or senior staff have ongoing conversations with the secretary or high level individuals at the department ofsecretary or high-l individuals at the department of veterans affairs. the question i would ask, does that result in a change in approach style management attitude at the v.a. that results in higher quality care for our veterans. iq for the opportunity to issue a statement and to ask the question. >> thank you. panel forthank the their testimony, their vision.ive and their i want to thank you for staying for this part of the hearing and express my apologies. i got tied up in a committee. i will follow-up with you in private. it is good to be asking questions about this. we agree access is the issue. it is the issue.

we have had everything talked about from dollars to construction to milestones to all sorts of stuff. helpful. i'm going to ask you, each one of you, because you represent veterans in this country that are being served by the v.a., i think you have an understanding of what the challenges are out there. you tell me what you would do first to fix the v.a. and what you would do second. i am assuming there will be 3, 4, 5 more down the line. is it money? is it the resources they have the need to be allocated different? do we need to put a focus on hiring professionals? you cannot say do all of them.

we want to hold folks accountable. if you can give me your priorities of what we need to do, it could be helpful. assessment is the first thing that needs to happen. speakhave heard the v.a. , they have enough money. they do not have the accurate numbers. system,are gaming the how many actual visits are they going to have a year? instead of having 85 million, will of the 150 million? you cannot assess a money value to that until you make an assessment as to what the problem is. >> want to get the assessment, you follow that assessment as a blueprint to fixing the v.a. does anyone else have anything to add? >> i have a list of four things i would like to talk about. first is resources. as our budget partners have

talked about, it may not be a numbers game, it may be an allocation of resources. >> what are you telling us to do? recommend taking the recommendations on how to properly fund v.a., things like capital infrastructure. andnd would be training outreach for your gatekeepers. the people that mandy call maners -- the people who the call centers. consistency across the board. your experience at one center is very similar to your experience at another center. finally, another i want to talk about his accountability. we have had a lot of talk about accountability. the secretary said 3000 employees were sanctioned in some way, whether that was termination, retirement, or transfer or devotion, what have you. there is a problem -- and having conversation over recent weeks, their art two things that we

know. reprimanding or firing an employee is a difficult process. has significant eeo and other legal protections. it can take a long time to take punitive action. second, when there is a vacancy in the federal government, not v.a. exclusive, it can take between six months to a year to fill that. when you have an underperforming employee, you have to make -- do you make the trade-off decision -- i have an underperforming employee. is it better to serve -- have them on the books serving some veterans or terminate them and have a vacuum of care for six months or possibly longer? bring us around to another discussion about how we can work with the department. this could apply to all agencies and government. reduce the red tape for hiring. it takes too long to get that

done. thent to ask about accountability portion. myountability is, from perspective, really easy to talk about. sometimes, it is very difficult to put your finger on where the problem is, who is the problem, and quite frankly, how you deal with it. example --n -- for the argument could be made that because we have hired all of these middle management folks, you made a good point on that -- we should not be doing that. these should be on the ground folks. we have hired these middle-management folks to make sure the folks on the ground are doing the job. how do you deal with accountability? do you contract it out? what do you do? secretary orw the is everybody else held harmless? introduced by mr.

miller on the house side is a good start. people said do you favor the bill that strips people at the the a of protections, but there is a reasonable point in between mr. miller's bill as it currently is and what we have now. they cannot fire people. they say they can't, but they cannot. the lady from kansas city, they removed her as a director, but kept monday morning, we her here at government expense and flew her back every three years, paying her $180,000. they need flexibility. >> thank you. thank you, mr. chairman. to everybody who is here, this has been extremely helpful. i think we are going to find that the access issue which you consistently say is the problem,

is going to be easier to identify than resolve. i think about a va hospital needs five specialists. they are probably going to recruit from the area around and compete with private doctors, hospitals, and that is true, whether it is a doctor, a nurse, or the medical technician, whatever it is. building that capacity, even would be af money challenge. i think we agree to that. let me ask you a question. i also agree, we are waiting for a hospital in omaha. i am beginning to wonder if it will happen in my lifetime. i am a fairly young man. i am not too old. the moneyd get all of all at once, which would be hard

to accomplish, how much construction can you get up and going on and on? let me ask you a question about access. let's say we're thinking about this and we have all of this population that is needing more access, not less. be a non-arab people, a whole group of people and we are aging. we are the baby boomers and we need more access, not less. open to anmembers be idea that said something like they say iy call, need to see a health care professional because i have a spot on my leg that does not look right. i think it might be cancer. want to see you just as quick as we can, but that will be four months or six months or whatever.

would your members be open to an idea that says, if you cannot or in within two weeks, three weeks, or whatever the appropriate timeline is, you can seek private care. you can go to your local doctor or specialist or whatever. the government will pay the cost we will cover that because we do not want you to wait. we believe that is the best way be the with access to quickest and most effective way. the other thing i mentioned is in states like mine, we are a western state, the state of nebraska. rural veterans is difficult and especially difficult in some areas like mental health and specialized care.

