education, especially for women. how can we sustain going forward with the ultimate goal, of course being to one day transition them to complete afghan control with the decreased footprint on the ground, will we be able to provide needed oversight to make sure projects stay on track? >> usaid developed a expensive remote monitoring process used successfully in a number of other challenging virmts. i hope our witnesses will

address vit cal components required for monitoring programs and whether they believe this type of monitoring can be successful in afghanistan. any development work of this scale will falgs the fair share of challenge and successes but i believe we're doing important work that directly impacts society. it's my hope to continue to shed light on how to ensure congress and state and d.o.d. and usaid are working together to make make sure aid is possible. >> please yield to our subcommittee chairman. >> thank you for calling this hearing to continue this subcommittee's oversight of u.s. reconstruction efforts in afghanistan. president obama's recent announcement that efgs pulling out about the 9800 u.s. troops out by year's end and then

having that in 2015 and pulling all troops out by the end of 2016 is troubling. announcing a departure date no matter what the conditions on the ground just tells the taliban how long they have to wait for us to leave before they can then in their mind take over the country. this announcement puts at risk i'm afraid the sacrifice of our men and women in uniform have made in that country, not to mention the billions of dollars the u.s. invested in stabilization relief and reconstruction efforts. i fear that we may see something similar to what we saw in iraq when we all thought there would be a -- a number of troops that would remain there. they were all pulled out, fallujah to al qaeda, we see rather than a u.s. ally there, we have extreme iranian influence and i would hate to see a repeat of that. thank you very much for holding this. >> thank you so much. mr. higgins, of new york.

>> obviously this situation is sobering at best. $103 billion commitment other the past 12 years and look at the condition of that country and you get the afghan economy about $20 billion. and in one year we spent 75% of that, some $15 billion in reconstruction. $75 billion from a turbine in the southwest, $230 million highway project in the east. $4 billion in training in equipping afghan security forces and i think any assessment of the condition of all of those projects is one that requires a lot of explanation. when we consider that congress last year approved $53 billion to rebuild the bridges of america, a nation of 300 million, and yet we spend $89

billion rebuilding roads and bridges of afghanistan, a nation of some 31 million. at the very least, the corrupt nature of the government, the inadequacy of the afghan security forces does not justify the commitment we made. i look forward to listening to the work of the inspector general and the rest of the panel in exploring these issues more deeply. >> thank you, mr. higgins. mr. weber of texas. >> thank you, madam chair. i'm going to be short. let's go. >> mr. cicilline. >> thank you, madam chairman and ranking member deutsche for holding today's hearing. i want to extend my sympathy to the families of five soldiers killed yesterday in afghanistan. as we begin drawing down combat operations in afghanistan, it's important to say again that the responsibility rests with the afghan people to operate, build and maintain their own civilian

and military capacity. the united states has built an important foundation for afghanistan's future but long term security and sustainable peace in the region can only be accomplished when the people of afghanistan take on these responsibilities. some have argued that helping to rebuild afghanistan's schools and bridges and roads and hospitals has been important to the mission. and some like me believe it's time to return our focus to supporting our own schools and bridges and roads and hospitals. but i hope that all would grell we need to ensure whatever funds have been used and will be used are used wisely and building programs that are sustainable and institutions that are sustainable. but as mr. higgins said, there's a lot of explanation that needs to be provided when you look at the magnitude of the resources that have been invested when we have urgent needs here in the own country. i look forward to hearing the two witnesses today and yield back. >> thank you, mr. cicilline. >> thank you, chairwoman and

ranking member deutsche for calling this important hearing. it is important we conduct this oversight in order to ensure that american taxpayer dlaz are being used appropriately and to ensure no our that our various agencies and departments are making use of best practices. without appropriate oversight, money will go to waste in afghanistan. i also look forward to a discussion of how we discuss with the american people the issues that are the subject of this hearing. after is an emotional issue for the american people as we have seen this past week with the case of sergeant bergdahl. as we finally leave afghanistan, we need to make sure we're communicating effectively and honestly with the american people about our departure and what will come next. >> now we're pleased to ipt deuce our witnesses. we're pleased to welcome special inspector general for

afghanistan reconstruction john supco. mr. sopco has more than 30 years of experience as a prosecutor, congressional counsel and senior federal government adviser. he spent over 20 years on the hill, poor thing. serving in the senate and house of representativeses including on the house select committee on homeland security. and in the senate permanent subcommittee on investigation. he was sworn in as special inspector general on july 2nd, 2012. we welcome mr. michael johnson, the senior executive and director of international affairs and trade at the u.s. government actability office. in his role he assesses counterterrorism and security efforts focusing on afghanistan, pakistan and other terror safe havens. prior to this position, mr. johnson was an assistant director in gaos homeland

security and team and spent a year detailed to the house of representatives homeland security committee. we thank you, gentlemen for your patience and expertise and waiting around. we're so pleased to yield to you know. we'll start with mr. sopco. >> thank you very much, chairman ros late ton and members of the subcommittee, it's a pleasure to be here to discuss my agency's oversight of reconstruction efforts in afghanistan. today's hearing is very timely. we're in the middle of the a pivotal transitional year in afghanistan. the ongoing military political and economic transition will undoubtedly shape afghanistan's future for many years to come. for instance, this week's presidential runoff election could result in the first peaceful democratic transition

of presidential power in afghanistan's history. likewise, the president announced his plan to reduce the military presence to approximately 10,000 troops by the end of 2014 and by the end of 2016, the u.s. presence in afghanistan will be reduced to a normal embassy operation in kabul with a small security assistance office. this may lead many to incorrectly assume that the reconstruction effort is also coming to an end when in fact it is likely to continue for the foreseeable future. this is largely due to previous commitments made by the united states and international community at the chicago and tokyo conferences, in addition to the weak state of the afghanistan's economy and the limited capability of the afghan government to collect revenue. since 2002, congress has

appropriated roughly $103 billion for relief in reconstruction in afghanistan. this is more than united states has ever spent to rebuild any single country in our history. to give this number some context, by the end of this year, we'll have spent more money on afghanistan reconstruction than we did to rebuild europe under the marshall plan after world war i ii. this year alone we plan to spend more money on afghanistan reconstruction than we spend on the next four countries that's israel, egypt and pakistan and iraq combined. an unforeseen consequence has been that we have built infrastructure in a security force and national government that the afghans could not currently sustain on their own. for example, the afghan government generates roughly $2 billion in annual revenue.

while it needs as much as $10 billion annually to cover all government operations, including the importance afghan national security forces. as a result, for many years to come, the afghan government will depend on external assistance from the united states and international community to meet this budget shortfall. accordingly, it is critical that effective management and oversight remain a top priority for all u.s. agencies as we prepare to enter a post 2004-2014 reality in afghanistan. given the appropriated funds remain to be spent by u.s. agencies as of march 31st, 2014. including approximately $7 billion by the state department in usaid.

