protect our va and to protect our veterans and to upgrade the systems that you need? yes, ma'am. we find out during a subsequent hearing that -- and $17 billion request, that we have allocated long before i got here, this committee has consistently faithfully allocated all the money the v.a. i.t. department has asked for and then we find out a revelation in one of these hearings that they are using 1985 scheduling software. that's one of the most shocking revelations that i heard. where the billions of dollars, where did they go in this giant v.a.? they obviously weren't addressing i.t. and when you come to us and ask for $17 billion and nobody can answer the question why we're using antiquated equipment, the i.t. at the v.a. is a disaster, what is the answer to the question of how can we possibly trust you now even for another billion

just for i.t. when all that money has been unaccounted for and the revelation under oath was we're using 1985 software. i think that is shocking and i think the american taxpayers deserve an answer as to where their money go and how can they trust you with another $17 billion or just $1 billion in i.t. upgrade? either of you. >> i was listening for a question there. >> any question is how can the american people trust you for more money, een a billion? >> be glad to -- give you a lay down of the work that i.t. does on an annual basis, the projects that are undertaken, the systems that are both maintained and developed, and the functionality that's delivered. >> so i guess mr. chairman if i can indulge one final question. i guess the information we heard that day from the. -- i.t. was incorrect. it cannot have been correct information for us to find out

under a hearing that we're using 1985 outdated sced ewing software, when he simply sat there to see we need no more money, we're compliant, we're fine. thank you very much. the informing he gave us wasn't true, correct? >> i think he gave you a honest answer. i think what you heard was the result of an organization that's managing to a budget as opposed to an organization that's managing to requirements. i would tell you one of things we need is a scheduling system. we've got it built into our budget in 2015 and 2016. >> according to your professional, it was built into the budget for years and we were funding it and we were trusting that it was used for the allocation that was requested. >> there was a highly reported failed development effort that occurred back years ago, where v.a. invested a substantial amount of money into a scheduling system and it wasn't able to deliver and i would tell you in the years since that

time, starting in 2010, when v.a. developed the project management accountability system and i would refer to you and i'll make sure that we get you a copy of the recent report, where seven different departments were look at and the progress they have had in i.t., v.a. was the only one of the seven departments that passed the grade with gao. >> i appreciate it. the other question -- >> lots of -- if that guy who is in charge of your imple t. got a bonus, i'm curious for the information that he's provided for the lack of adequate resources that you have. i want to know if he got a bonus. >> we actually were going to have an oversight hearing this week in regards to i.t. we were not able to do it because the person who is responsible for i.t. is out of the country on a long planned family vacation and so we canceled in hopes that he will be able to attend.

mr. waltz, you are recognized. >> thank you, mr. chairman. i for one am thankful and grateful that this nation still produces citizens like yourself. i've had the privilege of working with you in other capacities and your commitment is unquestioned and i think when you started out, mr. secretary, when you talk about, i agree with you on this, this is one of our greatest opportunities to make lasting improvement. what we do possibly within the next weeks and months will have decades long implications. that's important why we get it right. not just get it done. they are hand in hand. i've been advocating what's been missing is a priorities being set. what i'm hearing and i think what you are hearing the concern on this is this nation is committed to getting it right and providing the resources but

we also have the commitment to ask that every dollar be spent in a wise manner, and they are not exclusive. i want to clarify when we talk about the private sector, let's be clear, eight out of ten wizes -- businesses fail out in the private sector. this over simplification and the government is going to get it right, that clouds it, it takes us away from the mission is, there's best practices there are things that are out there. i would ask you this and this is what i would like to get your take on, mr. secretary. i have the privilege of representing the number one hospital in the nation in the mayo clinic and i've watched and i've looked at and i understand how mayo has done this and one of the things that mayo has always of course been focused on is the patient first, just like we're talking about the veterans first but systems analysis from the very beginning over a hundred years ago has been at the mantra of what they have done and these things as far as bald ridge criteria and

performance drives what they do. it starts with leadership and it ends with results and so my question is in mayo they have a quality academy, the levels correspond to six sigma. mayo was founded on battlefield medicine. they are deeply ingrained into battlefield medicine. they have partners with you. they are asking what they can do. my question is when the under secretary sat here, she talked about certification. if they can come back and answer where this is from. what are you suggesting or what can be done in the vha to ensure a bald ridge type mayo six sigma type performance so then we know if we give you the money how it's going to be implemented? >> interestingly enough, when we did a review of scheduling practice ses and access practices we invited folks from may yo to come and brief us. when we look at water safety practices in the v.a., we

