agriculture he is known for the agricultural adjustment act. which was the first time that farmers were asked not to produce. at first people couldn't believe the things that he was proposing regarding that but then as prices went up they started to listen to him. and people still refer to him today as the genius secretary of agriculture.

>> good morning. we look forward and welcome mr. sloan gibson who is the acting secretary of the department of veterans affair who will be discussing with us what he has been doing in what i perceive -- since y active you've held that position and what he perceives the problems facing the v.a. in the months and years to come. and i would want to member toft members of the can he that next

week on the 22nd we will be holding a confirmation hearing for bob mcdonald, the president's nominee for secretary of the v.a. last month, 93 senators put their differences aside to vote for a piece of legislation which we hope will address many pieces of legislation that we worked very hard on. i want to thank everybody for their support. it is my hope that legislation and the conference can he that we're having with the house will be completed by the time we leave here for the august break. it is clear to all of us that the v.a. faces many, many

challenges and they are well documented. the concerns that i have that have been well publicized is that we have many, many many veterans in many parts of this country who are unable to access v.a. care in a timely manner. we have significant problems in terms of accountability all of us find it totally unacceptable that people have manipulated data in terms of waiting times, people have treated whirbles in a contempt tuss way. people have lied. and that is unacceptable and we want to hear from mr. gibson in terms of what he is doing to address those many problems. but the issue that i want to focus on is that while we are determined to do everything that we can to make the v.a. -- which is a huge institution providing 6.5 million veterans a year with health care. while we want to do everything

that we can to make that agency efficient and accountable, there is another issue that we have got to address that is also part of our responsibility. and that is what are the legitimate needs, what are the real needs facing the 22 million veterans in this country and how as a congress are we responding to those needs? so number one, the v.a. has got to be accountable, it has to the got to be efficient we have to address many of the internal problems that we have all heard in the last several months. secondly we have to ascertain what the problems facing the veterans community and their families are and do everything we can to make sure that the v.a. is on the kind of position that it needs to be to address those problems. let me just mention some of them. of the 2 million men and women who served our country, put their lives on the line in afghanistan and iraq, studies suggest that 20 to 30% have

come home with ptsd or tbi. simply stated, that means those rs have created some 500,000 mentally wounded american veterans and as a result very serious problems regarding suicide and this can he will be dealing with that issue in sd, substance h pt abuse, ability to hold on to a job, divorce, and ability to deal with the kids. it is not just u the veterans, it is the wife and the kids. the number of veterans receiving specialized mental health treatment has risen from just over 927,000 veterans to more than 1.4 million in fiscal year 2013. this means that in fiscal year 2013, over a quarter of those

receiving care at v.a. were being treated for mental health conditions. in other words, v.a. currently ovides 49,315 outpatient mental health appointments a ay -- a day. 49,000 mental health outpatient appointments a day. imagine the scope of that. and imagine the challenge if we had end less supplies of money, if we had the best, if we had adequate numbers of psychologists and psychiatrists in this country which we do not have this would be an insurmountable problem and yet we are where we are. that is the cost of war. insuring timely access for high quality health care is critical for our veterans and for their loved ones and the stakes are high. as i've said we are all aware and i know johnny ikesson among

others has taken a look at suicide. it is a tragedy beyond words. not easily dealt with but one we have got to address. like most americans we are all concerned about these horrendous waiting periods. and i know that mr. gibson is going to be talking about that in his testimony. 46 -- let me go through the numbers to understand the scope of the issue that we're dealing with. over 46,000 veterans are on lists waiting to be scheduled for medical appointments. over 8,000 of them have waited over 120 days. now, we can have an argument -- although i don't think there is much -- about 14 days was an appropriate number. i think that was not i think that was overly ambishes. but i don't think there is much argument that when you have 8,000 veterans waiting over 120 days to receive an appointment that's 120 days before they are

told when they are going to be seen that that is unacceptable. more than 600,000 veterans have an appointment that is more than 30 days from the date that the appointment was initially requested or from the date that was desired. that is not acceptable. the numbers are staggering. and that is an issue obviously that we are addressing right now and we will hear from mr. gibson as to how he is going to go forward with that. i think the goal of every member of this can he -- and i would hope and expect every member of congress and of the american people -- is that the veterans of this country, people who have suffered so much deserve quality health care and deserve it in a timely manner and what i look forward to hearing from mr. gibson is some straight honest talk about the needs of the v.a. in achieving that goal. if we are talking about a staggering number of veterans

coming home, with ptsd or tbi, how many mental health workers do you need and how are you going to get them? we don't have enough doctors in this country. how many primary care physicians do you need how many specialist doss you need? if the goal is to provide timely health care in a cost effective manner we need some answers from the v.a. and i hope we can get some of them today from mr. gibson. needless to say the other issues that i know that members of the can he are going to be asking is what actions the department has taken to reprimand employees who have lied or manipulated data. that is something that nobody on this can he toll rates. what has the department done to ensure that this manipulation no longer occurs? what has the department done to improve other areas of concern identified by the inspector general, the g.a.o. and other auditting organizations?