today the oversight comrades are already contending with a restricted oversight access. based on the best estimate is likely that far less than 20% of afghanistan will be accessible to civilian u.s. oversight personnel by december of this year. that's more than a 50% decrease since 2009. despite these challenges, sigar is committed to the oversight mission and developing innovative methods to adapt in the environment. given at what's at stake, sigar believes oversight must be to use a military term, mission critical. if it is not the historic investment we have made to date and the billions more yet to be spent on reconstruction will be significantly vulnerable to possible waste, fraud and abuse. thank you very much for the opportunity to testify. i look forward to your questions. >> thank you so much.

mr. johnson? >> ranking chair, i'm pleased to be here to discuss efforts in afghanistan. since 2003 gao has a special publication in 2014 highlighting key issues for oversight and numerous congressional hearings and briefings on u.s. efforts in afghanistan. during the course of our work, we made over 150 recommendations on a range of actions that should be taken to improve program policemlanning and mana and oversight. today i want to highlight a few key issues, among them are the need to mitigate over the risk, the oversight and accountable of u.s. development projects and as chair noted, including the need for comprehensive database and need for contingency planning as u.s. transitions to predomina predominantly civilian led presence. regarding direct assistance to

the aftghan government, the u.s pledged to provide 50% of its development assistance support through direct assistance. this was contingent on certain controls being in place. we reported in 2011 that the u.s. fulfilled its pledge by tripling its awards in the first year, going from $470 million in fiscal year 2009 to about $1.4 billion in fiscal year 2010. we also reported that while usaid complied with other controls it had not always assessed the risk of providing direct assistance. although they took steps, we have learned the sigar findings that they may have provided assistance without mitigating against all identified risk.

with respect to afghanistan, since 2002, u.s. agencies allocated $23 billion for government and related promgz. they have taken some steps in prior reviews to improve efforts, usaid continues to fallen short in maintaining knowledge in some areas and still needs to strengthen its oversight of its contractors. additionally as the ranking member noted in his opening statement, to avoid the potential for overlap and duplication and full account ago of usaid and dod and state funded projects, gao made multiple recommendations and actually dating back to 2008 including suggesting congressional action to account for u.s. funded projects. although state and usaid have taken some steps, nearly six years later we continue to report on the need for data

base. this is due in part to the lack of dod action. regarding the need for contingency planning. we reported while circumstances in iraq somewhat difrled from those in afghanistan, potential lessons could be learned from that transition. when you transition from a military led presence. program implementation, oversight and accountability in afghanistan have are very likely to be to be challenged by many factors, pref lens of corruption and limited ability of the afghan government. it is critical to a successful transition and to ensure that the environment is conducive to carry out operations and also carry out oversight. the plans to invest billions more in afghanistan challenging working environment underscored

the need for continued oversight of u.s. efforts. in closing, members of the subcommittee, i would like to personal thank dedicated gao staff members who put their lives on the line in carrying out oversight and thank the congress and members subcommittee for calling this hearing on key issues and note gao stands ready to assist congress and administration in ensuring that there's oversight and accountability of the u.s. partnership in afghanistan. i thank you for the opportunity to testify this concludes my statement. i would be happy to answer questions you may have. >> thank you, both for excellent testimony. i will begin with question and answer segment of our hearing. corruption is so systemic and pervasive in afghanistan, it only serves to exacerbate the already difficult obstacles facing the government's ability to govern effectively. not home that, but it undermines the security of both the international forces and the

afghan people. it erodes the people's confidence in their government. and while it leaves them to distrust us and it leads to the waste of billions, billions of taxpayer dollars, yet for all of these warnings, and all of the reports we have had about corruption in afghanistan, we have yet to develop an anti-corruption policy. even karzai -- karzai, if you can believe it, acknowledged that this is a major obstacle to progress. how is it even possible that we still don't have an anti-corruption policy, even as we're sending billions of dollars in direct assistance to afghan ministries despite all of the warnings and do we have any insight into updated amounts of direct assistance. and sticking with the direct assistance issue, after the

assessment that the ministries were not ready or capable of receiving direct assistance and after recommendations from gao to mitigate all identified risk before proceeding with direct assistance, usaid apparently continued anyway without regard to these warnings. why did usaid continue to provide drengt assistance despite the warnings and are there any other instances where usaid has ignored recommendations? also, how would you characterize your relationship with usaid and what does congress need to do to ensure that usaid is in full compliance before going forward with these high risk programs? i'm also greatly concerned about the duplication of efforts where we see overlaps between state

and dod on infrastructure projects because there's no central and comprehensive database. i know that one thing that you both would say is seriously lacking and something that we need to address, what else would you say congress needs to do to ensure that uxts said and dod are accountable for billions of dollars we're spending in afghanistan? what tools do you need us to give to you to ensure that you have everything you need to continue to do your work. i know it will be extremely difficult for you with the troop drawdown and the uncertainty over the bsa, but we want to help you to keep you safe while you continue to perform your duties. thank you.

>> starting with your last point, i think it would be useful for congress to respond to the very valid recommendation that gao has made about a centralize the data base i don't know if that's appropriations language. one of the hardest problems we have and i'm certain gao and i know my colleagues in the other igs have, we don't even know where the money has been spent. you start with that problem. by requiring the agencies to put together that data base, that would be extremely useful. we are starting to do that ourselves with the background material we gave you, we are trying to collect this information. but it really isn't the role of the inspector general to be the first one to collect this. this is something that should be done. as for the issue about direct

assistance, i think a serious problem here was that aid had finally done some really good assessments. we praised them in our audit that came out earlier this year about direct assistance and assess the afghan ministries in what we had hoped they would have done would have been to actually use that as leverage to bargain on conditionality to get in place, particularly in the future where it's going to be more difficult to go out there and kick the tires of the programs. they waived it and we don't have an answer why they waived it. >> i can chime in with updated numbers. first the point about corruption, corruption as we all have said will remain a challenge and has been one of the biggest challenges that the

u.s. and others face. with regard to direct assistance funding, the latest figures we have is roughly the amount is 800 million for 2012 and approximately 900 million in 2013 in direct assistance. that shows a dropoff from the 1.4 and it's closer to their target of 50% but not quite -- has not met that goal. it has come down somewhat but still pretty significant. in terms of what more congress can do, i would agree as we sorts of suggested that you consider mandating that there be a shared data base or comprehensive database with the entire inventory, over $23 billion has been invested over the taxpayer money. as i mentioned earlier, they have taken action. afghan info is designated as the official database, but the department of defense have basically not agreed to are you

te routinely use that data base or any other database for that matter. we suggested congress may need to mandate that given the aif funding and task force and business operations and all funding that exists there. we looked at this in more depth comparing those three programs to the usaid programs under esf or development assistance. we didn't find exact duplication but 53 cases of potential duplication between the agencies. the reason we couldn't say that, the data that dod was maintaining did not go down to the level it needed to to capture data on villages that were receiving assistance. we think a shaffered database would encompass that organization. it would also put the attention of the congress on the agency requesting money every year, additional funding. with respect to cooperation from gao and oversight community as well. i would say over the last two years or 18 months, there have been significant challenges in