invited mayo to come. i think one of things we need to look at, i agree with your characterization, we should look at it as a system and look at our entire health care system as a system, not just focusing on a metric here, a metric there, but looking at concepts like throughput, being veteran centric, how do we measure, manage, assess that. i think over the next couple of months we're going to take a look at some of our productivity work that we've done. we've briefed dr.wenstrep on that. does this work? can we deploy it? test it, measure it, use the principles of measurement for the long term sustainablity,

there used to be these academies that we've let erode. we have to invest in them to succeed. >> that's what we want to hear. this corresponds and it stems from there. this is an opportunity to build the hybrid. the core mission of the v.a. needs to remain intact. there are certainly positive lessons out there. we heard last week that offered up positive suggestions. there was a great one offered up from indiana. he knows on any given day they are only using 79% of their capacity. let's tap that other 21. so mr. secretary. >> i was going to say i was in st. louis on tuesday and had the opportunity to visit our training academy on and on that side of the business and cited

that as an internal best practice that we need to import into the vha, because we don't have the kind of talent development and succession planning inside of vha that you would find in a private sector. >> the older members here will remember this, the crisis out at our sem terry's out at arlington and others, and the focus that's been put on there. we can do this, but if we miss this opportunity or don't rise to the occasion, then shame on all of us. so i yield back. >> mr. runyan, you are recognized for five minutes. >> thank you mr. chairman. i'm going to throw out a couple of receipt tory kal questions and some an nal you didn't see. i want to throw it out there and see if you can respond why someone would even ask, is v.a.

too big to fail? i mean, that's something that we've dealt with in other sectors in the last decade. i think it's a legitimate question. and when we talk about trust and processes, how are we going to get there? as representative flores said earlier and you follow up answering mr. hulskamp question about process. your quote was you need a set of facts to act on. that can be done in a budgetary process. i'll use the analogy. your girlfriend broke up with you, you made up the next day but you didn't ask her to marry her that day. the legitimate processes of gaining trust over time, and to go to that, and i love the fact that you brought up manage to

requirements. there's eight members on this committee that serve on armed services. and mr. wals brought up quad drinal defense review. they tweak the requirements to make the budget. they don't lay the whole thing out to congress and allow us to say at some point we're going to have to prioritize what we're going to do there's only so much to go around. we have to know what's out there. when we're dealing with a crisis like this and i ask the question to under secretary last week, i said when we're attacking something like the claims backlog, that's a category of claims. now, when you do your analysis to say we need this much money to solve this problem, are we going all the way back into

everything from -- i know it changed on a daily basis, could you do it by a quarterly basis or biannual basis to say to eliminate all of the claims in whether it's death benefits, bur yals, education, you know, pension, all that kind of stuff, is that even possible to move the overlay of what we're making definitions of putting claims in piles to say do you have an idea of even what that number is v.a.-wide? because you've alluded to it on several patient aspects, but in an overall claims, because when we continue to -- we're only going to ask for this much because i put this overlay on it, what is the overall big picture? what is that requirement to eliminate this once and for all?

i don't think these questions really get asked and/or answered on a regular basis. >> and you are talking about on the claims side on the benefits side? i'm not sure. >> just to boil the whole thing down. let's just say claims. every single one of them that is sitting on a desk in an r.o. somewhere, what is that number and what is that fiscal number that goes to eliminate that? you talk a lot about modeling and all that. your models you are using filters and layers to actuate the numbers that come out of those models. what is the big picture? is the crisis bigger than we -- i think we're realizing it's bigger than we thought it was a year ago, but can we did at point push all this back and really say we really got to step back and take a look at this and realize that this is a bigger problem and we really need to

dive into this deep? >> i think as it relates to both to the claims side of the -- the benefits side of the business, if you will, and the health care side of the business, part of what you are seeing is this regular weekly publication of detailed information, not just about the disability claims, but also now detailed information about all the nonrating claims buckets, so that people have that complete picture. the same thing on wait times. you know, up until six weeks ago, we weren't pushing detailed wait time information out on every single location. care quality and patient safety information out on every single location. so that we're creating that kind of openness and transparency so that people can understand the magnitude of the problem. i sit here and say it's 641,000 veterans that got appointments that are more than 30 days than