>> what is your thought about that? --the v.a. utilizes medicine. even though there is only a utilizingy can -- by -- >> i appreciate that, how would your members react if i said look, we are not going to make you wait anymore. if the v.a. cannot meet your needs within a certain period of time, we will allow you, if you choose, to seek private care. if you want to wait, you can. >> we would not be opposed to that because we want the best health care fast as possible, ve to put ao hal feett on that because they -- the fee-based will be higher. >> i get that, but we are saying we want the best care.

>> that is the point. if you are not willing to give the a the resources it needs to allow for access in the facility, you're going to need to give them more resources i sending veterans out to the community. ba has the authority, i do not think they use it enough, for purchase care. out, if a veteran cannot be seen in a certain timeframe, they should be able to get that care by a private doctor that needs to coordinate the care, but we need to be careful that we do not start increasing the money going out to private doctors and taking away the v.a. possibility to hire internally because all we are doing is robbing peter to pay paul. we will have less money to do it on the private sector. >> i am out of time. here's my point. if it results in better care, isn't that what we are trying to achieve?

i hope i can have a discussion. >> can i address that? it is my understanding that the is envisioned to address part of the problem that you outlined specifically. that is what we want. we want coordinated care. the key is the continuity of care and ensuring that the v.a. is ultimately responsible for that veteran so they know what the veteran his roots -- is receiving. in the it is moving direction of addressing the concerns you are raising. >> senator blumenthal. >> i want to thank all of the leaders who are here today for your presence today, but also relentlessss and work on behalf of the veterans of america. your leadership has made a big

not only in the performance and outcomes in the veteran's administration, but in countless communities and other areas across the country. my thanks to you. my questions are simple. me,of you would agree with i believe, that the asestigation should hard-hitting, aggressive, thorough, and prompt as possible. the resourceses ive agencies,stigat they ought to be called on as well. would you agree? >> i do, senator. >> we not only agree, but our national president road to the eternal -- attorney general of

arizona last week and the u.s. attorney for the district of arizona, asking them to launch criminal investigations into reckless endangerment, possibly resulting in loss of life. earlier, were not here let me just tell you that i urge that the secretary of the v.a. shockingly -- strongly consider and recommend he involved the department of justice because there is ample evidence and i emphasize evidence, not just allegations of criminal tongdoing to warrant the fbi review this situation, as they do, my. the reason is simple. not only the evidence, but also the inspector general lacks the

jurisdiction authority, the resources, and the expertise to do a prompt and effective criminal investigation. only the fbi can provide the resources, expertise, and and the department of justice includes the attorney in everya and the ones in state that may be affected here. we share a determination. i believe the secretary of the v.a. shares this as well, to get to the bottom, to provide relief to anyone denied access. i think that is a determination that unites us in this room and accountability means changing the team if necessary. there may, at some point, be a need to consider those changes as well. my thanks for being here. my time is limited. i think the chairman.

>> thank you, senator blumenthal. i apologize if this question has been asked, but senator murray asked earlier as to what a face to face audit should involve. i would like to ask you and perhaps we can start with mr. bellinger, what needs to happen in a face to face audit to elicit the kind of information we need to address the challenges and problems that v.a. hospitals and clinics? i.t. has to start with first. they have to look at the process of the books as far as what actually occurs and they have to go through the administration and the employees and also get input from the stakeholders and

the veterans. >> did that happened the last time? there have been audits before. when those audits were conducted, where the stakeholders included? >> i do not have that information. >> to the rest of you have any do the rest of you have any information that will help us? >> often, we are not included. if you ask the veterans, they say, we got hurt, we got wounded. the veterans will tell you how to fix the facility. >> would you agree that any face to face audit should include -- this is probably a rhetorical question. input from the veterans organizations as well as veterans at the particular facility.

and iould agree with that would also, as we pointed out, recommend there be an independent third-party expert involved. it would alleviate a lot of the questions that were raised about the audit. i think it would help everyone be assured that these audits were being done properly and everything was being looked at. >> what do you mean by an independent third-party? >> i do not have the expertise to determine are the people cooking the books, are veterans theyng timely care, are spending sufficient time or too much time with the doctors? there needs to be someone who is an expert in time management and accessing medical care that can be there to make a determination , are they asking the right questions and are the answers

sufficient to address this problem. suggest also, if they are going to do a thorough audit, it would take more than a couple of weeks. a thorough audit would be an examination of the entire system. that might involve clinicians, nurses, whatever that may be. audit that is going on right now is what senator moran suggest happens, that is disheartening. that is not going to solve any problems as far as we are concerned. it might get to the bottom of a problem, a shallow depth problem at a local facility, but i don't know if it will solve the deeper rooted problems. >> i would envision that an assessment of the entire v.a. health care system was involved not just in this process that

has been described to us, but it would be an ongoing kind of assessment. i hope that will be the case. the secretary is still here and to heart he is taking the suggestions and comments you are providing. secretary, ine regards to all that we have been discussing, whether you think this is taking away from the v.a.'s core mission of providing health care for the veterans. does anybody care to respond? as aere is no such thing homeless veteran. there are veterans whose problems have been so acute and not address that they have ended up without homes.