terms of our normal operation with usaid. they previously has been one of the more cooperative agencies but we have run into major challenges in trying to carry out our mission for the congress. >> thank you very much. >> yes, mr. sopko. >> if i can just add, i echo the statement by my colleague with gao. although we have had very good support from d.o.d. in cooperation, particularly under general cole and number of those colleagues over there. we had some problems with aid and getting access through over classification and we think an improper classification of some material unclassified sensored but unclassified. can i add to my colleague's numbers? i think he was focusing on the state and usaid direct

assistance. but we have to keep in mind the biggest player in all of this is d.o.d. to direct assistance, d.o.d. is giving approximately 4.2 billion right now in direct assistance, that is going directly to the ministry of interior and ministry of defense and also going through some of the trust funds. that is the biggest play. although we were focusing on the aid assessments, there's still never been a ministerial assessment on the ministry of interior and defense by d.o.d. we have highlighted that as a potential problem. >> well, thank you very much. our ranking member, mr. deutsche is recognized. >> thank you, madam chairman. mr. sopko, did i understand you said there's been more money spent on afghanistan reconstruction than the marshall plan? >> by the end of this year taken into consideration reinflation, et cetera. >> was the total amount? as youa agnalyze the data, what

the total amount spent? >> the appropriations on afghanistan reconstruction is $103 billion, i believe. >> and for both of you as you analyze -- as you analyze what we refer to as waste fraud and abuse but fraud and abuse ultimately is waste as well, from all of mr. johnson, from all of the good reports that you've put out, is there a total? can you -- is there a total amount of that $103 billion, is there a total amount that's been wasted? >> i'm not in a position to give you an exact figure on that. that's something we haven't looked in depth at. but we do know there's been various inefficiencies and concerns about is there an inventory to note that.

the biggest problem is many of the agencies weren't keeping good performance metrics to look at whether or not the money had been used for its intended purpose and met its goal. >> mr. sopko? >> i agree. we can't come up with an would spi spending all of our time trying to figure out what was lost in the past. we've leaking forward. i think it's safe to say a lot of money has been wasted. probably wasted than is actually stolen. if going back if we don't know where the money was spent, it's hard for us to come up and quantify particularly gag of standards which is the generally accepted auditing standards how much money was wasted. >> and explain to me, again, we don't know where the man was spent how much of that $103 billion do you think we don't know where was spent? >> first of all out of the $103 billion that's authorized and appropriatated as i mentione ee $18 billion is still in the pipe

line. it is still safe. it hasn't gone r gone out and been obligated out. the vast majority of the money was over 60% was on dod it could be on sir programs or numous programs. that's where the money is mainly dod. dod is the afghanistan reconstruction. >> i also want to look forward but for everything that you've looked johnson, there are plenty of examples where you pointed to because of the lack of systems in place, because of lack of oversight, because of the contracting -- everything all the myriad of reasons we're discussed, there's been some significant amount of waste. i would -- it would be helpful if there was some range, even of the reports that you've done, even of the review that you've done where you know there's been waste. here is my point.

i want to look forward, too. but as we deal with this issue of a shared data base, it's a whole lot easier to convince all of our colleagues here and those who may not be inclined to support a shared data base where it's important if beyond speaking generally about the types of problems that exist, we can point out that of $103 billion in taxpayer dollars, that x percent has been wasted. so i don't -- i'm not asking you to re-create the wheel but based on all of the analysis that you've done, you must have some sense? >> you think question speak in broader terms and can give specific examples but i think it gets back to the point that a lot of stuff wasn't done efficienty or it cost a lot more than it probably would have costed in other contingency

areas as well. woi note the asf where the biggest contribution was on the security side. obviously that goal was supposed to be accomplished back in 2008 where the afghan security forces were supposed to be fully capable and flnt. well what happened over time when we put billions of dollars in there and huge amounts of money, the benchmarks continued to be reset every single year. we lowered the standards of their capability ratings. initially we were trying to do it the u.s. way. well, that wasn't deemed to be ultimately afghan right or afghan first. so we wasted a lot of money in the beginning buying u.s. type equipments that he can't maintain or sustain. we build a force that obviously the afghan government could not sustain. the u.s. contributed 90% of the afghan public expenditures related to security issues. united states has paid for that.

we are the largest contributor on the security side in terms of waste and efficiencies there it could have been done more efficiency is what i would say would be the message there. we can give you examples where a was going to go in and build a road that perhaps dod had already done. so usa id as they've noted to us would like to know what dod is going to be leaving lynned behi they'll have some indication of what's already there as they move forward with their planning. >> what's the biggest imbed pedt to this shared data base. >> we don't really see a major problem. the dod is that they are concerned of the security of the data itself. if there's sufficient fire walls to prevent others from getting in. i honestly think it's a relu reluktance on the part of dod. they give it two or three months

for usa id to upload. they eventually get in there and it's not readily avalable. >> does the residency from dod -- is there concern about what we shee going forward -- here -- since 60% of the $103 billion is dod funding and we're in a position to identify the total amount of waste, is there a concern that going forward there's going to be -- some of what you described, mr. johnson, i would suspect that our friends at dod would view differently than the way you describe it this terms of changing standards of why those standards were changed. the standards for security. what do we do to help convince them that this is ultimately necessary and, again, i just go back to where i started, i would really urge you for all of the

analysis that's been done it would be are immensely helpful for us to have a conversation not just about going forward but if we can't acknowledge that we've spent $100 billion and we know billions have been wasted but we can't really even identify some ball park range of what that is and where that comes from. it makes it even harder to support -- forget the creation of a shared database. it makes it harder to support continued funding if we're not able to identify where the problems was to start with. with that i kweeld back. >> thank you so much. now i'm so pleased to yield to a real war hero. both iraq and afghanistan. a fighter pilot. >> thank you, madam chair. thank you all for being here. the important thing to do at very top of it is for everybody

to remember why we're in afghanistan in the first place. that is, it was a beautiful day in september and we were attacked right in the united states of america when we thought we were completely defensible by two oceans. thousands of americans lost their lives. since that day on september eleventh, thousands of americans have lost their lives securing freedom for the afghan people. i think importantly, too, thousands of afghans have lot their lives. we see today in the -- i guess kind of the post war mission of afghanistan the afghan people, the afghan security forces are really stepping up to security their country. there's going to be a lot of challenges. in fact two weeks ago, the president announced his plan to withdrawal nearly all american services members at the beginning of 2014. combat mission end ing at the beginning of 2014. in the following year those numbers will be reduced to the amount necessary to provide security at our embassy in

cable. i know this is the purpose of this hearing to memory, the parallels between what's happened in iraq and i think what the president hasafghanist. in fact i read the news and find out that a place i had been multiple in the times in the war in iraq that's just fallen to extremists. we see what happens in a post american situation. with that said, the reduction of force is going to place a significant dpland on the afghan national security forces. as the gao has reported between fiscal years 2002 and 2014 nearly skpie65% of funding went toward supporting afghan areas such as developing the security forces and narcotics effort. >> yeses with the looming draw down more of the onus will be placed on the afghan security forces to maintain the security of the country. are they now prepared to take the lead? can they help sustain an