they wanted to be seen. >> my time run out and i've experienced this in my four years in congress, as you build trust and we say we're going to do it one step at a time i don't think there's anybody on this committee that would have a problem you tackling $10 million at a time. i don't think they would and make sure we get it right and have that set of facts that we can act on as you said. so with that, i'll yield back, chairman. >> ms. can you sayd -- cuss ter, thank you for taking on this extraordinary task. i want to echo the comments of my colleagues. i think you'll find that this is one of the very rare bipartisan committees that where we strife

to work together. i want to mention on the issues of ethics of accountability. what my concern is while i wholeheartedly believe that we naed to do every possible thing to ensure that our veterans get the care that they deserve, i have a hard time addressing the funding request before we get into how the v.a. is going to fix this underlying systemic of integrity and in particular the testimony that we've heard here about this scandal of people receiving bonuses based upon manipulated data, frankly, lack of truthfulness, truthiness if you call it. honesty and integrity that not only the veterans deserve but frankly the american taxpayer deserves and so if you could address, before we get into the

additional funding, how do you intend to restore that level of integ grit throughout this system and what will be the actions taken for deceit and failure to abide by basic, basic issues of integrity? >> yes, ma'am. when the president told me he was going to tap me to be the acting second, don't expect me to behave like acting is in front of the job title and i have tried not to do that consistently. we have moved out on every front that we can conceivably move out on, so it's been a process of working not sequentially on attacking different issues but working across a much broader front at the same time. working to get veterans off of

wait lists and fix scheduling issues and simultaneously working to build the processes so that we can hold people accountable for willful misconduct and management negligence when it arises. as we went through this process, i perceived the need for additional expertise in that area which is why i went and recruited lee bradley and with secretary hagel's strong support to come return to the department of veterans affairs. we have built underneath a cross functional team of senior leaders across the organization. part of the challenge we're going through right now is just what it takes in the federal government to pursue personnel actions to have them done in a way that you at least hope it's going to stand up in an appeal. the other challenge that we're working through right now is really the recalibration of the

department's yardstick if you will. that behavior that looks like this which in the past might not have had any accountability action associated with it as all, at all, may in the future be a deemed appropriate for removal from federal service or for a very extended period of suspension. so what we've done and as we have now, i mentioned earlier, gotten the first of these cases in from the ig, are now exercising that process. following due process, but also managing through this reset that has to happen, this recalibration that has to happen toen sure that appropriate accountability actions are taken for the wrongdoing that's been identified. >> if there's anything that we can do in our capacity in congress, i know that including passing a bill to give you the authority to literally fire employees because i think that

is the only thing that's going to bring this integrity back, and ij want to say for the record i had a tremendous honor this week. my constituent, sergeant ryan pitts received the presidential med dal of honor and i was there with at the ceremony and with his wife and his son, and when he was inducted in the hall the fame at the pentagon. i was very interested in his comments this morning on national television when asked about his own care at the v.a., that the care he has received in new hampshire is -- has been very high quality. but i want to say for the record that every veteran deserves that care, and my time is coming up, but i do want to say that i hope you will pursue best practices because i think we have some exemplary care in new hampshire and i would like to see that

throughout the country. so thank you on that i yield back. >> thank you very much, mr. second, i apologize. some members are going to have to depart to go to a conference committee meeting over in the visitors center which is at 12:00 noon. we tried everywhere we could to find a time that was agreeable for everybody, but i'm going to turn the chair over to to someone else at this time. thank you for your service and candor and i look forward to continuing to work with you.