if other services come through, people do not end up on the street. each one is a failure. it does not mean people set out to fail, but we have failed those folks coming home somehow. the vfw believes the resources the v.a. can provide should never come at a trade-off. the obligations to provide holistic services to the assistance,ployment but also health care has to remain a cornerstone. when veterans transition off of active duty, there are a litany of transitional resources that need to be made available to them. -- to deliverhe most of those. seeould never want to trade-offs made on how we deliver other benefits. , other --t injecting

will suffer. >> senator moran did not talk about audits, i just one of the theesses to know that was assessment of chairman miller, from the house committee. jackson. i am not sure how many facilities he is covering. that was his assessment of the audit process. not that i do not love you guys, but we're going to try to get the next panel and before we get into a series of votes. thank you. >> thank you. let me just say this. thank you for what you do everyday representing veterans. most importantly, we all know that we are not going to create the great health care system without your active participation. we need you. thank you for being here. keep up the good work.

>> if we could bring up the third panel. >> let me introduce our third panel. 'spresenting the v.a. independent inspector general

office is its acting inspector general and he is accompanied by feday.n from the national association of state directions of the veteran affairs, we have clyde. from the government haventability office, we debra draper. finally, joining us today, senior research fellow. thank you for being here. mr. griffin, you may begin. >> mr. chairman, members of the committee, thank you for the opportunity to provide testimony at this hearing. i would like to provide an overview of our ongoing review at the unix health care center.

the aig has assembled a multidisciplinary team, comprised of auditors, health care inspectors, board-certified -- to address these allegations. our team toted focus on two questions. where the facilities electronic waitlist or parsley amended the names of veterans waiting for care, and if so, at whose direction. number two, whether the depths ofany of these -- the deaths any of these veterans were related to delaying care. this, we the bottom of have an exhaustive review underway that includes seven parts. number one, interviewing staff with knowledge of patient scheduling practices and

schedulingncluding clerks, supervisors, patient care providers, management staff , and whistleblowers who have stepped forward to report allegations of wrongdoing. number two, collecting and analyzing reports and documents from information technology systems related to patient scheduling and enrollment. medicalhree, reviewing records of patients who may be related to delays in care. number four, reviewing .erformance ratings number five, reviewing past and newly received complaints to the as well as those complaints shared with us by members of congress and by the media.

reviewing other prior reports to these allegations, including reports from veteran health administration offices of the medical inspector. finally, number seven, reviewing massive amounts of e-mail and other documentation pertinent to this review. to facilitate our work on may 1, place thesecretary to phoenix director, associate director, and another individual on administrative leave. this was done because of the gravity of the allegations and , some whocooperation have expressed concern about talking to the team. techie -- thee secretary agreed to my request.

we have the resources and talent to complete a thorough review. we are using our top audit examine all of the scheduling related records. board-certified physicians will ,e reviewing medical records treatment and harm that may have happened. forensic experts are assisting the team. we are working with federal prosecutors from the united states attorney's office from the district of arizona and a public integrity section from the department of justice here

in washington. we will determine any conduct that merits criminal prosecution. since the phoenix story broke, we have received additional reports of manipulated waiting even at other facilities, through the hotline, members of congress and the media. these reviews are being conducted by other staff to enable the team working on the phoenix review to complete efforts on their project. we expect these reviews will give us insight into the extent scheduling -- in other facilities. while much has been done, much

more remains ahead. review is theis top priority and maximum resources, dedicated to bring about its timely conclusion, we intend to bring you and other and areof the congress ready to publish our reports. we project finishing the project of publishing the report in august of this year. inc. you -- thank you for holding this hearing and we would be pleased to answer any questions. >> thank you very much. >> my name is clive marsh. i am the president of the state directors of veterans affairs. present in the news of

state directors from all 50 states. agencies,vernmental we -- the processing of claims. we provide over half of all of the long-term care in our state nursing homes. state health care is strong. the v.a. has medical centers in the majority of major cities in america. community -- expanded our community base in recent years. the vha has moved out of the box, taken advantage of technology to provide tele-help, and have also taken

steps to provide transportation for those veterans in rural areas to make their appointments. customer satisfaction has been trending higher. the v.a. may not get everything perfect every time, however on a national level, we are one of the leading health care providers in the country and providing good, quality health care. those of us in the health delivery business or v.a., we strive to get it right and we work on that every single day. experience, we are on the same page. endorse the resignation along with his top administration officials.

they will be needed to follow actions to swiftly correct any procedural issues that may be identified. and is not ine the interest of our veterans to make premature decisions. the u.s. department of veteran affairs is transforming a pre-world war ii claims process into a paperless system that has reduced compensation and claims backlog by 44% as reduced veteran's homelessness by 24% and has enrolled more than 2 million veterans in the health care system since 2009, receiving some of the highest quality care ratings in decades.