environment in which development and infrastructure projects which we've put in place will succeed? this is important because for 13 years we fought to create an environment that they can take over. i want to make sure at the end of the day we're not in hurry to fulfill a complain promise that 13 years of efforts by the american people and by the afghan people doesn't go to waste because i any in 20 years history books will judge us very harshly if that's the case. so i will go with you first. is there an envieronment in a post american era they can succeed? >> the answer to that question is a couple parts. yes, of course they can succeed. there have been great successed with the military. you've seen the afghan military hold their own over the last fighting season. i think everyone is hopeful that they will continue in that

robust fashion. there are concerns. the major concerns that we've highlighted and i believe general dunford has highlighted that you need the bsa side. if there's no bs a, there's very likelihood -- >> we can assume it will be. it seems like it's on track to sosh. >> we are very hopeful. i have no inside information. that's what i've read in the press in a it's very hopeful that both candidates would say they would sign it. the second issue which i think again i can't speak for general dunford he's really the expert on the military capabilities but it's basically the back end, it's the tail of the ansf, the salaries, the support, the buildings. getting the fuel. getting them to understand and how to do that which is what he is working on and i think, the vast majority of the assistance going forward will be trying to make that military capable to do

that. we're looking at -- we've looked at share parts. we've looked at fuel. we've looked at literacy. in all of those areas there are serious problems. so we have to make certain we get those right. >> i understand you're not a policy maker so i'm not putting this on you but you know, i think my big concern in this is in 2016, the president has put on outline that says counter terrorism is a good mission in 2016, advising and supporting the afghan government is a good mission in 2016 but in 2017 it's not a good mission because we are going to pull all of our troops out only for embassy security. my question is presuming we have two years in which to miraculously bring the afghans to where they can operate without american assistance, there's a lot of progress that has to be made in two years. if all troops happen to be out today, if we happen to pull them all out today, what do you think would han ppen to the future of afghanistan and those projects if that would happen today. that gives us a benchmark of

where we need to be in two years so it doesn't fall apart. >> i wf would have to refer to the testimony of general dunford who i think was over here in the house armed services committee or the senate armed services committee just last month who said if we pulled out today, there would be a collapse. i have to rely on his expertise. we've not done a study on that. i don't have any audits on that. >> thank you. i think the point there is if all troops were out today an we'd see an utter collapse, instead of having a mission for the next couple of years where we're focused on withdrawal and we're focused on pulling out, it might be smarter to actually have a mission past 2016 in which we can have a long term game of getting afghanistan where they need to be. >> thank you so much. >> thank you madam chair woman. i know you want to look forward but i think before we do that we need to glance backwards and see

what we've learned or not learned. reading your reports, mr. sofco and press stories, and including press stories referring to you, and listening to your testimony and that of mr. johnson's today, i got to tell you, one has the awful sense of de ja, vu all over again. the biggest mission in the world was in vietnam. there was no aspect of life in south vie etet naum we weren't helping to finance. the waste, the lack of metrics to show what we didn't do positively has been eerie echo in your testimony today. as the chair woman knows i used to be a senate staff member in the senate foreign relations committee. we used to have a chart called

the all spig ots chart showing all sources of assist franom thp united states from mf to asf to direct development assistance and other things. when you refer to $103 billion total reconstruction funding, is that all spiggots? does that include all of the dod money? >> no, it does not include war fighting, straight title ten. this is just reconstruction so $103 billion joo -- >> for the entirety -- for the duration of this war. >> in only u.s. funding. >> would that include serp. >> yes, it would, sir. >> so all right. let's take that as our universe. i know you are reluctant got wasted. tell me how much you're comfortable in looking at it that you think performed fairly well by some metrics.

we got some of some metrics here. >> congressman, i would love to till 50%, 60%, 70%, i live unfortunately in the world of generally accepted government accounting standards and i can't say that. i know my good colleague over in iraq reconstruction once came up with a number and it was later shown for wrong or nothing supporting it. i can't say that. i look at specific programs. the specific programs we can say they succeeded or different succeed or they run a risks. a lot of times we're running in and alerting people that you run a risk of fraud or waste or abuse. i assume my colleague has the same. we can't come in and say, they've lost x amount or they've succeeded. now, we have identified some successes. actually, i asked -- i think the last time i testified before another committee, i said i sent a letter to the secretary of state, secretary of defense, and head of the aid said give me your success stories.

and why. i thought we could use that in our analysis of lessons learned but i just can't answer had a question as i don't have a basis for saying what percentage worked or didn't. >> let me just tell you the consequence of not being able to answer that question. i'm picking up where you left off. it says to the public by implication all of it was wasted. if you can't site metrics, not anecdotal but metrics, 30% went to the intended target and is performing well. another 20% is in a grayer category and 50% is wasted. whatever the metrics may be. if the answer is i cannot answer that question at all then it suggests to the united states taxpayer, $103 billion in construction was down the drain in aftghanafghanistan.

i think every inspector general if you asked whether it's the department of energy aig, vig, hhsig, not answer that question. i don't know if the american people immediately jump at the response and the answer that all of the money is being wasted. i don't think any -- you cannot give us enough money to answer that question. we would be spending all of our time trying to highlight what worked and if you actually look at our legislation, you look at the 78 act and my act, it's not to find out what has worked. my brief is given to me by you is to highlight problems no. to highlight successes. >> yes but you also demured in the answer to my colleagues question, all right how much is wasted? >> so we're not going to -- we can't put a metric on how successful we've within and neither can we apparently have a

metric to his question about how much do we feel confident was wasted in retrospect. >> if i can -- >> mr. swrojohnson. >> the biggest problem we face is that there's poor data being collected. when data is being collected. i will give you an example of the usiad when we looked at the agriculture program. an enormous amount of information was going in from the partners who didn't assess the data. actually their ads requires them to approve their implementing targets. they weren't even approving them. so for us to come in, we can look at programs -- >> mr. johnson. i appreciate your answer. this is 2014. we have been running bilateral and multilateral aid programs since after world war ii. what do you mean we're just

throwing money and aid to evaluate the efficacy of a program. let alone $103 billion. >> it's a good question. with the recommendations we've made perhaps usiad and others in the state department will be more accountable when they come up and ask you guys for money and they don't have metrics. >> would the chair indulge -- absolutely. please continue. >> i thank the chair. something that bothered me when i was in afghanistan, iraq was serp. because it's in a category of -- okay. in a sense, it was well intentioned walking around money. so a military officer, commander could see a problem and fix it on the spot. see a judbridge is out, let me p prepare it. that program, however, became an enormous equivalent by i lateral aid program run by the military

who is not experts in economic development. it's all cash so one worries in the category of what could go wrong with that? i wonder if you could just share with us your observation and of the serp program. >> congressman, you're highlighting a program that we have serious concerns with. i think many members of congress have sear kwlous kirious concer. if i can make a comment probably a little out of my league, i think it was a wise decision in your consolidated appropriations bill of 2014, i think serp funding is pretty well cut. but there was nearly $2.29 billion obligated of which $2.26 billion has been disbursed.