>> thank you, mr. chairman, i appreciate that. i recognize myself for five minutes. mr. secretary, thank you for your service to our country. mr. second, are you aware of this incident that occurred on monday in orange county, florida, facility, where a marine, a veteran was actually waited for three hours for care, did not receive that care, and then he was subsequently locked into a facility during closing time, so it was inadvertent obviously? what are we going to do about this? this is accountability. are you investigating this, will the people and straight tors be held accountable? >> all i know about it is what i read in the clippings this morning. it will be an object of intensive review to investigate what happened. >> can you report back to me mr. secretary with regard to that. >> yes, sir, will do. >> i mean it's outrageous as far as i'm concerned.

you have directed that an independent external audit of v.a. practices perform. what do you expect it to reveal? has a contract been awarded and how long do you anticipate this to go on and then i have a couple of other questions. >> the contract has not been awarded yet which is why i'm in a position to be able to reveal the entity that we are working wi with. i believe once it's announced the reaction will be they must be pretty serious about making sure this gets done right. quite frankly it doesn't tell us anything that we don't already know. i hope it confirms that we now have in place are scheduling practices that are aligned to our policies. i think to some of the earlier questions that were asked about the need for some verification,

we're publishing wait time valid every two weeks, is it valid data and for one of issues is for us to look at the scheduling practicing, have independent review, determine that they are sound practices aligned with our policy and therefore we've got credible data for external consumption as well as for our own internal actions. what is the expected costs of the audit? >> i don't have a number for you. i'll take that for the record. >> okay. very good. thank you. again, with regard to the bonuses, have any bonuses been reskinned -- rescinded so far due to willful misconduct or negligence management? can you answer that question? >> i will give you the best answer as i know it. there were some bonuses that were rescinded recently that were associated with administrative error. the law allows us to do that.

where there is a -- something is learned after the end of the performance period and after the performance contract has been officially the performance review has been officially approved, we don't legally have the ability to go back and change that performance evaluation and, therefore, claw back that particular bonus. we do have the ability to go and reduce salary and take other actions which would be the typical actions upon some subsequent -- learning of some subsequent information that affected performance during a performance period. >> okay. last question. i understand that you implemented a hiring freeze for the vha, central office, and visiting offices with the exception of so-called critical positions to be approved by you in a case by case manner. what would you consider a critical position for a vha

central office and visiting offices? >> for example, we currently have four vacant visin director positions and if we were where we had the right person identified to step into that those key leadership roles, i would be prepared to grant an exception for that personnel action. >> have you granted an exception so far? >> i have not for that purpose. there is one employee i granted an exception for, where he had already been given an offer and he agreed to an offer, and had already started to relocate. i did that. this is roughly 3,000 people that surprised the vzn central office relationship. there are other staff that are associated with those particular areas, such as call centers. we have thousands of people that work in our call centers in vha

and those would not be positions because they are providing -- that would be subject to the hiring freeze because they are providing direct service to veterans. >> how long will the hiring freeze be in effect? >> don't know. >> you can't anticipate how long, huh? >> you know, the real purpose of that hiring freeze was to very directly here was to basically send a shot across the bow of the bureaucracy to say we've got to get ourselves refocused here on delivering the support that the front line needs, the people who are taking care of veterans day in and day out. that's really the purpose behind that particular freeze. >> thank you very much. i appreciate that. and i have ms. mccloud. you are recognized for five minutes, ma'am. >> thank you, mr. chairman, thank you, mr. acting second for being here. however being near the end, all

of questions have been asked, so rather than be redundant, i yield my time. >> you are finished. thank you very much. i apologize. thank you. i'll recognize mr. fitzpatrick for five minutes. >> i also thank the chairman, and thank the acting secretary for your time here today. i know that we all honor and appreciate your service. it hasn't been said here today about your time at the uso which was a real turn around, a great success, great american story. >> yes, sir. >> and i want to thank you for that. we sense that. we saw that in philadelphia with the uso organization there. we all hope that you can bring that enthusiasm and success and bring it back to the organization at the v.a., it desperately needs it and your leadership there and echo some of the comments of my previous colleagues who said that we hope that you stick around the v.a.

>> i plan to. >> the v.a., it's a stool with three legs, and we have the health administration here, we have the benefits administration, the third is the semester semesterry administration, and as mr. walz, it hasn't been without his its issues. coming from bucks county, we have a national sem teary. so the veteran community, the families of military and the bigger communities is left with a very positive view of the veterans administration because of the semester ry administratin there in the community. not so much with the benefits administration. mr. secretary, i'm sure you are familiar with the hearing last week. there was a whistle-blower from

philadelphia, an outstanding employee, very dedicated employee, who is a whistle-blower for her work, providing direct outstanding service to veterans, and indirect service by going to her managers by pointing out flaws in the system. she's pointed out backlog and delays, thes pointed out duplicative payments that should be recalled. she's been vilified. i know that you were in philadelphia a couple of weeks ago. my staff really appreciated your time and commitment in going there, but based on what you saw in philadelphia, and based on what you heard and what you now know, and i would ask what is the plan, what are the action steps to turn around the philadelphia office which would apply to many of the other r.o.s across the country?