so with that let me give the mike over to the ranking member senator burr. >> thank you mr. chairman and acting secretary gibson, welcome. since our last hearing there have been several developments relating to the scheduling irregularities among the v.a. and its negative impact on patient care. v.a. has begun to take the necessary steps to address the systemic problems and the corrosive culture that have been identified and substantiated by several independent sources. however these changes will not happen overnight and this can he must provide the oversight to ensure those changes occur and are effective. even with the steps v.a. has take ton improve access for many veterans there will continue to be reports and allegations regarding v.a. health care facilities and workers. these reportless not only highlight critical areas of

needed reform but identify the magnitude and the breadth of the systemic issues facing the v.a. the ongoing internal evaluation by v.a. as well as investigations currently being conducted by the office of special counsel and inspector general are essential to rebuilding not only veterans' trust but also the trust of stakeholders and employees. to undertake the needed reforms within v.a. the role of the office of special counsel and the inspector general are even more crucial now than ever before. both offices have been essential in identifying systemic issues facing the v.a. . i would like to highlight a few critical reports that have been released since the last meeting. at the time of may 15's heartsdz there were several stakeholders who did not want to rush to judgment until the allegations surrounding phoenix had been substantiated. since that hearing the ig

released an interim report regarding the allegations of scheduling irregularities and a secret wait list. not only did the ig substantiate irregularities and the secret wait list but identified roughly 1700 veterans waiting for appointments and not included on an appropriate electronic waiting list. they found there are systemic issues across v.a.'s health care system and that this was not an isolated event. additionally, the ig has received numerous allegations regarding mismanagement, inappropriate hiring decisions, sexual harassment and bullying behavior by mid and senior level managers at this facility. these allegations speak to the corrosive culture that has taken deep root throughout the entire department. within a 3-week period the office of special counsel released a statement on v.a.

whistleblower repriseles and sent a letter to the president regarding v.a.'s lack of responsiveness to osc requests. in this letter the office of special counsel described the office of medical inspector consistent -- inspectors consistent use of harmless errors. this is their defense where the department acknowledges the problem but claims patients eren't -- their cases were unaffect. the letter details 10 cases of egregious cases in which the omi substantiates errors but dismisses potential patient harm. in one case two veterans were admitted to an inpatient mental health ward at the brockton v.a. facility didn't receive comprehensive evaluations for more than 7 years after being admitted to the facility. another case in the letter described how pumnolingses

copied previous provider notes in more than 1200 patient medical records instead of recording current readings for these patients. i want to be crystal clear. the culture that has developed at v.a. and the lack of management and accountability is simply irreprehensible and it will no longer be tolerated. secretary gibson, you've taken several actionable steps in the last month-and-a-half and i commend the work that you've done. however, what has happened over the course of years is a horrendous blemish on the v.a. ds reputation and much more work will be needed to repair that damage. as v.a. continues to move forward and improving veterans' access to care and changing the culture that has taken deep root within the department this can he has a lot of work to do. the can he needs to take an

active vigorous oversight role to ensure that the problems that have been identified over the last several months and i might say over the next several reports a host of ig come out are effectively and appropriately addressed. and they aren't allowed to happen again. again, secretary gibson, thank you for being here. mr. chairman, i thank you and yield. >> thank you. senator murray. >> mr. chairman, thank you very much for holding this hearing as we all know this is a critical time for the department. the v.a. is still struggling with major systemic problems. there are many vacancies in key leadership positions and most importantly veterans are still waiting too long for care. secretary zpwibson as we talked about yesterday i really appreciate your stepping up during this crisis. the department needs strong leadership right now because the v.a. is facing serious

challenges. identified several of these issues which we've also been discussing here for some amount of time, a crosive culture has developed in the department one that is unworthy of v.a.'s many dedicated and talented medical providers who do only want to help veterans, management failures, lack of communication is a problem at all levels and v.a. needs more providers more space and modern i.t. systems. as we continue to work in the conference commitee to craft a final bill i hope an agreement will be reached so we can send it to the president and start making the changes needed at v.a. so veterans get into care we create transparency and hold people accountable. the compromised bill will be an important first step as more reviews are done and more problems found we will need to take additional steps and while we continue working on these problems we cannot lose sight of many other pressing issues. too many veterans still die by suicide each day.