any asemtsessments that have be done, we're still in the process of doing that. once it has been done i am happy to report back to you with the other committees what we're finding. it was a good intention. but if i can answer -- use that question to try to answer your question and mr. doiches's question. even taking that serp money, some of it actually worked. it is going to be so difficult and try to do that. you're just taking the serp. to do that for every one of these programs it's going to be difficult to say what percentage worked and what didn't. we have to get the metrics and apply the metrics what my colleague and i are saying, we aren't given the metrics or they don't use a metrics so how do we determine whether serp works or not. i have beraided by dod or even questioning the serp proposal because it saved lives.

i don't know what that means maybe it did save lives and maybe that is the metrics that te wanted to use, it's hard for me to take that then saving lives and saying the $2.2 billion is wisely spent. that's where you see the dedi predicament we're in and mr. johnson is in over at goa. >> thank you so much. while some of us would say when i was in iraq or afghanistan. here is a man who was really in iraq. a vet who is still serving our country valiantly in the airforce reserve. mr. collins is recognized. >> madam chairman. i would appreciate that. he might want to stay here for just a moment. we're getting ready to agree whole heartedly right here -- look. you all have pointed out some things. i came for some other questions and i will get to those in a minute but let me just say if anybody from usa id is here, dod

is here, or you're watching my camera. the only way is if these who are supposed to oversee what is being spent, tell me that they are not getting the metrics to spend money, they are not getting the metrics on how to even evaluate these programs, then maybe it's time to cut the money off. maybe it's just time to say, let's stop. if you can't handle this because -- this is the problem that i've seen so far and i am for being in the military we've got to rebuild. i've got to problem with that. i have a huge problem with no accountability. the people of the 9th district of georgia do not get it. we're not spending monopoly money here. we're not spending money that just pops out the air and somebody says it's free health care. free this. it's not that. it comes out of my back pocket and your back pocket. it's tax dollars. we got a va system that has problems april ind issues and w this problem where we are blowing money and we don't even

go the metrics where you guys can't even do your job. are you kidding me? madam chair, this is amazing to me. i feel for you that you're trying to do a job with no metrics. you're trying to do a job in which they are given money and say go spend it be happy. see it it works or not. but we're not going to provide you the metrics. if dod gets upset at your question, so what send them to me. i will ask the same question and then get mad at me. this is ridiculous. you know, i have committed language in the state and foreign appropriations bill forcing usa id to take a look at programs it's allocating over in afghanist afghanistan. frankly as we've just said over $100 billion what promise do we have if we continue this? i agree with my friend, there's some things that we need to do to hopefully keep this country

stable. and not have to send our sons and daughters back there in a matter of a few years or send others there. but how can we take it seriously if you usa id and others can't even provide metrics because they don't want to. how can we have any effect? either one of you would like to answer that. >> it is definitely difficult and you know that's part of the way we do our work. we need to measure the u.s. progress against the u.s. identified strategic goals and objectives. in order to do that we absolutely need metrics. these metrics need to be collected routinely and not every so many year buzz they should be collecting those depending on the type of program it is throughout the lifetime of program and making those available to us. they should be approving the metrics that they are asking with their partners to carry out in some of the projects. quite frankly we did find several deficiencies in that area. i think later on, it probably came up, how do you gather and

collect information in a war zone or in an environment like there? well they've done it in other locations. they've done it in pakistan where they collected data using other alternative means to get that data and to report on progress so i don't think it's something that can't be done in gaff afghanistan. the agencies need to commit to doing it. >> congressman. can i add something to my colleague. it's something that the congressman alluded to, that is lessons learned from lessons learned from vietnam and iraq. i sited a report done by aid in 1988, it's a lessons learned report on aid's operations in afghanistan from 1950 to 1979. i couldn't find anybody in our embassy or anybody at aid who had ever read it. this is 12 years. if i was bag signed to a.i.d. i think i would want to read my

lessons learned report from 1950 to 1979. i spoke to a very prominent general, a wise general who says, i'm in the army. we do lessons learned report like going to the bathroom pulling paper. we write them like crazy. the problem is that they are not applied. i think one of the things you can do and congress can do is mandate that each of the services do these lessons learned reports but more importantly that aid and state do them. in the future as we all know this will be an all government approach to a problem. that means we need to mandate that aid stayed in dod and any other agencies involved, probably the intel community do combined lessons learned reports on contingencies. remember under gold water nick ols, you created purple in the military. you have not created mult

militamilpurple in agencies. you have not required lessons learned in all of the various -- i know you served in the military so you understand the lessoned learns reports. you're not seeing combined doctrine coming out on the next contingency so i would throw that out if you want to make certain we succeed, maybe not for afghanistan but at least we learn from our mistakes before we do it again. that's something you may want to consider, sir. >> madam chair if you'll just indulge me for one moment. i understand what you're saying here. what bothers me is simply looking at this is a simple plan. you don't just give me -- i have april o an idea. is there maybe a way that we say the metrics have to be applied before the money is ever transferred once thematter. they don't care. i think the problem we have here. i will go back to his statement, whether it's good or bad, i

think i come from a background where either or. if you tell me nothing has happened or everything has happened. i will discount it immediately and tell you where it's wrong. a lot of things have been done wrong. when we look at this repeatedly, the people of american 9th district, they want the truth and honestly of what's going on. they will accept the truth even if it's hard but they will not accept incompetence and this is simply incompetence that you've unveiled. now it may be vailed in community service, asaid may call it whatever they want to call it. it's incompetence. plain sim, fireable incompetence. i don't understand we continue to do this and frankly, it disturbs me. i don't think we've learned a lesson. we've not learned anything. we have to do hot washes. when i transferred out of iraq, i had to do listons learned. i had to tell the person coming in who took my job here is the

lesson learned. it didn't involve where is the defact? it had to do when what we found on the ground and how you worked it out. i applaud your work. in some ways i feel for you. you're in a no way situation. this country ought to be ashame somed of what we're doing in this area because we can do better. if we truly want to fix it. we can do better. the agencies that i'm talking to today, my office is 513 canon, come explain your incompetence to me. >> thank you very much. just in conclusion as our memo points out, as of march 31, 2014, cumulative appropriations in afghanistan total approximately $117 billion. this is more than the united states has ever spent to rebuild a single country. the findings finance audits were not conducted for 99 of those

140 assistances awards. usa id did not meet the strategies objective to use performance indicators to measure and evaluate its performance toward meeting the strategies goal. goa has previously reported on systematic weakness in usa id's monitoring of evaluating programs. goa and over overfight agencies have hooil lighted gaps that show usa id continued to inconsistent fall out in maintaining institutional knowledge. the subcommittee will continue to do its work. we thank you you very for appearing before us. with that the subcommittee has adjourned. >> thank you. #