>> that's a great question, congressman. i think we're back to the earlier point of leadership. we have one of our most capable and experienced senior leaders that is in the process of relocating to take over that troubled location and i would expect in the wake of her arrival to see steady improvement. i have as i go out to visit medical centers, i make a point of visiting regional offices in the communities and there are a number of those that i visited fairly recently that not that long ago were not necessarily distinguishing themselves for a variety of reasons in terms of the timeliness or the accuracy of the work that they were doing or some other challenges and problems. and yet find address we get new leadership there on the ground, the right kind of leadership, that we see a very strong recovery and improvement and that's what i'm looking for in philadelphia and expecting. it's a vital location for us.

>> there needs to be a complete change in culture and there's been a lot of discussion about the number of $17.6 billion. how many billion dollars does it take to fix a broken culture within the v.a.? >> i would say as i was alluding to earlier, this is not a one-stage effort. this is not something either that we feel like veterans expect us to tackle some of these problems in sequence because if we did, we would be three years before we got veterans off of wait lists, the way they need to be gotten off of wait lists, so there are things we're doing to get veterans off wait lists to fix scheduling practices, to address cultural issues, to enforce accountability, and along with that, part of that is identifying and quantifying the resources we believe that we need over the next several of years in order to meet timely

delivery. >> in my remaining time here, i want to get to the issue of the goal to eliminate the backlog. i think you said you have an intent to eliminate that backlog. >> by 2015. >> it's an audacious goal, i find it hard to believe based on our own investigations where you have middle managers where they can produce reports and send them up to the change of command to say based upon these metrics, we've met the goal, which is a hollow victory which is no victory at all, we may look like we met the goal, but there's still hundreds of thousands of veterans still waiting for care. >> we make steady progress. that's one particular goal that

doesn't necessarily lend itself to the most frequent and accurate measurement, but there is steady progress being made in reducing the number of veterans that are living on the streets and i'll tell you and i'll say it again right now, i believe that we will eliminate the disability claims backlog in 2015. i think we're on track do that, notwithstanding the challenges we've got at a number of our regional offices. we've got work to do. >> thank you, mr. secretary. >> yes, sir. >> thank you. thank you, mr. fitzpatrick. if there are no further questions, you are now all excused, and i'll invite the second panel, the final panel for witnesses, all the witnesses to the table, please. >> the house veterans affairs committee also heard testimony from legislative directors from a number of veterans services organizations. among them the american legion, the disabled american veterans and the veterans of foreign

wars. they all gave their recommendations for improving veterans access to health care to the v.a. this is two hours. >> on our second panel, we have ms. verna jones, veterans affairs director for the american legion. welcome. mr. ryan galluci, mr. carl blake, welcome, sir. mr. joe valente, welcome, sir. mr. rick widen, executive director of the government affairs for the veterans, again vietnam veterans of america. welcome, sir, and mr. alex

nickle son who is a legislative director for the iraq and afghanistan veterans of america. welcome, sir. thank you all for joining us here this morning. thank you so much for your patience. your complete written statements will be made part of the hearing record. ms. jones, if you are ready, you are now recognized for five minutes. >> i wonder how many people in this room would bet their last $40 on a long shot chaness to make some sense of the v.a.? mr. vice chairman, on behalf of the national commander and the 2.4 million members of the american legion, thank you for your diligence and oversieg during this crisis. the american legion has been the last six weeks in five cities setting up crisis centers. we've send over 2,000 veterans. i've been at each one of those crisis centers and i can tell you firsthand that it's bad and i'm deeply saddened the american

legion is sadnded. we've listened to veterans and widows and children who won by one told their stories of broken promises, pain, mistreatment, delays, and, yes, even death. many of them full of hurt, anger, confusion, and uncertainty, just want to be heard. yet they have told their stories many times, but their pleas have fallen on deaf ears. during the town hall meetings, the american legion listened because what they have to say is important and we want to help. it's woven into the very fabric who we are as an organization. i'm going told you about a man who is in fort collins, colorado who spent his last $40 on a cab drive. i met a woman in phoenix, arizona, reduced to sleeping in public bathrooms because the v.a. couldn't get her dic claim