to supportinged vha and the health care system. at the local level, state directors are in constant coordination with the medical center directions -- center directors. attention to confirming those individuals who have been nominated to fear -- to fill vacant leadership positions. it is imperative that the a -- that the v.a. and vha received .he necessary support those folks will be coming as a result of the war and military drawdown. the bottom line is, the v.a. may

require more in terms of the budget. doctors,need more nurses, technicians, clinicians, and even facility expansions or operations. we look forward to participating as copartners or facilitators. we remain dedicated and committed to doing our part. believe that v.a. leaders will transform into a technology-based and veteran centered.

have the director of health care. collects i appreciate the opportunity to discuss access to care problems in v.a.. for over a decade, gao and thats have reported medical centers do not provide timely care. in some cases, these delays have resulted in harm to veterans. across our work on access, several common themes have emerged. policies andguous processes, subject to interpretation, resulting in variation in confusion at the local level. antiquated software systems that do not facilitate good practices. ofaining, and use

unreliable data for monitoring. they did not always record the desired appointment date, the date the veteran or provider wants the veteran to be seen. this is due to lack of clarity in the scheduling policies and how to record the desired date. byituation made nor -- worse the large number staff that could schedule appointments. during our site visits, more than half of the schedulers we observed did not record the desired date correctly, which may have resulted in a shorter wait times and veterans experienced. some staff said they changed the dates so that they aligned with the v.a.'s goals.

we found follow-up appointments being scheduled without ever talking to the veteran, who would then receive notification of their appointment through the mail. in addition, we found scheduling systems electronic waitlist was not used to track new patients. they put these patients at risk for delayed care were not receiving care at all. ofalso found the completion required training was not always done, although officials stressed its importance. additionally, we found a number of other factors that negatively impacted these usually processed area for example, officials described the software system used for scheduling as antiquated, error-prone, and cumbersome. turnovershortages in of scheduling staff, provider staffing shortages, i telephone call volumes without sufficient staff to answer the calls. takecommended the v.a.

actions to improve the reliability of its way time theures, and sure consistent implementation of a scheduling policy, allocate scheduling resources based on need, and improve telephone access for medical departments. the v.a. concurred with our recommendations and told us he were taking steps to address them. we are pleased that actions are being taken, but more progress is needed to ensure timely access to care. work examiningng v.a.'s management, which is a type of medical plan. the preliminary work has identified a number of problems, including delays in care, or care not being provided all comment at each of the five medical centers included in our review. console data, systemwide closure of 1.5 million consoles older than 90 days with no documentation as to why they were close. we expect to publish our

findings this summer. as the demand for the health care continues to escalate, it is imperative that v.a. addresses this. since 2005, the number of patients served by v.a. has increased nearly 20% and the number of annual outpatient medical appointments has increased by approximately 45%. in light of this, the failure of the v.a. to address the access to care problems, including the accurate tracking and reporting of wait times and specialty care consults will worsen. this concludes my opening remarks. i am happy to answer any questions. >> thank you very much, mr. eber. >> thank you for giving me this opportunity. different than the

other panelists. i am not a veteran. i am not affiliated with the v.a. in any way. i am not affiliated with veteran service organizations. bookhere because i wrote a anywhere: whyare v.a. care would be better for anyone." for my book came from losing my wife robin to breast cancer. in oneas treated prestigious corner of the american health care system in washington, d.c. suffice it to say, what i saw during the six months between her diagnosis and demise caused me to become radically interested in the questions of medical quality and safety.

died, theyer robin instituted a report that has been alluded to already, showing that there are 98,000 people that are killed by medical errors. that is equivalent to a jumbo jet falling out of the sky, killing everybody on board every third day. the chairman has alluded to other estimates, showing that as many as a quarter of a million people are killed by various forms of overtreatment, under treatment, maltreatment. i set out to find out who is doing a better job.

i was surprised to find, after healthng literature on care quality and talking to many experts and veterans and such, that the da health care system, by many metrics out performs the rest of the u.s. health-care system as a whole. i seem to have come to a broad consensus, is he a health care -- v.a. quality health care is very high quality health care. the problem is access. robind have welcomed being treated in a hospital that had an inspector general. would that not have been wonderful? ifld it have been wonderful two committees of congress exercised oversight of that hospital? would it have been great if there were various broad-based effective citizen organizations

akin to the american legion that erplied scrutiny to that corn of the american health care system. i also would want to draw attention to the fact that we have a problem with someone times ormetric on wait some other metric that the v.a. applies, that is because there is a metric. health-careof the system, there are no quality metrics that are exercised, let alone wait times. it took me 2.5 years to find a primary care physician who is still taking patients. mammogram momor a enough for her tumor to grow from this size to the size areas many people in the united states live in places where there is a

queue primary care shortages. we have a problem with access. times, so much of what we are doing is trying to has aine whether somebody service related disability or not. hearing allou are of this -- losing your hearing -- we have this tremendous administrative machine that adjudicates that kind of question. how much smarter when we be if we opened the v.a. to all veterans, thank you for your service, come in. thank you. >> thank you.

all the testimony was excellent. thank you. a few questions. let me reiterate. we chatted on the phone. do you have the necessary theurces to undertake investigation that needs to be done regarding phoenix. >> yes, we do. have 120 medical clinicians, who for a number of years are doing reviews of the a medical centers. and --.doctor the reason the system was set up the way it was is so you have people with knowledge of the department.

that is why we're the right group to do this review. >> when you told us a few moments ago that you do not -- isyou can do this there anyway you can give us a preliminary review? many members would like to get a sense of what you found out there. progresses,view part of this review could lead to criminal charges and we do not want to do anything to jeopardize the ultimate outcome.