. >> the house potential has barred the transfer of funds at the swap of five taliban leaders for an imprisoned american solder army soldier joe bergdahl. the appropriations committee voted 33 to 13 for an amendment to the defense spending bill sponsored by republican receiptative of new jersey and backed by six democrats. the full house debates the bill next week. # voters groing to the polls today in six states. five of those states are holding congressional primaries. maine, nevada, north dakota, south carolina and virginia. arkansas residents are voting on attorney general. south carolina lindsey graham is

facing six challengers in the republican primary. he must clear 50% of the vote in order to avoid a run off. we will have the result tonight. eric cantor is facing college professor david brat in the republican prime yar. his seat was considered safe but even so he spent millions on that race. we will also have those result tonight on cspan. >> we will need to learn again, how to work together. how to compromise. how to make pragmatic decisions. in the upcoming midterm elect n elections americans will have choices to make about which panel to go down and what investments to make in our people. i will leave that discussion to others. but for a lot of us in the private and nonprofit sectors, we have work to do, too. government doesn't have a

monopoly on good ideas, obviously. and even if it wanted, it couldn't and shouldn't try to solve all the problems by itself. we have responsibilities to do what we can. >> hillary clinton's latest book is called hard choices about her time as secretary of state and how her experiences there shape her view of the future. friday live on cspan two. watch book tv coverage of secretary clinton starting at 6:00 p.m. eastern follow bid zmoorning with a book signing in arlington virginia. both events are reair saturday night at 8:30 book tv. telephone for serious readers. every weekend on cspan two. >> the house affairs committee is looking into the delays at some va facilities. the committee heard from a inspector general who said millions had been wasted by contractors to update va's outdated scheduling system.

this hearing is over two hours. >> good evening everybody. we had set aside time for a business meeting tonight to talk about a subpoena that we thought we were going to need to issue. we ask for some information from the department almost a year and a half ago. miraculously it appeared today. so that negates the need for us to move forward with a subpoena. on that particular issue. so we will not be having the business meeting that we originally had noticed and talked to everybody here on the committee and i appreciate it. good evening everybody. i want to welcome you again to tonight's hearing entitled oversight hearing on data man iplation and access to va health care. testimony from goa, ig, and from

va. tonight we are going to address ongoing issues of systematic wait times, manipulations that occurred throughout the veterans administration and negatively impacts the veterans that we serve and the care that should be provided. wait times have been the subject of many committees for many yiers. we have many outstanding requests for information and have held hearings to address the problems within va that have led to veterans waiting so long for needed care. the va's office of inspector general has also repeatedly warned the va about the substandard scheduling practices. from as early as 2005 in numerous reports, vaoig has noted that medical facilities did not have effective electronic waiting list procedures. their outpatient scheduling

procedures needed improvement nation wide. their data was often unreliable and they overstated their success regarding patient wait times. in december of 2012, goa found that va's reported wait times remained unreliable. vha's policy continued to be implemented inkop consiconsiste across va. vha's appointment scheduling system was outdated and inefficient. despite the repeated warnings that have come from congress, from of the gao and even from the va's own investigative body. wait times and scheduling remain a pervasive problem today. last year this committee suggested goa conduct a separate investigation to confirm the programs regarding congoing issues with patient wait times

an console delays. gao will testify as to its findings tonight. recently the committee received whittle blower complaints that explained how the facility was keeping numerous wait lists to give the impression the wait times were much shorter than they actually were. one of the secret waiting lists at the facility source found that as many as 40 patients may have died while they were awaiting care. after the committee was able to confirm these allegations, we made the issue public during our april 9th, 2014 hearing. at that hearing, i asked that the vaoig look into those allegations, which prompted its investigation. the interim results of that investigation were released on may 28th of 2014. in that report, the oig substantiated a number of problems that the phoenix vamc but also noted how it has opened

or has planned to open investigations into 42 different va medical facilities. the oig found that at phoenix, at least 1,700 patients who were waiting for a primary care appointment were not on the electronic wait list. meaning that these veterans may never receive such an appointment. additionally, oig found that the phoenix leadership considerably underestimated new patient wait times which it note ed is the metric used to consider bonuses and salary increases for v a, employees. >> va owe also stated that inappropriate scheduling practices like those found in phoenix are systemic across the veterans health administration. finally we were notified early last week that va would provide the findings of its internal audit of appointment wait times by last friday.

va provided us those findings earlier this afternoon. tonight i look forward to hearing to what va has to say about its audit. how it plans to prepare the audit that it has caused by tampering with veteran's access to care. with that i yield to the ranking member with any opening statement he may have. >> thank you very much mr. chairman for having this this evening. there's nothing more important ln the men and women who have served this country with honor and distinction. i'm pleased our committee is continuing to move quickly in a bipartisan manner to investigate the many shortcomings within the va especially those regarding access to health care. now is the time for us to identify the problems so we can move forward and implement changes. that mines working together on oversight and legislative solution. it also means having very frank conversations with veterans about their personal experiences. so we know what we're -- how we

can improve the system. over the years, this committee has identified to help fix many of the problems within the va but the va is clearly facing a crisis. a crisis that is now being addressed by the media in our increase oversight efforts. in this environment this is especially important that we are fair in our oversight and measured in our responses but above all, we must never fall short of doing what we need to insure that veterans have access to the health care system that they have earned and deserved. it is important for us to work together to achieve the va we envisioned. we must work together across the aisle and across branches of government to fix these problems and ensure that the va is caring for our veterans. when we work together, this committee works best. we now -- the work that we must put forward that we must ensure that the va is receiving the

necessary assistance and resources that they need to do what they have to. as i see it, there is critical questions that should be asked by this committee. questions that get to the root causes of the problems. questions related to the broad strategic changes needed at va. changes in the leadership climate. environment with other agencies like dod and hhs. increased utilization of the private sector and long term resource planning. we need to ask the hard question, what should the department look like in the future? these are not easy questions nor do they have easy simple answers but today, more than ever, we must ask these questions and come up with these answers. i believe thoughtful measured sound policy is needed today more than ever. the answers need to be kpro comprehensive and when

necessary, knnuanced. when holding leaders accountable, we need to not only focus on senior executive members but also the doctors and nurses who occupy, administrative or executive leadership positions. as i mentioned early, hr 434399 closes a gap in the current package of legislation being considered by the house and senate. mr. chairman i've always been proud of the bipartisan nature in which this committee has operated. my hope is that we will continue that spirit working together to help identify the problems and working towards a solution. no single individual has a m monopoly on the answers. no single individual or institution has all the answers. the work ahead of us will be hard. it will require all of us to work together in that regard. the veterans service organization, the department, this committee, the senate, and

the white house and mr. chairman, he want to thank you once again for your robust efficacy for our veterans in holdinga of these hearings that we're having for the oversight. it's my hope that when the committee asks for information from the department of veterans affairs that they provide that information in a timely manner so we will not have to issue subpoenas to get the information that we need so we can do our oversight hearing. that's our responsibility. we expect the department to help us do our oversight hearing as well. with that, mr. chairman, i yield back to balance my time. >> i thank you very much for your comments this evening. i would ask that all members would wave their oepening statements. as customary in the committee, i would invite now the witnesses to konl come to the witness tab. tonight we are going to hear from dr. debra draper. mr. philip mcoskpi assistance