correct. she came to us in tears. in el paso, texas, within the first three days, with 74 veterans, we recovered $462,000 on the spot for those vet vans who were entitled to those monies. i read a letter from the office of special counsel about v.a. and the harmless errors that included a veteran waiting more than eight years for a psychiatric appointment. eight years. we have veterans taking their own lives, 22 veterans a day here in america and it's a harmless error that a veteran has to wait eight years for an appointme appointment? we saw in north carolina a veteran who had been working on his claim for 14 years as he left the crisis center, said i can't believe it took me 90 minutes to fix what i've been working on for 14 years. nothing we've been doing, five cities, and we have a half a

dozen more scheduled were making the extra effort, that's what it takes. we all heard a whistle-blower talk about the boxes of mail languishing in pennsylvania. you can identify that mail she said, it just takes a little extra effort, but they don't allow you to make the effort. if an employee wants to make extra effort to help veterans at the v.a., that employee shouldn't have her car vanlized and be subject to harassment. you need to promote that kind of employee. i hope the v.a. is listening. how about you take the whistle blowers, the people with the guts to stand up and say that's not the right way to treat veterans and put them in leadership positions so they can be the example for the people who work for them. you can make some room for them by getting rid of ones who covered up veterans waiting for care so they could earn extra money or overstate accuracy to look good. it's not about tearing down the

v.a. it's about saving the v.a. the american legion want a good v.a. for all veterans. abraham lincoln who shall have born the battle to care for his widow and/or fan. who talked to veterans in every city a place to belong to them. they want doctors and medical professionals who understand their needs. when the american legion says the v.a. has a problem with access and leadership, we don't want to throw out the v.a. we want to make it what veterans deserve. the man i told you about in colorado, he had been let down by the system. the system was supposed to care for him. he was broke. he felt broken. and he spent his last $40 on a cab ride to get to the american legion crisis center. all of his worldly possessions on his back in a knapsack. he arrived at the crisis center after it closed that day, so he had to sleep at a gas station waiting for us to open.

the next morning, we were able to get him in front of the v.a. and that gentleman was placed in a housing program and received the services that he really needed. our chairman of veterans affairs rehabilitation for the american legion was so affected that he gave that gentleman back his $40 because the american legion truly believes that no veteran should have to pay for services they have already paid for by virtue of their own service. we've served over 2,000 veteran through these centers and life changing decisions have been made and we pressure the support and collaboration of the v.a. those v.a. employees came into the crisis centers and worked with veterans and they did a great job. this is what happens when we all come to go and do what we know is right. and while we as an organization have been honored to help, the question still remains, why did it have to come to this point in the first place? thank you for listening. >> thank you, ms. jones. thank you so much for that testimony. now, we'll recognize mr. galucci

for five minutes. >> thank you. on behalf of the veterans of foreign wars. thank you for the opportunity to testify on the state of v.a. care and restoring trust in the v.a. system. the allegations made against v.a. are outramgs and our members are rightfully outraged. plus the vfw worries that the loss of trust has the potential to be more harmful than some of the impropriety we've seen. we advise advertised our help line, where veterans could return for assistance or share their experiences. we conducted a series of town halls and over the first two months of of our outreach, we receive more than 1,500 comments most of which were negative. we work with v.a. leadership to help resolve some of these issues. we made specific recommendations to fix the system.

v.a. care is far too important, since many of its services cannot be duplicated civilian side. my full comments are submitted for the record. today, i will share specific issues with regard to the v.a. timely access, there are concerns for wait times. v.a. knows that its antiquated patchwork system allows patients to slip through the cracks. this is why the scheduling system is riffe with -- arrive -- riffe problems with problems. at first, v.a. said it would take six months to see primary care. after sich months, the v.a. told the six months later, six months later, when he was called, he was informed he was disenrolled since he had not been seen in more than a year.