>> what we have been reading in the media, at least 40 u.s. veterans waiting for appointments at the phoenix veteran affairs health-care system. many were placed on a secret waiting list. at this point, can you tell us how may people you have identified who have died while waiting on a secret waiting list. >> i cannot give you that number. the number that has been wildly pressd -- quoted in the does not represent the total number of veterans we are looking at. that was one list created by the facility. we need to do an analysis of recordst, both death --. there are also other people who have come through the congress, who have come to the media, who have come through our hotline.

, none ofultiple lists them identical. we are going through the basis of going through those lists and the initial list that we were given, we have gone through and there were only 17 names on that list. our review to date, we want to have more than one set of eyes look at all of the records. those 17, we did not conclude that delay caused death. be on ae thing to waiting list, is another thing to conclude that as a result of being on a waiting list that is the cause of death. it is dependent upon what your illness might have been at the beginning. >> you have not identified

anyone that has died as a result of being on the waiting list as of this point. this is complicated stuff. >> we have been provided names of people who are on various lists and it is true that those veterans whose names were on the list have died. we have looked at a substantial number of cases and we have been looking at those cases to determine that yes, there was a delay in care, as has been expressed. quality standards were not met. -- we have found that some patient harm.

to draw a conclusion between patient harm and death has so far been a tenuous connection. to records we have looked at date are mostly v.a.'s medical records. to the extent that a patient died, we are in the process of getting death certificates, autopsy reports, if they were in another hospital, there are procedures we need to go through to get the rest of those records. we may need to interview people who are knowledgeable about the events surrounding the death. it is a serious problem. we won't work through that. >> thank you.

the conclusion states unreliable ait time has resulted between positive way time. this is v.a. report that you are talking about was the report presented to the v.a. in december 2012. it became a public document in january 2013. what i have said so far about your comments are on record. the secretary of the v.a. was --ommended to take action to the reliability of wait time measures. the sector of the v.a. under the secretary of the director felt to take action to consistently and accurately implement the scheduling policy.

for the two recommendations, v.a. specified in their comments that these recommendations had a ofgeted completion date november 1, 2013. let me ask you -- based upon the knowledge you have today, has this process at the v.a. been completed as it relates to those two actions in your report from december 2012? >> and has not been fully completed. >> is this an ongoing communication? to be quite frank, it has been almost a year and a half. we would have expected more progress to be made. >> do you or your predecessor, and thank you for serving in that capacity. you are a standup guy.

we have great confidence in what you and your team will do, can produce, and accuracy of it in the reliability of it. please share that with the folks who are working so hard. >> do you or did your predecessor have a scheduled meeting with the secretary? meetings with the entire leadership team every two weeks. my predecessor went to one, i went to the other one. we had occasional meetings with the secretary at different times during the year. >> how many meetings have you had since the issue of phoenix arose. had one meeting that was unconnected to the review. it was a budget related meeting. we had a second meeting when i went over to request certain

individuals be put on administrative leave. >> from a standpoint of the who is handling that? of theng the course administrative leave discussion, not un-similar to the -- we are going to be looking at. i put someone in administrative leave that i thought was completely appropriate. we are independent. we cannot be told to not do something or to do something because it would violate our independence. a report that completes, when phoenix is finished, if it happens like every other work, will you or

your staff sit down with the secretary and brief him on the findings? we issue probably 300 reports a year. not all of them would rise to the level. at the assistant inspector general level, dr. jay meets with the bha senior staff to discuss these things. we just heard about the process of getting closure and reports. there is an ongoing follow-up process. >> how many years have you been in the v.a.? >> about 13 out of the last 16 years. >> how many times have you set awn -- sat down with secretary and brief them?

i would say, a report of this magnitude, maybe a couple of times a year. depending on -- there are 300 reports. i would say at most, quarterly. >> on a reporter multiple? >> on a report. the doors open. it is just the issues are resolved. meetingave requested a -- have you ever had one ray meeting was not made available to you? >> no. >> thank you. i want to thank you for your testimony. you said you have 120 medical investigators. are there more investigators than that?