sexual assault survivors still need help. the v.a. has to continue to make progress towards the commendable and even more challenging goals of eliminating veterans' homelessness and reducing the claims backlog. on a positive note secretary gibson i really appreciate your help in finally getting the money to build the walla walla veterans home. we've been working on this for a very long time and now hundreds of veterans in that area will be able to access the long term care that they need. as i have said repeatedly here in this room when the nation goes to war it also commits to taking care of the veterans when they return home. their needs are a cost of war and we will provide for them no matter what. we know many veterans will need v.a. care for several decades to come. otherless come to the v.a. for the first time many years after their service has ended. so today i'm hoping to hear about solutions to these systemic problems and smart ways to strengthen the v.a. for the long term because the v.a.

does need to be there for our veterans ready to help right away every time. thank you, mr. chairman, and i yield to senator ikesen. >> thank you senator murray. secretary gibson thank you very much for accepting this interim responsibility you're a brave and courageous man and while i'm encouraged by some of the serious steps you've taken i'm still not satisfied. we have serious problems. as indicated by special council learner from which i want to quote one paragraph i remain concerned about the department's willingness to acknowledge and address the impact of these problems meaning the whistleblowers may have had. the office has consistently used the term "harmless error" as a defense while -- where the department acknowledges problems claims patients have been uneffected this has prevented v.a. from acknowledging the problems and

taking necessary steps to provide quality care. the letter goes on to delineate specific cases where veterans health suffered because of the agency looking the other way. i have become personally convinced that this begins and ends with the failure of senior leadership in the v.a. for years to overlook or to look over the manipulation of numbers, to make things look better than they really were, to hope that congress wouldn't come and look. i think congress is partially to blame for not looking enough. i learned when i was raising my children that if parents look inside you have a better behaved kid. i think some of the departments are exactly the same thing and the pervasive culture of cooking the books for personal benefit such as pay raises is absolutely inexcuse yauble. lastly, i hope in your remarks which i'm looking forward to you will address how the memo written by mr. shone hard in august of 26, 2010, that

delineated specifically many of the problems we are now discovering four years ago how a memo to senior leaders across the network and to senior management could have gone totally unlooked at by anybody in the v.a. and the problems that we're now trying to fix lasted four more years within the v.a. because there was a culture of just looking the other way when there was a criticism or accountability in place. so while i appreciate very much your willingness to come forward as a ci civilian, i am not satisfied yet that the v.a.'s culture is any different than it has been, and we're going to have to see that the culture changes and we have accountability from top to bottom, but in particular, in the senior leadership. i'll now yield to -- >> i will just say that a vote has been called, so a number of senators are going to be leaving. we will go to senator tester, moran. by then the chairman will return. >> thank you.

i want to thank sanders and burr, even though they're not here for their work on this committee. access to healthcare for our veterans did not pop up overnight. this is a topic that many of us have been working on for years. solutions must be based on good information. you can't make good decisions without good information, and hopefully the conversation today will be straightforward and frank so we can get down to some solutions. it's going to require tough decisions, focus and engagement from folks on the ground in washington that last will be on he media span. veterans deserve better than to have folks jump on the latest crisis or two, and then you never hear about it again. they want answers. they want solutions. they want the benefits they've earned, not press releases. i'm approached by veterans whenever i go home.

they are direct. they are straightforward, and they give me the best view of what's going on on the ground with the v.a. in fact, this friday i'm going to hold another roundtable, this time in a capital city in virginia to hear about the services that they're getting and the difficulties they're having, along with the successes. since our last hearing, we conducted a nationwide audit and found the biggest obstacle is a lack of service providers. it's a lack of service providers. i'm looking forward to hearing from the v.a. on this audit and the follow-up actions moving forward. the white house has also completed review on issues impacting access to care. this review echoed what we've already heard, that the v.a. provides high-quality healthcare once the veterans get in the door. the review also found out that the technology is outdated, i believe 30 years old. it is secondary to the need for additional resources, such as

doctors, nurses, and other healthcare professionals. physical space, inappropriately trained administrative support personnel. since our last hearing, the senate also passed a comprehensive, bipartisan bill that would address major issues impacting access to timely medical care at the v.a. it passed by an overwhelming 93 votes. we seldom get 93 votes for anything in the united states senate. right now we're conferencing that bill. we're in the fourth week. there isn't much to show for it. those questions would be good to get answered today too. because some members of this body i think of the conference committee are balking at the cost, look, we just shipped 800 folks off to iraq. i did not hear one person talk about cost. back in 2003, when we invaded iraq, i was not here, but i certainly never heard anybody talk about the cost and making sure that there were offsets for that cost. look, these folks went to war. they performed incredibly well.