we have to do better than this. this is why congress must provide the resources necessary to inquire a modern and sustainable scheduling system. however, v.a. must have the responsibility and resources to properly coordinate and deliver non-v.a. care, otherwise veterans will suffer. earlier this week, i spoke with a veteran caregiver in missouri who experienced a nightmare in v.a. care. what followed was a bu accuratic mess, after the operation was completed, he was told the hospital had no other responsibility. he had to travel to the v.a. to receive proper medication. it was not communicated to the veteran prior to the procedure. moreover, the caregiver reported that the non-v.a. facility was

inflexible while caring for a veteran in their care. v.a. must continue to serve as the guarantor of such care and congress must ensure that v.a. referral teams and private networks can make responsible, timely health care decisions. finally, we all know accountability is a major problem for v.a. and a problem that goes beyond executive employees. secrecy and low morale is a problem. employees are afraid to speak up and worse as we heard today penalized when they do. we need to change this mind set. this needs strong leadership and strong whistle-blower policies.

v.a. acknowledges it cake up to a year to fill vacancvacancies. thankfully, not everything the vfw hears about v.a. care has been bad. nearly 40% of the veterans who contacted us, praised v.a. others offered perspective on how the system has improved over the years. we believe the system can work but cannot work without congress taking action. this week, at our convention, a resolution was passed calling for change. our members insist that congress absolutely cannot go into the august recess without passing this bill. when the current scandal broke,

every legislation legislature in washington agreed this was a national em pairtive. we have a opportunity to show our veterans that our nation's promise will care for those who defend it. we have to get this right and restore confidence in the v.a. system. mr. chairman, ranking member, members of the committee, this concludes my testimony and i'm happy to answer my questions that you may have. >> thank you, mr. gallaccui, i now recognize mr. bilirakis. >> it truly is frustrating to see about the things that have been reported about the v.a. health care system in the last several months. not a think we have heard is surprising. pva members, are the highest percentage urgs of the v.a.

health care system in the veteran population. i can promise you that our members have experienced the long delays and the scheduling gimmicks have been exposed. i'm a regular user of the v.a., it has happened to me. however, we are fortunate because pva 30 years ago developed an agreement with the v.a. to allow us to do annual site visits to fully understand what goes on in the system of care. and make sure adequate staffing and resources are developing to that system. the sad reality that other veterans do to the have that luxury. the fact is we are all responsible for these problems. veterans services organizations should have promoted greater examination of our concerns. meanwhile, the administration should have been fully honest about the resources and staffing it needed to meet actual demand on the system.

not manipulating demand da it and statistics to make things look better than they obviously were. finally congress should have actually listened to what we had to say as advocates as and we've been saying for years. these access problems can be traced back to 2003, when the v.a. had to begin denying enr l enrollment to eligible veterans because it did not have the resources then. we allowed the v.a. to close its doors to some people and now it simply got worse. here we are today talking about this problem. in a meeting recently, a member of congress told several of us in the community we thought we were giving the v.a. enough resources. that is a ridiculous statement. this just affirms that no one is listening to what we the vsos and the co-authors of the independent budget have to say because we've been pointing to these problems in both our budget and policy recommendations for 28 years.

in fact, for four years now, we have not once had the opportunity to formally present in front of the mill-con appropriations subcommittee to outline our scores. i will not dispute the fact that the v.a. health system has been given large sums of money in recent years and they have done a poor job of managing and spending those resources. those are facts. that does not automatically mean that additional resources are not needed now. we believe they absolutely are whether to address the recommendations made by the v.a. or the administration or the white house or whoever made the $17 billion recommendation or to address legislation that the conference committee is currently rangling other right now. unfortunately, the discussion has turned more accessing private health care instead of

restrengthening the systems we have. the v.a. has provided its appraisal and yet some members of congress have laughed that off as being unseasonal or -- unacceptable or not part of this debate. when will this be part of the debate? i'm not convinced that it's part of the debate. if congress really not interested in fixing the v.a. from within. i hear about the discussions about the culture. it needs to be fix. i can tell you i prefer to go to my v.a. doctor. the question was asked of this committee hearing last week about the possibility of v.a. contracting out for most services, not specialized care or care that's unique to the v.a. but that question ignores the fact that primary care is not a generic function, particularly when it comes to veterans.