have about 615 personnel in the ig organization. david andm work for they are health-care inspectors. they are doctors, nurses, psychologists, clinicians. we have about 150 criminal investigators. we have people in 39 cities around the country. we have over 200 auditors. >> how many people are working on this investigation. 185 people have touched this investigation. >> for how many weeks? >> this is the third week. >> you anticipate a final by august? >> correct. anticipate a preliminary report before that? >> to the extent that it will not impact the outcome of the work to include the fact that we

are working with two different groups from the department of justice, looking at a possible criminal violation. about seniortalk management staff, including the secretary and the v.a.. asked those folks for information? >> no, we have not. we did ask them for a list that they suggested to us that they had of veterans who died on an electronic list. >> this is where want to get to. have they been open? have they been transparent? what is the other word i am trying to think of? helpful in your investigation. >> they have. resources, buted we do not want to give anyone the impression that our independence was being questioned. we have not received any

resources nor do i intend to. >> up to this point, being fully transparent with what you need, would you ask, they deliver. any -- maybebeen you can say this and maybe you cannot. [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2014]

ongoing that involve facilities in kansas? >> i'd like to take that for the record. i know we have in the past week and a half our criminal investigators who are located around the country have made a rapid response to 10 new allegations and in the matter

of two days over the previous week went to 50 medical centers unannounced in order to see if what was being alleged was occurring at those facilities. >> i'd be happy to know that. i was referring not necessarily a current investigation beginning as a result of the current circumstance but over the last year or so and the reason i ask the question is there have been allegations of incidences, circumstances, consequences within the v.a. in my state and our effort to find out what's going on, what response the department has taken to these stories out there. we have never received a response from anyone at the department of veterans affairs either here in washington with the secretary or with kansas individuals who work at the v.a. within our state and i do not know those circumstances at least having a conversation are being investigated by you.

if you'd follow up with me. >> i will. the majority of our audit and health care reports go to the member whose district that facility's located in. some of the criminal reports take longer because of the judicial process and privacy issues involved with the criminal cases. >> i apologize for interrupting. i think there are 95 senators waiting for us to vote. his was a great panel. and i very much appreciate the wonderful testimony. the hearing is adjourned.

[captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2014] >> testimony from two penls of

leaders of veterans groups and the administration answering questions on health care for military veterans. and earlier we heard from veterans affairs secretary eric shinseki who was subpoenaed to testify today from the veterans' affairs committee on the state of veterans affairs after recent reports of 40 veterans died waiting for care at a facility in phoenix, arizona, and we plan to open our phone lines to hear your thought about veterans health care. in particular, what can the v.a. do to improve care for veterans? we have two lines available. line for military vets only 202-585-3885. and a line for all others, as you can see on your screen, it's 202-585-3886. we will also continue to take your reaction via social media. as you can see a number of you have sent tweets on the hearings. you can use the #cspanchat and we also have a facebook

question up. what's your reaction to today's veterans' affairs committee hearing and that's at facebook .com and we plan to get those comments on the air shortly. before we get to your calls, we are going to go back to some of the opening statements made by committee chair bernie sanders, and then we'll hear from senator jerry moran as this hearing was just getting under way. >> very serious allegations have been made about v.a. personnel and their doings in phoenix and in other locations. i take these allegations very seriously, as i know every member of this does which is why i have supported an independent investigation by the v.a. inspector general. as we speak right now the inspector general is in phoenix doing a thorough examination of the allegations. and my hope is their report to us will be done as soon as

possible. and what i have stated and repeat right now is that as soon as that report is done, this committee will hold hearings to see what we learned from that report and how we go forward as soon as we possibly can after their investigation is completed. i think there is no member of this committee disagrees and nobody in the united states that this country has a moral obligation to provide the best quality care possible to those who have put their lives on the line to defend this nation. and i believe that every member of this committee will do everything that we can to get to the truth of these allegations. but if we're going to do our job in a proper and responsible way, we need to get the facts and not rush to judgment. one of the concerns that i

have, to be very honest, there has been a little bit of a rush to judgment. what happened in phoenix? well, the truth is we don't know, but we are going to find out. >> mr. chairman, thank you. and senator byrd for conducting this hearing. mr. secretary, good morning. i arrived a few minutes late this morning because i just returned from a world war ii memorial where a kansas flight was there. had conversations with kansas veterans, again, this morning. it's a moving experience each and every time to have that opportunity to visit with our world war ii veterans. and, again, the conversation was the v.a. is failing them, please make certain, senator moran, that doesn't continue. thousands of veterans across the country but hundreds of veterans in kansas visit with me on an ongoing basis and they tell me they're struggling and suffering stories because of circumstances they find at the department of veterans affairs. they would tell me that the sacrifice that they encountered if they were willing to say

this less than humble sentence they would say, why can't we have the service we earn and deserve? the rally is they've earned and deserve that service and the department of veterans affairs are not providing those worthy veterans what we have committed to do. in the -- and the sad story is veterans across the country and many of those in kansas have lost hope in the department of veterans affairs and just believe that nothing is going to get better. your announcement of a face-to-face review across the system, mr. secretary, i find lacking in what needs to be done. the reality is that we have had review after review, inspector general report after inspector general report, questions by this committee and the house veterans' affairs committee as a result as far as i can tell result in no action from the department of veterans affairs. the idea that you can conduct a systemwide, as you indicate in your opening testimony, review

of the v.a. using 220 v.a. employees and visiting medical centers, mr. secretary, we have 1,700 v.a. points access to care and you indicate in your testimony this will provide a full understanding of v.a.'s scheduling policy and continued integrity in providing patient access to care. i don't see a review that last two weeks using 220 employees and looking at 153 medical facilities as capable of providing that information. so i would suggest it seems to me to be more damage control than it does to be solving the problem. i actually think we don't have the need for more information, although there's always welcomed. what we need is action based upon the information that's already been provided to the department of veterans affairs. i served 18 years on the veterans' affairs committee. i served with nine secretaries of veterans affairs and what seems true to me is the quality of na service, the time of that service is diminishing.