deputy under secretary for health for administrative operations for the department of veteran as fares. richard griffin acting inspector general for the department of veteran as fares. he is accompanied by linda holiday, assistant inspector general for audits and evaluations for the department of veterans affairs. i would ask witnesses the if you would to please stand, raise your right hand. do you solemnly swear under penalty of perjury that the testimony you are about to provide is the truth, the whole truth, and nothing but the truth? >> i do. >> thank you very much. please be seated. all of your complete written sta statements will be entered into the hearing record. thank you for being here tonight. dr. draper, you're now recognized for five minutes. >> chairman miller, ranking member misho and members of the kpl committee, i appreciate the opportunity to be here today to discuss the ongoing difficulties

that veterans are experiencing in obtaining medical care. in 2001, we reported wait times with wait times and scheduling at va facilities. in 2012 we again saw problems including the inconsistent scheduling of va policy which impacted the timely delivery of care. we are currently conducting work examining va's management of va consults. and have again identified problems that may hinder veterans timely access to care. across our body of work on va health care, several common themes have emerged. these include week and ambiguous policies and processes which result in significant variation, confusion and increased risk of indesirable practices at the local level. software systems that do not

facilitate good processes and unclear staffing need and allocation priorities and inadequate oversight which relies largely on facilities self certification without independent verification and the use of unverified data for monitoring. my comments today focus on preliminary observations regarding ongoing work. we found most of the 150 consults we reviewed were not managed in accordance with va's guidelines. specifical wi found that one of five requests were not triaged within the guideline. 19% were completed within fli90 days but the provider failed to properly close out the consult in the relekt ronnic system. in the remaining 43% were closed without the veterans being seen. va medical center officials tell

us increased demand for services, patient no shows and canceled appointments are among factor that's lead to delays and impact the ability to meet the completion guideline. we also identified one consult in which the veteran experienced delays and died prior to obtaining needed care. i want to walk through the time lines of events. in september of 2013 the veterans with a dieing notagnos two anurisms. the surgery was subsequently canceled to due to staffing issues. they referred the veteran to a hospital for local hospital. in late december, it was provide that the nonva provider had lost the veteran's information which

the medical center resubmitted. in february of 2014 he veteran died. this particular case is insightful for a number of reasons. including while nonva care may expand facility there are also some potential pit falls. for example, nonva care needs prior approval which may delay care. wait times nor nonva care are not tracked by va. their findings relative to our ongoing work include variation in how medical centers have implemented new business rules for specialty consults which limits the use of data for monitoring and overseeing consults system wide. an overall lack of oversight of the process, including no independent verification of medical center's actions. as the demand for va health care continues to escalate, it is imperative to va address the

access to care problems. since 2005 the number of patients has increased nearly 20% and the number of annual outpatient medical appointments has increased approximately 45%. in light of this, the failure to address its access to care problems, will considerably worsen and already untenable situation. mr. chairman this concludes my oipi opening remarks. i am happy to answer any questions. >> thank you very much dr. draper. i understand you don't have prepared comments but you are prepared to make some comments. >> that is correct. >> you're recognized for five minutes . good evening members of the committee. no veteran should have to wait unreasonable time for their care. they have earned this care. americans deserve better. secretary shinseki, and gibson have stated that we now know

that within some of our health care nafacilities there are systemic and totally unacceptable lack of indid heing integra integrate. i poapologize to veterans, thei loved ones. members of congress, organizations, our employees and the member people. after this committee raised the issues in phoenix at the va health care system in mid-april, secretary shin sec where i directed a nation wide audit. i will be talk being that audit tonight and answering some detailed questions. this audit visits over 700 locations involved over 400 of our national and field staff at the senior executive level, senior manager level, and frankly, line management levels. we interviewed over 3,700 front

line staff members. we saw this as the opportunity. the opportunity for us to set a reset. to sweep away and establish a clear-eyed assessment of our actual performance, not our reported performance and to establish a system wide understanding of the change we needed to realize in our agency. we released our results this morning on all va medical centers. all cbocs most mid and small cbocs. the rumesults confirm the goa studies and the va report. i'm here to answer questions about this audit and other concerns. our audit revealed a number of things. number one we have hard working staff on the front line who work in a high stress, complicated environment with quite frankly

completely outdated technology. the most frequent challenges sited by our staff are frankly a lack of appointment slots into which to schedule veterans. they have a difficult understanding our policies and they rely on an antiquated system that requires numerous work arounds by well intentioned staff. i have to admit that unfortunately we found that our staff had received strekinstruc to enter a date other than the one the veteran wanted to be seen. we know there is an integrity issue here among some of our leaders. we can and will address this issue. i want to make a comment about reprisals against employees acting secretary gibson had mentioned this that it is not tolerated in our system. we need our staff at all levels but most importantly, at the point of care. we need them to tell us how to

improve our system to be able to deliver care better for veterans and they must feel safe to identify problems and they must feel empowered to find solutions. acting secretary gibson has announced immediate actions. we will expand and create new veteran satisfaction surveys for patient care. we will begin with veterans and their perspectives. we are holding senior leaders accountable. all of our senior leaders in the field over the next 30 days are expected to inspect their practices in their facilities and to be personally accountable for the integrity of those practices. we removed the 14 day scheduling goal from employee performance plans. we are increasing the transparency in the reporting of our data we will be releasing our data by monthly from here on out. affecting secretary gibson

announced an independent audit. we are deploying a team to phoenix to fix all as pecks not just the scheduling and management practices we are formalizing a process for the high performing sites in both quality, ak is haccess and integrity. we have directed staff to phoenix to hire additional staff, to bring in temporary clinical staff, to bring in mobile medical unit that's are currently on the ground. to increase local contracts to include for primary care and we are removing leadership where appropriate. we are going to -- we have suspected all se serks ps perfo awores for vha. we may focus our hr hiring efforts on bringing clinical engineering and administrative staff to the field.