it was admitted they had need to time to understand the nature of the veteran patient population before they could actually meet demand. one of the other representatives who sat right here in this seat said we have longstanding concerns about the rates of reimbursement. are we not concerned when the people that it seems we are going to turn to to help us address these access problems will redly admit that they fully do not understand veterans as patients and they are worried about how much they are going to get paid? their moeskses are not our moeskses motivations, their mission is not the mission of the v.a. to be clear, pva finds is wholly unacceptable that tens of thousands of veterans have waited far too long for care. not a single veteran should have to wait for care when it is needed and it is incumbent upon this committee, all of this at this table and the folks sitting behind me to get this right, because it will matter in the

long run to millions of veterans. >> now, i'll call on mr. valetne. >> thank you. thank you for dividing dav to testify today. when the allegations of secret waiting lists came to lying, we were outraged. but like you, we wanted to wait for all the facts before reaching final conclusions. today, there is no longer any doubt that the serious problems uncovered by this committee invalidated by va's oiv are real and must be corrected. over a decade ago, v.a. faced similar crisis. in may, 2003, a presidential task force reported the

following and i'll quote from this book. as of july 2003, at least 236,000 veterans were waiting six months or more for first appointments or initial follow-up. a clear indication -- a clear indication of lack of sufficient capacity or at a minimum a lack of adequate resources to provide required care, end quote. the ptf concluded there was a mismatch in v.a. between demand for access and available funding. as mr. michaud pointed out earlier at a hearing in february, 2004, the secretary sat at this table and stated, i asked omb for $1.2 billion more than i received. one year later, after stating unequivocally that v.a.'s budget

for fy-2005 and '06 were sufficient, secretary nickleson admitted v.a. needed an additional $975 million for '05 and $2 billion more for '06, even when v.a. accurately indicates its needs, omb passbacks a lower number in the final budget. that's why dav and our ib partners have testified over the past decked that va's medical care and construction budgets were inadequate. in the prior ten years, the funding provided for medical care was more than $7.8 billion less than what the ib recommended. for next year, we project it will be $2 billion less than needed. here's what the congressional budget office said in a recent report and i quote, under

current law for 2015, and cbo's baseline projections for 2016, v.a.'s proepgss for health care are not projected to keep pace with growth in the patient population or growth in per cap i at that spending for health care, meaning that waiting times will tend to increase, end quote. in addition, over the ten years that funding appropriated for construction has been about $9 billion less than what was needed, and that's based on v.a.'s own internal analysis. mr. chairman, in 190 a, american philosophy george santiana famously wrote those who cannot remember the past are condemned to repeat it, end quote. the question is will we learn from the mistakes of the past? in our view, the debate over

whether there is a mismatch between demand for v.a. health care and the resources provided is a settled issue. why else would the house vote 426 to zero and the senate vote 93 to 3 for legislation to expand veterans access to health care that cbo estimated could cost $30 billion for two years of coverage and up to $54 billion annually after that if there was already enough money? acting secretary gibson testified about the progress made offer the past two months, adding more clinic hours, filling physician vacancies and using temporary staffing resources. secretary gibson also testified in order to continue this expanded access initiative for this year and the next three years, v.a. will need

supplemental resources totaling $17.6 billion. unlike the proposals in the conference committee, v.a.'s proposal would have an immediate impact by continuing v.a.'s expanded access initiative and its purchase care while building up internal capacity for the future for these reasons we support the supplemental request approach. mr. chairman, dav has for decades said that funding provided to v.a. was inadequate to meet current and future health care needs for veterans. sadly, history has proven us correct. it is up to congress and the administration to stake steps necessary to end the mismatch, provide the v.a. the resources it needs and work with vsos to strengthen the v.a. health care system so enrolled veterans receive high quality, timely, and convenient medical care. that concludes my testimony. i'll be happy to answer

questions. thank you. >> thank you, sir. mr. wideman, you are recognized for five minutes. >> thank you very much, congressman. weaver a simple -- we're a simple bunch and our agenda for the congress consisted only of four things. number one, fix the v.a., and what we meant by that was gobbledegook that meant nothing in terms of accomplishing the mission. there be true accountability, if people lie, they are fired. you can't run an outfit where people system kael and do not tell the truth. the third thing they have adequate resources and i have to agree with my colleagues here, they don't have adequate resources, and lastly, on our

agenda is addressing toxic wounds which really hasn't been done for any veteran. it wasn't done in world war ii, vietnam vets. with agent orange exposures. not view for those exposed to sarin gas. it's something that needs to change in the system. and not an hod on in which the v.a. system approaches health care.