we have a significant number of veterans that we serve today, but mr. speaker, we can anticipate more as our military men and women retire from service in afghanistan and iraq. we have an aging world war ii veteran population. if we can't care for the veterans that we are trying to care for today, how do we expect the department of veterans affairs to care for those as the numbers and seriousness of their condition increase? so mr. secretary, i look forward to hearing what you have to say today. i welcome that conversation, but in my view, an additional review by your department is not the answer. the answer is action by the department of veterans affairs, the changes the system that you are leading and changes the culture and nature of the folks that are your employees. i look forward to your testimony. i look forward to making senior citizen we keep our commitment to those -- making certain we keep our commitment to those who served our country. thank you. >> and that part of the testimony we heard today, and your calls and reaction on the treatment of veterans at the nation's health care facilities and what the v.a. should do to

improve health care for veterans. military vets only, here's your line, 202-585-3885. all others you can call in on 202-585-3886. we will also take your reaction via social media. we'll use the #cspanchat for your tweets and we will also get to our first call. first call is from harry in dade city, florida, calling on the veterans' line. go ahead, harry. caller: good morning. my take on this is i've been going to the v.a. for 30 years here in tampa, florida, and i think the veterans should have a choice whether they want to go to v.a. or whether they want to go to a private doctor and let v.a. pick up the tab. because i've been a couch potato for seven years, been trying to get them to do surgery on my back and i get all the excuses except the right one. >> what branch of the service did you serve in? >> united states marine corps. >> appreciate your service. next to martha in san antonio,

texas, another military caller. caller: yes, sir. i just wanted to call and say the only reason i live in san antonio, texas, is because of the excellent care that i receive at auddy murphy hospital. and we, veterans, are also to blame and no one said it yet. you get a card for your appointment and says if you can't make it please call in to make a space for a veteran who needs an appointment. and from what i understand, many, many, many vets do not call and cancel their appointments. so you just wasted the doctor's time and another veteran didn't get an appointment. >> now, do you have friends in the military who've experienced some of the things that have come up in the hearing today? caller: i have not. >> ok. appreciate your call. up next is -- let's see, it's tina. tina is in st. paul, minnesota.

go ahead, tina. caller: hi, thank you. i'm calling -- i have a fiance who served in the 82nd airborne in the 1980's, suffered multiple medical issues and he's 100% disabled. through the military. what needs to happen is the whole revamping of the v.a. needs to be redone on that system. a lot of veterans are being lost in the cracks. many are -- many are homeless right now. i'm in the st. paul-minneapolis area. you can drive down the main streets and see many veterans who are homeless. it's untrue that the secretary said there is no homeless veterans. at this time, my fiance is going to the v.a. to try and get service, and his psychiatrist actually stopped his anti-psychotic because he has canceled several appointments due to having a new diagnosis of seizures.

>> well, thanks for your call this afternoon. you'll notice flag is at half staff at the capital. that's in tribute to the police officers who have died in the line of duty. this is police week here in washington, d.c. let's continue with our phone calls. craig in mount pleasant. you're next on c-span. caller: hi. i'm calling to address the bonuses for people who supposedly do a good job where, in my opinion, they're receiving bonuses for receiving a good job. most people don't get bonuses. maybe a certificate. but they're getting incentive to fudge documents so they can get their money at the end of the month. and i don't -- i don't understand how that is is even part of the program. >> craig, you're next. actually, we took craig.

edwin is next in hollywood, florida. go ahead, edwin. caller: hi. i'm a veteran of the first iraq war. my concern is the following -- i think all decisions have come into realizations after our veterans returned from war. what needs to happen is a change in policy that the secretary of veterans affairs is a member and the government to decide who can go to war at any given time to have the veterans attended for. it's a sad story we hear this week. of re celebrating the birth florens -- florence nighting has to the government

have a committee before we go to war. any war. i don't care if we go to war right now. if we have the right reason. also, we need to be sure that our veterans are taken care of when they return. i mean, this has to be part of the plan, the strategy, because we are going to fall into this trap over and over again. we know what needs to be done, but it's not being done because, why? we need to inform the people, a, we're going to go to war, but we also need to have the resources for our veterans when they come back. so the people need to understand that. don't get that surprise. >> robert in smyrna, georgia, what should the v.a. do to improve health care for veterans? caller: well, i only had a comment about some recent history, my experience with the v.a. here in atlanta. i was affected with dental