>> secretary gibson trafwill tr to a series of facilities over the weeks to meet with veterans, their families and employees to identify obstacles to quality health care. >> secretary gibson has said we must restore the trust in va health care system. we must restore that one veteran at a time. our dedicated work force over a third of whom are veterans are engaged. mr. chairman thank you to our dedication and your care for our nation's veterans . mr. griffin, you're recognized for five minutes. >> chairman miller, ranking member m, ichode and members of the committee, thank you for the opportunity to testify tonight to discuss the results of the office of inspector general's work related to delays in care at the phoenix health care system. which accompanied by miss linda

holiday, assistant inspector general for audits in evaluation. the issue of manipulation of wait lists is not now va and since 2005, the oig has issued 18 reports that identified at both the national and local level, deficiencies in scheduling resulting in lengthy wait times and a negative impact on patient care. we are using our combined expertise in audit, health care, inspection, and criminal investigators to conduct a comprehensive review, requiring an in depth examination of many sources of information, necessitating access to records an personnel both within and internal to va. we are charged with reviewing the merits of many allegations

and determining whether sufficient factual evidence exists to hold va or specific individuals accountable on the basis of criminal, civil, or administrative laws and regulations. veterans who utilize the va health care system deserve quality care and timely care. therefore it's necessary that information relied upon to make mission critical management decisions regarding demand for vital health care services must be based on reliable and complete data throughout va's health care networks. to date, we have ongoing or scheduled work at 69 va medical facilities and have identified instances of manipulation of va

data that distort the legitimacy of va waiting times when sufficient credible evidence is identified supporting a potential violation of supporting a potential violation of criminal law, we are coordinating our efforts with the department of justice. our work to date has substantiated serious conditions at the phoenix health care system. we identified about 1,400 veterans who did not have a primary care appointment but were appropriately listed on the phoenix electronic wait list. however, we identified an additional i ditional 1,700 veterans who were waiting for a primary care appointment but were not on the electronic wait list. we reviewed a statistical sample of 226 phoenix appointments for

primary care in fiscal 842013. va national data, which was reported by phoenix, showed these 2426 veterans waited on average 24 hour days for their first primary care appointment and only 43% waited more than 14 days. however, our review showed that those 242426 waited on average 15 days with approximately 80% waiting more than 14 days. we did not report the results of our ongoing clinical reviews in our interim report as to whether any delay in scheduling a prime ar care appointment resulted in a delivery or a delay and diagnosis or treatment, particularly for those veterans who died awaiting care.

the assessments needed to draw any conclusions require analysis of va and not va medical records and certificates and autopsy results. we've made requests to appropriate state agencies and have subpoenaed subpoenas to obtain non-v. a medical records. all of these reports will require a detailed review by our critical teams. while we make recommendations to the va in our final report, we made four recommendations to the va secretary for immediate implementation to insure veterans receive appropriate care. we will address the sufficiency of va's implementation in our final report. our recommendations include taking immediate action to review and provide appropriate health care for the the 1700

veterans identified on, not listed on the waiting list at phoenix and to take the same action at all facilities in the va system. this concludes my statement and we would be ready to answer any questions. >> thank you, mr. griffin, for your testimony. members, we will all do a round of questions at five minutes apiece and we will do a second round, i am sure, after the first round. dr. draper, in your comments, you said that 43% of the consults you reviewed were closed without the veterans being seen. can you give me an exmanation as to why the care wasn't provided? . >> there are various reasons, one is patient no show, cancelled appointment, either cancelled by the patient or the medical center. we also found instances of some records we couldn't tell, we looked at it and there was no

documentation as to why the consults were closed. >> how does va schedule appointments? is it through a telephone call to the veteran or by a letter? >> it is typically through a veteran t. veteran may call us. we will notify the veteran on a recall reminder process, which does involve a letter, sir. >> that's interesting, because i've heard numerous veterans receiving letters telling them when their appointment will be and not asking whether or not they can attend that particular appointment. so i'm a little confused. >> sir, i've heard that as well. >> that is not appropriate. >> that increases our rate of no shows. it is not veteran centric. we need to change that. we should be having a conversation with a veteran asking him or her when they want to be seen and scheduleing around their requirement. >> the va has consistently stated the alternate list or list in phoenix used to populate

the electronic wait list was destroyed immediately after the ewl was populated. so my question is, was there any independent verification, in fact, that every veteran on the alternate wait list was successfully transferred to the ewl or can you provide any documentation or assurance to us that no veteran was left off the alternate wait list? >> i've had a team on the ground, sir, reviewing their practices and their scheduling processes. i have a report that's only their first draft report. i will get a final report from them and i will be able to dig a little bit deeper. at this point in time i don't have any reason to believe that any veterans were left off the final ewl count. y but i will await the final report. >> can you the el the central committee who at the central office knew or instructed or coached anybody how to

manipulate wait lyme times? >> i do not know i don't know e anyone that has done that circumstance no, in the my direct experience. >> so you don't know whether they have or haven't? >> i certainly hope not. >> that would run kourn counter. i certainly hope not. >> a brief if may of 2009, dr. mike davie, the national director of systems redesign indicated there were 49,4743 veterans waiting for care as of september 15th of 2008. now more than five years later, the va's audit shows and has been reported in the media that it has risen to 57,000 veterans mateing more than 90 days and an additional 64,000 veterans that appear to have fallen through the cracks. how can this be? >> the correct use of the electronic wait list is the number that's 57,000, sir. we use the electronic wait lists in we are unable to schedule a veteran who is receiving their

first specialty consult within 90 days. the contradict use of that is to insure that we can work a veteran into an appointment sooner. the 57,000 number is a much more conservative number. the known direct clinical care is only 40,000. we have to get eyes on the ewl. we have to manage it. we have to make sure that our front line staff and our medical centers are accurately working that list, getting veterans from waiting for an appointment into an appointment. as to the scour,000, that was the new enrollee appointment wait liss. mr. griffin had told us that that was one of the reldations, that if we could find that in phoenix that, we should look across the entire country. as we had a team review the new enrollee appointment request list, we identified every single veteran from the beginning of the period of enrollment who may have requested an appointment when they provide their enrollment data.

if we could not verify they had an appointment, we went ahead and added them to the list so we could begin contacting them tomorrow. >> mr. griffin, one final question before i yield to the ranking member, had you found evidence of criminal activity in your assessment? >> we have found indications of some supervisors directing some of the methodologies to change the times. we have been in discussion with the department of justice concerning those and whether or not in the opinion of the department of justice they rise to the level of criminal prosecution. >> that is still to be determined in most instances. >> i appreciate you talking with the department of justice. the committee has written a letter also asking they open an investigation. we haven't heard anything from them to date other than the fact that they got our letter. but i appreciate it.

>> thank you very much, mr. chairman. dr. draper in follow-up on a question the chairman asked about the va close consultants due to no-shows. what percentage were no-shows versus the va can selling? >> well, we looked at no-shows and cancellations and we went through the one 50 consults, of the cases we looked at to look at the history of the consult request and we found that more than half either had a no-show or a cancelled appointment. so that's a large percentage of the consults. so it's a big problem for va and what we see is that the policies at the local level vary as to how local facilities handle no shows and cancelled appointments. >> thank you. mr. matkocsky, they report wait

times are not tracked for non-va care. why don't you track wait times for non-va care? >> historically, sir, we have not, congressman, we have two initiatives, both in full deployment at this point. the first one is for non-va care coordination. effectively, what is occurring now is when we refer a veteran to care in the community, if we could not proprietary, it creates an appointment inside a clinic. it allows us to monitor that and watch that appointment. we are now collecting time lead datas on that. we have a nation wide contract called patient centered care in the community. >> that contract has a performance requirement from our two contractors that they both schedule and see veterans within 30 days of the referral from us. we think those two approaches will help us in the long run insure coordination and management of non-va care. dr. draper also alluded the requirement to manage the coordination of that care. it's not enough just to refer care into the community. we do need t