some of them came back missing arms, legs. some of them came back with mental health conditions that they didn't have when they left, health problems they didn't have when they left. it is very frustrated when i come from a state where we're about 22 docs down to hear folks on the conference committee a few weeks back say what we need to do is we need to schedule more patients for the doctors, that will solve the problem. that will not solve the problem. we need more healthcare professionals on the ground, and sloan, i hope to hear from you today on those issues about what those deficiencies are, because i think it's critically important it that we get our arms around that as a committee so that we can move forward and provide the accountability that needs to happen within the v.a. to make sure ultimately the veterans get the care they deserve. i will tell you something right now. i am very concerned that this conference committee will end up taking a step backward for veterans healthcare in this

country. that cannot happen. veterans deserve better. they've earned the healthcare. we need to make sure we step up to the plate, give them the resources they need, and then hold them accountable for the job they do. veterans deserve our best. they've demonstrated their best in the field. we need to demonstrate our best as policy makers, and you folks as leaders of the v.a. with that i yield the floor. >> mr. secretary, thank you for joining us. thank you very much for having a conversation with me by phone several weeks ago. i appreciate that. it's been one of the experiences i've had in recent years with the v.a., just no ability to convey the concerns of kansas veterans. we have the ability to convey that information to the department, but virtually no response time and time again, and so i appreciate the fact that you took time to have a telephone conversation with me. i'm going to present to you today or shortly a letter that

i have compiled addressed to you. i heard the testimony from the house veterans affairs committee last week in which some of the topic was about whistle blowers and the apology that the department made. what i've discovered as a result of what's transpired over the last several months is many kansans, veterans in particular, but also many employees of the department of veterans affairs, are presenting stories of problems within the v.a., and they are reluctant. in fact, decline to present that information to a whistle blower, as a whistle blower to -- in a formal way because of fear of retribution and concern about their future and their employment. so mr. secretary, we will be providing you an outline of things that we still consider significant challenges and problems in my home state of kansas. i indicated several months ago that i had been a member of the veterans committee since i came

to congress, and there have always been challenges at the v.a. there's always challenges in healthcare. what seems to me to be different today, mr. secretary, and it's occurred over time is the recognition that the v.a. in a sense was just shrugging its shorlse -- its shoulders, no real attention to problems, and that resulted in veterans telling me they no longer had faith to provide the services that they are entitled to as military men and women of our country. i thought a change in leadership at the department of veterans affairs was required. it's now taking place. i look forward to meeting mr. mcdonald this afternoon in my office, but what i know is that the -- that only changing the secretary, only changing the top leadership is insufficient to solve the problems that

exist. i look forward to working with you to see that the results are things that we all can be proud of and the commitments that we have made are kept to our veterans. most of my conversations with 60's of veterans affairs have dealt with rural issues, and i want to explore that with you today in your testimony, but i'm very anxious to hear about the steps that you are taking to change the nature. to it doesn't matter whether you're an urban veteran, that the veterans affairs department is something different than it has been over the last several years. and then i'm happy to get to the issues that we face like urs. i want to make sure we have the tools necessary, it's been my commitment since i came to congress, but i need the commit

from the department of veterans affairs that the resources they're broad, the tools they're given, are going to be used in a cost-effective, compassionate, caring way, that there's an attitude, that there is no higher calling than to take care of the men and women who served our country. hank you, sir. >> thank you very much, and thank you, chairman sanders and ranking member burr, for our continuing focus on the issues and challenges facing the v.a. when the issues relating to wait times first arose over a month ago, the situation was designed as an emergency. there was a sense of urgency, and i want this committee and this congress to continue to be motivated by the sense of urgency and to continue to recognize that this emergency needs to be addressed, because there is every potential for

issues to come to the fore and for congress to be distracted. important as these other issues may be, we always tell veterans to stay the course. i share the sentiments of the chairman and member statements this morning that we need to hear from you for your short-term solutions and addressing the issues at hand, and over the long term, to address the systemic problems and challenges facing v.a. i have been visiting with the veterans in my state, frankly long before the particular crisis arose, and they've shared with me their concerns out the lack of doctors, the changover of doctors, and those are some of the practical considerations that they've raised with me. and so most of us, i think all of us have had the opportunity

to talk with veterans in our communities one on one, and we have a commitment to make sure that we continue to stay the course. that to me is the most important thing that this committee can do, and i thank the chairman for not allowing us to move on to other matters that may be pressing, but what could be more pressing, than to make sure our veterans receive the care that they need and deserve. thank you, mr. chairman. >> other members will be iltering back, but i would like to hear from the acting secretary now, and we get five minutes, but you will have more time. this is a serious discussion, and we want you to have the time you need to make your case, and we want the members here to have the time they need to ask you the questions.