problems. i had -- i was in the military back in the early 1980's and i waited four months to get a -- to receive an appointment which was last week, and i got to the appointment, i waited four hours to get in to see someone and i had another scheduled appointment so i couldn't stay there and then someone called yesterday, i guess, since all of this flack has been raised about timeliness, called me yesterday. i missed the call. i called right back and it took 40 rings, three different times and no one answered. so i'm just frustrated. like all the people around the country that are having a problem. and it's quite a shame that we eved served, people served in wartime and they can't get the help. and we give all these millions away to everybody else. it's just a sad situation. >> was there any speculation

for the delay? you said you were waiting six hours? caller: none whatsoever. i dealt with the v.a. for years. it took two years to get a bridge done. i mean, this has gone on for 25, 30 years. it's always delayed. it's always, you know -- and there's no explanation as to why. waited 3 1/2, four months for an appointment and when the appointment came i was five minutes early and waited four hours and didn't get to see anybody. >> thanks for your call. looking at your facebook comments. isa says -- tara said, i've had nothing but excellent experience. i don't agree with only looking at the negative things within the v.a. health system. there are things that need to be fixed but you can't complain about the problems without suggesting a solution. stop the blame game. also, william smith says in his

facebook comment -- i'm waiting two months on an appointment to have a study done so i can get the help i need. i think as a vet that's not right. and we continue to take your facebook comments. what's your reaction to today's veterans' affairs committee hearing? and you can leave your comment at facebook.com/csp nambings. p next our next -- facebook.com/cspan. up next is our next caller. caller: my husband served in the air force. he had surgery when he was in okinawa and they removed a pleaseon from his chest -- they removed a leasion from his chest and he went mistreated. they found out he had c.l.l. and he went untreated. so my thing is that the -- they need better -- screen better

people for taking care of veterans because he went undiagnosed and he was just drinking to try and cover up the fact that he had mental injury while he was in okinawa. and my family suffered a lot. and i think it is time that the military take responsibility for what they do not only to the veterans but to the veteran's family as well. children are suffering, you know, from this. my husband died in 2013, and he had filed a claim and he waited for his claim for three years and he died not being able to receive the care that he needed. and i think that's terrible because my family has endured so much pain and so much suffering through his illness that he received when he was in the service. and i just think it's time for them to take responsibility for what they've done to the veterans and to the veteran's family as well.

>> another call on our line for military veterans, ron from roanoke, virginia. caller: hello. my name is ron brown. i think the v.a. is totally overcrowded, underfunded and understaffed. wouldn't be opposed to them opening up to let veterans see outside providers to help take some of the strain off of the v.a. because it's just going to continue to get worse with our current war winding down. there's going to be a massive influx of veterans going into the v.a. from that war, and it's just going to add more problems, more wait times and probably more issues like we're seeing with this hearing today. i, myself personally, sent a letter from the v.a. i go to where they won't see me to treat my fibromyalgia and i

have to pay out of my pocket to go to d.c. to see a specialist to have it treated. >> veterans affairs secretary eric shinseki as he arrived this morning on capitol hill for this hearing on veterans' care at veterans' hospitals. secretary shinseki has been the secretary since january of 2009. he's a four-star general. served as army chief of staff from 1999 to 2003. north , angie from carolina. y ller: i'm calling, m daughter -- my husband is a vietnam veteran and he goes to the service in north carolina and had numberous problems going there. he had a broken leg and they sent him home in a boot and

then he had to have surgery. when he comes home four days later the v.a. calls and say they have an appointment set up for an orthopedic in seven to 10 days. well, might as well forget that because he had done had surgery. after that he ends up back in the hospital with multiple blood clots in his lungs. almost -- he almost died. and then he goes back to the v.a. finally after all this is over with, they don't have anything to do with his leg or nothing and look at it. then he had to go back and have surgery again and have the plates taken out at another hospital because the v.a. won't do nothing about it. i guess what i'm trying to say, i agree with the lady that spoke before about his husband passing away because that's what i feel about my dad. you know, they go there and if they go in and they see their primary care clinic doctor and they have an earache and they say, my ear hurts, they won't touch the ear. you need to make an appointment with the e.n.t. we'll call you.

that's a month later. what happens when you see your primary care doctor and i have an earache or toothache or whatever that they sent you on over to the specialty clinic to have it taken care of? my dad went in the e.r. with a leg broken and they stuffed him in a boot and had his weight bearing on it. had he not went to the other hospital and had surgery done on his own he would have been at home waiting for almost four weeks before he got a call for an appointment that was two more weeks out. this -- it's ridiculous. i mean, absolutely ridiculous. what they need to do is remember why they're there and reprioritize and be more efficient. >> ben locke says in his facebook comment, veterans will never have competence or trust the v.a. health care system again unless some drastic things happen. this from suzanne. she said, glad they're having this hearing. as a surviving spouse for someone the system failed this

is long overdue. and also this comment from david munoz. take away the medical side and contract it out to a proven health system. the government hasthe governmens not capable of delivering quality care in the least amount of time. list for long waiting treatment. you can offer your comments and react to today's veterans affairs committee hearing. a final call will be bill. villas in tucson, arizona. military family. we had excellent service from the v.a. in new york. faced duringt i accuracy was they decided not to allow veterans of rejoin theeight to v.a. system.